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03850
PUTNAM COUNTY HEALTH DEPARIMENP R � i _9 /
DIVISION OF ENVIRONMENTAL HEALTH SERVICES I 1
�PItOPOSA% FOR 'SEVkWE° DISPOSAL SYSTEK - .... ._ ..._._.., - -
OWNER'S NAME
6ae-6 R 6 CrL
PHONE
CZ 6 _ 3 Of
SITE LOCATION
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MAILING ADDRESS Vv�-r V AC-Ca Y , t%�( -Y - 18
PC HD Canplaint #
Name & Relationship (i.e, owner,tenant, etc.)
TYPE FACILITY Psi
PHo NE S' 2 E °�2 Sir
REGISTRATION #
Pro (include sketch locating all adjacent wells):
NOTE: Repair must be in same location and of same type as original sewage disposal system.
Different location may require submittal of proposal from licensed professional engineer or
registered architect.
Proposal approved Proposal Disapproved
s Signature &
to
Proposal approved with the following conditions:
1. Procurement of any Town permit, if applicable.
2. Submission of as built repair sketch in duplicate showing:
a. Owner's name.
b. Site Street Name, Town and Tax Map number.
c. vocation of installed components tied to two fixed points (e.g.,house corners).
d. System description (e.g., 1250 gal. concrete septic tank, three precast 6' diem. x 6' deep
drywells surrounded by one foot + gravel).
e. Installer's name and number.
3. System repair to be performed in accordance with the above proposal and conditions.
I, as owner, or reported agent of owner agree to the above conditions.
SIGNATURE: "- TITLE DATE
PIES: Mite (KHO): Yellow (fin BI); Pink (An licant)
LORETTA MOLINARI
Public Health Director
4L
DEPARTMENT OF HEALTH
1 Geneva Road; Brewster, New York 10509
ROBERT J. BONDI
County Executive
Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921
Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085
Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648
July 19, 2004
Whitmore
44 Orchard Road
Putnam Valley, NY 10579
Re: Addition — Whitmore, Orchard Rd.
No Increase in Number of Bedrooms
(T) Putnam Valley, TM #83.1.2 -3 -29
Dear Mr. Whitmore:
I have received and reviewed the plans for the proposed addition to the above - mentioned residence.
The proposal for the addition has been approved as per plans bearing the approval stamp from this
Department dated July 15, 2004. The addition is approved with the following conditions.
1. The total number of bedrooms must remain at three without prior approval by this
Department.
2. The area of the existing sewage disposal system, and its expansion area, must be
maintained.
3. All plumbing fixtures must be updated with water saving devices, i.e., new low flush
toilets, restrictors for shower heads and faucets, etc.
Any permits or variances required are the responsibility of the applicant and the jurisdiction
of the Town of Putnam Valley.
If you have any questions, please contact me at your convenience.
ML:lm
cc: BI (T) Putnam Valley
Sincerely,
Michael Luke
Public Health Sanitarian
ocbf
HOUSE PLAN S APPROVED FOR
BEDROOM COUNT ONLY;
3 BEDR8OMS f
oy
Signature &artle Date'".
,N
lu
LORETTA MOLINARI
Public Health Director
DEPARTMENT OF HEALTH
1 Geneva Road, . Brewster, New York 10509
0
ROBERT J. BONDI
County Executive
Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921
Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085
Early Intervention/Preschool (845) 218 - 6014 Fax (845) 278 - 6648
PROPOSED ADDITION APPLICATION (RESIDENTIAL ONLY)
1
STREET `r Ci ��6'���4 U _ TO* WNT ,f V f� . TX MAP #
NAME ;�c L f l'� l;✓ 61 r 4 J �� PHONEj L �� PCHD # ZAja - 9
MAILING ADDRESS
DESCRIPTION OF ADDITION '' ' -f i U s ^ Ut. f ��. An
NUMBER OF EXISTING BEDROOMS PROPOSED # OF BEDROOMS
(FROM CERT. OF OCCUPANCY OR
CERTIFICATION FROM BUILDING INSPECTOR)
;
*Any addition which is considered a bedroom requires formal approval of plans (Construction
Permit) prepared by a Professional Engineer or Registered Architect in accordance with
applicable sections of the Putnam County Sanitary Code,. __
Please submit this form and the following to Putnam County Health Dept., 4 Geneva Rd.,
Brewster, NY 10509, Phone 278 -6130.
1. Certified check or money order for $100.00
2. Sketches of existing floor plan (drawn to' scale, all living area including basement)
* Non - professional sketches are acceptable
3. Two sets of proposed floor plan (drawn to scale, with name, street, and tax map #)
* Non - professional sketches are acceptable
4. Copy of,survey showing well and septic location, to the best of your knowledge. Include date
of installation if known. Label all wells and septic systems within 200 feet of the property line.
Contact this office with any questions.
5. Copy of Cert.'of Occupancy from Town or Certification from Building Dept. with legal
bedroom count of dwelling. .
OFFICE USE
Comments
Feb 98
y
BRUCE R. FOLEY ~
Public Health Director
LORETTA MOLINARI RN., M.S.N.
Associate Public Health Director
Director of Patient Services
DEPARTMENT OF HEALTH
1 Geneva Road
Brewster, New York 10509
Environmental Health (945)279-6130 Fax (845) 278 - 7921
Nursing Services (945)278-6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085
Early Intervention (845)278-6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648
June 28, 2004
Putnam County Dept. of Health
4 Geneva Road
Brewster, NY 10509
Re: 44 Or-c- aYa :Ro;;d
Residence
Tax Map 83..12 -3 =29
Town o-f Puts era ley
Gentlemen:
According to records maintained by the Town, the above noted dwelling
IS ._��_ xx
IS NOT
in compliance with Town code and the total number of bedrooms on record is 3
This information has been obtained from:
CERTIFICATE OF OCCUPANCY:
ASSESSORS RECORD: XXx
OTHER
BFhouseguidelines
Ass't Building Inspector
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SURVEYED & PREPARED BY
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20 WOOOSBRIDGE ROAD
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KATONAH. NEW YORK 10536
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