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631- 589 -8100
83.50 -1 -16
BOX 30
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BRUCE R. FOLEY
Public Health Director
LORETTA MOLINARI R.N., M.S.N.
Y 0� Associate Public. Health - Director
Director of Patienf' Services'' - - -
DEPARTMENT OF HEALTH
1 Geneva Road
Brewster, New York 10509
Environmental Health (845)278-6130 Fax (845) 278 - 7921
Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085
Early Intervention (845) 278 - 6014 . Preschool (845) 278 -6082 Fax (845) 278 - 6648
ADDITION APPLICATION (RESIDENTIAL ONLY)
STREET g` 9.c w .-,.-T OWN w 3% TX MAP# Cf 3 -
i`,'AME l.A fh -,,j JI. 0. PHONE CHD# -o �
MA1LI\TG ADDRESS P. O.
41 el.
DESCRIPTION OF ADDITION zg)[Jk -^ g ir•
NUTIMBER OF EXISTING BEDROOMS Z 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 Road, Brewster, NY
10509, Iblione 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
Feb98
BFhouseguidelines
BRUCE R. FOLEY
Public. Health Director
LORETTA MOLINARI R.N., M.S.N.
Associate Public Health Director
Director of Patient. Services
DEPAKINIENT11—OF HEALTH
1 Geneva Road
Brewster, New York 10509
Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921
1 Nursing Services (845)278-6558 WIC (845) 2781- 6678 Fax (845) 278 - 6085
Early Intervention (845) 278 - 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648
Putnam County Dept. of Health
4 Geneva Road
Brewster, NY 10509
Gentlemen:
_ Zoo /
Re: do 8
Residence
Tax Map Y3,5-0
Town 61419VI a e
According to records maintained by the Town, the above noted dwelling
IS -
IS NOT
in compliance with Town code and the total number of bedrooms on record is
This information has been obtained from:
CERTIFICATE OF OCCUPANCY:
ASSESSORS RECORD:
OTHER
Building Inspector
BFhouseguidelines
.R iCB . fit.. F%Y,
Public Health Director
DEPARTMENT OF HEALTH
1 Geneva Road
Brewster, New York 10509
Associate Public Health Director
Director of Patient Services
Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921
Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085
Early Intervention (845) 278 - 6014 Fax.(845) 278 - 6648
Preschool (845) 228 - 5912 Fax (845) 228 - 6113
October 1, 2001
Catherine Cobb
PO Box 265
Lake Peekskill, NY
Re: Addition- Cobb- 186 Tanglewylde Rd.
No Increases in Number of Bedrooms
(T) Putnam Valley Tax # 83.50 -1 -16
Dear Ms. Cobb:
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 form this
Department dated October 1, 2001 The. addition is approved with the following conditions:
1. The total number of bedrooms must remain at Two without prior approval
by this department.
_ 2. The area..gf_the existing sewage disposal system, and its.expansion area, m;zst b_c,
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 other 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.
Very t ly yours,
William Hedge
WH:kg Senior Public Health Sanitarian
cc: BI
Area = 11.577 Sq. Ft.
M/s mop was prepared /br the exdus/w
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Notes
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Iowa
2. Unauthorized a/terab n w aaWto n to! o abcwmwt pr*0vd by o
licensed /and surw.Wr Is o rtdatlw of Sectlan 72M, Sub -DUsan 2
of the New Yak State Education Low.
J All cwtl/kntians are m1ld for this niop and copes thereof only If sold
mop or cepas bear the embossed anal of the surw)w chose signature
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SURVEY OF PROPERTY
CA THE -RIM %I. COBB
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TOWN OF PUMAM VALLEY a
PUTNAM COUNTY
NEW YORK
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Notes
J. COPYRIQ4T oi- by sADEY B wAJmv - %1rw)mg B Engmewbng, P.G
A# Rights Resrrrod Unouthodzed oupl/cot /on Is o *Wot /on of wp//cab/e
Iowa
2. Unauthorized a/terab n w aaWto n to! o abcwmwt pr*0vd by o
licensed /and surw.Wr Is o rtdatlw of Sectlan 72M, Sub -DUsan 2
of the New Yak State Education Low.
J All cwtl/kntians are m1ld for this niop and copes thereof only If sold
mop or cepas bear the embossed anal of the surw)w chose signature
,wn�w,w A�.y.... �
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123.38'
Pfi Set \\ 271l'
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SURVEY OF PROPERTY
CA THE -RIM %I. COBB
g7ZIA JE /N ME
TOWN OF PUMAM VALLEY a
PUTNAM COUNTY
NEW YORK
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