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83.72 -1 -2
BOX 31
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SHERLITA AMLER, MD, MS, FAAP
Commissioner of Health
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
Dean Mulvey
29 Elinor Pl.
Lake Peekskill, NY 10537
Dear Mr. Mulvey:
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
ROBERT J. BONDI,
County Executive
February 4, 2005
Re: Addition — Mulvey, 29 Elinor Pl.
No Increases in Number of Bedrooms
(T)Putnam Valley, TM #83.72 -1 -2
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 February 3, 2005. 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 dispgsal. system,. and its expansion area, must. be .
... - ..... � . .. _ ...... _�..._
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
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
LORETTA MOLINARI
Public Health Director
DEPARTMENT OF BEAL,TH
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 s
Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648
PROPOSED ADDITION APPLICATION (BESIDENTiAL ONLYI
.
STR�E� 22 �'�-� Ado (� �1� l�ct� �'®WN_L- _ TX l # �' 3 , � a � I - c
NAME �,t uer- PHONE -52 2 - a ga?PCHD # - 0,5
MAILING ADDRESS 09 6 NOR. R -fete , ill i'
DESCRIPTION OF ADDITION � t ,) c pj
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.
aacRblp sectiarrs oftlie F'utnarti Comity Sanitaiy Code: _,......._ .. .. = ... - .
Please submit this form and the following to Putnam County Health Dept., 4 Geneva Rd.;
Brewster, NY .10509, Phone 278 -6130.
+! Certified check or money order for $100.00
V2. Sketches of existing 'floor plan (drawn to scale, all IiWng area incRuding basement)
Non - professional sketches are acceptable
;J Two sets of proposed floor plan (drawn to scale, with name, street, and tax map #)
* Non - professional sketches are acceptable
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
'Fab 98 i
LORETTA MOLINARI
Public Health Director
ROBERT J. BONDI
County Execrative
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/Preschool (845) 278 - 6014 Fax (845) 278 - 6648
Putnam County Dept. of Health
1 Geneva Road
Brewster, NY 10509
To Whom It May Concern:
Re: nyi U L_—VF—!j
Residence
Tax Map —
Town T L "
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: S l �
houseguidelines
Building Inspector
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PUTNAM COUNTY DEPARTIAENT OF'.HEALTH
HOUSE PI-11011'133. APPROVED FOR
BEDROC"INI, ("OU'r-IT ONLY;
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2-/3/c:)S
Signature &. Tole Date
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PUTNAM COUNTY DEPARTIAENT OF'.HEALTH
HOUSE PI-11011'133. APPROVED FOR
BEDROC"INI, ("OU'r-IT ONLY;
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Signature &. Tole Date
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PCITNAM COUNTY DEPARTMENT OF HEALTH
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HOUSE,PLANS APPROVED FOR
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