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631 -589 -8100
83.73 -1 -8
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BRUCE R. FOLEY
Public Health Director
LORETTA MOLINARI R.N., M.S.N.
.- _Associate., Public. Health Director
Dir`ec" "tor p o%' Patient 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 %� %l� UPr -S�_ TOWN ,/ �1 TX MAP#
NAME iS s&7 PHONE V,O�S" 5U6- Y-677 PCHD#
MAILING ADDRESS 91 77dt�e,%k •�'�. % /�eel(S�/i� /, �tl -! /y S`37
DESCRIPTION, OF ADDITION tz:,X2 ' )l 62# ' b. (/124 lCcCm
NURNMER 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 Road; Brewster; �N
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
Feb98
BFhouseguidelines
BRUCE R. FOLEY
Public Health Director
\o F o q'Y _. .. v.... YSa yt ._.Y. -��I � tii�yF�'1v:T.'f +✓a.. Gr :— a „�
DEPARTMENT OF BEALTH
1 Geneva Road
Brewster, New York 10509
LORETTA MOLINARI R.N., M.S.N
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
March 8, 2002
Robert Kristoferson
91 Traverse Rd.
Lake Peekskill, NY 10537
Re: Addition - Kristoferson - Traverse Rd.
No Increases in Number of Bedrooms
(T) Putnam Valley Tax # 83.73 -1 -8
Dear Mr. Kristoferson:
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 March 7, 2002 . The addition is approved with the
following conditions:
1. The total number of bedrooms must remain.at_T'mo :without .prior- approval ...
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 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 truly
William Hedges
WH:kg Senior Public Health Sanitarian
cc: BI
BRUCE R. FOLEY
Public Health Director
. ,...
ARTMENT. OF
1 Geneva Road
Brewster, New York
LORETTA MOLINARI.R.N., M.S.N.
Associate Public Health Director
-Director .of.•'Paticru•"Servrces' ' ° ' - •
HEALTH
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
Putnam County Dept. of Health
4 Geneva Road
Brewster, NY 10509
Re: M191"OMECSoM
Residence
Tax Map g 3. i 3 I_ a
Town -'N r%ry -N A1- LZ Vj
Gentlemen:
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.
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