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631- 589 -8100
83.81 -1 -36
BOX 32
04216
J
_
IN
04216
I
r"
BRUCE R. _ FOLEY
"
• ..< 'Public Health Director;' •' -
LORETTA. MOLINARI R.N., M.S.N.
Associate Pti� is "Health Director
Director of Patient Services
DEPARTMENT OF HEALTH
1 Geneva Road
Brewster, New. York 10509
Environmental Health (914) 278-6130 Fax (914) 278-7921
Nursing Services (914)278-6558 WIC (914)278-6678 Fax (914) 278-6085
Early Intervention (914)278-6014 Preschool (914) 278 -6082 Fax (914) 278 - 6648
October 26, 1999
Daniel Ballard
53 Laurel Rd.
Lake Peekskill, NY 10537
Re: Addition- Ballard - Laurel Rd.
No Increases in Number of Bedrooms
(T) Putnam Valley Tax # 83.81 -1 -36
Dear Mr. Ballard:
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 October 26, 1999 .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 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 yours,
Michael Luke
ML:kg Public Health Technician
cc: BI
f
DEPARTMENT OF . HEALTH
Division of Environmental Health Services
4 Geneva Road
Brewster, New York ..10509
Tel. (914) 278 - 6130 Fax (914) 278 - 7921
PROPOSED ADDITION APPLICATION . (RESIDENTIAL ONLY)
- BRUCE: -R'. FOLEY -
Public Health Director
STREET ,?� �� t-. TOwNLA TX MAP. #.
NAME R �t P. P �' �i PHONE_ CHD #
MAILING ADDRESS 53 j P tl ie L L. k O I��-1
DESCRIPTION OF ADDITION
NUMBER OF EXISTING BEDROOMS o2 PROPOSED # OF BEDROOMS o2
(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. Cop&f survey showing well and septic location, to the best of your knowledge. Include date
k_
�
of idWlation if known. Label all wells and septic systems within 200 feet of the property line.
= Con
fia'�t this office with any questions.
< _ Cop�Sbf Cert. of Occupancy from Town or Certification from Building Dept. with legal
k:_ bedroo=ount of dwelling.
S
Vogne
Feb 98
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DEPARTMENT OF. HEALTH
Division . Of Environmental Health Services
4 Geneva Road, Brewster, New York 10509
. ` (914) 278 -6130
Putnam County Dept. of Health
4 Geneva Road
Brewster, NY 10509
Gentlemen:
BRUCE R. FOLEY. R.S.
Acting Public .Health Director
Re: 0/j --L1, 1z D
Residence
Tax Map
Town
According to records maintained by the Town, the above noted dNvelling
,IS
IS NOT '
in compliance with Town code and the total number of bedrooms on record
is ltd
This information has been obtained from:
CERTIFICATE OF OCCUPANCY:
ASSESSORS RECORD:
OTHER
Building Inspector
N/F HIRSCH
t
N/F DORG
S 51'55'25' V
LOT 127 LOT 126 t.oT 125
js.
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1'.
N/F HIRSCH
N/F CHOI
N/F DORG
S 51'55'25' V
LOT 127 LOT 126 t.oT 125
°'
Lar U:T 123 Lm 1 120 \
124 \ \ \
187.95' F
LOT ttv FD
s
a' LOT NUMBERS
ENTITLED "LAIC
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FRM.
SHED \ \ \
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AND FILED AS
IN
AREA= 0.5 5Ac .
53 LAUREL ROAD
FRM. z
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GARAGE 3
F
PATq
PAMO
$A710
N/F APERGIS
STY.
FRM. DW
N/F LUFr
RF Q- WA- t
&5
31
N 56*36'E
R= 416.50' t
=77u�
d =10.36 \ �•vWrnr° \\ ��
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` "SAD
,EP
SURVEY
FOR /TO
THIS SURVEY IS ACCURATE
AND CORRECT 9Y:
GERALD L. LMT
LAND SURVEYOR, P.C.
WAPPINGERS FALLS, Y
N.Y.S21,S. No. 049292
ALL CERTIFICATIONS HEREON ARE'VALID
FOR THIS MAP AND COPIES TBERE OF
ONLY IF SAID MAP OR COPMS HEAR THE
DdPRES°3ED SEAL OF THE SURVEYOR
WHOSE SIGNATURE APPEARS HEREON.
-- I HEREBY CERTIFY TO --
ULSTER? SAVINGS BANK
It's Successors and /or assigns
&
TIMELY TITLE SERVICES. Ltd.
As Agent For
CHICAGO TITLE INSURANCE COMPANY
LORI G. MINOZZI
JOSEPH F IMBROGNO
TOWN OF PUTN;AM VALLEY
(LAKE PEEF.SKILL)
PUTNAM COUNTY
NEW YORK
DECEMBER f3, 1994
a
T-
7'-
mlmmmmmm� 94 ,
10'2
BEDROOM
i j4)
12'2 4'10 -
3T6
12'2
- 29'6 -
LIVING AREA
837 sq ft
j
12'6
8'2
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8'
9
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PUTNAM COUNTY DEPARTiMENT OF HEALTH
3 1 HOUSE PLANS APPROVED FOR
BEDROOM COUNT ONLY;
—2-BEDROONIS
a /
Tign-ature 9--Tit10 Deter
0
N
29'6 _.
29'6 ---
LIVING AREA
757 sq ft
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PUTNAM COUNTYDEPARTMENT OF HEALTH -
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
INITIAL IND.IVUDAL ADDITION/REPAIR FORM
SECTION A: GENERAL INFORMATION
Name of Project 3 1-- (T)(u) y TNI�
Year of Construction Size of Parcel
SECTION B: TOPOGRAPHY (Please check all appropriate boxes)
1. MIEUy ❑Rolling [Steep Slope ❑Gentle Slope ❑Flat
2. ❑Evidence of wetland Clow area subject to flooding Clodies of water
❑Drainage ditches Of ock outcrop
YES
, ...
�. Property lines evident. ? ❑
4 e el: ❑
. Water courses exist on, or adjacent o parcel:
n/
5. Existing individual wells within 200ft of the existing SSTS?
l� �� - . ❑
SECTION C. EXISTING SUBSURFACE SEWAGE TREATMENT SYSTEM(SSTS)
1. Physical character of existing SSTS area.
A. []Level [Gentle Slope ❑Steep slope
B. ❑Well drained Moderately well drained
❑Somewhat poorly drained ❑Poorly drained
C. Area available for SSTS. (Primary & Reserve)
❑Extremely limited ❑ �-� Somewhat limited [Adequate fft x ft
D. IINSPECTION Date ✓ 'Z. �� Inspector
LINo eridence of failure ®Evidence. of f *lure- _,.-0.,�wence of seasonal failure
G� ;
i-----=--=--------------------- - - - - -- -- - - - - -- - -- ------------------- - - - - -=
n
n
lte T
�.. Y
(1) Indicate location of SSTS
A. Size and type of septic tank gallons
CIMetal OConcrete ®Plastic
B. Type of absorption area
1. Fields ft. 2. Pits 3. Gallies ft.
(2) Indicate setbacks, front street, backyard, and side yard dimensions
(3) Show location of well
(4) Show location of driveway
(5) Note physical features (steep slopes, rock outcrops, streams /wetlands)
SECTION E. EXISTING `CATER SUPPLY
OPWS ®Shared well LJ 'individual well
06rilled CIDua - 11 Casing above ground
COUNTS:
REPAIRS ONLY: Status:
As Built Inspection Required: As Built Submitted:
As Built Inspection Done: Inspector: