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BOX 34
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SHERLITA AMLER, MD, MS, FAAP
'Commissioner of Health
ROBERT J. BONDI
County Executive
°^ ,i R i�AlViflt;�t� Ri;�TtII, MS�t.. �...�s , Y� r,..`: 'n�:.�a. •.:. 'f,i ...r..RUBEftT MURRIS, PE:::�._;�a�:::r.
Associate Commissioner of Health . Director of Environmental Health
DEPARTMENT OF HEALTH
1 Geneva Road. Brewster, New York 10509
ADDITION APPLICATION RESIDENTIAL ONLY
f1i T*IV
STREET JAtzle, TOWN TAX MAP
NAME > USA PHONE Z8 ' --V 0 3 PCHD#
MAILING
ADDRESS
DESCRIPTION OF
ADDITION 01114E Z� F-A S TO rt —Od rZ-
NUMBER OF EXISTING BEDROOMS' ..'PROPOSED # OF BEDROOMS 3
(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., 1 Geneva Rd,
Brewster, NY 10509, Phone: (845) 278 - 6130.
Certified check or money order.for $100.00.
2. Sketches of existing floor plan (drawn to scale, all living area including basement, to be
�w arid:diriens i� M eac.. room specified (u• e �ei.tior �.c o� -Bull: tiri
r' r' r {j.� Cs... f.
3. Two sets of proposed floor plans (drawn to scale — with name, street and tax map #)
* Non - professional sketches are acceptable and preferred. (See Section 3.d of Bulletin
HA -1)
4. Copy of survey showing all well and. septic locations on the subject property to the best
of your knowledge. Include date of installation known. Contact this office with any
questions.
15. Copy of Certificate of.Occupancy from the Town or Certification from the Building
Department with legal bedroom count of dwelling:
OFFICE USE .
COMMENTS
s.
Environmental Health (845) 278 -6130 Fax (845) 278 -7921
Water Supply Section (845)225 =5186 Fax (845) 225 -5418
Nursing Services (845) 278 -6558 Fax (845) 278 -6026
Nursing Home Care Fax (845) 278 -6085 WIC (845) 278 -6678
Early Intervention /Preschool (845) 228 -2847 Fax (845) 225=1580
I
REBECCA WITPENBE1tG, RN, BSN
Public Health Director
RODER
Director of Enkronmental Health
Eduardo & Anna Sousa
81 Barger Street
Putnam Valley, NY 10579
Dear Mr. & Mrs. Sousa:
PAUL ELDREDGE
County Executive
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
845- 808 -1390
October 14, 2011
Re: Addition- A- 121 -11
No Increase in Number of Bedrooms
81 Barger Street
(T) Putnam Valley, T.M. 85. -1 -6
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 13, 2011. 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..
4. This Department recommends you contact your local Building Department to ensure setbacks
and other current codes can be met.
5. The approval is for the proposed changes only. This approval does not validate any
construction shown as existing that has not obtained proper approvals
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 (845) 808 -1390, ext. 43261.
Sincerely,
ene D. Reed
Senior. Engineering Aide
GDR:cw
cc: BI, (T) Putnam Valley
SHERLITA AMLER, MD; MS, FAAP
Commissioner -of Health
LORETTAIVI 'UL`YIYA1t�,T21�;'�I�1`I
Associate Commissioner of Health
DEPARTMENT OF HEALTH
1 Geneva Road. Brewster, New York 10509
Town Legal Bedroom Count & Proposed Addition Status
ROBERT J. BONDI
County Executive
FE---
Director of Environmental ' Health
Re: SOUSA
Tax Map #_ 85.-l-6
Address: 81 Barger St..
Town: Putnam Valley
(Owner's Name)
Year Built:. 194-()*
9 4 0
According to records maintained by the Town, the above noted dwelling,
is . , xx in compliance with Town Code.
Is not in compliance with Town Code.
The Legal Bedroom Count is: 3
This information has been obtained from:
...� � .a /,. .. ...• ... ��. ... .. .- ... N. .. ,-: �..k.�.. .. - a��. ... ...a ,+ - .�...- . .u...rli .... i.. .. -... .ss. -..., ... r. .. r ... .. .- ..... .. . . ♦n s � .tr.. .... Y. ...._w- . . -. v .... ..
Certificate of .Occupancy:
Other:' As.sessor.'s Records
The plans for the proposed addition are considered:
New Construction
xx Addition to existing house only
Teardown and /or re -build allowed under Town Regulations
10iog Inspector ...John. H.... Landi _Date.
6.
Environmental Health (845) 278 -6130 Fax (845) 278 -7921
Water Supply Section (845) 225 -5186 Fax (845) 225 -5418
Nursing.Services (845) 278 -6558 Fax (845) 278 -6026
Nursing Home Care Fax (845) 278 -6085 WIC (845) 278 -6678
Early Intervention / Preschool (845) 228 -2847 Fax (845) 225 -1580