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P PUTNAM COUNTY DEPARTMENT OF HEALTH
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DIVISION OF ENVIRONMENTAL HEALTH SERVICES
pon,Q 2 5,� -/ 94
APPLICATION TO CONSTRUCT A WATER WELL �' �.�
please print or type IPCH Pe m 4ele
Well Location
Street Address: jown/Village: Tax Map #
J fl Map Block Lot(s)
Well Owner:
Name:
Address:(r 90N C" ufael
Phone #:
Use of Well:
L-Residential v Public Supply Air /cond /heat pump _Irrigation
1- Primary
Business Farm Test/monitoring — Other(specify)
2- Secondary
Industrial Institutional Standby
Amount of Use
Yield Sought t— gpm # People Served Est. of Daily usage gal.
f✓ Replace Existing Supply Test/Observation Additional Supply
Reason for Drilling
New Supply (new dwelling) Deepen Existing Well
Detailed Reason
4 6 o �` 4 � L'1 �c..;,. e � � : a� C, Ley
for Drilling
Well Type
!.., Drilled D iven Gr vel ther
Is well site subject to flooding? ....................................................... ............................... Yes _ Nd'"-
Ic4well located in a.realty subdivision? ......... :......... .:.::.:..:::....... ............. -:::., .............. ,.. � •Yes _ Nri
Name of subdivision
Water Well Contractor: A/6 11 Address: �6 _ �
Is Public Water Supply available on site? ....................................... ........................ ........ Yes No [--.-
_
Name of Public Water Supply: Town/Village
Distance to property from nearest water main:
Proposed well location & sources of contamination to be provided on separate sheet/plan..
Date:, . i r`7� Applicant Signature:. /✓ /a•a -ti
PERMIT TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam
County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty
(30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump
the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County
Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Departmel
take appropriate action to assure that any and all water and waste products from such well drilling operations be
contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater
APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the
well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified
when considered necessary by the Commissioner of Health.. Any revision or alteration of the appro d plan requires a
new permit. Well to be constructed by a water well driller certified by Putnam C unty.
Date of Issue vii Permit Is ng Offi al:
Date -of Expiration Title: I
Permit is Non - Transferable
Q, White copy - HD file; Yellow -copy - Building Inspector; Pink copy - ner; Orange copy - filler
Form WP -97
Rev. 3/06
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ALLEN BEALS, M.D., J.D.-
Commissioner of Health
ROBERT MORRIS, P.E., MPH
Director of Environmental Health
November 3, 2014
Jorge Duque
5 Wood Street
Mahopac, NY 10541
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
Phone # (845) 808 -1390 Fax # (845) 278 -7921
Re: Addition – A- 158 -14
No Increase in Number of Bedrooms
5 Wood Street
(T) Carmel, T.M. 85.15 -2 -2
MARY -ELLEN ODELL
County Executive
... ..Dear n%Ir.�D�agUe• � . _ � _ . .. . , „ . � .: � � .._, .. _. _....... .... . -. .... - ....,,.
This Department has 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 November 3, 2014. 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.. The approval is for the modifications only and does not validate any construction shown
as existing that has not obtained proper approvals from other agencies having
jurisdiction.
5. This approval is valid for two (2) years and expires on November 3, 2016.
Any permits or variances required under the jurisdiction of the Town of Carmel are the
responsibility of the applicant.
If you have any questions, please contact me at (845) 808 -1390 ext. 43261.
Respectfully,
t 1
Gene D. Reed
Principal Environmental- Engineering Aide ...._ .. _
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A.LLIEN BEA.LS, M.D., ID.
Commissioner of Health
ROBERT MORRIS, P.E.
Director ofEnvironmental Health
a
January 5, 2012
DEPARTMENT GE HEALTH
1 Geneva Road, Brewster, New York 10509
Phone # (845) 808 -1390
Fax # (845) 278 -7921
Town Zoning Board
265 0scawana Lake Road
Putnam Valley, NY 10579
MARYELLEN ODELL
County Executive
Re: Addition Procedures and Policies
To whom it may concern:
Please be advised that this Department recently revised its procedures and policies for the review
of house additions. At this time the Department will not require a septic system to be updated to
current codes due to proposed construction over 50% of the dwelling's original square footage.
A copy of the current Procedures and Policies is enclosed.
If you have any further questions, please contact me at (845) 808 -1390 ext. 43261.
Sincerely,
Gene D. Reed
Environmental Health Engineering Aide
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9
PUTNAM COUNTY
DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
FOR
HOUSE ADDITIONS
Bulletin HA -1
TABLE OF CONT ENTS
n.® 'IlgTRO DUCT ION .................................... ............................... I
2.0 ADDITION GUIDELIN ES .......................... ............................... I
3.0 SUBAU TAI., PROCEDURES ..................... ............................... 3
APPENDIX
A. ADDITION APPLICAT'I ®N F® RIB' I ............. ............................... 4
B. LEGAL BEDROOM COUNT F® IMI ........... ............................ .... 5
C. SAMPLE HOUSE PLAN SKETCH ............. ............................... 6
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PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
1.0 INTRODUCTION
The Putnam County Department of Health (the "Department"), Division of
Environmental Health services has developed this detailed guide for submission
requirements, policies and procedures relative to approval of house additions.
The Department must review and approve all proposed house additions prior to
construction. The following is a description of the requirements of the
Department for submission of an application for a house addition. The
Department may require additional information or procedures as considered
necessary, based upon engineering review of a project. Professional
architectural house plans are not required for addition approvals by the
PCDOH and it is strongly advised that architectural house plans not be
obtained prior to approval by the PCDOH. A pre - submission conference
with the PCDOH staff is also strongly advised.
2.0 ADDITION GUIDELINES & PARAMETERS
n... _b .. ,lam .Ti,e nepartsnent -. must. review all proposed • additions, .which-- wili. -result - iri-an.
increase in living: area.
2. A complete tear down and rebuild of an existing residence will be reviewed on a
case by case basis.
3. Adding any or a potential bedroom(s) to a house requires a Department
construction permit for the expansion or complete replacement of the SSTS. The
Department will determine the need for complete replacement of the SSTS based
upon the age and condition of the existing septic system.
4. Houses destroyed by fire or other catastrophic event will be permitted to be
rebuilt, in kind, if they meet building department criteria for grandfathering.
5. Houses which will not be rebuilt in the same footprint or do not meet building
department criteria for grandfathering may require a permit for a new SSTS. If the
subject lot is listed or determined to be vacant, than a new SSTS meeting current
code requirements must be provided.
6. Any addition which is considered an increase in the potential bedroom count
requires a formal approval. of SSTS plans (Construction Permit) by the
Department and plans are to be prepared by a Professional Engineer or Registered
Architect in accordance with applicable sections of the Putnam County Sanitary
Code, unless the SSTS is presently designed for the propose d number of
bedrooms. The plans shall provide for the installation of additional and/or new
�__ . _..,_....... _ SSTS -area7meeting'present code requirements: (See PCHD'Bulletn ST -19):
7. A proposed house addition shall not reduce the size of the existing SSTS reserve
area.'An addition which encroaches upon the existing SSTS or reduces the SSTS
expansion area will require a formal Department approval (see # 6 above).
8. The Department does not object to reducing the number of bedrooms in a house
since SSTS sizing is determined by the number of bedrooms. The addition of
rooms such as dens, offices, libraries, exercise rooms, studies, bonus/unfinished
rooms, etc. may: �bP. considcred4 :s= potent�al:b;�door, and each
on a case by case basis by the Department.
1.
The determination of whether a proposed room addition to a house is considered a
potential bedroom will be made by Department staff based upon:
- location of the room in the house
- size of the room ,
a. Accessory rooms such as dens, libraries, studies, computer, rooms,
offices, sewing rooms, etc. may be considered potential
bedrooms.
b. Large bedrooms, greater than 24 feet by 10 feet, which may
easily be divided by a partition wall, may be considered two
potential bedrooms.
C. Storage areas or unfinished portions of the addition may also be
considered potential living area and/or bedrooms..
d. The partitioning of basements may result in the added rooms as
being considered potential bedrooms.
e. The renaming of a bedroom may not necessarily negate its
potential use as a bedroom and will be considered on a case by
case basis by the Department.
f. Rooms which will not be considered a potential bedroom must
meet one of the following criteria.
i. If the room has a floor area less than 70 square feet.
ii. If the room has a horizontal dimension less than 7 feet.
-Hi. If the room in: que.0inr_ � _ accessed thro»gh ... _ .._... _ . _...
another room with no other means of potential egress, one
of the rooms will be considered a potential bedroom, if the
dimension criteria for a potential bedroom is met or
exceeded by one or both rooms.
.9. For houses with current code SSTS's, excluding repairs, which
were approved without a waiver after December 31, 1989, the
Department will allow the following rooms on the first floor of
the house: living room, dining room, kitchen, family room and
home office /study. Any other rooms beyond those listed above
will be considered a potential bedroom except for rooms which
meet the criteria in item 'T
9. Any addition which does not result in an increase in the number of bedrooms
will require the submission of plans (to scale), prepared by the property owner,
showing the entire existing and proposed . house floor plan with each room
labeled. Once the review has been completed, the plans will be stamped by the
Department noting the number of bedrooms, including potential bedrooms. If the
number of bedrooms remains the same as existing, no further expansion of the
SSTS will be required, .provided the existing SSTS is functioning properly. The
__ Department will issue a letter indicating the total number of existing bedrooms
and that no expansion of the SSTS area will be requited- and that any other
permits or variances required are the jurisdiction of the local municipality.
If however, it is determined that an increase in potential bedrooms is proposed,
then refer to #6 on the previous age. Any previous repairs which have been done
on the SETS which do not meet current code requirements do not count towards
the SSTS capacity when an addition increases the bedroom count.
10. The existing SSTS
g�must
�.b�e functioning satisfactorily for an addition approval to
bAg J'lt�' y. t!'.." D:'I'ai�?'aent
2.
11. The SSTS design flow for additions that show multiple kitchens, existing or
proposed, will be increased by 200 gpd for each additional kitchen over one.
12. The legal bedroom count form must be completed by the Town Building
Department, even in the case where a Certificate of Construction Compliance
has been issued by the Department.
A" addition not covered in the general outline above will be handled on a case
by case basis.
3.0 SUBMITTAL PROCEDURES
Prior to the construction of a building addition, plans for the proposed work must
be reviewed and approved by the Department. The submission requirements for
an addition permit are as follows:
a) Addition Application (Appendix A)
b)' Permit application fee of $100.00 (Certified Check or Money
Order made payable to Putnam County Health Department). Note,
if the addition application requires a new SSTS, the fee is $500.00
($100.00 for the addition application plus $400.00 for the SSTS
review).
c) One h(1) ,set, of ,house, Mans, drawn to scale, showing.ronly the w
existing- conditions. All living areas', including basement, are to be ° y
shown on the plan(s). The use and dimensions of each room are also
to be provided on the plan. The plan is to include the applicant's
name, street address, town, and tax map number. Please refer to
Appendix C for an example. The plan does not need to be
prepared by a design professional.
d) Two (2) sets of house floor plans, drawn to scale showing the .
proposed building addition. All living areas, including basement, are
to be shown, on the plans. The use and dimensions of each room are
also to be provided on the plan. The plan is to include the.
applicant's name, street address, Town and tax map number. Please
refer to Appendix C for an example. The plans do not need to be
prepared by a design professional. .
e) The "Town Legal Bedroom Count and Proposed Addition Status"
form (Appendix B) is to be completed by the Town Building
Department.
fl A copy of the property survey showing the existing house, well and
SSTS and proposed building addition, drawn to scale.
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ALLEN BEALS, M.D., J.D.
Commissioner of Health
ROBERT MORRIS, P.E.
Director of Environmental Health
DEPARTMENT
a
OF HEALTH
Geneva Road, Brewster, New York 10509
Phone # (845) 808 -1390
Fax # (845) 278 -7921
MARYELLEN ODELL
County Executive
F�iwll
p °d
ADDITION APPLICATION RESIDENTIAL ONLY
��Tk 00,11
STREET W0 0 , TOWN TAY
MAP # /_S:1—
NAME Q PHONE PCHD# _ 'lh
MAILING
ADDRESS
-4 . T):`�ir.7CRJT..l A0NuO�. ,... •..... a. =... -x e., -.. 0,.n... . ,.q» ..:.. ; a•.., 2.:.. w�� � � '. :4� ...�
ADDITION ASe _>e1nAeQ .L.,14 bts. 4�c •YN1 ovlti,E% 11 / Gc e�
*NUMBER OF EXISTING BEDROOMS 3 NUMBER OF PROPOSED NEW 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) 808 -1390.
1. ' Certified check or money order for $100.00.
2. Sketches of existing floor plan (drawn to scale, all living area including basement, to be
shown and dimensioned and use of each room specified). (See Section 3.c of Bulletin
HA -1)
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
..... ......... ....... _.. w.._ _..questions:,._... ....._ .: __ .._ _ . .. _ .........
5. Copy of Certificate of Occupancy from the Town or Certification from the Building
Department with legal bedrdom count of dwelling".
OFFICE USE
COMMENTS
4.
/xn�e.ecS�n ct>lIi/J cxf,Pi�II Vt 2.u� GU�II.
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APPENDIX C
ALLEN SEALS, M.D., J.D.
Commissioner of Health
ROBERT MORRIS, F.E.
Director of Environmental Wealth
DEPARTMENT OF.HEALTH
1 Geneva Road, Brewster, New York 10509
]Phone # (845) 808 -11390
Fax # (845) 278 -7921
Re:
Town Legal Bedroom Count & proposed Addition Status
Tax Map #
Address:
(Owner's Name)
MARYELLEN ODELL
County Executive
....: ... Town:
Year Built:
According to records maintained by the Town, the above noted dwelling,
0
is in compliance with Town Code.
Is not in compliance with Town Code.
The Legal Bedroom Count is'-
This information has been obtained from:
Certificate of Occupancy:
Other:
The plans for the proposed addition are considered:
Addition to existing house only
Teardown and/or re -build allowed under Town Regulations
- - r3�Aldin :l loX , Data.. .- ..,..�..._.�.,. a
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® PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
APPLICATION TO CONSTRUCT A WATER WELL
please print or typeP".(r�fk1
Well Location
Street Address: own/Village: Tax Map #
�- �y ?s.
A L. ih4�.�w� Map Block Lot(s)
Well Owner:
Name:
Address: ry9� f, vy /f
Phone #:
Use of Well:
►Residential _Public Supply Air /cond /heat pump _Irrigation
1- Primary
Business Farm Test/monitoring _Other(specify)
2- Secondary
Industrial Institutional Standby
Amount of Use
Yield Sought -T- gpm # People Served Est. of Dally usage gal.
y Replace Existing Supply Test/Observation Additional Supply
Reason for Drilling
New Supply (new dwelling) Deepen Existing Well
Detailed Reason
4,6".4- a lP- - -j-(.d a e,() Q,( rw ,f. a
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, a H k r car
for Drilling
Well Type
ed D iven Gr vel Qther
Is well site subject to flooding? ....................................................... ............................... Yes Nd`'J
Is,well..located in.a roalty.subdivision -? ... :... ... No_�.... -
Name of subdivision Lot No.
_
Water Well Contractor: r' Address: %5 /64 196k � - .
Is Public Water Supply available on site? ....................................... ............................... Yes No 1✓
_
Name of Public Water Supply: Town/Village
Distance to property from nearest water main:
Proposed well location & sources of contamination to be provided on separate sheet/plan..
Dater Applicant Signature:
PERMIT TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above, is granted under provisions.of Article 10 of the Putnam
County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty
(30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump
the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County
Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department.
...
take appropriate action to assure that any and all water and waste products from such well drilling operations be
contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater.
APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the
well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified
when considered necessary by -the Commissioner of Health. Any revision or alteration of the approved plan requires a
new permit. Well to be constructed by a water well driller certified by Putnam Ciunty.
Date of Issue (��� Permit I
Date -of Expiration_ • Title:
Permit is Non - Transferable
White copy - HD file; Yellow copy - Building Inspector; Pink copy
Orange copy - filler
Form WP -97
Rev. 3/06
r 1 ,,
ALLEN BEALS, M.D., J.D.
Commissioner of Health
ROBERT MORRIS, P.E.
Director of Environmental Health
O
DEPARTMENT NT ®F HEALTH
H
1 Geneva Road, Brewster, New York 10509
Phone # (845) 808 -1390
Fax # (845) 278 -7921
Town Legal Bedroom Count & Proposed Addition Status
Re: JO(94 (Owner's Name)
Tax Map # 15-
Address: uJc e_n d
Year Built: P50
According t ecords maintained by the Town, the above noted dwelling,
is in compliance with Town Code.
Is not in compliance with Town Code.
The Legal Bedroom Count is`
This information has been obtained from:
Certificate of Occupancy:
Other: s Soc
The plans for the proposed addition are considered:
Addition to existing house only
Teardown and/or re -build allowed under Town Regulations
MARYEILLEN OIDEL L
County Executive
Pan COLA &�h*
Buildii:g fi-spector -Date �.....:T.. T °
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IMPROVEMENT SECTION
DIMENSION 2 QUANTITY GR I CO YEAR BUILT?
i
n uwrt WU 't. 10 ROW
5 COLONIAL 11 LOG CABIN
GARAGES
++—
6 CONTEMPORARY 12 DUPLEX
RG1 ATT 1 STORY
RG2 ATT Ilh STORY
TORY HEIGHT
V
RG3 ATT 2 STORY
-
R134 BET 1 STORY
XTERIOR WALL MATERIAL
RG5 BET 11h STORY
1 WOOD 05 CONCRETE
RG6 BET 2 STORY
2 BRICK OB STUCCO
3 ALUMINUM/VINYL 07 STONE
POOLS
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COMPOSITION
LS 1 STEEL VINYL
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5 �
LS3 PoURED CONCRETE
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LS4 GUNITE
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UMBER OF KITCHENS
LS5 ABOVE GROUND
j
JMBEfl OF BATHS
Q
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,BARNS
FB1_l STORY DAIRY
Ei
JMBER OF BEDROOMS
,
F02 11h STORY DAIRY
-
-
FB3 2 STORY DAIRY
TEPLACE
F84 1 STORY GEN
' -
FB5 11/: STORY GEN
+
A T TYPE 1 N3 CENTRAL 2 HOT AIR
FB6 2 STORY GEN
3 HOT WATER /STEAM 4 ELECTRIC
FB7 POLE
FB8 HORSE
EL TYPE 1 NONE 2 GAS 3 ELECTRIC
4 OIL
y
5 W53D 6 SOLAR 7 COAL
/
MISCELLANEOUS
RC1 CARPORT
NTRAL AIR BLANK = NO 1 = YES
GH2 GREENHOUSE
TCi TENNIS COURT
SEMENi TYPE 1 PIER/SLAB 2 CRAWL
3 PARTIAL 4 FULL
.CANOPIES
1
'i
CP5 ROOF ONLY
SEMENT GARAGE CAPACITY
;• CP6 WITH SLAB
i
CP7 SLAB /SCREEN
I,w
NOITION 1 PB(.R 2 FAIR 3 NORMAL
+
-
4 Gn—nD 5 EXCELLENT
3
SHEDS
-
FC1 MACHINE
ABE A EXCELLENT 8 GOOD C AVERAGE
FC2 ALUMINUM
1—
-
r�-
'
0 ECONOMY E MINIMUM
FL�3 GALVANIZED
It
FC4 BAKED ENAMEL
WE ADJUSTMENT
I
MOBILE HOME
FACHED GARAGE CAPACITY i
RM5 MOBILE HOME
MHl MOBILE HOME BASEMENT
?CH TYPE
AREA
.,MH2 MOBILE HOME ROOF
MHB MOBILE HOME 7X12 ROOM
MH7 - MOBILE HOME 7X24 ROOM
T '-
-
MH8 MOBILE HOME TIP -OUT RM
,
" .SIOENTIAL BUILDING AREA SECTION
MH9 MOBILE HOME WOOD AODON
I
iT STORY AREA
f
PORCH TYPES
1
RP1 OPEN
T�
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OND STORY AREA
RP2 COVERED
1
RP3 SCREENED -
)1TIONAL STORY AREA
RP4 ENCLOSED
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RP5 UPPER OPEN
F STORY AREA .
RP6 UPPER COVERED
RP7 UPPER SCREENED
EE QUARTER STORY AREA
RP8 UPPER ENCLOSED
STRUC CD
MC I
DIMENSION
1
SHED AREA OVER GARAGE
-
IMPROVEMENT CODES
(
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SHED ATTIC AREA a "a'
MEASURE CODE
-
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ED BASEMENT AREA
1 QUANTITY 3 SQUARE FEET
2 DIMENSIONS 4 DOLLARS
SHED HALF STORY FUM-AREA
GRADE
Vi
A EXCELLENT 0 ECONOMY
NISHED THREE QUARTER SiRY AREA
B GOOD E MINIMUM
C AVERAGE
I
1 1
1
NISHED FULL FLOOR AREA ._.,
CUNDITIDN
L_
ARE FOOT OF WING AREA - -
g
1 POOH 4 GOOD
2 FAIR 5 EXCELLENT
I
1 1
1
;RED RECREATION ROOM Afl•E(.
3 NORMAL
Y
3
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IMPROVEMENT SECTION
DIMENSION 2 QUANTITY GR I CO YEAR BUILT?
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