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631 - 589 -8100
91.33 -1 -29
BOX 36
04812
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BRUCE R. FOLEY, -
- � •"�.�liTt�.al�rlrli' °dir2CYOi`" :�� ""' .. _ _
Associate Public Health Director
Director of Patient Services
DEPARTMENT OF HEALTH
I 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 OkIM
STREET (CC� TOWN ClI X MAP#
—1
Nam HONE 9 I - - bT93 PCHD# -0
91
MAILENG ADDRESS C LG.- \V— P e s111
053`
DESCRIPTION OF ADDITION
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 applicable sections of the
Putnam County Sanitary Code.
Please submit `this form and the following to Putnam County Health Dept., 4 Geneva Road, 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 9)
*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. i
5. Copy of Cert. Of Occupancy from Town or Certification from Building Dept'. with legal bedroom
count of dwelling.
OFFICE USE j
Comments
Feb98
BFhouseguidelines
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BRUCE R. FOLEY
Public Health Direclar4...
LORETTA t MOLINARI; R Pl:; ivt:S.tJ. ~ '
Associate Public Health Director
Director of 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
Putnam County Dept. of Health
4 Geneva Road
Brewster, NY 10509
Gentlemen:
Re: L-a-friT--t 0 rC -&-..
Residence
Tax Ma � I % -'SS " I ° 2. C)
Town („
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 Z-
This information has been obtained from:
CERTIFICATE OF OCCUPANCY:
ASSESSORS RECORD``
• ,1 C
Building Inspector
BFhouseguidelines
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BRUCE R.�FOLEY
Public Health Director
DEPARTMENT OF HEALTH
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
July 18, 2002
Lafata/Cinquegrana
27 Chestnut St.
Lake Peekskill, NY Re: Addition - Lafata & Cinquegrana -27 Chestnut St.
No Increases in Number of Bedrooms
(T) Putnam Valley Tax # 91.33 -1 -29
Dear Mr. Cinquegrana:
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 July 17.2002. The addition is approved with the following
conditions:
1. The total number of bedrooms must remain at Two without prior approval
by this department.
-T'h,- area o thelexistiag sewage disposal system, and -its -expansion -area inust`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
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