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00549
OCR', -13 -98 TUE 10:09 AM PUNAM CTY ENV HEALTH FAX NO, 19142787921
DEPARTMENT OF HEALTH
Division of Environmental Health Services
4 Geneva Road
Brewster, New York 10509 -
Tel, (914) 278-6130 Fax (914) 279.-7921
P. 5 l
BRUCE R FOLEY
Public Health Director
STREET 3 11 TOWN -son TX MAP # _ i3loc.(� 5
Go�i¢e.v+ + (914 LO
NAME d PHONEAZ 3168 PCHD # -5 -- 98'
MAILINO ADDRESS_ k i
DESCRIPTION OF
NUMBER OF EXISTING REDROOMS,,6—
(FROM CERT. OF OCCUPANCY OR
CERTIFICATION FROM BUILPTNG D4SPECTOR)
PROPOSED # OF BEDROOMS 6
`Any addition which is considered a bedroom requires format approval of plans (Construction
Permit) prepared by a Professional Engineer or Registered Architect in accordance with
applicable sections of the Putnam County Sanitary Code,, ` .
?lease submit this form and the following to Putnam County Health Dept., 4 Geneva Rd.,
Brewster, NY 10509, Phone 278 -6130.
t L 5'63
1, Cerdfied 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 #)
* Dion professional ak tcbes = 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 &MIling. '
OFFICE USE
Comments
Feb 9a
J .
DEPARTMENT OF HEALTH
Division OF Environmental Health Services
4 Ceneva Road, Brewster, New York 10509
(914) 278 -6130
Putnam County Dept. of Health
4 Geneva Road
Brewster, NY 10509
Re:
Residence
BRUCE R. FOLEy, p.S.
Acting Public Health Director
Tax Map
Town
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 %15—
Building Inspector
1
1
E 0
Ca9 �1
®P BRUCE R. FOLEY
�� Public Health Director
DEPARTMENT OF HEALTH
Division of Environmental Health Services
4 Geneva Road
Brewster, New York 10509
Tel. (914) 278-6130 Fax (914) 278-7921
October 30, 1998
John Guilbeault, President
Tri County Construction, Inc.
313 Hudson Avenue
Beacon NY 12508
Re: Addition - Reginald and Colleen Powe,
Route 311 and Crushman Road
No Increase in Number of Bedrooms
(T) Patterson, TM# 73 -5 -1
Dear Mr. Guilbeault:
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 latest revision date of
October 29, 1998 and this Department's approval stamp.
Based on the information submitted, the above mentioned addition is approved with the following
conditions:
1. The total number of bedrooms must remain at eight 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, restructures 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 Patterson.
If you have any questions, please contact me at your convenience.
Very trul .ourW
William Hedges
Sr. Public Health Sanitarian
WH:tn
cc: BI (T)
Reinald and Colleen Powe
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WELL ^ S
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NOTE:
LOCATION OF HOUSE, WELL
& SEPTIC SYSTEM WERE
MEASURED BY
GARY L. SMITH, P.E.
NYS LICENSE NO. 56374 -1
ON 10 -15 -98
! 1 0 ` RD
S
PgP100
PROPERTY LINES PLOTTED FROM
METES AND BOUNDS DESCRIPTION IN DEED
DATED 2nd MAY, 1983
BY CYNTHIA SMITH, Drafting Services 10 -18 -98
PROPERTY OF
REGINALD AND COLEEN POWE
TOWN OF PATTERSON
SEC11ON 73, BLOCK 5, LOT 1
w _
N7393'00'W
31.03'
30'W
N2�1077'12p0'00'E
'30'W
4 ?&E WALL
Adler �r I I,;
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SEPTIC TANK C.O.
PROPOSED
1st FLOOR DMIENy
ADDITION r Ia
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30't
WELL ^ S
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S79'57'30" N °' 126-56' bP''
2 WAa FENCE (�' ALL AROUND)
STONE
g,
NOTE:
LOCATION OF HOUSE, WELL
& SEPTIC SYSTEM WERE
MEASURED BY
GARY L. SMITH, P.E.
NYS LICENSE NO. 56374 -1
ON 10 -15 -98
! 1 0 ` RD
S
PgP100
PROPERTY LINES PLOTTED FROM
METES AND BOUNDS DESCRIPTION IN DEED
DATED 2nd MAY, 1983
BY CYNTHIA SMITH, Drafting Services 10 -18 -98
PROPERTY OF
REGINALD AND COLEEN POWE
TOWN OF PATTERSON
SEC11ON 73, BLOCK 5, LOT 1
P YFDROO NT OF REA
HOUSE
BEDRO
Signature & Title - y .. Date
Ba"RO
ROOM - OUTSIOE
PORCH
S Al ROOK
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I 99E ENTRY I I 11" ROW W7' ROOM
GAME Y/ 7W S v OOM
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BATHROOM
C.M.
KITCHEN
19' -1. 15' -3"t
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1 STORY
APARTMENT
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PUTNAM COUNTY DEPARTMENT OF UAW
HPUSE PLANS APPROVED FOR
BEDROOM COUNT ONLYb,,I,,
BEDROOMS
e/
Signature &Title Da
BILLARD
ROOM
- DE
PORCH
M W� L-1
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T
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KITCHEN
1 STORY
APARTMENT
C H
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umNC RwM
Ir
FRONT MALL
PROPOSED
RENOVATED —T M-
BILLARD
ROOM
- DE
PORCH
GREAT ROOM/FAMILY ROOM
—f
NEW CONSTRUCTION 484
1 EMST. SUN IMCH/RMW
P WTH EIOST. SUNPWCH
FIRST FLOOR PLAN WITH PROPOSED ADDITION
,/e - --o-
W9C ROOM
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-4' w 15*-3•A
C.N.
FRONT MALL
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C.N. U�
H)'-a" 15*
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GREAT ROOM/FAMILY ROOM
—f
NEW CONSTRUCTION 484
1 EMST. SUN IMCH/RMW
P WTH EIOST. SUNPWCH
FIRST FLOOR PLAN WITH PROPOSED ADDITION
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ON I �WRV ,•, k: W
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PUTNAM COUNTY HEALTH DEPARTMENT
.- DIVISION OF ENVIRONMENTAL HEALTH SERVICES
'ES NO Internal Use Only
❑ Repair Permit issued in last 5 years
❑ Bo Re air within d's Comers, W. Branch or Croton Falls Res.
P Y
❑ Repair within 200 ft. of a watercourse or DEC - manned wetland
SITE LOCATION
OWNER'S NAME
MAILING ADDRESS
pA,
_ ❑ fy�i in Watershed j
Delegated
❑ Joint Review
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a
APPLICANT
Z"Na a &Relationship (i.e., owner, tenant, contractor)
DATE FACILITY TYPE KNS PCHD COMPLAINT #
PROPOSEP.INSTALLER ! /'c PHONE # / 4�
ADDRESS REGISTRATION /LICENSE #
Proposal (include a separate sketch locating the house, property lines, all adjacent wells within 200
feet of repair and the location of existing and proposed trenches)
NOTE: Repair must be in same location and of same type as original sewage disposal system.
Different location and proposed pump - systems will require submittal of proposal from licensed professional
engineer or registered architect.
I, as owner, or reported agent of owner Rree to the conditions stated on this form
SIGNATURE TITLE DATE /
Proposal approved with the following conditions:
1. Procurement of any Town Permit, if applicable.
2. Submission of as built repair sketch in duplicate showing:
a. Owner's name
b. Site Street Name, Town and Tax Map number
c. Location of installed components tied to two fixed points
d. System description (e.g., 1250 gal. Concrete septic tank, etc.)
e. Installers' name and phone number
3. System repair to be performed in accordance with the
above proposal and conditions.
F 'dpd,sal�Approved ,/ Proposal Denied
A4�= zz 13 6
Inspector's Signature & -Title - Date
COPIES: White (PCHD); Yellow (Town BI); Pink (Installer), Orange (Applicant)
PC -RP 99ML
Rev. 8/05
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