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HomeMy WebLinkAbout1257DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 25.64 -1 -56 BOX 12 �A% , � L � � , , r r, i g r :. T re r. T - 1 rm 01257 � L � � , , r r, i g :. re r. 01257 PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES - - 225= 3838/225 - 383 3/225 -3641 - -.. PROPOSAL FORISEWAGE DISPOSAL SYSTEM REPAIR OWNER'S NAME C .T �(' PHONE SITE LOCATION el TM# MAILING ADDRESS PERSON INTERVIEWED PCHD Complaint # Name & Relationship (i.e, owner,tenant, etc.) DATE ; I TYPE FACILITY PROPOSED INSTALLER zr PHONE (' ` 2 • q fl Pro (include sketch locating all adjacent wells): NOTE: Repair must be'in,'same location and of same type as original sewage disposal system. Different location may, 'require submittal of;.proposal from licensed professional engineer or registered architect., i /-& Je2. 7 S 1 v ®I with Proposal Disapproved conditions: Date . 1. rLWLLLE3RenL UL any, 'IV l PULUl1L1 IL aYJJ1LL:al�1C. 2. Submission of as Su.lt 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 (e.g.,house corners). d. System description (e.g., 1250 gal. concrete septic tank, three precast 6' diam. x 6' deep drywells surrounded by one foot + gravel).. e. Installer's nameiand number. 3. System repair to fie; performed in accordance with the above proposal and conditions. I, as owner, or reported agent o owner agree to the above conditions. SIGNATURE TITLE DATE i, OPlES: WAte' (PZD); Ydic I ( ffi); Pink (Aa2 iauit) r M, ALL SEASONS CONSTRUCTION RD 12 CRANE ROAD CARMEL, NY 10512 (914) 6284994 COMPLAINT: TAKEN BY REFERRED TO:- DATE: U, "TYPE'ON COMPLAINT FOW-1 INFORMATION FOR.-COMPLAINT.'-FORM COMPLAINTANT: COMPLAINT: TAKEN BY REFERRED TO:- DATE: U, ''`DAVID D. BFUEN County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services January 12, 1987 CERTIFIED RETURN RECEIPT REQUESTED. Mm Roslia Golser 64 -07 78th Street Middle Village, New York 12279 Re: House on Lakeshore Mohawk Trail, Putnam Lake Dear Mrs. Golser: 'L� JOHN' Ei M A NS, M.D. I Deputy Commissioner An inspection of your dwelling on January 9, 1987 in response to a complaint resulted in finding the cover of the septic tank unsafe and unsatisfactory. It was also noted that the septic tank had collas. which must be replaced. Any repairs made to the septic system requires approval. Forms may be obtained from this office. Should there be any questions please feel free to call this office at 225 -0310 Ext. 318. CG /jp Very truly yours,. Charles Gabriel Sr. Environmental Health Technician TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 i -.,� rof L �.z y �- 3 /G"f ---------------------------- i PETER C. ALEXANDERSON County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services February 5, 1987 __ ...._ __..._ ._...:.. ... _ . : .., . ,. _ I JOHN SIMMONS. M.D. Deputy Commissioner �i Ms. Roslia Golser 64 -07 78th street Middle Village, New York 12279 Dear Ms. Golser: I , The violation against you of a collapsed septic tank has been abated. Should you;have any questions.please feel free to contact me at this office. i; Very, .. , Y Bruce R. Foley, R.S. Sr. Public Health Sani ian I, 110 OLD, ;ROUTE SIX CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 I� i %I- � 4 WILLIAM J. KLUENDER "-ATTO'RNEY.'AT. "L"A%V. 64.06 MYRTLE AVENUE GLENDALE. N. Y. 11385 (718) 456 -3302 January 30, 1987 Putnam County Departmentof Health Old Route 6 Carmel, N.Y. 10502 Attn: Mr. Charles Gabriel Re; Golser Premises Lake Shore Dr. Patterson, N.Y. Dear Mr. Gabriel: as per our telephone conversation of today, enclosed please find a copy of a letter mailed to All Seasons Construction Corp. WJK /md encls: 1 cc: C. Compton Spain, Esq. 2 Clark Place Mahopac, N.Y. 10541 Very truly yours, William J. Kluender c, (g. ,.- IN OWNER I S NAME SITE L =TIOri ,• �. :I • L4 . i '�1` 1' . . •. 1.4 `17• V. TO PERSON INTERVIEf�dED —� )Co0 � PCHD C>nmplaint # G� & Relationship (i.e, owner,tenant, etc.) DATE q C TYPE FACILITY S PROPOSED ITJ.S PHONE Propos�d (include sketch locating all adjacent wells), NOM: Repair must he in'same location and of same type as original sewage disposal system. Different location may require submittal of proposal from licensed professional engineer or registered architect. o wit. •v. q M �L Proposal Disapproved AC-S; s is na ure & Title i ��t Proposal approved with the following condi ors; 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 camponents tied to two fixed points d. System description (e.g., 1250 gal. concrete septic tank, drywells surrounded by one foot + gravel). e. Installer's name and number. Dath (e.g.,house corners). three precast 61 diam. x 61 deep 3. System repair to be performed in accordance with the above prod and conditions. I, as owner, r reported agent of owner agree to the above conditions. SIGNATURE Q TITLE IA ka� DATE e VkAte (POD)® Yellcw (Tam HE); Pink (Applio3nt) 00, �,�l 60 &LUCcl I :p im �ti/1/�,Ps.,.. ��Ur.1�._M1N��__ _:._�o� 4��0 4��s�..... ..p I1 PUTNAM COUNTY HEALTH DEPARTMENT. DIVISION OF ENVIRONMENTAL HEALTH SERVICES. 225= 0310 ... . PROPOSAL FOR SFO,GE DISPOSAL SYSTEM REPAIR -20-411 OWNER'S NAME 'Zuliq 1'Agluccl . hAv PHONE 203 -y3k'ais'� SITE LOCATION 10 1 !: S r)R PF &Eas6d PL4 i-.k: 24# MAILING ADDRESS It CAamjiL N 4 1 0s l2. PERSON INTERVIEW D AR d.J A (7- rim 4. PCHD Complaint t O go q 1- l 9. Name & Relationship (i.e, owner,tenant, etc.) DATE 2. 1 TYPE FACILITY (- F�4wt 2 i3r'o Raa� ©1& n/ PROPOSED PROPOSED INSTALLER R' n► 0 A- Co+i3+ (20 �,./L PHONE Pr !(include sketch.locating all adjacent wells): NOTE: Repair must be zn same location and of same type as original sewage disposal system. Different location may require submittal of proposal from li�ensed professional engineer or registered architect, I i 6 A IJI"S) lVrW i`%RI GallteS JJ %3rz� OF &rawarL ),.l SAPnLf 40c/J4,0 -n/ 1'S 010 rl o C to S z R 'A' �/ y LJt` LS 1b 2 kiRi� Co�.2ScS. ProposalA�T?ed Proposal Disapproved ®AM 's r000sal amroved 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, drywells surrounded by'one foot + gravel). e. Installer's n=6*d number. �. (e.g.,house corners). three precast 6' diem. x 6' deep 3. System repair toibe perfomed in accordance with the above proposal and conditions. I, as own or reported agent of er agree to the above-conditions. SIGNATURE �,al: ��f� ►`�� TITLE �/Y DATE Z ^ TT VS: V&te (PW); YeUCW (inn EI); Plink (Ali=t) o� Ja /# SITE LOCATION _ NAILING ADDRESS PERSON INTER E DATE //4�2 PUTNAM COUNTY HEALTH DEPARTMM DIVIS10N_ OF_ _ _ . - HEALTH SMILES ._ 225 -0310 PROPOSAL FOR SEPVkGE DISPOSAL SYSTEM REPAIR /qu," C e, 4411E S &Je, p) J /az',3 TmI# icb,z bA' e-, r &,m ° v - 'f PW Complaint # 1� Name & Relationship (i.e, owner, tenant, etc.) q/ TYPE FAQ° n-s &61717m Q, bms. wrlrli5m Proposal (include sketch locating all adjacent wells): i Repair must tie in same gyp as original sewage disposal system. Different location may require submittal of proposal from licensed professional engineer or registered-architect. 's Siqnature & .......... Date roposal 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 canponents tied to two fixed points (e.g.,house corners). d. System description (e.g., 1250 gal. concrete septic tank, three precast 61 diam. x 61 deep drywells surrounded by one foot + gravel). e. Installer's name and number. 3. System repair to be performed in accordance with the above proposal and conditions. I, as owner, or re agent of caner agree to the above conditions. SIGNATiJRE 41 Ilem! TITLE DATE �' S: Mike (PCHW® YeUcw 03m ED; Pink (Agplioant) ! I'I �f�lQ./IG O,000IlIlfO?�• C�O/Id�J�lI.�IOIG (JO4. ✓1CG'' .. .._._. ..... ..... _ .._ P.O. Box 621 4 CARMEL, NEW YORK )'10512 (914) 225 -6277; r Dc r J F- •� I t r i _ 9 6 P (X*MI S NAME SITE LOCATION MAILING ADDRESS PERSON 7/� DATE PUI'NAM COUNTY HEALTH DEPARTKW DTVIq:kON. OF I ENVIRONMERM HEALTH SERVICES 225 -0310 PROPOSAL FOR SE*M DISPOSAL SYSTEM REPAIR IP , &/4HONE Mrtt. Doe, . Aff�rTllol-,,zs To INSTALLER ; 7 & .e, J PC HD Complaint #­6 ,tenant, etc.) TYPE mi l=c _ •:.�' Pr ,(include sketch locating all adjacent wells): : Repair must be in same ype as original sewage disposal system. Different location may require submittal of proposal from licensed professional engineer or registered itect.� �j Proposal Disapproved 's Signature & Title oved withithe following conditions: I Date 1. Procurement of anyiTown 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 (e.g.,house corners). d. System description (e.g., 1250 gal. concrete septic tank, three precast 6' diem. x 6' deep drywells surrounded by one foot + gravel). e. Installer's name and number. 3. System repair to ;be' performed in accordance with the above proposal and conditions. I, as owner, or repoA.W agent of owner agree to tte above conditions. SIGNATURE TITLE JIMr%Uk DATE CIP16: Write (FCID); Yellow 1(T An HI); Pink (Applicant) 1 PUTNAM COUNTY. :E E. 1� DIVISION • E ' •.' 13i . 'ice• =$I' M5. 225-0310 PROPOSAL FOR SEWAGE DISPOSAL SYSTEE2K RE� r atmes NAME ZkA1i4 1"AK1(4cCi . ©AVID Mldciz • 2AAJ1E YD9idba. PHCNE �03 y31 -a9sY SITE IACATION -10 14<J S h c 2rr N R 40A ifi: Q SGn/ P144 1--k, TK# y5' fi - / MULING ADDEE'SS Vo 60-iia4 OCo g rcQ. P,0 :,x 6.11 . C•AAmil- N � j c�;" 12 w PERSON INTERVIEWED f3R i o,.I O C i "•.., o R A G ei- }- PCHD Complaint # o g 0 ! y Name & Relationship (i.e, awner,tenant, etc.) DATE 2.- 2.1 - W 1 TYPE FACILITY PROPOSED INSTALLER 9Q A,-V a`Co n/,,0 c,2 C )os i Co 7,./c.. PHONE 22;-0-71 Proposal (include sketch locating all adjacent wells).- NOTE: Repair must be in same location and of same type as original sewage disposal system. Different location may require submittal of proposal from li ensed professional engineer or registered architect. to Rt'„ok; c GI„7 Scp-bc �; 14 s4tri. Ay . R��lltcc ice! 1^4k wk /V F L! [21 (Al'ih i,J 8,eo of L/rL 14 SAP"& X45 01l) S� S +n r/c clrSr/z W Proposal,A�ed 's Sianature tle Proposal Disapproved romsal aDmroved with the followincr 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, drywells surrounded by one foot + gravel). e. Installer's name and number. r- (e.g.,house corners). three precast 61 diem. x 61 deep 3. System repair to be perfoaned in accordance with the above proposal and conditions. I, as owner or reported agent of er agree to the above conditions. SIGNATURE t ;KZ�,�1, A t e A' TITLE S4-n 11 e-rL DATE 2- " 2- (- 9 S: white (PCB); YeUcw Damn HD); Pink (PppLicsnt) •• ;i ... (. i', �' , a'.Fi ",i,i :.t l4 '. ?f �Cf'�i L I iJ 4 1 t M - •� a wF �, .. -..� �' , ..` i j � •i I /• ,� - , ' • a ��//pp�� • I � WRCQI� O yn y�1 KsG� C�10ICIICO'1r' � (JQ . � O. I . J(� /' lILl7. . ✓ , CARMEL;`NEW YORK 10512 (914) 225 6277' I rv\ ys" - ,F n b PVL AlA!e'i Y i l W 7 ( 44 f (� i - 0N i t W ;W `W -.40 ; ....-5a "........_...._ /6., A i G