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Home My WebLink About1594DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 34. -5 -52 & 34. -5 -55 BOX 15 01594 ,�- ' '� W Ll 16 I r. 1 IL m m 01594 I ! °-7' �i` r�� U!"� sue' •� �- -- ,� -,.z� lir./12,.�• -.--- 6 oz ev- �_ 77 4�1 01 �a V4 All 34 'St 30 r 11 ;rO4 l`iv� �= �(e,tit d �� /= � G rQ/s ?ra T� ►�� v,T�l C q,�a PAO 7-ci o I r J 5 7 3 r d'4 c. JAI 11-61 T L 3 "...RE-CEIVED OCT 2 4 1990 POTNIAM C&UNTY, EPT. 10F HEALTH x PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES John M. Simmons, M.D. Deputy Commissioner of Health - FIELD ACTIVITY REPORT - ADDRESS No. MAILING ADDRESS P.O. Boat Post Office Zip Code 0 VD-1_ UST-15 PERSON IN CHARGE OR INTERVIEWED Title DATE �� /,R // rl?�Typ� FACILITY aff4ia TIME LEFT Sheet / of INSPECTION Orig. Routine Orig. Canplain Orig. Request Compliance Canplaint Camp _ Final Group Illness Construction Reinspection Field, Sampling Only Field Conference Explain FINDINGS: ,1 'o--� r v-'" , d9 sue-- O tz :t '00, - .0V e' o "� P'e2.� l ✓ �°•c."� dCB Cam' l/ dOy n INSPECTOR: tle PERSON IN CHARGE OR INTERVIEWED: I acknowledge this Field Activity Report. SIGNATURE: 6/86 TITLE: TELEPHONE: C�y� PUTNAM COUNTY HEALTH DEPARTMENT y DIVISION OF'ENVIRONMENTAL HEALTH SERVICES ., :. 225 -0310 _ PROPOSAL FOR SEWAGE DISPOSAL SYSTE K REPAIR-`: " 2 U• �� °-° '.11,6 MIS NAME ,9 1 17 4 !1 %Zl/ v / PHONE SITE LOCATION MAILING ADDPZSS PRISG 'DATE PRA ''`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 licensed professional engineer or registered architect. .. ..a.i.:LLCV1•:wvLV &.,...,. ....a�ucaaaaa. Name & Relationship (i.e, owner,tenant, etc.) TYPE FACILITY POSID INSTALLS PHONE ��' j/✓ mi l r +� /�S ✓' e ell Proposal aproved Inspe&t I s Signature Proposal Disapproved Date Pr; avroved with the following conditions: 1. Proctiraent of any Town permit, if. applicable. 2. SubKnjS >on of as built repair sketch in duplicate showing: a. Ownc's name. b. Sit Street Name, Town and Tax Map number. c. �Cion of installed components tied to two fixed points (e.g.,house corners). d. Sy�n description (e.g., 1250 gal. concrete septic tank, three precast 6' diem. x 6' deep clrylls surrounded by one foot + gravel) . e• =n�ller's name and number. .3. System repair to be performed in accordance with the above proposal and conditions. , as c�rac, or reported agent of owner agree to the above conditions. a POFD)% YeUcw (Tam ED; Pink (kjl. amt) TITLE WE f f PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES 225 -0310 PROPOSAL FOR SOGM DISPOSAL SYSTEM REPAIR OWNER'S NAME G/ t, PHONE %M-WJ 2-1? SITE LOCATION %' X-G �� j1' -�%� TO MAILING ADDRESS PERSON INTERVIEWED PCHD Complaint # Name & Relationship (i.e, owner,tenant, etc.) DATE TYPE FACILITY PROPOSED INSTALLER PHONE 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. A / '�GG y <�-- /�p�/ h Q/ r- p / .-1 yrCi d ✓ ld/ Y / 1 C/ r Sr f 's .c .� P /cY 4 /�i�� %'Sly mac, Proposal approve44�— Proposal Disapproved iG /s /tea te 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 6' diam. 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 reported agent of owner agree to the above conditions. SIGNATURE OOIS: V&te (P SD); YaUc w (Tam EU; Pink (Anlicant) TITLE DATE PUTNAM COUNTY HEALTH DEPARTMENT .. -- DIVISION OF ENVIRONMENTAL HEALTH SERVICES John M. Simmons,.M.D. Deputy Carnmissioner of Health = FIELD ACTIVITY REPORT - Sheet of 4 NAME / 0,09 A10 ADDRESS No. Street Town TM No. MAILING ADDRESS P.O. Box Post Office Zip Code TELEPHONE PERSON IN CHARGE OR INTERVIEEWED Name and Title DATE 3 !r 5/ TYPE FACILITY ' TIME "'eo 7 0 TIME LEFT 1N5Yh;flUN Orig. Routine Orig. Complain Orig. Request Campl iance Complaint Camp _ Final _ Group Illness Construction Reinspection Field, Sampling Only Field Conference Other Explain r- INUlNUb: e ®., 40��' 4- _9 a fto co MW.:: -�'� wmzol MO,-- M- V - INSPECTOR: PH Signature and Title PERSON IN CHARGE OR INTERVIEWED: I acknowledge this Field Activity Report. SIGNATURE: 6/86 TITLE: "' `„ PUl'NAM COUN'T'Y HEALTH DEPARTMENT DIVISION_ OF. ENVIRONMENTAL HEALTH SERVICES r 225 -0310 PROPOSAL FOR SEWAGE DISPOSAL SYSTEM REPAIR OWNERS NAME , ,� �r / / ` -7 ! PHONE SITE LOCATION /-�v ✓�,, %%j%tj�' Vic,/ T- �1 MAILING ADDRESS & DATE % k PCHD Camplaint # .e, owner,tenant, etc.) TYPE FACILITY PROPOSED INSTALLER PHONE 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 licensed professional engineer or registered architect. � S �O /� %� � C� ° ✓/�� stn � C t �=, ./� G ^3 � � `� Y� C / � "�,-� -- li L '�,�r � ..... Proposal approved Inspector's Signature & Proposal Disapproved rovosal amroved with the followincx 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 d. System description (e.g., 1250 gal. concrete septic tank, drywells surrounded by one foot + gravel). e. Installer's name and number. Ate (e.g.,house corners). three precast 6' diem. x 6' deep 3. System repair to be performed in accordance with the above proposal and conditions. I, as owner, reported agent of owner agree to the above conditions. SIGNATURE TITLE DATE .0 0 PIES: W &tie (PAD); YeUc w 0:mn HI); Pink Vq l amt) JOSEPH A. tLaWpeRA :,�Z�Di c J =: --DEPARTMENT ). Putnam Mahopa c pve „ Tr Ld RGE E. CARGAIN .Inspector _ .... _ JANET KRIVAK Assistant ' OF CONSUMER AFFAIRS / WEIGHTS & MEASURES County Office Facilities - Myrtle avenue Falls, N.Y. 10542 -0368 (914) 621 -2317 DO NOT WRITE IN THIS SPACE - FOR OFFICE USE ONLY File No. q( -(0 �,�j ( Date Received Received. by: Telephone ( ) Mail ( ) In Person ( ) Other Agency ( ) Investigated by:. Closing date Disposition Please print or type the information and include legible copies of all pertinent materials (cancelled checks, sales receipts, contracts, letters, etc.) CONSUMER INFORMATION VENDOR INFORMATION Name �� . � aLe � Name . Address ";;Ze c /o Address �S- city State .e �wfT e,r�:.. Zi /a 0 9 City State Zip 11ax, e Telephone r1 - 9"4w Telephone ~Q/� home business 1 Hours available jn 1contact person ��Jil/ OL-(J XJs 4 576 %QS16 'r Product or Service sett /C �:2�P�„ Date f Transaction COS K, D d 0 e a o Amount paid to date 1�0 Have you contacted the vendor about this matter? (�es ( ) No If yes, what transpired _S�f /C - 'YtE/ f 75flleC wi-14%/l 3�irf�.r. Sfi G L �/!� �1�"i N�' . / � y,L'��/lJ ,� //1J /✓d � GJ4,�,�i�j' . Have you contacted any other agencies concerning this matter? ( Yes ( ) No If yes, what transpired �,�/ /yt e d' ,P f A I J 7t et �P CI'7 P F!/ r9 VS C -4i,;V t0 V474- i a/2 w We, A r� �e PLEASE USE BACK OF FORM FOR COMPLETE DETAILS OF COMPLAINT &I Please do not forget to enclose copies of any pertinent documents PLEASE PRINT OR TYPE NATURE OF C MPLAINT ° ��,�` �I�iC �- y J�N-�' I% ,e 1 f- L wolf 0 's e9 -s'a Z L �e 7%-7' V_ 4 �r �X/ t� eal rr /� to "�h i a� 3 :n t� S 7``/f S S/-rfP s A V s�17 e l' 6-1" PIV I/ . 7!X f- f 711141 S V r,�P�i r.J�e �� Ze ✓e --r wg 7�� Ocif 0-l"- 7LIfe ON We- wee n v lila2t- .s'/A-lne Y BAY11fey- What resolution are you seeking: �JP cJ s�l f7 60M CZe-r e O- 7;' f�1 . v 17L 7ve v ahoy: ( Continue on separate sheet ff necessary) (J-,A c / p Since it is necessary for your office to release copies of my complaint to the vendor and/(oar C other agencies, I hereby certify that the information I have given herein is true and com- plete to the bes f knowled . . o ( Signed) o Date r �` JOSEPH A. LaBARBERA Director GEORGE E. CARGAIN Inspector JANET KRIVAK Assistant DEPARTMENT OF CONSUMER AFFAIRS / WEIGHTS & MEASURES tnnnn October 16, 1991 p� . Mr. Frank Evans. . PO Box 95 Mahopac Falls, NY 10542 CONSUMER: Mr. & Mrs. Reinhardt FILE NO: 91 -10 -151 Dear Sir /»iii: Enclosed is a copy of a recent complaint received regarding you or your firm for your review and response. Our objective is to investigate and hopefully mediate such complaints. Your assistance in helping co reach a fair and equitable solution to this matter would be appreciated. Please be assured that your position will be given equal consideration to that of the complainant. -- Please -let .us - h*ear.. from :you.,._. 3n_ writing.,.. within 10,.,days of receipt of this correspondence. Should you have any questions, please feel free to contact this office. Reply to: Very tr y yours, ` oseph Larbe aBra Director Janet Krivak Assistant enc. cc: LPd'tnam County Health Department - Attn: Bill Hedges Putnam County Office Facilities - Myrtle Avenue, Mahopac Falls, N.Y. 10542 -0368 (914) 621 -2317 /4 ro 3 0 �.3 ro 7—A T-o o Id ro W 73/ $A' Cl r' .wr.. f*l �;67 -i5�7 /)Old I /I ;r / %hf f: A d M d QS r� t'11C 37 ,�, I�,/P/d p6o Nk T)z cgp, 7-a b/�t/ 13c, x,;6Fs 7 16r3/ ti OCT PUTNie--:1— PEP T. OE. F�T--ALT:f s eor- L�/� 00L•� f 306/ _-!dG- b{r �? ��,,..� her• -, . r •-� � C"/ ' r lid/ S 7-a �;-Q / a 1 v n v L ,�, P A Ive-w w -A 13 r o To, c-tv IIIYLZ-- W r*111 C, 3 3 T-cl o To ra (1,410 4 6 • C& T o 0. 6 03 � yam, t3� -r.� m�m� P�� b 9 1—o New 13o,�� =s q�' �� '�s ,?�� o 3" - 9-P 0 (66 5,6 ra 4 r14 r. cl Al -I- A /o 14 A 7r-f r Wfle 13o Ices ., 12)?(;Ilv TA / ,A I STATEMEMT From iA Terms n PH rwtAl f. low M INS— I MY I I MMI OM �FAMWA�M_ Iwo