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b'1/01/2002 02:18 845bJb'11 /:d UL1N1 KERSHAW HAVE. b1
°Sent fly; MR ROOTER PLUMBING; 645 635 1173; Apr -19.10 8:43AMi Page 1/.2
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PUTNAM COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
PFiOIDOSAL Fwq SEWAGE TREATMENT SYSTEM REPAIR o
'ES Internal Use Only
L I.: Repair Permit ISsuaa In last 5 year,
Rapalr wrrhln Boyd% Comers, W. Hrancn or Craton r'atle.. Flea.
I Repair Within 2nn ft. of a watarcourse or DEC -mappad wetlonr
SITI: LOCATION -Xi 6 TOWN %%ti""
OWrVER'S NAME
MAIL -6W ADUHESS,
APPLICANT e
Nnnie & rlelationship (l.o., owner.
MIT 0
❑ tot In watyrshed� i
I7 ioint Rttview'�__�_
TM #.__— Z(— /.'P-
PHONE tl
DATE `k. \!. V3 FACiLITY TYPE PCi-ID COMPLAINT AIN'T it
PRCIPOSED iNSTALLER �1 ��� -r�+.� PHONE
Atr,nms �o %,o k yy` ,g Vo.1au REGISTRATION /LICENSE #
vsal (include a separate sketch locating the house, property lines, all adjacent wells within 204
feet of repair and the location of existing and proposed system)
NOTE; The Department may require Sul)mft dl Of proposal, from licensed.profe,s slondl d perirlingl u trio
nature and extent of the re Y,r— ��{(,, raja -1011 (ili ppll�
�ownerl
1, the! :+eptio installer, agree to comply with the conditions of this permit for the septic system repair
SIGtJATURE TiTLE�,�,, DA'Ik�1�1p _
(installer)
Proposal approved with the (oligl ina conditions:
1. Procurement of any Tuwn Parmit, if applicable.
2. Submission of as built repair sketch by the soptfe system 061allar within 30 days of the repalr, in duplinoHr, µI wwing:
e:. Ownar'c nsme, Oto Street Name, 'sown and Tax Mar) number
h. Location of installed cumpnnonts tied to two fixed points
c. System description (e.g„ 1250 gal. Concrete septic tank, etc.)
G, Installers' name and phone number
3. Svutorri repair to be performed in arrnrdanrP. wBh thy, shoe prupusal and condillurin
4. The proposiod SSTS repair Is conridcrod o hral fit decOg n and there is no yLarantee to the clUration ar whir.-Ii lUr
lomprated f;STS repair will function,
5. No completed work is to be bacicfiiled until authorization to do so has been oblainad from the Paparrmnn:.
_ INTERNAL. USE ONLY
Prop al Approv a Proposal Denied
Ins _cn•,rs Si nat�irr A, Title
i°
Date
Exrx atiOn i. atP.
Lir j jr,r )%M ls_ in wrnpliance wirh You ❑ Nc J$i
COPIES: PCHD; Owner; installer
PO -14P 99ML
RPv. 107,
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Jose' Roserfeld
294 Farm to Market Rood
Bre .ster NY 10509
As- Built - Drawing R- 067 -10
WALL WALL WALL WALL.
A -- 30' HOUSE TO SEPTIC
B = 20' NEW SEWERLINE FROM TRAP TO SEPTIC
C:= 7' ROUSE TO SEPTIC
T NK HAS IRON LID ON CONCRETE SLAB
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NC—r TO S-CA E 11 ^T TSCALE
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Drive Way
iivT TO SCALE
July 8, 1981
Putnam County Dept. of Health
County Office Building
Carmel, New York 10512
Attention: Mr. L. Gabriel
Dear Mr. Gabriel:
This is in reply to your letter. of June 30, 1981.
The problem has been corrected. We added a Curtaintrain
to my existing sewerage system. The size of the Curtaintrain
is 70 feet long, 4 foot deep and 2 foot wide, containing 3 feet
washed gravel 1 inch stones with perforated PVC pipe with an
additional distribution box. The job has been done by a local
contractor, Lee Schultz. We trust this is satisfactory in my
case.
,Enclosed is a sketch of my present sewerage system.
WSR /BB
Enc.
Very truly you ,
William S. Rihm
Farm To Market Rd.
Brewster, New York 10509
PUTNAM CO- hTALTH DEP • To
COUNTY OFFICE Cy BU]I,0512G
CARML •
JUL 9 '981
rOUNTY OFI,,I(-7 IlUEDING"
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CA�WL, IL Y,
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JUL 91991
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