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BOX 21
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PROPOSAL FOR SEWAGE DISPOSAL SYSTEM REPAIR
OWNER'S NAME �►'Y OCOCA
mi.! F - �-� PHONE (� 14� 5�(D - 4�
SITE LOCATION 0scGvvana hejrris frnrn VCLUe-.! TO C=s i 44—
MAILING ADDRESS =5:p n,-,cnwc?r-ja 1-7 SaY)tS rd N\11. 1 U5`7e5
PERSON INTERVIEWED PCHD Canplaint #
Name & Relationship (i.e, owner,tenant, etc.)
DATE - -- TYPE FACILITY
PROPOSED INSTALLER 4e f`G Li:- C1 /� ��GG Pik *IX// PHONE �dZ
REGISTRATION #
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 fran licensed professional engineer or
registered architect.
% y )4 A 1 S. / - 2 • . / w� <T ItV
Proposal approved
Inspector's Signature & Title
Proposal Disapproved
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 , or eported gent of owner agree to the above conditions.
,f�
SIGNATURE a TITLE tov\tnCr'- DATE -%j. 3p -79
PIES: Fite MED) i Yellc w (Tan HI); Pink (Appl.i®nt)
6'
:A
PROPOSAL FOR SEWAGE DISPOSAL SYSTEM REPAIR
FOR 39 OSCAWANA HEIGHTS ROAD, PUTNAM VALLEY, NY 10579
TAX MAP I D# 5 1 .- 1.44
PUiN1,°,,4 COUNTY I)Ep tv
/ //' /� (((�///,,,'///////// BEDROOM EI�Il.f ti 8., a'I.,e {(. li'.I f��1��F.. S i111�.�+rEI FOR
1r OO/ //� �/ \! J { r1Y1
clean-out la
clean-out lb
4" PVC PIPE
4" PVC PIPE
OF HEALTH
,
HOUSE �2— BEDR MSFRONT DOOR `"
FRONT SLI DING GLASS DOOR
distances from corners of foundation A & B:
A to 1 =15'
la =9'4"
1b= 16'2"
2 =27'
3 =42'
B to 1 =12'6"
la =12'
lb =15'4"
2 =26'
3 =39'
#
.1 000 Gal Ion Concrete tank
#2
750 Gal Io
#3
750 Gal
ALL WORK COMPLETE OCTOBER 1997
BY RI CHARD BECCARELLI - PUTNAM CONTRACTI NG
914 - 528 -3482
alley System
gal l ey system
a
. _. �.�.�.... H ORUCE R.. FOLEY, A4.
Acting Public Health Director
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
4 Geneva Road, Brewster, New York 10509
(914) 278 -6130 July 31, 1995
Mr. Apa
39 Oscawana Heights Road
Putnam Valley, NY 10579
Re: Addition -
Dear Mr. Apa:
I have received and reviewed the plans for the proposed addition to the above
mentioned residence.
The plans have been approved as per plans bearing this Departments stamp and
dated July 27, 1995.
The survey indicates that sufficient area .exists to expand or repair the sewage
disposal system, should it become necessary in the future. Therefore, based on
the information submitted, the above mentioned addition is approved with the
following conditions:
1. The total number of bedrooms must remain at two 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 replaced or updated with water saving devices,
i.e., low flush toilets, restrictors for shower heads and faucets, etc.
Approval is granted for sewage disposal only. 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.
RM /iP
cc: BI (T) Putnam Valley
Ver truly yours,
4a'�'z /&K*v
Robert Morris, P. E.
Public Health Engineer
01/17/1995 02:23 1- 914 - 528 -7184
MILT ASSOCIATES LTD
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01/10/1995 01:03
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Street 09,644AWA 494C 7M.: Vatf Construction
Mailing Address �cl l®rl Tcv, FC)-i Perms, t
Cescripticn of Additicn
Number of existing bedrooms Proposed number of bedreCms val
A) Square Footage of existing hcvsa iJ91:1
B] Square Footage of Prcpcsed Addition /god
.% increase in floor area ( A divided by B) X 1GO =
Please submit this form and the following to FUTW CWN7iiY HEALTH CEPAR17,41ENT, 4
GENEVA FOND, BgE11STER, NY 10509, Fhcne 278 -6130 with the following inr`ormaticn.
IF THE FFOFOSED ALDITION IS C-= EATER TP N 15 %.
CERTIFIED CHECK CR MCNEY CPO--R
1. CHECK for $100.00
2. Sketch of existing floor plans (all living area including basement, if army)
t•;crm- profassicral drawing
3. Ske'Lch of proposed floor plan.
Ncn professional drawing
4. Copy of survey showing wall and septic location, to the best of your
kncviledce. Include date of installation if known. Any questions please
contact William Hedges or Fcbert Morris.
IF THE ADDITICN WILL RESULT IN A.l ADDITIGIV,AL EEDRC0H THAJV
CERTIFIED CHECK CR MMEY CFDER
2. Sketch of existing floor p1Gns (all living area ^rl�+in_g:asc,�!e»t, it try)
Non- professional drawing
3. Sketch of proposed floor plan.
Non professional drawing
4. Plans for the Sewage Disposal System prepared by a Professional Engineer
meeting present code requirements, may be required.
OFFICE USE
Comments and /or conditions
Approved by:
Date:
cc: BI (T)
TITLE
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Public Health Ceft=,
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
4 Geneva Road, Brewster, New York 10509
(914) 278 -6130
Re: Addition
v �
I have received and reviewed the plans for the proposed addition to the above
mentioned residence.
The plans ave een approved as per plans bearing this Departments stamp and
dated , de
The survey indicates that sufficient area exists to expand or repair the sewage
disposal system, should it become necessary in the future. Therefore, based on
the information submitted, the above mentioned addition is approved with the
following conditions:
- ..:.....1.
,,The total number of bedrooms must remain at _3____ without prior approval
_._. try this '
Department;-
2. The area of the existing sewage disposal system, and its expansion area,' must- " " ~- -•--Z-
be maintained.
3. All plumbing fixtures must be replaced or updated with water saving devices,
i.e., low flush toilets, restrictors for shower heads and faucets, etc.
Approval is granted for sewage disposal only. Any other permits or variances
requirer�e- the_responsibility of the applicant and the jurisdiction of the Town
of //
If you have any questions, please contact me at your convenience.
Very truly yours,
Robert Morris
Assistant Public Health Engineer
RM /jP
cc: BI (T)
FORM: STAMPED ADDITION
01/17/1995 02:23 1- 914 - 528 -7184 MILT ASSOCIATES LTD PAGE 02/03
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