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Home My WebLink About2748DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 62. -1 -12 BOX 23 02748 1116-m JLL 02748 r r I RyrmM OD(AJPY HEALTH DEPAR'mw �V DIVISION OF ENVIRONMENM HEALTH SERVICES PROP06AL FOR SII�iGE DISPO6AL 'SYSTEM REPAIR OWNER'S NAME G , J _ C C, ro I g n - S �" , �, G 2, -1 - I Z PHOM 5 Z6 - SITE LOCATION �� 'L % /x' l /cs �. �n/. �� f,,.<�, r/,: !L<.,1 / ✓; Ma 60? -/ - r �- MAILING ADDRESS 6 -P.�� /ors Gl Jf c� �n N-_ �/ 1 /6,► A41' L S` PERSON =MVIEWED PCHD Complaint # Name & Relationship U.e, owner,tenant, etc.) DAM V (' j ii TYPE FACILITY PROPOSED INSTALLER Leo l-•cc .r ci i d �o YA Co n. S� . i PHONE , 73 6 y0 / n REGISTRATION #� G- ?> I! Z r N r 'C - 5 .` O 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. .r Mew- Proposal approved Proposal Disapproved 's Signature & Title Date tiroposal approved with the following conditions: 1. Procurement of any Town permit, if apple blca e. 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 eanponents 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. SIGNMRE O[FUS: Mite (EM); Yellow (Tim HE); Pink Vql amt) PC -RP 97 TITLE DATE 3✓ a lI Page No. of Pages Q LEONARDI & SON CONSTRUCTION, INC. _ 6 CAROLYN DRIVE - CORRTLL.�AND�■�T-MANOR, NY 10567 7- _ �. .7v.w.. -r.. _.. -t..an ...n +: K:.�. -. :u.x:e -.s .y t� r. .v :� l�^r��V l�� ,W VV IV•r .. rr ...r.r...:.a�. v>R.• Jn.:r �..,GCX.v.: -.;�.b :-. t. _ '.!. +�.�.b: LIC. # WC- 3112 -H90 o LIC. # PC -560 C.2_ 1 f L PROPOSAL SUBMITTED TO Authorized PHONE DATE CrlQ\1 T� C charge over and above the estimate. All agreements contingent upon strikes, accidents STREET or delays beyond our control. Owner to carry fire, tomado and other necessary insurance. JOB NAME //ll r✓i CITY, STATE and ZIP CODE i � 16, tt 4A ` ` JOB LOCATION ARCHITECT Signature DATE OF PLANS I JOB PHONE We hereby submit specifications and estimates for: C_v r• +lirh Omit)( /0 PREi i k vtf ; I fi r ctfn r S �– `�►r OJ - 6 zc -� ESTORp ON, OTHER THAN GRADING biSTURBED AREAS. IS INCLUDED UNLESS SECIFICALLY STATED.' Ot Pr0P069 hereby to furnish material and labor — complete in accordance with above specifications, for the sum of: dollars ($ ) Payment to be made as follows: A FINANCE CHARGE OF 1'/,% PER MONTH WILL BE ADDEDTO ALL UNPAID BALANCES, CUSTOMER IS RESPONSIBLE FOR ANY AND ALL COLLECTION FEES. ALL DISPUTES ARE TO BE SETTLED THROUGH BINDING ARBITRATION All material is guaranteed to be as specified. All work to be completed in a workmanlike Authorized manner according to standard practices. Any alteration or deviation from above specifications Signature g Involving extra costs will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents Note: This proposal may be or delays beyond our control. Owner to carry fire, tomado and other necessary insurance. withdrawn by us if not accepted within days. Our workers are fully covered by Workman's Compensation Insurance. Acceptance of Proposal— The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized Signature to do the work as specified. Payment will be made as outlined above. Date of Acceptance: Signature Bernard Peter Zipprich Architect ..ffighland-DrIve - Rauti_�; Bid 42-1— Peekskill, N.Y. 10566 (914) 739 0378 ,ftrdh 161, 1981 P;AtAL= county B-Opay tmd'at Of 144i'Ith : OiGA of tnvikorlmelitol Health sopvicea 'T-WO County Center Carmsj.t PIT" Votk 10512 RM JOU-s Residenca 0,011 0110-v llkoa'd I V, Ptitnaro valloy, t'aw York GeAtlomion t Purcuon'.L. to the infermation, furalob a to -t a. JwiOtt Jaduo during her P.0broavy 20 Visit It Y, Out Offidej wo emoloping for- your WOV#Att011, a COPY df Sites 'Pla-4 SK.-I't 44-ted illijArati, g a a:K,4a ef the ferenced s-te gd -tho. i- Ox sting g,4nit;lry. �krOa a0d auita�ble fo f -disposvo .1 a yp The ealargei,!ftent of - tlfho existing resi4e.noe w4,11 inorease thm total number of bod roops from, -hS t0t4l tea to thVe6- 06WOVOK., t AA 0', Un My rvaent inopect.l.on of Ove prostot. sanitar.y a-is �knped . posal, ar . pvidr -.nb indUatico of any prob-104matia corattionag not wete any repdrted to the Owtaev�is ftrljt,� it) : 't"�Ia last 400tic last we pr"ave4spoottP11 Y rvq'vest Oat th*' 446PO041 -system as ntyn *AtifIaa to SwO ths mess of this revid'ence and p#oposevd addition. Very truly your$4 tor'n,atfa ?4 4' A pp piriChg, Al� cc-. .I/X Jadus ' * ` � �~ . ' -- - - -+ -- R.D.4, 3 Bell Hollow Wad Putnam 0 11 ev,� New York- 10579 914-526-2372 Dear Mr. Hedges: ~ Included please find all of the papers concerning the addition to our house-and concerning the effect of such on the present septic system. Thank you. . - Mrs. Dale Jadus m I I I , - . 7e (loll 7z' S S '.r IV xi Of _-_---_--_-_--___ ------- '' |( | --------- --- ----- en'; PUTNM VALLEY �5_ 7- 517 -/ : I� - Department of Health - Div1j1(,L __ *1— i:1 DESIGN DATA SHEET Location.. SEPARATE SEWERAGE SYSTEM Located at. Lot Area.. Owner.� J�ze_e ............. Bldg. Type '> Occupandys Watershed, ;Xf Source of water supply,. drilled-driven-idug.,well-spring-public NO, OF ROOMS: Bedroomsj ... Future.*.. FIXTURES: Kitchen_dishwasher,,,,,.. Garbage-grinder ..... Bathrooms./..., Automatic laundry.,.... Other. .. .......................... 0 SEWAGE FLOW!. �200 gal. /bedroom).�/-Pq,C&** ............................. Iticrea'bed capacity re fired for garbage grinder -- 50%) TANZ.CAPACITY:�) Zf-gallons below flow line; depth air space ......... TANK MATERIAL: con-c4Z - total depth.......... liquid depth....,.0 width length ............. :: — partitiono.o.'t.o...,,4, SOIL TESTS: 1st 2d 3d Soil to 5-foot depth .......... ............ Tests made ................ -ABSORPTION RATE allowed g.p.s.f.p.d.; Chock.! Gallons....... Rate....... Requires. .13 ��sq. f t'. bottom area I= L::, Provided by (describe absorption field).,/. .4 0.44.............. distribution box providedoa., .... ao UABLE AREA AVAILABLE ON PREMISES: ......................... o ......... 1 'R A T R4 G B 0F. T, 00 D eke t ^h &zt*�j , r!�t 1 artificial_ ------------ ( -. Well-drained usable area MUST be provided before S' is REQUIRED and - must show all pertinent f eatur6 S, propdrty lines, existing structures, driveways, water or g,". water courses wells, springs, dry wells or drains for roof drainage; DISTANCES BETWEEN SUCH FEATURES: COMPLETE PLANS FOR '.4.T.1`;Q,:7ATR DRAINAGE OF SEWAGE DISPOSAL AREA -all details of workable sewago ,ystemo DATA SUBMITTED BY:,-) I ?r-_ date Signatlire Owner( ); Builder(011i. corporation, give title, existing field Checked by: records inspection By _ _.—.—dat6. (..67(- AM 0 (..67(- AM Ul ;r Ln 7 101 r lb t, NOO -- .I.Sd � 0 L L 0 V S - I - A F , ? L A N s C A L E I °= 50.0'1 NOIF: IA" Cm% MDT to ql-Vrxtv e-xi"T. W�iftfw. wor" Lki4jr C4 age- 1.114r. ftln W.90-1 Vgol:q LCgA-fioW %LM9 fti,* 'ro 94AY 1 gr.%,j oe A,•,P"i-T rwwc, ow (.1 ca..-510-r. ,� 0. J A 0 U -1 ?, E r; F- W C E Bernard PdW ZWd& Architect iF.L.L. WOO. -LOW ir, HWdal3d DdW --POIWAH Rowe 3. Box W N.V. WA I 16. 87 -, Q S so Ul ;r Ln 7 101 r lb t, NOO -- .I.Sd � 0 L L 0 V S - I - A F , ? L A N s C A L E I °= 50.0'1 NOIF: IA" Cm% MDT to ql-Vrxtv e-xi"T. W�iftfw. wor" Lki4jr C4 age- 1.114r. ftln W.90-1 Vgol:q LCgA-fioW %LM9 fti,* 'ro 94AY 1 gr.%,j oe A,•,P"i-T rwwc, ow (.1 ca..-510-r. ,� 0. J A 0 U -1 ?, E r; F- W C E Bernard PdW ZWd& Architect iF.L.L. WOO. -LOW ir, HWdal3d DdW --POIWAH Rowe 3. Box W N.V. WA I 16. 87