HomeMy WebLinkAbout2849DOCUMENT CONVERSION SERVICES PROVIDED BY
IMAGING & MICROFILM ACCESS, INC.
www.scanyourdocs.com
631- 589 -8100
62.10 -1 -46
BOX 24
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OWNER'S NAME S O Ue °+' 'y It A r PHCNE 2. 5 ��
SITE LOCATION l �`C� E S T S' D t 7M$
MAILING ADDRESS V-J'I4 A-M V A L L r, �
PERSON INTERVIEWED PC�ID C,amplaint $
Name &Relationship (i.e, owner, tenant, etc.)
DATE 2 Vq 3, TYPE FACILITY
PROPOSED &TAIIER tV 4A, �i�/� PHONE S'7, 6
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.
B�
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Proposal
s Signature &
Proposal Disapproved
Proposal 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 camponents 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 own or reported agent of owner agree to the above conditions.
SIGMA TITLE A-6 DATE
PJM: V&te (P(ID): Yellow (Tam ST); Pink La plioint)
S. Powers
150 West Shore Drive
Putnam Valley, N.Y. 10579
(845) 528-5996
February 7, 2004
To Whom It May Concern:
In 1989 we converted a structure at 150 West Shore Drive. It consisted
of a garage with a den and bathroom under it. The bathroom had been
connected to the septic system of the main house.
After the conversion... there was a studio on the first level ... and the den
and bathroom on the lower level.
On August 151h of 2003 the structure completely burned down. We plan
to rebuild it, the same way it was, but to code: den and bathroom on the
first level, studio above it.
Please contact us if there are any questions.
Steve Powers
1-d qRGq RRq qirR siamoA IQ ev:7!nT Jn In OAJ
S. Powers
150 West Shore Drive
Putnam Valley, N.Y. 10579
(845) 528 -5996
February 7, 2004
To Whom It May Concern:
In 1989 we converted a structure at 150 West Shore Drive. It consisted
of a garage with a den and bathroom under it. The bathroom had been
connected to the septic system of the main house.
After the conversion... there was a studio on the first level ... and the den
and bathroom on the lower level.
On August 151h of 2003 the structure completely burned down. We plan
to rebuild it, the same way it was, but to code: den and bathroom on the
first level, studio above it.
Please contact us if there are any questions.
Steve Powers
1 -d APRC R?Q CbR SJaMCA •c eC7:nT bn in aa4