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HomeMy WebLinkAbout2899DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 62.15 -1 -9 BOX 24 xi. ,1 6 ;. �. IN L IN is �.; IN IN ''. b PETER C. ALEXANDERSON County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914). 225 -0310 JOHN KARELL Jr., P.E., M.S. Public Health Director Joan Omorato PO Box '.214 Putnam Valley, New York 10579 Re: Septic Repair —As Built Sketch 21 White Birch Road, PV. .Dear Ms:.'Omorato "'A"ri app'lica:tion" fora sewage disposal .system was approved by the Putnam County ' Health Department on June 15, 1990. The approval was granted with the following condition. Submission of As -Built repair sketch in duplicate showing:�����,f> a) Owner's name. b) Site Street Name, Town and Tax Map number. c). Location of. installed components..tied to two fixed paints - .g., house 'corn'er's) d) System description (e.g., 1250 gal. concrete.tank, three precast 6' diam. x 6' deep drywells surrounded by one foot + gravel) e) Installer's name and number. You'are responsible for submitting this information to the Putnam County Health Department within 30 days. Fa.ilure to do so will make you liable for penalties provided by law. If you have any questions please -feel free to contact me. For the Public Health Director ry Puly yOU s Johfi Karell Jr., P.E. Public Health Director By : 54 1!(-,4 MB:CJ:jr r Chris Jo son Intermed to Clerk PETER C. ALEXANDERSON County Executive Joan Omorato PO Box 214 JOHN KARELL Jr., P.E. M.S. Public Health Director DEPARTMENT OF HEALTH Division Of Environmental Health. Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225-0310 Putnam Valley, New York 10579 Dear MS. Omorato: I Re: Septic Repair -As Built Sketch 21 White Birch Road, PV An application for a sewage disposal system was approved by the Putnam County Health Department on June 15, 1990. The approval was granted with the following condition. Submission of As -Built repair sketch in duplicate showing: a) Owner's name. b) Site Street Name, Town and Tax Map number. c) Locution of installed components _tied_ tef two -d) System description (e.g., 1250 gal. concrete tank, three precast 6' diam. x 6' deep drywells surrounded by one foot + gravel). e) Installer's name and number. You are responsible for submitting this information to the Putnam County Health Department within 30 days. Failure to do so will make you liable for penalties provided by law. If you have any questions please feel free to contact me. For the Public Health Director ry y my yo} Is /( G Johfi Karell Jr., P.E. Public Health Director By: MB:CJ:jr Chris Jo son Intermed to Clerk IDi SITE LOCATION 221., MAILING ADDRESS P 0 225 -0310 T. -� C1 PHONE -6� 6 "q! W TO PERSON INTERVIEWED PM Complaint # 6/1 % Name & Relationship (-i.e, owner,tenant, etc.) DATE TYPE FACILITY ..,. O� Pro (include sketch locating all adjacent wells): PHONE -5-:2-6 <--�2 5.S' I1 A .L Liz^ y e N, Y, 14 12-5� 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. Proposal approved Proposal Disapproved Inspector' ig Title Date 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' 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. w I, as owner, o reported agent of owner agree to the above conditions. SIGNATURE b TITLE DATE 61, 4iP6 CP1�.S: Vbibe MV; Yellow (Tam HE); Pink 0411=0 P, : Alt *-W tI+ ` r P-F - 13 cl) IV -------- V4 ALI � -- '--------- ---- -------------' 4.�''-- ------' -----------_--____-'___-_-_-_----__--_ »� ^ -� ----~/-��- �x��-' -- -' -' - - -- -' ---' --- - — -----' ----- ' -