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HomeMy WebLinkAbout2973DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 62.17-2-30 BOX 25 1 rm { �, + J or , T r ,6 , f- i - , 02973 PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES , PROPOSAL FOR SEWAGE TREATMENT SYSTEM REPAIR Int.ernal Us Onl1 PERMIT #� El Repair Permit issued in last 5 years Ll NOt in ❑ ❑ Repair within Boyd's Corners, W. Branch or Croton Falls Res. ❑' Delegated -Vr ❑ . ❑ Repair within 200 ft. of a watercourse or DEC - mapped wetland ❑ Joint Review SITE LOCATION �a Sthut�9 FiiLc:,P�� TOWN Frt M VA M #XO X 7-A- 3 6 OWNER'S NAME /1Z/ AaQQ ' S)C0 ,,rfa PHONE # 9/(/ -603 -,330y MAILING ADDRESS- 4/cgZ 5VA1.Ce r 1,416c;` A40-0 PI)7 ✓Ah4 APP —thy /V `j�� oS"7 APPLICANT Gec I eI 7' -t a� -;r Name & Relationship (i.e., owner, ten nt, contractor) DATE '1A, X/07 FACILITY TYPE PCHD COMPLAINT # PROPOSED INSTALLER °C vG /� FXCi,, .a "1' PHONE # . P1 7Go 16406 ADDRESS �( 3 S & f'4/0'- zc REGISTRATION /LICENSE # I �o S Proposal (include a separate sketch locating the house, property lines, all adjacent wells within 200. feet of repair and the location of existing and proposed system) NOTE: The Department may require submittal of proposal from licensed professional depending on the nature and extent of the repair. I, as wner,agreA11A-4 conditions stated on this form P SIGNATURE P TITLE 97 `''���� DATE (owner) I, the septic installer, agree to comply with the conditions of this. permit for the septic system repair % I i/-- /:- (installer)�� Proposal approved with the following conditions: 1. Procurement of any Town Permit, if applicable. 2. Submission of as built repair sketch by the septic system installer within 30 days of the repair, in duplicate showing: a. Owner's name, Site Street Name, Town and Tax Map number b'. Location of installed components tied to two fixed points c. System description (e.g., 1250 gal. Concrete septic tank, etc.) d. Installers' name and phone number 3. System repair to be performed in accordance with the above proposal and conditions 4. The proposed SSTS repair is considered a best fit design and there is no guarantee to the duration at which the completed SSTS repair will function. 5. No completed work is to be backfille until authorization to do so has been obtained from the Department. INTERNAL USE ONLY Pr posal Approved Proposal Denied ❑ 1 07 In ector's Signature & Title Date Expiration Date e air proposal is in corn pliance with applicable codes Yes No O COPIES: PCHD; Owner; Installer PC -RP 99ML Rev. 2/07 y2 SunSO 1h 1112c/ �(,fhcun 110 1(ty-N, y ED KUCK EXCAVATING 9 INCo (o2 (7_ -2 -30 - - P.O. BOX 395 Mahopac Falls, New York 10642 914 - 248-6148 I - ` -_ I T. Caioek, 5e ®r;alle�71) 61617 1;?4 U/14 A box -r'���►�� ©x y PS22-1 6'2.17 � -� tii cp cn to O _ r��.'..V*.� �..r. ♦.n.. r.. w� ai.. cv ['=•_v _r��'^' ;��:.��.:v !6 d.+Y.r r.. Or..yi'�4.tA'Y....+. -•�..t mow.. .+r -... .- .s...Y R�'.w... w�..aC ^.s.:.._ir� . ~• .. ... Yoti Of Al C { F a F X6.8 / o ti r 10, 1� lb �4c SNF CAI., A, 4mp. \x � 2 �`N U 41 a WALL' COR. 2:34'W: CHAT LINK FENCE 99.18 a ON LINE WALL v N39'36 'W Q RAME MASONRY STONE 9.58 - HEO BRICK p jFROM 1 v v zr �\ OCT 8 2007 23:40/ST.23:38/Ho.7520718533 P 2 'ihy:Yx+.MS�.:..uP.ay.... �.- wav- .Nyy.s....i.•a:��.(Y �. re.r .� .rsn ..o..e w.r .. �N r.. V . � O O VN 61a% 4L r OTgR ��P iv / X00 Cb qb O U4 0 .99.18' WWALL. " � COR. ' 9' ' W; CHAI UN FE ON UNE WALL N39'36'W� H� E A/A SONRY STONE 9.58 �- �1�1 '► klo O v �\ �, R t, (MON>OCT S 2007 23:40ZST.23:3;qZ"M<>.7620715633 p VAY, f�� .)o � el 74 f4o< A IIA71 P.O. BOX 396 Mahopac Falls, Now York i cud! 914r248-6148 lollrlLl I SEP -18 -2007 `02:20PM FROM - ENVIRONMENTAL HEALTH 1 8462767821 T -358 P.003/003 F -820 I v �• r r3 — I- n 7e °� iOg , 080 °d E0OMO* d OOE °1 1ZO10185b0 I415V3b 1VIBANOUTANHOdd MdOl:80 d00Z °O H3S a u° e C �v bg r3 — I- n 7e °� iOg , 080 °d E0OMO* d OOE °1 1ZO10185b0 I415V3b 1VIBANOUTANHOdd MdOl:80 d00Z °O H3S 9/ Ll.. - /)J? 33 ED KUCK EXCAVATING, INC. September 24, 2007 Michael Sbarra 42 Sunset Hill Road Putnam Valley NY 10579 P.O. BOX 395 Mahopac Falls. New York 10542 914-24"148 TM 62- 17 -2 -30 Phone- 914 603 3304 Job Descriptign• • Prep access road to septic and install silt fence • Remove existing septic system • Remove apx 5 -6 ft of dirt and expose boulders buried under system • Install clay in cavity holes on downhill side • Reinstall select fill • Install bank run (Allowance is 140 yds) • Install new 1250 gallon septic tank • Install either (3) 500 gallon drywells in gravel with junction box OR a row of concrete trigallies (apx (2) 25ft runs of trigallies) or, -Xnf�%I+r -a-1-o r-S • Boulders to be placed in lower access road to septic system • No Boulders to be removed off site • Backfill, rake and seed disturbed area Note — &patio needs to be r„ emoved reinstaltation_ofpatio is NOT included in this price ALSO jL140 My of bank run is not used you will be reimbursed at 43.00 per yd off the Total for above work is $30,440.00 Note $15,000 is needed to b_eein work Once bank run is installed second paym�, ent of $10,000 is due. Final Payment of $5,440 is due the day work is completed. "Upon signing this document you are going into contract with Ed Kuck Excavating, Inc. If payment is not made in full upon completion a 2% interest charge will be added per month until balance is paid in full. Owner of land will be responsible for all legal fees to collect unpaid balance for Ed Kuck Excavating, Inc. Edward L Kuck c��f Date: q Michael Sbarra Date: - 9 . A AMLER, MD, MS, FAAP dmmissioner of Health ,,)RE;I TA MOLINAR! ,R , "RS.'1, Associate Commissioner of Health DEPARTMENT OF HEALTH 1 Geneva Road,. Brewster, New York 10509 CERTIFIED RETURN RECEIPT REOUESTED ROBERT J. BONDI County Executive ' 120BERT MORRIS, PE -� - Director of Environmental Health Michael Sabarre PLEASE RETURN CORRESPONDENCE TO: 42 Sunset Hill Rd. NAME: William Hedges Putnam Valley, NY 10579 TITLE: Senior Public Health Sanitarian PHONE: (845) 278 -6130 Ext. 2168 DATE: .August 6, 2007 OFFICIAL NOTICE OF NON - COMPLIANCE YOU ARE HEREBY NOTIFIED that non - compliance with Article III Section 4 of the Putnam County Sanitary Code consisting of a discharge of sewage on the surface of the ground was found at 42 Sunset Hill Rd. (T) Putnam Valley, TM #62.17 -2 -30 by a representative of this Department on August 3, 2007. It is believed that you are responsible for correction of this condition. If you are not responsible, you are requested to notify immediately the inspector indicated above. Please be advised that appropriate steps must be taken immediately in order that. the sewage overflow cease by arranging for the septic tank to be pumped out and maintained pumped until the proper repairs are made to the system. Approval of proposed repairs must be obtained from this Department prior to any alteration or rebuilding of existing disposal systems. An application is enclosed. Failure to pump the septic tank immediately and further, to correct this condition by September l0, 2007 wi11 make y_ou iarle.fo,t a idiinri?I i�e.'rain�c`nfoivided b }' 1'��', r:;ll:uing YTo-ocution -an a -charge - of committing a violation punishalle by a fine or imprisonment, or both sueh fine and imprisonment, as prescribed by law, in addition to such other actions as may be prescribed. A re- inspection will be made. It is sincerely hoped that the above - mentioned further action will not be necessary and that you will cooperate by securing the correction of this condition. For the Public Health Director Very truly yours, Sherlita Amler, MD Commissioner of Heal By: William Hedges Senior Public Health Sanitarian WH:lm Enc: Permit Application cc: BI(T)Putnam VallU,ironmental Health (845) 278 -6130 Fax (845) 278 -7921 MAB Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 Co plaint Information Log # 298-07-19 Complaint Received 8/1/07 Received By In R6va- i�pers­o�n* d - vi Time Received Assigned TO Hedges, William 1--Complainant (Person Making Complaint) Anonymous FirstMICHAEL Last SABARRA Address 42 SUNSET HILL RD. "o City PUTNAM VALLEY . State Zip Phone 914-844-9799 ;.-Origin/Source of Complaint Origin/Source MICHALE SABARRA Address 42 . SUNSET HILL RD. Phone 914-844-9799 q 1 C40 Location Town of PUTNAM VALLEY Operation Type Complaints not associated with a eHIPS Facility Category A condition, action, activity, place or area that is ann Nature of Complaint Complaint Sewage exposure Status Needs Investigation Is Complaint-General Facility Address Sub-LHU Risk Level No risk assigned Date Resolved Description ActionTaken SEWAGE LEAKING AT BASE OF RETAINING WALL DYE TEST 811/07- 11: OOAM BH AFFECTING NEIGHBORS LOT .4* TM#62.17-2-30 Y,0 bq �,o Seo (4 /I- _Ala' �� /off ,� �'-� �� � J'�.o � �� �r e?� 7 we zF W I"ea'I'l C L 7�7 -t'p Page 1 of 1 Date Printed August 01, 2007 1 TEST PIT DATA 2 DESCRIPTION OF SOILS ENCOUNTERED IN TEST MOLES DEPTH 0.1 NQ: 0.5' 1.0' POWW i7 S4,44 1.5' ��✓ Sir � LOAM 2.0' 2.5' P o 3.0' ✓'a Clr 3.5' 4.0' 4.5' 5.0' 5.51 � 6.0'� 6.5' 7.5' zl• /eo�x_ 8.0' 8.5' a sorb. 9.0' Aa Indicate level at which groundwater is encountered AZO-1 1 Indicate level at which mottling is observed 00566W4,-J9 Indicate level to which water level rises after be' n ountered ItllA Deep hole observations made by: Date /S+O Design Professional Name: Address: Signature: _ X41 71"0. %) OFF Design Professional's Seal pvt�AM VA btF-y Ay I I PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES C1fa. 7L 9�S'.: �7i :uY`.tStiL "' ✓►7Y,►7'i3ilY•1.., OWNER'S NAME in k n k PHONE SITE LOCATION 70 PERSON INTERVIEWED OWN y r 4p= Complaint 5,�,�• -- Name & Relationship (i.e, owner,tenant, etc._ DATE 1-10- S -7 TYPE FACILITY RCS PROPOSED INSTALLER X14 l l-e- �J � Yc pau A-4 % PHONE REGISTRATION # PC10-i 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 r istered architect. J Proposal approved 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 components 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 perfornred in accordance with the above proposal and conditions. I, as owner, or reported agent of owner agree to the above conditions. SIGNATURE 2 g TITLE ��,.. DATE /v - s -7 PM: *!be (PCfD): YeUc w (fin BI); Pink Ug2j ent) . L 'WO s J Proposal approved 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 components 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 perfornred in accordance with the above proposal and conditions. I, as owner, or reported agent of owner agree to the above conditions. SIGNATURE 2 g TITLE ��,.. DATE /v - s -7 PM: *!be (PCfD): YeUc w (fin BI); Pink Ug2j ent) R'n .. ,.. e,. Y.. i?:4�� _r+ u ..�alw na x......v. ui ., .. � ,� �aN-._�- 'c�Mao+ ✓Talc r. r..- V'a a tv.�'i�Yw�i.e�.t'� �.'` - �.. , ut - _ � �. .� .�; � �.: �' c/ _., -:�, �. .. _� �- . , ...a -.- ....._ . �= 'n.,..> a .��... . i..t-...�Y_.... .... r ..�rY. ,� -...0 sr ..r -... «. _ ,.. _- . - ,r': - 'v.r - .a+r � ��..,:.csi+'*� -+. _ p� .. - r• . `4 .. �a� ...a., �av r. � ........ ,.� . _ . _... .. _.. ._ ... �.. .. ,_.. ...._ .. qn � ,,�v.. � .._ ........._, _..._.. .......... ...._ ._..,................... r� .� ... _ ,► Sri � _....._. -� -��_ iii SITE LOCATION OWNER'S MAILING PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES PROMS 'Folk ak;WA►(wll SP(�SAL SAS OFFICIAL USE ONLY / PERSON INTERVIEWED PCHD Complaint # Name & Kelationship i.e., owner, tenant, etc. DATE TYPE FACILITY PROPOSED INSTALLER PHONE ADDRESS REGISTRATION# 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. ,-,'-, e> e,- e -e k , "9 '70 /,,'1 oS! ?, 1-7 -�; 4-.-m. r- .4 2 -eev—, _L_as.owner,,or reported, agent of owner conditions s-fornl: SIGNATURE �d!`"L� ` .�� /�2 /� o � 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 components 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 e. Installers' name and number. 3. System repair to be performed in accordance with the above proposal and conditions. Proposal approved_ J Inspector's Signature & Title COPIES: White (PCHD); Yellow (Town BI); Pink (applicant) PC -RP 99ML