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HomeMy WebLinkAbout3024DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 62.18-1-33 BOX 25 moll F4ull Igo k i i 061 1 1 r • XLl. � 9 , 03024 a OWNED SITE MATT; PEM FIT-IN W ..,• •. D1 so 1 � 0+' • t .!a Y Proposal (include sketch locating all adjacent wells): NOTE: Repair must be in same location and of same type a original sewage disposal system. Different location may require submittal of proposal from licensed professional engineer or registered architect. 4:= Gc or -e c' vii.• -=, Coe � v �, /iZ /z° dL � �i �`-� . �.�-�- o�J�/ � / ,ro. --•-. �/J i--cy �nossd �, Proposal approved -- Inspector's Signa Proposal Disapproved Dath 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 canponents 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 7j: a orted agent o v agreeato the above conditions SIGNAT TITLE DATE / 'PISS: White (PAD); YeUc w (fin ffi); Pink Lk#j®nt) O T o � � \ � I � \ ,• pmr��0�l� t9uag --3. 450 m . �,' sr at - 252.86 ,- \ 1.84. Al I 88.8 �. 19 I ji '� B.8B�•' .. h I � � •�li,r.1 \ f2 '•sroRr. t: ill; �� 1 - I P 14&1 ez at k3 $ r l A R EA =/ 9 �284 S. F. i a /V.45 °05'W -comc. 210.00 WILL fl` PR£M /SES SHOWN HEREON BFIN6 Of tv: w r OF i- O r 6 SHOWN, G.V A CERTAIN 4AUREL, W000 MANOR, AROPE'Rr W /7W ME NINIaLlAW ,SrdNDARDS OF THE• `' �N� BljR,p fi HADD£N" F!LCO /H rHr PUYMA ' A330C/Ar/O.v Os Fs�G' irsiolo#A L L AND � y SEP r£/}l2E" R 23, 1917 AS MAP A- ?UrLlBE'D /l,/ 7'NE /R '•COD, OF MACr /CE' a`� 9 � o POGFrHfR WI M OTHER LANDS l V'Y.I '* ti4 5g69 M/N LAM6 5 J/ C C ivC rS A -'LOS' SR,40f, lea ANY, Wr SA'i W1. N/:1��'tO.9+• A NO, L. S. PD., AlO.VrROS &_, fi, V. �Uollll SURVEY OF PR0A S/TUA TE IN OF PUTNA PUTNA ,V c0uA.' - L o r �l 4d !�t k's 0 r a a ° d w t AR£A = 191,2 84 S. F. N.45005'6;'• 4 m - -- •- .,� `.. /� /fig •JTOI�Y,.,t; 11 xso r � r 6 CONC. If IL L � p¢ NFW oAt ` rp 1l M THE VINI.Vi/ SMODARDS OF rHE �Nl BU,�p, t t 7 A530CIAr /ON Ots FWV SOVO#VA L L AND G -2 U7 #E'D /Al rHV4 'CODE OF PRAMC£ a'� 1 o y2 � VE Y.1 /� cl . 5 �b9 ?C 210. 00 — f PREMISES SHOWN HERFON BE'INC' OF t O r 6 SHO WN CN A CERTA IN LAURS.L. WOOD MANOR, PROP£Rr HADC'.W FLED IN rHE PUrN f SE-P rFMt FR 25" 1-017 AS d/A,0 6 rOGETHER WITH OTHER LANDS t -5 2• - Z. - ?.`, t� LAND ��� r� />� JL EE ,(l� SURVEY OF PROP, 0 T 4 a S/ T U A T E IN U M1017 OR4 "0 /iz A rJY, R.°11T shlou'a. Nr:REO.Y. I 'i TOWN O i . -5. 45"O F- �,�a + _p 252.86 ,- 3.74 � �i ►� � _ ! ji I Iii +��I ��, - L o r �l 4d !�t k's 0 r a a ° d w t AR£A = 191,2 84 S. F. N.45005'6;'• 4 m - -- •- .,� `.. /� /fig •JTOI�Y,.,t; 11 xso r � r 6 CONC. If IL L � p¢ NFW oAt ` rp 1l M THE VINI.Vi/ SMODARDS OF rHE �Nl BU,�p, t t 7 A530CIAr /ON Ots FWV SOVO#VA L L AND G -2 U7 #E'D /Al rHV4 'CODE OF PRAMC£ a'� 1 o y2 � VE Y.1 /� cl . 5 �b9 ?C 210. 00 — f PREMISES SHOWN HERFON BE'INC' OF t O r 6 SHO WN CN A CERTA IN LAURS.L. WOOD MANOR, PROP£Rr HADC'.W FLED IN rHE PUrN f SE-P rFMt FR 25" 1-017 AS d/A,0 6 rOGETHER WITH OTHER LANDS t -5 2• - Z. - ?.`, t� LAND ��� r� />� JL EE ,(l� SURVEY OF PROP, S/ T U A T E IN U M1017 OR4 "0 /iz A rJY, R.°11T shlou'a. Nr:REO.Y. TOWN O ANO, L. S. P.!:., /joivrRO34,, V. Y. P U T N A .S! C 0L/A 0 .0 .9 x c S, t A� PREM /SES SHOWN HEREON BEINC1, Of NEW y p or L O T G smo wN ON A CERm IN �p ,p lAvREL. WOOD Am NOR, PROPaRi wI ?d rw aINImum sr.4AIDARDS Of rME `' N,t BUR � MADDEN " F1 L ED IN rmLr Purr r ASSOC/Ar /ON OF PROFESSIONAL LAND ��` RG SEPiERlt'R 25. /9/7° AS YA"L- ,2 0rLINE�D IN YNE' /R "CODE OF PRAMCE ��� 90 YOGE W-ft W17H OTHER. LANDS •o 4'G. 4 5 669 A NO, L. S. ��., '� ®� �� ®'��, �'' �` • P U T N A M C O l/ N [AND S11ay�l / � � C t A SURVEY OF PROPi s.G c.1 7•S� e - `\ I 1 S /%UA TE IN Y.S MLOGY GRADE, /P AND', AM S/IO16t OfJERJON. rOWN OF PU;rNA A NO, L. S. ��., '� ®� �� ®'��, �'' �` • P U T N A M C O l/ N 01ANE SITE MAIL I PERSON INTERVIEWED PaD Complaint # Name & Relationshio (i.e, own&'l-bihant, etc DATE TYPE iZiLITY A PROPOSED MMLER PHONE Proposal (include sketch locating all adjacent wells): Nam: 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. 'PPII-Cable and cc ` Proposa�lapproved 4tnam County Je-alti, A Inspector's Signature & Tit16t-"-;, til wigmed DatA 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 I 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.811250 gal. concrete septic tank,, three precast 61 diam..x.61 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.. SIGNATURE TITLE DATE % �, /`� / FRS: Vbite MUD); YeUcw (fi41 BI); Pink (Appliamt) 74 S1, 'PPII-Cable and cc ` Proposa�lapproved 4tnam County Je-alti, A Inspector's Signature & Tit16t-"-;, til wigmed DatA 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 I 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.811250 gal. concrete septic tank,, three precast 61 diam..x.61 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.. SIGNATURE TITLE DATE % �, /`� / FRS: Vbite MUD); YeUcw (fi41 BI); Pink (Appliamt) 7 b� 1 4 M �1 �G A� ! ruznam UDUnW Department or Ae8,tn JIVIs .on of En l�onraental Y51tk Bervices �` _.._....._ . "s noted for conformance with U-13 4 1 ypplicable Rules and Regulations of the : , 6 'utnam CountX_Health Department.• „ � -4° wl r,v rmE Q9 /N /mv& .SrAmPAROS OF THE E AS SOC/AE/OM Of PROFESSIONAL LAND 06/ ME'D /N TNEIR ' °CODE'' OF RRAMCE q VEYS2 " Y�Y1 Sa •-�, - a o 1��� OF NEW j'0 S G�'N� 8 URRG fi i '4 rthst`' y LA90 Sua/ 'S MLOV ®R4AE, /F .4NY, wT Show& MEMO#. 4 NO, L. S. RA, MoNTRosf, N. Y• A n PREMISES .SHOWN HEREOF OE/N6 or .,L O P 6 SHO W N ON A C E•RTA /N LAUREL. WOOD MANOR, PROPERT WADDEN f /LED IN rmE' Purr SE•PiEMtER 23. 1917 AS mAP 34 MgErHCR E9I M OMER LANDS SURVEY OF PRPPi S/ iU A iE /N TOWN OF P PUTMA M CODA/