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Home My WebLink About3267DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 73. -1 -71 BOX 26 03267 DR T '1 J DID �L T ..i Ty k �'•� ��' I, , ■ I .ti X711 '�T , , 03267 PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES PROPOSAL FOR SEWAGE DISPOSAL SYSTEM REPAIR OFFICIAL USE ONLY A 5 0 J_ LOCATION 3 41D RU,4 W4,&'o i.,, OWNER'S NAME A N 664- MAILING ADDRESS P i T 14 4A TM# 73 r PHONE IfIq 7 T '. 1 i PERSON INTERVIEWED PCHD Complaint #, Name & Relationship i.e., owner, tenant, etc. DATE it 11 I C ''u, PROPOSED INSTALLER ADDRESS A/W 6 G C J� , *Y, TYPE FACILITY PHONE 9'q (0.r?f REGISTRATION# eC- 3 y o sa (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. G�vC u o i 'c SJV�w Cr C-- � - Vc -!'/- !L nt_n__wnei a! re fo the. conditions stated o f i._ SIGNA '� TITLE r DATE 1 I C y 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 comers). 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 Inspector's Signature & Title DATE COPIES: White (PCHD); Yellow (Town BI); Pink (applicant) PC -RP 9%E AR -27 -9 i:53 AM JACK GRUMET 914 528 2072 P.01 5: �hatie (F�D)s 0. Ham. t� t � % Wram COMM MMUH WAttii W c DIVISION OF EWIRONN$31M HEALTH SERVICC'S PRQPOGAL Fit gM DISPOSAL SYS'ii' MM REPAIR DNW'S NAND G� �,tOV� PIKE Sa QU SITE LOCATION Li « \: ��.; �\ \ %�•a �i �3� " �} i MAILING ADDRESS 4e>rit 3� &,n o- PNCM IRM11319) M Ocuplaint 1 Name & Relationship R.e, awner,t,enant, etc.) DATE 'S � IL 6 TYPE FACILITY PROPOSED INSTALLER ..cl'� Ca`VwA,� '." Gul� ;C�`�► ram REGISTRATION # mmeal sketch locating all adjacent wells): ND►i'E: 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:�," �,. � � �/ � '' �* � ,• • •� ti � r �� eta �; IN Proposal appr .ed ..w Inspector's Signature 6 Title Proposal approved with the following conditions: `I. Procurement of any Town permit' it app icabLe. 2. Submission of as built repair sketch in duplicate showing: a. Owner,' 6 1 ow, 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' dim. x 6' deep &Iwel.ls 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. it os cxmer elpoxted anent of owner agree to the above conditions. sICNA'IURE TT= Cwtcr DaTE 1. �(, 1W 1W ('M HE); Pink (Palio W 9 MAR -27 -97 06:55 AM JACK GRUMET 914 528 2072 P.01 1 F� 0 f DEPARTMENT OF HEALTH Division Of Environmental Health Services Geneva Road, Brewster, New York 10509 (914) 278 -6130 July 1, 1992. Jack Grumet 405 Peekskill Hollow Road Putnam Valley, NY 10579 Re: Proposed addition — Grumet 405 Peekskill Hollow Road (T) Putnam Valley Dear Mr. Grumet: r JOHN KARELL Jr., P.E.; M.S. Public Health Director I have received and reviewed the plans for the proposed addition to the above mentioned residence. The plans indicate that the existing porch area (7' 3" x 14' 3 ") will become part of the living area. The survey - indicates that sufficient area exists to expand or repair the sewage disposal system, should it become necessary in the future. Therefore, based on the information submitted, the above mentioned addition is approved with the following conditions: 1. The total number of..bedrooms must remain at two without.prior approval by.. '1.1•a:i'O Lam: �JCir v /"CITY. - 2. The area of the existing sewage disposal system, and its expansion area, must be maintained. 3. All plumbing fixtures must be replaced or updated with water saving devices, i.e., low flush toilets, restrictors for shower heads and faucets, etc. Approval is granted for sewage disposal only. Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Putnam Valley. If you have any questions, please contact me at your convenience. 7r truly yours, ,1 hLti% Alto Robert Morris Assistant Public Health Engineer RM/jp cc: BI (T) PUtnam Valley 'k Y i4 RL�- lyi,61SO 251YEA.i -' fleg- Z-1u7Ee1v,< Di1-fHA -A5 10pus ,%UAJE ice. /9 91Z V� is • ,i Igo 6 s /«C,H E N �} 4 �3 M ASTER, I3 - �.1U /ti6 �t�f2U0`j fdRGR { .2sl3 li Y j 6 Como. CLOZ r o ,t GUEST '71,311 FO R {PoPGH AQEA C6TlAGE - X05 l��t��CiLL /4/v�LOly /�oi5'�D. .iRG.� GkWer T(�9�g/� S�k _m00% DEPARTMENT OF HEALTH Division Of' Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 March 26, 1993 Jack Grumet 405A Peekskill Hollow Road Putnam Valley, NY 10579 r JOHN KARELL Jr., P.E., M.S. Hee!th- 4iie�tpr _ Re: Renovation 405A Peekskill Hollow Road (T) Putnam Valley Dear Mr. Grumet: Review of the plan submitted indicates that no additional living space or bedrooms are proposed. Therefore, based on the above information this Department has no objection.to the proposed renovat.ion.of the existing 15.75 x 19..75 building. If you have any questions please contact me. VerX, truly yours, Robert Morris Assistant Public Health Engineer RM/jp DEPARTMENT OF HEALTH Division Of Environmental Health Services Geneva R77��97 er,� New k 10509 278 -613 0 JOHN KARELL Jr., P.E., M.S. Public Health Director i r l CJrr1 �'7— Dear Your applica ion has been eceived by this department on The applicatio ered incomplete and the following items must be submitted. (-Fee should be paid by Certified Check or Money Order only. Fee is not enclosed or incorrect amount. Fee due is: ( ) New Tax Map designation should be provided. ( ) Other: If you have any questions, please contact Robert Morris, ext. 166 or William Hedges, ext. 168 of this office. Thank you for your cooperation. Very truly yours, Christine Johnson Intermediate Clerk � mac. W ��tra'^C,riZNti. � i f r... s • r`lY 4� �.'YP�a�nvOtasasFY �."�4Y.+ti +� i iY.� L -.0 � .r� \ ^��+C'4AA VN.. :1LA ^r.'� � @t" af.v 6..t s.. "C%•"RS..rM_•Ti � _"7 ' +�2. . ,��.1� Jx.r,;s; � � �' ��, , � � �o . �- -- �� __ :f a� 0�- � �, � � �� ,� � a,� � � �� 1 `J' 6PUM 52 ri - 2 0 72 /119 li 71 /4o,S& -PraF—K.SKILJ-- �K> — (5R161NAL-- -P/,Ats.� 6Rvlvaa-r S29-2-o-72 11 I L Ll .........................c�" FEN I sr�RO/ti , FORMERL Y t%v � -- � - • -Vj l ` ..GNARL • J n FL-OX�F/VCE Q � II ti 'TG�PK /NS G : R F08 MERAP. /a .._.. .4RB. I '� CC. e I . yz i � NJ/gAQIKO K/YOP�/4v�A t, II III •5 �i�2. �� 2s1�901 ;'. Npry OR C PG.30,3 /.', ., � %. 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