HomeMy WebLinkAbout4060DOCUMENT CONVERSION SERVICES PROVIDED BY
IMAGING & MICROFILM ACCESS, INC.
www.scanyourdocs.com
631- 589 -8100
83.66 -2 -69
BOX 31
1�1./
!7
., r
,
,
f
,T
S
k4J6
1�1./
SITE
MATT.]
PERS(
C
1
i,�-7.7
Name & Relationship (i.e, owner tenant, etc.)
DATE A0 —132 � • TYPE FACILITY .-b w,
QA
PROPOSED INSTALLER O PHONE 9YYl 15
a
. a
Pr " sal (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
regi tered architect.
9Q oSo i-I \Je_ dy �1'�s �-- c� F 11 -18 -8 "1 1 S'O &C*1,
�n
per .
rhnnenci�.�►'��s � C�,iQ�In►.n�E �ros..1 e�ldsoc;
V%'-Ws, o n'0 1`5 i n
r
NY, rim' �G- h.ifes
Proposal
Inspector's
Proposal Disapproved
�.S
& Ti
i
Date
vim/ Cb
P. r . �I
Proposal approved with the following condition�-
��
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).
I 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 namme and number.
3. System repair to be performed in accordance with the above proposal and conditions.
I. as owner, r reporter of owner agree to the above conditions.
a A...J•+- y'.:�e: u • u�.y•.ane•„..a...:�il' ^.._- .'� .e'..w•.•..''':'::..•�..u,.,. . 4..s.P+...',.
_S2d14&UAE - - - TITLE O W if1Q,r DATE
JYM :. Vbite (PQD); YeUcw (Tam ED; Pink (Aaliamt)
1
n
SITE
11A
PERSON INTERVIEWMD `--/ PCHD Complaint #
Name & Relationship (i.e, owner,tenant, etc.)
DATE . $- I - $ TYPE FACILITY D w e- RJ 6 -
PROPOSED INSTALLER Igo //a tv 6Aa () K eo `v S �k 14 C 4 r v A.) PHONE 9 / y- .zb - as a ;R
Proposal (include sketch locating all adjacent wells): \
NM: Repair must be in same location and of same type as original sewage disposal system.
Different location may require submittal of proposal fret► licensed professional engineer or
register architect.
V .n ) n _ r e- e)C S - i PJ G- Se aJ +1 C, 40. k i. K /,z t f'� JU
Proposal. approved
Inspector
4
S
A"4
'7 C/ 4
// r J
f%/ 'N �'4
Proposal Disapproved
Date
Pro sal 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 natrle o
b. Site Street. Name, Town and Tax Map.number.
co Location of installed cmiponents tied to two fixed points ('e.g.,house corners).
d. System description.(e.g., 1250 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.
IMPH& VMte MED)i YeUcw (Tam HO; Pink Vgaiawt)
L�.... n_I
V, ��
PUTNAM COUNTY DEPARTMENT OF HEALTH NO-- 322- 7
r.
.CQ MPLAINT.. OR SERVIQE RE EST RECORD
.
.
TOWN PHILIPSTOWN DATE 6/4/87 REFERRED TO
TAKEN BY C.G. TELEPHONE CALL XX
IN PERSON LETTER
CONFIDENTIAL
REQUEST FROM HARBLIN TELEPHONE 528 -8961
ADDRESS ARGULA STREET, LK PEEKSKILL
ENVIRONMENTAL HEALTH: Home Sewage Rodents' Refuse Public Water Food Service
Migrant Camp other 38
COMPLAINT OR REQUEST NEIGHBOR, ROUNDS ON LAKE DRIVE, 528-7022,
TN,qTAT,T,PD qFPTTC SYSTEM TOO CLOSE TO HER WELL AND PROPERTY LINE.
ACTION TAKEN BY C(a DATE :Z
FINDINGS_ Ul-e� 1.()VN ale- AD CAA�_
M— TUM, & *1 WAr 0 5% F
cl��� MIff- 04A:75tlo,_��
As.
FOLWW UP :(NSPECTIOIA (s)
DATE '- /
FINDINGS
e -7 zo-
rl
DATE
FINDINGS- ,-,
---I P7
_17
PROBLEM ABATED
DATE PERSON NOTIFIED
ESTIMATED TOTAL MAN HOURS SPENT.
L
t
j:•
X0:6 0 C.
uc-
� a 1
5. v
j
.4{
r Y
.a
.L
.;L
a f,!
4.:
t.
rl
J
/, V, o'er
]v1nlc4ioa
i
'6
L I
{
j y(o C-C.
I
JJi
W 6 1
li � ai,.�� �YjA �` �l°sfaktf `,._�y.g 3 -. �. a. :r•(. .`�:
fW
x A!� ;r` y, ar,tr 7��F�` � ntact , c + `� � '•
i T . -3. A ` S 1 `Ti..r';t �YYi.14v FtL 4rj�A fi b•S� ;?` e f ., r �.. ,
'. �'4 so s Yu� a
1 jY t) Y f ( f Y
.. ; l P t } ... -, .::�`l •`4*' `z' S 3�.& ° � P } t'�'LF �� Y �� ��} � y r 1
COO
0 � t
�j,•'r,^ ° r3t i+►- N`j1`�' .eFiE �st3i ra ;}ht tits - xx rs#r u W
1 i L A t
F 9'4✓ V k F Yr s3f1. J`/f� i.i .K.!. � 1n�.,i �\ -� #,_
; .• 1 i t��'ib .�,yn1.. fj��111r1• - f` ,r` a
t �, �: :hs f"'"K ¢ hTM >V"'u�Y- 1 -•� FkSk�i � t." � :. � �. r'J. l� '7Vp, z iF r. RS �'
a ,y�
''1 � ti7 rz � aax,��i�����E�� v Y,y'�r°�a c i��. -. fff '`. � � �• i`a 1 t� � > �YT't)- t�,z"�r�7�•i' : t� c
qC' 1.Y�l���r� �n
p�yr �I ` J��•1 - -; 7*t.�z+•Ca ,' q �txt �Pu•1'` >i �Yyt «t +`', }s,.R� Y� 7n5i.; t� '# r�}'s�'L.A"..
La'F¢CC
ON
., ' i.. .. � £ £ r : l:,c s"`¢y� , - +zF �.' .,,' �"°F Y , s +F `�• �tR `' � `1Ps
TOW 14 ®r i.W AM V+ALLZY % 3 �, ��, j x F t
r•.
` 1 V V SL .c,/�_��x Y fI,�
7� fit(
,, e r ,.`r .. 't+�`,.'t,? 6 t ,.. p..• s 1 ' t + .. t "; t .� ...s'M .. s : V
U -tiwA. -x"• +;.., .. xf k�'". }*. �,,ivapS4'• a. K`.;,:•-
r 2. _ . t {+ 1 T S• �' ��`'''rh . a r ) Yy { h r
:�sa .,iR; 1 e'sk•Y!x;�.'� '�A��.:; r ..t. s � :�.<
x f r �1 :f'; h C} t� :. rt� ,�.h_ x � �±Y^•r ? 04'�'�`��'"i e � � r. 4 3 g aiiaCy Ss.
_ s.; _ .,i, rr � / !, x �, dr, rr �i:'�'� ,y #�ati'a t��� R�Ttli�; �'31s..v F� %s Ev ��- `�a-�V`�j#� � x''x'k"t•%a. atF� E^ 7 �`_ _�{ A..;byY,
}�r�t Y
0 _ r + 1 oils
4)Y` t ri i'�,Y4 } }ti c., t {s+ 4� F xRr.`'4 a Pl'i ,.• C .f tr`",i rl' :, K € za °'Y' l'+
S its
, �d}7
Ir 4 ��' •p, : � t Y ?� r� trtr � t `� t� � i yq } °4 T 4 s ! #� �+ W '.
s• �y t I F9 r 'a � `t � � r�4; �isE
' .,�;.. ;! r a ul. yy, ° s z Y •'rti'Y" Y s tictt �` ,}C 2,9••q �' t'
?s,
't rf�i'1r ; F�t7 ��. i t S �rrt..�,y: r ��e *hs.
(. '.. r y ¢��,�.pRk�f�tW i irf}},+r \ �V? 4< Pa:.
,r W F , itn �i�°'.�`T t�' l }'' MASK I \f: L "t" �•4 4 IN ;t
r�d? yr�rr9t r g}^Cs, sits: v xs;
S��S�l�t
1 r ( , 9 --!r '� `B"'•' ; .•' l ,}. s.r S' k f r4i rFf , bi j.'„': � m. ?.�k:f Y> �fr " `r�}S "[k� s, f Y �'Srr T t },tx'+rityr' S y t� d , i P> trf . - X-� 4 ySI�' _ its �I,
�i i � y ;'i;,;, . it �� , � ,{I?fF; . kttt � $ d 'iWIsrn._ssb ` K . E"; T '' r *i ` # T°' , �' t '3as s , s ; , . '� .• ;<M � s� .w , ark"r^ri i 7 t ' tE•.f4 ', a ' , �.fih, {F'}x . . t �• "�gs " . .i �' 4•3s N . '`.¢ i' x x3 �4 t yi' of 3 ` l� �s,7 j 6 ��:�5 '� ,f
%4" P",
,
.+i
'?rt'4
�' 1 v..:.. W'� `.,� � 1�,� /. I ,.. - ...•.: T"�r�'�z. t � � �'c �'r �F t � ?• fit.`'
'9c t•'. b i �, X_'� t' �, r '7�° 5 b �y�.�.v ,�'k. •}S'tl6 r., l -ss t l:fr$ ty
r>a Yr {.i4 Et11 - acs F s ?j .r t. +•,�'�'kT 6 c.[ t
�M EOTsN(� fti ;, s t. �' 1 } �n a ",c ra ", - - ;�» Si i4 r-�. 5�'sI a - 4�
1, x x >
Sd- j
V� w,� `�, S a SLkJ 3m S; t:Y P41yh X41 f 3Syt t
;u j
V fig y�* -? law t I t s f 3
1
weak
y Bir -
.:.1
r
1
:�] I
.S
iw
10
F WQAI
--``-- ax Gri"
�f9 �
Iw
I= b E
7 (�S�r+rAST
as. s s
1
1
Pi(J�E f�f'a�
-�gtd3
c�
j' i
`b
a.�
r•