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HomeMy WebLinkAbout4468DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 84.15 -1 -24 BOX 34 rem WO PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES L4Z� REPAI � +i- -.. "7' _ r.. _ .Y�u7 -� �..X '- �.. - - if. .: -i: r.lc�'L5•aJr�a��.�7�.:Ql�I��C :�!C.. �.��r'dd�-47. •. '� /. Dy n; ❑ Wepair Permit issued in last 5 years ❑ of in Watershed , ❑ Repair within Boyd's Corners, W. Branch or Croton Falls Res. Z Delegated ❑ Repair within 200 ft. of a watercourse or DEC - mapped wetland ❑ Joint Review SITE LOCATION is Wl /(�(. d TOWN OV TM # OWNER'S NAME ©'*He PHONE # MAILING ADDRESS 4 a. a ILL S d" APPLICANT S r. ma s ( --�Lpt j-� Ie, Name & Relationship (i.e., owner, tenant, contractor) DATE FACILITY TYPE PCHD COMPLAINT # / [1 PROPOSED INSTALLER AST PHONE # ADDRESS ( ly,�c, ► (%Q,�% REGISTRATION /LICENSE # ZZ 3 "Z .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. n I, as owner',agree the conditions stated on this form SIGNATURE ITLE N�Q� DATE S// t. l o (owner) I, the septic installer, agree to comply with the conditions of this permit for the septic system repair _ ._.._....:.. . SIGNATL =FF1., (installer) r 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 backfilled until authorization to do so has been obtained from the Department. Proposal Approved Inspector's Signature is in comDliance with a INTERNAL USE ONLY Proposal Denied codes D afe Yes Expiration Date / O No Ca' COPIES: PCHD; Owner; Installer PC -RP 99ML Rev. 2/07 GUALTIERI CONSTRUCTION CORPORATION a. o � CAV I��'. �.. °we,�p,'�'��•�,��'S T = :I)$�1�E As Built PHONE: 845- 528 -0280 NAME : Kurt & Barbara O Hare Date: 3/18/10 STREET: 42 Mill Street LICENSE #1137 TOWN Putnam Valley N.Y. 10 Permit # R- 032 -10 Job: Replace existing metal tank with 1250 Ga11on P.V.C. Tank A 1 B 1 19� A2 30' B 2 2,�, h/ r ^- 34 Columbus Ave Putnam Valley NY, 10579 -Fax 854 - 528 -8175 Cell Phone 914 -760 -6344 F & H Construction Robert Farley Box 436 RR #1 Arlington, VT 05250 Dear Mr. Farley: DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 December 10, 1991 JOHN KARELL Jr., P.E., M.S. Public Health Director . Re: Proposed addition - Kurt & Barbara O'Hare Mill Street (T) Putnam Valley I have received and reviewed the plans for the proposed addition to the above mentioned residence. The plans indicate that.a two story 26' x24' addition will be added consisting of a family room, mud room and den on the first floor and a bedroom, bath and closed on the second floor. Two smaller bedrooms will be combined so that the total number of bedrooms will remain at four. 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 four without prior approval by this Department.:_ " ~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. Very trulyyours, William Hedges Sr. Public Health Sanitarian WH /jp cc: BI (T) Putnam Valley I . tY(8P disbeP 3/p 69' aooPpc�stbr /y dMdPron / /n� bNaomn loads ®P end, MMAN "o* Am000loof ® ooulaar /r Alto 00 Alf /I. !°lilac ;• R L . im, Paz of dsee�. CO .. , �,r - . c: _.,. ,.. •;; r � � ,� ,;moo: .�: °J Y J momi OW&WARM mm� 1� �p AP grdY9/ • Owed '" a w�a � o/d wH -tried W@J /\ 92 / Moprox. f \� . � overload >a� /rss fi �. m S/IFp I' b b d 07 647 psi (9 wire fdnce rt H L.... pp /o � - overhead -/l/ 57'004'40 "W. flow or /eorme'll J s grovel p orb rna ao� i �v 'l Oct, 90 /9ei a ram - • po% 251. lye 5 4- 4 0/N ' E. RAXiER a s�sSO�: ti �� NSW ���� E. eq� U�• accardvgeeo w1 1h the B.ciss� n� Code, /'Prot /ice for La 4d Sv� s s UPYepOt'S O/fd! Planners � �o � � y jp .4 odopled by the Now Yor/ Slvie Assoc /ot /an of profess /ono/ Load Surveyors. dR�� /�B8 Und9ryroand dosemonls, 8lruetvres anv /or arneroochM&,?tS, Al °y1 � ase'� b 4� Bt,+y, na /shown. ��sFo a AND S� LIN. #0 6D,d94 ' _ —. ._.. .__. __.. ... .... �.�� �n.��i I Ilulvc Ivu. O✓J� JfJ 7C17k'! •ly •� Iec `4 `q V lil i� o� AREA=/2 45 Easterly, sovriser /y 0447 westery auunoo.ics> vivny "Ss/dia"sh~ hereon Are as recited in 1...351, P. B2 a / deeds; Rood line shown hdroon is as set forth in 4.246, P 205 of deeds. SURt/�"'Y 'OF PI'QPERTY —s/ TUA TE• IN--- / OWN OF PUTNAAf PUTNAM COUNTY, N. Y. • SCALE: / "� 40' .Pra o oral far PAW -ho E. a MARY It ,yr•e n r rbr FROM F&H.CONSTRUCTION INC. RTFARLEY PHONE NO. 802 375 9050 pol z 7 q 4 2Q- L r u c t o n F. Arl H. Coi P u L nnal V i.4 I I , N- Y. D (-: - i r: r . I I o -I--.j o '-, , F () b e r h 'J.'. r a r I F;., y Box 4:16 ArlirvIton, Vt. fiG4,*e'-'375-9o:� '/37r, 0 Vc-- f iml inforinvtion too oro.;;_rt of r t i ca r c 1Ur.,1tNA wi Mill "trc�L in Ful,na•yi Vallov P-'(-"q Yorl,. Yno ra n fi,-, cm by t (i r-, f 1 u,) r 1 n L-h,j L w,*2 a r 'L CLlft- _rltly in (-'hc;ir !lo.:iv, T- i, i r v-! i I J !)Q on.-, i t i ("I I two of the Pxi,.L I I h-a -'ralo into cmc i:; ...; cc)'P'l lu)'O ttlQl 00,;! 011 fil-`.. With th.-.- ►ow!; 0 -rl f i I ha vi_ e.1 r -a wn i v I t h -Z) aiz-)�)rox-i'n -..I Er I loc'a I.. i ors:a of thu r e) r i-, iio hi] i t7 r h.n c: :l 1,-> c:-.i L i on r-. 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