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04771
co P(rrNAM COUNTY HEALTH nEPARrtr i 10
DIVISION OF ENVIRAL HEALTH SERVICES C£
225 -0310 G ti�L 1 N'Y t0G
PROPOSAL FOR S MMM DISPOSAL SYSTEM RRPAIR
OWNERS NAME ell - S �" 1 - 7R PHONE, ft� — 5 —9.7
SITE IACATION 31 7U- 6Wc,,, _Sl-. �akv- _p-ee-ksk fl; A) Y , ICY37 w - io -3-2 -14 `L
'PERSON INTERVIEWED `� PCHD Camplaint #
Name & Rel'ationship (i.e, owner,tenant, etc.) J��
DATE TYPE FACILITYS i Ie �, &Q-
PROPOSED INSTALLER PHONE,JR- ,5-2 -? S'9S"-
(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
kegistered architect.
Proposal approved
Inspector's
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' name.
b. Site - Street Name, Town and Tax'Map number.
c. Location of installed canponents tied to two fixed points (e.g.,house oorners).
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 performed in accordance with the above proposal and conditions.
��I++oppas owner, or repor a aof owner agree to the above conditions.
OWES: Whine (PAD); YeUcw (Tam ED; Pink (Aaliamt)
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DEPARTMENT OF HEALTH
_ Division Of Environmental Health Services
4 Geneva Road, Brewster, New York 10509
(914) 278 -6130
June 4, 1996
Debbie Vittorio
31 Johnson Street
Lake Peekskill, NY 10537
Dear Ms. Vittorio:
BRUCE R. FOLEY, R.S.
Acting Public Health Director
Re: Addition - .
No increase in number of
bedrooms
I have received and reviewed the plans for the proposed addition to the above
The proposal for the addition has been approved as per plans bearing the latest
revision date of June 3, 1996 and this Department's approval stamp.
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
this Department.
2. The area of the existing sewage disposal system, and its expansion area, must
be maintained.
3. All plumbing fixtures must be updated with water saving devices, i.e., new
low flush toilets, restrictors for shower heads and faucets, etc.
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.
S, erely,
Robert Morris, P. E.
Public Health Engineer
RM /jp
cc: BI (T) Putnam Valley
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