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HomeMy WebLinkAbout0053DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 3.15 -1 -5 BOX 1 ��IOOM T r � ` I. ' ' ♦ r �i IN r ��IOOM P PUTNAM COUN'T'Y HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES /� — c�D '75— OWNER'S NAME - ` PHONE SITE LOCATION AV O i A �t� � k ) J� �diS�'V 6V • � � T1 MAILING ADDRESS G 6 x 4 -7 A1 Vt. S,0 -,-J PERSON INTERVIEWED PCHD Complaint # Name & Relationship (i.e, owner,tenant, etc.) DATE TYPE FACILITY PROPOSED INSTALLER (3- o t ';��. PHONE REGISTRATION # Proposal (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. �.... �� �✓ U� t �r � /sL Doti-, -- t�- •-�-t� � c�S%� -- �' .�° 6/�' �,^•- ' ` . Z11 �.� �� ..•� sue,- �.. --,.�/ Proposal approved Proposal Disapproved Inspector's Signature & Title Date 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 corners). 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, as owner, or reported agent of owner agree to the above conditions. SIGNATURE 14 /✓t U'4 -1-L TITLE IP1 V&be (PO:D); YeUcw 013,n HI); Pink (Pnl amt) DATE `�1Jy' E BRUCE R. FOLEY, R.S. Acting Public Health Director DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 January 27, 1995 Laurie & Joseph Verde North Street Patterson, NY 12563 Re: Addition Verde North Street (T) Patterson Dear Mr. & Mrs. Verde: I have received and reviewed the plans for the proposed addition to the above mentioned residence. The plans have been approved as per plans bearing this Departments stamp and dated January 26, 1995. 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 three without prior approval by this Department. 2. The sewage disposal system must be reconstruced as approved on January 18, 1995 (R- 20 -95). 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 Patterson. If you have any questions, please contact me at your convenience. WH/j p cc: BI (T) Patterson Very truly yours William Hedges Sr. Public Health Sanitarian N 'lEnvlront'-jntal,,Uss. Ith 56rvicet' ii6tbd for orfformanbe 'with .pproved,la-s. - 0 - - -the -.pplicAl-4.ifiile6',and-,Rp,gulatio-nd of :Iutnam ty-He lth Dmapartment....-. ,5-- a I QI WQ � �w ruinam County Department of health Division of Environmental Health SprVicep, -Ipproved ors noted for conformance with tpplicable Rules and Regulations of the utnam County Health D--pax--tmen',,,.., 'i�cne twee TItIn 'J ARI il 0`1�3 ARI il -545r --o C1' �X15TIN� �IW�I.LIN�% C--/ N -OK I, i /000 Gol. CoNC. Sep tic Tank So i .C. • NORTH STRIE�-tT 5505 Kt�rAlK rLAN 1 A�/R /E ¢ JOlEPfi� YERD� L..OGATl!� b AT : Jop) NO: q5GVI I NO2T N !3 -rKMT b�.1ti✓ ', l - l0 -OI5 rAT`>"r--,125o N , N Y // - O.•: : . CONSULTING SITE ENGINEERS hERG z Since 1865 1 FACTORY MAIN OFFICE SHOWROOM 1959 WEST FULTON ST. P. 0. BOX 8689 200 FIFTH AVENUE CHICAGO, IL 60612 COLUMBIA, SC NEW YORK, NY 10010 Received •of 29202 ROOM 1440 THE BEST PRODUCT AND THE BEST SERVICE- - SANDBERG'S SUCCESS FORMULA FOR OVER 120 YEARS PUTNAM COUNTY HEALTH DEPT 0. 14 7 4 Geneva Road (814) 278 - 6130 f �- Breweter,,NY 10508 � 19�� Date k Received •of e,: Sum Dollars $ �� , For THANK YOUR x' 0 Cash Check -J M O ` ❑ Credlt Card B THE BEST PRODUCT AND THE BEST SERVICE- - SANDBERG'S SUCCESS FORMULA FOR OVER 120 YEARS