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BOTH-000247-2016 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 at Community Development-Building& Codes (518)761-8256 CERTIFICATE OF COMPLIANCE Permit Number: BOTH-000247-2016 Date Issued: Friday, April 29, 2016 This is to certify that work requested to be done as shown by Permit Number BOTH-000247-2016 has been completed. Tax Map Number: 300.4-33 Location: 342 CLENDON BROOK RD Owner: John Merry Applicant: IBS Septic This structure may be occupied as a: Residential Septic Alteration By Order of Town Board TOWN ^OF QUEENSj BURY 4 ok-- Issuance of this Certificate of Compliance DOES NOT relieve the ` / )property owner of the responsibility for compliance with Site Plan, Variance,or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement Planning Board or Zoning Board of Appeals. TOWN OF QUEENSBURNir 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development - Building & Codes (S 18) 761-1256 BUILDING PERMIT Permit Number: BOTH-000247-2016 Tax Map No: 300.-1-33 Permission is hereby granted to: IBS Septic For property located at: 342 CLENDON BROOK RD In the Town of Queensbury,to construct or place at the above location in accordance with application together with plot plans and other information hereto riled and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Toning Ordinance Tae of Construction Owner Name: John Merry Septic Disposal $0.00 Owner-Address: 342 Clendon Brook RD Total Value 50.00 Queensbury,NY 12804 Contractor or Builder's Name l address Electrical Inspection Agency IBS Septic 2 WARREN ST Glens falls,NY 12801 Pians& Specifications Residential Septic Alteration $ 40.00 PERMIT FEE PAID •THIS PERMIT EXPIRES: Monday, April 24, 2017 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer ofthe Town of Queensbury before the expiration date,) Dated at the Towxa717- 2016 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement u CorrmllurtRy Development Office Town Of QU ns# ury 742 Bay Road - Queensbury, New `fol office Use Only .b..... k TAX MAP NO. N 0 PERMIT NPPERMIT EEE APPROVALS: ZONING TOWN CLERK APPLICA 77ON FOR SEPTIC DISPOSAL SYSTEM E T: A PERMIT MUST SE 013TAINED -— BEGINS.APPLICATION IS SUBJECT INSTALLER: FOR ISSUANCE f CSE A VALID PERMIT. d BEFORE �� ADDRESS: � � r � , � AI�IJ'RESS. PHONE NOS. y PHONE NOS_ 1kd LOCATION OF INSTALLATION: `lr� � � �`" k '" � RESIDENCE INFORMATION: YEAR BUILT X PUTA-n0N _ TOTAL DAILY FLOW BEDROOMS (Gallons,Mr bedroom), GARBAGE GRI 1'98©or older x 1517 = INSTALLED? 1951-19'91 x 13th � SPA OR HOT TU 1992-present x 110 INSTALLED? � PARCEL INFORMAMN: Tf3PCiCFwAPHY: FLAT I2C1LLl STEEP SLt PE °�'-SLO SOIL NATg1RF: SAIV'Di_ LOAM CLAY OTHER . V GIZOUNFDWWATEFt AT WHAT DEPTH? ,r' BEDRCDCI{nMPERVI9' S TERIAL- AT WHAT DEPTH? DOMESTIC WATER SLIPLY: MUNICIPAL WELL %4(1fw—ell.water supply from any septic system absorption is ~+ ft PERCOLATION TEST. RATE IS PER MIINUTE PER INCH(trrpi) (Test to be completed by a licensed professional' engineer or architect) PROPOSED SYSTEM FOR NEW CONSTRUCTION: All Individual sewage disposal systems must be designed by a licensed professional engineer or architect(unlessinstalled in a Planning Board approved''subdivision). �00TAMC SIZE.. GALLON MIN.SIZE IS 1.000 GAL.)Add 250 gallons to the size of the septic tank for each garbage grinder, spa or whirlpool tub- � o SYSTEM TYPE: / i i t3 ABSORPTION FIELD('WITH NO.2 STONE) Total lengt ft. Each tree h x 0 SEEPAGE PITS)(WITH NO.S STONE) How many? Size? D ALTERNATIVE SYSTEM Bed or other type? w HOLDING TANK SYSTEM Total required capacity? LUA—Tank size? Number of tanks? NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL'WORK MUST BE INSPECTED BY A TOWN,APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED. For your protection,please note that pursuant to Section 1.35-29 of the Code of the Town of Queensbury,any permit or approval granted which is based upon or is granted in reliance upon any material misrepresentation or failure to make a material fact or circumstance known by or on behalf of an applicant,shall be void. I have read the regulations with respect to this application and agree to abide by these a d all requirements of the Town of Queensbury QUESTIONS a CALL 761-8256 OR EMAIL San ry S ' Desai Ordinance. 1v 0 sIT OUR WEBslur�ensi�urv.net 1 TE FOR MORE INFORMA'nON Sia�raatu mson Responsible Datevww�ryw.oueensbury.net c: k 1 n t t d n a 1� g.i RR 2 7 2016 � err 1 ten,, ' °' r� r �.�uRY _ ! f- r � , pp NO �h TOWN,OF QU " "IN _ BUILDING QD - Reviewed By. Daae C)C 300-1-33 BOTH-000247-21016 Herat, John 342 Clcndon Brook Rd. ':._ _ Residential septic Alteration _