BOTH-000151-2016 TOWN OF QUEENSBURY
` 742 Bay Road, Queensbury,NY 12804-5904 (518)761-8201
" ~~ Community Development- Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: BOTH-000151-2016 Date Issued: Wednesday, May 30, 2018
This is to certify that work requested to be done as shown by Permit Number BOTH-000 151-2016
has been completed.
Tax Map Number: 266.1-2-6.2
Location: 1720 RIDGE RD
Owner: DANIEL ELLSWORTH
Applicant: Northern Poolscapes
This structure may be occupied as a: Inground pool 25' x 44'
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the lot
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 QUEENSBURY
742 Bay Road,,Queensbury,NY 128114-5904 (518,)761-8201
Community Development-Building& Codes (518)761-82:56
BUILDING DING PERMIT
Permit Number: BOTH-0011.51-2416
Tax Map No: 266.1-2-6.2
Permission is hereby granted to: Northern Poolseapes
For property located at,: 1720 RIDGE 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 tiled and approved and in compliancewith the NYS Uniform
Building Codes and the Queensbury Zoning Ordinance
Type ofConstruction
Owner Name: DANII L ELLSWORTII Swimming Pool $0,00
Owner Address: 1720 Ridge R13 Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name!Address L:Iectrical Inspection Agency
Northern Poolscapes
159 SUNNYSIDE RD,
Queensbury,NY 12804
Plans&Specifications
Inground pool 25'x 44'
$75.00 PERMITFEE PAID-THIS PERMI"I"EXPIRES: Thursday,March 23,2017
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the"Cowat of Queensbury before the ex 'ration d*, arch
Dated at the Town o uaeerasb a 4Mo 28,2016
SIGNED BY: for the Town OfQtreensbury.
Director ol'Building&Cade Enforcement
Town of Queensbury Eatlldirlg & Cads rReceived:
se onlw
SWIMMING POOL PERMIT APPLICATION ID:
A permit must be obtained before beginning construction
Permit No.: b4T)4,-M01�1-
Permit Fee: $ -"D-
Site PlantVariance No.:
1. Date: � .,.� � s
Z Tax Map ID: 2.(ob. 1 -� Z--
3. Pool Location Address: .
4. Zoning Classification:
5. Site Plan Review,Variance or Subdivision Approvals(list)
6. Property Owner: �� �� Phone:
Mailing Address:
City: `° °aw
7. Contractor's Name: as ClyPhone: �� . GSI
.aI
Mailing Address: V
City:
8. Contact Person for Building&Code Compliance; 'r , 4' Phone ��
ABOVE-GROUND OR INGROUND?
SIZE OF POOL:
MANUFACTURER:
MATERIALS USED IN CONSTRUCTION(CHECK ALL THAT APPLY):
Steel/Vinyl. Fiberglass Gunite Poured Concrete Other
E)eclaration. I acknowledge no construction activities shall be commenced prior to issuance of a valid permit. I certify that the application,
plans, and supporting materials are a true and complete stalement/description of the work proposed, that all work will be performed in
accordance with the NY State Building Codes, local building laws and ordinances, and in conformance with local zoning regulations. I
acknowledge that.I have read the application&plot plan requirements and I or my agents will obtain a certificate of occupancy before use
of the pool.
Print Name:
Signature:
Efate �
kamee
Town of Queensbury Building&Codes Swimming Pool Permit
518-761-8256
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TOWN OF OUEENSBURY" "
OWN 01: U BUILDING DEPARTMENT
VEN7
SBUYBased
on our limited examination,compliance
BUILDING' -C��, . �� with our comments,shall not he construed as
•- indicating the plans and s�ecitications are in
Revlelftled � full compliance with the wilding Codes of
Date
New York State.
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RESERVE AREA PROPOSED SEPTIC
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Please.assUre you are familiar with th
P001: I7claure requirements
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wha# iZ�quiPements you will have to
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--UNAUTHORIZED ALTTRATION OR AOL9RON TO A SURVEY - p7 n - _ - - - " .
v MAP BEARING A LICENSED LAND_SURVI.fORS SEAL IS A Plot Plan "made for -
SCaJe 1'-501
V10LATION OF SECTION 7209,SUB-DIVISION 2,OF THE - -
�! NEW YORK STATE EDUCATION LAW. -
-- 'ONLY COPIES FROM THE ORIGINAL OF THIS SURVEY -
_ - - - _ MARKED N11H AN ORIGINAL OF THE 4AND SURVEYORS -_-
_ _ Steve- - - SEAL SHALL BE CONSIDERED TO BE j SIG TRUE COPIES.-
-CERTIFICATIONS
- - - -
'CERTIFlCAl10N5 INDICATED HERE01,SIGNIFY THAT - - _ A�YNE _KELLOGG
_ - THIS SURVEY WAS PREPARED IN ACSL'RDANCE WITH THE - -
_ - - EXISTING CODE OF,PRACTICE FOR WID SURVEYORS ADOPTED _
_ V■^■ rye C BY THE NEW YORK STATE ASSOCIATI;N OF PROFESSIONAL -- - _ _Land S 1i r V C-�J 1J i TOTHEPERSON FOR MAom THE SUD SURVEYORS.SAID flrEYJS SS PREPARED,LL RUN LAND _
SHEE?1 OF.1
- - - _ - - ON HIS BEHALF TO TfIE TITLE COMP/V,F,GOVERNMENTAL- � - _�t - - � - � - - -
- AGENCY AND LENDING jN"STITUITION UITED HEREON,AND - - "Town of Queensbury,_ Warren ;County, New York -
269 Haviland Road Queensbury, "New York 12804 TO THE ASSIGNEES SHE LENDIND,N;TINTI�,.• ttELL000 C-801'
(518) 792-8474 New York Lic. No. 501.35 N0, DATE bESCRIPTlON owc. No. 01024=PERMIT
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