BOTH-000300-2016 TOWN OF QUERN BURY
742 Bay Road,Queensbury,NY 12804-590'4 (5 18)761-8201
iCommunity Development - Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number. BOTH-000300-20116
Tax Map No: 308.8-2-38
Permission is hereby granted to: Islander Pools
For property located at: 28 LEO ST
In the'Town of Queensbury,to construct or place at the above location in accordance with application together
with plat plans and other information hereto filed and approved and in compliance with the NYS Uniform
Building Codes and the Queensbury Zoning Ordinance
Type of Construction
Owner Name: Rayeanne Florin Swimming Pool $0.00
Owner Address: 28 LEO ST Total"Value $0.00
Queensbury,NY 1.2804
Contractor or Builder's Narne/Address Electrical Inspection Agency
Islander Pools
1967. Central AVE
Albany,NY 12205
Plans&Specifications
Above-ground pool
$ 40.00 PERMIT FEE PAID -THIS PE12mrr EXPIRES: Monday, May 15, 2017
(if a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town o iueen ury; ridtfortheTowncifQueensbury.
016
SIGNED BY:
Director of Building&Code Enforcement
, Office.,Use Only
Town of Queensbury Building & Codes
Deceived:
SWIMMING POOL PERMIT APPLICATION Tax Map 1p;
A permit must be obtained before beginning construction Permit No.: 20 t b
Permit Fee:
Site Plan/Variance No.:
1. Date:: '
2. Tax Map ID: , 2-
3. Pool Location Address:
4. Zoning Classification:
b.. Site'plan Review,Variance or Subdivision Approvals(list)
6. Property Owner: �" ± Phone:.
Mailing Address;
City:
7. Contractor's Name:
Phone:
Mailing:Address:
City, :
8. Contact Person for Building&Code Compliance: Phone
.� ,.
ABOVE-GROUND OR INGROUND?
�
SIZE OF POOL:
p
MANUFACTURER: "il� 17 2016 �
�.d ,
MATERIALS USED,IN CONSTRUCTION(CHECK ALL THAT APPLY): �`�� � � ` � � �
Steel!Vinyl Fiberglass Gunite Poured Concrete Other
Declaration: 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 statement/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: Date
ame/=eZ
Town of Queensbury Building&Codes Swimming Poul Permit 618-761-8266
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