BOTH-000310-2016 jJ 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-000310-2016 Date Issued: Tuesday, July 19, 2016
This is to certify that work requested to be done as shown by Permit Number BOTH-000310-2016
has been completed.
Tax Map Number: 278.19-1-4
Location: 593 MOON HILL RD
Owner: MATHEW BRENNAN
Applicant: MATHEW BRENNAN
This structure may be occupied as a: Above-ground pool 24'
Cross Ref.AV PZ 162-2016 ZBA approved By Order of Town Board
TOWN OF QUEENSBURY
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 QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development - Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number: BOTH-000310-2016
Tax Map No: 278.19-1-4
Permission is hereby granted to: MATHEW BRENNAN
For property located at: 593 MOON HILL 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 filed and approved and in compliance with the NYS Uniform
Building Codes and the Queensbury Zoning Ordinance
Type of Construction
Owner Name: MATHEW BRENNAN Swimming Pool $0.00
Owner Address: 593 Moon Hill RD Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
Above-ground pool 24'
$ 40.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Sunday, June 25, 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 th expiration d te.)
Dated at the Town f Quee s ury; f�Th 0, 2016
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
Town of Queensbury Building & Codes [Rec�eived:
f
SWIMMING POOL PERMIT APPLICATION x Map ID: fig•19-/-�
A permit must be obtained before beginning construction Permit No.: - '.tel (3 - 2s),1 �,n
Permit Fee: $-- 4MC CA.;,
Site Plan/Variance No.:
1. Date:
2. Tax Map ID:
3. Pool Location Address: -1
4. Zoning Classification: t o, 1
5. Site Plan Review,Variance or Subdivision Approvals(list)
fi. Property Owner; . flY '` Phane: _676
Mailing Address: bs—
City:
7. Contractor's Name: Phone:
Mailing Address: r 1
City:
8. Contact Person for Building&Code Compliance: Phone
ABOVE-GROUND OR INGROUND?
SIZE OF POOL: 1
MANUFACTURER:.. ti
MATERIALS USED IN CONSTRUCTION(CHECK ALL THAT APPLY):
Steel(Vinyl Fiberglass Gunite Poured Concrete Other C\ t �' ' �-�4-V-) P� c%-n c� S
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: M 62a tie
Signature: - Date �'
Name 1 Title
MAY 2 0 2016
Town of Queensbury Building&Codes Swimming Pool Permit 518.781.8256
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