BOTH-000487-2016 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-000487-2016 Date Issued: Tuesday, October 18, 2016
This is to certify that work requested to be done as shown by Permit Number BOTH-000487-2016
has been completed.
Tax Map Number: 290.13-1-16
Location: 84 MASTERS CMN NORTH
Owner: PATRICK RUSSELL 111,Deanna Russell
Applicant: Deanna Russell
This structure may be occupied as a: In-ground pool
By Order of Town Board
TOWNOFQUEENSBURY
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
ilt
Community Development-Building& Codes (518)761-8256
l
BUILDING PERMIT
Permit Number: BOTH-000487-2016
Tax Map No: 290.13-1-16
Permission is hereby granted to: Adirondack Pavilion Pools
For property located at: 84 MASTERS CMN NORTH
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 fled and approved and in compliance with the NYS Uniform
Building Codes and the Queensbury Zoning Ordinance
Tyne of Construction
Owner Name: PATRICK RUSSELL III Swimming Pool 50.00
Owner Address: 84 Masters Common N Total Value $0.00
Queensbury,NY 12804
Contractor or Builders Name/Address Electrical Inspection Agency
Adirondack Pavilion Pools
946 Route 29
Saratoga Springs,NY 12866
Plans&Specifications
In-ground pool
$75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Sunday,July 30,2017
(If a longer period is required,an application for an extension must be made to the code Enforcement Oflicer
of the Town ofQucensbury before the a 'ration d
Dated at the Town
0(:;
ueens khWugust ,2016
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
Town of Queensbury Building & Codes Office Use Only
Received:
SWIMMING POOL PERMIT APPLICATION Tax Map ID: 3 'f /
A permit must be obtained before beginning construction Permit No.: —Ijk-� �""ZP,iy
Permit Fee: $ retic
Site PlanNadance No.:
1. Date: .�1
2. Tax Map ID: v2d 3
3. Pool Location Address: 6T � erP r nmw�o !Vy•'`T
4. Zoning Classification:
5. Site Plan Review,Variance or Subdivision Approvals(list)
` 23
6. Properly owner: �.f� //Phone:
Mailing Address:
City:
7. Contractor's Name:
aMC, row �jv Phone: �'r7�c� ' �o�t'J `lob°
Mailing Address: q RhA 9 .Saraly �4'y Gt 6(&
City: N
8. Contact Person for Building&Code Compliance: Phone
ABOVE-GROUND OR INGROUND? T Y) 1-0%_ky")°
SIZE OF POOL:
MANUFACTURER: ��A1AAAT ovJ
MATERIALS USED IN CONSTRUCTION(CHECK ALL THAT APPLY):
Steel/Vinyl Fiberglass Gunite Poured Concrete Other V/, b I lwC-r/vini
Declaration: I acknowledge no construction activities shall be commenced prior to issuance of a valid permit. I certify that the application,
pians, 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 Slate Building Codes, local building laws and ordinances, and in conformance with local zoning regulations. [
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: a nn
Signature: Date r 2—J
mI
_1ur_ 7 2016
Town of Queensbury Building&Codes Swimming Pool Permit 518-761-8256
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
born, i b,.W _ No_ 44821
. .. 1 b
Permit No.................................. ...Cert. Cut-in Card No.....................................
Owner........,a?........... .5.5 ...................................... .............................................................
Location... ..r. ...�` HfYZO? ... .......Q.. �
... . .................
Installation Consisting of...t""�. n-j.L_&.11.. ..................
....................................................................................................................................................................................
....................................................................................................................................................................................
Installed By.........C,....../Vzf.�4nr........................................Lic.No...................................................
The conditions following governed the issuance of this certificate,and any certificate previously issued is
cancelled:-
This certificate only covers the electrical equipment and installation conditions as of date. Upon the
introduction of additional equipment or alterations,application shall be promptly made for inspection.
Inspectors of this Company shall have the privilege of making inspections at any time, and if its
rules are violated,the Company shall have the right-to revoke this c ' rcate.
Date....... . �i,L....... INSPECTOR
Member N.F.P.A.,I.A.E.I.
Aug. 02 . 2016 02 : 43 AM Adirondack Pavilion 5186954060 PAGE. 1/ 2
14
MOWN OF Q','E�.,,,IsBURY
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Att ntion ome Owner
Plea a sure yo are familiar with the
Pool Enc o' surer uirements specific to
Your poll. We 1 be happy to explain
what Require nts you will have to
meet per pend&' V
rl .al
New York St e Res
Code.
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Aug. 02 . 2016 02 : 44 AM Adirondack Pavilion 5186954060 PAGE. 2/ 2
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