BOTH-000208-2015 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
OL Community Development-Building&Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: BOTH-000208-2015 Date Issued: Tuesday, October 27, 2015
This is to certify that work requested to be done as shown by Permit Number BOTH-000208-2015
has been completed.
Tax Map Number: 295.8-1-8
Location: 12049
Owner: EDWARD G BAERTSCHI LIVING TRUST
Applicant: EDWARD G BAERTSCHI LIVING TRUST
This structure may be occupied as a: Above ground pool
By Order of Town Board
TOWN OF QUEEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the r/
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-000208-2015
Tax Map No: 295.8-1-8
REVISED
Permission is hereby granted to: EDWARD G BAERTSCHI LIVING TRUST
For property located at: 1204 State Rte 9
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: EDWARD G BAERTSCHI LIVING TRUE Swimming Pool $0.00
Owner Address: 1204 State Route 9 Total Value $0.00
Queensbury,NY 12804
Contractor or Builders Name/Address Electrical Inspection Agency
Plans&Specifications
Above ground pool
PERMIT FEE PAID-THIS PERMIT EXPIRES: Monday,May 25,2015
(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 Townonsbury; Sal y, ay 24,2014
SIGNED BY: for the Town of Queensbury.
Director of Building&Code 'nforcement
TOWN OF QUEENSBURY
FON
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20140193 Application Number: A20140193
Tax Map No: 523400-295-008-0001-008-000-0000
Permission is hereby granted to: EDWARD G BAERTSCHI LIVING TRUST
For property located at: 1204 STATE ROUTE 9
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 Value
Owner Address: EDWARD G BAERTSCHI LIVING T Above Ground Pool
NORMA E. BAERTSCHI IRREVOCf Total Value
90 ASSEMBLY POINT Rd
QUEENSBURY NY 12804-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
ELLSWORTH & SON EXCAVATING
57 ELLSWORTH Ln
LAKE GEORGE,NY 12845-0000
Plans&Specifications
2014-193
POOL above ground 30' diameter
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,May 28,2015
(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 u sbury 71 We i •s,ct . ay 28,2014
/A
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Town of Queensbury Building & Codes ecer ed:�s, r oOfficeee Use
M1 �F2
SWIMMING POOL PERMIT APPLICATION NSVD
A permit must be obtained before beginning construction
d 1�P,brmitNo:r"`
Permit Fee: $_1(1
r
Site PlanNariance No.:
1. Date: 51271144
2. Tax Map ID: 2`15. B - 1 - R
3. Pool Location Address: 1204 State Route q purensbur�/
4. Zoning Classification:
5. Site Plan Review,Variance or Subdivision Approvals (list)
6. Property Owner: BUff-SGhl LrVtnQ TIIST Phone: 518) 307- 102-1
Mailing Address: 12011 State 13ou1T. 9
City: Oueensbu% NY 128044
7. Contractor's Name: E I I S Worth *Son Eyr m/wm 4 Phone:( 8),3(p1 230
Mailing Address: 7tP EIISWOrth L.Wt EXT.-
City:
TCity: LkKE, Georgi-e_ i NY 128`45
8. Contact Person for Building&Code Compliance: .1CwIatmahl Phone 518 307-110 2 I
ABOVE-GROUND ORINGROUND? AboVC- hound
SIZE OF POOL: .30 Or royn V
MANUFACTURER: AOl�awood linsililatM Pools
MATERIALS USED IN CONSTRUCTION (CHECK ALL THAT APPLY): /
Steel/Vinyl Fiberglass Gunite Poured Concrete Other v
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 statementldescription 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: knniPw M.j�B, U p h 1 1
Signature: _M' ^""'�" Date 5127 /14
ame/title
Town of Queensbury Building&Codes Swimming Pool Permit 518-761-8256
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NO 06 2015 Insp. Date: 10/13/2015
Appl #: L15209
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BUILDING & CODES
ELECTRICAL CERTIFICATE
COMMONWEALTH ELECTRICAL
INSPECTION SERVICE, INC.
176 DOE RUN ROAD, MANHEIM, PA 17545
TELEPHONE: (717) 664-2347 ==-N
New York Office: (585) 624-2380 ...
Premises of: GREG FRANCE as SWIMMING POOL
Address: 1202 STATE ROUTE 9,QUEENSBURY NY
County of. WARREN Permit
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Installed by: M.TROMBLEY
Apparatus: POOL WIRING APPROVED
Inspected by: DONALD LOVELAND
The conditions following governed issuance of this certificate,and any certificate previously
issued is cancelled. Failure to have the property reinspected when additional equipment or wiring is
added;or within one year from the date of the certificate shall void the certificate in its entirely and the
49
company shall not be liable for any damages whatsoever.
This certificate does not guaramee efficiency. wearing qualities,maintenance or repair and the
company shall not be liable for any damages resulting from any defect or fault in the plans or specifica-
tions,including repair,reconstruction,personal injury or for the death of any person;and
This certificate only covers visual inspection of wiring and does not cover manufacture or use
of wiring.
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 the certificate. N.,
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