2014-250 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20140250 Date Issued: Wednesday, September 24, 2014
This is to certify that work requested to be done as shown by Permit Number P20140250
has been completed.
Tax Map Number: 523400-308-007-0001-007-000-0000
Location: 16 EVANNA Dr
Owner: ROBERT & LORRAINE CARPENTER
Applicant: ROBERT & LORRAINE CARPENTER
This structure may be occupied as a:
Inground Pool
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& ode a forcemeat
Planning Board or Zoning Board of Appeals.
j2(� TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20140250 Application Number: A20140250
Tax Map No: 523400-308-007-0001-007-000-0000
Permission is hereby granted to: ROBERT& LORRAINE CARPENTER
For property located at: 16 EVANNA Dr
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: ROBERT& LORRAINE CARPENTE Inground Pool
16 EVANNA Dr Total Value
QUEENSBURY,NY 12804-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2014-250
Inground Pool 20'x 34'
$75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,June 24,2015
(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 f Que sbu Tu a/Ju 1. • 24,2014
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: .Jal 2. 3 mit
A permit must be obtained before beginning construction Permit No.:
Permit Fee: $
1 Site Plan/Variance No.:
1. Date: Li l Li
2. Tax Map ID: ? 0 g' � -7
3. Pool Location Address: 1� �^^�'' �` b C
•
4. Zoning Classification: �4.5'x^"
5. Site Plan Review,Variance or Subdivision Approvals(list)
6. Property Owner: I- Corer,r*. P'`^ Phone: ''3 2-
Mailing
Mailing Address: l iv ✓ t r
City: JR % s bk,Ar•f A) Y i 2a,0Y
7. Contractor's Name: Poo pi.0S Phone: ~1C1 —2-92-Cf)
Mailing Address: y 5y 1'V►�- ^ j
City: p-arts 17..r1 ,V 1 i z`r3G`4
8. Contact Person for Building&Code Compliance: e_ Rr 1O-0 Phone 1C3" 1 Zq
ABOVE-GROUND OR INGROUND? rk 5/'v A
SIZE OF POOL:
MANUFACTURER: e—cin" 17G/S
MATERIALS USED IN CONSTRUCTION(CHECK ALL THAT APPLY):
Steel/Vinyl K Fiberglass Gunite Poured Concrete x 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: g '�
Signature: /Or Date e/2") /I Y
Town of Queensbury Building&Codes Swimming Pool Permit 518-761-8256
Frd
C --/D
Pool Inspection
Queensbury Building & Code Enforcement
Office No. (518) 761-8256
742 Bay Road, Queensbury, NY 12804
Date received: eiL/
NAME: 0:a_r-'f&n`1'c� r
LOCATION: f4, c_��enr�a..3 p-
PERMIT#: /{/._ 'En
INSPECTED ON: 9-19--/Y llam/pm
Arrive am/pm Depart:
�T� am/pm
I spec ors Initials:
Above Ground: In-Ground: \/
N N/A
Pool enclosure around
pool or yard
4 feet above grade
2 inch maximum
clearance to grade from /
underside of fence
4 inch maximum
clearance in fence
pickets
Wall or Doors have self
closing device or alarms
(30 second Alarm time)
Pool Surface Motion
Alarm
Ladder secured in place
and latched
Deck gate <56" to latch
no more than 1/2" spacing
in gate openings /
Gate opens outward, self . /
closing V
Padlock provided on
gates or ladder
Indoor pool all doors self
closing or alarmed per 7
AG105.2 Item 9
Timer on pool pump (no
plug in timer allowed)
Final electrical
Vehicle access gate
closed & locked
Ok to issue C/C
COMMENTS: v C�
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TOWN OF QUEENSBURY
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BUIL.DING DEPARTMENT
Based on our limited examination,compliance •
, ? r;) 1RNA.11.1.. _
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with our comments shall not be construed as I HAVE PERSONALLY MEASURED THE D1STANC
indicating the plans and specifications are in FROlf!E P.TO ' -' : INES TO THE
f_.., full compliance with the Building Codes of
New York State. P'••• ,: ac a--TRUCTU a'(S)OR SI2N,.(
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40
SR. • URE DATE 1
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