POOL-000076-2017 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: POOL-000076-2017 Date Issued:
This is to certify that work requested to be done as shown by Permit Number POOL-000076-2017
has been completed.
Tax Map Number: 295.7-1-16
Location: 51 SARA JEN DR
Owner: Lisa Ash,Robert Ash
Applicant: ROBERT ASH
This structure may be occupied as a: Inground Pool 22'x 36'
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the 0//
property owner of the responsibility for compliance with Site Plan, V�✓///'"
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
OL 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: POOL-000076-2017
Tax Map No: 295.7-1-16
Permission is hereby granted to: Pools Plus
For property located at: 51 SARA JEN 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
Owner Name: Lisa Ash Swimming Pool $0.00
Owner Address: 51 SARA JEN DR Total Value $0.00
Queensbury,NY 12804
Contractor or Builders Name/Address Electrical Inspection Agency
Pools Plus .
45 MAIN ST
Queensbury,NY 12804
Plans&Specifications
Inground Pool 18'x 36'
$75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,April 7,2018
(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 Townpk sury; Fr y, ril 7 017
SIGNED BY: `( for the Town of Queensbury.
Director of Building&Code Enforcement
oa_
SWIM Permitft: f �1-- �MING POOL PERMIT APPLICATION office Use Only
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/nun n(l prrrn.burr
Permit Fee: 5 ; Invoice ft:
742 Bay Road,Queensbury,NY 12804
P:518-761-8256 www.gueensbuy.net Notes:
Project Location:
(L ) SOP_jp
Tax Map ID #: a 7 S :7 — - /6 Subdivision Name: o�ELr.✓0 �7�r�S
CONTACT INFORMATION: rll_�_
Applicant: /� RA0 2 2017
Name(s): $ t1T- AS ____.__
Mailing Address, C/S/Z: 5 1 S kA �
t FUEcNSSURY
CellPhone- ( S )T ) '7 9 / O / S y Land Line: I
Email: Q(xs/-f 0_ Aly w, Q k-- Com
• Primary Owners).
Name(s): B IF QT'- 11-514
Mailing Address, C/S/Z: 5 1 S (1 &PC T�„J
Cell Phone: ( S/B' ) -7g/ — o/ S-7 Land Line: _ S/F' ) 799 7S 9-7
Email: Ws /-f ^/ I/ CAG►- QQ- G'oM
• Installer Buil er:
Business Name: S
Contact Name(s): 1) AOf S r> ✓a o, - Aitloti/
Mailing Address, C/S/Z: Y S f T g:F S
Cell Phone: _( ) Land Line: —( S/ Ft) — YA 9
Email: AA y Pod)_S PLVL C' 17� ro • Cd A4
Contact Person for Building & Code Compliance: Ad8rcQ-7— AS/7
Cell Phone: ( T1 r) -7 1T--7 S 97 Land Line:
Email: QA-S# e- .n/(/ Cp4. r2 A- - Crj•- 1
Town of Queensbury Building&Cade Enforcement Revised February 2017
SWIMMING POOL INFORMATION:
CIRCLE ONE: ABOVE- GROUND
9 IN GROUND
SIZE OF POOL: I T X 34
n
MANUFACTURER: -riN Peat A1— POO)-S
MATERIALS USED IN CONSTRUCTION (CHECK ALL THAT APPLY):
Steel/Vinyl_ Fiberglass Gunite Poured Concrete Other
aZ 5, 00 6,-P)-Lcr/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 NYS Building Codes, local building
laws and ordinances and in conformance with local zoning regulations. 1 acknowledge that I have read the
application and plot plan requirements and I, or my agents, will obtain a certificate of compliance before use
of the pool. n- I/ /�
PRINT NAME: B£2T T & 14 77L
SIGNATURE: _ _ DATE: -31P- 11-7
Town of Queensbury Building&Code Enforcement Revised February 2017
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•.I? ase asc, you are familiar with the F
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:Y ur pool.`We willbe.happy to explain,
h equirements you,,will have to
tper•Appendix.. the
dew York State Residelntial Code.
TOWN OF,QUEENSBURY
• BUILDING DEPARTMENT
Ba d on our limited examination,compliance
N it 'our comments shall not be construed as . ttention
ind 'ating the plans avid s ecifrcations are in ' I se assure y( ire tamillar• �jl dth the`.,
Idr sof
full compliance with the ai 'n Code
Ne' York State,
g Enclosure requirements specific ta,
S r pool ..We wi!: ¢ _ i;appy to-explain
t at Requireryie, you wilt have to
I •' � � . . � ° ,. •' meet•per A��p( r•"�,ix �:,r .ne • . "
1. ` , York State Residential Code.
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TOWN OF QUEENSBURY
BUILDING&CODES
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
?fJO L Cq-6-ZO%_�
Pennit No........................................Cert. N2 44920 Cut-in Card No.....................................
Owner..........fl. )�S- Y— .............._i...../..................
.............................................................
Location.... �Vtler lk ...........
................ ..................................... ke. ................
Installation Consisting,of. ... 6..............................
....................................... . ...............................................................................................
......................................................... .
Installed By );�...& ** �w
.,# .............................................Lic.No...................................................
.... .....d..'
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 mptly made for inspection.
Inspectors of this Company shall have the privilege of makinw/insnictions at any time, and if its
..........................................
rules are violated,the Company shall have the right-tothis icate-
ate.
Date..... ................... INSPECTOR............... ......
Member N.F.P.A.,I.A.E.I.