POOL-000671-2017 TOWN OF QUEENSBURY
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742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: POOL-000671-2017 Date Issued: Thursday, August 16, 2018
This is to certify that work requested to be done as shown by Permit Number POOL-000671-2017
has been completed.
Tax Map Number: 296.19-1-17.1
Location: 68 GLENWOOD AVE
Owner: Robert O'Connor
Applicant: Adirondack Pools
This structure may be occupied as a: Inground Swimming Pool
18 x 36 By Order of Tomm 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 a ad conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
a PIP
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: POOL-000671-2017
Tax Map No: 296.19-1-17.1
Permission is hereby granted to: Robert O'Connor
For property located at: 68 GLENWOOD AVE
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
Tyne of Construction
Owner Name: Robert O'Connor Swimming Pool $0.00
Owner Address: 64 Glenwood AVE Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Adirondack Pools
5 BOULEVARD
Queensbury,NY 12804
Plans&Specifications
Inground Swimming Pool
18x36
$75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Monday,November 5,2018
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town of eensb 4rid4t,02017
SIGNED BY: r the Town of Queensbury.
Director of Building&Code Enforcement
SWIMMING POOL PERMIT APPLICATION office use only
Permit#: ?(n)oL
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Permit Fee:$ S i; Invoice#:,2-�)-
742 Bay Road,Queensbury,NY 12804
P:518-761-8256 www.gueensbury.net Notes:
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Project Location: �
Tax Map ID #: (� , f 1 ( ! T, Subdivision Name: M
CONTACT INFORMATION:Applicant: &IVI�4
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Name(s): 44 &// .�' C��t'
Mailing Address, C/S/Z: lan u'Q- r1�
Cell Phone: 5-1 Land Line:
Email: /
• Primary Owner(s): /
Name(s):
Mailing Address, C/S/Z:
Cell Phone: _(�r+� ) ��� - �f3 Land Line: _( )
Email:
• Installer/Builder: - / ct S
Business Name: �✓�'1
Contact Name(s):
Mailing Address, C/S/Z: ()
Cell Phone: _( S71A ) r Land Line:
Email: ' ��c�� r lh_
Contact Person for Building & C de Compliance: 'i' /S sr-4
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Cell Phone: _ io ) �`�ly-11 � Land Line: ( $7$ )
Email: �'✓►�
Town of Queensbury Building&Code Enforcement Revised May 2017
SWIMMING POOL INFORMATION:
CIRCLE ONE: ABOVE- GROUND IN-GROUND
SIZE OF POOL:
MANUFACTURER: A )"ZY 3As�
MATERIALS USED IN CONSTRUCTION (CHEC ALL THAT APPLY):
Steel/Vinyl V Fiberglass Gunite Poured Concrete 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 NYS Building Codes, local building
laws and ordinances and in conformance with local zoning regulations. I 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.
I have read and agree to the above:
PRINT NAME:
SIGNATURE: DATE:
Town of Queensbury Building&Code Enforcement Revised May 2017
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BUILDINGTOWN OF 8 Q h
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UEENSBURY
Reviewed �iy� � ,�' COMM
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BUILDING N OFDEPARTMENT
Based on our limited examination,compliance
with our comments shai ,iot be construed as
indicating the plans anG specifications are in T f
full compliance.with the Building Codes of PER LT--p-�---"'New York State. I HAVE PERSDNALLY MEASURED THE DISTANUE
FROM THE PROPERTY LINES TO THE
PROPQ,S[-D ST URE(S) OR SIGN(S)
296.19-1-17.1 POOL-000671-2017 ;' • , /C�_•,Z;;`!
O'Connor, Robert SIGN ,PJRE DATE
68 Glenwood Avenue e 1
Inground Pool (1