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POOL-0104-2018 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-0104-2018Date Issued: Wednesday, January 2, 2019 This is to certify that work requested to be done as shown by Permit Number POOL-0104-2018 has been completed. 290.6-1-65.2 Tax Map Number: 16 SUNNYSIDE RD EAST Location: Josh Fish, Theresa Fish Owner: Josh Fish Applicant: This structure may be occupied as a: Above ground pool 24' round 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 & 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: POOL-0104-2018 Tax Map No: 290.6-1-65.2 Permission is hereby granted to: Pools Plus For property located at: 16 SUNNYSIDE RD EAST 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: Josh Fish Swimming Pool $0.00 Owner Address: 16 Sunnyside E Total Value $0.00 Queensbury,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency Pools Plus 45 MAIN ST Queensbury,NY 12804 Plans& Specifications Above ground pool 24'round $ 125.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Tuesday, March 26, 2019 (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 da e.) Dated at the Town Queen ury; 4M*r-c—h 26, 2018 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement SWIMMING POOL PERMIT APPLICATION office Use Only i Permit#: PO()L_— O 1 Q4 21)1� Town of(Lum7sbury Permit Fee:$ 125 ; Invoice#: 0 Z- 742 Bay Road,Queensbury,NY 12804 P:518-761-8256 www.gueensbury.net Notes: Project Location: A&Cb- Pic ss�- u EC9 [ Tax Map I®#e 5 1( �•c"�.CO-� -(a Subdivisi a MAR 15 2()1 CONTACT INFORMATION' TOWN OF QUEENSBURY BUILDING&CODES e Applicant: L Name(s): � C4 T ► 1 Mailing Address, C/S/Z: 6A t .► Cell Phone: (MSS )_h& 3 c 3 ` Land Line: (,� 1 �) 3 a Q g Email: ' t co ry--) e Primary Owner § :i Name(s): Of sc-_ ' JC� iviaiiing Address, C/S/Z: K-p SunruSirlp Cell Phone:J _) laU 3U"�IJ Land Line: _( F- t )`f Email:- i`t 15Vhq) ( Ca o Installer Builder: Business Name: ta—C-1 Contact Name(s): 4 Q-, S %--A Mailing Address, C/S/Z Cell Phone: _( ) J Land Line: Email: LS cv Contact Person for Building & Code Compliance: Cell Phone: _(`-I )jr)�V ���,3�� Land Line: _( `�I � ) �13.?��f�l Email: o<,hr%' v'm59IaS�S f���( �. L0ry--) Town of Queensbury 5uilding&Code Enforcement Revised February 2017 SUfJll9ilMING POOL INFORMATION, CIRCLE ONE: CA:BOVE-ROUND IN-GROUND SIZE OF POOL: rC �jiCOI MANUFACTURER: �(,°.tv'IMc ��J" 55T O�,Iet nfcx�� pall, } J �u� C1 cic - MATERIALS USED IN CONSTRUCTION (CHECK ALL THAT APPLY): Steel/Vinyl 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. f SIGNATURE: DATE: l Town of Queensbury'Suilding M Code Enforcement Revised February 2017