POOL-0197-2018 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building& Codes (518) 761-8256
CERTIFICATE OF COMPLIANC1-i.,'
Permit Number: POOL-0197-2018 Date Issued: Monday, June 18, 2018
This is to certify that work requested to be done as shown by Permit Number POOL-0197-2018
has been completed.
'fax Map Number: 308.10-1-57
Location: 15 WAYNE CT
Owner: Randy McKeever
Applicant: Randy McKeever
This structure may be occupied as a: Above Ground Swimming 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&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
•;, ,
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
--- . , ,`;, k Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: POOL-0197-2018
.Tax Map No: 308.10-1-57
Permission is hereby granted to: Randy McKeever
For property located at: 15 WAYNE CT
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: Randy McKeever Swimming Pool $0.00
Owner Address: 15 Wayne CT Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
Above Ground Swimming Pool
$ 125.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Thursday,May 2,2019
(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 date.)
Dated at the To Que bury; 4We'.' :•s, ,May 2,2018
,
Queensbury.
BY: 1 - t for the Town of Q ury•
Director of Building&Code Enforcement
SWIMMING POOL PERMIT APPLICATION Office Use Only
Permit#: POOL /17.20i
O .1 of OjjecnsbuzyPermit Fee:$4.5 Invoice#:
742 Bay Road,Queensbury,NY 12804
P:518-761-8256 www.ciueensbury.net Notes:
Project Location: //5 l/ "Y/Jj C-
Tax Map ID#: 30e f 10 - ! -5 / Subdivision Name: ,4' 1fcO c 2Ikc4't.C
ijEciFir& E
CONTACT INFORMATION: APR 2 6 2018
• Applicant: TOWN OF QUEEN BURY
Name(s): N c nu ri Ho!rs r�r a B 8�
Mailing Address, C/ /Z: /5 4/AY4/2--( Cr aotse-e-A4s.26 y
Cell Phone: (S/t ) 71/a- °7 90 Land Line: ( ) �/4
Email: lern c-iez<zsc ?/ `ri-i iL, C,C ry►
• Primary Owner(s):
Name(s): ��,,.� ,57.Arra /eV sr", /ICA% vim_
Mailing Address, C/S/Z: ii4)9vd 69;;V -9vsa -y An/ /0/6 DV
Cell Phone:_(54-- ) 7q/-WW O 2— Land Line: _( ) /V/4-
Email: /esa'► (,e A-vevi Li Cory,.
• Installer/Builder:
Business Name:
Contact Name(s): ,i� . e t L ti&I?
Mailing Address, C/S/Z: / L-i l � e'.�_ (526L�m_r t/✓L7 /1/V iceV OY
Cell Phon :_( ) 7./7'3 ii2- Land Line: _( ) /V/A -
Email: e4ie/r c -"‘2"2c }k\--(rA-iLm o Cctttok
Contact Person for Building & Code Compliance: /v,�
Cell Phone: (Sit) � L.. Land Line:_(/ )
Email: /�'� eF���t=� , r /44-/L.ta41
Town of Queensbury Building&Code Enforcement Revised March 2018
4
0.
SWIMMING POOL INFORMATION:
CIRCLE ONE: ABOVE-GROUND IN-GROUND
SIZE OF POOL: 3C)
MANUFACTURER: �P®e'[-- .`-,,Rt7/ 61,Q(w��
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.
I have read and agree to the above:
PRINT NAME: 2?1N22 /417�Gd�V-7
SIGNATURE: DATE: 9®/,/
Town of Queensbury Building&Code Enforcement Revised March 2018
EMIT P_'LO__T__PIAN
1 N I HAVE PERSONALLY MEASURED HED.:180 T ATNHCEE
FROM THE PROPERTY LINEST 1
N ':''''''N D TRUCTURE(S)OR Sii,IG, -S:4),• ,tE c E ii w E
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S ATURE
APR 2 6 2018
TOWN OF QUEENSBURY
COMMUN/TY DEVELOPMENT
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308.10-1-57 POOL-0197-2018
McKeever, Randy
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15 Wayne Court
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above round pool
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