POOL-0406-2018 e - 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-0406-2018 Date Issued: Thursday, July 19, 2018
This is to certify that work requested to be done as shown by Permit Number POOL-0406-2018
has been completed.
Tax Map Number: 301.20-1-73
Location: 26 Geneva DR
Owner: Steven Svoboda
Applicant: Steven Svoboda
This structure may be occupied as a: Above-ground swimming pool 27'round
By Order of Town Board
TOWN OF QUEENSBURY
it Issuance of this Certificate of Compliance DOES NOT relieve the 4
property owner of the responsibility for compliance with Site Plan, y e
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
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r' r 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
N Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: POOL-0406-2018
Tax Map No: 301.20-1-73
Permission is hereby granted to: Steven Svoboda
For property located at: 26 Geneva 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: Steven Svoboda Swimming Pool $0.00
Owner Address: 26 Geneva DR Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Steven Svoboda
26 Geneva DR
Queensbury,NY 12804
Plans&Specifications
Above-ground swimming pool 27'round
$ 125.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Saturday,June 29,2019
(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 Town uee ury; 4Fri ,J,!',-. 2018
I
SIGNED BY: .f for the Town of Queensbury.
Director of Building&Code Enforcement
*4i SWIMMING POOL PERMIT APPLICATION Office Use Only
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: . Permit#: 4-6(p-d--0 gi
Town of Qyeenilmary /Ae
/471r Permit Fee:$ Invoice#: 05.13
742 Bay Road,Queensbury,NY 12804
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P:518-761-8256 www.queensbury.net LI
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Project Location: ,A(42 ae(4,_
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Tax Map ID#: Subdivision Name:
CONTACT INFORMATION: JUGS 2 apiA
• Applicant. OF,k.;,.L7ENSBURY
Covip,,,9t
iztOPMENT
Name(s): Aar_te) lt,43 ke")
Mailing Address, C/S/Z:
Cell Phone: (<1 ) AO5 S,Sre) Land Line: (
Email: S att-1,0 C-014-1
• Primary Owner(s):
Name(s): ),At
Mailing Address, C/S/Z:
Cell Phone: ( Land Line: _(
Email:
• Installer/Builder:
eLS VAS_
Business Name:
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone:_( Land Line: _(
Email:
Contact Person for Building & Code Compliance:
Cell Phone: 26( ) eatj Lançl Line: (
Email:
Town of Queensbury Building&Code Enforcement Revised May 2017
SWIMMING POOL INFORMATION:
CIRCLE ONE: ABOVE-GROUND IN-GROUND
SIZE OF POOL: O o11-1
MANUFACTURER: S adl4.__
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: 0o40 vf) EEvo,ifar-le•-1
SIGNATURE: ��' do's. _ �� - DATE: (� r J
Town of Queensbury Building&Code Enforcement Revised May 2017
DO NOT WRITE HERE-FOR OFFICE USE ONLY THE CERTIFICATE#
Pc` INSPECTOR
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TEMP.# DATE BUILDING PERMIT#
CITY OR VILLAGE ZIP CODE TOWNSHIP COUNTY
•
*•'
STREET#AND OR ROAD Role Number
Additional helpful directions Section Block Lot
_-
OCCUPANTS NAME BUILDING OCCUPANCY
/
OWNER'S NAME&ADDRESS HOME TELEPHONE
CURRENT SUPPLIED BY FROM THEIR OFFICE WORK TELEPHONE •
BUILDING IS NEW OLD
WORK IS NEW ADDITIONAL DEFECTS'REMOVED
Inspection or Electrical Premises Survey:We have attended at the premises named herein to inspect the electrical installation and regret that we can not issue a
certificate of compliance for the reason(s)listed hereunder;
Concealed work not exposed suffiently for inspection. Additional work observed with no application for inspection being filed.
Installation not completed sufficiently for inspectiion.• Installation not in compliance with the NEC for reasons listed hereunder.
Key:Code number printed under column A listed below combined with code number printed under column B listed below indicates condition.
NEC VIOLATIONS Level NEC VIOLATIONS Level NEC VIOLATIONS Level NOTES
OSPEPTIOrsi,— INSPECTION INSPECTION 113(--'-'
Size of service APPLICANT ATTESTS THAT THERE IS NO OTHER APPLICATION PENDING WITH A QUALI-
Feeders FIED ELECTRICAL INSPECTION AUTHORITY, FOR INSTALLATION LISTED HEREIN. THIS
Work is exposed APPLICATION IS VALID FOR A PERIOD NOT EXCEEDING ONE YEAR FROM THE DATE
Work is concealed RECEIVED.
Service enters the structure overhead If The Inspector, LLC or any agent thereof is the prevailing party in any litigation,arbitration,or other
Service enters the structure underground proceeding resulting from a dispute relating to the Inspection site listed herein,The Inspector,LLC or its
agent(s),as the case may be,shall be awarded its reasonable attorney fees,and costs and expenses
Date inspection requested incurred.
PLEASE GIVE FULL AND ACCURATE INFORMATION.ALL SPACES MUST BE FILLED OR APPLICATION MAY BE RETURNED.
PRINT NAME AND ADDRESS
NAME OF APPLICANT DATE OF APPLICATION SIGNATURE OF APPLICANT
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STREET ADDRESS TELEPHONE#
CITY OR POST OFFICE LICENSE NUMBER
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8 7_ 5 3 5 5390 State Route 11
www.theelectricalinspector.com Burke,NY 12917
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TOVVN OF OLIEENSBURY
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' ‘41, N-"------- -"-- Attention Home Owner RERMT PLOT I:31_41NA
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assure you are familiar with the
FROM THE PROPERTY LINES TO THE
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i Pool Enclosure requirements specific to
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New York State Residential Code.
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TOWN OF QUEENSBURY TOWN OF QUEENSBURY
BUILDING DEPARTMENT
BUILDING & CODES PT. Based on our limited examination,compliance
with our comments shall not be construed as
FILE COPY
Reviewed By: ` -7) indicating the plans and specifipatioris are in
Date: full compliance with the Building Codes of
"-- New York State.