POOL-0534-2018 TOWN OF QUEENSBURY
A.
1 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
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a -' ', Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: POOL-0534-2018
Tax Map No: 301.9-1-35
Permission is hereby granted to: Pools Plus
For property located at: 18 WESTERN RESERVE TRL
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: Melony Reynolds Swimming Pool $0.00
Owner Address: 18 WESTERN RESERVE TRL 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
In ground pool
$ 125.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Wednesday,August 21,2019
(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 ue bury; 4 Tue..:y,js , _ 21,2018
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SIGNED BY: 'I \ for the Town of Queensbury.
Director of Building&Code Enforcement
t € SWIM Est i ', t+k 'MEC - �° TON Office Use only
Permit#: /749 a S3 tel
AUG 2 0 2018 Permit Fee:$ 1 2—S764 invoice#: i)92--
742 Bay Road Queensbury,NY 12:r
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Notes:
P:518-761-8256 TOWN OF QUEENSBURY
BUI DING&CODES
Project Location: I Ac8-ikSO L LY •
Tax Map ID#: -301 q. t 1 -33 Subdivision Name: ,,,,S
CONTACT INFORMATION:
• Applicant:
Name(s): -iqe, t
Mailing Address, C/S/Z: /� �� Yrc
Cell Phon : ('S�' )° 71j - e3 � Land Line: ( - )
Email: ,ierz-yle ��o ici-J— / Fa l°t 7
• Primary Owner(s):
Name(s):
Mailing Address, C/S/Z:
Cell Phone:_( ) Land Line: _( )
Email:
• Installer/Builder:
Business Name: jP JLJ PI��
_ Contact Name(s): ce�r.�e-_.
Mailing Address, C/S/Z: 6krle1c yz L,f/ -G4hc-t-c, �
Cell Phone:_( ) Land Line: (51 J' ) 2 'Z
Email:
Contact Person for Building & Code Compliance: 141.-- &vt.,,,e,o/c
Cell Phone: _(�1-7( ) 714/1-4- 'Z.6 Land Line: _(
Email: /,c-eiyr_ xol.E7l c c_
Town of Queensbury Building&Code Enforcement Revised August 2018
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SWIMMING POOL INFORMATION:
CIRCLE ONE: ABOVE-GROUND IN-GROUND
SIZE OF POOL: o�c2 'x 36
MANUFACTURER: p,Gc.-y-7u i.A /40,2,-2,e,„,... ..e.
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: 4e - t /?4.
SIGNATURE: r 1j �Cf✓/l�. DATE: tr/y/Ar
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Town of Queensbury Building&Code Enforcement Revised August 2018
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'th our comments shall not be construed as - `�� 1,
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