POOL-0695-2018TOWN 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-0695-2018Date Issued: Wednesday, July 10, 2019
POOL-0695-2018
This is to certify that work requested to be done as shown by Permit Number
has been completed.
301.5-1-53
Tax Map Number:
7 NOBLE WAY
Location:
Brenton Meilhede, LAUREN MEILHEDE
Owner:
Brenton Meilhede
Applicant:
This structure may be occupied as a: Inground Swimming Pool
Cross Ref. Z-AV-74-2018 for December 2018 review by ZBA
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
�ve ;
Community Development - Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number: POOL-0695-2018
Tax Map No: 301.5-1-53
Permission is hereby granted to: Brenton Meilhede
For property located at: 7 NOBLE WAY
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: Brenton Meilhede Swimming Pool $0.00
Owner Address: 7 Nobel Way 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
Inground Swimming Pool
Cross Ref.Z-AV-74-2018 for December 2018 review by ZBA
$ 125.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Monday,January 13,2020
(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 Queensbury; Friday, January 11, 2019
SIGNED BY: Ca ' 4 $ for the Town of Queensbury.
Director of Building&Code Enforcement
SWIMMING POOL PERMIT APPLICATION Office Use only
Permit#: )-c c c I c?
Town of Quecnsbury Permit Fee:$/a'N( , Invoice#: I
742 Bay Road,Queensbury,NY 12804 �+
P:518-761-8256 www.queensbury.net Notes: C�✓n SC Pef 4✓) /-e LE)
Ciece,vbe, ZJ34 Rem t+J
71, Spa n r� ,,0 t y
Project Location: 7 ,k1O101 . (k)414.--
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Tax Map ID#: 3&( . 511 -53 Subdivision Name: 61 .,
CONTACT INFORMATION:
• Applicant:
Name(s): -6(2 1±'bY) O.. 1-41 1 t"` a1�\M
Mailing Address, C/S/Z: 7 ) 06t W L�Ve nsh— ( f )2� i(
Cell Phone: ( S I ) Saa- 359 Land Line: ( cl Ss ) 74)-O7"7
Email: � ,;��r,,�p�J�,� . Gts'YYl
• Primary Owner(s):
Name(s): a/ a vv,c_
Mailing Address, C/S/Z:
Cell Phone: _( ) Land Line: (
Email:
• Installer/Builder:Business Name: YoDIS OUS
Contact Name(s): Pecv, ( &V)/ )
Mailing Address, C/S/Z: L/S fl%rn S] 1/te.r1SJ/Any IU y / Uy
Cell Phone: _( ) l0�3 -tP5 7� Land Line: _(518 ) 793 `d 9
Email: 1')1ypo15JS/ uS n�. 05Yn
Contact Person for Building & Code Compliance: Ecru/Y1 At°,IY(pie._
Cell Phone: _(c Iis ) 7—O1O Land Line: _(5 I R ) 71/1 - O77/p
Email: 7i116/fin ;/, e6
Town of Queensbury Building&Code Enforcement Revised September 2018
SWIMMING POOL INFORMATION:
CIRCLE ONE: ABOVE- GROUND IN-GROUND
SIZE OF POOL: (J X X10
MANUFACTURER: 7-v)1 ,(aJ2 P001 -C
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:
SIGNATURE: I��L`=cam c�L'-cam DATE:/o/ 9/ 7
Town of Queensbury Building&Code Enforcement Revised September 2018
TO
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QUEENSB_ BUILDING DEPARTMENT
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