application Office Use Only
Town of Queensbury Building & Codes
Received:
SWIMMING POOL PERMIT APPLICATION Tax Map ID:
A permit must be obtained before beginning construction Permit No.: tkDL_— 4(Li'c_O( 9
Permit Fee: $ P-L)
Site Plan/Variance No.: 1 rlin 1 LU 1 IQ
1. Date: 06/15/2019
2. Tax Map ID: 301-14-2-15 D Q
3. Pool Location Address: 15 McEchron Lane .1UN 1 7
2Gi9 ;
4. Zoning Classification: To
NSPUHY
5. Site Plan Review,Variance or Subdivision Approvals (list) ' (' ' ` " T
6. Property Owner: John Luttmer Phone: 518-791-2348
Mailing Address: 15 McEchron Lane
City: Queensbury
7. Contractor's Name: Dave Barlow-Pools Plus Phone: 518-793-2929
Mailing Address: 45 Main Street
City: Queensbury
8. Contact Person for Building&Code Compliance: Dave Barlow Phone 518-793-2929
ABOVE-GROUND OR INGROUND? In Ground
SIZE OF POOL: 18X36
MANUFACTURER: Hayward
MATERIALS USED IN CONSTRUCTION (CHECK ALL THAT APPLY):
Steel/Vinyl X Fiberglass Gunite Poured Concrete X 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 NY State Building Codes, local building laws and ordinances, and in conformance with local zoning regulations. I
acknowledge that I have read the application & plot plan requirements and I or my agents will obtain a certificate of occupancy before use
of the pool.
John Luttmer
Print Name:
Signature: Date 06/15/2019
me/Title
Town of Queensbury Building&Codes Swimming Pool Permit 518-761-8256