2005-211 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
4z Community Development- Building &Codes (518) 761-8256
CERTIFICATE (371rc COMPLIANCE
Permit Number. P20050211 Date Issued: Tuesday, June 13, 2006
This is to certify that work requested to be done as shown by Permit Number P2005021.1
has been completed.
Tax Map Number 523400-295-011-0001-028-000-0000
Location: 54 SARA-JEN Dr
Owner. EDWARD & DENISE MATTHEWS
Applicant: EDWARD & DENISE MATTHEWS
This structure maybe occupied as a:
Inground Pool
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the A
property owner of the responsibility for compliance with Site Plan, /V1
Variance, or other issues and conditions as a result of approvals by the Director of Building&Code Enfdremebb
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20050211 Application Number: A20050211
Tax Map No: 523400-295-011-0001-028-000-0000
Permission is hereby granted to: FDWARD & DENISE MATTHF,WS
For property located at: 54 SARA-JEN 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 Value
Owner Address: EDWARD & DENISE MATTHEWS
I
54 SARA-TEN Dr l
Total
Value
Pool
alue
QUEENSBURY, NY 12804
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2005-211
INGROUND POOL
$35.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Thursday, April 20, 2006
(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 Qu b day,April 20, 2005
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Application for Swimming Pool Permit
Building&Codes Office—Town of Queensbury 742 Bay Road Queensbury,NY 12804
(518)761-8256 1 Fee Paid
Instructions and requirements are attached. Notes:
1. Applicant/Owner /Contractor or Installer Information:
Room
, . t 2` �-� - � A ,
1�5- 7RS- '72E
2. Person Responsible for Code Requirements:
�/ � 5 , a
3. Pool Location Address: , AP-& j�� Z)P_ V J Tax Map No.
4. Swimming Pool Information: (check whichever applies and fill in the blanks) LIVED
A. m ❑Above ground pool Nluground Pool APR 15 2005
-.__. :x TOWN OF QUEENSBURY
B. �� Length ft. / width 2 C� ft. / diameter ft. / depth_& UILDING AND CODE
C. .< � - `' steel/vinyl; [:]fiberglass;❑gunite; ❑poured concrete;[:]other
5. Fencing Requirements for above-ground & inground swimming pools:
A. If an above-ground,indicate height from ground-grade to top of pool height inches
Note: If your above-ground pool is less than 48 inches above-grade,a fence must be installed within
the area of the pool.
If your above-ground pool is exactly 48 inches above-grade or more,a lift-up ladder with lock
must be installed.
B. If an inground pool,a fence must be installed meeting NYS Regulations,Appendix G.
6. Pool Pump Requirements—Time Clocks:
Pool pumps must be equipped with time clocks so the pumps can be set to shut off during periods of peak utility electrical
demand and set to control the length of time during which the filter nuns.
7. Final Inspection Information:
You are responsible for scheduling the following: A) Electrical Inspection; B) Final Certificate of Compliance Inspection
An electrical inspection is required before the Certificate of Compliance is issued. See attached sheet listing electrical inspectors.
The inspectors are contracted through the Town of Queensbury and you are responsible for payment to them directly. Their fee is
not part of this application.
A final inspection by the Queensbury Building&Codes Office is required before use of the pool is authorized. The Code Officers
will look for an approved electrical inspection(sticker on the panel box)and proper fencing around the pool or lift-up ladder.
Signature of Applicant: '
7J
Signature of Owner: C2 �� L =-r G2 � Date: /S C
Pool Inspection
Queensbury Building&Code Enforcement
Office No. (518)761-8256
742 Bay Road, Queensbury,NY 12804
Date received:
�/�
NAME:
LOCATION:
PERMIT#: � ZA�
INSPECTED ON: am/pm
Arrive: am/pm epa : amip
Inspector's Initials: /'� 1&AQ
Above Ground: In-Ground:
Y N N/A
Pool enclosure around pool
or yard
4 feet above grade 1
2 inch maximum clearance
to grade from underside of
fence
4 inch maximum clearance
in fence pickets
Wall or Doors have self
closing device or alarms (30
second Alarm time)
Ladder secured in place and
latched
Deck gate < 56" to latch no
more than ''/z" spacing in
ate openings
Gate open outward, self
closing
Padlock provided on gates
and ladder
Indoor pool all doors self
closing or alarmed per
AG 105.2 Item 9
Timer on pool pump (no
e wed
Final electrical
Ve_Tiil ss e closed
&locked
Ok to issue CIC
COMMENTS:
CoMMoN
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Dat°••.. b � e COntp ny hall
�a11 haalter he nsequl a ilt plic and'nstationalel. and an
cenificatioat
have the r'glt o'lve Of shall bePrCOnditi�s e preys°uslyis C' ••...
wspEcTop C ke t s c 'nspCc o tly made of date U su d is
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Pool Inspection
Queensbury Building&Code Enforcement
Office No.(518)761-8256
742 Bay Road, Queensbury,NY 12804
Date received:
NAME: _
LOCATION: MWI-
PERMIT #:
INSPECTED ON: )C,/ 0 m'pm
Arrive: am/pm Depart: L„ ' arnipm
Inspector's Initials: i
Above Ground: In-Ground:
T
Pool enclosure around
or yard
4 feet above grade
2 inch maximum cle
to grade from underside fence
4 inch maximum cle
in fence pickets
Wall or Doors have self
closing device or alarms (30
second Alarm time)
Ladder secured in place and
latched
Deck gate < 56" to latch no
more than 'l2" spacing in
ate openings
Gate open outward, self i
closing
Padlock provided on gates
and ladder
Indoor pool all doors self
closing or alarmed per
AG105.2 Item 9
Timer on pool pump (no
plug in timer allowed)
Final electrical
Vehicle access gate closed
&locked
Ok to issue CIC
COMMENTS: W.MR) ����