2004-164 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20040164 Date Issued: Monday, April 25, 2005
This is to certify that work requested to be done as shown by Permit Number P20040164
has been completed.
Tax Map Number: 523400-308-005-0001-079-000-0000-
Location: 20 LAUREL Ln
Owner: ANDREW & WENDY JAUSE
Applicant: ANDREW &WENDY JAUSE
This structure may be occupied as a:
By Order of Town Board
Inground Pool TOWN OF QUEENSBURY
- yx
Director of Building&Code E rceme
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040164 Application Number: A20040164
Tax Map No: 523400-308-005-0001-079-000-0000
Permission is hereby granted to: ANDRRW&WF,N1)Y JA1 TSR
For property located at: 20 LAUREL Ln
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: ANDREW&WENDY JAUSE
20 LAUREL Ln I Tootaltal Value
V Pool
alue
QUEENSBURY,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2004-164
INGROUND POOL
$35.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,April 14, 2005
(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 ,,i_"of Quegnsbury; Wednesday,April 14, 2004
SIGNED BY %1 - for the Town of Queensbury.
Director of Build g& de Enforcement
Application for Swimming Pool Permit permit NoX4"&I
Building&Codes.Office—'Town of Queensbury 742 Bay Road Queensbury,NY 12804 CDb
(518)761-8256 Fee Paid
Instructions and requirements are attached. Op Notes:
1. Applicant/Owner /Contractor or Installer Information:
� , Cantractor/ nstaller;_<_
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2. Person Responsible for Code Requirements:
3. Pool Location Address: 02 0 `-aQ re_( 1AM P �PJT_ Tax Map No. , 6 S — —7
4. Swimming Pool Information: (check whichever applies and fill in the blanks)
RECEIVED
A Type of Po r ❑Above ground pool [2 Inground Pool
B She foot Length ft. / width_L&__ft. / diameter ft. / depth 9 ft. p P D L 7 2 p 0 4
s
C MaZerrals;us�d zn cnnstrual�olz: E/steel/vinyl; ❑fiberglass; ❑gunite; Ypoured concrete;❑otherT0VW! E. SEURY
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 runs.
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: i Date: 7 -7 0/
Date: Loil
Signature of Owner: !/ui���-�.�� "D �/7
Pool Inspection q
Queensbury Building&Code Enforcement
Office No. (518)761-8256
742 Bay Road, Queensbury,NY 12804
Date receivedN`Ov
::NAME: t—k
LOCATION:
PERMIT#:
INSPECTED 07: /bC.S' Van]
Arrive: am/p6i part: ai
Inspector's Initia
Above Gray tid: In-Ground:
Y N N/A
Pool enclosure around pool
or yard
4 feet above grade
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 opens outward, self
closing
Padlock provided on gates
or ladder 14
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 C/C
COMMENTS:
MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
�Ger/ocea that the electrical wiring to the electrical equipment listed below has been examined and is approved as
being in accord with the National Electrical Code, applicable governmental, utility and Agency rules in effect on the date
noted below and is issued subject to the following conditions.
Owner: Andy Jause Date: 05/26/2004
Occupant: Unknown Location: 20 Laurel Lane
Queensbury, Warren Co. NY
Occupancy: Swimming Pool
Applicant Ambrose Electric
790 Watervliet Shaker Rd
Latham, NY 12110
No. 1 4G0,1•.3;1, 3.31-,HE' r..
Equipment:
1 — Switches;.:`;. 1 = .GFCI Receptacle; 1 — Fixtures; 1'- — Pump;
HP Motor; 1 Timer, 1 — Heater
This certificate applies to the electrical wiring to the electrical equipment listed immediately null and void. This certificate applies only to the use,occupancy and
above and the installation inspected as of the above noted date based on a visual ownership as indicated herein. Upon a change in the use,occupancy or ownership
inspection. No warranty is expressed or implied as to the mechanical safety, effi- of the property indicated above,this certificate shall be immediately null and void.
ciency or fitness of the equipment for any particular purpose. This certificate shall In the event that this certificate becomes invalid based upon the above conditions,
be valid for a period of one year from the above noted date. Should the electrical this certificate may be revalidated upon reinspection by Middle Department
system to which this certificate applies be altered in any way,including but not limit- Inspection Agency, Inc. An application for inspection must be submitted to Middle
ed to,the introduction of additional electrical equipment and/or the replacement of Department Inspection Agency, Inc. to initiate the inspection and revalidation
any of the components installed as of the above noted date,this certificate shall be process. A fee will be charged for this service.