POOL-0197-2021 SWIMMING POOL Office Use Only
PERMIT APPLICATION Permit#: �OtJ�' l� "�QZ-I
7biVti of Ludensbaty" Permit Fee:$i 1 V .Invoice#450502..
74%Boy Rgad,Icy@@ngbyry,NY 12694
Pi 616=761=6766 www.gueensbury.net Flood Zone? Y 40 Reviewed By6mx)
Project Location: •3 Z Rv6&, eo o'-r
aveE4.S&14' NN 12&0�f
Tax Map ID#; Subdivision Name:
30i, 15- 1' 3) DECEOWE
Proposed Install Date:
APR 0 7 2021
SWIMMING POOL INFORMATION: TOWN OF QUEENSBURY
CHOOSE ONE: ABOVE-GROUND IN-GROUND BUILDING&CODES
SIZE OF POOL:
MANUFACTURER: SKRRK L 6
MATERIALS USED IN CONSTRUCTION (CHECK ALL THAT APPLY):
6;l/Vi;) Fiberglass Gunite Poured Concrete Other
ADDITICONAL IMPQRTA-NT INFORM AP TION:
1, Any change§to the approved plang prior to or daring construction will require the submittal of_
amended plans, additional reviews and re=approval.
2, If, for any reason,the building permit application is withdrawn, 30/ of the fee is retained by thie
Town of Qu@@nsbary, After 1 year from the Initial application date, 100%of the tee is retained,
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: 100poA,56
SIGNATURE: 'i ,a �..� DATE: y/Io/21
Swimming Pool Packet Revised December 2020
J r r+
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s): J05F-m I.Owug 2�1a
Mailing Address, C/S/Z: 3 w—rexi ao(Q
Cell Phone- Land Line:
Email:
� �roncos ®�a�Mac�com
• Primary Owner(s):
Name(s):
Mailing Address, C/S/Z: nMtS
Cell Phone: Land Line.
Email:
Check if all work will be performed b roe owner onl
P Y property�1l �C
Installer/Builder: (List all additional contractors on the back of this form)
Contact Name(s):
Contractor Trade:
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email:
"Workers' Comp documentation must be submitted with this application"
Contact Person for Compliance in regards to this project:
Cell Phone: Land Line:
Email:
Swimming Pool Packet Revised December 2020
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pCCE0W E
AUG 0 4 2021
TOWN OF QUEENSBURY
BUILDING&CODES
C'C>sMIMON`'pEAi,TN ELECTRICAL INSPECTION SERVICE,INC.
V.
Ch..
• NtttNt Office 17611oC Ran Road-Menhctm,PA 1754$
.•: MiUNICIPAI.CLRTAFICNFE - ELECTRICAL APPROVAL
w' Permit No........................................C;ert. N 2 4 2 z 9 Cut to Card N ....................................
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`: Owner........................tryf;:.......f .f�n..o.. .N..S.t..........................................................................................
i ;... . Location..................J...... .... ....... ......................................................................-......-.•............. ..�
.............................. . ..............................................................................
-,:.. Inst811r�tiUn ConSiutittg�f................. .....
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Installed By.....L-e . ../LSre�r kcive!................................Lie.No................................................... :: Y
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-• '• i The condjtjnn:i fi+IloWing governed the issuance of this certificate,and any certificate previously issued is .•-_�,;
r;;i.•. This cerlifisale'only savers the clecttical equipment seed installatiotl coni►itions as of date. Upon the :•.�.yt19�
l�1'9:i�: •.Rtt
introduction of additional esattipment or altor:ttions,application stall be promptly made for inspection. . •„�
Inspectors cif this'Company shall have the privilegq of snaking• inspections at any time, and if its if;z
3ti> '
; ; rules are violated.the C:ontpemy sltnll have the right to revoke this certificate. • ;'Tts
bate.......... ...... ......... INSPLUOR ...............................
iq;' Member N.[�P-A.,I.A.E.I.
90 3Jdd maHnW NON V89186L 0Z:91 lzoz/00/80
A4212 -- Pool Watch Pool Alarm
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Introduction
Thank you for purchasing the Pool Watch NA4212 swimming pool alarm.
This product is the result of years of research and development and is
loaded with patented features, which will make your swimming
environment a safer area for yourself, family, guests, and pets.
This product has been designed using innovative and intelligent software,
coupled with high-tech sensors to provide you with an efficient yet trouble
free solution to pool security. It has been engineered to detect the
intrusion into the pool by a young child, while not having annoying false
alarms caused by wind, rain, filter, floating objects, or automatic cleaners.
It has been tested against to the toughest standards all over the world and is
now ready for your pool.
Vital Information
The NA4212 is easily installed on most pools with the following exception
of negative edge or infinity pools. Please read the entire installation manual
before beginning the installation of this alarm. Once read through, follow
the manual step by step to insure a quick and easy installation process.
The NA4212 is a pool alarm designed to detect an intrusion into an
unsupervised pool. It is not a lifesaving device and should not replace the
supervision of children around a pool by responsible adults. It is
recommended that a pool be protected by layers of protection such as a gate,
a gate alarm, pool cover, etc.
MAN
r IN POOL RESIN STEP & LADDER COMBINATION SYSTEM
' Fits Above Ground Pools From 48" to 54"
-- amide, Non-Slip Platform
Step System Creates Barrier That
,f Conforms to ANSI/APSP Barrier Standards
x Flip-Up Outside Barrier
Prevents Entry To Pool
- Area _1
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Cam'
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TIO I N OF-QU-E�N�S U. y
BUILD N &
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gat:
�ATtENTION HOME OWNER
PIe se-ass re yo aye familiar the Pool
Enc osure require en ts specs c t._ooJ_yo r pool.
You are required to meet all applicable codes
�egardir�g swimming pools, sp as-&hot-tubs
at- a-ti f-In6pe on
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SB SAY
301.15-131 POOL-0197-2021 BUILDING &CO
Donahue, Joseph
3 Briggs Ct
Above ground pool
print-gra ph-pa per.com