2004-667 TOVN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building &Codes (518) 761-8256
- CERTIFICATE OF COMPLIANCE
Permit Number. P20040667 Date Issued: Thursday, September 06, 2007
This is to certify that work requested to be done as shown by Permit Number P20040667 has been completed.
Tax Map Number. 523400-301-013-0002-083-000-0000
Location: 14 CHIPPEWA Cir
Owner. JOHN &DIANE D'AMBROSIO
Applicant: JOHN & DIANE D'AMBROSIO
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
property owner of the responsibility for compliance with Site Plan, j
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 i2804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040667 Application Number: A20040667
Tax Map No: 523400-301-013-0002-083-000-0000
Permission is hereby granted to: JOHN&DIANE D'AMBROSIO
For property located at: 14 CHIPPEWA Cir
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: JOHN&DIANE D'AMBROSIO Inground Pool
14 CHIPPEWA Cir Total Value
QUEENSBURY, N.Y. 12804
J
Contractor or Builder's Name/Address Electrical Inspection Agency
BOB BAKER POOLS
SISSON ROAD
SOUTH GLENS FALLS, NY
Plans&Specifications
2004-667
INGROUND POOL
$35.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday, September 02, 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 To of e s eptember 02, 2004
SIGNED BY �® for the Town of Queensbury.
Director of Building&Code Enforcement
application for Swimming NOW Permit Permit No.
Building&Codes Office—Town of Queensbury 742 Bay Road Queensbury,NY 12804 O
(518)761-8256 Fee Paid C�
Instructions and requirements are attached. Notes:
1. Applicant/Owner /Contractor or Installer Information:
Raw-
lop 0�
PW-
A G 3 0 2004
"TOWN OF QUEENSBURY
2. Person Responsible for Code Requirements:
3. Pool Location Address: ° Q Tax Map No. j J —��
4. Swimming Pool Information: (check whichever applies and
�fi..11 in the blanks)
A. ❑Above ground pool Inground Pool
B. i a "irl Length ft. / width ft. / diameter ft. / depth fL
C. a u�" a t steellvin 1• fiber lass ❑ to ❑poured concrete ❑other
m 1 Y ❑ g � ; P
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- ade 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 nms.
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 Date:
Signature of Owner: Date:
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THE INSPECTOR
7063 State Rt.374,Chateaugay,NY 12920
1-800-487-0535 tvmv.theelectricalinspector.cum
O
Date.April 13,2007 Application No.On File:043999 , m
r! THIS CERTIFIES THAT John Damdrosia >.
Only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of: r
14 Chippewa Court Town of Queensbury Contractor: Don Beagle
.In the following location, BasemcntX IST'loor 2"dTloor No,of Apt Garage Attie Outside X Commercial Residence X
7
t4
Was examined on 3/14/07 and found to be in com Hance with the requirements of the National Electric Code.
l GFCI Fixture Outlets Receptacles Switches Fixtures Ranges Cookie Decks Ovens Dish Washers I Exhaust Fans I Smoke/Heat
CI
r. Incandescent Fluorescent Other Amt. K.W. Amt. K.W. Amt. K.W. Amt. K.W. Amt. K.W, Detectors Ct
2
Dry
ers Furnace Motors Dimmers Water Heaters Unit I leaters Multi Outlet Sys. Electric Heaters \1
l Amt. K.W. Oil H.P. Gras H.P. Amt. Watt Electric Oil Gas Amt. Rating No.or Feet Amt. K.w. Amt. K.W. Ami. K.W. Amt. K. % I
Transformers Alarm Systems Special Receptacle Panels Motors Signs Track 1,ighting Dig osal �I
l Amt KVA AN PS Det Panel Amt. K.W. Amt. No.of circuits Rating Amt. H.P. Amt. No.of Lams No,of Heads Amt I H.P.
1 35 200 1 FR
t
1 2 20
r(Jl
Service Disconnect Equipment Service CD
.� i CD
Amt. Amp. I Type Meter I Phase 1 Phase 3 Phase 3 Phase No.of CC, AWG. No.of AWO,of No.of AWG of
2W 3W 3W 4W Cond.l base CC,cond. Ncutmis Neutrals HI-Les HI-Les O
to
lOtherApparalus
I Time Clock
Manager
This certificate must not be altered in arty manner,retuni to the office of THE INSPECTOR if incorrect, Inspector's credentials can be verified
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4
Pool Inspection
Queensbury Building & Code Enforcement
Office No. (518) 761-8256
742 Bay Road, Queensbury, NY 12804
Date received:
1
NAME:
LOCATION:
e
PERMIT#:
INSPECTED ON. .4141_ am/pm
Arrive: /pm Depart:
am/pm
Inspector's Initials: F,Ip,�
Above Ground: �In7-Ground:
Y N NA
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
Pool Surface Motion
Alarm
Ladder secured in place
and latched
Deck gate <56" to latch
no more than 1/2" spacing
in gate openings
Gate open outward, self
closing
Padlock provided on
ates and ladder
Indoor pool all doors self
closing or alarmed per
AG 105,2 Item 9
Timer on pool pump (no
plug in timer allowed
Final electrical
Vehicle access gate
closed & locked
Ok to issue C/C
COMMENTS: reic of ' cop
C11 .6166-tri CCU/ � ��,
`ram
Pool Inspection �444 (
Queensbury Building & Code Enforcement
Office No. (518) 761-8256
742 Bay Road, Queensbury, NY 12804
Date received:
O
NAME: /
LOCATION:PERMITINSPECTED ON; am/pm
Arrive: art;
am/pm
Inspector's Initials:
Above Ground: 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
Pool Surface Motion
Alarm
Ladder secured in place
and latched
Deck gate <56" to latch
no more than 1/2" spacing
in gate openings
Gate open outward, self
closin
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 C/C
COMMENTS: � -T(:5 W41q&y
Pool Inspection 3 //�` ��
/Vta;
Queensbury Building&Code Enforcement u a/ Joc
Office No. (518)761-8256 /
742 Bay Road,Queensbury,NY 12804
Date received: yy��
NAME: !J`A MrB i O
LOCATION: C'Y_
PERMIT#: 0 41—
INSPECTED ON:
Arrive: am/pm Depa t:N'am/pm
Inspector's Initials: _�� �yV
Above Ground: 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 %" spacing in
ate openings
Gate open outward, self
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 C/C �',�
COMMENTS:Q ��
Pool Inspection
Queensbury Building&Code Enforcement
Office No. (518)761-8256
742 Bay Road, Queensbury,NY 12804
Date received:
NAME: '`'J_ *"'4' 91 40 s Z-,)\
LOCATION:
PERMIT#: Q
INSPECTED ON: l am/pm
Arrive: am/pm Dep rt: - an*m
Inspector's Initials:
Above Ground: 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 i
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 %" spacing in
ate openings
Gate open outward, self
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
2lug in timer allowed
Final electrical
Vehicle access gate closed
&locked
Ok to issue C/C
COMMENTS:
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