2002-267 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902. (518)761-8201
Community Development-Building&Codes (518)761-8256
CERT IFICATE OF COMPLIANCE
Permit Number: P20020267 Date Issued: Ffiday,May 21,2004
This is to certify that work requested to be done as shown by Permit Number P20020267
has been completed. .
Tax Map Number: 523400-295-017-0001-044-000-0000
Location: 13 PINEWOOD HOLLOW Rd
Owner: RALPH BROTHERS SR
Applicant: RALPH BROTHERS SR
This structure may be occupied as a:
By Order of Town Board
Above Ground Pool TOWN of QUEENSBURY
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20020267 Application Number: A20020267
Tax Map No: 523400-295-017-0001-044-000-0000
Permission is hereby"granted to: RALPH BROTHERS SR
For property located at. 13 PINEWOOD HOLLOW-Rd
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: RALPH BROTHERS SR Above Ground Pool
13 PINEWOOD HOLLOW Rd Total Value
QUEENSBURY,NY 12804
Contractor or Builder's Name/ Address Electrical Inspection Agency
ISLANDER POOLS & SPAS.INC.
1967-73 CENTRAL AVENUE
ALBANY.14Y
Plans &Specifications
2002-267
ABOVE GROUND POOL AS PER PLOT PLAN SPECIFICATIONS
$25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Saturday,April 19i 2003
(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 the4oZnNkf Q ns pril 19,2002
SIGNED BY for the Town of Queensbury.'
Director of Building&Code Enforcement
Building.& Codes Office Swimming pool Z.
Town of Queensbury �
742Bay.Road Permit Application. �7ee Padd' $
Queensbury,NY 12804 'e, �ird7c�t c
(518) 761=8256
, 1 i
1. Applicant: V1 tIS Owner: l VLC rS,
Address: i?J �yt � <<�JX. Address: = �
3 /c APR 16 2002
Phone No. `a `1'4•IS li�6q3 _ Phone No.
TOWN OF QUEENSBURY
2. Person responsible for code requirements:
3. Contractor/Installers �„ n o�S
Address
5 CA
Phone No.
4. Pool Location Address:, . I-S ?i Ve ,��r� � � f-4X
S. Tax Map'Number. �GJ . �7 / --. 9. . ;
6. Type of Pool: Bove=ground poo I in-ground pool
7. Size of Pool: length ft. diameter a l ft•
width ft. depth 5Q. M
8. Approximate Water Capacity_�_gallons
9. Materials used in construction(circle below)
Sim Uviriyl Fiberglass Gunite Poured Concerte Other
F
10. Submit a:diagra n;drawn to show property Lines;existing structures,proposed or existing septic
system, location`ofproposed swimming pool. Show all-setback distances from property lines to
both-the pool and the,structures, as well as separations between them.
An electrical inspection is necessary before the Certificate of Compliance is issued.
See attached sheet for electrical inspectors.
The Building and Codes Office needs to be notified upon completion of construction; including
installation of fencing. A final inspection will be made before use of the pool is.authorized.
Applicant Signature: Date:
Owner Signature: Date:
(if different from applicant name)
Pac>1 Irl specticari .
Queerisbury Building &r- Code xrforcement
(DEf-ice 1 ®_ (518) 761-8256
742 Bay Road, C?ueensbury, NY 12804
Date received:
INSPECTED �N: /'� a �m
Arrive: m/ epQft:
Inspector's Initials:
NAME: -
PERMZT`
LO CATION:
Abo-re Cxround: ' •--'"' Ix�-ground :
Y N N/A
Pool enclosure arourid pool
or yard
4 feet above grade
2 irich maximum clearance
to grade from underside of
ferice
4 i_ ncl-i rriaxirrium clearance
iri fence ickets
Wall or Doors have self
closing device or alarms (30
second Alarm time
Ladder secured in place acid
latched
IDecic gate -- 56" to latch rio
more than -" spacing in
ate o enings
Gate opens outward, self,
closing
Padlock provided on gates
or ladder
Indoor pool all dc3ors self
closing or alarmed per
AG105.2 Item 9
Timer on pool pump (no
pl-ug iri timer allowed)
Final electrical
'Vehicle access gate closed
<�-- locked
Cal-- to issue CfC
C<J 1VI1\4IE IN-JC S
qwbo h----
Pc o(Dl Il x.spccti«n
Queernsbury 13uildirig Sz. Code F�nforcemerrt
+Gffico No. (518) 761-8256
742 Bay Road, Queerisbiiry, NY 12804
Date received:
ITTSPECTED ON: amlpriz
Arrive: iri/ z epart: arri/prri
Inspector's Initials v
LOCATION= 2-—
Above; Ground: In-Ground.:
Fool eneloszzre arourxd pool
or yarcl
4 feet above grade:
i maximum 2 inclaimum clearance
to grade from underside of
fence
4 inch rnaxirriurn clearance
in fence icicets
Null or Doors Have self
closing device or alarms (30
second Alar a time)
Ladder secured in place and
latched
Deck gate — 5 6" to Latch no
rnore than %" spacing in
ate o enin gs `
Gate opens outNvard, self
closin
Padlock provided on gates
or ladder NOO
Indoor pool all doors self
closing or alarmed per
AC3 1 O5 _2 Itern 9
Timer on pool pump (rio
plLig in timer allowed)
Final electrical
Vehicle access gate closed
�. lcscl{ed
OLc to issue C/C
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