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POOL-0201-2022 SWIMMING POOL Office Use Only PERMIT APPLICATION Permit#: (; Town of Queens 6ury Permit Fee:$ 140 ; Invoice#: 742 Bay Road,Queensbury,NY 12804 P:518-761-8256 www.gueensbury.net Flood Zone? Y Reviewed B� Project Location: r,a� �o�►e Tax Map ID #: 3c) . (P--a �� Sul vI'MID,, m �1 L� L � I Proposed Install Date: a,o -I a APR 19 2022 TOWN OF OI EENSPURY SWIMMING POOL INFORMATION: BL ILDIL\�G 8,CODE CHOOSE ONE: ABOVE- GROUND IN-GROUND UNHEATED ;�`HEATED (pool cover heater, R-12 req'd) SIZE OF POOL: lg X H 1 ' �6►^^� ��c� MANUFACTURER: POCI S LAk4w MATERIALS USED IN CONSTRUCTION (CHECK ALL THAT APPLY): Steel/Vinyl X Fiberglass Gunite Poured Concrete Other ADDITIONAL IMPORTANT INFORMATION: I. Any changes to the approved plans prior to or during 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 If,for any reason, the building permit application is withdrawn, 30% of the fee is retained by the Town of Queensbury. After 1 year from the initial application date, 100% of the fee 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: �a,i, �� ,,,,,, - SIGNATURE: DATE: Swimming Pool Packet Revised November 2021 CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Applicant: Name(s): 7 au I Mailing Address, C/S/Z: _ I Suicut-L-jar (s-kNf—' ,-e e.Ns on-j /V y Cell Phone: ( 51'�r ) 3 �-a G -,�, G" 3 Land Line: �) Email: 12 a,VeLl,a 5 � (8D aKA-cx 1 . r_a A • Primary Owner(s):. Name(s): Mailing Address, C/S/Z: Cell Phone: _( ) Land Line: _( ) Email: ❑ Check if all work will be performed by property owner only • Installer/Contractor: (List all additional contractors on the back o is form) Contact Name(s): See- T'�l C �-rn lA L- t)- - A--ct 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 November 2021 Maria Gagliardi From: David Cann <davec6253@gmail.com> Sent: Tuesday,April 19, 2022 9:30 AM To: Maria Gagliardi Subject: Re: pool permit for 3 Sweetbriar Lane ' u pnnlo.ufi off'rtFdward �s doingthe work. triip:-�al,poo.tsAare tFeirpler. Please lets a kno if yo.0 nee . iie�s .� ave�ca_nx� - - _..__ - -- On Apr 19,2022,at 9:20 AM, Maria Gagliardi<MariaG@queensbury.net>wrote: Good morning, This is Maria in the Town of Queensbury Building and Codes Department. I'm just inputting your pool permit into our computer system and have a question. You never filled out the "Installer/Contractor" information on the Contact Information sheet with your permit. So I would just like to know if Imperial Pools, listed on the cover sheet of the permit application, is going to be the installer, and what their exact contact information is, or if Sprague Pools, listed on the Worker's Comp information submitted with the permit, is going to be your installer and what their contact information is,or are the businesses one in the same. Thank you. Maria Gagliardi Maria gaJc IiaNdi, V own of Queens&T Senior 7ypisf (518l 761-821g www.queenstia .nef 1 » � E �' 9 . TOWN OF QUEENSBURY BUILDING DEPARTMENT APR 19 2022 t^_,.,{n., ;.... ,tip omp tp 1^ A �strue i the pi" are in TOWN OF OUEENSBURY Ali v<7,' of BUILDING& CODES hb-a rork Stateaa ..... 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