2002-931 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: P20020931 Date Issued: Wednesday,July 21, 2004
This is to certify that work requested to be done as shown by Permit Number P20020931
has been completed.
Tax Map Number: 523400-308-014-0001-037-000-0000
Location: 25 AMETHYST Dr
Owner: MICHAEL&KIMBERLY NELSON
Applicant: MICHAEL&KIMBERLY NELSON
This structure may be occupied as a:
By Order of Town Board
Inground 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: P20020931 Application Number: A20020931
Tax Map No: 523400-308-014-0001-037-000-0000
Permission is hereby granted to: MICT-TAFI.&KlMBFRLY NELSON
For property located at: 25 AMETHYST Dr
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. Ty
pe of Construction Value
Owner Address: MICHAEL &KIMBERLY NELSON Inground Pool
25 AMETHYST Dr Total Value
QUEENSBURY,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
BOB BAKFR
SOIJT14 GLENS FALLS.NY 12803-0000
Plans&Specifications
2002-931
Construction of a 3 2'xl 6'x8' inground swimming pool per plot plan.. t�specifications.
$35.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: a4ur,lay,November 15,2003
orc
(If a longer period is required,an application for an extension must be made to the code Enforc meet Officer
of the Town of Queensbury before the expiration date-)
Dated at the T wn o
3jul ovember 15,2002
SIGNED BY .......... for the Town of Queensbury.
Director of Building&Code Enforcement
Building& Codes Office Swimming pew a - 1
Town of Queensbury
742 Bay Road Permit Application 57ee Pdd $
Queensbury,NY 12804 � �Dom•
(518) 761-8256
1. Applicant: �I yt : G�A s j) Aj:f, Owner: jV mb)90�
^ b e vs�,r�
Address: �Gl rn Address: "ZS
Q3�rl.r
Phone No. Scy,Yy,e_ Phone No.
2. Person responsible for code requirements: $
3. Contractor/Installer f--I)v ater,
_
Address 5 a- G)
Phone No. RECEIVED
4. Pool Location Address: 2--5- N 0 V 0 4 Z0 02
5. Tax Map Number: /4 -1- 37 T BUILDING AND Q0
6. Type of Pool: above-ground pool in- ound oo
7. Size of Pool: length 3 Z ft. diameter ft.
width 1 to ft. depth 41�S- ft.
8. Approximate Water Capacity gallons
9. Materials used in construction(circle below)
SteeUv_i Fiberglass Gunite Poured Concert Other
10. Submit a diagram; drawn to show property lines, existing structures,proposed or existing septic
system,location of proposed 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: �qa P Date: l O 2
Owner Signature: / �.,�,� Ylej "�-�,, Date:
(if different from applicant name)
Qxxec-risbxiry l3ttildirig � A--c3da Eriforcernent ~, ' '' - -- ��
(DFf-ioc-- f518) 761-8256
742 nay Road, Qtic--cxisb"ry, 1,-T-)e' 12804
Date received:
1SSPE5I- ET_ C :- =L/px
Arrive: CPErt: a
Inspector's IliftLd s
PERMIT #_
Pool enclosure around pool
or yard
4 feet above grade
2 inch rriza:?clirrivirri CAe.-LYIUTICe
to g-raclf-- firc3,rri underside
fence
4 inc--la nia:2mcinaLirri clearance
in fence13ic-AccAs
Wall or ]Dc>c>rs have self
c--Ic>siia:g device cr alarms (30
secorid Alarm tirric--)
T-acicl(--r se<--iAr(--ci in plxc-c-- anal
latellt--cl
gate 56" to latch no
rnc,re than spac--ing in
Igate oD-pg--riinAs 00
clzlte 4DP4--ri outward, se--If
cJosirljg
1Pzxcllpc--lc- prc>-%.-ide-cl on gates
and I,-idcl4--r
Indoor pc)c>l all c1c>c3rs self
cl<3sitlg or ELlur=c--cl per
-A.C1105-2 lt4--rri 9
-rirrier on ]pc)c>l IaLirrip (ri<3
plti.g in tirric!r allowed
Final electrical
VcJliclo access gate C-lo-se-ci
Sr- lc3cl--ecl
Ok to issue <'-/C
C>Tl*,4 M IF-Pq-Y S:
COMMONWEALTH ELECTRICAL INSPECTION SERVICE, INC.
Main Office 176 Doe Run Road • Manhcim, PA 17545
MUNICIPAL CERTIFICATE o. ELECTRICAL APPROVAL �
Pemit No, 8 0 2 4 9!!!##uririnl111iNililiNl/i1r1llfiil w+��# � Cut-in Card No.
iiiifi11141fHilii!!#i{!{rrrr ##!!1
r/�n��rN#fifllt �► ii#ttM!!i #f #i1 #li1ii11111i#uilfFiii.ililFialiiilllu!•N#la!###falrllaarlrr!#rarlirlrr{114i1i#riaili111M#a#uiiiiiMi#iff+!!i.####i!u#.{#1
I �1�I //fi 1ai f i171 /q
�O�at10*�#/#{ !i{{#a###{{#!.!!/{{i!!#BIu11l/�i�/)ui i/.illrri •Nair!##{{ifuii!#{#iturfli#{luf{!###B•#iN1{#Bill!!!Ir{BN.I #fiHiiiiiiBillu{i{tfliiiN{tilfuili
InstallationConsisting of 1!i• rr llirlrililiilllrllr{{rlir{!rr{{!!!! rr r r#!!#/ 1!#nrr{f#rlrB1B{f#I#!##illll fit ill Irl!##r#1 rl • tlul{
#iliail##ii{if lBi##.NBIlIm####i#B##M#########Iiltr14INfN#44MMfoil!♦i#1{##B####B##r!###►t#IBB#BBiB##.#B###Iiiiltill MlililiB0#0000MS#N.if 1iiMM####I
#!#BBIBiBilliiifi#iiiilf f q!i!i#fH#r!{{{!!f!##{{#!#•i{!i1!#!!{!{Inlii#{{!n{##tu!!!###irlulNi{#!{t#NH#!H!!###{!!##!####lrur#!#friillBilf#{i iiiiB BiiiliBi./!tf lf#tl
Installed Byloo## Lie# No.
The conditions fallowing governed the issuance of this certificate, and any certificate previously issued i
cancelled,
This certificate only covers the electrical equipment and installation conditions as of slate. Upon tht
introduction of additional equipment or alterations, application shall he promptly made for inspection.
Inspectors of this Company shall have the privilege of snaking ins ns at any time, and if it.,
rules are violated, the Company shall have the right to r evoke this a Ica #
Date,06el,,Nlf#•!1{l !f#i!•#iliifliit.lrlli#/!tf{#{!fi{ INSPECTOR fill iH #!!##{ ## #{i!!#!!!##rrrrr!#i##liirr!#lllilliill�llflllil{#t/t#{!!{!/{tr!#rHl
Mprnher N.FPA.. I.A.F.1.
I
20'-411
4Y-2°
1 , b,l 1b'X32'
i 23 POOL
O -
DRIVEWAY 151111
HOUSE
921_811
NOTE:
POOL INSTALLER:BAKER POOLS
DIMENSIONS ARE 10 WATERS EDGE
RECEIVEL)
NOV 0 4.2002
TOWN ofQUEENSMY POOL SIDE PLAN
BUILQI��ANQ Q .
HOME OWNERS:
MICHAEL&KIMBERLY NELSON
•�� 25 AMETHYST DR,
,,� QUEENSBURY,N.Y,128D4