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final electrical inspection 7 f SWIMMING POOL office Use only PERMIT APPLICATION Permit#: Pow•© '��• Zo2Z Town of Queensbury Permit Fee:$ � •Invoice#: 742 Bay Road,Queensbury,NY 12804 P:518-761-8256 www.gueensbury.net Flood Zone? Y N Reviewed ByJ /` Project Location: :S'"0 RI/P-a /IE _ Tax Map ID #: Subdivision Name: Proposed Install Date: A-A7 UZ-2 - 30/2 C"02_ =;;�-� , W , �1 s E I, tit �� �J I SWIMMING POOL INFORMATION lease fill out completely): II �PA �UL 2 € 2022 � �, TYPE: CHOOSE ONE: TOWN ABOVE-GROUND 'UNHEATED �'J!' UI° �' ` j 'd_ IN-GROUND (inc. partially) — HEATED (pool cover heater, R-12 req'd.) COST OF CONSTRUCTION: 0 CIO SIZE OF POOL: j S MANUFACTURER: � `ram' MATERIALS USED IN CONSTRUCTION (CHECK ALL THAT APPLY): I Steel/Vinyl Fiberglass ��G u n ite Poured Concrete Other 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 cI rtificate of compliance before use of the pool. I have read and agree to the �/theea�bove: PRINT NAME: I-t U/l I 1 l, Iff SIGNATURE: DATE: i i Swimming Pool Packet Revised July 2022 CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Applicant: 1 Name(s): �� /- Mailing Address, C/S/Z: �5-gU Gt/e�� t` ouvi�•�zrl/C. I Cell Phone: ( 'b�l` ) 0 Land Line: ( 077?J ®'i Zk Email: 1<i [tali . oC4-1 i • Primary Owner(s): Name(s): T1-t�a Mailing Address, C/S/Z: S'OtAZ--aT- aloe Cell Phone: _ Land Line: _( Qom ) 017t d Email: 0 Check if all work will be performed by property owner only • Installer/Contractor: (List all ad itional contractors on the back of this form) Contact Name(s): A w G Contractor Trade: Mailing Address, C/S/Z: S lZd- fie(/ _ Cell Phone: _( 'dql�,-) Land Line: _( , Email: Coot cznf"�-S Ma _ G(^ "Work rs' Comp documentation must be submitted with this application" I Contact Person for Compliance in regards to this project: AK' is Cell Phone: S- ) Z- Land Line: Email: cn i i i i i Swimming Pool Packet Revised July 2022 i Sr 77 . � gi•3 � e� O � L O a _ Y e Y 0 N s cv t : :4 r A o'14) -Q GG _SENT 0 X E Please assur u familler wh%he Pool �� Enclosure requireme specific to your pool. ' ; You are required to eet all applicable codes jn• j -4 regarding swimmin pools, spas & hot tubs TF01- at the time of insp ction. . o p lr`1 :r f R O C* (D O _ - 89 :� }-. --- - rt M N TOWN OF ptENSBURY � � V BUILDING; C�7D�S DBPTo o a C Reviewed B�: � O Date, lV TOWN OF QUEENSBURY' N BUILDING DEPARTMENT p Based on our limited examination,compliance N with our comments shall not be construed as N indicating the plans and specifications are in full compliance with the Building Codes of New York State. I I j I� } I 3*014 Done ii ,)bdc577.ssl.cf2.rackcdn-Com of 1 j. PLAN VIEW 3 4' E I PROFILE Ee SECTION A—A VWIDW,MEP APFKY. mu rury N FEVr i SrM fA73 -Z, vvV USE OF DIVING EQUIPMENT IS PROHIBITED gD(tj= "Zi ot I.ME"4AAU7 ar-WA,x um;o rg Ay w "PP1-MMIN V-t.-it W's".V tl-VO M AT trit lom lftmv cr-WXL K wo"IXVA r%AT TM Wu cmn vo ft w mwfA--rps or m"mL., Moolm SIAL w"AX rcom no wn cmu C W"N=�M EF MMAR3 110 K SAL MO IL TIC 0 f=-00—WIM*ML U MTA"=al W PX&MOrcE M.Uxm 1,.Xm vw,W.tSA,,,,M Mim M#,Jt>:•N CF'm to%W um,"L.M cr IL WMWAU WM-M'Um C�l 04 Rke wu OR 0=w VArA I POOL I CWMIL SM D=103 S3 tE m,,qm A4 ft,= m—TZ K 3N-A4-r omA P.T.. m wwef%MMV.T Uo,CTHM-0-,--WrmKr KAY BE LMCREXSED jjM - Cr—*4 ➢Att MU KATO At-L I-L' wtowm ocxs-lAr m DA:o m Poo- 1 WALT I THE INSPECTOR 5390 State Route 11,Burke,NY 12917 1-800-487-0535 www.theelectricalinspector.com e � � Date:November 28,2022 Application No.On Fite:171918 THIS CERTIFIES THAT Shane Brown r ' Onlythe electrical equipment as described below and introduced b the applicant named on the above application number in the remises of: Y PP PP P �,I ,Ills 580 West Mountain Road Town of Queensbury In the following location: Basement Is'Floor 2'Floor No.of Apt Garage Attic Outside X Commercial Residence X Was examined on 9/27/22 and found to be in com liance with the requirements of the National Electric Code. GFCI Fixture Outlets Receptacles Switches Fixtures Ranges Cooking Decks Ovens Dish Washers I Exhaust Fans Smoke/Heat Incandescent 2 Fluorescent Other Amt K.W. Amt. K.W. Amt. K.W. Amt. K.W_ Amt. K.W. Detectors 1 Dryers Furnace Motors Dimmers Water Heaters Unit Heaters Multi Outlet Sys- Electric Heaters Amt. K.W. Oil H.P. Gas UR Amt. Watt EIectric Oil Gas Amt Rating No.of Feet Amt. K.w. Amt. K.W. Amt ICW. Amt. K.W. Transformers Alarm Systems Special Rece tacle Panels Motors Signs Track Lighting Dis osal Amt. KVA A/V PS Det. Panel Amt. K.W_ Amt. No.of circuits Rating Amt. I H.P. Amt. I No.of Lams No.of Heads Amt. H.P- 1 FR 1 2 50 1 1.5 Pent- air Service Disconnect Equipment Service Amt. Amp. I Type Meter 1 Phase 1 Phase 3 Phase 3 Phase No,of CC. AWG. No.of AWG.of No.of AWG of 2W 3W 3W 4W -Cond./phase CC.coed. Neutrals Neutrals HI-Les HI-Legs Other Apparatus Pool bonding Manager This certificate must not be altered in any manner,return to the office of THE INSPECTOR if incorrect. Inspector's credentials can be verified.