2015-088 TOWN OF QUEENSBUR'Y
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20150088 Date Issued: Tuesday, September 08, 2015
This is to certify that work requested to be done as shown by Permit Number P20150088
has been completed.
Tax Map Number: 523400-308-014-0001-036-000-0000
Location: 23 AMETHYST Dr
Owner: WILLIAM BORGOS
Applicant: WILLIAM BORGOS
This structure may be 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,
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 12804-5902 (518)761-8201
Foor
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20150088 Application Number: A20150088
Tax Map No: 523400-308-014-0001-036-000-0000
Permission is hereby granted to: WILLIAM BORGOS
For property located at: 23 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. Type of Construction Value
Owner Address: WILLIAM BORGOS Inground Pool
JILL CROMBIE-BORGOS Total Value
23 AMETHYST Dr
QUEENSBURY,NY 12804-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2015-088
inground pool 18' x 36'
$75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday, April 22, 2016
(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 Tow of Qu nsb e a n. • April 22,2015
SIGNED BY \ for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
Town of Queensbury Building & Codes
Received:
SWIMMING POOL PERMIT AP} s° n
A permit must be obtained before beginni g c�n c o U‘c) 0 5
APR ��1aPe ' $ T�
" Site PlanNariance No.:
1. Date: _`�'_ '�' OWN O,G&CO ES Y
2. Tax Map ID: 30,8 . \`� J \ -3
3. Pool Location Address: DSS /1\01�.��.
4. Zoning Classification: �G ._ \ VOM A,/ Ns:
5. Site Plan Review, Variance or Subdivision Approvals (list) NI!t
6. Property Owner: ,\\�GINA ', A `A,)5 Phone: \--) 13 \3(00
Mailing Address: AM
City: �(--(
7. Contractor's Name: � Vce-f- Phone: 51,a- -c - ���' i
Mailing Address: 1(Q .N._�,1(AA) ' .3 x(03
City: SovA (��en� \�<— c\)L(
8.'/Contact Person for Building&Code Compliance: Br4:11- nJe�"'W��v�r'1 Phone Wap-' S '7
ABOVE-GROUND OR INGROUND? ..- CDC o -'&
SIZE OF POOL: I xj
'MANUFACTURER: L.(-IL zn 1
MATERIALS USED IN CONSTRUCTION (CHECK ALL THAT APPLY):
Steel /Vinyl 7K Fiberglass Gunite 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 NY State Building Codes, local building laws and ordinances, and in conformance with local zoning regulations. I
acknowledge that I have read the application &plot plan requirements and I or my agents will obtain a certificate of occupancy before use
of the pool.
Print .•me:
Signatur:• ire/ l2b� Date
Name/Title �
Town of Queensbury Building&Codes Swimming Pool Permit 518-761-8256
RX DatelTime 061171201 5 08:15 7981584 P.002
06/17/2015 09: 57 7981584 RON MUMBLO PAGE 02
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COMMONWEALTH ELECTRICAL INSPECTION SERVICE.INC. ....
Main Office 176 Doe Run Road-Manheim,PA 17545
. . . MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL •
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Owner 6-1.- J(1:2,4,,C7C)...7 • •
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Location 2-2 A. .a.-2 r,,,Z:41y.i17...DA Q..u.2.z.c...n..s 6.. ./..,,-.;,/ ...
Installation Consisting of.....1..e.1„....6.:7,actsv,a0
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Installed By C,..cr.inii..‘,i3...- !la.;c...1.7a.1.(4.,.. Lie.No.
The conditions following governed the issuance of this certificate,and any certificate previously issued is
cancelled:-
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This certificate only covers the electrical equipment and installation conditions as of date. Upon the . . .
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introduction of additional equipment or alterations,application shall be promptly: made fur inspection. . .
Inspectors of this Company shall have the privilege of snaking inspections at any time, and if its . •• •-"k:
rules are violated,thc Company .5 hall have the-right to revoke this certificate..
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., Date C—Er-:./6 INSPECTOR.......L,Liel:42,,::4,4,-).2a,-&--- •
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LOT 22