2015-071 TOWN OF QUEENSBURY
4a 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20150071 Date Issued: Monday, September 28, 2015
This is to certify that work requested to be done as shown by Permit Number P20150071
has been completed.
Tax Map Number: 523400-297-017-0001-021-000-0000
Location: 39 MEADOW Ln
Owner: MICHAEL& SUSAN TRAVIS
Applicant: MICHAEL & SUSAN TRAVIS
This structure may be occupied as a:
In Ground 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.
i
TOWN OF QUEENSBURY
4111Plaki
wow 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20150071 Application Number: A20150071
Tax Map No: 523400-297-017-0001-021-000-0000
Permission is hereby granted to: MICHAEL& SUSAN TRAVIS
For property located at: 39 MEADOW Ln
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: MICHAEL& SUSAN TRAVIS
39 MEADOW Ln In Ground Pool
QUEENSBURY,N.Y. 12804 Total Value
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2015-071
$75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,April 08, 2016
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensb before the - piration da e,
Dated at the To of r s s.� 4 v • .01� . � esday,April 08,2015
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Town of Queensbury Building & Co B E L E un
:Received':SWIMMING POOL PERMIT APPLIC APR 0 �Ay ID:
A permit must be obtained before beginning con ructio Zotrj-0+1
TOWN OF QE RY , �cxa
BUILDING8Pe7�k7Ee6
Site Plan/Variance No.;
1. Date: i✓IARc N 3 /1 C 1
2. Tax Map ID: 197. 17 - i -.I
3. Pool Location Address: 3gArAacw l vv,t (3,, y / /z SOY
4. Zoning Classification:
5. Site Plan Review,Variance or Subdivision Approvals(list)
6. Property Owner dc'NAE_ Phone:SI t3. 7 Pf c'YU
Mailing Address:
City: Ny"
7. Contractor's Name: L C• L S lJL J f Phone: 797-0z?
Mailing Address: y /nA.'.j ,(r
City: a,E6N'jZ VA4e V
8. Contact Person for Building&Code Compliance: 2:14 te' 0 `73A4-10 Phone 772-2-72)
ABOVE-GROUND ORINGROUND? ING'/1.,.,lye
SIZE OF POOL: Y 31
MANUFACTURER: L^19Ca.,.Ae. LJ
MATERIALS USED IN CONSTRUCTION(CHECK ALL THAT APPLY):
Steel I VinylyEDFiberglass_ 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 Name: J
c�
Signature: -/L Date 1+f/1.4c_rf 7/, z c if
Name I itle
Town of Queensbury Building&Codes Swimming Pool Permit 518-761-8256
Merl
1 -3
Pool Inspection
Queensbury Building & Code Enforcement
Office No. (5 18) 761-8256
742 Bay Road, Queensbury, NY 12804
Date received: q 12r 2015
NAME: 1'GW�s
LOCATION: 2191 Me
PERMIT#: 15-m i 1
INSPECTED ON: 9 W 2Q5 am/pm
,Ar ive:_____jm/pm Depart:
y�_am m�
Inspector's Initl
moy
Above Ground: In-Ground: .
ild
@J
Y N NA
Pool enclosure around
pool or yard
4 feet above grade
2 inch maximum
clearance to grade from
underside of fence
4 inch maximum /
clearance in fence
pickets
Wall or Doors have self
closing device or alarms
30 second Alarm time
Pool Surface Motion
Alarm
Ladder secured in place
and latched
Deck gate<56" to latch
no more than 1/2" spacing
In gate openings
Gate opens outward, self
closing
Padlock provided on
gates or ladder
Indoor pool all doors self
closing or alarmed per
AG 105.2 Item 9
Timer on pool pump (no
pluq in timer allowed
Final electrical
Vehicle access gate
closed & locked
Ok to Issue C/C
COMMENTS:
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:'Attention Home O�wnei'
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^+ x Pl: �e assure you are familiar with the
�� P ; Enclosure requirements specific to
" pool. We will be happy to explain
y''`
, at Requirements you will have to
u i meet per Appendix G Of the
°; ,, New York State Residential Code.
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TOWN OF QUEENSBURY
.� BUILDING DEPARTMENT
�� Based on our limited exarrrination,compliance
t, with our comments shah iron be construed as
_-,, indicating the plans and s ecifications are in
full compliance with the Building Codes of
Nw York State.
Reviewed
Date: '�' ,.
I