2015-345 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20150345-42191 Date Issued: Monday,November 14, 2016
This is to certify that work requested to be done as shown by Permit Number P20150345-42191
has been completed.
Tax Map Number: 266.1-2-48
Location: 135 BOULDERWOOD DR
Owner: Parker Sherwood
Applicant: Parker Sherwood
This structure may be occupied as a: Inground Pool
By Order of Town Board
TOWN OFQUEEENNSBUnRY
Issuance of this Certificate of Compliance DOES NOT relieve the
property owner of the responsibility for compliance with Site Plan, VVV /r v
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.
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
Permit No.
.....
r..�..........Cert. N® 28745 Cut-in Card No.................................
Owner.......A.....5 f����91L7..Q P....................................................................................................
Location......45. ...... p...l../.�.Cr.'.k.�, 1�F`�C9...C....��. .,t....�L�. ..
Installation Consisting of... .., . ..41... 1. 1 N��J..... d?d2� ,-b
....... .. ..................
....................................................................................................................................................................................
....................................................................................................................................................................................
InstalledBy.......f��.,... .. !�Ia... .........................Lic.No...................................................
The conditions following governed the issuance of this certificate,and any certificate previously issued is
cancelled:-
This certificate only covers the electrical equipment and installation conditions as of date. Upon the
introduction of additional equipment or alterations,application shall be promptly made for inspection.
Inspectors of this Company shall have the privilege of making insc ons at any time, and if its
rules are violated,the Company shall have the right to r 'o�'is ce te.
.1..
Date......... .�.l.....:1.. ........... INSPECTOR....... . ..:..... ................ ...
Member N.F.P.A.,I.A.E.I.
TOWN OF QUEENSBURY
.4101fti
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
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Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20150345 Application Number: A20150345
Tax Map No: 523400-266-001-0002-048-000-0000
Permission is hereby granted to: PARKER& CYNTHIA SHERWOOD
For property located at: 135 BOULDERWOOD 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: PARKER& CYNTHIA SHERWOOD In Ground Pool
135 BOULDERWOOD Dr
QUEENSBURY NY 12804-0000 Total Value
Contractor or Builder's Name /Address Electrical Inspection Agency
SPRAGUE'S MERMAID POOLS
294 BROADWAY
FORT EDWARD.NY 12828
Plans&Specifications
2015-345
Inground pool
$75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Sunday,August 07,2016
(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 Town o • -ensbutya Fri . ,, ugust 07,2015
SIGNED BY for the Town of Queensbury.
V Nk
Director of Building& Cote Enforcement
Office Use Only
Town of Queensbury Building & Codes
Received:
SWIMMING POOL PERMIT APPLICATION Tax Map ID:
A permit must be obtained before beginning construction Permit No.: ?01`3• 34t5
Permit Fee: $ 3 'Q[�i�•
Site PlanNariance No.:
1. Date:
ri [E1�
Map �I
2. Tax ID: E C E v
3
3. Pool Location Address: / .r11� ;0_4.12: , 1. •
4. Zoning Classification: • ,. . . ENSBURY
BUILDING_& CODES
5. Site Plan Review,Variance or Sub' • • • 9•royals list)
6. Property Owner: (,(1g(Nw0,08Phone: 577 636 I F(7
Mailing Address: (35 EdiOe4i JJ(`.
City: (iQ L.L.---0-41.5 bcc..t`r
7. Contractor's Name: SpI t. '! ',f'1Y1cczaQ ?oats. phone:5// ' 7'/7 ? Z7G'
Mailing Address: 300 _Poe/Wcy
City: —FOP+ td&r. a1`ct._
8. Contact Person for Building&Code Compliance: ,p J�� e C?
uiL� i_5 Phone ,57F 74/7 QeZ7
ABOVE-GROUND OR INGROUND? "'_Ln rnm\A
SIZE OF POOL: 6 'x 37/ )s 1?
MANUFACTURER: p. (cab ZeZr rN N
MATERIALS USED IN CONSTRUCTION (CHECK ALL THAT APPLY):
Steel/Vinyl °/ 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 Name: V (14.r S`e odct_
Signature: LPIf./A1 G1- Date 53/3A.
Name/Title
Town of Queensbury Building&Codes Swimming Pool Permit 518-761-8256
�y,r - "s e..., ivi fii X141 ~s MADE I - \ E FROM AN ACP),� StJk"E.Y �:.:
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` New York State.
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