BOTH-000161-2016 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: BOTH-000161-2016 Date Issued: Tuesday, July 26, 2016
This is to certify that work requested to be done as shown by Permit Number BOTH-000161-2016
has been completed.
Tax Map Number: 289.8-1-42.1
Location: 734 MOON HILL RD
Owner: Richard Cavalier,Chellen Cavalier
Applicant: Richard Cavalier
This structure may be occupied as a: Inground pool 16 x 24 x 42
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 Building & Codes Office Use Only
Received:
SWIMMING POOL PER ^ ax Map to:
A permit must be obtained befItN
B,rgps"ttior�016 ermit No.:
MAS [L ermit Fee: $ � G b
OP y ite Plan/Variance No.:
BUILDING& CODES
1. Date: 3Ice, u/
2. Tax Map ID:
3. Pool Location Address: 73,1 r 1tioN rl'(,L JG-A,
4. Zoning Classification:
5. Site Plan Review,Variance or Subdivision Approvals(list)
6. Property Owner: jf0i'MT) 1- C){dl.L&J CAVA,t,UO!r = Phone: 70d- r/G Z l
Mailing Address: 73 y M&&,) i+L(, e,h,)
City: . . . y / 7 log
7. Contractor's Name: Nasse e6 Phone: . )d( Z ZZ- 6S 17
Mailing Address: Po A&Y -)'I r
City: i I-RtcCj e�—r
8. Contact Person for Building&Code Compliance: g(Lc'rr ✓h*J�0 0L w 4, 4,L Phone 7 Z Z- raS 7
ABOVE-GROUND OR INGROUND? L✓y t&+.
SIZE OF POOL: //0,r Z q•- N Z-
MANUFACTURER: /—A-rn Ar v. t.i as J k nc a i
MATERIALS USED IN CONSTRUCTION(CHECK ALL THAT APPLY):
Steel/Vinyl--Ax— 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. /� n
Print Name: IC.4,0) ( Ay4t ,,
Signature: & — Date 311lb-0141
ame rfifle
Town of Queensbury Building&Codes Swimming Pool Permit 518-761-8256
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development- 'Building& Codes (518)761-8256
BUILDING PERMIT"
Permit Number: BOTH-000161-2016
Tax Map No: 289.8-1-42.1
Permission is hereby granted to: Northern Poolscapes,Chellen Cavalier,Richard Cavalier
For property located at: 734 MOON H I U RD
In the Towyn of`Queensbury,to construct or place at the above location in accordance with application together
with plot plans and other information hereto lilcd and approved and in compliance with the NYS Uniform
Building Codes and the Queensbury Zoning Ordinance
Type of Construction
Owner Name: Chellen Cavalier Swimming fool $0.00
Owner Address: 734 MOON HILL RD Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical.Inspection Agency
Northern Poolseapes
PO Box 791
Glens Fal Is,NY 12801
Plans&Specifications
hwground pool 16 x 24 x 42
;1x75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,March 30,2017
(11"a longer period is required,an application for aro extension must be made to the code Enforcement Officer
of the Town of`Queensbury before the expiration date.)
Dated at the Town of` recnsbcand y A , 16
SIGNED BY: tier the Town orf"Queensbury..
Director of Building&Code Enforcement
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