BOTH-000226-2016 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
i
-- - Community Development-Building& Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: BOTH-000226-2016 Date Issued: Wednesday, October 26, 2016
This is to certify that work requested to be done as shown by Permit Number BOTH-000226-2016
has been completed.
Tax Map Number: 315.6-1-14
Location: 17 FOUNDERS WAY
Owner: Andrew Stevens
Applicant: Andrew Stevens
This structure may be occupied as a: Inground Swimming Pool
18'x 36' By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the QJ4...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 12804-5904 (518)761-8201
Community Development- Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number 130TH-000226-2016
Tax Map No: 315.6-1-14
Pennission is hereby granted to: Northern Pool Scapes
For property located at: 1.7 FOUNDERS WAY
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
Owner Name: Andrew Stevens Swimming Pool $0.00
Owner Address: 17 1'ottnders Way Total Value $0.00
Queensbut-y,NY 12804
Contractor or Builder's Name 1 Address Electrical Inspection Agency
Northem Pool Scapes
PO Box 791
Glens Falls,NY 12801
Plans& Specifications
Inground Swimming Pool
18'x36'
$ 75.00 PERMITFEE PAID -THIS PERMIT EXPIRES: Thursday, April 20, 2017
(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 rte bury; M*1y!1025, 2016
SIGNED BY: for the Town of Queensbury.
Director of Building R Code Enforcement
To�wn of Queensbury IBuilding & Codes Office Use Only
Received:
SWIMMING POOL PERMIT APPLICATION Tax Map ID:
A permit must be obtained before beginning construction Permit No,:
Permit Fee:
Site PlanNariance No.: IL10 '5 ),-)L
1. Date:
2. Tax Map ID:
3. Pool Location Address: AN 2 0 2016
4. Zoning Classification: TUWK55F-�7Tt'EF4,8 y
W[-Di'NG & C=ES
5. Site Plan Review,Variance or Subdivision Approvals (list)
6. Property Owner: /\Oi2gj� - Phone:
Mailing Address: 7 i'd-a'-we
City: f-v all-, I 2.Z 04,
7. Contractor's Name: fit Phone: -Z z,z-
Mailing Address: Vt) OUIX I I I
City: c)
8. Contact Person for Building&Code Compliance:, Phone
ABOVE-GROUND OR INGROUND? Al.
SIZE OF POOL:
MANUFACTURER: 1 0--—tj
MATERIALS USED,IN CONSTRUCTION (CHECK ALL THAT APPLY):
Steel/Vinyl V/" Fiberglass Gun: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 NY State Building Codes, local building laws and ordinances, and in conformance with local zoning regulations. I
acknowledge that l 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:
I ilz6
ev
Signature. (1,QDate
Name/Title
Town of Queensbury B,uil'iding&Codes Swimming Pool Permit 518-761-8,256
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