BOTH-000236-2016 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-000236-2016 Date Issued: Tuesday, June 21, 2016
This is to certify that work requested to be done as shown by Permit Number BOTH-000236-2016
has been completed.
Tax Map Number: 297.10-1-20
Location: 19 SHERATON LN
Owner: John Stomski,Christine Stomski
Applicant: John Stomski
This structure may be occupied as a: inground pool 16'x 28'
By Order of Town Board
TOWN OF QUEENNSSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the
property owner of the responsibility for compliance with Site Plan, c (GGtL"
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 QUE NSBURY
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742 Bay Road, Queensbury,NY 12804-5904 (5 t 8)761-8201
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y Community Development - Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: BOTIJ-000236-2.016
Tax Map No 297.10-1-2.0
Permission is hereby granted to: Jahn Stomski, Christine Stomski
For property located at: 19 SHERATON 1.,N
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: John Stomski Swimming Pool $0.00
Owner Address: 19 Sheraton LN Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Clearwater Pools
1100 State Route 29 'OVI O" ED
Greenwich,NY 12834 RE
Plans&Specifications
inground pool 16'x 28'
$ 75.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Friday,April 28, 2017
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbu before th xpiration e.
Dated at the Town f Quee 4TLI ay 3, 2016
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SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
Town of Queensbury Building & Codes Office Use Only
Received:
SWIMMING POOL PERMIT APPLICATION Tax Map ID:
A permit must be obtained before beginning construction Permit No.: 2. 6 2,C
Permit Fee: $ lloakl i o "o 2-fb
Site PlanNariance No.:
1. Date:
2. Tax Map ID:
....................
3. Pool Location Address: 17 910z I Ayw
4. Zoning Classificatiom
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5. Site Plan Review,Variance or Subdivision Approvals (list)
6. Property Owner: /6� A,, = Phone:
Mailing Address: N/z C5 Ag_� ZA_
City: f)� M lKi Iq
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7, Contractor's Name: Phone: I'
Mailing Address: C-)
City;
8. Contact Person for Building&Code Compliance:
ABOVE-GROUND OR INGROUND?
SIZE OF POOL:
MANUFACTURER: k
MATERIALS USED IN CONSTRUCTION (CHECK ALL THAT APPLY):
Steel/Vinyls_ 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 wilt be performed in
accordance with the NY State Building Codes, local building laws and ordinances:, and in conformance with local zoning regulations, 1,
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:
Signature: Z:.)— Date
Name )Ife
Town of Queensbury Building&Codes Swimming Pool Permit 518-761-8256
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