BOTH-000268-2016 TOWN OF QUIEENSBURY
y 742 Bay Road,Queensbury,NY 12804-5904 (518)'761-8201
i
Community Development Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: f3OTI1-000268-2016
Tax Map No: 308J6-2-20
Permission is hereby granted to: Douglas Smith
For property located at: 395 CORINT I RD
In the Town of Queensbury,to construct or place at tire above location in accordance witli application together
with plot plans and other information hereto tiled and approved and in compliance with the NYS Uniform
Building Codes and the Queensbury Zoning Ordinance
j r e or Constructioaa
Owner Name: Cheryl Ellis Swimming Pool $0.00
Owner Address: 395 Corinth RD Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Douglas Smith
395 Corinth RD
Queensbury,NY 12804
Plans&Specifications
Above-ground Swimming fool
(purchased from private sale and not a fool Company)
$40.00 PERMITFEE EE PAID-THIS HIS PEI1.MIT EXPIRES: Sunday,April 30,2017
(if a longer period is rewired,air application for an extension must be made to the code Eastbreeanent Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town o['Queensbury; 1"laau s a , y 5,20167
SIGNED BY; 4 9;0 for the']`own ofQucensbury.
Director of Building&Code t nk brcementt
Town of Queensbury Building & Codes Office Use,Onix
Received:
SWIMMING POOL PERMIT APPLICATION Tax Map ll): 30 e• It t
A permit must be obtained before beginning construction Permit No., �. V
Permit Feer $ '
Site PlanNariance No.:
1. Cate:
2. Tax Map ID: f' ��
S. Pool'Location Address: I' AY 0 4 2016
4. Zoning Classification: i u
5. Site Plan Review,Variance or Subdivision Approvals(list) °mm6 il" ("ODES
6. Property Owner i
< LUZ Sq I Phone:
Mailing Address:
City:
7. Contractor's Name: Phone:
Mailing Address:
City
8. Contact Person for Building&Code Compliance: Phone
ABOVE-GROUND OR INGROUNCl7
SIZE OF POOL.:
MANUFACTURER:
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
acknovviedge 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. .. Crate
Name/Title
Town of Queensbury Building&Codes Swimming Pool Permit 518-761-8256
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