BOTH-000267-2016 Amk TOWN OF QUEENSBURY
me 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: BOTH-000267-2016 Date Issued: Friday, August 26, 2016
This is to certify that work requested to be done as shown by Permit Number BOTH-000267-2016
has been completed.
Tax Map Number: 301.6-2-31
Location: 5 WILLOW RD
Owner: Joseph Giorgio
Applicant: Joseph Giorgio
This structure may be occupied as a: Inground Swimming Pool
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 1'N O F E EN E B U R A,.
i 742 Bay load,Queensbury,NY 12804-5,904 (518)701-43201
Community Development-Building&Codes (5'18)761-82.56
BUILDING PERMIT
Permit Number: BOTH-000267-2016
Tax Map No: 301.6-2-31.
Permission is hereby granted to: Pook flus
For property located at: 5 WILLOW ISI)
In the'rows crl'Queenshury,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 tlnifo"lt
Building Codes and the Queensbury Zoning Ordinance
"rypc of.C'onstrtuclion.
Owner Name: Joseph Giorgio Swimming fool $0.00
Owner Address 5'Willow RD Total Value $0.00
Queensbury,NY 1.2804
Contractor or Builder's Name/Address Electrical Inspection,agency
Pools,Plus
45 MAIN ST
Queensbury,NY 12804
Plans&Specifications
Inground Swimming Pool
$75.00 PERMIT FEE PAID-THIS PEiIZMIT I>XPIR"S: Sunday,April 30,20117
(11'a longer period is required,an application for<na extension trust be made to tine code E'riforceillent C iftucer
of the Town of Queensbury before the expir ion date.)
Dated at the Town of C Censbury„ arse 2016
SIGNED BY. a' for the`town of Queensbury.
Director ol'13uilding&Code Entbreement
Town of Queensbury Building & Codes Office Use Only
Received:
SWIMMING POOL PERMIT APPLICATION [Tax Map Ip:
A permit must be obtained before beginning construction
Permit No.:
Permit Fee: �
Site PlanNVadance No.:
1. Date
2. Tax Map ID: a „` " ,.,
2016
8. Pool Location address: r.1/00
t
4. Zoning Classification:
OF
a� o; ,°
5. Site Plan Review,Variance or Subdivision approvals(list)
i , �C � a.m
S. Property Owner: a4jt 6,a ,i 0
Phone: _5,./ ' : -q1 3
Mailing address:
City: e1,aS a r
7. Contractor's Name: P100 5' t. Phone: zq2ej
Mailing address: 5 , St
City: s6.0
8. Contact Person far Building&Cade Compliance: Phone
ABOVE-GROUND OR INGRaUND?
SIZE OF POOL: V -t a ,,I- `c z 9 '
MANUFACTURER N* Pr �. '
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:
61or-
�t cN rA t
4
Signature: ,. � 101
Date
Name/Title
Town of Queensbury Building&Codes Swimming Pool Permit 518-761-8256
05/10/2010 MON 14: 08 FAX 5197454437 Community Development nL 991/941
OE
' , INC. (515)656-3544
BOX 501,CLMRDALE,MY.12GRO
4.0
N F 4P/F`
[ fJ
T , r'iti Owner
Ple- e aSSLjr,eyou are, h rniii r with the
PA End6sure reqdrernentsspc�Tjfic to
You 6l. We will be h p' y, in explain
at. Requiirernents YOU will have to
fneet per Appendix G Off'the
W York Statin Residential Ccxie,.
d-.. 0pL__).EFS WN a` F E �yBURY
a
R ' i�e 2y:
ice e:
r,� r
301-6-2.31
BOTH 267-2016
Joseph & Dawn Giorgio
5 Willow Road
.. in-ground swimming pool
119
5eloli �' 1'
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
Permit No. .w..t...h.�2 �.2A n-Cert. N2 4 0 6 2/ Cut-in Card No.....................................
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Owner..........��...^^......
........................ c�
Location.....J.....LA1..� .� �.....f.4 ....
.. .. ..................................................................... .......................
Installation Consisting of... s .
......... ` .....
........ .. ..................................
....................................................................................................................................................................................
...............................DD............................ ..................................................................................................................
.....
Installed By.......1... .d�'S 7L. ............................................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 i tions at any time, and if its
rules are violated,the Company shall have the right to r e this rt' t e.
Date......G '. �.��.......... INSPECTOR...... ......
.............................. ........ .. ......................................................... .
Member N.F.P.A.,I.A.E.I.