BOTH-000502-2016 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-000502-2016
Tax Map No: 308.11-1-62
Permission is hereby granted to: Nicki Burdick
For property located at: 431 LUZERNE RD
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: Nicki Burdick Swimming Pool $0.00
Owner Address: 431 Luzerne RD Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
Above-ground swimming pool
pre-existing pool and has been in place since home was purchased 2 years ago.
$ 40.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Friday, July 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 Queensbury before the expiration date.)
Dated at the Townuee bury; st 2,2016
Tu
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
Town of Queensbury Building & Codes Office use Only
Received: 0l I '
SWIMMING POOL PERMIT APPLICATION Tax Map ID: 3 U2,Il JI—("'o
A permit must be obtained before beginning construction Permit No.: �JO
j
Permit Fee:
Site PlanNariance No.:
1. Date: � �� i �
2. Tax Map ID: �} ' • I I — 1—(v
3. Pool Location Address: I ( �
AUG 1 2016
4. Zoning Classification:
5. Site Plan Review,Variance or Subdivision Approvals(list)
6. Property Owner` , t G t f ofc G Phone:
Mailing Address: L1,1
City:
7. Contractor's dame: sk4 Phone:
Mailing Address:
City:
8. Contact Person for Building&Code Compliance: Phone
B�OVEJGROUND INGROUND?:
SIZE OF POOL: J4 jn'—eKfSirPail•dY —ho
MANUFACTURER:
� Ili f L3ifU�c.k
OW►�� 1-i �y✓S
MATERIALS USED IN CONSTRUCTION(CHECK ALL THAT APPLY):
Steel 1 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: �
Signature: D Date I
Name 1 Title
Town of Queensbury Building&Codes Swimming Pool Permit 518-761-8256
Tax Map Parcel No. Log Number
NOTICE OF 'VIOL.ATION -ORDER TO REMEDY
Town of Queensbury:
Date:
742 Bay Road
Queensbury,NY 12804 7 61 -8 2 5 6
Name: _ N�-�
Address:
Dear
You are hereby notified that you have been found to be in violation of the Town
of Queensbury Code., Section Subs tion
The specific violation is:
as observed by the Code Enforcement Officer on
The followingcorrective measures should be taken no later than
or court action may be commenced:
1 .
If you have questions,please contact me.
Sincerely,
Code Enforcement Officer
Please note: A violation of this code may be punishable by a fine not to Exceed$
Each(time period)-of continued violation shall constitute an additional,separate
offense,after court determination.
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