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TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20130315 Application Number: A20130315
Tax Map No: 523400-301-012-0001-021-000-0000
Permission is hereby granted to: JASON R KENYON
For property located at: 22 HELEN Dr
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 Value
Owner Address: JASON R KENYON
LEIGH A. KENYON I
22 HELEN Dr Tootalral Value
alPool
QUEENSBURY NY 12804-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
BOB BAKER POOLS
SISSON ROAD
SOUTH GLENS FALLS,NY
Plans&Specifications
2013-315
POOL inground 23'x 42'
$75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,July 19,2014
(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 Towof Que sbu Fr'� y9,2013
SIGNED BY /� for the Town of Queensbury.
Yom?
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.:
Permit Fee: $ ?S Uo
Site PlanNariance No.:
1. Date:
2. Tax Map ID: 301 , Z
3. Pool Location Address: 2 STP/eit ri '✓e-
4. Zoning Classification: o 1
5. Site Plan Review,Variance or Subdivision Approvals``(list)
6. Property Owner: Phone: �l�- 'R-q3
Mailing Address: "Zt 4e(e4, �r
City: -,s
7. Contractor's Name: Lam.kc-r Phone:
Mailing Address:
City: (,&5 F l s, JUY 12-903
8, Contact Person for Building&Code Compliance: 642l Phone
ABOVE-GROUND OR INGROUND? :!- ; r'oLkpl X
SIZE OF POOL: 5' K -� NI&�
MANUFACTURER: �� � 9 GI�-�'r t�►T�j7>�S
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: So`�' 2 r D^
Signature: Date y AA�
Na /Title
Town of Queensbury Building&Codes Swimming Pool Permit 518-761-8256
Pool Inspection
Queensbury Building & Code Enforcement
Office No. (518) 761-8256
742 Bay Road, Queensbury, NY 12804
Date received:
NAME: uyon
LOCATION: CA 3!
PERMIT 49
INSPECTED ON: am/pm
Arrive: am/pm Depart:
inspector's Initials:
Above Ground: In-Ground:
Y,A N N/A
Pool enclosure around
pool or and
4 feet above grade
2 inch maximum
clearance to grade from
underside of fence
4 inch maximum
clearance in fence
pickets
Wall or Doors have self V
closing device or alarms i
(30 second Alarm time kl�
Pool Surface Motion
Alarm V/
Ladder secured in place
and latched
Deck gate <56" to latch
no more than 1/2" spacing
in gate openings
Gate opens outward, self
closing V/..
Padlock provided on
_gates or ladder
Indoor pool all doors self
closing or alarmed per
AG 105.2 Item 9
Timer on pool pump (no
plug in timer allowed)
Final electrical
Vehicle access gate
closed &locked
Ok to issue C/C
COMMENTS:
e 2P
�
Pool Inspection
Queensbury Building & Code Enforcement
Office No. (518) 761-8256
742 Bay Road, Queensbury, NY 12804
Date received:
NAME: kAN14X4
LOCATION: 'rL'L- 1-h.-
PERMIT # :
INSPECTE*a /pm am/Pm
Arrive: amfpm Depart:
Inspector's Initials:
Above Ground: In-Ground:
V N NA
Pool enclosure around
pool or yard
4 feet above grade
2 inch maximum
clearance to grade from
underside of fence
4 inch maximum
clearance in fence
ickets
Wali or Doors have self
closing device or I r
30 second Alarm time
Pool Surface Motion
Alarm
Ladder secured in place
and latched
Deck gate < 56" to latch
no more than 1/2" spacing
in gate openings
Gate opens outward, self
closing
Padlock provided on
gates or ladder
Indoor pool all doors self
ciosina or alarmed per
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
Permit No..J... ....Cert. N 2 28638 Cut-in Card No.....................................
Owner..... ... ........................................................................ ...............
")a-4c,
Location... ...................................................6�. ...I. ..........
Installation Consisting of .............
0
................................ ..............................................................................................
.............................................................................................................................................................................
InstalledBy............ .......................................... 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�ions at any time, and if its
rules are violated,the Company shall have the right toe this this certifica,16.
Date...? ..................... INSPECTOR ........
z-164..,.��.... ..........
Member N.F.P.A.,I.A.E.I.
TOWN OF QUFENSBURY
BUILDING DEPARTMENT
Based on our limited examination,compliance Attciition Hc;ynz
With our cornments shall not be construed as Piease assure you are familiar wilth th'a
indicating the plans and s ecifications are 11)
full compliance with the specifications
Codes of Pool Enclosure requirements specific to
New York State. Your p&61. We will be happy to explain
what Requirements you will have to
nieet per Appendix G Of tha
r,
flew"(or,-,State R.-.-sidentialbP Cod
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