POOL-000146-2017 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: POOL-000146-2017 Date Issued: Monday, April 30, 2018
This is to certify that work requested to be done as shown by Permit Number POOL-000146-2017
has been completed.
Tax Map Number: 308.8-1-64
Location: 4 KYLIANS WAY
Owner: Michael Ashton
Applicant: Michael Ashton
This structure may be occupied as a: In Ground Pool
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the 4t
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 OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
OL Community Development-Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: POOL-000146-2017
Tax Map No: 308.8-1-64
Permission is hereby granted to: Sprague's Mermaid Pools
For property located at: 4 KYLIANS WAY
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
Tyne of Construction
Owner Name: Michael Ashton Swimming Pool $0.00
Owner Address: 4 KYLIANS WAY Total Value $0.00
Queensbury,NY 12804
Contractor or Builders Name/Address Electrical Inspection Agency
Sprague's Mermaid Pools
300 Broadway
Fort Edward,NY 12828
Plans&Specifications
$75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,April 14,2018
(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 Town Mee ury; Fri a , 2017
SIGNED BY: Ly(P/ /VJ for the Town of Queensbury.
Director of Building&Code Enforcement
Town of Queensbury Building & Codes V
on
Received:
SWIMMING POOL PERMIT APPLICATION
A permit must be obtained before beginning construction
QDCIL- 7-
$ S
r� -7 rier ':
1. Date:
2. Tax Map ID;
3. pool Location Address:
4. Zoning Classificatlon:
5. Site Plan Review,Variance or lSubdivision Approvals(1st)
6. Property Owner: r'1(U t 7/^6 phone: - X02
Mailing Address: �� ' .p s
City: l 1
7. Contractor's Name: ^ l Phone: -au) L F I
Mailing Address:
City: 02 b q
B. Contact Person for Building&Code Compliance: �� Phoner9f�! /,
ABOVE-GROUND ft INGROUND?. nn
SIZE OF POOL:
MANUFACTURER:
MATERIALS USED IN CONSTRUCTION(CHECK ALL THAT APPLY): APR O b 2611 D
SteellVinyl Fiberglass_ Gunito_ PouredConcrete�Other TBul lNGUEENSBURy
$CODES
DecieraUon• 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 statementldescription of the work proposed, that all worts 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 agerds will obtain a certificate of occupancy before use
of the pool, \,{ /�
Print Name: I- 11 Vie S V1
Signature: Date
Name l Title
Town of Queensbury Building&Codes Swimming Fool Permit 518-761.8256
I
308.8-1-64 POOL-000146-2017
Fro t' E � VEAshton, Michael
6 2017 4 Kylians Way
APR 0 In Ground Pool
uNLp NGU&CODEg
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erttlanome Owner
�l Please assure you are familiar with the y '�
1 Pool Enclosure requirements specific to
Your pool. We will be happy to explain
'�iI what Requirements you will have to
meet per Appendix G Of the
II New York State Residential Code.
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SIG1ATUkt
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TOWN OF QUEENSBURY
BUILDING & CO ES DEPT.
Reviewed BV:
Date: _-
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