POOL-000164-2017 TOWN OF QUEENSBURY
4a 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: POOL-000164-2017 Date Issued: Wednesday, July 12, 2017
This is to certify that work requested to be done as shown by Permit Number POOL-000164-2017
has been completed.
Tax Map Number: 266.1-1-1
Location: 135 PICKLE HILL RD
Owner: Lorie Crain
Applicant: Lorie Crain
This structure may be occupied as a: 1/2 inground and 1/2 above ground
swimming pool By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the r )J
property owner of the responsibility for compliance with Site Plan, /Y)
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-000164-2017
Tax Map No: 266.1-1-1
Permission is hereby granted to: Lorie Crain
For property located at: 135 PICKLE HILL 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
Tvce of Construction
Owner Name: Lorie Crain Swimming Pool S0.00
Owner Address: 135 Pickle Hill RD Total Value So.ou
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Clear Water Pools
1100 Route 29
Greenwich,NY 12834
Plans&Specifications
1/2 inground and 1/2 above ground swimming pool
$75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,April 20,2018
(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;Pk
ation date.)
Dated at the Town of ueensb hu ril 20,2017
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
Town of Queensbury Building & Codes Office Use Only
SWIMMING POOL PERMIT APPLICA I E U.Wag
A permit must be obtained before beginning const EMU.
o. �IY�L tc�10 17
APR 1 lFe :
TOWN OF Q ENSBUR nanc No.:
�� _ I-1 COMMUNITY D
1. Date:
2. Tax Map ID: 2 (,6 41
13 5 Prc-k le 07* 1-a Qjeeris bury Ny 1-ZS6
3. Pool Location Address: �/tt
4. Zoning Classification: L e— 7Z A
5. Site Plan Review,Variance or Subdivision Approvals(list)
6. Property Owner: Icw e 6w-i } S4,"4.Htw i4yag l Phone: ci0
Mailing Address: /3 S Pickle mw VA
City: C��^/cen S" NY izfdy
7. Contractor's Name: C.(etvr W&4-er f b" o k Phone: 3 i - 4 042-
Mailing Address: 1160 (Lov'r£. z 5
City: 4rreenwtck N`/ / SOS-G76y Cc)
8. Contact Person for Building&Code Compliance: Ste+ 14174keq �e 64;.r Phone '7R3-S 79 o 04)
ABOVE-GROUND OR INGROUND? tYZ `!/K rwn d
SIZE OF POOL:
MANUFACTURER: /?A'-Q1
MATERIALS USED IN CONSTRUCTION(CHECK ALL THAT APPLY):
Steel/Vinyl X Fiberglass_ Gunite Poured Concrete X 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: SAMPtrs1"N �Votj#,KeT' Date
Name I Tide
Town of Queensbury Building&Codes Swimming Pool Permit 518-761-8256
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266.1 -1-1 POOL 164-2017 u�&3iC s.og is'E s4•s r'
y Lone Crain & Samantha Honaker
t �-M-64 135 Pickle Hill Road
Queensbury, NY 12804