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POOL-000347-2017
14 f . TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 s Community Development-Building& Codes (518)761-8256 CERTIFICATE OF COMPLIANCE Permit Number: POOL-000347-2017 Date Issued: Monday, July 24, 2017 This is to certify that work requested to be done as shown by Permit Number POOL-000347-2017 has been completed. Tax Map Number: 289.12-1-2 Location: 24 TEE HILL RD Owner: Traci Bunting,MICHAEL DILORENZO Applicant: Traci Bunting This structure may be occupied as a: Above Ground Pool By Order of Town Board TOWN OF QUEENSSBUR�Yj Issuance of this Certificate of Compliance DOES NOT relieve the property owner of the responsibility for compliance with Site Plan, L((.«<++rrJ11333 V 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. r' TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761.8201 +� Community Development-Building&Codes (518)761-8256 BUILDING PERMIT Permit Number: POOL-000347-2017 Tax Map No: 289.12-1-2 Permission is hereby granted to: Traci Bunting For property located at: 24 TEE 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: Traci Bunting Swimming Pool $0.00 Owner Address: 24 TEE HILL RD Total Value $0.00 Queensbury,NY 12804 Contractor or Builders Name/Address Electrical Inspection Agency Jeff Weaver Plans&Specifications Above Ground Pool $40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,June 22,2018 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the Town of eens [ / hur 017 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement SWIMMING POOL PERMIT APPLICATION Office Use Only 2� Permit#: t a/Vt 7invn of(Lccnsbum,r Permit Fee:$i4`+ ;Invoice#: 742 Bay Road,Queensbury, NY 12804 T P:518-761-8256 www.oueensbury.net Notes: 8P 510!0 4 Project Location: o�q Yew U Rd--- Tax Map ID #: X99•/2 -/- oC _ Subdivision Name: CONTACT INFORMATION: • Applicant: Name(s): 1 QCI Qu nfinO MailingAddress C/S/Z• au T2t ( ©S U nM lLS��s� Cell Phone: 116 ) �'U7— �IS'—I Land Line: WI K Email: • Primary Owner(s): MILL Name(s): f n2 'Tr , &4y,)fije)6 Mailing Address, C/S/Z• o?L( Tft �/I 1 OS by W ILYU Cell Phone: _( ) Land Line: _(.r/t- ) rO2.— X939 Email: • Installer/Builder: Business Name: Contact Name(s): J P et1yey- Mailing Address, C/S/Z: Cell Phone: _(�I8' ) —191 —(103 / Land Line: _( ) Email: Contact Person for Building & Code Compliance: Cell Phone: ( ) Land Line: —( Email: 10 ; Ir ,_ _ On JUN 2 0 2?I7 � J ulc)JAR & Cr Town of Queensbury Building&Code Enforcement Revised February 2017 SWIMMING POOL INFORMATION: CIRCLE ONE: /ABOVE- GROUND IN-GROUND SIZE OF POOL: A7 fc ek MANUFACTURER: -&U2 l (1xa 0 . '00019- MATERIALS 00 1S'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 NYS Building Codes, local building laws and ordinances and in conformance with local zoning regulations. I acknowledge that I have read the application and plot plan requirements and I, or my agents, will obtain a certificate of compliance before use of the pool. PRINT NAME: GL �lX l SIGNATURE: , kin, DATE: cif U Town of Queensbury Building&Code Enforcement Revised February 2017 y TOWN OF QUEEN BURY BUILDING & CO ES T. Y: c: .•a 5 70 Dal'?� _' 3D C/) --i nN m = cz 0 r TOWN 0'F OUEENSB Y A BUILDING 6E9gR & T m Based on ourlimiled examination compliance - -- with OUf comments shah not be z o I mdcafing the plans and speecco� gc�ootnshued as o , = D full compliance with the Bulldin$�Codese of -U —� z New York State. m — O y m " ce R .n rk D N W N CT A C co < O K CO O rip � h G J/ a) da o° OO _ r fl c o � w c! Attention Home Ownnr u c J Please assure you are familiar k 11th the rG Pool Enclosure requirements sF !cift to Your pool. We will be happy to 9xplain `t _. __ what Requirements you will have to meet per Appendix G Of the " : �t New York State Residential Codo, I 4 I