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POOL-000352-2017 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-000352-2017 Date Issued: Tuesday, June 19, 2018 This is to certify that work requested to be done as shown by Permit Number POOL-000352-2017 has been completed. Tax Map Number: 289.11-2-49.2 Location: 19 TEE HILL RD Owner: Jill Trombley, MARY TROMBLEY Applicant: MARY TROMBLEY 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 property owner of the responsibility for compliance with Site Plan, �d 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 Community Development-Building&Codes (518)761-8256 BUILDING PERMIT Permit Number: POOL-000352-2017 Tax Map No: 289.11-2-49.2 Permission is hereby granted to: Northern Pool Scapes For property located at: 19 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 Tyne of Construction Owner Name: Jill Trembley Swimming Pool $0.00 Owner Address: 19 TEE HILL RD Total Value $0.00 Queensbury,NY 12804 Contractor or Builder's Name I Address Electrical Inspection Agency Northern Pool Scapes PO Box 791 Glens Falls,NY 12801 Plans&Specifications In Ground Pool $75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,June 23,2018 (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 Tom of ueensb j rid u 7 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement SWIMMING POOL PERMIT APPLICATION office Useoniv Permit#: POOL- 5JD2. • 20\'-+ hmn uf( uZrensburr Permit Fee:5 a"5 ;Invoice#: 742 Bay Road,Queensbury,NY 12804 P:618-761-8256 www.gue�en Notes: �sbuv.net t Project Location: )q / per '` ) Tax Map ID #: ��/, i 2- ` j 2 Subdivision Name: L, \� FUNJ' 79tT CONTACT INFORMATION: ip;/ TOWfJO1-OUE=NSBtJRY I • A licant: _ GUILDiP CiC1pr^; Name(s): , Mailing Address, C/ I 5 Cell Phone: 6 © ?S Land Line: �_) Email: • Primar Owners : C Name(s): . c ,c�c-n�� G� S Cc Y� UN-9, Mailing Address, C/S/Z: Cell Phone: _( ) Land Line: _( ) Email: • Installer Builder: Business Name: M N k 15c Contact Name(s): rA rvtfrlcC� Mailing Address, C/S/Z: i c1 tPnS Z Cell Phone:_(SIS $ ) ZLZ— ioS 1� Land Line: _( 'Sly ) 13 - 90(a Email: b`t�pa1 scs ASS rV caw c\ . w�) Contact Person for Building & Code Compliance: ! C Cell Phone: _( 5 l� ) Land Line: _( S I b ) k3 �-C)tc 3 Email: s r o--T. ozrw Town of Queensbury Building&Code Enforcement Revised February 2017 SWIMMING POOL INFORMATION: CIRCLE ONE: ABOVE- GROUND IN-GROUND SIZE OF POOL: I A yZ% MANUFACTURER: LrA\-\,.� MATERIALS USED IN CONSTRUCTION (CHECK ALL THAT APPLY): Steel/Vinyl —X— 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. —'c7�)I PRINT NAME: A1�p kA r SIGNATURE: DATE: Ip ZI — I Town of Queensbury Building&Code Enforcement Revised February 2017 � _ ��/`(�/�'(/—�)�����}y-(/7// !YY•v1V IJV VLVI 1 v!• Y — (S)N�IS `I0 (S)3 S C3SOdOHd 31'J.I. 01 :;JNII ..I1. do d 3H1 WO?Jd ' 3�NVl h i19-An1 '�''V W l,l 'VNvSa3d 3AVH I ,< h Id l Id _L tJ J _ - N �O. 00'-00" f ►50.00' f < ' J CT\— m 3 AOr@SEE ss.a f _ qq ® y CL a) C7 ( • w c E`g 'r s�aiy R Z2 _ E t a .x 6or K� s qp� Q gl N > �ieme ti s Cu �U 'O rn .Oo mt . : _ l: �QP®0 T^; [er` Y� OAeng � a C) N N O> —E �e m� ler C/) :—m 0-O o.w I ®areA 6 eet c N ON �3?' poo_ E' @rage (Dr- m + Rz- s f co a) O O 2 �11 Wsll �J n - - > o.. X LU d4ia0 From@ SRO f W � Yarin eng &4Betre6e F saes I.b' blefl 81 Le+e J II,fOrj�,�q — --- -- vd 1 '70 ®0400"W eV> @�— UnOer®eepn a i. JP ' ❑ ✓ ' °-C$ ofl i TOWN OF Cl� 1L 6� ��J � �8a cS yil..• I LBULD:Ni !�� 289.11-2-49.2 POOL-000352-2017 Trombley, Mary & Jill j✓ 19 Tee Hill Road '— = In Ground Pool