POOL-000502-2017 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-000502-2017 Date Issued: Thursday, October 12, 2017
This is to certify that work requested to be done as shown by Permit Number POOL-000502-2017
has been completed.
Tax Map Number: 289.7-2-16
Location: 16 Mark DR
Owner: Anthony Cerrone,Kathryn Cerrone
Applicant: Anthony Cerrone
This structure may be occupied as a: Inground 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,
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-000502-2017
Tax Map No: 289.7-2-16
Permission is hereby granted to: Pools Plus
For property located at: 16 Mark 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
Tyne of Construction
Owner Name: Anthony Cerrone Swimming Pool $0.00
Owner Address: 16 Mark DR Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Pools Plus
45 MAIN ST
Queensbury,NY 12804
Plans&Specifications
Inground Pool
$75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,August 23,2018
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expi ation�eM
date.)
Dated at the Town of ueensb s 3,2017
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
SWIMMING POOL PERMIT APPLICATION office use only
Permit#:
Town of Queensbury
Permit Fee:$ ;Invoice#:,Ll to l
742 Bay Road,Queensbury,NY 12804
P:518-761-8256 www.gueensburV.net Notes:
Project Location:
Tax Map ID #: of ya /. 7- `I w Subdivision Name:
CONTACT INFORMATION:
• Applicant:
Name(s): 114 nt. OWDrIL
Mailing Address, C/S/Z: 11 U.Qe
Cell Phone: ( ji-) "N4- Land Line:
Email: Lt,CPrrnne tehco.e-yw\
• Primary Owner(s): , )
Name(s): 61dr-,- KQ�hr "h 0ei(011"'
Mailing Address, C/S/Z: 61 MAW --br,.
Cell Phone:_(E rl44- q&t Land Line: _(SI ) -7 S3S
Email: G1,CLO(rDne UQ�Do. /D/Y)
•
Installer/Builder-
Business
nstaller Builder:Business Name: n DIS f"
Contact Name(s): A-Ve
Mailing Address, C/S/Z: 4�5_ ,/ 141} ► �f. Gl&Oosbu r� 1• � ��
Cell Phone:_( ) Land Line: _(S)�
Email: iV�tcW(l S a &CO, Cmy-
Contact Person for Building & Code Compliance: 4n4hotyOee-luu-7
Cell Phone: _(Slff ) �yy-(/ {�' Land Line: (Sik ) S
Email: (� (' rrc�n� CthA�•«m
E V E
D
AUG 16 2011
TOWN NG&CODES Y
Town of Queensbury Building&Code Enforcement Revised May 2017
SWIMMING POOL INFORMATION:
...........
CIRCLE ONE: ABOVE- GROUND C-_____________11
IN-GROUND
SIZE OF POOL: V .3
MANUFACTURER: /!)D /l _ PCv1S
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.
I have read and agree to the above: n
PRINT NAME: 11
SIGNATURE: DATE:
Town of Queensbury Building&Code Enforcement Revised May 2017
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
PDo L-50Z.- 20 t +
Permit No....—............................Cert. NO 44953
Cut-in Card No.....................................
Owner.......... ,I �,�20I/�............ ....................................
.................................................................
Location../Z... ...-D&:..................................................,u .L ...................................
Installation Consisting of...lpviv-4......ai%aeekluz....t A.. � � ........................••••.•
....................................................................................................................................................................................
. .............................................................................................................................................
Installed By..... r......eAk 4-'6..f'z41.....................................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 ' ections at any time, and if its
rules are violated,the Company shall have the right to e e this c ' cat
Date.....�5...:. .............. INSPECTOR... ...... ...... ...................................
Member N.F.P.A.,1.A.E.1.
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289.7-2-16 POOL-000502-2017
Cerrone, Anthony & Kathryn
16 Mark Drive
a Inground Pool
QD D