POOL-000645-2017 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-000645-2017
Tax Map No: 296.9-2-16
Permission is hereby granted to: Richard Jones
For property located at: 39 CEDARWOOD 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
Tvne of Construction
Owner Name: Nadine Jones Swimming Pool $0.00
Owner Address: 39 CEDARWOOD DR Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Sprague's Mermaid Pools
300 Broadway
Fort Edward,NY 12828
Plans&Specifications
Inground Swimming Pool 14 x 28
(replacing above ground pool)
$75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,October 24,2018
(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 ofeensb ues y O ,2017
SIGNED BY: /rrJ for the Town of Queensbury.
Director of Building&Code Enforcement
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SWIMMING POOL PERMIT APPLICATION office use only
Permit#:
Town of Quccnsbun, /uG
Permit Fee:$75 ;Invoice#: 3,7�
742 Bay Road,Queensbury,NY 12804
P:518-761-8256 www.gueensbury.net Notes:
Project Location: 39 Cedarwood Drive
Tax Map ID#: q b• _a`l.fo Subdivision Name: Twickwood
v 8� EE
CONTACT INFORMATION: OCT � 3 2017
• Applicant: TOWN OF QUEENSBURY
Name(s): Richard&Nadine Jones
Mailing Address, C/S/Z: 39 Cedarwood Drive, Queensbury, New York 12804
Cell Phone: 518 ) 681-9290 Land Line: 518 ) 743-9280
Email: mrsjones215@yahoo.com
• Primary Owner(s):
Name(s): Richard and Nadine Jones
Mailing Address, C/S/Z: Same as above
Cell Phone: _( ) Land Line: _( )
Email:
• Installer/Builder:
Business Name: Sprague Pools
Contact Name(s):
Mailing Address, C/S/Z: 300 Broadway, Fort Edward, New York 12828
Cell Phone: _( ) Land Line: _( 518 ) 747-9270
Email:
Contact Person for Building & Code Compliance: Not sure RyG ��/�� J n.JQ f 36 f- 3J5
Cell Phone: _( ) Land Line: _( )
Email:
Town of Queensbury Building&Code Enforcement Revised May 2017
SWIMMING POOL INFORMATION:
CIRCLE ONE: ABOVE-GROUND ( IN-GROUND
SIZE OF POOL: 14x28
MANUFACTURER:
MATERIALS USED IN CONSTRUCTION (CHECK ALL THAT APPLY):
Steel/Vinyl X Fiberglass Gunite Poured Concrete Other
Declaration: I acknowledge no construction activities shalt 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:
PRINT NAME: Richard&Nadine Jones
64 \
SIGNATURE: A/M DATE: 10/10/2017
Town of Queensbury Building&Code Enforcement Revised May 2017
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