POOL-0187-2018 L
rp , TOWN OF QUEENSBURY
742 Bay Road Queensbury,NY 12804-5904 (518)761-8201
T .T: Community Development-Building& Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: POOL-0187-2018 Date Issued: Wednesday, June 6, 2018
This is to certify that work requested to be done as shown by Permit Number POOL-0187-2018
has been completed.
Tax Map Number: 301.13-2-75
Location: 36 ALGONQUIN DR
Owner: Sean Smith
Applicant: Sean Smith
This structure may be occupied as a: Above ground swimming pool
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the4
/
roe owner of the responsibility for compliance with Site Plan,
property p t3' p
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.
TW 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-0187-2018
Tax Map No: 301.13-2-75
Permission is hereby granted to: Sean Smith
For property located at: 36 ALGONQUIN 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
Type of Construction
Owner Name: Sean Smith Swimming Pool $0.00
Owner Address: 36 ALGONQUIN DR Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
MTC Pool Service
PO Box 4722
Queensbury,NY 12804
Plans&Specifications
Above ground swimming pool
$ 125.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Thursday,April 25,2019
(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 een ; edn= ay, . .ril 25,2018
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
f
s/A
n L� .4 SWIMMING POOL PERMIT APPLICATION Office Use Only
Permit#: Poe '- 0 i C+-201 b
Town of QyeonsburyPermit Fee:$ 12_5 ; Invoice#:
742 Bay Road,Queensbury,NY 12804
P:518-761-8256 www.queensbury.net Notes:
Project Location: 3 E I4oit1ai;t b) , iteE ff .Q'/) /11 42F-0 f
Tax Map ID #: 'Jo\ • 1 zj^ 2-1-5 Subdivision Name: / /te S o
CONTACT INFORMATION:
• Applicant:
Name(s): F/4
Mailing Address, C/S/Z: 36 /,- nia/A b1, ) tieeALs-c.Er �l� E u
Cell Phone: ( 57 ) .79/-9g-hl Land Line: (
Email: 5)41; .51/15 e Aaia aF,c m
• Primary Owner(s):
Name(s): 5r i—t— M •
Mailing Address, C/S/Z: '3 / IV?,� r�d.��it�'� !JB'-. ��ems`�2 S� r.� 6`1�= „A„ g�'
Cell Phone:_( 5/g' ) 791-- 6V Land Line: _( ) /�
Email: 911// Smu t'/c/ 411 coin
• Installer/Builder:
Business Name: T Poo / ; vice
Contact Name(s): P7/c hoe_
Mailing Address, C/S/Z:
Cell Phone: ( , ) 3O7 —� / Land Line: _(g7 ) 3 --
` `/(�/ 7% '
Email: in4-6: oipr�"oS C�yo, oo.0 c/1
Contact Person for Building & Code Compliance: \ '0y<A"
Cell Phone: ( ) Land Line': (
Email:
APR 2 Q 2018
TOWl caF G coD�RJ
Town of Queensbury Building&Code Enforcement �j�11-�11� Revised May 2017
SWIMMING POOL INFORMATION:
CIRCLE ONE: `'ABOVE- GROUND IN-GROUND
SIZE OF POOL: f? u v f
MANUFACTURER: pools Pf us L-.a' ac 4, 9r/ �2� r , o/
At >aC S-ca
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:
PRINT NAME: of
SIGNATURE: DATE: V/�.01P
Town of Queensbury Building&Code Enforcement Revised May 2017
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3 /-1f ] I> 0 uee Sou r t
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130 -AL, ._____)
TOWN OF QUEENSBURY
d �_ ``�. ` � BUILDING DEPARTMENT
, Based on our limited examination,compliance
2-5 " qp„N. �-° 'c with our comments shaft not be construed as
r` ws indicating the plans ano specifications are in
full compliance with the Building Codes of
�-f-F. New York State.
t
OS� c. lD [ f
C.
_ J TOWN OF QUEENSBURY
BUILDING & CO S EPT.
dE.& C, `_____,.R6VRewe
Date: q0
e - I r`(
2._—__. / , ,
b f--- i v,e_
/11-1 0/..., 7 , fr 11,-
Mil IT PLOT AN
' I HAVE PERSONALLY MEASURED THE DISTANCE
FROM THE PROPERTY LINES TO THE
Attention Home Owner P DOSED ST UCTURE(S)OR SVGN(S)
Please assure you are familiar with the �����,
Pool Enclosure requirements specific to SIGNATURE DATE
Your pool. We will be happy to explain
what Requirements you will have to
meet per Appendix G Of the
New York State Residential Code.
301.13-2-75 POOL-0187-2018
Smith, Sean
36 Algonquin Drive
above ground pool