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POOL-0388-2018
�^ TOWN OF QUEENSBURY � 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 --__ Community Development - Building & Codes (518) 761-8256 CERTIFICATE OFCOMP 1ANCE Permit Number: POOL-0388-2018 Date Issued: Thursday, May 30, 2019 This is to certify that work requested to be done as shown by Permit Number POOL-0388-2018 has been completed. Tax Map Number: 297.14-1-4 Location: 517 RIDGE RD Owner: Levi Russell Applicant: Levi Russell This structure may be occupied as a: Above 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, 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 i tea`, f 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 r F --; Community Development-Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: POOL-0388-2018 Tax Map No: 297.14-1-4 Permission is hereby granted to: Levi Russell For property located at: 517 RIDGE 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 Type of Construction Owner Name: Levi Russell Swimming Pool $0.00 Owner Address: 517 Ridge RD Total Value $0.00 Queensbury,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications Above Ground Pool $ 125.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Wednesday,June 26,2019 (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 e expirati., ,•at;;.) Dated at the To of Qu b Ta cr, :,June 26,2018 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement '7,;:, a 3 •. �*41` � SWIM M G POOL PERMIT APPLICATION office Use only , / Permit#: 15 8-- 2_016 Town of Qcensbury Permit Fee:$125 ;invoice#: 05'1r4- 742 Bay Road,Queensbury,NY 12804 Notes: P:538-761-8256 www.oueensbury.net Project Location: SI 7 RI*C Tea/ U Tax Map ID#: ,a1'7, /4 -t -4 Subdivision Name: CONTACT INFORMATION: o Applicant: Name(s): t.,,,e ef; R(.1-Sbitt ©A-rcy L Ai('in ion Mailing Address, C/S/Z: ,/ 7 kid Te &o AO e20eMiodu,rY i(' /R. (NV Cell Phone: ( r`ii-- ) 5100 a--SI)a-7 Land Line: ( 75.- ) 19 - S13 ) rt 5 lig Email: O Primary Owner(s): Name(s): Le(',' fku.sstti A Air(y boArre/ -of) Mailing Address, C/S/Z: ;i/) R(c(l t ko,413 00 tie-OSA0 f',I nfy > ?1b. V Cell Phone:_( C ) ' "60--'61a2.--7 Land Line: _( br4' ) -? 97 —5-15 / Email: • Installer/Builder: Business Name: Levi R.w$Se (I Contact Name(s): Mailing Address, C/S/Z: Cell Phone:_( ) Land Line: _( ) Email: Contact Person for Building & Code Compliance: L co e fl,,,,cst 1 . Cell Phone: ( 57 ) no a 3--) Land Line: ( ) Email: LA-uj ykL.,Sct,(il I®cl4rieo ,cdAer • Town of Queensbury Building&Code Enforcement Revised March 2018 fa- SWIMMING POOL INFORMATION: CIRCLE ONE: OVE-AROUND IN-GROUND SIZE OF POOL: a 0'' % 'V "o?ep MANUFACTURER: i i -X 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° have read and agree to the above: . PRINT NAME: L Li �,�.a SSi✓�. SIGNATURE: 4 LAktiliDATE: 641,4V • Town of Queensbury Building&Code Enforcement Revised March 2018 ogle Maps OIL ry x ,s ` 517 Ridge Rd d 4 .a ', ABOVE- GROUND POOL � v fi � �t �� di � fits. i � '' rs :� .,.�� F ti G € > y / 441 ff w , aIr RX VIM ISMIRDi s £._ A ; M1 .xp j h k BUILDING DEPAk iv -04 Based on our limited examination,compliance with our comments shall not be construed as PERMIT_ !PLAN indicatin. the plans and specifications are in I HAVE PERSONALLY MEASURED THE DISTANCE full compliance with the Building Codes of FROM THE PROPERTY LINES TO THE New York State. PROPOSED STRUCTURE(S)OR SI N(S) Imagery©2018 Google, Map data©2018 Google 10 ft �a SIGNATURE DATE TOWN OF QUE 297.14-1-4 BUILDING & Russell, Levi 517 Ridge Ro Reviewed B Above grouni Date: ,.com/maps/place/517+Ridge+Rd,+Queensbury,+NY+12804/rr 43.3404929,-73.6304911,37m/data=!3ml!le3!4ml3!lm7!3m6!ls0x.,