POOL-0499-2018 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-0499-2018 Date Issued: Tuesday, September 18, 2018
This is to certify that work requested to be done as shown by Permit Number POOL-0499-2018
has been completed.
Tax Map Number: 308.7-1-22
Location: 20 WESTBERRY WAY
Owner: Christine Bushey
Applicant: Christine Bushey
This structure may be occupied as a: Inground Swimming 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, /� )0t
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.
f TOWN OF QUEENSBURY
t' �ir 4.i
� '>! 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
',-, ' Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: POOL-0499-2018
Tax Map No: 308.7-1-22
Permission is hereby granted to: Christine Bushey
For property located at: 20 WESTBERRY WAY
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:. Christine Bushey Swimming Pool - $0.00
Owner Address: 20 Westberry Way Total Value $0.00. .
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Hagaman Contracting,Inc.
PO Box 101
Amsterdam,NY 12010
Plans&Specifications
Inground Swimming Pool
$ 125.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Tuesday,August 6,2019
(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 Que bury; 4 Mo- ..y f u . t 6,2018
41
SIGNED BY: I \ for the Town of Queensbury.
Director of Building&Code Enforcement
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SWIlViMING POOL PERMIT APPLICATION Office Use Only C O -
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Permit#: >
Town ofQecnsbury Permit tee:$ 0—) ;Invoice#: al-9
742 Bay Road,Queensbury,NY 12804
P:518-761-8256 www.queensbury.net Notes:
Project Location: -) Piti t,..)
C2lj/
Tax Map ID#: 0o,7/�� SubdivisiOn Name9PI -i E��/c (R)01--s) ,
5 00 5' - 3`F/ i� c rc�-
CONTACT INFORMATION: 74' C E ' E 1 c;0 ce'
• Applicant: III AUG 0- 3 23$
Name(s): Chris 6L15h9
Mailing Address, / / GJ.2s�'bex• TOWN ' OUEE SBURY
Cell Phone: (5(9 )1q�/ g13L ! Land Line: - 41`��•
Email: C;brc 4 la ae G Ccsiv._
• Primary Owner(s):
Name(s): Ghrts +i n bathe-ger, .
Mailing Address, C/S/Z: e9D 1,)..e54-
Cell Phone:_( PI? ) 7 -1,(3'f Land Line: _( 5g ) 3 -30E
Email: cJ6rock (ggyahm.ontt.
o Installer/B ilder: _
Business Name: f, q a mCtm [ T 1�#?C
Contact Name(s): i J (n Ol br�Jch ,
Mailing Address, C/S/Z: bp
i 1 Ara51(.4- 6hiA. N ti %)-o/C-0
Cell Phone:_( 5/8 ) ,'05-5qc/a Land Line: _( )
Email:je.A1C9ArRaXIO bi lie .0
Contact Person for Building & Code Compliance: (.:kheS 5 hij
Cell Phone: ( wig ) •7tf'f,&43` - Land Line: _( ) /
Email:
Town of Queensbury Building&Code Enforcement Revised March 2018
it
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SWIMMING POOL INFORMATION:
CIRCLE ONE: ABOVE- GROUND IN-GROUND
SIZE OF POOL: c D X O2
MANUFACTURER: ) 41Q /YL6€.-f T a,
MATERIALS USED IN CONSTRUCTION (CHECK ALL THAT APPLY):
Steel/Vinyl y 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: Cit)(15
SIGNATURE: 06,14 2) DATE: g)**3-
Town of Queensbury Building&Code Enforcement Revised March 2018
INSPECTION WORKSHEET (POOL-006689-2018)
Town of Queensbury - Building and Codes - Fire Marshal
742 Bay Road - (518) 761-8256 Building (518) 761-8206 Fire Marshal
Case Number:
Inspection Date:
Inspector:
Case Module:
Inspection Status:
Inspection Type:
POOL-0499-2018
09/17/2018
John O'Brien
Permit
Passed
Pool
Job Address:Parcel Number:20 WESTBERRY WAY
Queensbury, NY 12804
308.7-1-22
Contact Type Company Name Name
Granted Permission Bushey, Christine
Contractor Hagaman Contracting, Inc.[Hagaman Contracting, Inc.]
Applicant Bushey, Christine
Primary Owner Bushey, Christine
Checklist Item Passed Comments
Building Inspector Notes YES 9/14/18 Final Inspection Not Approved
Remaining Items:
-Install Alarms on slider and door from garage to back
yard.
-Set self closing hinges on fence gate as discussed.
-Install pool alarm at edge of pool.
9/17/18 Final Inspection Approved-Swimming Pool
- Ok to issue CO!
Pool enclosure around pool or yard YES
4 feet above grade YES
2 inch max to grade from underside of fence YES
4 inch maximum clearance in fence pickets YES
Self closing device or alarms (30 sec Alarm time)YES -Install Alarms on slider and door from garage to back
yard.
Pool Surface Motion Alarm YES -Install pool alarm at edge of pool.
Gate less than 56 to latch ½ max spac in openings YES
Gate opens outward, self closing YES -Set self closing hinges on fence gate as discussed.
Padlock provided on gates or ladder YES
Timer on pool pump (no plug in timer allowed)YES
Final Electrical YES
Vehicle access gate closed & locked YES
Sep 17, 2018 Page (15)
INSPECTION WORKSHEET (POOL-006689-2018)
Checklist Item Passed Comments
Ok to issue CC YES 9/14/18 Final Inspection Not Approved
Remaining Items:
-Install Alarms on slider and door from garage to back
yard.
-Set self closing hinges on fence gate as discussed.
-Install pool alarm at edge of pool.
9/17/18 Final Inspection Approved-Swimming Pool
- Ok to issue CO!
Sep 17, 2018 Page (16)
O'Brien, John (Inspector)
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.w" 'UNAUTHORIZED ALMAIIGN OR ADOMON TO A SURVEY
titiJJ SNAP BEHDNO A UCENSED LAND SURVEYORS SEAL IS A Map of a Survey made for
VIOLATION OF SECTION 7200.SUB-DIVISION 2,OF THE
NEW YORK STATE EDUCATION LAW
*ONLY COPIES FROM THE ORIGINAL OF INS SURVEY
MARKED IM AN ORIGINAL OF THE LAND SURVEYORS
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ON HIS BEHALF TO THE TITLE COMPANY.00VEDNMENYAL `
uy, New York 12804 A AND PENDING INSIM7M LISTED HEWRIN'AND Town of Queensbury, Warren County, New York
TD THE ASSKUNEES OF THE LENOWD MM7UTKW.•
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