POOL-0544-2018 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-0544-2018 Date Issued: Monday, September 10, 2018
This is to certify that work requested to be done as shown by Permit Number POOL-0544-2018
has been completed.
Tax Map Number: 302.5-1-28
Location: 9 VISTA CT
Owner: Ann Marie Mason, Craig Mason
Applicant: Ann Marie Mason
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 (.W
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.
y : TOWN OF QUEENSBURY
�7 ; a 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
`,- ` 3 Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: POOL-0544-2018 V
Tax Map No: 302.5-1-28
Permission is hereby granted to: Ann Marie Mason
For property located at: 9 VISTA CT
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: Ann Marie Mason . Swimming Pool V $0.00
Owner Address: 9 Vista CT Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address • Electrical Inspection Agency
Adirondack Pavillion Pools
946 Lake AVE
Saratoga Springs,NY 12866
Plans&Specifications
Above ground pool
$ 125.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Wednesday,August 28,2019
(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 eensbury; 4 Tue...y, ugust 28,2018..„, ,
SIGNED BY: 'w' 11 for the Town of Queensbury.
Director of Building&Code nforcement
,. 4r
i SWIMMING POOL PERMIT APPLICATION Office Use only
Permit#: '�`60 L q t�
.
Town of Queensbury -— -- Permit Fee:$ /9W ;Invoice#:
742 Bay Road,Queensbury,NY 12804 P:518-761-8256 www.queensbury.net AUG 2 2 L'Yj Notes:
TOWN OF QUEENSBURY
6-FOMMI_MTV
Project Location: (54eL. DEVELOPMENT
Tax Map ID #: �O� �� /-.022 Subdivision Name:
CONTACT INFORMATION:
• Applicant:
Name(s): n n 1Y)arr'e 1714 S D � 1: /')')q Sv1
Mailing Address, C/S/Z: C!' (`i5 (� C� , Qc,teev1SbLrL NY /affbtf
Cell Phone: ( c (6 )a/— 7Fs7s". Land Line: ( ) L
Email: oil'i M E,3 ?tit p yat, C bin
• Primary Owner si:
Name(s): '1 (1 IY)I?x'e irkce)/-)
Mailing Address, C/S/Z: SkvYle
Cell Phone:_( ) Land Line: _( )
Email:
• Installer/Builder:
Business Name: 6 t.1iron d&ck- ?r v ► (c?7✓1 vvl -�
Contact Name(s): .J 1rvk
Mailing Address, C/S/Z: Like AV Sat r4L tjcL c5,or.h5s, /J y tag&
Cell Phone:_(S7 $ ) GCS"- '/D &O Land Line: _(,;/ ) S 0 Z -
Email:
Contact Person for Building & Code Compliance:
Cell Phone: ( ) Land Line: (
Email:
Town of Queensbury Building&Code Enforcement Revised August 2018
•
SWIMMING POOL INFORMATION:
CIRCLE ONE: ABOVE- GROUND IN-GROUND
SIZE OF POOL: G S"
MANUFACTURER: Cl-AG21/16 -t
MATERIALS USED
IN CONSTRUCTION (CHECK ALL THAT APPLY):
Steel/Vinyl V 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: Ann / / hri e
SIGNATURE: DATE: c9/3 4).
Town of Queensbury Building&Code Enforcement Revised August 2018
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. AUG 2 2 2013,,
302.5-1-28 POOL-0544-2018
Mason, Ann Marie & Craig •
ts,,,,,-— 1/4.4UEErvcsi#rni
9 Vista Ct ,va.LOPML--.PkIi *
I Above ground pool
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