POOL-0541-2018 �^ 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-0541-2018 Date Issued: Monday, May 20, 2019
This is to certify that work requested to be done as shown by Permit Number POOL-0541-2018
has been completed.
Tax Map Number: 295.15-2-10
Location: 69 JOHN CLENDON RD
Owner: John Glendon Hidden Estates LL
Applicant: Bryon Diel
This structure may be occupied as a: In 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
4.
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
-- - Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: POOL-0541-2018
Tax Map No: 295.15-2-10
Permission is hereby granted to: Adirondack Pools
For property located at: 69 JOHN CLENDON 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: John Clendon Hidden Estates LL Swimming Pool $0.00
Owner Address: 9 Mountainside DR Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Adirondack Pools
5 BOULEVARD
Queensbury,NY 12804
Plans&Specifications
In ground pool
$ 125.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Thursday,August 29,2019
(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 ue bury; 4 We s gust 29,2018
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
_
4' SWIMMING POOL PERMIT APPLICATION- Office Use Only
I Permit#: lf-04 t ° .2-°18
ii i {i1 t?iwettstailly Permit Fee:$ 125 ;Invoice#:6801
742 Bay Road,Queensbury,NY 12804
Notes:
P:518-761-8256 www,au@misini`yatiwt
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Project Location: 9 3 c? tI 7)� QG Nc ?tar
Tax Map ID#: 5. 15- 2 --10 Subdivision Name:
CONTACT INFORMATION:
• Applicant:
Name(s): 9 011 /Joffe //Nisei- >u Ca
s, c1zc*
Mailing Address, C/S/Z: I � fibi*-55 3z73 qC t'PS b A Aoi i- 14C.th rtv Atif, kle
Cell Phone: ( ) ���—��C� t Land Line: ( ) 1 z5a j
Email: lc-rP( ruxee®vvL.
• Primary Owner(s):
Name(s): dM e 115 -744.ik)As.
Mailing Address, C/S/Z:
Cell Phone:_( ) Land Line: (
Email:
• Installer/Builder: � ��
Business Name: Act),r> at'/ Pt/ Cl itC
Contact Name(s): �,/'�-�' 0AND
Mailing Address, C/S/Z: ,r/✓1 C.
Cell Phone:_((c96 ) — Land Line: ( )-gl[J'��7 S eYi'
l; 1 n !c=' -���—
Email: � s�° A c/
Contact Person for Building & Code Compliance: §(1 gq
Cell Phone: ( Si 6' ) - -='1 G Land Line: _( )
Email: lraJ -cork
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1111
/ TAUG222OJ7
Town of Queensbury Building&Code Enforcement TOWN OF QUEENBBURY Revised August 2018
BUILDING&CODES
SWIMMING POOL INFORMATION:
CIRCLE ONE: ABOVE-GROUND IN-GROUND
SIZE OF POOL: ' 3 y
MANUFACTURER: CARD/A-14,,,C,__
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:
SIGNATURE: DATE:•
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RX Date/Time 05/16/2019 12:13 15132731202 N o. 8 7 0 2 P 4/4 r•w,>:+
by=:May, 1 b. 2 019 11 51 AM:z4*-=MD I A . .,,�. �, �•, Syr-•..,.,:;:.:..� ,,� ,:� :
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MIDDLE DEPARTMENT INSPECTION AGENCY.. to,,,, , INC. e„)
that the electrical wiring to the electrical equipment listed below has been examined and is approved as �.
being in accord with the National Electrical Code, applicable governmental, utility and Agency rules in effect on the date •-
f ai noted below and is issued subject to the following conditions. I
<<) Owner: Dater
Brian Diel 05/10/2019 t'
�nOccupant: location:
:*3 Pool 69 John Glendon Rd. C>>
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��� Occupancy: Queensbury, Warren Co. NY
... Swimming Pool C
Applicant_I •
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�G ti Brown Brother's Elec. Inc. :........• l
~�) 175 State Rt 149 -- --- - )
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Lake George, NY 12845. . .-... • Ii'
� � hAHomlc No •
o 1003106480EL . TOWN OFQUEENS Y��� Eqi Ica
C1 -30 Amp Heat Pump; 1 -Switch; 1 -.Fixture; 1 -Twt-Lock Receptacle P�Qi_._ C5
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,,, This certificate applies to the electrical wiring to the electrical equipment listed immediately null and void. This certificate applies only to the use,occupancy and •?,-
`y�) above and the installation inspected as of the above noted date based on a visual ownership as indicated herein. Upon a change in the use,occupancy or ownership /�:�
i, ) inspection. No warranty Is expressed or implied as to the mechanical safety,effi- of the property indicated above,this certificate shall be immediately null and void. l
4 ciency or fitness of the equipment for any particular purpose. This certificate shall In the event that this certificate becomes invalid based upon the above conditions, `���
,,;. be valid for a period of one year from the above noted date. Should the electrical this certificate may be revalidated upon reinspection by Middle Department „,
l system to which this certificate applies be altered In arty way,including but not limit- Inspection Agency,Inc. An application for inspection must be submitted to Middle r
el• ed to,the Introduction of additional electrical equipment and/or the replacement of Department Inspection Agency. Inc.to initiate the inspection and revalidation 4)
Ai) any of the components installed as of the above noted date,this certificate shall be process. A lee will be charged for this service.
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INSPECTION WORKSHEET (POOL-002817-2019)
Town of Queensbury - Building and Codes - Fire Marshal
742 Bay Road - (518) 761-8256 Building (518) 761-8206 Fire Marshal
Case Number:POOL-0541-2018 Case Module:Permit
Inspection Date:Mon May 20, 2019 Inspection Status:Passed
Inspector:John O'Brien Inspection Type:Pool
Job Address:Parcel Number:69 JOHN CLENDON RD
Queensbury, NY 12804
295.15-2-10
Contact Type Company Name Name
Primary Owner John Clendon Hidden Estates LL
Granted Permission Adirondack Pools & Spas
Contractor Adirondack Pools & Spas
Applicant Diel, Bryon
Checklist Item Passed Comments
2 inch max to grade from underside of fence YES Raise grade at west gate
Self closing device or alarms (30 sec Alarm time)YES Install alarm on bedroom door and garage door
Ok to issue CC YES 5/20/19 Swimming Pool Final Inspection Approved- Ok to
Issue CO!
May 20, 2019 Page (1)
O'Brien, John (Inspector)