POOL-0758-2018 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-0758-2018 Date Issued: Wednesday, December 12, 2018
This is to certify that work requested to be done as shown by Permit Number POOL-0758-2018
has been completed.
Tax Map Number: 303.20-1-53
Location: 4 PARK AVE
Owner: Andrew Harrington
Applicant: Andrew Harrington
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 (-- .00P 4
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
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ag 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
•
Community Development - Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number: POOL-0758-2018
Tax Map No: 303.20-1-53
Permission is hereby granted to: Andrew Harrington
For property located at: 4 PARK AVE
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: Andrew Harrington Swimming Pool $0.00
Owner Address: 4 Park AVE 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,December 4, 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 To nsbury T e.d./ ---mber 4,2018
4SIGNED BY: '� . \ for the Town of Queensbury.
Director of Building&Code Enforcement
SWIMMING POOL PERMIT APPLICATION Office Use Only
Permit#: P20—~b i
Town o£Quecnsbuzy IE C IE O V E Permit Fee:$ 1 • Invoice#: ) D c
742 Bay Road,Queensbury,NY 12804
P:518-761-8256 www.aueensbuntmet NOV 2 9 2018 Notes:
T WN OF QUEENSBURY I
Project Location: £ 0Z.X BUILDING 8 CODES
Tax Map —ID #: �� Subdivision Name:
CONTACT INFORMATION:
• Appl� t:
Name(s): reA,'J 5- C\
Mailing Address, C/S/Z: PCGv/L (k 1I' Qucc Sk Lkl yi A.) l -sou`{
Cell Phone: ( v15' ) cW(i --O7 q Land Line: ( )
Email: CkVkc of f w<L , a70 ycc('l co,co rvl
• Primary Owner(s):
Name(s): S C(W L
Mailing Address, C/S/Z:
Cell Phone:_( ) Land Line: _(_ )
Email:
• Installer/Builder:
Business Name: 5 C vwl
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone:_( ) Land Line: _(
Email:
Contact Person for Building & Code Compliance: CO ,e
Cell Phone: _( ) Land Line: _( )
Email:
4,80fir,
Town of Queensbury Building&Code Enforcement Revised September 2018
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SWIMMING POOL INFORMATION:
CIRCLE ONE: ABOVE-GROUND IN-GROUND
SIZE OF POOL: A
MANUFACTURER: e4CtLkek.
MATERIALS USED IN CONSTRUCTION (CHECK ALL THAT APPLY):
Steel/Vinyl Fiberglass Gunite Poured Concrete Other UJOC)C4
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: A k‘n
SIGNATURE: ')/�/ � C DATE:
Town of Queensbury Building&Code Enforcement Revised September 2018
D 'llbS CPI ,
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• D t.0 TOWN OF QUEENSBURY —
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-I < O BUILDING DEPARTMENT _ o ,
O m O W Based on our limited examination,compliance > -o
C V with our comments shall not be construed 0 --r rn,
3 D indicating the plans and specifications are r"'„ 1-
fl- = full compliance with the Building Codes c rn
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0 m -0 New Y State. - � '
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o Attention Home Owner; ` 1-'
(A Please assure you are familiar wit the }v
s O n I
p0 ool Enclosure requirements specific to w
c 1 Your pool. We will be happy to ex lain u" o
what Requirements you will have o z
co
meet per Appendix G Of the m ui
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