building permit TOWN OF QUEENSBURY
X 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development - Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: POOL-0236-2018
Tax Map No: 265.-1-9
Permission is hereby granted to: Ruben Ellsworth
For property located at: 76 ELLSWORTH LN
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: Danna Ellsworth Swimming Pool $0.00
Owner Address: 76 ELLSWORTH LN Total Value $0.00
Lake George,NY 12845
Contractor or Builder's Name/Address Electrical Inspection Agency
Concord Pools Ltd.
60 BIG BOOM RD
Queensbury,NY 12804
Plans& Specifications
Inground Swimming Pool 18'x 36'
$ 125.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Wednesday, May 15, 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 o ueens ry; /lues , 2018
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement