application TOWN OF QUEENSBUk,
RECEIVED
TOWN OF QUEENSBURY
Bay at Naviland Road, Queensbury, NY 12804-9725-518-79 22 7 1992
SWIMMING POOL PERMIT APPLICATION N�
BLDG. & CODE °DE rn
FEE PAIDp5
OWNER'S NAME__In5p (5 cr( 0 , 64)(20/ TEL. G/nJ
LOCATION 3 (2//6C jJobtS Li t 3;('()2(1
PERSON RESPONSIBLE FOR CODE REQUIREMENTS: / c' S Pvie (j / /2 , . -6119
ADDRESS TEL.
TYPE OF POOL - 74 in-ground above- ground
SIZE: Length 2' ft. / Width /3-- ft. / Diameter ft. / Depth 7 ft.
APPROXIMATE WATER CAPACITY 1Fcoe gallons.
MATERIALS USED IN CONSTRUCTION: (circle one)
Steel/vinyl -- F ss. Gunite -- Poured Concrete -- Other
CONTRACTOR/INSTALLER -j/J ii V3Z/tk TEL.
ADDRESS //0s A c IL4y•
IMPORTANT INSTRUCTIONS:
On a separate piece of paper, submit a diagram; drawn to show: -
PROPERTY LINES - EXISTING STRUCTURES - PROPOSED OR EXISTING SEPTIC SYSTEM -
LOCATION OF PROPOSED SWIMMING'.POOL - Show all distances from lot lines to both
the pool and the structures, as well as separations between.
APPLICATION FOR 'ELECTRICAL INSPECTION IS NECESSARY. A COPY OF THE APPLICATION
IS TO BE FILED WITH THIS OFFICE.
THIS OFFICE. IS TO BE NOTIFIED UPON COMPLETION OF CONSTRUCTION; INCLUDING
INSTALLATION OF FENCING. A FINAL INSPECTION WILL BE MADE BEFORE USE OF THE
POOL IS AUTHORIZED.
Signature of Applicant: \`), Date: 5'-27-92_,
OVER