2005-501 TOWN OF QUEENSBURY
WOO
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1 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number. P20050501 Date Issued: Friday, July 21, 2006
This is to certify that work requested to be done as shown by Permit Number P20050501
has been completed.
Tax Map Number: 523400-265-000-0001-020-000-0000
Location: 1471 BAY Rd
Owner: ANDREW & LINDA DOBROSKI
Applicant ANDREW & LINDA DOBROSKI
This structure may be occupied as a:
Inground 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 nfoire ent
Planning Board or Zoning Board of Appeals.
411111kTOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20050501 Application Number: A20050501
Tax Map No: 523400-265-000-0001-020-000-0000
Permission is hereby granted to: ANDREW 8i I,1NDA DOBROSKI
For property located at: 1471 BAY 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 Value
Owner Address: ANDREW& LINDA DOBROSKI
1471 BAY Rd I Total Pool
o Value
Total Value
LAKE GEORGE, NY 12845
Contractor or Builder's Name /Address Electrical Inspection Agency
BAKER POOLS
NY 12804-0000
Plans&Specifications
205-501
INGROUND POOL
$35.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Tuesday, July 18, 2006
(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 T., . I ueens ry; oi ay, July 18, 2005
SIGNED BY r for the Town of Queensbury.
Director of Building: Code -nforcement
Application for SwimmingPool Permit
Permit Nov-2005--
Building&Codes Office—Town of Queensbury 742 Bay Road Queensbury,NY 12804 �,N_
(518) 761-8256 Fee Paid J'
Instructions and requirements are attached. Notes:
1. Applicant I Owner I Contractor or Installer Information:
Applicant Owner Contractor/Installer
_ .
t•C) f ,'D0i/20„ir/' s,ri+vlL / 2I ao/S
Address
Phone
1?)- /070 1t)I_ �) S 2005 '793 ' C-6)—
Fax
Phone: '' TOWN OF QUEENSBURY
BUILDING AND CODE
2. Person Responsible for Code Requirements:
3. Pool Location Address: / Teal L„,.oce: �;�„�� Tax Map No. ?d'."' f is
� f,� l 1-
4. Swimming Pool Information: (check whichever applies and fill in the blanks) t�0—�
A. Type of Pool: ❑Above ground pool fInground Pool
B. Size of Pool: Length 4(/ ft. / width /6 ft. / diameter ft. / depth S ft.
C. Materials used in construction: gsteel/vinyl; ❑fiberglass; ❑gunite; poured concrete; bother
5. Fencing Requirements for above-ground & inground swimming pools:
A. If an above-ground, indicate height from ground-grade to top of pool height inches
Note: If your above-ground pool is less than 48 inches above-grade,a fence must be installed within
the area of the pool.
If your above-ground pool is exactly 48 inches above-grade or more,a lift-up ladder with lock
must be installed.
B. If an inground pool,a fence must be installed meeting NYS Regulations,Appendix G.
6. Pool Pump Requirements—Time Clocks:
Pool pumps must be equipped with time clocks so the pumps can be set to shut off during periods of peak utility electrical
demand and set to control the length of time during which the filter runs.
7. Final Inspection Information:
You are responsible for scheduling the following: A) Electrical Inspection; B) Final Certificate of Compliance Inspection
An electrical inspection is required before the Certificate of Compliance is issued. See attached sheet listing electrical inspectors.
The inspectors are contracted through the Town of Queensbury and you are responsible for payment to them directly. Their fee is
not part of this application.
A final inspection by the Queensbury Building&Codes Office is required before use of the pool is authorized. The Code Officers
will look for an approved electrical inspection(sticker on the panel box)and proper fencing around the pool or lift-up ladder.
Signature of Applicant: I Date: 7 /
Signature of Owner: Date:
Pool Inspection
Queensbury Building&Code Enforcement
Office No.(518)761-8256
742 Bay Road, Queens fury,NY 12804
Date received: I.S(oCe
NAME: _ C�
LOCATION: "� c
PERMIT#: j
INSPECTED ON: l Lt ( Caniipm
pa
Arrive: am/p e . K....Cam/pm
Inspector's Initials:
Above Ground: In-Ground:
Y N N/A
Pool enclosure around pool
or yard
4 feet above grade i
2 inch maximum clearance
to grade from underside of
fence
4 inch maximum clearance
in fence pickets
Wall or Doors have self
closing device or alarms (30
second Alarm time) •
Ladder secured in place and
latched
Deck gate < 56" to latch no
more than t/2" spacing in
gate openings
Gate open outward, self
closing
Padlock provided on gates
and ladder
Indoor pool all doors self
closing or alarmed per
AG 105.2 Item 9
Timer on pool pump (no
plug in timer allowed)
'Final electrical
Vehicle access gate closed
&locked
Ok to issue C/C
COMMENTS: \f�2U' `C1) '—
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC. 0
Main Office 176 Doe Run Road-Manheim,PA 17545 �
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL V .....%
'emit No. Cert. No 89566 Cut-in Card No. � .
)wner /A. b(,� 6 se'<!y�^ /�
�ocation ! Z 7/ //r5iy /�`-1J• 4p
nstallation Consisting of... C.- C 1c� ,.,pA 4""�P '4/
nstalled By S Lic.No.
The conditions following governed the issuance of this certificate,and any certificate previously issued is
:ancelled:-
This certificate only covers the electrical equipment and installation conditions as of date. Upon the
ntroduction of additional equipment or alterations,application shall be promptly made for inspection.
Inspectors of this Company shall have the privilege of mak" g i spections at any time, and if its
ules are violated,the Company shall have the right t r ke th" c ificat
[/
)ate.... - 7 "� S� INSPECTOR..
Member N.F.P.A.,I.A.E.I.
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TOWN OF QUEENSBURY, WARREN COUNTY, AVEW YORK
C:ERTIFICATIC?N SCALE: 1" = 100' JUNE 9 1995
• FOUND IRON MARKER UPDA tff MARCH 27, 1996 TO SHOW
O SET IRON ROD W1Ttl CAP I hereby certify to Andrew T. and Linda {;. 0� ^NEW t';40F'OSED HOUSE ETC.
T3cfbroski Al bank FSB, its successors ar.d 'or �` � Ro• ` '_ TAX MAP N° 28 - 1 - 15 '
O PDfNT leQ ��� L.916 P.102 UPItA TED APRIL 25, !938 FOU'V✓A T70N L u A TION, DRIVE 8 WE-L ti
assigns and First American Title Insurance
�— POWER LINE Company of New York that this map has teed
STONE WALL prepared in accordance with the existing code 'ti _ •,,:
—x~x— FENCE of practice for Land Surveyors adapted by 'the
New York State Assoc. of Professional Land tis No.49098 �� • n
ONLY COPIES FROM THE ORIGINAL OF THIS SURVEY Surveyors. Fo LAND s\�
MARKED WITH AN ORIGINAL OF THE LAND SUR\il"--YOR'S
EMBOSSED SEAL OR INKED STAMP SHALL BE
CONSIDERED TO BE VALID TRUE COPIES. W % ROURKE,, ASS iCIATES
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f .SOB N violation of Section 7209, Subdivision j o Glens offs Y. 12843
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? I 2 of the a York ` WILL.IAM J. ROURKE, LICENSE LAND SURVEYOR N- 49098 SO�th G e 3 F , N. 95-99 B
z J New rk State Education I_a�r. ,., _ _