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2004-164 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20040164 Date Issued: Monday, April 25, 2005 This is to certify that work requested to be done as shown by Permit Number P20040164 has been completed. Tax Map Number: 523400-308-005-0001-079-000-0000- Location: 20 LAUREL Ln Owner: ANDREW & WENDY JAUSE Applicant: ANDREW &WENDY JAUSE This structure may be occupied as a: By Order of Town Board Inground Pool TOWN OF QUEENSBURY - yx Director of Building&Code E rceme TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20040164 Application Number: A20040164 Tax Map No: 523400-308-005-0001-079-000-0000 Permission is hereby granted to: ANDRRW&WF,N1)Y JA1 TSR For property located at: 20 LAUREL 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 Value Owner Address: ANDREW&WENDY JAUSE 20 LAUREL Ln I Tootaltal Value V Pool alue QUEENSBURY,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications 2004-164 INGROUND POOL $35.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,April 14, 2005 (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 ,,i_"of Quegnsbury; Wednesday,April 14, 2004 SIGNED BY %1 - for the Town of Queensbury. Director of Build g& de Enforcement Application for Swimming Pool Permit permit NoX4"&I Building&Codes.Office—'Town of Queensbury 742 Bay Road Queensbury,NY 12804 CDb (518)761-8256 Fee Paid Instructions and requirements are attached. Op Notes: 1. Applicant/Owner /Contractor or Installer Information: � , Cantractor/ nstaller;_<_ .... ,a a 1_1�1� Ja C Pt e5s P66 LS Ad�7r'ess� = r2�_j 79 1?hgne �axkw" Pone 2. Person Responsible for Code Requirements: 3. Pool Location Address: 02 0 `-aQ re_( 1AM P �PJT_ Tax Map No. , 6 S — —7 4. Swimming Pool Information: (check whichever applies and fill in the blanks) RECEIVED A Type of Po r ❑Above ground pool [2 Inground Pool B She foot Length ft. / width_L&__ft. / diameter ft. / depth 9 ft. p P D L 7 2 p 0 4 s C MaZerrals;us�d zn cnnstrual�olz: E/steel/vinyl; ❑fiberglass; ❑gunite; Ypoured concrete;❑otherT0VW! E. SEURY 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 -7 0/ Date: Loil Signature of Owner: !/ui���-�.�� "D �/7 Pool Inspection q Queensbury Building&Code Enforcement Office No. (518)761-8256 742 Bay Road, Queensbury,NY 12804 Date receivedN`Ov ::NAME: t—k LOCATION: PERMIT#: INSPECTED 07: /bC.S' Van] Arrive: am/p6i part: ai Inspector's Initia Above Gray tid: In-Ground: Y N N/A Pool enclosure around pool or yard 4 feet above grade 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 %z" spacing in ate openings Gate opens outward, self closing Padlock provided on gates or ladder 14 Indoor pool all doors self closing or alarmed per AG105.2 Item 9 Timer on pool pump (no plug in timer allowed Final electrical Vehicle access gate closed &locked Ok to issue C/C COMMENTS: MIDDLE DEPARTMENT INSPECTION AGENCY, INC. �Ger/ocea 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 noted below and is issued subject to the following conditions. Owner: Andy Jause Date: 05/26/2004 Occupant: Unknown Location: 20 Laurel Lane Queensbury, Warren Co. NY Occupancy: Swimming Pool Applicant Ambrose Electric 790 Watervliet Shaker Rd Latham, NY 12110 No. 1 4G0,1•.3;1, 3.31-,HE' r.. Equipment: 1 — Switches;.:`;. 1 = .GFCI Receptacle; 1 — Fixtures; 1'- — Pump; HP Motor; 1 Timer, 1 — Heater 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 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 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. 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 system to which this certificate applies be altered in any way,including but not limit- Inspection Agency, Inc. An application for inspection must be submitted to Middle ed to,the introduction of additional electrical equipment and/or the replacement of Department Inspection Agency, Inc. to initiate the inspection and revalidation any of the components installed as of the above noted date,this certificate shall be process. A fee will be charged for this service.