2004-205 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: P20040205 Date Issued: Thursday, August 05, 2004
This is to certify that work requested to be done as shown by Permit Number P2O040205 _
has been completed.
Tax Map Number: 523400-301-019-00.01-071-000-0000
Location: 6 FINCH Rd-
Owner: KURT & ELLEN DAUBENSCHMIDT
Applicant: KURT & ELLEN DAUBENSCHMIDT
This structure may be occupied as a:
By Order of Town Board
Inground Pool TOWN OF QUEENSBURY
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040205 Application Number: A20040205
Tax Map No: 523400-301-019-0001-071-000-0000
Permission is hereby granted to: K1TRT&F,T,T,F,N DA1TRFNSCffM DT
For property located at: 6 FINCH 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: KURT &ELLEN DAUBENSCHN�
6 FINCH Rd I Total o Value
Pool
Total Value
QUEENSBURY, NY 12804
Contractor or Builder's Name /Address Electrical Inspection Agency
SPRACTITE'S MERMAID POOLS
294 BROADWAY
FORT EDWARD- NY 12828
Plans&Specifications
2004-205
INGROUND POOL
$35.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,April 30, 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 To o eensb i1.30, 2004
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Application for Swimming Pool Permit Permit No.e-goLi— ' as
Building&Codes Office—Town of Queensbury 742 Bay Road Queensbury,NY 12804
(518)761-8256 , Fee Paid ,�j5V_
Instructions and requirements are attached. Notes:
1. Applicant/Owner /Contractor or Installer Information:
11 l
I WE
.� �a
M...
_ OII.� 'd.
dc�res�s 1��.ub eh sc.h w,�d f•
� F 1
Lo e 1 -717 ,`( &0 `j 6 Let
l:on�s�
2. Person Responsible for Code Requirements: J '0'1'e'15 i/'B T
3. Pool Location Address: L F(n G� the Tax Map No.
4. Swimming Pool Information: (check whichever applies and fill in the blanks)
A , ❑Above ground pool XInground Pool
Q
B ISreof Eaal Length 3 Z ft. / width ft. / diameter ft. / depth 8 ft.
C. Mexir used'in 1apsrtiate %steel/vinyl; ❑fiberglass;❑gunite; ❑poured concrete;❑other
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- rg ade,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: Date: / /e-O b /
Simature of Owner: G% ^^'� �ci � z � Date: c/ /Z 0`0
Pool Ins.--,(-.tion
Queensbury Building&Code Enforcement
Office No. (518)761-8256
742 Bay Road,Queensbury,NY 12804
Date received:
INSPECTED ON: d, m
Arrive: . a m art: am/pm
Inspector's Initial
NAME:
PERMIT#:
LOCATION:
Above Ground: In-Ground:
Y N N/A
Pool enclosure around po 1
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 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 p mp (no
plug in timer allo
Final electrical 6
Vehicle access g t closed
&locked
Ok to issue C/C
COMMENTS:
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL T
Permit No........................................Cert. No 7591 �Xut-in Card No..........................
Owner.... .. ........ fvcvC�l p l ................
... .................................�......^....................................................................................�
Location...CE.. v�� •••••.. . ....... Q................................ ....................................................G .. ...
Installation Consisting ofr L
....................................................................................................................................................................................
........................................................................................................................................................I...........................
Installed By....../Zt../.?'* .......................................Lie.No...................................................
The conditions following governed the issuance of this certificate,and any certificate previously issued is
cancelled:-
This certificate only covers the electrical equipment and installation conditions as of date. Upon the
introduction of additional equipment or alterations,application shall be promptly made for inspection.
Inspectors of this Company shall have the privilege of mak' 'nspections at any time, and if its
rules area violated,the Company shall have the righ o v ke t s c tifi te.
Date..../..n.L..:..U ,!.................. INSPECTOR
.... .. ................ ............................................................................
Member N.F.P.A.,I.A.E.I.