2004-928 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: P20040928 Date Issued: Wednesday, May 10; 2006
This is to certify that work requested to be done as shown by Permit Number P20040928
has been completed.
Tax Map Number: 523400-308-014-0001-073-000-0000
Location: 110 REVERE Rd
Owner: DWAYNE & SUSEAN ZUHLKE
Applicant: DWAYNE & SUSEAN ZUHLKE
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 Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury;NY 12804-5002, (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040928 Application Number: A20040928
Tax Map No: 523400-308-014-0001-073-000-0000
Permission is hereby granted to: DWAYNE& SUSEAN ZITHI,KE
For property located at: 110 REVERE 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: DWAYNE& SUSEAN ZUBLKE
110 REVERE Rd I Total
gro V l Pool
'Total Value _
QUEENSBURY, NY 12804.
Contractor or Builder's Name /Address_ Electrical Inspection Agency
BAKER POOLS
NY .12804-0000
Plans&Specifications
2004-928
INGROUND POOL
$35.00 PERMIT FEE PAID=THIS PERMIT EXPIRES: Tuesday, December 06, 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 th own zpr
; y,December 06, 2004
t..
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
?A
,1 ,p�lication for Swimming Pool Pe it PemutNo.`-�G
Building&Codes Office-Town of Queensbury 742 Bay Road Queensbury,NY 12804 c�
(518)761-8256 Fee Pai6-
Instructions and requirements are attached. Notes:
1. Applicant/Owner /Contractor or Installer Information:
lib 0^vt=p-L—a P'DNI� ((0 j2z-Vc2c- eon-
2. Person Responsible for Code Requirements: � lAy►�� Zv Ia L( U/�D�nl(�QUEF/,IS
�y SFr
3. Pool Location Address: I ko &4L� ( �Ut- j tiY/ az Map No -.-7- ,)
4. Swimming Pool Information: (check whichever applies and fill in the blanks)
A. []Above ground pool 0n9round Pool
B. Length ft. / width ft. / diameter ft. / depth ft.
Cs r steel/vinyl; ❑fiberglass;Ogunite; [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- rgr de,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: , u^' Date:
Signature of Owner: Date:
Ito
Pool Inspection
Queensbury Building&Code Enforcement
Office No. (518)761-8256
742 Bay Road,Queensbury,NY 12804
Date received:
NAME: C
LOCATION: ( l
PERMIT#:'''`, v —
INSPECTED ON: La am/pm
Arrive: am/pm epart: J6 am/pm
Inspector's Initials� '
Above Ground: 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
losing device or alarms (30
econd Alarm time)
Ladder secured in place and
latched
Deck gate < 56" to latch no
more than 'Yz" spacing in
ate openings
Gate open outward, self
closing
Padlock provided on gates
and ladder
Indoor pool all doors self
closing or alarmed per
AG105.2 Item 9
Timer on pool pump (no
lug in timer allowed)
Final electrical
Vehicle access gate closed
to issue C/C
COMMENTS: c�
C��Y�
Pool Inspection
Queensbury Building&Code Enforcement
Office No. (518)761-8256
742 Bay Road, Queensbury,NY 12804
Date received:
NAME: o'�,� '_
LOCATION: —
PERMIT#: c-
INSPECTED ON: �3 a.m
Arrive: a ,pm Depart: ain/pm
Inspector's Initials:
Above Ground: In-Ground:
Y N N/A
Pool enclosure around pool
or yard 4 -
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 '/2" spacing in
ate openings
Gate open outward, self
closing
Padlock provided on gates
and ladder
Indoor pool all doors self
closing or alarmed per
AG105.2 Item 9
Timer on pool pump (no
lug in timer allo ed
Final electrical
Vehicle access gate losed
&locked
Ok to issue C/C Yv
COMMENTS:
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVALU(JO
J�
Permit No........................................Cert. 8. 9 2 Cut-in Card No......................1 . s
Owner....................�.D.....a..... : .,r4J .......................................................................... ..... ....
Location........f...d.4�........ f� -.�1 / ... ........................................ 1 .
Installation Consisting of ...�'�l��� �.AIPZ kJ „
........................ ....................... .....................................................
....................................................................................................................................................................................
.................................................................................................................. ...............................................................
InstalledBy......��a..4.�'�...... .......................................Lic.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 makinyTn'lpections at any time, and if its
rules are violated,the(Coo�mpany shall have the right
Qt�ree ke this e ' icate.
Date...9.:`. `-G!................. INSPECTOR....'.."(....:.............. ... .......................................................................
Member N.RP.A..I.A.E.I.
y yt 'MLL.
BUILDING �r WCIDEI�1"gm -s oj` IUi►1MJM 6?h PC
Dk#k-U REVIEWED BY 'RezWeEa
SELF Gc,osi� DATE 2 G �
-"tj Attention Horne Owner
ecj'ce-�JA-- rD00X5 Please assure you are familiar with the
Pool Enclosure requirements specific to
Your pool. We will be happy to explain
what Requirements you will have to
meet per Appendix G Of the
New York State Resi Code.
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