2002-487 TOWN OF QUEENSBURY - -
742 Bay Road,Queeusbm7,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
CERT IFICATE OF COMPLIANCE
Permit Number: P20020487 Date Issued: Friday,May 14,2004
This is to cerd that work requeested to be-done as�shown by Perm t-Number P20020487
has been completed,
1
Tax Map Number: 523400-295-019-0003-041.000.0000
Location: 22 FOX HOLLOW Ln
Owner: MARY KUSIOR
Applicant: MAY KUSIOR
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 'F I L E COP Y
Community Development-Building&Codes-(518) 761-8256
BUILDING PERMIT
Permit Number: P20020487 Application Number: A20020487
Tax Map No: 523400-295-019-0003-041-000-0000
Permission is hereby granted to: MARY KUSTOR
For property located at: 22 FOX HOLLOW 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: MARY KUSIOR Inground Pool
22 FOX HOLLOW Ln Total Value
QUEENSBURY,NY 12804
Contractor or Builder's Name Address Electrical Inspection Agency
SPRACTITF POOLS
294 BROADWAY
FORT EDWARD.NY
Plans&Specifications
2002-487
INGROUND, POOL AS PER PLOT PLAN SPECIFICATIONS
$35.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday,June 24,2003
(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 Town 11ueen 4,2002
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
TOWN OF Q UEENSB U R X 'T7
Hay of Haviland Road, Queensbury, NY 12804-9725-518,792-5832
SWIMMING POOL PERMIT APPLICATION
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FEE PAID �-
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OWNER'S' NAME TEL.2,93 a �S
LOCATION o
TYPE OF'POOL - - /��( y� z/,tZy L in-ground above- ground
SIZE: . Lengthft, j. Width--,eft. / Diameter ft. / Depth3ft.
> _ ;
APPROXIMATE WATER CAPACITY j �V gallons.
%,-MATERIALS USED IN CONSTRUCTION: (circle one)
Steellviny] - Fibreglass --Gunite -- Poured Concrete -- Other
CON
TRACTQRIINSTALLER L S�%' 6'vt_ �P� � �oal TEL"":
ADDRESS
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 SWIMING POOL- - Show all distances f,om let 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 JS TO BE NOTIFIED UPON . COMPLETION OF CONSTRUCTION; INCLUDING .,-INSTALLATION OF FENCING. A FINAL INSPECTION WILL BE MADE BEFORE USE OF THE Its:POOL,`IS AUTHORIZED..
'1
Signature of Applicant: Date: ` ` � —
COMMONWEALTH ELECTRICAL INSPECTION SERVICE, IK
Main Once 176Igoe Run Road of Manheim, PA 17545
MUNIIPAL CERTIFICATE
- ELECTRICAL APPROVAL
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The conditions following governed the issuance of this certificate, and any certificate previously issuedi",
cancelled# -
This certificate onlycovers the electrical equipment and installation conditions as of date. Upon thi
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introduction of additional equipment or alterations, application shall he promptly made for inspection.
if
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Ins ectors of this Com an shall have the rivile a of ma'kinpecliossn at any time, and
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Residential Final Inspection
. Office No. (518)751-8255 Date Inspectionrre
Queensbury Building&Code Enforcement Arrive: 1� : am/ m
742 Bay Rd., Queensbury,NY 12804 Inspector's Init { _
NAME: ` ��d LOCATION: 1O3
TYPE OF STRUCTURE:
Comments
Y N N/A
Chimney Ht./"B"Vent/Direct Vent Location
Fresh Air Intake \,
3 inch Plumb Vent through roof
Roof Complete
Guard 30 in. or more @ stairs,decks,patios
Guard at stairwell at 34 in. or more
Guard at deck,porches 36 in.or more
Exterior Finish Complete
Interior/Exterior Rail in s 34 in.to 38 in. `
Platform at all exterior doors
Interior Handrails stairs 2 or more risers
Grade away from foundation 6 in.with 10 ft.
Handrail Termination at Newell Post or Wall
8 inch clearance to sill plate "
Gas Valve shut-off exposed/regulator 18"above grade
Gas Furnace shut-off within 30 ft. or within line of site
Oil Furnace shut-off at entrance to furnace area
Furnace/Hot Water Heater operating
Low water shut-off boiler
Relief Valve(s)installed
Interior privacy/trim/doors/main entrance 36 in.
Bathroom/Kitchen watertight
Safety glazing
Window in stairwells safety glazing
Interior Smoke Detectorg:
Every level: / Every Bedroom:
Outside every bedroom area:
Inter Connected: / Battery backup:
Bathroom Fans, if no window
Carbon Monoxide detector
Plumbing fixtures
Foundation insulation
Floor truss,draft stopping finished basement 1,000 sf "000'\�i
Emergency egress below grade
Basement stairs closed rise>4 inches
3/4 hour fire door/door closer
Garage fireproofing \
Duct work Sealed properly
Attic access 30 in.x 24 in.x 30 in.(ht.)In accessible area Crawl Spaces 18"x 24"access, 1 s .ft.-150 s .ft.vents
Building No./Address visible from road
Final Electrical .
Site Plan /Variance required
Final Survey Plot Plan
As Built Septic System/Sewer Dept.Inspection Sticker
Flood Plain Certification,if required
Okay to issue C/C(Cert. Of Compliance)
Okay to issue Temporary C/O(Cert. Of Occupancy)
Okay to issue Permanent C/O(Cert. Of Occupancy
L:\Sueffemingway\Building.Codes.Inspection.FORMS\Res.Final Insp.form 2.doe edited January 28,2003
PC3ol Inspection
Queensbury Building 8c Code Enforcement � � -}
C>fficc, 1�To_ (518) 761-8256 !
742 Bay Road, Queensbury, NY 12804
Date received:
u:, ., -- n
Arrive: airi/prn ]Depart: -- prt-I
Inspectc>r's Initials:
Above +Ground: In-Ground:
Y N NIA
Pool enclosure around pool
or yard
4 feet above grade
2 inch rnaximum clearance
to grade from underside of
ferice
4 inch maximum clearance
in fence icicets
Nall or Doors have self
closing device or alarms (30
second Alarm time)
Ladder secured in place and
latched
Deck gate -::: 5 6" to latch no
more than Vm" spacing iiz
gate; <32enin&rS
Gate: opens outward, self,
closing
Padlcoo-k provided on gates
or ladder
Indoor pool all doors self
closing or alarmed per
.G 1 O5.2 Item 9
Timer on pool pump (no
plug, in timer allow
Final electrical
Vehicle access to closed
8� locked
Qk to issue C!C
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