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POOL-0216-2022 SWIMMING POOL office Use only PERMIT APPLICATION Permit#: .1 lQ - 242 2-- Town.of Queensbury 742 Bay Road,Queensbury,NY 12804 Permit Fee:$ Invoice#:� ; P:518-761-8256 www.gueensbury.net Flood Zone? Y Reviewed B� Project Location: !O DaV-yyood l v4 Tax Map ID#: 291p . 10- 1"2 k Subdivision N Proposed Install Date: APR 2 20(� TO wN.©Z - SWIMMING POOL INFORMATION: eU1�OlfllGU ODS CHOOSE ONE: _ABOVE-GROUND IN-GR0 UNHEATED _ D ool cover heater, R-12 req'd) SIZE OF POOL: X - MANUFACTURER: I �/l MATERIALS USED IN CONSTRUCTION CHECK ALL THAT APPLY): Steel/Vinyl Fi rglass Gunite Pou ongrete Other ADDITIONAL IMPORTANT INFORMATION: 1. Any changes to the approved plans prior to or during construction will require the submittal of amended plans, additional reviews and re-approval. 2. If, for any reason,the building permit application is,withdrawn, 30%of the fee is retained by the Town of Queensbury. After 1 year from the initial application date, 100%of the fee is retained. Declaration: I acknowledge no construction activities shall be commenced prior to issuance of a valid permit. I certify that the application, plans and supporting materials are a true and complete statement/description of the work proposed, that all work will be performed in accordance with the NYS Building Codes, local building laws and ordinances and in conformance with local zoning regulations. I acknowledge that I have read the application and plot plan requirements and I, or my agents, will obtain a certificate of compliance before use of the pool. I have read and-agree to the above: PRINT NAME: /�!/^ G�&— I ar SIGNATURE: DATE: Swimming Pool Packet Revised March 2022 CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Applicant: Name(s): Mailing Address, C/S/Z: e) e7iq ve— J n-6 Cell Phone: (:??!5 ) y.�,o— 79562 Land Line: �) Email: 0���5�� d c 61 • Primary Owner(s): Name(s): Mailing Address, C/S/Z: Cell Phone: _( ) Land Line: _( ) Email: ❑ Check if all work will be performed by property owner only • Installer/Contractor: (List all additional contractors on the back of this form) Contact Name(s): 1-2,0015 74- Contractor Trade: D Mailing Address, C/S/Z: Cell Phone: _( ) Land Line: _( ) Email: Wy elo 6 61�r- 2 97"& "Workers' Comp documentation must be submitted with this application" 1 r Contact Person for Compliance in regards to this project: i Cell Phone: /,/D la Land Line: ( � ) Email: Swimming Pool Packet Revised March 2022 THE INSPECTOR, LLC 5390 State Route 11 Burke,NY 12917 1-800487-0535 www.theelectricalinspector.com 'z'Z\'Q--7,0 2�,2— Date:August 5,2022 Application No.On File:169353 THIS CERTIFIES THAT Adam Brod Only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of 30 Oakwood Drive Town of Queensbury Contractor: Shane Brown In the following location: Basement I'FIoor 2'Floor No.of Apt Garage Attic OutsideX Commercial ResidenceX Was examined on 6/30/22 and found to be in compliance with the requirements of the National Electric Code. GFC1 I Fixture Outlets Receptacles Switches Fixtures Ranges Cooking Decks Ovens Dish Washers I Exhaust Fans Smoke/Heat Incandescent Fluorescent Other Amt. K.W. Amt. K.W. Amt. K.W. Amt. K.W. —Amt. K.W. I Detectors 4 Dryers Furnace Motors Dimmers Water Heaters Unit Heaters Multi Outlet Sys. Electric Heaters Amt. K.W. Oil HP. Gas H.P. Amt. Watt Electric Oil Gas Amt. Rating No.of Feet Amt. K.w. Amt. K.W. I Amt. K.W. Amt. K.W. I I . Transformers Alarm Systems Special Receptacle Panels Motors Signs Track Ligh tin g _ Disposal Amt. KVA AfV PS I Det. Panel Amt. K.W. Amt. No.of circuits Rating Amt. H.P. Amt. No.of Lamps No.of Heads Amt. H.P. 1 4 70a 1 1.1 Service Disconnect— Equipment Service Amt. I Amp. I Type Meter I Phase I Phase 3 Phase 3 Phase No.of CC. AWG. No.of AWG.of No.of AWG of 2W 3W 3W 4W Cond./phase CC.cond. Neutrals Neutrals HI-Les HI-Legs Other Apparatus Pool Bonding Manager This certificate must not be altered in any manner, return to the office of THE INSPECTOR if incorrect. Inspector's credentials can be verified. L �a LARVIN .: ;.: '' � 29 6.10-1-21 POOL-0216-2022 �. Broil Monica & Adam 30 Oakwood Dr ''��e,-�, .: :},. Al In ground heated pool j'�' L 132•*2'kv E sU aria,f r, 0 .,_ . s requirisments c = ew y�p_R.q,.—.�.5y Rs_g,$.�.'�3,.M ?'%•s{ '� A 1!T" eA C:7rF4u�7€�� br�d'&GW , ()•t isi.'..I. �:r.,�..'-~.{F - re swimm! n o t60 Of spection. AP it Kj ANDMiA f z'i' nF 100 �Y ! ? a � ,u°� '�,` ,� 6,> h♦�Cam, J