2002-846 TOWN OF QUEENSBURY
742 BayRo4 Qaeensbury,NY 12804-5902 (518)761.8201
Community Development-Building&Codes (518)761.8256
R I F
r ATE "r ut COMPLIANCE
Pennit Number, P20020846 Date Issued: Wednesday,June 18,2003
This is to certify that work requested to be done as shown by Permit Number P20020846
has been completed.
Tax Map Number. 523400-295-010-0001-042-000.0000
Location: 21 JACQUELINE Dr
Owner. CLARK&DONNA PERKETT
Applicant; CLARK&DONNA PERKETT
This structure may be occupied as a:
By Order of Town Board
Inground Pool TOWN OF QUEENSBURY
Director of B 'ding&Code EnfokH
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20020846 Application Number: A20020846
Tax Map No: 523400-295-010-0001-042-000-0000
Permission is hereby granted to: CLARK &DONNA PERKETT
For property located at. 21 JACQUELINE Dr
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. Ty
pe of Construction Value
Owner Address: CLARK&DONNA PERKETT Inground'Pool
21 JACQUELINE Dr Total Value
QUEENSBURY,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
CONCORD POOLS
156 SPARROW BUSH Rd
LATHAM.NY 12110
Plans&Specifications
2002-846
Construction of a 20 ft. by 40 ft. sq ft in-ground pool per plot plan and specifications. Lz
$35.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday, October 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 To u day, October 24,2002
SIGNED BY nL7;n !I for the Town of Queensbury.
Director of Building&Code Enforcement
Building& Codes Office Swimming Pool Z'
Towit of Queensbury
742 Bay Road Permit Application :Pee Raid s
Queensbuty,AT 12804 Redd ZW.,
(518) 761-8256
1. Applicant: L6A L Owner:
Address: 0-Co � ,, Address:
U:E 19 nS 7hn4 L/
Phone No. Phone No.,
2. Person responsible for code requirements: .
3. Contractor/Installer 0kn CoIGL _Pmls
Address RECENED
Phone No.
OCT 0 7 HUZ
4. Pool Location Address: ToVqN I OF QUEENsBURY
A
5. Tax Map Number: -1�1� j\jg CODE
6. Type of Pool: above-ground pool ±in_ -ground pool
7. Size of Pool: length -3(, ft. diameter ft.
width ft. depth ft.
8. Approximate Water Capacity gallons
9. Materials used in construction(circle below)
Steel/vinyl Fiberglass Gunite Poured Concerte Other eD01 Ll�100rv'
10. Submit a diagram;drawn to show property lines, existing structures,proposed or existing septic
system, location of proposed swimming pool. Show all setback distances from property lines to
both the pool and the structures, as well as separations between them.
An electrical inspection is necessary before the Certificate of Compliance is issued.
See attached sheet for electrical inspectors.
The Building and Codes Office needs to be notified upon completion of construction; including
installation of fencing. A final inspection will be made before use of the pool is authorized.
Applicant Signatj �_ Date:
Owner Signature: Date:
(if different from applicant name)
RESIDENTIAL FINAL INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received: ,
Building&Code Enforcement
Dept,of Community Development Arrive Depa n
Town of Queensbury spector's Inn
742 Bay Road
Queensbury,New York 12804
NAME PERMIT##
LOCATION - 1 DATE
TYPE OF STRUCTURE
NIA YES NO COMMENTS
Chimney HeightP B"Vent/Direct Vent Location
Fresh Air Intake
Plumb Vent through roof
Roof Complete
Exterior Finish Complete
laterior/Exterior Railings 30"to 36"
Exterior Handrails,balconies,landing 18 in.or more
Interior Handrails stairs both sides 3 or more risers
Grade 2%away from foundation
8"clearance to sill plate
Gas Valve shut-off exposed/regulator 18"above grade
Gas Furnace shut-off within 30 feet or within line of site
Oil Furnace shut-off at entrance to furnace area
Furnace/Hot Water Heater operating
Relief Valve(s)installed
Headroom,6 ft.6 in.on stairs
Basement stairs,6 ft.4 in.
Handrail exterior stairs both sides more than 3 risers
Interior privacy/trim/doors/main entrance 36"
Floor Finish
Bathroom/Kitchen watertight
Interior Handrails Balconies/Landing 18 in.or more
Railing across window in stairwells
Smoke Detectors:
every level
every bedroom
outside every bedroom
inter connected
Bathroom fans
Plumbing fixtures
Foundation insulation
3/4 hour fire door/door closer
Garage fireproofing
Garage penetrations sealed
Furnace in separate room protected(in garage)
Light ventilation per room
Safety glazing 18"or less from floor
Final Electrical
Site Plan/Variance required
Final Survey Plot Plan
As Built Septic System layout required
Okay to issue C/C(Certif.of Compliance)
Okay to issue temp.C/O(Certif.of Occupancy)_
Okay to issue permanent C/O(Certif.of Occupancy)
I U.,1 rjJMPr-rr-3rr3-Pr-PLPL��'!::'JfixJ i: I� 10-0.112-01�:'rL3rL3PLPr-PLrL3rr3-rr3-PLPLPLPLrr3- 1,i,papEopr®rproral IMI
BY THIS CERTIFICATE -OF COMPLIANCE THE 5
5 5NEW YORK BOARD OF FIRE UNDERWRITERS
5
BUREAU OF ELECTRICITY
40 FULTON STREET - NEW YORK, NY 10038
5 S
CERTIFIES THAT
5 SUpon the application of upon premises owned by
c5
5
DONNA PERKETT DONNA PERKETT 5
5 5 21 JACQUELINE DRIVE 21 JACQUELINE DRIVE
QUEENSBURY NY 12804 QUEENSBURY, NY 12804
5 5
5 Located-at -241 -JACQUELINE DRIVE-QU=-ENO-8UP,Yi;N-Y-I2,04-_----_
Application Number: 1131802 Certificate Number: 1131802
Section: Block: Lot: Building Permit: BDC: A239
5 5
5 Described as a Residential occupancy,wherein the premises electrical system consisting of
5 electrical devices and wiring, described below, located in/on the premises at:
5 Basement,Outside,Pool/Spa,
5 S
5 was inspected in accordance with the National Electrical Code and the detail of the installation,as set forth below,was
found to be in compliance therewith on the 8th Day of May,2003. 5
5 Name OTY Rate Rating Circuit lype
Appliances and Accessories
Pool/Spa Bonding 1 0 5
5 Pool/Spa Circulator Pump/Motor 1 01 1 H.P. 5
Time Clock/Switch 1 0 40 Amps
Wiring and Devices
___5ti 2 -0— General Purpose - 5
5 Receptacle 1 0 Special
Receptacle 2 0 GFCI
5 Fixture 1 0 Pool/Spa
5 (Swimming Pool):This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to have 5
5 frequent test and/or repairs made by a qualified person.
Defects previously reported,as items of non-compliance,have been corrected. A visual inspection made of the exposed electrical equipment in 5
5 the premises indicated found no obvious unsatisfactory condition.
5 �°r��l- 5
5 = sa
3al
47PI-
Of
5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the l6cationindicated.
MM0311RIEPEZE9002= 0PLr@Fr3P I I 0�gj:l,'UL3pr I UL3 PL rrj3 fi�9�E
L: d MIL3 E E�Ulf. Q _PLPI:MJE[��, _r 12�MpLrrj3 r3 L3r[3jffj
BY THIS NOTICE OF DEFECT THE
NEW YORK BOARD OF FIRE''UNDERWRITERS
BUREAU OF ELECTRICITY
40 FULTON STREET - NEW YORK, NY 10038
on the application of upon premises of
DONNAPERKETT DON'NA PERKETT
21 JACQUELINE DRIVE 21 JACQUELINE DRIVE
QUEENSBURY NY 12804 QUEENSBURY, NY 12804
Application Number: 1131802
Located
NY 12804
Section: Block: Lot; Building Permit Number:
Regrets to advise that the electrical installation of the stated premises is not in compliance with requirements of
the reference standard as set forth below:
Item Location Description Reference Std.
pool light Pool/Spa grounding 680.25bl-2
pool motor Pool/Spa grounding 680.25c
This notice of defect is issued by: WALTER SONNTAG on the 2nd day of May,2003.
A239
QUEENSBURY,TN
TOWN OF QUEENSBURY
742 BAY ST.
QUEENSBURY,N.Y. 12804
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