2000-391 BUILDING PERMIT
Town of Queensbury, 742 Bay Road, Queensbury, NY 12804
County of Warren (518) 761-8256
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Building Permit No.
EISENS'CHMI-IDT,
Permission is hereby granted to
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Owner of property located at
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in the Town of Queensbury,to construct or place a
at the above location in accordance to 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.
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Builder's Name:
Contractor or Builder's Address:
SISSOIN ROAD
C U-1 H GI E N S EA--L S , IN-Y -12303
Electrical Inspection Agency:
OMM Tvq E 1,L. El -, ,,:,TR 1 CAL iiGEICY
Do BOX 706
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Type of Construction:
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Proposed Use:
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PERMIT FEE PAID-THIS PERMIT EXPIRES
(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 exirb date.)
Dated at the Town o Queensbury this Day of
SIGNED BY wdctk" , , for the Town of Queensbury
Code Enforcement Officer
TOWN OF QUEENSBURYry
Bay at-Haviland Road, Queensbu , NY 12804-9725-518-792-5832
ct SWIMMING POOL PERMIT APPLICATION
FEE
OWNER'S NAME 5ensckn i d TEL. -7 93- 576 -7
LOCATION
PERSON RESPONSIBLE FOR CODE REQUIREMENTS: _Fr" C_
ADDRESS TEL.
TYPE OF POOL
ground
< i_ above
SIZE: Length 3 ft. / Width_I Lf ft. Diameter ft. / Depth ft.
APPROXIMATE WATER CAPACITY —gallons.
MATERIALS USED IN CONSTRUCTION: (circle one)
C�SS7tee!�I/vi�nyl Fiberglass Gunite -- Poured Concrete -- Other
CONTRACTOR/INSTALLER a c'� TEL.
ADDRESS
IMPORTANT INSTRUCTIONS: JUN 0 5 ?000
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On a separate piece of paper, submit a diagram; drawn to show:
PROPERTY LINES - EXISTING STRUCTURES - PROPOSED OR EXISTING SEPTIC SYSTEM
LOCATION OF PROPOSED SWIMMING POOL - Show all distances from lot 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 IS TO BE NOTIFIED UPON COMPLETION OF CONSTRUCTION; INCLUDING
INSTALLATION OF FENCING. A FINAL INSPECTION WILL BE MADE BEFORE USE OF THE
POOL IS AUTHORIZED.
Signature of Applicant: Date:
OVER
TOWN OF QUEENSBURY
BUILDING & COY ENFAOORCEMENT
��� A
Y NY 12804 r761-8256
- -- I -
ARRIVE: DEPART:
FINAL INSPECTION REPORT - RESI. E AL
DATE INSPECTION REQUEST RECEIVED:
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NAME
LOCATION
DATE PERMIT
TYPE OF S UCT RE �—
FOOTINGS FOUNDATI N BACKFILL FRAMING
ROUGH PL___UMBING SEPTIC TOVEI OR U FIREPLACLATION E
FINAL ELECTRICAL__ WOODS
,NSA YES -No
CHIMN EY Jig GHTl.B VENT/H&IGHT
PLUMBING VENT --
itOOF T NG
EKTERIOR FMISII
DF�CR/PORCH/S'T9 L I N
LtELIEF VALVESS` --
F ACE HO + E O TING
INTERIOR T9IIM/PRIVACCY_, OORS
FINIgH FL_BA H KIT I WATER I HT _
HER FL R WE PABL
OTHER FL RS CARPETED
STAIR ;LEARRNCE/RIIINGS
SMOKE DETECTORS -- --
g
PLUMBING FIXTUAES
FOUNDATION INSUL TION
GAaAr FIRE PROOFING
DOOR CLOSER ""--
FINAL E TRICAL
SITE AN VARIANC RE
FINAL SURVEY P OT PLAN
OK TO ISSUE C O OR CZC
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 176 Doe Run Road-Manheim,PA 17545 ;-ZZiOl 0 --3'?/
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
Panel Board No.............__.............Cert. N2 67715 Cut-in Card No.....................................
Owner... ...... Ff -) ............................11...................................h...........
4� ... .............
Location... ..... 4. ......CI .........................
................. ..............�
Installation Consisting of... . ........ .......................................
..........I.......................I........... ...... ............................................ ..........._.............................
..................................I................ ..........1............. ...................... ............I....................I................
InstalledBy..... .................I..............................................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 "'akin, inspections at any time, and if its
rules are violated,the Company shall have the right t th c�t fii t
ok c
...................
. . INSPECTOR
Date...........................
Member N.F.P.A.,LA E.I.
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