98-138 CERTIFICKrE OF COMPLIANCE
TOWN OF QUEENSOURY
WARREN COUNTY , NEW YORK
Date ji l ly PR 199_$__..-_
98138
This is to certify that work requested to be done as shown by Permit No . -- -
has been completed .
This structure may be used as a INGROUND POOL
Location 21 PINION PINE LANE.
Owner BULOVA , JOHN R . By Order of Town Board
TAX MAP NO . 9 0 . - 9 - 1 1 -� TOWN OF E-''�r R Y
Director of Building & Code Enforcement
BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY No . 98138
TAX MAP NO . 90 . — 9 - 11 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to BULOVA 3OHN R .
OWNER of property located at 21 PINION PINE LANE Street, Road or Ave.
in the Town of Dueensbury, To Construct or place a INGROUND POOL
at the above location in accordance to application together with plot plans and other information Hereto filed and
approved and in compliance with the Town of Oueensbury Building and Zoning Ordinance.
1. OWNER'S Address is
21 PINION PINE LANE
QUEENSBURY . NY 12804
2. CONTRACTOR or SUI LDE RS Name
SPRAGUE POOLS
3. CONTRACTOR or SU1LDER'"S Address
294 13ROADWAY
FORT EDWARDr NY 12828
4. ARCHITECT'S Name
COMMONWEALTH ELECTRICAL AGENCY
S. ARCHITECTS Address
PO SOX 706
HAGUEe NY 12836
6. TYPE of Construction — (Please indicate by X)
POOL
I I wood Franc I f Masonry f I Steel I I
7. PLANS and Spoelfiostions
INf91ElOUND POOL AS PER PLOT PLAN SPECIFICATIONS
S. Proposed Use
INGROUNLI POOL
35 April 17 2000
$ PERMIT FEE PAID — THIS PERMIT EXPIRES 19
lif a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Oueensbury before the expiration date.l
17 April 19
Dated at the Town of Dueensbury this Day of 19
SIGNED By ?�' r� 1 �� for the Town of Queensbury
f;uilding and Zoning Inspector
TOWN OF QUEENSBURY _--
Bay at Flaviland Road, Queensbury, IVY 1 2804-9 725---5 1 8-792-5832
d J APR iOjq%
.� 2 L� DIY.
SWIMMING POOL PERMIT APPLICATION
FEE PAID i
OWNER ' S NAME ] �n . TEL .
LOCATION ' !ni ` hc
TYPE OF POOL - 7/ Dia%rmreter.ft .
above - ground
SIZE ; Length_. `ft . / Width j / Depth ft .
APPROXIMATE WATER CAPACITY gallons .
~1 %' lMATERIALS USED IN CONSTRUCTION : ( circle one )
r
Steel /vinyl - Fibreglass - -Gunite - - Poured Concrete - - Other
CONTRACTOR/INSTALLER c 7 `72 20
ADDRESS `- e
IMPORTANT INSTRUCTIONS *
On a separate piece of paper , submit a diagram ; drawn to show :
PROPERTY LIMES - . EXISTING STRUCTURES - PROPOSED OR EXISTING SEPTIC SYSTEM
LOCATION OF PROPOSED SWIMMING POOL - Shun all distainoes 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 FOOL IS AUTHORIZED.
d.
Signature of Applicant : Date : ,
TOWN OF QUEENSBURY
BUILDING742CODE
Brit O
SNFRCEMENT
{ QUEENSBURY NY 12804
(518) 761-8256
�1 DEPART : �- INSP
ARRIVE :
• FINAL INSPECTION REPORT - RESIDE
L l
DATE IN ECTIDN REQUEST RECEIVED *
NAME `
LOCATION •`
PERMIT X
DATE
. TYPE OF STRUCTURE
BACKFILL FRMING
FOOTINGS_ , FOUNDriTICIN I!^1SULATION
ROUGH PLUMBING SEPWTIC
PODST+OVE OR FIREPLACE
FINAL ELECTRICAL
N A YES N8
VEN I 1
M G
F
N SH
Q S E S RA LINGS
F V V S
R A O W T R O NG
E O PR V C R
FirNIS S '
E
i
E SWE P
O H LOQ PE E
ST rT! CL aRAN E S
g O S
S
U G U S
N N S ON
ING fy.�
FINA Ei.F.CTRICAL `
SITE PLAN VAR A CC R
l
A su V Y T N
O S E O OR C C
i
COMMONWEALTH ELECTRICAL INSPECTION SERVICE, INC.
Main office 357 Elwyn Terrace — Manheim, PA 37545
MUNICIPAL CERTIFICATE - E'LECTRICAL AQFRCISTA
Panel Board No. .............. Cert, 59869 Cut-in Card No, -. ........, .... . . . . .
. . . ..
Owner ... .... ....
Occupant ........................ ...... .._ .. ...-....-....,-........ . . ,. .,. .-..... .... . ............_...-.... f
P Al
f
Location ... . /.. ..... . . .... . . ., .. . . -. . . ..... .....-..... ...--....-_ ., . . ... .. . . .. ...
ddddddi�
' ...
Installation Consisting of ..-�- II. .., , +
�4f l., / r sl lCrs F .!tIIMM4/• �a. .
. ... . ..................
tC ) .. .. . . ... .... . . . ...
installed By .... .5 -:1f�.S-� ''►n� . ..I.. ... ... ...... . ...........
The conditions following governed the issuance of this certificate, and any certificate prevulusly
issued iscance lie d' —
on
This certificate only covers the electrical equipment and 'srt�uilaltaionnshalldbe promptly arnadeted pfor
the introduction of additional equipment or alterations, app
Inspection. time, and if itx
inspectors of this Company shall have the privHeye of maki ins ec n . at any
fiflatc-
rules are violated, the Company shall have the right to revo t rri
INSPECTo ..... ... .
Date ,.. ... ...... . ...• Member N.F.P.A.. LA.E.[.
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21 Pinion Pine Rd. New Fence LD
Queensbury NY, 12804mj
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