POOL-0362-2023 :'
SWIMMING POOL Office Use Only
�`_�,/ PERMIT APPLICATION Permit#: PCML' U'Jb2' Z�J2'J
Town of Queensbury
742 Bay Road,Queensbury,NY 12804 Permit Fee:$ ; Invoice#: 2.5
P:518-761-8256 www.queensbury.net Flood Zone?• Reviewed Byd. ----)
Project Location: 10 Apres Circle
Tax Map ID #: 315.10-1-60 Subdivision Name: West Mtn Estates
Proposed Install Date: 7/17/23
SWIMMING POOL INFORMATION (please fill out completely):
TYPE: CHOOSE ONE:
ABOVE-GROUND X UNHEATED
X IN-GROUND (inc. partially) X HEA = a•• cover heater, R-12 req'd.)
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. $49,100 �
COST OF CONSTRUCTION.
16x34 JUN 21 2023
SIZE OF POOL: TOWN D/
MANUFACTURER: Imperial Pools B��LDIrvOF Q&e�QDESRy
MATERIALS USED IN CONSTRUCTION (CHECK ALL THAT APPLY):
Steel/Vinyl X Fiberglass Gunite Poured Concrete Other
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: Meaghan Mahoney
SIGNATURE: 4ritf,t1
ottayvAltul DATE: 6/12/2023
Swimming Pool Packet Revised March 2023
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s): Meaghan and Charles Mahoney
Mailing Address, C/S/Z: 10 Apres Circle Queensbury
Cell Phone: ( )5187444601 Land Line: ( )
Email:mahoney92510@gmail.com
• Primary Owner(s):
Name(s): Meaghan and Charles Mahoney
Mailing Address, C/S/Z: 10 Apres Circle Queensbury
Cell Phone: (518 )7444601 Land Line: _(
Email:mahoney92510@gnnail.com
❑ 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): Dave Burnett-Burnett Excavation
Contractor Trade: Excavation and Pool Installation
Mailing Address, C/S/Z: 14 Aspinwall Rd Albany, NY 12211
Cell Phone: (518 )8571023 Land Line: _(
Email:
**Workers' Comp documentation must be submitted with this application**
Contact Person for Compliance in regards to this project:_ C ,Ayn,.a--o✓
Cell Phone: ( ) Land Line: ( )
Email:
Swimming Pool Packet Revised March 2023
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