2010-304 TOWN OFQ UEENSBURY
742 BayRoad,Queensbury,NY 12804-5902 (518)761-8201
Qu �Y,
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20100304 Date Issued: Thursday, September 16, 2010
This is to certify that work requested to be done as shown by Permit Number P20100304
has been completed.
Tax Map Number. 523400-301-009-0001-043-000-0000
Location: 5 WESTERN RESERVE Trl
Owner. WILLIAM & MARY ANN BERGMANN
Applicant WILLIAM & MARY ANN BERGMANN
This structure may be occupied as a:
Inground Pool
By Omer of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the 1
property owner of the responsibility for compliance with Site Plan,
Variance, or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
f4TTO 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20100304 Application Number: A20100304
Tax Map No: 523400-301-009-0001-043-000-0000
Permission is hereby granted to: WILLIAM & MARY ANN BERGMANN
For property located at: 5 WESTERN RESERVE Trl
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 Queens bury Zoning
Ordinance. Type of Construction Value
Owner Address: WILLIAM &MARY ANN BERGMA
5 WESTERN RESERVE Trl Inground Pool
QUEENSBURY,NY 12804-0000 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
CONCORD POOLS
156 SPARROW BUSH Rd
LATHAM, NY 12110
Plans &Specifications
2010-304
INGROUND POOL
$35.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Thursday,June 30,2011
(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 Torr Queens ry; WRd esday,June 30,2010
SIGNED BY �,,tv t 4 , 1. for the Town of Queensbury
Director of Building : Code orcement
r OFFICE USE ONLY4
TAX MAP NO. PERMIT NO, 6-3F7 PERMIT FEE 10 r, /
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APPROVALS: DEPOSIT
APPLICATION FOR SWIMMING POOL PERMIT;
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION AND/OR INSTALLATION.APPLICATION IS SUBJECT TO REVIEW
(� BEFORE ISSUANCE OF A VALID PERMIT..
S`
INSTALLER/BUILDER:CnCo -er_)'S OWNER: V 't i-1 �"�-E t C J J;
& G t)
ADDRESS: :.r?:'%f7;11:=J:1`•f ,/�
1'J-(P SQ,r�t'Jausb�sSn ADDRESS: S� V11�� tC;(�, 1�
J 241; 1141L-
PHONE NOS. S -- 5-R-1 --9 q Li y PHONE NO
CONTACT PERSON FOR BUILDING &CODES COMPLIANCE: L ,PL `2lI1 PHONE:
ADDRESS OF POOL LOCATION: 5- \al-S TCR.i3 � �U� R p , (— put-E-3,5
ABOVE-GROUND? OR INGROUND? �C SIZE OF POOL )to Z
MATERIALS USED IN CONSTRUCTION (CHECK ALL THAT APPLY): STEEL/VINYL k FIBERGLASS
GUNITE POURED CONCRETE OTHER
MANUFACTURER:
❖ FENCING &/OR LIFT UP LADDER REQUIREAENTS FOR ABOVE-GROUND &INGROUND POOLS:
o If above-ground, indicate height from grounc 'grade to top of pool HEIGHT INCHES
• If your above-ground pool is less ti 3n 48 inches above grade, a fence must be installed within the area of
the pool.
• If your above-ground pool is exac:y 48 inches above grade or more, a lift-up ladder with lock must be
installed. No fencing is required.
o If you are installing an inground pool, the pool must be provided with a fence or enclosure meeting the NYS
REGULATIONS,APPENDIX G
• REQUIREMENTS FOR POOL DURING CONSTRUCTION
o Section 1228.4 of the NYS Regulations rec .sires swimming pools be enclosed by a temporary enclosure during
construction of the pool, and requires the Temporary enclosure to be replaced by a permanent enclosure, which
complies with all applicable code provisior >, within 90 days of issuance of the permit or commencement of
construction (See the actual text of Section 1 28.4 for more details).
❖ SETBACK REQUIREMENTS FOR POOL PLACEMENT:
o Minimum side setback requirement is 10 FT.; Minimum rear setback is 20 FT.
o Pools may not be situated in the front or side yard. If this difficulty arises, you may apply for an area
variance to the ZONING BOARD OF APPEALS
❖ POOL PUMP REQUIREMENT—TIME CLOCKS (AVAILABLE FROM ANY ELECTRICAL SUPPLY CO.):
o Pool pumps must be equipped with TIME CLOCKS so the pumps can be set to shut off during periods of
peak utility electrical demand and set to control the length of time during which the filter runs. (See the
ENERGY CONSERVATION CONSTRUCTION CODE OF NYS, PART E504 ENTITLED SERVICE WATER
HEATING AND SUBSECTION E504.3.3 REGARDING TIME CLOCKS)
❖ FINAL INSPECTION INFORMATION:
o You are responsible for scheduling the following:
• *ELECTRICAL INSPECTION; FINAL CERTIFICATE OF COMPLIANCE INSPECTION
*NOTE: The Electrical Inspection is required before the Certificate of Compliance is issued. The Inspectors are contracted throught
the Town of Queensbury but you are responsible for payment to them directly. Their fee is not part of this application. A list of
Electrical Inspectors is available in our office and on our website listed below.
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MIDDLE DE INSPECTION AGENCY, INC. I ;;J
ce�that the electrical wiring to the electrical equipment listed below has been examined and is approved as `;t�
r being in accord with the National.Electrical Code, applicable governmental, utility and Agency rules in effect on the date `,:�
a noted below and is issued subject to the following conditions. %>>
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w Owner: Bergman Date: 08/05/2010 /(i) 3'
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Occupant: Same Location:5 Western Reserve Trail ()
:UN% (;?
-g.' Queensbury, Warren Co. NY `6?y,
(�
j Occupancy:Swimming Pool � �
(� Applicant: P,
1 John T.Wheeler �:r:. ;,•
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(0 This certificate applies to the electrical wiring to the electrical equipment hated Immediatelynull and void. This certificate applies only to the use,occupancy and .k.
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(' above and the installation inspected as of the above noted date based on a visual ownership as Indicated herein. Upon a change in the use,occupancy or ownership .,
(raj Inspection. No warranty is expressed or implied as to the mechanical safety,effi• of the property indicated above,this certificate shall be immediately null and void. ,,*
ciency or fitness of the equipment for any particular purpose. This certificate shall In the event that this certificate becomes invalid based upon the above conditions, %'
be valid for a period of one year from the above noted date. Should the electrical this certificate may be revalidated upon reinspection by Middle Department
.0 system to which this certificate applies be altered in anyway.Including but not limit- Inspection Agency.Inc. An application for inspection must be submitted to Middle 0)
!`.Y ed to.the introduction of addilionel electrical equipment and/or the replacement of Department Inspection Agency, Inc. to Initiate the inspection and revalidation 1
�.�,
..�If j any of the components installed as of the above noted date,this certificate shall be process. A fee will be charged for this service. s.
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Pool Inspection
Queensbury Building & Code Enforcement
Office No. (518) 761-8256
742 Bay Road, Queensbury, NY 12804
Date received:
NAME:
LOCATION: Sz` "$7''r 'Segue, 2
PERMIT#: /0-3( /
INSPECTE am/pm
Arrive: l�q am/pm Depart:
am/pm
Inspector's Initials:
Above Ground: In-Ground:
N N/A
Pool enclosure around
pool or yard
4 feet above grade
2 inch maximum
clearance to grade from
underside of fence
4 inch maximum
clearance in fence
pickets
Wall or Doors have self
closing device or alarms
(30 second Alarm time)
Pool Surface Motion
Alarm
Ladder secured in place
and latched
Deck gate <56" to latch
no more than 1/2" spacing
in gate openings
Gate opens outward, self
closing
Padlock provided on
gates or ladder
Indoor pool all doors self
closing or alarmed per
AG 105.2 Item 9
Timer on pool pump (no
plug in timer allow d
Final electrical ] k u
Vehicle accessa
g
closed & locked
Ok to issue C/C
COMMENTS:
Queensbury Building & Code Enforcement - Residential inal Inspection
Office No. (518) 761-8256 Arrive: am/pm Depart: 2 0- 1. (1/pm
Date Inspection request received: ,Cfie,I ; Inspector's Initials:
gi
NAME: SitiN.ky DATE:PERMIT#: - 30 �.
LOCATION: 2} Ml�4,te. e/I i
TYPE OF STRUCTURE:
k& AJ 3s. ' Comments:
Yes NQ NIA
4" Building Number Address visible from road
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumbing Vent through roof minimum 6 inches
Roof Complete/Exterior Finish Complete
Platform at all exterior doors
Handrail 4 or more risers
Guards at stairs,decks,patios more than 30 inches above grade
Guard at stairwell at 34 inches or more
Guard at deck,porches 36 inches or more
Handrail Termination at Newell Post or Wall
Interior/Exterior Railings 34 inches to 38 inches
Deck Bracing/Handicapped Ramp Compliant
Grade away from foundation 6 inches with 10 feet
6 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18 inches above grade
Interior privacy/trim/doors/main entrance 36 inches
Bathroom/Kitchen watertight
Safety glazing/Window in stairwells safety glazing
Interior Smoke Detectors/Carbon Monoxide Detectors
Every level: Every Bedroom:
Outside every bedroom area:
Inter Connected: Battery backup:
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area
Crawl Spaces 18 inch x 24 inch access, 1 sq.ft.-150 sq.ft.vents
Bathroom Fans,if no window
Plumbing fixtures
Foundation insulation/Insulation Certification
Floor truss,draft stopping finished basement 1,000 sq.ft.
Emergency egress below grade
Gas Furnace shut-off within 30 feet or within line of site ;4J)(
Oil Furnace shut-off at entrance to furnace area
Fumace/Hot Water Heater operating
Low water shut-off boiler A
Relief Valve(s)installed I Heat Trap/Water Temp 110
Enclosed Stairs Sheetrock Underside minimum'/2"Gypsum
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/3/4 hour fire door/door closer
Duct work Sealed properly
Gas Logs in Sealed or Glass Enclosure
Final Electrical
Final Survey Plot Plan
Arc Fault Breaker in Bedrooms
Flex Gas Pipe Bonding
As Built Septic System/Sewer Dept. Inspection Sticker
Site Plan /Variance r:•uired
Flood Plain Certification,if required
Okay to issue C I C or C I 0[Temporary/Permanent]
L:\Building&Codes Forms\Building&Codes\Inspection FormstResidential Final Inspection Form_revised_100405.doc;Revised
January 7,2008;Revised 6/26/08
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