2015-436 Church of the King � TOWN OF QUEENSBURY
f.
` � 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20150436 Application Number: A20150436
Tax Map No: 523400-289-019-0001-016-000-0000
Permission is hereby granted to: CHURCH OF THE KING. INC.
For property located at: 681 BAY Rd
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. Type of Construction Value
Owner Address: CHURCH OF THE KING, INC.
PASTORS DR. BILL&JEAN DAVID Sign
207 SUNNYSIDE EAST Rd Total Value
QUEENSBURY,NY 12804-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2015-436 CONDITION OF APPROVAL: Downlighting Only if sign is to be lit per C. Brown, ZA
Freestanding Sign 12 s.f., on retaining wall
Copy to read: Cedars Senior Living Center
$36.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday, September 23,2016
(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 of Q nsb ; , . . . .y, September 23,2015
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
37-. 10 1,S
Office Use Only
Town of Queensbury Building & Codes
Received:
SIGN PERMIT APPLICATION Tax Map ID: p�g9. /9-1-4;
Permit No.: 1
Permit Fee: $ 36 + �
Date Applicant 00W,or-412. h L'1c
Tax Map ID on q /?-1-/4' Address
Zoning
Property Owner C lAr?J 1 Drto nC7 rim C, Contractor/Agent:
Address 6gi_ Cs ss Address
Phone 6c2 74-S- S90(p Phone
Contact Person for Sign Code Compliance: '��"-'J Day Phone:
Building Stree •s ress: �P g1 && 1 Rd; i SfP ec' o,, e Ever-976) hzuie rL?x& A
Site Plan, , or Subdivision Approvals SV 3v-de)I S ( JAS(-- 'iuur 11) PIJ 1 C.- rhe
Location of proposed installation Logi el !oto���,�� 1,d4t/ '&- ilfn 40e
Business Complex/Plaza/Mall named aix•e_kr f ,r
Business name via Si��J , 37-026 i Cede-TJ ,S""nid( t4V/V �J KOn ivite v� E✓
` era rcii ,&ii
Type of Sign proposed re--a:- ;„ e,}e'L.
If sign is to be illuminated, indicate internal external Incandescent _neon other
Do signs currently exist on property? Yes No(if yes, list all existing signage)
Change of word/copy From to
Sign Wording/Copy reh;n1i
Sign Size Length x Width =Total sq.ft. f pin .JA-61 o rcA,,T4a c
Sign Height(freestanding)
Color&Material to be used
This application creates a change in the New
following existing site conditions(fill in all Change in number of signs from to
applicable spaces) Change in setback for sign from to
Change in size from to
Change in height of sign from to
Declaration: To the best of my knowledge, the statements contained in the application, together with the plans and specifications
submitted, are a true and complete statement of all proposed work to be done on the described premises and that all provisions of the
Zoning Ordinance, and all other laws pertaining to the proposed work shall be complied with,whether specified or noted, and that such
work is authorized by the owner.
APPLICANT-PRINT NAME Ll...t. A itkik llS 6+\J
111F4APPLICANT-SIGNATURE: / .ai I I Date: 2.3
Declaration: I hereby authorize th- applicant to place a sign on my property or building:
OWNER-PRINT NAME: fuCC hJct)n 1:.42Y--t
OWNER-SIGNATURE: � Date: a [ 26
-de il � hL
Town of Queensbury Building&Codes Sign Permit Application 518-761-8256
MAP,
VS
Y LINE
tERLY SIGN)
Church of the King BP 2015-436
681 Bay Road
Freestanding sign 12.s.f.
Copy: Cedars Senior Living Center
MUC ATION I AW.
PLAN
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