2012-213 0.1` TOWN OF QUEENSBURY
!OVA 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20120213 Application Number: A20120213
Tax Map No: 523400-309-017-0001-012-000-0000
Permission is hereby granted to: ROSEMARY& WILLIAM THREW
For property located at: 369 BIG 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: ROSEMARY&WILLIAM THREW Sign
21 EAGAN Rd Total Value
QUEENSBURY,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
WEST SIGNS
1100 DIX Ave
HUDSON FALLS, NY 12839-0000
Plans&Specifications
2012-213
5' x 8' freestanding sign
$120.00 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 expiration date.)
Dated at the Town 4f Que bu JFri • 13 .-.-!4, 2012
SIGNED BY for the Town of Queensbury.
Director of Building& Code Enforcement
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• OFFICE USE ONLY•
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' TAX MAP NO t7�[.(� —)-1 I --A 13 PERMIT FE I ?'UD i E
,� RMIT NO. , � �
APPROVALS: DEPOSIT i '
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SIGN PERMIT APPLICATION: Ula°iNU iSt
A permit must be obtained before installation of your permanent sign. All applicants'spaces on this application must
be completed and must appear on the application form. ', ,,
OWNER: 1'4-.),t 11.rr,n.-% C-7 T'h�'n€ J INSTALLER/BUILDER: (JJ N Q'T E ,v
ADDRESS: z-t E-A-9 ^) K-c ADDRESS: I I ►7,y. 4 `e--
PHONE NOS. 3 L'I - 3s4 3 PHONE `NOS. 117" 5,96 3
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LOCATION OF PROPOSED INSTALLATION:(LEGAL ADDRESS) 3 % i t 1, !2 �-Y 12)L/
BUSINESS COMPLEX/PLAZA/MALL NAME: 1
BUSINESS NAME: AD% CC) ��s� vCV, �i1 (- f LL,
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CONTACT PERSON FOR SIGN CODE COMPLIANCE:(J.'t ��CL PHONE: ( '/S- '3 7 Y--
TYPE OF SIGN PROPOSED: t—freestanding wall _awning _projecting
IF SIGN IS TO BE ILLUMINATED,PLEASE INDICATE: _Internal _External _Incandescent _Neon _Other
DO SIGNS CURRENTLY EXIST ON THE PROPERTY? les _No
IF YES,LIST ALL EXISTING SIGNAGE: �l/(�� l ?/S �r ,`Die r S j
The application creates a change New
in the following existing site Change in number of signs from to
conditions(fill in all applicable Change in setback for sign from to
spaces): Change in size of sign from to
Change in height of sign from to
Change of wording/copy from: to:
Sign Wording/Copy: A4)tA-etc—"Teoc cf—er2 pok (---1 C L C > 5 . cZ, ;t) Pc�
Sign size: Length 5 x Width 8 =Total Sq.ft. y C) Sign Height(freestanding sign): /6
Color and Material to be used: a,c , IeE.,Yv, v 1 J�
✓ Provide 2 copies of a scaled drawing or surveyed plot plan with the following information:
o Location of sign(walls signs: drawing of the facade
the sign will be located on,indicate sign on facade)
o Height of freestanding sign QUESTIONS? CALL 761-8256 OR EMAIL
o Depth of projecting sign codesequeensbury.net
o Distances from front and side property lines. VISIT OUR WEBSITE FOR MORE INFORMATION
✓ Provide 2 drawings or photos of sign design. www.queensburv.net
✓ Provide Applicant and Owner's signature(permission
for placement of sign on the property or building).
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 its - orized e owner.
/ 5/
APPLICANT SIGNATURz
� DATE: � z 1 L
I hereby authorize the apcan to place a sign on -.2,or building.
OWNER SIGNATURE: './. DATE: Z7� i/�
QTown of Queensbury• Community Development Office• 742 Bay Road, Queensbury, NY 12804
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TRUCK REPAIR
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518 615 0376
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