2013-081 (Queensbury Cigar & Pipe) TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Vera
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20130081 Application Number: A20130081
Tax Map No: 523400-296-009-0001-015-000-0000
Permission is hereby granted to: CUP O'JOES
CUMBERLAND MINE LLC
For property located at: 1036 STATE ROUTE 9
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: CUMBERLAND MINE LLC
PO BOX 76 Sign
STONY CREEK NY 12878-0000 Total Value
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2013-081 Cup O'Joes
SIGN freestanding 24 sq ft
$72.00 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 Quee bury 4,11'hif di ►I . eh 14,2013
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
r �
OFFICE USE ONLY •
TAX MAP NO.d '1'• l I1 .PERMIT N0. f � g PERMIT FEE '201.
01 2513 }f�
APPROVALS: DEPOSIT �v',1
SIGN PERMIT APPLICATION:
A permit must be obtained before installation of your permanent sign. All applicants'spaces on this application must
be complete and must appear on the application form.
OWNER: F n INSTALLER/BUILDERR:v V / (-AD
(�C-
ADDRESS: 1"" ) RC)X �(� L - v \ 13.<b-71:) } )ADDRESS: ` D C, t y l 1 V O. Sb Calls> WY
PHONE NOS. St I OQ PHONES. S) -- /17 —�Q.S.-
LOCATION OF PROPOSED INSTALLATION:(LEGAL ADDRESS) r 3 C -k u,+c 9 Ql' /156,0M I GSI
BUSINESS COMPLEX/PLAZA/MALL NAME: U
BUSINESS NAME: C p cv ,1�< -
CONTACT PERSON FOR SIGN CODE COMPLIANCE: ''+ h � -st c\ PHONE: Q0
TYPE OF SIGN PROPOSED: freestanding wall aw�ni g projecting
IF SIGN IS TO BE ILLUMINATED,PLEASE INDICATE: Internal —External _Incandescent _Neon _Other
DO SIGNS CURRENTLY EXIST ON THE PROPERTY? _Yes _No
IF YES, LIST ALL EXISTING SIGNAGE: ZINC/ K •W? k4r'Iii� r )USC V N
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 1
/Change of wording/copy from: � /Q I'� K to: C�o �YZSbu r' C-(3ct Cow�Y •
,
Sign Wording/Copy: J rVa C-l s c i ri 1=5`P�
Sign size: Length `/ x Width U =Total Sq. ft. L1 Sign Height(freestanding sign):
Color and Material to be used: W h i 1'Z .S(4} € !did( N f£o/ Y1 Qrj
✓ 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 codesAqueensbury.net
o Distances from front and side property lines. VISIT OUR WEBSITE FOR MORE INFORMATION
✓ Provide 2 drawings or photos of sign design. www.queensbury.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;an, all other laws pertaining to the proposed work shall be complied with,whether
specified or noted, and that such wor, '--_th gzed b, - . ner.
APPLICANT SIGNATURE: 1�br7dellib DATE: c9 I /3
I hereby authorize the applicant to pia :.: ign1 my •ror building.
OWNER SIGNATURE: l bile�-g DATE: cQoI
__
__ '1 Town of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804
D mansions Materials 'D. escf 1ioil of 'v brk Colors
height width sq. ft. Lettering Lettering
4' 6' 24 Vinyl Lettering Copy change to exisiting sign Black
Shadow
Gold
6'
Q ee r k ��� y'
ijiar Layouts and Designs by:
Pipe
Featu.niwg tke kr -
'=U.�,(pn,t point 338.:
Allt
1100 Dix Avenue
�p �pi� • Hudson Falls,NY 12839
n 518.747.5283
Cadee i u u ge www.WesiSigns.corn!
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