SIGN 2013-541 Back Home 01./4 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20130541 Application Number: A20130541
Tax Map No: 523400-302-006-0001-043-000-0000
Permission is hereby granted to: NORTHGATE ENTERPRISES INC
For property located at: 797 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: NORTHGATE ENTERPRISES INC
PO BOX 4514 Sign
QUEENSBURY,NY 12804-0000 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2013-541 BACK HOME
SIGN 12 x 3 wall sign
$108.00 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 of eens ry; F4ida , 1 • I. • •r 06,2013
fJ
SIGNED BY . for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
Town of Queensbury Building & Codes
Received: NOV 2113
SIGN PERMIT APPLICATION Tax Map ID:
Permit No.:
Permit Fee: $
Date Applicant /%q//, 'w /r».,A/),
Tax Map ID Address 797 Sh4 Jf V S4 /8
Zoning bol ci v.y Ny
Property Owner /i6r1hyak i-T 4 ta-rTc Contractor/Agent:
Address 777 7 Sic-;4,q Address
anrhvy Ny
Phone ZC U-57'70/ Phone
Contact Person for Sign Code Compliance: /,4// %i�:r.9.4/a , Day Phone: 0:95'O/
Building Street Address: 797 Jh,/,.. 9 Cop rtrl�v J• 41/
Site Plan,Variance, or Subdivision Approvals
Location of proposed installation Are Sh4, l L. ml, ,x
Business Complex/Plaza/Mall name
Business name Rock' A, .S/y//,/ 47- LiVijiy
Type of Sign proposed P/asbL r,cie /,,
If sign is to be illuminated, indicate X internal _external Incandescent _neon _other
Do signs currently exist on property? X Yes _No(if yes, list all existing signage)
Change of word/copy From to
Sign Wording/Copy (").✓
Sign Size Length / x Width S =Total sq.ft. 3E
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 /WA*ARIA/ //)emb/cr
APPLICANT-SIGNATURE: U41- L-u� Date: 42313
Declaration: I hereby authorize the applicant to place a sign on my property or building:
OWNER-PRINT NAME: L.-/nd e, 1�� �5���2 - �����I�c4/f O4/pri Sl'S C ,
/ •
// /
OWNER-SIGNATURE: %�' • G� Date: °/z 3/1.3
,r . i
Town of Queensbury Building&Codes Sign Permit Application 518-761-8256
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