BOTH-000296-2015 Fit City TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: BOTH-000296-2015
Tax Map No: 296.13-1-18
Permission is hereby granted to: Tara White
For property located at: 959 State Rte 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
Owner Name: Mount Royal Plaza(Zim Realty) Sign $0.00
Owner Address: 959 State Rte 9 Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Garnet Signs
6268 Main ST
Chestertown,NY 12807
Plans&Specifications
Wall sign 42 s.f.
Fit City,Space T
PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,December 9,2016
(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 Quee urv; / ! /� Tu s y er 15,2015
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
DO v Use Only
Town of Queensbury BL I & Codes 3 2015 *
�E i ed:
SIGN PERMIT APP ICpp Tax p ID: q - " I
T 0 Q BENSBU fermi No.:
BUILDING& OODE u
Fee: $ a ,
Date Applicant PfV A
Tax Map ID Sa34On''d �'�/ '��Oi -018-Address CI
Zoning I, 000 N �2
Property Owner o M eon! dT- O el t Contractor/Agent: �k�' S
Address Address
r fsoy
Phone 515 -7913 -ooz6 Phone Coi�.:1LLCatf �S�S� � tom•
Contact Person for Sign Code Compliance: \ Day Phone:
Building Street Address: ZC`
Site Plan,Variance,or Subdivision Approvals
Location of proposed installation — t c c{e- "r
Business Complex/Plaza/Mall name — LA
Business name
Type of Sign proposed Q L'`
If sign is to be illuminated,indicate X intemal —external _Incandescent _neon —other
Do signs currently exist on property? _YesNo(if yes,list all existing signage)
Change of word/copy From to
Sign Wording/Copy
Sign Size Length 44 " x Width LtdL L=Total sq.ft.
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 it IA-0 A
✓ APPLICANT-SIGNATURE: Date:
Declaration: I hereby authorize the applicant to place a sign on my property or building:
OWNER-PRINT NAME: ,A4,7 d r e--,j S v
C --_
OWNER-SIGNATURE: 4 Date: J c
Town of Queensbury Building&Codes Sign Permit Application 518-761-8256
144"
❑ ❑
42"
42"x144" LED Channel Letters Mounted on Raceway( Painted to match wall.)
CM1estermm 696-SSBI
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