2009-249 Freestanding "Safelite" TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20090249 Application Number. A20090249
Tax Map No: 523400-309-011-0001-048-000-0000
Permission is hereby granted to: LAWRENCE LUS SIER
For property located at: 20 MAIN St
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: LAWRENCE LUSSIER
PO BOX 4339 Sign
CLIFTON PARK,NY 12065-0000 Total value
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans &Specifications
2009-249
32 sq ft freestanding sign to read "SAFELITE AUTO GLASS"
$64.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Thursday,July 01,2010
(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 Queensbury, ednesday,July 01,2009
SIGNED BY f for the Town of Queensbury.
f
Director of BlingN Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
4z Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number. P20090249 Date Issued: Wednesday, July 01, 2009
This is to certify that work requested to be done as shown by Permit Number P20090249
has been completed.
Tax Map Number. 523400-309-011-0001-048-000-0000
Location: 20 MAIN St
Owner. LAWRENCE LUSSIER
Applicant: LAWRENCE LUSSIER
This structure may be occupied as a:
Sign
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the gym `
property owner of the responsibility for compliance with Site Plan,
Variance, or other issues and conditions as a result of approvals by the Director of Building&Code nforc ent
Planning Board or Zoning Board of Appeals.
_------------_------------------------------------------_----------- q
i OFFICE USE ONLY 15;l� tj
TAX MAP NO. PERMIT OZ-4 7 PERMIT FEE 11
JUN 10
1
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1 APPROVALS: DEPOSIT ; , +
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I i+-"-I SIGN PERMIT APPLICATION: TOBUILDING&CODES
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:�w,Qel2c e_ /�,{�J Ss/C� INSTALLER/BUILDER: i ��/
ADDRESS: W 14 (M /Z ADDRESS: Z(,G SIC-
PHONE C k1
NOS. t Z^ Z,3 PHONE NOS. 0 3 G t"9J3 �1 Z�
LOCATION OF PROPOSED INSTALLATION:(LEGAL ADDRESS) ZZ i 7 1 14 In (
BUSINESS COMPLEX/PLAZA/MALL NAME: ►JI ✓"10V1 i y 1� vj t� ��SS
BUSINESS NAME:,3ex k4� &A-5 C G�
CONTACT PERSON FOR SIGN CODE COMPLIANCE: PHONE:
TYPE OF SIGN PROPOSED: _freestanding wall awning 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: +c l� wigo
The application creates a change P/t 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
U---Change in height of sign from to
Change of wording/copy from:�tv On �y V4 6 to: _sic - t�-t 'e
Sign Wording/Copy: ���
Sign size: Length l�x Width =Total Sq. ft. 3 Z Sign Height(freestanding sign): L 3
Color and Material to be used: L,_- &V_, a lb RtA- L, <'e- God
✓ Provide 2 copies of a scaled drawing or surveyed plot plan with the following information:
o Location of Sign (walls signs: drawing of the fagade
the sign will be located on,indicate sign on fagade)
o Height of freestanding sign CQU7ESTIONS? CALL 761-8256 OR EMAIL
o Depth of projecting sign
codesCa�gueensburv.net
o Distances from front and side property lines. OUR WEBSITE FOR MORE INFORMATION
✓ Provide 2 drawings or photos of sign design. www.gueensbury.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 tha uc ork is authorized by the owner.
APPLICANT SIGNATURE: � DATE: S !c-
I hereby authorize th4applicao ce a sign o ro or buildilag.
OWNER SIGNATUR DATE: d
Town of Queensbury - Community Development Office • 742 Bay Road, Queensbury, NY 12804
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