2009-551 Temp Sign Papa Johns TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building &Codes (518) 761-8256
uE R�TIFICATE C)F COMPLIANCE
Permit Number. P20090551 Date Issued: Friday, November 20, 2009
This is to certify that work requested to be done as shown by Permit Number P20090551
has been completed.
Tax Map Number. 523400-296-017-0001-05 1-000-0000
Location. 870 STATE ROUTE 9
Owner. ALEXANDER POTENZA
Applicant: PAPA JOHNS
This structure maybe occupied as a.
Temporary Sign
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the
owner of the responsibility for compliance with Site Plan
property P t3' P �
Variance, or other issues and conditions as a result of approvals by the Director of Building&Cod nfo nt
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20090551 Application Number. A20090551
Tax Map No: 523400-296-017-0001-05 1-000-0000
Permission is hereby granted to: PAPA JOHNS
For property located at: 870 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: ALEXANDER POTENZA Temporary Sign
FRANK BORK Total value
403 GLEN St
GLENS FALLS,NY 12801
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans &Specifications
2009-551
21 sq ft sign to read "PAPA JOHNS BETTER INGREDIENTS BETTER PIZZA COMING SOON TO
YOUR NEIGHBORHOOD" - 14 DAYS 11/16/09 TO 11/30/09
$10.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Saturday,November 20, 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 To of Qu nsb F ay November 20,2009
/V SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
OFFICE USE ONLY ' ' DE
�
: 2-76 - 17 -
o TAX MAP NO. PERMIT NO. /POSIT: �� � J� Ell
a �!
APPROVALS: ZONING: TOWN CLERK: PERMIT FEE: �-:
"""iVVN OF Q u E � LIF i'
TEMPORARY SIGN PERMIT APPLICATION:
Applicant Information Business Information
Name: k"Oy t 3'0' car P Contact Person:
Address: �"?0 R� , Address: 9 6a�-�\cA m &e ;k
Phone No. (S15) Phone No.
Specific Information about your sign:
✓ What is the date for placement of your sign?
✓ What is the date for removal of your sign?
✓ How many days will your sign be displayed? 4 �5
✓ Indicate exact address for placement of sign: 'k:20
✓ Indicate tax map number for your parcel:
✓ Indicate the type of sign you will display:
V/ Wall Sign (cannot exceed 32 square feet)
Freestanding Sign (cannot exceed 16 square feet)
✓ What are the dimensions of the sign? :_ X _� _ _�sq. ft.
✓ Indicate in words what your sign will say:
Note: Failure to Remove sign at expiration may result in forfeiture of deposit as per the Code
of the Town of Queensbury, Section 140, Subsection 140-4 (Local Law No. 11, 1993)
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 sh a complied with, whether specified or noted, and that such work is
authorized by the owner.
APPLICANT SIGNATURE: �---„i� DATE: u "�
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