2009-605 Awning Liberty Income Tax �~ TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
4z Community Development- Building&Codes (518) 761-8256
uhivHFICATE OF COMPLIXNCE
Pemit Number.. P20090605 Date Issued: Monday, November 29, 2010
This is to certify that work requested to be done as shown by Permit Number P20090605
has been completed.
Tax Map Number. 523400-296-017-0001-051-000-0000
Location: 870 STATE ROUTE 9
Owner. ALEXANDER POTENZA
Applicant: ALEXANDER POTENZA
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
owner of the responsibility far compliance with Site Plan
property P tY P ,
Variance,or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
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: P20090605 Application Number: A20090605
Tax Map No: 523400-296-017-0001-05 1-000-0000
Permission is hereby granted to: ALEXANDER POTENZA
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
FRANK BORK Sign
403 GLEN St Total value
GLENS FALLS,NY 12801
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2009-605
57 sq ft awning sign to read "LIBERTY INCOME TAX"
$114.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Tuesday, December 21, 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 n�� op�1a3�-December 21, 2009
SIGNED BY �" "`V�� • :� ' for the Town of Queensbury.
Director of Building&Code Enforcement
-Z
A ________________ �/- OFFICE USE ONLY...........
_..__
0
'+ TAX MAP NO. PERMIT NO. / PERMIT FEE / F
+ +
+ ' '
+ APPROVALS: DEPOSIT u ;
SIGN PERMIT APPLICATION:
A permit must be obtained before installation of your permanent sign. All applicants'spaces on this application must _
be completed and must agar on the application form. �<
OWNER: L4 n y Z-f� INSTALLER/BUILDER: r
ADDRESS: 5 J- 6 4: ADDRESS: 7
PHONE NOS. S+a'- 7 i 1 '6, 2 r,P PHONE NOS.
LOCATION OF PROPOSED INSTALLATION:(LEGAL ADDRESS) 9;F0
BUSINESS COMPLEX/PLAZA/MALL NAME^ � (+: r-f 1 11 1,L✓l 2 A
BUSINESS NAME: 6--4-`? / —% S-i✓-Lt
CONTACT PERSON FOR SIGN CODE COMPLIANCE: V f ,`LA, PHONE: :3 3
TYPE OF SIGN PROPOSED: freestanding _vial! _awning _projecting -�- X ( S
IF SIGN IS TO BE ILLUMINATED,PLEASE INDICATE: —Internal _External _Incandescent _Neon _Other
DO SIGNS CURRENTLY EXIST ON THE PROPERTY? XYes _No
IF YES,LIST ALL EXISTING SIGNAGE:(//'e er I S t' Ley— 4 z /[ 14
Cli
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
1 Change in height of sign from to
Change of wordin g/copy from:�3`a A Y__ Aw ri to: t-.,% r—r iV lvse_s
Sign Wording/Copy: -5a-M e!
Sign size: Length Z.3 x Width'L S =Total Sq.ft. S 7 Sign Height(freestanding sign):
Color Material to be used: V
Provide 2 copies of a scaled drawing or surveyed plot plan with 4iollowing information:
o Location of Sign(walls signs: drawing of the facade
the sign will be located on,indicate sign on facade)
QUESTIONS? CALL 761-8256 OR EMAIL
o Height of freestanding sign
o Depth of projecting sign codes(a)ciueensburv.net
o Distances from front and side property lines. VISIT OUR WEBSITE FOR MORE INFORMATION
)?rovide 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 that such work is authorized by the owner.
APPLICANT SIGNATURE: DATE:
I hereby authorize the applicant to place a sign on my prope{ty yf
'� building.
S' OWNER SIGNATURE: "/ I' GATE: et 1
Town of Queensbw y - Community Development Office - 742 Bury Road, Queensbuq, NY 12804
501
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