2008-053 Freestanding Sign Adventure Family Fun Center TOWN OF QUEENSBURY
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IF.4742 Q4-54 (518)7 1-Bay Road,Queensbury,NY 12804-5902 82Q1 6
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Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20080053 Date Issued: Wednesday, November 05, 2008
This is to certify that work requested to be done as shown by Permit Number P20080053
has been completed.
Tax Map Number: 523400-295-012-0001-005-002-0000
Location: 1079 STATE ROUTE 9
Owner: KENNETH ERMIGER
Applicant KENNETH ERMIGER
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
property owner of the responsibility for compliance with Site Plan, c�
Variance, or other issues and conditions as a result of approvals by the Director of Building& de E rcement
Planning Board or Zoning Board of Appeals.
��` TOWN OF QUEENSBURY
woo 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20080053 Application Number. A20080053
Tax Map No: 523400-295-012-0001-005-002-0000
Permission is hereby granted to: KENNETH ERMIGER
For property located at: 1079 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: KENNETH ERMIGER
3494 LAKE SHORE Dr Sign
LAKE GEORGE,NY 12845-0000 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans &Specifications
2008-053
64 sq ft sign to read "Indoor Go-Karts Adventure Family Fun Center 3 Floors Star Wars Lazer Tag 150
Game Arcade Paint Ball Bumper Cars
$128.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Thursday, November 05,2009
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the To Queensb W dnesday,November 05,2008
SIGNED BY for the Town of Queensbury.
Director of Building Code orcement
Building &Codes Office-Department of Community Development-Town of G u spurt..,�, ..:.:..; 'ER/v1)-t'UMBERr
742 Bay Road,Queensbury,NY 12804
Dave Hatin,Director codes@queensburv.ne t F E IC
Phone: (518)761-8256 FAX: (518)745-4437 Ir tb �c� 260t7
Sign Permit Application T w OF i UEENst URY
BUILDING& CODES
Application & plans are subject to review before issuance of a vaha permit for placement cif a sign.
Instructions: A permit must be obtained before installation of your permanent sign. All applicants' spaces on this
application must be completed and must appear on the application form.
Applicant/Business 4ef. ert)Ioe Owner: 4'2, /l(s
y � ,
Address: 3'-f Q
�f?C�� ��-,t� Address:
Home Phone: �r -�I i$ O CP�'� Home Phone:
Email Address: Email Address:
Cell Phone: Cell Phone:
FAX Phone: FAX Phone:
Person responsible for supervision of work with respect to Sign Code compliance: eed: 36,1
Name: Sl6 N CAA T, 1rn/t-- C !df3reces
Address: / 1 UJf .3�� (r2e�S iAl) lif C' Phone -t g 2,- L/d?
Email Address:
Location of proposed installation: Legal Address: 10 ) I c7 Suite No.
Business Complex/Plaza/Mall Name: I t 7
Business Name: ( il\irC'_. t\
Tax Map Number: 7--9/�. I — 1-5
Type of sign proposed: /eestanding wall awning projecting
If sign is to be illuminated, please indicate: Internal _External _Incandescent _Neon _Other
Do signs currently exist on the property? . es / _No If YES, list all existing signage: q$ s c//'f /yt ,W
The applicati n creates a change in the following existing site conditions: fill in all applicable spaces
ew
Change in number of signs from ' to
✓Change in setback for sign from / 5 P to r
change in size of sign from r/f,54'(t' to
Change in height of sign from to f tf '
change of wording/copy
from e' (a- to
Sign Wording/Copy: rt.? jr- „
/ Ailed a 67f y/
Sign size: Length /4i x Width =Total Sq. ft. &' 1 Sign Height (freestanding sign)
Color and Material to be used: l'reri1c ff6,/ lux ` 't XAlki i 6r
Provide 2 copies of a scaled drawing or surveyed plot plan with the following information:
location of sign (walls signs: drawing of the façade the sign will be located on, indicate sign on façade)
height of freestanding sign
depth of projecting sign
distances from front and side property lines.
Provide 2 drawings or photos of sign design.
Provide Applicant and Owner's signature (permission for placement of sign on the property or building).
Declaration: Please sign below after you have carefully read the statement:
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
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H:ABorbs WVcrk\FORMS&APPLICATIONS\ZONING BOARD APPS\ZONING-WORD DOCSVAREA VARIANCE 4-24-
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SIGNATURE PAGE
This page includes the Authorization to Act as Agent Form, Engineering Fee Disclosure, Authorization for
Site Visits, Other Permit Responsibilities and Agreement to provide documentation required.
OWNER'S AGENT FORM:
Complete the following if the OWNER of the property is not the same as the applicant
Owner: KEN ERMIGER
Designates:
As agent regarding: Variance Site Plan Subdivision
For Tax Map No.: .Z 1SSection / Block 5 Lot
Deed Referen : �Book Page Date
OWNER SIGNATURE: DATE:
APPLICANT'S AGENT FORM:
Complete the following if the APPLICANT is unable to attend the meeting or wishes to be
represented by another party:
Owner:
Designates:
As agent regarding: Variance Site Plan _Subdivision
For Tax Map No.: Section Block Lot
OWNER SIGNATURE: DATE:
ENGINEERING FEE DISCLOSURE: Applications may be referred to the Town consulting engineer for review of septic design,
storm drainage, etc. as determined by the Zoning or Planning Department. Fees for engineering review services will be
charged directly to the applicant. Fees for engineering review will not exceed$1,000 without notification to the applicant.
AUTHORIZATION FOR SITE VISITS: By signing this page and submitting the application materials attached herein, the Owner,
Applicant and his/her/their agent(s) hereby authorize the Zoning Board or Planning Board and Town Staff to enter the
subject properties for the purpose of reviewing the application submitted.
PLEASE NOTE: Other permits may be required for construction or alteration activity subsequent to approval by the Zoning
Board or Planning Board. It is the applicant's responsibility to obtain any additional permits.
OFFICIAL MEETING MINUTES DISCLOSURE: It is the practice of the Community Development Dept. to have a designated
stenographer tape record the proceedings of meetings resulting from application, and minutes transcribed from those
tapes constitutes the official record of all proceedings. If there is a discrepancy between such record and the handwritten
minutes taken by the designated stenographer,the handwritten minutes shall be deemed the official record.
I, the undersigned, have thoroughly read and understand the instructions for submission and agree to the submission
requirements. I acknowledge no construction activities shall be commenced prior to issuance of a valid permit. I certify
that the application, plans, and supporting materials are a true and complete statement/description of the existing
conditions and the work proposed, and that all work will be performed in accordance with the approved plans and in
conformance with local zoning regulations. I acknowledge that prior to occupying the facilities proposed,1 or my agents
will obtain a certificate of occupancy as necessary. I also understand that I/we may be required to provide an as-built
survey by a licensed land surveyor of all newly constructed facilities prior to issuance of a certificate of occupancy.
I have read and agree to the above. SIGNATURE OF APPLICANT: Date
SIGNATURE OF AGENT: Date
#,Town of Queensbury •Zoning Office •742 Bay Road • Queensbury, NY 12804• 518-761-8238
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3' i FREE GO-KARTS TODAY!
SNACK BAR OPEN
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