2005-277 LA Weight Loss TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20050277 Application Number: A20050277
Tax Map No: 523400-296-013-0001-018-000-0000
Permission is hereby granted to: LA 1vW1C`rHT LOSS
For property located at: 959 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: GUIDO PASSARELLI
465 LAKE Ave Sign
Total Value
LAKE LUZERNE, NY 12846-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2005-277 LA WEIGHT LOSS
56 SQ FT WALL SIGN
$112.00 PERMIT FEE PAID-THIS PERMIT EXPIRES:
(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 T wn of een r i ay 20, 2005
V
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
TOWN OF QUEENSBURY Fee Paid:
Bay at Haviland Road, Queensbury, NY 12804-9725-518-792-5832 Approved By: nn
Permit #: U 7
SIGN PERMIT APPLICATION C�)
THE FOLLOWING INFORMATION IS REQUIRED: RWIAWIED2005
1. Detailed drawing or photo of sign. MAY 0 2 2005
2. Plot plan of location of sign.
3. Written consent of the owner of the building or land. TOWN OF QUEENSBURY
OWNER OF PROPERTY I44n n J�d,,rq��� },,� Ic��c� BUILDING AND CODE
ADDRESS �n,..lgt g3 _f TEL. 7G !5- GA2_1
NAME OF APPLICANT _12IC,�4Ai V 01_g0�j — OL 6f,3 Slrff Co 1 oc-
51�!
ADDRESS 1-750 yLM-r- 121�• r2 ECzTIA hy-e 123p2_TEL.
BUSINESS NAME IF DIFFERENT: -A Wff1C,yr ' L.bSS
TYPE AND LOCATION
Check What Applies: Existing Permanent - Projecting Sign
Temporary Non-conformin Existing
Free-Standing Wall New .
�1--�
Location: Tax Map Number ��•�
Address
Proposed Setbacks from Property Line (front) _ (side) _
If sign is to be illuminated, please check appropriate box:
Internal 061 External ( ), Incadescent ( ), Neon ( ) , Other ( )
Size of Sign: Width 10 ft. Length ft.
Total Square Footage: _5(0
Sign Copy: _ LA wr2L H7 L4e'!S
Color and Material T ed: 11 � Ar2sl fT �OL"�UR�B. �iRCrt
Signature:
_Cir,4 e n pplicSp wner, contractor or agent.
I HEREBY AUTHORIZE APPLICANT TO PLACE A SIGN ON MY PROPERTY OR BUILDING.
Signature of Property Owner: 2 0E,A A
ORIGINAL-Office Copy COPY-Applicant
M IKL LAM OTT PAGE 02
'I' .,ir' .
TOWN OF QUEENSSURY Fee Paid*
9tt air M8vimnd float!,0~19UY, MY t7ilDs A725- 6f8?92 Si+12 Approved ay:
Permit
SIGN PERMIT APPLICATION Receiv
TKi FOLLOWING INFORMATION IS kgvwl): &'AY () 2 2005
'I Detailed dra! ing or photo of sign. N� TOM OF QUEENSBUR
L, Plet plan. of location of sign. GANDCODEY
v, Written can-.-.ent of the owner of the building ;ir land.
OW`lER OF PROPERTY w. .
NAME OF APPL ICA14T _ Qoz ,r4,R2 ' dwc'a>J GV'_
Al)JRE55 r2�o� DEL. �Z. t "
BUSINESS NAME IF DIFFERENT: LA iN IGFn7_ ,L-n5cj "-
TYPE AND LOCATION
CheCk What Applies: Existing Permanent Pro:}c%=tin=:t Sign
Temporary Non-confnrminq Existing
Free-StandTng teal i _jof New _,�►!�.�
Location: Tax Map Number
Andress
Proposed Setbacks from Property Line (front) V ---
:,f sign is to be illuminated, please check appropriate' box:
Internal k), External E Incadescent Other t Size of cif Sign; Width .. — ft, Length t ft.
Total Square Footage:
Color and Material To Be Used: A(j36 t1 C.a481D.1���.
Signature:
Mc leOne; Applicant, owner, contractor or agefit.
I HEREBY AUTHORIZE APPLICANT TO PLACE A SIGN Olt MY PROPERTY OR BUILDING.
.Signature of Property Owner: 1 77—
___....__-..-
ORIGINAL-Office Copy COPY-Applicant
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aDO�aD® LA WEIGHT LOSS, QUEENSBURY, NY
DATE: 4/14/05 SCALE: NTS REVISED DRAWN BY KOLLAR
1750YIeYRoad See 1230Y NEW 42"x 16' ILLUMINATED WALL SIGN. VINYL LETTERING FILE NAME
(518)370-212118 LAW8T