2005-732 CSA Coin TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20050732 Application Number: A20050732
Tax Map No: 523400-302-006-0001-012-000-0000
Permission is hereby granted to: C.S.A. COIN& JEWELRY
For property located at: 717 GLEN 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: PARKER HAMMOND DEVELOPMI
2868 COUNTY RD 46 Sign
Total value
FT. EDWARD, NY 12828-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2005-732 CSA COIN& JEWELRY
12 SQ FT WALL SIGN
$24.00 PERMIT FEE PAID-THIS PERMIT EXPIRES:
(If a longer period is required,an application for an extension must he made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town of Queensbury; Thursday, September 29, 2005
SIGNED BY for the Town of Queensbury.
.41
Director of Build e Enforcement
Building&Codes Office-Department of Community Development-Town of Queensbury PERMIT NUM ER %-/
742 Bay Road,Queensbury,NY 12804
Dave Hatin,Director codes@-ciueensbyry.net FEE PAID
Phone: (518)761-8256 FAX: (518)745-4437
Sign Permit Application
Application & plans are subiect to review before issuance of a valid permit for placement of a sign.
Instructions: A permit must be obtained before installation of your permanent sign. All applicants' spaces on this
application must be con)pleted and must appear on the application form.
t-J/t4i;q",7 -77 lirQ Applicant/Business c>9 Gr.J � / h Owner: P,, to v
Address: 910 —� Address: '715' eft{, Co t-v, !;Rr�*r T
n.✓ .s r11� /2t1 _ Q,xe.s b..- N y 1 ZF o'f
Home Phone: Sid' 7-K oaa j Home Phone: SI'd'-7fi--729-0
Email Address: CSA 0 c :✓ Email Address:
Cell Phone: Cell Phone: 5,1 3�S-ds�
FAX Phone: 65"8 -2 oa oZ FAX Phone: ,,ir- ?v--3Z23
Person responsible for supervision of work with respect to Sign Code compliance:
Name: SlGnj C9 A71' B�ytne-rS
Address: 312 �'ziti` 64, S P4 Phone -7%2 . c-'S
Email Address:
Location of proposed installation: Legal Address: Z12 Upel�.2 e;�/ S Suite No.
Business Complex/Plaza/Mall Name:
Business Name:CtrQ c-o;A1
Tax Map Number: La , --"
Type of sign proposed: freestanding waH a ping projecting
I External `Incandescent Neon Other
If sign Is to be illuminated, please indicate: lifnterna _Exte a
Do signs currently exist on the property? �s / _No If YES, list all existing signage:
The appiicati n creates a change in the following existing site conditions: fill in all applicable spaces
hange in number of signs from �'- to t
Change in setback for sign from to
Change in size of sign from to
Change in height of sign from to
Change of wording/copy from to
>ign Wording/Copy: Gt56 64`6 ''
>ign size: Length Z x Width J�o =Total Sq, ft. l Z / Sign Height (freestanding sign)
�olar and Material to be used: �t"4 ✓1/��'�° ' J CdV1�7/' t4,,o, 1-hA44 /,rAeFlylA,y'L1
'rovide 2 copies of a scaled drawing or surveyed plot plan with the following information:
location of sign (walls signs: drawing of the fagade the sign will be located on, indicate sign on fa(;ade)
height of freestanding sign
depth of projecting sign
distances from front and side property lines.
rovide 2 drawings or photos of sign design.
-ovide Applicant and Owner's signature (permission for placement of sign on the property or building).
eclaration: Please sign below after you have carefully read the statement:
the best of my knowledge, the statements contained in the application, together with the plans and
)ecifications submitted, are a true and complete statement of all proposed work to be done on the described
'emises and that all provisions of the Zoning Ordinance, and all other laws pertaining to the proposed work shall
e complied with,whether specified ted, and that such work is authorized by the owner.
DATE:
'PLICANT SIGNATURE:
6.4c-c,;i)" - - Y
Iica t ce a Si on my propert wilding.
,ereby authorize the app'
DATE:
WNER SIGNAT
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MA LING: SHOWROOM.
P,Q. l;ox 332 * O ens Falls, NY 1.2801 52 Main,Street • +Qtieensbury, NY 12804
p►h. 518-792-4009 fx. 5181-792-4476
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