2005-735 CSA Coin & Jewelry TOWN OF QUEENSBURY
(2t 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20050735 Application Number: A20050735
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
FT. EDWARD, NY 12828-0000 Total Value
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2005-735 C.S.A. COIN & JEWELRY
30 SQ FT FREE STANDING SIGN
$60.00 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 To ueensb ; F i 2.22
ober 07, 2005
SIGNED BY for the Town of Queensbury.
Director of Building& ode forcemeat
Building&Codes Office-Department of Community Development-Town of Queensbury PERMIT N MBER -9 a �
742 Bay Road,Queensbury, NY 12804 ZT
Dave Hatin,Director codes@aueensbury.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 completed and must appear on the application form.
Applicant/Business Owner: 1�2�v �u�r+►v^� �''�jv '"v'�
Address: o Address: 71S v Pr 49;4,
Home Phone: 6/8- 7Y7- 0o02.- Home Phone:
Email Address: ,✓c�T Email Address:
Cell Phone: Cell Phone:
FAX Phone: S/8-7 y7- 0002 FAX Phone: stk -793-3223
Person responsible for supervision of work with respect to Sign Code compliance:
Name: /9 N C"71-r Brest 5��--
Address: EmNz °�` �A uke C cnit`1-- IS"� r Phone 5
Email Address:
Location of proposed installation: Legal Address: 1 ,C Suite No.
Business Complex/Plaza/Mall Name:
Business Name: C ,rq t� 2005
Tax Map Number: __.. -
Type of sign proposed: freestanding wall awning projectMg
If sign is to be illuminated, please indicate: Internal _External candescent _Neon _Other
Do signs currently exist on the property? -sXes / _No If YES, list all existing signage:
The application creates a change in the following existing site conditions: fill in all applicable spaces
✓New ,6t��p(,��enL vp�A,671N(s- Of ^ 16,01v St6i✓
~,,,'Change In number of signs from 1 to Z
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
Sign Wording/Copy: 365 6.A`1d'ur
Sign size: Length 5 x Width =Total Sq. ft. / Sign Height (freestanding sign)
Color and Material to be used: S-MAWA" SIGN
Provide 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
v 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
premises and that all provisions of the Z ' g Ordina ce, and all other laws pertaining to the proposed work shall
be complied with,whether s ecifie or not , and t at such work is authorized by the owner.
APPLICANT SIGNATURE: DATE: 2 O
I hereby authorize the pli n p ce a sign o my property or building.
OWNER U DATE.
L:\Sue Hemingway\Building.Permit.FORMS\Sign Permit Application.doc
V: 1/6/2005
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