2005-759 Home Base TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
112L Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20050759 Application Number: A20.050759
Tax Map No: 523400-296-019-0001-002-000-0000
Permission is hereby granted to: HOME BASE
For property located at: 123 QUAKER Rd
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. Tyne of Construction Value
Owner Address: FIRST NIAGARA BANK Sign
ATTN: REAL ESTATE MGBAACIL Total Value
P.O. BOX 514
LOCKPORT, NY 14095-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2005-759 HOME BASE
16 SQ FT FREE STANDING SIGN
(to be place on the same freestanding sign for First Niagara Bank)
$32.00 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 n o uee nesday,December 07, 2005
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Building&Codes Office-Department of Community Development-Town of Queensbury PERMIT NUMBER 0: J �
742 Bay Road,Queensbury, NY 12804
Dave Hatin,Director codes@aueensburv.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 _ r-8PnE Owner: �� 6
Address: d Address:
Home Phone: Home Phone:
Email Address: Lei ><b;-hamP ',�c� Email Address:
Cell Phone: - / 7/ V Cell Phone:
FAX Phone: FAX Phone: '7
Person responsible for supervision of work with respect to Sign Code compliance:
Name: ALLZAI
Address: be, T All/ D Phone 7Z3-7�/51T.
Email Address: .
Location of proposed installation: Legal Address: ite No.
Business Complex/Plaza/Mall Name: 556e 57
Business Name:
Tax Map Number: S lG- ,1
Type of sign proposed: 4y'-freestanding wall awning projecting
If sign is to be illuminated, please indicate: X Internal _External _Incandescent _.Neon _Other
Do signs currently exist on the property? , Yes / _No If YES, list all existing signage: - aD 7- / 19-4cFfe-a 61q- 1
The application creates a change in the following existing site conditions: fill in all applicable spaces
New
Change in number of signs from to
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: 8,w c 6e16.t✓-
I ,.
Sign size: Lengto x Width =Total Sq. ft. j / Sign Height (freestanding sign)
Color and Material to be used: Rr-�Ce Z1 eggAl
Provide 2 copies of a scaled drawing or surveyed plot plan with the following information:
location of sign (walls signs: drawing of the facade the sign will be located on, indicate sign on facade)
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
premises and that all provisions of the Zoning Ordinance, and all other laws pertaining to the proposed work shall
be complied with,>vhether.Specified or not and that such work is authorized by the owner.
APPLICANT SIGNA�URE: G2' DATE:
I hereby authorize the applicant to place a sign on my property or building.
OWNER SIGNAT 4� r DATE: t 19 DS
L:\Sue Hemingway\Building.Permit.FORM S\Sign Permit Application.doc
V: 1/6/2005
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