2005-777 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20050777 Application Number: A20050777
Tax Map No: 523400-303-019-0001-054-000-0000
Permission is hereby granted to: ARCA, INK.
For property located at: 4 HIGHLAND Ave
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: WAYNE KELLOGG
4 HIGHLAND Ave sign
Total Value
QUEENSBURY, NY 12804
Contractor or Builder's Name /Address Electrical Inspection Agency
SIGNCRAFT
KARL BRENNEISEN
P.O. BOX 332
GLENS FALLS, NY 12801-0000
Plans&Specifications
2005-777 ARCA INK
8 SQ FT WALL SIGN
$16.00 PERMIT FEE PAID -THIS PERMIT EXPIRES:
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town Quee bury h 1,Uril 06, 2006
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
-777
Building&Codes Office-Department of Community Development-Town of Queensbury PERMIT NUMBER Q
742 Bay Road,(2�ueensbury,NY 128044
Dave Hatin,Director codes®aueensburv.net FEE PAID'
Phone: (518)761-8256 FAX: (518)745-4437
Sign Permit Application
Application & plans are subiect to review before issuance of a valid permit for placement of a sign.
Instructions: A permit must be obtained before installation of your permanent sign. All applicants' spaces on this
application must be completed and must appear on the application form.
Applicant/Business Jqr e,& Sn k Owner: 0A14S KEU,OC-AA
Address: qA NIGNta,aD AlPe. Address:
Home Phone: 5go --2g54 Home Phone:
Email Address: Email Address:
Cell Phone: Cell Phone:
FAX Phone: FAX Phone:
Person responsible for supervision of work with respect to Sign Code compliance:
Name: wtiL —
Address: #c& o�D Phone I$ 0 ®7
Email Address: RCJFkPcDrt m 0,A0t_W,,•-
Location of proposed installation: Legal Address: A Suite No.
Business Complex/Pl/azz�a/Mall Name:
Business Name: t7rLCL -1n i<
Tax Map Number: 226)3, 19 -I 5;4
Type of sign proposed: freestanding X wall awning projecting
If sign is to be illuminated, please indicate: _Internal _External _Incandescent _Neon _Other
Do signs currently exist on the property? ,-Yes / _.No If YES, list all existing signage: \p�A(Z(tEt� THE _
The application creates a change in the following existing site conditions: fill in all applicable spaces
X New
XChange in number of signs from to 3
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: ARC.A, 'I-Mk — CUsum SGtWzN 2/NT&J
Sign size: Length x Width 2''=Total Sq. ft. / Sign Hei ht (freestanding sign)
Color and Material to be used: LUMIfrum 07
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
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,whether specified or noted, and that such work is authorized by the owner.
APPLICANT SIGNATURE: DATE: 6 10� 0S
I hereby authorize the of iplicant to place a sign on r�property or building.
OWNER SIGNATl1R DATE:
L:\Sue Herningway\Buildin .Permit.FORMS\Sign Permit Application.doc
V: 1/6/2005
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