2004-812 Prospect Child & Family Center, Aquatic Therapy and Administration Building TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number. P20040812 Date Issued: Friday, December 01, 2006
This is to certify that work requested to be done as shown by Permit Number P20040812
has been completed.
Tax Map Number. 523400-295-018-0001-075-000-0000
Location: 133 AVIATION Rd
Owner. COUNTIES OF WARREN & WSHINGTON I.D.A. ,
Applicant: COUNTIES OF WARREN & WSHINGTON I.D.A.
This structure maybe occupied as a:
Sign
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the
property owner of the responsibility for compliance with Site Plan,
Variance; or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
WWN Ur QUEEN 51i UKY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040812 Application Number. A20040812
Tax Map No: 523400-295-018-0001-075-000-0000
Permission is hereby granted to: COUNTIES OF WARREN&WSHINGTON I.D.A.
For property located at: 133 AVIATION 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. Type of Construction Value
Owner Address: COUNTIES OF WARREN&WSHI Sign
234 GLEN St
GLENS FALLS,NY 12801-0000 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans &Specifications
2004-812
20 SQ FT FREE STANDING SIGN (PROSPECT CHILD &FAMILY CENTER,AQUATIC THERAPY
AND ADMINISTRATION BULDING)
$96.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Saturday,December 01,2007
(If a longerperiod 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� ensb F ' a D mber 01,2006
SIGNED BY for the Town of Queensbury.
urY
Director of Building&Code Enforcement
v
Fee Paid:
TOWN OF QUEENSBURY c'
Bay at Haviland Road, Queensbury, NY 12804-9725-518-792-5832 Approved B y:
Permit #: `
SIGN PERMIT APPLICATION
THE FOLLOWING INFORMATION IS REQUIRED:
1. Detailed drawing or photo of sign.
2. Plot plan of location of sign.
3. Written consent of the owner of the building or land.
OWNER OF PROPERTY _ i� ��C L(Y Uoc,-I` o -A "
ADDRESS _ 3 Q `'C�A1 �hr� ex1 TEL.
NAME OF APPLICANT
ADDRESS TEL.
BUSINESS NAME IF DIFFERENT: plcoS no_c�t L LaA
TYPE AND LOCATION
Check What Applies: Existing __ Permanent ✓ Projecting Sign
Temporary Non-conforming Existing
Free-Standing ✓ Wall New .
Location: Tax Map Number _a 5 9-1?'
Address
Proposed Setbacks from Property Line (front) l J (side) f
If sign is to be illuminated, please check appropriate box: l✓6 AJ _.it,44,0n,
Internal ( ) , External ( ), Incadescent Neon ( ) , Other ( )
Size of Sign: Width / ft. Length ft.
1�
Total Square Footage: Alt 10.
Sign Copy: _56,- 1-4t-i-65✓7
Color and Material To Be Used: J�Z Sl�!✓���/ ��J�r/�� � �`�� /�°��
Signature:
Circle One: Applicant, owner, contractor or agent.
I HEREBY AUTHORIZE APPLICANT TO P'LAA A SIGN MY„ PROPS TY OR BUILDING.
Signature of Property Owner: l
ORIGINAL-Office Copy COPY-Applicant ,
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