2008-523 CWI Community Work & Independence TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building &Codes (518) 761-8256
CE RT I F I CAT E OF COMPLIANCE
Permit Number. P20080523 Date Issued: Monday, January 12, 2009
This is to certify that work requested to be done as shown by Permit Number P20080523
has been completed.
Tax Map Number: 523400-296-013-0001-018-000-0000
Location: 959 STATE ROUTE 9
Owner. RAYMOND HIPPELE
Applicant: RAYMOND HIPPELE
This structure maybe occupiety
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.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20080523 Application Number. A20080523
Tax Map No: 523400-296-013-0001-018-000-0000
Permission is hereby granted to: RAYMOND HIPPELE
CWI
For property located at: 959 STATE ROUTE 9
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: RAYMOND HIPPELE
50 ACORN Dr Sign
DIAMOND POINT,NY 12824-0000 Total value
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans &Specifications
2008-523 CWI Space T
21 SQ FT WALL SIGN TO READ "CWI, COMMUNITY WORK& INDEPENDENCE"
$42.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Wednesday, October 21, 2009
(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 Tgvvn of'Qpeenspury;,r Tuesday,.October 21, 2008
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
, E USE ONLY
01
fAX MAP NO. < PERMIT NO. '
PERMIT FEE: OVALS '
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SIGN PERMIT APPLICATION: _
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.
OWNER: L�11;1 { i,L � �, 7 INSTALLER/BUILDER:
ADDRESS: C • vl +A°e r ADDRESS: .f oy Di >c A& I✓DJ�� /`�Li,S
PHONE NOS. 'l' � i PHONE NOS. 51 K -7 q 7—`J ZY 3
LOCATION OF PROPOSED INSTgALLATION: (LEGAL ADDRESS)
BUSINESS COMPLEX/PLAZA/MALL NAME: t DUNZ QJ�/ PL Z
BUSINESS NAME: C W 11
CONTACT PERSON FOR SIGN CODE COMPLIANCE: Hy(ron 1de5+ PHONE: 7Y?�SZb'3
TYPE OF SIGN PROPOSED: freestanding X wall awning projecting
IF SIGN IS TO BE ILLUM ATED,PLEASE INDICATE: —Internal External _Incandescent Neon Other
d
DO SIGNS CURRENTLY EXIST ON THE PROPERTY? Yes —No
IF YES, LIST ALL EXISTING SIGNAGE: 0714 fA- S K-tts (V TOL pC.AZf(
The application creates a —KNew
change in the following _Change in number of signs from to
existing site conditions (fill in Change in setback for sign from to
all applicable spaces): Change in size of sign from to
Change in height of sign from to
Change of wording/copy from: to:
Sign Wording/Copy: -+- 1 n e.ge, eAr e
Sign size: Length v .x Width Y =Totai S(q�. ft. aIpsign Height (freestanding sign):
� � ?� Y� K 1 r
Color and Material to be used: ✓r► n✓ -ba�c (e*-fa L,ir�►+ e1,u4,c.
✓ Provide 2 copies of a scaled drawing or surveyed plot plan with the following information:
o Location of sign (walls signs: drawing of the fagade the sign will be located on, indicate
sign on fagade)
o Height of freestanding sign QUE=761-8256256 OR EMAILo Depth of projecting sign ry.neto Distances from front and side property lines.
VISIT OE INFORMATION✓ Provide 2 drawings or photos of sign design. ry.net
✓ Provide Applicant and Owner's signature (permission for placement of sign on the.property or
building).
Declaration: 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: r4, DATE: INOR
hereby authorize the ap licant t Ice sign my property or building:
OWNER SIGNATURE: DATE: Z S
Y`-' Town of Queensbury • Community Development Office • 742 Bay Road, Queensbury,NY 12804
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NEW SIGN PROPOSAL �
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HELPING HANDS & MT. ROYAL DAY SERVICES
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