2003-126 Fitness in Motion TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number,: P26030126 Application Number. A20030126
Tax Map No: 523400-296-013-0001-01'8-000-0000
Permission is hereby granted to: FITNFSS TN MOT1..0N
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: , GUIDO PASSARELLI
465 LAKE Ave Sign
Total Value
:LAKE LUZERNE,NY 12846-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans &Specifications
2003-126 FITNESS IN MOTION
CHANGE EXISTING SIGN FROM A 8 SQ FT TO 24 SQ FT AS PER APPLICATION
$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 of Que sbury 1 T ursday,April 10, 2003
SIGNED BY for the Town of Queensbury.
Director of Building&CMe Enforcement
o�D
Fee Paid:
TOWN OF QUEENSBURY
742 Bay.itoad, Queensbury, NY 12804 Approved By:
JlPermit #:
(518) 761-8256 -4
SIGN PERMIT APPLICATION
RECU ED
THE FOLLOWING INFORMATION IS REQUIRED: A P R 0 1 2003
1. Detailed drawing or photo of sign. TOW14 OF QUEENS13URY
2. Plot plan of location of sign. BUILDfi%*AND CODE
3. Written consent of the owner of the building or lane
OWNER OF PROPERTY -A
ADDRESS �Q ! /G-'7�� TEL.
NAME OF APPLICANT
ADDRESS /T<�/( TEL. cJ'�r�4�
BUSINESS NAME IF DIFFERENT:
TYPE AND LOCATION
Check What Applies: Existing Permanent _ Projecting Sign
Temporary Nan-co i g Existing
Free-Standing all _ New
Location: Tax Map Number
Address
Proposed Setbacks from Property Line (front) / J (side) _
If sign is to be illuminated, please check appropriate box: C�Q
Internal ( j , External ( ) , Incadescent ( ) , Neon ( ) , Other ( ) V v-c
Size of Sign: Width ft. Length ft. 4 ca U�J \
Total Square Footage: _ C�) p
Sign Copy:
Color and Material, o Be Used: (J�� 1tG60 S�
Signature:
Circle One Applicant owner, contractor or agent.
I HEREBY AUTHORIZE APPLICANT TO PLACE A SIGN ON MY PROPERTY OR BUILDING.
Signature of Property Owner:
ORIGINAL-Office Copy COPY-Applicant
_ 7`__.._...�-- -APR O 1 2003 _ __
RECEIVED
APR 0 1 2003
7�eati, V�Loc, C�� TCBVVN OF QUEENSBURY
Bu CODE
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