2003-419 Glens Falls Hospital and North Country Sports TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20030419 Application Number: A20030419
Tax Map No: 523400-296-012-0001-037-00 1-0000
Permission is hereby granted to: BAYBROOK PROFESSIONAL PARK
For property located at: 25 WILLOWBROOK Dr
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. I
Type of Construction Value
Owner Address: SCHERMERHORN COMM.HQLDI Sign
15F BIRDIE Dr Total Value
QUEENSBURY,NY 12804-0000
Contractor or Builder's Name j Address Electrical Inspection Agency
K.D. WHEELER CUSTOM SIGNS
16 RICHARDSON STREET
QUEENSBURY,NY
Plans&Specifications
2003-419 BAYBROOK PROFESSIONAL PARK
64 SQ FT FREE STANDING SIGN(GLENS FALLS HOSPITAL AND NORTH COUNTRY SPORTS
MEDICINE.
$128.00 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 To o ueens ry; Tilesday,June 17,2003
SIGNED BY for the Town of Queensbury.
Director of Building Code nforcement .
TOWN OF QUEENSBURY Fee Paid:
742 Bay Road, Queensbury, NY 12804 Approved By:
(518) 761-8256 Permit #: (03-L41q
SIGN PERMIT APPLICATION
siv
THE FOLLOWING INFORMATION IS REQUIRED: Rvf_4 "
I Detailed drawing or photo of sign. Oz.
2. Plot plan of location of sign.
,\PJTA or 00V:
3. Written consent of the owner of the building or l and.l()
OWNER OF PROPERTY \SC,14Ep 4E pop_k� CoHtjee LL I?-
ADDRESS 15f'-7 (DUEEkJS8L(eV MV 12-gg4TEL.
f FL 6(61�
NAME OF APPLICANT
ADDRESS AQ JZ-1CWAP-1>&Q3 &T, QUE-C-t3SSUP-V M /286
I y f i TEL.l
BUSINESS NAME IF DIFFERENT:
TYPE AND LOCATION
Check What Applies: Existing Permanent Projecting Sign
Temporary Non-conforming Existing
Free-Standing v Wall New
Location: Tax Map Number,?96.1� - 1 3.1
Address __a5 -
Proposed Setbacks from Property Line (front) (side)
If sign is to be illuminated, please check appropriate box:
Internal ( ), External (/) , Incadescent ( ) , Neon Other
Size of Sign: Width - 4 ft. Length _ J(p ft.
Total Square Footage: y -6-4
Sign Copy: -GI-e0s CoLk� y 'S'P62TS
Color and Material To Be Used:
141>1A
Signature:
Circle One: _ plicant,. owner, contractor or agent.
I HEREBY AUTHORIZE APPLICANT TO PLACE A SIGN ON MY PROPERTY OR BUILDING.
Signature of Property Owner:
A—A
ORIGINAL-Office Copy COPY-Applicant
War. gin; County �/24f02
Real Property Tax Agency
Tax Map Change Form
unicipality : 'Town of Queensbury Section 296.12 Block. 1 Lot 31
Formerly Section '60 Block 2 Lot p/o 4
Section 296.12 Block I Lot 32
Formerly Section 60 Block 2 Lot p o 4
Section 296.12 Block 1 Lot 37' .
Formerly Section 60 Block 2 Lot 'p/o 4
cantor Grantee Guido Passarelli
Liber Page Deed Recorded
ascription of work performed Parcels,296.12-1-31 & 32 merged into parcel
296,12-1-37 (by owners request dated 9/3/02)�and deleted from tax map.
Acreage for parcel 296.12-1-37. revised to 5.20, road frontage revised to 693.52' and
Coordinate Locator revised to E-717,112 N-1,644,715
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36.40
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cta} 34
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Queensbu:y, N.Y. 128011
F,c: a7.igonsr for Baybeuuk F rofies:iional i"aa rk
Dear Holly,
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