2003-632 North Country Sports Medicine TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY.12804-5902 (518)761-8201 .
Community Development=Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20030632 Application Number: A20036632
Tax Map No: 523400-296-012-0001-037-001-0000
Permission is hereby granted to: NORT14 COT JNTRY SPORTS M-FDTCINF._ PLT,C
Vor property located at: 25 WILLOWBROOK Dr r
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: SCHERMERHOR_ N_ COMM. H_ OLD_ I
'15F BIRDIE Dr Sign
Total Value
QUEENSBURY,_NY J 2804=0000 __ _ . .
Contractor or Buildees Name/Address Electrical Inspection Agency
K.D. WHEELER CUSTOM SIGNS . ..
16 RICHARDSON STREET
OI JEENSBURY. NY
Plans&Specifications
2003-632 NORTH COUNTRY SPORTS'MEDICINE, PLLC
40.69 SQ FT WALL SIGN AS PER APPLICATION
$82.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,August 21,2004
(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 u nsh ugust 21,2003
SIGNEDBY Mp
for the Town of Queensbury.
Directorof Building&Code Eent
TOWN OF QUEENSBURY Fee Paid:
742 Bay Road, Queensbury, NY 12804 Approved By:
Permit #: 45
r)- 3..),
(518) 761-8256 �
SIGN PERMIT APPLICATION
THE FOLLOWING INFORMATION IS REQUIRED: RECOVED
1. Detailed drawing or photo of sign. AUG o 4 2003
2. Plot plan of location of sign.
3. Written consent of the owner of the building or la
IYOWN OF QUEEt4SBURY
mill DING AND CODE
OWNER OF PROPERTY C4 H H e-r-C I A
ADDRESS iI r fSP-DiC kAe3G U E aos au_(2,y TEL.
NAME OF APPLICANT L 1-y
ADDRESS .16 TEL. Y3
BUSINESS NAME IF DIFFERENT:
TYPE AND LOCATION
Check What Applies: Existing Permanent X Projecting Sign
Temporary Non-conforming Existing
- Free-Standing Wall ;< New _X
Location: Tax Map
Address e 0(,1,C_
Proposed Setbacks from Property Line (front) (side)
If sign is to be illuminated, please check appropriate box:
Internal ( ) , External (,K), Incadescent ( ) , Neon Other
Size of Sign: Width 63 tk. Length 93 _er.
Total Square Footage: rf
Sign Copy:
— Qe771 CQUA17"I'lZ 'S36of-Ts 19fb1C1AJ6 7)1_kL
Color and Material To Be Used, '2>A,?_k, C_aCF_F&3 9 /4DU
Signature:
Circle O'ne_- AE�ca_n-l-,,, 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
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15FBIRDIE DftTVE ,•QIJEENSBLTRY,NEW YORK 128Q4
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.August 12,'2Q03'
TOWN OF QUEENSBURY
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PLANNING OFFICE �- :`
Wheeler Custom Signs 2
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E. 16 Richardson St ` a ;:-
:r Quee sbury;-N Y '12804:` - s.
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`` -.To Whom:It*y Concern, e-' _.
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Please be advised Wheeler Customs Signs has our permission to hang 2 wall signs.on the {
buliding located at 25 W low Brook Rd, ,ueensb, i::an`d N Y N
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