2003-631 Hearing Center TOWN OF QUEENSBURY-
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development,"Building&Codes (518) 761-8256
BUILIIING PERMIT
Permit Number: P20030631 Application-Number:- A20030631
Tax Map No: 523400-296-012-0001-037-001-0000
Permission is hereby granted to: CrT.F,NS FAT,T,S TTOSPTTAT.MEDTCAT, OFFICE CF.
For property located at: 25 'WILLOWBR.00K Di
in the Town of Queensbury,to constru6 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
' Fr q a�
Ordinance. r, t , 4 ve of Corstructiori Value
Owner Address: SCHERNMRHORN'CONW:HOL-DI"- SigII
15F BIRDIE Dr =` Total Value
QVEENSBU;RY NY 128040000
Contractor or Builder's Name/'Address x i 4" ; Electrical Inspection Agency
K:D. WHEELER CUSTOM SIGNS �
16 RICHARDSON STREET
•OTTEENSBURY- NY
Plans&Specifications
2003-631 GLENS FALLS HOSPITAL THE HEARING CENTER THE REHABILITATION CENTER
40.69 SQ FT WALL SIGN AS PER APPLICATION`':
$82,00 PERMIT•FEE PAID,-THIS PERMIT EXPIRES:
(If a longer period is required,an application for au extension most e rixacie to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)'. o
Dated at the Town . 7777
Th r d August 21., 2003
SIGNED BY for the Toum of,Queensbury:
Director of Budding&Cod. e.En- rcement
I
TOWN OF QUEENSBURY Fee Paid:
742 Bay Road, Queensbury, NY 12804 Approved By:
518) 761-8256 Permit #: -631
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
ADDRESS -DR. TEL. -7q $-0 to
NAME OF APPLICANT
ADDRESS T TEL. -7q3-,Q(
BUSINESS NAME IF DIFFERENT: /AJ Orn-c- &(Snq
TYPE AND LOCATION
ErCheck What Applies: Existing Permanent X Projecting SignS
Temporary Non-conforming Existing
Free-Standing __ Wall X New AUG 0 4 2903
Location: Tax Map Number 1�.- i - 31.4 T0\N'N 10F C)UEENt4SO"
Address
Proposed Setbacks from Property Line (front) (side)
If sign is to be illuminated, please check appropriate box:
Internal External 00 , Incadescent Neon Other
Size of Sign: Width q3 '1 r--. Length _ 63
Total Square Footage:
Sign Copy: 4EX)S �_,LS 77i-C
As Pi
Color and Material To Be Used, '—Paa Abu.
Signature:
)
Circle One: QEycan7, owner, contractor or agent.
I HEREBY AUTHORIZE APPLICANT TO PLACE A SIGN ON MY PROPERTY OR BUILDING.
Signature of Property Owner: A__t6A
ORIGINAL-Office Copy COPY-Applicant
nvv a! v.r TrLu J•t J etA JLIIBA�ICIIIIUitlY P lil, Itu. 0 t,113 j[t j j
S C .H-:R -RME RH- 0 RN
CON- B: TRUCTION L . L .- C .
15Y BIRDIE DM" •QUESNSI Off,NEW TOM U04
(618)798-Q674 I M(618)793-9653
August 12,2003.
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Whooler.Custom Signs .
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^�31
16 n St
Qucensbury,N.Y. 12904
To'Whom It May PD1 0011,
1'}caso be.�vised Wh�eeler.Cstorm Signs has our permission to hmr g 2 wall signs on tlta
buiidin�lu�ated at 25-'W.iilow]Brook Rd,Quembury,and N.Y.
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