2003-876 Ladies Workout Express TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20030876 Application Number: ' A20030876
Tax Map No: 523400-302-006-0001-054-000-0000
Permission is hereby granted to: LAT)TESWORKOUTEXPRESS
For property located at. 730 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. Tyke of Construction Value
Owner Address: DECOGLEN LP Sign
25 CORPORATE Cir Total Value
ALBANY, NY 12203
Contractor or Builder's Name Address Electrical Inspection Agency
Plans&Specifications
2003-876
3.6 5Q FT WALL SIGN AS PER PLOT PLAN SPECIFICATIONS
$72.00. PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday, October 22, 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 att 0
he Town say, October 2.2, 2003
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Ob
Fee Paid:
TOWN OF QUEENSBURY Approved By
742 Bay Road, Queensbury, NY 12804
Permit #:
(518) 761-8256
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 aC Co r_!26'C Tf_ cim)�_' /z2ca TEL. Lt. 0 051"1.
APPLICANT � A a � r
NAME OF APPL "Ec
ADDRESS TEL. 3-"(,' 3
BUSINESS NAME IF DIFFERENT: 12-
TYPE AND LOCATION
Check What Applies: Existing — Permanent — Projecting Sign
Temporary Non-conforming Existing
Free-Standing - Wall New
-4 .
Location: Tax Map Number 3 0 0
Address n�
1W,um"
Proposed Setbacks from Property Line (front)
If sign is to be illuminated, please check appropriate box:
Internal (External ) , Incadesce' nt Neon Other
Size of Sign: Width - \3 ft. Length ft* -
Total Square Footage: 66 11 00
Sign Copy: o,� v S
Color and Material To Be Used: A �L3 VV\_� LA_ L) M -eo,
Signature:
Circle 09,el 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
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