2003-917 Empire Wireless TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20030917 Application Number: A20030917
Tax Map No: 523400-302-006-0001-055-000-0000
Permission is Hereby granted to: F,MWRF,WTRFT FS,S
For property located at: 724 GLEN St
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 Vain
Owner Address: MARY JANE CANALE Sign
28 FOX HOLLOW Ln Total Value
QUEENSBURY,NY 12804
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2003-917 EMPIRE WIRELESS
21 SQ FT FREE STANDING SIGN AS PER APPLICATION
$42.00 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 Town f;�O�e-,,sjbury- 4We s y, November 19, 2003
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
TOWN OF QUEENSBURY Fee Paid:
742 Bay Road, Queensbury, NY 12804 Approved By:
Ir7
(518) 761-8256 Permit #: <:ko 91 1
SIGN PERMIT APPLICATION
THE FOLLOWING INFORMATION IS REQUIRED:_ RECEIVED
%//I. Detailed' drawing or photo of sign. 0-CT 3 0 2003
V2. Plot plan of location of sign.
3. Written consent of the owner of the building or land. TOWN OF QUEENSBURY
BUILDING AND CODE
OWNER OF PROPERTY
ADDRESS TEL. �13 -0035
NAME OF APPLICANT L� Ak R -rY
TEL. 4t
P P Cp i S- 6,5-450
ADDRESS '7 q
BUSINESS NAME IF DIFFERENT: aWe- C6k;
TYPE AND LOCATION
Check What Applies: Existing Permanent V Projecting Sign
Temporary Non;Ronforming Existing
Free-Standing Wall New
Location: Tax Map Number
Address
Rroposed Setbacks from Property Line (front) (side)
If sign is to be illuminated, please check appropriate box: i
Internal (1/, External Incadescent Neon Other
Size of Sign: Width -7 ft. Length ft.
Total Square Footage:
Sign Copy:
Color and Material To Be Used: 4,V C46 `AM1VyU<,&V7_
Signature:
Circle—One: (:2�ican owner, contractor or agent.
I HEREBY AUTHORIZE APPLICANT TO PfACE'A SI5k1_/ MY . 'PERTY OR BUILDING.
Signature of Property Owner:
ORIGINAL-Office Copy COPY-Applicant
MAILING: SHOWROOM:
. 7
P.O. Box 332 • Glens Falls,NY 12801 k-Main Street.• Queensbury,NY 12804
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