2001-146 North Country Sports Medicine, PLLC (71117-
TOWN OF QUEENSBURY
` 4T742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
O
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: p20010146 Application Number: a20010146
Tax Map No: 523400-099-000-0002-001-000-0000
Permission is hereby granted to: NORTH COUNTRY SPORTS MEDICINE, P.L.L.C.
For property located at: 751 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 Value
Owner Address: NIGRO COMPANIES Sign
20 CORPORTE WOODS Blvd Total Value
ALBANY,NY 12211
Contractor or Builder's Name/ Address Electrical Inspection Agency
MIKE BAIRD SIGNS
414 CORINTH ROAD
OUEENSBURY,NY
Plans &Specifications
2001-146 NORTH COUNTRY SPORTS MEDICINE
48 SQ FT WALL SIGN AS PER APPLICATION
$96.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Wednesday,April 09,2003
(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 u nsbu on o , ypril 09,2001
for the Town of Queensbury.
BY _ ��� Q ur3'•
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
g
APPLICATION FOR SIGN PERMIT" U
APR 0 9 200/
Application for a sign permit shall be submitted to 1N 1 iss
Inspector ector in duplicate in ink or typewritten. '4-&6NDOO 17"':
P P n? f:""
THE 'FOLLOWING"INFORMATION REQUIRED (1) Detailed drawing or plan, to
scale, showing .the area (size) and th'e lettering and/or pictorial
matter composing the sign (2) Plot plan showing it' s relation to nearby
buildings, structures, lot boundaries and any private or public streets
or highways (3) Written consent of the owner of the building or land.
All signs must have name plate attached giving sign permit number and
name and address of owner.1,. OWNER OF THE PROPERTY C1 \CS1
'a o Gs\ c .I. \e%, . . _ o0ff{
2. . ADDRESS \ ,\` N�1 'WIt�O5 TELEPHONE NO.��Vt . ' \ "
3." NAME OF APPLICANT �, �(1 c`, '► � M1 iR .l. .`--.C. -
rlArlp
4.. ADDRESS.
�.L.oe�Ja N4 1'&� TELEPHONE NO.10i3 \5l0
jr
5. LOCATION OF STRUCTURE OR LAND OF PROPOSED SIGN
Q.3-SIArnk, cit), Ciatuso.
6. . "SIZE OF THE SIGN . (Width) . 6, " ' Ft. " :" (Length)
Ft:.
7 If the. Sign is to be two faced give:the number of square feet of
each face . 4/ E Sq. :Ft.
8. If the Sign is to be Illuminated please check appropriate box:
Internal " (A , External ( ) , Incandescent ( ) , Neon ( ) , Other ( )
All illuminated signs shall be inspected and certified by the New
York Board of Fire Underwriters;
9. Type of, material used for construction of. Sign iC, I U Le xa n
10. If the Sign is to be attached to a building, please describe where'.
on the building the Sign is to be located and the distance from wall
SRAAear.
11 . Remarks or other information
Signature f app icant, please indicate
Date if owner, Contra tor or Agent
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TOWN OF L'EENSBURY Fee Paid: 1�. l )DDQ.
Q
�. . ° 742 Bay Road, Queensbury, NY 12804 Approved By:
(518) 761 8256 Permit #: / "/L/`o
SIGN PERMIT APPLICATION -� %i
APR 0 92001
THE FOLLOWING INFORMATION IS REQUIRED: 1:;0E'I/NopQu ," f�
BUILbINP�i�1LD ' �� V-
1. Detailed drawing or photo of sign. �. I)
2. Plot plan of location of sign.
3. Written consent of the owner of the building or land.
OWNER OF PROPERTY ` 1 h Yb Ee(IJ Esiait
ADDRESS ,26 Corp' e J Cook:s-Llud, C
A LI-o r-4 INA 0...J46.c TEL. /36 P lQ/
NAME OF APPLICANT 4/ol4A CUo»h'L% . ji„ fJ ntad/('//7e; /�/„L-�.
ADDRESS ?, 7 �/ Pr -�P<? 5/ J
i�,,,. /1 Agec,-y, � 'f /V,FOV TEL. 7)9- 9/5---
BUSINESS
NAME IF DIFFERENT:
TYPE AND LOCATION
Check What Applies: Existing — Permanent Projecting Sign __
Temporary _ Non-conforming Existing
Free-Standing Wall ✓ New ; T e--------
Location: Tax Map Number - ' ,.0-
...../
Address l
Proposed Setbacks from Property Line (front) (side)
If sign is to be illuminated, please check appropriate box:
Internal p() , External ( ) , Incadescent ( ) , Neon ( ) , Other ( )
Size of Sign: Width o ft. Length _ (9-. _ ft.
Total Square Footage: — . 5i H, II
Sign Copy: _. Orh (X)n rt1 , ' /i . 1 Ili' Se Sk&7z/A l
Color and Material To Be Used: A/Ci/h S/e 1/c(SSn //i i 7Gt -- YP621,W/b k
-/al.
Signature: /I-Circle
, ,! tgaibLC -,\
Circle One: Applic , owner, contractor r agent.
I HEREBY AUTHORIZE APPLICANT TO PLACE A SIGN ON MY PROPERTY OR BUILDING.
n / �
Signature of Property Owner: , �P(' H7�QC?hec
ORIGINAL-Office Copy COPY-Applicant
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DOUGLAS P. KIRPATRICK, M. D.
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RICHARD A. SAUNuERS.
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