2002-410 Sylvan Learning Center TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 ,(518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20020410 Application Number: A20020410
Tax Map No: 523400-296-013-0001-018-000-0000
Permission is hereby granted to: SYLVAN LF,ARNINCT CF,NTF,R
For property located at: 959 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 filled
and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning .
Ordinance. ! Type of Construction• Value
Owner Address: GUIDO PASSARELLLI
465 LAKE'Ave Sign
Total value
LAKE LUZERNE,NY 12846
Contractor or Builder's Name/Address` i :Electrical Inspection Agency
Plans&Specifications
2002-410 SYLVAN LEARNING CENTER
56 SQ FT WALL SIGN AS PER APPLICATION
$112.00 PERMIT-FEE PAID=THIS PERMIT EXPIRES:
(If a longer period is required,an application for an extension musi be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.) '
Dated at the Taw' of Qu nsb 4s y 28,2002
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Fee .Paid: Ad
TOWN OF QUEENSBURY
742 Bay Road, Queensbury, NY 12804 Approved By:
Permit #: Ll
(518) 761-8256
SIGN PERMIT APPLICATION
THE FOLLOWING INFORMATION IS REQUIRED:
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0
I Detailed drawing or photo of sign. 10, kv
2. Plot plan of location of sign. 0"
Q, 8001?
3. Written consent of the owner of the building or land.
X OWNER OF PROPERTY
ADDRESS TEL.
NAME OF APPLICANT C—ea -1-e
ADDRESS 6/1
Ila
491�V,11) (2-
TEL.
BUSINESS NAME IF DIFFERENT:
TYPE AND LOCATION
Check What Applies: , Existing Permanent Projecting Sign
Temporary Non-conforming Existing
Free-Standing Wall �'New .
Location: Tax Map Number
Address
Proposed Setbacks from Property Line (front) (side}
If sign is to be illuminated, please check appropriate box:
Internal (- , External Incadescent Neon Other
rl
Size of Sign: Width ft. Length ft.
Total Square Footage: 4I ,4
Sign Copy: 1/ 6t t4 -20_,P—vt t VT
Color and 'Material To Be Used. / q A) 1,44
—
Signature: ql ( lie_
.Circle On Applicant, weer, contractor or agent.
ON My
I HEREBY AUTHORIZE SIGN
PLACE A SIGN ON MY PROPERTY OR BUILDING.
Signature of Property Owner:
ORIGINAL-Office Copy COPY-Applicant
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SYLVA N �
y LEARNING CENTER
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