2001-609 Champion Sign Craft TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20010609 Application Number: A20010609
Tax Map No: 523400-296-017-0001-051-000-0000
Permission is hereby granted to: CHAMPION SIGN CRAFT
For property located at: 876 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. Type of Construction Value
Owner Address: ALEXANDER POTENZA Sign
FRANK BORK TotalnValue
403 GLEN St
GLENS FALLS,NY 12801
Contractor or Builder's Name/ Address Electrical Inspection Agency
Plans &Specifications
2001-609 CHAMPION SIGN CRAFT
25 SQ FT WALL SIGN AS PER APPLICATION
(SIGN CRAFT/PHONE#& LIST OF SERVICES)
$50.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Friday,August 23,2002
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the T Quee bu ; T ursday,August 23,2001
SIGNED BY C for the Town of Queensbury.
Director of Buildin &Co Enforcement
MS ,Q/V Fee Paid: L)
. TOWN OF QL�EENSBLIRY
S
•• 742 Bay Road, Queensbury, NY 12804 Approved By:
(518) 761-8256 Permit #: f /--- C1
SIGN PERMIT APPLICATION 1
RECEIVED
THE FOLLOWING INFORMATION IS REQUIRED: AUG p 9 2.001
1. Detailed drawing or photo of sign.
2. Plot plan of location of sign. T BUNOFQAND CODEY
3. Written consent of the owner Hof 1tthe building or land.
OWNER OF PROPERTY J\/()iJ Pa c t jiA
ADDRESS C[C)3 Gs -0 s17 , 6. ,1 , TEL.
NAME OF APPLICANT 1K (t_L g 12 7' 7t:5-50
ADDRESS jam Qj uit. C .TES INYI-(-4 TEL. 7 `t 7.--qdd1
BUSINESS NAME IF DIFFERENT: _ c4.LAYh ) df' c j6.i C(L ` T
TYPE AND LOCATION
Check What Applies: Existing __ Permanent Projecting Sign __
Temporary Non-conforming Existing __
Free-Standing ^— Wall New __
Location: Tax Map Number - -
Address
Proposed Setbacks from Property Line (front) (side)
If sign is to be illuminated, please check appropriate box:
Internal (4 ) , External ( ) , Incadescent ( ) , Neon ( ) , Other ( )
�
Size of Sign: Width 3 1I . Length I O ft.
Total Square Footage: Z5
Sign Copy: __ Dt60 c62-A 1- /P)4of i LL$t Ok- 56/1/l .f
Color and Material To e ed: L XApJ w'/ulrl yc Ge"(
Signature: ek-k--.( cc. g,„...„ ,
Circl One: scan , owner, contractor or agent.
I HEREBY AUTHORIZE APPLICANT TO PLACE A SIGN,ON MY PROPERTY OR BUILDING.
Signature of Property Owner: `' /jyt12- , ()""
v
ORIGINAL-Office Copy COPY-Applicant
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