2000-632 I love My Heart TOWN OF QUEENSBURY
742 Bay Road, Queensbury, IVY 12804-5902 (518) 761 -8201
Community Development - Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20000632 AnnIleation Number: A20000632
Tax Map No: 523400-070-000- 001 -009-000-0000
Permission is hereby granted to: I LOVE MY HEART
Owner of property located at: 959 STATE ROUTE 9
in the Town of Queensbury, to construct or place a Sign
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.
Owner Address: G IDO PASSARELLI
465 LAKE Ave
LAKE LUZERNE, NY 12846
Contractor or Buildefs Name 1 Address Electrical Inspection Agency
Type of Construction: Sign Value : $
Plans & Specifications
2000-632
3XIT WALL SIGN-36 SQ.`
$72.00 PERMIT FEE PAID - THIS PERMIT EXPIRES* Sunday, August 25, 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 Town f Que sbu F Ida u ust 25, 2000
SIGNED BY for the Town of Queensbury.
Director of Building & de E rcement
y Fee paid : � 0 0
_ "I"OWN OF QUEENSBURY
Approved By :
742 Bay Road, Queensbury, NY 128()4
Permit # : aC00 ' !c 3.;1
(518) 761-8256
SIGN PERMIT APPLICATION
THE FOLLOWING INFORMATION IS REQUIRED :
1 . Detailed drawing or photo of sign , AUG 2 2 2000
2 , Plot plan of location of sign .
3 . Written consent of the owner of the building or land .
OWNER OF PROPERTY ta+ � � �+'F I � S 1 " C-
ADDRESS _ 76 / # ['�� �r ---- TEL .
NAME OF APPLICANT
ADDRESS 400-F7,. r'1r'► r4 e�t.904 0 TEL .
BUSINESS NAME IF DIFFERENT : F-
TYPE AND LOCATION
Check What Applies : Existing _ Permanent Projecting Sign
Temporary Non- conforming Existing
Free - Standing Wall v. ' New
Location : Tax Map Number
Address —
Proposed Setbacks from Property Line ( front ) � ( side )
If sign is to be illuminated , please check appropriate box :
In . ernsx External
t Incadescent ( ) > Neon ( ) , Other ( }
('�} , ( ) ,
Size of Sign : Width ft . Length _12 T ft .
Total Square Footage : �a
or
Sign Copy :
Color and Material To Be Used :
Signature : 43
Circle One : Applicant , owner , contractor agent .
I HEREBY AUTHORIZE APPLICANT TO PLACE A SI+CN ON MY PROPERTY OR BUILDING_
Signature of property Owner:
ORIGINAL-Office Copy COPY-Applicant
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