5887 Convenient Food Mart Plaza BUILDING PERMIT
TOWN OF QUEENSBURY
No. 5887
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Convenient Food Mart Plaza
lessee o
O97Sff9OEi*of property located at south side Quaker Road Street, Road or Ave.
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in the Town of Queensbury,To Construct or place a Temporary Sign at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. c1
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1. OWNER'S Address is O
Walter Dombek O
Bolton Road
Lake George, New York
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2. CONTRACTOR or BUILDER'S Name ri
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3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
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5. ARCHITECT'S Address -
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6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( )
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7. PLANS and Specifications fi
Temporary sign 5 'x10 ' free-standing per sketch and 7y
No. application submitted for the' period 6-19-79 to 7-19-79 .
COPY: CONVENIENT FOOD MART PLAZA C
8. Proposed Use
Advertising
$25. 00 Deposit
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25. 00 July 19 19 79
$ PERMIT FEE PAID —THIS PERMIT EXPIRES � ..
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the 0
town of Queensbury before the expiration date.)
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Dated at the Town of Queensbury this 18th Day of June 19 79
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SIGNED BY Q �� for the Town of Queensbury LQ
Builg and Zoning Inspector e;
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TOWN OF;:QUEENSBURY
TOWN OF QUEENSBURY
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APPLICATION FOR SIGN PERMIT utrp
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A M P.M.
Application fora sign permit shall be submitted to thq*atpgI2�3����I9.
Inspector in duplicate in ink or typewritten. � �
THE FOLLOWING'``INFORMATION REQUIRED: (1) Detailed drawing or plan, to
,scale, showing the area (size) and the lettering and/or pictorial 0
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 Lia(ie_v 0 1j 'o -ek-
2. ADDRESS, /��I f2� L 0,-k _ CKa A _ TELEPHONE NO.
3. NAME OF APPLICANT C
4. ADDRESS . ()u,,,,/„ {i(j rci Xa c TELEPHONE NO.
5. LOCATION OF STRUCTURE OR LAND OF. PROPOSED SIGN 6), „,k2.4 a_oa 1
6. SIZE OF THE SIGN (Width) 5- Ft.Ft. (Length) 10 Ft.
7. If the Sign is to be two faced give the number of square feet of
each face 3-0 Sq. Ft.
8. If the Sign is to be Illuminated please check appropriate box:
Internal \(' ) , 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 (rts4
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10. If the Sign is to be attached to a building, please describe where
on the buildint9 the Sign is to b located and the distance from wall
11. Remarks or other information 0
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�u u. IPI 197 9 Si natur applicant, leas indicate
Date if owner, Contractor or
't. ;:AC..£ DETAILS —STANDARD 5
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PLOT PLAN
ScalerI
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110 -00>A
117411211121.11411111
Less than 30' req'd Rear. -Set-back (81to 12'actual)
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PROPOS",„„.,,_,, e,..,,..4- -,4,„eci* N , T r
STRLG •TION f�.
,{,�•.{/}J^,t r- - onvenien't .F_.•,d.Mart & Offices - Exist. Bldg - ;',
CO e22-J" a ne sbury 'ax Map No. 59, Block 5, Lot 2 = ;
. ", Walte r,-Dombek - owner .
GEORGE- KUROSAKA. .1R_.
CONSULTING ENGINEER
1t' `, 206 GLEN STREET
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�I•Is Fe,LZSi N.Xe 1.280Z • 19
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