SIGN 2011-261 Snack Shack TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20110261 Date Issued: Wednesday, June 22, 2011
This is to certify that work requested to be done as shown by.Permit Number P20110261
has been completed.
Tax Map Number: 523400-295-008-0001-002-000-0000
Location: 1161 STATE ROUTE 9
Owner: MITCHELL A COHEN
Applicant: THE SNACK SHACK. .
This structure may be occupied as a:
Sign
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the
property owner of the responsibility for compliance with Site Plan,
Variance, or other issues and conditions as a result of approvals b the
pp y Director of Building&trAde E rcelnent
Planning Board or Zoning Board of Appeals.
TOWN-OF QUEENSBURY
G 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20110261 Application Number: A20110261
Tax Map No: 523400-295-008-0001-002-000-0000
Permission is hereby granted to: THE SNACK SHACK
For property located at: 1161 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: MUCHELL A COHEN
PO BOX 21 Sign
LAKE GEORGE,NY 12845 Total value
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2011-261
96 sq ft wall sign-THE SNACK SHACK
$289.00 PERMIT.FEE PAID-THIS PERMIT EXPIRES:. Friday,June 22,2012
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the To n of eens ed V5 y,June.22,2011
SIGNED BY ��� for the Town of Queensbury.
Director of Building&Code Enforcement
_-__------ _-- ----------------------------------------"-- __--------_------
7�C7�_ OFFICE USE ONLY ' JUN 0 3
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� I 3tS _
TAX MAP NO. PERMIT NO. '—� PERMIT FEE
I
OF QUEENSBURY
APPROVALS: DEPOSIT UILDING& CODS$_____
---- ------ ----------- ----
SIGN PERMIT APPLICATION
A permit must be obtained before installation of your permanent sign. All applicants'spaces on this application must
be completed and must appear on the application form. r'1
OWNER:�GI,Y�►ce 0,66-tN INSTALLER/BUILDER: �PUh Cry +
ADDRESS: lotIRK�fwac br- &f m,,by( ( ADDRESS: G\e", LC, Ke _
PHONE NOS.1 �� q SS'(e PHONE NOS. (�5tb)
LOCATION OF PROPOSED INSTALLATION:(LEGAL ADDRESS) 1 '�CI RMAe 41
BUSINESS COMPLEX/PLAZA/MALL NAME:
BUSINESS NAME: -111%C Sv►4XX 5h4C,9, c `i
CONTACT PERSON FOR SIGN CODE COMPLIANCE: Me-b IA`•t k PHONE: (5,1 111 " Z2-7-
TYPE OF SIGN PROPOSED: a_.ieestanding ,wall _awning _projecting
IF SIGN IS TO BE ILLUMINATED,PLEASE INDICATE: r internal _External _Incandescent Neon Other
DO SIGNS CURRENTLY EXIST ON THE PROPERTY? Yes _No
IF YES,LIST ALL EXISTINGSIGNAGE: T-rIt f[oOMa�na% � '`5)�►-�=
The application creates a change _)k, New
in the following existing site Change in number of signs from to
conditions(fill in all applicable Change in setback for sign from to
spaces): Change in size of sign from to
Change in height of sign from to
Change of wordinglcopy from: to:
Sign Wording/Copy: 1N%t,5ncCK -Gk<,c.►'C T-fc. creme 6Ct•�u, Q442ck, �U�5%�t1xS4t
Sign size: Length__x Width _ =Total Sg.ft _ Sign Height(freestanding sig[n)._
Color and Material to be used:_ � 124cy—qr,A� I`31c c K
✓ Provide.2 copies of a scaled drawing or surveyed plot plan with the following information:
.o Location Of sign(walls signs: drawing of the fagade
the sign will be located on,indicate sign on fagade)
o Height of freestanding sign QUESTIONS? CALL 76141256 OR EMAIL
o Depth of projecting sign codes(a)-gueensbury.net
o Distances from front and side property lines. VISIT OUR WEBSITE FOR MORE INFORMATION
✓ Provide 2 drawings or photos of sign design. www.ciueensbury.net
✓ Provide Applicant and Owner's signature(permission y
for placement of sign on the property or building).
Declaration:. To the best of my knowledge,the statements contained in the application,together with the plans and
specifications submitted,are a true and complete statement of all proposed work to be done on the described premises and that
all provisions of the Zoning Ordin and all.other laws pertaining to the proposed work shall be complied with,whether
specified or noted,and that s rk is a. orized b the owner.
(APPLICANT SIGNATURE:_ DATE:
I hereby authorize the applicant ce on my property or building. ] )
OWNER SIGNATURE: DATE:
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Town o ueensbu� Community Development Office 742 Bat Road, ueensbu N] 12804
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