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2011-528 gjillkmpak TOWN OFQ UEENSBURY
742 BayRoad,Queensbury,NY 12804-5902 (518)761-8201
Q �Y,
Community Development- Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20110528 Date Issued: Monday, November 07, 2011
This is to certify that work requested to be done as shown by Permit Number P20110528
has been completed.
Tax Map Number: 523400-289-015-0001-001-001-0000
Location: 21 BLIND ROCK Rd
Owner: MARYLEE GOSLINE
Applicant: MARYLEE GOSLINE
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 ( i /
property owner of the responsibility for compliance with Site Plan, , y4,.12
Variance, or other issuesand
conditions as a result of approvals by the Director of Building&Code nforce ent
Planning Board or Zoning Board of Appeals.
1
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20110528 Application Number: A20110528
Tax Map No: 523400-289-015-0001-001-001-0000
Permission is hereby granted to: MARYLEE GOSLINE
For property located at: 21 BLIND ROCK Rd
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: MARYLEE GOSLINE
25 BLIND ROCK Rd Sign
QUEENSBURY,NY 12804-0000 Tota Value
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2011-528
12 sq ft sign to read "TAILS WAG INN"
$36.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,November 07,2012
(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 ofensb ; , ovember 07,2011
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
4EOFFICE USlE NLY
RMIT NO.
0)-MIT
APPROVALS: DEPOSIT
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.
OWNER:J GV_ 7L.e(7 t �^yr INSTALLER/BUILDER: Pes+
ADDRESS: l J I td JO c L /,i • ADDRESS: 1100 D�f /n 05,-.,.` c,Au-r/U`i(1/51PHONE NOS._5(8 C g - �/ TL '/- . PHONE NOS
.✓ g
18"77'S z 3
LOCATION OF PROPOSED INSTALLATION:(LEGAL ADDRESS) c I p t a ci Wor,IL (J-
BUSINESS COMPLEX/PLAZA/MALL NAME: FF" — — —
BUSINESS NAME: T/1/l S t-1/A h (QA/
CONTACT PERSON FOR SIGN CODE COMPLIANCE: /tN.4 Wes _PHONE:_7(0- 5-283 $ tit
TYPE OF SIGN PROPOSED: cfreestanding _wall awning projecting
IF SIGN IS TO BE ILLUMINATED,PLEASE INDICATE: _Internal _External _Incandescent _Neon _Other
DO SIGNS CURRENTLY EXIST ON THE PROPERTY? _Yes X' No
IF YES,LIST ALL EXISTING SIGNAGE:
The application creates a change 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
spate __Change in size of sign from to
Change in height of sign from to
Changed WolnlingVeapy from: _-- ------to:_ --
Sign Wlydil opy: (A'c,S t-' 6 1 Nt-/ ---- - -- -
Sign size: Lngth .3 x Width_ L/
e =Total Sq.ft. /Z Sign Height(freestanding sign): 6
Color find Material tirebe used: PUC /14A7�rc/"It r 6ree, cuC.
✓ Provide 2 Daisies of a scaled drawing or surveyed plot plan with the following information:
o Location of sign(walls signs: drawing of the facade
thit*n will be located on,indicate sign on facade)
o }fight of freestanding sign QUESTIONS? CALL 761-8256 OR EMAIL
o Depth of projecting sign codesCo?aueensburv.net
o Distances from front and side property lines. VISIT OUR WEBSITE FOR MORE INFORMATION
I Provide 2 drawings or photos of sign design. www.queensburv.net
✓ Provide Applicant and Owner's signature(permission
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 ptOVI$l ns of the Zoning Ordinance,and all other laws pertaining to the proposed work shall be complied with,whether
spedlbd Ormoted,and that such work is authorized by the owner.
APPLICANT SIGNATURE:�+— DATE: /D/6`//
I hereby authorize the applicant to place a '-n on my property or building.
OWNER SIGNATURE �� DATE: l U_ _ ((
Town of:Queer sbu t/niunity Development Office • 742 Bary Road, Queensbury, NY 12804
oQ
r
r
4' 0"
21 Sign is made of 1/2" PVC material.
Dark Green background w/vinyl letters.
TAILS Single sided sign.
INN M
DAYCARE dait
AND Layouts by:
.,i BOARDING
Otttgiis Point Iticst
1100 Dix Avenue
Hudson Falls, NY 12839
518.747.5283
Tails Wag Inn sign placement for
,rN1 1 c
21 Blind Rock Rdvor
F
-(1) k\)
Z
© ' - \
15
-TA- pli
- .
1
T'
<,..< ,,in
1- .
BOCK RD
0-.1"
Sign to be place just over 15'
from from and side property lines.