SIGN 2010-278 Blue Moose "Pig Roast" TOWN OF QUEENSBURY
742 Bay Road,Queensbury.NY 12804-5904 (518)761-8201
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. Community Development- Building&Codes (518)761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20100278-36921 Date Issued: Thursday, June 10, 2010
This is to certify that work requested to be done as shown by Permit Number P20100278-36921
has been completed.
Tax Map Number: 288.20-1-19
Location: 1300 State Route 9 Cn
vitt toP1
Owner: Double S Partners LLC
Applicant: Double S Partners LLC
This structure may be occupied as a:
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy 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 by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
4c$1 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20100278 Application Number: A20100278
Tax Map No: 523400-288-020-0001-019-000-0000
Permission is hereby granted to: DOUBLE S PARTNERS, LLC
For property located at: 1300 STA I F.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: DOUBLE S PARTNERS,LLC
14 LONE TREE LOOP Temporary Sign
DIAMOND POINT,NY 12824-0000 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2010-278 Blue Moose Tavern
temp sign to be displayed for 8 days-June 5th to June 13th to read "PIG ROAST$10 MILLER LIGHT
SPECIALS SILENT FURY BAND SAT 6-10 PM"
$10.00 PERMIT FEE PAID-THIS PERMIT EXPIRES:
(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 o nsb a Tb ride, ,June 10,2010
SIGNED BY cw„ 4 for the Town of Queensbury.
Director of Building&Code Enforcement
OFFICE USE ONLY r
TAX tAP N0. � � -•
PERMIT NO.��0f/DEPOSIT: On fit�,
APPROVALS: ZONING: TOWN CLERK: PERMIT FEE: 4 � `
TEMPORARY SIGN PERMIT APPLICATION:
Applicant Information Business Information
Name: WaI I, /(!. C,L4) Contact Person: N0--:4 s e I j, X✓ v�,�f�
Address: Lam- J t L r ,,L,t Address: 13,E S j
.-lL-t„,0 4, v7,1,(_ ` a. -e Gear l �f
Phone No. Sl �., Y•.-- aA 9 Phone No. Ste/ – 6 (1— ), c-1 )
Specific Information about your sign:
✓ What is the date for placement of your sign? Atito7 4-0�
✓ What is the date for removal of your sign?cikte J 15.t-L-1
✓ How many days will your sign be displayed'
i S
✓ Indicate exact address for placement of sign: L 3 o to SXy ,L
— 1.-44/4 -e- — Le- 14-129 r5-224,-r /651--
✓ Indicate tax map number for your parcel: a2 w , J I 17
✓ Indicate the type of sign you will display:
Wall Sign (cannot exceed 32 square feet)
Freestanding Sign (cannot exceed 16 square feet)
✓ What are the dimensions of the sign? 3 sq. ft.
✓ Indicate in words what your sign will say: _e,�
1; > i ,t r �� li 4
I(, by -1— f - 1 1'? c - -
Note: Failure to Remove sign at expiration may result in forfeiture of deposit as per the Code
of the Town of Queensbury, Section.14G, Subsection 140-4 (Local Law No. 11, 1993)
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 Ordinance, and all other laws
pertaining to the proposed work shall be complied with, whether specified or noted, and that such work is
authorized by the owner. a
APPLICANT SIGNATURE: DATE: v
I hereby authorize the applicant to place a sign on my property or building:
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