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2012-255 00/4 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20120255 Application Number: A20120255 Tax Map No: 523400-297-008-0001-026-000-0000 Permission is hereby granted to: 543 OUEENSBURY AVE.. LLC For property located at: 543 QUEENSBURY Ave 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: 543 QUEENSBURY AVE., LLC Sign 543 QUEENSBURY Ave Total value SUITE 1 QUEENSBURY,NY 12804-0000 Contractor or Builder's Name/Address Electrical Inspection Agency MIKE BAIRD 792-6261 414 CORINTH Rd OUEENSBURY NY 12804-0000 Plans&Specifications 2012-255 SIGN -Document Solutions of the North Country 10 sq ft free-standing sign $30.00 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 uee sbury• iri , ne 22, 2012 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement • ��/� /�/ /1� /O�FFICE USE ONLY 1.7-C) � • I • I f`�PCT'l /OS V I TAX MAP NO.� / MIT NO. -a5 PERMIT FEE d Date .a P : APPROVALS: DEPOSIT i • 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: 1;1`9c+,olGFur -co-1"412.`f INSTALLER/BUILDER: /2/ 3/4I(2 ADDRESS: S Y Gt v gR—Y Or- ADDRESS: PHONE NOS. c t & - 7°: 2 -`i 1 0 PHONE NOS. LOCATION OF PROPOSED INSTALLATION:(LEGAL ADDRESS) 54-01; BUSINESS COMPLEX I PLAZA/MALL NAME: BUSINESS NAME: 1:;''C.- r►w-4- TTGJJ6S- C ( r*€ )04(2-11A Ct'✓„'TQ.I - ; CONTACT PERSON FOR SIGN CODE COMPLIANCE: Rt CV: C-LL P PHONE: S7 S—- iK1 2 ci t(it TYPE OF SIGN PROPOSED: X freestanding _wall _awning _projecting IF SIGN IS TO BE ILLUMINATED,PLEASE INDICATE: _Internal _External _Incandescent _Neon _Other DO SIGNS CURRENTLY EXIST ON THE PROPERTY? Yes !No IF YES,LIST ALL EXISTING SIGNAGE: The application creates a change X. 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 wording/copy from: to: Sign Wording/Copy: D«v eft Thrt, r-714 a rfj.)" Sign size: Length 7 'z Width &/ =Total Sq. ft. it Sign Height(freestanding sign): 5 Color and Material to be used: ✓ Provide 2 copies of a scaled drawing or surveyed plot plan with the following information: o Location of sign(walls signs: drawing of the facade the sign will be located on,indicate sign on façade) o Height of freestanding sign QUESTIONS? CALL 761-8256 OR EMAIL o Depth of projecting sign codesaqueensbury.net o Distances from front and side property lines. VISIT OUR WEBSITE FOR MORE INFORMATION ✓ 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 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 wo is authorized by the owner. / APPLICANT SIGNATURE: I /�� / • DATE: / 2-// I hereby authorize the applicant to lace sig on pe or building. OWNER SIGNATURE: ) _ i DATE: Town of Queensbury• Community Development Office - 742 Bay Road, Queensbury, NY 12804 . Bf ,A6 •A5 • _ _ t, - LL', 7. N � .065. - SWIS : 523400 Print Key : 297 . 8-1-26 Comment : Photo ` JAN+•kr MIKE BA I RD SIGNS PHONE NO. : 518 792 6241 May. 08 2012 12:37PM P01 • • •i+ •• i I.,: I. 71 ,\,./.. .... ''''.l 1. - 'I 1 � ( -hjiiu� , Ii \ � ''''1>1.„:0,:.',1..,..,/; (c.)) :pis Ails'it i : (L) Airy JEil. 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