2014-042 0.14 TOWN OF QUEENSBURY
1742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
1
Community Development - Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20140042 Application Number: A20140042
Tax Map No: 523400-301-008-0001-012-000-0000
Permission is hereby granted to: OUEENSBURY FAMILY DENTISTRY
For property located at: 453 DIXON Rd BLDG 3
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: SDC EVERGREEN, LLC Sign
453 DIXON Rd BLDG 1 Total Value
QUEENSBURY NY 12804-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
SAXTON SIGN CORP.
518-732-7704 EXT 102
1320 STATE ROUTE 9
CASTLETON NY 12033-0000
Plans&Specifications
2014 042 Queensbury Family Denstistry
SIGN wall sign 18.25 sq ft(36" x 73")
$54.00 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 f Que sbu ;f r Tu:s,a/ M•rch 11,2014
i
SIGNED BY \ for the Town of Queensbury.
Director of Building&Code Enforcement
17,1
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OFFICE USE ONLYCL ! - FES 1 3 2014
TAX MAP NO.3Ol PERMIT NO.Pi— v I ERMIT FES 4 ;
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:A- \::\reAA I Le v kr1 1C:‘,3
INSTALLER/BUILDER:1 SA x—Th o
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ADDRESS:,2*,1 o L.�urC L <4. �)1.(Z `Jr. to ADDRESS: I,?U. 0 cl La414,h ri /1/4.`/ IZo
PHONE NOS. S l?r •SSC 4 - > I S( I PHONE NOS. ---;1 -'1 �' 'l 1 i 4
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LOCATION OF PROPOSED INSTALLATION:(LEGAL ADDRESS) 3 \'x
BUSINESS COMPLEX/PLAZA/MALL NAME:
BUSINESS NAME: C't I t c r\-z.kL&F�' PPrM L-L1-TaF'
CONTACT PERSON FOR SIGN CODE COMPLIANCE: S-6PHONE: 11 3,2-r)rl n
TYPE OF SIGN PROPOSED: freestanding V wall awning projecting
IF SIGN IS TO BE ILLUMINATED,PLEASE INDICATE: V- Internal _External _Incandescent Neon _Other
U U
DO SIGNS CURRENTLY EXIST ON THE PROPERTY? Yes 'NoEtC2- AIDIF YES,LIST ALL EXISTING SIGNAGE:
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 wording/copy from: to:
Sign Wording/Copy: �- -t� 1 c(7 -�1 t> S �;,
9 PY� G1,�QP�ShLs n �i'r�t u � �1 �- �.� I
Sign size: Length.3ic" x Width r1. =Total Sq. ft. ISS,z Sign Height(freestanding sign):
Color and Material to be used: 14. �i'YLt Ur,-0
✓ 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 facade)
o Height of freestanding sign QUESTIONS? CALL 761-8256 OR EMAIL
o Depth of projecting sign codes(ZI queensburv.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 work is authorized by the owner.
APPLICANT SIGNATURE24jt L r L�. c. DATE:
I hereby authorize the applicant to place a sign on my property or building.
OWNER SIGNATURE: �j�L—C� c_<_�� — DATE:
' Town of Queensbury • Conrmunity Development Office - 742 Bay Road, Queensbury, NY 12804
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36” x 73" Exterior Wall Sign / Interior lit with LED lamps
Sign Specifications: Queensbury Family Dentistry
453 Dixon Road
Queensbury, NY 12804
Building Owner: Andrew Levine DDS
286 Church St. Saratoga Springs, NY 12866
518-584-8150
1 . Single faced
2 . Wall Sign
3. As Sketched
4. Lexan Face
5. Vinyl Lettering
6. 36" x 73" = 18.25 Sq . Ft.
7. 52 . 5' from the front of the building to the property line
8 . Minimum 100 Sq . Ft. allowable
9. Sign cabinet fastened to the wall with screws
10 . Approx. 13' 10" from grade to the top of the sign
MAY REFERENCE:
MAP OF A SURVEY MADE FOR
EVERGREEN
Y AY27E,965O PARK
DATEDM
LAST REVISED: SEPTEMBER 12. 1589
BY: VAN CUSEN & ST, V S
LAND SUREVYORS
LEGEND:
.� = UTILITY POLE
❑ce= CATCN BASIN
= HYDRANT
= SIGN
= WELL
MAP NOTES:
1. ENTRE PROPERTY GIVEN USE VARIENCE
982 ISSUED APRIL 1985 ON FILE AT
q IEENSBLRY TOWN HALL.
2, BUILDING `B" GIVEN AREA VAMENCE
120? ISSUED DECEMBER 18, 1986 AND
INCtUCED SUBDMSION OF BUILDING
INTO TWO FOOTPRINTS. BUILDING NOW
IDENTIFIED ON TAX MAP AS NOS. 91-2-2.42
ARD 91-1-2.43
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