2013-386 New 2 U Consignment Shop 004 TOWN OF QUEENSBURY
4.4 .
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20130386 Application Number: A20130386
Tax Map No: 523400-303-016-0001-008-000-0000
Permission is hereby granted to: MARK GIGNAC
For property located at: 437 DIX 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: WILLIAM BARRETT
PO BOX 142 Sign
GLENS FALLS,NY 12801-0000 Total Value
Contractor or Builder's Name /Address Electrical Inspection Agency
WEST SIGNS
1100 DIX Ave
HUDSON FALLS.NY 12839-0000
Plans&Specifications
2013-386 NEW 2 U Consignment Shop
SIGN wall sign 30 sq ft
$90.00 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 Queensbu before the expiration date.)
Dated at the To of Qsb //�/J F i.a ' . _ st 30,2013
Y I
SIGNED BY - \. for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
Town of Queensbury Building & Codes
Received:
Tax Map ID: 363. /(a "1- e
SIGN PERMIT APPLICATION �_�
Permit No.:
Permit Fee: $ C?D pd
'dIS(S � 1 tick Com( V C- / 60 `0
Date Applicant q ,�� t`,�, � � Ca
Tax Map ID Address -Koat'�. AC
Zoning V)N , l2reD4
Property Owner ' 6;6( +t Contractor/Agent: ( ll(A
Address P. ai . y Address I I 0
61 a
OKI'PA JJNOfeidt SS ,.1\1J -
Phone `? S - S (1 `i 3 Phone *1%0--"5,g3
Contact Person for Sign Code Compliance:--ik, i{(\. & fi Day Phon : 1t l - -a'g3
/
Building Street Address: 3 � V'�
Site Plan,Variance, or Subdivision Approvals
Location of proposed installation -\OLtiC (k CC\ N\,(o\y\CQf.
Business Complex/Plaza/Mall name
Business name 1 .'( . ll &O,i S1pm()"( S it .
Type of Sign proposed q. l (l
If sign is to be illuminated, indicate internal 0 external Incandescent neon other
Do signs currently exist on property? _Yes v o(if yes, list all existing signage)
Change of word/copy From • i !/-- to
Sign Wording/Copy ; •, 6( ; .i2 > t f1G77\6-6 k9 U '
Sign Size Length (? I x Width 2 f( =Total sq.ft. 30 1
Sign Height(freestanding)
Color&Material to be used ` Yr,f, 1,,i1 c r , k)1 v i'�(f(.� art ()lf ( ELY1( a( /( 1VJ <
Tis application creates a change in the , New
following existing site conditions(fill in all Change in number of signs from to
applicable spaces) Change in setback for sign from 1 i to
Change in size from / / ! to
Change in height of sign from to
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-PRINT NAME l `� eni-,Q
APPLICANT-SIGNATURE: {• -,—� -Date: 67( (C L3
..---
Declaration:
Declaration: I hereby authorize the applicantntto place a sign on my property or building:
OWNER-PRINT NAME: / 'pliq/za�� `&43
OWNER-SIGNATURE: X---":„........./.. Date:
Town of Queensbury Building&Codes Sign Permit Application 518-761-8256
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