BOTH-000085-2016 TOWN OF QUEENSBURY
742 Bay Road.Queensbury,NY 12844-5904 (518)761-8201
Community Development- Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: BOTH-000085-2016
Tax Map No: 288.-1-51
Permission is hereby granted to: Centers Health Care,Signworks Sign Corp.
For property located at: 42 GURNEY LN
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
Owner Name: Centers Health Care Sign Sil.00
Owner Address: 4770 White Plains RD Total Value S0.(lcl
Bronx,NY 10470
Contractor or Builder's Name 1 Address Electrical Inspection Agency
Plans&Specifications
28.8 s.f,freestsanding monument sign
Sign Copy: Warren Center For Rehabilitation and Nursing
Fee Charged for new sign as property is no longer owned by Warren County;it is independently owned.
$86.44 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,February 25,2017
(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 ueens �jWed ay arch 2,2016
SIGNED BY: JJJJ�Ir for the Town of Queensbury.
Director of Building&Code Enforcement
.. . . . , . . .OFFICE USE ONLY._..... .. .. .Q. . . ...fy. . . . ;LI G�cs�Q 50
' TAX MAP NO PFRMIT NO PERMIT FEE f I '
APPROVALS _ DEPOSIT
: ... .... . . . . . . . . . ....................................................
SIGN PERMITAPPLIC'ATION:
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 Centers Health Care INSTALLERIBUILDER Signworks Sign Corp.
ADDRESS 4770 White Plains Rd., Bronx, NY 10470 ADDRESS- 27 Carey Rd., Queensbury, NY 12804_
PHONE NOS (718)931-9700 x 245 PHONE NOS. 745-0700 Fax:745-0702
LOCATION OF PROPOSED INSTALLATION:(LEGAL ADDRESS) 42 Gurney Lane, Queensbury, NY 12804
BUSINESS COMPLEX r PLAZA I MALL NAME: NIA
BUSINESS NAME' Warren Center For Rehabilitation and Nursing
CONTACT PERSON FOR SIGN CODE COMPLIANCE Fred A. Early PHONE: 745-0700
TYPE OF SIGN PROPOSED, X freestanding _wall _awning _projecting
IF SIGN M TOOL ILLUMINATED,PLEASE INDICATE. —Internal X External _W andosoent _Neon _Other
DO SIGNS CURRENTLY EXIST ON THE PROPERTY7 X Yes _No
IF YES,LIST ALL EXISTING SIGNAGE: 28.8 sq.€t. monument lawn sign and 17 sq.ft.entrance wall sign
The applicabon creates a change New
in the following existing site Change in number of signs from to
conditions(All in all applicable _Change in setback for sign(ruin to
epauie): Change In size of sign from to
Change in height of sign from _ ._.__ to
X__Change of wording/copy from: Westmount Health Center to.Warren Center For Rehabilitation and Nursing
Sign Wording/Copy. "Warren Center For Rehabilitation and Nursing"
Sign size Length 86.5" x Width 48" = Total Sq. ft. 28.8 Sign Height(freestanding sign) 6'
Color and Material to be used. This application is to change the facility name on an existing slf monument lawn sign.
Provide 2 copies of a scaled drawing or surveyed plot plan with the following information.
Location of sign (walls signs drawing or the farrade
the sign will be kmatod on,indicate sign on facade)
� Height of freestanding sign QUESTIONS? CALL 761266 OR EMAIL
o Depth of projecting sign cades{c>queensbury.net
u Distances from front and Side property lines. y1511 OUR WEBSITE FOR MORE INFORMATION
• Provide 2 drawings or photos of sign design. www.qucensbury.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 appficabon.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 SIGNATURE: DATE: 01/25/16
Fred A.Early,5ignworks P ect Coordinator
I hereby authorize the applicant to place a sign on my property or building.
OWNER SIGNATURE: See attached fax DATE: 01/28/16
Centers Health Care
Iow?I of.Quce llsl711rl1 • t'nrtralllrr;rly Dc7le•1nptnent Office., • 742 Bay Road, Qucen-shirt', NY 12804
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lull OF at1E£1SWRY PLANNING OWD
tot 2 RFSaLIRION APPROW nf1AL STAGE MR SODOMSION 2-2015 IWRREN Couwy
.LEGEND 31.S7t a•CTe$ I.dap ID 2e8-1-51,49/Property Addresa:Gurney Lam
A sub&.NT-¢ppk.tI.n has been rtad.I.the Ousene.ry f%Ping @card for the foo-i";AppiloaTd propox ovbdivibfon of a WAS acre parcel into two i0b at 8,10&31.57
CATCH BASIN COO awes.Punuoat to Chapter A-183 of the Zmring Q+Aoan¢e eubdfvfsan d red shall be.abject to Planniog 9aerd renew and approval.
(not surveyed)
UNAUTHORIZED ALTERATION OR ADDITION TO A SURVEY See inset nzagt P,xeoadt to relevant.--He-at the Tare of any zani.g each-Chapter A-1E3,the PtePning Baas has date mfaed that thN propvsul wear.U..raq jrdme.t..a atar�d
MAP BEARING A LICENSED LAND SURVEYOR'S SEAL IS A RURAL RESIDENTIAL MAN HOLE MHO
fn We Zord coda.
VIOLATION OF SECTION 7209, SUBDIVISION 2, OF THE NEW OVERHEAD WIRES --- The requfreme d nts of the State Environmental Qua ity R"w Act have been aanAdered and the f�iannirq Board odoiAad.SEQRA Neq.r-Oedwatton on 2-17-2015.
YORK STATE EDUCATION LAW. Th.%.Mn9 Beard made a dea.a eridaaert to the Zoning Bon of Appeals oa 2-17-2015.the 7-ing board of Appaala d the verf-re
RR-5A 'WATER MAIN -+ app we q ens an 2-18-2015; �
A pubk hearing ras whedded and held on 2-17�-2015&2-24-Z015:
`�
ONLY COPIES FROM THE ORIGINAL OF THIS SURVEY
MARKED WITH AN ORIGINAL OF THE FIND SURVEYOR'S MIN. LOT SIZE: 5 ACRES INS UPpkcouaa f aappartdd rite dl docamrntoiwn.pubk eomrnent.and Vpk,&m aatenal w fire file of scald: v
'stand pipe Atli EYE-'+�6lPy5gp un a_2a75 AM;!9Aee WARREN f31ya,^l tntrod ced by Pact Scf-ff.ha mmaeed ar it,ndapliam x onded by Georg.Perorm:
EMBOSSED SEAL SHALL BE CONSIDERED TO BE VA1JD MIN. LOT WIDTH 400' hydrant
dorxw TO AP z TRUE COPIES. MIN. ROAD FRONTAGE 400' h Ps the draft provided by.tdf a«rdtiande pp.the faea-�g: Uq O
1-Heal appro-.ed plans,in compliaxe liar the sabdfvfshm,moat be submitted to the Communfty I3e Aopment 0"ortm A hefine any furt rsher few by the 2oai Aalmwfstretor
THIS SURVEY WAS PREPARED WITHOUT THE BENEFIT OF AN ar Fkhdi a and each.pereanrral.
ABSTRACT OF TITLE OR TITLE REPORT AND IS, THEREFORE, 2.Adhereme to the items a,llinad in the 1.11a ep letter ednt rA he b t r".kWefi,
SUBJECT TO ANY EASEMENTS, COVENANTS, OR approximate water main location
RESTRICTIONS OF RECORD OR ANY STATEMENT OF FACTS as shown an Town of Oueensbury J truly adoptod the 24th day of February 2015.by the fanammi; ate:
SUCH DOCUMENTS WOULD DISCLOSE. Water Dept. drawings !J` *` AYES-etc.Bdeb.Mg.w ta.Mr.iaaPe.fAr seho .aR,etc.r,ner
NOES-.Na-
DEED REFERENCES " ABSENT:dr.dagaran.dr.n
HAVILAND G. TITUS AND NETTIE M. TITUS TO WARREN hydrant
COUNTY DATED 31 JANUARY 1919 AND RECORDED IN THE
WARRED! COUNTY CLERK'S OFFICE IN LIBER 140 OF DEEDS 469.27' ce o e
AT PAGE 438.
CHARLES CODNER AND L►ZZIE CODNER TO WARREN paved swale a �- o� 8'��4'� 2" 7'
sr
COUNTY DATED 8 JANUARY 1919 AND RECORDED IN THE Orl2,_ 4 \ oof $ E 418.g
WARREN COUNTY CLERK'S OFFICE IN USER 140 OF DEEDS g hydrant paved
paved garage
AT PAGE 440. cone ° �f °man hole 22.38 " C.
monument
sla M found
MAP REFERENCE / � cone. Tall ° loadiflg"dock`�fF electric t - �
TOWN OF QUEENSBURY: 288-1--51, 288-1-49 v C9° hand hole f__ -�-
3
5 OEVELOPMET DATA LOT 1 6ne_�-w ' man
utility pole; gate -
AREA/TYPE EXISTING PROPOSED TOTAL tiuitding setback
-c�`� C8 erece swalks °
SQ. FT. ADO.Fr SQ. FT. 1 -"f natural gas
j' light service
A. BUILDING FOOTPRINT 42,024 0 42,024 1 J cone. Nero 289 sq.ft. 1' gazeho /
, J
B- DETACHED GARAGE 1,098 0 7,098 `u :S paved wag sign osflParking dab � o /
C. ACCESSORY STRUCTURE 99 0 99 rn �. /
_ buiygi� flog pole /
11 O. HARD SURFACES 70.604 0 1rt57 201 5-30OW5y
light 70,604 setbq�°ne dC6 o t `own@ / 2a1s9s¢94 ps 2dYJf)15 11:17:97 A0A
E. PORCH/DECK N/A N/A N/A -` walks 1 Fages
F. OTHER N/A N/A N/A jot guts 7 ."z1'�.5 , I9ht� 'a �6s<- - MAP
8 W - paved Parking
G. TOTAL NON-P€RMEABLE 113.825 0 113.825 31.67.t acres I ��Z y , +v e panwla 1-vogbl.vv....Goakvb fR_ED
H. PARCEL AREA 356,321 0 356,321 {not surveyed) 14.2N 115.11�29r E tluilairlg,see inset reap ca I _ °cB
1. 9 OF IMPERMEABLE 1 32% 0 32% o + -- 1 a ,. / w-
7 cob
o tf! Aarch 7- �'
r
AREA REQUIRED EXISTING . PROPOSED 3 1 building 115, -__� man
B holes°
28.5 ° C2
FRONT(I) 100' 1 s4.9' 184.9'
FRONT(2) N/A ' z ''_.�� k wo!!, rr �-1cone. �p side calks SB,
SHORELINE N/A * ®
SIDEYARD E. 75' 55.8' 55.8' @ ! cover i --�0.6.]• rp r efo@ / /
SIDEYARD W. 75' 128.5' 128.5' tility pale ,SJ e �
REAR YARD(I) Too, S5.3' 55.3' °
'
� s �� = t y6 �'f Pie � PROPOSED UTILITY EASEMENT
`.� t r /t /
REAR YARD(2) N/A
TRAVEL CORRIDORN/A `�� ° b� `col/� /
`building setback line cover t/ 4z
HEIGHT (MAX) N/A r /
of
PERMEABILITY MIN 75% 68% 68% steps TOWNIOFSQUEENSBURY
paved par{dng �l,). // cone.
-,I/
PARKING SPACES N/A 1 o r ��/ ` monument
0 cone.�uildinc a man }toles jot I j, ^ found
FRONTAGE 400' 387.32' 387.32' I / a COVer 8.1801- acres
$EEE DDODPMET DATA LOT 2 ° Manhole
AREA/TYPE EXISTING PROPOSED TOTAL et wall �` .�' 48 288-1-49
So. FT. ADDITION SO. FT. 1 ` - b+rifdi P� s5.3
SQ. FT, o ! 1�n8 ^' of 31.67= AC.
(NOT SURVEYED)
A. BUILDING FOOTPRINTS 2,896 0 2,896 { cone. '� +`'� O� DO4W °O
-� Ilm
monument Existing 28.8 sq.ft. a� A/ o, �' Tanya BMW
B. DETACHED GARAGE N/A 0 N/A � utility pole found ty monumefltain ® '`
frM hales
C. ACCESSORY STRUCTURE N/A 0 N/A � �'- �l o O \ wry / /�7� yNvy b2 DoYai4T. LOf 1
D- HARD SURFACES UNKNOWN 0 UNKNOWN ! M Z4'.5v1 �s ?/ w3� ecuo �`� DmidP da enne f/seho 288--1-51
~� P 3' guy o h Cv 8.180t AC.
E- PORCH/DECK 239 0 239 ' roNer�1 Cf W lrtanflole �c woe MuaNdaeh
ne F. OTHER N/A N/A N/A culvert o Bn
/ ro �u l&000
4;
0' 30' S0' 100' 150' o 50 i a
G. TOTAL..NON-PERMEABLE < 300,000 < 300,000
H. PARCEL AREA 1,379,545 0 1,379,545 utility pole avert / 74 7-- GI1R 1 LANE
G` guy / t kerkay:Eata Vrafk§rr 0p'0P11
1. % OF IMPERMEABLE s 25% 0 [ 25% e 3873?, cenefery 63
5'ETBACK R-EQ.SIiB MENrs.LEST 2 '1" J � `' r3 Itm Howf-P.
/J SehermeeAorn
vy� heodwall 20.9 corer. Q- Lie
AREA REQUIRED EXtSTIJG PROPOSED _ 6' monument Patricia S.Bond.
found 75 and c
O 104 hL John F.Strough .`�"
FRONT N. BLD 100 1$3.1' 783.1' 64
Po9oorr-ld r��J� W"ibr i aok senor
FRONT S. BLD 100' 69.8' 69.8' y 1fi sfdwtaaA,t1.4
SHORELINE N/A yql.
SIDEYARD N. OLD E 75' 106.1' 106.1,
D
SIDcfARD S. OLD E 75' 21.7' 213'
REAR YARD N. OLD 100' 14.2' 14.2' s
INSET MAP T" _ ^'frOCJ'
REAR YARD S. SLID 100' 163.1, 163.1' F 1 1" v 5`A3 * SCALE
adopted Approved under authority o1 aresolutionresolution `''u PROPOSED SUBDIVISION OF LANDS OF 1" � 50'
TRAVEL CORRIDOR N/A SURVEYED V l'i d 1..7J i713
HEIGHT (MAK) N/A 49303 plc'.. Sry p�'1 �y p y�S���'7 p� pry FlELO Su,Thv
- •1"t LJ�V1lJ F. 171Y.I6:d'G�f..-.7 S ��r[�N L.1J�NTY
by the Planning card of the- Town of Quef;;nabury, <_ F,l� .. eoupl,ErloN:
PERMEABILITY MIN 75%.. _ > 75% > 75R � LAND SURVEYOR WESTMOUNT HEALTH FACILITY 11/14/14
. I HEREBY CERTIFY THAT THIS SUBDIVISION PLAT (((��� W.P COdPLE I(t;
PARKING SPACES NIA 9s�+v}-� WAS PREPARED BY ME AND WAS FROM AN ACTUAL DAVID F. BARRASS � ���L� ����� 1 9 15
New York. -„--�.-- CFI.aIRAdADt. TO'NN OF QUEENSBURY, WARREN. COUNTY
FRONTAGE 400' to93 1os3't SURVEY COMPLETED BY ME ON NOVEMBER 14, 2014. L.S. # 49363 CORINTH, NEW YORK NEW YORK
14-285