SIGN-000355-2017 Dejana Truck & Utility TOWN OF QUEENSBUR'Y
6 742 Bay Road,Queensbury,NY I2804-5904 (518)761-8201
Community Development-Zoning Department (518)761-8256
SIGN PERMIT
Permit Number: SIGN-000355-2017
Tax Map No: 309.9-2-7
Permission is hereby granted to: Dejana Truck&Utility Equipment Company,LLC
For property located at: 106 LUZERNE RD
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.
Tyne of Construction
Owner Name: 106 Luzeme Road,LLC Sign-Wall $0.00
Owner Address: 443 West Mountain RD Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/ Address Electrical Inspection Agency
Plans&Specifications
Wall Sign 30 sq.ft.
on building facing Luzeme Road
Sign Copy: Dejana Truck&Utility Equipment
$90.00 PERMIT FEE PAID
Dated at the Town of Queensb ; Thursday,June 22,2017
SIGNED BY: CTfor the Town of Queensbury.
Zoning Administrator
742 B�R�d �� sb NY 11j4f
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P:S18-761-8238 www.queensI, . at Permit Fee: Invoice#: I
TOWN OF
Sign Variance? Yes No
Date:
/axwmp/u Address:
Zoning:
Property Owner: ;,or m E h Tie Contractor/Agent: Alr_.E '36 1 AM
Contact Person for Sign Code Compliance: Phone:
Building Street Address:
Site Pan,Variance or Subdivision Approvals:
Location of proposed installation
Business Complex/Plaza/Mall name
Business name
Type of Sign proposed WA L., L
If sign is to be illuminated, indicate —internal external —Incandescent—neon other
Do signs currently exist on property? —Yes—No(if y ,s, list all existing signage) Wj011 ke a'o yed
Sign Wording/Copy
Sign Size Length /2�" x Width 3 Total sq.ft.
Sign Height(freestanding)
This 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 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 all 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: i \ | l ,
PRINT NAME: W � (( ��ki/��T -���
Z I / 7
SIGNATURE: DATE: u�
Declaration: I hereby authorize the applicant to place a sign on my property or building:
OWNER:
PRINT NAME
SIGNATURE: DATE: