SIGN 493-2017 Kassia's Play Dates LLC .� TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
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Community Development-Zoning Department (518)761-8256
SIGN PERMIT
Permit Number: SIGN-000493-2017
Tax Map No: 302.12-1-31
Permission is hereby granted to: Catherine May
For property located at: 238 BAY 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.
Type of Construction
Owner Name: Kubricky Construction Corp Sign-Wall $0.00
Owner Address: 269 Ballard RD Total Value $0.00
Wilton,NY 12831
Contractor or Builder's Name/ Address Electrical Inspection Agency
West Signs
1100 Dix AVE
Hudson Falls,NY 12839
Plans&Specifications
Wall Sign 18 sq.ft.
Sign Copy: Kassia's Play Dates,LLC
Location: front of building
$54.00 PERMIT FEE PAID
Dated at the Town of Queensbury; Monday,August 14,2017
SIGNED BY: Lk for the Town of Queensbury.
Zoning Administrator
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Office Use Only
Town of Queens ur
Received:
SIGN PER I P Tax Map ID: 3c Z . l Z- -
����nPermit No.: 5 ;�„—von �y3 .0
�1 n n Permit Fee: $ 5 �! .ODate MOW A lQ
Tax Map ID _ Address
Zoning (LOn M�.Y-C 1 () 1\Jy I a ROL4
Property Owner CJC§h Factor/Agent:t"NJ
Address Address AV
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Phone Phone 4_sam
Contact Person for Sign Code Compliance: Day Phone:_1CA LP— 11Oq
Building Street Address:
Site Plan,Variance,or Subdivision Approvals
Location of proposed installation - .I
Business Complex/Plaza/Mall name u
Business name i
Type of Sign proposed y\j a an I
If sign is to be illuminated, indicate internal _external _Incandescent _neon _other
Do signs currently exist on property? Yes _No(if yes, list all existing signage) etcTf,l�r
Change of word/copy From to
Sign Wording/Copy SS iG ` is ►�
Sign Size Length x Width 91 =Total sq.ft.16
Sign Height(freestanding) VV PW C_ C t t n
Color&Material to be used P-3l ld ( VDl jukm i
This application creates a change in the New V-t Utz.
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 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 CG+htX 1'C-1 AA
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APPLICANT-SIGNATURE: JjauDate:
Declaration: I hereby authorize the applicant to place a//sign on my property or bu ding:
OWNER-PRINT NAME: �'y�✓ f��
OWNER-SIGNATURE: Date: �/�117
Town of Queensbury Building&Codes Sign Permit Application 518-761-8256