2009-250 Wall "Safelite Auto Glass" TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20090250 Application Number. A20090250
Tax Map No: 523400-309-011-0001-048-000-0000
Permission is hereby granted to: LAWRENCE LUSSIER
For property located at: 20 MAIN St
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: LAWRENCE LUSSIER Sign
PO BOX 4339 Total value
CLIFTON PARK,NY 12065-0000
Contractor or Builders Name/Address Electrical Inspection Agency
Plans &Specifications
2009-250
18 sq ft wall sign to read "SAFELITE AUTO GLASS"
$36.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Thursday,July 01, 2010
(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 T V
urm ay,July 01,2009
SIGNED BY7 `j/� 6 t for the Town of Queensbury.
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
4z Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number. P20090250 Date Issued: Wednesday, July 01, 2009
This is to certify that work requested to be done as shown by Permit Number P20090250
has been completed.
Tax Map Number. 523400-309-011-0001-048-000-0000
Location: 20 MAIN St
Owner. LAWRENCE LUSSIER
Applicant: LAWRENCE LUSSIER
This structure maybe occupied as a:
Sign
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the
property owner of the responsibility for compliance with Site Plan,
Variance, or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
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TAX MAP NO. PERMIT NO. /{n / ERMIT FEE_ + JUN 1 2009
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SIGN PERMIT APPLICATION. & BUILDING & CODES
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: v5.SG2 INSTALLER/BUILDER: f4 l-e sr ,✓I
ADDRESS• �j W R . 0 2166"T ADDRESS: ZG Slck;" leL
PHONE NOS. L 23 PHONE NOS.
LOCATION OF PROPOSED INSTALLATION:(LEGAL ADDRESS) 6
BUSINESS COMPLEX/PLAZA/MALL NAME: �/►=►✓jto✓I /Z �i y
LA
BUSINESS NAME: S 1 (fJ I I C_
CONTACT PERSON FOR SIGN CODE COMPLIANCE: e 2 Yy-,A PHONE:
TYPE OF SIGN PROPOSED: freestanding wall _a . g projecting
IF SIGN IS TO BE ILLUMINATED,PLEASE INDICATE: _Internal _External _Incandescent _Neon _Other ,
DO SIGNS CURRENTLY EXIST ON THE PROPERTY? Yes _No
IF YES,LIST ALL EXISTING SIGNAGE: ?. O✓1 IV,4 / 9i1 U• e(
The application creates a change 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
Changejn fight of sign from to
Change of wording/copy from: , V 1 P. vNdn to:
Sign Wording/Copy: __�(— C_ `1 t� 'ASS
Sign size: Length 3 x Width =Total Sq. ft. Sign Height(freestanding sign):
Color and Material to be used: IG Q/ i�hi�-c. AlLMINJ wl
✓ Provide 2 copies of a scaled drawing or surveyed plot plan with the following information:
o Location of sign (walls signs: drawing of the fagade
the sign will be located on,indicate sign on fagade)
o Height of freestanding sign QUESTIONS? CALL 761-8256 OR EMAIL
o Depth of projecting sign codesCaD-gueens bury.net
o Distances from front and side property lines. VISIT OUR WEBSITE FOR MORE INFORMATION
✓ Provide 2 drawings or photos of sign design. www.gueensbury.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 Or ' a e,and all other laws pertaining to the propoWworshall,,bcomplied with,whether
specified or noted, and that su h w rk is authorized by the owner.
APPLICANT SIGNATURE: DATE:
I hereby authorize the applica o ce a si on perty pr building.
OWNER SIGNATURE. : DATE:
Town of Queensbury • Community Development Office - 742 Bay Road, Queensbury, NY 12804
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