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SIGN-000700-2016 Floormaster Carpet One ' TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development-Zoning Department (518)761-8256 SIGN PERMIT Permit Number: SIGN-000700-2016 Tax Map No: 302.7-1-13 Permission is hereby granted to: OMall Family Limited Partnership For property located at: 102 QUAKER 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. Tvne of Construction Owner Name: OMall Family Limited Partnership Sign-Wall $0.00 Owner Address: 35 Orchard DR Total Value $0.00 Queensbury,NY 12804 Contractor or Builder's Name/ Address Electrical Inspection Agency Signworks Sign Corp. 27 CAREY RD Queensbury,NY 12804 Plans&Specifications Building Sign(Wall)facing Quaker Road 58.7 sq.ft. Sign Copy: Floormaster,Carpet One Floor&Home Cross Ref.Sign Variance PZ-0177-2016 Fee Paid: $132 invoice no. 1141 Fee Paid: $44.10 invoice no. 1167 $44.10 PERMIT FEE PAID Dated at the Town of Queensb \ SIGNED BY: ^ for the Town of Queensbury. Zoning Administrator Office Use Only Town of Queensbury Building & Codes Received: Tax Map ID: SIGN PERMIT APPLICATION Permit No.: /J 70G'�4l�0 Permit Fee: $ Date Applicant Tax Map ID A 02. 7// Address Zoning r� p Property Owner ��i Contractor/Agent: ���,c / Address 'T Address - df Phone — 3 Phone Contact Person for Sign Code Compliance: Day Phone: Building Street Address: Site Plan,Variance,or Subdivision Approvals Location of proposed installation Business Complex/Plaza/Mall name Business name Type of Sign proposed 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) Change of word/copy From to Sign Wording/Copy Sign Size Length x Width =Total sq.ft. -1 Sign Height(freestanding) Color&Material to be used 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 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 �D C APPLICANT-SIGNATURE: Date: Declaration: I hereby autho45 the applicant to pl a -mq property or building: OWNER-PRINT NAME: OWNER-SIGNATURE: / Date: Town of Queensbury Building&Codes Sign Permit Application 518-761-8256