2001-061 J David Bannon, MD Orthopedic Surgery and Sports Medicine 0TOWN�` OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20010061 Application Number: A20010061
Tax Map No: 523400-060-000-0007-011-006-0000
Permission is hereby granted to: J DAVID BANNON MD PC
For property located at: 543 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 Value
Owner Address: ARCANGELA BANNON Sign
543 BAY Rd Total Value
QUEENSBURY,NY 12804
Contractor or Builder's Name/ Address Electrical Inspection Agency
K.D. WHEELER CUSTOM SIGNS
16 RICHARDSON STREET
OUEENSBURY,NY
Plans & Specifications
BP 2001-061
FREESTANDING SIGN: 25 SQ. FT.
J. DAVID BANNON MD/ORTHOPAEDIC SURGERY AND SPORTS MEDICINE
$50.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: .., 14 - 2003
(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 To ensb rid• , ;arch 16,2001
SIGNED BY 4 for the Town of Queensbury.
Director of Building&Code Enforcement
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Fee Paid: � � /i
TOWN OF QVEENSBURY
742 Bay Road, Queensbury, NY 12804 Approved By: i
(518) 761-8256 Permit #:
SIGN PERMIT APPLICATIONPECF�� j
THE FOLLOWING INFORMATION IS REQUIRED: EB 1 6 2001
T
1. Detailed drawing or photo of sign. EiLllu�,,UEENS1 URY
2. Plot plan of location of sign. ANbcQC/
3. Written consent of the owner of the building or land.
OWNER OF PROPERTY lg/'azity liq Bannon
ADDRESS _ 413 60 ' OQ( �. 567ki22e/7"1S) TEL. 193 609,3 (N9/7113 l)
NAME OF APPLICANT 3.= / M VO 8A/JAI Al H
ADDRESS J 4 3 & y /O' Z TEL. 7936O98
BUSINESS NAME IF DIFFERENT: J ,IAA"Jiv 809A1/VOAJ Alb T7A
TYPE AND LOCATION
Check What Applies: Existing __ Permanent Projecting Sign __
Temporary Non-conforming Existing _
c -St' Wall New ..
Location: Tax Map Number 4)0,-__ '7 - 1 . 49
Address � _ Bgi/ 1E'o1q
Proposed Setbacks from Property Line (front) 50 (side) S.s
If sign is to be illuminated, please check appropriate box:
Internal ( ) , External (✓) , Incadescent ( ) , Neon ( ) , Other ( )
Size of Sign: Width 3° ft. Length /d ft.
Total Square Footage: _ Sc
Sign Copy: 3 hAy/u 13Qfnor) ,iO Crryc-)pA ,v/C Surge y ct)cl
,spo 7 5- HEDIC/
Color and Material To Be Used: //vury //1 "S,gnlegm v 3 /-je
/2f/e�i�y nQ /e -eget-icy
Signature:
Circle One. Ap icant, wner contractor or agent.
I HEREBY AUTHORIZE APPLICANT TO PLACE A SIGN ON MY PROPERTY OR BUILDING.
Signature of Property Owner:
ORIGINAL-Office Copy COPY-Applicant
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Orthopaedic Sur6erg & Sports Medicine 111
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