2005-040 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20050040 Application Number: A20050040
Tax Map No: 523400-309-010-0002-017-000-0000
Permission is hereby granted to: ALLSTATE
For property located at: 39 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: ALFRED & AMY MERCHANT
39 MAIN St Sign
Total Value
QUEENSBURY, NY 12804
Contractor or Builder's Name / Address Electrical Inspection Agency
Plans&Specifications
2005-040 ALLSTATE
21 SQ FT FREE STANDING SIGN
$42.00 PERMIT FEE PAID-THIS PERMIT EXPIRES:
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queenshury before the expiration date.)
Dated at the Town of Queensbury; Friday, January 28, 2005
SIGNED BY for the Town of Queensbury.
Director of Build e Enforcement
Fee Paid:
.-D TOWN OF QUEENSBURY
742 Bay Road, Queensbury, NY 12804 Approved By:
(518) 761-8256 Permit #:
SIGN PERMIT APPLICATION
THE FOLLOWING INFORMATION IS REQUIRED:
I. Detailed drawing or photo of sign.
2. Plot plan of location of sign. {) BURY
3. Written consent of the owner of the building or landbU.
OWNER OF PROPERTY &
ADDRESS _3 q me of S4 • Qo e e,tS6u r4j to Y /JS6 Zi/ TEL. 7q3 --S48
NAME OF APPLICANT 3.�0 0.
ADDRESS 3 I /Y141?•i 5 � eh sreef e. /u� 1J8e3 y TEL. -568 f
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BUSINESS NAME IF DIFFERENT: - A I Lek , 4-e
TYPE AND LOCATION
Check What Applies: Existing _— Permanent _ Projecting Sign
Temporary Non-conforming Existing
Free-Standing Wall ,, New .
Location: Tax Map Number 3m_4_ —� -7
Address
Proposed Setbacks from Property Line (front) (� (side) 3 0
If sign is to be illuminated, please check appropriate box:
Internal ) , External ( ) , Incadescent ( ) , Neon ( ) , Other ( )
Size of Sign: Width l�, 15,f- Length ft.
Total Square Footage: 6Z 6A
Sign Copy:
f
Color and Material To Be Used: Lie-,!x Q.i/\
4
Signature:
Circle Ont.: Applicant, wner, contr for or agent.
I HEREBY AUTHORIZE APPLICANT TO PLACE A SI ON MY PROPERTY OR BUILDING.
Signature of Property Owner: 4
if
ORIGINAL-Office Copy COPY-Applicant
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