2005-281 Maxwell KBC (Kitchen Bath Closet) TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20050281 Application Number: A20050281
Tax Map No: 523400-302-006-0001-002-000-0000
Permission is hereby granted to: MAXWF,I,I,KBC
For property located at: 697 GLEN 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: 697 UPPER GLEN STREET, LLC
697 GLEN St Sign
Total Value
QUEENSBURY, NY 12804-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2005-281 MAXWELL KBC
32.5 SQ FT WALL SIGN
$68.00 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 Queensbury before the expiration date.)
Dated at e To Lof eb y, May 20, 2005
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Building&Codes Office-Department of Community Development-Town of Queensbury PERMIT NUMBER `-^'� I
742 Bay Road,Queensbury,NY 12804
Dave Hatin,Director codes@aueensburv.net FEE PAID
Phone: (518)761-8256 FAX: (518)745-4437
Sign Permit Application
Application & plans are subiect to review before issuance of a valid permit for placement of a sign.
Instructions: A permit must be obtained before installation of your permanent sign. All applicants' spaces on this
application must be completed and must ZMAXWC-LiL
pear on the application form.
Applicant/Business G)UCUUS -Ti SQ Owner: S ✓n L=
Address: S Address:
ui-E)uJaUey /VY I2-e0y
S
Home Phone: !2-79 z-�� IS Home Phone: -!;I F-- 75
Email Address: Email Address:
Cell Phone: .YI P -3-7 -32 g 1 Cell Phone: S I b'-3 7 G -3a 9 I
FAX Phone: 2 --s t 3 FAX Phone: S i ' -7 2 2 - S9 3
Person responsible for supervision of work with respect to Sign Code compliance:
Name: STieue -s4c�-OK.T- (W V�U,6,GeTc k
Address: _54Me A-s 4 Gov r_ Phone 75i---,?P ppe
Email Address:
Location of proposed installation: Legal Address: c(7 Uf°ly GCEOo Suite No.
Business Complex/Plaza/Mall Name:
Business Name: 0LE64Js K-�r7-C46- S I MAl\wCCC 1cQC, L � L
Tax Map Number: -2)c)a 1(.0 ._ to
Type of sign proposed: freestanding . wall awning projecting
If sign is to be illuminated, please indicate: (\—O Internal rExternal _Incandescent _Neon _OtherW-
Do signs currently exist on the property? Yes / No If YES, list all existing signage: tv C C S CA —
The application creates a change in the following existing site conditions: fill in all applicable spaces
-r New
Change in number of signs from � _ to
Change in setback for sign from to
Change in size of sign 3 from '-A 18 to
Change in height of sign from V to 1
.Change of wording/copy from SEE 67-ncc R 60 to
Sign Wording/Copy: 4WC-LC KQc Q U€CAS . 9Fn.s _ KX-TCH EfO d4-V C Cogs c
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Sign size: Length x Width ,2 =Total Sq. ft. L 1 / Sign Height (freestanding sign)
Color and Material to be used: rbgkiE aT�+4AJ�E_ � c Kr �, t/y ffX7� . /E C C
r
Provide 2 copies of a scaled drawing or surveyed plot plan with the following information:
location of sign (walls signs: drawing of the facade the sign will be located on, indicate sign on fa(;ade)
height of freestanding sign
depth of projecting sign
distances from front and side property lines.
Provide 2 drawings or photos of sign design.
Provide Applicant and Owner's signature (permission for placement of sign on the property or building).
Declaration: Please sign below after you have carefully read the statement:
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 SIGNATURE: DATE:
I hereby authorize the applicant to place sign on my property or building.
q� v GC � i LLc
OWNER SIGNATURE: DATE:
L:\Sue Hemingway\Building.Permit.FORMS\Sign Permit Application.doc
V: 1/6/2005
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