2005-631 Next Step Coaching & Counseling TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20050631 Application Number: A20050631
Tax Map No: 523400-302-007-0001-045-001-0000
Permission is hereby granted to: NEXT STEP COAC 14TNG& COTTNSF.T,TNCT
For property located at: 138 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. Type of Construction Value
Owner Address: GARY& SUSAN HIGLEY
31 CHESTNUT Rdg Sign
Total Value
QUEENSBURY, NY 12804
Contractor or Builder's Name / Address Electrical Inspection Agency
Plans&Specifications
2005-631 NEXT STEP COACHING& COUNSELING
2 SQ FT FREESTANDING SIGN
$4,00 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 the TowTo uee � ,August 25, 2005
SIGNED BY A for the Town of Queensbury.
Director of Building&Code Enforcement
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/&Codes Office-DeparTmenfi of Community Development-Town of Queensbury PERMIT NUMBER i
jy Road,Queensbury,NY 12804
a Hatin,Director cgde� s@aueensbury.net FEE PAID LI��
e: (518)761.8256 FAX: (518)745-4437
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Sign Permit Application
Application & plans are subject to review before issuanW aj#j AM,i" rmit for lacement of a sign.
Instructions: A permit must be obtained before installation o your permanent sign. All applicants' spaces on this
application must be completed and must appear on the application form.
Applicant/Business /y. .ls/,�nJGEy. Owner. 1
Address: 3 _zsz Address: •-
,�.R.nrt.�tD 501,
Home Phone: Home Phone:
Email Address: JA Email Address: g*t!t)t+.�4_c+e.G�.T/fwr`a..►�,�"•
Cell Phone: Cell Phone:
FAX Phone: "7?2-Z43
FAX Phone: '�' /,'�" -2
Person responsible for supervision of work with respect to Sign Code compliance:
Name:
Address: i f Phone 468 J;li`
Email Address: ,Q?
Location of proposed installation: Legal Address: ZAP dawAele
9 Suite No.
Business Complex/Plaza/Mall Name: eRd5lj & LS
Business Name: A l&r- .52XA 41"4 "W-A 'r"' A��le�s,�G�•�JG.
Tax Map Number: .36-7, 7 /f 149- 1
Type of sign proposed: freestanding wall awning 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:4S7,yunl, !S
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The application creates a change in the following existing site conditions: fill in all applicable spaces
New
Change in number of signs from to
Change in setback for sign from to
Change in size of sign from to
Change in height of sign from to
Change of wording/copy from !W#4bcJA) to rL�Ir�C} 2W AAkWy4!1
Sign Wording/Copy:
Sign size: Length 3C x Width =Total Sq. ft. Sig4 Hel t (freestanding sign)
Color and Material to be used:_1&4eAc '14 Aw EGA c
Provide 2 copies of a scaled drawing or surveyed plot plan with the following information:
location of sign (walls signs: drawing of the fagade 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: QS
67
I hereby authorize the applicant to ace a sign on my property or building.
OWNER SIGNATURE: DATE:
L:\Sue Hemingway\Building.Permit.FORMS\Sign Permit Application-doe
V: 1/6/2005
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