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2004-001 Brennan & White Attorneys at Law TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20040001 Application Number: A20040001 Tax Map No: 523400-289-020-0001-005-000-0000 Permission is hereby granted to: BRENNAN&WHTTF, ATTORNEYS AT LAW For property located at: 163 HAVILAND 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: BAY WEST ASSOCIATES Sign 169 HAVILAND RD Total Value QUEENSBURY,NY 12804 Contractor or Builder's Name /Address Electrical Inspection Agency Plans&Specifications 2004-001 BRENNAN&WHITE ATTORNEYS AT LAW 32 sq. ft. freestanding sign $64.00 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 th. own of Oneensb Tuesday, March 09, 2004 SIGNED Y for the Town of Queensbury. Director of Bu'ding& ode Enforcement Fee Paid: , ILI TOWN OF QUEENSBURY 742 Bay Road, Queensbury, NY 12804 Approved By: (518) 761-8256 Permit #: _ SIGfi PERpIT APPLICATION THE FOLLOWING INFORMATION IS REQUIRED: �1 1. Detailed drawing or photo of sign. 2. Plot plan of location of sign. fCtbcatcq ��C6i� GL 3. Written consent of the owner of the building or land. 4 OWNER OF PROPERTY — 1,��Xe-✓Y7 J ADDRESS A /��/� ��r/ � .�����ie e.✓��✓rc� IV Y TEL. 7y2-- 9'17 V NAME OF APPL---I-CANT /C^�i✓�ti ✓ ��i7z L L� ADDRES� v, la- y TEL. 7y3-3y-2 V / � J BUSINESS �IF; DIFFERENT: TYPE AND LOCATION Check What Applies: Existing / Permanent �/_ Projecting Sign n PP 9 Y -- Temporary Non onforming Existing —_ Free-Standing Wall New Location: Tax Map Number Address Proposed Setbacks from Property Line (front) �{ � (side) — If sign is to be illuminated, please check appropriate box: Internal ( j , External ( ) , Incadescent ( ) , Neon ( ) , Other ( ) Size of Sign: Width ft. Length _ ft. Total Square Footage: — 3,2 Sign Copy: —_�"L-d Color and Material To Be Used: A//) 0 Signature: - - �,✓ �� T C/// Circle 0 pplica t, owner, contractor or agent. I HEREBY AUTHORIZE APPLICAN TO PLACE A S ON MY PROPERTY OR BUILDING. Signature of Property Y� ORIGINAL-Office Copy COPY-Applicant 0 LA t A�� IZ nn, z Vr,j, Joseph",-,R ..................... Ali JOSEPH E. r 11(42..4,H 0 L S DATE ,Isen @ Karg Uimpannr= ALL REGHTS RIESIERVIEO APPROVED:J� REVISED: JMX =2 GLEMS FALW, NY MAILING: SHOWROOM: P.O. Box 332 • Glens Falls,NY 12801 52 Main Street • Queensbury, NY 12804 ph. 518-792-4009 fx. 518-792-4476 J 01�i 4