2004-025 Adirondack Sunrooms TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040025 Application Number: A20040025
Tax Map No: 523400-309-010-0001-088-002-0000
Permission is hereby granted to: ADIRONDAC'K SI NROOMS
For property located at: 53 LUZERNE 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: A& Q HOLDINGS INC
10 SAGAMORE St sign
Total Value
GLENS FALLS, NY 12801-0000
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Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2004-025 ADIRONDACK SUNROOMS
25 SQ FT WALL SIGN
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday, January 28, 2005
(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 Tgi�m of eens' ; e y, January 28, 2004
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Fee Paid: ,
TOWN OF QUEEVSBURY
742 Bay Road, Queensbury, NY 12804 Approved By: r/
518 761-8256 Permit #: o 5
SIGN PERP4IT APPLICATION
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THE FOLLOWING INFORMATION IS REQUIRED:
TOWN Oi %' �-* N6BURY
1. Detailed drawing or photo of sign. BUILDING AND CODE
2. Plot plan of location of sign.
3. Written consent of the owner of the building or land.
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OWNER OF PROPERTY _ �`�`i � � -r-( nL� '
ADDRESS 45. TEL. Q-ql
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NAME OF APPLICANTS�C,� � ��v��� S �C
ADDRESS 2 « C TEL.
BUSINESS NAME IF DIFFERENT:
TYPE AND LOCATION
/ RE PVE
Check What Applies: Existing _` Permanent ,.,- Projecting Sign
Temporary Non-conforming Existing
Free-Standing Wall 1/ New � 1' = f 4
Location: Tax Map Number - _ TOWN OF ')ti :r_NSBURY
BUILD!N-'-,1ND CODE
Address _ __
Proposed Setbacks from Property Line (front) _ (side) _
If sign is to be illuminated, please check appropriate box:
Internal ( ) , External ( ) , Incadescent ( ) , Neon ( ) , Other ( )
Size of Sign: Width �J !j f Length f 0 ( — ft.
Total Square Footage:
Sign Copy: _S_eZ' 414-1 w7-
Color and Material To Be Use ?�� � I/II�d `"��/���� IVIVV (_ Ca��
Signature: � '�
C'Ircle' One: Applicant, owner, contractor or agent.
I HEREBY AUTHORIZE APPLICANT TO PLAC ON MY PROPERTY OR BUILDING.
lC Signature of Property Owner: r~
ORIGINAL-Office Copy COPY-Applicant
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