2004-875 Dr. Kit E. Burkich ` TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040875 Application Number:, A20040875
Tax Map No: 523400-301-008-0001-016-000-0000
Permission is hereby granted to: KTT_FT JFN BTTRKTC;H
For property located at: 366 AVIATION 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: KIT ELLEN BURKICH
366 AVIATION Rd Sign
Total Value
QUEENSBURY, NY 12804
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2004-875 DR. KIT E. BURKICH
31.25 SQ FT FREE-STANDING SIGN
change of copy and increase in size sign from original permit 93-1611
Paid $14.51 for size increase.
$14.51 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 To f Queen ury; ue day, November 16, 2004
SIGNED BY for the Town of Queensbury.
\ Director of Building Cod nforcement
fi6i- �7 02(
d
Fee Paid
TOWN OF QUEENSBURY -- - -� -- - - - I
�'~ Approved By: YtU
742 Bay Road, Queensbury,ANY;'12804�
I Permit #:
(518) 761-8256 OC! Z-"'
� zoos
SIGN PERNIT,,APPLICATION
THE FOLLOWING INFORMATION IS REQUIRED:
1. Detailed drawing or photo of sign. atf
2. Plot plan of location of sign. Pf
� • � -� ' �I�
3. Written consent of the owner of the building or land.
OWNER OF PROPERTY _K 17 E. 'I3- U iCH bns
ADDRESS _ 1aL AyianotiJ �� G[EE�LJS/Sti I TEL• 793- 1117
NAME OF APPLICANT NOLl`� W MEGUSIC
ADDRESS Up CST L26, TEL.
BUSINESS NAME IF DIFFERENT: )�. b'
TYPE AND LOCATION
Check What Applies: Existing Permanent X Projecting Sign
Temporary Non-conforming Existing
Free_S-tand,in.g -x'• Wall New
Location: Tax Map Number
Address _ 36(o TAVr� Oej Wcb - e-:EoSatIle
Proposed Setbacks from Property Line (front) _ (side)
s check appropriate box: " U
If sign is to be illuminated, please ��
Internal ( j , External (X) , Incadescent ( ) , Neon ( ) , Other ( ) �,�
Size of Sign: Width 1�E. Length �5 _ ft.
Total Square Footage: _ .31•a
Sign Copy: J,te-KJC�D._r-i J/ �_etc•
Color and Material To Be Used:
Signature:
Circle One: plicant—,)owner, contractor or agent.
I HEREBY AUTHORIZE APPLICANT TO PLACE A SIGN ON MY ROPERTY OR BUILDING.
Signature of Property Owner:
b
ORIGINAL-Office Copy COPY-Applicant
3
'�Cpps a�� iw -&'�,�•;aN3r _ �. a'�'�
oZ L Mai,
eel
EP
or-
�3 4
{CUSTOM SIG , S
�_
A DIVISION OF THE WHEELER ART GROUP, INC.
16 Richardson St. .Queensbury, NY 12804
�
Phone/Fax: 518-793-2620 email: kdwheeler@adelphia.net A ,; .
1?00V
3.66
Dr. Kit 'E. Burkich
� dENT�ST
o
Dr. Michael E. Nolan
�ENT�ST
Natural Health of Queensbury
Acupuncture r Massage Therapy
to Kevin Campopiano, L.Ac.
M Cindy Campopiano, LMT
(518) 615-0505
naturalhealthofqueensbury.com
GO "
1
Client: Dr. Kit Burkich
Drawing: Office
Date: 9/22/04
QD 2004
This design Is copyrighted and Is
th"exclusive property of
The Wheeler Art group,Inc.
Approved by: it is not to be copied or reproduced In any way
until approved and accepted
through purchase by the client.
�y oo,
s
RED MAPLE
O.
i of
----- �. .., .
�J
APPROXIMATE
�N
vA
aS
v 1'9" WHITE_PINE
INS
r BLACKTOP .PARKING AR
5a' EA
lAk
22" WHITE, ..INE 7
HEDG i .
N 84
1> pp . . o