2004-974 Jiffy Lube TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040974 Application Number: A20040974
Tax Map No: 523400-296-020-0001-002-000-0000
Permission is hereby granted to: NnFFMAN_ T. RF,AT,TV TJ.C;
For property located at: 265 QUAKER Rd
in the Town of Queensbury, to construct or place
at the above location in accordathce 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. Tyne of Construction Value
Owner Address: HOFFMAN, T. REALTY LLC
1757 CENTERAL Ave Sign
Total Value
ALBANY, NY 12205-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2004-974 HOFFMAN CARWASH
26 SQ FT WALL SIGN (JIFFY LUBE)
$52.00 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 T of Quee bury; ! W nesday, January 05, 2005
SIGNED BY t ! for the Town of Queensbury.
Director of Building'&Cocre Enforcement
TOWN OF QUEENSBURY Fee Paid:
742 Bay Road, Queensbury, NY 12804 Approved By:
(518) 761-8256 Permit #: '
SIGN PERMIT APPLICATION
THE FOLLOWING INFORMATION IS REQUIRED: C�rC 2 1 2004
TOUVN OF
1. Detailed drawing or photo of sign. QQ1LDJ1VG�L'EEhjS8 RY
2. Plot plan of location of sign. E
3. Written consent of the owner of the building or land.
OWNER OF PROPERTY
ADDRESS JZ CL—Q7',P. L �I 1T ; ,�.11 TEL.
NAME OF APPLICANT Cz ( p Jl
ADDRESS J''�� TEL. , 5�9 71 2—
BUSINESS NAME IF DIFFERENT: fj�D/"j�J�6�'� Z _ jl��i Log&
Jd
TYPE AND LOCATION
Check What Applies: Existing __ Permanent Projecting Sign
Temporary Non-conforming Existing
Free-Standing Wall New X( .
Location: Tax Map Number -_ -_ ,;1�'� Z 2—
Address
Proposed Setbacks from Property Line (front) &D (side) A 00
If sign is to be illuminated, please check appropriate box:
Internal ( j , External ( ) , Incadescent ( ) , Neon ( ) , Other �) rr
Size of Sign: Width ft. Length 13 -ft. ��1� / 05
S/
Total Square Footage: _ �2, cd
Sign Copy:
Color and Material To Be Used: L,� t�J C- 4A�G,C���-3�
Signature:
Circle P
e: pplic nt, owner, contractor or agent.
I HEREBY AUTHORIZE APPLICANT TO PLAC A SW ON MY PROPERTY OR BUILDING.
Signature of Property Owner: // 1 1fr,
ORIGINAL-Office Copy COPY-Applicant
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FFMAN'CAR WASH —_JIFFY-LUB
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TOTAL 214
SIGNS- '.-10 IPPR
YED
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