2004-976 Hoffman Carwash Self Service Wash+ . TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040976 Application Number: A20040976
Tax Map No: 523400-296-020-0001-002-000-0000
Permission is hereby granted to:
For property located at: 265 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: HOFFMAN, T. REALTY,:LLC
1757 CENTERAL Ave Sign
Total Value
ALBANY, NY 12205-0000
Contractor or Builders Name /Address Electrical Inspection Agency
r �
Plans&Specifications
2004-976 HOFFMAN CARWASH
14 SQ FT WALL SIGN (SELF SERVICE WASH)
$28.00 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 Tp( oj.ueepury, a nesday, January 05, 2005
SIGNED BY � m for the Town of Queensbury.
Director of Building&Code nforcement
C
Fee Paid:
TOWN OF QUEENSBURY
742 Bay'Road, Queensbury, NY 12804 Approved By:
518 761-8256 Permit #: j
( )
SIGN PERMIT APPLICATION
THE .FOLLOWING INFORMATION IS REQUIRI_ ECEIV
1. Detailed drawing or photo of sign. D`C 2 1 2004
2. Plot plan of location of sign.
3. Written consent of the owner of the building or �� OF QUEENSBURY
U LDING AND CODE
OWNER OF PROPERTY _,
ADDRESS ! �`��� l�Cf�7'��L f���". ,,TEL. C2C
NAME OF APPLICANT C A t LJJ# J,
ADDRESS 'Mc
TEL. 5 7 46 bZ
BUSINESS NAME IF DIFFERENT: � �
TYPE AND LOCATION
Check What Applies: Existing —_ Permanent >( Projecting Sign
Temporary : Nan-conformin Existing
Free-Standing Wall New .
Location: Tax Map Number
Address cos _
— -
Proposed Setbacks from Property Line (front) (side) 160
If sign is to be illuminated, please check appropriate box:
Internal ) , External ( ) , Incadescent ( ) , Neon ( ) , Other
Size of Sign: Width ft. Length 1 _ ft.
Total Square Footage:
Sign Copy
Color and Material To Be Used:
Signature:
Circles ne: ppli ant, owner,. contractor or agent..
I HEREBY AUTHORIZE APPLICANT TO PLA E A IGN ON MY PROPERTY OR BUILDING.
Signature of Property Owner:
ORIGINAL-Office Copy COPY-Applicant
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