2012-077 Cumberland Farms TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
IFW
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20120077 Application Number: A20120077
Tax Map No: 523400-303-005-0001-024-000-0000
Permission is hereby granted to: CUMBERLAND FARMS. INC.
For property located at 410 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: VSH REALTY INC.
100 CROSSING Blvd#9003 sign
Total Value
FRAMINGHAM, MA 01702-5401
Contractor or Builder's Name /Address Electrical Inspection Agency
EMCO CONSTRUCTION
Plans&Specifications
BP 2012-077 Cumberland Farms
Change of Copy ONLY- freestanding sign
$0.00 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 Town c 432 bury eri ;, /nu.ry 25,2013
ff
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
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072 05--I--c)-4 OFFICE USE ONLY - •
T MAP NO. PERMIT Nd2 7 PERMIT FEE t" ,
APPROVALS: DEPOSIT 6 / , / f, • j
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SIGN PERMIT APPLICATION: _ 7
A permit must be obtained before installation of your permanent sign. All applicants'spaces o thi- ?
Pe Y l� 9 PPl P 1 :N =1rj'y
be completed and must appear on the application form. _ IjDi & s
OWNER: Cumberland Farms INSTALLER/BUILDER: Emco Construction
ADDRESS: 100 Crossing Blvd Frammingham MA ADDRESS: 2050 Western Ave Suite 210 Guilderland NY 12084
PHONE NOS. 508-270 /110 PHONE NOS. 518-456-1853
LOCATION OF PROPOSED INSTALLATION:(LEGAL ADDRESS) 410 Quaker Road
BUSINESS COMPLEX/PLAZA/MALL NAME:
BUSINESS NAME: Cumberland Farms
CONTACT PERSON FOR SIGN CODE COMPLIANCE: Kevin Huntington PHONE: 518-456-1853
TYPE OF SIGN PROPOSED: freestanding wall awning projecting
IF SIGN IS TO BE ILLUMINATED,PLEASE INDICATE: >4Intemal _External _Incandescent _Neon _Other
DO SIGNS CURRENTLY EXIST ON THE PROPERTY? 1Yes No
IF YES,LIST ALL EXISTING SIGNAGE:
The application creates a change New
in the following existing site Change in number of signs from to
conditions(fill in all applicable Change in setback for sign from to
spaces): Change in size of sign from X6 to # Y
Change in height of sign from to
Change of wording/copy from:
/ to:
Sign Wording/Copy: C v7 5et/,iv�6007s
Sign size: Length E x Width a =Total Sq. ft. z`li Sign Height(freestanding sign): /3 "I1
Color and Material to be used: /ICP,J P/175 3'167i&e &5 30/ �c y tic ,("A r,S to/WAr.,ecvoged
✓ Provide 2 copies of a scaled drawing or surveyed plot plan with the following information:
o Location of sign (walls signs: drawing of the facade
the sign will be located on,indicate sign on facade)
o Height of freestanding sign QUESTIONS? CALL 761-8256 OR EMAIL
o Depth of projecting sign codesOsmeensbury.net
o Distances from front and side property lines. VISIT OUR WEBSITE FOR MORE INFORMATION
✓ Provide 2 drawings or photos of sign design. www.queensbury.net
✓ Provide Applicant and Owner's signature (permission
for placement of sign on the property or building).
Declaration: To the best of my knowledge,the statements contained in the application,together with the plans and
specifications submitted,are a true and complete statemen • all pr... •. work to be done on the described premises and that
all provisions of the Zoning Ordinance,and .11 - Pe,n �,� . the proposed work shall be complied with,whether
specified or noted,and that such wog•s r'y°.
APPLICANT SIGNATURE: DATE:
I hereby authorize the applica • •ace . • •-4J•.building.
OWNER SIGNATURE: `/ �i-- DATE:
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Town of Queensbury• Community Development Office • 742 Bay Road, Queensbury, NY 12804
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Tax Map No. 109-3-36
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Free-Standing Sign
CUMBERLAND FARMS (Culf)
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LOCATION OF SIGN Quaker and Ridge Roads
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DATE ISSUED: June 9^ 1987
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PERMIT NUMBER: 87-94
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TAX MAP YVU8&BER: 109-3-36
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NAME AND ADDRESS OWNER V.S.H. Realty Inc.
/ _-�����==-- --_` ''_---_-
777 Dedham St.
Canton, MA 02021
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