2010-401 .4�` TOWN OFQ UEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Pernut Number. P20100401 Date Issued: Thursday, August 19, 2010
This is to certify that work requested to be done as shown by Permit Number P20100401
has been completed.
Tax Map Number. 523400-302-014-0002-027-000-0000
Location: 123 DIXON Rd
Owner. BAYVIEW PROJECTS LLC
Applicant: BAYVIEW PROJECTS LLC
This structure may be occupied as a:
Sign
By Order of Town Board
TOWN OF QUEENSBURY
11
Issuance of this Certificate of Compliance DOES NOT relieve the ` .` , 4';7+1 ;`.?�
property owner of the responsibility for compliance with Site Plan, `'
Variance, or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
iFfoN 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20100401 Application Number. A20100401
Tax Map No: 523400-302-014-0002-027-0004)000
Permission is hereby granted to: BAYVIEW PROJECTS LLC
For property located at: 123 DIXON 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 Queens bury Zoning
Ordinance. Type of Construction Value
Owner Address: BAYVIEW PROJECTS LLC
123 DIXON Rd Sign
QUEENSBURY,NY 12804-0000 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans &Specifications
2010-401
6 sq ft freestanding sign to read "Jay Wasserman DDS Dentist 123"
$12.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Friday,August 19, 2011
(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 eens ,
,'1' ursAugust 19, 2010
SIGNED BYE, y v' � °` for the Town of Queensbury.
Director of Building&Code Enforcement
3G %4 Z. "2. OFFICE USE ONLY •', I
a cr '
• TAX MAP NO. PERMIT NO. /0--40 !PERMIT EE /� r + i pt
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+ APPROVALS: DEPOSIT , ;
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SIGN PERMIT APPLICATION:
A permit must be obtained before installation of your permanent sign. All applicants'spaces on this application must
be completed and must appear on the application form.
OWNER: B,1'1"IA') P1 c 5-6C-17- I-1-C INSTALLER/BUILDER:
ADDRESS: .3 11 (X o N Rb
ADDRESS:
PHONE NOS. -7q2-- III 2 PHONE NOS.
LOCATION OF PROPOSED INSTALLATION:(LEGAL ADDRESS) 1 2-3 D I X 0 Al R0 A iT)
BUSINESS COMPLEX/PLAZA/MALL NAME:
BUSINESS NAME: A y vi A S S dvt i/rAi 17>7)..S
CONTACT PERSON FOR SIGN CODE COMPLIANCE: 3 r l y t/`i el S g WI 0-7\-/ PHONE: �C2 2 rl" / ?-
TYPE
TYPE OF SIGN PROPOSED: "freestanding _wall `awning —projecting
IF SIGN IS TO BE ILLUMINATED,PLEASE INDICATE: _`IInternal _External _Incandescent _Neon _Other
DO SIGNS CURRENTLY EXIST ON THE PROPERTY? ✓Yes _No /� "
IF YES,LIST ALL EXISTING SIGNAGE: 1--
4(
S I GA '�IllC-j Wi J&sLt-o Vel
h/�./tuc it olc.k St .v� o 3 S( &AY fz (The application creates a change 9 New J Q a S1
in the following existing site Change in number of signs from 0 to /�J`-r/
conditions(fill in all applicable Change in setback for sign from to
spaces): Change in size of sign from to
Change in height of sign from to
Change of wording/copy from: w "ito: ort -1559416661J:iiillOwistits.61"-5
Sign Wording/Copy: )4Y W 4 SS iM, DD-S 7A---.v c IS T 1 2 3
r GP i„,•t tr
Sign size: Length ` _f x Width [? =Total Sq.ft. Sign Height(freestanding sign): 1,,
Color and Material to be used: l+t c 11 b"''S I M v•'G-firw,q e- &r -- / r144✓ev d
I Provide 2 copies of a scaled drawing or surveyed plot plan with the following information:
o Location of sign (walls signs: drawing of the façade
the sign will be located on,indicate sign on facade)
o Height of freestanding sign QUESTIONS? CALL 7614256 OR EMAIL
o Depth of projecting sign codes0,queensburv.net
o Distances from front and side property lines. VISIT OUR WEBSITE FOR MORE INFORMATION
I Provide 2 drawings or photos of sign design. www.queensbury.net
✓ Provide Applicant and Owner's signature(permission oxisrid Cr S/
itrvi mow for placement of sign on the property or building). �a e: N/Z:/ 'e4 '7::1111.
e n: To the best of myknowledge,the statements contained in the icati Vogether with heplans and
Declaration: g > PPI , 09 PI
specifications submitted,are a true and complete statement of all proposed work to be done on the described premises and that
all provisions of the Zoning Ordinance,and all other laws pertaining to the proposed work shall be complied with,whether
specified or noted,and that such wos auth• ' •• •y the owner.
111
APPLICANT SIGNATURE: 40 ,' DATE: glia/0
I herebyauthorize theapplicant ••a - - sign on my property or building.
t9
OWNER SIGNATURE: (4,----,,,,_____ DATE: e! ' l
a
Ow Town of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804
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