2010-004 TOWN OF QUEENSBURY
w 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20100004 Date Issued: Wednesday, January 20, 2010
This is to certify that work requested to be done as shown by Permit Number P20100004
has been completed.
Tax Map Number. 523400-296-019-0001-029-000-0000
Location: 357 BAY Rd
Owner. OLD SCHOOL HOUSE L.L.C.
Applicant OLD SCHOOL HOUSE L.L.C.
This structure may be occupied as a:
Sign
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the /4/ /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
.141%
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20100004 Application Number. A20100004
Tax Map No: 523400-296-019-0001-029-000-0000
Permission is hereby granted to: OLD SCHOOL HOUSE L.L.C.
For property located at: 357 BAY 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: OLD SCHOOL HOUSE L.L.C.
ATTN: JOHN & DIANE MATTHEW Sign
2546 STATE ROUTE 9L Total Value
QUEENSBURY, NY 12804-0000
Contractor or Builder's Name/ Address Electrical Inspection Agency
Plans &Specifications
2010-004
18 sq ft freestanding sign to read "Allstate The Crosby Agency 745-8200"
$40.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Thursday,January 20, 2011
(If a longer period is requited,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 Townof Queensbury; �7 r` Wednesday, January 20, 2010
SIGNED BY „ae '9 for the Town of Queensbury.
i
Director of Building&Code Enforcement
p /_z_ OFFICE USE ONLY
_ 4--dv
1 MAP N PERMIT NO.20/0-OO/, PERMIT FEE
APPROVALS: DEPOSIT
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. Ag
el-IOW Mct &A/' 3 INSTALLER/BUILDER:t `r c At,0Agel o r
ADDRESS: gessL �1
I -PAW'�beN� V'l 1JOlDDRESS: LPL( -, 4 r ake0,vjowl
PHONE NOS. (7 6cc' '5-,./..(p ( PHONE NOS. C37E 79. _ - 'g i((
LOCATION OF PROPOSED INSTALLATION:(LEGAL ADDRESS) 3_c? Q _ I ack„.? , SA(i� - Cue J_*1Lftii AlI.:BUSINESS COMPLEX/(PLAZA/MALL NAME: /
BUSINESS NAME: fIl Stakets-v.s ((- c e
CONTACT PERSON FOR SIGN CODE COMPLIANCE: EVI&j C. fb`� PHONE: 37 t?— 71-4.5-- '-'0c
TYPE OF SIGN PROPOSED: A freestanding wall awning projecting
~ IF SIGN IS TO BE ILLUMINATED,PLEASE INDICATE: Internal _External _Incandescent _Neon _Other
DO SIGNS CURRENTLY EXIST ON THE PROPERTY?�? AYes _No (� qC;�tl1! 'u. � rCi® 51 y
IF YES, LIST ALL EXISTING SIGNAGE: ire x. -U f �C Q t 1 - I
( /
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 to 6-1W-
,/ Change in height of sign from to
Change of wording/copy from: `S I i\il ,pdf- a'd'z 1.1 `�'to (P� •6AV �1 P L ��
Sign Wording/Copy: n\\5t e e 1 .p/Vc " '71fs--g o -NCI,
A
Ca
Sign size: Length U x Width
/� =Total Sq. ft. 20 Sign Height(freestanding`- si n): 1
Color and Material to be used: AIL(*leo u. , .801c -i-f•Q /)'V`� ` �_di�A so 1vcr- 130%
✓ Provide 2 copies of a scaled drawing or surveyed plot plan with the following information: 411PIt.t. F
o Location of sign (walls signs: drawing of the facade I/,►11(5
the sign will be located on,indicate sign on façade)
o Height of freestanding sign QUESTIONS? CALL 761-8256 OR EMAIL
o Depth of projecting sign codesaqueensbury.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 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 work is authorized by the owner.
APPLICANT SIGNATURE: //e....... DATE: 1/7//0
I hereby authorize the applicant t/•lace a sign on property or building. /
OWNER SIGNA /
M�, 1/1/( DATE: // 7/j0
:..�� . Town of Quee fury CommunityDevelopment Office 742 BayRoad, Queensbury, NY 12804
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