NO. ________       

 

 VILLAGE OF DANSVILLE

TOWN OF NORTH DANSVILLE

Livingston County, New York

APPLICATION FOR SIGN PERMIT

                                                                                              DATE:    ____________

APPLICABILITY:

           No sign, advertising structure or devise which advertises the principal business or principal businesses conducted

            on which the sign is located shall be maintained or erected without a written permit .

 

INSTRUCTIONS:

           

            A.         Two (2) COMPLETED copies of this application to be filled in by typewritter or in ink and submitted to the     Code Enforcement Office. Any application which is missing information will be denied by the Code    Enforcement Office.

B.         A Plot Plan showing a DETAILED description of the location and position of the sign on any building or land, and its position in relation to nearby buildings, structures, or existing signs, and to any private or public streets or highways.

C.         Two (2) COMPLETE  sets of detailed drawings or blueprints showing a description of the construction details of the sign and showing the lettering and/or pictorial matter composing the sign; position of the lighting or other extraneous devices; a location planplans showing proposed construction

D.         Written consent of the owner of the building, structure or land to which or upon which the sign is to be erected, in the event the applicant is NOT the owner thereof.

E.         Upon approval of this application, the Code Enforcement Officer will issue a Sign Permit to the applicant and return one         (1) set of the plans and application. The permit shall be kept on the premises during the progress of the work.

            F.         The Building Inspector shall have the right to enter upon the premises for the purpose of inspection and        construction covered by this application at any time during the construction period without notice.

G.         NO Sign shall be used for any purpose whatever until a CERTIFICATE OF COMMPLIANCE has been granted by the Code Enforcement Office.

            H.         All wiring must be inspected by an approved agency. All wires and fixtures must be exposed for       preliminary inspection. Power Company must be contacted for application.

I.          Contact Code Enforcement Office for inspection when work is complete. Allow twenty-four (24) hours for inspection.

                       

 APPLICATION IS HEREBY MADE to the Code Enforcement Office for the issuance of a Sign Permit, pursuant to the Zoning Ordinance of the Town/Village of Dansville for  the signs as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations.

 

_______________________________________________________________________________________________

                              Signature of Applicant                                                                                                                Address

 

1.         Owner Name:__________________________________        Company Name:__________________________          

           

            Owner Address:________________________________        Owner Phone#: ___________________________          

           

2.         Contractor:____________________________________        Contractor Phone#: _______________________           

  

              Workmans’ Compensation & Disability Carrier & Policy #:________________________________________

            ** A COPY OF YOUR INSURANCE CERTIFICATE MUST ACCOMPANY THIS FORM – NO EXCEPTIONS

 

3.   Location of land on which the proposed work will be done:______________________________________________

 

4.   Tax Map No.:____________________________________     [can be found on tax bill]

           

5.   Type of Sign:                       Facia:_____________________              #:________________                

                                                Free Standing:   _____________             #: ________________

                                                Temporary: _________________

Other (describe): ____________________________________________________

 

6.   Finished dimension of sign:

            Height:______________ Length: _______________Sq.Ft.: ___________________                

                                   

7.   Size of lettered fascia:

                                                Height:______________ Length: _______________Sq.Ft.: ___________________                  

 

8.   If Sign is to be illuminated, what method will be used:

Interval: ___________________  __         Indirect: ___________________________

             

9.   Names of property owners immediately adjacent to property or building on which sign is to be placed:

 

            _______________________________________                _____________________________________

 

            _______________________________________                _____________________________________

 

10. Estimated Cost of Project:  $___________________

 

11. Zone or Use District in which the premises are situated:________________________________________________

 

12. On page three (3) of this application or on separate drawings, draw front and side view of sign giving shape, depth, length, width and height.

 

13. FEE(S):  SIGN:$___________           Planning:$______    ZBA Varience:$_______           TOTAL:$_____________

 

 

 

 

_____________________________HEREBY CERTIFIES THAT HE/SHE IS THE applicant and owner named above; and that all statements contained in this application are true to the best of his/her knowledge and belief, and that the work will be performed in the manner set forth in this application and in the plans and specifications filed therewith.

 

CONTRACTORS CERTIFICATION:  I hereby certify that all items in the Sign Ordinance will be enforced.

 

                                                                        _____________________________________________

                                                                                                Signature of Applicant

 

                                                                        _____________________________________________

­­­­­­­­­­­­­­­­                                                                                                Signature of Contractor

­­­­­­­­­           

                                                                       

 APPROVED

DISAPPROVED_________________________________________

                                    Code Enforcement Officer

 

 

 

Application is hereby made to the Zoning Board of Appeals and/or Planning Department for a Variance/Special Use Permit for the use of the premises as described above for which an application for a sign permit has been denied based upon the following information

 

 

 

 

 

___________________________________

          Code Enforcement Officer

 

 

Office Use Only:

           

            CERTIFICATE OF COMPLIANCE issued on _____/_______/________                                                                                                  

                                                                                                                                                ________________________________________

                                                                                                                                                  Code Enforcement Officer                          

 

 

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