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
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
SITE PLAN
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