HomeMy WebLinkAbout25411-zFORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 25411 Z Date DECEMBER 15, 1998
Permission is hereby granted to:
DIANE KELLY
4786 VALHALLA DRIVE
BOULDER CO, 80301
for :
CONSTRUCT A FENCE ENCLOSURE IN REAR YARD~ NOT TO EXCEED 6' IN
HEIGHT AS APPLIED FOR.
at premises located at 480
County Tax Map No. 473889 Section 117
pursuant to application dated NOVEMBER
Building Inspector.
FRED ST NEW SUFFOLK
Block 0004 Lot No. 019
24 1998 and approved by the
Fee $ 35.00
Author~ Signature
Rev. 2/19/98
ORIGINAL
November 26, 1998
4786 Valhalla Drive
Boulder, Colorado 80301
November 25, 1998
Southold Town
ATTN: Building Permit Dept.
RE: 480 Fred Street, New Suffolk, New York 19956
To Whom It Concern;
I hereby authorize Sarah Goldman to apply for a building permit to install a
temporary fencing structure on my property at 480 Fred Street, New
Suffolk. This structure will smwe as a fenced in area for Ms. Goldman's
dog.
The installation of concrete footers is not authorized.
/~~rely,
Diane Kelly
· FORH NO. I
TOWN OF SODTHOLD
BUILDING DEPARTi~RT.
TO~ ~.L
SOU~OLD~ N.Y. l ]97 I
'~L: 765-1802
Disapproved / -.- ..............
APPLICATION FOIl
BOARD OF BI~ALTB ...............
3 SETS 0¥ PLANS ...............
$I~VB¥
INSTRUCTIO1/S
a. 'mis applicetlcn mt, t be'c~plerely filled in by tTpe~iter or in ink and subnitted to the ~_~!lding InsI~tor
3 sets of plans, a~_~_~a~e plot plan to ~a!e. Fee __~mo__~ding to schedule.
b. Ptot plan slx~ing locatio~ of lot a~d of boila_!~ en trr_~!ses, ~elati~tp .to adjoining praises or public
streets or areos, an~ giving a detailed &__~t_ l~tO~ of layout of property ~,,-t be dra~ eft the diagra~ ~hicb is part of
~his applicatiom
c. 1he ~ork covered by this applicatio~ ~ mt be c~ced before isfmance of Building Pemlt.
d. Upc~ approval of thla applicaci~, tt~ Building Inspector ~rill i_~_~ a -~-~!ldlr~z Pemlt to ~ applicant. ~uch
pemia shall be.k~pt ~ ~e pr~_ 'Ises available for inspecCio~ thmt~hour the
e. No b~ilding ~all be oeoTiad or used' in ~hole or in part for any purpose ~batever tmtil a Ce~ificate of
Occupancy shall have been ~ced by ~ ~_~!lding T~3ector-
/uPFLI~C~ I$ ,libel ll~ to __rbe 9dlding Depar~,~ for the iss~'o Of a ~_,!ldi~g Pe~it pursuant to the
I~ldi~ Z~e Ord~nsnce of ti~ To~ of S~uthold, Suffolk Coun~y, Ne~ York, and off, er applicable L~, Ordi~s'or
........... t~ction of betlai~% ~t4tti~as or alteratic>~s, or for re--va1 or da~li~;i~, as herein
~he l~t agrees to
..... ~o ~/,nit ~thorized ;_nm2ectora ~ pre~_ ses ~ in b~~
State ~_her apptice~t is C~r, lessee, ~ent, architect, e~i~eer,' ~r~ral co~r~'tor, electrician, plt~her or buil&~
l~rr~ of oaner of pr~ntses ........................................................................
(as off ~ t~ roll or latest deed)
If applicant is a corporation, sig~atore of ~ly aur_horiz_~ officer.
(Na~e and title of cort~rate officer)
Builders Licease No ..........
Pl,~r~ Lice~-~e No ....
El~ctrlci~n-~ License No ............
.........
Ori~er Tr~,~e~_'s License No. ~'mo .............. ' ..................
I. Locatic~ of l~nd c~ utxlch 1~ he ~ ........ ~'"~' ~ .....
lkms~ N~her Street ,.~
..... ..... .............. .... .......
· Filed 1/ap
Sdodivlsle~ ...... ~ .......................... .Ilo ............... Lo~ ............
a. gxisEing tree and oe.c~an~ .....~0. o~...~..o
. f..m. ·
P~ture o[ ~rk (dieck ~ldd~ applic~t~le)~
~ir ............
~timt~ ~st ........................ f~ ..............................................
ti &~lli~, ~r oi ~11t~ ~tts .......... ',, t~r of ~11i,g ~its ~ ea~ ~r ................
If gnr~, ~r oE ~rs ......................................
I~ ~i~ss, ~.,.~z~ial ~ ~ ~, ~i~ ~ ~ ~t~t of ea~ ~ o~ ~ ......................
Oi~st~s of ~sti~ st~s, t~ ~ ~t ................ ~ ............... ~pth .................
t~i~t ...............
........... :
~pth ....................
~i~t .....................
9. 8i~ of lot:
10. ~te o~ ~d~a~ .....................
II. ~ or ~ dls~ict in ~i~ ~t~s ~ si~t~ ..............
12. ~s ~ ~t~ti~ ~ola~ ~ ~l~ 1~ ~i~ ~ ~latt~: ........................
13. ~ill lot ~ ~ .................... gill ~as f111
~o~tr~t~... .................... .. .. · . . ..... ~resa .... ........................... ~ ....... :.-.
15. Is this ~ ~tn ~ f~t of a tt~t ~tl~ * ~ .......... ~ ..........
~OT DIAG~
~r i~terior o: ~r lo~.
O~u'bl I~ ~ .......................
(~e of in~ivldual si~nin~
lie is tie ...................................................................................................
(gc~tractor, ~e~_~ COrlX:~nte o£[tcer, etc.)
of said c~mer or c)mers, ami is thlly auti~orized to perform or have per£ormed the said ~ot~k ami ~o rreke a~d £ile this
applicati~; that all state,~a~ts co~talred in this apj)lication a~e true to the best of his knc~led~ and beliefl m~d
that the ~rk will be perio,,~d in tie manner set f~rth i~ the application film tiere~th.