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Home My WebLink About24464-ZFORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HA~ $OUTHOLD, N.Y. 24464 BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ....... ~..o.y.~.U.~ ....... ..S. ......................... ~ 9.....9...?... Z Perml~lonls herebygrantedto: NORTH FORK NURSERY INC. P.O. BOX 645 ......... g...~...~9~.L.~ .................................... to ....... ~..u. 9~.~..~.~.~.~..6.~g.~P...~...~..~..~..~?~,..~.O.~ ......... at premises located at .................... ..9..3..5.......~...R~,.,~.~. ~ ~ ~.V..Z...~. ~.~....~ ......................... ~.g.~ .............. County Tax Map No ....... ~.'~..8_.8..8.~.... Section ..... ~.g~ ........... Block ...... 90.9.2. ....... Lot NO...O. gg.:. ,O...O.g... pursuant to application dated ..... ..o.g~g~ ....... ~.z. ....................... 19 ....... ,9.~..., and approved bythe Building Inspeotor. Fee $ .......... ~.5.. :,.0...0.... Rev. 6/30/80 Disapprt,~ed a/c .................................. .................................... .... APPLICATION FOR BUILDING PE~IT ¥ORt4 NO. TOI/N OF SOUTHOLD BUILDING DEPARTI4ENT TOIiN HALL SOUTHOLD, N.Y. { I97 TEl.: 765- 1802 IHSTRUCTIONS BOARD OF HEALTH ............... 3 SETS OF PLANS ............... SURVEY ........................ CI~CK ......................... SEPTIC FORH ................... NOTIFY: CALL ~. -'Y.g.~ ~ .... NAIl. TO: .................... a. 'l~is application ntmt be ean~letely filled in by type~iter or in i~ a~ ~itt~ to ~e ~dlding Ins~tor ~itl 3 ~ts o~ pl~, ~ate plot pl~ to ~ale. F~ ~co~i~ to b. Plot plm ~ l~ati~ of loc ~ of ~ildi~s ~ ~s, ~lati~ip to ~joini~ pr~i~s or ~lic struts or are~, ~ givi~ a ~tail~ ~ri~i~ of la~t of ~r~ ~t ~ dr~ ~ t~ di~ M~id~ is ~rt of this a~flicati~. c. 'fl~ ~ ~ ~ ~is a~licati~ ~] ~t ~ c~ ~fo~ isle o~ ~ildi~ Pe~it. d. U~ ~al of ~is a~li~ti~, t~ ~ildi~ lns~ctor will is~ a ~ildi~ Pemit to tl~ applier. ~mit ~11 ~ ~pt ~ ~ ~s avail~le for in~ti~ that t~ ~rk. e. ~ildi~ ~11 ~ ~i~ or ~ ingle ~ in ~rt for ~ ~at~r mtil a ~rtiflcate of ~ ~mll I~ ~n ~t~ ~ tim ~ildi~ l~tor. ~.I~H~ IS ~l ~ to t~ ~ildi~ ~r~nt for tim isle of a ~ildi~ ~t ~r~t to the ~ildi~ ~ ~i~ of ~ T~ of ~ld, ~ffolk ~, ~ Yo~, ~ ot~r a~li~le ~, ~ir~s or ~lati~, for t~ mt~ti~ of ~ildi~, ~iti~s or alterati~s, or for r~al or ~liti~, ~ ~reln ¢~ri~. ~ a~li~t ~s to ~ly wi~ all a~li~ble 1~, ordi~es, ~ildi~ c~, ~i~ c~, re~flati~s, ~ to ~it ~ri~ i~tors ~ p~i~s ~ in ~ildi~ for ~es~ ins~ti~s. (Signature of applicant, or hare, if a corporation) · ? /qy..7... ........ :.':": and title of corporate officer) l~dlders License No .......................... 4. FINAL o ~ MUST Pl~nbers License ~ .......................... ~ MEEr El~trici~ Li~ ~ ...................... ~ ~E N.Y. ~r ~'s Li~ ~ ..................... I. ~ti~ of 1~ ~ ~id~ ~ ~ rill ~ ~ .... ~.~.~,ffJ~ ............ ~~;.;~ ...... 1~ ~r St~t ~et ~ivisi~ ...................................... ~i1~ ~ ~ ................ let ............... (~) 2. State ~isti~ m ~ ~ of ~i~s ~ inte~ ~ ~ ~ of ~o~ ~st~ti~: a. F~sti~ m ~ ~ ....... ~.~.~.. ~4.~.d .................................................. P;~ture of ~o~k (check ~hich applic~lfle): ~ ~xldi~ .......... ~iti~ .......... ......................... ............................(to ~ ~id on filing Ods ]E garage, ,~r o~ ~ra ....... . .~ ............................ ui,,~.~i~,~ o~ ~i~ ~t.~. ir ~: ~ ........ /~[ .... ~ ............... ~.t~, . l~i~t ......................... ~r of Stories .... ~ ............... Di~nsi~ of ~m stature ~ith alterati~s or ~iti~s: ~ ............... ~ar ............... ~pth .................... l~i~e .................... K=d~r of Stories ............... Diuensi~m of entire ~ ~st~ti~: l~t ................ ~ar ............... ~pfl~ .............. l~i~t ......................... ~r of Stories ..................... ~ or u~ district in ~id~ pr~i~ a~ si~t~ ... ~.~ ................................................ ~s pro~ ~t~ti~ violate any ~i~ I~, o~i~e or re~lation: .~ ................... Will lot ~ ~r~ .................... ~ill ~ess fill ~ r~ ~ ~md~s: ~ o[ ~rd~it~t .................................... ~resa .............................. ~ ~ ............... Is this pt~rty wiflfin ~ f~t of a till ~tlmfl? * ~ .......... ~ .~. ..... ! PLOT DIAGRAH locate clearly and distinctly all buildings, ~hetlmr existing or proposed, and indicate all set-back dimensioos frcfa property lines. Give street and block r~ber or description according to deed, and sho~ street nares ar~l ir~licste xd~etlmr interior or corner lo£. ~ is tt~ ................ .~-...t~...~C~..~A~... .................................................................. (Cx~tractor, agent, cor~rate officer, etc.) ,f said (~r or ~ers, and is th~ly ~thori~ Lo i~rfonn or h~e [mrforn~ tim ~id ~rk at~l to ~ke a~l file this l~fl icatioG that all stato~nts c~tai~ in thi~ al~licati~ are tn~ to fl~e I~st of his ~]~ and I~lief~ and hat the ~rk will I~ {~rfon~l in tim ~s~r ~t foft[i is the al~lieati(m ~rn tO I~[ore ~ this ~ ~ ...... ...... /) // ~ot~ ~blie, Sta~ of ~w ~ I t ~o. 4~767~ Qualified in Suffolk Coun~ ~ ~ ~ duly s~orn, delX~S aiKI .says ttmt I~ is tim applicaot