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TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N'. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
CQMPLETION OF THE WORK AUTHORIZED)
N? 6476 Z
Permission is hereby granted to:
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................... ~i-~',~t~k .......................................
to .. ~u.:L..~ct... a~.- a~:~ ~1.~- ~.$o~.- ~n.. e~.s ~.:~.n-~.. ~we -Z.]: ~. rz g ........ : .....................................................
at premises located at ..]-0~,~.,-,~1~-~,~ ....... .T.O.'i.~y'~o(:~ .....................................................................
........................................ Meda¥...J~v.e .............. ~4a.~. ~,~o k. ..............................................................
pursuant to application dated ................... ~LD~.,I..J_. ....... ~"1 ........... .i., 19r].~..., and approved by the
Building Inspector.
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~ Buildin~ Inspector' ~
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