HomeMy WebLinkAbout9314-Z FORM NO. 2
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 9314 Z
Permission is hereby granted to:
.......... ;]L~sher~.. ]:.sland ............ ]~.~., ...............
to .....~. ~1,~,.. ~..m...f..~lX:r...~.!.l~ ...................................................................................
at premises located at ..~,.~1~[.......4~I'......~.~..~...~'~;~. ...... ..~.~.8...h~...~..$.....~..~.[.~.d.....~..a...~. ..............................
......................................... ~,,**0,,.~, ..... ~.enn_~ _n~_! ~..~o ~d .............. ~he~.s....Z.~l ~nd. ................
pursuant to application dated ...................... ~.e.......~.. ................. 19...~....., and approved by the
Building Inspector. N0~1~-$ Permit su~®~ t;o olM;a~ ~uffolk Oo~'~
~ Health Dept permit fo~ ee~e~age disposal
Fee $....~ ........
Building Inspector