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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. ¥.
BUILDING PERMIT
('THIS PEPJ~IT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Permission is hereby gr,an~ed to:J .,~.,
-~.~......:..,/.._¥~...~.~,~.... ................... ...~..~....~..~ ...........................................
, ...........................
at prem,ses located c~, ......~ ........ .~..~~.....~ ...............................................................
County Tax Mop No. 1000 Section ......... .~...~.. ...... Block .....~ ............ Lot No ........ .~.../.. .......
pursuant to application doted ....... ...~...~.. ...................................... , 19....~...,'~ond approved by the
Building Inspector.
Fee $..~..~
Rev. 6130/80
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