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FORM NO. Z
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)
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Permission is hereby granted to:
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to .......~l/..!.~.!)...............A..............A.c~..~..$.$.p.J~..y................]??!.'.~...p.~.~0.......... ...
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ot premises located at .............................................................................................................................
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pursuant to application doted ...............................~..~.~~....~.y...., 112....., ond approved by the
Building Inspector.
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Fee $........................
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Building Inspector
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