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BUILDING PERMIT R()~ -r '3 \ fbqo
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL fbf
COMPLETION OF THE WORK AUTHORIZED)
Date.................J~....d~............. 19.~~
FORM NO.3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HAll
SOUTHOLD. N.Y.
Permission Is herebygr:z: ~
....... Wf!::({..........! :$..42.{!.!.!.fi I..~.................
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/!It.q,,..74,....(3.Wl..~.6:?n.~.;/..~..iil..I1...~~~I#t...~.rr
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at premises located at...;::.;P,2$ZJ../4!/?(4'.~...&..1.,t"...~~................................
..................................,......................r.-<..C!4?#Lb...~.d:..~~.............................................
County Tax Map No. 1000 Section .......g"....... Block ........~............. Lot No. .!Y.................
pursuant to applicaffon dated ...................................~.;?........ 19.2Land approved bylhe
Building Inspector.
(JZ)
50-
Fee $.............~......
Rev. 6{30{80
.......~....