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FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
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BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO.
31145 Z
Date MAY
18, 2005
permission is hereby granted to:
R K & KEYDEL SCRIPPS
114 W 47TH STREET
NEW YORK,NY 10036
for :
ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR PER ZBA APPROVAL #5685Z
at premises located at
2745 PINE TREE RD
CUTCHOGUE
County Tax Map No. 473889 Section 104
Block 0003
Lot No. 006
pursuant to application dated MAY 16,
Fee $
267.00
. nature
Building Inspector to expire on NOVEMBER
ORIGINAL
Rev. 5/8/02
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