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FORM NO. 3
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO.
33424 Z
Date SEPTEMBER 26, 2007
permission is hereby granted to:
WILLIAM NIEDORODA
13-48 209TH ST
BAYSIDE,NY 11360
for :
CONSTRUCTION OF A NEW SINGLE FAMILY DWELLING WITH FRONT PORCH &
REAR DECK AS APPLIED FOR
at premises located at
700 DEEP HOLE DR
MATTITUCK
Block 0012
Lot No. 010
County Tax Map No. 473889 Section 115
pursuant to application dated SEPTEMBER 13, 2007 and approved by the
Building Inspector to expire on MARCH
26, 2009.
Fee $
1,422.80
~~
Authorized Signature
ORIGINAL
Rev. 5/8/02