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(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL ---
COMPLETION OF THE WORK AUTHORIZED)
Date Ip~..........................................." 19.7...[-:-
FORM NO.3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HAll
SOUTHOLD. N.Y.
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Permission Is hereby granted to:
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pursuantto application dated ....../L ~a. ~47 . ..... .... ............
Building Inspector. /''--''77/ .....................19................ and approved bylhe