HomeMy WebLinkAboutZ-4023FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certi[icate O[ Occupancy
No..Z. ~23 .... Date ........... 0etobel* - - 16. ·., 19..70
THIS CERTIFIES that the building located at 8/5. Oregon .Roed ....... Street
Map No. X~ ......... Block No .... Xx .... Lot No.~ ..... ¥,att~.tuek...
conforms substantially to the Application for Building Permit heretofore filed in this office
dated .......... 0et. · · ~16 · , 19. ~0 pursuant to which Building Permit No... NOI~.
dated ......... Oct..~6 ...... , 19-70, was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is . L~l~te. one .family. dwellSn~.. (. ~onve~.ted. l~rom, forme~, sohool bldg)
The certificate is issued to . Lo,do. lgolone~ ...... OwneF. ..........................
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval ·
House
0.. ............
Building Inspe~or
SCHD
RECEI'VED
0OT tS I~ 3:33
BEPART, f~N'? (¢,F h.,,L l t4
SUFFOLK COUNTY DEPARTMENT OF HEALTH
Date
Bldg. Permit No.
TO WHOM IT MAY CONCERN:
The sewage disposal facilities for a
(Give deed location)
structure located
have been inspected by this department and found to be satisfactory.
1978
District Engin~
District Engineer