HomeMy WebLinkAbout1644-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
I-:.EP. TIFICATE OF OP.E:UPANI-:Y
No. Z 296~ Date
THIS CERTIFIES that the building located at
Map No. ~ Block No. xX Lot No.
01d Harbor Road . Street
x~x. l~e.w..S..mff.q~.k,. ~,.Y, .....
conforms substantmlly to the Application for Building Permit heretofore filed in this office
dated ,,~r~..21 , 1962 pursuant to which Building Permit No. 16.~.bfg
dated ,]'al't. 23 . , 19 62, 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 P;~iv.~%e ~le..f.~.~jl,~y. ~0$~;k~g .................................
The certificate is issued to ¥1Ilcellt;. ,~,. C~ngha~l ....... [~,,,/tel'. ...............
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval N-R ....................
~O~M NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT.
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N.o 16ti' Z
Dote .............. ~v~12aA~r... 2.~ ..............19.~..
Permission is hereby granted to:
lr~.~.~;... ~., .. ~.l~z~;[;~gha. R~ ............................
.......... ]~a~te.. 1 ................................................
.................. Az'ao~, ..... Z[.~ ..............................
to .. ~.l~L..ae~...oz~e.. ~a~... ~wel~In~ .................................................................................
at premfses located at ..~(]~. B~I:~ .0kTLd..~a~.bo~..P-,oa~. ........................................................
.............................................. ~.. ~~.... ~..~.. ...................................................................
pursuant to application dated ..................... ~'Rml~.... ~'1 ......... 1~...., and approved by the
Budding Inspector
Fee $ ~0~.0~1 ...........