HomeMy WebLinkAbout9291-zFOB,M NO, 4,
TOWN OF $OUTHOLD
BUII,BING DEPARTMENT
Town Clerk's Office
Southold, N, Y,
Certificete Of Occupnncy
THIS CERTIFIES that the building located at ...~7.~..C.?.o..w~...L.e~..d...L..a~.e.... Street
Map No...6289. ..... Block No ......... Lot No .... .2. ~ ...........................
conforms substantially to the Application for Building Permit heretofore filed in this office
dated . .June..7 .......... , 197.7.. pursuant to which Bui]rtlng Permit No..9.2~?.Z..
dated . .June..7 ........... , 197.?., 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 Private One F~mily Dwelling
The certificate is issued to ...... Ru.~.h.H.e.f.di~..a~'~. ...............................
(owner, ~~
of the aforesaid building.
Suffolk County Department of Health Approval .... ?.-.S0.-?./4...M.a.y..3.0.: .~.~.7..8 .......
UNDERWRITERS CERTIFICATE No ........... .N.~..8.~.8.8.6. .........................
HOUSE NUMBER .. 27.5 ...... Street ...... .C.r..o.~n...L..a~..d..L..a~..e. .................
............................................. ~.~?.h.o.~..e.,. ?..'.L ..................
........
Building Inspector
' ~ORM NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWI~I CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
CI-HIS PERMIT MUST BE KEPT O'N THE PREMISES UNTIL FULL
COMPLETION OF THE~WORK' AUTHORIZED)
is hereby granted to:
. ..... .i .......... it~~ ...........................
.~..~..~...~...,~~ ...................................
~.t~ .t ..~.~ .......... - ~..~ ........................................................................
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SUFF. 'C~ DEPT. O~ H~L.TH 911RVICAI~ ~AT[MKNT OF IN~NT
FOR ~PROVAL OF C~U~ON ONLY
DHNC[ Wl~ C~F~M TO
~ANDA~ OF ~UFFO~K CO.
OF H~LTH.
APPROVe:
(~) ..........
APPLICA~
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'"~'=' t Ax/',4 x~ ,Lo 7-
.ODL'mCK VA~ ~JYL. ~'. C.
TO THiS SURVE~ IS A VIOLATION OF
o<
RODERICK VAN TUYL. P. C.
LIC. LAND SURVEYORS-GREENPORT. N- Y.
J~UCATJObl tAW.