HomeMy WebLinkAbout9155-zF~I~I NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
$outhold, N. Y.
Certificnte Of Occupnncy
THIS CERTIFIES that the building located at W/$ Skunk Lane Street
Map No. ~ ......... Block No...:KX ....... Lot No, ...X~....~.u..~.h.o.[~ .u.~ ................
conforms substantially to the Application for Building Permit heretofore filed in this office
dated ........... ap.r!~.. 7.., 19..7.7. pursuant to which Building Permit No..9.~..~.~.Z..
dated April 1 1977. 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 accessory storage 'building
The certificate is issued to Yfilliam I,._,~,l
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval . .~ ~.~.: .............................
UNDERWRITERS CERTIFICATE No.
HOUSE NUMBER .............. Street ...~...~..k...~,n. ,e ..... .C,u.t,e.h, 9g~e' ............
Building Inspector
FORM NO. 2
TO~N OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, hi.. ¥.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE P~REMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N.o 9155 Z
Date ......................... Ap~J.1 ....... .~ ......... , 19....~.?
Permission is hereby granted to:
..~..~.~L.? ......................................................
at premises located at .....~.../..~....~...~...~..~.e. ......................................................................................
pursuant to application dated .........................A.~.?...~..~......~ ............. , 19...?.~.i, and approved by the
Building Inspector.
10.00
Fee $ ........................
Building Inspecto~