HomeMy WebLinkAboutZ-412FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
THIS CERTIFIES that the building located at~..~ll~l.)....~l~t~t,.~¢~i~ ........................ Street
Map No..~;~f~:~ ........... Block No....~1~ .......... Lot No.~...~r.t,~..~.%r...~t~i~;l~.....l~,¥.o
conforms substantially to ~[]~1~~~~~
'~h;I,~.~..~,~l, Bt,~L.~.&o~..t~.., 19~2'...., i~i~ o..~x ....................
X~;~ .wl~ol~..~ol~;l~f..ol~l&l~l~ae..wal~.&d~t~.;~ and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is ..............
..... ......................................................................................
This certificate is issued to [~l~;~r~..~J~l~..~C~,...~l~l..~.~:]~C;~¢~,.~,~kl~&.....~...~l ....................
(owner, lessee or tenant)
of the aforesaid building.
STATE OF NEW YORK )
)
COUNTY OF SUFFOLK )
SS.:
STEVAN BANICK, being duly sworn, deposes and says:
That he is the owner of premises located at Horton's
Point, Southold, New York.
That since 194,4 the said premises have been so equipped
so as to be suitable for occupancy by at least two families and
that the same have been occupied by at least two families for at
least a part of each year since said 1944.
That this affidavit is made for the purpose of inducing
the Southold Town Building Inspector to issue a certificste of
occupancy for a two family dwelling in connection with said pre-
mises, and deponent makes this affidavit knowing that said build-
ing inspector will rely thereon.
Sworn to before me this
~y or__September, 1959.
No~ 57-20B4700 - Suffolk