HomeMy WebLinkAboutZ-2074FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
No...Z...-....~,O~.~. ...... Date .......................... F.a,~eh....~ ........... ,
THIS CERTIFIES that the building located at ....N/S.....I~.~..];[~)a~. ................................ Street
Map No.Z:II~ ............... Block No...Z,11~ ............ Lot No. ~ ........ llt.&$[...~?[Ol~l.....~,.], .......
.A~t_ipn..ap~'oye.~,. by_Board o.f.App, e.a.ls
conforms substantially to me~ hererorore ri~ea n this office dated
............................... Dee~l~e.2'.......~ ........ , 19..~.~. pursuant to which Building Permit No.
dated ........................................................ , 19 ......... was issued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is ........
.. ~C .. husir, e sa ..b. uild ing..( G~ o.c er~.. ,~ .t or.e )...&..Liv. ing.. ~ua~.~e r.a ..........................
The certificate is issued to .O~.~.~{;,~S..,~.e.'L.&..W.t.~'~ ........... ;..~'~GZt,~.....: .............................. [owner, lessee or tena~nt)
of the aforesaid building.
Building Inspecto!