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TOWN OF $OUTHOLD
BU~.nING DEPARTUl~IT
Town Cl~k's Ol[ice
$outhold, N. Y.
Certificate Of Occupancy
No..Z..q.a??. ..... Date ..... M.a?.c..h .... ? ............ , 19..7.9.
G~,eerneood Road
THIS CERTIFIES that the building located at .... Ty,l-er. l.~ne ............ ~l..Z.t~t
Map No ............. Block No ........... Lot No ..................................
REQIt. IR.EME~S., F.Q~ Tlg,O FAMILY DWELLINO BUILT_PRIOR
conforms substantially to the ' ' - ' ' - -t~LtCt~.~
TO ... C_,~TIFIC, ATE 10~. OCCUPANCY
~ .. t~INL1.....2~. ....... , 19.57. pursuant to wmen~~l~o. · 'Z96~7
dated .. Nat-ch ...7 .......... , 19.7.q, was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
~,m~ ~ ....... .~?.',-:~.o..~.9.~...~..~. ?~o.. ?~..SL.¥. p..~...~.~..~. ........................
The certificate is issued to ......... .R. qg.e.r..~a..~.n.a.c.h..e ..............................
( owner,
of the aforesaid building.
Sulfolk County Department of Health Approval ...... Pre..EXis.tlng ................
UNDERWRITERS CERTIFICATE No ............... Pz'a-,Existin$ ...............
HOUSE NUMBER .............. Street .. ~.eero~ood. Road..-, .T¥1~. Lane .......
/
........................................ as. Island .York ..........
BuiIdi-g ~,spector
County Tax Number
~000-092-9-9