HomeMy WebLinkAboutZ-5951FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No.. Z~9.~l ..... Date ............ ~T.B~.....1.0. ...... , 19. ~
THIS CERTIFIES that the building located at . .E./$. N.o!~ .t;.h..Str.ee.t. ....... Street
Map No. X:~ ........ Block No..~rz ..... Lot No. ~;~....C.u..t.~h.o..~....N:.Y.: .......
conforms substantially to the Application for Building Permit heretofore filed in this office
dated · · .Oat.. ~9. · - 19 73 pursuant to which Building Permit No. C~l~r~l'm~¢~ of
........ ' ...... ~lJ~tinl Bldl
dated ....... Oct ..... 29 ..... , 19.7~, was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is .. P~t¥.~.~..one..f..a.m~]:..y.d.~.e..]..].~n~ .(.c..o.n,e.r.~.e.d' .i'r~...e.x.~.s..t.~..g..b.? .~. !
The certificate is issued to ,..B.~..a~..ch.e, ,Berge. ...... . .o~...e.r ..........................
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval .. J..u~e,.,..~.,..~?.?~....b.y...R.o..V.~, ,l~....
UNDERWRITERS CERTIFICATE No...N.~,~.7.~..~ 2. .... .J..~x.., .~,~...~ .9..~. ..............
HOUSE NUMBER ..... J~.0 ..... Street ,, .N..o~.t.h...S.t.l*.e.e..t .........................
................................................. ........ ......
......... .... c:...l .....
Building Inspector
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY'
85 JOHN STREET, NEW YORK, NEW YORK 10038
.',.,,,,ea,,o.,o.o.;,,e 1 3791 2
~a~January t~, 197~ N
THIS CE~IFIES THAT
~anche Berne, e/side North St., 300' n/o Route 25, Cubchog~e, D.I.
~.~a~fo~o~.~o~t~o.; ~ ~.~ ~ ~r~. ~2.a r~. outside s~t~o~ m~ ~t
was examined on January ~ ~ ~ ~ 9 ~ ~ and found to be in complia~e with the requirements of th~ Board.
FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS
OUTLETS SWITCHES
FLUORE$CENT
10. 12
DRYERS TIME CLOCKS UNIT HEATERS MULTI-O~JTLET
SYSTEMS
NO. OF F~ET
E R V I C
OF CC. COND.
3/0
t40. Of HI-LEG
OF HI-LEG
OTHER APPARATUS:
*Special receptacles: 2-30~ups., 1-20amps.
Elec.room heaters: 1-3.0kw, '-~ ~-
~ .,:.pkw, 2-2.0kw, 1-1.25kw, 1-1.Okw,
NO. OF NEUTRALS OF NEUTRAL
1-. 75kw
John M. Lademann ~,,~
1200 Harbo~ Lane~ ~
Cutcho~ue, L.I. 11935 emem~L , /
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
/~-. 30'-1'l