HomeMy WebLinkAboutZ-319FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
THIS CERTIFIES that the building located at~/l.~t~l~..~m~t,..l~nd ........................... Stree~t
Map No..x~t ................Block No. ~--~ ............... Lot No. ~...~-nl~.JIIl~.~Gll,.Jl,][, .......................
conforms substantially J~ th~ Annllrntinn fnr R,~ilrlinn P~rmit h~,~tnfnre. ' ' ' ' dat~L.
· (~.-~s~m..Im~ne} ....... .~L,~t,~.a~z~~~--~,,~-,~,---_~,,~-, ~ .............................
dated ~n ..... : ..... = --= .......... I of th
.................................. '-.,~.. .... ¢o a e requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is ..............
........................ l~,~mt, e.. o~. ~aa4~.. da~3,3,tal .................................................................................
This certificate is issued to ...... ~).~.J.~.J;~lltA....(owner,) ................................................................
(owner, lessee or tenant)
of the aforesaid building.