HomeMy WebLinkAboutZ-6662FORM NO. S
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. ZW2....... Date ........... $!A ..... R....... 1975.
THIS CERTIFIES that the building located at Road..... Street
Map Nodass .Pt„ ... Block No. .......... Lot No. 62 ..............................
conforms substantially to the Application for Building Permit heretofore filed in this office
dated .......... s....., 19.71. pursuant to which Building Permit No. .AM=
dated ............... ? .. , 19? 5 . , 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 .. FAVOR. . 000. APAT. Ox! ?-ung ... 1tiU . 41twrot1040...... ....... .
The certificate is issued to .tlso !VY.......*,P; .................................
( owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval ....................................
UNDERWRITERS CERTIFICATE No. .. X.`R!.....................................
HOUSE NUMBER . ....... Street .. JIM sau Polat . Rd! ................... .
................................................................................
... . .... ...... ....... .
Building Inspector