HomeMy WebLinkAboutZ-7192FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificnte Of Occupency
No. Z7~92
Date ............ .A~.g .... .~. ......, 19 ?.~..
THIS CERTIFIES that the building located at ...W./.S..~.o.~..t~..uk.. ~.?~ ....... Street
Map No.. ~ ....... Block No.....X~X.. .... Lot No .... . .X~X.....1~..sh.e.~.s' .l.s..1.~..d....N.,.Y.:
Fe~uiremets fox. o~o finally dwelltaz
conforms substantially to the ~~Eo~,l~,~'~ ~'~~e~t ~10~' ~w~l[~ra~e~ ne~nv$
built ... · r ~.fi te oec aney
dated ..... bef.o.re. ~??...2.~.., 19..~ pursuant to which ~, .~--~d~o.z?~lr~....
dated ............. ~.~.ug....~..., 197~'.., was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
The certificate is issued to .[.Ii~:t~.~lSn.~ .~'.ICC~.coko~ ....... C.~mor. ...................
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval .p..r.e..-...e.x.~.s.t..:~. g. ..................
UNDERWRITERS CERTIFICATE No. .Dr.e.--..e.x.~_~.t.i.n.g ............................
HOUSE NUMBER ...n.e.~? ....... Street ...M.o.n.t..a.~....A.v? ..... .F.~..s~..s?.~...I.s.1..a~..5 .....
Chandler & Palner 6/1+/76
.... ........
Building Inspector ,
/