HomeMy WebLinkAboutZ-8091FORM NO. S
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
Date
THIS CERTIFIES that the building located at
Map No.... ........ Block No. .'Y Lot N
conforms substantially to the A-)�
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61
dated ......... 4. .:...... .
.............�'.�...°... 3,., 1971
f%�S
.......... .. Street
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�i444 4 L _ _ _ w_ _ w-7 • - �'TtWe on
19:?.7 pursuant to which
19? 2 . , was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for �which this certificate is n
issued is ' �. .
The certificate is issued to . . � ...� e� `.____ .7. ............ .
.. ....
(owner, lesse
of the aforesaid building.
Suffolk County Department of Health Approval!'../ ................
UNDERWRITERS CERTIFICATE No. Gl!'�- .... '''J"' .................. .
2
HOUSE NUMBER Street .. `.......... ..- (......... Q;.�........ .
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