HomeMy WebLinkAboutZ-5866FOI~M NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificnte Of Occupnncy
No..Z~..86.6 ...... Date ........... Al~r;~.], ..... ~9 .... , 19.
THIS CERTIFIES that the building located at .E~/~ .¢r&~;er~ .L~ne ........ Street
Map No.aoa~o~.. Block No ........... Lot No.. ~... ~o~he~.. ~.,~. .........
.before. kvril. ~. 19.~7. p~suant to which
. ., ~.~. ·
dated ........ ~R~ .... $~..., 19.~., was issued, and conforms to all of the req~re-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is . .~l~a~. ~e. ~Y .dwOX~g ......................................
The certificate is issued to . :~$i~. ¢'~ .L~- ~a ....... ~e~ ..............
(owner, lessee or ten,t)
of the afores~d building.
Suffolk County Department of Health Approval · .pr~..e~zt~ ..................
UNDERWRITERS CERTIFICATE No..p~,. ~ e~g ............................
HOUSE NUMBER .. ~ ........ Street .~rl.~e~.-~ ...........................
.......... ........