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1 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No:. 8b6. . . . . . Date . . . . . . . . THIS CERTIFIES that.the building,located at ,/,; . t°,y t,; ;. '' ,;;YiE• Street Map No.,��a;dwot9d. . Block No. . . . Lolzi'�d t No conforms substantially.to theR%%WA6AdR4KaWM code �a ed t. . 19 pursuant at Occupancy before.-Aoril, PIS'- , 57.. p suant. to which L dated . . :.. . . . .!A :;,,l. . . .�. 19.74 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 . Triva' e. ne. farm y. x1twol ling. . . . . . . . . . . . ... . . . . . . . The certificateis issued-to . .;� � ,. a� , ; . ; 12 an Rose Nners • • • • • . • • • • • (owner, lessee or tenant) of the aforesaid' building. Suffolk County Department of Health.Approval .pre... ,exi.s v3�:; • . . . • . . UNDERWRITERS CERTIFICATE No. ..pre,.,.. e.ixting'. . . . ; HOUSE NUMBER . '220. . . . . . . . Street .6 r t;©n Lane." . . . . . . . . . . . . . . . . . . . . . . . . . .. . . Building Inspector. , s , t, L i f� ' .:ii .c ,�,� l�.rJ t3 i 71 ti3 '�# s i i �•j�t .t" � .� i - � �}� E�. ,� �a�..- 1 ;� - t �:��9��VeG �'I�~fi. • � ��� mot' �:. q o -- uV i11 0 / \ / 21 vs u. vy0''00'%V- - 160.2 4• LOT :'UC>Tr . MAP OP' h eau ur�'vQpput� `�wawu ear�itzTO"nnepd i hURYCe�(i.D �� FILEYD ILIPTwl-'2uFFOLKGBtlt 14C GL� 1�5 D . 1L6"AbM4 ear2• Ljum — W LLIANi dr. .� 5 0 U�'UQE.C�a clti Lni T�{Ts Tuh Wo�6:fir«GIv,S,c�• W 611t ' yOGttG rh e rl3�i ssQtt�UpLD �b1ltr,ICtb F?,G JOK PAY 4ttC� s r .r S11RViYi * &CI`: It, :967 Yj iyy Si�T1 d t`- 4a - e s - Y`Ah..rk - { s�— �r