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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23465 Date JANUARY 20, 1995
THIS CERTIFIES that the building ACCESSORY
Location of Property 550 SALTAIRE WAY MATTITUCK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 100 Block 1 Lot 36
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 28, 1994 pursuant to which
Building Permit No. 22264-Z dated AUGUST 16, 1994
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
issued is INGROUND SWIMMING POOL WITH FENCE ENCLOSURE AS APPLIED FOR
The certificate is issued to WILLIAM & PATRICIA YOUNG
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-325471 - AUGUST 30, 1994
PLUMBERS CERTIFICATION DATED N/A
ildi g Inspector
Rev. 1/81
FORM NO.3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Date AlUGUST...16 19..9.4.....
NO 22264 Z
Permisslon Is hereby granted to;
i
GENE CHITUR POOL SVC..-..AC...-..YOUNG;,.WN & PATRICIA
P.O.. BOX 9
CUTCHOGUE... NY ARP
to CONSTRUCT AN INGROUND POOL WITH FENCE ENCLOSURE AS APPLIED FOR.
NOTE: DECK SURROUND NOT INCLUDED IN THIS PERMIT AT THIS TIME.
YOUNG, WN & PATRICIA
at premises located at....... 550.. SALTAIRE WAY. I., MATTITUGK
County Tax Map No. 1000 Section 100........... Block ~ Lot No. 36..........
pursuant to application dated ~Y.P$,.., 19...94........, and approved by the
Building Inspector.
Fee $.8-4....
B ng nspector
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLDi,
BUILDING DEPARTMENT f JAN 1 71995 k
TOWN HALL
765-1802 i3i_DC. i3rl'"f.
` , ...y.;!'OWf~ rJ~F SQI,1gki01;(.r
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: for new building or new use:
1. Final survey of property with accurate location of all buildings, property lines,
streets, and unusual natural or topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 1% lead.
5. Commercial building, industrial building, multiple residences and similar buildings
,and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
Fj. Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
"pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and
unusual natural or topographic features.
2. A properly completed application and a consent to inspect signed by the applicant.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00•, Commercial $15.00
Date .-(7.-95
New Construction......... Old Or Pre-existing Building
Location of Property.. ~5a„~A~TAIf2t W.Igy "If}TUC1~........
House No. Street Hamlet
Onwer or Owners of Property. LL I fl bt ; 4 PA-i-9 (C.4 M. ~`OJA)G
County Tax Map No 1000, Section ...,~bC?...... Block t.......... Lot....~.~0
Subdivision .Filceed Map............ Lot..................
Permit No.. y~ao1 ~o ....Date Of Permit... ~1ja/9.! , , , .Applicant. W1 L j P ,kt ~0 U,A7(I
Health Dept. Approval ..........................Underwriters Approval.........................
Planning Board Approval /
Request for: Temporary Certificate........... Final Certicate.. v
Fee Submitted: $......a5 off
,3- y 9 Va-) fi~,tt// y~
C66 0-;A5 NTG
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FOUNDATION (1st) H
FOUNDATION (2nd)
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PLUMBING
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INSULATION PER N. Y.
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STATE ENERGY
CODE
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FINAL
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ADDITIOPIAL COMMENTS: "m
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M-1802
BUILDING DEPT.
INSPECTION
[ ) FOUNDATION 1ST [ ) ROUGH PLBG.
FOUNDATION 2ND [ ) INSULATION
[ ) FRAMING ( a4eiNAL
REMARKS:
DATE h fll~ INSPECTOR
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE I
1185077 BUREAU OF ELECTRICITY
F 83 JOHN STREET, NEW YORK, NEW YORK 10038
Date AUGUST 30,1994 Application No. on file 06339294/94 N 325471
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
WILLIAM YOUNG, 550 SALTAIRB WAY, MATTITUCK, N.Y,
in thefollowinq locations Basement ? 1st Fl. ? 2nd Fl. OUT Section Block Lot
was examined on AUGUST 25 , 1994 and found to be in compliance with the National Electrical Code.
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
OUTLETS FCEPTACIE$ SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K W. AM} N. W AMi. N.W, pMi K.W AMT. H P
I 3 1 I.
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
AMT. K. W. OIL H. P. GAS H. P. MAT. NO A. W G. AMT. AMP. AMT AMPS. TRANS. NO.ST qM} H p SYSTEMS FEET AMT. WATTS
SERVICE DISCONNECT INO OF S E R V I C E
MT. AMP. TYPE METER L ~W SW T 3W SX AW NO. OF CC. COND A. W. G. NO OF HI-LEG A W G. NO. OF NEUTRALS A. W 0.
EQUIP. PER0 OF CC. COND. OF HLLEG OF NEUTRAL
OTHER APPARATUS:
SWIMMING POOL-1
TIME CLOCKS-W, 40..1
G, F. C.I- I
G.F.C.I.-.1
*(SWIMHING POOL,) This re>tificate
covers compliance at the date of
-inspection only. Because of unusual,
environments it it advisable have
blue frequent test/and or repairs
!~~~~r
Continued on Page 2 a»
GENERAL MANAGER
Per
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST, NOT BE ALTERED IN ANY MANNER.
D cPJ'rJ~rJ~rJ~c.frJ@PrJ'r~cPcTcPrJ~rJr~r~'rJ~rJrJr.TcPrJ~rJ~rJ'r.PrJ~rJcPrlcPcJ'~ rJcPr~cPcJ'rJ'rJ~rJ~rPcPcPrJ~rJ~rJ~cPr~r1'tPcPrJ~rJ~rJ~r1rJ'rJ~rJ~rJ~r~rJrJ~ ~
LSJ BY THIS CERTIFICATE OF COMPLIANCE THE
5 NEW YORK BOARD OF FIRE UNDERWRITERS 5
5 31v BUREAU OF ELECTRICITY 5
I ' --4Q FULTON STREET - NEW YORK, NY 10038 5
5
job / '7 G i b ~L3 LJ45;~ CERTIFIES THAT
5 Upon the application of upon premises owned by
5 C? 5
FRANK ZIMLINGHAUS WILLIAM & PATRICIA YOUNG
103 SOUTHERN BLVD. 550 SALTAIRE CSU EAST PATCHOGUE, NY 11772 MATT TUCK, NY 11952
5
~5 5
r5+ Located at 550 SALTAIRE WAY MATTITUCK, NY 11952 5
Application Number: 2050596 Certificate Number: 2050596 c5
Section: 100 Block: 1 Lot: 36 Building Permit: BDC: 5
ns11 c5
Described as a Residential occupancy, wherein the premises electrical system consisting of 5
5 electrical devices and wiring, described below, located in/on the premises at: 5
5 5
Basement, Outside,
A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5
5 herein, was conducted in accordance with the requirements of the applicable code and/or standard 5
5 promulgated by the State of New York, Depadrtment of State Cody nforcement and Administration, or other 5
5 authority having jurisdiction, and found to be R compliance the fit the Day of 5
S Name OTY Rate Rating Circuit Tvoe 5
5 Service 5
5 1 Phase 3W Service Rating 200 Amperes 5
5 Service Disconnect: 1 200 cb 5
S Meters: 1 p g a C/o
5
0 5
5 5
5 5
S 5
5 5
5 5
5 5
5 seal
~I
5 5
5 5
1 of 1 55
~c This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
5 5
O r INUIRRfRINW nRIMMIRrrrrrrrJ~cPrJ~rJrJcl a rJcrrJ~ rr~ cn~I arJ~ c nrrrrr~n rJ~r~cn~nrJ~rJ~ rJ~rlcPc P al!
80ARO OF HEALTH .
FORM NO. 1 3 SETS OF PLANS . ~ .
• TOWN OFSOUTHOLD SURVEY
BUILDING DEPARTMENT C11ECr .
TOWN HALL SEPTIC FORK
SOUTHOLD, N.Y. 11971
TEL.: 7G5-1802 t:OTiF't ~_7/.2
Examined v.~ CALL 7
19.. MAIL T0:
Approved I~ ermitNo...~
Disapproved a/c /
l/"Z
(Buildi g Inspe
APPLICATION FOR BUILDING PERMIT
' Date 7
19
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public street
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
c. The work covered by this application maY commenced before issuance of Building Permit.
d. Upon approval of this application, the Buitu ttspector will issued a Building Permit to the applicant. Such permit
shall be kept on the premises available for inspection Vr,,jughout the work.
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the "Own of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of. buildings, additions or alterations, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regul ions, and to
admit authorized inspectors on premises and in building for necessary inspections.
- ~?Lf`....~........
(Signature of applicant, or name, if a corporation)
U --fox - ~v Gib ~
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder s License No. l . /~J. ~.1
Plumber's License No. ,
gt pF SOHOLD
Electrician's License No . gpWN
Other Trade's License No. .
1. Location of land on which proposed work will be done . •
aJr~ ....................v~rA~c(!z~..G~~9.......
House Number /
Street Hamlet
County Tax Map No. 1000 Section .../LZ.'. , • , , , , • • , , Block ...D.~........ Lot. . ~
Subdivision .
.t0. K? c in rl4 4, ze, ..Luvr1 Piled N 1ap No. .~•~O Lot
(Namc) .
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ~fZ(
1
,Intended use and occupancy
P acute of work (check . whichRe IaPPlicable): New Building
Addition Alteration
Re air , ~moval .
Demolition cr Work
atcnm. t~g
4. Estimated Cost
(Descripttion)
Feo ....O.dIJ..
S. If dwelling, number of dwelli (to be paid on filing this application)
If garage, number of cars 11 : g units Number of dwelling units on each floor
•...p' y, sp.ncy, sp.......•
6. If business, commercial esse•ed..occuanc
nrtetuecify r aturc aftd extent of.cach type of use •
7. Dimensions existing
g st 'res, if any: Front . y , . Rear ~V "
Height , , , , , , • . Number of Stories Depth , , , , , ,
ch......
Dimensions of same structure with alterations or additions: Front
Depth ' Height • Number of Stories Rear
8. Di mensions of entire new construction: Front . : Rear
Hei-lit Number of Stories . Depth . .
9. Size of lot: Front .....!~j, iA..... Rear i• • •
10. Date of Purchase ' ' Depth 6?• e6 • '
. Na e o$ Fofrrter Owner .
11. Zone or use district in which premises are situated .ae; n
12. Does proposed construction violate any zoning law, ordina~e or regulation: 44)() ,
13. Will lot be regraded eS
14. Name of Owner of premisesGf //12?? ,f~a nePa Will excess fill be remov d r premises: ~ Nt
Name of Architect Y°" 4. Address .~f~.I e! ~y ~ hone No.. ,?Y sG 9l.-
Name of Contractor g,p"" , e i ' ' Address I Phone No.. .
L 70 l... vie,c . Address'~t 4' .9 L.... P ' :
15.' Is this property within 300 feet of a tidal wetland? * .Ph~e N . ~3Y!: Sjy,2.,••
*If yes, Southold Town Trustees Permit may be required. No.
PLOT DIAGRAM
Locate clearly and distinctly all h!ci;dings, whether existing or proposed, aiid;indicate all set-back dimensions from
property lines. Give street and block l.fri.r, 6: 'r or description according to deed, and show street names and indicate whether
interior or corner lot.
I.
I •
I
I
I
TATE OF NEW
'OUNTY OF ...tk.: S'~~
si' 'I ' • • being duly sworn, deposes and says that he is the applicant
Dove named T.Name of individual gnnS contract)
I
e is the ~Dw . I p .
(Contractor, agent, corporate officer, etc.)
said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the
>rk will be performed in tt mltnnerset forth in the application filed therewith.
:om to before me this
2®~
d
tary Public, , f• . S
ROBS .
NOTARY 8t , Staten N.Y. . • .
11o.4 ,Suffolk OIL (Signature ofapplicant)
Ter res may 31,19
TITLE NO. I I IS -7740
THIS LOT SUBJECT TO COVENANTS
FOR TREATMENT OF WATER SUPPLY
FOR THE FOLLOWING CONTAMINANTS:
IRON, NITRATES, PESTICIDES. ~i.
SC (.'f''(.OP
PJ~
~oa C3
IE14CLOS COMPW ~N
BEFOGS •pTE
30 9/'
4/. ea,
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~,,.1 LK
~j Dt ~N
/ t" tot 32
200.00 EL.4Gr ab o
T Do O 30 E Prey
O \ ~ Q
N• m ; u G-
EVS ASS ' :0.., 31.d ~ ~e•``~`~ ~ 71'
L~BO•T Z 0 i ~$tl ' ' O
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UpgS POOL TO CODE
UPON COMPLET N
BEFORE, MATER
SUFFOLK COUNTY HEALTH DEPARTMENT ' SURVEY FOR
DATE DEC 09 1965 WILLIAM YOUNG & PATRICIA YOUNG
LOT NO. 33," SALTAIRE ESTATES" OCT 24,1985
AT MATTITUCK DATE: OCT. 3, 1985
The co"%] d'. T(,'Ir3r.l n;TCi r~F~r enpply TOWN OF SOUTHOLD SCALE: IN S 501
faarilti,e s this 'loontton 11avO been
SUFFOLK COUNTY, NEW YORK NO. 85-1275
inspected by tliis dep, L~ICUt cud Toured
to be satls:altory. NUHRUTHOR12E0 ALTERATION ON ADDITION TO THIS GUARANTEED TO 4
SuRVLY M A VIOLATION OF SECTION 7200 OF THE
• NEW YORK STATE EDUCATION LAW FIRST AMERICAN T SURANCEOO.OFN.Y.
Chief of Gene 1 Engineering NCOPIES OF THIS SURVEY NOT KARIN$ THE LAND of NEW 1,
SURVEYORS INKED SEAL OR EMBOSSED SEAL SHALL If. 0,v
Services NOT BE CONSIDERED TO BE A VALID TRUE COPY rI N W. Y~ ,f
NGUARANTEES INDICATED HEREON $"ALL RUN ONLY TO 06 (iM
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT THE PERSON MR WHOM THE SURVEY IS PREPARES * v O
AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERN- P
_
N NEAREST WAT(R •AIN NI. ASOURCE OF WATER, MIWLTE PUBLIC MENTAL AGENCY AND LENDING INSTITUTION LISTED
N SUFF CO. TAX MAP YIST~QQ SECTION .iO.Q-BLACK _9.L- LOT~t¢~ HEREON, AND TO THE ASSIONEES OF THE LENDING g
NTHERE ARE NO OWELLIUSS WITHIN 100 FEET Of THIS PROPERTY INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE # r
OTHER THAN THOSE SHOWN HEREON. TO ADDITIONAL INSTITUTIONS ON SUBSEQUENT v+
Q o
M THE WATER SUPPLY AND SESMOL DISPOSAL SYSTEM FO11 THIS 019310E NCE OWNERS
NDI DISTANCES SHOWN HEREON FROM PROPERTY LINES g 'L
WILL CONFORM TO TH[ STANDARDS Of THE SUFFOLK COUNTY 0[?A11TM[11T t0 EXISTING STRUCTURES ARE FOR A SPECIFIC •y 'r
OF HEALTH SIDWIC[f. PURPOSE AND ARE NOT TO BE USED TO ESTABLISH 1~. ryO. 126
40 T,lO i
APPLICANT, PROPERTY LINES OR FOR THE ERECTION OF FENCES 't10 ,f 91REf'S
ADDRESS X1~
TEL. YOUNG & YOUNG R400 03TRANDER IVERHEAD, NEW YORK
NOTEt 0=STAKENaMONUMENT
ENGINEER
ENGINEER
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF ALDEN PROFESSIONAL
SUFFOLK COUNTY ON AUG. 3,1988 AS FILE NO. 4862 AND LAND YOUNG, W. SURVEYOR N.Y.S. LICENSE NO. 45
HOWARD W. YOUNG, LAND SURVEYOR
N THE LOCATION OF WELL(W),SEPTIC TANK(ST)S CESSPOOLS(CP) SHOWN HEREON N.Y.S. LICENSE NO.45893
ARE FRJM FIELD UUNW11IONS AND ON DATA OBTAINED FROM OTHERS
BRANOIS A SONS INC. 1046
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