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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 E-25102 Date JUNE 20, 1997
THIS CERTIFIES that the building ALTERATION
Location of Property 1600 DEEP HOLE DRIVE MATTITUCK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 115 Block 12 Lot 22
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 7, 1993 pursuant to which
Building Permit No. 21843-Z dated DECEMBER 17, 1993
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 ALTER AN EXISTING FOUNDATION AS APPLIED FOR.
The certificate is issued to JOSEPH MASCIA
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
.e[
Buildi 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) /y)
Date 19../. . 1117
N® 21843 Z
Permission Is hereby gra ed to:
/+~A A MA Sc(r9
k. ScNwA,er
.T. C~ ,e~~ ,......f.........
y......?....-......./.1./x.7/...........
to........'nI7?srer.G,C.-..... ../J./t........~}~ . E.........,/f......
<< .s................'~°4 ~e~
.
;
aTpremises located at........... V........../. n' . ..vf.....................
?'~!TT~~......`,............/.. ~1'07 .
County Tax Map No. 1000 Section .`...I/ Block Lot No. .....1 L
pursuant to application dated .........1~ c... 1 19... n...., and approved by the
Building Inspector.
Fee ftJ......
!~!t~j
/ Building Inspector
Rev. 6/30/80
TOWN OF SOUTHOLD
3ULTDING DE?ARTMETP
TOWN IUL
7b5-L802-APPLICATION FOR CERTIFICAT_= OF OCCUPANCY
A. Tais nolicacion must be filled in by cvDewn cer OR ink and submitted co the building
i,-ispector with the following: for new building or new use:
1. Final sur-ley of property w ck accurate location of all buildings, prooert7 lines,
streets, ana unusual natural or topographic features.
Final Approval from Health Denc. of water SUDD17 and sewerage-disposal(S-9 fora)
Approval of electrical installation from Board of Fire Underwriters.
Sworn statement from plumber cert4-271ng chat the solder used in system contains
lass than 2/10 of L; lead.
'5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificare of Code Compliance from arcaicacr or engineer
responsible for the building.
b. Submit Planning Board Approval of completed site plan requirements.
3. For existing buildings (prior to Aoril 9, 1957) non-conforming uses, or buildings and
"ore-existing" Land uses:
Accurate survey of property showing all prouert7 lines, streets, building and
unusual natural or topographic features.
A oroner17 completed application and a consent to inspect signed by the applicant.
If a Certificace of Occupancy is denied, the Building lnspecLOr shalt stare the
reasons therefor in writing CO the applicant.
C. Fees
1. Certificate Of Occupancy - New dwelling 525.00, Additions to dweIliag $25.00,
Alterations co dwelling 525.00, Swimming pool 525.00, Accessory building 525.00,
Additions co accessor-7 building 525.00. Businesses 550.00.
Certificate of Occupancy on ?re-existing 3uildin2 - $100.00
J. CaDV of Certificate of Occupancy - .25G.
4. Updated Certificate of Occupancy - $50.00
7. TemDorary Certificate of Occupancy - Residential $15.000, Commercial 513.00
Date
New Constrsction..... ...Old Or (Pre-existing Building
Location of Property ......~MOVJl...kl HmF..Qewr..... /
douse No.e Street Hamlet
Onwer or Owners of ?roperty... JD.e.z~IC~.j.ILIA. ishj........................................
Counc'7 Tax ;lap No L000, Section... l.L Block..17: Lor..:?.Zr
Subdivision
s/.......I..2 Filed Hap............ Lot........................r~
Permic NO..LI.b..(.J. ...Date Of Perinit..P210[93...Applicant./'M09 -,c-rlw4~zt &/r'r
Health Dept. Approval Unde= niters Approval.........................
Planning Board Approval
Raci;est for: Tamnorar'l C2rL1:1t3Ce........... Final ertitaCa..........
Fee Submitted: 5
S. .
3o S APPLIC.kNT
c c~~~151u~
Mark K. Schwartz. A.I.A. - Architect
275 Clearview Avenue
Southold, New York 11971
(516) 765-1798
Town of Southold Building Inspector
Town Hall, 53095 Main Road
PO Box 1179
Southold, NY 11971
June 9, 1997
Re: Buliding Permit #21843-Z
Joseph Mascia House
1600 Deep Hole Drive
Mattituck, NY
SCTM # 1000-115-12-22
Dear Building Inspector,
The final items of work requested from your re-inspection of 4-21-94 have been completed.
All work under this application has been completed as per plans and to my knowledge, as per
code. Please process the application for the Certificate of Occupancy. Thank you!
Please call this office if you have any questions or require any additional information.
/Very truly yours,
Y~ I VY - V S o 4
Mark K. Schwartz G`y ~~V IN SGy i
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Sqa 022339 {0
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Town Hall, 53095 Main Road O .~C Fax (516) 765-1823
P. O. Box 1179 y Telephone 765-1802
Southold, New York 11971 (516)
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
January 9, 1996
Mr. Joseph Mascia
60-23 69 Lane
Maspeth, NY 11378
Re: Building Permit#21843-Z
Premises: 1600 Deep Hole Drive, Mattituck
Suff. Co. Tax Map #1000-115-12-22
During a review of our files it was noted that the above
building permit has expired, and a Certificate of Occupancy has
never been issued.
According to the Code of the Town of Southold, Article
XXVIII 100-284, it is unlawful to occupy or use a structure
until a Certificate of Occupancy has been issued.
Please contact this office as soon as possible so that we
may clear up this matter.
Thank you for your cooperation in this matter.
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
'15L~ Z:C ION IIDniE I~ COMMENTS v -
~ r
FOUNDATION (1st)
FOUNDATION (2nd) mp
2.
o \
ROUGH FRA11E &
PLUMBING
n
u
3. y
~
m
m
INSULATION PER 11. Y. ~
STATE ENERGY
r
CODE
4. y
GO GLd %'v7/.lLo >i
17
FINAL \
ADDITIONAL COMMENTS:
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9
Co q 97 .O. ~ ° ti
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765-1502
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] 1 ULATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: -
r
DATE ~ 2-INSPECTOR
do__
M-1302
BUILDING DEPT.
~ANSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS
t
DATE 1lZ12v /4~ INSPECTOR
~ BOARD OF HEALTH
Ij rJ FORM NO.1 3 SETS OF PLAYS
TOWN OF SOUTHOLD SURVEY
{ II: BUILDING DEPARTMENT CtIECi
J ° TOWN HALL SEPTIC FORK
Y is
SOUTHOLD, N.Y. 11971
BLDG. DE?i. TEL.: 765-1802 t:o<IFY;
TOWN OF SOUTHOLr, 9~j CALL
Examined.... /y.~7... 191.! MAIL T0:
Approved ?L./l.)..... , Permit No
lO.l 3 _ .
Disapproved a/c
~ rte.......
ti/ig npector)
APPLICATION FOR BUILDING PERMIT
Date 19
INSTRUCTIONS 1
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 streets
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 not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit
shall be kept on the premises available for inspection throughout 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 Town 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 regulations, and to
admit authorized inspectors on premises and in building for necessary inspectio n
~FtlJf. .
(Signature of applicant, or name, if a corporation)
5
..........2 Ps A0. 4. t• N. Y . . . 1 l -y.7/............
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises ..7O SC`O-~. • • M. a 5;C. i - • •
(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 .
Plumber's License No .
Electrician's License No . . . .
Other Trade's License No .
I. Location of land on which proposed l work will be done . ............A....................................... .
40 ....t?-e.e.P.-t"IQte- -ortue ..............Y°14.11!+vLk..........................
House Number Street Hamlet
County Tax Map No. 1000 Section : 0 Block ~ 2........... Lot ~ Z
Subdivision Filed Map No. Lot...............
(Name) ,
2: State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy P1q C2 . . > - .
b. Intended use and occupancy . . . .
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal , Demolition Other Work .~X...... .
ip~ion)
4. Estimated Cos[
Fee................
(to be paid on filing this application
5. If dwelling, number of dwelling units 1......... Number of dwelling units on each floor .
. If garage, number of cars C'.......................................... .
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ...I...... .
7. Dimensions of existing structures, if any: Front ...3L......... Rear 2. 0. ! Depth q: r .
Height ....)5 . Number of Stories .....OVE . ~.T.D.?._l .
Dimensions of same structure with alterations or additions: Front IME...... . Rear .>61L?
Depth 5!lM& Height ....SA '.4e.......... Number of Stories .
8. Dimensions of entire new construction: Front Rear Depth
Height ....7.77 Number of Stories .
9. Size of lot: Front 7 Rear Depth
10. Date of Purchase Name of Former owner
11. Zone or use district in which premises are situated .
12. Does proposed constructio violate any zoning law, ordinance or regulation: N.Y............
13. Will lot be regraded Will excess fill be removed from premises: es No
14. Name of Owner of premises 5 lM ...c 1SAddress . . . . . . 4 Phone No. ,1.': ix . Z i .
. ~Q T
Name of Architect r. «Y Address Phone No.. 4-3 7J.. .
Name of Contractor 5 .O!'. f^......... Address .
...Phone No..7G.~.. A$c<
15. Is this property within 300 feet of a tidal wetland" *Yas........ No.........
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from
property fines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
IBC St-r~~ d~• w0~~1~ - ~ VL°+MfI ..G ~l;Cii ~-i 'c I~1~ Ljc(,~'?N.f'~''i ~'j c-vtiWl S~, '~t'L~
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STATE OF NO S.S
COYOF....
~/S fr 1t~e.!l~ being duly sworn, deposes and says that he is the applicant
(Name of individual signing c ntract)
above named.
He is the
(Contract , agen~orporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
application; that all statements contained in this application are true to the best of his knowledge and belief; and that the
work will be performed in the manner set forth in the application tiled therewith.
Sworn to before me this
t
day.... _ 19.. .
Notary Publi........ County
CLAIRE L (SLEW .
t.....tt
Notary PubNcStateafNewYait . . . . . . . . . . . . . . . . . .
J
o.4879505
N (Signature of applicant)
Qualified in Suffdk County
Commission Expires December 8, 19
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GPAwL I SP/I c~ ~ T` OCCUPANCY
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APPROVED AS NOTED `DATE: /D ~B,P.M
1Q I E:CIST. Fl.oofc ~KisT. FINK FEE: 7S0 BY. 1
~ ~1 I I 6 I ~ t--- - - - NOTIFY BUILDING DEPARTMENT AT
Ja~zTs <Jal s1'r 765-1802 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS: I, FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
- (c-V. VWJr i 2 ROUCH FRAMING & PLUPABING
1 INSULATION
I ~ 4 FINAL - CONSTRUCTION MUST ~I RE COMPLETE FOR C.O.
aQ ALL CONSTRUCTION SHALL MEET
-I THE REQUIREMENTS OF THE N.Y.
Elf fsT 6+JTVLtu afi~ STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
cf -M cEwR ~b~ ply DESIGN OR CONSTRUCTION ERRORS
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