HomeMy WebLinkAbout53115-Z TOWN of SOUTHOLD
Iasi, BUILDING DEPARTMENT
SOUTHOLD, NY
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 53115 Date: 07/08/2026
Permission is hereby granted to.
70 Deep Hole Dr LLC
c/o Roger Leifer
Westport, CT 06881
To:
construct fire repairs to an existing second-floor accessory apartment in an accessory building and to
legalize "as built" alterations on the first-floor of the existing accessory garage as applied for with
flood permit. Additional certification may be required. Two Cots will be required simultaneously.
Premises Located at:
70 Deep Hale Dr, Mattituck, NY 11952
SCTM# 115.-12-2
Pursuant to application dated 0+6/18/2026 and approved by the Building Inspector,
To expire on 07/07/2028.
Contractors:
Required Inspections.
Fees:
As Built Pool/Hot Tub $600.00
CO Swimming Pool $100.00
CO Accessory Structure $100.00
As Built Accessory Structure $280.00
Flood Permit $150.00
Total $1,230.00
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Building Inspector
sss TOWN OF S OUTIHOLD—BUILDING DEPARTMENT
TT
Town Mall Annex 54375 Main Road P. 0. .Box 1179 Southold,NY 11971-0959
Telephone 631 7+65-1 Fax(631) 765-9502 . �v-
........ ...
Date Received
APPLICATION FOR RUILD11VG q PERINAFT
For Office
Use On
ly
Al
PERMIT NO., �` Building Inspector:-
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Applications and forms must be filled out in their entirety. Incomplete
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applications will not be accepted. Where the Applicant is not the owner,an �U�ii!ding
Owner's Authorization form(Page 2)shad be completed. i6wn of ovil, 1
��� 0000
Date:
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OWNER(S)OF PROPERTY:
Name:70 Deep Hale Drive - LLCM SCTM#1000-115�-12_2
Project Address:70 Deep Hale Car, Mattituck, NY 11952
rogerleifer@gmail.com Email: erleifer rr�
0' @9mail.ca
Mailing Address:70 Deep Hale Dr, Mattituck, NY 11952
. .�
CONTACT PERSON:
Dame:Brady Leifer (Member of Trust)
MailingAddress:
70 Deep Hale Dr. Mattituck, N Y 11952
Phone#.203-858-8088
Email:rogerleifer@grnail.corn
DESIGN PROFESSIONAL INFORMATION:
Name:NJ Mazzaferra, PE
Mailing.Address::Pp Box 57, Green' art, NY 11944
p
Ph one#.516457 8596 Email:n l k c rnazzaferronverizan.net
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'CONTRACTOR INFORMATION:
Na me:TBD
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
.......
❑New Structure ❑Addition nAlferation Re air ❑Demolition Estimated `p �;ost of Project.
lil Other
Repair Fire Damage 1 Install Washer/Dryer,Cold Tub and Sauna in Existing Garage(No Exterior Work) 12,500
Will the lot be re-graded? 11Yes Na Will excess fill be remov d frorn premises. F]Yes" W No
.........................................
PROPERTY INFORMATION
Existing use of property:Single Residence Intended use of property:Single Residence
Zone or use district in which premises is situated., Are there any covenants and restrictions with respect to
R-40 this property? FlYes *No IF YES, PROVIDE A COPY.
EJ Check Box After Reading: The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by
Chapter 236 of the Town Code. APPLICATION 15 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,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 an premises and in building(s)for necessary inspections.False statements made herein are
punishable as a Class A misdemeanor pursuant to Section 210.45 of the New York State Penal Law.
..............
Application Submitted By(print name): Nicholas Ma,zzaferroPE WAuthoriled Agent El Owner
Signature of Applicant: Date:
STATE OF NEW YORK)
COUNTY OF
Nicholas Mazzaferro being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)he is the Ag I ent
(Contractor,Agent., Corporate 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/her knowledge and belief; and
that the work will be performed in the manner set forth in the application file therewith.
Sworn before me this
of L)4 20 0?te
Notary Public LYM E STEVENS
Notuy Public-State of New Y
NO.01 ST6269424
OF �J
PRI WNER AUTH ORIZ,o���MION
Qualified in Suffolk Coun
ty
(Where the applicant is not the owner) Conmission Expires
Brady Leifer 70 Deep Hole Rd
residing at
Mattituck, NY 11952 do hereby authdrize Nlcholas Mazzaferro, PE to apply on
my ehalf to"the Tow,n�� of So4thold 8, ing Depla tmient for approval as described herein.
I
6/17/2026
01 he, s,Signature!, Date
Brady
Print Owner's Name
2
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