HomeMy WebLinkAbout52267-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
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#: 52267 Date: 09/17/2025
Permission is hereby granted to:
Kathy A Ward
75 Madison Ave
Garden City Park, NY 11040
To:
Construct a new two-story single-family dwelling to include an HVAC system as applied for per SCHD
approval.
Premises Located at:
2455 Sigsbee Rd, Laurel, NY 11948
SCTM# 144.-2-25
Pursuant to application dated 07/18/2025 and approved by the Building Inspector.
To expire on 09/17/2027.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling-NEW $1,552.50
CO Single Family Dwelling-New $100.00
Total $1,652.50
j�l ;9
Building Inspector
rams
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone (631) 765-1802 Fax (631) 765-9502 li'ttps://www.southoldtarwiiny.
Date Received
APPLICATION FOR BUILDING PERMIT le r__\
W,
For Office Use Only
PERMIT NO.5a 0 Building Inspector:
Al
Applications and forms must be filled out in their entirety.Incomplete
applications will not be accepted. Where the Applicant s not the owner,an a °
Owner's Authorization form(Page 2)shall be completed.
Date:7/10/2025
OWNER(S)OF PROPERTY:
Name:Kathy Ward A�M# 00-144-2-25
Project Address:2455 Sigsbee Road, Mattituck NY 11952
Phone#:646-265-0681 Email:mkward07@yahoo.com
Mailing Address:75 Madison Avenue, New Hyde Park NY 11040
CONTACT PERSON:
I
Name:Joseph Nehrebecki, R.A.
Mailing Address: 1927 Bergen Street, Bellmore NY 11710
Phone#:516-690-3741 Email:jnehrebecki@gmail.com
DESIGN PROFESSIONAL INFORMATION:
Name:Joseph Nehrebecki, R.A.
Mailing Address: 1927 Bergen Street, Bellmore NY 11710
Phone#:516-690-3741 IEEllnehrebecki@gmail.com
CONTRACTOR INFORMATION:
Name:TBD
Mailing Address
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
®New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
❑Other Construct Two-Story Single Family Dwelling $500,000 -
Will the lot be re-graded? iiiYes ENO Will excess fill be removed from premises? *Yes ENO
1
PROPERTY INFORMATION
Existing use of property:Vacant Intended use of property:Single Family Dwelling
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
R_40 this property? ❑Yes @No IF YES, PROVIDE A COPY.
❑ 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 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 buildings6
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 on premises and In building(s)for necessary inspections.False statements made heroin are
punishable as a Class A misdemeanor pursuant to Section 210AS of the New York State Penal Law.
Application Submitted BY(Print name): RAuh ri dent
Downer
, aSi nature of Applicant: Dte: -STATE OF NEW YORK)
SS:
COUNTY OF
Joseph Nehrebecki, R.A. being duly sworn;deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the Agent
(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
day of 020
Notary Public
ALAN ROSENBERG
PROPERTYOWNER AUTHORIZATIONNOTARY PUBLIC, STATE OF NEW Y' RK
QUALIFIED IN NASSAU COUN
(Where the applicant is not the owner) NO.01 R06198480
MY COMMISSION EXPIRES DEC.22,
1, <37+( V "0,.V residing at -15
do hereby authorize Joseph Nehrebecki, R.A. to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
2-
Owner's Signature Date
a± -
Print wner's Name
2
Town Hall Annex Telephone(631)765-1802
64375 Main Road " Fax(631)765-9502
P.O. Box 1179
Southold, NY 11971-0959 ',
BUILDING DEPARTMENT
NOTICE OF UTILIZATION OF TRUSS TYPE CONSTRUCTION PRE-ENGINEERED
WOOD CONSTRUCTION ANDIOR TIMBER CONSTRUCTION
Date:
Owner: 4_.7 l
Location of Property:
Please take notice that the (check applicable line):
l,-� New commercial or residential structure
Addition to existing commercial or residential structure
Rehabilitation to an existing commercial or residential structure
to be constructed or performed at the subject property reference above will utilize
(check applicable line):
Truss type construction (TT)
Pre-engineered wood construction (PW)
Timber construction (TC)
in the following location(s) (check applicable line):
Floor framing, including girders and beams (F)
Roof framing (R)
Floor and roof framing (FR)
Signature:
Name (person submitting this form): '
Capacity(check applicable line):
er
Owner representative
TrussReg15.docx Effective 11112015
Generated by REScheck-Web Software
Compliance Certificate
Project 2455 Sigsbee Road
Energy Code: 2018 IECC
Location: Mattituck, New York
Construction Type: Single-family
Project Type: New Construction
Project SubType: None
Conditioned Floor Area: 2,306 ft2
Glazing Area 19%
Climate Zone: 4 (5331 HDD)
Permit Date:
Permit Number:
All Electric false
Is Renewable false
Has Charger false
Has Battery: false
Has Heat Pump: false
Construction Site: Owner/Agent: Designer/Contractor:
2455 Sigsbee Road Kathy Ward Joseph Nehrebecki
Mattituck, NY 11952 75 Madison Ave 516-690-3741
New Hyde Park, NY 11040 jnehrebecki@gmail.com
646-265-0681
mkward07@yahoo.com
Compliance: 7.1%Better Than Code Maximum UA: 380 Your UA: 353 Maximum SHGC: 0.40 Your SHGC: 0.30
The%Better or Worse Than Code Index reflects how close to compliance the house is based on code trade-off rules.
It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home.
�` s • w rin�"nNllaaVln&e path umn '��V'S Nnr"°6'N+;,, i ach skllb-oin grade
Slab-on-grade lirawuce�¢.a�u�� Qair:. uurb longer�abrn.aNm�r r�aa°N iirn ��ua. NDa�rain�ncewrPraairrnaburrrr.rmu . . . . .�. ... s-
aaaroseirirul�aNy M the malpe iffie.�a.Nnmaate zrnrur:a:dust rrneet E.I�ue rnro nirunuru�n erwn]y rode linv.flaaN.on R-vaallue aamro¢.N m�r.1pfth r4..(pflira.urina..nts.
Enmelope Assembfie5
Ceiling-Hot Roof: Cathedral Ceiling 1,367 30.0 0.0 0.034 0.026 46 36
Wall:Wood Frame, 16"o.c. 2,574 21.0 0.0 0.057 0.060 118 124
Door: Solid Door(under 50%glazing) 21 0.140 0,320 3 7
Door 1: Glass Door(over 50%glazing) 84 0.300 0.320 25 27
SHGC: 0.30
Window:Vinyl Frame 401 0.300 0.320 120 128
SHGC: 0.30
Floor:All-Wood Joist/Truss 1,234 30.0 0.0 0.033 0.047 41 58
Project Title: 2455 Sigsbee Road Report date: 04/01/25
Data filename: Page 1 of10
REScheck Software Version : REScheck-Web
Inspection Checklist
Energy Code: 2018 IECC
Requirements: 100.0% were addressed directly in the REScheck software
Text in the "Comments/Assumptions" column is provided by the user in the REScheck Requirements screen. For each
requirement, the user certifies that a code requirement will be met and how that is documented, or that an exception
is being claimed. Where compliance is itemized in a separate table, a reference to that table is provided.
Section Plans Verified Field Verified
& Req.ID Value Value CO P ' � � ptions
# Pre-inspection/Plan Review m Iles Comments/Assum
103.1, 'Construction drawings and ❑Complies Requirement will be met.
103.2 documentation demonstrate ❑Does Not
[PRl]1 j energy code compliance for the
to !building envelope.Thermal ❑Not Observable
envelope represented on []Not Applicable
construction documents.
103.1, ".Construction drawings and ❑Complies Requirement will be met.
103.2, documentation demonstrate ❑Does Not
403.7 energy code compliance for
[PR3]1 lighting and mechanical systems. ❑Not Observable
'Systems serving multiple [:]Not Applicable i
;dwelling units must demonstrate
compliance with the IECC
Commercial Provisions.
302.1, Heating and cooling equipment is: Heating: Heating: : ]Complies Requirement will be met.
403.7 sized per ACCA Manual S based Btu/hr Btu/hr ❑Does Not
[PR2]2 on loads calculated per ACCA cooling: Cooling: ;❑Not Observable
1 ; Manual J or other methods Btu/hr Btu/hr
approved by the code official. ❑Not Applicable
Additional Comments/Assumptions:
1 High Imrpact (Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3)
Project Title: 2455 Sigsbee Road Report date: 04/01/25
Data filename: Page 3 of10
Section Plans Verified Field Verified
# Framing /Rough-In Inspection Value Value Complies? Comments/Assumptions
& Re .ID __ _ _ _
lu
Door U-factor. U- U W� ❑Com lies °table e Envell pe assemblies
402.1.1, p
402.3.4 ❑Does Not
[FR1]1 ❑Not Observable
❑Not Applicable
402.1.1, Glazing U-factor(area-weighted U- U- ❑Complies ;See the Envelope Assemblies
402.3.1, average). ❑Does Not 'table for values.
402.3.3,
402.5 ❑Not Observable
[FR2]1 ❑Not Applicable
303.1.3 U-factors of fenestration products ... . .m w.- .. _. ...❑Complies Requirement will be met.
[FR4]1 are determined in accordance ❑Does Not
with the NFRC test procedure or ❑Not Observable
;taken from the default table.
❑Not Applicable
® .,.,... o ww ... ... W
402.4.1.1 ,Air barrier and thermal barrier ❑Complies Requirement will be met.
[FR23]1 installed per manufacturer's ❑Does Not
instructions. ❑Not Observable ;
❑Not Applicable
402.4.3 Fenestration that is not site built ❑Complies Requirement will be met.
[FR20]1 "is listed and labeled as meeting ❑Does Not
n AAMA/WDMA/CSA 101/i.5.2/A440: ❑Not Observable
or has infiltration rates per NFRC
400 that do not exceed code ❑Not Applicable
limits.
02.4.5 IC-rated recessed lighting fixtures ❑Complies Requirement will be met.
[FR16]2 sealed at housing/interior finish ❑Does Not
and labeled to indicate :52.0 cfm ❑Not Observable
leakage at 75 Pa.
❑Not Applicable
3.3.1 ;Supply and return ducts in attics ❑Complies Exception: Ducts located
[FR12]1 ;insulated >= R-8 where duct is ❑Does Not completely inside the
>= 3 inches in diameter and >_ ❑Not Observable building envelope.
R-6 where < 3 inches. Supply and
return ducts in other portions of ❑Not Applicable
the building insulated >= R-6 for
diameter>= 3 inches and R-4.2
for< 3 inches in diameter.
403.3.2 Ducts, air handlers and filter ❑Complies Requirement will be met.
[FR13]1 boxes are sealed with ❑Does Not
joints/seams compliant with ❑Not Observable
'International Mechanical Code or
International Residential Code, as ❑Not Applicable
;applicable. `
403.3.5 Building cavities are not used as ❑Complies Requirement will be met.
I[FR15]3 ducts or plenums. ❑Does Not
811 ❑Not Observable
❑Not Applicable
4 HVAC piping conveying fluids R- R- ❑Complies o Requirement will be met.
[FR17]2 above 105 °F or chilled fluids ❑Does Not
3elow 55 °F are insulated to>_R- ❑Not Observable
�-.4_
❑Not Applicable
.e--.n
03.4.1 Protection of insulation on HVAC ❑Complies Requirement will be met,
[FR24]1 piping. ❑Does Not
❑Not Observable
❑Not Applicable
403.5 3 Hot water pipes are insulated to R- R ❑Complies Requirement will be met.
[FR18]2 >_R-3. E❑Does Not
V ❑Not Observable
❑Not Applicable
1 High Impact (Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3)
Project Title: 2455 Sigsbee Road Report date: 04/01/25
Data filename: Page 5 of10
e tlon Plans Verified Field Verified
# Insulation Ins ectlon Value Value
Complies? mptions
303.1 •ID All installed insulation is labeled Dc�rr plies l Require
ommment/will s met.be
[IN13]2 or the installed R-values ❑Does Not
provided. ❑Not Observable
❑Not Applicable
402.1.1, ,Floor insulation R-value. R- R ❑Complies See the Envelope Assemblies
402.2.6 ❑ Wood ❑ Wood ❑Does Not table for values.
[IN1]1 ❑ Steel ❑ Steel ❑Not Observable
;❑Not Applicable
303.2, Floor insulation installed per ❑Complies Requirement will be met.
402.2.8 `manufacturer's instructions and ❑Does Not
[IN2]1 in substantial contact with the
,,,,,;,�, ;underside of the subfloor, or floor ❑Not Observable
'framing cavity insulation is in []Not Applicable
;contact with the top side of
sheathing, or continuous
insulation is installed on the
underside of floor framing and
extends from the bottom to the
top of all perimeter floor framing
members.
❑ ❑" �;
402.1.1, -Wall insulation R value.If this is a R �.. R- ❑Compll See the Envelope Assemblies
402.2.5, mass wall with at least 1/2 of the Wood Wood ❑Does Not 'table For values.
402.2.6 'wall insulation on the wall ❑ Mass ;❑ Mass 1❑Not Observable
[IN3]1 exterior,the exterior insulation
requirement applies(FR10). ❑ Steel ❑ Steel ❑Not Applicable
303.2 `Wall insulation is installed per [Complies Requirement will be met.
[IN4]1 manufacturer's instructions. ❑Does Not
❑Not Observable
❑Not Applicable
Additional Comments/Assumptions:
..�.
1 ,High Impact(Tier 1) 2 Medium Impact,(Tier 2) 3 Low Impact(Tier 3)
Project Title: 2455 Sigsbee Road Report date: 04/01/25
Data filename: Page 7 of10
Section Plans
` ventilation Verified .� Fiel,�. .f.,.i..e
Final InspectionProvisions ..Hd Complies?
e5, mments/AssumP
tions
Value Value
Almechanial sytem ❑Compes Requirement
will be met,
[FI25]2 fans not part of tested and listed ❑Does Not
HVAC equipment meet efficacy
and air flow limits per Table ❑Not Observable
R403.6.1. ❑Not Applicable
403.2 Hot water boilers supplying heat ❑Complies Requirement will be met„
[F126]2 through one-or two-pipe heating ❑Does Not
systems have outdoor setback
control to lower boiler water [:]Not Observable
temperature based on outdoor ❑Nat Applicable
temperature.
11 403.5 1.1 Heated water circulation systems ' ❑Complies Requirement will be met.
[F128]2 have a circulation pump.The ❑Does Not
system return pipe is a dedicated ❑Not Observable
return pipe or a cold water supply,
pipe.Gravity and thermos- ❑Not Applicable
syphon circulation systems are
not present. Controls for
circulating hot water system
pumps start the pump with signal
for hot water demand within the
occupancy. Controls
automatically turn off the pump
when water is in circulation loop
is at set-point temperature and
no demand for hot water exists.
403.5.1.2 Electric heat trace systems ❑Complies Requirement will be met.
[FI29]2 comply with IEEE 515.1 or UL ❑Does Not
515.Controls automatically ❑Not Observable
adjust the energy input to the
heat tracing to maintain the ❑Not Applicable
desired water temperature in the '
piping.
403 5.2 Demand recirculation water ❑Complies Requirement will be met.
[F130]2 systems have controls that ❑Does Not
manage operation of the pump
and limit the temperature of the ❑Not Observable
water entering the cold water ❑Not Applicable
piping to <= 1049F.
403.5.4 Drain water heat recovery units ❑Complies Requirement will be met.
[F131]2 tested in accordance with CSA ❑Does Not
B55.1.Potable water-side
pressure loss of drain water heat ❑Not Observable
recovery units< 3 psi for ❑Not Applicable
individual units connected to one
or two showers. Potable water-
side pressure loss of drain water
heat recovery units < 2 psi for
individual units connected to
three or more showers.
. . ...............
404.1 90%or more of permanent ❑Complies ;Requirement will be met.
[F16]1 ,fixtures have high efficacy lamps.' ❑Does Not
❑Not Observable
❑Not Applicable
404.1.1 Fuel gas lighting systems have
❑Complies Requirement will be met„
[FI23]3 no continuous pilot light. ❑Does Not
❑Not Observable
❑Not Applicable
401.3 Compliance certificate posted. ❑Complies Requirement will be met.
[F17]2 ❑Does Not
❑Not Observable
❑Not Applicable
g p 1 p Low Impact(Tier 3)Hi h Im act(Tier 1) 2 Medium Impact (Tier 2) 3
Project Title: 2455 Sigsbee Road Report date: 04/01/25
Data filename: Page 9 of10
m m
Above-Grade Wall 21.00
Below-Grade Wall 0.00
Floor 30.00
Ceiling / Roof 30.00
Ductwork (unconditioned spaces):
Window 0.30 0.30
Door 0.30 0.30
w m m m m a
Heating System:
Cooling System:
Water Heater:
Name: Date:
Comments
r
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y J i . BFVATIONS ARE BASED ON NAVDBB
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EL 14` CRAWL EL-16.67 +, HYDRO-ACTION -� ... 3MIN "..., ., INTO SWLE NTS
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NDres: C BILL OF MATERIALS sHEETTTcdt.
3 3 NA SYSTEM SHALL WATER LOCATED WITHIN 300'OF A 4 BEDROOM URE FOR PROPER VENTILATION "
2 HYDRO»A I�ONAN400 DESIGNED TO SUPPORT
A4BSTRU DROOM STRUCTURE y x ; y �
�� "• � `x�m � ,�Ad,wIPJW1NN� _ � PROPOSED SITE PLAN&SANITARY DETAILS
UTILIZE THE MAIN HOUSE WASTE PLUMBING
w -... ,..W «---U-...w �,.,-...y,V �.".".--.-..w ». .-... Ayy ...-o,VV ---- 5. P�E9CARSORINQ PROPE'RnES ALL.P`.CMMCTT TO PLwLWl WATPRN p 1'Sw1W dx wuxc'co wTInreYA
n fNE 2Q"DYAM,�DT'B'�R NNAYE,kTIN5T1'T AND IMSO01'4IRO%AP LOCKING 6YNERAkChRLAS' ,,,,,,,, ,,,,,,, �'Jwucww. dcvwwammN eannA^ra
i „UryV'EY1 S%IAUI.. µgI',p ANwNnp'PN 1ra1 uTl4mo uwdu',; ,,,,,,d,,, ,,,,,, 4, OWNER: rkwkP�l':: _
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.. SICNS*LE FAMILY 1tE$N%$tldC.E$,.OAIFTk IFECE.M69ER�7.9.'3Ot7:QD'D%7W70d'6�5'1&i...,A Skd;a7tl'PNS/V'CYIWM T"ddJkkd.. 'I ,,,,, 75 MADISON AVENUE.
EDGE OF ASPHALT BE PROVIDED. WARSIGSBE EROA
" - } TBD SIGSBEE ROAD
_ __E 6, OWTS SHALL BE TESTED FOR WATER TIGHTNESS PRIOR TO ARRIVING ON SITE USING A METHOD .... ,,,, ".- „ -- 'Y NEW HVDE PARK,NEW VOPo(71040
E� ". E E E E E E E E .E -- APPROVED BY THE MANUFACTURER ,,,.. ,,,, i •, ,,,,,•, EW YORK S9H•�an", ....
7, THE OATS INSTALLER SHALL HOLD AN,.DINTS ENDORSEMENT FROM SUFFOLK COUNTY =- �- """" P,E.SEAL
IT RESIDENCE 7RESIDENCE DEPARTMENT OF HEALTH AND SHALL BEAN AUTHORIZED INSTALLER - N � N ,fir
PUBLIC VIATER I PUBUC WATER PUBLIC WATER B„ THE OWTS INSTALLER SHALL REGISTER THE ONSITE TREATMENT SYSTEM WITH SUFFOLK COUNTY
DEPARTMENT OF HEALTH. ""`"" .
9. AGARBAGE GR041Xb2 SHALL NOT'IIIE:INSTALLED UPSTREAM OF THE OWTS. ®"" "' �" m � ��
10, THE VA OWTS SHML VENT THROUGH THE SEWER PIPE.AHOUSE TRAP SHALL NOT BE INSTALLED � �'. �P
11,. ALL F1BOIkY1CAL AND OOPPTiR..'OL WIRES SYIA'Ld.SE 6TgiU%ED INS REQUIRED. C
NOTICE UPSTR, OF GENERALHgTEs /r THE, CATS, QINAY,VC PO rw'i IS INS gt;.yrylOyylr g,QC!MprgO T)wgRlgd7W11A+5n'IC C1CMIFEIS AT Fm%AM. � 700 LAKELAND AVE,SUITE 2B
CH 40 PVC PIPE..DIRECT BURY IS NOT
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. A'NCl"A51AII1 T1"R IEIE gCORfC IAp04E0T ALLOWED.THE CONDUITS SHALL BE SEALEO WIMPle THEY ENTIER THE OWTS. 1, OMR�S SHALL 097'0"SNMM479k WAICAT04TI MOD IMBR' BOHEMIA,NY 11716
NSI liU 1N9R5H5Gb4T%V OF�PIVKY APBT M 12, CONTRACTOR SHALL CONFIRM INVERT ELEVATRTN PRIOR T%7 OQNSTRUCTION,CONTRACTOR SHALL 0,1td4RL'.GoVLHIMDM"1Wd 4'M'kJd'BN.R"5�°dXVwgLUP yK1CPXdiM1rWJW WA'M1'">+T«OJgTA 6d^r""JO'JT%17°%PON A�Ra�+'"IA"QdY` a0(M K ry60 � (631)9B&0000
NN NOTIFY ENGINEER OF RECORD OF ANY DISCREPANCIES. IM.h9¢?S AND
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PRN CAll'Y7"PACI4%*F"HFItlNCMNG Pn=,41HTYNOWNT OR Ire
ANY OGE OF THIS DRANING FON ANY OTHER PRO.ECTR 13, PROVIDE DEDICATED BREAKERS IN THE MAIN DWELUNG ELECTRICAL PANEL FOR THE OWTS.. DEG[MBER 7P,JO17.$KC"TK,Mx 6+111 h'SE.OA1'NCNARY FA,N&TV LIO SHRAL OE:%NIOVIFQP:'0, Bw.N, 'e^Wu• ^' xBeR®nnuHcoBucvaePwawN
PRWIBITS).ANY ALTERATION OR REFROOUCTION OF THIS 14. MAINTAIN A MINIMUM COVER OF 54 INCHES OVER THE PROPOSED WATER SERVICE. HYDRO-ACTION AN400 IfMbM9tl@YN A.NAwT„cN
DOCUMENT IS ALSO PROMBIIED YATHOUT THE WRITTEN / y+iY'A p--�^ e
CONSENT OF TIE ENGINBQt 6�UAL NK DETAIL (1R'AMAN Nrs BM'. DIhTC.' �EwK7 Etl[�TJ. CPW4rM J{pB L. B�C,M.G
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