The URL can be used to link to this page

Home My WebLink About52450-Z J TOWN OF SOUTHOLD 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#: 52450 Date: 11/12/2025 Permission is hereby granted to: Mark Canellos 20-40 Little Neck Blvd Bayside, NY 11360 To: Construct additions and alterations to an existing single-family dwelling as applied forto include a second story addition and to legalize the "as built"finished basement as per SCHD approval. Additional certification may be required. Premises Located at: 530 Woodcliff Dr, Mattituck, NY 11952 SCTM# 107.-8-13 Pursuant to application dated 10/01/2025 and approved by the Building Inspector, To expire on 11/12/2027. Contractors: Required Inspections: Fees: Single Family Dwelling- Addition&Alteration $659.00 As Built Alteration $647.00 CO Single Family Dwelling-Addition /Alteration $100.00 Total $1,406.00 Building Inspector °'J� 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 lift s://www,so ltholdtowim o'v Date Received APPLICATION FOR BUILDING PERMIT CE W For Office Use Only 5a yso ��a.:1) 3) 0 202 PERMIT NO. Building insPectorc G Applications and forms mia,st be filled out in their entirety,Incomplete appllcations will not be accepted. Where the Applicant Is not the owner,an i rt s Owwnees Authorization form(Rage 2)shall be completed. Date: 9-Z2-Zo Z4- OWNEIt(S)OF PROPERTY: Name: SCTM#1000- 107 .-06—Ui3 MAiZk 1-1-r<Tor(i S. Project Address: Phone#: Email: u.oS ZoAit CO,44 " i�` .1, 30� 6 � Mailing Address: 7 DaR-AJ— D 94V& ,,4.--r1NAS5 r dY'� I I b 30 CONTACT PERSON: Name, -tCfif- " ,Q4 ` Mailing Address„ N A- ,t �l i r JE�IfEv�, Y Ilea, Phone#: &-S 1, 727, ri-64y Email: 'S�ff�S��f ��lA�Cd• .CAM DESIGN PROFESSIONAL INFORMATION: Name: Mailing Address: 2<5 jg�o Io f64057 97' 1/10 1 Phone#: ?Z7, o* Email: *�� '" - +! ArQLtfi2orS.G�1 CONTRACTOR INFORMATION: Name: Mailing Address: Phone#: Ermiail: CAE CRIPTION=OF PROPOS D,CON'TRACTION' . , ❑New Structure Addition ❑Alteration ❑Repair ODemolition Estimated Cost of Project: ❑Other $ No"goa00 Will the lot be.re-graded? ❑Yes o. Will excess fill be removed from premises? Dyes 0 , . _ 1 PROPERTY INFORMATION Existing use of property: V-651 ocwrlA1— Intended use of property: 7-ES1IaE1-1Tl,4L- Zone or use district in which premises Is situated; Are there any covenaWO d restrictions with respect to cfo this property? ❑Yes 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 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 on 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 me • .A d ErAuthorized Agent Downer " Signature of Applicant: 77 Date: q- Sa STATE OF NEW YORK) SS: COUNTY OF -77AI44 being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, ( ) I� � r S he is the (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 knowled e n l f°and boo that the work will be performed in the manner set forth in the application file therewith. EVAN�J FR NMry Public-State of w York NA.01ZI0011"9"� Sworn before me this gUalifiet In SufTa& my My C4f'1Rt11ssiora Expires 15,2027 3() day of e,�1 b.� 20 Z S Notary Public PROPERTY OWNER AUTHORIZATION i!.�New York _.001.1953 (Where the applicant is not the owner) Suffclk County, LM,,, Lireo Aug 15, 2027 I, residing at do hereby"authorize o apply on my behalf to the Town of S-outhold Building Department for approval as described herein,' Owner's Signature Date Print Owner's Name: 2 Building De artmcnt Application AUTHORIZATION (Where the Applicant is not the Owner) I, MAeK residing at 53® :jp C,,L 07NE (Print property owner's name) (Mailing Address) rriTv,Gk I �'2 do hereby authorize = A (Agent) to apply on my behalf to the Southold Building Department. (Owen r' 'Signature) (Date) (Print Owner's Name) Telephone(631)765-1802 54375 Main Road Town Hall Annex , "fr" Fax(631)765-9502 � P.O.Box 1179 ' Southold, NY 11971-0959y a a BUILDING DEPARTMENT NOTICE OF UTILIZATION OF TRUSS TYPE CONSTRUCTION PRE-ENGINEERED WOOD CONSTRUCTION UCTION AND/OR TIMBER CONSTRUCTION Date: Owner: ((A Location of Property: Please take notice that the (check applicable line): 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 locations) (check-applicable line): Floor framing, including girders and beams(F) Roof framing (R) Floor and roof framing (FIR) Signature: Name`(Person subrrtitn a.forrni): Capacity(check appl'i a line). Owner Owner representative TruesRegi16.docx. .. Effective 1/1/2015. TM RE,S hC c e Compliance Certificate Project Information Project Title: Canellos Residence Energy Code: 2018 IECC Location: Mattituck,New York Construction Type: Single Family Project Type: Addition Project Sub Type: None Orientation: Bldg.faces 270 deg.from North Glazing Area: 10% Climate Zone: 4a(5331 HDD), All Electric: false Is Renewable: false Has Battery: false Has Charger: false Has Heat Pump, false Construction Site: Owner/Agent: Designer/Contractor: 530 Woodcliff Drive Mark&Antonia Canellos 'Jeff Zahn Mattituk,NY 11952 530 Woodcliff Drive 215 Roanoke Avenue Mattituck,NY 11952 Jeff A.Zahn,Architects,P.C. 917.921.3066 Riverhead,NY 11901 canellos20@gmail.com 631.727.0544 jeff@jeffzahnarchitects.com Project Notes: Report Title: Canellos Residence Report Date: 8/22/25, 1:38 PM 1 of 11 Envelope Assemblies Prop. Req. Assembly Gross Area or Cavity Cont. U- U- Prop. Req. Perimeter R Value R Value Factor/ Factor/ UA UA F-Factor F-factor Ceiling:Flat Ceiling or 621 30.0 0.0 0.035 0.026 22 16 Scissor Truss Ceiling 1:Cathedral 76 30.0 0.0 0.034 0.026 3 2 Ceiling Floor:All-Wood 696 30.0 0.0 0.033 0.047 23 33 joist/Truss Wall:Wood Frame,16" 993 15.0 3.0 0.061 0.060 54 53 O.C. Orientation: Unspecified Window:Wood Frame 103 0.300 0.320 31 33 SHGC:0.34 Orientation: Unspecified 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. Slab-on®grade tradeoffs are no longer considered in the UA or performance compliance path in REScheck.Each slab-on-grade assembly in the specified climate zone must meet the minimum energy code Insulation -value and depth requirements. Compliance Statement The proposed building design described here is consistent with the building plans,specifications,and other,calculations submitted with the permit application.The.proposed building has been designed to meet the 2018.IECC requirements in RESchec'k-Web and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Name-Title Signatat Date Report Title: Canellos Residence Report Date: 8122/25, 1:38 PM 2 of 11 C..00% �(j Inspection Checklist Energy Code:2018 IECC Requirements: 100%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. Pre-inspection/Plan Review Section Plans Field # Verified Verified &Req.ID i Pre-Inspection/Plan Review Value Value Complies? Comments/Assumptions 103.1' Construction drawings and ] Lj Complies 103.2 I documentation demonstrate [PR111 energy code compliance for the Does Not building envelope,Thermal omplY envelope represented on Not construction documents. Rservable PNot licable 103.1, Construction drawings and v,,. " Complies 103.2, documentation demonstrate 403.7 ener y code compliance for Does Not Q [PR3]1 light ng and mechanical P emplY systems.Systems serving l�l Not multiple dwelling units must 12servable demonstrate compllance with the ICCC Commercial Provisions, Not J pplicable 302.1, He and coolGng equipment Heating: Heating: Complies 403.7 is sized per ACCA Manual S Btu/hr Btu/hr [PR2]2 bused on loads calculated per Does Not ,ACCA Maanual I or other methods omPIY 1 approved by the code officIM. Cooling: Cooling: Not j Btu/hr Btu/hr' Observable Not pplicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Im act(Tier 2) 3 Low impact(Tier 3) Report Title: Canellos Residence Report Date: 8/22/25, 1:38 PM 3 of•11 Foundation inspection Section &Req.ID i Foundation Inspection Complies? Comments/Assumptions 303.2.1 A protective covering is installed to Complies Exception:Requirement is not applicable. [FO11]2 protect exposed exterior insulation and extends a minimum of 6 In.Wow Does Not grade. [omply Obi eorvable Not pplicable [FO12]z installed, g Y C rpo s Not l p q not applicable. 403.9 Snow-and ice-melting system controls Com lies Exception:Requirement is PY Not servable j PNot plicable Additional Comments/Assumptions: 1 Hi h Im act(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Report Title: Canellos Residence Report Date:'8122/25; 1:38 PM 4 of 1.1 Framing / Rough-in Inspection Section Plans j Field # Framing/Rough-In Verified Verified &,Req.ID j Inspection Value Value Complies? f Comments/Assumptions 402 3.1,, Glazing U-factor(area-weighted U"E= U ❑Complies See the Envelope 4021. average). Does Not Assemblies table for values 402.5 Comply [FR2]1 Not Ob' servable Not pplicable 402.4.1.1 Air barrier and thermal barrier O Complies [FR23]1 installed per manufacturer's Does Not instructions. omply ❑Not Observable y �� h Not pplicable 402.4.3 Fenestration that is not site built Complies [FR20]1 is listed and labeled as meeting Does Not AAMA/WDMA/CSA Q 101/I,5,2/A440 or has infiltration Comply rates,per NFRC 400 that do not 1 P Not exceed code Omits. � � servable p 'PNot i y plicable 402.4.5 IC-rated recessed lighting Complies [FR16]2 fixtures sealed at ,,,, [)Does Not housing/interior finish and 0 labeled to indicate<_2.0 cfm omply leakage at 75 Pa. Not r servable Not pplicable 403.3.1 Supply and return ducts in attics Complies [FR12]1 insulated>=R-8 where duct is Does Not " >=3 inches in diameter and In'Ir.tp 1i-6'0here' ly 3 iract5, om mplyandreturnductsiother J 1[�Not", f the b'ildi' servable lated>—R-6 for diameter Not >=3 inches and R-4.2 for<3 inches in diameter. y pplicable 403.3.2 Y Ducts,air handlers and filter 0 Complies [FR13]1 boxes are sealed with Does Not joints/seams compliant with Comply International Mechanical Code �; or International.Residential 1 PNot Code,as applicable. servable I t Not �'piicable. Building cavities are not used as , Complies, 4i! 15]3 ducts or plenums. ' Does Not omply �"Not . .r servable Not i Applicable Report Title: Canellos Residence Report Date: 8/22/25, 1:38 PM 5 of 11 Section Plans f Field # Framing/Rough-in Verified Verified I &Req.ID Inspection Value Value Complies? Comments/Assumptions me 1 403.3.7 Ducts declared to be within the Complies [FR28]3 conditioned space are either 1) [�Does Not completely within the continuous air barrier and within Umply the building thermal envelope,2)buried within ceiling Not insulation in accordance with Observable Section R403.3.6 and the air J Not 1 handler is located completely 1ppplicable within the continuous air barrier and within the building thermal 1 envelope and the duct leakage ] is<=1.5 cfm/100 square feet of conditioned floor area served by the duct system,or 3)the ceildn?insulation R-value installed against and'above the insulated duct>=to the proposed ceiling insulation R- value less the R-value of the insulation on the duct. z above 105$F or chilled fluids R R Complies Exception:Requirement 403.4 HVAC pipet conveyin fluids [FR17] is not applicable. below 55°F are insulated to-R- Does Not 3. omply (2Not servable PNot pl cable 403.4.1 Protection of insulation on HVAC Complies [FR24]1 piping. ', Does Not Pmply Not servable PNot plicable 403.5.3 Hot water pipes are insulated to R R Q Complies [FR18]2 Does Not Pomply PNot servable Appliocable . 403.6 Automatic or gravity dampers Q Complies [FR19]2 are installed on all outdoor air Does Not intakes and exhausts. Comply Q Not Observable Not PPlicable 1 303.1.3• U-factors of fenestration Complies [FR4]1 products are determined in accordance with the*NFRC test " r ❑Does Not { drocedt re or,taken frown the Comply RserNot servable P Not Pp plicable Additional Comments/Assumptions: w 1 High Im: act(Tier 1) 2 Medium Irri act(Tier 2) 3 Low Impact(Tier 3) Report Title: Canellos Residence Report Dater 8/22/25, 138 PM 6 of`11 Insulation inspection Section Plans field As Verified 'Verified lioel.lif Insulat:londnspectlon:i-,: Value Value Compiles? �Comments/Assumptions f 1303.1 All installed insulation is labeled 10 Complies (IN13]2 or the installed R-values provided. 9 Does Not f �imply i INot servable 0 Not pplicable 402.1.1, Floor insulation R-value. Complies: See the Envelope 402.2.6 R R� Assemblies table for [IN111 0 Wood Wood ornDpby Not values 0 Steel O Steel Not P� servable Not applicable 303,2, Floor insulation installed per 0 Complies 402.Y.8 manufacturer's instructions and Does Not [IN211 in substantial contact with the underside of the subfloor,or `OmpIY floor framing cavity insulation is Not In contact with the top side of servable sheath Ing,or contlnuous Insulation Is installed on the �Not underside of floor framing and 1ppplicable extends from the to of all erimeterfloor framing membersbottom to the 402.1.1, Wall insulation R-value.If this is R R Complies See the Envelope 402.2.5, a mass wall with at least%of Does Not Assemblies table for 402.2.6 the wall insulation on the wall Wood Wood P values [IN3]1 requirement exterior O Mass O Mass Qo Not O Steel O Steel Observable �Not Applicable 303.2 Wall insulation is Installed per 0 Complies [IN411. ma nufacturer'sInstruetaons, Does Not mply QNot servable �Not Pp0cable Additional.Comments/Assumptions: 1 Hih m act(Tier 1] �` Medium Impact(Tier 2) Low Impact(Tier 3) Report Title: Canellos Residence Report'Date: 8/22125, 1:38 PM 7 of 11 Final Inspection Provisions Section Plans Field # Verified Verified &Req.ID Final Inspection Provisions Value Value J Complies? Comments/Assumptions 402.2.1, Ceiling insulation R-value. R �� R � Complies See the Envelope 402.2.1, Assemblies table for 402 2,2, 10 Wood Wood Does Not values 402Z6 omply [Fill' Steel Steel Not i Qservable PNot licable 303.1.1.1, Ceiling insulation installed per 0 Complies 303.2 manufacturer's instructions. I [FI2]' i,Blown insulation marked every Does Not 300 W. Comply WNot ervable Not Jppplicable 403.1�2 Heat pump thermostat installed i" ` " '" "`" ",P Complies [FI10] on heat pumps. p �isxrcartpatplicableuirement PDoes Not omply Not y servable Not Applicable 403.5.1 Circulating service hot water Complies [Flll]z Systems have automatic or accessible manual controls. t" Does Not Comply � Not R servable n Not j� f pplicable 14 03.6.1 All mechanical ventilation I Q Complies [FI25]? systenn fans not art of tested 1 and listed HVAC equipment 1 y (�Does Not meet efficad�y and air flow limits J Com ly per Table R4ti3.i6.1. Not servable Not Applicable 403.2 Hot water boilers supplying heat I Complies Exception:Requirement [FI26]2 through one.or two-pipe Is not applicable. heating systems have outdoor P Does Not m setback control to lower boiler coply water temperature based on ❑Not outdoor temperature.. Observable Not 1 1. c 403.5.1.1 I hleated water circulation r.�..— ^,.....;`�..,..,., ��..,.......,,,,.,.,_� "plica pie a O Complies Exceptions Requirement [FI26]z ems have a circulation 'cable pump.The system return pipe Is Does Not is not appl a dedicated return pipe-or a omply cold water supply pipe,Gravity .. Nat and thermos-syphon circulation ?�servable s stems are not present. Controls for clrcuIa tin g hot Not. water system pumps start the 1 Appliccable 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 rakno demand f oh water 403.L2 `�Electric heat trace s stems Comp Not Exceptigd'Requirement . F12 l comply auto ati allyt. � �� . adjust the energy Input to tar . omply �s no applicable., { tracing to maintain the / (�Not thIred piping store In servable heat ter temper ' Not pilcabl Report Title: Canellos Residence Report Date: 8/22/25, 1:38 PIA 8 of 11 Section Plans Field # Verified Verified &Req.ID i Final Inspection Provisions Value Value Complies? Comments/Assumptions 403.5.2 Demand recirculation water I 0 Complies Exception:Requirement [F130]2 systems have controls that Does Not Is not applicable. manage o !ration of the pomp [] and limit tie temperature of the Comply water entering the mold water ('[ ]Not piping to<=1049F b�servable pp W Not I licable i403.5.4 Drain water heat recovery units 0 Complies Exception:Requirement [F131] z tested in accordance with CSA Ns not applicable. B55 1 Potable water-side Does Not Peat loss of drain water comply heat recover units<3 psi for (Q�Not individual Nis connected to observable one or two showers.Potable water-side pressure loss of drain Not. water heat recovery units<2 pplicable j psi for individual units connected to three or more showers. i 404.1 90 or more of permanent r /'0 Complies [F16]1 fixtures., Co s have high efficacy %, i Does Not lamps mply f, Not Observable 1 QNot f Applicable 404.1.1 Fuel gas lighting systems have 0 Complies [F123]3 no continuous pilot light. i Does Not amply Not servable y Not i �Pplicable r, 401.3� Compliance certificate posted„ 0 Complies I[F17]2�- (�Does Not f comply Not servable 0 Not Applicable j 303.3 Manufacturer manuals for Complies [FI18]3 mechanical and water heatingDoes Not systems.have been provided, P Doe mply Not servab[p Not �. pplicable 1 402 2.3 Vented e d attics with air permeable �; 0 Complies a[FI22] insulation include baffle adjacent to soffit and eave - ,r, Does Not vents that extends over Comply insulation. Not ., servable Not PPlicable I 1402.2.4 Attic access hatch and door R= �R� �0 Complies • " [FI311 insulation>R-value of the Does Not adjacent assembly. Q Comply ❑❑Not Observable PNot 402.4.1.2 Blower door test @ 50 Pa:< p able ] =5 A,CI�I 50= ACFi 5f1= 0 Complies [FI17]1 -c= in.ach in Zones Zones and -] � Does Not <=3 ach"in Climate Zones 3-8. t ,I amply Not servable Not Applicable Report Title: Canellos Residence Report Date: 8/22/25, 1:38 PM 9 of 11 Section Plans Field Verified Verified 1 &Req.II) Final Inspection Provisions Value Value Complies? Comments/Assumptions 403.3.3 Ducts are pressure tested to � �Complies [FI2711 determine air leakage with Does Not either.Rough-in test:Total cfm/100 ftz cfm/100 ftz leakage measured with a omply pressure differential of 0.1 inch (�Not w.g.across the system including 66servable the manufacturer's air handler enclosure if installed at time of [�Not test.Postconstruction test:Total 1ppplicable leakage measured with a pressure differential of 0.1 inch w.+,aoss the entire system Includc;ring the manufacturer's air handier enclosure. 403.3.4 Duct tightness test result of Complies [FI4] system r handler across the 1 <=4 c m/100 ft2 Does Not witho system or<=3 cfm/100 ft2 i cfm/100 ft2 cfm/100 ft2 25 Pa.For PO rough-in tests„verification may J Not need to occur during Framing �servable Inspection. Q Not Applicable '403.3.2.1 Air handler leakage designated0 Complies /o[F12411 by manufacturer at<=2 of p design airflow. MDoes Not 1 it comply j Not 10bservable 1 Not %Applicable 403.1.1 Programmable thermostats Complies [FI9)2 insstalled for control of primary heatin and cooling systems co Does Not and InRially set byy manufacturer r mply to code speciflcatl�ons, L Q Not 66servable Not Applicable Additional Comments/Assumptions: 1 Hi h Im act(Tier,l) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Report Title' Canellos Residence Report Date: 8/22125, 1:38 PM 10 of 11 Energy Efficiency Certificate Above-Grade Wall 18.00 Below-Grade Wall 0.00 Floor 30.00 Ceiling/Roof 30.00 Ductwork(unconditioned spaces): Window 0.30 0.34 Door 0.00 Skylight 0.00 Heating System• Cooling System• Water Heater• Name: Date: Comments:. Report Title: Canellos Residence Report Date: 8/22125, 1:38 PM 11 of 11 Fc11111L wr ooigie ramuy Kesiclences (Form WWM-104). It is the applicant's responsibility to schedule an inspection of the sewage,disposal and/or water supply facilities prior to backfilling.This includes inspections of the sewage collection and disposal systems,water supply system components and piping,and final grading as shown on the approved plans.This can be done by calling the department at(631)85 - 5754,or through the ACA Portal at httos•// ca-- rod,accela.com/SUFFOL 0 In certain cases,inspections of the soil excavation may be rewired to determine the acceptability of the soils for sewage disposal systems. Excavation inspections must be confirmed by calling(6 1)85 -5700 between : 0a.m..and g: 0 a.m.,the morning of the inspection..Article Vil-of th Cade, "Septic Industry Businesses,"requires that all installers of septic systems within shell possess a valid license from the Office of Consumer Affairs. This office will not perform inspections for or grant final approval for construction of projects that are installed by an unlicensed individual. It is therefore, in your best interest to Utilize a cesspool contractor with a valid license to avoid substantial delays in your project MO .�, ml Final approval issued by:the Department is necessary prior to the.occupancy of new buildings,additions to. 10`0existing buildings,.or for the use of sewage disposal.or Water supply systems. �DWATER ZONE: 1-7,121.42 50. FT. ION r 1A7 VW111\11-016 Page 1 of 2 =DROOM DWELLING 110 GPD = 660 GPI NCTION AN800 ,D CAPACITY = L300 GPD AREA = THE SCHD RESIDENTIAL STANDARDS A-5 400 MIN. SF WALL AREA USE: =F DEPTH POOLS = 400 SF WALL AREA :F DEPTH POOL (FUTURE 50% EXPANSION) TO BE ALLOCATED Z ENGINEER'S CERTIFICATION REQUIRED � SUBMIT P.E. OR R.A. CERTIFICATION V FOR INSTALLATION AND CONSTRUCTION Z } (� OF IA/OWTS W �/ Ln Q C/ FOR FINAL APFROiOAL. USE FORM WWfVI-073_ Q �n Q O C% � L � } W — u- z iu Abandonment of the existing sanitary system must be in �/ Q h-1-i --� conformance with the Department's requirements. Q v Submit completed form WWW-080 as proof O LU Q F---� K Fes— In W < V o Z � o 0 00 O o � � � a a � a APPROVAL STAMP 24,8 IA/OWTS Hy _rOActlon @&FP [POILCEo PR0JEGT5-24-M5 SUFFOLK COUNTY DEPARTMENT OF HEAt.TFi SERVICES PERMIT FOR APPROVAL OF CONSTRUC`r ION FOR SINGLE FAMILY RESIDENCE ONLY i DATE 8-29-2025 H.S. REF_ No. R-25-1184 APPROVED F®R MAXIMUM OF 6 DROOMS EXPIRES THREE YEARS FROM DATE OF APPROVAL �aC�C�4 G�]Ooo I of � ` l LOT NOW OR FORMERLY GARLO 4 ANNE 6ALANTE I 1 (PUBLIG WATER) 1 1 EL: 25.1- 11500, - �1 1 t 1 EXISTING CNOHATEF POOL EXIST. 1 SANITARY SYSTEM TO 1 —� BE ABANDONED i 1 � - NOW \ t EXIST. EXISTING 1 1 I STORY I FRAME DECK FRAME t 6ARAGE 1 1 EXISTING 1 -- PAVER PATIO 1 13=I EXISTING I STORY EXIST. 1 SEE 50-2 FOR FRAME DWELLING STONE ENLARGED PLAN (EXISTING 2 BEDROOM) DRIVEWAY i (PROPOSED 6 BEDROOM) I L, FINISHED FLOOR 32.0' I LOT NOW OR FORMERLY ` BARBARA GOSTANZO 1 - (PUBLIG WATER) +-TEST 1 1 EXIST.iBR16KHALK HOLE II 1 I I/A OWTS r r 1 HYDROAGTION 0.-00 J � � EXIST N6 TER. ANOOO Mlt=_ �.4-� SERVI E TO REMAIN (NO G AN6 I `r 0 i 1 I � lie S II' I-7' 20 E 25 .0 I 17l 20 E /�i II . WATER , EL: 30.24' CMETER WOODCLIFF DRIVE 57E l=lmAN 4 5 A ILen *1000 57E SCALE: NNN6 NN0TES ALL MATERIALS AND METHODS OF THE GONSTRUGTI ON SHALL CONFORM TO THE STANDAR1. DS OF HEALTH SERV I GES AND PUBLI G WORKS AND THE MANUFAGTURER'S SPEC I F I GATI ONS AS API TE AN EQUIPMENT AND MATERIAL STAGING AREA WITH TP 2. THE CONTRACTOR SHALL GOORD I HA 3. ANY DAMAGE TO THE PUBLIC RIGHT OF WAY OR NEIGHBORING PROPERTIES AS A RESULT OF EXPENSE TO THE SATISFAGTION OF THE ENGINEER. 4. DURING GON5TRU6TION, THE GONTRAGTOR IS RESPONSIBLE TO PROVIDE SITE SECURITY BY ME WORK 15 NOT TAKING PLATE. 5. THROUGHOUT THE DURATION OF GON STEEL PLATE GOVERS, ETG. TO ENSURE SAFETY STRUGTION TFOR VE HGLESHE OAND PEDESTRIANS TRAV N51BLE FOR E�NC- nan ir-/-T nr=mnl ITInN INr.I UDING REMOVAL OF EXISTING FAGILITIES, DRAINAGE SYSTEMS, RE-