HomeMy WebLinkAbout52528-Z 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#: 52528 Date: 12/09/2025
Permission is hereby granted to:
1160 Snug Harbor LLC
c/o Lupovici
New York, NY 10010
To:
demolish an existing dwelling and construct a new single-family dwelling as applied for per SCHD, DEC
and Trustees approvals.
Premises Located at:
1160 Snug Harbor Rd, Greenport, NY 11944
SCTM# 35.-5-39.1
Pursuant to application dated 01/21/2025 and approved by the Building Inspector.
To expire on 12/09/2027.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling-NEW $2,283.00
DEMOLITION $1,350.80
CO-RESIDENTIAL $100.00
Total $3,733.80
1�
Building Inspector
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 htt s://www.sotatitoldtownil . ov
Date Received
BUILDINGAPPLICATION FOR
For Office Use Only
c025
PERMIT NO. �� Building Inspector:
____ AL
Applications and forms must be filled out in their entirety.Incomplete Town Of Southold BuildingBuilding DPe fume
applications will not be accepted. Where the Applicant is not the owner,an
Owners Authorization form(Page 2)shall be completed.
Date:January 3, 2025
OWNERS)OF PROPERTY:
Name: John & Jessica Lupovici SC TM# 1000-35-5-39.1
Project Address: 1160 Snug Harbor Rd, Greenport NY
Phone#: 917-664-8673 Email.drlupo@mac.com
Mailing Address: 1160 Snug Harbor Rd, Greenport NY
CONTACT PERSON:
Name: Ashley Hancock
Mailing Address: PO BOX 400, South Jamesport NY 11970
Phone#: 631-703-0800 Email:Ashley@ PowersHancockDesign.com
DESIGN PROFESSIONAL INFORMATION:
Name: Powers Hancock Design
Mailing Address: PO Box 400, South Jamesport NY 11970
Phone#: 631-703-0800 Email: Info@ powershancockdesign.com
CONTRACTOR INFORMATION:
Name: Bill Boergesson
Mailing Address:
Phone#: 516-901-7908 Email: baboergconstr@gmail.com
DESCRIPTION OF PROPOSED CONSTRUCTION
igNew Structure ❑Addition ❑Alteration ❑Repair ®Demolition Estimated Cost of Project:
❑Other $ 2,000,000
Will the lot be re-graded? ❑Yes ®No Will excess fill be removed from premises? '[ Yes ❑No
1
PROPERTY INFORMATION
Existing use of property: Intended use of property:
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
R-40 this property? Yes ONO IF YES, PROVIDE A COPY.
0 - z _ - i 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.
Ashley Hancock
Application Submitted By(print name): glAuthorized Agent OOwner
Signature of Applicant: Date:
V
STATE OF Nf IC)
S ' 4U
COUNTY OF �,v<<1
•: ... being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)he is the 1A
(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 Jn ,20 c2
- Notary Public
KARIN VAZQUEZ
Notary Public
N
-Arizona
Marlcopa County
(Where the applicant is not the owner) Commission i1647817
4y Commission Expires April 30,2027
w
residing at V .
do hereby authorize Ashley Hancock to apply on
my behalf t Town of Southold Building Department for approval as described herein.
#wtl r's Signature Date
" (? RANDALL K ATKINSON
NOTARY PUBLIC-STATE OF NEW YOR
Print Owner's Name No. 01 AT62 i 9451
Qualified in Queens County
`` MY Commission Ex Tres u •�
Generated by ,EScheck-- !' b Software
Compliance Certificate
Project 1160 Snug Harbor Road
Energy Code: 2018 IECC
Location: Greenport, New York
Construction Type: Single-family
Project Type: New Construction
Project SubType: None
Conditioned Floor Area: 3,696 ft2
Glazing Area 30%
Climate Zone: 4 (5572 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:
1160 Snug Harbor Road John &Jessica Lupovici Ian Lanning
Greenport, NY 11944 Powers Hancock Design
631-480-3037
ian@powershancockdesign.com
Compliance: 7.1%Better Than Code Maximum UA: 934 Your UA: 868 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.
Slab-on-grade tradeoffs are no longer considered in the UA or performance compliance path In RESchec'k. Each stab-on-grade
assembly in the specified cdirnate,zone nwst rneet the mini alum energy code tnsuladon R-value and depth requirements.
Envelgpe.Asse-mblies
Gross Area Cavity Cont. Prop. Req. Prop, Req.
Perimeter
Ceiling-Hot Roof: Cathedral Ceiling 3,523 38.0 0.0 0.027 0.026 95 92
Wall:Wood Frame, 16"o.c. 4,679 27.0 0.0 0.051 0.060 174 205
Door: Glass Door(over 50%glazing) 488 0.300 0.320 146 156
SHGC: 0.30
Window:Vinyl Frame 776 0.300 0.320 233 248
SHGC:0.30
Wall-Partition: Wood Frame, 16"o.c. 180 27.0 0.0 0.051 0.060 8 10
Door 1: Solid Door(under 50%glazing) 21 0.140 0.320 3 7
Floor:All-Wood Joist/Truss 27 30.0 0.0 0.033 0.047 1 1
Project Title: 1160 Snug Harbor Road Report date: 01/06/25
Data filename: Page 1 of10
Gross Area Cavity Cont. Prop. Req. Prop� Req.
Perimeter
Basement Wall: Solid Concrete or Masonry
Wall height: 9.0' 2,709 0.0 10.0 0.058 0.059 145 147
Depth below grade: 8.0'
Insulation depth: 9.0'
Door: Glass Door(over 50%glazing) 21 0.300 0.320 6 7
SHGC:0.30
Window: Vinyl Frame 190 0.300 0.320 57 61
SHGC: 0.30
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 I!ECC requirements in
REScheck Version : REScheck-Web and to comply with the mandatory requirements listed in the REScheck Inspection Checklist.
Marvin Murillo - HERS Rater WkMZ 01/06/2025
Name-Title Signature Date
Project Title: 1160 Snug Harbor Road Report date: 01/06/25
Data filename: Page 2 of10
REScheck Software Version : REScheck-Web
Inspection o 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.
..... ...........
ESectlon � Plans Verified Field Verified
# Pre-Inspection/Plan Review Value ValueComplies? Comments/Assumptions� _........_.. ._
103.1, Construction drawings and ❑Complies Requirement will be met.
103.2 documentation demonstrate []Does Not
[PRI11 j energy code compliance for the ❑Not Observable
building envelope.Thermal
envelope represented on ❑Not Applicable
;construction documents.
103.1, Construction drawings and OComplies Requirement will be met.
103.2, documentation demonstrate []Does Not
403.7 energy code compliance for ❑Not Observable
[PR3]1 ,lighting and mechanical systems,
Systems serving multiple ❑Not Applicable
dwelling units must demonstrate
compliance with the IECC
Commercial Provisions.
302.1, Heating and cooling equipment is Heating: Heating: 1❑Complies ;Requirement will be met.
403.7 sized per ACCA Manual S based Btu/hr Btu/hr ❑Does Not
[PR212 on loads calculated per ACCA Cooling: `- Cooling: ❑Not Observable
Manual J or other methods Btu/hr Btu/hr
approved by the code official. ❑Not Applicable
E
t a
Additional Comments/Assumptions:
l l High Impact(Tier 1) 2 1 Medium Impact(Tier 2) 3 Low Impact(Tier 3)
Project Title: 1160 Snug Harbor Road Report date: 01/06/25
Data filename: Page 3 of10
ESection Plans Verified Field Verified � -
# Foundation Inspection Value Value Complies? p ons
Re .ID _
. . ... ....... .... ......Bement wall ._..,m- R- ,R._ �..a;l�Complie See the
402.1.1 Conditioned basement s
[F04]1 insulation R-value.Where interior R- R- ❑Does Not ;table for values.
insulation is used,verification ❑Not Observable
may need to occur during
Insulation Inspection. Not ❑Not Applicable
required in warm-humid locations E
in Climate Zone 3.
n
303.2 Conditioned basement wall ❑Complies Requirement will be met.
[F05]1 insulation installed per ❑Does Not
manufacturer's instructions. ❑Not Observable f
❑Not Applicable ;
402.2.9 Conditioned basement wall ft ft ,CCo'mplies See the Envelope Assemblies
[F06]1 insulation depth of burial or ODoes Not ;table for values.
distance from top of wall.
y ;❑Not Observable
![]Not Applicable
P p g Requirement will be met.
303.2.1 A protective covering is installed �Corr'� Nies
[FO11]2 to protect exposed exterior []Does Not
insulation and extends a
I minimum of 6 in. below grade. ❑Not Observable
❑Not Applicable
403.9 Snow-and ice-melting system OCornplies I Requirement will be met.
[FO12]2 controls installed. ElDoes Not
❑Not Observable e
❑Not Applicable
Additional Comments/Assumptions:
1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3
� p p .Low Impact(Tier 3)
Project Title: 1160 Snug Harbor Road Report date: 01/06/25
Data filename: Page 4 of10
Section Plans Verified Field Verified
# Framing / Rough-in Inspection Value Value Complies? Comments/Assumptions
& Re9,lD _
402.3.4 , m.maH.. � �w,�w...._... .._ �p..e.___. .� � .. -......__ _... w.....-.... _...
402.1.1, Door U-factor, ..._ U U ❑Compiles See the Envelope Assemblies
]1
oes Not table for values.
[FR1 ;❑Not Observable P
F ,
❑Not Applicable
402.1.1, Glazing U-factor(area-weighted U- U-
❑Compiles See the Envelope Assemblies
402.3.1, average). ❑Does Not table for values.
r
402.3.3, I❑Not Observable h
402.5
[FR2]1 1EINot Applicable
303.1.3 U-factors of fenestration products ❑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
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
AAMA/WDMA/CSA 101/I.S.2/A440 ❑Not Observable
or has infiltration rates per NFRC
400 that do not exceed code ❑Not Applicable
limits.
402.4.5 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
,.. m. .
403.3.1 !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 >= :building envelope.
R-6 where < 3 inches. Supply and, []Not Observable
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
International Mechanical Code or ❑Not Observable
International Residential Code, as ❑Not Applicable
applicable.
5 Building cavities are not used as 'DComplies Requirement will be met.
[FR15]3 ducts or plenums. []Does Not
❑Not Observable G
❑Not Applicable
403.4 HVAC piping conveying fluids R- R ❑Complies Requirement will be met„
[FR17]2 above 105°F or chilled fluids ❑Does Not
below 55°F are insulated to >_R- _ ❑Not Observable
3. Z Not Applicable
403.4.1 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 'OComplies Requirement will be met.
[FR18]2 >_R-3. ;;❑Does Not
.i ❑Not Observable
❑Not Applicable j
1 iHigh Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3)
Project Title: 1160 Snug Harbor Road Report date: 01/06/25
Data filename: Page 5 of10
Section Field Verified
Framing / Rough-In Inspection Plans Verified Value Value Complies? CornmentslAssumptions
e ID
..........
403.6 Automatic or gravity dampers are, ElComplies Requirement wiIII be met.
(FR19]z installed on all outdoor air ODoes,Not
intakes and exhausts.
[]Not Observable
ONot Applicable
Additional Comments/Assumptions:
Impact(Tier 2) 3 Low impact(Tier 3)
Project Title: 1160 Snug Harbor Road Report date: 01/06/25
Data filename: Page 6 of 10
Section Plans Verified Field Verified
I '�P�' labeled °- Value Value ❑Com lies Requirement will
& Rem ID Insulation Inspection Complies? Comments/Assumptions
# Insu
303.1 All installed insulation is e p ill be met.
(IN13]2 or the installed R-values ❑Does Not
provided.
i ❑Not Observable r
❑Not Applicable
402.1.1
®Floor insulation R-value. R- R �❑Complies See the Envelope Assemblies
�
�402.2.6 Wood „❑ Wood El Not ;table for values.
[IN1]1 ❑ Steel ❑ Steel ;❑Not Observable i
❑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 []Not Observable
, underside of the subfloor, or floor;
`framing cavity insulation is in ❑Not Applicable
contact with the top side of
sheathing, or continuous
insulation is installed on the
j underside of floor framing and
extends from the bottom to the
Mop of all perimeter floor framing
members.
402.1.1, Wall insulation R-value. If this is a" R- R- ❑Comp@ies See the Envelope Assemblies
402.2.5, mass wall with at least 1/2 of the a❑ ❑Does Not Wood El ;table for values.
402.2.E wall insulation on the wall ;❑ Mass ❑ Mass ❑Not Observable
[IN3]1 exterior,the exterior insulation
, requirement applies(FR10). ;❑ Steel f❑ Steel j❑Not Applicable
r
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:
g p ,_,, p Low Impact(Tier 3)
1 Hil h Impact (Tier 1) 2 Medium Im act(Tier 2) 3
Project Title: 1160 Snug Harbor Road Report date: 01/06/25
Data filename: Page 7 of10
Section Plans Verified Field Verified
# Final Inspection Provisions Value Value Complies? Comments/Assumptions
&ORe ID _ g _
R- -.
1�� � -_ ... _ � ..... �.... ...... .._... .. .__�� .A_.-. r�. w...w.._.__ _. .,. .., .
.1 Ceiling insulation R-value. �_ -.��a_.......
R '❑Complies See the Envelope Assemblies
402.2.1, ❑ Wood ❑ Wood ❑Does Not table for values.
402.2.2, ❑ Steel ❑ Steel ❑Not Observable
402.2.6
[Fill' ❑Not Applicable
303.1.1.1, ;Ceiling insulation installed per ❑Complies !Requirement will be met.
303.2 'manufacturer's instructions. ❑Does Not
[F12]1 ;Blown insulation marked every 300 ft2. ❑Not Observable
❑Not Applicable
402.2.3 Vented attics with air permeable ❑Complies Exception: Requirement is
[F122]2 insulation include baffle adjacent ❑Does Not not applicable.
to soffit and eave vents that
extends over insulation. ❑Not Observable
❑Not Applicable i
402.2.4 iAttic access hatch and door R- R- E]Complies Requirement will be met.
[FI3]1 insulation ?R-value of the r �❑Does Not
;adjacent assembly. I
❑Not Observable
L 1❑Not Applicable
Blower = ACH 50 = ;❑Complies ;Requirement will be met.
402.4.1.2 owe;door test @ 50 Pa. <-5 , ACH 50 =
[FI17]1 ach in Climate Zones 1-2, and ❑Does Not
<=3 ach in Climate Zones 3-8.
;❑Not Observable '
_❑Not Applicable
403.3.3 Ducts are pressure tested to cfm/100 cfm/100 DC'o plies Exception: All ducts and air
[FI27]1 `determine air leakage with ft2 ft2 !❑Does Not handlers are located within
;either: Rough-in test:Total conditioned space.
leakage measured with a :❑Not Observable
pressure differential of 0.1 inch j❑Not Applicable
w.g. across the system including
°the manufacturer's air handler
enclosure if installed at time of
;test. Postconstruction test:Total j
:leakage measured with a ;
pressure differential of 0.1 inch
w.g.across the entire system
f including the manufacturer's air
handler enclosure.
403.3.4 Duct tightness test result of<=4 cfm/100 cfm/100 "❑Complies ;Exception:All ducts and air
[F14]1 cfm/100 ft2 across the system or ft2 ft2 EDoes Not handlers are located within
%<=3 cfm/100 ft2 without air conditioned space.
`handler @ 25 Pa. For rough-in []Not Observable
;tests,verification may need to ❑Not Applicable
occur during Framing Inspection.
403.3.2.1 ;Air handler leakage designatedN. ❑Complies ;Requirement will be met.
[FI24]1 by manufacturer at <=2%of ❑Does Not
design air flow.
❑Not Observable
❑Not Applicable
403.1.1 Programmable thermostats ❑'Complies .;Requirement will be met.
JF19]2 installed for control of primary ❑Does Not
heating and cooling systems and
initially set by manufacturer to ❑Not Observable 1
code specifications. ❑Not Applicable
.w� .
40 .1.2 Heat pump thermostat installed ❑Complies Exception: Requirement is
[FI10]2 on heat pumps. ❑Does Not 4 not applicable.
❑Not Observable
❑Not Applicable
i
�403.5.1 Circulating service hot water ❑Complies ;Requirement will be met.
[FI11]2 systems have automatic or ❑Does Not
accessible manual controls.
❑Not Observable
❑Not Applicable
11 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 1 Low impact(Tier 3)
Project Title: 1160 Snug Harbor Road Report date: O1/06/25
Data filename: Page 8 of10
Section Plans Verified Field Verified
# Final Inspection Provisions Value Value Complies? Comments/Assumptions
& Re ID
401 All mechanical test and ventilation
listed _;... w .. .,.... .. ,. ❑❑Do Not mp , rN� Requirement will bemet.
125]2 fans not part
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.
(FI26]2 through one-or two-pipe heating ❑Does Not
systems have outdoor setback
control to lower boiler water ❑Not Observable
temperature based on outdoor ❑Not Applicable
temperature.
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 ,
return pipe or a cold water supply. ❑Not Observable
pipe.Gravity and thermos- ❑Not Applicable
syphon circulation systems are
not present. Controls for
circulating hot water system
pumps start the pump with signal
4I
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 Exception: Requirement is
[FI29]2 comply with IEEE 515.1 or UL ❑Does Not not applicable.
515. Controls automatically
adjust the energy input to the ❑Not Observable
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 meta
[FI6]1 ;fixtures have high efficacy lamps, ❑Does Not
❑Not Observable
i ❑Not Applicable j
.... ,
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
1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3)
Project Title: 1160 Snug Harbor Road Report date: 01/06/25
Data filename: Page 9 of10
F303-3
ction Plans Verified Field lderiti+ d Complies? Comments surr�ptions
Final inspection Provisions Value 'value q
l Pe uir .
g..._w_k m - �9orrrp9ies ement will be met.
Manufacturer manuals for Oboes Not
i mechanical
halve been and tlarovdeer i [ Not Observang
ble
[]Not Applicable
Additional Comments/Assumptions:
11 High Impact(Tier 1) Medium Impact(Tier 2) Low impact(Tier
Report date: 01/06/25
Project Title: 1160 Snug Harbor Road Page 10 of10
Data filename:
Effidency Certificate
WIN
Above-Grade Wall 27.00
Below-Grade Wall 10.00
Floor 30.00
Ceiling / Roof 38.00
Ductwork (unconditioned spaces):
Window 0.30 0.30
Door 0.30 0.30
Heating System:
Cooling System:
Water Heater:
Name• Date•
Comments
BOARD OF SOUTHOLD TOWN TRUSTEES
SOUTHOLD, NEW YORK
N
V DATE: MAY 17 2023
PERMIT NO. 10379 �
ISSUED TO: 1.160 SNUG HARBOR LLC c/o :iOHN LUPOYICI
PROPERTY ADDRESS: 116,0 SNUG HARBORROAD2 GREENPI ORT
SCTM# 1.000-35-5-39..1 ,
AUTHORIZATION ,
Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in w
accordance with the Resolution of the Board of"Trustees adopted at the meeting held on May 17 , and in
consideration of application fee in the sum of$250.00 paid by I_l 0 Snua harbor, LLC and subject to the
„ Terms and.Conditions as stated in the Resolution,the Southold Town board of Trustees authorizes and permits
�n the following:
Wetland Permit to demolish existing dwelling with wood deck and raised concrete patio,remove spa on a
concrete pad,remove shed on cast side of property,and a gravel driveway on west side of property; i
construct new two-story dwelling with a 2,445 sq.ft. first floor and 2,025 sq.ft.second floor and attached
522 sq.ft.two-story,two car garage; a 405 sq.ft.covered porch with SO sq.ft.basement staircase;a 407
sq.ft.seaward stone patio on grade on west side; 'a 105 sq.ft.seaward stone patio on grade on east side; a
walkway from covered porch to 42 sq.ft.outdoor shower on west side; install A/C mechanicals and a
..
generator on east side of dwelling; install a new 11A sanitary system landward of dwelling;on the west �w•
side install a walkway that lead's to a 980 sq.ft,gravel parking area and gravel driveway;on the east side
install a walkway from front door to 1,255 sq.ft,gravel driveway; for the existing 7'51'wide stone splash
a pad along the landward edge of the bulkhead to be established as a non-turf buffer area;and to install d.
t"
and perpetually maintain a 101'wide non-turf buffer along the landward of the edge of wetlands;with the r
h. condition to establish and perpetually maintain a non-turf buffer along the 5' contour line inclusive of
the peninsula on the property,approximately 50 feet from the house; a one to one replacement for any �.
trees lost during construction with native hardwood trees;.and removal of all non-compliant up-lighting
on property; and as depicted on the revised site plan last dated May 26,2023,and stamped approved on
June 7,2023.
IN WITNESS'W1.ERF-01",the said Board of Trustees hereby causes its Corporate Seal to be affixed, and
these presents to be subscribed by a majority of the said Board as of the day and year first above w*itten.
SITE INFORMATION
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SNUG HARBOR ROAD
04—Uae
Lupovlol Residence-1160S Harbor Road Proposed Site Plan
Date:02-28-2023_Flle for Southold Board of Trustees Scale: 7 rr =11-0
1
1
Revision:05-26.2023_Seuthold Board of Trustees Comments 32
POWERS HANCOCK DESIGN
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
Division of Environmental Permits,Region 1
SUNY @ Stony Brook,50 Circle Road,Stony Brook,NY 11790
P:(631)444-03651 F:(631)444-0360
www.dec.ny.gov
April 19, 2023
1160 Snug Harbor LLC
225 5th Avenue
New York, NY 10010
Re: Application ID# 1-4738-01793/00006
1160 Snug Harbor LLC Property— 1160 Snug Harbor Road
SCTM# 1000-35-5-39.1
Dear Permittee:
In conformance with the requirements of the State Uniform Procedures Act (Article 70,
ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your
permit. Please carefully read all permit conditions and special permit conditions
contained in the permit to ensure compliance during the term of the permit. If you are
unable to comply with any conditions, please contact us at the above address.
Also enclosed is a permit sign which is to be conspicuously posted at the project site
and protected from the weather.
Sincerely,
Kim Lamiroult
Environmental Analyst
cc: Patricia Moore
BMHP
File
NEWi t(art��tra��t of
YORK
�rrt, i ervirrtt�rtNtt (
Conservation
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
Facility DEC ID 1-4738-01793
PERMIT
.... o .... .a
Under the Environmental Conservation Law i�Ck'�mmm�_ ..........
Permittee and Facility Information
Permit Issued To: Facility:
1160 SNUG HARBOR LLC 1160 SNUG HARBOR LLC
225 5TH AVE 1160 SNUG HARBOR RDA 1000-35-5-39.1
NEW YORK,NY 10010 GREENPORT,NY 11944
Facility Application Contact:
PATRICIA C MOORE
51020 MAIN RD
SOUTHOLD,NY 11971
(631) 765-4330
Facility Location: in SOUTHOLD in SUFFOLK COUNTY
Facility Principal Reference Point: NYTM-E: 722.501 NYTM-N: 4554.84
Latitude: 41°06'51.8" Longitude: 72°20'59.7"
Project Location: Gull.Pond
Authorized Activity: Remove existing gravel driveway and establish 10'non-turf buffer. All work
shall be done in accordance with the survey prepared by Kenneth M. Woychuk Land Surveying, last
revised 3/19/2023, and stamped'NYSDEC Approved'on 4/19/2023. KLL (DEP ARNO)
NOTE: Based on the information you submitted,the portion of the property landward of the 10'contour
is beyond the jurisdiction of the Article 25 Tidal Wetlands Act. Therefore,in accordance with the Tidal
Wetlands Land Use Regulations(6NYCRR Part 661),no permit is required to conduct regulated
activities landward of the 10'contour.
Permit Author
11-"""""'-1-'.-----'-"-'
....�, r_.. _... Authorizations�.w...�
I
Tidal Wetlands-Under Article 25
Permit ID 1-4738-01793/00006
New Permit Effective Date: 4/19/2023 Expiration Date:4/18/2028
Page 1 of 6
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
Facility DEC ID 1-4738-01793
NYSDEC Approval
By acceptance of this permit,the permittee agrees that the permit is contingent upon strict
compliance with the ECL, all applicable regulations, and all conditions included as part of this
permit.
Permit Administrator: SHERRI L AICHER,Regional Permit Administrator
Address: NYSDEC Region 1 Headquarters
SUNY @ Stony BrookJ50 Circle Rd
Stony I .ook,NY 11790-3409
I
Authorized Signature: t" ... . ' Date q / Z3
Distribution List
PATRICIA C MOORE
Bureau of Marine Habitat Protection
File
Permit Co. onents
._....... .. ...µ_. m_,_ ..m
NATURAL RESOURCE PERMIT CONDITIONS
GENERAL CONDITIONS,APPLY TO ALL AUTHORIZED PERMITS
NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS
NATURAL . SOURCE PERMIT CONDITIONS..��.,.� . ... ........
�.....�..m - Apply to the Following
w
Permits: TI AL WETLANDS
1. Regulated Activities Authorized By This Permit This permit authorizes only those regulated
activities/structures identified under the section Description of Authorized Activity.NYSDEC does not
issue after-the-fact or as-built permits. This permit does not authorize activities,or legitimize the
existence of structures, which would have required a permit but for which no permit or other
authorization has been granted by NYSDEC.
2. Conformance With Plans All activities authorized by this permit must be in strict conformance
with the approved plans submitted by the applicant or applicant's agent as part of the permit application.
Such approved plans were prepared by Kenneth M. Woychuk Land Surveying, last revised 3/19/2023.
3. Failure to Meet Permit Conditions Failure of the permittee to meet all the conditions of this permit
is a violation of this permit and grounds for an order to immediately cease the permitted activity at the
project site.
Page 2 of 6
1 0 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
Facility DEC ID 1-4730®01793
4. Notice of Commencement At least 48 hours prior to commencement of the project,the permittee
and contractor shall sign and return the top portion of the enclosed notification form certifying that they
are fully aware of and understand all terms and conditions of this permit. Within 30 days of completion
of project,the bottom portion of the form must also be signed and returned, along with photographs of
the completed work.
5. Post Permit Sign The permit sign enclosed with this permit shall be posted in a conspicuous
location on the worksite and adequately protected from the weather.
6. Install,Maintain Erosion Controls Necessary erosion control measures, i.e., straw bales, silt
fencing, etc., are to be placed on the downslope edge of any disturbed area. This sediment barrier is to
be put in place before any disturbance of the ground occurs and is to be maintained in good and
functional condition until thick vegetative cover is established.
7. No Disturbance to Vegetated Tidal Wetlands There must be no disturbance to vegetated tidal
wetlands,tidal wetlands adjacent areas and protected buffer areas as a result of the permitted activity.
s. Storage of Equipment,Materials The storage of construction equipment and materials shall be
confined within the project work area and/or upland areas greater than the 10' contour or 75 linear feet
from the tidal wetland boundary.
9. Precautions Against Contamination of Waters All necessary precautions shall be taken to
preclude contamination of any wetland or waterway by suspended solids, sediments, fuels, solvents,
lubricants, epoxy coatings,paints,concrete, leachate or any other environmentally deleterious materials
associated with the project.
lo. No Vehicles in the Tidal Wetland Operation of wheeled or tracked vehicles within the tidal
wetland is prohibited.
11. Refueling of Power Tools Refueling of power tools is to take place in the upland area.
12. Demolition and Construction Debris Should any demolition or construction debris fall into the
waterway or enter the protected buffer area and/or tidal wetlands,it must be removed immediately.
13. Disposal of Demolition and Construction Debris All demolition and construction debris must be
disposed of at a facility permitted to accept such materials.
14. No Construction Debris in Wetland or Adjacent Area Any debris or excess material from
construction of this project shall be completely removed from the adjacent area(upland)and removed to
an approved upland area for disposal. No debris is permitted in wetlands and/or protected buffer areas.
15. Minimize Adverse Impacts to Wetlands,Wildlife,Water All work must be performed in a
manner which minimizes adverse impacts to wetlands,wildlife,water quality and natural resources.
Page 3 of
NEW YO K STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
Facility DEC ID 1-4738-01793
16. State May Require Site Restoration If upon the expiration or revocation of this permit, the
project hereby authorized has not been completed,the applicant shall,without expense to the State,and
to such extent and in such time and manner as the Department of Environmental Conservation may
lawfully require,remove all or any portion of the uncompleted structure or fill and restore the site to its
former condition. No claim shall be made against the State of New York on account of any such
removal or alteration.
17. State May Order Removal or Alteration of Work If future operations by the State of New York
require an alteration in the position of the structure or work herein authorized, or if,in the opinion of the
Department of Environmental Conservation it shall cause unreasonable obstruction to the free navigation
of said waters or flood flows or endanger the health, safety or welfare of the people of the State, or cause
loss or destruction of the natural resources of the State,the owner may be ordered by the Department to
remove or alter the structural work, obstructions, or hazards caused thereby without expense to the State,
and if,upon the expiration or revocation of this permit,the structure, fill, excavation, or other
modification of the watercourse hereby authorized shall not be completed,the owners,shall,without
expense to the State, and to such extent and in such time and manner as the Department of
Environmental Conservation may require,remove all or any portion of the uncompleted structure or fill
and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall
be made against the State of New York on account of any such removal or alteration.
18. State Not Liable for Damage The State of New York shall in no case be liable for any damage or
injury to the structure or work herein authorized which may be caused by or result from future operations
undertaken by the State for the conservation or improvement of navigation,or for other purposes,and no
claim or right to compensation shall accrue from any such damage.
GENERAL CONDITIONS - Apply to ALL Authorized Permits:
.................. ........................ ............. I", -------
1. Facility Inspection by The Department The permitted site or facility, including relevant records, is
subject to inspection at reasonable hours and intervals by an authorized representative of the Department
of Environmental Conservation(the Department)to determine whether the permittee is complying with
this permit and the ECL. Such representative may order the work suspended pursuant to ECL 71- 0301
and SAPA 401(3).
The permittee shall provide a person to accompany the Department's representative during an inspection
to the permit area when requested by the Department.
A copy of this permit, including all referenced maps, drawings and special conditions,must be available
for inspection by the Department at all times at the project site or facility. Failure to produce a copy of
the permit upon request by a Department representative is a violation of this permit.
2. Relationship of this Permit to Other Department Orders and Determinations Unless expressly
provided for by the Department,issuance of this permit does not modify, supersede or rescind any order
or determination previously issued by the Department or any of the terms, conditions or requirements
contained in such order or determination.
Page 4 o
goNEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
Facility DEC ID 1.- 738-01793
3. Applications For Permit Renewals,Modifications or Transfers The permittee must submit a
separate written application to the Department for permit renewal,modification or transfer of this
permit. Such application must include any forms or supplemental information the Department requires.
Any renewal,modification or transfer granted by the Department must be in writing. Submission of
applications for permit renewal,modification or transfer are to be submitted to:
Regional Permit Administrator
NYSDEC Region 1 Headquarters
SUNY @ Stony BrookJ50 Circle Rd
Stony Brook,NY11790 -3409
4. Submission of Renewal Application The permittee must submit a renewal application at least 30
days before permit expiration for the following permit authorizations: Tidal Wetlands.
5. Permit Modifications,Suspensions and Revocations by the Department The Department
reserves the right to exercise all available authority to modify, suspend or revoke this permit. The
grounds for modification, suspension or revocation include:
a. materially false or inaccurate statements in the permit application or supporting papers;
b. failure by the permittee to comply with any terms or conditions of the permit;
c. exceeding the scope of the project as described in the permit application;
d. newly discovered material information or a material change in environmental conditions,relevant
technology or applicable law or regulations since the issuance of the existing permit;
e. noncompliance with previously issued permit conditions, orders of the commissioner, any
provisions of the Environmental Conservation Law or regulations of the Department related to
the permitted activity.
6. Permit Transfer Permits are transferrable unless specifically prohibited by statute,regulation or
another permit condition. Applications for permit transfer should be submitted prior to actual transfer of
ownership.
Page 5 of 6
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
Facility DEC ID 1-4738-01793
_. ..� mm..... NOTIFICATION OF OTHER PERTT OBLIGATIONS
.......... ---1-1..........11 11---'-'-"-----...................................... ......-,---------- .... . : .., __._ .......__
11-
EE
Item A: Permittee Accepts Legal Responsibility and Agrees to Indemnification
The permittee, excepting state or federal agencies, expressly agrees to indemnify and hold harmless the
Department of Environmental Conservation of the State of New York, its representatives, employees,
and agents ("DEC")for all claims, suits, actions, and damages,to the extent attributable to the
permittee's acts or omissions in connection with the permittee's undertaking of activities in connection
with, or operation and maintenance of,the facility or facilities authorized by the permit whether in
compliance or not in compliance with the terms and conditions of the permit. This indemnification does
not extend to any claims, suits, actions, or damages to the extent attributable to DEC's own negligent or
intentional acts or omissions, or to any claims, suits, or actions naming the DEC and arising under
Article 78 of the New York Civil Practice Laws and Rules or any citizen suit or civil rights provision
under federal or state laws.
Item B: Permittee's Contractors to Comply with Permit
The permittee is responsible for informing its independent contractors, employees, agents and assigns of
their responsibility to comply with this permit,including all special conditions while acting as the
permittee's agent with respect to the permitted activities, and such persons shall be subject to the same
sanctions for violations of the Environmental Conservation Law as those prescribed for the permittee.
Item C: Permittee Responsible for Obtaining Other Required Permits
The permittee is responsible for obtaining any other permits, approvals, lands, easements and rights-of-
way that may be required to carry out the activities that are authorized by this permit.
Item D: No Right to Trespass or Interfere with Riparian Rights
This permit does not convey to the permittee any right to trespass upon the lands or interfere with the
riparian rights of others in order to perform the permitted work nor does it authorize the impairment of
any rights,title, or interest in real or personal property held or vested in a person not a party to the
permit.
Page 6 of
E
Y y 0 NEW Department of
ORK
ST
STATE Environmental
Conservation
NOTI (; E
I The Department of Environmental Conservation (DEC) has issued permit(s) pursuant
to the Environmental Conservation Law for work being conducted at this site. For further
information regarding the nature and extent of work approved and any Departmental
conditions on it, contact the Regional Permit Administrator listed below. Please
refer to the permit number shown when contacting the DEC.
Regional Permit Administrator
SHERRI AICHER
Permit Number: 1-4738-01793/00006
NYSDEC Region 1 Environmental Permits
50 Circle Road
Stony Brook, NY 11790-3409
Expiration Date: 04/18/2028 Email: dep.rl@dec.ny.gov
Note: This notice is NOT a permit
S.C.T.M. NO. DISTRICT: 1000 SECTION:35 BLOCK:5 LOT(S):39.1
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NYSDEC ELM$IA
APPROVED AS PER TERMS 102.53' < OL Eff
AND CONDIT4ONS OF
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DATES
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REVISED 03-19-23
REVISED 02-20-23
�3 I vY THE WA7ER SUPPLY, HELLS, DRYWELLS AND CESSPOOL
LOCA77ONS SHOWN ARE FROM FIELD OBSERVA77OVS
BUILDABLE AREA: 38,507 S.F. Or 0.88 ACRES AND OR DATA OBTAINED FROM OTHERS.
AREA:39,688 S.F. or 0.91 ACRES FIRM PANEL #36103CO176H ELEVAnoN DA7UM: NAVD88
CINAUTHDRI O AL1E A'T7 C�V Al T7ON 70 T7BS SfARIEY IS A IAOdAT1ON OF.�S/ECTION 72D9 OF TFFE NEW YORK STATE EDUO'A770N LAW..' COPIES OF MIS SURVEY
M"AP Nt7T BE'AR�NC'�C+aN!)5UR,9' 'YOAi'"S EMI9OSSEO'SEAL SPdALL.N!'TT`BE y.rx'', '0'E"RED YO BE A VAUD TRUE COPY GUARANTEES'NNONL":A?EO HEREOV 9WMU R1/N
ONLY TC�8F7E.PERSON FTC WFdOM 7FTE SURVEY 1S PREPAREO AND CNV W1S ETEHALF TO THE'line COMPANY, GOVERNMENTAL AGENCY AND GENOM FNSVTUTAON
d.ISTE'D HEREidIW AND'70 nrE ASSdGNEES OF°'RR^.fEE LEN01Nf8'1NST7TU71CFN; Gt/ARAN7EES ARE NOT TRANSFERABLE:
THE r7F�`T51 OR DIACENSrONS SHOWN fidEREOlV FTFOM 1'F1E PROPERTY'LINES TO TPAE STRUCTE+RES ARE F'OR A SPECIFIC PURPOSE AND USE 7HEREFOAdE?NIFY ARE
NO7 ANTENDED 7O MONI7MENT THE PROPERTY LINES OR 7O 0U1OE R!E ERECTION OF FENCES ADDInONAL S'TR11c"ES OR AND O7TAER IMPROWEMENTS EASEMENIS
AND✓"OR SUBSURFACE S'TRUC"nS RECORDED OR UNRECORDED ARE NOT"GUARANTEED UNLESS PHYSICALLY Etir1L7ENr ON THE.PREMISES A TYE'??ME OF SURVEY'
SURVEY OF: LOT 32, P/O LOT 33, P/O RESERVED PARCEL INCL. CERTIFIED TO: JOHN LUPOVICI JESSICA LUPOVICI;
......
I ..mm
MAP OF:CLEAVES POINT SEC. 2 ADVOCATES A6NSURT 1#"IC',;
FILED: MARCH 13, 1962 STEWART TITLE ANS(9RNACE C01«dPANY,
SITUATED AT: GREENPORT ....""
TOWN OF: SOUTHOLD KENNE H VE Cr, PLLC
SUFFOLK COUNTY, NEW YORK Professional Land Surveying and Design
MI ,! P.O. Box 153 Aquebogue, New York 11931
nLr F 17=i77 9CALL: T=30' or,Tc NOV. 28, 2017 PHONE (e31)E9e-1698 FAX(031) 298-1558
N.Y.S. USG NO. 050882 maintAi-i^-tLe lwwft of 9obvt L H—V s K-0th r.WoyeLok
H�QTICg OFqOMNENCEMENT OF C T UCT O
RETURN THIS FORM TO:COMPLIANCE Or Fax to: 631-444-0272
Marine Habitat Protection-NYSDEC E-Mail:dec.sm.R1MHP-BEH@dec.ny.gov
SUNY at Stony Brook
50 Circle Road
Stony Brook, NY 11790-3409
PERMIT NUMBER: EXPIRATION DATE;
PERMITTEE NAME&PROJECT ADDRESS:
CONTRACTOR NAME&ADDRESS:
TELEPHONE:
Dear DEC:
Pursuant to the special conditions of the referenced permit,you are hereby notified that the authorized activity shall commence on
. We certify that we have read the referenced permit and approved plans and fully understand
the authorized project and all permit conditions.We have inspected the project site and can complete the project as described in the
permit and as depicted on the approved plans. We can do so in full compliance with all plan notes and permit conditions.The permit,
permit sign,and approved plans will be available at the site for inspection in accordance with General Condition No. 1. (Both
signatures required)
PERMITTEE: DATE
CONTRACTOR: DATE
THIS NOTICE MUST BE SENT TO THE ABOVE ADDRESS AT LEAST TWO DAYS PRIOR TO COMMENCEMENT OF THE
PROJECT AND/OR ANY ASSOCIATED ACTIVITIES. FAILURE TO RETURN THIS NOTICE, POST THE PERMIT SIGN, OR HAVE
THE PERMIT AND APPROVED PLANS AVAILABLE AT THE WORK SITE FOR THE DURATION OF THE PROJECT MAY SUBJECT
THE PERMITTEE AND/OR CONTRACTOR TO APPLICABLE SANCTIONS AND PENALTIES FOR NON-COMPLIANCE WITH
PERMIT CONDITIONS.
tJQ1jCE OF gQMeLE11QN QE.0Ng18UPJ1Q
RETURN THIS FORM TO:COMPLIANCE Or Fax to: 631-444-0272
Marine Habitat Protection-NYSDEC E-Mail: dec.sm.R1MHP-BEH@dec.ny.gov
50 Circle Road
Stony Brook, NY 11790-3409
PERMIT NUMBER: EXPIRATION DATE:
PERMITTEE NAME&PROJECT ADDRESS:
CONTRACTOR NAME&ADDRESS:
TELEPHONE:
Pursuant to special conditions of the referenced permit,you are hereby notified that the authorized activity was completed on
We have fully complied with the terms and conditions of the permit and approved plans. (Both signatures
required)
PERMITTEE: DATE.
CONTRACTOR: DATE
THIS NOTICE, WITH PHOTOGRAPHS OF THE COMPLETED WORK AND/OR A COMPLETED SURVEY,AS APPROPRIATE,
MUST BE SENT TO THE ABOVE ADDRESS WITHIN 30 DAYS OF COMPLETION OF THE PROJECT.
EvanT. Steffens Nationalgrl
Senior Supervisor
Gas Customer Connections,NY
March 17, 2025
John Lupovici
225 Fifth Avenue
New York, NY 10010
E-Mail: IJRLUE apMAG.QOM ; BABO RGCONSTR@QMAIL.COM
National Grid WO#: T102664800
Service Address:
1160 Snug Harbor Road
Greenport, NY'11944
To Whom it may concern,
This Letter is to advise you that National Grid investigated your request and confirmed that the
subject property does not have an active gas service line.
By Law, excavators and contractors working in New York City and Nassau and Suffolk
Counties must contact New York"811"at least 2 full business days, not including the day
of contact, prior to digging by calling "811"or by using the website https://newyork-
811.com/.
This confirmation letter of no active gas service line to the subject property does not
relieve the excavator of contacting NY"811".
If you have any further questions, kindly contact me at 833-359-0645.
Respectfully,
Evan T. St ens
Senior Supervisor
Gas Customer Connections NY
1650 Islip Ave,Brentwood NY 11717
T: 833-359-0645 van., t ffen na i ,nal ri , nm n ridlirud r c in i nati nal id.co
Z �."esaigin VlIL'G)f( nsioi"R„Yl s cf(:6"tjfid ajt� orM1 wtie(, gOVd",d,
MSTLOBSERVETHEOWTSPRIORTO "uI )I'V"111u �I (.. (N( (. . .If�V�ll(,:aA�tl(.111'I "(.)(
SHALL
STARTUP,
Q HALL HOLD APPROPRIATE 102.53' ) u
r
H'W IIns flal:II):(II") and 4r.G,)),.v.ff'uc
COUNTY DEPARTMENT OF HEALTH
_ WR N(:(N) Of there0.,"( zE( " IRw pG;DE,b )8 aro/'wG: B" N
D INSTALLER,. hg �
HALL REGISTER THE ONSITE Use Fo lr Iry) \AAM (")i �s M ' 1 Sa County Rd.39
p�1 Q
FFOLK COUNTY DEPARTMENT OF Suite 10Southampton,N.Y.11966
_CORD SHALL PROVIDE RECORD q -____�.:��w _-:. _..�: _.'." _�9 ...."w...". �,..-mu�„...�..._..
'SCDH. Aba"�I)�IG,�Q.)�)�r))("'.nt o �����Ie Elxi('rt I� sanitary Lroy;lwt��'rn ��7ust 114.Me in Office/Fax(631)259-3959
)N AND MAINTENANCE CONTRACT � � � ....
PROVIDER AND THE PROPERTY eDepartment's
I X ,srr s � 4NS
I �L•) ii�uu. a. (. aIp�G :,e. a�"�IirrII' n re a illy: PRe�
TO THE SCDH.
u
IQ C9IV
TALL NOT BE INSTALLED UPSTREAM OF I (I �, �yJ. DCCA,,�CI
FORconformance I d � I( �R11 ))�.,. ()� .).. �.�I"C."),.�'� R ^�a
WATER TIGHTNESS PRIOR TO w a A
METHOD APPROVED BY THE x, w TEST HOLE _
STAKE a Q
ROM THE DWELLING TO THE CONTROL
PROPOSED WATER LINE g 1� w I O
TIGHT,
PANEL TO THE JUNCTION BOX s b i °�" uam' r I�� L�Nw�m cn c �� 0 a 09725S 4�
��
TIGHT. „� E
PROPOSED U/G ELECTRIC aYrO
;ET ON A PRECAST CONCRETE CONTROL PANEL sl 1BOVE GRADE TO PREVENT WATER
EXISTING WATER LINE
MIMMUM 3.0"FROM THE DRIVEWAY. EXISTING DWELLING �, TO BE REMOVED
TO BE REMOVED / S
SHALL.BE INSTA(LEiL71N-BETWEEN EXISTING OVERHEAD ELECTRIC
WVTS IF 3 FEET SEPARATION CANNOT ( EX EX TO BE REMOVED
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Revisions
No Date Descri
1 4/11/2022 SCDHSN
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LINE sic^ '.✓" — ... ..p.
TIE LINES ALONG MHW /
..\y!N\. SITE PLAN
2 5/2023
)WN LOAM OL r L v ) � 5
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AND(SP)
a PERMIT FOR APPROVAL OF CONSTRUCTION Fop,A
SINGLE FAMILY RESIDENCE ONLY Date: 3/9/2022
PALE BROWN Scale: NOTED
:DIUM SAND(sP) •PROPOSED SEPTIC PLAN
Rt—O ANI AR SCALE:1'-2®' DATE 11/2/2023 H-S. R 22-os��
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FDAELEVATIONS SHOWN ARE BARED ON USC AND GS DATUM NAVD 1988 H F ��� ���I ���6I �� 8 W'^ g�ry ")(")VM,R„'k