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52685-Z
I TOWN OE 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#: 52685 Date: 02/19/2026 Permission is hereby granted to: Tenforty Central LLC 58 Willoughby St Ste 1 Brooklyn, NY 11201 To: construct a single-family dwelling with a swimming pool addition as applied for per DEC Non- Jurisdiction letter, SCHD&Trustees approvals. Premises Located at: 1940 Central Dr, Mattituck, NY 11952 SCTM# 106.4-27 Pursuant to application dated 12/01/2025 and approved by the Building inspector. To expire on 02/19/2028. Contractors: Required Inspections: Fees: Single Family Dwelling-NEW $4,881.75 SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $300.00 CO-RESIDENTIAL $100.00 Total 5 28135 Wilding Inspector rapt TOWN OF SOUTHOLD--BUILDING DEPARTMENT Town Mail Annex 54375 Main Road P. 0. Box 1179 Southold,NY 11971 W0959 Telephone(631) 765-1802 Fax (631) 765-9502 �.ouol tov � �x, Y Date Received APPLICATION FOR BUILDING PERMIT J1 For Office Use Only a w, PERMIT Building Inspector ...... ....................... .......... ......... E C 1 t ' Applications and formsmust be filled out in their entirety.Incomplete applications will not be accepted. There the Applicant is not the owner,an Authorization form(Page� shall�►e completed. Owner s Aut pIete date:11/24/2025 OWNER(S)of PROPERTY N a me:TE N FO RTY Central LLC SCTM#1000-106.00-01.00-027.000 Project Address:1940 Central Drive, Mattituck, NY 11952 Phone#: g2g 235-0888 Email:claudio@italiangreendesign.com Mailing Address: 54 Willoughoby Street, Brooklyn, NY 11201 CONTACT PERSON* Name:Claudio Conter (Managing Member of Ten 1=ourty Central, LLC) Mailing Address: 54 Willoughoby Street, Brooklyn, NY 11201 Phone#:(929)235-0888 Email:claudio@italiangreendesign.com DESIGN PROFESSIONAL INFORMATION* Name:Sean Madigan, AIA Mailing Address:42 ,School Street, Hampton Bays, NY 11946 Phone#: 631 258-4749 Email:sean@madiganarchitects.com CONTRACTOR INFORMATIONS Name:Claudio Conter Managing Member of Ten I=ourty Central, LLC) Mailing Address: 54 Willoughoby Street, Brooklyn, NY 11201 Phone#: g2g 235-0888 Email:claudio@italiangreendesign.com DESCRIPTION of PROPOSED CONSTRUCTION N New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: CJ Other 000 000 Will the lot be re-graded? ©Yes ❑No Will excess fill be removed from premises? NYes ❑No 1 PROPERTY INFORMATION ----------------........... I Existing use of propertY:Vacant Intended use of property:Residential Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to R40 j this property? F�Yes ®No IF YES, PROVIDE A COPY. N.Check Box After Read'l*ng*. 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,clrdinances 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. _j Application Submitted By(print name):Sean Madigan NAuthorized Agent ElOwner Signature of Applicant: Date: STATE OF NEW YORK) SS: COUNTY OF Suffolk Sean Madigan 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, 120 Notary Public PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) I,Claudio Canter residing at ,do hereby authorize Sean Madigan to apply on my behalf to the Town of Southold Building Department for approval as described herein. 1 11/24/25 Owner's Signature Date Claudio Canter Print Owner's Name 2 O mill 6 br Compliance Project Information Project Title: 1940 Central Drive Energy Cade: 2018 IECC Location: Southold,New York Construction Type: Single Family Project Type: New Construction Project Sub Type: None Orientation: Bldg.faces 135 deg.from North Conditioned Floor Area-, 7632 ft2 Glazing Area: 50% Climate Zone: 4a(5572 HDD) Project No: 1793885 All Electric: false Is Renewable: false Has Battery: false Has Charger: false Has Heat Pump false Construction Site: Owner/Agent: Designer/Contractor: 1940 Central Drive Claudio Conter Sean Madigan Mattituck,New York 11952 42 School Street Madigan Architects Hampton Bays,,NY 11946 6312584749 sean@madiganarchitects.com Project Notes: Report Title; 1940 Central Drive Report Date: 12/1/25, 7:23 AM 1 of 14 Envelope Assemblies Gross Area Prop. Req. Assembly or Cavity Cont. U- U- Prop. Req. Perimeter R-Value R-Value Factor/ Factor/ UA UA F-Factor F-Factor Front Patio Composite Slab over 406 0.0 29.0 0.032 0.026 13 11 Basement:Flat Ceiling or Scissor Truss Back Patio Composite Slab over 349 0.0 29.0 0.032 0,026 11 9 Basement:Flat Ceiling or Scissor Truss Vaulted Ceilings:Cathedral 1401 30.0 0.0 0.034 0.026 48 36 Ceiling Sealed Attic:Cathedral Ceiling 766 30.0 0.0 0.034 0.026 26 20 Stud Wall-Front:Wood Frame, 1509 26.0 0.0 0.052 0.060 41 47 16"o-c- Orientation:Front W106A:Metal Frame w/Thermal 66 0.320 0.320 21 21 Break SHGC:0.32 Orientation:Front W113B:Metal Frame w/ 66 0.320 0.320 21 21 Thermal Break SHGC:0.32 Orientation:Front W113C:Metal Frame w/ 21 0.320 0.320 7 7 Thermal Break SHGC:0.32 Orientation:Front W207B:Metal Frame w/ 66 0.320 0.320 21 21 Thermal Break SHGC:0.32 Orientation:Front W206A:Metal Frame w/Thermal 21 0.320 0.320 7 7 Break SHGC:0.32 Orientation:Front W201A:Metal Frame w/Thermal 208 0.320 0.320 67 67 Break SHGC:0.32 Orientation:Front W212A:Metal Frame wl Thermal 66 0.320 0.320 21 21 Break SHGC:0.32 Orientation:Front W101A:Glass Door(over 50% 205 0.320 0.320 65 65 glazing) SHGC:0.32 Orientation:Front Stud Wall-Right:Wood Frame, 927 26.0 0.0 0.052 0.060 41 47 1611 o.c. Orientation:Right side W1061B:Metal Frame w/ 28 0.320 0.320 9 9 Thermal Break SHGC:0.32 Orientation:Right side W108A:Metal Frame w/Thermal 21 0.320 0.320 7 7 Break SHGC:0.32 Orientation:Right side W111A:Metal Frame w/Thermal 21 0.320 0.320 7 7 Break SHGC:0.32 Orientation:Right side Report Title: 1940 Central Drive Report Date: 12/1/25, 7:23 AM 2 of 14 Gross Area Prop. Req., Assembly or Cavity Cont. U- U- Prop., Req. Perimeter R-Value R-Value Factor/ Factor/ UA UA F-Factor F-Factor W211A:Metal Frame wl Thermal 21 0.320 0.320 7 7 Break SHGC:0.32 Orientation:Right side W21OA:Metal Frame w/Thermal 21 0.320 0.320 7 7 Break SHGC:0.32 Orientation:Right side W212B:Metal Frame wl 28 0.320 0.320 9 9 Thermal Break SHGC:0.32 Orientation:Right side Stud Wall-Back:Wood Frame, 1509 26.0 0.0 0.052 0,060 15 17 16"o.c. Orientation:Back W204B:Metal Frame w/ 95 0.320 0.320 30 30 Thermal Break SHGC:0.32 Orientation:Back W211C:Metal Frame w/ 95 0.320 0.320 30 30 Thermal Break SHGC:0.32 Orientation:Back W102A:Glass Door(over 50% 204 0.320 0.320 65 65 glazing) SHGC:0.32 Orientation:Back W116A:Glass Door(over 50% 154 0.320 0.320 49 49 glazing) SHGC:0.32 Orientation:Back W11OA:Glass Door(over 50% 154 0.320 0.320 49 49 glazing) SHGC:0.32 Orientation:Back W21IB:Glass Door(over 50% 154 0,320 0.320 49 49 glazing) SHGC:0.32 Orientation:Back W204A:Glass Door(over 50% 154 0.320 0.320 49 49 glazing) SHGC:0.32 Orientation:Back W202A:Glass Door(over 50% 208 0.320 0.320 67 67 glazing) SHGC:0.32 Orientation:Back Stud Wall-Left:Wood Frame, 764 26.0 0.0 0.052 0.060 28 33 16"o.c. Orientation:Left side W203A:Metal Frame w/Thermal 21 0.320 0.320 7 7 Break SHGC:0.32 Orientation:Left side WIVA:Metal Frame w/Thermal 21 0.320 0,320 7 7 Break SHGC:0.32 Orientation:Left side W114A:Metal Frame w/Thermal 21 0,320 0.320 7 7 Break SHGC:0.32 Orientation:Left side W113A:Metal Frame wl Thermal 79 0.320 0.320 25 25 Break SHGC:0.32 Orientation:Left side Report Title: 1940 Central Drive Report Date: 12/1/25, 7:23 AM 3 of 14 Gross Area Prop►. Req. Assembly or Cavity Cont. U- U- Prop. Req., Perimeter R-Value R-Value Factor/ Factor/ UA UA F-Factor F-Factor W207A:Metal Frame w/Thermal 79 0.320 0.320 25 25 Break SHGC:0.32 Orientation:Left side Stud Wall-Left Side of Right 282 26.0 0.0 0.052 0.060 15 17 Volume:Wood Frame,16"o.c. Orientation:Left side Stud Wall-Right Side of Left 197 26.0 0.0 0.052 0,060 10 12 Volume:Wood Frame,16"ox. Orientation:Left side Basement Wall-Front:Solid 624 7.0 7.0 0.051 0.059 32 37 Concrete or Masonry Orientation:Front Wall height:11.00 Insulation depth:11.00' Insulation position:Integral Insulation Basement Wall-Rear:Solid 693 7.0 7.0 0.044 0.059 30 41 Concrete or Masonry Orientation:Back Wall height:11.00 Insulation depth:11.00' Insulation position:Integral Insulation Basement Wall-Right:Solid 76 7.0 7.0 0.051 0.059 4 4 Concrete or Masonry Orientation:Right side Wall height:11.00 Insulation depth:11.00' Insulation position:Integral Insulation Basement Wall-Right(at 475 7.0 7.0 0.069 0.059 24 20 areawell):Solid Concrete or Masonry Orientation:Right side Wall height:11.00 Insulation depth:11.00' Insulation position:Integral Insulation W007A:Glass Door(over 50% 30 0.320 0.320 10 10 glazing) SHGC:0.32 Orientation:Right side W009A:Glass Door(over 50% 51 0.320 0.320 16 16 glazing) SHGC:0.32 Orientation:Right side W012A:Glass Door(over 50% 52 0.320 0.320 17 17 glazing) SHGC:0.32 Orientation:Right side Basement Wall-Left:Solid 72 7.0 7.0 0.044 0.059 4 Concrete or Masonry Orientation:Left side Wall height:11.00 Insulation depth:11.00' Insulation position:Integral Insulation Basement Wall-Left(at 455 7.0 7.0 0.069 0.059 21 18 areawell):Solid Concrete or Masonry Orientation:Left side Wall height:11.00 Insulation depth:11.00' Insulation position:Integral Insulation Report Title: 1940 Central Drive Report Date: 12/1/25, 7:23 AM 4 of 14 Cross Area Prop. Req. Assembly or Cavity Cont. U- U- Prop. Req. Perimeter R-Value R-Value Factor/ Factor/ UA UA F-Factor F-Factor W016A:Metal Frame w/Thermal 68 0.320 0.320 22 22 Break SHGC:0.32 Orientation:Left side W019A:Glass Door(over 50%b 85 0.320 0.320 27 27 glazing) SHGC:0.32 Orientation:Left side Compliance: Passes using UA trade-off r • f •`, Better Than Code + ` Your 1200 1189 0.40 0032 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 cast relative to a minimum-cede home. Siab..on...grade tradeoffs are no longer'considered in the UA or,l of orm nce cornpw i nce path in IRE cl['wec'l.IE clti slab-on-grade assernbly in the specitied cHrnote zone must meet the Minik`nUrn energy code insulation -v Ilae anid 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 REScheck-Web and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Name-Title Signature Date 6AkL C..••` Report Title: 1940 Central Drive Report Date: 12/1/25, 7:23 AM 5 of 14 Inspe ction Che cklist 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 trection Pla�n!§, Field V60fle" Vtwifi4d, &Rqq.10, Pre-InspectiOn/Plan Review Vallue". Va IMF 'Complies? commentsiAssumptlions 103.1, Construction drawings and off Complies Location on ns/c:npcs 103.2 documentation demonstrate Does Not A-720,A-721, 2,k [PR111 ener,�Y colde compliance tbr,the 723,A-724,A-760,A-761, WWI'ng envel,ope.'T'hermal Pomply A-762,A-763 envelope repreis,Onted on Not constrOction documents. Rservable , . i / Not pp lice ble ------------- 103.1, Con.9''truction,drawings,and Complies 103.2, docun,ientaticn demorMrate ��j�,�/�,/i///�/ Does Not 403.7 finer ,ore corriplionce(or //���/� [PR311 light"Og,and mechanic',al Pomply sys,ter6s.Sys. ser—ving Not niultiple d1wetling ijnit,s rn,ust /, �,� /f// Rservable derno'nst'rate coibiplianciewith Not the IE,CC Corrmv,,rcial Provisions. , /� % ;%/� ��� �, � %/�� ��� 0 P pplicable � ,/ „/ % , ......................I : ase 30 2,*1 lle and cooli�Iin ng equi'ment Heating: l-Ieating: Complies l? �'s iz 40117' per ACCA lcuantia Btu/hr Btulhr Does Not f102,17- bd on loa,ds cali al,tead ppr ACCA,Mlanua] or other,method omply s L--j approved i , 4e code offlidal. Cooling: Cooling: Not Btu/hr SW/hr Not PNot applicable Additional Comments/Assumptions: 1 Hi Impact(Tier 1) ........... Medium e T Im act(Tier 2) 3 Low Impact(Tier 3) Report Title: 1940 Central Drive Report Date: 12/1/25, 7:23 AM 6 of 14 Foundation Inspection sle"011611 Pla'"S"', "T161d Ve,eritted, WHO d ,&Re',q,.j,,b Foundatlart lln's'petitllon V81061 COMP00? comments/Assumptions 0 As Complies Excepti 30321 A pr tectiv,e covering on:Requirement instal'Ied to protect ex used %����/� is not ap,pficable. exter,ior insulation anTextends Does Not a minimum of 6 in.below grade. Pomply � %//,, � // i,//� /,, P Not oservable // %////// ,�.�// , /�. 0 Not /��,/�i% / pplicable 13,.9 Snow-and ice-melting system U Uomplies Exception:Requirement _IV", 41 controls installed. is riot applicable. PDoes Not omply %/�//// /% , �' // Not Rservable /��� ,, , PNot pplacable ;,„,,,����.. rill//// r///// /. ///._../.. 402.1.1 Conditioned basement wall Complies See the Envelope [170411 insulation R-value.Where P Does Not Assemblies table For interior insulation is used, values Verification maV T,,,ieed to occur R R1 omply d'ICI ring Insutatibin Ins: pection.Not Not - requ0eW in warm humid Rservable locations,in Clirnate Zon,e,3. Not Ppplicable Complies Location on plans/spec: 303.2 Conditioned basement wall Insulation installed per Does Not A-760,A-761,A-762 manufacturer's instructions. Pomply / /, %o ,0/ j; P3 Not servable i%, / / / %'i �y /��%�,���i���/� /�� / Not Xp-plicable .............. 402.2.9 Conditioned basement wall ft ft Complies See the Envelope [F0611 insulation depth of burial or es Not Do Assemblies table for distance from top of wall. Pomply values f-�Not Observable PNot plicable Additional Comments/Assumptions: 1 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 1_o��Impact(Tier 3)F�7 Report Title: 1940 Central Drive Report Date: 12/1/25, 7:23 AM 7 of 14 Framing Rtau h-In InspectionVerKliedverified Value� Vallu"e, Complies? Comments/Assumptions 402.1.1, Gila zing U-factor(area-weighted u= U= C)Complies .See the Envelope 402.3.1, a eta e). '" Assemblies table for 402.3.3, Does Not values Commei 402.5 Pomply [FR2]r Not 93servable Not Ppplicable ;L f 402.4.1.1 Air barrier and thermal barrier ,��i%//�o��%ii/%,;�i�// / ///id/;. Complies installed per manufacturer's �i���� ��� ��%f�!f�,� [FR23] i �/ifi , �/1 Does Not instructions. P m I Not serVable licable 402.4.3 Fenestration that is not site built 1/%rJf///i/ / /////%//// Complies 1 is listed and labeled as meeting %�%'�%'/�� � �//' / ' ���,� ,� � Does Not AAMA/WDMA/CSA ,/ /, / 1 // / // PO m101/1.5.2/A440 car has infiltration t////// ��� / �,���% p y rates per NFRC 400 that do not ,�i/� �J�/,/ / Not exceed cede limits. ��,/ �� ��// � � Rservable PNot pplicable 402p IC-rated recessed fi htin %��/�/// /%1°a /f/// i'i Complies FRpI„ ` �fixtures sealed at ' �� �/ Does D Not / housing/interiorfinish and ;,/ /� / labeled to indicate<2.0 cfm it %� rt%//,�� %Pomply leakage at 75 Pa, t Poservable livable ' a//ii/,ii,-../�/%//rI/11��,J,,,lr,//r//!9!/%%l// �;/,/1,//,l %i/i///,f//,%i%/�,�,l�l'%i� ... . 403.3.1 Supply and return ducts in attics //!i %' %////�� Complies Exce ion:Ducts located [FR12]1 insulated>=R-8 where duct i 1�; ��� comp etely inside the _ , � Goes Not / �—3 inches in diameter and ���//i/i ��f� �� /i� building envelope. where<3 inches. .,/,� ///� %%�� � i//, , � ......... Pomply Supply and return ducks m other ��,,,,�������/�t %� Not portions of the building f �� �� �� / �,� � Poservable insulated>=R-f for diameter f/, % Ppplicable Not >=3 inches and R-4.2 for<3 ,� � �;��1, ,% /��, inches in diameter. ,,, � /�//,/, �//% 403�.,,3.2 Ducts,air handlers and filter//�; /j�� ( Complies 1 'boxes are sealed with /� [FFt13] / � ���/ ���/ �r,�� � Pomply Does Not ���/ /, joints/seams compliant with // �� �%� International Mechanical Code /� or International Residential r ! /� %///�0 �r �// �/i� Rervable Not Code,as applicable. /% , /i! pP „� t � ���/, Nit / MON Ppplicable „ Building cavities are not used as Complies v ducts or plenums. // , �..� ���� FR �� p � �� . / � Does Not Pomply Not ail / Rservable Not plicable Report Title: 1940 Central Drive Report Date: 1.2/1/25, 7:2.3 AM 8 of 14 r '' anion Plans, field, ka I n0161g,�'00ugh-In Veietflid V� &- d; �l ' 11n p 16'n' " 1U, V Complies? Comments/Assumptions 117 Ducts declared to be within the /�� %///i''�� %' ��!''� Complies tFR284,11', conditioned space are either 1) % � / � �/ �,,, �,��,, Pomply Does Not within the / , completely ////�// / �/ , continuous air barrier and within �i „// / the buildingthermal envelope, / ///� /,. .. p � % / �rf,/���,�� servable Not buried within ceiling ,% %� l D �° //� insulation in accordance with Section R403.3.6 and the air �i/ , f/f;o/,� / / Not %% ! Ppplicable handler rs located completely �� �, / / within the continuous air barrier and i building tin h thermal envelo alage Is " ofconditioned,floor a ,s ed / r by.the duct system,or- the i ceilin insulation p.- alug ins ?'ed aTuct ait and above the rnsulate�d to the proposed ceiling insulation R- � value,Mess the R-value of the t insulation on the duct. H IAC pipin conveying fluids Complies F ,above 105 LIF or chilled fluids R'" R � �Does N t below 55 F are insulated to> PomplyR-. ° R Not servable Not pplicable 403.4.1 Protection of insulation on HVAC Complies [FR2411 piping. ,,/ �;,// /,, �� /�� Goes Not M Not Observable % 0 Not ,Applicable .,401,5113 Hot water pipes are insulated to R Complies R-3. PDoes Not omply Not serva ble Not � .Applicable . y � fir///.//„f,,i i.,r ,i/,/��, /,,�,',/,r,,� //�% G Automatic or gravity dampers /i /f % � %�/o Complies �,�, ' r installed on all outdoor air � �f % " intakes and exhausts. ///��o f%a,�� ,��/ ll Goes Not Comply RNot ervable Not Applicable 03.1.3 U-factors of fenestration /%� ////f��� f j//f������ Complies FR4 products,are determined in % , i/ '/i f�� Does Not accordance with the NFRC test procedure or taken from the �, /////,%� ,� �,�/ reply default table. Not Poservable Not Additional Comments/Assumptions: 1 =hIact(Tier 1) Medium Impact(Tier 2) 3 Law Im act(Tier 3) Report Title: 1940 Central Drive Report Gate: 12/1/25, 7:23 AM 9 of 14 Insulation Inspection S"V nField V i i l 114 ' � nsuiat n insp tlon� v 10, V w � w,pi es Comments/Assumptions, %/%%% '�f'// All installed insulation is labeled ,,,,,////� /%/�%�//%f�i�////� /� Complies 1 � or the installed R-values Pmply Does Not fNot servable Ppplicable Nat 402.1.1, Wall insulation R-value.If�this is Cj Complies See t 7blEniesvelNe fear 402.2.5, a mass wall with at least/2 of Does Notta 402.2.6 the wall insulation on the wall 0 Wood 0 Wood values [IN3]1 exterior,the exterior insulation Mass Mass amply requirement applies(FR10). 0 Q Not 0 Steel j Steel Rservable Not ppl-rcable /r;"it /%�iii ii ..........,, y 303.2 Wall insulation is installed per ,,///f „/,/,,,, ��///�% (�Complies / J/�/% // �j//; [IN4]�1 manufacturer's instructions. 1 ,,,��������,��_%��/ /,' �� Does Not PNot oservable Not P p Additional Comments/Assumptions: p 1 High Impact(Tier 1) 2" Medium Impact(Tier 2) 3 ...........1Low Impact(Tier 3) Report Title: 1940 Central Drive Report Date: 1211125, 7:23 AM 10 of 14 Fins Inspection Provisions I w Flbl wrified Final Inspection Provisions ions Complies? Comments/Assumptions R Ceiling insulation R-value. ! Complies See the Envelope 402.1.1, �Assemblies table for402.2.2, 0 Wood 0 Wood 402,2.1, Does Not values ply[[Fill' Steel ( Steel ( Not Rservable Not pplicable . i/r vrc %,%i /ri%�r,rriran„�✓r�rae,,, r r1,:�,,r�o%%/%//r uriii�` 303.1.1.1, %/�///�// / %%// ///j Complies Ceelwn insulation installed per ������� //o���/���/�`� � p 303.2 manufacturers instructions. / / ��� Does Not l Blown insulation marked every / i � %/,� � � pomply30Q ft. �////�/ , fi i R Nowt servable ONet pplicable ,,. ✓✓r G,,r.rri ,rrG,n ';/%✓//ilrrror, i;;;ire %/%/.. '; . . ,�. Heat pump thermostat installed Complies on heat pumps. '/ �� �� � Does Not Pomply � ble tabs Not e rva PNot pplicable r,r/r,/r,%/'r/ �., � Circulating service Prot water %/��///%//%�lei / i Complies ^�wyWv YYYq''',uy� yp'�@I ..vMyy ,1y;,�uu' 1�I,u ��� ������;' ;r 4 9k systems �a Od/iM torn MYM i^Mm�� lY �ll�/// �% Does No accessible manual al contr l wpomply Not Not �pplecable All mechanical ventilation /// / �%� / ( Complies 2 item fares not part of tested ��� �� Fl �/ r n ,D/ Does Not and listed HVAC eg ipment �� �i Irf //, /�� Comply it.et. �flcac and air pow limess � i//��/�,, er ale�, � �� ..� -l � / Not ������ Rservable Not P l�p�plecabl e i Got waterboi4ers supplying, teat Complies throvgh one- two,pipe � �� � / 1 ,,Pomply Does Not he tip � terns�liav��outdoor % / / / 1, i� water temperature based on !�� �,,t! � Rervable ot temperature. ,���o � /i//� � outdoorp % �� PNof pplicable Heated water circulation Complies circulation / �, . ,t �� � m /� iPomply Does Not n ,p�u �f�p,n le �t.e�m return pipe is �. .� dedicated return pipe r a 1d water supply.Opel.C r avrtY Not and thermos-syphon circulation Qery able s sterns are not present.ent. /,,,,� l� �%� /% .,, pp // �� Ppplicable Not Yontrols for circulating lain hot / � //water,s �teni: Burn� t t��he // �,/,,,,,,,/�,���,'��r/ / punipyiith srr°� � r hut..water in t anc . der�nan wrth �occur v C ntr l^ aut matmca��lly , m oft the pump when water is in circulation loop is at set-point and no demand for temperature hot water exists. ////G%ii �i�,,/ ��% "S���1.2��. Electric heat trace s sterns ,�,,%/% /%% % �/� ( Complies comply witch It E� ���.,�� r UL 5r, ;�„� / /;�%l /�/ % Does Not . m . � ,r ti all / /r//f /////// ////// % Comply adjust the energy input to the ,,/%�'„�// � �f,���� heat tracing to maintain the ///� / / Poservable Not desired water temperature in l,, i /%/oi� if P 1 �/�„/� the piping. Not Iwcable % �/ % Report Title: 1940 Central Drive Report Date: 12/1/25, 7:23 AM 11 of 14 FbOd Verified Varifted , fte,q.10 Final inspection Provisions VOIllue, VOUIA, 166*116s? Cornments/Assumptlmptions F 4 403.3.3 Ducls are pressure tested t�o Complies Exception:aredloc�sand [1712711 teninearlege, Does Not air handlers ted �either Ro uvh-i n test:Total CfM/100 ft2 CfM/100 ft2- within conditioned space. 3�3�-3 0 f F12 leak-age,ineasured with a Pomply pressure difforential of'O.1.inch Not w.g.across the systern inchiding the manufacturer'sair handier93servable enclosure if installed at time of Pp Not test.Postconstruction test:Total plicable leakage ineasuredwitha pre sure,differential of 0.Iinch w.ig,,across the,entire'sys ter nj 14idudingthe manufacturer"s,air handier encl'osure., 403.3.4 rDuct tightness test result of CJ Complies Exception:All ducts and < r --D F 1411 1'hi/100 ft,.2 across,the L---j Does Not air handlers are located systern or<=,3cfm/1OO U CfM/100 ft2 cfm/100 ft2 within conditioned space. Pomply Wit'hout air handler_@ 25 Pa,For rough-ii�i tests,,verificatIon"may Not need to occur daring,Frarning Rervable Inspection Not Applicable 403.3.2.1 Air handler,leakage desiqnated Complies [F12411 by,manufacturer at<=2'5/o of %����� � Does Not deli q n a i r flaw. Pompfy ///� % / Not /„/!% % /// Rerva ble � /�J �i/: Not //%/ /,,, P I i ca b le .111"."'1 Pro girani mable thermostats, Complies [F19'1,�" installed for coiitrof of pr[ma ry /���/�heating and cooling sys,(enis Does Not Pompl y a nd i nitia,l Ily sl,et"biy ni A nu facture P,�k i / to code spec1iftations. Not /� � � /�f� G/�� / �/,/�/ �i servable ����%// /�����/ / �; Not fi / % i�� Ppplicable Additional Comments/Assumptions: 17]Hi Impact(Tier 1) 2 Medium Imoact(Tier 2) 3 Low Impact(Tier 3) Report Title: 1940 Central Drive Report Date: 12/1/25, 7:23 AM 13 of 14 w, 20118 Efficiency Certificate r . . i Value Above-Grade Wall 26.00 Below-Grade Wall 14.00 Floor 0.00 Ceiling/Roof 30.00 Ductwork(unconditioned spaces): Glass & Door Rating U-Factor SHGq Window 0.32 0.32 Door 0.32 0.32 Skylight 0.00 Heati9q, & . • w Heating System: Cooling System: Water Heater: �Sjqnalture Name; Date: Comments: Report Title: 1940 Central Drive Report Gate: 12/1/25, 7:23 AM 14 of 14 V SUFFQ ' Ally�;rt J. Kr�. SIFOIKIM[WAcIFIE]k .v + 1\4ANAt r E [1E N 7FU . SOUTHOLD TOWN HALL-P.0.Box 1179 � . Town aSouthold 53095 Main.Road S(�UTHO L� � ���� 11971 CHAPTER 236 STORMWATER MANAGEMENT REFERRAL FORM ( APPLICANT INFORMATION To BE COMPLETED BY THE APPLICANT ONLY FOR PROPERTIES ONE ACRE IN AREA OR LARGER. ) ,.,-�.. r ,•�-�. .��, �, .....,�. �, � ,nw , gym LDesign Contractor, other) APPLICANT. (Property owner Professional 4 NAME. ft � - Date: '. ► (Pr•int) Contact Inf orat ion: mm � _000 ..rvrvrvrvrvrvrvrvrvrvry(E-Mail&Telephone Number) i� 5 00 1111!,ii I( 4 A A i2e,, Propertv Address / Location of Construction Site: C( (f,(�AJL J���//rye S.C.T.M. 1000 u District Section Block Lot qw f � z fk u TO BE COMPLETED BY SOUTHOLD TOWN ENGINEERING DE PART' �.E N � o. a N Area of Disturbance is less than 1 Acre. No S.P.D.E.S., Permit is Re wiredr Project does Not Discharge to Waters of the State. No S.P.D.E.S. Permit is er ui,red�! �] Area of Disturbance is Greater than 1 Acre & Storm-water Runoff Discharges Directly to Waters of the State of New York. THE APPLICANT MUST OBTAIN a S.P.D.E.S. Permit DIRECTLY From N.Y.S. D.E.C. Prior to Issuance of a Buildin Permit. Area of Disturbance is Greater than 1 Acre& Storm-water Runoff Flaws Through Southold Town's MS4 Systems to Waters of the State of New York. THE APPLICANT MUST OBTAIN a S.P.D.E.S.. Permit thr M ,!,i the,Southold Town Erg lneerin De.........partment Prior to Issuance of a Buildin Permit,, Date: Reviewed By: FORM * S CP-TTS December 2024 �- �r' , ,. „, ',�„ »a,;✓a�»' �� �"wxl"*w�'"x� a,��» ��y �';. ",,.� a�"� .a4,.tau mmM�'° "a �,ma",�"�;"' maw ,"r i �, I„ n r hp h � h 1 v ni i a P W„ Yr r. J g/ „ V T ry V r r i BOARD OF SOUTHOLD TOWN TRUSTEES h PERMIT NO. 10863 DATE: OCTOBER 15,2025 �y ISSUED TO: TENFORTY CENTRAL, �1 ry Gu f//!ir I l d PROPERTY ADDRESS: 1940 CENTRAL DRIVE,MA.TTITUC K 1 Y ■I Y/ i"+� � is � J SCTM# 1000-106-1-27 I AUTHORIZATION „r Y 11 h , h , Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held an October 15 2025 and % z y in consideration of application fee in the sum.of$1,250.00 paid by Tenfom Central, LLC and subject to the Terms and Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and permits the following: r , Wetland Permit to dear(including nine trees to be replaced 1 to 1 and re-grade area of property between the 50-foot and 100-foot to of bluff setbacks using approximately p p tY P � 227 cubic yards of earthen fill material sourced from proposed ro osed on-site construction located more than 1001 from the top of bluff,to create a more level rear yard by raising nr , (max.4ft. or lowering max. 2ft. existing grade elevations; construct at least 100ft. from bluff a two-story,2 304s .ft. single-family dwelling with a second-floor balcony, swimming pool with raised patio and outdoor kitchen area,and associated stoop and steps; install an IIA sanitary system; and to establish and perpetually maintain a 50- r: foot-wide non-disturbance buffer along the landward edge of the top crest of the bluff, and a 25-foot-wide non-turf buffer area betwveen. the 50-foot and 75-foot setbacks; and as depicted on the site plan prepared by Madigan.Architects, received on October 21, f� ry 2025, and stamped approved on October 22,2025. r �I'I IN WITNESS WHEREOF,t e r t Seal to be affixed h said Board of Trustees hereby causes its Corporate I and these resents to be u en above. ;p subscribed by a majority of the sold Board as of the day and year watt a o J f r f f is I � I wry 01,1 L/ lot, � 5 y- I , r f r ma's b Y u f / II FN G V 4 I TERMS AND CONDITIC)N The Permittee "eii f ,ti Central, l C, 19 Central Drive : .a lit ick e `Fork.as part of the consideration for the issuance of the Permit does understand and prescribe to the following; That the said Board of Trustees and the Town of Southold are released from any and all damages,or claims for damages,of suits arising directly or indirectly as a result of any operation performed pursuant to this permit,and the said Permittee will, at his or her own expense,defend any and all such suits initiated by third parties,and the said Pen ittee assumes full liability with respect thereto,to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 36 months,which is considered to be the estimated time required to complete the work involved,but should circumstances'warrant,request for an extension may be made to the Board at a later date. 3. That this Kermit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved,to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7 That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized,or if, in the opinion of the Beard of Trustees,the work shall cause unreasonable obstruction to free navigation,the said Permittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. 80, The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk.County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety(90)calendar days of issuance of this permit. 9 That the said Beard will be notified by the Permittee of the completion of the work authorized. 10. That the Permittee will obtain all ether permits and consents that may be required suppletnental to this permit,which may be subject to revoke upon failure to obtain same. I 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. J The Northern LonEared deeds Your Hel M „ i Please be advised that EXEC has documented the summer occurrence of 1 lea the Northern Long.Eared Bat NLEB) (Myotis septentrionalis), a species listed as threatened by both New York State and the US Fish &Wildlife Service within 1.5 miles of your property. A► 98% decline in the ' abundance of NLEB has been observed since 2006. The Northern Long Eared Bat Story - Habitat and Decline Northern long-eared bats (NLEB), also known as northern Myotis, are primarily forest-dependent insectivores. Bats consume approximately 3,O00 insects per day, including mosquitos and crop pests. They use a variety of forest habitats for roosting,foraging and raising young. In general, any tree large enough to have a cavity or that has loose barb may be used by the bats for roosting or rearing young. This species is listed as threatened because of a dramatic population decline throughout most of its range. This decline has been caused by white-nose syndrome(WNS) a disease caused by an invasive fungus that ultimately causes affected hibernating bats to starve to death over the winter. DEC has determined that tree cutting at your property between March 1 and November 30 of any calendar year may impact the bats in your area, and may result in the direct killing or injury of individual members of this protected species, interference with critical breeding,foraging, migratory or other essential behaviors, or adverse modification of the species' habitat (these activities are defined as a "take" by the Environmental Conservation Law). The "tape" of a species listed as endangered or threatened is prohibited in the absence of a permit from this Department. In order to avoid the possibility of an Endangered Species "tale,"no tree cutting activities should be conducted at your project site between the dates of March 1 and November 30 of any calendar yea r. Depending on site conditions, it is possible that future projects on your property will not require adherence to this restricted timefrarne. In some situations, an individual tree or very small trees may be cut at any time of the year without resulting in a "take" of endangered f threatened species or their habitat. If you have questions about the presence of protected species on or near your property,the potential effects of activities on these species or your responsibilities as a landowner or project sponsor under the Endangered Species Regulations,please contact the Regional Wildlife Manager at(E31)444-0310. Please note that if you received a DEC Permit with this NOTICE,any new project on your property may require additional DEC permits. For information contact the DEC Division of Environmental Permits at (631)444-0355. For more information on the Northern long-eared Bat, please visit: haos: r www.,d,ec.,ny,.,,,gk,)v/ariiima, 1 I I For more information on protective measures required for Northern Long-eared Bats when a project p' visit: _ ZI'W'�NW-dec.ny,,,,,�oyl2iii,,,,,mals/'10o090.ht.rnl occurs within occu red habitat, please visit. ht� sµ . own Halt t .nne;K S,0 54 375 Route 25 Glenn Goldsmith, President P,O. Box. 1.179 A Ttcholas ;rupski, "Mice President � Sautho]d, New Work 11971. Eric Sepenoski Telephone(631) 765 1 392 Liz GtHool;v � � Fax (63 �765 + +� 1 tizabeth Peeples � l BOARD F TOWN TRUSTEES TOWN OF SOUTHOLD +oUTHOLD TOWN BOA" OF TRUSTEES E of THE BOARDOF To CONTACT THE F � K OFF YOU ARE E TRUSTEES I C3 T °T "�" TC1HE H 0 U R,S P R 10 R To C 0 M M E C EM'E �T BELOW INSPECTION SCHEDULE Pre-construction, hay bale line/silt bourn/silt curtain 1'st day of construction 1/2 constructed When project complete, c all for compliance inspection; o NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Division of Environmental Permits,Region I SUNY @ Stony Brook,SO Circle Road,Stony Brook,NY 11790 P:(631)444-03651 F:(631)444-0360 www.dec.ny.gov LETTER OF NO JURISDICTION: TIDAL WETLANDS ACT & NOTIFICATION OF POSSIBLE ENDANGERED SPECIES ACT JURISDICTION September 8, 2025 Tenforty Central LLC 530 West 25 th St. New York, NY 10001 Re.: DEC# 1-4738-05089/00001 Tenforty Central LLC Property: 1940 Central Drive SCTM# 1000-106-1-27 Dear Applicant: Based on the information you submitted the Department of Environmental Conservation has determined that the portion of the subject property landward of the 10' contour line, as shown on the survey prepared Lenze Land Surveying, dated 12/11/2023, is beyond the jurisdiction of Article 26 (Tidal Wetlands). Therefore, in accordance with the current Tidal Wetlands Land Use Regulations (ONYCRR Part 661) no permit is required under the Tidal Wetlands Act. Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary, as indicated above, without a permit. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and your project (Le. a 15' to 20' wide construction area) or erecting a temporary fence, barrier, or hay bale berm. Please be advised that DEC has documented the summer occurrence of the Northern Long Eared Bat (NLEB) (Myotis septentrionalis), a species listed as "endangered" by both New York State and the US Fish & Wildlife Service, within 3 miles of the project location. We have determined that tree cutting at this location between March 1 and November 30 of any calendar year may result in the "take" of these endangered/threatened species or their habitat within the meaning of Environmental Conservation Law (ECL) §11-535. The term "take" is defined in part as the direct killing or injury of individual members of a protected species, interference with critical breeding, foraging, migratory or other essential behaviors, or the adverse modification of the species' habitat. The "take" of a species listed as endangered or threatened is prohibited in the absence of a permit from this Department issued pursuant to ECL §11-535. In order to avoid an Endangered Species "take," no tree cutting NEWYORK Departmentof gym, Enwironmrentai� comurm,ion, activities may be conducted at the project site between the dates of March I and November 30 of any calendar year. If you have questions about the presence of protected species on or near your property, the potential effects of activities on these species or your responsibilities as a landowner or project sponsor under the Endangered Species Regulations, please contact the Regional Wildlife Manager at (031) 444-0310. This letter shall remain valid unless site conditions change. Please note that this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other agencies or local municipalities. Sincerely,, a Scott Deputy Perm:1t Administrator cc: En-Consultants BMHP Wildlife file The Northern Long-Eared Bat Needs Your Help'. y Please be advised that DEC has documented the summer occurrence of the Northern Long Eared Bat (NLEB) (Myotis septentrionaiis), a species listed °1> as "endangered" by bath New York State and the US Fish & Wildlife Service, within 3 miles of your property. Northern long-eared bats (NLEB) are primarily forest-dependent insectivores. Bats consume approximately 3,000 insects per day, including mosquitos and crop pests. They use a variety of forest habitats for roosting,foraging, and raising young. In general, any tree large enough to have a cavity or that has loose bark may be used by the bats for roosting or rearing young.The dramatic population decline has been caused by white-nose syndrome; a disease caused by an invasive fungus that ultimately causes hibernating bats to starve to death over the winter.A 98% decline in the abundance of NLEB has been observed since 2006. DEC has determined that tree cutting at your property between March 1 and November 30 of any calendar year may impact the bats in your area and may result in the direct killing or injury of individual members of this protected species, interference with critical breeding,foraging, migratory or other essential behaviors, or adverse modification of the species' habitat (these activities are defined as a "take" by the Environmental Conservation Law). The "take" of a species listed as endangered or threatened is prohibited in the absence of an incidental "take" permit. An incidental Take permit is subject to additional Department review and approval and must establish a Net Conservation Benefit to the species which will contribute to its recovery in New York State. To avoid the possibilit of an Endangered Species "take" no tree cutt"ing,activities ec t for r val' f hafzardbus trees, r se ti immediate threat to human life or ro ert may be c ucted at our roject site between the dates of March 1 and November 30 of a,,M calendar year. Depending on site conditions, an individual tree or very small trees may be cut at any time of the year without resulting in a "take" of endangered/threatened species or their habitat. Regardless of time of year, any proposal for large-scale tree clearing (10 acres or more)will require coordination with the DEC and US Fish and Wildlife Service. If you have questions about the presence of protected species on or near your property,the potential effects of activities on these species,your responsibilities as a landowner or project sponsor under the Endangered Species Regulations, or the need for an incidental take permit,please contact the Regional wildlife Manager at (631)444-0310. Please note that if you received a DEC Permit with this NOTICE, any new project on your property may require additional DEC permits. For information contact the DEC Division of Environmental Permits at (631) 444-0355. For more information on the Northern Lang-eared Bat, please visit: htt s w °, ec.,n . ov a �i al,,s 106�" ,3, ,µ l For more information on protective measures required for Northern Long-eared Bats when a project occurs within occupied habitat, please visit: Ott, . eac.n . ov ni als ,0 , ,.htmI April 2024 COUNTY OF SUFFOLK p, EDWARD P. ROMAINE SU FFOLK COUNTY EXECUTIVE DEPARTMENT OF HEALTH SERVICES GREGSON H.PIGOTT,MD,MPH Commissioner PERMIT CONDITIONS Project Name: 1940 Central Drive Health Services Reference#: R-25-0759 SCTM#: 1000106000100027000 Revision#: The attached plan,when duly signed by a representative of the department, in conjunction with these conditions, constitutes a permit to construct a water supply, sewage disposal, and/or collection system for the property as depicted. The applicant should take note of any conditions of approval, which may be indicated on the plan or enclosed herein. Construction must conform with approved plans as well as all applicable standards including Standards for Approval of Plans and Construction for Sewage Disposal Systems for Single Family Residences.Omissions, inconsistencies or lack of detail on the plan do not release the applicant from the responsibility of having the construction done in conformance with applicable standards. Issuance of this permit shall in no way relieve the design professional of responsibility for the adequacy of the complete design. The permit(plan)expires three (3)years after the approval date. Any modification to the approved design requires the submission of a revised plan and additional fees (if applicable)for approval prior to construction. No inspections will be performed by the department if a copy of the approved site plan/survey is not on site during construction or if the permit has expired. Permits may be renewed, transferred, or revised in accordance with the procedures described in Instructions to Renew, Extend,or Transfer an Existing Permit for Single Family Residences(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) 852- 5754, or through the ACA Portal at tt s-, ; r .B c .g omS . In certain cases, inspections of the soil excavation may be required to determine the acceptability of the soils for sewage disposal systems. Excavation inspections must be confirmed by calling(631)852-5700 between 8:30a.m.and 9:30 a.m.,the morning-of the inspection.Article V11 of the Code, "Septic Industry Businesses," requires that all installers of septic systems within shall 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. Final approval issued by the Department is necessary prior to the occupancy of new buildings,additions to existing buildings,or for the use of sewage disposal or water supply systems. W W M-016 Page 1 of 2 Project Name: 1940 Central Drive Health Services Reference#: R-25-0759 SCTM#: 1000106000100027000 Revision#: CONDITIONS FOR OBTAINING FINAL APPROVAL OF CONSTRUCTED PROJECT As a condition of this permit to construct,the following items must be completed as a minimum, prior to building occupancy and use of the sewage disposal system or water supply facilities. For further information concerning this, refer to Instructions For Obtaining Final Health Department Approval Of Constructed Projects For Single Family Residences(Form WWM-041). INSPECTIONS REQUIRED— For all inspections call 631-852-5754 to request an inspection by 4:00 pm, one business day prior to the requested inspection day. Satisfactory inspection by Office of Wastewater Management of the sewage disposal system /sewage treatment system. Satisfactory inspection by Office of Wastewater Management of the water supply for the accessory building(s). Satisfactory inspection by Office of Wastewater Management of the water supply system. Check with local Building Dept. to verify if a building permit is required for the installation of an I/A OWTS (e.g. electric permit). DOCUMENTS REQUIRED: Four(4) prints of an As-Built plan (See instructions Form WWM-041) "Tap letter"or equivalent from water district indicating approval of the public water supply Certification from the licensed sewage disposal system installer(Form WWM-078) Signed copy of the Operations & Maintenance Contract for the I/A OWTS Completed Application to Register an I/A OWTS (Form WWM-304) Design Professionals Certification of Constructed Works (Form WWM-073) for: I/A OWTS and all related components WWM-01 6 Page 2 of 2 ....... ror �i a �tticiency,inspect and id FRP once every 3 months 5 5 wrewrm+remmnm y�w+y�/rvjw[/m�'nm�mmmwwwmm�a 1 L Y Y.✓ ,armYti�. 5 rvel r ... "" "" "' n �urvxwwwww wwwwwwww MIN ««pp�+y��r�Y[ SAFETY LILT rnnnmmx'�uu �wmm' �M�g w 4A Y rwY�JTUFTITERISER PNWN r ^GYP" .";1,ant(Optional) Not used ",,�2i nm,�` °" MANHOLE1�11W II OIIP o 4LOW OPENING WD TYPE a CONTACT MEDIA .r 4�CCJRCULAr10N -"%I...EAN BLOWERFUJI ASSEMBLY „G AEFRO81C MEDIA A I ATtION ASSEMBLY ,,SECTION B-B VIEW �F I m rc D .......... .. ._..... ���l� T GRADE ;r (J G r �� .I _�� -R SLATE COVERII l 77 ..n,,. r bi (( " D I J""'6« 3 " BEND A ��f�,r �r.4 V I � h I�F �I°t((al ^^ ... � +� I'I° U� r 60 E RAN C �� � V N E g u€h SCE SANE FR l._._IE � 0 FO OW hS » ",rm ,;v-r>y,..��rrr,.r,Y �.,nx�r,m�,rmrr Y��a�a,�. as ate 9aar,�vvvv4� 4». �,Y�F � o>na.�v�,Yrrr�ra:�,�Y;,n a,,�nY.r �I�„ N4 �rvt r.1 "w V�s; ivo��t nyw irrr'i �CAL GRAVITY qq��''"" x i � i r �*w. .... w I- PAVED AREA CLEAN-OUT DE FA II I........ a (1,�I�("ICI' I 1 OI n� �, � 'N�rv�-�'�""l V ""�o 48 V arft� `r e 4 u uv J Irxf y. !l J4 JIY Wv .. o I��dl�l iii JR r r s i pal III iP Ilu i1 Vq N t f I ' � I iiiwwwww... mmmnnnmm�nmm��oi CLEANMJT ARY yyr � i qd rWr bT I AWN " Sp v � o w �n w DRAINAC ROOF' Af ROOF AF ROOF' AF ,., DECK A,f r 4T ..... ROOF ,�" 0 i.F I� rROO AR NOTES; STORM PQUIP� NO O r . PROPCW ,3. DRYWW . .m�...... ...... Ij x o I i r ..n �w. ^ w '� l�W� LO, C� PUBLI', WATER _. ....�. '-DRYWF,,1 F O R i OUTDOOR KITCHEN PROPOSED , wµ DECK/PATIO » D:�WWLLI_..IINC PUB[IC WATER PROPOSED P'00I.. M 'WATER LINE DW+L TO GARAGE off"mau m � 5'FAIN,SAM ARY 1.11 eS rnU � d e y 'LINE::TO FOUNDATION Water,14---stbe ecte .� --UTILITY SINK IN ,4" �„ a „n w« W-.Rl—kqqu-Pht-Qe-j8 afth Se,(Vi a BATHROOM FACILITIES Call (6,31)852-513154:, 48 hours iiiiiii * JA VENT BLOWER&advance, Ia E ° i � C)NT PANE L 1, DWELLING PUBLIC, WATER 1 , OlgOrdkaN Jri�;ymtwidmrtw rrm Rm/Mam N1fuf v�'!���f �a�Q��r�rk Vu�io 6r'•!FM!�b�m;,M+,�M rtoM� lu4 DRIVE .m M MIN, ". r �a 00 m CU TO GROUND 20A TO WATER MAIN IN TO BLOWER m.. .� �tl � CENTRAL DRIVE� �..�w---�� a vACaN r � Q — ^ m TO PUMP DW'EI__LINC, PUBLIC; WATER m TO ALARM FLOAT b <r M� SURVEY NO: 24-0103 SURVEY NOTES: SURVEYED: 12-11-23 LOCATIONS OF EXISTING DWELLINGS ON ADJACENT LOTS ARE FOR REFERENCE ONLY AND ARE FROM SURVEYS REFERENCED BELOW. ^""" fl(iliESI WATER MAIRK THEY WERE NOT FIELD VERIFIED FROM ADJACENTDUE TO HEAVY BARE FROMRUSH AND LACK OF ACCESS ALL / f ) -CONTO RE RS DATA DERIVED FROMLOTS GROUND SURVEY SHOOTS LK TAKENTON t HEESSITE DATE OF SURVEY AS W'ELLAND ARE ASNAS CONTOUR DATA REFERENCED TAKEOUT: 1-15-24 AS THE WEBSITIE ON 1010124�� ��INL OF VI GI.1A1ION BELOW a� SURVEY REFERENCES INFO ADDED: 2-15-24 �j c° 1. COASTAL EROSION HAZARD AREA MAP,PHOTO No,59-533-83,SHEET 2 OF 49 HAZARD LINE ADDED: 3-13-24 2, CONTOUR DATA;htips://gis,ny.gov/nys-contours(SUFFOLK COUNTY) �� 3. FSM1A INFO FROM MAP do SHAPE FILE DERIVED FROM FEMA FIRM MAP 36103CO139H EFFECTIVE MAY 4th,1998 REVISED SEPTEMBER " *e" T1E LINE 4. TAX LOT 26 SURVEY BY NAHAN TAFT CORWIN III DATED DECEMBER 26th,2001(APPROXIMATE DWELLING LOCATION ONLY) CONIC. MQN SET: 6-21-24 5. TAX LOT 29 SURVEY BY PECONIC SURVEYORS PC DATED JANUARY 9th,2014(APPROXIMATE DWELLING LOCATION ONLY) TOPO ADDED: 10-11-24 ° ACREAGE CORR.: 10-23-24 N57 1DD F ' oe 41. �, ON . MON SET � TACK&NUB SET CON, CONIC 3N LNG 1 ON. MON SET <, FOUND �» N 1'ET I tpp PA hi I "'��` R w I/ � NA SET q T gjlt1L #Ile t 1 a . 1, DD'' CDNC, IOUND COASTAI EROSION "A>/ARO l� S(:A�.CD H OM Dr C I�lAIARf" .'" FOUND (SOU 1NOI_g) 7 ()I N � �y 6, INN Aoo 't ,0Y�1���T�N 46 r t" 00 3N 940 ," I„ D :.a �. a_ 0, aN CIDNC; oN— FOUND # 9200 '' Gq CDNC. .DA� 9200. W ,.y„r,C+ Ili V 8a.00 D114,AY g5.00 01w \0'0 1. 1 I I4 61 N` 1" 79' � , CONC. ;. q , FOUND O�Oa Ar CDNC. t � r "" y P SET ON ov'l�oN FOUND �. �a�" �R f A 120. �o a _0 TOTAL DEVELOPABLE LOT AREA(SOUTH OF T.O. BLUFF) 33,244 SQUARE FEET VERTICAL DATUM; NAVD88 SCALE: 1"=60' TOPOGRAPHICAL SURVEY �p� SITUATE AT 'm, MATTITUC TOWN OF SOU TN OLD COUNTY OF SUFFOLK LAND SURVEYING STATE OF NEW YORK FILED MAP: CAPTAIN KIDD ESTATES SURVEY PREPARED FOR AND CERTIFIED TO: �� 05 10 99 FILED: JANUARY 19th, 1949 FILE NO: 1672 BLOCK: 1 MASSAPEQUA ♦ NEW YORK LOT(S): 4 GERARD D.LENZE L.S, PRESIDENT TAX MAP ID: 1000-106.00-01.00-027.000 PHONE: (516)967-3028 NYS LICENSED LAND SURVEYOR EMAIL: LENZELANDSURVEYING@GMAIL.COM PROPERTY AREA(TO TIE LINE)=1.35 ACRES/58,635 SO.FEET LICENSE NO. 051099 SiwMY NOTES•UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE:EDUCATION LAW♦COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYORS INKED SEAL SHAD.NOT BE CONSIDERED TO BE A VALID TRUE COPY IT GUARANTEES OR CERTIFICATIONS INDICATED HERON SMALL RUN ONLY TO THE PERSON' (44 WHOM THE SURVEY IS PREPARED,AND ON HIS BEHALF TO THE TITLE COMPANY,LENDING INSTITUTION,AND GOVERNMENT AGENCY LISTED HEREON♦GUARANTEES ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS*ENCROACHMENTS BELOW GRADE AND/OR SUBSURFACE FEATURES,IF ANY,NOT LOCATED OR SHOWN HEREON•OFFSETS SHOWN ARE '...FOR UNFORMATIONAL PURPOSE ONLY THEY ARE NOT INTENDED 10 ESTABLISH PROPERTY LINES FOR THE ERECTION OF FENCES.STRUCTURES,OR ANY OTHER IMPROVEMENT f SURVEY IS SUB,ECT 10 ANY STATE OF FACTS WHICH AN UP-10-DATE TITLE EXAMINATION MAY DISCLOSE♦SURVEY PERFORMED IN ACCORDANCE WITH THE EXISTING'CODE OF PRACTICE FOR LAND SURVEYS' BY THE NEW YORK STATE ASSOCIATION OF PMSSON4 LARD VA'AvORS 4 PROPERTY C S wjk Not SE1 AS PART OF THIS%*VEY