HomeMy WebLinkAbout53060-Z 0 TOWN of SOUTHOLD
BUILDING DEPARTMENT
SOUTHOLD NY
1
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ONTHE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION O►F THE WORK AUTHORIZED)
Permit#: 53060 Date: 06/11/2a26
Permission is hereby granted to:
Graf wJ Irrev Trt
4855 Stillwater Ave
Cutchogue, NY 11935
To:
Demolish, by Town definition,and construct a new single-family dwelling with outdoor shower as
applied for per Trustees, DEC and SCHD approvals.
Premises Located at:
4855 Stillwater Ave, Cutchogue, NY 11935
SCTM# 137.-3-8.3
Pursuant to application dated 02/04/2026 and approved by the Building Inspector.
To expire on 06/10/2028.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling-NEW $2,036.50
CO Single Family Dwelling-New $100.00
Total 92,136.0
it ng Inspector
TOWN OF SOUTHOLD--BUILDING DEPARTMENT
Town Hall Anne. 54375 Maio. Road P. 0. BOA. 1179 Southold,NY 11971-0959
° Telephone(631) 7�65-1802 Fax (631) 765-9502 htt s sout o Ito n . . o
Date Received
APPLICATION FOR BUILDING
For Office Use Only
PERMIT NO �Ja
Building Inspector: FEB 4 2026
nu
Applications and forms must be filled out in their entirety.Incomplete
applications will not be accepted. Where the Applicant is not the owner,an
Owner's Authorization form(Page 2)shall be completed. � � ��C 1, ,�, :
Date:December 12, 2025
OWNER(S)OIL PROPERTY:
Name:The Susan K Graf Irrevocable Trust&The William J.Graf Irrevocable Trust SCTM ##'loco-137-3-8
Project Address:4855 Stillwater Avenue, Cutchogue, NY 11935
Phone#:646-505-8576 Email:c.statile@gmail.com
Mailing Address:4855 Stillwater Avenue, Cutchogue, NY 11935
CONTACT PERSON:
Name:Caroline Graf Statile
Mailing Address: ,']"'7 West 11 th Street, Apt 1 , New York, NY 10014
Phone#:640r505.8576 Email:cr,statlle 9 g mail.com
DESIGN PROFESSIONAL INFORMATION:
Name:John J. CondonSr., ondon Engineering, P.0.Jo
Mailing Address: 1755Sigsbee Road, Mattituck, NY 11952
Phone#: -298-19$5 Email:condoners� p@O tonline.net
631
CONTRACTOR INFORMATION:
Name:TBD
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure Addition 5RAlteration ®Repair ❑Demolition Estimated Cost of Project:
❑0th e r $600,000-$800,000
Will the lot be re-graded? ❑Yes W No Will excess fill be removed from premises? ❑Yes ®Na
g
i
1
PROPERTY INFORMATION
Intended use of property:
Existing use of property:primary residence
primary residence
Zone or use district in which premises is situated,,, Are there any covenants and restrictions with respect to
R ,4C� this property? MYes No IF YES., PROVIDE A COPY.
19 Check Box After Reading: The owner/contractor/design professional Is responsible for all drainage and storm water issues as provided by
Chapter 236 of the Town Code. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone
Ordinance of the.Town of Southold,Suffolk,County,New York and other applicable Laws,,Ordinances or Regulations,for the construction of buildings,
additions,'alterations car for removal or demolition as herein described.The applicant agrees to comply with all applicable laws,ordinantes,building code,,,
housing code and regUlations,and to fd me,� thorizedlnspectores on premises and in build Ing(s)for necessary,inspections.False,statements matle herein are
punishable as a class A misdemeanor pursuant to Section 210.45 of the New York State Penal Law.
Application Submitted By(print name):Car I,�e ,rLf StLtiIe 0Authorized Agent W owner
Signature of Applicant: Date: -1
STATE OF NEW YORK)
SS:
MOO
COUNTY OF IJ 001,
IN*��
of.
Caroline Graf Sta�tiI+�
being duly sworn, deposes am ikto JicWit
1� , a,V
P
(Name of individual signing contract) above named, 400:� , I 1(0 0 dim
0
"b 4W
00
owner 1425(")
(S)he is the VIA,
(Contractor,Agent, Corporate Officer,etc.)
��,N 1%*
k
of said owner or owners, and is duly authorized to perform or have performed the said ts(td, I file this
application;that all statements contained in this application are true to the best of his/her kril' ftVi6d belief;and
that the work will be performed in the manner set forth in the application file therewith.
Sworn before me this
IT44 day of C HS E R, 20 ......
�e'T
11 tary Public
lie
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
if residing at
,do hereby authorize t, o apply on
my behalf to the Town of Southold Building Department for approval as described herein.
Owner's Signature Date
Print Owner's Name
2
----------------------------—- ---------
.........---------------------------------------..........
SURVEYED 04.20.25/ REVISED 03.02.26
SCTM#1 000A 37vw3v%8-3 /41 ,356.73 S F ! .95 ACRES
ELEVATIONS NAVD 1988 DATUM
- ------------ ......
SUFF{JLK COUNTY DEPARTMENT OF MEF.LTH SERVICES
FEp.Ml7 F4R APPROVAL OP C01is'TR4.IC71ON FOiR A r�IP�EER'S CERTHR(ONt4TIC3i FREQUIRLED
SINGLE FAMILY RESIDENCE ONLY
SIJ13MIT P.E. OR R.A. CERTIFICATION
DATE Warzoza H.S_ RED. NO. R-25-2025 INSTALL-APON AND ONSTRUCTION
ir�►oaavurs
APPROVED �,rti� 4��.T- OF
FOR M+aXI1dUM OF B BEDROOMS FORR i-AP USE FORM WWM-073.
EXPIRES T}-IREE YEARS FROM DATE OF APPROVAL
Water lines must be insQected
!sft1k-,CW Degtl.of dealt r Se rvices. SEE ATTACHMEENT(S)
Call 1631)852-5754, 48 hours in
advance, to schedule inspeciion(s).
Abandonment of the existing sanitary system must be in
conformance with the Department's requirements.
Submit completed form WWlVl-080 as prof
a
LL. .
LL
L*QWMT D �- TIC I
OR BROWN O.
PROJECT LIMITING FENCE ACID}28,480 FP). LOAM _, '
*NOTE:A MADWTEAIAADCE CONTRACT Gt}NiINUliue MAINTEAUtNGE IS RED�UIREt3
FOR THE PROPER FUNCTIONING OF ALL IfA TREATMENT TANKS SILROWN
TY SAND
4. to
EXISTING 386 FT'48'OVERHANG TO BE REMOVED HIGHEST EXPECTED eRt3WN
GROUNDWATER FINE
ELEV.20 SAND
GROUNDWATER 7.8'
PROPOSED 4"x 73'C)UTLIC}CIR SHOWER TO DRAIN TO DRY WELL 1 ELEV,16 WATER IN i
BROWN § pc
-
(1)8`0 x B'DRY WELL
FINE
(1)10'0 x'DRY WELL SAND
FOR ROOF RUNOFF DRAINAGE
PROPOSED 212 FT'2-STORY AUDITION WITH SURVEYED tf 4 2fI 2 REVISED Q3 26
3 . SCTM#I D OO-137-34 3141,358 73 SF 1,95 ACRES
TFT"VfITRY PO" A — - _
PARTIALLY IN PLACE OF MSTING COVERED CONCRETE ?
RATIO AND ROOF OVERHANG
I� ._, e�A
{DIET 32 FT'INCREASE IN FOOTPRINT} F—,. T a
EXISTING 627 FT'COVERED CONCRETE PATIO � � �g. I � � VA
AND 103 FT'CONCRETE SLAB TO BE REMOVED McAONALfi GED}SERVICES
t uj
�
- F ?i
PROPOSED IAA-OWTSI T ��� ti
FLU_ - - - �
2'VENT T _$ PROPOSED 2ND FLOOR ADDITION
_ _
ELM
_ OVER 727 FT'PORTION OF EXISTING
T ,- ., J 1-STORY DWELLING TO BE RENOVATED
MOUNTED WITHIN VIEW OF TREATMENT TANK t - V FVk TOWN COME DEFEWT1004- G
ac
w18-3'DEEP LEACHING GALLEYS
+3 EXPANSION Cv4LLJ=`t5 1IN. 10 - G
1197 FT;PROPOSED ASPHALT DRIVEWAY t _ �� E � � � � 'AREA OF PROPOSED VEGETATED NON-TURF �
t e t BUFFER INCLUDING EXISTING AND CO C to
E FLY 3M_FP ADDITIONALLY PROPOSED PLANTINGS,
REMOVE 2,888 FT'CIF ASPHALT DRIVEWAY— ' _ _ t PLANTEDNEGETATED}AREA BETWEEN TOTALS APPROXIMATELY 4,29DI FI'
EXISTING EDGE OF LAWN AND TIDAL
E
WETLAND BOUNDARY TO BE MAINTAINED AS
t LJ
ABANDONED WELL TO BE USED FOR IRRIGATION A VEGETATED NON-TURF DUFFER� � _ - °`� � T � �� W
PUMPING AT «-
- � c
� r
(2)8'0 x 6'DRY WELLS FOR SITE DRAINAGE
- 1 APPROXIMATELY 670 FT'OF ADDITIONAL
-.�� �_ � �- �-� _ a � PROPOSED VEGETATED NON-TURF BUFFER
(1)6'0 x V D?EEP DRY WELL FOR GARAGE RUNOFF�- =
- - � IN PLACE OF EXISTING LAWN
(1)8'0 x 6'DEEP DRY WELL FOR : .�.
SWIMMING POOL BACKWASH
RAISE 1ST FLOOR ROOF HEIGHT OVER 698 FT'
PORTION OF EXISTING 1-STORY DWELLING
(ND 2ND FLOOR)
c � � a sT EXISTING 336 FT'WOOD DECK TO REMAIN
� �
17�' C� REPLACE DECKING AS NEEDED
t T PROPOSED 119 FP DECK ADDITION PARTIALLY
t
5 '- s IN PLACE OF EXISTING ENCLOSED PORCHTw
,T ;
E wzmmx+ for
_ F E7QSTING 333 FTa ENCLOSED PORCH AND 1— D
+ _ _ 117 FT'UNCOVERED WOOD PORCH TO BE REMOVEDco
,'•""
_ —
`+ I a PROPOSED 1 STORY 546 FT'ADDITION
PARTIALLY IN PLACE OF ENCLOSED
`F PORCH AND?UNCOVERED WOOD PORCH _ E�
TF aF J
�� � � �c �- (NET 25tI FT-INCREASE IN FOOTPRINT) L].)
4
_ 0
wrd:
EXISTING SEPTIC:TO BE REMOVED .. uaaa WM ALTW nrs IMs1
e ,. _ CW LAAitalE AFOA TtdKTiNC TTvaTFcatT srETrsF ffmK0FO f*matl Fmnra,cTeTaw earlmT awF L�uFo-T,,iF.F EFcc
REWA AS PER LATO" T i anaal mam c�AmEatr iTF AFO totaaEEA ArFsva na�+AAti ry r srotic vaL+rt•�€
0 WkWJA" ^""AAffA A uar DO WMED w artn 1L
i�AhO AM i
EXISTING,8'0 x F DRY WELL TO REMAIN LL � W
TO BE RELOCATED LAltAom�.srE�m+sa��„�r,c�racnortw+ommus.ymia cesac�t �ssrcue>sm.
car FFeatroTtc CrPARnAw a1ArTma_anFlcATn,AOACaFrtcrsa coarTIC&MM EN^AEwLT-FaAra
wicr oe■&MLIMM ro T+FE OvAruv rr"WK M*Pc FrT,wFt o+re W own Fan9mr4h rr no FaAanma —�
4p
' a FFE.IQ,DI1 FIRST FLOOR FOOTPRINT:882 FT' �.crcrir++�.rttiu acmnr M.cn.rs � rwv*vCOCK.
Cis
Nt&raTAu AtF USE E3 TTa MA van utAE MOM"T9 Tx AFC�IM o n mA1x
_
o� aaamrr M€rAF1ra n Nnu Tr.2 ErAFawc+e FaE Tc^AFTrrAt AM FEEear COPE1R+tiTM wo �
�� krsra.'nf�n+..e...r�nc t++Mrmrwa nW WE1M0.1E%CQY GVVMAow,FVUAM
- -+MICR AM Fa OWES MOMW A MIT.TM WET VOLL OF YDffW 19 THE amr OF nc A®maz Nam 6wm VENT
ME aeA<L EX10 A 1taAaF o r AEett TM FVW u+c AM T±a Tug w roc N91T NPWL MVE A bMWAM
WFsMaAL WAAAM-Tr%t Tv n,E wawa pwww C Tea�in cAm wPwa FT is owrr r%Acw.AL m mff
g TrMM Tr TU E]d�.ae W WA"MG Asmovew +a yeff pin€ VMS o+I�Kw. m En 4M�FMF, .,ONVENOGEa W zra W W
ITARY SITE _.- (Aa00 m 7 A+n WzFT Tt1aau7 TTF»,A CNU*R ROW�AtLVEPU Fru Hear FNY€Ft1 AN FMAUr Rcr F. i ar rF 77
- t GMOM ORM0t0 0 i FVT MEHCaEn ET)5aaai An M VWM p VA LOW"A++LW P �'7i VFWAM AL M Tp1A FeFFprf� _>:u
+.
SCALD:=120 viAnX&crTsraa auFLFCT aa£WAX I%TDM mown Fc .t►,a.F++na awi ea+c Tv, w a �
r.A RETi±Ei rAFr,L RM IiJtT=RiFaE!tE7ifME EiM A!L!TtFt#i VFW CA liii,ET1aiME brit R EeRt[,L TTtl
Water lines must be ioggg 11 HOT F"OVEi:A 1t,a M 9YTTMT04CH VALAMNATe iiaaaCAH'AMA AL Fntl TV%TCM IF MAMYAMV AM
III ru HEAP WY TM CWAPW1 OF TM�XDTV Ta Tow nEAA,rnERT F�adDat A T6tEAaT±1r Fay PC KITH to AFC
�� E ✓� 24 2Q^ 4DI' WTUT�A�E RMOM Fr w �m►AM9 F+e PvwM IIPW MU MOMMEN MUM A Mi KTIMAFtT TE 1E r c}F F�+AF ,,,r DftAVYRI DIY; KAt1
n ar
eaaaear Ere A MaFcaxIMP,M N:r Ac.30+vs^,1093ar,aaFt a+caAT rranmF r nc r+aFe MecTneAi rAA.tL Fc� g( 1) F EeanTrs 79 rM MACLE N COWMM ONIM r aewA:T ctwnr, aTa rF DATE: 08.20.25
Awi
IMF
# r t ( ;R(). `OCIA Tle�r '~A,n ACA RMEW wir .Tnd UMT F r Ee F 10� M Tt amwEpwTv Aw a T,c SCALE. AS NOTED
EXISTING UTILITIES TO REMAIN CONTAMFAF$A" MI"TOIISOME GENCUL
"zTwG L WTAU m CATS TA++a ACCCP 3M M WhALW*cnaWRI raFaFa AU+nueatE PgooksiOmEATzra 1\Am M SHEET
recMEo WY'Ma FwrFAt<MA tut_w ANUNVOM IKA.MMM NMVR twva T16oFHsa USE niW w ua
SPOIL PWX A VCM&CAR'f 01VE F OR R/A W dMEFifrA=EFk"N tAU
'NO TREES ARE TO BE PROPOSE:DLTTIU71ES M nswCATS.Fuwo JOIN AFFMVE..ETFurotHtOLMM"PWPA LLE a To ofWr=
REMOVED WITHIN IW OF w1 i WE FINCLOICY IMCUM er ARTT LE a MR PINWOUNAL F CM a FMM MMM nu FERM x NEW Fmjva
WETLANDS BOUNDARY - Avvv4tcs FUTALwMavjFVTMEFR tFT muff=.a"isms- o
-rltm Taft
TL oer+am METalATIC K 9PEMT L AM eR*ffVW a 105MIAMAM71 M!M M FELM FA AffltmE n erAPO CZ UU
"w Can oTVTDO pmIn a crc"Iwirr.m-wm Rmumkknaa Fina {+►Y w nx m IN Tw;E#a
acssaF rT,NECTM TaToc
OF 2 SHEETS
NEW, KATHY HOCHUL
YORE �� Governor
STATE Environmental
Conservation AMANDA LEFTON
Commissioner
May 6, 2026
The William J. Graf Irrevocable Trust
The Susan H. Graf Irrevocable Trust
C/O William J. Graf, II & Caroline Graf Stable
377 West 11 th St,Apt. 1 G
New York, NY 10014
Re: Application #1-4738-00771/00004
Graf Irrevocable Trust Property— 4855 Stillwater Avenue, Cutchogue, NY 11 935
SCTM# 1 000-1 37-3-8.3
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 for the referenced activity. 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
address below.
Enclosed is a permit sign which is to be conspicuously posted at the project site and
protected from the weather and a Notice of Commencement/Completion of
Construction.
Sincerely,
Ana Shore
Environmental Analyst
Cc: En-Consultants
BMHP
File
Division of Environmental Permits, Region 1
50 Circle Road, Stony gook, ICY 11790 1 dec.ny.gov I dep.rl@dec.ny.gov 1 (631)444-9365
Adh
Imhow
NEW YOUR STATE DEPARTMENT OF ENV_ERONMENTAL CONSERVATION
Facility DEC ID 1-4738-00771
PERMIT
Under the Environmental Conservation Law (EQU!
Permittee and Facility Information
Permit Issued To: Facility:
THE WILLIAM J GRAF/THE SUSAN H GRAF THE WILLIAM J GRAFTHE SUSAN H GRAF
IRREVOCABLE TRUST IRREVOCABLE TRUST
377 WEST 11 TH ST APT I G 4855 STILL WATER AVENUEJSctrn 1000-137-3-
8.3
NEW YORK,NY 10014 CUTCHOGUE,NY 11935
Facility Application Contact:
EN-CONSULTANTS
1319 N SEA RID
SOUTHAMPTON,,NY 11968
(631) 283-6360
Facility Location: in SOUTHOLD in SUFFOLK COUNTY
Facility Principal Reference Point: NYTM-E: 712.888 NYTM-N: 4543.063
Latitade'., 411100'39.5" Longitude: 72'28'06.2"
Project Location: EUGENE'S CREEK
Authorized Activity: Expand a single-family dwelling, construct a pool, and install an I/A OWTS.
All work shall be in strict conformance with the attached plans prepared by Maresca&Associates, page
I last revised 3/9/2026 and page 2 last revised 1/16/2026, and stamped "NYSDEC Approved" on
5/6/2026.
Permit Authorizations
Tidal Wetlands-Under Article 25
Pen-nit ID 1-4738-00771/00004
New Permit Effective Date: 5/6/2026 Expiration Date: 5/5/2031
Page 1 of 7
10how
NEW YORK STATE, DEPARTMENT OF ENVIRONMENTAL CONSERVATION
Facility DEC ID 1-4738-00771
NYSDEC Approval
By acceptance of this permit,the permittee agre6 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: KEVIN A KISPERT, Deputy Regional Permit Administrator
Address: NYSDEC Region I Headquarters
SUNY @ Stony BrookJ50 Circle Rd
Stony Brook,NY 11790 -3409
e7nv
Authorized Signature: Date
Distribution List
EN-CONSULTANTS
Bureau of Marine Habitat Protection
ANA SHORE
FILE
Permit Components
L
NATURAL RESOURCE PERMIT CONDITIONS
GENERAL CONDITIONS,, APPLY TO ALL AUTHORIZED PERMITS
NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS
NATURAL RESOURCE PERMIT CONDITIONS - Apply to the Following
Permits,: TIDAL WETLANDS
..............
1. 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.
2. 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 forin certifying that they
are fully aware of and tmderstand 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.
Page 2 of 7
Aft
Ishow
NEW YORK STATE DEPARTMENT OF ENVIERONMENTAL CONSERVATION 11111111W
Facility DEC ID 1-4738-00771
3. 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.
t�$
Such approved plans were prepared by Maresca&Associates,page I last revised 3/9/2026 and page 2
last revised 1/16/2026,1 and stamped "NYSDEC Approved" on 5/6/2026.
4. 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.
5. Materials Disposed at Upland Site Any demolition debris,, excess construction materials, and/or
excess excavated materials shall be 'immediately and completely disposed of in an authorized solid waste
management facility. These materials shall be suitably stabilized as not to re-enter any water body,
wetland or wetland ad J.acent area.
6. No Disturbance to Vegetated Tidal Wetlands There shall be no disturbance to vegetated tidal
wetlands or protected buffer areas as a result of the permitted activities.
7. Storage of Equipment,Materials The storage of construction equipment and materials shall be
4_.�
confined within the project work area and/or upland areas greater than 75 linear feet from the tidal
wetland boundary.
8. Seeding Disturbed Areas All areas of soil disturbance resulting from the approved project shall be
stabilized with appropriate vegetation(grasses, etc.) immediately following project completion or prior
to permit expiration, whichever comes first. If the project site remains inactive for more than 48 hours
or planting is impractical due to the season, then the area shall be stabilized with straw or hay mulch or
jute matting until weather conditions favor germination.
9. Clean Fill Only All fill shall consist of clean sand, gravel, or soil (not asphalt, slag,flyash, broken
concrete or demolition debris).
10. Department Jurisdiction The department retains jurisdiction of all regulated lands where fill has
been permitted. Placement of fill shall not be used to alter the department's Tidal Wetland jurisdictional
area at the project site. The area remains a regulated area subject to Tidal Wetland Land Use restrictions
of 6 NYCRR Part 66 1.
it. Wood Preservatives
a. Pressure treated wood used for construction of in-water structures must have undergone a
treatment process approved (stamped or otherwise marked as certified)by the American Wood
Preservative Association.
b. Wood treated with Pentachlorophenol (PCP)must not be used in marine or brackish waters. Wood
treated with PCP must be aged in the open air for at least three months prior to in-water use.
c. The use of creosote treated wood is prohibited both in the water and upland areas.
Page 3 of 7
dehow
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSER.VATIO.
:Facility DEC ID 1-4738-00771
d. Chromated Copper Arsenate (CCA) pressure treated wood must be cyan and free of CCA surface
deposits. Wood with surface deposits must be washed for at least 5 minutes under running water
prior to use. The washing must occur greater than 100 feet landward of any regulated wetland
and/or water body. (Note "E." below for handling wash water.)
e. Any wood debris such as sawdust or wash water must not enter any water body, including wetlands
or protected buffer areas.
12. Establish Vegetated Duffer To protect the values of the tidal wetlands, a permanent vegetated
buffer zone shall be established. There shall be no disturbance to the natural vegetation or topography
within the area extending 40-46 linear feet landward of the tidal wetland boundary as per the approved
plans.
13. Area of Disturbance for Structures Disturbance to the natural vegetation or topography greater
than 25 feet seaward of the approved structure is prohibited.
14. Install,Maintain Erosion Controls Necessary erasion control measures,i.e., straw bales, silt
fencing,etc., are to be placed on the do nslope 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.
15. Runoff Directed to Upland Drywells Roof runoff shall be directed to drywells a minimum of 50
linear feet landward of the tidal wetland boundary for immediate on-site recharge.
16. No Drywelis in or near'Wetland Dry wells for pool filter backwash shall be located a minimum
of 75 linear feet landward of the tidal wetland boundary.
17. No Pool Discharges to Wetland There shall be no draining of swimming pool water directly or
indirectly into wetlands or protected buffer areas.
18. Direct:Runoff Away from Tidal Wetland and Duffer Roads, driveways, and parking areas shall
be graded to direct runoff`away from tidal wetlands and protected buffer areas.
19. Authorized Innovative/Alternative Onsite Wastewater Treatment Systems (I/A OWTS) Septic
Systems This permit authorizes the *Installation of any models of I/A OWTS septic system which have
received the approval of the Suffolk County Department of Health Services (SCDHS). If SCDHS
rescinds its approval of one or more of these models during the terra of this permit,DEC will no longer
approve new installations of that model. The list of I/A OWTS systems which have received approval by
SCDHS are found on website b�qRs://reclaimourwater.i
20. Maintenance of installed Innovative/Alternative Onsite Wastewater Treatment Systems (I/A
OWTS) The perrnittee must maintain, service and repair the installed FA OWTS in accordance with
the maintenance schedule set forth in the Suffolk County Department of Health Services(SCDHS)
permit issued for the system.
21. Contain Exposed, Stockpiled Soils All disturbed areas where soil will be temporarily exposed or
stockpiled for longer than 48 hours shall be contained by a continuous line of staked.haybales/silt
curtains(or other NYSDEC approved devices)placed on the seaward side between the fill and the
wetland or protected buffer area. Tarps are authorized to supplement these approved methods.
Page 4 of 7
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
Facility DEC ID 1-4738-00771
22. 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.
23. 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 Envirorunental 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.
24. 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.
25. 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*
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 perinittee 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 perinittee shall provide a person to accompany the Department's representative during an inspection
accompany
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.
Page 5 of 7
Imbue
NEW"YORE STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
Facility DEC ID 1-4738-00771
2. Relationship of this Permit to Other Department Orders and Determinations Unless expressly
A
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.
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.information.the Department requires.
Any renewal, modification or transfer granted by the Department must be in writing. Submission of
app lications for permit renewal, modification or transfer are to be submitted to:
Regional Permit Administrator
NYSDEC Region I Headquarters
SU`NY @ Stony BrookJ50 Circle Rd
Stony Brook, NY1 1790 -3409
4. Submission of Renewal Application The permittee must submit a renewal application at least 3 0
days before permit expiration for the following permit authorizations: Tidal Wetlands.
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 pen-nit 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 6 of 7
AWk
w
NEW YORK STATE DEPARTMENT OF ENVIRONMENTA Abo
L CONSERVATION
Facility DEC ID 1-4738-00771
NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS
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
pennittee'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 Rule's 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 pen-nit, including all special conditions while acting as the
perml*ttee'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 7 of 7
NEWK Department of
STATE Ellvironmental
u Conservation
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: 1-4738-00771/00004 NYSDEC Region 1 Environmental Permits
50 Circle Road
Stony Brook, NY 11790-3409
Expiration Date,* 5/5/2031 Email: dep.r1 @dec.ny.gov
Note: This notice is NOT a permit
IDI OTICE OF!90MMENC T'0F'C0t,!SjMA CTIQ
RETURN THIS FORM TO:COMPLIANCE Or Fax to: 631-444-0272
Marine Habitat Protection-NYSDEC E-Mail: dee.sm.RIMHP-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
'i as u
We certify that we have read the referenced permlt and pproved plan and nderstand!
theauthorized p "ect and all permit conditions.We have inspected,the proji ct site and eancomplete,the project as described In the,
1roj e
permit and as depicted on the approved plarts. We can do so in full com,pli"Eince with all plari notes and permit,conditions.The permit
permit sign, and approved plans W111 be available at the site for inspection in accordance with General Condition No. 1. (Both
signatures required)
PERMITTEEN, DATE,
CONTRACTOR: DATE..
THIS NOTICE MUST BE SENT TO THE ABOVE ADDRESS AT LEAST TWO DAYS PRIOR To COMMENCEMENT OF THE
PROJECT AND IOR ANYASSOCIATED ACTIVITIES. FAILURE TO RETURN THIS NOTICE, POST THE PERMIT SIGN, OR HAVE
THE PERMI T A ND APPRO VED PLANS A VAILA BLEA T THE WORK S1 TE FOR THE DURA TION OF THE PROJECT MA Y SUBJEC T
THE PERMITTEE AND/CAR CONTRACTOR TO APPLICABLE SANCTIONS AND PENALTIES FOR NON-COMPLIANCE WITH
PERMIT CONDITIONS.
Cut alon this line X X X X X
NOTICE OF CO LPL' OF CO.N
RETURN THIS FORM TO:COMPLIANCE Or Fax to: 631-444-0272
Marine Habitat Protection-NYSDEC E-Mail: dec.sm.R1MHP-8EH @dec.ny-9ov
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 PHO TO G RA PHS OF THE COMPLETED WORK A NDIOR A COMPLE TED S UR VE Y,AS APPROPRIATE',
MUST BE SENT TO THE ABOVE ADDRESS WITHIN 30 DAYS OF COMPLETION OF THE PROJECT.
Fox,
'ENGINEERS CERTIFICATION IS REQUIRED FOR ALL IAA INSTALLATION E
DESIGN ENGINEER MUST BE CONTACTED WHEN THE BOARD OF HEAL THI WASTE 0xv ll
WATER MANAGEMENT INSPECTOR 15 CONTACTED FOR INSPECTION,ALL SEPTIC
—7
AND LEACHLNG FIELD COMPONENTS MUST BE MISLE,CALL 63`I-r2644W W;"ft
rk
PROJECT I-11MITING PENCE jAOD15ABOFT.") INOTE:A ED CA
z
MAINTENANCE CONTRACT&CONTINUOUS MAINTENANCE 1-5 REQUIR -
FOR THE PROPER FUNCTIONING OF ALL.VA TREATMENTTANKS 6
4 ff
HIGIA'EST EXPECTED ic
EXISTING 3136 PT`-A 6'1Qv ER.AAJG TO BE REMOVED
514-
49 w
ELEV 2 0
PROPOSED 4' 7,T OUTDOOR SHOWER TO DPbAIN TO DRY ViT_L
%
'ITE DAT T 14G ALL ]A SUPPLFED KENNEi H WOYC.4UK LAND SURVEY
FOR 9120F RlDl+QF T-_ORA*A_QE
SURVEYED 04,20 25;ROASED,03 02 26ff
l6
14 1,356 7-3 5F 1 951 ACRES !R
SCTMN100C-137 E& A
Ilk N, La ha
ELEVATIONS HA 1968 DATUM
0 w 6,Owr Vw_-L
LACE PARTIALLY IN CAY EAM co"CAFTIr i
OF!RoQ%'tVtG
A
PATIO AFM Roof OvEnvima
it WIFT TV wpwm--�17 04'FOOTP"ri jloe
Lp
LIN JK4 13 M
EXISTING 527 FP COVERED CONCRETE PAT 10 ;oe�. T-T
A Md;ONIALD GEOSERIACES
T NORETE 81-AB T 0 BEE REINADVED AND 103 1' t
t q
uj
PROPOSE'D'A-UvVTS 16 BE 1; sx- A*,
-DROO.i SYS I EMI
1 1, 1 t� z I Kom
FUJI CLEAN CENT TREATMENT TANK(7DO GPD'
bm
pqopascio jNn Rom AM W___44
r VENT 97ROM AE iAl OR hOUSING VENTED THROUGH HOUSE
F1 POR Twu 09 UtST-0.0
ECTRONIC COIN—1-ROL CENTER
Y
r V GFI OUTLET d MAC;CDRO 13LEER i ATM OYM LK-01 10 OJEL A-EN&VATE 13,
moxmisr W-0 PER Ta"Con-auft 1 K"
MOUNTED WITHIN VIEW OF TREATMENT Ti ANK IAL ell
we'S-T DEEP LEACHING GALLEYS
EXPANSION r,,,-LE-Y
U)
%st
ui
A, losp �v -
- " I -T UR
1197FPPR0P0SEDA5F>l4A DRIVEls'VAY 'AREA OF PIROPOSEEGIVEGETATED NON
A F
LT
BUFFER,INCLUDING EXISTING AM
x =Ih _T2
c:
A96 A_9vFpoxAlAu_Lv am IFT 4= ADDITIONAL!Y PROPOSED PI ANT
REMOVE:2,MG FT-1 OF ASPHALT DRIVEWAY 'AV pum I u%N�GEW w MWAA m I WWN T TA S-A-0 P R M I ELY 4,290
vvm mm
0-
Ak
DUNDA F V ljv=E i L A14 D 0 RYTOB-
A VEGETA ED NON-TURF BUFFER ui 0
A B AN L-70 N E D WE L L lRiaATION TO BE USED FOR IS 0.
AIL:
PUMPING.Ai I
i VK
A P R OXI NA T ELY 6 70 FTJ 01 F ADD IT 10NAL F
ca PROFOASED VEGETATED NON-TURF BUFFER
DRY WELLS FOR SITE DPAINAGIf fill,
11)X90 x 6 DEEP DRYWELLFOR GAIRAGE RUNOFF
XIS TING LJlvwN
a IN PLAGE:OF E_-
il)a'D x B'DEEP DRYWELL FOR
SWIMMING POOL BACKWASH
Lo
AlSr IST FLOOR ROOF EIGHT OVER 5958 FT,
T T POIRTION OF EXIS,ING 1-5,ORY ELFLING
j-ND ELDON-
"ODD DECK TO REMAIN EXISTING 336 FTI W
*Iml AS A&LDED
-e-
PROPOSED i 19 FT'DECK ADDITION PARrIALLY
v
-"M
IN PLACE OF:EXISTING ENCLOSED PORCH
XJV
EXIST N-
ING 533 Fl�ENCLOSED PORCH A.
VF 117 F`i-v U N C OV E rl E D IV6Z-:6 P 0 RCH T 0'B F_R F MIOV E Ll U)
m1h
PROPOSED I STORY_W Fi A A ION
ol
E OF ENCLOSED ARTIAi LY IN PLAC LLI
H 0��ORL. D UNCOVERED WOOD PORCH
W
_T CRIlASEIN FOOT PRINT)(NE.250 F F IN
A
C)0 Lu
N 0>z
A*'
Lu
> >
'V Lu
z
Eno CC ly Ea
w Z)
EXISTING SEE, TO RE REMOVER
p -4"1 A
CL
AS PER S---DHS REGULATIONS
U_
LL
FAIST !ra*5'awv&AL'laAoAAN
TO BE RELZCATEID ALL-�-k;k4i3—A
Z
EX!S-,.Ils US GARA1,3E TO REIAA-N
ad
FFE:10 91 FIRST ELOORI�ocfl PRINT 582PT�
Too
5 t-lLjLL4'C,,A;d;LqLA I A L�jk LLF CC�y I�7�0-V7WJhN Ae�V_W,�,A Ulc
V
�k, to
er-P.—LAL_'��Lm, -Wr—
A.L
SANITARY SITE PLAN F_
J
2V o' 20' 4w
DATE: 082025
SCALE� AS NOTEDI,
--d e�
�_A
EXISTING UTILITIES TAR a 'cw cc�kp SHEET
%034 Tl REE-li.%E TO BE:
Ile
I_c i$ .1r,r a
REMGVED�WIT IN li�1701`
oi.m
WETLANDS BOUND.ARRY EXISTING TBR
OF 1 SHEET
a
mm
, Fu
e
..-paem um
n -
EAU�_. � �
__ Mtn
7_11- - —
E e �
1 a
_
� =04 pjak
E
MUDF
l _
e
_.
Id-
f
i•
r
sx. r-
ch RL
r
T _
-,SANITARY SITE MENT NYSDEC
�S 1
- APPROVED AS PER TERMS
AND C
DATE 44
s - - -
1 � = F-c
�.- -
- e - _
_ _ —
I
LU
WWI
cn
m� . €..
- - -- -- - -- - -- e _ F _��. � z W
S.; .: .. y _ � _ _ ❑
- -
e - 021tea:`.o ®®.
� _ I_
- -
F
__
_ .. �
i
Ljj
ui
THOT
to-
3
1'sa � €"
i - F t19 WWCON
21
Ica
H SCALE-, AS NOT'E
- „ s£
e
= � - —
HIZED]A PROFILE
_
E
OF 2 SAS
VIJ
r
N
M i
P � NM
I
Southold, N.Y. 11971
HENRY E.RAYNOR,Jr.,Chairmn TELEPHONE
JAMES WALL
?65-19.38
BENNETT ORLOWSKI,Jr.
GEORGE RITCHIE LATHAI41,Jr.
WILLIAM F.MULL.EN,Jr.
October 14 , 1983
Mr. Edward Tashjian
401 Littleworth Lane
Sea Cliff, New York 11579
Re: Vincent Annabel
Minor Subdivision
Dear Mr. Tashjian:
The following action was taken by the Southold Town
Planning Board, Tuesday, October 11, 1983 .
RESOLVED that the Southold Town Planning Board approve
an amendment to Condition #3 of "Vincent Annabel Minor Sub-
division" to reduce the 100 foot setback to a 75 foot set-
back from the upland edge of tidal wetlands and shoreline
of Eugenes creek .for the construction of a residential
structure.
rev ,&
I 'd Very truly yours,
a
d HENRY E. RAYNOR, JR. , CHAIRMAN
D OWN PLANNING� U'�'HgLD T AN�+T IBC BOARD
4 /4-
By Susan E. Long, Secretary
D=er, Traqw
From: Lanza, Heather
Sent: Tuesday, April 14, 2026 1:49 PM
To: Dwyer, Tracey
Cc: Nunemaker, Amanda;Verity, Mike
Subject: FW: Inquiry re: Graf Irrevocable Trusts, 137-8-8.3
Attachments: So Trustees Permit 2-11-26.pdf,- RevSitePlanKSM02.12.26-BufferPostSV.pdf,- 225-49
3-2-26.pdf,- CO for house 1985.pdf,- 1000-1 37.-3-8.pdf,- 850926 site plan orig house
12899-z 14.pdf,- 850926 site plan septic orig house 12899-z 13.pdf,- 1984 Building permit
for house.pdf,- Graf letter to Planning.pdf
Hi Tracey,
I think this was yours.
The Planning Board's response on this was that at the time of the covenant, sea level rise was not anticipated.
They feel that in this specific case, if the building was originally the correct distance from the wetlands, and has
a c.o., then the old covenant should not apply to the new edge of wetlands, especially if the Trustees agree.
Usually old covenants must be upheld, but in this case the Planning Board felt that the requirement was met
when they built the house, and an unexpected occurrence of sea level rise has caused the issue. Their point was
that no one would make them move the house back because of that covenant if they didn't happen to have had a
fire.
Let me know if this is enough to put this issue to rest.
Thanks,,
Heather Lanza,,AJCP
Town Planning Director
Southold Town Planning
54375 State Route 25
P.O.Box 1179
Southold,New York 11971
Phone: (631)765-Y 93S
E-mail: die ath,,erl'O so,uthold't o,wn,n,,il.,OOvI
From: Robert Herrmann<rherrmann@enconsultants.corn>
Sent: Wednesday, April 1, 2026 1:09 PM
To: Lanza, Heather<heather.la nza @town.so uthold.ny.us>
Cc: Michaelis,Jessica<jessica.michaelis@town.southold.ny.us>
Subject: Inquiry re: Graf Irrevocable Trusts, 137-8-8.3
Hi Heather,
Hope you are well. At your earliest convenience,please take a look at the attached letter and documents and kindly let
me know if you can provide a determination based thereon or if you need any additional materials submitted. We will
also drop off a complete hard copy set of the letter and attachments.
Thanks so much,
Rob
Robert E.Herrmann,MEM
Coastal Management Specialist
En-Consultants
1319 North Sea Road
Southampton,NY 11968
Phone: 631-283-6360
Fax:631-283-6136
Email:rherrmann@enconsultants.com
www.enconsultants.com
N.
Vim,
110�9]f N 0 j 4�fpo�
YN-MM,";'pi I I'rV j, qifl!] f,In, 91" r. i 77j"777"R
ir 1,
I Ji J10,
lip
4A
W,
BOARD OF SOUTHOLD TOWN TRUSTEES
lk
"w"
SOUTHOLD, NEW YORK
AZY
PERMIT NO. 10923 DATE- FEBRUARY 113
'T ui/a/d 10t18
iil
ISSUED TO: THE LIALIJa GRAFIRREVOCA]ILE Tfflua, &
THE,SU"S,A.N'H.,G IRREVOCABLE,TRUST ula/j .
d 10/18/
P)�
AW
J101,11
V PROPERTY ADDRIESS: 4855 STILLWATER AVri.,,N`U,3,f-,!Jf.4CHO,G1L,
SCTM#1000-137-3-8.3
11
� �
AUTHORIZATION Ilr �
ff
iA
liv
e el l
in
e provisions of Chapter of the Town Code of the Town of Southold and
Pursuant to thby
accordance with the Resolution of the Board of Trustees adopted at the meeting held on FebruaU 11,2026,and
F IRREV BLE
in consideration of application fee in the sum of$1,250. paid by T,HE,'ML1LL1AMJ,
11 IRREVQCABLE,TRUS."l ud, I
0/ V2 and subject to
wag 18,&T
kill
the Tens and Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and
T, p ennits the following;
Wetland Permit to demolish(Per Town Code Derinition of Demolition)portions of fire damaged 1,325
one single-family dwelling and to construct additions and alterations consisting of constructing a
NA y
raising -story
kr�� % 727sq.ft.second floor addition, the roof over a 598sq.ft. portion of first floor, a 212sq.ft. two
f overhang to
addition with a 74sq.ft. entry porch and steps(partially In place of covered patio and 41 roof
iE
0
4 be removed}; a 546 one-story addition a nd 1 19sq.ft. deck ad dition(pa rtially i n p late of enclosed and
uncovered pore hes to be removed);install new window wells-, replace waterside steps with new 2.7'x I V
1 51,
steps- maintain existing 141x24'attached deck by replacing decking us needed; maintain existing 55sq.ft.
playhouse/deck; install a 4'x7.3' outdoor shower(piped to drywell); remove existing septic and install a
14 FYI
new I/A OWTS sanitary system landward of dwelling- install a stormwater drainage sy stem,including a
I
it
pool drywell for a proposed swimming pool installed outside Trustee jurisdiction; and to establish and
-turf buffer area in place of existing lawn to the
perp etually maintain a 10' wide,670sq.ft.vegetated non
-turf
south of the playhouse, landward of the approximately 3,620 sq.ft,area existing plfl ftfings 8190 to be
permanently maintained as a vegetated non-turf buffer area,for a total of an approximately 4,290sq.ft.
d,
vegetated non-turf buffer area; and as depicted on the site plan prepared by Marescm &Associates,, i
tln
received on February 20,2026,and stamped approved on.March 2,2026. 43 1 2,
IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed,
MrN
11 and these presents to be subscribed by a majority of the said Board As of the day-and year written above.
J1
A
4 1PI"
r
6
t #ri VLA..o,
................. ..... .... ... ..........
1 4 1
i,N r,0111 f
j,
�y
AA
.............
......... ..............
1
TERMS AND CONDITIONS
The WI 1RREVQCA, LF,TRUSTuad 10/1e P I AF 9........... -SAN"H
'lwa l 0 1 St�l er a Cutclio&,u"e,New York as part
GRA f(__JRREV0CARLh_*�J&.U,S]:u/a/d,
of the consideration for the issuance of the Pennit does understand and prescribe to the following:
L 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 Permitted will,at his or her own expense,defend any and all such
suits initiated by third parties,and the said Pertnittee asstunes 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 prior to expiration,
3. That this Pen nit should be retained M' definitely,or as long as the said Pcrmittee wishes to mamitain 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 provistions of the originating application may be cause for revocation of this
Permit by-resolution o b f the said Board.
S. A permit issued for work not including a demolition as per the definition in the Town Code,but
subsequent to issuance,the work results in a demolition,the permit is voided and a new application
must be submitted,
6. That there will be no unreasonable 'interference with navigation as a result of the work herein
authorized.
7. 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,
81,. 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 Board of Trustees,the work shall cause
unreasonable obstruction to free navigation,the said Peffnittee will be required,upon due notice,to
remove or alter this work project herein stated without expenses to the Town of Southold.
9. The Pennittee 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.
10. That the said Board will be notified by the Permittee of the completion of the work authorized.
11. That the Permiftee will obtain all other permits and CODSentg that may be required supplemental to this
permit,which may be subject to revoke upon failure to obtain same.
12. 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 impaniment of any rights, title,or interest in real or personal
property held or vested hi a person not a party to the permit.
��� ,
Glenn Goldsmith,President � � �" Town Hall Annex
A.Nicholas Krupsk i, Vice President 54375 Route 25
Erie Sepenoski P.O. Box 1179
Liz+Gillooly Southold,NY 11971
Joseph Finora � Telephone(631)765-1892.
Fax (631)765-6641
BOARD OF TOWN TRUSTEE
TOWN OF SOUTHOLD
YOU ARE REQUIRED ED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES
72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN
APPOINTMENT FOR A. PRE-CONSTRUCTION INSPECTION, FAILURE TO CEO SO
SHALL. BE CONSIDERED A VIOLATION LATION AND POSSIBLE REVOCATION ATIO OF THE
PERMIT.
INSPECTION SCHEDULE
Fora-construction, hay bale line/silt boom/silt curtain
Ist day of construction
% constructed
Project complete, compliance inspection
No. to�► a3
Issu ......
ed To W�U�°'"� �- S�`Sa^
Address yg� ....
SOT' ����'e� Ave, Cup c 041 ►�
TH IS N OTICE MUST E DISPLAYED DURING CONSTRUCTION
TOW- N TRUSTEES OFFICE,TOWN OF SOUTHOLD
SOUTHOLD. N.Y. 11971
TELm: 765-4892
TM
V
ofb
RIESch
Compliance Certificate
Project Information
Project Title: 4855 Stillwater Avenue
Energy Code: 2025 Energy Conservation Construction Code of New York State
Location: Cutchogue,New York
Construction Type: Single Family
Project Type: New Construction �-
Project Sub Type: None
Orientation: Bldg.faces 270 deg.from North
Conditioned Floor Area: 2768 ft2
Glazing Area: 23%
Climate Zone: 4a(5572 HDD)
Project No: 1837430
All Electric: false
Is Renewable: false
Has Battery: false
Has Charger: false
Has Heat Pump false
Construction Site: Owner/Agent: Designer/Contractor:
4855 Stillwater Avenue John Condon Sr
Cutchogue,NY 11952-3361 1755 Sigsbee Rd
Condon Engineering
Mattituck,NY 11952-3361
6312981986
condoneng@optonline.net
Project Notes:
Energy Credits
t
Description Credits
R408.2.3(2)(a):Gas-fired instantaneous water heaters(Option 1) 6.0
R408.2.5(1)ERV or HRV installed 0.0
R408.2.2(2):High Performance Cooling(Option 1) 2.0
R408.2.6 Energy efficient appliances 1.0
R408.2.3(8):Compact hot water distribution 2.0
R408.2.11 Higher efficacy lighting 0.0
Report Title: 4855 Stillwater Avenue Report Date: 3/3/26, 10:55 AM 1 of 14
WM a
cirivelope, Assemblies
Prop. Req.
Assembly Gross Area or Cavity Cont. U_ U_ Prop. Req.
Perimeter R-Value R-Value Factor/ Factor/ UA UA
F-Factor F-Factor
Ceiling:Cathedral Ceiling 2090 49.0 2.0 0.021 0.026 44 54
Floor 1;All-Wood joistfT-russ 1000 44.0 2.0 0.022 0.033 22 33
Wall West:Wood Frame, 891 21.0 2.0 0.050 0.045 29 26
1611 O.C.
Orientation:Front
Window 1:Wood Frame 14 0.300 0.270 4 4
SHGC:0.34
Orientation:Front
Window 2:Wood Frame 17 0.300 0.270 5 5
SHGC:0.34
Orientation:Front
Window 3-Wood Frame 168 0.300 0.270 50 45
SHGC:0.34
Orientation:Front
Window 4:Wood Frame 10 0.300 0.270 3 3
SHGC:0.34
Orientation:Front
Window 5:Wood Frame 15 0.300 0.270 5 4
SHGC:0.34
Orientation:Front
Window 7:Wood Frame 8 0.300 0.270 2 2
SHGC:0.34
Orientation:Front
Window 6:Wood Frame 15 0.300 0.270 5 4
SHGC.-0.34
Orientation:Front
Window 8:Wood Frame 10 0.300 0.270 3 3
SHGC:0.34
Orientation:Front
Window 9:Wood Frame 10 0.300 0.270 3 3
SHGC:0.34
Orientation:Front
Window 10:Wood Frame 10 0.300 0.270 3 3
SHGC:0.34
Orientation:Front
Window 1:Wood Frame 18 0.300 0.270 5 5
SHGC-0.34
Orientation:Front
Door 1:Glass Door(over 23 0.300 0.270 7 6
50%glazing)
SHGC:0.34
Orientation:Front
Wall North:Wood Frame, 803 21.0 2.0 0.050 0.045 35 31
161,O.C.
Orientation:Right side
Window 1:Wood Frame 18 0.300 0.270 5 5
SHGC:0.34
Orientation:Right side
Window 2:Wood Frame 18 0.300 0.270 5 5
SHGC:0.34
Orientation:Right side
Window 3:Wood Frame is 0.300 0.270 5 5
SHGC:0.34
Orientation:Right side
Window 5:Wood Frame 16 0.300 0.270 5 4
SHGC:0.34
Orientation:Right side
Window 4:Wood Frame 18 0.300 0.270 5 5
SHGC:0.34
Orientation:Right side
............. .................................
Report Title: 4855 Stillwater Avenue Report Date: 313/26, 10:55 AM 2 of 14
Prop. Req.
Assembly Gross Area or Cavity Cont. U_ U_ Prop. Req.
Perimeter R-Value R-Value Factor/ Factor/ UA UA
F-Factor F-Factor
Window 6:Wood Frame 16 0.300 0.270 5 4
SHGC:0.34
Orientation:Right side
South Wall:Wood Frame, 803 21.0 2.0 0.050 0.045 34 31
1611 O.C.
Orientation:Right side
Window 1;Wood Frame 37 0.300 0.270 11 10
SHGC:0.34
Orientation:Right side
Door 1:Glass Door(over 78 0.300 0.270 23 21
50%glazing)
SHGC:0.34
Orientation:Right side
Basement Wall 1:Solid 276 0.0 21.0 0.038 0.050 9 12
Concrete or Masonry
Orientation:Front
Wall height:8.00
Insulation depth:8.00'
Insulation position:
Integral Insulation
Window 1:Wood Frame 20 0.300 0.270 6 5
SHGC:0.34
Orientation:Front
Window 2:Wood Frame 20 0.300 0.270 6 5
SHGC:0.34
Orientation:Front
Basement Wall 2:Solid 344 0.0 21.0 0.038 0.050 13 17
Concrete or Masonry
Orientation:Left side
Wall height:8.00
Insulation depth:8.00'
Insulation position:
Integral Insulation
1,pg'1 i i !'11 slillimilig III
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.
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 2025 Energy Conservation
Construction Code of New York State requirements in REScheck-Web and to comply with the mandatory requirements listed in the
REScheck Inspection Checklist.
low
Name-Title Date
Report Title: 4855 Stillwater Avenue Report Date: 3/3/26, 10:55 AM 3 of 14
Inspection Checklist
Energy Code:2025 Energy Conservation Construction Code of New York State
Requirements: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.
Pre-Inspection/Plan Review
Section Plans Field
Verified Verified
&Req.10 Pre-Inspection/Plan Review Value Value Complies? CommentslAssumptions
................................. -----------------------
105.1, Construction drawings and Complies
105.2 documentation demonstrate Does Not
[PR1]1 ener,yy code Compliance for the
buill ng envelope.T hermal Comply
envelope,air barriers,energy Not
credits,renewable energy,, QOservable
battery,Storage,solar ready
systeti�s and energy compliance 0 Not
path represented on Applicable
construction documents.
105.1, Construction drawings and Complies
105.2, documentation demonstrate
403.8 ener? , d Does Not
y,co e compliance for,
pornply
JPR311 1110 ihg and mechanical
systenis.Systemsserving Not
multiple,dwelling unks must
I Qservable
demonstrate compliance with
the,IECC Com,rnercial Provisions. Not
Opplicable
wwwwwwuw�mmn ..................... ........
302.1, Heatin and coolin equil ment Heating- Heating: Complies
403.7 is si, per ACCA P' a:i ps Btu/h,,r, Stu,ffii
'--.......... .................
❑Does Not
[PR211 based on loads calculated per I-- -
ACCA Manual, or other,methods I--........... Comply
approved by tthe code,official., Cooling: Cooling: Not
0 servable
............. Not
Applicable
Additional Comments/Assumptions:
..................... ......
1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3)
.............................................................
Report Title: 4855 Stillwater Avenue Report Date: 3/3/26, 10:55 AM 4 of 14
Foundation Inspection
Section Plans Field
Verified Verified
&Req-ID Foundation Inspection Value Value Complies? Comments/Assumptions
ry
303.2 Conditioned basement wall E)Complies
[F0511 insulation installed per
manufacturer's instructions. Does NotPomply
2C► ot
Nat
[D Not
Applicable
.............__...............— 1
40-3.8 Sy'sterns,serving,multiple Complies
[F191]2 dwelling,units comply,with Does Not
Sections C403and C404 of the
commercial code. amply
Not
servable
Not
Applicable
403.9.1 Heating,systerns,installedJor Complies
(F19212 outdoor,heatin are radiant 0 Does Not
systems cone 011ed by,
occupancy sensing oi timer Comply
slwitc,h. Not
Oqservable
[]Not
Applicable
rz..............
403.9.20 Snow and ice-melting system Complies
403.9.3# controls installed to shut off Does Not
403.9.4 system When,pavement Pomply
[F19212 temperature�>50f and no
precipitation or automatic Not
controls to shut off the system Qsenrable
when outdoor temperature>
40F. [D Not
Applicable
............... ............
303.2.1 A protective covering I's Complies
[FO11]2 installe'd to,protect ex, osed Does Not
exteribrinsuliation,ailextends Pomply
a mint um of 6 in.below grade.
OqNot
servable
0 Not
Applicable
402.2.9 Conditioned basement wall ft ft 0 Complies See the Envelope
[F06]1 insulated in accordance with ........................... Does Not Assemblies table for
Table R402.1.3 with insulation values
depth the minimum of 10 ft Pomply
below grade or to the basement Not
floor. Oqservable
� Not
pplicable
Additional Comments/Assumptions:
I High Impact(Tier 1) 2 ............. Medium!"Tp 3 Low Impact(Tier 3)
Report Title: 4855 Stillwater Avenue Report Date: 3/3/26, 10:55 AM 5 of 14
Framing f Rough-in Inspection
Section Plans Field
Framing/Rough-in Verified Verified
&Req.ID Inspection Value Value Complies? Comments/Assumptions
303-1.3 U-factors of fenestration Complies
[FR411 products are determined in
accordance with the NFRC test Does Not
procedure or taken from the Pomply
default table. QNot
servable
Not
Applicable
................................. ...................... ...........
402.5.1.1 Air barrier and thermal barrier Complies
[FR2311 installed per manufacturer's Does Not
instructions. Comply
QNot
servable
r--)Not
Applicable
...........
402-5.3 Fenestration that is not site built 0 Complies
[FR20]1 is listed and labeled as meeting Does Not
AAMA/WDMA/CSA
101/i.S.2/A440 or has infiltration Comply
rates per NFRC 400 that do not Not
exceed code limits. Paservable
(3 Not
Applicable
402.5.4 IC-rated recessed lighting Complies
[FR16]2 fixtures sealed at Does Not
housing/interior finish and Complylabele to indicate---2.0 cfm
leakage at 75 Pa. Not
Qservable
0 Not
Applicable
403.4 HVAC pipinq conveying fluids f tql, 4
Complies
(FR1712 above 105 OF or chilled fluids R..R.................................................................................................. Does Not
below 55 QF are insulated to>R ❑-
3. Comply
Not
servable
❑Not
Pplicable
403.6 Automatic or gravity dampers Complies
[FR1912 are installed on all outdoor air Does Not
intakes and exhausts for
mechanical ventilation systems. Pomply
Tat
ervable
Not
Applicable
1 Ventilation systems in climate 0 Complies
[FR3012 zone 6 shall utilize heat or Co Does Not
energy recovery with balanced Comply
ventilation and a sensible
recovery efficiency(SRE)>= Not
65%at 32 F. Qservable
[D Not
Applicable
403.3.3 SUPPIT and return ducts in attics Complies
[FR12]1 ed>=R-8 where duct is Does Not
>=3 inches in diameter and
>=R-6 where<3 inches. Does
RNot
servable
0 Not
Applicable
Report Title: 4855 Stillwater Avenue Report bate: 3/3/26, 10:55 AM 6 of 14
Section Plans Field
Framing/Rough-in Verified Verified
&Req.lD Inspection Value Value Complies? Comments/Assumptions
403.3.6 Ducts,air handlers and filter Complies
[FR1311 boxes are sealed with ❑Doeply s Not
joints/seams compliant with Com
International Mechanical Code
or International Residential Not
Code,as applicable. I Rservable
[D Not
Applicable
............ ......
403-4.1 Protection of insulation on HVAC 0 Complies
i
[FR24]1 piping. D Does Not
Comply
qNot
servable
Not
Applicable
403.5.2 Hot water p)"pes are insulated to .............................................. 1 E)Complies
R�>1 inc of insulation.
[FR1812 h ................................ Does Not
Pomply
WsNot
ervable
D Not
Applicable
402.5.5 Air-sealed electri_ ,�. �. n, ,,,,,,,, „,r ,�,,rrY
cal and C)Complies
[FR2912 communication boxes installed in,the thermal boundaryboundaryof the .F 1 Does Not
envelope seated to limit Comply
air-
leaka,9, 0 betwelenconditioned Not
and unconditioned spaces. qOservable
C)Not
Applicable
....................
403.3.1 Duct systems are design and Complies
[FR12]1 sized in accordance with ACCA
Manual D based on HVAC sizing Does Not
calculations in R403.7.Duct Pomply
systems servin g mul tipl.e Not
dwelling,units is sired in Oqservable
accordince with ASHRAE
Handbook of Fundamentals, Not
ACCA Manual D or an equivalent Opplicable
methodology.
1403.3 Duct systems are design and ElComplies
[FR31]1 sized in accordance with ACCA Does Not
Manual D.Duct systems serving
multiple.dwelling,units is sized Comply
in accordance with ASHRAE Not
Handbook of Fundamentals, P3servable
ACCA Manual D or an equivalent ED Not
methodology. Applicable
.......................................
402.1, Glazing U-factor(area-weighted U 0 Complies See the Envelope
402.4.10, average). ................... Assemblies table for
402.4.3, PO Not Does values
402.6 mply
[FR2]1 Not
Oqservable
[]Not
Applicable
Additional Comments/Assumptions:
h Im a Tier 1) 2 Medium 11 act(Tier 2) =1mact(Tier 3)
Hi,9
Report Title: 4855 Stillwater Avenue Report Date: 3/3/26, 10:55 AM 7 of 14
Insulation Inspection
............ .............
Section Plans Field
# Verified Verified
&Req.11113 Insulation Inspection Value Value Complies? Comments/Assumptions
................ .........
303.1 All installed insulation is labeled Complies
[IN13]2 or the installed Et
provided. Does NotPomply
qNot
servable
(D Not
Applicable
................................
303.2 Wall insulation is installed per Complies
[IN4]1 manufacturer's instructions. Does Not
Comply
Not
servable
E)Not
Applicable
402.1, Floor insulation R-value. ...................................................................................... Complies See the Envel9pel
R
402.2.,8 Does Not Assemblies table for
[IN1]1 Wood Wood Comply values
(D Steel El Steel n Not
Observable
0 Not
Applicable
............. ..........................
303.2, Floor insulation installed per C]Complies
402.2.8 manufacturer's instructions and Does Not
[IN2]1 in substantial contact with the
underside,of the sub floor,or Pomply
floor framinet cavity insulation is Not
in contact Wth the top side of Qservable
sheathing or a combination of
cavlt+ing continuous'Insulation Not
is Installed so cavity insulation Ppplicable
is in contact With top side of
continuous insulation.
Wall insulation R-value.If this is 0 Complies See the Envelope
402.2.6, a mass wall with at least 1/12 of ............ Does Not Assemblies table for
402.2.7 the wall insulation on the wall OWood D Wood values
UN311 exterior,the exterior insulation mply
requirement applies(FR10). 0 Mass �E)Mass Po Not
Steel Steel servable
NotIN
Applicable
402.2.3, Wood attic knee walls or roof 0 Complies
402.2.3.1 trusses separating conditioned
[IN14]1- space from unconditioned attic Does Not space comply with"die, Pomply
insulation requirements In Table Not
R40,21-1:Attic knee walls Rservable
contain an air barrier between 0 Not
the conditioned and
unconditioned space. Applicable
Additional Comments/Assumptions:
I High Impact Mier 1) 2 Medium Impact(Tier 2) ............. .............. Low I!gp.act(Tier_p ......
Report Title: 4855 Stillwater Avenue Report Date: 3/3/26, 10:55 AM 8 of 14
Final Inspection Provisions
Section Plans Field
Verified Verified
&Req.ID Final Inspection Provisions Value Value Complies? Comments/Assumptions
. .............. ........... .............. ......
303.1.1.1, Ceiling insulation installed per Complies
303.2[F12]1 manufacturer's instructions. Does Not
Blown insulation marked
every 300 ft2. Comply
qNot
servable
0 Not
Applicable
303.3 Manufacturer manuals for Complies
[FI18]-3 mechanical and water heating Does Not
systems have been provided. Comply
(9Not
servable
11 Not
Applicable
403.1.2 Heat pump,supplementary 0 Complies
[F110]2 heat controls to prevent Does Not
supplemental heat,when heat
Dump compressor can serve Comply
the heating load. Not
9servable
0 Not
Applicable
403.2 Hot water boilers have Complies
(F126]2 automatic outdoor setback
control to lower boiler water Does Not
temperature based on outdoor Comply
temperature,indoor Not
temperature or water Nat
temperature sensing.
0 Not
Applicable
403.3.6.1 Air,handler,leakage Complies
[F12411 desiviriated b manufacturer Does
at< ��2%of Yesign air flow. pomply Not
WNNat
ervable
Cj Not
Applicable
4033.7 Ducts are pressure tested in _.. 0 Complies
[F12711
accordance with
ANEI/RESNET/ICC 380 or cfm/100 ft2 cfm/100 ft2 Does Not
ASTME1554 to determine air Pmply
I eal a
k e wftb,elther.Rough-In Not
test:-T� Wervable.
otal leakage measured
witha ressure differential of
0.
I W.q.across tie "
Not 9
system including the applicable
manufacturer's air handler
enclosure if installed at time
of test.Postconstruction test:
Total leakaWe measured with a
pressure d erential of 0.1
inch w.g.across the entire
system including the
manufacturer's air handler
enclosure.
403.3.8 Ducttikhtness test,result Of Complies
,r
-=4 - �nIIOO ft2 across the,
[F14]1 Does Not
Cfm/100 ft2 CfM/100 ft2
system or<=3 cfm/1,00,ft2, PO
Without air handler, 25 Pa, mply
Duct tightness,-t=811 dbil'100 Not
ft,2 for ducts within thermal Observable
envelope..For rough-in tests,
verific6don may need to occur, Not
during Framing Inspection. Applicable
403.5.1 Circulating service hot water, Complies
[FI11]2 systems Sa;eautomatic or
accessible m anual Does Not controls.. Pomply
Not
servable
Not
Applicable
Report Title: 4855 Stillwater Avenue Report Date: 3/3/26, 10:55 AM 9 of 14
Section Plans Field
Verified Verified
&Req.ID Final Inspection Provisions Value Value Complies? Comments/Assumptions
403.5.1.1.1 Demand recirculation water Complies
(F132)2 systems have automatic C]Does Not
controls to start pump when
hot water is requested. Comply
qNot
servable
[]Not
Applicable
................--—------............. .............. ........... ........................
403.5-1.1 Heated water circulation 0 Complies
[F128]2 systems have acirculation p Does Not urnp.I fie pipe
is a dedicated re,turn pipe,I or' Comply
Cold water,supply piper Not
GraVity,and thermos-syphon observable
circulation systems,are,nopresert Controls t
',r Not
er systemE Applicable
-m with
,r, emand
whin the ncy.Coritrols
automatically turn off the
puMp'When water is in
circulation loop is at set-point
temperature and no demand
for hot water exists.
.5.1.2 Electric heat trace,%sterns Complies
F12912 comp with,JE1 .1 or UL
,51 �ontrols,auto matically, Does Not
adj ust the e�nergy,inpu I t,to'the Comply eat tracing�to-Ma i 6ta I n"the Not
desired water temperature.in Qservable
the piping. [D Not
Applicable
403.5.3 Drain water heat recovery Complies
[F131)2 units tested in accordance Does Not
with CSA B55.1.Potable
water-side pressure loss of Comply
drain water heat recovery., Not
units<3 psi for Indilvidual Rservable
units connected to one or two showers.Potable water-side Not
ressure loss of drain water Ppplicable
eat recovery units<2 psi for
individual units connected'to
three or more showers.
............
401.3[F17]2 Compliance certificate posted E]Complies
with building specifications, Does Not
compliance patli.R408,energy
credits,results and solar Pomply
ready,zone if prvvided. Not
Oqservable
(3 Not
Applicable
..............
403.6.2 All mechanical ventilation Complies
[F125]2 systernfans not,part of"tested Does Not
a system listed HVAC equipment
meet efficac and air,flow Comply
limits per,Tagle R4,016-1, Not
Wervable
PNot
pplicable
..........
403-6.3 Mechanical ventilation 0 Complies
[F133]2 systems tested and verified to Does Not
meet the minimum flow rates
required by Section R403.6. Comply
PNot
oservable
Not
Applicable
..................
403.6.5 Intermittent exhaust for Complies
(F13412 bath rooms/toilet rooms has Does Not
automatic control,occupant Po mply
sensor control,humidity
control or contaminant Not
control. Oqservable
[]Not
Applicable
Report Title: 4855 Stillwater Avenue Report Date: 3/3/26, 10:55 AM 10 of 14
-------------
Section Plans Field
Verified Verified
&Req.ID Final Inspection Provisions Value Value complies? Comments/Assumptions
403.7.1 Electric resistance heating 0 Complies
[F16]1 total capacity for dwelling Does Not
units,sleeping units and
occupanices in the building Pomply
<—2.0 M. 1�Not
0 servable
0 Not
Applicable
402.1, Ceiling insulation R-value. .......................................................................... See the Envelope
R,- ;E)Complies
,402.2.1, 0 Does Not Assemblies table for
402.2.2, Wood Wood Comply values
'402.2.7 Steel Steel
[Fl1j1 Not
0
servable
Not
Applicable
........ ---------------
403.13 Gas fireplaces equipped with C]Complies
403.13.1 on-demand pilot,intermittent Does Not
IF13533 Ignition,or interrupted ignition.,
Fireplaceefficien?>50%in Goes
''S,
acc6rdance with A P.4.1 Not
Observable
(D Not
Applicable
404.1[F16]1 100%of permanent fixtures Complies
have high efficacy tamps. Does Not
Pomply
Not
servable
Not
Applicable
404.1.2 Exterior lighting ewer is Complies
[F135)3 belowthei allowable wattage 0 Does Not
in Table R404.1. Comply
[�Not
Observable
0 Not
Applicable
.................................. .........
404-1.5 Fuel gas lighting systems Complies
[F123]3 have no continuous pilot light. Does Not
pomply
WNot
ervable
El Not
Applicable
11111_,,,................................. ................ ......................
404.2.1, Permanent interior lighting 0 Complies
404.2.2 shall be controlled with either
[F136]3 a manual dimmer,occupancy Po Does Not
sensor or auto shut off control mply
based on occupancy built with Not
manual override. Wervable
ONot
pplicable
404.3 Exterior lightin 30,watts Complies
[F137]3 shafl,have the Roc,110win
controls:rnanual on tor I switch Does Not
with autornatic shut-off, Comply
automatic shut-off,in daylight Not
hours,and controls that Wervable
override automatic shutoff
that returns to automatic Not
control within 24 hours. Opplicable
404.4 Where renewable enn Does Not
o y Complies
[F(36]3 generation equi "it
installed,,sl Tattestation
for renewable.enerly credhs comply
(RECs)or ener t af bbutable Not
semi sates( k, assoclated, Rservable
withn the renewable energy, 0
,used for co mpH ance are FJ Not
provided to the code,official. Applicable
Report Title: 4855 Stillwater Avenue Report Date; 3/3/26, 10:55 AM 11 of 14
Section Plans Field
Verified Verifled
be Req.ID Final Inspection Provisions Value Value Complies? Comments/Assumptions
402.2.4 Vented attics with air Complies
(F122]2 permeable insulation Include, Does Not
baffle adjacent,to soffit and
eave vents that extends over, Does
insulation. I Not
Qservable
C]Not
Applicable
.......... ......................
408.2.2.1(2) Air conditioner installed with Complies
[F146]1 efficiency>=15.2 Does Not
SEER2/12.0 EER2 for
additional efficiency credit Comply
qNot
servable
(3 Not
Applicable
408.2.3(2) Gas-fired instantaneous water Complies
(a)[F161]1 heater efficiency>=0.92 UEF
for additional efficiency credit P Does Not
Comply
PNot
3servable
E)Not
Applicable
402.5.1.3 Blower door test @ 50 Pa. ACH 50 AR 50 Complies
i<=3.0 ACH50 in Clmate Zones 4-5 and<=2.5 ACH50 El ...................J L. Does Not
7D
in Climate Zones 6. Comply
qNot
servable
Not
Applicable
408.2.3.1 Dwellin unit designed with a 0 Complies
compae-
[F]70]1 hot water piping Does Not
layout so that the longest pipe
run between source of heated Does
water and farthest fixture Not
contains<=16 ounces of Observable
water for additional efficiency
credit 0 Not
Applicable
402.5.2 Wood-buml,,,fireplaCeS li�ave 0 Complies
(F1812 tight fitting e darnpers,and Co Does Not
outdoor air`for combustion. Comply
(9Not
servable
C]Not
Applicable
----—------ .................
408.2.5(1) 'An Energy,Recovery Ventilator 0 Complies
[F175]1 (ERV)>=50%latent 0 Does Not
re'Ce",lov /moisture transfer
(LA MT)or Heat Recovery Comply
Ventilator>=75%sensible Not
recovery efficiency(SRE)is Observable
installed for additional
efficiency credit O Not
applicable
-—--------—---------- .............. -—------
408.2.6 Refrie'rators,dishwashers Complies
I
[FI80]1 a nd c3othes wash ers/d rye rs
are ENERGY SITAR rated for Does Not
additional efficiency credit pornply
QNot
servable
PNot
pplicable
................
402.3 Radiant barriers comply with ............................................................................... Complies See the Envelope
Rj.
(F1431z ASTM C1313/CI313M and are Does Not Assemblies table far
installed in accordance with 0 Wood Wood PO values
ASTM C1743 0 Steel Steel mply
Not
Observable
(D Not
Applicable
Report Title: 4855 Stillwater Avenue Report Date: 3/3/26, 10:55 AM 12 of 14
............
Section Plans Field
Verified Verified
Req.ID Final Inspection Provisions Value Value Complies? Comments/Assumptions
WN .....
408.2.11 All hardwired lighting has Complies
[F18411 lamp efficacy>=90 lumens
per watt for additional Does Not
efficiency credit amply
QNot
servable
❑Not
applicable
403.1.1 Programmable thermostats Complies
[F19]2 installed for control of primary P Does Not
h,eatinp and cooling systems
and inj"tialty,set by mply
manufacturer to code
Not
specifilcations.
servable
0 Not
Applicable
Additional Comments/Assumptions:
..........
....................
2 Low Im
2) 3 ow Im act(Tier 3)
........."---
Report Title: 4855 Stillwater Avenue Report Date: 3/3/26, 10:55 AM 13 of 14
2025, Energy
Conservation
Construction Code,
of New, York State
Energy Efficiency
Certificate
Above-Grade Wall 23-00
Below-Grade Wall 21.00
Floor 46-00
Ceiling/Roof 51-00
Ductwork(unconditioned spaces):
Window 0.30 0.34
Door 0.30 0.34
Skylight 0.00
. ..............................
Heating System:
Cooling System:
Water Heater:
Name: Date:
Comments:
Report Title: 4855 Stillwater Avenue Report Date: 3/3/26, 10:55 AM 14 of 14