HomeMy WebLinkAbout53172-Z TOWN OF SOUTHOLD
a
BUILDING DEPARTMENT
T�Sod LDNY o
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT CAN THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 53172 Date: 08/OS/2026
Permission is hereby granted to,
Treed Farms LLC
2090 Sound Ave
Calverton, NY 11933
To:
Construct a new single-family dwelling to include HVAC system and pool/spa addition as applied for
per Land Preservation and SCHD approvals. Provide required pool barrier as per 2025 Residential
Code of New York State.
Premises Located at:
19SOO route 2% Mattituck, NY 11952
SCTM# 115.4-13.2
Pursuant to application dated 06/12/2026 and approved by the Building Inspector.
To expire on 08/04/2028.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling-NEW $6,756.50
SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $300.00
Co Single Family Dwelling-New $100.00
Total SMS6.0
Building Inspector
DEPA
iL � MEN
Main RoaTOWN OF SOUTHOLD
-0959
d P. O. �C�x 11�79 Southold,NY
1971
Tow Wall Annex 54375 M
1;� Te l ep o e (631) 765-102 Fax (63 l) 765-9502
Date Received
APPLICATION FOR BUILDING PERMIT rr= P
IDr
For office Use Only
JUN 1 2 2026
I.
Building inspectorm..... . � —
PERMIT NC3.
it entire ���incomplete �{c�it� DepartmentA Applications and forms be filled out in the an Town of Southold
pp Applicant�s not the�► ne�c� `�►
applications will not be-��pted. Where the App
ow
r er's Authc+ri anon (Page 2)shall be completed.
..
Date:4/101202
owNER(S)OF PROPEf
V SCTM#1000-11 -07-13.2
Name:TreeO FarrnS LLCM
Project Address.195 ',Main Road
attituck NY 11952
Phone#:(516) 807-3448
Email:'ef owenbrothers.corn
ue C:alverton, NY 11933
Mailing Address209 Sound Aven ��
C '
N� A
Na me.Wllarn Dares ° Barba Architectural Design
Mailing Address:po EBDX 1554 Quogue,
Email:wbarba@bardarch-carry
Phone#:(631) 998-M95
DESI
GN PROFESSJONAONFORMATION41
Name.Barba A►r
ch itrctu rai Design
Mailing Address:PO Ebx 1554 CCU
o ue NY 11959
Email:wbarba@bardarch.tom
Phone#:(631) 995_ W
COWRACTOR N
Name:Owen Consbu, ction Corp
Kin Address:48 Mzin St E�..,� Westhampton NY►each, � 11959
g
Email-m l ke(Coenconstructioncorp com
Phone#:(631) 288-4663
DESCRIPTION
ICON OF PROPOSED CONSTRUCTION
Iition Estimated cost of Project:
�New struct
ure F�Acldtion RAlteration ORepair DDemo 2,500,000
CJ 0ther ❑Yes W No
Will excess fill be removed from premises.
Will the lot be re-grade` ' Yes 0 No ,
PROPERTY INFORMATION
Existing use of property:Agricultural Intended use of property:Ag ricultural/Residentia I
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
A-C this property? *Yes 7No IF YES,,, PROVIDE A COPY.
R,Chei&Biox After Reading".1 The owner/contractor/design professional Is responsible for all drainage and storm water Issues as provided by
Chapter 236 of the Town Code. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone
Ordinance of the Town of Southold,Suffolk,County,,New York and other applicable Laws..Ordinances or Regulations,for the construction of buildings,
additions,alterations or for removal or demolition as herein described.The applicant agrees to comply with all applicable laws,ordinances,building code,,
housing code and regulations and to admit authorized inspectors on premises and in building(s)for necessary inspections.False statements made herein are
punishable as a Class A misdemeanor pursuant to Section 210.45 of the New York State Penal Law.
l iam BarbaApplication Submitted By nt na, e): RAuthori(priozed Agent [30wner
Signature of Applicant: Date:
CONNIE D.BUNCH
Notary Public,State of New York
STATE OF NEW YORK) No.OIBU6185050
SS: Qualified In Suffolk County
COUNTY OF Commission Expires April 14, 2-rWA6
William Barba being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the Architect-A ent
(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 2q
Notary Public
PROIRIERTY OWNER ALYTHORIZATION
(Where the applicant is not the owner)
re s i d i n g at 2-C7 3cp �A"l lf'l`7 (CA btf�ON 1`4V,
*
do hereby authorize \A/IL u-'b hem to apply on
my behalf toth V own of Southold Building Department for approval as described herein.
Signature Date
A
Print Ow et's Name
2
P
LILLIAN F.MCCULLOUGH ' 4���° OFFICE LOCATION:
Town Hall Annex
LAND PRESERVATION1 ` I 54375 State Route 25
EXECUTIVE ASSISTANT` � 37
Iillianm@southoldtownny.gov (corner of Main Rd&Youngs Ave)
Southold,New York.
Telephone(631)765-5711
Facsimile(631)765-6640 MAILING ADDRESS:
P.O.Box 1179
www.southoldtownn.gov � Southold,NY 11971-0959
DEPARTMENT OF LAND PRESERVATION
TOWN of SOUTHOLD
To: Tracey Dwyer, Building Department office Assistant
CC: William Barba(,wba,irba�Fi),'ba,,rc larch. of '
FROM: Lilly McCullough, Land Preservation.Executive Assistant
RE SCTM# 115.-7-13.2
Tree . Farms LLC
Structure/Use Application—Installation of Underground Water Line
DATE: July 23, 2026
The above-listed property is subject to a Town Development Rights Easement
("Easement"). on July 21, 2026, the Land Preservation Committee discussed the landowner's
proposal to install an underground water line on the above-listed property to service a proposed
single-family dwelling on the development rights intact Reserve Area. In connection with this
request, the Committee reviewed the Easement; survey dated April 16, 2026 depicting the
proposed dwelling; a survey dated June 11, 2024 ("PDR Survey"); and an Agreement for Water
Lines and Appurtenances ("Agreement").
The Easement Area includes a 0-foot-wide"Water Line Agreement Area.,"as depicted on
the PDR survey (attached). This area is subject to the Agreement (attached), which reserves a
"permanent and perpetual right and reservation . . . consisting of the right to install, operate,
maintain,repair,remove and replace . . .a subsurface water service line or line and appurtenances"
within the 3 0-foot"Water Line Area."
The Town purchased the Easement subject to the terms of this Agreement.The lando er's
agent, William Barba,confirmed that no area outside the Reserve Area or"Water Line Agreement
Area,"as depicted on the survey dated.June 11,2024(attached),would be disturbed in connection
with the installation of the,water lines or the construction of the proposed dwelling. Accordingly,
the Committee determined that the request as proposed is not inconsistent With the Easement terms.
Please feel free to reach out if you have any questions.
Atts: April 16, 2026 Building urve _115.-7-13.2
June 11, 2024 urvey_115.- -13.2
Water Line Agreement-1 15.- -13.2
a
o
f
UFFOLK COUNTY CLERK
RECORDS OFFICE
RECORD ING PAGE
Type of Instrument: AGREEMENT Recorded: 05/X6/2024
umber ref. ages: 5 At: 01:45:08 P
Receipt Number : 24-0063768
LI R: DOO 13249
PAGE: 1:13
District: Section: Block:. Lot
1000 115.00 07.00 013.002
EXAMINED AND CHARGED AS FOLLOWS
Received' the Following Fees For Above instrument
Exempt Exempt
Page/Filing $15.0D NO Handling $20.00 NO
COE $5.00 NO NYS SR.CHG $15.00 NO
Affidavit $0.00 NO T'P-584 $0.00 NO
Natation $0.00 NO Cert.:Copies. $6.2 5 NO
RP"T $200.00 N .
Fees Paid $271.25
THIS PAGE IS A PART, OF THE INSTRUMENT
THIS IS NOT,, A BILL
VINCENT PULEO
County Clerk, Suffolk County
�d.
RECORDED
Number of pages 2024 [lay 16 1:45.GC F'11
VEi'`CENT PL ILEC
CLERK OF
This document will be public SilFFOLK 'COUNTY
record. Please remove all L D nor i s;2r4 q
Social Security Numbers P 11
prior to recording.
Deed I Mortgag'a Instrument Deed l Mortgage Tax Stamp Recording I Filing Stamps
FEES
m
Pa e t FIIIn Fee logage ���;�,
9 9 � 1,Basic Tax
Handling 20• 00,
2. Additional Tax
TP-564 Sub Total
Notation Spec.lAssit.
6
JC 11
or
EA-5217(County) Sub Total Spec./Add.
EA-5217(State) TOT.MTG.TAX„
.P :S. �.C Dual Town Dual County
R A.
Held for Appointment
Comm.of Ed. . ....._ W__ Transfer Tax
Atfidavil
Mansion Tax
� x
The property covered by this mortgage is
rti'l,ed Copy' r or will be improved by a one or two
NYS Surcharge 1& 00
...... � family dwelling only.
Sub Total " .�°'�, �� ��" �� YES or NO
Other n�� �
Grand Total � If NO,see appropriate tax clause on
page# of this instru nt.
..............
4 Dist.1 5317190 1000 11500 0700 013002 02 5 Community Preservation Fund'
Real Proper) P S, Consideration Amount
Tax Service
Agency 7=2
" CPF`'Tax Due'
Verification
Improved
s Ilcrw°s is arge e�sds List Frop ny Owner ,ailing Add ms
6 RECORD&RETURN TO:- lVacantLand .
Attn:Abigail A.Wickham,Esq.
Wickham,Bressler&Gea a,P.C. TD
P.O.Box 1424
Matbtuck,NY 11952 T[3
TD
Mail to� Vincent Puleo,,Suffolk County Clerk 7 Title Company information
310 Center Drive, Riverhead, NY 11901
Co.Name
www.suf#olkcauhtyny.gov/clerk
Title
Suffolk County Recording & Ee
This page farms part of the attached Nreementfor Water Unes and A pu en,an,ces made
by: fSPECIFYTYPEV l STRUW
McCall Family,,Holdings Limited Partnership,,, L Premises herein is,situa:l d in,
SUFFOLK COUNTY,NEW YOLK.
TO In the TOWN of Southold
McCall-Family Holdings Limited Partnership,LLLP In the VILLAGE
or HAMLET of Mattituck
BOXES 6 THRU 8 BUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR To RECORDING OR FILING.,
N.
r
AGREEMENT FOR
WATER LINES AND APPURTENANCES
made this . "da of May, 2024 b McCALL FAMILY'
THIS INDENTURE, � Y Y Y
HOLDINGS LIMITED PARTNERSHIP, LLLP, having an address of 3370 Panthersville
Road, Decatur, Georgia 30034, hereinafter"Owner".
Whereas,Owner owns real„property'l ocated at 19500 Main R,oad',, Mattit ck,
New York 1W19 2.; TIVI#1000-11 -7 11 (the"'Property"),as more filly deacr�bed in
Schedule A,attached hereto, and
Whereas, Owner wishes to grant a permanent and perpetual water line
cribed in
{ � �and oft he e Property as d ��
installation area. t Line Area over the portion o
Schedule attached hyereto,for the Installation and al
�ntenance of a subsurface water
service line to be used solely for the purpose of providing water service•from the public
water distribution system for the Property.
WITNESSETH:
The Owner, in consideration of Ten Dollars($10.00)and other good and valuable
consideration, does hereby grant for itself and confirm that the property is and shall be
encumbered by:
A permanent an �perpetual right t and,re ervation, runnin,' °with the land,,
p
� nsistin� the right to natall operate,,maintain,in,repair,remove and replace.,at
Owner's,cost and expense,,asubsurface water service line a,'
lines and,appurtenances
wlthin the ort'ion�of Owner's Property described inSch Schedule attached and made a
part hereof(hereinafter the"',Water Llhe Areal, .
The water service lines installed pu rsua nt to this,agree en't shall be used for
the purpose of transmitting water from the pudic water distribution systernacross and
for the benefit of r e Property,and shall be and remain the personal;property,of the
Owner, its successors and assigns,forever.
Owner shall, rod t` `an tits
p ih sta lla1i
n st�n.d � ense ray �
repair or rn i ter an�ce,restore the a,ter�Lire Area,`tw the condition which,existed prior
p p
to the installation of service,line or,lines and after each exercise of its ri ht to maintain,
repair,remove or replace,the service line or lines Itactivity disturbs the Water Line Area.
'This,agreement shall not,preclude the installation and maintenance of water
distribution lines for water service within the Property.
This Reservation shall be forever binding upon Owner,its successors and
assigns,for the benefit of the Property,and Owner,its successors,and assigns.
IN WITNESS WHEREOF,the Owner has hereunto executed this Agreement on the
day and year first above written.
Q
mefn ar.wu.ruia wu¢.rc ewa mmau vrrU rff rFW m y r.jig mi iwn very µeve m, w •-W feww Bm .�5yn_mra vury re-w n ,my®A W^'^-w<i w v au,lda mw --w....aoN r w rrr 'fA Iw W M'"-,{f u "
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Grantor: McCALL FAMILY HOLDINGS LIMITED PARTNERSHIP, LLLP
5y: McCall Family Management Company, LLC,General Partner
Name: Ru sell C. McCall, Manage
State'of,NEW YORK }
County of Suffolk }ss.:
On'the !'. day of May,'2024, before me,the undersigned,a Notary Public in and for
said state, personally appeared RUSSELL C.McCALL
. r
personally known to me or proved to me on the basis of satisfactory evidence to be the
individual whose name is subscribed to the within instrument and acknowledged to me
that he/she executed the same in his/her capacity,and that by his/her signature on the
instrument,the individual executed the instrument.
-Notat Pub,fic
ABIGAiLA.WICKHAM
Notwry POW,,Stale of New Yo*
No.5,9281
WilledI 'f olk count
Cow Flo,EVUes,Sept 3%20
Schedule A--Description of Property
Schedule B—Description of Water Line Area
u ,
•mn i6 rrt..,,µ.0>nr iuw c.tee 4......
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SCHEDULE A
(Description of the Land--Entire.Parcel)
For Tax Map 11)(s):1000-115.00-07.00-013.002
ALL that certain plot piece,or parcel of Viand situate tying and being in teT,on of Sootol at
a Muck..County�°of So oily,and' to m of New York,being ounded and described as follows:
BEGINNING at thecornarformed by the In"tersertion of the westerly side of Locust,Avenue with the
southerly side ofl l Road and.from said,,point or-place of a innin ;
Rol' NIN' G THENCEatang the westerly side,of Locust,A,venue,South,8 degrees 11 minute!s 10 seconds
West 1073.76,feet(deed);1073 feet auto
E"NCE North 86 degrees 08 minut s o s econd4 W,ast 517 75 feet(deed),;,815.3 feet(actual);
THENCE North 'degrees 43 minutes 50 seconds East.22514 feet,(deed);224.53 actual)
'1 E� C `bout �,,96 degre s_2 iputes 40 seconds,East°l 91.42 fdeto
THENCE North,6 d6 rees 04,minutes,10,seconds East 6' 5.6 feet(deed);820.26 feet(actual)to the
souther°side of Main Road'
RUNNINGTHShIbE easterty,along the souither1q,st o of Main Road South 87 de reya 26 minutes 20
seconds East 675.36,feet deed),676.32 f t(:,actual)to the point,or place ofBEGINNING,
m
mnu ei(n^:buuum mmr m!Iwn mrx^:nrmM.*l µwawnev a WM'A,w,ruwnw:n vm ri.�.x•a IMYF�'WP^�umwm�wv-.@,dw�,we. m,�"^-:*I',q.:.:,3uR iYk� renow v¢u mr mr w ry mu uvss uvr •A- 15:^rc mm mw , P umw fines^ k,+fi '.,Fw nip on v ^.,p:,iv N A mm v "
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ni, iY0
SCHEDULE B—Water Line Area
McCall 1000-116.00-07.00-013.002
ALL-that,cedsal'n plot, '"ece or parcel ,f land,situate,lying and being In,they'Tows of Souiho'ld at
attituc ,.County of SuffolR and State.of New York,being bounded and de feed as follows'.
BEGINNING at the corner formed by the intersection of the westerly side,of.Locust Avenue with the
southerly side of Main Road(NYB Route 25),and from said point or place of beginning;.
RUNNING THENCE along-the westerly side of Locust Avenue,South 8 degrees 11 minutes 10.seconds
West 1673.69 feet, ,
THENCE North 88 degrees 08 minutes 00 seconds West 30.00 feet;
THENCE North 8 degrees 11 minutes 10 seconds East 1074 feet,more or less,to the southerly side of
*Main Road(NYS Route 25);
w
THENCE South 87'degrees 28 minutes 20 seconds East 30.00,feet,more or less,to the point or place of
Beginning.
OF
r'" WAY H0pt tlXmm^M�IW'9AL� l R * ..
$lURVEy
ANY NOT SHOWN T L���y��� 10" �`NEW
W.
Tate'Area=731,420 al. ,.=PtES OF,TKs s � ; r �
Premises n as: sl R"I r S
or 16.79 Acres SSE m S NOT a SDI
Main' Road M aft'�tuek
fO. iC "givers
Mari Road S.A, A ,5
��;p�'veneal
4�e Fence
row '°D� ° �" e comer
&oa f $T�B'2011E "�1 Polo 28'S
f.9'►!t
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I nd �. s OONE , 1
UN, dlYv�n�! 191.42' Rcbcr
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47 OZE
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Nod fence
Blossom 817-75'Dead
N86'08 00 W a.
Lai
Ben,d
Certified to; E3oundarry Survey of Described Property
TOWN OF SOUTHOLD "� � situate at
WCALL FAMILY HOLDINGS LIMED'PARTT E attituc
ADEM NATORk THE IN URMCE C4M€MY
Taw of ' authald
SO f 01 k County, New York
Mi ch aI;el W. ffin t o; L.S..P.C. , District 1000 Section 115 Block 7 P/0 Lot 13.002
LICENSED PROFESSIONAL LAND SURVEYOR � ,r y
YO K STATE LICENSE NUMBER 050871 Scale 1 = 150 Surveyed April 19, 2024
87 Woodv ew -.Lane
Centereach, N.Y. 11720 �' API-IC SCALE
PHONE/FAX: (63 f) 580-12112 160 Sao
CELLULAR, (631) 766--9714
EMAIL: mlkv.mintvlspc@gmall,com �re
IN FEET)
1 inoh = 150 ft.
Albert J. Krupski, Jr. � S]C'0]KI��1[WA\]C']ElK
SUPERVISOR ]NA[A\,NA\,G1EN111EN�F
SOUTHdLD TOWN HALL-P.O.Box 1179
53045 Main Road-SdiJTHOLD,NEW PORK 11971 � Town of Southold
CHAPTER 236 - STORMWATER MANAGEMENT REFERRAL FORM
APPLICANT INFORMAT[OlV TO BE COMPLETED BY THE APPLICANT
ONLY FOR PROPERTIES ONE ACRE IN AREA OR LARGER. )
APPLICANT: (Property Owner, Design Professional, Agent, Contractor, Other)
NAME: t.}Ic.�,;�� �S�"��+- Date:
(Pr� tyt} e7 4 , 12,126
15igrutKurel
Contact Information: C.Jof) n�(2
(E-Mail&Telephone Number)
J 019Z 2 3
1 a-,
Property Address / Location of Construction Site:
S.C.T.M. #: 1000
District
1/6 67 f3 2
Section Block Lot
TO BE COMPLETED BY SOUTHOLD TOWN ENGINEERING DEPARTMENT
- Area of Disturbance is less than 1 Acre. No S.P.D.E.S. Permit is Re wired!
Project does Not Discharge to Waters of the State. No S.P.D.E.S. Permit is Required
- 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 Building Permit.
- Area of Disturbance is Greater than 1 Acre & Storm-water Runoff Flows 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 through the Southold Town Engineering Department
Prior to issuance of a Building Permit.
Reviewed By: Date:
FORM SMCP-"f'OS December 2024 7 6
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Ap"M AOOO J*
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'flance cert'lifica-L,
comp
rr ecrWrafln
19500 Main Road
Project Title:
�- Conservation Construction Code of' �e York'Sta e
2025 Ene 9y
Energy Code:
M attituck,New'York
Location.
Single'Family
Construction T *'
New Construction
Project Type: alone
Project Sub Tye' 7564 ft2
Conditioned Fl a:
2 4%
Glazing Area, 4a(5331 HDD)
Climate Zone: 1871897
project No, false
All Electric: false
is Renewable: false
Has Battery' false
Has Charger,
false
Has Heat Pump
owner/Agent:ent: Designer/Contractor:
C�v+r g
Construction William 13arba
Jeff Owen 6: .-996-2395
19500 Main Roav wbar`ba brdarch.corn
Mattituck,NY ITE
Project Notes:
Energy dits CredytS
7.0
Deser t110n
thermal distribution 2.0
or hydronic
P.400.2.441�Duel R,408.2.2(2):Higoifformance Cooling(op 1
(option ) 6.0 R.408.2.3( (option 2�
2)(b):mired instantaneous water heaters(op
Report Date: 5/5126, 12:05 PM
1of13
Report Title: 195CMain Road
nvej0pV&0 S b �
Se�'Y1 , +�
Prop. Req. eq"
U_ Prep.
Cavity Cont. Factor/ TIC Y
Gross Area a►c -'Value R-Value Factor/
Assembly Perimeter F-Factor 'F-Factor
38 0 0,027
0.026 139 134
0.0
Ceiling-Hot Ro6-►thedral 5141 0.033 8 8
ceiling0.0 0.033
30.0 18,8 217
Floor;p,ll-V1lc�odruss 251 0,039 0.045
27.0 5.0
Wall.'�jlfood Fra"-6"'�,"�, 631�i 0,270 0.270 293 293
Window.Vinyl F" 1085 0.270 3 6
SHG,C; 0.3 0.140
Door 1;Solid Ddunder 21 102 102
50%glazing) 0,270 0,270
Door 1; Glass DI(over 377
50%glazing) 0,045 9 8
SHG�C; 0.3 19 8 27,0 O.t� 0,051
Wall-Partition: j 36
'Frame,16"O.C. 0.140 0.270
Door:'Solid Dodder 21
50%glazing) 15.0 0.044
t3,050 160 182
Basement.Wall:�'ld
3708 0,0
concrete or M13XI
eight"9A,
l'nst lotion d :p 0'
los,ulatior,1 05i* 0,270 8 8
integral Inul 0,270
Window:Vinyl Fes' 30 0.270 11 11
SHGC: 0.3 0,270
Door.Glass Doo*er 42
50%glazing)
SHGC, 0.3
se is based on code trade-off rules.It DOES
n,Code Index reflects how close to co mplianc
_cdehhorne.
The%Better o� ►ate of energy use or cast relative to a n,,inimum �i°�irES�chec � Each slab -grade.
provide a 1 ce ..M al
NOT p � � ce iatl'�i
w . ' ode�n�lu�lat" �..�e and de�l'l��~euire�w�ro��en�ts�
Slab-on-grade t
s are n longer considered�n e or energy code
co
bl in th- lied clirTnate zone must meet the minim
urn
y
Compliale, Statement
��� p and tier ulRn
n�� pe�c`�ic ..
,� � plc
y � �n a't
�wd �r `
nse
design,des here.�s corst�nt wtl t uirern� t listed in the
the 25 IEner y
The,proposed ���� uildiu e n �,� � � h ato � ,
��tn��: ��� proposed � � ��has��� the ��n �, � �
liC t'on the
s ,b����t'ted with �,nl fit, , rer'u� �rnejjts An R ��1� °, -We and r f ""
Construction �dew
1E5check jnspedtCbecklistA � .,
151
Matthew a ERRS Rater date
Signature
Name.�rytlf
Report Date: 5/5126, 12:05 P
20f13
Report Title: 195Pa1n Road
acklist
�ti� s ion Che
gY 2)� Con servati 011 C,onstruction Code of New York State
finer Cold e� &,e rgy
J ly ere addrf!,s5ed,dixeCUY in the RE501eCk Software 1�,T-:Scheck Requirements screen.For each
Re'cl;j ire ments,,I -4,%w d is provide-d by tjj,,e kj,$,P.r in the'
C OgL ASSU11 Orls,"c,olumn t,is documented,or that an exception is being
Text in the .Vts/A Ilplb ement wifl,be met and hfow tha ovided.
requj,renient,thew certihe�jl that a code re quir ate table.,areferencet,,lo thattable is pr
clainle,6-WheraVAiance isitemized in a separ
PgTion/Plan Review
A
Pre-ins .......
F iield
Plans ptions
Verified Comments/Assum
n (jan
Ver
ified Complies?
Sectio Value
# [p 'Review` ....................
*kIs Pe'c't 0 Complies
C1,.,%jVUIct'jan drawings and Does Not
I
105.1, dwev"Ita"jillon demoITSt,r'ate pomply
105.2 cedecwjpjjan,ce,fo,r the b0 Not
I
[PRIM eflv elope,,Thermal 9
air,barriers.ever y, Qservable
c#*6,gene able ever gy�
rage, 5,01"ar ready Not
10V Mpf lance Applicable
s,and enefgY 00
OV,pr,e,sented ......
ction dor,,�iments-
C,40� I I-------- Complies
sand, Does Not
105.1, nstrate
comply
105.2, ince for
403.81 and"
v
Not
[PR31 rS` ysltenlS sere sery able
e ejjing units I'MJ Not
d rate 1, p
,V �oinp,jjance plicable
C'Olrn ni err.iaJ P rovi s n io 's.,
.....................
Complies
me,nt Heating" Heating'
and coblin�,eqolg� Btu/hr Btu/hr Does Not
302.1, WperACCA anua pomply
403.7 1,10a,d's cfaic,ulated per ......... Not
�,ieth6ds
[PR211 A,Warnsal o,r other Cooling- Cooling,&
0, tie code offiCiall. tUMT Btu/hr, Lis e ry-b I e
B ,
Not
p plicable
Additional cawents/Assumptions: ---------
1p��c
: w IM (Tier 3)
3 Low IM,
�Mr eldium Impact(Tier,2) :
,
jdui ier 11)
Report Date: 5/5/26, 12:05 PM 3 Of 13
Report Title: 1956ain Road
Foundi0m, Inspectmon ......... .......
P'lan'
of � 1l
e vtue
�
41" ry comp303.2
F 531 in tr t ion �
Isere
Not
, pplicable
Complies
mmmm�'^'^� nmmn'6f�'+'wwP@Fi19D
-01'0%
I'VilIg
Does Not
3,8 � c nnpl with, POMPIY
C403 and C404 of the
Not
s,erva l
Not,
rnpfies
........... Co
�Y r,« f«,,µifDoesNot
`� r'
� C r� �
40 3ou'w '6 ,ply
Not,
S'ervable
N Olt
w 4,p'lAlca l e
�m
Coigjqplies
alvement
401,9Mr V�>50 r p Not
rPwale
lo
m o t off t1he system
t em,pe ra"j re
»»� o ie'
......"���� w� �e�3 631
'A-7
A-Does,,Not'
Omply
,tends
� grade. Not,
erblee
4k,
it i
m aw Complies, See the''`r ed` 1
mAse s,table,for
�
lh ft
p values
4f 2. .3 0 In a�in
����� ��
ly
JFC 61- �� 1t �rtsulation � ;p
New
�'j my`11n 10 ft 'Not
t,W grads car to�d, e ,s� �er�t ser le
1N
ppl cabl
--------------
Additional Cgments/Assump
-------------------
� d pat f'rjer
it
Report Cate: 5f5/26, 12.05 PM
4 of 13
Report Tale: 19 ain Road
ec ton
»>Frarni, ,- �
;
Field on� r COS � , ,
�
_rairn
«Y. ,tors es�trati�on Does Not
303.1.3 jr is are detetrn,A, ed i
[FR411 test
Comply
`� � �tl� �NFR�tw
Mdare ortaken tr j Not the Poservable
t table.
(�]Not
applicable . . ,
Y
m
. u,�e, o Complies
r� f,"
Dees Not
402.5.1.1 rajj-r'°ier and thermal
Y 1 id�d per,m ` tW e Pomply
[� � Ctions.
PN of
aservable
C]Not
Applicable
CD complies
bu i l't�
t,is, of C3 Does Not
�D2�5��� r �ro the n�-re '�,�
dand l�abdt as comply
�FR3 ,,„jw'D' ,1C5
St . AA40 o°r 11 s infi1tr t,1,0 Qservable Not
jw� r
N 'SRC 0 ,that do not
ed code,11MA ,d Not
,pplicablc .....................................
------
7 Complies
� ." recessed li �tin Does Ncat
isjrvd'4,
se',6'le. omply
to% indicate; 2-O' r QNot�7�11
qe
t 5 pa, servable
Not
plicable
ta
complies
C]
[does Not
n, �nMvip
llle
,
ho
° 55 'F�� �� iuited ,� comply
Not
( bservable
Not
Applicable
cD complies
� w �f9� rapt darrwpers Does No
����y, lled��r�r lli otdu6r air
ComplY
� i i ventil�t°r, r �y`ste 5— ( Not
Osenrable
N cat
pplicable
° o complies
` t tipr s st,erns PO
Does Not
ed
ll�t�Ji e °r heat mply
re,covert'-p ith biala nf
L,t�'n�and ai sens l;e [�Not
r -ry e
(iie 'y�(S Observable
1t 2 ,. C3 Not
Applicable
D
located
..,� Ccrnplies �ompte� n the
3.3. and return ducts in attics Does Not uildit� er�vel�p��
� —R-8 where duct is
FF 1211 ied Pomply in diameter and
A where<3 inches. Not
Poservable
0 Not
Applicable
Report Date: 5/5f261 12-.05 PM
5of13
Report Title- 19110lain Road
Plan�S Fiel'd
..............— ........... "".
ifted
Sc Yalu
41
g " Vales
� :� ° 0 complies
air ll r�dlers and filter403.3.6 'W Does Not
with
IF1311 pliant,e seated with Pornply
Nc�t
"�tinl larkal l°code, 6servable
applicable Not
Qplicable
m ";»...
insulation�n NAB t
.,"ion of insula Does No
403.4.1 P
m pl'y
[FR241
6Not
servable
Not
plicable �
"
....]Complies
is 'lte-d tO �. """ m" pees Not
4a,� ter � ".. ,
Web `ins-ulatn. amply
JFRIV Not
Poservable
apNot
plicable
Complies
i� ic 1 end; Doe
s Not
b 402�5- M rst�lled POmplY
�� �tii ��
. 1 � br"n l blot f the
se l d t hirli PNext
bet elen coy dtin�d serable
litiun d "p aces. Not
pplicable
o complies
I and Does Not
403.11 Ih Pomply
[FR1211 n sed VAC sizing Duet Not
H° � Poservable
srvi �multi l
unfits is sil in
Not
» pplicable
of'rundaTn'Ll3f6tals.
1,D or are equivalent
�� ds n.and Dees Not
403.3
C rda n r.e w h, C
l
[FR3111 D,'Duct s ster 's sowing
nits is side Nit
ltook t Fundy°me t�ls� C]Not
Applicable
Flu "
° m» � �the�rv�ip
Cj complies -ernb ° t j,"le for
i D" ""°� " �.yu Does Not values
402.1, tW 1
4.C}2,4-.4[FRIP
ply°y
N,ot
rbl
s Not
4lfi able
velOPe
COMpl'Ie See tl i tad fir
«<.. ass °ntlb
rep- i bted , """."rv� Does Not values
yp'�}�{y c�r a Irk
4'pV'1�16'+�y.�I y{ ���ry`y��7�W ��C.�'L�t � k ..uw.wwiviww.�.w'^'w iioum P
402.4.1, 0 ��I� ��� l t
402.4.3, � Nit.
402.6 ' � , r ble
Not
�ApPli,ca
1 ,
............... ---------
ns:
Additional Cci nt�l�►s�ump►t��r
�w
�.
Report Date. 5/5/26. 12.05 PM
6 of 13
Report Title; 3.95Pain Road
3
r2
I 1"
=Wqb
Report pate: 515126f 12-.05 PM
7of13
Report Tittle: 19' ain Road
l at inspection ...........
�w „Y
..w,�,R ���ti��, �n�..�..�� _ I ,Fi M �As/ . lions
w
Plans,
eld,
C'O'Mpfie's?
e y Value
P y�y
I�'M1M�� f� N � _ nummm � >v
'
006es No't
e "m u ouuar✓m 'P......
�unnmM m mmmlM �mmnmhFf�
lab
eied �..
installed -val, e� �.
ll "� ode Not
Poservable
Not
applicable .....----------
w�
JJmam W�IVN2N'�.wnWmeWmmmmv,�rsff�i yyuuumdMdW4�mvn�W'wtiv!'AliPmnuvMNW.f4anw..�i UHfWw whMN�'w � W.+�✓
u-no Compli
rQa/MN,WMMI{ oirri�+�m-"mom
b is ns ill d---------
Does Not
J o P303.2 � ,Ct���er,,s it fs r,� ns mply
[1N411 Not
ant
i
e
lies e ,table
ele
�.
for
value" Se
or Not: values
j �6
R
,1 wood
4� � D�Jc�ad Q
402.2.B
[1N 13" Steel (]Steel Nit
lsetvable
Not
,pplicable ...
CD Complies
tin ,nstal�e p� �' lees"Not
and
rer s i�nsru � �" p
32 �w�atu b,the
l
y t;a nti l on"a�t. ��� of
J.1N21,� � de �the sub �oof",a
;v��it in Ala'io"is
�a,min de
a �t� ( the to Not
rwb"in'atinf o'
ln" r� � ppli�able
and n in ou',, ulati r
5f fled,S cavity
insulation
side «< mow ::
` p °'
i � ta�It w�tl" See the nvel� e
tuous l j.sulya w on. H ��w complies
� (� s ,����l� tahle for
l this�s l Does Not valves
�s��lat�n�n l�
all i al 1Naad "hod
�,
12, . j at leas cam
2.� tt0ln� lato n s f��� has! Not
4� the et� o���i� M�d��n�� 0 etas
�,.� le
1,I '3 `, �jen�e�nt applies( Steel steel � r ab
0 1 l� k Not
I. livable
p w �
w� .�
m.�w��
�Y�P�flyww�� Complies
�pat�lc knee walls t�o �d [ices Not
402.2�3, epara �n F rod Pornply
402.2.3,1 t14� � u���nnditi ��ed antic
1N ply` it.�the &Not
servable
Lion sir°em" nt ��� Table
"3 Attic knee w lulus Not
1 an air bat,,rier between,
pplti ca l�wl a - ,�ww.� F
t dit �d on an w�.��
j,,ditj ned spa .
Add
it�on nts/AsSUMptions:
w
M
�c�w lrn, at leer 1
(Tler�""�
fed � IMPS I
1
'le r 1
Report Cate: 5/5/26, 12:05 PM
Report Title:IgWain Road
Final lopction ProvisionsVerified COMM
,7 plans
.
«,mm� Verified Complies"
Section
Value
� lVau>>�e
provision
�
�inspection
CD Complies
j irls,all � 'r ti Does Not
1.1, E ' in tr tionS.,
3t 3. F12 � e wirer Comply
303.2[ � �n lati r�� �� Not
300ft servable
L]Not
Applicable
0 Complies
Irrr,jals(Of, �-,Goes No
ter heating, 1�������
303.3 * h nr :al 3n Comply
[F118 erns have be� it p(ovide�d�., Not
&servable
Net
Applicable
Complies EXceo !Requirement
Comp licabl ��
mm teentary t Does Not
Pump,S01,
403.1.2 troll'o prev nt: Comply
Flit 1l�ernental ea when heat Not
O0Mpres�s �r�can serve servable
"tin la
Not
Applicable �
C3 Complies
" have Goes
Not
P
, 3.2. ulr�,o' ' m pl J
�
1126 l oiler`watt
wee° tot Not
ratur. based n able
in a"Or,
best e ( sery
e to' Not
rgure s��ns ,applicable
k
-------- ..
complies
ryes Nt
l
4C13.3.6.1 t na
�`'leakage
at � nufactut'er Comply
[F124 �= °! r�esl n stir flog. Not
servable
Not
Applicable
Complies
� does Not
4()3.3.7 �tl ft2 cfm110U ',�,-ply
[F12711 4� SN IC [CfM/100
Not
etarin air
4 t Row h-if servable
Wj 9e�i,t h pit°heir
fataj,teaka e rn e redNot
resume l,iferet�al l ,applicable
r� U
�, tlrn,1; 6,din 'the nr ler
»�fa�trr`ws air la
�sor if irwy'p� Wv.ypglie1mu ryy{atpvµ.tj,test:
���
mm+^'IM'.U
J,la ,a me,
Our a
O r� 1f"�erential f
^ . ,a ro s the entire
ern inn,lul inn the, �.�
w,if ndler
i sure. �. ,�� Complies
Est rs� lt ,u
t , s the Goes Not
t.irl�ltr"ass ���� �
403.3.3 r.n t lt�air cfmll00 ft
[F14] rW „ 3 f jt ,ft2 cfm/1 �ftz Comply ot
air,1.ta' n ler 2 1 a
�I11�'t�re,ss fni�/ servable
ducts Within le C]Not
` r rq h in tst,� � � � M� Applicable
�,a�tion M�a e d Curs
'FraMirl lr spy t� � � f Complies
»rr
,ry Alt rwi �hot water Dues Not
a
����� se
. �rrp ve almatic
41`�3 �• orpomply
F1 5sibe"j,, controls. Not
&servable
Not
Applicable �..
Report Cate. 5/5/2 12:05 PM 9 of 13
Report Title, Ig lain Road
section, valuo!
# S,Pe" 110ITS
jctjOn PrOVIS ................tit Complies
rec rCul ill Does 5 Not
nd when PO
r,,Vs re,qU Idoservable
Not
pplicable
," f�Vff(b.��vuPN anlf. o0 rtw Ux'W ���
complies
i, c l ti p Dees Not
cis utati r comply
�, '�r�
system � ���'� �'t
i �r r pop hion
e k servants
rvq,ater supply Pip ,
��i. p Not
forIn �,
lli steOISl ire pP"lc. ble
Z Itt't �°pmYiernand
With
P° emCY u '
l l orbcolctrl
thei Occupall
tLjrn Oil"the
MI-at afl)yjat r is,in
oP l -pile
ti I Op ''
� and rij,odetilWid
° � Tm^.-.+'� a�u a fDNYN���'V@Nwwmi�'emm"ru�wmmnrv 'es
wxuwr�l�wW,MM!YmA4 �! , m wIDili Do"^W
vv rvK j S pO
It vy
Not,
lL
1 �� I wcll
��,� ;i°c1 tma 1
�,
iopA
he� g.
p maintain 1e rbl
w,a,ter
a
to 'p r t i Nc►t
g. pplicabl .............
complies
; at recovery� (.,)l t
C pl
c
y
Potabte IN 't
at heat r,
3psi. Not
rteb to one or WO
licable
ater-Side Pp
Potable W
), r i for
rec�o it's 2 psi ,
id1u on
ce ..........................................
Tewe
ri
cic pod Does Not
dy zon1 PTOvieblbservable
` „pp�licbl
complies
Not
1 it ti � Do Not
m� c i c
3�° iS not,pert 'ft 0
I
`Alit ipNot
vid air flow
�bj
6.2.
I �servablie
Not
�pplicable, .
umm�'IW o��pe��MFIYNti�I 4WA��lPMYr�MwSvrlff�PlOID ..
CD complies
r !�'w 1 Not
PO
��� ��� ,���� icl �1 ���s
�' � � � � die mipl�'
er arates Not"
b1
pplicb'l
+Complies
�� D Not
has
Not
1 t c
t $,ejb1
i Not
Pliable
mm.
E!1�4A�w�^'^'�u,twwwrv�rvivw�:�uwin�m
.wua VVVJ�i '^^^nrvNwWv
nnmmrw'A"' b�Wal��
Gr �
......... id mmm
r vmmmN'�"°� mri ^
o� i J
-4
Report Date: 515126, 1.2:05 PM
Report Title: 1950ain Read
Ptans Field,
yywuwJwo r� vim^ w,rW I M�I� �
Verified' #`
...
eel p'`O js M'�S -
'...
V",fir Ins C3 CompliesAOL �
C)oes.Not
403.7.1 �a ac�it 1`or dwelling Pomply
[F1 �',�sleep inxg Nat
' thK�Tanice .In ��� u�ldi servable
uw XWW M .
QNot
Pplicable
«,w m�„�, plies dope
f � } Not va�ue"� R �3fjfe for
-value. - rv� [l(]'S
f
402.1, � wood 0 good om ply
402.2.2. CD Steel Steel Not
4p2.2.7 serval le
['Fill, Not
Qplicable
CD Complies
��l u1ed wiutl�� Does Not
end ��[Hier ��mitutent omply
4u �r ante°rrupted! of
�A R4M , Poservable
nce i, Not
Applicable
„ o Complies
. , Bern anent fixtures Does Not
of
404.1IF 11 �� efhoac, lamps. omply
Not
servable
QP
Not
plicable
Complies
��� � owr is Goes Not
D for jightir
404.1. tl allc_ le wattage Porriply
F15Mbje ,4. 4.1. Not
,servable
Not
pplicable
_a
...,�rrtaaw�ry ,..
complies
.. steams Does Not
4� 41� gas liiglln '
1 coat'11100US plot light. Pomply
,F123Not
Poservable
N of
pplicable
Complies
�
gg Goes Not
,1,„ %anent it terror wi h ei her
4 M n �be controlled Pomply
44, . rual dimmer Occupancy Not
Fp3 r or auto shut o col
servable
�l 011 occp=a�n
c l'lt with
seal owverridem Not
QPplicable
.. ... ;w uwyn'rvii `�owouwawa n m,'10 it nrwwr f]Complies
,rarwrv�rummmi �1.�.._1{
� watts Goes Not
�� llght�n 44. , a � "
omply
,F 37 1 switch
o Not
turnat�c hula �
servable
uat� $l1utou�ls thatyl.iht
� nt � huts Not ---------
t��de ut;o�nlat"c t�c� pplical�le
° tur��°��s t ,autom��
aH
l within 24 hours. „w�v�� �������
� �� 0 Complies
7
r a at le energy Cues Not
404,14 a j n e � r en omply
ties$
43� red AS led-si.to Not
foewal e eoe wrjl �wtadlleQ servable
o er��er9�aft
c'ates(EA sl a$soci,ated Not
hey renewable energy pplicable
lance
tlor.co,1�pl are � ..��..
#ed to t1ie cede official. ��n�
wnf.Yr��
Report Gate: 5/5/26. 12.05 PM
11 of 13
Report Title: 195' ain Road
m A
a
Sep y Values value,,
'" , pp1
"th,air � Does t
�� iMlvdie
eble i,ed atticS, it and
Cbmplly
1,1ts 'h ��� ;��, over .�� .
�� �� r ble
Not"
mm
o
complies
witil Not
kpconditi
EER2 for Not
,'t4lt nal,���:�nc `credit Poservable
pNot
plicable
Complies
rid M � ater Dees
n, NOt
408,2.3 2
.��5 �"�
rc,d PornplY
�.Y, able
Not
plicabl
ACH 5 0
,C1 „
%,&er r751 Does NOt
[Fl ;� 4-5 end< 2 of
P
' Not
,plic, ble
C3 Complies
M ronic system Dees Not
within Pomply
[F171 �sp c ,credit for � t
�::
ti�nal� '� ��
�inl �rinc credit swpva'11
Not
pplial
w � Jope
� Complies rnpli s t, � aj I for
M mom , mmm� As lie
�
valuers, s Ds, et VM�areWant bar ii
�
rdanceo Wood o Wood
l Not
�C1743 Steel �`- serval
f
mmm jt
y �41 llca l
Complies
4 w 11 rl r c tr,ol of,l�r�' 'r PO
m plY
1 '' in (_doling , st 's
end �►�t
e,
vn�ti�alf , 905ervable
to,code
QNot
Pplicable
m.
AdditiOna
, ents/Assum►ptions: 3 LOW mm
impact Mer 3
lug Ir'np
Hi h
Report Date: 515125� 12:05� P
12 of 13
Report Title: 195Main Road
2025 'Energy
Conservation
ConstructCode
of' New York State
Energy Ef1hic I iency
Certificate
Above-Grade Wall 32.00
Below-Grade Wall 15.00
Floor 30.00
Ceiling/Roof 38.00
Ductwork(unconditioned spaces): -
& o U Factot SHGC 0
"Glass Dor
...............
Window 0.27 0.30
Door 0.27 0.30
Skylight 0.00
Heati*io,,& Cooll!�4
Heating System:
Cooling System:
Water Heater:
•
...............................
Name: Date:
Comments:
Report Title: 19500 Main Road Report Date: 5/5/26, 12:05 PM 13 of 13
% i
V/4 Telephone(631)765- 6 2
',gym I Fax(631)755-95 2
Town Hall Anne
5 Main Read
543? �
1179
NY 11971-09hY 41
4 WOF
BUILDING
DE PARTMENT"
4ERED,,
*ONTRU
�
LITILIZAT10N OF TR,tJS,S'TYPfE C
NOTICS R C0NSTRUCTIONI
Date. 04/1`' r2o -------
T Farm
m .....................
Owner.
195oo Main Road, Mattituck, N
Location o#fbperty:
Plea
se taktrtce that the (check applicable line:
�
commercial or residential structure
x New Addition to existing commercial or residential structure• • �ercial or residential structure
Rehabilitation to an existing cow
performed at the subject
• property reference above will utilize
to be co n suited or
prep Y
(check appiible line):
Truss type construction (TT)
X Pre-engineered ered wood construction (PW)
. I
Timber construction (TC)
e fll�o � location(s) (check applicable line):
i tearns (F)
floor frarning, includingirders and b�
' ovf framing (R)
x 'door and
roof framing (FR)
. m
q
Signature:
rso submitting this form):
Vii1•am�
J Barba
ame (�a
Capacity (ctsk applicable line):
owner
x owner representative
Effective 1/1/2015
TrussRegl5.docx
k
P
V
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