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Home My WebLink About46969-Z ��O�oS1lEFOlk G � Town of Southold 7/7/2022 P.O.Box 1179 y z, 53095 Main Rd 4%11�1 Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 43218 Date: 7/7/2022 THIS CERTIFIES that the building SINGLE FAMILY DWELLING Location of Property: 565 Mailler Ct, Southold SCTM#: 473889 Sec/Block/Lot: 70.-9-36 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/6/2021 pursuant to which Building Permit No. 46969 dated 10/14/2021 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: single family dwelling with unfinished basement, covered porches and attached garage as applied for per ZBA#7374 dated 6/25/2020. The certificate is issued to Roberts Premier Dev LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R-21-0851 6/27/2022 ELECTRICAL CERTIFICATE NO. 46969 6/15/2022 PLUMBERS CERTIFICATION DATED 5/3/2022 quin Ro do t o z d Signature �o�soEFn TOWN OF SOUTHOLD ay BUILDING DEPARTMENT TOWN CLERK'S OFFICE oy • ��u SOUTHOLD, NY 0 BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 46969 Date: 10/14/2021 Permission is hereby granted to: Gobic, Mileva 12 Roscoe Ct Greenvale, NY 11548 To: Construct new single family dwelling on vacant land as applied for and per ZBA#7374 and SCHD approval. At premises located at: 565 Mailler Ct, Southold SCTM #473889 Sec/Block/Lot# 70.-9-36 Pursuant to application dated 10/6/2021 and approved by the Building Inspector. To expire on 4/15/2023. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $2,397.20 CO-NEW DWELLING $50.00 Total: $2,447.20 Building Inspector OF SO(/r�,ol � o Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 aQ sean.devlinAtown.southold.ny.us Southold,NY 11971-0959 QI�COUffm�� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Roberts Premier Dev LLC Address: 565 Mailler Ct city:Southold st: NY zip: 11971 Building Permit#: 46969 section: 70 Block: 9 Lot: 36 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Morrison Electrical License No: 48402ME SITE DETAILS Office Use Only Residential X Indoor X Basement X Service X Commerical Outdoor X 1 st Floor X Pool New X Renovation 2nd Floor X Hot Tub Addition Survey Attic X Garage X INVENTORY Service 1 ph X Heat Duplec Recpt 54 Ceiling Fixtures 19 Bath Exhaust Fan 5 Service 3 ph Hot Water Gas GFCI Recpt 8 Wall Fixtures 20 Smoke Detectors 4 Main Panel 200A A/C Condenser 2 Single Recpt Recessed Fixtures 45 Heat Detectors 1 Sub Panel A/C Blower 2 Range Recpt Gas Ceiling Fan Combo Smoke/CO 5 Transformer UC Lights Dryer Recpt 30A Emergency Fixture Time Clocks Disconnect 3 Switches 52 Z LED Exit Fixtures Pump Other Equipment: Fridge, Mini Fridge, Oven, DW, Hood, MD, Septic Disconnect Notes: New Two Story w/ Unfinished Basement Inspector Signature: Date: June 15, 2022 S.Devlin-Cert Electrical Compliance Form af� �F sou Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 -- Q Southold,NY 11971-0959 ..b=--ala r DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION 1 Date:^ �a Building Permit No. 14 U q u 01 Owner: �bt-k S. -Piss MA,& Oc'-C� �I res (Please print) 1 j Plumber: cl u i ^ ° 05A'Z'a (Please print) ; { ! 1 certify Haat Clue solder used in the water supply system contains less than 2/10 of 1% lead. lumbers Signature) Sworn to before me this day of�G� 20 D JUL - 5 2022 a ! Notary Public, County v BiJ]LDING DEPT. Lydia Nolan Notary Public,State of New York TOWN OF SOUTHOLD No.01 N06225438 ' Qualified in Suffolk County Commission Expires 7/19/20'��" S�ffOL.,I- BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD Town Hall Annex- 54375 Main Road '- PO Box 1179 Southold, New York 11971-0959 y01`. . ,p Telephone (631) 765-1802 - FAX (631) 765-9502 rogerr southoldtownny.gov — seand(c_southoldtownny.go O APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: Company Name: RoFLnnril. f �k 14C_ Electrician's Name: )o5ev u'_(. License No.: -(b -(o7 - �AE Elec. email: to �(�Elec. Phone No: c, I_�(?��$c�o ❑I request an email copy of Certificate ofpliance Elec. Address.: i t'� ►-ecf�G.-5 A\IC-71 C. Ph-rCft6,eue: e'17 C_ JO.B-SITE INFORMATION (All Information Required) Name: I-�oi�^^+5Pr-eTKIeyY - .L�� Address:. Cross Street: 7. :.. Phone No.:.. 7� 71 131ft.. errr)it#: - --- ------- --=mart: -- TMa District:; 1:Q00, S cti6n: Block: Lai:: P 2 PTaO�1:OF.aA/C .R INCIiARE F0;0 . ... . ....: ..: 6f�(E .:DE 1. ac 1=: . S (. .0 . , . Sgtare>.Fo)�ag�e'� : ZZ 0irclle All That ApP.ly: ;IsJob ready for inspection?: YES�.NO FjRough In •a Final you a.Temp Certifcate?: YES a N0 Issued Or Temp lnformati+on: . (All-information.requited) . .,... :S:eryice Size 1..:Pf`a&.Pt Size: ..ZGC� A #.Meters Old:Meter# New Service Fi'—Reeonnect :�� Flood`:Reconnac#:03ervice RecorinectoUn. rgrou d i]Overhead. ❑, fl #Underground Laterals 1 2 H'Frame Pole -Work done on Service? Y N Additional Information: ...... -....... ..._....--PAYMENT-DUE-VVIT-H APPL-IEAT-ION--_... .-_. . ._._.... . ... _.. . .... .... .__... .. ObpE SOGIyo # # TOWN OF SOUTHOLD BUILDING' DEPT. �o • �o `ycourm��'' 765-1802 _ INSPECTION [ FOUNDATION 1ST. [ G. [ ] OUNDATION 2ND . [. =] INSULATION/CAULKING [ FRAMING /STRAPPING [ ] FINAL [: ] FIREPLACE &CHIMNEY [ ] FIRE SAFETY INSPECTION- . [. ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ' ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION ( ] PRE C/O REMARKS: o S�� ✓vim _ S DATE C (� �ZZ INSPECTOR SOUTyo } # TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECION [ ] FOUNDATION 1ST [ ROUGH PL13G. 4 [ ] UNDATION 2ND [ ] INSULATIOWCAULKING [ F AMI PPING [ ] FINAL [ -FIREPLACE & CHIMNEY [ ] FIRE SAFETYINSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: V✓-z" m IG DATE _ 2 INSPECTOR �a0f 50Ulyo �o * # TOWN OF-SOUTHOLD BUILDING DEPT. `ycouanN�'' 765-1802 t -INSPECTION : [ ] FOUNDATION 1ST [ ] -ROUGH PLBG. [ - ] 'FOUNDATION 2ND-. [` ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [. ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION = ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: -6 L2Qd V", ........... DATE ~ [ �/ INSPECTOR r , aq so # # O NZF SOUTHOLD BUILDING DEPT. Courm��' 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [. ] FIRE-RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) �4 ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RE AL REMARKS: U .SSo DATE Z INSPECTOR r OF SOUTh°lo �l # TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] SULATION/CAULKING [ ] FRAMING /STRAPPING [ FINAL 0 [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: . pw/� el 6 Aw l svvvp. ggt&,�, plo-&v-n, BA X) &#WhA IU(7� to DATE v INSPECTOR 2 Windemere Court,P.O. Box 169 Speonk,New York 11972' gKKe,i Kazel, Architecture P: 631-874-2925 F: 631-874-7377 keri@kazelarchitects.com October 14, 2021 Building Permits Examiner Town of Southold Building Department Annex Building 54375 Main Road Southold, NY 11971 Re: Permit #: 46969, 565 Mailer Court in Southold To whom it may concern, Please accept this letter of inspection for the above referenced property. An inspection was made on January 11, 2022, for the re-bar in the footings and January 16, 2022 for the damproofing on the foundation walls. Both inspections were adequate. Please feel free to contact our office if you have any questions. Thank you Sincerely yours, Ep C , 4C 0 rti Keri Kazel, Architect A ao 9743-� SOF NES WWW ka7PlarrhitP.rtc rnm 2 Windemere Court, P.O. Box 169 Speonk,New York 11972 Keri Kazel, Architecture P: 631-874-2925 F: 631-874-7377 9 keri@kazelarchitects.com October 14, 2021 Building Permits Examiner Town of Southold Building Department Annex Building 54375 Main Road Southold, NY 11971 Re: Permit #: 46969, 565 Mailer Court in Southold To whom it may concern, Please accept this letter of inspection for the above referenced property. An inspection was made on January 11, 2022, for the re-bar in the footings and January 16, 2022 for the damproof.ng on the foundation walls. Both inspections were adequate. Please feel free to contact our office if you have any questions. Thank you Sincerely yours, S��FtE D7/ NN Keri Kazel, Architect T �O SOF NES r-z n r �, D rr3� M A,9 - 3 2022 R.Y�4�,T)Wf3 ME!"T T1'F 1'4 r �� /1 xnxnslra�nlarrhitartc rnm and F Master Pluinbing[Heating Kitchens&U-1di's Joeman!521 Overizon.net Patchogue, New York 11772 May 3,2022 Job site 565 Mailer Court Southold New York 11971 Building permit# Pressure test document Supply and install gas piping just outside wall to LP gas tank location Supply and install gas piping to one gas fired stove ;i- Supply and install gas piping to two gas fired furnaces Supply and install gas piping to one hot water heater s- Preform pressure test on gas piping I Joaquin Rosado President of- J and F Master Plumbing/Heating Inc. Located at 31 Wood Avenue Patchogue New York 11772 Have installed and pressure tested all gas piping for the above 465 addresses as per local and state codes Joaquin Rosado May 3,2022 Notary '-Lydia Nolan Notary Public,State of New York No.01 N06225438 Qualified in Suffolk County Commission Expires 7119120P-l' Home Energy Rating Certificate Rating Date: 2021-06-05 ENGYpp . Registry ID: av ale ire Projected Report Ekotrope ID:x25o8ppd HERS' Index Score: Annual Savings Home: Your home's HERS score is a relative 565 Mailer Ct performance score.The lower the number, '$3, 99 Southold, • the more energy efficient the home.To 56learn more,visit www.hersindex.com *Relative to an average U.S.home Roberts Premier Development Your Home's Estimated Energy Use: This home meets or exceeds the Use[MBtu] Annual Cost criteria of the following: Heating 77.1 $2,749 2016 New York ECCC Cooling 2.6 $68 2018 International Energy Conservation Code Hot Water 11.6 $417 2015 International Energy Conservation Code Lights/Appliances 18.3 $486 2012 International Energy Conservation Code Service Charges $164 2009 International Energy Conservation Code Generation(e.g.Solar) 0.0 $0 2006 International Energy Conservation Code Total: 109.5 $3,883 Home Feature Summary: Rating Completed by: M—F-0 HomeType: Single family detached Energy Rater:Matt ISO Model: custom home Wahl Existing 140 Community: n/a RESNETID:2572845 Homes no Conditioned Floor Area: 2,238 ftp Rating Company:Energy Rating Service Inc IT<I Number of Bedrooms: 4 35 Tellar Dr,Islip Terrace,NY 117S2 110 631-566-8439 Reference IN Primary Heating System: Furnace-Propane•96 AFUE Home se Primary Cooling System: Air Conditioner•Electric•14.5 SEER Rating Provider:Building Efficiency Resources B0 Primary Water Heating: Water Heater-Propane•0.87 Energy Factor PO Box 1769 Brevard,NC 28712 m 800-399-9620 House Tightness: 3ACH50 � "° " sow it:x,`�;, 65 CFM,65 CFM•22.75 Watts(Default),22.75 watts ' � This Home 16 Ventilation: ,,.., .° (Default) w Duct Leakage to Outside: 40 CFM @ 25Pa(2.76/100 ftp •5 � n., w 20 Above Grade lNalls: R-21 Zero Ene o Ceiling: Vaulted Roof,R-39 Home kVindowType: U-Value:0.3,SHGC:0.28 Matt Wahl,Certified Energy Rater •^_••� a�,rnusy Foundation Walls: N/A Digitally Signed:7/14/21 at 10:29 AM ..e,RATER-Versie r ekotrope EnergyThe . ApprovedRating This report..e not constiturt New York ECCC 2020 UA Compliance Property Organization Inspection Status EMWgreivki'_ce 565 Mailer Ct Energy Rating Service Inc Results are projected Southold, NY 11971 Matt Wahl Model: custom home 631-566-8439 Community: n/a Builder R1021-1-565MAILER-MJW Roberts Premier 565 Mailer Ct, Southold Development This report is based on a proposed design and does not confirm field enforcement of design elements. Building UA Elements IECC Reference As Designed Ceilings 75.6 73.4 Above-Grade Walls 144.1 152.5 Windows, Doors and Skylights 196.8 186.8 Slab Floor: 0.0 0.0 Framed Floors 96.7 81.6 Foundation Walls 0.0 0.0 Rim Joists 8.6 7.4 Overall UA(Design must be equal or lower): 521.8 501.7 Requirements ® 402.1.5 Total UA alternative compliance passes by 3.9%. ® 2 Glazed Fenestration SHGC 9 Avera a SHGC:0.28 Max SHGC:0.40 Fenes ® R402.4.1.2 Air Leakage Testing Air sealing is 3.00 ACH at 50 Pa.It must not exceed 3.00 ACH at 50 Pa. R402.5 Area-weighted average fenestration SHGC R402.5 Area-weighted average fenestration U-Factor ® R404.1 Lighting Equipment Efficiency ® Mandatory Checklist Mandatory code requirements that are not checked by Ekotrope must be met. ® R403.6 Mechanical Ventilation Rate ® R403.6.1 Mechanical Ventilation Efficacy ® R403.3.3 Duct Testing 403.5.3 Hot water pipe insulation Design exceeds requirements for New York ECCC 2020 Prescriptive compliance by 3.9%. Name: Matt Wahl Signature: Organization: Energy Rating Service Inc Digitally signed: 7/14/21 at 10:29 AM Ekotrope RATER-Version 4.0.0.2710 New York ECCC 2020 Prescriptive compliance results calculated using Ekotrope RATER's energy and code compliance algorithm,including appropriate amendments. Ekotrope RATER is a RESNET Accredited HERS Rating Tool.All results are based on data entered by Ekotrope users. Ekotrope disclaims all liability for the information shown on this report. l New'York 2020 ECCC Compliance Report (ERI Pathway) Projected Energy Rating Index Report Property Organization Energy Rating Index Information Builder:Roberts Premier Development Company:Energy Rating Service Inc Projected Rating Address: Phone:631-566-8439 Rating No: 565 Mailer Ct, Southold, NY 11971 Rater:Matt Wahl Rater ID (RTIN):2572845 Date Rated:2021-06-05 ed Annual Energy • . . Rated Home Calculated Energy Use Rated Home Cost($/yr) (MBtu) Heating 77.1 $2,749 Cooling 2.6 $68 Water Heating 11.6 $417 Lights &Appliances 18.3 $486 Photovoltaics 0.0 $0 Total 1. 109.5 $3,883 'Based on standard operating conditions ERI with PV:57 ERI without PV.57 Annual Estimates Electric(kWh):6,962.0 CO2 Emissions(Tons):8.9 Natural Gas(Therms):0.0 EnergyMaximum • Index-.62 • • 6 • 1 nde)(-5-tPASS This home MEETS the Energy Rating Index Score requirement of New York 2020 ECCC Compliance Report (ERI Pathway)for Climate Zone 4. It MEETS all of the requirements verified by Ekotrope. Mandatory requirements are summarized on the 2nd page of this report, some of which are not verifie y E�gtrope. Name: Matt Wahl Signature: Organization: Energy Rating Service Inc Digitally signed: 7/14121 at 10:29 AM IREifing'Provider Data and oyMov sT Company:Building Efficiency Resources ��- �' �A p Address:PO Box 1769 Brevard, NC 28712 �( ; Phone#:800-399-9620 98445 �a Fax#:877-399-1361 cRearTwttaN To determine if a provider is properly accredited go to:www.resnet.uslprofessionallprograms/search_directory (Projected. Confirmation required.) Climate Zone a Mandatory -• Provision Number Topic Compliance Decision 2010 ECCCNYS Table Building thermal envelope minimum insulation levels and ' PASS 402.1.1 or 402.1.3 maximum fenestration U-factor and SHGC R401.3 Post a permanent certificate listing the level of efficiencies Certificate required for CO installed in the house R402.4.1.2 Envelope air leakage maximum leakage rate PASS R402.4.1 1 Table Comply with air sealing and insulation requirements in Table Checklist required for CO R402.4.1.1 R402.4.1.1 R402.4.4 Rooms containing fuel-burning appliances PASS* R402.5 Maximum fenestration U-factor and SHGC (U-Factor)PASS (SHGC) PASS R403.1.2 Heat pump controls PASS* R406.2 Ducts outside of conditioned space to be insulated to a PASS* minimum of R-6. R403.3.2 Duct sealing on all ducts PASS* R403.3.3 Duct testing for ducts in unconditioned space PASS* R403.3.5 Building cavities not used as ducts. PASS* R403.5.1 Heated water circulation and temperature maintenance PASS* systems comply R403.5.3 Hot water pipe insulated to R-3 PASS R403.6 Mechanical ventilation meeting the requirements of the IRC PASS* or IMC. Outdoor air and exhaust dampers installed R403.7 ACCA Manual J and S conducted for all heating and cooling ACCA forms required for systems. permit R403.8 Systems serving multiple dwelling units to meet the PASS* mechanical requirements of IECC commercial code R403.9 Snow melt and ice system controls installed where applicable PASS* R403.10. Pools and permanent spa energy consumption meet PASS* requirements for heaters,time clocks and covers R403.11 Portable spas meet the requirements of APSP-14. PASS* R404.1 High efficacy lights installed in 90%of permanently installed PASS fixtures. *This is a projected rating.These items must eventually be field-verified by the Rater, Field Inspector, Code Inspector,or Builder. 565 Mailer Ct Southold, NY 11971 Builder: Roberts Premier Development Model: custom home Community: n/a This report is based on a proposed design and does not confirm field enforcement of design elements. THIS HOME IS CERTIFIED TO MEET THE NEW YORK 2020 ENERGY CODE I Building Features Ceiling Vaulted Roof,R-39 Duct Supply R-8.0,Return R-8.0 Above Grade Walls R-21 Duct Leakage to Outside 40 CFM @ 25Pa(2.76/100 ftz) Foundation Walls NIA Total Duct Leakage 40 CFM @ 25Pa(Post-Construction) Framed Floor R-30 Heating Furnace•Propane•96 AFUE Slab N/A Cooling Air Conditioner•Electric•14.5 SEER Infiltration 3 ACH50 Water Heating Water Heater•Propane•0.87 Energy Factor Window U-Value:0.3,SHGC:0.28 As a 3rd party extension of the coda jurisdiction utilizing these reports,I certify that this energy code compliance document has been created in accordance%,.Hh the requirements of Chapter 4 of the adopted International Energy Conservation Code based on Climate Zone 4.If rating is Projected,I certify that the budding design described herein is consistent Will the � building plans,specifications,and other calculations submitted with the permit application.if rating is Confirmed,I candy that the address referenced daabove �has been Inspecteditested and that the mandator,provisions of the IECC have been installed to meet or exceed the intent of the IECC or will be verified as such by anther party / ✓�'/ Name: Matt Wahl Signature: Organization: Energy Rating Service Inc Digitally signed: 7/14/21 at 10:29 AM Ekotrope RATER-Version 4.0.0.2710 New York ECCC 2020 Certificate compliance results calculated using Ekotrope RATER's energy and coda compliance algorithm.including appropriate amendments. Ekotrope RATER is a RESNET Accredited HERS Rating Tool AO results are based on data entered by Ekotrope users. i Ekolrope disclaims all Iiabi0ty for the information shown on this report. Air Leakage Report EN remblce Property Organization Inspection Status EN 565 Mailer Ct Energy Rating Service Inc Results are projected 7aR9 Southold, NY 11971 Matt Wahl Model:custom home 631-566-8439 Community: n/a Builder R1021-1-565MAILER-MJW Roberts Premier 565 Mailer Ct, Southold Development General Information Conditioned Floor Area[ft] 2,238 Infiltration Volume[ft'] 34,593 Number of Bedrooms 4 Air Leakage Measured Infiltration 3 ACH50 ACH50 (Calculated) 3.00 ELA[sq. in.] (Calculated) 94.89 ELA per 100 s.f. Shell Area(Calculated) 1.161 CFM50 (Calculated) 1,730 CFM50 I s.f. Shell Area (Calculated) 0.212 Duct Leakage System 1 System 2 Leakage to Outdoors 25 CFM @ 25Pa 40 CFM @ 25Pa (3.17/ 100 ft2) (2.76/ 100 ft-) Total Leakage Test Type Post-Construction Post-Construction Total Leakage [CFM @ 25 Pa] 25.0 40.0 Total Leakage [CFM25/100 s.f.] 3.2 2.8 Total Leakage [CFM25/CFA] 0.032 0.028 Mechanical Ventilation Rate[CFM] 65 CFM, 65 CFM Hours per day 12.0, 12.0 Fan Power 22.75 Watts (Default), 22.75 Watts (Default) Recovery Efficiency% 0.0, 0.0 Runs at least once every 3 hrs? true, true Average Rate [CFM] 32.5 CFM, 32.5 CFM 2010 ASHRAE 62.2 Req. Cont.Ventilation 59.9 2013 ASHRAE 62.2 Req. Cont.Ventilation 34.9 Ekotrope RATER-Version 4.0.0.2710 All results are based on data entered by Ekotrope users.Ekotrope disclaims all liability for the information shown on this report. Building Summary Fnr rProperty Organization Inspection Status tGF7)Ip EIUICB 565 Mailer Ct Energy Rating Service Inc Results are projected c/ Southold,NY 11971 Matt Wahl Model:custom home 631-566-8439 Community:n/a Builder R1021-1-565MAILER-MJW Roberts Premier Development 565 Mailer Ct,Southold Generai-Building information Number Of Bedrooms 4 Number Of Floors 2 Conditioned Floor Area[sq.ft.] 2,238 Has Electric Vehicle Ready Space No Unconditioned,attached garage? No Conditioned Volume[cu.ft.] 34,593 Total Units in Building 1 Residence Type Single family detached Floor Number - Model custom home Community nla Climate Zone 4A Foundatio"n Wall None Present Foundation Wail,Library List None Present Slab, ;- None Present Slab.:Library List None Present Framed F oor Name Library Type Carpet R Floor Grade Surface Area Location Basement R30,FG2,10-16 eko w/o 0 Above Grade 1,449.0 ft2 Insulated Unconditioned sheetrock Basement garage ceiling R30,FG2,10-16 eko 0 Above Grade 524.0 ftz Unconditioned,attached garage garage ceiling-Copy R30,FG2,10-16 eko 0 Above Grade 85.0 ftz Exposed Exterior 1 Building Summary EN Property Organization Inspection Status 565 Mailer Ct Energy Rating Service Inc Results are projected Southold,NY 11971 Matt Wahl Model:custom home 631-566-8439 Community:n1a Builder R1021-1-565MAILER-MJW Roberts Premier Development 565 Mailer Cl,Southold % 4A 20-�U' Name Effective R-value R30,FG2,10-16 eko 25.729 R30,FG2,10-16 eko w/o sheetrock 25.004 1 09111 Name Library Type Surface Area Location 1-amb R 20.0 158.0 ft" Exposed Exterior 1-gar R 20.0 28.0 ft' Unconditioned,attached garage Name Effective Insulation R-value R 20.0 20.00 Wall 'g- APA Sm Name Library Type Surface Color Surface Area Location exterior walls 1 R21,FG2,6-16 Medium 1,580-0 ft' Exposed Exterior exterior walls 2 R21,FG2.6-16 Medium 720.0 ft2 Exposed Exterior gable walls 1420,LDF1,6-16 eko Medium 237.0 it' Exposed Exterior garage common walls R21,FG2,6-16 GCW eko Medium 280.0 111 Unconditioned,attached garage stairwell walls R15,FG2,4-16 GCW eko Medium 200.0 ft' Insulated Unconditioned Basement Building Summar reAceProperty Organization Inspection status �FiYJIIG 565 Mailer Ct Energy Rating Service Inc Results are projected d Southold,NY 11971 MattWahl Model:custom home 631-566-8439 Community:nla Builder R1021-1-565MAILER-MJW Roberts Premier Development 565 Mailer Ct,Southold -VVal1Libra' ` List' Name Effective R-value R15,FG2,4-16 GCW eko 11.65 R20,LDF1,6-16 eko 17.862 R21,FG2,6-16 16.134 R21,FG2,6-16 GCW eko 15.434 Gia ph � h Name Libra q Wall Foundation Is O rhan gq g Overhan Ft Tb Overhang Ft To Orientation Surface Area Type Assignment Wall perable OveDept b Top Bottom Assignment Unnamed Glazing U:0.30, exterior walls 2 Yes 2 1 4 East 9.0 ft2 SHGC:0.28 Unnamed Glazing U:0.30, exterior walls 2 Yes 0 0 0 East 47.0 1t2 SHGC:0.28 Unnamed Glazing U:0.30, exterior walls 1 Yes 6 1 3 East 11.0 ft' SHGC:0.28 Unnamed Glazing U:0.30, exterior walls 1 Yes 12 1 4 East 32.0 ft' SHGC:0.28 Unnamed Glazing U:0.30, exterior walls 1 Yes 0 0 0 East 7.0 ft' SHGC:0.28 Unnamed Glazing U:0.30, exterior walls 2 Yes 10 0 5 West 30.0 ft2 SHGC:0.28 Unnamed Glazing U:0.30, exterior walls 2 Yes 10 0 9 West 158.0 ftz SHGC:0.28 Unnamed Glazing U:0.30, exterior walls 1 Yes 10 2 7 West 78.0 ftz SHGC:0.28 Unnamed Glazing U:0.30, exterior walls 1 Yes 10 2 9 West 41.0 ft' SHGC:028 Unnamed Glazing U:0.30, exterior walls 1 Yes 0 0 0 South 46.0 ft' SHGC:028 Unnamed Glazing U:0.30, exterior walls 2 Yes 0 0 0 North 18.0 ft' SHGC:0.28 Unnamed Glazing U:0.30, exterior walls 1 Yes 0 0 0 North 13.0 ft' SHGC:0.28 Unnamed Glazing U:0.30, exterior walls 1 Yes 8 0 9 North 27.0 ftz SHGC:0.28 'Glazin'":Libya °:List.t :n.., :f Name Shgc U-factor U:0.30,SHGC:0.28 0.28 0.300 3 Building Summary E�' . reAtceProperty Organization Inspection Status 565 Mailer Ct Energy Rating Service Inc Results are projected r Southold,NV 91971 Matt Wahl Model:custom home 631-566-8439 Community:n1a Builder R1021-1-565MAILER4MJW Roberts Premier Development 565 Mailer Ct,Southold e u .:^,?'. �':t.�t:.Ye"i",yA^.� ..1�'+' ..�.Y n`,�h'K:'� `r } <,�":{^?:�. .ay+.:'�§�r" x'y�.:.; .�3'i ii,>t.a cq^.. ..:e�. .:<'r. ',v' .x.•. .s ,`J -�.. ��rr .p.,y..• ': _ 'a`� .- None pPresent wS Er htLtbra [ List , . Y.,„ •, :;� None Present p.q ;, �� . =� � �. .. - •gam,..; n•�w';'g - - - '� _ •-s....�....-s�gs:,..,.,._._.:..�`.a._,�...r.=�.- Name Library Type Wall Assignment Foundation Wall EmittancSolar -SurfaceCalor Surface Area Location Assignment Absorptance Unnamed Opaque Door 2-114 Wd solid exterior walls 1 0.9 0.75 Medium 32.0 ftz Exposed Exterior core Unnamed Opaque Door 2-114 Wd solid stairwell walls 0.9 0.75 Medium 21.0 112 Exposed Exterior -Copy core Unnamed Opaque Door R5 steel insul garage common 0.9 0.75 Medium 21.0 ft' Exposed Exterior -Copy-Copy walls Unnamed Opaque Door 2-114 Wd solid exterior walls 2 0.9 0.75 Medium 24.0 ft' Exposed Exterior -Copy-Copy-Copy core - `s�A .. �; x..tkf�s`�,k �'Qpaque DoorLibraryLisf� n, Name Effective U-factor 2-114 Wd solid core 0.357 R5 steel insul 0.200 Name Library Type Attic Exterior Area[ft:] Clay or Concrete Roof Surface Color Surface Area Location Tiles Roof Rafters R38,LDF1,4-24s truss 2,909 No Medium 2,909.0 f12 Vaulted Roof eko 4 Building Summary FMY �. Property Organization Inspection status Wa �� eTUtt�565 Mailer Ct Energy Rating Service Inc Results are projected Southold,IVY 11971 t-tatt Wahl Model:custom home 631-566-8439 Community:n/a .Builder R1021-1565MAILER-MJW Roberts Premier Development 565 Mailer Ct,Southold �� '�` =In, lation Library List `�' � ,x�;��a�� j��r,M� . 04 Name Has Radiant Barrier Effective R-value R38,LDF1,4-24s truss No 39.62 eko �tllhc�ie house Infiltration ` F Infiltration Measurement Type Shelter Class 3 ACH at 50 Pa Blower-door tested 4 Me^chanical l/entitation =,: Vft"M-'�20tMEN 1-1.� ol�ffl Ventilation Type Ventilation Rate!tt'I Operational hours per day Fan Watts Runs once every three Energy Recovery Percent Minute] hours Exhaust Only 65 CFM 12 22.75 Watts(Default) Yes 0 Exhaust Only 65 CFM 12 22.75 Watts(Default) Yes 0 wt 'i ":dtyla _ •#d 'Yv-z`y'l, _r3., Mal %Interior Fluorescent %Interior LED Lighting %Exterior Fluorescent %Exterior LED Lighting %Garage Fluorescent %Garage LED Lighting Lighting Lighting Lighting 0 100 0 '100 0 100 F. �:;,., ��.a_,� :,��, ap_ff;;•.,�';-sem.: :=�i� � ,,�ti;h ''R,H:°: ' '=x, z+:a;:_..._-..,,-_ None Present Onsite Generation library list ""A None Present 5 Building Summary ENP a,#Property Organization Inspection Status rAwe 565 Mailer Ct Energy Rating Service Inc Results are projected Southold,NY 11971 Matt Wahl Model:custom home 631-566-8439 Community:nta Builder R1021-1-5651VIAILER-MJW Roberts Premier Development 565 Mailer Ct,Southold r None Present 4, I , 4 "X 4- "Al A None Present .7, 7 MIDNi 11 NEWi<er 1_ibra List IN L None Present f �Conclitw 111 Name Library Type Heating Percent Load Cooling Percent Load Hot Water Percent Load Location Cooling 1st Floor All 30K,14.5 SEER 0% 50% 0% Unconditioned Basement/ Crawlspace Cooling 2nd Floor ACC,18K,14.5 SEER 0% 60% 0% Conditioned I Sealed Attic Heating 1st Floor Prop Fum,40k,96%ECM 50% 0% 0% Unconditioned Basement Cral Heating 2nd Floor Prop Fum,40k,!96%ECM 50% 0%. 0%, Conditioned I Sealed Attic Water Heating Prop,IT,55gal,95B% 0% 0% 100% Unconditioned Basement! Crawlspace 1E13.lK, U fill 8' Equipment Type Air Conditioner' Fuel Type Electric Distribution Type Forced Air Motor Type PS.C(Sing_le Speed) 'Cooling Efficiency 14.5-SEER Codling Capacity[kBtu/h] 18 Building Summary ENYProperty Organization Inspection Status �Q1711p ensue 565 Mailer Ct Energy Rating Service Inc Results are projected el Southold,NY 11971 Matt Wahl Model:custom home 631-566-8439 Community:n/a Builder R1021-1-565MAILER-MJW Roberts Premier Development 565 Mailer Ct,Southold - Equipmen T pe 1aC�C�30K�14 5�SEEkv� := Equipment Type Air Conditioner Fuel Type Electric Distribution Type Forced Air Motor Type _PSG(Single Speed)' Cooling Efficiency 14.5 SEER Cooling Capacity[kBtulh] 30 Equipiment hype Prop FurA020 ,96 Equipment Type Furnace Fuel Type Propane Distribution Type Forced Air Motor Type ECM(Variable Speed) Heating Efficiency 96AFUE Heating Capacity[kBtuih] 40 Use default EAE No EAE[kWh] 450 Equipment Type Water Heater Fuel Type Propane Distribution Type Hydronic Delivery(Radiant) Hot Water Efficiency 0.0 Energy Factor Tank Capacity(gal.) 55 Hot Water Capacity[kBtu/h] 40 Recovery Efficiency 0.95 7 Building Summary IVreAeProperty Organization Inspection Status Etaj7fly 565 Mailer Ct Energy Rating Service Inc Results are projected r Southold,NY 11971 Matt Wahl Model:custom home 631-566-8439 Community:n1a Builder 81021-1-565MAILER-MAV Roberts Premier development 565 Mailer Ct,Southold DistribUtion Systiem ° f Distribution Type Forced Air Heating Equipment Heating 2nd Floor Cooling Equipment Cooling 2nd Floor Sq. Feet Served 789 Return Grilles 4 Supply Duct R Value 8 Return Duct R Value 8 Supply Duct Area[µ1`121 213.03 Return Duct Area[fl2] 157.8 Leakage to Outdoors 25 CFM @ 25Pa(3.171100 f12) Total Leakage 25 CFN125 Total Leakage Duct Test Conditions Post-Construction Use Default Flow Rate Yes Duct 1 Duct Location Conditioned Attic(insulated walls and Percent Supply Area 100 Percent Return Area 100 Duct 2 Duct Location Conditioned Space Percent Supply Area 0 Percent Return Area 0 Duct 3 Duct Location Conditioned Space Percent Supply Area 0. Percent Return Area 0 Duct 4 Duct Location Conditioned Space Percent Supply Area 0 Percent Return Area 0 Duct 5 Duct Location Conditioned Space Percent Supply Area 0 Percent Return Area 0 Duct 6 Duct Location Conditioned Space Percent Supply Area 0 Percent Return Area 0 8 Building Summary EN Property Organization Inspection Status 565 Mailer Ct Energy Rating Service Inc Results are projected Southold,NY 11971 Matt Wahl Model:custom home 631-566-8439 Community:n1a Builder R1021-1-565MAILER-MJW Roberts Premier Development 565 Mailer Ct,Southold Distrltiution Sy'Md. Distribution Type Forced Air Heating Equipment Heating 1st Floor Cooling Equipment Cooling 1st Floor Sq. Feet Served 1,449 4 Return Grilles 1 Supply Duct R Value 8 Return Duct R Value 8 Supply Duct Area[ft2] 391.23 Return Duct Area[ft2] 72.45 Leakage to Outdoors 40 CFM @ 25Pa(2.76 1100 ft2) Total Leakage 40 CFM25 Total Default Duct Test Conditions -Post-Construction Use Default Flow Rate Yes Duct I Duct Location Basement(insulated basement ceiling) Percent Supply Area 100 Percent Return Area 100 Duct 2 DuctLocationConditioned Space Percent supply Area 0 Perce'ni Retu m Area Duct 3 Duct Location Conditioned Space Percent Supply Area 6 Percent Return Area 0 Duct 4 Duct Location Conditioned Space Percent Supply Area 0 Percent Return Area 0 Duct 5 Duct Location Conditioned Space Percent Supply Area 0 Percenf Return Area 0 Duct 6 Duct Location Conditioned Space Percent SupplyArea0 Percent Retu rn Area 0 G-- -T: 41 Has Ceiling Fan'- No rCf m Per Watt 100 Water Fixture Type Standard Use Default Hot Water Pipe Length No Hot Water Pipe Length[ft] 65 At Least R3 Pipe Insulation? Yes Hot Water Recirculation System? No Recirculation System Pipe Loop Length[ft] 30 Drain Water Heat Recovery? No- 9 Building Summary Eli Property Organization Inspection Status reAe 565 Mailer Ct Energy Rating Service Inc Results are protected Southold,NY 11971 Matt Wahl Model:custom home 631-566-8439 Community:Wa Builder 81021-1-565MAILER-MJVV Roberts Premier Development 565 Mailer Ct,Southold Cef 3.01 Fuel Type Electric Field Utilization Moisture Sensing Is Outside Conditioned Space No Clothes DryrerAvailable Yes Defaults Type HERS Reference S 8, Label Energy Rating 152 kWh/Year Annual Gas Cost S12.00 Electric Rate S0.12/kWh Gas Rate S1.09/Therm Capacity 4.2 Imef 2-06 Defaults Type ENERGY STAR Load Type Front-load Loads Per Week 6 Is Outside Conditioned Space No Clothes Washer Available Yes DIS' h*40pr"� Dishwasher Efficiency 325.75758 kWh Dishwasher Size Standard Annual Gas Cost S33.12 Electric Rate S0.12/kWh Gas Rate S1.09/Therm Is Outside Conditioned Space No A pp,Iances,.And,C6 fitr6ls Programmable thermostat? Yes RangelOven Fuel Electric Convection Oven? Yes Induction Range? No Range/Oven Outside Conditioned Space? No Refrigerator Consumption 578 kWh/Year Refrigerator Outside Conditioned Space? No 10 Building Summary E� Property Organization Inspection Status GlIIIQ reAe 565 Mailer Ct Energy Rating Service Inc Results are projected Southold,NY 11971 Matt Wahl Model:custom home 631-566-8439 Community:Na Builder R1 021-1-865MAILER-MJW Roberts Premier Development 565 Mailer Ct,Southold 1— q Notes . MJW 06103/2021 565 MAILER CT HOUSE DESCRIPTION -HERS RATING ONLY -NEW HOME -HERS INDEX,2020 NY ECCC -PROPANE,ELECTRIC -3,12, 11:12, 12:12 PITCH -4 BEDROOMS -2 STORY -FRONT FACES EAST -BASEMENT HOUSES HOT WATER, I AIR HANDLERJ AC COILJ FURNACE -ATTIC HOUSES I AIR HANDLER.1 AG COIL,1 FURNACE -RETURN GRILLS 2 -INDOOR AIR QUALITY.BATH FAN 65 CFM X24HRS -SOLAR PV N/A RESNET HOME ENERGY RATING Standard Disclosure For home(s) located at: 565 Mailer Ct, Southold, NY Check the applicable disclosure(s): 1.The Rater or the Rater's employer is receiving a fee for providing the rating on this home. 2. In addition to the rating, the Rater or the Rater's employer has also provided the following consulting services for this home: EA. Mechanical system design Wj B. Moisture control or indoor air quality consulting. C. Performance testing and/or commissioning other than required for the rating itself D. Training for sales or construction personnel E. Other(specify) 3.The Rater or the Rater's employer is: A. The seller of this home or their agent El B. The mortgagor for some portion of the financed payments on this home C.An employee, contractor, or consultant of the electric and/or natural gas utility serving this home 4.The Rater or Rater's employer is a supplier or installer of products, which may include: Products Installed in this home by OR is in the business of HVAC systems Rater Employer Rater Employer Thermal insulation systems JqRater WjEmployer JqRater REmployer Air sealing of envelope or duct systems §qRater REmployer §FRater MEmployer Energy efficient appliances URater MEmployer DRater []Employer Construction (builder, developer, construction contractor, etc) Rater Employer Rater Employer Other(specify): I URater ElEmployer Rater Employer []5.This home has been verified under the provisions of Chapter 6, Section 603 "Technical Requirements for Sampling" of the Mortgage Industry National Home Energy Rating Standard as set forth by the Residential Energy Services Network (RESNET). Rater Certification #: 2572845 Name: Matt Wahl Signature: A*d Organization: Energy Rating Service Inc Digitally signed: 7/14/21 at 10:29 AM I attest that the above information is true and correct to the best of my knowledge.As a Rater or Rating Provider I abide by the rating quality control provisions of the Mortgage Industry NationalHome Energy Rating Standard as set forth by the Residential Energy Services Network(RESNET). The national rating quality control provisions of the rating standard are contained in Chapter One 102.1.4.6 of the standard and are posted at https://standards.resnet.us The Home Energy Rating Standard Disclosure for this home is available from the rating provider. RESNET Form 03001-2 -Amended March 20, 2017 r Builder Affidavit Property Organization Inspection Status ENEW reAe 565 Mailer Ct Energy Rating Service Inc Results are projected Southold, NY 11971 Matt Wahl Model: custom home 631-566-8439 Community: n/a Builder 81021-1-565MAILER-MJW Roberts Premier 565 Mailer Ct,Southold Development Important Notice to Builder Builder affirms in this affidavit that all building characteristics described in the Building Summary Report accurately reflect this New Home. Builder agrees to allow the Home Energy Rating System (HERS)Provider and/or Rater to verify building characteristics of this New Home fully at the HERS Rater/Provider's discretion. The HERS Provider and Rater do not create or imply any duty or obligations to Builder or any subsequent owner. Builder is responsible for taking any actions necessary to protect Builder's interest.There is no guarantee or warranty whatsoever expressed or implied from the HERS Provider or Rater. HERS®Index Score:56 Builder Name: Roberts Premier Development Builder Signature: Name: Matt Wahl Signature: ASW Organization: Energy Rating Service Inc Digitally signed: 7/14/21 at 10:29 AM Ekotrope RATER-Version 4.0.0.2710 All results are based on data entered by Ekotrope users.Ekotrope disclaims all liability for the information shorn on this report. Home Energy Rating Certificate Rating Date: 2022-06-21 Viy P Final Report Registry ID: 333591811 .yi:aIi/W (Yenuce Ekotrope ID: x25o8ppd HERS' • - • Home: ur home's HERS score is a relative 565 Mailer Ct 56yperformance score.The lower the Southol• NY 11971 number, • - energy $ 3545 • - hoome.To learn more,visit --Melative to anaverage U.S.h ome Roberts Premier Development Your Home's Estimated Energy Use: This home meets or exceeds the Use[Ml3tu] Annual Cost criteria of the following: Heating 63.4 $2,260 2016 New York ECCC Cooling 1.1 $28 2020 New York ECCC b� Hot Water 13.9 $499 ( ( 1 1 2018 International Energy Conservation Code Lights/Appliances 17.9 $476 2V International Energy Conservation Code Service Charges $164 0z1J2 International Energy Conservation Code Generation(e.g.Solar) 0.0 $0 N � 0 6s2 b.9 International Energy Conservation Code Total: 96.2 $3,427 026 International Energy Conservation Code HERVInclex Home Feature Summary: J c-,j iting Completed by: Q MorcEnergy HomeType: Single family detached :7-- ,fixr Rater: Matt Wahl :50 Model: custom home ; gY E„isting iw Community: n/a �.RE$1JETID: 2572845 Homes 230 Conditioned Floor Area: 2,238 fe �iting Company: Energy Rating Service Inc 220 Number of Bedrooms: 4 3§`ellar Dr,Islip Terrace,NY 11752 Reference -- a�0o Primary Heating System: Furnace•Propane•96.1 AFUE 631-566-6439 Home Primary Cooling System: Air Conditioner•Electric•15.1 aE� 90 Rating Provider: Building Efficiency Resources so Primary Water Heating: Residential Water Heater•Propane-0.72 UEF PO Box 1769 Brevard,NC 28712 70 House Tightness: 1548.2 CFM50(2.69 ACH50) 800-399-9620 60_ Ventilation: 65 CFM,65 CFM•22.75 Watts(Default),22.75 Watts 4 • so (Default) 40 This Home Duct Leakage to Outside: 40 CFM @ 2513a(2.76/100 ft') $0 Above Grade Walls: Vaulted 4 wp Ceiling: Vaulted Roof,R-39 Zero Energy i9 Window Type: U Value:0.3,SHGC:028 Home o Foundation Walls: N/A Matt Wahl,Certified Energy Rater lessEnetiy Framed Floor: R-30 Digitally signed:6/23/22 at 1:16 PM -------------- ibekotrope Ekotrope RATER-Version:4.0.02933 r ' Energy Code Inspection Checklist ENPProperty Organization Inspection Status raft este 565 Mailer Ct Energy Rating Service Inc Results are projected Southold, NY 11971 Matt Wahl Model:custom home 631-566-8439 Community: n/a Builder R1021-1-565MAILER-MJW Roberts Premier 565 Mailer Ct,Southold Development General Building Information Conditioned Area (sq ft) 2,238 Conditioned Volume(cubic ft) 34,593 Insulated Shell Area (sq ft) 8,170 The building energy model in Ekotrope reflects the building assemblies and energy features listed below. Sometimes energy features will change in the field from what has been modeled.The inspection process should identify any changes and ensure that the home continues to meet the applicable energy code. Slab None Present Framed Floor NqName: Basement(1,449 s.f.) R-0 continuous insulation, R-30 cavity insulation Insulation Grade: II Name: garage ceiling (524 s.f.) R-0 continuous insulation, R-30 cavity insulation Insulation Grade: 11 Name: Overhang (85 s.f.) R-0 continuous insulation, R-30 cavity insulation Insulation Grade: II Foundation Wall None Present Above Grade Wall Name:exterior walls 2 (720 s.f.) R-0 continuous insulation, R-21 cavity insulation Insulation Grade: II Name:exterior walls 1 (1,580 s.f.) 1 R-0 continuous insulation, R-21 cavity insulation Insulation Grade:11 Energy Code Inspection Checklist JFN , Property Organization Inspection Status �aZ!��Y&Axe 565 Mailer Ct Energy Rating Service Inc Results are projected Southold, NY 11971 Matt Wahl Model: custom home 631-566-8439 Community: n/a Builder R1021-1-565MAILER-MJW Roberts Premier 565 Mailer Ct, Southold Development Name:gable walls (237 s.f.) R-0 continuous insulation, R-21.45 cavity insulation Insulation Grade: 1 Name:garage common walls (280 s.f.) R-0 continuous insulation, R-21 cavity insulation Insulation Grade: 11 Name:stairwell walls (200 s.f.) R-0 continuous insulation, R-15 cavity insulation Insulation Grade: 11 Rim Joist leName: 1-amb (158 s.f.) R:20.00 Name: 1-gar(28 s.f.) R: 20.00 Ceiling 1 Roof Name: Roof Rafters(2,909 s.f.) R-25.9 continuous insulation, R-12.95 cavity insulation Insulation Grade: I Opaque Door Name: Unnamed Opaque Door(32 s.f.) U: 0.357 Name: Unnamed Opaque Door-Copy(21 s.f.) U:0.357 El Name: Unnamed Opaque Door-Copy-Copy (21 s.f.) U: 0.200 2 Name: Unnamed Opaque Door-Copy-Copy-Copy(24 s.f.) U: 0.357 Y Energy Code Inspection Checklist Property Organization Inspection Status EN 'yenice 565 Mailer Ct Energy Rating Service Inc Results are projected Southold, NY 11971 Matt Wahl Model: custom home 631-566-8439 Community: nla Builder R1021-1-565MAILER-MJW Roberts Premier 565 Mailer Ct, Southold Development Glazing NqName: Unnamed Glazing (9 s.f.), U: 0.300, SHGC: 0.28, Orientation: EAST Name: Unnamed Glazing(47 s.f.), U: 0.300, SHGC: 0.28, Orientation: EAST Name: Unnamed Glazing (11 s.f.), U: 0.300, SHGC: 0.28, Orientation: EAST Name: Unnamed Glazing (32 s.f.), U: 0.300, SHGC: 0.28, Orientation: EAST Name: Unnamed Glazing (7 s.f.), U: 0.300, SHGC: 0.28, Orientation: EAST Name: Unnamed Glazing(30 s.f.), U: 0.300, SHGC: 0.28, Orientation: WEST Name: Unnamed Glazing (158 s.f.), U:0.300, SHGC: 0.28, Orientation: WEST Name: Unnamed Glazing (78 s.f.), U: 0.300, SHGC: 0.28, Orientation: WEST Name: Unnamed Glazing(41 s.f.), U: 0.300, SHGC: 0.28, Orientation:WEST Name: Unnamed Glazing(46 s.f.), U: 0.300, SHGC: 0.28, Orientation: SOUTH Name: Unnamed Glazing (18 s.f.), U: 0.300, SHGC: 0.28, Orientation: NORTH Name: Unnamed Glazing(13 s.f.), U: 0.300, SHGC: 0.28, Orientation: NORTH Name: Unnamed Glazing (27 s.f.), U: 0.300, SHGC: 0.28, Orientation: NORTH Skylight None Present Mechanical Ventilation 3 Energy Code Inspection Checklist Property Organization Inspection Status EN"G2a9reiAce 565 Mailer Ct Energy Rating Service Inc Results are projected Southold, NY 11971 Matt Wahl Model:custom home 631-566-8439 Community: n/a Builder R1021-1-565MAILER-MJW Roberts Premier 565 Mailer Ct, Southold Development Mechanical ventilation system rated for, and capable of, providing continuous ventilation. System shall include automatic timing controls. System type: Exhaust Only, 12 hrs/day, 22.75 Watts (Default) 0 Mechanical ventilation system rated for, and capable of, providing continuous ventilation. System shall include automatic timing controls. System type: Exhaust Only, 12 hrslday, 22.75 Watts (Default) Mechanical Equipment Cooling 2nd Floor-.Electric• 50% Cooling Load @ 14.5 SEER Cooling 1st Floor • Electric•50% Cooling Load @ 14.5 SEER Heating 2nd Floor• Propane•50% Heating Load @ 96 AFUE Heating 1st Floor• Propane • 50% Heating Load @ 96 AFUE Water Heating • Propane• 100% Hot Water Load @ 0.87 Energy Factor Air Leakage Control Test Status: Blower-door tested House is air-sealed as to achieve 1,730 CFM50(3.00 ACH50)or less at final blower-door test. Infiltration Requirements for IECC in Climate Zone 4 2009 IECC Infiltration limit for the design home is 7 ACH50. 2012 IECC Infiltration limit for the design home is 3 ACH50. 2015 IECC Infiltration limit for the design home is 3 ACH50. 2018 IECC Infiltration limit for the design home is 3 ACH50. 2021 IECC Infiltration limit for the design home is 5 ACH50. 4 Energy Code Inspection Checklist E`� I1` VV �� Property Organization Inspection Status WJ7Wervue 565 Mailer Ct Energy Rating Service Inc Results are projected Southold, NY 11971 Matt Wahl Model:custom home 631-566-8439 Community: n/a Builder R1021-1-565MAILER-MJW Roberts Premier 565 Mailer Ct, Southold Development Duct Leakage Duct System 1 All ducts and equipment within conditioned space Leakage to Outside specified as:25 CFM @ 25Pa (3.17/ 100 fF) Total Leakage specified as:40 CFM @ 25Pa (Post-Construction) Duct System 2 NOT entirely within conditioned space, testing required Leakage to Outside specified as:40 CFM @ 25Pa (2.76/ 100 fF) Total Leakage specified as:40 CFM @ 25Pa (Post-Construction) Duct Leakage Code Requirements for IECC 2009 IECC: Postconstruction Leakage Test: Duct Leakage to Outdoors<=8 CFM25/ 100 sq ft CFA. Rough in Test with AHU:Total Duct Leakage<=6 CFM25/100 sq ft CFA. Rough in Test without AHU:Total Duct Leakage<=4 CFM25/100 sq ft CFA. 2012 IECC Mandatory,2015 and 2018 IECC Prescriptive Paths: Postconstruction Leakage Test:Total Duct Leakage<=4 CFM25/100 sq ft CFA. Rough in Test with AHU:Total Duct Leakage<=4 CFM25/100 sq ft CFA. Rough in Test without AHU:Total Duct Leakage<=3 CFM25/ 100 sq ft CFA. 2015 and 2018 IECC Performance Paths(Cost Compliance): Leakage testing is required UNLESS all ducts and air handlers are located entirely within the thermal envelope. There is no pass/fail threshold for duct leakage on the performance path. 5 Energy Code Inspection Checklist Property Organization Inspection Status atn9 ervue 565 Mailer Ct Energy Rating Service Inc Results are projected Southold, NY 11971 Matt Wahl Model: custom home 631-566-8439 Community: nla Builder R1021-1-565MAILER-MJW Roberts Premier 565 Mailer Ct, Southold Development Project Notes MJW 02/21/2022 INSULATION FIELD VERIFICATION-OK/PASSING -R21 EXT WALLS, OC ROOF RAFTERS, FG BASE CEILING -WINDOWS .30/.28 -STAIRWELL AND FIN INSH STAIRS NOT INSTALLED MJW 06/03/2021 565 MAILER CT HOUSE DESCRIPTION -HERS RATING ONLY -NEW HOME -HERS INDEX, 2020 NY ECCC -PROPANE, ELECTRIC -3:12, 11:12, 12:12 PITCH -4 BEDROOMS -2 STORY -FRONT FACES EAST -BASEMENT HOUSES HOT WATER , 1 AIR HANDLER,1 AC COIL,1 FURNACE -ATTIC HOUSES 1 AIR HANDLER,1 AC COIL,1 FURNACE -RETURN GRILLS 2 -INDOOR AIR QUALITY. BATH FAN 65 CFM X24HRS -SOLAR PV: NIA 6 e t - / i 7E ♦•' Sri h 'zl a +ti '3 1 � • f � 3. J R 6/27/22, 12:55 PM Yahoo Mail-Sticker = 1 I 565 MailerQSouthold NY i.*�Opgmtlylo:33359,91, Mnud Estlmaus: Rating Company. t)ectnc i1.5Yh1: 4760.3 Energy Rat ing se,Ke Inc R.Ung Predden Pmpane(GatlensY. 9342 aij,sding Efficiency Resourms a CO2(Tonst: 88 Rathy Provider Address: Ap pm Energy Cost $1.842 PO Box 17698rr ard.NC 18712 Florae Feature Summary: r SINN furuly detached 4 . � Sitimu+g 96.1 AFUE i Caartvg 15.1 SEER .. .r..... `" Hot Wit":(172 UEF .. __ ea AJr Leakage. 13442 CFM5t1(269 ACH5M ventifatro t 65 CFM.6S CFM-22.75 W 22.75 W(Ddavlu 40 1D: �ff M..e 2sva R.T6/laoft'I Ab—Gnde Weltf:R-21 %b ted Ree(R-39 1Wdar.u a3.5HraC:ole f—datKM Wags:WA 1 AOF l ` New York 2020 Label 565 Marler Cf Model_custom home Ekotrope RATER-Version:4 0.02933 HERSO Index Score:56 stdllEht9loP0 _' Ceiling:R-39 Above Grade Walls:R•21 Foundation Walls:WA - Exposed Floor R-30 Stab:WA Infill7arion:1548.2 CFµ50(2.69 ACHSO) Duct Insuteton:Supply R8,Retum:R8 Duct Lkg to Outdoors:40 CFM P 25Pa(2 76 1100 ft') ~Oig(apoor$p"a —wilm.. U-value:0.3,SHG-C:028 Doo,R-2 Mechanlatl f g47PR4M 8RlS IHeaun9.Furnace•Propano•96.1 AFUE Cwling-Air Conditioner•Electnc•15.1 SEER Ha Wale..ReNdenhal Water Heater•Propane 0.72 UEF Avera Oe Mechan,t-al Venblatron.65 CFM Builder41'r p(r -Rt9twlepl__ _. s nature: i t JUN 2 7'9n99 BUILDING DEPT. TOWN OF SOUP;iU1_t'7 PON .77 777 - _ e; Yahoo Mail-Hot water 565 Mailer Court - y: 10 a .+ P j:p5rnllh _ I rim y � � Aja a BUILDrNTG DF_.FT. TOWN OF SOUTTI-TOLD 2/3 6/24/22,3:00 PM image0000001.jpg J L sa OF a . �'•.'� ii https://mail.google.com/mail/u/1/#inbox/QgrcJHsTmZxVhdnZgrNgxPpWpfgtrgjHPzQ?projector=1 1/1 6/24/22,3:00 PM image0000001.jpg 3, #r° hftps://mail.google.com/mail/u/1/#inbox/QgrcJ HsTmZxVhdnZgrNgxPpWpfgtrgjH PzQ?projector=l 1/1 6/24/22,3:00 PM image0000001.jpg V T I M. 2022 47 https://mai1.googIe.com/mail/u/1/#inbox/QgrcJ HsTmZxVhdnZgrNgxPpWpfgtrgjH PzQ?projector=1 1/1 6/24/22,3:00 PM image0000001.jpg F. pryT r l?FPT. r. I ' https://mai1.google.com/mail/u/1/#inbox/QgrcJ HsTmZxVhdnZgrNgxPpWpfgtrgjH PzQ?projector=1 1/1 1 • • FOUNDATION • 1 e e Ini MALIK= Allll� ,' e 1 INSULA ITIONTER N.Y. . / W VIM In • 16 ® • B 0 • S�fFot� TOWN OF SOUTHOLD—BUILDING DEPARTMENT y Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 ?y�o Telephone(631) 765-1802 Fax(631) 765-9502 https://www.southoldtowm.aov Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only D E C� E � �� E PERMIT NO. -/�O Building Inspector: - OCT 16 1U111 DD BUILDING DEPT. Applications and forms must be filled out in their entirety.Incomplete TOWN OF SOUTHOLD applications will not be accepted. Where the Applicant is not the owner,an Owner's Authorization form(Page 2)shall be completed. Date:10/05/2021 OWNER(S)OF PROPERTY: Name:Roberts Premier Development LLC _ s TM#1000-70-09-36 _ Project Address:565 Mailer court Phone#:631-909-4246 Email:Bridget@twinpondscabinetr .Com_. Mailing Address:3 Sandie Lane Manorville NY 11949 CONTACT PERSON: Name:David Roberts Mailing Address:3 Sandie Lane Manorville NY 11949 Phone#:631-905-4789 Email:david@djcustom homes.com_ DESIGN PROFESSIONAL INFORMATION: Name:Keri Kazel Architecture MailingAddress:2 Windemere court P.O.Box 169_Speonk NY 11972 Phone#:631-874-2925 _ _ _ _ Ema�l_keri@kazelarchitects.com CONTRACTOR INFORMATION: Name: DJ Custom Homes, Corp Mailing Address:383 Main St Center Moriches 11934 Phone#_631-848-3507_ _ ^_ Emaii:James@djcustomhomes.com DESCRIPTION OF PROPOSED CONSTRUCTION BNew Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: ❑Other $325,000 Will the lot be re-graded? ❑Yes ®No Will excess fill be removed from premises? ®Yes []No 1 PROPERTY INFORMATION Existing use of property: scantan pstory Intended use of property:Proposed 2 sto residence Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to Residential R=4O this property? ❑Yes ®No IF YES, PROVIDE A COPY. ❑ Check Box After Reading: The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by Chapter 236 of the Town Code. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold,Suffolk,County,New York and other applicable Laws,Ordinances or Regulations,for the construction of buildings, additions,alterations or for removal or demolition as herein described.The applicant agrees to comply with all applicable laws,ordinances,building code, housing code and regulations and to admit authorized inspectors on premises and in building(s)for necessary inspections.False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the New York State Penal Law. Application Submitted By(print name):David Roberts , ❑Authorized Agent BOwner Signature of Applicant: Date: O p STATE OF NEW YORK) c S : COUNTY OF JI 0 I IC ) n\� � d C being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the �VUacy— (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 1-1 IU� day of , 20 Notary Public PATRICIA A.WALSH Notary Public,State of New York 067 PROPERTY OWNER AUTHORIZATION No.O1W Qualified in Suffolk Suffolk QuaCoo nty (Where the applicant is not the owner) Commission Expires I, residing at do hereby authorize to 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 TOWN OF.SOUTHOLD BUILDING PERMIT APPLICATION CHECIST BUILDING G DEPARTMENT Do you have or need the following,before applying? TOWN.HALL Board of Health SOUTHOLD,NY 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey Southoldtownny.gov PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application � 'i Flood Permit Examined ,20 .i �=a U V _ i'� Single&Separate Truss Identification Form SEP 2 6 2019 - Storm-Water Assessment Form Contact: Approved 20 BT?14)�?G D 3PT, ' �`=c-'' �r,• .,:�;� Mail to: Disapproved a/c 1 D Phone:,1/'76A——V2,`27!o Expiration. ,20 Building Inspector APPLICATION FOR BUILDING PERMIT Date ��. (� _)-20 INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accurate plot plan to scale. Fee according to schedule. : b. Plot plan showing location of lot and of buildings on premises,relationship to adjoining premises or public streets or areas, and waterways. c: The work covered by this application may not be commenced before issuance of Building Permit. d:Upon approval of this application,the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e.No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f..Every building permit shall expire if the work authorized has not commenced within 12 months after the date of. issuance'or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim,the Building Inspector may authorize,in writing,the extension of the permit for'-an addition six months. Thereafter, a new permit shall be required. 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, or alterations or for removal or demolition as herein-described.The applicant agrees to comply with all applicable laws, ordinances,building code,housing code a ulations, and to admit authorized inspectors on premises and in building for necessary inspections. gnature of applicant or name,if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,piumber'or.builder Name of owner of premises (As on the tax roll of latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) �V Builders License No. Plumbers License No. Electricians License No. Bry' Other Trade's LicenseNo 16 1. Location of land on which pro osed wo k will be done: House Number Street Hamlet Block Lot County Tax Map No. 1000 Section `�L� �s Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction.: . a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition _ ther oI oil`51400r oon — WC(lyef ap (Description)IY1. IP 4. Estimated Cost Fee (Tq be paid on filing this application)' 5. If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth. ' Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does.proposed construction violate any zoning law, ordinance or regulation? YES NO 13. W.ilt lot be re-graded? YES NO Will excess fill be removed from premises? YES NO 14.Names of Owner of premises Address Phone No. Name of Architect Address Phone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is.this property within 300 feet of a tidal wetland? * YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on suivey. 18. Are there any covenants and restrictions with respect to this property? * YES NO * IF YES, PROVIDE A COPY. STATE OF NEW YORK) � SS: COUNTY OF_,?i being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)He js the (Contractor, gent, 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 knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sw to before me 's J o a p C 2�ETSYA. PERKINS ryl�ubilc, State of New York Plot No.01 PE6130636 otary PublicOualffiSuffolk Coun Signature of Applicant 'NbCommission Expires July 18, FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL DATE: October 7, 2019 TO: Patricia Moore(Gobic) 51020 Main Road Southold, NY 11971 Please take notice that your application dated September 26, 2019 For a permit for a waiver of merger at Location of property 465 Mailler Court, Southold, NY County Tax Map No. 1000 - Section 70 Block 9 Lot 35 Is returned herewith and disapproved on the following grounds: The subject lot (SCTM# 1000-70-9-35) has merged with the adjacent lots (SCTM# 1000-70-9-361 pursuant to Article II Section 280-10 A., which states, "Merger. A nonconforming lot shall merge with an adjacent conforming or nonconforming lot which has been held in common ownership with the first lot at any time after July 1, 1983. An adjacent lot is one which abuts with the parcel for a common course of fifty (50) feet or more in distance. Nonconforming lots shall merge until the total lot size conforms to the current bulk schedule requirements." (:Lz1 Damon Rallis, Plans Examiner Note to Applicant: Any change or deviation to the above referenced application may require further review by the Southold Town Building Department. CC: file, Z.B.A. BOARD MEMBERS Southold Town Hall �r3F S0Ujiyl 53095 Main Road •P.O.Box 1179 �t Leslie Kanes Weisman,Chairperson � Q h O Southold,NY 11971-0959 D' k Patricia Acampora [ Office Location: Eric Dantes cn Town Annex/First Floor, Robert Lehnert,Jr. 0 ,^,aa�� 5437.5 Main Road(at Youngs Avenue) Nicholas Planamento 1�C0(f �`c.` Southold,NY 1.1971 IVE V + http://southoldtownny.gov ZONING BOARD OF APPEALS JUL 7 2020 J U L 1 2020 TOWN OF SOUTHOLD , BIT,jING DEFT• Tel.(631)765-1809 •Fax (631)765-9064 Southold Town Clerk SOLD FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF JUNE 25, 1020 ZBA Application No.: 7374 Applicants/Owners: Mileva Gobic and Dragana Gobic Property Location: 465 Mailler Court, Southold,NY SCTM: 1000-70-9-35 & 1000-70-9-36 SEQRA DETERMINATION: The Zoning Board of Appeals has visited the property under consideration in this.application and determines that this review falls under the Type II category of the State's List of Actions,without further requirements under SEQRA. SUFFOLK COUNTY .ADMINISTRATIVE CODE: This application was not required to be referred.to the Suffolk County Department of-Planning under tlf6 Suffolk-County-A-dministrative-Eode--Sections A--1-4-1 -to---- - --- - - 23. LWRP DETERMINATION: The relief; permit, or interpretation requested in this application is listed under the Minor Actions exempt list and is not subject to review under Chapter 268. PROPERTY FACTS/DESCRIPTION: The subject non-conforming, 22,250.03 square feet, .51 acre corner parcel, known as Lot 23 of Smithfield Park subdivision (SCTM: 1000-70-9-36) located in the R-40 Zoning District measures 42.09 feet along irregular frontage at Custer Avenue and continues 111.21 feet east, establishing a northern boundary, to a corner with Mailler Court and then continues south 95.99 feet before turning west, 199.71 feet along an undeveloped and vacant lot to the south, subject of this waiver of merger application, known as Lot.22 of Smithfield Park subdivision (SCTM: 1000-70-90-35), then returns north 124:87 feet along two residentially developed lots to the west. Lot 22 is a non-conforming, 20,873.69 square feet, .48 acre rectangular-shaped parcel, located in the R-40 Zoning District and measures 100 feet along Mailler Court, then runs west 217.79 feet along a residentially developed lot to the south, then runs north 101.62 feet along two residentially developed lots to the west and returns east, 199.71 feet along an undeveloped and vacant lot to the north, subject of this waiver of merger application, known as Lot 23 of Smithfield Park subdivision. Both lots are vacant of any improvements and in their natural state as shown on the survey prepared by Kenneth M. Woychuk Land Surveying, PLLC and dated September 12, 2019. BASIS OF APPLICATION: Request for a Lot Waiver under Section 280-11 to unmerge a vacant land area of 22,250.03 square feet (SCTM 1000-70-9-36) from an adjacent land area of 20,873.69 square feet(SCTM: ---1-000=70=9=3-5r, basest on-the-Buil-ding-Inspector's-Notice-off-Disapproval,—dated-October-7-20-19,-pursuant-to-------------=— Section 280-10A, determining the properties have been merged. 1� Page 2,June 25,2020 #7374, Gobic . SCTM No. 1000-70-9-35 &36 "A non-conforming lot shall merge with, an adjacent conforming or non-conforming lot held in common ownership with the first lot at any time after July 1, 1983. An adjacent lot is one which abuts with the parcel for a common course of fifty (50) feet or more in distance. Non-conforming lots shall merge until the total -lot size conforms to the current bulk schedule requirements,..minimum 40,000 sq. ft. in.the,R-40 Residential _ Zoning District; located, at 465 Mai Her Court, Southold NY 11971. SCTM Nos. 1000-70-9-36 and 1000-70- 9-35. ADDITIONAL INFORMATION: Mileva Gobic,joint tenant in common with her daughter, Dragna Gobic, offered testimony that she resides at 12 Roscoe Court, Greenvale, NY and living outside of the Town of Southold, had no knowledge or ever received any notification from a Town authority that the lots merged and that at the time she purchased them, August 19, 1982, she was not informed of the need to maintain separate title to ensure that the lots would not merge. She added that she purchased two lots with the intent to either develop them independently or to sell them, individually, at a-future date as an investment. The applicant has continuously owned the subject.premises since prior to the merger law went into effect. . The applicant submitted as evidence, supporting their waiver of merger application, a copy of the original subdivision map entitled Subdivision Plan: Smithfield Park, dated and filed December 27, 1966 as Map number 4770 (Lots 22 and 23); individual surveys, each dated May 1, 1992, by Peconic Surveyors, PC illustrating proposed dwellings meeting zoning'setbacks and proposed locations for on site waste water treatment and well-head; individual Town of Southold Consolidated Real Property Tax Bills for each parcel; notarized Single& Separate Search for each lot. Furthermore, the applicant's agent illustrated that the lot conforms to the original Smithfield Park subdivision and is similar in lot size to over 50 lots in the subdivision and general area and also offered several Waiver of Merger applications in the immediate area where relief was granted. Smithfield Park subdivision appears on the Exemption List, §100-12 of the Town code. No member of the public or an immediate neighbor spoke in favor of or against this application. FINDINGS OF FACT/REASONS FOR BOARD ACTION: The Zoning Board of Appeals held a public hearing on this application on March 5, 2020, at which time written and oral evidence were presented. Pursuant to § 280-11(A) the Applicant has submitted documentation, to the satisfaction of the Board that there have been no transfers of ownership of the lot outside the family since the time merger was effected. Consequently, the lot is eligible for a waiver of merger. Pursuant to §280-11(B), the Zoning Board finds that (1) The waiver would recognize a lot that is comparable in size to a majority of the improved lots in the neighborhood because the subdivision map of Smithfield Park, filed December 27, 1966 appears on the Exemption List, §100-12 of the Town code and is similar in size to the immediate neighborhood and the majority of properties as illustrated on the Suffolk County Tax Map, page 1000-70. waiver would--recognize-a-lot-that--is-vacant--and-has-histor-ieally-been-treated-and--maintained-as-a -. -- - — separate and independent residential lot since the date of its original creation because it remains in its natural Page 3,June 25,2020 #7374,Gobic SCTM No. 1000-70-9-35 &36 wooded state, does not contain any improvement, has separate Town of Southold Assessor's Property Cards and is taxed independent of the adjacent lot. (3) The proposed waiver and recognition will not create an-adverse impact on the physical or environmental conditions in the neighborhood or district because'it is similar in size to the majority of developed lots in the Smithfield-Park subdivision and public water is available. - RESOLUTION OF THE BOARD: In considering and balancing the above factors and pursuant to the Waiver Provisions of the Town of Southold Merger Law, Section 28.0-11, motion was offered by Member Planamento, seconded by Member Lehnert, and duly carried to GRANT the waiver of merger as applied for, and as shown .on the survey prepared by Kenneth M. Woychuk,Land Surveying,PLLC, and dated September 12,2019. SUBJECT TO THE FOLLOWING CONDITIONS: I. Proof that waiver of merger is effected by way of a recorded deed from the applicant to a separate individual or entity conveying title to that portion of the property known as 1000-70-9-36 be provided to the ZBA within 2 years of the date of this decision.Failure to comply with this condition will result in nullification of the waiver of lot merger granted herein. 2. When developed the individual or entity.building a residence on either lot, shall use a Suffolk County Board of Health approved Innovative and Alternative Onsite Wastewater Treatment System (UA OWTS). 3. In the event that an approval is granted subject to conditions, the approval shall not be deemed - - --- -- --effective-until-the-required-conditions-have-been--met;-and failure-to-comply-therewith-wi-ll--render this--- ------- ---- — approval null and void. Vote of the Board: Ayes: Members Acampora,Dantes,Lehnert,Planamento, and Chairperson Weisman (5- 0), Leslie Kane's Weisman Chairperson Approved for filing /oZ 6 /2020 gUfFO�� p� COGy BUILDING DEPARTMENT-Electrical Inspector c TOWN OF SOUTHOLD Town Hall Annex-54375 Main Road-PO Box 1179-Southold, NY 11971-0959 Telephone (631) 765-1802 Temporary Certificate # (iZ� Date 2022 Customer Name o L 7 �-` Lr LL Electrician Name Address Jcv al/ r v o4 Phone / 7 (?-Go b e-mail e-mail e � f o e lAe on Phoned ,, License# L( �j Size / A Phase Overhead Underground #of Meters Remarks #of Underground Laterals 1 2 New "H" Frame or Pole H P Fire Reconnect Was work done on Service? Y/N Flood Reconnect Old Meter# Service Reconnected Application for electrical service equipment is on file with the town of Southold.On the applicant's notification that this installation is complete,the town will conduct a premises inspection of the service equipment. This verification i for ays from the date ab e. Authorized by e ' BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD ca z Town Hall Annex - 54375 Main Road = PO Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 rogerrasoutholdtownny.gov - seandO—southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: Z •Company Name: asf a o Name: - License No.: u®-2— email � lk -L�, ,�.S�e'*YN Phone No: 'C�l 01 request an email copy of Certificate of Compliance Address.:. " JOB SITE INFORMATION (All Information Required) Name: \ U to Ik5 Address: �(� 1�- ct Cross Street: r' Phone No.: Bldg.Permit#: email: Tax.Map District: 1000 . Section: Block: ® Lot: BRIEF DESCRIPTION OF WORK (Please Print Clearly) o . Check All That Apply: Is job ready for inspection?. ❑YES .NNO ❑Rough In ❑Final Do you need a Temp Certificate?: 10YES [:]NO Issued On Temp Information: (All information required) Service Size [R]1 Ph ❑3 Ph Size: 2.00 A # Meters Old Meter# New Service ❑ Service Reconnect ❑ Underground [:]Overhead # Underground Laterals-E]1 ❑2 ❑H Frame n Pole Work done on Service? CRY ❑N Additional Information: PAYMENT DUE WITH APPLICATION Electrical Inspection Form 2020.xlsx Suffat BUILDING DEPARTMENT- Electrical Inspector ��0 cOGyc TOWN OF SOUTHOLD y = Town Hall Annex- 54375 Main Road - PO Box 1179 W ^+ Southold, New York 11971-0959 CR *A Telephone (631) 765-1802 - FAX (631) 765-9502 rogerr(a)southoldtownny.gov — seand(c�southoldtownny_go O APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (Ail information Required) Date: 3-iS�ZZ CompanyName: Electrician's Name: License No.: Elec. email: Elec. Phone No: c,31��(��JBco CD ❑I request an email copy of Certificate of Compliance Elec. Address.: l I't I-(ci�C.-5 - c_. PA-rc.4ocuc: o7 C_ JOB SITE INFORMATI_IO-N� (All Information Required_)` Name: o �5 �'1(\l e-y- l- Address: Cross Street: Phone No.: -- ----- ---- -Bldg.-Permit#:c��q_��------ ----- --- - --- -----email:-- -- ------ -Tax ----Tax.Map District:. 1000 Section:- 'Jf(� Block: Lot:_b BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please:Print Clearly): Square Footage: ZZ-o(0 Circle All That Apply: -Is job ready for inspection?: YES ❑ NO ❑Rough In ❑ Final Do you need a Temp Certificate?: YES ❑ NO Issued On {Ma_ 4-5-ate Temp Information: (All information required) Service Size�1 Ph❑3 Ph Size: Z°U A # Meters Old.Meter# fNew Service❑Fire Reconnect❑Flood Reconnect❑Service ReconnectnderWY d❑Overhead # Underground Laterals 1 2 H Frame Pole Work done on S rvice? N Additional Information: - - - - --PAY-MENT-DUE-WIT-H APPL-ICA-T-ION- - 114 pal 4C c 1�� , :BUILDING. -'Electric ' TOWN OF SOUTHOLD H x Town Hall Annex-.54375 Main Road - PO:Box:117.9 o • Southold, New York 11971-0959- Telephone 1971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502' _ ' (J rogerr _southoldtownny.gov - seand(Dsoutholdtownny.go APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (Au Information Required) Date: Company Name: 1 JL0F4_, GLt��v Cv � Electrician's Name: License No.: Elec. email,: �T oN ,� opzc (,,�(L Elec. Phone No: co3j-K- u_ ; ,co ❑I request ani email copy of Certificate of Compliance Elec. Address.: i i—i �_tc _5 u- �. Pit �c�Qv4cr� t17 C_ JOB SITE INFORMATION (All Information Required) Name: R Address: Cross Street: Phone No.: Bldg.Permit#: -email: - - Tax Map District: 1000 Section: Block: Lot:'�3(0 BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Square Footage:' llzzoo Circle All That Apply: 1. Is job ready for inspection?: ErYES ❑ NO n Rough In El-Final Do you need a Temp Certificate?: ErYES NO Issued On {,ryta;Q,_ =5-a'L Temp Information: (AII information required) Service Size E_1 Ph❑3 Ph Size: Z°U A # Meters t Old.Meter# 0 New Service0 Fire Reconnect❑Flood Reconnect❑Service Reconnect ndergrou d QOverhead # Underground Laterals Efl D2 0 H Frame D Pole Work done on S rvice? Y MN Additional Information: PAYMENT DUEWITH APPLICATION pal &1)( .3 PERMIT# Address: 4 • r SwitchesZ C Outlets G F I's Surface Jill ZPj Sconces ' r H H's 17 � U UC I_ts �- 2 Fans Fridge HW Exhaust s Oven ,Yi W/D �G Smokes DW Mini l Nj 1 Carbon Micro Generator Combo S Cooktop Transfer AC ( Hood- Service Amps Have Use Special: Comments. -4"-&P7l� �t �� A 'I _ asuEl"OL - Town Hall Annex4 Telephone(631)765-1802 54375 Main Road �. Fax(631)765-9502 P.O. Box 1179 0 �. Southold, NY 11971-0959 $y. . BUILDING DEPARTMENT NOTIC_ _EOF UTILIZATION OF TRUSS TYPE:CONSTRUCTION,.PRE-ENGINEERED: WOOD CONSTRUCTION AND/OR TIMBER CONSTRUCTION Date: 4/26/2022 Owner: Roberts Premier Development LLC. Location of Property: 565 Mailer court Southold NY 11971 Please take notice that the (check applicable line): X New commercial or residential structure Addition to existing commercial or residential structure Rehabilitation to an existing commercial or residential structure to be constructed or performed at the subject property reference above will utilize (check applicable line): Truss type construction (TT) X Pre-engineered wood construction (PW) Timber construction (TC) in the following location(s) (check applicable line): X Floor framing, including girders and beams (F) Roof framing (R) ;Fl000 d roofframing (FR) Signature: Name (p rson submitting this form): David Roberts Capacity(check applicable line): X Owner Owner representative TrussReg15.docx Effective 1/1/2015 g Ent* Town HMI Annex es Telbpfiom(631i))765 4!802 54376 Main Road Fax('q 31))766-9 502 P-0.Sox II79: Southold,MY 11971-0959 BUILDIN-G-DEPARTI-HENT i NOTICE ORUTILIZATION QFTRUSS`TYPEZONSTRUCT-101.PRE-Eff-GINEERED' WOOD-CONSTRUCTIO _ P.C NAND71011.1;IMBE._- , ONST RIWC- T- 1 10_R_ ___ Date7. 21 T� Omer Location of Property: C',Z"(A �I�easetakanotice that the (check applicable line): Now commerciaL or res[dentiallstructure ------------ Addition.to,existing commercial!or residential structure, Rehabilitation to,,an existing comm erclat or residentfall structure. to be constructed or performed at the subject property,reference:above.,wilt utilize (check appffcab[s line): Truss type;construction:(TT) Pre-engineered,wood construction(PW) Timber construction(TC) in following location(s),(check applicable lfnq)�', Floor framing, - EFa including DD Roof framing(R, , Floor q and romln91 C J U N 2 7' 2022 -DR Signature: BLUDING TOWN OF Name(pe Won.`submitting:this form): -A C, (check applicable line).. , Owner Owner representative TrussRecriSAcox Effwffve 1/4120t5 DWELLING I DWELLIN�WITH WELL N SANITARY SYSTEM DESIGN: DWELLING ON PUBLIC WATER WELL LOCATION UNKNOW RESIDENTIAL 90F BEDROOMS: 4 USES PUBLIC, LOCATION UNKNOWN I I ADVANCED TREATMENT UNIT: FUJI CEN5 I I UAOWTS CAPACITY REQUIRED: 440 GAL PER DAY,AS PER TABLE 3,SCOHS RESIDENTIAL STANDARDS VAOWTS CAPACITY DESIGNED: 500 GAL PER DAY I C.L.EL. 22.5' LEACHING SYSTEM: (1)17 DEEP,S DIA LEACHING POOL,AS PER I AS PER TABLE 4 FOR DEPTH TO GROUNDWATER OVER 17 FEET. I C.L.EL. I SITE PLAN BASED ONT HE SURVEY OF LOT 23 21.7' ) MAP OF SMITHFIELD PARK GENERAL CONDTONs COST AVENUE PUBLIC WATER IN STREE•n •J ) FILEDSOUTHOLD,T W OFSO966. IUTHOLLE NO. 770 r CONC.CURB AT SOLRHOLD,TOWN OF SOUTHOLD 1.SEEM P S REGN SHALL WMV'LY WI IH SVFFULK WUNIY L>=F'PND SH I OF HtN.IH �R \ ! ! SUFFOLK COUNTY.SIERLI NY SERMCES REGULATIONS,STANDARDS,ANO REVURENENTS,MONS.LL BE �' W \ ! i00a7o-o9-36 STRICTLY IN ACCORDANCETO THE MANUFACRhRER'SINSTRUCRIONS. _ EDGE PAVEMENT P.C2. 1 ! BYPECON 49618 VEYORS,P.C., 2,IHIE IN'SIALLIERMUSI HOLUAUJRRbNl UQUDWASIt UCENSEPUHSJANI IU " I 111.21 _____EL.22.3' ( NYSUCN049618 CHAPTER 563 ARTICLE VII rtPTICINIXISTRY BUSNESSESSTI AND ENDORSEMENT J �� ! PO BOX 909 (INNOVATIVE AND ALTERfJATr 7FREATNENr SYSTE741NSTALLER)THROUGH THE i `S84'4]rD0"E (V82'37'1D"E ! 1230 TRAVELER ST,SOUTHOLD,NY1971 SUFFOLK WUNTYCEPARTMEM OF LABOR,LICENSING AND CONSUNERR AFFAIRS, 42.09r -r�� DATED MARCH 2,2021. PURSUPM TO SUFFOIIC COUN7V CODE A5837901)1J1•TFE DFPARTNEM OF LABOR, I �- ,�-"��---� �`� ,WITH REVISIONS MARCH 31,X21 LICENSING,ANDWNSUMER AF FAIRSMAINTAINSAUSTOF UOUDWASTE LICENSE I I ,L HOLDERS. P.COK qV�, 8 9Y AREA:22,266 SF I EL 20 91st / ELEVATIONS AND CONTOLR LINES ARE !.ALL INSI PLLtUI/A UW I S AFit HtUUHtU I V HAVt AN IW IIAL'SYtAN WAHHAN Y. \ / I \ SITEREFIS ACED TO 7 TO G6 4,ALL INSTALLEDI/A OWrSARE REQUIRED TO HAVEACTIVE 01IM((OPERATON ANC I o ® SITE ISAPPROX 65T TO GOOSE EK PROVIDER.ANCE)AGREEMENTS BETWEEN THE PROPERTY OWNER ANDSERVICE ( \\ g N fi- In 5.SERVICE FROMIDERSMUST REPORT ALL OBMACTIVITIES TOSCOHS(SUFFOLK !II \ LOT 23 a p COUNTY DEPARTMENT OF HEALTH SERVICES). \ 6.COVENAMSMAY BE REQUIRED ON PROPERTIES WHEREI/A OWTS ARE INS7PLLED ! _ROrX EQUIRING',SYSTEM REPLACEMENT IN EVENT OF FAILURE 08M REOUIREMOT / ___-_ - - rT1 r ACCESS TOCHSINSPECTIONSAfvPIJNG ON QUPRTERLV BASISIF NEEDED OTHER LOT 13 / �� / TTI REQUIREMENTS THAT SCORSDEEMS NECESSARY. O O / _� DWELLING 7.PERFORMANCE STANDARDS FOR VA OWTS TECHNOLOGIES ?Q / VA OWTS MUST MEET TREATED EFFLUENT CONCENTRATIONS FOR TOTAL M I ROGEN DWELLING y I 2STRY. // 1 n ONPUBLICWATER OF NINETEEN(19)MG/L OR LESS. WITHWELL / � PROPOSED GAIR / xa IA O PEPTIC EATNENT CONSTRUCTION CRITERIA i.StYuvIHtAIMtrNI \�� $ FFFL EL 23.5' �// DW I ALL NOP-CONCRETE TANKWALLS,FLOORS,ROOFANDACCESS COVERS SHALL Snclnswe $ _ ALL AN APPLIED FORCE OF 300 POUNDS PER SQUARE FOOT(PSE). / sTA�� '' \ // 40.0' 150'TO PROPER LINE OF II. NOMI. tit H7tFP1921C'AItU SFYIIU IANKK VAUWISSNALL WNFOFdr11U / 1 \ / 1 4 DWELUNG ON ELL THE INTERNATIONAL ASSOOATION OFPLUMBING ANDMEOHAMCAL OFFICIALS POWER SUPPLY CONNECTED TO ANEPoCAN NATIONAL STANDARD FOR PREFABRICATEDSEPTICTAIKS'ANS �� / e I DEDICATED 115 VOLT AC.SINGLE-� / FUJI DENS i Z1000.2007ANDANY UPDATESTHERETO. / PHASE,20 AMP CIRCUITBREAKER 1 12 D,SDIA I III. EACHSEPTCTANK&I/A OWTS SHALL BE IOENTIREO BY THE MANUFACTURER �•\ / 6.0' I () ANI: U`JiAYIHtFULLUWINGINFOHMAIION PERMANENILYMAHKtUAIIHIE / ttf ENDFE. oNHQusEMAw INLET ENDOF THETANK p O.2'W. IN AREA FOR _ LP EXP SON 1. MANUFACURER NAME OR LOGO / \p ` ///Y m, I 9 LD G 2, (AHA(2IY AWNUM IEH VF Ol`hNlNUS / ` / _ O f 13.3' � 3, MAN DAM DESGNLOAD Dire / ------'-- ••=Ei€ p 0' IN n MALE THREADED SLATE OR OTHER MALE THREADED MALE THREADED 4 THE DATE MANUFACTURED. �� eewmo eK°�+_--.y--��'�pNTROL PANEL SM C.L.EL. IV ALL CASs-IR ON AND HOPE COVERS SHALL E SET AT RNSHED GRADE. In �� 1 �6 11.0' LP en Z07' ADAPTER AND CAP SUITABLE COVER ADAPTERAND CAP ADAPTERAND CAP LOOKING. z --_J- FUJI BLOWER IN COVER ON PAD TAMPER-RESISTANT,WATERTIGHT.INSECT.PROOF,FLAT,SKIDPROOF,AND BE k No x IA onnoN+LveHr W D( APPROVEDFORSEWAGEUSE COVERS AND RISERS SHALL BE CAPABLEOF 1t� z WITH STANDING ATRUCKWHEEL LOAD(36 SIN.OF 2500 LB FOR 60 MIN WITH A o H (� P.COR m m MA,, VEHI1LAL UtrLILCI ION OF I.S IN V.PHHOPE COVERS AND RISERS ARE REQUIRED TO EE USEDON NONIIDNCRETE DWELLING 1gg 71r EL.21.2' 03 y w TEST HOLE m Z w TANKS.THEY SHALL BE SET AT RMSHED GRADE,BE LOCKING.WATERTIGHT, ON PUBLIC WATER a INStII-F'HWF,ANU kA1°F+tQYtD HOH S'tWtHAGt USE. EL.21.3' 9 LOT 13 ; SEWER PIPE > V.IF A RISER COVER WF3GHSLESS THAN 901135 A SECONDARY SAFETY UD OR W < DOUBLE SIDED DEVICE SHALL PROVIDED. P.COR. S84e58'20" 45 DEG.ELBOWS WYE LOT 14 EL.18.0' VACANT 3 m casco Daa6 Dao 2.SEPIICIANK&I/ACWISSHALLHt WAINJRIIGHIANUWNSIRUOIEUCHWUNU N fM1 y DWELLING 30 DEG ELBOW 60 DEG WYE i� OR EQ, - AND DURABLE MATERIALS THAT ARE NOT SUBJECT TO EXCESSVE CORROSION OR DECAY' �l 0 20 40 60 PT ON PUBUC WATER A ALLSEPTICTANK&I/AOWTSMJSTSECERTIREDASWATERTIGHr EY MANUI-ACIURLH USING Ell HER VACUUM ItSIINU OR WAI LH IIESIING LOT 22 I I METHODS. ALTERNATE A:FOR BENDS ALTERNATE 91:FOR USE WITH ALTERNATE B2:FOR USE WITH 1. VACIAIM TESTING MUST PULL Ar OF MERCURY CHO),FOR 2 MNUTESWITHA LOSS OF 10%OR LESS. BLDG.EXTENSION/CONNECTION BLDG.EXTENSION/CONNECTION II. WAlbRItS11NG:b-ALIANKHILLIANKWIIHWAItHlUVUILtIINVGRI W/DOUBLE SIDED SWEEP ELEVATION CLEAN OUT DETAIL FOR AREAS NOT SUBJECT TO VEHICULAR TRAFFIC FOR 24 HOURS.REFILL THE TANK TO OUTLET INVERT AFTER 24HOUR PERIOD ANDLEr STANDFOR IO HOURS.APPROVED IF WATER LEVEL IS HEY D FOR 10 Willi OWTS LAYOUT HOURS. /-a1 CLEANOUT DETAILS B. ALL PENETRATIONS PIPES SHALL BE CONNECTEDTO TANKS WITH A 1°=2O'-0' N.T.S. WATERTIGHT, SEALED FLENBLE JOINT AND THE PIPE GASKET SHALL BE FASTENED TO THE PIPE HATH A STAINLESS STEEL RETRACTABLECLAMP. Design Professional's Certification Required. RHEA� REDFROMTHE OUTLET INVERT TO THE BOTTOM OF TTANK COVERSubmit P.E.or R.A.Certification For FUJICLEAN I/A OWTS 4.AU-1-SS IU EACH IANKVRCOWAN IMEN I UH IHR IANKSHALLthPROVIDED BY l osa The Installation and Construction of the Sewage Disposal System AN ACCESS COVER WITH AN INSIDE DIMENSION OF AT LEAST 201NOHES IN DIAMETER, P Y ALLALPENC GS SH-IALL MEET TH1Eo 5.114B.7 R0EQUIRREME�NTSDBurIAL STANDARD 2116. Use Form W W M-073 A OPENINGS SHALL LkWOVILIEUOVER ALL INLFI AND OU[LEI PINES vEZNTTERMINATION _ SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES S. WHEREEXTENSMS ARE REQUIRED,THEY SHALL SEWATERTIGHT VENT PIPES SHALL EXTEND A MINIMUM OF 6 INCHES ABOVE THE PERMIT FOR APPROVAL OF CONSTRUCTION FORA C. SEPTIC TANK&VA OWTS M4NUFACURERS SHALL PROVIDE A LABEL OF ROOF LINE AND THETOP OF THE VENT SHALL HAVE A MINIMUM NONCORROSIVE HOPoZONTAL SEPARATION OF 121NCFES TO TFE SLOPED MAIEHIALINWO INtNILVCAIICNAIL-AU iA.LXI:bSUF'tNNGIOW/WN r PormoNOPTHE ROOF. SINGLE FAMILY RESIDENCE ONLY 'ENTRANCE INTO TANK MAY BE FATAL' 1 POWER SEP➢CTANK 81/A OWTS IN5iALlATON STANMR05: DMAT D 115 VOLT AC,ED 70 SEE ATTACHMENT`S) DEDI.I TE0115 VOLT AC,SINGLE-PFHNSE.20 AMP 1.ALLAPPLICABLE RCCOMMENDATON9 PROVIDED BY THE MANUFACTURER SHALL BE I i CIRCUIT BREAKER ON HOUSE PANEL IMPLEMENTED 5/1312021- . R-21-0851 2.THE SEPTICTANK&I/A OMS SHALL BE INSTALLED AT LEVEL IN ALLORECTIONSWTH I CONTROLPANEL DATE H.S.REF.NO. A MAXIMUM TOLERANCE IN ANY ORSCTIM OF-F ONE OUARTER INCH)ON A MINIMUM 3 ' INCH THIOR((=ANUFACNRERS RECOMMENDATION)BEDOFPROPERLYLEVELEDANO 1 r BLOWER IN COVER ON PAD APPROVED .. - COMP%TEDSAND(FREE FROM ROCKS)OR PEA GRAVEL BACKFILL SHALL BE PLACED ARWNOTHE SEPTIC TANK&I/A OMS IN SUCH A MANNERAS TO AVODOAMAGE AND iI 4'(2'MIN.)DIA.HDPE VEMW/CAREION FOR MAXIMUM OF 4 BEDROOMS COMPACTEOIN&INOH LIFTS.BACKFILL SHALL BE FREE OF LARGE STONES.STUMPS, I I FILTER:IB'MIN.ABOVE GRADE, AND CONSTRUCTION DEBRIS. HOUSE i i 36'MIN.FROM ANYWINDOW ORDOOR 4`WASTE EXPIRESTHREE'YEARS OM DATE OF APPROVAL 3.THE TCP OF THE SEPTIC TANK&VA TINTS SHALLNOT BE LOCATED GREATER THAN ' I OPTIONAL WHEN NO HOUSE TRAP CLAS52400 OR SDR 35, NJOAND HALF FFR?OR LESS THAN ONE FOOT BELOW FINAL GRADE FOR SEPTIC TAM< I I 1/6'PER 12'SLOPE MIN. &I/A ONUS WITH DOMES,THE TOP OF THE DOME SHALLNOTSE LOCATEDGREATER ' ' 4`WASTE,CAST IRON WITHIN 7 FROM THAN TWO AND HALF FEET OR LESS THAN WE FOOT BELON FINAL GRADE. I I 1 CLASS 2400 OR SDR 35,(OR SDR40) FOUNDATION WALL,CONTINUED TO EL.23.5'+/-r IENBEFO ANY EXECUTION,VERIFY ON SITE.IF APPLICABLE I ' 1/4'PER 12'SLOPE MIN. GPADE ELEVATIOISATTHE HOUSEMERRE 7HE WASTE MAIN PENETRATES. _ H -GRADE EIF/ATIONSW1ERE EACH UNITWILLEE INSTALLE0. - EL.21.3'N- 12'RISERSW/SAFEN -HCUSEWASTE UNE MAIN LOCATIONS AND INVERT ELEVATIONS. I ; ,i_ I DEVICE(TYP) I -i= P�JEC[: No. OeseH on Date -ANY UNDERGROUND UTUTIES,INFTb1STRUCNRES,ANDOR STTd1CTURES Innovative and Altemative Onsite -ANY TREES WHICH MAY AFFECTTOTI-E UA OWLS INSTALLATION I 1 L_ - GROUTED ELEVATION 21.3' WastewaterTreatmeM System 2. GARRAGE DISPOSALUNTTS SHALL NOT BE USEDWITH A VA CATS. _ __ 3. TANKS SHCULDNor BERIMPEDWHEN GROUNDWATER ISHIGHORFLOOD CELLAR -J N - -Y +"' 01. I/AOWTS 565 MailerCt. CONDRIONS EXIST. _` DARK BROWN + ,J ,,IL, I., + c, FUJI CENS K,"`U c I I I s SM 3' BROWNSILTYSAND Studio CITU architects 651 West Maki Street, . .nEO AR ABBREVIATIONS: _ RMerhead,NY 11901 O & AND LP LEACHING POOL LEACHING ' 6316912402 Q5µ ® AT MAX. MAXIMUM I✓�' I PSL _ I'a"°L�r� 6313231426 B.C. BOTTOM OF CURB MIN. MINUAUM - I� `'� I I ��I Blyris(�sludloebarcHtecls.com BW BOTTOM OF WALL N.TS. NOT TO SCALE �N- ':a�, SP PALE BROWN FINE SAND CONI. CONCRETE PROP. PROPOSED `� I�'CL`, -r„,I meIllrLg address: C.O. CLEANOUT REQ. REQUIRED I: T I�_°k�. PO B.444 •9 DB DISTRIBUTION BOX SCDHS SUFFOLKCOUNNDEPARTMENTOF ,-Y,, r it I- .`4°'I I °el Client NY 11957 7ZcOFN E Bar ELEC. ELECTRIC HEALTH SERVICES ELEV.or EL. ELEVATION ST SEPTIC TANK G GAS T.O. TOP OF �>3 w �� ` ` ¢ e`C HDPE HIGOVATIV AND T.C. TOP OF CURB HIGFESTEXPECTED ?O mow L "•W•°_°_'a'.==.' -v t- 3:=LI NOTE:NO WATER ENCOUNTERED I/A OWTS INNOVATIVE AND ALTERNATIVE ONSITE TW TOP OF WALL - -+- - o a1sNr: WASTEWATER TREATMENT SYSTEM W WATER GROUNDWATER EL.2.0 2y- X z TEST HOLE BY, IIA OWTS S La out INV. INVERT W/ WITH r.., 0 '^ o MCDONALDGEOSCIENCE D J CUSTOM HOMES Y LG LEACHING GALLEY W r B Ir __ _ _ DATE 1/15,2001_____________ ----- �---mow-- 0 -- PIT,Jea number 21201 EL.0+7- HIGHEST EXPECTED GROUNDWATER EL.2.0 HIGHEST EXPECTED GROUNDWATER --�� REPLACE SOIL WITH CLEAN SAND ELEVATION 2.0 BASED ON USGS Data 4/9/2021 AND GRAVEL ABOVE EXISTING SP GROUNDWATER CONDITIONS ON LI. Dr-by GB 0 5 10 FT OR SW SOIL LAYER / property Tax Map Q Checked by HA 1000.0700409.00-036.000 TACTION DIAGRAM _ 3 TEST HOLE DATA He streel addram C.01 N.T.S. 566 Mailer Y 11 Sce1e e souurola,Nv 119n As indicated r I 2.12'VENTLATON SCUM BAFFLE B - - PIPE CONNECRON RECIRCULATIONFLUI 2'-03/4° INCNEOED INSTALLED CONTROL PANEL 2'-101/4" 2'-71/2"l, AIRLIFT PUMP CONNECTION 6FTLONG WIRE ,/ INSTALLED ON WOOOENPOST DISINFECTION Y' SERVICE RECEPTACLE CYLINDER MANUFACTURER (OPTIONAL) TANKWALL PROVIDED PROTECTION COVER Control Panel Wiring Diagram p.2 CONNECTION HARDWIRED PLASTIC LANDSCAPE STONE roar rp nr°se 4-INLET PIPE 4-OUTLET PIPE ADAPTER FROM BY ZABEL ENVIRONMENTAL,OR EQ. vp __ ___ _ ___-__ 1B° p i i��_0___0_91__Q------ SUPPLY __�_Q'Tes a CLASS 2400 CLASS 24000R 314'PVC CONDUIT POWER tH lhabelzane.coM J ORSjg'POR 35 q A SDR35 SUPPLY—� MAC BOR PLAN R i I r I r BLE BASE SLOPE MIN J TA SLOPE MIN AIRLINE ' NOT TO MOVE BY FROST ACTON ; u 12'AIR BUM SEALANT �j•ylq, i i r r i so INTAKE PRESSED AROUND. TO FUJI UNDERGROUND AIR LINE TO CEN-5 UNITQ EFF e yy� INLET BAFFLE AIRLIFT T PERIMETEROF CEN FLEXIBLE y4'AIR UNE:3/4°PVC CONDUITLU r UNIT INSTALL PUMP 43/8" 43/6° %°FLEXIBLE IRRIGATION LINE,100 PSI MAX. r - * MAY ALSO BE USED FOR THE F_______________J.__________, r SECONDARY r i SAFETY FLOIRWLATON PIPE FLOW BAFFLE 12'AUR INTAKE _____________• i DEVICE,TYP. B AIR INTAKE CONNECTION DETAIL MAC BOR ELEVATION VIEWS MAC BOR BLOWER DETAIL FLOW OPENING(lYP) OPENING) CONNECTED TO BE N.T.S. I won p noxa ran,lana.suua OPENING) CONNECTED AIR LINEEE BE IN ; FLOAT SENSOR CONTROL CONNECTION PLAN VIEW MIN.6'DEEP TRENCH � 0 O na„iYn..lx ashae 20'INSULATED COVER 24'INSULATED COVER INSTALL SECONDARY CHIIMBERVOLUME VOLLPAE(GAL) BLOWER SPECIFICATIONS } uhf I 4n11 ONINSULATED I2'RISER ON INSl1LATED I2'PoSiER SAFETY DEVICE.TYP. rAERATION ' LATED COVER 1 SEDIMENTATION CHAMBER 277 MODEL: MAC BOR t r 24'MAXJ BY TUF•TTE, (24' Y TUFTTE, 2ANAEROBIC FILTRATION 278 AIR FLOW:2.BCFM NOTES: P5°` ( MAX)) DISINFECTION LATED I2°RISER I wa OR EQ. OR EQ. CYLINDER )BY TUF-TTE, 3 AEROBIC CONTACT FILTRATION CHAMBER 127 NORMAL PRESSURE 22 PSI (OPTIONAL) 4 STORAGE CHAMBER 63 POWER: 12W/1.0AB0Itr BRANCH CIRCUIT PROTECTION, ,. PENING SOISINFECTON CHAMBER 4 OUTLETCONNECTION:3/4 INCH pROTECTIONAND MAINDISCONNECT�O� TOTAL VOLUME 74g WEIGHT: 11 LBS tB1 e, erns POWER CONSUMPTION:55 W PROVIDED BY OTHERS,AND MUST BE SYSTEM SPECIFICATIONS POWER CABLE:6 FEET SIZED ACCORDING TO PUMPAIOTOR e v`Si 3 4'INLET PIPE MODEL: FUJI SEN,5 INSTALLATION I OPERATION$ MANUFACTURING SPECIFICATIONS. O _ FWL D TYPE ANAEROBIC MEDIA PP IPE FILLING RATE 32% EXTERNAL COMPONENTS COMPRESSOR ��r ua Aq�6-- ACT MEDIA BOARD TYPE AEROBIC MEDIA PVC/PP•PE FILLING MAINTENANCE NOTES: AND/OR PUMPS,AS APPLICABLE), WATERTIGHT RATE16% -INSTALL BLOWER CONCRETE STABLE BY _ SEALED WL WL AEROBIC MEDIA PP/PE FlLUNG RATE 57% BASE,NSINGSITPAD(BY OR ROV`DEDgppROVED THERMALLY UL "a. FLEXIBLE JOINT 5U BLOWER 2.8 CFM CONDENSING UNIT PAD(B7' nh DREG)ENSURE divarsitech.com PUMPS a' TI—�i--------------- ---------------- FASTENED TO TANK FRP r THE PIPE W/ ® PIPING PVC/PPIPE Il ATE °0 STAIM.ESS STL _ © ACCESS COVERS PLASTIC OREO).ENSUREADEQUCT ® ULATION VENTILATION AND PROTECT INSTALLED CONDUCTORS MUST BE AT ' Z DISINFECTANT OPTIONAL CHLORINE TABLETS AGAINST SUNLIGHT. RETRACTABLE ® LY ( ) LEAST 140 DEG.F.60 DEG.C. -MAINITENANCEREQUIRESA ( ) p CLAMP,7YP. NOTE TRAINED TECHNICIAN. TERMINAL STRIPS AND GROUND LUG USE zf -FOR MAXIMUM EFFICIENCY. TERMINAL LSTRPS AND ONLY. I AFTER NTATI NG THE TANK WITH FRE "aif9 + ® SEDIMENTATION TANK(01)WITH FRESH WATER TO INSPECT AND CLEAN INTERNAL AIR MEDIA THE LOW WATER UNE. FILTER ONCE EVERY 3 MONTHS -REPLACE DIAPHRAGM/VALVE CONNECT GROUND LUG IN PANEL TO A ASSEMBLY ONCE EVERY 12 SECURE EARTH GROUND •'«•,• I„.,'h•••...'•.-' `t•yv N ASSEMBLY WILL MONTHS (NOTE:APAMAGED DIAPHRAGM DASHED UNE PRESENTS FIELD WIRING c -�-----�-----o-_________ _____ M LL TRIGGERTHE SECTIONA-AVIEW 4 TO 6'SAND AND GRAVEL BEDAUTOMATIGSTOP FUNCTION). °®n wan •'"n°tl 1/4'To 12,COMPACTED,LEVEL SECTONB-BVIEW P CEN 5 0 1 2FT TO WITHIN 1B° j FIELD WIRING CONTROL PANEL 1 FUJI CEN DETAILS 2 ELECTRICAL DIAGRAM-FUJI 1/2"=1'-0" N.T.S. BACKFILL MATERIAL TO BE h CLEAN SANDAND CONCRETE COVER GRAVEL `�.• 20"MIN.®®O ;•;i - w:'( IMPERVIOUS INLET - !'-; SOIL P1Mbx PlEGBT y� I�'1c ®A SITE DRAINAGE NOTES: MIN.4°DIA. I :;i r•;.,f I ®O corc6ErE - APPROVED ,'-, , PIPE -„•5,.+• ,•.i-II PREdeT 1.APBelow Grade Drainage Pipe shell be4'Diemeler Clens 2400 Pipe. PITCFED 1B' ;':F•%`. ®G a r .0 2.Al pipe Connections shati provide for WalerTightseals m prevent leakage. PER I7 MIN. •••.t •••103 93 rwlshEoswoE ®®O 3.AI vertical and horizontal changes in Pipe direction shell u0ize 90 degree sweeps or a mO MIN_ canbinali oftwa-45 degree an bbendsM provide for a.r9mT flowin alldrectiors. o ®D I DRAINAGE SYSTEM CALCIMTONS 9 9 R vi -- ,•,t � ®O ••COLLAR•--- / � ow P�uer 4.All Horizontal Drainage Pipe shall have a minimum pitch dl/4"period e:S•�.-•':• ®O ,•i- an urPnr,gMln couc�*E�cr+w HOUSE ROOF AREA 5.NI Class 2400 Pipe oonnectirns,where required,shall be fuly grouted to Precast ;,•,� a, --.° �• zP I awo,TTP BACK.PARTIALSIDE: 1,692SF Concrete Lesohing Rings with Concrete Mortar. 13 D •`': FRONT,PARTIAL SIDE:1 74 SF wraT:(damn Q �e nsrw enuo a 6.All Leaching Pools F driveway shell have Cast Iron Grate$Frames to Final Grade or "r.'_. HW —_a MVELr1 TOTAL:3266 5F SEE / TTA C H E fV T S ^ ® O qy Q' 00T Finished Paved Shaface �.' _�• 03 13 9 S MIN. O ��IIL� X 0.167(7 RAIN 1-112-W-0=646 CF LEACHING ®D i PENETRATION I O I1��III'� 7.Leeching poob shell be prec-ted corxrate cement sWctures as manufachaed by •••_ SECTIONS ®p - INTO A VIRGIN ( ( VIII B'DIA RING HAS 4229 CFNF Suffolk Precast Inc.or equivalent. °• �� ®p _.. ••.°• STRATA OF - I-Iron 646/42.29-12.9 VF REQUIRED 8,All concrete cement used in firs—facturing of precast structures shall develop a t JIIII 'I-•ted_ ®O ...:`-1 SANDAND - chsxu sxxosoawE� I / rrinimurn compressive strength of 4,000 P.S.I.In 28 days. GRAVEL PROVIDED: 14 VF 9.All drainsge structuresacceptable shall be placed to leaching salts.In the event poor Liz -+f�•� •}�` t8'-0""L CI'�-��'•-� k•= IF MIN.PENETRATION IS oaowow4T[a leaching materiel is encountered,excavation is to be continued to suitable materiel and NOTAVAILABLE. I backfilled as detail _ EXCAVATE APD 10.No trench,pil,or other mxravadon shall be left open and unattended E.rravalbns shell REPLACE SOILWI be protected methods. as directed by fire Nohited with fences,banimclas and other approved HIGHEST RECORDEDHIGH •J' CLEAN SAND AND GROUNDWATER GRAVEL, 11.Invert elevations may be adjusted in the field to meet field conditions,but maintaining ELEVATISW ON 0 2 4 FT TO REACH TO SP oft eft-Live depths presabed. SOIL,WHICH DEPTH SUBMERGED,NO SURFACE DRAINAGE IS MORE THAN B (ECAC LEACHING POOL DETAIL ___ _ _ ___ _ _ 4 STORMWATER LEACHING DETAIL 1/4"=1'-0" IT=1'-0" aaec. No. oescrl Lan Innovative and Alternative Onsite Wastewater Treatment System I/A OWiS 565 Mailer M. studio a/b architects 651 West Mab Street. RNe,lim”.NY 11901 ygFt�'"g NL Ogg 631 591 2402 6313231 26 Was@st xilmi erchiteds.com k malling address: e PO Box 444 .q •a, Orient NY 11957 N D J CUSTOM HOMES I/A OWTS Detaiis Project number Data 4k Drawn by property Tax Map A Checked by 1000-070.0409.00.036.000 site street addess: C 565 Malley Court Scale As Ind Sordhold NY 11971 S.C.T.M. NO. DISTRICT- 1000 SECTION: 70 BLOCK: 9 LOT(S):35/36 STER AVENUE C EDGE OF PAVEMENT R a Re 111.21' L�3 42.09' � D S 84°47'00"E N 82°37'10"E c Do 0 N O_ LOT 13 LOT 23 LAND N/F OF 22,250.03 SQ.FT. CHRISTOPHER LAPPE 0.51 ACRES VACANT —NO STRUCTURES— m 0 Fes• o � � M � r r 199.71' S 84058'20"W o ri L, F�a a y 0 Lor 14 LAND N/F OF LOT 22 MARGARET KILLIAN 20,873.69 SQ.FT. 0.48 ACRES VACANT —NO STRUCTURES— o 0 0 0 0 M O 0 O Z 217.78' I LOT 15 LAND N/F OF S 84058'20"W GEORGE CARBONE I Lor 21 I LAND N/F'OF VINCENT TIRELLI Bldg Dept copy from ZBA I Final reviewed documents ZBA Fil # j Date: / THE WATER SUPPLY, WELLS, DRYWELLS AND CESSPOOL LOCA77ONS SHOWN ARE FROM FIELD OBSERVA77ONS ZONED R-40 AND OR DATA OBTAINED FROM OTHERS AREA: 43,123.72 SQ.FT. or 0.99 ACRES ELEVAT70N DATUM. —y�_ UNAUTHORIZED AL TERA 77ON OR ADD177ON TO 7HIS SURVEY IS A VIOLA 77ON OF SEC77ON 7209 OF THE NEW YORK STA TE EDUCA 77ON LA W. COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE T17LE COMPANY, GOVERNMENTAL AGENCY AND LENDING INS77TU77ON LISTED HEREON, AND TO 774E ASSIGNEES OF THE LENDING INS7777J770N, GUARANTEES ARE NOT TRANSFERABLE. 774E OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO 774E STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FENCES, ADD177ONAL STRUCTURES OR AND OTHER IMPROVEMENTS EASEMENTS AND/OR SUBSURFACE S7RUEfURES RECORDED OR UNRECORDED ARE NOT GUARAN7EED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE 77ME OF SURVEY SURVEY OR LOTS 22 & 23 CERTIFIED TO: DRAGANA GOBIC; MAP OF: SMITHFIELD PARK MILEVA GOBIC; FILED: DEC. 27th 1966 No. 4770 SITUATED AT: SOUTHOLD TOWN OF:SOUTHOLD KENNETH M WOYCHUK LAND SURVEYING, PLLC SUFFOLK COUNTY, NEW YORK Professional Land Surveying and Design P.O. Box 153 Aquebogue, New York 11931 FILE # 19-128 SCALE: 1 =30 DATE: SEPT. 12, 2019 PHONE (831)298-1588 FAX (831) 298-1588 N.Y.S. LISC NO. 050882 maintaining the records of Robert J. Hennessy & Kenneth M. Woychuk SUR VEY SHOWING .FOUNDATION . LOCA TION . AT SOUTHOLD TO WN OF SOUTHOLD SUFFOLK COUNTY N. Y. 1000-70-09-36 C.LEL. SCALE• 1'=30 22.5' CUA!�T C.L.EL r T + DECEMBER 17, , 2021 (Foundation Location) �� 21.7 V STREET +, AVElVTE LIC WAR IN - CONC. CURB . - (PUB 1 EDGE PAVEMENT P. U I/ 111.21 L:22.3' (� �--• S84-47'p�p"E 82'3710»E 42.09 �• �2 ��?3 �--- �� EL.20.9' -P N LOT F 13.5' w m I • . LOT 13 / 25.1' 22,5' m 40.0' \ CONCRm 40.0' 22 1•.{ DWELLING FOUNDA ,. METAL 13.0 w . WITH WELL ENCLOSURE �, w TOP w 0'M \ gL,�21.2 w SHED (� END FE. l� 0 V 0 0.2' w \\ 38.1• c SAN 1 2022 \ C.L.EL: BUILDING DEPT. TEST HOLE 20.7 A TOWN OF SOUTHOLD Z p EL. 21.3' + \ P.COR A i 199.71' EL21.2' rn z P'.COR. S84!58'20"W E0,6.-Op m © nmj NEW yo i DWELLING ' ON PUBLIC. WATER \ yoof 'A - LOT N'. Y.S LIC. NO. 49618 ELEVA77ONS REFERENCED TO NAVD 88 N.Y.S. LLC. ND. 051.132-01 ? ANY,ALTERATION OR, ADDI.77ON TO THIS SURVEY IS A WOLA776N 0 - SEC 77ON 7209 OF THE-NEW YORK STATE EDUCA77ON W. -EXCEP PECONlC SVR. ORS, ,P C. AS PER SEC77ON 727209-SUBDIVISION 2. ALL CER77n 770NS HEREON (631) 765-5020 FAX (631) 765--1797 ARE VALID FOR THIS MAP AND COPIES THEREOF ONL IF SAID MAP P.O. Box 909'. OR COPIES BEAR THE IMPRESSED SEAL OF THE SUR YOR WOSE 1230 TRA VBLER STREET 21-002 SIGNATURE APPEARS HEREON. +: SOU7NOC©, N.Y. 119-71 found. loc. SURVEY OF LOT 23 'MAP OF SMITHFIELD PARK' FILED DECEMBER 27, 1966, FILE NO. 4770 o AT SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. 1000-70-09-36 SCALE.- 1'— 30' JUMARCH 2, 2021 �d 2 7 2022 MARCH 31, 2021 (revisions) JULY 9, 2021 (Certifications) r-777 MAY 5, 2022 (FINAL SURVEY) DWELLING DWELLING DWELLING ON PUBLIC WATER WITH WELL INTH WELL WELL LOCATION UNKNOWN WELL LOCATION UNKNOWN C.LEL 22.5' C.LEL CUSET R 21.7' AVENU STREET)LIC WATER IN CONC. CURB (PUB \ EDGE PAVEMENT P.0 1 1 � 22.3' S84047'00"E N82•37'10"E M� 111.21 WELL 42.09 r 150' f O^i U o LOT © a'o a.x4' M o ` m 1 ��' 'ter F m 401' '�' DWELLING LOT ?© I 20\ Sao' m 2 STRY. � � ON PUBLIC WATER DWELLING \ \ FR* HSE & GAR. z� \ 4 BEDROOMS) 19�, DW. WITH WELL ME L F Fin.FlC 9'Dia.x7' ENCLOSURE�� oor. �A 1` 2.3.5' 1, COVERED \ A MASONRY t SHED COVEREDPORCH END FE. MASONRY 2C�� 8 UTIL POLE ^ / 00 0.2' W. PORCH CIO ip td Hws- 32.3' A 8'Dio.02'Deep 0) C T' DW. 00 IPELL. OB 2 Min LP 1 20.E n to 8'Dia.x3' CONCRETE \ \ Z o WNDW.WELL � BLOWER 1� 1 J + D UNAITS CENS P.caR 199.71' EL.21.2' z TEST HOLE P.COR. $$4055'20"W 1 EL 21.3' > O EL18.0' N m DWELLING (P LOT J ON PUBLIC WATER \ LOT ©2 LOT 14 \ ` VACANT DWELLING \ \ ON PUBLIC WATER t ` SEPTIC SYSTEM LOCATION DIMENSIONS Certified to: (B)l OTHERS) Gina M. Mavuro A B Daniel Fernandes Bank of American, NA 1ST 21.0' 28.5' Red Stone Title Agency, LLC 2 LP 33.0' 38.0' Old Republic National Title Insurance Company DRY WELLS C F 3 18.0 25.0 D F = REBAR 4 62.5' 8.5' ® = WELL 5 14.5' 66.D' ® = PIPE TEST HOLE DATA A = STAKE McDaMLD GEOSCIENCE 1/15/2021 M = MONUMENT 21.3 0.5'DARK BROWN LOAM OL ® = TEST HOLE BROWN SILTY SAND SM ��`�!YOq d<C j*5T2G 4% HG. � AREA= 22,266 SQ F7'. PALE BROWN FINE SAND SPNO S 5 ELEVATIONS & CONTOUR LINES ARE REFERENCED TO NA VD 88' ANY ALTERATION OR ADD1710N TO THIS SURVEY IS A WOLA77ON 17' ajA&2N.YS. LIC: NO. 49618 OF SECTION 7209OF THE NEW YORK STATE EDUCA710N LAW. PECONIC SU MORS, P.C. EXCEPT AS PER SEC77ON 7209—SUBDIVISION 2. ALL CER77RCA77ONS NOTE: NO WATER ENCOUNTENED (631) 765-5020 FAX (631) 765-1797 HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY 1F P.O. BOX 909 SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR WHOSE 57GAIA7JRE APPEARS HEREON. 1230 TRAVELER STREET SOUTHOLD, MY 11971 121-0021 2-1/2"VENTILATION SCUM BAFFLE B PIPE T-10 3/4" FUJI CLEAN CONTROL PANEL CONNECTION RECIRCULATION 2'-101/4.. 2'-7 1!2" 2'-0 3/4" AIR LIFT PUMP PVC WELDED SFT LONG WIRE INSTALLED ON WOODEN POST CONNECTION KFUJI SERVICE RECEPTACLE DISINFECTION MANUFACTURER CYLINDER TANKWALL PROVIDED PROTECTION COVERControl Panel Wiring Diagram p.2 (OPTIONAL) CONNECTION eD HARDWIREDPLASTIC LANDSCAPE STONE MMA re IL IN-Lr4"INLET PIPE 4"OUTLET PIPEADAPTER FROMBY ZABEL ENVRONMENTAL,OR EQ. -aq e a a s s T rwCLASS 2400 OR POWERhttp://zabelzone.oml Q pCLASS 2400 1/8"I3/4"PVC CONDUIT SUPPLYSDR 35 AIR LINE STABLEBASEOR SDR 35 A 1/4"PER 12" o 1/8"PER 12" MAC 8OR PLAN VIEW 1 SLOPE MIN NOT TO MOVE BY FROST ACTION SLOPE MIN v 1!2"AIR BUM SEALANT IA•INTAKE PRESSED AROUND UNDERGROUND AIR LINE TO CEN-5 UNIT N Li Lv`rp r EFFLUENT PERIMETER OF CEN FLEXIBLE 3/4"AIR LINE:3/4"PVC CONDUIT Irnx U I _ AIR UFT THREADS FFF�� ' 1XA°w k/ea rLnor 1 INLET BAFFLE © UNIT 1 I w © PUMP 4 318 4 318" '/e°FLEXIBLE IRRIGATION LINE,100 PSI MAX, r I " I ---------------�`------awnmr I INSTALL MAY ALSO BE USED FOR THE AIRLINE r ' I 1 SECONDARY SAFETY RECIRCULATION PIPE FLOW BAFFLE J 1!2"AIR INTAKE r DEVICE,NP. (CLEANING B 3/4"AIR LINE E BE AIR INTAKE CONNECTION DETAIL MAC 80R ELEVATION VIEWS MAC 6OR BLOWER DETAIL �-------------- FLOW OPENING(TYP.) OPENING) CONNECTED N.T.S. awe p celoe rztr.wan a,sIIEA[r AIR LINE TO BE IN rTN31oe FLOAT SENSOR CONTROL CONNECTION PLAN VIEW MIN.6"DEEP ATRIUM A TRENCH ' c1Acu11AK{R " 20"INSULATED COVER 24"INSULATED COVER INSTALL SECONDARY BLOWER SPECIFICATIONS 1 L c ® � I CHAMBER VOLUME VOLUME(GAL) rozAc to; I =' AN°= 1 SEDIMENTATION CHAMBER 277 MODEL: MAC 80R a7Ni° ON INSULATED 12"RISER ON INSULATED 12"RISER SAFETY DEVICE,TYP. 24"INSULATED COVER I r (24"MAX.)BY TUF-TITE, (24"MAX.)BY TUF-TITE, DISINFECTION ON INSULATED 12"RISER 2 ANAEROBIC FILTRATION CHAMBER 278 AIR FLOW: 2.8 CFM esue I e OR EQ. OR EQ. CYLINDER (24"MAX.)BY TUF-TITE, 3 AEROBIC CONTACT FILTRATION CHAMBER 127 NORMAL PRESSURE:2.2 PSI NOTES: OPTIONAL OR EQ. 4 STORAGE CHAMBER 63 POWER: 120V/1.OA16OHz SWITCH ( ) BRANCH CIRCUIT PROTECTION,OVERLOAD FLOW OPENING 5 DISINFECTION CHAMBER 4 OUTLET CONNECTION: INCH TOTAL VOLUME 749 WEIGHT: 11 LBS PROTECTION AND MAIN DISCONNECT rel rel `Tn5 POWER CONSUMPTION:55 W PROVIDED BY OTHERS,AND MUST BE FSnS SYSTEM SPECIFICATIONS POWER CABLE: 6 FEET SIZED ACCORDING TO PUMP/MOTOR MANUFACTURING SPECIFICATIONS. 4"INLET PIPE MODEL: FUJI SEN-5 a-s"no"r 11170,71111,o N ANAEROBIC MEDIA PP/PE FILLING RATE 32% INSTALLATION!OPERATION 8 HWL BOARD TYPE MAINTENANCE NOTES: EXTERNAL COMPONENTS(COMPRESSOR CONTACT MEDIA BOARD TYPE AEROBIC MEDIA PVC/PP/PE FILLING - INSTALL BLOWER ON STABLE AND/OR PUMPS,AS APPLICABLE), WATERTIGHT RATE 16� o BSE,SUCH AS ONCRETE OR PROVIDED BY OTHERS AND MUST BE ' U.L. WL AEROBIC MEDIA PP IPE FILLING RATE 57/" APPROVED THERMALLY PROTECTED telco SEALED WL CONDENSING UNIT PAD(BY I'm JOINT © BLOWER 2.8 CFM DIVERSITECHwww.diversitech.com PUMPS : Is ate•--------------, ----------------- FASTENED TO TANK FRP OR EQ.).ENSURE ADEQUATE Lawssou THE PIPE W/ 4) (� PIPING PVC/PP IPE VENTILATION AND PROTECT tIR[ulr eRGRER © ACCESS COVERS PLASTIC TEMPERATURE RATING OF FIELD STAINLESS STL ® RECIRCULATION AGAINST SUNLIGHT. INSTALLED CONDUCTORS MUST BE AT RETRACTABLE D `� ® `r ASSEMBLY DISINFECTANT(OPTIONAL)CHLORINE TABLETS _ MAINTENANCE REQUIRES A LEAST 140 DEG.F.(60 DEG.C.) A - CLAMP,TYP. > a NOTE TRAINED TECHNICIAN. I a FOR MAXIMUM EFFICIENCY, TERMINAL STRIPS AND GROUND LUG USE MARR AFTER LEVELING THE TANK,FILL THE INSPECT AND CLEAN INTERNAL AIR 1 Q SEDIMENTATION TANK(#1)WITH FRESH WATER TO COPPER CONDUCTORS ONLY. AEROBIC MEDIA THE LOW WATER LINE. FILTER ONCE EVERY 3 MONTHS REPLACE DIAPHRAGM/VALVE CONNECT GROUND LUG IN PANEL TO A ASSEMBLY ONCE Y 12 AERATION ASSEMBLY MONTHS ADAMAGEDDRAPHRAGM SECURE EARTH GROUND �� r a---- o----------^ ^--_--N nTin * DASHED LINE PRESENTS FIELD WIRING —{s}---- slz e WILL TRIGGER THE tivcu�'perrR ww Tna I I AUTOMATIC-STOP FUNCTION). SECTION A-A VIEW 4 TO 6"SAND AND GRAVEL BED SECTION B-B VIEW 1/4"TO 1/2"COMPACTED,LEVEL p -, CEN 5 2 FT TO WITHIN 1/8" 9 j FIELD WIRING CONTROL PANEL # FUJI CEN DETAILS ELECTRICAL DIAGRAM-FUJI BACKFILL MATERIAL TO BE iv CLEAN SAND AND z CONCRETE COVER GRAVEL o It ®CIa INLET ®IM CQ I IMPERVIOUS eTNIcxPRECAsr - y SOIL CONCRETE SITE DRAINAGE NOTES: MIN.4"DIA. d` t ®® a _ APPROVED I v I ®®C1 PRECAST 1.All Below Grade Drainage Pipe shall be 4"Diameter Class 2400 Pipe. PIPE t' _ I 2.All Pipe Connections shall provide for Water Tight seals to prevent leakage. PITCHED 118" a ®® n I I CONCRETE FlNISHED GRADE PER 12"MIN. IJ'_'J ®®®a 3.All vertical and horizontal changes in Pipe direction shall utilize 90 degree sweeps or a ®® 3'-0"MIN.. combination of two-45 degree angle bends to provide for a uniform flow in all directions. c ®® n �rjnvDRAINAGE SYSTEM CALCULATIONS rr11 / 4.All Horizontal Drainage Pipe shall have a minimum pitch of 1/4"per foot. ®93 '-COLLAR•– — VOR W'DIA PRECAST El®q •;• ;e a R +a'P�Fes.rm^ :5•,.:..„ i CONCRETE LEACHING HOUSE ROOF AREA 5.All Class 2400 Pipe connections,where required,shall be fully grouted to Precast 93El �• p RING,TVP. BACK,PARTIAL SIDE: 1,692SF 1' i Concrete Leaching Rings with Concrete Mortar. wLEra°Demee ® FRONT,PARTIAL SIDE:1.574 SF 2a� P� ®❑ .LEAN SANDs 6.All Leaching Pools in driveway shall have Cast Iron Grate&Frames to Final Grade or GRAVEL FILL TOTAL:3,266 SF ®®® I — Finished Paved Surface. q " ' 6'MIN. ❑ ��— X0.167(2"RAINFALU12"/FT)=546 CFy 0 7.Leachin ols shall be recasted concrete cement structures as manufactured bLEACHING ®® PENETRATION It I I ❑ I� 9 Po P Y SECTIONS ®® :,` , INTO A VIRGIN ❑ VDIA RING HAS4229 CFNF Suffolk Precast inc.or equivalent. 7�51 b R i�—I IIIc 546142.29=12.97F REQUIRED 8.All concrete cement used in the manufacturin of recast structures shall develo a STRATA OF 9 P P*.• j SAND AND .LEAN SANDa GRAVEL. minimum compressive strength of4,000 P.S.I.in 28 days. ® .+ : GRAVEL PROVIDED: 14 VF} 9.All drainage structures shall be placed in acceptable leaching soils. In the event poor .1,1=.� �-�;�'=:E', —— — — — -�— — leaching material Is encountered,excavation is to be continued to suitable material and IF MIN.PENETRATION IS caouruDwnrER NOT AVAILABLE, I backfilled as detailed. in EXCAVATE AND - - 10.No trench,pit,or other excavation shall be left open and unattended. Excavations shall — — —— — —— —— — — — REPLACE SOIL W/ be protected as directed by the Architect with fences,barricades and other approved HIGHEST RECORDED HIGH CLEAN SAND AND methods. GROUNDWATER GRAVEL, 11.Invert elevations may be adjusted in the field to meet field conditions,but maintaining ELEVATION 0 2 4 FT TO REACH TO SP OR effective depths prescribed. SW SOIL,WHICH DEPTH SUBMERGED, NO SURFACE DRAINAGE IS MORE THAN 6' 3 TYPICAL LEACHING POOL DETAIL 4 STORMWATER LEACHING DETAIL 1/4"= 1'-0" 1/4"=1'-0" PROJECT. No. Description Date Innovative and Alternative Onsite Wastewater Treatment System (I/A OWTS) 565 Mailer Ct. studio a/b architects 651 West Main Street, r-D AR Riverhead,NY 11901 tGR r IA•eE9 631 591 2402 631 323 1426 glynis@studioabarchitects.com J mailing address: PO Box 444 Orient NY 11957 9 OF N AS-BUILT CLIENT D J CUSTOM HOMES I/A OWTS Details Project number 21201 Date 6/1/2022 Drawn by GB o to property Tax Map#: Checked by HA 1000.070.00-09.00-036.000 02^/ N site street address: C. N 0 565 Mailer Court Southold,NY 11971 Scale As indicated Z-a DWELLING j DWELLING WITH WELL I WELL LOCATION UNKNOWN SANITARY SYSTEM DESIGN: _ DWELLING ON PUBLIC WATER RESIDENTIAL #OF BEDROOMS: 4 USES PUBLIC,LOCATION UNKNOWN ADVANCED TREATMENT UNIT: FUJI CEN 5 I/AOWTS CAPACITY REQUIRED: 440 GAL PER DAY,AS PER TABLE 3,SCDHS RESIDENTIAL STANDARDS - --- ______ - I/AOWTS CAPACITY DESIGNED: 500 GAL PER DAY -- I C.L.EL. • I 22.5' LEACHING SYSTEM: (1)12'DEEP,8'DIA LEACHING POOL,AS PER { I AS PER TABLE 4 FOR DEPTH TO GROUNDWATER OVER 17 FEET. C.L.EL. I SITE PLAN BASED ONT HE SURVEY OF LOT 23 21.7' MAP OF SMITHFIELD PARK GENERAL CONDITIONS: W AJER IN STREE ) I FILED DECEMBER 27,1966,FILE NO.4770 R e ( CONC.CJRB AT SOUTHOLD TOWN OF SOUTHOLD _ 1.INSTALLATION SHALL COMPLY WITH SUFFOLK COUNTY DEPARTMENT OF HEALTH ��ST�' r`�� `QUgLIC I SUFFOLK COUNTY,NY r SERVICES'REGULATIONS,STANDARDS,AND REQUIREMENTS,AND SHALL BE WM ! 1000-70-09-36 I STRICTLY IN ACCORDANCE TO THE MANUFACTURER'S INSTRUCTIONS. EDGE PAVEMENT / P•�R• ! BY PECONIC SERUVEYORS,P.C., j 2.THE INSTALLER MUST HOLD A CURRENT LIQUID WASTE LICENSE PURSUANT TO { S84 47 pp 710nE { - 111•21 _____ EL.221 I PO BOX 90NYS LIC 949618 i CHAPTER VE ARTICLE VII(SEPTIC INDUSTRY BUSINESSES)AND ENDORSEMENT J `- - - - i \ A� p^I ° 820 �- - - _`� \� / DATED1230 TRAVELER ST,H REV1S O S MARCH 31020,NY 11971 (INNOVATIVE AND ALTERNATIVE TREATMENT SYSTEM INSTALLER)THROUGH THE "F J SUFFOLK COUNTY DEPARTMENT OF LABOR,LICENSING AND CONSUMER AFFAIRS, _ \ PURSUANT TO SUFFOLK COUNTY CODE§563-79(11)(J).THE DEPARTMENT OF LABOR, - �_--____ O,Q \ LICENSING,AND CONSUMER AFFAIRS MAINTAINS A LIST OF LIQUID WASTE LICENSE -- --___ - �t 22 9 / and DECEMBER 17,2021 HOLDERS. I I P.COI 4\ ~ �t,9' AREA:22,266 SF L 3.ALL INSTALLED I/A OWTS ARE REQUIRED TO HAVE AN INITIAL 3-YEAR WARRANTY. +{ I iEL.20.g???\ V / ELEVATIONS AND CONTOUR LINES AKE I 9y REFERENCED TO NAVD'88 1 4.ALL INSTALLED VA OWTS ARE REQUIRED TO HAVE ACTIVE O&M(OPERATION AND S I ^ �+\ �/I SITE IS APPROX 65T TO GOOSE CREEK MAINTENANCE)AGREEMENTS BETWEEN THE PROPERTY OWNER AND SERVICE I I �' v� '� 1� N I PROVIDER. ! On 5.SERVICE PROVIDERS MUST REPORT ALL O&M ACTIVITIES TO SCDHS(SUFFOLK ! I \\ LOT i COUNTY DEPARTMENT OF HEALTH SERVICES). / f 4'X VDIA O/ 1 D f 6.COVENANTS MAY BE REQUIRED ON PROPERTIES WHERE VA OWTS ARE INSTALLED ! DW ;/ { D f REQUIRING;SYSTEM REPLACEMENT IN EVENT OF FAILURE;O&M REQUIREMENT; / ¢ 0/ I, rTt F ACCESS TO DHS INSPECTION/SAMPLING ON QUARTERLY BASIS IF NEEDED;OTHER LOT 13I \ / rn REQUIREMENTS THAT SCDHS DEEMS NECESSARY. O j E F / ,0 DWELLING 7.PERFORMANCE STANDARDS FOR I/A OWTS TECHNOLOGIES: l' / 2Q I/A OWTS MUST MEET TREATED EFFLUENT CONCENTRATIONS FOR TOTAL NITROGEN DWELLING � 0 1 ON PUBLIC WATER OF NINETEEN(19)MG/L OR LESS. / I \ 2 / WITH WELL / \\ = STRY.SE&GAR. // ®p II `LZ _ / METAL CONSTRUCTION CRITERIA: / \\ ° F FFL EL 23.5' C / -�1 I / TX 8'DIA /v 1.SEPTICfIREATMENT I ALL NON-CONCRETE TANK WALLS,FLOORS,ROOF AND ACCESS COVERS SHALL \ ENCLOSURE \ RESIST AN APPLIED FORCE OF 300 POUNDS PER SQUARE FOOT(PSF). \\ / I LOCATION DIMENSIONS \\ // __ /1n Q ` 150'TO PROPER LINE OF IL NON-CONCRETE PREFABRICATED SEPTIC TANK&I/A OWTS SHALL CONFORM TO A C / DWELLING ON WELL THE INTERNATIONAL ASSOCIATION OF PLUMBING AND MECHANICAL OFFICIALS \ / POWER SUPPLY CONNECTED TO \ j 1 21' 28.5' / FUJI CEN S "AMERICAN NATIONAL STANDARD FOR PREFABRICATED SEPTIC TANKS"ANSI \ / sHco I 2 33' 38' DEDICATED 115 VOLT AC,SINGLE- Z1000-2007 AND ANY UPDATES THERETO. \ / I PHASE,20 AMP CIRCUIT BREAKER (1)12'D,8 D(A LP� I III. EACH SEPTIC TANK&VA OWTS SHALL BE IDENTIFIED BY THE MANUFACTUREREND FE. ON HOUSE MAIN - i. AND DISPLAY THE FOLLOWING INFORMATION PERMANENTLY MARKED AT THE / \\ W 1 DRY WELLS / AREA FOR-�U'rl�E LP EXPANSION -D INLET END OF THE TANK: / \\ 0.2'W. C F �� _ C.0 1. MANUFACTURER NAME OR LOGO 0 3 18' 25' -- 2. CAPACITY AND NUMBER OF OPENINGS " x p E // J i.9' 0 W 3. MAXIMUM DESIGN LOAD 7I� 4 62.5' 8.5' D s* � �_� 5M"N 0 r ` MALE THREADED SLATE OR OTHER MALE THREADED MALE THREADED 4. THE DATE MANUFACTURED. o I �'.� CONTROL PANEL t0 i � C.L.EL. n N ALL CAST-IRON AND HDPE COVERS SHALL BE SET AT FINISHED GRADE,BE 5 14.5' 66' LP qIN / ADAPTER AND CAaz// SUITABLE COVER ADAPTER AND CAP ADAPTER AND CAP LOCKING, --� Z �DIMENSiIONS BY OTHERS may( FUJI BLOWER IN COVER ON PAD 20'7' 1 TAMPER-RESISTANT,WATERTIGHT,INSECT-PROOF,FLAT,SKID-PROOF,AND BE --,.ate C� ; m �i{ APPROVED FOR SEWAGE USE. COVERS AND RISERS SHALL BE CAPABLE OF '""�-x._ WITHSTANDING A TRUCK WHEEL LOAD(36 S IN.OF 2500 LB FOR 60 MIN WITH A I ,_- P.COR O rn MAX.VERTICAL DEFLECTION OF 1.5 IN. DWELLING 1 f - 0) V. HDPE COVERS AND RISERS ARE REQUIRED TO BE USED ON NON-CONCRETE -- EL.21.2'l ) w SEPTIC __ --------- 199.71 TESTHOLE I m Z TANKS THEY SHALL BE SET AT FINISHED GRADE,BE LOCKING,WATERTIGHT, ON PUBLIC WATER ---- .Q 0 K Q _ _ EL.21.3' { I LOT 13 SEWER PIPE INSECT-PROOF,AND BE APPROVED FOR SEWERAGE USE. D -'-I > � VI. IF A RISER COVER WEIGHS LESS THAN 60LBS A SECONDARY SAFETY LID OR o °W ` G A 'i DOUBLE SIDED DEVICE SHALL BE PROVIDED. P.COR. S84 58 20 DEVELOPED m m 45 DEG.ELBOWS WYE LOT 14 Ell.18.0' USES PUBLIC WATER m m DWELLING 30 DEG ELBOW 60 DEG WYE LASCO D448-040 2.SEPTIC TANK&I/A OWTS SHALL BE WATERTIGHT AND CONSTRUCTED OF SOUND OR EQ. AND DURABLE MATERIALS THAT ARE NOT SUBJECT TO EXCESSIVE CORROSION OR DECAY. i cp 0 20 40 60 FT ON PUBLIC WATER -,4(J�L171 J-�LYy.JI A. ALL SEPTIC TANK&I/A OWTS MUST BE CERTIFIED AS WATERTIGHT BY + LOT 22 { MANUFACTURER USING EITHER VACUUM TESTING OR WATER TESTING I \ METHODS. I I. VACUUM TESTING MUST PULL 4"OF MERCURY(HG),FOR 2 MINUTES WITH A ALTERNATE A:FOR BENDS ALTERNATE B1:FOR USE WITH ALTERNATE B2:FOR USE WITH � 1 1 LOSS OF 10%OR LESS. I BLDG.EXTENSION/CONNECTION BLDG.EXTENSIONICONNECTION II. WATER TESTING:SEAL TANK;FILL TANK WITH WATER TO OUTLET INVERT W/DOUBLE SIDED SWEEP ELEVATION CLEAN OUT DETAIL FOR AREAS NOT SUBJECT TO VEHICULAR TRAFFIC FOR 24 HOURS.REFILL THE TANK TO OUTLET INVERT AFTER 24-HOUR PERIOD AND LET STAND FOR 10 HOURS.APPROVED IF WATER LEVEL IS HELD FOR 10 I/A OWTS LAYOUT n CLEANOUT DETAILS B. ALL PENETRATIONS PIPES SHALL BE CONNECTED TO TANKS WITH A 1 1"=20'-0" N.T.S. WATERTIGHT, SEALED FLEXIBLE JOINT AND THE PIPE GASKET SHALL BE FASTENED TO THE PIPE WITH A STAINLESS STEEL RETRACTABLE CLAMP. 3.THERE SHALL BE A MINIMUM ONE-FOOT AIR SPACE MEASURED FROM THE OUTLET INVERT TO THE BOTTOM OF THE TANK COVER. SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES 4 ACCESS TO EACH TANK OR COMPARTMENT OF THE TANK SHALL BE PROVIDED BY APPROVAL OF CONSTRUCTED WORKS FOR AN ACCESS COVER WITH AN INSIDE DIMENSION OF AT LEAST 20 INCHES IN DIAMETER, A SINGLE FAM i LY RESIDENCE AND IN COMPLIANCE WITH 5-111 AND 5-1148-7 OF CDHS RESIDENTIAL STANDARD 2016. ALL OPENINGS SHALL MEET THE FOLLOWING REQUIREMENTS: A. OPENINGS SHALL BE PROVIDED OVERALL INLET AND OUTLET PIPES VENT TERMINATION B. WHERE EXTENSIONS ARE REQUIRED,THEY SHALL BE WATERTIGHT I VENT PIPES SHALL EXTEND A MINIMUM OF 6 INCHES ABOVE THE Dale 6/27/22 rws . \� r-21-0851 C. SEPTIC TANK&I/A OWTS MANUFACTURERS SHALL PROVIDE A LABEL OFROOF LINE AND THE TOP OF THE VENT SHALL HAVE A MINIMUM NONCORROSIVE HORIZONTAL SEPARATION OF 12 INCHES TO THE SLOPED _ -MATERIAL IN PROMINENT LOCATION AT EACH ACCESS OPENING TO WARN"ENTRANCE INTO TANK MAY BE FATAL" I PORTION OF THE ROOF. The sewage disposal andies at tt11S I�CatlOn have been Inspected andlorcertifiedt er other a encies and found POWER SUPPLY CONNECTED TO SEPTIC TANK&VAOWTSINSTALLATIONSTANDARDS, DEDICATED 115 VOLT AC,SINGLE-PHASE,20 AMP to be satisfactory FORA -__._FED OOfr1J. 1.ALL APPLICABLE RECOMMENDATIONS PROVIDED BY THE MANUFACTURER SHALL BE I I CIRCUIT BREAKER ON HOUSE PANEL IMPLEMENTED. j �. 2.THE SEPTIC TANK&I/A OWTS SHALL BE INSTALLED AT LEVEL INALL DIRECTIONS(WITH j CONTROL PANEL A MAXIMUM TOLERANCE IN ANY DIRECTION OF+/-ONE QUARTER INCH)ON A MINIMUM 3 I 1 CRAIG KNE "'ER,P E , I L.F INCH THICK(OR MANUFACTURER'S RECOMMENDATION)BED OF PROPERLY LEVELED AND I I BLOWER IN COVER ON PAD Of`iCe Of tNa St 'later Nt en'ent COMPACTED SAND(FREE FROM ROCKS)OR PEA GRAVEL.BACKFILL SHALL BE PLACED 9 AROUND THE SEPTIC TANK&VA OWTS IN SUCH A MANNER AS TO AVOID DAMAGE AND j 4"(2"MIN. DIA.HDPE VENT W/CARBON COMPACTED IN 6-INCH LIFTS.BACKFILL SHALL BE FREE OF LARGE STONES,STUMPS, I I ) AND CONSTRUCTION DEBRIS. FILTER;18"MIN.ABOVE GRADE, HOUSE i j 36"MIN.FROM ANY WINDOW OR DOOR 4"WASTE 3.THE TOP OF THE SEPTIC TANK&IIA OWTS SHALL NOT BE LOCATED GREATER THAN 1 I OPTIONAL WHEN NO HOUSE TRAP CLASS 2400 OR SDR 35, TWO AND HALF FEET OR LESS THAN ONE FOOT BELOW FINAL GRADE.FOR SEPTIC TANK 1 1 1/8"PER 12"SLOPE MIN. &I/A OWTS WITH DOMES,THE TOP OF THE DOME SHALL NOT BE LOCATED GREATER 1 1 4"WASTE,CAST IRON WITHIN 2'FROM THAN TWO AND HALF FEET OR LESS THAN ONE FOOT BELOW FINAL GRADE. I I FOUNDATION WALL,CONTINUED TO GENERAL NOTE EL.23.5W. i CLASS 2400 OR SDR 35,(OR SDR40) 1. BEFORE ANY EXECUTION,VERIFY ON SITE,IF APPLICABLE: 1 1/4"PER 12"SLOPE MIN. -GRADE ELEVATIONS AT THE HOUSE WHERE THE WASTE MAIN PENETRATES. iv -GRADE ELEVATIONS WHERE EACH UNIT WILL BE INSTALLED. '- EL.21.3'+/- 12"RISERS W/SAFETY -HOUSE WASTE LINE MAIN LOCATIONS AND INVERT ELEVATIONS. ;1DEVICE(TYP) PROJECT: No. Description Date -ANY UNDERGROUND UTILITIES,INFRASTRUCTURES,AND/OR STRUCTURES 1 I GROUND ELEVATION 21.3' Innovative and Alternative Onsite -ANY TREES WHICH MAY AFFECT TO THE VA OWTS INSTALLATION I I �_ Wastewater Treatment System 2. ANY DISPOSAL UNITS SHALL NOT BE USED WITH A I/A OWTS. _ - -7CEN { 1 3. TANKS SHOULD NOT BE PUMPED WHEN GROUNDWATER IS HIGH OR FLOOD CELLAR t 0L 0.5' DARK BROWN LOAM (I/A OWTS) 565 Mailer Ct. CONDITIONS EXIST. L - - SM 3, BROWN SILTY SAND studio a/b architects 651 West Main Street, D AR ABBREVIATIONS: _ I Riverhead,NY 11901 �P & AND LP LEACHING POOL ` I b I � LEACHING 1 631 591 2402 POOL 6313231426 { @ AT MAX. MAXIMUM i I I i glynis@studioabarchitects.com [t,J dr. �r B.C. BOTTOM OF CURB MIN. MINIMUM ro SP PALE BROWN FINE SAND # BW BOTTOM OF WALL N.T.S. NOT TO SCALE N { 1 mailing address: .i CONC. CONCRETE PROP, PROPOSED I I I PO Box 444 e►6 O C.O. CLEAN OUT REQ. REQUIRED 9 02� Orient NY 11957 DB DISTRIBUTION BOX SCDHS SUFFOLK COUNTY DEPARTMENT OF u� N r OF N E or ELEC. ELECTRIC HEALTH SERVICES ^'w ^' 0i 1 _ I I I ELEV.or EL. ELEVATION ST SEPTIC TANK O2 le ib G GAS T.O. TOP OF w= w FQ LU I o Lu 1 of 1T AS-BUILT HDPE HIGH-DENSITY POLYETHYLENE T.C. TOP OF CURB > > O _j > O C VA OWTS INNOVATIVE AND ALTERNATIVE ONSITE TW TOP OF WALL HIGHEST EXPECTED z O Z m O w ? L w--- ---_F 3,.--J NOTE:NO WATER ENCOUNTERED WASTEWATER TREATMENT SYSTEM W WATER GROUNDWATER EL.2.0' >. -wt z CLIENT INV. INVERT W/ WITH ? 0 z m > TEST HOLE BY:O MCDONALDGEOSCIENCE D J CUSTOM HOMES IIA OWTS Layout LG LEACHING GALLEY ru f-o_ of - - - - - - - - - - - - - - - - - z-- -0LL_j- - CO. - - DATE 1!15/2001 HIGHEST EXPECTED GROUNDWATER EL.2.0' m O w Project number 21201 EL.0'+/- HIGHEST EXPECTED GROUNDWATER Date 6/1/2022 - - REPLACE SOIL WITH CLEAN SAND ELEVATION 2.0'BASED ON USGS AND GRAVEL ABOVE EXISTING SP GROUNDWATER CONDITIONS ON LI. Drawn by GB 0 5 10 FT OR SW SOIL LAYER property Tax Map# Checked by HA go 1000-070.00-09.00-036.000 n SECTION DIAGRAM ,,,\TEST HOLE DATA N site street address: C.01 V.O 1 N 3/16"=V-0" N.T.S. 565 Mailer Court Southold,NY 11971 Scale As indicated ADVOCATES ABSTRACT, INC. Issuing policies of �stewarf title insurance company Title No. ADV-10205-S SINGLE & SEPARATE SEARCH STATE OF NEW YORK) . ss.. COUNTY OF SUFFOLK) STEPHEN M. RICHARDSON,being duly sworn, deposes and says: That he is the President of Advocate's Abstract,Inc.,an Agent of Stewart Title Insurance Company, and has had a search made,under his direction, of the records and/or files of the County Clerk and Registrar of the County of Suffolk for the purpose of an application for a-variance affecting the following premises: TAX MAP DESIGNATION: District: 1000 Section: 070.00 Block: 09.00 Lot: 035.000 That such search includes a chain of title as to the premises and all of the adjoining lots. ' That this affidavit is made to assist the TOWN OF SOUTHOLD to reach any determination which requires that said Board will rely upon the truth hereof. This Company's liability is limited to Twenty-Five Thousand and 00/100 ($25,000.00)Dollars for negligence only. No policy of insurance is to be issued hereunder. ADVOCATE'S ABSTRACT,INC., as Agent for Stewart Title Insurance Company BY. Stephen M. Richardson, President Sworn to before me this 27th day of April, 2019. KARMA Rte, NOTARY PUBM,State Q(WW** 011114837M, Ot affad In Suffolk 3 6302 Route 25A • Wading River, NY 11792 631-929-6686 • 631-929-3708 fax SUBJECT PREMISES: 1000-070.00-09.00-035.000 Lucy M. Leicht Dated: 11/23/1953 to Rec'd: 11/27/1953 Edith M. Leicht Liber: 3518 Page: 340 (Covers p/o premises) Edith M. Leicht died on 05/11/1954. Lucy M. Leight Dated: 06/30/1964 to Rec'd: 07/20/1964 Charles Christensen and Liber: 5580 Page: 246 Margaret Christensen, ux. (Covers p/o premises) Lucy M. Leight Dated: 06/30/1964 to Rec'd: 07/20/1964 Charles Christensen and Liber: 5592 Page: 576 Margaret Christensen, ux. (Covers p/o premises) Doris Simpson Dated: 09/15/1964 to Rec'd: 01/15/1965 Margaret Christensen Liber: 5686 Page: 291 (Covers p/o premises) Charles C. Christensen and Dated: 06/15/1966 Margaret Christensen Rec'd: 06/16/1966 to Liber: 5975 Page: 169 Daniel T. Smith, George Herbert Smith (Covers p/o premises) and William B. Smith Continued..... ADVOCATE'S ABSTRACT, INC. BY: STEPHEN M. RICHARDSON Sworn to before me this 27" day of August, 2019. Page 2 of 20 KAREN L RICHARDSON NOTARY PUBLIC,State of Now York 01R14837291 Qualified m ke$Ma Commission Expires 3 Continuation 1000-070.00-09.00-035.000 Edith B. Mailler Dated: 01/29/1966 to Rec'd: 02/02/1966 Daniel T. Smith, George Herbert Smith Liber: 5905 Page: 181 and William B. Smith (Covers p/o premises) Daniel T. Smith, George Herbert Smith Dated: 07/22/1966 a/k/a George H. Smith and William B. Rec'd: 07/25/1966 Smith Liber: 5998 Page: 560 to (Covers all of premises) W.H.D. Realty Corporation Conrad Adams Dated: 05/29/1907 to Rec'd: 06/05/1907 Katherine Breitstadt Liber: 623 Page: 92 (Covers p/o premises) John Diller and Dated: 02/07/1884 Annie Diller, ux. Rec'd: 02/15/1884 to Liber: 279 Page: 467 Christopher Leicht (Covers p/o premises) Katherine Breitstadt died on 09/28/1935. John Breitstadt died on 10/2/1938. Continued.... ADVOCATE'S ABSTRACT, INC. BY: STEPHEN M. RICHARDSON Sworn to before me this 27t' day of August, 2019. KAREN L.RICHARDSON NOTARY PUBLIC,State of New York 01R14837291 Qualllied In Suffol Commission Expires k n a3 Page 3 of 20 Continuation 1000-070.00-09.001035.000 Edith B. Mailler Dated: 01/29/1966 to Rec'd: 02/02/1966 Daniel T. Smith and Liber: 5905 Page: 181 George Herbert Smith (Covers p/o premises) Christopher Leicht died on 08/09/1953 Frederick C. Leicht died on 07/08/1954 Lucy M. Leicht Dated: 08/09/1954 to Rec'd: 08/13/1954 Charles C. Christensen and Liber: 3740 Page: 559 Margaret L. Christensen (Covers p/o premises) Map of Smithfield Park Filed on 12/27/1966 as Map No. 4770. W.H.D. Realty Corp. Dated: 08/07/1970 5 to Rec'd: 08/11/1970 Herman Reinhardt Liber: 6788 Page: 489 (Premises and more) Herman Reinhardt Dated: 10/10/1972 to Rec'd: 12/13/1972 Vito David Cecchini Liber: 7303 Page: 258 Vito David Cecchini Dated: 08/19/1982 to Rec'd: 08/24/1982 Pn Mileva Gobic and Liber: 9230 Page: 451 Dragana Gobic, as joint tenants (Premises and more) (LAST DEED OF RECORD) ADVOCATE'S ABSTRACT, INC. BY Sworn to before me this 27`h day of August, 2019. KAREN L.RICHARDSON Page 4 of 20 NOTARY PUBLIC,State of New York 01R14837291 Oualified In Suffolk qounty Commission Expires • e PREMISES ADJOINING NORTH OF SUBJECT PREMISES: 1000-070.00-09.00-036.000 Lucy M. Leicht Dated: 11/23/1953 to Rec'd: 11/27/1953 Edith M. Leicht Liber: 3518 Page: 340 (Covers p/o premises) Edith M. Leicht died on 05/11/1954. Lucy M. Leight Dated: 06/30/1964 to Rec'd: 07/20/1964 Charles Christensen and Liber: 5580 Page: 246 Margaret Christensen, ux. (Covers p/o premises) Lucy M. Leight Dated: 06/30/1964 to Rec'd: 07/20/1964 Charles Christensen and Liber: 5592 Page: 576 Margaret Christensen, ux. (Covers p/o premises) Doris Simpson Dated: 09/15/1964 to Rec'd: 01/15/1965 Margaret Christensen Liber: 5686 Page: 291 (Covers p/o premises) Charles C. Christensen and Dated: 06/15/1966 Margaret Christensen Rec'd: 06/16/1966 to Liber: 5975 Page: 169 Daniel T. Smith, George Herbert Smith (Covers p/o premises) and William B. Smith Continued..... ADVOCATE'S ABSTRACT, INC. BY: STEPHEN M. RICHARDSON Sworn to before me this 27`h day of August, 2019. KAREN L.RICHARDSON Page 5 of 20 NOTARY PUBLIC,State of New York 01R14837291 Qualified in Suffoik ntv Commission Expires 3 Continuation 1000-070.00-09.00-036.000 Edith B. Mailler Dated: 01/29/1966 to Rec'd: 02/02/1966 Daniel T. Smith, George Herbert Smith Liber: 5905 Page: 181 and William B. Smith (Covers p/o premises) Daniel T. Smith, George Herbert Smith Dated: 07/22/1966 a/k/a George H. Smith and William B. Rec'd: 07/25/1966 Smith Liber: 5998 Page: 560 to (Covers all of premises) W.H.D. Realty Corporation Conrad Adams Dated: 05/29/1907 to Rec'd: 06/05/1907 Katherine Breitstadt Liber: 623 Page: 92 (Covers p/o premises) John Diller and Dated: 02/07/1884 Annie Diller, ux. Rec'd: 02/15/1884 to Liber: 279 Page: 467 Christopher Leicht (Covers p/o premises) Katherine Breitstadt died on 09/28/1935. John Breitstadt died on 10/2/1938. Continued.... ADVOCATE'S ABSTRACT, INC. BY: STEPHEN M. RICHARDSON Sworn to before me this 27th day of August, 2019. 0 KAREN L.RICHARDSON NOTARY PUBLIC,State of New York 01R14837291 Qualified in suffouqounty Commission Expires--3 Page 6 of 20 Continuation 1000-070.00-09.0 -036.00 Edith B. Mailler Dated: 01/29/1966 to Rec'd: 02/02/1966 Daniel T. Smith and Liber: 5905 Page: 181 George Herbert Smith (Covers p/o premises) Christopher Leicht died on 08/09/1953 Frederick C. Leicht died on 07/08/1954 Lucy M. Leicht Dated: 08/09/1954 to Rec'd: 08/13/1954 Charles C. Christensen and Liber: 3740 Page: 559 Margaret L. Christensen (Covers p/o premises) Map of Smithfield Park Filed on 12/27/1966 as Map No. 4770. W.H.D. Realty Corp. Dated: 08/07/1970 to Rec'd: 08/11/1970 Herman Reinhardt Liber: 6788 Page: 489 (Premises and more) Herman Reinhardt Dated: 10/10/1972 to Rec'd: 12/13/1972 Vito David Cecchini Liber: 7303 Page: 256 (Subject Premises) Vito David Cecchini Dated: 08/19/1982 to Rec'd: 08/24/1982 �- Mileva Gobic and Liber: 9230 Page: 451 Dragana Gobic, as joint tenants (Premises and more) (LAST DEED OF RECORD) ADVOCATE'S ABSTRACT, INC. BY: STEPHEN M. RICHARDSON Sworn to before me this 27`h day of August, 2019. Page 7 of 20 KAREN L.RICHARDSON NOTARY PUBLIC,State of New York 01R14837291 Qualified In SuffolkC un Commission Expires 3 PREMISES ADJOINING SOUTH OF SUBJECT PREMISES: 1000-070.00-034.000 Lucy M. Leicht Dated: 11/23/1953 to Rec'd: 11/27/1953 Edith M. Leicht Liber: 3518 Page: 340 (Covers p/o premises) Edith M. Leicht died on 05/11/1954. Lucy M. Leight Dated: 06/30/1964 to Rec'd: 07/20/1964 Charles Christensen and Liber: 5580 Page: 246 Margaret Christensen, ux. (Covers p/0 premises) Lucy M. Leight Dated: 06/30/1964 to Rec'd: 07/20/1964 Charles Christensen and Liber: 5592 Page: 576 Margaret Christensen, ux. (Covers p/o premises) Doris Simpson Dated: 09/15/1964 to Rec'd: 01/15/1965 Margaret Christensen Liber: 5686 Page: 291 (Covers p/o premises) Charles C. Christensen and Dated: 06/15/1966 Margaret Christensen Rec'd: 06/16/1966 to Liber: 5975 Page: 169 Daniel T. Smith, George Herbert Smith (Covers p/o premises) and William B. Smith Continued..... ADVOCATE'S ABSTRACT, INC. BY• STEPHEN M. RICHARDSON Sworn to before me this 27`h day of August, 2019. Page 8 of 20 KAREN L.RICHARDSON NOTARY PUBLIC,State of New York 01894837291 Qualified in Suffolk Cpuniy Commission Expires Continuation 1000-070.00-09.00-034.000 Edith B. Mailler Dated: 01/29/1966 to Rec'd: 02/02/1966 Daniel T. Smith, George Herbert Smith Liber: 5905 Page: 181 and William B. Smith (Covers p/o premises) Daniel T. Smith, George Herbert Smith Dated: 07/22/1966 a/k/a George H. Smith and William B. Rec'd: 07/25/1966 Smith Liber: 5998 Page: 560 to (Covers all of premises) W.H.D. Realty Corporation Conrad Adams Dated: 05/29/1907 to Rec'd: 06/05/1907 Katherine Breitstadt Liber: 623 Page: 92 (Covers p/o premises) John Diller and Dated: 02/07/1884 Annie Diller,ux. Rec'd: 02/15/1884 to Liber: 279 Page: 467 Christopher Leicht (Covers p/o premises) Katherine Breitstadt died on 09/28/1935. John Breitstadt died on 10/2/1938. Continued.... ADVOCATE'S ABSTRACT, INC. BY: STEPHEN M. RICHARDSON Sworn to before me this 27"'day of August, 2019. KAREN L.RICHARDSON NOTARY PUBLIC,State of New York 01814837291 Qualified in Suffolk ounty Page 9 of 20 Commission Expires 3 Continuation 1000-070.00-09.00-034.000 Edith B. Mailler Dated: 01/29/1966 to Rec'd: 02/02/1966 Daniel T. Smith and Liber: 5905 Page: 181 George Herbert Smith (Covers p/o premises) Christopher Leicht died on 08/09/1953 Frederick C. Leicht died on 07/08/1954 Lucy M. Leicht Dated: 08/09/1954 to Rec'd: 08/13/1954 Charles C. Christensen and Liber: 3740 Page: 559 Margaret L. Christensen (Covers p/o premises) Map of Smithfield Park Filed on 12/27/1966 as Map No. 4770. W.H.D. Realty Corp. Dated: 02/06/1971 to Rec'd: 02/09/1971 James F. Lombardo and Liber: 6883 Page: 554 Vita Lombardo, ux. (Subject Premises) James F. Lombardo and Dated: 03/18/1978 Vita Lombardo, ux. Rec'd: 03/21/1978 to Liber: 8402 Page: 805 Robert F.Neville and Elizabeth A.Neville, ux. Robert F. Neville and Dated: 03/12/1981 Elizabeth A. Neville, ux. Rec'd: 03/19/1981 to Liber: 8975 Page: 442 Elizabeth Ann Neville Continued.... ADVOCATE'S ABSTRACT, INC. BY• STEPHEN M. RICHARDSON Sworn to before me this 27`h day of August, 2019. Page 10 of 20 KAREN L.RICHARDSON NOTARY PUBLIC,State of New York 01R14837291 Qualified in SuffolkC unty Commission Expires` a3 Continuation 1000-070.00-09.00-034.000 Elizabeth Ann Neville Dated: 07/28/1999 to Rec'd: 08/19/1999 Vincent Tirelli and Liber: 11983 Page: 930 Louise Tirelli, his wife (LAST DEED OF RECORD) ADVOCATE'S ABSTRACT, INC. BY: �0 STEPHEN M. RICHARDSON Sworn to before me this 27`''day of August, 2019. �p KAREN L.RICHARDSON NOTARY PUBLIC,State of New York DIR14837291 Qualified In Suffolk qounty Commission Expires 3 Page 11 of 20 PREMISES ADJOINING WEST OF SUBJECT PREMISES: 1000-070.00-09.00-027.000 Lucy M. Leicht Dated: 11/23/1953 to Rec'd: 11/27/1953 Edith M. Leicht Liber: 3518 Page: 340 (Covers p/o premises) Edith M. Leicht died on 05/11/1954. Lucy M. Leight Dated: 06/30/1964 to Rec'd: 07/20/1964 Charles Christensen and Liber: 5580 Page: 246 Margaret Christensen, ux. (Covers p/o premises) Lucy M. Leight Dated: 06/30/1964 to Rec'd: 07/20/1964 Charles Christensen and Liber: 5592 Page: 576 Margaret Christensen, ux. (Covers p/o premises) Doris Simpson Dated: 09/15/1964 to Rec'd: 01/15/1965 Margaret Christensen Liber: 5686 Page: 291 (Covers p/o premises) Charles C. Christensen and Dated: 06/15/1966 Margaret Christensen Rec'd: 06/16/1966 to Liber: 5975 Page: 169 Daniel T. Smith, George Herbert Smith (Covers p/o premises) and William B. Smith Continued..... ADVOCATE'S ABSTRACT, INC. BY STEPHEN M. RICHARDSON Sworn to before me this 27`h day of August, 2019. , Page 12 of 20 KAREN L.RICHARDSON NOTARY PUBLIC,State of New York 01R14837291 Qualified in Suffolk Cpunty Commission Expires Continuation 1000-070.00-09.00-027.000 Edith B. Mailler Dated: 01/29/1966 to Rec'd: 02/02/1966 Daniel T. Smith, George Herbert Smith Liber: 5905 Page: 181 and William B. Smith (Covers p/o premises) Daniel T. Smith, George Herbert Smith Dated: 07/22/1966 a/k/a George H. Smith and William B. Rec'd: 07/25/1966 Smith Liber: 5998 Page: 560 to (Covers all of premises) W.H.D. Realty Corporation Conrad Adams Dated: 05/29/1907 to Rec'd: 06/05/1907 Katherine Breitstadt Liber: 623 Page: 92 (Covers p/o premises) John Diller and Dated: 02/07/1884 Annie Diller, ux. Rec'd: 02/15/1884 to Liber: 279 Page: 467 Christopher Leicht (Covers p/o premises) Katherine Breitstadt died on 09/28/1935. John Breitstadt died on 10/2/1938. Continued.... ADVOCATE'S ABSTRACT, INC. BY STEPHEN M. RICHARDSON Sworn to before me this 27th day of August, 2019. KAREN L.RICHARDSON NOTARY PUBLIC,State of New York 01R14837291 Qualified In Suffolk C unty Page 13 of 20 Commission Expires 3 Continuation 1000-070.00-09.00-027.000 Edith B. Mailler Dated: 01/29/1966 to Rec'd: 02/02/1966 Daniel T. Smith and Liber: 5905 Page: 181 George Herbert Smith (Covers p/o premises) Christopher Leicht died on 08/09/1953 Frederick C. Leicht died on 07/08/1954 Lucy M. Leicht Dated: 08/09/1954 to Rec'd: 08/13/1954 Charles C. Christensen and Liber: 3740 Page: 559 Margaret L. Christensen (Covers p/o premises) Map of Smithfield Park Filed on 12/27/1966 as Map No. 4770. W.H.D. Realty Corporation Dated: 10/12/1973 to Rec'd: 10/16/1973 Anthony Bracco and Liber: 7510 Page: 494 Mary Bracco, ux. (Subject Premises) Anthony Bracco and Dated: 04/22/1994 Mary Bracco,ux. Rec'd: 05/06/1994 to Liber: 11675 Page: 741 Anthony Barkidjija and Katherine Barkidjija, ux. John Barkidjija and Dated: 12/20/1999 Katherine Barkidjija, ux. Rec'd: 01/04/2000 to Liber: 12011 Page: 544 Todd Johnson Continued.... ADVOCATE'S ABSTRACT, INC. B STEPHEN M. RICHARDSON Sworn to before me this 27th day of August, 2019. Page 14 of 20 KAREN L.RICHARDSON NOTARY PUBLIC,State of New York 01R14837291 Qualified in Suffolkou ty Commission Expires I Continuation 1000-070.00-09.00-027.000 Todd Johnson Dated: 07/24/2002 to Rec'd: 08/14/2002 Margaret A. Killian Liber: 12203 Page: 516 (LAST DEED OF RECORD) ADVOCATE'S ABSTRACT,INC. BY: STEPHEN M. RICHARDSON Sworn to before me this 27t'day of August, 2019. KAREN L.RICHARDSON NOTARY PUBLIC,State of New York 01R14837291 Qualified in Suffolk C unty Commission Expires 5 Page 15 of 20 PREMISES ADJOINING WEST OF SUJECT PREMISES: 1000-070.00-09.00-028.000 Lucy M. Leicht Dated: 11/23/1953 to Rec'd: 11/27/1953 Edith M. Leicht Liber: 3518 Page: 340 (Covers p/o premises) Edith M. Leicht died on 05/11/1954. Lucy M. Leight Dated: 06/30/1964 to Rec'd: 07/20/1964 Charles Christensen and Liber: 5580 Page: 246 Margaret Christensen, ux. (Covers p/o premises) Lucy M. Leight Dated: 06/30/1964 to Rec'd: 07/20/1964 Charles Christensen and Liber: 5592 Page: 576 Margaret Christensen, ux. (Covers p/o premises) Doris Simpson Dated: 09/15/1964 to Rec'd: 01/15/1965 Margaret Christensen Liber: 5686 Page: 291 (Covers p/o premises) Charles C. Christensen and Dated: 06/15/1966 Margaret Christensen Rec'd: 06/16/1966 to Liber: 5975 Page: 169 Daniel T. Smith, George Herbert Smith (Covers p/o premises) and William B. Smith Continued..... ADVOCATE'S ABSTRACT, INC. BY• - STEPHEN M. RICHARDSON Sworn to before me this 27`'day of August, 2019. A Page 16 of 20 KAREN L.RICHARDSON NOTARY PUBLIC,State of New York 01R14837291 Qualified in Suffolk Coun Commission Expires Continuation 1000-070.00-09.00-028.000 Edith B. Mailler Dated: 01/29/1966 to Rec'd: 02/02/1966 Daniel T. Smith, George Herbert Smith Liber: 5905 Page: 181 and William B. Smith (Covers p/o premises) Daniel T. Smith, George Herbert Smith Dated: 07/22/1966 a/k/a George H. Smith and William B. Rec'd: 07/25/1966 Smith Liber: 5998 Page: 560 to (Covers all of premises) W.H.D. Realty Corporation Conrad Adams Dated: 05/29/1907 to Rec'd: 06/05/1907 Katherine Breitstadt Liber: 623 Page: 92 (Covers p/o premises) John Diller and Dated: 02/07/1884 Annie Diller,ux. Rec'd: 02/15/1884 to Liber: 279 Page: 467 Christopher Leicht (Covers p/o premises) Katherine Breitstadt died on 09/28/1935. John Breitstadt died on 10/2/1938. Continued.... ADVOCATE'S ABSTRACT, INC. BY: STEPHEN M. RICHARDSON Sworn to before me this 27`h day of August, 2019. KAREN L.RICHARDSON NOTARY PUBLIC,State of New York 01 R14837291 Qualified in Suffolk Qounty Page 17 of 20 Commission Expires 3 Continuation 1000-070.00-09.00-028.000 Edith B. Mailler Dated: 01/29/1966 to Rec'd: 02/02/1966 Daniel T. Smith and Liber: 5905 Page: 181 George Herbert Smith (Covers p/o premises) Christopher Leicht died on 08/09/1953 Frederick C. Leicht died on 07/08/1954 Lucy M. Leicht Dated: 08/09/1954 to Rec'd: 08/13/1954 Charles C. Christensen and Liber: 3740 Page: 559 Margaret L. Christensen (Covers p/o premises) Map of Smithfield Park Filed on 12/27/1966 as Map No. 4770. W.H.D. Realty Corporation Dated: 09/17/1970 to Rec'd: 09/22/1970 Frederick R. Weber and Liber: 6811 Page: 139 Adrienne E. Weber, ux. (Subject Premises) Frederick R. Weber and Dated: 11/18/1992 Adrienne E. Weber, ux. Rec'd: 12/14/1992 to Liber: 11589 Page: 374 Roy Sichler and Marianne Sichler,ux. Roy Cichler and Dated: 02/07/1997 Marianne Sichler,ux. Rec'd: 03/04/1997 to Liber: 11819 Page: 4 Marianne Sichler Continued.... ADVOCATE'S ABSTRACT, INC. C� r BY: - STEPHEN M. RICHARDSON Sworn to before me this 27`h day of August, 2019. Page 18 of 20 KAREN L.RICHARDSON NOTARY PUBLIC,State of New York 01R14837291 Qualified in Suffolk qounty Commission Expires Continuation 1000-070.00-09.00-028.000 Roy Sichler Dated: 06/01/1998 to Rec'd: 06/19/1998 Marianne Scarsella Liber: 11900 Page: 282 f/k/a Marianne Sichler Marianne Kreidler Dated: 10/19/2004 f/k/a Marianne Scarsella and Rec'd: 10/30/2004 Marianne Sichler Liber: 12352 Page: 150 to Roy L. Morrow Jr. and Jennifer L. Mittleman Roy L. Morrow Jr. and Dated: 05/26/2005 Jennifer L. Mittleman Rec'd: 07/12/2005 to Liber: 12397 Page: 130 Roy L. Morrow Jr. Roy L. Morrow Jr. Dated: 12/12/2005 to Rec'd: 12/23/2005 Meryl Greenbaum Liber: 12427 Page: 165 Meryl Greenbaum Dated: 06/28/2013 to Rec'd: 07/23/2013 George T. Carbone and Liber: 12737 Page: 573 Danielle Hsu (LAST DEED OF RECORD) ADVOCATE'S ABSTRACT, INC. BY• STEPHEN M. RICHARDSON Sworn to before me this 27" day of August, 2019. KAREN L.RICHARDSON Page 19 of 20 NOTARY PUBLIC,State of New York 01R14837291 Qualified in Suffolk Cpuntrvi Commission Expires PREMISES ADJOINING EAST OF SUBJECT PREMISES: Mailler Court Dated: August 27, 2019 ADVOCATE'S ABSTRACT, INC. BY:: 9 STEPHEN M. RICHARDSON Sworn to before me this 27"day of August, 2019. KAREN L.RICHARDSON NOTARY PUBLIC,State of New York OI R14837291 Qualified in Suffolk C unty Commission Expires 3 Page 20 of 20 FORM NY-010 Residential Contract orsale Modifications to the form contract rife set forth in bold. Jafl(l'J prepared kr the Real Praperry Section aj(he:VCN'York State Bar Association.rhe:very Yo)-k Sta:e Lard Trr?e,lssecia(%ar.,:ire Cor,;mitree ar.Rea!?raperrn LC:r efBre Association.oft!,liaroftlte G:v of Nee Y"ark and 9ie Cm;;mi(:ec on Rea!Proper}v!mv of;re 3`eu-York Coenm Lara ers'As:eciarior.. NVA N�ENIG:NO REPRESENTATION IS MADE THAT THIS FORM OF CONTRACT FOR THE SALE AND PURCHASE OF REAL ESTATE COMPLIES WITH SECTION 5.702 OF THE GENERAL OBLIGATIONS LAW(`PLAIN LANGUAGE-). CONTSULT YOUR LAWYER BEFORE SIGNI�G TIM AGREEI'If_YT NOTE:ME Al\'D CASUALTY LOSSES AND CONDENMATION. This contract form does not provide for what happens in the went of rue,or other casualty loss or condemnation before the lido closing Unless differett provision is[Wade in this wntrne-y Section5-1311 oCth,,General Obligations Law will apply.One part of that laav makes a Ptnhascr responsible ror fire and casualty loss upon hrldng possession of dre Preiniscs before the title closing. ResidenOW Contract of Sale Contract of e�aie made as of day of: �{ `" ,� �'�. 2020 BETWEEN MILEVA GOBIC Address: 12 ROSCOE COURT,GREENV_ALE. NY 115748 SMi�t�..,=a1'.1-u_alilhnc�£f :,s.—rayl I•• hereinafter called"Seller'and R00 3QE r:C Address 3 S,-"-NZ > i�v.LE 11�I 1 9`19 hereinafter called"Purchaser"_ 91)e tlortiey berebp agree tis foltoiu5: 1. Premises_Seller shall sell and convey and Purchaser shall purchase to the Escrowee(as hereinafter defined),subject to collection,the receipt the property, togetlte< with all buildings and improvements thereon or which is hereby acknowledged to be held in escrow pursuant to (collectively the'Premises), more fully described on a separate page paragraph 6 orchis contract(Iiia-Do.vnoayment7): marked"Schedule A",rime.ed hereto and made a part hereof and also known as: Street Add SG1UTkIO�I,D 4y._1s-.:_;_ .. • _ `r•- ter.....- �__. Tax-Map Designation: 1000-70-9-'5G Together with Seller's Mmershi and ri ~i d p o�ifany,:o land]yinE in the bed of anv sleet or higbway,opened or - proposed adjoining tbz Premises to the center line thereof including any right of Seller to any unpaid award b)• - reason of any taking by condemnation and-'or for any damage to the Premises by reason of change of`-radeofany srreetorhighway.Seller shall (d) balance at Closing in accordance with paragaph�: deliver at no additional cost to Purdraser, at Closing (as hcramafter defined),or thereafter,on demand any documents that Purchaser ntav 5270,000 reasonably require for the conveyance of such title and the asi runent and 4. Existing Mortga e collection of such award or damases. 2_ Personal Prnperty.x�r__:__' `•��.•�•h.�-.trtleles� -.. _ -- - - - "-:". -- -- lL�' L •x ,.Li._rfsrtFScc -_�• _r, �'' _' _ _ -rj Y..\'..._.,.- ..._ .. _•:.,i.:__ 1!111 e ESd--Pne.4_ <— -. i-n qC... •- \3t: - •• - •_ -. ___ __ - _._ .___ _-e-:ez-..ems A_ •J eear•EeE _y .,�. —_ r.y\ t1;..., x••.v®_- a L •- .`d•�" n a eegmm n-•-s{rYA iT3PP..'•eSLn•y� ,S'•S•�r —f._— _ _ ,,.. `t e t_qq\_�_._'Jyy��__�� //\\�� _._.. - _�_ _ -moi. PRi15ES CONSISTS OF VACANT LAND essl be _ `_ ` - Is_•ll zai ;rx e-ou - C9'�OI-FI9ti- a_ •' -'- - ._: -_ _ Sri 3_ Purchase Price_The purchase price is 5300,000 payable as follows (a) omtbesieninaofthiscoatsctbyPurchascesgoodchm*payable "q, 4.zm Ell.5'_i._. li— Escrow ecorany member of it,,firm,shall be permitted to act PL-Ehae= as counsel for Seller in any dispute as'to the disbursement of the Downpayment or any other dispute between The parties whether or not 0 m65:�-e6,and at�he ewne af Glesiq-WiR 4o b - Escrowee is in possession of the Downpayment and continues to act as aed Lliil'E et.-;,''iflg faeFtgaga me es mi, eFiy diez Ecrowee- �%e 68!M�i LF ie- _e'"4e i.��k9r-e";a'-= 4!Eeefby (I)In the event that Purchaser defaults and Yclosing,does not occur, and a demand has been made upon the Escrowee by Seller for ekie W payment of the Downpayment,and the Escrowee has given notice of '4! 1 e 5e. ;Aeat,'a such demand to the Purchaser,and if within fifteen(B)business days of said notice by Escrowee the Escrowee receives an objection from by i Purchaser to the proposed Payment,then the Escrowee shall continue eqeffley -==at ---!a!A�=rs to hold the Downpayment in escrow for a period ol'sixty(60)days. ----- Should the Purchaser not commence a ICgA action to recover the Downpayment within said sixty(60)days,then the Escrowee shall sant release the Downpayment to the Seller unless Seller has moved to an L' e t oyF undisclosed location. This paragraph shall also apply to any escrow funds held in this transaction- ..r. 7.Acceptable Funds.All none'PAN yabIc under this contract�unless -ise specified shall be paid by: PeFeefi4 P4 afetu�n:Hid 4�-. othent kie�be Sdmd'Eii) P.. (a)Cash.but not over$1,000 (b)Good certified check of Purchaser drawn on or official check issued by arry bank,savings bank.trust company or savings and e ie -6 b F on having a banking office in the Sue of New Yod, dieeqF pa ....... associati AaR else net a!--f OP afte� unendorsed and abletothe order ofSeller,oras Seller may.otherwise t_14 direct upon not less than 3 business days notice(by-_vi q4ee and%F�-L 9 ep.d4in telephone or L4L�-,e�tepa-_a otherwise)to Purchaser. (c)Astomoney other than the purchase price payable to Seller 6. Downpayment in Escrow.(a)Seller's attomey("Escrowee")shall at Closin&uncertified check ofPurchaser up to the amotuitol'S1,00 hold the Downpayment in escrow in a segregated bank' account at BRIDGEHAMPTON NATIONAL BANY, MAIN ROAD, (d)As otherwise agreed to in writing by Seller or Seller's SOUTHOLD,NY until Closing or sooner termination of this contract and attorney. shall pay over or apply the Downpa-y ment in accordance with the terms of this paragrapli. Escrowee shall (not) (Delete if inapplicable) hold the (e)If Purchaser's uncertified checks giYen,at Closing are not Downpayment in an interest-bearing account for the benefit of the parties. paid by Purchaser's bank.Purchaser agrees to reimburse the Seller Ifinterest is held for the benefit of the parties,it shall be paid to die party for all collection expenses including reasonable attorneys fees This entitled to the Downpayment and the party receiving the interest-bail pay provision shall survive delivery of the deed. any income coxes thereon-If interest is not held for thebenctit ofthe parties. the Downpayment shall be placed in an IOLAL account or as otherwise &Mortgage Contingency.(INTENTIOX-ILLYDELETED permitted orrequiredby law.The Social Security or Federal Identification numbers,of the partiQ-,,sDal[be furnished to F-scrowce upon request At 9. Permitted(Exceptions.The Premises are sold and shall be conveyed Closing,the Downpayment shall be paid by Escrowee to Seller.If for any subject to: reason Closing does not occur and either party,gives Votice(as defined in (a) Zoning and subdivision laws and regulations. and landmark-, paragraph 25)to Escrowee demanding payment of the Downpa'yment, historic or wetlands designation.provided that they are not violated by.the Escrowee shall give prompt Notice to the other party of such demand-if existing buildings and improvements erected on the property or their use-, Escrowee does not receive notice of objection from such other party to the proposed payment within 10 business days after die givin.g of such Notice- (b) Consents for the erection Ofany structures On,under or above any Escrowee is hereby authorized and directed to make such payment if Strem on which the Premises abut,• Escrowecdoes receivesuch Noticeofobjecion within such 10 day period or if for any other reason Escrowee in good faith shall elect not to make (c) Encroachment;of stoops,areas,cellar steps.'trim and cornices, such payment,Escroweeshall continue to hold such amount until otherwise if any.upon any street or highway. directed by Notice from the parties to'this conti-act ora rimaj,nonappealable judgment order or decree of 2 court.However,Escrowee shall have die, (d) Real estate taxes that are a lien,but are not yet due and payable; right at any time to deposit the Downpayment and the interest thereon with and the clerk Ora court in the county in%vhich the Premises are located and shall giive (c) The other mattcrs�if any,including a survey exceptionset forth . gNotice of such deposit to Seller and Purchaser.Upon such deposit or in a Rider attached Escrowee disbursement in accordance with the terms-of this pamEmpli- Escrowee shall be relieved and discharged of all firther oblizations.and (f)CovenauM restrictions,utility easements and reservations,if responsibilities bereunder. -Jk-Z%z5X_=, any of record,provided that same are not violated by existing use or es.u. less the fifle insurance company (b)The parties acknowledge that-ittthough Escrowee is holding structur ' " y will insure that any such the Downpa}mcnt for Seller's- violation M11 not result in reversion or forfeiture;and account for all other puTose,Escrowee is acting solely as a stakeholder at their request and for their convenience and (00 Such state of facts as the attached survey prepaed by Kxuu eth that FscrLnv=shall not be liable to either party for any act or omission on last dated may show- 'Efl disregard of this fecc-Ir its part unless taken or suffered in bad faith or in willF %, contract or involving gross ncZ-li_=cc an the par,off-'crower-Seller and 10. Governmental Violations and Orders.(a)Seller shall comply with Purchak-r Jointly and severally agree to deferid- indemnity and hold all notes orno6et-ofviolations oftaw or municipal ordinances,orders or Escrowee harmless from and k-gamst all casts. claims and cXPLln"Sez requirements noted or issued as of the date}sent of dosing by,any govemmLy-tal department having authority'as to lands,housing,buildings, (including reasonable atwaneys' fees) incurred in connection 1,ith he fire.healffi,en-vironmental and labor coadidorts,affecdng the"rearises.The performance ofEscrowe-c�sduties hereunder-except%%ithrespect to actions Premises shall be coag-ed fir=Of daern at Closing.Seller shall furnish or omissions taken or-suffered by Ewro-xce in bad faith or in-,villfh', Purchaser with any zutliprim-tions necessan,to make the searches iia, disregard of this canira=or involving gross nea-tig = gence on the part of could disclose Ehe:3'c matters. ff.b"-ever.the cwt or such compliance Escrowre shall exceed 31,000,Seiler may ccei t.his Contract and refund the Downp2ymeut to the Pa-rchaser, at which time all of the Parties' (c)Escr(iwce may act or refrain froin acting in respect ofimv obligations hereunder shall be deemed terminated. Tn=t--referred to herein in ffill reiliatice upon and with the advice of counsel which may tie selected by it(including any member ofitsfirm) 6 --pFe-ises ga4e-E and shall be fully protected in So acting or reftaining from action upkv the e, Gky advice ofsich counsel-(ff)Escruwtz,acknowledges receipt of the P-3 Dowrim.racrit try check suiJect to ColiectiOL)and Escrowee's agreeMMIt to the Prtiv`i-iOris Of this Pa294!-A,b,si2ning in-,he place indicated on he 11. Seller's Representations. (a} Seller represent, acrd varram- to siginib-'re page of this contract. Purchask-_:hat: � t (i) The Premises abut or have a right of access to a public road-• ustte+ t+•;�eo_tra s,,,:•.,f-- __ _ _ _ __ _ _ --- '-- ----• -- __-...__ monies najd..t.;_Ryt:Stiw�4i^ ,.=�- (ii) Seiler is the role owner of the Premises and has the full right, power and authority to sell,convey and transfer the sante it,accgrdancet:i a2s ag •�t .`. with the terms of this contract $n�e{;�"w'tl""`t"- -- - ••-••t• -1�- m�..Tu- -;3t;:a•�_ (iii) Seller is not a`roreian person", as that terns is defined for (c) The del;very by Seiler to Purchaser of a certificate stating that purposes of the Foreign Investment in Real Property Tax Act,Internal Seller is not a foreign Person.which certificate shall be in the form then Revenue Code(`IRC")Section 1445.as anit.nded. and the regulations required by FIRPTA Or a tt+ithhoiding certificate horn the LRS.If Seller promulgated thereunder(collectively-FiRPTA"). fails to deliver the aforesaid ccrtificate or if Purchaser is not entitled under FIRPTA to rely on such cer,ificate,Purchaser shall deduct and;withhold (iv) The Premises are not affected by any exemptions or abatements Tom the purchase price a sum equal to 10%thereof(or any lesser amount of taxes;and permitted by law)and shall at Closing remit the withheld amount with the required forms to die Internal Revenue Service (v) Seller has been known by no other name for the oast ten years, except (d) The delivery of the Premises mm-!-.:1!-!-,;!•+_ _, , z�r .hQ vacant (b) Seller covenant,,and warrants that all of the representations and and free of leases or tenancies, warranties set forth in this contract shall be true and cortcct at Closing. (c) ALIPI (c) Except as otherwise expressly set forth in this contract,none of Sellers covenants, represeitaYmoms. warranties or other obligations eq* comained in this contract shall survive Closing. lap -Z-'rm?=�:�=a':•:i=;®�' *-.�yE;-�__..�� I2. Condition of Property.Purchaser acknowledges and represents that 't 6.__ r' ! - � -__ -"- eF - - _ Purchaser is fully aware of the physical condition and state ofrepair of'the rye Premises and of all other property included in this sale, based on Purchaser's atm inspection and investigation thereof and that Purchaser is o'_ -- _- ;;-ewoa entering into this contract based solely upon such inspection and tri€;,• _ , _ - - - investigation and not upon any information, data, statements or �;�be representations,written or oral,as to the physical condition,state ofrepair, uSC,cost of operation or any other matter related to the Premises or the t36-RG 1 - -- e_.t .erest other property included in the sale, given or made by Seller- or its �w• -` '''= - reptcsentatiwes and shall accept the same"as is"in theirpresent condition ter 3s ii�s:t4 5 vT and state of repair,subject to reasonable use, -,vtvr tear and natural deterioration between the date hereof and the date of Closin,(except as -+•• r.oy,t,_� otherwise set forth in paragraph 16(i)), without an), reduction in the purchase price or claim of any kind for any change in such condition by (fl _. __"._ . ..: reason thereof sulbsequerit to the date of this contract Purchaser and its authorized representatives shall have the nigh!_of reasonable times and -,-�... -•-"-„j----'-_""-- -- - - - - upon reasonable notice(by telephone or otherwise)to Selig,to inspect t,'te d- —=_='-'"' lt -- Premises before Closing. (g) The deliver by the parties of any other affidavits required as a 13. Insurable Title.Sallers}tall'git-catiipuwlas&. (n t;uch.&L conditionofrecordingthedcc(L as: ANY LICENSED TITLE INSURANCE6CHtZPAtd Ufil7tpFE7GFSIN. SUFFOLK COUNTY, NY shall be willing to approve and insure in 17. Died Transfer and Recording Taxes. At CIosin9, certified or accordance with its standard faun of title polity approved by tndIv sure in official bark checks payable to the order of the appropriate Stale City or Sate insurance D Counter officer in the amount of any applicable transfer and/or recording Department subject only to the matters provided for in this (ax payable by reason of the delivery or recording of are deed or mortgagee contract_ X 9V 4 if any,shall be deliveredby the party required by law or by this contract to 14. Closing,Deed and Title.(a)"ClosinC means the settlement ofthe Pa%'such transfer and''Pr recording tax, together with any required tax obligations of Seller and Purchaser to each other under this contract, returns duly executed and sworn to,and such party shall cause any such including the payment of the purchase price to Seller.and the delivery in chi's and returns to be delivered to the appropriate officerprompay after Closing.The obligation to pay any additional tai or deficiency and any Purchaser of a BARGAIN AND SALE DEED WITH COVENANTS interest or r(ra!tiec thereon;hall survive C osing- AGAINST GRANTOR'S ACLS deed in proper statutory short form for record,duly executed and acknowledged,so as m com-ey to Purchaser fee13. APportiopmeats and Other Adjustments; Nater Meter and simple title to the Premises,free of all encumbrances,except as otherwise 111SWment Assessments(a)To the extent applicable the following herein stated The deed shall contain a covenant by Seller as required by snail be apportionti as of midright of the day before the day of Closirh_ zubd.5 of Section 13 of the Lien Law. (i) taxes,water charges and sewer;rem on the basis of the f_-:__, (b) i f Sellcr is a(•orporadon it shall deliver-to Purchaser at the time Tien period for which assessed;'r=-w' A •..----- -- ofClo.in.,(i)aresoiudon ofits Board ofDirectors authorizing the sale and delivery of the deed,and(iri)a ceiificate by the Secretary or Assistantn"' e`<=s'� r.4--•--._^ = - --T hy Secretary of the corporatin ocertifying such resolution and scuing r'orth i7en - -. -- se farts showing that the transfer is in conformity u%ith the requithemetns of Section 909 of the Business Corporation Law.The deed in such case shall (b) 14 Closing slmall- Occur before a new tax rate is tired, the contain a recital sufficient to establish compliance with that SeC.ioe+ apportionment of(axes shall be upon the basis Of the tax rate for the immediately precedimr seal period applied to the latest assessed valuation 15:-tLasrs�gteandlce-estasinrzs} lriktlitPrnofi SEL 'I;T�111Vy DID o'cl :o-it Ci+I OII A - ir"T (c) If there is a water meter on the Premise,Seiler shall famish a �°� r ceding to a date not more than 30 days bectra Closing and are unfixed tR3F3ka" ffi) fru>;t.=_rem°iPtoF=Str?tot -"Coarita-Lieattlt -10.tvaittrnit o efamil:dww3[Ea m cite,=e and sets sent it anv,shall be apportioned on the basis of ��s y-Sz such last reading. g+�l'ttg cusiii cat`apL'aat and"wll`be'adaiat mmvtth. (d) If at the date of Closing the Premises are affected by an 16. Conditions to Closing.This contract acrd Purchaser's obli_galion to assmsmen-.,x hich is or unsay bine payable in annual instal"series,and the Purchase the Premises are also subject to and conditioned uwr! the first instal inherit is men a ler,.or has beer:paid,then for the purposes ofthis fulfillment of the fallowing conditions precedent contract all die unpaid installments shall be considered due and shall be paid by Seller at or p or to Closing, ra) The acc r-e_v,as of the date of ClO§m&of?lie representations and waman-des of Seller made in this contract " (e) Any errors or omissions in comporting apportionments or other 4ro52nir5 at Closing shall be corrected within a reasonable time tb) T ---- � r �-.-ti. _ following Clossg This sabot agplt shah survive Closing n � r;� �� l9. Allow cc for Unpaid Tales etc_Seller 1r� he oution to credit -c -----.cater' _•_ - ,-....<-- -__• Purchaser-as an adjrsancu to the prrchasc price ivith the amount of any unpaid taxes,zsseasrrrcots,r ater chat- and serve urn m together x+h any _-4R_-4 ---__� -- _ __ mtercr and penalties}etcon to a date not less than five business days after --_- _ - - ---'•-" Closing,prenidtd that ofiical bills therefor computed to said date are produced aClosith 20. Use or Purchase Price to Remove Enaambrantrs.If or CIO, there are other liens or encumbrances that Seller is obligated to. payor reasonable expenses of examination of tide to the Premises and of an discharge,Seller may use any portion of the cash balance of the purchase survey and survey inspection charges. are hereby made liens on the price topayordischarge them,provided Seller shall simultaneously deliver Premised,but such Hens shall not continue-after default byPutchaszrunder to Purchaser at Closing instruments in recordable form-and sufficient to this contract. satisfy such liens or encumbrances of record, together%%ith the cost of recording or filing said instruments.As an alternative Seller may deposit 25. Notices.Any notice or other communication(-\otice•°)shall be in sufficient monies with the dile insurance company employed by Purchaser writing and either(a) sent by either of the parties hereto or by their acceptable to and required by it to assure their discharge,but only if the r-sPective attornevs who arc i erebv authorized to do so on their behalf or title insurance company will insure Purchaser`s title clear of the matters or by the Escrowee_by registered or certified mail,postage prepaid,or insure against their enforcement out of die Premises and will insure Purchaser's Institutional Lender clear or such mauers.Upon reasonable (d) delivered in person or by overnight courier, with receipt prior notice(by telephone or otherwise),Purchaser shall provide separate acknowledged,to the respective addresses given in this contract for the certified or official bank checks as requested to assist in clearing up these party and the Escrowee,to whom the Notice is to be_aiven,or to such other matters. address as such party or Escrowce shall hereafter designate by Notice given to the other party or parties and the Escrowee pursuant to this paragraph. 21. The Examination;Seller's liability to Convey;.Limitations of Each Notice mailed shall be deemed given on the third business day Liability.(a)Purchaser shall order an examination of title in respect or the following the date of mailing the same,except that any notice to Escrowee Premisesfrom a tidecompany licensed or authorized to issue title insurance shall be deemed given only upon receipt by Escrowee and each Notice by the New York State Insurance Department or aav agent for such tide delivered in person cr by overnight courier shall be deemed giverwhen company promptly after the execution of this contract or,if this contract is delivered.or subject to the mortgage contingency set forth in paragraph $,after a mortgage commitment has been accepted by Purchaser.Purchaser shall (e) With respect tO'FJ(b)or"20,sent by fax to fie party's attorney. cause a copy of the,title report and of any additions thereto to be delivered Each Notice by fax shall be deemed given when transmission is confirmed to the attomey(s)for Seller promptly after receipt thereof. by the sender's fax machine.A cop,•of tach Notice sent to a party shall also be sent to the party's attorney.The attorneys for the patties are hereby (b)(i) If at the date of Closing Seller is unable to transfer title to authorized to give and receive on behalf of their clients all\otices and Purchaser in accordance with this contract-or Purchaser has other valid deliveries, grounds for refusing to close,whether by reason of liens,encumbrances ar other objections to title or otherwise(herein collectively called"Defeets"), 26. No Assignment.This corirmct may not be a signed by Purchaser other than those subject To which Purchaser is obligated to accept tide without the prior written consent of Seller in each instance and any hereunder or which Purchaser may have waived and other than those which Putpened ass%mnentts)made without such consent shall be void. Seller has herein expressly agreed to remove remedy or discharge and if Purchaser shalt be unwilling to waive the same and to close title without 27;;Br,okei:Seller mad.Purchascreheitrepnxet andwarrants'todneothcr abatemeatof the purchase price then except as hereinafter set forth,Seller that jt has`.tio dealE with a"v'bro<er:irr connection retch this saleothzzili'ul; shall have the right-at Seller's sole election.either to take such ac ion as `' ELl'l'Si4° al3rol e i"and Stil«'stiall. cot ec a>iy Seller may deem adiiaable to remove,remedy,dschar a or comply with conitmr °P'earrted putsturnt tori--a sbparata<,agrpsist bebi'tci'Slet:hid such Defects or to cancel this contras i; f Seller elects to take ac ion to Broker Saltra'arrd Purcltasi5 liali.ini3eoutiiv acrd'it fcttd,egrit'otlier.agairr t Sl )i remove,remedy or comply with such Defects.Seiler shall be entitled from cow'claims"and,.i�p uses 'tnclvditrg rcasadakttt ajlo�se s"Beta tbne to time,upon Notice to Purchaser,to adjourn the date for Closing �artsmb out of the brcach'pn ll etr,res tetive parts of gay representation or hereunder fora period or periods not exceeding 60 days in the aggregat 'agmernent.cogtahicxi tri this b Thd PPh F1s i?p •. provisions"of,this (but not extending beyond the date upon Nvhieh Purchaser's mortgage sliall surytve f losing or,if Ctpsipg,dpes not Occur,the temiina&.o£iliu commitment, if any,shall expire), and the date for Closing shall !±e :contra adjourned to a date specified by Seller not beyond such period.If for any 28. Miscellaneous. (a) All prior understandings. agreements, reason whatsoever,Seller shall not have succeeded in removing,rernedyino representations and warranties, or complying with such Defects at the expiration of such adjournment(s), POral or written, between Seiler and urchaser are merged in this contract-.it completely expresses their fill and if Purchasershall still be unwilling to waive the same and to close tide agreement lad has been entered into afterall investigation,neither party without abatement of the purchase price,then either party may cane,.^i this relying upon any statement made by anyone else that is not set forth in this contract by Notice to the other given within 10 days after such adjourned contact date;(iii)notwithstanding the foregoing,the existing mortgage(unless this sale is subject to the same)and any matter created by Seller after the date (b) Neither this contract nor any provision thereof may be waived, hercofsha!l be released,discharged or otherwise cured by Seiler at or prior changed or cancelled except in:writing.This contract shall also apply to to Closing. and bind the heirs, distributees, legal represcntad-W , successor, and pennittcd assigns of the respectiveby_parties.The parties hereauthorize (c) If this contract is cancelled nursutant to its terms,other than as a their respective attomeys to agree in writing:to any changes in dates and result of Purchasers default,this contract shall terminate and come to an time ot-riods prpvided for in this contact end,and neither party shall haveany furthertight,,obligations or liabilities against or ro the ocher hereunder or otherwise except that(i)Seller shall (c) Any singular word or ten;herein shall also be mad as ill the promptly refund or rause the Escrowee to refund the Do:vnpayment to plural and the neuter shall'include cite masculine and feminine gender, Purchaser and, unless cancelled as a result of Purchaser's default or -6enever the sense of this contract may require it pursuant to paragraph & to reimburse Purchaser for the nes cost of examination of title,including any appropriate additional charges related (d) The captions ire.this contract gra for conve,•rience or reference thereto,and the net cost if actually paid or incurred by Purchaser,for only and in no way define.limit or describe the spine of this contract and updating the existing suzeyofthe Ptxnisesorofanewsur. ;and(ii}1±e shptlrotbeconsideredintheinterpretationefthiscontractoranyproision obligations under paragraph .7 shall surhe die rennin gripe of this hereof. contract (e) This contract shall not be binding oret3•ecd•:euntil duly executed 22. Affidavit as to Judgments,Bankruptcies,etc Ila tide examination and delivered by Seller and Purchaser. disclosesjudgments bankruptcies or other returns against persons having names he same as or similar to that of Seller.Seller shall deliver m (i) Seller and Purchaser shall comply with IRC reporting affidavit at Closing showing that they arc not against Seller. requirements,if applicable.This Subparagraph shall survive Closinc 23. Defaults and Remedies.(a)lfpnrchas�atlef .rdcr.seller's (g) Each party shall.at any time and!tom time to time,execute. sole remedy shall be to receive and retain dee Dowapaymens as liquidated acknowledge where appropriate and definer, ttm ch further irtstreuts and damages, it being agreed that Sellers damages in case of Purchaszr s documents and take such other action as may be reasonably requested by default might be impossible to ascertain and that the Downpaytnent the other in order w tarn out the intent ap_d purpose orths contract This constitutes a fair and reasonable amount of damages under the subpaagaph shall survive Closing. chcumstarices and is not a penalty. (h) This contract is intended for he exclusive bentY±t of the parties (b) If Saler defaults herr ,rider,Purchaser shall have such remel s hereto and.except as of ervise expressly provided herein,shall not be for as Purchaser shall be aiti led to at law or in ui the benefit of.and shall not create any r ghts ire_or be emorccable by,any limited to.specific performance ry.including,but riot other person or entity'- 2i. Purchaser's Lica.All money paid on account ofthis con;tract_and the (siglaatw-es on next page] IN WITNESS WHEREOF,this contract has been duly executed by the parties hereto. MILEVA GOBIC, -Seller Purchaser Receipt of the do acknowledg-cd and the undersigned with�;5MR! ers cd a---r=to act in acconknce ir. the PrOxisions ofpar-gmph 6 Attorney for Seller: Attorney for Purchaser. PATRICIA C.MOORE MIC11AEL FERRUGGIA 51020 Main Road SOUU101d-New York 11971 2A5 BROADHOLLOVtr RD sTE 420 Tel 631-765=1330 Fax:631-7654643 MELVILLE,NY 11747 (631)390-0010 RIDER TO CONTRACT OF SALE: SELLER:MILEVA GOBIC PURCHASER:ROBERT'S PRET IIER BUILDERS LLC PREMISES:565 MAILER COURT;SOUTHOL.D,NEW YORK SCTM: 1000-70-9-36 This Rider to Contract shall supersede the provisions of the Standard"Form"Contract to which it is attached and made a part hereof if the provisions of this Rider are inconsistent with the Contract. A. Peco iC Bay Community Preservation Fund The Purchaser is responsible to pay the Peconic Bay Community Preservation Fund tax. B. Purchaser's Information 52171.Purchaser hereby confmns the information set forth below is correct_ ALL information required to complete the New York State RP-5217 must be provided at the time of contract signing as the Suffolk County CIerk WILL NOT accept handwritten changes on said form at the time of recording the Deed after the Closing. Purchaser's currentmailing address: P.O.Box or Sheet.Address 3 ScF Town i Village, State,Zip . .Code Mailing Address where Purchaser wants tax bill for the Premises to be mailedF after Closing: Purchasers Telephone C. Representation-In addition to the representations set forth in section 12 of the Contract,the Purchaser expressly warra-uts and represents that the Purchaser has examined the premises,has had ample time to perform such tests as have been agreed upon (if any); has consulted independent professionals concerning the property and surrounding area,has made necessary inquiries with city,state and federal agencies about environmental conditions on the property and in the surrounding area,and has had the opportunity to thoroughly investigate all zoning issues, certificates of occupancy, and other matters that might affect the value, reputation,or other use of the property. D. Permit aovrovals: tgsdtract.is subiect to Purchaser,at their own cost and expense,obtaining from the Sutfolk��ouuiy Healthy e�rt a, ermi�tg c ns2ructanfiA�s �pT ita�y�s�t�a _-�, �r �,)io � nrsnrzn=tam decislon �� authoiYed`to'dull=orrsnore=tes%firii'es`.ucler_ tc�obtandata o the.subsoil-cundiricrnssaedting Hath pepa standards. Purchaser shall have 90 days from date of contract containing all required information for filing Suffolk County Health Department application_ Purchaser shall promptly order a survey. Provided Purchaser has pursued said applications diligently,Seller a-ill extend contract time up to an additional 60 days for receipt of Health Department approval_ S��r aUsa�ecuSr�s �s t.,e�f t� �L�f tuY� eaiaIIfdZ 1WsiuC»L�cc't', E. Signatures This Contract may be executed by "electronic" signatures, and signature by facsimile or scanning are acceptable for the execution of this Contract. The Contract may be signed in counterparts which When taken together shall constitute a binding Contract. This Contract shall not constitute a binding Contract until such time as the DoWnpayment has been received and deposited by the Escrowee and the Seller has signed the Contract and same has been delivered to the Purchaser's attorney. WITNESS WHEREOF,this contract has been duly executed by the parties hereto. /Z, RQB.ir BY: NIILEN A GQBIC, Seller Purchaser 1 DoCUSign Envelope ID:FF7DD25E-0121-41 B4-A27A-938F23CEOB44 1 J RECENED NOV'A 7 2059 VAGp? ' yygllfY . , n? t feco•r fQ�.r a rne�• Z45 CUST67 A E nos •4} I7J:7J' 1�3a,�r .Zi9 Baal `y pper�,® 1V in °V ._ aw • 0 .. fi q P—e O Muft us � tss 99.7t' o �."G:zft VACANT 9 O Carred TW t Nero QA* SURVEY 0!F c�= LT23 do ° r.reraaced In an ° T.23 "==ad s.aWM, .r , ATSOV77MLD 77m vmt&- TOWN OF SOMW SUTOW itis� at r�smr'c�p '�.-•70—�- . Ste:r"=40' W or fhw,da awest.e��,oHsal� sr�ax oea CF> e s MT '-sow PC P.a B= 3f�' A HAV ROAD SO� MY. 1197Y 92-15-68 I Il IIIII 111!l IIII IIIII 11111 II I I I II III IIIII 11111 III!Il l! {111111 1111(11!(1 IIII Illi SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DEED Recorded: 09/29/2021 Number of Pages: 4 At: 11:43:35 AM Receipt Number : 21-0170819 TRANSFER TAX NUMBER: 21-06358 LIBER: D00013122 PAGE: 056 District: Section: Block: Lot: 1000 070.00 09.00 036.000 EXAMINED AND CHARGED AS FOLLOWS Deed Amount: $300,000.00 Received the Following Fees For Above Instrument Exempt Exempt Page/Filing $20.00 NO Handling $20.00 NO COE $5.00 NO NYS SRCHG $15.00 NO EA-CTY $5.00 NO EA-STATE $2$0.00 NO TP-584 $5.00 NO Notation $0.00 NO Cert.Copies $0.00 NO RPT $200.00 NO Transfer tax $1,200.00 NO Comm.Pres $4,500.00 NO Fees Paid $6,220.00 TRANSFER TAX NUMBER: 21-06358 THIS PAGE IS A PART OF THE INSTRU14ENT THIS IS NOT A BILL JUDITH A. PASCALE County Clerk, Suffolk County E-11[fl Number of i3ages RECORDED 2021 Sep 29 11:43:35 RM This document will be public JUDITH R. PRSCRLE CLERK OF record.Please remove all SUFFOLK COUNTY Social Security Numbers L D00013122 prior to recording. P 056 DT8 21-06358 Deed/Mortgage Instrument Deed J Mortgage Tax Stamp Recording/Filing Stamps 3 1 FEES Page/Filing Fee Mortgage Amt. 1.Basic Tax Handling X2.0, 00 2. Additional Tax TP-584 J _ Sub Total Notation SpecJAssit. or EA-5217(County) Sub Total SSpec./Add. EA-5217(State) r TOT.MTG.TAX R.P.T.S.A. mID7Qi�, Dual Town Dual County _ -`Zr. Held for Appointment Comm.of Ed. 5. 00 Transfer Tax Affidavit _ Mansion Tax The property covered by this mortgage is Certified Copy or will be improved by a one or two NYS Surcharge 15. 007� family dwelling only. SubTotal YES or NO Other _ J-a 6 Grand Total — f NO,see appropriate tax clause an page# f this 1 strument. -a 4 Dist.lppp 21049695 1000 07000 0900 036000 0 5 Community Preservation Fund Real Property RFs Consideration Amount Tax Service IM1111MIN111 Agency 14SEr'2t CPF Tax Due $ r Verification Improved 6 Satisfactions/Discharges/Releases List Property Owners Mailing Address L RECORD&RETURN TO: Vacant Land I�Obt?I�S PI CYYIi�I'V-velcp%q+ ("Vf- TD _ `bavld hbw+s 3 Sandier k arl�lq TD Manwvige, - - TD Mail to:Judith A.Pascale,Suffolk County Clerk 7 Title Company Information 310 Center Drive, Riverhead, NY 11901 Co.Name :nfPl 1f1G www.suffolkcauntyny.gov/clerk Tltle q Alhiblaq B Suffolk County Recording & Endorsement Page This page forms part of the attached d made by. (SPECIFYTYPE OF INSTRUMENT) **lli Yway Ob1C The premises herein is situated in lu I wa Cep biC SUFFOLK COUNTY,NEW YORK. TO In the TOWN of QnhP�s Premier kiejupmE0 L-i-r- IntheVILLAGE T or HAMLET of BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. over r BARGAIN AND SALE DEED WITH COVENANT AGAINST GRANTOR'S ACTS(INDIVIDUAL OR CORPORATION) STANDARD NYBTU FORM 8007 CAUTION:•THIS AGREEMENT SHOULD BE PREPARED BY AN ATTORNEY AND REVIEWED BY ATTORNEYS FORSELLER AND � PURCHASER BEFORE SIGNING A�Nval LoNVE72NGG do 8 �lm� THIS INDENTURE made thhe rN da of 2021 between Miroslav Goble and Mileva Goble,as husband and wife, residing at 12 Roscoe Court,Greenvale,NY 11548 fon ar party of the first part,and Roberts Dvwpany Development LLC,a domestic limited liability company with offices located at 3 Sandie Lane,Manorville,NY 11949 party of the second part, WITNESSETH,that the party of the first part,in consideration of Ten Dollars and other valuable consideration,paid by the party of the second part,does hereby grant and release unto the party of the second part, the heirs or successors and assigns of the parry of the second part forever, ALL that certain plot,piece or parcel of land,with the buildings and improvements thereon erected, situate,lying and being in the 1000 SEE SCHEDULE A ATTACHED(DESCRIPTION OF PREMISES) DSO'0D BEING AND INTENDED TO BE the same premises described in a deed made by Mi lcra Qvbfo and pq,OD Dr9am Qober 4D Nileva Qobic and Mtroslod 4obic 6" 91o/21 and Irtkndcd k be. D34.60D reed cimulistneousy hvaa eA. -/ TOGETHER with all right,title and interest,if any,of the party of the first part in and to any streets and roads abutting the above described premises to the center lines thereof, TOGETHER with the appurtenances and all the estate and rights of the party of the first part in and to said premises, TO HAYEAND TO HOLD the premises herein granted unto the party of the second part,the heirs or successors and assigns of the party of the second part forever. AND the party of the first part,covenants that the party of the first part has not done or suffered anything whereby the said premises have been encumbered in any way whatever,except as aforesaid. AND the party of the first part,in compliance with Section 13 of the Lien Law,covenants that the party of the first part will receive the consideration for this conveyance and will hold the right to receive such consideration as a trust fund to be applied first for the purpose of paying the cost of the improvement and will apply the same first to the payment of the cost of the improvement before using any part of the total of the same for any other purpose. The word"party"shall be construed as if it read"parties"whenever the sense of this indenture so requires. IN WITNESS WHEREOF,the patty of the first part has duly executed this deed the day and year first above written. IN PRESENCE OF.- A&—&—. MftevX BbIG L h4ireslav�6ell'ie M l rOSjatl O brG NYSBA Resideaaal Real Estate Foma on Hoa?ocs'(9/00) Copyright Capsoft'Development Schedule A Description Revised: 07107/2021 Title Number ADA6630-S Page 1 ALL that certain plot, piece or parcel of land situate, lying and being in the Town of Southold, County of Suffolk and State of New York, known and designated as Lot 23 on a certain map entitled, "Map of Smithfield Park" and filed in-the Suffolk County Clerk's Office on December 27, 1966 as map no. 4770, bounded and described as follows: BEGINNING at a point on the Westerly side of Mailler Court which point is the extreme Southerly end of an arc of a curve connecting the Westerly side of Mailler Court with the Southerly side of Custer Avenue; RUNNING THENCE along the Westerly side or Mailler Court South 05 degrees 00 minutes 45 seconds East 96.09 feet; RUNNING THENCE South 84 degrees 58 minutes 20 seconds West 199.71 feet; RUNNING THENCE North 05 degrees 13 minutes 00 seconds East 124.97 feet to the Southerly side of Custer Avenue; RUNNING THENCE along the Southerly side of Custer Avenue the following three (3)courses and distances: 1. South 84 degrees 47 minutes 00 seconds East 42.09 feet; 2. North 82 degrees 37 minutes 10 seconds East 111.21 feet; 3. Along said arc of a curve bearing to the right having a radius of 23.99 feet,, length of 38.67 feet, to the point or place of BEGINNING. FOR INFORMATION ONLY; premises being known as: 565 Mailler Court, Southold, Town of Southold 1000-070.00-09.00-036.000 r 1 State of New York ) ss: County of Suffolk ) On this a� day of 2021,before me,the undersigned,personally appeared Miroslav Gobic and Mileva Gobic,persohally known to me or proved to me on the basis of satisfactory evidence to the be individuals whose names are subscribed to the within instrument and acknowledged to me that they executed the same in their capacities,and that by their signatures on the instrument,the individuals,or the person upon behalf of which the individuals acted,executed the instrument. otary Pub is BETSY A.PERKINS Notary Public,State of New York No.01PF6130635 Qualified In Suffolk Commission Expires July ,QaS R,et m� and "M; Roberis hmier Devd+w r>f-WZ }Arlie NY 14 H9 NYSBA Residential Real Estate Forms on HotDoes'(9/00) Copyright Capsoll'Development -2- 1 I I#11111 Illi IIIII IIIII 111#I IIIII(fill Illil IIII!fill 1111 1111111111111111 I l l l I I I I SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DEED Recorded: 09/29/2021 Number of Pages: 4 At: 11:43:35 AM Receipt Number : 21-0170819 TRANSFER TAX NUMBER: 21-06360 LIBER: D00013122 ' PAGE: 058 District: Section: Block: Lot: 1000 070.00 09.00 035.000 EXAMINED AND CHARGED AS FOLLOWS Deed Amount: $305,000.00 Received the Following Fees For Above Instrument Exempt Exempt Page/Filing $20.00 NO Handling $20.00 NO COE $5.00 NO NYS SRCHG $15.00 NO EA-CTY $5.00 NO EA-STATE $250.00 NO TP-584 $5.00 ' NO Notation $0.00 NO Cert.Copies $0.00 NO RPT $200.00 NO Transfer tax $1,220.00 NO Comm.Pres $4, 600.00 NO Fees Paid $6,340.00 TRANSFER TAX NU14HER: 21-06360 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL JUDITH A. PASCALE County Clerk, Suffolk County 1 Numberofpages . RECORDED 2021 Sep 29 11:43:35 RM A. rRLE This`document will be public J�ICLEW OFA record.Please remove all SUFFOLK COUNTY Social Security Numbers L DOM13M 058 prior to recording. DT# 216360 Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps 3 FEES Page/Filing Fee � Mortgage Amt. 1.Basic Tax Handling 20. 00 2. Additional Tax TP-584 Sub Total Notation Spec./Assit. or EA-5217(County) Sub Total Spec./Add. EA-5217(State) TOT.MTG.TAX R.P.TS.A. Dual Town Dual County Held for Appointment t Comm.of Ed. S. 00 Transfer Taxum ! Affidavit • Mansion Tax Certified Co The property covered by this mortgage is Py or will be Improved by a one or two NYS Surcharge 15. 00 family dwelling only. Other Sub Total YES or NO Grand Total If NO,see appropriate tax clause on age# f this Inst^m nt 4 Dist.l0bf 21049698 1000 07000 0900 035000 X00 5 Community Preservation Fund T Real Property R SMI A Consideration Amount Tax Service 11111110fill f4SEP� Agency CPF Tax Due $ Verification Improved 6 Satisfactions/Discharges/Releases List Property Owners Mailing Address / I RECORD&RETURN TO: Vacant Land// Roberts t�aDevdoprnerra' TD j� D41rd itobcrk5 1 .Salndf•o kwle' j(9HR TD N(q,norv,'I1e N.y. TO Mall to:Judith A.Pascale,Suffolk County Clerk 7 Title Company Information 310 Center Drive, �Riverhead, NY 11901 Co,Name 090*164n ar2zQrn fahSdr'a c -I-a www.suffolkcountyny.gov/clerk Title# 8 Suffolk County Recording & Endorsement Page This page forms part of the attached dGCeol made by. (SPECIFYTYPE OF INSTRUMENT) Wkyu cla bl c The premises herein is situated In SUFFOLK COUNTY,NEW(tYORK. TO In the TOWN ofRoberts 84pn j aeL4cnm=4-LLC In the VILLAGE or HAMLET of BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. over ADA(n(P31- BARGAIN AND SALE DEED WITH COVENANT AGAINST GRANTOR'S ACTS(INDIVIDUAL OR CORPORATION) STANDARD NYBTU FORM 8007 CAUTION.THIS AGREEMENT SHOULD BE PREPARED BY AN ATTORNEY AND REVIEWED BY ATTORNEYS FOR SELLER AND PURCHASER BEFORESIGN'9161 A�� ' THIS INDENTURE,made the (o day of i� 2021 between Mileva Goble residing at 12 Roscoe Court,Greenvale,NY 11548 party of the first part,and Roberts Property Development LLC,a domestic limited liability company with offices located at 3 Sandie Lane,Manorville NY 11949 party of the second part, WITNESSETH,that the party of the first part,in consideration of Ten Dollars and other valuable consideration,paid by the party of the second part,does hereby grant and release unto the party of the second part, the heirs or successors and assigns of the party of the second part forever, ALL that certain plot,piece or parcel of land,with the buildings and improvements thereon erected, situate,lying and being in the SEE SCHEDULE A ATTACHED(DESCRIPTION OF PREMISES) ®pg'� BEINGng q�TE dctfed 19ag sf .2oa1 premises j`Kc-d cl deed nuaf7eou y ob�o • 035 0o J TOGETHER with all right,title and interest,if any,of the party of the first part in and to any streets and roads abutting the above described premises to the center tines thereof, TOGETHER with the appurtenances and all the estate and rights of the party of the first part in and to said premises, TO HAVEAND TO HOLD the premises herein granted unto the party of the second part,the heirs or successors and assigns of the party of the second part forever. AND the party of the first part,covenants that the party of the first part has not done or suffered anything whereby the said premises have been encumbered in any way whatever,except as aforesaid. , I AND the party of the first part,in compliance with Section 13 of the Lien Law,covenants that the party of the first part will receive the consideration for this conveyance and will hold the right to receive such ' consideration as a trust fund to be applied first for the purpose of paying the cost of the improvement and will apply the same first to the payment of the cost of the improvement before using any part of the total of the some for any other purpose. The word"party"shall,be construed as if it read"parties"whenever the sense of this indenture so requires. IN WITNESS WHEREOF,the patty of the first part has duly executed this deed the day and year first above written. IN PRESENCE OF. Mileva Goble NYSBA Restdcatud Real Estatc Fortes on HotDocs'(9100) Copyright CapsofF Development -r- Schbd,ul.q.A Qqkcflpjion- .4evised: Oi/Ofi2dil Tidd Whibeir:ADA663f-S Page I ALL,thldf d6ftbin bf land situate; !y'ing%nd being iffti*t6Wn of;Southoldi,County:of'Suffolk-and State-of:New York-, known.and'designated as Lot 22,on a.certain map entitled; "Map df...Smithfield:Park"and,filed ln:..thff:SUffo1k County Clerk's-bfrice:o n,December 27, .1b-66-as map!no, 4.770, bounded and described asJollows; 9P-GINNINO•at a polff 6n tfie Weitdily:S11de oi.Ma'ilter:.Cci'Lii,t:diifahf:96.09 feet` ff6 M' 'th6 extreme So.utherly diftd of an are of a c'u'rve pqhn!66tI n*6,thb-Westerly. side of WbIlldf Court With-the'Southeft.gld6 of GUM&-Av6hij6: RUNNING THENCE lildh'§ft We§t&Iy-61d6 bf W116r C6urt:-Sb degrees 01--minute's 40:s6doh*db:Ebst-1100:00 febt.* RUNNINd�'THEINOE-SWh 84 degrees.'58 mlnutesl�d tedbridsV6d 2*J*" feet; -RU14NI146-THE14CE;Norfh 05&grees:fb-minutesroO,8econds East 1011 1-;6 1 24e4i; .RUNNING THENCE Nbrth,84,degrees..58 rnihutbs.20.skonds EaitJ 99.7.1,feet 16-the WiBstetiv:side of*Mailler'Court.,the blfit-df pjqdq-of-BEGINNING. I ... ... ... .... Court„. .. ....P, ... ... 'FOR INFORMATION ONLY;. ,premises being khbyvrf as; 465.Mailler Court, Soutlioldl,Town of.-S.out.hold loop-Q7Q.Q0-:Q9.Q0-L035.000 ....... .......... .... ............ ...... ... ... ...... .......................... ...... .. State of New York } ss: County of Suffolk ) On this day of 2021,before me,the undersigned,personally appeared MILEVA GOBYC','personally known to m or proved to me on the basis of satisfactory evidence to the be individuals whose names are subscribed to the within instrument and acknowledged to me that they executed the same in their capacities,and that by their signatures on the instrument,the individuals,or the person upon behalf of which the individuals acted,executed the instrument. Notary Publ' BETSYA.PERKINS Notary Public,State of New York No.01PE6130636 Qualified In Suffolk Coun Commission ExplresJuly 1s, RyR: obcrts R�pr. bo&k mem uc in favid 44-"t+q 3 Sangre Lane) matior»ile, NY IIQ-qq NYSBA Remdenttal Real Eatate Fortis on Moo&(9/00) Copyright Capsoa'rkvelopmeol .2- ATTN: SOUTHOLD BUILDING DEPARTMENT To whom It may concern, We are filing for a building permit at the physical location of 565 Mailer court Southold NY SCTM#1000-70-09-36 Attached to this letter are the following documents 1. Building permit Application 2. Approved board of health plan 3. Survey 4. 4 sets of plans 5. Electrical application 6. Contractors' insurance 7. One copy of RES check and Manual J Please let us know if any other documentation is needed Thank you kindly. Yours truly, David Roberts 631-905-4789 Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 10/06/21 Receipt#: 287433 Quantity Transactions Reference Subtotal 1 Septic Permit-Construct- Resid. 5077 $10.00 Total Paid: $10.00 Notes: Payment Type Amount Paid By CASH $10.00 Roberts, David Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Roberts, David 3 Sandie Ln Manorville, NY 11949 Clerk ID: SABRINA Internal ID:5077 2 Windemere Court, P.O. Box 169 Speonk,New York 11972 UKKeri KazeL Architecture P: 631-874-2925 F: 631-874-7377 keri @kazelarch itects.com October 14, 2021 Building Permits Examiner �� J L� Town of Southold Building Department MAR _ 9 ?OZZ Annex Building 54375 Main Road Southold, NY 11971j' :`T � ��.Fl. Re: Permit #: 46969, 565 Mailer Court in Southold To whom it may concern, Please accept this letter of inspection for the above referenced property. An inspection was made on January 11, 2022, for the 3- #5 Re-bars in the footings, and January 16, 2022 for the damproofing on the foundation walls. Both were constructed as per New York State Residential Building Code. Please feel free to contact our office if you have any questions. Thank you Sincerely yours, � 'p ED A e • \Gj,�� AN k Fy,�� .: � n'j�f Keri Kazel, Architect Q 9743-1 �0 j OF NE`N www.kazelarchitects.com < - 1 A`40 V CERTIFICATE OF LIABILITY INSURANCE DATE(tHMJDDJYYYY) 8/19/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT NAME,— Debra Ferraro Brazier Insurance Agency PHON e . (631)286-1400 FAX No: (691)286-1406 1745 Montauk Highway ADDRES..brazier–debra@optonline.not INSURER(S) AFFORDING COVERAGE NAIC p Bellport NY 11713 INSURERA:Southwest Marine 6 General Insurance Cc INSURED INSURER B DJ Custom Homes Corp. tNSURERC: 3 Sandie Lane RMRER D: INSURER E: Manorville NY 11949 pSURERF: COVERAGES CERTIFICATE NUMBER:CL2181919221 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCEAFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE ADOL R POLICY NUMBER MMfDDO EFF MSC EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 A CLAIMS-ME ❑X OCCUR PREMISES Ea occurrence S 500,000 X GL2020RLBOOSI? 10/24/2020 10/24/2021 MED EXP(Any one person) S 10,000 PERSONAL BADV INJURY S 2,000,000 GENLAGGREGATE UMITAPPUES PER: GENERAL AGGREGATE S 4,000,000 X POLICY ❑JECT LOC PRODUCTS-COMPIOPAGG S 4,000,000 OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S Ea accident ANYAUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTYDAMAGE $ HIREOAUTOS AUTOS (Per S UMBRELLA LLAB OCCUR EACH OCCURRENCE $ EXCESS L IAB HCLAIMS-MADE, AGGREGATE S OED RETENTION$ S WORKERS COMPENSATION PER OTH- TAT ER AND EMPLOYERS'LIABILITY YIN ANYPROPRIF-MPJPARTNER/EXECUTIVE EL EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? NIA (Mandatory In NH) E.L DISEASE-EA EMPLOYEE 1$ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $' DESCRIPTION OF OPERATIONS[LOCATIONS/VEHICLES(ACORD 101,Addtdonal Remarae Schedule,maybe attached U mom apace Is required) The certificate holder is additional insured with respect to General Liability coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Southold THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 53095 Route 25 ACCORDANCE WITH THE POLICY PROVISIONS. Southold, NY 11971 _. R1ZED TATIVE The uadasfQneA nF( t0 °A K in Brazier/DEBRA Amha4.jd.f01c' ©1968-2014 ACO RPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are red marks of ACORD INS025 pouot) ! Z N Y S ' F New York state Insurance Fund 8 CORPORATE CENTER DR,3RD FLR,MELVILLE,NEW YORK 11747-3129 I nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE � D All^^^A 461572203 BRAZIER AGENCY 1745 MONTAUK HIGHWAY • Y BELLPORT NY 11713 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER DJ CUSTOM HOMES CORP TOWN OF SOUTHOLD 3 SANDIE LANE 53095 ROUTE 25 MANORVILLE NY 11949 SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE 12366960-9 791457 07/17/2021 TO 07/17/2022 8/19/2021 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2366 960-9, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY,INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS:If WWW.NYSIF.COM/CERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. PRESIDENT DAVID ROBERTS VICE PRESIDENT JAMES ROBERTS DJ CUSTOM HOMES CORP THE POLICY INCLUDES A WAIVER OF SUBROGATION ENDORSEMENT UNDER WHICH NYSIF AGREES TO WAIVE ITS RIGHT OF SUBROGATION TO BRING AN ACTION AGAINST THE CERTIFICATE HOLDER TO RECOVER AMOUNTS WE PAID IN WORKERS'COMPENSATION AND/OR MEDICAL BENEFITS TO OR ON BEHALF OF AN EMPLOYEE OF OUR INSURED IN THE EVENT THAT, PRIOR TO THE DATE OF THE ACCIDENT, THE CERTIFICATE HOLDER HAS ENTERED INTO A WRITTEN CONTRACT WITH OUR INSURED THAT REQUIRES THAT SUCH RIGHT OF SUBROGATION BE WAIVED. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER:889938339 U-26.3 i 1 sNEw Workers' CERTIFICATE OF INSURANCE COVERAGE I Compensation Board DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW PART 1.To be completed by Disability and Paid Family Leave Benefits Carrier or Licensed Insurance Agent of that Carrier 1a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured DJ CUSTOM HOMES CORP 3 SANDIE LANE MANORVILLE,NY 11949 1c.Federal Employer Identification Number of Insured Work Location of Insured(Only required if coverage is specifically limited to or Social Security Number certain locations In New York State.i.e.,Wrap-Up Policy) 461572203 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) ShelterPoint Life Insurance Company TOWN OF SOUTHOLD 3b.Policy Number of Entity Listed in Box 1 a" 53095 ROUTE 25 DBL571625 SOUTHOLD, NY 11971 3c.Policy effective period 01/01/2021 to 12/31/2022 4. Policy provides the following benefits: ® A.Both disability and paid family leave benefits. B.Disability benefits only. C.Paid family leave benefits only. 5. Policy covers: 0 A.All of the employer's employees eligible under the NYS Disability and Paid Family Leave Benefits Law. M B.Only the following class or classes of employer's employees: Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has NYS Disability and/or Paid Family Leave Benefits insurance coverage as described above. Date Signed 8/19/2021 By 440 ht (Signature of insurance carrier's authorized representative or NYS Licensed Insurance Agent of that insurance carrier) Telephone Number 516-829-8100 Name and Title Richard White, Chief Executive Officer IMPORTANT: If Boxes 4A and 5A are checked,and this form is signed by the insurance carrier's authorized representative or NYS Licensed Insurance Agent of that carrier,this certificate is COMPLETE. Mail it directly to the certificate holder. If Box 46,4C or 5B is,checked,this certificate is NOT COMPLETE for purposes of Section 220, Subd.8 of the NYS Disability and Paid Family Leave Benefits Law. It must be mailed for completion to the Workers'Compensation Board, Plans Acceptance Unit, PO Box 5200, Binghamton, NY 13902-5200. PART 2.To be completed by the NYS Workers' Compensation Board (only if Box 4C or 56 of Pan 1 has been checked) State of New York Workers' Compensation Board According to information maintained by the NYS Workers'Compensation Board,the above-named employer has complied with the NYS Disability and Paid Family Leave Benefits Law with respect to all of his/her employees. Date Signed By (Signature of Authorized NYS Workers'Compensation Board Employee) Telephone Number Name and Title Please Note:Only insurance carriers licensed to write NYS disability and paid family leave benefits insurance policies and NYS licensed insurance agents of those insurance carriers are authorized to issue Form DB-120.1.Insurance brokers are NOT authorized to issue this form. DB-120.1 (10-17) 11DB-120.°°11°111m11u11111°1IIII III Generated by REScheck-Web Software Compliance Certificate Project 565 Mailer Ct Southold, NY Energy Code: 2018 IECC Location: Southold, New York Construction Type: Single-family Project Type: New Construction Conditioned Floor Area: 2,238 ft2 Glazing Area 13% Climate Zone: 4 (5572 HDD) Permit Date: Permit Number: Construction Site: Owner/Agent: Designer/Contractor: 565 Mailer Ct Southold, NY 565 Mailer Ct Southold, NY Energy Rating Service, Inc Matt Wahl Islip Terrace, NY 11752 631- 566-8439 energyratingservice@yahoo.com trade-offCompliance: Passes using UA Compliance: 9.5%Better Than Code Maximum UA: 463 Your UA: 419 Maximum SHGC: 0.40 Your SHGC: 0.30 The%Better or Worse Than Code Index reflects how close to compliance the house is based on code trade-off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. Envelope Assemblies Gross Area Cavity Cont. Prop. Req. Prop. Req. Perimeter Ceiling 1: Cathedral Ceiling (no attic) 209 38.0 0.0 0.027 0.026 6 5 Ceiling 2: Cathedral Ceiling (no attic) 270 38.0 0.0 0.027 0.026 7 7 Ceiling 3: Cathedral Ceiling (no attic) 267 38.0 0.0 0.027 0.026 7 7 Ceiling 4: Cathedral Ceiling (no attic) 398 38.0 0.0 0.027 0.026 11 10 Ceiling 5: Cathedral Ceiling (no attic) 254 38.0 0.0 0.027 0.026 7 7 Ceiling 6: Cathedral Ceiling (no attic) 260 38.0 0.0 0.027 0.026 7 7 Ceiling 7: Cathedral Ceiling (no attic) 105 38.0 0.0 0.027 0.026 3 3 Ceiling 8: Cathedral Ceiling (no attic) 1,064 38.0 0.0 0,027 0.026 29 28 Wall 1:Wood Frame, 16" D.C. 34 21.0 0.0 0.057 0.060 2 2 Wall 2:Wood Frame, 16" D.C. 22 21.0 0.0 0.057 0.060 1 1 Wall 3: Wood Frame, 16" o.c. 100 21.0 0.0 0.057 0.060 4 4 Window 1: Other 30 0.300 0.320 9 10 SHGC: 0.30 Wall 4: Wood Frame, 16" o.c. 32 21.0 0.0 0.057 0.060 2 2 Wall 5: Wood Frame, 16" D.C. 13 21.0 0.0 0.057 0.060 1 1 Wall 6: Wood Frame, 16" o.c. 45 21.0 0.0 0.057 0.060 3 3 Wall 7: Wood Frame, 16" o.c. 34 21.0 0.0 0.057 0.060 2 2 Project Title: 565 Mailer Ct Southold, NY Report date: 07/14/21 Data filename: Page 1 of11 Gross Area Cavity Cont. Prop. Req. Prop. Req. Perimeter Wall 8:Wood Frame, 16" o.c. 7 21.0 0.0 0.057 0.060 0 0 Wall 9:Wood Frame, 16" ox. 46 21.0 0.0 0.057 0.060 3 3 Wall 10: Wood Frame, 16" ox. 100 21.0 0.0 0.057 0.060 5 5 Window 2: Other 15 0.300 0.320 5 5 SHGC: 0.30 Wall 11:Wood Frame, 16" ox. 8 21.0 0.0 0.057 0.060 0 1 Wall 12:Wood Frame, 16" ox. 42 21.0 0.0 0.057 0.060 2 3 Wall 13:Wood Frame, 16" ox. 92 21.0 0.0 0.057 0.060 4 5 Window 3: Other 15 0.300 0.320 5 5 SHGC: 0.30 Wall 14: Wood Frame, 16" ox. 10 21.0 0.0 0.057 0.060 1 1 Wall 15:Wood Frame, 16" o.c. 134 21.0 0.0 0.057 0.060 5 5 Window 4: Other 48 0.300 0.320 14 15 SHGC: 0.30 Wall 16: Wood Frame, 16" ox. 151 21.0 0.0 0.057 0.060 7 7 Window 5: Other 18 0.300 0.320 5 6 SHGC: 0.30 Window 6: Other 18 0.300 0.320 5 6 SHGC: 0.30 Wall 17:Wood Frame, 16"o.c. 53 21.0 0.0 0.057 0.060 3 3 Wall 18: Wood Frame, 16" ox. 134 21.0 0.0 0.057 0.060 6 6 Window 7: Other 27 0.300 0.320 8 9 SHGC: 0.30 Wall 19: Wood Frame, 16" ox. 171 21.0 0.0 0.057 0.060 9 9 Window 8: Other 16 0.300 0.320 5 5 SHGC: 0.30 Wall 20:Wood Frame, 16" ox. 36 21.0 0.0 0.057 0.060 2 2 Wall 21: Wood Frame, 16" ox. 40 21.0 0.0 0.057 0.060 2 2 Wall 22: Wood Frame, 16"ox. 86 21.0 0.0 0.057 0.060 4 4 Window 9: Other 21 0.300 0.320 6 7 SHGC: 0.30 Wall 23: Wood Frame, 16" ox. 134 21.0 0.0 0.057 0.060 7 7 Window 10: Other 14 0.300 0.320 4 4 SHGC: 0.30 Wall 24:Wood Frame, 16" o.c. 151 21.0 0.0 0.057 0.060 7 8 Door 1: Solid 21 0.290 0.320 6 7 Wall 25:Wood Frame, 16" ox. 351 21.0 0.0 0.057 0.060 15 15 Window 11: Other 71 0.300 0.320 21 23 SHGC: 0.30 Window 12: Other 23 0.300 0.320 7 7 SHGC: 0.30 Wall 26: Wood Frame, 16" ox. 151 21.0 0.0 0.057 0.060 8 8 Window 13: Other 9 0.300 0.320 3 3 SHGC: 0.30 Window 14: Other 9 0.300 0.320 3 3 SHGC: 0.30 Wall 27: Wood Frame, 16" o.c. 92 21.0 0.0 0.057 0.060 4 4 Door 2: Solid 21 0.290 0.320 6 7 Project Title: 565 Mailer Ct Southold, NY Report date: 07/14/21 Data filename: Page 2 of11 Gross Area Cavity Cont. Prop. Prop. Perimeter Wall 28:Wood Frame, 16" o.c. 26 21.0 0.0 0.057 0.060 1 2 Wall 29: Wood Frame, 16" o.c. 158 21.0 0.0 0.057 0.060 5 5 Door 3: Solid 35 0.280 0.320 10 11 Window 15: Other 31 0.300 0.320 9 10 SHGC: 0.30 Wall 30:Wood Frame, 16" o.c. 39 21.0 0.0 0.057 0.060 1 1 Door 4: Solid 21 0.280 0.320 6 7 Wall 31:Wood Frame, 16" o.c. 23 21.0 0.0 0.057 0.060 1 1 Wall 32:Wood Frame, 16" o.c. 98 21.0 0.0 0.057 0.060 6 6 Wall 33:Wood Frame, 16" o.c. 39 21.0 0.0 0.057 0.060 2 2 Wall 34: Wood Frame, 16" o.c. 138 21.0 0.0 0.057 0.060 8 8 Wall 35: Wood Frame, 16" o.c. 62 21.0 0.0 0.057 0.060 4 4 Basement Ceiling:All-Wood joist/Truss 1,449 30.0 0.0 0.033 0.047 48 68 Garage Ceiling:All-Wood Joist/Truss 524 30.0 0.0 0.033 0.047 17 25 Overhang:All-Wood Joist/Truss 85 30.0 0.0 0.033 0.047 3 4 Compliance Statement. The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application.The proposed building has been designed to meet the 2018 IECC requirements in REScheck Version : REScheck-Web and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. matthew Wahl, hers rater 2572845 Matthew Wahl Digitally signed Matthew Wahl Date:2021.07.141 1 0:39:50-04'00' Name-Title Signature Date Project Title: 565 Mailer Ct Southold, NY Report date: 07/14/21 Data filename: Page 3 ofll REScheck Software Version : REScheck-Web Inspection Checklist Energy Code: 2018 IECC Requirements: 97.0% 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. Section Plans Verified Field Verified # Pre-Inspection/Plan Review Value Value Complies? Comments/Assumptions & Req.ID 103.1, ;Construction drawings and ❑Complies ;Requirement will be met. 103.2 !documentation demonstrate []Does Not [PR1]1 !energy code compliance for the 4)1 ;building envelope.Thermal ❑Not Observable ienvelope represented on ❑Not Applicable ;construction documents. 103.1, ;Construction drawings and ❑Complies ;Requirement will be met. 103.2, .documentation demonstrate ❑Does Not 403.7 ;energy code compliance for [PR3]1 !lighting and mechanical systems. ❑Not Observable !Systems serving multiple ❑Not Applicable ,dwelling units must demonstrate ;compliance with the IECC !Commercial Provisions. ; 302.1, ;Heating and cooling equipment is; Heating: ; Heating: !❑Complies ;Requirement will be met. 403.7 sized per ACCA Manual S based ! Btu/hr ! Btu/hr :❑Does Not [PR2]2 ion loads calculated per ACCA ! Manual J or other methods ; Cooling: Cooling: ;❑Not Observable ; approved by the code official. Btu/hr Btu/hr !❑Not Applicable , Additional Comments/Assumptions: 11 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3- Low Impact(Tier 3) Project Title: 565 Mailer Ct Southold, NY Report date: 07/14/21 Data filename: Page 4 of11 Sec tion.- # Foundation Inspection Complies? Comments/Assumptions & Req.ID 303.2.1 iA protective covering is installed to ;❑Complies :Requirement will be met. [FO11]2 i protect exposed exterior insulation :❑Does Not t� ;and extends a minimum of 6 in. below !grade. ❑Not Observable ❑Not Applicable 403.9 'Snow-and ice-melting system controls;El Com plies Requirement will be met. [FO12]2 installed. ❑Does Not ❑Not Observable; j ;❑Not Applicable Additional Comments/Assumptions: 11 High Impact(Tier 1) 2 1 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: 565 Mailer Ct Southold, NY Report date: 07/14/21 Data filename: Page 5 ofll Section Plans.Verified Field Verified, # - Framing/Rough-In Inspection Value Value Complies? Comments/Assumptions & Req.ID 402.1.1, ;Door U-factor. U- U- ;❑Complies ;See the Envelope Assemblies 402.3.4 ; ;❑ table for values. Not [FR1]1 Does i ;❑Not Observable Q) ❑Not Applicable 402.1.1, ;Glazing U-factor(area-weighted U- U- ;❑Complies ;See the Envelope Assemblies 402.3.1, average). ;❑Does Not table for values. 402.3.3, 402.5 I :[:]Not Observable ; [FR211 I ;❑Not Applicable t 303.1.3 i U-factors of fenestration products; ❑Complies ;Requirement will be met. [FR4]1 are determined in accordance ❑Does Not with the NFRC test procedure or �- ;taken from the default table. ;❑Not Observable r �❑Not Applicable 402.4.1.1 ;Air barrier and thermal barrier ❑Complies ;Requirement will be met. [FR23]1 I installed per manufacturer's ❑Does Not instructions. ] ❑Not Observable ❑Not Applicable 402.4.3 ;Fenestration that is not site built (❑Complies ;Requirement will be met. [FR20]1 :is listed and labeled as meeting y� - , ,❑Does Not ;AAMA/WDMA/CSA 101/i.5.2/A440 or has infiltration rates per NFRC J❑Not Observable 1400 that do not exceed code i❑Not Applicable 1 limits. j 402.4.5 1IC-rated recessed lighting fixtures t ❑Complies Requirement will be met. [FR16]2 jsealed at housing/interior finish ❑Does Not land labeled to indicate_<2.0 cfm - { leakage at 75 Pa. k . ❑Not Observable ; i❑Not Applicable 403.3.1 ;Supply and return ducts in attics ` '❑Complies ;Requirement will be met. [FR12]1 !insulated >= R-8 where duct is 1❑Does Not >= 3 inches in diameter and >_ ' ' ! ❑Not Observable R-6 where < 3 inches. Supply and , I return ducts in other portions of i 1❑Not Applicable !the building insulated >= R-6 for ;diameter>= 3 inches and R-4.2 ; !for< 3 inches in diameter. 403.3.2 ;Ducts, air handlers and filter ;❑Complies ;Requirement will be met. [FR13]1 !boxes are sealed with �. (❑Does Not :joints/seams compliant with I International Mechanical Code or a❑Not Observable ; :International Residential Code, as ;❑Not Applicable !applicable. : I 403.3:5 )Building cavities are not used as J❑Complies ;Requirement will be met. [FR151.. ducts or plenums. '1❑Does Not - 111 3❑Not Observable I I❑Not Applicable 403.4. 1 HVAC piping conveying fluids R- R- ;❑Complies ;Requirement will be met. [FR17f above 105°F or chilled fluids ! :❑Does Not below 55 °F are insulated to >_R- i - ?3 ;❑Not Observable ; ❑Not Applicable 403.4.1 :Protection of insulation on HVAC a❑Complies ;Requirement will be met. [FR2411 :piping. j❑Does Not 1❑Not Observable ; e !❑Not Applicable 403.5.3 'Hot water pipes are insulated to R- R- ;❑Complies :Requirement will be met. [FR18]2 >R-3. '❑Does Not i UNot Observable j❑Not Applicable 11 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3= Low Impact(Tier 3) Project Title: 565 Mailer Ct Southold, NY Report date: 07/14/21 Data filename: Page 6 of 11 Section Plans Verified Field Verified # Framing/Rough-In Inspection Value Value Complies? Comments/Assumptions & Req.ID 403.6 iAutomatic or gravity dampers are i ❑Complies ;Requirement will be met. [FR19]2 installed on all outdoor air l ❑Does Not intakes and exhausts. ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 11 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: 565 Mailer Ct Southold, NY Report date: 07/14/21 Data filename: Page 7 of11 Section, 'Plans Verified Field•Verified # Insulation Inspection Value Value Complies? Comments/Assumptions. & Req.ID 303.1 ` ;All installed insulation is labeled ❑Complies ;Requirement will be met. [IN13]2 iorthe installed R-values `' j❑Does Not arovided. f i p J❑Not Observable j❑Not Applicable 402.1.1, !Floor insulation R-value. R- R- ;❑Complies ;See the Envelope Assemblies 402.2.6 ❑ Wood ;❑ Wood ;❑Does Not table for values. [IN1]1 j E] Steel ❑ Steel ;❑Not Observable A ; ;❑Not Applicable I 1 1 t i 303.2, ;Floor insulation installed per ❑Complies ;Requirement will be met. 402.2.8 :manufacturer's instructions and !'❑Does Not [IN2]1 :in substantial contact with the S (; underside of the subfloor, or floor`r ;❑Not Observable 1framing cavity insulation is in ]❑Not Applicable f ;contact with the top side of 1 ;sheathing, or continuous t � 1 insulation is installed on the underside of floor framing and extends from the bottom to the top of all perimeter floor framing - ;members. i # 402.1.1, ;Wall insulation R-value. If this is a; R- R- ;❑Complies ;See the Envelope Assemblies 402.2.5, !mass wall with at least 1/z of the ❑ Wood ❑ Wood :❑Does Not ;table for values. 402.2.6 !wall insulation on the wall ❑ Mass ❑ Mass t❑Not Observable [IN3]1 ;exterior,the exterior insulation ; ray) i requirement applies (FR10). ;❑ Steel ❑ Steel �❑Not Applicable ; 303.2 ;Wall insulation is installed per i JDComplies ; [IN4]1 manufacturer's instructions. []Does Not ❑Not Observable 7❑Not Applicable Additional Comments/Assumptions: 11 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: 565 Mailer Ct Southold, NY Report date: 07/14/21 Data filename: Page 8 of 11 Section. Plans Verified Field Verified # Final Inspection Provisions Value Value Complies? Comments/Assumptions & Req.ID 402.1.1, ;Ceiling insulation R-value. ; R- ; R- ;❑Complies ;See the Envelope Assemblies 402.2.1, ❑ Wood ;❑ Wood ;[]Does Not 1 table for values. 402.2.2, ❑ Steel ;❑ Steel :❑Not Observable 402.2.6 [Fill' j :❑Not Applicable � , , ; 303.1.1.1,;Ceiling insulation installed per ; ODoes Complies ;Requirement will be met. 303.2 :manufacturer's instructions, Not [FI2]1 !Blown insulation marked every 300 ft2. ❑Not Observable ; f ❑Not Applicable 402.,2.3 Vented attics with air permeable ;insulation include baffle adjacent ❑Complies ;Requirement will be met. [FI22]z _ j ❑Does Not ito soffit and eave vents that f extends over insulation. ❑Not Observable I '❑Not Applicable 402.2.4 ;Attic access hatch and door R- ; R- ;❑Complies ;Requirement will be met. [FI3]1 insulation >_R-value of the UDoes Not ;adjacent assembly. ;❑Not Observable ❑Not Applicable 402.4.1.2 Blower door test @ 50 Pa. <=5 ; ACH 50 = ; ACH 50 = ;❑Complies ;Requirement will be met. [FI17]1 :ach in Climate Zones 1-2, and ❑Does Not (<=3 ach in Climate Zones 3-8. ;❑Not Observable ; j ;❑Not Applicable 403.3.3 ;Ducts are pressure tested to cfm/100 ; cfm/100 ;❑Complies Requirement will be met. [FI27]1 ;determine air leakage with ft2 ; ft2 ;❑Does Not i either: Rough-in test:Total ;leakage measured with a UNot Observable pressure differential of 0.1 inch ;❑Not Applicable ; w.g. across the system including ;the manufacturer's air handler enclosure if installed at time of ; test. Postconstruction test:Total leakage measured with a , pressure differential of 0.1 inch w.g. across the entire system ;including the manufacturer's air ; handler enclosure. ; f 403.3.4 i Duct tightness test result of<=4 ; cfm/100 cfm/100 ;❑Complies ;Requirement will be met. [FI4]1 cfm/100 ft2 across the system or ft2 t ft2 ;❑Does Not <=3 cfm/100 ft2 without air handler @ 25 Pa. For rough-in ; ,❑Not Observable ; !tests,verification may need to ;❑Not Applicable ;occur during Framing Inspection. f 403.3.2.1 ;Air handler leakage designated } f❑Complies ;Requirement will be met. [FI24]1 ;by manufacturer at<=2%of k ;design airflow. i❑Does NotI { ❑Not Observable s ❑Not Applicable 403.1.1 !Programmable thermostats (❑Complies ;Requirement will be met. [Fl 9]2 installed for control of primaryt❑Does Not z heating and cooling systems and " 1 initially set by manufacturer to ONot Observable code specifications. �❑Not Applicable 403.1,2 ;Heat pump thermostat installed ❑Complies ;Requirement will be met. [FI10]z on heat pumps. i ❑Does Not i ❑Not Observable { ❑Not Applicable 403.5.1 Circulating service hot water I{ ;❑Complies ;Requirement will be met. [FI11]2 systems have automatic or �❑Does Not accessible manual controls. ❑Not Observable ; .. ❑Not Applicable 11 High Impact(Tier 1) 12 IMedium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title: 565 Mailer Ct Southold, NY Report date: 07/14/21 Data filename: Page 9 ofll -Section Plans Verified Field Verified - # 'Final Inspection Provisions Value Value Complies? Comments/Assumptions & Req.ID" 403.6.1 All mechanical ventilation system ❑Complies ;Requirement will be met. [F125]2' Mans not part of tested and listed ❑Does Not HVAC equipment meet efficacy land airflow limits per Table I 5❑Not Observable ; 1R403.6.1. 1❑Not Applicable 403.2 1 Hot water boilers supplying heat J❑Complies ;Requirement will be met. [FI26]2 "through one-or two-pipe heating - ❑Does Not j (systems have outdoor setback ❑Not Observable icontrol to lower boiler water Itemperature based on outdoor :,q-]Not Applicable jtemperature. ; 403.5.1.1 i Heated water circulation systems ❑Complies ;Requirement will be met. [F12.8 ;have a circulation pump.The ❑Does Not "system return pipe is a dedicated ` )return pipe or a cold water supply a❑Not Observable ; 'I pipe. Gravity and thermos- F ❑Not Applicable ;syphon circulation systems are ; not present. Controls for ; circulating hot water system a pumps start the pump with signal { "for hot water demand within the - occupancy. Controls I automatically turn off the pump ;when water is in circulation loop is at set-point temperature and I no demand for hot water exists. 403.5.1.2 4 Electric heat trace systems - ❑Complies ;Requirement will be met. [F129]2complywith IEEE 515.1 or UL " ❑Does Not j 515. Controls automatically adjust the energy input to the I ,.i - ", ❑Not Observable ; heat tracing to maintain the , ❑Not Applicable desired water temperature in the f piping. 403.5'.2 Demand recirculation water [ ;❑Complies ;Requirement will be met. [F130]2: }systems have controls that '❑Does Not manage operation of the pump ; ;and limit the temperature of the J[]Not Observable "water entering the cold water ❑Not Applicable ; "piping to <= 104°F. 403.5.4 Drain water heat recovery units ❑Complies ;Requirement will be met. F1]2 13 in accordance with CSA ;❑Does Not 855.1. Potable water-side i pressure loss of drain water heat ❑Not Observable recovery units < 3 psi for ❑Not Applicable individual units connected to one Ior two showers. Potable water- - r "side pressure loss of drain water r3 heat recovery units < 2 psi for individual units connected to , three or more showers. I 404.1 ;90%or more of permanent ❑Complies ;Requirement will be met. [FI6]1 'fixtures have high efficacy lamps ❑Does Not I ❑Not Observable i J❑Not Applicable 404A.1"- 'Fuel gas lighting systems have `gg :;❑Complies ;Requirement will be met. [F123]3 no continuous pilot light. 1 ❑Does Not ..` ❑Not Observable ❑Not Applicable 401.3 !Compliance certificate posted. ❑Complies :Requirement will be met. [FI7]z. ❑Does Not I ❑Not Observable ❑Not Applicable 1High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title: 565 Mailer Ct Southold, NY Report date: 07/14/21 Data filename: Page 10 of1l Section Plans Verified Field Verified # Final Inspection Provisions Value Value Complies? Comments/Assumptions & Req.ID 303.3 Manufacturer manuals for j❑Complies ;Requirement will be met. [FI18]3 mechanical and water heating ;❑Does Not systems have been provided. - � �❑Not Observable j [:]Not Applicable Additional Comments/Assumptions: 11 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3.1 Low Impact(Tier 3) Project Title: 565 Mailer Ct Southold, NY Report date: 07/14/21 Data filename: Page 11 ofll