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HomeMy WebLinkAbout51683-Z TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 51683 Date: 02/25/2025 Permission is hereby granted to: Karrass G Trust 1615 Stanford St Santa Monica, CA 90404 To: Construct additions and alterations to an existing single-family dwelling as applied for per SCHD and HPC approvals. Premises Located at: 1495 Village Ln, Orient, NY 11957 SCTM#25.-3-2.1 Pursuant to application dated 11/22/2024 and approved by the Building Inspector. To expire on 02/25/2027. Contractors: Required Inspections: Fees: Single Family Dwelling- Addition &Alteration $1,561.50 CO Single Family Dwelling-Addition /Alteration $100.00 Total $1,661.50 Building Inspector TOWN OF SOUTHOLD—BUILDING DEPARTMENT �d Town Hall Annex 54375 Main Road P. ©. Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 l qns.// v . cant � kilo x t1 Date Received APPLICATION FOR BUILUKG '7 For Office Use Only PERMIT N0. �U J Building Inspector:,,,, lV Applications and forms must be filled out in their entirety. Incomplete BUILDING G E . applications will not be accepted. Where the Applicant is not the owner,an Owner's Authorization form(Page 2)shall be completed. 1 Date: OWNER(S)OF PROPERTY: Name: lotl SCTM# 1000- Project Address: r Vc Phone#: �Z�J. yZ�. �7�pC Email: e� 'OC CiOM Mailing Address I&L57 CONTACT PERSON: ►�+t Name: Mailing Address: a 0 6 L/h �O/ Phone#: '�� 'a f Email: "'I / lee- 7 5 4A4 O-C& l DESIGN PROFESSIONAL INFORMATION: Name: MailingAddress:0* WN&OLAJ O• ;; / 4 Phone#: Cot!) I . vim&. Email: i��t`�l� w�• CONTRACTOR INFORMATION: Name: Mailing Address: Phone#: Email: DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure Addition lteratior epair ❑Demolition Estimated Cost of Project: ❑other "Ols $ Will the lot be re-graded? ❑Yes O Will excess fill be removed from premises? Ves ❑No 1 PROPERTY INFORMATION Existing use of property: I � Intended use of property: Zone or use district in which premises is situated: Are there any covenan tsnd restrictions with respect to this property? ❑Yes IF YES, PROVIDE A COPY. ❑ Check Box,After Read iing: The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by Chapter 236'of the To Wn Code. APPLICATION IS HEREBY M"E 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): t7pf.,1 Authorized Agent ❑Owner Signature of Applicant: Date: STATE OF NEW YORK) SS: COUNTY OF ) M- being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)he is the + (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 Xj day of CIO ,20 N a r iio.State of New York No.01 HU6434316 Quel W in SOON CourItY 6 rltifsic»<r► .0"310 (Where the applicant is not the owner) 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 COUNTY OF SUFFOLK r U ; EDWARD P. RolvtmNE I .: SUFFOLK COUNTY EEXECUTrVE DEPARTMENT OF HEALTH SERVICES GREGSON H.PIGOTT,MD,MPH COMMISSIONER August 2, 2024 Mrs. Melissa Butler 206 Lincoln Street Riverhead,NY 11901 Subject: Variance Hearing SCDHS Ref.: R-23-0987 —Property of Karrass Property Location: —e/s/o Village Lane, 43.45 s/o Orchard Street, Orient t/o Southold SCTM No. 1000-025.00-03.00-002.001 To Whom It May Concern: Your request to appear before the Board of Review of the Suffolk County Department of Health Services has been received. The review of this case has been scheduled for August 15, 2024 at 9:30 a.m. in the Suffolk County Department of Health Services' Conference Room, 360 Yaphank Avenue — Suite 2C, Yaphank,New York 11980. You and interested parties are requested to appear, with or without counsel. On that occasion, you may produce any information or evidence you wish to be considered concerning the above-referenced property. Should you have any questions, please call (631) 852-5800. Very truly as a n " ..ngen , E. Director of ivi. >nment;al Quality Chair, Boar o1" eview Enclosure Cc: Board of Review File—Yaphank Mr.Edward Lyons —Reviewer Mr.Andrew Freleng—SC Planning Department Town of Southold Planning Department Mr.Daniel Butler,RA Mr.Bryan Grogan,P.E. Mr.Gary Karrass Ms.Pamela Wilson Mr.Mitchel Cohen and Mr.Dale Weiner Mr.Sinan Karabas and Mr.Charles Dean U,,,,,, •Division Of Environmental Quality+ Board Of Review+ 360 Yaphank Avenue,Suite 2B Yaphank NY 11980• Phone(631)852-5801 Fax(631)852-5825 PublicHealth Generated by REScheck-Web Software Compliance Certificate Project 1495 Village Lane - Addition (Historic) Energy Code: 2018 IECC Location: Southold, New York Construction Type: Single-family Project Type: Addition Project SubType: None Climate Zone: 4 (5572 HDD) Permit Date: Permit Number: All Electric false Is Renewable false Has Charger false Has Battery: false Has Heat Pump: false Construction Site: Owner/Agent: Designer/Contractor: 1495 Village Lane Gary Karrass Trust Orient, NY 11957 Compliance: 7.7%Better Than Code Maximum UA: 233 Your UA: 215 Maximum SHGC: 0.40 Your SHGC: 0.19 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. Sgab-orr..grade tmad(a",otgs are no aon r.r considered � s . grade M � � � g� �aderarg in tire. 4.gA or g"mr,rg'rwarnm�n°rr:r��°;e„am��rgmll.rourc¢� Faotu�u iom t't0� mc9°w�,ck garl,r�lul� mmrm m sser��mNy in the s edfied climate zone :�nust meet the rr�0nr mum energy code 4isu6atksrm R vaiue and depth requo emeot:s. Envelope Assemblies- Gross Prop.Cavity Cont. Prop. Perimeter Ceiling 1: Flat Ceiling or Scissor Truss 1,114 49.0 0.0 0.026 0.026 29 29 Skylight: Metal Frame w/Thermal Break 13 0.350 0.550 5 7 SHGC: 0.36 East Wall:Wood Frame, 16" D.C. 375 21.0 0.0 0.057 0.060 15 16 Window: Wood Frame 113 0.310 0.320 35 36 SHGC: 0.18 North Wall: Wood Frame, 16" o.c. 498 21.0 0.0 0.057 0.060 23 25 Window 1: Wood Frame 86 0.350 0.320 30 28 SHGC: 0.18 South Wall: Wood Frame, 16" o.c. 382 21.0 0.0 0.057 0.060 18 19 Window 2: Wood Frame 67 0.350 0.320 23 21 SHGC: 0.18 Floor 1: All-Wood joist/Truss:Over Unconditioned 1,114 30.0 0.0 0.033 0.047 37 52 Space -............ .........._....... ........ _� Project Title: 1495 Village Lane -Addition (Historic) Report date: 11/22/24 Data filename: Page 1 of10 Compliance Stag:me t T`i , r'"w osed building design described here is consistent with the building plans, specifications, and other calculations submA t w ¢t �a rmit application.The proposed building has been designed to meet the 2018 IECC requirements in REScheck Versio � e �fi no t6,s omply with the mandatory require its listed in the REScheck Inspection Checklist. Name-TitleR' r4 Signature Date Project Notes. r,a °Way ..ri, Addition to i to Home Project Title: 1495 Village Lane -µAddition (Historic) -� WW�W Report date: 11/22/24 Data filename: Page 2 of10 REScheck Software Version : REScheck-Web Inspection Checklist Energy Code: 2018 IECC Requirements: 0.0% 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. .. '-..—.[- Se# Complies ion [Pre-Inspection/Plan Review Plains Verified Field Verified - e ? Comments/Assumptions , .w..... _ __... ........... 103.1, Construction drawings and Corplies 103.2 documentation demonstrate ❑Does Not [PR1]1 energy code compliance for the ;❑Not Observable building envelope.Thermal envelope represented on ❑Not Applicable construction documents. Coin❑ lies 103.1, Construction drawings and " �� p 103.2, documentation demonstrate ❑Does Not 403.7 energy code compliance for ❑Not Observable [PR3]1 lighting and mechanical systems , Systems serving multiple ,,, ❑Not Applicable ; dwelling units must demonstrate 'compliance with the IECC Commercial Provisions. �" - .. _....................�_._......_ _ .. .,,,,,,: _ __._ ...._..w......_.-.ww.._...._.m...............-.__.._W................ . 302.1, Heating and cooling equipment is Heating: Heating. ;ElComplies 403.7 sized per ACCA Manual S based Btu/hr Btu/hr ❑Does Not [PR2]2 :,on loads calculated per ACCA Cooling: Cooling: ;❑Not Observable 0 Manual J or other methods Btu/hr........... Btu/hr www approved by the code official, _ j❑Not Applicable Additional Comments/Assumptions: �_. .._ www _. t............_._w_.. mm...�.iu .Impa..ct(Tier...2} �... [......� ..�....._w. ). .. �1 High Impact(Tier 1) 2 Medium I mmmmm � � 3 Low Impact(Tier 3 ....................... ___ www_............ ww...... g p.�....�...�....-...... ......... _�w_.... _..........�_w_.....�. Project Title: 1495 Village Lane - Addition (Historic) Report date: 11/22/24 Data filename: Page 3 of10 &S eRc . r Complies? ._ .. ,..�Co mments/Assumtions_— Foundation Insliection 30121 A protective covering is installed to ❑Complies [FO11J2 protect exposed exterior insulation ❑Does Not and extends a minimum of 6 in. below grade. ;❑Not Observable 40 : + Snow-and ice-...._. ....... ....... .. ww__�❑Not Applicabl.e.�...._w.w_.......n... _.................... .._._w__......._._w. ....._____w....�...__...�...._�.__w_mm.......w.....� melting system controls ❑Corplies ( 'installed, fDoes Not ❑Not Observable, ❑Not Applicable Additional Comments/Assumptions: dh . mW ✓ W ...... __w l lgImpact( ierl) mtaact(Tier w2)w....._.w � Law m.. _p.i..ct~(Tierw3)� _....� Project Title: 1495 Village Lane -Addition (Historic) Report date: 11/22/2,1 Data filename: Page 4 of10 # _.. ... ..�....,....._ aVereifie Field V luef,�.��.. ,�._ ...._ � �. � ..........m ��,, Section raming / Rough-In Inspection Plans_Verified tl Complies. Comments/Assumptions & 402.1.1, Glazing U-factor(area-weighted U-a_mmm_ _ U-_mmm_mmm_ ❑Complies See the Envelope Assemblies 402.3.1, average). ❑Does Not table for values. 402.3.3, 402.5 I❑Not Observable [FR211 ❑Not Applicable �d I ............ 303.1... U-factors of fenestration_.M.__.M_w...w w w_ __w .,_w..µ.... ...,. .. _... ......�._... ...�........ ............ ....._.........._.... .av_..,.___ �....w......._..._.... _._.... stration products ❑Complies [FR411 are determined in accordance ❑Does Not with the NFRC test procedure or taken from the default table. ❑Not Observable ❑Not Applicable _..._......... .... ...... .,, ..... .:..... .. _.... ....................... 402.1.1, :Skylight E..)Complie U-factor. U. U- s See the Envelope Assemblies 402.3.3, ❑Does Not table for values. 402.3.6, 402.5 ❑Not Observable [FR511 ❑Not Applicable ._........... ................ __.w......................M._ ........... .. .......... 402.4.1.1 .Air barrier and thermal barrier ,� Complies [FR23]1 installed per manufacturer's ❑Does Not instructions. ❑Not Observable k❑Not Applicable ..................................... � � __... 402.4.3 Fenestration that is not site built G❑Complies [FR20]1 is listed and labeled as meeting ❑Does Not AAMA/WDMA/CSA 101/I.S.2/A440 ,or has infiltration rates per NFRC ❑Not Observable 400 that do not exceed code ❑Not Applicable `limits. ........................... ' ww.............................. ........ .�.... t �. w 402.4.5 IC rated recessed lighting fixtures, ❑Complies [FR16]2 sealed at housing/interior finish ❑Does Not and labeled to indicate <_2.0 cfm leakage at 75 Pa. ❑Not Observable 3.1 ,. ❑Not Applicable 403.,,�w. �. ..... _- _.M�. '...Supply and return ducts in attics ,❑Complies [FR12]1 insulated >= R-8 where duct is ❑Does Not >= 3 inches in diameter and >_ '❑Not Observable R-6 where < 3 inches. Supply and return ducts in other portions of ❑Not Applicable the building insulated >= R-6 for diameter>= 3 inches and R-4.2 for< 3 inches in diameter. _..........._.w,..�........................................._....... _.... _....................._. _. ..........w......... ... ... 403.3.2 Ducts, air handlers and filter ❑Complies [FR13]1 boxes are sealed with ❑Does Not ,A,p joints/seams compliant with International Mechanical Code or ❑Not Observable International Residential Code, as ❑Not Applicable applicable. __._-..M,.m.H.....w__w _w_.. .... .............. .,�.. ._..... _. ......,. 403.3.5 Building cavities are not used as ❑Complies [FR15]3 ducts or plenums. ❑Does Not ❑Not Observable ❑Not Applicable ..................... 403.4 . .............. m__,,,..w..,,.,..... _ ... w_._ . _.., ...... _ . ................w ww... _... . HVAC piping conveying fluids R-u.a .._ R _„mm ❑Complies [FR17]2 above 105 °F or chilled fluids ❑Does Not below 55 °F are insulated to >_R 3 ❑Not Observable ❑Not Applicable ......W.......................... ..........._.....__........ __ _.._..ww._..wwww-- .. .... _._ ........_... .. .m.,,_ ._. �_............_- .. ........ww.__..—.r..............._. _..................._.w.vwvwv_._._._._.... 403.4.1 Protection of insulation on HVAC '❑Complies [FR24]1 piping. ❑Does Not ❑Not Observable ❑Not Applicable ... .� w 1 �2 Medium Impact( ............... ..........�..............w Project 1495 Village _w......_............. p ............_... 1 e Lane - Addition (Historic) Report date: 11/22/24 Data filename: Page 5 of10 otalt) .am.. i_.g.... FouglIn inspecio .Pa n..s. . .......f.wi_er ......ls..t....wwµ......i_f.i.e.d, . ._...M s? _ � n FFIr" n Value ValueCompile marts/Assumptions Re. � _v _..__..._ ._... ..... i0rMd Hot water pipes are insulated to R- R- .)Complies [FRI'1 >_R-3. _ ❑Does Not ;❑Not Observable E]Not Applicable 4016 Automatic or gravity dampers are w.... . . _. - .. DE-o'rn ies _._.... ..._...._. .... .. .................. ( R1 installed on all outdoor air ❑Does Not intakes and exhausts. ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: .-, -..�..�..�..�� ...w.....��..� 1 High Impact(Tier 1) Medium Impact(Tier 2) � Low Impact (Tier 3) �. ., _ ................ �„ _.... .o"wTier �,... _....__..........._............ .........___ �.._....._w�_w __.....w................... w_.w ..� ._._..........wwwww Project Title: 1495 Village Lane -Addition (Historic) Report ort date: 11/22/24 Data filename: Page 6 of10 Insulation Inspection. ...., Ra is" e�^If- ..-. ._„ll�iel+d...Verifi 9 Complies? � ,..... ............. ctlon ..I +ec l!R __.. .._......_........ -_ w Value Value Comments/Assumpt�onS 3C13.1 All installed insulation is labeled E]Complies f W13J" or the installed R-values ❑Does Not t provided. ❑Not Observable EINot Applicable _ 402.2.E table for values.w. _.... � 402.1.1, .Floor insulation R-value. R- R �..)Corr�plios see the Envelope Assemblies ess Wood ❑ Wood ElDoe Not [IN1]1 ❑ Steel ❑ Steel ❑Not Observable ❑Not Applicable 303.2 Floor insulation installed per ❑Complies -µtoµµµ _....._...., _mwM._ _.w_........... .w... 402.2.8 manufacturer's instructions and ❑Does Not [IN2)3 in substantial contact with the ;❑Not Observable underside of the subfloor, or floor framing cavity insulation is in E]Not Applicable contact with the top side of sheathing, or continuous 'insulation is installed on the underside of floor framing and -_..-,-. ,,,,-", -.�,- „•„-, , 'extends from the bottom to the top of all perimeter floor framing members. 4021..3„ Wa..i.l...insulation R-value.�If this is a R.._ . .,.:...-.__.� .�:;.w.,.M.. ... _..,_._.�w�__.�.......__m-.._��_....w.....__.....w�......�W_.�_........._..-w. 2 R _ ElComplies See the Envelope Assemblies 4012.5, �mass wall with at least 1/2 of the ❑ Wood ❑ Wood ElDoes Not table for values. 402.2.E wall insulation on the wall ❑ Mass Mass ❑Not Observable ; (IN3)1 exterior,the exterior insulation ❑ Steel ( ] Steel j❑Not Applicable requirement applies (FR10). I . iinstalled _.. � _..., �_.,_.. __......... 303.2 Wall insulation is inst alled per �DComplies [IN4)1 manufacturer's instructions. `DDoes Not Observable �E]Not Applicable Additional Comments/Assumptions: .....,,,.v_. ct("N ��..._.._�...w Medium Im act.........�ww.� ... , _ _ '_. .°.. pact(T..�...rww_...._,., 1. H ..kpa _.'ier 1) 2 ....(Tier 2) w Iarwlac.t(Tier 3).w. ....... ..... Project Title: 1495 Village Lane - Addition m(...�....�.�.�.. �...�-���.............�w._. w,Historic) Report date: 11/22/24 Data filename: Page 7 of10 Section visions plans Verrf�ed Field Verified Complies? Comments/Assumptions & Re ID InspectionValue Value 402.1.1, Ceiling linsulation R al,u_. .. ._.,,,,, _....._ _...... ........_w...... _. _...... 0 e, R _ R- ❑Complies See the Envelope Assemblies 402.2.1, ❑ Wood E] Wood ❑Does Not table for values. 402.2.2, 402.2.E ❑ Steel ( Steel ❑Not Observable [FI1]1 ❑Not Applicable 303.1.1.1, Ceiling insulation installed per ❑Complies _......._.�..w.m ___- 303.2 manufacturer's instructions. E Does Not [F]2]1 Blown insulation marked every 300 ft2. ❑Not Observable ❑Not Applicable 402.2.3 Vented attics with air permeable ❑Compliies+ _... .........ww. ww .. [F122]2 insulation include baffle adjacent ElDoes Not to soffit and eave vents that extends over insulation. '❑Not Observable ___.. _... _ ._.w. �. ,w. ... ❑Not Applicable 402.2.4 Attic access hatch and door R '; R- ;❑Complies _ ... _www..m__.............._,�ww ........ [FI3]1 insulation >_R-value of the ❑Does Not adjacent assembly. ❑Nat Observable _ ❑Not Applicable 402.4.1.2 Blower door test@ 50 Pa. <=5 NN ACH 50=WWW ,MACH 50 = W T Cornpliies [FI17]1 ach in Climate Zones 1-2, and _ ❑Does Not I<=3 ach in Climate Zones 3-8. j❑Not Observable __... _. ......www�ww.. ..MM...ww [.Not Applicable 402.4.2 'Wood-burning fireplaces have '❑Complies [FI8]2 tight fitting flue dampers and J❑Does Not outdoor air for combustion. � ,, ❑Not Observable ❑Not Applicable 403.3.3 Ducts are pressure tested to _...... cfm/100 _ M cfm/100� ❑ComphiesWWW ................... ....... [FI27]1 determine air leakage with ft2 ft2 ❑Does Not either: Rough-in test:Total leakage measured with a I❑Not 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. ...., w w,....._._ _... .....ww..........._ w..._._, .... ...M........_.. .... _.......-............. 403.3.4 Duct tightness test result of<=4 cfm/100 cfm/100 (,...Complies [FI4]1 cfm/100 ft2 across the system or ft2 ftz cmDoes 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. ..u._.................._.____w_�,m_.._.._.... � _w ww.._... .,,,....�._w__.. .._.. � _._..�. __w........ . �....., w w..._ .._.._. _._......._. , . 403.3.2.1 Air handler leakage designated ❑Corplies [F]24]1 by manufacturer at<=2% of ❑Does Not design airflow. ❑Nat Observable ❑N . _ _ ww_. _....._....._,_�...._w ,,.M._..._......... 403.1.1 Programmable thermostats (_jlComplies [F19]2 installed for control of primary ❑Does Not heating and cooling systems and initially set by manufacturer to ❑Not Observable code specifications. ❑Not Applicable _,,, ..,o.._ .....w_.m _....._.w. w_ _.......... ..... 403.1.2 Heat um thermostat installed .�......._ _� �.,,,�.._,.�.. ...�..,,µ..m..�...�........_.__,,._.....w�_ .�....w,__ ....w.,_............w.�_�.._.,._���......._.......w.. pump ❑Complies [FI10]2 on heat pumps. ❑Does Not ❑Not Observable ❑Not Applicable 0.� .�w_..__..�_... _.._n�_,...�....r 1) ...,. � ium Impact(Tier p dHigh Impact(Tier 1]....... . ._2 Me�d..._ w_. ............._ _.. ....... _. Project Title: 1495 Village Lane -Addition (Historic) Report date: 11/22/24 Data filename: Page 8 of10 Se# Final Inspection Provisions71—P anVaVerified Fiel VerifiedFC,mplies? Co& Rco mments/Assumptions ...03.5 � ._ ._. _.. _ ..,.. .. . , .._.. .,....., Value _.,..__ .,...._,,, 4 .1 Circulating service hot water DCounplies [FI11]2 systems have automatic or ❑Does Not accessible manual controls. ❑Not Observable ❑Not Applicable ........... .... __ww_... ..._... w ..._ ...w—------ 403.6,1 All mechanical ventilation system DCornplies [F125]2 fans not part of tested and listed ❑Does Not HVAC equipment meet efficacy and air flow limits per Table ❑Not Observable []NotR403.6.1. Not Applicable 403.2 _Hot water boilers suppl ❑Complies _..._. ... .w.w..... .. ... ........_ [F126]2 through one-or two-pipe heating ❑Does Not systems have outdoor setback control to lower boiler water ❑Not Observable temperature based on outdoor ❑Not Applicable _ temperature. ww ..... 403.5.1.1 Heated water circulation systems OCompliesM �__-......_. [FI28]2 have a circulation pump.The ❑Does Not system return pipe is a dedicated ; .. .,,,....,.,, v,.;❑Not Observable return pipe or a cold water supply pipe. Gravity and thermos- ❑Not Applicable syphon circulation systems are not present. Controls for " ,circulating hot water system pumps start the pump with signal for hot water demand within the occupancy. Controls .,v„ automatically turn off the pump ,when water is in circulation loop ,,,,, ";,', . . % is at set-point temperature and ; 03, no demand for hot water exists. .•5.1.2 _....�w_ ........._.._.............. x w. _.... a. �... .. .�....... .... ........._-- �.w.........�m_ www__. -.._. 4 _ Electric heat trace systems ❑Cor'nplies [F129]2 'comply with IEEE 515.1 or UL ❑Does Not 515. Controls automatically �� � ��� �� � �� ����� ����' ❑Not Observable ; adjust the energy input to the heat tracing to maintain the ❑Not Applicable desired water temperature in the , 'piping. _ ......... _.w,, ........ -­1111 403.5.22 ;Demand recirculation water ❑Complies [F130]2 systems have controls that ❑Does Not manage operation of the pump ❑Not Observable and limit the temperature of the water entering the cold water ❑Not Applicable piping to <= 104°F � .,. ..... ..... .... . .a.. w. ... __ ........ ...__.._ _.. .... ..wv.. .._..w... _.w...... 404testedinwaereatrecovery units Elkompli.. I3 ] o with CS oes Not B55.1. Potable water-side ❑Not Observable pressure loss of drain water heat recovery units < 3 psi for ❑Not Applicable individual units connected to one or two showers. Potable water- side pressure loss of drain water heat recovery units < 2 psi for individual units connected to _ three or more showers. _ 404.1 90%or more of permanent ❑Complies [F16]1 fixtures have high efficacy lamps. ❑Does Not ❑Not Observable ❑Not Applicable _....._............ ___.._.•••••._..W.............M.M._ ........... .........,...,. ...................... ..........___. ._.................... .._....._ .. ........w.._._ 404.1.1 Fuel gas lighting systems have ❑Complies [FI23]3 no continuous pilot light. ❑Does Not ❑Not Observable ❑Not Applicable 1 High Impact (Tier 1) 2 Medium Impact(Tier2) 3 Im act(Tier_ n... .. ...... M.w ,.p..._...... ......� ._, ow..._.....p.._ww r..3.�..,....v__ Project Title: 1495mmVilla e Lane - Addition (Historic) YYYW11MYYYOYIN��.�.w�,....,��w��..._.. Report date: 11/22/24 Data filename: Page 9 of10 ticrro irenaM..w .,,.._ ... ..._eR_om."i ,..... Inspection Provision tioProvisions re �Complies? ,.. a rertsdAsstr t icrsVaire Vaicr fal ans 401.3 Compliance certificate posted. NComplies (FIT( ; Does Not ❑Not Observable ❑Not Applicable .. �" , "�....... .... _........_... . �. . ._..w CI Manufacturer manuals for 'DCornplies [FII,813 mechanical and water heating 0Does Not systems have been provided. ❑Not Observable ❑Not Applicable Additional Comments/Assumptions; m_.g..._.Impact(Tier..M.M......M.M_. .....ww.k....__ ......_:_.wvw.. 2 �w Low Im Hi act Ti( er 3.. .. 1 h .l)............. 2 M edium Irn act(Tier_} _.�p...�... w .w�w_.M.M.M._....w.. n Project Title: 1495Villag�e Lane -Addition (I iistoric) Report date: 11/22/24 Data filename: Page 10 of10 Certificate( 2018 IECC Energy J Efficiency ------------ Above-Grade Wall 21.00 Below-Grade Wall 0.00 Floor 30.00 Ceiling / Roof 49.00 Ductwork (unconditioned spaces): ................ r . . Window 0.31 0.18 Door Skylight 0.35 0.36 Heating System: .............. Cooling System: Water Heater: Name: �__.._..� Date: Comments COUNTY OF SUFFOLK EDWARD P. ROMAINE SUFFOLK COUNTY EXECUTIVE DEPARTMENT OF HEALTH SERVICES GREGSON H. PIGOTT, MD, MPH Commissioner r"ERMIT CONDITIONS a Project Name: 1495 Village Lane Health Services Reference#: R-23-0987 SCTM#: 1000025000300002001 Revision#: 0 The attached plan, when duly signed by a representative of the department, in conjunction with these conditions, constitutes a permit to construct a water supply, sewage disposal, and/or collection system for the property as depicted. The applicant should take note of any conditions of approval, which may be indicated on the plan or enclosed herein. Construction must conform with approved plans as well as all applicable standards including Standards for Approval of Plans and Construction for Sewage Disposal Systems for Single Family Residences. Omissions, inconsistencies or lack of detail on the plan do not release the applicant from the responsibility of having the construction done in conformance with applicable standards. Issuance of this permit shall in no way relieve the design professional of responsibility for the adequacy of the complete design. The permit(plan) expires three(3)years after the approval date. Any modification to the approved design requires the submission of a revised plan and additional fees(if applicable)for approval prior to construction. No Inspections will be performed by the department if a copy of the approved site plan/survey Is not on site during construction or if the permit has expired. Permits may be renewed, transferred, or revised in accordance with the procedures described in Instructions to Renew, Extend, or Transfer an Existing Permit for Single Family Residences (Form WWM-104). It is the applicant's responsibility to schedule an inspection of the sewage disposal and/or water supply facilities prior to backfilling. This includes inspections of the sewage collection and disposal systems, water supply system components and piping, and final grading as shown on the approved plans. This can be done by calling the department at(631) 852- 5754, or through the ACA Portal at - r I . , and In certain cases, inspections of the soil excavation may be required to determine the acceptability of the soils for sewage disposal systems. Excavation inspections must be confirmed by calling (631)852-5700 between 8:30a.m. and 9:30 a.m., the morning of the inspection.Article Vll of the Code, "Septic Industry Businesses," requires that all installers of septic systems within shall possess a valid license from the Office of Consumer Affairs. This office will not perform inspections for or grant final approval for construction of projects that are installed by an unlicensed individual. It is, therefore, in your best interest to utilize a cesspool contractor with a valid license to avoid substantial delays in your project. Final approval issued by the Department is necessary prior to the occupancy of new buildings, additions to existing buildings, or for the use of sewage disposal or water supply systems. WWM-016 Page 1 of 2 Project-Name:-1495-Vill age-Lane Health Services Reference#: R-23-0987 SCTM#: 1000025000300002001 Revision#: 0 CONDITIONS FOR OBTAINING FINAL APPROVAL OF CONSTRUCTED PROJECT As a condition of this permit to construct, the following items must be completed as a minimum, prior to building occupancy and use of the sewage disposal system or water supply facilities. For further information concerning this, refer to Instructions For Obtaining Final Health Department Approval Of Constructed Projects For Single Family Residences (Form WWM-041). INSPECTIONS REQUIRED: For all inspections call 631-852-5754 to request an inspection by 4:00 pm, one business day prior to the requested inspection day. 1) Excavation-Inspection(s) by the Office of Wastewater Management prior to installation of any leaching structures to`determine acceptability of soils. After requesting, confirm the inspection by calling 631-852- 5700 between 8;30 am and 9:30 am on the morning of the requested inspection. Excavation Inspections are not performed on Fridays. 2) Satisfactory inspection by Office of Wastewater Management of the sewage disposal system /sewage treatment system. 3) Check with local Building Dept. to verify if a building permit is required for the installation of an I/A OWTS (e.g. electric permit). DOCUMENTS REQUIRED: 1) Four (4) prints of an As-Built plan (See instructions Form WWM-041) or upload a scalable PDF to the online portal. 2) Certification from the licensed sewage disposal system installer (Form WWM-078) 3) Certification of Sewage Disposal System Abandonment (Form WWM-080) 4) Water analysis by a NYS certified laboratory (performed within one year) 5) Signed copy of the Operations & Maintenance Contract for the I/A OWTS 6) Completed Application to Register an I/A OWTS (Form WWM-304) 7) Design Professionals Certification of Constructed Works (Form WWM-073) for: I/A OWTS and all related components WWM-016 Page 2 of 2