The URL can be used to link to this page

Home My WebLink About28506-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPAi~CY No: Z-30035 Date: 02/20/04 TR~S CERTIFIES t~at t_he building ALTERATIONS Location of Property: 302 TOW~ CREEK LA [HOUSE NO.) (STREET) FJL~rLET) County Ta~ Ms~ No. 473889 Section 64 Block 1 Lot 12 Subdivision Filed Map No. Lot No. SOUTHOLD conforms substantially ~o the Application for Building Permit heretofore filed in tkls office dated JUNE 26, 2002 pu~s~t to which Building Permit No, 28506-Z dated JUNE 27, 2002 was i~sued, and conforms to all of the requlremenms of the applicable proviszons of the law. The occupancy for which this certificate ms issued is ALTEP~ATIONS TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR & AS PER NEW YORK STATE PETITION 52002-1227. The certificate is issued to PHILIP & JEi~NIFER STAMTON (OWNER of the aforesaid building. SUFFOLK COUAVfYDEPART~ENTOF ~R. ALT~tAPPRO~-~J~ ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A 3253 09/08/03 02/17/04 MATTITUCK PLUMBING uthorized sii~ure FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT HUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED, PEPJ~T NO. 28506 Z Date JUNE 27, 2002 Permlssmon ms hereby gran5ed to: BRUCE FIELDS 71 GREENE ST 2D FLR NEW YORK,NY ~0012 for : ALTERATIONS (~ i-. -~ --~ AS PER PROPOSED PLANS at premises located at 302 TOWN CREEK LA County Tax Map No. 473889 Section 064 Block pursuant Building SOUTHOLD 0001 Lot No. 012 to application dated JUNE 26, 2002 and approved by the Inspector to exlDire on DECEMBER 27, 2003. Fee $ 150.90 Rev. 5/8/O2 ORISINAL k Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIHCATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitled to the Bdild/~ Department with the following: Ao For new building or new use: 1 Final survey of property with accurate location of all buildings, property hnes, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of ,,rater supply and sewerage-disposal (S-9 form). 3. Apprcrval-of electrieal installation from Board of Fh'e Underwriters. 4. Sworn sta~gment frompl~umber c~ertifying that the solder used in system contains tess than 2/10 of 1% lead. 5. Commemi~ SullYing,/I/rt~str~al building, mol..~fiple residences and s/milar buildings and installations, a certificate o~Code C~mpti~ee fron~arc~tect or engineer responsible for tke build/ng. 6. Subnn( Ptanmug Board Approval of completed ate plan reqmrements. B. For existing buildings (prior ~o Aprll 9,1957) non-conforming uses, or buildings and "pre-existing' land uses: t. Accurate survey o~property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly complefed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. C.~Srtificate of Occupancy - New dwelling $25.00. Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. CertificateofOccupancyonPre-existingBuilding- $100.00 3. Copy o£Ccrtificate of Occupancy- $.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00. Commercial $15.00 Date New Construction: Old or Pre-existing Building: J Location of Property: ~ ~)~ (~' ~"~/~ ~_ Cr~_ ~_~-'_J--,r:~t~ House No. Street O~er or Owners of Prope~y: ~(~[5 ~ ~_},,~r 3 [~ Suffo~ Co~ty Tax Map No 1000, Section ~ ~ Block Sub~sion Filed Map. Pe~t No. ~ ~ Date of Pemt. Applic~t: Health Dept. Approval: (check one) Hamlet Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Underwriters Approval: Final Certificate: Lot Lot: check one] Applicant Signature STATE OF NEW YOrK DE:PARTI4E:NT Of STATE: 4 ] STATE STREET ALBANY. NY I ~31-000 J GEORGE E. PATAKi In the Matter of the Petition of: Michael C. Widener For a 'Variance to the New York State UnifOrm Fire Prevention & Building Code DECISION RANDY A. DANIELS PETITION NO, 2002-1227 Upon~'he-appflcatio~ of Michhae[*C. Widener, filed pursuant to 19 NYCRR 450 on November 13, 2002 and upon all other papers in this matter, the Department makes the following determination: NATURE OF GRIEVANCE AND RELIEF SOUGHT The petition oertains to the alteration of an existing building of A1 (one-family) occupancy, two stories in height, of type 5 (wood frame) construction, approximately 1,600 square feet in gross area. located at 302 Town Creek Lane. Town of Southold. County of Suffolk. State of New York. The petitioner is seeking relief from: 9 NYCRR 711.2(b), which requires that non-habitable space have a minimum height of 7 feet. and 9 NYCRR 1233.4(a)(4)(iv), which requires that the width of stairs shall not be less than 30 inches. [The petitioner wishes to install a second story toilet room under a sloping ceiling and a stair to the second floor having a width of 28 inches between the handrail and the opposite wall.] FINDINGS OF FACT 1. The building is undergoing substantial alteration and the petitioner wishes to install a new toilet room on the second floor m an area where the roof slopes from 7 feet 3 inches to 4 feet 7 inches. 2. The toilet room fixtures are located where the ceiling height exceeds 6 feet at locations where users are required to stand to properly use these facilities. As such these do not appear to create a substantial negative effect on its users. 3. Furthermore another toilet room with no ceiling height deficiencies exist within the dwelling, The subject toilet 'eom will therefore be for secondary convenience. 4. The existing stair to the second floor has a landing and turns 90 degrees. As a result of this. the opemng accommodating the stair is approximately 3 feet even though a portion of the stair is only approximately 28 Petition No. 2002-1227 Page 2 inches wide between the handrail and the opposite wall. 5 Anth~:opometric data from NFPA 101 suggests that the width at the hips at the 97 percentile female is 22 inches with sway. Therefore a clearance of 28 inches appears to be acceptable for travel through the portion of the stair that is less than 30 inches wide. 6. The petitioner proposes to place smoke detecting alarm devices throughout the dwelling in accordance with 9 NYCRR 721. These devices should provide a safety enhancement to the occupants of the dwelling in the event of a smoke or fire condition. CONCLUSIONS OF LAW Strict compliance with the provJs~ons of the Uniform Fire Prevention and Building Code would produce a negligible additi(~nal health, safety and secudty benefit to the occupants of the building. DETERMINATION WHEREFORE IT IS DETERMINED that the application for a variance from 9 NYCRR 711.2(b) and 1233.4(a)(4)(iv), to permit a second story toilet room and a stair to the second floor as noted: be and is hereby PROPOSED TO BE GRANTED with the following condition: 1. That smoke detecting alarm devices shall ~3e installed throughout the dwelling unit in accordance with 9 NYCRR 721.1 This DECISION is issued under 19 NYCRR 450.6. Unless obiected to by the petitioner in e wdtinq received by the Department, the decision shall become FINAL after fifteen days of receipt of the decision by the parties~ This decision is limited to the specific building and application before it, as contained within the petition, and should not be interpreted to give Implied approval of any general plans or specifications presented in support of this application. CWN:sg STATE OF NEW YOrK DEPARTMENT Of STATE 4 I STATE STReE-- ALBANY. NY i 223 ~-000 83303 n the Matter of the Petition of: Michael C. Widener For a Variance to the New York State Un foh'n firePre'yehtion &.Building Code DECISI'ON PETITION NO, 2002-1227 F~AND¥ A. DANIELS Upen tl~e application of Michael C. Widener, filed pursuaa{ to 19 NYCRR 450 on November 13, 2002 and upon all other papers in this matter, the Department makes the foaowing determination: NATURE OF GRIEVANCE A~;D RELIEF SOUGHT The petition pertains to the alteration of an existing buildiag of Al (one-family) occupancy, two stodes in height of type 5 (wood frame) construction, approximately 1.600 souare feet in gross area. located at 302 Town Creek Lane Town of Southold, County of Suffolk. State of New York. The petitioner is seeking relief from: 9 NYCRR 71'1.2(b), which requires that nomhabitable space have a minimum height of 7 feet. and 9 NYCRR 1233.4(a)(4)(iv), which requires that the width of stairs shall not be less than 30 inches, iThe petitioner wishes to install a second story toilet room under a sloping ceiling and a stair to the second floor having a width of 28 inches between the handrail and the opposite wall.] FINDINGS OF FACT 1. The building is undergoing substantial alteration and the petitioner wishes to install a new toilet room on the second floor in an area where the roof slopes from 7 feet 3 inches to 4 feet 7 inches. 2. The toilet room fixtures are located where the ceiling height exceeds 6 feet at locations where users are required to stand to properly use these facilities. As such these do not appear to create a substantial negative effect on its users. 3. Furthermore another toilet room with no ceiling height deficiencies exist within the dwelling. The subject toilet room will therefore be for secondary convenience. 4. The eyJsting stair to the second floor has a landing and tc ~ns 90 degrees. As a result of this the opening accommodating me stair is approximately 3 feet even though a portion of the stair is only approximately 28 P~tition No: 2002-1227 Page 2 inches wide between the handrail and the opposite wall. Anthropometric data from NFPA 101 suggests that the width at the hips at the 97 percentile female is 22 inches with sway. Therefore a clearance of 28 inches appears to be acceptable for travel through the portior of The stair that is tess than 30 inches wide. The petitioner proposes to place smoke detecting alarm devices throughout the dwelling in accordance with 9 NYCRR 721. These devices should provide a safety enhancement to the occupants of the dwelling in the event of a smoke or fire condition. CONCLUSIONS OF LAW Strict compliance with the provisions of the Uniform Fire Prevention and Building Code would produce a negligible additional health, safety and security benefit to the occ~ 9ants of the building. DETERMINATION WHEREFORE IT IS DETERMINED that the application for a variance from 9 NYCRR 711.2(b) an(~ 1233.4(a)(4)(iv), to permit a second story toilet room and a stair to the second floor as noted: be and is hereby PRQPOSED TO BE GRANTED with the following condition: 1. That smoke detecting alarm devices shall be installed throughout the dwelling unit in accordance with 9 NYCRR 721.1. This DECISION is issued under 19 NYCRR 450.6. Unless objected to by the petitioner in a wdtinq received Dy ~he Department, the decision shall become FINAL after fifteen days of receipt of the decision by the parties. This decision is limited to the specific building and application before it, as contained within the petition, and should not be interpreted to give implied approval of any general plans or specifications oresented in support of this application CWN:sg Petition No: 2002-1227 .Tile;persons below are advised to TAKE NOTICE of the attached document. The attached d0cumem pertains to a petition for relief related to code requirements. If there are any q.uestions, call (5 ~ 8~474-4073 anti ask for the Variance Unit. Please refer'to the petition number in all related conversafibns or horrespo_ndence uZith us. MIChAeL C WIDgNER I'90 PONDWAY / BRUNO SIMONE ~ TOWN OF SOUTIgOLD BLDG DEPT 53095 MAiN ROAD ~PO BOX 1179 SOUTHOLD NY 11971-0959 PHILIP & JENNIFER STANTON 302 TOWN CREEK LANE SOUTHOLD NY 11971 Town Hall, 53095 Main Road P.O. Box 1179 Southold. New York 11971-0P59 Fax (631) 765-9502 TelephoCe (631) 765-1802 BUILDING DEPARTMENrI TOWN OF SOUTHOLD CERTIFICATION Date: Building Pgrmit No. Owner: ~ ~-(Please print) ¢le~e p~t) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this day of ~&t~, 20bcJ Notary Public, County (Plumbers Sil~mture) I Nassau Suffolk Electrical Inspections, Inc. 5A Caual Street * Center Moriehes, New York 11934 * Tek 631-878-3500 * l~a~c 631-878~3764 9/8/03 Lic#:2781-E Application: 3253 Date: Issued to: STANTON Address:. 302 Town Creek Lane Village: Southold Introduced By:. ~CO Electric was examined and approved up to the above date and was in compliance with the NEC Switches33' , Receptacles37, Fixtures19 G_F.I.4 Range Hood Whirlpool Oven Carbon Fans ~' Dish,rasher WasberlAmps Dryer/Amps , Range/Amps Manoxide t-Ex bath ? I 1 I 1 Furnace 2!/Oil Gas Heat Zones Smoke DeB ,2,. Detectors Traasformers I yes 2 3 ... [, . .~*,~ Meter Amps Phase Motors 1 150A UG 1 )ther Eq uiprnent: 2-Zone Central AC ut, Res This certificate must not be altered in any manner FROM PC-lONE NO, : G32 28~ ~&~ Mau. 28 20~3 ~ES:2~PH P~ New Y~ ~f ~0~)2 Town Hall. 53095 Main Road P.O.,Box 1179 Southotd. New York 11971-0959 Fax (63t) 765~9502 Telephone (631) 765-1802 BUILDING DEPARTMENT TOWN OF SOUTHOLD STOP WORK ORDER TO: Michael C. Widener, Sr. 190 Great Pond Way Southold, N.Y. 11971 a/c Philip & Jennifer Stanton YOU ARE HEREBY NOTIFIED TO SUSPEI~D ALL WORK AT: 302 TOWN CREEK Lg_NE, SOUTHOLD, N.Y. TAX HAP NUMBER 1030-64-1-12 Pursuann no Section 45-13 of the Code of the Town of Southold, New York, you are notified to immediately suspend all work and building activities until this order has been rescinded BASIS OF STOP WORK ORDER: SCOPE OF WORK BEING PERFORMED OUTSIDE OF BP#28506Z CONDITIONS I/NDER WHICH WORK MAY BE RESUMED: WHEN THESE ISSUES ARE RESOLVED. Failure no remedy the applicable provisions by fine or imprisonmenn DATED: 0CT.25,2002 conditions aforesaid and no comply with the ef law may consnlnuue an offense punishable or both. ~runo J S Building Inspector (Cert. Mail) .10/28/02 !{0N 12:00 FAX 540 37'2 7841 CULPEPER WOOD F'BURG ~00.1 PHIBRO-TECH INC. (S~TER., 2395 ~INS MILL RO~ S~TER SC 29154 9101 1 CULPEPER WOOD PRESERVERS 10229 TIDEWATER TRAIL FREDERICKSBURG VA 22408 IF THERE ARE ANYREGULATORY QUESTIONS, PLEASE CONTACT TOM MORAN 201-944-6000. OTHER INQUIRIES SHOULD BE DIRECTED TO CAREY JACKSON AT 803-481-8528 X 209. CCLf~PER WOOD F BURG ~]002, 1.0/28/02 MON 12:70 FAX 540 372 7841 ~-~', ~A~'~I'~ DATA SH~T ~MSDS~'~ 9849 PAGE 2 70 52 PHIBRO-TECH INC. ,~ TEL# (201) 944-6000 ONE PARKER PLAZA FA3f# (201) 944-7916 FORT LEE NJ 07024 ******* 24 HOUR.EMERGES~CY'CONTACTI CH~MTREC (80'0) 424-9300 ******* 24 HOUR E~ERG~CY CONTkCT~ COMPANY (803) ~81-8528' ******~ DATE: 3/31/99 SUPERSEDES: 10/01/96 Ti~E NA34E: CUPRIC SULFATE SOLUTION TANKWAGON <7065> I PRODUCT IDENTIFICATION NA = NOT APPLICABLE, ND = NOT DETERMINED DEGREE OF HAZARD 4 = EXTREME 3 = HIGH 2 = MODERATE i = SLIGHT 0 INSIGNIFICANT EMERGFAICY HAZARD RATING HEALTH FIRE REACTIVITY SPECIFIC HAZARD TRADE NAME: CUPRIC SULFATE SOLUTION - TANKWAGON FORMULA: CU$O4 IN H20 MOLECULAR WT.: SYNONYMS: 159.59 (ANt-fY) COPPER(II)SULFATE PENTAHYDRATE (1:1:5), SOLUTION; BLUEVITRIOL SOLUTION; SULFURIC ACID COPPER (2+) SALT (1:1) PENTAHYDRATE, SOLUTION 2 ,'INGREDIENTS INGREDIENTS (CAS NO.) WT PCT PEL TLV (TWA) (APPROX) ~G/M3 PPM MG/M3 PPM CUPRIC SULFATE {7758&98-7) ~3~ 14 1 (cu) 1 (cu) THE TLV'S ARE GIVEN FOR GUIDANCE; LOCAL'APPLICABLE REGULATIONS 'SHOULD ALWAYS BE FOLLOWED, INGREDIENTS APE THOSE PRESENT AT'l% OR GREATER, OR AT 0.1% OR GREATER IF LISTED AS POTENTIAL CARCINOGENS BY OSHA/IARC/NTP. PROPRIETARY INGREDIENT IDENTITIES ARE AVAILABLE IN ACCORDANCE WITH 29 CFR 1910.1200. CARCINOGEN: NTP'- NO IARC - NO OSHA ~ NO 10/28/02 ~[0N 12:01 FAX 540 372 7841 CULPEPER WOOD F BLaRe t-~z~.u ~'~:'l'I DATA SHEET !~ MSD~ 9~)49 PAGE 3 3 PHYSICAL AND CHEMICAL CHARACTERISTICS D = DECOMPOSES BOILING POINT, 760 MM HG (DEG C) MELTING/FREEZING POINT (DEG C): S~EC:IFIC GRAVITY (WATER = VAPOR pRESSURE (MM HG): VAPOR DENSITY (AiR = i): WATER SOLUBILITY (% BY WT): VOLATILES (% BY WT) EVAPORATION RATE ( BUTYL ACETATE = 1 PH OF ,SOLUTION: ~ 400 c (D) LOSES WATER AT 110 C 1.25 MISCIBLE ND 1.5 - 2.5 AP~EA_RAi~CE/ODOR: ODORLESS, TRANSPARENT BLUE LIQUID. 4 PHYSICAL HAZARD DATA · CUPRIC SULFATE SOLUTION IS NOT CONSIDERED TO BE A FIRE HAZARD. FLASH POINT (DEG C): NA TEST METHOD: NA FLAMMABLE LIMITS (% BY VOL): NA AUTOIGNITION TEMP. (DEG C): NA EXTINGUISHING MEDIA: FIRE. USE ANY SUITABLE MEANS TO EXTINGUISH SURROUNDING SPECIAL FIRE FIGHTING PROCEDURES: USE SPECIAL BREATHING EQUIPMENT AND PROTECTIVE CLOTHING APPROPRIATE TO THE SURROUNDING FIRE. UNUSUAL FIRE OR EXPLOSION HAZARDS: NOT CONSIDERED TO BE AN EXPLOSION HAZARD. REACTIONS WITH INCOMPATIBLE MATERIALS MAY POSE AN EXPLOSION HAZARD. SEALED CONTAINER MAY RUPTURE DURING FIRE CONDITIONS FROM PRESSURE OF WATER VAPOR RELEASES. 5 REACTIVITY DATA THERMAL STABILITY: STORAGE. STABLE UNDER ORDINARY CONDITIONS OF USE AND INCOMPATIBILITY: AT TEMPERATURES GREATER THAN 250 C THE ANHYDROUS SALT WILL IGNITE HYDROXYLAMINE. SOLUTIONS 'ARE ACIDIC AND CAN REACT WITH MAGNESIUM TO EVOLVE FLAMMA2~LE HYDROGEN GAS. CONDITIONS TO AVOID: NOT DETERMINED. HAZARDOUS POLYMERIZATION: WILL NOT OCCUR. HAZARDOUS DECOMPOSITION PRODUCTS~ WHEN HEATED TO DECOMPOSITION CUPRIC ~XIDE AND SULFUR OXIDES ~AY FORM. 6 HEALTH HAZARD INFORMATION EFFECTS OF OVEREXPOSURE: SYMPTOMS' OF INGESTION: TOXIC! MAY CAUSE BURNING PAIAI IN THE MOUTH, ESOP~L~GUS, AND STOMACH. HEMORl%3{AGIC GASTI~ITIS., NAUSEA, VOMITING, ABDOMINAL PAIN, METALLIC TAST. E~ ~ASLD DIARRMEA MAY OCCUR. IF' VOMITING DOES NOT OCgUR '_EDIATELY, sySTEMIC COPPER POISONING MAY OCCUR. SYMPTOMS 5~AY INCLUDE CAPILLARY DAMAGE, HEADi~CHE, COLD SWEAT,, WEAK PUTuS, E., KIDNEY AN~ LI1rER DA/4AGE, CENTRAL NERVOUS EXCITATION. FOLlowED BY DEPRESSION, JALrNDICE.,' CONVULSIONS, PARALYSIS., ~ coMA~. DEATH MAY OCCUR FROM SHOCK OR R~ENAL FAILURe,. SYMPTOMS OF INHALATION: ~MAY 'CAUSE IRRITATION OF' THE UPPER RESPIRATORY TRACT. SY~RTOMS MAY INCLUDE COUGHING, SORE THROAT, A!~D SHORTNESS OF BREATH. MAY ALSO CAUSE SYi~PTOMS S~ILAR TO THE COMMON COI~D, INCLUDING CI-IILLS AND STUFFINESS OF TI~E HEAD. SYMPTOMS OF SKIN CONTACT: MAY CAUSE IRRITATION, REDNESS, AND PAIN. SYMPTOMS OF EYE CONTACT: DUST MAY CAUSE IRRITATION. CONTACT MAY CAUSE CONJUNCTIVITIS, ULCERATION OR CLOUDING OF THE CORNEA. CHRONIC EXPOSURE: PROLONGED OR REPEATED SKIN EXPOSURE MAY CAUSE DERMATITIS. PROLONGED OR REPEATED EXPOSURE TO DUSTS OR MISTS OR COPPER SALTS MAY CAUSE DISCOLORATION OF THE SKIN OR HAIR, ULCERATION/L kiD PERFORATION OF THE NASAL SEPTUM, RUNNY NOSE, METALLIC TASTE, ATROPHIC CHANGES, AND IRRITATION OF THE MUCOUS MEMBRANES, TOXICITY DATA: ORAL TOXICITY: 300 MG/KG (RAT) AS (CUS04.SH20) 7 EMERGENCY AND FIRST AID PROCEDURES EYE CONTACT: [MMEDIATELY, FLUSH WITH COPIOUS AMOUNTS OF WATER FOR AT LEAST 15 MINUTES WHILE HOLDING EYELIDS APART. WASHING WITHIN ONE MINUTE IS ESSENTIAL TO .ACHIEVE MAXIMLIM EFFECTIVENESS. GET IMMEDIATE MEDICAL ATTENTION AFTER FLUSHING. SKIN CONTACT: WASH AFFECTED AREA THOROUGHLY WITH SOAP AND WATER. REMOVE CONTAMINATED CLOTHING AND LAUNDER BEFORE REUSE. IF iRRITATION SHOULD DEVELOP, GET MEDICAL ATTENTION. INHALATION: REMOVE TO FRESH AIR. IF NOT BREATHING, GIVE ARTIFICIAL RESPIRATION. IF BREATHING IS DIFFICULT, GIVE OXYGEN. CONSULT A PHYSICIAN. INGESTION: NEVER GIVE ANYTHING BY MOUTH TO AN UNCONSCIOUS PERSON. INDUCE VOMITING IMMEDIATELYBY GIVING TWO GLASSES OF WATEROR ].0/28/02 ~ION ].2:02 FAX 540 372 7841 .,v,.~'.I.'.~F,~AL SAFETY D~ S~T .M~D~ 9 8 ~ 9 PAGE MIT.K IF AVAILABLE 'AND STICKING FINGER DOWN THROAT. CALL A PHYSICIAN IMMEDIi~ITELY . NOTES TO PHYSICIAn: TAKE APPROPRIATE ACTION TO COUNTERACT SYMPTOMS. INDUSTRIAL HYGIENE ~ OCCUPATIONA~L CONTROL PROCEDURES VENTILATION: .A SYSTEM OF LOCAL EX~L%UST IS RECOMMENDED TO KEEP EF~PLOYEE EXPOSURE BELOW THE AIRBORNE EXPOSURE LIMITS'. LOCAL EFd-tAUST IS USUALLY PREFERRED BECAUSE IT CONTROLS THE EMISSION AT ITS SOURCE, PREVENTING DISPERSZON OF IT INTO THE GENERAL WORK AREA. REFER TO THE ACGIH DOCUMENT ~'INDUSTRIAL VENTILATION, A M3~/9-UAL OF PREFERRED PRACTICES" FOR DETAILS. RESPIRATORY PROTECTION: NIOSH/MSHAAPPROVED RESPIRATORIF EXPOSURE MAY OR DOES EXCEED OCCUPATIONAL EXPOE.URE LIMITS. GENERALLY, A DUST/MIST RESPIRATOR MAY BE WORN IN AREAS WHERE THE TLVIS E~CEEDED UP TO TEN TIMES. ALTEi~NATIVELY A SUPPLIED AIR FULL F~CEPI~CE~RESPIRAToR OR AIRLINED HOODMAY BE WORN. EYE PROTECTION: CHEMICAL SPLASHGOGGLES AND/OR FACE SHIELD. CONTACT LENSES SHOULD NOT BE WORN WHEN. WORKING WITH THIS MATERIAL. ANEYE WASH FOUNTAIN AND QUICK-DRENCH FACILITIES SHOULD BE .MAINTAINED IN THE WORK AREA. SKIN PROTECTION: USE RUBBER OK PLASTIC IMPERVIOUS GLOVES BODY-COVERING CLOTHING. PERSONAL HYGIENE: WASH THOROUGHLY AFTER HANDLING. 9 SAFE HANDLING, STORAGE i~uND USE PRECAUTIONS PRECAUTIONARY MEASURES: AVOID CONTACT WITH SKIN, EYES, AND CLOTHING. WEAR PROTECTIVE CLOTHING, GLOVES, AND SPLAS~GOGGLES OR SHIELD. WASH THOROUGFLLY AFTER USING. AVOID BREATHING DUST OR MIST. USE WITH ADEQUATE VENTILATION. STORAGE AND HANDLING: STORE.IN A COOL, DRY, WELL VENTILATED AREA. ISOLATE FROM INCOMPATIBLE MATERIALS. PROTECT FROM PHYSICAL DAMAGE. 10 REGULATORY INFORIHATION AND DISPOSAL PROCEDURES SPILL/LEAK CLEA~-UP PROCEDURES: VACUI/M UP SPILLED MATERIAL. AVOID MISTING OR 'SPRAYING. PACKAGE FOR RECLAMATION OR RECOVERY. WHATEVER CANNOT BE RECOVERED MAY BE ABSORBED ONTO SODA'ASH OR LIKE. DISPOSAL METHOD: DISPOSE IN ACCORDANCE WITH APPLICABLE FEDERAL, 1.0/28/62 ~ION 12:03 FAX 540 372 7841 :'CULPEPER WOOD F'BURG f~MSD~;. 9 ~849 PAGE STATE, AND LOCAL ENVIRONMENTAL AND REGULATORY REQUIREMENTS. TOXIC SUBSTANCES CONTROL ACT(TSCA): CHEMICAL INGREDIENTS ARE ON THE TSCA IN'v'ENTORY. SUPERFUND REPORTABLE QUANTITY(RQ): t0#/4.54 KG. (CUSO4) HAZARDOUS WASTE NO.: NOT REGULATED. SARA TITLE III: THIS PRODUCT IS ACOPPER COMPOUND WHICH IS (SECTION 313) SUBJECT TO REP0RTI~G. CANADIAN (WI{MIS) LIST: THIS.PRODUCT IS SUBJECT TO REPORTING. {.COPPER COMPOUNDS} NEW JERSEY LIST: EMPLOYERS WHO PRODUCE, USE, OR STORE THIS MATERIAL ARE REQUIRED TO FILE AN AAIigllALSURVEY DUE ON MARCH OF EACH YEAR. (COPPER COMPOUNDS, HAZARDOUS SUBSTANCES, N.O.E.) FOR STATES NOT LISTED: PLEASE CHECK [$ITH THE APPROPRIATE AGENCIES. WARNING: THIS PRODUCT MAY CONTAIN A CHEMICAL KNOWN TO THE STATE OF CALIFORNIA TO CAUSE CANCER, OR BIRTH DEFECTS, A/~D/OR OTHER REPRODUCTIVE HARM. 11 TRANSPORTATION DATA DOT SHIPPING NAME: DOT HAZARD CLASS: HAZARDOUS INGREDIENTS: IDENTIFICATION NUMBER: PACKING GROUP: LABEL: ADDITIONAL MARKING: RQ, ENVIRONM~ITALLY HAZARDOUS SUBSTANCES, LIQUID,N.O.S., (CUPRIC SD-LFATE SOLUTION) COPPER SULFATE UN 3082 III CLASS 9 "NL~RINE POLLUTANT" REQUIRED FOR BULK SHIPMENTS THE WORDS "MARINE POLLUTANT" MUST BE ENTERED ON THE SHIPPING PAPER IN ASSOCIATION WITH THE BASIC DOT DESCRIPTION FOR BULK SHIPMENTS. NOTE: DURING AN INCIDENT INVOLVING THIS MATERIAL, USE 0FDOT EMERGENCY RESPONSE GUIDE NO. 171 (1996 VERSION) IS ALSO RECOMMENDED.. 12 ADDITIONAL WARNINGS AND INFORMATION IT IS REASONABLE TO ASSU~E THAT COPPER COMPOUNDS CONTAIN ARSENIC, CADMiLIM, CHROMIUm, AND LEAD IN CONCENTRATIONS RANGING FROM A FEW PARTS PER BILLION TO SEVERAL HUNDRED PARTS PER MILLION. ALL INFORMATION PRESENTED HEREIN IS GIVEN IN GOOD FAITH_AND IS BASED ' .~?~?ER woo9 F stag I~oo7 10/28/02 R0N 12:04 FAX 540 372 7841 :¥~SD~ 9,8~ 9 PAG~ 7 o~ SQ~CES ,AND TESTS CON$~DER~.D TO BE RELIABLE, BUT CANNOT BE G~A~TEED. IT IS THE USER'S FULL RESPONSIBILITY TO ACCW~PT RISK FOR TH~, SAFETY, TOXICITY, HAI~ISIG, STORAGE, ~ USE OF THS PRO~,~ AS WELL AS TO D~TE~ THE SUIT~I~I~ 0F T~ Pa0DUCT FOR a sPEciFIc ~POSE. WE .~ NO W~m~ AS.TO THE RESETS TO BE oBTkINED IN USING T~ PR~UCT; ~EREFO~E ~L R~ISKS MUST BE ASE~ED BY THE USER. Material Safety Data Sheet Material Name: ACQ Preserve Pressure Treated Wood tn; CSI-010 *r ~ * , S~ctlon 1 ~ chem ~.al Profuct and Company Id'entificatl~on * * * ~ Chemical Name: PressuretreatedwoodwithAIkatineCopperaedQuartemaryAmmaniumObmoounos Pr~duc~ Use: Lumber Manufacturer Information NOTE: Emergency telephone numbers are to be used only in the even[ of chemical emergencies involving a soilL leak f~re. exposure, or accident involving chemicals. All non-emergency questions should be diretad to Section 2- Cam ICAS # Component 3ercent Not Available Wood/Wood dus~ 141-4,3-5. Monoethanolamine Proprietary Copper complex expressee as Copper oxides 0.3-2.1 10043-35-3 Bode acid 0.2-1.2 68391.0%-5 ' ^lkyl dimethyl benzyl ammonium chloride** 7173-51,-5 , Didecy] dlmethyl ammonium chloride" 0.2-1.0 "Nots: This proauc[ contains either one or tr~e other of the above Quaternary ammonium comoounds depending on which ACQ Wood'Preservative is used Component Related Regulatory Information Th~s p¥oc~uct ?ay ce regulated, have exposure limits ct other information identified as me icl!owing: Wood dust a sbt aJ~d h~rd woods, Wood dusts-soft woods Wood dusts-hard wood, Copper (7440-50~}, Copper compounds mo,s,. Comoonent thfdrmatlon/Information on Non-Hazardous Components [ Emergency Ov~rvlew WARNING ! Wood dust may form explosive mixture with air. Wood dustS may cause4rfitation to the eyes. skin a nd~ res pi;rat c~ry tract. ~' ,' "., ,"|' '~"~?: Eyes '~use irritation to the eyes, Symptoms can include irritation redness( scratcmng of the cornea Potential Health,Eft,acts: Skin W,oqd~t ~ay cause irritation to the skin Mechanical rubbing may increase skin irritation, Some WOOd species ma~ cad~e ~tnatitis or allergic skirl reactions in sensitized individuals. ACQ Preserve Pressure Treated Wood oroducts are mace up of wood u'aateo with one of the ACQ family of EPA registered products, Thi~ product is considered hazardous under the cdteda specified in 29 CFR 1910.1200 (Hazard Communication S: a~dar~ an8 the Canadian Workplace Hazardous MaTerials Information System (WHMIS). * * * Section 3 - Hazards Identificatio.n ' ' * . Page I of 8 ssue Date: 08/14/01 Revision: 2,0000 ~riot Date: 8/20/2001 Material Name: ACQ Preserve Pressure Treated wood - .- Material Safety Data Sheet Material Name: ACC[ Preserve Pro,*sure Treated Wood -~_~:¢ rD: CSP010 Po~:enttal Health Effects: tnges~on dr~ges~on of wood er wqecl~flus~i~nbkel~'. If fngestion does q~r,.sJ~ght~asttointest~nal i~ita~on may result. C~Aa[R.sp,~i~s ~'wood a~r ~u~t~ may con.in nat~l {oxlhs Which c~n have adveme ~c~ in h~a~. PotEntla Health Eff~ Wood dust is i~tadng.~ me.~ose throat and lungs. Symptoms may include nasa~ d~ness deposes or ~bs{ru~o~ in the ~i pa&~ages cough ng, sneezing d~ne~ and'soreness of throat and s nuses. hoameness~ and~e~z~ Pmldfl~ed or repeated inhalation of ~od dusts may cause respimto~ i~tation. ',!e J;:a' Ce~:I::;~ A~9ravaled by Exposure ' ' * * Section 4- First Aid Measures * ' ' .... I~]a~e y flush eyes w~h o enty of ~: for at east 15 m nu~s Seek immobile medicat F~rst A ~, S~m . F~s~[~ ~act wash immediately v~th soap'and water. Continue flushing skin with water for 15 minutes ~]~h persists, get ~di~] a'tten~on, if wood's~]inte~ are in e~ed under the skin get medical atten~oh' First Aid; [ftb~¢~t~da[ Js swallowed, 9e( ~m~ediate medical at(enrich or advice -- Do not induce vomkin9 [~ d~'are,,~,~ inhaled, remove pe~soh to frssh air If sym~Oms pemist gel me~caPa~e~fion. R'es.D~ a merits ed~' or~isting skin conditions may be aggravated by exposure to w~od ~usL . * * * Section 5- Fire Fighting Measures * * * Flash Point: N~[ applicable Method Used: Not avai[ab]e Upper Flammable L m t (UFL Not available Lower Flammable Limit (LFL): Not avaiiabie Auto Ign~on: ~ot a~a labia FlammaUili~ Cl~$slfl~tion: Combustible ~ of Bu~ih~: N~ a~iiable Woo~s combustible, and wood dusks may form explosive mixtures with air in the eresence of an Ignition source. Hazardous Combustion Products co, m~st[on products ~ay yield I~ting and toxic ~mes and gases including organic chloride, aldehydes, a~in~,.. ~ hydrogen chledde 'amman a, copper compounds, oxygen, bodc oxide oxides of ca~n and nff~gen. Extinguish~Me~ia ' ' Us~ water to wet down wood and to reduce ~e likelihood of ignition or dispemian of dust into the air. Fire Fighting~ Equlpmen~lnstructions Fire¢~t~ ShouM wear full protective clothing incJuding see contained breathing ap~m~us. NFPA Ra~]n~: Health: I Fire: 1 ReactJvi~: 0 Hazard S~]e: 0 = Mi~ima[ 3 = Slight 2 = Moderate 3 = Serious ~ = Severe ~ Se~ion 6- ~ **" Accidental Release Measures * * * Contai~ment~rocedures No co¢~inme~ procedures are needed, as this produ~ cannot spill or leak the prese~ative. Keeo away sp~ and flame._ . Page 2 of § Issue Data: 08/14/01 Revision: 2.0000 ~ Idnt Date: 8/20/2001 Material Name: ACQ Prese~e Pressure Treated Wood Material Safety Data Sheet Material Name: ACQ Preserve Pressure Treated Wood ID: CSI-OIO Clean-Up. Proeedur, es Wear appropr at~e protect ye equ pmenf[ and cloth ng dur ng c ean-up Wet down accumulated dusts prior to sweeptn9 o]; vacuuming in aras!' to ,prevent explosion haZards, Sweep up, or '/acuum small pJ~ee and,~.uats end place in appropriate ~ntai~].er '~or d~si)osaL Gather Target pieqes by an appropriate method. A¥oid;~he generation o[aYrborne dusts duriag cleanup. Do ~ot inhale de,ts dt~ring cleanup Evacuation P~ocedures ]s:o?~ate are~ Keep unnecessary pers,onnel away. Special Pr?c~d,~res ~.ar~,l~P. Top~at~ ~emgn~ pr~e e~pment. FoJtaw all Local State, Federal and Provincial regulations for inignition source when sawing, cutting er grinding wood. ,Avoid contact of wood dusts with Skin and eyes. Dn not breathe smoke when handling this material or in areas where dusts of this product are ,, such as sweep ng regularly to ava d accumula Jan of dusts t, sparks and open flame, ,~ Sect on 8 - Exl~osure Contra s / Personal Protection * * * Exposure,,Garde nos A: General Pro~uct~lnformation F~IloW ~J[ applicable exposure limits, B: Compone~n~, Exposure Limits Wbod~/Wood dust ~CGrHi (5 rog/m3) TWA (related to Wood dost soft wood)) (10 rog/m3) STEL (related to Wood dust (soft wood)) OSHA 5 rog/m3 TWA (relaterl to Weed dust, all soft and hard woods, ex~ept western red cedar) V~ca~ed: 10 rng/m3 STEL (related to Wood dusi. all soft and hard woods, except western red cedar) "NIOSH: ,1 rog/m3 TWA; NIOSH Potential Occupational Carcinogen ~ see A~pendix A (related to Wood dust~ Engineering Controls Use exhaust venQIotTan when cutting, grinding or sanding in enclosed areas and iT it is anticipated the exposure limits for wood dust may be exceeded during working with this product, PERSONAL PROTECTIVE EQUIPMENT Personal Protective Equipment: Eyes/Face Wear safety glasses with side shields;when handling, cutting, sanding or grinding this material Use a face shield during processes that may generate excessive dL~ts and splinters, Personal Protective Equ,iPment: Skin Wear puncture re,slatant work glove.% such as leather. Personal Protective EqUipment.*' Respiratory Not normally needed, Use a dust mask for particulate concentrations exceeding the Occupational Exposure Limit,[ Persona Protectl~;e~Equipme~t: General Launder work clothes frequently. Eye wash fountain is recommended. Page ,~ of ~ issue Date: 05~14J0'~ Revision: 2.0000 Print D~te; 8/20/2001 Material Name: ACQ I:~reserve Pressure Teeated Wood b'd 96P'OW AqBBS DO3B ~WBHW3AIb NdPO:2 ~B02'8~'±30 Material Safety Data Sheet Material Name: ACQ Preserve Pressure ~Teated Wood Appearance MaY vary Physlcal S~ate: SOlid wood Vapor Press,ute: Not available Boil~g ~nt: No[e~Dl~ble Solubility (H2O): ~ns0]uble ID: CSI-OI 0 Odor: Ammoniacal~Vood Odor pr: Not applicable VaporDensity: Not appiioable Melting Point: Netepplicable Specifi~ Gravity: Not available This Ps e Chemical Avoid sparks and open flame. Keep away from incompatible materiels, and oxid[zing agents. and toxic fumes and gases including organic ch]or[de, aidehyaes, copper compounds, oxygen, boric ox[de, oxides of ~arbon and nitrogen. * * * Section 11 - Toxicological Information ** * Acute ~h~ C~ronic~'Toxici{y General Product nformetlon Wopd'c~u~ts ~ay be irritating [o the ayes. skin and mspirato~ tract, Prolonged or repea~ed inhalation of wood dus[maly~u~e respiratory irritation, recurrent bronchilis'and prolonged co ds. Depend n9 on the species of w~odi r~;;urrent eXPosure may cause allergic skin and respiratory reactions in so~e indIviduals. B: Component, Analysis - LDSO/LC50 M'onoethano~amine Omi LD50 Pat: 1720 rog/kg Ora~ LDS0 Mouse: 700 rog/kg Derma[, LDS0 ~Rebbit: 1 mL/kg 30~ ppm ,IDLH Copper~complex (Proprietary) dusts or mist§ as CU: ~00 rog/m3 IDLH 'related to Copper) Boric ~¢id (10043-35~3) Omi EDS0 Ra~: 2680 mg/kg Oral LD50,Mquse: 3450 rog/kg Di~e~ytdi~ethyl ammonium chloride*' (7173-~1-5) Oral [D~0~R'~t: 84 mgJkg O~al ~D50~M0us?: 266 mglkg Alkyl~ ~tl~l benzyl ammonium chloride (68391-01-5) Ore[ l~5~,{nb species indicated): 735 rog/kg for males and females combined Derm;a~ L[D~G (nc species indicated): 3350 mgtkg for males ~nd females combined Page 4 of ~ Issue Date: 08/14101 Revision: 2.0000 Print Date: 8/Z0t2001 Material Name: ACQ Preserve Pressure Treated Wood G'~ g6~'OH AqUaS 9Q98 OU3H~3AI~ NdS0:2 ~002'8~'±D0 Material Safety Data Sheet Material Name; ACQ Preserve Pressure Treated Wood ID: CSI-010 Carcinogeniclty A: General Product Information ACQ Preserve pressure treated wood and its components are not tis(ed as carcinogens by ACGIH, NIOSH, or IAPC. Wood dust is ~,Iasai§ed es a human carcinogen or occupational carcinogen by ^CGtH, NIOSH and I^RC, This cSassification is based on an increased incidence ~f nasa[ and paranasal cancers in people exposed to wood dusts. C¢~mponent Carcino!lc~,iclty Wood/Wood dust (Not Available) ,~CG.. I: /,I ~-Cn;[rmed Hurhan ~rc~oge~ (relat~ to Wood dusts~rd wood) NfOSH: O~d~pa~bnal caTc~nogen (re,amd to Wood dust) IARC: Monograph 62,1995 h · atari to Wood dust} (Group 1 (carcinogen c to humans)) It. Ecotoxicity **'~ Section 12- EcoloRical Information General Product Information This Product i~s not expected to [eac[- harmful amounts of preservative into the environment. However, the wood preserver[vas,in this~reduct contain fungicides and insecticides which whet released into the environment, are expected to adversely effect or destroy contaminated plants. They may be harmful or fatal to wildlife. B: Component Ana]ysts- Ecotoxicity - Aquatic Toxicity MonOetha~lamine ' (1~1~43-5) Test & Spe~¢i~s LC50 (96 hr}goldfish 170,0 moIL. ECS0 (30 r~in) P~otobacterlom 13,7 molL Microtox pnosphore~ test. Ce~ditiens Copper complex (Proprietary) Test & Species LC50 (96 hr) fa(head minnow 23 ug/L L~CSO (96-hi");reihbow trout 13.8 ug/b LC50 (96 hr)~luegjll 236 - 892 1050 (72 hr) freshwater algae 120 ug/L ?cenedesh~,us subspicatus) C§~) (96 hi') water flea 10 ug/L Lc50 (96 h~', water flee 200 ug/L Conditions 20 mg CaCO3/L juveniles adults (related to Capper'~ (related to Copper) 45 mg CaCO3/L 226 mg CaCO3/L (related to Copper) Boric acid (~0043-35-3) Tesf& Species LCS0 (48 hr)~wster flea Conditions 115.0-153.0 moll Static. Environmental Fate No information available. Page Issue Date: 08,'14/01 Reglsion: 2.0000 Print Date: 8120/2001 Material Name: ACQ Preserve Pressure Treated Wend Material Safety Data Sheet Material Name: ACQ Preserve Pressure Treated Wood iD: C~1-010 pfions Genera} Product Information Although aa Ep,~ Waste Numbers are applicable for this product's components, you must test your waste to d~terminA if it meets appt{bable definlUons of hazardous wests end for State re~uirements, D ~ o~'~a~ materi~a~ord ng to Local, State, Fedora and Prov~ne~ Envirenmen~l ~egulations. * ~ * Section' 14 - Transpo~ation Information * US DOT nformation Shipping Name; Not regulated Canada Tran~.portat[a~ of Dangerous Goods r ot regulated Pe'~i~ Group: 'None ~e~ed ~be (s): None Information US Fed ei-a~;~l~j~l ail b n s * ' * Section 15 - Recjulatorv Information A: Gene~l pi;~)duc~t Information ~hi~d~u~ ia pressure ireatec with either of three FIFRA registered wood preserva~ves which fell under Env~r~m'e~tel Pi-erection Agency regulations. ACQ 2100.is registered with the EPA under registration n,u, meer 10465-37, Ac,Q. ~10~ ~ ~egisteJ'ed with the EPA under registration number 10465-40 ACQ 2102 iS,registered with the EPA under registration number 10465-39. B: Compon~rtt Analysis q-hi~aterlal centaur, s one or more of the following chemicals required to be identified under SARA Section 302 (4(~ ~FR 355 Append/ix A), SARA Section 313 (40 CFR 372.65) end/er CERCLA (40 CFR 302_4). Copper complex expressed es Cc,pper oxides (Proprietary) SARA 3,13: form R reporting required for 1.0% de minimie concentration (related to Copper) [arm R reporting required for 1.0% de minim~s concentration; Chemical Category N100; (does not [nelLIde copper ph[halocyenine com0oLInds substituted onlywith hydrogen and/or bromine or chlorine) (related to ~ epper compounds) C: Federal Insecticide, Fungicide, and Rodent/c/de Act This. material contains the fo/Iow)ag chemlcals present on either the Listing of Pesticide Chemicals {40 CFR 180/ or Pesticides Classified for Restricted Usa as listed by FIFRA; Copper complex (Proprietary) FIF~A Se~tlon number 180.!$38 (related te copper) Page 6 of 8 Issue Date: 08/14/01 Revision: 2,0000 Print Date: 8/20~'2001 Material Name: ACQ Presecve Pressure Treated Wood Material Safety Data Sheet Material Name: ACQ Preserve Pressure Treated Wood ID: CSI.010 D. Marine Pollutant DOT This material contains one or more of ihs following chemicals reqaited by USDOT to be identified as marine pollutants. Copper Complex ,proprietary} SARA 3tl/312: Acute Health Yes Chronic Health Yes Fire Yes Pressure No Reactive No State Regulations A_' Genera/Product Information Qther eta e regulations may apply, Check individual state requirements. B; Component Analysis - State ~. '_~-"_."" 2 ........ r ,-... . .~ .th..~l.C..hq_.n ctate hazardous substances lists; ~7 he~Wdods) (Zrel~'ted 1o Wood dusts-soft ~oods) ;Mon~e~ol~ihe , 141~5 Yes ~ Yes J Yes Yes Yes Y~ Coppe~com~lex ,('related to Copper) ~ Pmprieta~ ~ Yes~ ~ Yes~ ~ Yes~ ~ Yes' I Yes* ~ Yes~ I Compon~ent;Ana/ysJs - WHMIS IDL - ....',"~ ' · ' '"!ntified BOric acid Jnder the Canadian Hazardous Products Act Ingredient Disclosure I Jet: CAS ~t 141-4-3-5 Propd ets['y 10043-35~ Minimum Concentration 1%; English Item 1096; French Item 1170 1%; English item 433; French tern 57~ (related to Copper eemente[) 1%; English item 431 French Item 577 (relatadto Copper compounds, a.o.s.) ' 1%; English Item 204; French Item 67 WHMIS Classification: D2A, D2B Additional Regulatory Information A: General Product Information All components are on the U.S, EPA, TSCA Inventory List, ~1 components are on the Canadian Domestic ~ubsts~cee or Non-Domestic Substances Inventory Lis[s/The component, the Canadian Non-Domestic oxides, which is not listed on the Canadian Dameslic Substances List is on Copper complex expressed as copper Substances Inventory List. Page Issue Data: 08/14/01 ~evlsiom 2,0000 Print Date: 8/20/2001 Ma~rlal Name: ACQ Preserve Pressure Treated Wood 3'd 961~'0H AqcJ~JS 9C["1~ ([~3H~3~ I~J Nd90:2 800~'8~'.L30 Material Safety Bata Sheet Material Name: ACQ Preserve Pressure Treated Wbod ID: CSI-O:IO B; Component Analysis, InYentoryComponent Analysis - Inventory I chto~de'* , ~ ~y~ dimethy b'ep~ I ammon ~h d~e" ~ CA$.~ TS'CA; 13,~L ' NDSL: CINECS: AUST; MITI ; PH~. ' KOREA ' ~.LINC$ ' CHINA ' 1., ,, I v.... ..... N., · ¥-~ '-~'2~ Y.'..-. ! ~..= 10,fi4~-35.~ .... ~"~c~ ~ ~ I N' Y:.~ Y~,., v~r, Y~ '~;~s ~3 I :"*~'~1 ~ : ~,;-' ~.~ ~:= ";;~ ~ ¥-.., '~:~, ~ ' T"b ~,-=:'--'~ J Yes Ye~ 'No Ye~ - ~ ' Ye~ .Na Yes' No ; Ye~ * * * Section 16- Other Informatmn *~ O~her :fnform~fio~ Sbp~er ~ yes no wa%'antyof:merchant b ty or of f ness for ~ pa~ cu~rpumese Any pro~uct p~ch~sed s so d on t~e assumpt on tE~ purChaser w~l mage h~s ~n tests to de~ermme th~ quaht~ a~d seiteb[Sty of ~e pmdu~ Sup~l'e~ expres~!v d~c~m~ ~p,, and ~ 'ability for~nc denta and/or c~nseqg~a ;pm~e~ da~g~ a~s ng out o~ th~ us~.' :r.s [;'oduct. Xc, ..:;rT :4 ep prowded shall be deemed to be~,r~dat[o~ Io~se a~product in j c0~fJi~ffr 3r ,~' ex'r~irp r:,'):er'~t r:cn:,;. Read the Material Safe~ Data .Sbeeg~6~r~a~dli~g pr~uc~. ~ = Amedca~ rence of (3overnmental Industrial Hygienists. ~ Abstract Service CERCLA ~- Act, CF[~ = Code of Federal Regul Domestic Substance List. European Lis~ of Notified ~ = High Efficiency Part cu ate A r ..... . . " =,: ,~earch on Caacer. IDLH = .............. fade and Industry, NDSL: ?. = -,' ' ' · NIOSH = Nat[pnal ]nstitu; '" NTP = Natiorta Tox co og .; lot Applicable, ; ' -, , - ,... .A ct Chemical and l-his is the end of MSDS # CSI-010 Page 8 of 8 Issue Date: 08/14/01 Revision: 2.0000 Print Date: 8/2012001 Material Name: ACQ Preserve Pressure Treated Wood 6'~ 96P'OH A~S 9Q~E QU3FI~3AI~ Nd90:~ ~00~'88'±00 Officials ER.4g~I Re/~uedNovember f. 1999 OWNER 0~: SOUTVIOLD PROPERTY RECORD CARD SUB. LOT OF BUILDING RES. SEAS. VL. LAND .... IMP. TOTAL COMM. CB, MICS. Mkt. Value REMARKS AGE BUILDING CONDITION -NEW NORMAL · BELOW --~RM Acre Value Per AcCe Tillable Woodlc~nd Meadowbnd House Plot ABOVE Value FRONTAGE ON WATER FRONTAGE ON ROAD DEPTH BULKHEAD coLOR M. BId . Exteneion Extension izxtenmo~:/2 Porch Porch Bieezewqy Patio Total ~ I Foundation Basenient Ext. Walls Fire Place Robf Beth Heat Rooms Is~ FloolL Room ROoms 2hd Floor Drive~oy Town Hall. 53095 Main Road P.O. Box 1179 ~S6uthold. New York 11971-0959 Fax (631) 765-9502 Telephone '631) 765-1802 BUILDING DEPARTMENT TOWN OF SOUTHOLD November 19, 2002 Michael Widener 190 Great Pond Way Southol~, NY 11971 To Whom It May Concern: Please take notice that in review of your permit application, for "as built" alterations to a single fancily dwelling at 302 Town Creek Lane, Southold, N.Y., County Tax Map Number 1000-64-1-12, it has come to our attention that the permit will not be processed until the following information is submitted to this office: 1) Approval from the New York State Department of Environmental Conservation. Any construction within 300' of water or wetlands requires approval from the NYS DEC. 2) Approval from the Southold Town Landmark Preservation Committee. ~e~ Your permit application is currently being review)ed by the committee. Your 1'~ permit will not be issued until this agency has signed off on the plan. IY~ 3) Energy Calcula~our architect .rrg~, t subr~ ener~w~ c~ode c~lations before we call'sue your permit. //~/.~,/t~,4~ f~//~7/~,~-~'~-~ 4) A compl~t~d~flood permit applicat~on. Becanse a portion of ~6mYproperty is in a ~o0~z. one, a .floo~ pf .r~fit application is requ/red along with a fee for $10~0j2h, e~ ap.~Y/ca_fiojt. ~an ly~ picked up. at our~o ffice during ~ormal bm~es s hours, ff~.a.t~.~".~~'~ Because yda have started construction without a permit f~om this 6ffice. you are in violation of town code and must address thks situation immediately or further action will be taken. If you have any questions, you can contact this office at (631) 765~1802, between the hours of 8:00 a.m. and 4:00 p.m., Monday through Friday. CC: File 12/02/2002 0~:18 2iS-538-153B PA~E Bi CHORNO ASSOCIATES No. vemher 30th, 2002 B~t~,Department NY 11~71 Re: Siamon ReNdance Dear Mr Deamon: The drawings for the residence were presented to obtain a demolition perml~ before July of this year. When I was. ready to complete the dr~:wings, I called your department and Mr Vadty told me that I would not be required to do the Energy computation as per the new Code. Mr Widener, contractor for the Job, h;¢,~ated that you requested those calculations, and the old computatior;s would not suffice. The values used were taken from the Sweet's Catalogue and the Graffio Standerds. I would ~ppreciate your advice as to ~3~ to proceed to finalize these documents. Mr Bruno suggested that I write to you before doing any further work. · rhez~ you for your attention,. Sincerely O~C OCCUPANCy J ~t~ ~ROVEDAS~NOT~D _ o?~ Eu~d 76~."f8o~ 9 A~ TO ~ p~ ~0~ FOLLOWING iNS:PE~iON~: FOR P~UR~D CONCR~ [NSU~ON F~N~L. OONSTRUCTiON MUST n~L cOnsTRuCTIoN SHA~ STATE~ O0~TRUC~i~N & ENERGy CODE~ N~T RESPONSiELE ~OR MICHAEL C, WIDENER .'~-79~/2~4 13 6 DBA NORTH FORK CARPENTRY 0124108036 / / PH. 516-810-7278 190 GREAT POND WAY DAT~ Routine Variance Petition Nombe~ ~.~0~~O0_~For 755-1095 Instructions · Answer all. qu~stiOas, Please type or print legibly. · Enclose a check, money qrder or voucher ',government agencies only) for $50 (Filing Fee for Routine Variance Review Process) made payable lo NYS Department of State. · Send this form. sppporung documents such as cop~ of survey, site plan. architectural drawings, pnotograpns cost estimates etc. and the fee payment to NYS Department of State, Codes Bureau - Long island Regional Office 560, Broad Hollow Rdad, Suite 11'0; Melville, NY 11747, · Petition, fee ~s nOn-reauadable and variance cannot De orocessea until fee is received at the above adoress. · For infccrrrt;~tF0n regarding the status of this variance petition, call the regional office representative that is handling your ae~itidh, at:ihe number indicated above. Please have your petition number available. APPLICANT FOR. VARIAN,CE Name: L/~i¢-~O.~- { ('. ~'V~,~tAr ~'' Telephone:(~LAf ) Address: .(~ V . . / APPLICANTS Relationship to Property in Question: o Owner ¢'~wner's Representative u Other PROPERTY OWNE i( m-.Je~,~,T~cL..._~.~ m Telephone: {iff7 ) 77[ _(2977 Prooerty Location: .3 :3 City ~ Town ~ Village Building Use: ,~)r-- [ Code Enforcement Official -~---(.~ ~/~ ~ · Street address ~{, ~ __ County ~. 4~L {~ Total sauare footage of building: ~pp~ (~>~0 ---.Sa.Ft Name Telephone: ( ) Code Sections in Question: 9 NYCRR or Brief Descrimion NOTE: PETITION FEES ARE NON-REFUNDABLE . nave en~r'¥sad a I~tition ~ilin.,9 fee for thee above referenced property in the amount of $ I0 ~d~lI$ A3qN~±S i, U~. Z~/IS A39N¥15 BO 765-1802 BUILDING DEPT. INSPECTION [ ] FOUND~t~'TION 1ST [ [ ] FOUNDATION 2ND [ [ ] FRAMING [ [ ] FIREPLACE & CHIMNEY ] ROUGH PLBG. ] INSULATION ] FINAL REMARKS: DATE ~ 765-1802 BUILDING DEPT. INSPECTIO/N~ FO~TION 1ST [//~OUGH PLBG. ~] F~U'NDATION/2ND [ ] INSULATION FRAMING [ ] FINAL FIREPLACE & CHIMNEY / ' '~ :v.~ ..% .... (. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] RO~HPLBG. [ ]/~NDATION 2ND ~/~NSULATION ~ FRAMING O//~'*~ [ ] FINAL [ ] FIREPLAC,,E%&CHIMNEY INSPEC~.~~ 765-1802 ~ BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] ROUGHP~~. [ ] I~TION [ ~NAL [ ] FIREPLACE & C~M'~'Y DATE ~~/~ INSP~ ROUGlt '~RA1VITdffG & t'L UM?B IN G ST~4.TE ENERGY CODE F~AL TOWN HALL SOUTHOLD, NY 11971 T L ,(631) 765 802 F~xi (63~,) 765-9502 / Ex~ined f ,20 Approved ~f~ ~ ,20 Disapproved ~c / E~k~ion ' 'y / BUrbD1NO'PERMI? AP~CA%fION CHECKLIST Do yon ~ve,or n~e~ foHo~, before ~pl~g? Bo~d of~ ~3 scm ofBmq~g P~ Plug Bb~d approvM PE~T NO.~~ ~S~e~'Che~ S~fic~o~ N.Y.S,D,~C. ~'- ~ Contact: APPLICATION FOR BU~D~G PE~T ~ ~ ~STRUCTIONS a. This application MUST be completely filled in by ¢ypewriter or in ink and submitted to the Building Inspector with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing [ocat/on of lot and of buildings on prenaises, relationship to adjoining prermses or public streets or areas, and waterways. c. The work covered by this apphcation may not be commenced before issuance of Building Perm/t. d. Upon approval of this application, the Building Inspector will issue a Buildin~ 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 Ocenpancy. f. Eve~-y building penn/t 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 zon/ng 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 Buildirfg Department for the issuance of a Building Pemfit pursuant to the *?Bu/ldmg Zone Ordinance of the Town of Southold, Suffolk C6unty, New York, and other applicable Laws, Ordinances or Regulatiens, for the construction of buildings, additions, or alterations or for removal or damolitien as herei~ describe& The applicant agrees ro comply with all applicable laws, ordiffances, building code, houfmg code. and regulations, and to adm/t authorized inspectors on premises and in building for necessary inspections. (Signatur~ of applicant or name, ifa corporation) (Mailing address of appli~:ant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerofprmnises .J e tx. !a,nYffc /-~ot~A~-"~5 ~A-'-~o4 (As on the tax roll or latestdeed) If applicant is a corporation, signature of duly authorized officer '(Name and title of corporate officer) · Builders License No. [~-I ~---~"~--~ -- ~'~J~- Plmnbers License No. Electricians License No. Other Trade s License No. Location of land on which proposed work will begone: House N~b~ S~reet County Tax Map No. 1000 Section Subdivision Filed Map No. Lot 2. :State'ex~stmg use and~scupancy of pr, emls.~e¢ and intended use and occupancy of proposed a. Existing use a~. occupancy b.. Intended use and occupanc~ (;[j'~ ~ ~ 3. Nature of work (check which applicable): New Building Addition Alteration Repauc Removal Demolition / Other Work (Description) Fee (To be paid on filing t~s,applicafiun) Nuraber of dwelling units on each floor 5. Ifdwelhng, number ofdwelling units If garage, number of'cars [ 6. Ifbusiness, commerc/~ or.mixed occupancy, specify nature and extent of each type of use. T---------~ 7. Dimensions o~' exist~g structures, if any: From ,.%-~ Rear '-f [ ' Depth ~ ~-- Height Number of Stories ~ Dimensions of s~a~e structure with alterations or additions: Front ~ 5- Rear l~ech ~o 5, Height Number of Stories 8. ~)imensions of entire new construction: Front ¢~eight Number of Stodes Rear JDepth 9. S/ze of lot: Front Rear .Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are sitaated 12. Does proposed construction violate any zomng taw. ordinance or regulation? YES NO / 13. Wilt lot be re-graded? YES NO '//Will excess fill be remove,d fro,m prcmi,ses? YES NO 14. Names of Owner of premises-T~¢r~.r [~,~[o~ %~'~¢¢~*dress ]4¢.~0 ~c~, f'[g. ,o~$xPhone No.o~lg q'. q Name of Architect Address Phone No Name of ContractorgL( a¢/,' r3r Address/qod.¢~pP~¢~ vekone No. NO 15 a. Is this property w~thin 100 feet of a tidal wetland or a freshwater wetland? *YES * IF YES, SOUTHODD Tow2q TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet ofatidal wetland? * YES ~"~'NO ~ IF YES. D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, re scale, with accurate foundation plan and distances to property lines· 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK'~ SS: COUNTY OF ) 1~~ C~ ~ ~ ~¢'; being duly sworn, deposes and says that (s)he is the applicant of ,n= ab*e (Contractor, Agent, Co,orate Of~cer, ~c.) of said owner: or owners, and is duly authorized to perform or have performed the said work and to make and file th/s application; that all stateme~nts contained in this application are trae to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application fried therewith. Sw_o.i~n to before me this~ JOYCE M. Nota~ Public, State of N~w York No. 49~246, Surfak Coun~ Term Expires June t2, SignaturQe o f ~ppticant SUR~/E~'E ~EMA Z~ 1000=~4 PROPERTY 50UTHOLP ,50UTHOLP C, OUNT'i', 1,h' OD- 4-02 .50UNTY' TAX :~ i-12 ' ' * BSTEACT, INC. N LAND NO21 O,~. FOR,NERL¥ OF ~D~INA ® LATSON ,$ ALF~F:T t~. LATSON I[I S86o42'00.E 169.61 ' 2 N86°$1'00"W 91.70' NOTES:I · o FLOOI AREA ®P-.APHi C. ONORETE 'I'dONUMENT FOUNI~ PIPE FODND' STAK. E FOUNE~ ZONE AN~ TOPO LINES 5NCE USC® N®VD '2q DATUH 24,h~0 SF OR 0.55 AORE5 SCALE I"=DO' c JOHN 'C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET N.Y.S. Lie. NO. 50202 RIVERItEAD, N.Y. 11901 369-8288 Fax 369-8287 REF.\~Ip server\d~PROS\02-129.pro