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r FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24287 Date April 17, 1996 THIS CERTIFIES that the building ADDITION Location of Property OFF EAST END ROAD FISHERS ISLAND,NY House No. Street Hamlet County Tax Map No. 1000 Section 1 Block 1 Lot 3.13 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 15, 1995 pursuant to which Building Permit No. 22968-Z dated AUGUST 25, 1995 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 ADDITION TO EXISTING STORAGE & MAINTENANCE BUILDING AS APPLIED FOR & TO CONDITIONS OF SUFF.CO. DEPT. OF HEALTH DATED 1/12/95. The certificate is issued to F.I. DEVELOPMENT CO. (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 10-0-180 - HM-350 UNDERWRITERS CERTIFICATE NO. PENDING - APRIL 15, 1996 PLUMBERS CERTIFICATION DATED NOVEMBER 17, 1995-MARIO ZANGHETTI, JR. Building Inspector Rev. 1/81 FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD,N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ...... .. ............................... ....... 19.5 . NR 22968 Z Permission Is hereby granted to: 7 , C �..... ;/ ... `�......... ........ � :...... `- .��.. moo, '�............. ...... ......................................... �.. -.-��� .. ., X........... to '' �A c .... ....... . i.. •. r p /b at premises located at..... G ... 1 ...... .. ................................................................... ..........................................................................................................................:...........I......................... County Tax Map No. 1000 Section .........Z........... Block........../............ Lot No. ....... .... pursuant to application dated ...... /�!�.................................... 19.. and approved by the Building Inspector. Fee -97. . 4 di ... Bullding Inspector Rev. 6/30/80 Form No. 6 - TOWN OF SOUT110LD BUILDING DEPARTMENT TOWN HALL 765-1802 2919,95 APPLICATION FOR CERTIFICATE OF OCCUPANCY t. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2.' Final. Approval from Health Dept. of water supply and sewerage-disposal(S-9 form) . 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn- statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial .building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer ' responsible for the building. 6. - Submit Planning Board Approval of completed site plan. requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a 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. Fees 1. Certificate 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. Certificate of Occupancy on Pre-existing Building - $100.00 3., Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . . . . 11.447�95. . . . . . . . . . . . . . .. . . . . . . . w Construction. . . .�c. . . . . . Old Or Pre-existing Building. . . . . . . . . . . . . . . . . . . • cation of Property. . . , off. East .end road. . .. . . . . • . • . House No. Street• • . • • • . . .. . . . .Hamlet. . .. . . . . . . . . . wer or Owners of Property. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . ... .. . . . ... . . 1nty Tax Map No 1000, Section. . . X. . . , , , , , , .B1ock. . .1. . . . . . . . . . . .Lot 3..13 • • •. . • . • • bdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . .. . . . . . . . . . . . . . . Cmit N0. . . . . 22968. . . . .Date Of Permit.8?A/95 Z&S Contractin� •Inc. • . . . . . . .Applicant. • . Ilth Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . ... . . . . . . inning Board Approval. . . . . . . . . : . . . . . . . . . . . . . . 1uest for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . � Submitted: $. 25;00. . . . . . . . . . . . . . . . . . . . . . tz . 51og8' . . . . . . . . . . . . . . . . �. . . .. . . . . . . . . . . . . . . . . . . . . . . . ; APPLICANT r i ' TEL.765-1802' . o��FF�Lkco TOWN OF SOUTHOLD t' jy�c OFFICE OF BUILDING INSPECTOk = o P.O. BOX 728 f :I TOWN HALL SOUTHOLD, N.Y. 11971 C E R T I F 'I C A' T I' O N 'Date 11/27/95 Building Permit No 22968 Z Owner F.I . Club (please print) ' Plumber Mario Zanghetti Jr. (please print) I certify that the solder . used .in the water supply system contains less than 2/10 of 1% lead. Arm (p mb r 's * signature) Swc to . befor`e�me this �d y of w04dQ.4-, op 19 ' Notary Public Notary :P.ublic, 4Ltrr C unty. tHOMAS F.QOWERTY,fib. NotOfy Public State of New York No.4806559. Cluelltloo in Sutiolk Co ty Term Expires 12/s1iw 1� 1 17 1:.:c': C i II vG 1c�L blr�. \i .OUNDATION ( 1st ) FOUNDATION ( 2nd ) _ 2 . AO ?OUGH FRAME & 'PLUMBING ' ` ti H , 3 . rrri-7 INSULATION PER N. Y. y U STATE ENERGY , • CODE . - /52 �TJ 4 . FINAL ADDITIONAL COMMENTS : r� " x V M x •N ro H\ 9 H ' O \ � V C*] l o do rn New York State Department of Environmental Conservation Building 40—SUNY, Stony Brook, New York 11790-2356 Telephone (516) 444-0365 Facsimile (516) 444-0373 Langdon Marsh Commissioner March 27, 1995 Fishers Island Country Club P.O. Box 133 Fishers Island, NY 06390-0133 RE: 1-4738-00600/00004-0 Dear Permittee: In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your permit. Please read all conditions carefully. If you are unable to comply with any conditions, please contact us at the above address. Also enclosed is a permit sign which is to be conspicuously posted at the project site and protected from the weather. Very truly yours, C� :' ( ,L'-" Charles T. Hamilton Deputy Regional Permit Administrator CTH:cg enclosure AUG t6w !` 1 r)r U1fPCJ or,rPCVC1Pd�nPr 9&20-1 (8187)-9d New York State Department of Environmental Conservation NOTICE The Department of Environmental Conservation (DEC) has issued permit(s) pursuant to the Environmental Conservation Law for work being conducted at this site. For further information regarding the nature and extent of work approved and any Departmental conditions on it, contact the Regional Permit Administrator listed below. Please refer to the permit number shown when contacting the DEC. Regional Permit Administrator Permit Number /-1' 73F-0001 oo Q O rRQ-`ERT A. GREENE Expiration Date 3 NOTE: This notice is NOT a permit NYSDEC Commencement Notice Bureau of Environmental Protection `d SUNY, Bldg. 40 IWO, Stony Brook, NY 11790-2356 Permit No: 1-4738-00600/00004-0 Issued To: 'PTSHERS 121-AND G91TNT_?C3' (;J UB Contractor's Name: Contractor's Address: Contractor's Phone No.: To whom it may concern: Pursuant to Supplementary Special Condition D of the above referenced permit you are hereby notified that the authorized activity shall commence on The permit sign will be posted at the site and copy of permit will be available at site for inspection. Submitted by: This notice is to be sent at least 2 days in advance of commencement of the project. Failure to notify or post will leave owner and/or contractor subject to applicable penalties for non-compliance with permit conditions. Cut along this line 4 NYSDEC Completion Notice AM Bureau of Environmental Protection SUNY, Bldg. 40 NOW Stony Brook, NY 11790-2356 Permit No: 1-4738-00600/00004-0 Issued To: FISHERS ISLAND COUNTRY CLUB Contractor's Name: Contractor's Address: Contractor's Phone No.: To whom it may concern: Pursuant to Supplementary Special Condition D of the above referenced permit you are hereby notified that the authorized activity was completed on Submitted by: This notice, with photos of completed work and/or completed survey, is to be sent to above address promptly upon completion of project. Failure to notify will leave owner and/or contractor subject to applicable penalties for non-compliance with permit conditions. NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION DEC PERMIT NUMBER EFFECTIVE DATE March 09, 1995 1-4738-00600/00004-0 FACILITY/PROGRAM NUMBER(S) p E I T EXPIRATION DATE(S) Under the Environmental March 15, 1998 Conservation Lam TYPE OF PERMIT ■ New ❑ Renewal 0 Modification ❑ Permit to Construct 0 Permit to Operate 0 Article 15, Title 5: Protection ❑ 6NYCRR 608: Water Quality ❑ Article 27, Title 7; 6NYCRR 360: of Waters Certification Solid Waste Management 0 Article 15, Title 15: Water ❑ Article 17, Titles 7, 8: SPDES 0 Article u27, Tistetle ea9; 6NYCRR 373: HazardoSupply 0 Article 19: Air Pollution 0 Article 15, Title 15: Water Control ❑ Article 34: Coastal Erosion Management Transport 0 Article 23, Title 27: Mined Land ❑ Article 15, Title 15: Long Reclamation ❑ Article Floodplain Island Wells Management ■ Article 24: Freshwater Wetlands 0 Articles 1, 3, 17, 19, 27, 37; ❑ Article 15, Title 27• Wild, Scenic and Recreational Rivers 0 Article 25: Tidal Wetlands 6NYCRR 380: Radiation Control 0 Other: TELEPHONE NUMBER PERMIT ISSUED TO Fishers Island Country Club (516) 788-7224 ADDRESS OF PERMITTEE P.O. Box 133 i Fishers Island NY 06390-0133 CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER Glenn Just/JMO Consulting (516) 653-0607 NAME AND ADDRESS OF PROJECT/FACILITY Fishers Island Country Club Property East End Road LOCATION OF PROJECT/FACILITY Fishers Island COUNTY TOWN WATERCOURSE NYTM COORDINATES Suffolk = Southold Unnamed Freshwater Wetland CESIMIKION CF AflHQ;12H) X71VITY Construct a 20' x 40' addition to existing maintenance building in accordance with NYSDEC approved plan. By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, the General Conditions specified (see page 2) and any Special Conditions included as part of this permit. DEPUTY REGIONAL PERMIT ADMINISTRA- ADDRESS TOR: Charles T. Hamilton Bldg. 40, SUNY, Room 219, Stony Brook, NY 1 1 790-2356 AUTHORIZED SIGNATURE DATE March 27, 1995 Page 1 of 5 GAL CCNDITICINS Inspections 1 . The permitted site or facility, including relevant records, is subject to in- spection at reasonable hours and intervals by an authorized representative of the Departmnt of Envirorrmntal Conservation (the Department) to determine Mether the permittee is ctrrplying with this permit and the ECL. Such represen- tative may order the work suspended pursuant to ECL. 71-0301 and .WA 401 (3) . copy of this permit, including all referenced maps, drawings and special conditions, rrust be ava i I ab I e for inspection by the Depa r trrent at all tin-es at the project site. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. 0 Permit Changes and Ftxxmis 2. The Department reserves the right to modify, suspend or revoke this permit Men: a) the scope of the permitted activity is exceeded or a violation of any condition of the permit or provisions of the ECL and pertinent regula- tions is found; b) the permit vves obtained by misrepresentation or failure to disclose relevant facts; c) new material information is discovered; or d) envirom-ental conditions, relevant technology, or applicable law or regulation have materially changed since the permit wes issued. 3. The permittee mast submit a separate written application to the Department for reneAe 1 , modification or transfer of this permit. Such application rrust include ' any forms, fees or supplemental info m stion the Department requires. Any renem 1 , rrr)dification or transfer granted by the Department rrust be in writing. 4. The permittee crust sutmit a renaneI application at Ieast: a) 180 days before expiration of permits for State- Pollutant Discharge Elimination SystEm (SPDES) , Hazardous Vlbste IVbnagemnt Facilities (F'MF) , major Air Pollution Control (APC) and Soli d V16ste IVbnagTmnt Facilities (SMJF) ; and b) 30 days before expiration of all other permit types. 5. Unless expressly provided for by the Department, issuance of this permit does not modify, supersede or rescind any order or determination perviously issued by the Department or any of the terms, conditions or requireT ents contained in such order or determination. Other Legal Cbligations of Permittee 6. The permittee has accepted expressly, by the execution of the application, the full legal responsibility for all damages, direct or indirect, of Matever nature and by W mever suffered, arising out of the project described in this permit and has agreed to indam ify and save harmless the State from suits, actions, damages and costs of every nam and description resulting from this project . 7. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the irrpa i m..Ent of any rights, t i t I e, or interest in real or personal property held or vested in a person not a party to the permit . 8. The permittee is responsible for obtaining any other permits, approvals, lands, easemnts and rights-of-way that Trey be required for this project. Page 2of 5 ,15-20-ba(7192)-25c Freshwater Wetland ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (Title 5), 24, 25, 34 and 6 NYCRR Part 608 ( ) 9 That if future operations by the State of New York require an al- other environmentally deleterious materials associated with the teration in the position of the structure or work herein authorized,or project. if, in the opinion of the Department of Environmental Conservation 13 Any material dredged in the prosecution of the work herein permitted it shall cause unreasonable obstruction to the free navigation of said shall be removed evenly,without leaving large refuse piles,ridges across waters or flood flows or endanger the health, safety or welfare of the bed of a waterway or floodplain or deep holes that may have a the people of the State, or cause loss or destruction of the natural tendency to cause damage to navigable channels or to the banks of resources of the State,the owner may be ordered by the Department to a waterway. remove or alter the structural work, obstructions, or hazards caused thereby without expense to the State, and if, upon the expiration or 14 There shall be no pnreasonable interference with navigation by the work revocation of this permit, the structure, fill, excavation, or other herein authorized. modification of the watercourse hereby authorized shall not be com- 15 If upon the expiration or revocation of this permit,the project hereby pleted, the owners, shall, without expense to the State, and to such authorized has not been completed,the applicant shall,without expense extent and in such time and manner as the Department of Environmental to the State, and to such extent and in such time and manner as the Conservation may require,remove all or any portion of the uncompleted Department of Environmental Conservation may require,remove all or structure or fill and restore to its former condition the navigable any portion of the uncompleted structure or fill and restore the site and flood capacity of the watercourse.No claim shall be made against to its former condition. No claim shall be made against the State of the State of New York on account of any such removal or alteration. New York on account of any such removal or alteration. 10 That the State of New York shall in no case be liable for any damage 16. If granted under 6 NYCRR Part 608, the NYS Department of Environ- or injury to the structure or work herein authorized which may be caused mental Conservation hereby certifies that the subject project will not by or result from future operations undertaken by the State for the contravene effluent limitations or other limitations or standards under conservation or improvement of navigation,or for other purposes,and Sections 301, 302. 303, 306 and 307 of the Clean Water Act of 1977 no claim or right to compensation shall accrue from any such damage (PL 95-217)provided that all of the conditions listed herein are met. 11 Granting of this permit does not relieve the applicant of the responsi- 17 All activities authorized by this permit must be in strict conformance hility of obtaining any other permission, consent or appro%al from with the approved plans submitted by the applicant or his agent as part the U.S Army Corps of Engineers, U.S. Coast Guard. New York State of the permit application. Office of General Services or local government which may be required. Such approved plans were prepared by >Chandler Palmer 12 All necessary precautions shall be taken to preclude contamination > t of any wetland or waterway by suspended solids, sediments, fuels. King; last revision on 2/01/95 solvents• lubricants,epoxy coatings, paints,c6ncrete, leachate or any SPECIAL CONDITIONS 18. Permittee shall install 110± linear feet of hay bales or silt fence along the landward edge of the Freshwater Wetland prior to commencement of regulated activities and remain in place until project completion. 19. All excavated material from project will be brought to an approved upland area. 20. During construction concrete or leachate shall not escape or be discharged nor shall washings from transit mix truck enter freshwater wetlands or adjacent areas. 21. There shall be no alteration or disturbance to freshwater wetlands or any adjacent area other than addition site location. 22 . No fill is authorized for project. 23 . Any debris or excess material from construction of this project shall be completely removed from adjacent area (upland) and removed to an approved upland area for disposal. 24 . Storage of construction equipment and materials shall be confined to project worksite or upland areas greater than 75' landward of the freshwater wetland boundary. DI PLRN11r NUm131R 1-4738-00600/00004-0 PROGRAM I AOLITY NUMBER Page 3 0f 5 95-2;6f(7)87)-25c NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION SPECIAL CONDITIONS For Article 24 Freshwater Wetland 25. The permittee shall incorporate the following language as a notice covenant to the deed: "Regulated freshwater wetlands associated with MY-29 are located on or near the properties of Fishers Island Country Club and its heirs, assigns or successors. This property is subject to the provisions of Environmental Conservation Law (ECL) Article 24, and the conduct of regulated activities may occur only pursuant to ECL Article 24 if prior approval is given by the New York State Department of Environmental Conservation (NYSDEC) or its successor(s) . Regulated activities include, but are not limited to clearing of vegetation; application of chemicals; excavation; grading and filling; and erection of any structure(s) . " This deed covenant shall be recorded with the Clerk of Suffolk County within 90 days of the issuance of this ' permit. A copy of the covenanted deed or other acceptable proof of record, along with the number assigned to this permit, shall be sent within one calendar year of the issuance of this permit to: NYSDEC, Regional Manager .BEP, SUNY Bldg. 40, Stony Brook, New York 11790-2356. Supplementary Special Conditions (A) through (F) attached DEC PERMIT NUMBER 1-4738-00600/00004-0 FACILITY ID NUMBER PROGRAM NUMBER Page 4 of 5 SUPPLEMENTARY SPECIAL CONDITIONS The following conditions apply to all Tidal Wetlands; Freshwater Wetlands; Coastal Erosion Management; and Wild, Scenic, and Recreational Rivers Permits: A. A copy of this permit, including all conditions and approved plans, shall be available at the project site whenever authorized work is in progress. The permit sign enclosed with the permit shall be protected from the weather and posted in a conspicuous location at the work site until all authorized work has been completed. B. The permittee shall require that any contractor, project engineer, or other person responsible for the overall supervision of this project reads, understands, and complies with this permit and all its general, special, and supplementary special conditions. Any failure to comply precisely with all of the terms and conditions of this permit, unless authorized in writing, shall be treated as a violation of the Environmental Conservation Law. If any of the permit conditions are unclear, the permittee shall contact the Division of Regulatory Affairs at the address on page. , one or telephone (516) 444-0365. C. If project design modifications become necessary after permit issuance, the permittee shall submit the appropriate plan changes for approval by the gegional Permit Administrator prior to undertaking any such modifications. The permittee is advised that substantial modification may require submission of a new application for permit. D. At least 48 hours prior to commencement of the project, the permittee and contractor shall sign and return the top portion of the enclosed notification form certifying that they are fully aware of and understand all terms and conditions of this permit. Within 30 days of completion of the permitted work, the bottom portion of that form shall also be signed and returned, along with photographs of the completed work and, if required, a survey. E. For projects involving activities to be undertaken in phases over a period of more than one year, the permittee shall notify the Regional Permit Administrator in writing at least 48 hours prior to recommencing work in subsequent years. F. The granting of this permit does not relieve the permittee of the responsibility of obtaining a grant, easement, or other necessary approval from the Division of Land Utilization, Office of General Services, Tower Building, Empire State Plaza, Albany, NY 12242 (516) 474-2195, which may be required for any encroachment upon State-owned lands underwater. DEC Permit No. 1-4738-00600/00004-0 Page 5 of 5 07/24/95 oe:31 CHANDLER PALMER 9: KING 15157937991 .01 Fk lIM 7mf i CONSUL T 1 Na PHONE NO. 653 0607 Mar. 21 1995 PO:� xrr�4Q.' Albert J, Krups)d, President Town Hall John Holmlel, Vice President 53095 Main Road N, Giarrell William 3 CP, Albertson P.O, Box 1179 Mdurtlrt Southold, Now York 11971 Peter Wencxel �`b� Telephone.(516) 765.1892 aJ Pax(S 16)165.1 823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD March 17, 1995 J.M.O. Consulting P.O. Box 447 Quogue , NY 11959-0447 Ro: Fishers island Country Club SCTM #1-1-3. 13 , Dear Mr. Just, According to the information submitted, the. Trusteas have found that the proposed construction of a- 20' X 40' addition onto an existing maintenance building, the Construction of the new practice area, the extension of the irrigation system into the practice area, and the completion of work on the three "sand bunkers" are all out of our jurisdiction under the Town wetlands ordinance. If you have any questionaj please call our office, Yooulrs truly, �10 j j' Albert J. Krupski, ar. AUG 1 6 President, Board of Trustees AJK/djh - _ - �- S r COUNTY OF SUFFOLK A ROBERT J. GAFFNEY SUFFOLK COUNTY EXECUTIVE DEPARTMENT OF HEALTH SERVICES MARY E. HIaBERD, M.D.. M.P.H. , COMMISSIONER BUREAU OF ENVIRONMENTAL ENGINEERING APPROVAL NOTICE DATE: 01/12/95 CHANDLER, PALMER & KING - lJ' L`7 ARCHITECTURE, ENGINEERING AND SURVEYING 110 BROADWAY AUG 6 6 19cr NORWICH, CONNECTICUT 06360-4452 Attn: RICHARD H. STROUSE, P.E. , L.S SCDHS Job No. : HM94-350 SCDHS Fac. I_D. No. : 10-0180 Site Location: FISHERS ISLAND GOLF COURSE SC Tax Map No_ : District: 1000 Sectional Block: l Lot: 3 . 13 Project Description: PROPOSED CONSTRUCTION FOR STORAGE AND DISTRIBUTION OF GOLF COURSE CHEMICALS , AND CONTAINMENT AND RECOVERY FOR ACCIDENTAL SPILLS . Design Engineer: RICHARD H. STROUSE, P. E. Review Engineer: Richard Markel , P. E. Senior Public Health Engineer (516) 854-2544 15 HORSEBLOCK PLACE ■ FARMING VILL E, NEW YO RK 1 I738-1220 (516)854-25 • FAX tt854-2505 -2- ' Your application for a permit to construct the project described above has been reviewed for compliance with Article 12 of the Suffolk County Sanitary Code. The application has been approved with the following conditions: 1. The storage facility will be constructed in accordance with the approved plan. A copy of the approved plan must be kept at the construction site. 2 . The tank (s) will be used in the service specified in the ' Permit to Construct as approved by this office. 3 . The tank and all. monitoring devices will be maintained in accordance with Article 12 requirements and best industry practice. ' 4 . Any changes in the use of the tank or modifications to the tank must be approved by the Department . 5 . All safe construction practices shall be followed during the installation of the tank. 6 . The tank installation contractor is strictly prohibited from substituting items of equipment clearly listed on the plan without the written consent of the Department . The contractor must. also advise the owner that equipment sub- stitutions are being made. You must contact John Gladysz of this office at 854-2524 at least 48 hours prior to commencement of any work to arrange for the re- quired construction inspections . The storage facility cannot be placed into service until this department performs a final installation inspection and issues an interim permit to operate. The documents submitted in support of this application for a per- mit to construct pursuant to section 760-1206 of Article 12 of the Suffolk County Sanitary Code was reviewed for compliance with Articles 7 and 12 of the Sanitary Code only. Y y . -3- Please contact your local building department or fire safety en- forcement office for any additional requirements that may apply to your project. You have one year from the date of this notice to construct your project. You can renew your application any time during the year after the construction permit expires . There is a $100 fee for this renewal . If the Department does not receive a renewal application for this project within the year after the construction permit expires, the application will become void and you will be required to refile a new application for a permit to construct. All ap- plicable fees will become due and payable. If you have any questions regarding the review process or need assistance, contact this office at the telephone number given above. Very truly yours, /icahard arkel, P.E. Senior Public Health Engineer Bureau of Environmental Engineering I;JFFOLK CO. DEPT. OF HEALTH SERVICES Permit requested for: (check all that apply) ' ® above ground tank ❑ upgrade exstg. faci 1 i ty -- APPLICATION -- ❑underground tank ❑ transfer facility PERMIT TO CONSTRUCT ® drum/portable Cont. ❑ re-piping I TOXIC/HAZARDOUS MATERIALS STORAGE FACILITY ❑ vapor recovery ® dry bulk O other: ❑. generic tank plan NOTICE* Construction may not take place without a valid Permit to Construct. Plans will not be reviewed without a completed application. Property Tax Map No. District loon Section 001 Block 01 Lot 3 13 Fishers Island Golf Course Fishers. Island i Facility Name: Facility owner: Development Corp. Address: P.O. Drawer "E" Owner's address: P.O. Drawer "E" I (no.) (street) Community: Fishers Island Community: Fishers Island State: NY 7iQ- 06390 State: —NY Zip: 06390 Phone: ( 516 ) 788-7251 Phone: ( 516 ) 788-7251 1 Person to contact for this project: Tom Doherty Phone: ( 516 ) 788-7251 Address (if different from owner) (no.). (street) -- (city) (state) (zip) Briefly describe project: Proposed construction for storage and distribution of Golf Course chemicals . Also containment and recovery for emergency spills . �0 ° Olio I C I FY TH L I NFORM ION SUPPLIED HEREON AND ATTACHED HERETO 15 TRUE TO T E BE Y KNt9 LE Tom Doherty applicants signature print name date This application with attached plans and reports has been viewed and approved for construction d the permit expires n r L . APPROVING ENGINEER DATE SCDHS JOB NO. — J�� FAC. I D.NO. LO — 0/ 07/24/95 08:31 CHANDLER PALMER 8: KING ; 151 G?@e7991 9e31 FN;"lM rmCi CONSULT I N5 PHOI 4E- NO. 653 0607 Mar. 21 1995 1.2:29PM P02 xrs.c•�ci.• Albert J. Krupskl, President Town Hall John Holzspfel, Vice President 53095 Main Road WilliamC1, Albertson P.O. Box 1179�Martin H. GuTell Southold, Now York ]1971 Peter Wenczel �`�� Telophono(516) 765.1892 rx,o� Fax($16)765.1823 BOARD Or TOWN TRUSTEES TOWN OF SOUTHOLD March 17, 1995 J.M.C. Consulting P.O. Box 447 Quogue, NY 11959-0447 Re: Fisher& Island Country Club SCTM #1,-1-3. 13 Dear Mr. Just, According to the information submitted, the- Trust©os have found that tho proposed construction of a 20 ' x 401 addition onto an existing maintenance building, the construction of the new practice area, the extension of the irrigation system into the practice arena, and the completion of wont on the three "sand bunkers" are all out of our jurisdiction under the Town wetlands ordinance. If you havo any questions, please call our office, Yours truly, , �' . �• Albert J. Krupski, Jr. AUG 16 Mj kr®sident, Board of Trusteas AJK/djh BOARD ' OF HEALTH . . . . . . . . . FORM NO. 1 3 SETS OF PLANS TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK ... . . . . - . - . . . . . . . . . . . TOWN + r ,SEPTIC FORT! _ - . . . . . . . . . . . SOUTHOLD, N. i 1971 TEL.: 765-1802 NET I r-Y ; CALL iiiine 19 �� . . . . . � nn I L TO . . . . . . . . Exa . . . . . . . . Approved . . . . �. ?. . . . 19 :?. Permit No. . . . . . . . - - - . . . . . . . . . . . . . . . . - - - . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . (Building Inspector APPLICATION,FOR BUILDING PERMIT qq. Date . . . . . . . . . .. lq/: INSTRUCTIONS la. This application must be completely filled in by typewriter 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 location of lot and of buildings on premises, relationship to adjoining•premises or public stieets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. 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 issued a Building Permit to the applicant. Such 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 whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. 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, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ... . . . . . . . . . (Signature of applicant, or n me, if a corporation) (Mailing address of applicant) . s State whether applicant is owner, lessee, a.g/ent,_J architect, � engineer; general contractor, electrician, plumber or builder. . . . . . .. . . . . . . . �vler✓ � . . . (r4�Y.�I't!v►c!WL . . . . . . . . . . . . . . . ell Name of owner of premises . . . . . -LI . .L.�Glhi�. �fG��. . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applican is a corporation, signature of duly authorized officer.- �- _ 1. (Name d title of corporate officer) - 2 y , Builder's License No. . fit.c�r7la�. . . . �.`_. . . . . AM 1 6 M Plumber's License No. . . .y- . . . , . . . Electrician's License No. . ��. . . . . . . . . , - 1. Other Trade's License No. .: , , , , 1. Location of land on which proposed work will be done. . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Y* y. . . . . . . . . . . . .... . . . . . . . . House Number Street Hamlet County Tax Map No. 1000 Section . . . OP/. . . . . . . . . . Block ;, . . . Lot . . .. 3. . . . . . . . . . Subdivision . . .. . . . . ... . . . . . . . Filed Map No: r . . . . . Lot . . . .'. . . . . . . (Name) 2, State existing use and occupancy of premises and intended`use and occupagcy;.of proposed construction: a. Existing use and occupancy .. . . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . .� qe, . . . L?�!%/.�iN.. , , . . . . . . .. . . . _ . _ . . . -3. Nature of work (check which applicable): New Building Addition A . . . . . Alteratior� . . . . . . t ^ . Repair . . . . . . . . . . . . . . Removal . . . . . . . Demolition . , . . . , . . Other Work . . . . . . . . . . . . . . . 4. Ec..• , . . . . . . . . . . . . . . . . Fee . . . . �J•'�• CT�. . . . . . . . . . (D:escription). . (to be paid on filing this application) S. 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 Stories . . . . . . . . . . . . . . . . . . . . . . . . . of . 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: . • 13. Will lot be regraded . . . . . . . ; . , • • , , , , , , , , , , , , • , , , Will excess fill be removed from premises: • 'Yes • • • • • • . 14. Name of Owner of premises . . . . . . . . . . . . . . . No . ... Will .Phone No. • Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . .Address . . . . . . . . . . . . . . . - . Phone No. . . . . . . . . . . . Name of Contractor . Address .Phone No. 15. . Is this property within 300 feet of a tidal wetland? . . . . * . . . • . . . . . . . Yes.. . . No. . . . . . . . . *If yes,- Southold Town Trustees Permit may-be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and.indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF . . . . . . . . . .S.S ' . ' ' • • • • • • 7"olvos• ' • J�'a/`Q . . . . , being duly sworn, deposes and says that he is the a licant (Name of individual signing contract) pp above named. / He is the . ... . . . . . . . . . . . . . . . . .6-E/er4/ . . . .G'O 1!I l+y'2gcD�t�►2� . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) :)f 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 Borth Ln the application filed therewith. Sworn to before me this �w . . . . . . . . . . . . . .. . .day of�. . . . . . 19�7.� Votary Public. . . . . . . . . . . . . . . ,1;�, .'`` . Count EILEEN G. WALL' .� NOTARY PUBLIC, NEW YORK STATE . . . . . . . . . . . . . . . . . . . . . . . NO. 01WA9509185 - (Signature of applicant) QUALIFIED IN SUFFOLK COUNTY Y TERM .EXPIRES OCTOBER 31,. 19gS REVISIONS AR SRL Ih12ERIo2 �VMR 6PSIh{ W.GLL.$,T R.os6 ..LZ— I ( (SEG, PW cl M-1 ) Po.up 'r�Ita sela�i,6R RrxF_ II �I GON3T'Al PSL�'G i rARTiA,, PLAN SUM P lusuvarlou Fty_ _-- LIMITS OF \\ '� Q Rohr' -II P G % MTL. BLDDGC// N{Iu.luFn.G. —IJETLLLIDS \ lON01 hI�,TGH S�GIFIGAI'IO+t/5 LINE IIIA \ - = Z, /I f Ilha—PzoPERTY LING EMERGENCY WA5N/ i Hu S(IN6 / 'rUrcF � I _ LIUE Gr EK1�3T �gLpIN6 +wE�- / / GeEEN I EL'Isr MAI4.IrEY-�4.uce -�/ / +}" (?rU1LpI4JG MEr- STU bsfV��P VWo. MET STUos+ YC FL'N+p �''-�' 'IC � c� / �--PLASTIC FPGED F7.41EL E UIP^ STORAGE m 5' OLD MaluTEl-JAucB / \` w EQ TO"AbPT IBI" SIDE+./Mly -K}- FACILaTY --���� • $ Eo��musLe See AJorasln WD. 5A45E TeEAYF.A 2X4 PRC`•'ILGT GIRD 1 / G4LILK PT TOP.000U26 MATCN EYIGI'' y 1 �. �EW Gr.AVE:L <uPF4�Eb _ 'I CoC ,1 1 �� eXls-l-luv� `�� �� PazIc.INb r�e-�A coNc cNrea, 4° Hl,srl � F .uc GueB,4' HIGH q �� PATN V _� �I nJ�-su.�o H♦=?� 'Y P,u:SN, ,I-�.�-SKIO 6GOXY P+.JISH p� / / EKISTIIJ6 \�\ E 1U a,p 4° UP GUR2 Exrbvo 3%z'JP CURB N ... Cpucaefb=-EUA•1 Jl FPc C' F c G j UNP I '" V2°P� �IIh L. RL � L Up uSrE Pe +L �'4 � 3Yz" MST III w j FL SLAG 4"COlJC. FL SLA® R ImbB� � @ G 3 M. K- " Iv" d 1 9TH - - L 0..c 4 eo0 @ ?lF'O.c: .I �" LOA1G) I u �p � 4"c., ,1 Tl5LA6 W " 411 � J 6 TYPSECrIou1 - ECT lON e- EMERG- WASM — -- U a � A E,elsn hl.-: rsnRZAees + FRS P�UI L P I N G S EGT I OIJ � ��I�� , Vli TF: >=,eisrlu� _ I SrewTueaL. W+u F¢A,�c SHADED A2E6. SHEDS -)Q _ IN DILATES EKIS"1''G '�I�I l000 � / —_- ENrE21o,¢ 51 PIUG ( 4`ad I "KIRESY" NEL PLD'6. Cf/ SUMP PJL' `Ill a �� W ccuc PM I c�i 2: �Nc. PIER _ ( CC.ISTING MAIh1TENAI.ICE EQUIPMENT STORAGE .,,� EMER A-icy' I, GPEEM16AL- 5TORAG "i%LCt C�eY chi EvTicALTi72�eE6 lbs. MAN. Llgt�o C+IEH�I- STO O +Lescug �' —CLE62141G IIJ TN1562.E1 Tc� `MF IG � ll a.Lldu Foe- bol_-oDVTe P.a��n�E JL C' GFIO �CFS.131L�TY 'r� I�cN1G1ES. • I I 7] v =E �• it '�1 I 24'. Wio PItlEO SrL. c1+E�I c " 0v '�\ PIPE-3b"PFF +� 1 b (TfP. OF 4� I(o'WI[vED ' LO G,dT ION Pl_AIJ � ' �T�t'P o SE'.GTIOI-] r /z' � ryry�1177 FD 4 1 _ ■ Nm M �P� m p ILISL%1.TE PEEiry oP, T IJ E¢.nL*ne NT SrMnEaE � VZ° P YWp,OVgP� /. MET ^.n INSLV-.ATE F"I�. O SLa6 ELEV. la.a' CHEM. Toe%�. SLAB ELS V. �-5 A) v Q a Zo W ELEV. EbIST'6 i+n , I � >, a 4H ,q-, I O ✓r p Z E' t C H EM I CA L_ STof-AG E ADE> IT I O N u� �" ' OCCUPANCY OR .� ONDE�W IFMAE USE IS UNLAWFUL. <�t?k TWINED WITHOUT CERTIFICATE OF OCCUPANCY r. AP NOSD AS PIED DATE: S' .S B.P.N -- NOTES: vo / µ FFE DI021 Y UI GL'--PART ;A7 COORDINATE DISTANCES ARE MEASURED FROM — Tse-�so2 q Am TO n Pm & THE rnIg F LOVJI IOV 1. FOUNDATION - VC'REdUIRED " c �' o YzU.S. COAST AND GEODETIC SURVEY TRIANGULATION 5erl_ IUSULFRP(.1URED CONCRETE w J ^G•' 1 , a PLUMBING p STATION EAST END 2 STu@, GJGH - FPAmiNT & W 3 INSULATION rq 2. 517E 15 N THE TOWN OF 50UTHOLD, COUNTY OF `r - ' vvP HaFeAME uv (. o=favC•L CONSTRUCTION ml➢�T VZ" PLYhIv. SUFFOLK, TAX MAP 1000, SECTION 001, BLOCK I, `e - - .1-- .� - I IN Rc"c:c nPLETEtehc.il. t- , a a \k +,1 r, 1 c . .n _— /Z" F, AIL CONSTRULUr SHALT_ N1,, v 4 LOT 5.13. _ ' . 'I ., No _ _ - " InrL. . IAsH wc- THE REOUIREMENIS OF THE N.Y pAwrEp •N Iv CM. H M FY GL}NSTRtlJCFOGN & ENERGY 3. SITE IS PONSIC 5ERVIGED BY MUNICIPAL WATER --- - E ' r ' M ea' Ir. PI IrEo PAIN ED cIDeS. NGT RFRUCTIONE FORIL AND ON SITE SEWAGE DISPOSAL SYSTEM IN - -- r DESIGN GRCGNSTRUCnONERRGRS i., <" Fi ��� a ' COMPLIANCE WITH THE STANDARDS AND REOUIREMENTS OF THE SUFFOLK COUNTY DEPARTMENT OF HEALTH. +, SITE IS IN R-120 ZONE. DETaI 5 QII JA/'IE HEAD DETAIA HEAD DE-TAIL 5. OWNER: FISHERS ISLAND DEVELOPMENT CORP. 1251 AVENUE OF THE AMERIGA5 N.Y., N.Y. G/O MORGAN STANLEY B GO. DATE: O O O R S G H E ' lJ L E JULY 20 1984 6. ON SITE WELL USED FOR GOLF COURSE IRRIGATION ONLYSCALE' Ae NOTED DOOR FRAME No. LOCATION SIZE - REMARKS "I 7. TOTAL ACREAGE OF THE SITE: 154 +/- ACRES. type IabT. mat'I. type lab'L r,e 5111l_1 Y ATHENS PVWu65EWIGE rx�>¢_ �' '1 C-I EQUIPMENT STORAdE IZ-o' x lo'-o° x ores Heho aaoeoco azo-.�. IMLv 6ii W/CLeC FLf TOR Jj' 5Ee kIA2F3LE SILL, 6GO,IJ MOFTAK. CHEMICAL 5TC>RArE A'-O' x 6'- 8" I'�au IHM I H,MM REN G-8 EMEKSENc�! WASH 2'-� x 6'-8� ,9/4,u IBCy. I 'H�M I -- � ' M VrygRPLS 51LL� SED TAI bbOi'PQ. i , H Ma. I —_ I[e.M. I F1%M. 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