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Home My WebLink About46635-Z TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit #: 46635 Date: 7/28/2021 Permission is hereby granted to: Town of Southold ... .........._... ............................. __......__----- 53095 Route 25 SoutholdNY 11971 ............ . __..w__w_ .w.w. .. ._____.....�... l ..... _ �.. ..... �. ..... __ ._..... � _..._......... __.......... To: replace existing generator for Verizon Wireless Facility as applied for. At premises located at: 165 Peconic Ln,, Peconic SCTM # 473889nn Sec/Block/Lot# 75.-5-14.1 Pursuant to application dated pp /2/2021 and approved by the Building Inspector, 6 To expire on 1/27/2023.ww„ Fees: ACCESSORY $100.00 ELECTRIC $85.00 CO-COMMERCIAL $50.00 Total: $235.00 ail Inspector TOWN OF SOUT'IIOLD — BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1 179 Southold, NY 11971-0959 .._._._. .... l.,. .. ._,,.—, Telephone (631) 765-1802 Fax (631) 765-9502 htths //www.southoldtgwnny.r,�o}_ Date Received APPLICATION BUILDING PERMIT g For Office Use Only !r PERMIT NO Building Inspector, _.,. JUN 2021 ri ltcatro s arbcl f rnws ra st tae, upp qult tit tltetrw ea tlret r lnro tete �' aPaltcatrots wall not be accepted' Mier ttaeeP (tcn1 1 not tie orrnr�an PI' f T�f f,f )e:I'T'. Oane�" otl�ori��itlon form t�' e �` li�ill Ise c�irrtPCete ��- "� -�, �- ;F L. (,,,.moi' „d�o..' �.ffi,o ,//f � /i„n,/„E,m�,, ,. ;, f „` �� ✓.,,,/r r/ � t Date:6/1/2021 /-',yi(,/rl'�r(,/ri?q„irN,r�rl„F,i,l,y%ri„rr ,,,,,,: r +f„ r,' ,,;.! /.rff/� ! yrr/nrfi//inrJ�/i ` H r' 77, ,r .. / r! r /.Yrr�` , „ .Ie �0 / r.r/1L 15, / n �Jr/ ;• 1, � ,, r ,..� r.. ��.L�r, .a�,„a�G�r�r,..,, O lrO,r,' „! „L,,: ,'/,,pica✓oil/��//I/U�Grr✓/r/�,c„�,o9l�l,�rf��lr.ee Irl.l,c„,;� rr,.,r,%, r ,,..1�f;/ Name:Town of Southold scTM # 1000-075.00 - 05.00 - 014.001 Project Address:41450 Main Road, Peconic NY - _..-.- Phone #:,(631) 765-1802 Email: Mailing Address:54375 Main Road,l7r,v,�+l✓/l/,re.r.-,/,dw.rrl,u.r,/r... / Srorurttrc r1hov✓�,��m��lr/d N?,,/✓rrrnr,l�+,. ,iY 1i„.,,iw,r11i9..✓r///.�71 Yle'r� kln,dY�J&&' /�rrG,rr/,/r�,lr�//r:�./.,�•/rarr/JyO/r.1/,,,„.ir�„r��lw.,...��rrir w��(I,r r r,��r N i h;:,-/.,r�,,�” ,�d'�,DII„. Name: /�Jrrfl�r(//rrJ;rrr/r/��i.✓o./rr�,,1./:,,H��J/(oaN',�YN/r/A/>lrl/a.;.t..r�,.,t.Ni�('lr�/�,l1�,J�1�!ifr/1.,,I,m�/lrf��V/rl ,., '.. Matthew ,Zagelbaurn (attorney for New York SMSA Limited Partnership d/b/a Verizon Wireless) Mailing Address:c/o Amato Law Group, PLLC, 666 Old Country Road Suite 901 Garden City, NY 11530 Phone #: r5,,Y.�.ra.1, 6 +2y4/�,7.�2_ru"��R7;.y..,...-6.<3fl643 ,...T't0 r�,f.:/r.%./,„�,i/,tr,l�/r6r,�/.%//�/./,�orr�1li�r'1��✓'%.„rr,r/�.f,„,r�iI�r,a,;l,,,P//I//E,u`ma�././.ir/// m. z .✓''/;/lr�If,,',�„gr,r,„,�„plr,hr,rrau�mr lr lrda1f m�, ayl/l,t,r,r oflfirrrm/%�r/�r�,„✓i' .r,c�trrio�r/.rr1 r.mr �.,i.y ,r„,� b;.. 7 , uwuy,T r,r�r,,rr�,',`r�.,,r lr,tTif�,n,(urG,/�i/✓r,,,t�ri,,,,ifG�rrG,r,,,nl.,/hr ,(r ��1"l/I rr” f r r �/' h a 1 %'! r� �, r”u, � I! �% , � .ad / , ,�„ Name:APT Engineering Mailing Address:567 Vauxhall Street Extension - Suite 311 , Waterford, CT 06385 Phone #:-(860) 663 1697 Email smodonoughallrintstech.com r / y r r, y f r , ,N ,� p.y�ry«,,,!/,r r 1 r r � �//�r rl r �, �/r�i rrx' /.,,,,,// r r b ✓ „r ar, fH , r � / 1 , ✓r /r ,, .,r Name:AMP Communications LLC Mailing Address:32 Spruce Street Suite 13Oakland, NJ 07436 Phone # (201) 245-7852 Email Mgr n@ampc Iffl ommunlcatlons.com DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: OOther Replacement of existing diesel generator as depicted on construction drawings submitted herewith $25,000,00 Will the lot be re-graded? ❑Yes ®No Will excess fill be removed from g � premises? ❑Yes BNo 1 PROPERTY INFORMATION .....�.._____. Existing use of property: Intended use of property: NO Change Zone or use district in which remises Is situated: Are there an covenants and restrictions with P Y respect to R-80 this property? ❑Yes �No IF YES, PROVIDE A COPY. R Clf Cif Boer rafter,,Rt�adln m`rhe cr wmer/r.ontrsrtior/desipn Profession I Is respbnsible for all drainage a.�m,w te____..._ ' � � "" and storntytirat+rrr lssocx as provided by Chanter„236 of the Toton Corte. APPLICATICIhi IS EpEtty MADE to the Building Department for bre Issuance ref a Building Pernift pursuant t6the Wilding Zone orrBirranrp of that Towrn of oaathoid,wr fuiir,county,EVevuYork at',qr ler�Ppifu 066biirnas ordinances or fCe ulatiori „for the corrstrrartioas o9 Izwbfkrfirsg s„. addtlons,alterations or for rc rnomal or dr rrrolfbon as herein,dr srrdlZad 11he rppiiqn aggrs a�to r"ornply with all applicable laws,ordina6j� 6o'lidhij code, h04p rods and reg uiatfon. Ifd to admit atrtraorbr d tnsppctoMir rr prernkes and;irr b6ilding(s)for ner�:siar I'spectioris,rape�taterot�n s osadr her fn ee frarrishabie a aSS, ons_emeanor ni r want tri ertfort A4f AS as ffmcs` tl vu prk state Pend Law. New York SMSA Limited Partnership d/b/a Verizon wireless Application Submitted By(print name): BAuthorized Agent ❑Owner Signature of Applicant: By: Date: 1012-1 Nam�obert C arni ..� / STATE OF NEW YORK) Title: Network EnginerrfMIg - Real Estate l SS: COUNTY OF O sS0.y ) a� " �j ,leif E� Ne,,v Y,,JcfAf4l,rm,W (ref)q.$4jp dlblp 14,1610,- lVi-4105 being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)he is the (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;that all statements contained in this application are true to the best of his/her knowledge and belief; and that the work will be performed in the manner set forth in the application file therewith; s�gttl4lililg//�/ w0 YATS r Sworn before me this : a j "'" rfy° iL y - .` t �''-da of �'�` '� 20 2...1 � rl� lf �AMff2� - �t'--00�l t TY Notary gc ,rtgs ill i3 PROPERTY OWNER AUTHORIZATIONgrOF NE' 0 (Where the applicant is not the owner) residing at . do hereby authorize _ ... . .. _ to apply on njy behalf to Town of Southold Building Department for approval as described herein... . eve .. .. ______________..... �.., _...... War's Signature Date Town of Southold Print Owner's Name 2 " r""-111, 666 OLD COUNTRY ROAD, 9TH FLOOR AMA .1` GARDEN CITY, NY 11530 L A W G K c,, (J 11, 11 is 1,C TEL: 516.227.6363 FAX: 516.227.6367 June 1,2021 VIA FEDERAL EXPRESS JUN 2 2021 Town of Southold Building Department Town Hall Annex Building 54375 Route 25 PUTI 17' N Southold,NY 11971 0 V Re: Building Permit Application (the "Application") by New York SMSA Limited Partnership d/b/a Verizon Wireless ("Verizon Wireless")to the Town of Southold (the "Town") in connection with the replacement of the existing generator for the existing public utility communication facility (the "Communication Facility") located at 41450 Main Road, Peconic, New York, with Suffolk County Tax Map designation District 1000/ Section 75 /Block 5 /Lot 14.1 (the "Property") Verizon Wireless Ref.: Peco ic (GEN)/Our File No. 100-2186 .............. Dear Sir/Madam: In connection with Verizon Wireless' Application to the Town for the replacement of its existing generator for the existing Communication Facility at the Property, enclosed please find the following: I One (1) original Application for Building Permit, completed and executed by Verizon Wireless(we respectfully request that an authorized signatory of the Town, as Property owner, execute the Property Owner Authorization section on the second page); 2. One (1) original Owner's Authorization (we respectfully request that an authorized signatory of the Town, as Property owner, execute same); 3 Certificates of Worker's Compensation, Liability, and Disability Insurance; 4. Four(4) surveys of the Property; 5. Four (4) sets of construction drawings, prepared, signed, and sealed by APT Engineering, with a last revision date of May 18, 2021 (the "Construction Drawings"); and 6. Check payable to the "Town of Southold," in the amount of$235.00, representing the Application -filing fee. As depicted on the Construction Drawings, Verizon Wireless is proposing to replace its existing diesel fired generator and sub-base fuel tank located in the existing equipment shelter as part of the Communication Facility. 405 LEMNUI-ON AVI"NUE, � CHRYS�,ER BMLDINk 26` FLOOR � iNIDAI �010(,NY M'A �! 212A 85 6000 402,MA[N STRL]iY � SUITE?04 ! NIF-ITUCHEN,N 08840 � i�2 31/ 15H w. Please note that the Spectrum Act and the Federal Communications Commission Order' mandate an abbreviated, streamlined municipal application process for wireless communication facility applications which qualify as "eligible facilities requests," including a 60-day application review and approval timeframe. Verizon Wireless respectfully submits that this Application qualifies as an "eligible facilities request," which the Town "may not deny, and shall approve" within the required timeframe. Should you have any questions or concerns, please do not hesitate.to contact me. Thank you for your attention to this Application. Sincerely Matthew Zagelbaum Encls.. cc: Verizon Wireless (via e-mail,without enclosures) 'See 47 U.S.C. §1455 and FCC Report and Order No. 14-153,respectively. 2