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HomeMy WebLinkAboutSubject File �� ,,� MAILING ADDRESS: Town Hall P.O. Box 1179 54375 tae Route 25 LOCATION:OFFICE µ Southold,NY 11971 (cor.Main Rd. &Youngs Ave.) Southold, NY Telephone: 631 765-1938 www.southoldtownny.gov PLANNING BOARD OFFICE TOWN OF SOUTHOLD July 23, 2024 Lois Rightmyer c/o Dish Wireless and Crown Castle 695 Route 46 West Suite 300 Fairfield, NJ 07004 Re: Approved Amended Site Plan for Dish Wireless @ Baxter Located at 415 Elijah's Lane, n/w corner of Elijah's Lane & NY- 25, Mattituck SCTM#1000-108.4-11.3 Zoning District: Limited Business (LB) Dear Ms. Rightmyer: The Planning Board has found that the requirements of the above-referenced Amended Site Plan have been completed based on the site inspection made May 31, 2024. The site is now in conformance with the Approved Amended Site Plan for "Dish Wireless @ Elijah's Lane, Mattituck" prepared by John S. Stevens, P.E., dated September 3, 2021 and last revised April 8, 2022, and supports the issuance of a Certificate of Occupancy. This letter does not condone any other changes from the approved Site Plan and approvals from other agencies; Planning Board approval is required prior to any significant changes to the site. Respectfully James H. Rich III Chairman cc: Michael Verity, Chief Building Inspector Michael Collins, Town Engineer Brittany Townsend, Sr. Manager— Program Management, Crown Castle From: Carl <warehouse@lkrtechnical.com> Sent: Monday,May 13,2024 2:26 PM To: Michaelis,Jessica Subject: [SPAM]-Final Planning Board inspection-Sec/Bloc/Lot#108.-4-11.3(DISH WIRELESS SITE @ BAXTER)SITE ID NYNYCO2191A (Z ues�r sc-aY cEtcancam - c+e�vA�l -S14- Wx )Pc tcn - T 1�" co t oc � + r Hi,jessica, My original email was returned.Please see information listed here. Final Planning Board inspection-Sec/Bloc/Lot# 108.4-11.3 (DISH WIRELESS SITE @ BAXTER) SITE ID NYNYCO2191A 5�bf ME .Wn a .. EIVED ......._._.................................._._....w_...... Me Planning Board 12:36 PMSENT jessicam,Vaidas Ciplys,Arif Mannichan,Kris Ramgarib,'ckillion' Jessica, I am requesting the final Planning Board site inspection for the above lot site located 415 Elijah Lane Mattituck. Could you please make the necessary arrangement and let me know. Regards, Carl King Main Office OFFICE LOCATION: 1V AILING ADDRESS: Town Hall Annex P.O.Box 1179 54375 State Route 25 � Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) Telephone: 631 765-1938 Southold,NY www.southoldtownny.gov PLANNING BOARD OFFICE TOWN OF SOUTHOLD August 23, 2022 Lois Rightmeyer c/o Dish Wireless and Crown Castle 695 Route 46 West Suite 300 Fairfield, NJ 07004 Re: Approval —Amended Site Plan for Dish Wireless @ Baxter Located at 415 Elijahs Lane, on the NW corner of the intersection of Elijah's Lane and NYS Route 25, Mattituck SCTM#1000-108-4-11.3 Zoning District: Limited Business (LB) Dear Ms. Rightmeyer: The following resolutions were adopted at a meeting of the Southold Town Planning Board on August 22, 2022: WHEREAS, this Amended Wireless Communications application is for a proposed Dish Wireless colocation at 88' a.g.l. on an approved 107'6" tall monopole, and the addition of associated ground equipment within a 75 sq. ft. lease area. There are three other carriers already located on this monopole, and there is an existing ±9,900 sq. ft. workshop building, all located on 1.85 acres in the Limited Business Zoning District; and WHEREAS, on November 1, 2021, Lois Rightmeyer, authorized agent, submitted a Building Permit application to the Building Department; and WHEREAS, on November 22, 2021, pursuant to §280-74A(4) of the Town Code, the Planning Board required the submission of $4,000 into an escrow account with the Town Comptroller's Office to cover the cost of the Technical Consultant's Review; and WHEREAS, on December 17, 2021, Lois Rightmeyer, authorized agent, submitted a check in the amount of $4,000 to the Office of the Planning Board; and WHEREAS, on June 24, 2022, Lois Rightmeyer, authorized agent, submitted an amended site plan application for review; and Southold Town Planning Board Page 12 August 23, 2022 WHEREAS, on July 7, 2022, the Planning Board authorized CityScape Consultants to proceed with the work as outlined in the agreement; and WHEREAS, at a Work Session on July 25, 2022, the Planning Board accepted the application as complete for review; and WHEREAS, on July 25, 2022, pursuant to Southold Town Code §280-131(H), the Southold Town Planning Board agreed to waive the requirement for a public hearing regarding this amended application which involves a wireless colocation on an approved existing monopole with no height increase or ground equipment compound expansion; and WHEREAS, at a Work Session held on August 8, 2022, the Planning Board reviewed the report issued by Cityscape Consultants on July 14, 2022; and, determined that the action falls within the FCC regulations of the Middle-Class Tax Relief and Job Creation Act of 2012. Therefore it is recommended for approval with the understanding that the proposed Hybrid cable will be installed inside the monopole shaft; and WHEREAS, at a Work Session held on August 8, 2022, the Planning Board found that all applicable requirements of the Site Plan Regulations Article XXIV, §280— Site Plan Approval of the Town of Southold have been met; and WHEREAS, at their public meeting on August 8, 2022, the Planning Board granted a Negative Declaration for the proposed Unlisted Action; be it therefore RESOLVED, that the Southold Town Planning Board grants Approval with conditions to the amended site plan entitled "Dish Wireless @ Elijah"s bane, Mattituck", prepared' by John S. Stevens, P.E., dated. September 3, 20�21 and last revised April 8, 2022, and authorizes the Chairman to endorse the site plan including the following plans: T-1 Title Sheet E-3 Electrical One-Line, Fault Calcs & Panels A-1 Overall and Enlarged Site Plan G-1 Grounding Plans and Notes A-2 Elevation, Antenna Layout and Schedule G-2 Grounding Details A-3 Equipment Platform and H Frame Details G-3 Grounding Details A-4 Equipment Details RF-1 RF Cable Color Code A-5 Equipment Details GN-1 Legend and Abbreviations A-6 Equipment Details GN-2 General Notes E-1 Electrical/Fiber Route Plan and Notes GN-3 General Notes E-2 Electrical Details GN-4 General Notes Conditions: 1. All new vertical feed lines/cables shall be installed inside the monopole structure; 2. All feed line access ports shall be sealed to prevent access by any birds or other wildlife; 3. The facility shall remain secured and protected from unauthorized personnel. Southold Town Planning Board Page 13 August 23, 2022 Please note the following requirements in the Southold Town Code relating to site plans: 1. Any outdoor lighting shall be shielded so the light source is not visible from adjacent properties and roadways. Lighting fixtures shall focus and direct the light in such a manner as to contain the light and glare within property boundaries. 2. All storm water run-off from grading, driveways and gravel areas must be contained on site. 3. Approved Site Plans are valid for eighteen months from the date of approval, within which time all proposed work must be completed, unless the Planning Board grants an extension. 4. Any changes from the Approved Site Plan shall require Planning Board approval. 5. Prior to the issuance of a Certificate of Occupancy, the Planning Board must inspect the site to ensure it is in conformity with the Approved Site Plan, and issue a final site inspection approval letter. Should the site be found not in conformance with the Approved Site Plan, no Certificate of Occupancy may be issued unless the Planning Board approves the changes to the plan. A copy of the Approved Site Plan is enclosed for your records. One copy will also be sent to the Building Department and the Town Engineer/Highway Department. If you have any questions regarding the above, please contact this office. Respectfully, Donald J. Wilcenski Chairman Encl. cc: Building Dept. w/map; Town Engineer w/map Southold Town Plan nin Board Work Session - July 22 02 P� o ect Name .._. . ..__... to . .m . .®. _._. ..w....6 . Location* w........�......._� 1135 Silvermere Road,,, � SCTM# 1000 4 5 ^ 7 21 ..�,...� , reenport pr � Silver Sands o ..w0. I Description: This Site Plan is fo p _ ..� � r the proposed conversion of an existing accessory storage building (boathouse) to a freestanding restaurant with office and 6 storage space for restaurant operations„ and conversion of an existing single-family dwelling to a commercial kitchen for the restaurant to include 111 indoor/outdoor seats and 19 parking stalls on 2.1 acres in the; Resort rtResidential Zoning_District. _ _ 9 ...._ ® ._ . Status: ... Review Referrals_&,Draft ZBA Comments A i ttachments; _ ...._wL.Staff aepo! . ..W .w__. . . _ __.. .... ..._w .......ect Name: Dish Wireless Colocation at J Project V SCTM# 1000 108.-4-11 3 dp BaxterLoc _..._.�_�_.._... .I.. Description:Lion: This Amended s„Lane, Mattituck . ,-PP __.... .. mended Wireless Communications application i w... _. Dish Wireless colocation at 88 p w..... s far a proposed ' ' a.g.l. on an approved 107'6" tall monopole, and the addition of associated ground equipment within a 75 sq. ft. lease area. There are three other carriers already located on this monopole, and there is an existing ±9,900 sq. ft. workshop building, all I the Limited Business Zoning District located on 1 85 acres in _ .. Status .M._._.. pproyed......... ....__ .. w._ _. ... ....... ....... Action: Review for CO ! Attachments: Staff Report _..... Southold Planning Department Staff Report Site Plan Application Work Session — Request for CO Date July 22, 2024 Prepared By: Mara Cerezo I. Application Information Project Title: Dish Wireless Colocation at Baxter Applicant: Dish Wireless Date of Submission: June 24, 2022 to Planning Tax Map Number: 108.-4-11.3 Project Location: 415 Elijah's Lane Hamlet: Mattituck Zoning District: LB- Limited Business II. Description of Project Type of Site Plan: Wireless colocation Acreage of Project Site: 1.85 acres Building Size 107'6" Tower existing (exterior mounted antenna) ±9,900sf existing This Amended Wireless Communications application is for a proposed Dish Wireless colocation at 88' a.g.l. on an approved 107'6" high concealment pole, and the addition of associated ground equipment within a 75 sq. ft. lease area. There is an existing ±9,900 sq. ft. workshop building on 1.85 acres in the Limited Business Zoning District. II. Analysis A. Existing 1. Approved 2012 site plan for colocation to 107'6" on existing tower originally constructed in 1992. Four carriers exist on the pole at 64'6" a.g.l., 81'3" a.g.l., 98'0" a.g.l and 107'6" a.g.l. including AT&T, Verizon, New Cingular and TMobile; 2. Related equipment cabinets, cables, and related hardware within ±5,100sf equipment compound B. Approved: Dish Wireless colocation: 1. Three (3) mounted panel antennas at 88' above ground level; 2. ±75 sf equipment compound lease area, GPS and cable transfers; Staff: The site appeared to be constructed as approved during the site inspection on May 31, 2024 , except for the open ports on the pole which are required to be sealed in order to prevent access from wildlife. After consulting the Tower Owner, 1 the applicant stated that this was a pre-existing condition on the tower and that poorly sealed ports created an ultimate fall hazard so they would not support this action. Planning staff reached out to CityScape for guidance since they are the Planning Board's technical consultant for wireless projects. CityScape stated that covering of ports is not a (tower ANSI) code requirement. Covers are not generally necessary other than aesthetics or protection from potential environmental debris (birds, leaves, etc.). Other municipalities have differing views on this topic. In addition, the applicant was told to keep in mind NYSDEC operating and maintenance guidelines when working near an active Osprey nest, as there appears to be an active nest built on the highest antenna array V: Item to Consider: A. Does the Planning Board support the issuance of a Certificate of Occupancy (CO) from the Building Department, based on the analysis above and the final site inspection findings? OFFICE LOCATION: MAILING ADDRESS: Town Hall Annex P.O.Box 1179 54375 State Route 25 �� Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) Southold, NY Telephone:631 766-1938 www.southoldtownny.gov PLANNING BOARD OFFICE TOWN OF SOUTHOLD August 23, 2022 Lois Rightmeyer c/o Dish Wireless and Crown Castle 695 Route 46 West Suite 300 Fairfield, NJ 07004 Re: SEQRA: Amended Site Plan for Dish Wireless @ Baxter 415 Elijah's Lane, n/w corner of Elijah's Lane & NY State Route 25, Mattituck SCTM#1000-108-4-11.3 Zoning District: Limited Business (LB) Dear Ms. Rightmeyer: The following resolution was adopted at a meeting of the Southold Town Planning Board on August 22, 2022: WHEREAS, this Amended Wireless Communications application is for a proposed Dish Wireless colocation at 88' a.g.l. on an approved 107'6" tall monopole, and the addition of associated ground equipment within a 75 sq. ft. lease area. There are three other carriers already located on this monopole, and there is an existing t9,900 sq. ft. workshop building, all located on 1.85 acres in the Limited Business Zoning District; and WHEREAS, the applicant submitted an amended site plan application for review on June 24, 2022; and WHEREAS, at a Work Session held on July 25, 2022, the Planning Board accepted the application for review; and WHEREAS, the Southold Town Planning Board, pursuant to State Environmental Quality Review Act (SEQRA) 6 NYCRR, Part 617, has determined that the proposed action is an Unlisted Action as it does not meet any of the thresholds of a Type I Action, nor does it meet any of the criteria on the Type II list of actions; be it therefore RESOLVED, that the Southold Town Planning Board has determined that this proposed action is an Unlisted Action under SEQRA as described above; and be it further Southold Town Planning Board Page 2 August 23, 2022 RESOLVED, that the Southold Town Planning Board, pursuant to the State Environmental Quality Review Act, makes a determination of non-significance and grants a Negative Declaration. A copy of the Negative Declaration is enclosed for your records. If you have any questions regarding the above, please contact this office. Respectfully, Donald J. Wilcenski Chairman Encl. OFFICE LOCATION: MAILING ADDRESS: Town Hall Annex �� � �� P.O.Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) Southold, NY Telephone:631 765-1938 www.southoldtownny.gov PLANNING BOARD OFFICE TOWN OF SOUTHOLD State Environmental Quality Review NEGATIVE DECLARATION Notice of Determination Non-Significance August 8, 2022 This notice is issued pursuant to Part 617 of the implementing regulations pertaining to Article 8 (State Environmental Quality Review Act) of the Environmental Law. The Southold Town Planning Board, as lead agency, has determined that the proposed action described below will not have a significant effect on the environment and a Draft Environmental Impact Statement will not be prepared. Name of Action: DISH Wireless Colocation at Baxter SCTM#: 1000-108-4-11.3 Location: 415 Elijah's Lane, Mattituck SEQR Status: Type ] ( ) Unlisted (X) Conditioned Negative Declaration: Yes ( ) No (X) Description of Action: This Amended Wireless Communications application is for a proposed Dish Wireless colocation at 88' a.g.l. on an approved 107'6" tall monopole, and the addition of associated ground equipment within a 75 sq. ft. lease area. There are three other carriers already located on this monopole, and there is an existing ±9,900 sq. ft. workshop building, all located on 1.85 acres in the Limited Business Zoning District. Reasons Supporting This Determination: An Environmental Assessment Form has been submitted and reviewed and it was determined that no significant adverse effects to the environment were likely to occur should the project be implemented as planned. The property is currently improved with a 108' flagpole monopole and multi-equipment structures within a fenced compound (see photo below). .A 91i r r r"� q �+° ���✓� , ��/' �i "`��f� � "r �"� ti *"-� y,r y� ,. '" a ^ .,,�r ► ,a �+j/�r. � l�l� a i �. � xe �x,k, / ; %fir o�V� ir+ ✓ /W ti /�� � /a%''r�i�✓ 4$f :. � �� A r'�"�'; W) ^"„ i �';�'� fir:.�r ✓r�'4 �,..' "'�,WMM rr7 r n r ,,ii/ B �' ii // a / wr✓ r r t yiUJ G 1r rri/ I>Di /. rLL i 7 ✓ //l/ � ,^� r r/ �° - e'. dw rrir i r %r'�" ,� t %(�� / ( �'�r t 1 ,a 'Yi"a �` � , ,4r � %rv�i �✓ f,✓ "r "tYYf l Ali, kw� / rl f/4,:, /N°w r r j �:w'w dif/F�r�i y r Ji�'� ! /� r k.' •""M, �"y`'".,° r ,w �i �,� �;`��� �+w ,a: l�"�°✓�ra r,�rf �,`i -;' w"-,;•�`«�+� ,,�""�"+"a "�ti,r�µ.,�,, wr� Figure 1. 108' monopole with antennae arrays The property is zoned Limited Business (LB). Zoning districts located within the vicinity of the parcel include R-40 (Residential) to the north, east, west and south. The zones R-80 (Residential) and AC (Agricultural Conservation) occur to the south and southeast of the parcel. The land use on site is storage and telecommunication facilities. Surrounding land uses within the vicinity of the site are residential and business (an auto parts store is located to the south). Based on the existing use and improved facilities, the proposed action will not cause a substantial intensification of use over the current use. Further, the proposed action will not cause significant impacts to agricultural, open space, or recreational resources. The proposal will minimize ground disturbance. No substantial adverse change in existing air quality, ground or surface water quality or quantity, traffic, or noise level is expected due to this colocation. The tower is visible from New York State 25; a New York State Scenic Byway and secondary roads. Dish wireless proposes to add 3 antennas, 6 radio units and 1 hybrid to the existing tower. All will be external. The Planning Board has determined that the placement of antennas on the existing monopole will not result in significant impacts on the view sheds important to the community due to the current use and operation of a wireless monopole on-site. Equipment cabinets are located in a fenced compound surrounded by vegetation and are not visible from public areas. No major change in the use of either the quantity or type of energy will occur. 2 The applicant has submitted an assessment a Structural Analysis Report. Cityscape, the Town of Southold consultant on the project indicates that the structural usages were determined to be 86.2% of Maximum Tower Capacity and 83.2% of Maximum Foundation Capacity. A Radio Frequency (RF) Compliance report was also submitted and concluded that the radio frequency emissions from the combination of the existing and proposed antenna are in compliance with FCC Maximum Permissible Exposure (MPE) limits (1997). Maximum exposure at ground level was determined to be 15.3% of the FCC general population Maximum Public Exposure level (MPE). Therefore, no known creation of a hazard to human health is expected to occur as a result of the proposed action. No significant removal or destruction of large quantities of vegetation will occur. The New York Department of Environmental Conversation in a 2009 policy memorandum entitled Guidelines for Consultation with NY Natural Heritage regarding Proposed Collocations of Telecommunication Facilities on Existing Towers and Buildings (2009) has determined that proposed actions involving the co-location of new equipment on an existing structure (tower) are not likely to adversely affect Federally- listed species in New York, nor have any significant impacts on migratory birds or other trust resources. Therefore, no substantial interference with the movement of any resident or migratory fish or wildlife species, significant habitat area or result in adverse impacts to a threatened or endangered species or the habitat of such a species are expected to occur. No significant, new ground disturbance will occur, therefore, the action would not result in adverse impacts on cultural/historic resources nor impair the character or quality of important historical resources. The site is currently improved and the proposed action will not result in significant adverse impacts to aesthetic resources or to existing community or neighborhood character or result in a material conflict with the community's current plans or goals as officially approved. Based upon such, no significant adverse environmental impacts are expected to occur should the project be implemented as planned. For Further Information: Contact Person: Mark Terry, Assistant Town Planning Director Address: Southold Town Planning Board Telephone Number: 631-765-1938 cc: Town Board Building Dept. 3 Agency Use 0 rdy[If applicable] Full Environmental Assessment Form Project! IDish Colocation Baxter Part 2-Identification of Potential Project Impacts Date: ugust z2,2ozz Part 2 is to be completed by the lead agency. Part 2 is designed to help the lead agency inventory all potential resources that could be affected by a proposed project or action. We recognize that the lead agency's reviewer(s)will not necessarily be environmental professionals. So,the questions are designed to walk a reviewer through the assessment process by providing a series of questions that can be answered using the information found in Part 1. To further assist the lead agency in completing Part 2,the form identifies the most relevant questions in Part 1 that will provide the information needed to answer the Part 2 question. When Part 2 is completed,the lead agency will have identified the relevant environmental areas that may be impacted by the proposed activity. If the lead agency is a state agency and the action is in any Coastal Area,complete the Coastal Assessment Form before proceeding with this assessment. Tips for completing Part 2: • Review all of the information provided in Part 1. • Review any application,maps,supporting materials and the Full EAT Workbook. • Answer each of the 18 questions in Part 2. • If you answer"Yes"to a numbered question,please complete all the questions that follow in that section. • If you answer"No"to a numbered question,move on to the next numbered question. • Check appropriate column to indicate the anticipated size of the impact. • Proposed projects that would exceed a numeric threshold contained in a question should result in the reviewing agency checking the box"Moderate to large impact may occur." • The reviewer is not expected to be an expert in environmental analysis. • If you are not sure or undecided about the size of an impact,it may help to review the sub-questions for the general question and consult the workbook. • When answering a question consider all components of the proposed activity,that is,the"whole action". • Consider the possibility for long-term and cumulative impacts as well as direct impacts. • Answer the question in a reasonable manner considering the scale and context of the roject. 1. Impact on Land Proposed action may involve construction on, or physical alteration of, ®NO ❑YES the land surface of the proposed site. (See Part 1. D.1) I "Yes", answer questions a-j. ff"No", move on to Section 2, Relevant No,or Moderate Part I small to large Question(s) impact impact may may occur occur a.The proposed action may involve construction on land where depth to water table is E2d ❑ ❑ less than 3 feet. b.The proposed action may involve construction on slopes of 15%or greater„ Elf ❑ c.The proposed action may involve construction on land where bedrock is exposed,or Eta ❑ ❑ generally within 5 feet of existing ground surface. d.The proposed action may involve the excavation and removal of more than 1,000 tons 132a ❑ of natural material. e.The proposed action may involve construction that continues for more than one year Dle ❑ 13 or in multiple phases. f.The proposed action may result in increased erosion,whether from physical D2e,D2q ❑ ❑ disturbance or vegetation removal(including from treatment by herbicides). g.The proposed action is,or may be,located within a Coastal Erosion hazard area. B 1 i ❑ ... 13 h.Other impacts: ❑ Page 1 of 10 FEAF 2019 ............ ...�._................ 2. Impact on Geological Features The proposed action may result in the modification or destruction of, or inhibit access to, any unique or unusual land forms on the site(e.g.,cliffs, dunes, ONO ❑YES minerals, fossils, caves). (See Part 1. E.2.g) f" s a-c. If No", move on to Section 3. I Yes answer questions ._.. ........-.... .._.... Relevant No,or Moderate Part I small to large Question(s) impact impact may may occur occur a.Identify the specific land form(s)attached: E2g b.The proposed action may affect or is adjacent to a geological feature listed as a E3ca registered National Natural Landmark. Specific feature: c. Other impacts:....._. ....... _ _._._. _. 3. Impacts on Surface Water The proposed action may affect one or more wetlands or other surface water ONO ❑YES bodies(e.g.,streams,rivers,ponds or lakes). (See Part 1.D.2,E.21) If"Yes answer questions a-1. I "No", move on to Section 4. Relevant No,or Moderate Part I small to large Question(s) impact impact may ........ _._ ma occur occur a.The proposed action may create a new water body. I D2b,Dlh ❑ .......... ...... ...... b.The proposed action may result in an increase or decrease of over 10%or more than a 132b ❑ ❑ 10 acre increase or decrease in the surface area of.any body of water„ c.The proposed action may involve dredging more than 100 cubic yards of material 132a from a wetland or water body.. d.The proposed action may involve construction within or adjoining a freshwater or E2h ❑ ❑ tidal wetland,or in the bed or banks of any other water body. e.The proposed action may create turbidity in a waterbody,either from upland erosion, D2a,132h ❑ runoff or by disturbing bottom sediments. f.The proposed action may include construction of one or more intake(s)for withdrawal D2c ❑ of water from surface water. .... ....-.... ........._. .... ..... ........ ........ .. _..... g.The proposed action may include construction of one or more outfall(s)for discharge D2d ❑ ❑ of wastewater to surface water(s). h.The proposed action may cause soil erosion,or otherwise create a source of D2e ❑ ❑ stormwater discharge that may lead to siltation or other degradation of receiving water bodies. i.The proposed action may affect the water quality of any water bodies within or E2h D downstream of the site of the proposed action. j.The proposed action may involve the application of pesticides or herbicides in or D2q,E2h ❑ ❑ around any water body. k.The proposed action may require the construction of new,or expansion of existing, D 1 a,D2d n ❑ wastewater treatment facilities. Page 2 of 10 1.Other impacts: ❑ ...... ..................................... 4. Impact on groundwater The proposed action may result in new or additional use of ground water, or ONO ❑YES may have the potential to introduce contaminants to ground water or an aquifer. (See Part 1. D.2.a,D.2.c,D.2.d,D.2.p,D.2.q,D.2.t) If'"Yes'., answer questions a-h. If"No"" move on to Section 5. Relevant No,or Moderate Part I small to large Question(s) impact impact may mI occur occur a.The proposed action may require new water supply wells,or create additional demand D2c Cl I ❑ on supplies from existing water supply wells. b.Water supply demand from the proposed action may exceed safe and sustainable D2c ❑ ❑ withdrawal capacity rate of the local supply or aquifer. Cite Source: ___ __.. c.The proposed action may allow or result in residential uses in areas without water and D 1 a,D2c ❑ sewer services. d.The proposed action may include or require wastewater discharged to groundwater. D2d,E21 ° ° e.The proposed action may result in the construction of water supply wells in locations D2c,E If, ❑' where groundwater is,or is suspected to be,contaminated. Elg,Elh f.The proposed action may require the bulk storage of petroleum or chemical products D2p,E21 ❑ ❑ over ground water or an aquifer. g.The proposed action may involve the commercial application of pesticides within 100 E2h,D2q, feet of potable drinking water or irrigation sources. E21,D2c h. Other impacts: ry_ FJ T 5. Impact on Flooding he proposed action ma y result in development on lands subject to flooding. ❑✓ NO ❑YES (See Part 1.E.2) I""Yes", answer questions a-.g. t°"No"„ move on to Section 6. Relevant No,or Moderate Part I small to large Question(s) impact impact may May occur occur a.The proposed action may result in development in a designated floodway. E2i ❑ 0! _. ......... b.The proposed action may result in development within a 100 year floodplain. E2j ❑ ❑ ............--........... ..._ _._._ ..... ...................._ c.The proposed action may result in development within a 500 year floodplain. Elk ❑' ° d.The proposed action may result in,or require,modification of existing drainage D2b,D2e 113 Q patterns. e.The proposed action may change flood water flows that contribute to flooding. 132b,E2i, n 0 ?j=E2k f.If there is a dam located on the site of the proposed action,is the dam in need of repair, Ele ❑ ❑ or aipgrade'r Page 3 of 10 . ..... g.Other impacts: ❑ ❑ _.� ........ 6. Impacts on Air The proposed action may include a state regulated air emission source. ❑✓NO ❑YES (See Part 1. D.2.f.,D.2.h,D.2.g) If"Yes", answer questions a-f If"No", move on to Section 7. Relevant No,or Moderate Part I small to large Question(s) impact impact may may occur occur a.If the proposed action requires federal or state air emission permits,the action may also emit one or more greenhouse gases at or above the following levels: i. More than 1000 tons/year of carbon dioxide(CO2) D2g ❑ ❑ ii. More than 3.5 tons/year of nitrous oxide(N20) D2g ❑ iii.More than 1000 tons/year of carbon equivalent of perfluorocarbons(PFCs) D2g 11 iv.More than.045 tons/year of sulfur hexafluoride(SF6) D2g v. More than 1000 tons/year of carbon dioxide equivalent of D2g hydrochloroflourocarbons(HFCs)emissions 10 vi.43 tons/year or more of methane D2h ❑ b.The proposed action may generate 10 tons/year or more of any one designated D2g 0 ❑ hazardous air pollutant,or 25 tons/year or more of any combination of such hazardous air pollutants. ... .... c.The proposed _..._..-.. .-... ... ....... m..... . .._....- p p action may require a state air registration,or may produce an emissions D2f,D2g 0 ❑ rate of total contaminants that may exceed 5 lbs.per hour,or may include a heat source capable of producing more than 10 million BTU's per hour. d.The proposed action may reach 50%of any of the thresholds in"a"through"c", D2g ❑ above. e.The proposed action may result in the combustion or thermal treatment of more than 1 D2s ❑ ❑ ton of refuse per hour. f.Other impacts: ❑ Ca _7» .................. ..._ .......... - Impact on Plants and Animals The proposed action may result in a loss of flora or fauna. (See Part 1.E.2.m.-q.) ❑✓NO DYES If"Yes", answer questions a-J. If"No", move on to Section 8. Relevant No,or Moderate Part I small to large Question(s) impact impact may may occur occur a.The proposed action may cause reduction in population or loss of individuals of any Ego 0, ❑ threatened or endangered species,as listed by New York State or the Federal government,that use the site,or are found on over,or near the site. b.The proposed action may result in a reduction or degradation of any habitat used by Ego 113 any rare,threatened or endangered species,as listed by New York State or the federal government. ......._� _....... c.The proposed action may cause reduction in population,or loss of individuals,of any E2p ❑ species of special concern or conservation need,as listed by New York State or the Federal government,that use the site,or are found on,over,or near the site. d.The proposed action may result in a reduction or degradation of any habitat used by E2p ❑ ❑'' any species of special concern and conservation need,as listed by New York State or the Federal government. Page 4 of 10 .............. _._._._. m ____ _ _ .... ...... e.The proposed action may diminish the capacity of a registered National Natural E3c ru Landmark to support the biological community it was established to protect. f.The proposed action may result in the removal of,or ground disturbance in,any E2n t portion of a designated significant natural community. Source: g.The proposed action may substantially interfere with nesting/breeding,foraging,or Elm ❑ o over-wintering habitat for the predominant species that occupy or use the project site. h.The proposed action requires the conversion of more than 10 acres of forest, Elb grassland or any other regionally or locally important habitat. Habitat type&information source: i.Proposed action(commercial,industrial or recreational projects,only)involves use of D2q ❑ ❑ herbicides or pesticides. .. j.Other impacts: 8 PpAgricultural g Resources The proposed action may impact agricultural resources. (See Pa rt 1. E.3.a. and b.) WINO ❑YES I "Yes", answer questions a-h. If"No"„ move on to Section 9 Relevant No,or Moderate Part I small to large Question(s) act impact may Q �s) impact P Y may occur occur ..... .. .............. ........ .......... ..... a.The proposed action may impact soil classified within soil group 1 through 4 of the E2c,E3b ❑ ❑ NYS Land Classification S stern. b.The proposed action may sever,cross or otherwise limit access to agricultural land Ela,Elb El 0 (includes cropland,hayfields,pasture,vineyard,orchard,etc). c.The proposed action may result in the excavation or compaction of the soil profile of E3b active agricultural land. d.The proposed action may irreversibly convert agricultural land to non-agricultural Elb,E3a ❑ ❑' uses,either more than 2.5 acres if located in an Agricultural District,or more than 10 acres if not within an Agricultural District. ...., e.The proposed action may disrupt or prevent installation of an agricultural land El a,Elb ❑ management system. ..... ........ _ _._..... _. _. £The proposed action may result,directly or indirectly,in increased development C2c,C31 0 potential or pressure on farmland. D2c,D2d g.The proposed project is not consistent with the adopted municipal Farmland C2c ❑ El Protection Plan. h.Other impacts: _ ❑ ❑ Page 5 of 10 .......... ............. _.. 9. Impact on Aesthetic Resources The land use of the proposed action are obviously different from,or are in NO EYES sharp contrast to,current land use patterns between the proposed project and a scenic or aesthetic resource. (Part 1.E.La,E.Lb,E.31.) If"Yes answer questions a-g. f No", go to Section 10. ...... ......._ _ ....... Relevant No,or Moderate Part I small to large Question(s) impact impact may ma occur occur a.Proposed action may be visible from any officially designated federal,state,or local E3h 0 scenic or aesthetic resource. b.The proposed action may result in the obstruction,elimination or significant E3h,C2b ?$' ❑ screening of one or more officially designated scenic views. c.The proposed action may be visible from publicly accessible vantage points: E3h i.Seasonally(e.g.,screened by summer foliage,but visible during other seasons) ❑' ii.Year round ....... d.The situation or activity in which viewers are engaged while viewing the proposed E3h action is: E2q, i. Routine travel by residents,including travel to and from work based activities Elc 0 ❑ ii.Recreational or tourism 0 ❑ e.The proposed action may cause a diminishment of the public enjoyment and E3h ❑ appreciation of the designated aesthetic resource. .......... ..... ............. ..... ...... f. There are similar projects visible within the following distance of the proposed Dla,Ela, project: Dlf,Dlg 0-1/2 mile '/2-3 mile 3-5 mile 5+ mile g.Other impacts: _ ...... ....... ❑ ..... .............. ............................ .............. ......... 10. Impact on Historic and Archeological Resources The proposed action may occur in or adjacent to a historic or archaeological NO YES resource. (Part 1. E.3.e,f. and g.) If"Yes", answer questions a-e. If"No",go to Section 11. Relevant No,or Moderate Part I small to large Question(s) impact impact may a....."1��e proposed sect action ......... a ...occur whtoll or partially within,or s�._—` _........__. may occur-.- ..___sic. ar ......... p of y ...c y.___ y it �bstantially contiguous to,any buildings,archaeological site or district which is listed on the National or De 0 0 State Register of Historical Places,or that has been determined by the Commissioner of the NYS Office of Parks,Recreation and Historic Preservation to be eligible for listing,on the State Register of Historic Places. b.The proposed action may occur wholly or partially within,or substantially contiguous E3f ❑ to,an area designated as sensitive for archaeological sites on the NY State Historic Preservation Office(SHPO)archaeological site inventory. c.The proposed action may occur wholly or partially within,or substantially contiguous E3g ❑ ❑ to,an archaeological site not included on the NY SHPO inventory. Source: Page 6 of 10 d.Other impacts: ❑ ❑ ._........_.... ....... _ ....... If any of the above(a-d)are answered"Moderate to large impact may C. occur",continue with the following questions to help support conclusions in Part 3: i. The proposed action may result in the destruction or alteration of all or part De,E3g, ❑ ❑ of the site or property. E3f ii. The proposed action may result in the alteration of the property's setting or De,E31 ❑ ❑ integrity. E3g,Ela, Elb iii. The proposed action may result in the introduction of visual elements which De,E3f, 11 are out of character with the site or property,or may alter its setting. E3g,E3h, C2,C3 ...__. ............ 11. Impact on Open Space and Recreation The proposed action may result in a loss of recreational opportunities or a �NO YES reduction of an open space resource as designated in any adopted municipal open space plan. (See Part 1. C.2.c,E.l.c., E.2.q.) If"Yes", answer questions a-e. If"No", go to Section 12, Relevant No,or Moderate Part I small to large Question(s) impact impact may ma occur occur a.The proposed action may result in an impairment of natural functions,or"ecosystem D2e,Elb ❑ ❑ services",provided by an undeveloped area,including but not limited to stonnwater E2h, storage,nutrient cycling,wildlife habitat. Elm,E2o, E2n,E2 b.The proposed action may result in the loss of a current or future recreational resource. C2a,E I c, ❑ C2c,E29 c.The proposed action may eliminate open space or recreational resource in an area C2a,C2c ❑ ❑ with few such resources. Elc,E2q d.The proposed action may result in loss of an area now used informally by the C2c,Elc ❑ )mrrtt pity.as an open space resource. e. Other impacts:_ ❑ nta 12. Impact on Critical Environmen tal 1 Areas The proposed action may be located within or adjacent to a critical 1 NO YES environmental area(CEA). (See Part 1.E.3.d) If"Yes", answer questions a-c. I "No", o to Section 13. Relevant No,or Moderate Part I small to large Question(s) impact impact may Ma occur occur a.The proposed action may result in a reduction in the quantity of the resource or E3d ❑ ❑ CEA. characteristic which was the basis for designation o the .... __.. .............. .... b.The proposed action may result in a reduction in the quality of the resource or E3d ❑ ❑' characteristic which was the basis for designation of the CEA. c.Other impacts: ❑ ❑ Page 7 of 10 ........ 13. Impact on Transportation The proposed action may result in a change to existing transportation systems. ❑✓ NO YES (See Part 1. D.2.j) If"Yes'', answer questions a-f. If"No",go to Section 14, FReervant No,or Moderate small to large (s) impact impact may ma occur occur a.Projected traffic increase may exceed capacity of existing road network. D2j ❑ ❑ b.The proposed action may result in the construction of paved parking area for 500 or D2j ❑ Q more vehicles. c.The proposed action will degrade existing transit access. D2j ❑ �' d.The proposed action will degrade existing pedestrian or bicycle accommodations. D2j ❑ 11 ... e.The proposed action may alter the present pattern of movement of people or goods. D2j ❑ f. Other impacts, _IT _,_,_, p _. ........ .......... 14. Impact on Energy The proposed action may cause an increase in the use of any form of energy. ONO ❑✓ YES (See Part 1. 13.21) "Yes", answer questions a-e. If"No",go to Section I5. L. __..... ............................... Relevant No or Moderate Part I small to large Question(s) impact impact may may occur occur a.The proposed action will re uire a new,or an u ade to an existin ,substation. D2k 0 ❑ _....... ....._. .__•_ _.. . b.The proposed action will require the creation or extension of an energy transmission Dlf, 0 El or supply system to serve more than 50 single or two-family residences or to serve a Dlq,D2k _commercial or industrial use. c.The may action proposed y ut ilize more than 2,500 MVVhrs per year of electricity. D2k d.The proposed action may involve heating and/or cooling of more than 100,000 square Dlg 0 ❑ feet of building area when completed. e.Other Impacts:.m._ _ ❑ ❑ ... ........ ..................................... ..................... .. _....._...._ __..... 15. Impact on Noise,Odor,and Light The proposed action may result in an increase in noise,odors,or outdoor lighting. �✓ NO DYES (See Part 1.D.2.m.,n., and o.) If"Yes", answer Auestions a_-f. If"No", to Section 16. _._._. _. Relevant No,or Moderate Part I small to large Question(s) impact impact may may occur occur _......... ......... a.The proposed action may produce sound above noise levels established by local D2m regulation. b.The proposed action may result in blasting within 1,500 feet of any residence, D2m,Eld hospital,school,licensed day care center,or nursing home. c.The proposed action may result in routine odors for more than one hour per day. D2o ❑ ❑ Page 8 of 10 d.The proposed action may result in light shining onto adjoining properties. D2n [ e.The proposed action may result in lighting creating sky-glow brighter than existing D2n,Ela t D area conditions. f.Other impacts: _.... _......._...,.-.... ...-.. _...... ....... ..... ...... 16. Impact on Human Health The proposed action may have an impact on human health from exposure NO ❑✓ YES to new or existing sources of contaminants. (See Part 1.D.2.q.,E.1. d.f. g. and h.) If"Yes", answer questions a-m. If No",go to Section 17, Relevant No,or Moderate Part I small to large Question(s) impact impact may may cccur occur ......... ...... a.The proposed action is located within 1500 feet of a school,hospital,licensed day Eld ri care center,group home,nursing home or retirement communi . b.The site of the proposed action is currently undergoing remediation. Elg,Elh 0 ❑ ....... _._ _ ......... c.There is a completed emergency spill remediation,or a completed environmental site Elg,Elh 0 rem_ediation on,or adjacent to,the site of the proposed action. d.The site of the action is subject to an institutional control limiting the use of the Elg,Elh 0 property(e.g.,easement or deed restriction). e.The proposed action may affect institutional control measures that were put in place Elg,Elh 0 to ensure that the site remains protective of the environment and human health. ........ ........ �.... ......._ ...... ._ .... f.The proposed action has adequate control measures in place to ensure that future D2t ❑ generation,treatment and/or disposal of hazardous wastes will be protective of the environment and human health. g.The proposed action involves construction or modification of a solid waste D2q,Elf management facility h.nThe proposed action may result in the unearthing of solid or hazardous waste, D2q,Elf ' i.The proposed action may result in an increase in the rate of disposal,or processing,of D2r,D2s solid waste. j.The proposed action may result in excavation or other disturbance within 2000 feet of Elf,Elg ❑ a site used for the dis,osal of solid or hazardous waste. Elh k.The proposed action may result in the migration of explosive gases from a landfill Elf,Elg ❑ site to adjacent off site structures. 1.The proposed action may result in the release of contaminated leachate from the D2s,Elf, 0 project site. D2r .................. ......... ............ ......_. ....... i in.Other impacts: ... �_.. .........._............. �I ❑ Page 9 of 10 ...........�. _..... _._. ._. __... 17. Consistency with Community Plans The proposed action is not consistent with adopted land use plans. ❑✓ NO YES (See Part 1. C.1,C.2. and C.3.) If"Yes", answer questions a-h. If"No", go to Section 18. Relevant No,or Moderate Part I small to large Question(s) impact impact may may occur occur a.The proposed action's land use components may be different from,or in sharp C2,C3,Dla ❑ LI contrast to,current surrounding land use pattem(s). Ela,Elb b.The proposed action will cause the permanent population of the city,town or village C2 ❑' 11 in which the project is located to grow by more than 5%. c.The proposed action is inconsistent with local land use plans or zoning regulations. C2,C2,C3 ❑ ❑ .___... .................... d.The proposed action is inconsistent with any County plans,or other regional land use C2,C2 ❑ ❑ plans. ....... ........ e.The proposed action may cause a change in the density of development that is not C3,Dlc, ❑ supported by existing infrastructure or is distant from existing infrastructure. D 1 d,D 1 f, Dld,Elb ...._........__ _...___ ......., ... ' _..__ ............... f.The proposed action is located in an area characterized by low density development C4 D2c,D2d that will require new or expanded public infrastructure. D2j _. ............. g.The proposed action may induce secondary development impacts(e.g.,residential or C2a ❑ ❑ commercial development not included in the proposed action) h.Other: _........................__ ........................... ................. 18. Consistency with Community Character The proposed project is inconsistent with the existing community character. �✓NO YES (See Part 1. C.2,C.3,D.2, E.3) If"Yes", answer questions a-g. If"No", roceed to Part 3. Relevant No,or Moderate Part I small to large Question(s) impact impact may mad occur occur a.The proposed action may replace or eliminate existing facilities,structures,or areas De,E3f,E3g ❑ ❑ of historic importance to the community. b.The proposed action may create a demand for additional community services(e.g. C4 schools,police andfire) c.The proposed action may displace affordable or low-income housing in an area where C2,C3,Dlf ❑ ❑ there is a shortage of such housing. D l g,E l a _ d.The proposed action may interfere with the use or enjoyment of officially recognized C2,E3 ❑ ❑ or designated public resources. e.ITTheITproposed action is inconsistent with the predominant architectural scale and C2,C3 character. f.Proposed action is inconsistent with the character of the existing natural landscape. C2,C3 ❑ Ela,Elb E2 ,Egg h g.Other impacts:........... PRINT FULL FORM Page 10 of 10 Southold Town Plannin Board Work Session Au ust 8 2022. -- Pa e 3 _" .... � 1000-108-4-11 3Name: DWireless C ol -cation tm SCTM#:Project Baxter .._ _. .._.. proposed n Location. . � � 415 Ehlh's Lane, Mattituck Communications application is fora Description: Dish Wireless dcolocat on at 88' a g-1 pp . on an approved 107'6" tall monopole, and the addition of associated ground equipment within a 75 sq. ft. lease area. There are three other carriers already located on this monopole, and there is an existing t9,900 sq. ft. workshop building, all _ located on 1.85 acres in the Limited Business Zoning lstrict Status Review for Determination _ Action. _ Staff Report Attachments ...... St._._ ...�........�� ....,.�....._ , . Discussion: ❖ Planning Board Monthly Report for July, 2022 ❖ ZBA Requests for Planning Board Comments: o Roland Grant, 800 Horton Lane, Southold SCTM#1000-63-1-9 DUE: 9/1/22 o Elyse James & John Sinning, 5000 & 5300 Paradise Point Road, Southold SCTM#1000-81-3-1.4 & 24.3 DUE: 9/1/22 ❖ Future Site Plan Application Process (expedited reviews): o Hard Corner Partners Restaurant, Retail & Apartment, 210 Pike Street, Mattituck, SCTM#1000-141-4-6.1 o North Cliff Vineyard Storage Building, 7305 Wickham Avenue, Mattituck, SCTM#1000-107-5-6.3 Southold Planning Department Staff Report Site Plan Application Work Session -Analysis Date August 8, 2022 Prepared By: Brian Cummings I. Application Information Project Title: Dish Wireless Colocation at Baxter Applicant: Dish Wireless Date of Submission: June 24, 2022 to Planning Tax Map Number: 108.4-11.3 Project Location: 415 Elijah's Lane Hamlet: Mattituck Zoning District: LB- Limited Business II. Description of Project Type of Site Plan: Wireless colocation Acreage of Project Site: 1.85 acres Building Size 107'6" Tower existing (exterior mounted antenna) ±9,900sf existing This Amended Wireless Communications application is for a proposed Dish Wireless colocation at 88' a.g.l. on an approved 107'6" high concealment pole, and the addition of associated ground equipment within a 75 sq. ft. lease area. There is an existing ±9,900 sq. ft. workshop building on 1.85 acres in the Limited Business Zoning District. A. Existing: 1. Approved 2012 site plan for colocation to 107'6" on existing tower originally constructed in 1992. Four carriers exist on the pole at 64'6" a.g.l., 81'3" a.g.l., 98'0" a.g.l and 107'6" a.g.l. including AT&T, Verizon, New Cingular and TMobile; 2. Related equipment cabinets, cables, and related hardware within ±5,100sf equipment compound B. Proposed Dish Wireless colocation: 1. Three (3) mounted panel antennas at 88' above ground level; 2. ±75sf equipment compound lease area, GPS and cable transfers; C. C,ItvScape Technical report dated July 11 2022: 1 Dish Wireless @ Baxter 1. Structural Analysis dated April 11, 2022 shows the tower at 86.2% of maximum storage capacity (out of an allowable 105%) and base foundation at 83.2% (out of an allowable 110%) and is sufficient; 2. RF Exposure Analysis dated February 16, 2022 found consistent with FCC guidelines and takes into account the operations at the facility of existing Verizon, AT&T and other personal wireless facilities known to operate at this site; 3. Conclusion: i. The application meets the requirements of an eligible facility and recommends approval for streamlined processing and administrative approval, with the understanding that the Hybrid cable will be installed inside the monopoles shaft. ii. The applicant is reminded that any planned a ui meat changes that differ from the submitted Construction Drawings must be filed with the Town for review and approval., V: Item to consider: Based on the analysis referenced above and included in the CityScape Technical Report dated July 11, 2022, all site plan requirements have been met and the Planning Board may make a determination of approval at tonight's Public Meeting. 2 Southold Town Plannina Board Work Session — July 25 2022 — Page 4 Project Name. Baxter ireless Colo _ ...... - cation at f SCTM# � 1000 108 4 11 3 L 415� ia .� � sDescri tion: This s Amended Communications application is f�or a. pro posed Dish Wireless colocation at 88' a.g.l. on an approved 107'6' tall monopole, and the addition of associated ground equipment within a 75 sq. ft. lease area. There are three other carriers already located on this monopole, and there is an existing ±9,900 sq. ft. workshop building, all PP a Limited Busines s Zoning District. [ Status.... _. . .. located on acres in New A licat.on Review for Completeness Action, ........... �.. ..... "'"'.. -. ........._. � ........ .. ....... _ Attachments. I Staff Report......------- Discussion: ❖ Site Plan Use Determinations (SPUD): o Hard Corner Partners Restaurant & Market, 210 Pike Street, Mattituck, SCTM#1000-141-4-6.1 o North Cliff Vineyard Storage Building, 7305 Wickham Avenue, Mattituck, SCTM#1000-107-5-6.3 Southold Planning Department Staff Report Site Plan Application Work Session - Completeness Date July 25, 2022 Prepared By: Brian Cummings I. Application Information Project Title: Dish Wireless Colocation at Baxter Applicant: Dish Wireless Date of Submission: June 24, 2022 to Planning Tax Map Number: 108.4-11.3 Project Location: 415 Elijah's Lane Hamlet: Mattituck Zoning District: LB- Limited Business II. Description of Project Type of Site Plan: Wireless colocation Acreage of Project Site: 1.85 acres Building Size 107'6" Tower existing (exterior mounted antenna) ±9,900sf existing This Amended Wireless Communications application is for a proposed Dish Wireless colocation at 88' a.g.l. on an approved 107'6" high concealment pole, and the addition of associated ground equipment within a 75 sq. ft. lease area. There is an existing ±9,900 sq. ft. workshop building on 1.85 acres in the Limited Business Zoning District. A. Existing: 1. Approved 2012 site plan for colocation to 107'6" on existing tower originally constructed in 1992. Four carriers exist on the pole at 64'6" a.g.l., 81'Y a.g.l., 98'0" a.g.l and 107'6" a.g.l. including AT&T, Verizon, New Cingular and TMobile; 2. Related equipment cabinets, cables, and related hardware within ±5,100sf equipment compound B. Proposed Dish Wireless colocation: 1. Three (3) mounted panel antennas at 88' above ground level; 2. ±75sf equipment compound lease area, GPS and cable transfers; V: Items to consider: 1. Accept the application as complete for review and processing; 1 Dish Wireless @ Baxter 2. Obtain review and analysis from our technical consultant CityScape to ensure all other colocation requirements have been met prior to determination (structural, RF, etc.) 3. Due to the fact that there is an approved tower on site and this colocation does not proposed to extend the tower any higher or expand the ground equipment area, consider waiving the public hearing for the proposed coloration amended site plan. §280-131(H) The Planning Board shall hold a public hearing to consider the application. Notice shall be provided pursuant to Chapter 55, Notice of Public Hearings. Notwithstanding this requirement, with respect to applications involving modifications to existing structures with no substantial change to the existing tbot rint where the Plannin Board determines that such modifications or w7y than e in use will not re dire significant Chan es to existing ma"or site deli n features as well as applications involving uses strictIV related to a r o eratons the w Planning Planniag Board shall have the discretion to waive the public hearing re uirement andmay act on such application by filed resolution at a dul noticed public meetin 2 OFFICE LOCATION: : MAILING ADDRESS: Town Hall Annex w ~ P.O. Box 1179 ��� � �54375 State Route 25 ��� �„�x Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) a, Southold, NY ,t�„ Telephone: 631 765-1938 www.s outholdtownny.gov PLANNING BOARD OFFICE TOWN OF SOUTHOLD MEMORANDUM To: Michael J. Verity, Chief Building Inspector From: Heather M. Lanza, AICP, Planning Director��;� Date: June 8, 2022 Re: Planning Department Report Wireless Co-location DISH Wireless @ Baxter 415 Elijahs Lane, Mattituck SCTM#1000-108-4-11.3 Zoning District: LB The Planning Department has received a report from our Wireless Technical Consultant, Cityscape, Inc. (see attached report) and provides the following: 1. CityScape has determined the application as complete for review. The applicant has provided a Structural Analysis dated April 11, 2022 and a RF Exposure Analysis dated January 16, 2022. 2. Pursuant to §280-71(13)(2)(b) of the Southold Town Code, site plan review and approval by the Planning Board is required for the proposed co-location because it causes a visible change to the exterior and is not an interior mount. A site plan application for wireless communications facility is required to be submitted to this office. Thank you for your cooperation. OFFICE LOCATION: ; , MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 � �� ° fir, Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) Southold, NY � � ��, Telephone: 631 765-1938 www.southoldtownny.gov June 8, 2022 PLANNING BOARD OFFICE TOWN OF SOUTHOLD Ms. Lois Rightmeyer inRange Solutions, LLC 695 Route 46 West, Suite 300 Fairfield, NJ 07004 Re: Wireless Co-location DISH Wireless @ Baxter 415 Elijahs Lane, Mattituck SCTM#1000-108-4-11.3 Zoning District: LB Dear Ms. Rightmeyer: The Planning Department has received a report from our Wireless Technical Consultant, Cityscape, Inc. (CityScape) and has determined the building department application as complete for review based on the provided Structural Analysis dated April 11, 2022 and a RF Exposure Analysis dated January 16, 2022. Pursuant to §280-71(13)(2)(b) of the Southold Town Code, site plan review and approval by the Planning Board is required for the proposed co-location. A complete site plan application for a wireless communications facility is required to be submitted to this office for review and approval. The full requirements for this application are included in the Town Code §280. Upon receipt of a complete site plan application, the Planning Board will conduct their substantive review, including reviewing a report from their technical consultant CityScape. We will do all we can to expedite the review as quickly as possible. If you have any questions regarding this site plan or its process, please do not hesitate to call this office. Respectfuily,. Brian Cummings Planner Crown Castle CROWN 2000 Corporate Drive CC CASTLE Canonsburg, PA 15317 May 27,2022 Via Email USPS Priority Mail BULDIU G DEPT, 'VOVAIN OF SOU.111HOLD Town of Southold Building Department/Michael Verity Town Hall Annex 54375 Main Road PO Box 1179 Southold,NY 11971-0953 Re: Federal Deadline Expiration Notice Eligible Facilities Requests for Modification of Existing Wireless Facility Located at 415 Elijah's Lane, Crown Castle BU#843211 (NYNYCO2191A) Dear Mr. Verity On 10/29/21,on behalf of our customer DISH Wireless, Crown Castle USA, Inc. ("Crown Castle") applied to the Town of Southold,NY for review of DISH 's proposed modification of the existing wireless tower located at the Site 415 Elijah's Lane. As described in the cover letter that accompanied the Application, this Application proposes an "eligible facilities request" ("EFR") that will not result in a "substantial change" to the existing wireless facility, as such terms are defined by applicable federal law. The purpose of this letter is to provide background information about the applicable federal law as well as explain that the federally mandated, 60-day approval period for the Application has expired. The applicable federal law is comprised of a federal statute commonly known as "Section 6409," which is codified at 47 U.S.C. § 1455(a) and the regulations set forth at 47 C.F.R. § 1.6100 as well as several Federal Communications Commission ("FCC") Orders interpreting these provisions.' Section 6409 mandates that local governments, like the [Township/City/County], "shall approve" and"may not deny" EFRs within a 60- day shot clock or they can be "deemed granted" by operation of law.2 Applications that have been properly deemed granted under Section 6409 are legally valid and must be treated as such by the Town of Southold and its departments. More than 60 days have elapsed since the EFR Application was filed with the Town of Southold without the town acting on the Application. Thus, the time within which the town should have acted on the Application has expired and the Application may be deemed granted by operation of federal law should DISH Wireless elect to do so. ' Acceleration of Broadband Deployment by Improving Wireless Facility Siting Policies, 80 Fed. Reg. 1238-01 (Jan. 8, 2015) (the "2014 Infrastructure Order");Accelerating Wireless and Wireline Broadband Deployment by Removing Barriers to Infrastructure Investment, 85 Fed. Reg. 45126 (July 27, 2020) (the "5G Upgrade Order"); and Accelerating Wireless and Wireline Deployment by Streamlining Local Approval of Wireless Infrastructure Modifications,WT Docket# 19-250,RM-11849;FCC 20-153 (Nov. 3,2020)(the"Compound Expansion Order"). 2 47 C.F.R. § 1.6100(c)(2)-(4); 2014 Infrastructure Order at paras. 135-241; 5G Upgrade Order at para. 7. The pathway to possihle. CrownCastle.com As agent for Dish Wireless for the Application, Crown Castle requests the town issue all necessary permits for the Application without any further delay. However, should the town refuse or fail to issue the permits,DISH Wireless reserves all its rights under federal law, including the right to issue a deemed granted notice under Section 6409. 'If you have any questions,please do not hesitate to contact me. Best regards, Lois Rightmyer Agent on behalf of Crown Castle/DISH WIreless cc: Lira:niiwru(,"w'O lle,carn Town of Southold, New York Telecommunications Site Review C ON S U L T A N T s , 1 N C Application 2423 S.Orange Ave#317 Collocation A PP Orlando,FL 32806 Tel:877.438.2851 Fax:877.220.4593 RECEIVED April 18, 2022 ... Mr. Brian Cummings, Planner PR 2 6 2022 . Town Hall Annex Building c 53095 Route 25 Planning Board Southold,NY 11971 APPLICANT/PROVIDER: Dish Wireless LLC PROVIDER SITE ID: NYNYCO2191A OWNER SITE ID: BU#843211 /Mattituck ADDRESS: 415 Elijah's Lane, Mattituck,NY 11952 LATITUDE: 40° 59' 57.79"N LONGITUDE: 72° 30' 40.17"W SCTM#: 1000-108-4-11.3 STRUCTURE: 107.5' Existing Monopole Tower(110.5' including appurtenances) Dear Mr. Cummings, At your request, on behalf of the Town of Southold ("Town"), CityScape Consultants, Inc. ("CityScape"), in its capacity as telecommunications consultant for the Town, has considered the merits of the above-referenced application submitted by Crown Castle on behalf of Dish Wireless ("Applicant") to collocate new equipment on an existing one hundred and seven and a half(107.5) foot monopole tower. The tower, owned by Crown Castle, is located at 415 Elijah's Lane, Mattituck, New York, see Figure 1. T-Mobile, Verizon and AT&T also operate at this site. In emails sent to the Applicant between December 20, 2021 and March 11, 2022, CityScape directed the Applicant to resolve the following completeness deficiencies in its equipment collocation application: 1) Provide a full structural analysis report verifying that the proposed loads will not exceed the maximum permitted stress rating of the tower. 2) Provide an RF exposure study as required in §280-70K of the Town Ordinance, demonstrating that the RF emissions of the proposed Dish operation, together with the RF emissions from the other carriers at the site, will not cause RF exposure levels at accessible areas to be in excess of FCC limits. 3) Explain why the proposed feed line cannot be mounted inside the monopole as is normal practice instead of on the exterior surface of the monopole. As of April 12, 2022, the Applicant has submitted all information needed for CityScape to fairly review the application. Town of Southold—SCTM#1000-108-4-11.3 AM Dish Wireless/NYNYCO2191 A %ifta April 18,2022 C O N S U L T A N T S , I N C , Page 2 Support.Structure& Equipment The Applicant proposes to install a new collocated wireless facility on the tower for Dish Wireless by adding the following equipment at the eighty-eight (88) foot above ground level, illustrated in Figures 2 and 3: TOWER EQUIPMENT # ADD 1 Commscope MC-PK8-DSH Antenna Platform w/Support Rails 3 JMA Wireless MXOFRO665-21 Antennas w/Mount Pipes 6 (3)Fujitsu TA08025-6604 RRUs&(3)Fujitsu TA08025-13605 RRUs 1 I Raycap RDIDC-9181-PF-48 Overvoltage Protector 1 1 1-3/8"Hybrid Cable(installed inside monopole) Engineering staff for Dish Wireless confirmed that there is an entry port available to install the one proposed Hybrid cable inside the monopole shaft, as is indicated in Figure 2. At ground level in the compound, the Applicant proposes to install a new metal 5-foot by 7-foot equipment platform and a 12-inch wide waveguide bridge between the proposed platform and the monopole. Equipment on the platform will consist of a site service cabinet, a telco fiber enclosure, a power protective cabinet and a utility H-frame. All indicated ground-level changes will be within the fenced compound except for new fiber lines in conduit and a fiber vault, both of which will be underground and within the utility easement. Structural Analysis The Applicant submitted a structural analysis report prepared by Crown Castle, dated April 11, 2022, based on ANSI/EIA/TIA-222-H, Risk Category II and Exposure Category C standards. The analysis indicates that, after the Applicant's proposed modifications, the tower would be at 86.2% of maximum usage capacity (out of an allowable 105%) and the base foundation would be at 83.2% of maximum usage capacity (out of an allowable 110%). Thus, it is determined that the structure, with the proposed modifications, would be structurally compliant,see Figure 4. The Applicant did not submit a mount analysis; however, as this is a new collocation, a full mount analysis is not deemed necessary, and since the platform mount is designed for up to nine (9) antennas and only three (3) antenna positions will be occupied, it is assumed the mounts to be used will be sufficient for the proposed equipment. RF Exposure Safety To verify RF exposure safety, the Applicant provided an RF exposure assessment of the proposed installation based on mathematical worst-case calculations, prepared by Henry Gultom Town of Southold—SCTM#1000-108-4-11.3 Dish Wireless/NYNYCO219IA Ay April 18, 2022 CONS U LTA N T S , I N C Page 3 and dated February 16, 2022. The information provided within the study was found to be consistent with FCC guidelines and takes into account the operations of the Applicant's proposed/existing facility and those of Verizon, AT&T and other personal wireless facilities known to operate at this site. The ground level analysis indicates that the maximum RF exposure level is only 15.3% of the general public MPE level,see Figure 5,thus meeting the FCC exposure requirements in ground-level areas that are unrestricted. Summary The Spectrum Act, which is found within the Middle-Class Tax Relief and Job Creation Act of 2012 ("The Act") and administered by 47 CFR §1.6100 of the FCC Rules, states that a personal wireless facility collocation, modification or upgrade is considered an eligible facilities request if it meets six criteria, most notably (1) it does not increase the structure height by 10% or 20 feet, whichever is greater, (2) it does not involve adding an appurtenance to the body of the tower that would protrude from the edge of the tower more than 20 feet or more than the width of the tower at the level of the appurtenance, whichever is greater and (3) it does not require any excavation outside the existing ground compound or leased area. 47 CFR §1.6100(c) further states that if an application meets the criteria, the application should be approved and not denied. CityScape has determined this application meets the requirements of an eligible facility and recommends approval for streamlined processing and administrative approval, with the understanding that the proposed Hybrid cable will be installed inside the monopole shaft. The Applicant is reminded that an planned equipment changes that differ from the submitted Construction Drawin s must be filed with the Town for review and approval.. I certify that, to the best of my knowledge, all the information included herein is accurate at the time of this report. CityScape only works for public entities and has unbiased opinions. All recommendations are based on technical merits without prejudice per prevailing laws and codes. CityScape verified that the proposed appurtenances shown by Applicant's construction drawings were listed in the structural report, but we did not independently verify the calculations, statements or the appropriateness of the analysis criteria contained therein. Town staff should verify compliance with applicable building and fire codes prior to issuance of a permit for this modification. Respectfully submitted, B. Benjamin Evans Senior Project Engineer CityScape Consultants, Inc. Town of Southold—SCTM41000-108-4-11.3 AM Dish Wireless/NYNYCO219 I A %mikysicape April 18,2022 C0NSU1. TANTS , INC . Page 4 • DeLorme Street Atlas USA@ 2011 I w, tnnOw . o ipro a Site; y 1 uz�tr o r% m `R aysawrirWrrw �44Y c N Z a f ROAD B m O ms 10 ,n P 8 I� x ° afe�ersae „mt'w sufr0' g 0 WrIvos �trrnurA atrs���yt s,W eu1tjk Data use ea to license © DeLorma DeLorme Street Alas USAfI 2011 v~delorrrie cum 1 t"r"1,60 7 4 •,,-• U415 r.OAT,14.0 Town of Southold—SCTM#1000-108-4-11.3 Dish Wireless/NYNYCO2191A Xmikyscatimu April 18,2022 C0NSU1. TANTS , INC „ Page 5 Figure 1 — Site Location Ma EX�'i\G -ANEL ANTENNAS �,, !/ RAD CENT=R a "�0-6.,.AGE_ E ING VONO .,E "y qr ._... o � "w�' 6+ AGE ,._ i. ... R D Cc\TAR 9D p N6 aAG- EX g �. R<X 5 NGERA® 0"L 98'1N AGS� 3) POMMM OM 0 PROPOM Ow r W+. Pow rX S.IN � Rc can 7 E. C5 k AG-I � 1 ,I N .......— cAS i =ANEI ANTE,AAS 1 ry RAp.C.N_r R...�....n_....6" AGL ..,. r !4 Ow VAMOM �r M r F9 Cue � ..,EXISTING VCNCPO_ MjMW �I U6 ryUp 141 ON PROPOM M r am• PROPOM Ow Wbow".LLC. tlICE PRW P �,�yy,yy�ry�O OM�i Ut, VS 41N EXIS''NC EN-RY FORT V■ � cx15 ING UONO E Figure 2 —Elevation Drawing of Structure & Proposed Equipment Town of Southold—SCTM#1000-108-4-11.3 Aft Dish Wireless/NYNYCO219 1 A %oftyscape April 18,2022 C O N S U L. T A N T S ) N C Page 6 PROPOSED DUN wrw.I.L.C.ANMM CIYP 1 PER SECIOR 70TAL 3 PRDPCSEO1..DIEI 10wPFrr 1" IM CM z PER sPMM TDIAL 0) PROPOSED°aI OF I PER At rT",4fi, � tj► PROPOSED DISH I1.Q CVP DEVICE Ct PROPOSED M Do w4vie x IJP..P.".AFRElAOL 81 ANTENNA LAYOUT 14 2 AMEW A nYN9IF=CAM SECIOR POMICH � y� ICOEL MMMleMMOIDCI SDE DIM :27WTW--W .MD An 4�FI�Wt AIPFN Al PROMM RIMESS/WCOSFROSSS-zl x 7zD�x 2O.V -W (1 Mmi- rc ..ETA 91 PROPOSED NEEUM/WIDFII0085-21 90 72w x 200' -W KOM CYBSPSYOPFE GWA C1 PROPOSED YIIEIESS/IDOAFROQlFzt 00 720'x SDA' (121'IDIID) RMM Nam SEC= PosllaN WAMacriiiiiiMJIOER MtA1F1TECIVIOLOGY 1. CONP VC=10 REFER TD POK C@6RRICIMI ROS FOR ALL RF Al FIAA=/TAOS07S-9004 00 � ALPM 2 ANIOIN PM RAH YODELS INY CMAGE DUE TO EDIRP EM Al P11J19U/TADe02e-Ee09 90 "W" P HE APPROVED OM DESIGN AM AND 91 FIAIM/TADIIOMS- D4 00 snamik ANALYSES. am In F inw/TA00100411 00 1 90 Cl '..... F1MW/TADlO1�0004..... DO aAI91A f7cl Furlsl/TAD9o75-eeo9 m ANTENNA SCHEDULE ND SMME 3 Figure 3 — Overhead View of Proposed Equipment Configuration Town of Southold—SCTM#1000-108-4-11.3 `' cagwalm Dish Wireless/NYNYCO2191A April 18,2022 C O N S U LTA N T S , I N C . Page 7 f, CROWN Date: April 11,2022 CASTLE Crown Castle 2000 Corporate Drive Canonsburg,PA 15317 (724)416-2000 Subject: Structural Analysis Report Carrier Designation. DISH Network Co-Locate Site Number: NYNYCO2191A Site Name: NY-CCI-T-843211 Crown Castle Designation: BU Number: 843211 Site Name: MATTITUCK JDE Job Number: 640434 Work Order Number: 2081886 Order Number: 549093 Rev.2 Engineering Firm Designation: Crown Castle Project Number: 2081886 Site Data: ELIJAH'S LANE,MATTITUCK,SUFFOLK County,NY Latitude 40°59'57.79",Longitude-72°30'40.17" 107.6 Foot-Monopole Tower Crown Castle is pleased to submit this"Structural Analysis Report"to determine the structural integrity of the above-mentioned tower. The purpose of the analysis is to determine acceptability of the tower stress level. Based on our analysis we have determined the tower stress level for the structure and foundation,under the following load case,to be: LC7:Propose�Equipm�entCon�figuratlon '���� Sufficient Capacity This analysis utilizes an ultimate 3-second gust wind speed of 128 mph as required by the 2020 New York State Uniform Code.Applicable Standard references and design criteria are listed in Section 2-"Analysis Criteria". Structural analysis prepared by:Jared Koski,El Respectfully submitted by: OF NEWJ SIT 8p O Rohit Soni,P.E. Senior Project Engineer C"D t734tz'a yrfr � FESS1 CityScape Comment: Structural Usages determined to be 86.2% of Maximum Tower Capacity and 83.2% of Maximum Foundation Capacity. tnxTower Report-version 8,1.1.0 Figure 4 — Structural Analysis Summary Town of Southold—SCTM#1000-108-4-11.3 Aft %.jjty�*%AM Dish Wireless/NYNYCO2191A *0160 April 18, 2022 C o N S u L. T A N T S , I N C Page 8 0 Statistical Summary X c Statistical Summary e % 0 99PY Dates. 1600 100.00 % of Total R )OF Area 0 00 0 1 00..... m ��( . Area 100.0 - 500.0 0 % of Sot, Area 500.0 - 5,OOC IN", ' t 0.00 %' of; Area Area FCcf , sc� Mire 9/4"PE' 0;'* ' With FCC 1997 Public Standard There is no EU exposure(%1 f 0%)on the ground level. CityScape Comment: Maximum Exposure at ground level determined to be 15.3% of the FCC general population Maximum Public Exposure Level (MPE). 8 Confidential and Proprietary E;)2021 DISH WIRELESS Figure 5 —RF Exposure Assessment at Ground Level Town of Southold, New York cKyscape Telecommunications Site Review C o N S « L T A N T S , a N Cl . Collocation Application 2423 S.Orange Ave#317 Orlando,FL 32806 Tel:877.438.2851 Fax:877.220.4593 July 14, 2022 Mr. Brian Cummings, Planner Town Hall Annex Building 53095 Route 25 Southold, NY 11971 APPLICANT/PROVIDER: Dish Wireless LLC PROVIDER SITE ID: NYNYCO2191A OWNER SITE ID: BU#84321 1 /Mattituck ADDRESS: 415 Elijah's Lane, Mattituck,NY 11952 LATITUDE: 40° 59' 57.79"N LONGITUDE: 72° 30' 40.17"W SCTM#: 1000-108-4-11.3 STRUCTURE: 107.5' Existing Monopole Tower(110.5' including appurtenances) Dear Mr. Cummings, At your request, on behalf of the Town of Southold ("Town"), CityScape Consultants, Inc. ("CityScape"), in its capacity as telecommunications consultant for the Town, has considered the merits of the above-referenced application submitted by Crown Castle on behalf of Dish Wireless ("Applicant") to collocate new equipment on an existing one hundred and seven and a half(107.5) foot monopole tower. The tower, owned by Crown Castle, is located at 415 Elijah's Lane, Mattituck, New York, see Figure 1. T-Mobile, Verizon and AT&T also operate at this site. In emails sent to the Applicant between December 20, 2021 and March 11, 2022, Cityscape directed the Applicant to resolve the following completeness deficiencies in its equipment collocation application: 1) Provide a full structural analysis report verifying that the proposed loads will not exceed the maximum permitted stress rating of the tower. 2) Provide an RF exposure study as required in §280-70K of the Town Ordinance, demonstrating that the RF emissions of the proposed Dish operation, together with the RF emissions from the other carriers at the site, will not cause RF exposure levels at accessible areas to be in excess of FCC limits. 3) Explain why the proposed feed line cannot be mounted inside the monopole as is normal practice instead of on the exterior surface of the monopole. As of April 12, 2022, the Applicant has submitted all information needed for CityScape to review the application. Town of Southold—SCTM#1000-108-4-11.3 ckyscape Dish Wireless/NYNYCO2191A Page Cc7NSui, 'rA NTS , INC . Support Structure & Equipment The Applicant proposes to install a new collocated wireless facility on the tower for Dish Wireless by adding the following equipment at the eighty-eight (88) foot above ground level, illustrated in Figures 2 and 3: TOWER EQUIPMENT # ADD 1 Commscope MC-PK8-DSH Antenna Platform w/Support Rails 3 JMA Wireless MXOFRO665-21 Antennas w/Mount Pipes 6 (3)Fujitsu TA08025-13604 RRUs&(3)Fujitsu TA08025-13605 RRUs 1 Raycap RDIDC-9181-PF-48 Overvoltage Protector 1 1-3/8"Hybrid Cable(installed inside monopole) Engineering staff for Dish Wireless confirmed that there is an entry port available to install the one proposed Hybrid cable inside the monopole shaft, as is indicated in Figure 2. At ground level in the compound, the Applicant proposes to install a new metal 5-foot by 7-foot equipment platform and a 12-inch wide waveguide bridge between the proposed platform and the monopole. Equipment on the platform will consist of a site service cabinet, a telco fiber enclosure, a power protective cabinet and a utility H-frame. All indicated ground-level changes will be within the fenced compound except for new fiber lines in conduit and a fiber vault, both of which will be underground and within the utility easement. Structural Analysis The Applicant submitted a structural analysis report prepared by Crown Castle, dated April 11, 2022, based on ANSI/EIA/TIA-222-H, Risk Category 11 and Exposure Category C standards. The analysis indicates that, after the Applicant's proposed modifications, the tower would be at 86.2% of maximum usage capacity (out of an allowable 105%) and the base foundation would be at 83.2% of maximum usage capacity (out of an allowable 110%). Thus, it is determined that the structure, with the proposed modifications, would be structurally compliant, see Figure 4. The Applicant did not submit a mount analysis; however, as this is a new collocation, a full mount analysis is not deemed necessary, and since the platform mount is designed for up to nine (9) antennas and only three (3) antenna positions will be occupied, it is assumed the mounts to be used will be sufficient for the proposed equipment. RF Exposure Safety To verify RF exposure safety, the Applicant provided an RF exposure assessment of the proposed installation based on mathematical worst-case calculations, prepared by Henry Gultom Town of Southold—SCTM#1000-108-4-11.3 ckyscape Dish Wireless/NYNYCO2191A Page C0NSui, 'rA NTS , INC and dated February 16, 2022. The information provided within the study was found to be consistent with FCC guidelines and takes into account the operations of the Applicant's proposed/existing facility and those of Verizon, AT&T and other personal wireless facilities known to operate at this site. The ground level analysis indicates that the maximum RF exposure level is only 15.3% of the general public MPE level, see Figure 5, thus meeting the FCC exposure requirements in ground-level areas that are unrestricted. Summary The Spectrum Act, which is found within the Middle-Class Tax Relief and Job Creation Act of 2012 ("The Act") and administered by 47 CFR §1.6100 of the FCC Rules, states that a personal wireless facility collocation, modification or upgrade is considered an eligible facilities request if it meets six criteria, most notably (1) it does not increase the structure height by 10% or 20 feet, whichever is greater, (2) it does not involve adding an appurtenance to the body of the tower that would protrude from the edge of the tower more than 20 feet or more than the width of the tower at the level of the appurtenance, whichever is greater and (3) it does not require any excavation outside the existing ground compound or leased area. 47 CFR §1.6100(c) further states that if an application meets the criteria,the application should be approved and not denied. Cityscape has determined this application meets the requirements of an eligible facility and recommends approval for streamlined processing and administrative approval, with the understanding that the proposed Hybrid cable will be installed inside the monopole shaft. The Applicant is reminded that any planned equipment changes that differ from the submitted Construction Drawings must be filed with the Town for review and approval. I certify that, to the best of my knowledge, all the information included herein is accurate at the time of this report. Cityscape only works for public entities and has unbiased opinions. All recommendations are based on technical merits without prejudice per prevailing laws and codes. CityScape verified that the proposed appurtenances shown by Applicant's construction drawings were listed in the structural report, but we did not independently verify the calculations, statements or the appropriateness of the analysis criteria contained therein. Town staff should verify compliance with applicable building and fire codes prior to issuance of a permit for this modification. Respectfully submitted, B. Benjamin Evans Senior Project Engineer CityScape Consultants, Inc. Town of Southold—SCTM#1000-108-4-11.3 Ckysicape Dish Wireless/NYNYCO2191A Page C0NSui, 'rA N 'rs , INC DeLorme Street Attas USArvMil ��s�✓ vo c � �rywrd�`' �r�j ✓ r �� / re a Prop S14e 'AeusPOO— ry� m " gxGJRaCb��� �t'i � v ✓,aa WtiSamr am „µEWs,5tltl"M=0.V&wK FwV'4„ n nn r ° All mGttta�tk -�UNCAA6Wpyp�, COO tJ"rac„lcn,net[7a�.A.mzrorur eaPawmt Atlas U:'s T�� � rdc 1�i7tlUl7 ie _ .'AGJ 2ll11, r.�ma�auwaa Ww+.lwvdclorrrr corn 1 1 J,76f 7 Pt Iata Z a mn 14-0 Town of Southold—SCTM#1000-108-4-11.3 Ckyscape Dish Wireless/NYNYCO2191A Pages C0NSui, 'rA N 'rS INN Figure 1 — Site Location Map 70 �r I�C 1, R h.A, t � 4�' �F rCr°, PR8OPO9ED am RRA di L.LC AWE RAD CENTER0 el—L'd ACL PROPOSED OEMR Wk.%w L LC EWMIiY PM lJ u • i A% AN i NNA n, IN N' q1 1 r i I W, "N➢,ti�� '�r d CARE ROUTED MIDE POLE PROPOSED N r M r f r i r DISH ftwom L.L.0 SO MPWEWr CPR PROPOSED STEEL � L'uVORM PROPOSED OM ME MOM PROPOSED oW Wb*M L.L.C. I CPS UWPT h� Mc NA;•w,, Figure 2 — Elevation Drawing of Structure & Proposed Equipment Town of Southold—SCTM#1000-108-4-11.3 ckyscape Dish Wireless/NYNYCO2191A Page C0NSui, 'rA N 'rS INN PROPOSED DEN W6 skm LLC.ANTENNA OW 1 PER SECTOR,TOTAL a) PROPOSED DISH WkeMee- RR H OW 2 PER SECTOR,TOTAL B) PROPOSED DISH WnMets L.L.C. I1ACK-TO-Bnac MOUNT(im OF i PER SECTOR,TOTAL� Al PROPOSED DISH W relew ._ .! LA..C.ON+DEMICE Cl PROPOSED DISH Wh41ew f L.I.C.ANTENNA PLATFORM, COMASCOPE MC-PKS-DSH (TYP. 1) BI ANTENNA LAYOUT 3/4•®1'-0` ANTENNA LION CABLE SECTOR POSRICH yµUF AER MODEL TECHNOLOGY SIZE OWA2IWMPAD FEED LINE TYPE PROPOSED cum AND LENGTH ALPHA Al PROPOSED JMA womm/ 21 OO 72.0'x 20.0' W W-O' (1) MGAI-CAWAdTT BETA Bi PROPOSED JMk WNBI.ESS/MO OSS-2t SO 72.W x 20.0' 15V MB'-0" CI 12PSMOP6-121 GAMMA C1 PROPOSED AIA WIRELESS/M} 465-21 60 72.0'x 20A' 27W W-O' (121'LONG) RRH NOTES SECTOR POSITION MANUFACTURER-MOM TECHNOLOGY I NUMBER 1. CCNTWA:TOR TO REFER TO FINAL CONSTRUCTION RFDS FOR ALL RF Al FLANTSU/TA08025-OW4 50 DEI ALPHA 2. ANTENNA NO RBI MODELS MAY CHANGE DUE TO EQUIPMENT Al FWRSU/ SO AVA ABEDY.ALL EQUIPMENT CHANGES MUST BE APPROVED AND REMAIN IN COMPLIANCE WITH THE PROPOSED DESIGN AND B1 FWRSU/TAOW25-9604 SO STRUCTURAL ANALYSES. BETA Bi FWRSU/TM8025-11605 SO Ct ROM/TAOMO25-OW 50 0AIMIA Ct I FLMITSU/TAOM25-NO 50 ANTENNA SCHEDULE NO SCN E Figure 3 — Overhead View of Proposed Equipment Configuration Town of Southold—SCTM#1000-108-4-11.3 Ckyscape Dish Wireless/NYNYCO219 I A Pagel C 0 N S u i, 'r A N 'r S , I N C CROWN Date: April 11,2022 CASTLE Crown Castle 2000 Corporate Drive Canonsburg, PA 15317 (724)416-2000 Subject: Structural Analysis Report Carrier Designation: DISH Network Co-Locate Site Number: NYNYCO21 91 A Site Name: NY-CCI-T-843211 Crown Castle Designation: BU Number: 8432111 Site Name: MATTITUCK JDE Job Number: 640434 Work Order Number: 2081886 Order Number: 549093 Rev.2 Engineering Firm Designation: Crown Castle Project Number: 2081886 Site Data: ELIJAH'S LANE,MATTITUCK,SUFFOLK County,NY Latitude 400 59'57.79", Longitude-720 3040,17" 107.6 Foot-Monopole Tower Crown Castle is pleased to submit this"Structural Analysis Report"to determine the structural integrity of the above-mentioned tower. The purpose of the analysis is to determine acceptability of the tower stress level. Based On Our analysis we have determined the tower stress level for the structure and foundation,under the following load case,to be: LC7:Proposed Equipment Cortfiguratiorr Sufficient Capacity This analysis utilizes an ultimate 3-second gust wind speed of 128 mph as required by the 2020 New York State Uniform Code.Applicable Standard references and design criteria are listed in Section 2-"Analysis Criteria". Structural analysis prepared by:Jared Koski,El Respectfully submitted by: ��O NIFW IT So Rohit Soni,P.E. Senior Project Engineer UJ 7- W 10345CA PesslOkl CityScape Comment: Structural Usages determined to be 86.2% of Maximum Tower Capacity amid 83.2% of Maximum Foundation Capacity. tnxTower,Report-version 8.1.1.0 Figure 4 — Structural Analysis Summary Town of Southold—SCTM#1000-108-4-11.3 ckyscape Dish Wireless/NYNYCO219 I A Page 8 C 0 N S u I, 'r A N 'r S I N C 0 Stafis6i.,A Sumrnimy X ............... ............... ............... ............... ............... Statistical Summary oe KM Nliilii,il,ii URM 1600 100.00 0/6 of Total R )OF Area 0 - 100ar............. J Area 1. 1600 .................. ................. ...................6 100.0 - 500. , % Of Area 500.0 5,000 1 0.00,,,% 'dBabe i Area > 5,� .................. 0.......... MW/h At�� �I Area R00fArea 16,00 sq, ft,, EITEO/0--H— Mjft No M P E, '0 With FCC 1997 PUblic Standard HELP j EECIIE--,E1-11—' CityScape Comment: Maximum Exposure at ground level determined to be 153% of the FCC general population Maximum Public Exposure Level Confidential and Nopiietzmy,',12021 DISH WIRELESS Figure 5 — RF Exposure Assessment at Ground Level RECEIVED SOUTHOLD PLANNING BOARD �U�9 4 2022 SITE PLAN APPLICATION FORM SoutholaTown Planning Board Site Plan Name and Location Site Plan Name: Dish wireless Application Date: 6 / 23 / 22 Suffolk County Tax Map#1000- 108 - 4 _ 11.3 Other SCTM#s 108-00-04-011-003 Street Address: 415 Elijah's Lane Hamlet: Mattituck Distance to nearest intersection: Type of Site Plan: X New Amended Residential Zoning District LB Owners/Anent Contact Information Please list name, mailing address, and hone mtmber for the people below: Property Owner SBA Towers IX,LLC Street 8051 Congress Avenue City Boca Raton State Florida Zip 33487 Home Telephone Other Applicant Lois Rightmyer,agent on behalf of Dish Wireless and Crown Castle Street 695 Route 46 West Suite 300 City Fairfield State NJ Zip 07004 Home Telephone 973-865-0983 Other Applicant's Agent or Representative: Contact Person(s)* Same as Applicant Street City State Zip Office Telephone Other *Unless otherwise requested, correspondence will be sent only to the contact person noted here. Site Plan Application Forfn 211812010 Site Data Proposed construction type: New X Modification of Existing Structure Agricultural Change of use Property total acreage or square footage: ac./sq. ft. Site Plan build-out acreage or square footage: ac./sq. ft. Colocation to Existing Tower Is there an existing or proposed Sale of Development Rights on the property? Yes No x If yes, explain: Does the parcel(s) meet the Lot Recognition standard in Town Code§280-9 Lot Recognition? YN If"yes", explain(and attach any necessary documentation—title report, subdivision approval, etc.) Building Department Notice of Disapproval Date: Is an application to the Southold Town Zoning Board of Appeals required? Yes No X If yes, have you submitted an application to the ZBA? Yes No If yes, attach a copy of the application packet. Show all uses proposed and existing. Indicate which building will have which use. If more then one use is proposed per building, indicate square footage of floor area per use. List all existing property uses: Telecommunications Tower List all proposed property uses: No Change in use Other accessory uses: Existing lot coverage: % Proposed lot coverage: % Gross floor area of existing structure(s): sq. ft. Gross floor area of proposed structure(s): Parking Space Data: #of existing spaces: #of proposed spaces: Loading Berth: Yes No Landscaping Details: Existing landscape coverage: % Proposed landscape coverage: % Wetlands: Is this property within 500' of a wetland area? Yes No Maybe I, the undersigned, certify that all the above information is true. Signature of Preparer: ( Date: o�3A-)­� 2 Site P1ai7Application Form 211812010 Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law.,This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except nzinor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net),the Board of Trustees Office,the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 108 - 4 - 11.3 PROJECT NAME Dish wireless The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board 0 Building Dept. ❑ Board of Trustees ❑ 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital ❑ construction, planning activity, agency regulation, land transaction) ❑ (b) Financial assistance(e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: Dish Wireless proposes to add(3)antennas,(6)Radio Units(1)OVP and(1)hybrid to the existing tower. Location of action: Elijah's Lane Mattituck,NY 11952 Site acreage: Present land use: Telecommunications tower Present zoning classification: LB 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: Lois Rightmyer,agent on behalf of Dish Wireless and Crown Caslte (b) Mailing address: 695 Route 46 West suite 300 Fairfield,NJ 07004 (c) Telephone number: Area Code( ) 973-865-0983 (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes ❑ No 0 If yes,which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. ❑Yes ❑ No 0 Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No 0 Not Applicable � , V Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria ❑ Yes ❑ No 0 Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria ❑ Yes ❑ No ❑ Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria ❑ Yes ❑ No ❑Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22 through 32 for evaluation criteria. ❑ Yes ❑ No ❑Not Applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes ❑ No❑ Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes ❑ No 0 Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. ❑ Yes❑ No❑ Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES L Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III—Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No ❑ Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes ❑ No ❑ Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III—Policies; Pages 62 through 65 for evaluation criteria. El Yes ❑ No❑ Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No ❑ Not Applicable PREPARED BY Lois Rightmyer TITLE Agent DATE 6/23/22 on behalf of Dish Wireless/Crown Castle Amended on 811105 LG Ri htm er From: Michaelis,Jessica <jessicam@southoldtownny.gov> Sent: Wednesday, December 8, 2021 9:48 AM To: LG Rightmyer Subject: RE: Dish Wireless Colocation -415 Elijahs Lane, Mattituck SCTM#1000-108-4-11.3 Great. Payment is required for the official submission and once we receive it the shot clock will start. Thank you. Thank you, Jessica Michaelis, Office Assistant Southold Town Planning Department 54375 NYS Route 25 P.O. Box 1179 Southold,NY 11971 Phone: 631-765-1938 Email: Tes,,s%caM southoIdtow oar From: LG Rightmyer<lg@inrange-Ilc.com> Sent:Tuesday, December 7, 20214:24 PM To: Michaelis,Jessica <jessicam@southoldtownny.gov> Subject: Re: Dish Wireless Colocation -415 Elijahs Lane, Mattituck SCTM#1000-108-4-11.3 I have requested this check from Crown Castle. Thank you, Lois Rightmyer Sent from my iPad On Dec 7, 2021, at 9:39 AM, Michaelis,Jessica <'essicam southo9citownn ov>wrote: Good Morning Lois, The Planning Department is in receipt of an application to up-grade an existing facility and related equipment at the existing site referenced above. Pursuant to §280-130A of the Southold Town Code, the Planning Department is required to provide a brief report to the Building Department concerning the proposed wireless communications up-grades to determine whether they meet the guidelines for wireless facilities. Pursuant to §280-74A(d) of the Town Code, the Planning Board will hire a Technical Consultant to aid in the review of the application and hereby requires the submission of$4,000.00 into an escrow account with the Town Comptroller's Office to cover the cost of the Technical Consultant's review. Please remit a check in the amount of$4,000.00 payable to the Town of Southold. Any unused portion of the Technical Consultant's Fee will be returned to you. 1 Our consultant is CityScape Consultants, Inc. They may contact you directly regarding this application. If you have any questions regarding this application or its process, please do not hesitate to call this office. Thank you in advance for your prompt payment. Thank you, Jessica Michaelis, Office Assistant Southold Town Planning Department 54375 NYS Route 25 P.O. Box 1179 Southold,NY 11971 Phone: 631-765-1938 <LOA Southold TMO 415 Elijah.pdf> 2 2423 S.Orange Ave,#317 %iRyScapeOrlando, Florida 32806 C O N S U L T A N T S I N C . Tel:877.438-2851 Fax:877.220-4593 LETTER OF AGREEMENT December 6, 2021 Brian Cummings, Planner Town of Southold 53095 Route 25 Southold, New York 11971 Re: Agreement between Town of Southold, New York (Town)and CityScape Consultants, Inc. (Consultant) Dear Mr. Cummings, As per the above referenced Agreement between Town and Consultant, Consultant agrees to provide a review and analysis for a Q'ISH Wireless application to modify and/or upgrade equipment at a wireless communications facility located at SCTM#108-00-04-011-003� 415 Elijah's Lane Mattituck, NY 11952. Review services for the Application will be performed at an agreed upon rate of four thousand, dollars ($4,000). There will be no additional costs of fees associated with the review of this Application and/or follow-up letters relating to this Application. Consultant will provide the services as outlined in Exhibit A, Scope of Services, of the Agreement. Sincerely, Elizabeth Herington-Smith Government Relations Manager CityScape Consultants, Inc. INRANGE SOLUTIONS 695 Route 46 West, Suite 103 Fairfield,NJ 07004 October 28,2021 Town of Southold 1 RECEIVED- Building Department NOV 2 2 2021 Town Hall Annex 54375 Main Road tzutTo UT wt i PO Box 1179 Planning Board Southold,NY 11971-0959 RE: Request for Minor Modification to Existing Wireless Facility—Section 6409 Site Address:415 Elijah's Lane Mattituck,NY 11952 Crown Site Number;843211 Customer Site Number:NYNYC2191A Dear Building Department: On behalf ofDISII Wireless LLC. ("Applicant"),Crown Castle USA Inc.C C'rown Castle")is pleased to submit this request to modify the existing wireless facility noted above through the collocation, replacement and/or removal of the Applicant's equipment as an eligible .facilities request for a minor modification under Section 64091 and the rules of the Federal Communications Commission C,1-,CC„'),2 Section 6409 mandates that state mid local governments must approve any eligible facilities request for the modification of an existing wireless tower or base station that tides not substantially change the physical dimensions of such tower or base station. Under Section 6409,to toll the review period, if the reviewing authority determines that the application is incomplete,it must provide written notice to the applicant within 30 days, which clearly and specifically delineates all missing documents or information reasonably related to whether the request meets the federal requirements,." Additionally, if a state or local government,fails to issue any approvals required for this request within 60 days,these approvals are deemed granted.The FCC has clarified that the 30-day and 60-day deadlines begins when an applicant:(1)takes the first step required under state or local law; and (2)submits information sufficient to inform the jurisdiction that this modification qualifies under the federal law4. Please note that with the submission of this letter and enclosed items,the thirty and sixty-day review periods have started.Based on this filing,the deadline for written notice of incomplete ampp]ication is November 26,2021,and the deadline.for issuance of approval is December 26,2021. The proposed scope of work for this project includes: Install antennas,ancillary tower and ground equipment etc.at an unmanned wireless facility with no change to structure height or ground space as per plans. At the end of this letter is a checklist of the applicable substantial change criteria under Section 6409.Additionally,please find enclosed the following information in support of this request: (1) Building Permit Application (2) Section 6409 Substantial Change Checklist. As these documents indicate;(i)the modification involves the collocation„removal or replacement of transmission equipment; and(ii)such modification will not substantially change the physical dimensions of such tower or base station,As such,it is an "`eligible facilities request" as defined in the FCC's' rules to which the 60-day deadline for'approval applies. Accordingly, Applicant requests all authorization necessary for this proposed minor modification under Section 6409, Our goal is to work with you to obtain approvals earlier than the deadline.We will respond promptly to any request for related information you may have in connection with this request.Please let us know how we can work with you to expedite the approval 1 Middle Class Tax Relief and lob Creation Act of 2012,Pub.L.No. 112-96,§6409(2012) (codified at 47 U.S.C.§1455). Z Acceleration of Broadband Deployment by Improving Wireless Facility Siting Policies,29 FCC Rcd. 12865 (2014) (codified at 47 CFR§ 1.61.00);and Implementation of State&Local Govern meat 'Obligation to Approve Certain Wireless Facility Modification Requests Under Section 6409(a)of the Spectrum Act of 2012, WT Docket No. 19-250 (June 10,2020), 3 See 47+CFR§1.61oo (c)(, ), a, ee 2020 Upgrade Order at paragraph 16. process. We look forward to working with you on this important project, which will improve wireless telecommunication services in your community using collocation on existing infrastructure. If you have any questions,please do not hesitate to contact me. Sincerely, L-&,k Rigkt"etr, age4� o-w b4aif of G'oww/ Disco inRange Solutions, LLC 695 Route 46 West, Suite 300 Fairfield,NJ 07004 Mobile: 973-865-0983 Fax: 973,860,2424 -mail:: lg�inran -I.:LC.cotrl le IRANGE. 0 L U T 1 0 N S ,ter TOWN OF SOUTHOLD —BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY 11971-0959 Telephone (631) 765-1802 Fax(631) 765-95021tt . cttlhQltowan . APPLICATION FOR BUILDING PERMIT Date Received For Office Use Only II_ 1'�! PERMIT NO, Building P2021 Ins actor,. V O 1 NOV Ap��cations and forms must e lr(Ned oft N their ent�ret r r �r r y lComplete / BUILDING DEPT aplNcttwpS wih no#be accepted Where the Applicant is noth �wnerr a �� TOWN OF SOUTHOLD �glPri a l+'/`�sriJl r�i�e✓1i1an///�f�"l/°'tr�fl r //r�fl/l//dr /r/ /// �//! p;,. �r lr i /f� e !n ��,�%�q �qM�✓✓l�'•�1 uLir/ r,Jiy✓r/,yl�,��/Il,rm��;r„✓�%r��l��'�� �r/fir rr„a�P „/,�.,�r / l��ir /N {��; Date:10/8/2021 r 5,' i 1 :�,,; ;� w r, '',r f � r H� %' /r/I r/ r/✓r�r���r�f�i � r"j��� " �„ ,. „'„ r �a ,xr?✓l,:r u�iae/��i:7;.,�„qo a� �rr!r�rH�Vd�Nm,���'. r �ura.r a me SBA Towers IX, µEEC CTI'u1# s000-108-00 04-011-003 µw415 Eli��h's Lane ,�tt�t�o NY 11952 Email n., Phone# Mailing Address 8051 Congress Ave n_.ue...Boca Rat on, FL 33487 Attn. Site Adm In +C011MTACT IRON rri/A,'frY,,y��MF"i%%��%�����;y��,��?%rir,�/f�ir��(r��/r✓f�%r���lr���7j����� tag��1 Name Lois RI w n Castle/ Dish Wireless Mailin Address.� g� If Of Cro � �r t on beha .. .. g 69 I��Ntc. .�F .. �. alrflel NJ 07004 Phone# 973 865 0983 �� � Email:lg@inRange Ilc.com f/+Yll ax':rnw,1{r�'r j� U� 2! �5/i N 1i y f - ---�,mm.—�.- DEION PROFESSIONAL INFORMATION l "' � ,,,,, �/irr, „a� �lylHr/,JIr✓o�r���.?',�. ,,!r/c�l�rd�r,C�+�r,T�,� �, ,rAl�/�d Na me Inflnlg ��. . .Higgins 0 . we Mailing Ad��uesu: �` Estates IL 60169 g �� 0 W. Hi in Hoffman Esta s Road Suite 500 Ho m e Phone h..o enrr�1177� 68 4068 Email,. . �. .,_.. C®NTRACTOR INFORMATION- Name: e, anaggrripnt Ma iling Address: 55 Commercial Street Freeport, NY 11520 Phone# 516-779 3226 Email: eneraloffice@nwmanagment.net DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Sttrudc re ElAddition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: lil0ther d (3) as, (6)RRH (1)OVP and one Hybrid to existing tower $33,000 Will the lot be re-graded? ❑Yes IRNo Will excess fill be removed from premises? ❑Yes *No 1 PROPERTY INFORMATION ,. Existing use of property:Cell Tower Intended use of property: Cell Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yes ®No IF YES, PROVIDE A COPY. C09 ter Check B Box After Reading. The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by P the Town Code. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold,Suffolk,County,New York and other applicable Laws,Ordinances or Regulations,for the construction of buildings, additions,alterations or for removal or demolition as herein described.The applicant agrees to comply with all applicable laws,ordinances,building code, housing code and regulations and to admit authorized inspectors on premises and in building1s)for necessary inspections.False statements made herein are purulshahle as, CIasS A misdemeana�m pursuant tm7 Section 210.45 of tJxe peIV York Skate Penai Law .WiSi htm erhcatlon Submitted Bg Y BAuthorized Agent ❑ownerAp d.e Y(prl P Signature of Applicant: Date STATE OF NEW YORK) (fie SS: COUNTY OF ) LD iS being duly sworn, deposes and says that(s)he is the applicant (Nameofindi,vid I signing c ntract) above named, A (S)he is the d (Contractor,Agent,Corporate Officer,etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;that all statements contained in this application are true to the best of his/her knowledge and belief;and that the work will be performed in the manner set forth in the application file therewith. Sworn before me this day ofn Cjab 2 2 20�� NotaryNOT ky* l PROPERTY OWNER AUTHORIZATION ATION Come#4 (Where the applicant is not the owner) I Kimberly Myl (Crown Castle, Tower Owner) residing at 1200 MacArthur Boulevard, Suite 200 Mahwah, NJ 07430 do hereby authorize in Range to apply'on my behalf to the Town of Southold Building Department for approval as described herein. -- 10/13/2021 Owner's Si, tore Date Kimberly Myl Print Owner's Name 2 FCERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY' t CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. TIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICTHIS IES OW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED RESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPOTANT., If fiRcate holder conditions of the policy,certain policies p Y( the terms certificate holder is an ADDITIONAL INSUIRED, the olio es must be endorsed. If SUPBROGATION IS WAIVED',subject to P Y� s may require an endorsement. A statement on this certificate does not confer rights to the older in lieu of such po icy,certain ER 10 CON ACT rks Insurance Agency —. �It'naIUlfano NAME; ion Rd,Suite#7ryRsCapS (rfoSnSUIaI1CC COF W � ,NY 11713 , 1$Q()E-MAILNAre#Y INSURIcRA ravel ers Indemni t Co o .....�... ravel _.... ._ Ameri a- nagementlnc INcIRERcGeneralStarIndemmCo oAm rica ravelers Casualt Insmercial Street Freeport, NY 115202831 Company, 37362 ER B IN$UR,ERE: ShelterryPoinLife,Insuralt Ins Co 23850 ._�.�.�._�.._�....._._......_......�.....�. ante.. M_ INSUREIaF, Harti�ord lire Insurance Co SION NUMBER.- THIS IS GES CERTIFICATE NUMBER. COVERAGES TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUREDS AIMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN„ THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, ENISrt ... •• ----- -----. —_-.-.�......�„-._ ,,,,,.� '!AFN MAY HAVE BEEN REDUCED BY LAID CLAIMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN AISOIL LTR� TYPE OF INSURANCE POLICY YE PO$.1CY EKP ..�...�... ,_._. ..m..�..-.....,......�.......... ... GENERAL LIABILITY POLICY NUMBER M M1D0 Y MMIDO M LIMITS ✓ COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 It�( nr q .-J'�LAIMs-MADE M"�occuR P� Mls �^ -c a rce �.. 300,000 X X 680-6K115641-18-42 /1 21 2/1/22 MED ExIa Ara one p aroni ..� �5,000 IERSONAL&ADV INJURY ✓ Contractual Liability S— .A—L—&.�mm_J _w $ 1,000,000 RITW GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE-- � ., $ 2,°000,000 POLICY ✓ PRD- PRODLICTS-.20Mt/OF!AGG $ LOC' 2,000,000 AUTOMOBILE LIABILITY — $ COMBINED SINGLE L,pMp7 ✓ ANY AUTOINJURY 1000,000 B ✓ AUTOS TOS AUTOS IX X X BA-2N1612OA-21-42—G INJURY(Per person) $ ALL OWNED 2�1�21 2�1�22 BODILY.. ... - ..�.� .. .. NON-OWNED BODILY INJURY Per accident AUTOS PROPEIITY DAMAGE ' ✓ Hired PD CaaIdI}_ _�._... $ UMBRELLA LIAB OCCUR $ AB cLAIMs.-MADE X X IXG9a9776B EACH OCCURRENCE 5,000,000 C EXCESS LI � ✓mm. �.. 2/1'/21 1 22 - � — G19REGATE $ ,000,000 DEDi I EIENTGON �.-0,00 WORKERS COMPENSATION $ AND EMPLOYERS'LIABILITY WC ST TU- OTH ANY PROPRIETOMPARTNEI EXECUTIVE YIN -T`C IDEN7' L OFFICOVMEMBER EXCLUDED?' N/A (Mandacr in NH) D e6i describe under El SEAS -EA EMPLOYE ... $ yy DESCRIPTION OF OPERATIONS bM*w E EA EMPLOYE E.L.DISEASE-POLCY'LIMIT $ D Excess Liability X X PUB698603 $5,000,000 211121 2j1122 Insurer E ShelterPoint-DBL policy# DESCRIPTION OF OPERATIONS I LOCATIONS D226216 Statutory Certificate holder is included LES as(Attach as additional ACORD 101,•Additionai Remarks Schedule,if more space 1s required) Insured if required by written contract or agreement CERTIFICATE HOLDER CANCELLATION Town of Southold 53095 Route 255 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PO Box 1179 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY'PROVISIONS. Southold, NY 11971 AUTHORIZED REPRESE"'"""—l- ©1900-cU 1 U Ailutw%lum!"vrw 1 wrv. r+n rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD y�� �workers' CERTIFICATE OF INSURANCE COVE svA Compensation RAGE BOerd DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW PART 1.To be completed by Disability and Paid Family Leave Benefits Carrier or Licensed Insurance Agent of that Carrier 1a. Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured N.W.MANAGEMENT INC 55 COMMERCIAL STREET 516-432-8700 FREEPORT,NY 11520 1c.Federal Employer Identification Number of Insured Work Location of Insured(Only required if coverage is specifically limited to or Social Security Number certain locations in Mew York.state,i.e.„wrap-Up policy) 201330499 2. Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) ShelterPoint Life Insurance Company Town Of Southold 3b.Policy Number of Entity Listed in Box"I a" 53095 Route 25 DBL226216 P O Box 1179 3c.Policy effective period Southold, NY 11971 12'/01/2020 to 11/30/2022 4. Policy provides the following benefits: © A.Both disability and paid family leave benefits. B.Disability benefits only. C.Paid family leave benefits only. 5. Policy covers: © A.All of the employer's employees eligible under the NYS Disability and Paid Family Leave Benefits Law. B.Only the following class or classes of employer's employees. Under ertily insured haslNYS Disability y Of pin o nd/orhPaid Family Leave Benefits nsur�an a ged agent of the above.ce carrier referenced above and that the named coverage as described above. Date Signed 10/11/2021 By (1j,641 rr (Signature of insurance carrier's authorized representative or NYS Licensed Insurance Agent of that insurance carrier) Telephone Number 516-829-,8100 Name and Title Richard White Chief xeCtttive Officer IMPORTANT: If Boxes 4A and 5A are checked, and this form is signed by the insurance carrier's authorized representative or NYS Licensed Insurance Agent of that carrier, this certificate is COMPLETE. Mail it directly to the certificate holder. If Box 4B,4C or 5B is checked,this certificate is NOT COMPLETE for purposes of Section 220, Subd,8 of the NYS Disability and Paid Family Leave Benefits Law. It must be mailed for completion to the Workers'Compensation Board, Plans Acceptance Unit, PO Box 5200, Binghamton, NY 13902-5200, PART 2.To be completed by the NYS Workers'Compensation Board (Only if Box 4C or 5B of Part 1 has been checked) State of New York Workers" Compelri, ation Board) According to information maintained by the NYS Workers'Compensation Board the above-named employer has complied with the NYS Disability and Paid Family Leave Benefits Law with respect to all of his/her employees, Date Signed By (Signature of Authorized NYS workers'compensation Board Employee) Telephone Number Name and Title Please Note:Only insurance carriers licensed to write NYS disability and paid family leave benefits insurance policies and NYS licensed insurance agents of those insurance carriers are authorized to issue Form DB-120.1, Insurance brokers are NOT authorized to issue this form. DB-120.1 (10-17) Il��l��l�ll��l�ll���l�l�ll�ll��ll�l�nl��ll IIIIIIIDB-120.1 (10_17) IIIIIII NYSIF New York State Insurance Fund 8 CORPORATE CENTER DR,2ND FLR,MELVILLE,NEW YORK 11747-3166 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE AAAAAA 201330499 %.40.9 TWIN FORKS INSURANCE AGENCY 16 STATION RD STE 7 BELLPORT NY 11713 SCAN TO VALIDATE POLICYHOLDER AND SUBSCRIBE N W MANAGEMENT INC CERTIFICATE HOLDER 55 COMMERCIAL STREET TOWN OF SOUTHOLD FREEPORT NY 11520 53095 ROUTE 25 P0 BOX 1179 SOUTHOLD NY 11971 EPOLICY NUMBER CERTIFICATE NUMBER H2371 659-0 1903 POLICY PERIOD DATE 09/29/2021 TO 09/29/2022 10/12/2021 FUND UNDER POLICY NO. 2371 659-0„ COVER ROVE ENTIRE INSURED WITH THE NEW PORK STATE THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED A. WORKERS COMPENSATION UNDER THE NEW YORK THETWORKERS COMPENSAITION OFON THIS HWITH RESPECT TO AL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE P0'LICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY,, IF YOU UidViISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY,INCLUDING ANY NOTIFICATION OF CANCELLATIONS OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WESSITE AT HTTP S.f .NYSIF«CC9IVI/CERT/CERT"VAL,AP,THE. NEW YORK STATE INSURANCE FUND IS NOT LIABLEIN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. IS POLICY DOES NOT COVER INSURED CORPO'RATIO N. CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE RESIDENT WALTER DAHLEM (1 OF 1) N W MANAGEMENT INC THE POLICY INCLUDES A WAIVER OF SUBROGATION ENDORSEMENT UNDER WHICH NYSIF AGREES TO WAIVE ITS RIGHT OF SUBROGATION TO BRING AN ACTION AGAINST THE CERTIFICATE HOLDER TO RECOVER AMOUNTS WE PAID IN WORKERS'COMPENSATION AND/OR MEDICAL BENEFITS TO OR ON BEHALF OF AN EMPLOYEE OF OUR INSURED IN THE EVENT THAT, PRIOR TO THE DATE OF THE ACCIDENT, THE CERTIFICATE HOLDER HAS ENTERED INTO A WRITTEN CONTRACT WITH OUR INSURED THAT REQUIRES THAT SUCH RIGHT OF SUBROGATION BE WAIVED. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY, NEW YORK STATE INSURANCE FUND •26.3 VALIDATION NUMBER:283226902 DIRECTOR,INSURANCE FUND UNDERWRITING CROWN Date: 8/13/2021 CCCASTLE Crown Castle 2000 Corporate Drive Canonsburg, PA 15317 (724)416-2000 Subject: Structural Evaluation Carrier Designation: DISH Network Co-Locate Site Number: NYNYCO2191A Site Name: NY-CCI-T-843211 Crown Castle Designation: BU Number: 843211 Site Name: MATTITUCK JDE Job Number: 640434 WO Number: 2009145 Order Number: 549093 Revision. 0 Site Data: ELIJAH'S LANE, MATTITUCK, SUFFOLK County, NY Latitude: 40° 59'57.79" Longitude: -72°30140.1711 107.5 Foot—MONOPOLE Tower Crown Castle is pleased to submit this"Structural Evaluation"to determine the structural integrity of the above- mentioned tower. The purpose of this evaluation is to determine the suitability of the tower structure to support the proposed equipment configuration listed in Table 1. Based on a comparison of loading listed in the previous analysis dated 6/9/2021, the proposed loading change will not have significant impact on the overall tower stress rating. Therefore, the final proposed equipment. configuration listed in Table 1 is structurally ACCEPTABLE. Table 1: Pro osed E ui ment Confi oration Haunting Center Line Numbuer Antenna Antenna Number, Fdbd Line Level Elevation of of Feed ft AntennasManufacturer el t i ae Size(In) nu ac urer pMod � 88 1 MOUNTS Cofnrnsco e_M C-PK8-0SH 88 1 RAYCAP RDI DC-9181-PF-48 88 88 3 FUJITSU TA08025-13604 1 1-3/8 88 3 FUJITSU TA08025-13605 88 3 JMA WIRELESS MX08FR0665-21 E�l Respectfully submitted by: It is a violation of the law"section 7209 of the Article 145 „ of the State Education Law'for arty person to alter any D.F NEW document that bears the seal of a professional engineer. �y M i 0bel Dentinger, P. unless the person is acting under the direction of a licensed Ct Sr Project Engineer professional engineer. , Digitally signed by Maribel Dentlrb¢ger Dak 2021.08.13 16:41:11 Dentinger D"' 84717 A� SS 4 Structural Evaluation OFFICE LOCATION:. MAILING ADDRESS: Town Hall Annex P.O. Box 1179 SOUS m 54375 State Route 25 " Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) Southold, NY Telephone: 631 765-1938 www.southoldtow-nny.gov CoUm,� PLANNING BOARD OFFICE TOWN OF SOUTHOLD MEMORANDUM To Accounting �k From; Planning Department Date. December 17, 2021 Re Check The attached check is a Consultant Escrow Fee for the project review listed below. Please deposit into B691 Deferred Revenue Account. Thank you. Applicant/Project Tax Map Amount Check Date/No. Name & Type # Dish Wireless Colocation @ 1000-108- $4,000 _ 12/8/21 -#23241 Baxter (415 Elijahs Lane ) 4-11.3 Crown Castle 7 .'a '�ufimx% wwxz �w, 1k➢ WS; aCn" �. bY� eWaaTM a. "YG �" r- akG w ddG . 2 ., 'CROWN CA$TL.E- ETA P'kOPERTY w, 6325 ARDRE"Y'`KELL'ROAD,SUITE 600 CHARLOTTE,�c ip � � DATE . e. a "- TO THE ORDER OF-.. DOLLARS ---HASE�a�k p► 51-�-� � _..._ . w OFFICE LOCATION: tiJr� � � �G a MAILING ADDRESS Town Hall Annex C��' �•< ��>? P.O. Box 1179 54375 State Route 25 ,`�� CD ;; Southold� .� �, � �• ,NY 11971 cor. Main Rd.&Youngs Ave. s rry Telephone: 631-765-1938 Southold,NY ,y www.southoldtownny.gov PLANNING BOARD OFFICE TOWN OF SOUTHOLD MEMORANDUM To: Accounting From: Planning Department Date: June 24, 2022 Re: Check Please deposit the attached check into B691: Deferred Revenue. Fee is for a Site Plan Application not yet accepted by the Planning Board. Applicant/Project Name & Type Tax Map # Amount Check Date/No. Dish Wireless Colocation at Baxter 108-4-11.3 $500.00 6/23/22 - #3648 Site Plan Inrange Solutions JAM Aft.