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{��UFFOtk� r �0�0 �oGy Town of Southold 8/31/2022 P.O.Box 1179 co g 53095 Main Rd �yjj0 0,'6 Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 43389 Date: 8/31/2022 THIS CERTIFIES that the building GENERATOR Location of Property: 18915 Soundview Ave., Southold SCTM#: 473889 Sec/Block/Lot: 51.-1-15 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 5/16/2022 pursuant to which Building Permit No. 47983 dated 6/22/2022 was issued,and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: accessory generator as applied for. Maintain 36 inch clearance to shrubs at all times. The certificate is issued to Burns,Gertrude&Miraglia,Loretta of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 47983 8/5/2022 PLUMBERS CERTIFICATION DATED Aut ri ed ature S�EFai� TOWN OF SOUTHOLD ao�° coat' BUILDING DEPARTMENT TOWN CLERK'S OFFICE 00 • ��� SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 47983 Date: 6/22/2022 Permission is hereby granted to: Burns, Gertrude 769 Western Hwy Blauvelt, NY 10913 To: install generator as applied for. At premises located at: 18915 Soundview Ave., Southold SCTM #473889 Sec/Block/Lot# 51.-1-15 Pursuant to application dated 5/16/2022 and approved by the Building Inspector. To expire on 12/22/2023. Fees: ACCESSORY $100.00 ELECTRIC $85.00 CERTIFICATE OF OCCUPANCY $50.00 Total: $235.00 Bui in spector pF SO!/r�ol 0 Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 �Q sean.deviinCaD-town.southold.ny.us Southold,NY 11971-0959 OOUfV1`(,� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Gertrude Burns Address: 18915 Soundview Ave city:Southold st: NY zip: 11971 Building Permit#: 47983 Section: 51 Block: 1 Lot: 15 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Gen Ready License No: 2740ME SITE DETAILS Office Use Only Residential X Indoor X Basement Generator X Commerical Outdoor X 1 st Floor Pool New X Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors Sub Panel A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO Transformer UC Lights Dryer Recpt Emergency FixturesTime Clocks Disconnect Switches 4'LED Exit Fixtures Pump Other Equipment: 24kW Generac Generator w/200A Whole House Transfer Switch and Two 60A Load Sheds Notes: Generator Inspector Signature: Date: August 5, 2022 S.Devlin-Cert Electrical Compliance Form 50UT 'lto-j y�lo # f TOWN OF SOUTHOLD BUILDING DEPT. 631-765.1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ELECTRICAL (FINAL) [ ] CODE VIOLATION -�[ ] PRE C/O [ ] RENTAL REMARKS: pj< DATE L INSPECTOR r a So(/TyO� # # TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] SULATION/CAULKING [ ] FRAMING /STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: 44� f. KAK 2�(or1 C AV 41,x Lt 4-a S41vu jn - DATE )'LP ZD'Y1/ INSPECTOR I DJ E C E � IJ E Mr. Faucet Service Co. JUL 1 2 2022 201 Northwest Drive, Suite #8 BUILDING DEPT Farmingdale,NY 11735 TOWN OF SOUTH&D Phone &Fax - 516-752-1000 Town of Southold July 7, 2022 Re: TRUDIE BURNS 18915 SOUNDVIEW AVE. SOUTHOLD,N.Y. 11971 Section: 51, Block: 1, Lot: 15 This is to certify that I, Gerard Aaron, am a licensed plumber, licensed to practice in the State of New York/Suffolk County under license #MP-32128. I further certify that an installer from my company installed natural gas lines to the generator at the above referenced address and pressure-tested the line at 4.0 PSI for a minimum of(1) hour. I have determined that the work stated complies with the Residential Construction Code of New York State, the Town of Southold codes, and all other rules and regulations applicable to this work. I make this statement under penalty of law knowing that the Town of Southold will rely on this information to determine compliance with the applicable Codes. Signa e: Gerard Aaron Sworn to before me On this '7 day, a/1-i 20 a� �,y�41\111 IPI Fly,, ���lo e s STA-FE ",`O P'' Notary Public ;'OF NEW yOFK NoTAI PU?P_ i i v,.r rcm ` Qualified in N �1A aCounty av� ,� � 9124g ������ FIELD INSPECTION REPORT DATE COMMENTS ►a FOUNDATION(1ST) H ------------------------------------ C FOUNDATION (2ND) 14, z —' o H v 'b ROUGH FRAMING& y PLUMBING i r INSULATION PER N.Y. y STATE ENERGY CODE ' ✓b C,�7 r nr�l �s FINAL ADDITIONAL COMMENTS Cor+ - 0 z m NX P H O t" H x d r� b H �aPS�fFO�r000� TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 oy�0 a�g Telephone(631) 765-1802 Fax(631) 765-9502 https://www.southoldtownny.gov Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only D qlg PERMIT NO. ✓ Building Inspector: MAY 1 G lW Z DD Applications and forms must be filled out in their entirety. Incomplete BUILDING DEPT. applications will not be accepted. Where the Applicant is not the owner,an TOWN OF SOUTHOLD Owner's Authorization form(Page 2)shall be completed. Date:2/28/2022 OWNERS)OF PROPERTY: N1. ame:Trudie Burns SC #Z000-51-01-15 Project Address:18915 Soundview Avenue, Southold, NY 11971 Phone#:914-522-0170 Email:nywtrdog@aol.com Mailing Address:18915 Soundview Avenue, Southold, NY 11971 CONTACT PERSON: Name:Ed Reiff/ Gen Ready Mailing Address:128 Pulaski Road, Kings Park, NY 11754 Phone#:6317544-0400 Email:office@getgenready.com DESIGN PROFESSIONAL INFORMATION: Name:N/A Mailing Address:N/A Phone#:N/A Email:N/A CONTRACTOR INFORMATION: Name:Ed Reiff/ Gen Ready Mailing Address: 128 Pulaski Road,_Kings_Park, NY 11754 Phon11 e#:631-544-0400 Email:office@getgenready.com DESCRIPTION OF�PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: (]Other 24kw generator installation. $25,900.00 Will the lot be re-graded? ❑Yes ®No Will excess fill be removed from premises? ❑Yes ®No 1 PROPERTY INFORMATION) Existing use of property: Residence Intended use of property: Residence Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yes N No IF YES, PROVIDE A COPY. 8 Check Box After Reading: The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by Chapter 236 of 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 1h building(s)for necessary inspections.False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the New York State Penal Law. Application Submitted By(print name):Ed Reiff / Gen Ready BAuthorized Agent Downer Signature of Applicant: Date: STATE OF NEW YORK) SS: COUNTY OF ) Ed Reiff / Gen Ready being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the Contractor/Agent (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 t day of , 20 ay-Public PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) Trudie Burns residing at 18915 Soundview Avenue, Southold, NY 11971 do hereby authorize Ed Reiff / Gen Ready to apply on my behal the To of Southold Building Department for approval as described herein. �v• Owner's Signature Date Trudie Burns TAMMY ROBERTO Print Owner's Name Nota NObf New York 01R064o Qualified i6 Suffolk County 2 Commission Expires 09/08/2024 �S�FFOj,�c BUILDING DEPARTMENT- Electrical Inspector eU TOWN OF SOUTHOLD POwNp SGOFA ® Town Hall Annex - 54375 Main Road - PO Box 1179 O Q o v' � Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 rogerr(aD-southoldtownny.gov — seand(cD-southoldtownny.gov APPLICATION FOR ELECTRICAU[NSPECTION. ELECTRICIAN INFORMATION (All Information Required) Date: 1/12/2022 Company Name: Gen Ready Name: Ed Reiff License No.: ME-2740 email: office@getgenready.com . Phone No: 631-544-0400 . 01 request"an email-copy of Certificate'of.Compliance Address.: 128 Pulaski Road, Kings Park, NY 11754 JOB SITE INFORMATION (All Information Required) Name: Trudie Burns Address: 18915 Soundview Avenue, Southold, NY 11971 Cross Street: Mt. Beaulah Avenue Phone No.: 914-522-0170 Bldg.Permit#: Ltj 9 85 email: nywtrdog@aol.com Tax Map District: 1000`- 1 Section: 51 Block: 01 , Lot: 15 BRIEF DESCRIPTION OF WORK (Please Print Clearly) Install a 24kw natural ga generator. Check All That Apply: Is job ready for inspection?: YES ❑✓ NO Rough In Final Do you need a Temp Certificate?: YES [Z]NO Issued On Temp Informa ' (All information required) Service Size oPh 3 Ph Size: 100 A # Meters Old Meter# Mdv RdcUlbd RdcpWd Qdbnmrdbs Trrcdcf cpt nu Nudcgd' c # Underground Laterals 1 2 H Frame Pole Work done on Service? Y N Additional information: w'sel—R PAYMENT DUE WITH APPLICATION Electrical Inspection Form 2020.x1sx � cne��c 2144W N Y S I F PO Box 66699,Albany,NY 12206 New York'State Insurance Fund I nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ^^AAAA 112763133 VINCENT C DALEY 859 CONNETQUOT AVE ISLIP TERRACE NY 11752 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER GENREADY INC TOWN OF SOUTHOLD 128 PULASKI ROAD 54375 MAIN ROAD KING PARK NY 11754 SOUTHHOLD NY 11971 POLICY NUMBER I CERTIFICATE NUMBER POLICY PERIOD DATE 11046 681-1 847503 05/20/2022 TO 05/20/2023 04/25/2022 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1046 681-1, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW,AND,WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK,TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY, INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE, VISIT OUR WEBSITE AT HTTPS://WWW.NYSIF.COM/CERT/ CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. PRESIDENT EDWARD S REIFF VICE PRESIDENT ANDREW J REIFF OF GEN READY INC-A TWO-PERSON CORP. _ 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 DIRECTOR,I SURANCE FUND UNDERWRITING VALIDATION NUMBER: 515653917 1110110 0 0 010 0000103703708�u���� Form WC-CERT-NOPRINT Version 3(08/29/2019)[WC Policy610466811] U-26.3 20 [00000000000103703708 0001-000010466811 ##I 1587408 ][ ][ j[ ][Cert_NOP-CERT 1][01-00001] YORK workers' CERTIFICATE OF INSURANCE COVERAGE sTeerf Compensation Board NYS DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW PART 1.To be completed by NYS 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 GENREADY,INC. 631-544-0400 128 PULASKI ROAD KINGS PARK,NY 11754 1 c.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 New York State,i.e.,wrap-Up Policy) 112763133 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 54375 MAIN RD 3b.Policy Number of Entity Listed in Box"l a" SOUTHOLD, NY 11971 DBL265291 3c.Policy effective period 01/01/2022 to 12/31/2022 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: ❑X 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 penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has NYS Disability and/or Paid Family Leave Benefits insurance coverage as described above. Date Signed 4/22/2022 By Via-4� (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 Executive 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 emailed to PAU@wcb.ny.gov or it can 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 413,4C or 56 have been checked) State of New York Workers' Compensation 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(Article 9 of the Workers'Compensation Law)with respect to all of their 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 (12.21) 111111111°°°1°°i!iiuuiiiiiiii�igiiiiiuii�l1111 AC<>R"® CERTIFICATE OF LIABILITY INSURANCE DATE(M 04/22//20222022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME FARM FAMILY CASUALTY PHONE FAX AIC No Ext): A/C No): 859 CONNETQUOT AVENUE ADDRESS: ISLIP TERRACE,NY 11752 INSURER(S)AFFORDING COVERAGE NAIC# 631-277-7770 INSURERA: FARM FAMILY CASUALTY INS.CO. 13803 INSURED INSURERS: STATE INSURANCE FUND 36102 GENREADY, INC. INSURERC: SHELTER POINT 81434 128 PULASKI ROAD INSURER D: KINGS PARK NY 11754 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 125539 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY 3152X1390 05/07/22 05/07/23 EACH OCCURRENCE s 2,000,000 CLAIMS-MADE OCCUR PREMISES(ETO a RENTED ence) $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 X POLICY 1 PEC LOC PRODUCTS-COMP/OP AGG $ 4,000,000 OTHER: $ A AUTOMOBILE LIABILITY 3152C4335 05/07/22 05/07/23 (aaccaent)SINGLE $ 1,000,000 IxANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS X AUTOS BODILY INJURY(Per accident) $ HIREDAUTOS X NON-OWNED PROPERTY DAMAGE AUTOS (Per accident) $ A X UMBRELLA LIAB X OCCUR 3101E1933 06/03/22 06/03/23 EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED I X I RETENTION$$10,000 g B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN CERTIFICATE STA UTE R ANY PROPRIETOR/PARTNER/EXECUTIVE❑ NIA ATTACHED E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) 1046681-1 E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C NYSDBL DBL 265291 01/01/07 INDEFINITE STATUTORY DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN OF SOUTHOLD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 54375 MAIN ROAD ACCORDANCE WITH THE POLICY PROVISIONS. SOUTHOLD, NY 11971 AUTHORIZED REPRESENTATIVE I ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Labor,Suffolk County Dept.of ' Licensing&Cons R.. I ,, umergffairs �^-�. � 'WASTER ELECTRICAL LICENSE Name EDWARD S REIFF this certifies that the Business Name -learer is Cly licensed 3y the.County of Suffolk GENREADY,INC. Rosalie Drago Llcense Number;ME_2740 COM- Issued: 05/01/1980 ssioner Expires: 05/01/2024 Additional Instructions for Form 1313-120.1 By signing this form,the insurance carrier identified in Box 3 on this form is certifying that it is insuring the business referenced in Box 1 a for disability and/or Paid Family Leave benefits under the NYS Disability and Paid Family Leave Benefits Law.The insurance carrier or its licensed agent will send this Certificate of Insurance Coverage(Certificate)to the entity listed as the certificate holder in Box 2. The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is cancelled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from coverage indicated on this Certificate.(These notices may be sent by regular mail.)Otherwise,this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent,or until the policy expiration date listed in Box 3c,whichever is earlier. This Certificate is issued as a matter of information only and confers no rights upon the certificate holder.This Certificate does not amend,extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This Certificate may be used as evidence of a NYS disability and/or Paid Family Leave benefits contract of Insurance only while the underlying policy is in effect. Please Note: Upon the cancellation of the disability and/or Paid Family Leave benefits policy indicated on this form,if the business continues to be named on a permit, license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Insurance Coverage for NYS disability and/ or Paid Family Leave Benefits or other authorized proof that the business is complying with the mandatory coverage requirements of the NYS Disability and Paid Family Leave Benefits Law. NYS DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW §220. Subd. 8 (a) The head of a state or municipal department, board, commission or office authorized or required by law to issue any permit for or in connection with any work involving the employment of employees in employment as defined in this article, and not withstanding any general or special statute requiring or authorizing the issue of such permits,shall not issue such permit unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair,that the payment of disability benefits and after January first,two thousand and twenty-one,the payment of family leave benefits for all employees has been secured as provided by this article. Nothing herein, however, shall be construed as creating any liability on the part of such state or municipal department, board, commission or office to pay any disability benefits to any such employee if so employed. (b)The head of a state or municipal department,board, commission or office authorized or required by law to enter into any contract for or in connection with any work involving the employment of employees in employment as defined in this article and notwithstanding any general or special statute requiring or authorizing any such contract,shall not enter into any such contract unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair,that the payment of disability benefits and after January first,two thousand eighteen,the payment of family leave benefits for all employees has been secured as provided by this article. DB-120.1 (12-21)Reverse P RK workers• CERTIFICATE OF INSURANCE COVERAGE atE Compensation Board NYS DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW PART 1.To be completed by NYS disability and Paid Family Leave benefits carrier or licensed insurance agent of that carrie 1 a.Legal Name$Address of Insured(use street address only) 1 b.Business Telephone Number of Insured MR.FAUCET SERVICE COMPANY INC DBA INSTALLGAS.COM 516-752-1234 201 NORTHWEST DRIVE SUITE 1 FARMINGDALE,NY 11735 1c.Federal Employer Identification Number of Insured Work Location of Insured(Only required if coverage 1s specifically limited to or Social Security Number certain locations In New York State,i.e.,Wrap-Up Policy) 112851548 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 53095 Route 25, 3b.Policy Number of Entity Listed in Box"l a" PO Box 1179 DBL338240 Southold,NY 11971 3c.Policy effective period 04/30/2021 to 04/29/2023 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 employers employees: Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has NYS Disability andlor Paid Family Leave Benefits insurance coverage as described above. Date Signed 3/29/2022 By (Signature of insurance carrier's authorized representative or NYS Licensed Insurance Agent of that insurance carrier) Telephone Number 516-829-8100 Name and rue Richard White, Chief Executive 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 413,4C or 513 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 emailed to PAU@wcb.ny.gov or it can 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 48,4C or 5B have been checked) State of New York Workers' Compensation 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(Article 9 of the Workers'Compensation Law)with respect to all of their 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 Fort DB-120.1.Insurance brokers are NOT authorized to Issue this form. oe.,zo., (12.21) �IIIIIPIgII�IQ2IIQI1IIIIf(i12«i2l1)iyQll� NY S ' F PO Box 66699,Albany,NY 12206 New York State Insurance Fund I nySlf com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE A A A A A A 112851548 0 Q KEEVILY,SPERO-WHITELAW INC. 500 MAMARONECK AVENUE HARRISON NY 10528 ❑. y SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER MR.FAUCET SERVICE CO.,INC. TOWN OF SOUTHOLD DBA INSTALLGAS.COM 53095 ROUTE 25 201 NORTHWEST DRIVE,SUITE#1 PO BOX 1179 FARMINGDALE NY 11735 SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE G 1149 296-4 701999 05/01/2022 TO 05/01/2023 03/29/2022 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1149 296-4, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS'COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW.- IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY, INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE, VISIT OUR WEBSITE AT HTTPS:/MIWW.NYSIF.COM/CERT/ CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. 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 DIRECTOR,ISURANCE FUND UNDERWRITING VALIDATION NUMBER: 217780990 I�p I�®®If900000000000107 7950177®®ER Four WC-CERT-NOPRINT Va sion%(OK:29,2019)IWC Policy-114929641 U-26.3 289 (oa00000o00a102206on)(00014=01140296411Qae11WSS-34pcart pwP- 3Mi 11101-00(1011 A ORE® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDOPAIM 04/1312022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder Is an ADDITIONAL INSURED,the pollcy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WANED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Kat MlStretta NAME: National Insurance Brokerage of New York,Inc. PAHCONN E (631)273-0242 FAX o. (A,,,,,,: (831)273-8991) 175 Oval Drive ADDRESS: KMistrelte@nibony.com INSURERS AFFORDING COVERAGE NAIL 0 Is�ndia NY 11749 INSURER A: Merchants Mutual insurance Co 23329 INSURED INSURER B: Mr.Faucet Service Company Inc INSURERC: dba Installgas.com$Paul E.Muhs INSURER D: 201 Northwest Drive INSURER E: Farmingdale NY 117354920 INSURER F: COVERAGES CERTIFICATE NUMBER: 22-23 MASTER REVISION NUMBER: THIS IS TO CERTIFYTHATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. L ITR TYPE OF INSURANCE SO WD POLICYNUMBERPOLICY EFF MOMMID LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,00D,000 CLAIMS-MADE a OCCUR PREMISES Fa oeamence S 500,000 Contractual Liability MED EXP one personli S 15,000 A BOP1048048 05/01/2022 0510112023 PERSONAL a ADV INJURY S Included GENLAGGREGATE LIMIT APPLIES PER.* GENERALAGGREGATE S 2.000,001) POLICY®jECT F-1 LOC PRODUCTS-COMPIOPAGG S 2,000,000 OTHER: S AUTOMOBILELIABILITY COMBINED SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Par person) S OWNED AUTOS ONLY ALITOSSCHEDULED BODILY INJURY(Per acddore) S HIRED NON-OWNED PROPFRTYDAMAGE AUTOS ONLY AUTOS ONLY pera dder S a UMBRELLA.UASOCCUR EACH OCCURRENCE S EXCESS LIAR HCLAIMSMAO9 AGGREGATE S DED I I RETENTIONS S WORKERS COMPENSATION I PER OTH- ANDEMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETORIPARTNERIEXECUTNE ❑ NIA E.L.EACH ACCIDENT S OFFICERIMEMBER EXCLUDED? (MendstoryInNH) hs.desedbo under E.L.DISEASE-EA EMPLOYEE $ DESCRIPTION OF OPERATIONS below E.L.DISEASE.POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORO 101,Additional Romadm Schedule,may he attached If mora space to required) The CeAlfrcate Holder is Included as additional Insured A.T.I.M.A with respect to General Liability as required by written contractWtten agreement per the policy terms,conditions and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Southold ACCORDANCE WITH THE POLICY PROVISIONS. 53095 Route 25 PO Box 1179 AUTHORIZED REPRESENTATIVE Southold NY 11971 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD n., Q� x�f -w 91, -4p ph _'52*t n y V-Y� Pet MA I AN 31W .�......... ............t ............. ...................... -Ale. Al R Suffolk County Dpnartment ofLabor, Licensing & fil":1TI Consumer Affairs R VETERANS MEMORIAL HIGHWAY HAUPPAUGE, NEWYORK 11788 &&R %4 10/08/2002 MP-32128 DATE ISSUED: No. ... ........... SUFFOLK COUNTY Master Plumber License This is to certify that Gerard J Aaron Alz/ /q. AqW doing business as Mr Faucet Service Company Inc DBA -ice having given satisfactory evidence of competency, is hereby licensed as MASTER PLUMBER in accordai X. T h� with and subject to the provisions of applicable laws, rules and regulations of the County of Suffolk, State of New York. "A"0�0� NOT VALID WITHOUT Additional Businesses TMENTAL S -AL DEPAR Installgas.com AND A CURRENT CONSUMER AFFAIRS ;J ID CARD F Suffolk County Dept.of An airs Labor,Licensing &consumer Aff JI., "N'-,\P MASTER PLUMBING Name 4_1 1) 1. A Jz GERARD J AARON Rosalie Drago B usinazz 11.1 am.8 Y-s�' Commissioner This certifies that the Mr Faucet Serv;ce Company Inc DBA bearer is duly licensed by the County of Suffolk License Number:MP-32128 Rosalie Drago Issued: 1010812002 ................ ............... Expires: 10101/2022 ............ .... ....................... ...... comm;ssione, V, 9� RUM LJ, 14-11NOL SOUND S.C.T.M. No. 1000-61-01-JS it-07 AR96 = VDIOIS Tv sw Luvff .3.! 37f S W19,00' .E VD.W. LF? AMA = ssfff*6 3%,R 170 Copaffull rm �P.y M, U,9 -- — LOT COVMUGS OF HUMMUMC LAND HOUST = 1.212 S.F. As rLIP GARAGE = 467 aF. SrZIPS = 78 S.F. POOL = 518 S.F. VMM NA L 2.Zn S.F. / ll.JLX L 0 P[,,-17.4 Yy'-'l 3',! LAAW TITIA' rNSVRA,'VCi04IMP"Mil" 97:1 Y'm,PM Ski*"14lTw w MAN=% AMP wwwwl� ism'" I Mir, rum cr �n I Fl sp i3 7i 06 z aver nww ECF � VE MAY I FD R 6je* rakr BUILDING DEFT TOWN OF SOUTHOLD off- OFF k Orr(W 5,11,ayAhoh jjl All 00. SOUNDIVIER AVEN 1w''' o2P7i3J EU SECCAFICO LAND SpURVE'?7JVG PC 5-00 Mant*(llt piqfl�q Neiv YLW Yz 7,1355 i Mr. Faucet Service Co., Inc. InstallGas.com 201 Northwest Dr. Farmingdale, NY 11735 Trudie Burns 18915 Soundview Avenue Southold, NY 11971 i METER GENERATOR (low I J t Ce APPR VED AS NOTED DATE:,6 B.P.# U FEE: BY: NOTIFY BUILDING 'EPARTMENT AT 765-1802 -8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE .2., ROUGH,r FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONE," ")N MUST BE COMPLETL ALL CONSTRUCA L-t. -ALL MEET THE REQUIREMENTS OF;HE:CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF SeTtft ,T BOARD .SOLJqHeLD7_MRUSTEES c_ OCCUPANCY OR 0 US,E 1-S UNLAWFUL WITHOUT CERTIFIC1, OF OCCUPANCY ELECTRICAL INSPECTION REQUIRED t ® Fesidential UARDIAN SERIES 2®/22/24 W MAY 1 6 '�U�1 Standby Generators BUILDING DEPT Air-Cooled Gas Engine TOWN OF SOUTHOLD INCLUDES: Standby Power Rating G007038-1,G007039-1,G007038-3,G007039-3(Aluminum-Bisque)-20 kW 60 Hz • True Power''Electrical Technology G007042-2,GO07043-2,GO07042-3,G007043-3(Aluminum-Bisque)-22 kW 60 Hz • Two-line multilingual digital LCD Evolution'"' controller' G007209-0,G007210-0(Aluminum-Bisque)-24 kW 60 Hz (Eng li sh/Spani sh/Fren ch/Portug uese) • 200 amp service rated transfer switch available • Electronic governor r. • Standard Wi-Fi®connectivity • System status&maintenance interval LED indicators • Sound attenuated enclosure • Flexible fuel line connector T'`, • Natural gas or LP gas operation ° " • 5 Year limited warranty • Listed and labeled by the Southwest Research Institute allowing installation as close as 18 in(457 mm)to a structure.* t Of a *Must be located away from doors,windows,and fresh air intakes and in accordance with local codes. us or C@us QUI haps://assets.swri.orgllibrary/DirectoryOfListedFroducts/ I�/ QEF f (2� Constructionlndustryl973_DoC 204_13204-01-01_Rev9.pdf LISTED n Note:CETL or CUL certification only applies to unbundled units and units packaged with limited circuit switches.Units packaged with the Smart Switch are ErL or UL certified in the USA only. FEATURES O INNOVATIVE ENGINE DESIGN&RIGOROUS TESTING are at the heart of Gen- O SOLID-STATE, FREQUENCY COMPENSATED VOLTAGE REGULATION: This erac's success in providing the most reliable generators possible. Generac's G- state-of-the-art power maximizing regulation system is standard on all Generac mod- Force engine lineup offers added peace of mind and reliability for when it's needed els.It provides optimized FAST RESPONSE to changing load conditions and MAXI- the most.The G-Force series engines are purpose built and designed to handle the MUM MOTOR STARTING CAPABILITY by electronically torque-matching the surge rigors of extended run times in high temperatures and extreme operating conditions. loads to the engine.Digital voltage regulation at±1%. O TRUE POWER'"ELECTRICAL TECHNOLOGY:Superior harmonics and sine wave O SINGLE SOURCE SERVICE RESPONSE from Generac's extensive dealer network form produce less than 5%Total Harmonic Distortion for utility quality power.This provides parts and service know-how for the entire unit,from the engine to the small- allows confident operation of sensitive electronic equipment and micro-chip based est electronic component. appliances,such as variable speed HVAC systems. O TEST CRITERIA: O GENERAC TRANSFER SWITCHES:Long life and reliability are synonymous with ✓ PROTOTYPE TESTED ✓ NEMA MG1-22 EVALUATION GENERAC POWER SYSTEMS.One reason for this confidence is that the GENERAC ✓ SYSTEM TORSIONAL TESTED ✓ MOTOR STARTING ABILITY product line is offered with its own transfer systems and controls for total system compatibility. O MOBILE LINK®CONNECTIVITY:FREE with select Guardian Series Home standby O PWRVIEW' TRANSFER SWITCH: The Generac PWRview Automatic Transfer generators, Mobile Link Wi-Fi allows users to monitor generator status from any- Switch integrates the PWRview energy monitor to provide real-time energy con- where in the world using a smartphone,tablet,or PC.Easily access information such sumption data that can help lower a home's electricity bill. Using a convenient as the current operating status and maintenance alerts. Users can connect an mobile app,homeowners can access energy usage and alert information while under account to an authorized service dealer for fast,friendly,and proactive service.With utility power or generator power.The PWRview energy monitor is a simple to use and Mobile Link,users are taken care of before the next power outage. low cost tool which helps save money over the life of the generator.Included with model G007210-0. w GENERAC M1p� (rgGE®PROMISE PWRIM } GENERAL® 20/22/24 kill! Features and Benefits _ Engine cm • Generac G-Force design Maximizes engine"breathing"for'increased fuel efficiency.Plateau honed cylinder walls and plasma moly rings help the engine run cooler,reducing oil consumption and resulting in longer engine life. • "Spiny-lok"cast iron cylinder walls Rigid construction and added durability provide long engine life. • Electronic ignition/spark advance These features combine to assure smooth,quick starting every time. f 6 • Full pressure lubrication system Pressurized lubrication to all vital bearings means better performance,less maintenance,and longer engine ' life.Now featuring up to a 2 year/200 hour oil change interval. • Low oil pressure shutdown system Shutdown protection prevents catastrophic engine damage due to low oil. • High temperature shutdown Prevents damage due to overheating. Generator • Revolving field Allows for a smaller,light weight unit that operates 25%more efficiently than a revolving armature generator. • Skewed stator Produces a smooth output waveform for compatibility with electronic equipment. • Displaced phase excitation Maximizes motor starting capability. • Automatic voltage regulation Regulating output voltage to±1%prevents damaging voltage spikes. • UL 2200 listed For your safety. Transfer Switch (if applicable) • Fully automatic Transfers vital electrical loads to the energized source of power. • NEMA 3R Can be installed inside or outside for maximum flexibility. • Integrated load management technology Capability to manage additional loads for efficient power management. • Remote mounting Mounts near an existing distribution panel for simple,low-cost installation. PWRview Transfer Switch(if applicable) • PWRview energy monitor Energy usage at-a-glance. • Ability to view real-time energy consumption data Better understand the home's energy profile. • PWRview mobile app Access daily energy intelligence and insights. Evolution-Controls • AUTO/MANUAUOFF illuminated buttons Selects the operating mode and provides easy,at-a-glance status indication in any condition. • Two-line multilingual LCD Provides homeowners easily visible logs of history,maintenance,and events up to 50 occurrences. • Sealed,raised buttons Smooth,weather-resistant user interface for programming and operations. • Utility voltage sensing Constantly monitors utility voltage,setpoints 65%dropout,80%pick-up,of standard voltage. • Generator voltage sensing Constantly monitors generator voltage to verify the cleanest power delivered to the home. • Utility interrupt delay Prevents nuisance start-ups of the engine,adjustable 2-1500 seconds from the factory default setting of 5 seconds by a qualified dealer. • Engine warm-up Verifies engine is ready to assume the load,setpoint approximately 5 seconds. • Engine cool-down Allows engine to cool prior to shutdown,setpoint approximately 1 minute. • Programmable exercise Operates engine to prevent oil seal drying and damage between power outages by running the generator for 5 minutes every other week.Also offers a selectable setting for weekly or monthly operation providing flexibility and potentially lower fuel costs to the owner. • Smart battery charger Delivers charge to the battery only when needed at varying rates depending on outdoor air temperature. Compatible with lead acid and AGM-style batteries. • Main line circuit breaker Protects generator from overload. • Electronic governor Maintains constant 60 Hz frequency. :4 t GENERAC® 20/22/24 kW Features and Benefits 04 Unit CD • SAE weather protective enclosure Sound attenuated enclosures ensure quiet operation and protection against mother nature,withstanding winds up to 150 mph(241 km/h).Hinged key locking roof panel for security.Lift-out front for easy access to all routine maintenance items.Electrostatically applied textured epoxy paint for added durability. • Enclosed critical grade muffler Quiet,critical grade muffler is mounted inside the unit to prevent injuries. • Small,compact,attractive Makes for an easy,eye appealing installation,as close as 18 in(457 mm)away from a structure. 3 of , Installation System • 14 in(35.6 cm)flexible fuel line connector Listed ANSI Z21.75/CSA 6.27 outdoor appliance connector for the required connection to the gas supply piping. • Integral sediment trap Meets IFGC and NFPA 54 installation requirements. Connectivity(Wi-Fi equipped models only) • Ability to view generator status Monitor generator with a smartphone,tablet,or computer at any time via the Mobile Link application for complete peace of mind. • Ability to view generator Exercise/Run and Total Hours Review the generator's complete protection profile for exercise hours and total hours. • Ability to view generator maintenance information• Provides maintenance information for the specific model generator when scheduled maintenance is due. ♦ Monthly report with previous month's activity Detailed monthly reports provide historical generator information. • Ability to view generator battery information Built in battery diagnostics displaying current state of the battery. • Weather information Provides detailed local ambient weather conditions for generator location. S GENERAC® 20/22/24 kW Specifications Generator Model G007038-1 G007042-2 G007038-3 G007042-3 G00720M G007039-1 G007043-2 G007039-3 G007043-3 G007210-0 _ (20 kW) (22 kW) (20 kW) (22 kW) (24 kW) - _ 20,000 Watts' 22,000 Watts' 24,000 Watts' Rated maximum continuous power capacity(LP)"_ � .20,000 Wats' � 22,000 Watts' _ _ Rated maximum continuous power capacity(NG) 18,000 Watts' 19,500 Watts• 18,000 Watts' 19,500 Wafts' 21,000 Wafts' tRatedvoltage •• .. .. •. . , --�- __-_' _ .:___:: : . - __-___ ;240 _ _ . � � 5.0 91.7/81.3 Rated maximum continuous load current-240 volts(LP/NG) 83.3/7 83.3/75.0 91.7/81.3 100/87.5 .. - Total Harmonic Distortion • •: t Less than'5% Main line circuit breaker 90 amp 100 amp 90 amp 100 amp 100 amp Number of rotor poles 2 - Rated ACfrequen_cy,"•`; „ _ 60 Hz_^ Power factor 1.0 Buttery requirement(not included) `:i _ _ _ _ 12 Volts,Group 26R 540 CCA m_ihimum or Group 35AGM 650 CCA_m_inimu_m_ Unit weight(lb/kg) 448/203 466/211 436/198 445/202 455/206 Dimensions(L x'W,ii H)in/cm.. x v: .". ' 48 x 25 x 29%,121.9 x 63:5 x 73:7 Sound output in dB(A)at 23 It(7 m)with generator operating at normal load" 61 67 67 - 67 67 ;Sound output In dB(A)at 23 ft(i m)with generator m Outet-Test"low-speed exerase mode":. - 55 57 55 57 57 - - - -- - Exercise duration 5 min Engine Engine type GENERAC G-Force 1000 Series 3,Number of cylinders .-- <: --`y 2 Displacement 999 cc Cylinder bfock; Aluminum w/cast iron sleeve Valve arrangement Overhead valve ;Ignition system Solid-_state w/magneto 6 —'— -- - - Governor system Electronic ,Compression ratio ; 9.5:1' Starter 12 VDC ;Oil,capacfty including filter , Approx1.9 qt/,1.8 L Operating rpm 3,600 Fuel consumption " Natural gas :" tt3/hr(m3/hr) .. r• ` "1/2 Load 204(5.78) 228(6:46) - 164(4.64) 20$(5.75) Full.Load•- • 301(8.52) . ` . 327.(9.26) 287.(8.13) '_ 306(8.66) Liquid propane, 1`13/hr(gaff)[Uhr], ;. 1/2 Load. -87(2,37)18.991 92(2.53)[9.57] 86(2.36)[8.95] 92(2.53)[9.57]' ___ Full Load _ :,- 130(3.56)(13.48] 142(3:90)[14.77] 136(3'.74)[1'4.15] ` 142(3.90)[14.77) Note:Fuel pipe must be sized for full load.Required fuel pressure to generator fuel inlet at all load ranges-3.5-7 in water column(0.87-1.74 kPa)for NG,10-12 in water column(2.49-2.99 kPa)for LP gas.For BTU content,multiply Offir x 2500(LP)or ft3/hr x 1000(NG).For Megajoule content,multiply m3/hr x 93.15(LP)or m3/hr x 37.26(NG). Controls Two-line plain text multilingual LCD Simple user interface for ease of operation. Mode Iiuftons:AUTO _' _ _ Automatic start on utility Failure.,Weekly;Bi weekly,"or Manihly'selectable exerciser. MANUAL Start with starter control,unit stays on.If utility fails,transfer to load takes place. -- OFF Stops unit.-Power is removed.Control and charger still operate, _ i _-.—..v---..._-- - - - - - -- Ready to AuNMaintenance messages Standard Standard Programmable start delay between 2-1500 seconds_ Standard(programmable by dealer only) :Utility Voltage Loss(Return to Utility adjustable_ oui(firownsetting) From 140-171 V/190-216V. Future Set Capable Fxerciser/Exercise Set Error warning Standard iRun/Alarm/Mairitenancetogs; 50 eventseach Engine start sequence Cyclic cranking:16 sec on,7 rest(90 sec maximum duration). Starter lock-out- ,- •: � - -, � ,. •-. ,�`- - � __•_• Starter cannohre-engage until 5 sec aker engine Pias stopped. _ Smart Battery Charger Standard :Charger FaulUMissing AC waming--y _-_ :: :;; Stzndard Low Battery/Battery Problem Protection and Battery Condition indication Standard 9�-- Automatic Volta a Regulation with Over and Under Voltage Protection - i Standard' c_ Under-Frequency/Overload/Stepper Overcurrent Protection Standard _Safety Fused/FuseProblemProtoction, - Shdndard - _ Automatic Low Oil Pressure/High Oil Temperature Shutdown Standard ;Overcrank/Overspeed(@ 72 Hz/rpm Sense Loss;Shutdown Standard' - High Engine Temperature Shutdown Standard ;Internal FaulVlncorrecfWiring protectibn_ ..,- - _, ,-;. • . _'-,_•_:;-,__ � - - - Standard- - Common external fault capability Standard :Field upgradable,firmware __ Standard ..Sound levels are taken from the front of the generator.Sound levels taken from other sides of the generator may be higher depending on installation parameters.Rating definitions-Standby:Applicable for supplying emergency power for the duration of the utility power outage.No overload capability is available for this rating.(All ratings in accordance with BS5514,IS03046 and DIN6271)."Maximum kilovolt amps and current are subject to and limited by such factors as fuel BTU/megajoule content,ambient temperature,altitude,engine power and condition,etc.Maximum power decreases approximately 3.5%for each 1,000 it(304.8 m)above sea level;and also will decrease approximately 1%for each 10 IF(6°C)above 60 IF(16°C). , r CENERAC® 20/22/24 kW Switch Options Service Rated Automatic Transfer Switch Features Model G007039.1,0007039-3(20 kW) • Intelligently manages up to four air conditioner loads with no additional hardware. 0007043-2o 0007043.3(22 kW) _ Y .< C'4. .. • Up to eight additional large(240 VAC)loads can be managed when used in conjunction Current rating(amps) _ M 200 with Smart Management Modules(SMMs). —• -- .--_._._-_.__ .- . !Vdltage'ratting;NAq)' ' ,. 0/240,'19_':r = • Electrically operated,mechanically-held contacts for fast,clean connections. utility voltage monitor(fixed)* - • Rated for all classes of load,100%equipment rated,both inductive and resistive. -Pick-up 80% Dropout . . _:_.• . �APpo65% • 2-pole,250 VAC contactors. o 6 • Service equipment rated,dual coil design. Exercises bi-weekly for 5 minutes* Standard a listed`"`` • Rated for both aluminum and copper conductors. E� :_ '` ' ,;"• ; = ;Starida�d _. ^ Enclosure type NEMA/UL 311 ' ~ • Main contacts are silver plated or silver alloy to resist welding and sticking. i- uit breaker_.� • NEMA/UL 3R aluminum outdoor enclosure allows for indoor or outdoor mounting flexibility. Lug range 250 MM-#6 *Function of Evolution controller Dimensions Exercise can be set to weekly,bi-weekly,or monthly w, 200 Amps 120/240,1e Open Transition Service Rated Height Width Hi H2 Wi W2 Depth in 26.8 30.1 10.5 13.5 6.9 r_ `'f cm 67.95 76.43 26.67 34.18 17.5 "1 Wire Ranges ; Conductor Lug Neutral Lug Ground Lug 250 MCM-#6 350 MCM-#6 2/0-#14 oePtx l--wz--i PWRview Automatic Transfer Switch Features Model G007210-0(24 kW) rlVor'ofpoles`e��� .`:.'': :^'•:;�;�'}�-`•, ." r:-;••;„,.• ;-2M,:�.''=s,� ,, ';_ ..: • Integrated PWRview monitor provides real-time energy usage data through PWRview app. 1— Current rating(amps) 200 • Intelligently manages up to four air conditioner loads with no additional hardware. Current rating(amps) • Up to eight additional large(240 VAC)loads can be managed when used in conjunction Utility voltage monitor(fixed)* with Smart Management Modules(SMMs). -Pick-up 80% • Electrically operated,mechanical ly-held contacts for fast,clean connections. Dropout 65%- -- . --..•,--, x -:.-;,..•:., :••,-::-• :.,--;., •. . • . is Rated for all classes of load,100%equipment rated,both inductive and resistive. Exercises bi-weekly for 5 minutes* Standard • 2-pole,250 VAC contactors, rETL of Ul lis{etl rt_..__..__•.._•.__-_....._.�- ;_Standard:) ' 1 � V . • Service equipment rated,dual coil design. Enclosure type NEMA 3R r._�•.::- jCirc,iit;breakefproiected • Rated for both aluminum and copper conductors. Lug range w� t 250 MCM-#6 • Main contacts are silver plated or silver alloy to resist welding and sticking. *Function of Evolution controller • NEMA 3R aluminum outdoor enclosure allows for indoor or outdoor mounting flexibility. Exercise can be set to weekly,bi-weekly,or monthly • Heavy duty Generac Contactor is an ETL recognized device. w' Dimensions 200 Amps 120/240,1e Open Transition Service Rated Height Width ' "' Hi H2 W1 W2 Depth in 26.8 30.1 10.5 1 13.5 6.9 cm 67.95 76.43 26.67 1 34.18 17.5 r�r .Y Sn Wire Ranges BalmI—wZ—I Conductor Lug Neutral Lug Ground Lug 250 MGM-#6 350 MCM-#6 210-#14 y. GENERAC® 20/22/24 kW Available Accessories 'Model'#' Piodbct 'Desai tion :; 04 fG005819-0 26R Wet Cell Battery- _1Every standby generator requires a batteryto startthe system.Generac offers the3recommended 2611wet cell batteryfor f ;use with all air-cooled standby product(excluding PowerPact®). 6007101-0 _.-- !Battery Pad Warmer ;Pad warmer rests under the battery.Recommended for use if temperature regularly falls below 0 OF(-18°C).(Not nec-' :essary for use with AGM-style batteries). 6007102-0 — FOil Warmer Oil warmer slips directly over the oil fitter.Recommended for use if temperature regularly falls below 0 OF(-18°C). ' of IG007103-1 (Breather Warmer ;Breather warmer is for use in extreme cold weather applications.For use with Evolution controllers only in climates where` I `heavy icing occurs. 605621-0 iAalTliryTransfer Switch The auxiliary transfer switch contact kit allows the transfer switch to lockout a single large electrical load that may not be ;Contact Kit ;needed.Not compatible with 50 amp pre-wired switches. Bisque fFasciaBaseWrap Kit ;6007027-0 Bis -_ __.__.___.----_._.-•_-- ____. -_.._.... .-` q The fascia base wrap snaps together around the bottom of the new air-cooled generators.This offers a sleek,contoured i(Standard on 22/24 kW) lappearance as well as offering protection from rodents and insects by covering the lifting holes located in the base. {6005703-0 Bisque Touch-Up Paint Kit !If the generator enclosure is scratched or damaged,it is important to touch up the paint to protect from future corrosion. i Jhe touch-up paint kit includes the necessary paint to correctly maintain or touch up a generator enclosure. !6006485-0 €Scheduled Maintenance Kit-i-G--- scheduled maintenance kit provides all the items necessary to perform complete routine maintenance on a Generac automatic standby generator(oil not included). rGc07005-0 TW-Fi LP Tank Fuel Level—;The Wi-Fi enabled LP tank fuel level monitor provides constant monitoring of the connected LP fuel tank.*Monitoring the; IMonitor ILP tank's fuel level is an important step in verifying the generator is ready to run during an unexpected power failure.Sta-' f Aus alerts are available through a free application to notify users when the LP tank is in need of a refill. sG007000 0(50 amp),Smart Management Module'Smart Management Modules(SMM)are used to optimize the performance of a standby generator.It manages large alae-. GO07006-0 'trical loads upon startup and sheds them to aid in recovery when overloaded.In many cases,using SMM's can reduce ;(100 amp) ;the overall size and cost of the system. ;6007169-0-4G LTE:Mobile Link Cellular The Mobile Link family of Cellular Accessories allow users to monitor generator status from anywhere in the world,using 'G007170-0-Wi-Fl/ 'Accessories a smart phone,tablet,or PC.Easily access information such as the current operating status and maintenance alerts.Us- 'Ethernet 'ers can connect an account with an authorized service dealer for fast,friendly,and proactive service.With Mobile Link, :users are taken care of before the next power outage. .6007220-0-Bisque •Base Plug Kit ;Base plugs snap into the lifting holes on the base of air-cooled home standby generators.This offers a sleek,contoured :appearance,as well as offers protection from rodents and insects by covering the lifting holes located in the base.Kit, ;contains four plugs,sufficient for use on a single air-cooled home standby generator. Dimensions & UPCs Model UPC 537.6mm 1216mm [25.1 Inl r48.0 Inl G007038-1 696471074185 G007038-3 696471074185 G007039-1 696471074192 G007039-3 696471074192 G007042-2 696471074208 727.2 mm (28.6 1n1 G007042-3 696471074208 G007043-2 696471074215 G007043-3 696471074215 a o 0 G007209-0 696471071511 G00721 0-0 696471078220 [25.51n] 1[4 5 MI LEFT SIDE VIEW FRONT VIEW Dimensions shown are approximate.See installation manual for exact dimensions.DO NOT USE THESE DIMENSIONS FOR INSTALLATION PURPOSES. GENE RAC® Generac Power Systems,Inc. • S45 W29290 HWY.59,Waukesha,WI 53189 • generac.com ©2020 Generac Power Systems,Inc.All rights reserved.All specifications are subject to change without notice.Part No.A0000937814 Rev.B 07/30/2020