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48678-Z
�o�OgtlFF�(�py Town of Southold 5/28/2023 P.O.Box 1179 o • �i 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 44136 Date: 5/28/2023 THIS CERTIFIES that the building GENERATOR Location of Property: 705 Capt Kidd Dr,Mattituck SCTM#: 473889 Sec/Block/Lot: 106.-5-8 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 12/2/2022 pursuant to which Building Permit No. 48678 dated 12/30/2022 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 standby generator as applied for. Maintain 36 inch distance to shrubs. The certificate is issued to Regan,Mary&Michael of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 48678 5/10/2023 PLUMBERS CERTIFICATION DATED riz d ignature TOWN OF SOUTHOLD BUILDING DEPARTMENT Y� ✓'s TOWN CLERK'S OFFICE SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 48678 Date: 12/30/2022 Permission is hereby granted to: Regan, Mary 4835 43rd St Apt 5C Woodside, NY 11377 To: Install accessory standby generator at existing single family dwelling as applied for. At premises located at: 705 Capt Kidd Dr, Mattituck SCTIVI #473889 Sec/Block/Lot# 106.-5-8 Pursuant to application dated 12/2/2022 and approved by the Building Inspector. To expire on 613012024. Fees: ACCESSORY $100.00 ELECTRIC $85.00 CO-RESIDENTIAL $50.00 Total: $235.00 Building Inspector pf SO!/j�ol 0 Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 aQ sean.devlin('D-town.southold.ny.us Southold,NY 11971-0959 'Q �yCOUM,� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Mary Regan Address: 705 Captain Kidd Dr city:Mattituck st: NY zip: 11952 Building Permit#: 48678 Section: 106 Block: 5 Lot: 8 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: Electrician: Wildwood Electric License No: 4836ME SITE DETAILS Office Use Only Residential X Indoor X Basement Service Commerical Outdoor X 1st Floor Pool New X Renovation 2nd Floor Hot Tub Addition Survey Attic Generator X 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 Transfer Switch 200A UC Lights Dryer Recpt Emergency StrobeHeat Detectors Disconnect Switches 4'LED Exit Fixtures Sump Pump Other Equipment: 20kW Kohler Generator w/200A Whole House Transfer Switch Notes: Generator Inspector Signature: Date: May 10, 2023 S.Devlin-Cert Electrical Compliance Form ,D �. "rte 13L I G DEPARTMENT- Electrical Inspector v•���suFFat,�� , O� 1-E". 2023 TOWN OF SOUTHOLD Town Hall Annex - 54375 Main Road - PO Box 1179 BIjILDaIG DE,FT. Southold, New York 11971-0959 topbone (631) 765-1802 - FAX (631) 765-9502 rogerr(D_southoldtownny.gov — seandO)southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All information Required) Date: 2 I 2 Company Name: 7, .c"c b Electrician's Name: Y% License No.: m2s, Elec. email: ��a�t�� ; cel cz�� V`Rc� ta 0)VY) Elec. Phone No: ._ b ❑I request an email copy of Certificate of Compliance Elec. Address.: i JOB SITE INFORMATION (All Information Required) Name: Ro (� Address: qoo Y1 e1E? ©'�-T �� Sova 41ra Cross Street: Phone No.: 6'31— 43— S Bldg.Permit #: MR 6 iy email: Tax Map District: 1000 Section: Block: Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): o✓1 112� be,) )--oov%,�/ Square Footage.- Circle ootage:Circle All That Apply: Is job ready for inspection?: YES ❑ NO g Rough In ❑ Final Do you need a Temp Certificate?: ❑ YES ® NO Issued On Temp Information: (All information required) Service Size❑1 PhF—]3 Ph Size: A # Meters Old Meter# ❑New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground[]overhead # Underground Laterals FI 1 2 FI H Frame Pole Work done on Service? Y 17 N Additional Information: PAYMENT DUE WITH APPLICATION : l OF SOUTyOIo 00 # # TOWN OF SOUTHOLD BUILDING DEPT. cou631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH. PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION �VkLECTRICAL (ROUGH) ] ELECTRICAL (FINAL) r [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: 0/\. Ake, DATE INSPECTOR ���K 1 ✓ ���F 50UTy� -- - ----- # * TOWN OF SOUTHOLD BUILDING DEPT. �ycou631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] NSULATION/CAULKING [ ] FRAMING /STRAPPING [ FINAL ,b 4,ft� [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ]' RENTAL REMARKS: 4AV*4- k 6e c AD&/ - h- ivy A9 dw4", DATE !Jl0fWkl2 INSPECTOR of SOUTyolo Li b & 76 * # TOWN OF SOUTHOLD BUILDING D PT. �y000rm, ' 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: l L a v_/ A' k-kr "&�c . DATE /G INSPECTOR Of SOUTyo� l l l Valv # # TOWN OF SOUTHOLD BUILDING DEPT. `ycou631-765-1802 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) �3ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: - e ou CV (211$ IL OAQA(2,�dl-& A a ✓ / s (Z fA I c P/0 4,Ujt\ ®U� DATE 3 23, INSPECT R PERMIT tt Address- f 1 Switches Outlets I / I � GFI's I f fI Surface ,1 Sconces HH's UC Lts �Z Fans1 �I Fridge HW Exhaust Oven AeA)OC W/D Smokes DW I Mini l ICarbon Micro Generator Combo Cooktop Transfer AC AH Hood Service Amps Have Used Special: Comments Cel c �r `� '�4wn�rLw�n..w.s. �..�.�,..w.r++..4e4uw�+a•w++i-.�.x--- ._ _ ___ .. . ., I #1 ` .�.., w...+�.r+r.rrw.�rl+ .__. _ �. iy _� F 4 f f � ,4\ !i w Ile k �� �, Kcww�.. _...� _.,.;, � j {r f, f t�- e, M ,� � ♦v 7 J FIELD INSPECTION REPORT I DATE COMMENTS FOUNDATION (1ST) ------------------------------------- DO FOUNDATION (2ND) m O Ult d ROUGH FRAMING& OG PLUMBING Q- r INSULATION PER N.Y. 17 4 STATE ENERGY CODE we FINAL IL ADDITIONAL COMMENTS c_o i�v ' c 1 o — � o Z m � k � ro C9 • O z x Z� x d H tion° cO�s 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) 765-9502 htt�s://WWW.SOLLtholdLownnv., ov Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only ® L PERMIT NO. Building Inspector: DEC U 2 2022 Applications and forms must be filled out in their entirety.Incomplete •roIBUIL 80E)EFTr1r, applications will not be accepted. Where the Applicant is not the owner,an Owner's Authorization form(Page 2)shall be completed. Date: OWNER(S)OF PROPERTY: Name: SCTM#1000- 106 - -5-- 9 Project Address: G lr. �/�,Ue aAX,/UcZ "o •t /l�/ Sa Phone#: -5/0/ Email:'V/ Mailing Address: -7os'' Ca e ,,,L b/• lvcl CONTACT PERSON: //--//-- Name: Z' -7 c e Mailing Address: 117-5c,--7 //TCJ(2G IU t 117161 U/J i »z r c` Phone#: 6/;z1- S-G 7_ a 700 Email:�r Sw e�e�ar�c f_s,Ca DESIGN PROFESSIONAL INFORMATION: Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: Name: 6u Cf. -5-e,-LJ Mailing Address:�G vee ni �L G Phone#: 63,1-56 /- ;2700 Email DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: P101her Will the lot be re-graded? ❑Yes 0 N Will excess fill be removed from premises? ❑Yes ONO 1 PROPERTY INFORMATION Existing use of property: Intended use of property: Zone or use district in which premises is situated: Are there any covenants d restrictions with respect to this property? ❑Yes L1 O IF YES,PROVIDE A COPY. ❑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 in 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):Zr Sa D;;�j e,-Tc Cia 4411 Authorized Agent ❑Owner Signature of Applicant: , fJa...��C Date: STATE OF NEW YORK) SS: COUNTY OF / ) L , J a- ,'! ,2 e de /Al being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the 4c /Z--I- (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 ofUaWe e.,'" ,20 JANET DAMIANO Notary Public NOTARY PUBLIC-STATE OF NEW YORK No. OIDA5061073 Qualified In Suffolk C u fy PROPERTY OWNER AUTHORIZATION My commleelon Expires .. �-- (Where the applicant is not the owner) Yoolu - 2e aW residing at -_-fD5_ C� QA7 vE 1-7,1 rr1_rJC1C,✓01 /f 95� do hereby authorize 2. s 0 ' b,1_75e el,-4f to apply on my behalf to the Town of Southold Building Department for approval as described herein, /1✓ a0:�» ` �L�'�L 0 lam_Z_zya z O nees Signatu e `�-- --� Date 11'1R�`� �• oC yb�N - f�C Aw Print Owner's Name 2 15 C DEC 0 2 ?072 BUILDING DEPARTMENT-Electra ctor dvOG1 TOWN OF SOUTHOLD Pok 1D Town Hall Annex- 54375 Main Road - PO Bok y Southold, New York 11971-0959 a4/1oo� Telephone (631) 765-1802-FAX (631) 765-9502 71 ' 0 rogerr@sQutholdtownny.aav-seand@southoidtownnv.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: 1 - ZZj- 2 Z Company Name: E-L 1.=.C A .I C '1��- • ' Name: License No.: �,1F - 4 _ email: (-,rdf' h 2 (vi t '1 `f(-iC .0 ►'Y) Address: �)c j:'�c-3y Phone No.: L-51Q 29- - L►e�E �3 - Z. - Z.?� f JOB SITE INFORMATION (All Information Required) Name: e- -7 -7 Address: S- Cross Street: Phone No.: S/6 - SSO -61013 Bldg.Perrnit* email: Tax Map District: 1000 Section: /o Block: Lot: BRIEF DESCRIPTION OF WORK(Please Print Clearly) 'LEG"i�/c�►L G'o�vn►�c�ivnl or A Zd Kw I<oyt.�x G�NrTo2 Circle All That Apply: Is job ready for inspection?: YES/ NO Rough In Final Do you need a Temp Certificate?: YES NO Issued On Temp In7ndLaterals on: (All informati required) rvize 1 3 Ph e: A #Meters Ofd fN r# N Service econnect-F d Reconnect- rvice Reconne d-Undergro d-Overhe #Undergr 1 H Frame Pole Work done on Servi Y N Additional Information: PAYMENT DUE WITH APPLICATIONZ I�12 - �e 6 r Request for Inspection FormAs l TE70325' S 86°Q8WE 100-00' 3 m. LOT 187 u 6RAVEL DwEmftfo z9.r 35 Ir LOT 189 Z DWY, 1 J p 3 f ala t o CLj uN i o I 1 ST FRAME 20.5 ' DWELLING i �• Ul I G C ! F 11.0' 4� 1.� GANOP'( �p/ J ch 4.rX28' o �,rSarAR54 f3t Z WD iiAr ��J3,y7.a 11e _.._._ CiAR 29.4 ,<-+,m...e..*""'""' ! e •�'�`�\_K. �sr a -V7OODFfflXEP ' 4 .R N 86000' + �100A0' _ NIFJ0M Si�lIEcf U[�17.PAl)d CIS E- co F -S,.,P–V Y UPDATCD: `'~ f'r�,y'`1 slZolz� dna cflNb / Ajt.f u L✓A LL/ C, FILE NAP Na 1672 1119/49 Urtmdhottzed aitewlan ar add[Ia„bthis d&meat is s vit Wft of Sermm!?= offtNvwYa,kSt9leEdum9mtLaw SURVEY OF: c ea,>aref.t rdtatr+�me, qtwubnabpmmw LOT 188 OWGUNS behaftott,sT.acompMT.Q fAgeogrsadteea9ag ` "°�°"adbd "'�°'�°�4° 1d0 or sabsegaantmmers. CAPTIAN KIDD ESTATES BLOCK 15 Copies oT88s dowmeetnot basing the ptclbmWWskM aetd a embossed (a im„p��miftwgld*ml4mmpmpeftb=aa MATTITUCK,TOWN OF SOUTHOLD faresper�pr poseatdmem.attttse[a,®moraddanI wg+iaeeisett,cemat ` t tetafnl,g vsft peau.pttnitlg a,eft add to-bags orad o0mmr SUFFOLK COUNTY, NEW YORK afOahtafwapandrwt:ammefftaf ,ifoW.10shmnam SURVEY DATE: .617102 SCALE: 1"=30 CERTIFIED ONLY TO: CHRISTOPHER AND ITA THIRKIEL.D 10 Sylvia Lane/NSddle island/New Ya&11453 (631)345-2658 Fax(631)924-7270 ; E-asn!mfspc@optmdiae nm IVE K Workers' CERTIFICATE OF INSURANCE COVERAGE ATE Compensation Board 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) 1 b.Business Telephone Number of Insured WILDWOOD ELECTRIC, INC. 6319294219 PO Box 373 Rocky Point NY 11778 1c.Federal Employer Identification Number of Insured Work Location of Insured(Only required if coverage is specifically limited to certain locations in New York State,i.e.,Wrap-Up Policy) or Social Security Number 11-2782074 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Town of Southold Standard Security Life Insurance Company of New York 3b.Policy Number of Entity Listed in Box"1 a" L82898-000 ' 53095 Route 25A,P.O.Box 1179 SOUTHOLD,NY 11971 3c.Policy effective period 1/1/2017 to 10/20/2023 4. Policy provides the following benefits: X❑ A.Both disability and paid family leave benefits. B.Disability benefits only. C.Paid family leave benefits only. 5. Policy covers: XO 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 insuran a coverage as described above. Date Signed 10/21/2022 By ir (Signature of insurance carrier's aut onzed r eta eve NY5 kicen Insurance Agent of that insurance carrier) Telephone Number (212)355-4141 Name and Title Bebi Ishmail,Supervisior-DBL/Policy Services 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' 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 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 D13-120.1. insurance brokers are NOT authorized to issue this form. DB-120.1 (10-17) 111111,11111111 I1111iiiiii111(11111111111mii)igllll ' 161 DATE(MMIDDlYYYY) A41CORIO CERTIFICATE OF LIABILITY INSURANCE 1oi21�2o2z 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 have ADDITIONAL INSURED provisions or 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). CNTACT O PRODUCER NAME: Jennifer Heiser 4 509 Nicholas Devito Agency,Inc. PHONE w�,AExti; (631)509.6388 _� Noi (631 -0099 L_ 449 Route 25A EMAIL FAX jennifer@deVitoagency.com Mount Sinai, NY 11766 INSURERS)AFFORDING COVERAGE _ NAIC# _ INSURERA: Merchants Mutual.Ins.Co. _ 23 INSURED ` INSURERB: Merchants Preferred Ins.Co. 1129_01 Wildwood Electric Inc. INSURER C; 49A Rocky Point Yaphank Road INSURER D: �„-,,,, Rocky Point, NY 11778 —�-- I INSURER F; COVERAGES CERTIFICATE NUMBER: 000103`19-915110 REVISION NUMBER: 68 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. 'INSR - IADOC�SUBRf ! POLICY EFF! POUCY EXP LIMITS LTR TYPE OF INSURANCE ' -.�--POLICY NUMBER MMIDDIYYYY 1DDIYWY A �(�COMMERCIAL GENERAL LIABILITY I' 13OP1099122 104/16/2022 04/16/2023 I EACH OCCURRENCE I$ 1,000,000_ HAMAGE�O' ENT£D CLAIMS-MADE 1 X�I OCCUR l $ 500000 MED EXP(Any one person) $ 15,000 Xi_Contractual - ! X Liability _ j PERSONAL&ADV_INJUR� Y r$ _Included GEN'L AGGREGATE LIMIT APPLIES PER: f ! GENERAL AGGREGATE ;S 2000.000. POLICY l��JEu LOC I I I PRODUCTS-COMPIOPAGG S ,- 2,000,000- !$ OTHER: I COMBINED SINGLE LIMIT B AUTOMOBILE LIABILITYi {CAP1070996 104116/2022 {04/16/2023 i Vi , !s 1.000.000 ANY AUTO ( I BODILY INJURY(Per person) I$ OWNED ? 7I SCHEDULED i !BODILY INJURY(Per accident)j$ ...�..i AUTOS ONLY i"X'1 AUTOS I ' f PROPERTY DAMAGE !$ __� HIREDX NON-OWNED YY AUTOS ONLY i=I AUTOS ONLY i$ AyX,.-)UMBRELLA LIAR � OCCUR ' 'CUP9149680 104/16/2022 1 04116/2023 EACH—OCCURRENCE I S 1,000,000 I EXCESS LIAB I X;CLAIMS-MAOE' j I .AGGREGATE i 3, 1,000 000 I DED I RETENTIONS WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE i j t E.L.EACH ACCIDENT _ $ OFFIC£RIMEMBER EXCLUDED? N I A I ! I I EL DISEASE-EA EMPLOYE S (Mandatory in NH) 11 yes-describe under ' DESCRIPTION OF OPERATIONS below ! E.L.DISEASE--POLICY LIMIT S I I I I ! DESCRIPTION OF OPERATIONS I LOCATIONS I 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 53095 Route 25 ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1179 AUTHORIZED REPRESENTATIVE Southold, NY 11971 J-H ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Printed by J-H on 10/21/2022 at 03:06PM I uK Workers' CERTIFICATE OF Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1 a.Legal Name 8 Address of Insured(use street address only) I Business Telephone Number of Insured Wildwood Electric Inc. 631-929-4219 49A Rocky Point Yaphank Road 1c.NYS Unemployment Insurance Employer Registration Number of Rocky Poiret, NY 11778 Insured Work Location of Insured(Only required ircoverage is specifically limited to 1d.Federal Employer Identification Number of Insured or Social Security certain locallons in New York State,i.e.,a Wrap-up Policy) Number 11-2782074 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Cartier (Entity Being Listed as the Certificate Holder) Sentinel Ins. Co. Town of Southold 3b.Policy Number of Entity Listed In Box"'lie 53095 Route 25 PO Box 1179 12WECAC6TZH Southold, NY 11971 3c.Policy effective period 12/31/2021 to 12/31/2022 3d.The Proprietor,Partners or Executive Officers are ® included.(Only check box it all partnerslofflcers included) ❑ all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box"1 a"for workers' compensation under the New York State Workers'Compensation Law.(To use this form,New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above 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 canceled 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 the 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 Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note:Upon cancellation of the workers'compensation 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 Workers'Compensation Coverage or other authorized proof that the business Is complying with the mandatory coverage requirements of the New York State Workers'Compensation law. 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 the coverage as depicted on this form. Approved by: Nicholas Devito (Print name of authorized representative or 5 sed a n of insurance can err)) Approved by: lr�J�✓!� ' "C� r /J (Signature) (date) Title_ Authorized Representative Telephone Number of authorized representative or licensed agent of insurance carrier. 631-509-6388 Please Note:Only insurance carriers and their licensed agents are authorized to Issue Form C-1052.Insurance brokers are NOT authorized to issue it. C-105.2(9-17) ww+rr.wcb.ny.gov B DATE(MM/DDIYYYY) A�1eo CERTIFICATE OF LIABILITY INSURANCE 10/20/2022 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()es)must have ADDITIONAL INSURED provisions or 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 CON-FACT Borg&Borg Inc. PHONE I FAx 148 East Main Street �c Ho.E:p 631-673-7600__ ;_ML No);_631-351-17 .00 Huntington NY 11743 gp�eess INSNAIC 0 _ INSURERA:Ohio Security Insurance Co 24082 INSURED POWESER-01 INSURER B:Ohio Casually Ins.CO. 24074 Power Pro Service Co.Inc. 608 Johnson Ave,Ste 6 irrsur: s,c; Bohemia NY 11716 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1962309390 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. INSRLTR ..A.N -------jll'�D4Q�R�._.__.__ —T'POLICY EFF I POUCY U(P.... TYPE OF I POLICYNUMBER I MMIDDfYYYY I MM/D 7 YY LIMITS A X COMMERCIAL GENERAL LIABILITY Y BKS59794035 5/712022 5/7/2023 EACH OCCURRENCE $1,000,000 DAMAGE TO EED CLAIMS-MADE X!OCCUR PREMISES Ea occur onto) s300,000 X Contractual Uab MED EXP(Any one poison) ,$15,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: � � GENERAL AGGREGATE $2,000,000 I X I PRO' II I I PRODUC75•COMPIOPAGG 52.000.000 POLICY' :JECT l_J LOC ! I ,. .T - ._. ._ OTHER:- -- 1 I I .$ A AUTOMOBILE LIABILITY BK559794035 5/7/2022 i 5/7/2023 1COMBBINEDSINGLE LIMIT $1,000,000 X ANY AUTO I BODILY INJURY(Per person) S OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTYDAMAGE 5 AUTOS ONLY AUTOS ONLY (Per accident) S B X UMBRELLA LIAB i X i OCCUR US059794035 5/7/2022 51712023 EACH OCCURRENCE s 5,000,000 EXCESS LIAB L CLAIMS•MADE _AGGREGATE $5.000,000 DED X RETENTiONSInnnn I $ WORKERS COMPENSATION I PER 0TH• AND EMPLOYERS'LIABILITY YIN I I ( „STATUTE •_ ,ER . I— ANYPROPRIETOFiIPARTNER/EXECUTIVE i I I E.L.EACH ACCIDENT S OFFICERIMEMBER EXCLUDED? ❑ N IA I ---"- (MandatorylnNH) I E.L.DISEASE-EA_EMPLOYEE S If yes,describe under 4 DESCRIPTION OF OPERATIONS below E.L.DISEASE•POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached If mora space Is(equired) certificate holder is added as additional insured CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Southold 54375 Main Road AUTHQRMEDREPRESENTATIVE Southold NY 11971 f / ©1988-20115 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ro& Workers' CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1 a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured PowerPro Service Co., Inc. 631-567-2700 608 Johnson Ave, Ste 6 Bohemia, NY 11716 Ins NYS Unemployment Insurance Employer Registration Number of Insured Work Location of Insured(Only required if coverage is specifically limited to 1d.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-Up Policy) Number 113430118 xx- 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) West American Insurance Compan Town of Southold 54375 Main Road 3b.Policy Number of Entity Listed in Box"la" Southold, NY 11971 XWW59794035 3c.Policy effective period 05/07/2022 05/07/2023 3d.The Proprietor,Partners or Executive Officers are included.(Only heck box if all partners/officers included)all excluded or certain partners/officers xclu?I. L❑ This certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box 1 a"for workers' compensation under the New York State Workers'Compensation Law.(To use this form,New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy).The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above 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 canceled 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 the 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 Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note:Upon cancellation of the workers'compensation 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 Workers'Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. 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 the coverage as depicted on this form. Approved by: Borg& Borg Inc., David M Borg President (Print name of authorized representative or licensed agent of insurance carrier) 10/20/2022 Approved by: (Signature) (Date) Title:_Authorized Representative Telephone Number of authorized representative or licensed agent of insurance carrier: 631-673-7600 Please Note:Only insurance carriers and their licensed agents are authorized to issue Form C-105.2.Insurance brokers are NOT authorized to issue it. C-105.2(9-17) www.wcb.ny.gov YORK Workers'Compensation CERTIFICATE OF INSURANCE COVERAGE STATE Board DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW PART 1.To be completed by Disability and Paid Family Leave Benefits Carrier or Licensed Insurance Agent or that Carrier 1 a.Legal Name and Address of Insured(Use street address only) 1 b.Business Telephone Number of Insured PowerPro Service Co., Inc. 631-567-2700 608 Johnson Ave, Ste 6 Bohemia, NY 11716 1c. Federal Employer Identification Number or Social Security Number Work Location of Insured(Only required if specifically limited to 113430118 certain locations in New York State,i.e.a Wrap-Up Policy) 2. Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier Hartford Life And (Entity Being Listed as Certificate Holder) 3b.Policy Number of entity listed in box"1a": LNY811134 Town of Southold 54375 Main Road 3c.Policy effective period: Southold, NY 11971 01!01/2014 12/31/2023 4. Policy provides the following benefits: _A. All for the employer's employees eligible under the New York Disability Law _B. Only the following class or classes of employer's employees: _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 penalty of perjury, 1 certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has NYS Disability Benefits insurance coverage as described above. Date Signed 10/20/2022 By: David M Bork (Signature of insurance carrier's authorized representative or NYS Licensed Insurance Agent of that insurance carrier) Telephone No. 631 673 7600 Name and Title:President IMPORTANT: If box 4a is 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"is checked,this certificate is NOT COMPLETE for the purposes of Section 220,Sub.8 of the Disability Benefits Law. It must be mailed for completion to the Workers'Compensation Board,DB Plans Acceptance Unit,328 State Street, Schenectady,New York 12305 PART 2.To be completed by the NYS Workers Compensation Board(Only if Box 4C or SB of Part 1 has been checked State of New York Workers' Compensation Board According to information maintained by the NYS Workers'Compensation Board,the above-named-insured employer has complied with the NYS Disability Benefits Law with respect to all or his/her employees. Date Signed By (Signature of NYS Workers'Compensation Board Employee) Telephone No. Title: Please Note: Only insurance carriers licensed to write NYS disability benefits insurance policies and NYS license 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) ) Labor,Licensing&Consumer Affairs HOME IMPROVEMENT LICENSE w. Name FRANK NAVETTA r ' Business Name rr,s cerifies:hat the >earer is duly licensed POWERPRO SERVICE COMPANY INC ay the County of suffolk License Number:H-44193 Rosalie Drago Issued: 02/21/20D8 Commissioner Expires: 02/01/2024 j •; , i. �. 1 <'rr � •«�./ .\ �fr. � \ '-}z/, rl�kt.; 7 prt :1 .-r-,...1- I },,..._ _ (f,({ f � iy } - _ 1 {+ '7 i}f t,1,r J. .:fy _ r'r'� "�,+.. �,' tib,!' •/., �,+i R,�r .,% „�, �t, .'�\1! '••�` ` IV I AP ' t , t Orin R s i �Kt >F.�-�, � ) U 7 rim`• ,, t 1 il`v-:'�C a '' ...,may-..�.-rte •--� � �= �' - r'+ ".` zev`a '+x`4�.s �-' O�l'i n ! A 1 Pm Y's ► } '�'r'' � 'S- y T i�A� `i �•l�n�� �- �'�4 rl� � n � .�i ;;!1��i���yt-�`�.tzS'�-,�:�.��1.;.:�,f-���� aSf�' !x 0 r 1� � ��jI ! - *MR� - r Jk.i � r i r r M� i �� �jY��ll'1�`1�1«it""} ���� '�w',t���`� `� _ • _ , JJ a I .. - �.�.�.�,.. -_tis---•— r__... _ 2 { rjIN"� Aln r�::�•�1 t \'��:ti..-.�\��._ Af(ff�'V t /�A-'��,\ti .;: _..�� � .t -�11��•-� \l,_.�li`\,'I. \t .�.-�4,�,� ,//\1'�.��.1.�,�'�.�I/���...`>•,�,� Il\�`=lyj�t ,;:�//\�tf%f>. �'���/\1f�1' J/1\� t L� 1 KOHLER. D__M®delso 20RCA(L) Multi-Fuel LPG/Natural Gas 09001 Standard Features 14 KOHLEP, • RDC2 Controller NATIONALLY REGISTERED o .One digital controller manages both the generator set and transfer switch functions(with optional Model RXT). o Electronic speed control responds quickly to varying -"" _::t:,..s=• �:• demand. o OnCue®Plus Generator Management System for remote ` monitoring is included with the generator. ': • Kohler Command PRO Engine Features o Kohler Command PRO®OHV engine with hydraulic valve �i lifters for reliable performance without routine valve adjustment or lengthy break-in requirements. • Designed for Easy Installation 1COf#� o Sturdy aluminum base can be mounted on gravel or a concrete mounting pad. o Fuel and electrical connections through the enclosure wall The Kohler® Advantage eliminate the need for stub-ups through the base. o Customer connection terminal block located near the • High Quality Power controller allows easy access for field wiring. Kohler home generators provide advanced voltage and o Designed for outdoor installation only. frequency regulation along with ultra-low levels of • Certifications harmonic distortion for excellent generator power quality to o Meets emission regulations for U.S. Environmental protect your valuable electronics. Protection Agency(EPA)with both natural gas and LPG. • Extraordinary Reliability ' o UL 2200/cUL listed (60 Hz model). Kohler is known for extraordinary reliability and o CSA certification available(60 Hz model). performance and backs that up with a premium 5-year or o Accepted liy the Massachusetts Board of Registration of 2000 hour limited warranty. Plumbers and Gas Fitters. • Powerful Performance o Meets 181 mph wind rating. Exclusive Powerboost' technology provides excellent starting power.§ • Approved for stationary standby applications in locations served by a reliable utility source. • Aluminum Enclosure • 20RCAL models packaged with a Model RXT automatic o Attractive aluminum enclosure allows installation as _ transfer switch are available. See page 4 and the Model close as 18 inches from your home or small business.' RXT ATS specification sheet. o Enclosure panels can be removed without tools to allow easy access for maintenance and service. • Warranty o 5-year/2000 hour limited warranty for on-grid(standby) applications in locations served by a reliable utility source. Generator Ratings Standby Ratings Line Circuit Natural Gas LPG Breaker Alternator Voltage Phase Hz kW/kVA- Amps kW/kVA Amps Amps Poles 2F7 120/240 1 60 18/18 75 20/20 83 100 2 120/208 3 60 17/21 58 17/21 58 70 3 2G7 120/240 3 60 17/21 51 17/21 51 60 3 277/480 3 60 17/21 26 17/21 26 30 3 Note: The line circuit breaker is automatically selected based on the generator set model and voltage configuration. RATINGS:Standby ratings apply to installations served by areliable utility source.All single-phase units are rated at 1.0 power factor.The standby rating is applicable tovariable loads with an average load factor of 6o%for the duration of the power outage.No overload rapacity is specified at this rating. Ratings are In accordance with ISO-3046/1,BS5514,AS2789,and DIN 6271.GENERAL GUIDELINES FOR DERATING:ALTITUDE:Derate 4%per 305 m(1000 ft.)elevation above 153 m(500 ft.).TEMPERATURE:Derate 21/6 per 5.5°C(10°F)temperature increase above 16°C(60°F). Availability is subject to change without notice.The generator set manufacturer reserves the dghtto change the design or specifications without notice and without any obligation orllability,-whatsoever. Contact your local Kohler Co.generator distributor for availability. l § Check the appliance manufacturer's specifications for actual power requirements.Consult a Kohler©Power systems professional to calculate your exact residential power system requirements. t Meets NFPA guidelines for 16 inch clearance to combustible materials. Check state and local codes for minimum distance required from a structure. G4-272(20RCA) 4/19a • KOHLER CO.,Kohler,Wisconsin 53044 USA KOHLER, Phone 920-457-4441,nearestalesFax 920-459-1646 For the nearest sales and service outlet in the US and Canada,phone 1-800-544-2444 KOHLERPower.com Generator Set Standard Features Automatic Transfer Switches and Accessories • Battery cables ❑ Model RDT ATS • EPA certified fuel system ❑ Model RXT ATS • Aluminum sound enclosure ❑ Model RXT ATS with combined interface/load • Critical silencer management board C] Load shed kit for RXT or RDT • Field connection terminal block ❑ Power relay modules(use up to 4 relay modules for • Fuel solenoid valve and secondary regulator each load management device) • Line circuit breaker ❑ Other Kohler®ATS • Multi-fuel system,LPG/natural gas,field-convertible 20RCAL Model Packages • Oil drain extension with shutoff valve ❑ 20RCAL with 100 amp RXT with 16-space load center and • OnCueo Plus Generator Management System NEMA 1 steel enclosure for indoor installation • Premium 5-year limited warranty ❑ 20RCAL with 200 amp service entrance-rated Model RXT • RDC2 generator set/ATS controller with combined interface/load management board and corrosion-resistant NEMA 3R aluminum enclosure • Rodent-resistant construction • Sound-deadening,flame-retardant foam per UL 94, Warranty class HF-1 ❑ 5-Year Comprehensive Limited Warranty ❑ Available Options 10-Year Comprehensive Limited Warranty Approvals and Listings ❑ CSA approval Communication Accessories ❑ OnCues Plus Wireless Generator Management System Concrete Mounting Pads ❑ Concrete mounting pad,3 in.thick ❑ Concrete mounting pad,4 in.thick (recommended for storm-prone areas) Electrical Accessories ❑ Battery ❑ Battery heater, 120VAC Generator Set Dimensions and Weights ❑ Battery heater,240VAC Generator Set Size,L x W x H: 1193 x 666 x 817 mm ❑ Cold weather package, 120VAC (47 x 26.2 x 32.2 in.) ❑ Cold weather package,240VAC Shipping Weights: C] Emergency stop kit 20RCA Generator Set: 252 kg(555 Ib.) C) 20RCPowerSync19 Automatic Paralleling Module(APM) 20RCAL with 100 A RXT ATS AL with 200 A RXT SE ATS:TS:w/L272 kg(60277 kg( lbs (600 lb.)) (single phase only; parallel two 20kW residential generator sets with the RDC2 controller) i - L ❑ Programmable interface module(PIM) (provides 2 digital inputs and 6 relay outputs) Fuel System Accessories ❑ Flexible fuel line(included on QS models) H Mo ❑ Carburetor heater, 120 VAC ❑ Carburetor heater,240 VAC Carburetor heater is recommended for reliable starting 115--mmi at temperatures below O'C(32,F) W Literature NOTE:Dimensions are provided for reference only and should not be used for planning installation.Contact your local distributor for more detailed Information. ❑ General maintenance literature kit DISTRIBUTED BY: ❑ Overhaul literature kit ❑ Production literature kit Maintenance ❑ Maintenance kit(includes air filter,oil,oil filter,and spark plugs) C9 2018,2019 by Kohler Co.All rights reserved. G4.272(20RCA) 4/19a t 'w Alternator Specifications Alternator Specifications Alternator Features Specifications Alternator . Compliance with NEMA, IEEE,and ANSI standards for Manufacturer Kohler temperature rise. Type 2-Pole,Rotating Field 9 Self-ventilated and dripproof construction. Leads,quantity 2F7 4 • Windings are vacuum-impregnated with epoxy varnish for 2G7 12 dependability and long life. Voltage regulator Digital • Superior voltage waveform and minimum harmonic Insulation: NEMA MG1-1.66 distortion from skewed alternator construction. Material Class H • Digital voltage regulator with t1.0% no-load to full-load Temperature rise 130°C Standby RMS regulation. Bearing:quantity,type 1,Sealed • Rotating-field alternator with static exciter for excellent Coupling Direct load response. Amortisseur windings Full . Total harmonic distortion(THD)from no load to full load with Voltage regulation,no-load to full-load RMS t 1.0% a linear load is less than 5%. One-step load acceptance 100%of Rating Peak motor starting kVA: (35%dip for voltages below) 240 V.1 ph 2F7(4 lead) 41 (60 Hz) 240 or 480 V,3 ph 2G7(12 lead) 69(60 Hz) Application Data Engine Exhaust Engine Specifications Exhaust System Manufacturer Kohler Exhaust temperature exiting the Engine:model,type CH 1000 4-Cycle enclosure at rated kW,dry,°C(°F) 260(500) Cylinder arrangement V-2 Lubrication Displacement,cm3(cu.in.) 999(61) Bore and stroke,mm(in.) 90 x 78.5(3.54 x 3.1) Lubricating System Compression ratio 8.81 Type Full Pressure Main bearings:quantity,type 2,Parent Material Oil capacity(with filter),L(qt.) 1.9(2.0) Rated RPM Oil filter:quantity,type 1,Cartridge 60 Hz 3600 Oil cooler Integral Max.engine power at rated rpm,kW(HP) Kohler recommends the use of Kohler Genuine oil and filters. LPG,60 Hz 23.0(30.9) Natural gas,60 Hz 20.2(27.1) Fuel Pipe Size Cylinder head material Aluminum Valve material Steel/Stelliteo Minimum Gas Pipe Size Recommendation,in.NPT Pipe Length, Natural Gas LPG Piston type and material Aluminum Alloy m(ft.) 281,000 Btu/hr. 340,000 Btu/hr. Crankshaft material Heat Treated,Ductile Iron 8 (25) 1 3/4 Governor:type Electronic Frequency regulation,no load to full load Isochronous 15 (50) 1 1 Frequency regulation,steady state w0.5% 30 (100) 1 1/4 1 Air cleaner type Dry 46 (150) 1 114 1 1/4 61 (200) 1 1/4 1 1J4 Engine Electrical Engine Electrical System Ignition system Electronic, Capacitive Discharge Starter motor rated voltage(DC) 12 Battery(purchased separately): Ground Negative Volts(DC) 12 Battery quantity 1 Recommended cold cranking amps: (CCA)rating for-1 B°C(0°F' 500 Group size 51 G4-272(ZORCA) 4119a Fuel Requirements • LED indicators for utility power and generator set source Fuel System availability and ATS position(Model RXT transfer switch required) Fuel types Natural Gas or LPG • LCD display: Fuel supply inlet 1/2 NPT o Two lines x 16 characters per line Fuel supply pressure,kPa(in.H2O); o Backlit display with adjustable contrast for excellent Natural gas 0.9-2.7(3.5-11) visibility in all lighting conditions LP 1.7-2.7(7-11) • Scrolling system status display: Fuel Composition Limits* Nat.Gas LPG o Generator set status Methane,%by volume(minimum) 90 min. - o Voltage and frequency Ethane,%by volume(maximum) 4.0 max. - o Engine temperature Propane,%by volume 1.0 max. 65 min. o Oil pressure Propene,%by volume(maximum) 0.1 max. 5.0 max. o Battery voltage C4 and higher,%by volume 0.3 max. 2.5 max. o Engine runtime hours Sulfur,ppm mass(maximum) 25 max. • Date and time displays Lower heatin value, MJ/m3(Btu/ftp),(minimum) 33.2(890) 84.2(2260) • Smart engine cooldown senses engine temperature * Contact your local distributor for suitability and rating derates based • Digital isochronous governor maintains steady-state speed at on fuel compositions outside these limits. all loads • Digital voltage regulation: ±1.0%RMS no-load to full-load Operation Requirements e Automatic start with programmed cranking cycle Fuel Consumption,m3/hr.(cfh)@ 6OHz • Programmable exerciser can be set to start automatically on %Load Natural Gas LPG any future day and time,and run every week or every two weeks 100 8.0 (281) 3.9 (136) • Exercise modes: 75 6.9 (243) 3.1 (109) so 4.6 (161) 2.3 (82) o Unloaded weekly exercise with complete system diagnostics 25 3.6 (127) 1.7 (59) Exercise 2.6 (71) 1.0 (35) o Unloaded full-speed exercise o Loaded full-speed exercise(Model RXT ATS required) Nominal fuel rating: Natural gas: 37 MJ/m3(1000 Btu/ft.3) • Front-access mini USB connector for SiteTech M or USB LPG: 93 MJ/m3(2500 Btu/ft.3) Utility connection LPG conversion factors: 8.58 ft.3=1 Ib. • Integral Ethernet connector for Kohler©OnCue©Plus 0.535 m3=1 kg 36.39 ft.3 =1 gal. • Built-in 2.5 amp battery charger • Remote two-wire start/stop capability for optional connection Generator Set Sound Data of a Model ADT transfer switch Model 20RCA 8 point logarithmic average sound levels are • Diagnostic messages: Displays diagnostic messages for the 64 dB(A) during weekly engine exercise and 69 dB(A)during engine,generator, Model RXT transfer switch,programmable interface module(PIM),and load management device. full-speed generator diagnostics and normal operation.* • Maintenance reminders All sound levels are measured at 7 meters with no load. • System settings: * Lowest of 8 points measured around the generator. Sound levels at o System voltage,frequency,and phase other points around generator may vary depending on installation o Voltage adjustment parameters. o Measurement system,English or metric RDC2 Controller • ATS status (Model RXT ATS required): o Source availability a o ATS position (normal/utility or emergency/generator) o Source voltage and frequency Voltago: 240 V Fre,: 60.0� • ATS control(Model RXT ATS required): o 0 0 0 o Source voltage and frequency settings I Wit, o Engine start time delay o Transfer time delays o Voltage calibration o Fixed pickup and dropout settings Programmable Interface Module(PIM)status displays: The RDC2 controller provides integrated control for the o Input status(activelinactive) generator set,Kohlera Model RXT transfer switch, o Output status(activernactive) programmable interface module(PIM), and load shed kit. .• Load control menus: RDC2 Controller Features o Load status • Membrane keypad: o Test function o OFF,AUTO,and RUN pushbuttons o Select and arrow buttons for access to system configuration and adjustment menus • LED indicators for OFF,AUTO,and RUN modes G4-272 (20RCA) 4I19a OCCUPIED STRUCTURE OCCUPIED STRUCTURE MAY 10 2023La e NOTE: Q THE RECOMMENDED DISTANCE FROM A STRUCTURE IS DEPENDENT ON STATE AND z Z a LOCAL CODES. PRODUCT HAS BEEN M a a DEMONSTRATED IN ACCORANCE WITH NEPA 37 SECTION 4. 1 . 4. 2---BY A THIRD PARTY TEST FACILITY TO THE DIMENS-IONS SHOWN. ! Q FOR INSTALLATIONS NEAR NON-COMBUSTIBLE OR I -HOUR FIRE RATED STRUCTURE, A MINIMUM DISTANCE SERVICE DOOR SET OF 18" IS REQUIRED TO ENSURE PROPER GENERATOR COOLING. SET MOUNTING AREA MOUNTING AREA SERVICE DOOR ACCEPTABLE 4 FT. CLEARANCE 1 ) EXHAUST IS AIMED AWAY OR PARALLEL TO STRUCTURE . AT EXHAUST END 2) EXHAUST IS NOT DIRECTED AT PLAY AREAS, PATIOS OR L�jn OTHER AREAS WHERE PEOPLE CONGREGATE. VZ ¢L 3) THE NEAREST WINDOW, VENT, DOOR OR SIMILAR STRUCTURE Cf- OPENING IS AT LEAST 5 FEET FROM THE EXHAUST END OF THE SET. ¢En w w¢ 4) SET 'HAS PROPER OFFSET FROM STRUCTURE. vx x 5) WINDOWS 8 DOORS ON ADJACENT WALLS ARE CLOSED. wH Q¢ 6) FURNACE AND OTHER SIMILAR INTAKES ARE AT LEAST 10 FEET FROM EXHAUST END OF SET. 7 ) WEED BARRIER AND 3 INCH THICK GRAVEL BASE OR CONCRETE PAD z LOCATED TO PREVENT GRASS 8 WEEDS FROM GROWING TOO CLOSE OCCUPIED TO THE SET. STRUCTURE = a 0 8) NO PLANTS, SHRUBS OR OTHER COMBUSTIBLES ALLOWED IN CLEARANCE AREA. (MINIMUM 4 FT. FROM EXHAUST END) . 18" MIN. 9) REFER TO OWNERS MANUAL FOR OTHER INSTALLATION CONSTRAINTS. AA 10) NO PLANTS, SHRUBS, OR OTHER COMBUSTIBLES ALLOWED WITHIN 30" OF AIR INTAKE. SET SERVICE DOOR MOUNTING AREA wo Vz zw I REV DATE ON COMPOSITE DWGS, SEE PART NO. FOR REVISION LEVEL BY DO NOT SCALE REFERENCE THE MODEL FOR ALL UNSPECIFIED DIMENSIONS ¢`D 9-23-17 NEW DRAWING [CT1,79368) ADP ZD KOHLER. w¢ A 2 S 1 7 SEE E S H E E T 3 OF 5 [CTI 8 2 5 3 5] K RM UNLESS DIMENSIONS SPECIFIED CLINE iCR$ („)2 GENERAL RAL iOLERANCEG NIA KOHLER,WISCONSIN 53094 x B 5-24-I8 (A-5,C-7) 30" MIN WAS 18" MIN; (C-3) NOTE UPDATED ADP THIS DRAWING IN DESIGN AND DETAIL 15 KOHLER w ICT1817351 CO. ,P ROPERTY AND MUST NOT BE USED EXCEPT IN CONNECTION WITH KOHLER CO. WORK. ALL RIGHTS w H C 19JUN20I9 (B-3l 30" WAS 18"; (C-7 8 B-5) 0 REMOVED AWK tNmmeNmerlEO=ION OF DESIGN OR INVENTION ARE RESERVED. v¢ FROM 30" MIN DIMENSIONS 1PR082381 ®EE] ""E APPROVALS I DATE DIMENSION PRINT, 14/20KW RCA 14/20RCADN•YYom SINGLE UNIT ADP 9 23 I7 SC.EE o Is «D NO SxE[i4 D! 5 cxuYED VPP 9-23- 7 Y CONFIGURATION 'p-D BJF 9-23-17 DYD D ADV-8928 D OCCUPIED OCCUPIED OCCUPIED STRUCTURE STRUCTURE STRUCTURE 18" MIN. SERVICE DOOR SERVICE Z Z DOOR z a a a MOUNTING SET SET MOUNTING AREA AREA o a M a a M if wo wo MOUNTING 5 FT. jz SERV ICE zw zw AREA DOOR ¢ SET ¢ SET SERVICE SET ¢ ¢� MOUNTING MOUNTING AREA w w DOOR J¢ J¢ AREA V X x SERVICE DOOR � a4 FTw� w� . CLEARANCE ¢ ¢ Ln AT EXHAUST END Q wo wo Vz5 FT. Vz zw zw ¢ Q ¢ SET w w MOUNTING AREA z U= v= OCCUPIED a x x SERVICE DOOR STRUCTURE = a w w CD 4 FT. CLEARANCE ¢ ¢ AT EXHAUST END Q Q w V� 18" MIN. z z ¢w of wV) J� V¢ SERVICE DOOR X SET 0H L� OCCUPIED STRUCTURE y MOUNTING AREA Q Q o a wwx r x z ¢ow a ~ w zw� vo a - p zz - cc00 ¢w w An J� V¢ MOUNTING AREA MOUNTING AREASERVICE DOOR X SET MOUNTING AREA v a SET SET NOTE : SERVICE SERVICE APPLY NOTES ON SHEET 4 OF 5 DOOR DOOR TO SHEET 5 OF 5 . 4 F T. CLEARANCE 4 F T. CLEARANCE REV DATE ON COMPOSITE DWGS, SEE PART NO. FOR REVISION LEVEL BY DO NOT SCALE. REFERENCE THE MODEL FOR ALL UNSPECIFIED DIMENSIONS AT EXHAUST END AT EXHAUST END 9 23 17 NEW DRAWING [CT119368] App UN LE" TNEANISESPCCI'IED. KOHLER. A 12-1 5-1 7 SEE SHEET 3 OF 5 ECT 1825351 KRM GEN DINE NSLERS IN. LLINF ICRS GENFAAL TULFRANCES. NIA KOHLER,VVISCpNSIN 53044 B 5-24-18 (D-7,D-1,8-2) 30" MIN WAS 18" MIN ECT1877351 ADP THIS DRAWING IN DESIGN AND DETAIL IS KOHLER I N T A K E TO C 19JUN2019 SEE SHEET 4 EPRO82381 AWK CO. PROPERTY AND MUST NOT BE USED EXCEPT IN -NWHB E F T. CONNECTION WITH KOHLER CO WORK. ALL RIGHTS TQ♦fl Awie PaOIEC'IDN OF DESIGN OR INVENTION ARE RESERVED FROM EXHAUST TIT« 14/20RCA APPROVALS+, DATE DIMENSION PRINT, 14/20KW RCA PARALLEL UNIT DRAWN ADP 9-23-17 CONFIGURATION cx¢cm VPP 9-23-17 "1 o Is CID"� "F Ts or s ovc o "°"`° BJF 9-23-17 ADV-8928 D 0 0 N O O O RL 1193 [47. 0] AIR INLET HIGH VOLTAGE EXHAUST AIR 191 ELECTRICAL Z OUTLET STUB-UP AREA 0 En 0 o e Z ° �w o LOW VOLTAGE — ELECTRICAL ¢ STUBTUPCAREA O rh rn jA�7 - co Q EM NPT (FEMALE ) N D u UEL INLET Q ti lo 11 M 91 [3. 6] 620 [24. 4] 261 _ 101 . 5 [4. 0] MAXIMUM [ 10. 3] CONDUIT ALLOWED OUTSIDE UNIT 570 [22. 4] 338 [ 13. 3] 136 [5. 4] 4X 038. 1 [ 1 . 50] 850 [33. 53 LIFTING HOLES APPROX . MAX OPEN POSITION A- B ° ° °O° °O° ° ° B oo N LnO O Lo U ° ° °O° °O° ° o NOTE : DIMENSIONS IN [ ] ARE INCH EQUIVALENTS. REV DATE ON COMPOSITE DWGS, SEE PART NO. FOR REVISION LEVEL BY DO NOT SCALE. REFERENCE THE MODEL FOR ALL UNSPECIFIED DIMENSIONS 9-23-17 NEW DRAWING [CT179368] ADP UNLE55OTHERWISE SPECIFIED. KOHLER. A 12-15-17 SEE SHEET 3 OF 5 [CT1825351 KRM ALL DIMENSION$IN NILLINETCR$ GENERAL TOLERANCES:N/A KOHLER,WISCONSIN 53044 B 5-24-I8 SEE SHEET 4 8 5 [CT187735] ADP THIS DRAWING IN DESIGN AND DETAIL IS KOHLER C 9JUN209 SEE SHEET 4 [PR082381 AWN CO. PROPERTY AND MUST NOT BE USED E%CEPT IN 4 X 1 1 0 [0. 4 3] MOUNT I N G HOLES CONNECTION WITH KOHLER CO. WORK. ALL RIGHTS Twmurae PRG�iIW OF DESIGN OR INVENTION ARE RESERVED. 2 3 6 [9. 31 6 7 0 [2 6. 4] ®B APPROVALS I DATE DIMENSION PRINT, 14/20KW RCA DA" ADP 9-23-17 SCALE D. G C.LO MD SHE EI O i 5 14/20RCA CHEUED V P P 9-23-17 ROIED B J F 9-23-17 ADV-8928 D OIL FILTER AIR CLEANER OIL DIPSTICK CARB HEATER (OPTIONAL ) �R WE Lv \� .F 11L rIL- OIL DRAIN VALVE EXHAUST AIR OUTLET REV DATE ON COMPOSITE DINGS, SEE PART NO, FOR REVISION LEVEL BY DO NOT SCALE REFERENCE THE MODEL FOR ALL UNSPECIFIED DIMENSIONS - 9-23-17 NEW DRAWING [CT 1793681 ADP IC�HLER. A 12-15-17 SEE SHEET 3 OF 5 [CT182535] KRM UNLESS OTHERWISE SPECIFIED ALl DIME NSIDK$IN MI EE IMF iER$ B 5-24-18 SEE SHEET 4 8 5 [CT187735] ADP GEM[R�L TOLERANCES K11 NpiLER,AWING1�M DES THIS DRAWING IN DESIGN AND DETAIL I$ KOHLER C 19JUN201 SEE SHEET 4 [PR08238] AWK CO PROPERTY AND MUST NOT BE USED EXCEPT IN CONNECTION WITH KOHLER CO WORK ALL RIGH TS T�CAR�IEIIRA`Ipl OF DESIGN OR INVENTION ARE RESERVED APPROVA®DATE - DIMENSION PRINT, 14/20KW RCA oRAn ADP 9-23- 1 -Ru<<-.0 16 IT 0( 5 14/20RCA `"""° VPP 9-23-11 ° R0 F0 BJF 9-23-1 7 ADV-8928 USB PORT CONTROLLER i i • LOAD CIRCUIT BREAKER I �+ —CUSTOMER CONNECTION BLOCK FUEL REGULATOR HEATER PAD (OPTIONAL ) 1 0IL DRAIN HOSE BATTERY CABLES fes` ( INCLUDED) J/ BATTERY LOCATION (BATTERY NOT INCLUDED) REV DATE ON COMPOSITE DWGS. SEE PART NO. FOR REVISION LEVEL BY DO NOT SCALE REFERENCE THE MODEL FOR ALL UNSPECIFIED DIMENSIONS - 9-23-17 NEW DRAWING ICT1793687 ADP UNLESS OTMERVISESPECIFIED KOHLER. A 12-15-17 UPDATED FUEL REGULATOR GEOMETRY [CT 1823537 IRM ALL DIMENSIONS IN MILLIMETERS B 5 24 18 SEE SHEET 4 d 5 (CT 1817357 ADP GENERAL TOLERANCES xiA KOHLER MOONBYl57OU THIS DRAWING IN DESIGN AND DETAIL IS KOHLER C 19JUN2O1 SEE SHEET 4 [PRO82387 AWK CO. PROPERTY AND MUST NOT BE USED EICEPT IN CONNECTION WITH KOHLER CO. WORK. ALL RIGHTS Vm/A�As�PlOi10A OF DESIGN OR INVENTION ARE RESERVED APPROVALS DATE DIMENSION PRINT, 14/20KW RCA DOHA ADP 9-23-17 - 14/20RCA VPP 9-23-11 Swl[ 0 30 CID 10 CxE[A[D SHEET Dr s °°xaED BJF 9,23-17 o.D xo ADV-8928