Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
47402-Z
SUfFO[ �, Town of Southold o� oG r ou 11/27/2023 y� P.O.Box 1179 l 53095 Main Rd Southold,New York 11971 4j01 � tis CERTIFICATE OF OCCUPANCY No: 44769 Date: 11/27/2023 THIS CERTIFIES that the building GENERATOR Location of Property: 40200 Route 25, Orient SCTM#: 473889 Sec/Block/Lot: 15.-9-8.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 11/4/2021 pursuant to which Building Permit No. 47402 dated 1/28/2022 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. The certificate is issued to 40200 Main LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 47402 8/17/2023 PLUMBERS CERTIFICATION DATED ut orize ignature SUFFoc TOWN OF SOUTHOLD �c�ay BUILDING DEPARTMENT N x TOWN CLERK'S OFFICE Wo rh 4V[ 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#: 47402 Date: 1/28/2022 Permission is hereby granted to: 40200 Main LLC c/o RWN Management LLC 712 Fifth Ave FI 30 New York, NY 10019 To: Remove existing generator and install new diesel generator with sound enclosure at existing Verizon Wireless communication facility as applied for, with flood permit and per Trustees #10051A and Planning Board approvals. At premises located at: 40200 Route 25, Orient SCTM #473889 Sec/Block/Lot# 15.-9-8.1 Pursuant to application dated 11/4/2021 and approved by the Building Inspector. To expire on 7/30/2023. Fees: WIRELESS COMMUNICATIONS -MODIFICATIONS $100.00 ELECTRIC $85.00 CO-COMMERCIAL $50.00 Flood Permit $100.00 Total: $335.00 Building Inspector pF SO!/ryol � o Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 �Q sean.devlina-town.southold.ny.us Southold,NY 11971-0959 couffN,� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: 40200 Main LLC Address: 40200 Route 25 city,Orient st: NY zip: 11957 Building Permit#: 47402 Section: 15 Block: 9 Lot: 8.1 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: Electrician: RKO Electric Corp License No: 4125ME SITE DETAILS Office Use Only Residential Indoor Basement Service Commerical X Outdoor X 1st Floor Pool New X Renovation 2nd Floor Hot Tub Addition Survey X Attic Generator X INVENTORY Service 1 ph Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan Service 3 ph X 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 UC Lights Dryer Recpt Emergency Strobe Heat Detectors Disconnect Switches 4'LED Exit Fixtures Sump Pump Other Equipment: 50kW Kohler Generator Notes: Generator Inspector Signature: Date: August 17, 2023 S. Devlin-Cert Electrical Compliance Form OFFICE LOCATION: MAILING ADDRESS: Town Hall Annex �F soar P.O.Box 1179 54375 State Route 25 O�� y�l Southold,NY 11971 (cor. Main Rd. &Youngs Ave.) O Southold NY Telephone: 631 765-1938 CO3 ANC www.southoldtownny.gov PLANNING BOARD OFFICE 3 �\ TOWN OF SOUTHOLD ; v/ Jl OCT 2 0 2023 MEMORANDUM BUH ING D EPT. To: Michael J. Verity, Chief Building Inspector From: Heather M. Lanza, AICP, Planning Director Date: October 19, 2023 Re: Planning Department Report Verizon Generator Replacement SCTM#1000-15.-9-8.1 40200 Route 25, Orient The Planning Board has found that the requirements of'the above-referenced Verizon Wireless generator replacement have been completed based on the site inspection made October 13, 2023. The improvements are in compliance with the General Requirements of§280-70 and the Planning Department report dated January 27, 2022; therefore, we recommend a Certificate of Occupancy be issued for this application. Thank you for your cooperation. Mejia, Evelin From: Denise Vista <dvista@amatofirm.com> Sent: Thursday, November 9, 2023 4:22 PM To: Mejia, Evelin Subject: RE:Verizon Wireless' Building Permit<# Hi Evelin, Just following up on the close-out of Verizon Wireless' Building Permit and the eL ftal-il,that was provided-.fro.m S�DHS,t which indicated that an inspection fo.r_the_installed tank was not required. Thank you. Denise J. Vista, Esq. --- M A Tc LAW GROUP, PLLC 666 Old Country Road,Suite 901 Garden City,New York 11530 ' Tel: (516) 227-6363 Fax: (516) 227-6367 Cell: (516) 455-2824 dvista@amatofirm.com www.amatolawgroup.com CONFIDENTIALITY NOTICE:This electronic message contains information from the law firm of Amato Law Group,PLLC.This e-mail and any files attached may contain confidential information that is legally privileged.If you are not the intended recipient,or a person responsible for delivering it,you are hereby notified that any disclosure,copying,distribution or use of any of the information contained in or attached to this transmission is STRICTLY PROHIBITED.If you have received this transmission in error,please forward same to sender and destroy the original transmission and its attachments without reading or saving in any manner From: Denise Vista Sent: Monday, November 6, 2023 12:41 PM To: 'evelinm@southoldtownny.gov'<evelinm@southoldtownny.gov> Subject:Verizon Wireless' Building Permit#47402 Hi Evelin, As discussed today, Suffolk County does not require an inspection of the new tank. Please see the email below from the Office of Pollution Control, Division of Environmental Quality stating same. Let me know if you have any questions regarding the foregoing. Thank you. Denise J. Vista, Esq. 1 , OF SOUIyoID '1 I v 1 O � •'�eo (/�j�� f * TOIN OF SOUTHOLD BUILDING DEPT. `ycourm N�' 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] 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: 1? � DATE G IT3 INSPECTOR ' qlqv ts f SOUTyolo # # TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] SULATION/CAULKING [ ] FRAMING /STRAPPING [V FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION PRE C/O [ ] RENTAL REMARKS: I !1� � G On OL000r Ci DATE I ?/ INSPECTOR VY9 tA Taw uZC k0AM T rt;z<;zz KOHLER [ d. 4 s e e s � e . • e e • e • • e • ------------- AO UGH • INSULAT�ON.PER N. ee +A r , e • �i:`XIA a11f� �� ` • / 'ate J/ A � III AMIUMIL 1 � t g F Ottc =mop o6s�l TOWN OF SOUTHOLD —BUILDING DEPARTMENT N Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 oy�0 a�l� Telephone(631) 765-1802 Fax (631) 765-9502 https://www.southoldtownngov Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only ® i PERMIT NO. VOC� Building Inspector: NOV 0 4 2021 BUI Applications and forms must be filled out in their entirety. Incomplete TOWN OF SOUING THOLD 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:40200 Main LLC scTM#i000-15-9-8.1 ress: Project A dd ... _ N... -_. . _ . ....-... _. � .. .__.M40200,.Main. Road_,,Orient, ..New York.._. .._.,.___ ._ Phone ( ) Em : .._-_.. #: . . _... 631. „323-2424 r.. _. ...._..M.... _..__..._..._._...... . .... _.... _.-_ .._._ . _._ ...._._..__.... _.�....�_ .._...__ - ... ..._w_......__. ._.___..._.�. .M_ailing Address 40200 Main Road,__Orient, New_York 11957 CONTACT PERSON: Name:Denise. Vista, Mailing Address:Amato Law Group, PLLC, 666 Old Country Road, Suite 901, Garden City, NY 11530 Phone#:(5.16)_227-6363 Email:dvista@ imatofirm,.com DESIGN PROFESSIONAL INFORMATION: Name:WFC_Architects - 'Mailing Address:l 2-1 Technology._Drive,--Setauket,-„NY. 1.1.733n. .- Phone#-(631 )__689-8450.,_.._...._ .Ta l:tom.maher@wfCai.a.com CONTRACTOR INFORMATION: Name:Odyssi-a,-Global_Communications_Corp. __,.,-_ Ma Ad' -34.45th--_Street,.-Astoria.,._- ..__ ..-_iling�._- ,._ _- 4 -_.._v.._- _ N.Y_..1 0._... Phone#:(71 v8.)-c392-481-9_ DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration []Repair []Demolition Estimated Cost of Project: DOtherReplace existing Verizon Wireless emergency back-up generator with new generator $15,000.00 Will the lot be re-graded? ❑Yes �RNo Will excess fill be removed from premises? ❑Yes ®No 1 PROPERTY INFORMATION Existing Use Of-pro pe rty:_Me I dn-a.-restaur-ant,.&--wireless c-ommu-ni-cation I s-f I a-cility Intended use of pro-pe.rt-y_:.s am e__as. exis-fing Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to M ahi this property? RYes ONO IF YES, PROVIDE A COPY.ri -e- I'l Z 6 h ih' D i S_ tr i c f lig 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. I Robert Czarniawski, on behalf of New York SMSA Application Submitted By(print name): Limited Partnership d/b/a Verizon Wireless R Authorized Agent []Owner NewY_ M invited Z � , hip d/-b-/a Verizon Wireless------ Signature of Applicant: By:( � , Date: Title: Network qnin)e—rih'g --- ------ STATE OF NEW YORK) SS: COUNTY OF 00A5�cu Robert Czarniawski, on behalf of New York SMSA Limited Partnership d/b/aVerizon Wireless being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)he is the Network Engineering-Real Estate (Contractor,Agent, Corporate Officer, etc.) UMAYoV&*A*XMX94, 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. K A Sworn before me this N N�(0.02ZA6292 day of Au S�� 20 Notar NASSAU COUNT r 14 PROPERTY OWNER AUTHORIZATION /11/C)F111N E1litl0k (Where the applicant is not the owner) I zce Marc Rowan on behalf of 40200 Main ,LLC residing at c/o 40200 Main Road New York SMSA Limited Partnership d/b/a Orient, New York 11957 do hereby authorize Verizon Wireless/Amato Law Group, PLLC to apply on my behalf to the Town of Southold Building Department for approval as described herein. 1 40200 Main ( LL;C .0011111 - _le .Owner's Signature Date A"e., F—DWA41L ::�� Print Owner's Name MARY HARADA Title: President Notary Public, State of Connecticut 2 My Commission Expires 3/31/2026 Building Department Application AUTHORIZATION (Where the Applicant is not the Owner) Marc Rowan on behalf of I, 40200 fain LLC residing at c/o 40200 Main Road, Orient, New York 11957 (Print property owner's name) (Mailing Address) do hereby authorize New York SMSA Limited Partnership (Agent) d/b/a Verizon Wireless/Amato Law Group, PLLC to apply on my behalf to the Southold Building Department. 40200 Hain LLC B : 6.4- . 2�2I (Owner's Signature) (Date) (Print Owner's Name) Title: Tvi- MAIRY(Votary PublcticutMy Commiss26 O�s FFOoG TOWN OF SOUTHOLD—BUILDING DEPARTMENT y2 Town Hall Annex 54375 Main Road P. O. Box 1179 So w m Y9I1V-p959 oy o� Telephone(631) 765-1802 htt s://www.southo: o C, Fr APR 2 7 2022 Floodplain Development Permit PROPERTY INFORMATION: Flood Zone: AE FIRM Panel: SCTM#10V7�5-9-8.1 Address: 40200 Main Road City: Orient Zip: 11957 'CONTACT PERSOW, Name:Denise J. Vista, Amato Law Group, PLLC Phone#:(516)227-6363 Mailing Address: 666 Old Country Road, Suite 901, Garden City,New York 11530 PROJECT DESCRIPTION: Replace existing generator with new generator on existing platform SECTION A:STRUCTURAL DEVELOPMENT(CHECK ALL THAT APPLY) Type of Structure Type of Structural Activity, . ❑Residential(1 to 4 families) ❑New structure ❑Residential(more than 4 families) ❑Demolition of existing structure ❑ Combined use ❑Replacement of existing structure [XNon-residential ❑Relocation of existing structure M Elevated ❑Addition to existing structure ❑ Flood proofed(attach certification) ❑ Alteration to existing structure ❑Manufactured Home IXOther: Public utility wireless communication facility ❑Located on individual lot ❑ Located in manufactured home park SECTION B:OTHER DEVELOPMENT(CHECK ALL THAT.APPLY) ' ❑ Clearing of trees,vegetation or debris ❑ Mining ❑ Grading ❑ Drilling ❑ Dredging ❑ Connection to public utilities or services ❑ Paving ❑ Placement of fill material ❑-Drainage improvement(including culvert work) ❑ Roadway or bridge construction ❑ Fence or wall construction ❑Watercourse alteration (attach description) ❑ Excavation (not related to a structured development) ❑ Other development not listed (specify): By signing be"low I agree to the terms and conditions of this permit and certify to the best of my knowledge the,information contained. in this application is,true and'accurate. I understand that no work may start until a-permit is issued.The permit maybe revoked if any false statements are.made herein.If revoked,all work must'cease until permit is re-issued.Development shall not be used or-,occupied until a Cert.of Compliance is issued:The permit will expire if no work is commenced within one year.of issuance.Other permits may be required to"fulfill regulatory'requ'irements.Applicant gives consent to local authority or.representative to make•reasonable inspections to verify compliance. Application Submitted By(print name): Robert Czamiawski of New York SMSA Limited Partnership dba Verizon Wireless Signature of Applicant: Date: Zb�Z Glenn Goldsmith, President so Town Hall Annex A. Nicholas.Krupski,Vice President ,`O l0 54375 Route,25. . P.O. Box 1179 John M..Bredemeyer III Southold, New York 11911 Michael J.Domino G • Telephone(631) 765-1892 Greg Williams 'fly. � Fax(631) 765-6641 BOARD OF .TOWN TRUSTEES - TOWN.OF SOUTHOLD: . -:�Permit No :. 10051A: Date of Receipt of Applicatiori..:December 20, 2021.' Applicant: 40200'.Main LLC c/o Verizon WireCess SCTM#: 1000-15:- "8.1 : Project-Location: 40200 Main Road., Oriente Date of Resolution%Issuance:January 19, 2022 Date of Expiration: January 19, 2024 Reviewed by.: Board pf.Trustees Project Description: Existing Verizon wireless communication facility and.the .. replaceme.ht of its existing generator. Fin:dings::The project meets al.....a requiremenfs.:for issuance-of an Administrative. . Permit'set forth in Chapter 275'of`the Southold To..wn Code: The issuance'of Administrative.Permit,-allows forrthe;.operations•as-indicated on the site plan prapared b ..Neil AleXan.der IVlacDonald >last dated December 9 2021` and:stain'ed ;Jan a . :19 22 and he sit - la, u . ,.2Q. , t . e p n re` ared.b. wfc Architects;:received:oii:Decemper°`: rY. P I? Y . 20, 2021; and stamped approved.on January.19 . ... :. ..:. pecial.Conditions:: None ion ih .l.l.�: l n Ins ':ect s: F a s" ect o P .. . P.- Ifthe:" ro osed dbtivities..do noYmeet:,the"requirements.for:,iss.uance..of an Administrati e:.: ..:: ; p p Permit set fortfi.in Chapter 275 of::fhe Southold TownCode, a Wetla:nd.Perrnit:will.f?e required. This is not a determination from any other agency.. -Glenn Goldsmith; President Board of Trustees Glenn Goldsmith,President QF S0!/r Town Hall Annex ��� Ol0 54375 Route 25 A.Nicholas Krupski,Vice President P.O. Box 1179 Eric Sepenoski Southold,New York 11971 Liz Gillooly G Q Telephone(631) 765-1892 Elizabeth Peeples Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE 2.091 C Date: October 15, 2023 THIS CERTIFIES that the existing Verizon Wireless communication facility and the replacement of its existing generator; At 40200 Main Road, Orient . Suffolk County Tax Map#1000-15-9-8.1 Conforms to the application for a Trustees Permit heretofore filed in this office Dated December 20,2021 pursuant to which Trustees Administrative Permit#10051A Dated January 19, 2022,was issued and conforms to all the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for existing Verizon Wireless communication facility and the replacement of its existing generator; The certificate is issued to 40200 Main LLC c/o Verizon Wireless owner of the aforesaid property. 0 Authorized Signature OFFICE LOCATION: MAILING ADDRESS: Town Hall Annex �F SOU,, P.O. Box 1179 54375 State Route 25 Southold,NY 11971 (cor.Main Rd. &Youngs Ave.) Q Southold, NY Telephone: 631 765-1938 www.southoldtownny.gov CIO �yCOUN1`1,� PLANNING BOARD OFFICE TOWN OF SOUTHOLD = MEMORANDUM To: Michael J. Verity, Chief Building Inspector From: Heather M. Lanza, AICP, Planning Director Date: January 27, 2022 Re: Planning Department Report Verizon Generator Replacement SCTM#1000-15-9-8.1 40200 Main Road, Orient The Planning Department has conducted a review of the proposed generator pursuant to §280-74 B.(2), and recommends approval of this.application. The generator is a replacement for an already existing generator, and it will be located within a sound enclosure. Town Code §280-70 1 sets the standards for wireless facilities in the MII Zoning District and there are no noise limitations. Thank you for your cooperation. BUIL EPARTMENT- Electrical Inspector 1 TOWN OF SOUTHOLD � o Town Mall Annex - 54375 Main Road - PO Box 1179 ,iHoum Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 rogerr southoldtownny.gov — seand(a-southoldtownny.aov -u"zrrc�` APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: 3/31/2022 Company Name: RKO ELECTRIC CORP Electrician's Name: Randy K Overbaugh License No.: ME-4125 Elec. email: rkoelectric@gmail.com Elec. Phone No: 516 680-5271 ❑I request an email copy of Certificate of Compliance Elec. Address.: 206 Idle Hour Blvd. Oakdale, NY 11769 JOB SITE INFORMATION (All Information Required) Name: New York SMSA Limited Partnership d/b/a Verizon Wireless Address: 40200 Main Road, Orient, New York Cross Street: Phone No.: c/o (516) 227-6363 Bldg.Permit#: 0 email: dvista@amatofirm.com Tax Map District: 1000 Section: 15 Block: 9 Lot: 8.1 BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Replace existing diesel generator with a new 50 kW diesel generator on the existing equipment platform Square Footage: Circle All That Apply: Is job ready for inspection?: ❑ YES ❑✓ NO ❑Rough In ❑ Final Do you need a Temp Certificate?: ❑ YES 0 NO Issued On Temp Information: (All information required) Service Size❑1 Ph❑3 Ph Size: A # Meters Old Meter# ❑New Service❑Fire Reconnect[]Flood Reconnect❑Service Reconnect❑Underground❑Overhead # Underground Laterals[7]1 2 H Frame Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION C I OCCUPANCY OR � APPROVED AS NC�T''1 USE IS UNLAWFUL DATE:-Z.5 A?l,3 4 47/�A ��335_��,� N _ ��ITUOUT CERTIFICATE ET ---- 4R_ OCCUPANCY NOTIFY BUILuiNG uEP/;. .�I� .AT , 769-'302 8 AM TO 4 PM I-OR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWC REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST 'COMPLY WITH ALL. CODES OF BE.COMPLETE FOR C.O." NEW YORK:STATE & TOWN CODES:. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW -.AS REQUFRED AND CONDITIONS OF`` YORK STATE. NOT RESPONSIBLE FOR SOUTHOLDTOWNZBA ' ..DESIGN OR CONSTRUCTION ERRORS. d as SOUTHOLO TOWN PLANNINGBOOD j 0 022 �- SOUTHOLD TOWN TRUSTEES N.Y.S.DEC FLOW ZONk�fi 9 END DAM.A( ,Pnm w9frw RETAIN STORM WATER RUNOFF wic PURSUANT TO CHAPTER 236 OF THE TOWN CODE. N W A�L S MAIN ROAD(S.R 25)(66') ,B,.Tz'<'—��� N87.09'2('E 4201 1- � .�T --- e_ ; '`, •e. ,gyp .\ D � -- P, .a. 0 = r� a • -- Pf 6r g 1D a E �� —sea-.a,.� ,.,.�„:•, 1;":=�� � �� �5 MONOPOLE DETAIL d i10 4 s67•o9'2ow Q A NOTES: 1)ELEVATIONS NAVD88. to.�`rZ `✓\v^V����- /\�^-���� $' 2)PILINGS INSIDE MARINA NOT INDICATED, 3)FLOOD ZONES EXTRAPOLATED FROM F.E.MA FLOOD INSURANCE RATE MAP#88OF / MAPH36103C0088 H DATED SEPTEMBER 25.25,2009.9. J.P 4)HEIGHT OF TOWER FROM TOP OF CONCRETE BASE i IS 69.8•. UNDER CONSTRUCTION MONOPOLE. Z RELATEDSTRUCNRES,4MECNONICALS O ONJUNE2BP L-4. V O SHEET HO: PRO,ECT. PROJECT Na as-ro99 FIlE Na m FINAL SURVEY OF DAM'' ND"E'"B�i2011 5DA1E "D HAWKINS WEBB JAEGER PLLC DMGNE0 BY: ro MONOPOLE AND EQUIPMENT DRAa„Br, mwiD,m I oim.Br. M.S.M.C. ENGINEERS—ARCHITECTS—SURVEYORS—PLANNERS RENSED: SURVEY UPDATED 7.2.2ODB,FB 529.P.1-2(FB 493,P.20.22 SURVEY (ORIENT POINT MARINA,40200 MAIN ROAD) 580 WALT(631*MAN ROAD,SNILE( NY,11747 32-7 ORIGINALLY PERFORMED db2006)ELEVATIONS UPDATED TO NAY088162i-2011 ESTAB.1872 PNQ1E(831)732-7777,FAL�OLE(631)732-7760 SITE AREA-4.64 ACRES FINAL SURVEY PF MONOPOLE AND EQUIPMENT PLATFORM 11.1 S2014 f SIUATE AM ORIENTPOINT.SOUTHOLD.N.Y. SC.TAX MAP H4. 1000.154a.1 9 A MATO 666 OLD COUNTRY ROAD, 9T"FLOOR GARDEN CITY, NY 11530 LAW GROUP, P L L C TEL: 516.227.6363 FAX: 516.227.6367 November 3, 2021 BY FEDERAL EXPRESS Building Department Town of Southold Town Hall Annex Building 54375 Route 25 Southold,New York 11971 Re: Building Permit Application (the "Application") by New York SMSA Limited Partnership d/b/a Verizon Wireless ("Verizon Wireless") to the Town of Southold (the "Town") in connection with the generator-replacement for the existing public utility wireless communication facility (the "Communication Facility") located at 40200 Main Road, Orient, New York, known and designated as District 1000, Section 15, Block 9, Lot 8.1 (the "Property") NYSMSA Site Reference: Orient Point 2/Our File No. 100-0773 Dear Sir/Madam: Verizon Wireless is submitting the Application for an eligible facilities request to modify an existing wireless facility located on the Property. This eligible facilities request must be approved administratively under Section 6409 of the federal Spectrum Act and Federal Communications Commission ("FCC") rules. Review by the Town is limited to determining whether the proposed modification qualifies as an eligible facilities request that does not substantially change the physical dimensions of the facility. The Building Permit must be approved within 60 days of the request date set forth above, subject to tolling for incompleteness. Proiect Description Verizon Wireless was issued Building Permit #41667, by the Town Building Department on May 25, 2017, for the existing Communication Facility located on the Property. In connection with the foregoing, on September 24, 2018, the Town issued Verizon Wireless a Certificate of Occupancy, # 39918. The approved Communication Facility includes a 10 kW diesel generator, which is located on Verizon Wireless' existing equipment platform. As reflected in the construction drawings submitted herewith, Verizon Wireless is now proposing to remove the existing generator and replace same with a 50 kW diesel generator with sound enclosure, to be situated in the same location as the existing generator, on the existing equipment platform. 405 LEXINGTON AVENUE I CHRYSLER BUILDING,26T"FLOOR I NEW YORK,NY 10174 1 212.485.6000 402 MAIN STREET I SUITE 204 1 METUCHEN,NJ 08840 1 732.317.1511 Application Materials In connection with Verizon Wireless' Application for the replacement of the existing generator, enclosed are the following materials: 1. One (1) original Application for Building Permit; 2. One (1) original Owner's Authorization; 3. Certificates of worker's compensation, liability, and disability insurance for the general contractor, Odyssia Global Communications Corp.; 4. Four(4) surveys of the Property; 5. Four (4) sets of construction drawings, prepared, signed, and sealed by WFC Architects, last revised on August 3, 2021; and 6. A check, made payable to the Town, in the amount of$235.00, representing the Application"filing fee. Eligible Facilities Request The Spectrum Act states that"a State or local government may not deny,and shall approve, any eligible facilities request for a modification of an existing wireless tower or base station that does not substantially change the physical dimensions of such tower or base station." (See, 47 U.S.C. § 1455(a)(1)).An"eligible facilities request"is defined to include any collocation,removal, or replacement of transmission equipment. (See, 47 U.S.C. § 1455(a)(2)). The FCC adopted rules providing legally binding guidance on key terms of the Spectrum Act, notably defining "substantial change" with certain thresholds. (See, Report and Order FCC 14-153, 29 FCC Rcd. 12865 (FCC October 17, 2014); see also, Report and Order FCC 20-153, 2020 WL 6501650 (FCC October 27, 2020)). Based on the FCC's definition, the proposed modification (i.e., replacement of the generator) does not substantially change the physical dimensions of the tower. As depicted on the enclosed construction drawings, the proposed generator will be located on the existing equipment platform, which will-not be extended or expanded. In sum, the modification clearly qualifies as an "eligible facilities request" under the Spectrum Act and FCC rules, because it does not exceed any of the thresholds, such that it would "substantially change"the physical dimensions of the tower. As stated above, the FCC requires that qualifying eligible facilities requests be approved within 60 days, subject to tolling for incompleteness. (See, 47 C.F.R. § 1.6100(c)(2), (3)). Since the proposed modification involves removal and replacement of equipment (i.e., the replacement generator) that will not substantially change the physical dimensions of the tower,the Town may only require documents that are relevant to determining that same qualifies as an eligible facilities request. (See, 47 C.F.R. § 1.6100(c)(1)). If the Town does not render a decision within the 60-day period, an eligible facilities request can be deemed granted by operation of law. (See, 47 C.F.R. § 1.6100(c)(4)). 2 If you should have any questions,please do not hesitate to contact me. Thank you for your attention to this Application. Vetsruly yours, Denise J. Vista Enclosures cc: Verizon Wireless (via email,w/out enclosures) 3 Nunemaker,.Amanda From: Nunemaker,Amanda Sent: Tuesday,January 4, 2022 1:02 PM To: 'Denise Vista' Subject: RE:Verizon Wireless' Building Permit Application for the Generator Replacement at 40200 Main Road,-Southold I will also need (2) more sets of plans as there are only 2 in the file. From: Denise Vista <dvista@amatofirm.com> Sent:Tuesday,January 4, 2022 11:27.AM To: Nunemaker,Amanda.<Amanda.Nunemaker@town.southold.ny.us> Subject: RE:Verizon Wireless' Building Permit Application for the Generator Replacement at 40200 Main Road,Southold Hi Amanda, Happy New Year—hope you enjoyed your holidays! Following up on your below email,we filed the Administrative Wetland Permit Application with the Town Trustees on December 20, 2021, and it is tentatively scheduled for the January 19th meeting. As such, please.confirm that once the Administrative Wetland Permit is issued, if anything else is required to obtain the Building Permit.for-the generator replacement. Thank you. Denise J.Vista,Esq. AM, AT 0 [>•A1�1� `G R=C�[J-P: .I''L LC.• 666 Old Country Road, Suite 901 Garden City,New York 11530 Tel: (516) 227-6363 Fax: (516) 227-6367 Cell: (516) 455-2824 dvista@amatofirm.com www.amatolaw,grouF.corn CONFIDENTIALITY NOTICE:This electronic message contains information from the law firm of Amato Law Group,PLLC.This e-mail and any files attached may contain confidential inform ation.that is legally privileged.If you are not the intended recipient,or a person responsible for delivering it,you are hereby notified that any disclosure,copying,distribution or use of any of the information contained in or attached to-this transmission is STRICTLY PROHIBITED.If you have received this transmission in error,please forward same to sender and destroy the original transmission and its attachments without reading or saving in any manner. From: Nunemaker,Amanda [mailto:Amanda.Nunemaker@town.southold.nv.us] Sent: Friday, November 19, 20218:27 AM 1 To: Denise Vista<dvista@amatofirm.com> Subject: RE:Verizon Wireless' Building Permit Application for the Generator Replacement.at 40200 Main Road,Southold Hi Denise,- I did not review the original application, but it should have required Trustees approval at that time as well. I had verified with the Trustee office prior.to calling you on Wednesday to ensure their approval is required. Any activity within 100' to wetlands require Trustee approval. You can contact their office at 631-765-1892. From: Denise Vista <dvista@amatofirm.com> Sent:Thursday, November 18, 2021-1:31 PM To: Nunemaker,Amanda<Amanda.Nunemaker@town.southold.nv.us> Subject:Verizon Wireless' Building Permit Application for the Generator Replacement at 40200 Main Road,Southold Hi Amanda, Thank.you for your-voicemail regarding the referenced matter. I understand you are out of the office today, and I will not be-in the office tomorrow,so I thought I would follow-up with an email. You indicated in your email that Trustees approval would be required for the generator replacement, due to the property's Iocation to the water. Can you clarify this approval, as I do not,recall having to obtain same for.the original installation of the facility, as only Planning and Zoning Board of Appeals relief were required (as well as permits from NYSDEC and the Building Department)? Thank you. Denise J. Vista, Esq. M _ . . [: V1 G:R`01U;R;. C:I[:LC. 666 Old Country Road,Suite 901 Garden City,New York 11530 Tel: (516) 227-6363 Fax: (516)227-6367 Cell: (516) 455-2824 dvista @amatofirm.com. htWs://link.edgel2ilot.com/s/ed86b3f0/gY�8iCTNXEShk8RNefxwsw?u=htW://www.amatolgm=oul2.com/ CONFIDENTIALITY NOTICE:This electronic message contains information from the law firm of Amato Law Group,PLLC.This e-mail and any files attached may contain confidential information that is legally privileged.If you are not the intended recipient,or a person responsible for delivering it,you are hereby notified that any disclosure,copying,distribution or use of any of the information contained in or attached to this transmission is STRICTLY PROHIBITED.If you have received this transmission in error,please forward same to sender and destroy the original transmission and its attachments without reading or saving in any manner ATTENTION:This email came from an external source. Do not open attachments or click on links from unknown senders or unexpected emails. Links contained in this email have been replaced. If you click on a link in the email above,the link will be analyzed for known threats. If a known threat is found, you will not be able to proceed to the destination. If suspicious content is detected,you will see a warning. 2 i V , i Nunemaker, Amanda From: Nunemaker,Amanda Sent: Tuesday,January 4, 2022 1:01 PM To: 'Denise Vista' Subject: RE:Verizon Wireless' Building Permit Application for the Generator Replacement at 40200 Main Road, Southold Hi Denise, Happy New Year! In addition to receiving the Trustees permit, I also need correspondence from the Planning Board that will allow for the generator replacement. The application and plans had been sent up to their department. You may want to contact them to see what the status is. (631-765-1938) Amanda From: Denise Vista <dvista@amatofirm.com> Sent:Tuesday,January 4, 2022 11:27 AM To: Nunemaker,Amanda <Amanda.Nunemaker@town.southold.ny.us> Subject: RE:Verizon Wireless' Building Permit Application for the Generator Replacement at 40200 Main Road,Southold Hi Amanda, Happy New Year—hope you enjoyed your holidays! Following up on your below.email,we filed the Administrative Wetland Permit Application with the Town Trustees on December 20, 2021, and it is tentatively scheduled for the January 19th meeting. As such, please confirm that once the Administrative Wetland Permit is issued, if anything else is required to obtain the Building Permit for the generator replacement. Thank you. Denise J.Vista, Esq. �IAM -A-"-ro LAW, G R-0 UP; P L L C 666 Old Country Road, Suite 901 Garden City,New York 11530 Tel: (516) 227-6363 Fax: (516) 227-6367 Cell: (516) 455-2824 dvistaQamatofirm.com www.amatolawgrou2.com CONFIDENTIALITY NOTICE:This electronic message contains information from the law firm of Amato Law Group,PLLC.This e-mail and any files attached may contain confidential information that is legally privileged.If you are not the intended recipient,or a person responsible for delivering it,you are hereby notified that any disclosure,copying,distribution or use of any of the information 1 4contained in or attached to this transmission is STRICTLY PROHIBITED.If you have received this transmission in error,please forward same to sender and destroy the original transmission and its attachments without reading or saving in any manner. From: Nunemaker,Amanda [mailto:Amanda.NunemakerCitown.southold.ny.us] Sent: Friday, November 19, 20218:27 AM To: Denise Vista <dvista@amatofirm.com> Subject: RE:Verizon Wireless' Building Permit Application for the Generator Replacement at 40200 Main Road,Southold Hi Denise, I did not review the original application, but it should have required Trustees approval at that time as well. I had verified with the Trustee office prior to calling you on Wednesday to ensure their approval is required. Any activity within 100' to wetlands require Trustee approval. You can contact their office at 631-765-1892. From: Denise Vista <dvista@amatofirm.com> Sent:Thursday, November 18, 2021 1:31 PM To: Nunemaker,Amanda <Amanda.Nunemaker@town.southold.nv.us> Subject:Verizon Wireless' Building Permit Application for the Generator Replacement at 40200 Main Road,Southold Hi Amanda, Thank you for your voicemail regarding the referenced matter. I understand you are out of the office today, and I will not be in the office tomorrow,so I thought I would follow-up with an email. You indicated in your email that Trustees approval would be required for the generator replacement, due to the property's location to the water. Can you clarify this approval,as I do not recall having to obtain same for the original installation of the facility, as only Planning and Zoning Board of Appeals relief were required (as well as permits from NYSDEC and the Building Department)? Thank you. Denise J. Vista, Esq. MwA 0 &0 0. 666 Old Country Road,Suite 901 Garden City,New York 11530 Tel: (516) 227-6363 Fax: (516) 227-6367 Cell: (516)455-2824 dvista@amatofirm.com https://Iink.edgepilot.com/s/ed86b3fO/p Vg8jCTNY,EShk8R.Nefxwsw?u=htw://www.amatolg=oul2.com/ CONFIDENTIALITY NOTICE:This electronic message contains information from the law firm of Amato Law Group,PLLC.This e-mail and any files attached may contain confidential information that is legally privileged.If you are not the intended recipient,or a person responsible for delivering it,you are hereby notified that any disclosure,copying,distribution or use of any of the information contained in or attached to this transmission is STRICTLY PROHIBITED.If you have received this transmission in error,please forward same to sender-and destroy the original transmission and its attachments without reading or saving in any manner 2 ,ATTEN i ION:This email came from an external source. Do not open attachments or click on links from unknown senders or unexpected emails. Links contained in this email have been replaced. If you click on a link in the email above, the link will be analyzed for known threats. If a known threat is found, you will not be able to proceed to the destination. If suspicious content is detected,you will see a warning. 3 WIG: � � � � 666 OLD COUNTRY ROAD, 9T" FLOOR GARDEN CITY, NY 11530 LAW GROUP, P L L C TEL: 516.227.6363 FAX: 516.227.6367 UU @2�,12t BY HAND DELIVERY Building Department APR 2 7 2022 D , Town of Southold Town Hall Annex Building TOBUILDING UTHO o 54375 Route 25 Southold,New York 11971 Re: Building Permit Application (the "Application") by New York SMSA Limited Partnership d/b/a Verizon Wireless ("Verizon Wireless")to the Town of Southold (the "Town") in connection with the generator replacement for the existing public utility wireless communication facility located at 40200 Main Road, Orient, New York, known and designated as District 1000, Section 15, Block 9, Lot 8.1 (the "Property") NYSMSA Site Reference: Orient Point 2/Our File No. 100-0773 Dear Sir/Madam: In connection with Verizon Wireless' Application for the replacement generator at the Property, enclosed are the following: 1. Floodplain Development Permit Application,executed by Verizon Wireless; 2. Application for Electrical Inspection; and 3. A check, made payable to the "Town of Southold", in the amount of $100.00, representing the remaining Application fees. Fu ,the general contractor for this project was rece anged from Odyssia Global Co cations Corp. to: E.T. Vanderbeck, Inc. /UW 69 Lee Ave Haledon,New Jersey 07508 (973) 689-6841; cyaghan@etvanderbeck.co d are E.T. Vande s certificates of liability, disability and workers' compensation insurance, naming the Town as a certificate holder/additional insured. Kindly issue the Building Permit at your earliest convenience. If you should have any questions,please do not hesitate to contact me. 405 LEXINGTON AVENUE I CHRYSLER BUILDING,26TH FLOOR I NEW YORK,NY 10174 1 212.485.6000 402 MAIN STREET I SUITE 204 1 METUCHEN,NJ 08840 1 732.317.1511 iG Thank you for your attention to this Application. Very truly yours, lenise J. Vista Enclosures cc: Verizon Wireless(via email,w/out enclosures) R EFI f i S I I APR 21 2022 TOWN Of SOU 1HOLD 2 AM ��® ! � 666 OLD COUNTRY ROAD, 9T"FLOOR GARDEN CITY, NY 11530 LAW GROUP, P L L C ! ,J, TEL: 516.227.6363 FAX: 516.227.6367 - JUL 1 3 2023 BUILDING DEFT. July 12, 2023 BY FEDERAL EXPRESS Building Department Town of Southold Town Hall Annex Building 54375 Route 25 Southold,New York 11971 Re: Building Permit # 47402 issued to New York SMSA Limited Partnership d/b/a. Verizon Wireless ("Verizon Wireless")by the Town of Southold (the "Town") in connection with the generator replacement for the existing public utility wireless communication facility located at 40200 Main Road,Orient,New York,known and designated as District 1000, Section 15,Block 9, Lot 8.1 (the "Property") NYSMSA Site Reference: Orient Point 2/ Our File No. 100-0773 Dear Sir/Madam: In connection with Building Permit 47402 issued by the Town to Verizon Wireless to install a replacement generator utilized with its communication facility located at the Property, Verizon Wireless requests a six(6)month extension of the Building Permit(copy enclosed),which expires on July 30,2023, as construction is not yet complete. Kindly make a note of the foregoing within the Town's records on the Building Permit and provide a letter from the Town reflecting such extension. Should you have any questions, please do not hesitate to contact me at the above number or dvista@amatofirm.com. Thank you for your attention to this matter. V yo s, Denise J. Vista Enclosure cc: Venzon Wireless (via email,w/out enclosures) 405 LEXINGTON AVENUE I CHRYSLER BUILDING,26T"FLOOR I NEW YORK,NY 10174 212.485.6000 402 MAIN STREET I SUITE 204 1 METUCHEN,NJ 08840 1 732.317.1511 ` 666 OLD COUNTRY ROAD, 9TH FLOOR AMATO GARDEN CITY, NY 11530 LAW GROUP, P L L C TEL: 516.227.6363 1 FAX: 516.227.6367 October 26,2023 VIA FEDERAL EXPRESSS Building Department Town of Southold Town Hall Annex Building 54375 Route 25 Southold,New York 11971 Re: Building Permit#47402 issued to New York SMSA Limited Partnership d/b/a Verizon Wireless("Verizon Wireless")by the Town of Southold(the"Town")in connection with the generator replacement for the existing public utility wireless communication facility located at 40200 Main Road, Orient,New York, known and designated as District 1000, Section 15,Block 9,Lot 8.1 NYSMSA Site Reference: Orient Point 2/Our File No. 100-0773 Dear Sir/Madam: In connection with the close-out of Verizon Wireless' Building Permit (copy enclosed) for the replacement generator at the Property, and in response to the requests made by the Town following the inspection on August 17,2023,enclosed are the following: 1. Memorandum from the Town Planning Board, dated October 19, 2023, recommending issuance of the Certificate of Occupancy; 2. Certificate of Compliance issued by the Town Board of Town Trustees,dated October 15, 2023; 3. Copy of the passing Electrical Inspection Report conducted by the Town on August 17, 2023;and 4. Photo of the rapid shutoff switch installed on the replacement generator. Please note that we were advised by Suffolk County Office of Pollution Control, Division of Environmental Quality,that an inspection is not required for the replacement generator. Additionally,the generator contractor was advised that since the Town conducted its, own electrical inspection .(copy of passing inspection enclosed),an electrical certificate is not required. Kindly issue the Certificate of Occupancy at your earliest convenience. If you should have any questions,please do not hesitate to contact me. Thank you for your attention to this matter. V t y ours, e Vista Enclosures cc: Verizon Wireless(via email,w/out enclosures) E.T.Vanderbeck,Inc.(via email,w/out enclosures) 405 LEXINGTON AVENUE I CHRYSLER BUILDING,26TH FLOOR I NEW YORK,NY 10174 212.485.6000 402 MAIN STREET I SUITE 204 1 METUCHEN,NJ'08840 1 732.317.1511 NEW � porkers' YORK CERTIFICATE OF c re Compensation Board NYS WORKERS' COIWPENSATION INSURANCE COVERAGE 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of insured Odyssia Global Communications Corp 718-932-4819 24-34 45th Street Astoria NY 11103 1c.NYS Unemployment Insurance Employer Registration Number of Insured 7116377 Work Location of Insured(Only required if coverage is specifically limited to 1 d.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i e., a Wrap-Up Policy) Number 113401156 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Continental Indemnity Company Town of Southold 3b.Policy Number of Entity Listed in Box"I a" 53095 Rte 25 37-225487-01-04 Southold NY 11971 3c.Policy effective period 01/30/2021 to 01/30/2022 3d.The Proprietor,Partners or Executive Officers are QX included.(only check box if all partners/officers 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 1a"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 Zulkofske (Pri'n�t n�m of a hodzed representative or licensed agent of insurance carder) Approved by: r (Sign ure) (Date) Title:Authorized Agent Telephone Number of authorized representative or licensed agent of insurance carrier: 631-941-4113 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 r Workers' Compensation Law Section 57. Restriction on Issue of permits and the entering into contracts unless compensation is secured. 1. 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 a hazardous employment defined by this chapter, and notwithstanding 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 compensation for all employees has been secured as provided by this chapter. 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 compensation to any such employee if so employed. 2. 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 a hazardous employment defined by this chapter, 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 compensation for all employees has been secured as provided by this chapter. C-105.2 (9.17) REVERSE PORK workers' CERTIFICATE OF INSURANCE COVERAGE STATE Compensation Board DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW PART i,To be completed by Disability and Paid Family Leave Benefits Carrier or Licensed Insurance Agent of that Carrier 1a.Legal Name&Address of Insured(use street address only) 1b,Business Telephone Number of Insured ODYSSIA GLOBAL COMMUNICATION CORP 718-932-4819 24-34 45TH STREET ASTORIA,NY 11103 1c.Federal Employer,Identification Number of Insured or Social Security,Number Work Location of Insured(Onlyraquired if coverage is specifically limited to certain locations In New York State,i.e.,Wrap-Up Policy) 113401156 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) ShelterPolnt Life Insurance Company Town of Southold 53095 Rte 26 3b.Policy Number of Entity Listed in Box"la" Southold NY 11971 DBL176633 3c.Policy effective period 01/31/2021 to 01/30/2023 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 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 8/24/2021 By (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 56 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 t 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 DB-120.1.insurance brokers are NOT authorized to Issue this form. DB-120.1 (10-17) �I�IIPIQIIDI�OIo[IIfIIiIIIBoI�II(I![[III�IDI ACORD' CERTIFICATE OF LIABILITY INSURANCE DATE(MMlODIYYYY) �.-,- 0812412021 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 Ileu of such endorsoment(s). PRODUCER NAMFACT Brookhaven Aaency Inc Brookhaven Agency,Inc. PHONE 631 941.4113 FAX 631 941-4405 100 Oakland Ave,Ste 1 E-MAIL • Certificates Brookhavena enc .com Port Jefferson,NY 11777 INSURER(Sl AFFORDING COVE ME NAIC 0 INSURERA: Utica Mutual Insurance Co. 26976 INSURED INSURER , Continental Indemnity Co 28268 Odyssia Global Communications Corp INSURERC Merchants Mutual Insurance Co. 23329 24-34 46th Street INSURER D•Westchester Fire Insurance Co. 10030 Astoria NY 11103 mugrig E• Homeland Ins Co of Delaware 14231 INsuRER F, Th Ohio Casualty Insurance Co. 24074 COVERAGES CERTIFICATE NUMBER: 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. INSR P LTR TYPE OF INSURANCE ADDL UBR POLICY NU OLICY EFF POLICY EXP LIMITS DDIYYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1 00O 000 A CLAIMS-MADE 7 OCCUR DAMAGE TO RENTED $10O 000 X Contractual Liability X X 5429003 01/30/2021 0113012022 MED EXP(Any oneperson) $5 000 X Includes XCU Coverage PERSONAL&ADV INJURY $1 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s2,000,000 POLICY[j]jFCr LOC PRODUCTS-COMP/OP AGG s2,000,000 E&O $2 000 000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1 000 000 C X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED X X CAP1068043 01/30/2021 01/3012022 BODILY INJURY(Per accident) $ AUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS SUM Coverage $1 000 000 X UMBRELLA LIAB N OCCUR EACH OCCURRENCE $5 00O 000 C EXCESS LIAR CLAIMS-MADE X X CUP0002353 01/30/2021 01/3012022 AGGREGATE $5 000 000 R $ WORKERS COMPENSATION X I PER JER OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN N E.L.EACH ACCIDENT S i,000,000 B OFFICERIMEMBEREXCLUDED7 ❑N NIA X 37-225487-01-04 01/30/2021 01/3012022 (Mandatory In NH) E.L.DISEASE.EA EMPLOYEE $1,000,000 If yes, IPTION OF under OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 F Installation Floater BMO(22)63108118 05/09/2021 '06/0912022 1,000,000 1,000,000 D Umbrella Liability(2nd 6m) X X N11036351 004 01/30/2021 01/30/2022 6,000,000 per occ 6,000,000 agg DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) CERTIFICATE HOLDER CANCELLATION Town of Southold SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 53096 Route 25 ACCORDANCE WITH THE POLICY PROVISIONS. Southold,NY 11971 AUTHORIZED REPRESENTATIVE <NSZ> 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014101) The ACORD name and logo are registered marks of ACORD I nB DATE(MMIDD/YYYY) ,4�o CERTIFICATE OF LIABILITY INSURANCE 03/30/2022 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 policy(ies)must have'ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of t�i gpolicy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu f h,endorsement(s). PRODUCER �\ NAME: Stephen PuntaseCca I V1 IThe HeidtAgency ( ` CO No Ext: (201)258-7450 FAX,/ No: (201)857-4737 A 226 Rock Road ®�t1 DRless: Steve@theheidtagency.com N� INSURER(S)AFFORDING COVERAGE NAIC q Glen Rock NJ 0745 INSURERA: Ohio Security Insurance Co. 24082 INSURED XtAq v�0 INSURER B: Ohio Casualty Insurance 24074 E T Vanderbeck Inc.Nbecku B INSURER C: 69 Lee Ave o �F INSURER D: INSURER E: Haledon NJ 07508 INSURER F: COVERAGES CERTIFICATE NUMBER: NY Master Cert 21 to 22 REVISION NUMBER: THIS IS TO CERTIFY THATTHE 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. CY EXP INSR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDIDYIVYYY MMIDDIYYYY LIMITS FGENI'L MERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE 7 OCCUR PREMISES Ea occurrence $ 300,000 ntractors E&0/Professional MED EXP(Any one person) $ 15,000 A Y Y BKS58396423 10/11/2021 10/11/2022 PERSONAL BADVINJURY $ 1,000,000 GREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY [9 JERO-CT 7 LOC 2,000,000 PRODUCTS-COMP/OPAGG $ OTHER: I Expense Mod Factor 1 $ AUTOMOBILE LIABILITY ! COMBINED SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOSONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 10,000,000 B EXCESS LIAB CLAIMS-MADE Y Y US058396423 10/11/2021 10/11/2022 AGGREGATE $ 10,000,000 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE --I NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED?(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Additional Insured applies in favor of Town Of Southold as respects operations performed by and on bahalf of the named insured.CG8810 applies. 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 AUTHORIZED REPRESENTATIVE Southold NY 11971 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 26(2016103) The ACORD name and logo are registered marks of ACORD PORK workers' CERTIFICATE OF INSURANCE COVERAGE STATE Compens ation 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 1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured E.T.VANDERBECK INC 973-689-6841 69 LEE AVENUE HALEDON,NJ 07508 1c.Federal Employer Identification Number of Insured or Social Security Number Work Location of Insured(Only required if coverage is specifically limited to certain locations in New York State,i.e.,Wrap-Up Policy) 222095499 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 Rte 25 3b.Policy Number of Entity Listed in Box"l a" Southold NY 11971 DBL421170 3c.Policy effective period 10/25/2021 to 10/24/2022 4. Policy provides the following benefits: 0 A.Both disability and paid family leave benefits. B.Disability benefits only. C.Paid family leave benefits only. 5. Policy covers: n 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 3/30/2022 By 44da 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 413,4C 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) 111 DB-120.1 (12-21)ii�1110 /7 \\ ICI YS I F New York State Insurance Fund PO Box 66699,Albany,NY 12206 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE %I . A A A A A A 222095499 E.T.VANDERBECK INC. 69 LEE AVENUE HALEDON NJ 07508 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER E.T.VANDERBECK INC. TOWN OF SOUTHOLD 69 LEE AVENUE 53095 ROUTE 25 HALEDON NJ 07508 SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE E2429156-9 754823 10/18/2021 TO 10/18/2022 3/30/2022 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2429156-9, 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:I/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 MIKE YAGHAN 1 OF 1 E.T.VANDERBECK INC. THE POLICY INCLUDES A WAIVER OF SUBROGATION ENDORSEMENT UNDER WHICH NYSIF AGREES TO WAIVE ITS RIGHT OF SUBROGATION TO BRING AN ACTION AGAINST THE CERTIFICATE HOLDER TO RECOVER AMOUNTS WE PAID IN WORKERS'COMPENSATION AND/OR MEDICAL BENEFITS TO OR ON BEHALF OF AN EMPLOYEE OF OUR INSURED IN THE EVENT THAT, PRIOR TO THE DATE OF THE ACCIDENT, THE CERTIFICATE HOLDER HAS ENTERED INTO A WRITTEN CONTRACT WITH OUR INSURED THAT REQUIRES THAT SUCH RIGHT OF SUBROGATION BE WAIVED. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE SUR NCE FUND T I�/ DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 353866218 U-26.3 COMMERCIAL GENERAL LIABILITY CG 88 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX SUBJECT PAGE NON-OWNED AIRCRAFT 2 NON-OWNED WATERCRAFT 2 PROPERTY DAMAGE LIABILITY—ELEVATORS 2 EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) 2 MEDICAL PAYMENTS EXTENSION 3 EXTENSION OF SUPPLEMENTARY PAYMENTS—COVERAGES A AND B 3 ADDITIONAL INSUREDS—BY CONTRACT,AGREEMENT OR PERMIT 3 PRIMARY AND NON-CONTRIBUTORY—ADDITIONAL INSURED EXTENSION 6 ADDITIONAL INSUREDS—EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" 6 WHO IS AN INSURED—INCIDENTAL MEDICAL ERRORS/MALPRACTICE AND WHO IS AN INSURED— 6 FELLOW EMPLOYEE EXTENSION—MANAGEMENT EMPLOYEES NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES 7 FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES 7 KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT 7 LIBERALIZATION CLAUSE 7 BODILY INJURY REDEFINED 7 EXTENDED PROPERTY DAMAGE 8 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US— 8 WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU ©2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 1 of 8 i With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. A. NON-OWNED AIRCRAFT Under Paragraph 2. Exclusions of Section I—Coverage A-Bodily Injury And Property Damage Liability, exclusion g.Aircraft,Auto Or Watercraft does not apply to an aircraft provided: 1. It is not owned by any insured; 2. It is hired, chartered or loaned with a trained paid crew; 3. The pilot in command holds a currently effective certificate, issued by the duly constituted authority of the United States of America or Canada, designating her or him a commercial or airline pilot; and 4. It is not being used to carry persons or property for a charge. However, the insurance afforded by this provision does not apply if there is available to the insured other valid and collectible insurance,whether primary, excess (other than insurance written to apply specifically in excess of this policy), contingent or on any other basis, that would also apply to the loss covered under this provision. B. NON-OWNED WATERCRAFT Under Paragraph 2. Exclusions of Section I—Coverage A—Bodily Injury And Property Damage Liability, Subparagraph (2) of exclusion g.Aircraft,Auto Or Watercraft is replaced by the following: This exclusion does not apply to: (2) A watercraft you do not own that is: (a) Less than 52 feet long; and (b) Not being used to carry persons or property for a charge. C. PROPERTY DAMAGE LIABILITY—ELEVATORS 1. Under Paragraph 2. Exclusions of Section I—Coverage A—Bodily Injury And Property Damage Liability, Subparagraphs (3), (4) and (6) of exclusion j. Damage To Property do not apply if such "property damage" results from the use of elevators. For the purpose of this provision, elevators do not include vehicle lifts. Vehicle lifts are lifts or hoists used in automobile service or repair operations. 2. The following is added to Section IV—Commercial General Liability Conditions, Condition 4. Other Insurance, Paragraph b. Excess Insurance: The insurance afforded by this provision of this endorsement is excess over any property insurance, whether primary, excess, contingent or on any other basis. D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) If Damage To Premises Rented To You is not otherwise excluded from this Coverage Part: 1. Under Paragraph 2. Exclusions of Section I -Coverage A-Bodily Injury and Property Damage Liability: a. The fourth from the last paragraph of exclusion j. Damage To Property is replaced by the following: Paragraphs(1), (3) and (4) of this exclusion do not apply to"property damage" (other than damage by fire, lightning, explosion, smoke, or leakage from an automatic fire protection system) to: (i) Premises rented to you for a period of 7 or fewer consecutive days; or (Ii) Contents that you rent or lease as part of a premises rental or lease agreement for a period of more than 7 days. Paragraphs(1), (3) and (4) of this exclusion do not apply to"property damage"to contents of premises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to this coverage as described in Section III—Limits of Insurance. ©2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 2 of 8 b. The last paragraph of subsection 2. Exclusions is replaced by the following: Exclusions c.through n. do not apply to damage by fire, lightning, explosion, smoke or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner.A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III—Limits Of Insurance. 2. Paragraph 6. under Section III—Limits Of Insurance is replaced by the following: 6. Subject to Paragraph S. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of"property damage"to: a. Any one premise: (1) While rented to you; or (2) While rented to you or temporarily occupied by you with permission of the owner for damage by fire, lightning, explosion, smoke or leakage from automatic protection systems; or b. Contents that you rent or lease as part of a premises rental or lease agreement. 3. As regards coverage provided by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) - Paragraph 9.a. of Definitions is replaced with the following: 9.a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with the permission of the owner, or for damage to contents of such premises that are included in your premises rental or lease agreement, is not an "insured contract". E. MEDICAL PAYMENTS EXTENSION If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this policy are amended as follows: Under Paragraph 1. Insuring Agreement of Section I—Coverage C—Medical Payments, Subparagraph (b) of Paragraph a. is replaced by the following: (b) The expenses are incurred and reported within three years of the date of the accident; and F. EXTENSION OF SUPPLEMENTARY PAYMENTS—COVERAGES A AND B 1. Under Supplementary Payments—Coverages A and B, Paragraph 1.b. is replaced by the following: b. Up to$3,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies.We do not have to furnish these bonds. 2. Paragraph 1.d. is replaced by the following: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or"suit", including actual loss of earnings up to$500 a day because of time off from work. G. ADDITIONAL INSUREDS -BY CONTRACT,AGREEMENT OR PERMIT 1. Paragraph 2. under Section II—Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract, written agreement or permit. Such person or organization is an additional insured but only with respect to liability for"bodily injury", "property damage"or"personal and advertising injury" caused in whole or in part by: a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your on going operations for the additional insured that are the subject of the written contract or written agreement provided that the"bodily injury"or"property damage"occurs, or the"personal and advertising injury' is committed, subsequent to the signing of such written contract or written agreement; or ©2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 3 of 8 b. Premises or facilities rented by you or used by you; or C. The maintenance, operation or use by you of equipment rented or leased to you by such person or organization; or d. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit subject to the following additional provisions: (1) This insurance does not apply to"bodily injury", "property damage", or"personal and advertising injury"arising out of the operations performed for the state or political subdivision; (2) This insurance does not apply to"bodily injury' or"property damage"included within the "completed operations hazard". (3) Insurance applies to premises you own, rent, or control but only with respect to the following hazards: a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and similar exposures; or (b) The construction, erection, or removal of elevators; or (c) The ownership, maintenance, or use of any elevators covered by this insurance. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. With respect to Paragraph 1.a. above, a person's or organization's status as an additional insured under this endorsement ends when: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project(other than service, maintenance or repairs)to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2) That portion of"your work"out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. With respect to Paragraph 1.b. above, a person's or organization's status as an additional insured under this endorsement ends when their written contract or written agreement with you for such premises or facilities ends. With respects to Paragraph 1.c. above, this insurance does not apply to any"occurrence"which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the"bodily injury"or"property damage". We have no duty to defend an additional insured under this endorsement until we receive written notice of a"suit" by the additional insured as required in Paragraph b. of Condition 2. Duties In the Event Of Occurrence, Offense, Claim Or Suit under Section IV—Commercial General Liability Conditions. ©2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 4 Of 8 2. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section I -Coverage A-Bodily Injury And Property Damage Liability: This insurance does not apply to: a. "Bodily injury' or"property damage"arising from the sole negligence of the additional insured. b. "Bodily injury" or"property damage"that occurs prior to you commencing operations at the location where such "bodily injury"or"property damage"occurs. C. "Bodily injury", "property damage"or"personal and advertising injury' arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment,training or monitoring of others by that insured, if the"occurrence"which caused the"bodily injury'or"property damage", or the offense which caused the"personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. d. "Bodily injury"or"property damage"occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the ' location of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. e. Any person or organization specifically designated as an additional insured for ongoing operations by a separate ADDITIONAL INSURED—OWNERS, LESSEES OR CONTRACTORS endorsement issued by us and made a part of this policy. 3. With respect to the insurance afforded to these additional insureds, the following is added to Section III— Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: a. Required by the contract or agreement; or b. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. H. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. Condition 4. Other Insurance of SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: a. The following is added to Paragraph a. Primary Insurance: If an additional insured's policy has an Other Insurance provision making its policy excess, and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional insured's policy for damages we cover. ©2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 6 of 8 b. The following is added to Paragraph b. Excess Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non-contributory, this insurance is excess over any other insurance for which the additional insured is designated as a Named Insured. Regardless of the written agreement between you and an additional insured, this insurance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies. I. ADDITIONAL INSUREDS -EXTENDED PROTECTION OF YOUR"LIMITS OF INSURANCE" This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. 1. The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim or Suit: An additional insured under this endorsement will as soon as practicable: a. Give written notice of an "occurrence"or an offense that may result in a claim or"suit" under this insurance to us; b. Tender the defense and indemnity of any claim or"suit"to all insurers whom also have insurance available to the additional insured; and C. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. d. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a"suit" by the additional insured. 2. The limits of insurance applicable to the additional insured are those specified in a written contract or written agreement or the limits of insurance as stated in the Declarations of this policy and defined in Section III—Limits of Insurance of this policy, whichever are less. These limits are inclusive of and not in addition to the limits of insurance available under this policy. J. WHO IS AN INSURED -INCIDENTAL MEDICAL ERRORS/MALPRACTICE WHO IS AN INSURED -FELLOW EMPLOYEE EXTENSION -MANAGEMENT EMPLOYEES Paragraph 2.a.(1) of Section II -Who Is An Insured is replaced with the following: (1) "Bodily injury"or"personal and advertising injury": (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co-"employee"while in the course of his or her employment or performing duties related to the conduct of your business, or to your other "volunteer workers"while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co-"employee"or"volunteer worker"as a consequence of Paragraph (1) (a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1) (a) or(b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. However, if you are not in the business of providing professional health care services or providing professional health care personnel to others, or if coverage for providing professional health care services is not otherwise excluded by separate endorsement, this provision (Paragraph (d)) does not apply. ©2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 6 of 8 Paragraphs (a) and (b) above do not apply to"bodily injury'or"personal and advertising injury"caused by an "employee"who is acting in a supervisory capacity for you. Supervisory capacity as used herein means the "employee's"job responsibilities assigned by you, includes the direct supervision of other"employees"of yours. However, none of these"employees"are insureds for"bodily injury"or"personal and advertising injury"arising out of their willful conduct, which is defined as the purposeful or willful intent to cause"bodily injury"or"personal and advertising injury", or caused in whole or in part by their intoxication by liquor or controlled substances. The coverage provided by provision J. is excess over any other valid and collectable insurance available to your "employee". K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES Paragraph 3. of Section II -Who Is An Insured is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; b. Coverage A does not apply to"bodily injury"or"property damage"that occurred before you acquired or formed the organization; and C. Coverage B does not apply to"personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. d. Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership,joint venture or limited liability company that is not shown as a Named Insured in the Declarations or qualifies as an insured under this provision. L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES Under Section IV—Commercial General Liability Conditions,the following is added to Condition 6. Representations: Your failure to disclose all hazards or prior"occurrences" existing as of the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior"occurrences" is not intentional. M. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT Under Section IV—Commercial General Liability Conditions,the following is added to Condition 2. Duties In The Event of Occurrence, Offense, Claim Or Suit: Knowledge of an"occurrence", offense, claim or"suit" by an agent, servant or"employee" of any insured shall not in itself constitute knowledge of the insured unless an insured listed under Paragraph 1. of Section II—Who Is An Insured or a person who has been designated by them to receive reports of "occurrences", offenses, claims or"suits"shall have received such notice from the agent,servant or "employee". N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the day the revision is effective in your state. O. BODILY INJURY REDEFINED Under Section V—Definitions, Definition 3. is replaced by the following: 3. "Bodily Injury" means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death that results from such physical injury, sickness or disease. ©2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 7 of 8 P. EXTENDED PROPERTY DAMAGE Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following: a. Expected Or Intended Injury "Bodily injury"or"property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to"bodily injury"or"property damage" resulting from the use of reasonable force to protect persons or property. Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US—WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU Under Section IV— Commercial General Liability Conditions, the following is added to Condition 8. Transfer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against a person or organization because of payments we make for injury or damage arising out of your ongoing operations or"your work"done under a contract with that person or organization and included in the"products-completed operations hazard" provided: 1. You and that person or organization have agreed in writing,in a contract or agreement that you waive such rights against that person or organization; and 2. The injury or damage occurs subsequent to the execution of the written contract or written agreement. ©2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 8 of 8 !,N CONSTRUCTION DOCUMENTS FOR WIRELESS COMMUNIC ATIONS FACILITY: ORIENT POINT 2 rpm" 40200 MAIN ROAD, NY VZW PROJECT ID : 16318733 WFC PROJECT NO : 21 - 14738 ARCHITECTS 12.1 TECHNOLOGY DRIVE, SETAUKET, NY 11733 P. 631.689.8450 1 F. 631.689.8459 www.wfcaia.com SITE I' T I OROJECT COr' OTACTS D I G NDEX INITIAL ISSUANCE LATEST ISSUANCE ¢cD qRf, REVISION NO. 8, DATE VERIZON WIRELESS SITE NAME: "ORIENT POINT 2" APPLICANT: NEW YORK SMSA LIMITED PARTNERSHIP (914) 714-7371 DWG. NO. DRAWING TITLE d/b/a VERIZON WIRELESS « 4 CENTEROCK ROAD ARCHITECTURAL .� 1 WEST NYACK, NY 10994 SITE TYPE/DESCRIPTION: AT GRADE: EXISTING VERIZON WIRELESS 1 OKW DIESEL DC T-100.00 TITLE SHEET 7/27/21 1 8/3/21 GENERATOR TO BE REMOVED AND REPLACED WITH NEW PROPERTY OWNER: M.G.H. ENTERPRISES, INC. (631) 323-2424 G-100.00 GENERAL NOTES AND ABBREVIATIONS 7/27/21 1 8/3/21 - �8 4 50KW DIESEL GENERATOR WITH SOUND ENCLOSURE SET 40200 MAIN ROAD, ORIENT, NY 11957 ATOP EXISTING ELEVATED STEEL DUNNAGE EQUIPMENT ROBERT HAASE SP-100.00 ARCHITECTURAL SITE PLAN OF 7/27/21 1 8/3/21 A-100.00 EAST ELEVATION AND ENLARGED EQUIPMENT PLAN CONSULTANT: PLATFORM. 7/27/21 1 8/3/21 LEASING CONTACT: JIM KORWAN (516) 946-8920 A-101.00 GENERATOR INFORMATION 7/27/21 1 8/3/21 PROJECT LOCATION: 40200 MAIN ROAD ORIENT, NY 11957 TAX MAP INFO:: SECTION 15, BLOCK 9 AND LOT 8.1 CONSTRUCTION CONTACT: PETE MCCARTHY (631) 236-2108 ZONING DISTRICT: 1000 ZONING DESIGNATION: MARINE II A/E (ENGINEER) CONTACT: NEIL A. MacDONALD,AIA, LEED AP (631) 689-8450 EXT.115 LATITUDE: 41.15294 (NAD 83) NO. DATE SUBMISSION LONGITUDE: -72.24419 (NAD 83) ELEVATION: 5' +/-AMSL (NGVD 29) PSEG LONG ISLAND CONTACT: SUSAN BRUCE-FEINSOD (631) 348-6044 1 7/ 1 8/33/21/21 ISSUED FOR REVIEW REVISED PER ATTORNEY COMMENTS ZONING JURISDICTION TOWN OF SOUTHOLD VZW SITE ID: 5008164 VZW PROJECT ID: 16318733 NO. DATE REVISION KEY PLAN: AREA OF WORK cEnn BINgI Bow(PVf(p.Qm L WncuurmrrAn renx rnnnaL�� ( l BYA u biAlY r,Lun ` E - r n�mmm�BerA'ra covYnrnmrr m.mn uunii eecu.rrr rnoersm LOCATIO-mi'mmMAPKEY P ' P�smisla37d � w. ` . Arirsc�P t)isrmsr Csrtrr... Orient Point Ferry t" Plimi Islind 0 51) we 40200 Main R '� taf �4 "ORIENT POINT 2" jxU200 Main Rd GENERATOR REPLACEMENT 4' 40200 MAIN ROAD ORIENT, NY 11957 TITLE: TITLE SHEET 4 , DATE: JULY 14, 2021 PROJECT NO: 21-14738 DRAWN BY: MM R !� Df. Lr n CHECKED BY: TM SCALE: AS NOTED �� _ � �- DRAWING NO: SITE LOCATION NORTH SITE LOCATION SCALE: 1 - 200 NORTH 1-C:VVI'J01:SUUIHOLD SHEET NO: 1 OF NiI;" :' :x, <. A. " ... :£�;'.� n1 gnu >E:. .; •£< . [at ft r xi EXISTING OVERHEAD \ UTILITY LINES FROM UTILITY POLE #35 A R C H I T E C T S \ BEYOND 12-1 TECHNOLOGY DRIVE, SETAUKET, NY 11733 P. 631.689.8450 1 F. 631.689.8459 1 www.wfcaia.com s•0�02 \ \�� DER O� �9 P 1001 / / /' FF' ✓ 0 9 / P��' CONSULTANT: PROPERTY LINE, TYP. / ' O NYSDEC Freshwater Wetlands 1011 / O EXISTING / <�O� STORAGE / o �V " BUILDING xp / / Sl- O p�1` /•'' r / ��� sue+ Q \�� ��1 / /O W. C, O GAO ./1 °� \�� co-) NO. DATE SUBMISSION p�`/ �EXISTING F'Lp 0 7/27/21 ISSUED FOR REVIEW 7+% MARINA e 1 8/3/21 REVISED PER ATTORNEY COMMENTS 100, 0, 61 'P-p CLOSEST DISTANCE BETWEEN LIMITS OF /.• c CLEARING AND WETLANDS A 9 s°o �' EXISTING ' O-C' 3F -}- EXISTING VERIZON WIRELESS EQUIPMENT AND ' o� / / ® oA' ,i 1° oo AFT TRANSFORMER, METER Py o GENERATOR MOUNTED ON EXISTING ELEVATED / s • �^Z�, ry0• A O��A AND DISCONNECT GALVANIZED STEEL PLATFORM. SEE �A-100.00 / `�s °� `� �, ,c• ``°o O9°9<< - v �' FOR MORE INFORMATION /' �� ///' 9�'0 �y °�9 EXISTING RESTAURANT AND QP�i �P NO. DATE I REVISION / F s� �A MARINE FUELING STATION QFPo •' /•�/ °ti° c,'",c.'AF�O o + n�j KEY PLAN: EXISTING QF COMPATIBLE S�'A� /.• � // / s � � S 9 �� / AREA OF WORK CONCEALMENT POLE WITH s �q,G,p9 1�9 �o��Z +— �O� //,/ �� ? • �/� �� /O CEOMBINpIXWDIPVl10.lV) EXISTING 20' 0" EXTENSION / ' lop (p / 2 � / / O Q tlRWlIOm1ANUR1AT6PAIIl(LOMM®9Q1 �+ //i/ Q °° J• M4¢!(!BG®BTA,L'PAxKI E 01 s \ems / //6// c^ X_ ° "Oil / + / ///i/ �P° /+ /� 1 �P F?O rtmRrATPA O,ANMfP (� m.um 3sunn PAcuTx Pxoeearn Z—EXISTING P' . • 0 60 —9 MARINA F,Fz�P 0 � ' + NYSDEC i al Wetlan + �� 13 LQ CD wayur Z yoe . o AApR r / co/(O ' m M yoRF4NF 1�°% "ORIENT POINT 2" / ti• � v ��l + GENERATOR REPLACEMENT s / A-100 O /+ t�P 4�,1� ��� , '/ 40200 MAIN ROAD \�°�;°' ��� .,�� ��P� s• + ORIENT, NY 11957 EXISTING BOAT LAUNCH RAMP 01 48 41' �� — ti TITLE: NYS _ ���°° EXISTING BULKHEAD ARCHITECTURAL SITE PLAN DEC Tjal Wetsand � _ + LATITUDE: 41.15294 (NAD 83) s � \ _ C0R LONGITUDE: -72.24419 (NAD 83) DATE: JULY 14, 2021 S39'44'40-W ELEVATION: 5 +/-AMSL ) PROJECT NO: 21-14738 A D , EXISTING BAY ENTRANCE (NGVD 29 TAX MAP INFO:: SECTION 15, BLOCK 9 AND LOT 8.1 DRAWN BY: MM EXISTING SHORELINE ?oyF qF�F \ �� ZONING DISTRICT: 1000 CHECKED BY: TM a� ZONING DESIGNATION: MARINE II SCALE: AS NOTED 7 DRAWING NO: 0' 20' 40' 80, 0 0 0 a 0 ARCHITECTURAL SITE PLAN 1 "=40'-0" 1 SCALE = 1 " = 40'-0" NORTH SHEET NO: 3 OF 5 . •2 v S• l, � 6 +r wrvpP9�',�N a 2« EXISTING VERIZON WIRELESS ICE BRIDGE WITH EXISTING 7/8"0 ANTENNA CABLES EXISTING VERIZON WIRELESS GPS UNITS MOUNTED : '''`:; TO EXISTING WEATHER CANOPY EXISTING TRIPLEXERS MOUNTED TO EXISTING VERIZON EXISTING CANOPY POST, TYP. WIRELESS ICE BRIDGE EXISTING DUAL BAND RRHs MOUNTED TO } , EXISTING UNISTRUIT FRAME (STACKED) II EXISTING VERIZON WIRELESS 10KW DIESEL DC GENERATOR ii TO BE REMOVED AND REPLACED WITH NEW 50KW DIESEL ,' s : ___ GENERATOR WITH SOUND ENCLOSURE SET ATOP EXISTING II I�I r----i r----� r----� r---i r---- r---- r----- r---- r— i EXISTING VERIZON �,; ' - ' ' ' ' -J ' ELEVATED STEEL DUNNAGE EQUIPMENT PLATFORM WIRELESS SECTOR I -- --- --- �__ --- --- --- ANTENNAS AND w DASHED LINE REPRESENTS EXISTING x x x x x x x x x x x x �s�— x x x x EXISTING DIPLEXERS LESSEE WEATHER CANOPY ABOVE / �� ^ �l A R C H I T E C T S MOUNTING WITHIN ( , 11 i �D,44 , � EXISTING 89'-0" RF �� x / x 12-1 TECHNOLOGY DRIVE, SETAUKET,NY 11733 _ .. . .I .I.I i[ �.i _l t p M m j- ;a�ro m�„sIs, ono;' �a:r:ro r:; � CONCEALMENT POLE. `_ ' ` 1� L1 i 1 uE �'13 P. 631.689.8450 I F. 631.689.8459 www.wfcaia.com } mom ��Sz�iai R O� D�DER EXISTING VERIZON WIRELESS STEEL STAIR— x� I I MI f I ' x „ � , Y'I tic, EXISTING 89 -0 I I ! I ( t i w _ RF CONCEALMENT POLE. Z I DELTA DELTA DELTA � x �•"�--' CABINET N CABINET CABINET 9 NEW ,r -694 O 50KW DIESEL �OF NE`�� x GENERATOR x CONSULTANT: ��� i i ,fr i �1 NEW W12X26 STEEL BEAM TO BE INSTALLED x I \ x (LENGTH AS REQUIRED). SEE DETAIL UP �` I i �� i /�� i ,� i / \ 3/A-100.00 FOR MORE INFORMATION • e e • e x x I EXISTING EXTERIOR FIRE EXTINGUISHER CABINET ATTACHED i TO EXISTING PLATFORM RAILING / EXISTING DC GENERATOR DISCONNECT TO BE REMOVED x x x x x x �c x x x o x x x x �e�Z— x x NO. DATE SUBMISSION 0 7/27/21 ISSUED FOR REVIEW EXISTING VERIZON WIRELESS HELICAL PILES (f20' DEEP) x EXISTING DELTA CABINETS AND EXSITING DELTA BATTERY CONCRETE PIERS WITH CONTINUOUS CONCRETE PILE CAP CABINET SET ATOP EXISTING STEEL DUNNAGE EQUIPMENT 1 8/3/21 REVISED PER ATTORNEY COMMENTS PLATFORM WITH EXISTING WEATHER CANOPY ABOVE EXISTING VERIZON WIRELESS TELCO CONDUIT TRENCHED FROM EXISTING LESSEE TELCO CABINET TO EXISTING MESA + x EXISTING CHAIN LINK FENCING WITH PRIVACY SLATS SPAN CABINET WITHIN EXISTING AT&T COMPOUND x EXISTING FLOOD LIGHTS MOUNTED TO EXISTING CANOPY POSTS, TYP. EXISTING POWER PANEL/ATS TO REMAIN ENLARGED EQUIPMENT PLAN 8" 1'-4" 2'-8" 2 NORTH NO. DATE REVISION SCALE = 3/8" = 1 '-0" 3/8"=1'-0" KEY PLAN: AREA OF WORK EXISTING VERIZON WIRELESS 7/8"0 ANTENNAS CABLES ROUTED WITHIN EXISTING CFMN BINCfI Ro6o NYf,o.e� CONCEALMENT POLE EXISTING 13'-0" HIGH CHAIN LINK FENCING WITH PRIVACY SLATS BeAC66tATe,Au E EXISTING VERIZON WIRELESS 1OKW DIESEL DC GENERATOR TO BE REMOVED AND REPLACED WITH NEW 50KW DIESEL GENERATOR WITH SOUND ENCLOSURE SET ATOP EXISTING ELEVATED STEEL DUNNAGE EQUIPMENT PLATFORM '�-x-- EXISTING 1 -1/2"x3/16" ID.UMLU•WePACILIlYPeOlHe'M Nrt UNrRD 6fATP9 aovHfirf"vrt Q SERRATED GALV. STEEL GRATING. z EXISTING VERIZON WIRELESS GPS UNITS MOUNTED z Q TO EXISTING WEATHER CANOPY NEW GALV. STL. 16GA. DIAMOND PLATE — Q Z EXISTING DELTA CABINETS AND EXISTING DELTA BATTERY ACROSS NEW STEEL DUNNAGE UNDER J CABINET SET ATOP EXISTING STEEL DUNNAGE EQUIPMENT NEW GENERATOR, AS REQUIRED to w J Q PLATFORM WITH EXISTING WEATHER CANOPY ABOVE o 0 0 Ln r—i r� w V) z z EXISTING AT&T FENCED IN EQUIPMENT AREA TO REMAIN W z z NEW W12X26 zz � EXISTING TREES TO REMAIN Z N Q Q z EXISTING W12X26 BEYOND C) 10 T > o w NEW 2-1 2"X2-1 2"X5 16" I ' CONTINUOUS STEEL ANGLE �'' c� z .3 BOLTED TO NEW W12X26 W/ 1/2 O F > z Z a\y� � ..; ,, : �..XV\; s zLij , I IIIII IIIII�II ff �- � .. ®; �. P t, �e. � y ? .. 111111' BOLTS, 18 O.C. '' t Ljjz_ X X c� ti,�, >. . ,g. a ,': :TX` :, . °: III lilill_ w y h_J I/A -H V/ It _z -] I'�Y�,.�Xy' `3£.Fy,.l'' ',�+,� :. ,'> 't,.y.•<>�q �"'`.>$.' '..""'. - O O }:'!Y`,r ..,,A- 3 '•nX 'd\ �,;\� -.? fl GALV. STEEL L4x4x5/15x6 IillIII!!I!!!II Li 0 LONG CLIP ANGLES, TYP. OF F- t� c� c �,. :' \,." T<�. '=a, III! IIIlII!lII:.`� r,= /2 PER CONNECTION �� �� Z�i, o _ �,✓ ORIENT POINT 2 Z n . y w A ° `" A ex, Q Q Q Q Q " ;`� �j(6 e` �.��x�•'X. .'>" «'�� d\�n t ,' '.E M �",: '"\! \>', i''^>.k 8 O •\.�•� �F. �� ! > �: � �y a'z.'�. �t\ ya>e\. ,,.•',>''X�r". eY \ s" t'„ �\?" -� -H N z GENERATOR REPLACEMENT O O O W V 1 CD W > 3 ,,rrJ(X. q! ' f \•n „V' `t; @aa''nn \i q Y 40200 MAIN ROAD ORIENT, NY 11957 II I ,lq- LT T T T T E E E E E E E E E E E _ TITLE: EAST ELEVATION AND l I L L _J L -H ENLARGED EQUIPMENT PLAN EXISTING FENCING NEW FENCING DATE: JULY 14, 2021 PROJECT NO: 21-14738 DRAWN BY: MM EXISTING VERIZON WIRELESS HELICAL PILES(f20' DEEP/CONCRETE PIERS WITH CONTINUOUS CONCRETE PILE CHECKED BY: TM CAP SCALE: AS NOTED DRAWING NO: 0' 1'-4" 2'-8" 5'-4"EAST ELEVATION STEEL DUNNAGE DETAIL. 1 3„ 3/16"=1'-0" SCALE — 3/16„ = 1 —0 SCALE — 1 -1/2" = 1 '-0" SHEET NO: 4 OF 5 COOLING ALTERNATOR SPECIFICATIONS `x SPECIFICATIONS: ALTERNATOR: • NEMA MG1 , IEEE, AND ANSI STANDARDS COMPLIANCE FOR RADIATOR SYSTEM: 49-STATE CALIFORNIA ;;:'' `', :~ TEMPERATURE RISE AND MOTOR STARTING. ENGINE SCAQMD ` k' ,.: ,.,j `,.: - F THE RATED `;<�;��"�`; t KOHLER • SUSTAINED SHORT-CIRCUIT CURRENT OF UP TO 300% 0 MANUFACTURER: 'C ('F)* 50 (122) 4-POLE, ROTATING-FIELD CURRENT FOR UP TO 10 SECONDS. AMBIENT TEMPERATURE, y 4 TYPE: EXCITER TYPE: BRUSHLESS RARE-EARTH SUSTAINED SHORT-CIRCUIT CURRENT ENABLING DOWNSTREAM CIRCUIT ENGINE JACKET WATER CAPACITY, L (GAL.) 4.5 (1.19) `�°E€€. PERMANENT MAGNET BREAKERS TO TRIP WITHOUT COLLAPSING THE ALTERNATOR FIELD. RADIATOR SYSTEM CAPACITY, INCLUDING t `:: 12, RECONNECTABLE 4, LEADS: QUANTITY, TYPE • SELF-VENTILATED AND DRIPPROOF CONSTRUCTION. ENGINE L (GAL.) 12.3 (3.2) WITH EPDXY VARNISH FOR VACUUM-IMPREGNATED ARE 110- 120/220- 240 V WINDINGSENGINE JACKET WATER FLOW, LPM (GPM) 125 (33) 120 (32) VOLTAGE REGULATOR SOLID STATE, VOLTS/HZ DEPENDABILITY AND LONG LIFE. HEAT REJECTED TO COOLING WATER • SUPERIOR VOLTAGE WAVEFORM FROM A TWO-THIRDS PITCH STATOR INSULATION: NE SAS MFG1 AT RATED KW, DRY EXHAUST, 37.8 (2207) 41.3 (2352) ;_ ,.g AND SKEWED ROTOR. MATERIAL CLA KW (BTU/MIN.) HEAT REJECTED TEMPERATURE RISE 130-C, STANDBY SPECIFICATIONS: ALTERNATOR: TO AIR CHARGE COOLER ATE 1 SEALED RATED KW, DRY EXHAUST, BEARING: QUANTITY, TYPE b FLEXIBLE DISC VOLTAGES BELOW KW (BTU/MIN.) 12 682 8.4(477) COUPLING: PEAK MOTOR STARTING KVA: (35% DIP FOR ) ( ) ., , AMORTISSEUR WINDINGS: FULL 1 gp WATER PUMP TYPE CENTRIFUGAL 480 V 4P7BX 12 LEAD VOLTAGE REGULATION, FAN DIAMETER, INCLUDING BLADES, MM (IN. 597 (23.5) NO-LOAD TO FULL-LOAD: CONTROLLER DEPENDENT 480 V 4P8X (12 LEAD) 261 ) V 4P10X 12 LEAD 275 FAN, KWM (HP) 1.8 (2.3) I, . 480 ( ) ONE-STEP LOAD ACCEPTANCE. 100% OF RATING MAX. RESTRICTION OF COOLING AIR, UNBALANCED LOAD CAPABILITY: 100% OF RATED STANDBY 240 V 4Q7BX (4 LEAD) 113 INTAKE AND DISCHARGE SIDE CURRENT 240 V 4Q8X (4 LEAD) 121 240 V 4Q10X (4 LEAD) 144 OF RADIATOR, KPA (IN. H2O) 0.125 (0.5) IZ C H I T E C T S *ENCLOSURE REDUCES AMBIENT TEMPERATURE CAPABILITY BY 5°C (9°F). 12-1 TECHNOLOGY DRIVE, SETAUKET,NY 11733 ENGINE ENGINE ELECTRICAL OPERATION REQUIREMENTS P. 631.689.8450 1 F. 631.689.8459 www.wfcaia.com ENGINE SPECIFICATIONS: 49-STATE CALIFORNIA ENGINE ELECTRICAL SYSTEM: 49-STATE CALIFORNIA AIR REQUIREMENTS: 49-STATE CALIFORNIA ENGINE SCAQMD ENGINE SCAQMD ENGINE SCAQMD DA��h/ MANUFACTURER KOHLER DIESEL BATTERY CHARGING ALTERNATOR: RADIATOR-COOLED COOLING AIR, {ta � �1gc �O ENGINE MODEL GROUND (NEGATIVE/POSITIVE) NEGATIVE M3/MIN. (SCFM) 96.3 (3400) ='I; ,�: -� KDI KDI VOLTS (DC) 12 COMBUSTION AIR, M3/MIN. (CFM) 4.8 (170) 4.0 (140) M 3404TM 3404TCR AMPERE RATING 90 HEAT REJECTED TO AMBIENT AIR: f A's ENGINE TYPE 4-CYCLE, TURBOCHARGED STARTER MOTOR RATED VOLTAGE (DC) 12 ENGINE, KW (BTU/MIN.) 13.2 (750) CYLINDER ARRANGEMENT 4 INLINE BATTERY, RECOMMENDED COLD CRANKING ALTERNATOR, KW (BTU/MIN.) 7.6 (435)RESTRICTION, 6 DISPLACEMENT, L (CU. IN.) 3.4 (207) AMPS (CCA): MAX. AIR INTAKE �4F BORE AND STROKE, MM (IN.) 96 X 116 (3.28 X 4.57) QUANTITY, CCA RATING ONE, 650 KPA (IN. HG) 5.2 (1.54) 4.2 (1.24) COMPRESSION RATIO 18.5:1 17.0:1 BATTERY VOLTAGE (DC) 12 *AIR DENSITY = 1.20 KG/M3 (0.075 LBM/FT3) CONSULTANT: PISTON SPEED, M/MIN. (FT./MIN.) 418 (1371) 510 (1673) MAIN BEARINGS: QUANTITY, TYPE 5, REPLACEABLE INSERT FUEL CONSUMPTION 49-STATE ENGINE RATED RPM 1800 MAX. POWER AT RATED RPM, KWM (BHP) 64 (86) 70 (94) FUEL DIESEL. LPH (GPH) AT % LOAD STANDBY RATING CYLINDER HEAD MATERIAL CAST IRON FUEL SYSTEM: 49-STATE CALIFORNIA 100% 17.4 (4.6) CRANKSHAFT MATERIAL CAST IRON ENGINE SCAQMD 75% 13.2 (3.5) VALVE MATERIAL: 50% 9.1 (2.4) INTAKE CHROMIUM-SILICON STEEL FUEL SUPPLY LINE, MIN. ID, MM (IN.) 8.0 (0.31) 25% 5.3 (1 .4) EXHAUST CHROMIUM STEEL FUEL RETURN LINE, MIN. ID, MM (IN.) 6.0 (0.25) GOVERNOR: TYPE, MAKE/MODEL MECH. (OR ELECTRONIC MAX. LIFT, ENGINE-DRIVEN DIESEL. LPH (GPH) AT % LOAD PRIME RATING 2'-0" ELECTRONIC *) FUEL PUMP, M (FT.) 6.0 (20.0) 3.7 (12.1) 100% 16.1 (4.2) FREQUENCY REGULATION, MAX. FUEL FLOW, LPH (GPH) 46 (12.2) 87.4 (23.1) 75% 12.1 (3.2) NO SMOKING SIGN NO-LOAD TO FULL-LOAD DROOP, 5% MAX. RETURN LINE RESTRICTION, 50% 8.3 (2.2) „ (OR ISOCHR. *) ISOCHRONOUS KPA (IN. HG) 20 (5.9) 17.7 (5.2) 25% 4.9 (1 .3) DIESEL FUEL. ' 1 FREQUENCY REGULATION, STEADY STATE 10.5% t0.28% FUEL FILTER NO. DATE SUBMISSION FREQUENCY FIXED PREFILTER 74 MICRONS FUEL CONSUMPTION CALIF. SCAQMD ENGINE CAPACITY ' o0 7/27/21 ISSUED FOR REVIEW AIR CLEANER TYPE, ALL MODELS DRY PRIMARY/WATER SEPARATOR 5 MICRONS © 5 MICRONS @ DIESEL. LPH (GPH) AT % LOAD STANDBY RATING I .A : :. "' N 1 8/3/21 REVISED PER ATTORNEY COMMENTS * REQUIRES AVAILABLE ELECTRONIC GOVERNOR OPTION 98% 95% 100% 15.2 (4.0) EFFICIENCY EFFICIENCY � \ RECOMMENDED FUEL #2 ULTRA LOW SULFUR DIESEL 75% 11.6 (3.1) 00 2294/-\LLONS50% 8.0 (2.1) '00, EXHAUST 25% 4.6 (1.2) 19 WOWING EXHAUST SYSTEM: 49-STATE CALIFORNIA DIESEL. LPH (GPH) AT % LOAD PRIME RATING \-2" HIGH MINIMUM CONTRASTING LETTERS ENGINE SCAQMD LUBRICATION 100% 12.3 (3.2) PLACE A MINUMIM OF (2) NO EXHAUST MANIFOLD TYPE DRY ENGINE SYSTEM: 49-STATE CALIFORNIA 75% 10.6 (2.8) FUEL SIGN SMOKING SIGNS NEAR THE EXHAUST FLOW AT RATED ENGINE SCAQMD 50% 6.6 (1 .7) 8.8 (310) 25% 4.1 (1.1) SIGN (GREEN BACK GROUND PERMANETLEY GENERATOR/FUEL TANK AREA KW, M3/MIN. (CFM) -APE FULL PRESSURE AFFIXED TO FUEL TANK ) EXHAUST TEMPERATURE AT RATED KW, OIL PAN CAPACITY, L (QT.) 15.3 (16.2) DRY EXHAUST, 'C ('F) 490 (914) 471 (880) OIL PAN CAPACITY WITH FILTER, L (QT.) 15.6 (16.5) MINIMUM/MAXIMUM ALLOWABLE BACK 6 (1.8)/ 8 (2.4)/ OIL FILTER: QUANTITY, TYPE 1, CARTRIDGE NO. DATE REVISION PRESSURE, KPA (IN. HG) 9 (2.7) 13.5 (4.0) OIL COOLER WATER-COOLED KEY PLAN: EXHAUST OUTLET SIZE AT KOHLER RECOMMENDS THE USE OF KOHLER GENUINE OIL AND FILTERS. AREA OF WORK ENGINE HOOKUP, MM (IN.) 63.5 (2.5) EXHAUST RAIN CAP 33.87" DOOR OPNG. NOTES: 1 . BOTH SIDES OF THE GENERATOR ARE SERVICE ACCESSIBLE WITH EASY ACCESS SERVICE PANELS. _ ca.Ann nr,wcrn rrte erAre rAa 2. 6 AMP BATTERY CHARGER. 3. 120VAC ENGINE BLOCK HEATER. - 0 0 0 ° ° ° ° E 4. GENERATOR MUST BE GROUNDED. ` 5. SOUND ATTENUATED ENCLOSURE STANDARD WITH GENERATOR. c ' KOHLER. •c ° ° _ 6. MUST ALLOW FREE FLOW OF DISCHARGE AIR EXHAUST. ° ° KOHLER. Systems Power m KOHLER. 7. MUST ALLOW FREE FLOW OF INTAKE AIR. 8. IT IS THE RESPONSIBILITY OF THE INSTALLATION TECHNICIAN TO ENSURE THAT THE GENERATOR Power Systems Power Systems x- INSTALLATION COMPLIES WITH ALL APPLICABLE CODES, STANDARDS AND REGULATIONS. A OLIIM siwno rAcum r•orrarn ALTERNATOR ACCESS 0 ° PANEL rn ° 0 AIR INTAKE KOHLER Power.com . ° ° KOHLER Power.com ° ° L0 • • c 60 � • c60 • • • _v/_ - o 0 0 \ / ° o 00 0 0 0 ° 0 0 0 0 0 0 0 ° o o ° ° ° 0 0 0 • e . ° J. • o o ' Oo 0 o Iq 0 O • o 0 10 - • y t AIR INTAKE it`. 90.6" 37.99" 86.61" i STUB-UP 40.94" 100.99" LENGTH 0 0 0 0 0 'TANK NOTES: "ORIENT POINT 2" ° 0 000 00 0 0 N 14 �B ®F E ® ❑ A. NPT EMERGENCY VENT PER NFPA 30 WITH VENT CAPS (QTY 2) GENERATOR REPLACEMENT Z ❑ O Q ° ° o Q IB. FUEL FILL WITH LOCKABLE CAP AND 2" RISER AIR DISCHARGE LLl H � W 0 ,� d o, o ELECTRICAL W ID. NORMAL VENT WITH MUSHROOM VENT CAP AND 3 RISER 40200 MAIN ROAD ° ° rn rn C? STUB-UP Q O ° ~ IE. REMOVABLE ENGINE SUPPLY DIP TUBE WITH CHECK VALVE ORIENT NY 11957 ENGINE EXHAUST V j Z AREA OPEN TO BOTTOM IF. REMOVABLE FUEL RETURN DIP TUBE / 0 ° DO H. FUEL LEVEL SENDING UNIT TITLE: ° ° o 0 0 0 0 0 0 0 0 M. BASIN DRAIN o GENERATOR INFORMATION N. FUEL IN BASIN SWITCH 14.57" t 79.76 1. FULL WEIGHT: 918LBS © 275 GAL. DATE: JULY 14, 2021 100.99" 15.16" 63.87" PROJECT NO: 21-14738 / \ DRAWN BY: MM �. REMOVABLE CHECKED BY: TM / \ END PANEL T o m SCALE: AS NOTED / \ o O DRAWING NO: 0 ar w 1 GENERA �R INFORMATION °SHEET NO: 5 OF 5 SCALE = N.T.S. -