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Town of Southold 5/13/2024 a t P.O:Box 1179 o _ 53095 Main Rd 'f.1jo1 �ao�f' Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 45174 Date: 5/13/2024 THIS CERTIFIES that the building GENERATOR Location of Property: 2900 Stanley Rd,Mattituck SCTM#: 473889 Sec/Block/Lot: 106.-8-59 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 12/26/2023 pursuant to which Building Permit No. 50261 dated 1/26/2024 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 Peleg,Maya of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 50261 04/26/2024 PLUMBERS CERTIFICATION DATED Aut onUdignatureV o�SUFFaI�,coG TOWN OF SOUTHOLD BUILDING DEPARTMENT y x TOWN CLERK'S OFFICE oy • SOUTHOLD, NY col � Sao 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#: 50261 Date: 1/26/2024 Permission is hereby granted to: Peleg, Maya 201 E 25th St Apt 8J New York, NY 10010 To: install generator as applied for. At premises located at: 2900 Stanley Rd, Mattituck SCTM #473889 Sec/Block/Lot# 106.-8-59 Pursuant to application dated 12/26/2023 and approved by the Building Inspector. To expire on 7/27/2025. Fees: ACCESSORY $125.00 ELECTRIC $100.00 CERTIFICATE OF OCCUPANCY $100.00 Total: $325.00 Building Inspector OF SO!/Tyol � o Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 G Q Southold,NY 11971-0959 sean.devlinCa�town.southold.ny.us COMM BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Maya Peleg Address: 2900 Stanley Rd city:Mattituck st: NY zip: 11952 Building Permit* 50261 Section: 106 Block: $ Lot: 59 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: Electrician: GenReady Inc License No: 2740ME SITE DETAILS Office Use Only Residential X Indoor X Basement X Service Commerical Outdoor X 1st Floor X Pool New X Renovation 2nd Floor Hot Tub Addition Survey X Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO Transfer Switch 200A UC Lights Dryer Recpt Emergency Strobe Heat Detectors Disconnect Switches 4'LED Exit Fixtures Sump Pump Other Equipment: 22kW Generac Generator w/200A Whole House Transferswitch, Sticker on Meter . Notes: Generator Inspector Signature: Date: April 26, 2024 S.Devlin-Cert Electrical Compliance Form 0f S00TyO� L C'j+ 'L' j •� G &0 # # / OF li✓ 0" `J y , TdWN.OF SOUTHOLD BUILDING DEPT. cout, 631-765-1802 INSPECTION [ '] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING/STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) 17T ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS:- /' , DATE11-16o 1111SPECTOR OE SOUT,yo� # # TOWN OF SOUTHOLD BUILDING DEPT. cou 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I SULATION/CAULKING [ ] FRAMING /STRAPPING [ FINAL J [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: t �� GI tS S .D. .dc DATE INSPECTOR ✓ .;. r A Mr. Faucet Service Co, - ,��,' !`3 DBA Install Gas 201 Northwest Drive, Ste 8 Farmingdale, NY 11735 `,. ��, pQR , 9 Zak 516-752-1000 5a w April 3, 2024 Town of Southold Town Hall 53095 Route 25. PO Box 1179. Southold,NY 11971 Re: Maya Peieg 2900 Stanley Road Mattituck, NY 11952 Permit#50261 Gas line to Generator Mr. Faucet Service Co. DBA Installgas, pressure tested the gas lines at the above referenced address. The test was held at 4.0 PSI for 30 Minutes. If you need any further information, please do not hesitate to contact me at 516 752-1000. e and Aaron L ensed Plumber License: TTP09TOB Sworn before me on this 3 day ot/04 L , 2024 LE RO NOTARY PUBOF NEW YORK RegistratiAL6091248 Qualified COUNTY Commission IL 28 2027 Mr. Faucet Service Co. Inc. InstallGas.com 201 Northwest Dr, STE 1 Farmingdale, NY 11735 Maya Peleg 2900 Stanley Road M attitu ck, NY 11952 Plumbing Line: 20 ft 2 - existing 420# LP tanks LP TANKS GENERATOR 1 " poly 18" deep w/tape and wire FIELD INSPECTION REPORT DATE COMMENTS r FOUNDATION (1ST) ------------------------------------ � C FOUNDATION (2ND) co� z �o o � 7Ho ROUGH FRAMING& PLUMBING Do CA INSULATION PER N.Y. y STATE ENERGY CODE FINAL ADDITIONAL COIVMENTS 0 5 LA r 1 - a. � rn v z x r� x d b H S��fFQc® TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone(631) 765-1802 Fax(631) 765-9502 https://www.southoldtowmy.gov Date Received APPLICATION FOR BUILDING PERMIT E PU E � V E For Office Use Only DEC 2 6 2023 PERMIT NO. Building Inspector: Building DaMr rant Applications and forms must be filled out in their entirety.,Incomplete: ' ', ' Town of Southold applications will not be accepted. Where the Applicant is riot.the owner,an Owner's Authorization form(Page`2)shall be completed.. Date: OWNERS)OF PROPERTY: Name:Maya.Peleg_,_ _..__ scTM#1000-106 - 8 - 59 Project Address:2900 Stanley Road, Mattituck, NY 11952 Phone#:917-703-5802 Email:maya.peleg@gmail.com Mailing Add ress:201 E. 25th Street,,uapt 8J, New_York, NY 10010 CONTACT PERSON: . . Name:Ed Reiff/ Gen Ready „ Mailing Address: 128 Pulaski Road,Kings Park,, NY 1,1754 Phone#:631-544-0400 Email:ofce@getgenready.com, DESIGN PROFESSIONAL INFORMATION: Name:N/A Mailing Address:N/A Phone#:N/A Email:N/A CONTRACTOR INFORMATION: . Name:Ed Reiff/ Gen Ready, Mailing Address: 128 Pulaski Road,•,Kings Park,_NY 11754 Phone#: 6311-544-0400 Emaii:office@g!ptg_e!lre'ady.com DESCRIPTION OF'PROPOSED.CONSTRLICTION .- ❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: lil0ther Install a 22kw liquid propane generator. , P, tQ1 Af $12,850.00 Will the lot be re-graded? ❑Yes ®No Will ex ess fill be removed from premises? ❑Yes ®No 1 'PROPERTY.INFORMATION _ Existing use of propertyµReSidence Intended use of property:Residence Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? Dyes ®No IF YES, PROVIDE A COPY. B_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,constructioh 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)4or necessary inspections.False statements made herein are . punishable as a Class A misdemeanor pursuant to Section 210.4s of.the New York State Penal Law." Application Submitted By(prin a •Ed Reiff / Gen Ready BAuthorized Agent ❑Owner Signature-of Applicant:- Dace: STATE OF NEW YORK) SS: COUNTY OF Ed Reiff / Gen Ready being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the: Contractor/Agent (Contractor,Agent,Corporate Officer,etc.) of said owner or owners,and is_d6ry autlio_r ied to perform or have performed the said work and to make and file this application;that all statements contained in this application are true to the best of his/her knowledge and belief;and that the work will be performed in the manner set forth in the application file therewith. Sworn before me this day of of ,20 en Notary eublic PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) Maya Peleg residing at 2900 Stanley Road Mattituck, NY 11952 do hereby authorize Ed Reiff / Gen Ready to apply on my behalf to the Town of Southold Building Department for approval as described herein. � . � 12-1 L7_0 Ownek sig' natkre Date EDWARD,R. CHALFIN Maya Peleg Notary Public„State of New York No:' ll-4971117 Print Owner's Name Qualified]16 Bronx County Certificate Filed in New York County 2 Commission Expires August 27, oZ- ®SUFFO� C BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD o = Town Hall Annex - 54375 Main Road - PO Box 1179 o Southold, New York 11971-0959 a0� Telephone (631) 765-1802 - FAX (631) 765-9502 V rogerrcDsoutholdtownny.gov — seandCD-southoldtownny.aov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: Company Name: GenReady Inc. Electrician's Name: Ed Reiff License No.: ME-2740 Elec. email: office@getgenready.com Elec. Phone No: 631-544-0400 ❑1 request an email copy of Certificate of Compliance Elec. Address.: 128 Pulaski Road, Kings Park, NY 11754 JOB SITE INFORMATION (All Information Required) Name: Maya Peleg Address: 2900 Stanley Road, Mattituck, NY 11952 Cross Street: Sunset Drive Phone No.: 917-703-5802 Bldg.Permit#: 6"/vvlP email: maya.peleg@gmail.com Tax Map District: 1000 Section: 106 Block` 8 Lot: 59 BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Install a 22kw liquid propane generator. Square Footage: Circle All That Apply: Is job ready for inspection?: ❑ YES 0 NO ❑Rough In ❑ Final Do you need a Temp Certificate?: ❑ YES 0 NO Issued On Temp Information: (All information required) Service SizeFltRC3 Ph Size: A # Meters Old Meter# ❑New Service❑Fire Reconnec lood Reconnect❑Service Reconnect❑Underground❑Overhead # Underground Laterals 1 2 H Fr a Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION ifFQe,C BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD Town Hall Annex - 54375 Main Road - PO Box 1179 w ^ Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 rogerr@southoldtownny.gov — seand(@-southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: Company Name: GenReady Inc. Electrician's Name: Ed Reiff License No.: ME-2740 Elec. email: office@getgenready.com Elec. Phone No: 631-544-0400 ❑I request an email copy of Certificate of Compliance Elec. Address.: 128 Pulaski Road, Kings Park, NY 11754 JOB SITE INFORMATION (All Information Required) Name: Maya Peleg Address: 2900 Stanley Road, Mattituck, NY 11952 Cross Street: Sunset Drive Phone No.: 917-703-5802 Bldg.Permit#: -j 0Z-/6 email: maya.peleg@gmail.com Tax Map District: 1000 Section: 106 Block: 8 Lot: 59 BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Install a 22kw liquid propane generator. Square Footage: Circle All That Apply: Is job ready for inspection?: ❑ YES NO Rough In ❑ Final Do you need a Temp Certificate?: ❑ YES NO Issued On Temp Information: (All information required) Service Size❑'-P-h❑3 Ph Size: A # Meters Old Meter# ❑New Service❑Fire Reconnec lood Reconnect❑Service Reconnect❑Underground❑Overhead # Underground Laterals 1 2 H Fr e Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION PERMIT# Address: Switches Outlets GFI's Surface Sconces H Hs UC Lts Fridge HW POOL Fans Mini Fr. W/D Panel Pump Exhaust Oven Sump Heater Trnsfmr Smokes DW Generator Salt Gen. Carbon Micro GrbDis Water Bond Lights Heat Pucks ERV HOT TUB/SPA Inst Hot DeHum Transfer Disc Combo Cooktop Minisplit Blower AC AH Hood Blower Service Amps Have Used Sub Amps ,ave Used Comments ��" " C� Ol. SURVEY OF:PROPERTY r 1 .L-9r =ae ONTEIE,- I SUBDIWWWf b f)p •THE FMLDS AT MATnTum LOT 5 ` FILED MARCF1,3 1-2006 115 MAPN0.11370 •:�" N� `°" � .•nzrov �.c ��"`J MA strtrn7EAT fir-- `�•. ; -_:-, D° ��`�59•' +ps' _ 1 .�..0 �,'± r.; ���•� ` • .o�. �Nr, TTIT(ICK TOWNOF.SOUTHOT.D SUFFOEX COUNTY;49W YQRK �,•. N r, - ci ••.••• �57.fP' 'AREA OF PARCEL = 38.395t SO.iT. OR 0.881 t ACRE Vl peaL � ..:�;�,• R�`-- c¢% � N �. 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"1 Contact Info: MR FAUCET SERVICE COMPANY INC DBA GERARD J AARON 201 NORTHWEST DRIVE,SUITE L FARMINGDALE, NY 11725 Work Description: Suffolk County Dept.of Labor,Licensing&Consumer Affairs WASTER PLUMBING Name ail�Illlllh- GERARDJAARON Business Name This certifies that the bearef is duly li=ersee tM Faucet Sew.=e Conaaany Inc DBA by lie County of suffo4: License Number:IvIP-32128 Rosalie Drago Issued: 1010812002 Comnissioner Expires: 10/0112024 3 , a i DATE .4►4►�ORV CERTIFICATE OF LIABILITY INSURANCE 031281200223 n 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(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CON NAME• Kat Mistretta National Insurance Brokerage of New York,Inc. PAHIMo. I. (831)273-4242 No): (831)273-8990 175 Oval Drive kmistrettEt@nibony.com ADDRESS: INSURERS)AFFORDING COVERAGE NAIC N Islandia NY 11749 INSURER A:.Merchants Mutual Insurance Cc 23329 INSURED INSURER B: Mr.Faucet Service Company Inc INSURER C: dba Installgas.com&Paul E.Muhs INSURER D: 201 Northwest Drive,Ste 8 INSURER E: Farmingdale NY 117354920 1INSURERF: COVERAGES CERTIFICATE NUMBER: 23-24 MASTER 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 OFANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TOALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE INSDWVOPOLICYNUMBER MMIDDWYYY) (MMfDDfYYYY1 LIMITS COMMERCIAL GENERAL LIABIUTY EACH OCCURRENCE S 1.000,000 CLAIMS-MADE ®OCCUR PREMISES Ea 9 Mane $ 500,000 Contractual Liability MED EXP(Any one person) S 15.000 A BOP1048048 05/01/2023 05/01/2024 PERSONAL aADVINjuRY g 1,000,000 GEN'LAGGREGATE UMITAPPUES PER: GENERALAGGREGATE S 2,000,000 POLICY ®JEcr ❑LOC 2,000.000 PRODUCTS-COMPIOPAGG S OTHER: $ AUTOMOBILE LIABILITY Ee U IT S •ANYAUTD BODILY INJURY(Per person) S OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) S HIRED NON-OWNED FROPERW DAMAGE $ AUTOS ONLY AUTOS ONLY Per aeddeM S UMERELLA LIAB OCCUR EACH OCCURRENCE S EXCESS UAB CLAIMSAIADE AGGREGATE $ DED I I RETENTION S S WORKERS COMPENSATION R T - AND EMPLOYERS'UABIUTY' STATUTE ER ANY PROPRIETORIPARTNERIEXECUTIVE YIN N OFFICER(MEMBEREXCLUDED9 NIA E.LEACHACGDENT S (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S 11 yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE.POLICY LIMB IS DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,AddMonal Remarks Schedule,may be cNached If more space is required) The Certificate Holder is included as additional insured A.T.I.M.Awith respect to General Liability as required by written contract/written agreement per the policy terms,conditions and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Southold ACCORDANCE WITH THE POLICY PROVISIONS. 53096 Route 25 PO Box 1178 AUTHORIZED REPRESENTATIVE Southold. NY 11971 l ®1988-2015 ACORD CORPORATION. All rights reserved. ACORD 26(2016103) The ACORD name and logo are registered marks of ACORD NYSIFPO Box 66699,Albany,W 12206 New York State Insurance Fund nysifcom CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ^A A A A 112851548 p KEEVILY,SPERO-WHITELAW INC. 500 MAMARONECK AVENUE HARRISON NY 10528 O- SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER MR.FAUCET SERVICE CO.,INC. TOWN OF SOUTHOLD DBA INSTALLGAS.COM 53095 ROUTE 25 201 NORTHWEST DRIVE,SUITE#1 PO BOX 1179 FARMINGDALE NY 11735 SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE G 1149 21 103008 05/01/2023 TO 05/01/2024 03/28/2023 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1149 296-4, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS'COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK,EXCEPT AS INDICATED BELOW. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY, INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE, VISIT OUR WESSITE AT HTTPS-INVWW.NYSIF.COMICERTI CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THE POLICY INCLUDES A WAIVER OF SUBROGATION ENDORSEMENT UNDER WHICH NYSIF AGREES TO WAIVE ITS RIGHT OF SUBROGATION TO BRING AN ACTION,AGAINST THE CERTIFICATE HOLDER TO RECOVER AMOUNTS WE PAID IN WORKERS'COMPENSATION AND/OR MEDICAL BENEFITS TO OR ON BEHALF OF AN EMPLOYEE OF OUR INSURED IN THE EVENT THAT, PRIOR TO THE DATE OF THE ACCIDENT. THE CERTIFICATE HOLDER HAS ENTERED INTO A WRITTEN CONTRACT WITH OUR INSURED THAT REQUIRES THAT SUCH RIGHT OF SUBROGATION BE WAIVED. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUND DIRECTOR,I SURANCE FUND UNDERWRITING VALIDATION NUMBER: 592896695 IS1110000000000011 8098361®111 Fenn WC.CEtT-NOPRW Version 3(Can9R019)[WC Policy414929641 U-263 111 t00000000000113�H381f0001.Oeo01149M67II��GUt610He1(CaLfdoP{BtT_IU01-000011 rSTAT Workers' CERTIFICATE OF INSURANCE COVERAGE srnirE Compensation Board NYS DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW PART 1.To be completed by NYS disability and Paid Family leave benefits carrier or licensed insurance agent of that came 1a.Legal Name 8 Address of insured(use street address only) 1 b.Business Telephone Number of Insured MR.FAUCET SERVICE COMPANY INC DBA INSTALLGAS.COM 516-752-1234 201 NORTHWEST DRIVE SUITE a FARMINGDALE,NY 11735 1c.Federal Employer Identification Number of Insured Work Location of Insured(only►equlred Ncoverage/sspedHcailyilmited to or Social Security Number certain iocations In New Yore state.I a,Wisp-Up Policy) 1128515Q 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) ShelterPoInt Ufa Insurance Company Town of Southold 53095 Route 25 3b.Policy Number of Entity Listed In Box"1a' PO Box 1179 DBL338240 Southold,NY 11971 3c.Policy effective period 04/30/2022 to 04/29/2024 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 carder referenced above and that the named Insured has NYS Disability and/or Paid Family Leave Benefits Insurance coverage as described above. Date Signed 3/28/2023 By WX,At (stgnature of Insurance carrier's authorized representative or Fry 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 SA 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 48,4C or 58 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 4B,4C or 513 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 disabUlly and paid family leave benefits Insurance po/ldes and NYS licensed Insurance agents of those Insurance carriers are authorized to Issue Form DB-120.1.Insurance brokers are NOT authadzed to Issue this fomr. DB-120.1 (72-21) �IDII�IUII�Id2I0QI1IIIlII112111121u;II�II� Additional Instructions for Form D13-12O.1 By signing this form,the insurance carrier identified in Box 3 on this form is certifying that it is insuring the business referenced in Box I for disability and/or Paid Family Leave benefits under the NYS Disability and Paid Family Leave Benefits Law.The Insurance carrier or its licensed agent will send this Certificate of Insurance Coverage(Certificate)to the entity listed as the certificate holder in Box 2. The Insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is cancelled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the Insured from coverage indicated on this Certificate.(These notices may be sent by regular mail.)Otherwise,this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent,or until the policy expiration date listed in Box 3c,whichever is earlier. This Certificate is issued as a matter of information only and confers no rights upon the certificate holder.This Certificate does not amend,extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This Certificate may be used as evidence of a NYS disability and/or Paid Family Leave benefits contract of insurance only while the underlying policy is in effect. Please Note:Upon the cancellation of the disability and/or Paid Family Leave benefits policy indicated on this form,if the business continues to be named on a permit,license or contract Issued by a certificate holder,the business must provide that certificate holder with a new Certificate of insurance Coverage for NYS disability and/ or Paid Family Leave Benefits or other authorized proof that the business Is complying with the mandatory coverage requirements of the NYS Disability and Paid Family Leave Benefits Law. NYS DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW §220. Subd. 8 (a), The head of a state or municipal department, board,commission or office authorized or required by law to issue any permit for or iri connection with any work involving the employment of employees in employment as defined in this article, and not withstanding any general,or special statute requiring or authorizing the issue of such permits,shall not Issue such permit unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair,that the payment of disability benefits and after January first,two thousand and twenty-one,the payment of family leave benefits for all employees has been secured as provided by this article.Nothing herein,however,shall be construed as creating any liability on the part of such state or municipal department,board,commission or office to pay any disability benefits to any such employee if so employed. (b)The head of a slate or municipal department,board,commission or office authorized or required by law to enter into any contract for or in connection with any work involving the employment of employees in employment as defined in this article and notwithstanding any general or special statute requiring or authorizing any such contract.shall not enter into any such contract unless proof duly subscribed by an insurance'carrier is produced in a form satisfactory to the chair,that the payment of disability benefits and after January first,two thousand eighteen,the payment of family leave benefits for all employees has been secured as provided by this article. DO-120.1 (12.21)Reverse AC R® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 05/03/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY.AND CONFERS.NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE,AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT .CONSTITUTE A ,CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the•policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER CONTACT NAME FARM FAMILY CASUALTY PHONE Ext: No 859 CONNETQUOT AVENUE ADDRESS: ISLIP TERRACE,NY 11752 INSURER(S)AFFORDING COVERAGE NAIC# 831-277-7770 INSURER A: FARM FAMILY CASUALTY INS.CO. 13803 INSURED INSURER B: STATE INSURANCE FUND 36102 GENREADY, INC. INSURERC: SHELTER POINT 81434 128 PULASKI ROAD INSURER D: KINGS PARK NY 11754 INSURER E: INSURER R COVERAGES CERTIFICATE NUMBER: 125539 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.,NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL,THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ' ILTR TYPE OF INSURANCE ADDL UBR POLICY EFF POLICY EXP INSD WVD POLICY NUMBER MM/DD/YYYY) (MMIODNYM LIMITS A X COMMERCIALGENERALLIABILITY 3152X1390 05/07/2023 05/07/2024 EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE FK OCCUR PREMISES(Ea occurrence) $ 100,000 MED EXP(Anyone person) $ 5,000 PERSONAL&ADV INJURY . $ 2000000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE. $ 4,000,000 X POLICY PR LOG PRODUCTS-COMP/OP AGG $ 4,000,000 OTHER: $ A AUTOMOBILE LIABILITY 3152C4335 05/07/2023 05/07/2024 (Ea accident)SINGLEBINED LIMIT $ 1,000,000 IxANY AUTO BODILY INJURY(Per person) $ AUT OWNED X SCHEDULED BODILY INJURY(Per accident) $ HIREDAUTOS N -O NONWNED PROPERTY DAMAGE AUTOS (Per accident) $ A X UMBRELLA LIAB X OCCUR 3101 E1933 06/03/2023 06/03/2024 EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED I X I RETENTION$$10,000 $ B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN CERTIFICATE E E ANY PROPRIETOR/PARTNER/EXECUTIVE❑ N/A ATTACHED E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (MandatoiInNH) 1046681-1 E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C LYSDBL DBL 265291 01/01/07 INDEFINITE STATUTORY T, DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY-OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN OF SOUTHOLD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 54375 MAIN ROAD ACCORDANCE WITH THE POLICY PROVISIONS. SOUTHOLD, NY 11,971 AUTHORIZED REPRESENTATNE ©1988-2014 ACORD CORPORATION.-All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD voRK workers' CERTIFICATE OF INSURANCE COVERAGE STATE Compensation Board NYS DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW PART 1.To be completedby NYS disability and Paid Family Leave benefits carrier or licensed insurance agent of that carrie 1a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured GENREADY,INC. 631-544-0400 128 PULASKI ROAD KINGS PARK,NY 11754 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) 112763133 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) ShelterPoint Life Insurance Company TOWN-OF SOUTHOLD 54375 MAIN ROAD 3b.Policy Number of Entity Listed in Box"1a" SOUTHOLD, NY 11971 DBL265291 3c.Policy effective period 01/01/2022 to 12/31/2023 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 12/29/2022 By WA hf (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 4113,4c or 513 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_720.1 (12-21) �I011'iiiiiu1�2i0oi1iiiiii1i2iui21)ii�l� 1 Additional Instructions for Form D13-120.1 By signing this form, the insurance carrier identified in Box 3 on this form is certifying that it is insuring the business referenced in Box 1a for disability and/or Paid Family Leave benefits under the NYS Disability and Paid Family Leave Benefits Law.The insurance carrier or its licensed agent will send this Certificate of Insurance Coverage(Certificate)to the entity listed as the certificate holder in Box 2. The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is cancelled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from coverage indicated on this Certificate. (These notices may be sent by regular mail.)Otherwise, this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent, or until the policy expiration date listed in Box 3c,whichever is earlier. This Certificate is issued as a matter of information only and confers no rights upon the certificate holder.This Certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This Certificate may be used as evidence of a NYS disability and/or Paid Family Leave benefits contract of insurance only while the underlying policy is in effect. Please Note: Upon the cancellation of the disability and/or Paid Family Leave benefits policy indicated on this form, if the business continues to be named on a permit, license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Insurance Coverage for NYS disability and/ or Paid Family Leave Benefits or other authorized proof that the business is complying with the mandatory coverage requirements of the NYS Disability and Paid Family Leave Benefits Law. NYS DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW §220. Subd. 8 (a) The head of a state or municipal department, board, commission or office authorized or required by law to issue any permit for or in connection with any work involving the employment of employees in employment as defined in this article, and not withstanding any general or special statute requiring or authorizing the issue of such permits,shall not issue such permit unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair,that the payment of disability benefits and after January first,two thousand and twenty-one,the payment of family leave benefits for all employees has been secured as provided by this article. Nothing herein, however, shall be construed as creating any liability on the part of such state or municipal department, board, commission or office to pay any disability benefits to any such employee if so employed. (b)The head of a state or municipal department, board, commission or office authorized or required by law to enter into any contract for or in connection with any work involving the employment of employees in employment as defined in this article and notwithstanding any general or special statute requiring or authorizing any such contract,shall not enter into any such contract unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair,that the payment of disability benefits and after January first, two thousand eighteen,the payment of family leave benefits for all employees has been secured as provided by this article. DB-120.1 (12-21)Reverse N Y S I F PO Box 66699,Albany,NY 12206 New York State Insurance Fund nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE A A A A A A 112763133 l Q VINCENT C DALEY 859 CONNETQUOT AVE ISLIP TERRACE NY 11752 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER Ll Ni GENREADY INC TOWN OF SOUTHOLD 128 PULASKI ROAD 54375 MAIN ROAD KING PARK NY 11754 SOUTHHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE 11046 BE 280221 05/20/2023 TO 05/20/2024 05/03/2023 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1046 681-1, COVERING THE ENTIRE OBLIGATION.OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW,AND,WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK,TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY, INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE, VISIT OUR WEBSITE AT HTTPS://WWW.NYSIF.COM/CERT/ CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. , PRESIDENT EDWARD S REIFF VICE PRESIDENT ANDREW J REIFF OF GEN READY INC-A TWO-PERSON CORP. _ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. 1 NEW YORK STATE INSURANCE FUND 4' DIRECTOR,I SURANCE FUND UNDERWRITING VALIDATION NUMBER: 511098554 III11 00 000 000®Ell 51R205®811111 Form WC-CERT-NOPRINf Version 3(08/29/2019)[WC Policy-10466811] U-26.3 6 [00000000000115120528][0001-000010466811][##I][I6130-16][CerLNoP{ERR 1][01-00001] Suffolk County De . ofiabar, Licensing & Consumer Affairs °r FASTER ELECTRIC AL LICENSE Name EDVVARD S REIFF T? S�Cerrtrfies that'the Business Name nearer is liven. eo Dy the CountIy,y of Suffolk. GEIVREADY; INC. Rosalie Dra License ,Number: �v ME-274 0 Gamrrf..sMioner Issued; 05/01/19g0 Expires: 05/01.12024 4APPROD AS NOTED DAB.F?# FEBY:NODEPARTMENT AT 631 765-1802 8AM TO 4PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION-TWO REQUIRED FOR POURED CONCRF7' 2. ROUGH—FRAMING&PL:..c,`, a 3. INSULATION 4. FINAL-CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTON ERRORS COMPLY WITH ALL CODES OF NEW YORK STATE&TOWN CODES AS REQUIRED AND CONDITIONS OF SOUTHOLD TOWN Z SOUTHOLD TOW CANNING BOARD SOUTHOLD TO TRUSTEES N,Y.S,DEC SOUTH HPC SCHD OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICA- OFOCCUPANCY ELECTRICAL INSPECTION REQUIRED GENERAC� r , 20 22 24 kW GUARDIAN® SERIES _ Residential Standby Generators I I Air-Cooled Gas Engine r , INCLUDES: Standby Power Rating G007038-1,G007039-1,G007038-3,G007039-3(Aluminum-Bisque)-20 kW 60 Hz r • True Power'Electrical Technology G007042-2,G007043-2,G007042-3,G007043-3(Aluminum-Bisque)-22 kW 60 Hz I G007209-0,G007210-0(Aluminum-Bisque)-24 kW 60 Hz • Two-line multilingual digital LCD Evolution'" controller (Eng lish/Spani sh/French/PoOuguese) • 200 amp service rated transfer switch available • Electronic governor w A • Standard Wi-Fig connectivity • System status&maintenance interval LED indicators • Sound attenuated enclosure } , • Flexible fuel line connectort • Natural gas or LP gas operation GENERAC • 5 Year limited warranty I • Listed and labeled by the Southwest Research Institute allowing '' \ installation as close as 18 in(457 mm)to a structure.` ' 'Must be located away from doors,windows,and fresh air intakes and in accordance with local codes. T1 Us h/losllassets.svyd.org//ibraiylDirectofyOfListedProductsl I V or C(S)us U� US Q I _ I CoWndc6on1ndus,'P/1973_DoC_204 13204-01-07_Rev9.pot ` `� LISTED �XIJ u j Note:CETL or CUL certification only applies to unbundled units and units packaged I with limited circuit switches.Units packaged with the Smart Switch are ETL or UL certified in the USA only. t i I FEATURES O INNOVATIVE ENGINE DESIGN&RIGOROUS TESTING are at the heart of Gen- O SOLID-STATE, FREQUENCY COMPENSATED VOLTAGE REGULATION: This erac's success In providing the most reliable generators possible. Generac's G- state-of-the-art power maximizing regulation system is standard on all Generac mod- Force engine lineup offers added peace of mind and reliability for when it's needed els.It provides optimized FAST RESPONSE to changing load conditions and MAXI- the most.The G-Force series engines are purpose built and designed to handle the MUM MOTOR STARTING CAPABILITY by electronically torque-matching the surge rigors of extended run times in high temperatures and extreme operating conditions. loads to the engine.Digital voltage regulation at 2:1%. O TRUE POWER'"ELECTRICAL TECHNOLOGY:Superior harmonics and sine wave O SINGLE SOURCE SERVICE RESPONSE from Generac's extensive dealer network form produce less than 5%Total Harmonic Distortion for utility quality power.This provides parts and service know-how for the entire unit,from the engine to the small- allows confident operation of sensitive electronic equipment and micro-chip based est electronic component. appliances,such as variable speed HVAC systems. O TEST CRITERIA: O GENERAC TRANSFER SWITCHES:Long life and reliability are synonymous with ✓ PROTOTYPE TESTED ✓ NEMA MG1-22 EVALUATION GENERAC POWER SYSTEMS.One reason for this confidence is that the GENERAC f ✓ SYSTEM TORSIONAL TESTED ✓ MOTOR STARTING ABILITY product line is offered with its own transfer systems and controls for total system ( compatibility. O MOBILE LINKO CONNECTIVITY:FREE with select Guardian Series Home standby O PWRVIEW'" TRANSFER SWITCH: The Generac PWRview Automatic Transfer 4 generators,Mobile Link Wi-Fi allows users to monitor generator status from any- Switch integrates the PWRview energy monitor to provide real-time energy con- where in the world using a smanphone,tablet,or PC.Easily access information such sumption data that can help lower a home's electricity bill. Using a convenient as the current operating status and maintenance alerts. Users can connect an mobile app,homeowners can access energy usage and alert information while under account to an authorized service dealer for fast,friendly,and proactive service.With utility power or generator power,The PWRview energy monitor is a simple to use and Mobile Link,users are taken care of before the next power outage. low cost tool which helps save money over the life of the generator.Included with model G007210-0. w GEN,�E�RAC' ��PROMISE @@(07 PW R GENERAC' 20/22/24 kIN Features and Benefits _ Engine • Generac G-Force design Maximizes engine"breathing"for increased fuel efficiency.Plateau honed cylinder walls and plasma moly rings help the engine run cooler,reducing oil consumption and resulting in.longer engine life. • "Spiny-lok"cast iron cylinder walls Rigid construction and added durability provide long engine life. • Electronic ignition/spark advance These features-combine to assure smooth,quick starting every time. 41� Full pressure lubrication system Pressurized lubrication to all vital bearings means better performance,less maintenance;and longer engine life.Now featuring up to a 2 year/200 hour oil change interval. • Low oil pressure shutdown system Shutdown protection prevents catastrophic engine damage due to low oil. • high temperature shutdown Prevents damage due to overheating. Generator • Revolving field Allows for a smaller,light weight unit that operates 25%more efficiently than a revolving armature generator. . • Skewed stator Produces a smooth output waveform for compatibility with electronic equipment. • pisplaced phase excitation Maximizes motor starting capability. • Automatic voltage regulation Regulating output voltage to±1%prevents damaging voltage spikes. • UL 2200 listed For your safety. Transfer Switch (if applicable) • Fully automatic Transfers vital electrical loads to the energized source of power. • NEMA 3R Can be installed inside or outside for maximum flexibility. • Integrated load management technology Capability to manage additional loads for efficient power management. • Remote mounting Mounts near an existing distribution panel for simple,low-cost installation. PWRview Transfer Switch(if applicable) • PWFMew energy monitor Energy usage at-a-glance. 4P Ability to view real-time energy consumption data Better understand the home's energy profile. • PWRview mobile app Access daily energy intelligence and insights. Evolution—Controls • AUTO/fAANUAUOFF illuminated buttons Selects the operating mode and provides easy,at-a-glance status indication in any condition. •, Two-line multilingual LCD Provides homeowners easily visible logs of history,maintenance,and events up to 50 occurrences. • Sealed,raised button's Smooth,weather-resistant user interface for programming and operations. • Utility voltage sensing Constantly monitors utility voltage,setpoints 65%dropout,80%pick-up,of standard voltage. • Generator voltage sensing Constantly monitors generator voltage to verify the cleanest power delivered to the home.. • Utility interrupt delay Prevents nuisance start-ups of the engine,adjustable 2-1500 seconds from the factory default setting of 5 seconds by a qualified dealer. • Engine warm-up Verifies engine is ready to assume the load,setpoint approximately 5 seconds. • Engine cool-down Allows engine to cool prior to shutdown,setpoint approximately 1 minute. • Programmable exercise Operates engine to prevent oil seal drying and damage between power outages by running',the generator for 5 minutes every other week.Also offers a selectable setting for weekly or monthly operation providing flexibility and potentially lower fuel costs to the owner. • Smart battery charger Delivers charge to the battery only when needed at varying rates depending on outdoor air temperature. Compatible with lead acid and AGM-style batteries. • Main line circuit,breaker Protects generator from overload. 0 Electronic governor Maintains constant 60 Hz frequency. GENER•AC@ 20/22/24 kW Features and Benefits !' Unit ! SAE.weather protective enclosure 'Sound attenuated enclosures ensure quiet,operation and protection against mother nature,withstanding winds up to 150 mph(241 km/h).Hinged'key I,ocking raof•panel for security:Lift-out front,for easy access to all routine.maintenance Items.Electrostatically applied textured epoxy paint for added durability. • Enclosed critical grade muffler Quiet,critical grade muffler is mounted inside the-unit to prevent injuries. • Small,compact,attractive Makes for an easy,eye appealing installation,as close as 18 in(457 mm)away from a structure. Installation System • 14 in(35.6 cm)flexible fuel line connector Listed.ANSI Z21.75/CSA 6.27 outdoor appliance connector for the required connection to the gas supply piping. • Integral sediment trap Meets IFGC and NFPA 54 installation requirements, Connectivity(Wi-Fi equipped models only) • Ability to view generator status Monitor,generator with a smartphone,tablet,or computer at any time via the Mobile Link application for complete peace of mind. • Ability to view generator Exercise/Run and Total Hours Review the generator's complete protection profile for exercise hours and total hours. f • Ability to view generator maintenance information Provides maintenance information for the specific model generator when scheduled maintenance is due. f • Monthly report with previous month's activity Retailed monthly reports provide historical generator information. f • Ability to view generator battery information Built in battery diagnostics displaying current state of the battery. • Weather information Provides detailed local ambient weather conditions.for generator location. IF i• GENERAC6 20/22/24 kW Specifications Generator Model G007038-1 G007042-2 G007038-3 G007042-3 G007209-0 G007039-1 G007043-2 G007039-3 G007043-3 6007210-0 (20 kW) (22 M (20 MY) (22 kW) (24 km 'Rated maximum continuous power capacity(LP) N,006 Watts' 22,000 Wafts*' 20,000 Watts' 22,000 Watts' 24,000 Watts' Rated nemmum continuous power capacity(NG) 18,OOD Watts' 19,500 Watts' 18,000 Walls" 19,500 Watts' 21,00]Watts' Rated voltage 240 — Rzted maximum continuous load current-240 volts(LP/NG) 83.3/75.0 91.7/81.3 83.3/75.0 91.7/81.3 100/87.5 ' ' Taal Farmatic D star on Less than 56. Again line arcrrt breaker 96 amp 100 amp 90 amp 160 amp 100 amp Prue 1 tsnaet of roux PC!es 2 alzdACf;zquzrxy_ .-- - � z PO _racts - -- - - - -- - - - -- .. - - 1.0 -'. - --- - -- - Ba?zy rznrzmzni(ram inc;ixled) 12 54_Volts,Group 26R 0_CCA minimum or-Group 35AGM 650 CCA rrdrdrtwm Urea w ig t(Ib/ka) - 448/203 466/211_ 436!4 445/202 455/206 Dsr'k'dons(LxWxH)in/art 48x_25x29/121.9x63.5x73.7 Sau„d output in dB(A)of 231f(7 m)with generator operating at normal load" 67 67 67 67 67 Souna outprit in dB(A)at 23 f[(7 in)with generator in Odet-Test'"law-speed exercise'mode`" 55 57 55 57 57 Exercise duration T 5 min Engine frgir4 Type GENERAL G=Force.1000 Series tb it of cylinders __. _ 9c Disp'.acamzrd 999 cc L}iQer block - _ Aluminumw/cast iron sleeve Va:earrang=_men: ? Overheadvalve Ig an system - Solid-state w/magneto Gorrerm sys'am Electronic Compress on ratio _ 9.5:1 Starter 12 VDC Ql ca'piay including filter Appiox.1.9 ql/1.81- e» �rp� 3,600 Ftis.cctiva.srvxidn Nz't.4zl as ft3(rw(VAr) 204(5.78 228(6.46) 164(4.64) 203(5.75) 112 Load Full Lad 301(8.52) 327(9.26) 267(8.13) 306(8.66) L ,d Rica trails(gaV1/2 Load 87(2.37)[8.99] 92(2.53)[9,57] 86(2.36)[8.95] 92(2.53)[9.57] Full Lad 130(3,56)[13.4B] 142,(3.90)[14.77] 136(3.74)114.15) 142(3.90)[14.771 I Note:Fuel pipe must be sized for full load.Required fuel pressure to generator fuel inlet at all lad ranges-3.5-7 in water column(0.87-1.74 kPa)for NG,10-12 in water column(2.49-2.99 kPa)for LP Gas.For B TU con+err multiply ka/hr x 2500(LP)or fts/hr x 1000(NG).For Megajoule content multiply m3/hr x 93.15(LP)or m3/hr x 37.26(NG). Controls Two-Ime pain text multilingual LCD Simple user interface for ease of operation. Mode bons:AUTO Automatic start on utility failure.Weekly;Bi-weekly,or Monthly selectable exerciser. MAWAL- Start with starter control,unit slays on.If utility tails,transfer to load lakes place. OFF Slops unit.Power is removed,Control and charger still operate.- - - - fleady to Rurt'?!a:nterunce m?s_sagzs -- Standard Encine run tours indication Standard Ptograrnmab!a start delay between 2-1600 seconds Standard(programmable by dealer only) Utruty Voltage LossiRetrrn to Utility adjustable(brownout setting) From 1.40-171 V/19D-216 V Future Szl Capable-Exerciser/Exercise Set Error warning Standard RurVAfamVMa:ntenance togs. 50 events each Engine steill sequence Cyclic cranking:16 sec on,7 rest(90 sec maximum duration). Stade,lock ail Starer cannot re-engage until 5 sec after engine has stopped. Sault Bazary Crarger Standard Cr rger Fa'AlMissirg AC waning Standard Lvwr Bacz:y/Brrery Problem Protection and Battery Condition indication Standard A,:or;atrc Voltage Regu ation wilh Over and Under Voltage Protection Standard Urn7et-Frequency/O,nrlad/Stepper Overcurrent Protection Standard Safety Fused/Fuse Problem Protection Standard _ -- Automatic Lavi- it Pressure/High bil Temperature Shutdown Standard Nercran'v/Overspeed(@ 72 Hz)/rpm Sense Loss Shu td-own Standard High Engine Temperature Slutttlown Standard Inl=.rrral Faullnncoirecl Wiring protection Standard Common ex ernal fatilt capability Standard .Field Amdab%firmerare- Standard Sound levels are taken from the front of the generator.Sound levels taken from other sides of the generator may be higher depending on installation parameters.Rating definitions-Standby:Applicable for supplying a,nergency pvaer for the duz*jon of the utility poref outage.No merlad capability is available for this rating.(All ratings in accordance with BS5514,IS03046 and DIN6271).'Maximum kilovolt amps and current are sus echo and ltrni:ed by such actors as fuel BTU/megajou!e contend,ambient temperature,altitude,engine power and condition,etc.Maximum power decreases approximately 3.5%for each 1,000 k(304.8 m)above sea level;and also will decrease approximately 1%for each 10'F(6°C)above 60 T(16`C). i.l GENERACe i I 20/22/24 kW Switch Options I i Service Rated Automatic Transfer Switch Features Model 0007039-11,G007039-3(20 kW) _ I • Intelligently manages up to four air conditioner loads with no additional hardware. 0007043-2,G007043-3(22 kW) {No.of,pol'es.F.. _ 2 - • Up to eight additional large(240 VAC)loads can be managed when used In conjunction Current rating(amps) 200 with Smart Management Modules(SMMs). ;Voltage raiingV(VACj 120%240;10' • Electrically operated,mechanically-held contacts for fast,clean connections. Utility voltage monitor(fixed)' • Rated for all classes of load,100%equipment rated,both inductive and resistive. -Pick-up 65% -Dropout __.,- . _ = 65% • 2-pole,250 VAC contactors. ty' _ r Return to Utili Approx.l3 see • Service equipment rated,dual coil design. Exercises bi-weekly for 5 minutes' Standard •.ETL or-UL listed Standard • Rated for both aluminum and copper conductors. Enclosure type NEMANL 3R • Main contacts are silver plated or silver alloy to resist welding and sticking. Circuit breaker protected._ 22.000_ • NEMA/UL 3R aluminum outdoor enclosure allows for indoor or outdoor mounting flexibility. Lug range 250 MCM-#6 `Function of Evolution controller Dimensions Exercise can be set to weekly,bi-weekly,or monthly WI- i 200 Amps 120/240.10 Open Transition Service Rated Height Width H1 H2 W1 W2 Depth ( I in 26.8 30.1 10.5 13.5 1 6.9 1 HI f cm 67.95 76.43 26.67 � r i Wire Ranges 1 Conductor Lug Neutral Lug Ground Lug 250 MCM-#6 350 MCM-#6 210-#14 DEPTH L-W2----� PWRview Automatic Transfer Switch Features Model G007210.0(24 kW) • Integrated PWRview monitor provides real-time energy usage data through PWRview app. No.of poles - .__ P _ _ - Current rating(amps) 200 • Intelligently manages up to four air conditioner loads with no additional hardware. Voltage ratio (VAC) _120/240,10 • Up to eight additional large(240 VAC)loads can be managed when used in conjunction Utility voltage monitor(fixed)' with Smart Management Modules(SMMs). -Pick-up 80% -Dropout 65% • Electrically operated,mechanically-held contacts for fast,clean connections. {Return to Utility" ._A'pprox.13 sec r • Rated for all classes of load,100%equipment rated,both inductive and resistive. Exercises bi-weekly for 5 minutes* Standard • 2-pole,250 VAC contactors. 4 EA or UL listed Standard Enclosure type NEMA 3R • Service equipment rated,dual coil design. Circuit tireaker protected� 22,000 • Rated for both aluminum and copper conductors. Lug range 250 MCM-#6 • Main contacts are silver plated or silver alloy to resist welding and sticking, `Function of Evolution controller • NEMA 313 aluminum outdoor enclosure allows for indoor or outdoor mounting flexibility. Exercise can be set to weekly,bl-weekly,or monthly • Heavy duty Generac Contactor is an ETL recognized device. W1— I Dimensions 200 Amps 120/240,1 e Open Transition Service Rated Height Width Depth i xr H1 H2 W1 W2 in 26.8 30.1 10.5 13.5 6.9 cm 67.95 76.43 26.67 34.18 17.5 ! ; Wire Ranges Conductor Lug Neutral Lug Ground Lug 250 MCM-#6 350 MCM-#6 2/0-#14 G E.N E RAC' 20/22/24 k1N Available Accessories Model# P.rdduct Description, G005819-0 26R Wet Cell Battery Every standby generator requires a battery to start the system.Generac offers tfia recommended 26R wet cell battery for., :use with all air-cooled standby product(excluding PowerPacttO). ,G007101-0 {Battery Pad Warmer Pad warmer rests under the battery.Recommended for use if temperature regularly falls below 0°F(-18°C).(Not nec-; essary for use with AGM-style batteries). _ _ G007102-0 Oil Warmer -_ Oil warmer slips directly over the oil filter.Recommended for use if temperature regularly falls below 0°F(18°0). G007103-1 Breather Warmer Breatherwarmer is for use in extreme cold weather applications.For use with Evolution controllers only in climates where' ' heavy,icing occurs. ,6005621-0_ 'Auxiliary Transfer Switch The auxiliary transfer switch contact kit allows the transfer switch to lock out a single'large electrical load that may not be i .Contact Kit :needed.Not compatible with 50 amp pre-wired switches. ___ _.. _ _.-. ._ ,-_ -_. `• "GQ07027-0-Bisque :FascWa a_se Wrap Kit- The fascia base wrap snaps together around the bottom of the new air-cooled generators.This offers a sleek,contoured!, '(Standard on 22/24 kW) appearance as well as offering protection from rodents and insects by covering the lifting holes located in the base. ,GO05703-0-Bisque Touch-Up Paint Kit If the generator enclosure is scratched or damaged,it is important to touch up the paint to protect from future corrosion. i The touch-up paint kit includes the necessary paint to correctly maintain or touch up a generator enclosure. G006485-0 'Scheduled Maintenance Kit;Generac's scheduled maintenance kit provides ail fhe items necessary to perform complete routine maintenance on a 'Generac automatic standby generator(oil not included)` a �G007005-0-- _:1Ni-ri LP Tank Fuel Level -The Wi-Fi enabled LP tank fuel level monitor provides constant monitoring of the connected LP fuel tank.Monitoring the; !Monitor LP taws fuel level is an important step in verifying the generator is ready to run during an unexpected power failure.Sta-; i ttus alerts are-available through a free application to notify users when the LP tank is in need of a refill. G007000 0(50 amp),Smart Management Module Smart Management.Modules(SMM)are used to optimize the performance of a standby generator.It manages barge elec ,13007006-0 trical loads upon startup and sheds them to aid in recovery when overloaded.In many cases,using SMM's can reduce r '(100 amp) the overall size and cost of the system. i G007169-0-413 LTE Mobile LiWs''Cellular 'The Mobile Linkfamily of Cellular Accessories allow users to monitor generator status from anywhere in the world,using'• 1G007170-0-Wi-Fi/ Accessories a smart phone,tablet,or PC.Easily access information such as the current operating status and maintenance alerts.Us-I Ethernet ers can connect an account with an authorized service dealer for fast,friendly,and proactive service.With Mobile Link,) f users are taken care of before the next power outage. G007220.0-Bisque Base Plug Kit Base plugs snap into the lifting holes on the base of air-cooled home standby generators.This offers a sleek,contoured appearance,as well as offers protection from rodents and insects by covering the lifting holes located in the base.Kit; contains four plugs;sufficient for use on a single air-cooled home standby generator. Dimensions A UPCs Model UPC °��°^°^ 1218nun (25,1 N] 1218 rnl G007038-1 69647107418.5 G007038-3 696471074185 G007039-1 696471074192 G007039-3 696471074192- G007042-2 696471074208 7271- 12e.e NI 0007042-3 696471074208 G007043-2 696471074216 G007043-3 696471074215 v 0 —1011 G007209-0 696471071511 G007210-0 696471078220 mm 1232 mm (25.5 ml - 148.5 MI LEFT SIDE VIEW FRONT VIEW Dimensions shown are approximate.See installation manual for e)acl dimensions.DO,NOT USE THESE DIMENSIONS FOR INSTALLATION PURPOSES. GENE RAC'- Generac Power Systems,Inc. • S45 W29290 HWY.59,Waukesha,WI 531.89 • generac.com C2020 Generac Povfer Systems.Inc.All rights reserved.All specifications are subject to change without notice.Part No.A0000837814 Rev.B 07/30/2020 I I