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Home My WebLink About32073-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32476 Date: 07/16/07 THIS CERTIFIES that the building WIRELESS TELECOMM. Location of Property: 23300 MAIN RD (HOUSE NO.) County Tax Map No. 473889 Section 18 (STREET) Block S ORIENT (HAMLET) Lot 13. 8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 18, 2006 pursuant to which Building Permit No. 32073-Z dated JUNE 2, 2006 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 CO-LOCATION & WIRELESS COMMUNICATION FACILITY AS PER CONDITIONS OF ZBA #S80S DATED 04/13/06. The certificate is issued to ORIENT FIRE DISTRICT (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 10944SC 11/20/06 N/A PLUMBERS CERTIFICATION DATED 4zri~ Rev. 1/81 07/09/2007 14:25 00000000 PAGE 02/02 . Form No.6 TOWN OF SOUTHOLD HUll..DING D.EPARTMENT TOWN HALL 765-1802 I C (f._f) /" I~fll -"- . I (1) I t~1 " 2'-/0-535 - 7577 fV\ lKE.. Sw."'"'--'s€. "<-. --~ ,r, \,"t. \",',\ Al'P.LICATION FOR CERTIfICATE OF OCCUPANCY .._-" (':' \ \ This application must be filled in by typewriter or ink and submitted to the Building Department with the followipgll . JUl \ 3 L" A. For new building or new use: . I. Final survey of property with accul'lIte location of all buildings, property lines, streets, and I:,!!,sual natural or topographic features. .' . 2. Final Approval from Health Dept. of water supply and sewmge-disposal (5-9 form). ~..;.. 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. .~ n. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings Ilnd "pre-existing" land uses: I. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant Ifa Certificate of Occupancy is denied, the Building Inspector shall state the reaSOnS therefor in writing to the applicant. c. Fees 1. Certificate of Occupancy ~ New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate ofOccupnncy - Residential $15.00, Commercial $15.00 Date. 7- / 1- 01 New Construction; / Old or Pre-existing Building; (check one) Location of Property: :J..J30D !\A.p"u K.1::,.. House No. OQJI::t\.'lT Street Hamlet Owner or Owners of Property; .OI:lE.I.:iT It=', \2.~ D,<,.-e.\L\ Suffolk County Tax Map No 1000, Section 473389/ DJ'il / Block Dt.{)5" Lot 013.00'2. Subdivision z Date ofpermit.:J.,,,,E' 1 . loo&, Filed Map. Applicant: C.'IUG;. 0.2. Lot; PerrnitNo.32.07<. U2H(lr:'1 t= " Health Depi. Approval; Planning Board Approval: Request for: Temporary Certiticate Fee Submitted; $ $ SO. CO _____ Underwriters Approval: Fjnal Certificate: ( ( check one) Applicant Signature ~,')'\l~ C-o f- 3J:2.lf 7~ FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 32073 Z Date JUNE 2, 2006 permission is hereby granted to: CINGULAR WIRELESS 23300 MAIN ROAD ORIENT,NY 11957 for : CO-LOCATION & WIRELESS COMMUNICATION FACILITY PER ZBA #5805 & PLANNING AS APPLIED FOR; CERTIFICATION OF INSTALLATION REQUIRED at premises located at 23300 MAIN RD ORIENT County Tax Map No. 473889 Section 018 Block 0005 Lot No. 013.008 pursuant to application dated MAY 18, 2006 and approved by the Building Inspector to expire on DECEMBER 2, 2007. Fee $ 200.00 ;J~w~ WL / Authorized Signature ORIGINAL Rev. 5/8/02 . PLANNING BOARD MEMBERS JERILYN B. WOODHOUSE Chair KENNETH L. EDWARDS MARTIN H. SIDOR GEORGE D. SOLOMON JOSEPH L. TOWNSEND . MAlUNG ADDRESS: P.O. Box 1179 Southold, NY 11971 OFFICE WCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY Telephone: 631765-1938 Fax: 631 765-3136 March 30, 2007 PLANNING BOARD OFFICE TOWN OF SOUTHOLD Lawrence C Re Munley, Meade, Nlelsen & Re 36 North New York Avenue Huntington, NY 11743 Re: Proposed Amended Site Plan for Orient FD Telecom Located on the s/ s/ 0 Main Road at the s/ e intersection of Main Road and Tabor Road in Orient. SCI'M# 1000-18-5-13.8 Zoning District: R-80 Dear Mr. Re: At the written request of Edward J. Bo}U requesting final site plan inspection, Planning Department staff performed a site visit on Jan1l3.1)'4, 2007. In reference to the above, the Planning Board held a work session on March 19, 2007 to discuss the submitted materials, the approved site plan and resolution dated June 13,2006, the final swveydated December 27, 2006 and the letterfrom Vmcent Cannuscio for Michael Walker dated February 7, 2007 detailing the changes from the approved site plan. Please be aware the Planning Board has accepted the "Final SwveyTower Site Orient F.o." prepared by PJM Land SwveJIDg, PILe dated December 27,2006 for the file. The Planning Board accepts the letter from Vincent Cannuscio for Michael Walker dated February 7,2007 detailing the changes from the approved site plan. This is to inform you that the site plan requirements have been satisfied and include the following items: · The Planning Board approves the installation of all landscaping, including seeding, in the Spring of 2007. The Planning Board recognizes that, due to weather constraints, this will be completed no later than June 30, 2007. If the landscaping is not installed byJune 30, 2007, the applicant must request an extension from the Planning Board, in writing, detailing the expected time of completion. · As per the landscape swvivabilityguarantee, the applicant agrees to replace any of the landscaping which fails to survive within three (3) years of planting. . All outdoor lighting shall be shielded so that the light source is not visible from adjacent properties and roadways. Lighting fixtures shall focus and direct the light in such a manner as to contain the light and glare within property boundaries. The lighting must meet the Town Code requirements. · The Planning Board approves the fencing and relocation of the gates around the equipment compound as detailed in the letter from Vincent Cannusio for Michael Walker dated February 7,2007. · The applicant agrees to complete the remaining asphalt work no later than June 30, 2007. If this work is not completed by June 30, 2007, the applicant must request an extension from the Planning Board, in writing, detailing the expected time of completion. · The Planning Board acknowledges and approves the revised driveway layout. . . Orient PO Telecom Page Two March 30, 2007 This letter does not condone any other changes from the approved site plan or approvals from other agencies if required. Sincerely, ~~~ t:1erilyn B.~oodhouse Otairperson Cc: File Building Departrnent* Town Engineer* Edward]. Bo)U, Esq.* Enc: Letter from Vincent Cannuscio for Michael Walker dated February 7, 2007* , .'" . I APPEALS BOARD MEMBERS Ruth D. Oliva, Chairwoman Gerard P. Goehringer James Dinizio, Jr. Michael A. Simon Leslie Kanes Weisman hUp:/ Isoutholdtown.northfork.net --- V~.... \? \', ZONING BOARD OF APPEALS TOWN OF SOUTHOLD Tel. (631) 765-1809 . Fax (631) 765-9064 \, \ '0 ' \l\~ Mailing Address: Southold Town Hall 53095 Main Road' P.O. Box 1179 Southold, NY 11971-0959 Office Location: Town Annex IFirst Floor, North Fork Bank 54375 Main Road (at Youngs Avenue) Southold, NY 11971 \' -:"', ~' FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF APRIL 13, ;1006 Appl. No. 5805 - CINGULAR WIRELESS; NEXTEL; VERIZON WIRELESS (Co-Applicants) Zone District: R-80 Residential <<l en,T, Property Location: 23300 Main Road (State Route 25) and Tabor Road, lOa&r~ariQ:(JP CTM 1000-18-5-13.8 SEQRA DETERMINATION: The Zoning Board of Appeals has visited the property under consideration in this application and determines that this review falls under the Type II category of the State's List of Actions, without an adverse effect on the environment if the project is implemented as planned. PROPERTY FACTS/DESCRIPTION: The applicant's property consists of 4.355 acres, situated on the south side of the Main Road (NYS Route 25) and the east side of Tabor Road in East Marion. The property is improved with the following buildings and structures: (a) fire station with an existing antenna facility and (b) detached metal building. BASIS OF APPLICATION: Zoning Code Section 100-162A, and the Building Department's, /''l March 14, 2006 Notice of Disapproval, which states the applicants' proposal requires a Special Exception from the Southold Town Zoning Board of Appeals (and site approval from the Southold Town Planning Board). CODE PROVISIONS: TELECOMMUNICATION TOWER -- A telecommunication tower is a type of wireless communication facility designed and constructed specifically to support an antenna array, and may include a monopole, self-supporting tower, guy-wire support tower and other similar structures. A wireless communication facility attached to an existing building or structure shall be excluded from this definition. [Added 11-12-1997 by L.L. No. 26-1997] WIRELESS COMMUNICATION FACILITY -- Any unstaffed facility for the transmission and/or reception of wireless telecommunications services or other radio transmission and/or receiving service or use usually consisting of a wireless communication facility array, connection cables, an equipment facility and a support structure to obtain the necessary elevation. The support structure is either a building, telecommunication or radio antenna or tower or other approved structure. [Added 11-12-1997 by L.L. No. 26- 1997; amended 2-2-1999 by L.L. No. 3-1999] Page 2 - April 13, 2006 Appl. No. 5805 - Clngular, Nextel, Verizon 18.-5-13.8 at Orient FINDINGS OF FACT The Zoning Board of Appeals held a public hearing on this application on March 2, 2006 and March 30, 2006, at which time written and oral evidence were presented. Based upon all testimony, documentation, personal inspection of the property, and other evidence, the Zoning Board finds the following facts to be true and relevant: APPLICANTS' REQUEST: The Applicants are seeking to install a public utility wireless telecommunications facility at the premises by affixing wireless telecommunications antennas within an approved pole to be built, and to install related equipment as required to be functional. RELATED INFORMATION: The owner of the property, the Orient Fire District (OFD), has a current building permit (the first having been issued June 22, 2005 under No. 31215), by the Southold Town Building Inspector for a 90 ft. high telecommunications tower facility. The OFD has an existing antenna facility at the Orient Fire Station, also used by the Town Police Department to transmit and receive messages to and from its various mobile units, marine units and personnel patrolling the areas and adjacent waters. The purpose of the requested wireless communications tower to provide improved emergency communication services for the entire area lying east of the East Marion causeway. Following approvals by the town agencies (but prior to the start of actual construction), the Commissioners of the OFD retraced their efforts to assure the most unobtrusive location for the crucially needed tower, and have, with recommendations for local authorities and members of the Orient community, determined that a location directly south of the existing main firehouse building would better suit the needs of the District and the interests of the community. This location is fairly close to where an existing radio transmission facility is located, which tower will be removed once the new public safety communications system becomes fully operational. RELATED FACTS: The property is 4.35 acres in size, with 341 linear feet along Tabor Road, a side street, 226 linear feet along the Main Road (State Route 25), 570.70 linear feet along the most southerly property line, and variables along the easterly property line of 169.30 and 287.60 linear feet. The fire house is closest to the Main Road, and the tower is proposed behind the OFD building. The Orient Fire District has an existing antenna facility at the Orient Fire Station, also used by the Town Police Department to transmit and receive messages to and from its various mobile units, marine units and personnel patrolling the areas and adjacent waters. The purpose of the requested wireless communications tower facility is to provide improved emergency communication services for the entire area lying east of the East Marion causeway. The new wireless telecommunications tower is in the process of being constructed at the rear of the fire house, behind the metal building, on this 4.35-acre parcel. The tower Is Page 3 - April 13, 2006 Appl. No. 5805 - Clngular, Nextel, Verlzon 18.-5-13.8 at Orient proposed to be located south of the fire department's metal building located in the rear yard, distant 145+- feet from the northerly property line at its closest point, 140+- feet from the easterly property line, 135+- feet from the southerly property line, and at least 315 feet from Tabor Road to the west. The telecommunications use requested herein on the same telecommunications tower that was approved under ZBA Appeal No. 5408 and Building Permit Issued June 22, 2005 under Permit No. 31215-Z to the OFD (special district under Section 100-162A), except that It has been moved closer to the buildings on the same parcel, and the co-applicants, as public utilities, wish to co-locate with the consent of the ownerlspecial district (OFD). RELATED INFORMATION: By application dated 6/27/03, the OFD stated that an antenna height of at least 90 feet is mandated, to provide the coverage necessary to reach the furthest extent of the mainland Southold, on physical sciences governing public service radio communications. The OFD and Town Policy Public Safety Indicate a height at 90 ft. AGL is required, with 'low band' vertical whip antenna and future carrier antennas (see plans prepared by Michael Walker Design/Builder dated 10/5/04). At the top of the OFD's tower is a 9'6" dipole array to be externally mounted, 2.5" in diameter. During the hearings, concerns were expressed and disputed by residents as to whether or not the public utility is eligible to place its antenna facility and use on the site, since the new tower is not existing, although the tower has a valid and current building permit in effect for its construction. OTHER CONSIDERATIONS: In addition to the matters to be considered in Article XXVI of this Code, the Zoning Board of Appeals has given consideration to the following in issuing a special approval for wireless communication facilities: (1) The height of the proposed tower is the minimum necessary to render adequate service. (2) The wireless communication facility has been situated to minimize its proximity and visibility to residential structures, residential district boundaries and landmarks designated by town, federal or state agencies. (3) The wireless communication facility is designed and situated to be compatible with the nature of uses on adjacent and nearby property. (4) The wireless communication facility has been designed to use the surrounding topography to minimize Its visual Impacts. Page 4 - April 13, 2006 Appl. No. 5805 - Clngular, Nextel, Verizon 18.-5-13.8 at Orient (5) The wireless communication facility has been designed to use the surrounding tree, building or foliage coverage to minimize its visual impacts. (6) The wireless communication facility maximizes design characteristics to reduce or eliminate visual impacts or obtrusiveness. (7) Other adequate conditions have been placed on the wireless communication facility which will minimize any adverse impacts of the facility on adjoining properties. REASONS FOR BOARD ACTION: On the basis of testimony presented, materials submitted and personal inspections, the Board makes the following findings: The new wireless communications tower will be co-located on a new telecommunications tower, to be constructed in place of the existing OFD telecommunications tower facility, and will meet the height and restrictions placed by the ZBA under Decision No. 5408. 1. The proposed Communications Facilities consist of the installation of three (3) sets of panel antennas, each set representing one wireless carrier, internally mounted within a recently approved 90' high monopole. The monopole will be situated immediately behind the south end of the OFD firehouse, and associated equipment cabinetry for each carrier mounted alongside the monopole within a fenced and screen compound. The co- applicants' proposal represents the least obtrusive means for three (3) FCC licensed telecommunications carriers to provide service in the vicinity of emergency, fire, police, ambulance companies and departments need wireless mutual aid communication systems. The mutual aid and Individual (private) ambulance, radio and other aid companies are involved with the mutual aid system. There are existing dispatch problems, problems in scene management, fire safety issues, and fire ground operation issues. The fire departments and other companies join together to assist as needed, with fundamental resources (low-band paging and radios). These systems clearly need to be improved and expanded and to provide for more effective long-range communications and senior managing during multiple fire ground and other emergencies. Because safety of citizens and fire personnel is of primary concern, an improved wireless communications facility is necessary and desirable. 2. Other experts, including that of members of the Orient community, gave unrebutted testimony that effective coverage of the subject area can be provided by a communications tower of 90 feet or less. 3. While safety is the primary concern, other values, such as aesthetic considerations, character of the neighborhood, and preservation of the scenic nature of the State- designed Scenic Byways Corridor must be heeded to the extent that they do not compromise the tower's effectiveness in the locale it is designed to serve. In addressing visual concerns, the applicant has offered: a) a neutral color and flagpole design, and b) to locate the structure behind the existing OFD buildings as far south from the Main Road as feasibly possible. These measures do not satisfy the concerns about visibility, since ! . I Pat. S ~ AprIl 13, 200G : . Appl. No. 6806 ~ Clngular, Nextel, Varlzon 18."0.8 at OrIent the tower will be visible particularly at the top half portion of the tower where the antennas are Visible over th~ existing buildings and tree lines llnd not screened from view. A tower structure et 120 feet in height compromises the scenic and historic surroundings along the State designalied Scenic Highway Corridor and Is not consIstent with the surrounding rural charaoter of this area, with clear visibility from various segments of the lands surrounding the Itower slte. The installation of these antennas and public utility telecommunications facility, on a telecommunications tower approved under appeal No. 5408 Ilnd BUilding!,Permit #31215,z Issued June 22, 2005 will be a reasonable alternative to placing a new tower facility on another site to serve within the gap of Dervice for this ,,_,"unity, and will meet the Iltrict requirement of the zoning Code Section 100.162.,A.. 4. It is the zoningl'BOard's determination that the co-Iooallo.n of the three antennas onto a new 90 fl wireless communioallons/teleoommunications tower, to be built at thi$ alte of the OFD, I" allorNed in the R-80 Residential Low-Density Zone District by Special ~Xception. . , RESOLUTION OF iTHE BOARD: In considering all of the above factors and applying the balanolng test under New YOfk Town Law 267-13, motieln was offered by Member Goehrlnger, seoonded by Member Simon, and duly carried, to GRANT ~onlng approval under Section 100-162A, for public utility antennas and telec;ommitnioations use, 8$ applied and shown on the site and pole elevation maps preparecl by Michael Walker signed 3/6/2006 (with ZBA date stamp of Marc:h 8, 2006), <<UBJECT TO THE FOllOWING CONDITION: Applicant shall post a bOnd, In the favo;Jr of the Town for the purpose of guaranteeing to Ille Town that In lhe event lh" Use of lhe proposed Tower is discontinued and not used for telecomm",nicatlon purposes. the applicant herein will faithfully cause the tower to be decommissioned, deconstructed, demolished or otherwise removed from the site, with the site restored to Its original condition. Bllsed upon the submission bf the appliclmt and reviews by the Town Engineering Ins~Qtor, the recommended amount of such bond shall be not less than $10,000, subject to the approval and acceptan~ by the Town Board and In a form acceptable to the Town Attorney. , Vote of the Board: Ayes: Members Oliva (Chairwoman Weisman. This rMolution was duly adopted (5.0). Get;...t P. GOehringer ?/,'ApPfoved for Filing FOUNDATION (1ST) DATE 10/' l ( COMMENTS 1/ /)< ~JJA ,~, 0.... d I.. A ... / / (.~-~ 9'-\/.~./ // / ~~ Cl, ~ .J- vJ;; FIELD lNSPECTION REPORT . . . ~ 'd M" ot'! (' ;. "1z 9 FOUNDATION (2ND) I N/If { I . ~ lY~ (y[;i at'! ()'"' ROUGH FRAMlNG & PLUMBlNG 3 S. ~~ . t'I ... I lNSULATlON PER N. Y. STATE ENERGY CODE FlNAL - 1/3 ; ') 7 11/ 0 t2.P .fllJ- oY\ /'..r- "l' IJ A7f " b PJ--/71~ .' J. (}4 '-- d. . u ^ , '/.J /::;- --1:5.- c~.J ~~ fJ r;~-J-:. - ,v 0 _ _ - '-F-j - r ,., r ./"" 7' '::u - ..Le/ P D f- ~ 1-fJ//) ~_ f./. (/"0 ~h '-- ~ , of( ~~tJ , .... OH.\V , ./ (/..-./ o ~. p (\\- - L Z- -\ ~ ~ 41 m '\- ::;..:>:1)> ~\ 7V ADDITIONAL COMMENTS 1/ J7./o 7 AJ2.p R A- /~; ~7- oj, . -yJ ~.4-, , ~ ~ r. -:1;;-. .'ih-~ 0 k' /7. C ,..L.vo ~ ; /.J_ v v...... , , 4 - t'! v:><i . ." 'V- . ~ o '"' ~o z .'. t . = t'! ?~ -----3 5;;; t'! ." '"' , I , FOR INTERNAL USE ONLY ,.- --4iil S.-f ~,s, V.L Initial Determination O,'e'b.:1J I ).,.. O~ s"", 7 I cP b prOjectNam((lll'aC/~' O~(~r'.ARE " ~lpVo- Project Address:d.!?806 fYM.m IZI. OI2.//A.d- SITE PLAN USE DETERMINATION .}-- Suffolk County Tax Map No.:1000-~_ T- /?,Jt' Zoning District: ~-f?tJ ~q~:,~-~,~~;: ~I ;'::~flJ.17 %V:~~A> 4>V (Note: Copy of Building Permit Application and supporting documentation as to proposed use or uses should be submitted.) Initial DeterQ1ination as to wheti! use is permitted: I)f'.-' Ar2.r,..,,~ S//J"A~.f fl1Krn/3 _' / I - 7 Initial Determination as to whether site plan is required' ~ /) Planning Department (P.O.) Referral: P.O. Date Received:L/~/ t7.J Signature 0 . Ing Inspector ~ (/ /rJ -J I, I Final Determination Date:LQj /J-/ or- O~...,~~~~~.",_. 'c ~I'_~ ~~~~..) !3ignature of Planning Dept. Staff Reviewer __"_____.1 "- , "'~ '" Si~specto~ FOR INTERNAL USE ONLY SITE PLAN USE DETERMINATION Initial Determination D,'eo-1-).n J'- . ,,;.," D~ Seot 1 J d h Project Nam{ClliGuUJ:j . (}~'~1' .h12E . ~ V2Va- Project Address:~,!?80() ~m IZI. (j12//A,A..-!- .1'- Suffolk County Tax Map No.:100o-lf - J- ~J'" Zoning District: 4~f?1J ~q~:sjfJ ~%(:~:, ~/ ;.;)~~ ~i;;(;=-+A/ A7V (Note: Copy of Building Permit Application and supporting documentation as to proposed use or uses should be submitted.) Initial DeterQ'lination as to whet~e is permitted: I},['I" ~.......~ .5//JeA~ Il~(~/~ . F f -, Initial Determination as to whether site plan is required' . Iv- /) ~ (//~ - Signature 0 . Ing Inspector Planning Department (P.D.) Referral: P.D. Date Received: I I Date of Comment: I I Comments: Signature of Planning Dept. Staff Reviewer Final Determination Date: I I Decision: Signature of Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www.northfork.net/Southold/ I. ~ 'Je1 '0 -(; BUILDING PERMIT APPLICA nON CHECKLIST Do you have or need the following, before applying? Board of Health 3 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: Lawrence C. Re' MailtoMunley, Meade, Nielsen & Re' 36 North New York Ave. ,Hunti ngton, / NY 11143 Phone: 631-425-4100 Fax: 631-425-4104 I':i-\R 8 PERMIT NO. Examined Approved Disapproved ale ~\1..-- r"{lI\ \ ,20~ ,20~ Expiration '\'}-\o,20~ Ii ~ 'uilding Inspector APPLICATION FOR BUILDING PERMIT Date March 6 2006 '- INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location oflot and of buildings on premises, relationship to adjoining premises or public streets or areas, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an addition six months. Thereafter, a new permit shall be required. APPLICA nON IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of South old, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions, or 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 for necessary inspections. NEW CINGULAR WIRELESS PCS, LLC (Signature of applicant or name, if a corporation) 333 Crosswavs Park Drive, Woodbury, NY 11797 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Lessee Name of owner of premises rient Fire District i lit o~~gn the tax roll or latest deed) u y a~tlionzed"' officer -B.:-" (Name and title Joseph Sweet, S Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. Manager I. Location of land on which proposed work will be done: 23300 Main Road House Number Street Orient Hamlet County Tax Map No. 1000 Section Subdivision 18.00 Block 05.00 Filed Map No. Lot 013.008 Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existinguseandoccupancy Firehouse and Public Safety b. Intended use and occupancy Public Utility Wireless Telecommunications Facility 3. Nature of work (check which applicable): New Building Repair Removal Demolition Addition Alteration Other WorkT~?~~gmMS~1 Uti~~~%ecsil i ty (Description) 4. Estimated Cost $55.000.00 Fee 5. If dwelling, number of dwelling units N/ A If garage, number of cars N/ A (To be paid on filing this application) Number of dwelling units on each floor N/ A 6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use. N/ A (FH=Firehouse; A=Accessory Buildi~) 7. Dimensions of existing structures, if any: Front FH=80 I ;A=40 ' Rear FH=43' :A=40 ' Depth FH=110' ;A=80 ' Height FH=30'; A=25' Number of Stories FH=I; A=1 Dimensions of same structure with alterations or additions: Front Unchanqed Rear Unchanged Depth Unchanged Height Unchanged Number of Stories Unchanged 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 9. Size ofIol: Front 226' Rear 570' Depth 458't Irre9ular shaped lot. 10. Date of Purchase November 14, 1985 Name of Former Owner Barbara Dwight Schriever I I. Zone or use district in which premises are situated Res i dent i a 1 R-80 12. Does proposed construction violate any zoning law, ordinance or regulation? YES ~ NO_ 13. Will lot be re-graded? YES_NO~.Will excess fill be removed from premises? YES_ NO~ Orient 23300 Main Road 14. Names of Owner of premises Fire District Address Orient. New York Name of Architect Address Name of Contractor Address Phone No. Phone No Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES _NO ~ * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES_NO---1L- * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF "'....s'S<t.LI... ) JOSEPH SWEET being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (~Heisthe System Development Manaqer of New Cinq~~r Wireless pes. LLC (Contractor, Agent, Corporate Officer, etc.) Lessee-Authori zed Agent of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn ~ before me this J2,., ?~f~;:: 200L C-/ ~. - / Notary Public '--...J By: ignature of Applicant weet, System Development Manager LAWRENCE C. RE' Notary Public, State of New Vor\( No. 52-4799664 Qualified in Suffolk Cou'llll. n"''l . Commission Expires May 31,' LJ.JU..r-- TOWN OF SOUTHOLD : BUILDING DEPARTMENT COUNTY OF SUFFOLK: STATE OF NEW YORK ---------------------------------------------------------------------------------)( In the Matter of the Application of NEW CINGULAR WIRELESS PCS, LLC, a Delaware Limited Liability Company, successor in interest to UN CELLULAR COMMUNICATIONS (NY) LLC, successor in interest to CELLULAR TELEPHONE COMPANY 23300 Main Road Orient, New York District 1000 Section 18.00, Block 05.00, Lot 013.008 ---------------------------------------------------------------------------------)( AUTHORIZATION OF OWNER STATE OF NEW YORK ) ) SS. COUNTY OF SUFFOLK ) ~Jl"{''''~'<r..r<' being duly sworn, deposes and says: I am the ~M,^\SS\"~ of Orient Fire District, owner in fee of the premises known as Section 18, Block 5, Lot 13.8 (the "Premises" hereafter), and do hereby authorize New Cingular Wireless PCS, LLC, a Delaware Limited Liability Company, successor in interest to LIN Cellular Communications (NY) LLC, successor in interest to Cellular Telephone Company ('Cingular' hereafter), and its representatives to bring such applications for municipal approvals as may be necessary for constructing or installing on the Premises such antennas, support structures, and related equipment as Cingular may require for the establishment of its public utility wireless telecommunication facility. As such, I will fully cooperate with Cingular and its agents in obtaining any required Approvals. ORIENT FIRE DISTRICT ~ By: ~ I~ Sworn to before me this ,2005. NOTARY PUBLIC EDWARD JOHN BOYD 5th Notary Public State of New York 0260037&625 Suffolk County Commission Expiles April 30. 200 r:r 3}A)1)~ TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [~OUNDATION 1 ST [ [ ] FOUNDATION 2ND [ [ ] FRAMING I STRAPPING [ [ ] FIREPLACE & CHIMNEY [ ] ROUGH PLBG. ] INSULATION ] FINAL ] FIRE SAFETY INSPECTION REMARKS: k I1wL- IN ~ crt ' (3- G/r~ - DATE 1f9/h4 I / INSPECTOR ~ d-073 Z TOWN OF SOUTH OLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND [ ] FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUCTION REMARKS: [ ] ROUGH PLBG. [ ] INSULATION ~FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION ----- " DATE 7~ 3 -t/ 7 INSPECTOR ~~ i~ @: ~: . ~, e j ! ., ""- . ~ i1~Q~tJ .I.V. D MICHAEL WALKER DESIGN/BUILDER, LLC 500 Horseneck. Road South Dartmouth, MA 02748 Tel: (508) 287-4313 Fax: (508) 300-6051 e-mail: mwdb@comcast.net Michael Walker, AlA CONSTRUCTION INSPECTION AFFIDAVIT December 27, 2006 , r" r.> " ,.., .. q\ I> . Building Official Town of South old Building Department Southold Town Hall 53095 Main Road Southold, NY 11971-1179 MARl.? Telephone: Fax: (631) 865-1809 (631) 765-9064 Project: Orient Fire District Telcom 23300 Main Road, Orient, NY In accordance with the Building Code of New York State (BCNYS), paragraph 1704, I, Michael Walker, New York Registered Architect No: 11545 of South Dartmouth Ma., being a registered professional architect hereby certify that I have prepared or supervised the preparation of all design plans, computations and specifications for the above indicated project. To the best of my knowledge, these plans, computations and specifications have met the applicable provisions of the Building Code of New York State, general engineering practice and applicable laws regarding the proposed project. On site inspections were perfonned in accordance with the BCNYS 1704 during the course of construction: 1) Bearing strata for the pole foundation was inspected at the time of excavation. Bearing strata was observed to be on natural undisturbed earth. The bottom of the excavation was compacted prior to placing rebar. Bearing strata was judged suitable and equal to the soil characteristics described in the report of on-site Slake Test Boring investigations conducted on May 2,2005. 2) Concrete material and placement was observed. Concrete design exceeded the 300Q-psi required by specifications. Placement was made in a continuous pour and consolidated with a vibrator. Test cylinders were made. Test cylinder reports are submitted under separate letter. 3) Rebar installation was in accordance with the foundation design. Rebar was grade-60 and securely tied in place. Rebar was installed on chairs with a minimum of 3-inch cover at sides, bottom and top. 4) Anchor bolts were of the proper size and material and were provided by the pole manufacturer. At the time of installation, anchor bolts were placed and securely held in position with a template provided by the pole manufacturer. 5) Qualified and experienced tower erectors erected the pole. The pole connection(s) were slip connections and did not require bolting. Anchor bolts were properly leveled and tightened. Deliver on lime 0 Focus on Quality 0 Think Safety :/. ~ Orient Fire District Telccm 12/27/06 Page 2 of 2 pages This completion affidavit is to verify that the construction inspections required by BCNYS 1704 were perfonned and the installation of the foundation, concrete and pole were completed in accordance with specifications. The work is substantially and satisfactorily completed without exceptions. Very truly yours, MICHAEL WALKER DESIGN/BUILDER, LLC /~~ / ' '" " ," ! " ,\ '. ~' ", I ^ n :. .''.~, ~ \\ " ""I' 'I ," ~ 1 , ", ), ~y:;:: 'I)' I! i ~{ t/ \- ; II,.::,/:,i-i)i! . ;! ii :i ':1:,)7/"0 ii' \1 ~~&iJ\,l~j: ii:\'- t,~ i:/~,.~j;{\" U u 'V .....~, \lJl ;.' '",,:.v"" 1\ V~J ~ iI ---. v V ~. \'\. ~ Michael Walker, AlA, Architect Manager Deliver on Time 0 Focus on Quality Think Safety MUNLEY, MEADE, NIELSEN & HE ATTORNEYS AT LAW REPLY To: 0 REPLY To: 0~ 160 M1001,E NECK ROAD MAR 8 36 NORTH NE\\" YORK A'\.'E:-;eE HU1'Io"'"TINOTON, N~. YORK 1]743 GRI<;AT NP.CK, NE\'" YORK 11021 (516) 487-6500 (631) 425-4100 'l'ELECOPIF.R TELECOPIER (516) 487-6539 (631) 425-4104 March 8, 2006 BY HAND Ms. Patricia Conklin Building Permits Examiner Building Department Town of South old Main Road Southold, NY 11971 RE: Building Permit Applications for Issuance of Revised Letters of Rejection New Cingular Wireless PCS, LLC ("Cingular"), Nextel of New York, Inc. ("Nextel"), and New York SMSA Limited Partnership d/b/a Verizon Wireless ("Verizon Wireless") Premises: 23300 Main Road Orient, New York SCTM#: 1000-18.00-05.00-013.008 Dear Ms. Conklin: We submit, herewith, one counterpart each of revised signed and sealed "Plot Plan and Pole Elevation" and "Compound Plan with Planting" drawings, prepared by Michael Walker Design Builder, LLC, for your use as a reference in your review of the captioned Building Permit Applications. Please direct any questions or comments regarding the foregoing to the undersigned. Thanking you for your courtesies, we remain Very truly yours, MUNLEY, MEADE, NIELSEN & RE By: LCVWV0Y\.Ce.1 C. 'Rb Lawrence C. Re LCR:db Enclosures MUNLEY, MEADE, NIELSEN & HE ATTORNEYS AT LAW REPLY To: 0 REPI.Y To: ~ 36 NORTH NE\-\' YORK AVENl'J.; HeNTIXOTOS, NE'W YORK 11743 ] 60 MU>OI.E NECK ROAD GRI<:AT NECK, NEW" YORK 11021 (516) 487-6500 (631) 425-4100 TELEl.~()PIER TELECOPIEH (516) 487-6539 (631) 425-4104 March 8, 2006 BY HAND Ms. Patricia Conklin Building Permits Examiner Building Department Town of South old Main Road Southold, NY 11971 RE: Building Permit Application for Issuance of Revised Letter of Rejection New Cingular Wireless PCS, LLC, Premises: 23300 Main Road Orient, New York SCTM#: 1000-18.00-05.00-013.008 Dear Ms. Conklin: On behalf of our client, New Cingular Wireless PCS, LLC, and pursuant to your request, we submit herewith the captioned Application as follows: I) Completed and executed Building Permit Application (for Denial); 2) Owner's Authorization Affidavit; 3) Three (3) sets of signed and sealed Construction Drawings, including Site Plan; 4) Filing fee check made payable to the "Town of South old" in the sum of$35.00. Please note that a survey is already on file with the Town. Kindly direct any questions or comments regarding the foregoing to the undersigned. Thanking you for your courtesies, we remain Very truly yours, MUNLEY, MEADE, NIELSEN & RE By: LCtMJ Y'e.t'\,C€/ C. R& Lawrence C. Re LCR:db Enclosures FORM NO.3 NOTICE OF DISAPPROVAL DATE: October 12,2005 RENEWED: March 14,2006 TO: Munley, Meade, Nielsen & Re NC Orient Fire District (CINGULAR) 36 North New York Avenue Huntington, NY 11743 Please take notice that your application dated September 23, 2005 For permit for co-location of a wireless antenna on an existing telecommunications tower with related equipment structure at Location of property: 23300 Main Road. Orient. NY County Tax Map No. 1000 - Section l8. Block..i Lot 13.8 Is returned herewith and disapproved on the following grounds: The proposal requires special exception from the Southold Town Zoning Board of Appeals and site plan approval from the Southold Town Planning Board. Note to Applicant: Any change or deviation to the above referenced application, may require further review by the South old Town Building Department. CC: file, Z.B.A., Planning FORM NO.3 NOTICE OF DISAPPROVAL DATE: October 12, 2005 TO: Munley, Meade, Nielsen & Re NC Orient Fire District (ClNGULAR) 36 North New York Avenue Huntington, NY 11743 Please take notice that your application dated September 23, 2005 For permit for co-location of a wireless antenna on an existing telecommunications tower with related equipment structure at Location of property: 23300 Main Road. Orient. NY County Tax Map No. 1000 - Section l8. Block.2 Lot 13.8 Is returned herewith and disapproved on the following grounds: The proposal requires special exception from the Southold Town Zoning: Board of Appeals and site plan approval from the Southold Town Planning Board. Youma a I Si e Note to Applicant: Any change or deviation to the above referenced application, may require further review by the Southold Town Building Department. CC: file, Z.B.A., Planning