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HomeMy WebLinkAbout39164-Z FGt1rcOG: Town of Southold 9/21/2017 P.O.Box 1179 0 o 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39226 Date: 9/21/2017 THIS CERTIFIES that the building GENERATOR Location of Property: 1475 Sterling Rd, Cutchogue SCTM#: 473889 Sec/Block/Lot: 104.-2-23 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 8/28/2014 pursuant to which Building Permit No. 39164 dated 9/9/2014 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 Powers,Kevin&Powers,Clare of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 39164 08-16-2017 PLUMBERS CERTIFICATION DATED Authorized Signature o�S�FFn�rr�oTOWN OF SOUTHOLD BUILDING DEPARTMENT y TOWN CLERK'S OFFICE oy • SOUTHOLD, NY poi � 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#: 39164 Date: 9/9/2014 Permission is hereby granted to: Powers, Kevin & Powers, Clare 7 Pleasant St Bedford, NY 10506 To: Installation of an,accessory generator as applied for. At premises located at: 1475 Sterling Rd, Cutchogue SCTM # 473889 Sec/Block/Lot# 104.-2-23 Pursuant to application dated 8/28/2014 and approved by the Building Inspector. To expire on 3/10/2016. Fees: ACCESSORY $100.00 CO -ACCESSORY BUILDING $50.00 ELECTRIC $90.00 Total: $240.00 Building Inspector Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings,property lines,streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-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. B. For existing buildings (prior to April 9, 1957)non-conforming uses,or buildings and"pre-existing"land uses: 1. 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.If a 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$50.00,Additions to dwelling$50.00, Alterations to dwelling$50.00, Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,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 of Occupancy-Residential$15.00,Commercial$15.00 Date. New Construction: // Old or Pre-existing Building: i/ (check one) Location of Property: �`7� �2(�; aA �� Cc,_�_ House No. '" Street " Hamlet Owner or Owners of Property: S� ��� �d C�� C�U v e Suffolk County Tax Map No 1000, Section U L Block Z Lot 2 Subdivision Filed Map. Lot: Permit No. 4 Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: c// (check one) Fee Submitted: $ U' A ' ant ignature CONSENT.TO INSPECTION j �� ► v� W 2 CS the undersigned,do(es)hereby state: Owner(s)Name(s) That the undersign d(is)(are)the owner(s)-of the premises in the Town of' Southold,located at '*7.5 _ which is shown and designated on the Suffolk. ty,Tax Map-as District 1000, .SectionjQq .Block . Z ,Lot 23 That the undersigned(has)(have)filed,or cause to be filed;an.application in the Southold.Town Building Inspector's Office for the fo_llowing: ' ;(klrv, o ICvI�(e �Kul'' Zb S1' C e ` t rift f��'i 1ii Le 4, - i That the undersigned do(es)hereby give consent,to the Building Inspectors of the i Town of Southold to eater upon the above described property,including any and all buildings located thereon,to conduct-such inspections as they may deem necessary with respect to the aforesaid application,including inspections to determine that said premises comply with all of the laws,ordinances,rules and regulations of the Town of Southold. The undersigned,in consenting to such inspections,do(es)so with the lmowledge and understanding that any information obtained in the conduct of such inspections may be used in subsequent prosecutions for violations of the laws,ordinances,rules or regulations of the Town of Southold. Dated: O 1h. V " - ht Name) • (Signature) (Print Name) f i SO�j��®� Town Hall Annex ® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 �� roper.richert(CD-town.southold.ny.us Southold,NY 11971-0959 COU BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Powers Address: 1475 Sterling Road city:Cutchogue st: New York zip: 11935 Building Permit#: 39164 Section. 104 Block: 2 Lot. 23 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: MTS Power Systems License No: 39289 SITE DETAILS Office Use Only Residential X Indoor Basement Service Only Commerical Outdoor X 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt Ceding Fixtures HID Fixtures 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 Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks Disconnect Switches Twist Lock Exit Fixtures TVSS Other Equipment: Standby Generator with 150A Transfer Switch. Notes: Inspector Signature: Date: August 16, 2017 0-Cert Electrical Compliance Formas OF SOUlyolo cou TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) J/�'J ELECTRICAL (FINAL) REMARKS: 61 A 0�/_ c e�10 DATE . ,� j — INSPECTORv t TOWk-OF S� UTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD, NY 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey SoutholdTown.NorthFork.net PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined 20 Single&Separate Storm-Water Assessment Form 1 Contact: <( "Approved 20 Mail tot i Disapproved a/c 14-111 N(66k ( 3s Phon /( Expiration l d ,20_A_�p CPvoof' - I S � 9A`� Building Ins' ctor ID W APPLICATION FOR BUILDING PERMIT AUG 2 8 2014 0 Date BLDG DEPT INSTRUCTIONS TOWN OF SOUTHOLD a. I his application e completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accurate plot plan to scale.Fee according to schedule. b.Plot plan showing location of lot 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. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County,New York,and other applicable Laws,Ordinances or Regulations,for the construction of buildings,additions,or alterations or for removal or demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code,housing code, gulations,and to admit authorized inspectors on premises and in building for necessary inspections. (Signatdre7f applicant or name,if 4 corporation) f��f2 �Oew ��i�,h wc+� Fli�d�r✓�o�Uc�(e Nil d 1735 (Mai mg addless of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder aa P,if& I Name of owner of premises 1`� CEJ�V) ?owe(5 (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. G Electricians License No. sq — M Other Trade's License No. 1. Location of land on which proposed work will be done: Jnrge- N`-I House Number S eet J yHamlet County Tax Map No. 1000 Section 0 Block Z Lot Z_J Sutdivisio Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Z -CS b. Intended use and occupancy ¢,3 CQ 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work (�' ��(- .r (Description) 4. Estimated Cost 10 ,606 Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation?YES NO—�k- 13. Will lot be re-graded? YES NO �A* ,Will excess fill be removed from premises?YES NO 14. Names of Owner of premises l eyi h ?3 wers Address Phone No. U 676 Name of Architect Address Phone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO Xs 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_ 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. 18. Are there any covenants and restrictions with respect to this property? * YES NO —K-- * IF YES,PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF N t1 being duly sworn,deposes and says that(s)he is the applicant (Name of individu 1 signing contract)above named, (S)He is the (Contract Agent,Corporate Officer,etc.) of said owner or owners,and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief;and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this day of20 1 V oQa n nature plicant f N Y. Qualified� jyaon Commission Expues'6/1372 t ' r ''a Scott A. Russell °Su�TQ �T(0)j [ - SUPERVISOR MANAGEMENT NT z SOUTHOLDTOWN HALL-P.O.Box 1179 D 'own of Southold 53095 Main Road-SOUTHOLD,NEW YORK 11971 'Lj� CHAPTER 236 - STORMWATER MANAGEMENT-WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) - - - - -- - --- DOFS TMS PROJECT I1�TVCDI. " 1F3]CL�D�4lIN (CHECK ALL THAT APPLY) Yes No ❑[ A. CIearing, grubbing, grading or.tripping of land which affects more than 5,000 square feet of ground surface_ t ` ] B. Excavation or f illing involving more than 200 cubic yards of material within any parcel or any contiguous area. ❑ j C. Sitd preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. [l Va D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. El E. Site preparation within the one-hundred-year floodplain as depicted on FIRM Map of any watercourse. - -- :-El�:.F. Installation- of new -or--resurfaced-impervious-surfaces of a,_QQQ square_-4_ r feet or more, unless prior approval of a Stormwater Management 1 Contro-I Plan was received by the Town and the proposal includes in-kind teplacement of impervious surfaces. - If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name, Signature, Contact Information, Date & County Tax Map Number! Chapter 236 does not apply to your project. If you answered YES to one or more of the above, please submit Two copies of a Stormwater Management Control Plan and a completed Check List Form to the Building Department with your Building Permit Application. -- ----=— --- — --------- --- -- - Date: APPLICANT_ (Property Owner,Design Professional. Contractor,Other) e S•C-T.M. 1000 �L District / NAME: Ct r/2t . _ t v r 2 3 N Section Block Lot FOR BLt1LDI C DEllf;RTME-NT USE ONLY Contxt)nform�twre ry�✓O �r��/� - RcrcpcmcNumt:d Reviewed By. Date: Property Address / Location of Construction Work: — — — — — — — — — — — — — — — /q 73' ` ,/�r�� �� Approved for processing Budding Permit- — — — r Stormwater Management Control Plan Not Required. Ct)& ❑ Stormwater Management Control Plan is Required. r (Forward to Engineering Department for Review.) FORM - SMCP-TOS MAY 2014 631-750-6661 08:34:54 a.m. 08-16-2017 1 /1 17t1f lbf ZVI f k2b.17b bJl f bObb4l bUU 1 HULL 1 KUB 1 tt5 h'AUL F71f bl TOM HaU Amax � J� Telooppheone(�fi881)7865-1802 X4375 Main Road c ilager,rid7�rtCQ2tow' 3i.saUEn5U1 P-0.Box 1179 .ml.us Southold,NX 11971.11959 I3LJMUNG DEPART11WWr �rawzv aF sotcrx�aa� A#�PLICATION FOR ELECTRICAL INSPEQTION REQUESTED BY: Date: l� Company Name: Name: License No.: Address: Phone No.: r.Moto . 401381TE INFORMATION: ( Indicates required information) "Name: *Address: *Cross Street: i C Tr-cf kbdd *Phone No.: (__7SD_ Permit No.: I(Q Tax-Map District 1000 Section: Q Bloats:_ �, Lot-, 23 *BRIEF DESOMPTION OF WORK(Please print Cleady) ' (Please Circle All That APpiy) *Is job ready for Inspeutron; Qi? No. Rough In Final *Do•you need a Tamp Certiffc:ate: , Yr=8 EOW Tamp Information:(if. ad) 'Service Size: 9 so 3Phase 100 454 4a�, 300 350 400 Other ' New Saw)= Re-conn Underground NuMber of Meters ( Change of Service Overhead Additional Information: PAYMENT DUE WITH PPLI ATION B24Request For Inspection Farm TOWN OF S®U'i'HOLD PROPERTY RECORD,. CARD OWNER STREETl VILLAGE 'DISTRICT SUB. LOT�y„ s .� �'0�v l e Illy Ina:_ �W'T� / ��F-- ,�:�GI r3'�'� C.• �✓ 7'c 19� � - FORMER OWNER '� u© N j� E ACREAGE 1 _ ff S W TYPE OF BUILDING RES. 'x v� SEAS. VL. FARM COMM. I IND. I CB. I MISC. I Est. Mkt. Value LAND IMP. TOTAL DATE / REMARKS , �c J 3 4 © 3 f d e-,; z1 �5,�l / 7��/G' i1 c^G,� C ��`'`U��+�a c�t a�/Gr1 ':r�•f[ � ei �' it / •� ,f -ter U �`��`® �+ ` 1 e17- 10l? '7.7 ALD,? l CRC tt V 3a=x; Hua b 1 DDi i�an� '�� !l o r ��';�� t�I � od C1J a► illr, t/0 .­ / BUDDING CGNDIT ON - -7/o)—Josfp1q Jr4t1 � l4-c p0 sSoo �z� 3, �� FRONTAGE ON WATER Farm Acre Value Per Acre Value FRONTAGE ON ROAD Tillable 1 BULKHEAD Y� rel/r/–�1G Tillable 2 DOCK Tillable, 3 Woodland ­211 �c* – J QS2 J ., Swampland l r7 W m - ( g7j5-M a � it 1)o f'VI2 �c -n Brushland _ (p CI D +' �V�Pi,Ftl '' r;ti,2 LtSLS i 1t House Plo v +� g 2--L. 6&uyls -I\JC, Total r, ! 1 � i-i�,nyrf.�;c t•.fr ��G�;�.�5•, V• - �� i i ,s °r �, ''m-.%-'.�.I„�� .lf/�'�•4;};"� 'tS-. P�.r`n .!' _ :i, I l �j"� �l/`� ' i ���xc,,. .� � , I y 1 6e, /li 11 VIM + �„' :�. :,�it,*'.•i'�.,,..,%"�.?3F: 1'�i'� w'%Xl'"sP'" i� ��"`: �r'. � ,'�; ��<-?^'u�`'�"a`„r',;,' M. Bldg. ! 2-- 3 `7 S �- FoVdation Extension Ba ement Floors , Extension I n Ext. Walls Interior Finish + Extension Fire Place Heat _•. , Porch Roof Type ;a;•- .�.., t _ Porch Rooms 1 st Floor f �J Z �/� = >S�© /� Sa S.rx, Patio Rooms 2nd Floor I Garage Driveway Dormer i. l 1 O. B. Kohler 20 RESA generator(48x26 2x29.n) _ to be 5 feet from house,as per manufacturers specs N SURVE� ryYOk PROPERTY Al 4UTCHOWE J TOWW` OF SOUTHOLD ! SUFFOLK COUNTY, N.Y.. 1 } 100th-10f-M M & 24 - N86u6'Oa E I� AMW 24 2012 11&16' NgS'�t WE 125,41', FE W �►nev�t 0. 41, D ��++ Y ? ' 1EIed--10l-dk`,L�4 CP-O F10 ` 'q,p'0 00- 5 P ASL=,17,49!SQ.fT. a - Y! $ QM vo w ftAPA110 �Oa� �d ,/11 �� Ifl' � y aP ��• � J 1 FRA-4E RA-4E A ARM Q f $jo � m 14AMSa moi. WELL u� / / t q J P� MGM la m xwr s¢s-asoo,�r goad' Yjt7]�s�e����s'jaa�a g�p� p� AT(RIP)RVV?70 WAP f'NASSAU fAR4'FW W tiSd�'%lbYfllb ROAD 6°A90i 24 rM AS FS,S xA r; ANY ALIEM W OR AWVW M 7W Si 7WV 15 A"247M AY.S !1G Ma 4961/1 W MCM 72OW RX Adler Yam srAw EMU VW eAJ9 £C(iN1iC ron P.C. Zg&r AS MR 5MMW M&MM AW Myy , Z Y (631) 765-5020 FAX(631) 765-1797 atv JMM A4 ttn+ts E2AR rNF avftcx_ssEn s?at of fttE 57tTSfiiW P.O. BOX SQ9 Su7VARAW 4PffAg5 MEM 123p 7RAMER S1Rff'T sour f&A we 1797, F1.0-223 . r APPROVED AS NOTED COMPLY !KITH ALL CODES OF DATE: B.P. NEW YOR E` STAI E: & TOWN CODES FE BY. AS REQUIRED KID GQ^,��Tinnic n� NOTI BUILDING DEPARTMENT AT 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: SC ni n rroeini ai ani i ARD 1. FOUNDATION - TWO REQUIRED SOU1=0MrRIi4TEES FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING P .S.DE 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR CO. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR ELEG F-iiCAL DESIGN OR CONSTRUCTION ERRORS. NFS�F_-CT RE(3U0 R. _.00CUPANCY OR ",,-USE IS UNLAWFUL WITHOUT- CERTIFICATE OF OCCUPANCY r } Models: 14r/20RESA Multi-Fuel KOHLER. Power Systems LPG/Natural Gas GreenButlder' O sM""- ® ®° Standard Features �Iw �5i5rEnas • RDC2 Controller NATIONALLY REGISTERED o One digital controller manages both the generator set and transfer switch functions (with optional Model RXT transfer switch). o Designed for today's most sophisticated electronics. o Electronic speed control responds quickly to varying household demand, v, r' o Digital voltage regulation protects your sensitive electronics from harmonic distortion and unstable power quality. o Two-line, backlit LCD display with adjustable contrast is easy to read,even in direct sunlight or low light. • Kohler Command PRO Engine Features o Kohler Command PRO@ OHV engine with hydraulic valve The Kohler® Advantage lifters for reliable performance without routine valve adjustment or lengthy break-in requirements • High Quality Power o Powerful, reliable air-cooled performance Kohler home generators provide advanced voltage and o Simple field conversion between natural gas and LPG frequency regulation along with ultra-low levels of fuels while maintaining emission certification harmonic distortion for excellent generator power quality to protect your valuable electronics. • Designed for Easy Installation • Extraordinary Reliability o Polymer base eliminates the need for a concrete Kohler is known for extraordinary reliability and mounting pad, reducing installation time and cost performance and backs that up with an Industry-leading o Hinged, locking roof 5-year or 2000 hour warranty. o Fuel and electrical connections through the enclosure wall • Powerful Performance eliminate the need for stub-ups through the bottom Exclusive Powerboost- technology provides excellent o Load connection terminal block allows easy field wiring starting power. The Kohler 14 kW generator can easily c Designed for outdoor Installation only start and run a 5 ton air conditioner.* • Certifications • Corrosion-Proof Enclosure o Meets emission regulations for U.S. Environmental The bold new Kohler design Is completely corrosion proof, Protection Agency(EPA)with both natural gas and LPG. even in harsh seaside environments,and is Note: CARB does not regulate emergency standby impact-resistant even at-34° C (-30° F). generators with outputs less than 50 HP. Only the EPA • Fast Response standards apply. Kohler's unique Fast-Response' excitation system o UL 2200 listed (60 Hz model) delivers excellent voltage response and short-circuit o CSA certification available(60 Hz model) capability. o GOST certified (Russia) • Quiet Operation • Warranty Kohler home generators provide quiet, neighborhood- o 5-year/2000 hour warranty for on-grid (standby) friendly performance. applications In locations served by a reliable utility source o 18 month/1000 hour warranty for off-grid (non-standby) Generator Ratings applications(Model 14RESA only) Standby Ratings Natural Gas LPG Model Voltage Phase Hz Alternator kW/kVA Amps kW/kVA Amps 14RESA 120/240 1 60 2F5 12/12 50.0 14/14 58.3 115/230 1 50 2F5 10/10 43.5 11/11 478 20RESA 120/240 1 60 2F7 18/18 75.0 20/20 833 115/230 1 50 2F7 14/14 60.8 15/15 652 RATINGS Standby ratings apply to installations served by a reliable utility source.All single-phase units are rated at 0power factor The standby rating is applicable to variable loads with an average load factor of 80%for the duration of the power outage No overload capacity is specified at this rating Ratings are In accordance with ISO-3046/1,BS5514,AS2789,and DIN 6271 GENERAL GUIDELINES FOR DERATING ALTITUDE Derate4%per 305m(I000ft.)elevation above 153m(500ft) TEMPERATURE*Derate2%per 55°C(10*F)temperature increase above 16'C(60°F) Avadab,I ty is subject to change without notice The generator set manufacturer reserves the right to change the design orspecIfications without notice and without any obligation or liability whatsoever Contact your local Kohler Cc generator distributor for availability Check the appliance manufacturer's specifications for actual power requirements. Consult a Kohlerm Power Systems professional to calculate your exact residential power system requirements G4-209 (14/20RESA) 11/13e 1 I Alternator Specifications Alternator Specifications Alternator Features PowerBoost- Generator e Compliance with NEMA, IEEE,and ANSI standards for Specifications 1-Phase temperature rise Manufacturer Kohler Output reconnectable 120/240 * Self-ventilated and drlpproof construction Type 2-Pole,Rotating Field • Vacuum-impregnated windings with fungus-resistant Leads,quantity 4 epoxy varnish for dependability and long life Voltage regulator Digital • Superior voltage waveform and minimum harmonic Insulation. NEMA MG1-1 66 distortion from skewed alternator construction Material Class H • Digital voltage regulator with±1.0% no-load to full-load Temperature rise Class H RMS regulation Bearing-quantity,type 1,Sealed Ball • Rotating-field alternator with static exciter for excellent Coupling Direct load response Amortisseur windings Full • Total harmonic distortion (THD)from no load to full load with Voltage regulation,no-load to full-load a linear load is less than 5%. RMS ±1.0% One-step load acceptance 100%of Rating Peak motor starting kVA @ 240 V: 14RESA 35 20RESA 405 Application Data Engine Engine Electrical Engine Specifications 14RESA 20RESA Engine Electrical System 14RESA 20RESA Manufacturer Kohler Ignition system Electronic, Engine-model,type CH740 CH1000 Capacitive Discharge 4-Cycle 4-Cycle Starter motor rated voltage(DC) 12 Cylinder arrangement V-2 Battery(purchased separately)- Displacement,cm3(cu.in.) 725(44) 999(61) Ground Negative Bore and stroke,mm(in.) 83 x 67 90 x 78.5 Volts(DC) 12 (3 27 x 2 64) (3.54 x 3.1) Battery quantity 1 Compression ratio 9:1 8.8.1 Recommended cold cranking amps- Main bearings:quantity,type 2,Parent Material (CCA)rating for-18°C(0°F) 500 Rated RPM Group size 51 60 Hz 3600 50 Hz 3000 Lubrication Max.engine power at rated rpm,kW(HP) Lubricating System 14RESA 20RESA LPG,60 Hz 17.6(23.6) 230(30.9) Type Full Pressure LPG,50 Hz 15.8(21.2) 20 0(26 8) Oil capacity(with filter),L(qt)* 1.8(1.9) 2.7(29) Natural gas,60 Hz 153(20.5) 20.2(27.1) Oil filter quantity,type 1,Cartridge Natural gas,50 Hz 138(18.5) 16 8(22 5) Oil cooler Integral Cylinder head material Aluminum * Oil capacity for a new,dry engine. Valve material Steel/Stellate® Fuel Pipe Size Piston type and material Aluminum Alloy Crankshaft material Heat Treated,Ductile Iron Minimum Gas Pipe Size Recommendation,in.NPT Governor-type Electronic 14RESA 20RESA Frequency regulation,no load to full load Isochronous Natural Natural Frequency regulation,steady state ±0.5% Pipe Gas LPG Gas LPG Length, 193,000 203,000 281,000 340,000 Air cleaner type Dry m(ft.) Btu/hr. Btu/hr. Btu/hr. Btu/hr. Exhaust 8 (25) 3/4 3/4 1 3/4 15 (50) 1 3/4 1 1 Exhaust System 14RESA 20RESA 30 (100) 1 1 1 1/4 1 Exhaust temperature exiting the enclosure at rated kW,dry,°C(°F) 260(500) 46 (150) 1 1/4 1 1 1/4 1 1/4 61 (200) 1 1/4 1 1 1/4 1 1/4 G4.209 (14/20RESA) 11/13e Fuel Requirements RDC2 Controller Fuel System 14RESA 20RESA Fuel types Natural Gas or LPG I Fuel supply inlet 1/2 NPT Vollage 240 V Fuel supply pressure,kPa(in.H2O): Fraq sooriz Natural gas 1.2-2.7(5-11) ® o 0 0 0 LP 1.7-2 7'(7-11) 4®Q o O O r Fuel Composition Limits* Nat.Gas LPG �+ Methane,%by volume(minimum) 90 min Ethane,%by volume(maximum) 4.0 max. - Propane,%by volume 1 0 max 85 min. Propene,%by volume(maximum) 0.1 max. 5 0 max The RDC2 controller provides integrated control for the C4 and higher,%by volume 0.3 max. 2.5 max. generator set, Kohler@ Model RXT transfer switch, Sulfur,ppm mass(maximum) 25 max. programmable interface module(PIM), and load control module Lower heating value, LCM MJ/m3(Btu/ft3),(minimum) 33 2(890) 84.2(2260) ( ) * Contact your local distributor for suitability and rating derates based The RD02 controller's 2-line LCD screen displays status on fuel compositions outside these limits. messages and system settings that are clear and easy to read, even in direct sunlight or low light. Operation Requirements Fuel Consumption RDC2 Controller Features Fuel Fuel Consumption,m3/hr.(cfh) • Membrane keypad Model Type %Load 60 Hz 50 Hz o OFF,AUTO, and RUN pushbuttons 100 54 (193) 49 (175) o Select and arrow buttons for access to system 75 4.7 (163) 4.2 (148) configuration and adjustment menus Natural 50 35 (124) 3.1 (108) a LED indicators for OFF,AUTO,and RUN modes Gas 25 2.6 (93) 2.4 (84) a LED indicators for utility power and generator set source Exercise 1.7 (60) 1.7 (60) availability and ATS position (Model RXT transfer switch 14RESA 100 2.3 (81) 2.1 (74) required) 75 2.1 (75) 19 (68) • LCD display LPG 50 1 8 (60) 15 (53) o Two lines x 16 characters per line 25 1.2 (45) 1.1 (40)_ o Backlit display with adjustable contrast for excellent Exercise 0.8 (30) 0.8 (30) visibility in all lighting conditions 100 80 (281) 64 (225) a Scrolling system status display 75 6.9 (243) 5.4 (189) o Generator set status Natural 50 4.6 (161) 3.9 (139) o Voltage and frequency Gas 25 3.6 (127) 2.9 (103) o Engine temperature Exercise 2.0 (71) 20 (71) o Oil pressure 20RESA 100 3.9 (136) 29 (102) o Battery voltage 75 3.1 (109) 2.4 (85) o Engine runtime hours LPG 50 2.3 (82) 1.8 (63) . Date and time displays 25 17 (59) 13 (47) a Smart engine cooldown senses engine temperature Exercise 1.0 (35) 1.0 (35) Nominal fuel rating: Natural gas: 37 MJ/m3(1000 Btu/ft 3) a Digital isochronous governor to maintain steady-state speed LPG: 93 MJ/m3(2500 Btu/ft.3) at all loads LPG conversion factors- 8.58 ft 3=1 Ib. a Digital voltage regulation: ±1.0% RMS no-load to full-load 0.535 m3=1 kg • Automatic start with programmed cranking cycle 36.39 ft 3 =1 gal. a Programmable exerciser can be set to start automatically on any future day and time,and run every week or every two Sound Data weeks Model 14RESA 8 point logarithmic average sound levels are a Exercise modes 63 dB(A)during weekly engine exercise and 67 dB(A) during o Unloaded weekly exercise with complete system full-speed generator diagnostics and normal operation. The diagnostics lowest point sound levels are 5&dB(A) and 63 dB(A) o Unloaded full-speed exercise respectively as compared to competitor ratings.* o Loaded full-speed exercise(Model RXT ATS required) Model 20RESA 8 point logarithmic average sound levels are a Front-access mini USB connector for SiteTech' connection 64 dB(A) during weekly engine exercise and 69 dB(A) during * Front access mini-breaker protects the alternator full-speed generator diagnostics and normal operation. The • Integral Ethernet connector for Kohler®OnCue' lowest point sound levels are 62 dB(A)and 67 dB(A) a Built-in 2.5 amp battery charger respectively as compared to competitor ratings.* • Remote two-wire start/stop capability for optional connection All sound levels are measured at 7 meters with no load. of Model RDT or RSB transfer switches * Lowest of 8 points measured around the generator. Sound levels at See additional controller features on the next page. other points around generator may be higher depending on installation parameters G4-209 (14/20RESA) 11/13e KOHLER CO.,Kohler,Wisconsin 53044 USA Kohler Power Systems Phone 920-457-4441,Fax 920-459-1646 Asia Pacific Headquarters For the nearest sales and service outlet in the 7 Jurong Pier Road US and Canada,phone 1-800-544-2444 Singapore 619159 KOHLERPowercom Phone(65)6264-6422,Fax(65)6264-6455 Additional RDC2 Controller Features Available Options, Continued • Diagnostic messages Controller Accessories o Displays diagnostic messages for the engine,generator, ❑ Emergency stop kit Model RXT transfer switch, programmable Interface ❑ Programmable interface module(PIM) module (PIM),and load control module(LCM) (provides 2 digital inputs and 6 relay outputs) o Over 70 diagnostic messages can be displayed ❑ Load control module(LCM) • Maintenance reminders (provides 4 power relays and 2 HVAC relays) • System settings Electrical System o System voltage,frequency,and phase o Voltage adjustment ❑ Battery o Measurement system, English or metric ❑ Battery heater • ATS status(Model RXT ATS required) Fuel System o Source availability o ATS position (normal/utility or emergency/generator) ❑ Braided stainless steel flexible fuel line o Source voltage and frequency Literature • ATS control (Model RXT ATS required) ❑ General maintenance literature kit o Source voltage and frequency settings ❑ Overhaul literature kit o Engine start time delay o Transfer time delays ❑ Production literature kit o Voltage calibration Starting Aids o Fixed pickup and dropout settings ❑ Carburetor heater, 120 VAC(recommended for • Programmable Interface Module(PIM)status displays reliable starting at temperatures below 0°C [32°F]) o Input status (active/Inactive) ❑ Fuel regulator heater pad (20RESA; recommended for o Output status (active/inactive) reliable starting at temperatures below-18°C[0°F]) • Load control module(LCM) menus Kohler®Automatic Transfer Switch o Load status o Test function ❑ Model RXT,see specification sheet G11-121 Generator Set Standard Features ❑ Model RDT,see specification sheet G11-98 • Battery cables ❑ Model RSB,see specification sheet G11-101 • EPA certified fuel system ❑ Other Kohler@ ATS • Corrosion-proof polymer sound enclosure • Critical silencer Generator Set Dimensions and Weights • Field-connection terminal block Overall Size,L x W x H. 1216 x 665 x 733 mm (48 x 26.2 x 29 In.) • Fuel solenoid valve and secondary regulator Shipping Weight. 14RESA 191 kg(420 Ib.) • Line circuit breaker: 20RESA 243 kg (535 Ib.) 14RESA: 70 amps 20RESA: 100 amps L • Multi-fuel system, LPG/natural gas,field-convertible • Oil drain extension with shutoff valve • Premium 5-year limited warranty H i • 18-month limited warranty for non-standby(off-grid) applications (14RESA only) 1 • RDC2 generator set/ATS controller jj— W • Rodent-resistant construction NOTE* Dimensions are provided for reference only and should not be used for planning • Sound-deadening,flame-retardant foam per UL 94, installation Contact your local distributor for more detailed information class HF-1 Available Options DISTRIBUTED BY: Approvals and Listings ❑ CSA approval Communication Accessories ❑ OnCues Generator Management System ©2011,2012,2013 by Kohler Co,All rights reserved. G4-209 (14/20RESA) 11/13e 8 7 6 5 4 3 2 I D D 1217 147,91 AIR INLET LOW VOLTAGE ELECTRICAL EXHAUST AIR STUB-UP AREA C OUTLET C 0 112 NPT xQ ® ® ® (FEMALE) o FUEL INLET ® �m _ OO B APP ROX SPAN OPE13POSITION 4X 031 1 CI 501 620 124 41 .1.313 [123] 141 .n B LIFTING HOLES CS 5] 13 CO 51 168 [6 6] HIGH VOLTAGE 63 ELECTRICAL • 12 51 STUB-UP AREA LOW VOLTAGE COMMUNICATION LEADS TT n� r° HIGH VOLTAGE LOAD LEADS NOTE DIMENSIONS IN 13 ARE INCH EQUIVALENTS A A 501 �7 REF REV DATE ON CONPGGITE ONGS SEE PART NO FOR REVISION LEVEL BV xj .Nl�ni KOHLER CQ METRIC PRO-E 119 75) - 10-24-11 NEVI DRAPING 192069-11 DOH riiaii �rt°)tl rtH Fv FONER SYSTE.S nox LFR WI eJ044 u N o 4-X0--, 0 1 6 4 3] A 3-1-12 (5-41 LOW VOLTAGE 9 HIGH VOLTAGE LEADS SHOWN CCT055551 VPP i IN: iH IS DRAWING in DESIGN AND DETAIL 5 xR AER CO MOUNTING HOLES I B 5-30-12 SEE SHEET 3 OF 4 ECT149921 GFR nwL[s: ° "N'.vftoe[RTx AND xusr xai BE USED EXCEPT IN -jl / T CONNECTION 11TH IONLER RESERVED ALL RIGHTS OF 270 L 10 61 6� 20 124 41 �� N C 3-1-13 SEE SHEET 4 1CT3903D1 SVP d x'' DESIGN DN IWITIN IOx ARE COO WORK D 4-16-13 SEE SHEET 4 ECT438451 SVP -� 1190 1469) OIA - DATE DIMENSION PRINT 22H 10-24-1I 14/20RESA ODx IG-24-11 .13N 10-24-11 ADV-8424 D 8 7 6 5 4 3 2 1 8 7 6 5 4 3 2 I D p - OIL FILTER AIR CLEANER OIL DIPSTICK ? . 8 rwy �0 8 IL FILL EXHAUST) AIR OUTLET - - - OIL DRAIN VALVE A A REV DATE ON COMPOSITE MS SCE PART NO EOR REVISION LEM By xRIIRt= KOHLER CO. METRIC PRO-E 10-24-11 NEW DRAWING[92089-I1 DDH i1 iatel 1nlsiii E POWEN SYSTEMS E,ONLCR .1 A 3-1-12 SEE SHEET I ECT055551 VPP i V t IS ORAWIx'u 111 DESIGN AND OFTAIL 5 K.—M CO B 5-30-12 SEE SHEET 3 OF d 1GT14992] GFR I-Es: 4 'E"PROeERT,AxD MusT xot DE uSED%F C 3-1-13 SEE SHEET 4[CT390301 SVP �d rMA' OESIGgTOPx IWI ENTFOMEARECNFSERVE6 ALI RIGxiS Of D 4-16-13 SEE SHEET 4 ECT438451 $VP xv APPRDVALs I DATE DIMENSION PRINT DDn Io-z4 11 4 zs<a 14/20RESA DDx ID-24-11 a,o JJN to-z4-11 ADV-8424 D 8 7 6 5 4 3 2 I 8 7 6 5 4 3 2 I D D ` - LOAD CIRCUIT BREAKER '' _ :w''•J USB PORT ONTROLLER •, •'dz,- 43 Lay'i= - .. _ i� :' :•T+.- �'ii''d CUSTOMER CONNECTION BLOCK (LOCATED _ _ - _ ��...�.:.'i:' �:ii BEHIND PANEL) l <r BATTERY CABLES -. r^,tl, ;,r�u•-rte�'"`�''~ ""nom (INCLUDED) AIR INLET BATTERY LOCATION (BATTERY NOT NCLUDED) IL DRAIN HOSE A A REV DATE ON COxPOSRE DWGS SEE PART No FOR REVISION LEVEL By °6GIx[Ras i[51°c anon,, KOHLER CO, METRIC PRO-E - 10-24-II NEW DRAWING 192089-I1 DON N•"aL°'n'v EPOWER SrsTENS .RLER WI Sita, u A 3 1-12 SEE SHEET I ICTD55551 ON i AT H5 R4WIxo IN GEN IGx x0 GFTEYL 5 nNxLER c0 B 5-30-12 (C-2)USB PORT WAS FUSES A USE PORT ECT14992]GER ivNLEa 3 ' / ° ROPEATR Ax 5i Gr BE SEG EPi C 3-1-13 SEE SHEET 4 CCT390301 SVP I faNs CO DES- WITN RONLER Co WORN ALL RIGxfS or ' CES IGx ON IDITH IOx ARE RESERVED D 4-16-13 SEE SHEET 4 ICT438451 SVP .i *--.EEEj 11-APPROVILS ATF DIMENSION PRINT DDH 10024-I 14/20RESA DDH 10-24-11•-,e JJN 10-24-11 ADV-8424 D 8 7 6 5 4 3 2 I 8 7 6 5 4 3 2 0 0 U OCCUPIED STRUCTURE OCCUPIED STRUCTURE OCCUPIED STRUCTURE D OCCUPIED STRUCTURE D 18" MIN SERVICE DOOR SET 18" MIN s 0 U SERVICE DOOR °J4 SET � w 7 � a ?= LL�N s W O— C z f �� C SERVICE DOOR zN "�N SET aW SET mo— WQ _ mQ a z SERVICE DOOR >o 4 FT GRAVEL BED AT EXHAUST END w 6 IN GRAVEL ON ALL REMAINING SIDES z 8 FT aoo= ECOMMENDED c>o DISTANCE — zo ACCEPTABLE �w 1) EXHAUST IS AIMED AWAY OR PARALLEL TO STRUCTURE a E r 2) EXHAUST IS NOT DIRECTED AT PLAY AREAS, PATIOS OR OTHER AREAS VIHERE PEOPLE CONGREGATE B 3) THE NEAREST WINDOW, VENT, DOOR OR SIMILAR STRUCTURE 6 Eoa — OPENING IS AT LEAST 5 FEET FROM THE EXHAUST END OF THE SET 10 4) SET HAS PROPER OFFSET FROM STRUCTURE a NOTE• 5) WINDOWS d DOORS ON ADJACENT WALLS ARE CLOSED 'a 1) THE REQUIRED DISTANCE FROM A 4 STRUCTURE IS DEPENDENT ON STATE AND 6) FUR14ACE AND OTHER SIMILAR INTAKES ARE AT LEAST 10 FEET FROM LOCAL CODES NFPA 37, STANDARDS EXHAUST END OF SET FOR THE INSTALLATION AND USE OF 7) WEED BARRIER AND 3 INCH THICK GRAVEL BASE LOCATED TO PREVENT STATIONARY COMBUSTION ENGINES GRASS 8 WEEDS FROM GROWING Too CLOSE TO THE SET AND GAS TURBINES, STATES THIS 8) NO PLANTS, SHRUBS OR OTHER COMBUSTIBLES ALLOWED IN DISTANCE SHOULD BE AT LEAST 5 FEET GRAVEL AREA (MINIMUM 4 FT FROM EXHAUST END) FROM A COMBUSTIBLE STRUCTURE 2) FOR INSTALLATIONS NEAR NON-COMBUSTIBLE 9) SENSITIVE PLANTS, PATIO FURNITURE, ETC ARE AT LEAST 8 FEET FROM STRUCTURE, A MINIMUM DISTANCE OF 18" IS EXHAUST END OF SET REQUIRED TO ENSURE PROPER GENERATOR COOLING 10) REFER TO OWNERS MANUAL FOR OTHER INSTALLATION CONSTRAINTS A 11) NO PLANTOF S SHRUINTABS OR OTHER COMBUSTIBLES ALLOWED WITHIN A REV DATE ON COMPOSITE OWLS SEE PART NO FOR REVISION LEVEL BV U wNtIA[I METRIC PRO-E B 5-30-12 SEE SHEET 3 OF 4 [CT149921 GFR AI FS Art ' KCINLER CO, pw[R SYSTEMS D EO-2 D-5 C-3)DIM I8'MIN `d/I°s°CoOENS NIEGCN TpFIOR N IIxIVI ETNxi M1lM1OOONxNLEARqE<0nEWI SRVEp14 U C 3-I-13 NOTE R UPDATED. NOTE it AODEO, f0.-SI DESIGN ED DETAIL IS KOHLER CO NOTE UPDATED (C-a D-1)DIM IB'MIN 3 FT PO3[OAN ANSI 101 0USEFOORNEI[APLL R-IGNTSOf RECOMMENDED AUDI ADDED[CT390301 svP '°"° B° DIMENSION PRINT D 4-16-13 (0-4,D-7,C i C 5,1'TO LAWN FURNITURE,SENSITIPPROVALS I DATE PLANTS ETC'NOTE REMOVED IA-21'EMININUN 4 FT FROM DDH 10-24-II sus 0 4D uoo —4.1 4 14/20RESA EXHAUST END)'ADDED,(B-7)NOTES REMCVEO IC1438451 SVP`°` DDN 10-24-11 oR a �° JJN ID-24-u ADV-8424 D 8 7 6 5 4 3 2 1 DATE(MM/DD/YYYY) A��® CERTIFICATE OF LIABILITY INSURANCE 8/28/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Fatima Lorenzo NAME. National Insurance Brokerage of New York, Inc. P"C.N (631)273-4242 FAX No) (631)273-8990 175 Oval Drive EDORLEss florenzo@nibony.corn INSURER(S)AFFORDING COVERAGE NAIC# Islandia NY 11749 INSURERAMerchants Mutual Insurance Co 23329 INSURED INSURER B Merchants Preferred Ins Co. 12901 MODERN ELECTRICAL TECHNOLOGIES INC INSURERc:Hartford Property & Casualty 34690 PO BOX 1624 INSURERD:First Rehabilitation Ins. Co. 81434 INSURER E QUOGUE NY 11959-1624 INSURERF' COVERAGES CERTIFICATE NUMBER:CL1462415584 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 IADDLSUBR N R WVD POLICY NUMBER MM/DDY EFF MMIDDn XP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 500 000 PREMISES Ea occurrence $ r A I CLAIMS-MADE X❑OCCUR BOPI050110 6/30/2014 6/30/2015 MED EXP(Any one person) $ 15,000 X Contractual Liabil3.ty PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PRO LOC $ AUTOMOBILE LIABILITY EO aBIINdE�DtSINGLE LIMIT 1,000,000 B X ANY AUTO BODILYINJURY(Per person) $ ALLOWNED SCHEDULED API052462 6/30/2014 6/30/2015 BODILYINJURY(Per accident) $ AUTOS AUTOS XX NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS PeracadZ Medical payments $ 5,000 UMBRELLA LIABOCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED RETENTION$ $ („` WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N X O LIMITS ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory In NH) 12WECZY8232 6/30/2014 6/30/2015 E L DISEASE-EA EMPLOYE $ 100 000 If yes,describe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ 500,000 D Disabil3.ty D424311 /1/2014 Cont3.nuous STATUTORY LIMIT DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) The Certificate Holder 3-s included as additional insured A.T.I.M.A with respect to General Liability as required by wr3.tten 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. 53095 Route 25 Southold, NY 11971 AUTHORIZED REPRESENTATIVE Frank Corm3.o/FATIMA ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. IKIS026 oninn91 M Tha annizr1 nnma eknrl Innn am raniclararl marlrc of Ar'npn