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123 HAYDENVILLE RD COMMONWEALTH OF MASSACHUSETTS BP-2021-1834 Map:Block:Lot:11-002-002 Permit: Alts Renovations CITY OF NORTHAMPTON Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS • DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2021-1834 PERMISSIONIS HEREBY GRANTED TO: Project# ANTENNA Contractor: License: Est.Cost: 35000 RICHARD BUKER 108437 Const.Class: Exp.Date:09/10/2022 Use Group: Owner: GLOBAL TOWER ASSETS LLC Lot Size (sq.ft.) Zoning: SC Applicant: TILSON TECHNOLOGY MANAGEMENT INC Applicant Address Phone:, Insurance: 16 MIDDLE ST (413)822-1712 WA2-65D-29 1 9 1 6-03 1 PORTLAND, ME 04101 ISSUED ON:09/13/2021 TO PERFORM THE FOLLOWING WORK: INSTALL 3 ANTENNAS POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: • • _ . Xi + 11 • Fees Paid: $245.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner Z - QK File #BP-2021-1834 APPLICANT/CONTACT PERSON:TILSON TECHNOLOGY MANAGEMENT INC 16 MIDDLE ST PORTLAND, ME 04101(413)822-1712 PROPERTY LOCATION 0 HAYDENV1LLE RD MAP:LOT 11-002-002 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Building Permit Filled out Fee Paid $245.00 Type of Construction: INSTALL 3 ANTENNAS ,6 New Construction Non Structural Renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement orLicense 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: .1( Approved Additional permits required (see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Plan Major Project: Site Plan AND/OR SpecialPermit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § • Finding Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclosed Other Perm its Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay 972_, Si ture of Building ficia l Date / Note:Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health, Conservation Commission,Department of public works and other applicable permit granting authorities. *Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of Planning&Development for more information. �1lC. TOTALLY COMMITTED. August 23, 2021 Town of Northampton Building Department 212 Main Street Northampton MA 01060 Re: ATC #371771— Dish Wireless BOBDL00161A—123 Haydenville Rd Northampton MA- Collocations Dear Building Department, Dish Wireless is proposing to install 3 Antennas, 1 Antenna Mount, 6 RRHs, 1 OVP, 1 Hybrid Cable, all to be installed on existing tower. Dish Wireless ground equipment will consist of installing 1 proposed metal platform, 1 Ice bridge, 1 PPC Cabinet, 1 Equipment Cabinet, 1 Power Conduit, 1 Telco Conduit, 1 Telco —Fiber Box, 1 GPS Unit, 1 Safety Switch if required, 1 Ciena Box if required, 1 Meter Socket, all to installed within our existing lease area. Included for your review and approval are (2) sets of construction drawings,(2) copy's of the Structural Analysis and the Building Permit Application. Please let me know if you require additional information, and once the application is approved please notify me, so I can make arrangements for payment. I can be reached at 267-304-1349 or dgresham@nbcllc.com. Thank you for your assistance. Sincerely, Darryl Gresham Site Acquisition Associate Agent of Dish Wireless 1777 Sentry Parkway W,Veva 17 + Suite 400 + Blue Bell, PA 19422 + '267 460 0122 + www.networkbuilcling.corn The Commonwealth of Massachusetts Office of Public Safety and Inspections Massachusetts State Building Code(780 CMR) Building Permit Application for any Building other than a One-or Two-Family Dwelling n� /n i_ , (This Section For Official Use Only) Building Permit Number. f,7 f�Date Applied: Building Official: SECTION 1:LOCATION 123 Haydenville Road Northampton MA 01053 No.and Street City/Town Zip Code Name of Building(if applicable) NHAM-000011-000002-000001 Assessors Map# Block#and/or Lot # SECTION 2:PROPOSED WORK Edition of MA State Code used If New Construction check here 0 or check all that apply in the two rows below Existing Building 0 Repair 0 Alteration 0 Addition 0 Demolition 0 (Please fill out and submit Appendix 2) Change of Use 0 Change of Occupancy 0 Other ❑ Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes 0 No 0 Is an Independent Structural Engineering Peer Review required? Yes 0 No ❑ Brief Description of Proposed Work: Dish Wireless proposes to install 3 antennas. 1 antenna mount. 6 RRU's, 1 OVP 1 hybrid cable, all to be install on the existing tower. Dish Wireless ground equipment installation will consist of installing 1 metal platform. 1 ice bridge. 1 ppc cabinet. 1 equipment cabinet, 1 power conduit. 1 telco conduit. 1 telco fiber box, 1 gps unit, 1 safety switch if required, 1 ceina box if required, 1 meter socket, all to be install in our existing lease area. SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑ Existing Use Group(s): U Proposed Use Group(s): No Change SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft) Total Area(sq.ft.)and Total Height(ft) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4❑ A-5 0 B: Business 0 E: Educational 0 F: Factory F-1❑ F2 0 H: High Hazard H-1❑ H-2 0 H-3 0 H-4 0 H-5 0 I: Institutional I-1 0 I-2❑ I-3❑ I-4❑ M: Mercantile 0 R: Residential R-10 R-2 0 R-3 0 R-4 0 S: Storage S-1 0 S-2 0 U: Utility a Special Use 0 and please describe below: Special Use Description: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA 0 IB ❑ IIA ❑ IIBEl IIIA ❑ IIIB ❑ IV 0 VA 0 VB 0 SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item) Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal: Public 0 Check if outside Flood Zone 0 Indicate municipal 0 A trench will not be Licensed Disposal Site 0 Private 0 or indentify Zone: or on site system 0 required 0 or trench or specify: permit is enclosed 0 Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable E Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed❑ Yes 0 or No Yes 0 No IX SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): U Type of Construction: I I B Does the building contain an Sprinkler System?: Special Stipulations: Design Occupant Load per Floor and Assembly space: SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner City of Northampton 212 Main Street Northampton MA 01053 Name(Print) No.and Street City/Town Zip Property Owner Contact Information: - - 413-587 -1240 Title Telephone No.(business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes: Name Street Address City/Town State Zip to apply for and act on the property owner's behalf,in all matters relative to work authorized by this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1) If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here❑. Otherwise provide construction control forms(see section 107 in the code)as required. 10.1 Registered Professional Responsible for Construction Control (the professional coordinating document submittals) Inchiia Rrodpr 207-653 -0573 jbroder@tilsontech.com CS-108437 Name(Registrant) Telephone No. e-mail address Registration Number 16 Middle Street 4th FL Portland MF 04101 9-1 0-2022 Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor Tilson Technology Management Inc Company Name Richard Buker Name of Person Responsible for Construction License No. and Type if Applicable 16 Middle Street 4th Fl _Portland ME 04101 Street Address City/Town State Zip - 413 -822 - 1712 rbuker©tilsontech.com Telephone No.(business) Telephone No. (cell) e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§25C(6)) A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Is a signed Affidavit submitted with this application? Yes IN No ❑ _ SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Estimated Costs:(Labor Item and Materials) Total Construction Cost(from Item 6)=$ 35,000 1.Building $ 30,000 Building Permit Fee=Total Construction Cost x _ (Insert here 2.Electrical $ 5,000 appropriate municipal fac pr)=$ 3.Plumbing $ 4.Mechanical (HVAC) $ Note:Minimum fee=$ 2 (contact municipality) 5.Mechanical (Other) $ Enclose check payable to 6.Total Cost $ 35,000 (contact municipality)and write check number here (, gy, SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and ate to t of my knowledge and understanding. Darryl Gresham, AGENT 267 _304 _ 1349 g ZJ-z,i Please print and sign name Title Telephone No. Date 1777 sentry pkwy w veva 17 ste 40(1 Blue Bell PA_ 19422 rtgresham n hcllc corn Street Address City/Town State Zip Email Address ' 9 13 Municipal Inspector to fill out this section upon application approval: 'i Name Dae City of Northampton iatNAM ,0 Massachusetts a+. S�cl` �vr 4f* ° f, DEPARTMENT OF BUILDING INSPECTIONS 1 4 212 Main Street • Municipal Building vs Ca 7~° -: a� Northampton, MA 01060 .1.•. j`� Pt, arD CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: 79 Dow Road Building 2 Bow NH 03304 The debris will be transported by: Name of Hauler: Tilson Technology Management Signature of Applicant: eafili41----------- Date: F 23— 21 The Commonwealth of Massachusetts = Department of Industrial Accidents fr) o,t�l_; Office of Investigations Lafayette City Center _� t 2 Avenue de Lafayette, Boston,MA 02111-1750 wwwmass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Tilson Technology Management, Inc. Address: 16 Middle St., 4th Floor City/State/Zip: Portland, ME 04101 Phone#:207-591-6427 Are you an employer? Check the appropriate box: Type of project(required): 1.❑� I am a employer with 515 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' [No workers' comp.insurance comp.insurance.t 9. ❑Building addition required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no Telecommunications employees. [No workers' 13. Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Liberty Mutual Fire Insurance Company, 175 Berkely Street, Boston, MA 02116 Policy#or Self-ins.Lic.#:WA2-65D-291916-031 Expiration Date:4/1/2022 Job Site Address: 123 Haydenville Road City/State/Zip: Nort ampton MA 01053 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi th pains and penalties of perjury that the information provided above is true and correct. Signature: Date: Jun 11,2021 (207)613-7346 Timothy Schneider,General Counsel Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(check one): lDBoard of Health 21:1 Building Department 3❑City/Town Clerk 4.121 Electrical Inspector 50Plumbing Inspector 6.0 Other Contact Person: Phone#: WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY �; , I.ibcrty Mutual. INSURANCE INFORMATION PAGE 17s e4 ►,.14,SOW ao►tun MA 02114 Issued by Liberty Mutual Fire Insurance Company (a stock company) 16586 Policy Number WA2-05D-291910,-031 Issu ng Offoe Lewiston. ME Renewal Of WA2-650-29191C-030 Issue Date 03124;2021 Account Number 5-291916 Sub Account 0001 1 Insured and Mailing Address FEIN 0 1-050953 7 Tilson Technology Management. Inc. NJ TIN 010509537000 16 Middle Street 4th Floor Portland ME 04101 Risk ID 913719333 Association 9004 Status Corporation Other workplaces not shown above: See Item 4. Premium- Extension of Information Page 2 Policy Period The policy period is from 04r01i2021 to 04r01/2022 12:01 A.M standard time at the Insured's mailing address. 3. Coverage A Worker's Compensation Insurance Part One of the policy applies to the Workers Compensation Law of the states listed here AL AZ AR CA CO CT FL GA ID IL IN IA KS KY LA ME MA MI MN MS MO MT NE NV NH NJ NM NY NC OR PA RI SC TN TX UT VT VA WV B Employers Liability Insurance: Part Two of the policy applies to work in each state listed in Item 3 A The omits of our liability under Part Two are Bodily Injury by Accident S 1.000,000 each accident Bodily Injury by Disease $ 1,000,000 policy limit Bodily Injury by Disease 5 1.000,000 each employee C Other States Insurance Part Three of the policy applies to the states, if any, listed here All States except those listed in Item 3 A and the States of: ND OH WA WY D. This pol•cy includes these endorsements and schedu'es See Item 3 Coverage D - Extension of Information Page 4 Premium: The premium for this policy wll be determined by our Manuals of Rules. Classifications. Rates and Rating Plans. All information required below is subject to verification and change by audit. Classifications Code Premium Basis Total Rate per$100 Estimated Annual Number Estimated Annual Remuneration of Remuneration Premium :See Extension of Information Page Minimum Premium Total Estimated Annual Premium $ Premium will be bred Monthly Deposit Premium $ Deposit Tax'Surcharge Assessment S Producer 0002 000008 Countersigned by Authonzed Rep (FL) MARSH USA INC 99 HIGH STFL 13 BOSTON MA 021 105021 _ WC 00 00 01 A 17:.1987 National Counc on Compensation Ins:.•a^ce,In: WC 00 CO 01 B (CA) Ed 07.01.2011 AJI Rigrts Reserved Pa•;e ' of 1 ® DATE(MMiDD/YWI� A�o CERTIFICATE OF LIABILITY INSURANCE 07/21/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION iS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT MARSH USA,INC. NAME: PHOE 99 HIGH STREET (A/CNNo.Extli FAX No): BOSTON,MA 02110 E-MAIL Attn:Boston.certrequest@Marsh.com Fax:212-948-4377 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# CN130061406-wIXS-GAWUX-21-22 INSURER A:Liberty Mutual Fire Insurance Company 23035 INSURED INSURER B:Endurance American Specialty Insurance Company 41718 Tilson Technology Management,Inc — 16 Middle Street,4th Floor INSURER C Portland,ME 04101 INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: NYC-010819194-07 REVISION NUMBER: 6 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLTYPE OF INSURANCE INSO SUER POLICY NUMBER (MM/POLID//CYYYYY)_LMM/DD//YYYCY Y) LIMITS LTR INSR WVD A X COMMERCIAL GENERAL LIABILITY TB5-651-291916-021 04/01/2021 04/01/2022 EACH OCCURRENCE $ 2,000,000 DAMAGE TO CLAIMS-MADE X OCCUR PREMISES(Ea occu RENTED $ 1,000,000 MED EXP(Any one person) _$ 10,000 — PERSONAL&ADV INJURY _$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY X 1 ispi 1 LOC PRODUCTS-COMP/OP AGG $ 4,000,000 OTHER: $ A AUTOMOBILE LIABILITY AS2-651-291916-011 04101/2021 04/01/2022 COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS_ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) $ B UMBRELLA LIAB X OCCUR ELD30001012502 04/01/2021 04/01/2022 EACH OCCURRENCE $ 3,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 3,000,000 _ DED RETENTION$0 $ _ A WORKERS COMPENSATION WA2-650-291916-031 04/01/2021 04/01/2022 x PER STATUTE i ER H AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N _E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUDED? N N/A 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Evidence of Insurance CERTIFICATE HOLDER CANCELLATION Tilson Technology Management,Inc SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 16 Middle Street,4th Floor THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Portland,ME 04101 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee 2•4..ofu-akou I 01988-2016 ACORD CORPORATION. All rights reserved. Commonwealth of Massachusetts �� Division of Professional Licensure Board of Building Regulations and Standards Cons ry f't i�i j rvisor CS-108437 tipires:09/10J2022 JTSHUA BRQ15ER . :16mIDDLEs1EET R • 4TtiFLOOR 'a • PORTLAND ME"p4101 O : Commissioner doi..2 K. Fit rQ __ Construction Supervisor Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters) of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For information about this license Call(617)727-3200 or visit www.mass.gov/dpl . Eng. # 13681399_C2_02 May 21, 2021 Page 1 of 2 AMERICAN TOWERS CORPORATION Structural Evaluation ATC Site 371771 Reviewed By: Number&Name NORTHAMPTON MA,MA Carrier Site Number BOBDL00161A &Name BOBDL00161A Site Location 123 Haydenville Road 140F Northampton,MA 01053-9753, Hampshire County y�N MASSy 42.3569 N/72.686 Wn BRYAN K. �yG LANIER `I Tower Description 191.2 ft Monopole o STRUM'AL Basic Wind Speed 90 mph (3-second gust,VAso)/116 mph (3-second gust,Val-) No.51 :g Basic Wind w/Ice 40 mph (3-second gust)w/1" radial ice concurrent A, 04 Applicable Code ANSI/TIA-222-G/2015 IBC/Massachusetts State Building Code, 4' 9th Ed. SS/ON&0' q D"r1 Evaluation Results: The loading in the tables below was evaluated with respect to the tower and foundation Authorized by "EOR" capacities. As future loading is added,or if actual loading is different from these tables, 23 May 2021 09:15:35 cosi8n re-evaluation shall be required. This tower and foundation are adequate to support the below loads in conformance with specified requirements. Created By: Christinaminor Existing and Reserved Equipment Elev.1(ft) Qty Equipment Mount Type Lines Carrier 6 Kaelus DBC0061F1V51-2 6 Powerwave Allgon TT08-19DB111-001 3 CCI TPA-65R-LCUUUU-H8 (2)0.39" (10mm) 3 Andrew SBNH-1D8585C Fiber Trunk 3 CCI HPA65R-BU8A (6)0.78" (19.7mm) Triangular Platform with 186.0 3 Ericsson RRUS-11 8 AWG 6 AT&T MOBILITY 6 Ericsson RRUS 12-Band 2(PCS) Handrails (12) 1 5/8"Coax 3 Ericsson RRUS 32 B30(53 Ibs) (2)3"conduit 3 Ericsson Radio 4426 (1)7/8"Coax 1 Raycap DC6-48-60-0-8F 2 Raycap DC6-48-60-18-8F 3 RFS APXVAARR24_43-U-NA20 3 Ericsson Radio 4449 B71 B85A Triangular Low Profile (4) 1 1/4" (1.25"- 176.0 3 Ericsson RRUS 4415 B25 T-MOBILE Platform 31.8mm) Fiber 3 Ericsson Air6449 B41 3 Ericsson AIR-32 B2A/B66Aa 3 Commscope NNVV-65B-R4 6 Alcatel-Lucent 800MHz RRH w/Type 1 Notch Filter(64 Lbs) (4) 1 1/4" Hybriflex 166.0 SPRINT NEXTEL 3 Alcatel-Lucent 1900MHz RRH (65MHz) T Arm Cable 3 Alcatel-Lucent TD-RRH8x20-25 w/Solar Shield 3 RFS APXVTM14-ALU-120 Equipment to be Removed Elev1(ft) Qty Equipment Mount Type Lines Carrier No loading was considered as removed as part of this analysis. ATC Tower Services,Inc. 3500 Regency Parkway,Suite 100-Cary,NC 27518—919-468-0112 Office—919-466-5414 Fax-www.americantower.com w Eng. # 13681399_C2_02 May 21, 2021 Page 2 of 2 AMERICAN TOWER" CORPORATIO N Proposed Equipment Elet1(ft) Qty Equipment Mount Type Lines Carrier 1 Commscope RDIDC-9181-PF-48 136.0 3 Fujitsu TA08025-B604 Triangular Platform with (1) 1.60" (40.6mm) DISH WIRELESS L.L.C. 3 Fujitsu TA08025-8605 Handrails Hybrid 3 JMA Wireless MX08FR0665-21 'Contracted elevations are shown for appurtenances within contracted installation tolerances.Appurtenances outside of contract limits are shown at installed elevations. Install proposed lines inside the pole shaft. ATC Tower Services,Inc. 3500 Regency Parkway,Suite 100-Cary,NC 27518—919-468-0112 Office—919-466-5414 Fax-www.americantower.com