Licensing and Management System

General Information

Section	Question	Response
Attachments	Are attachments (other than associated schedules) being filed with this application?

Fees, Waivers, and Exemptions

Section	Question	Response
Fees	Is the applicant exempt from FCC application Fees?	No
	Indicate reason for fee exemption:
	Is the applicant exempt from FCC regulatory Fees?
Waivers	Does this filing request a waiver of the Commission's rule(s)?
	Total number of rule sections involved in this waiver request:

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant	Address	Phone	Email	Applicant Type
PEMBROOK PINES ELMIRA, LTD. Applicant Doing Business As: PEMBROOK PINES ELMIRA, LTD.	1705 LAKE STREET ELMIRA, NY 14901 United States	+1 (607) 733-5626		OTH

Contact Representatives (2)

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Contact Name	Address	Phone	Email	Contact Type
JAMES L TRAVIS CONSULTANT	12372 HUCKLEBERRY CT RANCHO CUCAMONGA, CA 91739 United States	+1 (607) 661-2531	JIMTRAVISENGINEERING@GMAIL.COM	Technical Representative
MILES S. MASON, ESQ. PILLSBURY WINTHROP SHAW PITTMAN LLP	1200 SEVENTEENTH STREET, NW WASHINGTON, DC 20036 United States	+1 (202) 663-8195	MILES.MASON@PILLSBURYLAW.COM	Legal Representative

STA Purpose

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Section	Question	Response
STA Purpose	This Special Temporary Authority is requested for use of:	Other antenna system

Channel and Facility Information

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Section	Question	Response
Proposed Community of License	State	New York
	City	SOUTHPORT
	Channel	258
	Frequency	99.5
Facility Type	Facility Type
Station Class	Station Class

Antenna Location Data

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Section	Question	Response
Antenna Structure Registration	Do you have an FCC Antenna Structure Registration (ASR) Number?	Yes
	ASR Number	1006946
Coordinates (NAD83)	Latitude	42° 01' 55.0" N+
	Longitude	076° 47' 01.0" W-
	Structure Type
	Overall Structure Height	98 meters
	Support Structure Height
	Ground Elevation (AMSL)
Antenna Data	Height of Radiation Center Above Ground Level	Horizontal:55 meters Vertical:55 meters
	Height of Radiation Center Above Average Terrain	Horizontal:191 meters Vertical:191 meters
	Height of Radiation Center Above Mean Sea Level	Horizontal:594 meters Vertical:594 meters
	Effective Radiated Power	Horizontal:0.22 kW Vertical: 0.22 kW

Antenna Technical Data

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Section	Question	Response
Antenna Type	Antenna Type	Off the Shelf

Directional Antenna Relative Field Value

Degree	Value	Degree	Value	Degree	Value	Degree	Value

Additional Azimuths

Degree	Value

STA Certifications

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Section	Question	Response
Environmental Effect	Would a Commission grant of Authorization for this location be an action which may have a significant environmental effect? (See 47 C.F.R. Section 1.1306)

Certification

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Section	Question	Response
General Certification Statements	The Applicant waives any claim to the use of any particular frequency or of the electromagnetic spectrum as against the regulatory power of the United States because of the previous use of the same, whether by authorization or otherwise, and requests an Authorization in accordance with this application (See Section 304 of the Communications Act of 1934, as amended.).
	The Applicant certifies that neither the Applicant nor any other party to the application is subject to a denial of Federal benefits pursuant to §5301 of the Anti-Drug Abuse Act of 1988, 21 U.S.C. § 862, because of a conviction for possession or distribution of a controlled substance. This certification does not apply to applications filed in services exempted under §1.2002(c) of the rules, 47 CFR . See §1.2002(b) of the rules, 47 CFR § 1.2002(b), for the definition of "party to the application" as used in this certification § 1.2002(c). The Applicant certifies that all statements made in this application and in the exhibits, attachments, or documents incorporated by reference are material, are part of this application, and are true, complete, correct, and made in good faith.
Authorized Party to Sign	FAILURE TO SIGN THIS APPLICATION MAY RESULT IN DISMISSAL OF THE APPLICATION AND FORFEITURE OF ANY FEES PAID Upon grant of this application, the Authorization Holder may be subject to certain construction or coverage requirements. Failure to meet the construction or coverage requirements will result in automatic cancellation of the Authorization. Consult appropriate FCC regulations to determine the construction or coverage requirements that apply to the type of Authorization requested in this application. WILLFUL FALSE STATEMENTS MADE ON THIS FORM OR ANY ATTACHMENTS ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. Code, Title 18, §1001) AND/OR REVOCATION OF ANY STATION AUTHORIZATION (U.S. Code, Title 47, §312(a)(1)), AND/OR FORFEITURE (U.S. Code, Title 47, §503).
	I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.	RICHARD A. FOREMAN

Attachments

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File Name	Uploaded By	Attachment Type	Description	Upload Status
1648795_1309385.txt	Applicant	All Purpose	STA CIRCUMSTANCES	Done with Virus Scan and/or Conversion
1648795_19277967.pdf	Applicant	All Purpose	Exhibit 3 - Environmental Compliance	Done with Virus Scan and/or Conversion
1648795_19278000.pdf	Applicant	All Purpose	Exhibit 4 - Service Contours	Done with Virus Scan and/or Conversion
D:\data\prod\cdbs\letters\\59\A-1648795_F-47322_L-59217-BSTA-20150706ABB.pdf	Internal	All Purpose	imported letter	Done with Virus Scan and/or Conversion