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�o�c,UFFQ(�cTown of Southold 7/25/2019 3 P.O.Box 1179 o - tl' 53095 Main Rd 4,o o Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 40546 Date: 7/25/2019 THIS CERTIFIES that the building SOLAR PANEL Location of Property: 17130 Main St.,New Suffolk SCTM#: 473889 Sec/Block/Lot: 117.-9-28.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 5/20/2019 pursuant to which Building Permit No. 43812 dated 5/30/2019 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: roof-mounted solar panels as applied for. The certificate is issued to Simon,Michael of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 43812 6/27/2019 PLUMBERS CERTIFICATION DATED A thorized Signatu TOWN OF SOUTHOLD BUILDING DEPARTMENT Ca a TOWN CLERK'S OFFICE o . SOUTHOLD, NY 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#: 43812 Date: 5/30/2019 Permission is hereby granted to: Simon, Michael PO BOX 303 New Suffolk, NY 11956 To: install roof-mounted solar panels as applied for. At premises located at: 17130 Main St., New Suffolk SCTM # 473889 Sec/Block/Lot# 117.-9-28.1 Pursuant to application dated 5/20/2019 and approved by the Building Inspector. To expire on 11/28/2020. Fees: SOLAR PANELS $50.00 CO -ALTERATION TO DWELLING $50.00 TRIC $100.00 otal: $200.00 Build g 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$15.00 Q (Date. New Construction: Old or Pre-existing Building: (check oneA C . Location of Property: 1� House No. StreetQQ Hamlet r Qwner or Owners of Property6 1')a�'l a` 11.E m rGbL[II � 51 m&-) —Suffolk County Tax Map No 1000,Section .0Q Block ©`l.06 Lot . Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: 4��Ja&A 7LA Health Dept.Approval: Underwriters Approylal: Planning Board Approval: ` Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted:$ pp is gnature t rg so Town Hall Annex ® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O. ox 117 Southoldd,,NY 11971-0959 a sean.devlina-town.southold.ny.us et` BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To Michael Simon Address: 17130 Main St city,New Suffolk st: NY zip: 11956 Building Permit# 43812 Section: 117 Block- 9 Lot 28.1 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE contractor: DBA: Sunrun Installation Services License No: 33878-ME 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 X 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 Fixtures Time Clocks Disconnect Switches Twist Lock Exit Fixtures TVSS Other Equipment: 15- Rec solar panels Rec290TP2 Blk, 1- Solar Edge Technologies Inverter SE 3800 H-US, 3-AC disconnects and 1-DC disconnect Notes Roof mounted photovoltaic system Inspector Signature: Date: June 27, 2019 S Devlin-Cert Electrical Compliance Form As pF SOGTyo� # # TOWN OF SOUTHOLD BUILDING DEPT. `ycourm tip' 765-1602 INSPECTION.. [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH)ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: Kt eol— DATE 2 INSPECTOR F]7/ Z�.H structural ENGINEEfZS ® r June 13,2019 r- Sunrun Inc. 133 Technology Dr,Suite 100 JUL 2 4 2019 j l Irvine,CA,92618 Subject:Structural Certification for Installation of Solar Panels FUIT' qp T DT, Job Number: 19-03836 Client:Shannon Simon-211R-130SIM0 Address: 17130 Main ST,New Suffolk,NY 11956 Attn.:To Whom It May Concern On the above referenced project, I reviewed the PV Installation specified in the plan.The purpose of the review was to verify the installation and their conformance with the specifications and that any modifications were acceptable. After review, I certify that the PV Installations were installed in general conformance with the plans and specifications for this project,and the installation complies with the provisions of 2015 IRC with 2017 NY State Uniform Code Supplement,ASCE 7-10,and NDS-15. If you have any questions on the above,do not hesitate to call. OF NEIN Sincerely, K• Zq - !;0 Q a� tOi LU XP 073 1//3 Paul Zacher,S.E. r �{•�'"• c ! "�.7n1 2 � 91365- ��c= AROFESSIONP 1478 Stone Point Drive,Suite 190, Roseville, CA 95661 T 916.961.3960 F 916.961.3965 W www.pzse.com Experience I Integrity I Empowerment FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION (1ST) 'FOUNDATION (2ND ) to � Z d ROUGH FRAMING& PLUMBING y TV INSULATION PER N. Y-. H STATE ENERGY CODE FINAL ADDITIONAL COMMENTS z d TOWN OF SOUTHOLD 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 Southolc$Town.NorthFork.net PERMIT NO. Check Septic Form p� N.Y.S.D.E.C. (' � 1 Trustees �, LLL:��� � C.O.Application Flood Permit Examined ,20-2 M AY 17 2019 Single&Separate Storm-Water Assessment Form Contact: Approved 130 20 VV ® �� • IVG�� �ei•1-te: ____ Disapproved a/c 415 Oser Avenue - Suite W Hauppauge, NY 11788 (631)827-5675/(631) 637-1769 Expiration ,20 LIPermits@sunruni .tom Building Inspector - - - APPLICATION FOR BUILDING PERMIT Date ,20 INSTRUCTIONS a.This application MUST be 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 havebeen enacted in the interim,the Building•Inspector may authorize, in writing,the extension of the-permitfor,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,addition's,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 re lations,and to admit authorized inspectors on premises and in building for necessary inspections. a e o applicant or name,i s corporation) L4 is- 0 tA-\K,4 1 �,3 (Mailing address of pli ant) avell I��-�1 )bTder�x�State whether applicant is owner,lessee,agent, architect, engineer, general n actor, el cian,plumber Name of owner of premises 51YAOc7�� � ���\ yl C'nD l (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title offccoorpor officer) Builders License No. �H' Plumbers License No. Electricians License No. hlYi Other Trade's License No. / 1. 11"fland on wh'cI heproR osed ( rk will be done: House Number Street ,Hamlet County Tax Map No. 1000 Section ROO Block L,/-I.� Lot Subdivision Filed Map No. Lot 2. State existing use and occupancy of miser.and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupanc 3. Nature of work(check which applicable):New BY1171Ag,`=s`�,/!1 ,- z Addifioit"`A" Alteration Repair Removal DemolitionOther Work(_ a 5 f (Description) r ' Y 4. Estimated Cost 16 Fee, R { ry (To be paid on filing this application) 5. If dwelling,number of dwelling units Number o_f 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 13.Will lot be re-graded?YES NO Will excess fill be removed from premises?YES NO 4.Names of Owner Qf premises Address Phone,No dres L11$ a -Y Name of Contract Addres Ine 4W 1 15 a. Is this property within 100 feet of a tidal wetland ora 941k4qR%W. 171KO * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C.PERMITS MAY BE REED. 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 iespect to this property? *YES NO * IF YES,PROVIDE A COPY. STATE OF NEW YORK) COUNTY OFa"L pn �w being duly sworn,deposes and says that(s)he is the applicant (Name of in dual s•gmng cco�, Fact)above named, Vl (S)He is the C/" ' S__ �® (Contractor,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 ore me �\ \'E L --� day of . ��' 20 9y 9,L 0.0 86323849•N QUALIFIED IN SUFFOLK COUNTY Not" P is o4_zM2 ? Y-v\ (L' UQMS e ofApplicant N"9�''pUBL1G• •pQ��`� �s'�voF1NE``t • f eco%% A. Russell SUFFIZ S�C'�0��[�I��J WA\TEIK SUPERVISOR MCA NA\G]EMIENT. SOUTHOLD TOWN HALL-P.O.Box 1179 . 0 53095 Main Road-SOUTHOLD,NEW YORK 11971 ti JO �d- Town of Southold CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET _..(TO BE COMPLETED BY THE APPLICANT) DOES THIS PROJECT INVOLVE ANY OF THE FOLLOWING: i Yes No (CHECK All THAT APPLY) ❑ A. Clearing, grubbing,•grading or stripping of land which affects more r than 5,000 square feet of ground surface. ❑® B. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area.---- El rea.❑ /C. Site preparation on slopes which exceedLO feet vertical rise to ❑d1100 feet of horizontal distance. D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. ❑Q] . Site preparation within the one-hundred-year floodplain as depicted on FIRM Map of any watercourse. ❑ F. Installation of new or resurfaced impervious surfaces of 1,000 square feet or more, unless prior approval of a Stormwater Management 1 Control Plan was received by the Town and the proposal .includes in-kind replacement of impervious surfaces. If you answered NO to all of the questions above,STOP! Complete the Applicant section below with your'Name, ignature,-Contaetlnfor-mationTDate-&-Country-Tax-Map_Numbcr Chapter..236-doeszot-apply-lo-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. APPLICANT: IPr pert S.C.T.M_ $: 1000 Date Owncr,Design Professional,Agent,Contractor,Other) pstnu NAME: �.� Mail, @^^ Section Block Lot dLl ' / n `"':• I-OR BUILDING DL' RTINI ENT USE ONLY Contact Inrormation: Reviewed By: / -7 - - — — — — — — — — — — — — Pro err Y Address/,Local ion of st Conruction Work: — - - - - - - - - - - Date: 5a — — — — — _ — — — — — — — — — ,Approved for processing Building Permit. LJ Stormwater Management Control Plan Not Required. ❑ Slormwaler Management Control Plan is Required. (Forward to Engineering Department for Review.) FORM SMCP-TOS MAY 2014 -pF SOFT Town Hall Annex ,11 „ A Telephone(631)765-1802 54375 Main lioad N tr{68! '765-95 lUoP.O.Box 1179roderAchertwnV us Southold,NY 11971-0959 WADING DEPARTMENT fj TOWN OF SOUTHOLD _APPIJOATION FOR t:LEGTRICAL-INSE-ECTIO'N REQUESTED BY: Date: Company Name: - Nam;e: J I F License No.: Address: - - - Phone_No. .; , -_ ,- =�- - - - - . - ; - ?J JOBSITE INFORMATION: (*Indicates required information) *Name: Yl 4- «Address: L_ 5b /" L cz Cross Street: - - !' I Permit No.. — - -- - - - - _ Tax Map District: _ 1000 Section: Block:()ADO Lot:=�$ *BRIEF DESCRIPTION OF WORK(Please Print Clearly) {Please Circle All That Apply) !- - *ls job ready for inspection: YES/ NO Rough in Final - *Do•you need a Temp Certificate: YE NO Temp Information(If.needed) *Service Size: 1 Phase 3Phase 100 150 200 300 350,' . 400 Other *New Service:, Re-connect Underground Number of Meters Change of Service Overhead Additional Information: PAYMENT DUE WITH•APPLICATION: 82=Request forinspecGon Form Yo K Workers' CERTIFICATE OF STATE Compensation Board NYS WORKERS, COMPENSATION INSURANCE COVERAGE 1a.Legal Name&Address of Insured(Use street address only) I b.Business Telephone Number of Insured (805)528-9705 Sunrun Installation Services Inc. 1c.NYS Unemployment Insurance Employer Registration 775 Fiero Lane,Suite 200 Number of Insured San Luis Obispo,CA 93401-7904 50-864264 Work Location of Insured(Onlyrequired Wcoverage,is spec/flcallylimlted to f d.Federal Employer Identification Number of Insured or certain locations In New.York State,Le.,a Wrap=Up Policy) Social Security Number 77-0471407 2.Name and Address of the Entity Requesting Proof of Coverage 3a. Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Zurich American Insurance Company 3b.Policy Number of entity listed in box"la" WC 0136961-04 Town of Southold 3c. Policy effective period 53095 Route 25 10/01/2018 to 10/01/2019 Southold, NY 11,971 3d. The Proprietor,Partners or Executive Officers are ® included. (Only check box if all partners/officers included) ❑ all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated,above in box "3" insures the business referenced above in-box "la" for workers' compensation under the New York State Workers'Compensation Law.(To use this form,New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2" Will the carrier notify the certificate holder within 10 days of a policy being cancelled for non-payment of premium or within 30 days if cancelled for any other reason or if the insured is otherwise eliminated from the coverage indicated on this certificate prior to the end of the policy effective period?®YES ❑NO This certificate is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend,extend or alter the coverage afforded by the policy listed,nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation,contract of insurance only while the underlying policy is in effect. Please Note: Upon the cancellation of the workers' compensation policy indicated on this form, if the business continues to be named on a permit,license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers' Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury, I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Kelly Cada (Print name of authorized representative or licensed agent of insurance carrier) Approved by: f G`d''` 10/1/2018 (Signature) (Date) Title: Vice President-Enterprise Support Operations Telephone Number of authorized representative or licensed agent of insurance carrier:, 800-382-2150 'Please Note:Only insurance carriers and their licensed agents are authorized to issue Form C-105.2.Insurance brokers are NOT authorized to issue it. C-105,2(9-15) www.wcb.ny.gov 1 y AC®® DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 9/12/2018 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 pol)cy(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 Arthur J.Gallagher&Co. PHONE FAX Insurance Brokers of CA. Inc.License#0726293 A/c No Ext.415-546-9300 A/C No):415-536-8499 1255 Battery Street#450 ADDRESS• San Francisco CA 94111 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA•Zurich American Insurance Company 16535 INSURED SUNRINC•01 INSURER B.Navigators Specialty Insurance Company 36056 Sunrun Installation Services,Inc. 775 Fiero Lane,Suite 200 INSURER San Luis Obispo,CA 93401 INSURER D INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER:1523403087 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS ILTR TYPE OF INSURANCE ADDL 3 POLICY EFF POLICY EXP NSD WVD POLICY NUMBER MM/DD MM/DD LIMITS B X COMMERCIAL GENERAL LIABILITY LA18CGL2303211C 10/1/2016 10/1/2019 EACH OCCURRENCE $1,000,000 CLAIMS-MADE �OCCUR T RENTED PREMISES Ea ocwrtence $1,000,000 X $50,000Retenbon MED EXP(Anyone person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000,000 X POLICY PRO- JECT F7LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER* Total Policy Limit $10,000,000 A AUTOMOBILE LIABILITY BAP915542505 10/111018 10/1/2019 COMBINED SINGLE LIMIT $2,000,000 Ea accident 1X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED (Per stu AUTOS ONLY AUTOS ( )BODILY INJURY Pdent $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION WG013696004 10/1/2018 10/1/2019 X STATUTE ERH A AND EMPLOYERS'LIABILITY YIN WC013696104 10/1!2018 10/1/2019 ANYPROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $1,000,000 OFFICER/MEMBEREXCLUDED? N/A (Mandatory In NH) E L DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more apace Is required) WC013696004-$25,000 Deductible;WC013696104-FL,HI,MA,NJ,NY,OR,VA,WI only.Named Insureds.Sunrun Inc.,Sunrun Installation Services Inc, Sunrun South LLC,AEE Solar,Inc.,Clean Energy Experts LLC,Sunrun Solar Electrical Corporation Evidence of insurance CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Southold 53095 Route 25 Southold NY 11971 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD I YORK Workers' CERTIFICATE OF INSURANCE COVERAGE STATE Compensation UNDER THE NYS DISABILITY BENEFITS LAW Board PART 1. To be completed by Disability Benefits Carrier or Licensed Insurance Agent of that Carrier 1a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number,of Insured Sunrun Installation Services Inc 845-268-2595 595 Market Street,29th Floor 1c.NYS Unemployment Insurance Employer Registration Number of San Francisco,CA 94105 Insured Work Location of Insured(Only required if coverage is specifically limited to certain locations in New York State,i.e.,a Wrap-Up Policy) 1d.Federal Employer Identification Number of Insured or Social Security 'Number 15 Charlotte Ave 77-0471407 Hicksville,NY 11801 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being tasted as the Certificate Holder) The Prudential Insurance Company of America Town of Southold 3b.Policy Number of Entity Listed in Box"1a" 54375 Route 25 CG-52830-NY P.O.Box 1179 Southold,NY 11971 3c.,Polio effective pe-iod' 01/01/2018 to 12/31/2020 4.Policy covers: ®,A.All of the employers employees eligible Under the New York Disability Benefits Law E] B.Drily the following class or classes of employers employees: Under penalty of pedury,I certify that I,am an authorized representative or,licensed agent of the insurance carrier referenced above and that the named insured has NYS Disability Benefits insurance coverage as-described above. Date Signed January 26,2618 By (Signature of insurance carrices authorized representative or NYS Licensed Insurance Agent of that insurance tamer) Telephone Number 973-548-6389 Title Statutory Disability Coordinatof IMPORTANT: If Box"4a"is checked,and this form is signed,by the insurance carriers authorized representative or NYS Licensed Insurance Agent of that carrier,this certificate is COMPLETE.Mail'it directly to the certificate holder. If Box'4b"is checked,this certificate is NOT COMPLETE for purposes of Section 220,Subd.8 of the Disability Benefits Law.ifmust be mailed for completion'to the Workers'Compensation Board,DB Plans Acceptance Unit,328 State Street,'Schenectady,NY 12305 PART 2.To be completed-by the NYS Workers'Compensation Board(Only if Box'"4b"'of Part 1 has been checked) $fate'of New York Workers'-Compensation Board— --_w___ According to information maintained by the NYS Workers'Compensation Board,the above-riamed employer has compiled with the NYS Disability Benefits Law with,respect to all of his/her employees., Date Signed By Signature of NYS Workete Compensation Board Employee) Telephone Number Title Please Note. Only Insurance carriers licensed to write NYS disability benefits insurance policies and NYS,'licensed insurance agents of those insurance carriers are authorized to issu-e•Form DB-120.1. Insurance brokers are NOT authorized to issue this form. 138-120.1(9-15) hT, NRI —Z 7 0 W90% A Z,�...... PSI; r i A-M-1 Y p. 4A. RIS, n Suffolk 'County Department ® Labor Licensing & Consumer Affairs- ;d ............. VETERANS MEMORIAL HIGHWAY HAUPPAUGE,NEW 11788 AN W, i DATE ISSUED: 10/1/2003 No. 33818-ME SUFFOLK COUNTY Master Electrician License 3 i This is to certify that 2§Th" SAMY A MOUNAS doing business as SUNRUN INSTALLATION SERVICES INC Navin g given satisfactory evidence of competency, is hereby licensed as MASTER ELECTRICIAN in accordance with and subject to the provisions of applicable laws,rules and regulations of the County of Suffolk,State of New York. M wz Additional Businesses A NOT VALIDWITHOUT DEPARTMENTAL SEAL T ;:A*,� AND A CURRENT CONSUMER AFFAIRS ID CARD Aq Acting Commissioner I 4P �il;ov' A."J"UT PP 4y 5 AM 6d� DD �A IB s c� structural COMPLY WITH ALL CODES OF May 5,2019 ENGINEERS NEIN YORK STATE & TOWN C®DES- Sunrun Inc. AS REQUIRED AND-C—eNG910IN&OF 133 Technology Dr,Suite 100 Irvine,CA,92618 SQA 111NGII AM Subject:Structural Certification for Installation of Solar Panels Job Number:19-03836 §Q ITH f nMOUSTEES Client:Shannon Simon-211R-130SIMO Address:17130 Main ST,New Suffolk,NY 11956 Attn.:To Whom It May Concern A field observation of the condition of the existing framing system was performed by an audit team from Sunrun Inc.. From the field observation of the property,the existing roof structure was observed as follows: The existing roof structure consists of: • Composition Shingle over Roof Plywood is supported by 2x6 @ 16"o.c.SPF#2 at ARRAY 1.The rafters are sloped at approximately 23 degree and have a maximum projected horizontal span of 11 ft 10 in between load bearing supports. Design Criteria: • Applicable Codes=2015 IRC with 2017 NY State Uniform Code Supplement,ASCE 7-10,and NDS-15 • Ground Snow Load=20 psf;Roof Snow Load=13.9 psf ARRAY 1 • Roof Dead Load=7.6 psf ARRAY 1 • Basic Wind Speed=130 mph Exposure Category D As a result of the completed field observation and design checks: • ARRAY 1:is adequate to support the loading imposed by the installation of solar panels and modules.Therefore,no structural upgrades are required. I certify that the capacity of the structural roof framing that directly supports the additional gravity loading due to the solar panel supports and modules had been reviewed and determined to meet or exceed the requirements without structural upgrade in accordance with the 2015 IRC with 2017 NY State Uniform Code Supplement. If you have any questions on the above,do not hesitate to call. Additional Sincerely, Certification AAPPRO ED !`^tom? NO"FED D May Be Required. Paul Zacher,S.E. DATE: L�, B.P.,,��$t� OF NEIti� K. 2q Cy 0 FEE..,.� ...e..._.m yY ,��.a..�. � Q NOT FY BUILDING V-P,AHTMIENT AT .�, 'a � 765-1802 8 AM TO 4 PIVi FOR THE a,, w FOLLOWING INSPE OTIC}NS: C O XP� 7131/ 2 1. FOUNDATION ION - TWO REOUIRED ,p 1365- v� FOR POURED CONCRETE ROfiESS1oNP 2. ROUGH - FRAI'VIING & PLUMBING 3. INSULATION 4. FINAL - COiv3TRUCTION MUST 05/05/2019 BE COMPLETE FOR C.G. ALL CONSTRUCTION SHALL. MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. N01 RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. 1478 Stone Point Drive,Suite 190, Roseville, CA 95661 T 916.961.3960 F 916.961.3965 W www.pzse.com Experience I Integrity I Empowerment RZE structural May 5,2019 ENGINEERS Sunrun Inc. 133 Technology Dr,Suite 100 Irvine,CA,92618 Attn.:To Whom It May Concern re:Job 19-03836:Shannon Simon-211R-130SIMO The following calculations are for the structural engineering design of the photovoltaic panels located at 17130 Main ST, New Suffolk, NY 11956.After review, Paul Zacher certifies that the roof structure has sufficient structural capacity for the applied PV loads. If you have any questions on the above,do not hesitate to call. of NEW K. Zq y cy 0CO Sincerely, w u?. W O91365- Paul Zacher,,S.E. AROFESSIONP 1478 Stone Point Drive,Suite 190, Roseville, CA 95661 T 916.961.3960 F 916.961.3965 W www.pzse.com Experience I Integrity I Empowerment Project: Shannon Simon -=Job#: 19-03836 PZH Date: 5/5/2019 Engineer: PZSE Gravity Loading Roof Snow Load Calculations Ground,Snow Load Ce=Exposure Factor=_ - - 0.9 e - j(ASCE7-Table 7-2) 4C,=Thermal Factor (ASCE7-Table 7-3) I=Importance Factor L pf=0.7C.Cti pe 14 psf_t__ (ASCE7-Eq 7-1) where pe 5 20 psf,Pf min=I x,pg= N/A _- where pg>20 psf,Pf min=20 x I= ±N/A Per ASCE 7-10,minimum values of Pf shall apply to hip'and gable roofs with slopes Less Therefore,pf=Flat Roof Snow Load= _ 14 psf p:=qpf _ ._ -__-__ _. _ ,(ASCE7-Eq 7-2) TCs=Slope Factor= 1.000 ARRAY 1 Ps=Sloped Roof Snow Load= 13.9 psf ARRAY 1 [�� PV Dead Load=,3 psf(Per Sunruri Inc.) a � • Roof Live Load•=. 18.91 psf.°._ _ ARRAY 1 Note:,Roof live loa&is removed in area's covered by PV array. Roof Dead.Load ARRAY 11 Composition Shingle 4.00 2x6 Rafters @ 16"o.c. 1.13 VaultedCeiling - -� �- _.__ Oy00 —,_,Ceiling Not Vaulted Miscellaneous 0.37 Total Roof,DL ARRAY 1 J^ 70P _sf DL Adjusted to 23 Degree.Slope 7.6 psf 2of5 PzH Project: Shannon Simon-- Job#: 19-03836 Date: 5/5/2019 Engineer: PZSE Wind Calculations Per ASCE 7-10 Components and Cladding Input Variables, _ Wind Speed _ 130 mp_h Exposure Category _ - D - _Roof Shape Gable Roof Slope - - 23 degrees Mean Roof Height 15 ft Buiid'ing Least Width Effective Wind Area - ___13.0 sf Roof Zone Edge Distance,a 3.0 ft Controlling C&C Wind Zone- Zone 3 Design Wind Pressure Calculations Wind Pressure P_ =qh*(G*Cp)_ _ F__ --_-- - qh=0.00256*Kz*Kzt*Kd*VA2 ___--(Eq_30.3-1)_i ^ Kz(Exposure Coefficient),3.03 - (Table 30.3-1) -____-Kzt_(topographicfactor)= 1~ (F_ig.26.8-1)j Kd(Wind Directionality Factor)= 0.85 (Table 26.6-1) V(Design Win d_Speed)= 130 mph (Fig.26.5-1A) Risk_Category=_II -(Table 1.5-1) Ch= 37.9 psf Standoff Uplift Calculations Zone 1 Zone 2 Zone 3 Positive -1.68 -2.58 0.49 Uplift Pressure= -20.38 psf -38.26 psf- -58.63 psf 16.00 psf Attachment Dead Load= 3.00 psf -_3.00 psf 3.00 psf i _ Max Rail Span Lengt_h_= 4.00 4.00 4.00 __Longitudina_ILength= _3.253.25 3_.25_ ,Attachment Tributary Area= 13.00 W 13.00 13.00 1 Attachment Uplift= _-242.00 _-474.00- _ 739.00 Lag Screw Uplift Capacity Check _ Fastener= 5/16 inch__ Number of Fasteners= i Minimum_ Threaded Embedment Depth= 2.5 inch _ - T. _-___�Withdraw Capacity_Per_Inch= 205 Ib�_______(NDS Eq 12.2-1) _ __Allowable Withdraw Capacity= 820 lb (NDS Eq 11_.3-1) 820 Ib capacity>739 Ib demand Therefore,OK Lag Screw Shear Capacity Check Embedment Depth Reduction Factor 1_ _ Lateral Force from Gravity Loads= 86 Ib - _Attachment Lateral Capacity 288 Ib_ (NDS Table 12K) 287.5 Ib capacity>861b demand Therefore,OK -' 3 of 5 Project: Shannon Simon-- Job#: 19-03836 PZH Date: 5/5/2019 Engineer: PZSE Framing Check ° ARRAY 1 PASS w=39 plf Dead Load 7.6 psf PV Load 3.0 psf Live Load 18.9 psf 2x6 Rafters @,16"o.c: Member Span=11'-10" Governing Load Comb. DL+LL Note:Attachments shall be Staggered. Total,Load 29.5 psf Member Properties. Member Size 5(in^3) I(in A4) Lumber Sp/Gr Member Spacing 2x6 7.56 20.80 SPF#2 @ 16"o.c. Check Bending Stress Fb(psi)= f'b x Cd x Cf x Cr (NDS Table 4.3.1) 875 x 1.25 x 1.3 x 1.15 Allowed Bending Stress=1635.1 psi Maximum Moment = (wL^2)/8 = 688.617 ft# = 8263.4 in# Actual Bending Stress=(Maximum Moment)/S ='1092.7 psi Allowed>Actual--66.9%Stressed -- Therefore,OK �- °- Check Deflection Allowed Deflection(Total Load) = L/120 (E=1400000 psi Per NDS) = 1.183 in Deflection Criteria Based on = Simple Span Actual Deflection(Total Load) _ (5*w*L^4)/(384*E*I) = 0.597 in = L/238 < L/120 Therefore OK Allowed Deflection(Live Load) = L/180 0.788 in Actual Deflection(Live Load) _ (5*w*L^4)/-(384*E*I) 0.382 in L/372 < L/180 Therefore OK Check Shear Member Area= 8.3'in^2 Fv(psi)= 135 psi (NDS Table 4A) Allowed Shear = Fv*A = 1114 Ib Max Shear(V)=w*L/2 = 233 Ib Allowed>Actual--20.9%Stressed -- Therefore,OK 4of5 PZ® Project: Shannon Simon --Job#: 19-03836 Date: 5/5/2019 Engineer: PZSE Lateral Check:2015 IEBC Existing Weight of Effected Building Level Area Weight(psf) Weight(lb) Roof 700 if 7.6 psf _ 53201b Ceiling 700 sf 6.0 psf 4200 Ib Vinyl Siding 550 sf 2.0 psf- 1100 Ib (10'Wall Height) Int.Walls- 275 sf 6.0 psf 1650 Ib Existing Weight of Effected Building 12270 Ib Proposed Weight of PV System Weight of PV System(Per Sunrun Inc.) 3.0 psf ---------------- --------- -- ---- ------- Approx.Area of Proposed PV System 267-sf-- Approximate 67sfApproximate Total Weight of PV System 801 Ib 10%Comparison 10%of Existing Building Weight(Allowed) 1227 Ib . _ Approximate Weight of PV System(Actual) Percent Increase 6.5% 1227 Ib>801 Ib,Therefore OK Per IEBC 402.4&403.4 and by inspection,portions of the roof that are impacted by installation of the array will'be subject to a net reduction in design loading. Therefore,the existing structure may remain unaltered. 5 of 5 SCOPE OF WORK GENERAL NOTES LEGEND AND ABBREVIATIONS TABLE OF CONTENTS PAGE 9 DESCRIPTION • SYSTEM SIZE:435OW DC,380OW AC • ALL WORK SHALL COMPLY WITH NEC 2014,IBC 2015,MUNICIPAL CODE,AND SOLAR MODULES • MODULES:(15)REC SOLAR REC290TP2 BLK ALL MANUFACTURERS'LISTINGS AND INSTALLATION INSTRUCTIONS SE SERVICE ENTRANCE PV-1 0 COVER SHEET • INVERTERISI: • PHOTOVOLTAIC SYSTEM WILL COMPLY WITH NEC 2014 PV-2 0 SITE PLAN (1)SOLAREDGE TECHNOLOGIES SE380OH-US WITH • ELECTRICAL SYSTEM GROUNDING WILL COMPLY WITH NEC 2014 REVENUE GRADE METERING • PHOTOVOLTAIC SYSTEM IS UNGROUNDED NO CONDUCTORS ARE SOLIDLY MP MAIN PANEL PV-3 0 LAYOUT • RACKING: GROUNDED IN THE INVERTER SYSTEM COMPLIES WITH 690 35 PV-4 0 ELECTRICAL SNAPNRACK RL,FLASHTRACK COMP SEE DETAIL • MODULES CONFORM TO AND ARE LISTED UNDER UL 1703 SNR B MOUNT SD-00708 . INVERTER CONFORMS TO AND IS LISTED UNDER UL 1741 SP SUB-PANEL SNR A MOUNT PV-5 0 SIGNAGE • RACKING CONFORMS TO AND IS LISTED UNDER UL 2703 • SNAPNRACK RACKING SYSTEMS,IN COMBINATION WITH TYPE I,OR TYPE II • TRENCHING REQUIRED:(AC)WIRE TO BE TRENCHED 40 FT MODULES,ARE CLASS A FIRE RATEDLC PV LOAD CENTER ® CHIMNEY IN SOIL MATERIAL. • RAPID SHUTDOWN REQUIREMENTS MET WHEN INVERTERS AND ALL CONDUCTORS ARE WITHIN ARRAY BOUNDARIES PER NEC 690.12(1) • CONSTRUCTION FOREMAN TO PLACE CONDUIT RUN PER 690 31(G) SM SUNRUN,METER fl ATTIC VENT • ARRAY DC CONDUCTORS ARE SIZED FOR DERATED CURRENT - • 9 71 AMPS MODULE SHORT CIRCUIT CURRENT FLUSH ATTIC VENT • 15 17 AMPS DERATED SHORT CIRCUIT,CURRENT 1690 8(a)&690 8(b)] PM DEDICATED PV METER OF NIF o PVC PIPE VENT K 240 yp INVERTER(S)WITH INV INTEGRATED DC ® METAL PIPE VENT ? # DISCONNECT AND AFCIEZ ® T-VENT - •, = (� AC DISCONNECT(S) SATELLITE DISH p 136 ' DC ROFESSIONP� REA DC DISCONNECT(S) ® FIRE SETBACKS For Structural Only .e COMBINER BOX HARDSCAPE o- r——1 INTERIOR EQUIPMENT —PL— PROPERTY LINE LC J SHOWN AS DASHED SCALE NTS A APERE s AC ALTERNATING CURRENT u n r u n AFCI ARC FAULT CIRCUIT INTERRUPTER VICINITY MAP - AZIM AZIMUTH COMP COMPOSITION 54139-ME DC DIRECT CURRENT (E) EXISTING 15 CHAFLOTM AVE HIC"B LLEW 11801 ' �.., ,ss^ EXT EXTERIOR PHtN1EBO8.WD.8A81 i - FRM FRAMING r=Axeaiaama _ INT INTERIOR CUSTOMER RESIDENCE LBW LOAD BEARING WALL _ « _ SHANNON SIMON MAG MAGNETIC 17130 MAIN ST,NEW SUFFOLK, MSP MAIN SERVICE PANEL NY,11956 Cutchogue . - •'`�. ;:• ' (N) NEW NTS NOT TO SCALE TEL(631)734-7237 OC ON CENTER _ ,.;^ - PRE-FAB PRE-FABRICATED APNB 1000.117-00-09-00-028-001 o- a PROJECT NUMBER r PSF POUNDS'PER SQUARE FOOT 1 _ -PV PHOTOVOLTAIC 211R-130SIMO TL TRANSFORMERLESS DESIGNER (415)5846920 ex3 ortri Fn_rK Country Club. TYP TYPICAL V VOLTS TYLER GOLD W WATTS sHEECOVER SHEET REV NAME DATE COMMENTS a_ _� - :1713gtv)ain67reet , REV A_ 5/32019 PAGE PV-1.O SITE PLAN-SCALE=3/32"=1'-0" SITE PLAN DETAIL-SCALE=1132"=1'-0" ARRAY TRUE MAG PV AREA PITCH AZIM AZIM (SOFT) ® P AR-01 1 23° 830 950 2696 AC SE MAIN S7 PL (E)RESIDENCE (E)RESIDENCE 9 AC 0 r (E)DETACHED 72 STRUCTURE (N)CONDUIT RUN (ENTRENCHED—40 FT) PL AACC ,NV sunrun OF NLP K Z40, Op� 54139-ME t � t 15 CHARLOTTE AVE H=SVLE W 11M PHCHEea5s 5. FAX 5aam6am v09136� s`t=� CUSTOMER RESIDENCE SHANNON (N)ARRAY AR-01 OFESSIONQ� ST,N 17130 MAIN ST,NEW SUFFOLK, NY,11956 For Structural Only TEL(631)734-7237 (E)DETACHED APN#1000-117-00-09.00-026-001 STRUCTURE PROJECT NUMBER 211R-130SIMO DESIGNER (415)580-6920 ex3 TYLER GOLD SHEET SITE PLAN REV A 5/3/2019 PAGE PV-2.10 ROOF TYPE MOUNTING DETAIL ROOF HEIGHT ROOF FRAME FRAME TYPE FRAME MAX FRAME OC ROOF EDGE MAX PEN MAX MOD DESIGN CRITERIA EXPOSURE MATERIAL SIZE SPAN SPACING ZONE SPACING OVERHANG MODULES: AR-01 COMP SHINGLE FLASHTRACK COMP SEE DETAIL SD-00708 1 STORY EXPOSED WOOD RAFTER 2 X 6 ll'-10' 16" 3' 4-0" 2'-0" REC SOLAR REC290TP2 BLK MODULE DIMS: D1-AR-01-SCALE:114^=1'-0^ 65 94"x 39 25"x 149"(38mm) PITCH:23' MODULE CLAMPS: AZI M.83' Portrait 8 2"-16 4" Landscape 0"-9 75" MAX DISTRIBUTED LOAD:3 PSF SNOW LOAD:20 PSF WIND SPEED: 130 MPH 3-SEC GUST LAG SCREWS' 5/16"x4.0" 2 5"MIN EMBEDMENT NOTE: INSTALLERS TO VERIFY RAFTER SIZE,SPACING AND SLOPED SPANS,AND NOTIFY E 0 R OF ANY DISCREPANCIES BEFORE PROCEEDING 2T-9 4'-7" � PENETRATION SPACING. FULLY STAGGERED El 1' ROW SPACING: El 1.00"BETWEEN ROWS COLUMN SPACING: 0 75"BETWEEN COLUMNS E3 E3 E3 1t7 4'TYP— sunrun 10" 54139-ME OF NfW 15 LHAFLDRE AVE,HICNSVILlE NV 11 W1 �YL ZAC y0 wa Emssmsmr qFA%86i�6Fe co Fp* CUSTOMER RESIDENCE r_ SHANNON SIMON }� 17130 MAIN ST,NEW SUFFOLK, NY,11956 136a� S510NP TEL(631)734-7237 APN#1000-117-00-09-00-028-001 PROJECT NUMBER 211R-130SIMO DESIGNER (415)580.6920 ex3 TYLER GOLD SHEET LAYOUT REV A 5/3/2019 SEE SITE PLAN FOR NORTH ARROW PAGE PV-3.0 120240 VAC SINGLE PHASE SERVICE O METER# M PSEGLI 58 696 608 UTILITY ACCOUNT#9622506102 GRID 1 EXISTING / 200A MAIN l BREAKER T EXISTING SOLAREDGE TECHNOLOGIES 200A IN)LOCKABLE (N)LOCKABLE (N)LOCKABLE SE3800H-US WITH REVENUE MAIN BLADE TYPE BLADE TYPE BLADE TYPE GRADE METERING FACILITY PANEL AC DISCONNECT AC DISCONNECT AC DISCONNECT 3800 WATT INVERTER JUNCTION BOX PV MODULES LOADS3 3 3T 3 2 OR EQUIVALENT 1 REC SOLAR REC290TP2 BLK (15)MODULES OPTIMIZERS WIRED IN I' (1)SERIES OF(15)OPTIMIZERS 20A PV SQUARE D SQUARED SQUARE D LOAD RATED DC DISCONNECT BREAKER AT DU221RB DU221RB DU221RB WITH AFCI,RAPID SHUTDOWN SOLAREDGEPOWER OPTIMIZERS OPPOSITE END 3R,30A,2P 3R,30A,2P 3R,30A,2P COMPLIANT P320 OF BUSBAR 120240VAC 120240VAC 120240VAC CONDUIT SCHEDULE NOTES TO INSTALLER- 1 15 VDC EXPECTED OPEN CIRCUIT STRING VOLTAGE # CONDUIT CONDUCTOR NEUTRAL GROUND 2 ADD 20 AMP PV BREAKER TO MAIN PANEL 1 NONE (2)10 AWG PV WIRE NONE (1)6 AWG BARE COPPER 2 1"PVC OR EQUIV (2)10 AWG THHN/THWN-2 NONE (1)10 AWG THHN/THWN-2 s u n r u n 3 1"PVC OR EQUIV (2)10 AWG THHN/THWN-2 (1)10 AWG THHN/THWN-2 (1)8 AWG THHN/THWN-2 1"SCH 40 PVC 3T (BELOW GROUND) (2)8 AWG THHN/THWN-2 1"SCH 80 PVC (1)10 AWG THHN/THWN-2 (1)BAWG THHN/fHWN-2 54139-ME (ABOVE GROUND) 15CHMiL AVE,HXYSVXL W11801 A10NE 805.505691 FA%BdS.]8= CUSTOMER RESIDENCE SHANNON SIMON 17130 MAIN ST,NEW SUFFOLK, NY,11956 MODULE CHARACTERISTICS P320 OPTIMIZER CHARACTERISTICS: \ TEL(631)734-7237 REC SOLAR REC290TP2 BLK 290 W MIN INPUT VOLTAGE B VDC APN#1000-117-00-09-00-028-001 OPEN CIRCUIT VOLTAGE 38 8 V MAX INPUT VOLTAGE 48 VDC MAX POWER VOLTAGE 321 V MAX INPUT ISC 11 ADC PROJECT NUMBER 211R-130SIMO SHORT CIRCUIT CURRENT 9 71 A MAX OUTPUT CURRENT 15 ADC DESIGNER (415)580-6920 eXJ SYSTEM CHARACTERISTICS-INVERTER 1 TYLER GOLD SYSTEM SIZE 4350 W SHEET SYSTEM OPEN CIRCUIT VOLTAGE 15 V SYSTEM OPERATING VOLTAGE 3BO V ELECTRICAL MAX ALLOWABLE DC VOLTAGE 480 V SYSTEM OPERATING CURRENT 11 45 A REV A 5/32019 SYSTEM SHORT CIRCUIT CURRENT 15A PAGE PV-4.O INVERTERI _ NOTES AND SPECIFICATIONS Q! WARNING. QI WARNING gir, •SIGNS AND LABELS SHALL MEET THE REQUIREMENTS OF THE NEC 2014 ARTICLE 110 21(B),UNLESS SPECIFIC INSTRUCTIONS ARE REQUIRED BY SECTION 690,OR - m •m •e 11 45 •o r IF REQUESTED BY THE LOCAL AHJ ELECTRICAL SHOCK HAZARD ELECTRICAL SHOCK HAZARD -. � ,r e •® m •. ;gp I a �� � ® J _ _ •SIGNS AND LABELS SHALL ADEQUATELY WARN OF HAZARDS USING EFFECTIVE _, �_ �~ WORDS,COLORS AND SYMBOLS DO NOT TOUCH TERMINALS. IF GROUND FAULT IS INDICATED o 480 0 y,, ' s 1 0 ® ®® _ •LABELS SHALL BE PERMANENTLY AFFIXED TO THE EQUIPMENT OR WIRING TERMINALS ON LINE AND LOAD ALL NORMALLY GROUNDED o• Ss .c METHOD AND SHALL NOT BE HAND WRITTEN SIDES MAYBE ENERGIZED IN CONDUCTORS MAYBE LABEL LOCATION •LABEL SHALL BE OF SUFFICIENT DURABILITY TO WITHSTAND THE ENVIRONMENT THE OPEN POSITION UNGROUNDED AND ENERGIZED) LABEL LOCATION UTILITY SERVICE ENTRANCEIMETER,INVERTER/DC INVOLVED INVERTER(S),DC DISCONNECT(S) DISCONNECT IF REQUIRED BY LOCAL AHJ,OR •SIGNS AND LABELS SHALL COMPLY WITH ANSI 2535 4-2011,PRODUCT SAFETY LABEL LOCATION LABEL LOCATION PER CODE(S)CEC 2016 690 53,NEC 2017 690 53,NEC OTHER LOCATIONS AS REQUIRED BY LOCAL AHJ SIGNS AND LABELS,UNLESS OTHERWISE SPECIFIED S1 NEC0 53 PER CODE 53, C 201 INVERTER(S),AC DISCONNECT(S),AC INVERTER(S),ENPHASE ENVOY 2014 69D ()CEC 2018 89012,NEC 2014 680 12, •DO NOT COVER EXISTING MANUFACTURER LABELS COMBINER PANEL OF APPLICABLE) ENCLOSURE OF APPLICABLE) NEC 690 56,IFC 2012 605 111 PER CODE(S)CEC 2016 690 17(E),NEC PER CODE(S)CEC 2016 690 5(C),NEC 2014 690 17(E),NEC 2011 690 17(4) 2014 690 5(C),NEC 2011 690 5(C) &I WARNING &WARNING ELECTRICAL SHOCK HAZARD DUAL POWER SUPPLY THE OC CONDUCTORS OF THIS SOURCES:UTILITY GRID PHOTOVOLTAIC SYSTEM ARE AND PV SOLAR ELECTRIC UNGROUNDED AND MAY BE ENERGIZED SYSTEM LABEL LOCATION LABEL LOCATION INVERTER(S),DC DISCONNECTS UTILITY SERVICE METER AND MAIN PER CODE(S)CEC 2016 690 35(F),NEC SERVICE PANEL 2014 69035(F),NEC 2011 69035(F) PER CODE(S)CEC 2016 70512(D)(3), NEC 2014 70512(D)(3),NEC 2011 70512(D)(4) &WARNING &WARNING INVERTEROUTPUT CONNECTION PHOTOVOLTAIC SYSTEM DO NOT RELOCATE THIS COMBINER PANEL OVERCURRENT DEVICE DO NOT ADD LOADS LABEL LOCATION -LABEL LOCATION: s u n r u n ADJACENT TO PV BREAKER OF PHOTOVOLTAIC AC COMBINER OF APPLICABLE). APPLICABLE) PER CODE(S)CEC 2016. PER CODE(S)CEC 2016 70512(D)(2)(3)(b),NEC 2014• 70512(D)(2)(3)(c),NEC 2014 BUILDING SUPPLIED BY UTILITY 70512(D)(2)(3)(b),NEC 2011 70512(0)(7) 705 12(D)(2)(3)(c),NEC 2011 705 12(0)(4) GRID AND PHOTOVOLTAIC 54139-ME SYSTEM15CHMil°TfEAV WC LLl W11801 FA%80.5250.1D]2 ®® ® ® ® CUSTOMER RESIDENCE LABEL LOCATION SHANNON SIMON17130 MAIN ST,NEW SUFFOLK, INTERIOR AND EXTERIOR DC CONDUIT EVERY 10 FT, AT EACH TURN,ABOVE AND BELOW PENETRATIONS, NY,11956 ON EVERY JBIPULL BOX CONTAINING DC CIRCUITS PER CODE(S)CEC 2016 690 31(G)(3).690 31(G)(4),NEC TEL(fi31)734-7237 2014 69031(G)(3).690 31(G)(4).NEC 2011 69031(E)(3), 690 31(E)(4),IFC 2012 605 11 1 4 APN 0 1000-117.00-09-00-028-001 PROJECT NUMBER •�yyy����1yy81I9�® ® ® o ® 211R-130SIMO �•n're�+le� °•,_ PV SYSTEM DESIGNER (415)580-6920 eX3 o DISCONNECT TYLER GOLD LABEL LOCATION SHEET AC DISCONNECT(S),PHOTOVOLTAIC SYSTEM POINT OF SIGNAGE INTERCONNECTION PER CODE(S)CEC 2016 690 54,NEC 2014 690 54,NEC 2011 69054 REV A 5/3/2019 LABEL LOCATION POINT OF INTERCONNECTION PAGE (PER CODE NEC690 56(B),NEC705 10,225 37,230 24E)) PV-5.0 SnapNrack- Solar Mounting Solutions Series 100, Residential Roof Mount System The SnapNrack Series 100 Roof Mount System is engineered to optimize material use, labor resources and aesthetic appeal. This innovative system simplifies the process of installing solar modules, shortens installation times, and lowers installation costs; maximizing productivity and profits. The Series 100 Roof Mount System boasts unique, pre-assembled, stainless steel "Snap- In" hardware and watertight flash attachments. This system is installed with a single tool. No cutting or drilling means less rail waste. It is fully integrated with built-in Wire management, solutions for all roof types, ®ne=size-fits-all features, and can withstand extreme environmental conditions.- Series 100 is listed to UL Standard 2703 for Grounding/Bonding, Fire Classification and Mechanical Loading. UL 2703 Certification and Compliance ensures that SnapNrack installers can continue to provide the best in class installations in quality, safety and efficiency. Appealing design with built-in aesthetics No grounding lugs required for modules All bonding hardware is fully.integrated Rail splices bond rails together, no rail ,,` jumpers required .:tom/'^r" •` J.-' ld .• ' -, rY No drilling of rail or reaching for other tools �` r"F l 5 K�4", f Lr I _..i ,�"J 'nab-�yp''•' r. _ —........ required Class A Fire Rating for Type 1 and 2 modules .=:y}k=,.�-rti" ' ' "�:.:'�•$`"r� ,.,t.Yp•}Y�`'..;ila:t;��',4j)ri�.:41�`„''.t,..ji;�,�-i}y=J System Features Include LYE= Snap in Single Tool Easy No Cutting Hardware Installation Leveling or Drilling I ISS , Integrated Wire Preassembled Integrated bonding UL 2703 Certified Management hardware Resources snapnrack.com/resources 0 Design snapnrack.com/configurator .p Where to Buy snapnrack.com/where-to-buy SnapNrack Solar Mounting Solutions -� Stainless Bolt with Stainless Steel Bonding Splice Standard Rail Split-Lock Washer Bolt with Split- Insert - - 075-09816 Lock Washer Banding Adjustable Bonding End Clamp Top Splice Mid Clamp Base Bonding Bonding Adjustable t4r—Bonding Channel Nut End Clamp Bottom Channel Nut Stainless Stainless Hardware with Bolt with Split-Lock Washers Split Lock Bonding Adjustable Bonding Mid Clamp Bonding StandardWasher End Clamp 242-02053 Reil Splice Ground Lug 242-02067 242-04015 242-02101 12-6 AWG Copper Wire Ground Lug Assembly ® (ONE REQUIRED PER ROW OF MODULES) Unlversal End Clamp(UEC) n / Wave UEC Pull Strap UEC Wedge Stainless Steel Bolt with Flat Washer Universal End Clamp F F IF IF z42-ozns Standoff Clamp Assembly � - Rubber-40Serrated Stainless Channel Channel Nut Rain Collar Steel Flange Nut Nut - Stainless Serrated Stainless— Flange Nut Steel Flange Bolt 92 Degree Stainless Mill Finish Standoff L Foot �� Flange Bolt All Purpose L Foot Mill Finish Standoff Metal Roof Base(1-Hole Mill Finish rol Base Assembly Base Shown) ��1� Flashing L Foot Base ' Metal Roof Base Standoff J L L Foot Base with Flashing Jwith L Foot 242-92057 242-92050 242-02037 SERIES 100 TECHNICAL DATA f • 6000 Series aluminum 1 I Materials • Stainless steel • Galvanized steel and aluminum flashing _J • Silver and black anodized aluminum • Mill finish on select products Material Finish • Silver or black coated hardware Note:Appearance of mill finish products may vary and change over time. i Wind Loads -- 110190 mph (ASCE 7-10)�^ Snow Loads 0-120 psf Array Pitch 0-60 degrees I i ,877-732-2860 p www.snapnrack.com 3 contact@snapnrack.com ©2016 by SnapNrack Solar Mounting Solutions.All rights reserved Tloo��.�21 � y B0.1ar o Qe • Single ase Invev with HD-Wave Technology f®r North America SE300OH-US/SE380OH-US/SE500OH-US SE600OH-US/SE760OH-US/SE10000H-US/SE1140OH-US solar=M '•.'+i"9��w�c �'. ?<,>�:i,`: :? �! ,.�:,�?S'', an, solar-- AD.. '� Y _5+ ,`f.=;;�''���:'�i �„• `�79W®iien141• �� t,, Fl - :.$-��;_�:,,,,:4��,�Y"''_ _r g .. .................'_ - _'�_• �•dg -nJ`•1•I - ;'S _ �`iu'�� s'fi:r�rt''6-y`s.-',',�.�.,,"' 1 `;_'_ .. - ._..____- _.._ ,.,-w4._�'�x•"'I pc..µ„",r _.. :,`r`„ - �Rrm i, '�'° '. l�r, j!^tJ V fa, - ` �""~"."�.t_-.r. �.,r">.4 45 r� aou =g�,Ee. w}, K Qptimized, installation with M-Wave te'chno'logy - Specifically designed to work with power optimizers Record-breaking efficiency Fixed voltage inverter for longer strings Integrated arc fault protection and rapid shutdown for NEC 2014and 2017,per article 690.11 and 690.12 - UL1741 SA certified,for CPUC Rule 21 grid compliance Extremely small High'reliability without any electrolytic capacitors ]j Built-in module-level monitoring QlIQBQ �� Outdoor and indoor installation Optional: Revenue grade data,ANSI C12.20 Class 0.5(0.5%accuracy) www.solaredge.us Sofa, ingle®- ® - _ with HD-Wave Technology for,NN'or th, Amorl'ta " SE300OH-US/SE380OH-US/SE5000H'-US/ " SE6000H-US/SE7600H-US'/S'E10000H-US/SE'11:40:0,H-U,S' =' • ;` :SE3000H-US SE380OH-US SE5000H-US ( SE6000H-US SE7600H-US 'SE10000H-US T SE11400H-US :.,'OUTPUT , 3800 @ 240V 6000 @ 240V Rated'AC Power 0ufput 3000. 5000 7600 10000 11400 VA ,;�;•;•; ,;,• 3300,@ 208V,, 5000• 208V, „ 3800 @ 240V 6000 @;240V . Max:AC'Power0utput', 8000'.. 5000 7600 10000 11400 VA 3300 @ 208V ,., 5000 208V AC Outppt'V ege Min'.-Nom:Max., - ✓ """""" (1$3=208,= Vac ✓ - AC OutputVoltage'MinrN6,M.-mg)X: '✓' ` ✓ (211;240,:2641;.:::.''AC ✓ ! ✓ ✓ ✓ 14 Vac,Ereguenctrr jNominal�; a: 59. _6 ui.... ........ . 3 ..x-60:5 HZ.. MaxlmuniContinuousOutptitCurrent - "' """"' c.Y., j.r,. ,,• '' p _ .. ,.. A, ... Maxim um°Continuous Output Current .x'.12.5...... .......16...... 21 2i ....,..25 .... 32 41', , 47.5,. A' GFUThreshdltl ,?', -_ .j`'..,, 1' ......... ° ..•.. ..... 1Jti111 y Miinitoring,'�sianding Protection.............. . ........ ............ ...... A Coilnt' Confi'ura6le Threslioltls°' '.''P• Yes' ' r Maulmum1DC'Power@240V:,; : 4650 5900. 7750 9300;,•,,.• 11800, 15500' 17650' W` maximum DC Power @208V, 5100; 7750• " ;Trarisformer•Iess,Ungrounded: ...............6..•.•...•............. ......... ..... ..Yes. __ . =Maxirhum'.In ut VoltaBe`'i ' - ra — ..:..•..... ._•`..... _ ." ;'.;:« _: .'T_ Nominal,DClnputVoltai 380: Vdc ... J?le !Yjya.*utCu`rreiO208V, 13; 400„ Vd'c Maxitntirti'Iri`uf Crirreni @24Q11 z+, 8.5 10.5 135 .....• p.�. 1'.... �. :.. . 16:5:' .. 20 ` 2T ....... Atic, Max`.'IriputShoftGircuit`Currenti` '' 45 .;;•' ..... :ReveFserP,ola�i ................. ;.:.:.... -::• .. Yes•.. fiault:lsolation'detiectiori 6001mSensitivi' "' ' .f.'.....,...... ........... .. r'' ......... ...... ..•,• '•' MoXimum,lnverfer,•Eficiency; 99. �, 96a CEC1N�1"hted EffiiciencSi;..,`` 9'..',1., Nlghfhme;PouirerrConsum'tim., '., ',�, - - :;w,,,;f+'. a5:¢o-rC'r` .,'L 1Hx t;; .y; ins ,yr•,a, -- 'S r. 'W' , >:•Ai1DITIONAL;FEATFJRES:� :a,;� ���"...:, `%•' �;,,�,;: .,,�,'� T; , Suppo-dd!Cd'- riltation`Interfaces` ' _ : RS485,Ethernet ZigBee o"tional Cellular d tianal r. �.P.., �. �.P.. :,Rgveriue""`Grade Data•ANSI'C12;201 pti Rapid'Stiutd'owrr ,NEC20;14'ari8 2077, 0onal - 690.12 '' ; Automatic Rapid Shutdown upon AC Grid'Dlsconnecfs •STAMOA&COM0LIAWcE,'; - Safe#y UL1741,UL1741 SA;UL1699B;CSA•C22:2;CanadlantAFCI'accordin to TLL M'07' Grid.Connectiom5fandarils: IEEE1547 Rule I' "' ""' Emissions: rs; ' _ FCCPaitV5Class•B' (` :INSTALL(ATION;SPEcIFICATIONS,.` ' " r `ACOutputGondult3ize,%AWGRange:` a a3'4".`minftriur»'.14r6AWG 314"'mi' �•.... �'.. / nimum_14-4AWG:; �t)'C'IripufCondu(t5iie!(�ffo'fStrings%" _ �� ........... . .... ........':t. ..... ..-.. . ...,. ... ....•.%. ; ..... AWG Ran a 3/4 fn1himums/•,1-2`strings/,146!AWG 3�4' rn[AiIUWin,'1=3 strings ....... 0aw7:y x 14. , , : • 0)mes( n ' itiDl x 185;; in`/mm` Wel�ht wltli Safety Switch... ... ... 22(10 �: 38.8• 'j?' Nd .�',,25:1(,11:4•.��..... .'26,2 f 11:9...... � /'1 6��. :•Ib' .k.,. se,......... .................. ...... 25. c50 dBA Coaling Natural CoP%ecl70n f Naturalconve'ction:,._........,... OperatinTe:..erature:Ran e.......... :.la mp 6 -13.to+140%'_25Ya+60 ,(40°F(-40°C,option)!_ •p,� :.Protection Rating _ ,... •C:.. NEMA,3R(InJerter with Safety 5witcn)r Iu For other regional settings please contact SolarEdge support iy Revenue grade Inverter P/N:SExxxxH•USOo0NNt2 (�For power de•raNng InroPmallon refer t6;haps://www,solaredge.cam/site's/default/,Ales/se•tamperaturo•derating•note•na.pdf• 40 verslon,P/N:$ExxxxH..US000NNU4. • �o _ _ _ e P .moo• P o ► -`r - - °e.°- a•- � a•- _ ll� ui✓��sa tt� n �i\��Z., �1 13V REE TWINPEAK '2 5ERIE5- PREMIUM SOLAR PANELS WITH SUPERIOR PERFORMANCE- REC TwinPeak Z Series solar panels feature an innovative design with high panel efficiency and power output,enabling customers to get the most out of the space used for the installation. Combined with industry-leading product quality and the reliability of a strong and established European brand,REC TwinPeak Z panels are ideal for residential and commercial rooftops worldwide. u{sem. •' `S oil.,x PID FREE MOREPOWER IMPROVED PERFORMANCE 100% REDUCES RAI ANCEOF OUTPUT PER M' IN SHADED CONDITIONS PID FREE SYSTEM COSTS RE[ TWINPEAK 2 SERI __1675S25I85.94301L__ EFFICIENCY 2811 11 910[3591 _ 382 5[5 OS] O 1:0-11-9-00-"1, + YEAR PRODUCT WARRANTY I1 YEAR LINEAR POWER OUTPUT WARRANTY o a y*FRF US IMPORT DUTY FREE a '111±0'11302 [043 309J F' 205305'~ RATINGS to 7e 3ooal12001471 m Nominal operating cell temperature(NOCT) 446"C(t2°C) } Temperature coefficient of PMP, -0.39%/"C 45[14 + Temperature coefficient ofVcc -0.3151./°C Measurementslnmmllnl 138[15] Temperature coefficient of l,c 0.045%/°C Nominal Power-PM,p(Wp) 275 280 285 290 295 Celltype• 120 REC HCmulticrysta[line Watt Class Sorting-(W) 0/+5 0/+5 0/+5 0/+5 0/+5 6 strings of 20 cells Nominal Power VoltageVM,p(V) 31.5 31.7 319 32.1 32.3 Glass 013"(32mm)solar glass with anti-reflective surface treatment Nominal Power Current-IMpp(A) 874 8.84 895 9.05 9.14 Backsheet. Highly resistant polyester Open Circuit Voltage-Voc(V) 38.2 384 38.6 38.8 39.0 polyolefin construction Short Circuit Current-15C(A) 9.30 939 949 9.58 965 Frame: Anodized aluminum (Available in sliver or black) PanelEfficlency(%) 16.5 16.8 171 174 17.7 Junction box IP67 rated,3-partwith 3 bypass diodes Values at standard test conditions STC(airmass AM 1.5,Irradiance 1000 W/m3,cell temperature 25°C) 12 AWG(4 mm2)PV wire,35"+47"(0.9 m+12 m) At low Irradiance of 200 W/m'(AM 15 and cell temperature 25°C)at least 94%of the STC module efficiency will be achieved `Wherexxxindicatesthenominalpowerclass(PM,e)atSTCindicatedabove,andcanbefollowedbythesuffixBLKforblackframedmodules Connectors: Staub(iMC4PV-KBT4/PV-KST4 12 AWG(4 mm2) Nominal Power-P,,,(Wp) 206 210 214 218 223 Operational temperature -40..+185'F(-40...+85°C) Nominal Power Voltage-VMpp(V) 292 294 296 298 300 Maximum system voltage. 1000 V Nominal Power Current-IM„(A) 707 715 724 732 743 Design Loads. (+)75.2 lbs/ft2(3600 Pa) Open Circuit Voltage-Vo,IV) 35.4 356 35.8 360 362 (-)3341bs/ft2(1600Pa) Short Circuit Current-l,c(A) 752 759 768 7.75 785 Refer to Installation manual Nominal operating cell temperature NOCT(800 W/m2,AM 1S,windspeed 1 m/s,ambient temperature 20°C) Max series fuse rating, 20A *Where xxx indicates the nominal powerclass(P.)at STC indicated above,and can be followed by thesuffixBLK forblack framed modules � Max reverse current: 20A r +v c c CE OVE �� 10 year product warranty Dimensions 65.9x39.25x15(1675x997x38mm) h C 25year linear power output warranty Area: 1798ft2(1.67m2) C us (max degression in performance ofO 7%p a from 97% UL1703,Fire classification Type 2•IEC612IS,IEC61730, after thefirstyear) Weight: 40 8 lbs(18 5 kg) c IEC 31701(Salt Mist-severity level 6),IEC 62804(PID Free), See warranty conditions for further details z IEC 62716(Ammonia Resistance),ISO 11925-2(IgnitabilityClass 1), UN18457/9174(Class A),150 9001.2015,15014001,OHSAS 18001 Note!Specifications subject to change without notice. Founded In Norway in 1996,REC is a leading vertically integrated solar energy company Through integrated manufacturing from `� silicon to wafers,cells,high-quality panels and extending to solar solutions,REC provides the world with a reliable source of clean energy REC's renowned product quality is supported by the lowest warranty claims rate in the industry. REC is a Bluestar Elkem companywith headquarters in Norwayand operational headquarters in Singapore.REC employs morethan2,000 people worldwide, producing]4 GW of solar panels annually. www.recgroup.com