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HomeMy WebLinkAbout44410-Z �g11F K 40 Town of Southold 8/18/2020 a P.O.Box 1179 0 a' 53095 Main Rd �ylj p� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41364 Date: 8/18/2020 THIS CERTIFIES that the building SOLAR PANEL Location of Property: 2745 Wickham Ave, Mattituck SCTM#: 473889 Sec/Block/Lot: 139.-2-3 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 11/7/2019 pursuant to which Building Permit No. 44410 dated 11/14/2019 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 on existing single-family dwelling as applied for. The certificate is issued to Schultz,David of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 44410 8/10/2020 PLUMBERS CERTIFICATION DATED Authorized Signature i ��o�g�FFut,r°oTOWN OF SOUTHOLD �y BUILDING DEPARTMENT C TOWN CLERK'S OFFICE SOUTHOLD, NY i' 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#: 44410 Date: 11/14/2019 Permission is hereby granted to: Schultz, David PO BOX 624 Mattituck, NY 11952 To: install roof-mounted solar panels on existing single-family dwelling as applied for with flood permit. At premises located at: 2745 Wickham Ave, Mattituck SCTM # 473889 Sec/Block/Lot# 139.-2-3 Pursuant to application dated 11/7/2019 and approved by the Building Inspector. To expire on 5/15/2021. Fees: SOLAR PANELS $50.00 ELECTRIC $100.00 CO -RESIDENTIAL $50.00 lood Pernrit $100.00 Total: $300.00 wilding 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. 10/31/19 New Construction: Old or Pre-existing Building: X (check one) Location of Property: 2745 Wickham Avenue Mattituck House No. Street Hamlet Owner or Owners of Property: David Schultz Suffolk County Tax Map No 1000, Section 139 Block 2 Lot 3 Subdivision �(��// Filed Map. Lot: Permit No. `� -1 / l 0 Date of Permit. Applicant: GreenLogic LLC Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: X (check one) Fee Submitted: $ 50 1 fi�(PpKicant Signature Building Department Application AUTHORIZATION (Where the Applicant is not the Owner) residing at f a �0� 6 Z �Z'�� /®C lv (Print property owner's name) (Mailing Address) IKS2-dado hereby authorize GreenLogic LLC (Agent) to apply on my behalf to the Southold Building Department. (Owner's Signature) (Date) 04V/dI P oyc�a 0/ev—, (Print Owner's Name) CONSENT TO INSPECTION David Schultz ,the undersigned, do(es) hereby state: Owner(s)Name(s) That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold, located at 2745 Wickham Avenue, Mattituck, NY which is shown and designated on the Suffolk County Tax Map as District 1000, Section 139 , Block 2 , Lot 3 That the undersigned (has) (have) filed, or cause to be filed, an application in the Southold Town Building Inspector's Office for the following: Roof mounted solar electric system That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southold to enter 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 knowledge 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: Signature) (Print Name) (Signature) ,(Print Name) ®��oF sovey®� Town Hall Annex ~ ® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 G ® Q sean.deviin(cD-town.southold.ny.us Southold,NY 11971-0959 Cowm,��' BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To. David Schultz Address: 2745 Wickham Ave city-Mattituck st: NY zip: 11952 Building Permit#: 44410 Section- 139 Block. 2 Lot: 3 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Green Logic LLC License No: 43858ME SITE DETAILS Office Use Only Residential X Indoor Basement Solar X Commerical Outdoor X 1st Floor Pool New X Renovation 2nd Floor Hot Tub Addition Surrey X Attic Garage INVENTORY Service 1 ph X Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors Sub Panel A/C Blower Range Recpt Ceding Fan Combo Smoke/CO Transformer UC Lights Dryer Recpt Emergency Fixtures Time Clocks Disconnect Switches 4'LED Exit Fixtures Pump Other Equipment: 11.200kW Roof Mounted Solar Power System w/ 32 SPR-X21-350-BLK-E-AC Panels, Symphony II Power Management System, SunPower Monitoring System, AC Disconnect Notes, Solar Inspector Signature: Date: August 10, 2020 S.Devlin-Cert Electrical Compliance Form.xls oF so�Tyo� Li L/Li 10 , # # TOWN OF SOUTHOLD UILDIN DEP . `ycourm ' 76S-1802 INSPECTION - FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING/STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ j FIRE.SAFETY INSPECTION - [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ -ELECTRICAL (FINAL) �I ® �t [ ] CODE VIOLATION ] PRE C/O REMARKS: DATE INSPECTOR .� A M E S J. S T 0 U T AIRCHITECIT & Assoc. 2 G REG LANE. E AST 1° O RT" HP (} RT I . Y. 631 — a 56. 9 as B Post Installation Letter June 3, 2020 RE: David Schultz 2745 Wickham Ave Mattituck, NY 11952 To Whom It May Concern: This letter is to confirm that as of this June 3, 2020 I, James J Stout, NYS license 021633 have personally inspected the placement and installation of the roof top solar panels at the above listed address. The solar panels have been installed as per manufacturer's guidelines and specifications. The racking system design and installation complies with the 2017 NYSRC and 2017 New York State Uniform Code Supplement and all related provisions. The installation was done as per plan. Thank you for your cooperation in this matter. James J. Stout Architect A r 4 3� OF �i Q OV D. J U L 2 4 2020 BUDDY YG DEPT. FIELD INSPECTION REPORT -DATE COMMENTS _ t IV FOUNDATION (IST) (' -------------------------------------- FOUNDATION (2ND) z � o -� tACIO ROUGH FRAMING& y � PLUMBING 9 r INSULATION PER N.Y. H STATE ENERGY CODE FINAL ADDITIONAL COMMENTS �J �rn L r ' b H ' O y� a H x • e TOWN OF SOU THOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEP)tRTMENT Do you have or need the following,before applying? TOWN HALL t Board of Health SOUTHOLD,NY 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 76579502 Survey Southoldtownny.gov PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application 4 , , Flood Permit Examined 20Single&Separate Truss Identification Form Storm-Water Assessment Form Contact: Approved I I ,20 Mail to: Green Logic LLC Disapproved a/c - 97 North Sea Road, Southampton, NY Phone: 631-771-5152 Expiration ,20 gl Buildin nspector • r i APPLICATION FOR BUILDING PERMIT NOV - 6 2019 Date October 31 520 19 "''` 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 Inspectormill 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,and regulations,and to admit authorized inspectors on premises and in building for necessary inspections. GreenLogic LLC (Signature of applicant or name,if a corporation) • c - 97 North Sea Road, Southampton, NY 11968 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder Contractor Name of owner of premises David Schultz As on the tax roll or latest deed) If applicant is a corporation, signator o au zed officer John,Rocchetta,Vice President (Name and title of corpgr/ e f1 er) Builders License No. 402277 Plumbers License No. N/A Electricians License No. 43858-M E Other Trade's License No. N/A r 1. Location of land on which -proposed work will be done: 2745 Wickham Ave Mattituck House Number Street Hamlet County Tax Map No. 1000 Section 139 Block 2 Lot - 3 Subdivision _ 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 Single family dwelling b. Intended use and occupancy Single family'dwelling 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Work Roof mounted solar electric system (Description) 4. Estimated Cost $413788 Fee $200 (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 10/16/1979 Name of Former Owner John R. Albrecht 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation?YES NO X 13. Will lot be re-graded?YES -NO X Will excess fill be Oopremises?YES NO X P Box 4 14.Names of Owner of premises Address Phone John SchultzMattituck, NY 11 No. 631-678-3124 Name of Architect James stout rc itect& ssoc Address 2 Greg Ln,E.Northport, N)Phone No 631-858-9388 Name of Contractor GreenLogic LLC Address97 North Sea Road Phone No. 631-771-5152 out ampton, NY 11968 15 a. Is this,properly within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES x 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 x NO * IF YES,PROVIDE A COPY. STATE-OF NEW YORK) SS: COUNTY OF Suffolk ) John Rocchetta being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)He is the Contractor ° (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 tyerewi .t0* SG�.ee Sworn to before me this Gp' °k or.; � ` jj���,,�� ���day of C'TUY�K 20LI p�P Notary Public OJ��y Signature of Applicant F SCHEDULE B A• F.r '� � � s„ l «a.5" «t-`ib, '�=A "� r, i•.hC`-5i.- e..'�;; H nom, .S «, x�jv }�•e _S 3.?C',L-'.». ' Y'-'XQ'Sh- F.BS?s�4".�,^ a"' , `_ �° t• + ]BOARD OF S UTHOLD TOWN TRUSTEES r SOUTHOLD,NEW YORK PERMIT NO. 9375 DATE: DECEMBER 12,2018 r.;t n ISSUED TO: DAVID SCHULTZ .` �. PROPERTY ADDRESS: 2745 WICKHAM AVENUE.MATTITUCK . SCTM# 1000-139-2-3 ,q AUTHORIZATION � E m: Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on December 12, 2018, ` and in consideration of application fee in the sum of$250.00 paid by David Schultz and subject to the Terms ` and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the s following: y<N ti Wetland Permit to raise in-place existing one-story,single-family dwelling 24 inches to a t proposed FEMA compliant first floor elevation of 11.1' on a new FEMA compliant foundation; remove existing cellar entrance,and fill basement; demolish and reconstruct existing chimneys; construct new roof addition over existing first story to remain; construct±81x23' one-story i ' addition on southwest side of house in place of existing wood deck to be removed; construct ` 61x10'porch on southwest side of dwelling with attached 51x10' steps in place of existing landing and steps to be removed; construct a 5.3'x4.5' porch with attached 3.5'x5' steps at rear a of house; remove existing nonconforming sanitary system from southwest side of dwelling and a install new S.C.D.H.S.approved sanitary system on landward side of dwelling; remove existing concrete block wall from landward side of dwelling; install a drainage system of leaders, gutters and drywells to dwelling; and establish and perpetually maintain a 10'wide non-turf buffer along the landward edge of the tidal wetlands; and as depicted on the survey prepared by Nathan Taft Corwin III,Land Surveyor dated August 1,2018,and stamped approved on December 12,2018. e ¢ IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, j and these presents to be subscribed by a majority of the sand Board as of the 12th day of December,2018.. +Ili e : +e a TERMS AND CONIDITIONS The Permittee David Schultz;residing ati2745 Wickham Ayenue..Mattituek. New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following:' 1. That the said Board of Trustees and the Town of Southold are released from any and all damages,or claims for damages,of suits arising directly or indirectly as a result of any operation performed pursuant to this permit,and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto,to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 24 months,which is considered to be the estimated time required to complete the work involved,but should circumstances warrant,request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely,or as long as the said Permittee wishes to maintain the structure or project involved,to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents,and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized,or if,in the opinion of the Board of Trustees,the work shall cause unreasonable obstruction to free navigation,the said Permittee will be required, upon due notice,to remove or alter this work project herein stated without expenses to the Town of Southold. 8. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety(90)calendar days of issuance of this permit. 9. That the said Board will be notified by the Permittee of the completion of the work authorized. 10. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit,which may be subject to revoke upon failure to obtain same. 11. No right to trespass or interfere with riparian rights. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights,title, or interest in real or personal property held or vested in a person not a party to the permit. 2 Si>'�jjyo{ 0 Town Hall Annex 4 Telephone(631)765-1802 54375 Main Road P.O.Box 1179 G rogerAchertr'c te`wn soutli01 nv us Southold,NY 1197I-0959 Q �O BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Barbara Casciotta Date: 10/31/19 i Company Name: GreenLogic LLC Name: Robert Skypala License No.: 43858-ME Address: 97 North Sea Road Southampton, NY 11968 Phone No.: 631-771-5152 i JOBSITE INFORMATION: (*Indicates required information) *Name: David Schultz i *Address: 2745 Wickham Avenue, Mattituck, NY 11952 1 *Cross Street: *Phone No.: 631-678-3124 Permit No.: i Tax-Map District: 1000 ection: 139 Block: 2 Lot: *BRIEF DESCRIPTION OF WORK(Please Print Clearly) Roof mounted solar electric system (Please Circle All That Apply) *Is job ready for inspection: YES NO Rough In Final *Do you need a Temp Certificate: ES NO Temp Information(If needed) *Service Size: 1 Phase 3Phase 100 150 200 300 360 400 Other *New Service: Re-connect Underground Number of Meters Change of Service Overhead Additional Information: PAYMENT DUE WITH APPLICATION 9JD X82-Request for Inspection Form Y � Scott, A, Russell ,���' �� STORM\SVA\TIER SUPERVISOR C MANAGEMENT SOUTHOLD TOWN HALL-P.O.Box 1179 � 53095 Main Road-SOCTCHOLD,NEWYORK 11971 . Town of Southold CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET (TO BE COMPLETED BY THE APPLICANT ) DOES THIS PROJECT INVOLVE, ANY {3E THE FOLLOWING- (CHECK ALL T HAT APPLY") Yes No ❑Q A. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. s ❑ B, Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. ❑0 C. Site preparation on slopes-which exceed 10 feet vertical rise to ; 3 100 feet of horizontal.distance. ❑(x] D: Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. xE] E.. Site preparation within the one-hundred-year floodplain,as depicted on FIRM Map of any watercourse. ❑Q F. Installation of new or resurfaced impervious surfaces of 1,000 square feet or more, unless prior approval of a Stormwater Management Control Plan was received by the Tawn 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, 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,Departament with your Building Permit Application. APPLiCA1%M ;Profierty Owner,Demgn Profeb conal,Agent,Contractor,01herl 'C•T" I��� Pate. Dwric: NAYIE: 139 2 3 10/31/19 .e: Section Block Lot t i FOR 13UILDING DLPARTNILN'I'USI:ONL=Y Contact lmaticm, 631-771-5152 l rhMph..N—t", i� REVICWC(1 BY: 1 — — — — — — — — — — — — — — — — — 1 i I ' Date: i Properiv Address J Location of Construction Work: — — — — — — — — — — — — ;— Approtired.for processing Building Permit. ! 2745 Wickham Ay nueStorm l - - — — — — — — — — — — — — — evater 11�fanagement Control Plan Not Required. Mattituck, NY 11952 Stormwatei-Management Control Plan is Required. a ! ® tFor«Ord to Engineering Department for Review.) i i >~oRms# smcr—TipsM&Y 20 l 4 _._ SO�jjyo! � o Town Hall Annex 4 4 Telephone(631)765-1802 54375 Main Road ��r��raaxx 05015. P.O.Box 1179 G Q ro(]E�rlCherf(mLOW(1 SOl� nV uS Southold,NY 11971-0959 ���� ►�'�� !. BuaDING DEPARTMENT f TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Barbara Casciotta Date: 10/31/19 t Company Name: . GreenLogic LLC Name: Robert Skypala ' License No.. 43858-ME Address: 97 North Sea Road Southampton, NY 11968 Phone No.: 631-771-5152 3 JOBSITE INFORMATION: (*Indicates required information) *Name: David Schultz *Address: 2745'Wickham Avenue, Mattituck,.NY 11952 *Cross Street: *Phone No.: 631-678-3124 Permit No.: Tax-Map District: 1000 ection: 139 Block: 2 Lot: *BRIEF DESCRIPTION OF WORK(Please Print Clearly) Roof mounted solar electric system (Please Circle All That Apply) Is job ready for inspection: YES NO Rough In Final Do-you need a Temp Certrfica#e: _ . ES NO - Temp Information(If.needed) *Service Size: ' 1 Phase 3Phase 100 150 200 300 360 400 Other *New Service: Re-connect Underground Number of Meters Change of Service Overhead Additional Information: PAYMENT DUE WITH APPLICATION D B2�f2equest for Inspection Form �5`� Ned n _.J rs m. Mme, APPLICATION • PAGE I n1 4 —` TOWN OF SOUTHOLD FLOODPLAIN DEVELOPMENT PERMIT APPLICATION "Phis form is to be filled out in duplicate. SECTION 1 GENERAL, PROVISIONS (APPLICANT to read and sign): 1. No work may start until a permit is issued_ 2 The permit may be revoked if any false statements are, made herein. 3. If revoked, all work must cease until permit is rc-issued. 4. Development shall not be used or occupied until a Certificate of Compliance is issued. 5. The permit will expire if no work is commenced within six months of issuance. 6. Applicant is hereby informed that other permits may be required to fulfill local,state and federal regulatory requirements. 7. Applicant hereby gives consent to the Local Administrator or his/her representative to make reasonable inspections required to verify compliance. 8. I,THE APPLICANT,CERTIFY THAT ALL STATEMENTS HEREIN AND IN ATTACHMENTS TO THIS APPLICATION ARE,TXTHFV- OP MY OIvLEDGE,TRUE AND ACCURATE. (APPLICANT'S S�tJ1ATUREDATE 10/31/19 SECTION 2: PROP SEB D `c.LOPMENT b be com lctcd by APPLIC NAME ADDRESS TELEPH NE APPLICANT GreenLogic LLC 97 North Sea Road, Southampton, NY 11968 631-771--5152 BUILDER GreenLogic LLC 97 North Sea Road, Southampton, NY 119 - - 152 ENGINEERJames J. Stout Architect &Assoc. 2 Greg Lane, East Northport, NY 11731 631-858-9388 -PROJECT LOCATION: To avoid delay in processing the application. please provide enou¢h information to easily identify the project location. Provide the street address, lot number or legal description (attach) and, outside urban areas, the distance to the nearest intersecting road or well-known landmark. A sketch attached to this application showing the project location would be helpful. 2745 Wickham Avenue, Mattituck, NY 11952 SCTM: 1000-139-2-3 Roof mounted solar electrics stem FDP(93) ' A-PPLICATION PAGE 2 OF 4 ---- DESCRIPTION OF WORK (Check all apphcable boxes) A. STRUCTURAL DEVELOPMENT AC'TIV17 STRUCTURE TYPL- ❑ New Structure 0 Residential (I-4 Family) ❑ Addition O Residential (More than 4 Family) ® Alteration O Non-residential (Floodproofing? ❑ Yes) ❑ Relocation ❑ Combined Use (Resi(iential & COmmerclal) 0 Demolition ❑ Manufactured (Mobile) Home (In Manu- 0 Replacement factured Home Park? ❑ Yes) ESTIMATED COST OF PROJECT s 41,788 B. OTHER DEVELOPMENT ACnVITIES: ❑ Fill ❑ Mining 0 Drilling ❑ Grading ❑ Excavation (Except for Structural Development Checked Above) ❑ Watercourse Alteration (Including Dredging and Channel Modifications) O Drainage Improvements (Including Culvert Work) [3 Road, Street or BAdge Construction O Subdivision (New or Expansion) 0 Individual Water or Seltr System ® Other (Please Spec7y) Roof mounted sol After completing SECTION 2, APPLiCANX should submit form to Local Administrator for review. SECTION 3 FLOODPLAIN DETERMINATION (To be completed by LOCAL ADMIIdISTRATORI The proposed development is located on FIRM Panel NO-- . Dated The Proposed Development: O lisiT Q•[located in a Special Flood Hazard Area (Notify the applicant that the application review is complete and NO FLOODPLAIN DEVELOPMENT PERMIT IS REQUIRED). • ❑ Is located iu a Special Flood Hazard Area_ FIRM zone designation is 100-Year flood elevation at the site is: Ft. NGVD (MSL) ❑ Unavailable ❑The proposed development is located in a floodway FBFM Pancl No. Dated ❑ See Section 4 for additional instructions. SIGNED DATE t APPLICATION PAGE 3 OF a SECTION 4 ADDITIONAL INFORMATION REQUIRED (To be completed by LOCAL ADMINISTRATORI The applicant must submu the documents checked below before the apptieat]on can be processed: ❑ A site plan shoving the location of all existing structures, water bodies, adjacent roads, lot dimensions and proposed development. ❑ Development plans, drawn to scale, and specifications,including where applicable:details for anchoring structures,proposed elevation of lowest floor(including basement), types of water resistant materials used below the first floor,details of floodproofutg of utilities located below the first floor and details of enclosures below the first floor. Also ❑Subdivision or other development plans (If the subdivision or other development exceeds 50 lots or 5 arses, whichever is the lesser, the applicant must provide 100-year flood elevations if they are not otherwise available). ❑ Plans showing the extent of watercourse relocation and/or landform alterations. ❑ Top of new fill elevation Ft. NGVD (MSL). ❑ Floodproofing protection level (non-residential only) Ft.'NGVD (MSL). For .1.: floMiroofed structures, applicant must attach certification from registered engineer or architect. ❑ Certiticalio n from a registered engineer that the proposed activity in a regulatory floodway will not result in any increase in the height of the 100-year flood. A copy of all data and calculations supporting<t-his finding must also be submitted. ❑ Other: E 5: PERMIT DETERMINATION agbe cornikted by L ADMINI R I have determined that the proposed activity. A.13 Is B.❑ Is not • in conformance with provisions of Local Law . 19 The permit is issued subject to the conditions attached to and made part of this permit. SIGNED , DATE I_f BOX A is checked, the Local Administrator may issue a Development Permit upon payment of designated fee. if BOX 8 is checked, the Local Administrator will provide a written summary of deficiencies. Applicant may revise and resubmit an appfication to the Local Administrator or may request a bearing from the Board of Appeals APPLICATION a PAGE a OF d APPEALS Appealed to Board of Appeals 0 Yes O No Hearing date: Appeals Board Decision --- Approvcdl 0 Yes ❑ No Conditioas SECTION G• AS-BUILT ELEVATIONS (To be submitted by APPLICANT before Certificate of Compliance is issued The following information must be provided for project structures. This section must be completed by a registered professional engineer or a licensed land surveyor (or attach a certification to this application) Complete I or 2 below. 1. Actual (As-Built) Elevation of the top of the lowest floor, including basement(in Coastal High Hazard Areas, bottom of lowest structural member of the lowest floor, excluding piling and columns) is: Fr. NGVD (MSL). 2. Actual (As-Buil() Elevation of floodproofng protection is FT. NGVD (MSL). < ,% NOTE: Any work performed prior to submittal of the above information is at the risk of the Applicant. .'41: ,SECTION 7 COMPLIANCE ACTION (To be comr?leied by LOCAL ADMINISTRATOR) The LOCAL ADMINISTRATOR will complete this section as applicable based on inspection of the project to ensure compliance with the community's local law for flood damage prevention. INSPECTIONS: DATE BY DEFICIENCIES? DYES ONO DATE BY DEFICIENCIES? Cl YES O NO DATE BY DEFICIENCIES? 0 YES ❑ NO SECTION 8 CERTIFICATE OF COMPLIANCEfTo be completed by LOCAL ADMINISTRATOR) Certificate of Compliance issued: DATE: BY: Attachment B SAMPLE CERTIFICATE OF COMPLIANCE for Development in a Special Flood Hazard Area • TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE FOR DEVELOPMENT IN A SPECIAL FLOOD HAZARD AREA (0"'N-ER MUST RETAIN THIS CERTIFICATE) PREMISES LOCATED AT: PERMIT NO. PERMIT DATE OWNERS NAME AND ADDRESS: CHECK ONE: ❑ NEW BUILDING O EXISTING BUILDING ❑ VACANT LAND THE LOCAL ADMINISTRATOR IS TO COMPLETE A. OR B. BELOW: A. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19 SIGNED: DATED: B. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 1.9-, AS MODIFIED BY VARIANCE # , DATED SIGNED: DATED: C/C(93) DEC,L-ARATION OF COVENANTS TI-HS DECLARATION made this day of .2019,by David Palmer Schultz,residing at 2745 Wickham Avenue,Mattituck,NY 11952,hereinafter referred to as "DECLARANT": WITNESSETH: WHEREAS,DECLARANT is the owner of certain real property located at 2745 Wickham Avenue,Mattituck,Town of Southold,County of Suffolk, State of New York,described in the Suffolk County Tax Map as District 1000, Section 139,Block 2,Lot 3,which is more particularly bounded and described as set forth in Schedule"A" annexed hereto,hereinafter referred to as the Property; and WHEREAS,the Property is situated on lands within the jurisdiction of the Board of Trustees of the Town of Southold(hereinafter the"Trustees")pursuant to Chapter 275 of the Town Code of the Town of Southold or its successor,and various activities conducted upon the property may thus be subject to the regulation and approval of the Trustees prior to being conducted; and WHEREAS,the DECLARANT therefore made application to the Trustees for a permit pursuant to the Wetlands Law of the Town of Southold to undertake certain regulated activities;and WHEREAS,on December 12,2018,the Trustees approved the application and issued a permit with terms and conditions;and WHEREAS,the issued permit,terms and conditions of the permit,as well as the survey prepared by Nathan Taft Cowin III Land Surveyor,dated August 1,2018,and stamped approved on December 12,2018, upon which the permit is based,are annexed hereto as Schedule"B;"and WHEREAS,as a condition of the granting of a Wetlands Permit to undertake such regulated activities, the Trustees required that a ten-foot wide"non-turf buffer"be established and maintained along the landward edge of the tidal wetlands,as depicted on the survey prepared by Nathan Taft Corwin III Land Surveyor,dated August 1,2018,and stamped approved on December 12,2018;and WHEREAS,the DECLARANT has considered the foregoing and has determined that the same will be for the best interests of the DECLARANT and subsequent owners of the Property. NOW,THEREFORE,the DECLARANT does hereby covenant and agree as follows: 1} Upon the substantial completion of the aforementioned permitted activities there shall be established and perpetually maintained along the landward edge of the tidal wetlands on the subject premises a ten-foot wide"non-turf buffer"as defined by Chapter 275 of the Town Code,as depicted on the survey prepared by Nathan Taft Corwin III Land Surveyor,dated August 1,2018,and stamped approved on December 12,2018. 2) The DECLARANT shall at all times comply with the Terms and Conditions of the permit, a copy of which is attached hereto in Schedule`B"annexed hereto. 3) These covenants shall run with the land and shall be binding on the DECLARANT,his heirs,assigns,purchasers,or successors in interest and may be modified only upon resolution of the Board of Trustees. (THIS SPACE LEFT BLANK INTENTIONALY) 2 s IN WITNESS WHEREOF, the owner has duly executed this instrument this day of .2019. David Palmer Schultz STATE OF ss: COUNTY OF On the day of , in the year 2019,before me the undersigned, a Notary Public in and for said State,personally appeared,David Pahner Schultz'personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his capacity, and that by his signature on the instrument, the individual or the person on behalf of which the individual acted,executed the instrument. Notary Public 3 t SCHEDULE A ALL that certain plot,piece or parcel of land,with the building and improvements thereon erected, situate, lying and being at Mattiuck,Town of Southold,County of Suffolk,and State of New York, bounded and described as follows: BEGINNING at a point on the northwesterly side of a 20 foot Right of Way which said point is distant southerly 3.07 feet from the point of intersection of the southwesterly side of Wickham Avenue with the northwesterly side of the 20 foot Right of Way; Running thence along the northwesterly side of the 20 foot Right of Way South 22°20' 10"West 47.22 feet to land of Agarabi(formerly Cambria); Thence along the northeasterly line of land of Agarabi(formerly Cambira)North 52°57' 40"West 168.0 feet to the ordinary high water mark of Long Creek branch of Mattituck Creek; Thence northeasterly along the ordinary high water mark of Long Creek to a point which is North 28°20' 20"East 46.20 feet from the end of the last course; Thence along the southwesterly side of a 8 foot right of Way south 52°57' 40"East 163.0 feet to the point or place of BEGINNING. TOGETHER with an easement over the 20 foot Right of Way to Wickham Avenue. 4 GREENLOGIC° ENERGY January 31, 2019 Town of Southold Building Department Town Hall 53095 Route 25 Southold, NY 11971 Dear Building Inspector: Please find attached a building permit application on behalf of David Schultz who has engaged us to install a roof mounted solar photovoltaic(PV) electric system located at 2745 Wickham Avenue, Mattituck, NY. In connection with this application, please find attached: • Building Permit application • A Storm Water Assessment Run-off Form • Certificate of Occupancy Application • Floodplain Development Permit Application Application for Electrical Inspection NOV — 6 2019 • 2 Surveys of the Premises • Declaration of Covenants a 4 Engineer's Reports • 2 Three Line Electrical Drawings • 2 Spec.sheets of the solar panels • 2 Spec. sheets for Racking System • GreenLogic Suffolk County Home Improvement License • GreenLogic Certificate of Liability Insurance • GreenLogic Certificate of Worker's Compensation Insurance Coverage • Installation Manager's Master Electrician's License • Check for$200 ($50 Building Permit/$50 CO/$100 Electrical Inspection) Please let us know if you need anything else in connection with this application. Yours truly, XaJ,ma emciotta Barbara Casciotta Account Manager Barbara@Greenlogic.com 631-771-5152 ext. 117 GREENLOGIC LLC e www.Green Logic.com Tel 631 771.5152 Fax 631.771.5156 SOUTHAMPTON ROSLYN HEIGHTS 97 North Sea Rd , Suite 3 200 S Service Rd , #106 Southampton, NY 11968 Rosyln Heights, NY 11577 GREE 1L®GIC® ENERGY July 22, 2020 The Town of Southold Building Department 54375 Route 25 P.O. Box 1179 Southold, NY 11971 Re: Building Permit No.44410 David Schultz 2745 Wickham Avenue, Mattituck, NY To the Building Inspector: Enclosed please find the Engineer's Certification Letter for the above referenced address. Can you please close the building permit and send the Certificate of Occupancy? Please let me know if you have any questions about the installation. Sincerely, Xa4ma ea6cio tac Barbara Casciotta Account Manager Barbara@Greenlogic.com 631-771-5152 Ext. 117 o ' Du� d. J U L 2 4 2020 -BUMpIIG DEPT. To, ^ _ OLD GREENLOGIC LLC ®www.GreenLogic.com Tel. 631 771.5152 Fax: 631.771 5156 SOUTHAMPTON ROSLYN HEIGHTS 97 North Sea Rd.,Suite 3 200 S Service Rd ,#106 Southampton, NY 11968 Rosyln Heights, NY 11577 �tC DATE CERTIFICATE OF LIABILITY INSURANCE Fol/31/2019 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(les)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 Brookhaven Agency,Inc. PHONE 631 941-4113 FaxNola 631 9414405 128 Old Town Road,Suite C E-MAIL , CustomerService@ brookhavena enc .com P.O.BOX 850 INSURERS AFFORDING COVERAGE NAIC p East Setauket NY 11733 INSURER A: Southwest Marine&General Insurance Co. INSURED INSURER B: Merchants Preferred Insurance Co. GreenLogic,LLC INSURER c: First Rehab Life Insurance Co. 97 North Sea Rd,Suite 3 INSURER D. National Liability&Fire Insurance Co. Southampton NY 11968 INSURER E: AGCS Marine Insurance Co. INSURER F: COVERAGES - COVERAGES CERTIFICATE NUMBER: 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 INSR TYPE OF INSURANCE ADDLSUBR POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 A CLAIMS-MADE ®OCCUR DAMAGE TO RENTED $100,000 X Contractual Liability X X GL201900012922 01/31/2019 01/31/2020 MED EXP(Any oneperson) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER* GENERAL AGGREGATE $2,000,000 POLICY Ej]JE LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 B X ANY AUTO BODILY INJURY(Per person) $ OWNEDSCHEDULED X X CAPI043565 08/11/2018 08111/2019 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS XHIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $1,000,000 A EXCESS LIAB CLAIMS-MADE X X UM201900007751 01/31/2019 01/31/2020 AGGREGATE $1,000,000 DED I I RETENTION 0 $ WORKERS COMPENSATION X I PER OTH- AND EMPLOYERS'LIABILITY D ANY OFFICER/MEM ErR R EXCLUD DXECUTIVE� N/A V9WC857891 06115/2018 06/15/2019 E L EACH ACCIDENT $1,000,000 (Mandatory in NH) E L DISEASE-EA EMPLOYEE $1,000000 ''XS f yes,describe under DESCRIPTIO OF OPERATIONS below E L DISEASE-POLICY LIMIT $1,000,000 C NYS Disability D251202 04111/18 04/11/19 Statutory Limits E Installation Floater/Property T SML93076366 4115118 4115/19 $250,000 $1000 Ded DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Certificate holder is also named as Additional Insured. CERTIFICATE HOLDER CANCELLATION TOWN OF SOUTHOLD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BUILDING DEPARTMENT ACCORDANCE WITH THE POLICY PROVISIONS. 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 NEW is Workers' CERTIFICATE OF -1 VOW STATE Compensation NYSWORKERS' COMPENSATION INSURANCE COVERAGE Board 1a.Legal Name&Address,of Insured(use street address only} 1b.Business Telephone Number of Insured 631-771-5152 Greenlogic LLC 97 North Sea Road Suite 3 1 C.NYS Unemployment Insurance Employer Registration Number of Sbuthamplon NY 11968 Insured Work Location of insured(Only required if coverage is specfltcally limited to 1 d Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i e.,a Wrap-Up Policy) Number 243541104 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Molder) National Liability&Fire Ins Co Town of Southold 3b.Policy Number of Entity Listed in Box"ia" Building Dept,53095 Route 25 V9WCO23041 Southold NY 11971 3c.Policy effective period 06115/2019 to 06/1612020, 3d.The Proprietor,Partners or Executive Officers are + [ included.(Only check box if all partnerstotticert Included) all excluded or certain partnerslofftc ets excluded. This certifies that the insurance carrier indicated above in box 7'insures the business referenced above in box"1a"`f'or 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". The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is canceled due to nonpaymentof premiums-or within 30,days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate.(These notices may be sent by regular mail.)Otherwise,this Certificate is valid for one year afterthis form is approved by the insurance carrier or its licensed agent,or until the policy expiration date listed in box"3c",whichever is earlier. 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 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,l 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 tills form. Approved by: Nicholas Zulkofske (Punt name cnzed representative or ticensed'agent of insurance carrier) Approved by 'J ✓ J {Si aturej (nate) Title:Authorized Agent Telephone Number of authorized representative or licensed agent of insurance carrier: 631-941-4113 Please Note:Only insurance carriers and their licensed agents are authorized to issue Form C-106.2.Insurance brokers are NOT authorized to issue it. C-106.2(9-17) www.wcb.ny,gov i Suffolk County Executive's Office of Consumer Affairs VETERANS MEMORIAL HIGHWAY HAUPPAUGE, NEWYORK 11788 [ D ' 12/10/2007 SUFFOLK Master Electrician License r ROBERT1This is to certify that SKYPALA doing business as GREENLOGIC LLC \ {'A� having given satisfactory evidence of competency,is hereby licensed as M ASTER ELECTRICLA.N in accordance \ with • subject to the provisions of •• • and regulations f Additional Businesses th e County of Suffolk, State of New York. 4 NOT VALID WITHOUTh^ I .JDEPARTMENTAL SEAL ` X CURRENT L, CONSUMER AFFAIRS IT)CARD Director .i l {�/ll -a�''• _ ���•_ �,,. _ 1�\ r,.^ ., - •f,�•'. �• r��Z�1 �1,` ..i { 11�-.:-f����. f 'i'\�-/.� �-f(�,v f fc,': ���`�1}� ;5n V Suffolk County Executive's Office of Consumer Affairs VETERANS MEMORIAL MGHWAY HAUPPAUGE, NEWYORK 11788 DATE ISSUED: 5/25/2006 No. 40227-H SUFFOLK COUNTY Home Improvement Contractor License 0 WX. This is to certifv that MARC A CLEAN doing business as +f fi GREEN LOGIC LLC having furnished the requirements set forth in accordance with and subject to the provisions of applicable laws,rules and regulations of the County of Suffolk, State of New York is hereby licensed to conduct business as a HOME IMPROVEMENT CONTRACTOR,in the County of Suffolk. Additional Businesses NOT VALID WITHOUT DUARTMENTAL SEAL AND A CURRENT CONSM�IER AFFAIRS ID CARD Director S, IfWi A%, k tv 1, A. _•x 2, OF PROPERTY cg MATTITt CK TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No 1000-139-02-03 SCALE I"z 10' MAY 16, 2007 AP,4 A; .2 fit V 11 ,J 1V • 01 10, 4Fv 4,• !•, VAI 1.;%t vfll,�, • tip 1A1 'p 14 V &A"I201� 41, i TOTAL AREA - 7.286 sq. It go, 0 t67 cc UPLAND AREA - 7.141 stA ft C, �,1111 Skoel', f I �11 , WETLANDS AREA = 130 69 ft "I)V # It FX1SrJAFG LOT COVFRAVF OVER UPLAND AREA (7 141 sil ft j AACA EXIST HOUSE 1,079 Qq It 13 Ix EXIST26 it 32% _4 ;low DECK e p�Tv EXIST CARAOC _t 373 to 52X j� TOTAL EXIST. IABD 24 It 2559 PROPOSED LOT COVERAGE 0 VER UPLAND AREA (7.141 mg ff MP HOUSE 11.267 sq 11 17$9 PROP. PO 60 SQ It. oux PORCH I 1117VATIONS ARE REFERENCED TO t938 N AV D DATUM • EXIST WAGE 373 eq to t SIX EMSTM, LUEVAnONS ARE SHOWN THUS 1" 4. PROPOS1,700 sq ft 23 OX 2 FLOW ZONE INFORMATION TAKEN FROM, FLOOD INSURANCE RATE MAP No 161030048111 X0.4 N ftly KOOD ftVAT,0Ns SCIER%vtC, ZOK I &RIA-S fAtILAW-MI)*Elf 0� *[ rk(f 02%VALAL L-O. f1O0Qr%AA /A pj� 3.(XISTbID SEPTIC STSICU STRUCTURES SHALL BE PUMPED CLEAN AND AtIEViED IN ACCORDANCE WITH SC 0 H S. STANDARDS eo,/ JEWISTING LOT COVERAGE OVIER ADJACJCIWT ARRA EL ummt;*j SEM 1AHK CAPACITIES TOR 3 BEDROOM HOUSE IS 1.000 CALLOkS. 41 p ,9. (AREA DETWEEN LANDWARD WrrL,41INDS LANE I Tom: W LONG, 4'-$"WIDE W-7, DEEP AND 10 CONTOUR LINE' A 115 sq It 5- WNJMUM LCAC'ONC SYSTEY'rOR 3 BEDROOM HOUSE IS 250 .4 It SIDIEWAU AREA. L, "SCWTION AREA IV I,* 5 POOLS. 2'OCEP,8*di. 44__ tt V-11 41 EXIST.HOUSE 1.072 sq. tL 21Jx Jx 10 EXIST. WOOD DECK 228 eq ft PROPOSED rUTURC SOX MANSION POOL • y l K A• TOTAL EXIST I-soy sq. ft 256X % N F Yert PROPOSED LOT COMACIT OVER (ARVA E,,,,ADJACWNr AREA PROPOSED W DIA. X 2'DEEP LEACHIND POOL 46' y�SC r• N JANDWARD WtTLANDS LAAW AND TO' CONTOUR 1JNs.- 6,I15gq ft "SCRIPY04 I AREA X Lai Covatla PROPOSED 1.000 CALLON SIEPVC ?AUK • PROP.HOUSE 1.267 sc, it 248% iii �4 OBSERVAT104S AND/OR OATA.09FA1NE0 FkOM OTHERS a L 11 06 It 277- 6 THE LOCATION Of WELLS AND CESSPOOLS 34OW14 HEREON ART FROM nELD 4 Z X "VI 2MM TEM CALCULATIONS-CL—M 4 "ME ROOF ABU- 1.340 .1. C., 1.348 q It X 0 17 - 30 230 au ft 142 2 = 5.5 w6rtkoi ft,of 0' d7o loathing pool reqLwe6d /0 j I / ry PROVIDE (3) S' ditz. X 2'b-0 STORM DRAIN.POOLS AD IV GARAGE ROOF AREA- 373 sq ft 40 1 373 2q. D .0 X 20-217 ff 4 = 2 *1 It of 8' die Itach,ng pool eeqwirod PROVIDE(1) S' dio X 2'high STORM DRAIN POOL PROPOSED a' ow A 2*,DEEP omCus FOR Roor RUN—orr ARE 51towr4 THUS. TEST HOLE DATA (frITY faC DUC Of ON APP4 JO ")Pj PROPOSED SEPTIC SYSTEM DETAIL to smo GRAM 4tv 100 '40 LEA` APPOW)tAD t B9 strye, et. mot I/Al". It B ED C, 01 GROLAID ft" 5 Pm SV-SN.M "ME 401 tovliVo Nathan Taft Corwin Ill PTI .4 A3�f 4LY 2 Land Surveyor WAM'A M 1101�1"M r DIEP,ff ft no A I It 11170— 9T42 paC9CM If 7,M W I- �Ildr$l 3 I.C.0,153 p 11 A E0-011Y,fft w C 11 MIT-S,Alc'A �I_ _a 0 m w 0M 7 0,MW r-mwu cwu*lt(m IRM)0,� It -1 —1W I-( -T .1L.1-r11 ftLle�t Wr 1 -A�pqwm Sats a 0,pacAr 4(pwt*= .O.A,.-,!A" t,=. AM AM T" 4 4K_1�0a. r2. SL-C -F LAI of 0- Im.0 m4m 407m map,/, "1 -0 'A J A M E S J. S TOUT A R C H I T E C T & Assoc. 2 GREG LANE EAST NORTHP ORT N. Y. e s 1 — e 5e 93ea Letter of Certification October 28,2019 Schultz Residence 2745 Wickham Avenue Mattituck, NY 11952 To Whom It May Concern: I,James J.Stout, registered architect NYS license number 021633 would like to submit the following. I have inspected and analyzed the roof structure at the above- mentioned address and have determined the structure and the panel attachment to be adequate to support the new additional load imposed by the proposed solar panel system and complies with the 130-mph wind design load as 2017 New York State Uniform Code(2017 NYSUC), 2017 New York State Residential Code(2017 NYSRC)=(2015 International Residential Code(2015 IRC)(2nd Printing)and 2017 New York State Uniform Code Supplement(2017 NYSUCS)as well the Long Island Unified Solar Permit Initiative(LIUSPI)and the 2014 National Electric Code NFPA 701 2014 National Electric Code, and the ASCE 7-10. The existing 2"x 6"@ 16"o.c, and 2"x 10: 16"o.c. roof rafters will provide the required support. Thank you for your understanding in this matter James J.Stout qR 02 1633 yOQ OF NE`N t My_, r " et C t 11 GREENLOGIC' - GreenLogic,LLC Approved Schultz,David 2745 Wickham Avenue Mattitucc,NY 11952 Surface#A: Total System Size:11.200kW Array Size:9.100kW 1 circuit of 8 on a 20A breaker 1 circuit of 8 on a 20A breaker 1 circuit of 10 on a 20A breaker Azimuth:204° Pitch:38" Monitoring System: SunPower PaneVArray Specifications: Panel:SPR-X21-350-BLK-E-AC Racking:SunPower Invisimount Panel:61.39"X 41.18" Array:41'4 318"X 13'11" Surface:48'5"X 162" Magic*.Invisimount Legend: 26 SunPower 350W Panels ® SunPower Invisimount Rail • 60 Quick Mount E Lag 8 2x10"Douglas Fir Rafter 16"O.C. Notes: Number of Roof Layers:1 Height above Roof Surface:4" Materials Used:Quick Mount,SunPower Added Roof load of PV System:3.5psf Engineer/Architect Seal: S��R�o aR�y�T c 216 ATF F NE`V'I� Dra :MA Drawing#1 of 8 Date:10/1112019 REV:A Drawing Scale:1/8"=1.0' GREENLOGIC') ;y GreenLogic,LLC Approved Schultz,David 2745 Wickham Avenue Mattltuck,NY 11952 Surface#A: Total System Size:11.200kW Array Size:9.100kW 1 circuit of 8 on a 20A breaker 1 circuit of 8 on a 20A breaker 1 circuit of 10 on a 20A breaker Azimuth:204° Pitch:38" w, Monitoring System: SunPower Panel(Array Specifications: Panel:SPR-X21-350-BLK-E-AC Racking:SunPower Invisimount Panel:61.39"X 41.18" Array:41'4 3/8"X 13'11" Surface:48'5"X 15'2" dX Magic#:Invis(mount Legend: 26 SunPower 35OW Panels ® SunPower Invisimount Rail 60 Quick Mount E Lag 8 2x10"Douglas Fir Rafter 16"O.C. Notes: Number of Roof Layers:1 Height above Roof Surface:4" Materials Used:Quick Mount,SunPower Added Roof load of PV System:3.5psf Englneer/Ar ct Seal: ,��4tED ARC 0 1633 OQ'E TF�F NSN.A Drawn By:MA Drawing#2 of 8 Date:10/11/2019 REV:A Drawing Scale:1/8'=1.0' GREENLOGIC`' GreenLogic,LLC Approved Schultz,David 2745 Wickham Avenue Mattituck,NY 11952 Surface#A: Total System Size:11.200kW Array Size:9.100kW 1 circuit of 8 on a 20A breaker 1 circuit of B on a 20A breaker I circuit of 10 on a 20A breaker Azimuth:204' Pitch:38" w1 Monitoring System: SunPower PaneUArray Specifications: Panel:SPR-X21-350-BLK-E-AC Racking:SunPower Invisimount Panel:61.39"X 41.18" 1 Array:41'4 3/8'X 13'11" Surface:48'5'X 15'2" Magic#:Invisimount 2 Legend: 26 SunPower 35OW Panels 3 SunPower Invisimount Rail 60 Quick Mount E Lag 2x10"Douglas Fir Rafter 16"O.C. 3 Notes: Number of Roof Layers:1 Height above Roof Surface:4" Materials Used:Quick Mount,SunPower Added Roof load of PV System:3.5psf Engines I: 1 G\S�E ARC �pM S J.eT y�F n� a- wn By. A I Drawing#3 of 8 Dat O/ /2019 1 REV:A Drawing Scale:1/8"=1.0' GREENLOGIC- GreenLoglc,LLC Approved Schultz,David 2745 Wickham Avenue Mattituck,NY 11952 Surface#B: Total System Size:11.200kW Array Size:2.100kW 1 circuit of 6 on a 20A breaker Azimuth:204" Pitch:33° Monitoring System: N SunPower PaneVArray Specifications: Panel:SPR-X21-350-BLK-E-AC Racking:SunPower Invisimount Panel:61.39"X 41.18' Array:15"S 5/8"X 6'11118" Surface:21'4"X 8'1" Magic t Invisimount Legend: © 6 SunPower 35OW Panels ® SunPower Invisimount Rail 16 Quick Mount E Lag 8 2x6"Douglas Fir Rafter 16'O.C. Notes: Number of Roof Layers:1 Height above Roof Surface:4" Materials Used:Quick Mount,SunPower Added Roof load of PV System:3.5psf Engineer/Architect Seal: 5 DAR 021 3'3 OQ" TF OF Dra ADrawing#4 of 8 Date:10/11/2019 REV:A Drawing Scale:114"=1.0' POW C GREENLOGIC"' GreenLog/c,LLC Approved Schultz,David 2745 Wickham Avenue Mattituck,NY 11952 Surface#B: Total System Size:11.200kW Array Size:2.100kW 1 circuit of 6 on a 20A breaker Azimuth:204" Pitch:33" Monitoring System: SunPower Panel/Array Specifications: Panel:SPR-X21-350-BLK-E-AC Racking:SunPower Invisimount Panel:61.39"X 41.18" Array:165 5/8"X 6'11 1/8" Surface:21'4"X 8'1" Magic#:Invisimount Legend: 0 6 SunPower 35OW Panels ® SunPower Invisimount Rail • 16 Quick Mount E Lag 8 24"Douglas Fir Rafter 16"O.C. Notes: Number of Roof Layers:1 Height above Roof Surface:4" Materials Used:Quick Mount,SunPower Added Roof load of PV System:3.5psf E � PEES J.gT �T 1� "• i� 2 33 OATF O N W� n e ADrawing#5 of 8 Date: /11/2019 REV:A Drawing Scale:114"-=1.0' GREENLOGIC" GreenLogic,LLC Approved Schultz,David 2745 Wickham Avenue Matdtuck,NY 11952 Surface#B: Total System Size:11.200kW Array Size:2.100kW 1 circuit of 6 on a 20A breaker Azimuth:204° Pitch:33" Monitoring System: `v SunPower PanellArray Specifications: Panel:SPR-X21-350-BLK-E-AC Racking:SunPower Inwsimount Panel:61.39'X 41.18" Array:15'5 5/8"X VI 1 1/8" 4 Surface:21'4"X 8'1" Magic#:Invisimount Legend: 6 SunPower 35OW Panels ® SunPower Invisimount Rail 4 • 16 Quick Mount E Lag H 24"Douglas Fir Rafter 16"O.C. Notes: Number of Roof Layers:1 Height above Roof Surface:4" Materials Used:Quick Mount,SunPower Added Roof load of PV System:3.5psf EngineerlArch I: , ARC r i F IJE:`��✓ Drawn By Drawing#6 of 8 Date:10/11/2019 REV:A Drawing Scale:114"=1.0' No Vent Pipes Will Be Covered By The Solar ArraX G R E Eft LOGIC`° LEGEND L1`4E_ f AR -Access root per R202 definitions RAP -Roof access point-to be away from RWV -Roof with valley. GreenLog/q LLC Approved overhead obstructions.doors. 18-minimum from valley Schultz,David windows,decks.fences,landscaping 2745 Wickham Avenue GA -Ground access area per R324.7.3 width AP -Access Pathway,36-minimum SVO -Smoke vent operatlon per Mattituck,NY 11952 to be same as AP as measured at eave width per R324 7 4 and R324.7 5 R324.7 7,18"minimum from ridge Total System Size;11.200kW 1 circuit of 8 on a 20A breaker 1 circuit of 8 on a 20A breaker 1 circuit of 10 on a 20A breaker 1 circuit of 6 on a 20A breaker Aamtdh:204° .1 RAP RAP Monitoring System: N SunPower Panel/Array Specifications: Panel:SPR-X21-350-BLK-E-AC Racking:SunPower Invisimount I 1 Panel:61.39"X 41.18" 1 Array:93'8"X 18'3" IOl jAP Surface:120'6"X 34'10" I I I Magic#:Invisimount I I Legend: 1 ——————————Rim----------• 32 SunPower 35OW Panels — SunPower Invisimount Rail 1 I 0 76 Quick Mount E Lag t t B B 2x10"Douglas Fir Rafter 16"O.C. j 0 8 2x6"Douglas Fir Rafter 16"O.C. 1 I I I 6 SunPower Notes: 35OW Panels Number of Roof Layers:1 Height above Roof Surface:4" Materials Used:Quick Mount,SunPower Added Roof load of PV System:3.5psf 26 SunPower 350W Panels Engineer/Architect Seal: EO \s,��RR ch'i /Meter d , T.f � MA Drawing#7 of 8 Date:10/11/2019 REV:A Drawing Scale:1/16"=1.0' GREENLOGIC" GreenLogic,LLC Approved Schultz,David 2745 Wickham Avenue JCBLW Mattituck,NY 11952 Total System Size:11.200kW 1 circuit of 8 on a 20A breaker 1 circuit of 8 on a 20A breaker 1 circuit of 10 on a 20A breaker 1 circuit of 6 on a 20A breaker Azimuth:204° iA WSW W Monitoring System: ,v SunPower Panel/Array Specifications: Panel.SPR-X21-350-BLK-E-AC CztA Li imrrAbL grggodct4EIadcAlu7imniHaNrg X Racking:SunPower Invisimount WV/8,8CVIWirgPilg Panel: X Array:933''8 8""X 188''3" Surface:120'6"X 34'10" Magic#:Invisimount ©i 32 SunPower 35OW Panels SunPower Invisimount Rail • 76 Quick Mount E Lag 8 8 2x10'Douglas Fir Rafter 16'O.C. 05 2x6"Douglas Fir Rafter 16"O.C. Notes: Number of Roof Layers:1 Height above Roof Surface:4" Materials Used:Quick Mount,SunPower Added Roof load of PV System:3.5psf Englneer/A Seal: J. cy/ I 02163' �OQ� F Drawn By: Drawing#8 of 8 Date: 1/2019 REV:A Drawing Scale:1/16"=1.0'