HomeMy WebLinkAbout45424-Z F04 46"
Town of Southold_� 3/14/2021
P.O.Box 1179
e _
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 41884 Date: 3/14/2021
THIS CERTIFIES that the building SOLAR PANEL
Location of Property: 700 Harbor Lights Dr., Southold
SCTM#: 473889 Sec/Block/Lot: 71.-2-14
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
10/26/2020 pursuant to which Building Permit No. 45424 dated 11/9/2020
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:
relocation of existing solar panels as applied for.
The certificate is issued to Lundquist,Daniel&Wile,Allison
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 45424 1/29/2021
PLUMBERS CERTIFICATION DATED
-3�L-
Authorize Signature
�SUFFVIA, TOWN OF SOUTHOLD
BUILDING DEPARTMENT
z TOWN CLERK'S OFFICE
oy • �� '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#: 45424 Date: 11/9/2020
Permission is hereby granted to:
Lundquist, Daniel
80 Pierrepont St Apt 4
Brooklyn, NY 11201
To: relocate solar panels as applied for.
At premises located at:
700 Harbor Lights Dr., Southold
SCTM #473889
Sec/Block/Lot# 71.-2-14
Pursuant to application dated 10/26/2020 and approved by the Building Inspector.
To expire on 5/11/2022.
Fees:
SOLAR PANELS $50.00
CO-ALTERATION TO D $50.00
ELECTRIC $100.00
Tota . $200.00
Building Insp
tf SID
Town Hall Annex ® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 sean.devlin(a)-town.southold.ny.us
Southold,NY 11971-0959
QUO,
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Daniel Lundquist
Address: 700 Harbor Lights Dr city,Southold st: NY zip: 11971
Building Permit# 45424 Section- 71 Block. 2 Lot: 14
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA. GreenKLogic LLC License No: 43858
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Solar X
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt Ceding Fixtures 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 11 Pump
Other Equipment
Notes, Relocated Panels - Same System and Size
Q
Inspector Signature: IIS2Date: January 29, 2021
S Devlin-Cert Electrical Compliance Form.xls
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. 10/21/2020
New Construction: Old or Pre-existing Building: X (check one)
Location of Property. 700 Harbor Lights Drive Southold
House No. Street Hamlet
Owner or Owners of Property: Daniel Lundquist
Suffolk County Tax Map No 1000, Section 71 Block 2 Lot 14
Subdivision , L Filed Map. Lot:
Permit No. L � Date of Permit. Applicant: GreenLOglc LLC
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: X (check one)
Fee Submitted: $ 50
pplicant Signature
CONSENT TO INSPECTION
Daniel Lundquist , 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 700 Harbor Lights Drive, Southold, NY 11971 ,
which is shown and designated on the Suffolk County Tax Map as District 1000,
Section 71 ,Block 2 , Lot 14
That the undersigned(has) (have) filed, or cause to be filed, an application in the
Southold Town Building Inspector's Office for the following:
Remove 13 solar panels and relocate on separate roof surface
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: v
(/Si mature)
a~�r-I t"h V)S rf
(Print Na e
(Signature)
(Print Name)
Building Department Application
AUTHORIZATION
(Where the Applicant is not the Owner)
I, Daniel Lundquist residing at_-7 D O i4,v\,o✓ UPS. ' t
(Print property owner's name) (Mailing Address)
do hereby authorize GreenLogic LLC
(Agent)
to apply on my behalf to the
Southold Building Department.
tIDb ZJ
(Owner's Signature) (Date)
Daniel Lundquist
(Print Owner's Name)
pF SOUTyOIo 4 54 Zq �� (.� �'G>�,o �p
# # TOWWOF SOUTHOLD BUILDING DEPT.
cou765-1802
As
NPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING-
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) KA ELECTRICAL (FINAL)
[ ] CODE VIOLATION ] PRE C/O
REMARKS:
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DATE `�� INSPECTOR �-
FIELD INSPECTION REPORT DATE COMMENTS
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FOUNDATION(1ST) --cl y
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FOUNDATION(2ND) r�
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ROUGH FRAMING&
PLUMBING
INSULATION PER N.Y. `3
STATE ENERGY CODE
FINAL
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ADDITIONAL COMMENTS
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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
Southoldtownny.gov PERMIT NO. "1 C Check
Septic Form
N.Y.S.D.E.C. '
Trustees
C.O.Application
Flood Permit
Examined 120 Single&Separate
Truss Identification Form
Storm-Water Assessment Form
2020 Contact:
Approved 120 ®C� 2 Mail to: Green Logic LLC
Disapproved a/c 97 North Sea Road, Southampton, NY
11968
,W �� ® � ` Phone: 631-771-5152
Expiration ,20 tia
ui ding tnspector
APPLICATION FOR BUILDING PERMIT
Date 10/21 20 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.
0
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 Al
(Signature of apple nt or name,if a corporate n)
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 Daniel Lundquist
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
Nesim Albukrek, President
(Name and title of corporate officer)
Builders License No. 40227-H
Plumbers License No. N/A
Electricians License No. 43858-ME
Other Trade's License No. N/A
1. Location of land on which proposed work will be done:
700 Harbor Lights Drive Southold
House Number Street Hamlet
County Tax Map No. 1000 Section 71 Block 2 Lot 14
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 Relocate solar panels to another
roof surface (Description)
4. Estimated Cost $4,500 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 Name of Former Owner Matthew Campbell
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 removed from premises?YES NO X
700 Harbor Lights Dr
14.Names of Owner of premises Daniel Lundquist Address Southold, NY 11971 Phone No.
Name of Architect james J. Stout Address 2 Greg Ln, E. Northport Phone No 631-858-9388
Name of Contractor GreenLogic LLC Address97 North Sea Road Phone No. 631-771-5152
Southampton, NY 11968
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO_X
* IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES NO X
* IF YES,D.E.C. PERMITS MAY BE REQUIRED.
16. Provide survey, to scale,with accurate foundation plan and distances to property lines.
17. If elevation at any point on property is at 10 feet or below,must provide topographical data on survey.
18.Are there any covenants and restrictions with respect to this property? * YES NO X
* IF YES,PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF Suffolk )
Nesim Albukrek 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 therewith.
Sworn to before me this
c bT'�� Q�a
day of 200to
Nota Public BARBARA A CASCIOTTA Signature of Appl' ant
Notary PublicrState of New Yorks
No.01-CA4894969
Qualified In Suffolk County
jCommission kxpires May 11.2023
Scott A. Russell 6,°$11IFQ�- 9T01kMWAk,1F1E1R..
SUPERVISOR ( �j
1\�1[Al�A\G11E11y[]E�'7C'
SOUTHOLD TOWN HALL-P.O.Box 1179
53095 Main Road-SOUTHOLD,NEW YORK 11971 Town of Southold
pl
CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET
( TO BE COMPLETED BY T14E APPLICANT )
DOES THIS PROD E('T_INVOLVE ANY�OF THE FOLLOWING-
(CHECK
O LI.CIWING-(CHECil ALL'rHA1' APPLY)
Yes No
❑0 A. Clearing, grubbing, grading or stripping of land which affects more
than 5,000 square feet of ground surface.
00 B. Excavation or filling involving more than 200 cubic yards of material
i
within any parcel or any contiguous area.
I
{ ; ❑ID C. Site preparation on slopes which exceed 10 feet vertical rise to
f 100 feet of horizontal distance.
❑ x❑ D. Site preparation within 100 feet of wetlands, beach, bluff or coastal
erosion hazard area.
{ ; ❑ x0 E, Site preparation within the one-hundred-year floodplain as depicted
l j on FIRM Map of any watercourse. j
❑0 F. Installation of new or resurfaced impervious surfaces of 1,000 square j
! ; feet or more, unless prior approval of a Stormwater Management
Control Plan was received by the Town and the proposal includes
3 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 Department with your Building Permit Application.
APPLICANT—(Prolway Owner.Deign Professional,Agent,Contractor,Other) � S C T'M �' I��� gate
s , llunria
j NAME, Creenl-ogi LLC (Nesim Albukrekl 71 2 14 10/21/2020
Section Block Lot
' I I
FOR BUILDING DLPAWI'MLN'I'USE ONLY
Contact Infonnatiom< 631-771-5152
Reviewed BY:
'r– — — — — — — — — — — — — — — — — i Date: j
Property Address/ Location of Construction Work: — — — — — — — — — — — — — — — — — i
Approved for processing Building Permit. {
700 Harbor Lights Drive Stormwater Management Control Plan Not Required.
l Southold, NY 11971 — — — — — — — — — —
Stoimwater Management Control Plan is Required.—
,l
(Forward to-Engineering Department for Review.) '
----
FORM *—SMCP-TOS MAY 2014 _ _--
BUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD s
Town Ball Annex- 54375 Main Road - PO Box 1179
. , Southold, New York 11971-0959
""
Telephone (631) 765-1802 - FAX (631) 765-9502
rogerrcW-southoldtownny.gov seandAsoutholdtownny.gov
APPLI'CATI.ON FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date: 8/20/20
Company Name: rreenLopis LL
Name: Robert Skypala
License No.: 43858-ME email: Barbara@Greenlogic.com
Address: 97 North Sea Road, Southampton, NY_ 1.1968
Phone No.: 631-771-5152
JOB SITE INFORMATION (All Information Required)
Name: Daniel Lundquist
Address: 700 Harbor Lights Drive, Southold, NY 11971
Cross Street:
Phone No.:
Bldg.Permit#: 45 Z email: tundquist.daniet@gmaii.com
Tax Map District: 1000 Section: 71 Block: 2 Lot: 14
BRIEF DESCRIPTION OF WORK (Please Print Clearly)
Relocate 13 SunPower SPR-E20-327-E-AC panels from one roof surface to another. Tie into existing panel F
and monitor
Circle All That Apply:
Is job ready for inspection?: YES NO Rough In Final
Do you need a Temp Certificate?: YES NO Issued On
Temp Information: (All information required)
Service Size 1 Ph 3 Ph Size: A # Meters Old Meter#
New Service- Fire Reconnect- Flood Reconnect- Service Reconnected - Underground - Overhead
# Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
Additional Information:
PAYMENT DUE WITH APPLICATION
Request for Inspection FormAs
_-PGREENLOGICO
ENERGY
October 22, 2020
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 the Daniel Lundquist,700 Harbor Lights
Drive,Southold who has engaged us to relocate 13 solar panels to another roof surface.
In connection with this application, please find attached:
• Building Permit application
• Owner Authorization
• Consent to Inspection
• A Storm Water Assessment Run-off Form
• Certificate of Occupancy Application
• Application for Electrical Inspection
• 2 Surveys of the Premises
• 4 Engineer's Reports
• 2 Three Line Electrical Drawings
• 2 Spec.sheets of the solar panels
• 2 Spec. sheets for Racking System
• 2 Spec.sheets for Monitoring 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,
J`3aJ=ac ewcioUa
Barbara Casciotta
Account Manager
Barbara@Greenlogic.com
631-771-5152 ext. 117
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
G R E E N LO G I C� .... ,' ,-L✓� .�'V,.i t;r-,tom: , V f._,.,_,,
ENERGY )
JAN 252021
{YY.
January 22, 2021
The Town of Southold
Building Department
54375 Route 25
P.O. Box 1179
Southold, NY 11971
Re: Building Permit No.45424
Dan Lundquist
700 Harbor Lights Drive, Southold
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,
J3w6ww '(coccioua
Barbara Casciotta
Account Manager
Barbara@Greenlogic.com
631-771-5152 Ext. 117
GREENLOGIC LLC m 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
SURVEY OF
LOT 19
MAP OF
j� HARBOR LIGHTS ESTATES
• SECTION ONE
�0
STONewkc S - 11� FILE No. 4362 FILED JUNE 8, 1965
SITUATE
�64��s''o• •j"G��' SOUTHOLD
TOWN OF SOUTHOLD
N 4oA,y" BBck6tA, OOfOpAq �- a 1 SUFFOLK COUNTY, NEW YORK
` 0:Op• �� S.C . TAX No. 1000-71-02-14
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BY THE DIA LS AND APPROVED AND ADOPTED
FOR SUCH USE BY THE NEW YORK STATE LAND
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UNAUTHORRED ALTERATION OR ADDM
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YORK STATE
pJ3 °RNathan Taft Corwin III
°< 'Df COPIES OF THIS SURVEY IMP NOT BEARING
THE.L� 'OO SEAL OR
EMBOSS D SEAL SOHALL INKED
BE CONSIDERED
Land Surveyor
T O 014.f�kpOt TO BE A VAUD TRUE COPY
Q 0' Cf� \"Cf CERTIFICATIONS INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY
IS PREPARED,AND ON HIS BEHALF TO THE
TITLE COMPANY,GOVERNMENTAL AGENCY AND Title Surveys-Subdivisions - Site Plans - Construction Layout
LENDING INSTRUTION LISTED HEREON,AND
TO THE ASSIGNEES OF THE LENDING INSTI-
TUTION CERTIFICATIONS ARE NOT TRANSFERABLE PHONE (631)727-2090 Fax (631)727-1727
OFFICES LOCATED AT MAILING ADDRESS
THE EXISTENCE OF RIGHTS OF WAY 1586 Main Road PO Box 16
AND/OR EASEMENTS OF RECORD, IF Jamesport,New York 11947 Jamesport, New York 11947
ANY, NOT SHOWN ARE NOT GUARANTEED.
39-316B
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Suffolk County Executive's Office of Consumer Affairs
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VETERANS MEMORIAL HIGHWAY HAUPPAUGE,NEWYORK 11788
DATE ISSUED: 5/25/2006 No. 40227-H
SUFFOLK COUNTY
Home Improvement Contractor Licensev .
This is to certifv that MARC A CLEAN
doing business as
GREEN LOGIC LLC
having ftumished 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 I..........
'V`
NOT VALID WITHOUT
-AL
D)EPARTMENTAL SE
AND A CURRENT
CONSUNJER AFFAIRS
ID CARD
Director
......... .......
R
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Suffolk County Executive's Office of Consumer Affairs
VETERANS MEMORIAL HIGHWAY * HAUPPAUGE, NEW YORK 11788
DATE ISSUED: 12/10/2007 No. 43858-ME
SUFFOLK COUNTY _
Master Electrician License
This is to certify that ROBERT J SKYPALA
doing business as GREENLOGIC LLC
having 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.
Additional Businesses
_ f
NOT VALID WITHOUT
DEPARTMENTALSEAL
AND A CURRENT
CONSUMER AFFAIRS
IID CARD 1
a p �
Director �`
DATE
A�R CERTIFICATE OF LIABILITY INSURANCE Fol/28/20M/DD/YYYY)
20
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT Nicholas Zulkofske
Brookhaven Agency,Inc. PHONE 631 941-4113 FAx 631 941-4405
128 Old Town Road,Suite C E-MAIL , Certificates@ brookhavena enc .com
P.O.BOX 850 INSURERS AFFORDING COVERAGE MAIC S
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 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.
rA
TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000
CLAIMS-MADE FXI OCCUR DAMAGE TO RENTED $100,000
X Contractual Liability X X OL202000012922 01/3112020 01/31/2021 MED EXP(Any oneperson) $5,000
PERSONAL&ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000,000
POLICY[j]PRO-
jE LOC PRODUCTS-COMP/OP AGG $2,000,000
OTHER E&O Liability $1,000,000
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,0()0
B X ANY AUTO BODILY INJURY(Per person) $
OWNED SCHEDULED X X CAP1043565 08/1112019 08/11/2020 BODILY INJURY(Per accident) $
AUTOS ONLY
AUTOS
HIRED NON-OWNED PROPERTY DAMAGE $
X AUTOS ONLY X AUTOS ONLY
X UMBRELLA LIABX OCCUR EACH OCCURRENCE $
A EXCESS UABCLAIMS-MADE X AGGREGATE $
DED I I RETENTION 0 $
WORKERS COMPENSATION X PER I STAT I 11T7OTH-
AND EMPLOYERS'LIABILITY
D OANY FFICER/MEM ER EXCLUDED9 ECUTIVE YIN N/A V9WCO23041 06/1512019 06/15/2020 E L EACH ACCIDENT $1,000,000
(Mandatory In NH) E L DISEASE-EA EMPLOYEE $1,000,000
yes,descnbe under
DESCRIPTION OF OPERATIONS below E L.DISEASE-POLICY LIMIT $1,000,000
C NYS Disability 0251202 04M1/19 04/11/20 Statutory Limits
E Installation Floater/Property SML93076366 4/15119 4115120 $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 <NSZ>
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
NEW orker�" CERTIFICATE OF
Ti guard Compensation NYS WORKERS` COMPENSATION INSURANCE COVERAGE
��ard
1a.Legal Name&Address of insured(use street address only) 1b.Business Telephone Number of insured
Greenlogic LLC, 631-771-5152
97 North Sea Rd Suite 3 1c.NYS Unemployment Insurance Employer Registration Number of
South Hampton,NY 11968 Insured
Work Location of Insured(Cinty requited if coverage is specifically/invited 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
203801194
2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier
,(Entity Being Listed as,the Certificate )Holder
" United Wisconsin Insurance Company
Town of Southold
Building Department 36.Policy Number of Entity Listed in Box"1a"
53095 Rte 25 WC532-00243-020-SZ
Southold,NY 11971
3c.Policy effective period
7/23/2020 to 7/23/2021
3d.The Proprietor,Partners or Executive Officers°are
E] Included.(Only.check box if all partners/officers included)
,Q all excluded or certain partners/officers excluded.
Thls.certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box"1 a"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 7
The insurance-carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is canceled
due to nonpayment of 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
ti
Cercate is valid for one year after this 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,t certify that I am an authorized,tepresentative or licensed agent of the insurance carrier referenced
above and that the'named insured has the coverage as depicted on this form.
Approved by: Alicia Christiansen
(Print nam f thonzed representative,,r licensed agent of insurancetamer)
�t-
Approved by:
x
(Signature) (Date)
Title:Assistant Director of Sales Operations
Telephone Number of authorized representative or licensed agent of insurance carrier. 941-306-3077
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(9-17) www.wcb.ny.gov
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WI-P. i 8x'211 blgtn 2.4 GHz acid 5 G,lz
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SUMP E
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SunPower' Residential
. : AC Module
Built specifically for use with the SunPower Equinox system,the only fully
integrated solution designed,engineered,and warranted by one
manufacturer,
° Maximum Power. Minimalist Design.
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ndustry-leading e`fic�ency means r-ore power and savings
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per avail:;b e spa(_e b''1th fC'•,ver modules i equ,-ed and
hidren micro,nvertei s,less is tri-y snore,
Highest Lifetime Energy and Savings.
Designed to deliver 60-',,6 mo,e energy over 25 years in
real-world_orditions I[Ke par.ial shade and high ternperatures.'
MEiandam'en°t !!y®iff, re�it: t ' a , ,,:
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why we stand behind our module and rricroinverter
, �','F�• � � ;-vim the induswys nest 25-year C ornbined Power ano
Produd Warra,ity ncl.;ding the highest='ovver Warranty
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Inverter Model-Enpha:;e IQ 7XS(IQ7XS-96-ACM-US) @240 VAC @208 VAC
f'-a'<O,)tpi it',over 320 VA 320 VA
Max Cot-nijo-_-,_,Outou,Po.,,,,er ?1S VA '3'3 VA
Nang L 240!111-264 208118�-229
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weight— - 2915s(195 kg)
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effirwnt.,alnprox, Frn` (twin)
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Suecjfication�mcluded _e LISTED
P 2018 qunPowrCorpxatlon A41 Right,,Rese-ved SUNTr-WEER ne mdl.F.pe;fTyp.2 S U PO WTV ER
S�N PO-VIER logo onoWY-;<ECN d re regtste�re�tr adv-Trarks of-sunpow'r
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APP OVED AS NOTED
DATE: i 1 2j> B.P.#
jiL
FEE:
®® BY:
NOTIFY BUILDING DEPARTMENT AT
765-1802 8 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C C.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OFTHE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.
COMPLY WITH ALL CODES OF
NEW YORK STATE & TOWIJ CODES
AS REQUIRED A?QNSOSOBOARD
SOSN.YOCCUPAN
USE IS UNLAWFUL
WITHOUT CERTIFICATE
F OCCUPANCY
GREENLOGICO
ENERGY
GreenLogic,LLC Approved
2 SMA Inverters Matthew Campbell
18" Service Walkway 700 Harbor Lights Drive
located in basement, adjacent to Southold,NY 11971
34 SunPower 327W Main Panel Total System Size:11 11 8k
Panels Array Size:11.11BkW
1 string of 8 and 1 string of 8 on SPR-5002m
1 string of 6 and 2 strings of 6 on SPR-6002m
Azimuth:190°
Pitch:25" N
Monitoring System:
SunPower
1 Panel/Array Specifications:
I Panel:SPR-E20-327
1
I Racking:UniRac SunFrame
I Panel:61.39"X 41.18"
I Array:61'6 3/16"X 10'81/16"
I Surface:66'7"X 16'7"
I Magic#:4116/16"
I Legend:
® 34 SunPower 327W Panel
-------------------------------- --------------- —
U niRacSunFrameRail
• 67 Eco-Fasten Quik Foot
a2x6"Douglas Fir Rafter 16"O.C.
x x • Notes:(SD)
2x4 Douglas Fir Pullas To Be Added From East
Exterlor Wall To End Of LVL.Total Of 32 Ir 2x4's
Number of Roof layers.1
Height above Roof Surface*4"
xlxg x Materials Used Eco-Fasten,UmRac.SunPower
Added Roof load of PV System,3 5psf
Engineer/Architect Seal:
OF ISIS
�Q' �� PAc�'ci o,A
a
G6618`L
OFFS s10N
Drawn By:MMB Drawing#4 of 6
Date:3/5/2015 REV:A
Drawing Scale:3/32"=1.0'
AME SS T01JT A R C H I T E C T Assoc.
2 G REG L ANE E AST NORTHPORT N. Y. 63 i — a 53 9383
Post Installation Letter
December 15, 2020
RE; Lundquist Residence
700 Harbor Lights Drive
Southold, NY
To whom it may concern:
This letter is to confirm that as of this December 15, 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 2020 NYSRC and 2020 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
At?
t
�jt
021 ro yam
R
r
•J A M E S J. S TOUT A R C H I T E C T & Assoc.
2 G REG L ANE E AST N0RTHPORT N. Y. es i — o 5e 93ao
Letter of Certification
October 7, 2020
Lundquist Residence
700 Harbor Lights Drive
Southold, NY 11971
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 per 2020 Residential
code of NYS (RCNYS), 2020 building code of NYS(BCNYS) residential code,2020
Energy conservation construction code of NYS(ECCCNYS)and the 2017 National
Electric Code NFPA 7012017 National Electric Code,and the ASCE 7-10.
The existing 2"x 10"@ 16"o.c. roof rafters will provide adequate support.
Thank you for your understanding in this matter.
James J.Stout
Architect
ED ARC
�'9T 2I!633 y��
F F NES
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GreenLog►c,LLC approved
Lundquist,Dan
700 Harbor Lights Drive
Southold NY 11971
Surface A:
Total System Size:11.118kW
Array Size:4.251 WV
1 string of 6 and
1'siring of 7 on SB-50WTL-US-22
Azimuth:282°
Pitch:
Z
Monitorinrin
g System:
SunPower
Panel/ASpecifications:
Panel:SPR-E20-327
Racking:Unirac Sunframe
Panel:61.39"X 41.18"
------------------------------------------ Array:429.73"X85.11"
Surface:518"X 149"
XXXX777 Legend:
® 13 SunPower 327W Panel
Unirac Sunframe Rad
• 29 QuicanountE-Lag
p B 2x10"Douglas Fir Rafter 16'
y O.0
Notes•
Number of Roof Layers:1
Height above Roof Surface:4"
Materials Used:QuicdNount,SunPower,
SMA
Added Roof load of PV System:3.5psf
En new/Architect Seal:
BRED ARC
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Drawn By:DV Drawing#i of 5
Date:09/18/20 REV:A
Drawing Scale:l/8"=1.0'
C; _ LOGIC
GreenLogfc,LLC Approved
Lundquist,Dan
700 Harbor Lights Drive
Southold NY 11971
Surface A:
Total System Size:11.118WV
Array Size:4.251WV
1 string of 6 and
1 string of 7 on SB-6000TL--US-22
Azimuth:282"
Pitch:
Monitoring System:
SunPower
Panel/Array Specifications:
_ Panel:SPR-F20-327
Reciting:Unirac un me
Panel:61.39"X 41.18"
Array:429.73"X 85.11"
Surface:518'X 149"
Legend:
® 13 SunPower 327W Panel
Unirar,Sunframe Rail
• 29 Quidvnount E-Lag
B 8 2x10"Douglas Fir Rafter 16"
O.C.
Notes:
Number of Roof Layers:l
Height above Roof Surface:4"
Materials Used:QuwddWount,SunPower,
SMA
Added Roof load of PV S em:3.5psf
Engineer/Architect Seal:
SPED ARC
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JA 02163'5 OQ
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Drawn By:DV Drawing#2 of 5
Date:09/18/20 REV.-A
Drawing Scale:1/9'=1.0'
LOGIC"'
GnsenLogfcj UC Vprwed
Lundquist,Dan
700 Harbor Lights Drive
Southold NY 11971
Surface A:
Total System Size:11.118WV
Array Size:4.251kW
1 string of 6 and
1 string of 7 on S&5000TL-US-22
Azimuth:262°
Pitch:25*
Monitorinrin
g System: -tip"
SunPower
Pand/Anray Specifications:
Panel:SPR-E20-327
Raddng:Unirac Sunfiame
Panel:61.39"X 41.18"
Array:429.73"X 85.11"
5 Surface:518'X 149"
Legend:
4 13 SunPower 327W Panel
Unirao Sunframe Rail
29 Quiclanount E-Lag
8 8 2x10"Douglas Fir Rafter 16"
O.C.
Notes:
Number of Roof Layers:l
Height above Roof Surfaoe•4"
Materials Used:Quic Wount,SunPower,
SMA
Added Roof load of PV S m:3.5Psf
En neer/Mchitect Seal:
� ED ARc'�'i
cci S 7. ,,S T )�
02163'5 y0Q
TF 0p NES
Drawn By:DVDrawing#3 of 5
Date:09/18/20 I REV:A
Drawing Scale:1/&'=I-V
No Solar Panels Will Be Installed Over Existing Vent Pipesi ` . `t LOGIC°'
LEGEND
AR Access roof per R:D:deftniaons RSP -Roof access point-to tea,ar from RIA, -Roof do vaeey QreenLO¢q LLC Approved '
ovemaad oostructtons doors 18 minimum from valley
indors decks fences andscapmg Lundquist,Dan ,
GA -Ground access area per R324 7 3•rdM AP -Access PaM..ay,36'minimum S.0 -SmoMe vent operation per RAP 700 Harbor Lights Drive
RAPto be same as AP as meaw ed at ea.e v M per R324 4 and R324 7 5 R324 7 7 18 minlmum from ndge Southold NY 11971
GA GA
I 1 Total System Size:11.118kW
1 I Array Size.4.251kW
I I 1 string of 6 and
1 string of 7 on S13-5000TL-US-22
APi iAP
1 I Azimuth:282"
1 I Pitch:25"
I 1 Monitoring System.
I I SunPower
— — — — — — — — — - - — — — — — — — — 1
— — — — Panel/Array SpecNicafions:
Panel-SPR-E20-327
Racking•Unkac Sunffame
° Panel:61.39"X 41.18"
Array:429.73"X 85.11"
• I Surface:518"X 149"
I
1 Legend:
p ® 13 SunPower 327W Panel
I — Unirac Sunframe Rail
I �
1 • 29 Quidanount E-Lag
1 Q 2x10"Douglas Fir Rafter 16"
O.C.
Notes:
I
Number of Roof Layeml
I Height above Roof Surfaos:4"
I Materials Used:QurddWount,SunPower,x cr f
I SMA i
Added Roof load of PV System&5psf
En neer/ArcMect Seal:
13 SunPower 327W �p�E.D ARCS
Panels C�����s J :sr
I ° * ;
L q 021633 yOQ
1 L--- F OF NEIN
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Drawn By:DVDrawing#4 of 5
RAP Date:09/18/20 7 REV:A
Drawing Scale:3/32"=1.0'
11LOGIC"'
wl
&eenLo9/c,LLC Approved
Lundquist,Dan
700 Harbor Lights Drive
Southold NY 11971
JOB MATERIAL LIST I Total system Size:11.118M
Array Size:4.251M
1 string of 6 and
1 string of 7 on SB-5000TL--US-22
Azimuth:282°
Pitch:25°
Monitoring System: N
Material List gt L. Rail Material List SunPower
Panel/Array Specifications:
Panel:SPR-E20-327
Racking:Unirac Sunframe
Cast Aluminum Mounting Block w/Black Aluminum Flashing 29 Panel:61.39'X 41.18"
5/16"x7/8"EPDM Sealing Plug 29 Array:429.73"X 85.11"
Surface:518'X 149"
5/16"x5.5"Hex-Head Lag Screw 29 Legend:
5/16"x1.25"Fender Washer 29
® 13 SunPower 327W Panel
Unvac Sunframe Rad
• 29 Quidvnount E-Lag
8 2x10"Douglas Fir Rafter 16"
O.C.
Notes.
Number of Roof Layers:l
Height above Roof Surface:4"
Materials Used:Quid0ount,SunPower,
SMA
Added Roof load of PV System:3.5psf
En neer/Archited Seal:
ED ARC
'g'i
�S J. ,S T ��
w P�� \, ,
d~��r 021633 y0Q
R OF
Drawn By:DV Drawing#5 of 5
Date:09/18/20 REV.A
Drawing Scale:3/32"=1.0'
I