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�o�OgUFF�tK Town of Southold 6/24/2021 SA o P.O.Box 1179 o _ 53095 Main Rd ypj�l � Y¢ Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 42112 Date: 6/24/2021 THIS CERTIFIES that the building SOLAR PANEL Location of Property: 230 Private Rd#27, Southold SCTM#: 473889 Sec/Block/Lot: 78.-7-32.8 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 2/12/2021 pursuant to which Building Permit No. 45857 dated 2/26/2021 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 292 Waterview LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 45857 4/29/2021 PLUMBERS CERTIFICATION DATED r Au or zedAignature SUFFot,�� TOWN OF SOUTHOLD o� yGy� BUILDING DEPARTMENT y TOWN CLERK'S OFFICE �y • SOUTHOLD, NY dol� Sao 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#: 45857 Date: 2/26/2021 Permission is hereby granted to: 292 Waterview LLC C/O Joshua Bloom 51 Belmont Dr Roslyn Heights, NY 11577 To: install roof-mounted solar panels on existing single-family dwelling as applied for. At premises located at: 230 Private Rd #27, Southold SCTM #473889 Sec/Block/Lot# 78.-7-32.8 Pursuant to application dated 2/12/2021 and approved by the Building Inspector. To expire on 8/28/2022. Fees: SOLAR PANELS $50.00 ELECTRIC $100.00 CO-ALTERATION TO DWELLING $50.00 otal: $200.00 BuiIdi g I ftpedfor Oslo Town Hall Annex ® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 sean.devlin(cD-town.southold.ny.us Southold,NY 11971-0959 ® �® BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: 292 Waterview LLC Address: 230 Private Rd #27 city Southold st: NY zip: 11971 Building Permit#: 45857 section- 78 Block: 7 Lot- 32.8 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: GreenLogic LLC License No: 43858ME SITE DETAILS Office Use Only Residential X Indoor X Basement Solar X Commerical Outdoor X 1st Floor Pool New X Renovation 2nd Floor Hot Tub Addition Survey EJ 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 Ceiling Fan Combo Smoke/CO Transformer UC Lights Dryer Recpt Emergency Fixtures Time Clocks Disconnect Switches 4'LED Exit Fixtures 11 Pump Other Equipment: 12.753kW Roof Mounted PV Solar Energy System w/ (39) SPR-320-327-E-AC Modules, SunPower Monitor, sub (disconnect) w/220x5 215x1 Notes* Solar Inspector Signature: Date: April 29, 2021 S.Devlin-Cert Electrical Compliance Form.xls Iftsf s 0 '-2-_�c ct . to l ✓ # # TOWN OF SOUTHOLD BUILDING DEPT. °�ycouKn,N�'' 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE-&-CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: DATE -r INSPECTOR pF50Ul # TOWN OF SOUTHOLD-BUILDINGDEPT. 765-1802 INSPECTION . ' .- FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] NSULATION/CAULKING [ ] FRAMING/STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION - [ ] FIRE RESISTANT PENETRATION- [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: r4v Mfnh SWt"_ 42) ate_(40 eA DATE Iv ?fit INSPECTOR j f/ f / r R f w� f f J A M E S J. S TOUT A RCHITECT & Assoc . 2 G REG L ANE E AST NORTHP0RTN. Y. 631 - 8 58 9388 Post Installation Letter , r. May 12, 2021 MAY 2 4 2021 RE: Bloom Residence 292 Waterview Drive-a3o 20( *L a 7 Southold, NY 11971 Iran To Whom it May Concern: This letter is to confirm that as of May 12, 20211, James J Stout, NYS license 021633 have personally inspected the placement and installation of the roof top solar panels at the above-mentioned 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 NYSUCS building code and provisions of ASCE 7-16. The installation was done as per plan. Thank you for your cooperation in this matter. James J. Stout Architect EARC' SJSTC fix v � �c aae 02 633 OQ- cof NEV.� FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION(1ST) ------------------------------------ d FOUNDATION(2ND) • - z cn ROUGH FRAMING& PLUMBING INSULATION PER N.Y-. H STATE ENERGY CODE -49 ISt000 v - FINAL ADDITIONAL COMMENTS ,JA I So I - 010N . o z m z ' d ���UffQtq�� TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 '' �► Telephone (631) 765-1802 Fax(631) 765-9502 https://wwNv.soutlioldtownny.gov Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only PERMIT N0. � Building Inspector: FEB B 1 Z 2021 .,t k�V >� ,�?�M t� ,.: ,.,. ,� �'\t.s_Y>Y+.aY>anu'.5_;>..""."w> iia �" {•.,.� .v'"._..'^ r;;sus ..:.'�j ��.� — `AjtiPtication"s`and formi�v!'�ust be�i�l�d out=iii-their entirety:frteornplefe,�, ��` � �-�•-• -•��� r''. .:t','.: ..`� z appticat o sw ft"iiot b ecepte`\ Wherti the'ApRlicanfiis>no the own er=aa,;-< � �,a_• :r_ fSuirnerNWAhorixatio; lr orm 1Page 2j shall be°completed:` , " n,n Date:2/10/2021 -�OliUl1[fER�Sj=OFs PItC�PERTY.z.<:; Name:292 Waterview LLC -7SCTM#1000-78 -32.8 Project Address:230 Private Rd #27, Southold _ . ._.....__.._._.._...__...._._._ ...__..__.__ . ...... _..__._.. .._.. ._. Phone#:917-215-0327Tail:292waterview@gmail.com Em Mailing Address: GON'fACT PER50N• s r=ice . " .`a- ,tam-a`�rrs fi=r<='sem-` -�,�fi` -•r. Name:Barbara-GreenLogic LLC_ Mailing Address:97 North Sea"Road, Southampton3" y 11968 _._. ............_... __._._. __r.._. w. .._..._... ... _.. Phone#:631-771-5152 x117 Email:BarbaraPGreenlogic.com - w 27 77= DESIGN PR{ZEESS(ONAI INEORMATt Name:James J. Stout Architect & Associates Mailing Address:2 Greg Lane, East Northport, NY 11731 V4 Phone#:631-858-9388 Email:StouthubOiamesstoutarch.com CQNTRACTQIi i1VFt�RMA ICiN `'<'" : ,- :' Name:GreenLogicµLLC . ___ ......_..__ ..._...._. ...... ........... .. ._._._. .-._.._....._ _... . ....._._.... ...._._._._._........._._........ ._.. .__ Mailing Address:97 North Sea Road, Southampton. NY_>a11.968 Phone#:631-771-5152 Email:AMOGreenlogic.com _ ;,DESCRIPTION=t31= 1i PpSARCONSTRUCTIQN,.7 i.s'`<"".>.>'"a.L°;"•`:C.;»,..^. " � = m'�8�.,u, w. El New Structure ❑Addition ®Alteration ❑Repair ❑Demolition Estimated Cost of Project: Eil Other Solar Panels $40,000 Will the lot be re-graded? ❑Yes ®No Will excess fill be removed from premises? ❑Yes ®No 1 PROPERTY INF�3RIVIATIOIV,a T- - Existing use of property: t vqd I,,riq _1.6 CL (L-W, Intended use of property: Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? E]Yesf/No IF YES, PROVIDE A COPY. ChecBo)rA kA4 Reading:-'T ofesslohal is responsible fot�all drainpgq,;' !is h6bwnerftpritra�ctor/design Pr' and storm water issue by' CleOt.,:;3616i ih-e'Town code.APPLICATION IS HEREBY MADE to the,Oullding Department for the'iss6nce of,6'4uiIdIng Permit pursuant to the Building Zone ^'drdinanceoi`the Town of Southold,SuffbJk;County,-N I#W York and other I applicable Laws,ordi'n^inoes,brRega�itions,,foithe construction of buildings, �additions;`alterations odor remoual or-demolition wherein edThe applkiritagreesto-complywfltb ail'aPplic-abie laws,ordinances;-building-- A- siogtddeand regulations Anidt'oadr6it'authorized'inspeciorsoiipremises acid inbijilding(s)foinecessary�ti)specU4riif-.False statem(ints'madefieteina-re i�punishabtias',�aClass TisqemFanorPu rivant,to Section 210.45 Wihe New York State Penal Law, Application Submitted By(print name):Green Logic LLC ®Authorized Agent El Owner Signature of Applicant: Date: l0 601-'l 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/her knowledge and belief;and that the work will be performed in the manner set forth in the application file therewith. Sworn before me this �j� n dayof ., 2091 blooWb� Notary Public BARBARA A CASCIOTTA Notary Pubiic-State of New York PROPERTY OWNER AUTHORIZATION No.01-CA4894969 Qualified in Suffolk County (Where the applicant is not the owner) Commission Expires May 11,2023 1, residing at fl{G 1,j rj I . 11 do hereby authorize GreenLogic LLC to apply on myoown of Sout Building Department for approval as described herein. OwlfqT's Signature Date j�Jost�jo IlSk.Lq-owy Print Owner's Name 2 BUILDING DEPARTMENT- Electrical Inspector V TOWN OF SOUTHOLD Town Hall Annex- 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 rogerra_southoldtownny..qov — seand(&-southoldtownny._qov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All information Required) Date: 2/10/2021 Company Name: GreenLogic LLC Name: Robert SkypaLa License No.: 43858-ME email: Barbara@Greenlogic.com Address: 97 North Sea.Road, Southampton, NY 11968 Phone No.: 631-771-5152 JOB SITE INFORMATION (All information Required) Name: 292 Waterview LLC Address: 230 Private Rd #27, Southold, NY Cross Street: Phone No.: 917-215-0327 Bldg.Permit#: email: 292waterview@gma_i_1.c'om TaxMap District* 1000 Section: 78 Block: 7 Lot: 32.8 BRIEF-DESCRIPTION OF WORK (Please Print Clearly) --Roof mounted solar electric system (39) SunPower SPR-320-327-E-AC modules, (39) SunPower SPR-320-327-E-AC inverters (1),SunPower monitor PVS6 System Size: 12.753kW Circle All That Apply: Is job ready for inspection?: YES NO Rough In FFinal L----------a 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 1#Underground-Laterals 1 2 H Frame Pole Work done on Service? Y N -Additional finformatior`' PAYMENT DUE WITH APPLICATION Request for Inspection Form,xis PERMIT# Address: Switches Outlets GFI's Surface Sconces H H's UC Us Fans Fridge HW Exhaust Oven Dryer Smokes DW Service Carbon Micro Generator Combo Cooktop Transfer AC AH Mini Special: Comments. ooA /_Z4 _ -2 � ' ILA 9L C z 1"I'f) 'fib er , a 'P4AN ec o z 7 -tea a�-x ' _ /�'°6A1N '4sr +r+>r. a fd✓ x * 4sa'' �.".Yr„ne eC.�x., �,�r.�a- 'tif ,—JC s . - ., ,KwS.s1aJ�`,r aa�pt ...Ft,a pis ,aco CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) � 01129/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Nicholas Zulkofske Brookhaven Agency,Inc. PHONE 631 941-4113 EW, 631 941-4405 100 Oakland Ave,Ste 1 EMAILEssm Certificates@ brookhavena enc .com Port Jefferson,NY 11777 INSURERS AFFORDING COVERAGE NAIC# 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 o: 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. INSLTR TYPE OF INSURANCE ADOL SUBR POLICY HUMBER POLICY EFF POLICY EXP MM YYYI LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 A CLAIMS-MADE IX-1OCCURDAMAGES(RENTED $100,000 X Contractual Liability X X OL202100012922 01/3112021 01/31/2022 MED EXP(Any oneperson) $5,000 PERSONAL&ADV INJURY S1,000,000 GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE s2,000,000 POLICYFil ECT LOC PRODUCTS-COMP/OP AGG $2 00O 000 OTHER E&O Liability $1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1000000 (Fa armident)B X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS X X CAP1043565 08/11/2020 08/11/2021 BODILY INJURY(Per accident) $ X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ WORKERS COMPENSATION PER OTH- TU AND EMPLOYERS'LIABILITY Y/N A T7 I FR ANY PROPRIETOR/PARTNER/EXECUTIVE❑ N/A see seperate certificate E L EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E L DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below I I I I E L DISEASE-POLICY LIMIT $ C NYS Disability 0251202 04/11120 04/11/21 Statutory Limits E Installation Floater/Property SML93076366 4/15120 4/15/21 $300,000 $2,500 Ded DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be 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> 191;�k @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD E Workers' CERTIFICATE OF RK ST E =r=adon NYS WORKERS' COMEEiVSATI®N INSURANCE COVERAGE 1 a.Legal Name&Address of insured(use street address only) 1 b.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(Only required if coverage is specifically 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 203801194 2.Name and Address of Entity Requestir j Proof of Coverage 3a Name_ of Insurance Carrier (Entity tieing Listed as the Certificate Holder) United Wisconsin Insurance Company Town of Southold Building Department 36.Policy Number of Entity Listed in Box"ia" 53095 Rfe 25 WC532-00243-020-SZ Southold,NY 11971 3c.Policy effective period 7123/2020 to 7/23/2021 3d.The Proprietor,Partners or Executive Officers are M included.(Only check box if all partners/officers included) ❑ all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated`above in box 3"insures the business referenced above in box"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 INFOIINIATION 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'withm 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 Certificate 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 th&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 this form. Approved-by: Alicia Christiansen (Pnnt riam € thonzed representative or licensed agent of insurance tamer) -7 bao re^ Approved by- A, ' (Signature) (Date) Title_Assistant Director of Sales Operations Telephone Number of authorized representative or licensed agent of insurance carrier. 941-306-307.7 Please Note:Only insurance carriers and their licensed agents are authorized to issue Form C-405.2_insurance brokers are NOT authorized to issue it. C-405.2(947) www.wcb.ny.gov s NEW r--� YORK Workers' Compensation CERTIFICATE OF INSURANCE COVERAGE Board DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW PART 1.To be completed by Disability and Paid Family Leave Benefits Carrier or Licensed Insurance Agent of that Carrier 1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured GREENLOGIC,LLC 631-941-4113 97 NORTH SEA ROAD,SUITE 3 SOUTHAMPTON,NY 11968 1 c.Federal Employer Identification Number of insured Work Location of Insured(Only required rf coverage is specifically ilrruted to or Social Security Number certain locations in New York State,ie.,Wrap-Up Paricy) 203801194 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) SheiterPoint Life Insurance Company i Town of Southold 53095 Route 25 3b.Policy Number of Entity Listed in Box 1 a" Southold NY 11971 ©BL251202 3c.Policy effective period 04111/2020 to 04/10/2021 4. Policy provides the following benefits: ® A.Both disability and paid family leave benefits. B.Disability benefits only. (� C.Paid family leave benefits only. S. Policy,covers: © A.All of the employer's employees eligible under the NYS Disability and Paid Family Leave Benefits Law. B.Only the following class or classes of employer's employees: Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has NYS Disability and/or Paid Family Leave Benefits insurance coverage as described above. Date Signed 4/13/2020 By (Signature or insurance carrier's authonzed representative or NYS Licensed Insurance Agent of that insurance carrier) Telephone Number 516-829-8100 Name and Title Richard White Chief Executive Officer IMPORTANT: If Boxes 4A and 5A are checked,and this form is signed by the insurance carrier's authorized representative or NYS Licensed Insurance Agent of that carrier,this certificate is COMPLETE.Mail it directly to the certificate holder. If Box 4B,4C or 5B is checked,this certificate is NOT COMPLETE for purposes of Section 220,Subd.8 of the NYS Disability and Paid Family Leave Benefits Law.It must be mailed for completion to the Workers'Compensation Board,Plans Acceptance Unit, PO Box 5200,Binghamton,NY 13902-5200. PART 2.To be completed by the NYS Workers'Compensation Board(Only if Box 4C or 513 of Part 1 has been checked) State-of New York Workers' Compensation Board According to information maintained by the NYS Workers'Compensation Board,the above-named employer has complied with the NYS Disability and Paid Family Leave Benefits Law with respect to all of his/her employees. Date Signed By (Signature of Authorized NYS Workers'Compensation Board Employee) Telephone Number Name and Title Please!Vote:Only insurance carriers licensed to write NYS disability and paid family leave benefits insurance policies and NYS licensed insurance agents of those insurance carriers are authorized to issue Form D8-920.1.insurance brokers are NOT authorized to issue this form. D13-120.1 (10-17) DB1II2II � I�I11li01@71)11 � 1 { i -.77 7 m C f p".; Suffolk County Executive's Office of Consumer Affairs VETERANS MEMORIAL HIGHWAY HAUPPAUGE,NEWYORK 11788 DATE ISSUED: 5/25/2006 No. 40227-H SUFFOLK COUNTY Home Improvement Contractor License This is to certifv that MARC A CLEAN doing business as GREEN LOGIC LLC =irhaving 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 DIEFARTMENTAL SEAL AND A CURRENT CONSW;IER A"AIRS ................... ID CARD Ytiajsfi . m Director tl4,s `) I Suffolk County Executive's Office of Consumer Affairs { ,. VETERANS MEMORIALrNEWYORK 11788 .. No. 43858-ME DATE ISSUED: 12/10/2007 SUFFOLK COUNTY ROBERTMaster Electrician License This is to certify that rf doing business as `7 c-flGREENLOGIChaving given satisfactory evidence of competency,is hereby licensed as MASTER ELECTRICIAN in accordance7 with and subject to the provisions of applicable laws,rules and regulations of the !'r Countyof • of York. Additional Businesses NOT VALID WITHOUT DEPARTMENTAL SEAL ANDACURRENT ' CONSUMER AFFAIRS 11) D a. Director i i� GREENLOGIC® ENERGY February 10, 2021 Town of Southold Building Department Town Hall 53095 Route 25 Southold, NY 11971 Project Info: 292 Waterview LLC 230 Private Rd#27 Southold, NY 1000-78-7-32.8 Dear Building Inspector: Please find attached a building permit application to install a roof mounted solar photovoltaic(PV) electric system for the above referenced property. In connection with this application, please find attached: • Building Permit application with owner authorization • 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, 53a46ma ea6cioftac Barbara Casciotta Account Manager BarbaraGreenlogic.com GREENl G1C�L�11C"51vw Xtepljlogic.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 GREENLOGIC® ENERGY _ A MAY 242.021 May 20, 2021 The Town of Southold Building Department 54375 Route 25 P.O. Box 1179 Southold, NY 11971 Project Info: Building Permit No. 45857 292 Waterview LLC 230 Private Road #27 Southold, 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, XaJc w Ca6ccu:tttt Barbara Casciotta Account Manager Barbara@Greenlogic.com 631-771-5152 Ext. 117 GREENLOGIC LLC o 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 ` J AMES J. S TOUT A R C H I T E C T & Assoc . 2 GREG LANE E AST NORTHPORT N. Y. 631 — 8 58 9388 Letter of Certification January 25, 2021 COMPLY WITH ALL CODES OF Bloom Residence NEW YORK STATE & TOWN CODES 292 Waterview Drive 230 priOahe. 20t REQUIRED AND CONDITIONS OF Southold, NY 11971 STH p �D�2d�1 n?�1WN PI dNAIIAIa p�ARD To Whom it may concern; SOUTH01 n TnWN TRUSTEES N.Y.S.DE I, James J. Stout, registered architect NYS license number 021633 would like 0 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 7-16. The existing 2"x 12" @ 16"roof rafters will provide adequate support. OCCUPANCY OR USE IS UNLAWFUL Thank you for your understanding in this matter. WITHOUT CERTIFICATE James J. Stout OF OCCUPANCY Architect APPROVED AS NOTED ED 'SRC DATE: B.P.# \�� 5 3. T FEE: D.. _ BY NOTIFY ,BUILDING PARTM T AT 765-1802 8 AM TO a PM FOR THE FOLLOWING INSPECTIONS: I. FOUNDATION - T4ti') REQUIRED FOR POURED r-A FTE ®21, 33 y0 2. ROUGH - FRAV '. 1LUMBING NE.S1 3. INSULATION 4 FINAL - COF:; .710N MUST BE COMPLE'L C 0. ELECTRICAL aLL CONSTRUG T I;;r. SHALL MEET THE INISPECTION REQUIRE® 'EQUIREMENTS OF i HE CODES OF NFA'; 'ORK STATE. NOT RESPONSIBLE Fr- )ESIGN OR CONSTRUCTION ERROR; f Vj 3 G N L®t.�'1 C" ENERGY GreenLogfc,LLC Approved Bloom,Josh 292 Waterview Drive Southold,NY 11971 Surface#A: Total System Size: 12.753kW Array Size:4.578WV 1 circuit of 6 on a 20A breaker 1 circuit of 8 on a 20A breaker Azimuth:170° Pitch:28° Monitoring System. SunPower I)— Panel/Array Specifications: I y I Y Y Y Panel:SPR-E20-327-E-AC Racking:SunPower Invisimount Panel:61.39"X 41.18" Array:36'6 3/4"X 10'3 1/2" Surface-37'8"X 18'10" o Magic#:Invisimount Legend: x x x ® 14 SunPower 327W Panels ® SunPower Invisimount Rad 30 Quids Mount E Lag 2x12"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:2.84psf Engineer/Architect Seal: f 5 r � y pZ Drawn By:MA Drawing#1 of 11 Date: 1/22/2021 1 REV.A Drawing Scale-3/16"=1.0' GREENUMMOCO ENERGY GreenLogic,LLC Approved Bloom,Josh 292 Waterview Drive Southold,NY 11971 Surface#A: Total System Size: 12.753kW Array Size:4.578kW 1 circuit of 6 on a 20A breaker 1 circuit of 8 on a 20A breaker Azimuth:170° Pitch:28° Monitoring System. N SunPower Panel/Array Specifications: Panel:SPR-E20-327-E-AC INV Racking:SunPower Invisimount Panel.61.39"X 41.18" Array:36'6 3/4"X 10'3 1/2" Surface:3T 8"X 18'10" MagicM Invisimount Legend: ® 14 SunPower 327W Panels SunPower Invisimount Rail AA CO 30 Quick Mount E Lag O 2x12"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.2.84psf Engineer/Architect Seal:/ ED C S ). 2 i 102133 TF F E`N Drawn By.MA Drawing#2 of 11 Date: 1/22/2021 REV:A Drawing Scale:3/16"=1.0' G::� LOrO O ENERGY GreenLogic,LLC Approved Bloom,Josh 292 Waterview Drive Southold,NY 11971 Surface#A: Total System Size. 12.753kW Array Size:4.578kW 1 circuit of 6 on a 20A breaker 1 circuit of 8 on a 20A breaker Azimuth,170° Pitch:28' Monitoring System: 44 SunPower 2 Panel/Array Specifications: 1 2 2 Panel:SPR-E20-327-E-AC Racking:SunPowerinvisimount Panel:61.39"X 41.18" Array:36'6 3/4"X 10'3 1/2" Surface:37'8"X 18'10" 0 Ma is#:Invisrmount Legend: 1 2 2 © 14 SunPower 327W Panels SunPower Invisimount Rad 30 Quick Mount E Lag 2x12"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:2.84psf Engineer/Architect Seal:/ EaE° c 3. q� 021 3'' y0� Drawn By:MA Drawing#3 of 11 Date: 1/22/2021 REV:A Drawing Scale:3/16"=1.0' ,Pz' GREENLOGPr,o ENERGY GreenLogic,LLC Approved Bloom,Josh 292 Waterview Drive Southold,NY 11971 Surface#B: Total System Size-12.753kW Array Size:4.251 kW 1 circuit of 6 on a 20A breaker 1 circuit of 7 on a 20A breaker Azimuth:260° Pitch:28° Monitoring System. SunPower Panel/Array Specifications: Panel:SPR-E20-327-E-AC x x Racking:SunPowerinvisimount Panel:61.39"X 41.18" Array:20'7 3/4"X 12'1 1/4" Surface:29'6"X 13'10" Magic#:Invisimount Legend: xx © 13 SunPower 327W Panels ® SunPower Invisimount Rad 77 ® 29 Quick Mount E Lag 8 B 2x12"Douglas Fir Rafter 16"O.C. ------------ Notes: Number of Roof Layers:1 x x x Height above Roof Surface:4" Materials Used:Quick Mount,SunPower V ------- Added Roof load of PV System:2.84psf E— Engineer/Architect Seal: / RED C —� x r 9 pZ 1�g3 ypQ' Drawn By:MA Drawing#4 of 11 Date: 1/22/2021 REV:A Drawing Scale:1/4"=1.0' ENERGY GreenLogic,LLC Approved Bloom,Josh 292 Waterview Drive Southold,NY 11971 Surface#B: Total System Size:12.753WV Array Size:4.251 kW 1 circud of 6 on a 20A breaker 1 circuit of 7 on a 20A breaker Azimuth:260° Pitch:28° Monitoring System: SunPower - Panel/Array Specifications: Panel:SPR-E20-327-E-AC Racking:SunPower Invisimount Panel:61.39"X 41.18" Array:20'7 3/4"X 12'1 1/4" Surface:29'6"X 13'10" Magic#:Invisimount Legend: ® 13 SunPower 327W Panels ® SunPower Invisimount Rail ® 29 Quick Mount E Lag 2x12"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:2.84psf Engineer/Architect Seal:/ D �5 c, J. ¢ �Q' A 021033 OQ Drawn By:MA Drawing#5 of 11 Date:1/22/2021 REV:A Drawing Scale:1/4"=1.0' � GREENLOMV ENERGY GreenLogic,LLC Approved Bloom,Josh 292 Waterview Drive Southold,NY 11971 Surface#B: Total System Size-12.753kW Array Size:4.251 kW 1 circuit of 6 on a 20A breaker 1 circuit of 7 on a 20A breaker Azimuth.260° Pitch:28" Monitoring System: SunPower Panei/Array Specifications: Panel.SPR-E20-327-E-AC 3 Racking:SunPower Invisimount Panel.61.39"X 41.18" Array:20'7 3/4"X 12'1 1/4" Surface:29'6"X 13'10" Magic#:Invisimount Legend: 3 4 ® 13 SunPower 327W Panels SunPower Invisimount Rail 0 29 Quick Mount E Lag 8 2x12"Douglas Fir Rafter 16"O.C. Notes: 4 Number of Roof Layers:1 Height above Roof Surface:4" Materials Used:Quick Mount,SunPower Added Roof load of PV System:2.84psf �Sy Engineer/Architect Seal: / QED C o r 0-210'3' pQ Drawn By:MA Drawing#6 of 11 Date: 1/22/2021 REV:A Drawing Scale:1/4"=1.0' r >GREENLO PC' ENERGY GreenLogic,LLC Approved Bloom,Josh 292 Waterview Drive Southold,NY 11971 Surface#C: Total System Size:12.753kW Array Size:3.924kW 1 circuit of 12 on a 20A breaker Azimuth:80° Pitch:28° ISL Monitoring System: SunPower Panel/Array Specifications: Panel:SPR-E20-327-E-AC x x x x Racking:SunPower Invisimount Panel:61.39"X 41.18" Array:20'7 3/4"X 12'1 1/4" Surface:29'6"X 13'10" Magic#:Invisimount Legend: ® 12 SunPower 327W Panels ® SunPower Invisimount Rail ® 28 Quick Mount E Lag B 8 2x12"Douglas Fir Rafter 16"O.C. Notes: Number of Roof Layers.1 x x Height above Roof Surface:4' Materials Used:Quick Mount,SunPower Added Roof load of PV System:2.84psf Engineer/Architect Seal:/ Drawn By:MA Drawing#7 of 11 Date: 1/22/2021 REV:A Drawing Scale:1/4"=1.0' ( GREENLOMCO C-6- ENERGY GreenLogic,LLC Approved Bloom,Josh 292 Waterview Drive Southold,NY 11971 Surface#C: Total System Size:12.753kW Array Size:3.924kW 1 circuit of 12 on a 20A breaker Azimuth:80" Pitch:28° Monitoring System: SunPower Panel/Array Specifications: Panel:SPR-E20-327-E-AC Racking:SunPower Invisimount Panel:61.39"X 41.18" Array:20'7 3/4"X 12'1 1/4" Surface-29'6"X 13'10" Magic#:Invisimount Legend: ® 12 SunPower 327W Panels SunPower Invisimount Rail ® 28 Quick Mount E Lag 8 8 2x12"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:2.84psf En ineer/Architect Seal:, ED c �� S ). C' X21 33 OQ 9TF F E�y Drawn By:MA Drawing#8 of 11 Date. 1/22/2021 REV:A Drawing Scale:1/4"=1.0' GREENLOOT ENERGY GreenLogic,LLC Approved Bloom,Josh 292 Waterview Drive Southold,NY 11971 Surface#C: Total System Size:12.753kW Array Size:3.924kW 1 circuit of 12 on a 20A breaker Azimuth.80" Pitch:28" Monitoring System: SunPower PaneliArray Specifications: Panel:SPR-E20-327-E-AC 5 Racking:SunPower Invisimount Panel:61.39"X 41.18" Array:20'7 3/4"X 12'1 1/4" Surface:29'6"X 13'10" V17- Magic#:Invisimount Legend: 5 ® 12 SunPower 327W Panels ® SunPower Invisimount Rail ® 28 Quick Mount E Lag H 2x12"Douglas Fir Rafter 16"O.C. Notes: 5 Number of Roof Layers:1 Height above Roof Surface:4" == /AMaterials Used:Quick Mount,SunPower Added Roof load of PV System,2.84psf AZ \1/ \V N Engineer/Architect Seal: i ��RED C 4 r {q 02143'' OQ Drawn By:MA Drawing#9 of 11 Date: 1/22/2021 REV:A Drawing Scale.1/4"=1.0' No Vent Pipes Will Be Covered By The Solar Array ��^� EE L®SPC° LEGEND: ENERGY AR -Access roof per R202 definitions RAP -Roof access point-to be away from RWV -Roof with valley, GreenLogic,LLC Approved overhead obstructions,doors. 18"minimum from valley Bloom,Josh windows,decks,fences,landscaping 292 Waterview Drive GA -Ground access area per R324.7.3 width AP -Access Pathway,36"minimum SVO -Smoke vent operation per Southold,NY 11971 to be same as AP as measured at eave width per R324.7A and R324.7.5 R324 7.7,18'minimum from ridge Total System Size.12.753kW 1 circuit of 6 on a 20A breaker 1 circuit of 8 on a 20A breaker 1 circuit of 6 on a 20A breaker 1 arcuit of 7 on a 20A breaker 1 circuit of 12 on a 20A breaker Azimuth:170° RAP RAP Monitoring System: N SunPower �' Panel/Array Specifications: 1 I I Panel*SPR-E20-327-E-AC I I (� Racking.SunPower Invisimount I (— Panel:61.39"X 41.18" I I Array:38'3"X 34'4" API IAPI Surface:42'11"X 59'2" I 1 1 Magic#:Invisimount t I I Legend: 14 SunPower I I 1 ® 39 SunPower 327W Panels 327W Panels I ______ I I — SunPower Invisimount Rail SVO • 87 Quick Mount E Lag 8 B 2x12"Douglas Fir Rafter 16"O.C. NV t I Notes. I 1 Number of Roof Layers: 1 I I Height above Roof Surface:4' Materials Used:Quick Mount,SunPower Added Roof load of PV System:2.84psf i Engineer/Architect Seal:/ SPED t6? h Or Meter 13 02I 33 ,l O�� / 9T d/ 327WPanels 12 SunPower � F QF/tvE 327W Panels Drawn By MA Drawing#10 of 11 Date:1/22/2021 REV.A Drawing Scale:1/16"=1.0' c GREENLOOC" ENERGY GreenLogic,LLC Approved Bloom,Josh __---__-- _-- _ __--___-___ ----.--_ _�_____,_________.._____-__ __ -- --_---- _—_ -_ 292 Waterview Drive -_-_---- JOB MATERIAL LIST out o 1971 Total System Size:12.753kW 1 circuit of an a 20A breaker 1 circuit of 8 on a 20A breaker ___.._-.___�______.____ .____._ _._�___..�_.____._ ____ __._..__w__---__- _ _. ._ ___ _.._._ _._.__ _._-._______.__. _,._- _;_-._------_--•-__-._ -._-_-,_ _. 1 circuit of 6 on a 20A breaker 1 circuit of 7 on a 20A broker ! 1 circuit of 12 on a 20A breaker Azimuth: Material list thy. Rail Material List ! I Monitoring system: - - - - - - -- - _- --- - - - -- - - r -- - }- - -- - SunPower Panel/Array Specifications: Panel:SPR-E20-327-E-AC Cast AluminumMounting Block w/Black Aluminum Flashing 87 ; ;� i Racking:SunPower Invisimount _._ _._ _ ... 5/16"x7/8"EPDM Sealing Plug 87 ! Panel:61.39"X 41.18" 5/16 Array.38'3"X 34'4" " urce:x5.5 Hex-Head Lag Screw 87 Surface:42'11"X 59'2"{ 5/16"x1.25"Fender Washer 87 Magic #:Invisimou nt .___-_ -.____-.____.-..__._____.._-.- -----______ ________,-..----.__-,______-__;__._-- .__. --_.._.._._----__•--- _ --_--__ _-.. _ _______----- -.---_i_.__-_:_--- ----- _._ Legend: _-,..-----_-..__,-_. __ _ ------ SunPower 327W Panels i o SunPower Invisimount ail i 87 Quick Mount E Lag 8� 2x12°Douglas Fir Rafter 16"O.C. ! Notes: Number of Roof Layers: 1 Height above Roof Surface:4" Materials Used:Quids Mount,SunPower Added Roof load of PV System:2.84psf Engineer/Architect Seal: / FLED RC / q� 3 02163 P E� Drawn By:MA Drawing#11 of 11 Date: 1/22/2021 REV.A Drawing Scale:1/16"=1.0' f rrt" SUNPOWERO Sunft erO -Series® E20-327 I E19-32 SunPowerc Residential w AC Module Built specifically for use with the SunPower Equinox"'system,the only fully integrated solution designed,engineered,and warranted byone manufacturer. Maximum Power. Minimalist Design. inclustry-leading effic,ency means more power and savings per availaole space With fewer-noaules i equired anc. hicden microinvertei s less is truiy mor e. Highest Lifetime Energy and Savings. m Designed to deiwer 601,%o more ene,gy over 25 gears in real-world conditions IjKe par.ral shade and high.emperatures." ai .da'rraei > ally Die�er�$ a ::; - - /�pig Better.'`ea `P1r®" y"S7L�i6.�f;.'` es, 1`095 I{Jp to V, y tca ;more r'� (lifetime 47 lenergy 7. 104 e ;��. u's`e.a° g o '�y �'t,,., ` ',.-The SunPawier,,Maxeon-Solar Cell` ' Years of operation �< Erlabl trlgheSt-;`fscfenLy rrocu' _```�J Best Reliability. Best Warranty. 91 With more than 25 miion moauyaround deployed`iles de loed ard ,� °prove `1-k re an cvri,wsiul` the work,Sun Power technology is proven to las, That's wl'yv.,e stand heir d our module and rmcroinverter ;'dlrn the Indu'sir/s be51 25-.year t omhlned Power and Product Warrariby, including the highest Power Warranty In solar 14 Factory iritegratet3Microinverter,' SiiIDI ;'',6;ter-iristapavo- !,I'n'LgrJted'y,.'hE sJx �°,°c ;�:�„ df �,N,, � X12% ' Ju",°` is a- fnteil , . _ - myR FFEti59.° n"d.•�e;r,",,�-r'; bY<>', ,yp>?'€Ebb an , moresntdown by ' power r rl(OO:Y'e't*BOE S1f,1� V @�li'J(i in year ! .-i' Y , Y @ � M' g '"�' 14V> d ,w�4el '�fxw. k 5;5 4r aJi 9 .".�-="? �� 125 21� 75 Years of operation : E-Series: E20-327 I E19-320 SunPower'"Residential AC Modu,e Inverter Model Enphase IQ 7XS(IQ 1XS-96-ACM-US) -@240 VAC - @208 VAC utiiut 'o•rr^, - - - --- 320 VA- - - 3113 VA -- tviar Al VA S!5 VA 243/2')-164 2081181 -229 < r—tnJ( arl'ur., ra r(„ - - - - - - -- - - - --31 Ma (,r;r,-r2(:i-,ti,l3-a^:1:,1161:- - - --- 2(s'Itg1epl•ast:) --- 10(acv pole)Wye - - =( ' rl):nte'i y �• ••,ve -- - - - 9101'6 °tom Frr:uucncy r.0 I tz 1-47 AC AC`nor,C-ur f as-L_,r'rl't 0,mi :jr,•_ S J A i vis r)V`'i','..:,t:,e D')aar f ai tc,`C._rr,•�a - -- - - - - --- - - - - - -t ' 'k (y_trYf^�(`•-_t__ _0 rleao / J,,lad > _ _,.•- aC!Ve I;u�_:ak'tc'1 t?rG • 'i e„C.'.;_Itst•,.i..`n)n� - --- —..-------- -- - --_--_-___ SPR-E20-327-E-AC SPR-E19-320-E-AC 'Warr 'rtes :S-real linated Fciaaor itiairat y - -- - - - 'J:'m PcwPr`';Pno'r l 3.7!`r 3'C:"d 2S=,r_r,i lin-Aed pled,,, wet raniy r^^6Md TJI - -- - 15'-011111 - -- _,;-0; - I--- t,l_ I/03 -- ---- -- -- - --- , C-!thea:ons "Aooule Eff c e,-:.y 20 4Y. ;9 9�': - A 1'41 K t."odu'e(Tyrie"'fre ra(ed) I and T -rro Coef(Povver) -0 3>li/"i -C 3; %"C _62109 ,ICC(521 O9-_ Cortpl ance cCC_Pi r-15 Clays 3 ' •rnree bvaas,:11x1-s 'CES-3003 Gass E i 511ade-ol IrteJ',z,ed T;)aule-lev:Irrozmnur*1 c power CAy,CS;ti-SA '07 -0 nttrck'm 1111---h- - --- 1111 I •Cr".Rule 21 (.,LSA;: preludes lfoltNar and Rcicuve Po:vet Frict b/i I •,JL' sten.`V Pap-.^ Lc a;,menrs Coeraang "emp -43'11-to+I8S'F(_at)°C Cc.-6-,'C)Max Ambien-,Term; - —122"F(50'C) Enao'es nstallatl n n at or dr;nc Nth - - - --- -- - ---- - - - - \1FC 690 6(AC mo.ule) Vv,,c 62 p_f K'00,,Pa g0r,kg/mR frons ry nick I NI-C 6;'0'2 Rao':I;h.b or�n(uslde ani a,tilde the array) _iov,• P:ax _oad , 125 p,'.COLO Pa 611 KglrTl''1 n�'t F I .''!rC b90'SAC Connectors,6SO 13(,1)1-(E)(1; I TDact Resis,ance - 1 ,r.^?.S mm)dlame(er!-ail r„1;2 mph:=3 - Vvr•er•used,6th InvlsAluur•, ,,,ki-,'cmd'nvGlitrioun 8c.essor es �. ;UL 2i0K) Sclar+-e'ls 96 Vo iocrVst<vline tv,axeor Ger Iii i ! 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Module Fre Per(ar ...Type 2 SJN('QVJER legJ one WAXEC'�are rehateree troderriarks c'sunpow'r Coruor�tl,-.u ,re 11 S anJ-,,nercaunvies s r.el 1-8:)J a^.P(J>rvE.< t9ea•,(lea( thr S,.f,•y 1"d Gtl'a s 531948 ReVA 0© 5� ,7_11 %,�pwv,v�h " 7,7,7�.,7; 7'PRE-71 7*"-�777,,F,VP�i 7777,7, 7477 7 'r -y ''ZN4, J '4' R, 5', 'Simple and Fast Installation` 717— Integrated moclule-�o-rall groundong 4,� A -sembled rrild anc end ciamp.� • LeViiatii)g,mid clampfor easyplikement'-- damO,,AAdth_'facfl1taies consistent,event MgdL]'e spaldrig', Simple,'pre-or illed rail splice a 2703 Listed'intle rated gr 9 Pundincy Flexible,Design Addresses nearly all sloped residential roofs Design'in landscape ane portrait Flails enable easSrobstacle;rnanagernenv _7 X Custbrri' er7Preferred Aesthetics 1 m6d'616 arid,41,mounting aesthetics, Best-in-class system aesthetics Elegant Simplicity Premium,loi4-pi-ofile,clesi�n B.Iac,k,ahodiz6cl components SunPowerO InvisiMount",' is a SunPower-designed Hicld.eh�m,d clamps anclencl,clai mps, rail-based mounting system.The Invi-,'Mount -system aP#Sapp0d,,IlYsh sacs addresses -esidertial sloped roofs and combines faster Part.of Superior System,, inscal:ation time, design flexioility, and superior aesthetics. i,,,,,0LjjJt-f6r'uk wth SunP6wer DC and AC modules The InvisiMount product was specifically envisioned and Best-in-crass systernireliaulity and aestheucs' engineered to pair with SunPower modules. 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I a B 1 I I BKR-i AC-DSC-1 AC DISCONNECT r II BKR-2 PV-SA-3FM I . . . �= (�I • • • 1 V BKR-3 MAIN I BKR I PV-SA-4 A j 1 j -¢ FUSED N IEGC N TYPICAL PV MODULE WITH IIII INTEGRAL DC/AC INVERTER III ( EGC I i t IIII I i EGC IIII I I I I 1 j I j I I i EXISTING AC PAN GEGTING Lul-----------L-----------------►— GEC -----i __---------------------------------------------� fi cu — PROPOSED 3-LINE ELECTRICAL DIAGRAM REVISIONS Bloom, Josh GREENLOGICO 292 Waterview Drive (-5, ENERGY Y Southold, NY 11971 ELIMINATING THE COST OF ENERGY 1 ) INITIAL SUBMITTAL WITH APPLICATION Page 1 of 3 Drawing No: Bloom-3LD1 Revision: 1 Revised: 1/20/21 EQUIPMENT& COMPONENT SCHEDULE TAG DESCRIPTION SPECIFICATION PV-SA-1 PV SUB-ARRAY SPR-E20-327-E-AC EN PHASE IQ7XS-96-ACM-US, 1-CIRCUIT OF 12-MODULES PV-SA-2 PV SUB-ARRAY SPR-E20-327-E-AC EN PHASE IQ7XS-96-ACM-US, 1-CIRCUIT OF 12-MODULES PV-SA-3 PV SUB-ARRAY SPR-E20-327-E-AC EN PHASE IQ7XS-96-ACM-US, 1-CIRCUIT OF 12-MODULES PV-SA-4 PV SUB-ARRAY SPR-E20-327-E-AC EN PHASE IQ7XS-96-ACM-US, 1-CIRCUIT OF 3-MODULES ELECTRICAL LOAD SUMMARY AC CIRCUITS TAG POWER, MAX VOLTAGE MAX.AC VOLTAGE, NOMINAL RANGE CURRENT PV-SA-1 3924 WATTS 211-264 VAC 15.95 A AC 240 V, AC PV-SA-2 3924WATTS 211-264 VAC 15.95 A AC 240 V,AC PV-SA-3 3924 WATTS 211-264 VAC 15.95 A AC 240 V,AC PV-SA-4 981 WATTS 211-264 VAC 3.99 A AC 240 V, AC PROPOSED EQUIPMENT SPECIFICATIONS REVISIONS Bloom, Josh AGREENLOGIC . 292 Waterview Drive ENERGY Southold, NY 11971 ELIMINATING THE COST OF ENERGY ; 1.) INITIAL SUBMITTAL WITH APPLICATION Page 2 of 3 Drawing No: Bloom-3LD1 Revision: 1 Revised: 1/20/21 EQUIPMENT& COMPONENT SCHEDULE TAG DESCRIPTION SPECIFICATION AC-CMBP AC COMBINER PANEL 250V, 200A, NEMA-1, 1-PH, 3-WIRE BKR-1 CIRCUIT BREAKER, PV-SA-1 MATCH AC COMBINER PANEL BRAND, 2-POLE, 20A BKR-2 CIRCUIT BREAKER, PV-SA-2 MATCH AC COMBINER PANEL BRAND, 2-POLE, 20A BKR-3 CIRCUIT BREAKER, PV-SA-3 MATCH AC COMBINER PANEL BRAND, 2-POLE, 20A BKR-4 CIRCUIT BREAKER, PV-SA-4 MATCH AC COMBINER PANEL BRAND, 2-POLE, 20A AC-DSC-1 AC DISCONNECT SWITCH (LINE TAP) 250V, 100A, NEMA-1, FUSED; FUSE RATING: 100A CONDUCTOR SCHEDULE TAG TYPE CONDUIT AWG. / EGC A USE-2/PV/UF 3/4" PVC-40 12 / 6 B TH W N-2 2" PVC-40 4 / 6 C THWN-2 2" EMT 4 / 6 1.) CONDUCTOR TYPES AND SIZES TO BE ADJUSTED FOR TEMPERATURE, DISTANCE,AND DERATING FACTORS. 2.) ELECTRICAL CONDUIT TO BE MIN. PVC SCHEDULE 40,ADJUST FOR SITE CONDITIONS. 3.) ALL ELECTRICAL MATERIALS AND INSTALLATION METHODS TO COMPLY WITH NEC AND LOCAL CODE RE- QUIREMENTS. 4.) NOTE: GROUNDING ELECTRODE CONDUCTOR TO BE#6 COPPER. PROPOSED EQUIPMENT SPECIFICATIONS REVISIONS Bloom, Josh � 292 Waterview DriveZENERGY Southold, NY 11971 ELIMINATING THE COST OF ENERGY 1.) INITIAL SUBMITTAL WITH APPLICATION Page 3 of 3 Drawing No: Bloom-3LD1 Revision: 1 Revised: 1/20/21