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HomeMy WebLinkAbout46710-Z TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE 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#: 46710 Date: 8/19/2021 Permission is hereby granted to: Perros, Alexander 19215 Soundview Ave Southold, NY 11971..._ ............_ _....... ...._ .w.. _ ....... To: install (2) energy storage systems in existing attached garage of existing single-family Y dwelling as applied for. At premises located at: 19215 Soundview Ave., Southold ._MCMT # 473889.. ._..........�. _ww� ..........�.... www_.. .... �.___.__w .... .......___.... _w,,,..... www..... .... _M Sec/Block/Lot# 51.-1-18 Pursuant to application dated 8/9/20 and approved by the Building Inspector. pp 21 To expire on µ 2/18/2023. Fees: ACCESSORY $50.00 ELECTRIC $100.00 CO-ALTERATION „" DWELLING $50.00 Total: $200.00 Building Inspector TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex.54375 Main Road P. O. Box 1179 Southold NY 11971-0959 Telephone(631) 765-1802 Fax(631) 765-9502ft e Receiyed LIQ T PE11"" 41T I ���� .� �� �� ._.� For Office Use Only ti 16 PERMIT NO. % ...... Building Inspector- ' Applications and forms must be filled out in their entirety.Incomplete applications will not be accepted. Where the Applicant is not the owner,an Owner's Authorization form(Page 2)shall be completed. Date:$/3/2021 OWNER(S)OF PROPERTY: Name: Alexander Perros 5CTM#1000- 51 - 5 Project Address: 19215 Soundview Ave Southold, NY 11791 Phone#: 917-318-0027 Email: alexanderperros@startmail.com Mailing Address: 19215 Soundview Ave Southold, NY 11791 CONTACT PERSON: Name:Tesla Energy Operations,Inc./Anais Fernandez Mailing Address: 15 Grumman Rd West Suite 400 Bethpage, NY 11714 Phone#: 631-406.9567 Email: anafernandez@tesia.com DESIGN PROFESSIONAL INFORMATION: Name:Equilux Engineers LLC Mailing Address: 4129 Brittany Drive Ellicott City MD 21043 Phone#: 443-416-7800 Email: hkariuki@equiluxengineers.com CONTRACTOR INFORMATION: Name:Tesla Energy Operations,lnc./Anais Fernandez Mailing Address: 15 Grumman Rd West Suite 400 Bethpage, NY 11714 Phone#: 631-406-9567 Email: anafemandez@tesla.com DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition 2Alteration ❑Repair ❑Demolition Estimated Cost of Project: ❑Other $14,000 Will the lot be re-graded? ❑Yes 12No Will excess fill be removed from premises? ❑Yes 91 No 1 PROPERTY INFORMATION Existing use of property: Residential Intended use of property: Residential Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yes ONO IF YES, PROVIDE A COPY. 12 Check Box After Reading: The owner/contractor/design owner/contractor/designprofessional Is responsible for all drainage and storm water Issues as provkled by Chapter 236 of the Town Code. APPUCATION 1S HEREBY MADE to the BuildingDepartment 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 ,Ordinances or Regulations,for the construction of buildings, additions,alterations or for removal or demolition as herein described. e applicant agrees to comply with all applicable la ,ordinances,building code, housing code and regulations and to admit authorized Inspectors on premises and In building(s)for necessary Inspections.Fal statements made herein are punishable a ss rnisd nor pu ant to ion 216m of tl Yo&State penal Law. Application Submitted Y p nt name): Anais Fem o - w ' MAUth ize Agent DOwner Signature of Applicant: Date: STATE OF NEW YORK) , , • ,. SS: COUNTY OF Nassau Anais Fernandez being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the contr or/a ent (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 o" day of f,, --------------- 20 I No ty Public PATRICIA M, ZULL@ NOTARY PUBLIC-STATE OF NEW `FORK PROPE � �r ' �� Ii �� 1 `� �^� i � I No.OlZU6328662 (Where tie applicant.IS not tete owner) My Suffolk County C�"1u61if ed y Commission Expires 08-03-2023 i, residing at do hereby authorize to apply on my behalf to the Town of Southold Building Department for approval as described herein. Owner's Signature Date Print Owner's Name LL 2 j B 111 PVJ Building Department Application AUTHORIZATION (Where the Applicant is not the Owner) ------- .........residing at m e-LU Ave (Print property owner's name) (Mailing Address) Tesla Energy Operations,Inc. do hereby authorize .......-------------- (Agent) Anais Fernandez.................... ............ to apply on my behalf to the Southold Building Department. _. _ .. __ - ............ ............. -1-111j,1Zi....._____1 . .......... (Owner's Signature) (Date) (Print Owner's Name) Workers! YORK CERTIFICATE OF STATE Compensation �4� BoardNYS WORKERS" COMPENSATION INSURANCE COVERAGE " 1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured Tesla Energy Operations,Inc. 650-963-SIOO 901 Page Avenue I c.NYS Unemployment Insurance Employer Registration Numberof Fremont,CA 94538 Insured 49-892777 Work Location of Insured(Only required if coverage is specifically limitedto I d.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-Up Policy) Wrilbel 02-0781046 2.Name and Address of Entity Requesting Proof ofCoverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) American Zurich Insurance Company Town of Southold 3b.Policy Number of Entity Listed in Box"l a" 54375 Main Road WC 1074583-03 Southold, NY 11971 3c.Policy effective period 10/31/2020 Jo 10/31/2021 3d.The Proprietor,Partners or Executive Officers are 0 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"forworkers' 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 arid the Workers'Compensation Board within 1Ddays|F a policy incanceled due hanonpayment ofpremiums mrwrthin3Odays}Fthere are reasons other than monpa~ ` nonpayment � ` -that r eUm/mnhethe insured mumthe coverage indicated onthis Cextifioate (These notices may be sent by regular maii � )Qn�� ise,th-- Certificate Is valid for one year after this fonn|s approved bythe insurance carrier nrits licensed agent,oruntil the policy expirationD `, ��#* �����o��� 3c~^wh&cheverisearlis,. 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 ofthe New York State Workers'Compensation Law. Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage oedepicted onthis form. Appmvadby: - Susan B. Kendzicira(Print name of authorized representative or licensed agent of insurance carrier) ' Approved by: /me:Vice Pr sid !It-j; Telephone Number ofauthorized representative orlicensed agent ofinsurance carrier:800-382-2150 Please Note:Only insurance carriers and their licensed agents are authorized moissue Form C-1V5.2.|nouronuebrokers are NOT authorized toissue it. C-105.2(9-17) |NTERNALUSE ONLY EW Workers' YORK compensation CERTIFICATE OF INSURANCE COVERAGE Board DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW PART 1.To be completedbyDisability and Paid Family Leave Benefits Carrier or Licensed Insurance that -Carrier i mil Le ante Agent of that Carrier 1 a.Legal Name&Address..........�f .�_�.�.�..�....�.�...,,____ ............. ......_..... __M..._____.___..._.______________ .. _ .... ...,_.��......_....._... g ss o Insured use street address only) 1b.Business Telephone Number of Insured Tesla Energy Operations, Inc. 901 Page Avenue Fremont, CA 94538 1c.Federal Employer Identification Number of Insured Work Location of Insured(Only required if coverage is specifically limited to or Social Security Number certain locations in New York State,i.e.,Wrap-Up Policy) 02-0781046 .w.._.—— ....__W_..__....._ Coverage 3a.Nam e of Insurance Carrier (Entity Being Listed as the Certificate Holder) The Prudential Insurance Company of America Town of Southold 3b.Policy Number of Entity Listed in Box"1a" 54375 Main Road CG-51526-NY Southold, NY 11971-0959 3c.Policy effective period 01/01/2021 to 12/31/2022 4. Policy provides the following benefits: ❑X A.Both disability and paid family leave benefits. ❑ B.Disability benefits only. ❑ C.Paid family leave benefits only. 5. Policy covers: RX 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 November 25, 2020 B % w w Y (Signature of insurance carrier's authorized representative or NYS Licensed Insurance Agent of that insurance carrier) Telephone Number 215-658-5178 Name and Title H. Richard Brummett-Statutory Disability Coordinator 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 sB of Part 1 has been checked) ._..........__._. State of New York Workers' Comipenaation 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 _.............M. ___.___._ w_ ._(Signature of Authorized NYS workers'Compensation Board Employee) Telephone Number Name and Title __.__-___ ...... .,,,, _ - __ .... ._._.__. .._ .................... _ Please Note. 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 DB-120.1. Insurance brokers are NOT authorized to issue this form. 1313-120.1 (10-17) B-1.20.1 (10-17ii � ° I� RECEIPT SUFFOLK COUNTY GOVERNMENT DEPARTMENT OF LABOR, LICENSING,AND CONSUMER AFFAIRS COMMISSIONER ROSALIE DRAGO P.O. BOX 6100, HAUPPAUGE, NY 11788 (631)853-4600 Today Date: 03/22/2021 Application: ME-37295 Application Type: Master Electrical License Receipt No. 421664 Payment Method Ref. Number Amount Paid Payment Date Cashier ID Comments Check 149 $400.00 03/22/2021 CHRIST11 Renewal Contact Info: JASON KANE INC JASON KANE 127 WEST BLVD EAST ROCKAWAY, NY 11518 Work Description: Po� Suffolk County Dept.of Labor,Licensing a Consumer Affairs d1, MASTER ELECTRICAL LICENSE Name %- JASON KANE Business Name This certifies that the bearer is duly licensed JASON KANE INC by the County of suffolk License Number:ME-37295 Rosalie Drago Issued: 04/2012005 Commissioner Expires: 04/01/2023 Suffolk County dept.of Labor,Licensing&Consumer Affairs 'l HOME IMPROVEMENT LICENSE Name CHARLES J MCAR0 Business Name This certifies that the TESLA ENERGY OPERATIONS INC hearer is duly licensed by the County o`su"o;< License Number:HI-62558 Frr-K Nord AJi, Issued: 911212019 Commissions, Expires: 9/1/2021 a ABBREVIATIONS ELECTRICAL NOTES JURISDICTION NOTES A AMPERE AC ALTERNATING CURRENT BLDG 1. THIS SYSTEM IS GRID—INTERTIED VIA A UL—LISTED ALL WORK TO COMPLY WITH SECTION R327 OF THE BUILDING CONC CONCRETE DC DIRECT CURRENT POWER—CONDITIONING INVERTER. 2020 RESIDENTIAL CODE OF NYS. EGC EQUIPMENT GROUNDING CONDUCTOR (E) 2. A NATIONALLY — RECOGNIZED TESTING EXISTING EMT ELECTRICAL METALLIC TUBING FSB LABORATORY SHALL LIST ALL EQUIPMENT IN FIRE SET—BACK GALV GALVANIZED GEC GROUNDING COMPLIANCE WITH ART. 110.3. ELECTRODE CONDUCTOR GND GROUND HDG HOT 3. WHERE ALL TERMINALS OF THE DISCONNECTING �f r DIPPED GALVANIZED I CURRENT Imp CURRENT AT MEANS MAY BE ENERGIZED IN THE OPEN POSITION, ( f MAX POWER Isc SHORT CIRCUIT CURRENT kVA A SIGN WILL BE PROVIDED WARNING OF THE KILOVOLT AMPERE kW KILOWATT LBW LOAD HAZARDS PER ART. 690.17. BEARING WALL MIN MINIMUM (N) NEW NEUT 4. EACH UNGROUNDED CONDUCTOR OF THE d/ NEUTRAL NTS NOT TO SCALE OC ON CENTER PL MULTIWIRE BRANCH CIRCUIT WILL BE IDENTIFIED BY PROPERTY LINE POI POINT OF INTERCONNECTION PHASE AND SYSTEM PER ART. 210.5. PV PHOTOVOLTAIC SCH SCHEDULE S STAINLESS 5. CIRCUITS OVER 250V TO GROUND SHALL COMPLY STEEL STC STANDARD TESTING CONDITIONS TYP WITH ART. 250.97, 250.92(B). TYPICAL UPS UNINTERRUPTIBLE POWER SUPPLY V 6. DC CONDUCTORS EITHER DO NOT ENTER BUILDING VOLT Vmp VOLTAGE AT MAX POWER Voc VOLTAGE OR ARE RUN IN METALLIC RACEWAYS OR AT OPEN CIRCUIT W WATT 3R NEMA 3R, RAINTIGHT ENCLOSURES TO THE FIRST ACCESSIBLE DC DISCONNECTING MEANS PER ART. 690.31(E). 7. ALL WIRES SHALL BE PROVIDED WITH STRAIN RELIEF AT ALL ENTRY INTO BOXES AS REQUIRED BY UL LISTING. 8. MODULE FRAMES SHALL BE GROUNDED AT THE UL — LISTED LOCATION PROVIDED BY THER �7' MANUFACTURER USING UL LISTED GROUNDING HARDWARE. 9. MODULE FRAMES, RAIL, AND POSTS SHALL BE AUG - 9 2021 BONDED WITH EQUIPMENT GROUND CONDUCTORS. Bl DMTG DEPT. TOWN 0-F S01711OLD VICINITY MAP INDEX Sheet 1 COVER SHEET Sheet 2 SITE PLAN Sheet 3 POWERWALL MOUNTING (WOOD) Sheet 4 THREE LINE DIAGRAM LICENSE GENERAL NOTES Sheet 5 ESS LOCATION Sheet 6 INTERIOR FLOOR PLAN 1. ALL WORK SHALL COMPLY WITH THE 2020 NYS Cutsheets Attached UNIFORM CODE. 2. ALL ELECTRICAL WORK SHALL COMPLY WITH THE 2017 NATIONAL ELECTRIC CODE. 3. ALL WORK SHALL COMPLY WITH THE 2020 NYS FIRE CODE. MODULE GROUNDING METHOD: WEEB 4. ALL WORK SHALL COMPLY WITH THE 2020 AHJ: Southold Town BUILDING CODE OF NYS. REV BY DATE COMMENTS 5. ALL WORK SHALL COMPLY WITH THE 2020 RESIDENTIAL CODE OF NYS. REV A NAME DATE COMMENTS 6. ALL WORK SHALL COMPLY WITH THE 2020 UTILITY: PSE&G—Long Island EXISTING BUILDING CODE OF NYS. CONFIDENTIAL- THE INFORMATION HEREIN JOB NUMBER: JB-1192113 0 0 CUSTOMER: DESCRIPTION: DESIGN: CONTAINED SHALL NOT BE USED FOR THE Alexander Perros 27 KWH ENERGY STORAGE SYSTEM Ximeno Becerril Franco T 5 L n BENEFIT OF ANYONE EXCEPT TESLA INC., NOR MOUNTING SYSIEN: SHALL IT BE DISCLOSED IN WHOLE OR IN 19215 Soundview Ave PART TO OTHERS OUTSIDE THE RECIPIENT'S MODULES Southold, NY 11971 ORGANIZATION, EXCEPT IN CONNECTION WITH THE SALE AND USE OF THE RESPECTIVE TESLA EQUIPMENT, WITHOUT THE WRITTEN INVERTER: PACE NAME SHEET: REV: DATE PERMISSION OF TESLA INC. 9173180027 COVER SHEET 1 a 7/15/2021 Inv ; RELAY _1 1 EXISTING © \ I INVERTERS ;Inv i ' D ' � I Existing System — 10.2 kW EXISTING ARRAYS .LEGEND (E) UTILITY METER & WARNING LABEL Inv INVERTER W/ INTEGRATED DC DISCO & WARNING LABELS POWERWALLS © AUTOMATIC RELAY WILL BE ATLEAST © DC DISCONNECT & WARNING LABELS 3' APART r © AC DISCONNECT & WARNING LABELS SOF NEW 1'0 ,'ESS 0 DC JUNCTION/COMBINER BOX & LABELS L__--J F/7, � O ENERGY STORAGE SYSTEM FOR STAND co 1¢ ESS ' ALONE OPERATION w Front Of House F@ DISTRIBUTION PANEL & LABELS � LOAD CENTER & WARNING LABELS � O DEDICATED PV SYSTEM METER MUCTURAL0 S5� RSD RAPID SHUTDOWN 0 STANDOFF LOCATIONS CONDUIT RUN ON EXTERIOR HUMPHREY K I Digitally signed by HUMPHREY K ®®® CONDUIT RUN ON INTERIOR KAR�UK� GATE/FENCE KARIUKI - e: 2021 .0 .15 18:24:56 -04�00� rO HEAT PRODUCING VENTS ARE RED (E) DRIVEWAY I�^'I INTERIOR EQUIPMENT IS DASHED L=.J SITE PLAN Scale: 1/8" = 1' Z 19215 Soundview Ave 0 1' 8' 16' m CONFIDENTIAL- THE INFORMATION HEREIN JOB NUMBER: J B-119 2113 O O CUSTOMER: DESCRIPTION: DESIGN: CONTAINED SHALL NOT BE USED FOR THE Alexander Perros 27 KWH ENERGY STORAGE SYSTEM Ximena Becerril Franco BENEFIT OF ANYONE EXCEPT TESLA INC., NOR MOUNTING SYSIEN: T S SHALL IT BE DISCLOSED IN WHOLE OR IN 19 215 Soundview Ave Lri PART TO 07HS OUTSIDE THE RECIPIENT'S ORGANIZATION,IXCEP N CONNECTION VATH MOUULES: Southold, NY 11971 THE SALE AND USE OF THE RESPECTIVE TESLA EQUIPMENT, WITHOUT THE WRITTEN PIVQtiFR PAGE NAME SHEER REV. DATE- PERMISSION ATEPERMISSION OF TESLA INC. 91 73180027 SITE PLAN 2 a 7/15/2021 POWERWALL INSTALLATION INFORMATION: 1. INSTALL (N) POWERWALL UNIT CENTERED BETWEEN A MINIMUM OF (E) 2x WOOD STUDS WITH MAXIMUM STUD SPACING BASED ON TABLE 1. (WALL LL L WOOD �� STUDS 2. FASTEN (N) POWERWALL UNIT TO A MINIMUM OF (E) 2x WOOD STUDS W/ (N) WOOD SCREWS W/ MIN. 21" EMBEDMENT. PLACE (N) FASTENERS AT CORNERS OF BRACKET IN ANY HOLE. MAKE SURE THAT THE SCREWS ARE PLACED IN THE (N) l xl x12 GA WALL STRUT NARROW FACE OF THE STUD SO THAT LOADS ARE APPLIED TO THE STRONG AXIS. MOUNT(N) POWERWALL FASTENED TO MIN. (3) WALL STUDS WITH 3. MIN. STUD LUMBER GRADE ASSUMED IS "STUD" GRADE. BRACKET To (N) STRUT (1) FASTENER®EACH STUD. W/(4) r HEXHEAD 4. POWERWALL UNIT(S) MUST BE PLACED PER SPECIFIED LOCATION ON SITE PLAN. DO BOLT W/STRUT NUT NOT MOUNT BELOW OR ABOVE WINDOWS. IF LOCATION NEEDS TO BE CHANGED, PLEASE CONTACT DESIGN TEAM. ANY UNUSUAL FRAMING NEAR THE POWERWALL (N) POWERWALL BRACKET, WOOD SCREWS TO STUDS BEYOND. THAT MAY COMPROMISE THE WALL STRUCTURAL INTEGRITY SHALL BE RELAYED TO POWERWALL UNIT NOT PROVIDE MIN. (1) SCREW THE DESIGN TEAM PRIOR TO INSTALL. SHOWN FOR CLARITY 7711EACH STUD IN ANY HOLE 5. 1 POWERWALL UNIT INSTALLED ON WALL PER A MINIMUM OF (E) 2x WOOD STUDS AND UP TO 3 POWERWALL(S) STACKED ON GROUND PER A MINIMUM OF (E) 2x WOOD STUDS. 3-STUD UNISTRUT ATTACHMENT: FRONT VIEW W-4 NTS TABLE 1:MIAMUM SND SPAC NG 2x4 STUDS 2x6 STUDS RMOR WALL 24' 24' MMOR WALL 16, 24' POWERWALL UNIT (E)WOOD �oF NEW'"0 WALL STUDS �Q'� V(AN.lq .•, 9 LAG SCREWS TO STUDS BEYOND. � �¢�'�,,'•� PROVIDE MN.(1)SCREW O EACH CORNER N ANY HOLEMIN.PENETRATON Lu INTO WALL STUDS Uj POWERWALL WALL BRACKET �� •• SS���P ' STRUCTURAL 0 WOOD STUD ATTACHMENT: WALL MOUNTED SIDE VIEW ONE POWERWALL NTS CONFIDENTIAL- THE INFORMATION HEREIN JOB NUMBER:- JB-1192113 00 CUSTOMER: DESCRIPTION: DESIGN: CONTAINED SHALL NOT BE USED FOR THE Alexander Perros 27 KWH ENERGY STORAGE SYSTEM Ximeno Becerril Franco T 5 L n BENEFIT OF ANYONE EXCEPT TESLA INC.,NOR MOUNTING SYSTEM: SHALL IT BE DISCLOSED IN WHOLE OR IN 19215 L, Soundview Ave ORGANIZATION,IXCEPT N CONNECTIONNWTH MODULES: Southold, NY 11971 THE SALE AND USE OF THE RESPECTIVE TESLA EQUIPMENT, WITHOUT THE WRITTEN INVERTER: PAGE NAME SHEL. REY: DATE PERMISSION OF TESLA INC. 9173180027 POWERWALL MOUNTING WOOD 3 a 7/15/2021 GROUND SPECS MAIN PANEL SPECS GENERAL NOTES LICENSE BOND (N) AWG #6 TO (N) GROUND ROD Panel Number:Q0054UF ' AT PANEL WITH IRREVERSIBLE CRIMP Meter Number.80353970 Underground Service Entrance E 200A MAIN SERVICE PANEL E 20OA/2P MAIN CIRCUIT BREAKER (E) WIRING AUTOMATIC RELAY (N) 200A INTERNAL Z oOA 2P 50A 2P TO EXISTING N SOLAR G —� — ----- I 30A2P r———————————————————————————————————————————————————————————————— --——————————————— L1 EGC :::] ENERGY STORAG SYSTEMS (E) 125A EXISTING 10.2KW PV ARRAYMPV — ---- LOAD CENTER 1 I T30A 2P 2 L1 i ABB I Lz X ENERGY I PVI-3.6—OUTD—S—US—Z—A I 1 a 1 N STORAGE I 20Al2P TRINA SOLAR G N _——__— — EGC SYSTEM TO RELAY �I` LZ zaov TSM-255PDO5.18 AND N I I STORAGE __________—__ EGC ___ DC+ TO 120�240V I EGC N L2 L1 � N G r__—— SIN(T E PHASE I 1 I TN DG DG (18) PV MODULE UTILITY SERVICE j GND JDC+ EGC __ EGC __ ------------- Z i 1 30A 2P I I I I I I I 1I I ABB L------ I E LOAD I — —————————j PVI-5000—OUTD—US—Z—A I � I I • I 1 TRINA SOLAR I 0 i i u zaov TSM-255PDO5.18 I • I I L2 I I N I 1 EGC --- DC* DC+ TN ��D- DG ) 225A LOAD CEN(E) 200A I GND EGC _____________� DISTRIBUTION PANEL POI (1)Gro d Roo (3)AWG #2/0. THWN-2,Black A C 5r8g x 8. Copper O (1)AWG #6, THWN-2, Green H Z (1)Tesla i�1232100-00—E (1)2D PVC; Schedule 80 Baric—up Gateway 2.0 NA for AC PW 2.0 —(1)Eaton # BW2200 . 200Atain Circuit Breaker, 2—Pole, 24OV, 1OkAIC PT (1)AW6 1U, THWN-2 Black —(1)CUTLER—HAMM BR250 O (1)AWG#10, THWN-2, Red Breaker, 50A 2P, 2 Spaces (1)AWG X10, THWN-2, White —(2)CUTLER—HAMMER#BR230 —(1)AWG X10, THWN—Y,Green -(1 Conduit Kiti 1"EMT Breaker, 30A 2P, 2 Spaces —(I)PanelAb,arsdp1ccessofor GW 20 NA 20062ir, 1y02 V. 1PH X (2)1092170-05—J TESLA AC POWERWALL 2.0; Home Energy Storage,13.5KWH,Stackable, 5.8kVA CONFIDENTIAL— THE INFORMATION HEREIN JOB NUMBER: JB-1 19 2113 O O CUSTOMER. DESCRIPTION DESIGN: BENEFIT O SHALL NOT CE USED FOR THE Alexander Perros 27 KWH ENERGY STORAGE SYSTEM Ximena Becerril Franco T S L 1"I BENEFIT OF ANYONE EXCEPT TESLA INC., NOR MOUNTING SYSIEN: � SHALL IT BE DISCLOSED IN WHOLE OR IN 19215 Soundview Ave TS ORGANIZATION.PART TO EXCEPIDN CONNECTE THE ION MODULES Southold, NY 11971 THE SALE AND USE OF THE RESPECTIVE TESLA EQUIPMENT, WITHOUT THE WRITTEN WVERT[7t PAGE NAME SHEET: REV: DATE- PERMISSION ATE PERMISSION OF TESLA INC. 91 73180027 THREE LINE DIAGRAM 4 0 7/15/2021 _ POWERWALLS WILL BE AT LEAST 3' APART 66 , 5 a 1 • tam •,�..; �r , t !�°c, �,gip � �- ��� _ I �, � �• i� y ,�s4 � y� 4 � v 5i, POVUERWALLS ,�` ^" � •: v �ori�.� ' � , 1 t a F 'tet t r r• •r ��l. t� , I 1 .� s e2t t � i • CONFIDENTIAL— THE INFORMATION HEREIN J06 NUMBER J B-11921 13 00 CUSTOMER. DESCRIPTION. DESIGN: CONTAINED SHALL NOT BE USED FOR THE Alexander Perros 27 KWH ENERGY STORAGE SYSTEM Ximena Becerril Franco BET OF ANYONE SHALL IT BE DISCLOSEDCIN WHOLE OR IN T TESLA INC., NOR MOUNTING SYSTEM: 19215 Soundview Ave T S5 L n PART TO OTHERS OUTSIDE THE RECIPIENTS ORGANIZATION, EXCEPT IN CONNECTION WITH MODULES Southold, NY 11971 THE SALE AND USE OF THE RESPECTIVE TESLA SION OFNT, LA INC. THE WRITTEN [R�� 9173180027 PAGENAME: ELOCATION SHEET: 5 Ria D7/15/2021 PERMISSION OF TESLA INC. NTERIOR STORAGE ROOM 23'-6" 20' 3'-6» 3'-1" POWERWALLS lit DOORS OPEN OUTWARDS DOUBLE DOORS INSTALLATION SHALL MEET 2020 RESIDENTIAL NYS CODE, SECTION R327. SYSTEM WILL BE INSTALLED AS PER NFPA 70. ROOMS ALLOCATING ESS WILL BE PROVIDED WITH SMOKE ALARMS IN ACCORDANCE WITH SECTION R314 PER R327.7. HEAT DETECTORS OR HEAT ALARMS TO BE INTERCONNECTED TO SMOKE ALARMS AS REQUIRED. ROOMS CONTAINING ESS TO BE PROTECTED BY NO LESS THAN 5/8" TYPE X GYPSUM BOARD IN ACCORDANCE WITH R327.8. ESS TO BE INSTALLED OUT OF VEHICULAR IMPACT. WHEN INSTALLED INSIDE THE GARAGE, THEY WILL BE WALL MOUNTED BEHIND THE WALLS HOLDING GARAGE DOOR IN ACCORDANCE WITH R327.9. CONFIDENTIAL— THE INFORMATION HEREIN J OB NUMBER: JB-1192113 O O CUSTOMER: DESCRIPTION: DESIGN: CONTAINED SHALL NOT BE USED FOR THE Alexander Perros 27 KWH ENERGY STORAGE SYSTEM Ximena Becerril Franco T BENEFIT OF ANYONE EXCEPT TESLA INC., NOR MOUNTING SYSTEM: 19215 Soundview Ave 1 E 5 L n SHALL IT BE DISCLOSED IN WHOLE OR IN PART TO OTHERS OUTSIDE THE RECIPIENTS ORGANIZATION, EXCEPT IN CONNECTION WITH ULES: Southold, NY 11971 THE SALE AND USE OF THE RESPECTIVE TESLA EQUIPMENT, WITHOUTINC. THE wRnTTIJ 9173180027 PAGE NAME:-INTERIOR FLOOR PLAN SHEET. 6 R a D7/15/2021 PERMISSION Of TESLA INC. Label .•- LOAD CENTER CAUTION Per Code: TRI POWER SOURCE •• NEC 408.4 1, 4 SECOND SOURCE IS PHOTOVOLTAIC SYSTEMNEC 1 THJRD SOURCE IS ENERGY STORAGE SYSTEM Label • • CAUTION DO NOT ADD NEW LOADSPer Code: .•- • • NEC ' WARNING Per ..- THIS EQUIPMENT FED BYNEC 1 _ Label MULTIPLE SOURCES.TOTAL Location: RATING OF ALL OVER CURRENT CAUTION DEVICES, EXCLUDING MAIN THIS PANEL HAS SPLICED FEED- PerCode: SUPPLY OVERCURRENT DEVICE, THROUGH CONDUCTORS: NEC 312.8.A(3) SHALL:NOT EXCEEDAMPACITY OF BUSBAR. LOCATION OF DISCONNECT AT ENERGY STORAGE BACKUP LOAD PANEL - NOMINAL ESS VOLTAGE 120/24gV "• Location: Location:Label CAUTION MAX AVAILABLE SNORT- -. ..- DUAL POWER SOURCE Code: CIRCUIT FROM ESS: 32AP06 : 1. .•- • •- -• - . SECOND SOURCE IS 1 ARG FAULTCLEARING ENERGY STORAGE SYSTEM TIME FROM ESS: G7ms Label DATE OF GALCULAT[ON': Location: ENERGY STORAGE SYSTEM ON SITE LOCATED WITHIN LINE OF SIGHTPerCode: Label • • ENERGY STORAGE SYSTEM ON SITE LOCATED ON ADJACENT WALLPer •• Label • • ENERGY STORAGE SYSTEM ON SITE LOCATED ON OPPOSITE WALLPer • - Label • • ENERGY STORAGE SYSTEM ON SITE LOCATED INSIDEPer Code: AC Disconnect Backup Load Center Label (MP): Main Panel - POWERWALL TYPICAL SYSTEM LAYOUTS i Tesla Powerwall is a fully-Integrated AC battery system for j WHOLE HOME BACKUP residential or light commercial use Its rechargeable lithium-Ion ( r battery pack provides energy storage for solar self-consumption, optional; time-based control, and backup. ` I❑ Powerwall's electrical Interface provides a simple connection to j solar any home or building. Its revolutionary compact design achieves market-leading energy density and Is easy to Install, enabling owners to quickly realize the benefits of reliable, clean power. (' o ❑ Solar Inverter --------------------------- Main panel Backup Gateway Utility meter Grid including service disconnect T 2 5 L PERFORMANCE SPECIFICATIONS MECHANICAL SPECIFICATIONS AC Voltage(Nominal) 120/240 V Dimensions' 1150 mm x 753 mm x 147 mm /- (45 3 in x 29.6 in x 5.75 in) Feed-In Type Split Phase Weight' 114 kg(251 3 lbs) Grid Frequency 60 Hz --------------- -- - -- ------------ Mounting options Floor or wall mount Total Energy' — - 14 kWh --- -_ _ _ - Powerwall Whole home -- ----- -- ;Dimensions and weight differ slightly if manufactured before March 2019 backup Usable Energy' 13 5 kWh Contact Tesla for additional information ----- -- -- --^— ------ Real Power,max continuous 5 kW(charge and discharge) 75 75 6 m) (5 753 mm 147 mm Real Power,peak(10s,off-grid/backup) 7 kW(charge and discharge) Apparent Power,max continuous — 5 8 kVA(charge and discharge) Apparent Power,peak(10s,off-grid/backup)7.2 kVA(charge and discharge) e3 L q PARTIAL HOME BACKUP Load Start Capability 106 A LRA for each Powerwall Maximum Supply Fault Current 10 kA optional I Maximum Output Fault Current 32 A 1150 mm I -- - -- - (45 3 in) Overcurrent Protection Device 30 A ' Imbalance for Split-Phase Loads 100% Solar Power Factor Output Range +/-1 0 adjustable Power Factor Range(full-rated power) +/-085 Internal Battery DC Voltage 50 V — o 0 0 ❑ Round Trip Efficiency'-' 90% ENVIRONMENTAL SPECIFICATIONS ❑ Warranty 10 years -- -- ----- Solar inverter 'Values provided for 25°C(770F).3.3 kW charge/discharge power Operating Temperature -20°C to 50°C(-4°F to 122°F) Sub panel Backup Gateway Main panel Utility meter Grid 2AC to battery to AC,at beginning of life Recommended Temperature 0°C to 30°C(32°F to 86°F) Operating Humidity(RH) Up to 100%,condensing— T=s L Storage Conditions -20°C to 30°C(-4°F to 86°F) COMPLIANCE INFORMATION Up to 95%RH,non-condensing State of Energy(SoE) 25%initial Certifications UL 1642,UL 1741,UL 1973, Maximum Elevation 3000 m(9843 ft) UL 9540,IEEE 1547,UN 38 3 ------ - - — --- Environment Indoor and outdoor rated Grid Connection Worldwide Compatibility ----- -- Powerwall Backup loads Home loads Enclosure Type NEMA 3R Emissions FCC Part 15 Class B,ICES 003 ------ ----- -- ----- --- --- Ingress Rating IP67(Battery&Power Electronics) Environmental RoHS Directive 2011/65/EU IP56(Wiring Compartment) Seismic AC156,IEEE 693-2005(high) Wet Location Rating Yes Noise Level @ 1m <40 dBA at 30°C(86°F) T B 5 L Fi TESLA COM/ENERGY T c 5 L n N?-BACKUP-20=1-06-01 TESLA COM/ENERGY 1 POWERWALL Backup Gateway 2 The Backup Gateway 2 for Tesla Powerwall provides energy management L a t r ' and monitoring for-solar self-consumption,time-based control,and backup The Backup Gateway 2 controls connection to the grid,automatically detecting outages and providing a seamless transition to backup power , When equipped with a main circuit breaker,the Backup Gateway 2 can be Installed at the service entrance When the optional internal panelboard Is Installed,the Backup Gateway 2 can also function as a load center. The Backup Gateway 2 communicates directly with Powerwall,allowing you to monitor energy use and manage backup energy reserves from any mobile device with the Tesla app I PERFORMANCE SPECIFICATIONS MECHANICAL SPECIFICATIONS -------- ------------------- - -- ---- --------------- ------ ----------------------------- -------- AC Voltage(Nominal) 120/240V Dimensions 660 mm x 411 mm x 149 mm Feed-In Type T Split Phase _ ___ (26 in x 16 in x 6 in) Weight 20 4 kg(45 Ib) Grid Frequency 60 Hz _ Mounting options Wall mount,Semi-flush mount Current Rating 200 A Maximum Input Short Circuit Current 10 kA1 Overcurrent Protection Device 100-200A,Service Entrance Rated' Overvoltage Category Category IV AC Meter Revenue accurate(+/-0 2%) Primary Connectivity Ethernet,Wi-Fi _ y s N L F5 Secondary Connectivity Cellular(3G,LTE/4G)' User Interface Tesla App Operating Modes Support for solar self-consumption, 660 time-based control,backup,and o off-grid Backup Transition Automatic disconnect for seamless backup Modularity Supports up to 10 AC-coupled Powerwalls Optional Internal Panelboard 200A 6-space/12 circuit Eaton BR Circuit Breakers Warranty 10 years 1 When protected by Class J fuses,Backup Gateway 2 is suitable for use in �— 4'11 149 circuits capable of delivering not more than 22kA symmetrical amperes 2 The customer is expected to provide internet connectivity for Backup Gateway 2,cellular should not be used as the primary mode of connectivity Cellular connectivity subject to network operator service coverage and signal strength COMPLIANCE INFORMATION ENVIRONMENTAL SPECIFICATIONS Certifications UL 67,UL 869A,UL 916,UL 1741 PCS Operating Temperature -20°C to 50°C(-4°F to 122°F) —_ CSA 22 2 0 19,CSA 22 2 205 Operating Humidity(RH) Up to 100%,condensing Emissions FCC Part 15,ICES 003 — _— — -- ______--___— Maximum Elevation 3000 m(9843 ft) Environment Indoor and outdoor rated Enclosure Type NEMA 3R 7 = S L n N-;2010-05-2S TESLA COM/ENERGY