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Home My WebLink About45239-Z �S'004c Town of Southold o pG 10/5/2021 y P.O.Box 1179 0 co 53095 Main Rd yjj0 ao�� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 42390 Date: 10/5/2021 THIS CERTIFIES that the building SOLAR PANEL Location of Property: 2175 Bay Shore Rd., Greenport SCTM#: 473889 Sec/Block/Lot: 53.4-14 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 9/14/2020 pursuant to which Building Permit No. 45239 dated 9/22/2020 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: roof mounted solar panels as applied for. The certificate is issued to Rengifo,Robert&Collins, Sara of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 45239 1/13/2021 PLUMBERS CERTIFICATION DATED J Authorized Signature I 1 o�SUEFoc��o TOWN OF SOUTHOLD ' oy� BUILDING DEPARTMENT C* z TOWN CLERK'S OFFICE "o • SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 45239 Date: 9/22/2020 Permission is hereby granted to: Rengifo, Robert 450 W 17th St Apt 1804 New York, NY 10011 To: install roof mounted solar panels as applied for. At premises located at: 2175 Bay Shore Rd., Greenport SCTM #473889 Sec/Block/Lot# 53.4-14 Pursuant to application dated 9/14/2020 and,approved,by the Building Inspector. To expire on 3/24/2022. Fees: SOLAR PANELS $50.00 CO-ALTERATION TO DWELLING $50.00 ELECTRIC $100.00 Flood Permit $100.00 Total: $300.00 B ilding Inspector i i i 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. 9/11/2020 New Construction: Old or Pre-existing Building: X (check one) Location of Property: 2175 Bay Shore Road Greenport House No. Street Hamlet Owner or Owners of Property: Robert Rengifo Et Sara Collins p Suffolk County Tax Map No 1000, Section 53 Block 4 Lot 14 Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: GreenLogic LLC Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: X (check one) Fee Submitted: $ 50 pplicant Signature Building Department Application AUTH[OMATTION (Where the-Applicant is riot the Owner) I, residing at (Print property owner's name) (Mailing Address) ! ,do hereby authorize GreenLogic LLC (Agent) to,apply on my behalf to the Southold Building Department. (OWher's Signature) (Date) (Print Owner's Name) r ' CONSENT TO INSPECTION 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 2175 Bay Shore Road, Greenport, NY 11944 which is shown and designated on the Suffolk County Tax Map as District 1000, Section 53 , Block 4 , 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: solar panels 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. 1 Dated: �2 (Si (Print Name) (Signature) (Print Name) F S \o tl® ® Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 • �® sean.devlin(aD-town.southold.ny.us BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE t SITE LOCATION Issued To: Robert Rengifo Address: 2175 Bay Shore Rd city:Greenport st: NY zip: 11944 Building Permit#. 45239 Section. 53 Block- 4 Lot. 14 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 X Pool New X Renovation 2nd Floor Hot Tub Addition Survey X Roof X Garage INVENTORY Service 1 ph X Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors Sub Panel X A/C Blower Range Recpt Ceding Fan Combo Smoke/CO Transformer UC Lights Dryer Recpt Emergency Fixtures Time Clocks Disconnect Switches 4'LED Exit Fixtures Pump Other Equipment* 11.200M Roof Mounted PV Solar Energy System w/ (28) SunPower SPR-A400- G-AC Modules / Micro Inverters , SunPower Monitoring System„ Sub Panel w/220x3 and 215x1 Notes: Solar Inspector Signature: Date: January 13, 2021 S.Devlin-Cert Electrical Compliance Form As Pacifico Engineering PC _ Engineering Consulting 700 Lakeland Ave, Suite 2B P C Ph:631-988-0000 Bohemia, NY 11716 i G c solar@paclficoengineering.com December 1,2020 Town of Southold Building Department 54375 Route 25, P.O. Box 1179 Southold, NY 11971 Subject Solar Energy Installation for Robert Rengifo&Sara Collins 2175 Bay Shore Road Greenport, NY 11944 1 have reviewed the solar energy system installation at the subject address on December 1,2020.The units have been installed in accordance with the manufacturer's Installation Instructions and the approved construction drawing. I have determined that the installation meets the requirements of the 2020 Residential Code of New York State and ASCE7-16. To my best belief and knowledge,the work In this document is accurate, conforms with the governing codes applicable at the time of submission, conforms with reasonable standards of practice,with the view to the safeguarding of life, health, property and public welfare. Regards, Ralph Pacifico, PE Professional Engineer �QF NE1� PAC/'�i�,®� ALO 065182 ,✓ � .� �� JAN 1 4 2021 dw ®izEss1®N� Ralph Pa 11 co, ro essi al Engineer NY 0661821 NJ 24GE04744306/FL 87297 uM` 3, _ , FIELD INSPECTION REPORT DATE COMMENTS n FOUNDATION(1ST) ------------------------------------- FOUNDATION(SND) m ROUGH FRAMING& PLUMBING H INSULATION PEA N.Y. y STATE ENERGY CODE FINAL ADD I iN ,L COmNTS t.)g X 4 su N z ZZ ' H b H 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. Check Septic Form N.Y.S.D.E.C. Trustees C.O Application Flood Permit Examined ,20 ® t`��7�:` ��]� Single&Separate v D , Truss Identification Form 2�- DStorm-Water Assessment Form D SEP 1 4 2020 contact: Approved 120 Mail to: GreenLogic LLC Disapproved a/c B�J�M1�?�`1G�E�° 97 North Sea Road, Southampton, NY T9NFOR ,DPhone: 631-771-5152 Expiration ,20 ectorAPPLLDING PERMIT Date September 11 , 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. 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 me-A�� (Signature of applic t or name,if a corpor tion) 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 Robert Rengifo Et Sara Collins (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 corpor e officer) Builders License No. 40227-H Plumbers License No. N/A Electricians License No. 43858-M E Other Trade's License No. N/A 1. Location of land on which proposed work will be done: 2175 Bay Shore Road Greenport House Number Street Hamlet County Tax Map No. 1000 Section 53 Block 4 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 Roof mounted solar electric system $40 000 (Description) 4. Estimated Cost 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 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 Robert Rengifo 450 W 17th St Apt 1804 14.Names of Owner of premises Sara Collins Address New York, NY 10011 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 X NO * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES X NO * IF YES,D.E.C.PERMITS MAY BE REQUIRED. 16. Provide survey, to scale,with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below,must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? * YES NO * 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. Swonj to before me t day of " 20.t0 hwlpk- �c e du.u,&T,-t-. — —A- - Notary Public BARBARA A CASCIO'TTA Signature of Applicalat Notary Public-State of New York No.01-CA4894969 Qualified in Suffolk County Commission Expires May 11 2023 ' " BUILDING DEPARTMENT- Electrical Inspector " 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 ro err southoldtownn . ov — seand asoutholdtownn . ov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (Ail information Required) Date: 9/11/2020 Company Name: lGreenLoRic LL Name: Robert Skypala License No.: 43858-ME email: Barbara@Greenlogic.com Address: 97 North Sea Road, Southampton, NY 11968 Phone No.: 631-771-5152 JOS SITE INFORMATION (All Information Required) Name:,, Robert Rengifo Et Sara Collins _ Address: 2175-Bay Shore Road, Greenport, NY 11944 Cross Street: Phone No.: Builder - Seifert Construction 631-831-7501 Bldg.Permit#: email: john@seifertconstruction.com Tax-Map District: 1000 Section: 53 Block: 4 Lot: , 14 BRIEF DESCRIPTION OF WORK (Please Print Clearly) Roof mounted solar electric system (28) SunPower SPR-A400-G-AC modules, (28) SunPower SPR-A400-G-AC micro inverters, (1) SunPower monitor PVS6 System Size: 11.200kW Circle All That Apply: Is job ready for inspection?: YES NO Rough In Final Do you need a Temp Certificate?: EEJNO 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 Form,xis i i 13 t' BUILDING DEPARTMENT-Electrical Inspector TOWN OFSOUTHOLD 3 Town Hall Annex- 54375 Main Road - PO Box 1179 - Southold, New York 11971-0959 ; ` '< ' 'Telephone (631) 765-1802 - FAX 631 765-9502' ` rogeri-0southoldtownnv.gov_� seandCa?sout oldtownny.aov APPLIG-ATI,ON FOR ELECTRICAL INSPECTION, ` ' ELECTRICIAN INFORMATION (All Information Required) Date: 9/11/2020 - Company [Mame: r_eenL-o is-LL =__ _ _ . - = . Name: Robert Skypala _License No:: 43858-ME email: Barbara@Greenlogic.com Address:_ 97 North Sea Road, Southampton, NY 11968 Phone Nb.: 631-771-5152 JOB SITE INFORMATION (Ail Information Required) Name: Robert Rengifo 4 Sara Collins_-_ „ -- - - T Address: 2175 _Pay Shore Road, Greenport, NY 11944 Gross Street: ` Phone No'..' Builder'- Seifert Construction 631-831-7501 ` Bldg.Permit#: 5a3 g email: john@seifertconsteuction.com { Tex Map-District:_ 1000 Section, 53 Block: 4__ Lof: 14 -_ ___ _ _ C __ _ __ __ _ _ _ 1 S,,RIPF QESCRIPTION:OF WORK(Pleose-Print Clearly) _Boof_mounted solar electric.system (28) Sunpower SPR-A400-G-AC modules, (28) SunPower SPR-A400-G-AC micro inverters, ___(1)_5unPower monitor_PV56.5ystem Size: 11.200kW Circle All That Apply; Is job ready for inspection?: YES NO Rough In' Final Do you need a Temp Certificate?: FYESj 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-Informatibit PAYMENT DU,E WITH APPLICATION Request for Inspection ForM.As z PERMIT# Address: Switches Outlets GFI's Surface Sconces H H's UC Lts Fans Fridge HW Exhaust Oven Dryer Smokes QW Service Carbon Micro Generator Combo Cooktop Transfer AC AH Mini Special: 1 `7 Comments. �� FQ Scott,A. Russell Q,$0' Ir TOR MWAT]ER- SUPERVISOR MANAGEMENT SOUTHOLD TOWN HALL-P,O,sox 1179 53095 Main Road-SOUTHOLD,NEW YORK 11971 Town h Df Southold Q� CHAPTER 236 - STORMWATER MANAGEMENT WORD SHEET ( TO BE COMPLETED BY THE APPLICANT ) --- — DOES THIS PROJECT I 'C LVE ANY OF THE FOLILO tNTtsr: (CHECK .41L'rHXr APPLY) Yes No i QQ A. Clearing, grubbing, grading or stripping of land which affects more , than 5,000 square feet of ground surface. ; ❑Q B. Excavation or filling involving more than 200 cubic yards of material s = within any parcel or any contiguous area. i 9 ❑ x] C. Site preparation on slopes which exceed 10 feet vertical rise to 100,feet of horizontal distance. Di Site preparation within 100 feet of wetlands, beach, bluff or coastal ' erosion hazard area. E] E. Site preparation within the one-hundred-year floodplain as depicted on FIRM Map of any watercourse. ❑E] F. Installation of new or resurfaced impervious surfaces of 1,000 square feet or more, unless prior approval of a Stormwater Management Control Plan was received by the Town and the proposal includes in-kind replacement of impervious surfaces. If you answered NO to all of the questions above, STOP! Complete the Applicant section below,with your Name, Signature,Contact Information,Date,& County Tax Map Number! Chapter 236 does not apply to your project. -If you answered YES to one or more of the above,please submit'Two copies of a Stormwater Management Control Plan and a completed Check List Form to the Building Department with your Building Permit Application. APPLI a{u rtd()ti nc r.Demme n Prafesa�anal,.A gent,Cantractar,Q3hea S,C*"A �: 1000 gate llhtrFei NAME- Cr_eenLo�i� LLC(N sim Atb ikmk). �, 53 4 14 9/11/2020 Section Block Lot " r H: FCIII E3UILUli\G DLI'Al ['i4L 'i"L 1: ONLY Contact Information 631-771-5152 i ii'cSylarca h,naSer €�� Reviewed By: ii Date_ Properly Address J Location of Conskructton Werk; � ` — — — — — — — — _ — — F$ 3 — — — a Approved for processing Building Permit. 2175 Bay Shore Road i Stormwater'Managernent Control Plan Not Required. Greenport,-NY 11944 , - - - - - - - - - - - - - - - - { 1 ® Stormwater Management Control Plan is Required. (Forward to Engineering Department for Review.) { 4 FORM - SMCP-TOS M AY 2014 r APPLICATION V PAGE- T of 4 — - TOWN OF SOUTHOLD FLOODPLAIN DEVELOPMENT PERMIT APPLICATION This form is to be filled out in duplicate. SECTION 1: GENERAL PROVISIONS APPLICANT to read and sign): 1. No work may start until a permit is issued. 2 The permit may be revoked if any false statements are made bercin. 3. If revoked, all work must cease until permit is re-issued. 4. Development shall not be used or occupied until a Certificate of Compliance is issued. 5. The permit will expire if no work is commenced within six montbs of issuance. 6. Applicant is hereby informed that other permits may be required to fulfill local,state and federal regulatory requirements. 7. Applicant hereby gives consent to the Local Administrator or his/her representative to make reasonable inspections required to verify compliance. 8. I,THE APPLICANT,CERTIFY THAT ALL STATEMENTS HEREIN AND IN ATTACHMENTS TO THIS APPLICATION ARE,TO THE BEST OF MY KNOWLEDGE,TRUE AND ACCU TE. (APPLICANTS SY(OIATURE) DATE 0 SECT I N 2: PROPOSED D54--LOPMENT b be completed by APPLIC NAME ADDRESS TELEPH NE APPLICANT GreenLogic LLC 97 North Sea Road, Southampton, NY 11968 631-771-5152 BUILDER GreenLogic LLC 97 North Sea Road, Southampton, NY 11968 631-77 5152 FNGINEERIames J. Stout Architect &Assoc. 2 Greg Lane, East Northport, NY 11731 631-858-9388 PROJECT LOCATION: • To avoid delay in processing the application. please provide enough information to easily identify the project location. Provide the street address, Iot number or legal description (attach) and. outside urban areas, the distance to the nearest intersecting road or well-known landmark- A sketch attached to this application showing the project location would be helpful. 2175 Bay Shore Road, Greenport NY 1194 Roof mounted solar electrics stem FDP(93) APPLICATION PAGE 2 OI n ---- DESCRIPTION OF WORK (Check all apphcablc boxes) A. STRUCTURAL DEVELOPMENT ACTIVITY STRUCTURE_ TYPE ❑ New Structure W Residential (1-4 Family) ❑ Addition ❑ Residential (Marc than 4 Family) N Alteration ❑ Non-residenual (Floodprooftng? ❑ yes) ❑ Relocation ❑ Combined Use (Residential & Commercial) ❑ Demolition ❑ Manufactured (Mobile) Home (In Manu- 0 Replacement factured Home Park? ❑ Yes) ESTIMATED COST OF PROJECT s 40,000 B. OTHER DEVELOPMENT ACTIVITIES: ❑ Fill ❑ Mining ❑ Drilling ❑ Grading ❑ Excavation (Except for Structural Development Checked Above) ❑ Watercourse Alteration (Including Dredging and Channel Modifications) ❑ Drainage Improvements (Including Culvert Work) ❑ Road, Street or Bridge Construction ❑ Subdivision (New or Expansion) ❑ Individual Witer or Seyr System 0 Other (Please SpectTy) Roof mounted sola After completing SECTION 2, APPLICANT should submit form to Local Administrator for review. SECTION 3. FIAODPLAIN DE'T'ERMINATION f1'o be eomoleted by LOCAL ADMINISTRATOR) The proposed development is located on FIRM Panel No. Dated The Proposed Development: O Is +EM located in a Special Flood Hazard Area (Notify the applicant that the application review is complete and NO FLOODPLAIN DEVELOPMENT PERMIT IS REQUIRED). ❑ Is located in a Special Flood Hazard Arca. FIRM zone designation is 100-Year flood elevation at the site is: Ft. NGVD (MSL) ❑ Unavailable Cl The proposed development is located in a floodway FBFM Panel No. Dated ❑ Sec Section 4 for additional instructions SIGNED DATE • APPLICATION PAGE 3 OF a SECTION 4• ADDITIONAL INFORMATION RE )UIREQ (To be completed by LOCAL ADMINISTRATOR} The applicant must submit the documents checked below before the application can be processed 0 A site plan showing the location of all existing structures, water bodies, adjacent roads, lo[ dimensions and proposed development. ❑ Development plans, drawn to scale, and specifications,including where applicable:details for anchoring structures,proposed elevation of lowest floor(including basement), types of water resistant materials used below the First floor,details of flood proofing of utilities located below the first floor and details of enclosures below [hr, first floor. Also 0 Subdivision or other development plans (If the subdivision or other development exceeds 50 lots or 5 awes, whichever is the lesser, the applicant must provide 100-year flood elevations if they are not otherwise available). ❑ Plans showing the extent of watercourse relocation and/or landform alterations. ❑Top of new fill elevation Ft. NGVD (MSL). ❑ Fiood'proofmg protection level (non-residential only) Ft.'NGVD (MSL). For flo MV'roofed structures, applicant must attach certification from registered engineer or architect. ❑ Certification n from a registered engineer that the proposed activity in a regulatory flood-ay will not result in any increase in the height of the 100-yeas flood. A copy of all data and calculations supporting this finding must also be submitted. ❑ Other: SECTION 5 PERMIT DETERMINATION M be completed byLD.C&-ADMiNISIRATORI I have determined that the proposed activity. A»13 Is B.❑ Is not in conformance with provisions of Local Law t , 19 The permit is issued subject to the conditions attached to and made part of this permit. SIGNED , DATE If BOX A is checked, the Local Administrator may issue a Development Permit upon payment of designated fee. If BOX B is checked, the Local Administrator will provide a written summary of ddicicncies. Applicant may revise and resubmit an application to the Local Administrator or may request a bearing from the Board of Appeals APPLICATION 4 _ PAGE 4 OF 4 APPEALS Appealed to Board of Appeals? ❑ Ycs ❑ No Hearing date- Appeals Board Decision --- Approved) ❑ Yes ❑ No Conditioru SECTION G,• A-5-BUILT ELEVATIONS (To be submitted by APPLICANT before Certificate of Compliance is issued The following information must be provided for project structures, This section must be completed by a registered professional engineer or a licensed land surveyor (or attach a certification to this application) Complete I or 2 below, 1. Actual (As-Built) Elevation of the top of the lowest floor, including basement(in Coastal High_Haurd Arcas, bottom of lowest structural member of the lowest floor, excluding piling and columns) is: FT. NGVD (MSL). 2. Actual (As-Built) Elevation of floodproofing protection is FI'. NGVD (MSL). NOTE: Any work performed prior to submittal of the above information is at the risk of the Applicant. SECTION 7• COMPLIANCE ACTION (To be completed by LOCAL ADMINISTRATOR) The LOCAL ADMINISTRATOR will complete this section as applicable based on inspection of the project to etLsure compliance with the community's local law for flood damage prevention. INSPECTIONS: DATE BY DEFICIENCIES? ❑ YES ❑ NO DATE BY DEFICIENCIES? ❑ YES ❑ NO DATE BY DEFICIENCIES? ❑ YES ❑ NO SECTION 8• CERTIFICA'T'E OF COMPLIANCE(To be completed by LOCAL ADMINISTRAT R Certificate of Compliance issued: DATE: BY: } • Attachment B SAMPLE CERTIFICATE OF COMPLIANCE for Development in a Special Flood Hazard Area C c TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE FOR DEVELOPMENT IN A SPECL4L FLOOD HAZARD AREA (OWNER MUST RETAIN THIS CERTIFICATE) PREMISES LOCATED AT: PERMIT N0. PERMIT DATE OWNERS NAME AND ADDRESS: CHECK ONE: 17 NEW BUILDING ❑ EXISTING BUILDING ❑ VACANT LAND THE LOCAL ADMINISTRATOR IS TO COMPLETE A. OR B. BELOW: A. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19 SIGNED: r DATED: B. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19AS MODIFIED BY VARIANCE # , DATED SIGNED- DATED: C/C(93) PROPERTYINFORMATION 2175 BAY SHORE ROAD,GREENPORT,NY 11944 S,C,T.M,NUMBER 1000-53-04-14 LOT AREA: =23,043 sq.ft.OR 0.529 ac.(TO TIE LINE) J =12,865 sq,ft OR 0 295 ac.(TO BULKHEAD) STRUCTURES .,. .ALLOWABLE SF. PROPOSEDYSF BUILDING COVERAGE AREA TO BULKHEAD(12,865 S.F.) X(20%)=2,573 S.F. 2.280 S.F. EXTERIOR STAIRCASE 167 S.F, PERVIOUS DRIVEWAY 0 S.F. TOTAL LOT COVERAGE 2,447 S.F.(19%) yczo USD LEGEND1 1 tE� TSL nl�ND SI-IEL 1 [ J EXISTING TO BE REMOVED 5 47'04'35" E 35,32' PROPOSED 5 53.26 3. 6550 " arm ra TOP OF BULKHEAD ygwlow?55o• -�, , SIP BOTTOM OF BULKHEAD nA> TOP OF WALL dv/ BOTTOM OF WALL SEPTIC TANK g ! - tG LEACHING GALLEY - € —_ -- _ f DCINC 101, DRYWELL 101, s-� 4" . � I 7 � I I f 7 K�JOf/ 4��q rg s: _ lam `::`}�a Ri., •�;.. -' S� > > tet '. ` BOARD UI TOWN O .DATE i' S4 'rPJww APPROXIMATE LOCATION OF",w^;^''' EXI9`1NG SEPTIC SYSTEM TO ` BE[¢q J •i 1A t�YiWfiNEf7f atGyrge- ,� "TO V,,41' <,aa.� ��,�„r'•','�'!„'<f�.»;'^ ,r,sit , PROPOSED LOCATION FOR NEW SEPTIC SYSTEM PENDING SUFFOLK COUNTY HEAt T-i DEPT.APPROVAL w <C,, t `>' v ,w">t� Yi ` {r` 7A10 r v1 ,_:7 '� O'er'`. .��•�, �� s �• �� --_—_ �,-z�am-..` `,�” �. f 028220 ��Q� r / n`t` N 6� 0 OF N, k�0 1- SCALE 1132"=1'-0" BERGDESIGN COLLINS RENGIFO RESIDENCE- PROPOSED SITE PLAN ARCHITECTURE 2175 BAY SHORE ROAD,GREENPORT,NY 11944 DATE:JANUARY•23,2018 REF NO.194 GREENLOGIC® September 11, 2020 ERGY ® F=CZ0V[E S E P 1 4 2020 Town of Southold Building Department tq��yy��'�D�T�7D7rE.�. �{p Town Hall 53095 Route 25 Southold, NY 11971 Dear Building Inspector: Please find attached a building permit application on behalf of Sara Collins & Robert Rengifo who has engaged us to install a roof mounted solar photovoltaic(PV) electric system located at 2175 Bay Shore Rd, Greenport, NY. 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 • Floodplain Development Permit Application • Application for Electrical Inspection • 2 Surveys of the Premises • 4 Engineer's Reports • 2 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$300 ($50 Building Permit/$50 CO/$100 Electrical Inspection/$100 Floodplain) Please let us know if you need anything else in connection with this application. Yours truly, J3aJxm 'Cwck*a Barbara Casciotta Account Manager g hh ra�Gree to c.com GREENLOa�C�LG� www.�re �o is com Tel: 631.771.5152 Fax: 631.771 5156 631-771-5152 ext 11 SOUTHAMPTON ROSLYN HEIGHTS 97 North Sea Rd ,Suite 3 200 S Service Rd ,#106 Southampton, NY 11968 Rosyln Heights, NY 11577 GREENLOGIC® ENERGY January 13, 2021 The Town of Southold Building Department 54375 Route 25 P.O. Box 1179 Southold, NY 11971 Re: Building Permit No. 45239 Sara Collins/Robert Rengifo 2175 Bay Shore Road, Greenport To the Building Inspector: Enclosed please find the Engineer's Certification Letter for the above referenced address. Can you please close the building permit and send the Certificate of Occupancy? Please let me know if you have any questions about the installation. Sincerely, Xa 4cww&6ciotta Barbara Casciotta _. Account Manager Barbara@Greenlogic.com 631-771-5152 Ext. 117 ' ,JAN 1 d 2021 GREENLOGIC LLC o www.GreenLogic.com Tel. 631.771.5152 Fax 631.771 5156 SOUTHAMPTON ROSLYN HEIGHTS 97 North Sea Rd.,Suite 3 200 S Service Rd.,#106 Southampton, NY 11968 Rosyln Heights, NY 11577 r� -:l-K. '? _..''"'tC�' ' y`I.�-.wl. ^4rJ Yr .t.- � :`ll:� 4,-'.� k.•.Z L..,.._�, .�..i'^k�,.y,Y•.k �'.F t�^- � �r� �3� \� .�� ••,J .. , y� �• q v� y79 �y /:.Y ✓." r Say �! N rP. Ln4 ? ! ;L: .�`�',�'1✓. � y` F r _'J '� .•i r _ /.ti r ,,�' 4�.0 . ��hY � ,, r?y., ITi, ,_) `. i��,�••�l ,v� 1 5_- .��d_. x:.:. f�:?.-+ i •;;F f :r�f.. -L, y.:... •y../.��a t F ,. X .:.t�RFr F t _ �. ..,.,t-�F. 5. �h?.. �.tt�'� v, F•Y„° W�v ) Suffolk County Executive's 0 ce of Consumer Affairs ` VETERANS MEMORIAL HIGHWAY HAUPPAUGE,NEW YORK 11788 DATE ISSUED: 1 • r , }�r f SUFFOLK COUNTY Home 3j Improvement / / 1 This is to certifv thatv N ? doing business r. /$ > GREEN LOGIChaving ftunished the requirements set forth in accordance with and subject to the provisions of applicable laws,rules S t� 4-7 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. P a - Additional � `:. NOT VALID WITHOUT \ D)EPARTMENTAL SEAL r ° 1 -4 AND A CURRENT CONSUNIEk AFFAIRS J < x 1 CARDs # =y 2 x� (,tDirector1 t . `. C��r 4.rr1� A Fly tt�/ h r•�� i� r �' cr. � >� ,,."f �..} ,(�. l��ef� �y.l� I..��, r n'• i� It _.c i5�d:�''f ( R•ir l �j\:1 .` -•. pyo/', -.�. ,. k '^-t - , :lc^ •�*,-;�°+,. ,;A.,-c^fr ., �l "4 t. ,' � e., t•�+L�tl„ y ��.;'`'�A.,s ,�.;uu�, '�`� �� f �>--y` ) '`�e •:3't' t `�a.-. �r.=.. ,4. � c-'Y': ;'p,`� .. y�' ..G, L5` .�. a• ;Y �..�;. YE ��:��y��1'\'� r- 1. �. .�`��y 1 •j. x W -'r Y ':f� 1.. ,�b...,.:o- 1' -e.:'. :��$ 4. yr ;�� ;,, .��„ r,�...?r. � ,,x,,, 4„.�.yr �w«�� ;J�,w.?.. �'v.r, 4,.,�,.�: 5 �• 4-«'” r'V r` ��k�� tia � r�;:� { ��f r�' �.,�,.,J.w '.,,r,,ti� np�•}. �;: .r�.�ti'Z' ti 41,E rt ;-!�` 1 t;t J,ry^' �2� ��.1.�wi ��°p'1 ^ �"ti). �i:.tY•N �r.`•;y,.. �'�.'� ny}+..w"n_' -d,. i5. I. ��{., �K �..t.; .•..r. ��.�.�. a�"�+ :�: r•� � ,��" h.. . h- 4 �' �s-�� '•;. �,� :.r.4�.�-., ,��r r.:,... �a �-.� a(i�... .....;. �y :'tir.;w-. ��.,,,•}:.. ..�.�.,.,r �..9., ., .S��«,.r:r.;.. , �'Y .i- .,n -r. - A �.,., i �-.+i� ,ti F,;.'.w w..^..n '>r+}:_� ��,;.,fi t+:;��. �•,;;�A,.o<' -ie: -�,c.:�/ \�';iss, -. � nay - ♦ tt llH."�Kl l ..? r W-J�.• ,iJ.w i..r an\�� N;. -,Ask- Aid. nor r--- - - " - '--' -- --'- ----------------- -- '--- --- i 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 r 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 NOT VALID WITHOUT DEPARTMENTAL SEAL AND A CURRENT CONSUMER AFFAIRS 1 Ip CARD 4 Director - ---- -------- - ---- -- -_J i 7 A . � CpVIE D ASS DATE. L��'[ Z . B P.FE 0-0 N ,IFY BUILCIPIC� U'- ,"!TENT @.T 755-1802 8 AM To 1',PM F()R THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - COP S1 RUCTION MUST BE COIt!IPLL FOR C 0 ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE-FOR DESIGN OR CONSTRUCTION ERRORS, CO!vIDI LY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED A7TOWN N OF lSOBASOLANNING BOARD SORUSTEESN: OCCUPANCY 0IR USE IS UNLAVVIFUL WITHOUT CERMFiCjp-,iT` OF 0000N0 ELECTRICA MSpWnoM11 REQUIRED �ETF,M STORM WATER RUNOFF PURSUANT TO CHAPTER 236 OF THE TOVVN CODE. Pacifico Engineering PC __ _ Engineering Consulting 700 Lakeland Ave, Suite 2B G[, �• ,�t— Ph:631-988-0000 Bohemia, NY 11716 c INE c solar@pacificoengineering.com August 17, 2020 Town of Southold Building Department 54375 Route 25, P.O. Box 1179 Southold, NY 11971 Subject- Solar Energy Installation for Robert Rengifo&Sara Collins 2175 Bay Shore Road Greenport, NY 11944 I have reviewed the roofing structure at the subject address.The structure can support the additional weight of the roof mounted system.The units are to be installed in accordance with the manufacturer's installation instructions. I have determined that the installation will meet the requirements of the 2020 Residential Code of New York State and ASCE7-16 when installed in accordance with the manufacturer's instructions. Roof Section A Mean roof height 22.0 ft Pitch 2 degrees Roof rafter 11-7/8"TJI 230 Rafter spacing 16 inch on center Reflected roof rafter span 12.5 ft Rafter span max allowable 25.0 ft The climactic and load information is below- CLIMACTIC AND Ground Wind Live Load, Point GEOGRAPHIC DESIGN Exposure Snow Speed,3 Pnet per pullout Fastener Type Category Load,Pg, sec gust, ASCE 7, CRITERIA psf mph psf load,Ib Roof Section A C 20 130 26 - 419 (2)5"&(6)3"#14-13 DP1 concealer screws Weight DistributionSOF NiE� array dead load 3.5 psf Q� PAC r® load per attachment 56.3 Ib COO @?� '��C® The subject roof has 1 layer of shingles. * 4 Panels mounted flush to roof no higher than 6 inches above roof surface. Ralph Pacifico, PE 4 r Professional Engineer 4�0. ®g618 Ra s r n, NY 0661$ _�� L 87297 GREENLOGICO ENERGY GreenLogic,LLC Approved Collins,Sara 2175 Bay Shore Road Greenport,NY 11944 Surface#A: Total System Size. 11.200kW Array Size:11.200kW 1 Circuit of 11 on a 20A Breaker 1 Circuit of 10 on a 20A Breaker 1 Circuit of 7 on a 20A Breaker Azimuth:232° Pitch:2° Monitoring System: SunPower 0 Panel/Array Specifications: Panel-SPR-A400-G-AC Racking:SunPower Invisimount Panel:72.2 X 40.0 Array:26'4 5/8"X 25'8" Surface:32'2"X 26'11" Magic#:Invisimount Legend: ® 28 SunPower 40OW AC Panels ® SunPower Invisimount Rad 77 Eco-Fasten Fast Feet(White Flashing) 0 8 a TJI 230 X 12"Depth 16"O.C. ONotes: Number of Roof Layers:1 Height above Roof Surface:4" Materials Used:Eco-Fasten,SunPower Added Roof load of PV System:3.5psf o - Engineer/Architect Seal: OF ro Vi PAC/ ir slot, ` Drawn By:MMB Drawing#1 of 5 Date:8/12/2020 REV:A Drawing Scale:3/16"=1.0' GREENLOMC@ ENERGY GreenLogic,LLC Approved Collins,Sara 2175 Bay Shore Road Greenport,NY 11944 Surface#A: Total System Size:11.200kW Array Size: 11.200kW 1 Circuit of 11 on a 20A Breaker 1 Circuit of 10 on a 20A Breaker 1 Circuit of 7 on a 20A Breaker Azimuth:232° Pitch:2° Monitoring System: SunPower Panel/Array Specifications: Panel:SPR-A400-G-AC Racking:SunPower Invisimount Panel-72.2 X 40.0 Array:26'4 5/8"X 25'8" Surface:32'2"X 26'1171 " Magic#:Invisimount Legend: 28 SunPower 40OW AC Panels ® SunPower Invisimount Rail 40 77 Eco-Fasten Fast Feet(White Flashing) aTJI 230 X 12"Depth 16"O.C. Notes: Number of Roof Layers: 1 Height above Roof Surface 4" Materials Used:Eco-Fasten,SunPower Added Roof load of PV System:3.5psf Enginee chitect Seal: OrN ccw ®' 06618 s Drawn By:MMB Drawing#2 of 5 Date:8/12/2020 REV:A Drawing Scale:3/16"=1.0' GREENLOGIC° ENERGY GreenLogic,LLC Approved Collins,Sara 2175 Bay Shore Road Greenport,NY 11944 Surface#A: Total System Size. 11.200kW Array Size-11.200kW NVT 1 Circuit of 11 on a 20A Breaker 2 1 Circuit of 10 on a 20A Breaker 1 Circuit of 7 on a 20A Breaker Cq cn Azimuth:232° Pitch:2° 2 Monitoring System: ? SunPower 0 Panel/Array Specifications: Panel:SPR-A400-G-AC 2 Racking:SunPower Invisimount Panel:72.2 X 40.0 0 Array:26'4 5/8"X 25'8" - Surface:32'2"X 26'11" Magic#:Invisimount Legend: 2 3 ® 28 SunPower 40OW AC Panels ® SunPower Invisimount Rail 77 Eco-Fasten Fast Feet(White Flashing) o a TJI 230 X 12"Depth 16"O.C. 1 O Notes: Number of Roof Layers:1 Height above Roof Surface.4" Materials Used Eco-Fasten,SunPower Added Roof load of PV System-3 5psf ° 1 Engineer/Architect Seal: 1 1 0��F NE ! DA 61A RA a: IN ®A 06618 ®LNESSIOI P Drawn By:MMB Drawing#3 of 5 Date:8/12/2020 REV:A Drawing Scale:3/16"=1.0' No Vent Pipes Will Be Covered By The Solar Array EE L®GIC® ENERGY LEGEND: GreenLogia,LLC Approved AR -Access roof per R202 definitions RAP -Roof access point-to be away from RWV -Roof with valley, Collins,Sara overhead obstructions,doors, 18"minimum from valley 2175 Bay Shore Road windows,decks,fences,landscaping Greenport,NY 11944 GA -Ground access area per R324.7.3 width AP -Access Pathway,36"minimum SVO -Smoke vent operation per to be same as AP as measured at eave width per R324.7.4 and R324.7.5 R324,7.7,18"minimum from ridge Total System Size: 11.200kW Array Size:11.200kW 1 Circuit of 11 on a 20A Breaker 1 Circuit of 10 on a 20A Breaker 1 Circuit of 7 on a 20A Breaker RAP RAP Azimuth-232° _' GA GA Monitoring System: Meter SunPower GA Panel/Array Specifications: > J 28 SunPower >< >< >< Panel:SPR-A400-G-AC 40OW Panels AP AP Racking:SunPower Invisimount Panel:72.2 X 40.0 Magic#:Invisimount Legend: ® 28 SunPower 400W AC Panels ° SunPower Invisimount Rail Stairway To Roof Deck 40 77 Eco-Fasten Fast Feet(White Flashing) ° &2 nd Floor B TJI 230 X 12"Depth 16"O.C. O Notes: Number of Roof Layers:1 Height above Roof Surface:4" AP Materials Used:Eco-Fasten,SunPower Added Roof load of PV System:3.5psf Engineer/Architect Seal: ®14 PA � '0 06 182 SO " Drawn By:MMB Drawing#4 of 5 Date:8/12/2020 REV:A Drawing Scale: 1/8"=1.0'