HomeMy WebLinkAbout47261-Z eel Town of Southold 4/8/2022
0
°. P.O.Box 1179
o - 53095 Main Rd
y,�j01 dao Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 42977 Date: 4/8/2022
THIS CERTIFIES that the building SOLAR PANEL
Location of Property: 255 Zena Rd.,Mattituck
SCTM#: 473889 Sec/Block/Lot: 106.-5-16
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
12/3/2021 pursuant to which Building Permit No. 47261 dated 12/23/2021
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 to existing single family dwelling as applied for.
The certificate is issued to Sullivan,Carol
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 47261 3/1/2022
PLUMBERS CERTIFICATION DATED
Auth zed Sign ture
SOFFe TOWN OF SOUTHOLD
ao� oGy. BUILDING DEPARTMENT
co TOWN CLERK'S OFFICE
.44'
• o� SOUTHOLD, NY
ol� �a
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#: 47261 Date: 12/23/2021
Permission is hereby granted to:
Soullas, Peter
825 Herricks Ln
Riverhead, NY 11901
To: Install roof mount solar to existing single family dwelling as applied for.
At premises located at:
255 Zena Rd., Mattituck
SCTM'#473889
Sec/Block/Lot# 106.-5-16
Pursuant to application dated 12/3/2021 and approved by the Building Inspector.
To expire on 6/24/2023.
Fees:
SOLAR PANELS $50.00
ELECTRIC $100.00
CO-RESIDENTIAL $50.00
Total: $200.00
",-Y�
Building Inspector
ho�%pF SOUTyQI
0
Town Hall Annex Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 �Q sean.devlinCaD-town.southold.ny.us
Southold,NY 11971-0959 Q
�ycoum,N
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Carol Sullivan
Address: 255 Zena Rd city:Mattituck st: NY zip: 11952
Building Permit#: 47261 Section: 106 Block: 5 Lot: 16
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Greenlogic LLC License No: 43858ME
SITE DETAILS
Residential X Indoor X Basement Solar X
Commerical Outdoor X 1st Floor Pool
New X Renovation 2nd Floor Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors
Sub Panel A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO
Transformer UC Lights Dryer Recpt Emergency Fixtures Time Clocks
Disconnect 2 Switches 4'LED Exit Fixtures Pump
Other Equipment: 10.92 kW Roof Mounted PV Solar Energy System w/ (26) SunPower SPR-A420-G-A(
Panels, SunPower Monitor , (2) AC Disconnects 47A, Sub Panel Combiner w/ 220x3 215x1
Notes:
Solar
Inspector Signature: Date: March 1, 2022
S.Devlin-Cert Electrical Compliance Form
BOE SOUIyo l (
how �o
# # TOWN OF. SO.UTHOLD BUILDING DEPT.
co 7654802
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: r� /
-P�l AIA-L---
DATE 7i INSPECTOR
F
OE SOUIyo�
# TOWN OF SOUTHOLD BUILDING- DEPT.
"Courm, ' 765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] NSULATIOWCAULKING
[ ] FRAMING /STRAPPING [V FINAL'SO Ij'r—
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
D I�h/ tJovkll
l 5 iwiLorw,,2It r4
r
DATE C0 °�°�`� INSPECTOR
J A M E S J. S TOUT A. R C H I T E CT & .Assoc.
2 G REG L ANE E AST NORTHP0RTN. Y. 631 — 8 58 9388
Post Installation Letter
February 25, 2022
RE: Sullivan Residence
255 Zena Road
Mattituck, NY 11952
To Whom It May Concern:
This letter is to confirm that as of February 25, 2022 I, James J Stout, NYS license
021633 have personally inspected the placement and installation of the roof top solar
panels at 255 Zena Road, Mattituck 11952. 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
I
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F NE
MAR 2 8 2022
BUILDING DEPT —ID
TOWN OFSOUTHOLD
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FIELD:INSPECTION°REP RT MATE:: COMMENTS
FOUNDATION;(1ST);
1�=]
t �
:FOUNDATION
ROUGH FRA=gG&
PLUllBING. y
r
INSULATION. 'ERN Y., H.
STATE ENERGY CODS`
• �" fM
FINAL
ADDITIONAL,C�MME;TS ..
•
•
:
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://ww,,v.southoldtoma-ny.,izov
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
PERMIT NO. 72 4e/ Building Inspector:
DEC 012021
ID
Applications andjo irmg must be filled out in pm ple't e' ,,
�a ptcatiphs wi[I'I Where th6Appiica-"n '�i;snpt"
�th"g owner,�'an'
BUILDING DEPT
TOWN OF SOUTHOLD
O�Ozatlorq inivag";yA, 0�6ecompleted�
Date:11/22/2021
JOFeROPERTY
Name:Carol Sullivan SCTM#1000-106-5-16
Project Address: ,d
o
na 255 ZeRaMattituck, NY 11952
........—--------------- -------- —------ .........
Phone#:917-975-9935 Email:CSPgramercynf.corn
Mailing Address:
............. ..........
CONTACT
Name:Barbara - GreenLoaic LLC
.......... ......
Mailing Address:97 North Sea Road, Southampton,
................ .. ------- ..............
Phone#:631-771.5152,x117_._. Email:BarbaraOGreenlo
g-ig.-g—om.......
'DESIG14, SS,1 ROF ON
Name:Jarnes J. Stout Architect & Assoc
--------- --- -------
Mailing Address:2 Greg Lane, East Northport, NY 11731
...........
Phone#:631-858-9388Email:stouthubOiamesstoutarch.com
........... ......
CSNTRAGTOR
lNFORNIATION
Name:GreenLoaic LLC
Mailing Address 97 North Sea Road, Southampton, 968
N)� 11
-------- mm_„
Phone
--Phone#:631m-771-5152 Email:AM rqpqlpgjc.corn
" S
-DES0115TION.Of PRO,POSED,.CONSTRUCTION
E]NewStructure ElAddition ®Alteration F_]Repair ElDemolition Estimated Cost of Project:
bother Solar Panels $ 41,000
--------------------—
Will the lot be re-graded? ElYes ®No Will excess fill be removed from premises? E]Yes ®No
PROPERTY INFORMATION' "
Existing use of property: hr�.l �� Intended use of property:
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑Yes NlNo IF YES, PROVIDE A COPY.
0 Check 8ox'After'Reading: The owner/contractor/design professional is responsible for all drainage and storm.water Issues as provided by,
Chapter 236 of the Town Coder'APPLICATION IS HEREBY MADE to the Building Department for the Issuance of a Building Permit pursuant to the Bullding'2one
Ordinance of the Town of Southold,Suffolk,County,New York and other applicable Laws,Ordinances or Regulations,for the construction of buildings,
m
additions,alterations or for removal`ordeolition 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(s)for necessary inspections.False statements made hereln are.
punishable as a Class A misdemeanor pursuant to Section 210.45 of the New.York State Penal Law.
Application Submitted By(print name):GreenLogic LLC [@Authorized Agent [I owner
Signature of Applicant: Date: 11,2.2—
STATE
-STATE O,F 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 0-9"
day of nC12 ,20
j AMY M BEA LEY
NOTARY PUBLIC,STATE OF NEWYORK
PROPERTY OWNER AUTHORIZ��'ION Qualified Reg.No.01 BE5039767
in Suffolk County
(Where the applicant is not the ow,ne�s�mmission Expires February 27,20L3
I, G'4KOLL 5''u-1y4^f residing at 2��i41<0 44A-7T17-UGle—
do hereby authorize GreenLOgio LLC to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
O'
Owner's Signature �— Date
hoz- SUGL/V,f�l�
Print Owner's Name
2
B D G DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
51j4L1D1S�V�,*L all Annex- 54375 Main Road - PO Box 1179
loWN of Southold, New York 11971-0959
` Telephone (631) 765-1802 - FAX (631) 765-9502
rogerr(cDsoutholdtownny.gov -- seand(aD-southoldtownny.gov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date: 11/22/2021
Company Name: GreenLogic LLC
Name: Robert Skypala
License No.: 43858-ME email: Barbara@Greenlogic.com
Phone No: 631-771-5152 ®krequest an email copy of Certificate of Compliance
Address.: • 97 North Sea Road Southampton, NY 11968
JOB SITE INFORMATION (All Information Required)
Name: Carol Sullivan
Address: 255 Zena Road, Mattituck, NY
Cross Street:
Phone No.: 917-975-9935
Bldg.Permit#: c���(p email: cs@gramercynf.com
Tax Map District: 1000 Section: 106 Block: 5 Lot: 16
BRIEF DESCRIPTION OF WORK (Please.Print Clearly) Roof mounted solar electric system
(26) SunPower SPR-A420-G-AC panels It (26) SunPower SPR-A420-G-AC micro inverters
(1) SunPower PVS6 monitor System Size: 10.920M
Check All That Apply:
Is job ready for inspection?: DYES R]NO -❑Rough In Final
Do you need a Temp Certificate?: QYES ❑NO Issued On
Temp Information: (All information required)
Service Size ❑1 Ph ❑3 Ph Size: A #Meters Old Meter#
❑New Service ❑ Service Reconnect ❑ Underground ❑Overhead
# Underground Laterals 01 ❑2 ❑H Frame❑Pole Work done on Service? ❑Y ❑N
Additional Information:
PAYMENT DUE WITH APPLICATION
Electrical Inspection Form 2020.xlsx
GREENLOGICO
ENERGY
November 22, 2021
Town of Southold
Building Department
Town Hall
53095 Route 25
Southold, NY 11971
Project Info:
Carol Sullivan
255 Zena Road
Mattituck, NY 11952
1000-106-5-16
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,
J9wd maa ,a,jciafta
Barbara Casciotta
Account Manager
Barbara@Greenlogic.com
GREENkZ74t!i� .{ iLogic.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
f Survey for:
OVA R0
R PG RL 2s . CAROL SULLIVAN
'CAPl 0o Lot 173, Block 14
"Captain Kidd Estates"
i ; At
Mattituck
Town of
Southold
Suffolk County, -New York
S.C.T.M.: 1000-106.00-05.00-016.000
1-72 1.13 S "),10
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11 1 I�•2G, �V FINK FENCE 0.N,
.wPLI. C)ihlN _ 1. AREA = 11,250 S.F.
G µ1hEK ~ I GOCSG�W h'(
EEN Dbw DmcK 'coN ' °R1�E N 2. ■= MONUMENT FOUND, -A = STAKE 'FOUND.
N 3. SUBDIVISION MAP "CAPTAIN KIDD ESTATES" FILED
p,8'W WASE �N 2Z?
°ONGREIE D �s IN THE OFFICE OF THE CLERK OF SUFFOLK
wµ` Ap, COUNTY ON JAN. 19, 1949 AS FILE NO. 1672.
Lot X73
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' S 2i CONGRE�E I�
i colflR o o DATE: JUNE 28, 2021
1 y U In, Y
x '6 slop,'( p, ;� JOB N0:2021-323
HOUSE CERTIFIED TO:
CAROL SULLIVAN
O co�12E0 FIDELITY'NATIONAL- TITLE INSURANCE COMPANY
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DAVID H. FOX, L.S. P.C. N.Y.S.L.S. #50234
y FOX LAND SURVEYING
W 4
LOt 64 SUNSET AVENUE
57'26 WESTHAMPTON BEACH, N.Y. 11978
AS
(631) 288-0022
OBNT p7E
UNAUTHORIZED ALTERATION OR�ADDI'IION TO THIS SIJRVEY
t IS A VIOLATION OI"SI:CTION /2US)'OE Uir NLW YORK STATE
1 EDUCATION LAW. COPIES OI' THIS SURVEY MAP NOT HEARING
' THE LANE) SURVC:YOR'S INKED SFAI OR EMBOSSED,SEAL
SHALL NOT RE CON SIDERE.O TO BE A VALID TRUE COPY
CERIIFICAEION INDICATED )'1EREON SITALI. RUN ONLY TO THE.
PERSON FOR WIiOM1100 SURVEY IS PREPARED AND ON ITIS
OL:IIALF-IO'THE TITLE COMPANY, GOVERNME.N-LACt_NCY _
AND LENDING INSTITUTION LISTL'.D HEREON , AND 7'O 7th
AS :T
SIGNEES OF HE LENDING INSTITUTION, CERTIFICATIONS
ARC NOT TRAM SI-MADI-E TO ADDIIIONAL INS717U71ONS
SUOSEOUENT OWNERS.
1
1 nuln. nnn� Ana
i
Survey for:
K�pD
?,0 ND RCAROL SULLIVAN
CAP�A1 zs Lot 173, Block 14
"Captain Kidd Estates"
At
Mattituck
Town of
fi o Southold
Suffolk County, New York
S.C.T.M.: 1000-106-00-05.00-016.000
2 �yg PIPE
} �/ OOs oti s FOUND 20 0 20
\_o / 125•
a+
W000 cu
RB SCALE:1"=20'
G nE NOTES:
p9M VAI��26'00 CHPIN UNK FENCE aNN _,3s•o E I'I 1. AREA = 11,250 S.F.
K
o��WP� 2. = MONUMENT FOUND, A = STAKE FOUND.
FFJ+ pe BRICK WPB CCNc W� N N
p 3. SUBDIVISION MAP "CAPTAIN KIDD ESTATES" FILED
N41N 7Yt N
°aw w,u CONCRE� ' IN THE OFFICE OF THE CLERK OF SUFFOLK
COUNTY ON JAN. 19, 1949 AS FILE NO. 1672.
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Lot 173 ~ ao
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.0 T n O 0OOVEft `rt o CONCRE1f WPIK vi
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_ a DATE: JUNE 28, 2021
c ,.epRY JOB NO:2021-323
z our CERTIFIED TO:
CAROL SULLIVAN
r FIDELITY NATIONAL TITLE INSURANCE COMPANY
O COVERED
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00 W p11CIIC- 23 2 Q
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snEo DAVID H. FOX, L.S. P.C. N.Y.S:L.S. #50234
9.z s�•26'OOaW t14 FOX LAND
32 LD 64 SUNSETT AVENUE AVENUE
WESTHAMPTON BEACH, N.Y. 11978
w 6-1 tD (631) 288-0022
UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY
IS A VIOLATION OFSECTION 7209 OF THE NEW YORK STATE
EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT BEARING
THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL
SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY.
CERTIFICATION INDICATED HEREON SHALL RUN ONLY TO THE
PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS
BEHALF TO THE TITLE COMPANY,.GOVERNMENTAL AGENCY
AND LENDING INSTITUTION USTED HEREON . AND TO THE
ASSIGNEES OF THE LENDING INSTITUTION.CERTIFICATIONS
ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS
OR SUBSEQUENT OWNERS.
DWG: 2021-323
A D CERTIFICATE OF LIABILITY INSURANCE DATE,MM/°D/YYYY)
01/29/2021
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(les) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER c0NTACT ' Nicholas Zulkofske
Brookhaven Agency,Inc. PHONE 631 941-4113 FAX 631 941-4415
100 Oakland Ave,Ste 1 E MAIL Certificates@ brookhavena enc .com
Port Jefferson,NY 11777 .INSURERS AFFORDING COVERAGE NAIL 0
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 0.National Liability✓3<Fire Insurance Co.
Southampton NY 11968 INSURER E: AGCS Marine Insurance Co.
INSURER F
COVERAGES CERTIFICATE'NUMBERe REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF-ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE.ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES..LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADDL SUB POLICY EFF POLICY ERP
LTR TYPE OF INSURANCE imn POLICY NUMBER p LIMITS
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000
A CLAIMS-MADE F OCCUR DAMAGE TO RENTED
$100,000
X Contractual Liability X. X GL202100012922 01/31/2021 01/31/2022 MED EXP(Any oneperson) $5,000
PERSONAL&ADVINJURY $1,0009000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
POLICY X�jECT ❑LOC PRODUCTS-COMP/OP AGG s2,000,000
OTHER: E&O Liability $1,000,000
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000
(Ea accident)
B X ANY AUTO BODILY INJURY(Per person) $
OWNED SCHEDULED X X CAP1043565: 08/11/2020 08/11/2021 BODILY INJURY Per accident $
AUTOS AUTOS (: )
HIRED NON-OWNED,. PROPERTY DAMAGE $
X AUTOS ONLY X AUTOS ONLY
$
UMBRELLA LIAS OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE - AGGREGATE $
DED RETENTION S - $
WORKERS COMPENSATION PEROTH-
AND EOPLOYERS'LIABILITY
qTATIITF FR
ANY PROPRIETOMPARTNERIEXECUTIVE Y/N
OFFICER/MEMBER EXCLUDED? N/A See seperate Certificate E.L.EACH ACCIDENT $'
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
C NYS Disability 0251202, . 04/11/20 04/11/21 Statutory Limits
E Installation Floater/Property SML93076366 4115120 4!15/21 $300,000 $2,500 Ded
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 1019 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 11.971 - AUTHORIZED REPRESENTATIVE <NSZ>
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
"'W Workers"
YOM : CERTIFICATE OF
sYST� Cor>rapensat6�rn NYS WORKERS' COMPENSATION INSURANCE COVERAGE
i a Legal Name&•Address of'lnsured use,street address,only) 1 b.'Busine4f6lwhone Number of Insured;
Greenfogic LM 631;771-51'32
97 North Sea fid., S
:South Hantpton,NY 11968 1c..NYS'Unempigyment Insurance Employer Registration Numberof
..
inured:
T.
Wor{c Locatiori trf Insured(Onty required rycave av is 40;,'I si to: ujedera{Employer(dentifit tion Nurnt er of tnsijred or Social Seeairity
eertarri:Jo%atrOnsin iVeru.York;Sfaie,r e?,a Wrap-iJp PoGcyj r
203.8111194`
2;Name and Address of Ent►ty c sung,Proof of Coueiage 3a:Name;rtf Insurance CatiYer
Re ue .
(Entay Being Listed as the 0etificata Hotder)
United Unrsconsln.lnsurance Company
Town of Scuth4ld olicy ftffiber of F t�tyc l isteif m Box"1 a°
Budding[>eparfrrienf:
53095 Route 26 WC5¢9 UD1i�3 02 t Z'.
Southold,NY 11:977•
c Policy effect{ye perigri
12/011202-1 to 12/0/12022
"U.-,
Pro�rietor,Pbktners iv Fxecutrvs:bfficers are
Q.rn d {Onrychboxi>eupartnels/officers.inGudeti)
[] all`excluded:orxortampaitnerslo(fieers•ezcluded,
This certifies that;t#re insurance earner.indicated atigve trt.bo) 3" insures the business refe ohce4Above,n lox"'1a"for workers'
compensation under the New York State fttkers'Gompensabon Law,(To:.use this form,brew York.(NY}must be,listed under:ltem 3A
on the INFORMATION PAGE,of the workers:compensation rnsur ince policy,}; The.lnsurance Carrier-ortts licensed agent.will pend
this Cert ficate of1nsurabcs tb the<en#tt}I'Iis#ed abova as `ee,,' bficate hold- box"2"
The insurance carrier M.ust;notify,the above;certificaate.holder•nd the Workers'Codipensation.Board within'10 days:IF a poliey:is:canceled
due to nonpayment of,premt- - ..lthirt.30 days:IF thereare reason"s.other than.nonpayment of pretnitlms.thatcancel the policy or
eliminate the insured.frotn_the.coverage Indicated on this.Certficate;(These notices;:may be serrt by.;regular mats),O�erMse,,this
Certificate is valid far one year•firer#his#orm is approved by.:the insurance earner or ifs licensed.agertt,,or untrIt epollqy
eziratia!<a date Listed iq box"3c'; oft.s earl►ec
Tuts certificate:is:issued as,a:matter*of rnforrCtation;onlyandz6nfers no nght's upon;#he,cerbfieate holder This certificate tloes.not emend,.
extend.ar-alter ttre:noverage afforded py Lha pohcy:I sted,,nor does.it confer any rights or.responsibllities beyond'thwe,cP*Ubed in•the
refereneed policy:.
'flits certificate maybe.'used as evidence of a ltlfor".kers'Cgrnpensation contract of imurance.only whilethe:underiying policy-Js In,effect
Piease Note Upon cancellation.of the workers':comperr$ation:oolicy indicated:on this form,,lf the business continues.to be
named,on a permit,liceinse..or contriict issued by a certificate holder;.ft.,business must Pr
business holder with a
new Certificate of Workers`Cbtnpensation Coverage,or,,.othe[authorized proofthat the business is.aomptying with the
mandato[y coverage,requrr-Oi ri ;ofthe-,NewYork:State Woikers'.60, satiop Law..
Under penalty,of perjury;I certifyr that i am.anauthorrzed representative ar icensed agent;of the;nsurance carrier'referenced
above and:titat the named insured has the coverage as:depicted.ori.ttiisfocm. .
Approved bj s,.Alred[hdstiansen
(Rint name:of<autho�zedrepresentative or'l censed.agern'd insurance carrier);
Approved by
(Sigfiafrire�
(Dde)
Tr1;le:,Qireetor:of Sales Qperations.
Telephone Number of authorized'representatve or licensed agent:of insurance.carrier. 941-306-3077
Please Note-,Oniv,insurance carriers and their licensed agents_are authorized#o,issue Form C-10.5.2.Insurance broker's are.NOT
authorized to issue.it.
C-105.2(9-17) www.wcb.ny.gov
__( YEW
workers' CERTIFICATE OF INSURANCE COVERAGE
STATE Compensation
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
1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured
GREENLOGIC,LLC 631-941-4113
97:NORTH SEA ROAD,SUITE 3
SOUTHAMPTON,NY 11968
'1c.Federal'Employer Identification Number of Insured
Work Location of Insured(only required IF coverage Is spedBcarty limited to or Social Security Number
certain tocatbri in New York State,l e.,Wiap IIp Policy) . 203801194
2.Name and Address of Entity Requesting•Proof of Coverage 3a.Name of Insurance Carrier
(Entity Being Listed as the Certificate Holder) ShelterPoint Life Insurance Company
Town of Southold
53095 Route 25 3b.Policy Number of Entity Listed in Box"1a"
Southold,NY 11971 DBL251202
3c Policy effective.period -
04/11/2020 to 04/10/2022
4. Policy provides the following benefits:
® A.Both disability and paid family leave benefits.
B.Disability benefits only.
C.Paid family leave benefits only.
5. Policy covers:
® A.All of the employer's employees eligible.underlhe NYS Dlsabilityand_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 LeaveBenefits insurance•covereg6 as described above..
Date Signed 4/7/2021 B � Ur G
y
ISlgnature of insurance caMees authorized representative or NYS Ucensed 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 carrierthis certificate is COMPLETE.Mail it directly to the certificate holder.
If Box 4B,4C or 51B 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'Bo_ 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'.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 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.
DB-120.1 (10-17) IIQIIPIUII�ID2I0QI1IIIl1(100(0117)Il�l�
lr"4 KX
R
Suffolk County Executiv ie's Office of Con-
sumerAffairs
VETERANS MEMORIAL HIGHWAY HAUPPAUGE, NEWYORK 11788
DATE ISSUED: 5/25/2006
No. 40227-H
4{`ySUFFOLK COUNTY
Home improvement Contractor License
.. . .........
This is to certifv that
MARC-A CLEAN
doing business as . ............
GREEN LOGIC,LLC-
.havingfdrnish&d.the
waccordahe
e with;=O�subject wthe pro�isio
nsbf applicable laws,rules
and iegulationsof the C'0 Mis hereby licensed,to conduct business as a HOME
Su
Z
] Y0RO
iinlhe County, S
of
'rtiAdd • al gusinesses
NOT VALED WITHOUT:
1
9PARTMENTA L- SEA'L
ANDA CURRENT.
CONSWAER A!*AIRS'
ID CARD
Director
ZIP.
a
Suffolk County Executive's- 0ffice of Consumer Affairs
VETERANS MEMORIAL HIGHWAY * HAUPPAUGE, NEW YORK 11788
Y
DATE ISSUED: 12/10/2007 No. 43858-ME
SUFFOLK COUNT'
Master Electrician.License
This is to certify that ROBERT J SKYPALA '
doing business as G-REENLOGIC 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. C,
Additional Businesses
NOT VALID WITHOUT
DEPARTMENTAL SEAL
AND,N CURRENT
CONSUMER AFFAIRS '
' ISI CARD
r
Director ��
APPROVED AS NOTED OCCUPANCY O
DATE: as B.P.,# USE IS UNLAWFUL
FEBY. WITHOUT CERTIFICATE
NOTIFY BUILDING DEPARTMENT AT OF OCCUPANCY
765-1802 8 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST COMPLY WITH ALL CODES OF
BE COMPLETE FOR C.O. NEW YORK STATE & TOWN CODES
ALL CONSTRUCTION SHALL MEET THE AS REQUIR AND CONDITIONS OF
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR SO0THOLDTOWN ZBA
DESIGN OR CONSTRUCTION ERRORS. SOUTHOLD TOWN PLANNINBBOARD
SOUTHOLD TOWN TRUSTEES
N.Y.S.DEC
nom P'EQUIRED
RETAIN STORM WATER RUMOR
PURSUANT TO CHAPTER 236
OF THE TOWN CODE.
4
J A M E S J. S TOUT ARCHITECT & Assoc.
2 G REG . L ANE E AST NORTHP0RTN. Y. 831 - 8 58 9388
Letter of Certification E C E
DEC 0..3 2021
November 17,2021
BUILDING DEPT
TMAJIM OF SOUTHOLD
Sullivan Residence
255 Zena Road
Mattituck, NY 11.952
To Whom it may concern:
I,James J.Stout, registered architect NYS license number 021633 would like to
submit the following. I have inspected and analyzed the roof structure at the above-
mentioned address and have determined the structure and the panel attachment to
be adequate to support the new additional load imposed by the proposed solar panel
system and complies with the 140-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),the Long Island Unified
Solar Permit Initiative(LIUSPI)and the 2017 National Electric Code NFPA 7012017
National Electric Code, and the ASCE 7-16.
The existing 2"x 10"@ 16"o.c rafters will provide adequate support.
Thank you for your understanding in this matter.
James J.Stout
Architect
��RED gRcy
�5 �sro iT
9 a
NE`N
I
LOGIC !
Green Logic,LLC Approved
Sullivan,Carol
255 Zena Road
Mattituck,NY 11952
Surface#A:
j Total System Size:10.920kW
1 circuit of 9 on a 20A bleaker
i
I circuit of 9 on a 20A breaker
i 1 circuit of 8 on a 20A breaker
I
........................................... Azimuth:246°
Pitch:6°
Monitoring System:
SunPower
Panel/Array Specifications:
j / \ ` l \ / \ / \ \ % `• \ I i Panel:SPR-A420-G-AC
Racking:SunPower Invisimount j
Pune!:72.2"X 40.0"
Array:30'6"X 18'2 118" I
Surface:36'1"X 19'5"
Ma is#:Invisimount
Legend:
x x 26 SunPower 420W Panels
® SunPower Invisimount Rail
{0 40 Ecu-Fasten Fast Feet E
- ,.x.GJvu,las Fir Rafter 16"0.G_i
Al Notes:
— I Number of Roof Layers:1
Height above Roof Surface:4"
Materials Used:Eco-Fasten,SunPower
Added Roof load of PV System:2.54psf
Engineer/Architect Seal:
f✓� -
02163 yam¢
't
1 Drawn 6y:NIA Drawing# 1 of 5 !
Date:11,115l2U21 REV:A
Drawing Scale:3116"=1.0'
LOGIC:
Green Logic,LLC Approved
Sullivan,Carol
255 Zena Road
Mattituck,NY 11952
Surface#A:
Total System Size: 10.920k4N
I circuit of 9 on a 20A breaker
circuit of 9 on a 20A breaker
1 circuit of 8 on a 20A breaker
...... ...... ....... ...... ...... ...... ...... ...... ------ Azimuth:246'
...... ......9 1 T 11 Pitch:6'
Monitoring System:
Sun Power
Panel/Array Specifications:
Panel:SPR-A420-G-AC
Racking:SunPower Invisimcunt
Panel:72.2"X 40.0"
IN
Array:30'6'X 18'2 118'
Surface:36'1"X 19'5"
Magic#:Invisimount
Legend:
26 SunPower 420W Panels
L
V
SunPower Invisimount Rail
'K V
40 Eco-Fasten Fast Feet
2x-,O"Douglas Fir Rafter 16"O.C.1
f
Notes:
Number of Roof Layers:I
Height above Roof Surface:4"
Materials Used:Eco-Fasten,SunPower
I > I JK I Added Roof load of PV System:2.54psf
Engineer/Architect Seal:
-A
Drawn By:MA Drawing iF 2 of 5
Date:'11/1612021 REV:A
Drawing Scale: 116"= 1.0'
i
LOGI
Green Logic,LLC Approved
Sullivan,Carol
255 Zena Road
Mattituck,NY 11952
Surface#A:
Total Systent Size:10.920kW
1 c:oc:uil,of 9 on a 20A breake,
1 circuit of 9 on a 20A breaker
1 circuit of 6 on a 20A breaker
_.......................... Azimuth:246°
Pitch:6° Z
Monitoring System:
SunPower
1 Panel/Array Specifications:
Panel:SPR-A420-G-AC
Rackin SunPower EnvisimeLnt
_ - ; Panel:72.2"X 40.0"
Array:30'6"X 113 2
/ Surface:36'1"X 19'5"
Magic#:Invisimount
Legend:
2 26 SunPower 42OW Panels
® SunPower Invisimount Rail
7/ \\
7/ \\
40 Eco-Fasten Fast Feet
2x10"Douglas Fir Raftef 16"O.G.;
/ \ i Notes:
Number of Roof Layers:1
3 Height above Roof Surface:4"
Materials Used:Eco-Fasten,SunPower
Added Roof load of PV System:2.54psf
Engineer/Architect Seal:
L'
* ',> Ar
021633 yQe
i . •
i Drawn By:MA j Drawing#3 of 5
Date:11,1512021 1 REV:A
Drawing Scale:3116"=1.0'
- i
No Vent Pipes Will Be Covered By The Solar Array LOGIC``'
Legend: GreenLogic,LLC Approved
Sullivan.Carol
AR-Access Roof AP-Access pathway, 36" minimum width SVO—Setback at ridge 255 Zena Road
per R202 definitions per R324.6.1 as per R324.6.2.1 Mattituck,NY 11952
Total System Size:10 920kW
1 circuit of 9 on a 20A breaker
i 1 circuit of 9 on a 20A breaker
1 circuit of 8 on a 20A breaker
I Azimuth:246°
I
AP ; AP Monitoring System:
SunPower
1 I Panel/Array Specifications:
1------------------ ------------------------ -----i 1
Panel'8PR-A420-G-AC
I SVQ Racking:SunPower Invisimount
--—————————--———————— ——— SVO——————————————————————— Panel:72.2"X40.0„
❑ ❑ ❑ Magic#:Invisimount
Legend:
................................................................................................................. 26 SunPower42OW Panels
SunPower Invisimount Rail
Meter I • 40 Eco-Fasien Fast Feet
2x10"Douglas Fir Rafter 16"0.1.{
r ! Notes:__._.__-.__..__.
Number of Roof Layers:1
Height above Roof Surface:4"
Materials Used:Eco-Fasten,SunPower
❑ Added Roof load of PV System:2.54psf
XIX Engineer/Architect Seal:
26 SunPower
420W Panels * ;.
❑ 02163
I �rF Or -.41E411 I
j Drawn 6y:MA I Orawing#4 of!
Date:11/1612021 REV:A
Drawing Scale:3/32"=1.0'
I
LOGIC.
_ I
GreenLogic,LLC Approved
Sullivan,.Carol
255 Zana Road
10B MATERIAL LIST ; Mattituck,NY 11952
Total System Size:10.920kIN �.
4 circuit of 9 on a 20A breaker
1 circuit of 9 on a 20A breaker
I circuit of,-3 on a 20A breakwr i
Azimuth:246°
Material Listice.. Rail Material Listtgy. Monitoring System:
SunPower
Panel/Array Specifications:
Eco-Fester•"Fast Fee`°Base Nate 40 Panel;SFR-A420-G-AC j
Eco-Fasten"Fast Feet`Aluminum Block40 Racking:SunPower Invisimount
Panel:72.2"X 40.0" I
Eco-Fasten"Fast Feet"EPDM Flashing 40 Magic#:Invisimount
#14-136TPI Concealer Screw 80
Legend:
#14130"DPI Concealer Screw 240 26 SunPower 420W Panels
SunPower Invisimount Rail
it 40 Eco-Fasten Fast Feet
4
2xt0"IDouglas Fi:Ramer 16"O.C.1
___............
(Votes: i
Number of Roof Layers: 1
Height above Roof Surface:4"
Materials Used:Eco-Fasten,SunPower
Added Roof load of PV System:2.54psf
Engineer/Architect Seal:
I i
4 ^? QAR- i
Ar
S
0216"x-5 A0�
I Drawn By:MA j Drawing#5 of g
Date:11115!2021 ' REV:A
Drawing Scale:3132"=1.0'
�— -------------- NEW EQUI=PMENT— — ---------------a---- EXISTING SERVICE
PV—SA-1 A AC—COMBINER, -PANEL 120/240, 1 PH, 31N
AC—CMB-1
(�I • • • '._ _ _ _-__.-_. _ (PV LOADS-ONLY-).-11
200A
I
. • . A j :e
' 1 ,
,
: KWH
..............................
...... ............
PV—SA-2 8KR-1 A B C
AC—DSC-1 .
AC DISCONNECT
.l.
( � BKR 2FM FmMn
PV—SA-3 A
. . . s
' ,
MAIN
AN
{ FUSED• ,
I PV—SA-4 A J I j._ - I r
w M....r.: ,.. ...:. .
�FMI-
EGC
f
I \-TYPICAL IAV MODULE WITH N
INTEGRAL DC/AC INVERTER I J I l
EGC EGC
IIII I I
IJl ( I I
EXISTING AC PANdLEXISTJNG
GEC
------------------_— LLI1--=— _� _ L --1—__
GEC —_ ---�
F � 6 cu
10.920kW DC -®--
9.516kW AC
PROPOSED 3 LINE ELECTRICAL DIAGRAM
Sullivan, Carol
ce
_ 255 Zena Road- � - �- � ;.x.�r g . .:. . & _ R '
Mattituck, NY 11952. , I INITIAL SUBMITTAL TEI 6.0$,T"tF ANERGY
WITH APPLICATION
h eF�
Page 1 of 3 " "-Drawing iq6 a 9i 11JVD1
n an 3L' Revisi'on:
.1._. .0 Revised: 10/28/21
i
EQUIPMENT& COMPONENT SCHEDULE
TAG DESCRIPTION SPECIFICATION-
PV-SA-1 PV SUB-ARRAY A420-G-AC � , SUNPOVI/ER SPWR;-A4, 1-CIRCUIT OF 7-MODULES
PV-SA-2 PV SUB-ARRAY A420-G-AC j SUNPOWE SPWR=A4, 1-CIRCUIT OF 7-MODULES
11
PV-SA-3 PV SUB-ARRAY A420-6-AC SU.NPOWER SPWR-A4, 1-CIRCUIT OF 7-MODULES
PV-SA-4 PV SUB-ARRAY A420-G,-AC SUNPOWE SPWR;A4, 1-CIRCUIT OF 5-MODULES
ELECTRICAL LOAD SUMMARY
AC CIRCUITS
VOLTAGE MAX.AC
TAG POWER;,MAX VOLTAGE, NOMINAL
RANGE ; CURRENT
PV-SA-1 2940 WATTS 211-264 VAC 11.96 A AC 240 V,AC j
-PV-SA-2 2940.WATTS 211-264 VAC 1196 A AC 240 V,AC
PV-SA-3 2940 WATT5. 211-264 VAC 11.96 A AC` 240 V, AC
V=ssA=4 2106-W7TT : L233=264 VAC 8.53 A'AC 24.0 V, AC t
I
PROPOSED EQUIPMENT PECIFICATIONS
i REVI$IONS . I
Su(livan, Carol I
L
255 Zena Road N -
RGY
Mattituck, NY 11952
1.) INITIAL SUBMITTAL WITH APPLICATION IML.tMINATINA TH9 COST (1F.ENERGY
Page 2 of 3 Drawing No: Sullivan-3LD1 evisio'n: 1 Revised: 10/28/21
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 THWN-2 2"PVC-40 ' 4 / 6.
C THWN-2 2:' EMT 4 / .6
1.)CONDUCTOR TYPES AND SIZES TO BE ADJUSTED PORiEMP.ERATUR€,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-
QUFREMENTS.
4.) NOTE: GROUNDING ELECTRODE CONDUCTOR TO BE.#6 COPPER.
PROPOSED EQUIPMENT SPECIFICATIONS
REVISIONS
Sullivan, Carol G., EENLOGIC�
255 Zena Road 1RO
Mattituck, NY 11952E lMlr~t irlN�THS cosi 4f i�'N OGY
1.) INITIAL SUBMITTAL WITH APPMATIgN
Page 3 of 3 Drawing No: Sullivan-3LD1 Revision: 1 Revised: 10/28/21
S UN -POWEK
420-390 W Residential AC Module
SunPowerMaxeon'Technology
Built specifically for use with the SunPower Equinox`system,the only fully
integrate;solution designed,er gineerec,and warranted by ons n anufact rrer.
Highest Power Density Available.
Y
.•_ z:
TEI SunPower's new Maxeonl'Gen S cell is 65%larger than
prior generations,delivering the most powerful cell and
highest-efficiency module in residential solar.The result is
more power per square nletel"than any Commercially
n available solar.
171
_..•'I
/
E �.
LA.
larger
;a ent Ily D`-fferenf z R A
ndkBet a �
Highest Lifetime Energy and Savings.
Designed o deliver 60 more energy o�•e �5 years in
'o
r � . real world conditions IE�e partial shade,and high tempe5ratures 7
�� 's
Power Jl iaxeon Tec no o i= -"____ ` _------------------------ s
• � •+ 1� gi RNl�I? 07Tca 14011 ----- ---- -
`�7��1a: �5�1, �ist�l�tl�� l�a�i3"� �'a �. s ��N a ,30-11• _
720'5 • `V}D/to
730 c
- 15 1004c -more
" r e sr, / 8 ,_ lifetime
75 20 25
A", w`
�
Years of o eration P
Best Reliability. Best Warranty.
r ''� 'xa{" �^ �� With more than 2_i rrlllll�n modules deployed 3rOUi"?d
r Gx.F`N G r
v Faacto�rymqi ntegrated icrornve� r{ rt1)43#? the world,S; nPower technology is proven to last.ThaCs
pw
�. � � .-
•� ,tee,r}c�tier ni xr�le 9 t� r?cyii�le tub we stand bei ind our module and microinverterIF
o ,-
rT � Y
with the indus.ny s best 25-year Combined Power and
sigh tlra 7 p icr S nF^ner P.11�
Product Warranty,including the highest Power Warranty
l� in solar.
0.
A-Series:A420 A415 A410 I A400 A390 SUnPowerlReside ntial AC Module
®.
Inverter Model:SPWR-A4(Enphase IQ 7AS) @240 VAC
. . --
._..._._..---------- --'-- --...._....--- -----'--- ----... --........._._-.._-...........---'-----------------)
,_:,:,•..:.�::.,t.: .sari
3 5r:VP
(.`ax t_i;ritl:'1i. JS C. - :.c F Low r 349:J'.A
Max.C..ti!lt?ri!JO•:_Jt:C�Jsi t.iJfl'�!'iF tA,-
--__..._...-_.._-___
Max.!'fills C=f2�--'!-Li rrar;Cl': _,... ..
,r;.-r.,.l_ier?r 60 Hz
...............-...._._.......-- --._._.............._.....-„-....._.-._...__._.._-._... --'--.........-.....--' ............ - ---'-.-.....-------.-......-_............-----...._...-
L-KtL'(:,1=�;1 treGscr:'" :,,.,....., - ' !
�J.,..:.,.c 1.-5rs HZ
.�r:(,r rcvr.r::.11t. ufrent Cyr:,_, 5.8 A rr:is
e Class AC Poll. -
Ar...,.t 3ackfee..Currie nt. i 8 mA
..........
_..................
1.0
;:.
------------'--.... -..._._._.._....__...---.....__-._... --._.................- -.....__._..._..................
Power Factor(ac,:,..,,.:.ble) 0.7 lead./ 0.7 lag.
® �B ® • S
42c ;A:
A415-GAC A410-G-A A.400-G-:,C A390-G-AC I 25-year limited powerviarranty
_......._...------.....__._ _ _ Warranties
V` � las
Non1.Power (P^ort)`r'J 12t1 415 ' 410 400 =year limiter product warranty
i�ower Tol. +5<-045 UL_1 703
i certification 111-1741 i IEEE-1547
'Module Effidenev 225 22.3 22.0 21:$ . 2,,:9 UL 1 711 AC Module tType 2 fire fated)
11emp.Coef.(Power) o.291s;°C i and UL 62109-1 'IEC 02109-2
-- - �_- -Compliance - - -- ----- ---
Shade T 1. r crate i m ,lute le.-el me>:po4�r p�r re brag ECC Part 1 i ass G"
-- ---- - ;- ICES-0003C1ass.3
® Q o^ ® 4 CAN/CSA:C22.2 N0. 107.1-01
-- - _ CA 1121(UL 1711 SA)i
Oiler t�P letup. -40'F to 185°F(-40°C to+8� C� 1c1 „,.:,
...r__-_-- I t„ odes clvVar and Reactive Power., r Priority,
er ---- --- -- --...,- ---- ....._.Max.Ambient Temp. 122'F(50-C) UL Usied PV Rapid S^:utdc:.r?Equipment'
4Jirr:i 8?os F,9000 Pa,917 m2 bark
Max.Test Load' Enables installation in accordance with:
Snow:187 psf,9000 Pa,91? Wmz front
............ --..__._....._........._...._._.-_._. -.1.....-----...-................... . f EftsFc 6 ;
Design L Wind:62 psf,3000 Pa,30 kg/mz bath I' NEC 690.12 Rapid Shc tdoivir(insiti'c'and outside the array)
aac Snood:125 psl`.6000 Pa,611 11, rn'front !
i •NEC 590.15 AC Cernectors,690.3.;(+;-(E)(1)
11npact,Resistance i inch;(25 mm)diameter hail It 52 mph(73 m's)
--'- ------- - - - ;- -4^then used with InvisiMount r,eking and Invis Mound accessories
•. (UL 2703): -
I Solar Cells 56 P,lonpery,tallire lelaxeon den 5 Module grounc it?g and bonding through•:r?v'isiP.9ount
--- --�: i Class A fire rased
High-transmission'tempered. lass with' !
Front Glass When used with AC module Q Cables and ao essories(l_IL 6703 and
ant:-ref ectiwe coat;ng ! Ul 2238)6:
Environmental Rating Outdoor rated Rated for load break disconr;ect
i Frarre Class 7 black anodized(h glie'CA�ivtA Ming'; ! PID Test Potential-induced degradation free
----.....................-----......__...._...._._.
Weight 46.5 lbs(211.1 kg) --
Reconlrnended Max. --- --- -..
1•'k�du de Sri5cing
1 3 ir..(33 mm). j
1 SunPo'wer 415 611,22.3 h f f dent,compared to a Cervendon:al P 7nel on same-sized �i 72.2(1835)
arrays(260 VI 1G>5 ef=cient,approx.1.6 m'}.79>5 +ore e;rerg; ersvatt(based on
PVSyst pan files for avg.US dim:ceL 0.5,411 slower degracia0on rate Oordan,et.if,
"Robust P'?egraclat:on htethodclagyand Application.'PVSC 2018). _
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and 022.1.201 5 Rule 64.218 Rapid Shutdown of PdS}>tems:for,.:arid-rC condu-tars;
when installed according to manufacturer's instructions.
---------,'-Please re:.,d the safetyand instal:anon€nscructionsi rmore-information regarding load -- -- -- - ---- - - - - -- - -- - -- -- ---
ravings and mounzir:g configurtions.
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I End Clamp Black anodized aluminum alloy G063-TG i 110 g(3.88 oz) - -
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i Rail Black anodized aluminum alloy 6005-T6 ; 830 g!m(9 Oz/ft)
Rail Splice Aluminum alloy 6005-TS ` 830 glrn(9 ozlft) 25 year product warrant,
- j Warranties
Ground Lug 304 stainless 106.5 g/m(3.75 oz) I 5-year finish warrant
[ Assembly (A2-70 bolt;tin-plated copper lug)
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UL-1703 Listed 1 '
Certifications
Class A Fire Rated
Composition Shingle Rafter AttaEhmen" PA
Composition Shingle Roof Decl<ing At[, hment
Application i
• Curved and ElatTile Roof Attachment
Universal Interface for Other Roof Attachments j Refer to roof attachment hardware manufacturers documentation.
*Module frame that is compatible with the ImesiMount system require for hardware interoperability.
,0 20,5 SunPower Corporation. All Rights P,ese:wed.St1NPOWER he INPOWEER logo,and INVI.SINDt1INT are trademarks or registered
trademarks of Sunpower Corporation.Ali other trademarks are the pr perty of their respem evmers. sunpower.com
Specifications included in d-ris datashect are subject to change without�Otice. Document#509506 RevC
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Number of SUnPower AC modules 85 Temperature 22°F to+140°F(-30°C to+60°C)
supported per P1VS6 Humidity(maximum) 95%,non-condensing
-
- - Highspe�d_ir ter-ret c{essvla-accessibl¢--_
fniemet access _ _._ router or switch
Power • 00-240 VAC i L-N),9D or 60 Flz
• 208 VAC(L-L 11 3-phase),6^Hz
RS-485 Inverters and meters
channel etre,?n:�e-g arae nrrxiriCtion rr�ln
Integrated Metering • Two channels of consumption metering
---- --, -------....
---_._.__....------- ---.._.._
Weight 5.5 lbs(2.5 kg Ethernet 1 LAN(or optionalINAN)port
-.__—_Dimensions—.:-----1-1.8.x8.0-x .
42.in.-(30.5 x 20.5-x-10 8 cm)---
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Enclosure rating UL_SOE Type 3R
Vvl-Fl 802.11 blgJn 2.4 GHz and 5uFlz
Cellular LTE Cat7M1l3G UMTS
Zig82e IEEE 802.15.4 MAC,2.4GHz ISM.band
son= « « Data Storage 60 days
Customer site CT':O�'Iltor.US.SUn�OWer:cg qtr -- --- ..
Partner site, pvsmgmtussrqpowercom Upgrades AutomaticfirmvvareUpgrades
Browser Firefox,Safari,and Chrome
Mobile devices Rhone=,iPad',and Android*'
Customer app 1.Create account Mine at monjtor.US.;unpQwer.rom. «
2.on a mobile device,dol the Su Pover Monitoring `nVarranty 10-year Limited Warranty
app from Apple App Store,or Google Player"store,
3.Sign:in using account email and pass ord. Certifications UL dJL CE,UL 61101&1 and-2,FCC Parc 15(Class B)
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