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HomeMy WebLinkAbout1000-45.-2-8 SUNKEEPER K11- CONSULTANTS -CONSULTANTS E S "A' I T E F J Ho 0 L F Um" I ON O"N 03 Z i ITE 'PROJECT: CCC CCC 4444 L F&J HOLDINGS ESS SITE 1 865 RTE.28,GREENPORT NY 11944 3 CLIENT: SUMMIT RIDGE ENERGY 100 CHURCH STREET,STE.800,NEW YORK -- - ' NY 10007 KEY PLAN PROJECT NARRATIVE SHEET LIST ` -- ---- -- -- -- _ ' THIS DRAWING SHALL NOT BE USED FOR - GENERAL INFORMATION TO ADJACENT CONTAINERS OR i. AT'SECURITY FENCE WILL SURROUND THE DRAWING NO. TITLE j CONSTRUCTION UNLESS APROFESSIONAL STRUCTURES, ESS,THE FENCE WILL HAVE MULTIPLE 12' 1 T-100 TITLE SHEET SEAL AND SIGNATURE HAVE BEEN APPLIED. 1. PROJECT CONSISTS OF A CONTAINERIZED 3, THE SITE WILL BE EQUIPPED WITH A FIRE ACCESS GATES WHICH WILL BE 4 _= AREA OF WORK ENERGY STORAGE SYSTEM(ESS).THE ALARM SYSTEM.THE FIRE ALARM WILL BE KEY-LOCKED FOR SECURITY.UPON - A-ip0 SITE PLAN - ' PLANNED SYSTEM SIZE IS 4290 KVA 114,825 MONITORED BY A CENTRAL STATION,IN REQUEST BY THE AHJ A KNOX BOX OR --. KWH.THIS SIZE MAY DECREASE PENDING ADDITION TO 2417 MONITORING OF THE EBS OTHER MEANS OF EMERGENCY i A-701 SITE DETAIL 3 ' REVIEW 0Y PSEG•LI,OUT WILLNOT CONTROL SYSTEM BY TME RESPONDER ACCESS WILL 8E PROVIDED. ? - - -- INCREASE.ESS WILL BE MANUFACTURED MANUFACTURER. 2. A V EGRESS PATH WILL BE MAINTAINED - 855 RTE 25 BY TESLA. 4. EACH CONTAINER IS EQUIPPED WITH AROUND THE ESS CONTAINERS,AND - 2. THE SYSTEM WILL CONSIST OF(5)EBS DEFLAGRATION VENTING,SIZED AND BETWEEN THE PERIMETER FENCE AND ALL j - .- CABINETS,WHICH CONTAIN BATTERY DESIGNED BASED ON UL9540A FIRE TEST ESS EQUIPMENT. - RACKS,DC BUS CONNECTIONS,POWERDATA. 3. POLE-MOUNTED SITE LIGHTING WILL BE CONVERSION SYSTEM,THERMAL 6, EMERGENCY POWER OFF(EPO)SWITCHES PROVIDEDTO ILLUMINATE ALL EQUIPMENT MANAGEMENT SYSTEM,AND CONTROLS, WILL BE MOUNTED NEAR THE SITE GATES AT NIGHT. _[ 3. THE SYSTEM IS STANDALONE(NOT PAIRED AND WILL OPEN ALL DC CONTACTORS IN 4. OTHER AUXILIARY EQUIPMENT INCLUDES ( _ WITH ANY OTHER GENERATION)AND WILL EACH CONTAINER,AS WELL AS TRIPPING CONTAINER-MOUNTED HVAC SYSTEMS, 1 BE INTERCONNECTED TO PSEG-LI.THE ALL AC BREAKERS.THIS WILL SHUT DOWN CONTAINER INTERIOR LIGHTING,AND 0 I.07-27-2020. ISSUED FOR REVIEW 685 RTE 25 SYSTEM WILL IMPORT AND EXPORT POWER INVERTERS,AND SHUT OFF AC POWER TO UNINTERRUPTIBLE POWER SUPPLIES(UPS) SITE INFORMATION I PERIODICALLY THROUGHOUT THE DAY AND ALL ELECTRICAL EQUIPMENT ON THE FOR THE CONTROL AND SAFETY 1 TAX MAp M,10pp - REV DATE DESCRIPTION WILL BE COMPENSATED BY PSEG-LI CUSTOMER SIDE OF THE POINT OF EQUIPMENT. 2. SECTION:;1 DRAWING: f�}- ff ? THROUGH THE VALUE STACK TARIFF. COMMON COUPLING WITH THE UTILITY, ! 3. BLOCK,2 i ' I `£F' - BATTERY INFORMATION ELECTRICAL EQUIPMENT 4. LOT;e £- s. ZONING:LB LIMITED BUSINESS : TITLE SHEET 1 BATTERY MODULES ARE MANUFACTURED f ELECTRICAL EQUIPMENT WILL CONSIST OF BY TESLA. PADMOUNTED MEDIUM VOLTAGE 1 r= _ 2. BATTERY MODULE CHEMISTRY IS LITHIUM TRANSFORMERS,MEDIUM-VOLTAGE _ - i/ _ ION. SWITCHGEAR.AND ALOW VOLTAGE 1 - SCALE NTS WHEN PRINTED ON 11X17 ' h - AUXILIARY SWITCHBOARD. FIRE PROTECTIONS SAFTEY 2. ALL EQUIPMENT IS PADMOUNTED AND WILL 1 SEALBS)GNAY*- PROJECT NUMBER SKS20120 NOT SE HOUSED INSIDE OF ANY G �.._ 1- ESS CONTAINERS ARE OF STRUCTURE. 1 :DRAWN 8Y: Me I_ s NONCOMBUSTIBLE(STEEL] 3. THE SYSTEM WILL BE CONNECTED TO T - CONSTRUCTION. PSEG-LIS RADIAL OVERHEAD SYSTEM VIA ,r * CHECKED BY: I 2. THE SYSTEM HAS UNDERGONE ULS54GA DEDICATED SERVICE AND WILL INCLUDE A } FIRE TESTING,TEST DATA IS AVAILABLE POLE-MOUNTED MEDIUM•VOLTAGE - { _ CHECK CODE: UPON REQUEST AND DEMONSTRATES DISCONNECT SWITCH. I )L - I DRAWING NO. THAT FIRES ORIGINATING WITHIN AN EBS I = 1 CONTAINER REMAIN CONTAINED WITHIN SITE AAUXFLIARY EQUIPMENT - THE CONTAINER AND DO NOT PROPAGATE a '-"` ?SHEET t OF 3 - -ir /i -. - / i - � -. F �0�/M SUNKEEPER E , + rrNY CONSULTANTS =r' V, 72'-2' 72'-2' f } J/ -' 1 ESS SYSTEM AT$85 RTE 25 214'- ' TO BE FILED UNDER SEPARATE PROJECT: _-- ---- APPLICATION,SHOWN HERE r r FOR CLARITY ONLY r 508'-4" r 855RTE.25 F&J HOLDINGS ESS r SITE 1 855 RTE.25,OREENPORT NY 11944 r' 3 - --. ---... CLIENT: O \\ SUMMIT RIDGE i UNDERGROUND CONDUITS T' € ENERGY i WIRING TO FRONT f- 100 CHURCH STREET,STE.8DQ NEW YORK OF PROPERTY r NEW PSEG-LI POLE(S) NY 10007 AND POLE-MOUNTED i DISCONNECT SWITCH - --.. ----. (EXACT LOCATION 1 - PENDING PSEG-LI _ THIS DRAWING SHALL NOT BE USED FOR - PROPERTY - - j LINE BOX . REVIEW} �. CONSTRUCTION UNLESS A PROFESSIONAL r SEAL AND SIGNATURE HAVE BEEN APPLIED. # 347-8" / ( - r r�-u..TO IL - - j 585 RTE.25- ff 6^" CUSTOMER POCC STATE WETLAND I _ 9 Y WETLAND CHECK ZONE 007-27-2020 ISSUEDFOR REVIEW A REV .ATE DESCRIPTION t \>` ZONING LOT DRAWING: BOUNDARY SITE PLAN ,l ®EXISTING STRUCTURES SCALE=11128"=P-0` WHEN PRINTED ON 17X17 �k Il S 8`S GNATURE PROJECT NUMBER:SK82D120 DRAWN BY: MB --. CHECKEDBY: - CHECK CODE: x } DRAWING NO. -100.00 _SHEET 2 OF 3 SUNKEEPER S L A R CONSULTANTS sr-r 2 i BESS SWITCHGEAR 227'-2' PROJECT. F&J HOLDINGS ESS BESS TRANSFORMERS ITYR OF SITE I 866 RTE.25,GREENPORT NY 11944 PULL BOX FOR CLIENT: UNDERGROUND WRING SUMMIT RIDGE EBB SYSTEM AT 585 RTE 25 ENERGY To i BE FILED UNDER SEPARATE BESS EQUIPMENT APPLICATION SHOWN HERE 100 CHURCH STREET, i NY 1 STE BGS NEW YORK FOR 'CLARITY ONLY 0007 THIS DRAWING SHALL NOBE USED FOR CONSTRUCTION UNLESS AT PROFESSIONAL BEAL AND SIGNATURE HAVE SEEN APPLIED. PROPOSED 7'FENCE i 84'-9' ENCLOSING BESS EQUIPMENT PROPOSED IZ ACCESS GATE M OF 0 07-27-MO ISSUED FOR REVIEW I T CAL 4) i PULL BOX FOR REV DATE DESCRIPTION UNDERGROUNDDRAWING: WIRING EASEMENT CROSSING TO BE COORDINATED WITH PSEGJJ AND SKALL FOLLOW ALL (5 PSEEC–U REQUIREMENTS SITE DETAIL SCALE IW=V-0" WHEN PRINTED ON I 1XV SEAL PROJECT NUMBER SKS20120 DRAWN BY: ME CHECKED BY: — CHECK CODE: 3 DRAWING NO.TUONFRONT ROGFUPNRDOWPIERRINTGY A-101.00 SHEET 3 OF 3 SUNKEEPER A S@L R /r aRml-YN NY lil2m 94 'CONSULTANTS - ­NTIT I IT _V =tz— Y­_ zz= nv= —7- PROJECT: F&J HOLDINGS ESS SITE I ----------- 855 RTE.25,GREENPORT NY/}94a 3 My CLIENT: nm, 7EI SUMMIT RIDGE ENERGY 100 CHURCH STREET,STE,800,NEW YORK NY 10007 THIS DRAWING SMALL NOT BE USED FOR CONSTRUCTION UNLESS A PROFESSIONAL SEAL AND SIGNATURE HAVE BEEN AFI`UtU. OVERALL SYSTEM SIZE 4290 KVA 14825 KWH ESS SCHEDULE INVERTER SCHEDULE SEE SHEET E-301 FOR WIRE SCHEDULE i UNIT SESSA,2,3.45 i MANUFACTURER TESLA .......... MFG TESLA ����11A,INTEGRAL TO 11�169i EBB DO WIRING IS UNGROUNDED.EBB CONTROL RACKS INCLUDE INSULATION MONITORING.ON DETECTION OF A GROUND FAULT IN DO WIRING,CONTROL MtN MErAPACK 4-HR RATED POWER 858 KVA RACKS WILL OPEN BATTERY RACK DO CONTACTORS AND GENERATE AN 12 MAX.REAL P NUMBER OF POWERSTAGE DINER(LIMITED BY ALARM DC POWER) 741.2 KW RATED POWER 7M.2 KW 1988 KVA RATED AC VOLTAGE 480V 24 WYE ALL PHASE VOLTAGES AND CURRENTS ARE BALANCEDRATED ENERGY 2965 KWH 1 07-27 2020 ISSUED FOR REVIEW FREQUENCY 60 HZ REV DATE DESCRIPTION MODULE MFG I -302 FOR RELAY FUNCTIONAL DIAGRAMS TESLA SEE SHEET E RATEDACCURRENT 1032A 5 MODULE CHEMISTRY i i DRAWING: LITHIUM[ON HARMONIC DISTORTION(THD) .3% SINGLE LINE CONTAINER DIM 23'9 X 5'-3"X 8'4° PEAK 1746A CONTAINER WEIGHT(EA.) i 56,000 LBS SHORT CIRCUIT CONTRIBUTION TRANSIENT rK-1235A DIAGRAM STEADY STATE 1,=1236A -4 AVAILABLE BUT NOT ENABLED 'SCALE NTS WHEN PRINTED ON 1IX17 VOLT-VAR P-0 CONTROL BY DEFAULT, POWER FACTOR SETPOINT "GO* SEAL&SldNAJURE�, PROJECT NUMBER:SKS20120 DRAWN BY: ME RAMP RATE USER SETTABLE UNCONSTRAINED BY DEFAULT' CHECKED BY; — AVAILABLE BUT NOT ENABLED 'ICHECKCOOE: — FREQUENCY DROOP CONTROL BY DEFAULT' w' UL LISTING 1741 SA DRAWING NO 'UL 17415A FUNCTIONALITY.NOT ENABLED BY DEFAULT AND NOT PLANNED TO BE USED FOR PROJECT,BUT AVAILABLE IF INTERCONNECTION. i " - I - - DEMONSTRATED TO BE NECESSARY FOR 300-00 .SHEET I OF 3 x G SUNKEEPER : S I L A CONSULTANTS i 3 � 2 f r,�'F^s�I may' t-{t € u �J' t1 y =PROJECT: F&J HOLDINGS ESS SITE 1 # _ {+ '� € } 855 RTE.25,OREENPORT NY 14&44 3 CLIENT: $T SUMMIT RIDGE ENERGY Ijnea h- 100 CHURCH STREET,STE.500,NEW YORK 1 � ' NY 10007 _ a THIS DRAWING SHALL NOT BE USED FOR CONSTRUCTION UNLESS A PROFESSIONAL F� - I _ SEAL AND SIGNATURE HAVE BEEN APPLIED. .p 173 r }7 CONDUIT&CONDUCTOR SCHEDULE N TAG CONOUIT, CONDUCTORS IN EACH CONDUCTOR MATERIAL CONDUIT SIZE AND MATERIAL2020' CONDUIT 0 -07 2T ISSUED FOR REVIEW ' PER TAG i 1 16KV RATED.133%EPR,COPPER `4-RPVC,CONCRETE ENCASED - f-. - REV i DATE DESCRIPTION A i 3+«410 AWG&t-#2 DEC FULL SIZE CONCENTRIC NEUTRAL i IN TRENCH - 4-3N AWG&#2 EGC XHHWIXHHW-2 COPPER 3'RPVC(BURIED) ( DRAWING: THREE LINE DIAGRAM G 4 4.500 MOM&imto EGC XHHWIXHHW-2 COPPER a RPVC(BURIED) D 1 4-012 d#12 EGC THHWITHWN-2 COPPER 3/4'RMC k t----.--- I SCALE=NTS WHEN PRINTED ON 71X17 E 1 2-012&#1ZEGC THHW7THWN-2 COPPER 314*RMC SEALS SIGNATURE iPROJECT NUMBER:9KS20120 #12M SHIELDED&#12 -- - - I I DRAWN BY: Me F 9 THHWITHWN-2 COPPER 3t4'RMC ' I EGC _ � vm)`i�. ,CHECKED 8Y: - -. CHECK CODE; 4-q SHIELDED&#12 (t - G ' 1 EGC THHWffHWN-2 COPPER � t'ftMG -�- I ---. ` € t I ! _DRAWING N0. NOTES; .. 1.MV CABLE SHALL MEET UTILITY SPECIFICATIONS.ALL MV CABLE AND CABLE TERMINATION SPECS TO BE APPROVED BY —UTILITY PRIOR TO INTERCONNECTION. 1 2.PROVIDE 90'C RATED CABLE AND TERMINATIONS FOR TRANSFORMER SECONDARY CABLE CONNECTIONS TO - TRANSFORMERS AND MEGAPACK AC SUSBARS, _ SHEET 2 OF 3 SUNKEEPER 1 $ L E (CONSULTANTS 't va_wsiu w.wr �a aa.+Rrarosr� r�.+m Rxuv�ru � RELAY SETTINGS SCHWEfT7PR SE1351 v�T�E -�;ca�.r.a, rxw - Rni i 2 ; v_"_____e_" PROJECT: Y — aG F&J MOLDINGS ESS o„ m ..------------ -------------- . SITE 1 855 RTE.25,GREENPORT NY 11844 I } 3 ,MAIN Pf OTEGTIV RELAY FURICTIONAL DIAGRAKA CLIENT: 4 E-3D2'WT.S SUMMIT RIDGE ENERGY 100 CHURCH STREET,STE.800,NEW YORK NY 10007 THIS DRAWING SHALL NOT BE USED FOR CONSTRUCTION UNLESS A PROFESSIONAL SEAL AND SIGNATURE HAVE BEEN APPLIED. RELAY SETTINGS suers» i SCHWEITZER SEL 501 I - if 0 +07-27-2020= ISSUED FOR REVIEW 3 i REV DATEDESCRIPTION i a •� anm _ m_=_J 'DRAWING: _ ____F___ RELAY FUNCTIONAL DIAGRAM €SCALE=NTS WHEN PRINTED ON 11%17 SEAL 5 SIGNATURE.,- _PROJECT NUMBER:SKS20120 'DRAWN BY: MB 3 1' iCHECKED BY; CHECK CODE: ---- 3 DRAWING NO. z 1SECON DARY UVERCURRENT RELAY FUNCTIt NAL DIAGRAM `�E-3G2 N.T.S E-302.00 t -''€# SHEET 3 OF 3 1 AUG 2 G 2020 FORM NO. 3 �,it g Scrod NOTICE OF DISAPPROVAL DATE:August 20,2020 TO: F&J Land Holding LLC 855 Route 25 Greenport NY 11944 Please take notice that your application dated August 11,2020 For permit to instk Lla b tierStora Y energy system at Location of property: .R aLgt�25,,Grccn c� J County Tax Map No. 1000—Section 45 Block-2. Lot 8 Is returned herewith and disapproved on the following grounds: "1w prc, asjt use isnw�t ems,,nitt cl,p wm tawltwtq licle 11I11 Sec .041,.A..:�"1?prr���tte�_C�se�.x, battery storgpLenergyAystem is not a,per pitted it in the LB zonae. I W@ v r gn is rantedk the S utholdwT crena Iowa pg Board of p eat�plan approv� l frown the Southold Town I?lannin ward will e g uire �........... ffiorized Signature Note to Applicant:Any change or deviation to the above referenced application may require further review by the Southold Town Building Department. CC: file,Z.B.A.,planning - I °' FOR INTERNAL USE ONLN SITE PLAtV USE TERMINATION ...Nanning �..�Boar��� ..._...�...,' rct al 1 tarn'tlnat,o,, Date _...�...�._.. �~ Project-Name: Project Address: � J Zoning Dist�€�ct;�.. -,� County Map No.:1'000=�'�---�- Suffolk .�Tax Requesf: ° documentation as to d (Note: Copy of BuildinghP should be submitted.) r I allcation ansupporting proposed use or uses Initial Determination as to whether use is permitted: -m1t, ------------------ Initial Determination as to whether site plan is required ..�.�....._��;�-- ...-�, -�-. .�... ,..:tor .. ....... Signature.. �._.,w _- Signature o' Buil Ing artment (P.D..) Deferral: Planning Dep . Date Received: -� Iq Date of COmment:� = -- P. go ornments: - rp Signature of Plannin ept. Staff Reviewer Fir at D t rr� hlaorr Date: �nPctor eir.nafitre, of Ruiklin❑ In TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Hcalth 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 Single&Separate Truss identification Form Storm-Water Assessment Form Contact: Approved 20 Mail to: Disapproved ate Phone: Ex iration .20 Building Inspector J AUG 1 1 2620 _ APPLICATION FOR BUILDING PERMIT Date 7/27 20 2Q Tf; BUILDINGDEM INSTRUCTIONS a.This application MIDST 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 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. (Signa re of applicant or name,if a corporation) 639 M rlborough Rd. Brooklyn NY 11230 (Mailing address of applicant) State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder Agent for lessee Name of owner of premises F&J LAND HOLDING LLC (As on the tax roll or latest deed) If applicant is a corporation,signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: 855 Route 25 Greenport House Number Street Hamlet County Tax Map No. 1000 Section '45 Block 2 Lot 8 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 COMMERCIAL/VACANT STORAGE b. Intended use and occupancy ADDITION OF NEW ENERGY STORAGE SYSTEM CONNECTED TO PSEG-LI DISTRIBUTION SYSTEM 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other WOIkINSTALLATION OF BATTERY STORAGE EQUIP. (Description) 4. Estimated Cost $7,414,000 Fee $50 (To be paid on filing this appplication) 5. If dwelling,number of dwelling units N/A Number of dwelling units on each floor N/A If garage,number of cars N/A 6. If business,commercial or mixed occupancy,specify nature and extent of each type of use. SEE ABOVE 7. Dimensions of existing structures,if any:Front 627 Rear 62'9" Depth 73'10" Height 15' Number of Stories 1 Dimensions of same structure with alterations or additions: Front 62'9" Rear 62'9" Depth 73'10" Height 15' Number of Stories 1 8. Dimensions of entire new construction:Front Rear Depth Height Number of Stories 9. Size of lot:Front 347' Rear 294' Depth 506' 10.Date of Purchase 4@412008 Name of Former Owner SCHOENSTEIN,FRED ROBERT 11.Zone or use district in which premises are situated LB 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 X NO_ 14.Names of Owner of premises F&d Landhotdin9 LLC Address 855 RTE,25,GREENPORT Phone No. (914)819-8291 Name of Architect Address Phone No Name of Contractor Address Phone No. 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 NO_X *IF YES,D.E.C.PERMITS MAY BE REQUIRED. 16.Provide survey,to scale,with accurate foundation plan and distances to property lines. 17.If elevation at any point on property is at 10 feet or below,must provide topographical data on survey. 18.Are there any covenants and restrictions with respect to this property?*YES X NO *IF YES,PROVIDE A COPY. PSEG-LI EASEMENT IS KNOWN TO EXIST BASED ON PREVIOUS SURVEY,SEE ATTACHED SITE PLAN STATE OF NEW YORK) SS: COUNTY OF n"1,-H fl_-_R( S being duly swom,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the AGENT (Contractor,Agent,Corporate Officer,etc.) of said owner or owners,and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief;and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this 7'4- day of 20 3'O Regina J.Brooks lies•York otary Public No.0IBR6310577 Kinds County Signature of Applicant Commission Expires 09.25 2022