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�o�p CpG � Town of Southold 8/17/2023 P.O.Box 1179 o _ 53095 Main Rd y�ol �a°�tfis Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 44459 Date: 8/17/2023 THIS CERTIFIES that the building SOLAR PANEL Location of Property: 25 Mechanic St, Southold SCTM#: 473889 Sec/Block/Lot: 61.4-31 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 3/10/2023 pursuant to which Building Permit No. 49067 dated 3/29/2023 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 Nieuwenhuis,Kenneth&Vera of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 49067 4/18/2023 PLUMBERS CERTIFICATION DATED uth riz S nature , �SUFFo c TOWN OF SOUTHOLD Gy BUILDING DEPARTMENT C* x TOWN CLERK'S OFFICE "oy • o� fi 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#: 49067 Date: 3/29/2023 Permission is hereby granted to: Nieuwenhuis, Kenneth 771A Union St Brooklyn, NY 11215 To: install roof-mounted solar panels to existing single-family dwelling as applied for. At premises located at: 25 Mechanic St, Southold SCTM #473889 Sec/Block/Lot# 61.4-31 Pursuant to application dated 3/14/2023 and approved by the Building Inspector. To expire on 9/27/2024. Fees: SOLAR PANELS $50.00 ELECTRIC $100.00 CO-ALTERATION TO DWELLING $50.00 Total: $200.00 Building Inspector pf SOUI�,oI 0 Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 �Q sean.devlinl D-town.southold.ny.us Southold,NY 11971-0959 Q�ycOUNTV,�� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Kenneth Nieuwenhuis Address: 25 Mechanic St city:Southold st: NY zip: 11971 Building Permit#: 49067 Section: 61 Block: 4 Lot: 31 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: Electrician: Long Island Power Solutions License No: 36178ME SITE DETAILS Office Use Only Residential X Indoor X Basement Service X Commerical Outdoor X 1st Floor Solar X New X Renovation 2nd Floor Hot Tub Addition Survey X Attic 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 100A A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors Sub Panel A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO Transfer Switch UC Lights Dryer Recpt Emergency StrobeHeat Detectors Disconnect Switches 4'LED Exit Fixtures Sump Pump Other Equipment: 100A Panel 20 Circuit/28 Used, 3.95kW Roof Mounted PV Solar Energy System w/ (10) REC395AA Pure Modules, Load Center, AC Disconnect Notes: Service Upgreade & Solar Inspector Signature: Date: April 18, 2023 S.Devlin-Cert Electrical Compliance Form O��OF SOUIyO O/n 2-5 M& AAA C * TO N OF SOUTHOLD BUILDING DEPT. Couto, 631-765-1802 INSPECTION [ ] FOUNDATION IST [ ] 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 [ ] RENTAL REMARKS: DATE INSPECTOR qqorqjf 50UlyO� TOWN OF SOUTHOLD BUILDING DEPT. cou631.765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ YNSULATIOWCAULKING [ ] FRAMING /STRAPPING [ ] FINAL�p4✓ [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: DATE Y INSPECTOR lo4 LfQo �7 Michael E. Miele, PE <5 Licensed Professional Engineer Licensed In New York, New Jersey, Connecticut& California J/ New York License#079676 j New Jersey License#44042 JUL 2 0 2023 Connecticut License#23158 California License#31508 11U1LDING]DEPT. June 14, 2023 Town of Southold Building Department The Office of the Building Inspector 54375 NY-25 Southold, NY 11971 Re: Kenneth Nieuwenhuis—25 Mechanic Street, Southold, NY 11971 Single Family Residence, Solar Panel Installation Certification Town of Southold, County of Suffolk, State of New York Dear Building Department, I have reviewed the solar energy system installation at the subject address. The system has been installed in accordance with the manufacturer's installation instructions and the approved construction drawing. I have determined that the installation meets all building code requirements and is certified as for all code and approved plans for the Town of Islip. I completed my final inspection on June 7, 2023 and I can hereby certify that the installation complies with the 2020 New York Stare Residential Building Code and all applicable codes and design loads as referenced on the approved plans, including ASCE 7-16 (Minimum Design Loads and Associated Criteria for Buildings and Other Structures). If you have any questions, please feel free to call me at any time. Thanks, in advance. Sincerely Yours, pF NEO/ M X'Q- eoW l"y M r \ ( m Michael E. Miele, PE m cu (� exipi_•oy V �o 079616 33 Quaker Ave. PO Box 530, Cornwall, NY 12518 ♦ Phone 845.629.9693 ♦ NYPSengineer@gmail.com FIELD INSPECTION REPORT DATE COMMENTS b FOUNDATION(1ST) ® " l -------------------------------------- FOUNDATION (2ND) No V1 H ROUGH FRAMING& \ ' y PLUMBING S � n � C r INSULATION PER N.Y. y STATE ENERGY CODE ^ C> , S v FINAL ADDITIONAL COMMENTS -- 10 b H O z x r� x e b H d��s¢FFn TOWN OF SOUTHOLD—BUILDING DEPARTMENT yoo Gy=� Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 oy • Vfj Telephone(631) 765-1802 Fax(631) 765-9502 https://www.southoldtonm.jzov Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only PERMIT NO. 4`�M-7 Building Inspector:_j MAR 1 0 2023 LD Applications and forms must be filled out in their entirety.Incomplete 8WW"FMG DEPT applications will not be accepted. Where the Applicant is not the owner,an TOWN OFS007H LD Owner's Authorization form(Page 2)shall be completed. Date:03/09/2023 OWNER(S)OF PROPERTY: Name:Kenneth & Vera Nieuwenhuis SCTM#1000-61.-4-31 Physical Address:25 Mechanic Street, Southold NY 11971 Phone#:732-259-8486 Email:ken.nieuwenhuis@gmaii.com Mailing Address:25 Mechanic Street, Southold NY 11971 CONTACT PERSON: Name:Permit Dept./Long Island Power Solutions Mailing Address:2060 Ocean Ave., Ronkonkoma, NY 11779 Phone#:631-348-0001 Email:Permits@longislandpowersolutions.com DESIGN PROFESSIONAL INFORMATION: Name:Michael E. Miele, PE Mailing Address:33 Quaker Avenue.- PO Box 530 Cornwall, NY 12518 Phone#:732-259-8486 Email: MikeMielePE@gmail.com CONTRACTOR INFORMATION: Name:Michael Catizone/Long Island Power Solutions Mailing Address:2060 Ocean Ave., Ronkonkoma, NY 11779 Phone#:631-348-0001 Email:mike@longislandpowersolutions.com DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition RAlteration ❑Repair ❑Demolition Estimated Cost of Project: N Other Proposed( 10 )panel roof mounted array. ( 3,950 )kW System $21,830.32 Will the lot be re-graded? ❑Yes RNo Will excess fill be removed from premises? ❑Yes 9 N 1 a J PROPERTY INFORMATION Existing use of property:Single Family Dwelling x _ -- _Intended use of property:Sle Family.Dwelli,-n9 -- ------ ----- ---- 9 ------ - ----- -- -_--_ ----- ------ _in-g------- Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yes ®No IF YES, PROVIDE A COPY. 8 Check Box After Reading: The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by Chapter 236 of the Town Code. 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,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(s)for necessary inspections.False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the New York State Penal Law. Catizone Electrical/Long Island Power Solutions Application Submitted By(print n e): BAUth riz d Agent ❑Owner Signature of Applicant. � - Date:C ^2015 STATE OF NEW YORK) SS: COUNTY OF Suffolk ) Michael Catizone 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 day of uniz l }-- Notary Public PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) I, Winne-�h �u�.l����nht��� residing at���I�I�Ct(1►L ���-�'� �,-�'�1'�c���1 N Michael Catizone/Long Island Power Solutions do hereby authorize to apply on my behalf to th of S u Id Building Department for approval as described herein. Ow is Signature Date Print Owner's Name 2 i S.o�OS�f�p1,�cOG^y BUILDING DEPARTMENT-Electrical Inspector TOWN OF SOUTHOLD Town Hall Annex - 54375 Main Road - PO Box 1179 ' N0* 4� $ Southold, New York 11971-0959 � � Telephone (631) 765-1802 - FAX (631) 765-9502 �.-: Wit"` roQerr(a7southoldtownny�ov seandOsoutholdtownny.gov _ - - - -:- APPLICATION FOR ELECTRICAL INSPECTION'. ELECTRICIAN INFORMATION (All Information Required) Date: 03/09/2023 Company Name: Catizone Electrical/Long Island Power Solutions Name:Michael Catizone License No.: 36178-ME email: sue@longislandpowersolutions.com Address: 2060 Ocean Avenue,Ronkonkoma,NY 11779 Phone No.: 631-348-0001 JOB SITE INFORMATION (All Information Required) Name: Kenneth Nieuwenhuis Address:25 Mechanic Street, Southold, NY 11971 Cross Street: Mechanic Street East Phone No.: 732-259-8486 _ -- Bldg.Permit#: email: ken.nieuwenhuis mail.com Tax Map District: - 1000 Section,, 61Block_ 4- _— Lot: 31 BRIEF DESCRIPTION OF WORK (Please Print Clearly) Proposed( 10 )panel roof mounted array. ( 3,950 )kW System Circle All That Apply: Is job ready for inspection?: YES / NO Rough In Final Do you need a Temp Certificate?: YES / NO Issued On Temp Information: (All information required) Service Size 1 Ph 3 Ph Size: --A #Meters -. Old Meter# _ New Service - Fire Reconnect- Flood Reconnect-Service Reconnected- Underground -Overhead # Underground Laterals 1 2 H Frame Pole Work done on Service? Y N Additional Information:, Modules : 10 REC 395AA PURE Inverter: (10) Enphase IQ8PLUS_-72-2-US Support: Iron Ridge XR100 -PAYMENT-DUE-WITH-APPLICATION Request for Inspection FormAs Firefox about:blank �pR ® BUILDING DEPARTMENT-Electrical Inspector 7®,4� f S y TOWN OF SOUTHOLD o Town Hall Annex-54375 Main Road - PO Box 1179 o Southold, New York 11971-0959 y Off' Telephone (631) 765-1802- FAX (631) 765-9502 rogerr@southoldtownny.nov-seand@southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: 4/13/23 Company Name: Long Island Power Solutions Electrician's Name: Mike Catizone License No.: 36178-ME Elec.email: mike o owersolutions.com Elec. Phone No: ®I request an email copy of Certificate of Compliance Elec. Address.: 2060 Ocean Ave Ronkonkoma NY 11779 JOB SITE INFORMATION (All Information Required) Name: Address: —25MechanocSt, Southold, NY 11971 Cross Street: Phone No.:—732-259-8486 BIdg.Permit#: 49067 email:ken.nieuwenhuis mail.com Tax Map District: 1000 Section: 61 Block: 4 Lot: 31 BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): 100 amp service panel change Square Footage: Circle All That Apply: Is job ready for inspection?: a YES❑NO ❑Rough In R Final 4/18/23 Do you need a Temp Certificate?: FX] YES❑NO Issued On Temp Information: (All information required) Service SizeFX-11 Ph❑3 Ph Size: 100 A #!Meters Old Meter# ❑New Service❑Fire Reconnect❑Flood Reconnect[:]Service Reconnect❑Underground❑Overhead #Underground Laterals D 1 FJ2 R H Frame R Pole Work done on Service? RY RN Additional Information: PAYMENT DUE WITH APPLICATION S� o 1 of 1 4/13/2023,9:34 AM Firefox about:blank Via! BUILDING DEPARTMENT-Electrical Inspector TOWN OF SOUTHOLD 0 v Town Hall Annex - 54375 Main Road - PO Box 1179 `n ^ Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 rogerr©southoldtownny.gov - seandQsoutholdtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: 4/13/23 Company Name: Long Island Power Solutions Electrician's Name: Mike Catizone ` License No.: 36178-ME Elec. email: mike@qopowersolutions.com Elec. Phone No: 631-348-0001 ®I request an email copy of Certificate of Compliance Elec. Address.: 2060 Ocean Ave Ronkonkoma NY 11779 JOB SITE INFORMATION (All Information Required) Name: Kenneth Neemenbuis Address: 25MechanocSt Southold, NY 11971 Cross Street: Phone No.: 732-259-8486 Bldg.Permit#: 49067 email:ken.nieuwenhuis mail.com Tax Map District: 1000 Section: 61 Block: 4 Lot: 31 BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): 100 amp service panel change Square Footage: Circle All That Apply: Is job ready for inspection?: YES❑NO F—]RoughIn Final 4/18/23 Do you need a Temp Certificate?: YES❑NO Issued On Temp Information: (All information required) Service Sized Ph F Ph Size: 100 A. #Meters Old-Meter# ❑New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground❑Overhead # Underground Laterals 1 2 H Frame Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION �1' r 2,V p �ofQ _ �e- Ck- n ne ok 1 of 1 4/13/2023,9:34 AM � � 2f� 2� �I �, REFERENCE: N/F ROTHMAN SURVEY OF PROPERTY KNOWN AS DISTRICT 1000, SECTION 061, BLOCK 4, LOT 31 AT OUTHO N73'10'007- SUFFOLK COUNTY, NYS DAT DLD, JANUARY 17, 1977, BY RODERICK VAN TUYL, P.C., LICENSED LAND 60.40 SURVEYORS, GREENPORT, N.Y. 0 U DISTRICT 1000 N/F HOFFNER 00 SECTION 061 oco 0x BLOCK 4 m LOT 31 o N W N AREA=7,438 S.F.t 0 a.w 0 a l ` 9't 1 STY � ENCL 3 = LORCH 0m N ,N 0 '� 0 (p �1' a 2 STORY N I fz FRAME & BRICK ;n 3 N oa DWELLING ^ �, NO. 25 (� 16'f V W r� MONUMENT MO 19' E. 60.39' 1.71' N. S76'25'30 V MECHANIC STREET 49.5' WIDE R.O.W. THE NIEUWENHUIS RESIDENCE 0 10 20 40 25 MECHANIC STREET SCALE.' 1 "-20' SOUTHOLD SUFFOLK COUNTY, N.Y. t Suffolk County Dept.of Labor,Licensing&Consumer Affairs ti HOME IMPROVEMENT LICENSE Name MICHAEL J CATIZONE Business Name This certifies that the xareris duly licensed LONG ISLAND POWER SOLUTIONS INC ay the County of suBolk License Number:1-1-53562 Rosalie Drago- IssueiJ: 06/06/2014 f Commissioner Expires: 06/01/2024 Suffolk County Dept_;of tab,--Licensing&Consumer-Affairs VRSTEFt ELECTRICAL.LICENSE js .1 Name MICHAEL-CAT1ZOht-, .13usrnes s Naitie Tn;scer-.ifir,,.,hattte L tSL11e.DP�V:cRSOlUTIONSih:, geararisduly Gcensec D/ire Ccunlp hf suyolP. .- { License Nurnbor:dvlE,5*3'60 Rosatlo Prago 195usd; .0610612014` 'Cemrr•ssiQr.Fr, Exptses'' O6iG1t2(12�U , NEW KR workers' CERTIFICATE OF INSURANCE COVERAGE Compensation Board NYS DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW PART 1.To be completed by NYS disability and Paid Family Leave benefits carrier or licensed insurance agent of that carrier 1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured CATIZONE ELECTRICAL CONTRACTING, INC. 2060 OCEAN AVE 631-348-0001 RONKONKOMA, NY 11779 Work Location of Insured(Only required if coverage is specifically limited to 1c.Federal Employer Identification Number of Insured certain locations in New York State,i.e.,Wrap-Up Policy) or Social Security Number 45-5213112 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Standard Security Life Insurance Company of New York TOWN OF SOUTHOLD Y P Y 53095 ROUTE 25 3b.Policy Number of Entity Listed in Box 1a SOUTHOLD, NY 11971 R97483-000 3c.Policy Effective Period 1/1/2015 to 11/9/2023 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: ❑X A.All of the employer's employees eligible under the NYS Disability and Paid Family Leave Benefits Law. ❑ B.Only the following class or classes of employer's employees: Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has NYS disability and/or Paid Family Leave benefits insurance coverage as des c' d above. Date Signed 11/10/2022 By (Signature of insurance carrier's authoriled representative or NYS licensed insurance agent ofthat insurance carrier) Telephone Number (212) 355-4141 Name and Title SUPERVISOR-DBL/POLICY SERVICES IMPORTANT:lf Boxes 4A and 5A are checked,and this form is signed by the insurance carrier's authorized representative or NYS Licensed Insurance Agent of that carrier,this certificate is COMPLETE. Mail it directly to the certificate holder. If Box 4B,4C or 5B is checked,this certificate is NOT COMPLETE for purposes of Section 220, Subd.8 of the NYS Disability and Paid Family Leave Benefits Law. It must be emailed to PAU@wcb.ny.gov or it can be mailed for completion to the Workers'Compensation Board, Plans Acceptance Unit, PO Box 5200, Binghamton, NY 13902-5200. PART 2.To be completed by the NYS Workers'Compensation Board(Only if Box 4B,4C or 5B 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(Article 9 of the Workers'Compensation Law)with respect to all of their 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 (12-21) IIIIIP1°�ii1i2i0�i1iiiiii1eia21)°�I� r Additional Instructions for Form D13-120.1 By signing this form, the insurance carrier identified in Box 3 on this form is certifying that it is insuring the business referenced in Box 1a for disability and/or Paid Family Leave benefits under the NYS Disability and Paid Family Leave Benefits Law. The insurance carrier or its licensed agent will send this Certificate of Insurance Coverage(Certificate)to the entity listed as the certificate holder in Box 2. The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is cancelled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from coverage indicated on this Certificate. (These notices may be sent by regular mail.)Otherwise, this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent, or until the policy expiration date listed in Box 3c, whichever is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This Certificate may be used as evidence of a NYS disability and/or Paid Family Leave benefits contract of insurance only while the underlying policy is in effect. Please Note: Upon the cancellation of the disability and/or Paid Family Leave benefits policy indicated on this form, if the business continues to be named on a permit, license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Insurance Coverage for NYS disability and/ or Paid Family Leave Benefits or other authorized proof that the business is complying with the mandatory coverage requirements of the NYS Disability and Paid Family Leave Benefits Law. NYS DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW §220. Subd. 8 (a) The head of a state or municipal department, board, commission or office authorized or required by law to issue any permit for or in connection with any work involving the employment of employees in employment as defined in this article, and not withstanding any general or special statute requiring or authorizing the issue of such permits, shall not issue such permit unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair,that the payment of disability benefits and after January first,two thousand and twenty-one,the payment of family leave benefits for all employees has been secured as provided by this article. Nothing herein, however, shall be construed as creating any liability on the part of such state or municipal department, board, commission or office to pay any disability benefits to any such employee if so employed. (b)The head of a state or municipal department, board, commission or office authorized or required by law to enter into any contract for or in connection with any work involving the employment of employees in employment as defined in this article and notwithstanding any general or special statute requiring or authorizing any such contract, shall not enter into any such contract unless proof duly subscribed by an insurance carrier is produced in a form,satisfactory to the chair,that the payment of disability benefits and after January first,two thousand eighteen,the payment of family leave benefits for all employees has been secured as provided by this article. DB-120.1 (12-21)Reverse 1 Workers' v"o K: CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured Catizone Electrical Contracting Inc. 631348-0001 2060 Ocean Avenue - Ronkonkoma, NY 11779 1c.NYS Unemployment Insurance Employer Registration Number of Insured Work Location of Insured(Only required if coverage is specifically limited to certain locations in New York State,i.e.,a Wrap-Up Policy) 1d.Federal Employer Identification Number of Insured or Social Security Number 202241963 2.Name and Address of Entity Requesting Proof of Coverage(Entity 3a.Name of Insurance Carrier Being Listed as the Certificate Holder) Utica Mutual Insurance Company 3b.Policy Number of Entity Listed in Box 1 a" Town Southold 4766763 3095 Route 25 3c.Policy effective period Southold,NY 11971 07/01/2022 to 07/01/2023 3d.The Proprietor,Partners or Executive Officers are 0 Included.(Only check box if all partners/officers included) 0 all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box"1 a"for workers' compensation under the New York State Workers'Compensation Law. (To use this form,New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy).The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2". The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.) Otherwise,this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent,or until the policy expiration date listed in box"3c",whichever is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note: Upon cancellation of the workers'compensation policy indicated on this form,if the business continues to be named on a permit,license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers'Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Leonard Scioscia (Print name of authorized representativeorlicensed agent of insurance carrier) Approved by: 6/24/22 (Signature) (Date) Title: Authorized Representative Telephone Number of authorized representative or licensed agent of insurance carrier: 631-390-9700 Please Note:Only insurance carriers and their licensed agents are authorized to issue Form C-105.2.Insurance brokers are NOT authorized to issue it. C-105.2(9-17) www.wcb.ny.gov Workers' Compensation Law Section 57. Restriction on issue of permits and the entering into contracts unless compensation is secured. 1. The head of a state or municipal department, board, commission or office authorized or required by law to issue any permit for or in connection with any work involving the employment of employees in a hazardous employment defined by this chapter, and notwithstanding any general or special statute requiring or authorizing the issue of such permits, shall not issue such permit unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair, that compensation for all employees has been secured as provided by this chapter. Nothing herein, however, shall be construed as creating any liability on the part of such state or municipal department,board,commission or office to pay any compensation to any such employee if so employed. 2. The head of a state or municipal department, board, commission or office authorized or required by law to enter into any contract for or in connection with any work involving the employment of employees in a hazardous employment defined by this chapter, notwithstanding any general or special statute requiring or authorizing any such contract, shall not enter into any such contract unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair, that compensation for all employees has been secured as provided by this chapter. C-105.2(9-17) REVERSE Client#:83176 CATIELE /2712 ACORD,. CERTIFICATE OF LIABILITY INSURANCE D6 /DD/YYYIf) /27�2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAMEAcr Commercial Support Edgewood Partners Ins.Center PHONE 40 Marcus Drive E-M(AIAILo Ext): A/C No 3rd Floor ADDRESS: NECertificates@epicbrokers.com Melville,NY 11747-2647 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Utica Mutual Insurance Company 25976 INSURED INSURER B: Catizone Electrical Inc 2060 Ocean Avenue INSURER C: Ronkonkoma,NY 11779 INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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. LTR TYPE OF INSURANCE NSRADDL WVD POLICY NUMBER MM/DDY EFF MM/LDIDY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY X CPP4784747 7/01/2022 07/01/2023 pEJAICMHp�OECTCURgqRENCE $1,000,000 CLAIMS-MADE 51OCCUR PREMISES Ea Deco ranee $100,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $2,000,000 X POLICY JECOT �LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION 4766763 7/01/2022 07/01/2023 X IsPTFARJOTH. AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $500,000 OFFICERIMEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500 OOO If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Town of Southold is included as additional insured for general liability coverage as required by written contract. 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 53095 Route 25 ACCORDANCE WITH THE POLICY PROVISIONS. Southold,NY 11971 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S4115391/M4115046 KOS01 Y 'workers' CERTIFICATE OF INSURANCE COVERAGE STATE Consation 'BoardmpeNYS DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW PART 1.To be completed by NYS disability and Paid Family Leave benefits carrier or licensed insurance agent of that carrier 1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured LONG ISLAND POWER SOLUTIONS INC 2RA NEW YORK 0 0 OCEAN AVE OWER SOLUTIONS 2060 6313480001 RONKONKOMA,NY 11779 Work Location of Insured(Only required if coverage is specifically limited to 1 c.Federal Employer Identification Number of Insured certain locations in New York State,i.e.,Wrap-Up Policy) or Social Security Number 27-1175107 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Standard Security Life Insurance Company of New York TOWN OF SOUTHOLD Y P Y 53095 ROUTE 25 3b.Policy Number of Entity Listed in Box 1a SOUTHOLD, NY 11971 R97411-000 3c.Policy Effective Period 1/1/2015 to 7/19/2023 4. Policy provides the following benefits: 0 A.Both disability and Paid Family Leave benefits. ❑ B.Disability benefits only. F1 C.Paid Family Leave benefits only. 5. Policy covers: © A.All of the employer's employees eligible under the NYS Disability and Paid Family Leave Benefits Law. B.Only the following class or classes of employer's employees: Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has NYS disability and/or Paid Family Leave benefits insurance coverage as desc' d above. 44Te?;t Date Signed 7/20/2022 By (Signature of insurance carrier's authori d representative or NYS licensed insurance agent of that insurance carrier) Telephone Number (212) 355-4141 Name and Title SUPERVISOR-DBL/POLICY SERVICES IMPORTANT:lf Boxes 4A and 5A are checked, and this form is signed by the insurance carrier's authorized representative or NYS Licensed Insurance Agent of that carrier,this certificate is COMPLETE. Mail it directly to the certificate holder. If Box 4B,4C or 5B is checked,this certificate is NOT COMPLETE for purposes of Section 220, Subd.8 of the NYS Disability and Paid Family Leave Benefits Law. It must be emailed to PAU@wcb.ny.gov or it can be mailed for completion to the Workers'Compensation Board, Plans Acceptance Unit, PO Box 5200, Binghamton, NY 13902-5200. PART 2.To be completed by the NYS Workers'Compensation Board(only if sox 4B,4C or 5B 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(Article 9 of the Workers'Compensation Law)with respect to all of their 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 Foran DB-120.1. Insurance brokers are NOT authorized to issue this form. DB-120.1 (12-21) 11111111i�uiiiuiiiui�iiiiiiiiiivuiH°��1Jill Additional Instructions for Form 1313-120.1 By signing this form,the insurance carrier identified in Box 3 on this form is certifying that it is insuring the business referenced in Box 1 a for disability and/or Paid Family Leave benefits under the NYS Disability and Paid Family Leave Benefits Law. The insurance carrier or its licensed agent will send this Certificate of Insurance Coverage(Certificate)to the entity listed as the certificate holder in Box 2. The insurance carrier must notify the above certificate holder and the Workers' Compensation Board within 10 days IF a policy is cancelled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from coverage indicated on this Certificate. (These notices may be sent by regular mail.) Otherwise, this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent, or until the policy expiration date listed in Box 3c,whichever is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This Certificate may be used as evidence of a NYS disability and/or Paid Family Leave benefits contract of insurance only while the underlying policy is in effect. Please Note: Upon the cancellation of the disability and/or Paid Family Leave benefits policy indicated on this form, if the business continues to be named on a permit, license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Insurance Coverage for NYS disability and/ or Paid Family Leave Benefits or other authorized proof that the business is complying with the mandatory coverage requirements of the NYS Disability and Paid Family Leave Benefits Law. NYS DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW §220. Subd. 8 (a) The head of a state or municipal department, board, commission or office authorized or required by law to issue any permit for or in connection with any work involving the employment of employees in employment as defined in this article, and not withstanding any general or special statute requiring or authorizing the issue of such permits, shall not issue such permit unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair,that the payment of disability benefits and after January first, two thousand and twenty-one, the payment of family leave benefits for all employees has been secured as provided by this article. Nothing herein, however, shall be construed as creating any liability on the part of such state or municipal department, board, commission or office to pay any disability benefits to any such employee if so employed. (b)The head of a state or municipal department, board, commission or office authorized or required by law to enter into any contract for or in connection with any work involving the employment of employees in employment as defined in this article and notwithstanding any general or special statute requiring or authorizing any such contract, shall not enter into any such contract unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair,that the payment of disability benefits and after January first,two thousand eighteen, the payment of family leave benefits for all employees has been secured as provided by this article. D13-120.1 (12-21)Reverse Client#:83393 LONGISL15 ACORD,. CERTIFICATE OF LIABILITY INSURANCEDATE(MWDD/YYY`) 2/22/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Commercial Support Edgewood Partners Ins.Center PHONE 631-390-9700 FAX 631-390-9790 40 Marcus Drive E-MAIL Ext): ac,Ne ADDRESS: NECertificates@epicbrokers.com 3rd Floor INSURER(S)AFFORDING COVERAGE NAIC# Melville,NY 11747-2647 INSURER A:Southwest Marine&General Ins Co 12294 INSURED INSURER B: Long Island Power Solutions,Inc dba New INSURER C York Power Solutions; Michael Catizone INSURER D: 2060 Ocean Avenue INSURER E: Ronkonkoma,NY 11779 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD MM/DD A X COMMERCIAL GENERAL LIABILITY PK202200020693 2/28/2023 02/28/2024 EACH OCCURRENCE s21000,000 CLAIMS-MADE a OCCUR PREMISES ERENTED rrnce $100,000 X PD Ded:5,000 MED EXP(Any one person) $10,000 X Contractual Liab. PERSONAL BADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 PRO- POLICY FX�ECT F LOC PRODUCTS-COMP/OP AGG $4,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I RETENTION$ $ WORKERS COMPENSATIONPER OTH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Town of Southold is included as additional insured for general liability coverage as required by written contract. 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 53095 Route 25 ACCORDANCE WITH THE POLICY PROVISIONS. Southold,NY 11971 AUTHORIZED REPRESENTATIVE @ 1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S5283287/M5282808 CPRAV NYS 1 F PO Box 66699,Albany,NY 12206 New York State Insurance Fund I nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE AAAAAA 271175107 LOVELL SAFETY MGMT CO.,LLC 110 WILLIAM STREET 12TH FLR NEW YORK NY 10038 ❑■ . SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER LONG ISLAND POWER SOLUTIONS INC TOWN OF SOUTHOLD 2060 OCEAN AVENUE 53095 ROUTE 25 RONKONKOMA NY 11779 SOUTHOLD NY 11971 POLICY NUMBER I CERTIFICATE NUMBER POLICY PERIOD DATE Z 2467 078-8 539135 04/01/2022 TO 04/01/2023 03/08/2022 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2467 078-8, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK,EXCEPT AS INDICATED BELOW. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY, INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE, VISIT OUR WEBSITE AT HTTPS://WWW.NYSIF.COM/CERT/ CERTVAL.ASP. THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. PRESIDENT MICHAEL CATIZONE VICE PRESIDENT JOSEPH MILILLO TWO OF TWO OFFICERS LONG ISLAND POWER SOLUTIONS INC _ THE POLICY INCLUDES A WAIVER OF SUBROGATION ENDORSEMENT UNDER WHICH NYSIF AGREES TO WAIVE ITS RIGHT OF SUBROGATION TO BRING AN ACTION AGAINST THE CERTIFICATE HOLDER TO RECOVER AMOUNTS WE PAID IN WORKERS'COMPENSATION AND/OR MEDICAL BENEFITS TO OR ON BEHALF OF AN EMPLOYEE OF OUR INSURED IN THE EVENT THAT, PRIOR TO THE DATE OF THE ACCIDENT, THE CERTIFICATE HOLDER HAS ENTERED INTO A WRITTEN CONTRACT WITH OUR INSURED THAT REQUIRES THAT SUCH RIGHT OF SUBROGATION BE WAIVED. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUND �l2 DIRECTOR,I SURANCE FUND UNDERWRITING VALIDATION NUMBER: 396794370 I1110M00000000000®02®0 561IN111 Form WC-CERT-NOPRINT Version 3(08/29/2019)[WC Policy-24670788] U-26.3 198 [00000000000102106564][0001-000024670788][##Z][15840-36][CertNOPLERT 1][01-00001] N Y S I F PO Box 66699,Albany,NY 12206 New York State Insurance Fund I nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE AAAAAA 271175107 m Q LOVELL SAFETY MGMT CO.,LLC 110 WILLIAM STREET 12TH FLR _ NEW YORK NY 10038 01 Y 1 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER LONG ISLAND POWER SOLUTIONS INC TOWN OF SOUTHOLD 2060 OCEAN AVENUE 53095 ROUTE 25 RONKONKOMA NY 11779 SOUTHOLD NY 11971 POLICY NUMBER I CERTIFICATE NUMBER POLICY PERIOD DATE Z 2467 078-8 870486 04/01/2023 TO 04/01/2024 03/06/2023 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2467 078-8, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK,EXCEPT AS INDICATED BELOW. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY, INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE, VISIT OUR WEBSITE AT HTTPS://WWW.NYSIF.COM/CERT/ CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. PRESIDENT MICHAEL CATIZONE VICE PRESIDENT JOSEPH MILILLO TWO OF TWO OFFICERS LONG ISLAND POWER SOLUTIONS INC _ THE POLICY INCLUDES A WAIVER OF SUBROGATION ENDORSEMENT UNDER WHICH NYSIF AGREES TO WAIVE ITS RIGHT OF SUBROGATION TO BRING AN ACTION AGAINST THE CERTIFICATE HOLDER TO RECOVER AMOUNTS WE PAID IN WORKERS'COMPENSATION AND/OR MEDICAL BENEFITS TO OR ON BEHALF OF AN EMPLOYEE OF OUR INSURED IN THE EVENT THAT, PRIOR TO THE DATE OF THE ACCIDENT, THE CERTIFICATE HOLDER HAS ENTERED INTO A WRITTEN CONTRACT WITH OUR INSURED THAT REQUIRES THAT SUCH RIGHT OF SUBROGATION BE WAIVED. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUND DIRECTOR,kURANCE FUND UNDERWRITING VALIDATION NUMBER: 530864363 I�11�00000000000®®BYIO®®T1 711111 Form WC-CERT-NOPRINf Version 3(08/29/2019)[WC Policy-24670788] U-26.3 288 [00000000000113053317][0001-000024670788][SSZ][I6088-30][CertNoP-CERT 1][01-00001] LONG ISLAND 0WE R 2060 Ocean Ave Ronkonkoma, NY 11779 4 FScOLUTIONS 631348-0001 www.longislandpowersolutions.com TOWN OF SOUTHOLD—Building Division C� I II iV/ Town Hall Annex Building 54375 Route 25 MAR 0 2023 P.O. Box 1179 Southold,NY 11971 Tuvvi � FsotjERT Ui1i�OFSOU THOLE) Dear Building Dept: As per your Building Department, enclosed please find the building permit application, submitted on behalf of our client/property owner: Property Owner: Kenneth Niuwenhuis—732-259-8486 Project/Property Address: 25 Mechanic Street, Southold NY 11971 Section/Block/Lot: 1000-61-4-31 Electrician/36178-ME: Michael Catizone—2060 Ocean Ave.,Ronkonkoma,NY 11779—(631)348-0001 Contractor/53562-H: LI Power Solutions—2060 Ocean Ave.,Ronkonkoma,NY 11779—(631)348-0001 Architecture&Planning: Michael E.Miele,PE—705 Orrs Mills Rd,New Windsor,NY 12553—845-629-9693 Enclosed Please find: • Application Fee: $200.00 • Permit Application • (4) Copies of the Property Survey • (4) Copies of the Engineering Drawings & Specs • Liability, Disability & Workman's Comp Insurance Certs Please send the Receipt and Permit to Long Island Power Solutions. Should you require anything further, please contact me. Sincerely, Escaylin Rivera Permit Manager Long Island Power Solutions 2060 Ocean Avenue Ronkonkoma,NY 11779 Ph- 631-348-0001 Fx- 631-348-0018 Permits@Gopowersolutions.com Go Green Save Green LONG ISLAND VscOWER 2060 Ocean Ave Ronkonkoma, NY 11779 631 348-0001 www.longislandpowersolutions.com OWNER AUTHORIZATION This affidavit certifies that Long Island Power Solutions has been granted permission to sign for and obtain permit(s) on behalf of the property owner(s). I, (Xl� l N1e�x a�P_�1k1��1 , Owner of the property located at: O c Yyrn-1; _5isi2 - �_:: ,c Irl N Street Town State Zip Tax Map ID L�- 1 Do hereby give: Long Island Power Solutions permission to sign all applications and to have the permit(s) sent directly to: Long Island Power Solutions 2060 Ocean Avenue Ronkonkoma,NY 11779 Attn: Permit Dept. rnAr)(A lU n��` (Property Owner)_4"ntVame (Propertcaner) Signature Sworn To Before Me This Day Of , 20 (NOTARY PUBLIC SIGNATURE) 11 ESCAYLIN CRISOL RIVERA RODRIGUEZ NOTARY PUBLIC-STATE OF NEW YORK I No. 01R16434031 Qaslified in Suffolk County My Commission Expires 05-31-2026 Notary Stamp Go Green Save Green l • �V- APPR VED AS NOTED DATEa'1 x B.P.# FEE:.v� U BY: NOTIFY BUILDING DEPARTMENT AT 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: ELECTRICAL 1. FOUNDATION - TWO REQUIRED INSPECTION REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FO : C.O. ALL CONSTRUCTir',-N SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF Tn MLVN pl 6tiIR%BOARD n,T'.�ff�RUSTFES OCCUPANCY OR 'JSE IS UNLAWFUL .'WITHOUT CERTIFICAT =:)F OCCUPANCY *Michael E. Miele, PE Licensed Professional Engineer Licensed In New York, New Jersey, Connecticut& California New York License#079676 New Jersey License#44042 Connecticut License#23158 California License#31508 March 2, 2023 Town of Southold Building Department The Office of the Building Inspector 54375 NY-25 Southold, NY 11971 Re:_ Kenneth Nieuwenhuis—25 Mechanic Street,Southold, NY 11971 Single Family Residence,Solar Panel Loading Certification Town of Oyster Bay,County of Suffolk,State of New York Dear Building Department I am the engineer of record for the above referenced project. I have prepared the attached plans dated November 7,2022 that consists of the installation of(10) REC395AA PURE solar panels at the above referenced location. I can hereby certify that the existing roof structure combined with the additional weight of the solar panels meets the requirements of The 2020 Residential Code of New York State, Publication Date, November 2019. The design loads were as follows, Roof Design Load: 20psf live load Wind Design Load: 140mph No additional structural members were-required. The roofs are currently framed with 2x6 true dimensional wood framing @ 16"O.C.The roof structural members are in compliance with ASCE 7-16 for deflection and acceptable bending stress. If you have any questions, please feel free to call me at any time.Thanks in advance. Sincerely Yours, .��OF NQIr EDWARD ®� _`S Michael E. Miele, PE W 079676 < 33 Quaker Avenue, PO BOX 530,Cornwall, NY 12518 ♦ Phone:845.629.9693♦ NYPSengineer@gmail.com UDOWER PHOTOVOLTAICS: \ISOLLUTIONS (10)REC395AA PURE 2060 OCEAN AVENUE, NEMA3R RO NKKONK631)�OMA NY 11779 JUNCTION BOX INVERTERS: 8-0601 BLACK-L1 ENGAGE CABLE (10)ENPHASE IQ8PLUS-72-2-US NIEUWENHUIS RED-L2 GREEN-GROUND CIRCUITS: RESIDENCE (1)CIRCUIT OF(10)MODULES 25 MECHANIC STREET SOU HOLD,NY 11971 732-259-8486 S:61 B:4 L:31 PROJECT DATA:0228367 INVERTER.(10)ENPHASE IO6PLUS•72-2-US MODULES:(10)REC395AA PURE 12 AWr.TKVYN FORRUNS UNDER 100' RACKING:IRON RIDGE XR100 /10 AWG THVVN FOR HOME RUNS OVER 100' WATTAGE,3,950 (1)UNE1 PROOF TYPE:COMPOSITION SHINGLES (1)UNE 2 DISCONNECT WIND LOAD.-64.6PSF®130MPH (1)GROUND METER FASTENER 5116'DIA SSS LAGS PER CIRCUIT O IN 1'OR1}'PVC CONDUIT oil WATf:DACIXnP>!I'CIR<iENT 12.1 A Itfl6p 04FAMACVOLTAGE 240 y PHOTOVOLTAIC MICHAEL E.MIELE,PE MAIN SOLAR SYSTEMun,wa Profwlend 6nalnw 33 QUAKER AVE.-PO Box 530 AC DISCONNECT I CORNWALL' NY 12518 I{ TELEPHONE(W)029.9693 EYAR:M WIMMEOpna— NEW MAIN SERVICE 125A LOAD CENTER 100A ----- - ------- - -----.--- 20A BACKFED BREAKER (1)-20A BREAKER PER CIRCUIT DISCONNECT INVERTER OUTPUT CONNECTION I fi4 DO NOT RELOCATE THIS •12 AWG THm OVERCURRENTDEVICE p�uNEt 1 UNE2 ALTPRNIDN aP]W9pOM1ffiiI® BYA (1)NEUTRAL AC DISTRIBUTION PANEL (1J EGC Puex sm tr.trUnm $ IN t'PYC CONOUR OR SUB PANEL DATE: 11172022 Y DESIGN BY: MW .� CHECKED BY; EE REVISIONS: 3 AC COMBINER: NOTE: 2020RESDEMNLLCODE OFNEWYORKSTATE,202OEN WCONSERVA71ONCODE OFNEWYORKSTATE, 1-PHASE,MAIN LUG LOAD CENTER,125A ALL WIRING TO MEET THE 2017 NEC AND 2020 ENERGY CODE TOWN OFSOUTHOLDCODE,2017NATMMEUSCIRICCODEASCE7d6. ELECTRICAL PLAN E■1 v 60A FUSED SERVICE RATED DISCONNECT AERIAL OWER R ' SOLUTIONS t ' %�e 2060 OCEAN AVENUE, a RONKONKOMA, NY 11779 (631)348-0001 R-1 ` # MODULES (8) . , NIEUWENHUIS PITCH: 11 ° p- RESIDENCE AZIMUTH: 2440 �� 25 MECHANIC STREET SOUTHOLD, NY 11971 _31-411 To 732-259-8486 `T S: 61 B: 4 L: 31 A R-3 PROJECT DATA:#226367 ti ��NPH 9 INVERTER:(10)ENPHASE IQ8PLUS-72-2-US # MODULES GE`'SPP (2) fir, MODULES:(10)REC395AA PURE RACKING:IRON RIDGE XR100 "PG PGG�c,S PITCH: 32° WATTAGE:3,950 ROOF TYPE:COMPOSITION SHINGLES AZIMUTH: 1540 ISHEETINDEX WIND LOAD:-54.6PSF @ 130MPH S-1 SITE PLAN FASTENER:5/16"DIA.5"SS LAGS w, 1 S-2 DETAILS E-1 ELECTRICAL PLAN y� cFss L-1 MOUNTING PLAN ]EllA MICHAEL E. MIELE, PE Licensed Prof...1 1 Engineer 33 QUAKER AVE.— PO Box 530 \ CORNWALL, NY 12518 TELEPHONE: (845) 629.9693 EMAIL: MikeMielePEQgmoil.com GENERAL NOTES P -ENPHASE IQ8 PLUS MICRO INVERTER a�SSPP� LOCATED ON ROOF BEHIND EACH MODULE. ;,\ P° -FIRST RESPONDER ACCESS MAINTAINED AND FROM ADJACENT ROOF. O� OSS -WIRE RUN FROM ARRAY TO CONNECTION IS 40 FEET. tQQ -COGEN DISCONNECT IS LOCATED ADJACENT TO UTILITY METER. -LAYOUT SUBJECT TO CHANGE BASED ON ALTERAUON OF THIS DOCLWENT EXCEPT BY N SITE CONDITIONS AT DATE OF INSTALL LICENSED PROFESSIONAL ISBLEGAL r PAPER SIZE:11"x 17"(ANSI B) LEGEND DATE: 11/7/2022 DESIGN BY: Mw Y MAIN SERVICE PANEL (INTERIOR) CHEC EDGY: EE s COGEN DISCONNECT REVISIONS: UTILITY METER REPRESENTS ALL FIRE CLEARANCE FIRST RESPONDER ACCESS 2020 RESIDENTIAL CODE OF NEW YORK STATE,2020 ENERGY CONSERVATION CODE OF NEW YORK STATE, _ INCLUDING ALTERNATIVE METHODS I MINIMUM OF 36"UNOBSTRUCTED AS PER TOWN OFSOUTHOLDCODE,2017NATIONAL ELECTRIC CODE.ASCE7.16. SITE PLAN S■1 THE 2020 RESIDENTIAL CODE OF NYS UFO, lronRidge XR 100 Rail OWER SOLUTIONS 2060 OCEAN AVENUE, RONKONKOMA, NY 11779 (631)348-0001 r� NIEUWENHUIS Cad RESIDENCE w Flashing 25 MECHANIC STREET SOUTHOLD, NY 11971 ` 732-259-8486 �,r ;, r S: 61 B: 4 L. 31 Iroaf idge XR 100 Rail ,,�"` `� 5�16 X S Stainless � ii �� PROJECT DATA:#226367 IronRidge XR 100 Rail i p INVERTER:(10)ENPHASE IQ8PLUS-72-2-US Steel La Dolt MODULES:(10)REC395AA PURE RACKING:IRON RIDGE XR100 Solar Module WATTAGE:3,950 3/S—16 x 3/; ROOF TYPE:COMPOSITION SHINGLES NEX HEAD BOLT 3/S-16 + WIND LOAD:-54.6PSF @ 130MPH FLANGE NUT � � 3-5/8 11 FASTENER:5/16"DIA.5"SS LAGS Q Q GENERAL NOTES: MICHAEL E. MIELE, PE R3 —L FEET ARE SECURED TO ROOF RAFTERS @ 72" s L,� d Professional Engineer O.C. USING 5/16" x 5" STAINLESS STEEL LAG BOLTS. 33 QUAKER AVE.— PBox 530 1 CORNWALL, NY 12518 -SUBJECT R TELEPHONE: (845) 629.9693 F HAS ONE LAYER. EMAIL: MikeMielePE@gmail.com —ALL PENETRATIONS ARE SEALED AND FLASHED. R1-L-FEET ARE SECURED TO ROOF DECK @ 48"O.C. USING(4) 1/4"X 3"STAINLESS STEEL LAG BOLTS. 0 ; ROOF PITCH RIDGE RAFTERS LENGTH OVERHANG NOTES R1 110 211x6" 2"x6"@ 16"O.C. 81-1111 0" Q U I C KM O U N T R3 32° 2if 2"x6"@16"O.C. 14'-1 " 0" ALTERATION OF THIS DOCUMENT EXCEPT BY A LICENSED PROFESSIONAL IS ILLEGAL PAPER SIZE:11"x 17"(ANSI B) DATE: 11/7/2022 DESIGN BY: MVV CHECKED BY: EE L REVISIONS: 7 ^J DESIGNED AS PER ASCE 7-10 2020 RESIDENTIAL CODE OF NEW YORK STATE,2020 ENERGY CONSERVATION CODE OF NEW YORK STATE, MODULES MOUNTED FLUSH TO ROOF TOWN OF SOUTHOLD CODE,2017 NATIONAL ELECTRIC CODE.ASCE7.16. DETAILS S'2 NO HIGHER THAN 6"ABOVE ROOF SURFACE OWER PHOTOVOLTAICS: SOLUTIONS (10) REC395AA PURE 2060 OCEAN AVENUE, NEMA 3R RONKONKOMA, NY 11779 JUNCTION BOX INVERTERS: (631)348-0001 BLACK-L1 ENGAGE CABLE (10) ENPHASE IQ8PLUS-72-2-US RED-L2 NIEUWENHUIS GREEN-GROUND CIRCUITS. (1) CIRCUIT OF (10) MODULES RESIDENCE 25 MECHANIC STREET SOUTHOLD, NY 11971 732-259-8486 S: 61 B: 4 L: 31 PROJECT DATA:#226367 INVERTER:(10)ENPHASE IQ8PLUS-72-2-US MODULES:(10)REC395AA PURE RACKING:IRON RIDGE XR100 #1 UN 100 WATTAGE:3,950 #10 AWG THWN FOR HOME RUNS OVER 100' - (1)LINE 1 I ROOF TYPE:COMPOSITION SHINGLES WIND LOAD:-54.6PSF @ 130MPH (1)LINE 2 1 (1)GROUND METER FASTENER:5/16"DIA.5"SS LAGS PER CIRCUIT IN 1"OR 1i"PVC CONDUIT © t © RATMACOIlWC.UfT 12.1 A NOMINAL OPERATING AC VOLTAGE 240 V ELECTRIC SHOCK ■4Yi0> rw W.Yt HAZARD 11 DO NOT RPHOTOVOLTAIC HO OVOLTAIC ''' SIDES ' ' MICHAEL E. MIELE, PE MAIN SOLAR SYSTEM Lic—ed Pfof...i-I Engines IN THE •PEN POSITION AC DISCONNECT LINE SIDE TAP 33 QUAKER AVE.— PO Box 530 CORNWALL, NY 12518 TELEPHONE: (845) 629.9693 EMAIL: MikeMielePEOgmail.com 60A FUSED SERVICE MAIN SERVICE 125A LOAD CENTER _ RATED DISCONNECT 100A /'� V y0 (1)-20A BREAKER \ ARD 20A FUSE _17 ; �, fi PER CIRCUIT WAR1 V I 1� DISCONNECT INVERTER OUTPUT CONNECTION DO NOT RELOCATE:THIS #12 AWG THWN #6 AWG THWN OVERCURRENT DEVICE (1)LINE 1 (1)LINE 1 (1)LINE 2 (1)LINE 2 ALTERATION OF THIS DOCUMENT EXCEPT BY A N (1)NEUTRAL (1)NEUTRAL AC DISTRIBUTION PANEL LICENSED PROFESSIONAL Is ILLEGAL _ (1)EGC (1)EGC OR SUB PANEL PAPER SIZE:11"X 17"(ANSI B) IN 1"PVC CONDUIT IN 1"PVC CONDUIT DATE: 11/7/2022 `1 DESIGN BY: MW CHECKED BY: EE --- REVISIONS: c 3 z AC COMBINER NOTE: 2020 RESIDENTIAL CODE OF NEW YORK STATE,2020 ENERGY CONSERVATION CODE OF NEW YORK STATE, 1-PHASE,MAIN LUG LOAD CENTER, 125A ALL WIRING TO MEET THE 2017 NEC AND 2020 ENERGY CODE TOWN OF SOUTHOLD CODE,2017 NATIONAL ELECTRIC CODE.ASCE7.16. ELECTRICAL PLAN E■1 60A FUSED SERVICE RATED DISCONNECT POWER LUTIONS 2060 OCEAN AVENUE, RONKONKOMA, NY 11779 (631)348-0001 NIEUWENHUIS 14'-111 RESIDENCE 8'-11 25 MECHANIC STREET I SOUTHOLD, NY 11971 _ t __ 732-259-8486 S: 61 B: 4 L: 31 PROJECT DATA:#226367 INVERTER:(10)ENPHASE IQ8PLUS-72-2-US R-1 R-3 MODULES:(10)REC395AA PURE RACKING:IRON RIDGE XR100 # MODULES (8) # MODULES (2) WATTAGE:3,950 ROOF TYPE:COMPOSITION SHINGLES PITCH: 11 ' PITCH: 32' FAISTE ER:5/16"DIA.5""SS LAGS AZIMUTH: 244° AZIMUTH: 1540 11Z3 MICHAEL E. MIELE, PE Lie-ed Profsssio j Engin- 33 QUAKER AVE.— PO Box 530 CORNWALL, NY 12518 TELEPHONE: (845) 629.9693 EMAIL: MikeMielePEOgmoil.com O W,q 17' 0 14' 6 11' 4 8.5' 0 m O ALT NT LICENSED PROFESTION OF TMS SIONAL S ILLEGAL EXCEPT A N 4' 0 PAPER SIZE:11"z 17"(ANSI B) ■ SPLICE BAR 4 DATE: 11/7/2022 Y © PENETRATIONS 32 DESIGN ICHECED : Mw EE UFO 26 REVISIONS: 40MM SLEEVE 12 z END CAPS 12 CONSUMPTION CRITTER GUARD 110' MOUNTING PLAN L.'� e SOLAR'S MOST TRUSTED ® C C i 0 owns m . EXPERIENCE 405wp25 YEAR PROTRUST 219 'Nxm WARRANTY LEAD-FREE ELIGIBLE ROHS COMPLIANT PERFORMANCE REC PRODUET 5PEE1F1E/\T10'N5 SOLAR'S MOST TRUSTED 1821♦15[71.7±0.1] CERTIFICATIONS X28[l.11 901[35.51 460[18.11 IEC 61215:2016,IEC 61730:2016,UL 61730 IEC 62804 PID ❑ 153.7[6.051 IEC 61701 Salt Mist 1100[433]+ IEC 62716 Ammonia Resistance + IS011925-2 Ignitability(Class E) 60±02 IEC 62782 Dynamic Mechanical Load .._............._..._ [0.24:0.011 _ IEC 61215-2:2016 Hailstone(35mm) IEC 62321 Lead-freeacc.toROHSEU863/2015 IS014001:2004,ISO 9001:2015,OHSAS 18001:2007,IEC 62941 ul Ua�. �„Y 11±0.2 e / P.-°vweer<a ar°� o Mux t°ao-rre° ,md��g:die [0.43±0.011 1 WARRANTY' F 205±0.5 00[472] ._..__... .....__ Standard REC ProTrust �- 12 Installed by an REC Certified 153.7[6.051 Solar Professional No Yes Yes System Size All 425 kW 25-500 kW 45[18] 22.5[0.91 671 t3[26.4±0.121 Product Warranty(yrs) 20 25 25 V30[l.M Power Warranty(yrs) 25 25 25 Measurements in mm[in) Labor Warranty(yrs) 0 25 10 Power in Year 1 98% 98% 98% GENERALDATA Annual Degradation 0.25% 0.25% 0.25% 132half-cut REC heterojunction cells StaubliMC4PV-KBT4/KST4(4mm2) Power in Year 25 92% 92% 92% Cell type: with lead-free,gapless technology Connectors: in accordance with IEC 62852 See warranty documents for details.Conditions apply 6 strings of 22 cells in series IP68 only when connected 3.2 mm solar glass with 4mm2solarcable,1.1m+1.2m MAXIMUM RATINGS Glass: Cable: -"- anti-reflective surface treatment in accordancewith EN S0618 Operational temperature: -40...+85'C Backsheet: Highly resistant polymer(black) Dimensions: 1821x1016x30mm Maximum system voltage: 1000V .. eMaximum test load(front): +7000Pa(713kg/m2y Frame: Anodized aluminum(black) Weight: 20.5 kg Maximum test load(rear): -4000Pa(407kg/m2y c Junction box: 3-part,3 bypass diodes,lead-free Origin: Made in Singapore ........-. Max series fuse rating: 25A _...-...__..._..... ...._......_ IP68 rated,in accordance with IEC62790 Max reverse current: 25A A L 'See installation manual for mounting instructions. IT ELECTRICAL DATA Product Code':RECxxxAA Pure Design load-Test load/1.5(safety factor) d Power Output-PM (WP) 385 390 395 400 405 TEMPERATURE RATINGS' Watt Class Sorting-(W) 0/+5 /+5 0/+5 0/+5 0/+5 Nominal Module Operating Temperature: 44°C(±2°C) 1 0 Nominal Power Voltage-V-PM 41.2 41.5 41.8 42.1 42.4 Temperature coefficient ofPm,x: -0.26%/°C F Nominal Power Current-I�(A) 9.35 9.40 9.45 9.51 9.56 .............._... ...... .. Temperature coefficientofVoc: 0.24%/°C n .. Open Circu it Voltage Vw(V) 48.5 48.6 48.7 48.8 48.9 Temperature coefficient of 15C: 0.04%/°C ..... ._.._ ................. ShortCircuitCurrent-Isc(A) 10.10 10.15 10.20 10.25 10.30 'The temperature coefficients stated are linear values Power Den sity(W/m2) 208.1 210.8 213.5 216.2 219.0 LOW LIGHT BEHAVIOUR Panel Efficiency(%) 20.8 21.1 21.3 21.6 21.9 Typical low irradiance performance ofmoduleatSTC; o Power Output-Pm (Wp) 309 m Nominal Power Voltage-VMre(V) 1 .... J -" ---------i i---------------! o 0 Nominal Power Current-I p(A) 7.55 7.)53 7.68 ----=--------I--------1--------?------ ° __ _____ �.-.----- Open Circuit Voltage-Va(V) 45.7 u9 45.9 46.0 ShortCircuitCurrent-Isc(A) 8.16 8.20 8.24 8.28 8.32 rlrradlance(W/m=) Values at standard test conditions(STC:air mass AM IS.irradiance 1000 W/m2,temperature 2S°C),based on a production spread with a tolerance of P,x,,,,Va&Is<:3%within one watt class.Nominal module operating temperature(NMOT:air mass AM 1.5,irradiance 800 W/m2,temperature 20°C,windspeed 1 m/s).'Where xxx indicates the nominal power class(P_)at STC above. Founded in 1996,REC Group is an international pioneering solar energy REC company dedicated to empowering consumers with clean,affordable solar power.As Solar's Most Trusted,REC is committed to high quality, www.recgroup.com innovation,and a low carbon footprint in the solar materials and solar panels it manufactures.Headquartered in Norway with operational '0 headquarters in Singapore,REC also has regional hubs in North America, Europe,and Asia-Pacific. ❑t R ` ENPHASE rR NWM m IQ8 and IQ8+ Microinverters Our newest IQ8 Microinverters are the industry's first microgrid-forming,software- defined microinverters with split-phase power conversion capability to convert DC power to AC power efficiently.The brain of the semiconductor-based microinverter Easy to install is our proprietary application-specific integrated circuit(ASIC)which enables the Lightweight and compact with microinverter to operate in grid-tied or off-grid modes.This chip is built in advanced plug-n-play connectors 55nm technology with high speed digital logic and has super-fast response times Power Line Communication to changing loads and grid events,alleviating constraints on battery sizing for home (PLC)between components energy systems. • Faster installation with simple two-wire cabling ase •_ High productivity and reliability Produce power even when the year limited grid is down More than one million cumulative 25 Part of the Enphase Energy System,IQ8 Series I08 Series Microinverters redefine reliability hours of testing Microinverters integrate with the Enphase IQ standards with more than one million Battery,Enphase IQ Gateway,and the Enphase cumulative hours of power-on testing, Class II double-insulated App monitoring and analysis software. enabling an industry-leading limited warranty enclosure of up to 25 years. Optimized for the latest high- powered PV modules Microgrid-forming CERTIFIED Complies with the latest advanced grid support Connect PV modules quickly and easily to I08 Series Microinverters are UL Listed as Remote automatic updates for I08 Series Microinverters using the included PV Rapid Shut Down Equipment and conform the latest grid requirements Q-DCC-2 adapter cable with plug-n-play MC4 with various regulations,when installed connectors. according to manufacturer's instructions. Configurable to support a wide range of grid profiles ©2021 Enphase Energy.All rights reserved.Enphase,the Enphase logo,I08 microinverters, Meets CA Rule 21(UL 1741-SA) and other names are trademarks of Enphase Energy,Inc.Data subject to change. requirements IQBSP-D 5-0002-01-E N-U 5-2021-10-19 IQ8 and IQ8+ Microinverters INPUT DATA IOCI 108-60-2-US 108PLUS-72-2-us Commonly used module pairings' w 235-350 235-440 Module compatibility 60-cell/120 half-cell 60-cell/120 half-cell and 72-cell/144 half-cell MPPT voltage range V 27-37 29-45 Operating range v 25-48 25-58 Min/max start voltage V 30/48 30/58 Max input DC voltage v 50 60 Max DC current2(module Isc] A 15 Overvoltage class DC port II DC port backfeed current mA 0 PV array configuration 1x1 Ungrounded array;No additional DC side protection required;AC side protection requires max 20A per branch circuit OUTPUT DATA IACI 108-60-2-US ,.. Peak output power VA 245 300 Max continuous output power VA 240 290 Nominal(L-L)voltage/range' V 240/211-264 Max continuous output current A 1.0 1.21 Nominal frequency Hz 60 Extended frequency range Hz 50-68 Max units per 20 A(L-L)branch circuit4 16 13 Total harmonic distortion <5% Overvoltage class AC port III AC port backfeed current mA 30 Power factor setting 1.0 Grid-tied power factor(adjustable) 0.85 leading-0.85 lagging Peak efficiency % 97.5 97.6 CEC weighted efficiency % 97 97 Night-time power consumption mw 60 „ . Ambient temperature range -40°C to+600C(-40°F to+1400F) Relative humidity range 4%to 100%(condensing) DC Connector type MC4 Dimensions(HxWxD) 212 mm(8.3")x 175 mm(6.9")x 30.2 mm(1.2") Weight 1.08 kg(2.38 lbs) Cooling Natural convection-no fans Approved for wet locations Yes Acoustic noise at 1 m <60 dBA Pollution degree PD3 Enclosure Class II double-insulated,corrosion resistant polymeric enclosure Environ.category/UV exposure rating NEMA Type 6/outdoor COMPLIANCE CA Rule 21(UL 1741-SA),UL 62109-1,UL1741AEEE1547,FCC Part 15 Class B,ICES-0003 Class B,CAN/CSA-C22.2 NO.107.1-01 Certifications This product is UL Listed as PV Rapid Shut Down Equipment and conforms with NEC 2014,NEC 2017,and NEC 2020 section 690.12 and C22.1-2018 Rule 64-218 Rapid Shutdown of PV Systems,for AC and DC conductors,when installed according to manufacturer's instructions. (1)No enforced DC/AC ratio.See the compatibility calculator at https://Iink.enphase.com/ module-compatibility(2)Maximum continuous input DC current is 10.6A(3)Nominal voltage range can be extended beyond nominal if required by the utility.(4)Limits may vary.Refer to local requirements to define the number of microinverters per branch in your area. 1O8SP-DS-0002-01-EN-US-2021-10-19 IRONRIDGE Roof Mount System ffffi ------------- Built for solar's toughest roofs. IronRidge builds the strongest roof mounting system in solar. Every component has been tested to the limit and proven in extreme environments. Our rigorous approach has led to unique structural features, such as curved rails and reinforced flashings, and is also why our products are fully certified, code compliant and backed by a 20-year warranty. Strength Tested PE Certified All components evaluated for superior ® Pre-stamped engineering letters structural performance. available in most states. Class A Fire Rating Design Software Certified to maintain the fire resistance ® Online tool generates a complete bill of rating of the existing roof. materials in minutes. Integrated Grounding 20 Year Warranty ® UL 2703 system eliminates separate Twice the protection offered by module grounding components. competitors. 1 I XR Rails XR10 Rail XR100 Rail XR1000 Rail Internal Splices A low-profile mounting rail The ultimate residential A heavyweight mounting All rails use internal splices for regions with light snow. solar mounting rail. rail for commercial projects. for seamless connections. • 6'spanning capability 8'spanning capability 12'spanning capability Self-tapping screws • Moderate load capability Heavy load capability Extreme load capability Varying versions for rails • Clear& black anod. finish Clear& black anod. finish Clear anodized finish Grounding Straps offered Attachments - FlashFoot Slotted L-Feet Standoffs Tilt Legs Anchor, flash, and mount Drop-in design for rapid rail Raise flush or tilted Tilt assembly to desired with all-in-one attachments. attachment. systems to various heights. angle, up to 45 degrees. • Ships with all hardware High-friction serrated face Works with vent flashing Attaches directly to rail • IBC & IRC compliant Heavy-duty profile shape Ships pre-assembled Ships with all hardware • Certified with XR Rails Clear& black anod. finish 4" and 7"Lengths Fixed and adjustable Clamps & Grounding -- End Clamps Grounding Mid Clamps T Bolt Grounding Lugs Accessories Lk, Slide in clamps and secure Attach and ground modules Ground system using the Provide a finished and modules at ends of rails. in the middle of the rail. rail's top slot. organized look for rails. • Mill finish & black anod. Parallel bonding T-bolt Easy top-slot mounting Snap-in Wire Clips • Sizes from 1.22"to 2.3" Reusable up to 10 times Eliminates pre-drilling Perfected End Caps !MM • Optional Under Clamps Mill & black stainless Swivels in any direction UV-protected polymer Free Resources - -- _ - Design Assistant ♦ NABCEP Certified Training Go from rough layout to fully VOW Earn free continuing education credits, -_ -- engineered system. For free. A X while learning more about our systems. _ - Go to IronRidge.com/rm ♦ Go to IronRidge.com/training Oc 2014 :11 ea