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Home My WebLink About50131-Z TOWN OF SOUTHOLD �rcBUILDING DEPARTMENT � rry TOWN CLERK'S OFFICE SOUTHOLD, NY kBUILDING 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#: 50131 Date: 12/15/2023 Permission is hereby granted to: McDowell Kathleen 51540 Route 25 Southold, NY 11971 To: install roof-mounted solar panels on existing accessory garage as applied for per HPC approval. At premises located at: 51540 Route 25, Southold SCTM #473889 Sec/Block/Lot# 70.-2-1 Pursuant to application dated 11/16/2023 and approved by the Building Inspector. To expire on 6/15/2025. Fees: SOLAR PANELS $100.00 ELECTRIC $125.00 CERTIFICATE OF OCCUPANCY $100.00 Total: $325.00 Building Inspector TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O.Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax(631) 765-9502 1t ..s:`' � °�, . oatlurlirwnnw' APPLICATION FOR BUILDING PERMIT L For Office Use Only PERMIT N0. Building Inspector: Applications and forms must be filled out in their entirety. Incomplete applications will not be accepted. Where the Applicant is not the owner,an Owner's Authorization form(Page 2)shall be completed. Date:June 21, 2023 OWNER(S)OF PROPERTY: Name:Kathleen McDowell SCTM#1000-70.-2-1 Physical Address:51540 Route 25, Southold, NY 11971 Phone#:631-639-1309 Email:kmmcdowell@gmail.com Mailing Address:51540 Route 25, Southold, NY 11971 CONTACT PERSON: Name:Permit Dept. / Long Island Power Solutions Mailing Address:2060 Ocean Avenue, Ronkonkoma, NY 11779 Phone#:631-348-0001 Email:Permits@gopowersolutions.com DESIGN PROFESSIONAL INFORMATION: Name:Michael E. Miele, PE Mailing Address:33 Quaker Avenue PO Box 530, Cornwall, NY 12518 Phone#:845-629-9693 Email:MikeMielePE@gmail.com CONTRACTOR INFORMATION: Name:Michael Catizone / Long Island Power Solutions Mailing Address:2060 Ocean Avenue, Ronkonkoma, NY 11779 Phone#:631-348-0001 Email:mike@gopowersolutions.com DESCRIPTION OF PROPOSED CONSTRUCTION [:]NewStructure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated cost of Project: ii Other Proposed� )Panels rooftop mounted solar array.(17.640)kW system , ' S.54,944.95 Will the lot be re-graded? ❑Yes RNo Will excess fill be removed from premises? Dyes RNo 1 PROPERTY INFORMATION ATION .. Existing use of property:. Family Dwelling intended use of property: e Family Dwelling 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, _ g Presponsible _ - 8 Check BOX After Rea Ing The owner/contractor/desi n Professional is res p onsible for all drainage and storm water issues as provided by Chapter 236 of the Town Code. APPLICATION 15 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 name) /I_ �,• �-r/2o/1 IRALItlloriZ gent P.�O�wner Signature of Applicant: Date: � STATE OF NEW YORK) SS: COUNTY OF Suffolk ) Michael Catizone (Name of individual signing contract) above named, being duly sworn, deposes and says that(s)he is the applicant (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 m day of Notary Public ESCAYLIN CRISOL RIVERA RODRIGUEZ PROPERTYAUTHORIZATION NOTARY PNoL101R1643 031C-STATE OF NEW YORK (Where the applicant is not the owner) Qualified in Suffolk County My Commission Expires 05-31-2026 mw ". l � � +� °� � residing �, __. �� gatb a � ." ," Michael Catizone/Long� j?s nd Power�� r mom" ` do hereby authorize Solutions to apply on my bi�half to the Town of Southold Bull, Department for approvajasdescri ed herein,. Onerrs Signature Date Print Owner's Name 2 BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD Town Hall Annex- 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 roerr southoldtownn . ov - seand southoldtownn . ov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: 12/14/2023 Company Name: Catizone Electricanong Island Power Solutions Name: Michael Catizone License No.: email: Permits@GoPowerSolutions.com Address: 2060 Ocean Avenue,Ronkonkoma,NY 11779 Phone No.: 631-348-0001 JOB SITE INFORMATION (All Information Required) Name: Kathleen McDowell Address: 51540 Route 25, Southold NY 11971 Cross Street: Tuckers Lane Phone No.: 631-463-4310 Bldg.Permit#: email: Tax Map District: 1000 Section: 70 Block: 2 Lot: 1 BRIEF DESCRIPTION OF WORK (Please Print Clearly) Proposed( 48 )panel roof mounted array. ( 20,160)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: Inverters: 48 E hale IQX-96-US Modules 48 Rec420AA Pure-R Support: Iron Rid e XR-100 PAYMENT DUE WITH APPLICATION Request for Inspection Formals �r Mariella Ostroski, Chairperson our un; Town Hall Annex a4e 54375 Route 25 Anne Surchin,Vice Chair ,. PO Box 1179 Allan Wexler ` ,. Fabiola Santana ' Southold,NY 11971 Jeri Woodhouse kimf@southoldtownny.gov , Telephone:(631)765-1809 Marina de Conciliis Kim E. Fuentes, Coordinator est p ` ERVAT04 Qy ` tt of Southold Historic Preservation Commission N0", )2° Certificate of Appropriateness November 9, 2023 ' ' �' RESOLUTION #11.09.2023.1 7. . " . RE: 51540 NYS Route 25, Southold, NY. SCTM# 1000-70-2-1 Owner: Kathleen McDowell RESOL L> TION WHEREAS, 51540 NYS Route 25, Southold,NY, is on the Town of Southold Registry of Historic Landmarks; and WHEREAS, as set forth in Section 56-7 (b) of the Town Law (Landmarks Preservation Code) of the Town of Southold, all proposals for material change/alteration must be reviewed and granted a Certificate of Appropriateness by the Southold Town Historic Preservation Commission prior to the issuance of a Building Permit; and, WHEREAS, on September 8, 2023, the applicant's representative, Michael Miele, P.h., submitted a proposal to install roof mounted solar panels on an existing two-Gamily dwelling and an accessory garage uponresidential property listed on the Town of Southold Registry ofHistoric Landmarks; and WHEREAS, a Site Plan and Engineered Plans indicating proposed improvemexrts, prepared by Michael E. Miele, P.E., last revised October 29, 2023; were received by the Commission on November 9, 2023; and WHEREAS, the applicant and the applicant's representative, Kevin Orlando, came before the Commission on November 9, 2023, at a public hearing in order to review the proposed improvements to the single family dwelling; and WHEREAS, the applicant shall submit to the Commissioners photographs of the finished improvements upon completion; and WHEREAS, the Commissioners may conduct a site inspection of subject premises once improvements are completed. Certificate of Appropriateness#11.09-2023.1 HPC, McDowell, 51540 Route 25, Southold. SCTM No 1000-70-2-1 NOW THEREFORE BE IT RESOLVED, that the Southold Town Historic Preservation Colitmission determines that Site Plan and Engineered Plans prepared Michael E. Mielle, P.E. (Sheets S-1, S-2, E-1, [,-I, 1 -1 thru R-4, A-1 thrU A-8), last revised October 29, 2023, meets the criteria for approval tinder Section 17O-8(A) of the Southold Town Code; and BE IT FURTHER RESOLVED, that the Commission approves the issuance of a Certificate of Appropriateness, subject to approvals by all involved agencies; and BE IT FURTHER RESOLVED,that any deviation from the approved plans referenced above may require further review from the commission. Motion made by Commissioner de Conciliis Motion seconded by: Commissioner Ostroski VOTES: AYES: Commissioners Ostroski, Wexler, Santana, Woodhouse and de Conciliis. (5-0) RESULT: Passed Please note that any deviation from the appro ved plans referenced above may require further review from the comml, ion. Signed: Kim E. Fuentes,Coordinator for the Historic Preservation Commission Date: November 15,2023 Michael , Miele, Licensed Professional Engineer Licensed In New York, New Jersey, Connecticut& California ` New York License#079676 New Jersey License#44042 Historic Preservation Commission Connecticut License#23158 California License#31508 ResolUtion w C �. .', I Dated: November 3, 2023 Town of Southold Building Department The Office of the Building Inspector 54375 NY-25 ` Southold, NY 11971A01-0 Re: Kathleen McDowell 51540 Route 25,Southold NY 11971t ' Single Family Residence Solar Panei Loadi'n Certification Town of Southold 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 22, 2022 that consists of the installation of(48) REC 420AA PURE-R 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: 130mph o additional structural members were re aired, The rooves are currently framed with 2x6 true dimensional wood framing @ 16" O.C. and 2x8 wood framing @ 24" 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 NEI,, ,off° �,. �. � P 40 C12 cc- Ud Michael E. Miele, PE *.w 07967b � C " SSOA� 33 Quaker Avenue, PO BOX 530, Cornwall, NY 12518 A Phone:845.629.9693 A NYPSengineer@gmail.com Suffolk County Dept of Labor,Licensing&Consumer Affairs HOME IMPROVEMENT LICENSE Name MICHAEL J CATIZONE Business Name This diesThat the nearer is duly licensed LONG ISLAND POWER SOLUTIONS INC 3y the County of suftolk License Number:H-53562 Rosalie Drago Issued: 06!0612014 Commissioner Expires: 06101/2024 �waJwwwlw,, Suffolk County flep Labor,Licensing&Consume,Affairs AoVA$TER ELE�`TA' C,Al LICENSE MICK49L CATIZONE 80siness,Nance Tjmb$ troaa rte p(�1d1E ZSOLUTIONS beaver is ouly liner! �O . by ire County of 11woolk4 i,I4nse 3680 R04110 omoo 014 Comnstr3 IQ. O 1 0,2 1RXworkers' CERTIFICATE OF INSURANCE COVERAGE SAT Compensatlon 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 INC 477 MADISON AVE 6TH FLOOR#6975 646-383-3599 NEW YORK, NY 10022 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) Town of Southold Standard Security Life Insurance Company of New York 54375 Main Road 3b.Policy Number of Entity Listed in Box 1a Southold, NY 11971 R97483-002 3c.Policy Effective Period 1/1/2020 to 10/1/2024 4. Policy provides the following benefits: Q A.Both disability and Paid Family Leave benefits. B.Disability benefits only. C.Paid Family Leave benefits only. 5. Policy covers: Q 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 descr' d above. Date Signed 10/3/2023 By ` (Signature of insurance carrier's author"r d representative or NYS 9icensed 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 413,4C 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 46,4C or 513 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) 111II1111111°11°1°1°°°°°111°!1°1!1!1!°1111111 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 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. DB-120.1 (12-21)Reverse Client#:83176 CATIELE =23 /Y- DYYY)ACORM CERTIFICATE OF LIABILITY INSURANCE 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 certificateholderis an ADDITIONAL INSURED,the ol..lc (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 Comm ercial Support PHONE Ed ewood Partners Ins.Center A T mm' .. �.... (NC4,N 631-390-9700 : 63I-390-9790 NaExt 40 Marcus Drive E-AJILS, NEcertificates@epicbrokere.com mm ... 3rd Floor . ........ A,,m _............ ............ .... a INSU-R...E.R(S.).AFFORDING COVERAGE NAI C Melville, NY 11747-2647 INSURE A:Utica Mutual Insurance Company 25976 E ...-. .......... .._.... ..... INSURD # INSURER B: ....... ...... ............ ww., Catizone Electrical Inc URE SR C 2060 Ocean Avenue IN§" ER D INSUR Ronkonkoma,NY 11779 INsuRER .� __ R 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 .� �A170 LSUSR VI/V0........... ..........�m.N (POLICY.._-F POLICYEXPXP LIMITS TYPE OF INSURANCE POLICY NUMBER MM/DD EF MM/O MMERCIALGENERALLIABILITY CPP4784747 7/01/2023 07/01/202 EACAOCCURRENCE CCUR EKED $11.000.000, ' A ... _ _ co � CLAIMS-MADE X OCCUR PREMISES Es ocCWfrYNSnce),m,�,,,,, $100 000 MED E pj( y one person) $10,000 PERSONAL&ADV INJURY $11000w00O GEN'L AGGREGATE LIMIT APPLIES PERS GENERAL AGGREGATE $Z OOO,tOOO _... PRO. n PRODU $2[000.000 POLICY JEOT LOC COMI9ENE'IMSBNGME IT $,,, X OTHER: ....... ....�,... ..-m.... ......w...._. — ......-..---..-. �.�........ .,,,_.. AUTOMOBILE LIABILITY Ea accdd�gC ANY AUTO BODILY INJURY(Per person)_ $.......... OWNED SCHEDULED BODILY INJURY(Per HIRED S ONLY NON-OWNED ONLY AUTOS ONLY AUTOS j OPoc dp A&IACaL accident) $ UMBRELLA WLIA m�. LA LIARCUR EACH OCCURRENCE $ EXCESS LIAB TAIMS-MADE AGGREGATE $ -A AND KERSEMPLCOMPENSATION O MS'N LIABILITY LTY R EN $ 4766--�-.. .,�. ..._ ...._..,..-. ._W... _.,.. 763 7/01/2023 07/01/202 X PER JOfH ANY PROPRIETOR/PARTNER/EXECUTIVE E_ _ ...... ... Y/N L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? Fy] N/A . (Mandatory In NH) DISEASE EA EMPLOYEE $500,000 Ifyy es,describe under 500 000 RIPTION OP OPERATIONS below �, .... .E.L.DISEASE-POLICY LIMIT 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 #S5673106/M5666984 KC001 Yom c Workers' CERTIFICATE OF rA1lw I Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board �. ...... 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured atizone Electrical Contracting Inc. 631.348-0001 2060 Ocean Avenue Ronkonkoma, NY 11779 1c.NYS Unemployment Insurance Employer Registration Number of Insured 1d.Federal Employer Identification Number of Insured or Social Security Work Location of Insured(Only required if coverage is specifically limited to Number certain locations in New York State,i.e.,a Wrap-Up Policy) 202241963 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Utica Mutual Insurance Company Town of Southold 54375 Main Road 3b.Policy Number of Entity Listed in Box"1 a" Southold,NY 11971 4766763 3c.Policy effective period 07/01/2023 to 07/01/2024 3d.The Proprietor,Partners or Executive Officers are ❑ included.(Only check box if all partnerstofficers included) ❑ all excluded or certain partners/officers excluded. This certifies that the insurance carder 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 contractissued 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 representative or licensed agent of insurance carrier) -. eA Approved by: 6/5/23 (Signature) (Date) Title: Authorized Re resentative 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 4JAe workers' CERTIFICATE OF INSURANCE COVERAGE An 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 LONG ISLAND POWER SOLUTIONS INC 2060 OCEAN AVE 631-348-0001 RONKONKOMA,NY 11779 Work Location of Insured(Only required if coverage is specificallylimitedto 1c.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 54375 Main Road 3b.Policy Number of Entity Listed in Box 1a Southold, NY 11971 R97411-000 3c.Policy Effective Period 111/2015 to 6/4/2024 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 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 d'escl d above. Date Signed 6/6/2023 By of insurance carriers authori d re resentBtNe or NYS licensed(Signature i� ensed insurance agent of that insurance carrier) Telephone Number 46)509-2100 Name and Title SUPERVISOR-DBL./POLIO' SERVICES IMPORTANT: If Boxes 4A and 5A are checked,and this form is signed by the insurance carrier's authorized representative or NYS Licensed Insurance Agent of that carrier,this certificate is COMPLETE. Mail it directly to the certificate holder. If Box 413,4C 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 4E,4C or 513 of Part 1 has been checked) State of New York Workers'Gompensation 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) 11111111111111111111111��°°1°°1111°°�IIIIII Client#:83393 LONGISL15 DATE(MMIDDIYYYI) ACORM CERTIFICATE OF LIABILITY INSURANCE 12/22/2023 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. JIMPORTANT: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 N,0ATACT Commercial Support Ed ewood Partners Ins.Center g �",�"�� E,eI 631 390-9700 � N� 631 390 9790 40 Marcus Drive EanAl'L NLCertlficatesep�cbrokers.com 3rd Floor _ _ INSURER(S)AFFORDINGCOVERAGE NAIC# Melville,NY 11747-2647_ iNsuRERA:Southweme 8 General Ins �� Long Island Power Solutions, W. ....... .. st Mar' Co 12294 INSURED INSURER B Inc dba New � .. .. ... .. .. .....A ,. . York Power Solutions; Michael Catizone INSURER°°°°C """"""' '.�" ".""�."' """� INSURER D: 2060 Ocean Avenue .... _ � .. ...... .. .. — Ronkonkoma, NY 11779 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. INSR J ____-- POLCYEF /DrEX LTR TYPE OF INSURANCE INSRD POLICY NUMBER (MDD MWIDYYYPYI ........ . M_IT_S W..__ .� A X. COMMERCIAL GENERAL LIABILITY PK202200020693 2/28/2023 0212812024 EACH OCCURRENCE $2 OOO OOO CLAIMS-MADE „X OCCUR PA � , , mrnca _w;$100000 X PD Ded:5,000 ,,,,MEDXP E ,,,,, Any one person) $1 O 000 X Contractual Lia W... .. PERSONAL&ADV INJURY $2,000.000.m m...�.. mGEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 PoucY JECT Loc $ 000.000 OTHER _.... ----- .. .,...... .............. _.�OOM N'ED SIhIGL�F LIMIT $.,. {{ PRO 4 .1 AUTOMOBILE LIABILITY ANY AUTO BODILY INJURY(Per person) $ ..mm,mm AUTOS ONLY AUTOS $ OWNED SCHEDULED HIRED mm "' NON-OWNED EMILY INJURY Per accident) M�ROPE.RTY'DAMAGE; $ AUTOS ONLY AUTOS ONLY L. acTMl) $ UMBRELLA LIABEACH OCCU........... ......_. OCCUR $ RRENCE mm EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDE RETENTION$ WORKERS COMPENSATION �ER 0- T.-H-AND EMPLOYERS'LIABILITY Y/N TUTE ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $� OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) ISEASE EA EMPLOYEE $ E.L.P..._.... ........."_.........,,m..,,..,__ ......................................�. If yes,describe under E.L.DISEASE DESCRIPTION OF OPERATIONS below SE-POLICY LIMIT $ O 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 NYSIFPO Box 66699,Albany,NY 12206 New York State Insurance Fund nySlf.Com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE AAAAAA 271175107 Q LOVELL SAFETY MGMT CO.,LLC 110 WILLIAM STREET 12TH FLR NEW YORK NY 100381 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 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,I 'SURAN'CE FUND UNDERWRITING VALIDATION NUMBER: 530864363 II 00000000001305317 Form WC-CERT-NOPRINT Version 3(08/29/2019)[WC Policy-246707881 U-26.3 288 [00000000000113053317][0001-000024670788][##Z][16088-30][Cert_NoP{ERT 1][01-00001] workers' TE. CoCERTIFICATE OF INSURANCE COVERAGE 4mpensation 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 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured LONG ISLAND POWER SOLUTIONS INC 2060 OCEAN AVE 631-348-0001 RONKONKOMA, NY 11779 Work Location of Insured(Only required if coverage is specificallylimited 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 54375 Main Road 3b.Policy Number of Entity Listed in Box 1a Southold, NY 11971 R97411-000 3c.Policy Effective Period 1/1/2015 to 6/4/2024 4. Policy provides the following benefits: © A.Both disability and Paid Family Leave benefits. B.Disability benefits only. C.Paid Family Leave benefits only. 15. 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. Date Signed 6/6/2023 By (Signature of insurance carrier's authorli d representative or NYS licensed insurance agent of that insurance carrier) Telephone Number 646 609-2100 Name and Title SUPERVISOR-DBL/POLICY SERVICES IMPORTANT: If Boxes 4A and 5A are checked,and this form is signed by the insurance carrier's authorized representative or NYS Licensed Insurance Agent of that carrier,this certificate is COMPLETE. Mail it directly to the certificate holder. If Box 413,4C 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. D13-120.1 (12-21) 111111111111111111111111111111 °111°u111111°�IIIIII Client#: 83393 LONGISL15 ACORD. CERTIFICATE OF LIABILITY INSURANCE [!2/:22:12CO23 YYY) 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. IM tT T. If the certificate holder Is an ADDITIONAL INSURED,the poitcy(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 any rights to the certificate holder in lieu of such'endorsement(s). ACT PRODUCER NAME: Commercial Support Ed ewood Partners Ins.Center g PHONE 631-390-9700 Ext E rMloaR1L� s. 0N. 631-390-9790 40 Marcus Drive NECertflcat @ p'cbrokers.com _.m 3rd Floor INSURER(S)AFFORDING COVERAGE NAIC# Melville,NY 11747-2647- INSURER A:Southwest Marine 8 General Ins Co 12294 INSURED LoIsland Power Solutions, Inc dba New INSURER B ng INSURER C York Power Solutions; Michael Catizone INSURER o � 2060 Ocean Avenue INSURER E. � � Ronkonkoma,NY 11779 INSURER F___._ w ; 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. .. NCE ADDLSUa:R ..... ,..., _ .... t"ON.tCYE'EF POLICYEXP LIMITS 4VViD —,POLICY NUMBER 'A/4tDi"1'YYY,(MMIDDIYYYI�' A X'COMMERCIAL OGENERAL LIABILITY PK202200020693 2/28/2023 021281202. EACH GOCCURRENCE y$2�000�000 CLAIMS-MADE OCCUR DA aLl? Eos"'I^ Dnce,)— $1OOr000 X PD Ded:5,000 MED EXP(Any one person) A-19A00 X Contractu alLlab. PERSONALBADVINJURY $2000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000;000 PRO- PRODUCTS-COMP/OPAGG j4 00% POLICY JECT _ LOC , I,000 OTHER: $ OOIAt1tNEO SII+IGI.E t pMIT AUTOMOBILE LIABILITY ;0=:, ktf ,) ( ANY AUTO BODILY person) $ -....._. ��BODILY INJURY Per ED NON-OWNED P (Per accident) $ OWNED AUTOS ULED RrJpERGYbJh1AG .. � �� AUTOS ONLY AU OS ONLY .�..- CLAIMS MADE:.. ...m.,., ... .... w...,..�..... -- � ..... ._. .�.. .. .-_,. OCCUR RRENCE $ ,EACH OCCU� ..,..._,. �.. .... .. ]" EXCESS LIAB _ AGGREGATE .. .. $ UMBRELLA LIAB DED RETENTION$ _. ....... . ._ _ OTH $ AND KERSEMPLCOMPENSATION ATION PER WORKERS COMPENSATION T S'LIABILITY STATUTE------- V R.. ._�� . ..... AN'Y'CEWMEETO RFPARTNER/EXECUTIVE Y I" E L EACH ACCIDENT $mmmm...... . pEFIpER?MEMt)E'.R EXCLUDED? F—] NIA (Mandatory In NIH) EMPLOYEE E.L.DISEAS:E.:_�.m-, d..._.........___.....:.:_m,.,. . If yes,describe under ]-2ESCRIPTIpN OF OPERATIONS below ,,, ,DISEASE POLICY LIMIT $ 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 I ' ©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 40 1�-NN NYSIFPO 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 wI 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 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,I 'SURANCE FUND UNDERWRITING VALIDATION NUMBER: 530864363 11111II 1'®II I 1®II lal®1®I Ndili®11111 �®11111 13 00000000000113053317 I Form WC-CERT-NOPRINT Version 3(08/29/2019)[WC Policy-24670788] U-26.3 288 [00000000000113053317][0001-000024670788][##Z][16088-30][Cert_NoP{ERT 1][01-00001] LONG ISLAND OW=m 2060 Ocean Ave Ronkonkoma, NY 11779 631348-0001 J(I SOLUTIONS www.longislandpowersolutions.com Mw lift t Au .h o ru . The signature below constitutes consent by the homeowner to have the Solar Permit, Receipt and Town Approved Drawings sent directly to Long Island Power Solutions. Long Island Power Solutions 2060 Ocean Ave Ronkonkoma, NY 11779 Or ueC lora island iowersolutions.coct1 Once the complete permit package is received and documented, Long Island Power Solutions will forward original permit package to the homeowner. Homeowner Signature I hereby certify under penalty of perjury that I am acting on my own behalf and that the foregoing statements are true and correct to the best of my knowledge and belief. Subscribed and sworn to before me this = t day of12 3 Date 2� � Notary Sigaaaturer.j ESCAYLIN CRISOL RIVERA RODRIGUEZ NOTARY PUBLIC-STATE OF NEW YORK No. 01816434031 Qualified in Suffolk County My Commission Expires 05-31-2026 Go Green Save Green », Suffolk County Dept.of 1 Labor,Licensing&Consumer Affairs �� HOME IMPROVEMENT LICENSE Name MICHAEL J CATIZONE Business Name This certifies that the nearer is duly licensed LONG ISLAND POWER SOLUTIONS INC :)y the County of suffolk License Number:H-53562 Rosalie Drago Issued: 06/06/2014 Commissioner Expires: 06/01/2024 Sutfofk County Dept of Labor,Licensing&Corwsut�ter Affairs /c VASTER ELECTRIC&&_LICENSE r t lWainne CATIZ�'FNFw Business Name cer"fie.^Wr3Y':Irw vNU 9 at�.4dkY F 4 =tt EC.7Ll-ICkI;3 it C 6Py r i IiY�4'�4 0 h. r A'��1 License Nu rnkser:ME-5350 Rgealla tDrago Issuers', 06106,2014 „cmrrssiorer Espirexs. p&'d01'?_O �t NEW Workers' Yom CERTIFICATE OF INSURANCE COVERAGE sTATE 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 .. ........ Ta_Le_gal 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 1 c 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 TOW (EntityN BeOFing LSOUTHOLDisted as the Certificate Holder) Standard Security Life Insurance Company of New York 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 E] C.Paid Family Leave benefits only. 5. Policy covers: R] A.All of the employer's employees eligible under the NYS Disability and Paid Family Leave Benefits Law E] 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 descr' µd above. By Date Signed 11/10/2022 (Signah.n*esyr insiarcancp"T"Ir".1G8;,cAdep!rfen t msw'ance carneil Telephone Number1212) 355-4141 Name and Title SUPERVISOR-DBL/POLICY SERVICES ........... IMPORTANTIf 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 41::x, 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 48,4C or 513 of Part I has been checked .......... State of New York Workers" Compensation Board According to infornnafion maintained by the NYS Workers' Compensation Board, the above-named employer has complied with the NYS DisabHrty and Paid Family Leave Benefits Law(Article 9 of the Workers'Compensation Law)with respect to all of their employees Date Signed By ................ (Signab.iie ofAiRhonzed NYS Boal,c.l Employee) Telephone NumberName 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 I Insurance brokers are NOT authorized to issue this form. DB-120.1 (12-21) 11111111..11'°1°1°11111111°°1111111°°11111111111111 11111111 Client#:83176 CATIELE -_ DATE(MM/DD/YYYY) ACORD., CERTIFICATE OF LIABILITY INSURANCE 6/27/2022 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. ADDITIONAL INSURED,the polic les)must have ADDITIONAL INSURED provisions or be end IM��f�R�"Ii�NN�';If the cer^tlflcak holder Is an�J� .� YC ) p 'sl endorsed. IfSUBROGATION 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), g PW F- mmercial Support Ed PRODUCER Partners Ins.Center �� . � E-r IL rtif ates@epicbrokers come f No NEC I �fm NSI ..— 40 Marcus Drive ADDRESS, ...-...._.e.....�:.:icat icbro.e .:,,_. ...... .: 3rd Floor INSURERS)AFFORDING COVERAGE NAIC# Melville, NY 11747-2647 ITITITITITITITITITITITITIT� � ........ ....._�_.��_ ............. ..._..._ ....__ .INSURER A:Utica Mutual Insurance Company 25976 INSURED INSURER B: Catizone Electrical Inc _"""' ITITITITITmmITITmmmmmm NSURER C 2060 Ocean Avenue I........ ..... ..�. ........ ...... Ronkonkoma, NY 11779 _INSU...R........_ER 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. IN SR WUbL SUB -- POLICY POLICY EXP LIMITS LIS TYPE OF INSURANCE POLICY NUMBER ,MMMON MNIJT7DfY"o�3"Y�„ .� COMMERCIAL _ E $1,000rO,OO A )4 X CPP4784747 7/01/2022 07/01/202 EACHOOCURRENC CLAIMS-MADE X�OCCUR M�µEpDyEXP( n onepDnoel $100000 LftS a occwu arson) $10 000 PERSONAL&ADV INJURY _!11000,0q9_____ GR . L AGGREGATE .:2 000,000 6, GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ ITsmIT _. POLICY JECT 0 LOC Wm. P/OPAGG $2,000,000 ..... PRODUCTS COM ',. OTHER: $ ....._. �.. ...............__ .,, ............, ,..�._,�...... .m.�..,........ ....... �...,,,,�...,.��..., .,.,. .._ �.. AUTOMOBILE LIABILITY COMBIN 6 afiaLF ILIMIT ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS PROPERTY DAMAGE...�'-, HIRED AUTOSNON-OWNED ONLLYY 0eea $ AUTOS ONLY AUTOS ...,,,,-_...�.. $ UMBRELLA LAB ,..., ...,,,,, _-' . ^... EACHOCCURRENCE $ .,. .,. .. .. -........ ...... ,. OCCUR $ EXCESS LABRETENTIOAGGREGATE $ _ A WORKERS COMPENSATION N$ ...._....,�,.., 4766...., .. .,.ww.._.. . ...,,,... ............ . .. PER OTH _ AND EMPLOYERS'LIABILITY STA ACCIDENT .. .... 763 7/01/2022 07/01/202 X �500�000 OFFICEY�MEMBANY ER/EXXCLU'D'ED'�:ECUTIVE Y N/A E L EACH Y/N (Mandatory in NH) ❑ E.L DISEASE EA EMPLOYEEI$500.000 If yes,describe under DESCRIPTION OF OPERATIONS below .DISEASE-POLICY LIMIT ,$500,000 IPTI..,, ,.S .�.�.........._,� ._....�_�........_. ....... ............—, �.,.,.,,�...................�..m_....-.. E.�.�_._�.... ......__ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe 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 kW Workers' CERTIFICATE OF yot sT T Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 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 1d.Federal Employer Identification Number of Insured or Social Security locations in New York State,i.e.,a Wrap-Up Policy) 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 53095 Route 25 3c.Policy effective period Southold, NY 11971 07/01/2022 to 07/01/2023 3d.The Proprietor,Partners or Executive Officers are ❑ included.(Only check box if all psrfeer'sloffrtcers included) all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box"1 a"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 depleted on this form. Approved by: Leonard Scioscia (Print name of authorized representative or licensed agent of insurance carrier) Approved by: 6/24122 (Signature) (Date) Title: Authorized Representative p p g Tele hone 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 E workers' CERTIFICATE OF INSURANCE COVERAGE Yt R .��.� sE ,Compensation w 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 LONG ISLAND POWER SOLUTIONS INC DBA NEW YORK POWER SOLUTIONS 6313480001 2060 OCEAN AVE 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 TOnWN tity eOFing LSOUTHOLfi isted as the ate Holder) Standard Security Life Insurance Company of New York 53095 ROUTE 25 3b.. Policy Number of Entity Listed in Box 1 a 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 F] B.Disability benefits only, C.Paid Family Leave benefits only. 5. Policy covers: 0 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 descr" d above. 74�A . IA� Date Signed I /20/202 By nature of insurance carrier's aumorl +d re resen6five or N (Signature Si g � ,, YS licensed insurance agent of tha[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 513 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) 1111111111111111111111111111111111 iiiiriiiiuN 1111111 Client#: 83393 LONGISL15 DATE((MIM/DD/YYYY).. CERTIFICATELIABILITY I 22023 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. NCVCPORTANT.If the certificate hog ier is an ADDITIONAL INSURED,the ollc ies) must have ADDITIONAL INSURED provisions or be endorsed, I�' y( ) p. 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 NANME= c'r' Commercial Support Edgewood Partners Ins. Center PiIWNE 631-390-9700 FAX 631-390-9790 (Add NO, 40 Marcus Drive E-MAIL NECertificates@epicbrokers.com 3rd Floor Southwest Marine NAI.u Melville, NY 11747-2647 INSURER A:Soul arine&General Ins Co GE IN.5URER S)AF ..._ ............. .... _.,. ... .. ....... 12294 INSURED INSURER B Long Island Power Solutions, Inc dba New URER C York Power Solutions; Michael Catizone INSm NNSWRtR B7 2060 Ocean Avenue .--" Ronkonkoma, NY 11779 ' L........1. - . - .... �. INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE:: POLICIES OF INSURANCE LISTED BELLOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR 1 HE POI ICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECF To WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE:: AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCI...USIONS AND CONDITIONS OF SUCH POLICIES, I..IMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR ... ._......., ... _.. ...., Art X UBR ..� ._..... POLICY EFF " POLICY EXP ..... LIMITS..-GENERAL LIABILITY LIABILITY LtCY!NUMBER .- IMMID,DIYYYY �QMMdF,hOa1+h+YY)- - ....,.— LA COMMERCIAL GEN X ILI Occur,, wuv_D PK20220002069 - �A H CI�URR N�Cp�,,,. I... . s 1OOO TYPE OF INSURANCE 693 02/2812023 02128/2024 EACH OCCURRENCE s2,000,01010 .... CLAINIS-MADE I, ., ........� X PD Ded:5,000 ill"fl r XI'(FV`ry anc�Ipapc�,�nu) I S 1 0,000 X Contractual _._ v..11lrr s Liab. r1 1rvII 2 000 000 A1 Ae,,,rtl';e,reol 1 uM17 Ar>r>I o,;,1,1 r , ori s4 000 000 (c w a°'...... .. ,... .. _ n.,,.._ CON _----- ...... ..�..t rrNlrally .. - r� n rel ne r s4,000,000 s r,cl1 1 v y . � it r __. - ;ccr a dr 1 AUTOMOBILE LIABILITY "i e i......,._. ... .......,, ..._. (i ANY AlU1C,;) 1r rnrl . ,. C7i 111 lr IIVJ1A+l" i 7 r" rlRr��3/CtN1„/ I eUPrq-o fNI� 1 x111 IL11D I.�_. FII NICD. ONl lP'oI -- I �ilf li`d C}�a�INC i:y ',,, I I I Jsli YiA L,_... . .. .7 .Y -"Pof UMBRELLA LIAB i --- (,7(..:C.i.II i r Flf,l l f}f";f,"„l 11 artC h[C,f'. DED I61 E NTIL'N ....FalArl AY 4V)t!'. 'I1 ,.� ..,.._._.. t EXCESS LIAR Cf ..., ... .. .___ ............ ... ____ ........ .. .... ....w,...,..._—� Pehl... .,. WORKERS COMPENSATION OLH AND EMPLOYERS LIABILITY [ AGI C r IY11 IdY F .� N (Mandatory wrp66.RFpWlia:dk.1iC4J�”,"E;^sV rYl.,,a:C....Yld'� Y1... OF I''t hG NI)-Cv7BER r Y,CI I Irlr�)x N(A . in NH) _ ...4 CbVI 1 i o .. ------UIS A'�, C Y'V. .......,.. .......... ....__ If ye> describe under 1 +OESGRIPTION C)F OPERATIONS belowI II:oI.:iA;l I'CJL...IC Y 1�Iblll I P, I DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe 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(2016103) 1 of 1 The ACORD name and logo are registered marks of ACORD #S5283287IM5282808 CPRAV /7-104-kN1111 NYSIF PO Box 66699,Albany,NY 12206 New York State Insurance Fund I nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE A A A A A A 271175107 LOVELL SAFETY MGMT CO.,LLC 110 WILLIAM STREET 12TH FLR NEW YORK NY 10038mp � 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 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,I SU'RANCE FUND UNDERWRITING VALIDATION NUMBER: 530864363 1111111111111111111111101 1 � 0ME 111111053317111111111111111100000000000113 �II�II11�I III Form WC-CERT-NOPRINT Version 3(08/29/2019)[WC Policy-246707881 U-26.3 288 [00000000000113053317][0001-000024670788][#*Z][16088-30][CerLNOP-CERT_1][01-00001] t ' Michael E. Miele® PE Licensed Professional Engineer r, Licensed In New York, New Jersey, Connecticut&California New York License#079676 New Jersey License#44042 Connecticut License#23158 California License#31508 November 3, 2023 Town of Southold Building Department The Office of the Building Inspector 54375 NY-25 Southold, NY 11971 Re: Kathleen McDowell—51540 Route 25, Southold, NY 11971 Single Family Residence, Solar Panel Loading Certification Town of Southold,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 22, 2022 that consists of the installation of(48) REC 420AA PURE-R 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: 130mph No additional structural members were required. The rooves are currently framed with 2x6 true dimensional wood framing @ 16" O.C.and 2x8 wood framing @ 24" 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 NE y. PPV eD W A 9 0 0 co ��.. Cow,- -4 r Michael E. Miele, PE -_ EYCELSNP.; N�OA 079616 v< � 9OFESSO . 33 Quaker Avenue, PO BOX 530, Cornwall, NY 12518 A Phone:845.629.9693® NYPSengineer@gmail.com - N AERIAL O56� '5' WER N ' � SOLUTIC:9 ONS 2060 OCEAN AVENUE, RONKONKOMA, NY 11779 (631)348-0001 McDowell RESIDENCE 51540 ROUTE 25 SOUTHOLD, NY 11971 631-276-5456 S: 70 B: 2 L: 1 7B'FIRE ACCESS - 1 q R-6 - 14 PROJECT DATA:#226440 #MODULES(7) INVERTER:(48)ENPHASE IQ7X-96-2-US PITCH:3s° R-7 MODULES: 48 RE AZIMUTH: 183° #MODULES(14) ( ) C420AA PURE-R R-8 PITCH:13° E e $.. RACKING:IRON RIDGE XR100 #MODULES(2) y r AZIMUTH:183° WATTAGE:20,160 PITCH:35° AZIMUTH:93° ' ROOF TYPE:COMPOSITION SHINGLES W SHEET INDEX. WIND LOAD:-PSF @ 130MPH "' R4.D S-1 SITE PLAN FASTENER:5/16"DIA.5"SS LAGS \ U QA\\\\\ S-2 DETAILS CC \\ ., ,, > ROC) E-1 ELECTRICAL PLAN I.L �� \ 0 �\\ R-s L-1 MOUNTING PLAN to FIREA�c #MODULES(15) Fss PITCH:13° AZIMUTH:183° X\� MICHAEL E. MIELE, PE O �\\ Li.an d PI-fG-1 O1 Engineer Olt ® \ R-3 33 #MODULES(10) QUAKER AVE.— PO Box 530 LL PITCH:35° CORNWALL, NY 12518 AZIMUTH:183° TELEPHONE: (845) 629.9693 3'-8" HOUSE METER - - - EMAIL• MikeMielePE®gmoil.com (27)REC 420W GENERAL NOTES 5-8 METER#9633927756 -ENPHASE MICRO INVERTER LOCATED ON SOF NEI�i��, ROOF BEHIND EACH MODULE. 'A P 'EO►�1/q�y0`' '-8" GARAGE METER J58 " -FIRST RESPONDER ACCESS MAINTAINED " (21)REC 420W " ACCT.#:9633927801 AND FROM ADJACENT ROOF. METER#:80416317 -WIRE RUN FROM ARRAY TO CONNECTION IS 40 FEET. \,.2� • — «� s� , ti �� 796i6� - -COGEN DISCONNECT IS LOCATED � ,o - ADJACENT TO UTILITY METER. ��FESSIONP -LAYOUT SUBJECT TO CHANGE BASED ON ALTERATION OF THIS DOCUMENT EXCEPT BYA DEC 1 ;�.�C SITE CONDITIONS AT DATE OF INSTALL LICENSED PROFESSIONAL IS ILLEGAL PAPER SIZE:11"x 17"(ANSI B) s LEGEND DATE: 11 Cv DESIGN BY: /22/2022 MAIN SERVICE PANEL (INTERIOR) CHECKED BY: EE COGEN DISCONNECT REVISIONS: (4)10129123 KO ® UTILITY METER rois FIRST RESPONDER ACCESS 2020 RESIDENTIAL CODE OF NEWYORK STATE,2020 ENERGY CONSERVATION CODE OF NEWYORK STATE, REPRESENTS ALL FIRE CLEARANCE MINIMUM OF 36"UNOBSTRUCTED AS PER TOWN OF SOUTHOLD CODE,2017 NATIONAL ELECTRIC CODE.ASCE746. SITE PLAN o INCLUDING ALTERNATIVE METHODS THE 2020 RESIDENTIAL CODE OF NYS S.1 IronRidge XR 100 Rail &EDOWER ®� SOLUTIONS -. 2060 OCEAN AVENUE, - RONKONKOMA, NY 11779 (631)348-0001 - = McDowell Cap.__ : - RESIDENCE clamper-, - fi Flashincy 51540 ROUTE 25 SOUTHOLD, NY 11971 _" ,�Ctltnp 631-276-5456 S: 70 B: 2 L: 1 1ronRidgc?CR ►OORail 5/16 x5" Stainless PROJECT DATA:#226440 IronRidge�R 100 Rail T p INVERTER:(48)ENPHASE IQ7X-96-2-US Steel Lag Bolt MODULES:(48)REC420AA PURE-R Solar Module i RACKING:IRON RIDGE XR100 WATTAGE:20,160 "Ex HEAD 0%-A-T ROOF TYPE:COMPOSITION SHINGLES 3/8-1's 1. i WIND LOAD:-PSF @ 130MPH FLAMGE NUI /v FASTENER:5/16"DIA.5"SS LAGS GENERAL NOTES: GENERAL NOTES: R1, R8-L FEET ARE.SECURED TO ROOF RAFTERS @ R51 R6, R7-L FEET ARE SECURED TO ROOF RAFTERS MICHAEL E. MIELE, PE Licensed Professional Engineer 80" O.C. USING 5/16" x 5" STAINLESS STEEL LAG @ 72" O.C. USING 5/16" x 5" STAINLESS STEEL LAG 33 QUAKER AVE.— PO Box 530 CORNWALL, NY 12518 BOLTS. BOLTS. TELEPHONE: (845) 629.9693 -SUBJECT ROOF HAS ONE LAYER. -SUBJECT ROOF HAS ONE LAYER. EMAIL, MikeMielePE®gmail.com -ALL PENETRATIONS ARE SEALED AND FLASHED. -ALL PENETRATIONS ARE SEALED AND FLASHED. oF NEw Al q \. ' r .s/y4 m; Cr ROOF PITCH RIDGE RAFTERS LENGTH OVERHANG NOTES R3 350 2"x8" 2"x6"@16"O.C. 11 '-3" 14" ` `�0,�, 97967rO .9pFESS 0 IOj 3 R5 130 NA 2"x8"@24"O.C. 20 -1 ' �� HEADER 0 ALTERATION OF THIS DOCUMENT EXCEPT BY A " LICENSED PROFESSIONAL IS ILLEGAL R6 380 NA 2x8"@24"O.C. 12'-g" 0" PAPER SIZE:1 1'x 17'(ANSI B) R7 130 NA 211x8"@24"O.C. 20'-3" 0" HEADER DESIGN BY:/22/ 022 MVI/ CHECKED BY: EE 0 R8 350 2"x8" 2"x6"@ 16"0.C. 71-811 14 REVISIONS: (4)10129123 KO U V 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 OFSOUTHOLD CODE,2017 NATIONAL ELECTRIC CODE.ASCE7.16. DETAILS in NO HIGHER THAN 6"ABOVE ROOF SURFACE S-2 c GARAGE PHOTOVOLTAICS: Ca OWER (21) REC420AA PURE-R SOLUTIONS NEMA 3R 2060 OCEAN AVENUE, RONKONKOMA, NY 11779 JUNCTION BOX INVERTERS: (631)348-0001 BLACK-L1 ENGAGE CABLE (21) ENPHASE IQ7X-96-2-US RED-L2 McDowell GREEN-GROUND CIRCUITS: (1)CIRCUIT OF(11) MODULES RESIDENCE (1) CIRCUIT OF(10) MODULES 51540 ROUTE 25 SOUTHOLD, NY 11971 631-276-5456 S: 70 B: 2 L: 1 PROJECT DATA:#226440 INVERTER:(48)ENPHASE IQ7X-96-2-US #12 AWG THWN FOR HOME RUNS UNDER 100' MODULES:(48)REC420AA PURE-RRACKING:IRON RIDGE XR100 #10 AWG THWN FOR HOME RUNS OVER 100' (1)LINE 1 METER WATTAGE:20,160 � � � � (1)LINE L ACCT.#: 9633927801 ROOF TYPE:COMPOSITION SHINGLES (1)GROUND ! WIND LOAD:-PSF @ 130MPH FASTENER:5/16"DIA.5"SS LAGS PER CIRCUIT I&WA . M , "��27.510 METER #: 80416317 IN 1"OR 1a'PVC CONDUIT IMCMTMAC VOLTAGE 240 V HAZARDELEGTRIC SHOCK r — R PHOTOVOLTAIC A' ' d ° MAIN SOLAR SYSTEM IN THE _EN MICHAEL E. MIELE,®PE POSITION Licensed Professional En AC DISCONNECT 33 QUAKER AVE.— PO Box 530 CORNWALL, NY 12518 MAIN SERVICE TELEPHONE: (845) 629.9693 200A EMAIL- MikeMielePE@gmail.com 125A LOAD CENTER - 40A BREAKER LOAD SIDE TAP O F - Ep Wq ' YO (1)-20A BREAKER PER CIRCUIT �] V AR DISCONNECT 1�'r 1' m �¢i' INVERTER OUTPUT CONNECTION DO NOT RELOCATE THIS + #8 AWG THWN AR�FESSIONP� 3 OVERCLJRRENT DEVICE (1)LINE 1 AC DISTRIBUTION PANEL (1)LINE 2 OR SUB PANEL ` (1)NEUTRAL ALTERATION OF THIS DOCUMENT EXCEPT BY A N, (1)EGC LICENSED PROFESSIONAL IS II.I,EGAL iv IN 1"PVC CONDUIT PAPER SIZE:11"x 17°(ANSI B) DATE: 11/22/2022 Y DESIGN BY: MW CHECKED BY: EE REVISIONS: (4)10129113 KO c; N 3' 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 ASCE746. ELECTRICAL PLAN E-1c 60A FUSED SERVICE RATED DISCONNECT qLgERHOUSE PHOTOVOLTAICS: pso ONS NEMA 3R (27) REC420AA PURE 2060 OCEAN AVENUE, JUNCTION BOX RONKONKOMA, NY 11779 (631)348-0001 BLACK—L1 ENGAGE CABLE INVERTERS: RED-L2 I (27) ENPHASE IQ7X-96-2—US McDowell GREEN—GROUND CIRCUITS: RESIDENCE (1)CIRCUIT OF (12) MODULES (1) CIRCUIT OF(8) MODULES 51540 ROUTE 25 (1) CIRCUIT OF(7) MODULES SOUTHOLD, NY 11971 631-276-5456 S: 70 B: 2 L: 1 PROJECT DATA:#226440 INVERTER:(48)ENPHASE IQ7X-96-2-US MODULES:(48)REC420AA PURE-R #12 AWG THWN FOR HOME RUNS UNDER 100' RACKING:IRON RIDGE XR100 #10 AWG THWN FOR HOME RUNS OVER 100' • c WATTAGE:20,160 (1)LINE 1 ROOF TYPE:COMPOSITION SHINGLES (1)-LINE 2WIND' ; WIND LOAD:-PSF @ 130MPH (1)GROUND METER FASTENER:5/16"DIA.5"SS LAGS PER CIRCUIT A i , p p�, 135.37 A ACCTA 9633927756 IN 1"OR 14'PVC CONDUIT ,(� I , aTl AC ..T 240 V ELECTR(C # On- - � METER #: 98357884 D' ' TOUCH;t ; PHOTOVOLTAIC A' SIDES ' t MAIN SOLAR SYSTEM MICHAEL E. MIELE, PE INTH5 ®A ! Li---d Profe..T.nal Engineer AC DISCONNECT LINE SIDE TAP 33 QUAKER AVE.– PO Box 530 I J CORNWALL, NY 12518 TELEPHONE: (845) 629.9693 EMAIL:* MikeMielePE®gmoil.com 60A FUSED SERVICE MAIN SERVICE 125A LOAD CENTER200A "OF NE RATED DISCONNECT ; ��; IV y:\ *INSTALL 200A SERVICE* �, 0�,:\� (1)—20A BREAKER 50A FUSE *COMBINE METERS _ PER CIRCUIT WAW- Lu It A N L.7 ON HOME* ADISCONNECT INVERTER OUTPUT CONNECTION 07967_6 DO NOT RELOCATE THIS 1 #6 AWG THWN #6 AWG THWN ROFES SIONP%` ' OVERCdURRENT DEVICE' (1)LINE 1 (1)LINE 1 (1)LINE 2 (1)LINE 2 ALTERATION OF THIS DOCUMEEXCEPT BY A (I)NEUTRAL (1)NEUTRAL NT AC DISTRIBUTION PANEL LICENSED PROFESSIONAL IS ILLEGAL N (1)EGC (1)EGC OR SUB PANEL PAPER SIZE:11"x 17°(ANSI B) IN 1"PVC CONDUIT IN 1"PVC CONDUIT DATE: 11/22/2022 DESIGN BY: MVS/ Y CHECKED BY: EE 3 REVISIONS: (4)10129/23 KO C o — U 2 N AC COMBINER: NOTE: 2020 RESIDENTIAL CODE OF NEW YORK STATE,2010 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.ASCE746. ELECTRICAL PLAN E-1° 60A FUSED SERVICE RATED DISCONNECT in OWER 2SOLUTIONS _..�_.....�._—•L' _ —�Q :. _. ._t OCEAN AVENUE, RONKONKOMA, NY 11779 ' -_ 631 348-0001 McDowell RESIDENCE .��-,:;:}:'-y.. �r n.;,a-;a-> .,.;yl-d t��'y.:• �::&�"'�,fL'b::"" 1.a, s _ .0,: .{„ "S.`i 'aZ£;y< .2l low'°.KG:.r +aa;s-.. ,. .. •„i,.. e - - 'roY..' 51540 ROUTE 25 _J = SOUTHOLD, NY 11971 Q1== _ O- �- 631-276-5456 R-3 S: 70 B: 2 L: 1 R R-7 -3 PROJECT DATA:#226440 # -�¢ INVERTER:(48)ENPHASE IQ7X-96-2-US MODULES# (1 8) MODULES (8) # MODULES (2) MODULES:(48)REC420AA PURE-R P I T�H, 3 5 RACKING:IRON RIDGE XR100 WATTAGE:20,160 PITCH: 13 0 PITCH. 3 5 ROOF TYPE COMPOSITION SHINGLES AZIMUTH: 13 3 O AZIMUTH. 93'o WIND LOAD:-PSF @ 130MPH AZIMUTH: 183 FASTENER:5/16"DIA.5"SS LAGS MICHAEL E. MIELE, PE \ Licensed Professional Engineer 33 QUAKER AVE.— PO Box 530 CORNWALL, NY 12518 TELEPHONE: (845) 529.9693 EMAIL- MikeMielePE®gmoil.com 17' 14' 19 R-5 ?9 # MODULES (7) 0° 616/ # MODULES (15) o FESSIONP 3 8.5 0 PITCH: 33 - a O ALTERATION OF THIS DOCUMENT EXCEPT BY A o PITCH: 13 AZIMUTH: 13 3 O LICENSED PROFESSIONAL IS II<LEGAL PAPER SIZE: x 1T(ANSI B) ■ SPLICE BAR 12 AZIMUTH: 183° DATE: 11/22/2022 .cr © PENETRATIONS 111 DESIGN BY: mw UFO 140 - CHECKED BY: EE 0 40MM SLEEVE 70 REVISIONS: (4)10129123 K0 END CAPS 72 CONSUMPTION CRITTER GUARD 450' MOUNTING PLAN L•� M OWER SOLUTIONS 2060 OCEAN AVENUE, RONKONKOMA, NY 11779 (631)348-0001 McDowell V1 , 71- RESIDENCE ........ 51540 ROUTE 25 SOUTHOLD, NY 11971 Ak A 631-276-5456 S: 70 B: 2 L: I PROJECT DATA:#226440 INVERTER:(48)ENPHASE IQ7X-96-2-US MODULES:(48)REC420AA PURE-R RACKING:IRON RIDGE XR1 00 WATTAGE:20,160 ROOF TYPE:COMPOSITION SHINGLES WIND LOAD:-PSF @ 130MPH FASTENER:5/16"DIA.5"SS LAGS 7� MICHAEL E. MIELE, PE Lf.�d P"f ..i-�.l --------------- 33 QUAKER AVE.— PO Box 5,30 CORNWALL, NY 12518 TELEPHONE: (845) 629.9693 EMAIL, MikeMielePE@gmall.com OF NE4�,� j)W"i V, Cr 0796 M 4.2 ALTERA77ON OF TMS DOCUNENT EXCEYr BY A LICENSEDIROFESSIONALIS LEGAL PAPER SIZE:I 1")c 17"(ANSI B) DATE: 11/22/2022 DESIGN BY: mw CHECKED BY: EE REVISIONS: (4)10129/23 KO .4 RENDERING FRONT OF HOUSE R- t • i.� rv, tR�. � ,, fir. _ may., c� r , Py+[ • oaf rr� .1,i7r,♦,r;-. 1 y �'3 - ,`' °��J-`_-•� r. "'`�'' ti; _.'_» ' '',,,/J;,//w'•,F, -.C��y' 1, _41 • • ti �,r ie• ri- �/, "S, tt� - 1 -, iii -° yet `x`�f �1 �i: -�FAf �M'` E#!1 McDowell All RESIDENCE 51540 ROUTE 25 7 r , r s4 ` .. - a_ �y... � :�'a■'■r� � - „�j k 1{, I„ :.a • .,. - r �`" -"y*� r� .�a+ .• 1 1 1 �� .Yt ` -n^`!s7`'r' .r., � ..;, Ci�*k 1 �. � � �r' �I�,. %�r F, - fr.�•r ,� a r Yti • `t`Y-. ♦ `„ .•yams^ .r Y \ t�- y/�• "�.;`D _ _ $ - . . - L ♦l,.f! s b "xt f ,h ��.'i •`f .? iv{; wkt :T. 631-276-5456 ''•• � - >>'� v ��. '` ��r•'- 5<, :I' _ � .s}' ,sy 4 ti .,.,x'�.�'�' s- �"'�-Sar>a yPROJECT DATA:#226440 /•:r, �y h '�firtw.6sT*�r,L�i4- �✓ �� _, �'],� �iyr" t - s •2 i�-r i< • MODULES:(48)REC420AA �.' v. -'�.r •r-�� 7= l'j �"' .1.. . _ -_ �. '� _ , ° �. _ .f s{ R• 1 11• `Cf Y r rri •+ -7w C` r _ _ _ ��q 1 '• WATrAGE:20,160 er `r ♦ - � X4 J "y`p } C Rr"� I a» _ _ F �r l r v �"i� N t� ROOF • • r. o, aN SHINGLES 1 ••1130MPH ••: }f'r�_ -� - � y�! , �- �•�• _ --•— - k _ fry,-.� j �' � r.', '�c• y.,a".ti I it mv '2" -` s{`r4r f L-..ate .._ t , •' ,. _ �..flyR +�£r 7 � .. ,'r 3 '�",a r' rc•, 'tµ 1 v J }� I -■ E?t'.� ��,�iE#•rr � - , y.)� •� S roy� .�Y� i' +'�- ��'.� �j�,�_�,• ,^�,+�+ �. "��i!M-„ ^r- _F+`•. ��',S�j `� `a',"��. Y �#�• � •d- � .'lt J� ;�' �` �� a ;sc� �rY -�k 4,�_ '2�" 1" ,s. �'/.s�r.� �5�,,_ �'3'^'�j'r�1'a�yy - _ __ i._' .�,,C'�ik�,.'.t,;� �.,.} x, � � r'-'�+� �'` .'�P,»F}{_ �,s.�<e•• �p"^�',.�r :� � 'FIs x :t �„�'� ,a„ _ � �-- � r S''r •• • 41&�`"Y�_ - J.,;:� ,. > 1 • za �- R S i..:a-•-_ - " r t FI. _�':r i y-:1'Ye 1 �1 .I � S+-_6ti� _ / .J�u.:+�'` Fx ,t�Y�h. .. �'yr •..t.�- ° x� Shy` 4��a'L~ `�.,� F x �7y i�♦M �4ri' C'� i K.F` - G. • �`�.' „ti �• �,�:_ �� _ •,y r _ o ,t' � s:, T ' t �' I w aye >�" .� J;vL*�-:- �• .t '7� � _i. t'�*f�a r r r, i� r � { ♦ �r.� 'S.�,G c 1 w�• 'k. _ :G F fir "'9'.� k/ .j- wa✓a' •��=} r (R>3..r ss �yy _� -" ' .45' r-. �p� - C�.a,,?t�-,y, •ST ? - 2,4-•..j>7r3J' F'. 2"C` < .x.' ' y _7 1. s .( gf�tiA 1;n y� zz ; .• =� ,'L ±�y f i +�`r`�' �`ynj, .- n .rs c ..k. a C � �:�fi � '-^•- �*♦ .. _ _._"_—._ _ r Cyt d-3 J •t: �� ii.. ••� � i tr. L%_ y r P T ! ��.s-.+,+ I r'�` + .�e s�:�'l•',: 5 i f. � � 'raY S f :,i•' } .5s WI C+, /'I IJ •1" »f,` .i•C r. - .1.. fO DATE: 11/22/2022 DESIGN BY: IL mW CHECKED BY: EE �. / I 1 a RENDERING, ■ OVERHEAD ■ ' , Arno SOLUTIONS 2060 OCEAN AVENUE, RONKONKOMA, NY 11779 (631)348-0001 McDowell RESIDENCE =_ . 51540 ROUTE 25 SOUTHOLD, NY 11971 631-276-5456 S: 70 B: 2 L: 1 PROJECT DATA:#226440 o- INVERTER:(48)ENPHASE IQ7X-96-2-US MODULES:(48)REC420AA PURE-R ,,► y r t I RACKING:IRON RIDGE XR100 WATTAGE:20,160 A" ROOF TYPE:COMPOSITION SHINGLES `~ Vt WIND LOAD:-PSF @ 130MPH FASTENER:5/16"DIA.5"SS LAGS MICHAEL E. MIELE, PE Licensed Professional Englna 33 QUAKER AVE.— PO Box 530 !1 CORNWALL, NY 12518 TELEPHONE: (845) 629.9693 EMAIL: MikeMielePE®gmoil.com OF NEw,,. `P�-�EDWq� lJ• � /�GI / ALTERATION OF THIS DOCUMENT T BY A EXCEPT u LICENSED PROFESSIONAL IS EXCEPL C c PAPER SIZE:11'x 17°(ANSI B) Y DATE: 11/22/2022 DESIGN BY: MW 3 CHECKED BY: EE c REVISIONS: (4)10119123 KO 3 to ti RENDERING REAR YARD R■4 C4:)OWER SOLUTIONS 2060 OCEAN AVENUE, RONKONKOMA, NY 11779 (631)348-0001 McDowell RESIDENCE 51540 ROUTE 25 SOUTHOLD, NY 11971 631-276-5456 - - S: 70 B: 2 L: 1 i PROJECT DATA:#226440 —- ' --- - ❑ -- --- - INVERTER:(48)ENPHASE IQ7X-96-2-US MODULES:(48)REC420AA PURE-R - - RACKING:IRON RIDGE XR100 WATTAGE:20,160 ROOF TYPE:COMPOSITION SHINGLES - - - WIND LOAD:-PSF @ 130MPH FASTENER:5/16"DIA.5"SS LAGS 1H Ll B _ - --- - MICHAEL E. MIELE, PE LEI - 33 QUAKER AVE.- PO Box 530 -- - -- -' WAL , NY 12518 Ell. ___v _ _ ,-____, -_ TELEP ONE•L(845) 629 9693 -" -- - % - - i e ie eP at com _I EMAIL: M'k M' I E®gm 'I. --- o -- - - - - --- - -- - -- ipF _—_ _ __ ____--_IL_ -__ _-__ _ cc•.'Iil i ''.4• � � - W r i >FOA9. 967�P��li? ��FESSION�. N - ALTERATION OF THIS DOCUMENT EXCEPT BY A c� LICENSED PROFESSIONAL IS ILLEGAL C — PAPER SIZE:11"x 17"(ANSI B) L DATE: 11/22/2022 DESIGN BY: MW CHECKED BY: EE o REVISIONS: (4)10129123 KO 0 3 ELEVATION FRONT OF HOUSE A-1 . OWER SOLUTIONS 2060 OCEAN AVENUE, RONKONKOMA, NY 11779 (631)348-0001 McDowell RESIDENCE 51540 ROUTE 25 SOUTHOLD, NY 11971 _ 631-276-5456 S: 70 B: 2 L: 1 PROJECT DATA:#226440 INVERTER:(48)ENPHASE IQ7X-96-2-US MODULES:(48)REC420AA PURE-R RACKING:IRON RIDGE XR100 WATTAGE:20,160 ROOF TYPE:COMPOSITION SHINGLES WIND LOAD:-PSF @ 130MPH - LH - -- - / - - - FASTENER:5116"DIA.5"SS LAGS - -- - - _ 1 i -- --- - MICHAEL E MIELE P -/ - --- _- ------- --,-- _ _ _ ----- - -- _--- ____ - ---- -- --"--- -- __ —_ Licensed Professional Engine : 33 ----- ------ ----� ---FQUAKER - -- - - - 530 CORNWALVE. NY - _ - - -- -- --: PO Box y y L 7i - _ y TELEPHONE: (845) 629.9693 EMAIL ------ - '--' ------- ___-_ MikeMielePE®gmail.com f 00 - — --- - - r- : OF N - - -=- - - – ED W,4-,-. : I' . ,• _ -- V*_ , 9 o SSIONP\:' N ALTERATION OF THIS DOCUMENT EXCEPT BY A c LICENSED PROFESSIONAL IS ILLEGAL 0 PAPER SIZE:11'x 17°(ANSI B) Y DATE: 11/22/2022 DESIGN BY: MW 3 CHECKED BY: EE o REVISIONS: (4)10129123 KO N 61 3 ELEVATION A■� SOUTH SIDE OF HOUSE A -7 C OWER 4s:0)LUTIONS 2060 OCEANAVENUE, RONKONKOMA, NY 11779 (631)348-0001 McDowell RESIDENCE 51540 ROUTE 25 SOUTHOLD, NY 11971 631-276-5456 -'` S: 70 B: 2 L: 1 PROJECT DATA:#226440 INVERTER:(48)ENPHASE IQ7X-96-2-US MODULES:(48)REC420AA PURE-R -- RACKING:IRON RIDGE XR100 WATTAGE:20,160 ROOF TYPE:COMPOSITION SHINGLES WIND LOAD:-PSF @ 130MPH FASTENER:5/16"DIA.5,SS LAGS i - - - --- - ---------- ----- --,- - - -,--- MICHAEL E. MIELE, PE -- Lfcensed Professional Engineer - — - - - - - -- - - -- 33AVE.- P1 Box 530 ------ . AVE CORNWALL NY 8 TELEPHONE: (845) 629.9693 _ / ! EMAIL: MikeMielePE®gmoil.com o W - P ODW .p - - -- n ,w ; �FESSIONj' Q ALTERATION OF THIS DOCUMENT EXCEPT BY A N LICENSED PROFESSIONAL IS ILLEGAL PAPER SIZE:11'x 17'(ANSI B) DATE: 11/22/2022 Y DESIGN BY: MW CHECKED BY: EE REVISIONS: (4)10129123 KO c U c C ti ELEVATION BACK OF HOUSE A-3 4DOWER SOLUTIONS 2060 OCEAN AVENUE, RONKONKOMA, NY 11779 (631)348-0001 McDowell RESIDENCE 51540 ROUTE 25 SOUTHOLD, NY 11971 631-276-5456 S: 70 B: 2 L: 1 PROJECT DATA:#226440 INVERTER:(48)ENPHASE IQ7X-96-2-US MODULES:(48)REG420AA PURE-R - RACKING:IRON RIDGE XR100 WATTAGE:20,160 ROOF TYPE:COMPOSITION SHINGLES WIND LOAD:-PSF @ 130MPH -- - , --- -- - - - - FASTENER:5/16"DIA.5"SS LAGS ILA MICHAEL E. MIELE, PE -- ;- -- - - - - ---- 33 - 530 ® o . UAKER AVE. ■ -- :- ,- - -'— --- - -r7 CONWALL, NY 12518 TELE HONE: (84) 629.9693 EMAIL, MikeMielePE®gmaii.com OF NjE� - - - — -'- --: - - - - CrC i cb 079676 N ALTERATION LICENSED PROFESION DOCUMENT BY A ILLEGAL L CJ C d PAPER SIZE:11"x 17,(ANSI B) Y DATE: 11/22/2022 DESIGN BY: MW CHECKED BY: EE 3 REVISIONS: (4)10129123 KO 0 U U1 C 3 m ELEVATION A■A 4 o NORTH SIDE OF HOUSE fi FOWER UTIONS 2060 OCEAN AVENUE, RONKONKOMA, NY 11779 (631)348-0001 McDowell RESIDENCE 51540 ROUTE 25 SOUTHOLD, NY 11971 631-276-5456 S: 70 B:2 L: 1 PROJECT DATA:#226440 INVERTER:(48)ENPHASE IQ7X-96-2-US MODULES:(48)REC420AA PURE-R RACKING:IRON RIDGE XR100 WATTAGE:20,160 ROOF TYPE:COMPOSITION SHINGLES WIND LOAD:-PSF @ 130MPH FASTENER:5/16"DIA.5"SS LAGS ��-- 7 MICHAEL E. MIELE, PE Licensed Profesatonal Engineer 33 QUAKER AVE.— PO Box 530 CORNWALL, NY 12518 TELEPHONE: (845) 629.9693 EMAIL MikeMielePE®gmail.com f-pWq�yp: \oxx 07967 AROFESSIONPX� N ALCENSED P OFESUME �EXCEPT BY A SIIpNALISn i FGAL N PAPER SIZE:11"x 17'(ANSI B) DATE: 11/22/2022 DESIGN BY: MW CHECKED BY: EE 3 REVISIONS: (4)10129123 KO G :J V C 3 ELEVATION FRONT OF BARN A'5 O'ER C4s:) OLUTIONS 2060 OCEAN AVENUE, RONKONKOMA, NY 11779 (631)348-0001 McDowell RESIDENCE 51540 ROUTE 25 SOUTHOLD, NY 11971 631-276-5456 S: 70 B: 2 L: 1 PROJECT DATA:#226440 INVERTER:(48)ENPHASE 107X-96-2-US MODULES:(48)REC420AA PURE-R - - -- - — RACKING:IRON RIDGE XR100 WATTAGE:20,160 _ ROOF TYPE:COMPOSITION SHINGLES WIND LOAD:-PSF @ 130MPH FASTENER:5/16"DIA.5"SS LAGS - - MICHAEL E. MIELE, PE Licensed Professional Engineer i 33 QUAKER AVE.- PO Box 530 CORNWALL, NY 12518 TELEPHONE: (845) 629.9693 13 EMAILMikeMielePE®gmail.com ti .. 0F N_Ew y>,. EDW'q,0" , ,. ` r 079 \ 9OF_�--% •ter o - LICENSED PROFESSIONALis1 NT GA BY A n� (V EGAL PAPER SIZE:11"x 17"(ANSI 6) s DATE: 11/22/2022 DESIGN BY: MVS/ CHECKED BY: EE REVISIONS: (4)10129123 KO 0 0 U Ul G1 C 3 ELEVATION A- 6 ■c SOUTH SIDE OF BARN f1 V C4DOWER SOLUTIONS 2060 OCEAN AVENUE, RONKONKOMA, NY 11779 (631)348-0001 McDowell RESIDENCE 51540 ROUTE 25 SOUTHOLD, NY 11971 631-276-5456 S: 70 B: 2 L: 1 PROJECT DATA:#226440 INVERTER:(48)ENPHASE IQ7X-96-2-US MODULES:(48)REC420AA PURE-R RACKING:IRON RIDGE XR100 WATTAGE:20,160 ROOF TYPE:COMPOSITION SHINGLES WIND LOAD:-PSF @ 130MPH FASTENER:5116"DIA.5"SS LAGS Iij i _ I I _77 E3 -- -� MICHAEL E. MIELE, PE Licensed Professional Engineer 33 QUAKER AVE.— PO Box 530 CORNWALL, NY 12518 TELEPHONE: (645) 629.9693 EMAIL, MikeMielePE®gmoil.com SOF NE \ ED W q Ro 0' /c?%Q *\ mii Lm 079676/ / 3 \�FESSI�NP� Q ALTERATION OF THIS DOCUMENT EXCEPT BY A LICENSED PROFESSIONAL IS ILLEGAL N n PAPER SIZE:11°x 17°(ANSI B) C DATE: 11/22/2022 DESIGN BY: MW Y CHECKED BY: EE 3 REVISIONS: (4)10129123 KO 0 D N C 3 ELEVATION BACK OF BARN A-7 &DOWER SOLUTIONS 2060 OCEAN AVENUE, RONKONKOMA, NY 11779 (631)348-0001 McDowell RESIDENCE 51540 ROUTE 25 SOUTHOLD, NY 11971 631-276-5456 S: 70 B: 2 L: 1 PROJECT DATA:#226440 INVERTER:(48)ENPHASE IQ7X-96-2-US MODULES:(48)REC420AA PURE-R RACKING:IRON RIDGE XR100 WATTAGE:20,160 ROOF TYPE:COMPOSITION SHINGLES WIND LOAD:-PSF @ 130MPH FASTENER:5/16"DIA.5'SS LAGS MICHAEL E. MIELE, PE Licensed Prof®..i0n 1 Engin®ar 33 QUAKER AVE.— PO Box 530 CORNWALL, NY 12518 TELEPHONE: (845) 629.9693 EMAIL- MikeMielePE@gmoil.com F NEwy '. `x C) Lu'r }a \x,09 0-7967rO �FESS10 o MN OF NT EXCEPT c� AL L C _ENSED PROFESSIONAALL S=GALBY A R PAPER SIZE:11°x 17°(ANSI B) DATE: 11/22/2022 Y DESIGN BY: MW z CHECKED BY: EE REVISIONS: (4)10129123 KO c 0 U V L31 3 ELEVATION NORTH SIDE 01 BARN A■8