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Home My WebLink About50252-Z �Og�FFaLMco� Town of Southold 5/13/2024 ao �� P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 45178 Date: 5/13/2024 THIS CERTIFIES that the building SOLAR PANEL, - Location of Property: 420 Glenn Rd, Southold SCTM#: 473889 Sec/Block/Lot: 78.-2-22 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 12/22/2023 pursuant to which Building Permit No. 50252 dated 1/25/2024 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: solar panels to an existing one family dwelling as applied for The certificate is issued to Blum,Jeffrey&Melissa of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 50252 02/14/2024 PLUMBERS CERTIFICATION DATED Autho ized 6ignature o�SufF TOWN OF SOUTHOLD BUILDING DEPARTMENT CAx TOWN CLERK'S OFFICE • 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#: 50252 Date: 1/25/2024 Permission is hereby granted to: Blum, Jeffrey 420 Glenn Rd Southold, NY 11971 To: install roof-mounted solar panels on existing single-family dwelling as applied for. At premises located at: 420 Glenn Rd, Southold SCTM # 473889 Sec/Block/Lot# 78.-2-22 Pursuant to application dated 12/22/2023 and approved by the Building Inspector. To expire on 7/26/2025. Fees: SOLAR PANELS $100.00 ELECTRIC $125.00 CO-ALTERATION TO DWELLING $100.00 Total: $325.00 Building Inspector OF SO!/l�,ol . � o Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 Q Southold,NY 11971-0959 r1h sean.devlina-town.southold.ny.us BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Jeffrey Blum Address: 420 Glenn Rd city:Southold st: NY zip: 11971 Building Permit#: 50252 Section: 78 Block: 2 Lot: 22 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: Electrician: GreenLogic License No: 43858ME SITE DETAILS Office Use Only Residential X Indoor X Basement Solar X Commerical Outdoor X 1st Floor Pool New X Renovation 2nd Floor Hot Tub Addition Survey X Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors Sub Panel A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO Transfer Switch UC Lights Dryer Recpt Emergency Strobe Heat Detectors Disconnect Switches 4'LED Exit Fixtures Sump Pump Other Equipment: 10.92kW Roof Mounted PV Solar Energy System w/ (26) REC420AA Pure-R Module: SunPower Monitor, Combiner Panel Notes: Solar Inspector Signature: Date: February 14, 2024 S.Devlin-Cent Electrical Compliance Form pF So(/1,�°� # # TOWN OF SOUTHOLD BUILDING DEPT. 60?s �courm�� 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I SULATIOWCAULKING [ ] FRAMING/STRAPPING [ FINAL --SO/,t 9. [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PR C/O [ ] RENTAL REMARKS: DATE 5� 4' INSPECTOR rjf so # # TOWN OF SOUTHOLD BUILDING DEPT. co 631-765-1802 INSPECTION [" ] FOUNDATION 1 ST/ REBAR [ ] 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. Vow- DATE / INSPECTOR FIELD INSPECTION REPORT DATE COMMENTS ( � V ,'d O - N FOUNDATION(IST) N y ------------------------------------ C FOUNDATION(2ND) . 71 0 ROUGH FRAMING& y N PLUMBING . � N N O � INSULATION PER N.Y. STATE ENERGY CODE O FINAL ADDITIONAL COMMENTS rr \\ p �z N � N O c� z d b H. 11A o�gllffQ(K TOWN OF SOUTHOLD=BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O.Box 1179. Southold,NY 11971-0959 of �aa� Telephone (631)'765-1802 Fax(631)765-9502 https://www.southoldtom=.gov Date Received APPLICATION FOR BUILDING PERMIT , For Office Use Only PERMIT NO. 0� Building Inspector: ��C 'Z ZO2 3 ,_Applications and.forms must be filled out in their,entirety.Incomplete 10o,111AIng IDOV 1dth applications will knot be accepted.,;Where the Applicant is,not the o"w' ner,,an '[owl of`'®u Owner's Authorization form(Page 2)shall be-cornpleted. Date: 12.117123 OWNERS)OF PROPERTY Name:Jeffrey Blum SCTM#1000-78-2-22 Project Address:420 Glenn Road Southold NY 11971 Phone#:415-902-4205 Email:-jqblqm@gmail.com Mailing Address: yz p (V- V b �jOV-rE•(pL� �� )) ��-) CONTACT PERSON: Name_Barbara - GreenLogic LLC Mailing Address:97 North Sea Road, Southampton, NY 11968 h Phone#:631-771-5152 x117 Email:Barbara@Greenlogic.com DESIGN PROFESSIONAL'INFORMATION:, Name:J. J 550C - - Mailing Address: Phone#: 3- g mail: V CONTRACTOR INFORMATION: Name:GreenLogic LLC Mailing Address:97 North Sea Road, Southampton, NY 11968 Phone#:631-771-5152 Email:AM@Greenlogic.com DESCRIPTION OF PROPOSED,CONSTRUCTION', ❑New Structure ❑Addition RAlteration ❑Repair ❑Demolition Estimated Cost of Project: DOther Solar Panels $ 40,000 Will the lot be re-graded? ❑Yes RNo Will excess fill be removed from premises? ❑Yes BNo 1 h 1 PROPERTY INFORMATION Existing use of property:� p A�,,1l /� Intended use of property: 1 —Qf51.0 wL IQI WlI�7��E51, t '1G '� Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yes ONo IF YES, PROVIDE A COPY. B 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 Co 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&Regulations;for the construction of buildings, . additions,alterations or for removal or dainolition.as herein described.The applicant agrees to comply with all applicable laws;:6rdlnances;;building code, housing code and regulations and to'admit authorized inspectors on premises and'in building(s)for necessary inspections:Fals@statements made herein are punishable as a Class A misdemeanor pursuant to Section 21CAS of'the New York State Penal Law: Application Submitted By(print name):Green Logic LLC BAulthorized/Agent Downer Signature of Applicant: '(/�_ Date: STATE OF NEW YORK) SS: COUNTY OF Suffolk ) Nesim Albukrek being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the Contractor (Contractor,Agent,Corporate Officer,etc:) of said owner or owners,and is duly authorized,to perform or have performed the said work and to make and file this application;that all statements contained in this application are true to the best of his/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 i day of 20 023' No ry Public, BARBARA A CASCIOTTA Notary Public-State of New Ya* No.O1CA4894969 PROPERTY OWNER AUTHORIZATION auMedIn Suffolk Courlly (Where the applicant is not the owner) Go m i III P,n Evirm May 11,2W I, Jeffrey Blum residing at/4Zo CV,6NN F9 5out1-luij0,NV 1 lC( I do hereby authorize GreenLogic LLC to apply on my behalf to the Town of Southold Building Department for-approval.as described herein. Owner's Signature Date Jeffrey Blum Print Owner's Name 2 gUfFOLK�, BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD Town Hall Annex - 54375 Main Road - PO Box 1179 co Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 rr ; rogerr(aDsoutholdtownny.gov — seand(cDsoutholdtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: 12/18/2023 Company Name: GreenLogic LLC Name: Robert Skypala License No.: 43858-ME email: Barbara@Greenlogic.com Phone No: 631-771-5152 01 request an email copy of Certificate of Compliance Address.: , 97 North Sea Road Southampton, NY 11968 JOB SITE INFORMATION (All Information Required) Name: Jeffrey Blum Address: 420 Glenn Road, Southold, NY 11971 Cross Street: Phone No.: 415-902-4205 Bldg.Permit#: (�Zrj� email: jeblum@gmaii.com l Tax Map District: 1000 Section: 78 Block: 2 Lot: 22 BRIEF DESCRIPTION OF WORK (Please Print Clearly) Roof mounted solar electric system **(26) REC420AA PURE-R panels Et (26) Enphase IQ7XS micro inverters (1) SunPower PVS6 monitor System Size: 10.920KW Check All That Apply: Is job ready for inspection?- DYES ❑✓ NO ❑Rough In ❑✓ Final Do you need a Temp Certificate?: ❑✓ YES ONO Issued On Temp Information: (All information required) Service Size ❑1 Ph ❑3 Ph Size: A # Meters Old Meter# ❑New Service ❑ Service Reconnect ❑ Underground []overhead # Underground Laterals ❑1 02 ❑H Frame❑Pole Work done on Service? ❑Y ❑N Additional Information: `* Panels also known as SunPower SPR-U-420-BLK-R-DC PAYMENT DUE WITH APPLICATION Electrical Inspection Form 2020.xlsx 5 U RV EY Of LOT 6 N A5 SHOWN ON A CERTAIN MAP ENTITLED"MAP OF WE57 CREEK ESTATES" FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY AUGUST 19, 19G3A5 MAP NO.3848 Q� e 51TUATE: 50UTHOLD a W E TOWN : 5OUTHOLD 5UFFOLK COUNTY, NY w SURVEYED 1 1 -08-2018 PROPOSED 12- 18-2018 REVISED 01- I 0-2019 REVISED 02-2G-2019, 04-02-2019 04-05-2019 SUFFOLK COUNTY TAX # 1000 - 78 - 2 - 22 n/ CERTIFIED TO: JEFF BLUM Q asf',hla/��' MELISSA KONDAK CHICAGO TITLE INSURANCE SERVICES,LLC PROP05ED LOT COVERAGE INFORMATION / eQ 3OyA M wq TAX MAP N (ZONE R-4O) I GL7O-72-2-22 it / 'pER�R AREA LANDWARD OF FLAGGED WETLANDS 20,551 S.F. a T J EXISTING COVERAGE OQ: M/Nr N A r ¢�a� OL" EXIST.HOUSE i GARAGE 1,645 S.F. ; / '^ 1 gD�o' -' M/N' %FN A EXIST.DECK 387 S.F. 4 J 8 7r co PROPOSED&EXIST.COVERAGE PR p, ° i;I C'P A 1 gO�s Toe)Q E105TING HOUSE 1,645 S.F. PROPOSED ADDITIONS 348.E S.F. /Or 0/ PROPOSED POOL 5 I O S.P. ltil/ G10.3 M/N ai T O PROPOSED DECK 1,226.25,F. y� F,�T/tic / �O SoZO TOTAL PROPOSED COVERAGE 3.729.8 S.F.or",,, 9a / Gq gFlp�hpUSORY 41, ��r7 pR0 FF FFC.�'GF �. ZINZ OF OS /pOI TO FO < O jl O/T Rr' RSUST�fS 2p�ory`p /yF/C o��roN o 0) '0 pR0 `PROP c' Dr• Ors ( .6 236 oFo F3 oR�A � s9^ N�. �' 4'O N If) //\\\ �(S>\ \p00 D v tLv E To l / � t 0�C / 6i`` OO JUR SD�CT�N co / h/ IV e( ) 0 (j) o /Gh Wq R OOU� S 2 4g4 pAy ST c 22A WETLAND FLAGS SHOWN THUS#/ WERE SET DY SURVEYOR F.E.M.A. FLOOD ZONE SHADED X t AE(EL G) FROM F.I.R.M. PANEL 3G 103C01 GGH PROPOSED SEPTIC SYSTEM DETAIL F.F. (NOT TO SCALE) ELEV. .J COVER TEST HOLE DATA EL=8.0' ELFY. 1 '' GRADE LOCKING CAST IRON BY SURVEYOR TO GRADE GRADE ELEV.8.0' I I-OS-18 c/D TOP E4 7.9' TOP EL.7.2 .�_g•_I2• 1280 GAL. MIN.4-D4L. -6- BROWN BROWN LOAM APPROVED PIPE SEPTIC APPROVED LEACH Inc LEACNNG 1.5' �'73: min.PITCH 1/4"/1' ANK mn,PITCH 1/8"/1' INV.PEL.. .4' POOL INV.EL.7.0' INV,EL. 6.� e•—�-I I-- -�1 SW PALE BROWN FINE TO COARSE SAND �- B—� - -- RIAL DISTRIBUTION PoOL DF HIGHEST E%PELTED C�OARSCLS.AND&CRAV<L 7.3' 4 POOL SYSTEM DOT.EL.4.7' GROUND WATER SEPTIC TANK (1) ELEV.0.9' 1-5w] LEACHING POOLS (6) WATER IN PALE BROWN PINE 1,MINIMUM SEPTIC TANK A AtRWINIES FORA 4 BEDROOM HOUSE 6 1,250 GALLONS, 1,MIIRMUM LEACH114G'>YSTCU FOR A 4 BEDROOM HOUSE POOL HOUSE IS 300 IQ n SIDEWALL AREA, TO COARSE SAND 2.CONCRETE SHALL HOVE A MINIMUM COMPRESSM STRENGTH OF 3.000 A41 AT 2B DAY,. 6 POOLS;Y DEEP,e'6P. J.WALL TILS,BoS SHALL DE A SMALL OF X.IN A TOP TING 10 S RESIST a'AND A EDBOTTOM E OF 3SS OF a', 2.LEACHING POOLS PRE TO BE CONSTRUCTED OF PRECAST REINFORCED CONCRETE(OR EQUAL) 12.3' ALL WALLS,BOTTOM AND TOP SHALL CONTAIN REINFORGRiG TO RESIST AN APPLIED FORCE OF 300 ps1• LEACHING STRUCTURES,SOLID DOMES AND/OR SLABS. 4.ALL do SHALL BE SCALED SO THAT THE TANK IS WATERTIGHT. 3.ALL COVERS SHALL BE OF PRECAST REINFORCED CONCRETE(OR EQUAL). 5.THE SEPTIC TANK SHALL BE NSTALLED AT LEVEL IN ALL DIRECTIONS(WITH A MAY,TOLERANCE OF i1/4•) 4.A 10'm .DISTANCE BEIWEEN LEACHING POOLS AND WAIER LINE SIVLLL DE MMN`lAINED. ON A MINIMUM 3'THICK BED OF COMPACTED SAND DR PEA GRAVEL. 5.AN D' M.DISTANCE BETWEEN ALL LEACHING POOLS AND SEPTIC TANK SHALL BE MNNTAINED. COMMENTS:WATER ENCOUNTERED 7.3'BELOW SURFACE 6.A ID'min.DISTANCE BETWEEN SEP11C TANK AND HOUSE SHALL BE MAINTAINED. NOTES: "Unouthorized alteration or oddllion to a survey PIPE FOUND J O H N C. E H LE RS LAND SURVEYOR S�°�� NE�° map bearing a licensed,and surveyors ion (s o violation of section 7209.sub-division 2.of the ,�`Ci.ELr� ,✓� New York Slate Education Law." /L \ ��77 "Only copies from the original of this survey 51 �Q marked with on original of the land surmyor's '�•P stamped seal shall be considered to be valid true -ELEVATIONS REFERENCE NAVD 88 DATUM copies -ON PROPERTY IS FLOATING DOCK 4h24'4 RAMP 4'xI 1' O EAST MAIN STREET N.Y.S. LTC. NO, 50202 ;) AF. 'Certifications indicated hereon signify that this �y 4- survey was prepared in accordance with the ex- Area = 22 214 S Ft. RIVERHEAD N.Y. 11901 3G9-8288 Fax 3G9-8287 f isling Coda of Practice for Lend Surveys adopted �' t „ by the New York Stale Assoclotlon of Prole"onal Area = 0.5) Acres 0 cA �� Land Surveyors. Soid certifications shall run only 1c SC LE je5urvey@optonllne.net L 60202 `� to the person For whom the Survey Is prepared, s� p• and on his behalf to the title company,governmen- �. y, LANDS 1- lot agency end lending insUlutlon listed hereon, and to the assignees of the lending institution. CerNfico- ' 17-I j lions are not transferable to additional instilulions GREENLOGICO ENERGY December 18, 2023 Town of Southold Building Department Town Hall 53095 Route 25 Southold, NY 11971 Project Info: Jeffrey Blum 420 Glenn Road Southold, NY 1000-78-2-22 Dear Building Inspector: Please find attached a building permit application to install a roof mounted solar photovoltaic(PV) electric system for the above referenced property. In connection with this application, please find attached: • Building Permit application with owner authorization • Application for Electrical Inspection • 2 Surveys of the Premises. • 4 Engineer's Reports • 2 Three Line Electrical Drawings • 2 Spec. sheets of the solar panels • 2 Spec. sheets for Racking System • 2 Spec.sheets for Monitoring System • GreenLogic Suffolk County Home Improvement License • GreenLogic Certificate of Liability Insurance • GreenLogic Certificate of Worker's Compensation Insurance Coverage • Installation Manager's Master Electrician's License • Check for$325 ($100 Building Permit/$100 CO/$125 Electrical Inspection) Please let us know if you need anything else in connection with this application. Yours truly, J13avaom eaecMUa Barbara Casciotta Account Manager Barbara@Greenlogic.com GREENLgy�C �5 'ex er�llc ic.com Tel: 631.771.5152 Fax: 631.771.5156 SOUTHAMPTON ROSLYN HEIGHTS 97 North Sea Rd., Suite 3 200 S.Service Rd.,#104C Southampton, NY 11968 Rosyln Heights, NY 11577 ,ac v CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDmYY) t� Fol/2612023 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Nicholas Zulkofske Brookhaven Agency,Inc. PHONE 631 941-4113 Fax 631 941-4405 100 Oakland Ave,Ste 1 &MAIL Certificates@ brookhavena enc .com Port Jefferson,NY 11777 INSURER(SI AFFORDING COVERAGE NAIL# INSURER A- Southwest Marine&General Insurance Co. INSURED INSURER B: Merchants Preferred Insurance Co. GreenLogic,LLC INSURER c:First Rehab Life Insurance Co. 97 North Sea Rd,Suite 3 INSURERD:National Liability&Fire Insurance Co. Southampton NY 11968 INSURERE: AGCS Marine Insurance Co. 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1 000 000 A CLAIMS-MADE p OCCUR DAMAGE TO RENTED $1 OO OOO X Contractual Liability X X GL202300012922 01/31/2023 01131/2024 MED EXP(Any oneperson) $5 000 PERSONAL&ADV INJURY $1 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2 000 000 POLICY 7 PRO- LOC PRODUCTS-COMP/OP AGG $2 000 000 JECT OTHER: E&O Liability $1 000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1 000 000 B X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED X X CAP1043565 08/11/2022 08/1112023 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED Ix NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED RETENTION $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N ANY ECUTIVE E.L.EACH ACCIDENT $ OFFICERIMEM ER EXCLUDED? ❑ N/A see separate certificate (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C NYS Disability D251202 04/11/2022 04/1112023 Statutory Limits E Installation Floater/Property SML93076366 04/15/2022 04/15/2023 $300,000 $2,500 Ded DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Certificate holder is also named as Additional Insured. CERTIFICATE HOLDER CANCELLATION TOWN OF SOUTHOLD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BUILDING DEPARTMENT ACCORDANCE WITH THE POLICY PROVISIONS. 53095 ROUTE 25 SOUTHOLD,NY 11971 AUTHORIZED REPRESENTATIVE <NSZ> @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Y Workers'srnrs Compensation CERTIFICATE OF INSURANCE COVERAGE 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 carree 1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured GREENLOGIC,LLC 631-941-4113 97 NORTH SEA ROAD,SUITE 3 SOUTHAMPTON,NY 11968 SOUTHAMPTON,NY 11968 1 c.Federal Employer Identification Number of Insured or Social Security Number Work Location of Insured(Only required if coverage is specifically limited to certain locations in New York State,i.e.,Wrap-Up Policy) 203801194 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) ShelterPoint Life Insurance Company Town of Southold Building Department 3b.Policy Number of Entity Listed in Box"I a" 53095 Route 25 DBL251202 Southold, NY 11971 3c.Policy effective period 04/11/2022 to 04/10/2024 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: 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 described above. Date Signed 4/4/2023 By 1 , 4/ (Signature of Insurance carrier's authorized representative or NYS Licensed Insurance Agent of that insurance carrier) Telephone Number 516-829-8100 Name and Title Richard White, Chief Executive Officer IMPORTANT: If Boxes 4A and 5A are checked,and this form is signed by the insurance carrier's authorized representative or NYS Licensed Insurance Agent of that 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 413,4C or 58 have 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) III i III 11l DB-120.1 (12-21) k ' PORK Workers' CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured Greenlogic LLC (631)771-5152 97 North Sea Rd 1 c.NYS Unemployment Insurance Employer Registration Number of Suite 3 Insured South Hampton,NY 11968 Work Location of Insured(Only required if coverage is specifically limited to 1d.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-Up Policy) Number 203801194 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) United Wisconsin Insurance Company 3b.Policy Number of Entity Listed in Box"1 a" TOWN OF SOUTHOLD WC605-00090-023-SZ BUILDING DEPARTMENT 53095 ROUTE 25 3c.Policy effective period SOUTHOLD,NY 11971 01/01/2023 to 01/01/2024 3d.The Proprietor,Partners or Executive Officers are Included.(only check box if all partners/officers 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 depicted on this form. Approved by: Alicia Christiansen (Print name of authorized representative or licensed agent of insurance carrier) Approved by: '499 d� l2 2_0ZZ (Signature) (Date) Title: Director of Sales Operations Telephone Number of authorized representative or licensed agent of insurance carrier: 941-306-3077 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 DocuSign Envelope ID:7BC1668A-3838-462A-84OB-39E28CE1 FOC2 NEW Workers' CERTIFICATE OF YortSTATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Hoard 1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured 631-771-5152 GREENLOGIC LLC 97 N SEA RD STE 3 1c.NYS Unemployment Insurance Employer Registration Number of SOUTHAMPTON,NY 11968 Insured Work Location of Insured(Only required if coverage is specifically limited to 1d.Federal Employer Identification Number of Insured or Social Security certain locations in New York.State,i.e.,a Wrap-Up Policy) Number 20-3801194 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Indemnity Insurance Co.of North.America TOWN OF SOUTHOLD BUILDING DEPARTMENT 3b.Policy Number of Entity Listed in Box"la" 53095,ROUTE 25 C57207784 SOUTHOLD,NY 11971 3c.Policy effective period 12131/2023 to 12/31/2024 3d.The Proprietor;Partners or Executive Officers are ❑X included.(Only check box if all partners/officers 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 Carrieror 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 br 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 holderwith a new Certificate of Workers'Compensation Coverage or other authorized proof that the business is complying with the mandatoy coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury,I certify that'l 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: Lex Smith Docu, gtert8fie of authorized representative or licensed agent of insurance carrier) " ., 12/6/2023 Approved by: F. (Signature) (Date) Title: Assistant Program Manager Telephone Number of authorized representative or licensed agent of insurance carrier: 214-721-6248 Please Note:Only insurance carriers and their licensed agents,are authorized to issue Form C-105.2.1nsurance brokers are NOT authorized to issue it. C-105.2 (9-17) www.wcb.ny.gov Acct#:3031516 .......... .Y�y ft. q �T v ....... ... )VI Al .......... Suffolk County Executive's Office of Consumer Affairs VETERANS MEMORIAL HIGHWAY HAUPPAUGE,NEWYORK 11788 DATE ISSUED: 5/25/2006 No. 40227-H SUFFOLK COUNTY Home Improvement Contractor License ..... ..... This is to certifv that MARC A CLEJAN doing business as 5 3 GREEN LOGIC LLC having ftumished the requirements set forth in accordance with and subject to the provisions of applicable laws,rules olk, •State of New York is hereby licensed •to •conduct business as a HOME and •regulations of the County of Suff IMPROVEMENT CONTRACTOR,in the County of Suffolk. Additional Ausinesses 7. NOT VALID WITHOUT DJ�PARTMENTAL SEAL �gv AND A CURRENT CONSUNJER AFFAIRS ff G ff ID CARD a Director .......... '7, A2 • k M1441 ............. Su olk County Executive's Office of Consumer Affairs VETERANS MEMORIAL HIGHWAY * HAUPPAUGE, NEW YORK 11788 DATE ISSUED: 12/10/2007 No. 43858-ME SUFFOLK COUNTY Master Electrician License This is to certify that ROBERT J SKYPALA doing business as GREENLOGIC LLC - having given satisfactory evidence of competency,is hereby licensed as MASTER ELECTRICIAN in accordance with and subject to the provisions of applicable laws,rules and regulations of the County of Suffolk, State of New�York. Additional Businesses NOT VALID WITHOUT DEPARTMENTAL SEAL AND A CURRENT CONSUMER AFFAIRS 11)CARD Director J. ASV, ES J. S TOUT A R C H I T E C T & Assoc . 2 G REG LANE EAST NORTHPORT N. Y. 631 - 8 58 9388 Letter of Certification Kood December 8, 2023 RE: Blum Residence 420 Glenn Road Southold, NY 11971 To whom it may concern: I, James J. Stout, registered architect NYS license number 021633 would like to submit the following: I have inspected and analyzed the roof structure at the above mentioned address and have determined the structure and the panel attachment to be adequate to support the new additional load imposed by the proposed solar panel system and complies with the 140-mph wind design load as per 2020 Residential code of NYS (RCNYS), 2020 Energy conservation construction code of NYS(ECCCNYS), the Long Island Unified Solar Permit Initiative (LIUSPI) and the ASCE 7-16. The existing 2"x 8" a@ 16"o.c. roof rafters will provide the required support. COMPLY WITH ALL CODES OF Thank you, NEW YORK STATE&TOWN CODES James J. Stout AS REQUIRED AND CONDITIONS OF Architect /DEC WN ZBA AP 0 ED AS NOTED WN PLANNING BOARD D.P.# N TRUSTEES '6 Y TIFY UI ING DEPARTMENT AT 1.765- 80 8AM TO 4PM FOR THE �ReD c "`"""'� LLOW N INSPECTIONS: �\�'t FOU D TION-TWO REQUIRED C� FOR URED CONCRETE 7 OCCUPANCY OR ROUGH-FRAMING&PLUMBING INSu ION * USE IS UNLAWFUL FINA - ONSTRUCTION MUST ' BE C PLETE FOR C.O. ,9r 021 33 yOQ WITHOUT CERTIFICA ALL CON T UCTION SHALL MEET THE F F E� JF OCCUPANCY EQUIRE TS OF THE CODES OF NEW ORK S T . NOT RESPONSIBLE FOR ESIGN R ONSTRUCTON ERRORS ELECTRICAL INSPECTION! REOU.1p,p --------- NEW EQUIPMENT--- EXISTING SERVICE ------------------------ PV—SA-1 ,q (TYPICAL SYSTEM SCHEMATIC, I 120/240, 1 PH, 3W FINAL INSTALLATION MAY VARY, FEW AC—COMBINERPANEL REQUIRES LOCAL AHJ ' s s • AND UTILITY APPROVAL) N • • 2 1 AC—CMB-1 B I 200A KWH I I PV—SA-2 A MAIN s • s ® A B N C' ' N • • • 2 1 BKR-1 I I TYPICAL PV MODULE WITH I I BKR-2 INTEGRAL DC/AC INVERTER I i I I TYP. PV ARRAY BKR-N BKR-M MAIN PV—SA—N A I I A B N • s s i I N • • • 2 1 II BFB I ' ---- — --� i N PM TYPICAL PV MODULE WITH INTEGRAL DC/AC INVERTER III EGC iI I, iIi I MAIN C/T N I I I I III I I EGC i l i l i AC DISTRIBUTION i I III GC I (EXISTING) I I 1------- 6cu ►----------------------------------- I I IRREVERSIBLE BOND, TYP. I #4 1GEC CU PROPOSED 3-LINE ELECTRICAL DIAGRAM REVISIONS Blum, Jeffrey GREENLOGIO® 420 Glenn Road ct ENERGY Southold, NY 11971 2.) AS BUILT CONFIGURATION ELIMINATING THE COST OF ENERGY 1.) INITIAL SUBMITTAL WITH APPLICATION Pagel of 4 Drawing No: BLUM-3LD1 Revision: 2 Revised: 2/08/2024 SYSTEM SUMMARY TOTAL KW RATING: (AC POWER) _ 9.984 (PV) TOTAL KW RATING: (DC POWER) 10.920 (PV) CITY. COMPONENT SPECIFICATION SUNPOWER BRAND, MODEL: SPR-U-420-BLK-R-DC 26 PV MODULE: 420 W DC(NOMINAL), EACH ENPHASE BRAND, MODEL: IQ-7XS 26 PV INVERTER: (MICRO-INVERTER) 384 VA, 1.60 A, 240V AC, EACH REVISIONS Blum, Jeffrey GREENL.OGIC® 420 Glenn Road cf ENERGY Southold, NY 11971 2.) AS BUILT CONFIGURATION ELIMINATING THE COST OF ENERGY 1.) INITIAL SUBMITTAL WITH APPLICATION Page 2 of 4 Drawing No: BLUM-3LD1 Revision: 2 Revised: 2/08/2024 EQUIPMENT&COMPONENT SCHEDULE TAG DESCRIPTION SPECIFICATION PV-SA-1 PHOTOVOLTAIC SUB-ARRAY SUNPOWER SPR-U-420-BLK-R-DC, 1-CIRCUIT OF 8-MODULES PV-SA-2 PHOTOVOLTAIC SUB-ARRAY SUNPOWER SPR-U-420-BLK-R-DC, 1-CIRCUIT OF 8-MODULES . PV-SA-3 PHOTOVOLTAIC SUB-ARRAY SUNPOWER SPR-U-420-BLK-R-DC, 1-CIRCUIT OF 10-MODULES PM-1 PRODUCTION MONITORING SYSTEM SUNPOWER PVS6, POWER MONITOR AC-CMBP AC COMBINER PANEL 25OV, 100A, NEMA-311, 1-PH, 3-WIRE, MAIN-LUG BKR-1...BKR-3 CIRCUIT BREAKER, PV-SA-1 ... PV-SA-3 MATCH AC COMBINER PANEL BRAND, 2-POLE, 20A BKR-M CIRCUIT BREAKER, PRODUCTION MONITOR MATCH AC COMBINER PANEL BRAND, 2-POLE, 15A BFB-1 CIRCUIT BREAKER, GRID-TIE BREAKER, MATCH MAIN PANEL BRAND, RATING: 2-POLE, 50A REVISIONS Blum, Jeffrey GREENLOGIO° 420 Glenn Road ENERGY Southold, NY 11971 2.) AS BUILT CONFIGURATION ELIMINATING THE COST OF ENERGY 1.) INITIAL SUBMITTAL WITH APPLICATION Page 3 of 4 Drawing No: BLUM-3LD1 Revision: 2 Revised: 2/08/2024 ELECTRICAL LOAD SUMMARY,AC CIRCUITS TAG POWER, MAX VOLTAGE MAX.AC VOLTAGE, NOMINAL RANGE CURRENT PV-SA-1 3,072 WATTS 211-264 VAC 12.80 A AC 240 V,AC PV-SA-2 3,072 WATTS 211-264 VAC 12.80 A AC 240 V,AC PV-SA-3 3,840 WATTS 211-264 VAC 16.00 A AC 240 V,AC CONDUCTOR SCHEDULE TAG TYPE AWG. / EGC A NMB 10 / 10 B PVC-40 / 6 C NMB 12 / 12 1.)CONDUCTOR TYPES AND SIZES TO BE ADJUSTED FOR TEMPERATURE, DISTANCE,AND DERATING FACTORS. 2.)ELECTRICAL CONDUITTO BE MINIMUM PVC SCHEDULE 40,ADJUST FOR SITE CONDITIONS. 3.) ALL ELECTRICAL MATERIALS AND INSTALLATION METHODS TO COMPLY WITH NEC AND LOCAL CODE REQUIRMENTS. 4.) NOTE: PV ARRAY EQUIPMENT GROUNDING CONDUCTOR TO BE#6 COPPER, MINIMUM REVISIONS Blum, Jeffrey 420 Glenn RoadC+GF�EEIVL0C�1� NER-GY Southold, NY 11971 2.) AS BUILT CONFIGURATION ELIMINATING THE CAST OF ENERGY 1.) INITIAL SUBMITTAL WITH APPLICATION Page 4 of 4 Drawing No: BLUM-3LD1 Revision: 2 Revised: 2/08/2024 GREENLOGICO ENERGY GreenLogic,LLC Approved Blum,Jeffrey 420 Glenn Road Southold,W 11971 Surface#A: Total System Size:10.920kW Array Size:10.920M 1 circuit of 10 on a 20A breaker 1 circuit of 8 on a 20A breaker 1 circuit of 8 on a 20A breaker Azimuth:190" Pitch:27° Monitoring System: N SunPower Panel/Array Specifications: Panel.SPR-U-420-BLK-R-DC Racking:SunPower Invisimount El x Panel:68.1"X 44.0" Array:47'51/8"X 14'10 7/16" Surface:62' 'X 17'5" Magic#:I" mount Legend: 6 Power 420W Panels IQ-7XS Microlnverters SunPower Invisimount Rail • 70 Iron Ridge Flash Foot 2 M"Douglas Fir Rafter 16"O.C. A WjVING Notes: Number of Roof Layers:1 Height above Roof Surface:4" Materials Used:Iron Ridge,SunPower Added Roof load of PV System:2.32psf Engineer/Architect Seal: r' g J. CC i 02 t F N Drawn By:MMB Drawing#1 of 5 Date:12/2/2023 REV:A Drawing Scale:1/8"=1.0' GREENLOGICO' ENERGY GreenLogic,LLC Approved Blum,Jeffrey 420 Glenn Road Southold,NY 11971 Surface#A: Total System Size:10.920kW Array Size:10.920kW 1 circuit of 10 on a 20A breaker 1 circuit of 8 on a 20A breaker 1 circuit of 8 on a 20A breaker Azimuth:190' Pitch:27° Monitoring System: N SunPower Panel/Array Specifications: Panel:SPR-U-420-BLK-R-DC Racking:SunPower Invisimount Panel:68.1"X 44.0" Array:47'51/8"X 14'10 7116" Surface:62'8"X 17'5" Magic#:Invisimount Legend: 26 SunPower 42OW Panels ED 26 IQ-7XS Microlnverters SunPower Invisimount Rail • 70 Iron Ridge Flash Foot 2 B 2x6"Douglas Fir Rafter 16"O.C. AWNING Notes: Number of Roof Layers:1 Height above Roof Surface:4" Materials Used:Iron Ridge,SunPower Added Roof load of PV System:2.32psf Engineer/Architect Seal: C�PeD C S r �9 102 t 33 ,OQ Drawn By:MMB Drawing#2 of 5 Date:12/2/2023 �REV:A Drawing Scale:1/8"=1.0' GREENLOGICO ENERGY GreenLogic,LLC Approved Blum,Jeffrey 420 Glenn Road Southold,NY 11971 Surface#A: Total System Size:10.920kW Array Size:10.920kW 1 circuit of 10 on a 20A breaker 1 circuit of 8 on a 20A breaker 1 circuit of 8 on a 20A breaker Azimuth:190' Pitch:27' Monitoring System: N SunPower Panel/Array Specifications: Panel:SPR-U-420-BLK-R-DC Racking:SunPower Invisimount Panel:68.1"X 44.0" NO 3 3 2 Array:47'5 1/8"X 14'10 7/16" G Surface:62'8"X 17'5' Magic#:Invisimount 3 2 Legend: ® 26 SunPower 420W Panels 26 IQ-7XS Microinverters SunPower Invisimount Rail 3 1 • 70 Iron Ridge Flash Foot 2 B 2x6"Douglas Fir Rafter 16"O.C. AWNING 1 Notes: Number of Roof Layers:1 Height above Roof Surface:4" Materials Used:Iron Ridge,SunPower Added Roof load of PV System:2.32psf Engineer/Architect Seal: C�R�D C — 5 S J. ;may loz t�33 ,oQ rF 2FiNE� Drawn By:MMB Drawing#3 of 5 Date:12/2/2023 REV:A Drawing Scale:118"=1.0' No Vent Pipes Will Be Covered By The Solar Array aGREENLOGIC® . ENERGY Legend: 6reenLogic,LLC Approved AR-Access Roof AP-Access pathway,36"minimum width SVO—Setback at ridge Blum,Jeffrey 420 Glenn Road per R202 definitions per R324.6.1 as per R324.6.2.1 Southold,NY 11971 Total System Size:10.920kW 1 circuit of 10 on a 20A breaker 1 circuit of 8 on a 20A breaker 1 circuit of 8 on a 20A breaker Azimuth:190" Monitoring System: N SunPower t PanellArray Specifications: I j Panel:SPR-U-420-BLK-R-DC Racking:SunPower Invisimount 1 I Panel:68.1"X 44.0" AP i 1 AP Magic#:Invisimount I ' Legend: I 26 SunPower 420W Panels I I 26 IQ-7XS Microinverters SunPower Invisimount Rail -------- • 70 Iron Ridge Flash Foot 2 SVO _—_ _ —u _ _ 2x6"Douglas Fir Rafter 16"O.C. ------------------ --------- — Meter Notes: Number of Roof Layers:1 Height above Roof Surface:4" Materials Used:Iron Ridge,SunPower Added Roof load of PV System:2.32psf Engineer/Architect Seal: ,OWNING ��RED C j1 26 SunPower 35OW Panels �9 021 33 yoQ. TF QJN�� Drawn By:MMB Drawing#4 of 5 Date:12/2/2023 REV:A Drawing Scale:3/32"=1.0' GREENLOGICO ENERGY GreenLogic,LLC Approved Blum,Jeffrey 420 Glenn Road Southold,NY 11971 Total System Size:10.920kW 1 circuit of 10 on a 20A breaker 1 circuit of 8 on a 20A breaker 1 circuit of 8 on a 20A breaker Azimuth:190' - -- - - - - -- - - -- --- - Monitoring System: N JOB MATERIAL UST SunPower -- - - ----- - - - — - --- - - - - - PaneIZArray Specifications: Panel:SPR-U-420-BLK-R-DC Racking:SunPower Invisimount - -- - - --- -- - - Panel:68.1"X 44.0" Material List Qtv- Rail Material List OK Magic#:Invisimount Legend: ----- ® 26 SunPower 420W Panels -- --- ------ -- --- - -- -- __ _ _ _ _ __ ---- ----- -- -- ---.- ------- -- - - --- 26 IQ-7XS Microinverters Cast Aluminum Mounting Blockw/Black Aluminum Flashing 70 SunPower Invisimount Rail 5/16"x4.75"Hex-Head Lag Screw 70 5/16"x1.25"Fender Washer 70 -- - - - - - • 70 Iron Ridge Flash Foot g� 2x6"Douglas Fir Rafter 16"O .C Notes: - - - - - - - - - - - --- - Number of Roof Layers:1 Height above Roof Surface:4" Materials Used:Iron Ridge,SunPower Added Roof load of PV System:2.32psf Engineer/Architect Seal: A" r i'y (021 33 ypQ' Drawn By:MMB Drawing#5 of 5 Date:12/2l2023 REV:A Drawing Scale:3132"=1.0' �1r _ NEW EQUIPMENT — — — — EXISTING SERVICE 20/2-0. 1 PH. 3%N Pd—SA-1 A; 200A KWE- } ® . • • e EI A Lr a a — AC—COMBINER PANEL PV—SA-2 r AC—CMB-1 3 (PV La, S c" AC DISCONNECT V51l AC—DSC-1 B Ei EI � , i I PY-SA-3 J j SKI'., nnaiN ' I � FUSED ffEl E ` K?-5� A B N i �cc i EGC EGC EXISTING AC PANEL I I L [EXISTING j j _ — _ — ___ GEC t GEC IRREVERSIBLE SPLICE--- — 76 CU _ —�' 10.920kW DC 9.984kW AC PROPOSED 3-LINE ELECTRICAL DIAGRAM REVISIONS Blum, Jeff ` 420 Glenn RoadG ENERGY Southold, NY 11971 ELIMINATING THE COST OF ENERGY 1.) INITIAL SUBMITTAL WITH APPLICATION Page 1 of 3 Drawing No: Blum-KD1 Revision: 1 Revised: 12/4/23 EQUIPMENT&COMPONENT SCHEDULE TAG DESCRIPTION SPECIFICATION PV-SA-1 SUB-ARRAY REC420AA PURE-R EN PHASE IQ7HS-66-M-US, 1-CIRCUIT OF 10-MODULES PV-SA-2 SUB-ARRAY REC420AA PURE-R EN PHASE IQ7HS-66-M-US, 1-CIRCUIT OF 8-MODULES PV-SA-3 SUB-ARRAY REC420AA PURE-R ENPHASE IQ7HS-66-M-US, 1-CIRCUIT OF 8-MODULES ELECTRICAL LOAD SUMMARY AC CIRCUITS TAG POWER, MAX VOLTAGE MAX.AC VOLTAGE, NOMINAL RANGE CURRENT PV-SA-1 4200 WATTS 211-264 VAC 17.08 A AC 240 V,AC PV-SA-2 3360 WATTS 211-264 VAC 13.66 A AC 240 V,AC PV-SA-3 3360 WATTS 211-264 VAC 13.66 A AC 240 V,AC PROPOSED EQUIPMENT SPECIFICATIONS REVISIONS Blum, Jeff 420 Glenn Road ENERGY Southold, NY 11971 0~),IMINATING THE COST OF ENERGY 1.) INITIAL SUBMITTAL WITH APPLICATION Page 2 of 3 Drawing No: Blum-KD1 Revision: 1 Revised: 12/4/23 EQUIPMENT& COMPONENT SCHEDULE TAG DESCRIPTION SPECIFICATION AC-CMB-1 AC COMBINER PANEL 250V, 100A, NEMA-1, 1-PH, 3-WIRE BKR-1 CIRCUIT BREAKER, PV-SA-1 MATCH AC COMBINER PANEL BRAND, 2-POLE, 20A BKR-2 CIRCUIT BREAKER, PV-SA-2 MATCH AC COMBINER PANEL BRAND, 2-POLE, 20A BKR-3 CIRCUIT BREAKER, PV-SA-3 MATCH AC COMBINER PANEL BRAND, 2-POLE, 20A AC-DSC-1 AC DISCONNECT SWITCH (LINE TAP) 250V, 60A, NEMA-1, FUSED; FUSE RATING: 50 CONDUCTOR SCHEDULE TAG TYPE CONDUIT AWG. / EGC A USE-2/PV/UF 3/4" PVC-40 12 / 6 B THWN-2 1-1/2" PVC-40 4 / 4 C THWN-2 1-1/2" EMT 4 / 4 1.)CONDUCTOR TYPES AND SIZES TO BE ADJUSTED FOR TEMPERATURE, DISTANCE,AND DERATING FACTORS. 2.) ELECTRICAL CONDUITTO BE MIN. PVC SCHEDULE 40,ADJUST FOR SITE CONDITIONS. 3.) ALL ELECTRICAL MATERIALS AND INSTALLATION METHODS TO COMPLY WITH NEC AND LOCAL CODE REQUIREMENTS. 4.) NOTE: GROUNDING ELECTRODE CONDUCTOR TO BE#6 COPPER MINIMUM. PROPOSED EQUIPMENT SPECIFICATIONS REVISIONS Blum, Jeff ; ' RIEENLOGIC 420 Glenn RoadENERGY Southold, NY 11971 ELIMINATING THE IC08T OF ENERGY 1.) INITIAL SUBMITTAL WITH APPLICATION Page'3 of 3 Drawing No: Blum-3LD1 Revision: 1 Revised: 12/4/23 i yt SOLAIITSI.MOSTrTRUSTED x , 'A, ' -LPH 'R EC A p RI • E E Y7,<• ins, �v<3. .w�� ,,3�,s R S E «•��'d{�%��`4�r'" R 'e"k.=ig.; .� .'^N� �Gd CT�:SPECIFICATO La �a �"� j;.,,�' ga �.�:,\ �`$°` .,. .°�r,e. ,>43';,°,o iT <°' °.3y a:.'..�';$- °a4�.,a•.x �*.=p��'A,f�63�,n� ' �. v s�i;.•f°,,. '��o. " �� :..°.;a `t ro a F COMPACT Z �MODULE uiu' 'iu . ♦ = Milk i Xrp RE LIEHA PURE-R STR116 RE C PRODUCT 173°t2.5 f68.1i0.1j 'GENERAL'DATA:.. •.,u € ...S0.�4:h1................ 4251iG7j._... - --- - - 80half<cut REC,bifacial,heterojunction cells with ' �l '= -- ----__._..__.._..........__...._'t {i Cell type:.` lead free,gapless technologya - 3: Glass: 0.13 in(32 mm)solarglass with anti-reflective surface treatment i_� llll ygc='f f in accordance with EN 12150 i j a:a:aon ( I Backshaet:` 'Highly resistant p6lyrTier(black) s ;( 700t67j9 r700trr Frame: - 5 Anodizedaluminum(black) •{ _ v 4rpart,4bypassdiodes,lead-free. Junctionboxi, IP68rated,inaccordancewithlEC62790 li 1 Connectors: 5taubliMC4PV-KBT4/KST4(12AWG) in accordance with lEC62852,IP68onlywhenconnected ' 12AV^G(4inm2)PVwire,67+67in(1.7+1.7m) Cable: : rosy°7v t°remi°e°m in accordance with EN50618 Dimensions: 68.1 x44.0 x 1.2in(20.77ft-)/1730 x 1118 x30 mm(1.93 m2) - .... .-... ...> y..4,i1.81 2.510.91 • ................-i................: ...a :'Weight.. 1 47.41bs(21.5 kg). l ry Origin: Made in Singapore Measurements in inches Imm) ELECTRICAL"EIATA� '� � '•" Product Cnd@`:RECxxxAA PURER, CERTtEtLiATIQNS� PowerOutpuf Plarx(1Np}- '.; .:. 400 410 '., 420. ,.. 430 IEC 61215:2016,IEC 61730:2016,U L 61730 - ..... Watt Class Sorting-(W) 0/10 0/+10 0/4-10 0/+10 IEC62804 PID IEC 61701 Salt Mist Nominal Power Voltage-VV,Fe(V} 48.8 49.4- 50.0 50.5 IEC627'161 Ammonia Resistance c r Nominal Power Current-I.,(A) 8.20 8,30 8.40 8.52 UL61730 Fire Type Class 2 �. enCircultvottage-:V�c(V) 58,9 59:2 59.4 59.7._ Dynamic IEC 62782 is Mechanical Load IEC 61215-2:2016 Hailstone(3Smm) Short Circuit Current-I,c(A) 8.80 8.84 8.88 6.91 1EC62321 Lead-freeacc.to RoHS EU 863/2015 Power Density(W/ft2)_ 19.26 19:74 20.22 _ 20.70 ISO 14001,ISO 9001,IEC 45001,IEC 62941 Panel Efficiency(%) 20.7 21.2 21.8 22.3 - -.................................................. ....... ............................................__._.._.�... _ ....................................... ........._..................._..........._....-----_..._.....----._._.................................__. °Q /' / OVE Power Output,,PnaxNO 305 ;312 - 320 327', menel ♦♦ U.a-Free NominalPowerVolta1�1;a(V)ge-V 46.0 46.6 47.1 47.6 �TECv1PERATURE RATtNG5" �. :°_ 'i �'Nominal Power Current lilra{AJ" 6.6 6.70 6.80 6.88 Nominal ModuleOpe'ratingTemperature: 44°C(±2'C)' z Open Circuit Voltage-Voc(V) 55.5 55.8 56.0 56.3 Temperature coefficient ofP,�x: -0.24%/°C Short Circuit Current-I.-(A) -, 7.11, 7.16 7.20 724 Temperature coefficient ofVoc: -0.240/61°C Values at standard test conditions(STC:air mass AM15,irradiance 10.75W/sgfl:00001N/m?),temperalule77T(25°C),based onaproductienspread Tturecoefficientofl 0.04°o/°C with a tolerance ofP,, ,V0,&I t3%within one watt class.Nomiralmoduleoperatingtemperature(NMOT:air mass AM1.5,irradiance 800W/m Temperature p sc' temperature 68°F(20°C),windspeed 3.3ft/s(l m/s).'Where xxx indicates the nominal powerclass(P,,.)at STC above. The temperature coefficients stated are linear values MAXIMUM RATINGS' «'.; ` WARRANTY < I DEL,'1VERY"i, F R A ON* Opera tionaltemperature: 40:..+85°C Standard REC ProTrust Panels per pallet: 33 System voltage: 1000V Installed byan REC No Yes Yes Panels per40ftGP/highcubecontainer.. 858(26pallets) CertifiedY SolarP r Professional Test load(front): +7000 Pa(146 lbs/ft2)'1 Panels per 53 ft truck: 858(26 pallets) System Size, All s25 kW 25 500 kW Test load(rear): 4000 Pa(83.5 Ibs/ft2)' product Warrant rs 20 25 25 Lt}1tU.AGHTBEHAV.1t3UR a Series fuse rating: 25 A- 'Power Warranty(yrs) 25 25 25 g Reversecurrent: 25A Labor Warranty(lrs) 0 25 10 Typical low irradiance performance of module at STC: See installation manual formountin instructions. Power in Year 1 98%, 98%' - 98% o gg Design load=Test load/I.S(safetyfactor) Annual Degradation 0.25% 025% 0.25% „I.. ..................... ... PowerinYear2S 92% • ,92% 92%' iE x(..- >- - See warranty documents for details.Conditions apply _(" ""' n z vl Available from: - x � �Irradiance(W/m=) m 4 N • f/1 O I T tz ❑� �Q a a 1n 0 Founded in 1996,REC Group is an international pioneering solar energy company dedicated to empowering consumers with clean,affordable solar power.As o Solar's Most Trusted,REC is committed to high quality,innovation,and a low carbon footprint in the solar materials and solar panels it manufactures. 0 Headquartered in Norway with operational headquarters in Singapore,REC also has regional hubs in North America,Europe,and Asia-Pacific. www.i-ecgroup.com _ Data Shl-e-t EophasaK8icronvedera RegioniAMER|CAS �� M�� AU�� Q�� 8—D�� The high-powered smart grid-ready ��8,��"��°.�� Enphase /Q7MS��icro|Qve;�o[mVV�h |Dteg�t8d ��C4 Q��Q��m ��Nuu ��u ��m connectors dramatically simplify the installation process while achieving the highest system efficiency. ' The |QSeries K4iCFOinve[t8rS extend the reliability standards set forth by previous generations and undergo over a million hours Of power-on testing, enabling Enphaoeto provide anindustry-leading warranty OfUpt025years. Easy tnInstall ' Lightweight and simple ' Faster installation with improved,lighter two-wire cabling ` Built-in rapid shutdown compliant(NEC uol4.cnl7uoo2o) Efficient and Reliable ` Optimized for high powered bb-uo|l*modules ^ Highest Csc efficiency of970m ^ More than a million hours oftesting ' Class||double-insulated enclosure ' oLks,ed Smart Grid Ready ' Complies with advanced grid support,voltage and frequency ride-through requirements ' Remotely updates to respond m changing grid requirements ^ Configurable for varying grid profiles ^ Meets C4 Rule 21 (UL1741'84) ~��°/n/xnmm«"/momounn"�oo"°nm"ov/°u �� n ENPHASE Enphase IQ7HS Microinverter INPUT DATA(DC) IQ7HS-66-M-US Commoril bsed-rriodule p'6! 460 W Module compatibility 66-cell Pv modules _9'axirriurh input DC voltage.., Peak power tracking voltage 38 V-43 V whin/Max ing,'range -. - Iv- 1) V,,. .... lvlin/lvlla;start voltage 30 V/'59 V- I, x DC current • 7 _6,viervoltage class DC port II e current 7. b6�� Pv array configuration 1 x 1 ungrounded array;No additional DC side protection required; AC side protection requires max 20A per branch circuit OUTPUT DATA(AC) @240 VAC @208VAC ��_Peakoutput'powef_",',', Maximum continuous output power 384 VA 369 VA omin L-,L tage range Maximum continuous output current 1.60 A(240V) 1.77 A(208V) j,Nominal, reuenc60z Extended frequency range 47 to 68 Hz 47 to 68 Hz AC short ciPcuifi:fault (i�n—t 77�7� 82 Maximum units per 20 A(L-L)branch circuit3 10 9 Overvoltage NI ? class port AC port backfeed current 18mA 18 rnA 7, Q • Power factor(adjustable) 0.85 leading...0.85 lagging 0.85 leading...0.85 lagging EFFICIENCY @240 V @208 V 0 weighted efficiency 970, 96.5 7- 7 7 77 MECHANICAL DATA I LLtbietj�t� a -,40°C to,+60°C`u re i ng e Relative humidity range 4%to 100%(condensing) 77"....... I ma e, C4 FConnectori ype, 'StaU Dimensions(WxHxD) 212 mm x 175 mm x 30.2 mm(without bracket) Weight 8 k9 81 Cooling Natural convection-No fans ed:f6r Wet,locations, 6s7", , "Pollution degree PD3 7 Enclosure .:� .Glass corrosion resistant polymeric end 6sure. Environmental category UV exposure rating NE MA type 6 outdoor 7 2000rn FEATURES 1'Co Power Line,,Comffionibatiori(PLC) - mm'uhicAtidn Disconnecting means The AC and DC connectors have been evaluated and approved by UL for use as the load-break disconnect means required by NEC 690 and C22.1-201 8 Rule 64-220. CA Rule 21 1741-SA HECO vl.l':-' ' I 'UL621'09-1;UL,1741/IEEE 1547FCC!4rt .0003 Clas's 13� 15 Class B;�,ICES- CAN/CSA-C22,2'N0.:1 07.11-01,",�" his'iprodu6t'is`UL'Listed' P E _4;NEC- %,T as, V RdbidShut Down quipment and,conf6and With,NEC-201 7 s C 2020 and C'2 2015 Rule 64-218�Rap ids hiutdoWh Of PV:,System6,46�. 66tid -690.12�'.NE 2 il- '-AC according'and'bCbdnd66iors,wk66-instalie'd' to manufacturer s.nstructions. 1.No enforced DC/AC ratio.See the compatibility calculator at https7/leiinhase.comlen-us/sLit)portlniocILile-comt)atil)ility. 2.Nominal voltage range can be extended beyond nominal if required by the utility. 3.Limits may vary.Refer to local requirements to define the number of microinverters per branch in your area. To learn more about Enphase offerings,visit enphase.com @ 2,922 Enphase Energy.All rights reserved.All trademarks or brands:jsed are the property of Enphase Energy:Inc ENPHASE, 10-18.2022 16.� • .-„ .:, , - ° `ate .«s° = k> .i ...; N �•t ^ ��• b � ., r a a. � w 7 a'F;dar,'vs '.,�. ID a v • Simple and Fast Installation # Integrated module-to-rail grounding Pre-assembled mid and end.camos Levt:ating mid clamp,for easy placement. Midclam�i• idth facilitates conslStP..nt,even �� `` f, .. module spacing simple,pre-drilled rail splice uL 2703 Listed integrated grOUnallino Flexible Design - - Addresses nearly all sloped residential roofs i Design in landscape and porrait Rails enal::le easy obstacle manager-ent Customer-Preferred Aesthetics module and##1 mount'n nest!ctics Best-ir-class system aesthetics. . Elegant Simplicity Premium,low-profile design , Back anodized components SunPowert InvisiMountT"' is a SunPower-designed Ifdden mid clamps and end clamps rail-based mounting system.The In'visiM011nt system and capped,flush raiis addresses residential sloped roofs and combines faster Part of Superior System,. installation time: design flexibility, and Supc r for aesthetics. tics Built for use with SunPower DC and AC modules The InvisiMount product was specifically envisioned and Best-in-class systerr:reliability and aesthetics Combine with SunPm.,,ver modules and' engineered to pair with SunPower modules. The resulting monitoring app syster-n devel Capp-oach will amplify the aesthetic and installation benefits for both homeowners and installers. w° . rly1 lr`�111� �..� sunpower.com ✓' F..F:i. Q 4s'':'.... Von W®. zzz Z der. Module*/Mid Clamp and Rail Module*i End Clamp and Rail ri Mid Clat-nP End Clamp Rail&Rail Splice Ground Lug Assembly End Cap lw�-4 o 2 . TLrnueracure -401 C to 90'C(-40°F to 19L F) i Component: N/laterial weight ........................................ ................... 3000 Pa uplift ........... Max.Load oad(L.RFD') 6r)r)r)"a-lownforce Mid Clamp B!acK oxidesrainless steel AISI 30,1 63 8(2.2 oz) ....................... ............................... .................................................. ..................... End Clan-lp Back anodized alurninUrn dIlOY 6063-T61 110,9(3-88 07) IF IF 0 z"'t Rail B'ack anodized alurninurn alloy I() �0 (9 o f) Rail Aluminum -75 Splice Alumi alloy 6005 830 g/nn(9 oz.11`0 25-year product warranty Wanrantles Ground Lug 304stainiess 106 5 lii-(3.75 oz) 5-ye fi ar nish wri a 'anty, Assembly (A2-70 bolt:tin-prated copper!Ug) i ................................ .......................... ........................................................ ............................................ r.nd Cap Black acetal(PONI)copolymer 10.4 g(03 ...............--*--**- I .. ............................ -j UL 2703 Listed Certificad ion is Class A Fire Rated ........... Comp,)s:Linn Shingle Rafter A:Itachme.nt A Curripfisl:k,ion Shin'-de Roof Dedki rig At tachrrie,,k Application Curved and Flat Tile RoufAttachinent: Universal Interface lot-Other Roof Attachments RPFpt-to roof attar hment hardware marii-IfaCTILUm i's documentation. .................................................................................................................................................................................................................................-....................... .......................................................................................... ........................................................ ,,jfMe Char compatible ble with thc.Inv:sir0ount systemrequired for hardware interoperability. ib 7015 5unPower oi poration. All Rights Reset red.SUNPOWER,the SUNPOW,R INVISIMOUNT are vad^marlks or registered sjnpoo.,ei-.c.om u adr�marks or SunPower corporation.Aill other tradernzrks are the pi opertyw their respective Specifications included in:hisdatasneer are subjoct to change without noun. Docurnent#509506 RevC S U N"MW E R',' l`^ _ ^ ,." .. , r .. S• tl Ten,• h^n F A a a ,,:".. tee. n-• „> p '•tea` �.:v`: ";�„ " ..,y .:.�i♦�'A'x'„� A��°•^`Y y.r•E�r me9f`:'<rh •� '.J.g,.1 � - t n. , µ ..r �g Ah' � improve Support,' Reduce Maintenance Costs SunPower Erier�),yLiril<—Plug-arid-Play Installation An if?T_Wt!Ve monitoring Y+lebSlte E rlablc i you Co: This complete solution for residential and commercial monitoring and See a visual mli.p of customer sites,: c-on[rol includes file SunPe!.er''PV Supervisor 6(PV56)+,Jhich improves Rernorely manage hundreds of saes the installation process,overall systern reliability,and custo mer Receive elective system reporL`_ 41Xpe('ieerlce. -OcFte systerrl issues ar'd rerT'IOtelydiagnose COrCipaCt footprint for irn.proved aesthetics Diagnose issues online Robust cloud connectivity and comprehensive local connectivity - ` s Flexible configuration of devices during installation • gill do+n�rl for the s.n+.us of indivicat;�l devices �; C(:)nst.irTIptiori rneter ng _. Revenue-grade production metering(pen,ing) Web-based commissioning Remote diagnostics of PVS6 and inverters t Durable IUL Type 3R enclosure reduces maintenance costs - Easy n[egraLion'with SunPower e6oS - Add Value for.Custorriers With the SunPower jlcnitoringSystem Robust Cloud Connectivity SU, tf�t Multiple options to maintain optimal . customers can: ' p P _... connectivity: ee 4vhat;their solar system produces each :-day,month,or ye.r ,.. Hard+,wed Ethernet ootimize Their sour irvestrnent and save on Wi-Fi energy expenses . Cellular backup See tneir enerL;y use and estimated bil'savings See their solar'sysceni's pe forrnance:using the t. Suhr'ol,der moni_bring vvebsite or mobile app Jill�$ . f ' SunPower Monitoring Websites PVS6 SunPower AC Modules EX „ x i s' E ...IIUIIIIL t� EEEU ., au ena. y • - t' .......x .„L' Multiple communication options include oilE€ El '� �� '_`"" Ethernet,Wi-Fi,and cellular. t Number of SunPower AC mcdules 85 Eernperature 22°F to ,? 0°F( 3WC to i 60.Q supported per PVS6 Humidity(maximum) 95%,nor;-condensing High-speed Internet access via accessible Internet access router or switch • ,00-241)VAC(L-N),SO or 60 I-iz Power VAC(L-L in 3-phase).60 Hz �• RS-485 inverters and meters . One channel of revenue-grade production metering ; Inteerated Metering • T-v10 channels of CISnSI.imCJt.^n metering - ................................................_............................................................._...................................... .................................................................._..... ....... _._._ Weight 5.5 Ibs(2.5 k Ithernet 1 LAN(or optional`AIAN)port Dimensions 11.8 x 8.0 x 4.2.in.(30.5 x 20.5 x 10.8 cm) PLC PLC for SunPower AC modules Enclosure rating UL_50€Type 3R WI-F1 802.11 b 5/gIn 2.4 GHz and v Iz Cellular LIE:Cal.VA3G UMTS ZIgBee IE:E::E:.802.15.4 MAC,2.4(:3Hz ISM band Data Storage 60 days Customer site M-Q onus su€ip—)Nr,_o n -- Upgrades AuEornaVc f€rmvvare upgrades Partner site p2sm9,Mt.uss1-npower.com Growsers Firefox,safari,and Chrome Mobile devices iPhone",iPadl'and Android"" Customer app 1.Create account online at:monitor.us-sunpower.com. ` 2.On a mobile device,download the SunPo-wer tvlonitoring Warranty 10-year Limited Warranty app from Apple App Srore3 or Google Play'store. 3•Sigr in using account email and pass✓vord. Certifications UL,WL,CE,UL 61010-1 and-2,FCC Part 15(Class B) IWAOM C&us P6 1.s= FCC ID:YAW529027 E503346 ° • RO