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HomeMy WebLinkAbout45388-Z �O$uFFoea Town of Southold ooy` 5/29/2024 P.O.Box 1179 101 ` 53095 Main Rd yfj�lao�, Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 45221 Date: 5/29/2024 THIS CERTIFIES that the building SOLAR PANEL Location of Property: 215 Chablis Path, Southold SCTM#: 473889 Sec/Block/Lot: 51.-3-3.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/19/2020 pursuant to which Building Permit No. 45388 dated 10/28/2020 was issued,and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: roof-mounted solar panels to existing single-family dwelling as applied for. The certificate is issued to Murphy,Deborah&Paul of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 45388 12/1/2020 PLUMBERS CERTIFICATION DATED u hori e Signature TOWN OF SOUTHOLD Sao coy BUILDING DEPARTMENT Mo - TOWN CLERK'S OFFICE SOUTHOLD, NY BUILDING PERMIT r (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 45388 Date: 10/28/2020 Permission is hereby granted to: Murphy, Deborah & Paul 68 Cove Rd Huntington, NY 11743 To: install roof-mounted solar panels on existing single-family dwelling as applied for. At premises located at: 215 Chablis Path, Southold SCTM #473889 Sec/Block/Lot# 51.-3-3.1 - Pursuant to application dated 10/19/2020 and approved by the Building Inspector. To expire on 4/29/2022. Fees: SOLAR PANELS $50.00 ELECTRIC $100.00 CO -ALTERATION TO DWELLING $50.00 Total: $200.00 wilding Inspector Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings,property lines,streets,and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of I%lead. 5. Commercial building, industrial building,multiple residences and similar buildings and installations,a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings(prior to April 9, 1957)non-conforming uses,or buildings and "pre-existing"land uses: 1. Accurate survey of property showing all property lines,streets,building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied,the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy-New dwelling$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00, Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential $15.00,Commercial$15.00 Date. New Construction: Old or Pre-existing Building: X (check one) Location of Property: 215 Chablis Drive Southold House No. Street Hamlet Owner or Owners of Property: Paul & Deborah Murphy Suffolk County Tax Map No 1000, Section 0 51 Block 03 Lot 003 . 001 Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted:$ Applica gnature i DocuSign Envelope ID:AEE529CB-BOA3-4238-8D50-7EC8660FC915 I CONSENT TO INSPECTION Paul Murphy ,the undersigned,do(es)hereby state: Owner(s)Name(s) That the undersigned(is)(are)the owner(s)of the premises in the Town of Southold, located at 215 Chablis Path, Southold which is shown and designated on the Suffolk County Tax Map as District 1000, Section_0 51 ,Block 03 ,Lot 0 0 3 . 0 01 That the undersigned(has)(have)filed,or cause to be filed,an application in the Southold Town Building Inspector's Office for the following: Installation of a 12 .48 kW Solar PV System with (3 ) 4N nM-'I 0 nnf-Mnuntpd an 1 G That the undersigned do(es)hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, including any and all buildings located thereon,to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comply with all of the laws,ordinances, rules and regulations of the Town of Southold. The undersigned, in consenting to such inspections;do(es)so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used in subsequent prosecutions for violations of the laws,ordinances,rules or regulations of the Town of Southold. - r,0 S' d by: ", jl?nnt�Name):: rS'ignatur�);� (;IPrint Nam me�*'� �Zel MKIE OTT NOTARY PUBLIC-STATE OF NEW Y013K No.01OT6256196 Qualified in Suffolk County My Commission Expires 02-21-2024 I DocuSign Envelope ID:AEE529CB-BOA3-4238-8D50-7EC8660FC915 Building Department Application AUTHORIZATION (Where the Applicant is not the Owner) I, Paul Murphy residingat 215 Chablis Path, Print property owner's name p p Y. ) (Mailing ilddress), Southold do hereby authorize Timothy Ivins (Agent) Harvest: Power LLC to apply on my behalf to the. Southold Building Department. 0oaRS; ned by. +l'rtnt • '�•�,' id46 za JULIE OTT NOTARY PUBLIC4TATE OF NEW YORK No,01 OT6256196 ' Qualified In Suffolk County MY C®ft MiWOn Expires 02-21-2024 ' OF SO(/ryol Town Hall Annex ~ Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Q sean.devlini!)town.southold.ny.us Southold,NY 11971-0959 Owl BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Deborah Murphy Address: 215 Chablis Path city:Southold st: NY zip: 11971 Building Permit#: 45388 Section: 51 Block: 3 Lot: 3.1 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Harvest Power LLC License No: 54016ME SITE DETAILS Office Use Only Residential X Indoor X Basement Service X Commerical Outdoor X 1st Floor Pool New X Renovation 2nd Floor Hot Tub Addition Survey X Roof X Garage X INVENTORY Service 1 ph X Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors Sub Panel A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO Transformer UC Lights Dryer Recpt Emergency Fixtures Time Clocks Disconnect Switches 4'LED Exit Fixtures Pump Other Equipment: 12.48kW Roof Mounted PV Solar Energy System w/ (39) SN320M-10 Modules (39) Enphase IQ7 Inverters , Enphase IQ Combiner3, AC Disconnect Notes: Inspector Signature: Date: December 1, 2020 S.Devlin-Cert Electrical Compliance Form.xls su�ryolo L4 � 20L'tDSBf /,�TOWN OF SOUTHUILDI G DE T. 765-1802 4 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING/STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ]--FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) ( ] CODE VIOLATION _[(']' PRE C/O REMARKS: i6�, DATE INSPECTOR C� OFSOUIyO� --- # TOWN OF SOUTHOLD BUILDING DEPT. °`ycourm��' 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] !PgULATIOWCAULKING [ ] FRAMING /STRAPPING [ (FINAL y,JtV [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: DATE -, INSPECTOR Graham Associates 1981 Union Blvd. Bay Shore,N.Y. 11706 Building Consultants& Expeditors (516) 665-9619 Fax(516) 969-0115 November 18,2020 Town of Southold Building Department Town Hall Annex P.O. Box 1179 Southold, NY 11971 Re: Murphy Residence—215 Chablis Path,Southold, NY 11971 SCTM#1000-051-03-003.001 Permit No.45388—12.48 kW Rooftop Solar Photovoltaic System To Whom It May Concern, Please be advised that I have inspected the solar roof array at 415 Village Lane, Mattituck, NY 11952 and have determined that it has been performed in accordance with the manufacturer's recommendations,and the approved building permit.The installation meets the NYS Building Code, 2015 International Code,and ASCE 7-10. If you have any further questions,do not hesitate to call. aril , RA N O V 1 9 2020 �- .. ._�f`�C,',7;r •.':�r�*gin. FIELD INSPEC 'ION REPOPIT` D-T FOUNDATION(IST) C)(� FOUNDATION(2ND) ROUGH FRAMING PLUMBING y LA t INS.�L,ATION-PER N..Y. .. H. STATE ENERGY CODE :FINAL ' p ANT,, z F77 . .. TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NY 11971 4 sets of Building Plans TEL: (631)765-1802 Planning Board approval FAX: (631)765-9502 � Survey Southoldtownny.gov . PERMIT NO: Check Septic Form N.Y.S.D.E.C. Trustees o C.O.Application Flood Permit Examined ,20 Single&Separate Truss Identification Form Storm-Water Assessment Form Contact: Approved ,20 Mail to: Disapproved a/c Phone: JD Expiration 120 Bukipi In ector �-,,II PLICATION FOR BUILDING PERMIT 0 CT 1 9 2020 � . Date , 20 ?rvr T(11 ;t t 1771 INSTRUCTIONS a.Tfi'is'aplSlibatioii.V1UST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans,accurate plot plan to scale. Fee according to schedule. b.Plot plan showing location of lot and of buildings on premises,relationship to adjoining premises or public streets or areas, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application,the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e.No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim,the Building Inspector may authorize, in writing,the extension of the permit for an addition six months.Thereafter,a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold; Suffolk County,New York,and other applicable Laws,Ordinances or Regulations,for the construction of buildings,additions, or alterations or for removal or demolition as herein described.The applicant agrees to comply with all applicable laws,ordinances,building code,housing code,and regulations,and to admit authorized inspectors on premises and in building for necessary inspections. Carlo Lanza/Harvest Power LLC (Signature of applicant or name,if a corporation) 2941 Sunrise Hwy, Islip Terrace 11752 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Agent/Contractor Name of owner of premises Paul & Deborah Murphy (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. 4 8165-H Plumbers License No. Electricians License No. 54016-ME Other Trade's License No. 1. Location of land on which proposed work will be done: 215 Chablis Drive Southold House Number Street Hamlet County Tax Map No. 1000 Section 051 Block. 03 Lot 003 . 001 Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Residence b. Intended use and occupancy 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Work Solar (Description) 4. Estimated Cost JAV Fee $2 0 0 . 0 0 (To be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES NO Will excess fill be removed from premises?YES NO Paul & Deborah 215 Chablis Drive 14.Names of Owner of premises Murphy Address Southold,NY 11971 Phone No. (516) 313-0 7 61 Name of Architect Michael Dunn Address 1961 Union Blvd, Bay Shorephone No (6 31) 6 6 5-9 619 Name of Contractor Harvest Power Address2941 sunrise Hwy Phone No. (631) 647-3402 Islip Terrace, NY 11752 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO tI * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO _v * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey,to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? * YES NO_(1 * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS. COUNTY OF being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the GtoApyJ (Contractor,Ag nt,Corporate Officer,etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief;and that the work will be performed in the manner set forth in the application filed therewith. Sworn o before me this day of 20_& JULIE OTT NOTARY PUBLIC-ST tart'P lic No.01 OT6256196 , , ignat�r pplicant Qualified in Suffolk County My Commission Expires 02-21-2024 $ FOL,I' BUILDING DEPARTMENT- Electrical Inspector �4 TOWN OF SOUTHOLD o } Town Hall Annex - 54375 Main Road - PO Box 1179 o._. ^'` - Southold, New York 11971-0959 y►Ql; ` , o , Telephone (631) 765-1802 - FAX (631) 765-9502 ;- rocterr"(cis-o-uth.o-idtow-nnv.go�c—seandAsauttioldtownn cov APPLICATION FOR ELECTRICAL INSPECTION 'ELECTRICIAN INFORMATION (All Information Required) Date: 10/13/2 02 0 j Company Name: Harvest Power LLc - i Name: John D Aries/Fulton Electric Inc.- License License NO_; 54016-ME email;" jott@harvestpower.net Address: 2941 Sunrise Hw_y_�_ Islip. Terrace_,. .NY 11752 ---_ _ Phone NO (631) 647-3402 — -" JOB SITE INFORMATION (All Information Required) Name: Paul & Deborah Murphy--------------------------------------- -- - Address: _- __215 Cross Street: Chabli--, s _Drive, SouthQld_,_.NY 11971 - Soundview Avenue Phone No.:. (516) 313-0761 - Bldg.Permit#:.. 45388 - --- ---- - --- - - g_ — T'ax M; :District: 1000 Section: 131ocEc; 0 3 BRIEF DESCRIPTION OF WORK (Please Print Clearly) Installation of.,_a^l2__48.kW. _Solax" PV=System w/ (3:9) N32Q1M-10 - — ---- Rogf-Mounted Panels_ - - _ --- —-- Circle All That Apply: `— - Is job ready for inspection?: YE "/ NO Rough In Final Do you need a Temp Certificate?: YE / NO Issued On !,!",P�T Information:p (AI!information required)Service ze 1 P 3 Ph Size: A #Meters..�_I_:_ Old Meter#Service ire Reconnect-Flood Reconnect- Service Reconnecte - -pdergroun Overheadftiround Laterals . 1..:__2.. H Frame Pole , Work done on Service? Y N _ Addition.tir riforrh6tiort:: -- .. - �•,. �..� SPA j _ l -.- YMENT D�}�..VA/.ITH APPLICATION 4J I t t l 3 Request J Q PAioa Fc2@& PERMIT# Address: Switches Outlets ti GFI's Surface Sconces HH's UC Lts Fans Fridge HW Exhaust -------�--------— Oven Dryer Smokes DW. Service ..Carbon Macro Generator Combo Cooktop Transfer AC AH Mini Special: Comments: `C o , �S�--e,4 n 1 H A R V E S T P ® W E R Harvest Power LLC 1 2941 Sunrise Hwy., Islip Terrace, NY 11752 1 Office: 631-647-3402 Fax: 631-647-3404 November 18,2020 Town of Southold Building Department P.O.Box 1179 Southold,NY 11971 1 Re: Engineer's Post-Install Letter&Final Electrical Inspection Request Murphy Residence—215 Chablis Path, Southold—BP#45388 Dear Town of Southold Building Department: Enclosed,please find the Engineer's post-install letter and electrical inspection application for the PV solar installation completed at the above referenced residence. We would like to schedule the final electrical inspection at the Town's earliest convenience. Thank you for your attention to this matter. If you need any further information,please contact me at(631)647-3402 or via email at jott@harvesipower.net. Very truly yours, lie Ott Expeditor 3 N O V 1 9 2020 - tLicensed, insured & bonded License # Nassau County: H0811250000 License # Suffolk County: 48165-H 1 Suffolk County Dept.of Labor,Licensing&Consumer Affairs HOME IMPROVEMENT LICENSE i Name CARLO LANZA JR Business Name HARVEST POWER LLC This certifies that the i bearer is duly licensed License Number H-48165 by the County of Suffolk Issued: 11/18/2010 Commissioner p Ex ires: 1110112020 i A`C)R o® CERTIFICATE OF LIABILITY INSURANCE DATE 4/13l2020 ) 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 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 Capacity Group of NY LLC PHONE Margarita Kaminski FAX One International Blvd. AD No Ext:646-459-2470 (AC.No):646-459-2470 Suite 300 ADDRESS: mkaminski ca aci n .com Mahwah NJ 07495 INSURERS AFFORDING COVERAGE NAIC# INSURER A:National Liability&Fire Insurance Company 20052 INSURED 2478 INSURER B:Endurance American Specialty Insurance Company 41718 Harvest Power LLC' 2941 Sunrise Highway INSURERC:Travelers Insurance Company 25674 Islip Terrace NY 11752 INSURER D:James River Insurance 12203 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1741459260 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. 1�7R TYPE OF INSURANCE INSD WVD SUER POLPOLICY NUMBER MM DIDY� MM%DDY� LIMITS C X COMMERCIAL GENERAL LIABILITY 107080166 4/15/2020 4/15/2021 EACH OCCURRENCE $1,000,000 CLAIMS-MADE �OCCUR DAMAGE RENTED PREMISES Ea occurrence $50,000 X Contractual Liab MED EXP(Any one person) $Excluded X Primary-NonContr PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY ECT LOC PRODUCTS-COMP/OP AGG $2.000,000 X", OTHER: Ded Liab$5.000 Contractors Pollutio $1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED tid P BODILY INJURY(Per accident)AUTOS AUTOS ( ) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident L - I S D X UMBRELLA LIAB X OCCUR 00071179-4 4/15/2020 4/15/2021 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED I RETENTION$ $ A WORKERS COMPENSATION V9WC071830 4/15/2020 4/15/2021 X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $1,000.000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 B Inland Marine IMP10004799606 4/15/2020 4/15/2021 Contents Limit: 250,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Subject to Policy Terms&Conditions... Certificate Holder is hereby included as Additional Insured,with regards to work being performed for them by the insured,subject to the policy terms,conditions &as required per written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Southold ACCORDANCE WITH THE POLICY PROVISIONS. 53095 Route 25 P O Box 1179 AUTHORIZED REPRESENTATIVE Southold NY 11971 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD vORK 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 631-647-3402 Harvest Power LLC 1c.NYS Unemployment Insurance Employer Registration Number of 2941 Sunrise Hwy Insured Islip Terrace,NY 11752 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 20-4214746 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) National Liability&Fire Insurance Company 3b.Policy Number of Entity Listed in Box"1 a" Town of Southold V9WC195204 53095 Route 25 3c.Policy effective period P O Box 1179 4/15/2020 to 4/15/2021 Southold NY 11971 3d.The Proprietor,Partners or Executive Officers are eIncluded.(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"T'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: Pamela L.Wagner (Print name of authorized,,representative or licensed agent of insurance carrier) Approved by: � W ,,t_4.1(_ /14/2 2 (Signature) J (Date) Title: SVP Workers'Compensation Underwriting Telephone Number of authorized representative or licensed agent of insurance carrier: 215-600-0749 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 Yo T Workers' CERTIFICATE OF INSURANCE COVERAGE STATE Compensation Board DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW PART 1.To be completed by Disability and Paid Family Leave Benefits Carrier or Licensed Insurance Agent of that Carrier 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured HARVEST POWER LLC 2941 SUNRISE HIGHWAY 631-647-3402 ISLIP TERRACE, NY 11752 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 20-4214746 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 PO Box 1179 3b.Policy Number of Entity Listed in Box"la" Southold, NY 11971 35488-78 3c.Policy effective period 10/31/2018 to 10/11/2021 4. Policy provides the following benefits: ❑m A.Both disability and paid family leave benefits. B.Disability benefits only. C.Paid family leave benefits only. 5. Policy covers: Fo 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. Q�' Date Signed 10/12/2020 By -A^- — (Signature of insurance carrier's authoriz d representative or NYS Licensed Insurance Agent of that insurance carrier) Telephone Number (212) 355-4141 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 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 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 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 with respect to all of his/her employees. Date Signed By (Signature of Authorized NYS Workers'Compensation Board Employee) Telephone Number Name and Title Please Note: Only insurance carriers licensed to write NYS disability and paid family leave benefits insurance policies and NYS licensed insurance agents of those insurance carriers are authorized to issue Form DB-120.1. Insurance brokers are NOT authorized to issue this form. DB-120.1 (10-17) 111111111iiiiiuiiiiiiiiiiiiiiii�iiiiiiiiiiiiiiii'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 New York State Disability and Paid Family Leave Benefits Law.The Insurance Carrier or its licensed agent will send this Certificate of Insurance 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 my 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 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 NYS Disability and/or Paid Family Leave Benefits Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Disability and Paid Family Leave Benefits Law. 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 (10-17)Reverse Graham Associates 1981 Union Blvd. Bay Shore,N.Y. 11706 Building Consultants & Expeditors (631)665-9619 Fax(631)969-0115 October 13, 2020 Town of Southold Building Department 54375 Rt. 25 Southold, NY 11971 Re: Murphy Residence 215 Chablis Path Southold, NY 12.48 KW Rooftop Solar Photovoltaic Systems To Whom It May Concern, Please be advised that I have analyzed the existing roof structure at the above-mentioned premises and have determined that it is adequate to support the additional load of the solar panels and a 130 mph wind load without overstress, in accordance with the following: The 2020 New York State Uniform Fire Prevention and Residential Building Code; Town of Southold Local Code, Long Island Unified Solar Permit Initiative, (LIUSPI); and 2020 National Electric Code NFPA 70/2020 National Electric Code including ASCE7-10 If you have any further questions, do not hesitate to call. 4 t k' D O d S-Energy ,S,N� 60=Ce1: 11 T - Edition 300 �.9,000U 1,500V Monocrysta.11ine PV Modufe 320W -P- --m-402--m +I I ' II } i I ! Ii ! ' �` 4 b 4 � I j I • � 11 • 11 - „ u u r•„ � S-Energy'Co.,Ltd. I A 20 Pangyoyeok-ro 241beongil,Bundang-9u,Seongnam-si,Gyeonggi-do,Korea (3F MiraeAsser Tower) T +82=70-4339-7100 F+82-70 4339-7199 E inquiry@s-energy.com S-Energy America,Inc.. I A 18022 Cowan,Suite 260,.Irvine,CA 92614,U.S.A Homepage T +1-949-281-7897 F +1-949-281-7893 E sales.us@s-energy,com %- A S-Energy'Japan Co.,Ltd.. A 8F,MJ Abeno Bldg.,1-5-1 Maruyama-dori,Abeono-ku,Osaka-shi,Osaka,Japan(Osaka Headquarters) T +81-6-4703-S388 F +81-6-4703-5387 E sales-jp@s-energy.com S-Energy Japan Co.,Ltd. I A Fukuroku Building 2F,2-7 Kanda-Tsukasamachi,Chiyoda-ku,Tokyo,Japan T-N-M-5 (Tokyo Branch) T +81-3-6261-3759 F' +81-3-6261-3759 E sales-jp@s-energy,com 1,000V 1,500VSN 60-Cell Monoc rystalline PV Module SSSss SS s-Energy SN30OM-10T/15T•SN305M-10T/15T•SN31OM-10T/15T•SN315M-10T/15T SN320M-10T/15T § ELECTRICAL CHARACTERISTICS STC co-ra—1,000w/rrr,..dd,�csaarersc,ma=Is) i L SN30OM-10T/15T SN305M-10T/15T !I SN31OM-10T/15T 4 SN315M-lOT/1ST I SN32OM-lOT/15T Rated Power(Pmax) 300W 305W 31OW 315W 320W Y Voltage-at Pmax(Vmp) ^� L� 32.9V•- - u i 332V -� - -33.SV 33.9V Current at Pmax(Imp) 9.12A 9.20A 9.26A 9.30A 9.34A Warranted Minimum_Pmax - -� - `630OW ^ 305W�_ i-+31OW � `_-315W - 320W Short-Circuit Current(Isc) 9.58A 9.64A 9.69A 9.75A 9.81A Open-Circuit Voltage(Voc) - 39.77V _ ^ 39.9V _ 40.1V 40.3V 40.55V _ - Module Efficiency` 18.33% 18.63% 18.94% 19.24% 19.55% Operating,Module Temperature Y _ - �yT---40'C to+85"C Maximum System Voltage 1,000V/1,500V(DC) TMaximum-Series.FuseRating 20A ��- Power Tolerance 0-+3% MECHANICAL CHARACTERISTICS D„­age„oie A I Solar Cells .J Monocrystalline 156.75 x 156.75mm(6 inches) -_ 1 Number of Cells��, 60 Cells(6x10.Matrix) -i L Dimensions 1,650 x 992 x 35mm i, Weight~ � 18.Skg _•--���---�� - _=- � Front Glass High-Transmittance Low Iron Tempered Glass LONG CABLES •----^----� VCOIJNECTORS LFrame J Anodized Aluminum Frame(Silver/Black) y -) Outp Ca ut bles PV Wire(PV1-F),12AWG(4mm2),Cable Length:900mm _ -045 Connectors MC4 Connectable -—-—-—-- - -—-—-—-- i i o 0 o I Grounding mvl- 0 0 o r sP I TEMPERATURE CHARACTERISTICS , �+ r� Temperature coefficient of Isc 0.05%/'C I B B -Temperature coefficient of Voc �- -0.30%/°C - :� m—perature coefficient of power -^� -0.39%/•C Te I.---. __.._. �NMOT(rair.20'C;Irradiarxe80oW/m2;Wind lm/s) i 43t2'C ss.o-z.o 947.0±2.0 992.0{2.0 WARRANTY f Product Warranty 10-year Limited Product Warranty } j Minimum Power Output for Year 1:97% i Performance -`----------- sso Warranty i Maximum Power Decline from Year 2 to 24:0.71% i1-- --- --- --- _- -- - -- !_ I Power Output in Year 25:80% A. PACKING CONFIGURATION °��m ° �" -m ° _u�_,�_,_ ° m,�vdwg°NI c•v°IrageNl _Container �-»� _ 40'H/C J Modules Per Pallet 30pcs Pmax measurement tolerance:tz5% i Pallets Per.Container .. 28pallets ! REMARIKS 'S-Energy uses tripleA class ulator. _ --__ _ _ . :Specification subject to change without prior notice. Modules Per Container 840pcs S-Energy reserves the rights of final interpretation. Data Sheet Enphase Microinverters Region:US Enphase The high-powered smart grid-ready p Enphase IQ 7 MicroTM and Enphase IQ 7+ MicroTM IQ 7 and IQ 7+ dramatically simplify the installation process while achieving the highest system efficiency. Microinverters Part of the Enphase IQ System,the IQ 7 and IQ 7+ Microinverters integrate seamlessly with the Enphase IQ EnvoyTM, Enphase Q AggregatorTM Enphase IQ BatteryTM, and the Enphase Enlighten TM monitoring and analysis software. IQ Series Microinverters extend the reliability standards set forth by previous generations and undergo over a million hours of power-on testing, enabling Enphase to provide an industry-leading warranty of up to 25 years. Easy to Install Lightweight and simple F Faster installation with improved,lighter two-wire cabling > _ - Built-in rapid shutdown compliant(NEC 2014&2017) E � - Productive and Reliable • Optimized for high powered 60-cell and 72-cell*modules • More than a million hours of testing • Class II double-insulated enclosure • UL listed m Smart Grid Ready • Complies with advanced grid support,voltage and frequency ride-through requirements - Remotely updates to respond to changing grid requirements • Configurable for varying grid profiles • Meets CA Rule 21 (UL 1741-SA) U� *The IQ 7+Micro is required to support 72-cell modules. ENPHASE- To learn more about Enphase offerings,visit enphase.com �./ Enphase IQ 7 and IQ 7+ Microinverters INPUT DATA(DC) IQ7-60-2-US IQ7PLUS-72-2-US Commonly used module.pairings' -235 W-350 W+ 235 W-440 W+ Module compatibility 60-cell PV modules only �60-cell and 72-cell PV modules Maximum input DC voltage �Y� � 48'•V �� 60 V � �� Peak power tracking voltage 27 V-37 V _27 V-45 V Operating range ` 16 V-48 V 16 V-60 V Min/Max start voltage 22 V/48 V 22 V/60 V Max DC short circuit-current(module Isc) 15 A � 15 A. � Overvoltage class DC port II Y II DC part backfeed current 0 A 0 A 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) IQ 7 Microinverter IQ 7+Microinverter 1 Peak output power 250 VA _295 VA Maximum continuous output power 240 VA 290 VA Nominal(L-()voltage/range2 240 V/ R 208 V/ 240'V/ 208 V/ _ 211-264 V 183-229 V 211-264 V, 183-229 V Maximum continuous output current 1.0 A 1.15 A 1.21 A 1.39 A ;•Nominal frequency 60 Hz, 60 Hz LExtended frequency range 47-68 Hz _ 47-68 Hz AC sl5ort�circuit fault current over3 cycles 5.8 Arms 5.8 Arms Maximum units per 20 A(L-L)branch circuit3 16(240 VAC) 13(240 VAC) 13(208 VAC) 11 (208 VAC) 'Overvoltage class AC'port III` III' AC port backfeed current 0 A w 0 A Power factor setting . 1.0 1.0 : A Power factor(adjustable) w 0.7 leading...0.7 lagging 0.7 leading...0.7 lagging ~� EFFICIENCY @240 V @208 V @240 V @208 V Peak CEC efficiency - 97.6.% ��y•97.6°i°" 97.5%• :rt� 97-.3°i° y CEC weighted efficiency �97.0% 97.0% 97.0% 97.0% MECHANICAL DATA IQ 7 Microinverter I lArnbierttemperaturerange� �. -400Cto+650C Relative humidity range 4%to 100%(condensing) Connectortype _ �_ i�'.'MC4(orAmphenol'H4UTXwithadditionalQ-DCC-5adapter) Dimensions(WxHxD) �212 mm x 175 mm x 30.2 mm(without bracket)y '1_.08kg�(2.38lbs)' Cooling Natural convection-No fans Approved for wet locations. ���✓ ,Yes Pollution degree PD3 Enclosure __ - _ . Class II double-insulated,.corrosion resistant polymeric enclosure, Environmental category/UV exposure rating NEMA Type 6/outdoor FEATURES Communication -Power Line.Communication(PLC) _ Monitoring Enlighten Manager and MyEnlighten monitoring options. Both options require installation of an Enphase IQ Envoy. Disconnecting`means`-. -�"_fhe AC and DC'connectors have been evaluated and approved by UL for use as the load-break -,disconnect required by NEC 690. . Compliance CA Rule 21 (UL 1741-SA)_ UL 62109-1,UL1741/IEEE1547,FCC Part 15 Class B, ICES-0003 Class B, CAN/CSA-C22.2 NO.107.1-01 This product is UL Listed as PV Rapid Shut Down Equipment and conforms with NEC-2014 and NEC-2017 section 690.12 and C22.1-2015 Rule 64-218 Rapid Shutdown of PV Systems,for AC and DC conductors,when installed according manufacturer's instructions. 1.No enforced DC/AC ratio.See the compatibility calculator at https:Henphase.com/en-us/­support/­module-compatibilitv. 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 u EN PHASE. &)2018 Enphase Energy All rights reserved.All trademarks or brands used are the property of Enphase Energy,Inc. 2018-02-08 t o N N PAUL & DEBORAH MURPHY RESIDENCE E Y a d 12.480 KW ROOFTOP PHOTOVOLTAIC SYSTEM Ln z 39 S—ENERGY SN320M-10 "320" WATT MODULES iu to W n. 215 CHABLIS PATH, SOUTHOLD, NY 11971 co TAX MAP NO . DISTRICT 1000 SECT 051 BLOCK 03 LOT 3 .001 W!CD N BY z o W () z p- M � � � w HARVEST POWER LLC LU ozo ,� � . o � � o r m W w � = o .n M = o a � 0 W O C M 2 2 0 > of Q ��j u o U) ZW = O m J �_ W a LA.1 m 0 _ �0Y Q \ W V z /w/ Al:TITLE PAGE, MAP, RAIL CERTIFICATION ;;:- a'`� Ln a ��Ii (W A2: ROOF PLAN _ __- -_.:u:- -- - ----- ---- _ __ ____-___ _: - _,__ -- a Q ��•, X Q A& MOUNTING DETAIL, SINGLE LINE DIAGRAM, LOAD Q a = j CALCULATIONS, GENERAL NOTES % Z) A4: RACKING DATA SHEETS A5: PV SYSTEM LABELS Ra-'. ..' CD ( C' A& RAIL CERTIFICATION '� ' = N •_' ' -- W f .. �___ w INDEX :r,.. ,. o la L =fl a ' _ - •.� ..tip.•, _ �;:�t. _•�`�b ��,, iJ d •r'i` � � � - .� t; �-'.—�-� � �// i � � %fig/ +f rj''` Pool:King =~� MAP Map data©2019 Google TITLE PAGE Al ,l Ph a'1-.rz 2-11, 1 1 of6 0 N O N W e�q QN 19 CL d 17.43 ft 23.93 ft N Z O H o_ Array 2 of Rafter=2x12"—16"o.c. c y Max Span=14.85 ft W n 12 x PV Modules °o o U) 90°Azimuth v a O 40°Tilt m C N N I) - I- 8"Ventilation _ -- - 18'VenU7atlon - r l - - - -- - - - - - LLI V Array 3 _ - V o Z Rafter=2x12"—16"o.c. Z r\ '^ Max Span=16.98 ft a LLJ 0) p ---� Ll1 12 x PV Modules z Q r I m J V 90°Azimuth "' N o Q 21°Tilt LU Z u w t W LU W o J co LIt a = O r � a O W O V O M _ = 0 Array 1 a b Q W Rafter=2x12"—16"o.c• 3 Z Max Span=9.62 ft CO N N J = O 15 x PV Modules LU m o w (_ -i L � Z:180°Azimuth Q Q p \ _ LI -- 40°Tilt = a- / n ®-- J 11 Q2 7 ce-1 � =) N X "nd a = Z wl- G ppntl 36"Path Access _ A ee W Front of House 17.79 ft ~ H Q H F d= W W O OS Asphalt Driveway CHABLIS PATH ROOF PLAN SCALE 0.192357 ROOF PLAN P 8 tb 2of6