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o�gUFFD11r TOWN OF SOUTHOLD BUILDING DEPARTMENT ti x TOWN CLERK'S OFFICE o . �0� 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#: 50401 - Date: 3/7/2024 Permission is hereby granted to: Hansen, Ben 420 State St Brooklyn, NY 11217 To: install roof-mounted solar panels to existing single-family dwelling as applied for with flood permit. All solar panel equipment must be installed at elevation 8' or higher. At premises located at: 305 Narrow River Rd, Orient �'a'D 'a L) SCTM #473889a�l S I t�L���{2 STD Sec/Block/Lot# 26.-3-11 Pursuant to application dated 1/30/2024 and approved by the Building Inspector. To expire on 9/6/2025. Fees: SOLAR PANELS $100.00 ELECTRIC $125.00 CO-ALTERATION TO DWELLING $100.00 Flood Permit $150.00 Total: $475.00 Building Inspector FIELD INSPECTION REPORT DATE COMMENTS ILA ro Q � FOUNDATION (1ST) G -------------------------------------- FOUNDATION (2ND) ;6cn Lp Wo ROUGH FRAMING& PLUMBING r INSULATION PER N.Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS 5 R c eipt oa IQ-4 's a(0 3 0 ow, 614 rn t� � b O r� x b TOWN OF SOUTHOLD—.BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone(631) 765-1802 Fax(631) 765-9502 hql2s://www.southoldtom=.jzo Date Received APPLICATION FOR BUILDING PERMIT n r-- or Office Use Only PERMIT NO. Building Inspector: JAN 3 0 2024 A p t t eir•eintineit y�i e,Incomp e Plic6�i6ns.�afid:fo'rm!�,;m*us�t,'b'e filled 6 -u 'in� h I t ,.apipli6tiohs-�vffl nDib6';a6c6i3ted.�Where the"AOpllcantlfs not ih6 EURDINC111 74D.M."P. completed. s,Auth6rizatl'on_f Wor m Palr,2 shall be corn I Date: 1/17/2024 OWNERS OF,PROPERTY: : -Name: Berl Hansen S.CTM-#.10 0.0-21.6-3-11.1.1 Project Address: 305 Narrow River Road, Orient, NY 11957 0 Phone 212-219-9150 Email: ben@brharchitect.com Mailing Address: 420 Statp_stmpt, RroQklyn,-NY, 11217 CONTACT,PERSo N ' Name:Barbara - GreenLo ic LLC .M.alillin,g-Ad.,d,r.e.s.,s.:,-9.7,-North,Sea.Road,-Southampton,NY 11968 Phone#:631-771-5152 X1 17 Email:Barbara@Greenlogic.com DESION'.PkOFESSIONAL-I INFORMATION : Name: Pacifico Engineering PC 1.Mailing I I. 11 . Address:..,7100-.La-k.ell.a.-nd -AvIeln.ue,.-Su.i.te.-2B, .Bo„he.mia,,"NY. .11716 Phone#: 631-988-0000 solar@pacificoengineering.com CONTRACTOR Nt it 01:6WATION- Name:GreenLogic LLC Mailing Address:97 North Sea Road,-Southamptg!l,,Ny,b,rl-l..968 Phone#:631-771-5152 E,'pail:AM@,Greenlogic.com ,-DESCRIPTION OF PROPOSED CONSTRUC1,11OW, EI New Structure ElAddition ®Alteration EIRepair DDemolition Estimated Cost of Project: lilOther Solar Panels $44,000 Will the lot be re-graded? E]Yes igNo Will excess fill be removed from premises? ElYes W No _w ...... INFOR MATION G4 Existing use of property: , m Intended use of property:, W Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? Dyes Pfqo IF YES, PROVIDE A COPY. - . _ `Check Box After-RdWhi 4 is respcnaible.fo� &aifia' g: and storm water issues as prop�dect by e.TdWniCodi.-�'APPUCAT!PN�l$,.Hg�ES',, 4, 1 iii6htia tfid Bull chipter-236VAh il hbj�sqan;�:_ 0 g qq!..dln d o 'Ordinance of the TowrS'of Sodthold Suffolk;CqUh_tV"`,jq4 4�ik ap"ol.idh 1d'LaWs;0rdinaq0s'0rRegula tions; additions; applicant, l rei for necessary irispectlons.Fa te statements`rha fid .punishable Class A m 0, nState Application Submitted By(print name):GreenLogic LLC HAuthorized Agent ElOwner Signature. I of-Applicant:. Date: 72-4. STATE OF NEW YORK) SS: COUNTY OF Suffolk ___) Nesim AJbukrek being.duly sworn,deposes and says that fs)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 owijqr5,,;qjjd is(ji&ptIftripq�ft p-qrfQrmQr have performed the said work-and to make and file application;that all statements contained in this application are true to the best of his/her knowledge and belief;and that the work-will-be-performed-in the-manner set forth in the application file therewith. Sworn before me this day of 20Aq Notary Public 13ARBARA A CASCIOTTA Notary Public-State of New York PROPERTY OWNER AUTHORIZATION No.01 CA4894969 Qualified In Suffolk County (Where the applicant is not the owner) Commission Expires May 11.2027 %ij residing at Qlk"Tw PVCy- F-P . —do hereby authorize GreenLogic LLC -to apply on my be o the Town of Southold Building Department for approval as described herein. T ------- jl;j -u 2,3 wrier's Signature Date Print Owner's Name 2 o TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 https://Nvww.soutlioldtownny.gov Floodplain Development Permit Application PR©PERT,Y1NFORIVIATION: Flood Zone:AE-6 FIRM Panel: SCTM#1000-26-3-11 Address:305 Narrow River Road City:Orient Zip:11957 CONTACT PERSON: "a_°_: Name:Barbara Casciotta Phone#:631-771-5152 Mailing Address:GreenLogic LLC - 97 North Sea Road, Southampton, NY 11968 PAOJECTDESCRIPTloni:=- Roof mounted solar electric system SECTION°A::STRUCTURAL DEVELOPMENT.(CHECK ALLTHAT:APPLY),.: of Structure 3'l3. �:r 'Type'of.Structural Activity R Residential(1 to 4 families) ❑New structure ❑Residential(more than 4 families) ❑ Demolition of existing structure ❑ Combined use ❑ Replacement of existing structure ❑Non-residential ❑Relocation of existing structure ❑ Elevated ❑Addition to existing structure ❑ Flood proofed(attach certification) R Alteration to existing structure ❑ Manufactured Home ❑ Other: ❑ Located on individual lot ❑ Located in manufactured home park SECTION>B:OTHER DE1tELOPMENT(CHECK ALL THAT APPLY) ❑ Clearing of trees,vegetation or debris ❑ Mining ❑ Grading ❑ Drilling ❑ Dredging ❑ Connection to public utilities or services ❑ Paving ❑ Placement of fill material ❑ Drainage improvement(including culvert work) ❑ Roadway or bridge construction ❑ Fence or wall construction ❑Watercourse alteration (attach description) ❑ Excavation (not related to a structured development) ❑ Other development not listed (specify): Bjrssignirig below I agree- the terms and conditions of.this permit.and certify to the Kest of my knowledge,the`information contained in,this,applicatian•is-true and accurate.'i understand that np,.work may startruritil a permit.is issued.The permit rriay be revoked if anY false statements are"'Made herein.lf"evoked,all workiiiusi cease unt!l,' ermit is re-issued:Devel p►iient sfiall nat.b6 used or occupied" .until a Cert.=oftdrnpiiance"is issued.the permit w'ilVkpire if no work is donimenced"within anetyear of issuance.Other�periniU may be, required,to fulfill°regulatory requirerraents:Applicantgiues ccinsent to local authority..or representative to�make'reasonable inspections;:: „ . ,to verify compfiance:� Application Submitted By(print name): Nesim Albukrek - GreenLogic LLC Signature of Applicant: Date: BUILDING DEPARTMENT-Electrical Inspector TOWN OF SOUTHOLD Town Hall Annex - 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1802 - FAX (631) 765-9502 rogerr(absoutholdtownny.gov -- seandCcD-southoldtownny.aov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: 1/17/2024 Company Name: GreenLogic LLC Name: Robert Skypala License No.: 43858-ME email: Barbara@Greenlogic.com Phone No: 631-771-5152 gi request an email copy of Certificate of Compliance Address.: . 97 North Sea Road Southampton, NY 11968 JOB SITE INFORMATION (All Information Required) Name: Ben Hansen Address: 305 Narrow River Road, Orient, NY 11957 Cross Street: Phone No.: 212-219-9150 Bldg.Permit#: email: ben@brharchitect.com Tax Map District: 1000 Section: 26 Block: 3 Lot: 11 BRIEF DESCRIPTION OF WORK (Please Print Clearly) Roof mounted solar electric system **(25) Waare WSMD-406 panels Et (25) Enphase IQ7HS micro inverters (1) SunPower PVS6 monitor System Size: 10.000KW Check All That Apply: Is job ready for inspection?: ❑YES Q NO ❑Rough In OFinal Do you need a Temp Certificate?: R]YES ❑NO 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-400-BLK-W-DC PAYMENT DUE WITH APPLICATION Electrical Inspection Form 2020.xlsx GREENLOGICO ENERGY January 17,2024 Town of Southold Building Department Town Hall 53095 Route 25 Southold, NY 11971 Project Info: Ben Hansen 305 Narrow River Road Orient, NY 1000-26-3-11 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 • Floodplain Application • 2 Surveys of the Premises • 4 Engineer's Reports 2 Three Line Electrical Drawings • 2 Spec.sheets of the solar panels/inverters • 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) • Check for$175(Floodplain App) Please let us know if you need anything else in connection with this application. Yours truly, Xwtba w ewciatta Barbara Casciotta Account Manager Barbara@Greenlogic.com 631-771-5152 ext. 117 GREENLOGIC LLC•www.GreenLogic.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 GREENLOGIC° ENERGY .f L �`� ��%"�� March 11, 2024 MAR 4 �024 Town of Southold p , Building Department Town Hall 53095 Route 25 Southold, NY 11971 Project Info: Ben Hansen 305 Narrow River Road Orient, NY 1000-26-3-11 Dear Building Inspector: Please find enclosed a replacement check for$150 for the floodplain application. Please let us know if you need anything else in connection with this application. Yours truly, J3avcPma C'at ao to Barbara Casciotta Account Manager Barbara@Greenlogic.com 631-771-5152 ext. 117 GREENLOGIC LLC•www.GreenLogic.com Tel: 631.771.5152 Fax: 631.771.5156 SOUTHAMPTON ROSLYN HEIGHTS 97 North Sea Rd.,Suite 3 200 S.Service Rd.,#104C Southampton, NY 11968 Rosyln Heights, NY 11577 (1)UNAUTHORIZED ALTERATION CR ADDITION TO THIS SURVEY IS A VIOLATION OF SEC71ON 7209 OF THE NEW YORK STATE EDUCATION LAN.(Y)DISTANCES SHOWN HEREON FROM PROPERTY LINES 70 EMTNG STRUCTURES ARE FOR A SPECIFIC PURPOSE AND ARE NOT TO BE USCG 70 ESTABLISH PROPERTY LINES OR FOR ERECTION OF FENCES(3)COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S IRKED SEAL OR EMBOSSED SEAL SMALL NOT BE CONSIDERED 70 BE A VALID TRUE COPY.(A)CFATMATION INDICATED HEREON SHALL RUN ONLY 70 THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF 70 THE RITE COMPANY,GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON,AND TO THE ASSIGNEES OF THE LENDNG INSTITUTON,CERUMATIONS ARE NOT TRANSFERABLE TO ADO$nONAL INSTITUTIONS OR SUBEEOUENT OWNERS (S)THE LOCATION OF WELLS(M.SEPTIC YANKS(ST)@ CESSPOOLS(CP)SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND OR DATA OBTAWED FROM OTHERS. 400 Ostrander Avenue,Riverhead,New York 11901 \ , tel.631.121�2303 fax.631.121.0144 `Q�' i admen®youngenginoering.com \ Howard K Young,Land Svrveyor Thomas 0.V01pert,Professional Engineer IDouglas E.Adams,Professlonal"Ineer W 'INS Robert G.Taet,Architect \\ SITE DATA s ' 6 \ AREA = 12_905 50. FT. $ \ O^ \ • VERTICAL DATUM NA.V.DATUM(IG180) v \ 96��,Y \ HEALTH DEPARTMENT USE � \ a v N / \ / �Opal / \ / •t' 0t\� SURVEYOR'S CERTIFICATION �0 �4 0 0, �0 o,, PIP \1ll ]/c �, 1 irk BFl)3FVW�ODS ' �`_,l i;,t �k;�✓•....., .r.",S G rpIlk 1 40 U�1 H UNG OMARD K YO ,N.Y. .S.NO.4 3 { (A N � �Y\ J94 2D7+ 2.21 ,Q n ' / +244 ` SURVEY FOR +2.,9 2J6 V, Q i/E 1 1 1 lSir l , ' "J / +2•w .,n \• of Orlent, Town of Southold 5uffolk County, New York BUILDING PERMIT SURVEY County Tax Map District 1000 Seetlon 26 Block 03 Lot I I O s 09 ` FIELD SURVEY COMPLETED NOV.01,2014 ��2�A MAP PREPARED NOV.10,2014 + Record of Revisions RECORD OF REVISIONS DATE s m 40 o ao 40 eo w1 uUr \ Scale-. 1" = 40' -105 No.2014-0216 L DWG.2014_0216-.bp I of 1 17 = MONUMENT SET ■= MONUMENT FOUND c STAKE SET A= STArce FOUND ,�t n• CERTIFICATE OF LIABILITY 1 101/25/2024 DAT024®D/YYYY) THIS CERTIFICATE IS ISSUED AS A AAATTER OF INFORMATION ONLY AN1D t:t�NFIERS . RIG",T$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),AUTHORIgED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PROPUCEIR coNTACT Nicholas Zulkofske Brookhaven Agency,Inc, PHO6lE •j631 941-4113 .FAX 631 941-"05 100 Oakland Ave,Ste 1 ADDRESS-. Certificates@ brookhavena enc .com Port Jefferson,NY 11777 INSURERS AFFORDING COVERAGE Nail INSURER A: Southwest Marine&General Insurance Co. INSURED INSURE B: Merchants Preferred Insurance Co. GreenLogic,LLC INSURERC: First Rehab Life Insurance Co. 97 North Sea Rd,Suite 3 IN§UREIj D: National Liabili &Fire Insurance Co. Southampton NY 11968 INSURER F, AGCS Marine Insurance Co. INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS l.5 TO CF-RTIEY THAT THR RAL.IDIES`OP INSpRANO I.ISTE15 EELQW HAVE pi l;IV ISSUED'T0 THE INSURED NAMED A50VE FOR THEPOLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TBRM 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 EXPLTR LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1 OOO OOO A CLAIMS-MADE ®OCCUR DAMAGE TO RENTED $10O 000 X Contractual Liability X X GL202400012922 01/31/2024 01/31/2025 MED EXP(Any oneperson) 5,000 PERSONAL&ADV INJURY $1 000 000 GEN-L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s2,000,000 POLICY 7X O- LOC PRODUCTS-COMP/OPAGG s2,000,000 OTHER: E&O Liability $1 000 000 AUTOMOBILE LIABILITY COMBINEDISINGLE LIMIT $1 000 000 B j; ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED X X CAP1043565 08/1112023 08/11/2024 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNER PROPERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY $ UMBRELLA LIAR X I OCCUR EACH OCCURRENCE $1 000 000 A X EXCESS LIAB CLAIMS-MADE X EX202400003348 04/13/2024 01/31/2025 AGGREGATE $1 000 000 D D RETENTION _ g VdORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETORIPARTNER/EXECU'rIVE E.L.EACH ACCIDENT S OFFICER/MEMBER EXCLUDt;O? NIA see separate certificate (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE`$ (ryes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C NXS Disability D261202 04/11/2023 04/11/2024 Statutory Limits E Installation Floater/Property SML93076366 04115/2023 04/15/2024 $300,000 $2,500 Ded DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additlonal Remeft Schedule,may he attached U more apace to 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 l EPRESI NTATIVE <NSZ9 - .. - Q 1988-2015 ACQRpa CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD ir NEW R Workers'' CERTIFICATE OF INSURANCE COVERAGE STATE COmp@nsatlon Board NYS DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW PART 1.To be completed by NYS disability and Paid Family Leave benefits carrier or licensed insurance agent of that carrier 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured 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"1 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: 0 A.Both disability and paid family leave benefits. B.Disability benefits only. C.Paid family leave benefits only. 5. Policy covers: 0 A.All of the employer's employees eligible under the NYS Disability and Paid Family Leave Benefits Law. B.Only the following class or classes of employer's employees: Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has NYS Disability and/or Paid Family Leave Benefits insurance coverage as described aove. Date Signed 4/4/2023 By a6W-4f (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 48,4C or 5B 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) DB-120.1 (12-21) DocuSign Envelope ID:7BC1.668A-3838-462A-840E-39E28CE1FOC2 NEW Workers' CERTIFICATE OF STATE Calri BlgSaflall p NYS WORKERS COMPENSATION INSURANCE'COVERAGE Hoard la.Legal Name&Address of Insured(use street address.only) 1b:Business Telephone:Numberof'Insured 631-771=5152 GREENLOGIC LLC 97 N SEA RD STE 3 1a.NYS Unemployment Insurance Employer Registration Number of S.OUTHAMPTON,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 2.1Vame 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.Amenca TOWN OF SOUTHOLD BUILDING,DEPARTMENT 3b.Policy Number of Entity Listed in Box"I a" 53005 ROUTE 25 C57207784' SOUTHOLD,NY 11971 3c.Policy effective period 12131/2023 to 12/31/2024 3d.The Proprietor;Partners or Executive Officers aide ❑X included.(Only check box if all partners/of.cers•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"I a"for workers' compensation under the New York State Workers'Compensation Law. (T.o 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 agentwill 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 IQ days IF a policy is canceled due to nonpayment of premiums or within 30 day"s IF there are reasons other than nonpayment of premiums that cancel the policyor 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 bythe 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 maybe 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,l 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 F�Docu,F"rtame of authorized representative or licensed agent of insurance carrier) , ._ 12/6/202.3 Approved by: (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.Insurance brokers are NOT authorized to issue it. C-105.2(9-17) www.wcb.ny.gov Acct#:'3031516 DATE(MMlDD/YYYY) A o n• CERTIFICATE OF LIABILITY INSURANCE 01/2612023 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. PNONE 631 941-4113 FAX 631 941-4405 100 Oakland Ave,Ste 1 E-MAIL . Certificates@ brookhavena enc .com Port Jefferson,NY 11777 INSURER(Sl AFFORDING COVERAGE NAIC# 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 INSURER D: National Liability&Fire Insurance Co. Southampton NY 11968 INSURER E: 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LT R TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1 000 000 A CLAIMS-MADE X�OCCUR DAMAGE TO RENTED $100 000 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 s2,000,000 PRO- LOC PRODUCTS-COMP/OP AGG $2 OOD OOO POLICY� 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 AUTOS ONLY AUTOS X X CAP1043565 08/11/2022 08/11/2023 BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY UMBRELLA LIAR HOCCUR EACH OCCURRENCE EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ WORKERS COMPENSATION PERT[ITF OTH- AND EMPLOYERS'LIABILITY OFFICER/MEMBEA FP ANY R EXCLUD D7 ECUTIVE Y❑ N/A see separate certificate E.L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS helow E.L.DISEASE-POLICY LIMIT $ C NYS Disability 0251202 04/11/2022 04/11/2023 Statutory Limits E Installation Floater/Property .SMLS3076366 04/15/2022 04115/2023 $300,000 $2,500 Ded DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may he 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 DELNERED 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(2016/03) The ACORD name and logo are registered marks of ACORD 'N' • *4 J3, 0 V 4 -ak A X.L' Suffolk County Executive-s Office of Consumer Affairs "wo 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 7 doing business as GRFEN LOGIC LLC having furnished the requirements set forth in accordance with and subject to the provisions of applicable laws,rules and regulations of the County of Suffolk, State of New York is hereby licensed to conduct business as a HOME IMPROVEMENT CONTRACTOR,in the County of Suffolk. Additional Businesses n... -J NOT VALID WITHOUT DJ�PARTMENTAL SEAL AND A CURRENT CONSUNIElk AFTAIRS ID CARD 0 Director "3 `7 R Suffolk County Executive's Office of Consumer Affairs VETERANS MEMORIAL HIGHWAY * HAUPPAUGE, NEW YORK 11788 DATE ISSUED: 12/10/2007 No. 43858-ME SUFFOLK COUNTY M Master Electrician License f 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 r with and subject to the provisions of applicable laws,rules and regulations of the County of Suffolk, State of New York. [ 44 Additional Businesses I 1 r NOT VALID WITHOUT DEPARTMENTAL SEAL AND A'CURRINT E CONSUMER AFFAIRS I1)CARD Director q q Ems 9 a" q q P u 9 APP VE AS NOTED DA B.P.#t FEE BY Ao NOTIFY BUILDING DEPARTMENT 631-765-1802 8AM TO 4PM FOR THE FOLLOWING INSPECTIONS: -uuJ)LONE 1. FOUNDATION-TWO REQUIRED COMPLY WITH CHAPTER,"46° FOR POURED CONCRETE FLOOD DAMAGE PREVENTION 2. ROUGH-FRAMING&PLUMBING 3. INSULATION IOUTHOLD TOWN CODE. 4. FINAL-CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OFTHE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR -DESIGN OR CONSTRUCTON ERRORSCOMPLY WITH CODES OF � P NEW YORK STATE A&TOWN CODES AS REQUIRED AND CONDITI NS OF f soUrHOLDTOWN SOUTHOID TO NING BOARD SOUTHOLD T TRUSTEES N.Y.S.DE SO HPC SCH OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICA OF OCCUPANCY ELECTRICAL INSPECTION REQUIRED r /1 ' Pacifico Engineering PC Engineering Consulting 700 Lakeland Ave,Suite 2B Ph:631-988-0000 Bohemia, NY 11716 G c solar@pacificoengineering.com January 16,2024 Town of Southold Building Department 54375 Route 25, P.O. Box 1179 Southold, NY 11971 Subject: Solar Energy Installation for Ben Hansen 305 Narrow River Road Orient, NY 11957 I have reviewed the roofing structure at the subject address.The structure can support the additional weight of the roof mounted system.The units are to be installed in accordance with the manufacturer's installation instructions. I have determined that the installation will meet the requirements of the 2020 Residential Code of New York State and.ASCE 7-16 when installed in accordance with the manufacturer's instructions. Roof Section A Mean roof height 22.0 ft Pitch 2 degrees Roof rafter 2x10 Rafter spacing 16 inch on center Reflected roof rafter span 13.5 ft Table R802.4.1(1) max allowable 22.5 ft Fastener Type (2)5"_&(6)3"#14-13 DP1 concealer screws Fastener Capability 2125 Ib Fastener Spacing,Zone 1 /2/3 48/64/64 in Point Pullout, lb,Zone 1 /2/3 193/306/306 lb Zone Category 1 /2/3 1 /2/3 Uplift Pressure Zone 1 /2/3 16/19/19 psf Exposure Category B Ground Snow Load, Pg 20 psf Wind Speed, 3 sec gust 130 mph of NJ array dead load 3.5 psf P.��(i H load per attachment 42.3 lb D The subject roof has 1 layer of roofing. Q� �O Panels mounted flush to roof no higher than 6 inches above roof surface. , Ralph Pacifico, PE Professional Engineer NCO 6g18t� / R i ieer GREENLOGIC® ENERGY GreenLogic,LLC Approved Hansen,Ben 305 Narrow River Road Orient,NY 11957 Surface#A: Total System Size:10.000kW Array Size: 10.000kW 1 circuit of 10 on a 20A breaker 1 circuit of 8 on a 20A breaker 1 circuit of 7 on a 20A breaker Azimuth:150° Pitch:2° Monitoring System: 6" SunPower bo Panel/Array Specifications: Panel:SPR-U-400-BLK-W-DC J Racking:SunPower Invisimount Panel:68.1"X 44" Array:47'4 7/16"X 11'11 W Surface:50'7"X 14'4" Magic#:Invisimount Legend: ® 25 SunPower W Panels 25 IQ-7HS Microlnverters ® SunPower Invisimount Rail • 42 Eco-Fasten Fast Feet 2x10"Douglas Fir Rafter 16"O.C. Notes: ................. --------.................................................. Number of Roof Layers:1 Height above Roof Surface:4" CO - - Materials Used:Iron Ridge,SunPower °' 2'-5 1/4" Added Roof load of PV System:3.5psf Engineer/Architect Seal: of NE�,Y . PAGj,�� op U8616 ��ROF�ss►o :: Drawn By:MMB Drawing#1 of 5 Date:11/10/2023 REV:A Drawing Scale:1/8"=1.0' GREENLOGIC® ENERGY GreenLogic,LLC Approved Hansen,Ben 305 Narrow River Road Orient,NY 11957 Surface#A: Total System Size:10.000kW Array Size:10.000kW 1 circuit of 10 on a 20A breaker 1 circuit of 8 on a 20A breaker 1 circuit of 7 on a 20A breaker Azimuth:150" Pitch:2° Monitoring System: SunPower 10 Panel/Array Specifications: Panel:SPR-U-400-BLK-W-DC Racking:SunPower Invisimount Panel:68.1"X 44" Array:47'4 7/16"X 1 V 11 Y4" Surface:50'7"X 14'4" 77 Magic#:Invisimount Legend: ® 25 SunPower W Panels 25 IQ-7HS Microlnverters ® SunPower Invisimount Rail • 42 Eco-Fasten Fast Feet 2x10"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:3.5psf Engineer/Architect Seal: �P 1A PAC/,c, ur R�FES$10 Pv Drawn By:MMB Drawing#2 of 5 Date:11/10/2023 REV:A Drawing Scale,1/8"=1.0' GREENLOGIC® ENERGY GreenLogic,LLC Approved Hansen,Ben 305 Narrow River Road Orient,NY 11957 Surface#A: Total System Size:10.000kW Array Size:10.000kW 1 circuit of 10 on a 20A breaker 1 circuit of 8 on a 20A breaker 1 circuit of 7 on a 20A breaker Azimuth:150' Pitch:2° Monitoring System: SunPower -- .0 Panel/Array Specifications: Panel:SPR-U-400-BLK-W-DC Racking:SunPower Invisimount Panel:68.1"X 44" Array:47'4 7/16"X 11'11 W Surface:50'7"X 14'4" 1 3 Magic#:Invisimount Legend: ® 25 SunPower W Panels 25 IQ-7HS Microlnverters ® SunPower Invisimount Rail 2 3 • 42 Eco-Fasten Fast Feet H 2x10"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-3.5psf Engineer/Architect Seal: /.`of NEPA B y0 * 1 r✓ a 9oFESS1p Drawn By:MMB Drawing#3 of 5- Date:11/10/2023 REV:A • Drawing Scale: 1/8"=1.0' No Vent Pipes Will Be Covered By The Solar Array GREEN ENERGY Legend: GreenLogic,LLC Approved AR-Access Roof AP-Access pathway, 36" minimum width SVO—Setback at ridge 305 Narrow River Road per R202 definitions per R324.6.1 as per R324.6.2.1 Orient,NY 11957 Total System Size: 10.000kW 1 circuit of 10 on a 20A breaker 1 circuit of 8 on a 20A breaker 1 circuit.of 7 on a 20A breaker Azimuth: 150' 25 SunPower Pitch:2° 420W Panels . Monitoring System: SunPower Panel/Array Specifications: ------------------------------------------------------------------ Panel:SPR-U-400-BLK-W-DC Ell Racking:SunPower Invisimount Panel:68.1"X 44" Magic#:Invisimount ❑ AR Legend: _--------- ____ 25 SunPower W Panels ED ! 25 IQ-7HS Microlnverters { I SunPower Invisimount Rail ,t • 42 Eco-Fasten Fast Feet I 2x10"Douglas Fir Rafter 16"O.C. Notes: ! ! Number of Roof Layers:1 i ! Height above Roof Surface:4" Materials Used:Iron Ridge,SunPower Added Roof load of PV System:3.5psf „�,,�••— Engineer/Architect Seal: 5 __ of NE �pP PACs,�iy®'Q v RDF�SS10 P Drawn By:MMB Drawing#4 of 5 Date:11/10/2023 REV:A Drawing Scale:3/32"=1.0' GREENLOGIC® ENERGY GreenLogic,LLC Approved Hansen,Ben 305 Narrow River Road Orient,NY 11957 Total System Size:10.000kW 1 circuit of 10 on a 20A breaker 1 circuit of 8 on a 20A breaker 1 circuit of 7 on a 20A breaker Azimuth:150° Pitch:2°. - - - -- -- - -- - -- ,- - - - Monitoring System: Qt�� SunPower 10 Material List Qty. Rail Material List -'-7 - - - - ;------- - ------ - i -I - - - Panel/Array Specifications: -- -- - Panel PR U 400 BLK W DC - - - -- -�-- - --•- - --i - --- -- - ---- --- -- � -----'-----'------ � Racking:SunPower Invisimount - - - -- ---- ----- i -- -- - ----i-- Panel:.68 1"X 44„ - Eco-Fasten"Fast Feet'Base Plate 42 _ _ _ _ _ _ _ Eco-Fasten'Fast Feet'Aluminum Block !�_42— — —�_ �- Magic#:Invisimount Eco-Fasten"Fast Feet EPDM Flashing_ 42 I Legend: #14-13x3"DPI Concealer Screw__ ___ 252 ---� ---�------ 25 SunPower W Panels #14-13x5"DPI Concealer_Screw ;_84 25 IQ-7HS Microlnverters - -- - -- — -- SunPower Invisimount Rail - -- - - --- — • 42 Eco-Fasten Fast Feet 2x10"Douglas Fir Rafter 16"O.C. - -- - - ---= -1— -- — Notes: Number of Roof Layers:1 Height above Roof Surface:4" Materials Used:Iron Ridge,SunPower Added Roof load of PV System:3.5psf Engineer/Architect Seal: ,��®F la PA�My® '�P veCici 9 S10 P Drawn By:MMB Drawing#5 of 5 Date:11/10/2023 REV:A Drawing Scale:3/32"=1.0' r ------------- NEW EQUIPMENT-------------_ ---------- EXISTING SERVICE ' PV—SA-1 0A AC—COMBINER PANEL 120/240, 1 PH, 31N ' . . . AC—CMB-1 .._.....__...._._._....._..__.._...._... ff (PV LOADS ONLY) g I I . . . Eft Tl � —_—_ , 200A KWH 6 PV-SA-2I � I _�_ i ! eKR—i AC—DSC-1 AC DISCONNECT IIlit BKR-2 i PV—SA-3FM A I • • • E t�I • • r 2 1 I BKR-3 MAIN DL--� I I I I ( BKR-4 I A B N 1 PV—SA-4 j 1 FUSED c N . . . 2 1 i ! I N I I ! IEGC N TYPICAL PV MODULE WITH I ! I I I INTEGRAL DC/AC INVERTER I I I I EGC I � ilil I � i EGC II ! ! I ! I I 10.000kW DC i } EXISTING AC PAN GEc�NG 9.600kW AC --_ LLal-----------L-----------------I--- ------ �t CU PROPOSED 3-LINE ELECTRICAL DIAGRAM REVISIONS Hansen, Ben 305 Narrow River RoadC,�, GREENLOGJCO ENERGY Orient, NY 11957 ELIMINATING.THE.00STOFfNERGY 1.) INITIAL SUBMITTAL WITH APPLICATION Page 1 of 3 Drawing No: Hansen-3LD1 Revision: 1 Revised: 4/6/23 EQUIPMENT&COMPONENT SCHEDULE TAG DESCRIPTION SPECIFICATION PV-SA-I SUB-ARRAY WAAREE WSMD-400 ENPHASE IQ7HS, 1-CIRCUIT OF 7-MODULES PV-SA-2 SUB-ARRAY WAAREE WSMD-400 ENPHASE IQ7HS, 1-CIRCUIT OF 6-MODULES PV-SA-3 SUB-ARRAY WAAREE WSMD-400 ENPHASE IQ7HS, 1-CIRCUIT OF 6-MODULES PV-SA-4 SUB-ARRAY WAAREE WSMD-400 ENPHASE IQ7HS, 1-CIRCUIT OF 6-MODULES ELECTRICAL LOAD SUMMARY AC CIRCUITS TAG POWER, MAX VOLTAGE MAX.AC VOLTAGE, NOMINAL RANGE CURRENT PV-SA-1 2800 WATTS 211-264 VAC 11.39 A AC 240 V, AC PV-SA-2 2400 WATTS 211-264 VAC 9.76 A AC 240 V, AC PV-SA-3 2400 WATTS 211-264 VAC 9.76 A AC 240 V.,AC PV-SA-4 2400 WATTS 211-264 VAC 9.76 A AC 240 V,AC PROPOSED EQUIPMENT SPECIFICATIONS REVISIONS Hansen, Ben 305 Narrow River Road ENERGY Orient, NY 11957 ELIMINATING THE COST.OF ENERGY 1.) INITIAL SUBMITTAL WITH APPLICATION `Pa e 2 of 3 Drawing No: Hansen-3LD1 Revision: 1 Revised: 4/6/23 s EQUIPMENT&COMPONENT SCHEDULE TAG DESCRIPTION SPECIFICATION AC-CMBP AC COMBINER PANEL 250V, 200A, 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 BKR-4 CIRCUIT BREAKER, PV-SA-4 MATCH AC COMBINER PANEL BRAND, 2-POLE, 20A AC- SC-1 AC DISCONNECT SWITCH (LINE TAP) 250V, 100A, NEMA-1, FUSED; FUSE RATING: 100A CONDUCTOR SCHEDULE TAG TYPE CONDUIT AWG. / EGC A USE-2/PV/UF 3/4" PVC-40 12 / 6 B THWN-2 2" PVC-40 4 / 6 C THWN-2 2" EMT 4 / 6 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 RE- QUIREMENTS. 4.) NOTE:GROUNDING ELECTRODE CONDUCTOR TO BE#6 COPPER. PROPOSED EQUIPMENT SPECIFICATIONS REVISIONS a Hansen, Ben GREENLOGIC0 305 Narrow River Road ENERGY Orient, NY 11957 ELIMINATING THE 08T OF ENERGY 1.) INITIAL SUBMITTAL WITH APPLICATION Page 3 of 3 Drawing No: Hansen-3LD1 Revision: 1 Revised: 4/6/23 n r- riied U -Series ..................* ...... ............. OtFS!STANi .T1�A�F� ............. 1.*............... %............ ............ ............. %............... Highest reliability& Better performance Split junction box Reduced power PID resistant Sustain heavy M6 Mono enhanced crack under all losses up to with long wind&snow loads PERG cells tolerant 98B climatic conditions 1/4 times term reliability (2400 pa&5400 pa) module I® VARIATION WITH IRRADIANCE 12- 40.2W to- 020.8 1. 1—-630 WW ItWdmtlnd.-400~ M..w 4 2 a 10 20 "m I-V VARIATION WITH TEMPERATURE 10- 3-A W PJ O ID M rre Graphs are for refer me purpose only.Please consuft War.—technical team for further clarifications. t00% 6800% INTERNATIONAL & M linear Performance Warranty 91.35% 11 Standard Perfortname Vhmray NATIONAL CERTIFICATIONS IEC 61215 1 IEC 61730 UL61730 O 'C E � . IEC TS 62804-1 7 LISTED 5 12 27 '.§0-9 012015-.1_1SO 14001'-20,16 1 IM4400120118,0 , , I : I : BLACK 1. - " Ifidepe0ent.,as'sessm,ent offb6tori6is by 8LACK,k,,VE,ATCH-- ��,Ti.luiig 11 SunPower- certified U ELECTRICALCHARACTERISTICS Pmax(Wl ;.'Vittp(VI Imp.{Al; -'' Isc{A) Voc,(U) Models -" " Module Eff t°°l•. STC. NOCT STC: NOCT . 5TC NOCT 5TC; NOCT 6TC NOCT WSMD-395 395 296.8 37.77 34.70 10.47 8.55 11.24 9.08 45.00 42.10 19.78 WSMD-400 400 300.6 38.00 34.90 10.54 8.62 11.32 9.14 45:22' 42.30 20.03 WSMD-405 405 304.4 38.22 35.10 10.61 8.68 11.40 9.21 45.44 42.50 20.28 WSMD-410 410 308.2 38.44 35:30 10.68 8.74 11.48 9.27 45.66 42.70 20.53 WSMD-415 415 312.1 38.66 35.40 10.75 8.81 11.57 1 9.34 45.88 42,90 20.78 'Standard Test Conditions(STO-1000 00 irradiance,Air(Mass'.5 and 25'C:ell temperature.Nominal Operating Cell Temperature INOCO.8001WIm2 irradiance,fir Mass 1.5,AmVe!r temperature 20'C and Wrim!speed 1 Ws. Average poser reduction of 4.516 at 200 PJ(m2 as per IEC 60904-1.kleas:r,ng Uncertamty=3%. System Voltage 1500 V Series Fuse Rating 22 A MCHAMICAL CHARACTERISTICS Length x Width x Thickness(L x W x T) 1924 mm(L)x 1038 mm(W)x 35 mm(T) Weight 22 k s Solar Cells per Module(Units)/Arrangement 132 cells/(11 x6 ; 11 x6l Solar Cell Type&Size Mono PERC,83 x 166 mm Front Glass 3.2 mm Low Iron and Tempered glass with ARC coating Encapsulate PID Free&UV Resistant Junction Box(Protection degree/Material) IP68/Weatherproof PPO Cable&Connector(Protection degree/Type) IP68 rated/5taubli MC4 Connector Cable cross-section&Length 4 mma&1200mm Frame Anodized Aluminium Alloy,Anodization thickness>_15 micron Fire rating Type 2 DESIGN SPECIFICATIONS THERMAL CHARACTERISTICS ( . _ Temperature coefficient of Current(Isc),a(%/°C) 0.055 I; Temperature coefficient of Voltage(Voc),8(%/°C) -0.285 i Temperature coefficient of Power(Pm),y(°/a/°CI -0.365 NOCT(°C) 43±2 Operating temperature range(°C) 40 to 85 J 13GU.[Lx1.00� d�.mht.ca' a t Waaree Energies Ltd.is amongst the top Solar Energy Companies and has the g� country's largest Solar PV Module manufacturing capacity of 5 GW.In addition,it is committed to provide top notch EPC services,project development,rooftop solutions,solar water pumps and also in an Independent Power Producer.Waaree - has its presence in over 325_locations nationally and 68 countries globally. ........__........__._....._..........-------...._-- ..if you need specific product certificates,and if module installations are to deviate from our guidance specified in ourinstallation manual,please contact your local waaree sales and technical representatives. 12 Years Product Warranty• 27 Years Power Output Warranty •ThealadtritaldatagivonhereisforrAfarcrc9purpdseonly. _ ' :•pleas°,confirm your exact raqu:rcnientsAdth the saiesrepresentatve while pia'inyyourordec •AeferiostallationNarualinstructio s&VJaareeurrrantystatementf°cterms0canditions;.?; `' - •Waaree Reserves tfia i ightCo ehange the sped%:eatiors 4+rithout prior notice.z -' VAIN,r,waaree.ccm , WE(!E&P0/395-415t132+MP/NC.rCMir`01/27.07,2022, , Data Sheet Enphase Microinverters Region'.AMERIC;AS Enphase WHS The high-powered smart grid-ready Microinverter Enphase IQ7HS Microinverter'M with integrated MC4 connectors dramatically simplify the installation process while achieving the highest system efficiency. The 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 • Faster installation with improved,lighter two-wire cabling • Built-in rapid shutdown compliant(NEC 2014,2017&2020) Efficient and Reliable • Optimized for high powered 66-cell*modules • Highest CEC efficiency of 97.0% • More than a million hours of testing i • Class 11 double-insulated enclosure • UL listed 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) *The IQ7HS is required to support 66•cell modules. To learn more about Enphase offerings,visit enphase.com E N P H AS E• Enphase IQ7HS Microinverter INPUT DATA(DC) IQ7HS-66-M-US , Coisimorlty used mddule pairings'. .;.•< : ' ,;'... ,320 W-460 W+: ,�.. Module compatibility 66-cell PV modules Maximum<in ut DC volts e :,:,, 59 Vw Peak power tracking voltage 38 V-43 V Min/Max start voltage 30 V/59 V Max DC short circuit current Overvoitage class DC port II DG port backfeed current p'A k= 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 @208 VAC Peak output power•, 384 VA' 369 VA Maximum continuous output power 384 VA 369 VA NominaE(L L)voltagelrange?- 240•V.1211 264 V 208 V 1183 229 V Maximum continuous output current 1.60 A(240V) 1.77 A(208V)- N_oniinalfrequeiicy .._. Extended frequency range 47 to 68 Hz 47 to 68 Hz AG short:circuit fault currenfover 3'cycfes 4;82 A :4:82•A Maximum units per 20 A(L-L)branch circuits 10 9 Overvottage class AC port ' III III ... ._ . n. ........,w...- 4- AC port backfeed current 18 mA 18 mA __._. w.-. ,...-.. .,......_. ._. ,..-,..,N,.. Power_actor setting T.0 1:0. Power factor(adjustable) 0.85 leading...0.85 lagging 0.85 leading...0.85 lagging EFFICIENCY @240 V @208 V CEC.W6ighted"'efficien6y.' 97.0% 96.5°i MECHANICAL DATA :.Ambienttemperature:range ;°.,,:: 40°Cto+60°C Relative humidity range 4%to 100%(condensing) Connect or.type ;;"'';;' -Stautili made MG4 Dimensions(WxHxD) 212 mm x 175 mm x 30.2 mm(without bracket) , ight' i:08 23 Cooling Natural convection-No fans Approved for wet locations' ,Yes < Pollution degree PD3 I Encl'osure_:. Ciass'il,-dorrosion resistant,polymerie enclosure, Environmental category/UV exposure rating NEMA type 6/outdoor 77, ., FEATURES Communication" Power Line Communication(PLC}: F 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 C22.1-2018 Rule 64-220. 1 Compliance CA Rule 21.(UL 1741-SA};wECO.`v1.1 :':UL 621 n9-1,UL174111EEE1547 FCC Part_15 Class B, ICES-0003 Class B "CANLCSA-C22.2N0.107:1- 0i.":;;`-'.- .,;• -, �. . ,..,-.,.,. ,.• This product is,ULListed as PV and '' : ':•- .. +- .s ;�,: -- 2017.sec'ion 6 012'NEC�20 snd�G22.1 015 Rule 5d 2;18tR pidShu�dawn of t'V Systems'for,^' .; AC and DC conductors,when'instalied according to manufacturer's insfructions, 1.No enforced DC/AC ratio.See the compatibility calculator at https•!/enphase.com/en-us/support/module-corn l2atibi lily. 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 CD 2022 Enphase Energy.All rights reserved.All trademarks or brands used are the property of Enphase Energy,Inc SE, 10.18-2022 ENPHA ................. !z -7- Simple and Fast Installation lntegrated module-to=rjfl.,2roiLIding Pre-assembled mid and end c':'amps 4 f..cVii3tlng mid clamp for e y rn� as placeenr. ME Mid clamp wid',h facilit'tes consistent,even r,nodu':e spacing Simple,pre-ci'ilked,rail splice. UL 2/03 Listed..nUegratecl grodhidin'o Fl6ible Design aSrie I rlya d,residencial roofs 'AddreSse, i� .11'slopet Desigh in],,nJ en... Rails Cn�lbl'e easy obst JINX 1111ii c!e managen, k�. !IN: Cljstbmer--Preferrecl Aesthetics odule and#1,m6'unt'ngy aesihetics". Best-in class syscern aesthetics Elegant Simplicity -P re e,deslgn I i m i ium,lo W r�Prclffl B <cI c9mponei.its SunPowerO InvisiMOUnt is a SunPower-designed , anodized I-fidde n'm'd clampsand'encl�damp 5 rail-based mounting system.The InvisiMount system and ca p ped,ticrsh raNt -eside -aster addresses ! ,ntia' sloped roofs and combines f Pa"et of Supeirior Syst�em, -ior aesthetics. installation tirne, design flexibility, and SUpet BUilt for use with SunPoo.?er DC and AC modules J'he InvisiMoLirIt product was specifically envisioned and Best'in-class sysEer re"ability and aesthetks Combine w:*h SUnPok I%ier rn6dules and engine(,_,red to pair-with SunPower rnodUles. J'he reSLAlting mordLorin'g app systern devel approach will amplify the aesthetic and installation benefits for both homeowners and installers. sunpower.com z?`.. „ e `P ,�;f». �': "�-:�„ 4 � ��to LY'".. •�: ,:�H::.�.. ..:gam �°: MOdule-'*r Mid Clamp and Rai Module'*/End Clamp and Rail I IMid Ciatr.n [rind Clamp Rail k Rau Splice Ground Lug-Assembly End Cap V t. 'I'errrperab_Ire :0°C to 9U°C(-40'F to 194°F) Component' Material Weight _...._._..... J.F............... . ..................... ..._...................._............_-...................._.... __. _...........................— -----............................ h 3a 300 uF;lift i Mici Clarnp Brack oxide s:ain!ess steel AISI 304 163 g(2.2 oz) 6000?a wnforce -..................................---.............._............_! End Clarnp Black anodized aluminum alloy 6063-T6 110 g(3.88 oz) -- Rai! Brack anodized aluminum alloy 6005-T6 1830 g/m(9 ozrft) p.• a e Rail Splice Aluminum alloy 6005-TS 830 g/m(9 oz/(t).........._ ( 25-year product warranty _._r._._....—-......._. t ar.antic.:, ! Ground Lu<,, 304 stainless a r ! S i Assembly (A2-70 bolt;tin-plated copper lug) Lt. ,_ :i3. ..oz.) _.............................- --r.............._ ri n.�L...- -----__...._.............._..-....._.._.._..........._.._.._.._-....._..................................... .. ....................................._ ............... - - - — ! End Cap Pack acetal TOM)copolymer 10.4 g(0.37 oz) _......_........_...__.._...._..__.1.........--- - ----._.._....- ---.__.__...._.._.._.....__. _-.._............... IJL 2 70;Listed ' , I C,. blIcation, Class A Fire Raced j i ! Como;!lion:Shingle Rafter Attachment ApI:IL_�tion Cornpos!cion Shingle Roof Dcei:king Actachmenl' Curved and 11'at Tile Roof Attacnrnenc Universal Interface for Ottrer:<oar";5.ttachrnent. Refer CO roof attachment hardware manufacurers decumentatier,. ....................... _........... *Mndi.ile:`ramp.*.hats compz;.;ble with the Inv sirAonnt system required for hard";are int.eroperability. [;2015 S tPow er Corporation. All Rights Rescwecf.SIJNPOWI R,the.St.frdPOL'tFR l o o.aE d INULSIDdCiU`!T'e,re trademarks or registered sun?orn'ver .om trail^mar s of unPawer Corporai:on. Ali other trademarks are the property or tf'eir respective MON;. F Specifications included ir.t&,is datasheet are sUbjert to change without nrbrn. Document#509506 RevC , ..:ter�'�"„J2` .,. •,g,•� .,> .,.. ,t>•e,iU ,;:n,�" i^s'w'.;•� .,,�sy^ <F. i e'b`� ".,'�i, „„°,w '�pb.� •fix =4 < c 2K r :a s _ < ARM I , y improve Support, Reduce Maintenance Costs SuriPower Er�ergyLink—Plug-and-Play Installation 1rI ir)tuib e monitoring website enables you to: This complete solution for residential and commercial monitoring and See a visual rnap of custorrier,sites C01"Itr01 includes the SunPowerO'�PV Supervisor 6(PVS6)which?rnproves Rerr)otely manage hundreds of sites the installation process,overall systern reliability;and rustorner Receive elective system reports experience. i o- r`s stern Issues and i-ernotelycla%nose Corn pact TC)oC'r'ii"iC for tl7ipr'oVed deStfletlCS Diagnose Is5t1e5 Online. Robust.(:io(:d ConneCLl:lty and Con'i{:)rehensive local connectivity Drill down for the status o`indi:Jic uai devices Flexible configuration of devices during installation Consurnptior3 metering Revenue-grebe prod; ction rneterir g(pending) Web-based commissioning Remote diagnostics of PVS6 and inverters Durable UL Type 3R enclosure reduces maintenance cosy Easy in,"egrauon with SunPolver e60S Add Value for Customers tlrirhtf eSunPo.�rrKAonitorin System Robust Cloud Connectivity c<ustori?ers can: I`Jiuitiple options to maintain optimal ^' c onnectivit see-+•what Their solar system produces each, r y: day,montli,or year Hardwired Ethernet 3 .oodmize Their Solar ii lvestrnent ar.ld Save();� , i .. ... 1 ,JYI'f-i energy expenses backup cellular a; up see tnelr ener,y use and est?mated bill sav rigs i see their solar systern's Performance using the 'StIrlPower'monitoring vvebsEte or mobile app. .. •°E f, •uwa Rr,r. .a. ..rY _ ...a9.e • L .. j k` SunPower Monitoring Websites PVS6 SunPower AC Modules - . r, k .•,tis Multiple communication options include Ethernet,Wi-Fi,and cellular. ' �. (3n^ m Number of SunPower AC modules $5 Temperature -22°F to+140°F(-301Cto+60"Q supported per PVS6 Humidity(maximum) 9596,non-condensing High-speed Internet access via accessible Internet.access router or switch Power 100-2.40 VAC(L-N),50 or 60 Hiz 208 VAC(L-L in 3-phase),60 Hz RS-485 Inverters and meters • One channel of revenue-grade production metering Integrated Metering e To`o channels of consumption metering -- — ---._........_._._.._..----......_............--- --.....................---..-............ ..— Weight 5.5 Ibs(2.5 kg) Ethernet 1 LAN(or optional WAN)port Din tensions 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 Ui 40E Type 3R V...-Ft 802.11 b/gm 2.4 GHz and 5 GHz Cellular LTF Cat-U 1I3G UMTS ZigBee IEEE 802.15.4 AMAC,2.4GHz ISM hand Data Storage 60 days Customer site -- Upgrades Automatic firnwtrare upgrades Partner site pvsmgnt.ussunoower.com Browsers Firefaw Safari,and Chrome Mobile devices iPhone'',iPi and Android' Customer a Pp 1.Create account online at monittJr.us.sunpotwr.com. 2.On a mobile device,download the SunPower Monitoring Warranty 1 Q year Limited Warranty app from Apple App Store�'or Google Playwstore. 3.Sign in using account email and password. Certifications UL,cUL,CE,UL 61010-1 an d-2,FCC Part 15(Class B) F C L[lSiED FCC ID:YAW529027 E503346 si19ht5Teserm&,SuNP0WEk SUNPOWERIogictaod . I;t �soFFotKc TOWN OF SOUTHOLD �o o BUILDING DEPARTMENT y x TOWN CLERK'S OFFICE �y • o�s� 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#: 50401 Date: 3/7/2024 Permission is hereby granted to: Hansen, Ben 420 State St Brooklyn, NY 11217 To: install roof-mounted solar panels to existing single-family dwelling as applied for with flood permit. All solar panel equipment must be installed at elevation 8' or higher. At premises located at: 305 Narrow River Rd, Orient SCTM #473889 Sec/Block/Lot# 26.-3-11 Pursuant to application dated 1/30/2024 and approved by the Building Inspector. To expire on 9/6/2025. Fees: SOLAR PANELS $100.00 ELECTRIC $125.00 CO-ALTERATION TO DWELLING $100.00 Flood Permit $150.00 Total: $475.00 Building Inspector