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HomeMy WebLinkAbout51388-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
NMI
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#: 51388 Date: 11/18/2024
Permission is hereby granted to:
Daniel Halioua
377 6th Ave
Brooklyn, NY 11215
To:
Install roof mounted solar panels to an existing single-family dwelling as applied for per
manufacturers specifications.
Premises Located at:
190 Pheasant PI, Greenport, NY 11944
SCTM# 53.-4-44.36
Pursuant to application dated 11/14/2024 and approved by the Building Inspector.
To expire on 11/18/2026.
Contractors:
Required Inspections:
Fees:
SOLAR PANELS $100.00
CO-RESIDENTIAL $100.00
ELECTRIC -Residential $125.00
Total $325.00
__� Building Inspector ^~
s' TOWN OF SOUTHOLD-BUILDING DEPARTMENT
r Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone (631) 765-1802 Fax (631) 765-9502 hll s: vvav ,sot�llolell + n
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
PERMIT NO. Building lnspector•.,��._-..
Applications and forms must be filled out in their entirety. Incomplete
applications will not be accepted. Where the Applicant is not the owner,an
Owner's Authorization form(Page 2)shall be completed.
Date: 11/5/2024
OWNER(S)OF PROPERTY:
Name: Daniel Halioua SCTM# 1000- S3 q —lq,alp
Project Address: 190 Pheasant Place, Greenport, NY 11999
Phone#: (917) 428-8085 Email: dhalioua@gmail.com
Mailing Address: 190 Pheasant Place, Greenport, NY 11999
CONTACT PERSON:
Name: Katelyn Tornetta
MaiiingAddress: 2941 Sunrise Hwy, Islip Terrace, NY 11752
Phone#: (631) 647-3402 Email: hppermitting@harvestpower.net
DESIGN PROFESSIONAL INFORMATION:
Name: Michael Dunn, R.A.
Mailing Address: 256 Orinoco Dr, Brihtwaters, NY 11718
Phone#: (631) 665-9619 Email: Bayblueprint@aol.com
CONTRACTOR INFORMATION:
Name: Harvest Power LLC
Mailing Address: 2941 Sunrise Hwy, Islip Terrace, NY 11752
Phone#: (631) 647-3402 Email: hppermitting@harvestpower..net
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ®Alteration ❑Repair ❑Demolition Estimated Cost of Project:
❑Other
I
Will the lot be re-graded? ❑Yes ®No Will excess fill be removed from premises? ❑Yes XNo
1
PROPERTY INFORMATION
Existing use of property: Residence Intended use of property: (no change)
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑Yes ®No IF YES, PROVIDE A COPY.
® Check Box After Reading: The owner/contractor/design professional is responsible for all drainage and storm water issues,as provided by
Chapter 236 of the Town Code. APPLICATION IS HEREBY MADE to the Building Department for the Issuance of a Building Permit pursuant to the Building Zone
Ordinance of the Town of Southold,Suffolk,County,New York and other applicable Laws,Ordinances or Regulations,for the construction of buildings,
additions,alterations or for removal or demolition as herein described.The applicant agrees to comply with all applicable laws,ordinances,building code,
housing code and regulations and to admit authorized inspectors on premises and in building(s)for necessary Inspections.False statements made herein are
punishable as a Class A misdemeanor pursuant to Section 210.45 of the New York State Penal Law.
Application Submitted By( rint name): Authorized Agent ❑Owner
Signature of Applicant:_,, Date: 111�\��
STATE OF NEW YORK)
SS:
COUNTY OF
being duly sworn, deposes and says that(s)he is the applicant
(Name of individual Mining contract) above named,
(S)he is the fC r for, Agent Corporate Officer, etc.)
%. rJnt , Agent, r Corporate
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
application;that all statements contained in this application are true to the best of his/her knowledge and belief; and
that the work will be performed in the manner set forth in the application file therewith.
Sworn before me this
20
day o �. � 0-1
DINAtANZA Notary Public
NOTARY PUBLIC,STATE OF NEW YORK
Registration No.01LA60 4 14
ualif ed in Suffolk County/
Comrrtii sign Ex fires M 2,KC OIL Y OWNER AUTHORIZATION
_.... r t1 p1i is nott
►4 t�k residing idin at L V c s c r,�_fl CC
do hereby authorize f '1 vL to apply on
my behalf to t e Town of Southold Building Department for approval as described herein,
Owner's Sigr ate
La
Print Owner's Name
2
� BUILDING DEPARTMENT- Electrical Inspector
2 "'� 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
ex,
ia
mesh southoldtownn ov -� seared southoldtownn ov
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date:
Company Name: Harvest Power LLC
Electrician's Name: Carlo Lanza
License No.: ME-68518 Elec. email:hppermitting@harvestpower.net
Elec. Phone No: (631) 647-3402 ❑I request an email copy of Certificate of Compliance
Elec. Address.: 2941 Sunrise Highway, Islip Terrace, NY 11752
JOB SITE INFORMATION (All Information Required)
Name: Daniel Halioua
Address: 190 Pheasant Place, Glreelnport, NY 11944
Cross Street: Kerwin Blvd
Phone No.: (917) 428-8085
Bldg.Permit#: 5! '� email: dhalioua@gmail.com
Tax Mae District: 1000 Section:53 Block: 4 Lot:44.36
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
Installation of a 23 kW solar PV system with (50) REC460AA roof-mounted panels.
Square Footage:
Circle All That Apply:
Is job ready for inspection?: YES lr l NO Rough In �✓ Final
Do you need a Temp Certificate?: F YES [:] NO Issued On
Temp In-formation: (All information required)
Service Size'1 Ph F_�3 Ph Size: 200 A # Meters 1 Old Meter#
❑New Service❑Fire Reconnect[:]Flood Reconnect❑Service Reconnect OUnderground[]overhead
# Underground Laterals 1 2 0 H Frame M Pole Work done on Service? LJ Y N
Additional Information:
PAYMENT DUE WITH APPLICATION
lWilding Mpartment Avolication
AUTHORIZATION
(Where the Applicant is not the Owner)
Daniel Halioua residing at 190 Pheasant Place
(Print property owner's name) (Mailing Addrcu)
Greenport do hereby allthoriZe Katelyn Tornetta
(Agent)
Harvest Power LLC to apply on my behalf to the
..........
Southold Building Department.
Ow�ic r'i I'L
paniel,Halilolua.,
(PrUlt Ownct"s Name)
Suffolk County DePt.of
Labor,Licensing&Consrner Affairs
HOME IMPROVEMENT LICENSE
Name
CARLO LANZA
Business Name
Harvest Power LLC
Tttis certifies that the
weer is duiy licensed License Number H118165
by the County of surtotk Issued: 11/1812010
T- R086**Y Expires: 11/01/2026
Cornrnisioner
Client#: 110076 HARVPOW
ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE MMIDDIYYYY)
4/16/2024
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.
_ _ .. —
IMPORTANT:If the certificate holder is an p ed.
If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on
this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT Commercial Support
NAME:Edgewood Partners Ins.Center PHONE 631 00 FAX
NEcertifo of s 6 .!� !
LAIC No Ext
40 Marcus Drive 3rd Floor E-MAIL
Icbrokers.com
Melville,NY 11747 ADSXeE s fames River Insurance CompanyvERAGE NAl..
# mm INSURER(S)AFFORDING COVERAGE
_ _—
INSURER A: 112203
INSURED... �......... ..............,__ ........... ....
.m........m_..— ...... .... .-. fi _.
INSURER B Lloyd's of London
Harvest Power LLC, Friendly �INSURER .. ., .._._ .... .v .. _ ..........
c
Construction Company Inc,EZ Flashing LLC -�� '...........°° _ --� . _
2941 Sunrise Hwy RD
INSURER
INSURE ...__
Islip Terrace, NY 11752 �.. nRE,RE _. .. .....
INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
iNSROGENERAL L ABILITY ..�.,AOOL SU D POLICY NUMBER, __ blpC�D 'EdYk' dNMIDIDYIYYW EACH OCCURRENCE LIMITS$ —
LTR IhSR ! .. .._.n... �6.,....,.. L._...� l ..m...
_ 1
q COMMERCIAL000711808 04115/2024 04/15/2025 0� 00,000
yA A, T RENTED T'
CLAIMS-MADEX�,OCCUR IFdM155Emeirr,�nrrrp¢vr.�, . $SO�OOO m..
_MED EXP(An one rson) $Excluded
pe
OOO 000
mmXi $5 000 Ded PERSONALS A V IN
Contractual Llab. Y
I DJURY $1, ,�
GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AG
GREGATE $2,000,000
PRO. —,....
POLICY PRO E LOG
PRODUCTS-COMPIOP AGG $2,000 OOO
.. . AUTOMOBILE LIABILL.�.,..._„___.. ._ .......... ................_— .... .... ........_. L........... .. .e ----- ..
TM t �aDI INkCLF d.WI�iT $
ANY AUTO BODILY INJURY Per person $
OWNED SCHEDULED BODILY._.__
P q ' DAMAGE dent) $
�.��...
$
AUTOS ONLY AUTOS
AUTOS ONLY AUUTOS ONEY f POP a INJURY Per accident)
_ ----
. -._ ,.ACHOCCURRENCE..._.. ...�.$__. ....
UMBRELLA ExcEss paAB 4/15/2024 04/15/202 E
A �.X ...X. occuR 000711797 ..__.
OO
$4 000 00 AGGREGATE $4 OOO O
. - --- _ --- _..m $ o
_ TI(]N$ J PTATbdTF, �—..OTH.
WORKERSCOMPENSATION., ...,.._
DED RETEN
PER
ANY PROPRIETOR/PARTNER/EXECUTIVE EYIN ACH ACCIDENT $
'AND EMPLOYERS LIABILITY
OFFICER/MEMBER EXCLUDE D N/A
'
( ) .L.DISEASE EA EMPLOYEE
Mandatory in NH � �. ......._ �......,. �$.......- _.......... .
If yes,describe under
A -P�..... ........_ -------- .. DISEASE POLICY LIMIT $
Pollution Liab eRAnoNs below ,, 000711808 4/15/2024 04/15M26 $1 Mm ...... .........---_�._
� L MM Ea Claim/$1MM Agg
B Professional Liab HPL230064 41 512024 04/15/202` $2MM Ea Claim/$2MM Agg
$10K Ded Ea Claim
DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space is required)
Evidence of Insurance
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Town of Southold
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
P.O:Box 970 ACCORDANCE WITH THE POLICY PROVISIONS.
South Hold, NY 11964-0000
AUTHORIZED REPRESENTATIVE
La i
©1988-2015 ACORD CORPORATION.All rights reserved.
ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S6497815/M6497588 RH002
ION4Wy Workers' CERTIFICATE OF
T Compensation RK NYS WORKERS' COMPENSATION INSURANCE COVERAGE
Board
la.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured
HARVEST POWER LLC 1 c.NYS Unemployment Insurance Employer Registration Number of
2941 SUNRISE HWY Insured
ISLIP TERRACE,NY11752-2822
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) Indemnity Insurance Co.of North America
Town of Southold
3b.Policy Number of Entity Listed in Box"1 a"
P.O.Box 970
C72358624
Southold,NY 11964
3c.Policy effective period
10/1/2024 to 10/01/2025
3d.The Proprietor,Partners or Executive Officers are
❑X included.(Only check box if all partners/officers included)
❑ all excluded or certain partners/officers excluded.
This certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box 1 a"for workers'
compensation under the New York State Workers'Compensation Law. (To use this form,New York(NY)must be listed under Item 3A
on the INFORMATION PAGE of the workers'compensation insurance policy).The Insurance 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: Lex Smith
$f' Warne pf uthoTized representative or licensed agent of insurance carrier)
Approved by: it
.�- ► 09/11/2024
(Signature) (Date)
Title: Assistant PfCQf m Man@ger__
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#:2830004
NEW Workers' CERTIFICATE OF INSURANCE COVERAGE
s E Compensation
PART 1.To be completed by Disability and Paid Family Leave Benefits Carrier or Licensed Insurance Agent of that Carrier
la.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured
HARVEST POWER LLC (631)647-3402
841 SUNRISE HWY
NEW YORK, NY 11752-2822
1c.Federal Employer Identification Number of Insured or Social Security
Number,
Work Location of Insured(Only required if coverage is specifically 20-4214746
limited to certain locations in New York State,i.e., Wrap-Up Policy)
2.Name and Address of Entity Requesting Proof of Coverage(Entity 3a Name of Insurance Carrier
Being Listed as the Certificate Holder) HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY
Town of Southold b Policy Number of Entity Listed in Box"Ila"
53095 Rte 25
Southold, NY 11971 LNY713777882
c Policy effective period
10/01/2024 TO 09/30/2025
4.Policy provides the following benefits:
® A.Both disability and paid family leave benefits.
❑ B.Disability benefits only.
❑ C.Paid family leave benefits only.
5.Policy covers:
® A.All of the employer's employees eligible under the NYS Disability and Paid Family Leave Benefits Law.
❑ B.Only the following class or classes of employer's employees:
Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named
insured has NYS Disability and/or Paid Family Leave Benefits insurance coverage as described above.
Date Si ned 09/30/2024 T�
(Signature of insurance carrier's authorized representative or NYS Licensed Insurance Agent,of that insurance carrier)
Telephone Number (212)553-8074 Name and Title:Elizabeth Tello—Assistant Director,Statutory 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 Si ned B
(Signature of Authorized NYS Workers'Compensation Board Employee)
Telephone Number Name and Title
DB-120.1 (9-17) IIIIIII'°11!1�2�0 �1���0�9�!17IIIIII lH
Suffolk County Dept.of
Labor,Licensing&Consumer Affairs
MASTER ELECTRICAL LICENSE
Name
CARLO P LANZA
Business Name
This cerlifies that the Harvest Power LLC
bearer is d Y licensed License Number ME-68518
by the County ol''suffd9'h Issued: 11/30/2023
J Cabr, .p Expires: 11/01/2025
Commissioner
Client#: 110076 HARVPOW
DATE(MM/DD/YYYY)
ACORD,. CERTIFICATE OF LIABILITY INSURANCE 4/16/2024
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED
provisions or be endorsed.
If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on
this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s).
g 631 390 97Support
UCER NAME.- .)� .......... .. ... .._. ..,
Ed Dewood Partners Ins.Center �PHONE Commercial 00 '���
CONTACT
AIC No Ext ... ,_ AtCi Not
40 Marcus Drive 3rd Floor I E-MAIL �„ -
ADDRESS NEcertificates@epicbrokers.com
Melville,NY 11747
FORDING COVERAGE NAIC#
...W....... INSU RERIS)AF...............m....... ---...... ..._.. � ..........,.
INSURER A: River Insurance Company 112203
--— --- _ _ James .�... ..._... _. . _....
INSURED INSURERS Lloyd's of London Harvest Power LLC,Friendly
INSURER C
Construction Company Inc,EZ Flashing LLC I'°""" ".I
2941 Sunrise Hwy INSURERD
I ____.�
Islip Terrace,NY 11752 INSURERS
ENSURER 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.
NSA .. """""""_NCE_ „„,IN$FF Wd R ER POLICY EFF POLICY EXP
LTRTYPE OF LIMITS
NSA INSURANCE AODL D� POLICY NUMB IMMIDDIYYYY�IMMIpD/YYYYI
CLAIMS-MADE LIABILITY 000711808 4/15/2024 04/15/202 EACH OCCURRENCE :m4_$11Q9_0000
A Ry�I rr Rt NTS[�
A �COMMERCIAL GENERAL
X J OCCUR R YS_Ey51„j�aFc�a�rpMs'oroee) $50,000
XI Liab, &ADVINJ ^�$EXCIUded
� 1 $5 000 Ded�...L _.
MED EXP(Any one person)
INJURY $1�000 00.0
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 52,000,,000
,,�POLICY EOT " LOC P -COMP/OP AGG_($ , , O """""
OTHER _ 000 00 RODUCTS $
- TOMOSILE LIABILITY OMBINEt. Slh)GI.F:1.4m7IYT
AU E�aarr:,kdrca�t� S.,., .........__
BODILY INJURY
....w. .. person) $
_ ANY AUTO __ ..„... ........__
OWNED SCHEDULED BODILY INJURY(Per accident)($
AUTOS ONLY AUTOS
(Per
AUTOS ONLY NON-OWNED AUTOS ONLY CC�'ROPERTY Ohflhi4',�4GE....... ...m...�.$
.. ., UMBRELLA ----- _. ............ ........_ I U)..... 4 ...
$
LIA6 occuR 000711797 "� 4115/20 A X�
{ 24 04/15/202 EACH occ RRENCE $4 000 000
EXCESS LIAB E� �GREGAT �
... �" E $4 000 000
CLAIMS MAD
_ TONS
�$ .a � � .._m .
AND EMPLOYERS'LIABILITY O ...,.. Y.�,N _........n�, _,,..__._. ... ......... ............�W....._,� --- �.. .DED I RETE,N ,,._
WORKERS
ION
........ 5 .... �..m
L EACH
OFF CERJIM N(T EIR E CLUED F?,ECUTIVE � ..DISEASE EMP $
szAZLls�
P'ROP
OFFICERJMEMBER EXCI..UO�.O7 � NIA
NH) LOYEE.
If yes,describe Y under
DESCRIPTION OF OPERATIONS bellow E L DISEASE POLICY LIMIT � m
.... �.,......,.,., ....
A Pollution Liab. 000711808 0 4/15/2024 04/1 5/202� $1MM Ea Claim/$1MM Agg
B Professional Liab HPL230064 4/1512024 04116/2025` $2MM Ea Claim/$2MM Agg
$10K Ded Ea Claim
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space is required)
Evidence of Insurance
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Town of Southold
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
P.O.Box 970 ACCORDANCE WITH THE POLICY PROVISIONS.
South Hold,NY 11964-0000
AUTHORIZED REPRESENTATIVE
©1988-2015 ACORD CORPORATION.All rights reserved.
ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S6497815/M6497588 RH002
New Workers' CERTIFICATE OF
STA E Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE
Bout
1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured
HARVEST POWER LLC 1 a.NYS Unemployment Insurance Employer Registration Number of
2941 SUNRISE HWY Insured
ISLIP TERRACE,NY11752-2822
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) Indemnity Insurance Co.of North America
Town of Southold
3b.Policy Number of Entity Listed in Box"1 a"
P.O.Box 970
Southold,NY 11964 C72358624
3c.Policy effective period
10/1/2024 to 10/0112025
3d.The Proprietor,Partners or Executive Officers are
❑x included.(Only check box if all partners/officers included)
❑ all excluded or certain partners/officers excluded.
This certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box"1 a"for workers'
compensation under the New York State Workers'Compensation Law. (To use this form,New York(NY)must be listed under Item 3A
on the INFORMATION PAGE of the workers'compensation insurance policy).The Insurance 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: Lex Smith
('Pei r�aw�eaf authorized representative or licensed agent of insurance carrier)
Approved by:
09/11/2024
(Signature) (Date)
Title: Assiggnt Pro ram 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#:2830004
Y
1N0 Workers' CERTIFICATE OF INSURANCE COVERAGE
t7fRfC
;,,......�, STATE "(Yensatjtatt.
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 (631)647-3402
2941 SUNRISE HWY
NEW YORK, NY 11752-2822 1c.Federal Employer Identification Number of Insured or Social Security
Number
Work Location of Insured(Only required if coverage is specifically 20-4214746
limited to certain locations in New York State,i.e.,Wrap-Up Policy)
2.Name and Address of Entity Requesting Proof of Coverage(Entity a Name of Insurance Carrier
Being Listed as the Certificate Holder) HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY
own of Southold 3b Policy Number of Entity Listed in Box"la"
53095 Rte 25
Southold, NY 11971 LNY713777882
c Policy effective period
10/01/2024 TO 09/30/2025
4.Policy provides the following benefits:
® A.Both disability and paid family leave benefits.
❑ B.Disability benefits only.
❑ C.Paid family leave benefits only.
5.Policy covers:
® A.All of the employer's employees eligible under the NYS Disability and Paid Family Leave Benefits Law.
❑ B.Only the following class or classes of employer's employees:
Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named
insured has NYS Disability and/or Paid Family Leave Benefits insurance coverage as described above.
r
Date Signed 09/30/2024
(Signature of insurance carrier's authorized representative or NYS Licensed Insurance Agent of that insurance carrier)
Telephone Number (212)553-8074 Name and Title:Elizabeth Tello—Assistant Director,Statutory Services
IMPORTANT: If Boxes 4A and 5A are checked,and this form is signed by the insurance carrier's authorized representative or NYS
Licensed Insurance Agent of that carrier,this certificate is COMPLETE.Mail it directly to the certificate holder.
If Box 413,4C or 5B is checked,this certificate is NOT COMPLETE for purposes of Section 220,Subd.8 of the NYS
Disability and Paid Family Leave Benefits Law.It must be 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 Si ned B
(Signature of Authorized NYS Workers'Compensation Board Employee)
Te4eph+�ne Number Name and Title
11 1111DB-120.1 (9-17) —1.7 IH
,
5138(i� ,ss�ssc�Rs
Graham. Associates 256 Orinoco Drive, Suite A Brightwaters,NY 11718
Planning& Design (631)665-9619
November 5, 2024 5 -'� �� 36
Town of Southold
Building Department
54375 Rt. 25
Southold, NY 11971
Re: Daniel Haliqua Residence
190 Pheasant Place
Greenport, NY
Proposed 23.00 kWDC, 19.00 kWAC PV System
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 140 mph wind load and
20 psf snow 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 ASCE7-16
If you y further questions, do not hesitate to call.
,S,RED Ajy
02981
�OF
Mic nn, RA
PHOTOVOLTAIC ROOF MOUNT SYSTEM
50 MODULES-ROOF MOUNTED - 23.00 kWDC, 19.00 kWAC I f
RVEST`"#^"A'Mn
190 PHEASANT PL, GREENPORT, NY 11944, USA HA HARVEST POWER LLC
--- 2941 SUNRISE HIGHWAY ISLIP
SYSTEM SUMMARY: ,S E,NY 11752
(N)50-REC SOLAR REC460AA PURE-Rx(460W)MODULES GOVERNING CODES: SHEET INDEX
je 89-3585
2017 NATIONAL ELECTRICAL CODE(NEC) PV-0 COVER SHEET �L�� a t owernet
(N) U-JUNCTION
B E IQ8X-80-M-US MICRO-INVERTERS 2020 BUILDING CODE OF NYS PV-1 SITE PLAN WITH ROOF PLAN
(N)JUNCTION BOX 2020 RESIDENTIAL CODE OF NYS PV-1.1 ENLARGE VIEW `� 0
(E)200A MAIN SERVICE PANEL WITH (E)200A MAIN BREAKER 2020 EXISTING BUILDING CODE OF NYS PV-2 ATTACHMENT DETAILS co
(N) 100A FUSED AC DISCONNECT
Z
PV-3 THREE LINE DIAGRAM '�": f71
(N) 125A SOLAR LOAD CENTER 2020 FIRE CODE OF NYS --�
2020 PLUMBING CODE OF NYS PV-4 PLACARDS&WARNING LABELS D` Z n
2020 MECHANICAL CODE OF NYS PV-5 ADDITIONAL NOTES p� y
DESIGN CRITERIA: Pv-6+ SPEC SHEETS �� 17
ROOF TYPE:-ASPHALT SHINGLE N
YO sloN
NUMBER OF LAYERS:-1
ROOF CONDITION: GOOD
DES RIPTION DATE REV.
ROOF FRAME: -2"X8"RAFTERS @16"O.C.
BLDG.PERMIT 11/05/2024 0
STORY: -TWO STORY
SNOW LOAD: -25 PSF
WIND SPEED :-130 MPH
WIND EXPOSURE:-D
GENERAL NOTES:
1. INSTALLATION IN ACCORDANCE WITH MANUFACTURER a
RECOMMENDATIONS. ARRAY LOCATIONS T Pro-,"Mot�.+
2. ENGINEER TO INSPECT PROJECT AFTER INSTALLATION
CERTIFYAND 3. PRO ECTTO E INSTALLED WITH CODE COMPLIANT PROJECT SITE
RACKING INSTRUCTIONS FOR UNI-RAC SOLAR MOUNT ARSHAMOMAQUE PROJECT NAME
SYSTEM.
4. FOLLOW BALLASTING SCHEDULE ON ROOF PLAN. 25 Q
5. HARVEST POWER, LLC., THE SOLAR INSTALLATION aeertson Ln U)
CONTRACTOR, COMPLIES WITH ALL LICENSING&ALL Lighthouse Marine Z:) J
RELATED REQUIREMENTS OF THE GOVERNING
'r loServices,Inc. Q — O
MUNICIPALITIES AND THE LOCAL ELECTRIC UTILITY :D a_ It J
AHJ'S. p 0')
6. THIS PROJECT WILL COMPLY WITH THE CURRENT NEC
REQUIREMENTS INCLUDING ARTICLE 690 SOLAR <'� s �c Q Q Q U) 0
PHOTOVOLTAIC PV SYSTEMS. ' zs) _ U) Z Z CL LL_
Q 0
7. THE ROOF WILL HAVE NO MORE THAN A SINGLE LAYER �: W = z ~ Z
OF ROOF COVERING IN ADDITION TO THE SOLAR
EQUIPMENT. 4' SafeB Q
8. INSTALLATION WILL BE FLUSH-MOUNTED, PARALLEL 190 Pheasant PI, �� Z
TO AND NO MORE T `� . O
THAN 6.5"ABOVE ROOF Greenport,NY 11944, Q Z
9. MAINTAIN A MINIMUM OF 18"CLEARANCE AT RIDGE United States P LU
AND AT ONE GABLE EAVE. + Brlck Cove LL.I
10. THIS DESIGN COMPLIES WITH 130 MPH WIND +++ Q
REQUIREMENTS OF THE RESIDENTIAL CODE OF N.Y.S
North Fork
Adventures
11. WHEREVER THE ROOF PLAN DOES NOT COMPLY WITH ` Ciarterr Bloc Boa
ACCESS AND VENTILATION REQUIREMENTS OF THE SHEET NAME
UNIFORM CODE, HARVEST POWER PROPOSES THAT y COVER SHEET
ALTERNATIVE VENTILATION METHODS WILL BE
EMPLOYED. REVIEW AND APPROVAL SHALL BE AT THE
DISCRETION OF THE MUNICIPALITY IN WHICH THIS SHEET SIZE
DOCUMENT HAS BEEN FILED. ANSI B
12. THE DESIGN PLANS COMPLY WITH THE 2020 NEW
YORK STATE UNIFORM FIRE PREVENTION AND 11" X 17"
RESIDENTIAL BUILDING CODE. 1 AERIAL PHOTO 2 VICINITY MAP SHEET NUMBER
PV-0 SCALE: NTS PV-0 SCALE: NTS PV-O
MODULE TYPE, DIMENSIONS & WEIGHT ROOF ACCESS AREA:
NUMBER OF MODULES =50 MODULES SHALL BE LOCATED IN AREAS THAT DO NOT REQUIRE THE PLACEMENT OF GROUND
MODULE TYPE= REC SOLAR REC460AA PURE-RX(460W) MODULES OVER OPENINGS SUCH AS WINDOWS OR DOORS,AND LOCATED AT STRONG POINTS OF
MODULE WEIGHT= 51.58 LBS/23.4 KG. BUILDING CONSTRUCTION IN LOCATIONS WHERE THE ACCESS POINT DOES NOT
MODULE DIMENSIONS= 68.03"X 47.44"=22.41 SF CONFLICT WITH OVERHEAD OBSTRUCTIONS SUCH AS TREE LIMBS, WIRES OR SIGNS.
UNIT WEIGHT OF ARRAY=2.30 PSF
HARVEST ""'*10
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11" X 17"
PLAN WITH ROOF PLAN SHEET NUMBER
SCALE: 1/32"= T-0" PV-1
MODULE TYPE, DIMENSIONS & WEIGHT o��h ROOF ACCESS AREA:
NUMBER OF MODULES=50 MODULES Q�`L�Q SHALL BE LOCATED IN AREAS THAT DO NOT REQUIRE THE PLACEMENT OF GROUND
MODULE TYPE = REC SOLAR REC460AA PURE-RX(460W)MODULES P� �, OVER OPENINGS SUCH AS WINDOWS OR DOORS,AND LOCATED AT STRONG POINTS OF
MODULE WEIGHT=51.58 LBS/23.4 KG. BUILDING CONSTRUCTION IN LOCATIONS WHERE THE ACCESS POINT DOES NOT
MODULE DIMENSIONS— 68.03"X 47.44"=22.41 SF - CONFLICT WITH OVERHEAD OBSTRUCTIONS SUCH AS TREE LIMBS,WIRES OR SIGNS.
UNIT WEIGHT OF ARRAY=2.30 PSF ROOF#1 HARVEST "d'°''All '
(10) REC460AA PURE-RX (460W) HARVEST POWER LLC
RAFTERS=2"X8"@16" O.0 2941 SUNRISE HIGHWAY ISLIP
305°AZIMUTH, 22°TILT TERRACE,NY 11752
TEL:(801)989-3585
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(18) REC460AA PURE-RX(460W) �� FL ERSION
RAFTERS=2"X8" 16" O.0 E D 5 ION DATE REV.
ROOF#2 125°AZIMUTH, 3@4°TILT BLDG.PERMIT lvosrzoza o
(11) REC460AA PURE-RX (460W) i '%
RAFTERS=2"X8"@16" O.0
305°AZIMUTH, 34°TILT ♦ � ♦ ♦
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RAFTERS= 2"X8"@16" O.0 ` PROJECT NAME
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ROOF#6
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(02) REC460AA PURE-RX (460W) �v �� `��P (05) REC460AA PURE-RX (460W)
RAFTERS= 2 X8 @16 O.0 ENLARGE VIEW
125°AZIMUTH, 31°TILT (N) 1" PVC CONDUIT RAFTERS= 2„X8 @16„ O.0
RUN 7/8"ABOVE ROOF 125°AZIMUTH,31°TILT SHEET SIZE
(N) 125A SOLAR LOAD CENTER (E)200A MAIN SERVICE PANEL ANSI B
(N) 100A FUSED AC DISCONNECT WITH (E)200A MAIN BREAKER(INSIDE) 11�� X 17"
,� ENLARGE VIEW (E) UTILITY METER (E) CHIMNEY SHEET NUMBER
SCALE: 1/8"= 1'-0" PV-1 .1
PV MODULES 't I p
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HARVEST POWER LLC
2941 SUNRISE HIGHWAY ISLIP
E,NY 11752
G\CJT 9-358
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GENERAL NOTES: /
1. RAILS TO BE INSTALLED TWO PER PANELS AS SHOWN IN DETAIL. D DATE REV.
2. ALL PENETRATIONS TO BE MADE@ 48"O.C. BLDG.PERMIT 11/05/2024 0
3. BOLTS TOBE INSTALLED INTO RAFTERS.
4. MINIMUM 2.5" PENETRATION INTO WOOD FOR CODE COMPLIANCE.
1
ATTACHMENT DETAIL NOTE:-
"ACTUAL ROOF CONDITIONS AND RAFTERS(OR SEAM) LOCATIONS MAY
SCALE: NTS VARY. INSTALL PER MANUFACTURER(S) INSTALLATION GUIDELINES
AND ENGINEERED SPANS FOR ATTACHMENTS."
END/ MID CLAMP PV MODULES
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2.5" MIN.
EMBEDMENT SHEET NAME
ATTACHMENT
FLASH KIT PRO FLASHING DETAIL
SHEET SIZE
BUILDING STRUCTURE ANSI B
5/16" STAINLESS STEEL LAG BOLT 11�� X 17"
WITH SS EPDM BONDED WASHER,
2 ATTACHMENT DETAIL ENLARGE VIEW) 2-1/2" MIN. EMBEDMENT. SHEET NUMBER
SCALE:NTS PV-2
(50) REC SOLAR REC460AA PURE-RX(460W) MODULES BILL OF MATERIALS
(50) ENPHASE IQ8X-80-M-US MICRO-INVERTERS EQUIPMENT QTY DESCRIPTION
SOLAR PV MODULE 50 REC SOLAR REC460AA PURE-RX(460W)MODULES p
(05) BRANCHES OF 10 MODULES CONNECTED IN PARALLEL PER BRANCH INVERTER 50 ENPHASE IQ8X-80-M-US MICRO-INVERTERS
LOAD CENTER 1 125A SOLAR LOAD CENTER
HARVEST '^'°"2'-
SYSTEM SIZE:-50 x 460W=23.00 kWDC JUNCTION BOX 1 600V,55A MAX,4 INPUTS,MOUNTED ON ROOF FOR WIRE&CONDUIT TRANSITION
50 x 380VA= 19.00 kWAC HARVEST POWER LLC
AC DISCONNECT 1 AC DISCONNECT 100A FUSED,WITH 100A/2P FUSES,240V NEMA 3R,UL LISTED 2941 SUNRISE HIGHWAY ISLIP
TERRACE,NY 11752
TEL:(801)989-3585
harvest ower.net
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10 MICRO-INVERTERS IN BRANCH CIRCUIT#2 I
IT 11/05/2024 0
BI-DIRECTIONAL
I
M UTILITY METER
I SUPPLY TAP WITH
1-PHASE,3-W,
I JUNCTION TAP BOX 120V/240V
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Iv ^' �' I i (N)125A SOLAR
—j------- `—�------- J--------- I LOAD CENTER
10 MICRO-INVERTERS IN BRANCH CIRCUIT#3 i (N) 12X12X6
JUNCTION
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V ti I ,V i (N)JUNCTION BOX 15A FUSED,VISIBLE LOCKABLE PROJECT NAME
-_----- ----------- �j I LABELED, VA FUSES,
240 VAC
10 MICRO-INVERTERS IN BRANCH CIRCUIT#4 i L1 100A 200A -
FUSES O
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GREEN GROUND IN 1 1/4" (1)#6 THHN STRANDED GROUNDING Lll
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SHEET NAME
(50)ENPHASE IQ8X-80-M-US (5)Q CABLE THREE LINE DIAGRAM
MICROINVERTERS(240V) (1)#6 BARE CU GND
(LOCATED UNDER EACH PANEL) (10) 10 AWG THWN-2 SHEET SIZE
TERMINATOR CAP ON LAST CABLE (1)#6 THHN STRANDED ANSI B
CONNECTOR Q-CABLE(TYP) GREEN GROUND
IN 1"PVC CONDUIT 11" X 17"
*THREE LINE DIAGRAM SHEET NUMBER
SCALE: NTS PV-3
y _ _ 4
'AWARNING ARNING }
ELECTRICAL SHOCK HAZARD PHOTOVOLTAIC SYSTEM SOLAR PV SYSTEM EQUIPPED
COMBINER PANEL WITH RAPID SHUTDOWN TERMINALS ON LINE AND LOAD DO NOT ADD LOADS HARVEST
SIDES MAY BE ENERGIZED IN HARVEST POWER LLC
THE OPEN POSITION LABEL LOCATION:
H
PHOTOVOLTAIC AC COMBINER(IF ,S E HIY 11752
7 Z ISLIP
LABEL LOCATION: APPLICABLE). -3585)
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INVERTER(S),AC DISCONNECT(S),AC 3 TURN RAPID SHUTDOWN
COMBINER PANEL(IF APPLICABLE). SWITCH TO THE"OFF" /SOLARLECTRIC ?NELS
POSITION TO SHUT DOWN Z m
PV SYSTEM AND REDUCE 2 0
SHOCK HAZARD IN THE o y
ARRAY.
RSION
FOR • ■ PV SYSTEM DESCRIPTION DATE REV.
LABEL LOCATION: BLDG.PERMIT 11/05/2024 0
ON OR NO MORE THAT 1 M(3 FT)FROM THE SERVICE
LABEL LOCATION: DISCONNECTING MEANS TO WHICH THE PV SYSTEMS
UTILITY SERVICE ENTRANCE/METER,INVERTER/DC ARE CONNECTED.
DISCONNECT IF REQUIRED BY LOCAL AHJ,OR
OTHER LOCATIONS AS REQUIRED BY LOCAL AHJ.
AWARNING
POWER SOURCE OUTPUT CONNECTION
DO NOT RELOCATE THIS
RENT DEVIC PROJECT NAME
O� VERCUR
LABEL LOCATION: < Q
ADJACENT TO PV BREAKER AND ESS Z) J
QCPD(IF APPLICABLE). BUILDING SUPPLIED BY UTILITY a_
GRID AND PHOTOVOLTAIC 0 I— T- c� Z)
SYSTEM _j Z � Q LLI 0
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LABEL LOCATION:
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INTERIOR AND EXTERIOR DC CONDUIT EVERY 10 FT, Z Z �-
AT EACH TURN,ABOVE AND BELOW PENETRATIONS, z Lij
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ON EVERY JB/PULL BOX CONTAINING DC CIRCUITS. W u _
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PHOTOVOLTAIC AC DI
SHEET NAME
CURRENT:MAXIMUM AC OPERATING
(E)MAIN SERVICE PANEL PLACARD &
NOMINAL
. OPERATING
. . . VOLTAGE: ,, . (INSIDE)
m (E)UTILITY METER WARNING LABELS
(N)AC DISCONNECT SHEET SIZE
LABEL LOCATION:
AC DISCONNECT(S),PHOTOVOLTAIC SYSTEM POINT OF IN)SOLAR LOAD CENTER ANSI B
INTERCONNECTION. 11" X 17"
LABEL LOCATION: SHEET NUMBER
POINT OF INTERCONNECTION
(PER CODE:NEC690.56(B),NEC705.10,225.37,230.2(E)) PV-4
1. EACH MODULE TO BE GROUNDED USING THE SUPPLIED CONNECTION POINT PER
MANUFACTURER'S REQUIREMENTS. ALL SOLAR MODULES, EQUIPMENT, AND
METALLIC COMPONENTS ARE TO BE BONDED. IF THE EXISTING GROUNDING
ELECTRODE SYSTEM CAN NOT BE VERIFIED OR IS ONLY METALLIC WATER PIPING, , POWER LLC
IT IS THE CONTRACTOR'S RESPONSIBILITY TO INSTALL A SUPPLEMENTAL �� GH IP
752
GROUNDING ELECTRODE. we q 11585
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2. ALL PLAQUES AND SIGNAGE REQUIRED BY THE LATEST EDITION OF NATIONAL c
ELECTRICAL CODE. LABEL SHALL BE METALLIC OR PLASTIC, ENGRAVED OR k
o y
MACHINE PRINTED IN A CONTRASTING COLOR TO THE PLAQUE. PLAQUE SHALL
9
BE UV RESISTANT IF EXPOSED TO SUNLIGHT.
3. DC CONDUCTORS SHALL BE RUN IN EMT AND SHALL BE LABELED, "CAUTION DC VERSION
CIRCUIT" OR EQUIV. EVERY 5 FT. DESCRIPTION DATE REV.
BLDG.PERMIT 11/05/2024 0
4. EXPOSED NON-CURRENT CARRYING METAL PARTS OF ELECTRICAL EQUIPMENT
SHALL BE GROUNDED IN ACCORDANCE WITH 250.134 OR 250.136(A).
5. CONFIRM LINE SIDE VOLTAGE AT ELECTRIC UTILITY SERVICE PRIOR TO
CONNECTING INVERTER. VERIFY SERVICE VOLTAGE IS WITHIN INVERTER
VOLTAGE OPERATIONAL RANGE.
6. OUTDOOR EQUIPMENT SHALL BE NEMA-3R RATED OR BETTER.
PROJECT NAME
7. ELECTRICAL CONTRACTOR TO PROVIDE CONDUIT EXPANSION JOINTS AND
ANCHOR CONDUIT RUNS AS REQUIRED PER NEC. c/)
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8. ALL WIRING MUST BE PROPERLY SUPPORTED BY DEVICES OR MECHANICAL a _
MEANS DESIGNED AND LISTED FOR SUCH USE, AND FOR ROOF-MOUNTED O
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Q Up U)
Q Q '-
SYSTEMS, WIRING MUST BE PERMANENTLY AND COMPLETELY HELP OFF OF THE = Q Z z a- �
ROOF SURFACE. NEC 110.2 - 110.4 / 300.4
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9. ALL ROOF PENETRATIONS MUST BE FLASHED. SIMPLY CAULKING DOES NOT z a p Q �
SUFFICE. Q rn Z O
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SHEET NAME
ADDITIONAL NOTES
SHEET SIZE
ANSI B
11" X 17"
SHEET NUMBER
PV-5
REC
RE[ ALPHA PLIRE-RX SERIES
SOLAR'S MOST TRUSTED C C ..
HARVEST
HARVEST POWER LLC
2941 SUNRISE HIGHWAY ISLIP
GENERAL DATA :s 11752
Cell type: 88 half-cut REC bifacial,heterojunction cells
with lead-free,gaplesstechnology
Glass: 3.2 mm solarglass with anti-reflective surface treatment
T �2in accordance with EN12150 �� ��,•
Backsheet: Highly resistant polymer gill&
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® Frame: Anodized aluminum(black) �! _ + D O I Z m
Junction 4-part,4 bypass diodes,lead-free f (�
RE[ ALPHA IP68 rated,4 PV-accordance
BT4/KST4 462790
mm-) 02 y
Connectors- StSubli MC4 PV-KBT4/KST4(4 mma) � � 98
in accordance withlEC 62852.IP68 only when connected
in
PURE-RX 5ERIE5 Cable 4 mr1205 err cable,(2.087 ) t^ , �i
in accordancewith EN 50618 i-
Dimensions: 1728x1205x30mm(2.OSn� t t as sw 3 DESCRI DATE REV.
Weight: 23.4kg as
PRODUET 5PEEIREATION5 Origin: Made lnSingapore T. BLDG.PERMIT 11/O5/2024 0
00 Measurements in mm
ELECTRICAL DATA Product Code':RECxxxAA Pure•RX CERTIFICATIONS
i
Power Output-P.(Wp) 450 460 470 IEC 61215:2021,IEC 61730:2016,UL 61730
Watt Class Sorting-(W) 0/+10 0/+10 0/+10 IEC62804 PID
IEC 61701 Salt Mist
Nominal Power Voltage-V_IV) 54.3 54.9 55.4 IEC62716 Ammonia Resistance
Nominal Power Current-IN,(A) 8.29 8.38 8.49 IS0119252 Ignitability(EN 13501-1 Class E)
^ (V) 65.1 65.3 65.6 IEC 62782 Dynamic Mechanical Load
226 'vz Open Circuit Voltage-Va IEC61215-2-2016 Hai(stone(35mm)
Short Circuit Current-IX(A) 8.81 8.88 8.95 EC62321 Lead-freeacc.to RoHS EU 863/2015
Power Density(W/mg 216 221 226 :EC61730-22016 Fire Class C(as per UL 790)
Panel Efficiency(%) 21.6 1 22.1 22.6 ISO 14001,150 9001,IEC 45001.IEC 62941
PowerOutput-P.(Wp) 343 350 358 ♦ ,''
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Nominal Power Voltage-V.,(V) 512 51.7 SZ2
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NOminalPOWerCUrrent-I.(A) 6.70 6.77 6.86 wu a c°�" < Q
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Z Open Circuit Voltage-Voc(V) 61.3 61.6 61.8
' - J TEMPERATURE RATINGS
Short Circuit Current-Ix(A) 7.11 7.17 7.23 _ _ O
Values at standard test conditions(STC.air mass AM 1.5,bradiame 1000 WIrn,temperature 25'Cl based on a production spread with Nominal Module Operating Temperature- 44'C(**2°C) r-tJr-sqt
tolerance ofPyyxr Vim.&I,�.x3%within one watt class.Nominal module operating temperature(NMOT:airmass AM 1.5,aradence 800 W/me. Temperature coefficient ofP -0.24%/'C
a .a temperature r1_Zndspeed I m/sl`Where indicates the nominal power class(P.)at STC above. P rtuc' V �r�
MAXIMUM RATINGS Temperature coefficient ofVoc: -0.24%/'C O_ r L/
Temperature coefficient of Is,: 0.04%/'C J Z r Q W Q
Opera tionaltemperature: -40...+85°C Standard RECProTrst - Q
The temperature coefficients stated are linear values Q Cp (n
Maximums system 1000V Installed by an REC w U) Z Z a
R Y voltage: No Yes Yes DELIVERY INFORMATION Q _
MODULE Cer[ified5olarRofessxxial
�� 1 Maximum test load(front): +7000PaVl3kg/m=f LL
System Size All c25kW25-500kW w }
Maximum test load rear: -4000Pa 407k m�' Panels perpallet: 33 N � Z
(rear): ( g/ ) Product 20 25 25 w N
Max series fuse rating: 25A Power Warranty(yrs) 25 25 25 Panels per 40ftGP/high cube contaiier: 594(18pallets) _ - a � 0- J Z
Max reverse current: 25A Labor Warranty(yrs) 0 25 10 Panels per 13.6 in truck; 660(20pallets) T Z O Q
'See installation manual for mountinginstructions. Power in Year 98% 98% 98% q-, < a O
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Design load-Test load/1.5(safety factor) Annual Degradation 0.25% 0.25% 0.25% r
� Typical low irradiance performance of module at STC: ,;, w
Power in Year 25 92% 92% 92% o w 25 YEAR
The RECProTrustWarranty isonlyy available on panels purchased
a, r throughan REC Certified Solar Professional installer.Warranty - w LL
conditions apply.See wwwrecgroup.com for more details. �t -.. oc /f'►
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Founded in 1996.REC Group is an international pioneering solar energy company dedicated to empowering consumers '^! _ �/
with clean,affordable solar power.As Solar's Most Trusted,REC is committed to high quality,innovation,and a low 20 TuasSouth Ave.14 ® 1`� 1 1 t t /� 1 7 t r
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w � «."s..�•` 'w!r•. a carbon footprint in the solar materials and solar panels it manufactures.Headquartered in Norway with operational g P
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headquarters in Singapore,REC also has regional hubs in North America.Europe,andAsia-Pacific 8 P
SHEET NUMBER
` PV-6
SOLARMOUNT OF U N I RA
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- BETTER DESIGNS /. T1;
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TRUST THE INDUSTRYES BEST DESIGN TOOL CONCEALED UNIVERSAL o 1 �� :
1 I "1 1 1 1 •, 1 Start the design process for every project in our U Builder on-line design tool. ENDCLAMPS ® I
It's a great way to save time and money.
BETTER SYSTEMS %I ;r
ONE SYSTEM-MANY APPLICATIONS DESCRIPTION
Quickly sot modules flush to the root on steep pitched roofs.Orient a large variety
of modules in Portrait or Landscape.Tilt the system up on flat or low slow roofs. END CAPS INCLUDED ---
'` Components available in mill,clear.and dark finishes to optimize your design financials
WITH EVERY ENDCIAMP
and aesthetics. ---
BETTER RESULTS
MAXIMIZE PROFITABILITY ON EVERY JOB
CONCEALED Trust Unkac to help you minimize both system and labor costs from the time the job is
UNIVERSAL quoted to the time your teams get off the roof.Faster installs.Less Waste.More Profits.
CLAMPS UNIVERSAL SELF
r:•UNIRAC BETTER SUPPORT STANDING MIDCLAMPS
25 WORK WITH THE INDUSTRIES MOST EXPERIENCED TEAM
Professional support for professional installers and designers.You have access to --U
YEAR our technical support and training groups.Whatever your support needs,we've got e
• I 1 'I OPTIONAL you covered.Visit Unirac.com/solarmount for more information. j
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TOOL SAVES TIME&MONEY
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MECHANICAL LOADING BONDING&GROUNDING Visit design.unuac..cum a
UL2703SYSf �EMFIRECLASSIFICATION . LU •
UNIRAC CUSTOMER SERVICE MEANS THE HIGHEST LEVEL OF PRODUCT SUPPORT •
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UNMATCHED CERTIFIED ENGINEERING BANKABLE DESIGN PERMIT
r 'II 1 !1• ' 1 1 I 11 1 I 1 .1 EXPERIENCE QUALITY EXCELLENCE WARRANTY Toots DOCUMENTATION
TECHNICAL SUPPORT CERTIFIED QUALITY PROVIDER BANKABLE WARRANTY
Unnac's technical support team is dedicated to answering Unirac is the only PV mounting vendor with ISO Don't leave your project to chance.Unirac has the
questions&add ressing issues inrealtime.Anonline certifications for 9001:2008.140012004 and OHSAS financial strength to back our products and reduce your risk. SHEET NAME
THE PROFESSIONALS' CHOICE FOR RESIDENTIAL RACKING stamped
eocuments dtechnicaldng tasheetgreports, 1800t2007,m,andfh means
.Tesecertier certifications
onsdemohest nstrt Have
ceptiopeace of mind
.SOLAknowing YOU are pcoveredbproducts
5yearsiampedleflersandtechnicaltlatasheetsgreatly for fit,form,and function.These certifications demonstrate exceptional quality.SOLARMOUNTiscoveredbya25year SPEC SHEET
simplifies your permitting and project planning process. our excellence.and commitment to first class business practices. I imited product warranty and a 5 year limited finish warranty.
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BEST INSTALLATION EXPERIENCE-CURB APPEAL*COMPLETE SOLUTION•UNIRACSUPPORT
FOR QUESTIONS 0 R CUSTOMER SERVICE VISIT U N I R A C.C 0 M 0 R CALL (5 0 5) 248 2702 ENHANCE YOUR REPUTATION WITH QUALITY RACKING SOLUTIONS BACKED BY ENGINEERING EXCELLENCE AND A SUPERIOR SUPPLY CHAIN
FOR QUESTIONS OR CUSTOMER SERVICE VISIT UNIRAC.COM OR CALL (505) 248 2702
Unirac State Letter-NY fii1SlRllPn
HARVEST
Tectonic Tecton is Tectonic WO#:125524 HARVEST POWER LLC
August 12,2024
2941 SUNRISE HIGHWAY ISLIP T
S 1�� [ �N8Y17523585August 12, 2024 ■ Metal Roof: Standing Seam Attachments, PM-9000s, and PM Adjust Slotted � ower.ner
• Tile Roof: Solar hooks, Flashkit Tile Replacement JR) �
Unirac If
Attn: Engineering Services Department The U-Builder Tool should be used under the responsible charge of a registered
1411 Broadway Boulevard NE professional engineer required by the authority having jurisdiction. The design tool Cn Z M
Albuquerque, NM 87102-1545 and Unirac do not evaluate the existing roof structure, or the PV panels themselves. Z I
TEL: (505)242-6411 See the construction and installation drawings and manuals for additional o�
information provided by Unirac.
RE: ENGINEERING CERTIFICATION LETTER FOR THE UNIRAC SOLARMOUNT (SM)
ROOF PV PANEL SUPPORT SYSTEM Sincerely, ' W YO SION
STATE: NEW YORK ��or NEt7,Y IX-TON DATE REV.
TECTONIC WORK ORDER#: 12557.25 Tectonic �P !9 A. G&.1 0,9 BLDG.PERMIT 11/05/2024 0
*� �° �%
The Unirac SOLARMOUNT (SM) Photovoltaic Panel Su Q �' Ir
( Support System is a proprietary
framed photovoltaic panel support system that is installed on a roof. Tectonic m i
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Engineering Consultants, Geologists & Land Surveyors, D.P.C. (Tectonic) has -row ?�
reviewed the SM design methodology along with the U-Builder tool; a Unirac online °,o 0712g9
design tool. The review included the following SM products, SM Light, Heavy Duty, s10" 08/12/2024
and Standard rail with both the standard and pro hardware.
Antonio A. Gualtieri, P.E.
Tectonic has determined that the design is a rational approach and follows the Executive Vice President
structural requirements of the following reference documents:
Codes/Standards:
• 2020 Building Code of New York State.
PROJECT NAME
• 2018 International Building Code by International Code Council.
• ASCE/SEI 7-16 Minimum Design Loads for Buildings and Other Structures, by U) 0
American Society of Civil Engineers with provisions from SEAOC PV-2-2017. Q J
• 2020 Aluminum Design Manual, by Aluminum Association. J O
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This letter certifies that the structural analysis of the racking members,connections, 0 O
and components directly related to Unirac's system are in compliance with the
i z < LLI 0
above codes. The design methodology is acceptable under components and < Q — C/) Cn
cladding loads associated with the building's roof structure when the system is = Z Z LL.
installed in accordance with manufacturer specifications. If the loading criteria does J W Z } O
not meet Unirac's specifications, owner shall contact Unirac for a site-specific W = � a_ Z
certification. Z a 0 Q J
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Attachments approved for the SM system to the structure include the following W
and is installed per Unirac's U-Builder report and installation guides: W
• Shingle Roof: L-Foot Flashkit Pro, Standoffs, Flashloc Comp, Flash Loc Duo, O Q
and Flash Kit Pro SB
SHEET NAME
Project Contact Info Project Contact Info
1279 Route 300 I Newburgh,NY 12550 1279 Route 300 I Newburgh,NY 12550
SPEC SHEET
845.567.6656 Tel 1 845.567.8703 Fax 845.567.6656 Tel 1 845.567.8703 Fax
SHEET SIZE
tectonicengineering.com tectonicengineehng.com page 2 of 2 ANSI B
Equal Opportunity Employer Equal Opportunity Employer
11" X 17"
SHEET NUMBER
PV-8