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Z:.aS7Zcz— �o��SpffUiiNe Town of Southold 9/13/2024 a .G P.O.Box 1179 o _ 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 45544 Date: 9/13/2024 THIS CERTIFIES that the building SOLAR PANEL Location of Property: 2045 Marratooka Rd,Mattituck SCTM#: 473889 Sec/Block/Lot: 123.-2-3 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 4/26/2024 pursuant to which Building Permit No. 50795 dated 6/6/2024 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: roof-mounted solar panels to existing single-family dwelling as applied for. The certificate is issued to Lyall,Bruce&Julie of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 50795 8/28/2024 PLUMBERS CERTIFICATION DATED A or zed0 ature �SUFFoi,�° TOWN OF SOUTHOLD ao °aye BUILDING DEPARTMENT y x TOWN CLERK'S OFFICE oy • �� SOUTHOLD, NY poi � �oolt¢ 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#: 50795 Date: 6/6/2024 Permission is hereby granted to: Lyall, Bruce 2045 Marratooka Rd Mattituck, NY 11952 To: install roof-mounted solar panels to existing single-family dwelling as applied for. At premises located at: 2045 Marratooka Rd, Mattituck SCTM #473889 Sec/Block/Lot# 123.-2-3 Pursuant to application dated 4/26/2024 and approved by the Building Inspector. To expire on 1216/2025. Fees: SOLAR PANELS. $100.00 ELECTRIC $125.00 CO-ALTERATION TO DWELLING $100.00 Total: $325.00 Building nspector so�ryQl Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 �Q sean.devlinCaD-town.southold.ny.us Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Bruce Lyall Address: 2045 Marratooka'Rd city:Mattituck st: NY zip: 11952 Building Permit#: 50795 section: 123 Block: 2 Lot: 3 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: Electrician: Harvest Power LLC License No: 68518ME SITE DETAILS Office Use Only Residential X Indoor X Basement Service X Commerical Outdoor X 1 st Floor - Solar X New X Renovation 2nd Floor Hot Tub Addition Survey X. Attic Garage INVENTORY Service 1 ph X Heat Duplec Recpt . Ceiling Fixtures Bath Exhaust Fan Service 3 ph Hot Water GFCI Recpt Wall Fixtures' Smoke Detectors Main Panel 200A A/C Condenser Single Recpt 50A Recessed Fixtures CO Detectors Sub Panel A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO Transfer Switch UC Lights Dryer Recpt Emergency Strobe Heat Detectors Disconnect Switches 4'LED Exit Fixtures Sump Pump Other Equipment: 15.12kW Roof Mounted PV Solar Energy System w/ (36) REC420AA Modules, Enphase Combiner w/ (3) 220PVCircuits (1)215 Monitor, 60A Disconnect, Lineside Tapped in Panel Notes: 200A Panel 42 Circuits /42 Used & 50A Car Charger Outlet Underground Service, Solar & Carcharger Outlet Inspector Signature: Date: August 28, 2024 S. Devlin-Cert Electrical Compliance Form Copy gP SOUTyOlo S3--7 9 5 - `��') M oLl1r agoo k4 # . TOWN OF SOUTHOLD BUILDING DEPT.' couffm 631-765-1802 INSPECTION [ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] . FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: $ V I DATE - INSPECTOR -fi— ho�aOF SOUIyo� # * -TOWN OF SOUTHOLD BUILDING DEPT. coorm,��'� 631-765-1802 6,'�' INSPECTION [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. ] FOUNDATION 2ND [- NSULATION/.CAAULKING [ ] FRAMING/STRAPPING [ ] FINAL�dwv [ . ] FIREPLACE &CHIMNEY. [ "] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] - CODE VIOLATION [ ] PRE C/O [ ]. RENTAL REMARKS: I9,dy"L, c"k DATE.-I INSPECTO + /■ i � T I4 � VLA ' + . --- r )' ` ` 4r. Alt 's' fit b lwsk el .: LAj i � tool? 'r ' till . � all ° �, ap �, - Graham Associates 256 Orinco Dr,Brightwaters,NY 11718 Building Consultants&Expeditors (631)665-9619 Fax(631) 969-0115 July 23, 2024 Town of Southold Building Department Town Hall Annex Building P.O. Box 1179 Southold, NY Post Installation Certification Permit # 50795 Bruce Lyall Residence — 2045 Marratooka Rd., Mattituck, NY 11952 Installation Date: 6/26/2024 To Whom It May Concern, The roof mounted photovoltaic system at the above referenced residence has been installed properly in accordance with the approved plans and is certified by Michael K. Dunn, PE, to be in compliance with the minimum requirements of the 2020 New York State Residential Building Code; Town 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 have any further questions, do not hesitate to call. Si PeL K oG��� C� 'AT -k0 OF r-\14 FIELD INSPECTION REPORT DATE COMMENTS Qnro FOUNDATION(1ST) ------------------------------------ C FOUNDATION (2ND) r z 0 0 l� Vly ROUGH FRAMING& PLUMBING A Vv Or r INSULATION PER N.Y. y STATE ENERGY CODE Ark ✓ G FINAL ADDITIONAL COMMENTS Jz 107 103 4 c3zS 4 All W r- , -cw-� 0 1 aedfl-c �, Z . m X 23 t� o` H T'' O z • x r� x d ro H / �a F 11I'rO TOWN OF SOUTHOLD-BUILDING DEPARTMENT i � Town Hall Annex 54375 Main Road P. O.Box 1179 Southold,NY 11971=0959 Telephone(631)765-1802 Fax(631)765-9502 ht!ps://www..souiholdtow.g&.gov '�^-.erruyvF I Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only t f.J . PERMIT No. 6 Building Inspector: ;? (: APR 2 b 2024 r (•: 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: 4/10/2024 OWNER(S)OF PROPERTY: Name: Bruce Lyall FTM#1000- 123.-2-3 Project Address: 2045 Marratooka Road,Mattituck,NY 11952 Phone#: (516)729-8310 Email: bunkerpant@aol.com Mailing Address: 2045 Marratooka Road,Mattituck,NY 11952 CONTACT PERSON: Name: Katelyn Tornetta Mailing Address: 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 0 tu,V'.' $ �0�.1w Will the lot be re-graded? ❑Yes ®No Will excess fill be removed from premises? ❑Yes ❑No 1 I 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 ONO 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(print name): Katelyn Tornetta ®Authorized Agent ❑Owner Signature of Applica i Date: 04/10/2024 STATE OF NEW YORK) SS: COUNTY OF Suffolk, Katelyn Tornetta being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the (Contractor,Agent,Corporate Officer,etc.) of said owner or owners, and is duly authorized to,perform or have performed the said work and to make and file this application;that all statements contained in this application are true to the best of his/her knowledge and belief; and that the work will be performed in the manner set forth in the application file therewith. Sworn before me this day of 1 20 'c `I' S. INA I.AN NOTARY PUBLIC;STATE OF NEW YORK Registration No.01 LA6034714 Qualified Suffolk P_ROPERTY_OWNERAUTHORIZATIO CommssoExnll— May 30.20 'W ere a app ican is no a owner I, Bruce Lyall residing at 2045 Marratooka Road Mattituck,NY 11952 do hereby authorize Katelyn Tornetta,Harvest Power,LLC to apply on my behalf to Town of Southold Building Department for approval as described herein. Owner's Signature Date Bruce Lyall Print Owner's Name 2 •� 1 -rR I 1 I i 1 Building Department Application i AUTHOMATION (Where the Applicant is not the Owner) i I, Bruce Lyall residing at 2045 Marratooka Road (Print property owner's name) (Mailing Address)� Mattituck,NY 11952 do hereby authorize Katelyn Tornetta (Agent) Harvest Power LLC to apply on my behalf to the: Southold Building Department. 1 -E tzar s SSigna^""tiitc)1� �Datc) , Bruce Lyall OPP- (�1Pritzt C�?.rvner�s Name] CONSENT TO INSPECTION I Bruce Lyall ,the undersigned, do(es)hereby state: Owner(s)Name(s) That the undersigned(is)(are)the owner(s)of the premises in the Town of Southold,located at 2045 Marratooka Road,Mattituck,NY 11952 which.is shown and designated on the Suffolk County Tax Map as District 1000, ' Section 123 , Block . 2 ,Lot 3 That the undersigned(has)(have)filed,or cause to be filed,an application in the Southold Town Building Inspector's Office for the following: Installation of solar panels j �5�12�W G CbWY eV, lUCCr\,+ w be)UN 0NW u i That the undersigned do(es)hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, including any and all f buildings located thereon,to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises I comply with all of the laws,ordinances,rules and regulations of the Town of Southold. The undersigned, in consenting to such inspections;do(es)so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used in subsequent prosecutions for violations of the laws,ordinances,rules or regulations of the Town of Southold. Dated;a` W/ (S'ignature Bruce Lyall ((Signature ,�(IPrint Name„� E C E U U E AUG - 2 2024 o�OguFFO�,�COG BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD Building Department c Town Hall Annex- 54375 Main Road - PO B&410N Southold o • Southold, New York 11971-0959 y.1�01 �a0� Telephone (631) 765-1802 - FAX (631) 765-9502 iamesh(aD-southoldtownny.gov-- seand(aD-southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (Ali information Required) Date: 4/10/2024 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 01 request an email copy of Certificate of Compliance Elec. Address.:.2941 Sunrise Highway, Islip Terrace, NY 11752 JOB SITE INFORMATION (All Information Required) Name: Bruce Lyall Address: 2045 Marratooka Road, Mattituck, NY 11952 . Cross Street:' Bungalow Lane Phone No.: (516) 729-8310 Bldg.Permit#: 50795 email:bunkerpant@aol.com Tax Map District: 1000 Section:123 Block: 2 Lot:3 BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Installation of a 15.12 kW solar'PV system with (36) REC420AA roof-mounted panels. Square Footage: Circle All That Apply: Is job ready for inspection?: ❑� YES ❑ NO ❑Rough In ❑� Final Do you need a Temp Certificate?: ❑ YES 0 NO Issued On Temp Information: (All information required) Service SizeFv-�1 Ph❑3 Ph Size: 200 A # Meters 1 Old Meter# 98303186 ❑New Service❑Fire Reconnect[]Flood Reconnect❑Service Reconnect❑✓Underground❑Overhead # Underground Laterals n 1 FJ2 H Frame ✓ Pole Work done on Service? Fly ✓ N Additional Information: PAYMENT DUE WITH APPLICATION OSUFfQ��C, BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD N Town Hall Annex - 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 �y� apt Telephone (631) 765-1802 - FAX (631) 765-9502 1 ' jamesh@southoldtownny.gov - seandO-southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: 4/10/2024 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 01 request an email copy of Certificate of Compliance Elec. Address.: 2941 Sunrise Highway, Islip Terrace, NY 11752 JOB SITE INFORMATION (All Information Required) Name: Bruce Lyall Address: 2045 Marratooka Road, Mattituck, NY 11952 Cross Street: Bungalow Lane Phone No.: (516) 729-8310 Bldg.Permit#: n79. email: bunkerpant@aol.com Tax Map District: 1000 Section: 123 Block: 2 Lot:3 BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Installation of a 15.12 kW solar PV system with (36) REC420AA roof-mounted panels. Square Footage: Circle All That Apply: Is job ready for inspection?: dYES IOF]Rough In ❑✓ Final Do you need a Temp Certificate?: 0 YES ❑ NO Issued On Temp Information: (All information required) Service Size❑1 Ph❑3 Ph Size: 200 A # Meters Old Meter# [—]New Service❑Fire Reconnect[—]Flood Reconnect❑Service Reconnect❑Underground❑Overhead # Underground Laterals 1 2 R H Frame Pole Work done on Service? Y DN Additional Information: PAYMENT DUE WITH APPLICATION �0.),A re c 8o otD P �Su�Foc,��o BUILDING DEPARTMENT-Electrical Inspector o TOWN OF SOUTHOLD W • Town Hall Annex-54375 Main Road-PO Box 1179-Southold, NY 11971-0959 G'yjj01 �a0l. Telephone (631) 765-1802 Temporary Certificate # 1-7 W Date 1, 079 2024 Customer Name $rucL L &II Electrician Name yJ ?0-weve LL4 Address-1o4S Mayrx.Loka R Phone 31 . 47. 3 0'L 1l e-mail e-mail Q✓M•i n 6y S wer. rhe4 Phone License# m r=. ( 48 Size c200 A Phase Overhead Underground #of Meters Remarks #of Underground Laterals 1 2 New "H" Frame or Pole H P Fire Reconnect Was work done on Service? Y/N Flood Reconnect Old Meter# Service Reconnected Application for electrical service equipment is on file with the town of Southold.On the applicant's notification that this installation is complete,the town will conduct a premises inspection of the service equipment. This verification is valid for 90 to above. Authorized by ®S�FF01,��,•. BUILDING DEPARTMENT- Electrical Inspector �yO�, aGy TOWN OF SOUTHOLD Town Hall Annex - 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 oy�oft � Telephone (631) 765-1802 - FAX (631) 765-9502 4 iamesh southoldtownny.gov — seandOp southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (AII Information Required) Date: 4/10/2024 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 01 request an email copy of Certificate of Compliance Elec. Address.: 2941 Sunrise Highway, Islip Terrace, NY 11752 JOB SITE INFORMATION (All Information Required) Name: Bruce Lyall Address: 2045 Marratooka Road, Mattituck, NY 11952 Cross Street: Bungalow Lane Phone No.: (516) 729-8310 Bldg.Permit#: 50-7q.S email: bunkerpant@aol.com Tax Map District: 1000 Section: 123 Block: 2 Lot: 3 BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): Installation of a 15.12 kW solar PV system with (36) REC420AA roof-mounted panels. Square Footage: Circle All That Apply: 1�33 Is job ready for inspection?: V YES NO ❑Rough In ✓❑ Final Do you need a Temp Certific `fE�- NO Issued On Z �112-1 TemprService1:1 : (AII information required) h❑3 Ph Size: 200 A # Meters Old Meter# ❑Ne ' a Reconnect❑Flood Reconnect❑Service Reconnec erground❑Overhead # Unda 2 H Frame Pole Work done on Se ice? Y N Additiona ormatio . PAYMENT DUE WITH APPLICATION 1 (La Q V01.P �`` s° 5 PERMIT# Address: Switches Outlets G F I's Surface Sconces H H's UC Lts Fridge HW POOL Fans Mini Fr. WAD Panel Pump Exhaust Oven Sump Heater Trn Smokes DW Generator Salt he r Salt Gen. Carbon Micro GrbDis Water Bond Lights Heat Pucks ERV Inst Hot DeHum Transfer HOT TUB/SPADisc i Combo Cooktop Minisplit Blower AC AH Hood Blower Service Amps2 Have �4&..,Used ,Sub-', .Amps - Have Used a.. Comments Suffolk County Dept.of Labor,Licensing&Consumer Affairs t: MASTER ELECTRICAL LICENSE Name CARLO P LANZA -ems Business Name This certifies that the Harvest Polder LLC bearer is duly licensed License Number ME-68518 f� by the County of Suffolk Issued: 11/30/2023 I Je—i f'er Cixty era, Expires: 11/01/202.5 j Commissioner j i i"roR1 Workers' CERTIFICATE OF INSURANCE COVERAGE STATE Compensation Board under the NYS DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW PART 1.To be completed by Disability and Paid Family Leave Benefits Carrier or Licensed Insurance Agent of that Carrier 1a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured HARVEST POWER LLC 2941 SUNRISE HWY ISLIP TERRACE,NY 11752-2822 1c.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) 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"la" P.O. Box 970 South Hold, NY 11964-0000 LNY713777882 c Policy effective period 10/01/2023 TO 09/30/2024 4.Policy provides the following benefits: ® A.Both disability and paid family leave benefits. ❑ B.Disability benefits only. ❑ C.Paid family leave benefits only. 5.Policy covers: ® A.All of the employer's employees eligible under the NYS Disability and Paid Family Leave Benefits Law. ❑ B.Only the following class or classes of employer's employees: Under penalty of perjury, I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has NYS Disability and/or Paid Family Leave Benefits insurance coverage as described above. Date Signed 10-01-2023 E r� (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 SA 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 his complied with the NYS Disability and Paid Family Leave Benefits Law with respect to all of his/her employees. Date Signed B (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(9.17) 111111I'IN0111111111i11l, Jill 1H DocuSign Envelope ID:23FFBA00-E993-4182-B944-CC46A4AB8E3B YORK Workers' CERTIFICATE OF STATE Compensation Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured HARVEST POWER LLC 2941 SUNRISE HWY 1c.NYS Unemployment Insurance Employer Registration Number of ISLIP TERRACE,NY 11752-2822 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 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 C55973957 3c.Policy effective period 10/01/2023 to 10/01/2024 3d.The Proprietor,Partners or Executive Officers are ❑X included.(Only check box if all partners/officers included) ❑ all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box 1a"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 DocuRlgf"hi4me of authorized representative or licensed agent of insurance carrier) lye,dam^" 9/8/2023 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#:2830004 Client#: 110076 HARVPOW YYYY) ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/4/16MIDDf 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). PRODUCER NAME: Commercial Support Edgewood Partners Ins.Center PHONE 631-390-9700 A/C No Ext: 40 Marcus Drive 3rd Floor nI DREss: NEcertificates@epicbrokers.com Melville,NY 11747 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:James River Insurance Company 12203 INSURED INSURER B:Lloyd's of London Harvest Power LLC,Friendly INSURER C Construction Company Inc,EZ Flashing LLC INSURER D 2941 Sunrise Hwy INSURERS: Islip Terrace,NY 11752 INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDLSUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DDIYYYY A X COMMERCIAL GENERAL LIABILITY 000711808 04/16/2024 04115/2026 EACH OCCURRENCE $1 OOO 000 CLAIMS-MADE OCCUR PREMISES(E.0.ur....C, $50 OOO X Contractual Liab. MED EXP(Any one person) $Excluded X $5,000Ded. PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRO- POLICY III ECT LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ AUTOMOBILE LIABILITY (CO,M BINED INGLE LIMIT E accidentS $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident A X UMBRELLA LIAB X OCCUR 000711797 4/16/2024 04115/2025 EACH OCCURRENCE s4,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE s4,000,000 DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Pollution Liab. 000711808 04/15/2024 04/15/202 $1MM Ea Claim/$1MM Agg B Professional Liab HPL230064 4/15/2024 04/15/202 $2MM Ea Claim/$2MM Agg r 1 $1OK Ded Ea Claim DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Evidence of Insurance 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 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(2016103) 1 of 1 The ACORD name and logo are registered marks of ACORD #S6497815/M6497588 RH002 Client#: 110076 HARVPOW /YYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 4/DATE(MMIDD(MMIDD4 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). PRODUCER NAME: Commercial Support Edgewood Partners Ins.Center PHONE 631-390-9700 FAx 40 Marcus Drive 3rd Floor E-MAILo Ext: a/c,No): Melville,NY 11747 ADDRESS: NEcertificates@epicbrokers.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:James River Insurance Company 12203 INSURED Harvest Power LLC,Friendly INSURER B:Lloyd's of London Construction Company Inc,EZ Flashing LLC INSURERC: 2941 Sunrise Hwy INSURERD: Islip Terrace, NY 11762 INSURERE: 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. LTRR ADDLSUBR TYPE OF INSURANCE NSR WVD POLICY NUMBER MMIDDY� MM/LDDYIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY 000711808 04/15/2024 04/15/2025 EACH OCCURRENCE $1 00O 000 CLAIMS-MADE ❑X OCCUR PREMISES(ERENTED r nce) $60 000 X Contractual Liab. MED EXP(Any one person) $Excluded X $5,000 Ded. PERSONAL BADVINJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRO- POLICY F_X1 ECT CI LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident A X UMBRELLA LIAB X OCCUR 000711797 04/15/2024 04/16/2025 EACH OCCURRENCE s4,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $4 OOO OOO DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N1,9TATUTE I IER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICERIMEMBEREXCLUDED? El NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Pollution Liab. 000711808 04/16/2024 04/16/202 $1MM Ea Claim/$1MM Agg B Professional Liab HPL230064 04/15/2024 04/16/202 $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 Town of Southold SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 53095 Route 25 ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1179 Southold,NY 11971-0000 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) 1 of 1 The ACORD name and logo are registered marks of ACORD #S6497816/M6497588 RH002 Suffolk County Dept.of Labor,Licensing&Consumer Affairs HOME IMPROVEMENT LICENSE Name i' CARLO LANZA Business Name Th;s certifies that the bearer Is duly licensed Ha-vest power LLC by tie County of suffolk License Number:H-48165 Rosalie Drago Issued: 11/18.12010 Comm.ssioner Expires: 11/1/2024 Client#: 110076 HARVPOW DATE(MM/DD/YYY ACORDTM CERTIFICATE OF LIABILITY INSURANCE Y) 4M6/2024 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). PRODUCER CONTACT Commercial Support Edgewood Partners Ins.Center A/Co"N Ext:631-390-9700 a/c,Nu: 40 Marcus Drive 3rd Floor E-MAIL ADDRESS: NEcertificates ap icbrokers.com Melville,NY 11747 INSURER(S)AFFORDING COVERAGE NAIC n INSURER A:James River Insurance Company 12203 INSURED INSURER B:Lloyd's of London Harvest Power LLC,Friendly INSURERC: Construction Company Inc,EZ Flashing LLC INSURERD: 2941 Sunrise Hwy INSURERS: Islip Terrace,NY 11752 INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY 000711808 04/15/2024 04/15/2025 EACH OCCURRENCE $1 OOO 000 CLAIMS-MADE �OCCUR PREMISES Ea occu ence $50,000 X Contractual Liab. MED EXP(Any one person) $Excluded X $6,000 Ded. PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s2,000,000 PRO- POLICY X JECT LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident 5 A X UMBRELLA LIAB X OCCUR 000711797 04/15/2024 04115/2025 EACH OCCURRENCE s4,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE s4,000,000 DED I I RETENTION'$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/NISTATUTE I IER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Pollution Liab. 000711808 04/15/2024 04/15/202 $1MM Ea Claim/$1MM Agg B Professional Liab HPL230064 04/15/2024 04/15/202 $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 Town Of Southold: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 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(2016103) 1 of 1 The ACORD name and logo are registered marks of ACORD #S6497815/M6497588 RH002 Client#: 110076 HARVPOW ACORD,.' CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 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). PRODUCER CONTACT Commercial Support Edgewood Partners Ins.Center PHONE 631-390-9700 Fax 40 Marcus Drive 3rd Floor E-MAIL o Ext: Alc,No Melville,NY 11747 ADDRESS, NEcertificates@epicbrokers.com INSURER(S)AFFORDING COVERAGE NAIC M INSURER A:James River Insurance Company 12203 INSURED Harvest Power LLC,Friendly INSURER B:Lloyd's of London Construction Company Inc,EZ Flashing LLC INSURERC: 2941 Sunrise Hwy INSURERD: Islip Terrace,NY 11752 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDLSUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MMIDD/YYYY W MMIDD/YY A X COMMERCIAL GENERAL LIABILITY 000711808 04/16/2024 04115/2025 EACH OCCURRENCE $1 000 000 CLAIMS-MADE OCCUR PREMISES EaoccurrDence $50 OOO X Contractual Liab. MED EXP(Any one person) $Excluded X $5,000 Ded. PERSONAL&ADV INJURY $1 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY�ECOT- LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ A X UMBRELLA LIAR X OCCUR 000711797 04/16/2024 04/16/2026 EACH OCCURRENCE $4 000 OOO EXCESS LIAB CLAIMS-MADE AGGREGATE s4,000,000 DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N T ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMIT $ A Pollution Liab. 000711808 04/15/2024 04/15/202 $1MM Ea Claim/$1MM Agg B Professional Liab HPL230064 04/15/2024 04/15/202 $2MM Ea Claim/$2MM Agg $10K Ded Ea Claim DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Evidence of Insurance CERTIFICATE HOLDER CANCELLATION Town of Southold SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 53095 Route 25 ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1179 1 Southold,NY 11971-0000 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) 1 of 1 The ACORD name and logo are registered marks of ACORD #S6497816/M6497588 RH002 Yo K workers' CERTIFICATE OF INSURANCE COVERAGE STATE Compensation Board under the NYS DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW PART 1.To be completed by Disability and Paid Family Leave Benefits Carrier or Licensed Insurance Agent of that Carrier 1a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured HARVEST POWER LLC 2941 SUNRISE HWY ISLIP TERRACE,NY 11752-2822 1c.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) 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"la" P.O. Box 970 South Hold, NY 11964-0000 LNY713777882 c Policy effective period 10/01/2023 TO 09/30/2024 4.Policy provides the following benefits: ®.A.Both disability and paid family leave benefits. ❑ B.Disability benefits only. ❑ C.Paid family leave benefits only. 5.Policy covers: 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 above. Date Signed 10-01-2023 F ' r (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 513 is checked,this certificate is NOT COMPLETE for purposes of Section 220,-Subd.8 of the NYS Disability and Paid Family Leave Benefits Law.It must be mailed for completion to the Workers'Compensation Board,Plans Acceptance Unit,PO Box 5200,Binghamton,NY 13902-5200. PART 2.To be completed by the NYS Workers'Compensation Board (Only if Box 4C or 5B of Part 1 has been checked) State of New York Workers' Compensation Board According to information maintained by the NYS Workers'Compensation Board,the above-named employer has complied with the NYS Disability and Paid Family Leave Benefits Law with respect to all of his/her employees. Date Signed B (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(9-17) IIIIIII'iiiii12iiiii1iii09i17l�l�ll I DocuSign Envelope ID:23FFBA00-E993-4182-B944-CC46A4AB8E3B NW Workers' CERTIFICATE OF STATE Compensation Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured HARVEST POWER LLC 2941 SUNRISE HWY 1c.NYS Unemployment Insurance Employer Registration Number of ISLIP TERRACE,NY 11752-2822 Insured Work Location of Insured(Only required if coverage is specifically limited to 1 d.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-Up Policy) Number 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 C55973957 3c.Policy effective period 10/01/2023 to 10/01/2024 3d.The Proprietor,Partners or Executive Officers are ❑X included.(Only check box if all partners/officers included) ❑ all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box"1 a"for workers' compensation under the New York State Workers'Compensation Law. (To use this form,New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy).The Insurance 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 contracbissued 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 Docu(J9flW hErne of authorized representative or licensed agent of insurance carrier) 11", 9/8/2023 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#:2830004 I 1 HARVESTH:) POWE R Harvest Power LLC 1 2941 Sunrise Hwy., Islip Terrace, NY 11752 1 Office: 631-647-3402 Fax: 631-647-3404 Town of Southold Building Department Town Hall Annex Building 54375 Main Rd. P.O. Box 1179 Southold, NY 11971 To Whom it May Concern: With regards to permit 50795 (2045 Marratooka Rd.,Mattituck), attached you will find the application for electrical inspection, $125 application fee,and post install engineer's letter.We would like to please request that both the electrical and building inspection occur at your earliest convenience. Please let us know if you need anything further, and thank you for your assistance! Warm Regards, Harvest Power Expediting Team Licensed, insured & bonded I License # Nassau County: H0011250000 License # Suffolk County: 48165-H �a Graham Associates 256 Orinoco Drive, Suite A Brightwaters,NY 11718 Building Consultants & Expeditors (631)665-9619 April 15, 2024 COMPLY WITH ALL CODES OF NEW YORK STATE&TOWN CODES Town of Southold AS REQUIRED AND CONDITIONS OF Building Department /DEC N ZBA 54375 Rt. 25 N PLANNING BOARD Southold, NY 11971 N TRUSTEES N.Y.Re: Bruce Lyall Residence 2045 Marratooka Road D Mattituck, NY Proposed 15.12 kWDC, 11.34 kWAC PV Rooftop Solar 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 have any further questkpp lie3it to to call. NOTED �,y�C I-I l TFc DATE- H FEE B.P.# s6 BY. v�j \ Y_ NOTIFY BUILDING DEPARTMENT AT C7 U Q� 631-765"802 8AM TO ►� 0 FOLLOWING INSPECTIONS FOR THE 1. FOUNDATION-TWO RFGl'„r,r-� FOR POURED Iot.jCFII 2. ROUGH-FRAC'IING&F„ hEe unn, RA 3. INSULATION 4. FINAL-CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE €=C,I1 DESIGN OR CONSTRUCTION i:t-180.l3 (36) REC SOLAR REC420AA PURE-R(420W) MODULES BILL OF MATERIALS fit (36) ENPHASE IQ7X-96-2-US MICRO-INVERTERS EQUIPMENT QTY DESCRIPTION (03) BRANCHES OF 12 MODULES CONNECTED IN PARALLEL PER BRANCH SOLAR PV MODULE 36 REC SOLAR REC420AA PURE-R(420W)MODULES INVERTER 36 ENPHASE IQ7X-96-2-US MICRO-INVERTERS COMBINER BOX 1 ENPHASE IQ COMBINER BOX SYSTEM SIZE:-36 x 420W— 15.12 kWDC JUNCTION BOX 1 600V,55A MAX,4 INPUTS,MOUNTED ON ROOF FOR WIRE&CONDUIT TRANSITION HARVEST;'''"�. .Jr HARVEST POWER LLC 36 x 315VA= 11.34 kWAC LOAD CENTER 1 160A LOAD CENTER 2941 SUNRISE HIGHWAY ISLIP � TERRACE,NY 11752 E TEL:(801)969 3565 - site:www.harves owernet 12 MICRO-INVERTERS IN BRANCH CIRCUIT#1 Ju BI-DIRECTIONAL ��F N E��� ` VERSION 1 ,� I I I UTILITY METER ESCRIPTION DATE REV.1-PHASE,3-W, BLDG.PERMIT 04/12/2024 0 120W24OV,60Hz ————— ———————— ——————� I 12 MICRO-INVERTERS IN BRANCH CIRCUIT#2 I I SUPPLY TAP WITH LEII } a a 0 I JUNCTION TAP BOX I (N)JUNCTION BOX (N)12X12X6 I I I I JUNCTION ^, I ti I ti I I TAP BOX I I I I (N)60A LOAD ————— ———————— —_ —� (N)ENPHASE COMBINER BOX (N)60A PV CENTER � PROJECT NA ————— ME BREAKER LLI U d < o 12 MICRO-INVERTERS IN BRANCH CIRCUIT#3 j 720A EWAY 6. z Q U) oLU p Z) o O LID CD — (E)200A MAIN O O I SERVICE PANEL 0Lu O O I I WITH(E)200A ---- — r I JO � — 200A� Z OI I D }~" LL O Q I � NZ —————— (3)#6AWGTHWN W_ U T_ I I 1"PVC CONDUIT I Q O L--- O Q Z = (36)ENPHASE IQ7X-96-2-US m N 2 Q Q MICRO-INVERTERS rvJ EXISTING GROUNDING TERMINATOR CAP ON LAST CABLE (3)Q-CABLE (6)#10 AWG THVVN-2 / SYSTEM SHEET NAME CONNECTOR Q CABLE(TYP) (1)#6 BARE COPPER GND (1)#8 AWG THWN-2 GND S SINGLE LINE IN 1"PVC CONDUIT RUN DIAGRAM SHEET SIZE ANSI B 11" X 17" SINGLE LINE DIAGRAM SHEET NUMBER 1 SCALE: NTS PV-3 PHOTOVOLTAIC ROOF MOUNT SYSTEM 36 MODULES-ROOF MOUNTED - 15. 12 kWDC, 11 .34 kWAC 2045 MARRATOOKA ROAD, MATTITUCK, NY 1952, USA HARVEST HARVEST POWER LLC 2941 SUNRISE HIGHWAY ISLIP SYSTEM SUMMARY: GOVERNING CODES: SHEET INDEX TERRACE,NY 11752 (N)36-REC SOLAR REC420AA PURE-R(420W)MODULES PV-0 COVER SHEET E[�A TEL:(801)9M3585 2017 NATIONAL ELECTRICAL CODEG ste:www.harvest owernet (N)36-ENPHASE IQ7X-96-2-US MICRO-INVERTERS (NEC)( ) � (N)JUNCTION BOX 2020 BUILDING CODE OF NYS PV-1 SITE PLAN WITH ROOF PLAN �� (E)200A MAIN SERVICE PANEL WITH (E)200A MAIN BREAKER 2020 RESIDENTIAL CODE OF NYS PV-2 ATTACHMENT DETAILS 0\ " 'o_ K PV-3 SINGLE LINE DIAGRAM 441 C) (N)60A LOAD CENTER 2020 EXISTING BUILDING CODE OF NYS �p PV-4 PLACARDS&WARNING LA 2020 FIRE CODE OF NYS v� (N)ENPHASE IQ COMBINER BOX 2020 PLUMBING CODE OF NYS PV-5 ADDITIONAL NOTES s' 2020 MECHANICAL CODE OF NYS PV-6+ SPEC SHEETS k DESIGN CRITERIA: w11 ROOF TYPE: -ASPHALT SHINGLE N"9j "9 r N VERSION NUMBER OF LAYERS: - 1 OF CRIPTION DATE ROOF CONDITION: GOOD REV. ROOF FRAME: -2"X8" RAFTER 1O.C. .PERMIT 04/12/2024 0 STORY:-TWO STORY SNOW LOAD : -25 PSF WIND SPEED :- 130 MPH WIND EXPOSURE:-D GENERAL NOTES: 1. INSTALLATION IN ACCORDANCE WITH MANUFACTURER ARRAY LOCATIONS RECOMMENDATIONS. PROJECT SITE 2. ENGINEER TO INSPECT PROJECT AFTER INSTALLATION '+} �J l� J AND CERTIFY COMPLIANCE. 3. PROJECT TO BE INSTALLED WITH CODE COMPLIANT f RACKING INSTRUCTIONS FOR UNI-RAC SOLAR MOUNT Green' port PROJECT NAME SYSTEM. 4. FOLLOW BALLASTING SCHEDULE ON ROOF PLAN. W 5. HARVEST POWER, LLC., THE SOLAR INSTALLATION Shelter U Q � Q CONTRACTOR, COMPLIES WITH ALL LICENSING&ALL So thol r z Q U) J RELATED REQUIREMENTS OF THE GOVERNING ► Island j LU 0 c0 O MUNICIPALITIES AND THE LOCAL ELECTRIC UTILITY ;,►. O 2 AHJ'S. i Q � oO J F- 6. THIS PROJECT WILL COMPLY WITH THE CURRENT NEC 4 Lij CO Y a O (D Z:) REQUIREMENTS INCLUDING ARTICLE 690 SOLAR O N w 0 PHOTOVOLTAIC PV SYSTEMS. Sag ` J 0 O a 7. THE ROOF WILL HAVE NO MORE THAN A SINGLE LAYER Q Q Y N � OF ROOF COVERING IN ADDITION TO THE SOLAR EQUIPMENT. �,, 2045 Marratooka — F- 8. INSTALLATION WILL BE FLUSH-MOUNTED, PARALLEL -J < � Rd -I k, N Y. Q O TO AND NO MORE THAN 6.5"ABOVE ROOF ' Mattituc ,, uJ � � O j 0 9. MAINTAIN A MINIMUM OF 18"CLEARANCE AT RIDGE 11952 United States c U AND AT ONE GABLE EAVE , - Riverhead 10. THIS DESIGN COMPLIES WITH 130 MPH WIND South N _ REQUIREMENTS OF THE RESIDENTIAL CODE OF N.Y.S port m Q AND ASCE 7-16. Q �nooglslandl `' .�+9 11. WHEREVER THE ROOF PLAN DOES NOT COMPLY WITH .+�'"` Southampton ACCESS AND VENTILATION REQUIREMENTS OF THE Hampton SHEET NAME UNIFORM CODE, HARVEST POWER PROPOSES THAT . 27 Bays COVER SHEET ALTERNATIVE VENTILATION METHODS WILL BE 1 EMPLOYED. REVIEW AND APPROVAL SHALL BE AT THE DISCRETION OF THE MUNICIPALITY IN WHICH THIS r ; arm SHEET SIZE DOCUMENT HAS BEEN FILED. 12. THE DESIGN PLANS COMPLY WITH THE 2020 NEW ANSI B YORK STATE UNIFORM FIRE PREVENTION AND 11" X 17" RESIDENTIAL BUILDING CODE. 1 AERIAL PHOTO 2 VICINITY MAP SHEET NUMBER PV-0 SCALE: NTS 7V-0 SCALE: NTS P\/_0 MODULE TYPE, DIMENSIONS & WEIGHT ROOF ACCESS AREA: NUMBER OF MODULES=36 MODULES SHALL BE LOCATED IN AREAS THAT DO NOT REQUIRE THE PLACEMENT OF GROUND MODULE TYPE=REC SOLAR REC420AA PURE-R(420W)MODULES OVER OPENINGS SUCH AS WINDOWS OR DOORS,AND LOCATED AT STRONG POINTS OF f r MODULE WEIGHT=47.4 LBS/21.5 KG. BUILDING CONSTRUCTION IN LOCATIONS WHERE THE ACCESS POINT DOES NOT MODULE DIMENSIONS= 68.1"X 44.0"=20.81 SF CONFLICT WITH OVERHEAD OBSTRUCTIONS SUCH AS TREE LIMBS,WIRES OR SIGNS. UNIT WEIGHT OF ARRAY=2.28 PSF /-' j HARVESTrl^'lAf` -' -r HARVEST POWER LLC D A& 2g41 SUNRISE HIGHWAY ISLIP �� � GRACE,NY 11752 E L (,, /�� siteR 989-3585 wwwharvesower.net (E)CHIMNEY /'0 (E)TREE(TYP.) �/ o � 02981l `C OF NEB VERSION DESCRIPTION DATE REV. 0 `\ doBLDG.PERMIT 04/12/2024 0 cJ"1 cp «s� NO0 6, ROOF#2 \ j %' ♦ 4" �\ (08) REC420AA PURE-R(420W) \ ' \ RAFTERS=2"X8"@16" O.0 ♦ 158°AZIMUTH, 20°TILT j \ ♦ ♦ ♦ ♦ ♦ PROJECT NAME \ ♦ \ w ROOF#4 - «E \\ Z Q (¢ p0 (02) REC420AA PURE-R (420W) 0`\ LU O D co RAFTERS= 2"X8"@16" O.0 _158°AZIMUTH, 37°TILT '0.` (n Q to p -I ~ �,�" ♦ �� LLJ Y N LLI O • ♦ -' O >- p co t) (13) REC420AA PURE-RO(4020W) ♦ / RAFTERS=2"X8"@16" O.0 \ ♦ ♦ Q - or) } O 248°AZIMUTH, 35°TILT \` S(��P�l ♦ ♦ / Q Y N U ~ Z p -j (E) FENCE Ll.l I_- C) ? O ` (36) ENP SE IQ7X-96-2-US c) Lo \ ,3y 2;� ICRO- FRYERS N d Q (N) CTION BOX m (N) 1" PVC CONDUIT RUN 7/8"ABOVE ROOF SHEET NAME (N) ENPHASE IQ COMBINER BOX SITE PLAN WITH (N)60A LOAD CENTER ROOF PLAN (E) UTILITY METER SHEET SIZE (E) 200A MAIN SERVICE PANEL ANSI B" \/ WITH (E) 200A MAIN BREAKER(INSIDE) ROOF#1 11 X 17 SITE PLAN WITH ROOF PLAN (13) 2 PURE-R (420W) RAFTERSRS= 2"XSX8"@16" O.0 SHEET NUMBER SCALE: 1/16"= 1'-0" 158°AZIMUTH, 20°TILT PV-1 f� i HARVESTP01` REp ARVEST POWER LLC 494 UNRISE HIGHWAY ISLIP !,,T RACE,NY 11752 (N PV MODULES U� �� � ' �EL (801)989-3585 ) 4�ebsi harvest owecnet r' to i\t @0 981 �R— (E) ASPHALT SHINGLE FtS F N E ROOF " VERSION ENLARGE VIEW DESCRIPTION DATE REV. BLDG.PERMIT 04/12/2024 0 GENERAL NOTES: 1. RAILS TO BE INSTALLED TWO PER PANELS AS SHOWN IN DETAIL. 2. ALL PENETRATIONS TO BE MADE@ 48"O.C. 3. BOLTS TOBE INSTALLED INTO RAFTERS. 4. MINIMUM 2.5"PENETRATION INTO WOOD FOR CODE COMPLIANCE. NOTE.- ATTACHMENT DETAIL "ACTUAL ROOF CONDITIONS AND RAFTERS(OR SEAM) LOCATIONS MAY VARY. INSTALL PER MANUFACTURER(S)INSTALLATION GUIDELINES SCALE: NTS AND ENGINEERED SPANS FOR ATTACHMENTS." END / MID CLAMP PROJECT NAME PV MODULES LLJ zocno 0 LI.J Oa Z) oM O CV O J H L-FOOT Ili � N o W O lcl� O >- ocn00 (E) ASPHALT SHINGLE ROOF J Z o a O Q Y c Z _I C) -J Q CD � C) 0 ROOF DECK MEMBRANE W I.— U UNIRAC SM LIGHT RAIL CD _ m Q a 2.5" MIN. EMBEDMENT UNIRAC FLASH KIT PRO SHEET NAME ATTACHMENT 5/16" STAINLESS STEEL LAG BOLT DETAIL WITH 2-1/2" MIN. EMBEDMENT BUILDING STRUCTURE SHEET SIZE AND SS EPDM WASHER ANSI B 11" X 17" 2 ATTACHMENT DETAIL ENLARGE VIEW) SCALE: NTS SHEET NUMBER PV-2 (36) REC SOLAR REC420AA PURE-R(420W) MODULES BILL OF MATERIALS (36) ENPHASE IQ7X-96-2-US MICRO-INVERTERS EQUIPMENT QTY DESCRIPTION (03) BRANCHES OF 12 MODULES CONNECTED IN PARALLEL PER BRANCH SOLAR PV MODULE 36 REC SOLAR REC420AA PURE-R(420W)MODULES INVERTER 36 ENPHASE IQ7X-96-2-US MICRO-INVERTERS COMBINER BOX 1 ENPHASE IQ COMBINER BOX _ HARVESTS'^`"fc�' SYSTEM SIZE:-36 x 420W- 15.12 kWDC JUNCTION BOX 1 600V,55A MAX,4 INPUTS,MOUNTED ON ROOF FOR WIRE&CONDUIT TRANSITION HARVEST POWER LLC 36 x 315VA= 11.34 kWAC LOAD CENTER 1 60A LOAD CENTER 2941 SUNRISE HIGHWAY ISLIP TERRACE,NY 11752 ERED TEL:(801)989-3585 sitemww.harvest ower.net 12 MICRO-INVERTERS IN BRANCH CIRCUIT#1 a 2 n • • • h 9817 r1224 IONALOF � VERSION ETER ESCRIPTION DATE REV. ^/ ^, �, 3-W, BLDG.PERMIT 04/12/2024 0 I I ,60Hz ————— ———————— ———————I I 12 MICRO-INVERTERS IN BRANCH CIRCUIT#2 I I SUPPLY TAP WITH L • . . I JUNCTION TAP BOX I (N)JUNCTION BOX _—__ (N)12X12X6 I — I I JUNCTION ti ti ti I TAP BOX (N)60A LOAD ————— ———————— —————— (N)ENPHASE COMBINER BOX (N)60A PV CENTER PROJECT NAME EE BREAKER LLI 12 MICRO-INVERTERS IN BRANCH CIRCUIT#3 I IQ GATEWAY soA z Q < c) 0 CD %220A --- — --- N c) — 2 . . . I g Lo OJI (E)200A MAIN w Y O) OSERVICE PANEL N LLI O iI MAIN BREAKER O O 0'� j ='� j '� j I --- G --- J I 200A( (BOTTOM FED) J Q Z OM } O ---- ------- - I I (3)#6AWGTHWN I Q Y N (1)#8 AWG THWN GND G I 1"PVC CONDUIT i J Q LLJF- O I- O (36)ENPHASE IQ7X-96-2-US cl� 12�D Op Q Z = MICRO-INVERTERS m N Q Q EXISTING GROUNDING TERMINATOR CAP ON LAST CABLE (3)Q-CABLE (6)#10 AWG THWN-2 SYSTEM CONNECTOR Q CABLE(TYP) (1)#6 BARE COPPER GND (1)#8 AWG THWN-2 GND SHEET NAME IN 1"PVC CONDUIT RUN SINGLE LINE DIAGRAM SHEET SIZE ANSI B 11" X 17" SINGLE LINE DIAGRAM SHEET NUMBER SCALE: NTS PV-3 4" AWARNI _ AWARNIN4 ELECTRICAL SHOCK HAZARD PHOTOVOLTAIC SYSTEM S O LA R PV SYSTEM EQUIP PIED , COMBINER PANEL WITH RAPID SHUTDOWN TERMINALS ON LINE AND LOAD DO NOT ADD LOADS HARVESTPOWFQ SIDES MAY BE ENERGIZED IN HARVEST POWER LLC THE OPEN POSITION LABEL LOCATION: 2941 SUNRISE HIGHWAY ISLIP PHOTOVOLTAIC AC COMBINER(IF TERRACE,NY 11752 APPLICABLE). RE�Ark( TEL:(801)989-3585 LABEL LOCATION: �cJ4�^ INVERTER(S),AC DISCONNECT(S),AC 3° ebsite:www.harvest owernet COMBINER PANEL(IF APPLICABLE). TURN RAPID SHUTDOWN \Go SWITCH TO THE"OFF" SOLAR PAN�SR'° `S , POSITION TO SHUT DOWN '`'_;o —4 PV SYSTEM AND REDUCE SHOCK HAZARD IN THE RAPID SHUTDOWN ARRAY. 2981�1 SWITCH FOR •LAR PV QF N E\ VERSION DESCRIPTION DATE REV. SYSTEMLABEL LOCATION: BLDG.PERMIT 04/12/2024 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 PROJECT NAME OVERCURRENT DEVICE LL1 LABEL LOCATION: ADJACENT TO PV BREAKER AND ESS Z Q (/) � OCPD(IF APPLICABLE). LLI O co O BUILDING SUPPLIED BY UTILITY o 0 N CD J GRID AND PHOTOVOLTAIC w IOI_I o SYSTEM fy_ O } o u) v) 2045 MARRATOOKA ROAD -J Z CD a' LL � • • � � c) LABEL LOCATION: w _ O O INTERIOR AND EXTERIOR DC CONDUIT EVERY 10 FT, U �- `— I_ AT EACH TURN,ABOVE AND BELOW PENETRATIONS, Ln f— $ ON EVERY JB/PULL BOX CONTAINING DC CIRCUITS. N < Z = m Q Q PHOTOVOLTAIC AC DISCONNECT SHEET NAME MAXIMUM AC OPERATING AMPS PLACARD & NOMINAL O.ERATING AC VOLTAGE: 240 VAC WARNING LABELS (N)COMBINER BOX SHEET SIZE LABEL LOCATION: (N)LOAD CENTER ^ AC DISCONNECT(S),PHOTOVOLTAIC SYSTEM POINT OF (E)MAIN SERVICE PANEL ANSI INTERCONNECTION. (INSIDE) 11" X 17" (E)UTILITY METER 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 _p MANUFACTURER'S REQUIREMENTS. ALL SOLAR MODULES, EQUIPMENT, AND METALLIC COMPONENTS ARE TO BE BONDED. IF THE EXISTING GROUNDING HARVEST""""" ELECTRODE SYSTEM CAN NOT BE VERIFIED OR IS ONLY METALLIC WATER PIPING, HARVEST POWER LLC IT IS THE CONTRACTOR'S RESPONSIBILITY TO INSTALL A SUPPLEMENTAL �REDgR 2941 SUNRISE HIGHWAY ISLIP '� C TERRACE,NY 11752 GROUNDING ELECTRODE. C� �p,EL k p �� \ TEL:(801)989-3585 \G website:www.harvestpowernet 2. ALL PLAQUES AND SIGNAGE REQUIRED BY THE LATEST EDITION OF NATIONAL -� 48I►O :li(h ELECTRICAL CODE. LABEL SHALL BE METALLIC OR PLASTIC, ENGRAVED OR MACHINE PRINTED IN A CONTRASTING COLOR TO THE PLAQUE. PLAQUE SHALL (j) 5' BE UV RESISTANT IF EXPOSED TO SUNLIGHT. �� 0,9811 O� N ENj 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 04/12/2024 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 W ANCHOR CONDUIT RUNS AS REQUIRED PER NEC. z Q U) o w p D co O 8. ALL WIRING MUST BE PROPERLY SUPPORTED BY DEVICES OR MECHANICAL N o MEANS DESIGNED AND LISTED FOR SUCH USE, AND FOR ROOF-MOUNTED w o O SYSTEMS, WIRING MUST BE PERMANENTLY AND COMPLETELY HELP OFF OF THE 0 o U) CO ROOF SURFACE. NEC 110.2 - 110.4 / 300.4 Z CDLL co 0 Q Y 9. ALL ROOF PENETRATIONS MUST BE FLASHED. SIMPLY CAULKING DOES NOT o ::1 Q �- 0 � 0 SUFFICE. W < _ ULo N a- _ m Q Q SHEET NAME ADDITIONAL NOTES SHEET SIZE ANSI B 11" X 17" SHEET NUMBER PV-5 REE ALPHA - - - - 9 REC HARVEST HARVEST POWER LLC SOLAR'S MOST TRUSTED R C C PREDUET SPECIFICATIONS . O a 2941 SUNRISE HIGHWAY ISLIP TERRACE,NY 11752 TEL:(801)989-3585 maet]S aalao.,l ,'QED website:www.harvest ower.nef aeoo"I ti GENERAL DATA ane.n \GJ�V R^ Cellt 80half-cut RECbifacial,heterojunctioncellswith -- -- -'-- �i G E L - �[-�,' �.• �.a' o r yam" lead-free,gapless technology * .a•.. � `� O �� REE ALPHA Glass 013in(3.2mm)solarglasswithantFrefnccord surface treatment 0 1 in accordance with EN RI50 Z 0 a Backsheet: Highly resistant polymer(black) 1traetan zmaa Z `-{' «, Frame: Anodized aluminum(black) 1 . PURER SERIES � 4-Part,i bypass diodes,lead-free s lunctionbox: i+ y IPGB rated,in accordance with NEC 62790 L�- SthIEC 285MC4 IP68onlyw enc(4mm1) 2 Connectors: ,� ''9$1 7 `C- VERSION inaaordancewithlEC 6285Z IP68 only when connected ��^""-O° '� PRODUCT SPECIFICATIONS Cable: ( ) 0�1 TION 12AWG(4mm)PVwire,67+67in 17+17m ss,as , v DATE REV. -`-• braccordamewith EN50618 - p1°"a t"'�'^'-' LDG.PERMIT 04/12/2024 0 i� Dimensions: 68ix44.Ox12in(20.77ftl/1730x1118x3Omm(193mI r.��.. ,a � ssrza m,r•al.._...._�Weight: 47.4lbs(21.S kg) e tR `. Origin: MadeinSingapore •p .� Meawm reenis in arches(mml ELECTRICAL DATA Product Code':RECxxxAA PURE-R Power Output-P_(Wp) 400 410 420 430 IEC 61215-2016.IEC 61730,2016.UL 61730 Watt Gass Sorting-(W) 0/*10 0/+10 0/+10 0/•10 IEC62804 PID IEC 61[701 Salt Mist M x Nominal Power Voltage-V.(V) 48.8 49.4 50.0 50.5 IEC62716 Ammonia Resistance Nominal Power Current-I_(A) 8.20 830 8.40 8.52 UL61730 Fire Type Class 2 to Open Circuit Voltage-V«(V) 58.9 592 59.4 S93 IEC62782 Dynamic Mechanical Load pia Short Circuit Current-Is<(A) 8.73 8.81 8.89 897 IEC61215-2:2016 Hailstone(35mm) IEC62321 Lead-free acc.toRoHSEU863/2015 Power Density(W/ftj 207 212 218 223 ISO 14001.150 9001,IEC 45001.1 EC 62941 • y �' Panel Efficiency(%) 20.7 21.2 21.8 n 223 PROJECT NAME Outpu rr•x(Wp) r, t Power t-P 305 312 320 327 0� C C F tr w Nominal Power Voltage-V�(V) 46.0 46.6 47.1 47.6 U IC_ Q C) C)TEMPERATURE RATINGS' Z Q (n C ) J O Nominal Power Current-I_(A) 6.64 6.70 6.78 6.88 W 0 � C 0 ZNominal ModuleOperatingTemperature: 44'C(+2•C) Open Circuit Voltage-V«(V) 55.5 55.8 56.0 563 Temperature coefficient ofP„,�: -0.26%/•C 0 (D _ _ Short Circuit Current-Ix(A) 7.05 7.12 7.18 7.24 Temperature coefficient ofVa: -0.24%/`C �/1 Q -� Val-at standard testconditians(5TC ai mass AM 15,irrada,ce1075W/sq it0000W/nrj temperature 77OF(25'C),based onaprodctim spread vJ f \f COMPACT PANEL SIZE with atoleranre ofp„�.,,Va&4,c t3%with-one watt ciass.Nom:ul module operating tmgerature(NMOT air mass AM 15.iradaxeSMW/M2. Temperature coefficient of Ise 0.04%/-C W O) � I`1/I temperature 6B'Ff2TQwi,dspeed 3.3ft/s[Im/sl`Where,mr'mdimtes therromival po-rdass(P,,�„)at STC above. 'The temperature coefficients stated are linear values O - O ^ O v/ IMAX1MUM RATINGS WARRANTY DELIVERY INFORMATION J O Z C) • •m•MODULE m SOystem voltage: -40...'�Ov y Standard RECPmTnat Panels anelsperr40ftGPhi hcubecontainer: 858(26 allets) Q O �..• •' Installedb anRK Y N } .>�► ■ a8� No Yes Yes P / g P . Certified Solar Professional t U r _� Z Testload(rear):front� +7000Pa(1461bs/ft�' System Size All Q5kW 25-500kW J ._I Test load(rear): -4000Pa(83.51bs/ftj' Product Warranty(yrs) 20 25 25 _WTBEHAVIOUR Q LL Q �• Typical low irradiance per forman ce of module at S TC, W C 1�" ? O Sertesfuserating: 25A PowerWarranry(yrs) 25 25 25 4 Reverse current: 25A Labor Warranty(yrs) 0 25 10 X ,. U LO 'Seeinstaaatbn manual for mountingginstructions. Power in Year 98% 98% 98% z - Q Z Design load-Test ioad/1.5(safety factor) Annual Degradation 025% 025% 025% W o c j Power in Year25 92% 92% 92% I _ m N c Q Q m m �,•i See warranty documents for details.Conditions apply - w -���- - a Available from: SHEET NAME H --■ - m SPEC SHEET - _ SHEET SIZE Founded in 1996,REC Group is an international pioneering solar energy company dedicated to empowering consumers with cleart,affordable solar power.As Fr f ANSI B m■ ■ m • . m ■. • Solar's Most Trusted.REC is committed to high quality innovation.and a low carbon footprint in the solar materials and solar panels it manufactures. ❑a - a Headquartered in Norwaywith operational headquartersin Singapore.REC alsohas regional hubs in North America.Europe,andAsia-Pacific. www.recgroup.com q 1 n X q 7n WE SHEET NUMBER PV-6 SOLARMOUNT ::• UNIRAC • I I • 1 . 11 I• 1 .I 1 . I , I' 1 BETTER DESIGNS C TRUST THE INDUSTRY'S BEST DESIGN TOOL CONCEALED UNIVERSAL Start the design process for every project in our U-Builder on-line design tool. ENDCLAMPSI Y It's a great way to save time and money. / BETTER SYSTEMS _ ONE SYSTEM-MANY APPLICATIONS Quickly sot modules flush to the roof on sleep 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 --- --' ^• � Compongnts available in mill,clear,and dark finishes to optimize your design financials WITH EVERY ENDCLAMP and aestiietics. BETTER RESULTS MAXIMIZE PROFITABILITY ON EVERY JOB CONCEALED Trust Unirac to help you m ninav both system and labor costs from the time the job is UNIVERSAL quoted to the time your learns get off the roof.Faster installs.Less Waste.More Profits. CLAMPS UNIVERSAL SELF sPUNIRAC BETTER SUPPORT STANDING MIOCLAMPS ' 25 WORK WITH THE INDUSTRIES MOST EXPERIENCED TEAM Professional support tot professional installers and designers.You have access to - - _ --• YEAR our technical support and training groups.Whatever your support needs,we've got • you covered.Visit Unifac.com/selarmount for more information. r\ I 1 •I OPTIONAL I • . . ' r ' FRONT TRIM PdRfl Aum �� U-BU • z � r LDER ONLINE DESIGN TOOL ISAVES TIME& MONEYui • • • o ` Visit design.unnac.cmn •BONDING&GRUUNDIN6 �—� `�-c',� . ® MECHANICAL LOADING — t • UL2703SYSTIM FIRE CLASSIFICATION • • 'I • UNIRAC CUSTOMER SERVICE MEANS THE HIGHEST LEVEL OF PRODUCT SUPPORT • ■ 1 ( I UNMATCHED CERTIFIED ENGINEERING BANKABLE DESIGN PERMIT I r 'll , I r• 1 II. 1 11 1 1 I 1 1 .r EXPERIENCE DUALITY EXCELLENCE WARRANTY TOOLS DOCUMENTATION ■ • ■ TECHNICAL SUPPORT CERTIFIED QUALITY PROVIDER BANKABLE WARRANTY Unirac'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&addressing issues in real time.An online certifications for 9001:2008.14001.2004 and OHSAS financial strength to back our productsand reduce your risk. THE PROFESSIONALS' CHOICE FOR RESIDENTIAL RACKING stamyofdocuments dtechnicaldtng asheetgreatly 180t,form.ndfunc means .Teseceerthehionsdehest demonstrate Have ceptioceofmin.SOLARMOUN are scoveredbproducts 5year stamped letters and technical datasheelsgreatly for fit,form,and function.These certificaiionsdemonstrate exegltionalquality.SOLARMOUNTiscoveredbya25year simplifies your permitting and project planning process. Dur excellence and eommitmeritto first class business practices. limited product warranty and a 5 year limited finish warranty. IIIIIII IIIIIII IIIIIIIIIilllllll l l llllllllll llllllllllllll llllll lllllll llli lilllllll llltl lllll llllllll l l lllll l lllllllitllilll lllll l l lllllllllllfllllllllllll lllllllllllllllllllllll llllillllll l ll llllllll lillif.Illllllllllllllllil llllllllllllllfilllllllll llllll 111 llllll llllll lllliilllllflllll l l llllllllllllllllllllllll lllllllllllllllllllllllillllllllllllllll l l i i BEST INSTALLATION EXPERIENCE-CURB APPEAL•COMPLETE SOLUTION•UNIRAC SUPPORT ENHANCE YOUR REPUTATION WITH QUALITY RACKING SOLUTIONS BACKED BY ENGINEERING EXCELLENCE AND A SUPERIOR SUPPLY CHAIN FOR QUESTIONS 0R CUSTOMER SERVICE VISIT UNIRAC.00M 0R CALL (505) 248 2702 FOR QUESTIONS OR CUSTOMER SERVICE VISIT UNIRAC.COM OR CALL (505) 248-2702 1HP t Pz HARVESTDOW11 HARVEST POWER LLC 2941 SUNRISE HIGHWAY ISLIP Y 11752 truct ral structural TERRACE,N9-3585 ENGINEERS TEL:(801) vestpow NGINE�ERS 1ERE �lveb ' :www.harvest ower.net March 28,2022 Installation Orientation: See SOLARMOUNT Rail Flush Installation Guide. �5 Landscape-PV Panel long dimension is parallel to ridge/eave line of roof and the PV Unirac panel is mounted on the long side. 1411 Broadway Blvd.NE Portrait-PV Panel short dimension is parallel to ridge/eave line of roof and the PV a0el Albuquerque,NM 87102 is mounted on the short side. ,A 1 Attn.: Unirac-Engineering Department Components and Cladding Roof Zones: 0`��' � The Components and Cladding Roof Zones shall be determined based on ASCE 7-05,ASCE 7-10&7-16 Component an � 8 Re:Engineering Certification for the Unirac U-Builder 2.0 SOLARMOUNT Flush Rail ERSION Cladding design. of N TION DATE REV. PZSE,Inc.-Structural Engineers has reviewed the Unirac SOLARMOUNT rails,proprietary mounting system constructed BLDG.PERMIT 04/12/2024 0 Notes: 1)U-builder Online tool analysis is only for Unirac SM SOLARMOUNT Rail Flush systems only and do not from modular parts which is intended for rooftop installation of solar photovoltaic(PV)panels; and has reviewed the U- include roof capacity check. builder Online tool.This U-Builder software includes analysis for the SOLARMOUNT LIGHT rail,SOLARMOUNT 2)Risk Category 11 per ASCE 7-16. STANDARD rail,and SOLARMOUNT HEAVY DUTY rail with Standard and Pro Series hardware. All information,data and 3)Topographic factor,kzt is 1.0. analysis contained within are based on,and comply with the following codes and typical specifications: 4)Array Edge Factor YE=1.5 1. Minimum Design Loads for Buildings and other Structures,ASCE/SEI 7-05,ASCE/SEI 7-10,ASCE/SEI 7-16 5)Average parapet height is 0.0 ft. 2. 2006-2020 New York State Building Code,by International Code Council,Inc and New York State Department of 6)Wind speeds are LRFD values. State. 7)Attachment spacing(s)apply to a seismic design category E or less. 3. 2006-2020 New York State Residential Code,by International Code Council,Inc and New York State Department of State. Design Responsibility: 4. 2006-2018 International Building Code,by International Code Council,Inc.w/Provisions from SEAOC PV-2 2017. The U-Builder design software is intended to be used under the responsible charge of a registered design professional 5. 2006-2018 International Residential Code,by International Code Council,Inc.w/Provisions from SEAOC PV-2 where required by the authority having jurisdiction.In all cases,this U-builder software should be used under the PROJECT NAME 2017. direction of a design professional with sufficient structural engineering knowledge and experience to be able to: L1J 6. AC428,Acceptance Criteria for Modular Framing Systems Used to Support Photovoltaic(PV)Panels,November a Evaluate whether the U-Builder Software is applicable to the project,and z ❑ < O 1,2012 by ICC-ES. Q Understand and determine the appropriate values for all input parameters of the U-Builder software. w ❑ � O 7. 2015 Aluminum Design Manual,by The Aluminum Association,2015 Q _ This letter certifies that the Unirac SM SOLARMOUNT Rails Flush,when installed according to the U-Builder engineering � ) J Following are typical specifications to meet the above code requirements: � Q (� ❑ report and the manufacture specifications,is in compliance with the above codes and loading criteria. LLB Y 0') (N w 0 Design Criteria: Ground Snow Load=0-100(psf) O } C:) U) fn Basic Wind Speed=85-190(mph) This certification excludes evaluation of the following components: J 0 Z q) LL Roof Mean Height=0-60(ft) 1) The structure to support the loads imposed on the building by the array;including,but not limited to:strength Q Q Y N } O Roof Pitch=0-45(degrees) and deflection of structural framing members,fastening and/or strength of roofing materials,and/orthe effects N Z Exposure Category=B,C&D of snow accumulation on the structure. J Q D CCU Attachment Spacing: Per U-builder Engineering report. 2) The attachment of the SM SOLARMOUNT Rails to the existing structure. LJJ 7 �_ O I— O 3) The capacity of the solar module frame to resist the loads. c) H Cantilever: Maximum cantilever length is L/3,where"L is the span noted in the U-Builder online ZD H *k tool. This requires additional knowledge of the building and is outside the scope of the certification of this racking system. CJr N < z Q Clearance: 2"to 10"clear from top of roof to top of PV panel. DIGITALLY SIGNED CIDQ If you have any questions on the above,do not hesitate to call. pF Nt Tolerance(s): 1.0"tolerance for any specified dimension in this report is allowed for installation. A, K Z,4 y0 Prepared by: SHEET NAME PZSE,Inc.—Structural Engineers Roseville,CA 0 SPEC SHEET xo 0 SHEET SIZE 1478 Stone Point Drive,Suite 190, Roseville,CA 95661 1478 Stone Point Drive,Suite 190, Roseville,CA 95661 pRO�1365 F ANSI B 916.961.3960 916,961.3965 www.pzse.com 916.961.3960 916.961.3965 www.pzse.corn ESSION 11" X 17" SHEET NUMBER PV-8