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HomeMy WebLinkAbout51658-Z TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 51658 Date: 02/19/2025 Permission is hereby granted to: Robert J Haase Jr 400 Waterview Dr Southold, NY 11971 To: install roof-mounted solar panels to existing single-family dwelling as applied for. Premises Located at: 400 Waterview Dr, Southold, NY 11971 SCTM# 78.-7-55 Pursuant to application dated 01/06/2025 and approved by the Building Inspector. To expire on 02/19/2027. Contractors: Required Inspections: Fees: SOLAR PANELS $100.00 ELECTRIC -Residential $125.00 CO-RESIDENTIAL $100.00 Total $325.00 Building Inspector � µ TOWN OF SOUTHOLD—BUILDING DEPARTMENT � Town Hall Annex 54375 Main Road P. O.Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 htt S://NV a W.SQ Lit 110 Idtawliny.gov Date Received BUILDINGAPPLICATION FOR For Office Use Only f PERMIT NO, L.- k.� Building Inspector: JAIq — 6 25 Applications and forms must be filled out in their entirety. Incomplete applications will not be accepted. Where the Applicant is not the owner,an Building Depadment Owner's Authorization form(Page 2)shall be completed. Town of Southold Date: 01-02-25 OWNER(S)OF PROPERTY: Name: Robert Hasse SCTM#s000-078.00-07.00-055.000 Project Address: 400 Waterview Dr, Southold, NY 11971 Phone#: (631) 926-3737 Email:rhaase3737@yahoo.com Mailing Address: 400 Waterview Dr, Southold, NY 11971 CONTACT PERSON: Name: Michele Wise (EmPower CES LLC) Mailing Address:999 Stewart Ave, Suite 210, Bethpage, NY 11714 Phone#: 516-544-4592 Email: permitting@empower-solar.com DESIGN PROFESSIONAL INFORMATION: Name:Gregory Sachs, PE Mailing Address:999 Stewart Ave, Suite 210, Bethpage, NY 11714 Phone#: 516-837-3459 Email: permitting@empower-solar.com CONTRACTOR INFORMATION: Name: EmPower CES LLC Mailing Address: 999 Stewart Ave, Suite 210, Bethpage, NY 11714 Phone#: 516-837-3459 Email: permitting@empower-solar.com DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: 420ther Installation of roof mounted solar panels 27 MXN-6-440 W s37,935.69 Will the lot be re-graded? ❑Yes 2No Will excess fill be removed from premises? ❑Yes 2No �I 1 PROPERTY INFORMATION Existing use of property: Residental one family Intended use of property: Residental one family 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 15 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 210AS of the New York State Penal Law. Application Submitted By(print name): Michele Wise 2Authorized Agent ❑Owner Signature of Applicant: Date: 01/02/25 STATE OF NEW YORK) SS: COUNTY OF Suffolk ) Michele Wise being duly sworn,deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)he is the Agent (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 02 January day of 20 25 Notary Public Nf l a.41w1 P1 �� RWhere h OWNER �'I,,,1 RIZAT IN i�"NMCWME Y NO.OI MC64254'12 ( applicant is not the owner) 0461111111601 In NOmu County �afl!!EM NovwMmr,22,2021 Robert Hasse residing at 400 Waterview Dr, Southold, NY 11971 do hereby authorize Michele Wise to apply on my behalf to the Town of Southold Building Department for approval as described herein, 01/02/25 Owner's Signature Date Robert Hasse Print Owner's Name 2 ff BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD a Town Hall Annex - 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 ;w tir Telephone (631) 765-1802 - FAX (631) 765-9502 roger_r@southoldtownny.gov — seand southoldtownn . ov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: 01/02/25 Company Name: EmPower CES, LLC Name: Timothy CroLty License No.: ME-65990 email: permitting@empower-solar.com Address: 999 Stewart Ave Suite 210 Bethpage, NY 11714 Phone No.: 516-544-4592 JOB SITE INFORMATION (All Information Required) Name: Robert Hasse Address: 400 Waterview Dr, Southold NY 11971 Cross Street: Phone No.: 631 926-3737 Bldg.Permit#: 91�-j" email: rhaase3737@yahoo.com Tax Maps District: 1000 Section: 078.00 Block: 07.00 Lot: 055.000 BRIEF DESCRIPTION OF WORK (Please Print Clearly) Installation of roof mounted solar panels (27) MXN-6-440 W Circle All That Apply: Is job ready for inspection?: YES / NO Rough In Final Do you need a Temp Certificate?: YES / NO Issued On Temp Information: (All information required) Service Size 1 Ph 3 Ph Size: A # Meters Old Meter# New Service- Fire Reconnect- Flood Reconnect- Service Reconnected - Underground - Overhead Underground Laterals 1 2 H Frame Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION Request for Inspection Formals SURVEY OF PROPERTY AT BAYVIEW TOWN OF SOUTHOLD MD. " - SUFFOLK COUNTY, N.Y. 1000-78-07 55 SCALE- 1=40' ry' JUNE 17, 1998 ' A � � FEBRUARY 11, 2015 q,,.., ""'" JANUARY28, 2020(AS BUILT GARAGE) APRIL 1, 2024(FINAL SURVEY) 04�, xmy..& s SEPTIC SYSTEM AS INSTALLED He w [11 1250 gal.SEPTIC TANK --A ryC", W)TH TRAFFIC BEARING 70P Q [21 8 FT. DIA. X 6 F7.DEEP PRECAST `AN CONCRETE LEACHING RINGS "lp SCDHS REF. Na R 20-1359 G o3p SEPTIC LOCATION cf- A' B- ST 15, 43' LP(1) 26.5' }9' yry 1 2 cCb CO ai Uri UM eado, 4 CERTIFIED TO: FIDELITY NATIONAL TITLE INSURANCE COMPANY ASSOCIATED MORTGAGE BANKERS, INC., ISAOA ROBERT HAASE RACHEL HAASE AREA - 41,4M SO. Fr. hf.Yf. VC.. Na 49618 ANY ALIERA770M OR ADDIDON TO THIS SURVEY IS A WOLA77ON PECON/C SURVEYORS, P.C. OF SEC710N 7209OF THE NEW YORK STALE EDUCA80N LAW. EXCEPT AS PER SEC7708 7209—SUBDIVISION 2.ALL CER77RCA17DNS (631) 765-5020 FAX(631) 765-1797 HEREON ARE VALID FOR 7HIS MAP AND COPIES THEREOF ONLY IF P.O. BOX 909 SAID MAP OR COPIES BEAR 7HE IMPRESSED SEAL OF THE SURVEYOR 1230 TRAVELER STREET WHOSE SIGNATURE APPEARS HEREON. SOUTHOLD. N.Y. 11971 Suffolk County Dept.of Labor,Licensing &Consumer Affairs MASTER ELECTRICAL LICENSE Name TIMOTHY M GROTTY Business Name Empower CES LLC DBA This certifies that the bearer is duly licensed License Number ME-65990 by the County of suffolk Issued: 1111212021 Je�&x Cabrer& Expires: 11101/2025 Commissioner Suffolk County Dept.of Labor,Licensing &Consumer Affairs HOME IMPROVEMENT LICENSE Name GREGORY SACHS Business Name EMPOWER CES LLC DBA This certifies that ft bearer is duly wensed License Number H-50211 by the County Of suffOk issued: 05/30/2012 Expires: 0510112026 Commissioner t NYSIF PO Box 66699,Albany,NY 12206 New York State Insurance Fund I nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE A A A A A 522407627 ®� ` r AMWINS INSURANCE BROKERAGE LLC , 200 ELWOOD DAVIS ROAD SUITE 200 LIVERPOOL NY 13088 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER EMPOWER CES LLC TOWN OF SOUTHOLD 999 STEWART AVE,SUITE 210 54375 ROUTE 25 BETHPAGE NY 11714 SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE Z 2546 624-4 706038 05/01/2024 TO 05/01/2025 04/19/2024 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2546 624-4, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY, INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE, VISIT OUR WEBSITE AT HTTPS://WWW.NYSIF.COM/CERT/ CERTVAL.ASP. THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY AFFORDS COVERAGE TO THE SOLE PROPRIETOR, PARTNERS AND/OR MEMBERS OF A LIMITED LIABILITY COMPANY. DAVID SCHIEREN GREG SACHS EMPOWER CES LLC THIS CERTIFICATE DOES NOT APPLY TO THOSE JOB SITES WHICH ARE COVERED BY OTHER INSURANCE AND ARE SPECIFICALLY EXCLUDED BY ENDORSEMENT. THE POLICY INCLUDES A WAIVER OF SUBROGATION ENDORSEMENT UNDER WHICH NYSIF AGREES TO WAIVE ITS RIGHT OF SUBROGATION TO BRING AN ACTION AGAINST THE CERTIFICATE HOLDER TO RECOVER AMOUNTS WE PAID IN WORKERS' COMPENSATION AND/OR MEDICAL BENEFITS TO OR ON BEHALF OF AN EMPLOYEE OF OUR INSURED IN THE EVENT THAT, PRIOR TO THE DATE OF THE ACCIDENT, THE CERTIFICATE HOLDER HAS ENTERED INTO A WRITTEN CONTRACT WITH OUR INSURED THAT REQUIRES THAT SUCH RIGHT OF SUBROGATION BE WAIVED. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUND /"'� 4 DIRECTOR,I SU'RANCE FUND UNDERWRITING VALIDATION NUMBER: 547880610 II II III IIII000�0000000011216748554111111111111111111 Form WC-CERT-NOPRINT Version 3(08/29/2019)[WC Policy-25466244] U-26.3 201 r000000000001267466641r0001-0000254662441r##Z1r16372-33lrCert NoP-CERT 11r01-000011 - �. EMPOCES-01, ���, " CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY E/1/2024 ) 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 rights to the certificate holder in lieu of such endorsementis). PRODUCER License#077776 NCONTACT Ana Bello HUB International Insurance Services Inc. PHONE FAX 600 Corporate Pointe AN, rana3bello68hubinter Suite 600 A Dt3 � ...� ._ national com � Culver City,CA 90230 y ... —..... i t_ ERACmE .. . NAtC�� tNSkJff� �!S AFFORDING COV.._ µ. INSURER A µSouthwest Marine&General Insurance Company 12294 INSURED � INSgRITpm Certain Underwriters at Lloyds...._-—, - EmPower CES LLC INSURER C;Colony Insurance_Com,pany.W 39993 999 Stewart Avenue,Suite 210 �t?sp.R.ER..p......,� as ... ........ �..�,_ �.m Bethpage,NY 11714 ^' INSURER F: COVERAGES, _ Cl RTIFICATE NUMBER, REVISION!NtfMHER" 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. _ .......... TYPEOFINSURANCE.... -, ,.INSD_ .,....lnin POLICY.......... LIMITSLJR -...�..�.._.. INSR ADDL SUBR POLICY EFF POLICY EXP/ NUMBER A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 OCCUR PK202400006109 5l4/2024 5/4/2025 DAMAGE TO RENTED rjQQ,000 �., CLAIMS-MADE X� X _.)'RFN14.S.E54EeSJ�f�M1�.f���P1 ME,La EXP An one, erson . ,,_ 10,000 PERSONAL,&ADV„NJU,Ry $ 2,000 000 LOLICY X TAPP AGGREGATE 4,000,000, T 4,000,000 POLICY ATE LIMIT ❑ T P/OP AGG $ ... Gl LIES PER: GENERAL, _ 11-11 OTHER: Loc PER PROJECTAGG $ 5,000,000 COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY �. ,gGpt� -,,..., ..„,.. „,..,, ........a.... ANY AUTO IODILXINJURY(Per erson)„,._.,§„WWOWNED ,,,_,�,., _ w._........... BODILY INJURY, Per accident $ AUTOS ONLY SCHEDULED L_ ).,... ............e AMVp� ,.. N AMAG,E S ONLY .... ALTO L'kN. [-rO B EXCESSUMBRE LAB OCCUR ENVXSS425160 5/4/2024 5/4/2025 AGGRpGAURRENCE $ 3,000,000 30000 TE X EXCESS LIAB X CLAIMS MADE DED RETENTION$ $ WORKERS COMPENSATION jo _ PER OTH- EB AND EMPLOYERS' LITY YIN �AC I DE atory ) ... $ NYnPROPRIET PROPRIETOR/PARTNER/EXECUTIVE F L D SEASECEA EMPLOYEE$ O Ftl�.ER/MEMBER EXCLUDED? N/A If yes,describe under -- DESCRIPTION OF OPERATION below E.L.DISEASE-POLICY LIMIT $ C Excess(1M x 3M) EX04287265 5/4/2024 5/4/2025 Aggregate/Occ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached It.snore,Space is required) The certificate holder is listed as additional insured per attached endorsements#G20100413&#CG203.0413 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 ACCORDANCE WITH THE POLICY PROVISIONS. 54375 Route 25 Southold,NY 11971 AUTHORIZED REPRESENTATIVE 4UJa0W_ ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD a POLICY NUMBER: PK202400006109 COMMERCIAL GENERAL LIABILITY CG 2010 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSENS OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations Any person or organization to the extent required of you All Covered Locations by a written contract executed; however, the written contract must be: 1. Currently in effect or becoming effective during the term of this policy; and 2. Executed by you before the "occurrence". Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for "bodily injury", "property This insurance does not apply to "bodily injury" or damage" or "personal and advertising injury" "property damage"occurring after: caused, in whole or in part, by: 1. All work, including materials, parts or 1. Your acts or omissions; or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs) to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the location(s) location of the covered operations has been completed; or designated above. However: 2. That portion of "your work" out of which the injury or damage arises has been put to its 1. The insurance afforded to such additional intended use by any person or organization insured only applies to the extent permitted by other than another contractor or subcontractor law; and engaged in performing operations for a 2. If coverage provided to the additional insured is principal as a part of the same project. required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 10 0413 © Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these 2. Available under the applicable Limits of additional insureds, the following is added to Insurance shown in the Declarations; Section III—Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement, the most we applicable Limits of Insurance shown in the will pay on behalf of the additional insured is the Declarations. amount of insurance: 1. Required by the contract or agreement; or Page 2 of 2 ©Insurance Services Office, Inc., 2012 CG 2010 0413 POLICY NUMBER: PK202400006109 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED ETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations (Any person or organization to the extent required of you by a written contract executed; however, the written contract must be: 1. Currently in effect or becoming effective during the term of this policy; and 2. Executed by you before the"occurrence"..) Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III—Limits Of Insurance: with respect to liability for "bodily injury" or If coverage provided to the additional insured is "property damage" caused, in whole or in part, by required by a contract or agreement, the most we "your work" at the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional insured and 1. Required by the contract or agreement; or included in the products-completed operations hazard". 2. Available under the applicable Limits of However: Insurance shown in the Declarations; 1. The insurance afforded to such additional whichever is less. insured only applies to the extent permitted This endorsement shall not increase the applicable by law; and Limits of Insurance shown in the Declarations. 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 r workers' CERTIFICATE OF INSURANCE COVERAGE POR ST K ATE Compensation Board NYS DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW PART 1.To be completed by NYS disability and Paid Family Leave benefits carrier or licensed insurance agent of that carrie 1 a. Legal Name&Address of Insured(use street address only) 1 b. Business Telephone Number of Insured EMPOWER CES LLC DBA EMPOWER SOLAR 310-534-7994 999 STEWART AVENUE, SUITE 210 BETHPAGE, NY 11714 1 c.Federal Employer Identification Number of Insured or Social Security Number Work Location of Insured(Only required if coverage is specifically limited to certain locations in New York State,i.e,, Wrap-Up Policy) 522407627 2. Name and Address of Entity Requesting Proof of Coverage 3a. Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) ShelterPoint Life Insurance Company TOWN OF SOUTHOLD 54375 ROUTE 25 3b, Policy Number of Entity Listed in Box"l a" SOUTHOLD, NY 11971 DBL252634 3c.Policy effective period 05/10/2023 to 05/09/2025 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. Signed Date 4/5/2024 By ��a t (Signature of insurance carrier's authorized representative or NYS Licensed Insurance Agent of that insurance carrier) Telephone Number 516-829-8100 Name and Title Richard White Chief Executive Officer IMPORTANT: If Boxes 4A and 5A are checked, and this form is signed by the insurance carrier's authorized representative or NYS Licensed Insurance Agent of that carrier,this certificate is COMPLETE. Mail it directly to the certificate holder. If Box 4B,4C or 5B is checked,this certificate is NOT COMPLETE for purposes of Section 220, Subd.8 of the NYS Disability and Paid Family Leave Benefits Law. It must be emailed to PAU@wcb.ny.gov or it can be mailed for completion to the Workers'Compensation Board, Plans Acceptance Unit, PO Box 5200, Binghamton, NY 13902-5200. PART 2.To be completed by the NYS Workers' Compensation Board (only if Box 413,4C or 513 have been checked) State of New York Workers' Compensation Board According to information maintained by the NYS Workers' Compensation Board,the above-named employer has complied with the NYS Disability and Paid Family Leave Benefits Law(Article 9 of the Workers'Compensation Law)with respect to all of their employees. Date Signed By (Signature of Authorized NYS Workers'Compensation Board Employee) Telephone Number Name and Title Please Note:Only insurance carriers licensed to write NYS disability and paid family leave benefits insurance policies and NYS licensed insurance agents of those insurance carriers are authorized to issue Form DB-120.1. Insurance brokers are NOT authorized to issue this form. DB-120.1 (12-21) 11111111111111111111111111111 i � vc Gregory Sachs, PE 999 Stewart Avenue,Suite 210 (516)-544-4115 Bethpage, NY 11714 permitting@empower-solar.com January 2, 2025 To Whom It May Concern: The purpose of this letter is to certify that the existing roof structure located at: 400 Waterview Drive,Southold, NY 11911 can support the additional load of the solar energy system, in addition to wind,snow and gravity. Portions of roof structure covered and not covered with photovoltaic panels are in compliance with R324.4.1.1. Furthermore,it has.been determined that the structure complies with the 2020 Residential Code of New York State including the ASCE 7.:Please see Table 1 below for specific data relating to the calculations for each roof structure involved in the solar energy system installation. Table 1 Rafter Snow Wind ' Max Span Layers of Roof Surface ft spacing Cross Section Load Speed Kneewall Collar Ties ( ) (in) (psf) (mph) Shingles South 1 20.83 12 . Nominal 2x12 20 140 Yes No 1 1. Sincerely, Gregory Sachs, PE. . sAt- t 2 3 4 5 6 7 8 9 10 11 12 13 EMPOWER SOLAR 999 STEWART AVENUE,SUITE 210 0 BETHPAGE,NY 11714 TEL:516-837-3459 RESIDENTIAL FAX: 516-706-1789 www.empower-so[ar.com H SOLAR PROJECT H PTHE ROPERTY INFORMATION EMPOWER SE HERLLC. IN IS THE SOLE IZED REPRODUCTION OR DISTRIBUTION OF THIS PROJECT TEAM. MATERIAL IS STRICTLY PROHIBITED WITHOUT PRIOR SPECIFIC WRITTEN PERMISSION PROFESSIONAL SEAL OWNER: Robert Haase �.f1 Y.0R"/f- G G C� SAC A 2 Q OQ_'y Q1 cr c• PHONE: (631) 926-3737 ENGINEER OF RECORD: p6ay S�� F : GREGORY SACHS, PE F `/c `,ROF`�cb EMPOWER SOLAR �sED 999 STEWART AVENUE, SUITE 210 999 STEWART AVENUE, SUITE 210 BETHPAGE, NY 11714 BETHPAGE, NY 11714 PHONE:516-837-3459 E PHONE:516-837-3459 E D /y D REV: DESCRIPTION: DATE: PROJECT LOCATION DATA: SHEET INDEX: PROJECT NAME: P� Robert Haase ADDRESS:400 Waterview Dr, Southold, ST-01 COVER SHEET NY 11971 S-01 EQUIPMENT LOCATIONS 5 S-02 STRUCTURAL PROJECT LOCATION: SE-01 ELECTRICAL C 400 Waterview Dr, Southold, SE-02 THREE-LINE ELECTRICAL NY 11971 SCHEMATIC p PROJECT#: t PROJ.PHASE: PERMIT DATE: 1/2/2025 B B DESIGNED BY: ED CHECKED BY: GS SCALE: NTS MAP TITLE: COVER SHEET A A SHEET: ST-01 1 2 3 4 5 6 7 8 9 10 11 12 13 1 2 3 4 5 6 7 6 9 10 11 12 13 EQUIPMENT LEGEND: EMPOWER I 'SO LAR MODULES 999 STEWART AVENUE,SUITE 210 BETHPAGE,NY 11714 o TEL:516-837-3459 $ FAX: 516-706-1789 UTILITY METER www,empower-soIar.com H THE INFORMATION DISCLOSED HEREIN IS THE SOLE H PROPERTY OF EMPOWER CES,L-C.UNAUTHORIZED 4 3 INVERTERS REPRODUCTION OR DISTRIBUTION OF THIS MATERIAL IS STRICTLY PROHIBITED WITHOUT PRIOR SPECIFIC WRITTEN PERMISSION W PROFESSIONAL SEAL O 4❑ SOLAR DISCONNECT G > - . 5AC' MAIN SERVICE PANEL G k AO^ Z w: oc. � F F W n/ 1 E LIB SOUTH-1 ROOF: E W 27 MXN 440W-DCPV PANELS TOTAL POWER: 11.88 kW [ 1111L ORIENTATION: 160°; PITCH: 19° 1 TYPE 1: FLUSH MOUNT Q SOLAR ACCESS:92% 0 fill D TSRF: 88% D REV: DESCRIPTION: DATE: PROJECT NAME: HAASE RESIDENCE PROJECT LOCATION: c SETBACK LEGEND C 400 WATERVIEW DRIVE, SOUTHOLD,NY 11971 36"CLEAR PATH PROJECT#: ® 18"RIDGE SETBACK PROJ.PHASE: PERMIT DATE: 01/02/2025 B B DESIGNED BY: BD ® ACCESS ROOF CHECKED BY: GS SCALE: NTS TITLE: EQUIPMENT LOCATIONS A DRIVEWAY ROOF LAYOUT NOT TO SCALE A SHEET: S-01 1 2 3 4 5 6 7 8 9 10 11 12 13 1 2 3 4 5 6 7 8 9 10 11 12 13 EMPOWER 'SO LAR 999 STEWART AVENUE,SUITE 210 SUNPOWER MODULES - BETHPAGE,NY 11714 ON INVISIMOUNT RACKING TEL: 516-837-3459 SHINGLES FAX: 516-706-1789 www.empower-soIar.com SCLOSED HEREIN IS THE SOLE H THE INFORMA71ON H PROPERTY OF EMPOIWER CES,U-C.UNAUTHORIZED RAFTERS REPRODUCTION OR DISTRIBUTION OF THIS MATERIAL IS STRICTLY PROHIBITED WITHOUT PRIOR SPECIFIC WRITTEN PERMISSION PROFESSIONAL SEAL Y a R'K _ G G fi 2 . Q �- .^ 2 TYPICAL ROOF SECTION F cFNSE D FRp�`�` NOT TO SCALE SUNPOWER PANEL SPECS E MODULE POWER(Wdc) QTY MODEL# LENGTH WIDTH DEPTH WEIGHT TABLE S-1.1: MAX.ATTACHMENT SPACING E MXN-440 27 SPR-M-SERIES-AC 73.7" 40.6" 1.57" 48.0 LB PORTRAIT: 5'-4" LANDSCAPE: 8'-0" SPR-A-SERIES-AC 72.2" 40.0" 1.57" 46.5 LB SPR-E/X-SERIES-AC 61.4" 41.2" 1.81" 42.9 LB D REV. DESCRIPTION: DATE: NOTES' PROJECT NAME: 1. TOTAL SYSTEM DC POWER:11.88 kW 2. RACKING SYSTEM INSTALLED IN ACCORDANCE WITH CODE-COMPLIANT INSTALLATION Robert Haase MANUAL 3.ATTACHMENTS,TO BE SECURED TO ROOF ASSEMBLY USING 5 mm STAINLESS STEEL SCREWS PROJECT LOCATION: c AND/OR 5/16"STAINLESS STEEL LAG BOLTS SPACED ACCORDING TO TABLE S-1.1 400 Waterview Dr, Southold, 4. ALL ATTACHMENTS TO ROOF, MOUNTING BRACKETS & HARDWARE MEET OR EXCEED NYS , c NY 11971 CODE REQUIREMENTS 5. INSTALLATION TYPICALLY MAINTAINS 7/8 INCH SPACING BETWEEN MODULES 6. SIZES OF STRUCTURAL MEMBERS THAT WERE NOT ACCESSIBLE FOR DIRECT MEASUREMENT PROJECTM ARE BASED ON OBSERVATIONS OF ACCESSIBLE MEMBERS, CONSTRUCTION DEPTH OR PROJ.PHASE: PERMIT BOTH IN ADDITION TO KNOWLEDGE OF STANDARD CONSTRUCTION PRACTICES AT THE DATE: 1/2/2025 B TIME OF CONSTRUCTION B DESIGNED BY: ED 7. THIS DOCUMENT CERTIFIES THAT THE ROOF STRUCTURE HAS BEEN CHECKED FOR WIND, CHECKED BY: GS SNOW, UNBALANCED SNOW, LIVE AND DEAD LOADS BASED ON ASCE 7-10 CHAPTER 30 - SCALE: NTS WIND LOADS - COMPONENTS AND CLADDING (C&C) AND FOR CONFORMANCE WITH THE TITLE: 2020 RESIDENTIAL CODE OF NEW YORK STATE. THIS CERTIFICATION DOES NOT APPLY TO STRUCTURAL ANY ADDITIONAL ROOF ALTERATIONS AFTER THE DESCRIBED INSTALLATION A 8.THIS ROOF STRUCTURE AS SHOWN IS ADEQUATE TO SUPPORT THE PROPOSED LOADS A 9. REFER TO STRUCTURAL LETTER FOR SITE SPECIFIC AND ROOF SURFACE DATA SHEET: S-02 1 2 3 4 5 6 7 8 9 10 11 12 13 1 2 3 4 5 6 7 8 9 10 11 12 13 EMPOWER NOTES: , SOLAR 999 STEWART AVENUE,SUITE 210 BETHPAGE,NY 11714 0 1. NEUTRAL&GROUND ARE BONDED TOGETHER(ORIGIN OF GEC FOR SOLAR TEL:516-837-3459 ELECTRIC SYSTEM) FAX: 516-706-1789 2. GEC FROM SOLAR ELECTRIC SYSTEM BONDED TO EXISTING GEC IN THE MAIN www.empower-soIar.com STANDARD INVERTER ASSEMBLY: SERVICE PANEL USING'SPLIT-BOLT CONNECTOR' THE INFORMAONEIN IS THE SOLE H 3. IN SOME CASES POWER FOR DATA MONITORING ENCLOSURE MAYBE H PROPERTY OFnEM OPOWER ISCLCES,LLSED EC.UNAUTHORIZED REPRODUOF THIS DERIVED FROM MAIN SERVICE PANEL MATERIAL IS STRICTLY ION ORIPROHIBITIED ON WITHOUT PRIOR SPECIFIC WRITTEN PERMISSION 4. CONNECT UTILITY SIDE TO PANEL LUGS PROFESSIONAL SEAL 5. USE TAP RULES FOR SIZING TAP CONDUCTORS (NEC 240.21) 6. SIZE GEC AND EGC AS PER NEC 250.66, NEC 250.122 RESPECTIVELY 7. PROTECT GEC AND EGC SUBJECT TO PHYSICAL DAMAGE AS PER NEC Y O R, G SOLAR 250.64(B), NEC 250.120(C) G SAC ARRAY 1 8. FINAL SCHEMATIC SPECIFIC TO THIS INSTALLATION AVAILABLE UPON p.�A f� REQUESTINVERTER O AC h,, o DISCONNECT F cb�\ F CFNSED E STANDARD EXTERIOR INTERCONNECTION: STANDARD INTERIOR INTERCONNECTION: D D REV: DESCRIPTION: DATE: PROJECT NAME: INTERIOR EXTERIOR INTERIOR EXTERIOR Robert Haase PROJECT LOCATION: 400 Waterview Dr, Southold, c MAIN TAP BREAKER MAIN NY 11971 SERVICE ENCLOSURE G) 1 PANELETTE SERVICE O PANEL PANEL PROJECT#: UTILITY UTILITY PROJ.PHASE: PERMIT METER METER DATE: 1/2/2025 B B DESIGNED BY: ED 1 CHECKED BY: GS SCALE: NTS TITLE: ELECTRICAL A A SHEET: SE-01 1 2 3 4 5 6 7 8 9 10 11 12 13 2 3 4 5 6 7 8 9 10 11 12 13 ENCLOSURE UTILITY EMPOWER NEMA 3R METER S O L A R I M 999 STEWART AVENUE,SUITE 210 TO MAIN TOBETHPAGE,NY 11714 STRING C STRING B STRING A SERVICE UTILITY TEL: 516-837-3459 (7)SPR-MAX6-440 (10)SPR-MAX6-440 (10)SPR-MAX6-440 FAX: 516-706-1789 44OW MODULES 440W MODULES 440W MODULES PANEL GRID w w w,e m p o w e r-s o I a r.c o m TOTAL DC STC POWER:3.08 KW TOTAL DC STC POWER:4.40 KW TOTAL DC STC POWER:4.40 KW AC2 (3)MID-CIRCUIT INTERRUPTERS (4)MID-CIRCUIT INTERRUPTERS (4)MID-CIRCUIT INTERRUPTERS THE INFORMATION DISCLOSED HEREIN IS THE SOLE H H PROPERTY OF EMPOWER CES,LLC.UNAUTHORIZED REPRODUCTION OR DISTRIBUTION OF THIS MATERIAL IS STRICTLY PROHIBITED WITHOUT AC DISCONNECT PRIOR SPECIFIC WRITTEN PERMISSION 60A, 2P CB PROFESSIONAL SEAL 2 N DC1 L1 L Dc1 DC1 G ��Y 10RKiF G G �C� O SAC TESLA7.6kW .O INVERTER (U 0 40A, 2P CB F �i AC1 F /cl E D P E E AC COMBINING MLO PANEL D 1 - PHASE 120/240V D REV: DESCRIPTION: DATE: PROJECT NAME: LABEL DESCRIPTION LABEL DESCRIPTION HAASE RESIDENCE DC1 3/4"PVC AC1 1"PVC PROJECT LOCATION: C (2)#10 AWG (2)#6 AWG (1)#10 AWG,EGC (1)#8 AWG,EGC C 400 WATERVIEW DRIVE, SOUTHOLD,NY 11971 AC2 1 1/4"PVC (3)#4 AWG (1)#6 AWG,GEC PROJECT#: PROJ.PHASE: PERMIT DATE: 11/01/2024 B B DESIGNED BY: BD CHECKED BY: XX SCALE: NTS TITLE: THREE LINE NOTES: ELECTRICAL SCHEMATIC A 1.NEUTRAL&GROUND ARE BONDED TOGETHER(ORIGIN OF GEC FOR SOLAR ELECTRIC SYSTEM) TOTAL SYSTEM SIZE: 11.88 kW 2.GEC FROM SOLAR ELECTRIC SYSTEM BONDED TO EXISTING GEC IN THE MAIN SERVICE PANEL USING IRREVERSIBLE SPLICE (27) SPR-MAX6-440 440W-DCPV MODULES A SHEET: 3.USE TAP RULES FOR SIZING TAP CONDUCTORS(NEC 240.21) 4.SIZE GEC AND EGC AS PER NEC 240.66,NEC240.122 RESPECTIVELY (1)7.6 kW TESLA INVERTER:I 538000-XX-Y 5.USE MC ONLY IF INCLUDED GEC IS ADEQUATELY SIZED. c E_02 1 2 3 4 5 6 7 8 9 10 11 12 13 V 1 Maxleon 6 -- SPR-MAX6-XXX Home Solar Panel 425-440 W I Up to 22.8% Efficient . . n13 % Ideal for residential White backsheet,applications 4GO black frame More Lifetime Energy Designed to maximise energy generation through leading efficiency, enhanced performance in high temperatures, and higher energy conversion in low-light conditions like mornings, evenings and cloudy days. Uncompromising Durability Engineered to power through all types of weather conditions with �1 crack-resistant cells and reinforced connections that protect HOT-SPOT against fatigue and corrosion, to an electrical architecture that PROTECTED ' mitigates the impact of shade and prevents hot-spot formation. Superior Sustainability Clean ingredients, responsible manufacturing, and lasting energy production for 40 years make Maxeon panels the most sustainable choice in solar. PFA i The Industry's Longest Warranty Maxeon panels are covered by a 40-year warranty' backed by ME extensive third-party testing and field data from more than 50 million WARRANTY panels deployed worldwide. Power�Produ¢�SeMce P ' Installed by a Standard Maxeon Partner Product coverage (years) 40 25 Performance coverage(years) 40 25 Service coverage (years) 40 N/A Minimum warranted output in Year 1 98.0% Maximum annual degradation 0.25% Learn more about Maxeon panels m a xeo n r • . maxeon.com p; y Maxeon 6 POWER: 425-440 W I EFFICIENCY: Up to 22.8% Electrical Data Operating Condition And Mechanical Data SPR-MAX6-440 SPR-MAX6-435 SPR-MAX6-425 Temperature -40°F to+185°F(-40°C to+85°C) Nominal Power(Pnom)2 440 W 435 W 425 W Solar Cells 66 Monocrystalline Maxeon Gen 6 Power Tolerance +5/0% +5/0% +5/0% Tempered glass 0.13 in(3.2 mm),high-transmission tempered anti- Panel Efficiency 22.8% 22.5% 22.0% reflective Rated Voltage(Vmpp) 40.5 V 40.3 V 39.8 V Junction Box IP-68,EVOZ 3 bypass diodes Rated Current(Impp) 10.87 A 10.82 A 10.68 A Weight 46 Ibs(20.9 kg) Open-Circuit Voltage(Voc)(+/-3%) 48.2 V 48.2 V 48.1 V Wind:112 psf,5400 Pa,550 kg/m'front&backSnow.112 psf,5400 Pa,550 kg/m'front Short-Circuit Current(Isc)(+/-3%) 11.58 A 11.57 A 10.68 A Max.Load° HVHZ,Extension with 3 rails:' Max.System Voltage 1000 V UL&1000 V IEC Wind:125 psf,6000 Pa,612 kg/m'front&back Maximum Series Fuse 20 A Snow.187 psf,9000 Pa,917 kg/m'front Impact 1.57 inch(40 mm)diameter hail at 27.5 mph Power Temp Coef. -0.29%/°C Resistance (12.3 m/s) Voltage Temp Coef. 0.239%/°C Frame Class 1 black anodized(highest AAMA rating) Current Temp Coef. 0.057%/°C Packaging Configuration Tests And Certifications Number of modules per pallet 25 Standard Tests UL 61730(Type 2 Fire Rating),IEC 61215,IEC 61730 Number of pallets per 40ft HQ container 24 Quality Management ISO 9001:2015,ISO 14001:2015 Number of modules per container 600 Cents Ammonia Test IEC 62716 40.6 in Desert Test IEC 60068-2-68,MIL-STD-810G 11032 mm] -10 I FRAME PROFILE Salt Spray Test IEC 61701(Severity 6) PID Test 1000 V:IEC 62804 �(A)l EZ Available Listings UL,TUV,CEC ❑ �� IFLI Declare Label First solar panel labeled for ingredient transparency -�� and LBC-compliance.4 First solar panel line certified for material health, 73.7 in Cradle to Cradle [1872 mm] (A)Cable Length:52.0 in+/-0.4 in Certified'"Silver water stewardship,material reutilization,renewable energy&carbon management,and social foimess a [1320 mm+/-10 mm] Green Building Panels can contribute additional points toward (B)Long Side:1.3 in[32 mm] Certification Contribution LEED and BREEAM certifications. Short Side:0.9 in[24 mm] EHS Compliance RoHS,ISO 45001:2018,Recycle Scheme,REACH SVHC-163 Did LEAD _i_1.57 in[40 mmj oFRE� C`7 � � Declare. C E R0H5 Please read the safety and installation instructions. ?- Visitwww.maxeon.com/us/InstalIGuideUL Paper version can be requested through 0. techsupport.ROW@maxeon.com. 1 40-year warranty terms are not available in all countries or in all installations.In the United States,40-year warranty terms require digital warranty registration and installation by an authorized Maxeon Partner.Please refer to our published warranty documents or contact us for more information. 2 Standard Test Conditions(1000 W/m'irradiance,AM 1.5,25°C).NREL calibration Standard:SOMS current,LACCS FF and Voltage. . 3 Type 2 fire rating per UL 61730,Class C fire rating per IEC 61730. 4 Maxeon DC panels first received the Iriternational Living Future Institute Declare Label in 2016. 5 Maxeon DC panels are Cradle to Cradle CertifiedTM Silver - www.c2ccertified.org/certified-products-and-materials/maxeon-solar-panels.Cradle to Cradle CertifieclTM is a certification mark licensed by the Cradle to Cradle Products Innovation Institute. maxeon 6 As per IEC 61215-2016 tested and certified.See Safety and Installation Guideline for details. 7 Florida High Velocity Hurricane Zone(HVHZ)or equivalent US building codes.Please refer to the Safety and Installation guide for additional details. Made in Malaysia(Cells) Assembled in Mexico(Module) Specifications included in this datasheet are subject to change without notice. @2024 Maxeon Solar Technologies.All Rights Reserved. 552142 REV A/LTR_US View warranty,patent and trademark information at maxeon.com/legal. Publication Date:February 2024 Tesla Solar Inverter with Site Controller Tesla Solar Inverter completes the Tesla home solar system, converting DC power from solar to AC power for home consumption. Tesla's renowned expertise in power electronics has been combined with robust safety features and a simple installation process to produce an outstanding solar inverter that is compatible with both Solar Roof and traditional solar panels. Once installed, homeowners use the Tesla mobile app to manage their solar system and monitor energy consumption, resulting in a truly unique ecosystem experience. KEY FEATURES • Built on Powerwall technology for Designed to integrate with Tesla Powerwall and Tesla App exceptional efficiency and reliability 0.5%revenue-grade metering for Solar Renewable • Wi-Fi, Ethernet, and cellular connectivity Energy Credit(SREC) programs included with easy over-the-air updates T-5 L n I r _ 4« I E, I K I x. } x .a� March 17,2024 Tesla Solar Inverter Technical Specifications Electrical Specifications: Model Number 1538000-xx-y Output (AQ Output(AC)' 3.8 kW 5 kW 5.7 kW 7.6 kW Nominal Power 3,800 W 5,000 W 5,700 W 7,600 W Maximum Apparent Power 3,840 VA 5,040 VA 6,000 VA 7,680 VA Maximum Continuous Current 16 A 21 A 24 A 32 A Breaker(Overcurrent Protection) 20 A 30 A 30 A 40 A Nominal Power Factor 1 -0.9 (leading/lagging THD (at Nominal Power) <5% Electrical Specifications: MPPT 4 Input (DQ Input Connectors per MPPT 1-2-1-2 Maximum Input Voltage 600 VDC DC Input Voltage Range 60-550 VDC DC MPPT Voltage Range 60-480 VDC' Maximum Current per MPPT(IMP) 13 A Maximum Short Circuit Current per 17 Az MPPT(Isc) 'Maximum current. 2Where the DC input current exceeds an MPPT rating,jumpers can be used to allow a single MPPT to intake additional DC current up to 26 A IMP 34 A Isc• Performance Peak Efficiency 98.6%at 240 V Specifications CEC Efficiency 98.0%at 240 V Allowable DC/AC Ratio 1.7 Customer Interface Tesla Mobile App Internet Connectivity Wi-Fi (2.4 GHz,802.11 b/g/n), Ethernet, Cellular(LTE/4G)3 Revenue Grade Meter Revenue Accurate(+/-0.5%) AC Remote Metering Support Wi-Fi (2.4 GHz,802.11 b/g/n) Protections Integrated arc fault circuit interrupter(AFCI), Rapid Shutdown Supported Grid Types 60 Hz,240 V Split.Phase Warranty 12.5 years 'Cellular connectivity subject to network operator service coverage and signal strength. Tesla Solar Inverter and Solar Shutdown Device Datasheet 2 Tesla Solar Inverter Technical Specifications Mechanical Specifications Dimensions 660 mm x 411 mm x 158 mm (26 in x 16 in x 6 in) 00 ®® � ig9LK ME o 00 00 00 00 00 660 00 00 mm o0 ooa 00 l 411 mm �158 I I mm Weight 52 lb4 Mounting Options Wall mount(bracket) "Door and bracket can be removed for a mounting weight of 37 Ib. Environmental Specifications Operating Temperature -300C to 450C(-22°F to 113°F)5 Operating Humidity(RH) Up to 100%,condensing Storage Temperature -300C to 700C(-220F to 158°F) Maximum Elevation 3000 m (9843 ft) Environment Indoor and outdoor rated Enclosure Rating Type 3R ` J Ingress Rating IP55(Wiring compartment) Pollution Rating PD2 for power electronics and terminal wiring compartment, PD3 for all other components Operating Noise @ 1 m <40 db(A) nominal,< 50 db(A) maximum 'Performance may be de-rated to 6.2 kW at 240 V when operating at temperatures greater than 45°C. Compliance Information Grid Certifications UL 1741, UL 1741 SA, UL 1741 SB, UL 1741 PCs, IEEE 1547-2018, IEEE 1547.1 Safety Certifications UL 1741 PVRSS,UL 1699B, UL 1998(US), UL 3741 Emissions EN 61000-6-3(Residential), FCC 47CFR15.109 (a) Tesla Solar Inverter and Solar Shutdown Device Datasheet 3 1 Solar Shutdown Device Technical Specifications The Solar Shutdown Device is a Mid-Circuit Interrupter(MCI)and is part of the PV system rapid shutdown (RSD)function in accordance with Article 690 of the applicable NEC.When paired with Tesla Solar Inverter,solar array shutdown is initiated by any loss of AC power. Electrical Model MCI-1 MCI-2 Specifications Nominal Input DC Current Rating (1,,P) 13 A 13 A Maximum Input Short Circuit Current(Ise) 19 A 17 A Maximum System Voltage(PVHCS) 600 V DC 1000 V DC6 6Maximum System Voltage is limited by Tesla Solar Inverter to 600 V DC. RSD Module Maximum Number of Devices per String 5 5 Performance Control Power Line Excitation Power Line Excitation Passive State Normally Open Normally Open Maximum Power Consumption 7 W 7 W Warranty 25 years 25 years Environmental Operating Temperature -40°C to 50°C -45°C to 70°C Specifications (-40°F to 122°F) (-49°F to 158°F) Storage Temperature, -30°C to 70°C -30°C to 70°C (-22°F to 158°F) (-22°F to 158°F) Enclosure Rating NEMA 4X/IP65 NEMA 4X/IP65 Mechanical Electrical Connections MC4 Connector MC4 Connector Specifications Housing Plastic Plastic Dimensions 125 x 150 x 22 mm 173 x 45 x 22 mm (5x6xIin) (6.8x1.8x1 in) Weight 350 g (0.77 lb) 120 g (0.26 lb) Mounting Options ZEP Home Run Clip Wire Clip M4 Screw(#10) M8 Bolt(5/16") Nail/Wood screw Compliance Certifications UL 1741 PVRSE, UL 3741, Information PVRSA(Photovoltaic Rapid Shutdown Array) RSD Initiation Method PV System AC Breaker or Switch UL 3741 PV Hazard Control (and PVRSA) Compatibility See Tesla Solar Inverter.Installation Manual Testa Solar Inverter and Solar Shutdown Device Datasheet 4 Tech Brief IRONRIDGE Racking Accelerated- Aire°is a carefully-engineered, ergonomic racking system for pitched roofs—honoring both speed and precision. Each component has been designed to enforce ,4--�_�_---- a quality installation that can withstand the elements. a We've worked hand-in-glove with installers to provide the strongest, feature-rich, open-channel rail on the market. Two rail sizes come in black-anodized and mill finishes. Listed to UL 2703 and backed by a 25-year warranty. Fully-Certified Cable Tray Aire®is the only system listed as a One-Tool 1/2" System cable tray. It uses NEC-compliant rail, /1 I with NEMA VE1 and C2.22 ratings.The ` high-strength open channel sheds water \ uk �i to keep wire connectors high and dry,while � Wire Clips tame unruly PV&DG cables. Glove-Friendly Components u= Aire Lock®clamps are free-standing - � and universal,with Twist-n-Clicks T r' Technology for easy placement.The .._ clamps do not impede wires in the tray below and they provide clean aesthetics with 1/2-inch module gaps. :f i}. J c �^ F Aire® Flush Mount System Racking Accelerated® ad"1w i \\ b Two Optimized Aire°Rail Sizes Internal Bonded Structural Splices Al Rail meets most load conditions, while the heftier Aire°Ties connect two pieces of rail together without A2 Rail is best in heavy-snow and high-wind regions. penetrations. Its water-relief"bridge" allows drainage. :7.A Easy Hardware &Wire Placement Aesthetically-Pleasing Hidden Ends Quarter turn and Aire Lock®clamps stand freely. Wire Aire Lock°Stealth clamps module row ends. With a Clips press in, with a flat-head slot for quick removal. 150 angled bolt, rail cuts are not needed for access. Rail Selection Ekternal Load Rail SpanBetween - � The provided table* illustrates span 120 - differences for Aire®Al and A2 Rails. It was prepared in compliance with None 150 applicable codes and standards. 180 Al A2 1 Values based on the following 20 18080 IF criteria:ASCE 7-16, Gable Roof 150 Mobile Resources Flush Mount, Roof Zones 1 &2e, 30 180 ■ ■ Exposure B, Roof Slope of 80 to 200 �' and Mean Building Height of 30 ft. 40 180 80 180 r 180 ■ Visit IronRidge.com for detailed 120 _ certification letters. 'Table is for illustration purposes only.Use approved certification letters for actual design guidance.