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ho�"%pf SO(/lyo`o Town of Southold * # P.O. Box 1179 cz 53095 Main Rd Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 45932 Date: 02/03/2025 THIS CERTIFIES that the building SOLAR PANEL Location of Property: 25 Azalea Rd Mattituck, NY 11952 Sec/Block/Lot: 115.-6-13 Conforms substantially to the Application for Building Permit heretofore,filed in this office dated: 08/23/2017 Pursuant to which Building Permit No. 41929 and dated: 08/28/2017 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 on existing single-family dwelling as applied for. The certificate is issued to: Brian Gebbia, Amy Gebbia Of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL: ELECTRICAL CERTIFICATE: 41929 1/13/2025 PLUMBERS CERTIFICATION: Auto e Signature -of soaryo`o TOWN OF SOUTHOLD BUILDING DEPARTMENT • a TOWN CLERK'S OFFICE SOUTHOLD, NY BUILDING PERMIT RENEWED (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 41929 Date: 08/28/2017 Permission is hereby granted to: Renewal Date: 12/05/2024 Brian Gebbia 665 Cardinale Dr Mattituck, NY 11952 To: install roof-mounted solar panels on existing single-family dwelling as applied for. Premises Located at: 25 Azalea Rd, Mattituck, NY 11952 SCTM# 115.-6-13 Pursuant to application dated 08/23/2017 and approved by the Building Inspector. To expire on 12/05/2026. Contractors: Fees: Renewal Fee $100.00 Total Sloo Building Inspector gyFFolA, TOWN OF SOUTHOLD BUILDING DEPARTMENT o TOWN CLERK'S OFFICE 4Jk SOUTHOLD, NY dal, ,�aa 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#: 41929 Date: 8/28/2017 Permission is hereby granted to: Gebbia, Brian 665 Cardinale Dr Mattituck, NY 11952 To install roof-mounted,solar panels on existing single-family dwelling as applied for. At premises located at: 25 Azalea Rd, Mattituck SCTM # 473889 Sec/Block/Lot# 115.-6-13 Pursuant to application dated 8/23/2017 and approved by the Building Inspector. To expire on 2/27/2019. Fees: SOLAR PANELS $50.00 ELECTRIC $100.00 CO -ALTERATION.TO DWELLING $50.00 Total: $200.00 Buil pector o��OE SO(/T�QI � o Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 G • Q Southold,NY 11971-0959 'Q a BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: Brian Gebbia Address: 25 Azalea Rd City: Mattituck St: NY Zip: 11952 Building Permit#: 41929 Section: 115 Block: 6 Lot: 13 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: Electrician: Michael Mortensen License No: 52346ME SITE DETAILS Office Use Only Indoor rv— Basement r Service r Solar Outdoor W 1 st Floor r Pool r Spa 1- Renovation F 2nd Floor Hot Tub r Generator Survey rPo-j Attic r Garage Battery Storage r INVENTORY Service 1 ph F Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan Service 3 ph (— Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures 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 Other Equipment: 7.25kW Roof Mounted Pv Solar Energy System w/ (25) HanwhaQpeakBLKG4 290W Modules, 30A Rapid shutdown, Inverter M215-60-21-L-S22AG Inverter, Combiner Panel, On Notes: Backfed 30A Breaker Solar Inspector Signature: X Date. January 13, 2025 Sean Dev Electrical Inspector sean.devlin(�-)town.southold.ny.us 25AzaleaSo IarElectric Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings,property lines, streets,and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1%lead. 5. Commercial building,industrial building,multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings(prior to April 9, 1957)non-conforming uses,or buildings and"pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets,building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant.If a Certificate of Occupancy is denied,the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy-New dwelling$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00, Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 L... 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00,Commercial $15.00 Date. New Construction: Old/or Pre-existing Building: (check one)) ,{ Location of Property: C.Gc►2 rJ ✓�w� j P_ M G� ' 1 l `��-� House No. Street Hamlet // Owner or Owners of Property: 3 RI C-U1 In C c— Suffolk County Tax Map No 1000, Section Block Lot Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: V (check one) Fee Submitted: $ 5D Applicant Signature *pF SOUIyo * # TOWN OF SOUTHOLD BUILDING DEPT. IOUNr+,��' 631-765-1802 INSPECTION [ ] ' FOUNDATION 1ST[REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ rFIN ULATION/CAULKIN.G] FRAMING/STRAPPING [ AL �.JW0000' [ ] FIREPLACE & CHIMNEY [ ] -FIRE SAFETY INSPECTION [ ] FIRE.RESISTANT CONSTRUCTION [ . ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) ] CODE VIOLATION [ ] PREC/O [ ] RENTAL REMARKS: o DATE INSPECTOR 9, 11 2S - T. vi UE SO(/Th°� ' TO N O SOUTHOLD BUILDFNG DEP 631-765-1802 INSPECTION [ ] .FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. .[ ] FOUNDATION 2ND [ ] INSULATIOWCAULKING [ ] 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: DATE I INSPECTOR OF SO//lyOlo �� e —- - -- # TOWN OF SOUTHOLDD-BUILDING DEPT. ou 631-765-1802 INSPECTION ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATIOWCAULKING [ ] 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. 1 Td 4q faq 4 on -4 DATE INSPECTOR FIELD INSPECTION REPORT DATE COMMENTS i• � FOUNDATION (IST) ------------------------------- 'FOUNDATION(2ND) z 0 � CIO ROUGH FRAMING& l� H PLUMBING INSULATION PER N.Y. H STATE ENERGY CODE J FINAL ADDITIONAL COMMENTS Z m 0�)� 6. °z d b H NN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST UILDfJiG DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NY 11971 4 sets of Building Plans- TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey SoutholdTown.NorthFork.net PERMIT NO. Vq Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined 20-4 Single&Separate Storm-Water Assessment Form Contact: Approved 200 Mail to:1riv-500?c,0 Aj 2 Disapproved a/c 16 pv-) Yl 1 G Phon�- ?j I- -1 60 35 Expiration 920 D Ptm OV= BAPPLICATION uilding ector AUG 2 3 2017 FOR BUILDING PERMIT Date /`°/ , 20 1� 1�UIId)ING DEPT.TOWN OF SOUTHOLD INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises,relationship to adjoining premises or public streets or areas, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d.Upon approval of this application,the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e.No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f.Every building'permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date.If no zoning amendments or other regulations affecting the property have been enacted in the interim,the Building Inspector may authorize,in writing,the extension of the permit for an addition six months.Thereafter,a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County,New York,and other applicable Laws,Ordinances or Regulations,for the construction of buildings,additions, or alterations or for removal or demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances,building code,housing code,and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. app icant or name,if a corporation) 1 �t1Co hU tta �1V ailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder C( Name of owner of premises L G n J. (y fit, (As on.the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No.5) Plumbers License No. Electricians License No. 5 'LbgJ Other Trade's License No. 1. Location of land on which proposed work w'11 be House Number Street Hamlet County Tax Map No. 1000 Section 1 5 ' ' "! Jwlm '0F.o A r�`Sr�� Lot "�Ioek�� � r_iT .Ci i'f •�-!'tS�' `°F•r^-!i';t ;tnY L.?:ii;:'.si (!G!•.:.l i±�T;CA \ j Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and inten led use d occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work(check which applicable):New Building A i dition Alteration Repair Removal Demolition ( Other Work��� 4. Estimated Cost 1 1 G 5 C) - 6U Fee (Description) (To.be paid on filing this application) 5. If dwelling,number of dwelling units_—Nur iber of dwelling outs on each floor If garage, number of cars _ 6. If business, commercial or mixed occupancy, specify n iture anj extent of each type of use. 7. Dimensions of existing structures,if any: Front Rear Depth Height Number of Stories , Dimensions of same structure with alterations.oradditions: Front Rear Depth _Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height _Number of stories •r. 9. Size of lot: Front Rear Depth 10.Date of Purchase Name of Former Owner, 11.Zone or use district in which premises are situated .12.Does proposed construction violate any zoning law, or ' ance c r regulation? YES NO 13.Will lot be re-graded?YES NON Will excess fflfie--rem oved from premises?YES NO 14.Names of Owner of premiss"�� ��'� Ad ess EGG I�G�� Phone No. � 3i G V 5 �0&2 Name of Architect _Ad s _. Phone No Name of ContractorUiv►n �-SCQCky _Ad £s 11 Phone No.Q3 l '750 323S 15 a. Is this property within 100 feet of a tidal wetland or aewa er wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES &D!E.C. P .` 1VIITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * S NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey,to scale,with accurate foundation plan and dis ces to p roperty lines. 17. If elevation at any point on property is at 10 feet or beh w, must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? * YES NO'\ * IF YES,PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF 130?l D V7 being d 1Ey sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the �i�J V_( ,_- (Contractor,Agent,Corporati-.€46:r r•,etc.) of said owner or owners,and is duly authorized to perform or ha p.cf-fon ned the said work and to make and file this application; that all statements contained in this application are true to the be,loi of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therew t1i. Sworn to before me this day of _20_tj . NICOLE GIORG5`TTI wkV Notary Public,State of New 11 o t Public Qualifiedin, Suffolk Coun Signature pp licant Commission Expires Novamhar 12 2nty CONSENT TO INSPECTION e Aelq'6,17 Ir �e, 4l9- ,the undersigned, do(es)hereby state: Owner(s)Name(s) That the undersigned(is) (are)the pwner(s of the premiss Vi the Town of Southold, located at kr%2 ) 2�Ccn�/ � /1/� 'ftG !�IV G/� ,2— which is shown and designated on the Suffolk County Tax Map as District 1000, Section , Block , Lot That the undersigned(has) (have) filed, or cause to be filed, an application in the Southold Town Building Inspector's Office for the following: That the undersigned do(es)hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, including any and all buildings located thereon,to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comply with all of the laws, ordinances,rules and regulations of the Town of Southold. The undersigned, in consenting to such inspections, do(es) so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used in subsequent prosecutions for violations of the laws, ordinances,rules or regulations of the Town of Southold. Dated: O (Si nature) (Print Name) (Signature) NICOLE GIORGETTI Notary Public, State of New York No.01G16292933 (Print Name) Qualified in Suffolk County Commission Expires November 12,2017 17flI� i gUEF BUILDING DEPARTMENT- Electrical Inspector 0�0 C�Gy TOWN OF SOUTHOLD Town Hall Annex- 54375 Main Road - PO Box 1179 Southold, New York 11971-0959 y *° p� Telephone (631) 765-1802 - FAX (631) 765-9502 r iamesh D-southoldtownny gov- seand @southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: i is- Company Name: -, Electrician's Name: YLt i Lkae 1 ✓Vl o r den 5 eh License No.: SZ 3 4(.p - wl E Elec. email: Elec. Phone No: ❑1 request an email copy of Certificate of Compliance Elec. Address.: JOB SITE INFORMATION (All Information Required) Name: Address: 0R 5 .4-2a. I .r-a- 1� VVLA k k-- Cross Street: Phone No.: Bldg.Permit#: 41 4 2 cl email: Tax Map District: 1000 Section: Block: Lot: BRIEF DESCRIPTION OF'WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): �o \GLv^ Square Footage: Circle All That Apply: Is job ready for inspection?: ❑ YES 0 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 Reconnect❑Underground❑Overhead #Underground Laterals M 1 2 H Frame Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION PERMIT# Address: Switches Outlets GFI's Surface Sconces H H's UC Lts Fridge HW POOL Fans Mini Fr. W/D PanelPump Exhaust Oven Sump Heater Trnsfmr Smokes DW Generator Salt Gen. Carbon Micro GrbDis Water Bond Lights Heat Pucks ERV HOT TUB/SPA Inst Hot DeHum Transfer Disc Combo Cooktop Minisplit Blower AC AH Hood Blower Service Amps Have Used Sub Amps Have Used Comments LOT NUMBERS REFER 70 'MAP OF SUBUL19ON FOR MA771TUCK ESTATES. INC.'FILED IN WE SUFFOLK N COUNTY CLERK'S OFFICE AS FILE NO. 4453 ON SEPTEMBER El 7965 SURVEY OF PROPERTY Pp, AT SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y, d 1000-116-06-13 o� oo sA SCALE. 1'=40' �. ♦h +,� 2 OCTOBER 16, 20/2 }fite ak 00 + \+ \ 110 `o�r4\,f 00, ��. age p P y� o� s �J 4 CER RLED TO.• 6 qq 6• 1�� Y BRAN J. GEBBIA AM E. OE891A S { ULSTER SAVINGS BANK •�, '� FIDELITY NAAONAL 17RE INSURANCE COMPANY v�l� o*� o WELL 1 � 704 O LAN?J`•:J N.YS LIC NO. 49618 ANY AL TERA R0N OR Agpl nON TO TTIIS SURVEY IS A NOLA77ON ECONIC YORS, P.C. a PPIIDNUMENT EXCEPT ASS pER�C,7 E NEQg y UALL CER1/F7CAT10NS (631) 765-5020 FAX (631) 765-1797 ANEA-33,ZIB SO.F7. HEREON P.O. BOX 909 SAID MAP E VALID FgpTHIS MAP AND COPIES THEREOF ONLY/F MiDSE SIGMA COPIESAP 8RS iE IMP RESSM SEAL OF ]N£SURVEYOR SOUTNOLD, NER STREET1971 12-26 7 7 ® DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 08/21/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT MARSH USA INC. NAME' PHONE FAX 122517TH STREET,SUITE 1300 Arc No Ext: A/C No): DENVER,CO 80202-5534 EaVIAIL Attn:Denver.CertRequestC)marsh.com Fax:212-948-4381 ADDRESS: INSURER S AFFORDING COVERAGE NAIC# INSURER A:Axis Specialty Europe INSURED Vivint Solar,Inc. INSURER B:Zurich American Insurance Company 16535 Vivint Solar Developer LLC INSURER C:American Zurich Insurance Company 40142 1800 W.Ashton Blvd. INSURER D:NIA NIA Lehi,UT 84043 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: SEA-003174062-16 REVISION NUMBER: 2 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. INSR ADDLITYPE OF INSURANCE INSD SUER POLICY NUMBER MMIDDPOLICY EFF MPM/DDY YY LTR LIMITS A X COMMERCIALGENERALLIABILITY 3776500117EN 01/29/2017 11/01/2018 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE �OCCUR PREMISES RENTEDE occurrence $ 1,000,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑JECT LOG PRODUCTS-COMPIOPAGG $ 1,000,000 OTHER: $ B AUTOMOBILE LIABILITY BAPS09601502 11101/2016 11/01/2017 COMBIN ED SINGLE LIMIT Ea accident $ 1,000,000 IXX ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident Comp/Coll Ded $ 1,000 UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ C WORKERS COMPENSATION WC509601302(AOS) 11/01/2016 11/01/2017 X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER B Y r N WC509601402(MA) 11/01I2016 11/01/2017 1,000,000 OFF CEANYPRORIM MBEREXCLUDED7 PRIETORIPARTNER/EXECUTIVE � N rA E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION Town of Southold SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 53905 Main Rd THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Southold,NY 11971 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Kathleen M.Parsloerur„�7�r. IQt¢l�G ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Workers' PORK 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 Vivint Solar Developer,LLC 801-377-9111 1800 W Ashton Blvd. 1c.NYS Unemployment Insurance Employer Registration Number of Lehi,UT 84043 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 80-0756438 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) American Zurich Insurance Company Town of Southold 3b.Policy Number of Entity Listed in Box"1 a" 53095 Route 25 WC509601302 Southold,NY 11971 3c.Policy effective period 11/1/16 to 11/1/17 3d.The Proprietor,Partners or Executive Officers are © 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". Will the carrier notify the certificate holder within 10 days of a policy being cancelled for non-payment of premium or within 30 days if cancelled for any other reason or if the insured is otherwise eliminated from the coverage indicated on this certificate prior to the end of the policy effective period? ©YES E]NO 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 1 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: MARK ELIAS (Print name of authorized representative or licensed agent of insurance carrier) Approved by: O8/08/2017 ��'I(,:a,.,P, �.�.; (Signature) (Date) Title: SR Vice President Telephone Number of authorized representative or licensed agent of insurance carrier: 212 225 7000 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(9-15) www.wcb.ny.gov PORK Workers' CERTIFICATE OF INSURANCE COVERAGE STATE Compe Boardnsation UNDER THE NYS DISABILITY BENEFITS LAW PART 1. To be completed by Disability Benefits Carrier or Licensed Insurance Agent of that Carrier 1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured VIVINT SOLAR DEVELOPER,LLC 6317503235 1565 OCEAN AVE BOHEMIA,NY 11716 1c.NYS Unemployment Insurance Employer Registration Number of Insured PENDING 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 80-0756438 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Standard Security Life Insurance Company of New York Town of Southold 53095 Route 25 3b.Policy Number of Entity Listed in Box"la" Southold,NY 11971 D9555B-002 3c.Policy effective period 6/10/2013 to 8/21/2018 4.Policy covers: Z A.All of the employer's employees eligible under the New York Disability 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 Benefits insurance coverage as described above. Aug- Date Signed 8/22/2017 By ieA- (Signature of insurance carrier's authorize4 representat a or NYS Licensed Insurance Agent of that insurance carrier) Telephone Number (212)355-4141 Title SUPERVISOR-DBUPOLICY SERVICES IMPORTANT: If Box"4a"is 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"is checked,this certificate is NOT COMPLETE for purposes of Section 220,Subd.8 of the Disability Benefits Law.It must be mailed for completion to the Workers'Compensation Board,DB Plans Acceptance Unit,328 State Street,Schenectady,NY 12305 PART 2.To be completed by the NYS Workers'Compensation Board(Only if Box"4b"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 Benefits Law with respect to all of his/her employees. Date Signed By Signature of NYS workers'Compensation Hoard Employee) Telephone Number Title Please Note: Only insurance carriers licensed to write NYS disability 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 (9-15) Additional Instructions for Form DBA 20.1 By signing this form, the insurance carrier identified in box"3"on this form is certifying that it is insuring the business referenced in box"1 a"for disability benefits under the New York State Disability Benefits Law.The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed as the certificate holder in box"2". Will the carrier notify the certificate holder within 10 days of a policy being cancelled for non-payment of premium or within 30 days if cancelled for any other reason or if the insured is otherwise eliminated from the coverage indicated on this certificate prior to the end of the policy effective period? YES ZNO This certificate is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Disability Benefits contract of insurance only while the underlying policy is in effect. Please Note: Upon the cancellation of the disability benefits policy indicated on this form,if the business continues to be named on a permit,license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of NYS Disability Benefits Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Disability Benefits Law. DISABILITY BENEFITS LAW §220. Subd. 8 (a) The head of a state or municipal department, board, commission or office authorized or required by law to issue any permit for or in connection with any work involving the employment of employees in employment as defined in this article, and not withstanding any general or special statute requiring or authorizing the issue of such permits, shall not issue such permit unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair,that the payment of disability benefits for all employees has been secured as provided by this article. Nothing herein, however, shall be construed as creating any liability on the part of such state or municipal department, board, commission or office to pay any disability benefits to any such employee if so employed. (b)The head of a state or municipal department, board,commission or office authorized or required by law to enter into any contract for or in connection with any work involving the employment of employees in employment as defined in this article and notwithstanding any general or special statute requiring or authorizing any such contract, shall not enter into any such contract unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair,that the payment of disability benefits for all employees has been secured as provided by this article. DB-120.1 (9-15)Reverse Ak stj .. I K COUNTY OEPT ORLA 00. UCENSING,dAWNSMM AFEATRS. _ MASTER ELECTRICIAN MICHAfiL R MORTENSEN Twig'rt{ties•thetAN"i ,n _. ._. beaver li duly, �mrlNr sou+tr oeve cweR ctc 6cemed by the 52346-ME a8t24t20r3 cam+ . ovwnroiiosm 09/G172017' J, '3 i I I 1 I, I SUFFOLK COUNTY DEPT OF LABOR, LICENSING&CONSUMER AFFAIRS HOME IMPROVEMENT 4 CONTRACTOR i NAW {' DANIEL T GARRITY This certifies that the bearer is duly VIVINT SOLAR DEVELOPER LLC licensed by the County of Suffolk 03/01/2013 @ e� '51228-H e PM1101 wre 03/01/2019 r f s CQ/ APPROVED AS NOTED RETAIN STORM WATER RUNOFF DATE: B,P,# PURSUANT TO CHAPTER 236 FEE: BY: OF THE TOWN CODE. NOTIFY BUILDING DEPAR TAT 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING ELECTRICAL 3. INSULATIO-N INSPECTION REQUIRED 4. FINALJ >: ;';ON MUST BE COMP, ;":` C.O. ALL CONSTI.I., SHALL MEET THE REQUIREMEN";S OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF SOUTHOLD TOWN ZBA SOUTHOLD TOWN PLANNING BOARD SOUTHOLD TOWN TRUSTEES N.Y.S.DEC OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE & OCCUPANCY NO -M PV SYSTEM SIZE: I I a 7.250 kW DC C7 KEY n (25)Hanwha O.PEAK BLK-G6.1290 MODULES WITH AN Enpha.e M21S902LL-S22-I0 MICRO [�INVERTERMOUNTED ON THE BACK , OF EACH MODULE PV INTERCONNECTION POINT, ❑M LOCKABLE OIsroNNECr sN7rcH, ANSI METER LOCATION.B UTILITY O METER LOCATION TIE INTO METERS24SN265 900E 314•EMT CONDUIT FROM PANEL ON BOX TOELEC (, JUNCTION B - - � •I N BOX ATTACHED TO - - - _ .ARRAY TO KEEP JUNCT N ••• - _O l - BOXOFFROOF - - - i O CHIMNEY .......... ..........._..,_. '•- -'• -- - b SKYLIGHT G: SATELLITE DISH :'•:'••:"...::.....'..`:-`':•-."- -.....s:• ;m::.::.res: O PLUMBING VENT ••'-" ntitixi•:• q _ t`;`Y{ v �Q ROOF VENTS I '(•T 1= 3'FIRECODE OFFSET "� _ _ t'W ',.— I. .;j:.' O LU 9ikrn .) GROUND ACCESS ::`'::I ! Z _ s L z... CIRCUIT 1:13 MODULES YIEa}\yL CIRCUIT 2:12 MODULES *O,J�K C kQ PpA�7� AHEET Fa\\\Y U to +t NAME: W ZQ 963M1+ 665 Cardinal Dr, Mattituck NY 11952FSiN�� — — T — — — — — — SHEET — NUMBER: O Roof Section 1 Roof Section 2 A71mLM 217 Aumulh 217 SCALE:118"=V-0" Tut 30 O TIu:3B Tyµu.Cutup Shk!�a T a:I,wap Stk* (� PiR SLPE\Y PEP HfN. I V/ 1 C PlP:uvP.. ] tfU.'YSW 3t4fdY � �� all- �o SSmm PROFILE 40i5un PROFILE SFM-TRIMRAIL WITH 1 SFM-ROOF ATTACHMENT SFM-TRIMRAIL ROOF ATTACHMENT 4 SFM-3" RAIL 3.0 NOT TO SCALE 3.0 NOT TO 504LE (�(3.0 NO(10 SCALE PV 3.0 NOT TO SCALE - n "%'4lalcrnn+ SFM 0'A�1AC11cL15PL�i: G I Y'1 vaa � -.� SFM e°�iPltt:k p�`�ay F SFM r a c'3 ` v (SFM-9"ATTACHED SPLICE a SFM-9"SPLICE $ " PY 3.0 NOT Lo scALt PV 3 0 NOT To srALE p W�NQ m eC�Un4^ TRk"All SPLICE z N \\i W ` m TRIM1IFUA ROOF ATTACF:MENT,SEE TABLE U 22r1.� iRMItaR SHEET C OF Y�'{'t� NAME Size:2x6.2x8 1 r Spacing:18"O.C. � �� `�`.' '� fig: ❑ a U m * g ❑ SHEET NUMBER: pg6J3° r4'� 0 SECTION VIEW s SFM LAYOUT ` �PV 3.0 NOT To scALe PV 3,0 NOT TO SCALE d Vi��� � s 1800 W Ashton Blvd. Lehi, UT 84043 Structural Group Jon P. Ward,SE,PE J.Matthew Walsh,SE,PE Clint C. Karren,PE Structural Engineering Manager Senior Structural Engineering Manager Structural Engineering Manager jon.wardc@vivintsolar.com Omes.walsh@a vivintsolar com clint karren@vivintsolar com July 18,2017 Re: Structural Engineering Services Gebbia Residence 665 Cardinal Dr, Mattituck, NY S-5689779; NY-02 To Whom It May Concern: We have reviewed the following information regarding solar panel installation on the roof of the above referenced home: 1. Site Visit/Verification Form prepared by a representative from our office under my supervision identifying specific site information including size and spacing of members for the existing roof structure. 2. Proposed layout of the system including connection details for the solar panels. 3. Photographs of the interior and exterior of the roof system identifying existing structural members and their conditions. Based on the above information,we have evaluated the structural capacity of the existing roof system to support the additional loads imposed by the solar panels and have the following comments related to our review and evaluation: A.Description of Residence: The existing residence is typical wood framing construction with a maximum of two layers of composite shingle. All wood material utilized for the roof system is assumed to be Hem-Fir(North)#2 or better with standard construction components and consists of the following: • Roof Section: Dimensional lumber-2x8 at 16" on center and 2x4 collar ties at 48"on center. The attic space is unfinished and photos indicate that there was free access to visually inspect the size and condition of the roof members. • Roof Sections: Dimensional lumber-2x6 at 16" on center and 2x4 collar ties at 48"on center. The attic space is unfinished and photos indicate that there was free access to visually inspect the size and condition of the roof members. B. Loading Criteria 9.75 PSF=Dead Load(roofing/framing) 2.59 PSF=Dead Load (solar panels/mounting hardware) 12.34 PSF=Total Dead Load 30 PSF=Ground Snow Load (based on local requirements) Wind speed of 130 mph(based on Exposure Category B-the total area subject to wind uplift is calculated for the Interior, Edge, and Corner Zones of the dwelling.) C.Solar Panel Anchorage 1. The solar panels shall be mounted in accordance with the most recent "Unirac, Inc. Installation Manual", which can be found on the Unirac, Inc. website (Www.unirac.com). If during solar panel installation, the roof framing members appear unstable or deflect non-uniformly, our office should be notified before proceeding with the installation. Page 1 of2 vivint. SCD. I a r Page 2 of 2 2. The solar panels are 11/i'thick and mounted 4'/2" off the roof for a total height off the existing roof of 6". At no time will the panels be mounted higher than 6"above the existing plane of the roof. 3. Maximum allowable pullout per lag screw is 235 Ibs/inch of penetration as identified in the National Design Specifications (NDS) of timber construction specifications for Hem-Fir (North). Based on our evaluation, the pullout value, utilizing a penetration depth of 21/2", is less than the maximum allowable per connection and therefore is adequate. 4. The maximum allowed spacing was calculated for the Wind Speed shown in paragraph A above, using the wind load uplift procedures of ASCE 7-10 and is specified below. The following values have been verified by in- house testing and the mounting hardware manufacturers' data, which are available upon request. Panel support connections shall be staggered to distribute load to adjacent members. Modules in Landscape Modules in Portrait Roof Zone Interior Ede Corner Interior Ede Corner Max Vertical Spacing in 40 40 40 66 66 66 Max Horizontal Spacing in . 48 48 48 32 32 32 Max Uplift Load Ibs 174 113 63 293 191 107 D.Summary Based on the above evaluation,with appropriate panel anchors being utilized the roof system designed on will adequately support the additional loading imposed by the solar panels, if installed correctly.This evaluation is in conformance with the 2016 New York State Uniform Code Supplement,the 2015 IRC,the 2015 IBC,current industry standards and practice, and the information supplied to us at the time of this report. If there are any questions regarding the above, or if more information is required,please contact me. N&- y kq y0 Regards, �a G. s Clint C. Karren, PE NY License No. 096344 = 096344 � �SSIOTA vivi 1t. solar a . V o G � i I I a) Nm �p o°rN'w � �m a) �Q'z� LL UHF ua m O �O PV SYSTEM SIZE: I 7.250 kW DC KEY (25)Hanwha CREAK SLK-G4.1 290 MODULES WITH AN Enphase M215-60-2LLS22-IG MICRO INVERTER MOUNTED ON THE BACK OF EACH MODULE 1 Imo_ PV INTERCONNECTION POINT, - t LOCKABLE DISCONNECT SWITCH, M ANSI METER LOCATION,6 UTILITY O METER LOCATION TIE INTO ¢{ METER#24656265 99 OF--EMT CONDUIT 1Q10 FROM JUNCTION BOX TO I I ! ELEC PANEL Q � n JUNCTION TI N BOX ATTACHED TO ARRAYKEEP JUNCTION ................................................................. . ............ . BOXOFF ROOF ............................................................::. r Fol n CHIMNEY 1 O 1 .........=-] SKYLIGHT O SATELLITE DISH rn N O PLUMBING VENT o o ❑O ROOF VENTS 1 1 m m m g vO 3'FIRECODE OFFSET O 2 m 0: , V1 I.- 1 _ w O W m N Z N GROUND ACCESS O 2 O K¢ N .......... j w Z m w CIRCUIT 1:13 MODULES I PEE OF N,1-1 p I N J �•a� C Z 5 0 kq Zo ® CIRCUIT 2:12 MODULES * v ��! SHEET N U to * NAME: i -', , I LLI Z '096344 �� 1-J 665 Cardinal Dr, Mattituck NY 11952 '�fiss(°"P� CL SHEET NUMBER: Root Section 1 Roof Section 2 Azimuth:217 Azimuth:217 TO1 30 O Till:30 Type:Comp Shingle Type:Comp Shingle t vlee IAG STn�v , vERMPR � U o_ PUSRNG N 51lly—mREW � N W PER 6IFR. Na% Na 2Ymz aZm Uuf 3Z m= Ta- � 9U F 35mm PROFILE 40mm PROFILE � SFM -TRIMRAIL WITH 1 SFM -ROOF ATTACHMENT 2 SFM-TRIMRAIL 3 ROOF ATTACHMENT 4 SFM -Y RAIL k,pV3.0 N0T TO SCALE 3 NOT TO SCALE �pV3 0 NOT TO SCALE PV 3.0 NOT TO SCALE B �s n 5n6'BIAG GCREW SFM B'ATTACHED SPLIC p PER W. r A 2 , v SFM 9'SPLIC m SFM 3' N ME 9"ATTACHED SPLICE a SFM-9"SPLICE suLE PV 3.0 NOT To SCALE q m U) 6� xiri module W m TRIMRAIL SPLICE > j in Z K K co TRIMRAIL ROOF ATTACHMENT,SEE TABLE Z co W U_ �N J TRIMRAIL SHEET OF N,,z NAME: Size:2x6,2x8 yCQ C. /�q �p Z � Spacing:16"O.C. * �� Qp 9� Z z r U to * 0 WQ SHEET 'i•.i NUMBER: 096344 C9 SECTION VIEW s SFM LAYOUTIONP1'� O FESS CV PV 3.0 NOT TO SCALE PV 3.0 NOT TO SCALE d Photovoltaic System Conduit Conductor Schedule(ALL CONDUCTORS MUST BE COPPER). DC System Size(Watts) 7250 Tag# Description Wire Gauge #of Conductors/Color Conduit Type Conduit Size AC System Size(Watts) 5375 1 Enphase Engage Cable THWN-2 12 AWG 4(Ll,L2,N,G) N/A-Free Air N/A-Free Air N a Module/Inverter Count 25 1 Bare Copper Ground(EGC/GEC) 6 AWG 1 BARE N/A-Free Air N/A-Free Air °; ce o 2THWN-2 10 AWG 6(2L121_22N)B/R/W EMT 3/4" a 2 THWN-2-Ground 6AWG 1(GRN) EMT 3/4" Z Z m- 3 THWN-2 10 AWG 3(1L1 1L2 1N)B/R/W EMT 3/4" F o 3 THWN-2-Ground 6AWG 1(GRN) EMT 3/4" a ®� n n v a a u` a v a r; . S m O F_ C F W Z m 00 Pal nt of l nterconnecti on,Load N 20A Rapid Shutdown Side 705.12(D)(2) Z N Disconnect,Square D 26A DU221RB,240V/30A Z r' Unfused,NEMA3,or �i L2N f¢.. N rn 5A equivalent >- to 20A zZz ^ Inverter:Enphase SHEET M215.60-2LL-S22-IG NAME: Envoys eo \d' 2 0A Exl stl ng 240V/200A C PV Circuit2:12TNEMMAIJun 0 1O y�F Service Pane,Single 41 Modules/ 1 pO p� Phase,with WDA Main Parallel _ p�,tg I Disconnect J Rf C 0O��s" 3 3 0A• SHEET PVCircuitl:l3 m mer ane nvoy- 40VContinuous, NUMBER: Modules/ 1 protection max 60A breaker on combiner ouput: Parallel with 10 KAIC circuit breakers n Box with lrreversihle Visi I Loc le Knife'A/C Minimum GEC size4 Ground Splice(TYP) Disconnect AWG copper W PV Module Rating @ STC Conductor Calculations SOLAR MODULE Module Make/Model Hanwha Q.PEAK BLK-G4.1290 Max.Power-Paint Current(Imp) 9.07 Amps -Wire gauge calculated from art.code 330.15(B)(16)with ambient temperature calculations from m art.310.15(2)(a). Max.Power-Point Voltage(Vmp) 31.96 Volts w N For"On Roof'conductors we use the 90°C column ampacity,0.5"-3.5"off-the-roof temperature :2 Z Z rn Open-Circuit Voltage(Voc) 39.19 Volts adjustment from 310.15(B)(3)(c),and raceway fill adjustments from 310.15(B)(16). w Enphase M215-60-2LLS22-IG Short-Circuit Current Is[ 9.63 Amps R u 3 MICRO-INVERTER AT ( ) P For"Off Roof'conductors we use the 75°C column ampacity,or the 90°C column ampacity with u EACH MODULE,ATTACHED Max.Series Fuse(OCPD) 20 Amps the relevant ambient temperature and raceway fill adjustments,whichever is less. ~ a WITH ECOLIBRIUM SOLAR HARDWARE Nom.Max.Power at STC(Pmax) 290 Watts The rating of the conductor after adjustments MUST be greater than,orequal to,the continuous (D o ¢ > Max.System Voltage 1000 V(IEC)(UL) duty uprated output current. — tl6 BARE CU GROUND 7 (ATTACHEDTO FIRST MODULE IN Vac Temperature Coefficient -0.28 %JC Calculation Example-Wire Rating(90°C)x Ambient Temperature Adjustment x Conduit Fill ARRAY).BALANCE OF ARRAY Adjustment>=Continuous Duty Output Current - - GROUNDING CONNECTIONS AC Output Current According to art,690.8(B)(1) 22.5 Amps (On Roof,Tag 2):10 gauge wire rated for 40 A. 40 A x O.76 x 0.8(4 Conductors)=24.32 A>= MADE THROUGH ARRAY 14.625 A HARDWARE ; Nominal AC Voltage 240 Volts — THIS PANEL IS FED BY MULTIPLE SOURCES(UTILITY AND SOLAR) (Off Roof,Tag 3):10 gauge wire rated for 35 A, 35 A>=28.12 A l� MICROINVERTER CONNECTION TO ENGAGE TRUNK CABLE ' ��, Rooftop conductor ampacities designed in compliance with art. 0 690.8,Tables 310.15(B)(2)(a),310.15(B)(3)(a),310.15(B)(3)(c), 310.15(B)(16),Chapter 9 Table 4,5,&9. Loacation specific temperature obtained from ASHRAE 2013 data tables. Inverter Make/Model M215-60-2LL-S22-IG ASH RAE 2013- Max.Dc Volt Rating 45 Volts Highest Monthly 2%D.B.Design Temp.:32.1°C Max.Power at40 C 215 Watts Lowest Min.Mean Extreme D.B.:-17.5°C n Nominal AC Voltage 240 Volts i Max.AC Current 0.9 Amps m Max.OCPD Rating 20 Amps u Max.Panels/Circuit 17 Short Circuit Current 15 Amps N OCPD Calculations Breakers sized according to continuous duty output current.PV circuit nominal current based off# of modules per Circuit X(1.25(art.210.19(A)(1)(a)))X(0.9 Max AC current per micro-inverter) go ti Circuit#1=13 modules,Output Current wJ continuous duty=14.63<20A Breaker cc w Circuit#2=12 modules,Output Current w/continuous duty=13.5<20A Breaker m system output current w/continuous duty=28.12<30A(System OCPD) 5 N z W Z � W rn m m Other Notes Z z Z u1Oi •Designed according to,and all code citations are relevant to,the NEC 2014. SHEET •All ampacity calculations are made in compliance with art.220.5(B)..49 and below is rounded down to 0,and.50 and above are rounded NAME: up. •All specified equipment grounding devices/components must be listed for use N •Inverters are equipped with rapid shutdown. ;; m •690.11 DC Arcfault circuit protection.Enphase micro inverters are exempt because there are no DC strings. Z a SHEET NUMBER: N Ld 801UNIRAC U-BUILDER PROJECT REPORT VERSION:1.9.4 JUL 17,2017,09:45 PM PROJECT TITLE: NONE PROJECT ID: 9F5DCF1F Designed by . Name: None jacwb.allred@vivintsolar.com Address:.. None SUNF.RAME MicroRail-2.0 City,State: Madituck,NY,11952 25-290 Watt Panels Module: Q-Cells Q.PEAK BLK-G4.1 290(32 mm) 3 e 290 Watts 7.2 kWs BILL OF MATERIALS PARTS AND ACCESSORIES Legend:0 Base System 0 Part Accessory Part Suggested Unit Price Total List Number Part Type Description Quantity Quantity (USD) Price(USD) 230932E Micro Rail(9) - SFM ATT SPLICE 9 32MM - - -- 4-—— 4 — 36_27 - —145.08 240904D Roof Attachment SFM TRIM ROOF ATT ASSY HEX 10 10 14.20 142.00 --------- -- -... --.-_._.___.._. --------- -...-._..--------------- -- -- ._.. ----------- 008015S N-S Wire Clip WIRE BND CLIP 9 9 2.77 24.93 004016D Flashing SFM FLAT FLASHING 56 56 13.91 778.96 030027C Lag Bolt HDW LAG BOLT,5/16 X 4 56 56 0.79 44.24 240132E Trim SFM TRIMRAIL 66 32MM DIRK 4 4 78.92 315.68 240232B Trim SFM TRIMRAIL 132 32MM DIRK 2 2 155.36 310.72 240903D Trim Splice SFM TRIM SPLICE DRK 4 4 8.66 34.64 230332B Microrail(3) SFM MICRO RAIL 3 32MM 42 42 21.43 900.06 230132B MicroRail Splice SFM SPLICE 9 32MM 12 12 22.78 273.-36- 1008009P Grounding Lug ILSCO LAY IN LUG(GBL4DBT) 1 1 8.40 8.40 BASE SYSTEM ACCESSORIES TOTAL PRICE $1353.14 $1624.93 $2978.07 $0.187 PER WATT $0.224 PER WATT $0.411 PER•WATT This design is to be evaluated to the product appropriate Unirac Code Compliant Installation Manual which references International Building Code 2003,2006,2009,2012 and ASCE 7-02,ASCE 7-05,ASCE 7-10 and California Building Code 2010.The installation of products related to this design is subject to requirements in the above mentioned installation manual. DETAILED PARTS DESCRIPTIONS 230932E SFM ATT SPLICE 9 32MM Micro Rail(9) TBD 4 240904D SFM TRIM ROOF ATT ASSY HEX Roof Attachment TBD 10 r� 008015S WIRE BND CUP N-S Wire Clip TBD 9 004016D SFM FLAT FLASHING Flashing Includes flashing,attached gasket,washer,and square aluminum washer only.(12"x 56 8").Lag bolt and rail attachment component sold separately.NOTE:about other flashing options 030027C HDW LAG BOLT,5116 X 4 Lag Bolt Zinc plated steel,3-1/2"length,2-1/2"threaded length,5/16"shoulder diameter. 56 Confirm that bolt strength and penetrating length can withstand the maximum loads of for your application. 240132B SFM TRIMRAIL 66 32MM DRK Trim TBD 4 — 240232B SFM TRIMRAIL 132 32MM DRK— -- -- ---- ---- Trim TBD 2 240903D SFM TRIM SPLICE DRK Trim Splice TBD 4 230332B SFM MICRO RAIL 3 32MM Microrail(3) TBD 42 230132E SFM SPLICE 9 32MM MicroRail Splice TBD 12 008009P ILSCO LAY IN LUG(GBL4DBT) Grounding Lug For electrical bonding of PV modules and rails.Accepts 4-14 AWG copper wires.Tin 1 plated copper body,1/4"stainless steel fasteners.NOTE:about other lug options Mono. Multi Solutlons -"- THE ALLMAX©PLU5'MODULE PRODUCTS PE ELECTRICAL DATA WC) - TSM.DDGSAA8(l) 27PV CYCLE Took P-1a H,Pe JWp)- 270 275 2B0 2E5 290 295 TSM-DDOSADS(Ill '270-290W pow, OClpalid nn P (WI O-.S -THE Mown nPaww Ilbgp1 (V} 312 311 317 318 , 32.2 32.5 ALLM"AAX"PLUS" JBdd 864 897 9AI VB OIMENSIONSOFPV MODULF CronC Nl Vcltoge V«IV) •• 386 38; 39.0 -39,7 39.5 39.7 unll:mm/1M1GNed (Snarl CrcvilCwrenblic JAI '918 926• '935'. 945 9,50 9.55 MODULEMOOok EIOt Ency pn p&I 65 168t 17,1 i 17.6 18.0 _ = S)G.09a9r1:c lees Wln:Cc9lceparolyrc 2S'C A'rMou '�tMO � � .4 - noP blocgy+SZ Ij ELECTRICAL DATA(NOCT) -`--'--- p _ tMMoapvo•�t ne wPP lvoNP C pinemI•Wr�eIJh i vj1 I 1; 209 212 _-216 - 220 60 CELL 29.2 29< 246 2y.9 '30.2 MONOCRY$TALIINEMODE 696 70 710 117 723 726 3s7 xo 3a� xe ae.> '36:v" Short ChouilC t-1,JAI-n -.41. 748 R 755 763 7.67 7.71 t 7 if{t 2'I 0-29 W i NDG1:IrtvWcn.nar6Bn W,m ewn'.Alnl1—•dae-C,Wnd 14 al N, P F SOWER OUTPUTS MECHANICAL'DATA RANGE Maximize limited space with.top-end efficiency --"y_ •JP la 180 W/m'pOWe!Oen9lly SOIprCeW Mo ayst U ISe•156 Id cn sl Le u Inermol cpel5den!s for greater energy pfooeo60n of HuJn u:i} .. ,CcAOrfa Id ar 60 ells(d 101 T8.0 Opera*,ng,G nGOfpialGl Q , 1Motl kCime dons I650.991.35man(650x39Jx1.38 mcneg MAXIMUM EFFICIENCY n�a s�F+, Wag t ie6kglualGl N R _ r 3 mm(O 13 tm )High T -wn•AR CooledTempered Gla#.. Highly reliable due to stringent quality control li - eon , -Wmw(DDasn DBUDh eIOGR roolisA o$luli` 0 rA>.,},5�wJ •( R'/of •OVe,301n P ac lu i,(UV•IC.Hr.ano many ,fit{{ 1 "LOJ Inilouso1 ring 90c%-.11OeycnO cett licalion rOqullr:mt:nls •' Rom Biou IDO05A06JI1j0005A 05U11J B 1 100%i EL 10Ual0in570c11o� , B _ 1167 or U,6B0 d POSITIVE POWER'TOLERANCE'; ` w� _ t - - ^•- )B- IPnot—ftic Technology Coble 4 Omma(OD05'Ccokf r 1000mm(39,41nchvfl �Cor'In Glq MCICGTpb,bbb.Ampn Ml Hd/UT!( � w f a P IUDd l•g glut- x,m,lb I et } Certified to withstand challenging environmental - fun Typ Type I or type 2 ,nxr0 xrni n_p.tovolta cp nNc, �, conditions 1•V CURVES OF PV 10ODULE(295W) e n I GIGf ape bh il: ��''�� `'" 2400 P. ar Owl,x r.Jlu.ol to _caay.Ni!.ry -- .54D0 Po now l000 - TIiAVFRAIURERAUN03 MAXIMUM RATINGS bCClpr ffnCr alWna lnA glob¢lia:P "---- is vbk to D D 0e•C+cUntorlp5:enc�e 35 mm nail Stones at 97 km/h _- - No1n-1 OpemfLng Cell OCemflandT—PGla1— •60-+85•C 46•CJx2•CI IO eaCnC Slant:f nnnPn Wk-1 Move INOCTI: y �l Im m5,nle:n vau G I- 'Dowel :IIpW^^-rticnl Out t,nOv 1 ftSObie 1 'Iemp91 lui C IBD¢, ir, �•039R/C 0 000b fSC el,Ierodacl MII h 170 11g Q T 1g J a 1 _ - - -_ _ _ ( I d Da.O ng Aobf purl Wtl — — temp eCoeffxlem IVv -029%/'G _ M¢Y Serif;FVae Rd1.'tg a 15A Jaj< m,rao to ea dma a'✓Of>giG " y" '7n 1 Cliel Eceni all:i 0,05,&C nW NOB)bism•F rtll cO9olix011or,with __ - rripera are . �r6tallna,dCvelaPcvt•,.:i5nlDa1o7,pnd — - — - '"-- OH!etP.11-la Oinne—kDon0.ar 't._S.rGf9afmJnviryT Smorl EnarOY a a w a Y A . . . T•Y:,F1nAf. y,p WARRANTY . $Iw Nm,led. Comprehensive products and system certificates Pv CURVES OFPVMODULE(295W) IO yc Product W t npW ry j ' wwwJ"vwiG!Oc.com .._ - IPka. r.le opoevclrgnon Yloraeblrl {' � ••ISO 900:QUO 61730!Ol 1703/IEC 61701/IFC 62716 LLVPAgQLR5QW11A!REWA.VJiif !ISO 9001:OUOlity MOn,lg�Ten1$ySfCfil L - ( �O ISO 14001,Environmental Mcnogemenr Sysrcm :ISO 14064:GreenhDuSC Gases EmiSsioM YetifC01i0n '✓� - _ PACKAGING CONFIGURATION _` •'•w�- OHSAS 18001:OCcapolion neotin ano Sole:y Management SySlem �� rtoar pu oo Oyccei a ++I dam.. a 6,10 y 1• L3, Rya ^ R ` u— pv CYCLE .,. 'Ti lusolar CAU pM:READS EIY ANU WHA Ar1aU WSS¢YCTNh B?LOPE S GtnE P¢pJU ■�C 01016U4w 5a1u11artilva,AEr'rylnlcxvvJ,1 WUBw�W,nalcWvcdiniturtlulanl•v;gv I.cya 1p aunUcw4twl nolcc. $lion EnergyTugefher -Smart rgOIry� arrttlEnergy7�COetner Enphase S230 Microlnverter H DATA Enphase Mlcroinverters INPUT DATA(OC) '--"- _ S230-60-ILL-2-US,S230-60-LL-5-US' Commonly used module paidnge 195W-285W - - A/ Maximum Input DC voltage 48 V E n p h a s e-S 3 O Peak power tracking voltage 27V-37V Operating range 16 V-4a V M W Max start voltage 22 V/48 V Max DC short circuit current 15A `•""'.�' INPUT DATA(DC) 208 VAC 240 VAC Peak output power 230 VA 230 VA 3 4`1 Maximum continuous output power 220 VA 220 VA Nominal voltage/range 208 V/183-229 V 240 V/211-264 V Nominal output current 1.06A 092A Notninal frequency/range 60/57-fit Hz - 60/57.61 H. Extended frequency range 57-63 Ha 57-63Hz 4 i Power factor at power 1.0 1,0 a+rvy� Maximum units per 20 A branch circuit 25(three phase) 17(single phase) Maximum output fault current 663 mA rms,100 ms •,"i663 mA r ,1O0 ms f - ,Power factor(adjustable) 1/11.7leading-0.7.1agging 1/0J leading—0.7 lagging EFFICIENCY _ - - 208 VAC 240 VAC i - CEC weighted efficiency 96.5 95 92o% Peak inverter efficiency 967% 97,211- 1 MECHANICAL DATA - _ Ambient temperature range 40°Cto.65°C - - - Connectortype S230.60-LN-2-US:MC4 Built on the fifth-generation platform,the Enphase S230 Microinverter"achieves the highest Inverter efficiency S230-6a-LN-5-US:Amphenol H4 for module-level power electronics. With its al(-AC approach,the S230 simplifies design and installation for Dimensions(WxHxD) 172mmx175 him xSSmm(without bracket) 230 VA installations,and delivers optimal energy harvest.The S230 is compatible with storage systems, weight 1.8 kg(41DS) including battery management systems. Cooling Natural convection-No fans Enclosure environmental rating Outdoor-HEMA 6 The Enphase S230 integrates seamlessly with the Enphase Envoy-S'communications gateway,and Enphase FEATURES Compatibility _ 60-cell PV modules Enlighten"monitoring and analysis software. communication Power line Integrated ground The DC circuit meets the requirements for ungrounded PV arrays In NEC 69035.Equipment ground Is provided in the Engage Cable,No additional PRODUCTIVE SIMPLE AND RELIABLE ADVANCED GRID READY GEC or ground is required,Ground fault protection(GFP)Is integrated into the micrainvetter, -Maximizes energy production -No GEC needed for microinverter -Complies with fixed powerfactor, Monitoring Enlighten Manager and MyEnlighten monitoring options - Minimizesimpactofshading, •NoOC design or string calculation voltage and frequency ride-through Compliance UL1741/IEEEl547,FCC Part 16CfassB. dust,and debris required requirements CAWCSA-C22,2 NO.0-M91,OA-04.and 107.1.01 •More than 1 million hours of testing =Remote updating to respond to 15ugaes of y,mvdrie,.dl unit:ociripim. IndustVeading warranty, changing grid requirements `.tra l chagorang,oanbeexlendMbeyondnomumldreQuaMbythduNdy. up to 25 years Configurable for variable grid profiles like Hawaiian Electric Company (HECO)Rule 14H,California Rule 21 i.- EN PHASE. s�. To learn more about Enphase Microinverter technology, ... �- visit enphase.com " ENPHASE. 02016 mpnau brcr9r,aingnis resawa,aHaeemans or sandsin his mcunsm are regmernwlhw pocmuswrsr., Ja ,,2o16 i. SUNFRAMEMICRORAIL UNIRAC SUNFRAMEM"C'�IRQRA.IL :�UNLRI Ct IESS RAI", MORE'PEAfDR IANCE I - — Sotnsts OaW,B s�te%� I SUNFRAME MICRORAILI"(SFM)is a hybrid racking No rn ku I�ClrDaaitArtere�ufrt rraii t i' [ INDUSTRY LEADING FEATURES ,,,�,��„ ,, ,�„i$ f •. system including astmctulal front TrimraiPN for fastest = STRUCTURAL FRONTTRIMRAIL it &nmm oftrwlatticer e,Pwfran tu4q;,of MbAiraA ort xbrI array alignment and superior aesthetics.Minimize total labor with pre-assembled parts.integrated bonding : POSTANSTALLHEIGHTADJUSTMENT L1127O31iN Fri ttNmu ls4a UtHlry�uirer fs, 3 hardware and one tool installation,Compact packaging { tau£ aot�. wo�+sk's�iet�.5'Art�Gsms , with few SKUs lowers logistics costs from the r SINGLE MODULE ACCESS J+ neme+t�ru,bofaem durtrc� a7 f�wivee�ISaAEbaa%s rte warehouse to the roof.Patented mounting components Lk� TMr '.f,. r `I A.,- a°nt /;lit::[ ,,w�u; aaYsycatgv�&u ; rypr, od� provide post-install height adjustment and allow for Shane ensGyryxipac'i rggPtaas lmluW3, removal of individual panels for maintenance SINGlET00L INSTAtLATION areas, , ;rri, ai ,,,,,o, �;, OUICK&EASY ARRAY ALIGNMENT TRIMRAILWITH SEAMLESS MODULE MOUNTING MIXED ARRAYS-PORTRAIT&LANDSCAPE ORIENTATION w - - AVAILABLE MLPE MOUNTWITH CABLE MANAGEMENT F LOGISTICS OPTIMIZED-COMPACT PACKAGING FEW SKUS SIMPLIFIES INSTALLATION i 4 e ENHANCED U-BUILDER DESIGN/LAYOUTTOOL _- - — ,d._..d:_:a ON-SITEPRODUCTTRAINtNG COLLABORATION WITH INDUSTRY LEADING INSTALLERS-FIELD TESTED&VERIFIED WORLD CLASS U,OUIUrER FOR QUICK&EFIRCIENF DESIGN/LAYOUT WITHIN MINUTES FAST AND EASY.P[RMIT APPROVAL 5_, PRODUCT TRAINING WITH PROTECT MANAGEMENT SERVIGES TO.MINIMIZE INSTALLATION LEARNING CURVE. :LESS +R A I L_, M O R E PERFORMANCE tttrlltllGttLrSfLTPsER,FittikCt (€hfs'S tfETfiCIfFSFtt: l Ill:tC3tfUUC( llFLTEttitf TIJ'r`F£AL'.ttTNf3TlitlUST ,