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Home My WebLink About33710-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Date: OS/13/0S liIo: Z-33217 THIS CERTIFIES that the building SOLAR PANELS Location of Property: 1200 MILL RD (HOUSE NO.) County Tax Map liIo. 473SS9 Section 107 MATTITUCK (STREET) (IIAMLET) Block L- Lot 2.3 SUbdivision Filed Map liIo. Lot liIo. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 20, 200S pursuant to which Building Permit liIo. 337l0-Z dated FEBRUARY 27, 200S 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 SOLAR PANEL INSTALLATION ON AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to DENNIS SCHRADER & WILLIAM SMITH (OWNER) of the aforesaid building. SUFFOLK COw...': DBPAR~ OF IIElILTH APPROVAL N/A ELBC'l'RICAL CERTIFICATE NO. 3056370 05/01/0S PLOMBERS CERTIFICATION DATED N/A ~ ~C{?~_ Au horized Signature Rev. l/Sl \V\t:(J I Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 --,>.~ l. r>...'" ~ __~ . "' 4 -r fr~ c APPLICATION FOR CERTIFICATE OF OCCUPANCY l ; , it I , This application must be filled in by typewriter or ink and submitted to the Building Department with the follawing:.,:? 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. Swam statement from plumber certifying that the solder used in system contains less than 2/1 0 of I % 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 aud "pre-existing" land uses: J. 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 $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Ce11ificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Ce11ificate of Occupancy - Residential $15.00, Conuuercial $15.00 Date. _ C\ If !(!)] 4( J' New Construction: Old or Pre-existing Building: (check one) AA a.+J \ Wet- Hamlet Location of Property: fMf) House No. cctn+JLjI Qr( Street 'j-W('{(('atN\. c; I 0 rr ~ t)( - (L Lot Owner or Owners of Property: ~AJ.v' &t' tJ rJA~ ClI'~tlL Suffolk County Tax Map No 1000, Section / (!)()O Subdivision ~L- Le<<f,- rqU t? Permit No.3:571 0 c.. Date of Permit. 3, Filed Map. Lot: :5 Applicant: tZ r;>~.v J eJt{j 1('./ F/....<.eJ~"Jj y Underwriters Approval: A/ / A. t"'F Block Health Dept. Approval: A/I/} - I -'l) (p4- Temporary Certificate Planning Board Approval: Request for: Final Certificate: ./ (check one) mufi/dw Fee Submitted: $ e:l D Z;' 3~ ;).1{ ~ c:.1t!11 ').... ,..~ GREENLOGIC. ~ ENERGY Michael J. Verity Chief Building Inspector Town of South old 54375 Route 25 P.O. Box 1179 Southold, NY 11971 !.i:i-:-: . r ';/.' I I;'" Ii I-jUG :~'A-r~'- " 8 o,~ i.._.__.___ ___J~ .J Building Permit Number 33710 [Schrader] Dear Michael J. Verity: I am writing to certify that we, GreenLogic, LLC, have completed the installation of a solar electric system at Dennis Schrader's home, 1200 East Mill Road Mattituck, NY 11952, to the specifications of our Professional Engineer stamped plans and according to Unirac SunFrame Code-Compliant Installation Manual 809. Thank You, ~~ Ashlee W. Reiniger Project Manager .--.J GREEN LOGIC, LLC . www.GreenLogic.com SOUTHAM PTO N/COR PORATE 425 County Rd. 39A, #101 Southampton, NY 11968 Tel, 631.771.5152 Fax 631.771.5156 SOUTH OLD 52875 Main Rd., Box 435 Southold, NY 11971 Tel, 631. 765.0404 Fax, 631.771.5156 MANORVI LLE 40 Woodland Avenue Manorville, NY 11949 Tel,631.771.5152 Fax, 631.771.5156 ROSLYN HEIGHTS 200 S. Service Rd., #108 Rosyln Heights, NY 11577 Tel, 516.625.6880 Fax, 516.625.6881 II G1~~~~ ~ ~ 2 0 32 0 3. kw $0.00 $0.00 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~0 ~t} ~ . ~.: ~C ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ I I NEW YORK BOARD OF FIRE UNDERWRITERS BY THIS CERTIFICATE OF COMPLIANCE THE ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ Located at ~ ~ ~ ~ I BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by GREEN LOGIC 425 COUNTY RD 39A SOUTHAMPTON, NY 11968 DENNIS SCHRADER 1200 EAST MILL RD MA TTITUCK, NY 11952 1200 EAST MILL RD MATTITUCK, NY 11952 Application Number: 3056370 Certificate Number: 3056370 Section: Block: Lot: Building Permit: BDC: ns11 Described as a occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: photovoltaic, Detached Garage, Outside, @! A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed ~ herein, was conducted in accordance with the requirements of the applicable code and/or standard ~ promulgated by the State of New York, Department of State Code Enforcement and Administration, or other ~ authority having jurisdiction, and found to be in compliance therewith on the 1st Day of May, 2008. Name OTY Rate Rating Circuit' ll1l!< ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ Amount Miscellaneous photovoltaic system CORRECTION FEE Alarm and Emergency Equipment Inverter Unit Solar Panel Wiring and Devices Disconnect Disconnect $0.00 $20.00 Invoice Total $0.00 $0.00 $95.00 2 0 2 0 30a ale 30a die seal ~ I Th' ,",moo" "'" "" be ...., '" .~ "" ~, " ""~ 0:", ~ ,be ..,"" "' · ~"" -, .... "'",00 i"'k"" _ ............_ ___.. r.r.r.IF.Jr. FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 33710 Z Date FEBRUARY 27, 2008 permission is hereby granted to: DENNIS SCHRADER 1200 EAST MILL RD MATTITUCK,NY 11952 for : INSTALLATION OF SOLAR PANELS TO A SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 1200 MILL RD MATTITUCK County Tax Map No. 473889 Section 107 Block 0001 Lot No. 002.003 pursuant to application dated FEBRUARY 20, 2008 and approved by the Building Inspector to expire on AUGUST 27, 2009. Fee $ 200.00 ~-;(;:',~ CJL& I Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OFSOUTBOLD B~ING DEPARTMENT -'TOWN HALL SOUTBOLD. NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9501 www. northfork.netJSoatholdf PERMIT NO. ~~1J BUILDING PERMIT APPLiCATION CHECKLIST Do you bave or need the following. before applying? BoordofH_ "'.... 4 sets of Building Plans )/ II- l'Iat1nin8 Boord approval N\t" Survey v" Check ......... ~~o;;n~i~ CoaIocI: MaiJto: Po ~'1 ?oct P.n.;"'lt' ~I ?1M I R'a"Z- Pbooe: III~ I. ~:J-t - C;; IS z.. ~ Examined Approved Disapproved ale af") 1 .lOg{,. ~""20-Oi- v ..... Expiration ~ 13" 1- lO-Ifl (---.. PI IJ/ - ~speCtOf'-- - ,-- < / \' APPLICATION FOR BUILDING PERMIT ,o'i \J ",,) L. .,L Dale ~~11..., 20M '~ INSTRUCTIONS ---' .. This appIicFon MUST be oomp1etely IiJled in by typewri.... or in ink and SIJbnUtIM to the Bui1ding InspeoIor with 3 selBofpbms,""""" plot plan to seale. Fee .....dib& to .........10. b. Plot plan showing _ of lot and ofh..nd~ OIl premises. relatioosbip to 8lljoining premises or public _ or areas, and waterways. c. TIle _.......-I by 1his application may not be""""""'" beli>re _ ofBui1ding Permit. cI. Upon approVll1 of1his application, tile BuDding InspeoIor will issue a BoiIding Permit to tile appIieaot. Such a pennit sbaIl be bpt OIl tile premises lMIiIabIe fi:lrlDspo<:Mn lbrougbout the-. .. No building sbaII be oa:upied or used in whole or in part fur any purpose wbal so ever UDliI tile Building InspeoIor _ a eemliealeofOccupancy. t Il""'Y buildingpenDit sbaIl axpire if the _lIIJIhOri2lOd ...._~. ...""" witbilll211Kl1llbsafterthe dale of issuanc:e or bas DOt beeu ~.d wi1bin 18 momhs ftom such date..lfoo mniDg Arrw:n.inwnk or other fI'l8',IAtinnc affectiog the property bam: been enaded in tile interim, tile Bui1ding IDspe<Iormay IIIIIbori2I:, in wriling, tile emnsioo of tile pennit fi:lr an addition six JDllIlIbs. Tbereafter. a new pennit sbaIl be required. APPLICATION IS HEREBY MAD!! to tile Bui1ding DeptulmeIIllb<tIle issuaoee ofa Bui1ding Permit pwsuaot to tile Bui1dingZone o..u.-- of tile TownofSoodhnl4, Suftblk Couol)'. New York, and otbe< appIkabIo Laws, 0IdiDan<:es or R"8"I...u-, IiJr tile <OIISInIdion ofbuildiop, additions, or oIIl:raIions or IiJrftlDlJVlll or deonc>ljtVon as - described. TIle appIiamI agi'eeS to compJy with all applicable laws, ................" building code, housing code, and reguIaIions, and to admit IIUlborized iDspec:tcrs OIl premises aod in building fi:lr ~ I inspeetions. , .~~ (SignaIureohppliallltorlllllllC, if......potalion) Po ~i ,rl, ~'tI,.oL.o.-'1p~ (MaiIing_~icant) Ilti3"2- Slate wbe1her applicanl is owner, I...-, agenl, an:biIeCI, engineer, genenlIcontraclOr, e\eclrician, plumber or builder (~tu.l..M.ln:j i, ut: f N.:i:?r.LC.h:rr lix s61a./ pilA>U.l~ Nameof_ofpn........Je~ tt.is. <::"ryad Q/ (As 00 the tax roll or Ialesl deed) Ifapplieanl is a "",,,,,,oIion, signalure ofduly authorized officer (Name and lilIe of corporate oftic:er) Builders License No.--H 1'\ Plumbers License No. '" ~ E1.clliGians License No. '2.\ 4 !ll ~ lit F OIberTrade's License No. ,",017 -:t, \+ Su~ will be ~ \Mo<<.f(~ CountyTaxMapNo.\OOO Sectioo~Block. I Lot Subdivisioo Filed Map No. Lot (Name) \ . 2. State cx.i~ use and occupancy ofpremises,anP iDle'ldM use and 0CCUJlIIIlCY ofproposed construction: a. Existing use and occupancy ...1. ~!.I:1.qt ra, b. Intended use and occupancy r .t <iC(1.o~ 1'..( 3. Nature of work (check which applicable): New Buildin, Repair Removal DemoIi1ion 4. Estimated Cost 4 -;o,~ Addition Alteration QlberWork 111~.ftJlJ m/- ""'oun-lc.t! ~kv (Description) pe.w.oe.lS Fee S. If dwelling, number of dwelling units , . If garage, number of cars I r.rif 6. Ifbusiness, commercial or mixed occupancy, specify nature and extenI of each type of use. .----- , 7. DimensionsofexistingSl\'UClUreS,ifany:Front t~'f' Z~Rear n' of 2IS'Depth l/D' Height Number of Stories :;L Dimensions of same sbuclure with aIIeralions or addllions: Front 5n.n IJ - Rear Dep\t1 Jieight Number of Stories (fo be paid on filing this application) Number of dwelling units on each floor 8. Dimensions of entire new construction: Front.JLEI__Rear Height Number of Stories DepIh 9. Size oflot Front Rear 10. DateofPun:base~Name of Fonner Owner Depth Cnh.;L1 ~ I '- 'aNh~S 11. Zone or use district in which premises are situated 12 Does proposed consttuction violate any zoning law, oldinanc:e or regulation? YES_NO v-" 13. WllIlot be re-gmded? YES_ NO_Will ex<:esS fill be _ved ftom premises? YES_ NO~ 14.NamesofOwnerofpremi...~t\'I.s SJ.woa.~ rUlll ~ill ad.. ~~j,~I- l'ltl- ~It> Name of Arcbitect ~ Address Phone No NameofConlractorf., , "I:\IC. 1.11' Address tn BM ~( PboneNo. 1iI~1- ':llf1-S1';z.. p,."".w ~ 'I '\n. IS a. Is Ibis property wi1bin 100 feet of a tida\ wetland or a lieshw8ier weiiandf 'YES_ NO V . IF YES, SOUlHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b.ls dlis prqperty wltbin 300 feet of a tida\ wetland? · YES_NO ~ . IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accuraIe foundation plan and 0'- to property ~ 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) COUN'fYO~ ~x.~.n,.. me ~,r....... beiogdulyswom,deposesandsays1bal(sJleistbeappliaml (Name of individual sigDiDg _) above......... (S)Heistbe (~L.a--nI'C: (/M't'r'Ac..h/" 1~.uJ- (Cuuh~ (:orpoIaIe Oflk:er, etc.) of said owner or owners, and is duly auIbmizod ... perli>nn or have perfunned tbe said - and... make and file Ibis app/ic:aIion; Ibal all_ contained in Ibis epp\icalion are true to the best ofhis knowledge aod belief; and Ibal the _ will be perfunned in the _ set furIh in the """lir.olinn filed tboewiIb. swomtobefureme~ ~ ~~'=~Z"'~''',"~d~'~'' ~fi~ f( ._."'....'_._.~ CONNIE M. JACKSON Notary Public, State of New York No.01JAS125168 Qualified in Suffolk Count)' ",et Commission Expires April 11, 20(,,1. l. 3371D7- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION ] FOUNDATION 1 ST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ] INSULATION ] FRAMING I STRAPPING W' FINAL [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRlICnON [ ] FIRE RESISTANT PENETRATION REMARKS: -L~ ~1l....r2~/ ~ f'~~~ ~~, DATE 7-?-3 -0 f INSPECTOR ~~ T' . . . , . . .... FIELD INSPECTION REPORT DATE I , COMMENTS , , ()j>d \)J~ FOUNDATION (1ST) , ..j~ " -., 0"" ------------------------------------ ~gr: FOUNDATION (2ND) C~CIl 1?-pt<J - 2: 9-J 9 8 CIl ROUGH FRAMING & ~~ t<J PLUMBING -'., , - :;v C7 ~ --- -~ Q -------- ------- ------- 3;1: ~ --_.~-- p ~ ~ INSULATION PER N, Y. --- +~ ! STATE ENERGY CODE if -' , + c, () /' -7;"3-}-1. "l ~A" /) "tJ~ ,n") L Y'17 ; . + 77i -/-, ~ r~'~J :::,...-- ..d // VI?' J FINAL , , ADDmONAL COMMENTS U\ (' I 7J J>- (i 0 /i) :;;: z m V;T) NI r: C - cl' ~ d:i~ "iJ~ ....J ., ~- 0 0 ..Q 2: , ~ [::; ., ~ 0 t<J >d ~ r..... GREENLOGIC. ~ ENERGY ,-., - . , " ;' """''''.. D. ._.L~j__L:~;! n I g 'Q d!l l.. _J i,,~) July 16,2008 Town of South old Building Department Town Hall 53095 Route 25 Southold, NY 11971 'i _-1 ._~--:..:;:::....::;-- Dear Building Inspector: Please close out the building permit for Dennis Schrader, 1200 East Mill Road, Mattituck (Building Permit #: 33710). Enclosed is the electrical certificate. Please schedule a visual inspection of the solar system and contact us with the scheduled date of inspection. Yours truly, ~~ Alexandra McNear Office Manager GreenLogic Energy ftJ31- =171- S"/ S" 2- (~;cJ. lOT) GREENLOGIC, LLC . www.GreenLogic.com SOUTHAM PTON/COR PORATE 425 County Rd. 39A, #101 Southampton, NY 11968 Tel,631.771.5152 Fax 631.771.5156 SOUTHOLD 52875 Main Rd., Box 435 Southold, NY 11971 Tel, 631. 765.0404 Fax, 631.771.5156 MANORVILLE 40 Woodland Avenue Manorville, NY 11949 Tel,631.771.5152 Fax, 631.771.5156 ROSLYN HEIGHTS 200 S. Service Rd., #108 Rosyln Heights, NY 11577 Tel,516.625.6880 Fax, 516.625.6881 r.... GREENLOGIC ~ ENERGY Date: ~. l't I vwg Town of Southold Building Department Town Hall 53095 Route 25 Southold, NY 11971 Dear Building Inspector: Please fmd attached a building permit application on behalf of Dennis Schrader who has engaged us to provide a roof-mounted solar photovoltaic (PV) electric system for his property on 1200 East Mill Road in Mattituck, NY . In connection with this application, please fmd attached: . A building Permit application . An erosion, sedimentation, and storm water run-off assessment form . Survey of Premises . An engineers report approving the plan . A One Line Diagram of the electrical system . A Visio Diagram of the proposed system . Spec. sheets of the solar panels (Sanyo HIP-195 BA3) . Spec. sheets of the inverter (SMA Sunny Boy 3800 U) . Suffolk Count Home Improvement License . GreenLogic Certificate of Liability Insurance . GreenLogic Certificate of Worker's Compensation Insurance Coverage . Master Electrician's License Please let us know if you need anything else in connection with this application. ~~ Alexandra McNear Office Manager GreenLogic Energy GREENLOGIC, LLC 34 Squires Path East Hampton New York 11937 tel, 631.771.5152 fax, 631.771.5156 Bridgehampton I East Hampton I Southold I Hempstead I New York City www.GreenLogic.com 337/ C February 11,2008 Revised March 3, 2008 To: Building Department From: James A. Marx, Jr. P.E. Re: Engineer Statement for Schrader Residence, 1200East Mill Rd, Mattituck, NY for Solar RoofInstallation I have verified the adequacy and structural integrity of the existing rafter for mounting of Sanyo 195w solar panels and their installation will satisfy the structural roof framing design-loading requirements of the New York State Residential Code - without the need for adding reinforcing to the existing rafter bearns, For the installation of the solar mounting, the mounting rails will be supported by Unirac standoff feet and the structural plan drawings show the designed staggered anchorage pattern for the mounting rail rows. The design is based on wind speed of 120 mph, exposure C and roof snow load of 4S psf. The Photovoltaic system and the mounting assembly shown on the submitted drawings complies with the applicable sections of building code - "Solar Systems" and requirements of roof-mounted collectors as well as applied loading conditions that will satisfy the building code requirements. Thereby, I endorse the solar panel installation and certify this design for mounting the solar mounting assembly onto the existing rafter beams to be structurally adequate. Sincerely, d~~ James A. Marx, Jr. P.E. Professional Engineer 10 High Mountain Road Ringwood, NJ 07456 , cc: GreenLogic, Ashlee Reiniger \ U \ I ----"' February 11,2008 To: Building Department From: James A. Marx, Jr. P.E. Re: Engineer Statement for Schrader Residence, 1200 East Mill Rd, NY, 11952 for Solar Roof Installation I have verified the adequacy and structural integrity of the existing rafter for mounting of Sanyo 195w solar panels and their installation will satisfy the structural roof framing design-loading requirements of the New York State Residential Code - without the need for adding reinforcing to the existing rafter beams. For the installation of the solar mounting, the mounting rails will be supported by Unirac standoff feet and the structural plan drawings show the designed staggered anchorage pattern for the mounting rail rows. The Photovoltaic system and the mounting assembly shown on the submitted drawings complies with the applicable sections of building code - "Solar Systems" and requirements of roof-mounted collectors as well as applied loading conditions that will satisfy the building code requirements. Thereby, I endorse the solar panel installation and certify this design for mounting the solar mounting assembly onto the existing rafter beams to be structurally adequate. Sincerely, (j<<~ James A. Marx, Jr. P. 10 High Mountain Road Ringwood, NJ 07456 cc: GreenLogic, Ashlee Reiniger . . . . . . . . . . . . . . . . . . . . . . . . . . . - 1. l-t\ v'VW<;. -; Jo~ .~~~ I ~ FRONIUS IG GRID-TIED INVERTERS FOR PHOTOVOLTAIC SYSTEMS Light Weight Flexible Lower Cost LCD Display Plug-and-Play Reliable Warranty At 26 Ibs, the FRONIUS IG inverters are the lightest grid-connected inverters making them easy and cost effective to install. The wide voltage range of 150-500 V allows you to use different types of modules and system configuration possibilities. Integrated UL approved DC & AC disconnects which reduce installation time and complexity - often eliminating the need for additional disconnects. User-friendly and comes standard with every FRONIUS IG; tracks more than 20 critical system performance parameters. Expansion slots in the inverter allow you to easily upgrade the inverter with data communication options. Fronius has been in business for over 60 years and has more than 200,000 FRONIUS IG inverters installed worldwide. 10 year Premium Warranty. POWERING YOUR FUTURE DC Input Data FRONIUS IG 2000 FRONIUS IG 3000 FRONIUS IG 2500-LV Recommended PV nnwer 1500 - 2500 We 2500 - 3300 We 1800 - 3000 We Max. DC inout voltaae 500 V 500 V 500 V Operating DC voltage ranee 150-450V 150-450V 150 - 450 V Max. usable DC input current 13.6A 18A 16.9A AC Output Data FRONIUS IG 2000 FRONIUS IG 3000 FRONIUS IG 2500-LV Maximum outnutnOwer @40o C 2000 W 2700 W 2350 W Nominal AC output voltage 240 V 208 V UtilltVAC voltage range 212 - 264 V (240 V +10% 1-12%) 183-227V Maximum AC current 8.35 A I 11.25 A 11.25A Maximum utilitv back feed current O.OA I O.OA O.OA onerati~uencvranne 59.3 - 60.5 Hz (60 Hz nom) Total Hannonic Distortion THO <5% Power Factor (cos phi) 1 General Data FRONIUS 10-2600 I FRONIUS IG 3000 I FRONIUS IG 2500-LV Max_ efficiencv 95.2% I 95.2% I 94.4% Consumption in stand-bV < 0.15 W (ni9hl) Consumption during operation 7W Enclosure NEMA 3R Sizenxwxh) 18.5 x 16.5 x 8.8 inches (470 x 418 x 223 mm\ Weight 261bs. 11.8 ko) Ambient temperature range -5 to 122 OF (-20 to +50 oc) Coofinn controlled forced ventilaton Integrated AC and DC disconnects standard Ul approved DC & AC disconnects Protections Ground fault protection Internal GFDI, in accordance with Ul1741 DC reverse polarity protection Internal diode Islandinn protection Internal, in accordance with Ul 1741, IEEE 1547 Over tenmerature Out ut rower deratino Sume protection Internal DC & AC nrotection, Tested to 6 kV Compliance Safety UL 1741 EMI FCC Part 15; Class A & B Anti.lslandi'ji"Q[)rotection UL 1741, IEEE 1547 Ground fault detector and interrupter Compliant with NEC Art. 690 requirements, Ul1741 Miscellaneous Maximum AC over current rotection Two-pole, 15 / 20 A circuit breaker AC wire sizing Use maximum AWG 6 1940F (90 oc) copper wire DC wire sizinn Use maximum AWG 8 1940F (90 OC) copper wire AC disconnect 16A DC disconnect 25A Warranty 10 year Premium Warranty is Standard " ~ ~ 1! I Distributed by . c .!' .. I o = o . ! . ~ ~ ~i >- "="5 ~~ ~ .. ... ~~ g'!! fi -: .0 ~i. ~E ;~ -g]i ~. .e-g "'. &!' o~ e:: :: ~ ~~ ~ ~ o~ ~'a . 0 " 0 o . 5~ ~! 2 . ~~ ~ ~ ~~ 't;<.!! ~~ Fronius USA LLC Solar Electronic Division 10421 Citation Drive Suite 1100 Brighton, Mi 48116 Phone: 810-220-4414 Fax: 810.220-4424 E-Mail: pv-us@fronius.com www.fronius-usa.com '" ~ ~ M . N ..; 8 .; . . .- ~eI~ HIT" PHOTOVOL TAlC MODULES .. '-<0' f---t:- .L ~:...1--i. . I +---+~ ....- -f: 1--' t : ;-: . , I .-+-, "t: , -- , ~. . ..-. Specifications for Models: HIP-180BA3, HIP-186BA3, HIP-190BA3, HIP-195BA3, HIP-200BA3, HIP-205BA3 .+ -.-, '. --;-+ +- , , +~ 1- ,. r - , -, . . ,. to. -, ',. - ,. ,~ , - ,- .. -i. . - , - , .. , .. .. Proprietary Technology SANYO HIT" (Heterojunction wijh Intrinsic Thin layer) solar cells are hybrids of single crystalline silicon surrounded by ultra-thin amorphous silicon layers. High Efficiency SANYO HIT solar panels are a leader in cell and module efficiency. With models up to 16_2 Watts per sq. foot (17.4% module efficiency) you obtain maximum power wijhin a fixed amount of space_ You save costs by using fewer support materials and less time installing. The powerful panels are ideal for grid-connected solar systems, areas with performance based incentives, and renewable energy credits. Temperature Attributes As temperatures rise, SANYO HIT solar panels produce more electricity (kWh) than conventional crystalline silicon solar panels at the same temperature. Unique Structure SANYO HIT solar panels have a black anodized aluminum, double-wall frame for extra strength. The panels come pre-equipped with a touch-safe jundion box, lead wires, MCTM plug-n-play connectors, and unique mounting rails, all of which help to minimize BOS support structure materials, installation time and costs. Valuable Features SANYO HIT solar panels have no moving parts and weigh less than 31 pounds (14kg). The panels are 100% emission and noise free. The panels have a 20-Year Limited Power Output Warranty and a 2-Year Limited Product Workmanship Warranty. Panels are UL 1703 safety rated for wind, hail and fire_ Unique eco-packaging minimizes cardboard waste at the job site, and allows storage and transport of panels using less space. Quality & Ratings SANYO silicon wafers are manufactured in the USA, and the panels are . assembled in Mexico at an ISO 9001 and 14001 certified factory_ All panels undergo inspections to ensure strict compliance with electrical, mechanical, environmental and visual criteria. SANYO's conservative power ratings for models grant more kWh per rated kW, and assist with accurate predictions of performance and economics. 101 April 2007 Sanyo Energy (USA) Corp. s~~o Power Output Range 180-205 Watts (depends on model) Module Efficiency: 15.3%-17.4% Cell Efficiency: 17.8%-20.2% SAN YO HIT"' Solar Cell Structure p-typeli-type (Ultra-Ihin amorphous siliron layer) Fronl.s,," ~_~Th;nnx>M elect_ I crystalline sllloon . n wafer Rear.Side-_-'-~I'_ electrode Jr ~.,..- i-typeIn-type L. (Ultra-thin amorphous silicon layer) Unnecessary Section When Using SAN YO Increased Performance with SANYO 1_0 Up 10% :0 ~ lL ':i "- ':i o 'C " .!! .. E o 2 Kobe. Japan July 28, 2002 Faced due South Tilt an Ie 30~ 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 Time (Hours) . All HIP-xxxBA3 Models Electrical Specifications 180W 186W 190W 195W 200W 205W Rated Fl:>wer (Frrax)' W 180 186 190 195 200 205 Maxirrum Rlw er Vo~age (Vpm) V 54.0 54.4 54.8 55.3 55.8 56.7 Maxirrum Fl:>wer Current (\;>m) A 3.33 3.42 3.47 3.53 3.59 3.62 Open Orcutt Vo~ge (Voc) V 66.4 67.0 67.5 68.1 68.7 68.8 Short Orcutt Current (Isc) A 3.65 3.71 3.75 3.79 3.83 3.84 Mnimum FI:>w er (Rrin) W 171.0 176.7 180.5 185.3 190.0 194.8 Max SystemVoftage (Vsys) V 600 600 600 600 600 600 Serie!s Fuse Rating A 15 15 15 15 15 15 Temperalure Coefficient (Frrax) %f'C -0.33 -0.30 -0.30 -0.30 -0.29 -0.29 Temperalure Coefficient (Voc) V,.C -0.173 -0.168 -0.169 -0.170 -0.172 -0.172 Temperalure Coefficient (Isc) mAt'C 1.10 0.85 0.86 0.87 0.88 0.86 Electrical Tolerance % +10/-5 +101-5 +10/-5 +10/-5 +10/-5 +10/-5 Warranted Tolerance % +101-0 +101-0 +101-0 +10/-0 +101-0 +101-0 Cen Efficiency % 17.8 18.4 18.8 19.3 19.7 20.2 M:>dule Efficiency % 15.3 15.8 16.1 16.5 17.0 17.4 Rlwer per Sq. Foot W 14.2 14.7 15.0 15.4 15.8 16.2 Mechanical Specifications nternal Bypass Oodes 4 Bypass Diodes M:>dule Area (m') 12.69 Ft' (1.18m') Weight (kg) 30.86 Lbs. (14kg) llrrensions LxWxH (mm) 51.9x35.2x1.4in (1319x894x35mm) Cable Length -MaIe/+Female (mm) 30.7/24.8in (780/630mm) Cable Size 1 Connector Type No.12 A WG I M:;TM Connectors Static Load Wnd 1 Snow (Pa) 50PSF (2400Pa) 1 39PSF (1876Pa) Pallet Dimensions LxWxH (mm) 53x36x63in (1346x912x1600mm) Reces per FuR Pallet 1 Weight (kg) 36pcs 11111 Lbs (504kg) Ouanttty per 20'/40'/53' Container 360pcs 1 756pcs 1 972pcs Operating Conditions & Safety Ratings Temperature ('C) -4'F to 104'F (-20'C to 40'C)' Hail Safety lrpact Veloctty 1" hailstone (25mm) at 52mph (23m's) Fire Safety Oassification aass C Safety & Rating CertWications Ul. 1703, cUL, cs:: liTit:ed Warranties 2 Years Workrranship I 20 Years Power Output 'STC: CeR Temp. 25'C, AM1.5, 1000W/m' 2M:>nthly average low and high of the site. Dimensions Unit: mm (Inches) B94 (35.2) Ground Hole (1 place) 35(1.4) t440(17.3l r- _r ~I NnJ"""""B~ :: label T negative ( - ) positive ( + ) 1Q 11,j 7 18.3(~) Section A-A' ----..- , I ~ '" ,Wi Connector (Me'" PkJg) 1;;;- 1[ Front Side Back '.00 ,.,. ~ '00 'E 2." ~ 2.00 => (j ..,. '.00 0." 0.00 0 4.50 4.00 '-50 ~ '.00 'E ~ 2.50 " (j 2.00 1.50 '.00 0." 0.00 0 s~o Dependence on Temperature (Reference Data fOf 200 Watt Model) .,. , , , .______L______L______I_______ 75"C -,." , , ------1-------1--- , , ._-----~------~---- \ 1 o'c uuu'_______,____ __ _/..__ , , , , , , ------~------~---- 1- , , .______L______L____ , , , , .------r------r--~-- -I , , , .______L______L_____ 1__ Afi15 1CXXl'vV1m2 1 , ., 1 1 20 " 60 80 Voltage (V) Dependence on Irradiance (Reference Data for 200 Watt Model) 1 1 ell Temp. 250 1000W/m.4 - - - - - -... - - - - - - -1- - - - - -- , ______l______J__~__ ~_______ , , , , ,- , 800W/m~ , , -600W/m1 - - - - - - -l - - - - __ , , -------T------,----- 400W/m\ , 200W/m21 - - - - - - -l - - ~ - - ~ , , -----~T-~----I----- , , 20 " 60 80 Voltage (V) ! CAUTION! Read the operating instructions carefully before use of these products. Note: Specifications and products above may change without notice. 04/01/07 Visit www.SANYO.com or contact an Authorized Representative for more information: GreenLogic, LLC Proposed Schrader 6.24 kW 32 Sanyo 195W UniRac Sunframe Azimuth = 180 Pitch = 30 Scale 3/16" = 1.0' James A. Marx Jr. p,. - 'to. E1~ 10 HIgh Mountain RII8lf RIIvwod. New....., 07488 C; ~ /.' '2 II ",c., James A. Jr." "'':W~~ ProCessional Engineer Lie: S6.i6P '^ ~ -l...-I-"'''-,,-" ".1') 'i, ct W :u ;II ~ ~. /' . / ..II.~..IIII. ..11...11. Ifl.III--mmWllllilll'llfW-111 - - - - --.. - - - - - -- - - - -. - _ .. _ _ _H . ... _ _ _ _____ __0 _ _ - -- .- - - .. --... - ~ -- - - - - -.- - - -.-' - - -- - - ___ __ ._ ___.. u_ ___...____ __ _.. __ _ _ _ _____ ~__ _ . II.. .... '11' ........---11-- .-"ill"-" 11I'.-"'-'" - - -.- - - - - - - - - .. - - - -.. - .- - - -- - . - - -. -. Panel Dimension = 35.2 x 51.9" Array Length = 34' 8" Array Height = 12' 2" Surface Dimensions = 13'6" x 38' 1" o 4" Two Piece Flat Top Standoff UniRac Sunframe Rail = UniRac Sunframe Splice Kit Owner: Dennis Schrader 1200 East Mill Road Mattituck, NY 11952 I 2x10" Dougias Fir Rafter 16" On Center Sheet 1 oD Layout Created By: AWR Date: 1/14/08 Unirac SunfTarne rail With two piece 4" fla (2) ~,,",.:;~ ~ LAG ~r:s ca e = "-F~" -. ;' ~ ~~ c: ~ (') L\ S I ~ <ll ttop standoffs ~ ~<> ........ ~ \. GreenLogic. LLC Proposed Schrader 6.24 kW 32 Sanyo 195w UniRac Sunframe Azimuth = 180 Pitch = 30 S I 3/16" 1 0' James A. Marx Jr. 1>,.' '1II0~ 10 HIGh MaunlMl R* ~. New Jemey07<4S8 .~ ~ . Jt/t~ JlmesA. Marx ~o r NEW .Y: Professional EnginC!!!:~!J.c;"~1 . * It w w ~-:J~ ! ~~ 56461 ;,~ ' \\.~ FESc'\~ ---- . ~l Panel Dimension = 35.2 x 51.9" Array Length = 34' 8" Array Height = 12' 2" . Surface Dimensions = 13'6" x 38' 1" I I Owner: Dennis Schrader 1200 East Mill Road Mattituck, NY 11952 o 4" Two Piece Flat Top Standoff UniRac Sunframe Rail , 2x10" Douglas Fir Rafter 16" On Center Layout Created By: AWR Sheet 2 of3 \ Date: 1/14/08 GreenLogic, LLC Proposed Schrader 6.24 kW 32 Sanyo 195W UniRac Sunframe Azimuth = 180 Pitch = 30 Scale 3/16" = 1.0' 0 50"0 0 192" 0 0 0 0 0 o 50" 0 = 136" = = 0 0 140 0 0 96" 0 0 0 192" 0 0 = = 0 0 192" 0 0 0 96" 0 0 140 0 0 = = 0 0 140 0 0 96" 0 0 o 192" 0 0 = = = = 0 0 192" 0 0 0 96" 14(J" 0 0 0 0 0 Panel Dimension = 35.2 x 51.9" Array Length = 34' 8" Array Height = 12' 2" Surface Dimensions = 13'6" x 38' 1" o 4" Two Piece Flat Top Standoff UniRac Sunframe Rail = UniRac Sunframe Splice Kit Owner: Dennis Schrader 1200 East Mill Road Mattituck, NY 11952 I 2x10" Douglas Fir Rafter 16" On Center Sheet 3 of3 \ Layout Created By: AWR Date: 1/14/08 4 strings of 4 Sanyo 195W panels, Array total ofJ.12 kW watts 2 30 AMP two pole DC switches from panels to inverter . . @ ~I FRONIUS 3000 INVERT~ 30 AMP 3R switch near utility meter 240 VAG 240 VAC from inverter to a 30 Amp switch near utility meter 4 strings of 4 Sanyo 195W panels, Array total 013.12 kW watts 1 All panels to be grounded as per NEG code 2 30 AMP two pole DC switches from panels to inverter All panels to be grounded as per NEG code . . @ @ FRONIUS 3000 INVERTER 240 VAG 30 AMP 3R switch near utility meter 240 VAC from inverter to a 30 Amp switch near utility meter I . ACORD.. CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDI'tYYY) 02lO4lZOO8 PROllUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION LoVullo Associates. Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 6450 Transit Rd HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTENO OR ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. Depew NY 14043 INSURERS AFFORDING COVERAGE HAIC. INllUllEll G.......Loglc. LLC lNSURER A: SCOTTSDALE INSURANCE COMPANY 41297 PO Box 38 INSURER B: Brldg.hampton. NY 11932 INSURER C: INSURER 0: , INSURER E: COVERAGES THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY 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 POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH =ES. AGGREGATE UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. l~ E POLtcY NUMBER ~A~Y EFFECllVE POUCY EXPtRA noN OM'TS A ~ENERAL UABlUTY CLS14S2918 01/3112008 01/3112009 ~ . 1.000,000 X COMMERCIAL GENERAl UA8lUTY E -, . 100.000 I ClAIMS MADE [!] OCCUR MED EXP (Any OM DlnOfl) . 6,000 f- PERSONAl & M1V INJURY . 1.000,000 f- GENERALAQGREGATE . 2.000.000 IillAGG~nE ~~ Ar~~r,PER: PROOUCTS - COMPJOP AGG . 1.000,000 X POUCY PR Loe ~OMOBlLE LIABILITY COMBINED SINGLE UMIT . f- "'" AUTO (E._ f- All OWNED AUTOS BODlL Y INJURY lPerpiltlOfl) . f- SCHEDULED AUTOS f- HIRED AUTOS BODILY INJURY . f- NON-OWNEO AUTOS (Po<_Q f- PROPERlY DAMAGE . (Perac:ddent) ROE LIABILITY AUTO ONlY - EAACctDENT . >><< AUTO OTHER THAN EAN;C S AUTO ONlY: >GG . pCESSAlIfBREU.A lIABILITY EACH OCCURRENCE . OCCUR D ClAIMs MADE AGGREGATE . . R ~DOO11BLE . RET1!NT1ON . S WORKERS COMPENSATION AND WCSTATtJ.. 1O]).i- EIIPI..OYE.R8" UABIUTY E.L EACH ACCIDENT S AN'( PROPRIETORIPARTNERfEXECUTIve OfRCERlMEM8ER EXClUDED? E.L DtSEASE. EA EMPlOYE S grECw.~~NSbelOW E.L DISEASE - POUCY LIMIT . 01>lER DESCRIPTION OF OPERATIONS I LOCAnoNS' VEHIClES I EXCLUSK>NS ADDED BY ENDORSEMENT I SPECIAl PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DE8CRt8EO POUCIe8 BE CANCEllED BEFORe THE. EXPIRATION Town of Southold DAlE THEREOF, THe ISSUING INSURER WILL EHDI!AVOR TO MAil. ~ DAYSWRIT'TEN 63086 Route 26 NOTICE TO THE CER11FICATE HOLDeR NAMED TO lHE LEFT, BUT FAIWRE TO DO so SHALL Southold. NY 11971 IMPOSE NQ OBLIGATION OR UABIUlY OF ANY KINO UPON THE INSURER, fTS AGENTS OR REPREIENTATIVEI. , AUTIKlRR!OROPAESEHTAllVE ~-L~ ACORD 25 (2001/08) @ ACORD CORPORATION 1 988 .. _New York State Insurance Fund W"'*'"' CN-il4.. "r"",,"~ llI1II.JIt>. $p-M-Sbt<< 1914 - 8 CORPClRATE CENTER DR. 3RO FLR. MElVIllE. NEW YORK 11747-3129 _183111'!i8-43OO CERTIFICATE OF ~RS" COMPENSATION INSURANCE - AAAAAA GREENI..OGIC LLC 24 SUNRISE AVE PO BOX 38 BRIDGEHANPTON NY 11932 POLICYHOlDER GREENLOGIC LLC 24 SUNRISE AVE PO BOX 38 BRIDGEHAMPTON NY 11932 CERTIFICATE HOLDER 11iE TOWN OF SOUlllOlD BUIlDlNGDEPT 53095 ROUTE 25 SOUTHOLD NY 11971 POlICY NUMBER 11486 061-3 CERTIFICATE NUMBER 882013 PERIOD COVERED BY THIS CERTIFICATE 0811112001 TO 08111/2008 DATE llI8/2OO7 ':-r.- THIS IS TO CERTIFY THAT 11iEPOLJCVHOLDER NAIooED ABCVE IS INSURED WITH. THE NEW YORK STATE INSURANCE FUND UNDER POUCY NO. 1486 061-3 UNTIL 08I11/2l1Ol1, CO\IER!NG THE ENTIRE OBlIGo\TION OF THIS POLJCVHOLDER FOR WORKERS' ct.- _JSATION UNDER THE IEW YORK WORKERS' COMPeNSATION LAW WITH RESPECT TO ALL OPERATIONS IN THESTATE OF NEW YORK. ~, AS INDICATED BELOW, AND, WITH RESPECT TOOPERATIONS OUTSIDE OF NEW YORK, TO THE POI..ICVHOLDER' REGUI.AR NEW YORK STATE EIFLOYEES ONLY. IFSAlDPOUCYIS CA........,Rl.OR~PRIORT008I11J.:lOO8 IN SUCH MANNERAS TO AFFECT THIS CERTIFICATE. -10 DAYS WRITTEN N01lCE OF SUCH CN-' 4T1ON WIJ. BE GIVEN TO THE <.it:K"..ICATE HOLDER AB(NE. . NOTJCEBY REGULAR MAIL so AOOflES,V1 SHALL BE SUFFICIENT COMPlIANCE WITH THIS PROVISIClN. THE NEW YORK STATEINSURANCEFUND DOESNOrIlSSlIaE ANYUABUTY'" THE EVENT OF FALURE TOGlVE SUCH NOTlOE. THIS CERTlFICAlE DOES NOT APPLY TO BUIUlING DEMOLITION. THIS ~II...CATE IS IS8UEO AS A W.TTER OF INFORW.TIONONLYANOCONFERS NO RIGHTS NOR INSURANCE CO\/ERAGE - uPON THE camFlCATE HOLDER. THIS c-lI..ICATE DOES NOr AIeCl, EXTEND OR ALTER THE CO\/ERAGE AFFORDED BY THE POUCY. NEW YORK STATE INSURANCE FUNr:: /~m~ DIRECTOR.INSURANRJND~ lbIs certIIIcaIB can be ~. IJ~ on our W8b 8iIB at llIIps:IIwww.nysIf.comlceltlcertval.asp or by caIlng (888) ~., . lJ.26.3 VAlIDATION NUMBER: 814881542 . ......>s;jp:i~j~;ir,~~>i;;:~fjN.r;~:~Yfi:~~WIr]f~',:cf: , . .' :<::.::.:.. : \ ::.. ':,~; :. .:.:. 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I' .', ACORD", CERTIFICATE OF LIABILITY INSURANCE I DATE (MIWDIYYYY) 02/04/2008 PROIIUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION LoVu11o __,Ioe. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 6450 Transit Rd HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND DR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Depew NY 14043 INSURERS AFFORDING COVERAGE HAIC# ......., GreenLoglc. LLC INSURERA SCOTTSDALE INSURANCE COMPANY 41297 PO Box 38 INSURER B: Brldgehampton, NY 11832 INSURER c: INSURER D: INSURER E: COVERAGES THE POUCIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDtJCED BY PAID CLAIMS. = POLICY NUIlBER POLICY EfFECllVE POUCY EXPIRAllON A ~ERAL LlABlUlY CLSl452918 01/31/200B X COMMERCIAL GENERAL UABlUTY -W "'-""S MADE [!] OCCUR - UIUlS . 1,000.000 100,000 5.000 1.000,000 2.000,000 1.000.000 01/3112009 I=~ MED EXP (Any one p8I"IOn) PERSONAL & AJ:N INJURY . . . ~N'lAGG~E,UMIT~PER; X I POlICY I I~ I ILOC ~TOM08ILE UA8IUTY _ _ AUTO _ All OWNED AUTOS _ SCHEDULED AUTOS _ HtRED AUTOS _ NQN-OWNED AUTOS GENERAl AGGREGATE S PRODUCTS. COMPIOP AGO S ~GEUABlUTY 1 A}ff AUTO ~ESSIUMBRELLA UABIUTY -1 OCCUR D ClAIMs MADE I DEDUCnBlE I ~ETENTlON S WORKERS COMPENSATION AND EMPLOYERS" UABLfI'Y ANY PROPRJETORJPARTNERIEXECU11VE OFFlCERNJEM8ER EXCLUDED? ~~~bekM OtHER COMBINED SINGlE UMrr . (Eaaccklenl) ElODIL Y INJURY . (Per pereon) BODILY INJURY . (Perac:ddenl) PROPERTY DAMAGE . (Per acddent) AUTO ONLY - EA ACCIDENT . OTHER THAN EAACe . AUTO ONLY: AOO . EACH OCCURRENCE . AGGREGATE . . . DESCfUPl10N OF OPERATIONS' LOCATIONS' VEHICLES' EXCLUSIONS ADDED BY ENDORSEMENT' SPECIAL PROVlstONS CERTIFICATE HOLDER CANCELLATION SHOUlD ANY OF THE ABOVE DE'SCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Southold DATE THeREOF, THE ISSUING INSURER WILL ENDeAVOR TO MAlL ~ DAYSWRmEN 53095 Route 25 NOTICE TO THE CERnFICATE HOlDER NAIIIED TO THE LEFT, 8lJTFAlLURE TO DO SO SHALL Southold, NY 11971 IMPOSE NO OBLIGATION OR UA8IUTV OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATNES. I AU...-EDRS'RE8ENTA_ ~-L~ ACORD 25 (2001/08) @ACORDCORPORATIONl988 If .~::,~~kS~~~~..~:n.d_ '.....1914 8 CORPORATE CENTER DR. 3RD FLR. MELIIlLLE. NEW VORl< 11747-3129 _ \831)1lIlH3IID CERTIFICATE OF~ COMPENSATION INSURANCE, AAAAAA GREEN.OGIC u.c 24 SUNRISE AVE PO BOX 38 BRIDGEHAIFTON NY 11932 POUCVHOLDER GREENLOGIC U.c 24 SUNRISE AVE POBOX 38 IlRIOGEHAMPTON U::K.d-lCAlE HOLDER ntE TOWN OF SOUlHOlD , BUI.DlNGDEPT 53095 ROUJE'25 SOlJl'HOLD NY 11911 NY 11932 ~ I~ POLICY NUMBER 11486 061-3 CERTlFlCAlE NUMBER 882013 PERIOD COVERED BY THIS CERTlFlCAlE 0Bt1112fJ(J1 TO 0Bt11/2l108 THIS IS TO u::I\,lI-l' lllAT THEPOI..ICYHOLDER NAMED N1ICNE IS IlSURED WITH.THE NEW YORK STATE INSURANCE AJND UNDER POLICY NO. 1488061-3 lJIfTL 08fI1121108. COIIEIl!IlG THE ENTIRE OfII.IGATION OF THIS POl..ICVHOLDER FOR vnA<ERS ex- _J8ATION UNDER THE NEW YORK 'riOAKERS ___ _ISf:noN LAW WI1H t""" ~cr TO ALL OPERATIONS iii THESTATE OF NEW YORK. .......,... AS INDICATED 1lEI.OW. NID. WI1H RESPeCT TO OPERATIONS OUTSIDE OF NEW YORK. TO THE POUCYHOLDER'S REGULAR NEW YORK STATE ENPLOYEES ONLY. . IFSAOPOLICYIS CAI"""''':n,OR~PRIORTOO8fI1121ll1l1 iii SUCH MAHNERAS TO AI. _'I THIS ............""'TE. .10 DAYS W....,t:rl NOTICE OF SUCH CANCB.LATION wu. BE GM!N TO THE ",,",.~TE HOLDER N!IDJE. . NOTICE BY REGl. AR MAIL SO AOO I . SHALL BE SUFFK""'IT COMPI.IANCE WI1H THIS PAO\IlSION. THE NEW YORK STATEINSURANCEAJND DOESNaPSSO- ANYI.WJLITYIiI THE EVENf OF FItLIJRE TOGNE SUCH NaTKlE. THIS u:K' ....c.AlE DOES NOT APPLY TO IIUlI.DING DEMOI.ITION. THIS u:K.....::ATE 18 ISSUED AS A Mo\TlER OF N'ORMl\TIONONLY NlDCOl. -- NO RIGH1S NOR lNllURANCE CO\IERAOE \JPON THE u:KIIMCATE HOLDER. THIS u:KllFICATE DOES NOT MEND. EXrEND OR ALTER THE CO\IIiRAOE AfFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUND /~ 7H~' DIRECTOR,NllJRARlND~ lI1Is ........... c:an be .... !lid on cuWllb'" at hIIplI:/lwww.llJlllfAiOl."'-ItcelW--.porbyc:llllng(888)lJ7S.5798i/' lJ.28.3 VALIDATION NUMBER: 914881542 '- Town' of South old Erosion, Sedimentation & Sto....-Water Run-Off ASSESSMENT FORM ~..o,.",... LOCATIllH: S.C.T.IU; 1118 POU.CIWINO ACTIONS MAY IlI!QUIRE TIlE-8U11111811ON OF A I~ t~7. L~'2-- ~tvl'~~:==:~ ---------------------------------------------------- _ Number: (NOTE: A ~ Merit ( 01) for each Question is RequIred for 8 Con1{lI8I8 ""'...........} !!! .!!2 --1---~- ~a:...T=:..AI~==~~~-.=8I...:~aI~----- ~f I ~.and the pennanant_ orlrr1perlloUs surfac8I.) . 2 3 4 5 6 7 8 9 Doaa the SIte...... andIor SUrwy ~ AI "''''- Dn*lage _ ~odIcaIlng SIze &. LocalIon? 1l1Is 118m _ _ aU P,oposed Grade Changes and S\opeB c........... SuIfaoa w....._ Wi8 this. Piojec:l Require any Land Filling. Grading ... ExcavaIian _ _Is 8 d&1ga lIllhe - ~ Grade involving """" than 200 CUbic Y_ or__ any Pan:eI? WII this AppIcaIion Require Land DislLIbk1g AclivlUes El"""",. i ,Ir~ an _In Excess or Ava Thousand (5,000) Square Feet or Ground &.face? Is _ 8 Nalllr8I Water Course RuMk1g through the SIle? Is this Piojec:l wIlhIn the Trustaas jlailodi<tio<, ... wIlhIn One _ (100') _ or 8 _... Beach? WII_ be SIle "'......-.... ~ Grade Slopes _ E10ceed Rfteen (15)_orv_ Rlsalll One _ (1oir) 01 HorizllnIal DisIance? WII 0IMIways. ParIdng _... _1__ SurfaCes be SIopedlll DlractSb.....w_ R....otf Inloandlorlnllte _ of8 Town~ WII this Piojec:l Require the PIacemenl of MalertaI. Removal orV8Q8I8lIcn andIorthe COnstruction of any__1IteTown RJghl4Way"'--- (ThIs 118m will NOT Include the __n of Ilriv81InIy Aprons.) WIIJhIs ProjeclRequire Site Pr_alloc. _the One _ (100}Y_~,ofany_? v[d [dJ.-- [d~ Idv Id V Id [d [d " NOTE: If Any -'-to (\0........... One ~ NIne Is Answered _. C_ _In the Box, 8 Stonn-Waler. Grading. ~&_ Conlnll Plan Is RaquIrecI_ Mustba~for__to -........ of Any Building PennIlI ---------------------------------------------------- !!! .!!2 EXEMPTION: Doaa lhis plOjact.- lite minImUm _ for. . ........81 an AlJ-.aI Pnljec\? _ If You A........... Yasto _ QuestIon,. Slam"""....... GradIng, ~ & ErosIon ConlnII PIon Is NOT RequIred! ./' ---------------------------------------------------- srATEOFNEWYORK. COUNTI oFS..~..f.~.IS..._.......... SS 'That ~1:{~...IQ1:f.(1.~...... beingdu1y SWOrn; ~ and says that brJshe is the applicant for :permit. -",-oigIing~ . And that he/she is the ......~~.G......;....LOld.:tc..lLC..h:t::.....................................-................................ (Owno<. Ccldr8cb. _~0IIcw.....) Owner and/or representatNe of the Owner of Owner.. and is duly authorized to perfonn or have performed the said WOIt. and to make and file this appIicalin~ that aU statemc:nls contained in this application are true to the best of his knowledge and belief, and that the WOIt. wiD be performed in the manner set forth in the application filed herewith. Sworn 10 before me this; _...........$..~................... day~n~~'f!I!"'~J:i3;-"""""'"'"""'..",... ~ 0- \ \\ :-:::-.-" j ~...__. .--CONN;eM-:-JA~KsON .-.- Notary Pub~:.~..,:~V.~~.....-,.........N6tliry1"crtln!!;'Stllt!t-bf Ne 1'1"(": No.01JA6125168 FORM.06107 Commission Expires April 11. 26 --.--'--'-- --_. "--.--^'-'"-,,,- ,,~-'''--'--_. \~..~. '~;;'J.";':''e'~'t:';;,:.;~'';t)J':''''''~I.~,!",,-,-.tI...; ~ . ~ j ~ o ~ ~ i o ::; ~ ~ ~ i <> E ~ ~ " I ~ .- o H <> ~ ;!i ~ 9 ~ .!\ " .. ; N w s E 1- ~ ~ ~ \\\ ~~ ~ C'~ ~ -"'~...... ~ ~ ~ ~~ ~\ ~ ~ ~ 1\', . 1>':0 't^- \ \"\,, (J-O 0' <<-0.0 1-- \ , \ \ \ \.. \';; \ \ 'AI"-e. 000t> ~'" i ~ ~ ~\ (' ,,~Cl ~~c" ~ ~ ~ ~\) ,- ':) , ~\ ~. ~ III '" , , j I I i ot \ :' vo.\-i\e\Of' ~e..o.v~e.l gJ'O ufDD~ ; "'0o.....\..>J~~ I \"V"- t>'A 000 0'" \ \ \ \ \ \ El- "HONJIoENT SET ... HONJMENT FOUND &... STAK.E SET ..... STAJ<E FCU-ID co .. GHIMNE"( RO.. ROOF ov;:R 5" STOOP GE.. c.a.LAR EN'T'R.ANCE \ ~ "VL ~ ~ ---- ------ Young &:- Young 400 Ostrander Avenue, Riverhead, New York 11901 631-727-2303 How<1-ra W. Young. L<1-na Surveyor Thom.a.s C. Wolpert, Profession<1-l Engineer Robert C. Ta.st, Architect Dougla.s E. AdrLm.s. Profession<1-l Engineer NOTES AREA = SOPOO SG. FT. . SUBDIVISION - "MATTI11JCK CREEK ESTATES" FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON MAR. 25, 1"1"12 AS FILE NO. "1205 SURVEYOR'S CERTIFICATION . l^lE HEREBY C.ERTIFY TO WILLIAM .J. SMITH THAT THIS StJRVEY I"!AS PREPARED IN ACCORDANCE I^IITH THE CODE OF PRACTICE FOR LAND SURVEYS ADOPTED BY THE NEI^I YORK STATE ASSOCIATION OF PROFESSIONAL LAND StJRVEYORS. I/-rrv M..A- JA.{. !- SURVEY FOR ViILLIAM J. SMITH LOT 9 "MATTlnJCK CREEK ESTATES" At Mattltvck, TOl^ln of' Sovthold Svf'f'olk Covnt~, Nel^l York C.oLint~ Tox Mop Dlstrl" 1000 Seclio" 101 Slock 01 Lot 2.3 FOUNDATION lOCATION SURVEY MAP PREPARED DEC. 4,2001 NOV. 2"1, 2001 sc.ALE, 1"=40' JOB NO. 2001-0482 DI^l<S. 2001_04e2_rl FL oi~ul ~~~~ ,,!i~~ --~~ ~::l~8 J~"~ 15u~~ ~-l:Ie:< ~~~~ g;;~3 ~~!5i 'x< ~ " ~U ~Cllio ~:t~~ ~S~i ~:;~~ o<"'g: iffi~" ffi~~~ :;g15~ j!:~~~ g~31 >". ;;!~~ o . ~:;!F< "',,"og ~~i~ ilig<~ ~.~~ :ri515~ ~:~>- ~:r~g S15:11.' a:ez!l1 i!:t8.. Fa~~ ~~~~ ~. F ~lE 15 . u . . a:"'5 ~OD 1Z14!~ . ~~uti a.!;:!~", ~~~! ~~~~ il~ili> !!!il;;;!~ ~olil'" ~'1~. "08 h l:1 ili. ~giil~ ~~~~ ~<gl!i a.~~~ i!i",::Iu e~J:l15 ~.g3 "'i:!>-"- ~gg! i~~~ ~a~::I ",i!!<l: ~. ffi ~~h " . ",<~3:1 0",...:5 i!!i;::o~ F~~I= ~~~~ <.~. C.FU~ I:!~lll~ h;~ ~~~~