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Home My WebLink About35454-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~TMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34539 Date: 09/03/10 THIS CERTIFIES that the building SOLAR HOT WATER SYSTEM Location of Prc~perty: 330 MAPLE AVE (HOUSE NO.) (STREET) County Tax ~4ap NO. 473889 Section 107 Block 3 Subdivision Filed Map No. Lot No. MATTITUCK Lot 5 (HA~4LET) conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 30, 2010 pursuant to which Building Permit No. 35454-Z dated APRIL 9, 2010 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 HOT WATER SYSTEM AS APPLIED FOR. The certificate is issued to JOHN ALFIERII & PRISCILLA LEWIS (OWNER) of the aforesaid building. SUF~DI~COt~I"fDEPAR~)~TOFHF~%LTHAPPROVAL N/A EI~crKIC3%L f~RTIFICA~ NO. 35454 05/10/10 PLUMBERS CERTIFICATION DA'rKo N/A Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PEI{MIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 35454 Z Date APRIL 9, 2010 Permission is hereby granted to: JOHN ALFIERII 330 MAPLE MATTITUCK, NY 11952 for : INSTALLATION OF A HOT WATER SOLAR SYSTEM AS APPLIED FOR at premises located at 330 MAPLE AVE County Tax Map No. 473889 Section 107 pursuant to application dated MARCH Building Inspector to expire on OCTOBER MATTITUCK Block 0003 Lot No. 005 30, 2010 and approved by the 9, 2011. Fee $ 200.00 U Authorized Si-~nature ORIGINAL Rev. 5/8/02 Form No. 6 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 SEP 2 20]0 BLDG. DEH. TOWN OF SOUTHOL[I APPLICATION FOR CERTIFICATE OF OCCUPANCY This applieati0n mU~t be filled ia by typewriter or ink and submitted to the Building Department With the following: A. For new building or new use: '1. Final. survoy of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. Final Approval from Health Dept. Of water supply and sewerage-disposal (S-9 form). Approval of electrical installation' from Board of Fire Underwriters. '6. Sworn statement from plumber codifyiag that the solder used in system contains less than 2/10 of 1% lead., Commor~ll building, industrial build,g, multiple residences and :~imilor buildin~ and installatious, a Certificate of Code Compliane~ fi, om architector engineer responsible for the building. Submit Planning Board Approval o(6ompleted site'plan requirements. For exisflug.building~.(prior to April 9, 1957) non-conforming uses, or buildings and ~pre'e~isting- land uses: I.. Accurate survey of prepo~.showing all property lines, streets, building and unusual natural or topographic 2. A properly completed application and COnsent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Buildiag Inspector ahall state the reasons therefor in writing to the applicant. Fees 1. Certificate of 0c~upancy. New dwelling $25 00, Additinns to dweliing $25.00, Alterations to dwelling $25.00' Swimming pool $25.00 ACOessofy building $25.00, Additions to accessory building ~25.00, Businesses $50.00. 2. Certificate ofOcenpaneyon Preqexisting Building- $100.00 3. ' Copy ~f Certificate of Occupancy - $.25 4. Updated Certificate ofOecupancy - $50.00 5. Tempongy Certificate of Ocoupancy _ Residential $15.00, Commercial $15.00 House No. Old or Pre-existiag Building: i~lew ConStmctiom Location ofPm~' (check One) Strut , ' . Hamlet .Owner or Owng~s 9fpropotty!. e.._JO'tSr-K//xJffC~t~/ - 8..uffolk Co~mty Tax. Map No '! 000, Section.' 2 O7 Subdivision Penni; No.,'~ :~[7/..~.~' "Z. 'Date.of Permit. Health Dept. Approval: Pjanntng Board Approval: Request for: .Temporary Certificate Fee Submitted: $ ~- ~' Filed Map. , Lot: Applicant: C~ e-~..4L~ '~ ~1 Underwriters Approval:. / Final Certificate: ¢/ (check one) Town Hall AnllcX 54375 Main Road P.O. Box 1179 Southold, NY I 1!)71-0959 'l'elephol~e (631) 765-18()2 Fax (631) 765-9502 ro.qer, richert~town.southold.ny.us 1~1 JILl)IN(; I)EPARTMENT TOWN OF $OUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: John Alfieri (Lewis) Address: 330 Maple Ave. City: Mattituck St: NY Zip: 11952 Building Permit #: 35454 z Section: 1 07 Block: 3 Lot: WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Green logic LicenseNo: 43858-ME SITE DETAILS Office Use Only Residential ~ Indoor ~ Basement ~ Service Only ~ Commerical Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Servicelph ~ Heat ~ DuplecRecpt ~ Service 3 ph Hot Water GFCI Recpt Main Panel NC Condenser Single Recpt Sub Panel NC Blower Range Recpt Transformer Appliances Dryer Recpt Disconnect Switches Twist Lock Other Equipment: Ceiling Fixtures [~ HID Fixtures Wall Fixtures ~ Smoke Detectors Recessed Fixtures ~.~ CO Detectors Fluorescent Fixture ~.~ Pumps Emergency Fixtures~ Time Clocks Exit Fixtures ~ TVSS Photovoitaic system, 20 solar panels, 1 sunpower inverter, 1 a/c diseonnect Notes: Inspector Signature: Date: May 10 2010 81-Cert Electrical Compliance Form TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION l ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING ~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIREIIESlSTHt'rO0m~UCTmi [ ] RRE~G~STANTPmETK4TH)N REMARKS' DATE ~- / ? - /0 INSPECTOR ~'~~ Pacifico Engineering PC PO Box 1448 Sayville, NY 11782 www. pacificoengineering.com Engineering Consulting Ph: 631-988-0000 Fax: 631-382-8236 engineer@pacificoengineering.com August 4, 2010 Town of Southold Building Department 54375 Route 25, P.O. Box 1179 Southold, NY 11971 Subject: Solar Energy Installation for John Alfieri 330 Maple Lane Mattituck, NY 11952 I have reviewed the solar energy system installation at the subject address. The units have been installed in accordance with the manufacturer's installation instructions and the approved construction drawing. I have determined that the installation meets the requirements ofthe 2007 NYS Building Code, and ASCE7-05, specific to the fastening of panels to the roof, to comply with the NYS code re: 120 mph winds. To my best belief and knowledge, the work in this document is accurate, conforms with the governing codes applicable at the time of submission, conforms with reasonable standards of practice, with the view to the safeguarding of life, health, property and public welfare Regards, Ralph Pacifico, PE Professional Engineer August13,2010 AUG 1 7 2010 The Town of $outhold Building Department 54B75 Route 25 P.O. Box 1179 Southold, NY 11971 Re: Building Permit No. 35454 John Alfieri 330 Maple Lane, Mattituck To the Building Inspector: Enclosed please find the Engineer's Certification Letter for the post installation for John Alfieri's photovoltaic solar system, which we installed at 330 Maple Lane, Mattituck. Please arrange to send the certificate of compliance and close out the building permit. Please let me know if you have any questions about the installation. Sincerely, Barbara Casciotta Account Manager GreenLogic LLC 631-771-5152 ext. 117 QREENLOGIC, LLC · ~ww. GmenLoDc corn SOUTHAMPTON/CORPORATE: 425 County Rd. 39A Sou[hampton. NY 11968 Tel: 631.7715152 CUTCHOGUE: 1070 Depot Lane Cutchogue, NY 11935 Tel: 631.765.0404 MANORVILLE: 40 Woodland Avenue Manorville, NY 11949 Tel: 631.8300102 FIRE ISLAND: 125 Duneway Seaview, NY ]1770 Tel: 63].741.6400 ROSLYN HEIGHTS: 200S Service Rd.,gl08 Rosyln Heights NY 11577 Tel: 5166256880 ' ' ' COMMENTS ~;~,D INSPEC'!~ON REPORT DATE .. ~OUNI)~ON (~S~ FO~A~ON (2~) . ROUGH ~G & PL~G STA~ ~R~ CODE ~D~ION~ cOUNTS TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) %5-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork. net E inea Approved ?/q .20/O Disapproved Expiration t II / q, 20 I/ PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval Survey. Check Septic Form Building Inspector APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS .20 IO a. This application MUST be completely filled in by typewriter or m 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 pm for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. fi Every budding 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 peraut shall be required. APPLICATION IS HEPdEB Y MADE to the Building Daparhnent for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Soathold, 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. Loqtc_ LaC_- .. (Signagge of applicaator name, ifa corporation) a (Mailingtaddress of ~pplicant ) · State whether applicant is owner, less~, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ,~'3 ('~ ~ t'~¥'~ ( (As on the tax roll or latest deed) If applica~, t i,s a corporation, signature of duly apthorized officer (Name and title of corporate officer) Builders License No. /'4 {~)~,,~=~:~c- - {~ Plumbers License No. Electricians License No. /4-~-"fi-~ - ~ S:::: Other Trade's License No. 1, Location of land on which_ Rroposed work v~ill be done: House Number St'reet~ Hamlet County Tax Map No. 1000 Section IC)"~ Block ~ Lot Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended usa.and occupancy of I}roposed.construction: ~ Existing use and occupancy ~tt~.~ It'~_ ~eY't! ~,X,~ ~cZz]~ttle~.C~ 3 b. Intended use and occupancy ~ t .J t 3. Nature of work (check which applicable): New Building Addition AlteraXion Repair Removal Demolition Oti~er Work I~'~ (Description) 4. Estimated Cost '2Ig°3'~t (9~t ~' Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Height Number of Stories Rear Depth Dimensions of same structure with alterations or additions: Front Depth Height. 8. Dimensions of entire new construction: Front Height Number of Stories 9. Size of lot: From Rear 10. DateofPurchase 2 - 5. O '~ Number of Stories Rear Depth Name of Former Owner Rear .Depth 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES __ NO 13 Will lot be re graded9 YES NO Will excess fill be removed from premises'> YES NO ' ' . -- 5.~o n'Cp~, ,,,t,~. ' ' 14. Names of Owner ofpremises~O~O /~C[~q~r { Addressl'l~k't~t'-, t2~ Phone No. Name of Architect Address Phone No NameofContractor ~Ir~'r~LC~ tr- L(~- Address ql.~'t[o~s~'kt~d~r&PhoneNo.,_,., 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland. YES * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES ~' NO__ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, 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) M ~l t~e~ ~f { ~'DGt~ ~r~ being duly swom, deposes and says that (s)he is the applicant ~e of mdividu~ si~g mn~act) ~ove n~ed, (Contxactor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are n:ue to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me t[~ . ~ day of "~Q/,- ~ 20 Ix~t at7 Public Town Hall Annex 54375 Main Road P.O. Box ! 179 Souff~old, NY 11971-0959 BUILDING DEPARTMENT TOWN OF $OUTHOI.r~ APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: ~,=~ ~.~-~-=-~lO~t-{-,=:~ Date: ._~. ~5. I0 C, ompanyName: ~ r~l~ LC~ Name: ~ ~~ Li~nse No.: ~ ~ - ~ Address: Phone No.: JOBSITE INFORMATION: (*Indicates required information) *Address: ~0 I'~pl~ ~S.., Irl/~,,=~t---~"~-_, *Cm~ Street: ~ ~ ~ ' *Phone No.: Permit No.: Tax Map District: 1000 Section: lO'-+- Block: .~ Lot: *BRIEF DESCRIPTION OF WORK (Please Print Clearly) (Please Circle All That Apply) *is job ready for inspection: *Do you need a Temp Certificate: Temp Information (If needed} *Service Size: 1 Phase *New Service: Re-connect Additional Information: NO NO Rough In Final 3Phase 100 150 200 300 350 400 Other Underground Number of Meters Change of Service Overhead PAYMENT DUE WITH APPLICATION 82-Request for Inspection Form C GREENLOGIC® ENERGY March 29, 20~0 Town of Southold Building Department Town Hall 53095 Route 25 Southold, NY 11971 Dear Building Inspector: Please find attached a building permit application on behalf of John Alfieri who has engaged us to install a roof-mounted (flat to the roof) solar photovoltaic (PV) electric system and a solar domestic hot water system for his home at 330 Maple Lane, Mattituck, NY. In connection with this application, please find attached: A building Permit application · A Storm Water Assessment Run-off Form · Survey of Premises · Four Engineer's Reports (2 originals and 2 copies) · A One Line Diagram · A Visio Diagram of the proposed system · Spec. sheets of the solar panels (SunPower SPR-215WHT) · Spec. sheets of the inverters (SunPower SPR 4000m) · Spec. sheets of the hot water heating system (Velux CLIU12 SKOL218) · GreenLogic Suffolk County Home Improvement License · GreenLogic Certificate of Liability Insurance · GreenLogic Certificate of Worker's Compensation Insurance Coverage · Installation Manager's Master Electrician's License Please let us know if you need anything else in connection with this application. Yours truly, Barbara Casciotta Account Manager GreenLogic LLC GREENLOGIC, LLC · ww¢,'GreenLog~ccom SOUTHAMPTON/CORPORATE: 425 County Rd 39A Southampton NY 11968 Tel: 63177}5152 CUTCHOGUE: ]070 Depot Lane Cutchogue, NY ]1935 Tel: 631765.0404 MANORVILLE: 40 Woodland Avenue Manorville, NY 11949 Tel: 631.830.0102 FIRE ISLAND: 125 Duneway Seaview, NY 11770 Tel: 63174].6400 ROSLYN HEIGHTS: 200S Service Rd, #108 Rosyln Heights, NY ]1577 Tel: 5]6.625.6880 ? Will Driveways, Palldng Areas o~ other Impeh*lou~ Sun.:es ~ 8~d ~ DI~ S~Wa~r ~n~ff 8 ~ ~is P~ R~uim ~e Pia~ of M~dal; R~ ~v~ a~ ~e ~ of · If ~y Answ~ to Q~tl~l One ~gh ~ Ii ~md web a C~ ~ In ~e ~x, a ~r, D~e & ~lon ~1P~n Is Required and M~ ~ 8ubml~d ~ R~I~ P~r ~ ~/ues~ ~ Any BulM~g Town of Southold I1~/~ Erosion, Sedimentation ~ ~orm-Water Run-off A$$._eu_-_%-T FOR?' ......... ~1 ~ls P~ P~ any ~ RB~, ~ ~ ~ ~ ~ b a ~e ~ ~e N~ Is ~ a NaOmi Wa~r ~me ~n~ ~h ~ ~? 9 EXEMP~IONi Does this ix~ect neet the minimum standards for (:laaalfloalion aa.an Ag~cultural Project? Note: If You A~swlred Yes to thl. Queaflon, I 8toml-WMer, Gfadlllg, Omiesge & Erosiofl Co/tirol plan is NOT ReqiJiredl ~// STATE OF NEW YORK, ~ r ~ . COUNTY OF ZZ)Ct-[--t-o I I(- ~ · · ............... ; .................................................... being duly sworn, deposes and says that he/she is d~e a lica~ t; ' [mme o~ ImJivldUal ~ Doe~m~rZ PP or ~ermit, I And that he/she b the ................................. ~ ~..~.. C--I OV~' - . (o~, e--e~, ~at co.-es O~=r, ~) ................... Owner and/or represenlafi~e of rite Owner of Osmeffs, and is duly authorized to perform or have l~dormed the said work and to m~eandfile ' ' ' - ..... t. his application, t]~ all statements conlained In thil applicat~ofl are Irue to the best of his kno~edEe and belie~, and that the wod~ will be performed in the manner set fo,h in rite application filed herewith. Sworn to before me this; ,.,,,&~lu OF SOUTHOLn PROPERTY RECORD CARD 'WNER . i i S~REET ~ I VILLAGE : J DIST: ' SUB. LOT i . LAND j IMP. NEW_. I NO~V~.L F~RM ~ Tilk~ble 2 , Tillable 3 Woociland ; i~wampland Brushtand House Plot I Fi~PLM ~ cOMM- CB. MISC. Mkt. Value J -i~OTAL DATE REMARKS BELOW ~ , ~BOVE ~e :RONTAGE ON WATER FRONTAGE ON ROAD J )EPTH - ,,~ 7..~~ jBULKHrr_.AD J D0C. 2 IgY- "~/o/ COLOR TR~M ~,~Jon ~ ~t. Walls ~,./~ nterior Finish ~ [, LR. Fire PIoce 1 H~t ~ DR. ~siofi ' ' T~e Roof R~ms 1st Floor ~ ..... ~ R~s 2nd FIoo FIN. ~ ~.~ ~ ~.~ .~ //~ / Recreation ~. ~. Driveway I Garage ~ ~: ~ ~ I patio 0'~' To~,',n 1 fall Almcx .5 I37,5 Main Road P.O. Box 117!I Si)ulhold, NY 11971-09,59 Tclcphon¢ (631) 76,5-1802 l;ax (6:11) 76,5-9,502 BI III ])lNG 1)I';PAI/TMENT TOWN OF SOUTHOLD August 23, 2010 John Alfieri PO Box 1271 Mattituck, NY 11952 RE: 330 Maple Avenue, Mattituck TO WHOM IT MAY CONCERN: The following items are needed to complete your Certificate of Occupancy: Xx, j Application of Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. xN, J A fee of $25.00. Final Health Department approval. Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84) Trustees Certificate of Compliance. (Town Trustees #765-1892) Final Planning Board approval. Final Fire Inspection from Fire Marshal. Final Inspection from the Building Dept. Final Landmark Preservation approval. Building Permit: 35454-Z solar panels GRAPHIC ,c.;CAI_E 1"= 50' 0 50 100 150 SURVEY OF PI'~OF:'Er;~TY SITUATE: MATII'[UCK TOWN OF SOUTHOLD SUFFOLK COUNW, NY CEP. TIFIEO TO: 5~UTH BAY' ,~UR',IF-¥EI2 II/ I~ / 91 COUNTY' TAX REFEREHC.,E O'.EEl:;:': LIDER 11~'-~,2 · I,,IO NUI'4E 6IT FOUHC' ~00:2 FEI,lC.l= ~,~IE~ = ~,~,,51~'1 -¢..F=. ol=- '2.o_~ 0 o. 2: ':i 'k .- I 9;¢ t~, '%. CERTIFICATE OF LIABILITY INSURANCE PRODUCER THIS CERTIFICATE IS ISSUED AS A MA'Iq'ER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Brookhaven Agency, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 850 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 150 Main Street East Setauket NY 11733 INSURERS AFFORDING COVERAGE NAIC # iNSURED Greenlogic, LLC INSURERA: NGM INSURANCE COMPANY 425 County Road 39A Suite 101 ~NSUR~B: MERCHANTS PREFERRED INS CO Southampton NY 11968 [NSURER C: COVERAGES TH E PO L ICIES O FIN S U RANC E L ISTE D B E LOW HAVE BEE N ISSU E D TO TH E IN S U RE D NAM ED ABOVE FO R TH E PO LICY P E RIO DIN D ICA'rED. N O~NITH S TAN DIN G ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THEINSURANCEAFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTOALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. i~ENERAL LIABIU~ E~CH CCCURRENCE $ 1 z000,000 A X X COMMERC~LGENERALL~BILITY MPP1681L 01131/10 01131111 pR~MiRF~DAMAGETORENTEDI,~n~,mnc~,~ ;80,000 I CLAIMSMADE [] OCCUR MEDEXP(An¥one person} ~ 5,000 X XCU PERSONAL & ADV INJURY $ 1,000,000 ~- CONTRACTUAL LIAB GENERALAG~EGATE ; 2,000,000 B A X ANYAUTO CAPI043565 06112/2009 06/1212010 (EaaCCide~t) A X ~ OCCUR [] CLAIMSMADE CUP1681L 01131110 01131111 AGGREGATE $ 2,000,000 RETENTION ~ 10,000 $ WORKERS COMPENSATION I ....... [ IO~T~- CERTIFICATE HOLDER CANCELLATION TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 Phone: I Fax: ACORD 25 (2009101) The ACORD Rams and logo are registered marks of ACORD STATE OF ~ yORK · WORKERS' COMPENSATION BOARD CERTII~CATE OF NYS WORICI~,RS' COMPENSATION INSURANCE COVERAGE 1L'Le~i Nam~ & Addr~s of lnsnred (Us~ street add~ o~ly)* County Road 39.% SuJto 10! ~k)~tllampton, NY 11968 Work Location of I~red (0'~/~ rm/~/fcor~ b~ M~M M c~MM/ocodom M Nmv Yor~ ~atG L~, a Wra~-[/p 2. Name and Address of the Entity Requesdln_~ PFOOf of Coverage (Entity. Being Listed as the Certificate HoMer) Town 0f SouthoM Building Dept. lb. Business Telephone Number oflnsuFed 631-771-5152 lc. NYS Unemployment Insurance Employer Registratiou~Number of Insured Id Federal Employer ldendflcotlon Number of Insured or Sochl Security Number 20-380119 30. Name oflnsurenco Carrier Naflonnl Union Fire Insarenee . 31~ Poliey Number of entity listed in box WC00992419S 3e. Policy effective period - 08/11/2009 to 08fll/20i0 3d. The Proprietor, Partners _or Executive Officers are [] included. (only cheek box ir au Imrme~o~er~ handed) [] all excluded or cortnin partoers/officers excluded. compcosotion uncior tbe New york State Workn3' ~on Law. (To use this f~rm, New York (NY) must be Ibtal under Itan 3A on the INFORMATION PAGE of the workers' compensation imuranee polJey). The Insm~mce Can'ier or its licensed agent w~l s~d this ~ of Insurance to the cot~.'y listed above as tbe cortificw~e holder in box "2". Please Note: Upon the enncohfion of the workers' compensation policy indicoted on this fom, if the Imsine~s continues to be named on a permit, becose or eontract imued by a cefliflmto homer, the business must provMe that ce~dJcoto bolder wifls a new Cerli~nt~ of Worbe~' Compensation Coverage or other authorized proof Mt the ~ess is complying with the mamlntory coverage requir~snenfs of the New York Sbt~ Workers' Compensation Law. Under penalty of perjury, I certify that I nm au authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the eovernge as depicted on this form. Approved b~. Al~uved b~. (IMnt nan~ ofauflmfin~d rqm~ntsti~ ~r lioemed s~nt of ~ cm~r) 08/27/2009 Titio: Aulhori~d Represeulatlve Telephone Number of authorized represcoMtive o~ licensed agcot of iosui'albue carrier:..__631-283-8000 Please Note: Only ins~rtm~ ctwriers ami their licensed agents are ~;.ed to issue Form C-105.2. Instwance brokers are NOT ~l~or~z~l ~o issue iL C-105~ (9-07) www.wcb.state.ny.us Suffolk County Execu~ve's Office of Consumer Affairs VETERANS MEMORIAL HIGHWAY * HAUPPAUGE, NEW YORK 11788 12110/2007 SUFFOLK COUNTY DATE ISSUED: Master Electrician License No. 43858-ME This is to certify that ROBERT J SKYPALA GREENLOGIC LLC doing business as having give~ satisfactory evidence of competency, is hereby licensed as MASTER ELECTRICIAN in accordance with and subject to the provisions of applicable laws, rules and regulations of the County of Suffolk, State of New York. C(~qS~MER .~FF~P~S Pacifico Engineering PC PO Box 1448 Sayville, NY 11782 www. pacificoengineering.com March 20, 2010 Engineering Consulting Ph: 631-988-0000 Fax: 631-382-8236 engineer@pacificoengineering.com Town of Southold Building Department 54375 Route 25, P.O. Box 1179 Southold, NY 11971 Subject: Solar Energy Installation for John Alfieri 330 Maple Lane Mattituck, NY 11952 2;. Jc, l have reviewed the roofing structure at the subject address. The structure carC,~p~oCt th~iaCditibnaFwbig~t;~q~ T?E the roof mounted system. The units are to be installed in accordance with the h~ahiJfa~{~i;et'~;in~ilation' - ''~ ' Or' NeW ...... - - U FO nstructlons. I have determined that the installation will meet the requirements and ASCE7-05 when installed in accordance with the manufacturer's instructid~,¢luN OR CONSTRUCTI~JN .h.h~ur~. Roof Section A B O R mean roof height 32 ft 32 ft pitch 81/2 in/12 81/2 in/12 ",/V FU ! roof rafter 2x10 3X12 '?. : TIF;C;, rafter spacing 16 in OC 32 in OC Reflected roof rafter span 7.2 ft 15.4 ft ~ C ~;, , ' Y The climactic and load information is below: CLIMACTIC AND GEOGRAPHIC DESIGN CRITERIA Roof Section A B Ralph Pacifico, PE Professional Engineer Category C Wind Speed, 3 sec gust mph 120 Live load, pnet30 per ASCE 7, psf 37 37 Fastener Type Triangle Concealor #12-14 for DHW System 5/16" dia hanger bolt for PV System Pacifico Engineering PC Ralph Paciflco, PE NYS License 066182 GreenLogic, LLC Proposed Aifieri, John 4.3kW PV 330 Maple Lane Mattituck, NY 1 I952 516.426,6612 Layout Created By: BCA 4.3kW PV 20 SunPower 230w UniRac Sunframe Azimuth = 154° Pitch = 35° Scale 3/16"= 1.0' Panel Dimension = 61.39" x 31.42" Array Length = 125,68" Array Height = 223.04" Surface Dimensions = 35'6" x 19'10" Date: 3/8/2010 SunPower 230w (~ UniRac L-Foot UniRac SunFrarne Rail Pacifico Engineering PC ¢7;~]lph Pacifico, PE NYS License 066182 GreenLogic, LLC Proposed Airier;, John 4,3kW PV 330 Maple Lane Matt;tuck. NY 11952 516.426.66t2 Layout Created By: BCA 4.3kW PV 20 SunPower 230w UniRac Sunframe Azimuth = 154° Pitch = 35° Scale 3/16" = 1.0' Date: 3/8/2010 Panel Dimension = 61.39" x 31.42" Array Length = 125.68" Array Height = 223.04" Surface Dimensions = 35'6" x 19~10" SunPower 230w UniRac L-Foot UniRac SunFrame Rail 2" self-tapping stainless; steel mount!n~ screw . Pacifico Engineering PC PO Box 1448, Sayvi~e, NY 11782 Ralph Pacifico, PE NYS License 066182 GreenLogic, LLC Proposed Alfieri, John 4.3kW PV 330 Maple Lane Mattituck, NY 11952 5t6.426.6612 4.3kW PV 20 SunPower 230w UniRac Sunframe Azimuth = 154° Pitch = 35° Scale 3/16' = 1.0' Panel Dimension = 6I .39" x 31.42" Array Length = 125.68" Array Height = 223.04" Surface Dimensions = 35'6" x 19'10" SunPower 230w '~ UniRac L-Foot - UniRac SunFrame Rail Layout Created By: BCA Date: 3/8/2010 VELUX solar water heating system with electric bacbup System models: CLI U12 SKOL218 CLI U12 SKOL318 CLI U12 SKOW218 CLI U12 SKOW318 Cold water Hot water Heated glycol Cooledglycol -~4.~ 1. Collectors 2. Flashing 3. Connector tube 4. Flextubes 5. Air Separator 6. Pump station/controller 7. Expansion tank 8. Solar storage tank 9. Mixing valve 10. Temperature sensor 11. Electric auxiliary with thermostat Notes: 1. This drawing is meant to show a system piping concept only. The installer is responsible for all equipment and detailing by local codes. 2. AntFfreeze, non- potable heat treesfer fluid shall be used for the solar storage tank heat exchanger circuit eely. Never introduce AntFfreeze Solution to any other solar storage tank connection other than the solar heat exchanger. 3. If there is a check valve on the cold water feed tine, a thermaL expansion tank suitable for potable water must be sized and Installed within this piping system between the check valve and the cold water inlet of the solar storage Lank. 4. The an anti-scald mixing valve provided must always be installed as shown. 5~ For all electric hack-up models, make sure solar storage tank is fully purged of air before power is turned on to the back-up heat source. VELUX solar water heating system with electric back-up - Part 3: Solar water heater system installation - 7 VELUX solar pre-.heat water heating system System models: CLI U12 SKOL218 CLI U12 SKOL318 CLI U12 SKOW218 CLI U12 SKOW318 Cold water Cooled glycol 7.[ 1. Collectors 2. Flashing 3. Connector tube 4. Flextubes 5. Air Separator 6. Pump station/controller 7, Expansion tank 8. Solar storage tank 9. Mixing valve 10, Temperature sensor 11. Existing gas or electric water heating 12. Solar system bypass valves Notes: 1. This drawing is meant to show a system piping concept only. The installer is responsible for all equipment and detailing by local codes, 2. Anti-freeze, no~- potable heat transfer fluid shall be used for the soJar storage tank heat exchanger circuit only. Never introduce Anti-freeze solution to any other solar storage tank connection other than the solar heat exchanger. 3. If there is a check valve on the cold water feed line, a thermal expansion tank suitable for potable water must be sized and installed within this piping system between the check valve and the cold water inlet of the solar storage tank. 4. The an anti-scald mixing valve provided must always be Installed as shawe, 5. For all electric hack-up models, make sure solar storage tank is fully purged of air before power is turned on to the hack-up heat source. VELUX solar pre-heat water heating system Part 3: Solar water heater system installation - 9 Collector location on 16" o.c. rafters CLI U12 4000 - 2 Collector layout o 16" c.c. rafters -- 10"x5" hole -- 5"x5" hole 5"x5" hole-~ 4~.-6 3/4' 4'--6 3/4" CLI U12 4000 - 3 Collector layout o 16" c.c. rafters 5"x5" hole -- 10"x5" hole-- 5"x5" hole~f 3/4" __ 4'-8 3/4" 4'-6 3~4" 14 - Part 3: Solar water heater system Installation - Collector location on 16" o.c, rafters Collector location on 24" c.c. rafters CLI U12 4000 · 2 Collector layout · 24" c.c. rafters -- 10"x5" hole -- 5"x5" hole 5"x5" hole -- 4'-6 3t4" 4'-6 3/4" CLI U12 4000 · 3 Collector layout · 24" o.c. rafters Collector location on 24" o,c, rafters - Part3:Solarwaterheatersysteminstallation - 15 Gross 72.0 56.2 Packaging 56.1 48.2 34.0 3.2 48.7 57.4 ColleCtor weight 130 73 57 Weight (lbs,) Weight w/fluid ].41 79 64 Gross area 27.1 15.2 12.5 Aperture area 23.1 12.4 Collector area (sq. ft.) I Absorber area 23,4 12.6 10.0 Fluid volume (gal,) 0.58 0.34 0.24 Maxoperating pressure (psi) 87 87 _~___87 Test pressure (psi) 145 145 145 Stagnation temperature (°F) 374 374 365 I'"- Clear day i 29 15 12 Thermal performance rating - warm climate (lO00s btu/day) I~tildty cloudy dayi/ 20 11 8 Cloudy day ! 11 6 5 Clear day 19 10 8 Thermal performance rating- cool climate (lO00s btu/day) Mildly cloudy day 11 6 4 Cloudy day 4 2 1 etaO (start efficiency) ]__.0.6960 0.6610 0~6390 Efficiency al(Btu/hr*ft2*°F) ] 0,4747 0A666 0.4603 a2 (Btu/hr*ft2*~F2) I 0,0020 0.0019 0.0018 32 - PartS:Specifications - VELUXsolarcollector VELUX fiextubes and connectiens Max operating pressure (psi) 100 External diameter, pipe (mm) 21.8 Internal diameter, pipe (mm) 16.3 External diameter, insulation (mm) 4Z8 Liquid volume, (L/m) 0,24 Material, pipe Stainless steel / AIS1316 TI Material, insulation Foam EPDM Temperature limit, insulation (deg F) + 350 to- 40 F Insulation value (w/mK) 0.04 VELUXflextubesandconnectlons - Part 5: Specifications - 33 VELUX glass lined so/ar sro. age tank (with electric back-up) C a Hot water ~ outlet / ........ Cold water Inlet L "1 Temperature and Electronic i x~ // pressurerellefvalve thermostat '--~i~ ~ Anode rod Electric Element · Plastic jacket Surface mounted ~,~, ~ insulation Enamel lined tank wlth ~ ~ ~ flowcoattechnology ~--.,~ i Dimensions vlODEL # GAL i TFF12OO204US I 119 I 27" 64" 51%" 11" 10~/.," 21%" ITFFOSOO204US 80 i T' / 1V'., NPT Shipping weight (lbs) 237 336 MODEL # Solar HX volume gallons TFF080 0204US 1.5 gal Heated water volume of back up 37 gal ~ TFF120 0204US ~ 1.5 gal 67gal Recovery of back up in minutes 65° rise 90~ rise 78 min 108min 141 min 196 rain First draw* 65° rise ] 90odse 38 gal i 26 gal 70 gal i 46 gal * AMOUNT OF WATER DRAWN OUT OF STORAGE TANK WITHOUT ANY ENERGY IN PU ~ VELUX reserves the right to make product changes or updates without notice. VELUX will not be held liable for typographical errors in literature. For questions, please consult the factory. 34 - Part 5: Specifications - VELUX glass llned solar storage tank (with electric back-up) VELUX glass lined solar storage tank (with back-up heat exchanger) --. E Hot water outlet Boiler bacbup enamel heat with flow coat technology Surface mounted solar sensor Enamel lined tank with flow coat technology Sdar powered enamel heat~ flow coat technology Coldwaterinlet Temperature and pressure relief valve Plastic jacket insulation MODEL # GAL Dimensions A B C I D E F G H TFF 0801204US 80 I 23" 71~A'' 60IA'' 8lA'' 8" 34" 43" 55V~" TFF 1201204US 119 27" 64" 51W' 11" IO~A" 28" 36" 47" MODEL # GAL Heat exchanger outlet size Inlet / outlet size Shipping weight (lbs) TFF 0801204US 80 1" N PT i 1V~" NPT 286 TFF 1201204US I 119i FNPT I l'/z" NPT 367 Recovery of back up MODEL # HX volume gallons Heated water volume in minutes Boiler output for test First draw* Solar Boiler of backup recovery 65~rise i O0°rlse 65~rise 90°dse TFF 0801204US 2gal lgal 37gal ! 17min 24min 90,000 BTU/HR 38gal 26gal TFF]201204US 2gal 1gal 67gal I 22rain I 31rain iO0,O00BTU/HR I 70gal 46gal * AMOUNT OF WATER DRAWN OUT OF STORAGE TANK WITHOUT ANY ENERGY INPUT VELUX reserves the right to make product changes or updates without notice. VELUX will not be held liable for typographical errors in literature. For questions, please consult the factory. VELUX glass lined solar storage tank (wlth bacbup heat exchanger) - Part 5: Specifications - 35 240 VAC 215 SOLAR PANEL EXCEPTIONAL EFFICIENCY AND PERFORMANCE The SunPower 215 Solar Panel provides industry leading efficiency and performance. Utilizing 72 next generation SunPower all-back contact solar cells and an optimized panel design, the SunPower 215 delivers an unprecedented total panel conversion efficiency of 17.3%. The 215 panel's reduced voltage-temperature coefficient and exceptional Iow-light performance attributes provide far higher energy delivery per peak ~ower than conventional panels. SunPower's High Efficiency Advantage - Up lc> Twice the Power Efficiency kWs 90 215 SOLAR PANEL EXCEPTIONAL EFFICIENCY AND PERFORMANCE Pmax Rated Voltage 'imp 39.8 V Rated Current Imp 5.40 A O~en Circuit Voltage Voc 48.3 V Short Circuit Current Isc 5.80 A M~imum System VoJfage IEC, UL 1000 V. 600 V Temcerature Coe~cJents Power -0.38% ~C Voltage (Voc) -136.8 mV?C Current (Jsc) 3.5 mA/°C Series Fuse Boring 15 A Peak Power per Unit Area 173 W/m~', 16, ] W/fi= CEC PTC Boring 198.5 W Sobr Celb Front Gbss Junction Box Output Cables Frame Weight 3.2mm (1/8in ~nperea IP-65 rated with 3 ~voass choaes 7.0 6.0 5.0 4.0 :2.0 1.0 0.0 10a0 W/m2 0 10 20 30 40 50 60 Hall - 25mm 1 in at 23 m/s (52 mph) Cedifications IEC 61215. SafeF/tested IEC 6] 730; UL listed JUL 1703L Class C Fire Rating ~ Prlnted on recycled paper www.sunpowercorp.com 3000m & 4000m INVERTERS EXCEPTIONAL RELIABILITY AND PERFORMANCE The SunPower inverters 3000m and 4000m provide exceptional reliability combined with superior performance. Innovative design and advanced testing have been brought together to create a durable inverter that enables optimal system performance over the long term. Both models come with a standard lO-year warranty. ww~v.su npowercorp.com 3000m & 4000m INVERTERS EXCEPTIONAL RELIABILITY AND PERFORMANCE SPR-3OOOm SPR-4OOOm AC MaXimum Outget Current ~5^.~5A {@ 208V, 240V) AC NomlnaJ Vdtage / Ronge 183 -229 V @ 208 VAC 183- 229 V@ 208 VAC 60 HZ/59,3 Hz- 60Hz/59,3Hz- AC F~quency J Range 60.5 ~z 6c 5 Hz PowerFactor Peak Inverter Efficiency 96.6% 9@8% Recommended Army Input 3600 w Power (DC @ STC) 200 - 500 V @ 208V DC Input Voltage Range 2o0 -500 V @ 240V 4800 W 250 - 600 V @ 208 VAC 250- 6gO V @ 240 VAC SPRm Efficiency Curves 95 250 Vd ~ 90 3]ovd~,x ~ ~o 75 % of Rated Output Power Unit Dimensions W x H x O'i~ches Inverter Weight Shipping Weight Cooling Encbsure Mounting Ambient Tempera~re Range Peak Power Trackim~ VoJtage 2C0 - 4~0 V @ 240 VAC 250 - 480 V @ 240 VAC DC Max. Input Current ~7 ~ 18 A DC Voltage Ripple < No. of Fused 5~Jng Inputs Power Consumption: Standby/Nighttime <?w ol w J:used DC Djs¢onllect Standard: Com~ ~es w NEC Standards Certifications www. sunpowercorp.com