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Home My WebLink About35606-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~TMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34692 Date: 11/19/10 THIS C~I(TIFIES that the building SOLAR PA/qELS Location of Property: 1705 KERWIN BLVD (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 53 Block 4 Subdivision Filed Map No. __ Lot NO. __ GREENPORT (HAMLET) Lot 44 . 12 conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 19, 2010 purs,,~nt to which Building Permit No. 35606-Z dated JUNE 3, 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 PANELS AS APPLIED FOR. The certificate is issued to THOMAS E THORP & PATRICIA LAUTH (OWNER) of the aforesaid building. SUFFOLK COUNTYDEPARTMENT OF HEALTH APPRO~L ~.RL-i-KICAL t~KTIFICATE NO. PLUMBERS c~KTIFICATION DA'r~u3 N/A 35506 N/A 09/24/10 Signature Rev. 1/81 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. 35606 Z Date JUNE 3, 2010 Permission is hereby granted to: THOMAS E THORP 1705 KERWIN BLVD GREENPORT,NY 11944 for : INSTALLATION OF ELECTRIC SOLAR PANEL SYSTEM AS APPLIED FOR at premises located at 1705 KERWIN BLVD GREENPORT County Tax Map No. 473889 Section 053 Block 0004 Lot No. 044.012 pursuant to application dated MAY 19, 2010 and approved by the Building Inspector to expire on DECEMBER 3, 2011. Fee $ 200.00 Authorized Signature ORIGINAL Rev. 5/8/02 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 /)?93/ 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 $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. Certificate of Occupancy on Pre-existing Building - $100.00 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 New Construction: Old or Pre-existing Building: t,~. (check one) Location of Property: ] 7t9.~ &Kgt,~/~ ~/gr~/, ~,~ ~ House No. Street Hamlet OwnerorOwnersoferoperty: ~'~t~ ZO~-~t~r~F ~:~ ~/g'/C~C~ Suffolk County Tax Map No 1000, Section Block / Lot Subdivision /t~L/~fi' .~ ,7~ , .fi~' F~ Permit No. ~'~ ,~ Date of Permit. Filed Map. Applicant: Lot: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~.5, ~ Final Certificate: (check one) At~51icant~;ignature 3437,; Main Road P.t). Bo× 1179 SouthokL NY 11971-09,ZI ',4 Tclcph(mc (631) 76,3-1802 Fax (631) 76.34~,502 ro.qer, r chert~town.southold.ny.us 1½[ Ill J)IN(; 1)EI>ARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Thomas Thorp Address: 1705 Kerwin Blvd City: Greenport St: NY Zip: 1194~ Building Permit #: 35606 Section: 53 Block: 4 Lot: 44.12 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Green Logic License No: 43858 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: photovoltaic system, 3780 watts Ceiling Fixtures Wall Fixtures Recessed Fixtures ~ 'mU °err~ nC~t F~ ix~tuUrrees~ Exit Fixtures L HID Fixtures Smoke Detectors CO Detectors Pumps Time Clocks TVSS Notes: system consists of 18 solar panels, 1-4000 inverter, 2 disconnects Inspector Signature: Date: Sept 24 2010 81-Ced Electrical Compliance Form ,GREENLOGIC® ENERGY September 17, 2010 The Town of Southold Building Department 54375 Route 25 P.O. Box 1179 Southold, NY 11971 Re: Building Permit No. 35606 Thomas Thorp 1705 Kerwin Boulevard, Greenport To the Building Inspector: Enclosed please find the Engineer's Certification Letter for the post install and the Electrical Underwriter's Certificate for Thomas Thorp's photovoltaic solar system, which we installed at 1705 Kerwin Boulevard, Greenport. Please arrange to send him 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 GREENLOGiC. LLC · www GreenLo.~lc.com SOUTHAMPTON/CORPORATE: 425 County Rd. 39A SatJthamptor/, NY }}968 Tel: 631771.5152 CUTCHOGUE: 1070 Depot Lane Cutchogue, NY 11935 Tel: 631.765.0404 MANORVILLE: 40 Woodland Avenue ManorviLle, NY 11949 Tel: 631.830.0102 FIRE ISLAND: 125 Duneway Seaview, NY 11770 Tel: 631.741.6400 ROSLYN HEIGHTS: 200 S. Service Rd, #108 Rosyln Heights NY ]}577 Tel: bi6 6256880 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INS~JL~ON [ ] FRAMING / STRAPPING [ ~J:INAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION Pacifico Engineering PC PO Box 1448 Sayville, NY 11782 www.pacificoengineering.com August4,2010 Town of Southold Building Department 54375 Route 25, P.O. Box 1179 Southold, NY 11971 Subject: Solar Energy Installation for Patty Thorp 1705 Kerwin Blvd Greenport, NY 11944 .1~ E n g i nl~:ri;3gl?~)~-u01t~ ;g0 Fax: 631-382-8236 ~ engineer@pacificoengineeringcom 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 of the 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 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL soUTHoLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork. net Examined ~, /.~ ,20 [ 0 Approved /. /5 , 20~ Disapproved a/e Expiration UAY 19 a. This a PERMIT NO. ~ Building Inspector BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the follow/ng, before applying? Board of Health 4 sets of Building Plans Plmm~ng Board approval Survey_ Check Septic Form Trustees Flood Permit Storm-Water Assessment Form INSTRUCTIONS PERMIT Date ]a~XI I'~ ,20 tO ' filled in by typewriter or in ink and submitted to the Building Inspector with 4 to schedule. location of ,t and of buildings on premises, relationship to adjoining premises or public streets or 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 m 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 hispoctor 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. ]~ ~.Sigonature of appliqa~ 9! m/me, if a eot, po.ration) o Arha aa-f-o , toq t> (Mailing eddres~ of applicabt) State whether applicant is owner, le,stsee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises '--~~ (As on the tax roll or lotest deed) If ~~e of duly authorized officer ~}qame ~d title 0f ~rat~ officer) Builders Licmse No. Pl~rs License No, Ele~rici~s LicenseNo. ~ ~ ~ O~er Trade's License No. I. Location of land on which proposed work will be done: K rwm 6N,¢ P House Number S~eet Hamlet Co~ r~ Map No. 1000 Section ~ Block ~ Lot Subdivision Filed Map No. Lot 2. State existing nse and occupancy of premises and intended use and occupancy of proposed construction: ~ a~ Existing use and occupancy ("~__ 4aT~rvlt[~ ~,[nt~tlt~_t~ b. Intended use and occupancy {~ ~ ~, ~,~.t A/~OO l l f rl ~ 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work ~[,t~ I'YItlM~~ 4. Estimated Cost ' ~t. 2-~O(~) Fee (Description),~o~3~' (To be paid on filing this application) Number of dwelling units on each floor 5. If dwelling, number of dwelling units If garage, number of cars 6. If business, commerciai or mixed occupancy, specify nature and 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 or additions: Front Rear Depth Height. Number of Stories 8. Dimensions of entire new construction: Front Rear _Depth Height Number of Stories 9. Sizeoflot: From Rear Depth 10. Date of Purchase ~01 Name ofFormar Owner'J~O$ II I t C~ 0On ~cr~ ~.41 dr~ 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES__ NO F'r 13. Will lot be re-graded? YES NO V/ Will excess fill be removed from premises? YES NO fi/ 14. Names of Owner of premises P~'lqttr-4.a. L~tI~ Address~ rt'~iOOr'Jff Phone No. Name of Architect Address Phone No NameofContractor (e/l¢~r',LO~te_ ~ Address/-[g~;' C~-~Sq ~4- PhoneNo. ~[-~'[-~ I 15 a. is this property within 100 feet of a tidal wetland or a ~~ *~-~ES__NO ~/ * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet ora 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 · IF YES, PROVIDE A COPY. NO STATE OF NEW YORK) SS: COUNTY ~N,~'~ I,¥~ ~ ~'~L~ r~lff-.- being duly swom, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this day of ~ 20tO Notary Public ~ Public, State of New Yo~ 'O Signature of Applicant No. 01-CA4894969 {N~llified In Suffolk Coun~ . ~#~tillion E~lms May 11,, ~ t! Tow. n of Southold Erosion, Sedimentation & 8torm-Water Run-off ASBE88MENT FORM PROPERTY LOC~'TiON: &O.TAL~ ~ FOLLOWING AOTI~ MAY I~BOAJI~ ~ F_a~Ld~m!~ ~ A Item Nunber: (NOTE: A Cheok I,~ (,~) for .~h que~tlofl i8 Requl~Ki fCX. a O~rnplete AplMlc~tion) YeJ No Wlll ~ Pro)of ~ NI 8tem'l,-Water Run.Off Generated by at Two (2") k'lsh Kalnfad on 8ire? / (T~$ bm ~11 include eti nJn-ot/crnetecl by rite (:dearthg ar)Wo.:~neb~ction K~,,Atie~ as ~ ~ ~ ~ I~nixover.~ent. end the pem'wnent ~netiun of inT]eAous Surknes.) Do" the Site Plan and/or Survey 8how NI F~ed Dmlneoe 8truofur~ indlca,ng Size & ~? /' r~ ~ Item shall Include M Pn~oo~d Om~ C~ ~ 8101x~ Conlrotiing 8un~ce WatorRowi Wtil thb PmJeot R~ any Lend Ftillng, Grading or ExcaVldne ~ere them Is a ~hange to the N~ Existing Grade IrwolvlnO ~ the 200 Cubic Yard~ of Mateftel within any Paroe]? -- Will ~ Appll(~Jon I~ulre Land Di~',ndHng ~ Eneomp.,elng an Arne In Exce~ of r""l v Five Thou.nd (5,000) Square Feel of Ground 8udane? ~ __ Is them a Nalurll Water Course Ruining Ihrnegh the 81re? r'~ is this Projec~ within the Tmstnes JndadUine or vdthln One Hundred (100') feet of a Wetland ~- Beach? Onewill theteHundredbe 81to(100,)pmparatfonof Horizontal°n IF.~lstingDistenee?Grade Slopes which Exceed Filteen (15) feet of Vertical RiSe to ~] __V/ Will Driveways. Parking A~eas or ~ber Impeh4ous Su~anes be Sloped to Direct Stoml-Water I~Jn-Off into andlor in the dlreoflcm of a Town dght-of-,*ay? __ Will this Project Require the Heoement of Material; Removel of vegelatlun and/or the Conelruntlon of r'~ ./ any Item Within the Town Right-of-Way o1' Road 8boulder Ama? --L~ -Y (This Item will NOT Inolude the Inetahllon of Ddveway AprOne,) W#I thi' ProJeof Require Site Preparation wlthh the One Hundmd (t00) Yner Roodplaln of any Watercourse? [2 / NOTE: If Any Answ~' to Qne~tten. One fhmugh Nine I~ Anewernd with a Cheok Marl( I. the Bex, a 81orm-Wafor. Grndlng, Dmthage & Erosion Control Plan Is Requhd and Mnet be Submitted for Revtew Prior to tesuanoe dAny Bulldteg Perndtl EXEMPTION: Yne No Do. this Ixoject me~t the minimum standard~ for ola.lflo~ne e. en Ag~bJml Pro, ofT STATE OF NL%V YORK' ~---~.. .............. ss ................................................................................ being duly sworn, deposes and s~ys that hc/sbe is the applicant for Peri,it, (Name d incli~ s~g~k~ Documen~ And that h~/shc is the d) ~ ~[L~V~' · Owner and/or representative of the Owner of Own~s, and i~ duly authorized to perform or have performed the .id work and to make and file thi~ application; that all m_te~ents conOgnexl in this application are tree ~o the best of his knowte, dge and belie~,, and that the work will be performed in the manner set forth in the application filed he..~with. FORM- 06/07 =-= '[~'~''° v'~ Sworn to before me this; ................................. /~ da y or ......~ ..................... ~O..t...° Notary Public: ....~...~........~...~ ...... Town Hall Annex 54375 Main Road P.O. Box 1179 Soulhold, NY 119714959 Telephone (631) 765-180') · (631) 7 ro.qer, nchertd, t~n.so~oq~, ny. us BUII .I~lNG DEPARTMENT TOWN OF SOUTHOLr~ APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Company Name: Name: License No.: Address: Phone No.: JOBSITE INFORMATION: (*Indicates required information) *Name: *Address: *Cross Street: *Phone No.: Permit No.: Tax Map District: 1000 Section: '~ ~ Block: /'4- 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 3Phase *New Service: Re-connect Additional Information: 100 Underground YES/N~_~ Final 150 200 300 350 400 Other Number of Meters Change of Service Overhead PAYMENT DUE WITH APPLICATION 82-Request for Inspection Form 'l'o~n 1 lall 3-unox 3437.5 Mare Road P.O. Box I 'l'el,.'phlmc ({i31) 71}.5-1g02 I:ax (631) 76.~-9.51)2 1½[ :II,I)IN(; I)I,:PAP, TM I':NT TOWN OF SOUTHOLD September 21, 2010 Thomas Thorp 1705 Kerwin BIvd Greenport, NY 11944 TO WHOM IT MAY CONCERN: The following items are needed to complete your Certificate of Occupancy: ~ Application of Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. A fee of $25.00. Final Health Department approval. Plumbers Solder Certificate. (All permits involving plumbing after 4/'1/84) __ Trustees Certificate of Compliance. (Town Trustees #765-'1892) Final Planning Board approval. Final Fire Inspection from Fire Marshal. __ Final Inspection from the Building Dept. __ Final Landmark Preservation approval. Building Permit: 35606-Z solar panels OWNER LAND IMP. TOTAL TOWN OF SOUTHOLD PROPERTY RECORD CARD STREET ~ -'~ ~) ~ 1 VILlaGE I DI~T~ SUB. LOT TYPE OF BLD ~ '/ . ~ P.OP. ~o/~/o~-,/~~~/~/~/~ DATE FRONTAGE ON WATER FRONTAGE ON ROAD DEPTH BULKHEAD TILLABLE WOODLAND MEADOWLAND HOUSE/LOT TOTAL COLOR TRIM M. Bldg. Foundation ~)ce Bath ~t~en~n Extension Ext. Walls Extension Fire Place Patio Woodstove Porch Deck Attic Breezeway Rooms 1st Floor Garage o.~-- 7~e ~ ~I~ Pool CERTIFICATE OF LIABILITY INSURANCE PRODUCER THIS C=~<¥iriCATE iS iSSUED AS A MATTER OF INFORMAllON ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Brookhaven Agency, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 850 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 150 Main Street East Setauket NY 11733 iNSURERS AFFORDING COVERAGE NAIC # ,NSUeE~ Greenlogic, LLC ~NSURERA: NGM INSURANCE COMPANY 425 Count'/Road 39A Suite 101 ~NSURE~ E: MERCHANTS PREFERRED INS CO Southampton NY 11968 INSURER C: INSURER G: TH E P O U C I ES O FIN S U RAN C E LISTED B E LOW HAVE B E E N iS S U E D TO TH E IN S U R E D N AM ED ABOVE F O R TH E P O L ICY P E RIO DIN D ICATEO. N OT~NITH S TA N DiN G ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCEAFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECTTOALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLiCiES* AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 1 EACH O~URRENCE S ,~,~'~ A X X :OMMERCiALGENERALLABiLiTY MPP1681L 01131/10 01/31111 ppFMI~FRDAMAGETORENTEDI~ ~,~,re~l$ ~0,000 I CLAIMS MADE [] OCCUR MEDEXP(Anyonepersonl $ 5,000 X XCU PERSONAL & ADV INJURY $ 1,000,000 '~: CONTRACTUAL LIAB GENERALAGGREGA~ $ 2,000,000 B A ~X ANY^UTO CAP1043565 06112/2009 0611212010 A X ~loccu~ [] C~MSM^GE CUPI681L 01/31110 01131111 AC~REC~TE $ 2,000,000 RETE~JTION $10,000 AND EMPLOYERS' UABIUTY y I N E.L. EACH ACCIDENT $ (Mandatow In NH} ERTIFICATE HOLDER CANCELLATION TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 Phone: Fax: SHOULD AHY OF THE ABOVE DESCRIBEDPOLICIES BE CANCELLED BEFORETHE EXPIRATION ACORD 25 (2009/0t) The ACORD name and logo are registered marks of ACORD STATE OF NEW YORK WORKERS' COMPENSATION BOARD CERTIFICATE OF NYS WORKERS' COMPENSATION INSURANCE COVERAGE lo. Legal Name & Address of Insured (U~e street address only) Greenlogic, LLC 42S County Road 39A Suite 101 Southampton, NY 11968 Work Location of Insured (On/y required ~cov~n~e is rpec.~_~!~ limited to certain locations t~ New York ~tate, L&, a Wra~-Up 2. Name end Address of the Entity Requesting Proof of Coverage (Entity Being Listed as the Certificate Holderl TOWN OF SOUTHOLD BUILDING DEPARTMEN S309S ROUTE 25 SOUTHOLD NY 11971 lb. Business Telephone Number of Insured 631-771-51S2 lc. NYS Unemployment Insurance Employer Registration Number of Insured Id. Federal Employer Identification Number of Insured or Soq~d Security Number 20-3801194 3a. Name of Insurance Carrier National Union Fire Insurance Company 3b. Policy Number of entity JJsted in box 99~419S 3c, Policy effective period ~/11/2009 to 8/11/2010 3d. The Proprietor, Partners or Executive Officers are _~ included. (O~lycheckbosifallp~mers/of~cenbduded) [] all excluded or certain partners/officers excluded. This certifies that the insunmce cmrlcr indicated above in box "3" insu~s the business roforcnccd above in box "la" for workers' compensation under the New York State Workers' Compensation Law. (To use this form, New York (NY) must bo listed under Item 3A on the INFORMATION PAGE of the workers* compensation insurance policy). Tbe Insuronce Cartier or its liceused agent will send this Certificate of Insursnce to the entity listed above as the certificate holder in box "2". The In.~rance Carrier will also notify the above certificate holder within 10 days IF a policy b canceled due to nonpayment of premhtm~ or within 30 days IF there are reasons other than nonpayment of prernhtms that cancel tl~ policy or diminate tl~ insured from the cov~age indicated on this C~rtificate. (These notices may be sent by regulor mall.) Oth~wis~ this C~e is valitl for ot~e ycar niter this f~rm is appr~ed by t~ ~nsuranca cat~ie~ ~r its ~ensed ~geng ~r tmM t~e p~y eap~rat~n ~-~-~ ~sted ~n b~x "$~"~ w~re~ is earlier. Pinns~ Note: Upon the canceihtion of the woFkers' compensation policy indicated on thb form, ffthe business continues to be named on · permit, license or contract issued by · certificate holder, the business must provide that cerlfficate holder with n new Certfficate of Workers' Compemtion Coverage or other authorized proof that the business is complying with the mandatory ceverage requirements of the New York State Workers' Compensation Law. Under penalty of perjury, I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Approved by: (PrintAqm~ o f ~ ml~m~a~w ~r li~med ~mit of ~u~an~ c~n'~) ~/4f~ ~-'~~ AUG 10. 2009 (SL-,~,.~) (D~) Title: Authorized A~ent Telephone Number of authorized representative or liceused agont of iusurance carrier: 631-941-4113 Pie~e Note: Only insurance carriers and their licensed agent~ are authorized to issue Form C-105.2. Insurance brokers are NOT authorized to iz~ue it. C-105.2 (9-07) www.wcb.stateaiy.us Suffolk County Executive's Office of Consumer Affairs VETERANS MEMORIAL HIGHWAY * HAUPPAUGE, NEW YORK 11788 12/10/2007 SUFFOLK COUNTY DATE ISSUED: Master Electrician License No. 43858-ME This is to certify that ROBERT J SKYPALA GREENLOGIC LLC doing business as having given satisfactory evidence of competency, is hereby licensed as MASTER ELECTRICIAN in accordance with and subject to the provisions of applicable laws, roles and regulations of the County of Suffolk, State of New York. ' : Additional Businesses NOT VALID WITHOUT DEPARTMENTAL SEAL AND A' CURRENT CONSUMER AFFAIRS ID CARD Director JOB No. AUG-10 THE LOCATION OFWELLS,WATER SERVICE LINES, SEPTIC TANKS AND CESSPOOLS SHOWN HEREON A~E FIELD OBSERVA- TIONS AND OR DATA OBTAINED FROM OTHERS, \ \ \ R=2S,00' L=39,27' N SS°00'00"E 33,17'. ZONE AE WATER ZONE " I-~B / oL~ WOOD SEPTIC P,,ORCH R/O ~ - 0~$~1 2 ST FRAME OWE,U. ,';,'_ RNtR 4 C )[ f,E.t :, :5 C:ER !';FIE:E:: ':)4: Y 't'('): TIdOM,~ S T:,'4ORP ,kl',!D ;~A3 Fi(;lt,, I.AL 'i-ia WELL[; I ,~,F,~-, EA,q T02/2: I,E S'rlb:~cff COF'P '~' [ E.'3 'F] :~ GR~': {J ','; L;C ND. ~D(367 Pacifico Engineering PC PO Box 1448 Sayville, NY 11782 www.pacificoengineering.com May 15, 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 APPROVEDASNOTED Subject: Solar Energy Installation for DATE ,~/'~/"~ B.P. # Patty Thorp 1705 Kerwin Blvd FEE Greenpod, NY 11944 NO~IFY BUILDING DEPARTMENT AT . L~ 765-1802 8 AM TO 4 PM FOR THE ~ -~ ~ ~ ~ ~ . ~OLLOWING INSPECTIONS: ~'~ L? ~ ~ :' ~. FOUNDATON-TWO REQURED ' ' ' FOR POURED CONCRETE ~ i~ ~.j ,. ~, ' STRAPPING. ELECTRICAL & CAULKING 3 INSU~TION I have reviewed the roofing structure at the subject address. The struct~re~~i~f the roof mounted system. The units are to be installed in accordance instructions. I have determined that the installation will meet the require~~ and ASCE7-05 when installed in accordance with the manufacturer's in~t~E NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS Roof Section A mean roof height 14 ft pitch 61/4 in/12 roof rafter 2x8 rafter spacing 16 in OC Reflected roof rafter span 12.7 ft Table R802.5.1(1) max 16.8 ft collar tie 2x6 collar tie spacing 48 in OC The climactic and load information is below: CLIMACTIC AND Wind GEOGRAPHIC DESIGN Category Speed, 3 CRITERIA sec gust, mph Roof Section A B 120 Ralph Pacifico, PE Professional Engineer ALL CONS7 ~ ~,E~TTH~ R? UNDERW~'~?S CERTIFICATE E~QUIRED Liveload, prier30 per point ASCE 7, pullout psf load, lb 26 267 Fastener type 5/16" die screw, 4" length ~. ~LOGIC ,~, Pacifico Engineering PC PO Box 1448, Sayvilte, NY 11782 631-988-0000 ww~v Daci§coenQineer~nQ corn Ralph Pacifico, PE NYS License 066182 GreenLogic, LLC Proposed Thorp, Thomas 3.78kW PV 1705 Kerwin Bird Greenport, NY 11944 631.477.8234 3.78 kW 18 SunPower 210w UniRac Sunframe Azimuth = 228° Pitch = 27.5° Scale 1/4" = 1.0' Panel Dimension = 31.42 x 61.39" Array Length = 282.78" Array Height = 126.53" Surface Dimensions = 25' x 17' Magic # = 62.14" SunPower 210w · UniRac L-Foot UniRac SunFrame Rail t 2x8" D.o. uglas Fir Rafter 16 on center Layout Created By: BCA Date: 5.11.2010 I ]ELIMINATING THE COST OF ~N~'RG¥ I ~'~,, Paciflco Engineering PC PO Box 1448, Sayville, NY 11782 631-988~000 ww~v Dac~ficoenoineenna corn Ralph Pacifico, PE NYS License 066182 GreenLogic, LLC Proposed Thorp, Thomas 3.78kW PV 1705 Kerwin Blvd Greenport, NY 11944 631.477.8234 3.78 kW 18 SunPower 210w UniRac Sunframe Azimuth = 228° Pitch = 27.5° Scale 1/4" = 1.0' Panel Dimension = 31.42 x 61.39" Array Length = 282.78" Array Height = 126.53" Surface Dimensions = 25' x 17' Magic # = 62.14" SunPower 210w UniRac L-Foot UniRac SunFrame Rail I t2xg"DouglasFirRafter 16" on center Layout Created By: BCA Date: 5.11.2010 2 Strings of 9 SunPower 210 watt panels. Each sting has 1,890 watts Array total of 3,780 watts All panels to be grounded as per NEC code 30 AMP two pole DC switch from panels to inverter SUNflOWER SPR 4000 INVERTER ~ 24O VAC / 30 AMP 3R switch near ~/~ ~/ utility meter I 240 VAC from inverter to a 30 I Amn ~vlf~h n~r Hfilitv mAtAr 210 SOLAR PANEL EXCEPTIONAL EFFICIENCY AND PERFORMANCE SPR-210-WHT The SunPower 210 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 210 delivers an unprecedented total panel conversion efficiency of 16.9%. The 210 panel's reduced voltage-temperature coefficient and exceptional Iow-fight performance attributes provide far higher energy delivery per peak power than conventional panels. SunPower's High Efficiency Advantage - Up to Twice Ihe Power Thin Film Conventional Waits / Panel 65 165 Efficiency 9.0% 12.0% kWs 90 120 210 SOLAR PANEL EXCEPTIONAL EFFICIENCY AND PERFORMANCE _P~a_k ~'?,e,' (+/.,5%) _ ?~ 210w R a _l~l_._V.c~lta g e __ .¥mp .... 40.OV Rated Current Imp 5.25 A Open Circuit Voltage Voc 47.7 V $horf Circuit Current Isc 5.75 A Maximunr System Voltage IEC, UL 1000 V, 600 V Tem~eralure Coefficients Power -0.38% ~ Voltage ~Voc) -132.5rn V,.~C Current (lsc] 3.5m A/~C Series Fuse Rating 15 A Peak Po~er per Unit Area 169 W/m2, 15.7 W/~ CEC PTC Rating 193.7 W Solar Cells 72 SunPower all ~aclecoetact monocrystallirm Front Glass 3.2mm Jl/8 in.) I~m r~erea Junction Box P-65 rated wilh 3 bypass a~aes Output Cables 900mm length cable / Muli~ontact connectors Frame .~llodJz~d aluminum alloy lype 6063 Weight 15kg, 33lbs wC.r 7.0 6.0 5.0 lee0W/m~ 4.0 3.0 2.0 1.0 0 !0 Max Iaaa 50psf (2400 Pascals) Donl and back Im ~c't Resistance Hail- 25mm [1 in.) at 23 m/s ~52mph] Warranly 25 ~ar limiled power warranty 10 year limited ~roauc~ warranty Certifications IEC 61215 Saf~y tested IEC 61730; UL lisled JUL 1703), Class C Fire Rating 915 CAUT1ON: READ SAFE'I'Y AND INSTALLATION INSTRUCtiONS BEFORE USING THE PRODUCT. Go to w~wv.sunpowercarp.corn/panels ~or details SunPower designs, manufactures and delivers high-performance solar electric technology worldwide. Our high-efficiency solar cells generate up to 50 percent more power than conventional solar cells. Our high-performance solar panels, roof tiles and trackers deliver significantly more energy than competing systems~ ~e~ Printed on recycled paper sunpowercorp.com 3000m & 4000m INVERTERS EXCEPTIONAL RELIABILITY AND PERFORMANCE 'lhe SunPower inverters 3000m and 4000m provide exceptionaJ 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 1 O-year warrant. SPR-3OOOm and SPR-4OOOm v~wv. sunpowercorp.com 3000m & 4000m INVERTERS EXCEPTIONAL RELIABILITY AND PERFORMANCE SPR-3000m SPR-4000m 3500w ~'208 V / AC Maximum ~ Cun'ent ~SA, 12..SA 17A, 16.6A (O 208V, 240V) AC Namlnal Vdloge / Ronge 183 -22~v e 20e VAC 183 - 229 V e 208 VAC Power Fa~tm' ~ ~ Peak In'~er'mr Et~iency 96.6% 96.8% Weighted El~:iency 9.5.0 % · 20e v 95.5 % e 208 v CEC · ~:mllmml~mJ An'm~ Input 3600 w 4800 W DC Input Vdtage Range 200 -500 v ~. 208v 250-600v o 208 VAC 200 -500 V O 240V 250 -600V ~ 24OVAC SPRm Efficiency Curves 100 Ioo 75 80% 9O% 100% Shipping Dimemlons W x H x D imthes Unit Dimeesions W x H x D inches Im~'ter Weight Shipping Weight Enclosure Mounting 23.5# x 18.5# x 16,O' 17.8" x 13.8# x 9.3' 88 lbs 94 lbs Forced Air / Sealed Wall Mount Brackel Standard Peak Pow~ Tracking Vdmge DC Max. Input Cmrent 1FA iSA No. af Fused Siring Inputs Power Consumpllon: <7w/o.I w G~OUIKIJlIg Positive G~ound SunPower designs, manufactures and delivers high-performance solar electric technology worldwide. Our higJ~e~iciency solar cells generate up to 50 percent more power than conventional solar cells. Our high.performance solar panels, roof tiles and trackers deliver significanlJy more energy than competing systems. www. sunpower¢orp.com