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HomeMy WebLinkAbout35150-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34804 Date: 01/18/11 THIS C~TIFIES that the building SOLAR PANELS Location of Property: 300 FAY CT (HOUSE NO.) County Tax Map No. 473889 Section 123 Subdivision Filed Map No. MATTITUCK (STREET) (HAMLET) Block 5 Lot 11 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 4, 2009 pursuant to which Building Permit No. 35150-Z dated NOVEMBER 10, 2009 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 SOIJ%R PANELS ON AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. (NOTE: AKA 3360 CAMP MINEOI~k ROAD) The certificate is issued to MAJORIE DUNN of the aforesaid building. ( OWNER ) SUFFOLK CO~qTYDEPARTMENTOF HEALTH APPROVAL N/A ELE~-rKICAL CERTIFICATE NO. 11690 12/29/09 PLUMBERS CERTIFICATION DA'r~u N/A 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. 35150 Z Date NOVEMBER 10, 2009 Permission is hereby granted to: MAJORIE DUNN · 1570 OLE JULE LANE MATTITUCK,NY 11952 for : INSTALL SOLAR PANELS ON THE ROOF OF EXISTING SFD PER APPROVED PLANS AS APPLIED FOR at premises located at 300 FAY CT County Tax Map No. 473889 Section 123 pursuant to application dated NOVEMBER Building Inspector to expire on MAY MATTITUCK Block 0005 Lot No. 011 4, 2009 and approved by the 10, 2011. Fee $ 200.00 Authorized Signature ORIGINAL Rev. 5/8/02 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $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 $15.00 New Construction: Old or Pre-existing Building: ~ (check one) Location of Property: ~ 09 ~ House No. Street Hamlet Owner or Owners of Property: ~ ]~ Suffolk County Tax Map No 1000, Section Subdivision Block ~.~ Lot Filed Map. Lot: Applicant:~~~$~ Underwriters Approval: Permit No. Date of Permit. Health Dept. Approval: Planning Board Approval: Request for: Temporary.Certificate Fee Submitted: $ g~ Final Certificate: L~ (check one) ~(pplicant Signature SUFFOLK BUREAU 40 Nottingham Drive, Middle Island, NY 11953 Telephone: 631 495 8136 · Fax: 631 980 6455 · E-Mail: SBEIGS@gmail.com CERTIFICATE OF ELECTRICAL COMPLIANCE Applicant: Green Logic Rough In Inspection Date: December 29 ~2009 Application No.: 11690 LIPA Solar App No.: 08-4410-SP County Tax Hap No.: 1000 123 5 11 Certificate No.: 11690 Final Inspection Date: December 29,2009 Building Permit No.: ~'-~ This Certificate of Electrical Compliance is limited to the inspection and compliance of electrical equipment and/or work described below, installed by the applicant named above, located at the premise of and not after the final inspection date above: · Owner: Marjorie Dunn Site Location: DUNN, 3360 Camp Mineola Road, 300 Fay Court, Mattituck, NY 11952 Owner's Address (if different): ~ Residential [] Indoor· [] Basement [] Service [] Shed [] Commercial ~ Outdoor [] First Floor [] Pool [] Hottub [] New [] Renovation [] Second Floor [] Attic [] Garage []Addition []Survey Other: photovoltaic system INVENTORY Single Phase Heat Duplex Recpt Ceiling Fixture HID Fb(tures Tnme Phase Hot Waler GFCI Recpt W~all Fixture Smoke Main Panel AC Cond Single Recpt Recessed Fixture CO Det~-,t Sub Panel AC Slower Range Recpt Flourescent Pumps Transformer Appliances D~yer Recpt En~rgency Time Clock Disconnect 1-sc. Sw~tches Twist Lock Exit Fix'tums TVSS GFCI Breaker Heat Pump E~tdc Heat Pool Luminaire Exhaust Fan O~her Equipment: InstaIJ photovoltaic sotar system 5805 total watts 27 SunPower SPR215WHT panels I SunPower SPR6000m Inverter The electrical work and/or equipment described above were inspected and appear to be in compliance with local, state and national electrical code requirements and this office. Applicant: Green Logic Inspected By: Roger Richert License No.: 43858ME Date Of Certificate: Jan 04,2010 TOWN OF SOUTHOLD BUILDING DEPT. 765-t 802 INSPECTION [ [ ] ROUGH PLB~.G;~ [ [ ] INS~A~ION [ ['~]"I~NA L [ [ ] FIRE SAFETY INSPECTION [ [ ] FIRE RESISTANT PENETRATION REMARKS: ~ ~:~ // DATE ////~//,~ INSPECTOR ~~'~/ ] FOUNDATION 1ST FOUNDATION 2ND FRAMING / STRAPPING FIREPLACE & CHIMNEY FIRE RESISTANT CONSTRUCTION Pacifico Engineering PC PO Box 1448 Sayville, NY 11782 www.pacificoengineering.com December 30, 2009 Town of Southold Building Department 54375 Route 25, P.O. Box 1179 Southold, NY 11971 Subject: Solar Energy Installation for Marjorie Dunn 3360 Camp Mineola Ln Mattituck, NY 11952 Engineering Consulting Ph: 631-988-0000 Fax: 631-382-8236 engineer@pacificoengineering.com JAN ?0 ?? Bi DG DEPT. TOWN Of SOUfNOID 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. I have determined that the installation meets the requirements of the 2007 NYS Building Code, and ASCE7-05. 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 FI]~LD INSpEC-I~!ON REPORT I DATE FOUNDATION (1ST) FOUNDATION (2ND) ROUGH FRAMING & PL~G ~$~ATION PER N.Y. ..~ STA~ E~R~ CODE ~D~ION~ COUNTS 'i TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.lqor~hFork. net Disapproved ~7c g [h l .i din I. p ctor Ill ~ ~, ~ ~11 III ~]~<F ~ ATION FOR BUILDING PE~IT ~,}9V 4 ') Date ~O~ ~ ,200~ i s =,o s _ ~~ ~*o~a~Tl~com~e~bT~e d m by ,~ter or m of pl~, acc~~e. Fee drag to sched~e. ~ _ .;. vl~, ~howmg location of lot ~d of bulldogs on pre~ses, relatio~p to adjoining pre~ses or public s~ee~ or c. ~e work covered by ~is application may not be comenced ~fore issu~ce of Bufl~g Pe~t, d. Upon ~prov~ of~is ~plication, ~e Bufl~g ~ctor ~11 issue a Building Pe~it to ~e applicmt. Such a pemit sh~l ~ kept on ~e pre~ses av~l~le for ~cfion ~ou~out ~e work. e, No b~dhg shall be occupied or ~ed m whole or m p~ for ~y p~ose wh~ so ever ~ ~e B~g ~pector issues a C~ificate of Occup~cy. ~ Eve~ b~d~g ~t s~l expke if~e work auto.ed h~ not ~en~d wi~h 12 monks ~er ~e ~te of iss~ or h~ not been completed M~in 18 monks ~om such ~e. If no zomg prope~ Mve been enacted ~ ~e htem ~e Bufl~g I~pe~or may au~ofize, in ~it~g, edition s~ mon~. There~er, a new ~it sh~l be requked. ~PLICA~ON IS ~BY ~E to ~e B~ld~g Dep~t for B~ldhg Zone ~ of~e Tom of Sou~ol& Suffo~ Co~, New Yor~ ~d o~er applicable Laws, ~dhmms or Re~afiom, for ~e ~on ofb~gs, additiom, or ~ter~ions or for rmov~ or dmolifion applic~t ~ees to rumply wi~ ~1 ~plic~le laws, ordh~ms, b~l~g code, ho~hg code, ~d relation, ~d m a~it au~ofized ~pectom on pre~ses ~d in buildhg for necess~ ~pe~o~. reen Logic (Si~a~ of applic~t or ~e, ifa ~mtion) (As on the m roll or latest deed) If applic~t is a ~oration, signat~e of duly au~orized officer ~ ~d title off.rate officer) Builders License No. Pl~bers Li~nse No, Ele~ci~s License No. ~ ~ ~ O~er Trade's License 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 Sun, ey. Check Septic Form Trustees Flood Permit Storm-Water Assessment Form Contact: tlq oS' Lg..catipn of land o~,-which proposed work will be done: House Number Street - ' Hamlet County Tax Map No. 1000 Section I ~ ~ Block ~ Lot Subdivision ! ~,~ Filed Map No, .~' Lot j J_ 2. St :~e existing use and occupancy of preen, ises and intended use and,occupanc~of t~ro~ ~on: b. Iat~ad~d use and ocoup~cy .~; r-v~ 1~ ~_Lrv~, / 3. Nature of work (check which applicable): New Building Addition Alto'ation D,,o on ,,Wo,k ! CI~ b paid on filing ~ application) 5. If dw¢lllng, number of dwelting units Number of dwelling unita on each floor If garage, number of cam 6. If i*usiness, commercial or mixed occupancy, specify anture and exteat of each typo of use. 7. Dimenslons of existlng s~mctures, if any: Front Rear Depth Height. Number of Sto~es 9. Sizeoflot: Front I0. D~re of Purchase Dimensions of same structure with alteraltons or additions: Front Rear Depth. Height Number of Stories Dimensions of entire new conslxuctian: Front Rear .D~pth Height Number of Stories Name of Former Owner 11. Zcne or use distric~ in which premises ar~ siaaaed 12. Does proposed construction violate any zoning law, ordiannco or r~,ulation? YES NO / 13. Will lot be re-graded? YES NO /Will ~xcess fill be removed from p~misez? YES__ NO__ --~-~ r'toO~ ~ 14. N~cs of Own~ o~nnis~ "l~ ti,3 f) Addr~ Phone l~l,o. _ -~ N~me o!tconmiator c~ rmto,~/~ t C · Addressl~t~:iawnone No. ::~'-f ! - ~" I ~ ~'- 15 a. I s thia pioperty within 100 fe~t of a tidal wetland or a freahwatea- wctlanfl? YES NOt · IF '~ES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. lsthiapr~pe~ywithin300fee~ofatidalw~and?*YES__ NO ~ · IF YES, D.E.C. PERMITS MAY BE REQUIRED, 16. Provide survey, to scale, with accura~ fmmdafion plan and distances to property lines. 17. If ,:levafion at any point on prope~y is at 10 fe~t or below, mu~ provid~ topographical ~ on sua'vey. 18. Ar ¢ the~ any coven~mts and reswictiom wilh respect to this property? * YES__ NO · IF '~ES, PROVIDE A COPY. STATF, OF NEW YORK) l ama o f individunl sign~ ~m~t) nbove named, . (¢on~a~or, ng~a~ Coroor~ Otti~, ~.) of said own~ or own~s, and is duly authorized to perform or have performed the said wo~ and to msk~ and file ~ ~i~ that all statemems conmlned in this applicatio~ am line to lhe beat of his knowledge and belie~ ~d ~ ~ ~ ~ ~ perfon~ed in the mnm~- set forth in the application ~ed the~nv~h. Sworn lo ~fom m~ ~hls . ~,of. ~l:e~ ~0o5' ~b~c BARBARA A. cASCIO~A i~ of~i~t Notary public-State of New York No 01-CA48~969 Qual f ed in Suffolk County _ My Commission Exo res May 11, ~ f ~ Town of $outhold Erosl~m, Sedimentation & 8torm.Water Run-off A88F. S8MENT FOR_M THII FOLLOWIKO AGTIONI MAY RBCIUIRE THE ~llllAmm~ ~nN OF A ~TB GRADING DRAI~ B AND EROMOH OONll~L PLAN 2 3 4 5 6 7 8 9 Will thl~ Appla~ion Requlm Land DIMu~ng A=6vlllee Eneompm~ing an Area In E,xxmes of Five Thou~md (5,000) 8q~mre Feel of Ground 8udane? Is ~ a Natural Water Coume Rurming throogh the Is this Pro~ within the 1'~ jl~scll~iofl ~ ~ One Hundred (100') fee~ of a W~and or B~c~? will there be 8lie preparation on Ex~tthg Grade Slopes whlc~ ,~ F{Reen (16) fe~ o~ Vat,cai Rise to One Hundf~J (100')of Hodzortt~ Dlstenoe? Will Ddveway~, PaOdng Areas or other Impervious Suffa=es be 8loped to Direct Storm-Water Run-Off into ahd/or In the dl~ of a Town n~ght-of-v,~y? Will this Project Requine the Placement of M·~erial; Removal of Vegetation and/or 1he Constmc~on of any Item within the Town Right-of-Way or Read 8houldor Ama? ('Illin Item MU NOT Inolude the hlgtaltatlon of Driveway Apmne.) Will this Pro~ Require Site Pmporaflon within the One Hundred (100) year Fi~ain of any Watercourse? NOTE: If Any Answer to Qu~tlon· One through Nine la Almwsred with a Check Mark in the Bex, a 8tomlA~/ator, Grading, DrMnega & Erosion Control Plan In Required and Mu~t be Submitted for Review Pflor to baunnee of Any Building Petmltl eXBMPTlONt Yes N_~o Done th~ proJec{ meet the minimum standards for ~ltloa~on asan Ag~ulluml ~ ~ STATE OF NEW YORK, ~ ,~- co, m-r ............. ss That I,. ] ...~..~L J~/~...m~.,~..~.......]~... ........ being duly sworn, deposes and says that he./shc is the applicant t'or Peri, it, And that he/she is the .......................... ~.,.~.:..:.:..:..~.. ................................................................................... : ........ Owner md/or reprcsentali~e of the Owner of Owner's, and is duly authorized to perform or have performed the said work and to make and file this application; that all s~.mems contained in lifts application are tree to the best ofF. is knowledge and beli~ and that the work ~ be performed in the manner set forih in the application filed herewith. Sworn to before me this; ......... ....................... .......... ...... A cASCIOTIA , //(s~ RARBARA _: ........ YnrK FORM - 136/07 Notary~ hi-CA4894969 ~lu~l~f~ Suffolk County.. "3.~ I My commiSsiOn EiiSife~ Ma~'rT:-~, ~ C GREENLOGIC' ENERGY November 4, ;2009 Town of Southold Building Department Town Hall 53095 Route 25 5outhold, NY 11971 Dear Building Inspector: Please find attached a building permit application on behalf of Marjorie Dunn who has engaged us to install a roof-mounted (flat to the roof) solar photovoltaic (PV) electric system for her home at 300 Fay Court (3360 Camp Mineola Road) in Mattituck. In connection with this application, please find attached: · A building Permit application · A Storm Water Assessment Run-off Form · Surveyof Premises · Four Engineer's Reports (2 originals and 2 copies) · AOne Line Diagram · A Visio Diagram of the proposed system · Spec. sheets of the solar panels (SunPower SPR-215-WHT) · Spec. sheets of the inverter (SunPower SPR 600Om) · 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 GREENL~I~e~L~gi~-~AITC~'~If ~)g, ~om SOUTHAMPTON/CORPORATE 425 County Rd 39A, #101 Southampton, NY 11968 Tel: 631.771.5152 Fax 631.771.5156 SOUTHOLD 528/5 Main Rd, Box 435 Southold, NY 11971 Tel: 631.765.0404 Fax: 631.771.5156 MANORVILLE 40 Woodland Avenue Manorville, NY 11949 Tel: 63]7/] 5]52 Fax: 6317715156 ROSLYN HEIGHTS 200S Service Rd, #108 Rosylf~ Heights, NY 11577 Tel: 5166256880 Fax: 5]6 625 6881 iC GREENLOGIC ' ENERGY January 15,2010 The Town of Southold Building Department 54375 Route 25 P.O. Box 1179 Southold, NY 11971 Re: Building Permit No. 35150Z Marjorie Dunn 300 Fay Court/3360 Camp Mineola Road, Mattituck To the Building Inspector: Enclosed please find the Engineer's Certification Letter for the post install and the Electrical Underwriter's Certificate for Marjorie Dunn's photovoltaic solar system, which we installed at 300 Fay Court/3360 Camp Mineola Road, Southold. Please arrange to send her 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 (;RE[ NLOGIC, L LC · ',~,/,w G!I!( !/Lc/~JC ( Lu SOUTHAMPTON/CORPORATE: 425 County Rd 39A Southarnplo[~. NY 11968 Teh 6317715152 CUTCHOGUE: 1070 Depot Lane Cutchogue, NY t1935 Tel: 6317650404 MANORVlLLE: 40 Wo/)dlar/(J Av( IiLJ(! Manorvdle. NY 11949 h~h 631 830 0]02 FIRE ISLAND: 125 Duneway Seaview, NY 11770 Tel: 63}.74}.6400 ROSLYN HEIGHTS: 200S Service Rd, !i108 Rosyln Heights NY 11577 T~I: 5]6 6256880 Town Hall Annex 54375 Main Road P.O. Box 1179 Southold. New York 11971-0959 Telephone 1631 ) 765-1802 Fax (631 ) 765-9502 Januaw27,2010 BUILDING DEPARTMENT TOWN OF SOUTI-IOLD 3360 Camp Mineola Road (aka 300 Fay Court) %-/~ _ ,. Mattituck, NY 11952 '*'~--~--L. ~)q~q~..~ ~_~ TO WHOM IT MAY CONCERN: ~~ ~ ~ ~ The following items are needed to complete your Cedifi~te of Occupancy: Application for Ce~ificate of Occupancy. (Enclosed) Electrical Unde~riters Ce~ificate. ~ A fee of $25.00. Final Health Depadment approval. Plumbers solder cediflcate (all permits involving plumbing a~er 4/1/84.) Trustees Ce~ifi~te of Compliance. Final Planning Board Approval. Final Fire Inspection from Fire Marshal. Final inspection from the Building Depa~ment. Final Landmark Presemation approval. Building Permit: 35150-Z solar panels ACORD. CERTIFICATE OF LIABILITY INSURANCE OPID ('.az=s-7 I 01/19/09 ,~'o~ THIS C~F~ 18 I~E~ ~ A ~R OF INFO~ON ONLY ~D ~NF E~ NO ~G~ U~N T~ CE~F~ATE ~cess ~e=al ~,Inc. (CL) ~IS~FI~NOT~END,~END~ 365 ~OS~S P~ D~ ~R~E~E~O~BY~E~BEL~ ~DB~Y ~ 11797 Phone: 516-799-8222 INSU~ ~FO~NG CO~GE Gr~nl~ic ~ ~U~E~ c: 425 Co~ ~. 39A Suite 101 Sou~ ~m~t~ ~ 11968 C,~.Ne~. t.~ae.n'Y ~ OCCURRENCE $1,000,000 A X --X COMMERCIN. GENERALUABIUTY Lv~'P1681L 01/31/09 01/31/10 =,,.,~,~,O.,=,,,,=u~BmSES(£a~=~er~e) $50,000 Ic~s.~ E~occu. UmEX.(~,~.,.~) $5,000 PERSONAL & ADV INJURY $1,000 / 000 GE N~'~..'.~C~ EC-C~'m $2,000,000 GEITL AGGREGATE UMIT APPtiES FER: PRO0tlCTS * CO~PK)P AGG $1,000,000 A~ UAB~LFrY COMBINED SI~GI.E LN[I' CERTIFICATE HOLDER T(X~NOF SOUTHOLD 53095 ROUT~ 25 SOUTHOLD NY 11971 TOWNSOHI CANCELLATION ACORD 25 (2001/08) © ACORD CORPORATION STATE OF NEW YORK WORKERS~ COMPENSATION BOARD CERTIFICA~ OF NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1a. Legal Name & Address of'Insured (Use street address only) Greenlogic, LLC 425 County Road 39A, Suite 10! Sot~thampton, NY 11968 lb. Business Telephone Number of Insured 631-771-5152 lc. NYS Unemployment Insurance Employer Registration Number of Insured Work Loeation of Insured (On/y requiredO'couerage is specifically limited to certain locations in New Yorl~ A~ate, i.~, a Wrap-Up ~'oticy) 2. Name and Addr~,~s of the Entity RequeSting Proof of Coverage .(Entity Being Listed as the Certificate Holder) Town Of Southold Building Dept 53095 Route 25 Southold, NY 11971 Id. Federal Employer Identification Number of Insured or Social Security Number 20-380119 3a. Name oflnsuranee Carrier National Union Fire lnsuranee 3b. Policy Number of entity listed in box "la" WC009924195 3e. Policy effective period __08/11/2009 to__08/ll/20i0__ 3d. The Proprietor, Partners or Executive Officers are [] included. (Only cheek box ifa# Imrtners/offieers included) [] all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box "3" insm'es the business referenced above in box "la" for workers' compensation under the New York State Workers' Compensation Law. (To use this form, New York (NY) must be listed under Item 3A on the INFORMATION PAGE of the workers' compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insursnce to the entity listed above as the certificate holder in box "2". The Insurance Carrier will also notify the above certificate holder within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premioms that cancel the policy ar eliminate the insured from the coverage indicated on this Certificate. (Thee notices may be sent by regndar mail.) Otherwise, this Certificate is valid far one year after this form is approved by the insurance carr~ or its licensed agent, or until the policy e~lration date listed in box ~3e", whichever is ~arl~7. Please Note: Upon the cancellation of the workers' compensation policy indicated on this form, if the business continues to be named on a permit, lienase or eontraet issued by a eertificate holder, the business must provide that eertiticate holder with a new Certificate of Workers' Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers' Compensation Law. Under penalty of perjury, I certify that I am an authorized representative or licensed agent of the insuronee carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Approved by: Thomas P. Terry. (Print name of authodzed i,~,~,tative or licetmed agmt of insurar~ carrie0 (Signature) '~ (D~e) Title: Authorized Representative Telephone Nmnber of authorized representative or licensed agent ofinsurence carrier. __631-283-8000 Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insaranee brokers are NOT authorized to issue it. C- 105.2 (9-07) www.wcb.state.ny.us Suffolk County Executive's Office of Consumer Affairs · .--.,~1~1 VETERAN$ MEMO RIAL I-~ G HWAY* HA UPP A UGE, NE W YORK 11788 5(11 MasterElectricianLicense ]/~%~JlJ This is to certify that ROBERT J SKYPALA ~/[[ doing business as GREENLOGIC LLC ~'JJ[ having given satisfactory evidence of competency, is h~mby licensed as MASTER ELECTRICIAN in accordance ~J~JJJ with and subject to the provisions of applicable laws, rotes and regulations of '~l,'~JJl[ NOT VALID wITHouT I~JJJ [ DEPART.M, ENTAL SEAL S.C.T.M. NO. ~)IS'~i~;'~: 1000 SECTION: 123 BLOCK: 5 LOT(S): #R10-07-0125 NONCONFORMING LOT LESS THAN 20,000 SQ.FT. 35' FRONT 35' REAR 10' SIDE (25' TOTAL) 20% LOT COVERAGE ALLEN DRIVE [XISTINO SANITARY S'/S?EM TO BE ABANDONED & BACK FILLED WITH CLEAN COARSE SAND. DWELl;.' 'G W/PUBLIC WATER LAND N/F OF MAZUR SHED i'0 BE 45.0' DRAINAGE 2355 S.F. IMPERVIOUS .17 X 2355 S.F, 392.5 = 8' DIA 10 VERTICAL FEET SUPPLY 2 8'DIA 5' DEEP POOLS FOUNDATION LOCATION 04- 10-09 TF 12.1 100.00' W~RE FENCE 0.3'N ~, 18.0' 5' · EL 7.6 PiP[ MIN I 6 "OAK FO c 7.0 8 'DtAx2 'D~OOLS 1,200 GALLON SEPTIC EXISTING WAT~I~ SERVICE ELf7.5) PPOPOSED PERVIOUS I)RIV[WAY ! eEL 6.2 L 5.8 - 28.2' '--L(6.2) X'~PROPOSED ~ 2 'OA~ EL 5.~ ~ DR~ELL 8'DIA 5' DEEP 2 RAIL FENCE DWL-LLINGS W/PUELIC WATER 100.00' S 85011'00'' W U.P TAX LOT # 1000-123-5-12 SET BACK 9.2' TAX I.OT i¢ ?000-723-5-~2, SET BACK 9.9' TAX LOT // 1000-125-5-14 FACES REEVE AVE - 35' SIDEYAi?D TO FAY COURT WATER EL LO ELEV. 7.0 -- 4.0' ,,ADD DRYWELLS 5-29-08. REVISEL(';T COVERAGE 5-6- 08 THE WA TEN SUPPL Y, FvELLS AND CESSPOOL LOCATIONS SHOF/N ARE FROM FIELD OBSERVATIONS REVISE Hr) J~E 5-1-08 -' ' ZONE AE(EL I,,,v~ AND OR DATA OBTAINED FROM OTHERS. AREA: i0,0Oi) ~' F OR 0.23 ACRES PANEL 482 ELEVAtiON DATUM: USGS UNAUTHORIZED /,LTERATION OR ADDITION TO THIS SURVEY IS A IqOLATION OF S;C(.'TION 7209 OF THE NEW YORK STATE EDUCATION LAF~ CDP/ES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S EMBO,~SFD SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPK GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF Tile LEND/NO INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE. THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE NOT INTENDED TO MONUMENT THE PROPE'RTY LINES OR TO GUIDE THE ERECTION OF FENCES, AODITIO~IAL STRUCTLIRE. E 0:~ AND OTHER IMPROVEMENTS. EASEMENTS AND/OR SUBSURFACE STRUCTURES R~CORD._u. OR UNRECORDED /~PE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT TH/c- ]'I~E OF SURVEY SURVEY OF: DESCRIBED PROPERTY MAP OF: FILED: SITUATED AT: MATTITUCK TOWN OF: SOUTHOLD SUFFOLK COUNTY, NEW YORK FILE # 27--110 SCALE: 1"=20' DATE: SEPT. 21, 2007 N. Y, $. LIC NO. 50227 CERTIFIED TO: DUNN: I~NNETH M. WOYCHUK L.S. Land Surveying and Design P.O. Box 3, Mattituck, New York, 11952 PHONE (831) 208-1588 FAX (831) 208-i§88 Pacifico Engineering PC PO Box 1448 Sayville, NY 11782 www. pacificoengineering.com September 27, 2009 Town of Southold Building Department 54375 Route 25, P.O. Box 1179 Southold, NY 11971 Subject: Solar Energy Installation for Marjorie Dunn 3360 Camp Mineol~.,ri ~ Mattituck, NY 11952~ '~ _ Engineering Consulting Ph: 631-988-0000 Fax: 631-382-8236 engineer@pacificoengineering.com E,P. # 7f) qFM FOB THE ¢',~PEC'i iONS' TWO REQUIRED 2. ROUGH- CE .:iq'F'R , .... r L,O ,oN MUST , ,; ' : BE COf4PLEZE ;:OR C.O. i~&N¢~ ALL C~, o, I., ,~_,~ SHALL MEET THE ..... ~ OFTHECODES OFNEW YO~K S~,",YE. NOT ~ESPONSIBLE ~OR DESIGN OR CON;3T~UOTJON I have review~ the roofing structure at the subje~ address. The st~cture can suppo~ the adomona~e~ght of the roof mounted system. The units are to ~ ins~lled in a~ordan~ with the manufacturer's installation instructions. I have determined ~at the ins~llation will meet the r~uirements of the 2007 NYS Building C~e, and ASCET-05 when installed in a~rdan~ with the manu~ctureCs instructions. Roof Section A mean roof height 24 ft pitch 3 314 in/12 roof rafter 2x8 rafter spacing 16 in DC Reflected roof rafter span 10.4 ff Table R802.5.1(1) max 16.8 ft REQUIRED The climactic and load information is below: CLIMACTIC AND Wind GEOGRAPHIC DESIGN Category Speed, 3 sec gust, CRITERIA mph Roof Section A C 120 Live load, pnet30 per ASCE 7, psf 65 point pullout load, lb 341 Fastener type 5/16" dia screw, 4-1/2" length, 2 per Ralph Pacifico, PE Professional EC~gineer · ' ~"-'TIO RETAIN STORM WATER RUNOFF PURSUANT TO CHAPTER 236 OF THE TOWN CODE. LOGIC GreenLogic, LLC Proposed Dunn, Majorie 5.805kW PV 3360 Camp Mineola Lane Mattituck, NY 631.766.3881 5.805 kW SunPower 215 UniRac Sunframe Azimuth -- 164° Pitch = 17,5° Scale 3/16" = 1.0' Pacifico Engineering PC PO Box 1448, Sayvilte, NY 11782 631.988-0000 www ~acif~coen(~meennr~com Ralph Paci§co, PE NYS License 066182 6 5/16" 6 5/16" Panel Dimension = 31.42" x 61.39" Array Length = 282.78" Array Height =188.67" Surface Dimensions = 24'8" x 21'10" Magic # = 62.14" SunPower 215w ; ? 2x8" Douglas Fir Rafter 16" on center UniRac SunFrame Rail UniRac L-Foot Layout Created By: BCA Date: 7/23/2009 LOGIC GreenLogic, LLC Proposed Dunn, Majorie 5.805kW PV 3360 Camp Mineola Lane Mattituck, NY 631,766.3881 5.085 kW SunPower 215 UniRac Sunframe Azimuth = 164° Pitch = 17.5° Scale 3/16" = 1,0' Pacifico Engineering PC PO BOX 1448, Sayvllle, NY 11782 631-988.0000 ~www. Dacific~enaineerina.corn Ralph Pacifico, PE NYS License 066182 Panel Dimension = 31.42" x 61.39" Array Length = 282.78" Array Height =188.67" Surface Dimensions = 24'8' x 21'10" Magic # = 62.14" 2x4 Kneewall SunPower 215w I l 2x8"DouglasFirRafter 16" on center UniRac SunFrame Rail UniRac L-Foot UniRac L-Foot Slider Layout Created By: BCA Date: 7/23/2009 3 Strings of 9 SunPower 215 W panels, Each string 1935 wafts Array total of 5805 Warts All panels to be grounded as per NEC code SUNPOWER SPR 6000m INVERTER 2, 30 AMP two pole DC switches from panels to inverter 240 VAC 240 VAC from inverter to a 30 Amp switch near utility meter 215 SOLAR PANEL EXCEPTIONAL EFFICIENCY AND PERFORMANCE The SunPower 215 Solar Panel provides induslry 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 power than conventional panels. SPR-215-WHT SunPower's High Efficiency Advanlage - Up to Twice Ihe Power Watts / Panel Eificiency kWs Thin Film Conventicnal 65 165 9.0% 12.0°/0 90 120 215 SOLAR PANEL EXCEPTIONAL EFFICIENCY AND PERFORMANCE Peak Power (+/-5°/°) Pmc~ 215 W Rated VoJloge Vmp 39.8 V Rated Currant Imp 5.40 A ___~ c~tv_o~,_ . vo~ _ 48.3 v Short Circuit Currant Isc 5.80 A Maximum System VoJlage IEC, UL 1000 V, 600 V Temperatum Coefficients Power -0.38%/°C Voltage (Voc) -136.8 mV/°C Current (Isc) 3.5 mA/°C Ser~es Fuse Rating 15 A Peak Power per Unit Area 173 W/wA, 16.1 W/ft2 CEC PTC Rating 198.5 W IV Curve 7.0 6.0 5.0 ~oeow/,~ ~OW/m~ 0.0 0 10 20 30 40 50 60 Tempe'alum - 40~ C lo +850 C (-40° F Io +185° FJ Max load 50 psf (2400 Patois) front and back I'H I Ill ri! ' ~ ImpaclRe~Jstance Hail-~Srnmi'l in)a123m/sJ52mph) SoJar Ceils 72 SunPow"er allback coelad rnonoc~slalline 3.2mm Junction Box IP-65 rated with 3 bypass diodes Warrant,/ 25 year limiled power 'warranty Oulput Cables 9gOmm length cable / Mult~onlacl cc:nnedors 10 year limiled product warranty Frame Anodized aluminum alloy type 6063 Cert/fications IEC61215,Sa~l~edlEC61730; V~ight 15kg, 33lbs UL lisled (LJL 1703J, Class C FJm Rceing Dirn~iofls CAUTION: READ SAFETY AND INSTALLATION INSTRUCTIONS BEFORE USING THE PRODUCT. Go to w~wv sunpowercorp com/paneJs for detaiJs 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 liles and trackers deliver significantly more energy than competing systems. ~'~ Printed on recycled paper www. sunpowercorp.com 500Om, 6000m & 7000m INVERTERS EXCEPTIONAL RELIABILITY AND PERFORMANCE The SunPower inverters 500Om, 6000m & 7000m provide exceptional reliability and market-leading design flexibility. The SPRm line of Solar Inverters can be easily applied in residential or commercial installations. All models come with a 1 O-year warranly. SPR-5OOOm, SPR-6OOOm & SPR-7OOOm ~wv. sunpowercorp.com 5000m, 6000m & 7000m INVERTERS EXCEPTIONAL RELIABILITY AND PERFORMANCE AC Power Vd~nge / Range SPR-5OOOm Sl~-6000m SPR-7OOOm 24A. 20.SA. 18A 29A. 25A 2h6A 34A. 29A 25.3A 60Hz 59.3Hz- 60Hz 59.3Hz- 60Hz '59,3Hz- AC r-req / Range60,5 Hz 60.5 Hz 60,5 Hz Power Fao'or Peak IIWeft~' 96.8% 97.0% 97~1% 95.5 % @ 208 V 95.5 %iD 208 V 96.0 %iD 208 V C~C ~ghled 95.5 % iD 240 v 95.5 %iD 240 V 96.0 % iD 240 V ~ 95.5 % iD 277 v 96.0 % iD 277 V 96.0 % iD 240V Tracking Voltage Input Current Ripple No. d r,u~d String Inp~s Po,em' Comump: Standby/ <Tw o.25w Nigldtime Disconnect SPRm Efficiency Curves ~ .s,o 75 % d Ral~d Oulput Power shipping Dimenslons W x H x D inch~ 23.5~ x 31,0' x 16.0# Unff Dimensions W x H x D inch~ 18,4' x 24,1' x 9,5' In~erler Weight 143 lbs Shipping Weight 154 lbs Cuding Forced Air Sealed Electronics Endosure 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 files and lrackers deliver significantly more energy than competing systems. www. sunpowercorp.com