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HomeMy WebLinkAbout36184-ZTown of Southold Annex 54375 Main Road Southold, New York 11971 5/1/2011 CERTIFICATE OF OCCUPANCY No: 34921 Date: 5/1/2011 THIS CERTIFIES that the building SOLAR PANEL Location of Property: 58855 CR 48, Greenport, NY 11944, 2 SCTM #: 473889 Sec/Block/Lot: 44.-2-22 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 2/16/2011 pursuant to which Building Permit No. 36184 dated 2/16/2011 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: roof mounted electric solar panel system as applied for. The certificate is issued to Levin Family Ltd Prtnrshp (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 36184 4/13/11 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit #: 36184 Permission is hereby granted to: Levin Family Ltd Prtnrshp 320 Mt Beulah Ave Southold, NY 11971 Date: 2/16/2011 To: install roof mounted electric solar panel system as applied for At premises located at: 58855 CR 48, Greenport SCTM # 473889 Sec/Block/Lot # 44.-2-22 Pursuant to application dated To expire on 811712012. Fees: 2/16/2011 and approved by the Building Inspector. NEW COMMERCIAL, ALTERATION OR ADDITIONS CO - COMMERCIAL Total: $250.00 $50.00 $300.00 Building Inspector Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00, Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. New Construction: Old or Pre-existing Building: Location of Property: ~ ¢ }(7~t~ % (~'ff'~ House No. Street Owner or Owners of Property: LC~.IX} h~f'x Suffolk County Tax Map No 1000, Section q L[ (check one) ~ff-ff~/"~ f~Sf~ '~ Hamlet ~ ~-~T~ / Block Subdivision Pe. tNo. t Date of Permit. Filed Map. Applicant: Lot: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fcc Submitted: $ Final Certificate: (check one) Applicant Signature Town Hall Annex 54375 Main Road P.O, Box 1179 Southold, New York 11971-0959 Telephone (631 ) 765-1802 Fax (631 ) 765-9502 roger, richert~,town, so uthold, ny. us BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Soundview Inn Address: 58855 Route 48 City: Greenport St: NY Zip: 11944 Building Permit #: 36184 Section: 44 Block: 2 Lot: 26 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE .~ontractor: DBA: Green Logic License No: 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 A/C Blower Range Recpt Transformer Appliances Dryer Recpt Disconnect Switches Twist Lock Other Equipment: Ceiling Fixtures R HID Fixtures Wall Fixtures ~.~ Smoke Detectors Recessed Fixtures ~.~ CO Detectors Fluorescent Fixture ~.~ Pumps Emergency Fixtures~ Time Clocks Exit Fixtures [~ TVSS photovoltaic system, 12000 watts, 60-Sun Power Spr 210 panels, 3-Sun Power Spr 4000 inverters, 1 ac disconnect, I combiner box Notes: Inspector Signature: Date: April 13 2011 81-Cert Electrical Compliance Form TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTAIn' CONSTRUCTION [ ] ELECTRICAL (ROUGH) REMARKS: [ ] FIRE RESISTANT PENETRATION ~.~LEC'mlCAL (FINAL) iNSPECTOR~/'''~-~ DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSUlaTION [ ] FRAMING / STRAPPING [//]"FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAJ-,-,,f INSPECTION I ] ~""'STA"T CO.m~ [ ] F1.E RE~J.T mrrRJT,0. REMARKS: //~ ~./'¢/~,/~.~ //~,~/~-.;~/ /~ DATE ~ 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 April 11, 2011 Town of Southold Building Department 54375 Route 25, P.O. Box 1179 Southold, NY 11971 Subject: Solar Energy Installation for Ellen Wiederlight 58855 North Road Greenport, NY 11944 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 Paciflco, PE Professional Engineer APR 2 0 2011 BLDG DEPT. TOWN Of SOUTHOLD FOUNDATION (lST) FOUNDATION (2ND) , INSIIL, ATION PER N. Y. STATE RNRRG~ CODE , , , , , - ~ TOWN OF SOUTHOLD BUILI~ING DEP&RTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. North Fork. net Examined ~/'/~ , 20 ] 1/ Approved ea'~/I ~:~, 20 [ ( Disapproved a/c PERMIT NO. 3 ~/O~¢ 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 Trustees Flood Permit Storm-Water Assessment Form Contact: to:eS Coa k/ ¢.:1 A Expiration ~-'~n ~0 ~ [rN'N,I X Buildinglnspector W~ ~ III 4~L'CAT'°N voa BUILDING PERMIT I ~ ~ [ INSTRUCTIONS ~UST be comp~tely filled in by typewriter or in i~ ~d submitted to the Building Inspector with 4 set~~ffi* to scale2~ according to schedule. . ..... ~ v ..... ocanon of lot and of buildings on premises, relationship to adjoining premises or pumm s~eets or me~, and waterways. c. The work covered by tbis application may not be commenced before issuance o~Building Pe~it. d. Upon approval of this applicmion, the Building Inspector will issue a Building Permit to the applicant. Such a pe~it shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in pa~ for ~y purpose what so ever until the Building Inspector issues a Ce~ificate of Occup~cy. fi Eve~ building pe~it shall expire if the work authorized h~ not commenced within 12 months a~er the date of issu~ce or has not been completed within 18 months ~om such date. If no zoning amendments or other regulatiom affecting the pmpe~y have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the pe~it for ~ addition six months. Therea~er, a new pe~it shall be required. APPLICATION IS HEREBY MADE to the Building Dep~ment for the issuan~ ora Building Pemit pursuit 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 ~ herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectom on premises ~d in building for necessau inspections. (Signature of applic~Lor ~ame, ifa corporation) (M~iling address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises (As od the tax roll or latest deed) If appli~~duly authorized officer (N~a[ and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade% License No. 1. Location of land on which nro~osed work will be done: House Number Street Hamlet Count: Tax Map No. 1000 Section Ut q Block_ 2~. Lot Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy I~,t").-l-t~ [ h. ntended use and occupancy C I 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition ~ther Work ~0~-~, 4. Estimated Cost ~_[, ~% Fee (To be paid on filing this application) 5. I f 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 stractures, if any: Front Rear .Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Depth. .Height. Number of Stories 8. Dimensions of entire new construction: Front Height Number of Stories Rear .Depth 9. Size oflot: Front Rear _Depth. I 0. Date of Pumhase Rear Name of Former Owner-.~-.~ [.COt ~ I L~v' t ~ ..~r'lJt~tQr~ ~ ~.- 1 I. 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-graded? YES NO d/ Will excess fill be removed from premises? YES NO__ 14. NamesofOwnerofp~mises~ P~Address~t& , ~ PhoneNo. Name of Architect Address Phone No NameofContmctor~r~ AddmssqZ~ ~ ~ PhoneNo. 15 a. Is this prope~y within 100 feet ora tidal wetland or a freshwater wetland? *YES ~ NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITfl MAY BE REQUI~D. b. Is this prope~ within 300 [~et of a tidal wetland? * YES ff NO * IF YES, D.E.C. PERMITS MAY BE ~QUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on proper~ is at I 0 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) COUNTY OF "~h~"~ ~ I~: J~Jc'¢::~! ~ /'~ b/.J.~ r~ ~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is thc (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. Notary ~blic ~AR~IARA ~. CASGIOTTA ~taly Public, State of Ne,,,,/York No. 01-CA4894969 Qualified in Suffolk County,,.,,: Commission Expires lvlav 11, ._~.' ?"( ignature of Applicant ' Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John Bredemeyer Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0633C Date April 13,2011 THIS CERTIFIES that the roof mounted photovoltaic solar system onto existing motel building At 58855 Route 48, Greenport Suffolk County Tax Map #44-2-22 Conforms to the applications for a Trustees Permit heretofore ~ed in this office Dated 11/19/10 pursuant to which Trustees Wetlan~l Permit #7441A and Coastal Erosion Permit #7441C dated 12/15/10 were issued and conforms to ali of the requirements and Conditions_of the applicable provisions of law. The project for which this certificate is being issued is for the Roof mounted photovoltaic solar system onto existing motel building. The certificate is issued to LEV1N FAMILY LTD. PARTNERSHIP owners of the APR 2 0 2011 8LDG DEPT To?~rq OF SOglHOLD aforesaid property. A~'rized~:i~a~r~e .. GREENLOGIC® April19,2011 The Town of 5outhold Building Department 54375 Route 25 P.O. Box 1179 Southold, NY 11971 Re: Building Permit No. 36184 Levin Family Ltd Partnership 58855 County Road 48, Greenport To the Building Inspector: Enclosed please find the Engineer's Certification Letter and the Town of Southold Board of Trustees Certificate of Compliance for the Levin Family Ltd Partnership's solar electric system, which we installed at 58855 County Road 48, Greenport. Please arrange to send them the Certificate of Occupancy 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 BIOG. DE?I. TOWN OF SOUTHOLD ! .,r E"iiO{ii( ii( .,',~wG, Fl<;' ,:c~ : Tel: 877 7714330 Fax 877771.4320 SOUTHAMPTON/CORPORATE: CUTCHOGUE: MANORVILLE: FIRE ISLAND: 425 OoLJrlly R(J 39A 1070 Depot Lane 40 Woodlar/d Avenuc 125 Duneway S)ulharng)tom NY 11968 Cutchogue, NY 11935 Mar}orville. NY 11949 Seaview. NY 11770 ROSLYN HEIGHTS: 200 S Serwcc Rd #108 R©s~ir', Heights, NY ] 1577  Town of Southold Ero~on~ ,B~tkm & Bton~.Witer Rim-off ASSESSMENT FORM SCOl~O~'WOmr - Pl~Ol'OS~ CONS'I~UCTION .[J,'~,M# No / MiiMMo~ W Mly 11 54375 Ma~n Road P.O. Box 1179 Soulhold, NY 11971-0959 Telephone (631) 765-1802 ro,qer, richert('~,t~ (wn~.~s) o~ u~o~.n¥.us BUll .DING DEPARTMENT TOWN OF $OUTHOLD APPLICATION FOR ELECTRICAL INSPECTION iREQUESTED BY: company Name: Name: License No.: No..' Date: 2"3'1 t *Name: *Address: · *Cross Street: · Phone No.: Permit No.: Tax Map District: JOBSITE INFORMATION: (*Indicates required information) 1000 Section: qq- Block: *BRIEF DESCRIPTION OF WORK (Please Print Clearly) (Please Circle All That Apply) *Is. job ready for inspection: *Do you need a Temp Certificate: YEs/ ~. ~ NO Temp Information (If needed] ' *Service Size: 1 Phase ' 3Phase 100 *New Service: Re-connect Underground Additional Information: Rough In Final 150 200 300 350 400 I Other Number of Meters Change of Service PAYMENT DUE WITH APPLICATION Overhead 82-Request for Inspection Form i GREENLOGIC® February 3, 2011 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 Soundview Inn (Levin Family Ltd Partnership) who has engaged us to install a roof-mounted (flat to the roof) solar photovoltaic (PV) electric system for their motel at 54375 Route 25, Southold. In connection with this application, please find attached: · A building Permit application · AStorm Water Assessment Run-off Form · 2 Surveys of Premises · Four Engineer's Reports (2 originals and 2 copies) · AOne Line Diagram · AVisio Diagram of the proposed system · Spec. sheets of the solar panels (SunPower SPR-210BLK) · Spec. sheets of the inverter (SunPower SPR4OOOm) · 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 : ,p ,~ ~,~63~1,.~77tc5.1,5t,, e~xt ~ ti~Tel: 877.7714330 SOUTHAMPTON/CORPORATE: CUTCHOGUE: 425 Cour~ty Rd 39A 1070 Depot Lane SouDlamptorl, NY 11968 Cutchogue, NY 11935 Fax: 877771.4320 MANORVILLE: 40 Woodland Avenue Manorville, NY 11949 FIRE ISLAND: 125 Duneway Seaview, NY 11770 ROSLYN HEIGHTS: 200 S Service Rd #108 Rosvl~tt~ights NY 11577 CERTIFICATE OF LIABILITY INSURANCE THIS [.~K HFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER I NAME: Brookhaven A~lenc¥, Inc. Brookhaven Agency, Inc. I PHONE !.,c ..... ). (631) 941-4113 r ~c. No): (631) 941-4405 P.O. Box 850 ADDREss:E'MAIL brookhaven.agenc¥~verizon.net 150 Main Street PRODUCER East Setauket NY 11733 INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Torus Specialty Insurance Co. Greenlogic, LLC INSURERS: Merchants Preferred Ins. Co. 425 County Road 39A, Suite 101 INSURER C: Utica National Southampton, NY 11968 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS iS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WiTH RESPECT TO WHICH THtS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE iNSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDISUBI POLICY EFF POUCY EXP LTR TYPE OF INSURANCE INRRV~/~ POLICY NUMI~ER tMM/DD/YYYY~fMMIDI~/yyYYI LIMITS GENERAL UABILnY EACH OCCURRENCE $1,000,000 A ~- COMMERCIALGENERALLIABILITY X 50817A110B 01/31/11 01/31/12 DAMAGE TO RENTED P~FMIRFR IF ............ I $ 50,000 J CLAIMS-MADE [] OCCUR MEDEXP(Anyone~erson} $5,000 PERSONAL & ADV INJURY $1,000,000 ~ CONTRACTUAL LIAB GENERALAGGREGATE $2,000,008 GEN'L AGGREGATE LIMIT APPLIES PER: ,[F~T $ B X~ ANYAUTO X CAPI043565 06/12/201I 06/12/2014 (EaaCCidenD $1,000,000 X~ NON~)W NED AUTOS $ $ X~ UMBRELLA LIAB ~ OCCUR EACH OCCURRENCE $ 2,000,000 A EXCESSLIAB] I CLAIMS*MADEX 50817AI10A 01/31/11 01/31/12 AGGREGATE $2,000,000 X RETENTION ~ 10,000 $ C Installation Floater CPP 4182553 1130110 1/30/11 $105,400 Ded $1,000 CERTIFICATE HOLDER CANCELLATION TOWN OF SOUTHOLD BUILDING DEPARTIVE~NT 53095 ROUTE 25 SOUTHOLD, NY 11971 Phone: Fax: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE D~[LIVERED (N ACCORDANCE WITH THE POLICY PROVISIONS. © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD STATE OF NEW YORK WORKERS' COMPENSATION BOARD CERTIFICATE OF NYS WORKERS' COMPENSATION INSURANCE COVERAGE la. Legal Name & Address of Insured (Use street address only) Greenlogic, LLC 425 County Road 39A Suite 101 Southampton, NY 11968 Work Location of Insured (Only required if coverage is speciftcally limited to certain locations in New York State, i.e., a Wrap-Up Policy) lb. Business Telephone Number of Insured (631)771-5152 lc. NYS Unemployment Insurance Employer Registration Number of Insured Id. Federal Employer Identification Number of Insured 2. Name and Address 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 or Social Security Number 20-3801194 3a. Name of Insurance Carrier New Hampshire Insurance Co 3b. Policy Number ofentitylisted in box"la" WC1602420 3c. Policy effective period 08/11/2010-8/11/2011 3d. The Proprietor, Partners or Executive Officers are [~ included. (Only check box if all partners/officers included) all excluded or certain partners/officers excluded. This certifies that the insurance carder indicated above in box "3" insures 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 Insurance 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 premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.) Otherwise, this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent, or until the policy expiration date listed in box "3c", whichever is earlier. Please Note: Upon the cancellation of the workers' compensation policy indicated on this form, if the business continues to be named on a permit, license or contract issued by a certificate holder, the business must provide that certificate holder with a new Certificate of Workers' Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers' Compensation Law. Under penalty of perjury, I certify that 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: Thomas P. Terry, CPCU (Print name of authorized representative or licensed agent of insurance carrier) 08/0 /2010 (Signature) (Date) Title: Authorized Representative Telephone Number of authorized representative or licensed agent of insurance carrier: (631) 283-8000 Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insurance brokers are NOT authorized to issue iL C-105.2 (9-07) www.wcb.state.ny.us 3000m & 4000m INVERTERS EXCEPTIONAL RELIABILITY AND PERFORMANCE BENEFITS Reliable and Robust Design Proven track record for durability and longevity High Efficiency Weighted CEC efficiency over 95% and peak efficiency over 96% Reduced Installation Cost Integrated DC disconnect with fuses lowers material costs and labor requirements Attractive Aesthetics Integrated disconnect eliminates need for visible conduits to inverter Ideal Output Ideal for residential applications 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 1 O-year warranly. SPR-3OOOm and SPR-4OOOm www.sunpowercorp.com 3000m & 4000m INVERTERS EXCEPTIONAL RELIABILITY AND PERFORMANCE Electrical Data SPR-3OOOm AC Power 3000 W AC Maximum Oulput Current (@ 208V, 240V) AC Nominal Voltage / Range 183- 229 V@ 208VAC 211 - 264 V @ 240 VAC SPR-4000m 3500W@ 208 V / 4OO0W@ 240 V 183 229V@208VAC 211 264V@240VAC Power Factor I Peak Inverter Efficiency 966% CEC Weighted Efficiency 95 O % @ 208 V 955%@240V 3600W 200-500 V@ 208V 200 500 V @ 240V Recommended Array Input Power (DC @ STC) DC Input Voltage Range SPRm Efficiency Curves 100 95 250 Vdc~ 75 7O oto ~0~o 20% a0°/o 40% 50% 60% 70@ % of Rated Oulput Power 90% 100% Mechanical Data Shipping Dimensions W x H x D inches 235" x 185" x 160' Unit Dimensions W x H x D inches I ?8" x 138" × 93" Inverter Weight 88 tbs Shipping Weight 94 lbs Cooling Forced Air / Sealed Ambient Temperalure Range -13 to +113 °F 180 4OOV@208VAC 220 480V@208VAC Peak Power Tracking Voltage 2oo - 400 v @ 240 VAC 250 480 V @ 240 VAC DC Max. Input Current I? A 18 A DC Voltage Ripple < 5% No. of Fused Shing Inputs 4 Standby / Nighttime Certifications Warranty and CertificalJons About SunPower 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. www.sunpowercorp.com BENEFITS High Efficiency Industry leading panel efficiency of 16.9% More Power Delivers up to 50% more power per unit area than conventional solar panels and 100% more than thin film solar panels Reduces Installation Cost More power per panel means fewer panels per install. This saves both time and money Reliable and Robust Design Proven materials, tempered front glass, and a sturdy anodized frame allow panel to operate reliably in multiple mounting configurations 210 SOLAR PANEL EXCEPTIONAL EFFICIENCY AND PERFORMANCE The SunPower 210 Solar Panel provides industry leading efficiency and performance. Utilizing 79 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-light performance attributes provide far higher energy delivery per peak power than conventional panels. SunPower's High Efficiency Advantage - Up to Twice the Power Comparable sysl~ms covering 1000 m2 / 10,750 ~ Thin Film Conventional SunPower Watts / Panel 65 ]65 2~0 Efficiency 9.0% 120?/0 16.9% kWs 90 120 169 SPR-2 IO-WHT ~¢. C (~ 210 SOLAR PANEL EXCEPTIONAL EFFICIENCY AND PERFORMANCE Eleclrical Data Peak Power (+/-5%) Pmax 210 W Rated Voltage Vmp 40.0 V Rated Current Imp 5.25 A Open Circuit Voltege Voc 47.7 V Short Circuit Current Isc 5~75 A Maximum System Voltage IEC, UL 1000 V, 600 V Temperature Coefficients Power 4).38%/-°C Voltage (Voc) -132.5m V/°C Current (Isc] 3.5m A/~C Series Fuse Rating 15 A Peak Power per Unlt Area 169 W/m=, 15.7 W/ft2 CEC PTC Rating ] 93.7 W Solar Cells Front Glass Junction Box Output Cables Frame Weight Mechanical Data 72 SunPower a~l back~onlact monocryslalline 3.2mm (1/8 in.I tempered lPg5 rated with 3 bypass diodes 900mm length cable / Mult~Conlact connectors Anodized olumlnum alloy type 6063 15kg, 33lbs IV Curve 7.0 6.0 5.0 10C0 W/m2 4.0 ~o~w/~, :3.0 2.0 1.0 0.0 0 Temperature Max load Impact Resistance Certifications Tested Operating Conditions ~4oac Ia +850 C (40OF lo + 185aF} 50psf (2400 Pascals) front and back Hail- 25mm (1 in) al 23 m/s (52mph} Warranty and Certifications 25 year limited power warranty 10 y~ar limil~d product warranty IEC 61215, Safely tested JEC 61730; UL listed IUL 1703}, Class C Fire Ralbg Dimensions CAL~T~ON: READ SAFETY AND INSTALLATION INSTRUCTIONS BEFORE USING THE PRODUCT. Go to www.sunpowercorp.com/panels for details About SunPower 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. ~ Printed on recycled paper sunpowercorp.com 2 Strings of 10 SunPower 210 watt panels, ' Each string 2100 watts Array total of 4200 Watts I II II II II II II II I II II II II; All panels to be 9rounded as per NEC code 2, 30 AMP two pole DC switches from panels to inverter SUNPOWER SPR 4000 INVERTER 24O VAC / 240 VAC from inver[er to a 30 Amp switch near utility meter 2 Strings of 10 SunPower 210 watt panels, Each string 2100 watts Array total of 4200 Watts I II II II II II All panels to be I I grounded as per NEC code II 2, 30 AMP two pole DC switches from panels to inverter SUNPOWER SPR 4000 INVERTER 240 VAC // I 240 VA(; from inYerter to ' Amp switch near utild¥ meter 2 Strings of 10 SunPower 210 watt panels, Each string 2100 watts Array total of 4200 Watts I! II F SUNPOWER SPR 4000 INVERTER All panels to be grounded as per NEC code 2, 30 AMP two pole DC switches from panels to inverter 240 VAC 240 V^C from inverter to a 30 ^rap smtch near utility meter Pacifico Engineering PC PO Box 1448 Sayville NY 11782 www pacificoengin eering.com November 13 2010 Revised January 31 2011- updated to 60 pane~s Town of Southoid Building Depadment 54375 Route 25, PO Box 1179 Southold, NY 11971 Subject: Solar Energy Installation for Ellen Wiederlight 58855 North Road Greenport, NY 11944 Engineering Consulting Ph: 631-988-0000 Fax: 631-382-8236 engineer@pacificoengmeering.com APPROVEDAS NOTED DATE ,, B.P # FEE mBY NOTIFY BUILDING DEPARTMENT AT 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS FOUNDATION- TWO REQUIRED FOR POURED CONCRETE 2 ROUGH-FRAMING. PLUMBING STRAPPING ELECTRICAL & CAULKING 3 INSULATION 4 FINAL-CONSTRUCTION & ELECTRICAL MUST BE COMPLETE FOR C 0 ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW I have reviewed the roofing structure at the subject address. The struct~,.~,~'~j;~c~Cj~l~it of the roof mounted system The units are to be installed in accordance wit~r~'~'~"hEf'~'~tO'¢(~'¢~' Ih'~t~t~1~'" instructions I have determined that the installation will meet the requirements of the 2007 NYS Building Code. and ASCE7-05 when installed in accordance with the manufacturer's instructions. Roof Section A mean roof height 14 ft pitch 41/2 in/12 roof rafter 2x6 rafter spacing t6 in OC Reflected roof rafter span 8 2 ft Table R802.5.1(1) max 13.3 ft The climactic and load information is below CLIMACTIC AND Wind GEOGRAPHIC DESIGN Category Speed 3 CRITERIA sec gust mph Roof Section A C 120 Ralph Pacifico, PE Professional Engineer Live load point prier30 per ASCE 7, pullout ioad lb psi 58 304 5/16" dia screw, 4-1/2" length Pacifico Engineering PC PO Box 1448, Sayville NY 11782 Ralph Pacifico, PE NYS License 066182 IGreenLogic, LLC Proposed ~Wiederlight, Ellen 12.6kWPV 158855 Nodh Road Greenpo~, NY 11944 631.477.1910 Layout Created By: VDC 12.6 kW 60 SunPower 210w UniRac Sunframe Azimuth -- 150° Pitch = 20° .05" = 1' Date: 1/31/11 Panel Dimension = 61.39" x 31.42" Array Length = 1227.8" Array Height = 98.76" Surface Dimensions = 186' x 9'10" Magic # = 32.17" SunPower 210w UniRac L-Foot & Flashing I UniRac SunFrame Rail Paciflco Engineering PC PO ~ox 1448, Sayville, NY 1 Ralph Pacifico, PE NYS License 066182 GreenLogic, LLC Proposed Wiederlight, Ellen 12.6kWPV 58855 Nodh Road Greenport, NY 11944 631.477.1910 Layout Created By: VDC 12.6 kW I Panel Dimension = 61.39" x 31.42" 60 SunPower 210w Array Length = 1227.8" UniRac Sunframe :~ Array Height = 98.76" Azimuth = 150° Surface Dimensions = 186' x 9'10" I Pitch = 20° ~ .05" = 1' ~ Magic# = 32.17" Date: 1/31/11 SunPower 210w · UniRac L-Foot & Flashing , ' UniRac SunFrame RailI Pacifico Engineering PC PO Box 1448 Sayvil~e, NY 11782 Ralph Pacifico, PE NYS License 066182 4 x 4" Post //~ ~Concrete Pilinq with 8" Diameter I GreenLogic, LLC Proposed Sound View Inn 58855 Route 48 Greenport, NY 11944 12.6 kW 60 SunPower 210 I UniRac Sunframe Azimuth = 150° Pitch = 22° Scale 1/4" = 1.0' Layout Created By: VDC Date: 11.9,10 Panel Dimension = 61 39" x 31.42" Array Length = Array Height = Surface Dimensions = Magic # = SunPower 21 Ow ~' UniRac L-Foot UniRac SunFrame Rail I 2x10" Douglas Fir Rafters [ 16" On Center Pacifico Engineering PC POl~ox 448, Sayv e NY11752 Ralph Pacifico, PE NYS License 066182 4'~10" GreenLogic, LLC Proposed Sound View Inn 58855 Route 48 Greenport, NY 11944 Layout Created By: VDC 10.35 kW 46 SunPower 225 UniRac Sunframe Azimuth = 169° Pitch = 22° i Scale 1/4" = 1.0' Date: 11,9,10 Panel Dimension = 61.39" x 31.42" Array Length = Array Height = Surface Dimensions = Magic # = SunPower 225w · UniRac L-Foot UniRac SunFrame Rai, 2x "Douglas Fir , Rafte~s 16" On Center