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Home My WebLink About35892-ZTown of Southold Annex 54375 Main Road Southold, New York i 1971 5/11/2011 CERTIFICATE OF OCCUPANCY No: 34936 Date: 5/11/2011 THIS CERTIFIES that the building SOLAR PANEL Location of Property: 275 Waters Edge Way, Southold, NY 11971, SCTM #: 473889 Sec/Block/Lot: 88.-5-58 Subdivision: Filed Map No. conforms substantially to the Application for Building Permit heretofore 9/1/2010 pursuant to which Building Permit No. 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 on an existing one family dwelling as applied for. Lot No. filed in this ofliced dated 35892 dated 9/23/2010 The certificate is issued to Corbin, Peter & Corbin, Annette (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 35892 4/8/11 ~d Signature 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. 35892 Z Date SEPTEMBER 23, 2010 Permission is hereby granted to: P & A CORBIN 275 WATERS EDGE WAY SOUTHOLD,NY 11971 for : INSTALLATION OF AN ELECTRIC SOLAR PANEL SYSTEM TO AN EXISTING DWELLING AS APPLIED FOR PER TRUSTEE APPROVAL at premises located at County Tax Map No. 473889 Section 088 pursuant to application dated SEPTEMBER Building Inspector to expire on MARCH 275 WATERS EDGE WAY SOUTHOLD Block 0005 Lot No. 058 1, 2010 and approved by the 23, 2012. Fee $ 200.00 / w ~Uth6~ized 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 wi A. For new building or new use: 1. Final survey of property with accurate location of all buildings, pruperty lines, streets, and 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. Ifa 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 New Construction: Location of Property: House No. Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision Permit No.-=~'~Brq 2.- - 2. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ 51~). Date. Old or Pre-existing Building: / (check one) Street Hamlet Block 000% Lot ff Filed Map. Lot: DateofPermit. q · 2'?-o · ! L3 Applicant: ~v~O'x LO, lC L. LC..- Underwriters Approval: Final Certificate: ¢"" (check one) ~pplic~nt Signature Toxxn Hall Ampex 54375 Main Road ILO. Box 117!,} Southohl, NY 11!171-09,59 Tck, l)honc (631) 76,5-1ffi}~2 Fax (631) 763-9,502 rofler, dchert~town.southold.n¥.us BI tiLl)lNG I)I~;PAI>,TM ENT TOWN OF $OUTItOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Peter & Annette Corbin Address: 275 Waters Edge Way City: Southold St: NY Zip: 11971 Building Permit Ct: 35892 Section: 88 B~ock: 5 Lot: 5~ WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Green Logic LicenseNo: 43858-me SITE DETAILS office Use Only Residential [~ Indoor [~ Basement [~ Service Only ~ Commedcal Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage Service 1 ph I ~ Heat Service 3 ph ~ Hot Water Main Panel A/C Condenser Sub Panel A/C Blower Transformer Appliances Disconnect Switches Other Equipment: INVENTORY GFCl Recpt Single Recpt Range Recpt Dryer Recpt Twist Lock Ceiling Fixtures [~ HID Fixtures Wall Fixtures ~ Smoke Detectors Recessed Fixtures ~ CO Detectors Fluorescent Fixtur,N Pumps Emergency Fixture Time Clocks Exit Fixtures LI TVSS photovoltaic system, 7740 watts, to include, 36 Sun Power 215 modules, 2 Spr 4000 inverters, combiner box, ac disconnect (roof mounted system) Notes: Inspector Signature: Date: April 8 2011 81-Cert Ele~rical Compliance Form TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] ROUGH PLBG. [ ] INSULATION [ Fp~INAL [ ] FIRE SAFETY INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING / STRAPPING [ ] FIREPLACE & CHIMNEY Pacifico Engineering PC PO Box 1448 Sayville, NY 11782 www.pacificoengineering.com Engineering Consulting Ph: 631-988-0000 Fax: 631-382-8236 engineer@pacificeengineering.com April11,2011 Town of Southold Building Department 54375 Route 25, P.O. Box 1179 Southold, NY 11971 Subject: Solar Energy Installation for Annette Corbin 275 Waters Edge Way Southold, NY 11971 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 APR 2 0 2077 TOWN O[ $0!~[~01D DATE FOUNDATION (IST) FOUNDATION (2ND) · ~ouo,, Fata~ & PLUMBING INSULATION PER N. Y. STATE EN~I~GY CODE ADDITIONAL coMMENTS TOWN OF SOUTHOLD ~UILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork. net PERMIT NO. ;rPl;it, dved ,c Expiration ,3;c~"'~,, 20 ~* 8EP !" a. ~tin. MUST be c~ sets of~ ~J$~9Dpl~ to sc~e b. 7;., vi~, ~.wing locanon o BUILDING PERMIT APPLICATION CHECKLIST I~ u'lfd'ing Inspector Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval Survey Check Septic Form N Y.S DE.C. Trustees Flood Permit Storm-Water Assessment Form Contact: ~r~,C~r'~L4~:~t~ LL C_ Mailt0:t-4~.-~. ff O~"~'~ P~d ~ ,4- Phone: ~o-~l ' 9:~l-~;t ~-- PPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS ii?x) ,20lo npletely filled in by typewriter or in ink and submitted to the Building Inspector with 4 Fee according to schedule. t and of buildings on premises, relationship to adjoining premises or public streets or areas, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to thc applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building lnspeator 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 inspector 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 Dapartment for the issuance ora 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. (Signature of applicant or name, ifa corporation) (Mgiling address of ~pplicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner o£ premises '~'J~r"-~~lc~ c~c~-- (As on the tax roll or latest deed) If apRlicant is a cor0qration, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No.~'~ ~ Other Trade's License No. 1. Location of land on ~hicl0 proposed ~vork will be done: House Number Street -o I Hamlet County Tax Map No. lO00 Section ~> ~ Block 5 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 ~r*~lt~ ~?-~./m,~./~ b. lntended use and occupancy ~¢r~[lff_ -'f2~o'mc[X/ 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work (Description) ,.~ 4. Estimated Cost 2e9. ~LT't) Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars 6. 1 f business, commercial or mixed occupancy, specil~ nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Height Number of Stories Rear Dimensions of same structure with alterations or additions: Front Depth Height. 8. Dimensions of entire new construction: Front Height Number of Stories 9. Size of lot: Front 10. Date of Purchase I l ~9~2> ' O Number of Stories Rear Rear .Depth Name of Former Owner ~a. Depth Rear .Depth 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES__ NO ~/ 13. Will lot be re-graded? YES NO ~/Will excess fill be removed from premises? YES __ NO__ 14. Names o~n,~er o~.f.~remises P .~Or~, ~ Address~ ~~ No. Nameo~~ ~m~t~ Addmss~l~8,~'l~,~PhoneNo~l'~'~ Nme ofContmctor~t~ ~L~ Addmssq~ ~ ~ PhoneNo. ~-q~l 15 a. Is this pro~ within 100 feet of a tidal wetl~d or a freshwater wetl~d? YES ~ NO ~ * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PE~ITS MAY BE ~QUIRED. b. Is this prope~y within 300 feet ora tidal wetland? * YES / NO~ * IF YES, D.E.C. PE~ITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on properly is at 10 feet or below, must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? * YES NO V/' · IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY o C 4nCoi l l t.Lk r l<- being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the ~'~ Ot'~'~'v~' (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 trae 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 thisJ ~/ dayof~t:Ti/g~.'f- 20_ [ O Notary,,0ublic BARBARA A. CASCIOTTA Notary Public, State of New York No. 01-CA4894969 Qualified in Suffolk County,~.r) / ~[/f~ Signature of Applicant Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall Annex 54375 Main Road P.O. Box 1179 Southald, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 7393A Date of Receipt of Application: September 1, 2010 Applicant: Peter & Annette Corbln SCTM#: 88-5-58 Project Location: 275 Watersedge Way, Southold Date of Resolution/Issuance: September 22, 2010 Date of Expiration: September 22, 2012 Reviewed by: Trustee Bob Ghoslo Project Description: To install solar panels onto the existing roof of the dwelling. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the application received on 9/1/10 and plans stamped approved on 9/22/10. Conditions: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. Jill M.(JZ)oherty, Presidentl/ Board-of Trustees 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 # 0630C Date: April 7~ 2011 THIS CERTIFIES that the installation of solar panels onto the existing roof of the dwelling At 275 Watersedge Way, Southold, New York Suffolk County Tax Map # 88-5-58 Conforms to the application for a Trustees Permit heretofore filed in this office Dated September 1, 2010 pursuant to which Trustees Administrative Permit #7393A Dated September 22, 2010 was issued and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the installation of solar panels onto the existing roof of the dwelling The certificate is issued to PETER & ANNETTE CORBIN owner of the aforesaid property. APR 2 0 011 BLDG DEP1, Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM pROPERTY LOC~?ION: S.C.T.M. ~ THE FOLLOWING ACTIONS ~Y ~qUl~ THE SUBM~WN OF A ~ ~ ~ ~ 8TO~-WATER, G~INO, D~IN~E ~D ER~ION ~ROL P~ ~ s~ ,~ ~t CE~IFIED BY A ~SIGN PROF~S~ IN THE ~A~ OF N~ YO~ SCOPEOFWO~ - PRO~S~ CON~i'~U~ON 1'1'~ /WO~S~S~ Yes No a. ~at b ~e To~l Ama of the P~ ~ls? ' I ~ll ~b Pmj~t Retain NI ~W~r ~n~ (IndUe T~ ~ea of all Pa~eb Io~t~ w~in ~n~ by a Two (~) [~h ~1~ ~ S~? the S~e of Wo~ f~ P~ ~on) (s~. l ~) ~s item ~1 i~lu~ all ~ff c~ ~ ~ V an~or Ground Dlstu~n~ ~r ~e p~ Site I mp~eme~ a~ ~e ~a~on ¢ ~n~n a~v~ (S.F.I ~) 2~s the S~ Plan ancot Su~y ~ N] P~ ~on Pe~. 4 ~1 ~is P~ect R~uire any Land FI~i~, Gm~ng ~v.on ~ere ~re Is a ~e to ~e N~ml ~sti~ Gm~ Involving mom ~ 2~ Cubic Y~ of Ma~dal ~in ~y Pa~ (5,~ S.F.) Square F~ ~ O~ Su~? 6 ~ ~em a NaOmi Wa~r ~u~ Runnl~ ~h ~e or ~[n ~e Hu~md (100') ~t ~ a We~ or d~n~d~(l)or~; b~bgdi~d~anmea~l 7 ~erebeSHepmpara~onon~ngG~eSl~ i~g ~n ~ I~bg s~l ~n~s ~1~ ~an one (1} ~m ~ One Hundred (100') of Ho~n~l Dls~n~? CO~ O~ ........................................... ~c ~d fde ~s ~pli~on; ~ ~1 sta~men~ con~ed in fl~ ~pp~6on ~ ~c ~ ~e best of ~ ~o~e~ ~d ~i~ ~d · ~ ~e wo~ ~ be peffo~ed in ~e m~ner ~t fo~ in ~e appSm6on fded FORM - 061tO Notary Public. State of New York No. 01-CA4~'94969 Qualified in Suffolk County Commission Expires May 11, Towa ~ Armex 54~75 ~ Road P.O. Box llTg . Soulhokl, ~ ! 1971-095~ Telephou~ (631) 765-1802 ro~er, miche.~o (wn~.~s) o7 u~.ny.us BIm ~ING DEPARTMENT TOWN OF $OUTHOLD APPLICATION FOR ELECTRICAL INSPECTION ' Name: Name: No.: Date: ~-~o- tO *Name:. *Address: · *Cross' Street: *Phone No.: Permit No.: Tax Map District: JOBSITE INFORMATION: (*Indicates required information) 1000 Section: <~ ~' Block: *BRIEF DESCRIPTION OF WORK (Please Pdnt Cleady) tot ~ (Please Circle All That Apply) *,s ob ready in pe on: YES/ ~'Do you need a Temp Certificate: (~.S~NO Temp*lnformation (If needed}- *Service Size: I Phase ' 3Phase 100 *New Service: 'Re-connect Rough In Final 150 ~ 300: 350 400 Other Overhead Additional Information: Underground Number of Meters Change of ~ewice PAYMENT DUE WITH APPLICATION 82-Request for Inspection Form CERTIFICATE OF LIABILITY INSURANCE PRODUCER THIS CER'nFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Brookhaven Agency, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 860 ALTSR THE COVERAGE AFFORDED BY THE POLICIES BELOW. 150 Main Street East Setauket NY 11733 INSURERS AFFORDING COVERAGE NAIC # ~NSURED Greenlogic, LLC ~NSURE~^: NGM INSURANCE COMPANY 425 County Road 39A Suite 101 INSURERB: MERCHANTS PREFERRED INS CO Southampton NY 11968 INSURER C: INSURER D: I INSURER E: COVERAGES TH E P O L ICI ES O FIN S U RAN C E L ISTE D B E LOW HAVE B E E N I SS U E D TO TH E IN S U R E D NAM ED ABOVE FO R TH E PO LICY P ERIO DIN DICATE D. N OTW I TH STAN D I N 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 SUBJECTTOALL THE TERMS. EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. G.~ENERAL UABIUTY EACH OCCURRENCE i 1,000,000 A X X COMMERCIALGENERALL~BILITY MPP1681L 01/31/10 01/31/11 DAMAGETOREN~ED I CLAIMS MADE [] OCCUR MEDF=XP(An¥onepef~m) X XCU PERSONAL & ADV INJURY X CONTRACTUAL LIAB GENERALAGGREGA~ $ 2,000,000 AUTOMOBILE UABIUTY COMBINED SINGLE LIMIT $ 1,000,000 B A X ANY AU'tO CAPI043565 06/1212009 06/12/2010 (Ea EXCE~ I UMBRELLA LIABIU'P( EACH CCCURRENCE ~ 2~000~000 A X ~IoccL~ ~1CLAIMS MADE CUPI681L 01131110 01131111 AGGREGATE $2,000,000 $ RETE~"JlON S 10,000 $ CERTIFICATE HOLDER TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 Phone: I Fax: ACORD 25 (2009/01) CANCELLATION SHOULD ANY OF THE ABOVE DE~CRIBEDPOMClES BE CANCELLEDBEFORE THE EXPIRATION 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 specifically 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 of entity listed 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 partnera/officers included) all excluded or certain partners/officers excluded. This certifies that the insurance carrier 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 Carder 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 carder) 08/o3/2oio (Signature) (Date) Title: Authorized Representative Telephone Number of authorized representative.or licensed agent of insurance carder: (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 it. C-105.2 (9-07) www.wcb.state.ny.us VETERANS MEMORIAL I-~GI-IWAY * HAUPPAUGE, NEW YORK 11788 DATE ISSUED: 12/10/2007 No. 43858-ME SUFFOLK COUNTY Master Electrician License This is to certify that ROBERT J SKYPALA -'ao~ng business as GREENLOGIC LLC having given satisfactory evidence of competency, is hereby licensed as MASTER ELECTRICIAN in accordance with and subject to the provisions of applicable laws, rules and regulations of the County of Suffolk, State of New York. Additional Businesses NOT VALID WYI'HOUT DEPARTMENTAL SEAL AND A' CURRENT CONSUMER AFFAIRS Dh'ector O, GREENLOGIC® ENERGY April 18, 2011 The Town of 5outhold Building Department 54375 Route 25 P.O. Box 1179 Southold, NY 1:[971 Re: Building Permit No. 35892 Annette Corbin 275 Waters Edge Way, Southold To the Building Inspector: Enclosed please find the Engineer's Certification Letter and the Town of Southold Board of Trustees Certificate of Compliance for Annette Corbin's solar electric system, which we installed at 275 Waters Edge Way, Southold. Please arrange to send her 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 PR 2 0 2011 BLD6 DEP1. TOWN OF SOUIHOLD GF',EENLOGiC. LLC · ~,,,,,~", Cre~i!l :}g r }m Tel: 8777714330 Fax: 8777714320 SOUTHAMPTON/CORPORATE: 425 County Rd 39A Southampton, NY 11968 CUTCHOGUE: 1070 Depot Lane Cutchogue, NY ]1935 MANORVILLE: 40 Woodland Avenue Manorville, NY 11949 FIRE ISLAND: 125 Duneway Seaview, NY 11770 ROSLYN HEIGHTS: 2005 Service Rd,#lO8 Rosylrt Ilcights, NY 11577 Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631 ) 765-1802 Fax (631) 765-9502 BUILDING DEPARTMENT TOWN OF SOUTHOLD April 21, 2011 Green Logic LLC 425 CR 39A Southampton, NY 11968 RE: Corbin, 275 Waters Edge Way, Southold TWO WHOM IT MAY CONCERN: The Following Items Are Needed To Complete Your Certificate of Occupancy: Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. A fee of 50.00. Final Health Department Approval. Plumbers Solder Certificate. (Ail permits involving plumbing after 4/1184) __ Trustees Certificate of Compliance. (Town Trustees #765-1892) __ Final Planning Board Approval. __ Final Fire Inspection from Fire Marshall. __ Final Landmark Preservation approval. BUILDING PERMIT: 35892-Z solar panels 5URVtE"r' OF: LOT .5 MAP OF TtERR'r' IAIATER~ AT BA"r'VIF:IN FILED DEC,. 2<:I, Iq58, FILE No. 2qOI 51TUATE: BA'r%/IEIN TOINN: 50UTHOLD c~,IFFOLK C, OUNTY, NY' 5Li~.VE'i'EO~ PEG. 18, 200q IOOO - 88 - .5 - .58 ]PETF~ COI~IN CltICAC~ 'IFiliTLE ~ISUAANCE COMPANY TI[TLE lq@. 3809-8i~t3 NOTE~: · Are~ = Iq~18 S. F. Area = 0.4550 Acres ®t~APHIC %ALE MONUMENT FOUND PIPE FOUND Pacifico Engineering PC PO Box 1448 Sayville, NY 11782 www. pacificoengineering.com August 28, 2010 Town of Southold Building Department 54375 Route 25, P.O. Box 1179 Southold, NY 11971 Subject: Solar Energy Installation for Annette Corbin 275 Waters Edge Way Southold, NY 11971 Engineering Consulting Ph: 631-988-0000 Fax: 631-382-8236 engineer@pacificoengineeringcom NOTIFY 3UtLDING D[:~-,.~'F,'*ENT A~' 76~-~$02 .'~ AM 70 4 [M FOR THE FOLLOWING INSPECTIONS: 1, FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING. PLUMBING, STRAPPING. ELECTRICAL & CAULKING 3. INSULATION 4. FINAL- CONSTRUCT!ON & ELECTRICAL MUST 8E COMPLETE cOP ¢. O AIL CONSTRUCTION SHALL MEET THE REQUIREMENTS 0~: THE -;CSE. S OF.NEW I have reviewed the roofing structure at the subject address. The stlr~l~l-A~n _e~o~ ~t~¢~,e~_~ ~¢Sfght of the roof mounted system. The units are to be installed in accordan~:~N~l 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 16 ft pitch 3 in/12 roof rafter 2x10 rafter spacing 16 in OC Reflected roof rafter span 19.3 ft Table R802.5.1(1) max 20.6 ft The climactic and load information is below: CLIMACTIC AND Wind GEOGRAPHIC DESIGN Category Speed, 3 sec gust, CRITERIA mph Roof Section A C 120 Ralph Pacifico, PE Professional Engineer USE i,; i :;',!LAWFUL WITH'.; q CE TIFICATE Live load, point pnet30 per ASCE 7, pullout load, lb psf 59 604 RETAIN STORM WATER RUNOFF PURSUANT TO CHAP 'FR 236 O,c THF T~W~U ~'nnc Fastenertype 5/16" dia screw, 4" length ~ Pacifico Engineering PC PO Box 1448, Sayvil~e, NY 11782 631-988-0000 www oacificoenqineerinq ~m Ralph Pacifico, PE NYS License 066182 Chimney HT: 5' GreenLogic, LLC Proposed 7.74 kW Panel Dimension = 31.42" x 61.39" ~ SunPower 215w Corbin, Annette 36 SunPower 215 Array Length = 408.46~ · UniRac L-Foot 275 Waters Edge Way UniRac Sunframe Array Height = 188.67 --- UniRac SunFrame Rail Southold, NY 11971 Azimuth = 186° Surface Dimensions = 507"x 263" 631.765.2829 Pitch = 13° Magic # = 62.14" I I 2x10" Douglas Fir acorbin@madisoncg.com Scale 3/16"= 1.0'~ ~ Rafters 16" On Center Layout Created By: BCA Date: 8.27.2010 ELIMiNATiNG THE COST OF ENERGY Pacifico Engineering PC PO Box 1448, Sayville, NY 11782 631-988-0000 www oaciflcoengineerinQ corn Ralph Pacifico, PE NYS License 066182 Chimney HT: 5' GreenLogic, LLC Proposed Corbin, Annette 275 Waters Edge Way Southold, NY 11971 631.765.2829 acorbin@madisoncg.com 7.74 kW 36 SunPower 215 UniRac Sunframe Azimuth = 186° Pitch = 13° Scale 3/16" = 1.0' Panel Dimension = 31.42" x 61.39" Array Length = 408.46 Array Height = 188.67 Surface Dimensions = 507" x 263" Magic # = 62.14" SunPower 215w · UniRac L-Foot . UniRac SunFrame Rail I I 2xl0"DouglasFir Rafters 16" On Center Layout Created By: BCA Date: 8.27.2010 215 SOLAR PANEL EXCEPTIONAL EFFICIENCY AND PERFORMANCE SPR-215-WHT The SunPower 215 Solar Panel provides industry leading efficiency and performance. Utilizing 72 next generation SunPower all-back contact solar cells and an optimized panel design, the SunPower 215 delivers an unprecedented total panel conversion efficiency of 17.3%. The 215 panel's reduced voltage-temperature coefficient and exceptional Iow-light performance attributes provide far higher energy delivery per peak 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 90 120 215 SOLAR PANEL EXCEPTIONAL EFFICIENCY AND PERFORMANCE Peak Power (+/-5%) Pmax 215 W Rated Voltage ..... V_m_p .......... .~78 v. Rated Current Imp 5.40 A Open Circuit Voltage Voc 48.3 V Short Circuit Current Isc 5.80 A Maximum System Vollage IEC, UL 10OO V, 600 V Temperalure Coefficienls Power -0.38%/°C Voltage (Voc) -136.8 rnV/~C Current (Isc) 3.5 rnA/°C Series Fuse Rating 15 A 7.0 6.0 a.o 2.0 SOOWlr.2 1.0 0.0 0 I0 20 30 40 50 CEC PTC Rating 198.5 W Temp~rot~ ......... _-_40°_C ?~+$5~C (40° F Io +te5° F) Max load 50 psf (2400 Pascals) {Toni and back Solar Cells 72 SunPov~r al~ck coe~ct monocryslalline Front Glass 3.2mm (1/8 ira) tempered Oulput CabJes 900mm Je~glh cabJe / Mulli~o~tacl ~onnect~s 10 year limiled produd warranty Frame Anodized aluminum alloy type 6063 Certifications IEC 6121.5, Sa~ tested IEC 61730; Weight 15kg, 33lbs U~ lisled JUL 1703), Class C Fire Rali~g mr. ~,~ CAU11ON: READ SAFELY AND INSTALLAI'ION INSIRUCI10~S BEFORE USING IHE PRODUCT. Go to www.sunpowercorp.com/penels for details SunPower designs, manufactures and delivers high-performance solar eleclric technology worldwide. Our high-efficiency solar cells generate up to 50 percent more power than conventional solar cells. Our high-perfarmance solar panels, roof tiles and trackers deliver significanlh/more energy than competing systems. Prinled on recycled paper www.sunpowercorp.com !i 2 Strings of 9 SunPower 215 watt panels. Each sting has 1,935 watts Arroy total of 3,870 wafts All panels to be grounded as per NEC code 30 AMP two pole DC sw~tch from panels to inverter su. owE, s.. ooo 240 VaC 240 VAC from inverter to a 30 Amp switch near utility meter 30 AMP 3R switch near utility meter 2 Stdngs of 9 SunPower 215 watt panels. Each sting has 1,935 watts Arroy total of 3,870 watts All panels ~ be grounded as par NEC code 30 AMP two pole DC switch from panels to inverter su.~owE, s.. 4000 ~.VE.~. ~ 240 VAC 240 VAC from inverter to a 30 Amp switch near utility meter 30 AMP 3R switch near utility meter