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HomeMy WebLinkAbout36087-ZTown of Southold Annex 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY 1/23/2012 No: 35406 Date: 1/23/2012 THIS CERTIFIES that the building Location of Property: SCTM #: 473889 Subdivision: SOLAR PANEL 1450 MILL RD MATTITUCK, Sec/Block/Lot: 107.-1-2.4 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 11/24/2010 pursuant to which Building Permit No. 36087 dated 12/10/2010 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: roof mounted solar panels on an existing one family dwelling as applied for. The certificate is issued to John & Irene Bradley (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 36087 5/18/11 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUII~DING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 36087 Z Date DECEMBER 10, 2010 Permission is hereby granted to: JOHN G BR3LDLEY PO BOX 1588 MATTITUCK,NY 11952 for : CONSTRUCTION OF ELECTRIC SOLAR PANELS (ROOF MOUNT) AS APPLIED FOR at premises located at 1450 County Tax Map No. 473889 Section 107 pursuant to application dated NOVEMBER Building Inspector to expire on JUNE MILL RD MATTITUCK Block 0001 Lot No. 002.004 24, 2010 and approved by the 10, 2012. Fee $ 200.00 ~.- Authoriz'ed Signature ORIGINAL Rev. 5/8/02 Form No. 6 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to tile 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 tile solder used in system contains less than 2/10 of 1% lead. 5. Commemial 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: I. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic featu res. 2. A properly completed application and consent to inspect signed by the applicant. Ifa Certificate of Occupancy is denied, the Building Inspector shall state tile reasons therefor in writing to tile applicant. C. Fees I. Certificate of Occupaucy - 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 oil Pre existing Buildiug - $100.00 3. Copy of Certificate of Occupancy - $.25 - 4. Updated Certificate of Occnpaucy- $50.00 5. Temporary Certificate of Occupancy Residential $15.00, Commercial $15.00 Old or Pre-existing Building: ~ (check one) New Construction: Location of Property: House No. Street Hamlet Owner or Owners of Property: ~{~/f~f~ ~'~ ~f"~--~ i'(~ ~.~ Suffolk County Tax MapNo 1000, Section l C~ Block J[ Lot .c:~...' ¢ SuBdivision Permit No. ~2) ~> O¢~ Date of Permit. Filed Map. Lot: Applicant: Health Dept. Approval: Plamling Board Approval: Request for: Tem[ Fee Submitted: $ ~) Underwriter,. Approval: Certifi, Final Ce fi JAN 2 3 2012 BLDG DF_Pl. TOWN OF SOUTHOLI) (check one) Town Hall Annex 54375 Main Road P.O. Box I 179 Southold. New York 11971-0959 Telephone (631 ) 765-1802 Fax (631 ) 765-9502 ro.qer, richert~town.southo d ny us BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Irene Bradley Address: 1450 Mill Rd City: Mattituck St: NY Zip: 11952 Building Permit #: 36087 Section: 107 Block: I Lot: 2.4 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Go Solar Inc LicenseNo: 35972-me SITE DETAILS Office Use Only Residential ~ Ind°°r F~ Basement ~ Service Only ~] Commerical Outdoor 1st Floor Pool New Renovation ?nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 3 ph Hot Water GFCl Recpt Main Panel NC Condenser Single Recpt Sub Panel NC Blower Range Recpt Transformer Appliances Dryer Recpt Disconnect Switches Twist Lock Other Equipment: Ceiling Fixtures [~ HID Fixtures Wall Fixtures I I Smoke Detectors Recessed Fixtures~ CO Detectors Fluorescent Fixture J.~ Pumps Emergency Fixturas~ Time Clocks Exit Fixtures [_..j TVSS PHOTOVOLTAIC SYSTEM, 4620 watt array, 22 Kyocera 210 w panels, and 2 Xantrex 2.8 inverters Notes: Inspector Signature: Date: May 18 2011 81-Cert Electrical Compliance Form 01/0§/2012 14:25 FAX 18317793344 GO SOLAR INC ~001/001 Fisher Engineering Services, P.c. PO Box 30 · Oakdale · New York 11769 Phone: (631 ) 563-9028 May 17, 2011 Building Depara~ent Subject: Engineer Statement for So[ar Roof Installation Bradley Residence- 1450 East Mill Road, Mattituck, New Permit No. 36087-Z ~rk I have verified the adequacy and stntcturaI integrity of thc existing roof rafters for mounting the solar collector panels and their installation satisfies the structural roof framing design load requirements of the Resident/al Code of New York State. I have reviewed and certify that the manufacturer's guidelines and equipment for the photovoltaic equipment for the above residence meet the requirements for wind and snow load and that the roof structure is adequate to cant the flew loads imposed by the System. For the installation of the solar mounting? the rails are securely anchored to the rafters utilizing lag screws that have b~en designed for wind speed criteria of 120 mph Exposure C and snow ground criteria of 20 psf. Wind loads will exceed seismic loads. Other climate and gee design criteria are not applicable to this solar installation. The solar collector system and the mounting assemblies comply with the applicable s~ctions oft, he Residential Code of New York State- "Sola~ Systems" and loading requirements of roof-mounted collectors and the minimum requirements for buildings and structures of ASCE 7-05. This system has been installed properly at the above referenced residence. Thc installation is in accordance with the minimum requirements certified by this letter. I hope that this letter serves and meets with the approval of the Building Department. Sincerely, William G. Fisher, P.E. Licensed Professional ~ngineer Architectural ~iga - R~id~, ~diti~ s · Ex en~ o s, C~ve~i~ Con~i~t Eslimat~ / ~e~i~t · Ex~iti~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] FlOUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [/%~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SA~-,. ~ 11' INSPECTION [ ]FIRERESISTANTCO#SIRUCTIO# [ ]FIRERESISTANTI~E#ETRATION RE,ARKS: DATE "~-/'~ -- / / _ INSPECTOR ___~' J~"- TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ~-}.F.~CTRICAL (FINAL) REMARKS: DATE INSPECTOR~ TOWN OF. SOUYHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined Approved Disapproved a/c [qlD ,20 9,20 Expiration 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 N.Y.S.D.E.C. Trustees Flood Permit Storm-Water Assessment Form Contact: Phone: ~/'7;~7- ~'¢,"¢,~ Building Inspector APPLICATION FOR BUILDING PERMIT Date N}o~/- 2,/, ,20 lO INSTRUCTIONS a. This applic~tti6fi%7IJd_S_T_he.~ ,mp ere y fi led in by typewriter or in ink and submitted to the Building Inspector with 4 sets or pTfins, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and waterways. c. The work covered by this application may not be commenced belbre issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building 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 Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suflblk 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. State whether applicant is owner, lessee, (~architect, engineer, (SignatUre of applicant or name, ifa corporation) (Mailing address of applicant) general contractor, electrician, plumber or builder Nameofownerofpremises ~-~--{~'~' BO. Wp n the tax roll or latest deed) If applicant is a corporation, signature of duly authorized ofricer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location[qff0oflandil3 '/.~ ~°n which proposed(yio~_i~ac~x,l~j//]~work will be done: House Number Street County Tax Map No. 1000 Section Subdivision/'ot///'~d~ dl~ ~'~/ta,/-.,s 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~:~t.s ~,~ 1/4~c[- 5. If dwelling, number of dwelling units If garage, number of cars 6. b. Intended use and occupancy ,~ 0 $i':b ~ 'l~¢zt~ - Nature of work (check which applicable): New Building. Repair Removal Demolition Estimated Cost Fee Addition Alteration~'/t~'~/ Otl~er WorkX ~tqst~U-,*f'/~ ~ ~[~P-. ,/~t/s;'~/~ - (Description) ' (To be paid on filing this application) Number of dwelling units on each floor If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front ~'~S' ' Rear ,q-o~ / .Depth ~ Height Number of Stories ~ &,.-;': Dimensions of same structure with alterations or add~iti~ns: Front : ~ ¥' tl Rear Depth Height /," Number of Stor~'s :" ' ' 8. Dimensions of entire new construction: Front ~; ~,~ Rear Height Number of Stories 9. Size of lot: Front /O'~ ' Rear ! 0'~ ' Depth ,~ 8'~ ' Depth 10. Date of Purchase ~- [~'" lq f ~' Name of Former Owner 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,A/ 14. Names of Owner of premises _.~R e_.~ [3 ga~/,~,Address i ~l,~O Iltlil{ ~.~ Phone No.~-~/-,~qg-o)-oIr/ Name of Architect /Address Name of Contractor i~fl ..~o~,t~ ,J~o Address Phone No. 15 a. ls this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO,~ * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES__ NO~X * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? * YES · IF YES, PROVIDE A COPY. NO STATE OF NEW YORK) k~K--} q'~"""l being duly sworn, deposes and says that (s)he is the applicant (Name of iri'dividual,~igning contract) above named, ' (S)He is the ~ /~ 0vb ,~0 ~lk~ ¢~,.N) kl - ~ (Contractor, A~nt, 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 tree to the best of his knowledge and belief; and that the work will be pertbrmed in the manner set forth in the application filed therewith. Sworn to before me this day of ~t~V~:'-~ ~ 20. _/o_ ~ A ~ /z] ~ ~"/'~ Nota~' ' Signature of Applicant Nil. 01VE61~7 Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCAT ON S C.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A I I q S*OR.-.^T.R,G" ,.G,G" INAGEAND.ROS,ON DON*RO'. N District Section Block Lot J CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. PROPOSED CONSTRUCTION ITEM # / WORKASSESS1V-~ENT I Yes No SCOPE OF WORK a. What is the Total Area of the Project Parcels? Total Area of all Parcels located within 7~'-~. I Will this Project Retain All Storm-Water Run-Oft (Include Generated by a Two (2") Inch Rainfall on Site? the Scope of Work for Proposed Construction) ~ (This item will include all run-oft created by site (S,F. I Acres) b. What is the Total Area of Land Cleadng_ ~ cleadng and/or construction activities as well as all and/or Ground Disturbance for the proposed~'Ac~s imperviousSite ImprovementSsurfaces.)and the permanent creation of construction activity? ) 2 Does the Bite Plan and/or Survey Show All Proposed PROV]]DE BRieF PROJECT D~C~[~ON (Pmva, ~uonaIP~w as Ne~) Drainage Structures Indicating Size & Location? This 'I I Item shall include all Proposed Grade Changes and 5J~Pi~'~//~t ~-~ O~ /~00'l~/Id0g'~t~-~ '~I~Y$?~ SIopesControllingSuffaceWaterFIow. O~,'s-[ta~l o'lC,~ ~. ~¥0¢0~P.~ ~_h~,0/:~v~d-a) 3 Does the Site Plan and/or Survey descfibe the erosion and sediment control practices that will be used to 0 -- ' - ~ , - control site erosion and storm water discharges. This Construction Pefiod. 3~m ~.. h5 0 ¢ n~r~.~ H-A~-) ~ ~- ~,~.. 4 Will this Project RequireanyLand Filling, Gradingor Excavation where there is a change to ihe Natural ~-'O '{ ~. L. ~'~ ~ ~C~ ~; '~e_ ~,~ ~t. ~) Existing Grade Involving more than 200 Cubic Yards O/ · of Material within any Parcel? 5 Will this Application Require Land Distarbing Activities D Encompassing an Area in Excess of Five Thousand (5,000 S.F.) Square Feet of Ground Surface? -- 6 Is there a Natural Water Course Running through the ~ Site? Is this Project within the Trustees jurisdiction ~eneral DEC SWPPP Requirements: or within One Hundred (100') feet of a Wetland or -- Submission of a SWPPP is required tot all Const[uction activities involving soil Beach? disturbances of one (1) or more acres; including disturbances of less than one acre thai 7 Will there be Site preparation on Existing Grade Slopes ~ I are pad of a larger common plan that will ultimately dislurb one or more acres of land; which Exceed Fifteen (15) feet of Vertical Rise to U including Construction activities involving soil disturbances of less than one (1) acre where One Hundred (100') of Horizontal Distance? -- the DEC has dethrmined that a SPDES permit Is required for stom~ water dischan3es. SWPPP'$ Shall meet the Minimum Requirements of the $PDE$ General Permit 8 Will Dfiveways, Parking Areas or other Impervious 'or Storm Water Discharges from Construction activity - Permit No. GP.~.t0-O0t.) Surfaces be Sloped to Direct Storm-Water Run-Oft 1. The SWPPP shall be prepared prior to the submittal of the NOI. The NOI shall be into and/or in the direction of a Town fight-of-way? submtited to the Depaament prior to the commencement of construction actlv~y. 2. The SWPPP shall desc~be the erosion and sediment control practices and where 9Will this Project Require the Placement of Material, required, post-construction storm water management practices that will be used and/or Removal of Vegetation and/or the Construction of any~=il constructed to reduce the pogutsnts in storm water di$changes and to assure Item Within the Town Right-of-Way or Road Shoulder~ s~^~ o~ ~Ew YUma, C or ~ coum'y OF ........ .,J0..tL0..L .................. ss ~f Indlln~ual signing Document) being duly sworn, deposes and says that be~ d~e applicant for Pennit, And that he/O is the ...h;.~l*~.~ Owner mid/or representative of the Oumer or Owners, and is duly authorized to perfom~ or have peal'mined the said work mtd to make and file this application; that all statements contained in this application m-e Uae to die best of his lmowledge and belief; ~md that the work will be performed in the manner set forth in the application filed herewith. Sworn to before me this; FORM - 06/10 02/01/2011 10:37 FAX 18317793344 80 SOLAR INC. ~002/003 Tow~ H~I A~)ncx 5437,5 Main Road P.O. Box 1179 Southold, N~ 11971~0959 Telephone (681) 765-180~ (631) 7 - BUILDING DF, PARTMF.,NT TOWN OF SOUTFIOI.,I) APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Company Name: Name: License No.: Address: Phone No.: JOBSITE INFORMATION: (*lndi~tes required info~ation) 'Cross Street: ~) c. *Phone No.: It 5/- ~f~' ~0 I~ Pe~it No.: Tax ~p Distd~: 1000 Se~on: ~0~ Bl~k: e J *BRIEF DESCRIPTION OF WORK (Please Pdnt Clearly) Date: Lot: (Please Circle All That Apply) *Is job ready for inspection: *Do you need a Temp Certificate: Temp Information (If needed] *Service Size: I Phase *New Service: Re-connect Additional Information: 3Phase 100 Underground YES / NO Rough In Final (~NO 150 200 300 350 400 Other Number of Meters Change of Service Overhead PAYMENT DUE WITH APPLICATION ~ 82-Request for Inspection Form Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York I 1971-0959 Telephone (631) 765-1802 Fax (631 ) 765-9502 BUILDING DEPARTMENT TOWN OF SOUTHOLD May 23, 2011 Go Solar Inc 272 Main Road Riverhead, NY 11901 RE: Bradley, 1450 Mill Road, Mattituck NOTE: Please provide certification the Building Inspector requested on 5/13/11 (copy enclosed) TWO WHOM IT MAY CONCERN: The Following Items Are Needed To Complete Your Certificate of Occupancy: '~J Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. A fee of 50.00. __ Final Health Department Approval. __ Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84) __ Trustees Certificate of Compliance. (Town Trustees #765-1892) __ Final Planning Board Approval. __ Final Fire Inspection from Fire Marshall. __ Final Landmark Preservation approval. BUILDING PERMIT: 36087-Z solar panels Town Hall Annex 54375 Main Road P.O. Box 1179 Southold. NY I 1971-0959 Telephone (631) 765 1802 Fax (631) 765-9502 BUILDING DEPARTMENT TOWN OF SOUTHOLD January 4, 2012 Riv~e~,NY '11901 '~ '0 Re: Bradley, 1450 Mill Rd., MaRituck ~ TO WHOM IT MAY CONCERN: The Following Item(s) Are Needed To Complete Your Certificate of Occupancy: *Note: Please provide certification by RA or PE that th~panels were installed according to plans, as per request of the Building Inspector on 5/13/11. )C--~c t~:~ ,/-'*."5-~ ~'/~APplication for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. ~Afee of $50.00. Final Health Department Approval. Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84) __ Trustees Certificate of Compliance. (Town Trustees #765-1892) Final Planning Board Approval. __ Final Fire Inspection from Fire Marshall. - Bob Fisher __ Final Landmark Preservation approval. BUILDING PERMIT: 36087- Solar Panels Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Telephone (631 ) 765-1802 Fax (631) 765-9502 Januaw 6,2012 BUILDING DEPARTMENT TOWN OFSOUTHOLD John Bradley PO Box 1588 Mattituck, NY 11952 Re: 1450 Mill Rd., Mattituck TO WHOM IT MAY CONCERN: The Following Item(s) Are Needed To Complete Your Certificate of Occupancy: J~;~pplication for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. {~A fee of $50.00. Final Health Department Approval. Plumbers Solder Certificate. (All permits involving plumbing after 411184) Trustees Certificate of Compliance. (Town Trustees #765-1892) Final Planning Board Approval. Final Fire Inspection from Fire Marshall. - Bob Fisher Final Landmark Preservation approval. BUILDING PERMIT: 36087- Solar Panels AcORid' CERTIFICATE OF LIABILITY INSURANCE I e ,...c 1o,1 261o THIS CERTIFICATE 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, tho 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). PRODUCER CONTACT #~E: Walter P Geoghan Agency Inc LoVullo Associates, Inc. IA/c.PHONE. o. ;'~}; (631) 472-5000 I ~C, NO): (631) 472-5611 6450 Transit Road E-MAIL ADDRESS: Depew, NY 14043 INSURERIS) AFFORDING COVERAGE NAIC # ;NSURERa: SCOTTSDALE INSURANCE COMPANY 41297 INSURED Go Solar, Inc. iNSURER B: c/o Gary Minnick INSURER C: 272 Main Road iNSURER D: Riverhead, NY 11901 INSURER;: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW RAVE 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 THIS 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 ADDL SUBtq POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVO POLICY NUMBER {MM~DD/YYYYI (MMJDD/YYYY LIMITS A --GENERALLIABI{'ITY CPS1222661 10120/2010 1012012011 EACHOCCURRENCE $ 1;0001000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES lea OccurTe~Ce)$ f 00~000 I CLAIMS-MADE X~ OCCUR MED EXP (An~' one person! $ 5,000 PERSONAL & ADV INJURY $ 1~000~000 __ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1 ~000t000 AUTOMOBILE LIABIMTY COMBINED SINGLE LIMIT ~XCESS U^B~ CLA'M~M~E AGGREGate DED I I RETENTION $ $ A Business Personal Prooertv CPS1222661 1012012010 1012012011 $110,000 CERTIFICATE HOLDER CANCELLATION TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 923791 LOC #: ADDITIONAL REMARKS SCHEDULE Page 2 of 2 ICARRIE~cottsdaie Insurance Company NNCCODE 41297 NAMED INSURED GO Solar, Inc. cio Gary Mlnnick 272 Main Road Riverhead, NY 11901 EFFECTIVE DATE: 10/20/2010 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25(2010105) FORM TITLE: Certificate of Liability Insurance This Page Intentionally Left Blank ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NOTE: THIS PROI3ER~i~ DESIGNATED MAP OF' THE COUN'PI OF DONALD G. DEKENIPP LAND SURVEYOR 354 GARDEN STREET W. ISLIP, N.Y 11795 516-;521-1653 KD210 KD210 KD210 KD210 KD210 KD210 KD210 KD210 KD210 KD210 KD210 KD210 KD210 KD210 KD210 KD210 KD210 KD210 KD210 KD210 KD210 KD210 22 Kyocera KD210 2 Xantrex GT2.8 UniRac SunFrame South THE NEW VALUE FI~ONTIEI~ KD210GX-LP HIGH EFFICIENCY MULTICRYSTAL PHOTOVOLTAIC MODULE [ KYOEERa LI~D HIGHLIGHTS OF KYOCERA PHOTOVOLTAIC MODULES Kyocera's advanced cell processing technology and automated production facilities produce a highly efficient multicrystal photovoltaic module. The conversion efficiency of the Kyocera solar cell is over 16%. These cells are encapsulated between a tempered glass cover and a pottant with back sheet to provide efficient protection from the severest envimnmenta~ conditions. The entire laminate is installed in an anodized aluminum frame to provide structural strength and ease of installation. Equipped with plug-in connectors. APPLICATIONS KD210GX-LP is ideal for grid tie system applications. · Residential roof top systems · Water Pumping systems · Large commercial grid tie systems · High Voltage stand alone systems · etc. QUALIFICATIONS · MODULE: UL1703 listed QUALITY ASSURANCE · FACTORY: ISO9001 and I$O 14001 Kyocera multicrystal photovoltaic modules have passed the following tests. · ~ermal cycling test · T~ermal shock test · Thermal / Freezing and high humidity cycling test · Electrical isolation test · Hail impact test · Mechanical, wind and twist loading test · Salt mist test · Light and water-exposure test · Field exposure test LIMITED WARRANTY · ~ 1 year limited warranty on material and workmanship · ~ 20 years limited warranty on power output: For ~etail, please refer to "category IV" in Warranty issued by Kyocera (LOng term output warranty shall warrant ff PV Module(s) exhib~ p~wer output of less than 90% of the original min{mum rated power specified at the time of safe within 10 years and ~ess than 80% within 20 years after the date of sale to the Customer. ~qe power output values shall be t~ose measured under KyOCera's standard measurement conditions. Regarding the warranty conditions in detail, please refer to WarTanty issued by Kyccela) ELECTRICAL CHARACTERISTICS Current-Voltage characteristics of Photovoltaic Module KD210GX-LP at various cell terr ~eratures Current-Voltage characteristics of Photovoltaic Module KD210GX-LP at various irradiance levels 08O3 SPECIFICATIONS KD210GX-LP · Physical Specifications Umt: mrn (in.) 946(37.2in.) · Specifications Maximum Power (Pmax) 210W (+5%/-5%) Maximum Power Voltage (Vrnpp) 26.6V Maximum Power Current (Impp} 7.90A Open Circuit Voltage (voc) 33.2V Short Circuit Current (Isc) 8.58A Max System Volt~ge 600V Temperature Coefficient of Voc -0.120 V/'C Temperature Coefficient of Isc 5.15x10'3 A/~C 6.32A 29.9V 6.98A Maximum Power Volt~ge (Vmppl Maximum Power Current (Impp) Open Circuit Voltage (voc) Short Circuit Current (Isc) Number per Module I 54 Length X Width × Depth 15~rnrn{59.1b)×~r~39.0in}×3r~nm(1.4~n) Weight 18.5kg(40.81bs.) Cable + 76(hnm{29,~in),(-)1840mm(72.4 n) Length x Width X Depth 1~{3.9in)x1~mm{4~in)x15~([~n) IP Cede IP65 · Othem *Operatin~l Temperature -40'C ~90~C *his temperature is based on cell ternperatum, Please contact our office for further information KYOCERa KYOCERA Corporation · KYOCERA Corporation Headquartars CORPORATE SOLAR ENERGY DIVISION 6 Takeda Tobadono-cho Fushimi-ku, Kyoto 612-8501, Japan TEL;(81 )7~-6D4-3476 FAX;(81 )75-604-3475 http:#www, kyocera.co~ · KYOCERA Solar, Inc. 7812 East Acoma Drive Scoltsdale, AZ 85260, USA TEL;{1)480~948-8003 or (800)223-9580 FAX;(1)480-483-6431 http://www,kyocerasolar, com/ · KYOCERA Solar do Brasil Ltda. · KYOCERA Solar Pty Ltd. · KYOCERA Fineceramics GmbH · KYOCERA Asia Pacific Pta. Ltd. 298 Tiong Bahru Road, #13-03/05 Central Plaza, Singal)ore 168730 TEL;(65)6271-0500 FAX:(65)6271-0600 · Kyocera Asia Pacific Ltd. Room 801-802, Tower 1, South Seas Centre, 75 Mody Road, Tsimshatsui East, Kowloon, Hong Kong TEL:(852)2723-7183 FAX:(852)2724~IS01 · KYOCERA Asia Pacific Pte. Ltd., Taipei Office 1 OF, NO. 66, Nanking West Road, Taipei, Taiwar~ TEL;(886) 2-2555-3609 FAX;(886)2-2559-4131 · KYOCERA (Tianjin) Sales & Trading Corp. (Bolling Office)Room 2107, Boiling Huabin International E~uilding, NO,8 Yong An Dong Li, Jian Guo Men Wai Road, Chao Yang District, Belling, 100022, China · KYOCERA Korea Co., Ltd. Kyocera reseP/es the right to modify these specifications without notice LIFJI10A0711-$AGM The Xantrex Grid Tie Solar Inverter (GT Series) is designed to convert photovoltaic (PV) electricity produced by solar modules into utility-grade power that can be used by the home or sold to the local electrical utility. Offering high efficiency (up to 96.0 %}, clean aesthetics, high reliability, and a Iow installed cost, through ease of installation and integrated features, the GT Series is a proven, high-frequency design in a compact enclosure. The GT Series may be installed as a single inverter, for a single PV array, or in a multiple-inverter configuration for large PV arrays. Technology ~ An NEC compliant, integrated DC/AC disconnect, standard in the GT Series, eliminates the need for external DC (PV) disconnects, and in some jurisdictions, AC disconnects ~ Large heat-sink offers extraordinary heat dispersion without the need for a cooling fan ~ Liquid crystal display (LCD) provides instantaneous information - power level, daily and lifetime energy production, PV array voltage and current, utility voltage and frequency, time online "selling", fault messages, and installer-customized screens ~ LCD vibration sensor allows the tap of a finger to turn backlight on and to cycle through display screens ~ Free PC software for remote monitoring and system troubleshooting available online Installation ~ Flexible module selection and sizing due to wide PV input MPPT tracking voltage range i. Lightweight and versatile mounting bracket ~ Easy access DC (photovoltaic) and AC (utili~/) terminal block simplifies wiring ~ Rugged NEMA 3R inverter enclosure allows reliable indoor and outdoor installations Performance ~ Best-in-class efficiency to maximize solar system return on investment ~ Accurate MPPT tracking ensures maximum energy harvest under any conditions ~ FCC Part B compliance provides less external electronic interference Serviceability ~ 1 O-year standard warranty ~ Sealed inverter enclosure can be quickly separated from the wiring box allowing DC/AC connections to remain intact in the unlikely event the inverter needs to be seMced Standard 1 O-yea r warranty Xantrex Technology Inc. Customer Service~Technical Support custornerser~ice@xantrex.corn Toll free: 1~800~70~0707 www.xantrex.com Xantrex GT Series Grid Tie Solar inverters Models GT5.0 GT4.0N GT3.3N GT2.8 Output 240V 208V 240V 208V 240V 208V 240V 20gv AC frequency (nominal) 60 Hz Max. output over-curteut protection 30 A i 20 A 15 A Max. output over-current protection 30 Arms 25 Arms 20 Arms 20 Arms Max. utility backfeed current 0 A Total harmonic distortion (THD) < 3 % < 5 % - Power factor > 0.90 % (at rated power), > 0.95 % (fu~l power range) Utility monitoring, islanding protection UL1741-2005 / IEEE 1547 Max, array open-circuit voltage 600 Vdc MPPT voltage range (CEC & CSA) 240 - 550 Vdc 240 - 480 Vdc 200 - 400 Vdt 195 - 550 Vdc MPPT operating range Low: 235 Vdt / High: 550 Vdt Low; 235 Vdt / High: 550 Vdt Low: 200 Vdt / High: 550 Vdt Vdt Low: 193 Vdt / High: 550 Vdt Max. input current 22.0 Adc 20.0 Adc 18.0 Adc 17.0 Adc 17.5 Adc 16.5 Adc 15.4 Adc 14.9 Adc Reverse-polarity protection Short-circuit diode Max. inverter efficiency 95.g% 05.5% g6.0% g5.7% i gs.g% g5.6% 95,0% 94,6% CEC efficiency 95.5% 95.0% g5.5% 05.0% , 95.5% g5.0% 94.0% g3.5% Night-time power consumption 1 W Operating temperature range -13°F to +14g~F (-25% to +65%) Enclosure type NEMA 3 R (outdoor rated) Inverter weight 58.0 lb (25.8 kg) 58.0 lb (25.8 kg) 49.0 lb (22.2 kg) 49.0 lb (22.2 kg) 5hipping weight 65.0 lb (27.2 kg) 65.0 lb (27.2 kg) i 57.0 lb (25.9 kg) 57.0 lb (25.9 kg) Inverter dimensions (H x W x D) 28 1/2 x 16 x 5 3/4~ (724 x 403 x 145 mm) Mounting Wall mount (mounting bracket included) Input and output tenainal AC and DC terminals accept wires sizes of #14 to ~6 AWG PV I Utility disconnect Eliminates need for external PV (DC) disconnect. Complies with NEC requirements Display Backlit, two-line, 16-character liquid c~/stal display provides instantaneous power, daily and lifetime energy production, PV array voltage and current, utility voltage and frequency, ~n~ online "selling ", fault messages, and inst aller<ustomizable screens Communications Integrated R5232 and Xanbus RJ4$ communication pon Wiring box PV, utility, ground, ar~ communications connections. The inverter can be separated from the widng box Warranty 10-year standard Part number (negative ground) 864-1009 864-1008 8~4o1006 864-1001 Positive ground inverte~ are also available PV MODULE FRAMING AND MOUNTING SYSTEM FOR PITCHED ROOFS PV MODULE FRAMING AND MOUNTING SYSTEM FOR PITCHED ROOFS Module Compatibility Use SunPrame with PV modules from these major manufacturers: BP Solar, GE Energy, Isofoton, Kyocera, Mitsubishi, Photowatt, RWE Schott, Sanyo, Sharp. Call UniRac or your PV dealer for manufacturers not listed. Code Compliance SunFrame is designed to comply with the Uniform and California building codes when installed according to SunFrame installation insUmctions. Call UniRac concerning status of International Building Code compliance. Components O Inter-Module Rails support modules as little as 2.125 inches above the roof. O Full Length Cap Strips secure modules and finish the array topside forming a gap-free frame. Serf- tapping screws at 16-inch intervals provide the holding power. O Push-Fit End Caps neatly finish the rail ends. O L-Feet attach directly to asphalt shingle roofs and support the rails one-half to three-quarters of an inch above the roof surface to provide convective ventilation. O Splices safely extend rails. O Aluminum or Steel Standoffs (optional) in a range of heights sup- port L-feet above tile or shake mfs. UniRac offers appropriate flashings. Clear or dark finishes on all visible above-roof components, from L-feet to screw heads, match the frames of your PV modules. Component Specifications Rails, cap strips, two-piece standoffs, splices, and L-feet: 6105-T5 aluminum extrusion. End caps: UV resistant plastic. One-piece standoffs: Service Condition 4 (very severe) zinc-plated welded steel. Fasteners: 304 stainless steel. www. unirac.com See our SunFrame page for complete information: pricing, installation insU'ucfions appropriate to your build- ing code, and minimum requirements for the number and type of modules you plan to mount. Unillae, Inc. 3201 University Boulevard SE, Suite 110 info@unirac.com Albuquerque NM 87106-5635 USA 505.242.6411 505.242.6412 Fax Pub 050206.1ds · February 2005 © 2005 UniRac, Inc. All rights reserved. UNIRAC SOLARMOUNT SYSTEM (TYPICAL P-.AIL ACROSS EACH ROW OF ENTIRE ARRAY) (Only Two Shown for' Clarity) FHOTOVOLTAIC , MODULE (TYP) RIDGE RAFTERS 2"x8" @ 16" O.C. (-WP) ROOF PITCH 5:12 SPAN: I 1'-6" PARTIAL I-'10 UROOF SCALE: I/4" = I'-0" PLAN ROOF AREA 4,620 W SYSTEM 51ZE MODEL KD210 KYOCERA 210 WATT EA., 40.8#/MODULE, 59. I"L x 39"W x I .4"D (2.G#/SF) HOUSE: SOLAR MODULE ARRAY- 22 MODULES TOTAL MODULE ARRAY: I I MODULE ARRAY: SOLAR DISCONNECT INVERTER ( I ) XANTREX 2.8 GT Ex/;erlor PVC Conduit -j SOLAR DISCONNECT LF-J INVERTER (I) XANTREX 2.8 GT INV I Grounding : Electrode I AC DISCONNECTLJ~] AC DISCONNEcTL~-I 1 Groundmg Electrode FASTENER REQUIREMENTS: TOTAL ARRAY AREA = 352 SF WIND LOAD: ASCE 7 (SEE CALCULATIONS THIS 5MEET) 41.5 PSF TOTAL UPLIh-T = 41.5 PSF x 352 SF = 14,608 LB5 FASTENER: SOLARMOUNT LAG SCREW SPEC 203.2, 8/04: (FLAT WASHERS REQ TO BE USED WITH LAG BOLTS) LAG BOLT WITHDRAWAL VALUE; 5/I 6" DIA,, 266 LB/IN X 2-IN THREAD DEPTH= 532 LB. CAP. EACH MIN. NUMBER OF LAG BOLT5 REG. = 14,608 LB5 / 532 LBS/LAG BOLT = 28 TOTAL RAIL FEET, 107.3 FT = 107.3 RAIL FT/28 BOLTS = MAXIMUM SPAN BETWEEN MOUNTING FEET BOLTS: 3.68 MAX si:=: EXIST. POWER PANEL PP ULL PIOU E ROOF= PLAN SCALE: NTS EXIST, METER M .SY._ TEM ONI LINZ DIAGRAM (TYP) SCALE: NTS Wmd Load Calculation: ASCE 7-02: Partially Enclosed Buddmg Design (Assume Worst Case) Low Rise Bufldmg; h<=6Of~: Mean Height; h=3Of~ I. Dlrectlonahty Eactor: Kd per Section 6.5.4.4, (Table 6-6): Kd=0.85 2. Importance Factor: per Section 6.5.5, (Table 6- I') Catagory I1', I= I .0 3. Velooty Pressure Coefhc~ent: Kh per Section 6.5.6.4 (Exposure Catagory C per G.5.6 (Table 6-3); Kh=O.98 4. Topographic Factor: Kzt per Section 6.5.7 (Long Island); Kzt= I 5. Gust Factor: G per 6.5.8. I, G=0.85 6. Exposure Classlflcat~on: per Section 6.5,9 = II 7. Internal Pressure Coeffloent: GCp per Section 6.5. I I. I, Table 6-5; GC?i=0.55 8. External Pressure Coefficient: GCpf per Section 6.5. I I .2. I, Figure 6- I 0', GCpf=0.80 9. Velocity Pressure: qh per Section 6.5. I O: qh--(0.00256)(Kh)(Kzt)(Kd)(V ^ 2)(I) qh--(0.00256)(0.98)( J )(0.8,5)( J 20 ^ 2)(J) qb--30.7 I O. Design Wind Load per Sec'clon 6.5, I 2 p=qh(GC?f-GC?l) p=30.7(+0.80+0.55) p=30.7( I .35) p=4 I .5 psf MOUNTING FOOT W/ BUTYL RUBBER MEMBRANE BETWEEN FOOT ¢ ROOF SHIINGLE OR NO CALK PLASHING 3" STANDOFF MOUNTIN~Q FEET PER RESIDENTIAL CODE OF NEW YORK STATE ROOF PENETRATION5 CHAPTER 9 (TYP) TOTAL ROOF DEAD LOAD I O~/SF (ROOF) + 2.5#/5F (MODULE) = I 2.5#/5F TOTAL UNIRAC RAIL INSTALLATION GUIDEUNE5 PER MANUP,ACTURE'S REQUIREMENT5 MOUNTING FEET POSITIONED OVER ROOF RAFTER MEMBERS PER MFG'S REQUIREMENT5 / PHOTOVOLTAIC MODULE '~" (MAX SPAN) MAX, SPAN ~ETWEEN MDUNTING FEET = PHOTOVOLTAIC MODULE SECTION --._ UNIRAC RAIL SCALE: NTB NOTE: FASTENER5 5HALL NEVER EXCEED 48" BETWEEN RAIL FEET PER MANUFACTURER MODEL KD210 KYOCERA 2 I 0 WATT EA., 40.8#/MODULE, 59. I"L x 39"W x I ,4"D (2.G#/SP) MOUNTING BRACE-CT MATERIAL~ ARE NON-COMBUSTIBLE IN ACORDANCE WITH EM2301.2.2 AND CONSIST OP ALUMINUM L BRACKETS UNIRAC PAIL I5 DESIGNED AND WARRANTED BYTHE MANUFACTURER FOR LOADS UP TO 50 LBS/SQ. ET. (APPROX. 125 MPH WIND) WHEN INSTALLED AS REQUIRED BY THE MAUNUFACTURER. NOTE: THE MOUNTING FEET MUST BE ATfACHED TO THE BUILDING RAFTERS OR FRAMING (NOT JUST THE ROOF DECKING}, USE 5/I ~" OR 3/8" DIAMETER LAG BOLTS AND DRILL PILOT HOLE. FINAL TIGHTENING SHALL [bE BY HAND. ALL INSTALLATION PROCEDURES SHALL BE PER MANUFACTURER'S REQUIREMENT5. NOTE: Modules and panels and any mountmg hardware provided shall withstand, without evidence of structural or mechanical failure, i .5 time5 the design load when Les'ced as speclhed below. The design load IS to be 30 psf downward(posltwe) or upward (negative). All glazing members shall be o~ such strength to withstand these loads. The module% panels and any mount;lng hardware shall be factory tested under these loads for a period of 30 minutes. (Downward ¢ upward forces shall not be applied simultaneously. BUILDING REVIEW NOTE TOWN BUILDING FLAN5 FXAMINER HA5 P. EVIEWED THE ENCLOSED DOCUMENT FOR MIN,MUM ACCE~A~Ld P~N 5UBMI~AL ~au,~UK~I~Uf UH Or THE TOWN A5 SPECIFIED IN THE BUILDING AND/OR RESIDENTIAqg~ [0 OFTHE STATE OF NEW YORK. THIS REVIEW DOES NOT GUA~NTE~,I'[)L. !,~' UNLAWFUL UNBERTHEbdALANOSIGNATUREOFTHESTATEOFNEWYO~LIC~R~¢BU. ,~ ~.'~'.~/~ INTEKP~ED ~ AN A~E¢TATION THAT. TO THE BE~T OF THE LICENSe'S ~ ' BELIEF AND INFORMATION THE WO~ IN THE DOCUMENT ~5: APPROVED AS NOTED ~ TO THE SAFEGUARDING OF LIFE, H~ALTH, PROPER~ AND PUBLI~~ DESIGN OR CONSTRUCTION ERRORS. RETAIN STQR~ wATER ROi',lU~, pURSU~,NT ~O 6H~,pTER Of IHE IOWN cODE. 0 12-5-10 Scale: AS SHOWN Sheet No. I ELECTRICAL INSPECTION REQUIRED