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Home My WebLink AboutTR-7750A James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino 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 # 0754C Date: June 5, 2012 THIS CERTIFIES that the installation ora roof mounted solar electric system onto the existing dwelling. At 5000 Paradise Point Road, Southold, New York Suffolk County Tax Map # 81-3-I .4 Conforms to the application for a Trustees Permit heretofore filed in this office Dated February 24, 2012 pursuant to which Trustees Administrative Permit #7750A Dated March 21, 2012 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 a roof mounted solar electric system onto the existing dwellinE. The certificate is issued to ELYSE JAMES owner of the aforesaid property. Authorized Signature James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall, 53095 Main Rd. P.O. Box I 179 Southold, NY 11971 Telephone (63 I) 765-1892 Fax (631 ) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: Ch. 275 Ch. 111 INSPECTION SCHEDULE __ Pre-construction, hay bale line/silt boom/silt curtain __ 1st day of construction ¼ constructed Project complete, compliance inspection. INSPECTED BY: ~ J~ co7 CERTIFICATE OF COMPLIANCE: James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (631 ) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 1st day of construction ½ constructed Project complete, compliance inspection James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino 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 Permit No.: 7750A Date of Receipt of Application: February 24, 2012 Applicant: Eiyse James SCTM#: 81-3-1.4 Project Location: 5000 Paradise Point Road, Southold Date of Resolution/Issuance: March 21, 2012 Date of Expiration: March 21, 2014 Reviewed by: Board of Trustees Project Description: To install a roof mounted solar electric system onto the existing 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 site plan prepared by Pacifico Engineering PC, last dated February 9, 2012, and stamped approved on March 21,2012. Special Conditions: None. Inspections: 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. Jam~es F. King, r~sident Board of Trustees JFK:eac James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall Annex 54375 Route 25, P.O. Box 1179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD / Please be advised that your application dated F'e~f'u~oryc2q, Jo/,A has been reviewed by this Board at the regular meeting of ~ ~, '~1~ and your application has been approved pending the completion of the following items checked off below. __ Revised Plans for proposed project __ Pre-Construction Hay Bale Line Inspection Fee ($50.00) __ Ist Day of C~nstruction ($50.00) ~ ~ Constructed ($50.00) ~ Final Inspection Fee ($50.00) ~ Dock Fees ($3.00 per sq. ff.) Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is ~mputed below according to the schedule of rotes as set fo~h in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessa~. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: $ ~-~) ~ BY: James F. King, President Board of Trustees James F. King, President Bob Ghosio, Jx., Vice-President Dave Bergen John Bmdemeyer Michael J Domino P O Box 1179 Southold, NY 11971 Telephone(631 765-1892 Fax(631)765 664l Southold Town Board of Trustees Field Inspection/VVorksession Report D~te/Time: GreenLogic LLC on behalf of ELYSE JAMES requests an Administrative Permit to install a roof mounted solar electric system onto the existing dwelling. Located: 5000 Paradise Point Rd., Southold. SCTM#81-3-1.4 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: __Chapt.275 Chapt. 111 other Type of Application: __ Wetland __Coastal Erosion __Administrative__Emergency Pre-Submission __ ~Amendment Violation Info needed: Modifications: Conditions: Present Were: __J. King __B. Ghosio __ J. Bredemeyer___ Michael Domino Form filled out in the field by D. Bergen, D. Dzenkowski other Mailed/Faxed to: Date: N OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Jim King, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: March 15, 2012 Re: Proposed Wetland Permit for ELYSE JAMES SCTM#1000-81-3-1.4 GreenLogic LLC on behalf of ELYSE JAMES requests an Administrative Permit to install a roof mounted solar electric system onto the existing dwelling. Located: 5000 Paradise Point Rd., Southold. SCTM#81-3-1.4 The proposed action has been reviewed to Chapter 266, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is EXEMPT from LWRP review pursuant to: § 268-3. Definitions. MINOR ACTIONS item "11" which states: II. Additions to an existing building or rebuilt residential structure which results in no net increase in ground area coverage, except where the parcel is located in a coastal erosion hazard area; Maintenance or repair involving no substantial changes in an existing structure or facility; Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Lori Hulse, Assistant Town Attorney Office Use Only Coastal Erosion Permit Application Wetland Pennit Application ,.,//Administrative Permit Amendment/Transfer/Extension ~ecei~-ved Application: ~eceived Fee:$ ~ompleted Application e-.,~3~X.[~ __Incomplete __SEQRA Classification: Type 1 Type Il Unlisted__ Coordination:(date sent)_ ~-~WRP Consistency Assessment Form ~AC Referral Sent: _~te of Inspection:~.~. __Receipt of CAC Report: __Lead Agency Determination: __Technical Review: 'L~dffflic Hearing Held: Resolution: Name of Applicant Address ~ ~c--ff~C~[.\ Phone Number:( Suffolk County Tax Map Number: 1000- L'~rt Property Location: L.~C)C;I~ (provide LILCO Pole #, distance to cross streets, and location) AGENT: (1 f applicable) Phone: of Trustees Application0 Land Area (in square feet): Area Zoning: Previous use of property: Intended use of property: Covenants and Restrictions: Yes v/ No If"Yes", please provide copy. GENERAL DATA ok- Lq. qq Does this project require a variance from the Zoning Board of Appeals Yes ~/ No If"Yes", please provide copy of decision. Will this project require anyflemolition as per Town Code or as determined by the Building Dept. Yes ~/ No Prior permits/approvals for site improvements: Agency Date '// No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspen/ded by a governmental agency? i/No Yes lfyes, provide explanation: Project Description (use attachments if necessary):. ~ ~ ~¢{-,:a ( [ ~d of Trustees ApplicationO WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: 1 ~q-~'-'-'~ ti Area of wetlands on lot: C',~C~L- square feet Percent coverage of lot: % Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structure and upland edge of wetlands: feet Does the project involve excavation or filling? v/ No Yes If yes, how much material will be excavated? How much material will be filled? Depth of which material will be removed or deposited: Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: cubic yards cubic yards feet Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): of Trustees ApplicationO COASTAL EROSION APPLICATION DATA Purposes of proposed activity: Are wetlands present within 100 feet of the proposed activity? No v/ Yes Does the project involve excavation or filling? ~/' No Yes If Yes, how much material will be excavated? b/4- (cubic yards) How much material will be filled? ~d ,~' (cubic yards) Manner in which material will be removed or deposited: Describe the nature and extent of the environmental impacts to the subject property or neighboring properties reasonably anticipated resulting from implementation of the project as proposed, including erosion increase or adverse effects on natural protective features. (Use attachments if necessary) PROJECT ID NUMBER PART 1 · PROJECT INFORMATION 1. APPLICANT I SPONSOR 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) 2. PROJECT NAME cou.,y Sa CCat/< SEQR 3.PROJECT LOCATION: 4 PRECISE LOCATION: Street Addess and Road IntarseclJons. Prominent landmarks elc -or ;~rovide mad 5000 J 6, DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: IniUally acres UlUmataly acres 8 WiLL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? [~rYos [] No it no. dee=ibc g. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) E~Resl~enllal r"-~tndustrial r~commercia' F~Agriculture [~Park/ForesllOpenSpaca r-~other (deec,-ibe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) ]Yes F~NO yes. agency name a~d pennil / approval: list 11. DOES AN'( ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ]Yes r'~No If yes, list name and permit / I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicam I Sp~sor Name ; Date; ~t~he action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART II - IMPACT ASSESSMENT ITo be completed by Lead Agency) A. (DOES ACTION EXCEED ANY TYPE I ]}IRESHOLD {N 6 NYCRR, PART 617.4? If yes, ccerdi~ts the review process and use the FULL FAF. E~Yes [~No B. WILL ACTION REC~/E COOR~NATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 61 ~'.67 If No, a negative dedaratio~ ma)' be s~ by another I~velved agency. ~"-~ Yes [~]No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (.N~'wers may be handwfittefl, if legible) C1. Existing sir quality, surface or groundwater quality er quer4ity, noise levels, existing traffic pattern, solid waste produdion o¢ disposal, potential for eroslan, drainage er flooding prol~ems? Ex, lain briefly:. I I C2. Aesthetic, ngrlc~ltural, arc~aeologleal, historic, or other natural or cultural resources; or cemmum'ty er ueighbefllued charac[el'/Explain b~iefly:. I I C3. Vegetatio¢~ er fauna, fish, ~,heflflsh or wildr~fe species, slgnif~aM habitats, or lhma~ened or eeda~ered spedes? Explain briefly:. / ty g pla or gee s as ofi~al~y adopted or a change m use or I~te.sity of use of laud or other natural resources? Ex,am b~efly C5. Growth, subsequent devel0pmenL or related acbvities likely to be induced by the proposed action? Explain briefly: C6. Long term, short term, cumulati,,~, or other elfec~s not identified in C1~:57 Explain briefly: I C7. Other impacts (including changes in use of either quantiiy or type of eueegy? Explain bdel~y O. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL E. I~.~.?RE,LjYes o?~ISL~jI~'O''TH ~E~iI UKELY TO BE, CONTI~OVERSy RELATED TO POTENTIAL AOVERBE EN~RONMENTAL IMPACTS? If ~e$ e~r~: I PART III - ~ I ~qlI~INATION OF SIGNIRCANCE (To be =ompfated by Agenw) . INSTRUCTIONS: F~eachad~etsee~e~i~enti~edab~ve~de~ermineY~hetheritis$u~fan~'~r~s~nL Each effe~ shoflld be assessed in ~o~nection with its (a) setling [i.e. urban or rural); (b) pra~abtltiy of eccut~lg; (c) duration; (d) Irreverslblr~, (e) geogrephl~ scope; and (0 megnilude. If neoesse~, add ~fa or roferel~e SUl~OO~ng mate~fials. Ensure that ex~t~mltiefls oofltaln · uftideet detati ~o show Ihat all mlevanl[ adverse Impa~s have beer identified a~ ~ ~. If question d of pa('t Il was chede~ yes, the detem~inatk~ ofslgnlficanm must evaluate Ihe potentialimpa~of the pct~x~ecla(~lofl oe Ire em4ro~mefltalcharaderisllcs of the ~ C~m~k Ibis bex if ~o~ ~ve de~ I~ed on me In~mmatio~ a~d anal~ abeve .nd eny suppor~g d(~ume~o~, ~t ~ ~ a~ ~'ILL NOT ~ In a~y ~niflca~ adverse enviro~men~a! Impa~s AND preY{de, ~ a~hmen~ as necessary, the rea~of'~ su~oporl~g thl,, det~rmtnation. Board of Trustees Name of Lead Agency ~t er ¥~ ~a~ o~ ~aspo~s~le ~r in Le~ t~e~cy Sigt,~ffure of Responsib{e Officer in Lead ~ncy President ~ of Responsible Officer Signature of Preparer (If different from responsible officed Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM 1000 ~l ._~ ( . (.~ THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A STORM-WATER~ GRADINGF DRAINAGE AND EROSION CONTROL. PLAN Dis~i=t 8.cUon Ukx~ L~ CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK, SCOPE OI~ WORK - PROPOSED CONSTRUCTION 1'1'i~I # / WORKASSF~$MENT Yea No a. What is the Total Area of Ihe Project Parcels? (include Total Area el' all Parcels iscated wlthin I Will this Project Retain AIl Stom*.-Watsr RumOff Generated by a Two (2") Inch Rainfall ~ Site? the Scope of Work for proposed Consbuction) ~,' b. Whet is the Total Area of Land Clea~ing (S~F. / ~) (This item will include all run-off created by site clssdng and/or construction activities as well an all and/or Ground Disturbance for the pmpcoed Site Improvements and the permanent c~estion of construc~on actlvi[y? impervious surfaces.) (S.F. 2 Does the Site Plan and/or Survey Show All Proposed PROV]'DE ERr'IF PRO~..,CI' DF.~CRIFTION (Pmv~a~,~e~.~3 Drainage Structures [ndlcatthg Size & Lecaflo~?This r~ Item shall include all Proposed Grade Changes and -- · -50[.=9.~ ete'c-{->t. S~/SJc~.'~ 3 DoectheSitePlanand/orSurvoydasc~ipetheemaion V/ and sediment control practices that wig be used fo control site erosion and storm water discharges, This item must be maintained throughout the Entire Coastmctlon Period. 4 VViti this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural Existing Grade Involving more than 200 Cubic Yards~L=~U of Matedal within any Pamai? 5 Will this App]ication Require Land Disturbing Activities Encompassing an Area In Excess of Five Tnoussnd V (5,000 S.F.) Square Feet of Ground Surface? 6 is th~ a Natural Water Course Running through the Site? Is this Project within the Trustees judndlcfion e~neral eEC SWPPP Requirements= or within Ofle Hundred (100') feet of a We0and o~ -- disturbances o~ o~e (1) or n~3re acres; indudlng al[stuff)antes of lass ~an o~le aore ~hat 7 Will there be Site preparation on Existing Grade Slopes are prat of a larger common plan that will uliimataly disturb one or mom acres ~ la~d; which Exceed Fifteen (15) feet of verticol Rise to [notudlng Coflstlllcflon an~flee Involving soil disturbances of less ~lan one ( J ) acr~ wh~m One Hundred (100') of Horizontal Distance? / ........................................... ss That ! ................................................................................. being ~u]y swo~, deposes and s~ys that be/she is the ~ppli~mt for Permit, And that he/she is the ............................................ ~'~':~i//~;~;'~'~:~i~ ............................................................... Ow~er and/or representative of the O*~aer or Owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contahaed in this application are true to the best of his k~aowleflge and belief; and that the work a'ilt be performed in the manner set forth i~ the application filed herewith. Sworn to before me this; .................. !..W .................... of , L .............................. r ..... ................. ' ....... .......................... FORM - 06/10 ~-~No. 01-CA4894969 OeEltfied in Suffolk Courtly ~rd of Trustees Application0 County State of~ ~)¥~Z f-T/:~'D~~' BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, 1 HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. SWORN TO BEFORE ME THIS ~ (~ignature ,20 /dC ~-~ Notary Public ~)~HIGGINs of Trustees ApplicationO AUTHORIZATION (where the applicant is not the owner) (print owner of property) (mailing address) do hereby authorize (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalfi APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees. The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is (Last name, first name, mi~ldle initial, unless you are applying in the name of someone else or other entity, such as a company. If so, indicate the other NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other", name the activity.) Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood, marriage, or business interest. "Business interest" means a business, including a partnership, in which the town officer or employee has even a partial ownership of(or employment by) a corporation in which the town officer or emp[oyee owns more than 5% of the shares. YES NO ~ If you answered "YES", complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): __.A) the owner of greater than 5% of the shares of the corporate stock of the applicant (when the applicant is a corporation); B) the legal or beneficial owner of any interest in a non-corporate entity (when the applicant is not a corporation); __.C) an officer, director, partner, or employee of the applicant; or __.D) the actual applicant. DESCRIPTION OF RELATIONSHIP S u bm itted t hi~ s:~clay ~/~/J~t~ .,~.o~t Signature c~,ff-.~ [l~v~ --{7[ Print Name ~_/~t ~,~ ~t"l/~'¥,~ -- 20t a2 Town of Southoid LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS All applicants for permits* including Town of Southold agencies, .shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). If any question in Section C on this form is answered "yes", then the proposed action may affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, the action should be analyzed in more detail and, if necessary, modified prior to making a determination that it is consistent to the maximum extent practicable with the LWRP policy standards and conditions. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION The Application has been submitted to (check appropriate response): TownBoard ~'~ PlanningOept [] Building Dept. [] BoardofTrustees Category of Town of Southold agency ~tion (check appropriate response): (a) (b) (c) Action undertaken directly by Town agency (e.g. capital [] construction, planning activity, agency regulation, land transaction) [] Financial assistance (e.g. grant, loan, subsidy) Permit, approval, license, certification: [~/ Nature and extent of action: Location of action: Site acreage: Pre~nt land use: Present zoning ¢lossification: If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: (b) Mailing address: (c) Telephone number: Area Code (). (d) Application number, if any:. Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes [--] No F-~ If yes, which state or federal agency? DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation criteria. [~]Yes [] No [~NotApplicable At~ach addi~onal sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III - Policies Pages 3 through 6 for evaluation criteria [] Yes [] No [] Not Applicable Attach additional sheets if neeessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. Sec LWRP Section IH- Policies Pages 6 through 7 for evaluation criteria [] Yes [] No [~'Not Applicable Attach additional sheets if nee~saty NATURAL COAST POLICIES Policy 4. Minimize Io~ of life, structures, and natural resources from flooding and erosion. Sec LWRP Section III - Policies Pages 8 through 16 for evaluation criteria ~ Yes [] No [~Not Applicable AUach additional sheets ifneeezsmy Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III - Policies Pages 16 through 21 for evaluation criteria Yes [] No LJ~NotApplicable Attach additional sheets if necessary Policy 6. Protect and rest~ce the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22 through 32 for evaluation criteria. [] Yes [] No [--'~Not Applicable Attach additional sheet~ if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies Pages 32 through 34 for evaluation criteria. [] Yes [] No [~ Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and haT. talons substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. ~ Yes [] No ~iNot Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and reo'eational nse of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III - Policies; Page~ 38 through 46 for evaluation criteria. [] Yea~ No [~Not Applicable Attach additional she~ if nec~sary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promo~ siting of new water-dependent uses in suitable locations. See LWRP Section IH - Policies; Pages 47 through 56 for evaluation criteria. [] Yes [~ No ~]~Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Seetion III - Policies; Pages 57 through 62 for evaluation criteria. [-~ Yes [] No ~'Not Applicable Attach additional shoets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages 62 through 65 for evaluation criteria, [] Yes [] No [~'Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies; Pages 65 through 68 for evaluation eriteria. [] Yes [] No ~/Not Applicable Created on 5/25/05 11:20 AM C GREENLOGIC February 23, 2012 Town of Southold Town Trustees Town Hall 53095 Route 25 Southold, NY :1197:1 Dear Trustees: Please find attached a building permit application on behalf of Elyse James who has engaged us to install a roof-mounted (flat to the roof) solar photovoltaic (PV) electric system for her home on 5000 Paradise Point Road, $outhold. In connection with this application, please find attached: · 2 applications · 2 Transactional disclosure Forms · 2 Short environmentalAssessment Forms · 2 LWRP Consistency Assessment Forms · 2 Surveyof Premises · 2 Engineer's Reports · 2 One Line Diagrams · 2 Visio Diagrams of the proposed system · 2 Spec. sheets of the solar panels (SunPower SPR-240WHT) · 2 Spec. sheets of the inverters {SunPower SPR7000m) · 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 · Check for $50 Please let us know if you need anything else in connection with this application. Yours truly, Barbara Casciotta Account Manager Greenl_ogic LLC i Ci I i( · '.v !<'c:,L :<: Tel: 8777714330 Fax: 8/77714320 SOUTHAMPTON/CORPORATE: CUTCHOGUE: MANORVlLLE: NEW YORK CITY: ROSLYN HEIGHTS: q~b( )mtyRd }gA 1070 Depot Lane 40 W( odlalsd Aversue 241 6th Avenue #3B 200S Servic:e Rd ]!108 S(~hamptor~ NY 11968 Cutchogue, NY 11935 Mancsrvill( NY 11949 New York, NY 10014 Rosvh~Heights NY ]1577 )~Y , Survev for: ,, Subdivision Map Paradise Point, Section Surf. Co. File No. 5767 / / / NOTES: ROY JAMES & EL YSE JAMES At Bayview Town of $outholol Suffolk County, New York S.C.T.M.: 1000-081.00-0.3,00-001,004 SCALE: 1"=50' 1, AREA = 2.3,474 S.F. 2. · = MONUMENT FOUND, A = STAKE FOUND. 3. REFERENCE DEED L. 118,34 CP 798 ELEVATIONS SHOWN HEREON ARE REFERENCED TO N,G.V, DATUM (MSL 1929). 5. THIS PARCEL IS WITHIN ZONES SHOWN HEREON AS DILINEATED ON FIRM BOUNDARY MAP NO. `36q0`3C0167 O LAST DATED MAY 04. q998. FEB. 16. 2012 IJPDATL TAX MAP JAN. 5. 2012 u~D^: suRw, & ~o~o MAR. 05, 2006 UPD~ JUNE 01, 2005 eE~OVE~ ~OW DATE: JULY 15, 2004 dOB NO: 2004-415 CERTIFIED TO: ROY JAMES & ELYSE JAMES DAVI0 H. FOX NIY. S.L,S. #502`34 FOX LAND SURVEYING 64 SUNSET AVENUE WESTHAMPTON BEACH. N.Y. 11978 (6,31) 288-0022 DWG: 2004-415 Pacifico Engineering PC 700 Lakeland Ave, Suite 2B Bohemia, NY 11716 www.pacificoengineering com February 9, 2012 Town of Southold Building Department 54375 Route 25, P.O Box 1179 Southold, NY 11971 Subject: Solar Energy installation for Roy and Eiyse James 5000 Paradise Road Southold, NY 11971 Engineering Consulting Ph: 631-988-0000 Fax: 631-382-8236 engineer@paciflcoengineering com APPROVED BY BOARD OF TRUSTEES TOWN OF SOUTHOLD DAIE I have reviewed the roofing structure at the subject address. The structure can support the additional weight of the roof mounted system. The units are to be installed in accordance with the manufacturer's installation instructions. I have determined that the installation will meet the requirements of the 2010 NYS Building Code, and ASCE7-05 when installed in accordance with the manufacturer's instructions. Roof Section A mean roof height 22 ft pitch 1 in/12 roof rafter 2x12 rafter spacing 16 in CC Reflected roof rafter span 15.8 ft Table R802.5.1(1) max 23.8 ft The climactic and Icad information is below: CLIMACTIC AND Ground Wind Live Icad, GEOGRAPHIC DESIGN Category Snow Load Speed, 3 pnet30 per point CRITERIA pg sec gust, ASCE 7, pullout Fastener type mph psf load, lb Roof Section A C 20 120 37 379 #14-13x3" DPI Concealer Screw #14-13x5" DPI Concealer Screw "!~ Ralph Pacifico, PE t~\~.~, /~, ~1~1 Professional Engineer '~,~ ' NY 066182 / NJ 24GE~7~306 ELIMiNATiNG THE COST OF ENERGY Chimney 4' above roof. DRAWING NUMBER: 1 OF7 SURFACE 1 LAYOUT GreenLogic, LLC - Approved Layout 7,2kW 30 Sunpower 240w Roy and Elyse James 5000 Paradise Point Southold, NY UniRac Solarmount Azimuth = 305° Pitch = 4.5° to the North Scale 3/16" = 1 *Always double check measurements Panel Dimension = 61.39"x31,42" Array Length =368.34" Array Height = 63,84" Surface Dimensions =410"x270" Magic # = N/A iSSUES / SPECIAL INSTRUCTIONS PROJECT COMPONENT COUNT A) Attachment type and count: B) Rail type and count: UniRac Sunframe Sunpower 240w Attachment Point UniRac Solarmount 2x12" Douglas Fir Rafters 16" On Center Ralph Pacifico Professional Enginee__r_. -Layout Created By: MVP Date: 1-30-12 ELIM~NAI'ING TNE COST OF ENERGY Chimney ~URFACE 1 ATTACHMENTS~ *Always double check measurements GreenLogic, LLC - Approved Layout Roy and Elyse James 5000 Paradise Point Southold, NY 7,2kW 30 Sunpower 240w UniRac Solarmount Azimuth = 305° Pitch = 4.5° to the North Scale 3/16" = 1.0' Panel Dimension = 61.39"x31.42" Array Length =368.34" Array Height = 63,84" Surface Dimensions =410"x270" Magic # = N/A ISSUES / SPECIAL INSTRUCTIONS PROJECTCOMPONENTCOUNT A) Attachment type and count: 60 Fast Feet, B) Rail type and count: UniRac Sunframe Sunpower 240w Attachment Point UniRac Solarmount 2x12" Dougtas Fir Rafters 16" On Center Ralph Pacifico Professional Engineer NYS Lac# 066182 NJ LiCe4 249E04744300 Layout Created By: MVP Date: %30~12 EtJMINATING TRE COST OF ENERGY DRAWING NUMBER: 30F7 SURFACE 1 STRINGING 3X10 ON SPR7000M *Always double check measurements GreenLogic, LLC - Approved Layout Roy and Elyse James 5000 Paradise Point Southold, NY 7.2kW 30 Sunpower 240w UniRac Solarmount Azimuth = 305° Pitch = 4.5° to the North Scale 3/16" = 1.0' Panel Dimension = 61.39"x3I .42" Array Length =368.34" Array Height = 63.84" Surface Dimensions =410"x270" Magic # = N/A ISSUES / SPECIAL INSTRUCTIONS PROJECTCOMPONENTCOUNT A) Attachment type and count: B) Rail type and count: UniRac Sunframe Sunpower 240w Attachment Point UniRac Solarmount 2x12" Douglas Fir Rafters 16" On Center Layout Created By; MVP Date; 1-30-12 Ralph Pacifico Professional Engineer EEff~NAT NG TH[ COSI OF ENERGY 65/8" DRAWING NUMBER: 4OF7 SIDE ELEVATION *Always double check measurements Recif~co Engineering PC / GreenLogic, LLC- Approved Layout Roy and Elyse James 5000 Paradise Point Southold, NY 7.2kW 30 Sunpower 240w UniRac Solarmount Azimuth = 305° Pitch = 4.5° to the North Scale 3/16"= 1.0' Panel Dimension = 61.39"x31 Array Length =368.34" Array Height = 63.84" Surface Dimensions =410"x270" Magic # = N/A ISSUES / SPECIAL INSTRUCTIONS PROJECT COMPONENT COUNT A) Attachment type and count: B) Rail type and count: UniRac Solarmount Sunpower 240w Attachment Point UniRac Solarmount 2x12~' Douglas Fir Rafters 16" On Center Ralph Paciflco Profession__al Engi__.n_eer Layout Created By: MVP Date: %30-12 MATERIAL LiST Material List Eco-Fasten "Fast Feet" Base Plate Eco-Fasten "Fast Feet" Aluminum Block Eeo-Fasten "Fast Feet" EPDM Flashing #~-4-13x3"DPt Concealer Screw #14-13x5"DPI Concealer Screw UniRac 7~' Standoff Ot¥. 60 30 60 360 120 30 Rail Material List Ot¥. DRAWING NUMBER: 50F7 MATERIAL LIST *Always double check measurements. GreenLogic, LLC - Approved Layout Roy and Elyse James 5000 Paradise Point Road Southold, NY PROJECT COMPONENT COUNT 7.2 kW 30 Sunpower 240w UniRac Solarmount Azimuth = 305° Pitch = 4.5N° Scale 3/16" = 1.0' Panel Dimension = 61.39"x31.42" Array Length = Array Height = Surface Dimensions = Magic # = N/A Sunpower 240w e Attachment Point UniRac Solarmount : 2x12" Douglas Fir Rafters 16" On Center A) Attachment type and count: B) Rail type and count: UniRac Sotarmount ISSUES / SPECIAL INSTRUCTIONS Layout Created By: MVP Date: %30-12 LOG ELIMi~,~ATING TNE COST OF ENERGY Framing: 2x12 Douglas Fir rafters spanning 22'6", spaced 16" on center. 2x4 Douglas Fir exterior wall, DRAWING NUMBER: 6OF7 FRAMING GreenLogic, LLC - Approved Layout 7.2kW 30 Sunpower 240w Roy and Elyse James 5000 Paradise Point Southold, NY UniRac Solarmount Azimuth = 305° Pitch = 4,5° to the North Scale 3/16" = 1.0' *Always double check measurements Panel Dimension = 61.39"x31.42" Array Length =368.34" Array Height = 63.84" Surface Dimensions =410"x270" Magic # = N/A PROJECT COMPONENT COUNT A) Attachment type and count: B) Rail type and count: UniRac Solarmount ISSUES / SPECIAL INSTRUCTIONS Sunpower 240w Attachment Point UniRac Solarmount 2x12" Douglas Fir Rafters 16" On Center Ralph Pacifico Professional En¢?eer Layout Created By: MVP Date: 1-30-!2 18" Walkway DRAWING NUMBER: 70F7 FAST TRACK PERMIT *Always double check measurements GreenLogic, LLC - Approved Layout Roy James 5000 Paradise Point Road Southold, NY PROJECT COMPONENT COUNT A) Number of Roof Layers: 1 B) Height above Roof Surface: 7.2kW 30 Sunpower 240w UniRac Solarmount Azimuth =305° Pitch = 4.5N° Scale 3/32" = 1.0' C) Materials Used: UniRac Fast foot, UniRac standoff, UniRac Solarm( D) Added Roof Load of PV System: 3.5 PSF -~_Layout Created By: MVP Date: 1-30~12 Panel Dimension = 61.39"x31,42" Array Length = Array Height = Surface Dimensions = Magic # =N/A ISSUES / SPECIAL INSTRUCTIONS Sunpower 240w Attachment Point UniRac Solarmount 2x12" Douglas Fir Rafters 16" On Center Ralph Pacifico Professional Engineer I 111 I II II SunPower SPR-5OOOm, -600Om, -7000m and -8000m inverters offer superior reliability and performance and can be easily integrated into residential or commercial installations. All models are backed by a 1 O-year warranty. sunpowercorp.com I~800-SUNPOWER String Inverters SPR-5000m SPR-6000m SPR-7000m AC Nomlnol Power 5000 W 6000 W 7000 w SPR-8000m 7680 W @ 240 V 8000 W @ 277 V AC Max Output Current (@ 208V, 24 A, 21A, ISA 29A, 25A, 22A 34A, 29A, 25A 240V, 277V}: ACl:req / Range 60 Hz/593 Hz- 60 Hz/59.3 Hz- 60 Hz/593 Hz- 60.5 Hz 60~5 Hz 60.5 Hz (Nominal) 099 0~99 099 (Module @ STC) Tracking Voltage 250 - 480 V 250 - 480 V 250 - 480 V DC Voltage Ripple 4% 4% 4% No. of Fused Opemt[on/Nighltime SPRm EFFICIENCY CURVES N/A, 32A, 29A N/A@208 V 211 - 264V@240V 244 - 305 V @ 277 V 60 Hz/593 Hz- 60.5 Hz 099 96.5% N/A @ 208 V 960% @ 240 V 960% @ 277 V lO000W 300- 600 V 300-480 V 30A 4% 4 75 7O o% ~0~ 2o% ~o 4o% s0~ ,so~ ~'0~ % of rated output power Mechanical Data SPR-5OO0m, SPR-6000m, SPR-7000m and SPR-8000m Shipping Dimensions 23.5" x 31.0' x 16~0" W x H x D (inches) Unit Dimensions 18.4" x 24.1' x 9.5" W x H x D (inches) Inverter Weight Shipping Weight 141 tbs for SPR-5000m, -6000m and -7000m / 148 lbs for SPR-8000m 148 lbs for SPR*5000m, -6000m and-7000m /152 lbs for SPR-80OOm Forced Air / Scaled Cooling Electronics Enclosure Enclosure NEMA 3R Waft Mount Mounting Bracket Standard Ambient -13 to +113 °F Warranty and Cart float 0ns Warranly 10 year limited warranty Compliance: IEEE-929, 18.4" 9.5" Founded in 1985, SunPower Corp. Nasdaq: SPWRA SPWRB designs, manufactures and delivers the planet's most powerful so(ar technology. Residential, business, government and utility customers re y on the company's experience and proven resu ts to maximize return on investment. SER~ S The SunPowerTM 240 Solar Panel provides loday's highest efficiency and performance. Utilizing 72 all back-contact solar cells, the SunPower 240 delivers a total panel conversion efficiency of 19.3%. The panel's reduced vohage-temperature coefficient, anti-reflective glass and exceptional Iowdight performance attributes provide outstanding energy delivery per peak power wale. SunPower's High Efficiency Advantage 187o 14% 15% t9% Thin Film Conventional SunPower SunPower El8 Series E19 Series Peak Rower 1+5/-3%) Pm~ 240 W Efficiency il 193 % Rated Voltage Vmpp 405 V Rated Current Imp~ 593 A Open Circuit Voltage Voc 486 V Short Circuit Current Isc 630 A Maximum System Voltage UL 600 V Temperature Coeffidents Rower (P) 4).38% / K Voltage IVac) -132 5mV/K Current Ilsc} 3 5mA / K NOCT 45o C +/-2° C Series Fuse Ratb~g 20 A Sdar Cells Front Glass Junction Box Output Cables Frame Weight Mechanical Data 72 SunPower aBback contact monocrystal~ine High transmission tempered glass with anti-reflective (AR) coating IP-65 rated with 3 bypass diodes Dimensions: 32 x 155 x ]28 (mm) l O00mm length cables / MuJtiContad [MC4) connectors Anodized aluminum alloy type 6063 (black[ 33.1 lbs. (15.0 kg) I-V Curve 7 6 4 3 2 0 0 10 20 30 40 50 60 Voltage (V) Tested Operating Conditions Temperature -40° F to + 185° F [-40° C to + 85° C[ Max load 113 psf 550kg/m~ (5400 Pa) front- e.g. snow; 50 psf 245kg/m~ (2400 Pa) front and back - e.g. wind Impact Resistance Hail 1 in (25 mm) at 52mph (23 m/s) Warrantie~ and Certifications Warranties 25 year limited power warrcmty I 0 year limited product warranty Certifications Tested to UL 1703. Class C Fire Rating Dimensions MM 7 07 J [~o~ Suffolk County Executive's Office of Consumer Affairs VETERANS MEMORIAL HIGHWAY * HAUPPAUGE, NEW YORK 11788 DATE ISSUED: 12/10/2007 SUFFOLK COUNTY No. 43858-ME Master Electrician License This is to certify that ROBERT J SKYPALA GREENLOGIC LLC doing business as having given satisfactory evidence of competency, is hereby licensed as MASTER ELECTRICIAN in accordance with and subject to the provisions of applicable laws, roles and regulations of the County of Suffolk, State of New York. Additional Businesses NOT VALID WITHOUT DEPARTMENTAL SEAL AND A' CURRENT CONSUMER AFFAIRS "ID CARD Director