Loading...
HomeMy WebLinkAbout36996-ZTown of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 4/30/2012 CERTIFICATE OF OCCUPANCY No: 35568 Date: 4/30/2012 THIS CERTIFIES that the building Location of Property: SCTM #: 473889 Sec/Block/Lot: Subdivision: SOLAR PANEL 1060 Leeward Dr, Southold, 79.-7-40.3 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 2/13/2012 pursuant to which Building Permit No. 36996 dated 2/14/2012 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: roof mounted electric solar panel system for a one family dwelling dwelling as applied for. The certificate is issued to Rumpler III, John & Sharon (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 36996 4/4/12 Signature TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit #: 36996 Date: 2/14/2012 Permission is hereby granted to: Rumpler III, John & Rumpler, Sharon 1060 Leeward Dr Southold, NY 11971 mo~ install a roof mounted electric solar panel system to a dwelling as applied for At premises located at: 1060 Leeward Dr, Southold SCTM # 473889 Sec/Block/Lot # 79.-7-40.3 Pursuant to application dated To expire on 8/1512013. Fees: 2/13/2012 and approved by the Building Inspector. SINGLE FAMILY DWELLING - ADDITION OR ALTERATION CO - ALTERATION TO DWELLING Total: $200.00 $50.00 $250.00 ~g i nspe~"-"~'%tor Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Telephone (631 ) 765-1802 Fax (631) 765-9502 roger, richert~,town.southold.ny, us BUILDING DEPARTMENT TOWN OF SOUTHOI~D CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: John Rumpler III Address: 1060 Leeward Drive City: Southold St: NY Zip: 11971 Building Permit #: 36996 Section: 79 Block: 7 Lot: 40.: WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE 3ontractor: DBA: Green Logic LicenseNo: 43858-me SITE DETAILS Office Use Only Residential ~ Indoor ~ Basement ~ Service Only ~] Commerical Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 3 ph Hot Water GFCI Recpt Main Panel NC Condenser Single Recpt Sub Panel NC Blower Range Recpt Transformer Appliances Dryer Recpt Disconnect Switches Twist Lock Other Equipment: Ceiling FixturesI~l[~R HID Fixtures Wall Fixtures I I Smoke Detectors Recessed Fixtures CO Detectors Fluorescent Fixtur~ Pumps Emergency Fixture Time Clocks Exit Fixtures I I TVSS roof mounted photovoltaic system to include, 44 Sun Power panels 1-Sun Power 3000 inverter, 1-Sun Power 7000 inverter (10,120 watts) Notes: Inspector Signature: Date: April 4 2012 81-Cert Electrical Compliance Form,xls Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. 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 $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Location of Property: Date. Old or Pre-existing Building: '/' (check one) I Lc exo.a,.,,:t .bY. House No. Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision 1,..~' ¢-oo~.,.,~1 Permit No. ~ (o ¢(~(~ Date of Permit. Street Hamlet Block ~ Lot q O · ~ Filed Map. ~ ~ ~ ~ Lot: qO ' ~ Applicant: ~¢~t~ ~ ~ Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~ · OO Underwriters Approval: Final Certificate: (check one) /~pl~licant Signature TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] ROUGH PLBG. [ ] INSULATION ] FINAL ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION ~ECTRICAL (FINAL) [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING / STRAPPING [ [ ] FIREPLACE & CHIMNEY [ [ ] FIRE RESISTANT CONSTRUCTION [ [ ] ELECTRICAL (ROUGH) REMARKS: DATE ~INSPECTOR (~~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] ROUGH PLBG. [ ] INSULATION ~FINAL ] FOUNDATION 1ST ] FOUNDATION 2ND ] FRAMING/STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) REMARKS: [ ] ELECTRICAL (FINAL) DATE Pacifico Engineering PC 700 Lakeland Ave, Suite 2B Bohemia, NY 11716 www.pacificoengineering.com Engineering Consulting Ph: 631-988-0000 Fax: 631-382-8236 engineer@pacificoengineering.com April 3, 2012 Town of Southold Building Department 54375 Route 25, P.O. Box 1179 Southold, NY 11971 Subject: Solar Energy Installation for ~ John Rumpler 1060 Leeward Drive 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 2010 NYS Building Code, and ASCE7-05. To my best belief and knowledge, the work in this document is accurate, conforms with the governing codes applicable at the time of submission, conforms with reasonable standards of practice, with the view to the safeguarding of life, health, property and public welfare Regards, Ralph Pacifico, PE Professional Engineer TOWN OF SOUTHOLD BUILDING DEI~ARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork. net Examined o),/~"~, 20 /o? / Approved ~/~, 20/~.-_ Disapproved Expiration 20/3 PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets &Building Plans Planning Board approval Survey_ / Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Storm-Water Assessment Form Contact: Mail to:q~.'~ ~Oclrt~a i~A~3qA Phone: {' -Build-lng Inspector APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, 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 before 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 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) (Mailing address or'applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises (As on the tax roll or latest deed) If applicant is a corporation, 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 which proposed work will be done: lOGO C · oc,c+Wo House Number Street Hamlet County Tax Map No. 1000 Section -~ q Block ~ Lot Subdivision ~c'~co~,-J. /3~o-,-~ Filed MapNo. ,.~,~c~c~ Lot q-O. % '40 .~ State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~tr'~G~ '~rult.4 ,a b. lntended use and occupancy s,, 3te 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cars Addition Alteration Other Work P~oO~ ~'~tc s,[~.,~cription) Fee (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Height Number of Stories Rear .Depth Dimensions of same structure with alterations or additions: Front Depth Height. Number of Stories Rear 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 9. Size oflot: Front Rear .Depth 10. DateofPurchase q'2-~-Iq~q- Name ofFormer 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 14. Names of Owner ofpremisesJ ob,,s ~o_r~ol~,- Address 5~d, ~ Phone No. Name of Architect Paemeo ~t~,~ Address ~~ Phone N~ Name of Contractor~,e~m cc~ Address~Phone No. 15 a. Is this prope~ within 100 feet ora tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TO~ TRUSTEES & D.E.C. PERMITS ~Y BE REQUIRED. b. Is this propeay within 300 feet of a tidal wetland? * YES NO * 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) COUNTY OF ,..-~( ('o I~b: /'NJ~,,~ ~ ~/~ [~K_. being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the COFr+¥~ ~-~ 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 true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn tO before me this_ t./~:~/~ day of 20 I >-- Nota~ Public BARBARA A. CASCIOTTA · 'CA4894969 ~ualified in Suffolk CounN ~:~ffila$ion Expires Malt 11. '~lignature of Applicant Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM P~OPERTY LOCATION: $.(~.T~ THE FOI.LOWING ACTIONS MAY REQUIRE ~E SUBMI~ION OF A D~d a~ ~ ~ik~iFi=u BY A DESIGN PROFE~ION~ IN ~E ~ATE OF ~ YO~ a. ~al is ~e T0~l ~ea of ~e ~j~ · e Sco~ of Wink ~ P~ ~s~on) Gen~t~ by a ~ ~ In~ ~n~ll b. an~orWhat ~Gmund~e TO~lD~an~ ~ Land~ Cleadng~ ~ _ ~ ~fl~ 8n~ ~ns~ion (~F.~) 2 ~ ~e Site PI~ andl~ Su~y S~ NI Pm~ I~ s~ll include NI P~d Grade ~ang~ [ n + tl S,opes~BngSuEa~WaterFl~. i~ m~t be main~n~ ~g~ut ~ En~ ~s~n PeH~. 4 WIll ~ls Proj~ R~uJm any Land R~ing, Gmdi~ ~ Ex~va6on ~em ~m ~ a ~ange to E~g G~de InvoMng ~m ~an of Mate~al ~ln any ~? E~mpa~ing an ~a in ~ of (5.~ S.F.) ~uam Feet of G~nd 6 Is ~ a NaOmi Water ~u~ Run~ng ~mugh ~ S~e? Is ~is ~Je~ ~in ~e T~ jud~ Oeneml ~ S~PP ~ulm~: or ~in O~ Hund~ (1~') ~et of a W~ m'aT~ OF NEW YORK, ~ , ~ ~ [ ~ Thatl ~t~ ~k~v~ dul~mde esmd ' O~er m~or repres~mfive of ~e ~mer or 0~, m~d ~ d~ aufl~o~d m ~o~ or bare peffo~ m~e m~d file ~ applicon; ~at fll ~temen~ mn~ in ~is applicon ~e ~e m fl~e b~t ofb~ h~owle~ ~d ~; ~d · at ~e ~rk ~11 be ~ffo~ in ~e m~ner ~et fo~ in fl~e app~on ffl~ h~qfl~. S~m to before me ~s; FORM - 06/10 rF ew Yod; No. 01,-CA4~94969 (:bllJf'm(:l Iff Suffolk ¢ountL ~.. {~)mmitllon Expires May 11, ~ O/~_ $4375 ~ Road P.O. Box 1179 Southold, NY 11971-09.59 Telephone (631) 765-1802 BUn .r~ING DEPARTMENT TOWN OF SOU'[~Ol.n APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: 3ompany Name: Name: License No.: Address: Phone No.: *Name: *Address: *Cross Street: *Phone No.: Permit No.: Tax. Map District: JOBSITE INFORMATION: (*Indicates required information) to~o Le~oa~J .'br~, S0~4-1-,o~I -3a~obs ~ 1000 Section: ~ q Block: *BRIEF DESCRIPTION OF WORK (Please Print Clearly) C~4~ ~Po~e,~ ~,, z~o~o~' Lot: qO. '~ · {Please Circle All 3'hat Apply) *15 job ready for inspection: YES/(~ *Do you need a Temp Certificate: ~ NO Temp Information (If-needed) *SeMce Size: 1 Phase 3Phase *New Service: Re-~onnect Additienal Information: Rough In Final 100 150 200 300 350 ,400 Other Underground Number of Meters Change of Service Overhead PAYMENT DUE WITH APPLICATION 82d~equest ~or InspedJon Form February 13, 2012 Town of $outhold Building Department Town Hall 53095 Route 25 Southold, NY 11971 Dear Building Inspector: Please find attached a building permit application on behalf of John Rumpler III who has engaged us to install a roof-mounted (flat to the roof) solar photovoltaic (PV) electric system for his home at 1060 Leeward Drive, $outhold. In connection with this application, please find attached: · Building Permit application · AStorm Water Assessment Run-off Form · Certificate of Occupancy Application · 2Surveysofthe Premises · Four Engineer's Reports (2 originals and 2 copies) · Four Visio Diagrams of the proposed system · Two spec. sheets of the solar panels (SunPower SPR-230WHT) · Two Spec. sheets of the inverter (SunPower SPR3000m and SPR6000m) · 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 $250 ($200 building permit/S50 CO) · Application for Electrical Inspection with a check for $100 Please let us know if you need anything else in connection with this application. Yours truly, Barbara Casciotta Account Manager GreenLogic LLC 631-771-5152 ext. 117 Tel: 877.7714330 Fax: 877771.4320 SOUTHAMPTON/CORPORATE: 425 County Rd 39A Southamptoq NY 11968 CUTCHOGUE: 1070 Depot Lane Cutchogue, NY 11935 MANORVILLE: 40 Woodland Av{,uue Manorville NY 11949 NEW YORK CITY: 241 6th Avenue #3B New York, NY 10014 ROSLYN HEIGHTS: 200 S Service Rd, fl]08 Rosyh Heighls. NY 11577 Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Telephone (631) 765-1802 Fax (631 ) 765-9502 April 5, 2012 BUILDING DEPARTMENT TOWN OF SOUTHOLD John Rumpler III 1060 Leeward Dr Southold, NY 11971 TO WHOM IT MAY CONCERN: The Following Items Are Needed To Complete Your Certificate of Occupancy: Note: Please have an Architect or Engineer certify that the panels were installed according to New York State code. __ Application for Certificate of Occupancy. (Enclosed) (~;~ Electrical Underwriters Certificate. (contact your electrician) 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. (Planning # 765-1938) Final Fire Inspection from Fire Marshall. Final Landmark Preservation approval. BUILDING PERMIT: 36996- Solar Panels C GREENLOGIC® April 25, 2012 The Town of Southold Building Department 54375 Route 25 P.O. Box 1179 Southold, NY 11971 Re: Building Permit No. 36996 John & Sharon Rumpler 1060 Leeward Drive, Southold To the Building Inspector: Enclosed please find the Engineer's Certification Letter for John Rumpler's solar electric system, which we installed at 1060 Leeward Drive, Southold. Please arrange to send him 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 ': R(il~ ((il(' ~i('o.~,v,,~, ,,~ ,, ~r ,: ~ Tel: 877.771 4330 Fax: 877771.4320 SOUTHAMPTON/CORPORATE: 425 CoLJr/ty Rd 39A SouH/amptor/ NY 11908 CUTCHOGUE: 1070 Depot Lane Cutchogue, NY 11935 MANORVILLE: 40 Wo{]dlarld Aver/ue Mmorvdle, NY 11949 NEW YORK CITY: 241 6th Avenue #3B New York, NY 10014 ROSLYN HEIGHTS: 200 S Service Rd, #108 Rosyhl Heights. NY 1157/ Suffolk County Executive's Office of Consumer Affairs VETERANS MEMORIAL HIGHWAY * HAUPPAUGE, NEW YORK 11788 DATE ISSUED: 12/10/2007 No. 43858-ME SUFFOLK COUNTY Master Electrician License This is tocertifythat 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 STATE OF NEW YORK WORKERS' COMPENSATION BOARD CERTIFICATE OF NYS WORKERS' COMPENSATION INSURANCE COVERAGE la. Legal Name & Address of Insured (Usc street address only) Greenlogic, LLC 425 County Road 39A Suite 101 Southampton, NY 11968 Work Location of Insured (Only requiredifcoverageisspecifically limited to certain locations in /Vew York State, Le., a Wrap-Up Policy) 2. Name and Address of the Entity Requesting Proof of Coverage (Entity Being Listed as the Certificate Holderl TOWN OF SOUTHOLD BUILDING DEPARTMENT 53095 ROUTE 25 SOUTHOLD, NY 11971 I b. Business Telephone Number of Insured 631-771-5152 I c. NYS Unemployment Insurance Employer Registration Number of Insured Id. Federal Employer Identification Number of Insured or Social Security Number 20-3801194 3a. Name of Insurance Carrier New Hampshire Insurance Co 3b. Policy Number of entity listed in box "la' WC001602420 3c. Policy effective period 8/11/2011 to 8/11/2012 3d. The Proprietor, Partners or Executive Officers are X included. (Only check box if all partners/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 Rem 3A on the IN FORMATION PAGE of the workers' compensation insurance policy). The Insurance Carrier or its licensed aL, cut will send this Certificate of Insurance to the entity listed above as the certificate holder in box "2". The Insurance Carrier will also not~J the above certificate holder within I0 days IF a policy is canceled due to nonfca'ment qf preminms or within 30 days IF there are reasons otl~er than nonpayment of premiums that cancel the policy or eliminate t~e insured from the coverage indicated on this Certificate. IThese notices may be sent by regular mail.) Otb erwise, this Certificate is valid for one year after this form is approved by the insurance carrier or its lieensed agent, or until lite policy expiration date listed itt ho.~ "3c ", whichever is earlier. Please Note: Upon the cancellation of the workers' compensation policy indicated on this form, if the business conlinues 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 u ith the mundalury 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: Peter Zulko fske Approved by: (Prml name of'authorized representative or licensed agent of insurance carrier) August ( S ~gnatiI-re) (Dale) Title: Authorized Aeen[ Telephone Number of authorized representative or licensed agent of insurance carrier: 631-941-4113 Please Note: Only insurance carriers and their licensed agents are attthorized to issue Form C-105.2. Insuram',. %'o~er~ ute ~&:O'F authorized to issue it. C-105.2 (9-07) x ~ 'x~cb ~ :lie nv u'~ CERTIFICATE OF LIABILITY INSURANCE 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 ca~lflcate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT Brookhaven Agency, Inc. PRODUCER NAME: PHONE ;,,.(631) 941-4113 I ~.N~:(631) 941-4405 Brookhaven Agency, Inc. ~=-MAIL broo khaven.agencyl~.verizon.net P.O. Box 850 PRODUCER 150 Main Street ClI;tT'~M;=R In East Setauket NY 11733 INSURER{St AFFORDING COVERAGE NAIC # INSURED INSURER A: Torus Specialty Insurance Co. Greenlogic, LLC ~NSUREe S: Merchants Preferred Insurance Co. 425 County Road 39A, Suite 101 ~NSUeEEC: Commerce & Industry Insurance Co. Southampton, NY 11968 INSURER O: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH 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 ADDISwvUBDF~ POLICY EFF POLICY EXP iENERAL LIABILITY EACH OCCURRENCE $1,000,000 A ~' COMMERCIALGENERALLIABILITY X 50817A121B )1131112 01/31113 PR;MI~FRDAMAGETORENTEDIF; ~.~nc~ $50,000 X I CLAIMS-MADE [] OCCUR MED EXP (Any o.e person) $ 5,000 X XCU PERSONAL&ADV~NJURY sl,000~000 ~- CONTRACTUAL LIAB GENERAL AGGREGATE ~ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGG $ 21000,000 -- (La accident) $1,000,000 B x ANYAUTO CAPI043565 06/12/11 06112112 $ X~ UMBRELLA LIAB X~ OCCUR EACH OCCURRENCE $ 5~000,000 A EXCEEELIAS I I CLaIMS-MADE X 50817A121A 01131112 01/31113 AGGREGATE $5s000,000 X RETENTION $10,000 $ AND EMPLOYERS' LIABILI'~ Y I N $1,000~000 ANY PROPRIETOPJPARTN Er~EXEC UTIV WC001602420 08111111 08111112 E L EACH ACCIDENT (Mandato~' In NH) E.L. DISEASE - EA EMPLOYEI $1 ~000~000 D~(~RIPTI(~N ~F (~PERATIONS below E L DISEASE- POLICY LIMIT $1,000,000 C INSTALLATION FLOATER CPP4182553 01130111 01120112 $105,400 DED $1000 CERTIFICATE HOLDER CANCELLATION TOWN OF SOUTHOLD BUILDING DEPARTMENT 53095 ROUTE 25 SOUTHOLD, NY 11971 Phone: I Fax: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD Al).' 275;Sc2 AI~C: 80,98 ~ RODERICK VAN TUYL P.C. LICENSED LAND SM RVEYORS GREENPORT NEW YORK . SOFFOLK CO HEALTH DEPT, AFiPRO~AL' : STATEMENT OF INTENT THE WATE~PL¥ AND sEWAGE DISPOSAI~ SYSTEMS FOR THIS: RESIDENCE ~ILL CONFORM TO THE STANDARDS :OF THE SUFFOLK CO, DEPT, OF HEALTH,SERVICES. (si · '". ' APPLICANT . SUCFOL~ .COUNTY DEPT, OF HEALTH SERVICES--'FOR APPROVAL · OF 'CONSTRUCTION ONLY DATE: ' ' ,' ': ' 'APPROVED: , ' :' · ' SUFFOLK CO. TAX MAP DESIGNATION: DIST'. SECT~ BLEK .. PCL. OWNERS ADDRESS:.L~ '" : ' -':_:~E~N'PO~:~,~_~9~ ;- '- ::-~ ~9~---. Z: ...... -. .., 'TEST'HO~E '" , : STAMP"' .... [ ~ ~ ~u~l~ ~1 ~ ' -' . I ' ~ trip c~m~ny, g¢~.tal Ige~ [ ~ SEAL . 0 Pacifico Engineering PC 700 Lakeland Ave, Suite 2B Bohemia, NY 11716 www. pacificoengineering.com February 1, 2012 Town of Southold Building Department 54375 Route 25, P.O. Box 1179 Southold, NY 11971 Subject: Solar Energy Installation for John Rumpler 1060 Leeward Drive Southold, NY 11971 Engineering Consulting Ph: 631-988-0000 Fax: 631-382-8236 engineer@paciflcoengineering.com 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 20 ft pitch 6 in/12 roof rafter 2x10 rafter spacing 16 in OC Reflected roof rafter span 19.5 ft Table R802.5.1(1) max 20.6 ft The climactic and load information is below: CLIMACTIC AND Ground GEOGRAPHIC DESIGN Category Snow Load CRITERIA Pg Roof Section A C 20 Wind Live load, point Speed, 3 pnet30 per sec gust, ASCE 7, pullout mph psf load, lb 120 62 1269 Ralph Pacifico, PE Professional Engineer Fastener type 5/16" dia screw, 4-1/2" length, 2 per High spots in roof Chimney I I I I Awning Pacifico Engineering PC PO BOX 144~, S ayvilie, NY 11782 *~WayS^~ - double check measurements GreenLogic, LLC-Approved 10.12kW Layout 44 Sunpower 230w Panel Dimension = 61.39"x31.42" UniRac Sunframe Array Length = 345.62" John and Sharon Rumpler Azimuth = 132° Array Height = 250.81" 1060 Leeward Drive Pitch = 27° Surface Dimensions =476"x322" S outho Id, NY Scale 1/8": 1.0' Magic #: 62.14" ISSUES / SPECIAL INSTRUCTIONS PROJECT COMPONENT COUNT ~ Sunpower 230w A) Attachment type and count: 45 4" Unirac Standoffs · Attachment Point B) Rail type and count: UniRac Sunframe UniRac Sunframe I 2x10" Douglas Fir Rafters 16" Ralph Pacifico Professional En~]ineer On Center NYS Lic~ 0~6182 NJ Lic~ 249E04744300 Layout Created By: MVP Date: 1-12-12 LOGIC' High spots in roof Chimney Awning Pacifico Engineering PC PO Box 1448, S aywlle, NY 11782 *Always double check measurements .vLico~82 .u L~ 24~Eo~7.~0o GreenLogic, LLC - Approved 10.12kW Layout 44 Sunpower 230w Panel Dimension = 61.39"x31.42,, ~~~ UniRac Sunframe Array Length = 345.62" John and Sharon Rumpler Azimuth = 132° Array Height = 250.81" '~!) 1060 Leeward Drive Pitch = 27° Surface Dimensions =476"x322" Southold, NY Scale 1/8" = 1.0' Magic # = 62.14" ISSUES / SPECIAL INSTRUCTIONS PROJECT COMPONENT COUNT ~ Sunpower 230w ,,,-~~~/// A) Attachment type and count: 45 4" UniRac Standoffs · Attachment Point B) Rail type and count: UniRac Sunframe UniRac Sunframe ~~'/~-/ I I 2x10" Douglas Fir Rafters 16" Ralph Pacifico Professional En~lineer On Center Layout Created By: MVP Date: 1-12-12 Chimney High spots in roof XXXXXX×XXXX XXX ,," ×xxxx Xx Paciflco Engineering PC PO Box 1448, Sayvi~le, NY 11782 3xl 0 on SPR6000m g3~-.8~-0~ www.paciflcoengineerlng.com Ralph Pacdico, Pr(~ess~nal Engineer 2x7 on SPR3000m *Always double check measurements NYLicG66182 NJLic 24GEO474~300 GreenLogic, LLC-Approved 10.12kW Layout 44 Sunpower 230w Panel Dimension = 61.39"x31.42"~d-'~~'~'~ UniRac Sunframe Array Length = 345.62,, John and Sharon Rumpler Azimuth = 132° Array Height = 250.81" /i~-~'~'' ..~,, . ~ '~"~ 1060 Leeward Drive Pitch = 27° Surface Dimensions =476"x322" Southold, NY Scale 1/8" = 1.0' Magic # = 62.14" ISSUES / SPECIAL INSTRUCTIONS .ROJECT COMPONENT COUNT ~ Sunpower 230w A) Attachment type and count: · Attachment Point B) Rail type and count: UniRac Sunframe UniRac Sunframe I I 2x10" Douglas Fir Rafters 16" Ralph Pacifico Professional Engineer On Center NYS Lic~ 066182 NJ Lic# 249E04744300 Layout Created By: MVP Date: 1-12-12 1 LOGIC 2x10 Douglas Fir ridge. 2x10 Douglas Fir rafters spanning 26'10", spaced 16" on center. 2x6 Douglas Fir exterior wall. Pacifico Engineering PC PO Box 1448, Sayviile, NY 11782 *~,ways double check measurements ,~L,cO~l~ NJLic 24GE04744300 GreenL°gic',.y - LLC - Approved 4410.-- ~-12kW 230w ~~, /a,,ou* ~un,,ower Panel Dimension = 61.39"x31.42" UniRac Sunframe Array Length -- 345.62" John and Sharon Rumpler Azimuth = 132° Array Height = 250.81" ,,//./~,//~,, 1060 Leeward Drive Pitch = 27o Surface Dimensions =476"x322" Southold, NY Scale 1/8" = 1.0' Magic # = 62.14" ,~.~ ~ ~.~ ISSUES / SPECIAL INSTRUCTIONS PROJECT COMPONENT COUNT ~ Sunpower 230w '"~'~e",o -"~*-~e'6 ~"~',~""~// A) Attachment type and count: 43 Green Fasten Retro-Fit. · Attachment Point B) Rail type and count: UniRac Sunframe UniRac Sunframe I i 2x10" Douglas Fir Rafters 16" Ralph Pacifico Professional En[lineer On Center NYS Lic~ C~6182 NJ Lic# 249E04744300 Layout Created By: MVP Date: 1-12-12 LOGIC" ELIMINATING THE COST OF ENERGY ~ Eco-Fasten Green Fasten Flashing 42 Eco-Fasten Green Fasten Square Aluminum Blocks 42 5/16"x4.5" SS Lag Bolts 42 5/16" Stainless Steel Washers 42 UniRac Sunframe Rail 144' UniRac Sunframe Cap Strip 144' *Always double check measurements. GreenLogic, LLC - Approved 10.12kW ~ Sunpower 230w Layout 44 Sunpower 230w Panel Dimension = 61.39"x31.42" UniRac Sunframe Array Length = · Attachment Point John and Sharon Rumpler Azimuth = 132° Array Height = UniRac Sunframe 1060 Leeward Drive Pitch = 27o Surface Dimensions = ~ ~ Southold, NY Scale 3/16" = 1.0' Magic # = 2x__' Douglas Fir Rafters 16" On Center PROJECT COMPONENT COUNT ISSUES / SPECIAL INSTRUCTIONS A) Attachment type and count: B) Rail type and count: UniRac Sunframe Layout Created By: MVP Date: 1-12-12 SERIES The SunPowerTM 230 Solar Panel provides today's highest efficiency and performance. Utilizing 72 all bock-contact solar ceils, the SunPower 230 delivers a total panel conversion efficiency of 18.5%. The panel's reduced voltage-temperature coefficient and exceptional Iow-light performance attributes provide outstanding energy delivery per peak power watt. SunPower's High Efficiency Advantage 20% -- 18% o , 14% 15Yo 10% 19% 0% Thin Film Conventional SunPower SunPower E 18 Series E 19 Series Electrical Data Peak Power {+5/-3%) Pmax 230 W Efficiency q 18,5 % Rated Vollage Vmpp 40.5 V Rated Current Impp 5,68 A Open Circuit Voltage Voc 48.2 V Short Circuit Current Isc 6.05 A Maximum System Vollage UI. 600 V Tempera~Jre Coefficients Power (P) -0.38% / K Voltage (Voc) -132.5mV / K Current {Isc) 3.SMA / K NOCT 45° C +/-2° C Series Fuse Rating 20 A Solar Cells Front Glass Junction Box Output Cables Frame Weight Mechanical Data 72 SunPower all-back contact monocrystalline High transmission tempered glass ~P.65 rated with 3 bypass diodes Dimensions: 32 x 155 x 128 (mm) 1000mm length cables / MuhiContact (MC4) connectors Anodized aluminum alloy type 6063 (black) 33.1 lbs. (15.0 kg) I-V Curve 7,0 6,0 5,0 ................... ~ 4,0 ~ ¥ 2,0 0,0 0 10 ~0 go 40 ~0 60 Tested Operating Condillons Temperature -40° F to +185° F J-40° C to + 85° C) 113 psf 550kg/m2 (5400 Pa) front - e.g. snow; Max load 50 psf 245kg/m2 (2400 Pa) fronl and back - e.g. wind Impacl Resistance Hail 1 in (25 mm) at 52mph (23 m/s) Certifications Warranties and Certifications 25 year limited power warranty 10 year limited product warranty Tesled to UL 1703. Class C Fire Rating Dimensions sunpowercorp.com 2 Strings of 7 SunPower 230 W panels, Each string 1610 watts Army total of 3220 Watts II II All panels to be grounded as per NEC code SUNPOWER SPR 3000 INVERTER 2, 30 AMP two pole DC switches from panels to inverter 240 VAC 240 VAC from inverter to a 30 Amp switch near utility meter 3 Strings of 10 SunPower 230 W panels, Each string 2300 watts Array total of 6900 Watts II II II II All panels to be grounded as per NEC code 2, 30 AMP two pole DC switches from panels to inverter 240 VAC~fro! in!erter to a 30 Amp switch near utility meter