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HomeMy WebLinkAbout37403-ZTown of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY 10/15/2012 No: 35996 Date: 10/15/2012 THIS CERTIFIES that the building Location of Property: SCTM #: 473889 SOLAR PANEL 9350 N Bayview Rd, Southold, Sec/Block/Lot: 79.-8-12.3 Subdivision: Filed Map No. conforms substantially to the Application for Building Permit heretofore 7/19/2012 pursuant to which Building Permit No. 37403 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for Lot No. filed in this officed dated dated 7/27/2012 which this certificate is issued is: install an electric Solar Panel System to an existing single family dwelling as applied for The certificate is issued to Dickerson, David & Murray, Karen (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 37403 10/3/12 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 #: 37403 Date: 7/27/2012 Permission is hereby granted to: Dickerson, David & Murray, Karen 9350 N Bayview Rd Southold, NY 11971 To: install an electric Solar Panel System to an existing single family dwelling as applied for At premises located at: 9350 N Bayview Rd, Southold SCTM # 473889 Sec/Block/Lot # 79.-8-12.3 Pursuant to application dated To expire on 1/26/2014. Fees: 7119/2012 and approved bythe Building Inspector. SINGLE FAMILY DWELLING - ADDITION OR ALTERATION CO - ALTERATION TO DWELLING Total: $50.00 $50.00 $100.00 Building Inspector Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, 3. 4. 5. New Construction: Old or Pre-existing Building: Location of Property: q550 House No. ' Street Owner or Owners of Property: 1~,. 0~('P--V'~ Suffolk County Tax Map No 1000, Section /"~ Subdivision Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. Certificate of Occupancy on Pre-existing Building - $100.00 Copy of Certificate of Occupancy - $.25 Updated Certificate of Occupancy - $50.00 Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 l' t (check one) 5o, 4¼old Date of Permit. Permit No. f? Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ _~), frO/ Hamlet 0 d, ct Oic csor B,ock ~ Lot 19.5 Filed Map. Lot: Applicant: Underwriters Approval: Final Certificate: ~"~(check one) · -A~p~icant Signature Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Telephone (631 ) 765-1802 Fax (631) 765-9502 ro.qer, richert~,town, so uthold, ny. us BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION ssued To: Murray/Oickerson ~,ddress: 9350 N Bayview Rd City: Southold St: NY Zip: 11971 Building Permit #: 37403 Section: 79 Block: 8 Lot: 12.2 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 ~ Corn merical Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage Service 1 ph U Heat Service 3 ph ~ Hot Water Main Panel NC Condenser Sub Panel NC Blower Transformer Appliances Disconnect Switches Other Equipment: INVENTORY GFCI Recpt Single Recpt Range Recpt Dryer Recpt Twist Lock Ceiling Fixtures [~ HID Fixtures Wall Fixtures I I Smoke Detectors Recessed Fixtures[E~ CO Detectors Fluorescent Fixture ~ Pumps Emergency Fixtures[~ Time Clocks Exit Fixtures L~ TVSS PHOTOVOLTAIC SYSTEM, 10,290 watts, to include, 42 Sunpower SPR-245 pant 2-Sun Power 3000, 1-Sun Power 4000 inverters Notes: Inspector Signature: Date: Oct 3 2012 81 Ced Electrical Compliance Form.xls TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: C~'~ ~.) [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I~ISULATION [ ] FRAMING/STRAPPING [//] FINAL Pacifico Engineering PC 700 Lakeland Ave, Suite 2B Bohemia, NY 11716 ,,w,,w.pacificoengineering.com Engineering Consulting Ph: 631-988-0000 Fax: 631-382-8236 engineer@pacificoengineering.com September 28, 2012 Town of Southold Building Department 54375 Route 25, P.O. Box 1179 Southold, NY 11971 Subject: Solar Energy installation for Karen Murray 9350 North Bayview Rd Southold, NY 11971 Section: 79 Block: 8 Lot: 12.3 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 ASCET-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 TO~N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork. net Examined Approved Disapproved aJc :o 737,20 PERMIT NO. 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: Mail to: Phone: Expiration 2o / JUL 1 9 2012 Building Inspector LICATION FOR BUILDING PERMIT Date '7/] ~' ,20 I~,,. INSTRUCTIONS ,. This aplgl-~S~t~ffi be compk tely filled in by typewriter or in ink and submi,ed to the Building Inspector with4 sets of aa~, a~cmate 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 wate~ays. 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 pe~it shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in pa~ for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Eve~ 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 prope~y 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 Depa~ment 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. ( 'gn~ure of applicant or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ~O~4. ~[tor~O2c{ (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. /V' / Electricians License No. ~ Other Trade's License No. 1. Location of land on which proposed work will be done: House Number Street County Tax Map No. 1000 Section "~ Block (~' Subdivision Filed Map No. Hamlet Lot [ 2. '~ Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Prfl0_ ~LI~ [QO/~' b. Intended use and occupancy 3. Nature of work (check which applicable): New Building_ Repair Removal Demolition 4. Estimated Cost 5. If dwelling, numberofdwelling units M ]/4 If garage, number of cars Fee Addition Other WorkC__Ol_Ct~ Alteration (Description) (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 ,A,/ [ta, c Rear Depth Height, Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth. Height Number of Stories Dimensions of entire new construction: Front /V//JO Rear Depth Height Number of Stories 9. Size of lot: Front /q ]/Sf Rear 10. Date of Purchase .Depth Name of Former Owner 7 t)OJqlO, q; {5C~ tff,~mD tl. Zone or use district in which premises are situated IqL${d,~/l'f-; 12. Does proposed construction violate any zoning law, ordinance or regulation? YES 13. Will lot be re-graded? YES__ NO__Will excess fill be removed from premises? YES __ 14. Names of Owner of premise~Address~Phone No. Name of Architect ~ ~Address Phone No Name of Contractor Address Phone No. NO 15 a. Is this property within 100 feet ora tidal wetland or a freshwater wetland? *YES *IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. NO 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? * YES I,/ NO · IF YES, PROVIDE A COPY. ($ee a~,~ STATE OF NEW YORK) COUNTY OF ~1~: ~J ~[ItlA_ .,~ ~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (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. Pubhc~ ~l~'gnature of A pplleant II__em Number: (NOTE: A Check Mark (.~) for each O~eetiea is Requ~'ed for a Complete Applisatlon) Yes No Will {his Project Retain All Storm-Water Run-Off Generated by a Two (2") Inch Rainfall ~n Bile? (This Item will Include all ~un-off created by site clearing and/or construction ac~vtties as well as all Bite Improvements and the permanent oreaitorl of Impewloea s un~acec.) ~o. the Bite Plan and/or Buwey Show All Proposed Drainage Structures thdica~ng Size & Location? Tiffs Item shall include aU Proposed Grade Changes and ~t0pas Controlling Burface WaterFIowl Will this Project Require any Land Filling, Grading or Excavaito~ where there Is a change to the Nateml E. xis ling Grade Involving more than 200 Cubic Yards of Material within any Parcel? Will this Application Require Laed Disturbing Ac~.itJes Encompassing an Area In Excess of Five Thousand (5,000) Square Feel o, Groued Surface? Is there a Netural Water Conrce Running through Ihe Site? Is this Pr°icc( within the Trustees Jurisdicfiorl or wi~in One Hundred (t 00,) teal of a We,and or Bosch? Will there be Bite preparation on Existing Grade BIopes which Exceed Fiiteen (15) teat ct'Vertical Rise to O "und= Di.tence? Will Driveways, Parking Areas or other Impervious Surfaces be Sloped to Direct Storm-Water Run-Off into aed/or in the dlreclion of a Town right-of-way? Will ~his Projecl Require the Piecement of Material; Remo¥ol of Vegetation and/or Ihe COnstr~otio~ of any Item Within Ihe Town Right-of-Way or Ro~d Shoulder Area? (This tiem will NOT include the Installation of Driveway Aprons.) 9 Will this Pr°ject Require Site Preparalion within the One Hundred (100) Year Floodplain of any Watem. ourse? r~ NOTE: If Any Answer to Questions One through Nine is Answered with a Check Mark in the Box, a Storm-Water, Grading, Dmthage & Erosion Control Plan is Required and Must be Submitted for Revisw Prior to Issuance of Any Building Permit EXEMP'r/oNt Yes NO Does thIs project meet the minimum standards for clesslfl~a~co es.a~ Agricuitorai p~ Note: If You Aes~red Yes to thbi Question, a ~o~-Wa~r, Gmdthg, Dmtesge & ~slon Control Plan is NOT Requlredl ~ ~A~ OF NEW YO~, ................................................................. Owner ~or m~e ~ file · at ~e wo~ will ~ ~ffonned in ~e ~er set fo~ in ~e applicon fried h~. Sworn to ~[om ............... ................... ...................... FORM 06/07 Town Hall Annex 54~75 Main R~ad P.O. Box 1179 Southold, NY 11971-0959 / Telephone (681) 765-1809 ~ ro~ler, richertC~.t~(wn63.1s)oTu~(~.ny.us '~ z~-- BUH ,~G DEPARTMENT TOWN OF $OUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Company Name: Name: License No.: ~,ddress: Phone No.: Date: *Name: *Address: *Cross Street: *Phone No.: Permit No.: Tax. Map District: JOBSITE INFORMATION: (*Indicates required information) 1000 . Section: ~,,~. Block: ~ Lot: *BRIEF DESCRIPTION OF WORK (Please Print Clearly) (Please Circle All That Apply) *Is job ready for inspection: *Do you need a Temp Certificate: Temp Inf_o. rmation (Ifil *Service Size: *New Service: Re-connect Additienal Information: !NO Rough In Final 3Phase 100 150 200 300 350 .400 Other Underground Number of Meters Change of Service Overhead PAYMENT DUE WITH APPLICATION 82~Requestforlnspection Form . GREENLOGIC October 4, 2012 The Town of Southold Building Department 54375 Route 25 P.O. Box 1179 Southold, NY :11971 OCT - 9 2012 BLDG DEPT. TOWN OF gOUTMOID Re: Building Permit NO. 37403 Karen Murray/David Dickerson 9350 N. Bayview Road, Southold To the Building Inspector: Enclosed please find the Engineer's Certification for Karen Murray and David Dickerson's solar electric system, which we installed at 9350 North Bayview Road, Southold. Please arrange to send them the Certificate of Occupancy and close out the building permit. Please let me know if you have any questions about the installation. Sincerely, Barbara Casciotta Account Manager GreenLogic LLC 631-771-5152 ext. :1:17 Tel: 877.7714330 Fax: 8777714320 SOUTHAMPTON/CORPORATE: 3;::) OOunLy Rd 39A SoIjth~:F/ip/orl NY /1968 CUTCHOGUE: 1070 Depot Lane Cutchogue, NY 11935 MANORVILLE: 40 Wgodland Averm< Manc, rvil~ NY ~1949 NEW YORK CITY: 241 6th Avenue #3B New Yorkr NY 10014 ROSLYN HEIGHTS: 200 S Sc'rvice Rd , #]08 Rosyln Heights. NY 11577 Town Hall Annex 54375 Main Road P.O. Box 1179 Southold. NY I 1971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 October 9, 2012 BUILDING DEPARTMENT TOWN OF SOUTI-IOLD David Dickerson Karen Murray 9350 N. Bayview Rd Southold, NY 11971 TO WHOM IT MAY CONCERN: The Following Items Are Needed To Complete Your Certificate of Occupancy: NOTE: Need Certification from an Architect or Engineer to certify the fastening of the Solar Panels to the roof meets NYS Building Code. Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. (contact your electrician) A fee of $50.00. __ Final Health Department Approval. __ Plumbers Solder Certificate. (AIl permitsinvoiving plumbing after 4/1/84) __ Trustees Certificate of Compliance. (Town Trustees # 765-1892) __ Final Planning Board Approval. (Planning # 765-1938 __ Final Fire Inspection from Fire Marshall. __ Final Landmark Preservation approval. BUILDING PERMIT: 37403 - Solar Panels Td No.: (~31) 3~9~200 CHARL~ B. CUDDY AfforBey a~ Law ~45 Gralbq Avenu~ R/verhe~d, New York 1190J Pax N~.: (OJ) 369-90~0 TELECOPIER COVER SHEET To~ Number ofpa&es i ,1 induding ~v~r shMt, ~f u'ansmission is f~dty ~r hc:ompl~.., ple~,e inform us aS soon os poss~le. Re: Title No. AT00-3S31S Date: M.9.rchl4,2001 13, ~lm ~ S~lk ~n~ ~ ~ es Map ~o. 10583 ~tl~ ~Yap orNo~h Ba'~ W~s .,% IYgCLARATION Olt ~ ovtNAN~ AN~ l~s~ ~fC~ONS [TNE$SRTH: and 2) ~w.h 93 de~rees 14 m THIn, R~ .South 22 du~ 3256.73 616.42 i.d. *o Lot No. l! L. ROI'F-JtTY A~ ,e-. Rbd In .tho Of~ of~ CJe'k (d'tbe C. ou~ m 00 ~Monds P. du;, a dSstnn~ of ~tl 3 .$9 f~et~ s ~ rntmf~ 2o seeo~ds We~ ~ distmce of . j)&bq I of4 · e 0f1170.00~ to die poht m pike ·2of4 9. WeE~wd ~ t~ p~ Sudl ~ shall na~ 4mc~mtd six (6) 3nch~ ht I~,ht or t~-~om' ~TAT~ OF ~ YOIMC ) · ~O{~,~U~"EO{~C ) STATE OF NEW YORK WORKERS' COMPENSATION BOARD CERTIFICATE OF NYS WORKERS' COMPENSATION INSURANCE COVERAGE la. Legal Name & Address of Insured (Use street address only) Greenlogic, LLC 425 County Road 39A Suite 101 Southampton, NY 11968 Work Location of Insured (Only required if coverage is specifically limited to certain locations in New Yorl~ State, ge., 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. IOnly check box if all partners/officers included) [] all excluded or certain partners/officers excluded. l'his certifies ihat the insarance carrier indicated above in box "3" insures the business referenced above in box "la" for workers' compensation under the New York State Workers' Compensation Law. (To use this form, New York(NY) must be listed under Item 3A on the [N FORM ATION PAGE of the workers' compensation insurance policy). The Insurance Carrier or its licensed agent will send Ibis Certificate of Insurance to the entity listed above as the certificate holder in box "2". The Insurance Carrier will also notify the above certificate holder within 10 days IF a policy is canceled due to nonpayment of premiums or wilbin 30 days IF there are reasons ortner than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.) Otherwise, this Certi~cate is valid for one year ufter this form is' approved by the insurance carrier or its licensed agent, or until the policy expiration date listed in box "3c", whichever is earlier. Approved by: Title: Authorized Agent Please Note: Upon the cancellation of the workers' compensation policy indicated on this form, if the business continues to be named on a permit, license or contract issued by a certificate holder, the business must provide that certificate holder with a new Certificate of Workers' Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers' Compensation Law. Under penalty of perjury, I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by; Peter Zulkofske Telephone Number of authorized representative or licensed agent of insurance carrier: 631-941-4113 Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insurance brokers are NOT authorized to issue it. C- 105.2 (9-07) www.wcb.state.ny.us CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATFER 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 POUCIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s}. CONTACT Brookhaven Agency, Inc. PRODUCER NAME: Brookhaven Agency, Inc. ~"~ ~.E~ ;.!. (631) 941-4113 I ~r~c~. No~: (631 ) 941-4405 P.O. BOX 850 ~n~.;~, brookhaven.agency@verizon.net 150 Main Street PRODUCER East Setauket NY 11733 ~NsuaERISl AFFOR~N~ COVEP~C~ NA= # INSURED INSURER A: Torus Specialty Insurance Co. Greenlogic, LLC ~NSURER s: Merchants Preferred Insurance Co. 425 County Road 39A, Suite 101 ~NSURER C: Commerce & Industry Insurance Co. Southampton, NY 11968 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH 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 M)OL~USl POLICYEFF I POUCYEXP GENERAL LIABILITY EACH OCCURRENCE $1,000,000 A X COMMERCIALGENERALUABILITY X 50817AI21B 01/31/12 01131113 DAMAGETORENTED $50,000 X I CLAIMS-MADE [] OCCUR MED EXP IA.¥ one person) $ 5,000 X XCU PERSONAL & AOVINJURY $1,000,000 X CONTRACTUAL LIAB GENER,ed_AGGREGAT~ $2,000,000 -- (Ea accident) $1,000,000 B ~ ANYAUTO CAPI043565 06/12111 06/12112 BODiLYiNJURy (Per pe~on) $ $ X~ UMBRELLAUAB xL~ OCCUR EACHOCCURRENCE $5,000,000 A ~XCESS~I / CLAIMS-MADE X 50817A121A 01/31/12 01/31/13 AGGREGATE $5,000,000 X; RETEN~ON ~10,000 ~ wo.~co~.s~o. X I ........ I I°.~ AND EU~LO'~P.S' L~mLm' Y / r~ C ANy p ROPRiETOR/PAR~ N ~ RJEX~CUTI~ WC00t 602420 081111t I 08/11112 E.L. EACH ACClOENT ~ 1,000,000 (¥an~a~ry I~ NH) E,L. O~SEASE - EA EMPLOYEI $1,000~000 D~SCRIPT~QN QF OpERATION S bek3w E.L. OISEASE * POMCY UMIT $1,000,000 C INSTALLATION FLOATER CPP4182553 01/30111 01/20/12 $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 POUCIES 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 of=c CONTRACTOR f,~RC A CLEJAN 40227-H o5/25r2~6 Suffolk County Executive's Office of Consumer Affairs VETERANS MEMORIAL HIGHWAY * HAUPPAUGE, NEW YORK 11788 12/10/2007 SUFFOLK COUNTY Master Electrician License DATE ISSUED: This is to certify that doing business as No. 43858-ME ROBERT J SKYPALA GREENLOGIC LLC having given satisfacto~j evidence of competency, is hereby licensed as MASTER ELECTRICIAN in accordance with and subject to the provisions of applicable laws, rules and regulations of the County of Suffolk, State of New York. Additional Businesses NOT VALID WITHOUT DEPARTMENTAL SEAL AND A' CURRENT CONSUMER AFFAIRS ID CARD Director Suffolk County Executive's Office of Consumer Affairs VETERANS MEMORIAL HIGHWAY * HAUPPAUGE, NEW YORK 11788 DATE ISSUED: 5/25/2006 No. 40227-H SUFFOLK COUNTY Home Improvement Contractor License This is to certify that doing business as MARC A CLEJAN GREEN LOGIC LLC having furnished the requirements set forth in accordance with and subject to the provisions of applicable laws, rules and regulations o£the County of Suffolk, State of New York is hereby licensed to conduct business as a HOME IMPROVEMENT CONTRACTOR, in the County of Suffolk. NOT VALID WITHOUT DEPARTMENTAL SISAL AND A CURRENT CONSUIVJtER AFFAIRS ID C~,RD Director -'3UtP-.Vt~-'f' NORTH BA'CV'IEH FII ~ ~ I~, TO~ ~OLK ~, Pacifico Engineering PC 700 Lakeland Ave, Suite 2B Bohemia, NY 11716 www. pacificoengineering.com July 12, 2012 Town of Southold Building Department 54375 Route 25, P.O. Box 1179 Southold, NY 11971 Subject: Solar Energy Installation for Karen Murray 9350 North Bayview Rd Southold, NY 11971 Engineering Consulting Ph: 631-988-0000 Fax: 631-382-8236 enaineer~pacificoenaineering.com RETAIN-STORM W~ER RUNOFF PURSUANT TO CHAPTER 236 OF THE TOWN COD~ APPROVED AS NOTED DATE~B.P.# ,--'-~-~(dO --~ FEE' ~5'"~) B y ~-~-'( ;' Section: 79NOTIFY BUILDING DEPARTMENT AT Block: 8 765-1802 8 AM TO 4 PM FOR THE Lot: 12~LLO~NG INSPECTIONS: 1. FOUNDATION - ~ REQUIRED FOR POURED CONCRETE 2. ROUGH-F~ING, PLUMBING, STRAPPING, ELECTRICAL & CAULKING 3. INSU~ON 4 FINAL.CONSTRUCTION & ELECTRIC~ MUST BE C~PLETE F~ C.O. ALL CONS~TION S~LL ME~ ~ REQUIREMENTS OF THE CODES OF NEW YORK STATE. ~T RE~NSIBLE F~ DESIGN OR CONSTRUCTION ERRORS.. I have reviewed the roofing structure at the subject address. The structure can support the additional weight OT 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 B mean roof height 19 ft 19 ft pitch 12 in/12 12 in/12 roof rafter 2x10 2xl 0 rafter spacing 16 in OC 16 in OC Reflected roof rafter span 16.0 ff 12.3 ft Table R802.5.1(1) max 20.6 ft 20.6 ft The climactic and load information is below: ,.;NLAWFUL CERTIFICATE OCCiIPANCY CLIMACTIC AND Ground Wind Live load, point GEOGRAPHIC DESIGN Category Snow Loac Speed, 3 pnet30 per pullout Fastener type CRITERIA pg sec gust, ASCE 7, load, lb mph psf Roof Section A C 20 120 33 346 5/16" dia screw, 4-1/2" length B 33 346 5/16" dia screw, 4" length I'l I~- .--.~1_-_ /-'~ ov ~,!~, ~.- --"""'-''mu, AL Ralph PacJfico, PE '~:~h~ 0'¢.~<~ Professional Engineer ~' ~g' *¢c)~' LOGIC' CHIMNEY DRAWING NUMBER: Paciflco Engineering PC 1 OF 9 SURFACE 1 LAYOUT *Always double check measurements GreenLogic, LLC -Approved 10.29kW Panel Dimension =61.39"x31.42" Layout 42 Sunpower 245w Array Length = 245.56" UniRac Sunframe Array Height = 259.61" Karen Murray Azimuth = 156~ Sudace Dimensions =54'8"x25'7" 9350 North Bayview Pitch = 40° Magic ~ = 32.17" Southold, NY Scale 3/16" = 1.0' ~SSUES / SPECIAL INSTRUCTIONS A) Attachment ~pe and count: 57 Green Fasten Retro-Fit. · A~achment Point ~: B) Rail type and count: UniRac SunFrame ~ UniRac SunFrame ~ ~ 2x10" Douglas Fir Rafters 16" Ralph Pacifico Professional Engineer Layout Created By: MVP Date: 7-9-12 LOGIC CHIMNEY DRAWING NUMBER: Pacirmo Engineering PC PO Box t448, SaY~ille; Ny 1 ~URFACE I ATTACHMENTS *Always double check measurements NY Lic 066182 GreenLogic, LLC - Approved 10.29kW Panel Dimension =61.39"x31.42" Layout 42 Sunpower 245w Array Length = 245.56 ..... ' .... ' ~ · UniRac Sunframe Array Height = 259,61" "' '~' Karen Murray Azimuth = 156° Surface Dimensions =54'8"x25'7" Southold, NY Scale 3/16" = 1.0' ISSUES / SPECIAL INSTRUCTIONS ~ '5 ,? PROJECT COMPONENT COUNT ~ Sunpower 245w *"'~,~, .~.Z.-b,$ ~ 87. ~ ^~,,~1 ~,~-,~J~, ~'"~d~'~,,"~'~ A) Attachment type and count: 57 Green Fasten Retro-Fit. ~ Attachment Point B) Rail type and count: UniRac SunFrame ~--- UniRac SunFrame I I 2x10" Douglas Fir Rafters 16" On Center Ralph Pacifico Professional Engineer NYS Lic~ 056182 NJ Lic# 249E04744300 Layout Created By: MVP Date: 7-9-12 LOGIC / CHIMNEY DRAWING NUMBER: pacifico Engineering PC 3 OF 9 2x8 on SPR4000m SURFACE I STRINGING 2x6 on SPR3000m *Always double check measurements .~.o~..JL~ 24~7~oo GreenLogic, LLC- Approved 10.29kW Panel Dimension =61.39"x31.42" Layout 42 Sunpower 245w Array Length= 245.56" UniRac Sunframe Array Height = 259.61" ., Karen Murray Azimuth = 156~ Sudace Dimensions =54'8"x25'7" Southold, NY Scale 3/16" = 1.0' ISSUES / SPECIAL INSTRUCTIONS PROJECT COMPONENT COUNT ~ Sunpower 245w A) Attachment ~pe and count: · A.achment Point B) Rail type and count: UnJRac SunFrame ~ UniRac SunFrame ~ ~ 2x10" Douglas Fir Rafters 16" Ralph PacJfJco ProfessJonal EngJneer On Center NYS Layout Created By: MVP Date: 7-9-12 LOGIC' DRAWING NUMBER: Pactflco Engineering PC 4 OF 9 SURFACE 2 LAYOUT *Always double check measurements GreenLogic, LLC -Approved 10.29kW Panel Dimension =61.39"x31.42" Layout 42 Sunpower 245w Array Length =306.95" UniRac Sunframe Array Height = 130.93" Karen Murray ~imuth = 246° Sudace Dimensions =39'2"x20'4" 9350 "o~h Bayview Pitch= 40° Magic ~ = 32.17" Southold, NY Scale 3/16" = 1.0' ISSUES / SPECIAL INSTRUCTIONS A) Attachment ~pe and count: 31 Green Fasten Retro-Fit. · Attachment Point ~~' B) Rail ~pe and count: UniRac SunFrame -~ UniRac SunFrame ~ ~ 2x10" Douglas Fir Rafters 16" Ralph Pacifico Professional Engineer O n Center ~s u~ o~e2 NJ b~ ~49E~47~300 Layout Created By: MVP Date: 7-9-12 LOGIC Paciflco Engineering PC DRAWING NUMBER: po aox 1448, say~l~. Ny i17~2 ~ Pac~, ~ssior~ Engineer SURFACE 2 ATTACHMENTS *Always double check measurements GreenLogic, LLC -Approved 10.29kW Panel Dimension =61.39"x31.42" Layout 42 Sunpower 245w Array Length =306.95" UniRac Sunframe Array Height = 130.93" Karen Murray Azimuth = 246° Sudace Dimensions =39'2"x20'4" 9350 Nodh Bayview Pitch = 40° Magic.= 32.17" Southold, NY Scale 3/16" = 1.0' ~SSUES / SPECIAL INSTRUCTIONS PROJECT COMPONENT COUNT ~-~ Sunpower 245w A) Attachment ~pe and count: 31 Green Fasten Retro-Fit. . Attachment Point B) Rail type and count: UniRac SunFrame .... UniRac SunFrame ~ ~ 2x10" Douglas Fir Rafters 16" Ralph Pacifico Professional Engineer On Center NYS U~ 066~2 NJ U~ 24e~047~300 Layout Created By: MVP Date: 7-9-12 2x7 on SPR3000m DRAWING NUMBER: Pac~co Engineering PC 6 OF 9 SURFACE 2 STRINGING *Always double check measurements NY L~I~ GreenLogic, LLC - Approved 10.29kW Panel Dimension =61.39"x31.42" Layout 42 Sunpower 245w Array Length =306.95" UniRac Sunframe Array Height = 130.93" ~/~ Karen Murray Azimuth = 246° Sudace Dimensions =39'2"x20'4" 9350 NoAh Bayview Pitch = 40° Magic ~ = 32.17" Southold, NY Scale 3/16" = 1.0' ISSUES/SPECIAL INSTRUCTIONS PROJECT COMPONENT COUNT~ .~ ~' [ I ~ . ' ,O~ ~ ~lt ~ ~'.- ~ Sunpower 245w A) Attachment ~pe and count: A~achment Point B) Rail ~pe and count: UniRac SunFrame ---~ UniRac SunFrame ~ ~ 2x10" Douglas Fir Rafters 16" Ralph Pacifico Professional Engineer On Center NYS Li~ 0~182 NJ Li~ 249E~7~300 Layout Created By: MVP Date: 7-9-12 LOGIC'" ELIMINATING THE COST OF ENERGY Material List Otv. Rail Material List Otv. EEo-Fasten Green Fasten Flashing EEo-Fasten Green Fasten Square Aluminum Blocks 5/].6"x4.5" SS La§ Bolts 5/16" Stainless Steel Washers 88 88 88 88 DRAWING NUMBER: Pacifico Engineering PC 7 OF 9 MATERIAL LIST *Always double check measurements. GreenLogic, LLC - Approved 10.29kW Layout 42 SunPower 245w Panel Dimension = 61.39"x31.42" UniRac Sunframe Array Length = Karen Murray Azimuth = -° Array Height = ;/ 9350 North Bayview Pitch = - Surface Dimensions = South old, NY Scale 3,16" = 1.0' Magic,= ~RO~ECT COMPONENT COUNT C~l SunPower 245w v A) Attachment type and count: · Attachment Point B) Rail ~pe and count: UniRac Sunframe '~. n UniRac Sunframe ~','~-~,~ ..... ...... ;' ~.,//.. 2x10" Douglas Fir Rafters 16" On Center Ralph Pacifico Professional Engineer Layout Created By: MVP Date: 7-9-12 LOGIC S1 Framing: 2x12 Douglas Fir ridge. 2x10 Douglas Fir rafters spaced 16" on center, spanning 20'11". 2xl 0 Douglas Fir ceiling joists spaced 16" on center. 2x6 Douglas Fir exterior wall. %" Plywood sheathing. 2x10 Douglas Fir rafters spaced 16" on center, spanning 20'4". S2 Framing: 2x12 Douglas Fir ridge. 2x10 Douglas Fir ceiling joists spaced 16" on center. 2x6 Douglas Fir exterior wall. %" Plywood sheathing. DRAWING NUMBER: Pac~lico Engineering PC 8 OF 9 FRAMING *Always double check measurements GreenLogic, LLC -Approved 10.29kW Panel Dimension =61.39"x31.42" Layout 42 Sunpower 245w Array Length =" UniRac Sunframe Array Height =" Karen Murray Azimuth = Surface Dimensions = 9350 North Bayview Pitch: Magic #: Southold, NY Scale 3/16"= 1.0' ISSUES/SPECIAL INSTRUCTIONS PROJECT COMPONENT COUNT r~ Sunpower 245w 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: 7-9-12 DRAWING NUMBER: PO sox 1448, sayville, NY 11782 9 OF 9 FAST TRACK PERMIT *Always double check measurements NY Lic066182 NJUc 24GE04744300 GreenLogic, LLC-Approved 10.29kW .- ,'~ ,_:~ ,~a"ou* 42 SunPower 245w Panel Dimension = 61.39"x31.42" . Arra,, ~en,~h = .',' .'~ .'. ~ ~'' UniRac Sunframe Karen Murray Azimuth Array Height = Southold, NY Scale 3/32" = 1.0' Magic # = ISSUES / SPECIAL INSTRUCTIONS PROJECTCOMPONENTCOUNT , ? % O,~1 ~ .' .7% A) Number of Roof Layers: 1 L~ -~.~ SunPower 245w B) Height above Roof Surface: 4" ~ Attachment Point C) Materials Used: EcoFasten,UniRac,SunPower,SMA ~ n UniRac Sunframe D) Added Roof Load of PV System: 3.5 PSF ~ ~ 2x10" Douglas Fir Rafters 16" On Ralph Pacifico Professional Engineer Center ~¥s LiC~ CE~I $2 NJ Lic~' 2agE0,~7,44300 Layout Created By: MVP Date: 7-9-12 19% EFFICIENCY S~ nPo',,ver E19 panels are ti~e eadk'g efficiency panels on the market toaay, of snace MAXIMUM SYSTEM OUTPUT Comprehensive inverter cornpatibili~/ ensures that customers can pail' the highest- e I:iciency pa~ els with Ihe higilest-etficiency REDUCED INSTALLATION COST pe~ install This saves both time and money RELIABLE AND ROBUST DESIGN SunPawer's unique Maxeon ~' cell technoogy and advanced module design ensure industry-leading relk~b Jify MAXEON CELL TECHNOLOGY SERIES THE WORLD'S STANDARD FOR SOLAR" SunPov.:e~ ' E19 Solar ~aneJs p,owde ~oday% leading efiice,cy and performance. Powered by SunPawer Maxeon' cell technology, the El9 seres pravdes panel co~'version efflc:,encies of up to i 97% The E i 9's Iow voltage temperature coefficiem, artJ-reiJective glass ara excepti)naJ lev, x-light performance attributes provide outstanding energy dehve~y per peak power watt SUNPOWER'S HIGH EFFICIENCY ADVANTAGE 20% sunpowercorp,com MODEL: SPR-245NE-WHT-D ELECTRICAL DATA Peak Power (+5/-3%) Pmax 245 W Cell Efficiency q 22.9 % Panel Efficiency n 197 % Rated Voltage Vmpp 405 V Rated Current Impp 6.05 A Open~ircuJt Voltage Voc 48.8 V Short-Circuit Current isc 6.43 A Maximum System Voltage UL 600 V Temperature Coefficients Power {P) - 0.38%/K Voltage (Voc) -132.5 mV/K Current (Isc) 3.5 mA/K NOCT 45° C +/-2° C Series Fuse Rating 20 A Grounding Solar Cells Front Glass Junction Box Output Cables ' Frame Weight Positive grounding not required MECHANICAL DATA 72 SunPower Maxeon'~ cells High-transmission tempered glass with anti-reflective JAR) coating lpg5 rated with 3 bypass diodes Dimensions: 32 x 155 x 128 mm 1000 mm cables / Multi. Contact [MC4) connectors Anodized aluminum alloy type 6063 (black) 33.1 lbs. (15.0 kg) I-V CURVE 5 0 0 10 20 30 40 50 Voltage {V) TESTED OPERATING CONDITIONS Temperature -40° F to +185° F (-40° C to + 85° C) Max load 113 psf 550 kg/m2 (5400 Pa), front (e.g. snow) w/specified mounling configuraltans 50 psf 245 kg/m2 (2400 Pa) front and back (e.g. wind) Impact Resistance Hail: (25 mm) at 51mph (23 m/s) WARRANTIES AND CERT!FICAT ONS Warranties 25-year limited power warranty 10-year limited product warranty Certifications Tesled to UL 1703. Class C Fire Rating DIMENSIONS ENDS Please read safety and installation instructions before using this product, visit sunpowercorp.com for more details. TGI~I~ EN LOGIC' A,.G ,.E CHIMNEY DRAWING NUMBER: Pacffico Engineering PC SURFACE 1 LAYOUT *Always double check measurements ,~L~0~ N.t Lic 24GE047443(30 GreenLogic, LLC -Approved 10.29kW Panel Dimension =61.39"x31.42" Layout 42 Sunpower 245w Array Length = 245.56" UniRac Sunframe Array Height = 259.61" Karen Murray Azimuth = 156° Surface Dimensions =54'8"x25'7" 9350 North Bayview Pitch = 40° Magic # = 32.17" Southold, NY Scale 3/16" = 1.0' ~SSUES / SPECIAL INSTRUCTIONS PROJECT COMPONENT COUNT ~ Sunpower 245w A) Attachment type and count: 57 Green Fasten Retro-Fit. · Attachment Point UniRac SunFrame B) Rail type and count: UniRac SunFrame ' I I2x10" Douglas Fir Rafters 16" Ralph Pacifico Professional En,qineer Layout Created By: MVP Date: 7-9-12 DRAWING NUMBER: Paciflco Engineering PC Po ~ox 1448, Sayville, NY 11782 4 OF 9 ~oo SURFACE 2 LAYOUT *Always double check measurements .~ uc066182 NJ !Jc 24GE~4744300 GreenLogic, LLC-Approved 10.29kW Panel Dimension =61.39"x31.42" Layout 42 Sunpower 245w Array Length =306.95" UniRac Sunframe Array Height = 130.93" Karen Murray Azimuth = 246° Surface Dimensions =39'2"x20'4" 9350 North Bayview Pitch = 40° Magic # = 32.17" Southold, NY Scale 3/16" = 1.0' iSSUES / SPECIAL INSTRUCTIONS PROJECT COMPONENT COUNT ~ Sunpower 245w A) Attachment type and count: 31 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 Enclineer Layout Created By: MVP Date: 7-9-12