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Home My WebLink AboutTR-7903A James F. King, President SOF SO(/lTown Hall Annex 0 54375 Main Road Bob Ghosio,Jr.,Vice-President l0 P.O. Box 1179 Dave Bergen Southold, New York 11971-0959 John Bredemeyer Michael J. Domino �O Telephone(631) 765-1892 V3 COUNTi,�`� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0824C Date: December 11, 2012 THIS CERTIFIES that the installation of a ground mounted solar electric system At 285 Queen Street, Greenport, New York Suffolk County Tax Map # 40-3-8 Conforms to the application for a Trustees Permit heretofore filed in this office Dated August 22, 2012 pursuant to which Trustees Administrative Permit#7903A Dated September 19, 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 ground mounted solar electric system. The certificate is issued to RICHARD WINDMULLER & CAROLINE ROCCHETTA owners of the aforesaid property. -;7, '4 Affithorized Signat e Jill M. Doherty, President QF so(/ryo Town Hall Annex James F. King,Vice-President h0 54375 Main Road Dave Bergen P.O.Box 1179 Southold,New York 11971-0959 Bob Ghosio,Jr. u> >e John Bredemeyer . Telephone(631) 765-1592 UIVi 1, Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE F INSPECTION: Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction % constructed Project complete, compliance inspection. INSPECTED BY: COMMENTS: CERTIFICATE OF COMPLIANCE: Gce,it-1c. LLC called - � i Cc,C C oPy James F. King, President Bob Ghosio, Jr., Vice~President Dave Bergen John Bredemeyer Michael .L Domino Town Hall, 53095 Maia 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 Hail 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.: 7903A Date of Receipt of Application: August 8, 2012 Applicant: Richard Windmuller & Caroline Rocchetta SCTM#: 40-3-8 Project Location: 285 Queen Street, Greenport Date of Resolution/Issuance: September 19, 2012 Date of Expiration: September 19, 2014 Reviewed by: Board of Trustees Project Description: To install a ground mounted solar electric system. 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 project plan prepared by Richard Windmuller & Caroline Rocchetta, received on August 8, 2012, and stamped approved on September 19, 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, James F. King, President Board of Trustees 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 Southnld, NY 11971 Telephone (631) 765-1892 Fax (631 ) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application dated C~/?¢/IZ-- , ~ has been reviewed by this Board at the regular mee!ing of t q /1~1/I ?~ and your application has been approved pending the completi0r~ oF t'he following items checked off below. __ Revised Plans for proposed project __ Pre-Construction Hay Bale Line Inspection Fee ($50.00) __ 1st Day of Construction ($50.00) __ ½ Constructed ($50.00) v/' Final Inspection Fee ($50.00) __ Dock Fees ($3.00 per sq. ft.) Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above, COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: $ ,~'0. bO BY: James F. King, President Board of Trustees James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino PO Box 1179 Southold. NY 11971 Telephone (631 765-1892 Fax (631 ) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: GreenLogic LLC on behalf of RICHARD WINDMULLER & CAROLINE ROCCHETTA request and Administrative Permit to install a ground mounted solar electric system. Located: 285 Queen Street, Greenport. SCTM# 40-3-8 Type of area to be impa,,r,~d: __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 ~Amendment ~Administrative__Emergency Pre-Submission Violation Info needed: Modifications: Conditions: ~)//./ ~' ~Fv~/~ ,~' Prese~l.tOWere: J..,~i~g B. Ghosio . Bergen, ~'-JBredemeyer f Michael Domino D. Dzenkowski Form filted out in the field by Mailed/Faxed to: Date: other 2 Strings of 6 SunPower 327 W panels, Each stdng 1962 watts Array total of 3924 Watts I I I I All panels to be grounded as per NEC code SUNPOWER SPR 4000m INVERTER 21 30 AMP two pole DC switches from panels to inverter 240 VAC I 240 VAC from inverter to a 30 Amp switch near utility meter AUG 8 20~2 I GREENLOGIC® ENERGY EL M NAT NG THE COST OF ENERGY Ground Mount GreenLogic, LLC Proposed 3.924 kW Panel Dimension = 41.18" x 61.39" ~ 12 SunPower 327W Array Length = 247.08"/ SunPower 327W Winmuller, Richard DPW Ground Mount Army Height = 285 Queen St Azimuth = 180° Surface Dimensions = Greenport, NY 11944 Pitch = 20° Magic # = Scale 3/16" = 1.0' DPW Ground Mount Layout Created By: CDH Date: 4.18,12 Energy Consultant: JPHS 20% EFFICIENCY SunPower E20 panels are the highest efficiency panels on the markel today, providing more power in the same amount of space MAXIMUM SYSTEM OUTPUT Comprehensive inverter compatibility ensures that customers can pair the highest- efficiency panels with the highes~fficiency inverters, maximizing system output REDUCED INSTALLATION COST More power per panel means fewer panels per install This saves both time and money RELIABLE AND ROBUST DESIGN SunPower's unique MaxeonT'~cell technology and advanced module design ensure industry-leading reliability MAXEON CELL TECHNOLOGY Patented all back-contact solar cell, providing the industry's highest efficiency and reJiabiJiiy SERIES THE WORLD'S STANDARD FOR SOLARTM SunPowerT~ E20 Solar Panels provide today's highest efficiency and perfarmance. Pawered by SunPower Maxeon~'~ cell technology, the E20 series provides panel conversion efficiencies of up to 20.1%. The E20's Iow voltage temperature coefficient, anti-reflective glass and exceptional Iow light performance attributes provide outstanding energy delivery per peak power watt. SUNPOWER'S HIGH EFFICIENCY ADVANTAGE 20% 15% 10% --- 5% THIN FILM CONVENTIONAL SERIES SERIES SERIES sunpowercorp.com MODEL: SPR-327NE-WHT-D ELECTRICAL DATA Peak Power (+5/-3%) Pmax 327 W Cell Efficiency ~ 22.5 % Panel Efficiency q 20.1% Rated Voltage Vmpp 54.7 V Rated Current Impp 5.98 A Open Circuit Voltage Voc 64.9 V Short Circuit Current I~c 6.46 A Maximum System Voltage UL 600 V Temperalure Coefficients Power (P) - 0.38%/K Voltage (Vec) -176.6mV/K Currenl (Isc) 3.5rnA/K NOCT 45° C +/- 2° C Series Fuse Rating 20 A Grounding Positive grounding not required MECHANICAL DATA 96 SunPower MaxeonTM cells High-transmission tempered glass with anti-reflective (AR) coating IP-65 rated with 3 bypass diodes Dimensions: 32 x 155 x 128 mm 1000 mm cables / Multi-Contact (~.4) conneclors Anodized aluminum alloy type 6063 )black) 41.0 lbs (18.6 kg) Solar Cells Front Glass Junction Box Output Cables Frame Weight I-V CURVE 65 toe0w/~ ~ 4 e,0o w/~ 5o0 w/~ 0 0 10 20 30 40 50 vo~,ee (vi TESTED OPERATING CONDITIONS Temperature - 40° F to +185° F (- 40° C to + 85° C) 113 psf 550 kg/m~ (5400 Pa), front (e.g. snow) Max load w/specified mounting configurations 50 psf 245 kg/m2 (2400 Pa) front and back (e.g. wind) Impact Resistance Hail: (25 mm) at 51 mph (23 m/s) WARRANTIES AND CERTIFICATIONS Warranties 25-year limited power warranty 10-year limited product warranty Certifications Tested to UL 1703. C~ass C Fire Rating DIMENSIONS MM (A) - MOUNTING HOLES (Ii) - GROUNDING HOLES (~N} 12X O6.6 [.26] 10X O4.2 [.17] 301118] Please read safety and installation instructions before using this product, visit sunpowercorp.com for more details. SunPowerTM 3000m and 4000m Inverters offer exceplional reliability and superior performance. Innovative design and advanced testing are combined to create a durable inverter for optimal system performance over the long term. Both models are backed by a standard 1 O-year warranty. sunpowercorp.com 1-800-SUNPOWER SPR-3000m SPR-4000m AC Power 30o0 w AC Maximum Oulput Current (~ 208V, 240V) AC Nominal voltage / Range AC Frequency / Range 60Hz/59.3Hz- 60Hz/59.3Hz- 605 Hz 60,5 Hz Power Factor Peak Inverter Efficiency ~6.5% CEC Weighted Efficiency 95.0 % a 20e v 95.$ % a 208 v 95.5 % @ 240V 96.0% G 24OV Recommended Array Input Power (DC @ STC} DC Input Voltage Range 3750 W 4375 W @ 208 V 5000 W@ 240V 200-500 V ~ 208V 250 - 600 V @ 208 VAC 200-500 V @ 240V 250 - 6~0 V @ 240 VAC SPRm Efficiency Curves 100 75 % of Rated Output Power 8O% 90% 100% Mechanical Data Shipping Dimensions W x H x D (inches) 23.s' x 18.5' x 16.0' Unit Dimensions W x H x D (inches) 178'x 13,8~x93' Inverter Weight 88 lbs Shipping Weight 94 lbs Forced Air / Sealed Cooling Elecl~onics Enclosure Enclosure NEMA 3R MounlJng Wall Mount Bracket Standard Ambient Tempernture Range -13 to +113 oF Peak Power Tracking Voltage DC Max. Input Current DC Vohage Ripple No. of Fused String Inputs Power Consumption: S~andby / Nighlfime Fused DC Disconnect Eleclrkal Grounding Wa~anty Warranty and Certifications IO year limited warranty Compliance: IEEE-929, IEEE-1547, UL 1741-2005, UL 1998, FCC Parl 15 A & B About SunPower Founded in 1985, SunPower Corp. (Nasdaq: SPWRA, SPWRB) designs, manufactures and delivers the planet's most powerful solar technology broadly available today. Residential, business, government and utility customers rely on the company's experience and proven results to maximize return on investment. Pacifice Engineering PC 700 Lakeland Ave, Suite 2B Bohemia, NY 11716 www.pacificoengineering.com July 26, 2012 Town of Southold Building Department 54375 Route 25, P.O. Box 1179 Southold, NY 11971 Subject: Solar Energy Installation for Richard Windmuller 285 Queen Street Greenport, NY 11944 Section: 40 Block: 3 Lot: 8 Engineenng Consulting Ph: 631-988-0000 Fax: 631-382-8236 engineer{~pacificoengineering.com I have reviewed the proposed renewable energy installation at the subject address. The structure can support the imposed live and dead loads. 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. The climactic and load information is below: CUMACTIC AND GEOGRAPHIC DESIGN CRITERIA Ground Mount A Solar Array Ground Category Snow Load, Pg C 20 Ralph Pacifico, PE Professional Engineer Wind Live load, Speed, 3 pnet30 per sec gust, ASCE 7, mph psf 120 21 LOGIC I DRAWING NUMBER: Pao11~3 En~ PC I OF 3 (~ROUNDMOUNT LAYOUT *A~ays double check measurements GreenLogic, LLC -Approved 3.924kw Panel Dimension =61.39"x41.18" .~C~ Layout 12 SunPower 327w Array Length = 252.08" DPW Ground Mount Array Height = 122.78" Richard Windmuller Azimuth = 180° Surface Dimensions = N/A 285 Queen Street Pitch = 30° Magic # = N/A Greenpod, NY Scale 3/16" = 1.0' ISSUES I SPECIAL INSTRUCTIONS PROJECT COMPONENT COUNT ~ Sunpower 327w ?, A) Aflachment type and count: · Attachment Point B) Rail type and count: DPW Ground Mount ,-- DPW Power Rail --,... ,.. Ralph Pac~o Professional Engineer Layout Created By: MVP Date: 7-12-12 LOGIC DRAWING2oFNUMBER:3 GROUNDMOUNT DETAIL GreenLogic, LLC - Approved Layout Richard Windmuller 285 Queen Street Greenport, NY PROJECT COMPONENT COUNT 3.924kw 12 SunPower 327w DPW Ground Mount Azimuth = 180° Pitch = 20° Ground Mount Specifications Panel = SunPower 327w Panel Dimension = 61,39" x 41.18" GM Array Pitch = 30 degrees Concrete Footing Dimensions = 30"x48" Front Leg Height Above Ground = 9" Rail = DPW Power Rail P8 *Always double check measurements NOT TO SCALE Panel Dimension =61.39"x41.18" Array Length = 252.08" Array Height = 122.78" Surface Dimensions = N/A Magic # = NIA A) Attachment type and count: B) Rail type and count: DPW Ground Mount ISSUES / SPECIAL INSTRUCTIONS ~ Sunlx~r 327w · Attachment Point r-- DPW Power Rail Ralph Pacif ~[:b:~o~al Engineer Layout Created By: MVP Date: 7-12-12 LOGIC' DRAWING NUMBER: Pldlco ~ lac 3 OF 3 3ROUN~OUNTSTRINGIN 2X6 on SPR4000m *Always double check measurements GreenLogic, LLC -~prov~ 3.924~ Panel Dimension =61.39"x41.18" ~ ~,~, ~- Layout 12 SunPower 327w Array Length = 252.08" DPW Grou~ Mount Array He~ht = 122.78" ,/'~' . ~' ~" .. R~hard ~ndmul~r ~imulh = 180~ SuEa~ Di~nsions = N/A Greenpo~. NY Scale ~16''= 1.0' i~s/S~C,LINSTRUCTDNS~ Sunp--r PRO.CT COMPONE~ COUm 327W A) A~ch~nt ~pe and ~unt: · A~ment Point B) Rail ~pe and count: DPW Ground Mount r ~ DPW P~er Rail ..-.- .... ~: ~ . Ralph Pac~o~ro~ss~nal Engm~r ~yout Created By: M~ Da~: 7-12-12 END CLAMP TYP. SPR327 MODULE ~ RAIL BRACKE1 TYP. 123.01" MODULE LENGTH TYP. 30° 17" 48" 96" 79.53" ~] DIRECT POWER AND WATER ~111~"' W I ALBUQUERQUE. NEW MEXICO 87107 DPW -, P8-TTRGM 12-C~SUNPOWER- SOLAR SPR327-OP-30°-120MPH-25PSF SIDE VIEW GREENLOGIC WlNDMULLER END CLAMP TYP. 252' FINAL CUT (2 x 126" = 252' STANDARD LENGTH) MODULE *v~OTH 64" MAX. ~ (4 STRONGBACKS) FRONT VIL~N 61.38" MOOULE 1 RAIL TYP. RAIL TYP. ~IkJ DIRECT POWER AND WATER 4000 VASSAR DRIVE NE ~'-'~ I ALBUQUERQUE. NEW MEXICO 87107 DPW ,~, P8-TTRGM 12-C--SUNPOWER- S 0 L A R SPR327-OP-30°-120MPH-25PSF GREENLOGIC WINDMULLER 5/16" TURN BOLT -~ &FLANGENUT X~ ,._u,,,.J''x''5'x-'3~'~. C.A.. SEE VIEW A CROSS BRACE P6 POWER RAIL (EVERY OTHER BAY) 64" TYP. 4 LEGS POWER RAIL yP14 STRONGBACK ~-LEG 3"x1.5"x130" ALUM. CHANNEL BACK VIEW (PARTIAL, NOT TO SCALE 1 DIRECT POWER AND WATER DPW ~ P8-TTRGM 12-G-SUNPOWER- SOLAR SPR327-OP-30°-120MPH-25PSF GREENLO~IC WINDMULLER Suffolk County Executive's Office of Consumer Affairs VETERANS MEMORIAL HIGHWAY * HAUPPAUGE, NEW YORK 11788 DATE ISSUED: 5/25/2006 No. SUFFOLK COUNTY Home Improvement Contractor License This is to cerffv that MARC A CLEJAN doing business as GREEN LOGIC LLC 40227-H having furnished the requirements set forth in accordance with and subject to the provisions of applicable laws, rules and regulations of the County of Suffolk, State of New York is hereby licensed to conduct business as a HOME NOT VALID WITHOUT DEPARTMENTAL SEAL AND A CURRENT CONSUb,IER AFFAIR3 ID IMPROVEMENT CONTRACTOR, in the County of Suffolk. Additional Businesses Director 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 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 Ol OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cot. Main Rd. & Youngs Ave.) Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southold, NYl1971 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 ~ SEP ] 2012 Date: September 13, 2012 Re: Proposed Wetland Permit for RICHARD WINDMULLER & CAROLINE ROCCHETTA SCTM#1000-40-3-8 GreenLogic LLC on behalf of RICHARD WINDMULLER & CAROLINE ROCCHETTA request and Administrative Permit to install a ground mounted solar electric system. Located: 285 Queen Street, Greenport. SCTM# 40-3-8 The proposed action has been reviewed to Chapter 268, 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 "G" which states: G. Minor temporary uses of land having negligible or no permanent impact on coastal resources or the environment; 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 From: Greln Logic Energy LFax: (877} 77%4320 To: Elizabeth/rrus~ee; Depl Fax: +t (531> 76~-6641 2 of 8 8/2212012 11:52 Office Use Only A'JG - 8 £02 Sout~h0Id Tows Board of Trustees ~Coastal Erosion Permit Application __Wetland Permit Application ~ Administrative Permit I~ __Amendmentfl'rans~r/]~xtensioff ~Received Application:. ~_Received Fee:$ ~ ! __Completed Application __Incomplete __SEQRA Classification: Type 1 Type II Unlisted Coordination:(date sent). ~-LWRP Consistency Assessment Form CAC Referral Sent: ~ Date of Inspection: C~.] Receipt of CAC Report: Lead Agency Determination:__ Technical Review: ~ Public Hearing Held: Resolution: Address Phone Number:((,.~l) r.} t - ~"O ~ ~ Suffolk County Tax Map Number: 1000- PropertyLocation: ~'~ )- OC'~F--A/ '~'F') & ~ ~- (provide LIE~CO Pole Cf, distance ~o cross streets, and location AGENT: (If applicable) Address: Phone: ~oard of Trustees Applicationt GENERAL DATA Land Area (in square feet): ~ I~(~ ~'~ t Area Zoning: ~ ~r~ ~0~ ~0~~ Previous use of prope~: ~ ~ ~ ~ [~ Intended use of prope~: ¢~ I Dfi ~ C~ Covenan~ and Resthctions: Yes ~ No If"Yes", please provide copy. Does this project require a variance from the Zoning Board of Appeals __ If "Yes", please provide copy of decision. Yes / No Will this project require any~demolition as per Town Code or as determined by the Building Dept. Yes ,./ No Does the structure (s) on property have a valid Certificate of Occupancy ~ Yes No Prior permits/approvals for site improvements: _g ~ At'TA~-i/'I~I~ ~ ~U'CqOtl3 VOWi~ ~15(01~11) Agency Date __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspenCed by a governmental agency? ~/ No Yes If yes, provide explanation: Project Description (use attachments if necessary): od~ of w~d~: .~C~, f~ teaso~ of ~ ~,,,~,o~i oi~:tatiom (use ~ Board of Trustees Application 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? (cubic yards) How much material will be filled? .(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 SEQR ~ART 1 - PROJECT INFORMATION 1, APPLICANT/SPONSOR -- ~,'e~ I 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 3.PROJECT LOCATION;~ (~(~..,,.~{~l~ ~'f- 4. PRECISE LOCATION: S~et Addess and R~d Intersec~ns. Prominenl landmass etc -or pmvl~ mad IS PROPOSED ACTION: [] New r-lExpenaion r~Modiflcatkm/alteration 6. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? E~Yea [] No If no, describe briefly: RAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Chooaeasmanyasapely.) esl(Jential [~llnd~Jsb~al E~Commercial E~Agricullure •ParklForest/OpenSpa~ r~othe, (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, S~ate or Local) ]Yes [~No If list name and permit / yes, agency approval: 11. DOES A~____~SPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ]Yes ~No I! yes, list agency name and permit / approval: If the action la a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART II - IMPACT ASSESSMENT (To be completed by Lead A~lency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL EAF. [] Y .s 171.o B. WILL ,~CTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative declaration may be superseded by another involved agency. r']Yes ~]No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if !egib~e) C1. Existing air quality, surfaco or groundwater quality or quantity, noise levels, e~isfing traffic pattern, solid waste production or disposal, potential for erosion, drainage or fiooding problems? Explain bHetiy: I C2. Aesthetic, agricultural, archaeological, historic, or other nature or cultura resourcos; or community or neighbod~ood character? Explain bnefiy C3. Vegetation or fauna, fish, she ~sh or w Id ife species, significant hab tats, or threatened or endangered species? Expla n bce y C4. A communi[y's existi~ plens or goais'~s officially adopted, or a change in use or intensity of use of land or other natural resources? Explain ~xlafly; C5. GraPh. sub~q~ent develepment, or relatad acti~ties likely ~[o be indu~l by the proposed aclion? ~q~lain briefly: C6. Long form, short te~m. cumulative, or other effecta not identified in C'[-Cfi? E×plain D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA ICEAI? IIf )'es, explain briefl),: [~] Yes [~No I E. IS THERE, OR IS THERE LIKELY TO BE~ CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes ex{olain: PART III - D~= I ~_RMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adveme effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should bo assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (0 magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked yes, the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. Chec~ this box if yon have identified one or more potentially la rge or significant adveme impacts which MAY occur. Then proceed direclty to the FULL FAF aedlor prepare a posifi~ declaration. Check this box if you have determined, based on the information and analysis atxwe and any supporting documentation, that the proposed acfior WILL NOT result in any significant adverse environmental impacts AND provide, on atlachmerds as necassap/, the reasons supporting thi.~ determination. Board of Trustees Name of Lead Agency ~/' r Type Name of Respon~Officer in Lead Agency ~'Signature of Responsible Office//Ffn Lead Agency [] 5'~fl 7 '2.~,~ 7__ Date President [] Title of Responsible Officer Signature of Preparer (If different from responsible officer) Town of Southold Erosion,Sedimentation & Storm-Water Run-off ASSESSMENT FORM pROpERTY LOCATION: S,C.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A ~ qO --.~ ~ STORM-WATER. GRADING, DRAINAGE AND EROS ION CONTROL PLAN aec~on B~k L~t CERTIFIED BY A DESIGN PROFESSIONAL IN THE ~rATE OF NL~N YORK. SCOPE OF WORK ~ PROPOSF~ CONSTRUCTION ]*l'l!ki~# / WORKASSESS~ Yes No a. Whet Is the Totst Area of the Pro}ecl Parcels? (Include Total Ares of all Parcels located within , 0~ I GeneratedWill this ProjeCtby e TwoRetain(2")AlllnchSt°rm'WaterRainfall onRUn'Offsite'/ the Scope of Work for Piopesed Construclion) (S,F. I Acme) (This item will include all run-off created by site t/~ r'~ b. What is the Total Ama of Land Cisadeq clearing and/or can. struction activities as wei~ as all and/or Ground Disturbance for the proposed Site Improvements and the permanent creation of c~onstm~ion activity? Imbefvious surfaces.) ~a.F.,~,.,) 2 Does the stte Planand/or Survey Show AI] Proposed PRO'~JDE B]~.F PROJfi, CT DESCP, JYTION [Pm~* Add~=~ ~,,.mu) Drainage Stmcteras Indicating Size & Location? This imm shall include ell Proposed Grade Changes and l [~,~.'~-& ~.[ I~ ~ mO~"~' Slopes Controlling Smface Water Flow. and sediment control pmctlcas that will be used to control si~ erosion and storm water dlschmgas, This item must be maintained throughout the Entire Construction Period. 4 Will this prelect Require any Land Filling, Grading or Excavation where there Is a change to the Natural H Existing Grade Involving mom than 200 Cubic Yanks~ __ of Material within any Parcel? 5 WillthisApplicetionRequlreLandDistul~ngAcitvlttas D / Encompassing an Area In Excess of Five Thousand (5,000 S.F.) Square Fast of Ground Surface? 6 Is there a Na[ural Water Coume Running through the Site? Is this Project wi~ln the Trustees Jurlscliction or within One Hundred (100'} fast of a Welland or -- Isturban~sofone(1)ormomac~e~; i~cludlngdistud~a~cesoflesslhanoneac~that 7 Will there be Site preparatiDn on Existing Grade SIobes r~ are bert of a Is~e¢ commo~ plan that ,,,~11 ultimately disturb one or rrmm acme of land; which Exceed Fifteen (15) teet of Vertical Rise to J including Con~Ion activities involving sell dlstufoance~ ~ less ~han one (1) acre where One Hundred (100') of Horizontal Distance? L~J -- ~PP'i ~hllll Ilte~t tile lanlmum Requirements of the SPDES General Permit 8 Will Driveways. Paridng Areas er o~er Impel','ioas 1. The SWPPP shelt be prepem<l p~r lo the subntffal of the NOI. The NOi shall be [rite and/or in the direction of a To~n right-of-wa,/? -- Owner and/or representative o£the Ova~er or Owners, and is duly authomed to perform or have l~rt'ormed the ~ald work and to make and fde thi~ application; that all statement~ cm~tah~ed i~ fl~i,s application are m~e to the best of his knowledge and helie£; and that the work will be per£ormed in the manuer ~et £omh in the application £tled herewith. Sworn to be£ore me th~; FORM - 06110 No'tory ~No. 01 [~O6191941 Qualified m Suffolk County My Ool~ilelofl Expires August 25, 2012 ~oard of Trustees Applicatio~ County of Suffolk State of New York 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, I 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. Signature SWORN TO BEFORE ME THIS i ~k._ DAY OF ~ 20 I~'-- Notary Public MARINA KOKKINO~ Notary Public - State of New York No, 01KO6191941 Qualified in Suffolk County uy Col~lmlllion Expitet August 25, 2012 Board of Trustees Application 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 behalf. (Owner's signature) APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics t)rohibits conflicts of interest on the t~art of town officers and emolovees. The t~uroose 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 necessary to avoid same. (Last name, first name, middle initial, unless you are applying in the name of someone else or other entity, such as a company. If so, indicate the other person's or company's name.) 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 employee 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/agenffrepresentative) 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 (cheek 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 Form TS I Submitted this I..] day of ]M ,l,~ 200 I Signature ~ ~/',v~/~,v4{&· ,- -- Pr ntN~e L~t ~4~0 Town of Southold 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 Waterfi-ont 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 scm# it) 00 q O . - The Application has been submitted to (check appropriate response): Town Board [] Planning Dept. [] Building Dept. ~-~ Board of Trustees Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital [-~ construction, planning activity, agency regulation, land transaction) [-~ (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: Locationofaction: ~.~ ~ (~(-J.~g'~ ~-{-, ~ g'~'~"CXIDt~'''~ Site acreage:_ Present land use: Present zoning classification: ~'~,{dL-"r%'~ l- /qCI~-ct~-,~t..~r~,~ 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 [~ 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 [~Not Applicable Attach additional 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 necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III - Policies Pages 6 through 7 for evaluation criteria ~-~ Yes [] No [~Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III - Policies Pages 8 through 16 for evaluation criteria [] Yes [] No [ 'Not Applicable Attach additional sheets if necessary 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 ~Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore 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 sheets 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 hazardous substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. [] Yes [] No [~Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III - Policies; Pages 38 through 46 for evaluation criteria. [] Ye~ No [-~Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III - 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 Section III - Policies; Pages 57 through 62 for evaluation criteria. ~-~ Yes ~ No ~/Not Applicable Attach additional sheets 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 criteria. ~-~ Yes ~ No [--~Not Applicable Created on 5/25/05 11.'20 .dM GREENLOGIC E N E R G Y July 3, 2012 Town of Southold Town Trustees Town Hall 53095 Route 25 Southold, NY 11971 Dear Trustees: Please find attached a building permit application on behalf of Richard Windmuller who has engaged us to install a ground-mounted solar photovoltaic (PV) electric system for his home on 285 Queen Street Greenport, NY. In connection with this application, please find attached: · 2 applications · 2 Transactionaldisclosure Forms · 2 Short environmentalAssessment Forms · 2 LWRP Consistency Assessment Forms · 2 Survey of 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 327W) · 2 Spec. sheets of the inverters (SunPower SPR 4DOOm) · 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 Please let us know if you need anything else in connection with this application. Yours truly, Alexandra McNear Senior Account Manager GreenLogic LLC 631-771-5152 Ext. 107 SOUTHAMPTON/CORPORATE: CUTCHOGUE: MANORVILLE: NEW YORK CITY: ROSLYN HEIGHTS: /¢() C(t nly Rd 39A 1070 Delx)t Lm~e 40 Woodland Ay(nm 24] 6th Avenue #3B 200 S Service Rd i!108 ', hll, mlt()r NY 11968 Cutchogue. NY 11935 M,/m tv!lc NY 1 ]!}43 New York, NY 10014 Rosyln IIc~ghts, NY 11577 N $7 v ~z~.) AT, INS ~ s~~N N/O/F LENORE ANY ALTERATION OR AL)DITtON TO THIS SURVEY IS A VIOLATION OF SECTION 72090F 7F~E NEW YORK STA~ EDUCATION LA~ EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CERTIFICA HEREON ARE VALID FOb' ~lS MAP AND COPIES ~EREOF ONLY IF SAID MAP OR COPiE.9 E EAR ~E IMPRESSED SEAL OF THE SUR~YOR ~OSE SIGNA ~.'~E APF~'ARS HEF~EON. SURVEY OF PROPERTY AT ARSHAMOMOQUE TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. 1000-40-08-08 SCALE: I'=30' APRIL 30, 2009 AUG -8 2012 . Southhdd Town Board of Trustees APPROVED BY BOARD OF TRUSTEES TOW~ OF SOUTHOLD DATE CERTIFIED TO: R/CHARD WINDMULLER cAROLINE ROCHETTA CONTINENTAL HOME LOANS BIRDGER ABSTRACT, LLC STEWART TITLE INSURANCE COMPANY