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HomeMy WebLinkAbout37567-ZTown of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY 12/18/2012 No: 36090 Date: 12/18/2012 THIS CERTIFIES that the building SOLAR PANEL Location of Property: 285 Queen St, Greenport, SCTM #: 473889 Sec/Block/Lot: 40.-3-8 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 9/25/2012 pursuant to which Building Permit No. 37567 dated 10/9/2012 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: accessory solar panels as applied for. The certificate is issued to Windmuller, Richard & Rocchetta, Caroline (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 37567 12/5/12 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 #: 37567 Date: 10/9/2012 Permission is hereby granted to: Windmuller, Richard & Rocchetta, Caroline 14225 Soundview Ave Southold, NY 11971 To: construct an accessory Solar Panel ground array per Trustees approval as applied for At premises located at: 285 Queen St, Greenport SCTM # 473889 Sec/Block/Lot # 40.-3-8 Pursuant to application dated To expire on 4/10/2014. Fees: 9/25/2012 and approved by the Building Inspector. ALTERATION OF ACCESSORY BUILDINGS CO-ACCESSORYBUILDING Toml: $50.00 $50.00 $100.00 Building Inspector Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1502 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: Old or Pre-existing Building: V'/ (check one) LocationofProperty: ~_~ C~k~-~ ~>'~'- - ~--~l~.~C'~ House No. Street Hamlet Owner or Owners ofProperty: ~..~.C.-~d ~, (~'q~t'~D\' \e~'- q- Cf.k~(~/~O.~ Suffolk County Tax Map No 1000. Section t~(') Block O~ Lot Subdivision Filed Map. Lot: Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~-.~0 Underwriters Approval: Final Certificate: / (check one) ~bl~plicant Signature Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY I t 971-0959 Telephone (631 ) 765-1802 Fax (631 ) 765-9502 rofler, dchert~town southo d nv us BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION ssued To: Richard Windmuller Address: 285 Queen St City: Greenport St: NY Zip: 11944 3uilding Permit #: 37567 Section: 40 Block: 3 Lot: 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 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 Fixtures [~ HID Fixtures Wall Fixtures II Smoke Detectors Recessed Fixtures[~ CO Detectors Fluorescent Fixture ~.~ Pumps Emergency Fixtures~ Time Clocks Exit Fixtures [~ TVSS PHOTOVOLTAIC SYSTEM, to include, 12-Sunpower SPR 327 panels, 1-Sunpower 4000 inverter Notes: Inspector Signature: Date: Dec 5 2012 81-Cert Electrical Compliance Form.xls ,~/~OWN OF SOUTHOLD BUILDING DEPT.  765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING / STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ~_.._ELECTRICAL (FINAL) REMARKS: ROUGH PLBG. INSULATION FINAL FIRE SAFETY INSPECTION DATE iNSPECTOR~~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING / STRAPPING [ ] FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] IN~SULATION [~NAL ~~ ~/~ [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS.' ~ ~ Pacifico Engineering PC 700 Lakeland Ave, Suite 2B Bohemia, NY 11716 www. paciflcoengineering.com Engineering Consulting Ph: 631-988-0000 Fax: 631-382-8236 engineer@pacificoengineering.com December 4, 2012 Town of Southold Building Department 54375 Route 25, P.O. Box 1479 Southold, NY 11971 Subject: Solar Energy Installation for Richard Windmuller 285 Queen Street Greenport, NY 11944 Section: 40 Block: 3 Lot: 8 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 Paciflco, PE Professional Engineer NY 066182 / NJ 24GE04744306 TOWN'OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork. net Examined Approved /0/4,20~ Disapproved a/c PERMIT NO. 37 Jg 7 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: uilding Inspector PPLICATION 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 of a 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. eenLoc3t c- u (Signature of applicant or name, ifa corporation) ' (Ma ling address of applicant) State whether ap~plicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder b lSec Name of owner of premises · (As On the tax roll or latest deed) If applicant is ~a corporation, signature of duly authorized officer - Coo (Name anj title of corporate officer) Builders License No. C'{0 Plumbers License No. Electricians License No. ~ Other Trade's License No. L~t~n of lan~d on which proposed work will be ~[one: __ House Number Street Hamlet County Tax Map No. 1000 Section Subdivision Block Filed Map No. Lot O~ Lot James F. King, President Bob Ghosio, Jr., Vice-President Dave l~ergen John Bredcmeycr Michael J. Domino Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 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. Ii~ 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 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall Annex 54375 Main Road P.O. Box 1179- , Southold;~Ne~ York 11971-095~ ..... Teleph0, ne~(~31) 765-1892" CERTIFICATE OF COMPLIANCE # 0824C Date: December 11, 2012 THIS CERTIFIES that the installation ofa ~round 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. Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPEK'TY LOCATION: $.C.T.MI#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A ~/l~ ~ ~ ~2.2.~ qo~ STORM'WATER' GRADING~r DRAINAGE AN D EROSION ~"ON ' ~a"L PL"u~4 ~.,.,~M BIo~ CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW SCOPE OF WORK - PROPOSED CON$'i'u. UCTION ITEM# / WORKASSESSMENT [ Yes No a. WhatistheTotalAmaoftheProjoctParcals?' I Will this Project Retain All Storm-Water Run-Off (Include Total Area of all percels tocatnd wilhln Generatsd by a Two (2') inch Rainfall an Site? the Scope o! Work fc~ Proposed Canstmcllon) (3.v. i Acres} (This item wtil include all run-off created by site b. What is the Tofal Ama of Land Clearing clearing and/or caestruction aclivifies as wed es all and/or Ground Dlslur~anca for the proposed Site Improvements and the permanent creation of impervious surfaces.) c, onsitu c~ion activity? (s.F. / A~ss) 2 Does the Site Plan and/or Sun~ey Show Ali Proposed BP, I~ PRO./ECT DESCI~ON (P.,,l~ ~ ~-. N~ Drainage Struciures Indicating Size a Location? This PROVIDE Item shall include afl proposed Grade Changes and ?~C).~O(,..)~(~..¥iC~_~(~I~ ~..~[r'¥") 3 DoestheSitsPlanand/orSurveydesedbetheercaio~ - control site erosion and stcrm water dJscherges. This gem must be maintained throughout the Entire Construction Period. 4 Will th[s Project Requite any Land Fi,ling, Greding or D Excavation where there is a change to the Natural Existing Grade Involving more than 200 Cubic yin:Is of Material within any pamel? Encampasslng an Area in Excess of Five Thousand~ (5.000 S.F.) Square Feet of Ground Surface? 6 isthemaNaturalWaterCou~eRannJngthroughthe O Site? la this ~rol~t within the 'rmt~to~ luriedic~io~ or wi~in One Hundred (~ 00') f~t of a Wetland or -- risturbances of one (1) or mine acme; ~cludJng disturbances of less Ihan one ac~e ,aat 7 Will there be Site preparation on Existing Grade Slopes ~ are part of a ~arger common plan that will ultimately dlstu~ one or more acres of land: which Exceed Flftann (15) feet of Verticel Rles to I Incind~g Constmc~on activities involving scll ~SilJrbences ~ less than one (1) acm where Ofle Hundred (100') of Hodzontol Dlstsnca? I~l swPpP's Shill "ti~t the Minimum Requlremem of the SPOES General Per.it 8 Will Driveways, parking Areas oi' other Iropen~loca [--'"[ ST, ov COUNTY OF ........................................... SS Owner and/or rcpresentati¥c of the Owuer er Owners, and is duly authorized to perform or have p~d'onned the said wo~ and to make and fde this application; that all statements contab]ed in this application are true to the best of his knowledge and belie~, and that the work will be performed in the manner set forth in the application filed herewith. Swom to before me this; pG~RARAA C, ARCIOTIA FORM - 06/10 Notary Public, State of New York No. 01-CA4894969 Qualified in Suffolk Coun~ Commission Expires May 11, o%O/~ 5 43~ 5 M~Jn P.O. Box 1179 Sou:~old, N~ 119714)959 Tdcphonc (631) 765-1802 rD e ' (631) 7 BUTI .F~[NG DEPARTMEN~ TOWN OF SOUTHO~.r~ -APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Name: Name: License No.: 3.: JOBSITE INFORMATION:· (*Indicates required information) *Name: *CmssStmet: L0~y~. ~S/ ~. ~. ' *Phone No.: Tax.Map District: 1000 . Se~ion: *BRIEF DESCRIPTION OF WO~ (Please Print CleaHy) ~~ ~ '~Circle All That Apply) *Is job ready for inspection: *Do-you need a Temp Certificate: Temp Information (If neededl Rough In Final *Service Size: 1 Phase 3~0 150 200 300 350 .400 ;*New Service: Re-connect ~ergmU~p Number of Meters Change of Service AY" Addltienal Information: _. MENT DUE WITH APPLICATIOH Other Overhead 82q:~equest for Inspection Form P~ETLAND~ suRVEy OF' PROPERTY AT ARSHAMOMOOUE TO~N OF $OUTHOLD SUFFOLK COUNTY, N.'Y. I000-40-03-08 SCALE: I'=30' APRIL JO, 2009 ~ ' AUG - 8 ZOlZ -V- v _v.-V-/ -. Southhold Town : Board of Trustees _ _ ~ ~ .... '~ .......... ~PPROVED By ~b. = ./ , [ ..TOWNo~ sOre~0~ ,,  ~ ~/'-' ' :' ".'~., .4::':': '~ ~ ' ' .. .~.. : -',.. CERTIFIED TO; R/CHARD WINDMULLER ~AROLINE ROCHETTA CONTINENTAL HOME LOANS BIRDGER ABSTRACT, LLC sTEWART TITLE INSURANCE COMPANY A-D(INS ! L6NORE ~c STE~,I~N N/O/F .~NY ALTERATION OR AIJDITIOi'I TO THIS SURVEY IS A VIOLATION OF SECTION 720EOF Tt'IE NEW YORK'STATE EDUCATION LA~ EXCEPT AS PEri' SECTICN 7209-SUBDIVISION 2. ALL CERTIFICATIONS HEREON ARE VALID FOIl THIS MAP AND COPIES THEREOF ONLY IF - r~ ' I~.E IMPRESSED SEAL OF THE SURVEYOR SAID &~,AP OR L,O~ lES PEAR WHD$£ ~IGN,~ T;,fI,'E' APF£ARS tlEI-?EON. 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 of the County of Suffolk. State of New York is hereby licensed to conduct business as a HOME NOT VALID WITIIOuT DEPARTMENTAL SEAL AND A CURRENT CONSUMER AFFAIRS ID CARD IMPROVEMENT CONTRACTOR, in the County of Suffolk. Additional Businesses Direct~ OF LIABILITY INSURANCEM D'YYY' CERTIFICATE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ~.mt<'i"tFICATE 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 BE'rWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 I=.l~. (631) 941 4113 I ~F~. "o~: (631) 941'4405 Brookhaven Agency, Inc. E~RAJL P.O. Box 850 A~O.FSS~ brookhaven.agency~verizon,net PRODUCER 150 M~in Street cu~nuF. ~D #: East Setauket NY 11733 [NSURERfS) AFFORDING COVERAGE NAIC # INSURED INSURER A: Torus Specialty Insurance Co. Greenlogic, LLC INSURER B: Merchants Preferred Insurance Co. 425 County Road 39A, Suite 101 INSURER C: Commerce & Industry Insurance CO. Southampton, NY 11968 INSURER D: INSURER E: INSURER F: 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. GENERAL MABILn'Y EACH OCCURRENCE $1~000,000 A ~ COMMERCIAL GENERAL LIABILITY X 50817A121B 01131/12 01131/13 p. FMtRFRDAMAGE TO RENTEDiF= c~c~lrm.~l X I CLAIMS-MADE [] OCCUR UEDEXPtAnyoneperson} $5,000 X XCU PERSONAL & ADV INJURY $1,000,000 ~ CONTRACTUAL LIAB ;ENERALAGGREGATE ;2,000,000 AUTOIdlOelLE UABILITY COMBINED SINGLE LIMIT Ea accident) $1,000,000 B X i ANY AUTO CAPI043565 06/12/12 06/12/13 BODILY IN JURY (Per person) $ $ X UMBRELLA LIAB IX I OCCUR EACH OCCURRENCE $ 5,000,000 A -- EXCESSMAS~ CLAIMS-MADE X 50817A121A 01/31/12 01/31/13 AGGREGATE -- DEDUCTIBLE $ X RETEN~QN $10,000 AND EMPLOYERS' LIABILITY Y / N $1,000,000 C OFFICERIMEMBEREXCLUDED? Nl~ NIA ANY pROPR~ETOR/PARTNE~EXECU~V WC001602420 08/11/11 08/11/12 E g EACH ACCIDENT (Mandatoi'y In NH) E.L DISEASE - EA EMPLOYEI $1,000~0~ D~SCRIPTION OF OPERATIONS t3elOW E.L DISEASE - POLICY LIMIT $1,000,000 CERTIFICATE HOLDER CANCELLATION TOWN OF SOUTHOLD BUILDING DEPARTMENT 53095 ROUTE 25 SOUTHOLD, NY 11971 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE ~,~ ~ <NSZ> © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009~09) The ACORD name and logo are registered marks of ACORD 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 I nsu red (Only requiredifcoverage is specifically limited to certain locations in New York State, i.e., 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 -$152 lc. 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/I 1/2011 to 8/11/2012 3d. The Proprietor, Partners or Executive Officers are X included. (Oaly check box if aU partners/officers included) [] all excluded or certain partners/officers excluded. I 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 Item 3A on the INFORMATION PAGE of the workers' compensation insurance policy). The insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box "2". The Insurance Carrier will aiso noti~ the above certificate holder within I0 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons' other 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 Certificate is valid for one year after this form is' approved by the insuranee carrier or its licensed agen6 or until the policy expiration date listed in box "3c", whichever is earlier. Please Note: Upon thc 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 thc insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Peter Zulkofske Approved by: (S*gnatlfre) (Date) Title: Authorized ARent 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 Suffolk County Executive's Office of Consumer Affairs VETERANS MEMORIAL HIGHWAY * HAUPPAUGE, NEW YORK 11788 DATE ISSUED: This is to certify that 12/10/2007 No. 43858-ME SUFFOLK COUNTY Master Electrician License ROBERT J SKYPALA GREENLOGIC LLC doing business as having given satisfactory evidcncx 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. Addition 1 B inesscs NOT VALID WITHOUT DEPARTMENTAL SEAL AND A~ CURRENT CONSUMER AFFAIRS '~ ID CARD Director . GREENLOGIC® July 6, 2012 Town of Southold Building Department Town Hall 53095 Route 25 Southold, NY 11971 Dear Building Inspector: 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 at 285 Queen Street, Greenport, NY. 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) · FourVisio Diagrams of the proposed system · Two spec. sheets of the solar panels (SunPower SPR-327w) · Two Spec. sheets of the inverter (SunPower SPR400Om) · 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 $100 ($50 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~ ~Near Senior Account Manager GreenLogic LLC 631-771-5152 ext. 107 8777714330 Fax 8777714320 SOUTHAMPTON/CORPORATE: ,I;b ()ounty Rd 39A S~,uth*rr r:ton NY 11968 CUTCHOGUE: 1070 Depot Lane Cutchogue, NY 11935 MANORVILLE: 40 Woodland Avenue Marlorviile NY 11949 NEW YORK CITY: 241 6th Avenue #3B New York, NY 10014 ROSLYN HEIGHTS: 200 S Service Rd #108 Rosyh' Heights, NY 11577 C GREENLOGIC® ENERGY December 12, 2012 DEC 1 4 2012 Town of Southold Building Department 54375 Route 25, PO Box 1179 Southold, NY 11971 Dear Building Inspector, I've attached here the engineer certificate, electrical certificate and trustee Certificate of occupancy for the solar system we installed for Richard Windmuller at 28S Queen Street, Greenport, NY. We have requested an inspection for December 17th. Please close out this permit and send a certificate of occupancy once the inspection is complete. If you need anything else please let me know. Sincerely, Alexandra McNear Senior Account Manager 631-771-5152, ext. 107 Tel: 877771.4330 Fax: 877771.4320 SOUTHAMPTON 425 Com-ty Rd. 39A S)uthampton, NY 11968 ROSLYN HEIGHTS 2(/0 S Service Rd. Rosyln Heights. NY 11577 Pacifico 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 Engineering Consulting Ph: 631-988-0000 Fax: 631-382-8236 engineer~paciflcoengineering.corn RETAIN STORM WATER RUNOFF PURSUANT TO CHAPTER 236 OF THE TOWN CODE 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-O5 when installed in accordance with the manufacturer's instructions. The climactic and load information is below: CLIMACTIC AND GEOGRAPHIC DESIGN CRITERIA Ground Mount A Solar Array Ground Catego~j Snow Load, Pg C 20 Ralph Paciflco, PE Professional Engineer wind Speed, 3 sec gust, mph 120 Liveload, pnet3Oper ASCE 7, psf 21 APPROVED AS NOTED DATE'/.~/,~/~'~'" B.P. # ~ 7~-~/o ~' FEE' ~ , , ~" NOTIFY BUILDING DEPAR~[NT ~T ~55-1802 8 ~ TO 4 PM FOR THE F OLLO~NG INSPEC FIONS: 1 FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2 ROUGH - FRAMING PLUMBING, STRAPPING, ELECTRICAL & CAULKING 3. tNSU~TION 4. FINAL - CONSTRUCTION & ELECTRICAL MUST BE COMPLETE FOR C.O. ALL ~STRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YO~ STATE. NOT RESPONSIVE FOR ~SIGN OR CONSTRUCTION ERR~ iCATE ELECTRICAL PECTtON LOGIC: DRAV~NG NUMBER: I OF 3 GROUNDM~NT ~YOUT *A~ays double check measurements GmenLogic, LLC - Approved 3.924~ Panel Dimension =61.39"x41.18" Layout 12 S unPower 327w Array Length = 252.08" DPW Ground Mount Array He~ht = 122.78" Richard ~ndmul~r ~imuth = 180° Suda~ Dimensions = N/A 285 Queen Strut Pitch = 30~ Magic ~ = N/A Greenpo., NY Scale 3/16" = 1.0' ISSUES/SPEC~LI~RUCTIONS PROJECT C~P~ENT COUNT ~ Sunpo~r 327w A) A~chment ~pe and count: · A~h~nt Pant B) Rail ~ and count: DPW Ground Mount . , D~ P~r Rail Layout Cmat~ By: MVP Date: 7-12-12 LOGIC 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 DEAW~N(~2oFNUMBER:3 J GROUNDMOUNT DETAIL GreenLogic, LLC - Approved Layout Richard Windmuller 285 Queen Street 3.924kw 12 SunPower 327w DPW Ground Mount Azimuih = 180° Pitch = 20° Greenport, NY NOT TO SCALE PROJECT COMPONENT COUNT A) Attachment type and count: B) Rail type and count: DPW Ground Mount Layout Created By: MVP Date: 7-12-12 *always double check measurements Panel Dimension =61.39"x41.18" Array Length = 252.08" Array Height = 122.78" Surface Dimensions = N/A Magic # = N/A ISSUES I SPECIAL INSTRUCTIONS ~ Sunpower 327w · Attachment Point DPW Power Rail LOGIC DRAVVING NUMBER: 3 OF 3 ~ROUNO~OUNTSTmNG~N~ 2X6 on SPR4000m *Always doubl~ check measurement~ 3.024~ _reon__~.e, -...ro~ ~anel Dimension Layout 12 SunPower 327w~ z~na"~ u,-~en"*~ = 252.08" DPW Grou~ Mount Anay Height = 122.78" R~hard Windmul~r ~imuth 1 SuEa~ Di~ns~ns 285 Qu~n Street P~ch = 30~ Magic ~ = N/A A) A~ch~nt ~pe and ~unt: ~ Sun~r 327w · A~ment Point B) Rail ~pe and count: DPW Ground Mount , DPW P~er Ra~ END CLAMP TYP. SPR327 MODULE ~ RAILBRACKET TYP. MODULE LENGTH TYP. 48" 30° 123.01" 96" SIDE VIEW 79.53" SUPER POST DIRECT POWER AND WATER 4000 VASSAR DRIVE NE ALBUQUERQUE. NEW MEXICO 87107 P8-TTRGM 12-G-SU NPOVVER- SPR327-OP-30°-120MPH-25PSF GREENLOGIC ~IINDMULLER '" /' 252" FINAL CUT (2 x 126" = 252' STANDARD LENGTH) MODULE ' TYP P8 POWER RAIL MIO CLAMP TYp. 41.18" I 61.38" MOOULE P8 POWER RAiL TYP. END CLAMI TYP. RAIL TYp. RAIL TYP. FRONT VIEW ~kl DIRECT POWER AND WATER 4600 VASSAR DRIVE NE ~"'"'~ I ~aUQUERGUE, NEW MEXICO e?lo? DPW -'= P8-TTRGM 12-C--SUNPOVVER- SOLAR SPR327-OP-30°-120MPH-25PSF GREENLOGIC WINDMULLER CML o~; 7-t3-12 J.R. I'"~' 2 5/16" TURN BOLT -~ SEE Vl~ A CROSS B~CE P6 PO~R ~IL , (~ERY OTHER BAY) 64" TYP. 4 LEGS yP14 STRONGBACK LEG 3"xl.5'~(130" ALUM. CHANNEL BACK VIEW (PARTIAL, NOT TO SCALE) ~1 DIRECT POWER AND WATER 4~O0 VASSAR DRIVE NE ~-~1 ALBUQUERQUE, #EW MEXICO a7t 07 DPW ~- ~ SOLAR SPR327-OP-30°-120MPH-25PSF GREENLOGIC WINDMULLER 20% EFFICIENCY SunPower E20 panels are the highest efficiency panels on the market 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 highesl~effic[ency 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 Maxeon~Mcell technology and advanced module design ensure industry-leading reliability MAXEON~ CELL TECHNOLOGY Patenled all-back-contact solar ceil, providing the industry's highest efficiency and rehabih~y SERIES THE WORLD'S STANDARD FOR SOLART'~ SunPawerTM E20 Solar Panels provide today's highest efficiency and performance. Powered by SunPower Maxean~'~ 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 ri 22.5 % Panel Efficiency ri 20.1% Rated Voltage Vmpp 54.7 V Rated Current Irnpp 5.98 A Open Circuit Voltage Voc 64.9 V Short Circuit Current Isc 6.46 A Maximum System Voltage UL 600 V Temperalure Coefficienls Power (P) - 0.38%/K Vollage (Voc) -176.6mV/K Current (Isc) 3.5mA/K NOCT 45° C +/- 2° C Series Fuse Rating 20 A Grounding Positive grounding not required MECHANICAL DATA 96 SunPower MaxeonT~ cells High-transmission tempered glass with anti-reflective (AR) coating lpg,5 rated with 3 bypass diodes Dimensions: 32 x 155 x 128 mm 1000 mm cables / Multi-Conlact (MC4) connectors Anodized aluminum alloy type 6063 (black) 41.0 lbs (18.6 kg) Solar Cells Front Glass Junction Box Output Cables Weight I V CURVE 5 4 3 2 1 0 0 10 20 30 40 50 voltage (V) 6O 70 TESTED OPERATING CONDITIONS Temperature Max load - 40° F te +185° F J- 40° C te + 85° C) 113 psf 550 kg/m2 (5400 Pa), front (e.g. snow) w/specified mounting configurations 50 psf 245 kg/m2 (2400 Pa) front and beck (e.g. wind) Impact Resistance Hail: (25 mmI at 51 mph (23 m/s) WARRANTIES AND CERTIFICATIONS Warranties 25-year limiled power warranty ! O-year limited product warranty Certifications Tested to UL 1703. Class C Fire Rating DIMENSIONS MM (Al - MOUNTING HOLES (B) - GRGUNDING HOLES (IN) 12X O6,6 [,26] 1RX ~4,2 [,17] Please read safety and installation instructions before using this product, visit sunpowercorp.com for more details. [ GREENLOGIC® V ENERGY ELIMINATING 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 327VV Winmuller, Richard DPVV Ground Mount Array 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