Loading...
HomeMy WebLinkAbout37841-Z~® Town of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 36471 Date: 8/28/2013 8/28/2013 THIS CERTIFIES that the building SOLAR PANEL Location of Property: 1655 Old Farm Rd, Orient, SCTM #: 473889 Sec/Block/Lot: 26.-4-1 __ - - Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 2/28/2013 pursuant to which Building Permit No. 37841 dated 3/5/2013 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: roof mounted electric solar panel system as applied for. The certificate is issued to Thompson, Elizabeth & Fahs, Marianne (OWNER) of [he aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 37841 8/19/13 Aut ri7kd Si ature ~~ ~.~; ":. ~ ,: ~r ,~, . Permit #: 37841 Permission is hereby granted to: Thompson, Elizabeth 8~ Fahs, Marianne 165E 118th St New York, NY 10035 Date: 3/5/2013 To: construct a roof mounted electric solar panel system as applied for At premises located at: 1655 Old Farm Rd, Orient SCTM # 473889 Sec/Block/Lot # 26.-4-1 Pursuant to application dated 2/28/2013 To expire on 9/4/2014. Fees: SOLAR PANELS CO -ALTERATION TO DWELLING Total: Building Inspector 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) and approved by the Building Inspector. $50.00 $50.00 $100.00 form No. b TOWN OFSOUTHOLD 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 user 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. Approvalofelectrical installation from Board of Fire Underwriters. 4. Sworn statement Gom plumber certifying that the solder used in system contains less than 2/10 of I % lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from'arohiiect or engineer responsible for the building. 6. Submit'Planning Board Approval of completed site plan requirements. B. For ezisting buildings (priorto April 9, 1957)'non-conforming uses, or buildings and •`pre-existing" land uses: I. Accurate survey ofproperty showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by [he applicant If a Certificate of Occupancy is denied, the Building Inspector shall state [he reasons therefor in writing to the applicant. C. Fees I. Certificate of Occupancy -New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00, Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, 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 Oceupancy -Residential $15.00, Commercial $15.00 Date. ~ ~ J r'~ New Constritction: 1 /Old or Pre-existing Building: (check one) Location of Property: `~r77 ©~~ ~G~((Y1 ~Z(~ ~I~I~YI~ House Owner or Owners of Property: L ~11~cA ,: i Suffolk County Tax Map No 1000, Section ~ 'Block - Lot "`Subdivision Filed Map. Lot: Permit No. ~~ ~ Date of Permit. Applicant-. Health Dept Approval: _ Planning Board'Approval: Underwriters Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ Applicant Signature Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 °~~ ^ cO°y o 0 N o ~ ~ = ~ ~~~0! # ,r .~~}t~ Telephone (631) 765-1802 Fax (631)765-9502 rr~er.richertCa7town.southol d. nv.us BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Thompson Address: 1655 Old Farm Rd City: Orient St: NY Zip: 11957 Building Permit #: 37841 Section: 26 Block: 4 Lol: 1 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: $UnatlOn Solar SyStenlS License No: 33412-me SITE DETAILS Office Use Only Residential X Indoor X Basement Service Only Commerical Outdoor X 1st Floor X Pod New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage L`PI~:YT~ Service 1 ph Heat Duplec Recpt Ceiling Fixtures HID Fixtures Service 3 ph Hd W ater GFCI Recpt Wall Fixures Smoke Detectors Main Pand A/C Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel A/C Blawer Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixures Time Clocks Disconnect Switches Twist Lock Exit Fixtures TVSS other Equipment: 2940 watt roof mounted photovoltaic system to include, 12 Trina 245 wattpan els 1-Fronius IG 3000 inverter Niles: Inspector Signature: ~~.qc~ ~$,~~ Date: Aug 19 2013 Electrical Certificate.xls ~~/~~ n^, ~, TOWN OF SOUTHOLD BUILDING DEPT. "1 ~'~ 765.1802 "~ INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING /STRAPPING FIREPLACE & CHIMNEY FIRE RESISTANT CONSTRUCTION ELECTRICAL (ROUGH) [ ]ROUGH PLBG. [ ]INSULATION [ ]FINAL [ ]FIRE SAFETY INSPECTION FIRE RESISTANT PENETRATION ELECTRICAL (FINAL) REMARKS: ~l~.Cl~- C-~Lr~, --- c~ ~~ ~ti~s~,¢7CL--~ /~ ~~~ r DATE INSPECTOR Fisher Engineering Services, P.C. PO Box 30.Oakdale • New York 11769 Phone: (631)563-9028 June 18, 2013 Building Department Subject: Engineer Statement for Solar Roof Installation Thompson Residence: 1655 Old Farm Road Orient ,New York 11957 Permit: 37841 I have verified the adequacy and structural integrity of the existing roof rafters for mounting the solaz collector panels and their installation satisfies the structural roof framing design load requirements of the Residential Code of New York State. I have reviewed and certify that the manufacturer's guidelines and equipment for the photovoltaic equipment for the above residence meet the requirements for wind and snow load and that the roof structure is adequate to carry the new loads imposed by the System. For the installation of the solar mounting, the rails aze securely anchored to the rafters utilizing lag screws that have been designed for wind speed criteria of 120 mph Exposure C and snow ground criteria of 20 psf. Wind loads will exceed seismic loads. Other climate and geo design criteria are not applicable to this solar installation. The solaz collector system and the mounting assemblies comply with the applicable sections of the Residential Code of New York State- "Solaz Systems" and loading requirements ofroof-mounted collectors. This system has been installed properly at the above referenced residence. The installation is in accordance with the minimum requirements certified by this letter. I hope that this letter serves and meets with the approval of the Building Department. ,.:. w s Since~re~/lJy, ~Q ~* 'S'am ! F~ rA~ ~ m ~ ~ ~. William G. Fisher,~E.~ ~tis ~~ Licensed Professional Engineer ~`°o o>a~5~ ~~- n ~~/ _i if I f ~j'I AUG 1 9 2013 ~' Additions • Extensions • Conversions Construction Estimates /Oversight • Expediting • Inspections rr !;~o ~ovrm~~ t~ gp~A'1`I4PT {,ANA) G& ROiTp2,~J~BING us~'~~'~~ ~pE STA'i"~ gQtAL ~ro~ s# _a s-' ~~ ~~ I ~ 4 1 a i~ ~~ ~~ ~~ 1 (max ~~ I TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following, before applying? TOR~•N HALL• Board of Health SOUTHOLD, NY 11971 4 sets of Building Plans Yes TEL: (631) 765-1$02 Planning Board approval FAX: (631)7659502 2 Survey Yes ~ 7 SoutholdTown.NorthForh.oet PERMIT NO. J 8 I Check Yes Septic Porm N.Y.SD.E.C. Trustees Flood Permit ' Examined , 20 3 Storm-Water Assessment Form ~ ~ ~ Contact: SUN ti S l S I ~ ~ Approved .~/ to , 20 1 _ ar a on o ystems, nc. Mail to: Disapproved arc 1217 Montuak Hwy., Oakdale, NV 11769 Phmne:631-750-9454 Expiration ,20 n~-f.,, ~,'~.i,;.~,~ Buildinglnspector ,1 '' 11,• APPLICATION FOR BUILDING PERMIT 8 Z r ~ I I ><i Date February 25, , 2013 , INSTRUCTIONS lcation M be completely filled in by typewriter or in ink and submitted [o [he Building Inspector with 4 sets 1 tale. Fee according to schedule. TO %~'~~~ ht-IS mg location of lo[ and ofbuildings on premises, relationship [o adjoining premises or public streets or ~Re'dS, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of [his application, [he 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 pan 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 wmmenced within 12 months aRer the date of issuance or has not been wmpleted within I8 months Rom such date. I f no zoning amendments or other regulaioms affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit far an addition six months. Thereafter, a new permit shall be required. APPLICATION IS HEREBY MADE [o the Building Department for the issuance of a Building Perini[ pursuant to [he Building ?.one Ordinance ofthe 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. 1'he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, an~.tq admit authorized inspectors on premises and in building for necessary inspections. ~ ~ r< ~y ...i ~7'aH uy,»L9 S[a[e whether applicant is owner, lessee, agent, architect, engineer, general c~tAr~tov~' ice, nlumbCr bui r General Contractor d--~t3 F' 7F Name of owner of premises Elizabeth Thom son NOTIFY FIiiIL')!D:.; DEPARTMENT AT (As on the tax roll or lam E-.~_i G 4 PM FOR THE If applicant is a corporation, signature of duly authorized officer Scott Maskin, President SUNation Solar Systems (Name and title of corporafelgA5cer) Builders License No. 44104-H Plumbers License No. N/A ~ - Electricians License No.33412-ME - . ! Other Trade's License No. N/A - - I. Location of land on which I 1655 House Number Street workwill be done: rOLLU~nn lv„ M-; t,FECTIONS: 1. FOUN)F' ION -TWO REQUIRED FOi~i POUr1ED CONCRETE 2 ROUGH - r RA4711JG. PLUMBING, STRAPPIP~G ELECTRICAL & CAULKING 3. INSULATIGN 4'-FINAL -CONSTRUCTION & ELECTRICAL MUST BE CGMPLETE FOR C 0. ALL CONSTRUCTION SHALL MEET THE EOI'IREMENTS OF THE CODES OF NEW w°rd'-~-- ~---- OR CONSTRUCTION ERROF.S- County 'Lax Map No. 1000 Section 026 Block 4 Lot 1 Subdivision Filed Map No. Lot 2. Stale existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Residential b. Intended use and occupancy Residential 3. Nature of work (check which applicable): New Building Addition Alteration ~/ Repair Removal Demolition Other Work Solar Panels flat on roof (Description) 4. Estimated Cost $'19950 Fee ~/OD (To be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front Rear Depth I0. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_ NO~/ 13. Will lot be re-graded? YES_ NO~WiII excess fill be removed from premises? YES_ NO ^/ 14. Names of Owner of premises Elizabeth Thompson Address 1655 old Farm Rd., orient phone No. 917$48-15at Name of Architect wiuiam G. Fisher Address Po sox ao, Oakdale 1175tphone No sat-7asaals Name of Contractor SUNatbn Solar Systems, Inc Address 1217 Montauk Hwy, Oakdphone No. 631-7509454 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? •YES NO * IF YES, SOUTHOLD TO WN TRUSTEES & D.E.C. PERMITS MAY~RF,QUIRED. b. Is [his property within 300 feet of a tidal wetland? •YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17- If elevation at any point on property is at 10 feet or below, must provide topogrnphical data on survey. 18. Are there any covenants and restrictions with respect [o this property? •YES NO ^/ • IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF Suffolk I SCOtt McSkin, SUNation Solar being duly sworn, deposes and says [hat (s)he is the applicant (Name of individual signing wnnact) above named, (S)He is the Contractor (Contractor, Agent, Corporate OtTicer, 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. Town Hall Annex 54375 Main Road P.O. Box tt79 Southold, NY 11971A959 ~Of StfUly~ 1#r # ~~I,~~ BUII.DING DEPARTMENT 'TOWN OF 30UTH0][.D APPLICATION FOR ELECTRICAL INSPECTION ~__~_ ~ C\Il~(I~ 7L dUl 15 2U13 ;~ ~ ~~r c 521~un ~ lil!OlD REQUESTED BY: ~i f~ Date: `7 {/ /3 Company Name: a Name: ~ License No.: 3 2 - M~ Address: Z.l'1 ,~~ b Phone No.: ~ tp- $ JOBSITE INFORMATION: (*Indicates required information) *Name: *Address: *Cross Street: *Phone No.: Permit No.: Tax Map District: *BRIEF DESCRIPTION OF WORK (Please Print Clearly) lZ7r'raru 2~5~.~t ~-FY'vnri.~~.i-~+3.oe~act rve/ter- /kcr(u.(et (Please Cfrcle All that Applyj *Is job ready for inspection: YES NO Rough in Final *Do you need a Temp Certificate: YES NO Temp Information dj ' *Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other *New Service: e-connect Underground Number of Meters Change of Service rh d Additional Information: PAYMENT DUE WITH APPLICATION a,ti c <~ ~i L~ 3 82-Request for Inspection Form n ~ p , I x'13 `I " tL (~_~~ .~ SUNATION SOLAR SYSTEMS Powering your world February 24, 2013 Building Department Town Hall Annex Building 54375 Route 25 P.O. Box 1179 Southold, NY 11971 Re: 1655 Old Farm Road, Orient, NY 11957 Dear Sirs: Enclosed please find a building permit for the installation of a Solar System on the above referenced location. If all is in order please return receipt in self- addressed stamped envelope Thank you for your consideration in advance. Very truly yours, ~!~".",vim-. Christine Cathcart New York State Insurance Fund - _ _-_ Wnrkecc' Compettsatinn & Disabiliry• Benefrts Specinlists Since 1914 199 CHURCH STREET, NEW YORK. N.Y. 10007-1100 Phone: (866)997-3a63 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ^^^"^^ 753118816 SUNATION ROOFING SERVICES INC 1217 MONTAUK HIGHWAY OAKDALE NY 11769 _ _ ___ _ _. POLICYHOLDER SUNATION SOLAR SYSTEMS INC '~ 1217 MONTAUK HIGHWAY OAKDALE NV 11769 I .CERTIFICATE HOLDER ' TOWN OF SOUTHOLD 54375 ROUTE 25 SOUTHOLD NY 11971 POLICY NUMBER '. CERTIFICATE NUMBER Z 2160 670.2 775751 PERIOD COVERED BY THIS CERTIFICATE 09/06/2011 TO 01 /01 /2015 DATE ~ 11/26/2012 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2160670-2 UNTIL 01/01/2015, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF SAID POLICY IS CANCELLED, OR CHANGED PRIOR TO 01/01/2015 IN SUCH MANNER AS TO AFFECT THIS CERTIFICATE, 10 DAYS WRITTEN NOTICE OF SUCH CANCELLATION WILL BE GIVEN TO THE CERTIFICATE HOLDER ABOVE. NOTICE BY REGULAR MAIL SO ADDRESSED SHALL BE SUFFICIENT COMPLIANCE WITH THIS PROVISION. THE NEW YORK STATE INSURANCE FUND DOES NOT ASSUME ANY LIABILITY IN THE EVENT OF FAILURE TO GIVE SUCH NOTICE. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUND ~~~~~~~~ DIRECTOR,fNSURANCE FUND UNDERWRITING This certificate can be validated on our web site at https://www.nysif.corn/cert/ceMal.asp or by calling (888) 875-5790 VALIDATION NUMBER: 587614295 U-2s.3 484ICD45944-20/1198 j i I This certifies that the bearer is duly licensed by the County of Suffolk ClifFord Coleman a.a. SUfFOLKCOUNTY DEPARTMENT OF CONSUMER AFFAIRS MASTER ELECTRICIAN .... SCOTT A MASKIN w`ncst.wc SUNATION SOIAR SYSTEMS INC 334t2-ME os/za2oo3 cuw+en an 06/01(2013 '. ~ ! ;., t~ sc~ -~~'~! Suffolk County Department of Consumer Affairs ~= ~~~ ~__ ~- ~~' VETERANS MEMORIAL HIGI IWAY * 1IAUPPAUGE, NEW YORK 1 1788 ~~~ _ ~, ~~ r~"i, DATF, ISSUED: 3/6/2008 No. 44104-H t~~' ~ ~,' ~ SUFFOLK COUNTY e,r~, Home Improvement Contractor License ~,:~, C'r ~ ~a~i I~his is to cct2il\~ that' SCOTT A MASKIN f. ~~"+. doiu~ business as S[INA'fION SOLAR SYSTEMS INC ~;~~;~' having furnished the requirements set bath in accordance with and subject to the provisions of apphcablc laws, rules r - and 1'egulations of the County of SuFfolk, State of New York is hereby licensed to conduct husincss ati a I IOMIr. ~' 1MPRUVt?MGN'I' CON'fRn('~I'OR. in the County oCSuffolk. r~,~ , - = License C;tteun ~3;' Other t ~ NUT VALIID WITHOUT ~ddiliunal Businesses ~/,, Uf•,PARTMEN"PAL SGAL 'r-' ANDACURRF.NT ::E;- i CONSUMI?R AFFAIRti r ~ '. IU CAR11 ~ ~~ ~' ~~~~ ~ ~~...y~ ~- _ ~~ A Y~ F?~~~ (~~rJ) 111StlOnl'F ~ ~. ~ ~~ „y,> i ~ y~~. ' ,irk; r :~~i ~ ' .. -• ,-- l \ ~ ~ l J"' ~~~ STATE OF NEW YORK WORKER'S COMPENSATION BOARD CERTIFICATE OF INSURANCE COVERAGE UNDER THE NYS DISABILITY BENEFITS LAW PART 1.To be completed by Disability Benefits Carrier or Licensed Insurance Agent of that Carrier -----_ _ 1a. Legal Name antl Address of Irtwretl (Use sVeet adtlress only) 16. Business Telephone Number of Inwred SUNATION SOLAR SYSTEMS INC 631-737-9404 tc. NYS Unemploymem Insurance Employer Registration 1217 MONTAUK HIGHWAY Number of Insured OAKDALE, NY 11769 '.. 1d. Federal Employer Idemificetion Number of Insured ', or Social Security Number 753118816 2. Name and Address of the Entity requesting Proof of Coverage (Entity being listed as the Certificate Holtler) Town of Southold 54375 Route 25 Southold. NY 11971 3a. Name of Inwrance Carrier The First Rehabilitation Life Inwrance Company of America 3b. Policy Number of Entity listed in box "1a": DBL243442 3c. Policy effective period: 11/28/2012 m 11/27/2013 _ - ___ 4. Pol icy covers: a. ~ All of the employer's employees eligible under the New Yark Disability Benefits Law b. ~ Only the following class or classes of the employer's employees: Under penalty of perjury, I certify that 1 am an authorized representative or licensed agent of the insurance carrier referenced above and that the named irrwretl has NVS Disability Benefits inwrance coverage as tlescribetl ab~~o/ve~ Date Signed 2/24/2013 BY-____.-.-_- ~~°"'~"""~°P1tl~ (Signature of insurance cenier's authorized represemative or NVS Licensed Insurance Agem of Mat telephone Number-__ 516-829-8100 - ___- Tnle Chief Executive Officer I MPORTANT:If box "4a" is checked, and Mis form is signed by the inwrance cemier's authorizM representative or NVS Limned Imurence Agent of that Cartier, Mis certificate is COMPLETE. Mail i[ directly to Me certificate holder. If box "ab' is checked, Mis certificete n NOT COMPLETE far the purposes of Section 720. $ubd.8 of the Disability Benefin Law. It must be mailed (p corrgrlRion W MB Worker's Compemation Board, DB Plam Acceptance Unit, al Pxk Street, Albany, NV 17207. PART 2. To be completed by NYS Worker's Compensation Board (Only if box "4b" of Part 1 has been checked) State of New York Worker's Compensation Board Axording to information mairdained by Me NVS Worker's CompensMion Board, the above-named employer has complietl wiM Me NYS Disability Benefin Law with respect b all of hisMer ertgdoyees. Date Signed _______._ By_-._- (Signature W NVS Worker's Comperwtion Board Employee) Telephone Number Title _,_ Please Note: Only insurance caniers licensed to write NYS Disability Benefits insurance policies and NYS Licensed Insurance Agents of those inwrance carriers are athorized to iswe Form DB-120.7. Inwrance brokers are NOT authorized M issue Mis form. DB-120.1 (5-06) v ". td ...., _ ~: .. ~f.. 'li. Y.~ '. Y}29 . 4T i ~7 .. _. . 'F -SQ- NO. I H.~ . 1 ,' ~~ o ~a~~ , pr , ~r ~ e~ ~. ~~°~~~. ___. _. __._ 4 _.__~ StAT1aMENT pP INTENT ~ ~ ~. ~.~ ~~. ~ l~ ~ h b ~ ' THE YdATE'R SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR TMIS RESIDEN ~ ~~ ~ x s. ox ~+e CE WILL ~ ,ry ~ ~ ,~ ~ C'ONFQRM TO THE &tANDARDS OF THE .'' G~ ,} ~~~~ SUFFALK CO. DEPT. pF HEALTH SERVICES. ~ N ~ (s) APPL-C11NT \ ice' `, g~ ~ er•r~- ~ + F !TUFP04K COUNTY DEPT. OF HEALTH _.~, ~_ F ~ APPROVAL OF 11 R ~~ CONSt~tUCTIONLiNLY- G7 = rocbnume~rrf ~;:tarfk. ~ . ^ ~ = iron ~~ , ~ p~ 1 ~ Q '~ SUFFOLK CO. 'TAX MAP DESIGNATION: ~~j - ~ ~ - U DIS7. SEEt. COCK PCi.. y (O~Ip D2fo •4 ! _~-- ~ ~/ ~~a ~ ~' OM-N6RS AD>iy1RESB; ~ ~ ~~ ~. ~'1" / X11 900 We 3-f- oaf Avd. -- 2A '~!/y~ ~ E~ New York. ~l.Y. IOO " -7 ,~~ ~~~ ~ DEED: L. ~'~l~A P. (% J(J _ ~~ sec~wn 7zo8 d tha -1e~r rark Strp /JJ ( \~ ~\.\ ~• ~ ECapes o/SiM q~YSYn~p not 6eeHrq ,Q e ~~V '7-.~ ~ - e~mboceetlswiihir~e Ys~~NMwed. < "'' 1 _ \ V 3JL?R;,~ ~ totaraawdwoopK t #~ F ` ~ ~L'U~l ~_ o~rrom~.owrorwMmd~e°""" . ',: r '~ \.,` l~ ~. ~, ~-.._...._... _..... ~1. ~orewnaane an N. uen.nte th`~ S a sw~~vm,a \'' `•' \ ,~~ .\la ~! wi~.~uarmreesd.~'re rnt~tr,~neter~'anls _ J. \. ~~ `~. .. ~ # to aaa'aWn.~in.okuua. or.utwyq,,,nl house) ~ s. Jff/ ' ~ ~' ,~ratt~ ~~ ~ clt .'~ 4'. ~y '~ha>~• ~~n~mF MEAL j ~ ~ ~.Y`y"''~I Y ~ -~n-+~w.~...~T. ,~, ~Q. ~~I~~'~ •Y~ ' '.. T I tt •~4 i \\\_ 9 r -. KT'F [~4. ^: 'Y, kj. i4 '~7 "tic. .../ }.. f 3/ i X ~~~', .S ,~ F i+. L -::( p 3#~+~. ly. - ''F -'. . .. M. .. F 4 "F .. - ..-.. ,. .. :...: w. . Fronius IG Pfus PV Inverter 7 S2 ~ rst corr~~lete salutior,. ~rliable. *'r ~~.~~n. Smart An outstanding addition to [he family: The next generation Fronius IG Plus inverter builds on a / ~1 successful model with multiple enhancements, including maximum power harvest, abuilt-in six circuit string combiner, integrated, lockable DC ++.... ti; i Disconnect, significantly improved efticiency, and unbeatable reliability. New, larger power stages expand the proven Fronius IG family from 2 to ~~' , 12 kW in a single inverter. t / I POWERING YOUR FUTURE P~ http:/lwww.wholasalesolar.cotrYxrverhxs.html w http://www.wholesalesolar.wMinverters.htrnl INPUT DATA frmius IG Plus ~ 3.0-1 ~ ' 3.8-1 ~ ~ 6.0-1 utu ' 8.0-t ua ~ T5-.7 uN.. I 10.0-t ~ ttA-1 ~ I 11.4-3 „a 72.0-3 y~yrm Recommended PV-POwerlWp) 2500-3450 3200-4400 4250-6750 5100-6900 I. 6350-8600 ~ 8500-11500 9700-13100 9700-13100 X10200-13800 MPPT-VOttage Range 230...500 V DC Startup Voltage 245 V Max. Input Voltage (ai 1000 W,rm° r4'F pro°q in open circuit opaatlonl 600 V Nominal Input Curtent 8.3 A ~ 10.5 A '. 13.8 A 16.6 A ' 20.7 A i 27.6 A 31.4 A ~ 31.4 A '~ 33.1 A Max. usable Input Current 14 0 A_~ 17.8 A 23 4 A 28.1 A 35.1 A ~ 46.] A 53.3 A 53.3 A 56.1 A Admissible conductor size (DC) No. ib - 6 AWG Number of OC Input Terminals 6 Max. Current per DC Input Terminal 20 A; Bus her available for higher input curents GUTPUT DATA Fronioa IG Plua 3.0-1 yr 3.6-1 wi '~ 5.0-1 w 8.0-0 u,a 7.5-1 uru 10.0-1 uw 11A-t uw 11.4-9 ob 12.0-8 worm Nominal output power (Pk ~°°) 3000 W 3600 W SOOD W 6000 W ~ 7500 W 9995 W 11400 W 11400 W 12000 W Max. continuous output power 104°F (40°C) 208 V / 240 V / 277 V 3000 W 3800 W 5000 W I i 6000 W 7500 W , 9995 W 11d00 W I~ 11400 W 12000 W Nominal AC output voltage ~ 208 V / 240 V / 27] V '. 208 V / 240 V 277 V Operating AC voltage range 208 V (tlefaulq 240 V ~.~ 277 V ~, 183 - 229 V (-12 /+10 %) 211 - 264 V (-12 / +10 %) 244 - 305 V (-12 / +10 %) Max. continuous 208 V output Current 260 V' 277Vi 14.4 A i 12.5A I t0.6A 18.3 A 15.8A 13.7A_. _ 24.0 A 20.8A _ 18.1A 28.8 A ~'~. 36.1 A 48.1 A 25.0A '~. 31.3A 41.7A _ 21]A ~" 2L1A 36.1A I 54.8 A 47.5A 4t2A 31.6 A' 27.4 A' n.a. ~ n.a. n.a. 14.4 A' Admissible conductor size (AC) No. 14 - 4 AWG Max. continuous utility back feed current p A Nominal output frequency Operating frequency range 60 Hz 59.3 - 60.5 Hz Total harmonic tlistortion < 3 % Power factor 1 GENERAL DATA Fronius IG Phla ~ S.0-i w. I 3.6.1 wn 5.0-1 uw I 8.0-t ueu 7S-t urr 10.0-t w 11.4-1 11.4-3 Max. Efficiency 96.2 % CEC Efficiency 208 59V 0 % 95.0 % 240 V 95 5 % 95.5 % 277 V 95 5 % 95.5 % Consumption in stantlby (night) 95.5 % 95.5 % 95.0 % 95.0 % 95.5 % 95.0 % 95.5 % I 96.0 % 95.5 % 95.5 % , 96.0 % 95.5 % ~ 96.0 % ~ 96.0 % 96.0 % 96.0 % 96.0 % n. a. ~ 1 W Consumption during operation 8 W 15 W 22 W Cooling __ Controlled forced ventilation, variable fan speed Enclosure Type -__ NEMA 3R Unit Dimensions (W x H x D) 17.1 x 24.8 x 9.6 in. T 11.1 x 36.4 x 9.6 in. 1].1 x 48.1 x 9.6 in. Power Stack Weight 31 lbs. (14 kg) 571bs. (26 kg) 82 lbs. (37 kg) Wiring Compartment Weight '~ 24 lbs. (11 kg) 26 lbs. (12 kg) 261bs. (12 kg) Admissible ambient operating temperature -4 ... 122°F (-20 ... +50°C) Compliance UL 1741-2005, IEEE 1547-2003, IEEE 1547.1, ANSIAEEE C62.41, FCC Part 15 A& G NEC Article fi90 C22.2 No 1071-01 PROTECTION DEVICES Fronius IG Plua j 3.0-1 i 3.8-1 I 5.0-1 8.0-t 7.5-1 ~ 10.0-1 11A-1 17 4-3 ~ Ground tautt protection Internal GFDI ~ (Ground Fault Detector/Interrupter); in accordance with UL 1741-2005 antl NEC Art. 690 DC reverse polarity protection Internal diode Islantling protection Internal; in accordance wdh UL 1741-2005, IEEE 1547-2003 and NEC 12.0-3 n. a. n.a. 9fi.0 % Over temperature Output power Berating /active cooling F 'per Phase Fronius USA LLC Solar Electronic Division ` 10427 Citation Drive, Suite 1100, Brighton, Michigan, 48116 m E-Mail: pv-us®fronius.com www.fronius-usa.com http:IAwvw.wholesalesolar.~nverters.h6nl e ~!a I y ik s i /• ~ i ~ a , SolarMount Technical Datasheet Pub 110816.1td V1.0 August 2017 SolarMount Module Connection Hardware. Bottom Up Module Clip ............................... Mid Clamp .................................................. End Clamp .................................................. SolarMount Beam Connection Hardware.... L-Foot ......................................................... SolarMount Beams ........................................ ~i8:'i~r~Ol~,l °1r;vi.?~ ~~nraeciio;~ Fdarr, ~~,/ W a:,. ~ - Bottom Nut Up Clip •~,.. .. Beam m ~_ - Y a - - Dimensions specified in inches unless noted Washer Bottom Up Clip material: One of the following extruded aluminum (hidden..see alloys: 6005-T5, 6105-T5, 6061-T6 note") Ultimate tensile: 38ksi, Yeld: 35 ksi • Finish: Clear Anodized • Bottom Up Clip weight: -0.031 Ibs (14g) Bolt Allowable and design loads are valid when components are assembled with SolarMount series beams according to authorized UNIRAC documents • Assemble with one '/<"-20 ASTM F593 bolt, one '/<"-20 ASTM F594 serrated flange nut, and one Y." flat washer ~' Use anti-seize and tighten to 10 ft-Ibs of torque • Resistance factors and safety factors are determined according to part 1 section 9 of the 2005 Aluminum Design Manual and third- ` party test results from an IAS accredited laboratory • Module edge must be fully supported by the beam * NOTE ON WASHER: Install washer on bolt head side of assembly. DO NOT install washer under serrated flange nut Applied Load Average Allowable Safety Design Resistance Direction Ultimate Load Factor, Load Factor, Ibs (N) Ibs (N) FS Ibs (N) m Tension, Y+ 1566 (6967) 686 (3052) 2.28 1038 (4615) 0.662 Transverse, X± 1128 (5019) 329 (1463) 3.43 497 (2213) 0.441 Sliding, Zi 66 (292) 27 (119) 2.44 41 (181) 0.619 a ~~i~~ 1~-~t;. Mid Clamp >;. :rr[ - .x Dimensions specified in inches unless noted >cl~ri`+9ounY Intl ~i~;v~p r~r ^in. u2pn:r, ;p201; 2f, 3?9~^2n. 3q2 _:r.C 3CZOC3D. 332c~35G. 30'<C04D. 3"2.t)65w. 5brG05~. .,-~ 2'uSD. 3~eu sJ?.LAB ~-. asD so~f, ~ z.,,,.a - ,~_~,<-zr~ • Mid clamp material: One of the following extruded aluminum alloys: 6005-T5, 6105-T5, 6061-T6 • Ultimate tensile: 38ksi, Yeld: 35 ksi • Finish: Clear or Dark Anodized • Mid clamp weight: 0.050 Ibs (23g) • Allowable and design loads are valid when components are assembled according to authorized UNIRAC documents _ • Values represent the allowable and design load capacity of a single mid clamp assembly when used with a SolarMOUnt series beam to retain a module in the direction indicated • Assemble mid clamp with one Unirac'/."-20 T-bolt and one Y:'-20 ASTM F594 serrated flange nut • Use anti-seize and tighten to 10 ft-Ibs of torque • Resistance factors and safety factors are determined according to part 1 section 9 of the 2005 Aluminum Design Manual and third- party test results from an IAS accredited laboratory Applied Load Direction Average Ultimate Ibs (N) Allowable Safety Load Factor, Ibs (N) FS Design Load Ibs (N) Resistance Factor, m Tension, Y+ 2020 (8987) 891 (3963) 2.27 1348 (5994) 0.667 Transverse, Z± 520 (2313) 229 (1017) 2.27 346 (1539) 0.665 Sliding, X± 1194 (5312) 490 (2179) 2.44 741 (3295) 0.620 • End clamp material; One of the following extruded aluminum alloys: 6005-T5, 6105-T5, 6061-T6 • Ultimate tensile: 38ksi, Yeld: 35 ksi • Finish; Clear or Dark Anodized • End clamp weight: varies based on height: -0.058 Ibs (26g) • Allowable and design loads are valid when components are assembled according to authorized UNIRAC documents • Values represent the allowable and design load capacity of a single end clamp assembly when used with a SolarMount series beam to retain a module in the direction indicated • Assemble with one Unirac'/."-20 T-bolt and one'/."-20 ASTM F594 serrated flange nut • Use anti-seize and tighten to 10 ft-Ibs of torque • Resistance factors and safety factors are determined according to part 1 section 9 of the 2005 Aluminum Design Manual and third- party test results from an IAS accredited laboratory • Modules must be installed at least 1.5 in from either end of a beam Bolt __~__ ~'~, r - - End Clamp '~Serrefed ~`~ ~ Flangenhd '~~ .x Dimensions specified in inches unless noted Applied Load Direction Average Ultimate Ibs (N) Allowable Load Ibs (N) Safety Factor, FS Design Loads Ibs (Ni Resistance Factor, m Tension, Y+ 1321 (5876) 529 (2352) 2.50 800 (3557) 0.605 Transverse, Z± 63 ;279) 14 (61) 4.58 21 (92) 0.330 Sliding, X± 142 (630) 52 (231) 2.72 79 (349) 0.555 a ~_ ~1` a~ ^a'" 4 Y -X Dimensions specified in inches unless noted • L-Foot material: One of the following extruded aluminum alloys: 6005- T5, 6105-T5, 6061-T6 • Ultimate tensile: 38ksi, Yield: 35 ksi • Finish: Clear or Dark Anodized • L-Foot weight: varies based on height: -0.215 Ibs (98g) • Allowable and design loads are valid when components are assembled with SolarMOUnt series beams according to authorized golf UNIRAC documents L-Fool For the beam to L-Foot connection: • Assemble with one ASTM F593'/a"-16 hex head screw and one ASTM F594 '/,"serrated Flange nut • Use anti-seize and tighten to 30 ft-Ibs of torque • Resistance factors and safety factors are determined according to part 1 section 9 of the 2005 Aluminum Design Manual and third-party test results trom an IAS accredited laboratory NOTE: Loads are given for the L-Foot to beam connection only; be sure to check load limits for standoff, lag screw, or other attachment method Applied Load Direction Average Ultimate Ibs (N) Allowable Load Ibs (N) Safety Factor, FS Design Load Ibs (N) Resistance Factor, m Sliding, Z± 1766 (7856) 755 (3356) 2.34 1141 (5077) 0.646 Tension, Y+ 1859 (8269) 707 (3144) 2.63 1069 (4755) 0.575 Compression, Y- 3258 (14492) 1325 (5893) 2.46 2004 (8913) 0.615 Traverse, X± 486(2162) 213(949) 2.28 323(1436) 0.664 •i~i ~~ I~>8~$' ._ cd.~ Properties Units SolarMount SolarMount HD Beam Height in 2.5 3.0 Approximate Weight (per linear ft) plf 0.811 1.271 Total Cross Sectional Area ins 0.676 1.059 Section Modulus (X-Axis) in' 0.353 0.898 Section Modulus (Y--Axis) in' 0.113 0.221 Moment of Inertia (X-Axis) in° 0.464 1.450 Moment of Inertia (Y--Axis) in° 0.044 0.267 Radius of Gyration (X-Axis) in 0.289 1.170 Radius of Gyration (Y-Axis) in 0.254 0.502 r, ~ ~. ~y y ' SLOT FOR T-BOLT OR 1~" HEX HEAD SCREW 2X SLOT FOR BOTTOM CLIP SLOT FOR 3~" HEX BOLT .387 - 750 SLOT FOR T-BOLT OR -1'726 i/" HEX HEAD SCREW SLOT FOR BOTTOM CLIP I 1.316 SLOT FOR 3/a" HEX BOLT I f~-1.207 ~, IL---1.875 -X SolarMount HD Beam Y -X SolarMount Beam Dimensions specified in inches unless noted TSM-PA05 The Universal Solution O Module can bear snow loads up to 5400Pa and wind loads up to 2400Pa n Guaranteed power output (0--+3%) T High performance under low light conditions (Cloudy days, mornings and evenings) Independently certified by international certification bodies I5o Manufactured according to International Quality and Environment Management System (IS09001, 15014001) t~ linear performance 6 warranty ~ 5 10 year product warranty "alas 25 year linear power warranty Trina Solar (U.S.), Inc. 100 Century Center, Suite 340, San Jose CA 95112, USA T +1 800 696 7114 F +1 800 696 01fi6 E usa@trinasolar.com Trinasolar the power behind the panel Currently Trina Solar's most popular panel. Versatile and adaptable, with power output ranging from 225 to 245Wp, the TSM-PA05 is perfect for large- scaleinstallations, particularly ground-mounted and commercial rooftop systems. Using reliable and carefully selected components that are tested at the Trina Solar Center of Excellence, this panel comes with a 25 year performance guarantee of 80°/o power production. Founded in 1997, Trina Solar is a vertically integrated PV manufacturer, producing everything from ingots to modules, using both mono and muRicrystallinetedrnologies. By the end of 2011, the company will have a nameplate module capacity of 1.9GW.Trina Solar's wide range of products are used in residential, commercial, industrial and public utility applications throughoutthe world. Only by matching an efficient cost-structure with proven performance will we, as an industry, achieve grid parity. And at Trina Solar, we have both. IEC61 ]15, IEC61J30, UL1 ]03,TUV Safety Class II, CE sti<,,, 5 10 15 20 25 I SIVI-I'H~5 I he Universal Solution 37,05 inches L C v e e-oanw xae lurvcnaN o a0% NuaEVU-E ae s.u IN4nuwG nose ]-00GPOONOING HALE A I I I 3n nc ...~Ae~ Back View m W fl s ro A 9w 8.01 ~m fim Sm 4.m 3m ~m lm Qm 10.!" NV%m] -- -_ ' r 600w/m3 ~_ _ _ _ ~~ ~ iaowmlz I _ _ \ ~ 1 O,m 1Q°' 40~ 30.m 40.m Voltage (VJ Efficiency Wattage Years warranty A-A C UL US up to 15.0% up to 245W 25 CE a« . ... ~.r ,.., ..r .,.., .,, Peak Power Watts-PM~(WP) 225 230 235 240 245 Power Output Tolerance-P,aa%(%) 0/+3 0/+3 0/+3 0/+3 0/+3 Maximum Power Voltage-V~ (V) 29.4 29.8 30.1 30.4 30.7 Maximum Power Current-I,Naa (A) 7.66 7.72 7.81 7.89 7.98 Open Circuit Voltage-Vne (V) 36.9 37.0 37.1 37.2 37.3 Short Circuit Current-I5~(A) 820 8.26 8.37 8.37 8.47 Module Effciency Om (9G) 13.7 14.1 14.4 14.7 15.0 Values at Standard Test Conditions $TC (Air Mass AM L5, Inadiance 1000W/m', Cell Temperature 25°Q r.. Solar cells Multicrystalline 6 inches (156 x 156mm) Cells orientation 60 cells (6x10) Module dimension 64.95 x 39.05 x L57inches (1650 x 992 x40mm) Weight 43016 (19.$kg) Glass High transpera ncy solar glass 0.13inches (3.7mm) Frame Anodized aluminium alloy J-Box IP 65 rated Cables/Connector Photovoltaic Technology cable 0006inches'(4.Omn~, 39.4inches (t000mm), MC4 Operational Temperature -40-+8$°C. t0years workmanship warranty Maximum System Voltage 600VDC 23 years linear performance warranty Max Series FUSe Rating 15A (Please refer to Trlna Solar produc[warrantyfor de[ailsl Modules per box 25 pcs Modules per 40' container 650 pcs [pUTION: READ SAFETY AND INSTALLATION INSTflUCTI0N5 BEFORE USING THE PRODUCT O July ]011 Trina Solar Limited. All rights reserved. Specifcalions included In Ihls datashee[ are subjetl to change without no[ice. Nominal Operating Cell 46°C (t2°Q Temperature (NOCT) Temperature Qaeffcient of PMpa -0.4546/°C Temperature Coeffcient ofVpc -0.35°6/°C Temperature Coefficient of lx 0.03%/°C pl F Trinasolar www.trinasolar.com