Loading...
HomeMy WebLinkAbout37616-Z Town of Southold Annex ~3tlFF0[~ 1/24/2014 P.O. Box 1179 54375 Main Road 'Z@ F, Southold, New York 11971 * ,.1~ CERTIFICATE OF OCCUPANCY No: 36730 Date: 1/24/2014 THIS CERTIFIES that the building SOLAR PANEL Location of Property: 1565 Jacobs Ln, Southold, SCTM 473889 See/Block/Lot: 79.-6-4.3 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 10/18/2012 pursuant to which Building Permit No. 37616 dated 11/7/2012 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: roof mounted solar panels on an existing unheated accessory storage barn as unheated accessory storage barn as afor. lied The certificate is issued to Thilberg, Jack & Thilberg, Karen (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 37616 11/29/12 PLUMBERS CERTIFICATION DATED Authorized Signature TOWN OF SOUTHOLD BUILDING DEPARTMENT A ® 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 37616 Date: 11/7/2012 Permission is hereby granted to: Thilberg, Jack & Thilb_erg, Karen 1565 Jacobs Ln Southold, NY 11971 To: construct an electric Solar Panel system upon an existing unheated accessory storage barn for single family dwelling use as applied for At premises located at: 1565 Jacobs Ln, Southold SCTM # 473889 Sec/Block/Lot # 79.-6-4.3 Pursuant to application dated 10/18/2012 and approved by the Building Inspector. To expire on 5/9/2014. Fees: ALTERATION OF ACCESSORY BUILDINGS $50.00 CO - ACCESSORY BUILDING $50.00 Total: $100.00 Building Inspector Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1 % lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $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 Occupancy - Residential $15.00, Commercial $15.00 Date. New ConstructionOld or Pre-existing Building: (check one) Location of Property: 1'90S; c3Acab ej S 1.A~~ 7&o-r~ t4 y M7~ House No. j + Street Hamlet Owner or Owners of Property: ~ A-e-ec - '1 41 t_'>ETZ Cn Suffolk County Tax Map No 1000, Section 7°i Block 6a Lot 4, Subdivision E':,J- PMS, Filed Map. 823(V Lot: Permit No. Date of Permit. Applicant: -fAr o f 1Nzo~ Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate:/7_ (check one) Fee Submitted: $ ~ / / Applicant i ture pF SOUlyolo Town Hall Annex y Telephone (631) 765-1802 54375 Main Road 41 Fax (631) 765-9502 P.O. Box 1179 c Q roger.richert(c town. Southold. ny. us Southold, NY 1 197 1-0959 :Ns • i0 Comm N BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Jack Thilberg Address: 1565 Jacobs Lane City: Southold St: NY Zip: 11971 Building Permit 37616 Section: 79 Block: 6 Lot: 4.3 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Dawn electrical Cont Corp License No: 391-me SITE DETAILS Office Use Only Residential X Indoor X Basement Service Only Commerical Outdoor X 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpl Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks Disconnect Switches Twist Lock Exit Fixtures TVSS Other Equipment: PHOTOVOLTAIC SYSTEM, 10,200watts, 40-pm250-mao panels, with micro inverters, combiner box and disconnect Notes: Inspector Signature:s 9~c Date: Nov 29 2012 81-Cert Electrical Compliance Form.xls o~aOF 8011, TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING/ STRAPPING [ ] FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL )ROUGH) f~] ELECTRICAL (FINAL) REMARKS: p Kgig L - e_ DATE E /Sl Y INSPECTOR l Graham Associates 1981 Union Blvd. Bay Shore, N.Y. 11706 Building Consultants & Expeditors (631) 665-9619 Fax (631) 969-0115 August 16, 2013 Building Department Town of Southold Town Hall Southold, New York 11971 Re: Thilberg Residence; Permit No37616 10.2 kW Rooftop Solar Photovoltaic System 1565 Jacobs Lane Southold, New York 11971 Tax map # Dist. 1000/ Sect.79 /Block 6 / Lot 4.3 To Whom It May Concern, Please be advised that I have inspected the solar roof array installation at the above-mentioned premises and have determined that it has been performed in accordance with the manufacturer's recommendations and the approved building permit. If you have any further questions, do not hesitate to call. Sincerely, lvlicblt~ Dunn,RA JAN 2 4 2014 FIELD NMOM DATE COMMENTS FOUNDATION (1ST) - 4~-a FOUNDATION (ZND) S c x 0 ROUGH FRAAMNG & Li y PLUMBING Yy7) V INSULATION PER N. Y. ~j STATE ENERGY CODE V r FINAL ADDTTIONAL COMMENTS T ly ~ o z IM C\ -4 z e TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following, before applying? TOWN HALL Board of Health SOUTHOLD, NY 11971 4 sets of Building Plans TEL: (631) 765'I802 Planning Board approval FAX: (631) 76595112 Survey SouthohlTowo.Northlrork.net PERMIT NO. 3 7G~~ Check _ Septic Form N.Y.S.D.E.C. Trustees _ ~h , ~r Flood Permit Examined ) ( 20I 7' Storm-Water Assessment Form Contact: Approved ~L. 2111 y Mail W: Disapproved a/c C1Phone: 6 3 i- d y 7- S 40z Expiration 20 J - Building Inspector 8 2012 PPLICATION FOR BUILDING PERMIT UUU Date 120 pq DEFI. INSTRUCTIONS TON"'gtSbl'IIIO;O 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. a 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 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 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 Pewit 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. •atu~o a lice in mine if a corporation) ~ y ro VE ftVWgK 1~Y 11To(o (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder 4M-iCA),ST t$ 501-AR CoNTSZ,RC----T )9- ~y Name of owner of premises -TNI L$E~a V 4%w (As on the tax roll or latest deed) I pp cant 's a rporatiol signature of duly~q rth i offi r µ YV lpprst L LG C -co Builders License No. Yid 1 Plumbers License No. Electricians License No. _ Other Trade's License No. 1. Loc% ono land onwhich roposed work11 one: I 1A~ So iola~ 1~1=>'. 1(971 -37?~l House Number Street Harslet ^ 2 County Tax Map No. 1000 Sectio '19 Block 40 Lot "J ` Subdivision C:(AO ta)LgI{ t:. ti I Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed ~conktmction: a. Existing use and occupancy LIM GNAlu o&p ~ Qa~~71I7E1.ICk b. Intended use and occupancy L11J CAZ"t•!C-}~ D 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal - Demolition Other Work W55P-TVP n6 Afz. (Description) 4. Estimated Cost 302 000 Fee (To be paid on filing this ajp cation) 5. If dwelling, number of dwelling units Number of dwelling units on each floor t If garage, number of cars 111 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. t-4~ Q 7. Dimensions of existing structures, if any: Front Rear 3~.. Depth Height MIM Number of Stories Dimensions of same structure with alterations or dddions: Front III /A Re r K Depth Height tt Number of St ries 8. Dimensions of entire new construction: FrontyNC,tr~. Rear Depth Height Number of Stories - 9. Size of lot: Front 11~ Rear 1 ~b Depth 6 10. Date of Purchase Name of Former Owner 7 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 W ill excess fill be removed from premises? YES_ NO 14. Names of Owner of premise'M)LM~ Addmsl-%§4 a&~ tANEPhone No.A31 7 PS V51 Name of Architect Address Phone No -.~i,2 Name of Contractor Addres Phone No~.tr- DA%?5w am 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES _NO)~C_ • IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? • YES_ NO • IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. Qff"CP 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? • YES_ NO_ / • IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS COUNTY OFp CAULO T Uji.Lrok being duly swom, deposes and says that (s)he is the applicant (Name of indi signing contract) above named, (S)He is the ous V. WA~ 1..F+~l ~~b "Y0 hl~ r W C/~ (Contractor, Agent, Corporate Officer, etc.) .1 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. Swore tobeforg me this I Sr day of Dc. 4 k., 20 2- I J_ I otary Public NOMIRI Signature of Applicant NOTARY PU;UC-STATE OF NEW YORK NO. 01H06251112 Qualified in Sutto~k County My Commission Exp.ie, bao-e rte, 2- ,,S i aF sWlyo Twn Ha 54375 Kid. aoadx Jor 41 Tdtpho 1(16861)5 ~765p5g1802 I: P.O. Box 1179 Ls5ler.riche rt war %07no=d nv us Southold, NY 119714959 uNlr,'~' BUILDING DEPAR rmENT I : TOWN OF SOUTHOLD APP ICA IO FOR LECTRI 'AL INSPECTION REQUESTED BY. Ken Lietch Date: 1117/12 Company Name: pawn Electric Name: Ken Lietch License No.: 391-ME A I ddress: PO Box 7, Islip Terrace, NY 11752 - Phone No.: 631-582-8686 f JOBSITE INFORMATION: ("Indicates required information) `Name: Jack Thilberg 'Address: 1565 Jacobs Lane, Southold, NY 11971 i 'Cross Street: North Beyview Rd I 'Phone No.: 631.765-9231 Permit No.: 13 n 1~1 (I Tax Map District: 1000 Section: Btock:_b Lot: 4.. 3 'BRIEF DESCRIPTION OF WORK (Please Print Clearly) Installation of Solar PV System and inverters (Please Circle All That Apply) 'Is job ready for inspection: YES NO Rough In Final 'Do you need a Temp Certificate: S / NO Temp Information (if needed) Service Size: 315hase 100 150 200 300 350 400 Other 'New Service: Re-connect Underground Number of Meters Change of Service overhead Additional Information: PAYMENT DUE WITH APPLICATION tom,, e2•R"uest for Inspection F= I Thomas D. Reilly P.E. Consulting Engineer Fa every howe s bult by someone, but the balder of all thwgs is God' Hebrews 3:4 4 Bezel Lane Smithtown, N.Y. 11787 Td: (631) 7247888 Fa: (631) 774-5740 September 18, 2012 Harvest Power 57A Saxon Ave Bay Shore, NY 11706 Attention: Chris McCarthy Re: Thilberg Barn 1565 Jacobs Lane Southold, NY To Whom It May Concern: Please be advised that I have analyzed the roof trusses for the above-mentioned project and have determined that they are adequate to support the additional bad of the proposed solar panels without reinforcement or modification in accordance with the requirements of the Building Code of New York State. If you have any questions regarding this matter, do not hesitate to contact my office. Very truly yours, Thomas D. Reilly, P.E. J cc:mle Thilberg Barn Southold_9_18_2012.doc TDR:jd Attn: Building Department Town of Southold January 21,2014. To whom it may concern: Attached are the engineer letters for Building permits 37423 and 37616 that you requested to close out the permits. When the cos are closed could you send me a copy of them by mail or fax. Thank You. Regards, Michael J. Fasano Harvest Power LLC. 631-647-3402 631-647-3404 Fax JAN 2 4 2014 MO. -4w -vo l3 TOWN OF SOUTHOLD PROPERT"ECORD CARD STREET ~s VILLAGE DIST. SUB LOT FORMER OXVNER J N E ACR. 1V~'~Sf •`E-~ori~ c S W TYPE OF BUILDING RES. Z 1 SEAS, VL. FARM COMM. LAND IMP. TOTAL DATE REMARKS - Lau '~750 u.yl 7 ca ca E ~88 lo'z t" II,S k~ it 1 (Ar. Ic Qlo o,a. a o sAS 0 U 760o a 3:^ca ~ $3r~o -Z3 93 8g-~'iP~17Sc~.'>- G-~eck cicid'ftor~ ~i ovv 2~_ n c E7O0 Z 3 /n Ili I'71c1ci- ' caj 7 c- Lnrn x :Sv Z- r P* 2L) (off - St It, o o f m'= n exIsi,; de _ Do0~ r a 4H P :g'n"I coos+' In feu Nc. Z4S _ -nwyvQ 1 ~ y 1 ` _ .s/7a - 3P a ~o~ `onsi, Skn,-oon, )I GIs )I6 13ft 3z'tP6 Ula«s &P* 2-440(o - 112 )W W A30 goy-aqe- d FRONTAGE ON WATER TILLABLE a '•-N 57 74 FRONTAGE ON ROAD WOODLAND DEPTH t. MEADOWLAND BULKHEAD HOUSE/LOT TOTAL COLOR r z ~ TRIM 79.44-3 10/08 f kf . r~ Aj- ` J Ids. ~U Z 2 1 L} (aU Foundation C.B. Bath Dinette Extension Basement sue ` Floors W LA,1 Kit. Extension Ext. Walls Interior Finish I` L.R. CC= Extension Fire Place Heat D.R. V,./ j3 91 Patio Woodstove BR. Porch / jy( Dormer Fin. B. Deck l~ SC c o = S y o Z 8 d Attic ®44eaewsy pA{LJj Rooms 1st Floor Garage Z O `Z , 4C~ ( 2. Driveway Rooms 2nd Floor Pool Poor Iloo 4 o2~G o - Sep 26 03 02:12a Jack Thilberg 6317659231 p.3 Sep 26 03 02:11a Jack Thilberg 6317659231 p.2 SURVEY OF • ~ s LOT 3 ~ y~~'Ty Bq Y MAP OF o 3 , ~v ED /~tV iQpA FILM D 'ECD ZZ MM ME NO O TES yQ AT BA YV/EW TOWN OF SOUTHOLD SUFFOLK COUNTY, IVY 1000-79-06 4.3 fAa AEL.s Scale 1" =&Y Oct. 15, 1.987 Dec. 18.1987(under const) Ap[W K 19880x) a ell _Ff 0 sot O.~ _ Q- p StIFFDfi( CbUlf?Y DEP *~T w SI g F ILY D4t<ELLW(; ONIl t / DATE Y & i` H.S. REF. NO. Ry_ Sc ~ ~ O A;~~ The sewsR disposal and water supply facilities for this location have been inspected by this Deaarbneat and/or K o ther -es Ad fou -to' d by AV- Jy \ . g r pmpamd iri o mn v ~h rw a ak"am Chief Bureau of Nth A% ~ L for 1P6 m aurvep m a.ta6lidmed by anJ for rich the by The ow Title Awado&m. CERTIFIED TO' FIRST AMERICAN TITLE INSURANE 1ND 1Z COMPANY OF NEW YORK R.'t,lE?.HEAD SAY,WGS BANK /p Q f, A ! J 4 CK H. THILBEf?G - ~r 5~ ' ~T th` r.. ~ rA.REN M. THlLBRG / ~o yo o. Y. NO. 4966E r-r - / SOX # 8nom PECJ V ~~NGINEERS, P. fiS/6 O. BO STATE OF NEW YORK WORKERS' COMPENSATION BOARD CERTIFICATE OF NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1 a. Legal Name and address of Insured (Use street address only) 1 b. Business Telephone Number of Insured 631-704-4131 Harvest Power LLC 57A Saxon Avenue Bayshore, NY 11706 1 c. NYS Unemployment Insurance Employer Registration Number of Insured Work Location of Insured (Only required if coverage is specifically I d. Federal Employer Identification Number of Insured or limited to certain locations in New York State, i.e. a Wrap-Up Policy) Social Security Number 204214746 2. Name and Address of the Entity Requesting Proof of 3a. Name of Insurance Carrier Coverage (Entity Being Listed as the Certificate Holder) Harleysville Ins Co 3b. Policy Number of entity listed in box "Is": Town of Southold W000000099284M Building Department Town Hall 3c. Policy effective period: Southold, NY 11971 j _04/15/2012_ to _04/152013_ 3d. The Proprietor, Partners or Executive Officers are: X included. (Only check box if all partners/officen included) C all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box "3" insures the business referenced above in box "la" for workers' compensation under the New York State Workers' Compensation Law. (To use this form, New York (N1) 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 also notify the above certificate holder within 10 days 117a policy is canceled due to nonpayment ofpremiums or within 30 days II' 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/or a maximum of one year after this form is approved by the insurance carrier or its licensed agent Please Note: Upon the cancellation of the workers' compensation policy indicated on this form, if the business continues to be named on a permit, license or contract issued by a certificate holder, the business most provide that certificate holder with a am Certificate of Workers' Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers' Compensation Law. Under penalty of perjury, I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Margarita Kaminski - ARM-Capacity of NY LLC (Print nom faolhmv representative or licensed agent of insnrance carrier) Approved by: 07/24/2012 (Si (Date) Title: Account Executive Telephone Number of authorized representative or licensed agent of insurance carrier: 646-459-2470 Please Note: Only insurance carriers and their licensed agents are authorized to issue the C-I05.2form. Insurance brokers are NOT authorized to issue it. C-105.2 (09-07) All Workers' Compensation Law Section 57. Restriction on issue of permits and the entering into contracts unless compensation is secured. 1. The head of a state or municipal department, board, commission or office authorized or required by law to issue any permit for or in connection with any work involving the employment of employees in a hazardous employment defined by this chapter, and notwithstanding any general or special statute requiring or authorizing the issue of such permits, shall not issue such permit unless proofduly subscribed by an insurance carrier is produced in a form satisfactory to the chair, that compensation for all employees has been secured as provided by this chapter. Nothing herein, however, shall be construed as creating any liability on the part of such state or municipal department, board, commission or office to pay any compensation to any such employee if so employed. 2. The head of a state or municipal department, board, commission or office authorized or required by law to enter into any contract for or in connection with any work involving the employment of employees in a hazardous employment defined by this chapter, notwithstanding any general or special statute requiring or authorizing any such contract, shall not enter into any such contract unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair, that compensation for all employees has been secured as provided by this chapter. Definition of Demolition (Box "3e." on the reverse side of this form) A building wrecking or demolition is one where a building, chimney or steeple is razed, or where a floor, exterior wall or roof is removed. If the contract involves only the removal of interior walls, partitions or the facing only of any exterior wall, it is not considered demolition. Out-of-State Companies Working in NYS NYS Workers' Compensation and Disability Benefits Requirements for Permits, Licenses or Contracts issued by NYS Government Entities Generally, employers must have a workers' compensation policy or a combination of policies that cover each state in which they employ permanent employees to cover on-the-job accidents and disabilities. As you are probably aware, certain insurance carriers write policies that cover multiple states. "Riders" found under sections 3A and 3C on the Information Page of the policy specify the states of coverage. In addition, the operations covered in each state are identified in attachments to the policy. In addition to any other state's workers' compensation coverages, an out-of-state employer needs to be specifically covered for NYS workers' compensation insurance when there are "sufficient contacts" between that employer and the state. While there is no single determinative factor, any of the following criteria could be the basis for finding "sufficient contacts" requiring New York coverage: ? a physical location within New York State, ? $50,000 in payroll during a calendar year in New York State; ? one or more employees (including subcontractors) with a primary work location or hired within New York State; or ? employees (including subcontractors) working in New York State for more than 90 days during a calendar year. If an out-of-state employer meets any of the above criteria, it is required to carry a New York State workers' compensation policy. When New York is listed in Item 3A on the Information Page of an employer's workers' compensation insurance policy, the employer is fully covered under the NYS Workers' Compensation Law. If insured through a private insurance carrier, the out-of-state employer must file a C-105.2 --Certificate of Workers' Compensation Insurance (the business' insurance carrier will send this form to the government entity upon request) PLEASE NOTE: The New York State Insurance Fund provides its own version of this form, the U-26.3. If the out-of-state employer is legally, fully self-insured in New York State, the out-of-state employer must file a SI-12 Certificate of Workers' Compensation Self-Insurance (the business calls the Board's Self-Insurance Office at 518-402-0247). If the out-of-state employer is participating in group self-insurance, the out-of-state employer must file a GSI-105.2 Certificate of Participation in Worker's Compensation Group Self-Insurance (the business' Group Self-Insurance Administrator will send this form to the government entity upon request). If an out-of-state employer does not meet any of the above criteria and has New York (NY) listed in Item 3C on the Information Page of its workers' compensation insurance policy (the Other States Insurance section), NYS specific coverage is not required and the employer may be able to use its own state's workers' compensation coverage by filing a WC/DB-101 form. [The out-of-state employer's employees will be covered under NY benefits when working in New York by having NY listed in Item 3C on the Information Page of the workers' compensation insurance policy (the Other States Insurance section).] C-105.2 (12-03) Reverse , AC RO CERTIFICATE OF LIABILITY INSURANCE 71024Trzolz 'M~°""YY' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. IMPORTANT: If the 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 endorsemen s . NE. PRODUCER NOCONTAG' ARM-Capacity of New York, LLC PHONE FAx 90 Broad Street, Suite 1503 a~ Ne 1 New York NY 10004 o nESSinf m INSU S AFFORDING COVERAGE NAICx IMSURERA:Hadeysville In INSURED 2478 INSURER B: Harvest Power LLC BISURERC: 57A Saxon Avenue Bayshore NY 11706 INSURERD: INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: 403061632 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR SUN -1 -POM1 LTn TYPE OF INSURANCE N POLICYNUMBER POLICY EFF WDDr EYyYYI XP 1J611T3 A GENERAL LIABILITY Y V LD0000030499K 1115/2012 115/2013 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES EaEWED pe $700000 CLAIMS-MADE OCCUR NED EXP(Any one person) $Excluded PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE 52,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $2,000,000 POLICY F X_1 LOC § A AUTOMOBILE LIABILITY Y BAD00048369K 15/2012 111512013 Ea ant 1 000 ODO ANY AUTO BODILY IWURY(PW person) $ AL-OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per acoderl) $ waa ; AMAGE S X HIRED AUTOS X AUTOS (OPROPERTY E UMBRELLA IIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTIONS § A WORKERS COMPENSATION 00000099284M 115/2012 /1512013 X W C STATU- OTH- AND EMPLOYERS' LIABILITY Y I N ANY PR OPRIETORIPARTNEREXECUTIVE EL EACH ACCIDENT OFEICERIMEMBER EXCLUDED? NIA $1,000,000 (MarWalory In NN) E. L. DISEASE-EA EMPLOYE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE-POLICY LIMIT 51000000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AmCr ACCORD 101, AAdapral Remnb Schedule, N more space Is requ ) The certificate holder is hereby included as Additional Insured with regards to work being performed for them by the insured, subject to the policy terms and conditions. ) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Southold ACCORDANCE WITH THE POLICY PROVISIONS. Building Department Town Hall AUTHORIZED REPRESENTATIVE Southold NY 11971 ~.Z ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 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 and Address of Insured (Use street address only) sb. Business Telephone Number of Insured HARVEST POWER LLC 631-704-4131 le NYS Unemployment Insurance Employer Registration 57A SAXON AVENUE Number of insured BAY SHORE, NY 11706 0828169 1d. Federal Employer Identification Number of Insured or Social Security Number 204214746 2. Name and Address of the Entity requesting Proof of Coverage 3a. Name of Insurance Carrier (Entity being listed as the Certificate Holder) The First Rehabilitation Life Insurance Town of Southold Company of America 3b. Polity Number of Entity listed in box "1a": Building Department DBL348571 Town Hall 3c Polity effective period: Southold, NY 11971 10/07/2011 to 10/06/2013 4. Policy covers: a. Q All of the employer's employees eligible under the New York Disability Benefits Law b. Only the following class or classes of the employer's employees Under penalty of perjury, I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has NYS Disability Benefits insurance coverage as described above. Date Signed 7124/2012 By ~ ( (Signature of insurance carriers authorized representative or NYS Licensed Insurance Agent of that insurance carrier) Telephone Number 516-829-8100 Title Chief Executive Officer IMPORTANT: If box "b" is checked, and this form is signed by the insurance carrier's aunhmized representative or NYS Licensed Insurance Agent of that cerne, this cratifirare is COMPLETE. Mail it directly to the certificate holder. If box "4b" is chedwd, this certificate is NOT COMPLETE fortis purposes of Section 220, Subd- a of the Disability Benefits Law. It must be mailed for completion to the Workers Compensation Board, DO Plans Acceptance Unit, m Park Street, Albany, NY 12M. 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 According to information maintained by the NYS Worl Ws Compensation Board, the above-named employer has complied with the NYS Disability Benefits Law with respect to all of his/her employes Date Signed By (Signore of NYS Worker's Compensation Board Employee) Telephone Number Title Please Note: Only insurance ceniers licensed to write NYS Disability Benefits insurance policies and NYS Licensed Insurance Agents of those insurance carriers are authorized to issue Form DB-120.1. Insurance brokers are NOT authorized to issue this form. DB-120.1 (5-06) Additional Instructions for Form 1313-120.1 By signing this form, the insurance carrier identified in Box "3" on this form is certifying that it is insuring the business referenced in Box "1 a" for disability benefits under the New York State Disability Benefits Law. The insurance carrier or its licensed agent will send this Certificate of Insurance to the entity listed as the certificate holder in Box "2". This certificate is valid for the earlier of one year after this form is approved by the insurance carrier or its licensed agent, or the policy expiration date listed in Box "3c". Please Note: Upon the cancellation of the disability benefits policy indicated on this form, ifthe business continues to be named on a permit, license or contract issued by a certificate holder, the business must provide that certificate holder with anew Certificate of NYS Disability Benefits Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Disability Benefits Law. DISABILITY BENEFITS LAW Section 220. Subd. 8 (a) The head of state or municipal department, board, commission or office authorized or required by law to issue any permit for or in connection with any work involving the employment of employees in employment as defined in this article, and notwithstanding any general or special statute requiring or authorizing the issue of such permits, shall not issue such permit unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair, that the payment of disability benefits for all employees has been secured as provided by this article. Nothing herein, however, shall be construed as creating any liability on the part of such state or municipal department, board, commission or office to pay any disability benefits to any such employee if so employed. (b) The head of state or municipal department, board, commission, or office authorized or required by law to enter into any contract for or in connection with any work involving the employment of employees in employment as defined in this article, and notwithstanding any general or special statute requiring or authorizing any such contract, shall not enter into any such contract unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair, that the payment of disability benefits for all employees has been secured as provided by this article. DB-120.1 (5-06) Reverse M' Py 1. N THESE SHEETS ARE FORMATTED IN ACCORDANC ANCE WITH THE LONG ISLAND UNIFIED SOLAR PERMIT Il IT INITIATIVE o Qo ~I 7 o~ W THILB 10.25KW ROOFTOP S( 3ERG RESIDENCE LU z Q SOLAR PHOTOVOLTIC SYSTE." EM 4oAU0 UNISOq SON 255 WATT MODULES E> SOUTHOLD, 11971 1565-JACOBS LAI N O M SECT BLOCK 6 LOT ti TAX MAP NO. S 79 4413 r TO ~ HARVEST TOWN OF SOUTHOLD M V CO JWz J= BY IL W O r r O~ Z a r PO W,,,ER o a W ~>Q . o , ~ Ilpil ~ Y~I' ipwi }1 F~ pllul {1 IIIIII'I° m @~ III II J IIII IIII III ~ W ' I'ii llla II'IIII: la! 111 1 lug s pl I li II III I iI III g 1111,111 112 ITI W ~ T > ,~i - I I IiIIIIIIIi ' ulilllN I'IIiV I II, lllllllllV911 III" illl"II pp * = Q James A. Marx, Jr. PE Page2 oft sill 'SI, Ili J 4 it +l JI h~ u. IIiIi III I IYrv III III°~i~ III ^ I IIII Ili, ~ r--1 IIII .riot I '61llul'lllr~. M ~ Z James A. Marx, Jr. P.E. North Winds Center The design verification is based on: et% i~ IIIIIIIIII^~ IIII iIIII IIVI I p~ , III~,II 118+ ~ ~ IIIIIIIII z I IIII III IV o IIIIIIPI, H o III 1111 r ds el PlliIl, ls i! Ih „ High Mountain Road 1 I. 'ASCE7-02/05-ASiCE Standard / / I j III IIIIIIII IIIIIIII 4u V `JI lul'Illlpillll l mil JI Ringwood, NJ 07456 ~ia. III VIII IIII ~Jt~~ I`Ild IIIIIII VIII ill lil Ii III~w N A I E-mail: jamlight@bellatlautic.nel II. "Steel Construction Manual," Ath Ed., American Ins d., American Institute of Steel ~ j,'; III ICI I': I,n VIII I hli'I, I III' / LJj ~!I IIIIII II111 i11 5 "I'IY li Construction, Chicago, IL, 2005. ( ~~~lt V IIII III \ II III l r V 15. IIIIIII I I I + ul ll l IIIIII I IIII V I I I I I ~~,,i it a III. "Aluminum Design Manual", The Aluminum Associa uminum Association, Washington D.C., lu III I I ~,@, III I ~~I ' I I III Illi it IIIIIIII I ~ II, i III III ~ II Ii IIiIIIIIiIIII~ W III III P ' ti J IILIIhI June 15,2011 2005. IV. Mechanical Properties and Static Load Testing of Un III vd hIIIII d Testing of Unirac extruded rails and r I (IIIIIIIII I ~lil'lli IIII/ I Lo related components obtained from Dr. Walter Gerstle, . Walter Gerstle, PE, Department of It", III '~~~IiII I,iIII I'I ly!huI III, Ills /IIIIIII w III ELECTRICAL ~ w 1411 B Inc. Mexico, Albuquerque, NM Ip' 'III IIII' j'j III~I'~ rill' IIIIII LU p AISOy E C Of TB C~ REQUIRED H o 1411 Broadway Blvd. NE Civil Engineering, University of New Mexico, Albugr I Albuquerque, NM 87102 use: . ©m~o9uutll r IIIIIIIIII ~wbv~~IrY~o Wk' .,a ro co /r,,,, IrYrY Hors ~IivVt6 w Q To: Building Department or Others: Unirac SolarMounfrK is evaluated for use in locations where win, oeP w~ do not exceed 50 nsf or snow load conditions do not exceed 45 y not exceed 45 45 psf pround sound snow loads., , LEGEND MAPIIII. O W a RE: Engineer's Notice of Evaluation for UrdRac SoluMountTM For loading in excess of either of the above stated conditions, Uni I conditions, Unimc, Inc. should be oi~ O (L IL . Universal PV Module Mounting System contacted for suitability of installation. rtn' assembly, when installed in APPROVED AS NOrJt Dear Sir: By this letter, I certify that the IUnime SolarMountn' assembly, w accordance with the Installatiom Manual 227 will meet the require meet the requirements of the building l evaluate the structure to which the DATi B P. # w-li T , I have reviewed Unirac SolazMquntTM "Code-Compliant Installation Manual 227"; codes adopted by New York Store. Others should evaluate the stn copyright February 2008 and certify that the information and results are accurate. To Unirae SolarMounfM system iss to be connected on a case-by-rasa m a case-by-case basis, per Part 1; sa4 FEE: IS IJ. BY E 408; determine the design level forces, the appropriate wind speed shall be determined as htstaller's Responsibilities ofthre Installation Manual, to ensure it anal, ensure its adequacy to accept NOTIFY BUILDING DEPARTMENT A: prescribed by local jurisdiction requirements and applied in accordance to the New York attachments and to support all applied loadings par the building a 0r the buildiuilding coda, It Al: TITLE PAGE 785-1802 8 AM TO 4 PM FOR THE State Residential Code .2010 or New York State Building Code -2010. These building FOLLOWING INSPECTIONS: codes require that wind loading be determined based upon ASCE 7-05 and Unirac's sms. A2: MODULES, INVERTERS, PANEL LAYOUT POUT 1. FOUNDATION - TWO REQUIRED ~,J FOR POURED CONCRETE Manual 227 utilizes ASCE 7-05 that matches Method I for which Unirnc Table 2 is Please call me if you have any iquestions or concerns. 2 ROUGH-FRAMING, PLUMBING, based upon, that which is dependent upon conditions of spatial form, height and other structure ammeters that are specified in the code provisions for detenninin the applied Sincerely, F tJEW y P i g U e N- MA O A3: RACKING, MOUNTING, BUILDING SECTI p, 'OECTION STRAPPING, ELECTRICAL 8 CAULKING 3. INSULATION wind loading pressures imposed onto the Unirac SolarMounfrm rails supporting sole 4. FINAL- CONSTRUCTION B ELECTRICAL MUST BE COMPLETE FOR C,O. panels. The SolsrMmmtT railing and anchorage requirements for the installation are James A Marx ]r PE *k properly represented in the Installation Manual 227. w ALL CONSTRUCTION SHALL MEET THE Professional Engineer z w REQUIREMENTS OF THE CODES OF NEW High Mountain Road For other conditions; the determination of wind pressures should be determined by the 10 YORKSTATE. NOT RESPONSIBLE FOR aforementioned New York State Building Code and ASCE 7 procedures. Ringwood, NJ 07456 66A0 W .w DESIGN OR CONSTRUCTION ERRORS. (908-557-6080) \ROFE~S~ Pte. 1 Ill ° ' JIq :1 11 t Professional Engineer License 56467 WFU.. t i!r ccj James M.14d, Unirnc, Inc INDEX REILLY P.E. 4 BEZEL LANE SMITHTOWN, NY, 11788 631 .724.7888 d Al I OF 3 i d TH15 PROJECT WILL COMPLY WITH THE CURRENT NEC REQUIREMENTS INCLU: S INCLUDING o ARTICLE ba0 50LAR PHOTOVOLTAIC PV SYSTEMS Q~ :5: n t t x atw"e 3 r h t n. 0 t Glvicat~ tI r`}'y ms e -ire .fit i t;NI t rc ON, ,w -n i £F a phi rv Irk, A o~ •Mf i iyB.?°' t^ "'i.I4 %a } fP S4R^ ;}X.• ..R.fi"., t~i(h~P•nlii' x N:',..... { ~tx r1: J3 ~ 11 k " i i p 'xt'. t~}~5''.'y `rte'?5 t i'b "14~•~7 IV... ~I II 1.0. "5~ Il.v 10.1 5L' 10.99 y,+N 0,- a 01-1 1 { ~ t (3b) AUO 255 WATT PANELS ON BARN - RACKINr, ^5 ' -4 fits *s-n "et t 4 et i• t ~ h x ' +n.. INDICATED ~i r t PMb ':Sik s~ _ A%j 1 ` 1 yp 2 ~i \S I I L' I sL l eLf la" r/D(f 1 I i 5 ' 6,,l .S I ~;5 to C6Eg12 . r i3 Lb 21 ~ - 20 19 IB ~l'e, LL IS 14 Ifs jz 'i •N ~ F' - p,fy i t ~ ~t Y r+ of l~ ~ } ~ t I~ If lI~ I ~ ~trl 24 25 24}- 2b 29 3° 31 Sz 3j 3 3S 34 3T, 38 -3 QG r C4 tMT o , } w " ~ " du4un. 1 two" ~ • ~ ` s rt x, 6 A, ~~la I l.2tcl'2G ~lSR.h( I>^j(ptJ ~ACG~6S ~.LaI.1C ~Al-~O LD of Y I ~ g f I Y~% { , c . ' 7 wtt~ VIP, 16° T41. 1 b° "fR~fa -'tee G31- ~ - X131-`-' * P4 111", 11 w $4- * r w C, 1 'Ill Ile rtrt R ~ I A~flt 14 c Bs LANE, J z WALE, I' . 10' ~~4G ~T'1 '~w~ i:J'?„ J o n F, JN I T WALE. I" . 40'-0" ~ t . • • . • • I ]VA, PANEL LAYOUT it ROOF PLAN it SITE PLAN O I AN ~ Z w a ui I 1 BUI B,45I;G WIND SPEED: 110 MPH D N6FLAN Aom _ BIJIL 6EN GENERA NOTES > a aQ LIVt,LOAD: MODULES: 2.40 LB/5F RACKING: 1.25 L5/5F GENERAL I a 3ENERAL NOTES 'I p Q INSTALLATION IN ACCORDANCE WITH a = Q ~ • 1 '1 TOTAL: 5.65 L5/5F 1. INSTALL/ .3W MANUFACTURER RECOMMENDATIONS. - 5 a p ..Mymng4 ai@)" Y1 ' a 9 I I n .r JI - L4 ...................._;.r.._.._:._:......., 2. ENGINEE 5NO ` LOAF 20 P5F P351 I ' 109 ENGINEER TO INSPECT PROJECT AFTER I 1 Features nr mhand Stable Ener6Od[ ut t6sl i i it II r'i HI9 INSTALL 'na9~ WAND! INSTALLATION AND CERTIFY COMPLIANCE TO NYS Q r m2 L 1: total BUILDING CODES N 1 'n) n953 tll I H n L.._..... Ilr...::_....: L0,4D: 21.5 PSF BUILDIN A ll sn (ir,J)i f 1 9J t. 132501 lu i e2xs { }t •i. ti I (3.ldl Ali I^I• 3. PROJEC' 1:9 COMPLI, ti . PROJECT TO BE INSTALLED WITH CODE ~ ~ Hreseal 5 to 9 h d 1cdaP eV Designed far 1 I ooAOd9 n 2AYea MGgs Sttlmn t ~ y ' n W COMPLIANT RACKING INSRUCTIONS FOR UNI fn -RAC co mort enegy M d. ID' r - _c reLaLllll f thanlradlponal ) SOLAR MOUNT SYSTEM. FOR FURTHER INFO ON U Q ' II sy3lems IIII I , - n.- SOLAR? { ¦ AC Electrical Data N Mechanical Chat Economl< IIII I'r'' Safe 4, UNIRAC 1 Mechanical CharaQerlstlcs " UNIRAC CODE COMPLIANT INSTALLATION MANUAL o ImugrCYnllg oJS Co GOUIPuflt!":-„ 135W v I Guzmllmotlule: PE~4U4BLICP PUBLICATION 0909241 cc OF SEPT 2009 GO TO : W a ya Npnlnal Voiwge d90V ,k 1' I~~ o~md~llc9artxtv;fei -Norm aIF udn fi0Po ° 165Lh 9922140 mm (65.01 x 39.06 x 167 in) IILIp eudd~aans(tN W}LN) ",i Hel9Atatloveterlac+0o,. ttp:/ V http:/www.unirac.com/?q=residential/residential- mo: Is ul p eul to !,Vi 211-. Yi 'p vvuvvrv '3 inal t M 62mm(244m) LOAD CALCS w lapL r :,x R0.5(4 41m products) w a . wet u d«.r. 911 v va •vv I I ' N nPID Vp e Z11 ZfieV rvr„oCrto p?n to goN+l i M 9 9 . - m. rl ' II rmnt Clnv " that qnnln I,' 593 fi0IHi rmnt Ghu LII! MOhlrr,(D 13lr)solar glan (umperetl), )y products/solarmounti-residential ~ o b , • a9 Y AVID AC Unison is a new breakthrough in solar photovoltaic itr t M amar' 'smPlmmw No high III XQu b YPIL I F uetc IM ! "a -'r <s96' II I 1 a'm. 2 0AB l*"rp111 12 rs t 1 , 3,2 mm (013121) D.. a ~ (PV) technology. AUO combines its premium PV module with fI Idmyamtr armrin nab a oememaaale !y Ma ImPmumrspe 2gn,nm p ce° " III' Coll 1 II 11111~11111!11 60 monoc'ryslalllne rol+r aeld, `H 156 x 156 rnm(6 x 6121), - 4. FOLLOW FOLLOW BALLASTING SCHEDULE ON ROOF PLAN. { VIII, any budge mry hp [EG a9n1° n 9950 4 Ce uP lion reliable mlcroinvener technology to maximize PV' benefits for any IvUi°°°"`oaa mnthip nM I"f$ e~an! gr. P6klnYVler Elpden IPI, + 95509e, d5h l cd Piwpwlanon EVA B+rk Sheet ''I~IPI tanlposlle111m,bbck installers and end users. hd Frame VIII S, ae.afthe Prt PV Mod, ulll ¦DC Temperature Coefficient ^C rable lengm Frame s" ;,';'h 1 Moatretl aluminum Imma W+cN A,,Cmble leng0, eNputahk:696.1 Torl (27.40 IN ~J~~ Betemlon glae,t 049 mm(41301") - CONTRA HARVEST POWER, LLC. THE SOLAR INSTALLATION The integrated microlnverter converts module DC to grid „ - L,oduk u,9.saAClMbg it 'Fullµ9uarrletl IPcbnB x-carr4[t4i CONTRACTOR, COMPLIES WITH ALL LICENSING & compliant AC at each module. This Increases system erfor- 'I •W5, , amCn VC an a ra 4s:rc ~fodYkm MnrlaaACµal I~~ Typ Tempel I~9IRI Y 64 2 IL. ULnppovod i,,ulrmmrgmwarrmoaulsaoI - - OTHER I Gmund Wltlng imenertarrlMNrough mkmal lnvenens4tlng ARRAY1 WE5T OTHER REQUIREMENTS & IS NAMED ON THE manse by up to 25%, reduces shading losses, and makes PV Ill pnTypaiGllpPmtllla C°aJpuGrll oiV h"'. ; o3696rK Cmandiddng a `ti; II 4:. - r ran "I II I "II I 0 03AAK no.1s,"I rwnaM,es29ueM _ r;oakw PRE-SCI PRE-SCREENED INSTALLER LISTS ON THE LIPA 'safer to install and own. AUO AC Unison Is Installe encore Coni d, monitored, _ ~?_=G=-FS „ma e, ImtlrvryWe ln`h pnwm. ea-.' h+m a, nrtV is~ i 11 N m`~ 'Y 1 •]U <rw ErpnM[< i< and maintained With ease. ^ MudaemmlAlel Supsn°r } Enhu""arrenl . Warranties and l M AI, WvanviUJ p rb,,Ma ce inho'cl°nand ADC Electrical Data PmWd.Wartanry, ;"n Warranties and Certifications (bU) AUO WEBSITI PM25OMA0255 WEBSITE All AUO PV products are manufactured under AI strict loading tests to taderveakllght mPduk«Oablrnr t Pmtlllrl,Wart+nry, II myearpe+ra m6mnal mtl woMn+mh,p r II 255 watt modules quality control standards. AUO AC Unison is designed for 25 ! mxL5400Pa s°naw°mneh °mindtP^~'voamth '1I'! 295w25ov+ PmY,m,nce cgSi,~~P;11 loading asII di 'I Pwxrtolaanm ,III'' 01.3% II I'I PM6rmmm GWranhe 11 II Gwmnled oulpao19W61ar l0yken a" E., m:2s withlln'tegYated years of efficient production. rtg°rtmelu tradwdy myc PvM°dWelee lot is II *f "I IEC 61215' IC 61230, UL 1703 p N,odllk4ltah+ Solar ridge Micro v C Itm dr d'CECllsdn0(modd AUO PM250MO6000) Ir~J ,rters AC 200 amp ¦ Operating Conditions MIPrGlrvena eenAlm~pm MICmIlrvena euNlm~o IIIIIIIIIIIIII UL 1741 ' IJ CEC Ib6p(mod+L Snnmr p0e P235LV-2,40)' Model H P235LV Combiner ca IPV Mpdul/Op~iill l9 iGpperaidrel 90=a86'C 'r Ac0'aa IneelapA6ii r,d UL V41 - panel Gap 5ingle Phase _ Mlc iaMner ATbMIT peelu 40-.65C ~t AC latl kCelfig ion l IP Pmredl atd hII IP65 d III t I, I III 'hand up to 5400 PA acco, ing to - Mi nimu Sul rb[d td d Gpa EC n''~ , - dlscnnnect' 240M.S lce - el h~41 I 61215 tadrapcea test) panel 7i I The leading force' i fn gteen power s II T OMAS D. LIMREILLY AU Optronics Corporation - AUG Green Solutlons rnlMmmx - P.E. 4 BEZEL LANE 1524pB thy Blvd. Suite l a Milpitas, CA 9 v USA TeI:+1 N-dpa- 518-0800 Empflall:solar@tuo.cpT, vvw www.AWspm wwwdUOSOIar. XCOrtl Ww Auosolascom mo.man wr SOYINK, - SMITHTOWN, NY, 11788 ' ngr,m,pmuo mllwdmra d, dim nu n9hrrr.,n..d mm,mmol. n,v.mnm••nn°arnnnre 631 .724.7888 SHEET PG 2 ELECTRICAL DIAGRAM INVERTER SPEC SHEET PG 1 INVERTER SPEC SHEE I A2 I r 2OF5 l l j, I;. N_ O N IIl UNMRACE' SOLARMOUNTt, UNO-RACO Flashing a 0 ~ O Hill 111~11l, 1! " « M w s f r (Patent Pending) SolarMount Is a "PotentPendfng"mounting system designed for easy, safe and fast on-t Standard feandfast on-the-roof Installation y pV Module of PV modules. No tuore lilting cumbersome, pre-assembled arrays from the groune from the ground to the roof. r H s SolarMount"' Dual Slotted R z.:. ml Slatted) Rail's SoilarMaunt rails have a Footing Boll e a Footing Bolt Slot that provides infinite flexibility for positioning Sole positioning SolarMtount footings. - Module You can always lag directly Into a ro i. Bolt Slot Itrectly Into a foof member for maxi- Existing roof rafter Idty, - ~ Z Q mum structural integrity. I J V• The Module Galt Slot provides equal t provides equal flexibility for mount- GRK Fasteners JX 4" 2X422"OG ing your modules. The result is that he result is that 5olarMount can R55 (Rugged 'Structural Screw) mount any module on virtually any an virtually any roof. EXISTING TRUSS . - - - Footing Bolt slot i Unl-rac Solar Mount ? ? > SolarMuunt `Top-Down" Module Clamps Rail and L Foot a.. i Modules attach to the rails from the tap with unique i soiarMoantnKshown flush mounted 1 - ?r ) - 5clarMount clamps. - - - - - - - General Notes % First, attach the footings to the root, and the rails to In landscape (horizontal) made I. Rolle to be Installed two per panel as, shown In detail. a t the footings. Then, use the SolarMount clamps to IST FLOOR attach the modules to the rails from the top - one 71 2. All penetrations to be made e4b" ad. ? / module ata time. ilil4'rv 9. Bolts to be Inetdllsd into raftsro. ~ ratlon Into wood for code compliance 4. Hnlmum 2" pone,t.: N 5. Flash and Beal qs per manufacturer O SOLARMOuNTS are the easiest;`faStest, and safest Way 6. Use only bRK Fagtenero i' X 4' Bolts, for code eampllant Installation M to Install a PV array on the roof of virtually any building D e a a e SLAB ON GRADE Universal-Any64 Watt or larger, framed PV module Bi-Directional Mounting -Mount your modules in CG sold in North America can be mounted using landscape (horizontal) made, as shown above, or in T SolarMount. (See PV Module Compatibility List on the portrait (vertical) mode. It you have limited roof M back page.) space, you can even use bath orientations in a single Installation. 8•`~.. 5olarMounts can easily be mounted rsily he mounted in either landscape I _ O 1 ((horizontal array) or portrait (vertla Roof Top Assembly -'Because of its "top down" r portrait (vertical array) mode without clamps, SolarMounts are ideal for use with the new Meets Building Code Requirements- Whether the P+ortrait.arny special added parts. 11 arts. "plug "n play" PV modules. An entire array can be roof Is pitched or flat, and regardless of the moRng ' Mode jA variety at SolarMounts are availa[ )unts are available for mounting from z Fully assembled and wired where they'll be installed - material, SolarMount will securely attach your PV array ttwa to as many as nine madules, de nine modufes, depending on module 'y J= on the roof. This eliminates the awkward hazard of to your roof in compliance with U.S Building Codes. amdscape rfze. And, 5oiarMounfs con he set e rots Can he set end to end to create lifting partially assembled arrays to the roof, and then (See "Building Code Compliance" on the bath page.) Me a extended length arrays. (See Splice ays. (See Splice Kits an the facing page) a mounting and adjusting them on their footings. i,,, 0 „I Quick and Easy Installation- Continuous, dual slotted i (See Onside tar 'detaas)8- , W° SolarMount rails provide the ultimate in adjustability. T No more re-drilling holes, or repositioning footings, T i MOUNTING DETAIL SECTION VIE1 VIEW SCALE: 1/4"= 1' RACKING SHEET 1 RACKING SHEET 2 aZ W M u z F" 0 - w o V) _ SOLARMWOUNT-m ~Ty a t 1 h l PV Module Compatibility List as R Q w 4 ASE ASEI00, ASE300 +aN a h a o m 1; rj 4 911 =a Astroftver AP-65/75, APX-90, AN11011 2'0, AN 150, AP-610517105. AI -L" Footings P-610517105, AP-71©611206 "MIR z The standard SallatMount "L" shaped toot is designed to F6u ! BP Solar BP2701275, BP5851590, BP2150, MISX-120, SX-75180/65 1, S8-73180/95 SX-1101120 ` 25-YEAR WARRANTY , bolt through existing roofing material to the rafter, and 'HIGHEST ENERGY HARVEST'l, E-I I r ~ to be sealed with an appropriate roofing sealant under Y Evergreen EV-941102 LOWEST INSTALLATION AND each footing. Two vertical mounting holes provide for`; - OPERATING COSTS - SP,„.r1FIE'x,TSION e adjustment of the height of the SolarMount rail, a _ : • • • _ _ ' _ Kyocera KC-7018PW 9 d7adS~ ~:a..k" ',SAFEST SOLUTION P235LV-2 r~.'~d'' - - INPUT1t1ATA (DC) I ,I, . „4'thy' G, ° ° 'I P235LV 240 P23SHV-240 4'l'2' I I 2p ~ W Photuuatt PI F1VX1 ]C7040 T , Igsl vX. - Maximum Input Power (W)250 250 0 250 J ~~wA 01140159 `~d'k^s~;~ _ Maximum continuous Input power (W) 235 Reliable by Design Maximum input voltage 4e (W) 335 235' ' ?t I Lo i Siemens SP65170175, 58901100, SM1100/110, Sol 3011401150 a Standoffs ,i ~1¢t The SolarBddge Pantheon's ultra-reliable design protects a - MPPT voltage (V) 16-36 48 64 U3 16-36 25-50 W Wni-solar US-64 iIr module manufevlumes hard-won reputation for quality by - Maximum DC short circuit current (A) 14 (A) 14 14 "t Round standoffs (3" and 6" tall) are also available. AC Modules With SolarBddge supporting a 25-year warranty on the complete AC module. Maximum Input current (A) 1125 11.25 e They are installed under the roofing material, and are Pantheon MICfOInVE Iefs Its patented architecture utilizes highly reliable film capacitors - I,II °a compatible with Oatey 1114" diameter elastomer collared Corr UnrRac Ix Your PV deokr floe mry PV module not shorn. Solar modules that produce g id{comPatlble AC power have instead of failure-prone components such as eledrolyklo - jOUTPQVDATA (AC) I pa't, , i ShOWp. - been a long-sought goal of the FV Industry. The limitations capacitors, tantalum capacitors and apmisoimom. This - Maximum continuous odiput power (W) 225 Ir(W) 225 V flutings and other non-collared flashings. Visit 1, SolarBYdge Pantheon has undergone rigorous volatility testing Nominal output current(A) 0.9375 of traditional PV systems with lekes-wired DC modules and - - 0.9375Y O W a www.oatey.com for details of datey flashings) a.. - bath Independently and as part at an AC module - EmanainB Nominal voting. IV) 240 fellure-prams ventral Inverters have held solar beak from Its full standard construction requirements to ensure Its performance 240 - ¢ performance potential, and merle rooftop solar Impractical or Operating voltage range(V) 211.264 over the full operating life of,a PV array. - Nominal hequenry (Hz) 60 271.264 60 I rvQ ^ 6 SoltirMountr" Component Specifieat)ons 30 Year Limited Wa rr,7nt} h~ unsuitable for up to 50 perceni ,sites. ad tA~1I'P'a11`F - - Operating train range( 1) 59.3-60. 59.3-605 !!'rv."V.'.. L.L d H Until now, ThaSOlareridge Pantheon*a microlnvertar enables Highest Energy Harvest - Power (actor > or o the original Owner at the original installation site - a game-changing solar solution; highly reliable, Integrated AO Through modum4avel maximum power point tracking (MPPI), - distortion, 5% Total harmonic 17 >0198 r1.( r i T - I( ¦ SolarMount Rails and Mounting Clamps, s, Tilt Le uniffac, Inc. warr+n[s Wthe original mvrrei g P fortpedod S.I.M."Its shallbetreefmrnd'eoccf and "L" Shaped Footings - 6061-T6 Aluminum be has fmps d'afe:U In material and workmanship - modules that dramatically lmpioVe system reliability, Increase, the SOlarBndge Pantheon optimizes the output at each solar' - maximum Maximum units units per r 200 201 crunch 17 25X ex ~ ' 1 N ~1pHUULnY.. rla rl ~ - ..~.„I Y,;d t' p~ 1 Ettrusion is complete, Dorm( fmrneerci years from the earlier aft) the data the installation - energy harvest and simplify Installation to deliver the lowest panel By minimizing energy losses due to variable shading, - - is cmmplete, or 2y 30,0~ days s after the porch a 3' and 6" Standoffs- Grade 5 ZincPlated, odgimlmvner. 7humrontydoesnoacov lays after the purchase or the SoiarMount3 by the - levelized coat of energy. Welcome 1o a new era of solar. modulo mismatch and soiling, AC Modules with SolarBrdge - rEFFICIENCY ill"Y;i,1 1I, n, P S eHJ YnY ;'"''li'I scanty does not cover damage W 5ofarMosnb that - Welcome to the era of AC mociums. Pantheon micrainverters produce up to 25 percent more energy Welded Steel occur duri g shipmem, or prior W hntallat or prior W Installation. - , Peak Inverter efficiency 95.5% per site than alternative systems. - CEC weighted efficiency, 1 94.5% 955X 194 5% a Fasteners- 304 Stainless Steel If svithin such perlod the SoixMounts thi he SolarMmmllts shall be reasonably Proven in be Market-Expanding Ij ! " - Nominal MPP krec 99.6% -40C to +65C e Tilt Legs deoect[w, then UWbc shall repair or rapier, part thereof, at Un€Irac'r sale optiws. Such r shall repair. or replace the defective SoLuMocnts,ar _ The solareridge AC Module SXstam comprises the Sclareridga Lowest Installation and Operating Costs _ making ,99.6% 'tads epgan. Such repair el mpiacemllrstihallfullill _ Pantheon as well 08 the S.IwBrldgs Power Manager and Ready to prctlucegrid-aompetlbm power strelght from the Standard SolasMutint are designed to be flush mounted Building Code Compliance as UniPac's liability with respect to thowar ^foolery, AC modules with integrated SolarBddge Pantheon - KHECHANWAL,bATA 1P i i;i,l,1";i,'ai' xi h respect to this warrenty. - SolarBddge Power Poi forvsjteror remote management Ps,I on a pitched roof. SolarMounts are designed to complywilh the This warranty shall be wild if imtallatian a of a PV system. The entire solution enables module mmminvertem reduce lnsellation time by 20 percent or Operating ambient templange -40C to +1 wad if imtallagan of the SafarMourdz am not per- - men more. With no separate Invader or DC components to install, ` 'Night time power consumption (tare) <30mW re) <30mW andi s to provide grerin value to their with f8 network o f y, Minh UnipacSSalarMOUnI Installation Guidelines, or S". 6.W.1.25" If the roof is flat, or if the roof pitch is too low, tilt legs Uniform Building Code, 1997, Chapter 16. See formed In accordance with UnilGaca SalarM it the SalarMaunts have been modified, ref been modified, faired or reworked in a manner dealers ers and installers by offering AC modules dules wllhfactory- AC'modules are the simplest and most flexible n for Dimensions (W x H z D) Q" z 6.5," e pa foeflo PV Installations. Eliminating the needed for for costly Inverter _ Weight 4.3 lb., 4.5 lb., are available to lift your array to the desired angle to the installation Guidelines for details regarding specific not authorized by UniRac in svdting, or if I. lac in they willing, or if the deigned. vnls are alleged in - Integrated mlcrolnverter technology. P PV B y replacements. Pantheon rerte ongoing costa byafUll25 _ Cooling Natural Cr I,c they were rot designed. Ungizc shall not be AC rcoe powered by Solarprldpe enable manufacturers to percent nt over aber conventional inverter r solutions. . - Enclosure envvanmentalr4ting Outdoor - Natural Convection - No Fans Outdoor- Tested to UL 1703, _ y sun. The maximum angle can vary from 25 to 45 modules and loading. sun anvirimment for which they were not table for [onsequennat cardingen , u, Inc contingent, or incidental tal deranges arising out of _ overcome the limitations of f tra0llonal DC modules ules and deliver e - meets NEI ets NEI meets NEMA 6 degrees from horizontal, depending on the size and ori- use of the SolarMounts. L - differentiated AD solution that expands their market and grows Safest Solution - 1&Y z entation of the SolarMount and your PV modules. their bottom Irma, Soes with Vxrlefl layouts Ohpartisl shading can In addition to energy harvest and Installation cost benefits', - FFA*ruRes 'f~It I ' fiH,itllwi---!: , I now be viable for solar. Cuetorpere with limaed,spave or budget AC modules also have advantages in safety over DO-based Communication Powerllne Powerllne Carrier ek % oem naW consider solar because of the Inherent Hexibllity of PV systems. With no high-vaitage DC cables to Install and no - Warranty 25 years Y 25 years AC systems. l(1,; aocesilble DC wiring, AC modules are inherently safer to handle _ Compliance 'FCC PartI 'FCC Part 15 Class 8 ,1t s r VMIRACO Working with SolarBrdge, mall manufacturers Opd now than DC modules and do hot have the same potential for ~ " - UL'1741/f UL1741 / CSA 107.1 Unllac, Inc. penlelpale in the Inverter revenue stream, reversing the trend of are faults Which la critical fartlre prevention and rk~'PAr _ MAIN 572-637.6860 TOLLFREE B77;ag8,W6B , 2300 Buena Vista, SE, Suite 134 declining Mips and further iPpreeslnBtoles. rescue worker safety. fr SO LA R B RI 6137t MAIN ate-637.6860 rn e ,'Sr„ T'E O H N O L O G I It S' FAX512-697-8878 =AX512-837-8878 ~t Albuquerque NM 67106 USA golarbridg,etech,com 8229 Waterford Centre 3229 Watered! Centre Blvdi, Salle 118 p Alai 76766 UW 4Uelin,7 76758 USA Spiiec Kits " Phone: 505.242.6411 Fax: 505.242.6412 SOLARBRIDG FFI!' 1411 VII Ip-1 1 ;,111411 Spp t p THOMAS D. REILLY - SolarMounts can be mounted end to end In orderto e-mail: ireforgunleaceom IrIVi create continuous rows of modules. Simply splice as weuw.un9rac.com _ TECHNOLOGIES ' - III Ill;p ~p 1 4 COPYRIGHT 20119o,iffote Tedltnolog,ea il A; yrpp - r' fire ; !111ui~~~1 ~~1i t'l1 rh YMlil a 'd - All other lu dwirsm. are P.Pary of that mepeplrve owners, c y 'll~;~' w P.E. 4 BEZEL LANE espeelive owners, 740759 ' SMITHTOWN, NV, 11788 631 -724.7888 many SolarMounts together as required. !a I RACKING SHEET 3 RACKING SHEET 4 MODULEDATA PG 1 MODULE DATA DATA PG 2 A3 30F3