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HomeMy WebLinkAbout38791-Z 'ypiFpt,f Town of Southold Annex 7/10/2014 P.O.Box 1179 54375 Main Road Southold,New York 11971 4 OI CERTIFICATE OF OCCUPANCY No: 37014 Date: 7/10/2014 THIS CERTIFIES that the building SOLAR PANEL Location of Property: 2045 Lake Dr, Southold, SCTM#: 473889 Sec/Block/Lot: 59.-5-4 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 4/10/2014 pursuant to which Building Permit No. 38791 dated 4/18/2014 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 MOUNT SOLAR PANELS TO A SINGLE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Ball, Lillian (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 38791 05-27-2014 PLUMBERS CERTIFICATION DATED Authorized Signature TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, NY At 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#: 38791 Date: 4/18/2014 Permission is hereby granted to: Ball, Lillian 2045 Lake Dr Southold, NY 11971 To: construct an roof mounted electric Solar Panel system as applied for At premises located at: 2045 Lake Dr, Southold SCTM # 473889 Sec/Block/Lot# 59.-5-4 Pursuant to application dated 4/10/2014 and approved by the Building Inspector. To expire on 10/18/2015. Fees: SOLAR PANELS $50.00 ELECTRIC $100.00 CO -ALTERATION TO DWELLING $50.00 Total: $200.00 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. 03-20-2014 New Construction: Old or Pre-existing Building: X (check one) Location of Property.. 2045 Lake Drive Southold House No. Street Hamlet Owner or Owners of Property: Lillian Ball Suffolk County Tax Map No 1000, Section 5900 Block 500 Lot 4000 Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Lorne Brousseau. Horizon Solar Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ Applicant Signature SOUlyol 0 Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 G Q Southold,NY 11971-0959 .�ly� � �� roger.richert(aD-town.southold.ny.us nit BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Lillian Ball Address: 2045 Lake Dr City: Southold St: NY Zip: 11971 Building Permit#: 38791 Section: 59 Block: 5 Lot: 4 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE contractor: DBA: Horizon Solar LLC License No: 46976-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 Recpt 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 FixtureTime Clocks Disconnect Switches Twist Lock Exit Fixtures 9 TVSS Other Equipment: 3.75KW roof mounted photovoltaic system to include, 15 CS6P-250p panels, 1-SMA SB4000 inverter,AC disconnect Notes: Inspector Signature: Date: May 27 2014 81-Cert Electrical Compliance Form.xls Thomas D. Reilly P.E. Consulting Engineers "For every house is built by someone,but the builder of all things is God" Hebrews 3:4 4 Bezel Lane Smithtown,N.Y.11787 Tel:(631)724-7888 Fag:(631)724-5740 fur June 30, 2014 Mr. Lome Brousseau Horizon Solar LLCx- 1087 Fort Salonga Rd Northport, NY 11768 I j 1 0 2014 Re: Post Installation In I , spection—Ball Residence a�_I)c. crPT. 2045 Lake Dive,Southold TOVIN OF SoUT"inLo Dear Mr. Brousseau, The office of Thomas D. Reilly PE, Consulting Engineers has inspected the installation of the solar panels on the roof of the above-referenced residence. This letter is to certify that the solar panel assembly has been installed in accordance with the manufacturer's specifications. As installed, the roof remains structurally sound, and is capable of supporting the solar array configuration in accordance with the 2010 Residential Code of New York State and the minimum design requirements of ASCE 7-05 (specifically, based on a 120 mile per hour wind speed and 20 psf ground snow load). If you have any questions concerning the above, please do not hesitWe to call me at the number above or(631)525-8947. Very truly yours, 01- NP William P. Keenan, P.E. L- 9 a: cx: Thomas D. Reilly 1 z 0867`14 �FESS1 FMLD'DWEM2N REPORT DATE CONWIENTS On tv FOUNDATION(IST) � FOUNDATION(2ND) 0 Cly ROUGH FRAA9 Q& H PLUMING INSULATION PEft N.Y. . H STATE ENERGY CODE FINAL l ADDZTI&AL c6Mz ENTS O F 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)765-1802 Planning Board approval FAX:(631)765-9502 2a p Survey SoutholdTown.NorthFork.net PERMIT NO. 3 D 6 ( Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Examined j 20 P/ Storm-Water Assessment Form Contact: Approved 20 Mail to: Disapproved a/c / Phone: Expiration ` 20 Building Inspector APPLICATION FOR BUILDING PERMIT Date March 20 20 14 INSTRUCTIONS a.This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans,accurate plot plan to scale.Fee according to schedule. b.Plot plan showing location of lot and of buildings on premises,relationship to adjoining premises or public streets or areas,and waterways. c.The work covered by this application may not be commenced before issuance of Building Permit. d.Upon approval of this application,the Building Inspector will issue a Building Permit to the applicant.Such a permit shall be kept on the premises available for inspection throughout the work. e.No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f.Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date.If no zoning amendments or other regulations affecting the property have been enacted in the interim,the Building Inspector may authorize,in writing,the extension of the permit for an addition six months.Thereafter,a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold,Suffolk County,New York,and other applicable Laws,Ordinances or Regulations,for the construction of buildings,additions,or alterations or for removal or demolition as herein described.The applicant agrees to comply with all applicable laws,ordinances,building code,housing code,and regulations,and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant or name,if a corporation) 1087 Fort Salonga Road, Northport NY 11768 (Mailing address of applicant) State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder applicant is general contractor (Horizon Solar LLC) Name of owner of premises Lillian Ball (As on the tax roll or latest deed) If applicant is a corporation,signature of duly authorized officer Lorne Brousseau, Owner (Name and title of corporate officer) Builders License No. 48916-H Plumbers License No. Electricians License No. 46976-ME Other Trade's License No. 1. Location of land on which proposed work will be done: 2045 Lake Drive Southold House Number Street Hamlet County Tax Map No. 1000 Section 5 9 0 0 Block 500 11.iof i"4'66kl Subdivision Filed Map No. r of 1... i FEE: B f . . NOTIFY BUILDING DEPA I ,^,T 765-1802 8 AM TO 4 PM FOR Ti iE FOLLOWING INSPECTIONS: 1. FOUNDATION -TWO REQUIRED FOR POURED CONCRETE 2. ROUGH-FRAMING,PLUMBING, STRAPPING, ELECTRICAL&CAULKING 'WF' 'I 3. INSULATION �v F' 4. FINAL-CONSTRUCTION &ELECTRICAL MUST BE COMPLETE FOR C O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. RETAIN STORM WATER RUNOFF PURSUANT TO CHAPTER 236 OF THE TOWN CODE. a 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy single family residential b. Intended use and occupancy single family residential 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Work solar panel installation (Description) 4. Estimated Cost $15,787.50 Fee $50 permit; $50 CO; $100 elec. insp. (To be paid on filing this application) 5. If dwelling,number of dwelling units 1 Number of dwelling units on each floor If garage,number of cars 1 6. If business,commercial or mixed occupancy,specify nature and extent of each type of use. 7. Dimensions of existing structures,if any:Front 3 4 Rear 3 4 Depth 36 Height 25 Number of Stories 2 Dimensions of same structure with alterations or additions: Front 34 Rear 34 Depth 36 Height 25 Number of Stories 2 8. Dimensions of entire new construction:Front Rear Depth Height Number of Stories 9. Size of lot:Front 94Rear 98' Depth 275' 10.Date of Purchase 0b 1,m3 Name of Former Owner _LMfitr&h4A 11.Zone or use district in which premises are situated 12.Does proposed construction violate any zoning law,ordinance or regulation?YES_NO X 13.Will lot be re-graded?YES NO X Will excess fill be removed from premises?YES NO 2045 " NM 14.Names of Owner of premises 01,k 64 Address 1111 Phone No. ql 7-413`5444 Name of Architect &A ka,eh Address r7d n.7 k—Phone No L - 1 - a Name of Contractor L(e rr.At('� _0rjy Address 1 o z) L Phone No. (-31-6I,?-h Z 1 SA-V K/04r -,ti y 11Itf 15 a.Is this property within 100 feet of a tidal wetland or a freshwater wetland?*YES X NO *IF YES,SOUTHOLD TOWN TRUSTEES&D.E.C.PERMITS MAY BE REQUIRED. b.Is this property within 300 feet of a tidal wetland?*YES X 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 topographical data on survey. 18.Are there any covenants and restrictions with respect to this property?*YES NO X *IF YES,PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF 54- 0%1(-) Lorne Brousseau being duly swom,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)Heisthe Contractor; Horizon Solar LLC (Contractor,Agent,Corporate Officer,etc.) of said owner or owners,and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief;and that the work will be performed in the manner set forth in the application filed therewith. Swornbefore me this 2� day f 20 1 otary Publ' Signature of Applicant IYANaKNM11NM�1 NQf1M11111��tpti�� M�MMiC OWN �� 1 Scott A. RU SSel I °su p James A. Richter, R.A. SUPERVISOR Michael M . Collins' P.E. SOUTHOLD TOWN HALL-P.0.Box 1179 6 11971 Telephone#: (631)-765-1560 'f�O e F31 - - D15 MICHAEL.COLLINS@rOWN.SOUTHOLD.NY.US '� > UT Y.US Office of the Enginee L APR 15 2014 Town of Southold �t_or GEF'r. STORM WATER M ANAGEMEN T CONTROL PLAN "' T ( TO BE COMPLETED BY THE APPLICANT ) PLEASE NOTE: All Contact &Project Information Requested by this FORM is Nessary for a Complete Application. APPLICANT: (Property Owner,Design Professional,Agent,Contractor,Other) PROPERTY OWNER: (If Different from Applicant) NAME:Lorne Brousseau, Horizon Solar NAME: Lillian Ball ADDRESS: 1087 Fort Salonga Road ADDRESS: 2045 Lake Drive Northport 11768 Southold 11971 Telephone Number: 631-683-4898 Telephone Number: 917-453-5040 Completed Applications can be picked up at the Engineering Department after being notified by the Department, or; it can be Mailed to the Applicant with the submission of a Self Addressed 8.5"x 11" Envelope& Appropriate Postage. DATE: 04-01-2014 Property Address / Location of Construction Work: 2045 Lake Drive S C T M #: 1000 5900 500 400C Southold 11971 District Section Block Lot Required Documents for Stormwater Review: Copy of Complete Building Permit Application. Stormwater Management Control Plan. (2 Sets) Note: SMCPs are required whenever Grading or Excavations exceed 5,000 S.F,when New Impervious Saftes are created,and/or when emsting Roof Systerrls,DnveA%,s,Palos or other Impervious Surfaces are Re-Sxfaced. De Minimis Projects will NOT be Subject to the Submission of a SMCP During the Stormwater Review! Note: These Projects world be Limted to Interior Fdenvvations,Replacenw t of exterior Doors&Wndanis,Deck mon with Loose Fit Deddng,Installation arxilor Modification of Mechanical Systems or other similar Wxk A Complete Description of the Scope of Work Proposed under the Building Permit Application. A Completed Storm"r Review Checklist. If No or NA are Indicated, Justification is Required. **** OR E I RING DEPARTMENT USE ONLY **** Reviewed By: Date: q// Approed: ❑ Additi 1 Information Required: �os,,,FQIr CHAPTER 236 STORMWATER MANAGEMENT CONTROL PLAN CHECK LIST c' APPLICANT: (Property Owner,Design Professional,Agent.Contractor.Other) DATE: 04-01-2014 S C T M #: 1000 5900 500 400 NAME: Lorne Brousseau, Horizon Sol r Telephone Number: 631-683-4898 District Section Block Lot S M C P -Plan Requirements: The applicant must provide a Complete Explanation and/or validation of all Information Required by this Checklist if it has not been providedl I. A Site Plan drawn to scale Not Less that 60'to the inch MUST — If You answered No or NA to any Item, Please Provide Justification Here! show all of the following items: YE NO NA If you need additional room for explanations, Please Provide additional Paper. a. Location& Description of Property Boundaries 0O b. Total Site Acreage. 00 c. Existing-Natural & Man Made Features within 500 L.F. NA - The proposed building permit is for of the Site Boundary as required by§236-17(C)(2i. d. Test Hole Data Indicating Soil Characteristics&Depth to Ground Water. == e. Limits of Clearing& Area of Proposed Land Disturbance. =0 f. Existing& Proposed Contours of the Site (Minimum 2'Intervaisi 0 X lnstalle on the existing roof . The g. Location of all existing& proposed structures, roads, OO X driveways,sidewalks, drainage improvements& utilities. part of this build4:ng permit . h. Spot Grades& Finish Floor Elevations for all existing& proposed structures. 1. Location of proposed Swimming Pool and discharge ring. =PR u e (Z c LA i 6 or j. Location of proposed Soil Stockpile Area(s). OX t k. Location of proposed Construction Entrance/Staging Area W. 1. Location of proposed concrete washout area(s). .) M. Location of all proposed erosion&sediment control measures. 2. Stormwater Management Control Plan must include Calculations showing that the stormwater improvements are sized to capture,store,and infiltrate X on-site the run-off from all impervious surfaces generated by a two(21 inch tlf rainfall/storm event. 3. Details&Sectional Drawings for stormwater practices are required for approval. Items requiring details shall include but not be limited to: a. Erosion &Sediment Controls. X b. Construction Entrance&Site Access. �0 c. Inlet Drainage Structures (e.g.catch basins,trench drains,etc.) d. Leaching Structures (e.g.infiltration basins,swales,etc.) X FORM * SWCP Check List-TOS JAN 2014 ti Tom"Hall Annex � 41 Telephone(631)765.1802 54375 Main Road �j'}.q�[(631)7 P.O.Box 1179 �e roaer.richert�toWn SOny us Southold,NY 11971.0959 WELDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION ` REQUESTED BY: Lorne Brousseau Date: 03-20-2014 Company Name: Horizon Solar LLC ;.. Name, License No.: 46976-ME I' Address: 1087 Fort Salonga Road, Northport NY -11768 j Phone No.: 631-683-4898 j JOBSITE INFORMATION: (*Indicates required information) *Name: Lillian Ball *Address: 2045 Lake Drive, Southold 11971 *Cross Street: Kennys Road *Phone No.: 917-453-5040 Permit No.: q Tax-Map District: 1000 Section: 5 9 0 0 Block: 500 Lot: 4000 *BRIEF DESCRIPTION OF WORK(Please Print Clearly) . - j solar panel installation on roof of main residence panels will be flush mounted (Please Circle All That Apply) *Is job ready for inspection: YES Rough In Final *Do you need a Temp Certificate: YES k Tamp Information(If needed) *Service Size: 1 Phase 313hase 100 150 ® 300 350 400 Other *New Service: Re-connect Underground Number of Meters Change of Service ea Additional Information: PAYMENT DUE WITH APPLICATION 824Request for MspecWn Form i y CONSENT TO INSPECTION Lillian Ball ,the undersigned, do(es)hereby state: Owner(s)Name(s) That the undersigned (is) (are)the owner(s)of the premises in the Town of Southold, located at 2045 Lake Drive, Southold 11971 which is shown and designated on the Suffolk County Tax Map as District 1000, Section 5 9 0 0 , Block 5 0 0 , Lot 4000 That the undersigned(has) (have) filed, or cause to be filed, an application in the Southold Town Building Inspector's Office for the following: solar panel installation, flush mounted That the undersigned do(es)hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, including any and all buildings located thereon,to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comply with all of the laws, ordinances, rules and regulations of the Town of Southold. The undersigned, in consenting to such inspections, do(es) so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used in subsequent prosecutions for violations of the laws, ordinances, rules or regulations of the Town of Southold. • r Dated: 2 3 (Signature) Lillian Ball (Print Name) (Signature) (Print Name) Thomas A Reilly P.E. Consulting Engineers "For every house is built by someone,but the builder of all things is God" Hebrews 3:4 4 Bezel Lane Smithtown,N.Y.11787 Tel:(631)724-7858 Fax:(631)724-5740 fur March 22, 2014 Mr. Lome Brousseau Horizon Solar LLC 1087 Fort Salonga Rd Northport, NY 11768 Re: Roof Framing Evaluation—Ball Residence 2045 Lake Drive,Southold Dear Mr. Brousseau, In accordance with your request, I have inspected the roof structure at the above-referenced residence. The purpose of the inspection was to evaluate the existing roof structure to determine its suitability to support a proposed solar panel array system. Based on my evaluation of the existing roof structure and review of the manufacture spedfications for the solar assembly including the panels and supporting roof mounting system, I have determined that the odsting roof structure is capable of supporting the solar array configuration in accordance with the 2010 Residential Code of New York State and the minimum design requirements of ASCE 7-05. Specifically, the calculations are based on a 120 mile per hour wind speed and 20 psf ground snow load. If you have any questions concerning the above, please do not hesitate to call me at the number above or(631) 525-8947. Very truly yours, o oz William P. Keenan, P.E. .';.? k�.-y� cc: Thomas D. Reilly R A�a 0435c6 ��:> SOUryol 0 Town Hall Annex Telephone(631)765-1802 54375 Main Road N Fax(631)765-9502 P.O.Box 1179 G Southold,NY 11971-0959 �Q �y�DUN%� BUILDING DEPARTMENT TOWN OF SOUTHOLD May 29, 2014 Horizon Solar 1087 Fort Salonga Rd Northport, NY 11768 RE: Ball,2045 Lake Drive,Southold TO WHOM IT MAY CONCERN: The Following Items(if Checked)Are Needed To Complete Your Certificate of Occupancy: "Note: Need certification from an Architect or Engineer stating the panels were fastened to the roof per NYS Building Code Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. A fee of$50.00. Final Health Department Approval. Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84) Trustees Certificate of Compliance. (Town Trustees#765-1892) Final Planning Board Approval. (Planning#765-1938) Final Fire Inspection from Fire Marshall. Final Landmark Preservation approval. Final inspection by Building Dept. Final Storm Water Runoff Approval from Town Engineer BUILDING PERMIT — 38791 — Solar Panels om w'1AI sm, of r roo;;pe o l • •rti • � � �. . :� rl.�to l.ak C � • sur✓eyed f Qr p : Southold,. N. Y. jD • lb Scale • ! 50' b_ . Zg'.••.►. `'} �w�! �}�ofi��EQIi ,^ 8 /�/f onuryletlt Ap ... _ '� '��gP1r1.1P� •1.33•' �- y�t ••' S• :�.. ,. . Go.� ,nurrr,�sa rs rc�fe'r t0.� do unj�,/ed m�►,6, > „ er,t�r"lc/.. " f1/e�st• Saufhold-on- Oil ' - �.. . 8 ; 9 ;:; '�� - � •'. �Guc+YctN{a:ed:�a T�•�� •i Efle':� -C�uaYcxE-+1ee•C4. $ fa U'S. ._ UNAUTHORIZED AITERAT1O4 OR ADDITION _ • r :+'•. f0 TIAs Suva IS..A Y(OIATiOH OF •�� 'SL{YV�I.jC 'J@ �.�'�t7 1 J� I " S=10N 7:ZF Ch, E iMV TqM STATE (•• MUCATIO,t LA 1 I % ' COFICS Cr 7+1 5t°4tY VAr r•C'T&CARINA ME LAND ��t•:6 i IQ, �;'I� EM6CSSiDaAI.."!R;'1: •.ri'w`IGLD... �� To EIE A -. .,, '• !!tf�:��u�✓eyoe!a . 5 3 /� "C�G � �.;,; •,Gt>risat�r�s 1�.,�-Af: ••.:s^:+;•Y,h11,i� .�' �} Y I ` GrBetIAor#' w Y.. ol�r To I t , <: m sway Q � � ` lS FSE?A.°L..J1T ✓' ` .off���'�>�E '�,;t� ' �� t � ••1 . ` TETiE Cf�'i. flnf Q i� ..A:/1]tiiY�l r Jaw i i. �l6NrtlisG jO (�r •Ox..10uAiAmin . 1 TO w[IDa1G12tlYE q cc1'cracis 61R r._. ,��Rs. .! "Yi-tte HORIZA OP ID: RM A�ORO" CERTIFICATE OF LIABILITY INSURANCE DATE(MM03!241,201420114Y) 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 endorsement s PRODUCER Phone:516-681-4343 CNA.ME CT Schizzano Insurance Agency Inc Fax:516-681-5938 PHONE Fax 40 Commerce Place STE 204 c No Ext): A/C,No): Hicksville,NY 11801-5210 EMAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC f INSURER A:Arc h Specialty Ins Company INSURED Horizon Solar LLC INSURER B: 1087 Fort Salonga Road INSURER C: Northport, NY 11766 INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY EFF POLICY EXP LTR POLICY NUMBER MMIDDIYYYY MMADIYYYY LIMITS GENERAL LIABILITY ACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY E L000711600 12/16/2013 12116/2014 PREMISES Ea occurrence $ 100,00 CLAIMS-MADE Fx�OCCUR MED EXP(Any one person) $ 10,00 PERSONAL BADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 21000,00 GENT AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMP/OPAGG $ 1,000,00 POLICYL1 PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE HIR ED AUTOS AUTOS Peraccidenl $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED RETENTION $ WORKERS COMPENSATION WC STATUOTH- AND EMPLOYERS'LIABILITY YIN TORY LIMIT- ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ NIA E L EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION TOWNSOH 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. P Route 25 O Box 1179 AUTHORIZED REPRESENTATIVE P O B Southold,NY 11971 � ©1968-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD New York State Insurance Fund Workers'Compensation&Disability Benefits Specialists Since 1914 8 CORPORATE CENTER DR,3RD FLR,MELVILLE,NEW YORK 11747-3129 Phone:(631)756-4300 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE AAAAAA 263420621 HORIZON SOLAR LLC 1087 FORT SALONGA ROAD NORTHPORT NY 11768 POLICYHOLDER CERTIFICATE HOLDER HORIZON SOLAR LLC TOWN OF SOUTHOLD 1087 FORT SALONGA ROAD 53095 ROUTE 25 NORTHPORT NY 11768 SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER PERIOD COVERED BY THIS CERTIFICATE DATE 12232 489-1 53042 09/08/2013 TO 09/08/2014 3/24/2014 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO.2232 489-1 UNTIL 09/0812014, 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 TOOPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF SAID POLICY IS CANCELLED,OR CHANGED PRIOR TO 09/08/2014 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 POLICY DOES NOT COVER THE SOLE PROPRIETOR,PARTNERS AND/OR MEMBERS OF A LIMITED LIABILITY COMPANY. 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,I NSU RANCE FUND UNDERWRITING This certificate can be validated on ourweb site at https://www.nysif.com/cert/certval.asp or by calling(888)875-5790 VALIDATION NUMBER:717734828 U-26.3 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) 1b.Business Telephone Number of Insured HORIZON SOLAR LLC 631-871-1250 1c.NYS Unemployment Insurance Employer Registration Number of Insured 1087 FORT SALONGA RO AD NORTHPORT, NY 11768 1d.Federal Employer Identification Number of Insured or Social Security Number 263420621 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.Policy Number of Entity listed in box"ta": 53095 Route 25 DBL427406 Southold, NY 11971 3c.Policy effective period: 01/01/2014 to 12/31/2014 4.PoI icy covers: a. R] All of the employer's employees eligible under the New York Disability Benefits Law b.r] 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 thatthe named insured has NYS Disability Benefits insurance coverage as described above. Date Signed 3/24/2014 By (Signature of insurance carrier's authorized representative or NYS Licensed Insurance Agent of that insurance carrier) Telephone Number 516-829-8100 Tilde Chief Executive Officer IMPORTANT:If box"4a"is checked,and this form is signed by the insurance carrier's authorized representative or NYS Licensed Insurance Agent of that carrier,this certificate is COMPLETE.Mail it directly to the certificate holder. If box"4b"is checked,this certificate is NOT COMPLETE for the purposes of Section 220,Subd.0 of the Disability Benefits Law. It must be mailed for completion to the Worker's Compensation Board,DB Plans Acceptance Unit,20 Park Street,Albany,NY 12207. 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 Worker's Compensation Board,the above-named employer has complied with the NYS Disability Benefits Law with respect to all of his/her employees. Date Signed By (Signature of NYS Worker's Compensation Board Employee) Telephone Number Title Please Note:Only insurance carriers 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. D13-120.1(5-06) Additional Instructions for Form DB-120.1 By signing this form,the insurance carrier identified in Box"K on this form is certifying that it is insuring the business referenced in Box"la"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 val id 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"3e Please Note:Upon the cancellation of the disability benefits policy indicated on this form,if the business continues to be named on a permit,license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of 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,shal I 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 *` SUFFOLK COUNTY DEPT OF LABOR, LICENSING 3 CONSUMER AFFAIRS HOMEIMPROVEMENT CONTRACTOR LICENSE LORNE J BROUSSEAU This certifies that the bearer is duly HORIZON SOLAR LLC licensed by the County of Suffolk `"���•. OY°'�•""° 48916-H o6J16/2011 exrauna«w*E 06/01/2015 ` SUFFOLK COUNTY DEPARTMENT OF CONSUMER AFFAIRS MASTER ELECTRICIAN NAME KEVIN NONE This certifies that the B"s'"fss """"E HORIZON SOLAR LLC bearer is duly licensed by the Lic*ns* Number Date IssuedCounty of Suffolk Clifford Coleman 46976-ME 01 /12/2010 Otnetor � El(PtRAT10N DATE 01 /01 /2014 Residential Photovoltaic(PV) [� Design and Installation SOLAR 03-25-2014 Town of Southold Building Department 54375 Route 25 PO Box 1179 Southold, NY 11971 To whom it may concern, Please find enclosed a building permit application for solar panels. This application is for 2045 Lake Drive, Southold 11971. It is for a roof mounted system (flush to the roof). Since the house is within 100 feet of water I contacted the Town Trustees to inquire about getting a permit with them as well. I was told (Amanda)that solar panel roof installations are waived so no Trustee permit is required. Thank you, let me know if any material is missing from the application. Sincerely, �A , Lorne Brousseau Horizon Solar LLC HORIZON SOLAR, LLC 1087 Fort Salonga Road, Northport, NY 11768 Phone: (631)683-4898 11 Fax: (631)683-4899 j www.Horizon-Solar.com 3 j s R"y 6,g i `- ,`err d�s� ��'t r `7�^a f �,.f� 4�"'r4�✓ z rF, High Yields safe Simple Communicative •Maximum efficiency of 97 q •Integrated ESS DC switch- •Easily accessible connection area •Bluetooth*technology as standard •Multi-String technology` disconnector •Coble connection without tools •Multilingual graphic display •Transformerless,with H5 topology •DC plug system SUNCLIX •Multi-function relay as standard •Shade management with OptiTrac Global Peak SUNNY BOY 3000TL / 4000TL/ 5000TL Perfection Plus. Usability. The transformerless Sunny Boy generation More communicative,easier to use and more efficient than ever:this Sunny Boy is setting new standards in inverter technology. A modern graphic display,readout of daily values even after sunset,simplified installation concept and wireless communication via Bluetooth®:The new Sunny Boys fulfill every wish.With the new OptiTrac Global Peak shade management and an optimal efficiency of 97%,the inverters ensure optimum solar yield.As transformerless,multi-string devices,the Sunny Boy 4000TL and 5000TL provide maximum flexibility for plant design,and are the first choice for demanding generator designs. 'Sunny Boy4000TL/5000TL Technical data Sunny Boy Sunny Boy Sunny Boy Sunny Bay 3000TL 4000TL 4000TL/V 5000TL Input(DC) i Max.DC power(@ cos ip m 1) 3200 W 4200 W 4200 W 5300 W s Max.DC voltage 550 V 550 V 550 V 550 V MPP voltage range 188 V-440 V 175 V-440 V 175 V-440 V 175 V-440 V DC nominal voltage 400 V ADO V 400 V 400 V € 2 Min.DC voltage/start voltage 125 V/150 V 125V/150 V 125 V/150 V 125V/150V = Max input current/per string 17A/17A 2 x 15A/15A 2 x 15A/15A 2x 15A/15A Number of MPP trackers/strings per MPP tracker 1/2 2/A 2,B:2 2/A 2,B:2 2/A:2,B:2 Output(AC) AC nominal power(Q 230 V,50 Hz) 3000 W 4000 W 3680 W 4600 W 3 Max AC apparent power 3000 VA 4000 VA 4000 VA 5000 VA Nominal AC voltage;range 220,230,240 V; 220,230,240 V; 220,230,24O V; 220,230,240 V; 180-280V 180-280V 180-280V 180-280V AC grid frequency;range 50,60 Hz t 5 Hz 50,60 Hz,t 5 Hz 50,60 Hz;t 5 Hz 50,60 Hz;t 5 Hz .x Max.output current 16A 22A 22A 22A Power factor(cos p) 1 1 1 1 Phase conductors/connection phases 1/ Efficiency � Max.efficiency/Euroeto 97.0%/96.3% 97.0%/96.4% 97.0%/96A% 97.0%/96.5% � Protection devices DC reversepolarity protection • ♦ • ESS switch-disconnector • • • • AC short circuit protection • • • • s Ground fault monitoring • • • • Grid monitoring(SMA Grid Guard) • • t • ° Galvanically isolated/ oll-pole sensitive fault curtent monitoring unit /• —/• —/• /• 4 Y Protection class/overvokage category 1/111 General data u Dimensions(W/H/D)in mm 470/445/180 470/445/180 470/445/180 470/445/180 Weight 22 kg 25 kg 25 kg 25 kg Operating temperature range -25*C...+60*C -25*C...+60'C -25'C..-+60*C -25*C.-+60*C c Noise emission(typical) 5 25 dB(A) 5 29 dB(A) 5 29 dB(A) 5 29 d8(A) 8 Intemal consumption(night) <0,5W <0.5 W <O.S W <0.5W W Topology tronsformedess transformedess transformedess tronsformedess Cooling concept Convection Opticool OptiCool OptiCool Ele(as per IE 605291protectiorating/connection area IP65/IP54 IP65/IP54 IP65/IP54 IP65/IP54 f (as per IEC 60529) s Climatic category(per IEC 607213-4) 4K4H 4K4H 4K4H 4K4H P Features e DC connection:SUNCUX • • • • AC connection:screw terminal/plug connector/ spring"terminal //• —/—/• —/�• —/• u Display:text line/graphic /• —/• /• /• Interfaces:RS485/Bluetooth® O/• 0/9 0/0 0/0 Warranty:5/10/15/20/25 years 0/0/0/0/0 6/0/0/0/0 0/0/0/0/0 0/0/0/0/0 ertificotes and permits(more available on request) CE,VDE 0126-1-1,DK 5940,RD 661,RD 1663,G83/1-1,PPC,AS4777,EN 50438*, C10/Cl 1,PPDS,KEMCO(ordy SB 3000n-20) *Does not apply to all national deviations of EN 50438 i •Standard features O Optional features —not available Data at nominal conditions g Type designation SB 30DOTL-20 SB 4000TL--20 5B 4000TL--20/V 0159 SB 5000TL-20 ----- Accessories - Efficiency curve SUNNY BOY 5000TLi-------------------- --------------------------------------------------- - F 98 R5 Dira.485C&4mclr(trce 10 � 96 — — _ 94 B i 92 _ OS"A-SmeBB 9a. e i c 90 2?96. � 88 V„-400 V DC 195. _... V„-300 V DC ]00 300 400 i fl6 V„-200VDC, Y M ! T 1000 2000 3000 4000 5000 P [1N] zc www.SMA-Solar.com SMA Solar Technology AG r CanadianSolar On-grid Module ClearPower CS6P is a robust solar standardized module with a tempered glass front,transparent backsheet and anodized black(or silver) aluminium frame.These modules can be used for on-grid solar applications.Our meticulous design and production techniques ensure a high-yield, long-term performance for every module produced.Our rigorous quality control and in- house testing facilities guarantee Canadian Key Features Solar's modules meet the highest quality standards possible. • Cost-effective standardized solar modules for skylight, roofing,and facades applications • Transparent backsheet features aesthetic appearance Applications and light transmission/shading(Transmission rate:5%) • Skylight • Industry leading plus only power tolerance:+5W(+2%) • Carport shading • Greenhouse roofing • Strong framed module,passing mechanical load test of • Facades 5400Pa to withstand heavier snow load • Other on-grid applications • 6 years product warranty(materials and workmanship); 25 years module power output warranty Quality Certificates • The 1 st manufacturer in PV industry to apply ISO: TS16949(The automotive quality management system) • IEC61215/IEC61730,UL1703,CE in module production since 2003 • IS09001:2008:Standards for quality management systems • IS017025 for qualified manufacturer owned testing lab, • ISO/TS 16949:2009:The automotive quality fully complying to IEC,TUV,UL testing standards management system Environment Certificates • IS014001:2004:Standards for Environmental management systems • QC080000 HSPM:The Certification for Hazardous Substances Regulations UE cIL \ \0 ®OF PV.CYCLE www.canadiansolar.com CS6P-21012151220/2251230/235124012451250P ClearPower Electrical Data 0$04*za"-a4340+s c80P-ilk Nominal MaadmumPower atSTC(Pmax) 21 OW 215W 220W 225W 230W 235W 240W 245W 25OW Optimum Operating Voltage(Vmp) 29.OV 29.OV 29.2V 29AV 29.6V 29.8V 29.9V 30.OV 30.1V Optimum Operating Current(Imp) 7.25A 7.40A 7.53A 7.65A 7.78A 7.90A 8.03A 8.17A 8.30A Open Circuit Voltage(Voc) 36.4V 36.5V 36.6V 36.7V 36.8V 36.9V 37.OV 37.1V 37.2V Short Circuit Cunerd(Isc) 7.89A 8.01A 8.09A 8.19A 8.34A 8.46A 8.59A 8.74A 8.87A Operating Temperature -40'C—+85'C Mwdmum System Voltage 1000V(IEC)/600V(U L) Mwdmum Series Fuse Rating 15A Power Tolerance +5W Pmax -0.43%C Temperature Coefficient Voc -0.34%/'C Isc 0.065%fC NOCT 45°C Under Standard Test Conditions (STC) of irradiance of 1000W/m', spectrum AM 1.5 and cell temperature of 25C Mechanical Data Cell Type Poly-crystalline Cell Arrangement 60(6 x 10) Dimensions 1638x982x4Omm(64.6x38.7x1.57in) Weight 20.Okg(44.1 lbs) Front Cover Tempered glass Frame Material Anodized aluminium alloy Standard Packaging(Modules per Pallet) 20pcs Engineering Drawings IN Curves (CS6P-250P) III 1 16 j I � � b IIr f f V'Sslt tgeiV) Y t'+ltatlr,d Jl i 'Specifications included in this datasheet are subject to change without prior notice. i w About Canadian Solar Canadian Solar Inc. is one of the world's largest solar Canadian Solar was founded in Canada in 2001 and was companies. As a leading vertically-integrated successfully listed on NASDAQ Exchange (symbol: CSIQ) in manufacturer of ingots,wafers,cells,solar modules and November 2006.Canadian Solar has expanded its cell capacity to solar systems. Canadian Solar delivers solar power SOOMW and module capacity to 1.343W in 2010. products of uncompromising quality to worldwide customers. Canadian Solar's world class team of professionals works closely with our customers to provide them with solutions for all their solar needs.