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o�guFFat/'co TOWN OF SOUTHOLD �� Gy 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# 39897 Date 6/24/2015 Permission is hereby granted to Adsitt, Dwayne & Adsitt, Marilyn PO BOX 1146 Mattituck, NY 11952 To Installation of roof-mounted solar panels as applied for. At premises located at 220 Holbrook Ave, Mattituck SCTM # 473889 Sec/Block/Lot# 106.-9-18 Pursuant to application dated 6/16/2015 and approved by the Building Inspector To expire on 12/23/2016. Fees SOLAR PANELS $5000 CO -ALTERATION TO DWELLING $5000 ELECTRIC $10000 Total $20000 k , Builds spector 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 Plammng 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 dented,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 ZC_t4£, 11 , 20 J New Construction Old or Pre-existing Building (check one) Location of Properly ?,Z 6 B m l.J�Raoir__ A QV,)Q F,— "A-mz"m House No Street Hamlet Owner or Owners of Property F!P RMOI N V— D W& e- A DS-z-M Suffolk County Tax Map No 1000, Section 1 0(a Block Lot Subdivision �g Filed Map t' Lot Permit No r Date of Permit Applicant Health Dept Approval Underwriters Approval Planning Board Approval Request for Temporary Certificate Final Certificate (check one) Fee Submitted $ pplicant Signature FIELD INSPECTXil;U?0 T DATA CONIlYIE�TTS FQUNDAtION(1ST) FOUNDATION(2ND) S� G rA ROUGH FRAMINQ& H PLUMBING �- INSULATION PER N.Y. , y STATE ENERGY COM , FINAL ADDX'Z`� T5 0 , z m r � N 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)765-1502 Planning Board approval FAX: (631) 765-9502 3qq1 L.— survey SoutholdTown.NorthFork.net PERMIT NO. L— Check Septic Form NYSDEC Ft` �, E I Trustees r D Flood Permit Examined ,20 ( � , Storm-Water Assessment Form JUN 16 &QL.J Contact Approved ,20_[=� Mail to Disapproved a/c 1 BLDG DEPT TOK\J Or SOUT;4OLD Phone Expiration ,20J�o & Buildinl4a.spector APPLICATION FOR BUILDING PERMIT Date Me , 20AS— 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 gnature of ap licant or name,if a corporation) t ao wit eve P(Ace SuT-rF f®a ,ba NFtitX:A ey 1171 G (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect,engineer, general contractor, electrician,plumber or builder A(4iWT /SOLAR, (I)vTPAC O a2 Name of owner of premises PWAVA)E MAPTL yN ga r rT (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No Plumbers License No Electricians License No Other Trade's License No 1 Location of land on which proposed work will be done 220 NOL�'k� AVENUE h-.A'Tx70 C < House Number Street Hamlet County Tax Map No 1000 Section (0 60 Block q Lot Subdivision Filed Map No Lot M 2 State existing use and occupancy of premises and intended use and occupancy of proposed construction a Existing use and occupancy SI nQ�' _A6a'.LL Y 73�e_SXZE W),C b Intended use and occupancy Q=tJCQf_<_ FAMT: L. V 3 Nature of work(check which applicable) New Building Addition Alteration Repair Removal Demolition Other Work SOLA (Description) 4 Estimated CoO2 2&o Fee T (To be paid on filing this application) 5 If dwelling,number of dwelling units Number of dwelling units on each floor If garage, number of cars 6 If business, commercial or mixed occupancy, specify nature and extent of each type of use 7 Dimensions of existing structures, if any Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions Front Rear Depth Height Number of Stories 8 Dimensions of entire new construction Front Rear Depth Height Number of Stories 9 Size of lot Front Rear Depth 10 Date of Purchase Name of Former Owner 11 Zone or use district in which premises are situated 12 Does proposed construction violate any zoning law, ordinance or regulation?YES NO 13 Will lot be re-graded9 YES NO P Will excess fill be removed from premises9 YES NO L-� Po Sof[ it 4 fi 14 Names of Owner of premises DWA414 E A PS M Address t4AtrITUCK MA Phone No (031.29 S • 19107 Name of ArchrtectjM*ATg1T EP_Sf K� Addresstd ac%%A a PLoonnee No 732.7 SO- 1'7 6 S Name of Contractor A0 too N E SOVAw_ Address o ��t/0�(ll�hone Mo Col I •4H(p •SS25 oweAdtA MM 1171 co 15 a Is this property within 100 feet of a tidal wetland or a freshwater wetland9 *YES 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 NO U---' * 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 property9 * YES NO * IF YES,PROVIDE A COPY STATE OF NEW YORK) SS COUNTY OFS'yFFd(g A1NlE- LTM J A P being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the A(i FAIT/fS'O LA R 0�2 6n/T Q A C T-O R , (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 7day re me this of 20 15 Notary Public Si e of Applicant 1i G�_(C4 kb�r�'P061-C_ c_'c thec_J Y/cr1L Q`x�,b�,e6t i c t�7Css av�4/21� �..(c��j�(Y'vY►���1 CYl �P FFQ Scott A. Russell ,��°SU ��G STORMWA\T]EIK SUPERVISOR MANAGEMENT SOUTHOLD TOWN HALL-P O Box 1179 53095 Main Road-SOUTHOLD,NEW YORK 11971 Town of Southold CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) OOZES THIS PROJECT INVOLVE ANY OF THE FOLLOWING Yes No (CHECK ALL THAT APPLY) ® A. Clearing, grubbing, grading or stripping of land which affects more ,_,/ than 5,000 square feet of ground surface. [3 ❑ B. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. ❑ . Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. ❑ D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area E]E Site preparation within the one-hundred-year floodplain as depicted on FIRM Map of any watercourse. ❑ F. Installation of new or resurfaced impervious surfaces of 1,000 square feet or more, unless prior approval of a Stormwater Management Control Plan was received by the Town and the proposal includes in-kind replacement of impervious surfaces. If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name, Signature, Contact Information, Date & County Tax Map Number! Chapter 236 does not apply to your project If you answered YES to one or more of the above, please submit Two copies of a Stormwater Management Control Plan and a completed Check List Form to the Building Department with your Building Permit Application. APPLICANT (Property Owner Design Professional, gent, tractor,Other) S C T NI i` 1000 Date y� Datrict Q NAME �X&Z V _ fh�VLQ i i a+ _ Section Block Lot FOR BUILDING DEPARTMENT USE ONLY*" * Contact Information ITelrphmm Number) Reviewed By Pi over ty Addi ess/ Location of Construction Wo!k Date — — — — — — — — — — — — — — — — 27j�� 8 46('1 �� ® Appioved foi processing Building Peimit A p Stormwater Management Conti of Plan Not Requri ed talt /�1 �L "—r Stoi mwatei Management Conti of Plan is Requii ed (Forwai d to Engineei ing Depai tment foi Review) FORM # SMCP-TOS MAY 2014 oF SO�jryO Town Hall Annex 11 11 Telephone(631)765-1802 54375 Mwn Road yy��55gg QQ�� P.O.Box 1179 � roger.richert(�[01Nf1 So& oltl.ny us Southold,NY 11971-0959 , BUH.DING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION l`t-V1r�0�r1 REQUESTED BY QW� S'0(, � Nf>;tr}( F Date: 11 l S Company Name: p Name: �' �� License No.: Address: 50C. Phone No.- 631 Ll%4 - S 52 \rri JOBSITE INFORMATION: (*Indicates required information) *Name: *Address: 20 ®1. 00 PoV 6"t KA A4tt:LT Q Gtr_ *Cross Street- *Phone No.: ,Zqg . Permit No.- Tax Map District: 1000 Section: lQ Block- _ Lot: *BRIEF DESCRIPTION OF WORK(Please Print Clearly) a:N%7A 0 M OUNTH� G6 LAVA 5ZTVT C, (Please Circle All That Apply) *Is job ready for inspection: YES/ NO, Rough in Final *Do you need a Temp Certificate: YES t NO Temp Information(if needed) *Service Size: 1 Phase 3Phase 100 160 200 300 360 400 Other *New Service: Re-connect Underground Number of Meters Change of Service Overhead Additional Information: PAYMENT DUE WITH APPLICATION 82-Request for Inspection Form n rg' mom Home 170 Wilbur Place Suite 100 Bohemia NY 11716 1-800-75-SOLAR �® I 43p.a SOLAR June 10, 2015 Solar Panel Installation Adsitt Residence 220 Holbrook Avenue Mattituck, NY 11952 Dear Sir/Madam Please find the following attached documents for the Adsitt Solar Photovoltaic Installation at 220 Holbrook Avenue in Mattituck, NY • Check made payable to the Town of Southold for the fee of$200 • Two (2) original Southold Building Permit Applications • Application for Certificate of Occupancy • Application for Electrical Inspection • Stormwater Management Worksheet • Four (4) Sets of stamped and sealed architectural plans with spec sheets • Roof Diagnostics Solar's Insurance Information,including Workers Comp,Disability, &Liability documents. • Copy of ME License Please do not hesitate to contact me with any questions or concerns I can be reached at 631-416-5525 Sincerely, Jaime Coltman Permitting Specialist NRGHomeSolarcom STATE OF NEW YORK urORl{ERS'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 oft at Carrier In Legal Name atld Address of Insured(Use street address only) 1b Business Telephone Ntunber ofInsuled ROOF DIAGNOSTICS SOLAR AND (800) 757-6527 ELECTRIC OF NY LLC Ic NYS LltlemploynientInsuranceEmploy a Registration dba NRG HOME SOLAR Ntunber of hisuied 614 CORPORATE WAY VALLEY COTTAGE, NY 10989 Id Federal Eanployer Identification Ntunber of Inszned or Social Secant,Niumbet 454-17-5140 2 Name amid Address of the Entity Requesting Proof of 3a Name of Insutance Cattier Coverage(Entity Being Listed as the Celliftcate Holdei) NEW YORK STATE INSURANCE FUND Town of Southold Budding Department Budding 54375 Route 25 3b Policy Nlultberofentlt� 1lsleclnnbox"la" P O Box 1179 DBL 6523 96 - 4 Southold, NY 11971 3c Policy effective period 08/07/2014 to 08/07/2015 4,Policyco-vers- a.® All of the employer's employees eligible minder the Nei,Yeik Disability Benefirs Law b 0 Only the f0ll0%V30g class or classes of dYe enTIOoV S cnuployses Cinder penalty ofperjtiry I cel illy'that I aur an authorized representam a 0L licensed agent of the lnsturalce cancel refemced above and that the nalned nrsimed leas NYS Disability Benefits Insurance coverage as described ab0vv Date Signed 12/5/2014 lav -j;7- r Joseph J Masi (egret we of imuranoe m rner's autho nzed repesertatue of NYS Uca rsed insura rce Agent of that inisurarbe ra mer) 697-4332 Title Director of Disability Benefits Insurance Telelihone IVanlbea (866) IMPORTANT Ifbox-4a"is checked.and this form is signed b)flit ms u ice cmmees auihonxed represenialn-e or N1 S Licensed rnlsraaace Agent of dial camer,this cerlafocatc is CObIPLETE Mail a dtreelly to rite censftcate hokter. If boe'4V is checked alas ernrfieara is NOT COMPLETE for pwposes ofSeerion 220 5ubd Sof die Dimbt(tt}Benefits Labs. Ii must be ntailed Tor torupleaon W die AI+arkrrs'E''oanpCnsOfioa Board DB p8ons Attepiaettt Vint 20 P.�Snrtei Albany.Neu Yor11220 i PART 2.To be completed by NYS WorkerS'Carnpensatlon Board(Only If box"4W'of Part I has been checked) State Of New York Workers'Compensation Board According to information innultamd try the NYS Wort ers'Compensation Board the above-named eiWloyer has cQuiplled with the N'YS Disabihly Beliefits La%v wr(h resgeet to all of hLAer emeplovees Date Signed By (Situiarmg of NYS'a't'orhers'Conilmasarton Board Emplo)ee) Telephone Nnnlbel Title Please Note.Only insivance camels licensed to v ente NYS disability benefits insurance policies and NYS licensed insurance agents of diose mstitance comers are,iiithonaedto issue Fon11 DB-120.1, Insurance brokers are NOT atithorized io issue this ffonri, DB.1201(5-06) Certificate Number 298903 Additional histmctions for Fonn DB-120 1 By signing thus form, the insurance carrier identified in box"K on this form is certrftang that it is insuring the business referenced in box"1n"for disability benefits under the Next York State Disabiliti Benefits Lax% The Insurance Carrier or its licensed agent will send tilts Certificate of Insurance to the entity-listed as the cemficate holder in box "T' Tins Certificate is valid for the earner o one rear afier dirs form is approved Ar the in siiranc€carrier or its licensed agent,or thepoli-y expiration date listed in box "3c". Please Note Upon the cancellation of the dtsabilrn benefit poliq indicated ort tilts foam,if tate business continues to be named on a pernitt license or contract issued b: a certificate holder the business must pro=ute that certificate holden mth a nex Certificate ofTKYS Disabilin Benefits Cmerage or other aurhorized proof that the business is complving with the mandator-i cot erage requirements of the New York State Disability Benefits Lai DISABILITY BENEFITS LAW §220.Subd.8 (a) The head of a state or municipal depaltuient board, conlnlissioil of office autholized of lequiled by later to iasite any perinit for or 111 connection iN,ith any work illN,olving die employ lent of employees ill eniploynlent ab defined in this airicle. and not witllStaIltllnaally general or special statute requiring or authorizing the issue of such permits. �,liall not issue such penult liilles5 ploof duly subscirbed by ail insurance caiiier is produced ill a tolili Satisfactory to the chap, that the payment of disability benefits fol all einp10yees llas been sectued as p10N ided by this article. Nothing hele111, howeN el. Shall be consulted as cleating any liability oil the part of Such State 01 niullicipal departilient. board, coiiiniis51on or office to pay any disability bellefits to any such employee if so employed. (b) The head of a state of lllumcipal depaiiiiient, board, coniiiiisslon or office authorized of required by law to enter into any contract for or in connection iidth any wolk involving the elnploynient of employees In elllploy'nlent as defined ill thW aiticle. and Ilohvidistanding ally general oI special statute legillling of authorizing anv such contract. shall not enter into anv such contract tulless proof duly subscribed by all insurance camel is produced In a foriii satlsfactoly to the chap that the pavilient of disability benefits for all employees has been secured as provided by this article. DB-120 1 (5-06)Reverse A� CERTIFICATE OF LIABILITY INSURANCE °;tio5/220 4 Y' 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 ALTERTHE COVERAGE AFFORDED BYTHE 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 endorsements) PRODUCER CONTACT Danielle Butterfield MCGRIFF,SEIBELS&WILLIAMS,INC NAME PO Box 10265 AiCNtJo Ext 800 476-2211 C No Birmingham,AL 35202 E MAIL dbutterfield@mcgriff com ADDRESS INSURER(S)AFFORDING COVERAGE NAIC# INSURER A Scottsdale Insurance Company 41297 INSURED INSURER B Liberty Mutual Fire Insurance Company 23035 Roof Diagnostic Solar Holdings,LLC Roof Diagnostics Solar&Electric of NY,LLC dba NRG Home Solar INSURER C Federal Insurance Company 20281 614 Corporate Way Suite 4 Valley Cottage,NY 10989 INSURER D Navigators Specialty Insurance Company 36056 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER FNFXDPLK 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 TYPE OF INSURANCE ADDLISUBR POLICY EFF POLICY EXP LTR IN WVD POLICY NUMBER MM/DDlYYYY MM/DD/YYYY LIMITS A GENERAL LIABILITY 102590435C 08/04/2014 07/01/2015 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 100,000 CLAIMS-MADE OCCUR MED EXP(Any one person) $ excluded PERSONAL&ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 4,000,000 GEN L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 4,000,000 POLICY 71 PRO LOC $ B AUTOMOBILE LIABILITY S2Z91462454014 04/29/2014 04/29/2015 lE0 aBINdeD SINGLE LIMIT $ 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ IX HIRED AUTOS X AUTOS peracddent Deductible Comp/Coll $1,000 D UMBRELLA LIAR X OCCUR ELU782570/01/2015 08/04/2014 07/01/2015 EACH OCCURRENCE $ 5,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED I I RETENTION$ $ C WORKERS COMPENSATION 00447277940000 07/01/2014 07/01/2015 XTORY TAT OT AND EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE YIN N/A E L EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E L DISEASE-EA EMPLOYEE $ 1,000,000 If yes describe under 1,000,000 DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule if more space is required) Certificate Holder Is Additional Insured under General Liability as required by written contract 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 Annex Building 54375 Route 25 AUTHORIZED REPRESENTATIVE PO Box 11790 91. Southold,NY 11971 t i .LwS r-e Page 1 of 1 @ 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 WORKERS' COMPENSATION BOARD CERTIFICATE OF NYS WORKERS' COMPENSATION INSURANCE COVERAGE Ia. Legal Name&Address of Insured(Use street address lb Business Telephone Number of Insured only) 800-757-6527 Roof Diagnostics Solar&Electric of NY lc NYS Unemployment Insurance Employer Registration 614 Corporate Way,St 4 Number of Insured Valley Cottage,NY 10989 50-39533-4 ld Federal Employer Identification Number of Insured or Work Location of Insured (Only required if coverage is Social Security Number specifically limited to certain locations in New York State, 454175170 i e,a Wrap-Up Policy) 2 Name and Address of the Entity Requesting Proof of 3a Name of Insurance Carrier Coverage(Entity Being Listed as the Certificate Holder) Federal Insurance Company Town of Southold Building Department 3b Policy Number of entity listed in box"la" Town Hall Annex Building 54375 004 4727794 00 Route 25 3c Policy effective period PO Box 1179 Southold NY 11971 07/01/2014 to 07/01/2015 3d The Proprietor,Partners or Executive Officers are X included(Only check box if all partners/officers included) ❑ 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(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy) The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2" The Insurance Carver will also notify the above certificate holder within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on tins Certificate (These notices may be sent by regular marl) Otherwise, this Certificate is valid for one year after this form is approved by the insurance carver or its licensed agent, or until the policy expiration date listed in box"3c",whichever is earlier 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 must provide that certificate holder with a new Certificate of Workers' Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carver referenced above and that the named insured has the coverage as depicted on this form Approved by Ronald B Gadrosich.McGnff.Seibels&Williams hic (Executive Vice President) (Print name of authorized representative or licensed agent of insurance'camer) 12/5/14 Approved by (Signature) (Date) Telephone Number of authorized representative or licensed agent of insurance carrier (205)581-9415 Please Note Only insurance carriers and their licensed agents are authorized to issue Form C-105 2 Insurance brokers are NOT authorized to issue it C-105 2(9-07) tq-10%20 1 STATE OF NEW YORK WORKERS' COMPENSATION BOARD CERTIFICATE OF NYS WORKERS' COMPENSATION INSURANCE COVERAGE la Legal Name&Address of Insured(Use street address lb Business Telephone Number of Insured only) 800-757-6527 Roof Diagnostics Solar&Electric of NY lc NYS Unemployment Insurance Employer Registration 614 Corporate Way,St 4 Number of Insured Valley Cottage,NY 10989 50-39533-4 Id Federal Employer Identification Number of Insured or Work Location of Insured (Only required if coverage is Social Security Number specifically limited to certain locations in New York State, 454175170 i e,a Wrap-Up Policy) 2 Name and Address of the Entity Requesting Proof of 3a Name of Insurance Carrier Coverage(Entity Being Listed as the Certificate Holder) Federal Insurance Company Town of Southold Budding Department 3b Policy Number of entity listed in box"1 a" Town Hall Annex Building 54375 004 4727794 00 Route 25 3c Policy effective period PO Box 1179 Southold NY 11971 07/01/2014 to 07/01/2015 3d The Proprietor,Partners or Executive Officers are X included(Only check box if all partners/officers included) ❑ 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(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy) The Insurance Camer or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2" The Insurance Carver will also notify the above certificate holder within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons 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 marl) Otherwise, this Certificate is valid for one year after this form is approved by the insurance carver or its licensed agent, of until the policy expiration date listed in box"3c',whichever is earlier 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 must provide that certificate holder with a new Certificate of Workers' Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law Under penalty of penury, I certify that I am an authorized representative or licensed agent of the insurance carver referenced above and that the named insured has the coverage as depicted on this form Approved by Ronald B Giadrosich,McGrff,Seibels&Williams Inc (Executive Vice President) (Print name of authorized representative or licensed agent of insurance carver) 12/5/14 Approved by (Signature) (Date) Telephone Number of authorized representative or licensed agent of insurance carrier (205)581-9415 Please Note Only insurance carvers and their licensed agents are authorized to issue Form C-105 2 Insurance brokers are NOT authorized to issue it C-105 2(9-07) tq-10%20 1 r Tom Petersen Architects Planners Construction Official June 4,2015 Building Department for project at 220 Holbrook Lane Mattituck,NY 11952 Re Solar Panel Installation Adsitt Residence 220 Holbrook Lane Mattituck,NY 11952 Dear Sirs, I've reviewed the proposed solar panel installation at this location to evaluate the existing roof structure and the connection of the panels to the roof Criteria Applicable codes 2010 Residential Code of New York 2001 Wood Frame Construction Manual Design roof load 30 psf live load, 15 psf dead load,45 psf total load Design wind load 120 mph,35 psf,Exposure Category `B' My findings are as follows 1 The new solar panels will imply an additional dead load of 3 psf The existing roof structure (2x6 roof rafters @ 16"o c,with 2x4 knee walls and 2x8 ridge, spans=+/- 12'-10")is sufficient to bear this additional load 2 The solar panels are attached to the roof with the SolarMount-1 rack system by UNIRAC The rack system,roof connections and connection spacing are rated for 110 mph This project requires the larger Solar Mount I-2 5 beam(2 5"high)and spacing of flange foot connection to roof at 48"o c maximum Flange footing connections to the rail are not required to be staggered The flange foot connections to the roof are 5/16"diameter x 4"long lag bolts The total panel installation is no higher than 6"above the existing roof plane It is a violation of NYSED 7209 for any person, unless acting under the direction of a licensed professional, to alter an item in any way If an item bearing the seal of a licensed professional is altered, the altering licensed professional must attach the notation `altered by'with has seal, signature, date of alteration, and description of the alteration I therefore certify that this installation complies with the applicable codes and design loads mentioned above,as well as ASCE 7-05 and 2011 NEC(including Article 690),and is acceptable for approval Please let me know if you have any questions on this information Thanks' ASC F PET Sm rely yours, 0 !— olp. L Tom Petersen - Cc Kelcy Pegler,Roof Diagnostics, 0352913 -lp 6 Country Lane Howell,New Jersey 07731 m Telephone 732-730-1763,Fax 732-730-1783 of N E� ELECTROCAL 9NSPECTION' 'PROJECT DESCRIPTION' APRO 'ED AS NOTED nrg: 39 x 255W ROOF MOUNTED SOLAR PHOTOVOLTAIC MODULES TOTAL NUMBER OF PANELS 39 DAF ��P PROJECT SITE Home fm SYSTEMIZE 9 945kw Array Area FEE •DD By - _ S1,31 �I ROOF (Roof#1) 71022sye NOTIF BUILDING DEPARTMENT A, � DIAGNOSTICS SHEET INDEX 65' $� AM TO 4 Py? FOR THE x + SOLARANDELECTRr LLC PV-1 SITE PLAN & VICINITY MAP _ 4 PV-2 ROOF PLAN & PANELS OLL�1r,rl r; +�' ti's "" a QED Al?,IIS_ �� ,IiI.J 1 E PV-3 ROOF ATTACHMENT DETAILS F��If�D 9)IrJN Rr4y O�yapse oFrF�ii� & ELECTRIC EQUIPMENT /- - TN4 PEOUIRED v' O PV-4 ELECTRIC LINE DIAGRAM - �� T- q OR PO RED '-,? aCREl E PV-5 LABELING / Z UGH - FRA�v1IPv PLUMBING zzo+mmrao In PV-6 SPECIFICATION DETAILS PL�Iti4BING �r L 9r D�by90 �o PV-7 SPECIFICATION DETAILS /- 3 IN ULATlO r} < '�. i .` F OR NFA PV-8 SPECIFICATION DETAILS PV-9 SPECIFICATION DETAILS /- 4 FIN L - CO STRUCTION MUST •`4 6 v PV-10 SPECIFICATION DETAILS �- BE OMPLE FOR CO PV-11 SPECIFICATION DETAILS /' STRUC ION SHALL MEET TWE _ k / REQUIRE EN� F THE CODES OF N W / YORK TA E i 10 RESPONSIBLE FOR \` DESIGN%OR C 1S IUCTION ERROR 2 VICINITY MAP m PROJECT SITE 0 a) " COMPLAVI LL CODES O W 3 ° EW YORK 5A a WN CO 90- A REQUIRED >� u \` 91�\NP o05oal A �O DITION R Q abble A� ^ o o „ `sYN NY6 DEG fi �- � +' 10 40 31 w•'+x 777i��ts` � 3 - 14 '' U CY OR Rw \ � 36 Ouvl�g No ` "� 1936 3U'("•\�- �73 � E IS UNLAWFUL Rw� SOUR CAD V M Dela 15XIAY2015 -/ WITHOUT CERTIFIC T \ / CC SITE PLAN & SITE PLAN IFI ANCY 3 IHOUSE PHOTO VICINITY MAP —1 1 REWN STORM WATER RUNnrr ua.1v PV-1 mn�n� PURSUANT TO CHAPTER 236 OF THE TOWN CODE. Tom Petersen Architects Planners Construction Oficial June 4,2015 Building Department for project at 220 Holbrook Lane Mattituck,NY 11952 Re Solar Panel Installation Adsitt Residence 220 Holbrook Lane Mattituck,NY 11952 Dear Sirs, I've reviewed the proposed solar panel installation at this location to evaluate the existing roof structure and the connection of the panels to the roof Criteria: Applicable codes 2010 Residential Code of New York 2001 Wood Frame Construction Manual Design roof load 30 psf live load, 15 psf dead load,45 psf total load Design wind load 120 mph,35 psf,Exposure Category`B' My findings are as follows 1 The new solar panels will imply an additional dead load of 3 psf The existing roof structure (2x6 roof rafters @ 16"o c,with 2x4 knee walls and 2x8 ridge,spans=+/- 12'-10")is sufficient to bear this additional load 2 The solar panels are attached to the roof with the SolarMount-1 rack system by UNIRAC The rack system,roof connections and connection spacing are rated for 110 mph. This project requires the larger Solar Mount I-2 5 beam(2 5"high)and spacing of flange foot connection to roof at 48"o c maximum.Flange footing connections to the rail are not required to be staggered The flange foot connections to the roof are 5/16"diameter x 4"long lag bolts The total panel installation is no higher than 6"above the existing roof plane It is a violation of NYSED 7209 for any person, unless acting under the direction of a licensed professional, to alter an item in any way If an item bearing the seal of a licensed professional is altered, the altering licensed professional must attach the notation `altered by'with his seal, signature, date of alteration, and description of the alteration I therefore certify that this installation complies with the applicable codes and design loads mentioned above,as well as ASCE 7-05 and 2011 NEC(including Article 690),and is acceptable for approval Please let me know if you have any questions on this information Thanks) ED ARC ti S rely yours, <v0`��PSIF �rccp �� Tom Petersen Cc- Kelcy Pegler,Roof Diagnostics ql, 0352go �0 O F N 6 Country Lane•Howell,New Jersey 07731 •Telephone 732-730-1763,Fax 732-730-1783 E� ,—ARRAY-& ROOF AREA CALC'S - ='' nni- ROOF#1 ARRAY AREA = 71022 SF ome ROOF FACE AREA = 983 28 SF 710 22/983 28 = 72% OF ROOF SCA AR FACE AREA COVERED BY ARRAY ROOF DIAGNOSTICS SOLAR AND ELECTRIC LLC ♦°j��Pg o Quo 0� Y N�9 036990 pP lP OF Heb i ROOF DESCRIPTION COMPOSITE ASPHALT SHINGLES PITCH (R1) 24 AZIMUTH (R1) 167 SHADING 82% W T PONME a� , c x a APR OGM R os LEGEND N5ooyoe� ENPHASE MICROINVERTERS APs �� � M-215 60 2LL S22—IG Ep1P 2�yy Q A. ROOF ATTACHMENT -- — RAFTERS CONDUIT 11pN0 O ELECTRICAL EQUIPMENT lN���N1�C1 Pv SOND 17.1 GP ME�GZ l 11P0�Ot NO MS MODULE SPEC'S I I 36/�1 OnrMnO No 3'-3" 00vM9 Rw 0y 37 16 MAY 0010 SOLAR CAD Lr) I Lo TSM-255PD05 08 1 ROOF PLAN i E RODE PLAN & PANELS pnLFls PANELS-255W _ I W^ TRINA SOLAR PANELS '"'� PV-2 nrg. UNIRAC SOLARMOUNT Home RAIL WITH L-FOOT GREEN FASTEN FLASHING PV MODULE S;QI A ECO-GF1-BLK-812 WITH ECO-CP-SQ COMPRESSION ROOF BRACKET DIAGNOSTICS SOLAR AND ELECTRIC LLC 5/16"x4"S S LAG BOLT WITH GROUND WEEB& 2 5"MINIMUM PENETRATION SEALED MODULE CLAMP ya`�y�P pFT�9,� WITH APPROVED SEALANT COMPOSITE ASPHALT SHINGLES = ' ATTACHMENT DET&L 1 r U,�9�. °2629° ipp OF NE�V C T N rn C Cal a) � C> mom^ CCui ILL D I I I I I I I I I I I I I L a ❑ a�rZ In D: N FROM PV ARRAY Q o (N)JUNCTION BOX FOR ENVOY (N)iOOAMP PV LOAD CENTER O (EXTERIOR WALL) ;*xU � FROM UTILITY Ld PROVIDER C14 Ld (OVERHEAD) w (E)TO MAIN SERVICE PANEL w (INTERIOR WALL) (N)L GATE 120 PRODUCTION METER (EXTERIOR WALL) (N)UTILITY AC DISCONNECT o I (EXTERIOR WALL) D-M No (E)UTILITY METER °1O"°' ,!:S (EXTERIOR WALL) D O I L-A DO Dom tsMAvzots N I ® I SOLAR CAD t GRADELEVEL — OOF ATTACHMENT DETAILS &ELECTRIC EQUIPMENT ELECTRICAL ELEVATION DETAIL _ - mAyis PV-3 Home (E)MAIN SERVICE PANEL 60 FUSED AC L GATE 120 PV (E)Utility Meter 200ARATED BUS BAR DISCONNECT 45 AMP 60A FUSED AC DISCONNECT WITH PRODUCTION 1000 SOLAR ONLY SCA f LOAD CENTER JUNCTION BOX FUSES 45 A FUSESROOF GOo 3 D1 3 D2 g B ETER r;"% C 15Al2P 2 A BRANCH#1 DIAGNOSTICS 000 O O O AG/T111 AC- SOLAR AND ELECTRIC U.0 Oo0 N g! �p(SO An, __ -*---- ----- --- ----i- -JI `3�p8F PFT`pyiT (E)200A I I EGO ¢pFoF 9'Pm F' MAIN I I z I MODULES WITH .7- SOLAR Z I SOLAR ARRAY(9945kw) I I I GROUNDING WEEBS I BRANCH#1 +j"x �T-J I AND ENPHASE LL.ads 13 MODULES IN PARALLEL CONNECTED BRANCH CIRCUIT I i I M-21560-2LL S22 IG qr 03B2G° ,10 13 MODULES TRINA SOLAR TSM 255PD05 OB ON ROOF#1 I O JUN4TION BOX F F NQ 4 j BRANCH OPERATING CURRENT=14 625A I 2 BRANCH#2 I 15Al2 A BRANCH#2 13 MODULES IN PARALLEL CONNECTED BRANCH CIRCUIT j AO* 13 MODULES TRINA SOLAR TSM 255PD05 08 ON ROOF#1 I �AC�BRANCH OPERATING CURRENT=14 625A BRANCH#3 L_-1' GEC 13 MODULES IN PARALLEL CONNECTED BRANCH CIRCUIT I I EGC 13MODULES TRINA SOLAR TSM 255PD05 08 ON ROOF#1 I MODULES WITH I BRANCH OPERATING CURRENT=14 625A I j GROUNDING WEEBS I (E)GROUND ROD I I AND ENPHASE c _l_ I JUN4TION BOX M 215.60 2LL S22 IG 15Al2 2 A BRANCH#3 w Ac. W --AC c °a NOTES I N N 1 ALL MODULES WILL BE GROUNDED IN ACCORDANCE N WITH CODE AND THE MANUFACTURER S INSTALLATION INSTRUCTIONS I �_______J G O tj 2 ALL PV EQUIPMENT SHALL LISTED BY A RECOGNIZED TESTING LAB I EGC 0 D. 3 NOTIFY SERVING UTILITY BEFORE ACTIVATION OF PV SYSTEM I MODULES WITH w 4 WHEN A BACKFED BREAKER IS THE METHOD OF UTILITY 4 GROUNDING WEEBS D. INTERCONNECTION,BREAKER SHALL NOT READ LINE AND LOAD 1 15A11 P AND ENPHASE 1n WEATHER STATION I INFORMATION 5 WHEN A BACKFED BREAKER IS THE METHOD OF UTILITY INTERCONNECTION, I MONITORING M-215.60 2LL-S22 IG Q 'NO G SL THE BREAKER SHALL BE INSTALLED AT THE OPPOSITE END OF THE I to OUTLET ISLIPMAGA BUS BAR OF THE MAIN BREAKER ------ ------ ASHRAE 2%AVG 31 C 6 WORK CLEARANCES AROUND ELECTRICAL EQUIPMENT WILL BE MAINTAINED PER NEC 110 26(A)(1)110 26(A)(2)$110 269A)(3) 13.90 MM ABOVE 7 ALL EXTERIOR CONDUITS,FITTINGS AND BOXES SHALL BE RAIN TIGHT ROOF SURFACE AND APPROVED FOR USED IN WET LOCATIONS PER NEC 314 15 TEMP 53 C 8 ALL METALLIC RACEWAYS AND EQUIPMENTS SHALL BE BONDED AND MODULES SPECS ELECTRICALLY CONTINUES QTY 39 MODULES TYPE TSM 255PDOSB WATTAGE 255W INVERTER SPECS NOCT WATTAGE 184W 120%RULE FRAMETHICKNESS 35MM INVERTERTYPE ENPHASE 0 a0 Q BUSBARRATING 200 FRAME COLOR BLACK M215-60-2LLS221G ENGAGE CABLE 8, 3 010 THWN 2 MAIN BREAKER RATING 200 #BAWG BARE COPPER 1 #5THWN2EGCIGEC 3 #12 THWN2 3 #6 THWN2 (200x12)20GA-40A Voc 37 70 QTY 39 40A MAX BACKFEED Vpmax 305 WATTAGE 190.27OW GNO IN FREE AIR IN EMT CONDUIT 1 #12THWN•2EGC 1 #GTHWN2EGClGEC PROPOSEDSYSTEM 45A Isc8924 SERVICEVOLTAGE 240V VOC 240VAC VOC 240VAC VOC 240VAC IMP 836A CEO EFFICIENCY 965% ISC 117AAC ISC 11 7AAC ISC 351AAC DrawMB No SERVICE INFO ®3 JUNCTION BOX ENPHASE INVERTER BRANCH CALC"S JUNCTION BOX TO LOAD CENTER CALC"S ENPHASE INVERTER TOTAL SYSTEM CALC"S w�.By UTILITY COMPANY — O 1 L.GATE 120 PRODUCTION METER QTY 13 MAX AC 14 625A QTY 13 MAX AC 14 625A QTY 39 MAX AC 43 875A D°IP 15 MAY 2015 MAIN SERVICE VOLTAGE 240V 1 100A SOLAR ONLY LOAD CENTER NOC 09 (Oryx NOC).125% NOC 09 (GTY x Noc)x 126% NOC 09 (Of x NOC)x 135% MAIN PANEL BRAND - © 3 16A2PSOLAR BREAKER WIRE GAUGE #12 WIRE OCP 23 50A WIRE GAUGE #10 WIRE OCP 2345A WIRE GAUGE #6 WIRE OCP 61 10A SOLAR CAD MAIN SERVICE PANEL 200A D1 1 15ANP ENVOY BREAKER TEMP RATING 75°C PMPRATINGx TEMP DE RALE TEMP RATING 75°C MIP RATING.TEMP DE RATE TEMP RATING 75°C AMP RATING x TEMP DE-RATE MAIN CIRCUIT BREAKER RATING 200A �7 BOUSES AC DISCONNECT WITH MAXAC TOBELESS OR EOUAI TO AMP RATING 35AAMP RATING 65A MAXAC TO BE LE6OR EQUAL TO MAx AC TORE 1E56 OR EWAL TO MAIN SERVICE LOCATION EXTERIOR WALL 46A Fus5s AMP RATING 25A 1MpE OCP FORS LMRETOBE 1MREOCPFOR'MRETOBE 1 60AFUSEDACDI3CONNECTWITH wREOCPFORwRE 10 BE TEMP DE RATE 067 APPROVED BY 2011 NEC TEMP DE RATE 094 APPROVED 11 NEC SERVICE FEED TYPE OVERHEAD D2 45A FusE6 TEMP DE-RATE 0 94 APPROVED BY 2011 NEC MAIN SERVICE PANEL GROUND EXISTING GROUND R. ELECTRICAL LINE DIAGRAM ikPV-4 DISCONNECTION MEANS, TO BE INSTALLED AT AC OPPERATING VOLTS 240V nrgo ALL AC DISCONNECTS PER NEC 2008 690 14(C)(2) [AC 0PPERATING CURRENT 43 875 AMPS Home SOLAR AC DISCONNECT TO BE INSTALLED ON THE FACE OF THE `,01.AR SERVICE METER PANEL PER NEC 2008 ROOF 705 1 0 DIAGNOSTICS DISCONNECTING MEANS MAY BE ENERGIZED SOLAR AND ELECTRIC LLC IN THE OPEN POSITION,TO BE INSTALLED Marking Content And Format teaeD aec AT DISCONNECTING MEANS PER NEC 2008 690 17 y PgF PETFy�� Marking is required on all interior and exterior pv conduit, �'D� � 9s�� raceways, enclosures, cable assemblies, and function boxes to WARNING alert the fire service to avoid cutting them marking shall be s 04290 `2 r ELECTRIC SHOCK HAZARD placed every 10 feet, at turns and above and/or below OF 14 DO NOT TOUCH TERMINALS penetrations, and at all pv combiner and function boxes TERMINALS ON BOTH THE LINE AND LOAD SIDE MAY BE ENERGIZED Reflective weather resistant material suitable for the IN THE OPEN POSION IT environment (durable adhesive material must meet this INVERTER OUTPUT CONNECTION, requirement) TO BE INSTALLED AT MAIN SERVICE PANEL Marking Content and Format ca PER NEC 2008 690 64 (13)(7) • Marking Content caution solar circuit N Ca WARNING • Red Background a INVERTER OUTPUT CONNECTION • White lettering Minimum 3/8"letter height W o g DO NOT RELOCATE • All Capital Letters THIS OVER CURRENT DEVICE • Arial or similar font, non—bold N • Reflective weather Resistant material suitable for ¢ MARKING SHOULD BE PLACED ON the enviornment (durable adhesive material must ALL INTERIOR AND EXTERIOR PV meet this requ rement) CONDUIT, RACEWAYS, ENCLOSURES, AND CABLE ASSEMBLIES, EVERY 10 FEET, AT TURNS AND ABOVE AND/OR BELOW PENETRATIONS AND ALL PV COMBINER AND JUNCTION BOXES i I CAUTION- SOLAR CIRCUIT D,.*o No t TO BE LOCATED AT MAIN I `1 a By D, SERVICE PANEL SMAYM,S SOLAR CAD CAUTION SOLAR ELECTRIC SYSTEM CONNECTED } ' LABELING mnena �-5 nrge Home Enphaselli Mlcrolnverter//DATA SOLAR Enphase'Microinverters INPUT DATA(DC) M215-60-2LL-S22-IG/S23 IG/S24-IG ROOF Recommended input power(STC) 190-276W A DIAGNOSTICS En haseW Maximuminput DC voltage' 48V ^ rw ^ SOLAR AND ELECTRIC LLC Peak power track_ing_voftage127V-39V CPEO A9C Operating range 16V-48V aPs F PEtF Sia 9 F Mn/Max rt vtag Istart _ - `22 V/48 V _ sT lu _ so ,Z Max DC short circuit current ISA ~ r" Max input current 16A . + - 4 di Qr OUTPUT DATA(AC) 0208 VAC ®240 VAC A4rF 03 290 A 'Att,3 u R Peak'outPutp'wer- y 1 225W 225 W F _ I _ Rated(continuous)output power 215 W 215 w _r Nominal output curreor_ 11 A(A oris at nominal du_ratlon)�_ 0 9 A(Krms nominal duration), ! - - Nominal voltagelrange 208 V1 183-229 V 240 V/211264 V ot, Nominalfrequency/range' TA 0/57-61 HE ,'y 600/57-61 HE 60 a -' Extended frequency range' 57 62 5 HE _ 57.62 5 HE Y '�, Power factor s095_ >095 Maximum units per 20 A branch circuit 25(three phase) 17(single phase) d � t T maximum output fault current 850 mA rms for 6 cycles—`���y 850 mA rms for 6 cycles r EFFICIENCY N '. r - _ m CEC weighted effl eni 240 VAC 96 5% Lu oz$ cc CEC weighted effictency,208 VAC 965% O N ,Peak Inverter efficiency _ ' 95 5w _ ¢ Static MPPT efficiency(weighted,reference EN50530) 994% } W M m m �y O z Night time power consumption 65 mW max - - 0 p o The Enphase;Mm Microinverter with Integrated ground delivers increased energy harvest and MECHANICAL DATA n :t:r reduces design and installation complexity with Its ail-AC approach With the advanced M215,the DC Ambient temperature,range' -40'Cto+65*C' circuit is isolated and Insulated from ground,so no Ground Electrode Conductor(GEC(is required Dimensions(WxHxD) 163 mm x 173 mm x 25 mm(without mounting bracket) Q for the microinverter This further simplifies Installation,enhances safety,and saves on labor and _weight materials costs Cooling _ Natural convection-No fans ' Enclosure ernironmental rating_ Outdoor-NEMA 6 The Enphase M215 integrates seamlessly with the Engagep Cable,the Envoy'Communications FEATURES Gateway"%and Enlighten".Enphase's monitoring and analysis software Compahoaay„ ible with ;v Compatth 60,cell PV,modules " Communication Power line PRODUCTIVE S i fill P t E RELIABLE Integrated ground `_ _ The DC circuit meets the requirements for ungrounded PV arrays in NEC 690 35 Equipment ground is provided in the Engage Cable No` Maximizes energy production No GEC needed for imcromverter More than 1 million hours of testing 1 -__f` = additional GEC or ground is required Ground fault protection(GFP)is` _ integrated foto the m)croinveRer Minimizes impact of shading No DC design or string calculation and millions of units shipped Monitoring Enlighten Manager and MyEntighten monitoring options dust and debris required Industry-leading warranty up to 25 Compliance _ _^-r" UL174tlIEEEl5471FCC'Pari 15 Class 8 CAN/CSA- - 2 NO D-M91,= No single point of system failure Easy installation with Engage years 04-04.and 1071-01 Dasa Ne Cable Frequency ranges can be extended beyond nominal if required by the utility Drava g By Rev By Date 15MAY2015 Ot enphase- ro 1 To learn more about Enphase Micnverter technology, � �enphase SOLAR CAD p E N E R G Y C S visit enpha ie Con E N E R G Y e72r14 GqO. eErcfliy Aark#dvrar-"AttrariniwrWolnevxlw vi ileii5nnxyv ria m441,rid try tliu rrw{>C+9r,0<m+gx ELECTRICAL LINE DIAGRAM .as nrg. . ffi a a CABLING ACCESSORIES - DETAILS and SPECIFICATIONS Home SOLAR ROOF - DIAGNOSTICS SOLAR AND ELECTRIC LLC Voltage Connector Spacing Accommodates PV module orientation k•, 240VAC 4 conductors 1 025 meter(40') Portrait E�cyi� f 240VA•C,4 conductors 17 meter(67) Landscape i<' - v`r0 F9v, y 208VAC,5 conductors 1 025 meter(40') Portraitz 208VAC,5 conductors 17 meter(67') Landscape 0 290 -tp4 Description Rating Model Plumber+ Orientation #Connectors Approx weight Cable Temperature rating 90°C(194`F)wend ETiO 240-40 Portrait 40 40 ibs P 9 rY Cable insulator rating THWN 9 ET17 240 40 Landscape 40 45 lbs UV exposure rating UL 746 C Fl ET10-208-30 Portrait 30 30 lbs Conductor gauge 12A1A'G ETI 7 208-30 Landscape 30 351bs ' x Compliance UL1741•CAN/CSA C22 2 Nos 0,21 42 65 153 `additional lengths aemllable through Enphase autho tied 1821 182.2 and 182.3,IEC 60529 IP67 distributors to rn *• _ it C.6 s p in Q C x g 5+ m° W Branch Terminator Disconnecttoolcc W c a 2 Z One terminator needed per branch circuit Plan to use at least one per installation p Q h ET-TERM-10(quantity 10) ET-DISCOS(quantity 5) a The Engage Cable is a continuous length ACJ of 12AWG cable with pre-Installed Q connectors for Enphase Microlnverters to plug into The cable is handled Quick installation like standard outdoor-rated electrical EAST -Large branch capacity _ V ^ Watertight seaimg cap N = Cable clip wire,allowing it to be cut,spliced and One needed to cover each unused 2 Many needed to faster,cabling to the connector on the cabling ` racking or to secure looped cabling extended as neededSimple design ETSEAL-10(quantity 10) ET CLIP 100(quantity IOD) F L EX I S LE -No additional cables The Engage Accessories complement the 142 00013 Rev 01 Engage Cable and give it the ability to No high voltage DC S A F'E L Reduced fire risk 0 ing NO adapt to any installation Enphase Energy,Inc Drawing By S ® 201 St Street Rev By Petaluma,C0.94452 coca tsMAY 2ms Phone 877-797 4743 SOLAR CAD C us Fax 707-763.0784 r n$r4.+Dphas'nnergysnm a +t http lhvwti ennhase cons SPECIFICATION DETAILS n �d rg Haas THE Universal MODULE SOLAR Mono Multi Solutions - 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L�Pl G!"O YYI V'iq{SitiP 8tY 1.c Pli4flN0EY('f PACIIAC44r G0'tfI0UPA3fdt1 K oramn98 •` ` -,,.��,.�.^'+'-. - 1[i'Y"QLY7 PTaVtJCt i"}[.icPanly• S�§`G'GP Ltttf:UP Yat^Tt't�WaftCl'i1}•' .s �E �,., Mnifutuslntr6ae 30na^ctn,, ,; t_ _ Rev BY v "e1 \ MI. 15 MAY 2015 � 'M?d�'C3 i5EP 16'LRn14 n¢19 B40P,Cc93' ll k SOLAR CAD 6�o+"'sh�R,w - - - � ,,�",�.�,_ aJrylsfp � GJLYn+REAO],5f.l7 PMOwiULLn!6nP+5tP9G10 AMfukE USc+GIItf.PPOCt{,1 FIco{lar >^a'lili Sl+w..0aa533,5+RM Rlln�rtif PSM<ttl 3Pot4[a',9MuxiudrJ nitn5 U�`L'�nCt pr�54nF IrL�hul9e mlROui nC,cC SPECIFICATION r DETAILS nr�'` SOLANOUNT ® . . - IF U Horne &UNIRAC urlmcCvde-Compfrairflirstallatrotr�t[urrurcl SolarNlount -"'u` 'r` SOLAR Part III.Installing SolarMount SOLARMOUNT Seams ROOF Part No 110-1320,3101320-B.3101660 310168C-Et,310166D DIAGNOSTICS The Unirac Code-Compliant Installation Instructions support applicat ionsfor building permits for 3102o9C,31020$C-8,3102400,3102400-%310240D, SOLAR AND ELECTRIC LLC photovoltaic arrays using Um41014AM,4101088@, rac PV module mounting systems 410204119,410240M Aeo aq� This manual,SolarMount Planning and Assembly,governs mst:allauons using the SolarMount and aPg F PeT�S.�0 Solal Mount HD(Heavy Duty)systems. Properties Units SOLARMOUNT SOLARMOUNT HD a F� sz :._ Beam Height in 25 30 [3.1 ] SolarMount rail components Approximate Weight(per linear it) pir 0 911 1 271 N'4T 035490 aoQr F OF Nf y ` Total Cross Sectional Area ir? 0 678 1 059 Section Modulus(X,Aws) In, 0 353 0898 SedwnModulus(YAxrs) tn3 0113 0221 0 V Moment of Inertia(X Ams) m" 0464 1 450 �JX Moment of Inertia(YAms) iM 0 044 0 267 ..Chs` N car ` Radius of Gyration(X Ams) In 0 289 1 170 C Radius of Gyration(YAxis) in 0 254 0 502 Flgwe4 SolarMouiustandanirnticompomenm cu 0 'Ralts are ee[ruded using these atuminu a atiop 6005T5 6105•TS 6061 T6 aj ofN Cc) 0 Rad-Supports PV mvdules.Luse two per rowof lecl washer for attaching 1,400t.Flashings Use one per ¢ j, o modules.Aluminum ertruston,anodized standoff Untracoffers appropriate flashings tor both ; w„„= 7P �” ”„;” e ,' ~ 00 `0 } standoff types a.>',ClGs ,fi „', j� ," ;,^ Lu y� ao z 0 Rail splice-Joins and aligns rail sections into single Note.There is also aflange type standoff that dopes not a length of rail It can form either a rigid or thermal p require an L foot V_expansion loint.8 inches long,predrilled aluminum 0 Aluminum two-piece standoff{opuonal)(4"and 7') - in extrusion,anodized Use one per L-foot Two-piece Aluminum extrusion Q Includes 3/8"x3/4"serrated flange boltw[th EPDM %CTFOR T-BOLT OR r 728 washer for attaching L foot,and two 5/16'lag bolts. f SLOT FOR T-BOLT OR 0 Self drilling screw-(No JOx4r4°)-Use4perrigid f"HE%HEAD SCREW � r/a"HEX HEAD SCREW sphee or 2 per expansion joint Galvanized steel 0 Leg screw for L-foot(5/16")-Attaches standoff to 2X SLOT FOR SLAT FOR rafter _T 0 L foot-Use tosecure rails either through roonng BOTTOM CLIP 2 500 BOTTOM CUP material toles for gating re or standoffs Reftact to TopMoandng Clamps 3 DOD loading cables for spacing rdote.Please contact Unirac for use and specification of rouble L-foot TopAloun[ing Grounding Clips and Lugs 1316 �' Lfootbolt{3/8"x 3/4")-Use one per LfootrAsecure SLOT FOR rail to L foot StainlesssteelSLOT FOR 1 385 Installer supplied materials- HIX BOLT 3 HD(BOLT 10 Flange nat(3/8")-Use one per L-foot to secure rail to Leg screw for 1400t-Attaches L footof standoff to 387 Lfoot Stainless steel rafter Determine the,length and diameter based on.pull outvalues If lag screw head isesposed to elements,use 750 0 Flattop standoff(optional)(3/g") stamless steel Under flashings,zinc plated hardware is 875i�7 Drz W No Use standoffs m adequate oa�"g aY Increase the height of the arrayabove the surface of the Rev ar roof Or to allow for the use of flasl+mgs Use one per 'X '_'X ori. 75 MAY 2016 Waterproof roofing sealant-U,e a sealant appropriate L foo[ One piece Service Condition�(very severe) SOL.ARMOUam NT BeSOLARMOUNT HD Beam zinc plated welded steel Ineludes3/8"xV"bolt with to your roofing material Consult with the company SOLAR CAD cu rrentlyprovidmg warranty of roofing „r Dimeneorts speafied in Inches unless mated 14 SPECIFICATION DETAILS ,as -" nrg:, GreenFasten-GH Home ed4d for AssunbV Materials N, S01-AR Itemrto. Dexrphonotmatenaipat Quantity I ROOF 1 GF I F131111110 I 2 L1013'Dracler-(orheroprmn availitle) 1 DIAGNOSTICS 3 SOLAR AND ELECTRIC LLC 4 Lillsoltylo I F-0 ARO 74 _VT 0 Act -4 Wc Required Toot 'map, q, 4 F Al 7t_ 0 LA I I A A-- Vz-&afistm Mar 2 ftp LU 06 < ca ca W 2 z GrO6'(`a;WCFIPr-Aj,,t Guile CIL C �teri'GFI 0 CIL _0 2 normatmangmarenviinalts "ILI engagei"Is Wa5uro tem*,ptnq dqtance to a"t engaged taaarreg edge offthing Me diaiarvce desired in Step I Jipjope. AsEotmwtFY Notchilephnotto aceedZ length byllrvidtt l 4. 4b 4e nieWtUADop position for 4, 2,Will A Vlcrtfiala oWdNwaten far Me IAS bell Biglifta$61alitEcoft tarismir reC3MTner14SanEPI)Mfr3ZC lbele3ding edge of 5e.-pjqe T -C' ' l 4 POSMOM W00 Wging Mown, 4 UneupP110thOldofIM Gi-FINIttilflarningfirria. 1013,WOW 5CL 1913;2 lol-ronjuit holem the Dtamsng No Drawing By !Wnderrthe'lag ImIrglioigil the EPWwAMe&UtCQn`p R.By 5, bra&d andtttagafttil Date 15MAY2015 waster Intbefan'1419 ndudatheralter SOLAR CAD TwqueDeraogeist)eweoqloo-140torqueln0paUftdS(IV2ndingepthetAxofwo�Da andt(rr�afYearlbev,;UaldKtafrorpropemlq"i$ml*nthekPDMontheunderside ofthebwdeduatberbeTcHtOPUAIWtheSidLn2Sthe%a li-rcotripeise&tfusfigm t t DO—tOnlUethefasenerYodmay neem stop and We a Am it tomim Therrivell -retpidwed SPECIFICATION DETAILS V7.594M nrgm Locus Product Datasheet DIAGRAM-TYPICAL CONFIGURATION Home ENERGY LAR a Shielded CATS ROOF + DIAGNOSTICS INTERNET '3 t4:.•t�s SOLAR AND ELECTRIC LLC • f • MON ITORI9 .7ayh�t ;...Tsl�'o s'ii� 4i .a, si j �� pgF PET�.•P��t• os .. ¢F I f....t r'�� 1 t 3 1 6? 43 { L•tis €cab, 1/ ELECTRICAL TF t a cR Ir#S�nt�it � i �'i SERVICE OF NEVN St ° ate® ® INVERTER(S) LGAiE 120 [{vr [y�r si.rm ., M _ , ,�„�� "' PV ARRAY d isVibuted-3015",assets, x_ DIMENSIONS i SOCKET iIETEP ' METERBASE 'LOCtlSENERGY HETERMODULE COMM MODULE The LGate 120 combines,a revenue-grade,solid-state power meter with an advanced communications gateway 695m a m These components worir in conluriLtlan to remotely monitor the performance of resldentldl soldr energv Installation ± ` o C.6 Y N regardless of panel or Inverter type The LGate 120 is a one-piece completely under glass meter which Installs i 6311n a Q c X LO easily using a:tanddrTl socket base Performance data Is uploaded In near real-time to the Locus Energy SoIdIO5 _ -x?"+ "' rn° m } monitoring platform which provides a suite of toolsand analytics forasset managers ; ' „;w`, =a I_ __ ' o 0 a Z 546 in —a I a I— 600in —r ua DATA COLLECTION ^ tet —730 in ..y Q AC energy data Is collected by the meter and passed to the commun,cations,module Additional system performance data can be collected directly from meteorological sensors and supported inverters via RS-485 or Zlgbee connections All data is stored in non-volatile memory and then automatically uploaded to SolarOS at user configurable Intervals SPECIFICATIONS �PV 0040 ARM@ Pmb*dded CPU ' ' ' Accuracy ANS11229c1asX2% NETWORK CONNECTIVITY IDS CustomIwsionofL'nu(26OTA fhmwar-uWat-s Voltage Inputs 124-400vaC The communicalions gatewayinside the LGate120supportsplug andplay con nectivitythroughaceliularorEthernet Memory12UMRRAM_�' 4 rPhases sngl4�,asespntpnar�atsooreoNe network connection Once the unit Is installed and powered on it will immediately begin transmitting data without Display LCDsaeen SaceetType 25 any configuration For maximum reliability,the communications gateway-will automatically route uploads between the wireless and wired connections if either of the networks are unavailable Rsaeszynimand4`y+;ra _ y ANS TtloClass o2° F Nodous ^ FCC Part Se r D—ir No ZI9Me° PTCRD Ommdng By _ _ _ _. .. _ - AUT Carrier CumpUance Rev By FEATURES w.C ' _ Dam 15 MAY 2015 WgumIgIm ANSIC122Dpowermeter LarVcostinstallation LAN R1d5tOpdOEthernet,tullhafduplex au[opolauty - r SOLAR CAD • RS-485 and Zlgbee inputs Doesn It require entrance into the house Coular 3G GSM = yEnclasure NEMA3RType: • GSM cellular or Ethernet connectivity Plug and play activation wetuotl Ing or+cv cr scauc Weight 80Z over the air firrnwareupdates Configurable data upload interval '`Dimenskms,' 6WK,65"03 Enmronm>rit 2olo76c 95%RN non,.oridensing SPECIFICATION Warranty S-yearhmtedwarrant/ DETAILS