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$UFF�t'ftQ Town of Southold 9/1/2017 P.O.Box 1179 a 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39192 Date: 9/1/2017 THIS CERTIFIES that the building SOLAR PANEL Location of Property: 1235 Cedar Dr, East Marion SCTM#: 473889 Sec/Block/Lot: 22.-244 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 2/14/2017 pursuant to which Building Permit No. 41382 dated 2/23/2017 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: roof mounted solar panels on existing accessM garage as applied for. The certificate is issued to Menzel,Adam&Johanna of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 41382 8/8/2017 PLUMBERS CERTIFICATION DATED 2-C4 �A�Rs,,� A orized Signature gUFFOj,��, Town of Southold 9/1/2017 a P.O.Box 1179 0 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39193 Date: 9/1/2017 THIS CERTIFIES that the building SOLAR PANEL Location of Property: 1235 Cedar Dr, East Marion SCTM#: 473889 Sec/Block/Lot: 22.-244 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 2/14/2017 pursuant to which Building Permit No. 41382 dated 2/23/2017 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: roof mounted solar panels on existing one family dwelling as applied for. The certificate is issued to Menzel,Adam&Johanna of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 41382 8/8/2017 PLUMBERS CERTIFICATION DATED Authorized Signature %0 of TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE o • 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#: 41382 Date: 2/23/2017 Permission is hereby granted to: Menzel, Adam 18 Litchfield Rd Port Washington, NY 11050 To: install roof-mounted solar panels on the existing single-family dwelling and on the existing accessory building as applied for. Two CO's are required simultaneously. At premises located at: 1235 Cedar Dr, East Marion SCTM # 473889 Sec/Block/Lot#22.-2-44 Pursuant to application dated 2/14/2017 and approved by the Building Inspector. To expire on 8/25/2018. Fees: SOLAR PANELS $50.00 SOLAR PANELS $50.00 ELECTRIC $100.00 ELECTRIC $100.00 CO -ALTERATION TO DWELLING $50.00 CO -ACCESSORY B ING $50.00 Building ctor Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1502 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings,property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of I% 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. \ n\0 New Construction: Old or Pre-existing Building: ,/ (check one) Location of Property: House No. Street Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Block Lot Subdivision Filed Map. Lot: \e Permit No. Date of Permit. Applicant: c�� Health Dept.Approval: Underwriters Approval: Planning Board Approval: / Request for: Temporary Certificate Final.Certificate: ✓ (check one) Fee Submitted: $5l Applicant Signature pF SOUK,®l Town Hall Annex ® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 A ® �� roger.richert(cD-town.southold.ny.us Southold,NY 11971-0959 ®lycoum,�c� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Adam Menzel address: 1235 Cedar Drive city;East Marion st: New York zip: 11939 Budding Permit# 41382 Section: 22 Block: 2 Lot: 44 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE contractor: DBA: Long Island Power Solutions License No: 36178-ME SITE DETAILS Office Use Only Residential X Indoor 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 Ceding 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 Fixture Time Clocks Disconnect Switches Twist Lock Exit Fixtures TVSS Other Equipment: 11.310W Roof Mounted Photovoltaic System to Include 39 Hanwha 290 Panels with 39 Enphase M 215 Micro Inverters. Notes, Inspector Signature: Date: August 8, 2017 0-Cert Electrical Compliance Form.)ls - # TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL)- REMARKS: eqlc—� DATE ! INSPECTOR c FIELD II ZP' DMON=- OR'V ..DA m , S FUUNDA= (1ST) - .......�. , ._..------- FOUND�Tx4N'(2N19) � � N { ROUGH FR IY IQ& PLUM IN'G 411 INSULATION PEA N,Y. STATE ENMRCGY GORE 1 =-0 o" A 1 1 , • t b m TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN BALL Board of Health SOUTHOLD,NY 11971 4 sets of Bi ilding Plans TEL: (631)765-1802 Planning Board approval FAX: (631) 765-9502 2 Survey SoutholdTown.Norfforknet PERMIT NO. J Check 'Septic Form N.Y.S.D.E.C. Trustees C.O.Application 2 Flood Permit Examined 0\ 20 Single&Separate Storm-Water Assessment Form M � D Contact: Approved 20 ���� `° Mail to: Disapproved,a/c C) F 4 2017 Phone; Expiration 20 P1TII.DING DEPT• 'IC® nspector APPLICATION FOR BUILDING PERMIT Date 20_a_ 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 re a ' ns,and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant or name,if a corporation) (Mailing address of applicant)• State whether applicant is owner,lessee,agent,architect,engineer,general contractor, electrician,plumber or builder Name of owner of premises (As on the tax roll or latest deed) If applicant is a corporatio a duly a riz d officer ..� (Name and title ofco"r porate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. f5-SS( cA--!A 1. Location of land on whipproposed work will be done: Cl House Number Street !� Hamlet County Tax Map No. 1000 Section d�� Block Lot �,�. " - i Subdivision Filed Map No. !%:LN Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy e1�r_NK C-GX �Q$211-ca\ 3. Nature.of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Worker �oZYo t1 (Description) OCAr' 4. Estimated Cos` \t\AM-c)n Fee (To be paid on filing this application) S. 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-graded?YES NO__,,/Will excess fill be removed from premises?YES NO_,e!f i�3s c�cr O�`q3 14.Names of Owner.of pr mis e Z Address os�o 'hone No. ��-y5�'Oji\�?a Name of Architects Addres e � s �Phone No 63ic\-M Name of Contractor �ddressc c, Phone No.lo��-3 -b6C 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *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 * 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 ,/ *IF YES,PROVIDE A COPY. STATE OFNEW YORK) SS: COUNTY OF)(1 6 Ti e h o,�\ \i eL- Vr—cs \ being duly sworn,deposes and says that(s)he is the applicant (Name,of individual signing contract)above named, (S)He is the CMA�CE (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 thb best of his knowledge and belief,and that the work will be performed in the manner set forth in the applicatijit *GWMi015 ESTABROOKE NOTARY PUBLIC-STATE OF NEW YORK Sworn two before me this - "J ,No.01 ES6259997 day of (s 20 N _ Qusiified-ln Dutch®ss County Commission Expires 04-16.202 Notary Public Signature of Applicant Scott A. Russell ,� NSu Ir 116, STO][L.lMMIWA\' IE]k SUPERVISOR 09 MANAGEMENT SOUTHOLD TOWN HALL-P.O.Box 1179 Q 53095 Main Road-SOUTHOLD,NEW YORK 11971 Town of Southold CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET ( TO BE COMPLETED BY THE APPLICANT ) DOES THIS PROJECT INVOLVE ANY OF THE FOLLOWING: Yes No (CHECK ALL THAT APPLY) ❑[fA. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. ❑ff13. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. C. 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. ❑[Z E. Site preparation within the one-hundred-year f loodplain as depicted on FIRM Map of any watercourse. ❑[3F. 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,Agent,Contractor,Other) S.C.T.M. #: 1000 Date: /District NAME: ��� e � d` \� Qa�V Section Block Lot �" ++ tris—'' *FOR BUILDING DEPARTMENT USE ONLY k*" Contact Information frk�rc Nit Reviewed By: — — — — — — — — — — — — — — — — - - - - - - - -Date- - - - - Property Address/Location of Construction Work: — — — \, � Approved for processing Building Permit. Stormwater Management Control Plan Not Required. to111'1\ I� Stormwater Management Control Plan is Required. (Forward to Engineering Department for Review.) FORM * SMCP-TOS MAY 2014 d T - I 5f SQfjpy� Town Hall Annex 1�( Telephone(631)765.18.02 54375 Main Road rt� no RI P.O.Box 1179 ro erricheow ) otany .us Southold,NY 1197I-0959 �OUNt`I,� i BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: l-1 ®ate: Company Name: - / soil' Name: License No.: Address: Phone No.: JOSSITE INFORMATION: (*Indicates required information) *Name: *Address: ,r *Cross Street: *Phone No.: Permit No.. Tax-Map District: 1000 Section:�� Block: Lot:... ._... *B -SGR ORK(Please print Clearly) 4— (Please Circle All That Apply) *Is job ready for inspection: YES/ Ig Rough In Final *Do-you need a Temp Certificate: YES! NO Temp Information(1f needed) *Service Size: 1 Phase 313hase 100 150 200 300 350 400 Other *New Service: Re-connect Underground Number of Meters Change of Service Overhead Additional Information: PAYMENT DUE WITH APPLICATION 82=11equest for Inspection Form ®Cl f S' Il d ` 3122 Expressway Drive S. Islandia, NY 11749 631348-0001 POWER SOLUTIONS www.longislandpowersolutions.com February 8,2017 TOWN OF SOUTHOLD—Building Division D [E -\ C 7 1� Town Hall Annex Building ; D 54375 Route 25 FEB 1 4 2017 P.O. Box 1179 Southold,NY 11971 MILDlING DEPT. Dear Building Dept: TOWN OF SOUTHOLD As per your Building Department, enclosed please find the building permit application, submitted on behalf of our client/property owner: Property Owner: Menzel,Adam- (516)456-0418 Project/Property Address: 1235 Cedar Drive, East Marion,NY 11939 Section/Block/Lot: 1000-022-02-044 Electrician/36178-ME: Michael Catizone—3122 Express Dr. S.,Islandia,NY 11749—(631)348-0001 Contractor/53562-H: Long Island Power Solutions-3122 Express Dr. S.,Islandia,NY 11749—(631)348-0001 Architecture&Planning: Paul Cataldo-646 Main St, Suite 202,Port Jefferson,NY 11777—(631)509-6800 Enclosed Please find: • Application Fee: $200.00 • Permit Application • (4) Copies of the Property Survey • (4) Copies of Equipment Specs(Module and Inverter) • (4) Copies of the Engineering Drawings • Liability, Disability& Workman's Comp Insurance Certs Please send the Receipt and Permit to Long Island Power Solutions. Should you require anything further, please contact me. C ly, !� Sue Estabrooke Long Island Power Solutions 3122 Express Drive South Islandia,NY 11749 Ph- 631-348-0001 Fx- 631-348-0018 Sue@longislandpowersolutions.com GO Green Save Green Signature Affidavit I, of , owner of the property located at Tax Map# do hereby give Long Island Power Solutions permission to sign all applications necessary to obtain a building permit for the above. SIGNATURE OF PROPERTY OWNER Sw to before me thisday of r 20 e N ARY PUBLIC LYNDE SUSETT9 ESTABROOKE NOTARY PUBLIC-STATE OF NEW YORK No.01ES6259997 Qualified In Dutcheso County My Commission Expires 04-16-2020 ,N�w'" >� F°�^,t, �'�; ���✓n /"°,'-,'"•rad i/°J�»t;' y ,..� ', .c i* • r'� "t N 0_NUMENT N79'14'00T 120.00 k 7-1-k-ms%�k x„ C? U H® Z V a D � Gro ASPHALTR/VEWA - . CONC. GARAGE e MONUMENT FOUND ® O a4,EAST O V W000/ FENCE Ltj M � a PATlO o�N '^) 0 7,EAST Z ;i "� %C 26.3,1 A 'o a FENCE LEGEND: 0.2,EAST LRM. FRAME ENC. ENCLOSED MAS. MASONRY S ' CNTVR. CANHLEVER—— MO FENCE CONC. CONCRETE d0 Lg O 30 SHED O.N. OMMANO --- aW GARAGE DUX. RR/CK 42%VDRTN RIO ROOF OVER-––- A.0. A/R CONDMONER ASP. ASPHALT 1.1. L/NE E/G✓ C CONCRL7E WALK CE CELLAR ENA4Y O.N.=OVERHEAD UMMES ON STORr W.W WNDOW WEU GRAPHIC SCALE O.T. O/L TANK L!/W WSONRY WALK FENCE > INCH = 3G FEET FE. FIRE ESCAPE co, Immy Pox ASAP OF LOT 11 a AS SHOWN ON "MAP OF A0UAVIEW PARK AT EAST MARION" S/TVA TED AT EAST BARO®ND T®DAN OF SOUTHOL® MAP N0.5621 FILED 7/30/1971 SUFFOLK COUNTY NEW YORK TAX MAP DESIGNATION 1000-022-02-044 REFERENCE NO. 16776 DATE 7/02/2016 Ell CHRISTOPHER HENN, L.S SURVEY SOLUTIONS G) z. CERTIFIED TO. ADAM MENZEL u' JOHANNA MENZEL LAND SURVEYORS MKM ABSTRACT SERVICES, INC. 46 HUNTING HILL DR. FIRST AMERICAN TITLE INSURANCE CO. DlX HILLS, NY 11746 ff MB FINANCIAL BANK, N.A. (631) 858-1675 TITLE N0.MKM-S-32589 Fax 858-1676 N.Y.S. L/C. NO. 49857 (C)COPYRIGHT 1 i 7 SU OLK-.0 N*IY DEPT QF• BQR. 3NSUMER AFFAIRSlCEhIN C .` 4r' ,ye MASTER } i IT Mt 'HAEL S-CAT This C�tt1�IG hat'th+ CATIZONE ELECTRICAL CflI+JTRAC'TiNGbe6rerls-du�y 'INC, ' f o' ensed by th4 4 t ervsot�YattaLyFf D*e fslxms+!' i r, - �tP+f�A'B3Qi�C1��t5 conte. 12161 .8 ', 0 1 1 ng, Suffolk-C" unty Departmentofla-bor, Licens & Consumer Affairs- VETERANS MEMORIAL HIGHWAY HAUPPAUGE,NEW YORK 11788 K DATE ISSUED:,- 6/6/201-4 No. 53562-H SUFFOLK COUNTY v q Home Improvement Contractor License , % I This is to certify y that 'MICHAEL J CATIZONE doing business as LONG ISLAND POWER,SOLUTIONS,INC having furnished the�reqfiirements set forth in accordance with and subject to the provisions of applicable laws,•rules and regulations of the County of Suffolk;State of New York,is hereby licensed to conduct business as a HOME IMPROVEMENT CONTRACTOR,in the County of Suffolk, License Category J NOT VALID WITHOUT Additional Businesses, Other DEPARTMENTAL-SEAL AND A CURRENT CONSUMER AFFAIRS ID CARD Commissioner T 1ARV ,.,NV Suffolk County Department ®f Labor, Licensing Consumer Affairs VETERANS MEMORIAL HIGHWAY HAUPPAUGE,NEW YORK 11788 g DATE ISSUED: 6/6/2014 N6. 53560-ME SUFFOLK COUNTY Master Electrician License L This is to certify that MICHAEL J CATIZOr4E doing business as LONG ISLAND POWER SOLUTIONS INC having given satisfactory:evidenmof cam p6tency,is hereby-licensed as MASTER ELECTRICIAN in accordance N with and subject tb-the provisions of applicable laws,rules and regulations of the County of Suffolk,State of New York. Additional Businesses NOT VALID WITHOUT DEPARTMENTAL SEAL AND A CURRENT ID CARD "AA Commissiober LIPOWEO OP ID:CP ACORO° DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 02/26/2016 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 CONTACT CT Christine Pubins Joseph P.Price Agency,Inc. NAMPHONE 631-698-7400 ac No,631-698-5494 1150 Portion Road,Suite 14 a/c No Ext: Holtsville,NY 11742 E-MAILriceinsurance.com Joseph P.Price ADDRESS:c Pubins E-MAIL@joepriceinsurance.com _ INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Illinois Union Ins.Co INSURED Long Island Power Solutions, INSURER B:Standard Security Life Ins. 69078 Inc. 3122 Expressway Drive South INSURER c:Sentinel Insurance Company Islandla,NY 11749 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 MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR rypE OF INSURANCE D R POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICYNUMBER MM/DD MMIDD A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FRIOCCUR CG27957171 001 02/28/2016 02/28/2017 PREMIGE TO RENTED SES Ea occurrence $ 50,000 X Contractual MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY F—] E�7 F-1 LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER- $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ , HIRED AUTOS AUTOS Per accident UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER]EXECUTIVE E L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑N/A (Mandatory in NH) E L.DISEASE-EA EMPLOYE $ If yes,describe under ' DESCRIPTION OF OPERATIONS below E L.DISEASE-POLICY LIMIT $ B Disability Benefit R97411 01/01/2016 01/01/2017 Statutory C Install.Floater 12 SBA UMB629 06/17/2015 06/17/2016 100,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SOUTHOL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Townof Southold THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town Route h ACCORDANCE WITH THE POLICY PROVISIONS. Southold,NY 11971 AUTHORIZED REPRESENTATIVE , ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD LIP_OW 'EO _ -OP ID:JM �� ®y CERTIFICATE OPLIABILITI( MURANCE DATE(MMIDD,VYYYj 02/08/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON,THE-CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOTAFFIRMATIVELY- OR NEGATIVELY AMEND,,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE-OF INSURANCE DOES'NOT CONSTITUTE Al 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 statemernt,on-this;certificate does not confer rights to-the certificate holder in lieu of,such endorsement(s). PRODUCER CONTACT' Joseph P.Price A'gehcy;Inc. NAME: -Julie Fitzpatrick, 1150 Portion Road,Suite 14, _(arco.ao.Extl-631' 98-7400 - FAX No):631=698-5494 Holtsville,NY 11742 E-MAIL Joseph P.'Price ADDRFSSJ Itz atrickoe riceinsurance.com. __ _ -INSURER(S)AFFORDING COVERAGE ��NAIC 9 tINSURERE: SURER A:Illinois Union Ing.Co INSURED` Long Island Power Sol tions, SURER B:Standard SBCUrity Life'Ins. 169078 Inc. - ---�-..--,..--�---- 3122 Expressway Drive South suRERc:Sentinet Insurance Com Islandia,NY 11749 SURER D. INSURER F: COVERAGES CERTIFICATE NUMBER: REVIS16N 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 CONDIT104,OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO_WHICH THIS CERTIFICATE MAY BE ISSUED,OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HERE_IN IS'.SUBJE_CT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES;LIMITS,SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS' /NSR'' '___._.:._`""""."•' - ^-- —.AD�71'j I _U6ft.- '-'_�`__""'_T '"''[ POLICY EFF.T'POLICY€XP LTR i TYPE OF INSURANCE INS 1 WVD I -POLICY NUMBER E MMIDD/YYYY t(MMIDDIYYYYI LIMITS A I X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCEE -S 1,000;000 bAMH-O TORE-NCE CLAIM$-MADE XT OCCUR CG27957171 001 02/28/2017 s 02/26/2616 PREMISES a occurrence (S 50,000 F�: Contractual � �a E MED EXP(Any one person): $ 10,600 j I PERSONAL&ADV INJURY �S 1,000,000 j GEN' 'AGGREGATE LIMIT APPLIES PER GENERALAGGREGATE S 2,000,000 POLICY' PRO- - ��OJEGT FLOC jj t i PRODUCTS-COMPIOPAGG •5' 2,000,000 OTHER: AUTOMOBILE LIABILITY Ir 1 I i COMBINED SINGLE LIMIT S Ea accident ANY AUTO f 1 BODILY INJURY(Pei peison) ,S AOS SCHEDULED ft AUTOS AUTOS � � BODILY INJURY,(Per acciitenlj S AUTOSNON'O ( PROPERTY'DAMAGE S --^ HHIRED AUTOS" ! Peraccident) S �1 UMBRELLA UAB } OCCUR, (EACH OCCURRENCE S EXCESS LIAR i CLAIMS•MADE I AGGREGATE, S •�DED 1 t RETENTIONS i i S WORKERS COMPENSATION AND EMPLOYERS'11ABILITY` I i 1 STATUTE' ER H YlN t - JR ANY PROPRIETOR/PARtTNER/EXECUTIVE i I OFFICER/MEMBER EXCLUDED? El N/,A ] I E L.EACH ACCIDENT S I(Mandatoryin!NH) # ( f It yes,describe-under E L DISEASE-EA EMPLOYEE]S- . I t DESCRIPTION OF OPERATIONS below , i E.L DISEASE-'POLICY LIMIT $ B Disability Benefit JR97411 ' ;-0110112017 '0110112018'Statutory C InstalL,Fioater 12 SBA UM8629 06/17/2016 06/17/2017 160,000 1 _ - DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Addaional Romarks'Schodulo,may be attached if mors space is roqulred) CERTIFICATE HOLDER CANCELLATION SOUTHOL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Southold THE EXPIRATION DATE THEREOF, NOTICE WILD BE DELIVERED IN 53095 Route 25, ACCORDANCE WITH THE POLICY PROVISIONS. � Southold, NY 11971 AUTHORIZED REPRESENTATIVE [ v s a i ©1988-2.014 ACORD CORPORATION. All rights reserved. ACORD 26(2014101) The ACORD name and logo are registered marks of ACORD, New York State Insurance Fund 199 CHURCH STREET,NEW YORK,N.Y.10007-1100 (888)997-3863 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE AAAAAA 271175107 LOVELL SAFETY MGMT CO.,LLC 110 WILLIAM STREET 12TH FLR NEW YORK NY 10038 POLICYHOLDER CERTIFICATE HOLDER LONG ISLAND POWER SOLUTIONS,INC TOWN OF SOUTHOLD 3122 EXPRESSWAY DRRVE S 53095 ROUTE 25 ISLANDIA NY 11749 SOUTHOLD NY 11971 POLICY NUMBER I CERTIFICATE NUMBER PERIOD COVERED BY THIS CERTIFICATE DATE G 2354 803-5 663923 02/28/2015 TO 04/01/2017 01/08/2016 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2354 803-5 UNTIL 04/01/2017, 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. IF SAID POLICY IS CANCELLED,OR CHANGED PRIOR TO 04/01/2017 IN SUCH MANNER AS TO AFFECT THIS CERTIFICATE, 30 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 CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. PRESIDENT CATIZONE MICHAEL VICE PRESIDENT JOSEPH MILILLO LONG ISLAND POWER SOLUTIONS,INC 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 �J, DIRECTOR,INSURANCE FUND UNDERWRITING This certificate can be validated on our web site at https://www.nysif.com/certtcertval.asp or by calling(888)875-5790 VALIDATION NUMBER: 157257766 Imm�mmm�mm�nmm�nmtammuIIIII luum�lp�l���lllll 1111 11100000000000027237662 IIVV Fom1 WC-CERT-NOPRINT Version 1(03242014)[WC Pohey-23548035] U-26 3 54 [o00oD00000DD272376621[0001-0020235480351[##Gi[14291-11][Cert_NoP-CERT 1][01-00001] IWNEWorkers' CERTIFICATE OF INSURANCE COVERAGE ATE Com UNDER THE NYS DISABILITY BENEFITS LAW PART 1. To be completed by Disability Benefits Carrier or Licensed Insurance Agent of that Carrier 1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured LONG ISLAND POWER SOLUTIONS INC 6313480001 3122 EXPRESSWAY DRIVE SOUTH ISLANDIA,NY 11749 1 c.NYS Unemployment Insurance Employer Registration Number of Insured PENDING Work Location of Insured(Only required if coverage is specifically limited to 1 d Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-Up Policy) Number 27-1175107 2 Name and Address of Entity Requesting Proof of Coverage 3a Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Standard Security Life Insurance Company of New York Town of Southold 53095 Route 25 3b.Policy Number of Entity Listed in Box"1 a" R97411-000 Southold,NY 11971 3c.Policy effective period 1/1/2015 to 3/12/2017 4.Policy covers: 0 A All of the employer's employees eligible under the New York Disability Benefits Law ❑ B Only the following class or Gasses of employer's employees* Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has NYS Disability Benefits insurance coverage as described above. Date Signed 3/13/2016 By A&- ac,� (Signature of msurance camer's authonze4 representa ve or NYS Licensed Insurance Agent of that insurance camer) Telephone Number (212)355-4141 Title SUPERVISOR-DBUPOLICY SERVICES IMPORTANT: If Box"4a"is checked,and this form is signed by the insurance camer's authorized representative or NYS Licensed Insurance Agent of that tamer,this certificate is COMPLETE.Mail it directly to the certificate holder. If Box"4b"is checked,this certificate is NOT COMPLETE for purposes of Section 220,Subd.8 of the Disability Benefits Law_It must be mailed for completion to the Workers'Compensation Board,DB Plans Acceptance Unit,328 State Street,Schenectady,NY 12305 PART 2.To be completed by the NYS Workers'Compensation Board (Only if Box"4b"of Part 1 has been checked) State of New York Workers' Compensation Board According to Information maintained by the NYS Workers'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 Workers'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. DB-120.1 (9-15) CATIZOO OP ID:CP CERTIFICATE OF LIABILITY INSURANCE DA06113/2016I� 06/13/2016 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 CONTACT Christine Pubins Joseph P.Price Agency,Inc. -NAME: FAx 1150 Portion Road,Suite 14 ,C No E,d:631-698-7400 ac No:631-698-5494 Holtsville,NY 11742 E-MAIL Joseph P.Price ADDRESS:cpubins@joepriceinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Utica Mutual Insurance Company 10687 INSURED Catizone Electrical INSURER a:Utica National Assurance Co. 25976 Contracting,Inc. Michael Catizone INSURER C: 3122 Expressway Drive South INSURER D: Islandia,NY 11749 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 MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DDY EFF MPOMDCDY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ®OCCUR CPP 4784747 07/01/2016 07/01/2017 DAMAGE TO KENTFI) — PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 2,000,000 X POLICY F—]JECT F—]LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea a.d.nt ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per..dent UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATIONPER OTH- AND EMPLOYERS'LIABILITY STATUTE I ER B ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 4766763 07/01/2016 07/01/2017 E L EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED9 E-1 NIA (Mandatory in NH) EL DISEASE-EA EMPLOYEd$ 500,000 If DESCRnbe under IP ON OF OPERATIONS below E L DISEASE-POLICY LIMIT 1$ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached rf more space is required) CERTIFICATE HOLDER CANCELLATION SOUTHOL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Townof Southold THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town Route h ACCORDANCE WITH THE POLICY PROVISIONS. Southold,NY 11971 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD STATE OF NEW YORK CERTIFICATE OF NYS WORKERS' COMPENSATION INSURANCE COVERAGE Ia.Legal Name&Address,of Insured(Use street'address only) ]b.Business Telephone.Number of Insured 631-543-0282 Catizone Electrical,Contracting,Inc. lc.NYS Unemployment-Insurance Employer 3122 Expressway Drive.South Registration Number of Insured Islandia,NY 11749 Id.Federal Employer Identification Number of Insured or'Soeial Security Number Work Location of Insured (Only required if coverage is 45-5213112 specifically limited to certain locations In New Pork State, i.e., a Wrap-Up Policy) 2.Name and Address of the Entity Requesting Proof of Coverage(Entity Being Listed as the Certificate Molder) 3 a. Name of Insurance Carrier Utica Mutual insurance Co. 3b:Policy Number of entity listed in box"la" Town of Southold 4766763 53095 Route 25 Southold,'NY 11971 3c. Policy,effective period 07/01/16—07/01/17 3d. The Proprietor,Partners or Executive Officers are included. (Only check,box if all partners/officers included) all excluded or certain partners/officers excluded. This certifies thavthe insurance carrier indicated above in box "3" insures-the business referenced above in box"la" for workers' compensation under the.Netiv 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"T'. The Insurance Carrier will also notify the above certificate holder within 10 clays IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are-reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent.by regular inail.) Otherwise,this Certificate is valid for one year after this form is approved by the insurancc comer or its licensed agent,or until the policy expiration date_'listed in boa "3c", whicheveris 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 carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Joseph P Price (Print nanic of authorized rep resentative,or4icensed agent of insurance carrier) Approved by: ,i°_ '' <. 06/13/2016 (Signature) (Date) Title: Authorized Representative Telephone Number of authorized representative or licensed-agent of insurance carrier:97-3-331-8688 Please Note. Only insurance carriers and their licensed agents are authorized to issue Form C405?. Insurance brokers are NOT awhorized to issue if. C-105.2(9-07) www-.web state.ny.us <No RI( Workers' CERTIFICATE OF INSURANCE COVERAGE TATE Compensation Board UNDER THE NYS DISABILITY BENEFITS LAW PART 1. To be completed by Disability Benefits Carrier or Licensed Insurance Agent of that Carrier 1 a Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured CATIZONE ELECTRICAL CONTRACTING,INC. 6315430282 3122 EXPRESSWAY DRIVE ISLANDIA,NY 11749 1 c.NYS Unemployment Insurance Employer Registration Number of Insured PENDING Work Location of Insured(Only required if coverage is specifically limited to 1 d.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-Up Policy) Number 45-5213112 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Standard Security Life Insurance Company of New York Town of Southold 53095 Route 25 3b.Policy Number of Entity Listed in Box"1 a" Southold,NY 11971 R97483-000 3c.Policy effective period 1/1/2015 to 3/15/2017 4 Policy covers A.All of the employer's employees eligible under the New York Disability Benefits Law B.Only the following class or classes of employer's employees- Under penalty of perjury,I certify that I am.an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has NYS Disability Benefits insurance coverage as described above. Date Signed 3/16/2016 By (Signature of msurance camer's authonze4 representative or NYS Licensed Insurance Agent of that insurance carrier) Telephone Number (212)355-4141 Title SUPERVISOR-DBUPOLICY SERVICES 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 purposes of Section 220,Subd.8 of the Disability Benefits Law.It must be mailed for completion to the Workers'Compensation Board,DB Plans Acceptance Unit,328 State Street,Schenectady,NY 12305 PART 2.To be completed by the NYS Workers'Compensation Board (Only if Box"4b"of Part 1 has been checked) State of New York Workers' Compensation Board According to Information maintained by the NYS Workers'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 Workers'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. DB-120.1 (9-15) t APPROVED AS NOTED DATE: B.P.# 3 D ELECTRICAL FEE: ���BY: e,4SpECTj()1j REQUIRED NOTIFY BUILDING DEFP,R T AT 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING RETAIN STORM WATER RUNOFF 3. INSULATION 4. FINAL - CONSTRUCTION MUST PURSUANT TO CHAPTER 236 BE COMPLETE FOR C.O. OF THE TOWN CODE. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF S � S " dSTfES- N.Yss-6€t� OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY � 646 Main Street,Suite 202/ Port Jefferson,NY 11777 m Voice 631.509.6800/Fax 877.524.2732 m i www.PaulCataldoRA.com FIFDF113722,20.7 Municipality Having Jurisdiction Town of Southold Budding Department Town Hall Southold,NY 11971 Project Solar Photo Voltaic Panel Installation for Adam Menzel Section: 22 1235 Cedar Drive Block 2 East Marion,NY 11939 Lot: 44 A review has been prepared for above listed residence regarding solar panel installation on roof. Site visit verification has been prepared identifying specific site information,based on that information an evaluation of the structural capacity of the existing roof system to support the additional loads imposed by this solar panel installation Description of residence The existing roof structure is typical wood framing construction consisting of 2x6 roof rafters at a 4 in 12 and 7 in 12 pitches,all spaced at 16"on center, with a V-2"and 1'-0"eave overhangs,ridges are 2x8 and 2x6. Lumber species assumed to be Douglas Fir#2 in an unfinished attic,collar ties are 2x6 spaced at 48"on center on R-2,and the ceiling joists are 2x6 spaces at 16"on center.The subject roofs have a single layer of asphalt shingles assumed to be 3 PSF. Gypsum board ceiling is attached to the ceiling joist and not the roof rafters. �DAP Code References: ��q. Q4 �� ®� o IRC-International Residential Code 2015 o NYS Building Standards and Codes;2016 Uniform Code Supplement Q� ®® o International Energy Conservation Code 2015 v o o American Wood Council,Wood Frame Construction Manual 2012 o American Society of Civil Engineers Minimum Design Loads for Buildings and Other Structures 7-05 o National Design Specification for Wood Construction 2005 6) o Exposure Category"B"Surface Terrain331 ®� o Roof framing lumber Douglas Fir#2 ® � o All panels assumed to be in Roof Zone 3 F N *Net Design High Wind Pressure adjustment factor for building and exposure multiplier=1.25 C?1a I I7 I have reviewed the roofing structure at the project address. The structure can support the weight of the roof mounted solar photovoltaic array. The system is to be installed as per manufacturer's instructions I have determined the installation as designed will meet the requirements of the NYS Buildin Code 2016 Uniform Code Supplement,and ASCE7-05 when installed as per manufacturer's instructions. Roof Section 1 2 Mean Height 22 22 Pitch 4 in 12 7 in 12 Rafter Size(nominal) 2x6 2x6 Rafter Spacing(on center) 16" 16" Horizontal Rafter Span 13'-4" 7'-2" Allowable Spans Table R802.5.1 Max. 14'-4" 14'-4" Climatic& Ground Wind Live Load, Point Load Allowable Actual Geographic Category Snow Speed Pnet30 per withdrawal deflection Deflection Fastener Type Design Criteria Load 3 ASCE7 Lbs.per As per NYS Due to PSF Sec PSF lag bolt Building Code Gravity loads gust MPH Roof Section 1 C 1 20 130 -56.2 1 *-665 1 L/180 L/252 Use 5/16"dia.x 5"La s Roof Section 2 C 1 0 1 130 -30.4 1 *-344 1 L/180 L/557 Use 5/16"dia.x 5"Lacis As Per Lag bolt manufacturer and NDS 2005,Lag bolt Withdrawal rated at 266 lbs.per inch of thread in Douglas fir lumber,5"Lags to have 3-3/4"of embedded thread length,making withdrawal limit at 997 lbs,we use 798 lbs.as our limit per lag. Weight Distribution-Array dead load =3.5 PSF Paul Cataldo,Registered Architect ID 4N V ~Long Island°c �1 %1 ` -COGEN Disconnect POWER L I ONS Located adjacent to 3122 Expressway Drive South Utility meter - Islandia, NY 11749 - Inverter ® (631) 348-0001 Customer: Section Adam Menzel 22 _ 1235 Cedar Drive Block : East Marion, NY 2 Lot . �h,4 11939 44 i 1 Y 516-456-0418 Project: General Notes: Total system watts DC . -Enphase M-215 Micro Inverter 11531OW are located on roof behind each module. Total # of Modules -First responder access maintained and 39 from adjacent roof. -Wire run from array to connection is 40 feet. Module Type/Watt Wind Load, Q.PLUS-G4 290 Roof Section 1 Roof type Pitch Azimuth Pnet30ASCE7-05 er Fastener Type p Back-up/Inverter Type Rl Composition Shinglesl 190 680 -56.2 PSF Use 5/16 " dia. 5" Las En hase M-215 80 -30.4 PSF Use 5/16 " dia. 5" Las U ort: R2 Composition Shingles 30 15 pp Iron Ridge XR-100 Another Solar Installation Sheet Index Legend car � By S-0 Cover Sheet / Site Plan First responder access ® paul cataldo �<v B PLANNING PC 646 Main Street,Suite 202 S-1 Roof Diagram Utility Meter X900 � d " (-® ,�1 � " 'L~`'` r S-2 DetailPort Jefferson.NY 11777 �� Y F El'uPV Disconnect Voice 631 509 6800 Fax 877 524 2732 , F-C Fire Clearance o Vent Pipe Paul@PaulCataldORACOm 3631POWER SOLUTIONS 4 www.Pau1CataldoRA coin E-1 One - Line ° E-2 Micro Inverter riser diagram D4 Chimney Date: Q, Satellite 1.30.17 Cover S eet/ Revised: Site Plan This PV Solar project complies with the 2015 International Residential Code (IRC), the 2016 NYS Uniform Code Supplement,the 2015 Wood Frame Construction Manual (WFCM 2015), S-0 NFPA 70 Standard "National Electrical Code" and the Zoning Code of the Town of Southhold. TP G0 Lem ������0 501-611 POWER SOLU7qONS 24'-9" 3122 Expressway Drive South ° Islandia, NY 11749 (631) 348-0001 Sky 15'-4" Sky 9'-6" Customer: F7 T= 0 L Adam Menzel 1235 Cedar Drive East Marion, NY R-1 R-2 11939 # Modules 28 # Modules (11) Project: Pitch: 190 Pitch: 300 Total system watts DC . Azimuth: 680 Azimuth: 1580 11931 OW Total # of Modules 39 Module Type/Watt : Q.PLUS-G4 290 Back-up/Inverter Type . En base M-215 ppu ort: a Iron Ridge XR-100 paul cataldo CA X - ARC"17ECfVRE&PI -.PC �py��+ ®® zl. 646 Main Street,Suite 202 yp N Port Jefferson,NY 11777 Voice 631 509 6800 r Fax 877 524 2732 3'-3 1/ Paul@PaulCataldoRAcom � www PaulCataldoM com �� ® 63A ®� q Date: / 51-53/411 1.30.17 Revised: Diagram ,,. 1st Responder Access - 1 f minimum of 36"unobstructed as per Section 8324 of the 2015 IRC TP Long Island POWER SOLUTIONS 3122 Expressway Drive South IronRidge R 100 Rail Islandia, NY 11749 (631) 348-0001 f s Customer: ~ mid j L Foot Flashing Menzel .- .. _ g Adam 1235 Cedar Drive r-1 IronRidge XR 100 Rail „X5„ Stainless East Marion, NY ;IronRidgeXR100Rail 516 Steel Lag Bolt 11939 Project: Total system watts DC Designed as per ASCE7-05 1 1131O Total # of Modules : Modules mounted flush to roof Solar Module 39 no hiModule Type/Watt : higher than 6 above surface. Q.PLUS-G4 290 -I, INI.GE K - - 3 - )/8 Back-up/Inverter Type General Notes: En hase M-215 red to roof rafters. u - L Feet are secured _ pport: @80" O.C. using 5/16" x 5" stainless Iron Ridge XR-100 g SDA steel Lag bolts. CA�� - Subject roof has One layer. ® paul cataldo e `o �� J ARCHITECR/ftEBPWSNWG PC '1g �QY®Pe � - All penetrations are sealed and flashed. Po MamStreetSurte27 Port Jefferson,NY 11777 Voice 631 509 6800 � Fax 877,524 2732 Paul@PaulCataldORA corn 3 63A www PaulCataldoRA corn e Roof Section Pitch Ridge Roof Rafters Ceiling Joists Collar ties Overhang- Notes R1 4/12 2"x8" 2"x6" 16" O.C. 2"x6" 16" O.C. 1411Date: Detail - 1.30.17 TP R2 7/12 211x6" 211x6" @ 16" O.C. 2"x6" 16" O.C. 48 O.C. 12" 1Zevised. S -2 00017 f' Long Island `'c '� f �� F , �: PO1;, L TIONS 3 Access Pathway 3122 Expressway Drive South C7r®l1.nd Access Point Islandia, NY 11749 (631) 348-0001 OCustomer: Adam Menzel Utility Meter : 123 5 Cedar Drive T R-2 ata ° East Marion, NY # Modules (11) 11939 G Pitch: 30° Project: p Azimuth: 158° Total system watts DC O 11 31OW R-1 Total # of Modules . F M39 # Modules (28) -� Pitch: 19° Module Type/Watt : Azimuth: 680 Q.PLUS-G4 290 . 5. 3 Access Pathw y = Y:� _ Back-up/Inverter Type . H -215 . En has e M 9u ort: ro�.n�. Access Pont .-.. ; �,.� pP O = Iron Ridge XB-40.0 U APaul catal RB1-Z. C ® �� 646 Main Street,Suite 202 S Porton, 11777 Voiceice 63 631 5099 6800 (P� Fax 877.524 2732 p3 6 311 y®� Pau10Pau1Cata1doR&conn www.PaulCataldom corn E Fr N G�G Date: 1.s.17 F- Revised: C Composition Shingles on all Roof Surfaces Fire Clearance TP //,-"-Long Island �Q Equipment List: AC Combiner: 1-Phase Main Lug Loadcenter, 125A �� POWER SOLUTIONS - Photovoltaics: � 3122 Expressway Drive South (39) Hanwha Q.PLUS-G4 290 Note: Islandia, NY 11749 All wiring to meet the 2014 NEC and (631) 348-0001 Inverters: 2015 Energy Code Customer: (39) Enphase- M215-60-2LL-S22-IG 6OA Fused Service Rated Disconnect Maximum Inverters per 2OA Branch Circuit (16) Adam Menzel Photovoltaics: (39) Hanwha Q.PLUS-G4 290 123 5 Cedar Drive East Marlon, NY NEMA 3R En a e Cablel Inverters 11939 Junction Box (3 9) Enphase M-215 Micro Inverters Black-Ll Proj ec : Red-L2 White-Neutral Green-Ground Circuits: � (3) circuit of(13) Modules Total system watts DC 11,31OW . #12 AWG THWN for Home nms under 100' I Roof Total # of Modules #10 AWG THWN for Home runs over 100' (1)Line 1 39 (1)Line 2 (1)Neutral Module Type/Waft: (1)EGC Per Circuit >n 1" or 1 1/4"PVC Conduit Meter Q.PLUS-G4 29 OBack-up/Inverter Type : D En hase M-215 �upport: Iron Ridge XR-100 N —Lme Side Tap Y ��D 60A Fused Service Main Service Rated Disconnect 200A paul cataldo �� o O 0A 125A Load Center ® ""�"" _.""--- SOA Fuse i — _ gv4wo 646 Main Street Suite 202 (1)-20A Breaker Port Jefferson NY 11777 Voice 6315096800 Per Circuit Fax 877 524 2732 Paul@PaulCataldoRAcom 03 31 www PaulCataldoRA.com I ® I Date: Three-Lin AC Distribution Panel 1.30.17 or Sub Panel #6 AWG THWN AWG THWN 1 LRevised: Line 1 E- 1( )Line 2 (1)Line 2 Desgin subject to (1)Neutral (1)Neutral = change as per (1)EGC (1)EGC site conditions in 1 1/4"PVC Conduit (1)GEC m 1 1/4"PVC Conduit TP C`1 Long Island 0 � ENGAGE CABLE BLACK-L1POWER SOLUTIONS RED-12 WHITl -NEUTRAL GREEN--'dROOND 3122 Expressway Drive South Islandia, NY 11749 7_ , - (631) 348-0001 COMBINER BOX 1\J r ,'� 1nETER. Customer: _ - RMINATOkCAP IN5iALLED.ON Adam Menzel NOTE:The-grounding-method shown is one of multiple allowable methods:_ END OF CABLE TO METER � OR At bistRIBI noN _ UP 10 17 M215s 123 5 Cedar Drive W4EL PER'BRANCH 1RCUIT East Marion, NY ® 11939 ONE 2-ROLE 20 AMP Project: CIRCUIT BREAKERPER BRANCH CIRCUIT I 3 ETHERNET CONNECTION Total system watts DC )� ENVOY COMMUNICATIONS GATEWAY �TO BROADBAND ROUTER l M310W _ -- Total # of Modules : NEUTRAL GROUND 120 Vac POWER CABLE' 39 AC DISTRIBUTION PANEL 'OR SUBPANEL hIAGRAhVi p p p A IMPORTANT Make sure to-measure the line-to-Iine and the line-to-neutral voltage Module Type/Watt of all service entrance conductors prior to-installing any solar equipment.The voltages D FIELD WIRING forthe240Vacratedinicroinvehersshould beMthinthe fo11ot.ingranges' 240VAC SINGLE PHASE Q.PLUS-G4 290 line to line-211 to 264 Vac,line to neutral-105 to 132 Vac. Back-up/Inverter Type En hase M-215 u ort: Iron Ridge XR-100 All e uiment Conforms with UL 1741 �® 1paul cataldo ® MUfITECIVREB PUWNING PC 646 Main Street Suite 202 g�v PortJefferson,NY 11777 Voice 631 509 6800 Fax 877524.2732 Paurffau[CataldoRAcom 1. 36311 www PaulCataldoRA.com O �® Date: Wiring _ 1.30.17 Revised: Diagram TP E-2 1 � � Enphase®Microinverters EnphasUM215 en hese p E N E R G Y The Ernp Kase Microinverter System improves energy harvest, increases reliability, and dramatically simplifies design, installation, and management of solar power systems. The Enphase System includes the microinverter, the Envoy Communications Gateway,"and Enlighten® Enphase's monitoring and analysis software. PRODUCTIVE SMART - Maximum energy production -Quick and simple design, installation, - Resilient to dust, debris and shading and management - Performance monitoring -24/7 monitoring and analysis RELIABLE SAFE -System availability greater than 99.8% -Low-voltage DC - No single point of system failure - Reduced fire risk enphase° sA® E N E R G Y C us { Y Enphase®M215 Microinverter//DATA INPUT DATA(DC) M215-60-2LL-S22/S23 and M215-60-2LL-S22-NA/S23-NA(Ontario) Recommended Input power(STC) 190-270 W Maximum Input DC voltage 45 V Peak power tracking voltage 22,36 V Operating range 16-36 V 1 Min./Max.start voltage 22 V/45 V Max. DC short circuit current 15 A - -- - - - ------ - --- --- - -- --------- - --- - -------- - - --------- - - - - - ---- - - --- - -- ---- --- Max. input current 10.5 A OUTPUT DATA(AC) @208 VAC @240 VAC ? 'Rated(continuous),output power 215 W 215 W ' Nominal output current 1.0 A (Arms at nominal duration) 0.9 A(Arms at nominal duration) Nominal voltage/range 208/183-229 V 240/211-264 V Extended voltage/range 179-232 V 206-269 V Nominal frequency/range 60.0/59.3-60.5 Hz 60.0/59.3-60.5 Hz Extended frequency range 57-60.5 Hz 57-60.5 Hz Power factor >0.95 >0.95 Maximum units per 20 A branch circuit 25(three phase) 17(single phase) Maximum output fault current 1.05 Arms,over 3 cycles; 1.04 Arms over 5 cycles EFFICIENCY CEC weighted efficiency 96.0% Peak inverter efficiency 96.3/0 Static MPPT efficiency(weighted, reference EN50530) 99.6% Dynamic MPPT efficiency(fast irradiation changes,reference EN50530) 99.3% -- - -- - - --- - - - --- -- -- - - Night time power consumption 46 mW MECHANICAL DATA Ambient temperature range -40°C to+65°C Operating temperature range(internal) -400C to+850C Dimensions(WxHxD) 17.3 cm x 16.4 cm x 2.5 cm(6.8"x 6.45"x 1.0")without mounting bracket Weight 1.6 kg(3.5 lbs) Cooling Natural convection-No fans Enclosure environmental rating Outdoor-NEMA 6 FEATURES Compatibility Pairs with most 60-cell PV modules Communication Power line Monitoring Free lifetime monitoring via Enlighten software Compliance UL1741/IEEE1547, FCC Part 15 Class B CAN/CSA-C22.2 NO.0-M91, 0.4-04,and 107.1-01 To learn more about Enphase Microinverter technology, p- enphase® visit enphaseocom E N E R G Y ©2013 Enphase Energy Al rights reserved All trademarks or brands in this document are registered by their respective owner i •N"'� ':off,! J> ,,. sir.''„X 11 `s r all With its top performance and completely black design the new - — Q.PEAK GI,K-G4,1 is the ideal solution for all residential rooftop applications thanks to its innovative cell technology Q.ANTUM ULTRA.The world-record cell design was developed to achieve the best performance under real con- ditions–even with low radiation intensity and on clear, hot summer days. LOW ELECTRICITY GENERATION COSTS ®� Higher yield per surface area and lower BOS costs thanks to higher power classes and an efficiency rate of up to 18.3%. INNOVATIVE ALL-WEATHER TECHNOLOGY Optimal yields,whatever the weather with excellent low-light and temperature behavior. ENDURING HIGH PERFORMANCE Long-term yield security with Anti-PID Technology', Hot-Spot-Protect and Traceable-Quality Tra.QTM EXTREME WEATHER RATING OCELLS ' High-tech aluminum alloy frame,certified for high snow >fOP,BRAND Pv (5400 Pa)and wind loads(4000 Pa)regarding IEC. ' =2016' © MAXIMUM COST REDUCTIONS Up to 10% lower logistics costs due to higher module capacity per box. r= � � Phntnn t cins A RELIABLE INVESTMENT qurya�� Trysted emt Pco ymyriaumeJ raw my.�mum ,.Ww malule 2at4,, Inclusive'12-year product warranty and 25-year p,oa,ns�vmi�nm 3 .,;aPaasz xas linear performance guaranteez. ID 40032587 � ' APT test conditions:Cells of-1500V against grounded,with conductive me- tal fod covered module surface,25°C, THE IDEAL SOLUTION FOR: 168h z See data sheet on rear for further Rooftop arrays on information. residential budamgs Engineered in Germany QCELLS 1 1 Format 65 7 in x 39 4 in x 1 26 in(Including frame) (1670 mm x_1000 mm x 32 mm) Weight 4145 lbs(18.8 kg) -__--_ —_ °.cao�%o°m•ai>r�� ` Front Cover 0 13 in(3 2mm)thermally prestressed glass with anti,-reflection technology37 Back Cover Composite film „"„°°°•° Frame Black anodized aluminum �r'i°m••' i Cell 6 x 10 Q ANTUM ULTRA monocrystallme solar cells Junction box 2 60-3.03 in x 4 37-3 54 in x 0 59-0 75 in(66-77mmx 111-90 mm x� f 15-19_mm),Protection class IP67,with bypass diodes _ _ ,,��•u °•�"^° Cable 4 mm2 Solar cable;(+)2-39.37m(1000mm),(-)2t39 371n(1000 mm) Connector Multi-Contact MC4 or MC4 intermateable,IP68 °°°,.Qe,••, POWER CLASS 290 295= 300 f MINIMUM PERFORMANCE AT STANDARD TEST CONDITIONS,STC'(POWER TOLERANCE+5W/-DW) } Power at MPP2 Pm„ [W] 290 295 300 f Short Circuit Current* Isc [A] 9.63 970 977 E , -__ E ! Open Circuit Voltage*- V. [V] 39 19 39.48 ---39 76 Current at MPP* Im"- [A]- _ 9.07 9 17 926 1 Voltage at MPP* VMPP IV] -- -~ —3196- - 3219 V 32.41 J Efficiency2 r[ 1%] z17 4 217 7 Z 18 0 MINIMUM PERFORMANCE AT NORMAL OPERATING CONDITIONS,NOC' j Power at MP P2 Pm„ [W] - _ 2144 - LL- 2181 _ '_..__. -- 2218-1 ' e � Short Circuit Current* ----------- ------Isc -_-,[A] 777 782 78 + - --- - --- - _ ------ _-_ ---—--- - - - 8 V' Open Circuit Voltage* vac [V] 36 65 36 92 37 19 1 t� ; Current at MPP*-----_--�---_--IKPP� [A] --- -- 712 ----7 20 �-----1-- 727 Voltage at MPP* VmPP IV] 3012 3030 3049 '1000 W/m�,25°C,spectrum AM 1 5G °Measurement tolerances STC t3%,NOC x5% s 800 W/m°,NOCT,spectrum AM 15 G •typical values,actual values may differ vQ CELLS PERFORMANCE WARRANTY, PERFORMANCE AT LOW.IRRADIANCE At least 98%of nominal power during first year 10 --r-----r-----r i 55 Thereafter max.0 6%degradation per year '. ------------------------------ At least 92 6%of nominal power up to 10 years ! a - At least 83 6%of nominal power up to 25 years----------------- f 2 w All data within measurement tolerances s° - i - ' i „ i" 'u."�""' a• ___ Full warranties in accordance with the warranty ! _ s.,ayy terms of the Q CELLS sales organisation of your orespective country eo - IRRAeIANCEIW/m''I zi Typical module performance under low irradiance conditions in 4 { "tris Ne•t P� �b�°pro t. 2.W YEARS comparison to STC conditions(25°C,1000W/mr). _ — 4 '"TEMPERATURE COEFFICIENTS ~ Temperature Coefficient of Isc - - a_ [%/K] +004 Temperature Coefficient of Vim- -- -P-�[%/Kl _-_-- — -0.28 o' Temperature Coefficient of Pm, V [%/K] -0.39 Normal Operating Cell Temperature NOCT [°F] 113 t5.4(45 t3°C) 6 PROPERTIES: 1' RUJIGN Y Maximum System Voltage Vsrs [V] 1000(IEC)!1000(UL) Safety Class II I x Maximum Series Fuse Rating- _[A DC] - - 20 Fire Rating _ - - _- - C(IEC)/TYPE 1(UL) - a -- d Design load,push(UL)2 [lbs/ttz] 75(3600 Pa) Permitted module temperature -40°F up to+185'F - on continuous duty (-40°C up to+85°C) 1 -Design load,pull(UL)2 -- - [lbs/ft2] - 55 6(2666Pa) 2 see Installation manual - ! 1 1 ', i 1' i l 8 UL 1703,VDE Quality Tested,CE-compliant, Number of Modules per Pallet 32 j IEC 61215(Ed 2),IEC 61730(Ed 1)application class A - Number of Pallets per 53'Container 30 t /' Number of Pallets per 40'Container s °�E C c „us Pallet Dimensions(L x W x H) - -68.7 in x 45 3 in x 46 1 In (1745mm x 1150mm x 1170mm) I < Pallet Weight --- 1435 lbs(651 kg) NOTE.Installation instructions must be followed See the installation and operating manual or contact our technical service department for further information on approved installation and use of this product Hanwha Q CELLS America Inc 300 Spectrum Center Drive,Suite 1250,Irvine,CA 92618,USA I TEL+1949 748 59 96 1 EMAIL inquiry@us q-cells com I WEB www q-cells us Zlzf IRON RIDGE Roof Mount System d. o �VIIH115�1 s� � rte''3"c'P:,f .'•'''� ��.,�� _ 3 " r�,x>.�1•,• Iii .�"«:.•—,—''_'� .k.` e&1•�� ��Sti� °, `^ry� o {,�+ .F•j :xJ�*L.e' i{ ,�.�y:�,� ••Sh d,� rwVr;�'� ..f'S•�,p - "_ '•C. - "r J,'. n fl'-I j:Y r , ' � yam' �� r;�,,�` _ ' � _ `�,-4 'i;� ,L�_ • £`"..-IiT..Y�'•`.."".�.�.."'"" ^^^tet' °,: �'1U12`E';':;Y'{rY.� .�e,�,.,.,�, i�`�o•nr« „ rtl =- -. -,}•. .���- .u.; .[' .�'... " s "_ - - - - - _ _ _, -^ —, _ `""^ ,.sex w...�,,, . i;, :'a.' -X671,If, , h§' ,.r •; ,....u�'a,;:s-°`�"_«',.:�m^,_.-N-^ , f Built for so9ar's toughest roofs. IronRidge builds the strongest roof mounting system in solar. Every component has been tested to the limit and proven in extreme environments. Our rigorous approach has led to unique structural features, such as curved rails and reinforced flashings, and is also why our products are fully certified, code compliant and backed by a 20-year warranty. Strength Tested PE Certified ' k All components evaluated for superior ti; Pre-stamped engineering letters r r structural performance. available in most states. Class A Fire Rating Design Software Certified to maintain the fire resistance :'% Online tool generates a complete bill of rating of the existing roof. s:^ materials in minutes. Integrated Grounding 20 Year Warranty UL 2703 system eliminates separate t ' Twice the protection offered by module grounding components. ,h" = competitors. XR Reals XR10 Rail XR100 Rail XR1000 Rail Internal Splices ILI, A low-profile mounting rail The ultimate residential A heavyweight mounting All rails use internal splices for regions with light snow. solar mounting rail. rail for commercial projects. for seamless connections. • 6'spanning capability 8'spanning capability • 12'spanning capability • Self-tapping screws • Moderate load capability Heavy load capability • Extreme load capability • Varying versions for rails • Clear anodized finish Clear&black anod.finish • Clear anodized finish • Grounding Straps offered ®— Attachments FlashFoot Slotted L-Feet Standoffs Tilt Legs vfln Anchor,flash, and mount Drop-in design for rapid rail Raise flush or tilted Tilt assembly to desired with all-in-one attachments. attachment. systems to various heights. angle, up to 45 degrees. • Ships with all hardware High-friction serrated face Works with vent flashing • Attaches directly to rail • IBC& IRC compliant Heavy-duty profile shape Ships pre-assembled Ships with all hardware • Certified with XR Rails Clear& black anod.finish Lengths from 3"to 9" Fixed and adjustable lamps & Grounding End Clamps Grounding Mid Clamps Q T Bolt Grounding Lugs Q Accessories 1 y. Slide in clamps and secure Attach and ground modules Ground system using the Provide a finished and modules at ends of rails. in the middle of the rail. rail's top slot. organized look for rails. • Mill finish & black anod. Parallel bonding T bolt • Easy top-slot mounting • Snap-in Wire Clips • Sizes from 1.22"to 2.3" Reusable up to 10 times • Eliminates pre-drilling • Perfected End Caps • Optional Under Clamps Mill&black stainless • Swivels in any direction • UV-protected polymer Free Resources Design Assistant ®A� NABCEP Certified Training Go from rough layout to fully QV, Earn free continuing education credits, engineered system. For free. while learning more about our systems. � Go to IronRidge.com/rm V Go to IronRidge.com/training -7, �