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HomeMy WebLinkAbout42051-Z Town of Southold 1/19/2018 P.O. Box 1179 • 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39459 Date: 1/19/2018 THIS CERTIFIES that the building SOLAR PANEL Location of Property: 475 Lilac Ln, Cutchogue SCTM#: 473889 Sec/Block/Lot: 104.-1-17 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 8/28/2017 pursuant to which Building Permit No. 42051 dated 10/16/2017 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 TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Livanos,Alexis of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 42051 12-28-2017 PLUMBERS CERTIFICATION DATED tr Authorized Signature TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE a� 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#: 42051 Date: 10/16/2017 Permission is hereby granted to: Livanos, Alexis 45 Jefferson Rd Scarsdale, NY 10583 To: install roof-mounted solar panels on existing single-family dwelling as applied for. At premises located at: 475 Lilac Ln, Cutchogue SCTM # 473889 Sec/Block/Lot# 104.-1-17 Pursuant to application dated 8/28/2017 and approved by the Building Inspector. To expire on 4/17/2019. Fees: SOLAR PANELS $50.00 ELECTRIC $100.00 CO -ALTERATION TO DWELLING $50.00 Total: $200.00 r) I Bui ding Inspector Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings,property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1%lead. 5. Commercial building, industrial building,multiple residences and similar buildings and installations,a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957)non-conforming uses,or buildings and"pre-existing"land uses: 1. Accurate survey of property showing all property lines, streets,building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied,the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy-New dwelling$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00, Swimming pool$50.00, Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00, Commercial$15. 0 Date. New Construction: Old or Pre-existing Building: X (check one) Location of Property: j ^ C House No. Street Hamlet Owner or Owners of Property: �IcI\L51(�� Suffolk County Tax Map No 1000, Section Block I Lot Subdivision Filed Map. Lot: 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: $5 Q� P is Signature Version#71.2 PIL Project/Job# 1191598 RE. Installation Approval Letter IF NEW y Project: Livanos Residence0� E r L l P S E So 6VLi0" 475 Lilac Ln ti y Cutchogue,NY 11935 ENGINEERING InC.R.C. Date of Review 1/9/2018 Eclipse Engineering,as a third party, � Permit# 42051 6% Date of Install 11/8/2017 has provided a structuraknly review of AHJ Southold Town the enclosed project. s eqq,`; .a� „ oA 095379 Loca42-1: p ida, �OFESS% SC Office Long Island sreaz;�sPo Contact Into:l 31 Date-2018.01. 14:34:27.08'0 To Whom It May Concern, On the above referenced project,the roof structural framing has been reviewed for additional loading due to the installation of the solar PV addition to the roof The structural review,including the plans and calculations only apply to the section of roof that is directly supporting the solar PV system and its supporting elements. The capacity of the structural roof framing directly supporting the additional gravity loading due to the solar panel supports and modules had been reviewed and determined to be in accordance with the requirements of the 2016 NYS Uniform Code including 2015 IBC/IRC/IEBC& 2016 Uniform Code Supplement,ASCE 7-10,and 2012 NDS I certify that the work has been completed in accordance of the provisions of the approved permits of the applicable code. Should you have any further questions or requirements pertaining to this project,please do not hesitate to contact me Dp� FLT--�"L�]"14vi"1-�3 JAN 1 8 2018 T0WI-1 OF SUUTHOLD Tesla,Inc. T =—— S L r'9- 3055 Cleamew`Nay San Mateo CA 94402 p 650 638 1028 f 650 638 1029 pF SO!/ryQl Town Hall Annex Telephone(631)765-1802 54375 Main Road y Fax(631)765-9502 P.O.Box 1179 iQ roger.riche rt(cD-town.southoId.ny.us Southold,NY 11971-0959 Q �ycoum,� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Alexis Livanos Address: 475 Lilac Lane city,Cutchogue st: New York zip: 11935 Building Permit* 42051 Section: 104 Block: 1 Lot: 17 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor. DBA: Solar City License No- 51331-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 Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks Disconnect Switches Twist Lock Exit Fixtures NSS Other Equipment: 5.2 KW Roof Mounted Photovoltaic System to Include 16- 325 W Panels, 1- SE 5000 Inverter. Notes: Inspector Signature: Date: December 28, 2017 0-Cert Electrical Compliance Form.xIs / pf SO�Tyo6 V\ 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: .t '�--Ct,� DATE , �� 1 INSPECTOR '` FIELD INSPECTION REPORT DATE COMMENTS b FOUNDATION (1ST) y -------------------------------------- 'FOUNDATION -----------------------------------FOUNDATION (2ND) C ROUGH FRAMING& y c� PLUMBING r INSULATION PER N.Y. "3 STATE ENERGY CODE FINAL ADDITIONAL COMMENTS INWO O O 1 1 �ao v 1 t 1 x d r� TOWN OF SOUTIHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDINdDEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NY 11971 4-sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: 631 765-9502 LZ Survey SoutholdTown.NorthFork.net PERMIT NO: T� Check Septic Form Y.S.D.E.C. J r f F D ,. rustees D .O.Application �.� lood Permit, Examined 20_aAUG 2 5 2017 Single&Separate Storm-,Water Assessment Form RU"ING DEMontact: Approved Ilk_20 I l TOWN OF SOUTSOLD Mail to: SolarCity-Anais Fernandez Disapproved a/c 9230 Motor Parkway Hauppauge,NY 11778 Phone: �,3�_H0(Q-a 5(Q` - Expiration 4 120 M,4 Bu n Ins tor- APPLICATION FOR BUILDING PERMIT Date S ; J , 20 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. Everybuilding permit shall expire if the mork authorized has not commenced within 12 months after the date of issuance or has not;beeri,completed within 18 irionth§•from such date. If no zoning amendments.or other-regulations affecting the property.have.b`een'enacfed in the interim;the Building Inspector may authorize,in writing;the extension of the permit for an addition-si`x-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 inspection . iJurappl or name,if a orporation) 923C rkw y Hau Y 11788 (Mailing Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder Contractor/Agent Name of owner of premises 5 U\( a nos (As on the tax roll or latest deed) t a. If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. 52057-H Plumbers License No. Electricians License No. 51331-ME Other Trade's License No. 1. Location of land on which proposed work will be done: �,, House Number Street ° , ; 0J US-Vi r"i•,,t Hamlet County Tax Map No. 1000 Section �'�'"'" (� ��� Block`��-:,,.�;y���.�.::.:, i Lot � .._..�,�i%.r.<<?7�f.:'J�',Y.ZtIQw.`I..;�SirldlfUi��%.,--•-� • 1 Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Residential b. Intended use and occupancy 3. Nature of work(check which appj1'q bl a �_ i� �'t Addition Alteration Repair Removal : f 1010601 1—" Other Work Pfti)(- M6l bclt J P (Description) 4. Estimated Cost �� the , c Irl e ZI (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 i U.G1�'J1q 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 '"��, c 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 14.Names of Owner of premises 1 Address Phone No. Name of Architect Address hone No (j Name of Contractor SolarCi Address 923C Motor Parkway Phone No. 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 OF NEW YORK) SS: ' COUNTY OF� - I being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above nafned, (S)He is the Contractor/Agent (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. Sw before me thP day off- 20 PMIUCIA M. TARP PUBUC,STATE OF oa No.OIZU632 Notic• in Snff d U igna re of Appli commbsion Lams August 3,2019 Scott A. Russell S'7 01kMWA' IE]k SUPERVISOR MAkNA.G]EI\ IENT SOUTHOLD TOWN HALL-P.O.Box 1179 53095 Main Road-SOUTHOLD,NEW YORK 11971 ' O Town of Southold 1 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) ❑❑/A. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. ❑[:)/B. Excavation or filling involving more than 200 cubic yards of material within any parcel or any contiguous area. ❑n 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. ❑d E. Site preparation within the one-hundred-year f loodplain as depicted on FIRM Map of any watercourse. ❑[E(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 Idst Form to the Building Department witEyour Building Permit Application. APPLICANT: (Property Owner,Design Professional,Agent,Contractor,Other) S.C.T.M. 1000 Date NAME. � Section Block Lot Contact Information `�'°`' — FOR BUIL�DIN�G�DEP�RTMENT USE ONLY rt. ... Reviewed By. — — — — — — — — — — — — — — — — Q Date: 0 C),J�`/7 Property Address/ Location of Construction Work: — — — — — — — — — — — — — — — — — i I` � LLA 1 A C I 1- Approved for processing Building Permit. 1 1 r tJ_ A.X\ ® Stormwater Management Control Plan Not Required. Stormwater Management Control Plan is Required. (Forward to Engineering Department for Review.) FORM SMCP-TOS MAY 2014 SDI Town Hall Annex 1 41 Telleepphxone(6316)796550-11802 54.O.Box R79 y � roger.dcher�Uiown_souttiold.nV.us P.O.Box 1179 SouthoK NY 11971-0959 oly COQ �4UIWn,�� BUIMING DEPARTAENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Date: Company Name: Name: License No.: Address: Phone No.: JOBSITE INFORMATION: (*Indicates required information) *Name: r-, �'i�,�n noS *Address: *Cross Street: *Phone No.: UA—84RU Permit No.: j Tax-Map District: 1000 Section: _ Block:_ Lot: *BRIEF DESCRIPTION OF WORK(Please Print Clearly) (Please Circle All That Apply) *Is job ready for inspection: YES/ 0 Rough In Final *Do-you need a Temp Cerifrcate: / NO Temp Information (Ifneeded) *Service Size: 1 Phase 3Phase 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 q CM Imo_ 824 Request for inspection Form �O'of SO!/ryQl Town Hall Annex 4 Telephone(631)765-1802 54375 Main Road cn Fax(631)765-9502 P.O.Box 1179 G� Southold,NY 11971-0959 Q onNi`I,� January 2, 2018 BUILDING DEPARTMENT TOWN OF SOUTHOLD Solar City Anais Fernandez 923C Motor Pkwy Hauppauge, NY 11778 Re: Livanos, 475 Lilac Lane, Cutchogue TO WHOM IT MAY CONCERN: The Following Items(if Checked)Are Needed To Complete Your Certificate of Occupancy: NOTE: Post Installation Certification letter required stating the panels were installed per NYS Building Code Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. A fee of$50.00. Final Health Department Approval. Plumbers Solder Certificate. (al permits involving plumbing after 4/1/84) Trustees Certificate of Compliance. (Town Trustees#765-1892) Final Planning Board Approval. (Punning#795-1938) Final Fire Inspection from Fire Marshall. Final Landmark Preservation approval. Final inspection by Building Dept. Final Storm Water Runoff Approval from Town Engineer BUILDING PERMIT — 42051 — Solar Panels DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 08/17/2017 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 pollcy(les)must have ADDITIONAL INSURED provisions or 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 MARSH RISK& INSURANCE SERVICES NAME: 345 CALIFORNIA STREET,SUITE 1300 PHONE ac No): CALIFORNIA LICENSE NO.0437153 E-MAIL SAN FRANCISCO,CA 94104 INSURER(S) AFFORDING COVERAGE NAIC# 998301-STND2-GAWUE-1 6-17 INSURER A:Zurich American Insurance Company 16535 IN SOIE�Clty Corporation INSURER B.N/A N/A 3055 Gearview Way INSURER C.N/A N/A San Mateo,CA 94402 INSURER D:American Zurich Insurance Company 40142 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: SEA-003418784-11 REVISION NUMBER: 5 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. INSRLTR ADDLTYPE OF INSURANCE IVSD SUER POLICY NUMBER MMLIpY EFF MMND EXP LIMITS LTR WVD A X COMMERCIAL GENERAL LIABILITY GLOO182016-01 09/01/2016 10/31/2017 EACH OCCURRENCE $ 3,000,000 RENTED CLAIMS-MADE �OCCUR PREM SES GE ToE.occurrence $ 3,000,000 X SIR:$250,000 MED EXP(Anyoneperson) $ 5,000 PERSONAL 8 ADV INJURY $ 3,000,000 MOTHER: 1.AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 6,000,000 LOC PRODUCTS-COMP/OP AGG $ 6,000,000 POLICY 0 PRO- JECT $ A AUTOMOBILE LIABILITY BAP0182017-01 09/01/2016 10/31/2017 COMBINED SINGLE LIMIT $ 5,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ X OWNEDX SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Par. Per acddenl $ UMBRELLA LIAR HOCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ D WORKERS COMPENSATION WC0182014-02(AOS) 10/31/2017 X IPER D AND EMPLOYERS'LIABILI Y STATUTE ERS ANYPROPRIETOR/PARTNER/EXECUTIVE YIN WC0182015-02(MA) 09/01/2017 10/31/2017 1,0(10,000 A OFFICERIMEMBEREXCLUDED? N/A E.L.EACH ACCIDENT $ 10/31/2017 (Mandatory In NH) EWS 0182018-01(CA) 09/01/2016 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If es,describe under Limits apply excess of$500K SIR-CA 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Evidence of insurance. CERTIFICATE HOLDER CANCELLATION Town of Southold SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 54375 Main Road THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Southold,NY 11971-0959 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh Risk S Insurance Services Stephanie Guaiumi �f ��.rr rrwti ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD STATE OF NEW YORK WORKERS'COMPENSATION BOARD CERTIFICATE OF INSURANCE COVERAGE UNDER THE NYS DISABILITY BENEFITS LAW PART 1.To be completed by Disability Benefits Carrier or Licensed Insurance Agent of that Carrier la.Legal Name and Address of Insured(Use street address lb Business Telephone Number of Insured only) SolarCity Corporation lc.NYS Unemployment Insurance Employer Registration 3055 Clearview Way Number of Insured San Mateo,California 94402 Legal Name and Address of Division/Location requesting ld.Federal Employer Identification Number of Insured or certification: Social Security Number 02-0781048 2.Name and Address of the Entity Requesting Proof of 3a.Name of Insurance Carrier Coverage(Entity Being Listed as the Certificate Holder) CIGNA LIFE INSURANCE COMPANY OF NEW YORK Town of Southold 3b.Policy Number of entity listed in box"la": 54375 Main Road NYD075344 Southold,NY 11971 3c.Policy effective period: 01/01/2017 to 01/01/2018 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 the employer's employees- Under penalty of perjury, I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has NYS Disability Benefits insurance coverage as described above. Date Signed May 24,2017 By _vmny *I(. (Signature of insurance carriers authorized representative or NYS Licensed Insurance Agent of that insurance carrier) Telephone Number 1.866-761-4236 Title Underwriting Director 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,New York 12305. PART 2.To be completed by NYS Workers'Compensation Board (Only if box "41b"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 (12-13) YORK Workers' CERTIFICATE OF STATE Compensation Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured (650)963-5100 ' SolarCity Corporation 3055 Clearview Way 1c.NYS Unemployment Insurance Employer Registration Number of San Mateo,CA 94402 Insured 49-892777 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 02-0781046 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) American Zurich Insurance Company Town of Southold 3b.Policy Number of Entity Listed in Box"1 a" 54375 Main Rd,PO BOX 1179 WC 0182014-01 Southold,NY 11971 3c.Policy effective period 09101/2016 to 09/01/2017 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 that the insurance carrier indicated above in box"3"insures the business referenced above in box"1 a"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". Will the carrier notify the certificate holder within 10 days of a policy being cancelled for non-payment of premium or within 30 days if cancelled for any other reason or if the insured is otherwise eliminated from the coverage indicated on this certificate prior to.the end of the policy effective period? ®YES ONO This certificate is issued as a matter of information only and confers no rights upon the certificate holder This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note: Upon 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' Gail Sydow (Print name of authorized representative or licensed agent of insurance carrier) Approved by* IGZ� w 0 09/01/2016 (Signature) 61 (Date) Title: Vice President Telephone Number of authorized representative or licensed agent of insurance carrier (415)538-7109 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(9-15) www wcb.ny.gov Version#69.4-TBD PIL August 10,2017 RE. CERTIFICATION LETTER Project/Job#1191598 Project Address. Livanos Residence 475 Lilac Ln Cutchogue,NY 11935 AHJ Southold Town SC Office Long Island Design Criteria: Applicable Codes=2016 NYS Uniform Code including 2015 IBC/IRC/IEBC&2016 Uniform Code Supplement,ASCE 7-10,and 2012 NDS -Risk Category=II -Wind Speed=135 mph,Exposure Category C,Partially/Fully Enclosed Method -Ground Snow Load=20 psf - MPI 2x6 @ 24"OC,Roof DL=7 psf,Roof LUSL=19 psf(Non-PV),Roof LUSL=14 psf(PV) Note: Per IBC 1613.1, Seismic check is not required because Ss=0.20021 <0 4g and Seismic Design Category(SDC)=B<D To Whom It May Concern, A jobsite survey of the existing framing system of the address indicated above was performed by a site survey team from Tesla. Structural evaluation was based on site observations and the design criteria listed above. Based on this evaluation,I certify that the existing structure directly supporting the PV system is adequate to withstand all loading indicated in the design criteria above based on the requirements of the applicable existing building and/or new building provisions adopted/referenced above. Additionally,I certify that the PV module assembly including all standoffs supporting it have been reviewed to be in accordance with the manufacturer's specifications and to meet and/or exceed all requirements set forth by the referenced codes for loading. The PV assembly hardware specifications are contained in the plans/docs submitted for approval. pF NEIN Y E C L I P S E co` $9,10/V S DigitShenaol,,'21 b sh ENGINEERING InC.R.C. Location:42.1 ve r O STE,42�Spok W Eclipse Engineering,as a third party, Contacrinfo:5 9= 77 1 4i Date:�017.08. o has provided a structural-only review of 12:35:4'407 00'.= the enclosed project. `�0 095319 '0 095319 TTesla,Inc. 1 S- 5- L .n_ 3055 Clearview Way San Mateo,CA 94402 p 650 638 1028 f 650 638 1029 Version#69.4-TBD PIL HARDWARE DESIGN AND STRUCTURAL ANALYSIS RESULTS SUMMARY,TABLES Landscape Hardware-,Landscape Modules'Standoff Specifications. Hardware X-X Spacing X-X Cantilever Y-Y Spacing Y-Y Cantilever Configuration Uplift DCR MPI 72" 24" 41" NA Staggered 67.5% Portrait Hardware-Portrait Modules'Standoff S ecifications Hardware - X-X Spacing X-X Cantilever Y-Y Spacing Y-Y Cantilever Configuration Uplift DCR MP1 48" 21" 62" NA Staggered 68.0% Structure Mountin Plane.Framin Qualification Results- Type Spacing Pitch Member Evaluation Results MP1 Stick Frame 24"0 C. 23° Member Analysis OK Refer to the submitted drawings for details of information collected during a site survey. All member analysis and/or evaluation is based on framing information gathered on site.The e>asting gravity and lateral load carrying members were evaluated in accordance with the IBC and the IEBC. T Tesla,Inc. 1 5 L rl 3055 Clearview Way San Mateo,CA 94402 p 650 638 1028 f 650 638 1029 STRUCTURE-ANALYSIS - LOADING SUMMARY AND MEMBER CHECK- MP1' Member Properties Summary MPI Horizontal Member Spans Rafter Properties Overhang 2.16 ft Actual W 1 50" Roof System Properties Span 1,_ -12.45 ft Actual D 5:50" Number of Spans w/o Overhang) 1 Span 2 Nominal Yes Roofing Material Comp Roof San 3. Ain"2 8.25 Re-Roof No San 4 Sx(in."3 756 Plywood Sheathini Yes . San 5• Ix(in"4 2080 Board Sheathing None Total Rake Span 15.87 ft TL Defl'n Limit 120 Vaulted Ceiling No PV 1 Start 5.42 ft Wood Species SPF Ceiling Finish 1/2"Gypsum Board PV 1 End 12.00 ft Wood Grade #2 Rafter Slo w, 23° PV 2 Start Fb(psi). 875 Rafter Spacing 24"O C. PV 2 End Fv(psi) 135 Top Lat Bracing Full PV 3 Start E(psi) 1,400,000 Bot Lat BracingAt Supports PV 3 End E-min(psi) 510,000 Member Loading Summary Roof Pitch 5/12 Initial Pitch Adjust Non-PV Areas PV Areas Roof Dead Load DL 7 0 psf x 1 09 7 6 psf 7 6 psf PV Dead Load PV-DL 3.0 psf x 1 09• 3.3,psf :. Roof Live Load RLL 20 0 psf x 0.95 19 0 psf Live/Snow Load . LL/SL''Z 20.0 psf x 0.7 1 x 0.7 14 0 psf. 14 0 psf Total Load' Govemin LC TL 26.6 psf 24.9 psf Notes: 1 ps=Cs'pf;Cs-roof,Cs-pv per ASCE 7[Figure 7-2] 2. pf=0 7(CB)(CO(I,)p9, Ce 0.9,Ct=1 1,15=1.0 Member Analysis Results Summary Governing Analysis Max Moment @ Location . Capacity DCR Result + Bending Stress(psi) 1,403.3 8.6 ft 1,504.3 93% Pass [ZEP HARDWARE DESIGN CALCULATIONS'=MP1 Mounting Plane Information Roofing Material Comp Roof Roof Slope 23° Rafter Spacing 24"O C Framing Type/Direction Y-Y Rafters PV System Type S_ olarCity'SleekMountTm Zep System Type ZS Comp Standoff Attachment Hardware Comp Mount-SRV Spanning Vents No Wind Design Criteria Design Code IBC 2015 ASCE 7-10 Wind Design Method Partially/Fully Enclosed Method Ultimate Wind Speed V-Ult 135 mph Fig. 1609A Exposure Category J C Section 26.7 Roof Style Gable Roof Fig.30.4-24/B/C-5A/B Mean Roof Height h 25 ft Section 26:2 Wind Pressure Calculation Coefficients _ Wind Pressure Exposure KZ 095 Table 30.3-1 Topographic Factor Ks 1 00 Section 26.8 Wind Directionality Factor Kd 0.85 Section 26 6-1 Importance Factor I " NA Velocity Pressure qh qh=0.00256(Kz)(Kzt)(Kd)(V"2) Equation 30.3-1 37.5 psf Wind Pressure Ext. Pressure Coefficient U GCp(Up) -088 Fig.30.4-2A/B/C-5A/B Ext. Pressure Coefficient Down GCp(Down) 0.45= Fig.30.4-2A/B/C-5A/B Design Wind Pressure p p=qh (GCp) Equation 30 4-1 Wind Pressure Up p„ -32.8 psf Wind Pressure Down down 16.9 psf [ALLOWABLE-_STANDOFF SPACINGS ` X-Direction Y-Direction Max Allowable Standoff Spacing Landscape 72" 41" Max Allowable Cantilever Landscape 24" NA Standoff Configuration Landscape Staggered Max Standoff Tributary Area Trib 21 sf PV Assembly Dead Load W-PV 3.0 psf Net Wind Uplift at Standoff_ T-actual. =370 lbs Uplift Capacity of Standoff T-allow 548 lbs Standoff Demand/Capacity DCR 675% ' X-Direction. Y-Direction Max Allowable Standoff Spacing Portrait 48" 62" Max Allowable Cantilever Portrait 21" NA Standoff Configuration Portrait Staggered Max Standoff Tributary Area Trib 21 sf PV Assembly Dead Load W-PV 3.0 psf Net.Wind Uplift at Standoff T-actual -373 lbs Uplift Capacity of Standoff T-allow 548 lbs Standoff Demand/Ca acit DCR 68.0% ABBREVIATIONS ELECTRICAL NOTES JURISDICTION NOTES A AMPERE 1. THIS SYSTEM IS GRID-INTERTIED VIA A AC ALTERNATING CURRENT UL-LISTED POWER-CONDITIONING INVERTER. Sftcturat Only BLDG BUILDING 2. THIS SYSTEM HAS NO BATTERIES, NO UPS. pf NEIN y CONC CONCRETE 3. A NATIONALLY—RECOGNIZED TESTING . 0 Q. O Digitally signed by it 55o'-0EC LI P EDC DIRECT CURRENT LABORATORY SHALL UST ALL EQUIPMENT IN � Sheno 1teCo� EGC EQUIPMENT GROUNDING CONDUCTOR COMPLIANCE WITH ART. 110.3. Locatio A 1.;W ers' (E) EXISTING 4.. WHERE ALL TERMINALS OF THE DISCONNECTING ENGINEERING, InC.,P.C. h .SIE 421,Spoka ,, A _ � � O EMT ELECTRICAL METALLIC TUBING MEANS MAY BE ENERGIZED IN THE OPEN POSITION, Contact Info:5cc 0 - 7 1 't `� Eclipse Engineering,as a third party, n `� FSB FIRE SET—BACK A SIGN WILL BE PROVIDED WARNING OF THE Date�2017..08.1 GALV GALVANIZED HAZARDS PER ART. 690.17. 1235�3`,1^oZ!00 has provided a structural-only review of GEC-, GROUNDING ELECTRODE CONDUCTOR 5. EACH UNGROUNDED CONDUCTOR OF THE APP Q ED AS NOTED the enclosed project.• Fo 095379 GND GROUND MULTIWIRE BRANCH CIRCUIT WILL BE IDENTIFIED BY OS A9�FESSIONP� HDG HOT DIPPED GALVANIZED PHASE-AND SYSTEM PER ART. 210.5. DATE: 8•P•; I CURRENT 6. CIRCUITS OVER 250V TO GROUND SHALL Imp CURRENT AT MAX POWER COMPLY WITH ART. 250.97, 250.92(B). FEE: ._BY COMPLY WITH ALL CODES OF Isc SHORT CIRCUIT CURRENT 7. DC CONDUCTORS EITHER DO NOT ENTER NOTIFY BUILDING •DEPART!iW, AT NEW YORK STATE & TOWN CODE" kVA KILOVOLT AMPERE BUILDING 'OR ARE RUN IN. METALLIC RACEWAYS OR 765-1802 SAM 70- 4 PM FOR-THE kW KILOWATT ENCLOSURES TO THE FIRST ACCESSIBLE DC FOLLOWING INSPECTIONS: AS REQUIRED AND CONDITIONS Or LBW LOAD BEARING WALL DISCONNECTING MEANS PER ART. 690.31(E). 1. FOUNDATION - TWO REQUIRED MIN MINIMUM 8. ALL WIRES SHALL BE PROVIDED WITH STRAIN FOR POURED CONCRETE (N) NEW RELIEF AT ALL ENTRY INTO BOXES AS REQUIRED BY 2. ROUGH - FRAMh1I11 4 PLUMBING [ NEUT NEUTRAL, 'UL LISTING. 3. INSULATI' NTS NOT TO SCALE 9. MODULE FRAMES SHALL BE GROUNDED AT THE ; , ;� MUSTTRd${ E$ OC ON CENTER UL—LISTED LOCATION PROVIDED BY THE 4. FINAL.- PL PROPERTY LINE MANUFACTURER USING UL LISTED GROUNDING BE COM" G.L'. POI POINT OF INTERCONNECTION HARDWARE. ALL 'CONST''• ^'s SH)U MEET THE PV PHOTOVOLTAIC 10. MODULE FRAMES, RAIL, AND POSTS SHALL BE REQUIREMENT a OF THE CODES OF NEW ELECTRICAL- SCH SCHEDULE BONDED WITH EQUIPMENT GROUND CONDUCTORS. YORK STATE. NOT RESPONSIBLE FOR INSPECTION REQUIRED S STAINLESS STEEL DESMN OR CONSTRUCTION ERRORS. OCCUPANCY OR STC STANDARD TESTING CONDITIONS �+ ' /� C TYP TYPICAL USE IS UNLAWFUL UPS UNINTERRUPTIBLE POWER SUPPLY V VOLT W11 DTIr_1nATr Vmp VOLTAGE AT MAX POWER VICINITY MAP I INDEX Voc VOLTAGE AT OPEN CIRCUIT NGY W WATT PV1 COVER SHEET 3R NEMA 3R, RAINTIGHT PV2 SITE PLAN PV3 STRUCTURAL VIEWS- , PV4 THREE LINE DIAGRAM f Cutsheets Attached LICENSE GENERAL NOTES 1. ALL WORK SHALL COMPLY WITH THE 2015K �, RETAIN.STORM WATER RUNOFF IBC/IRC per 2016 NYS UNIFORM CODE. PURSUANT TO CHAPTER 236 2. ALL ELECTRICAL WORK SHALL COMPLY WITH THE 2014 NATIONAL ELECTRIC CODE. OF THE TOWN CODE. 3. ALL WORK SHALL COMPLY- WITH THE 2015 INTERNATIONAL BUILDING CODE MODULE GROUNDING METHOD: ZEP SOLAR 4. ALL WORK SHALL COMPLY WITH THE 2015 AHJ:-Southold Td'wn INTERNATIONAL FIRE CODE `r - REV BY DATE COMMENTS " r REV A NAME DATE COMMENTS _ �/ x x x x • x x x x UTILITY: PSE&G—Long IslandPREIIISE • O x CONFIDENTIAL- THE INFORMATION HEREIN JOB NUMBER: JB-1191598 0 O o DESrR�no� M: CONTAINED SHALL NOT BE USED FOR THE ALEXIS LIVANOS Alexis Livanos RESIDENCE Efe Celikbilek T 5 L n BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SYSTEM: NOR SHALL IT BE DISCLOSED IN WHOLE OR IN ZS Comp V4 w Flashing—Insert 475 LILAC LN 5.2 KW PV ARRAY PART TO OTHERS OUTSIDE THE RECIPIENTS ORGANIZATION, EXCEPT IN CONNECTION WITH [MODULES* CUTCHOGUE, NY 11935 THE SALE AND USE OF THE RESPECTIVE (16) SolarCity Standard #SC325 PACE NAME: SHEET: REV: DATE SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN INVERTER: PERMISSION OF SOLARCITY INC. SOLAREDGE SE5000A—US—ZB—U COVER SHEET PV 1 8/10/2017 PITCH: 23 ARRAY PITCH:23 MP1 AZIMUTH: 150 ARRAY AZIMUTH: 150 pF NEW Y MATERIAL:Comp Shingle STORY: 2-Stories � O 2 AC 2��oA 095319 © Inv R�FESS�ONP� Urtedural Only LEGEND �v M 1 O (E) UTILITY METER & WARNING LABEL h� INVERTER W/ INTEGRATED DC DISCO & WARNING LABELS © DC DISCONNECT & WARNING LABELS © AC DISCONNECT & WARNING LABELS Oi D i i O DC JUNCTION/COMBINER BOX & LABELS �. DISTRIBUTION PANEL & LABELS Q LOAD CENTER & WARNING LABELS FytofHouse (E) DRIVEWAY O DEDICATED PV SYSTEM METER RSD RAPID SHUTDOWN 475 Lilac Ln 0 STANDOFF LOCATIONS CONDUIT RUN ON EXTERIOR CONDUIT RUN ON INTERIOR — GATE/FENCE 0 HEAT PRODUCING VENTS ARE RED � INTERIOR EQUIPMENT IS DASHED L=J - SITE PLAN N Scale: 1/8" = 1' 0 1' 8' 16' F J B-11915 9 8 0 0 PREMISE OMER: DESCRIPTION: DES : CONFIDENTIAL- THE INFORMATION HEREIN lo°NUMBER: Efe Celikbilek T 5 L n CONTAINED SHALL NOT DE USED FOR THE ALEXIS LIVANOS Alexis Livanos RESIDENCE NORRSSiTOF ALL IT BE E EXCEPT DISCLOSED IN WHOLE OR IN ZSCITY INC.. SYSm 475 LILAC LN 5.2 KW PV ARRAY PART TO OTHERS OUTSIDE THE RECIPIENTS ZS Comp V4 w Flashin –Insert ORGANIZATION, EXCEPT IN CONNECTION WITH t+amum. CUTCHOGUE, NY 11935 THE.SALE AND USE OF THE RESPECTIVE (16) SolarCity Standard #SC325 PAGE NAME SHEET: REV. DATE S"CITY EQUIPMENT, WITHOUT THE WRITTEN INVERTER PERMISSION OF SOLARCITY INC. SOLAREDGE SE5000A–US–ZB–U SITE PLAN PV 2 8/10/2017 of NEw Y ' �gloty S �q� PV MODULE S1 * �.Zyt�` 5/16"x1.5" BOLT WITH O 5/16 FLAT WASHER INSTALLATION ORDER ' _ ZEP LEVELING FOOT LOCATE RAFTER, MARK HOLE 2`PF� 09537ZEP ARRAY SKIRT (1) LOCATION, AND DRILL PILOT A'90FESS%o ------ HOLE. -2" 12'-5" ZEP MOUNTING BLOCK CATTACH FLASHING INSERT TO (E) LBW cdurad Only ZEP FLASHING INSERT (3) MOUNTING. BLOCK AND ATTACH TER USING LAG SCREW. SIDE VIEW OF M P 1 NTS (E) COMP. SHINGLE (1). INJECT SEALANT INTO FLASHING A (E) ROOF DECKING (2) (3) INSERT PORT, WHICH SPREADS SEALANT EVENLY OVER THE MP1 X-SPACING X-CANTILEVER Y-SPACING Y-CANTILEVER NOTES 5/16" DIA STAINLESS ROOF PENETRATION. LANDSCAPE 72" 24" 41" 0" STAGGERED STEEL LAG SCREW. LOWEST MODULE SUBSEQUENT MODULES PORTRAIT 48" 21" 62" 0" (2-1/2" EMBED, MIN) INSTALL LEVELING FOOT ON TOP (4) OF MOUNTING BLOCK & ROOF AZI 150 PITCH 23 SECURELY FASTEN WITH BOLT. RAFTER 2X6 @ 24 OC ARRAY AZI 150 PITCH 23 STORIES: 2 (E) RAFTER C.I. 2x6 @16"CIC Comp Shingle S 1 STANDOFF X AND Y ARE ALWAYS RELATIVE TO THE STRUCTURE FRAMING THAT SUPPORTS THE PV. X IS ACROSS RAFTERS AND Y IS ALONG RAFTERS. Scale: 1 1/2" = 1', JB-1191598 00 P °" �" °ESIGWE CONFIDENTIAL- THE INFORMATION HEREIN ,loe NUMBLrt Efe Celikbilek CONTAINED SHALL NOT BE USED FOR THE ALEXIS LIVANOS Alexis Livanos RESIDENCE T 5 L n BENEFIT OF ANYONE EXCEPT SOIAROTY INC., MOUNTING SYSTm NOR SHALL IT BE DISCLOSED IN WHOLE OR IN ZS Comp V4 w Flashing-Insert 475 LILAC LN 5.2 KW PV ARRAY PART TO OTHERS OUTSIDE THE RECIPIENTS MODULES CUTCHOGUE, NY 11935 ORGANIZATION, EXCEPT IN CONNECTION WITH THE SALE AND USE OF THE RESPECTIVE (16) SolarCity Standard #SC325 PAGE NAME SOLARCITY EQUIPMENT, WITHOUT THE WRITTEN SHEET: REV. DAIS PERMISSION OF SOLARCITY INC. SPV- 3 8/10/2017 SOLALAREDGE SESOOOA-US-ZB-U STRUCTURAL VIEWS GROUND SPECS MAIN PANEL SPECS GENERAL NOTES INVERTER SPECS "MODULE SPECS LICENSE BOND (N) #8 GEC TO (N) GROUND ROD Panel Number:QOC40US Inv 1: DC Ungrounded' INV 1 —(1)SOLAREDGE ##SE5000A—US—ZB— LABEL: A —(16)SolarCity Standard #SC325 AT PANEL WITH IRREVERSIBLE CRIMP Meter Number:82976112 Inverter; 50GOW, 240V, 98� 3nifed Disco and ZB, AFCI PV Module; 325W, 306.5 PTC, 40MM, Blk Frm, MC4, 600v, ZEP, 96—C Overhead Service Entrance INV 2 Voc: 69.6 Vpmax: '57.6 INV 3 Isc AND Imp ARE SHOWN IN THE DC STRINGS IDENTIFIER �E 200A MAIN SERVICE PANEL E; 20OA/2P MAIN CIRCUIT BREAKER Inverter 1 (E) WIRING CUTLER—HAMMER 200A/2P Disconnect 2 SOLAREDGE SE5000A—US—ZB—U (E) LOADS A Ll L2 N 1 30A/2P ———_———_— Eccr °C' DC. MP 1 1x16 - PA AA-1 -------- --- DG-- EC—'C-------=------------•------------------- EGC------------------� N EGC/GEC — Z Z - TO 120/240V SINGLE PHASE UTILITY SERVICE I I I . EGC ON ROOF TO BE ROUTED WHERE NOT SUBJECT TO PHYSICAL DAMAGE. WHEN ROUTED SUBJECT TO PHYSICAL DAMAGE THE SIZE'MUST BE INCREASED TO #6 SOLID BARE COPPER. Voc* = MAX VOC AT MIN TEMP OI ( )SQUARED +/ 230 PV BACKFEED BREAKER e (ICUTLER—HAMMERDG221UR8 PV (16)SOLAREDGE P400-5NM4MZM 1 Breaker, 30A�2P, 2 Spaces, Plug—On ^ Disconnect 30A p240Vac, Non—Fusible, NEMA 3R AC PowerBox�ptimizer400W, ZEP DC -(1)Gr qd Rai —0) AMMER /D003ONB 578 x 8, Copper Ground�Neutral Kit 30A, General Duty(DG) . 1 AWG#10, THWN-2, Black (2)AWG#10, PV Mire, 60OV, Black Voc* =500 VDC Isc =15 ADC O�2 O'�(I)AWG i6, Solid Bare'Copper EGC Vmp =350 VDC Imp=14.66 ADC (1)AWG 110, THWN-2, Red- ���LLLLLL (1)AWG X10, 1HWN-2,White NEUTRAL Vmp =240 VAC_ Imp=23 AAC (i)Conduit Kit; '3/4' FAIT -(1)AWG#8, THWN-2, Green EGC/GEC—(1)Co*It Kit; 3/4'EMT JB-1191598 .0 0 �°° °"" n°lt DESIGN: _ CONFIDENTIAL— THE INFORMATION HEREIN 1013 NUM: T 5 L n CONTAINED SHALL NOT BE USED FOR THE ALEXIS LIVANOS Alexis' Livanos RESIDENCE Efe Celikbilek BENEFIT OF ANYONE EXCEPT SOLARCITY INC., MOUNTING SSft NOR SHALL IT BE DISCLOSED IN WHOLE OR IN ZS Comp 'V4 ,w Flashing—Insert 475 LILAC LN 5.2 KW PV ARRAY PART TO OTHERS OUTSIDE THE RECIPIENT'S MODULES: CUTCHOGUE, NY 11935 ORGANIZATION, EXCEPT IN CONNECTION WITH THE SALE AND USE OF THE RESPECTIVE (16) SolarCity Standard #SC325 PAGE NAME: SHEET: REV. DATE SOLARCITY EQUIPMENT;WITHOUT THE WRITTEN PERMISSION OF SOIARCITY INC' SOLAREDGESES000A—US=ZB—U THREE LINE DIAGRAM PV 4 8/10/2017 Label Location: Label Location: Label Location: WARNING:PHOTOVOLTAIC POWER SOURCE - WARNING WARNING ' Per Code: Code: NEC ELECTRIC SHOCK HAZARD � ELECTRIC SHOCK HAZARD NEC • 690.31.G.3 NEC 'DO NOT TOUCH TERMINALS 1 THE DC CONDUCTORS OF THIS 1 LabelTERMINALS ON BOTH LINE AND PHOTOVOLTAIC SYSTEM ARETO BE USED WHEN ANVERTERIS PHOTOVOLTAIC DC LOADN THESOPEN POS TIONIZED h1AY BEO ENDERG ZED UNGROUNDED DISCONNECTPer Code: NEC ••1 Label Location: • Location: PHOTOVOLTAIC SYSTEM MAXIN1Utv1 POWER- Per Code: POINT CURRENT(Imp)_APer • _ SHUTDOWNCEC 690.56(C) MAXINiUNI POWEp�_�� 691 POINT VOLTAGE Vm MAXIR4Utv1 SYSTEM �� VOLTAGE(Voc) SHORT-CIRCUII_ CURRENT(Isc) A Label Location, Per WARNING ..- NEC INVERTER OUTPUT CONNECTION 1 •_ DO NOT RELOCATE WARNING Per.CTHIS OVERCURRENT DEVICE ••- ELECTRIC SHOCK HAZARD 690.5(C) IF A GROUND FAULT IS INDICATED NORMALLY GROUNDED CONDUCTORS fv1AY BE UNGROUNDED AND ENERGIZEDLabel Location: CAUTION ' Per ..- PHOTOVOLTAIC SYSTEM CIRCUIT IS BACKFEDNEC690.64.13.4 Label • • WARNING ' Per ..- ELECTRICAL SHOCK HAZARD DO NOT TOUCH TERPa11NALSNEC 690.17(4) .•- • • OADISIDES MAY BE ENERGIZ o CAUTION (POI) THE OPEN POSITION DUAL POWER SOURCEPer Gode: DC VOLTAGE IS SECOND SOURCE ISNEC 690.64.13.4 ALWAYS PRESENT WHEN PHOTOVOLTAICSYSTENI SOLAR tv10DULES ARE EXPOSED TO SUNLIGHT Label • • PHOTOVOLTAIC POINT OF -• Label • • INTERCONNECTION _ Code: PHOTOVOLTAIC AC • bVARNING: ELECTRIC SHOCK 690.17.4; HAZARD.DO NOT TOUCH 690.54 • • DISCONNECTCode: TERMINALS.TERR4INALS ON (CB): Combiner Box NEC 690.14.C.2 BOTH THE LINE AND LOAD SIDE fv1AY BE ENERGIZED IN THE OPEN (D): Distribution POSITION. FOR SERVICE . DC Disconnect (IC): Interior Run Conduit DE-ENERGIZE BOTH SOURCE AND h4AIN BREAKER. Label Location: With Integrated DC Disconnect MAXItv1UM AC '• MAXIMUfvI AC A Load OPERATING CURRENT A Per •• OPERATING CURRENT (M): Utility Meter MAXItv1UM AC • 54 OMAXINIUM AC OPERATING VOLTAGE V • 1 OPERATING VOLTAGE V POI): Point of Interconnection Label Ze =9zsolar • • Single Phase Inverters for North America SE3000A-US/SE380OA-US/SE5000A-US/SE6000A-US/ soIar 0 SE7600A-US/SE10000A-US/SE11400A-US ' SE3000A-US,�SE39MWA-US's SE5000A-US.I.SE6MA-US' SE7600A-US SE10000A-US SE11400A-US - 'OUTPUT_ " - - - •' 9980 @ 208V Phase Inverters Nominal AC Power 3000 3800 5000 6000 7600 10000@240V 11400 VA SolarEdge Single Ph i 5400 @ 208V 1°800 @ 208V 12000 VA Max.AC Power Output 3300 4150 5450�a1240V 6000 8350 10950 @240V. AC Output Voltage Min:Nom:Max!I - - - CO North Amer In 183-208-229 Vac AC SE3000A-US/SE380OA-US/SE5000A-US/SE6000A-US/ 211-24 -264ageMin:Nom:Max.(') - 211-240-264 Vac Hz SE7600A-US/SE1000OA-US/SE1140OA-US 59.3-60-60.5 AC Frequency Min:Nom:Max,P1 24 @ 208V 48 @ 240V .I 47.5 A _ Max.Continuous Output Current 12.5 I 16 I 21('10 240V I 25 I 3242. / 1 A _ GFDI Threshold Yes Utility Monitoring,Islanding Protection,Couptry Configurable Thresholds '`• ,�; _,, - yINPUT - - 5100 6750 8100 10250 13so0Y 15350 W, -• '_ - Maximum DC Power(STC) - "' ... ... . . . . 4050^ Transformer-less:Ungrounded Yes 500 Vdc " C,,�<< Max.Input Voltage :2 Vdc Nom.OC Input Volta a 325 @ 208V/350 @ 240V r0 my H 16.5 @ 208V 18 I 23 33 @ 208V 9.5 34.5 Adt Max.Input Current(') I 13 I 15.5(la 240V I I'30.5 @ 240V .I Ack Max.Input Short Circuit Current 45 Reverse-Polarity Protection Yes 6pp� Sensitivity Ground-Fault Isolation Detection 98 98 .I 98 % Maximum Inverter Efficient 97.7 98.2 98.3 98.3 -- � CEC Weighted Efficiency y I I 78..('° 240V I @ 208V 97.5 I 97.5 97 @ 208V 97.5 97,5 98 97.5 Qv 240V <2.5 44 W Nighttime Power Consumption I I ADDITIONAL FEATURES, " -^ Ethernet,Zigo Supported Communication In RS485,85232, e (optional) toptional(') •• - Revenue Grade Data,ANSI C12.1 y ' ' Rapid Shutdown-NEC 2014 690.12 Yes .�.'.' ,)`STANDARD COMPLIANCE - n � - �•,A - _ d Connection Standards �f 1 SA UL1699B,UL M. .. ..547 UL1741,UL174 1998,CSA 22.2 el IEEE( Grid Emissions FCC part15 class B INSTALLATION SPECIFICATIONS. r 3/4"minimum/8-3 AWG 3/4 AC output conduit size/AWG range "minimum/16-6 AWG .. - - 3%4"minimum/1-3 strings/ !r f strings 16-6 AWG,• fJ o / strings in ut conduit size/ g minimum 1-2 st g / 14-6 AWG --- # P / _ t jl• t. AWG range 30.Sz12.5x10.5/ in/ _ Dimensions with Safety Switch 30.5 z 12.5 x 7.2/775 z 315 x 184 G 7752315x260 mm � ._.L` .� s• r� .(,HZWxD) I sa.7/za.7 sa 4/40.1 Ib/kg Weight with Safety Switch 51.2/23.2 ., , i`` r,::' "' '_�{3•+�" Natural 7t convection Natural Convection and internal Fans(user replaceable) Coo^` B fan(user :.tiu�..-m;r_.-n+ -fit._-^r..,-•_., -r� r .. _ replaceable) The best-choice for SolarEdge enabledtsystems - <2s <50 deA Specifically designed toork with power optimizers _ Noise Min:Max.Operating Temperature -13 to+140/-25 to+60(-40 to+60 version available(')) -F/'C 'w • Integrated'arc fault protection for NEC 2011690:11 compliance _ Range - - - Protection Rating NEMA 311 Rapid shutdown for NEC 2014 69012 ' - $UperlOr efficiency(98go) - - - - "` _ V ul For Other regional settings please contatt SolarEdge$uvport. la A higher current source may be used:the imerter will limit its input curve t to Ne values stated. u PI Revenue grade Inverter P/N:SExxnN-USOOONNR2 I(w 7gW W Imerter.5E7600A-US002NNR2). Small,lightweight and easy to Install On prOVlded bracket 4 - - _ I'I-40 version F/N:SEx=xA-USOOONNU4(for 760OW Irrverter:SE7600A-U5002NN1141. ` Built-in-module-level monitoring Internet connection through Ethernet or Wireless - Outdoor and indoor installatiori, Fixed voltage inverter,DC/AC.conversion only Pre assembled.Safety SwitcFi for faster installation " - sunsaE Optional-revenue grade Bata;ANSI C12.1 USA-CANADA-GERMANY-ITALY-FRANCE-JAPAN-CHINA-AUSTRALIA-THE NETHERLANDS-UK-ISRAEL-TURKEY-SOUTH AFRICA-BULGARIA www.solaredge.us _ o FU Next-Level PV Mounting Technology ® Next-Level PV Mounting Technology '"SOIafCity I ZepSolar SolarClty I ZepSolar Components 4'' •s ZS Comp for composition shingle roofs Mounting Block Array Skirt Interlock Part No.850.1633 Part No.850-1608 or 500-0113 Part No.850-1388 or 850.1613 Listed to UL 2703 Listed to UL 2703 Listed to UL 2703 in Flashing Insert Grip Ground Zep V2 Part No.850.1628 Part No.850-1606 or 850-1421 Part No.850.1511 Listed to UL 2703 Listed to UL 2703 Listed to UL 467 and UL 2703 eMPnr N�` '•�� Description pcj 0 PV mounting solution for composition shingle roofs Works with all Zep Compatible Modules eMP� Auto bonding UL-listed hardware creates structural and electrical bond DC Wire Clip • ZS Comp has a UL 1703 Class'A"Fire Rating when installed using modules from Captured Washer Lag End Cap 509 any manufacturer certified as"Type 1"or"Type 2" Part No.850-1631-001 Part No. Part LISTED 850-1631-002 (L)850-1586 or 8501460 Listedd t to UUL L 1 155655 Specifications 850-1631-003 (R)850-1588 or 850.1467 850-1631-004 • Designed for pitched roofs • Installs in portrait and landscape orientations • ZS Comp supports module wind uplift and snow load pressures to 50 psf per UL 2703 • Wind tunnel report to ASCE 7-05 and 7-10 standards • ZS Comp grounding products are UL listed to UL 2703 and UL 467 • ZS Comp bonding products are UL listed to UL 2703 • Engineered for spans up to 72"and cantilevers up to 24" • Zep wire management products listed to UL 1565 for wire positioning devices Leveling Foot, Part No.850-1397 zepsolar.com Listed to UL 2703 zepsolar.com - . is contained in the written product warranty for This document does trot create any express warranty by Zep Solar or about its products or services.Zep Solar's sole warranty is contained in the written product warranty for This document does not create any express warranty by Zap Solar or about its products or services.Zep Solar's sola warranty each product The and-user documentation shipped with Zep for products constitutes the sole specifications retorted of to the product warranty.The customer is solely responsible for verifying the suitability of ZepSolar's products for each use.specifications are subject to change without notice:Patents and Apps:upats.com. each product The end-user documentation shipped with Zep Solar's products constitutes the sole specifications referred to in the product warranty.The customer is solety responsible for verifying the suitability of ZepSolar's products for each use.Specifications are subject to change without notice.Patents and Apps:upats.com. Date last exported:April 29,2016 11:22 AM Data last exported:April 29,2016 11:22 AM Document#800-1839-001 Rev D Document#800-1839-001 Rev D • SolarEdge Power Optimizer - Zep CompatibleT" =ee solar a Module Add-On For North America P400-ZEP solar. z c Nenodutes) ' P300-ZEP(for 60-cell PV maiuiesl I P4W'LEP(for is a w.c . I I 1 SolarEdge Power Optimizer — {INPUT 40o W i Rated Input DC power•'I 300 Zep CompatibleTM Module Add-On Absolute Maximum input Voltage 48 80 Vdc temperature) 8-80 Vdc • MPPT Operating Range 8-48 S0 10.1 Adc For North America P300-ZEP, P400-ZEP Maximum Short CircuitCurrent(Isc) 125 12.63 Adc Maximum DC Input Current . 99.5 Maximum Efficiency % " 98.8 • Weighted Efficiency Overvoltage Category II OUTPUT DURING OPERATION(POWER OPTIMIZER CONNECTED TO OPERATIING INVERTER) Adc , Maximum Output Current Vdc \, Maximum Output Voltage 60 OUTPUT DURING STANDBY(POWER OPTIMIZER DISCONNECTED FROM INVERTER OR INVERTER OFF) Vdc _ Safety Output Voltage per Power Optimizer I I STANDARD COMPLIANCE, • EMC FCC Part15 Class B,IEC61000-6-2,1E C61000-6-3 . Safety IEC62109-1(class II safety),UL1741 Yes ROHS INSTALLATION-SPECIFICATIONS, Vdc 1000 Maximum Allowed System Voltage ' Dimensions including mounting bracket (WxLxH) 128 x 196 x 27.5/5 x 7 71 x 1.08 128 x 196 x 35/S x 7 71 x 1.37 mm/in / �Wr128x152x35/ mm/in Dimensions excluding mounting bracket (WxLxH) 128 x 152 x 27.5/5 x 5.97 x 1.08 5 x 5.97 x 1.37 840/1.9 kg lb Weight(including cables and mounting bracket) 720/1.6 MC4 Compatible Input Connector Double Insulated;MC4 Compatible Output Connector 1.2/3.9 I m/ft Out 0.95/3.0 Wire Length 'C/'F Operating Temperature Range -40-+85/-40-+185 IP68/NEMA 6P Protection Rating 0-100 % Relative Humidity t')Rated STC power of the module.Module of up to+s%power tolerance allowed. r [PV SYSTEM DESIGN USING A SINGLE PHASE THREE PHASE THREE-PHASE SINGLE PHASE 208V 480V SOLAREDGE]NVERT.ERLz? HD-WAVE • - g 10 18 Minimum String Length(Power Optimizers) 25 25 50 Maximum String Length(Power Optimizers) Compatible with Zep Groove framed modules s7oo(600owi. .I 52.50 6000 127so W Maximum Power per String SE7600H-US) 'Certified Zep Compatible"bracket - Mitigates all types of module mismatch losses,from Parallel Strings of Different Lengths or Yes Attaches to module frame without screws ieduces on-roof manufacturing tolerance to partial shading orientations 1 .. - Flexible system design for maximum space utilization tarordelaReaatrhe:�f�eh�rm,noirek,to:^ttp�n^,,,,.�o„redse.�pmi:,te:/deauwRlevSl;l��fne-."-pdf labor and mounting costs Power optimizer equipment grounded through the bracket Next generation maintenance with module-level monitoring Up to 25%more energy — Module_-level voltage shutdown for installer and firefighterPP safety Superior efficiency(99.5%) I rCE CIO www.solared e.us r= a USA-CANADA-GERMANY-ITALY FRANCE-IAPAN-CNINA-AUSTRAUA-THE NETHERLANDS-Ux-ISRAEL-TURNEY”HUNGARY-BELGIUM-ROMANIA-BULGARIA g a , SC325 - - SolarCity ELECTRICAL AND MECHANICAL CHARACTERISTICS 1 MECHANICAL DATA ELECTRICAL DATA u1xKa n1— Max.power(Pmax)[W] 325 _I e— I ^n^ More power, Weight or'MC46 . B' Dimensions:62.6"/41.5"/1.57" Mak,;power current(Imp)[A] 5.65 Connector'MC4 Open circuit voltage(VOO[V] 69.6 Frame Color Black ' Short circuit current(Isc)[A] 6.03 Snow load:5400 Pa I /1 � (� Max.over current rating[A] 15 C J panels ., +5/-0 Wind load:2400 Pa Power tolerance[%7' A A' Fire Type:Type 2 Max,system voltage[V] 600 'g v Solar Panel efficiency[%7 18.4 _ Note:Standard Test Conditions:Air mass 1.5:Irradiance=1000W/m2:cell temp.250C " 'Maximum power at delivery.For limited warranty conditions,please check MAP our limited warranty document. -' E _ E S TEMPERATURE CHARACTERISTICS72 - 44.0 Temperature(NOCT)['C] — J Temp.coefficient of Pmax[%/'C] -0.258 _ — = Temp.coefficient of Voc[%/'C 7 -0.235 r Temp.coefficient of Isc[%/'C] 0.055 S * - - - AT NOCT(NORMAL OPERATING CONDITIONS) 8 ' h _ - 247.5 uasst 1 power(Pmax)[W7 Max.power voltage<Vmp)[V] 54.2 a sa te> Section A-A' Max.power current(Imp)[A] 4.56 R - - OPen circuit voltage(Voc)[V] 66.1 Short circuit current(Isc)[A] 4.87 +Q Note:Normal Operating Cell Temp.Air mass 1.5;Irradiance=800W/m2 0l ' Air temperature 20'C;wind speed 1 m/s sAp2 4�''w e suu> I 1 '- AT LOW IRRADIANCE (20%) f Section B-B - , More power per panel 62.0 With a sunlight to electricity Max.pawei<Pmax>[W] Our 325W panel generates 20%more power than a standard Max.power voltage(Vmp)[V7 55.7 w -270W panel. DEPENDENCE ON IRRADIANCE �O Max.power current(imp) conversion efficiency of over 19._4O 1.11 'Open circuit voltage(Voc)[V] 65.1 700 the panel ranks amongst the More energy every yearTT Short circuit current 1.21 r000w/m' More yearly energy(kWh)compared to other panels as they perform 6,00Note:Low irradiance:Air mass 1.5;Irradiance=200W/m2;cell temp.=25°Cvv highest in the industry: That means better in the heat. soowim 5,00 our-panels can harvest more Outstanding durability sooty/m' LIMITED Power output: 10 years(90%of Pmin) am I-- With more than 20 additional tests performed beyond what is WARRANTY 25 years(80%of Pmin) a energy from the sun, which means currently mandated,these panels far excee&industry standards. Workmanship: 15 years ypg it takes fewer_of our panels to 4ww/m. More layers,more power Manufactured by by Panasonic for SolarCity.Ahe panel uses 200 power your home. Plus, they MATERIALS Cell material: Sinch ted tempered glass Heterojunction cell technology,which adds a layer of thin film silicon xoow/m, Glass material: Bl coated tempered glass generate more .power output on top of high efficiency cyrstalline silicon. Frame materials: Black anodized aluminium Connectors type: MC4 aao during the hottest times of the day.,. Leading warranty - - 0 10 2e 30 40 50. 60 10 - 80 Our panels rank among the best in warranty coverage, voltage(v) CAUTIONI Please read the installation manual carefully even in Warmer climates. with workmanship that extends to 15 years. before using the products. Y Panels are•manufactured by Panasonic to the specification of SolarCily. Panels are only warranted by Panasonic SolarCity '�, lice 71306-1 C if the panels are included in a PV system sold by SolarCity or Tesla. SolarCity and Tesla make no warranties a `Y IEC61730.1 ` ®DD® �` IEC6173A2 I o ^+r""' solarcity.com related to the panels,which are sold as-is. SolarCity will handle any warranty claims on behalf of any purchaser solarcity.com