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O�g�FFOLIr Town of Southold 7/26/2018 y� P.O.Bog 1179 C* 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39801 Date: 7/26/2018 THIS CERTIFIES that the building SOLAR PANEL Location of Property: 1120 Bridge Ln, Cutchogue SCTM#: 473889 Sec/Block/Lot: 85.-2-6 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 2/22/2018 pursuant to which Building Permit No. 42425 dated 3/1/2018 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 aapplied for. The certificate is issued to Merlo,Michael&Johnson,Katie of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 42425 7/9/2018 PLUMBERS CERTIFICATION DATED Authorized Signature p�S eco TOWN OF SOUTHOLD BUILDING DEPARTMENT z 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#: 42425 Date: 3/1/2018 Permission is hereby granted to: Merlo, Michael 1120 Bridge Ln Cutchogue, NY 11935 To: install roof-mounted solar panels on existing single-family dwelling as applied for. At premises located at: 1120 Bridge Ln, Cutchogue SCTM # 473889 Sec/Block/Lot# 85.-2-6 Pursuant to application dated 2/22/2018 and approved by the Building Inspector. To expire on 8/31/2019. Fees: SOLAR PANELS $50.00 ELECTRIC $100.00 CO -ALTERATION TO DWELLING $50.00 Total: $200.00 Building Inspector Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings,property lines,streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 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. 1�Ld rg New Construction: Old or Pre-existing Building: (check one) Location of Property: &L(b bit S M& (5 SVA House No. Street Hamlet Owner or Owners of Property: \,<�nv_- -�, 4-ao Suffolk County Tax Map No 1000, Section Block 2 Lot Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: y4�( r► Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ n U pp icant Signature pF SO!/r�,Ql Town Hall Annex Telephone(631)765-1802 54375 Main Road y Fax(631)765-9502 P.O.Box 1179 �Q roger.richertic'i_town.southold.ny.us Southold,NY 11971-0959 Q BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Johnson (Merlo) Address: 1120 Bridge Lane city-Cutchogue st: New York zip: 11935 Building Permit#: 42425 Section: 85 Block: 2 Lot: 6 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: EM Power License No: 31274-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 FA Exit Fixtures 11 TVSS Other Equipment: 14.061 KW Roof Mounted Photovoltaic System to Include 43-327W Sunpower Panels with Micro Inverters, A/C Disconnect, Combiner Box. Notes: Inspector Signature: �y�(�-- Date: July 9, 2018 0-Cert Electrical Compliance Form.xls OF SOUIyo� TOWN OF SOUTHOLD BUILDING DEPT. • YO 765-1802 42,51i INSPECT101C [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ELECTRICAL (FINAL) [ ] CODE VIOLATION [" �] CAULKING REMARKS: A/ DATE �� INSPECTOR'-W . Gregory Sachs, PE 221 Long Beach Rd., (516)-509-3912 Island Park, NY 11558 sachsg@gmail.com July 24, 2018 Town of Southold Building Department 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 RE: PE Certification Letter for 1120 Bridge Lane,Southold, NY—Permit no.42425 To Whom It May Concern: The Solar Electric installation at 1120 Bridge Lane, Southold, NY 11935 (Section: 85 Block: 2, Lot: 6) has been completed in compliance with structural engineer's requirements.The project is consistent with the specifications set forth in the permit application. SincereI O� N E^W YO D. sycy'Q°r g r chs,. � w DD JUL 2 5 2010 084531 pR0 FE55BMD]NG DEM TOWN OF SOUTB[OLD • �,y c FIELD INSPECTION REPORT DATE COMMENTS n FOUNDATION (IST) -------------------------------------- 'FOUNDATION -----------------------------------'FOUNDATION (2ND) �j r ' � 1 ROUGH FRAMING& PLUMBINGy INSULATION PER N.Y: y STATE ENERGY CODE G) FINAL ADDITIONAL COMMENTS a-� ifc� t z r.X CN o I ® p z d TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NY 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey Southoldtownny.gov PERMIT NO. 0 Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined ,20� Single&Separate Truss Identification Form Storm-Water Assessment Form Contact: Approved 3 ,2019 Mail to: Disapproved a/c Phone: Expiration ,20 r Bui D) i JI !° m ctor FEB 2 2 201 D PLICATION FOR BUILDING PERMIT Date �ArJ�RIt-.� 20 1 � J' :'!l!G: INSTRUCTIONS TOWN OF SOUTHOLD 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. b f.Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim,the Building Inspector,may authorize, in writing,the extension of the permit for an addition six months.Thereafter, a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County,New York,and other applicable Laws,Ordinances or Regulations,for the construction of buildings, additions; or alterations or for removal or demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code,housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (9' natturre o••-a'pplicant or name,if a corporation) •�,�l.l Lrar� t �� �ISI.�r�D P(&, (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder SoL-AfL_ Cak�<(LALIZ'AR Name of owner of premises Jv 1�a.15v �r/ (As o the tax roll or latdst deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. �� ME Other Trade's License No. 1. Location of land on which proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section Block 2_• Lot ,;1).,(•it ,i: , all, 'I' •� '!• U', , .'i 1. „ . '!r 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 occupancyMl�� ►{=wtN�' b. Intended use and occupancy 3. Nature of work(check which applicable):New Building Addition Alteration St,1, J2 Repair Removal Demolition Other Work (Description) 4. Estimated Cost �� Z3� v Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units I 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 t.,i 1 k" , Dimensions of same structure with alterations or additions: Front � -, ; Rear , Depth Height Number of Stories ' 8. Dimensions of entire new construction: Front Rear '''r ; ,NDepth ; Height Number of Stories 9. Size of lot: Front Rear Depth n 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 o O. wner of premises YINTE Jdl'gSprl Address ttto PSR-nr-bF U-1. Phone No. (00 q1L Name of A cGftEbosui D.SGI � I s Address'% `n°"�' a Phone No Cn G,) Stt 4 'fit;v Name of Contractor6,4.Qow,F,L L:A2 Address t sc, V c Phone No. (s,Q n37 3'�S� 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—K * IF YES,PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ) 7(L�C being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the �btirrr 'C�b� (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. Sworn to before me this i p �oA da of J�1y AAV 20 / 0 r THOMAS BUSSI 1CAAA Notary Public RY PUBNo. O. OI STABU6243517 n ture of Applicant Qualified In Nassau county My Commission Expires June 20, 2019 Scott A. Russell ,��°Su �v 5TOR IM[\IVA\T]ER. SUPERVISOR MANAGEMENT SOUTHOLD TOWN HALL-P.O.Bons 1179 53095 Main Road-SOUTHOLD,NEW YORK 11971 Town of Southold CHAPTER 236 - STORNMATER MANAGEMENT WORK SHEET (TO BE COMPLETED BY THE APPLICANT ) DOES TIM PROJECT WVOLViE ANY OF TI',tig✓ ]FOLLOVnNG: Yea 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. ❑ C. Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. [:1 El D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. ❑® E. Site preparation within the one-hundred-year f loodplain as depicted on FIRM Map of any watercourse. ❑® F. Installation of new or resurfaced impervious surfaces of 1,000 square feet or more, unless prior approval of a Stormwater Management Control Plan was received by the Town and the proposal includes in-kind replacement of impervious surfaces. If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name, Signature, Contact Information,Date & County Tax Map Number! Chapter 236 does not apply to your project. If you answered YES to one or more of the above,please submit Two copies of a Stormwater Management Control Plan and a completed Check List Form to the Building Department with your Building Permit Application. APPLICANT (Property Owner,Design Professional,Agent,Contractor,Other) S.C.T.M. i`: 1000 Date District NAME: ?J�� � S aN g� 2 1 I-1 dy m ma Section Block Lot �7 FOR BUILDING DEPARTMENT USE ONLY**** Contact Information t//��3 Creiephem Number) Reviewed By: - - — — — — — — — — — — — — — — Date: Property Address/Location of Construction Work: — —/Approved7o r processing Building Permit. Storm ater Management Control Plan Not Required. Stormwater Management Control Plan is Required. (Forward to Engineering Department for Review.) FORM # SMCP-TOS MAY 2014 1 owe <a ' Mrs Town Hall Annex � l� Telephone(631)765-1802 54375 Main Road �g 9 pQ P.O.Box 1179 roer richert tOw(n.sotltllolfl.n .us Southold,NY 11971-0959 BUaDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY. Bernard Farsky Date: 1/22/18 Company Name: EmPower CES LLC Name: Bernard Farksy �= License No.: 31274-ME Address: 221 Long Beach Road, Island Park, NY 11558 Phone No.: 516-544-4115 JOBSITE INFORMATION: (*Indicates required information) 'Name: Katie Johnson *Address: 1120 Bridge Lane, Cuthogue,-NY *Cross Street: Main Road (25) `Phone No.: 631-926-0985 - --" Permit No.: Tax-Map District: 1000 Section:— 5 Block: 2 Lot: 6 *BRIEF DESCRIPTION OF WORK(Please Forint Clearly) Installation of roof mounted solar (Please Circle All That Apply) *Is job ready for inspection: YES NO Rough inFinal *Do-you need a Temp Certificate: ()aSj NO Temp Information Qf.needed) *Service Size: 1 Phase 314hase 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 8241eWest for 1wection Form �/ Policy#PK201700006109 COMMERCIAL GENERAL LIABILITY GL 0202 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL LIABILITY BROADENING ENDORSEMENT- ENERGY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART With respect to coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified by the endorsement. SCHEDULE—EXTENSIONS OF COVERAGE Covera es Additional Insured Incidental Medical Services Coverage Additional Insured—Vendors Liberalization Blanket Waiver Of Subrogation Non Employment Discrimination Broadened Bodily Injury Non-owned Watercraft Coverage Broadened Named Insured Personal And Advertising Injury Duties In The Event Of An Occurrence, Offense, Claim Supplementary Payments—Increased Limits Or Suit Expected Or Intended Injury Unintentional Failure To Disclose Hazards Fire, Explosion, Sprinkler Leakage Or Lightning Legal Liability Coverage Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Coverage extensions under this section only apply in the event that no other specific coverage for these extensions is provided under this policy. If such specific coverage applies, the terms, conditions and limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otherwise noted in this endorsement. 1. Additional Insured Paragraph 2.of Section II—Who Is An Insured is amended by the addition of the following: e. Any person or organization is included as an additional insured, but only to the extent such person or organization is held liable for"bodily injury","property damage"or"personal and advertising injury"caused by your acts or omissions. With respect to the insurance afforded to such insured, all of the following additional provisions apply: (1) You and such person or organization have agreed in a written "insured contract'that such person or organization be added as an additional insured under this policy, (2) The "bodily injury", "property damage" or "personal and advertising injury" for which said person or organization is held liable occurs subsequent to the execution of such "insured contract'; (3) The most we will pay is the lesser of either the Limits of Insurance shown in the Declarations or the Limits of Insurance required by the"insured contract'; GL 0202 0413 Includes copyrighted material of Insurance Services Office,,Inc., Page 1 of 6 with its permission (4) Such person or organization is an insured only with respect to: (a) Their ownership, maintenance, or use of that part of the premises, or land, owned by, rented to, or leased to you, except such person or organization is not an insured with respect to structural alterations, new construction or demolition operations performed by or on behalf of such person or organization; (b) Your ongoing operations performed for that insured; (c) Their financial control of you, except such person or organization is not an insured with respect to structural alterations, new construction or demolition operations performed by or on behalf of such person or organization; (d) The maintenance, operation or use by you of equipment leased to you by such person or organization; (e) Operations performed by you or on your behalf and for which a state or political subdivision has issued a permit, provided such operations are not performed for such state or political subdivision, and are not included within the"products-completed operations hazard", (5) This insurance does not apply to"bodily injury', "property damage", "personal and advertising injury", "occurrence" or offense- (a) Which takes place at a particular premise after you cease to be a tenant of that premises, (b) Which takes place after all work, including materials, parts or equipment furnished in connection with such work to be performed by or on behalf of the additional insured at the site of the covered operations, has been completed; (c) Which takes place after that portion of"your work" out of which the injury or damage arises has been put to its intended use by any other person or organization other than another contractor or subcontractor engaged in performing operations for a principal as part of the same project, (d) Which takes place after the expiration of any equipment lease to which (4)(d) above applies; (6) With respect to architects, engineers or surveyors,coverage does not apply to"bodily injury","property damage" or "personal and advertising injury" arising out of the rendering or failure to render any professional services by or for you, including: (a) The preparing,approving,or failing to prepare or approve, maps,shop drawings,opinions, reports, surveys,field orders, change orders, or drawings and specifications; (b) Supervisory, inspection, architectural or engineering services However, if an Additional Insured endorsement is attached to this policy that specifically names a person or organization as an insured, then this subsection 2.e. does not apply to such person or organization. 2. Additional Insured—Vendors Unless the"products-completed operations hazard" is excluded from this policy, paragraph 2. of Section II —Who Is An Insured is amended by the addition of the following. f. Any vendor of yours is included as an additional insured, but only with respect to "bodily injury" or "property damage" caused by "your products" which are distributed or sold in the regular course of the vendor's business, subject to the following additional exclusions. (1) The insurance afforded to the vendor does not apply to (a) "Bodily injury"or"property damage'for which the vendor is obligated to pay damages by rea-son of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement, (b) Any express warranty unauthorized by you, (c) Any physical or chemical change in the product made intentionally by the vendor; (d) Repackaging, unless unpacked solely for the purpose of inspection, demonstration,testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container, (e) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; Page 2 of 6 Includes copyrighted material of Insurance Services Office, Inc., GL 0202 0413 ❑ with its permission (f) Demonstration, installation, servicing or repair operations, except such operations performed by the vendor in full compliance with the manufacturer's written instructions at the vendor's premises in connection with the sale of the product, (g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or (h) "Bodily injury" or "property damage" arising out of the liability of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. (2) This insurance does not apply to any insured person or organization from whom you have acquired such products or any ingredient, part or container, entering into, accompanying or containing such products. However,if an Additional Insured—Vendors endorsement is attached to this policy that specifically names a person or organization as an insured, then this subsection 21 does not apply to that person or organization. 3. Blanket Waiver Of Subrogation Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Commercial General Liability Conditions and Section IV—Products/Completed Operations Liability Conditions is replaced by the following. Transfer Of Rights Of Recovery Against Others To Us And Blanket Waiver Of Subrogation a. If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us.The insured must do nothing after the loss to impair those rights.At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. b. If required by a written "insured contract" executed prior to the "occurrence" or offense, we waive any right of recovery we may have against any person or organization named in such "insured contract", because of payments we make for injury or damage arising out of your ongoing operations or"your work" for that person or organization. 4. Broadened Named Insured Paragraph 3.of Section II—Who Is An Insured is replaced by the following: Any organization that you own at the inception of this policy,or newly acquire or form during the policy period, and over which you maintain during the policy period majority ownership or majority interest, will qualify as a Named Insured if: a. There is no other similar insurance available to that organization; b. The first Named Insured shown in the Declarations has the responsibility of placing insurance for that organization; and c. That organization is incorporated or organized under the laws of the United States of America. However: a. Coverage under this provision is afforded only until the next occurring annual anniversary of the beginning of the policy period shown in the Declarations, or the end of the policy period, whichever is earlier; b. Coverage A does not apply to"bodily injury" or"property damage"that occurred before you acquired or formed the organization; and c. Coverage B does not apply to"personal and advertising injury"arising out of an offense committed before you acquired or formed the organization. The final paragraph of Section 11—Who Is An Insured is replaced by the following. No person or organization is an insured with respect to the conduct of any current or past partnership,joint venture, or limited liability company that is not shown as a Named Insured in the Declarations However,this does not apply to a limited liability company that meets all of the conditions,of Section II —Who Is An Insured, above. GL 0202 0413 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 6 ❑ with its permission 5. Broadened Bodily Injury Paragraph 3. of Section V—Definitions is replaced by the following: "Bodily injury" means bodily injury, disability, sickness or disease sustained by a person, including death resulting from any of these at any time.'Bodily injury"includes mental anguish or other mental injury resulting from "bodily injury". 6. Duties In The Event Of An Occurrence, Offense,Claim Or Suit Paragraph 2.a. of Section IV—Commercial General Liability Conditions is replaced by the following: a. You must see to it that we or any licensed agent of ours are notified of a general liability"occurrence" or offense which may result in a claim as soon as practicable after it becomes known to: (1) You, if you are an individual; (2) Your partner or member, if you are a partnership or joint venture; (3) Your member, if you are a limited liability company; (4) Your executive officer if you are an organization other than a partnership, joint venture or limited liability company; or (5) Your authorized representative or insurance manager. Knowledge of an `occurrence" or offense by persons other than those listed above does not imply that those listed above also have such knowledge. b. To the extent possible, notice should include: (1) How, when and where the"occurrence" or offense took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the"occurrence" or offense. 7. Expected Or Intended Injury Paragraph 2.a. Expected Or Intended Injury of the Exclusions provision of Section I — Coverages, Coverage A—Bodily Injury And Property Damage Liability is replaced by the following: Expected Or Intended Injury "Bodily injury" or"property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to"bodily injury"or"property damage" resulting from the use of reasonable force to protect persons or property. 8. Fire, Explosion,Sprinkler Leakage Or Lightning Legal Liability Coverage The final paragraph of the Exclusions provision of Section I —Coverages, Coverage A — Bodily Injury And Property Damage Liability is replaced by the following: Exclusions c. through n. do not apply to damage by fire, explosion, sprinkler leakage or lightning to premises while- (1) Rented to you; (2) Temporarily occupied by you with the permission of the owner; or (3) Managed by you under a written agreement with the owner. A separate limit of insurance applies to this coverage as described in Section III—Limits Of Insurance Paragraph 6.of Section III —Limits Of Insurance is replaced by the following: Subject to paragraph 5.above,the Damage to Premises Rented To You Limit shown in the Declarations, for "property damage" to any one premises while rented to you, or in the case of damage by fire, explosion, sprinkler leakage, or lightning while rented to you, temporarily occupied by you with the permission of the owner, or managed by you under a written agreement with the owner, is the greater of: a. $300,000 Any One Premises; or b. The Damage To Premises Rented To You Limit shown in the Declarations Subsections 4.b.(1)(a)(ii) and 4.b.(1)(a)(111) of paragraph 4.b. Excess Insurance of the Other Insurance condition of Section IV—Commercial General Liability Conditions is replaced by the following: Page 4 of 6 Includes copyrighted material of Insurance Services Office, Inc., GL 0202 0413 ❑ with its permission (ii) That is Fire, Explosion, Sprinkler Leakage, or Lightning insurance for premises while rented to you, temporarily occupied by you with permission of the owner, or managed by you under a written agreement with the owner; (iii) That is insurance purchased by you to'cover your liability as a tenant for"property damage"to premises rented to you, temporarily occupied by you with the permission of the owner, or managed by you under a written agreement with the owner, Paragraph 9.a.of Section V—Definitions is replaced by the following: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, explosion, sprinkler leakage, or lightning to premises while rented to you, temporarily occupied by you with permission of the owner, or managed by you under a written agreement with the owner, is not an"insured contract", 9. Incidental Medical Services Coverage Section I--Coverages is amended to include the following additional coverage. We will pay for"bodily injury"arising out of the rendering of or failure to render the following treatment or services by an "employee" or"volunteer worker"for an�accident occurring during the policy period a. First aid treatment including cardiopulmonary resuscitation (CPR), and b. Medical, surgical, dental,x-ray,,or nursing service or treatment, or the furnishing of food or beverages in connection therewith; and the furnishing or dispensing of drugs, or medical, dental, or surgical supplies or appliances. However, this coverage does not apply to any insured or to any entity engaged in the business or occupation of providing the services or treatments described in a.and b.above. Paragraph e. Employer's Liability of the Exclusions provision of Section I—Coverages, Coverage A— Bodily Injury And Property Damage Liability does not apply to psychological injury arising out of the services described above. 10. Liberalization Section IV — Commercial General Liability Conditions is amended by the addition of the_ following - condition. Liberalization If we revise this endorsement to provide more coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders'as of the day the revision is effective in your state. 11. Non Employment Discrimination Liability Unless"personal and advertising injury" is excluded from this policy, the following applies: Paragraph 14. of Section V—Definitions is amended by the addition of the following- "Personal and advertising injury" also means injury, including consequential"bodily injury" arising out of "discrimination" Section V—Definitions is amended by the addition of the following- "Discrimination" means,the unlawful treatment of a person or class of persons because of their specific race', color, religion, gender, age or national origin in comparison to one or more persons who are not members of the specified class. Paragraph 2. ,Exclusions of Section I — Coverages, Coverage B — Personal And Advertising Injury Liability is.amended by the addition of the following exclusions. This insurance does not apply to: "Discrimination" directly or indirectly' related to the past employment, employment or prospective employment of any person or class of persons by any insured; "Discrimination" directly or indirectly related to the sale, rental, lease or sublease or prospective sale, rental, lease or sublease of any dwelling or permanent lodging by or at the direction of any insured; "Discrimination", if insurance thereof is prohibited by law; or Fines, penalties, specific performance, or injunctions levied or imposed by a governmental entity, governmental code, law, or statute because of"discrimination". GL 0202 0413 Includes copyrighted material of Insurance Services Office, Inc., Page 6 of 6 ❑ with its permission 12. Non-owned Watercraft Coverage Extension Paragraph 2.g.(2)of the Aircraft, Auto Or Watercraft exclusion of Section I—Coverages, Coverage A— Bodily Injury And Property Damage Liability is replaced by the following: This exclusion does not apply to- (1) A watercraft you do not own that is: (a) Less than 50 feet long; and (b) Not being used to carry persons or property for a charge, 13. Personal And Advertising Injury Liability Unless"personal and advertising injury" is excluded from this policy, the following applies: Paragraph e. Contract Liability of the Exclusions provision of Section I — Coverages, Coverage B — Personal And Advertising Injury Liability is deleted 14. Supplementary Payments—Increased Limits Paragraphs 1.b., 1.d.,-and 1.e. of Supplementary Payments — Coverages A and B of Section I — Coverages are replaced by the following. b. The cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies We do not have to furnish these bonds d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or"suit", including substantiated loss of earnings up to$500 a day because of time off from work. e. All court costs taxed against the insured in the"suit". 15. Unintentional Failure To Disclose Hazards Paragraph 6. Representations of Section IV—Commercial General Liability Conditions is amended by the addition of the following d. If you unintentionally fail to disclose any hazards existing at the inception date of this policy, we will not deny coverage under this Coverage Form because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal All other terms, definitions, conditions and exclusions of this policy remain unchanged. Page 6 of 6 Includes copyrighted material of Insurance Services Office, Inc , GL 0202 0413 ❑ with its permission 'SUFFOLK COUNTY DEFT OF.LABOR, UCENSINO 8 CONSUMER AFFAIRS MASTER ELECTRICIAN i. NATE - - l� BERNARD FARSKY This certifies that the "�9 j bearer Is duly EMPOYfIER CES LLC.DBA, licensed bythe L,.....,Am,., od.155oad County of Suffolk 04/12/2002 ani �:fir 312744E` - E➢PNAndNDA7E-04101/2018 . j • C SUFFOLK COUNTY DEPT OF LABOR, '- - LICENSING&CONSUMER AFFAIRS HOME'IMPROVEMENT s w CONTRACTOR r gLICENSE NAME GREGORY D SACHS' This certifiesythat the SUSNESSNAME bearer is duly EMPOWER CES LLC DBA licensed by the License Number oae.13ewe County of Suffolk 05/30/2012 50211—H - n , Commissioner 'ExPRAnoNm"G ,05/01/2018 Workers' k ' - YORK f CERTIFICATE OF s1:eaTE Coitfd ation I3o�lyd NYS WORKERS" COMPENSATION INSURANCE COVERAGE = 1a:t egal'Nafrie&Address of Insured(use street address only) 1b.Business Telephone Number of Insured EmPowar.CES,LLC 516-837-3459 221 Long Beach Rd. d Island Park,NY 11558 16.NYS Unemployment Insurance Employer Registration Number of Insured 47-472713 Work Location of Insured(Only required If coverage is,specifica/ly limited to 1d.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-Up Policy) Number 522407627 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) New York Marine&General Insurance Town of Southold 3b.Policy Number of Entity Listed in Box"1 a" 54375 Route 25 WC201700008912 Southold, N.Y. 11971 3c.Policy effective period 05/04/2017 to 05/04/2018 3d The Proprietor,Partners or Executive Officers are ' QX 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"l 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,dertif-co holder within 10 days of a policy tieing cancelled fnr 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 bf the policy effective period? xQYES []NO ^ONLY IF THEY WERE NOTIFIED OF A CONTRACTUAL REQUIREMENT IN ADVANCE. This certificate is issued as a matter of information only and confers no rights upon the certificate holden.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: Christine Howley (Print name of'auhGilzB fepre entellYe or licensed agent of insurance carder) I ,- 47 ,10",Approved by: 0,..Jn-nn,_ (Signature) (Date) Title:Program Manager Telephone Number of authorized representative or licensed agent of insurance carrier: 973-532-1758 Please Note:Only insurance carriers and their licensed agents are authorized to issue Form C-105.2.Insurance brokers areRM authorized to issue it. C-105.2(9-15) www.wcb.ny.gov ■� EMPOCES-01 ERI VERA ACORO FDATE;MM/DDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 0110/2018 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(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 License#0757776 CONTACT Ana Bello Los Angeles,CA-Center Drive-HUB International Insurance Services Inc. PHONE FAX 6701 Center Drive West,Suite 1500 (A/c,No,Ext) (310)568-5977 1(A/c,No) Los Angeles,CA 90045 E-MAIL ana.bello@hubinternational.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Southwest Marine&General Insurance Company 12294 INSURED INSURER B•New York Marine&General Insurance 16608 EmPower CES LLC INSURER C #(516)837-3459 221 Long Beach Rd. INSURER D: Island Park,NY 11558 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD MM/DDIYYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000'000 CLAIMS-MADE X OCCUR PK201700006109 05/04/2017 05/04/2018 DAMAGE TO RENTED 50Q000 X PREMISES Ea occurrence $ X Contractual Liab MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ 1'000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2'000'000 ' POLICY 1 YERa F] LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER $ B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ X ANY AUTO AU201700006954 05/04/2017 05/04/2018 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ X AUTOS ONLY X AUOTOS ONLY PROPERTY DAMAGE Per accident $ X comp&Coll Ded Deductibles $ 1,000 A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3'000'000 EXCESS LIAR CLAIMS-MADE UM201700002951 05/04/2017 05/04/2018 AGGREGATE $ 3'000'000 DED I X I RETENTION$ 10'000 $ B WORKERS COMPENSATION X STATUTE I EERH AND EMPLOYERS'LIABILITY YIN E L EACH ACCIDENT $ WC201700008912 05/04/2017 05/04/2018 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E L DISEASE-EA EMPLOYEE $ 1,000,000 If yes,descnbe under 1000000 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) The certificate holder is listed as additional insured per attached endorsement#GL0202 0413. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE of Southold THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town Town Route h ACCORDANCE WITH THE POLICY PROVISIONS. Southold,NY 11971 AUTHORIZED _ REPRESENTATIVE ACORD 25(2016/03) @ 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CONSENT TO INSPECTION the undersigned, do(es)hereby state: Owner(s)Name(s) That the undersigned(is) (are)the owner(s) of the premises in the Town of Southold, located at i k?,U SR-v D GV— lAr-AS - bu-re,amu( , 4 A 153 , which is shown and designated on the Suffolk County Tax Map as Districe 1000, Section � ,Block I- ,Lot 6. That the undersigned (has) (have) filed, or cause to be filed, an application in the Southold Town Building Inspector's Office for the following: That the undersigned do(es)hereby give consent to the.Building Inspectors of the Town of Southold to enter upon the above described property, including any and all buildings located thereon,to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comply with all of the laws, ordinances, rules and regulations of the Town of Southold. The undersigned, in consenting to such inspections, do(es) so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used in subsequent prosecutions for violations of the laws, ordinances, rules or regulations,of the Town of Southold. Dated: r{ J --- (Sinature) �1�'I,L (Print Name) (Signature) (Print Name) EmPowerSolirz February 21, 2018 To: Town of Southold Building Department Town Hall Annex Building 54375 Route 25 Southold,New York 11971 From: Rory Eblen Empower Solar Permitting Department 221 Long Beach Road Island Park,New York 11558 RE: Residential Solar Permit Application for 1120 Bridge Lane, Cutchogue,New York 11935. To whom it may concern, Please find-a complete building permit application package for a residential solar installation located at 1120 Bridge Lane, Cutchogue,New York 11935.When complete please mail permit documents to our office at: Rory Eblen EmPower Solar Permitting Department 221 Long Beach Road Island Park,New York 11558 If you have any questions or concerns,please do not hesitate to reach out directly at 516-544-4115'or email at,permitting@empower-solar.com. Respectful , Rory Eblen EmPower Solar 516-544-4115 permitting@emower-solar.com 221 Long Beach Rd,Island Park,INN 11558 www.empowerces.com 1 516.837.3459 pF SO!/Tg®! 0 Town Hall Annex Telephone(631)765-1802 54375 Main Road CA =Ae Fax(631)765-9502 P.O.Box 1179 G • Southold,NY 11971-0959 couffm BUILDING DEPARTMENT TOWN OF SOUTHOLD July 20, 2018 EmPower Solar Permitting Dept. 221 Long Beach Road j Island Park, New York 11558 foL RE: Merlo, 1120 Bridge Lane, Cutchogue NOTE:�Certification for installation required before the Certificate of Occupancy can be issued. TO WHOM IT MAY CONCERN: The items marked below are required to obtain your Certificate of Occupancy. Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. (Electrical Inspector 631-765-1802) A fee of$50.00. Final Survey with Health Department Approval. Plumbers Solder Certificate Trustees Certificate of Compliance. (Town Trustees#765-1892) Final Planning Board Approval. (Planning#765-1938) Final Fire Inspection from Fire Marshall. (631-765-1802) Final Landmark Preservation approval. Final Elevation Certificate required. Final Storm Water Runoff Approval from Town Engineer BUILDING PERMIT: 42425-Z solar panels e Gregory Sachs, PE 221 Long Beach Rd., (516)-544-4115 Island Park, NY 11558 permitting@empower-solar.com February 15, 2018 To Whom It May Concern: The purpose of this letter is to certify that the existing roof structure located at: 1120 Bridge Lane,Cutchogue,NY 11935 can support the additional loads due to wind and gravity from the solar energy system. Furthermore, it has been determined that the structure complies with the 2015 IRC, 2016 NYS Code Supplement including the ASCE 7. Please see Table 1 below for specific data relating to the calculations for each roof structure involved in the solar energy system installation. Table 1 Roof Surface Max Span Cross Section Snow Load Wind Speed (ft) (psf) (mph) South#2-Upper 17.33 Nominal 2x8 30 140 South#2-Lower .5.50 Nominal 2x8 30 140 South#1 14.67 Nominal 2x8 30 140 AW, VED AS NOTED `g II Sincerely, ®09N .3,10 E s r,0 DAVE:! f B.P.8 ° ,10,y� FEE: LC�7� BY: (0 co NOTIFY..BUILDING DEPARTM 'AT'� ,_ sad.' w 765 -18Q2 8 AM TO 4 PM FOR THE`� FOLLOWING INSPECTIONS: ' - n I. FOUNDATION TWO REQUIRED Gregory Sac s� � �2 - FOR POURED CONCRETE SF 08453 P`' 2. ROUGH = FRAMING & PLUMBING O F E ss\or� 3. INSULATION 4'. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. COMPLY WITH ALL CODES OF ALL CONSTRUCTION SHALL MEET THE NEW YORK STATE & TOWN CODES REQUIREMENTS OF THE CODES OF NEW AS REQUIRED AND CONDITIONS ®EYORK STATE. NOT RESPONSIBLE FOR 'DESIGN OR CONSTRUCTION ERRORS. ®CUUPANCY OR MTMtD10WNiRUffEES USE �S UNLAWFUL � cTRICA� WRO"U`� GERT CATS INSPECTION REQUIRED OF OCCUPANCY 4 - 1 2 3 4 5 6 7 8 9 10 11 12 13 SUNPOWER° by EmPower Solar I I 221 LONG BEACH ROAD ISLAND PARK,NY 11558 O _ TEL: 516-837-3459 FAX: 516-706-1789 JOHNSON RESIDENCE www.empower-solar.com H SOLAR PROJECT H THE INFORMATION DISCLOSED HEREIN IS THE SOLE PROPERTY OF EMPOWER CES,LLC-UNAUTHORIZED REPRODUCTION OR DISTRIBUTION OF THIS P ROJ ECT TEAM: MATERIAL IS STRICTLY PROHIBITED WITHOUT PRIOR SPECIFIC WRITTEN PERMISSION ' PRO I NALSEQl.�� OWNER: gACHS JOHNSON RESIDENCE Gp - Z ul ILL 1120 BRIDGE LN w eoo CUTCHOGUE, NY 11935 PHONE:613-926-0985 ENGINEER OF RECORD: F SOLAR INSTALLER: GREGORY SACHS, PE F EMPOWER SOLAR 221 LONG BEACH RD. 221 LONG BEACH RD. ISLAND PARK, NY 11558 ISLAND PARK, NY 11558 PHONE: 516-837-3459 Ef✓pt PHONE:516-837-3459 .y 1,12C Brid6e Un e, 1G5FyrJ�rr`z_ - D D REV: DESCRIPTION: DATE PROJECT DATA: SHEET INDEX: PROJECT NAME •~ '' Yt�'q -- � �; ADDRESS: ST-01 COVER SHEET JOHNSON RESIDENCE 1120 BRIDGE LN CUTCHOGUE, NY 11935 S-01 STRUCTURAL PROJECT LOCATION C c 1120 BRIDGE LN SECTION: 85 SE-01 ELECTRICAL CurCHOGUE,NY 11935 µ BLOCK: 2 ST-02 RACKING SPECIFICATIONS PROJECT# 1888 ST-03 MODULE SPECIFICATIONS PROJ PHASE PERMIT .� LOT: 6 DATE 2/15/2018 B k B DESIGNED BY JR �^� 4 CHECKED BY: GS SCALE NTS MAP TITLE: COVER SHEET A A SHEET: ST-01 1 2 3 4 5 6 7 8 9 10 11 12 13 1 2 3 4 5 6 7 8 9 10 11 12 13 _ S,UNPOWER® SECTION A SECTION B SUNPOWER SPR-327AC MODULES ON INVISIMOUNT RACKING by Empower Solar 2 LAYERS I 221 LONG BEACH ROAD XX OF SHINGLES ISLAND PARK,NY 11558 c TEL:516-837-3459 2X8 RAFTERS FAX:516-706-1789 @ 16"OC www.empower•soIar.com THE INFORMATION DISCLOSED HEREIN IS THE SOLE H H PROPERTY OF EMPOWER CES,I.I.C.UNAUTHORIZED REPRODUCTION OR DISTRIBUTION OF THIS MATERIAL IS STRICTLY PROHIBITED WITHOUT PRIOR SPECIFIC WRITTEN PERMISSION 2 PROFESSIONAI.SEAg q �E y s a ®� SECTION A G A, 00 G NOT TO SCALE T SOUTH ROOF M; co 16 SUNPOWER 327W.ACPJ PANELS OwTwrAno zi2s32kW it SUNPOWER SPR-327AC MODULES TYPE 1.FLUSH MOUNT SOUTH ROOF*2-LOWER 1 '� 60urH ROOF 02-UPPER SOLAR ACCESS 88To ON INVISIMOUNT RACKING n SSU NPOWFR 327W+ACPV PANELS 21 SUNPOWER 32TW.ACPV PANELS TOTAL POWER 1.982 kW TOTAL POWER 8.98T kW ORIENTATION:2IS;PITCH:19• ORIENTATION:215`PmxC 38• - 2 LAYERS FFOF SHINGLES r --BRIDGE LANE-- 2X8 RAFTERS @16"OC E E _ S :1 t ROOF LAYOUT NOT TO SCALE SETBACK LEGEND SECTION B ® ° 36"CLEAR PATH NOT TO SCALE D REV: DESCRIPTION: DATE: PROJECT NAME: EQUIPMENT LEGEND: NOTES: ® 18"RIDGE SETBACK 1. TOTAL SYSTEM DC POWER: 14.061 kW JOHNSON RESIDENCE a MODULES 40 SOLAR DISCONNECT 2.RACKING SYSTEM INSTALLED IN ACCORDANCE WITH CODE-COMPLIANT INSTALLATION - MANUAL PROJECT LOCATION: C ® 18"VALLEY SETBACK 3.ATTACHMENTS TO BE SECURED TO RAFTERS USING 5_/16"STAINLESS STEEL LAG BOLTS C 1120 BRIDGE LN UTILITY METER F MAIN SERVICE PANEL SPACED ACCORDING TO TABLE S-1.1 CUTCHOGUE,NY 11935 4. ALL ATTACHMENTS TO ROOF, MOUNTING BRACKETS & HARDWARE MEET OR EXCEED NYS ® GROUND ACCESS CODE REQUIREMENTS PROJECT* y 1888 3❑ AC COMBINER 5. INSTALLATION TYPICALLY MAINTAINS 1 INCH SPACING BETWEEN MODULES PROJ.PHASE: PERMIT 6.SIZES OF STRUCTURAL MEMBERS THAT WERE NOT ACCESSIBLE FOR DIRECT MEASUREMENT DATE: 2/15/2018 B ARE BASED ON OBSERVATIONS OF ACCESSIBLE MEMBERS, CONSTRUCTION DEPTH OR B DESIGNED BY. JR SUNPOWER PANEL SPECS BOTH IN ADDITION TO KNOWLEDGE OF STANDARD CONSTRUCTION PRACTICES AT THE CHECKED BY- GS MODEL# QTY. LENGTH WIDTH DEPTH WEIGHT TIME OF CONSTRUCTION SCALE: NTS 7. THIS DOCUMENT CERTIFIES THAT THE ROOF STRUCTURE HAS BEEN CHECKED FOR 140 MPH TITLE: SPR-327-AC 43 61.4" 41.2" 1.81" 45.5 LB WIND,SNOW, UNBALANCED SNOW, LIVE AND DEAD LOADS BASED ON ASCE 7-10 CHAPTER 30 - WIND LOADS - COMPONENTS AND CLADDING (C&C) AND FOR CONFORMANCE WITH STRUCTURAL THE 2015 IRC, 2016 NYS CODE SUPPLEMENT. THIS CERTIFICATION DOES NOT APPLY TO A TABLE S-1.1: MAX.ATTACHMENT SPACING ANY ADDITIONAL ROOF ALTERATIONS AFTER THE DESCRIBED INSTALLATION A SHEET: PORTRAIT: 5'-6" LANDSCAPE: 8'-0" 8.THIS ROOF STRUCTURE AS SHOWN IS ADEQUATE TO SUPPORT THE PROPOSED LOADS S-01 1 2 3 4 5 0 7 8 9 10 11 12 13 r 1 2 3 4 5 6 7 8 9 10 11 12 13 S-U N POWE R® by EmPower Solar NOTES: - 221 LONG BEACH ROAD ISLAND PARK,NY 11558 c 1.NEUTRAL&GROUND ARE BONDED TOGETHER(ORIGIN OF GEC FOR SOLAR TEL:516-837-3459 ELECTRIC SYSTEM) FAX:516-706-1789 2.JOIN GEC'S-FROM EACH INVERTER USING'SPLIT-BOLT CONNECTOR' www.empower-soIar.com STANDARD INVERTER ASSEMBLY: 3.GEC FROM SOLAR ELECTRIC SYSTEM BONDED TO EXISTING GEC IN THE MAIN THE INFORMATION REIN IS THE SOLE H SERVICE PANEL USING'SPLIT-BOLT CONNECTOR' H PROPERTY PO Q�g RVFo 4. IN SOME CASES POWER FOR DATA MONITORING ENCLOSURE MAYBE REPRO IWW. '19fPAT A�t T C 177E IPIZ DERIVED FROM MAIN SERVICE PANEL 5.CONNECT UTILITY SIDE TO PANEL LUGS �G9� s yC s 6. USE TAP RULES FOR SIZING TAP CONDUCTORS(NEC 240.21) f) �0d- 7. 7. USE#8 IN PROTECTED AREAS.SLEEVE GEC(SOLID BARE)WHEN EXPOSEDIJJ G SOLAR TO PHYSICAL DAMAGE Gj* _ ARRAY 1 8.SIZE GEC AND EGC AS PER NEC 240.66, NEC240.122 RESPECTIVELY ' 9. NEGATIVELY GROUNDED FOR SERENGETI MODULES, POSITIVELY GROUNDED cc)cc` FOR SUNPOWER MODULES 8453N �Qv INVERTER(S) AC 10. USE FUSED AC DISCONNECT SWITCH WHEN AMPACITY OVER STANDARD OFESg\O DISCONNECT EQUIPMENT RATING 11.USE MC ONLY IF INCLUDED GEC IS ADEQUATELY SIZED,OTHERWISE USE F EMT CONDUIT AND THWN-2 WIRE\ F 12.FINAL SCHEMATIC SPECIFIC TO THIS INSTALLATION AVAILABLE UPON REQUEST E E a v STANDARD EXTERIOR INTERCONNECTION: STANDARD INTERIOR INTERCONNECTION: D D REV: DESCRIPTION: DATE: PROJECT NAME: INTERIOR EXTERIOR INTERIOR EXTERIOR JOHNSON RESIDENCE PROJECT LOCATION: C C 1120 BRIDGE LN MAIN TAP BREAKER MAIN CUTCHOGUE,NY 11935 SERVICE ENCLOSURE O PANEL 1 PANELETTE SERVICE PANEL M PROJECT#: 1888 UTILITY UTILITY PROJ.PHASE: PERMIT METER METER DATE: 2115/2018 B B DESIGNED BY: JR CHECKED BY: GS -- - - SCALE: - NTS _ TITLE: - ELECTRICAL A A SHEET: SE-01 1 2 3 4 5 6 7 8 9 10 11 12 13 r , 1 2 3 4 5 6 7 8 9 10 11 12 13 SUNPOWER® by EmPower Solar I I 221 LONG BEACH ROAD ISLAND PARK,NY 11558 TEL:516-837-3459 FAX:516-706-1789 o >f '_ �i /:i " "vr•N a +�T_ i �' www.empower•solar.com ' +`� e��*•�''• -�- - - _ - - m - �I fi ^;�' �' -'y;^'•`�` - -a.- �- _ -_ ti THE INFORMATION DISCLOSED HEREIN IS THE SOLE $_- w Y?i: l� '' 5 -- t ' H PROPERTY OF EMPOWER CES,LLC.UNAUTHOR¢ED If �� �^ -S"� REPRODUCTION OR DISTRIBUTION OF THIS ' d _ _ "`•`-- _ - _ --- - _ - ��-'"' _ ---- ;- _ _ MATERIAL IS STRICTLY PROHIBITED WITHOUT `- ha,t< �_ - - - +iS'-r, _ c.t s -h-t;'I�rY;: • '`a«� ,';van' _"": :''+g. - - ..tk9€- a-?'&f+,? - ,_ r - ''�`, PRIOR SPECIFIC -EbL PERMISSION o PROFES - AIA$tTFLW !� Simple and Fast Installation I • 00 II/0Integrated module-to-rail grounding. i V. G G t Pre-assembled mid and end clamps i Motlu e'/M'd camp ani Rad Module I Ertl clan•p and Rall CO C7 r. ' iILI j Levitating cold damp for easy placement _ 4 Mid damp width facilitates even -_— _ f module sparing 0 simple,predrilled rail splice 'UL 2703Listed-integrated grounding F + F Flexible Design ; y Addresses nearly all'sloped resldentlal roofs_ Design in landscape and portrait i M11 clamn -End Gamp Fans Ran Spl ce Ground tug Asserby End Cary Ralis enable easy obstacle management d Customer-Preferred Aesthetics -�-�lyt�=c erer , - E #1 rnoduleand,#1 rrlouritingaesthetics E - Best-in•classsystemaesthetics Elegant Simplicity r Premium,low-prone design Black ari&ffizedcomponents SunPowerOlnvisiMounL'misaSunPower-designed •• T ••• f t Hidden mid clamps and'end clam S Companent VatzraY Weighs 7zmperalu'z -J0'C to 90`C(-40'F%a 194"7 p_ p rail-based mounting system.The lnvisiMount system 2400 ra uolft hardware,and capped,flush rails Max•Load pp ffdCtamp O'ark cxides;am'ess stee.A'�30J 63g(7_7 oz) 5 400 pa da.vnfarce addresses residential sloped roofs and combines faster Ertl Gamp a'ack anod:zzdauminum alloy 6063-io 110&066 oq D Part of Superior System installation time,design flexibility,and superior aesthetics. Ran 3'arkanodzeda'urnumalloy6305-T6 93091T(9cznq o ' r ' p REV: DESCRIPTION: DATE: Built for Use Whh SunPOWer DC and AC modules Rall spree Alum,num aPaf GOOs Ts f0D gtm(9 arfIL) 7s year p-oduct warranty Warran•:zs The InvisilViount product was specifically envisioned and syea-fin 3hwwrnnty PROJECT NAME: G=cund 1 ug 30J;u n'es; • Beso-in•dass system reliabllay.and aesthetics tDf:S gm:(3.75 c;I Ascemnly (A2.70 belt;tin-p6-ted[caper lug} Com6lnewithSunPowermod_ui_esand engineered topalrwithSunPowermodulesTheresulnng EEndcaD aackacetat(ro%')cmaymPr 1Daglos7o:) uL27D3Lt5ed JOHNSON RESIDENCE momtafingapp system-level approach will amplify the aesthetic and Ce-,I cm ons Class Afire rzrngwnendisancebetyeon { •.V111111.1 rcaf su*f and hZIMM of 9tn?a�r installation benefits for both homeowners and installers. e• o o modu'z fame's!3.5 PROJECT LOCATION: C � --- - - -- - - Comacsalon SrnBtz RaIIer A::achment App9r:;Ian Cnmpasttbn Sh'ngie Roof Oeck"ng Attathmen; C' 1120 BRIDGE LN Curved and Flat Mile Roof Attachment •• • CUTCHOGUE,NY 11935 �- )) unwrsat intecix- for Other Roof Aiach rents Refer to roof atudtment hardware manufacturer=doeumen:�(an sunpower.co_m PROJECT#: 1888 is a y y� PROJ.PHASE: PERMIT "' f U DATE: 2/15/2018 -Mcdu'e frame char H ca uhe vndt the 1—M—i tem r ed for twda me Inas Rw e Er apes y, DESIGNED BY. JR Carpa B -- - ?DIS Sunroner Corf>arAll Wghls FYs¢ntd.Slf:1POWLR,tIlE 5Ur1PO1V[Rkg0.and INL151"dOUNt en?trndemarts ones aetW B rradems;a,of5unnmerLoroouivort A7 when vadenurlcsrethe p.'ntxnyof rharee•.prnrve vrma•e sur-'onercnm CHECKED BY• GS 110n4" Nded"n dlu d4mhe&a le aUbm r0 dwnye wahoulno,IC. Davmzn:457.:05 Rev SCALE: NTS -sumTITLE:TITLE: •N'_•Ffi'?.r �r ''% 1l,•k - n _ l'�.p sl d #/ RYY�L7 -1S ' �: �- LJaIV J{ttj�'m = ,4t _ RACKING A A SHEET- ST-02 1 2 3 4 5 6 7 8 9 10 11 12 13 1 2 3 4 5 6 7 8 9 10 11 12 13 SUNPOWER° by Em Power Solar i I 221 LONG BEACH ROAD ISLAND PARK,NY 11558 c _ TEL:516-837-3459 FAX:516-706-1789 00'�••.�"�-'���-- .^ , ,r r`il www.empDwer-solar.com �x- � � THE INFORMATION DISCLOSED HEREUi IS THE SOLE ..+- _ - _ H PROPERTY OF EMPOWER CE3,LLC.UNAUTNORRED HREPRODUCTION�-.,1 -r _.. = '' •'' tom`. - • .fi MATERIAL IS STRI R DIST ROIBBITON OF THIS ED WITHOUT PRIOR SPE r7EN'•� MISSION PO G, J o © . a i0 • ! r3 9 a o- ©- ®0 PROF IQN �� j 0� o SAcy Design-Driven Advantages (� 4a ,, S G ; '.�1 m4 u�0 dCSifietirS ant C(fIULKICy� — -- SPR E26-327•C-AC SPR-69320{AC Solar CeI_= 96 Monocryszantne MaxLwn Gnil G •via Unmatched modulereliaUDiry3 h` SERIES 6loirinar?o•xr(Pnom) 327'rJ 32a FrantGass High uarsmkslenterrp>:et1g<ssw'rhrn0 U' i No elecrclytic capacitors h t r t PaAerTo'erartce -5;'C a +51 046 refecuve mating 25-year Combiriod PoWef and Product Warrant ; A',g Panel Etfc envy} 20 4". 199"6 CndronmeMat f I _ -Y,e _ Y' - Outdoor rased I Temp.Coef(Por«r) 03n4-c hating ` V MaxirriizeValueforRoof ,1hree Frame Class1Wackanodize,'i(htghestAAM41,raring) " 7passdlodes Oa�fO� O= f S+lade Te'erance •Into aced modu'e level ma lmum ower t"tei;,ln X551115(20 6 k;J : Size system ton-"roof,rtOt,for sirfig inverter 8 P r:Optlmize perfouriance gf eadi module polnttrchrt h'ax Recommended 13,in(23 mm) F Expand Deployment-Options o f'td"I`sp`c g F j complex'rotifs and paenal shading " - O,Iput C 2•so V(rttin;nomlmaxJ 2711240/264 v — i Small systems - Dulput C 208 V(mnJnom.:max,) 19J2081229V ° a Symemexpandabdlry OyeravrZFrequency(minJnonVna ) 593!60.060rsHz %4arrenoes 2S yew l;nffiedpowerwatiant, _V — --- Ourpul Pa:: Facto'(min) 0,99 2S Lear Ilm ted OrOduit a trranly •Simplify,&Speed Installation AC Max Continuous OtdputCurrent C240Y, 1.33A UL17x1,Indudrgmmp'4,nceYdtt Factory-Integratedmicroinverter Optimize System and InstallationEffleiency ACMax.Continuous Output Curreni@209V IFAA Epp'cau'etequaementsoflEEE1S47arid •.Robust,doubl&locking AC connectors: AC A1av Cont.O:rpu:Povt'r 320 W IEEE 1547.1 E Design Rexibitity,offsfe and onsite SunPrnver°AC Modules,which Include a factory in10VLed Sunft%er DC/AC CEC Cora'elslon Efficiency 960% •FCC and ICES 003 Clss B E ro>_14 ' Ajax Units Per_0 A 3randl Circus:a_40 V 12(single phase) )1%e • No DC string sizing process •AC module T 2 Flre Rased Fewer Installation steps than competing systerrs m Groin enter,provide a revolutionary combination of high effiooncy, Max unrs Per 20 A Brandt Clrcult @ 2(18 V 10 thvo pose) U ?7o31msiAlount"Llsung ma nainM t*t intuitive commissionirig high reliability,and module-lcwel DC io-AC paver comev.0 t rslon.Designed ccnifcatlons when Instaeir v. is AC Wvdule I _ •Clhss A Fite Rated::•hen msta)`rd v.1th specifically for use with SunPower InvislMouriff and Sunpoy.•er Monhoring ° Ir M%0,ount`and when d'sutince hczwCen i Component of' n Complete�System OperlmgTen,p a 40'Fto�165'F(go•cta.es" f Built for use firth SuriPdNer°Inp sddou tt"' _ System SunPower AC Modules enable rapid installation,best-linsystem ron'ser?aca and h�A rtt of UnPo,e: Max,Amo err.Temp 122`F{50"C) module frame Is<_3.5•(B 89 cm) and SunPower Monitoring system aesthetics,and intuitive vN;hlliry Into systerr.performance N[this comes wall Max Load Wild,62 psf,3000 Pa,305 kgtm=front&bas Alternating Current(AC)Module designVon D REV: DESCRIPTION: DATE: D •'superior system reliability and aes[he[t6 snow 125 ust.6000 Pa,611 m*front enZb'es Irsmilation In eccorda;ce v.-ah NEC the best Combined Power and Product Warranty 1 i-rd1(25 nn n)diam ter had ai 52 mph(23 6906 PROJECT NAME: impaaP.sstancc ms) PIU Test Potential induced degrada:tonfree JOHNSON RESIDENCE 2—'e.t � LIS PROJECT LOCATION: C C ».-� Plow] 1';r^ a1120 BRIDGE LN f: 'lr ""IsCUTCHOGUE,NY 11935 4 L°OII°S K ota :.P>.rn13•e_ann.'Jt'(w�'a.L 7Y.5r3T�_t.':.'�.7�ule D.`4.L•'.1n tuN,' -s;y .� `•:. tnnlrh':r"^Sr ccl_.1v.e,N [lal'SVb I 'rfrlr=tu`am_r i:lts:ai:tla saes rnx�'.tMae.ne,ra 3at5 sunpower.eom 'r-n•ua rata,iasna•:rti,•=nr,,:,ceA.ns,zs•q-ux_ta:ca'cn.^aesd.�s I P,vH PROJECT#: 1888 anotuc�rr,ftoaz rrcc:x amjcwnn:rtti,ro rma° PROD.PHASE PERMIT '�ei rail,tlTl NofJa ru rbtsr cs6oer",r:c;zcrc,i'res.nro•.•,=,rc;, •erlm rr�aLecrmce�tdran^�uL.Cay.,,pN.rcxi. . '3�-e andtMral e3ra ls ;:,mn,fmarnelerc:rM Crew 7, rtazs¢rti-±-to ':tyzd r•c� :nlncruc",resfv dcdls wan�n':wxrvouer..Sera.rccz'S.n?..•rn•-��rsc+,rFozm3, �.-n-..,.•.rry:-- tisra m:<r.la.re<n•arma�al DATE: 2/15)278 � 5:4.:,•.ni.nyr...rrcpxzrr.'.au's C-lati - Fvr�ed^,�„sc-:r�,:�ti.d_tdn�.n.,�s,{,•n.+aa,?1lt_J.e�s DaUrccrM1y5hA 17�.-e rLT;,V; B B DESIGNED BY: JR D P - u • CHECKED BY. GS SCALE: NTS TITLE: MODULES I A A SHEET: ST-03 1 2 3 4 5 6 7 8 9 10 11 12 13