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RC-000453-2016 , 41111K - TOWN OF QUEENSBURY / 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development-Building&Codes (518)761-8256 CERTIFICATE OF COMPLIANCE Permit Number: RC-000453-2016 Date Issued: Tuesday, August 14, 2018 This is to certify that work requested to be done as shown by Permit Number Re-:000453-2016 has been completed. Tax Map Number: 315.7-1-6 Location: 12 MORNINGSIDE CIR Owner: Emerson North Applicant: PosiGen Solar This structure may be occupied as a: Residential Alterations --solar panel systen Rafter Upgrades 408 s.f. By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Compliance DOES NOT relieve the lor property owner of the responsibility for compliance with Site Plan, Variance, or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement Planning Board or Zoning Board of Appeals. TOWN OF QUEENSBURY 10h 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 N=- %f Community Development - Building & Codes (518) 761-8256 BUILDING PERMIT Permit Number: RC-000453-2016 Tax Map No: 315.7-1-6 Permission is hereby granted to: Emerson North For property located at: 12 MORNINGSIDE CIR In the Town of Queensbury,to construct or place at the above location in accordance with application together with plot plans and other information hereto filed and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning Ordinance Type of Construction Owner Name: Emerson North Single Family-Alteration $12,480.00 Owner Address: 12 MORNINGSIDE CIR Total Value '$12,480.00 Queensbury,NY 12804 Contractor or Builder's Name f Address Electrical Inspection Agency PosiGen Solar 11 A Solar DR Halfmoon,NY 12065 Plans&Specifications Residential Alterations --solar panel system Rafter Upgrades 408 s.f. $ 61.20 PERMIT FEE PAID -THIS PERMIT EXPIRES: Monday,July 10,2017 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the Town o bury; Frid Ju 15, 2016 4 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement PRINCIPAL STRUCTURE APPLICATION Office Use only 1 Received Date: ��r` Tax Map ID Tax Map ID j I rj r — w Permit No. 2011 Permit Fee A 6 -20 nV- L1 Zone Ree Fee Historic Site Yes No Site Plan# Subdivision Name Lot# Subdivision# Project Location JU1 f„r,,�,r,,C� I TOWN BD,RESOLU'nON 86-2013: $850 recreation fee for new dwelling units—single family,duplexes/two-family, multiple family,apartments,condominiums,townhouses,and/or manufactured&modular homes,but not mobile homes. This is in addition to the permit fee(s). Applicant /� K '� , Owner - Address �"``'' ' Address Phone/E-mail 1 ` 40 PhoneSmail Contact Person for Building&Codes Compliance: Phone (-If TYPE OF CONSTRUCTION ✓Cheek all that apply New Addition Alteration lu floor sf 22d floor sf Total sf Height Single Family Two-Family s/ Multi-Family (#of units�, JUL 1 5 20 is Townhouse Business Office Retail-Mercantile Factory-industrial Attached Garage (1, 2, 3, `l}) Other If commercial or industrial please indicate of business Town of Queensbury Building&Codes Principal Structure Application Revised September 2015 Proposed use of building or addition Source of Heat(circle one) Gas Oil Propane Solar Other Fireplace: Complete a separate application for Fuel Burning Appliances&Chimneys Are there structures not shown on plot plan? Are there easements on the property? Site Information a. Dimensions or acreage of lot b. Is this a comer lot? c. Will the grade be changed as a result of construction Yes No d. Public water or Private well e. Sewer or Private Septic System Value of all work to be performed(labor or materials) $ W ARCLARATIQN: I. I acknowledge no construction shall be commenced prior to issuance of a valid permit and will be completed within a 12 month period. 2. If work is not complete by the 1 year expiration date the permit may be renewed, subject to fees and . department approval. 3. I certify that the application,plans and supporting materials are a true and complete statement/description of the work proposed,that all work will be performed in accordance with the NYS Building Codes,local building laws and ordinances,and in conformance with local zoning regulations 4. I acknowledge that prior to occupying the facilities proposed, I or my agents will obtain a certificate of occupancy. 5. I also understand that I/we are required to provide an as-built survey by a licensed land surveyor of all newly constructed facilities prior to issuance of a certificate of occupancy. I have read and agree to the above: PRINT NAME: „ ' L",7/7 ,,e,- DATE: SIGNATURE: ` —�.� DATE: For office use only Operating Permit Issued: Yes No Occupancy Type Construction Classification Assembly Occupancy Limit Special Conditions Town of Queensbury Building&Codes Principal Structure Application Revised September 2015 TOWN OF QUEENSBURY DocuSign Envelope ID:3AD24277-7F2B-4344-BFOA-587EEA543FEF BUILDING & CODES EPT. Reviewed y: os ' Gen P_,n Date: AUTHORIZATIC�, s ORM �otivni a� ty�PFR�`�1�E`s�om�liance 6l�li_r31N� tilna,�nn, � ,, d as Based On our 4lrnllcd e nI c, b�cans zue Gr jiments r,,,l �¢c ticatiDns are of with o�yrn~the 03ns anis uildin�} God�S iadlcat�t,ltaace �vikh the ltke�Yo k Skate• "TO ACT AS AGENT FOR" Emerson North , owner of the premises located at: 12 Morningside Circle Queensbury V RFWCounty,NY , NY 12804 ,Tax Parcel #, 315.7-1_6 hereby designate 'PosiG-en New York, LLC and/or its subcontractors as my AGENT regarding my Permit Application for PV Solar System Install 315.7-1-6 RC-000453-2016 North, Emerson 12 Morningside Circle — ❑ocusignedby: Residential Alt. (rafter upgrade) 408 s.f. Signature: fAwsbv. A& M --FMFEOBMOEPEMM ' JUL Date: 4/29/2016 10:58:35 AM CT • N (N .(U rn m rn LU m 0 Cf 0 V), I (V > C,4 2i C:) m7 ;3- C3 LO E IC77 rn❑ L- 0 <Chco V I E w u 4; 7 cn J, A > CX C14 Cc J-) q CL 4) C6 0 Q tn > LLI to w 6.2ft CA N 0> UJ cc w D CD En m CF) rz 0 G c U w W Ln 6.2ft .lit C3 M 6it i j C Cn N r r n w 43 J cZF CLa �1y m o 11 o ,va o M > N M Q C] c} O - M e0) 0 '- r L7 LO c �- 7� 1 COco 7 t`p6 W C r � cn 7. .O m N !3 N c m CL fu f 0. ul c Q ` V} cL` oG > 2 5r t 1- 101,11 { 2��k� �� � �+�' Ott qty�'It&r �i ��+ � it � i L�•.fG � '����� r �� ,. ^{,{' j�e ��aj e �� 3,m�. .a"• � v � ,o =�- "tt?'AF i3i''I=ICES Sandy ECTORLayton E n G i n it e R s St. George Project Number: U1900-0500-161 July 12,2016 PosiGen 997 Central Avenue Albany,NY 12205 ATTENTION: Madlin Rivera REFERENCE: Emerson North Residence:12 Morningside Circle,Queensbury,NY 12804 Solar Panel Installation Dear Ms.Rivera: Per your request,we have reviewed the attached layout and photos relating to the installation of solar panels at the above-referenced site.The following materials and components are proposed in the installation of the solar panels. Roof structure supporting the proposed panels:2x4 Rafters @ 24 in o.c. Roof material:Composite shingles Recommended attachment spacing:48 in o.c. Based upon our review,it is our conclusion that the installation of solar panels on this existing roof will require the existing roof rafters in the area of the solar panels to be strengthened.This can be accomplished by sistering one new 2x6 member of the same species and grade on each rafter. Connect the new rafters to the existing 2x4 rafters with 16d sinkers®6"Q.C.staggered.The design of solar panel supporting members and connections is by the manufacturer and/or installer. The adopted building code in this jurisdiction is the 2010 Building Code of New York State and ASCE 7-05. Appropriate design parameters,which must be used in the design of the supporting members and connections are listed below. Please verify these parameters with the local building department. Ground snow toad:50 psf Design wind speed:90 mph(3-sec gust) Wind exposure:Category C Our conclusion regarding the adequacy of the existing roof is based on the fact that the additional weight of the solar panels is less than 3 pounds per square foot.In the area of the solar panels,no 20 psf live loads will be present per Section 1607.12.5.3 of the International Building Code,2015 Edition.Regarding snow loads,it is our conclusion that since the panels are slippery and dark,effective snow loads will likely be reduced in the areas of the panels.Solar panels will be flush-mounted,parallel to and no more than 6"above the roof surface.Thus,it is our conclusion that any additional wind or seismic loading related to the addition of solar panels is negligible. During design and installation,particular attention must be paid to the maximum allowable spacing of attachments and the location of solar panels relative to roof edges. The use of solar panel support span tables provided by the manufacturer is allowed only where the building type, site conditions, and solar panel configuration match the description of the span tables. Attachments to existing roof trusses or rafters are designed by others and must be staggered so as not to overload any existing structural member. Waterproofing around the roof penetrations is the responsibility of others. Electrical engineering is beyond our scope.All work performed must be in accordance with accepted industry-wide methods and applicable safety standards. Vector Structural Engineering assumes no responsibility for improper installation of the solar panels. Please note that a representative of Vector Structural Engineering has not physically observed the roof framing.Our conclusions are based upon the assumption that all structural roof components and other supporting elements are in good condition,free of damage and deterioration,and are sized and spaced such that they can resist standard roof loads. Very truly yours, O� NE VECTOR STRUCTURAL ENGINEERING,LLC Hp Now York COA:009721 { W Wells L.Holmes,P.E. Project Engineer O 0?01f1� v WLH/djf AROFESS©�P 07/12(2016 9138 S. State St., Suite 101 /Sandy, UT 840701 T(8 01)990-1775/F (80 1)990-17761 www.vectors e.com �...�� POSIG-1 OP ID:SP AC'tt7R0 CERTIFICATE OF LIABILITY INSURANCE DATEWMIDDIYYYY) �....�' 0611012016 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($), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: H the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terns 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 NAME: Certificate Department Legacy Risk&insurance Svcs PHONE 926482-1000 I rtlg N.J:926.482-1001 CA License#OH66768 118A W- 1850 Mt.Dlabio Blvd,Ste#400 Walnut Creek,CA 94596 ADDRESS,certificatesgllegacyrisk.not Chris Lang,CPCU,ARM INSURER(S)AFFORDING COVERAGE NAIL IF INSURERA:LIO d's of London INSURED POS Gen,Inc 114SURERD: &Related Entities 2424 Edenborn Ave#560 INSURERC: Metairie,LA 70001 INSURER D: INSURER E: NSURER 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. INISR L TYPE OF INSURANCE AM SUOR POLICY NUMBER fall LIMITS A X COMMERCIAL GENERALUA13UTY EACH OCCURRENCE $ 16,000,0001 IT CLAtMS.MADE FRI OCCUR X S0164181301 05/11/2016 08111/2017 p MISE$ Eaoeaaleeue S 1,000,00 X $25,060Oedmcc MED EXP OM one S 10,00 PERSONAL&ADV IMURY S 16,060,00 GENT.AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 15,000,00 X POLICY❑JEMT F�LOC PRCOUCTS•COMPIOP AGG S 16,000,00 OTHER: $ Tam addenl AUTOMOBILE LIABILITY I $ ANY AUTO BODILY IWURY(Per person) 3 AtLLOWNED SCHEDULED D DULED BODILYIMURY(Per aaddent) $ HIREDAUTOS Ae $ S OS UMBRELLA LIAR HOCCUR EACH OCCURRENCE S EXCESS LtAB CLAIMS-MADE AGGREGATE S DED RETENTION S 14 FIWORKERS COMPENSATION ! STATUTE R AND EMPLOYERS LIABILITY ANY PROPRIETORIPARTNEROEXECU71VE YINNIA E.LEACH ACCIDENT S OFFICERIMEMBER EXCLUDED? (MandatoytoNH) E.LDISEASE-EAEMPLOYE S II ea,des OM undue I DE PTION OF OPERATIONS below I E.L DISEASE•PCXJCY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORO 1oi,Additional Remarks Schedule,may he attached N more space Is required) Sub1ectto allolicy terms limitations and conditions. Certificate Holder is Additl'anai Insured when required by written contract. CERTIFICATE HOLDER CANCELLATION TOWNOFQ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Queensbury ACCORDANCE WITH THE POLICY PROVISIONS. 742 Bay Road AUTHORISED REPRESENTATIVE Queensbury,NY 12804 0198&2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) 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 Disabik Benefits Carrier or Licensed Insurance Agent of that Carrier I a. Legal Name and Address of Insured(Use street address only) lb.Business Telephone Number of insured 504-293-5469 POSIGEN NEW YORK,LLC DBA POSIGEN SOLAR lc.NYS Unemployment Insurance Employer Registration SOLUTIONS Number of Insured 997 CENTRAL AVE. 5123979 ALBANY,NY 12205 Id.Federal Employer Identification Number of Insured or Social Security Number 901030545 2. Name and Address of the Entity Requesting Proof of 3a. Name of insurance Carrier Coverage(Entity Being Listed as the Certificate bolder) HARTFORD LIFE AND ACCIDENT Town of Queensbury 3b.Policy Number of entity listed in box"le: 742 Bay Road Queensbury,NY 12804 LNY818030 3c. Policy effective period: 01-01-2016 to 12-31-2016 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,l 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. 01-05-2016 YpGf'c'd seo Date Signed By (Signatumofinsumncc carrier's aohurhed mpmsaft ive orNYS Licensed Irstaanee Agentofthat iasuumwA carrier) Telephone Number (800)454-7020 Title Manaser IMPORTANT: If box"4a"Is checked,and this form is signed by the Insurance carrices authorized representative or NYS Licensed Insurance Agent*ribs( carrier,this certificate is COMPLETE. Mail It directly to the certificate holder. if box"4b"Is cheeked,this certirrcate is NOTCOMPLETE for purposes of ectfon 220,Subd.s of the Disability Beacilts Law.It must be malted for completion to the Workers'Compensation Board,DB Pians Acceptance Unit,20 Park Street,Albany,New York 12207. PART 2. To be com feted by NYS Workers'Compensation Board(Only if box 041b"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 compiled with the NYS Disability Benefits Law with respect to all of his/her employees. Date Signed By (Signature ofNYS Workers'Compe cation Board Employee) Telephone Number Title Please Note:Only insurance carriers licensed to write NYS disability benef fts insurance policies and NYS licensed insurancae agents of those Insurance carriers are authorized to issue Form DB-120.1. Insurance brokers are NOT authorized le issue this form. DB-120.1(5-06) STATE OF NEW YORK WORKERS'COMPENSATION BOARD CER'T'IFICATE OF NYS WORKERS'COMPENSATION INSURANCE COVERAGE 1a.Legal Name&Address of Insured(Use street address only) lb.Business Telephone Number of Insured Posiaen New York (504) 835-2510 997 CenL•ral Avenue Albany, NY 12205 le.NYS Unemployment Insurance Employer Registration Number of Insured Work Location ofInsured(Only required{fcoverageisspec Bally Id.Federal Employer Identification Number of Insured lsnited to certain locations In New York State, i.e., a Wrap-Up or Social Security Number Policy) 901030545 2.Name and Address of the Entity Requesting Proof of 3a. Name of Insurance Carrier Coverage(Entity Being Listed as the Certificate Holder) sw York Marine & general Insurance Compan 3b.Policy Number of entity listed in box"la" WC201500009680 Town of Queensbury 742 Bay Road 3c. Policy effective period Queensbury, NY 12804 9/4/2015 to 9J4/2016 3d. The Proprietor,Partners or Executive Oftleers are Included. (Only check box if all partaerdallieen Included) X all excluded or certainimrinersLtlLicers excluded. This certifies that the insurance carrier indicated above in box"3" insures the business referenced above in box ne 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 Insurancepolicy).The Insurance Carrier or its licensed agentwili send this Certificate of insurance to the entity Hated above as the certificate holder in box'7. The Insurance Carrier will also notr1y the above certificate holder within 10 days IF a palicy is canceled due to nonpayment ofpremiums or withhr 30 days IF titers are reasons other titan nonpayment of premiums that cancel the policy or eliminate the insumdfronr the coverage indicated on this Certificate. (Asse notices may be sent by regular mail) Otherwise,this Cert pcate is valld for oneyear giter this form Is approved by the insurance carrier or its licensed agent,or until the policy expiration date listed In box"3c",Wilchow Is aariier. Please Note:Upon the cancellation of the workers'compensation policy Indicated on this form,if the business continues to be named an a permit,license or contract Issued by a certificate holder,the business must provide that certificate holder with a now 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 depleted on fo this ns. Approved by: t' 1 � �J C (t4int nanzc uF u tm�xd lop�ent nneK Ucotue t a1H OF t0a�un CC CQai6�) Approved by: C _ , y Lull r (Sisrmd,ra) (u w) Title Telephone Number of authorized representative or licensed agent of insurance carrier: Please Note:Only insurance carriers and their licensed agents are authorized to Issue Form C-105.2.Insurance brokers are NOT authorized to issue it. C-105.2(9-07) vrww.wcb.statc.ny.us