SOLAR-0313-2018 01111111k\
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: SOLAR-0313-2018 Date Issued: Wednesday, January 23, 2019
This is to certify that work requested to be done as shown by Permit Number SOLAR-0313-2018
has been completed.
Tax Map Number: 289.18-1-35.2
Location: 14 BLACKBERRY LN
Owner: Ryan Wild
Applicant: High Peaks Solar LLC
This structure may be occupied as a: Solar Panel Installation
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the ("// 4 , `�
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.
'094. •• Jan, 23. 2U19g 2 : 53PM ,c:MU.A :�,F .� ' rq�` =� w $1.,�.�f yy, No. 6886— P. 3/14
., MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
IDex(Aa that the electrical wiring to the electrical equipment listed below has been examined and is approved as
�e='j being in accord with the National Electrical Code, applicable governmental, utility and Agency rules in effect on the date r�a
0.)) noted below and is issued subject to the following conditions- •a,t
.. Owner: • 0
�c Ryan Wild • Date: =
01/07/2019
1 Occupant: Location: 47
6
r Solar PV System
y 14 Black Berry Lane -'���
Occupancy
Queensbury,Family Dwg. Warren Co. NY
�4tJ Applicant: . (j
tta High Peaks Solar . . .
�� Kevin Bailey :.-:...._,.: ....-.. l.•
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� 180 Main Street •
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5.) L Wynantskill, NY 12198
C No. Joseph A.Holmes 032818107 •
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, i Equipment: •
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12 Solar Modules; 12 Micro Inverters; 1 - Back 1 -.. 75
Fed Breaker; 1 Production•Meter
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'f1. This certificate applies to the electrical wiring to the electrical equipment listed immediately null and void. This certificate applies only to the use,occupancy and .A..
`, above and the installation inspected as of the above noted date based on a visual ownership as indicated herein, •upon a change in the use,occupancy or ownership 0
:-j) Inspection. No warranty is expressed or implied as to the mechanical safety, effi- of the property Indicated above,this certificate shall be Immediately null and void.
g ciency or fitness of the equipment for any particular purpose. This certificate shall In the event that this certificate becomes Invalid based upon the above conditions, P,, be valid for a period of one year from the above noted dale, Should the electrical this certificate may be revalidated upon reinspection by Middle Department .,�:
a� system to which this certificate applies be altered in any way,including but not limit. Inspection Agency, Inc. An application for Inspection must be submitted to Middle SFhR
«.t ed to,the introduction of additional electrical equipment and/or the replacement of Department Inspection Agency, Inc. to initiate the inspection and revalidation 0,)
."!�] any of the components installed as of the above noted date,this certificate shall be process. A fee will be charged for this service, 44
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JAN 2 3 2019 itij
TOWN OF QUEENSBURY
BUILDING&CODES
SIL,p.Q.-- 0 1. ------2-C,4B
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development- Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number: SOLAR-0313-2018
Tax Map No: 289.18-1-35.2
Permission is hereby granted to: Ryan Wild
For property located at: 14 BLACKBERRY LN
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: Ryan Wild Solar Panel-Residential $0.00
Owner Address: 14 Blackberry LN Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
High Peaks Solar LLC
180 Main ST
Wynantskill,NY 12198
Plans&Specifications
Solar Panel Installation
$ 75.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Thursday,June 6,2019
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury befort the expiratio date.)
Dated at the To .of Q nsb *a-y-,-June 6,2018
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
Permit#: �,L�
Fee: $ '}CD.ri
742 Bay Road,Queensbury, NY 12804 Invoice#:
P:518-761-8256 www.gueensbury.net
SOLAR PANEL PERMIT APPLICATION
• Property Owner(s):
Na.me(s):
Mailing Address, C/S/Z:
Cell Phone:_( , ) 2}_ i' - (� 1 ebb Land Line:_(
Email: ✓ `invi 've ����p�s r� C
Project Address: cicbee cl L �`fi � ez� s�� , Ny
Section Block Lot:
Existing Use: Single Family ❑ 2-4 Family ❑ Commercial ❑ Other:
• Solar Contractor:
Business Name: 1'4 j
Contact Name:
Mailing Address, C/S/Z: � w����v �v�h+� , �✓Yv� � �sl<< lj . /�✓ Y l �
Cell Phone:_( ) A11A Land Line: _( l ) ? 1 1
Email: i< 1 �)�7
• Electrical Contractor: r
Business Name: oV'e
Contact Name: i pY 3
Mailing Address, C/S/Z: u _ s�
Cell Phone:_( ) Land Line: _( ) $Cg _1 COO
Email:
Contact Person for Building & Code Compliance: k C vl 3 a(
Cell Phone:_�) �/ Land Line: 5— )
Email: k boll" cv;,,,,
Solar Panel Application Revised December 2017
4
Esti ated cost of construction: $
Total S ste Ca acit Ratingsum of all panels):
Solar PV stem: kW DC
Select System Confi ur ion:
❑ Supply side connection 'th micro inverters
❑ Supply side connection with C optimizers
❑ Supply side connection with stri inverter
❑ Load side connection with DC optim ers
L� Load side connection with micro inverte
❑ Load side connection with string inver r
Please sign below to affirm that a answers are co ect and that you have met all the
conditions and requirements to ubmit a unified sola permit.
Homeowner's Signature Date
Solar Co. Repre entative Signature Date
Solar Panel Application Revised December 2017
DocuSign Envelope ID:B4E89FF1-BBE3-4C58-84CE-53D4347F3F64
Estimated cost of construction: $ �f'A" V l J woo +L �XjIltze, as C;. /PSG
Ct
Total System Capacity Rating (sum of all panels):
Solar PV System: -` �? kW DC
Select System Configuration:
❑ Supply side connection with micro inverters
❑ Supply side connection with DC optimizers
❑ Supply side connection with string inverter
❑ Load side connection with DC optimizers
M-- Load side connection with micro inverters
❑ Load side connection with string inverter
Please sign below to affirm that all answers are correct and that you have met all the
conditions and requirements to submit a unified solar permit.
�DocuSigned by:
AUt Ra 5/29/2018
4ECOtE9194B8459_.
Homeowner's Signature Date
Solar Co. e�presentative Signature Date
Solar Panel Application Revised December 2017