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SOLAR-0369-2018
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-0369-2018Date Issued: Tuesday, January 15, 2019 This is to certify that work requested to be done as shown by Permit Number SOLAR-0369-2018 has been completed. 302.18-2-19 Tax Map Number: 138 GRANT AVE Location: Eamon Foster, Vaness Foster Owner: Lotus Solar Applicant: 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 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 fl' 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development-Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: SOLAR-0369-2018 Tax Map No: 302.18-2-19 Permission is hereby granted to: Lotus Solar For property located at: 13 8 GRANT AVE 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 Tvpe of Construction Owner Name: Eamon Foster Solar Panel-Residential $27,972.00 Owner Address: 138 GRANT AVE Total Value $27,972.00 Queensbury,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency Lotus Solar 98 Green ST,Suite 4 Hudson,NY 12534 Plans&Specifications Solar Panel Installation $ 75.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Friday,June 21,2019 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Quee before t exp' atio to Dated at the Town ffQ'uee s T June 21,2018 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement 2 Office Use Onlv DL� V Permit#: JUN 18 2018 : Fee:$ �7 742 Bay Road,Queensbury, NY 12804 TOWN OF QUEENSBURY Invoice#: eq'� P:518-761-8256 www.aueensbury net BUILDING&CODES I SOLAR PANEL PERMIT APPLICATION • Property Owner(s): Name(s): Gc�, ,,, Fc,c�— ��n esca S�c��Y Mailing Address, C/S/Z: 9 38 UkT ,• -j y' 171-04 Cell Phone:_( tg ) 3o-7 JeCc! Land Line: ( ) Email: r t Project Address: 13 ' r;T�-- A, rf AJ V 0 Zf Section Block Lot: 3C?Z Existing Use: ©Single Family ❑ 2-4 Family ❑ Commercial ❑ Other: • Solar Contractor: Business Name: La`,-S S©(�- Contact Name: Xv 4- /-L Mailing Address, C/S/Z: %XI c` I-IV /2 53`/ Cell Phone: (51,F G/G-7 t / Land Line: ( �5-/r ) 2�? ?/o i� Email: A r r►n q � /V r Wn e-r-4 z� G 0 A-, J • Electrical Contractor: Business Name: La .so f�Y Contact Name: Mailing Address, C/S/Z: �'�r�-rG, �_ S'- Cell Phone:_( 1 trL 3v - A�& z Land Line: Email: Contact Person for Building & Code Compliance: h�/lam �1 opt e, Cell Phone: ( 151 P ) j 3O- c-/G land Line: ( ) J Email: fly/--I- fi1-1 /c i I0 14C-5 so/c%-r . c-0Alk Solar Panel Application Revised December 2017 Estimated cost of construction: $ ��r q 7 -- Total Svstem Capacity Rating (sum of all panels): Solar PV System: T i q kW DC Select Svstem Configuration: IJ Supply side connection with micro inverters ❑ Supply side connection with DC optimizers ❑ Supply side connection with string inverter ❑ Load side connection with DC optimizers ❑ 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. Homeowner's Signature Date Sol XAi� Co. epresentative Signature Date Solar Panel Application Revised December 2017 DocuSign Envelope ID:EEE879D1-BDFD-4E16-9D61-767AE21511DC 0 LOTUS ENERGY Solar Energy Systems Date:12—Apr-2018 1 10:53 EDT From: Vanessa C Seelev 138 Grant Ave Ext Oueensbury NY 12804 National Grid Account#33676-19157 SUBJECT:Authority Letter for Lotus Energy Inc. Dear Customer Service: I hereby authorize Lotus Energy Inc.of Hudson,NY and its employees to represent me for purposes of obtaining the permits required to connect their solar energy generating equipment to the electrical service at my location,as well as to obtain my electricity billing and usage information to ascertain my historical and ongoing energy usage and costs for data collection and analytical purposes. Sincerely, Docuftned by: VA LLSS& St,tk (Customer signature)