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29. 9. o
BUILDING-DEPARTMENT
VILLAGE OF RYE BROOK OCT — 1 2021
938 KrNGi,STREET RYE BROoK,NY 10573
(914)43 '0668 FAx(914)939-5801 VILLAGE OF RYE BROOK
BUILOING DEPARTMENT
, w ryebrooL. re Y.
FOR OFFICE US�1E ONLY:
Approval Date: 0 CT 2 5 21 rmit# //^'�� Application#
PP LJ pp
Approval Signature: ARCHITECTURAL RE{�VMW BOARD:
Disapproved: Date: OCT
2 0 2021
BOT Approval Date: Case# ; Chairman:
PB Approval Date: Case# ; Secretary.
ZBA Approval Date: Case#
Other:
Application Fee �� Permit Fees:
APPLICATION TO INSTALL PHOTOVOLTAIC SOLAR ARRAY
Application dated: 9/28/21 is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the
installation of a Photovoltaic Solar Array as per detailed statement described below.
1. Job Address: 541 Westchester Ave SBL:,� iO 7 �f CO Zone:
2 Type,M&Location of Array,(use additional sheets if necessary):
6.12KW PV SOLAR PANEL ROOF MOUNT(18) PANELS
2 Energy Storage System
3.Property Owner: Anyelina Galvez Address: 541 Westchester Ave
Phone# (347) 813-1438 Cell# e-mail anyelinagalvez@yahoo.com
4.Applicant: Margaret Mann Address: 227 N RT 303 CONGERS NY 10920
Phone# 914-433-3016 Cell# e-mail nynorthpermits@sunrun.com
5. Design Engineer: PZSE Address: 1478 STONE POINT DRIVE
Phone# 916-961-3960 Cell# e-mail PROJECTS@PZSE.COM
6.Solar Contractor: SUNRUN INSTALLATION SERVICES Address: 227 N RT 303 CONGERS NY 10920
Phone# 914-433-3016 Cell# e-mail nynorthpermits@sunrun.com
7. Occupancy,(1-Fam.,2-Fam.,Comrncrcial.,etc...)Pre-construction: 1 FAM Post-construction: 1 FAMILY
8. If building is located on a corner lot,which street does it front on:
9. N.Y.State Construction Classification: N.Y.State Use Classification:
10. Construction Type&Location:()Typical Western Lumber Frame;()Timber Frame[TC];()Wood Truss[TT];
O Pre-engineered wood[PW];Located;O Floor Franting[F];O Roof Framing[R];O Floor&Roof Framing[FR];Other:
11. Number of stories: Roof Style:(hip,shed,mansard,etc...)
12. Will a New Roof Be Installed: No IN Yes❑ (a separate roofing pcfmit is required to re-roof an existing building)
13. Ro6 fg,Material&Number of Layers,1 43 COMP SHINGLE
:'• (l7 Mr?.)14,21.rvi YK AILS+!
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14. Will the proposed project disturb 400 sq.ft.or more of land,or create 400 sq.ft.or more of impervious coverage requiring a
Stormwater Management Control Permit as per§217 of Village Code? No: IN Yes:❑ Area:
15. Will the proposed project require a Site Plan Review by the Village Planning Board as per§209 of Village Code?
No:n Yes: ❑ (If ycs,applicant must submit a Site Plan Application,&provide detailed drawings)
16. Will the proposed project require a Tree Removal Permit as per§235 of Village Code?No: ( Yes: ❑
(Ifycs,applicant must submit a Tree Removal Permit Application)
17. Does the proposed project involve a Home-Occupation as per§250-38 of Village Code? No: ❑Yes: ❑
Indicate:TIER I:—TIER II:—TIER III:_ (if yes,a Home Occupation Permit Application is required)
18. What is the total estimated cost of construction: $ 13,000
(Note:The estimated cost shall include all site improvements,labor,material,scaffolding,fixed equipment,professional fees,including any material and labor
which may be donated gratis.If the final cost exceeds the estimated cost,an additional fee will be required prior to issuance of the CIO).
19. Start Date: ONCE PERMIT IS APPROVED Completion Date:
This application must bear the notarized signature(s)of the legal owner(s)of the subject property,and the
applicant of record In the spaces provided.Any application not properly completed in Its entirety and/or not
properly signed shall be deemed null and void and will be returned to the applicant.Please note that application
fees are non-refundable.
STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as:
I, Margaret Mann ,being duly swum,deposes and states that he/she is the applicant above named,
(print name of individual signing as the applicant)
and further states that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the,
AGENT for the legal owner and is duly authorized to make and file this application.
(indicate architect,contractor,agent,attorney,ac.)
That all statements contained herein are true to the best of his/her knowledge and befiet;and that any work performed,or use conducted at
the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying
approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code
of the Village of Rye Brook and all other applicable laws,ordinances and regulations.
Sworn to before me this 2q+h orn to or a this ZO
day of 20 2 day o
otary Pubrp otary Public
r,
S gna f Property owner Sipatuie of Ap nt
Anyelina Galvez Margaret Mann
Print Name of Property Owner Print Name of Applicant
JACLYN M SGRO
NOTARY PUBLIC-STATE OF NEW YORK IBM ANNEWCHENKO-SEARLES
No.01 SG6315056 2 WORYi!IALic SM(WWWYOK
Qualified in Rockland County RdowdiaNceinixim
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