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HomeMy WebLinkAboutBP22-016PERMIT / c2DD—)'7 O L DATE: �aIXP; SECTION 3 BLOCK LOT ' TYPE OF ✓ 10B LOCATION vC L0002 l Lo n L OWNER CONTRACTOR, EST. CO T - FEE.d_- x/CO # FEE DATE TCO # FEE._ DATE - FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING E3 RGH PLUMBING GAS 0 SPRINKLER ELECTRIC LOW -VOLT ALARM C) AS BUILT 0 FINAL INSPECTION RECORD DATE INSP T a 4 szij �— X (O9ovqq i,�/ p p�Q zi0he >L� ki(4aj/S/ 7jq � a3 dTFIER APPR VALS aoa4 BOT PB ZBA dTHER QyE QR(�,�• W cc�ct 198 VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury www.ryebrook.org TRUSTEES BUILDING & FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE December 19,2023 Wagas Malik& Maria Khan 70 Rock Ridge Drive Rye Brook,New York 10573 Re: 70 Rock Ridge Drive, Rye Brook,New York 10573 Parcel ID#: 135.36-1-19.1 Building Permit#22-016 issued on 1/25/2022 for a Rooftop Solar Array This certifies that the rooftop solar array,installed under the above captioned permit has been satisfactorily completed. Sincerely, Steven E. Fews Building& Fire Inspector /to ` D ' E V DIDBUILD R MENT For office use only: ,- PERMIT FSEP 3 0 2022 VIL OF RYE ROOK ISSUED: — — 938 KING STRE YE BROOK, ENV YORK 10573 DATE: VILLAGE OF RYE BROOK 9 -06 O� FEE: PAIDJR BUILDING DEPARTMENT APPLICATION FOR CERTIFICATE OF OCCUPANCY, CERTIFICATE OF COMPLIANCE, AND CERTIFICATION OF FINAL COSTS TO BE SUBMITTED ONLY UPON COMPLETION OF ALL WORK, AND PRIOR TO THE FINAL INSPECTION +++++wsswws+++*+**++++ssswwwswwtwtwtww+w+rrsasssasssrs+++++++++++++wwtstsswsttatsrsssst+*++»++++*++++++++++»++++w+wwwwws+sww+ Address: 70 Rock Ridge Drive,Rye Brook,NY 10573 Occupancy/Use: Residential Parcel ID#: I S5,N - I r 11. 1 Zone: /P IO Owner: Waqas Malik Address: 70 Rock Ridge Drive,Rye Brook,NY 10573 P.E./R.A. or Contractor: Infinity Solar Systems Address: 575 Corporate Dr Ste 2200,Mahwah,NJ 07430 Person in responsible charge:Jan Bergus-Infinity Solar Systems Address: 575 Corporate Dr Ste 2200,Mahwah,NJ 07430 Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issuance of a Certificate of Occupancy/Certificate of Compliance for the structure/construction/alteration herein mentioned in accordance with law: STATE OF NEW YORK,COUNTY OF WESTCHESTER as: Jan Bergus-Infinity Solar Systems being duly swom,deposes and says that he/she resides at 575 Corporate Dr Ste 2200 (Print Name of Applicant) (No.and Street) in Mahwah ,in the County of Bergen in the State of NJ ,that (Cir%/TowN Village) he/she has supervised the work at the location indicated above,and that the actual total cost of the work,including all site improvements, labor,materials,scaffolding,fixed equipment,professional fees,and including the monetary value of any materials and labor which may have been donated gratis was:$ 44,000 for the construction or alteration of installation of 32 rooftop solar panels Deponent further states that he/she has examined the approved plans of the structure/work herein referred to for which a Certificate of Occupancy/Compliance is sought,and that to the best of his/her knowledge and belief,the structure/work has been erected/completed in accordance with the approved plans and any amendments thereto except in so far as variations therefore have been legally authorized,and as erected/completed complies with the laws governing building construction.Deponent further understands that it shall be unlawful for an owner to use or permit the use of any building or premises or part thereof hereafter created,erected,changed,converted or enlarged,wholly or partly,in its use or structure until a Certificate of Occupancy or Certificate of Compliance shall have been duly issued by the Building Inspector as per§250-10.A.of the Code of the Village of Rye Brook. Swornto before me this oCV^ Sworn to before me this day 20.-Q,9 day of 20 ity Solar Systems Signature of Property bwner ignature of Ap cant Wagas Malik Jan Bergus-Infinity Solar Systems Print Name of Property Own Print Name of Ap icant Notary Public ILLONA AGAPOVA Notary Public NOTARY PUBLIC-STATE OF NEW YORK ILLONA AGAPOVA No.01 AG6277583 NOTARY PUBLIC-STATE OF `NSW YORK Qualified in New York County No.01 AG6277583 My Commission Expires 03-1 1-2026 Qualified in New York County My Commission Expires 03-11-2026 QyE BR(��. BUILDING DEPARTMENT ❑ UILDING INSPECTOR rJ ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 King Street . Rye Brook,NY 10573 (914) 939-0668 FAx (914) 939-5801 www ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS :— / UC.�C IC rJ� DATE: 12 /y- l OL..3 PERMIT# F) Z Z Li ISSUED: I SECT: 3S .3�- BLOCK: LOT: LOCATION: I� Qu 4 CS 1-)e%G. 1 OCCUPANCY: ❑ Violation Noted THE WORK IS... ff/pASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION r I - ❑ Natural Gas _ I - �-- �J O c..n 5 S ❑ L.P. Gas ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION (FINAL ❑ OTHER ■ r s a CV N N e hry rl ri r Q .Ti 944 'O 1+4 G4+ W ~ w O a W O 3 a A, v Y Xu � v 00 Q. To ■ � � Q O /\^`J 01 � � Cd a `a o w 2 6 8, co= Q �r � •� � C � U � v;� � J h i cs u z E ON i � � ,,,�//„� L� � � f�l � Q � `t o�G � � � � eta rL-.-1� ■ 0 v, Q /� ■ C7 Gti 05 9 � � 00 E ID z z w W z c t y d -d c x `n a o .� � S 0, 1-1 A d Q z o G a v e as b U A d u W z14 OO O p o o S Az � o o z F o Y d U b • BUILDI TMENT C E O /] ED VI LL E OF RY OOK l'I 938 KING S EET RYE BR ,NY 10573 i 14 9-0 , JAN — 3 2022 I wNV.AM&wro r VILLAGE OF RYE BROOK BUILDING DEPARTMENT FOR OFFICE USE ONLY: Approval Date:AN 2 0 2022 Ngernjitg C7d' /C//O Application# Approval Signature: ARCHITECTURAL REVIEW BOARD: Disapproved. = Date: JAN 1 9 2022 BOT Approval Date: Case# Chairman: Iri PB Approval Date: Case# Secretary: ZBA Approval Date: Case# Other: Application Fee:* 5` b Permit Fees: APPLICATION TO INSTALL PHOTOVOLTAIC SOLAR ARRAY Application dated: December 18,2021 is hereby made to the Building Inspector of the Village of Rye Brook.NY.for the issuance ofa Permit for the installation of a Photovoltaic Solar Array as per detailed statement described below. 1. Job Address: 70 Rock Ridge Drive Rye Brook,NY 10573 SBL: 135.36-i-t9.i Zone: 02 2 Type,kW&Location of Array,(use add ntonal sheets it'necessary): Rooftop solar installation of 32 solpar panels(13.6 kW) Panels are LEG model LG425QAK-A6 3.Property Owner: Wagas Malik Address:7o Rock Ridge Drive Rye Brook,NY 10573 Phone# 609-287-6900 Cell# e-mail wagas.malik87@gmail.com 4.Applicant: Infinity Solar Systems Address:575 Corporate Dr;Ste 2200 Mahwah,NJ 07430 Phone# 845-474-0068 Cell# e-mail inspections@infinitysolarsystems.com 5. Design Engineer: Mike Miele Address: 705 Orrs Mill Rd New Windsor,NY Phone# 845-534-2628 Cell# e-mail mikemielepe@gmall.com 6.Solar Contractor: Infinity Solar Systems Address: 575 Corporate Dr;Ste 2200 Mahwah,NJ 07430 Phone# 845-474-0068 Cell# e-mail inspections@infinitysolarsystems.com 7. Occupancy;(1-Fam.2-fam„Commercial..etc...)Pre-construction: i fam Post-construction: t fam 8. If building is located on a corner lot,which street does it front on: Rock Ridge Dr 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]; ( )Pre-engineered wood[PW];Located;()Floor Framing[F];()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 permit is required to re-roof an existing building) 13. Roofing Material&Number of Layers: 1 9/12/2021 ' 14. Will the proposed project disturb 400 s ft.or more of land,or create 400 s ft.or more of impervious coverage requiring a P P P J q• q• P g q g Stormwater Management Control Permit as per§217 of Village Code? No: n Yes: ❑ Area: 15. Will the proposed project require a Site Plan Review by the Village Planning Board as per§204 of Village Code? No: El Yes: ❑ (If yes,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: ❑ (Irves,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: N 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: S 45,000 (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). 14. Start Date: within 1 month of permit approval 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: 1, Achilles Tzoulafis ,being duly sworn,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,etc.) That all statements contained herein are true to the best of his/her knowledge and belief,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 Sworn to before me this day of ze-ce r+ .20 a,/ day of 20. ILLONA AGAPOVA ILLONA AGAPOVA 4<_70 No.TARY PUBLIC-STATE OF NEW YORK OTARY PUBLIC-STATE OF NEW YORE: G6277583 7563 Notary Public Notary Public Qualified in New York County Qualified i New York County mission Expires 03-1 t-2 12� M Co is Expires 03-11-2026 Sig atur of Property Owner Signature of Applicant 1nl f A�s MAL�� Print Name of Property Owner Print Name of Applicant 2 8/12/2021 N W N O W OG 0~0 ON u x �•y M '" 25 QG .. a �_ Q N cn O co O z a O c7� w o z c z z rA " rr O z z 't w A a s o W � 00 W z ►r VN 1� V A a O oZ w z < < P f, H H 00 0-4 z o � o a U N c� o V a d w F8 U 0 w z 0. x O z � w � z A o � t Q w Z W a o O .. J a � a 0.4 a z 5 w o � yEaRnv D EVE9 V E BULL E MENT FEB 14 2022 ID VIL E OF RYE K 938 Knv ET RYE B ,NY 10573 VILLAGE OF RYE BROOK (914)9 939-5801 BUILDING DEPARTMENT .or ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required d FOR OFFICE USE ONLY BP#: BP-22016 EP#: 3 —U Approval Date: FEB 1 5 022 Permit Fee: $ Approval Signature: Other: Disapproved: (fees are non-refundable) Application dated, February 1,2022 is hereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of a Permit to install and/or remove electrical equipment,wiring, fixtures,or to perform other high or low voltage electrical work as per the detailed statement described below. The applicant & property owner, by signing this document agree that all electrical work performed will be in conformance with all applicable Federal,State,County and Local Codes. l 1.Address: 70 Rock Ridge Dr Rye Brook,NY SBL: Z3J,r 3 SO r�-�9. / Zone: I0 2.Property Owner: Waqas Malik Address: 70 Rock Riidge Dr Rye Brook,NY Phone#: 609-287-6900 Cell#: email: wagas.malik87@gmail.com 3.Master Electrician: Jason Monforte Address: 88 Casper Ct Port Chester,NY 10573 Lic.#: 1911 Phone#: 914-819-3709 Cell#: email: Jason@aperfectgoldman.com Company Name: Infinity Solar Systems Address: 575 Corporate Dr; Ste 2200 Mahwah,NJ 07430 4.Proposed Electrical Work/Fixture Count: Rooftop installation of 32 solar panels(13.6 kW) Includes 32 solar panels,32 micro inverters,combiner panel,monitoring system,50 amp fuse AC disconnect Kx*xxxx��xxxxxx**xxxx***xxKxx*�xKxx**********�*xxFx,xxx,x,xx**xx,�x,xxxxxxxxxxxxx,x,xx,xxxx, x,xx,;**�xKx;,� STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: Jason Monforte being duly sworn,deposes and states that he/she is the applicant above named,and does further (print name of individual signing as the applicant) state that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the Contractor for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,attorney,etc.) The undersigned further states that all statements contained herein are true to the best of his/her knowledge and belief,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 M Sworn to before me this day of 20,12-- day of&kym,20� Sig6attife of Property Owner Si ature of Applicant In1� as 111K Print Name of Property Owner Print Name ofApplic t Notary ublicT�� Notary Pdlt ILL AGAPOVA ILL"APOVA NOTARY PUBLIC-STATE OF NEW YORK NOTARY PUBLIC-STATE QF NEW YORK. No.01AG6277583 No.01AG6277683 Qualified in New York County Qualified in New York C®Unty 1/19 My Commission Expires 03-1 1-2026 My Commission Expires 03.11.2076 STATEWIDE • Service Willi liil(%qri1.V 1080 Main Street,Fishkill, NY 12524 1 email:office@swisny.com SWIS JOB APPLICATION :4 1 914.219.1062 SWISNY.com • • Office Use Elect.Permit# � n� \ � O�� Date Bldg Permit# Utility ID# Final Certificate# City/Village Zip , Township �L County Address —, Q n Cross Street n Section Block Lot Owner Name/Address(if different than above) Contact Number ❑Basement ❑1st Fl. ❑2nd Fl. 3rd Fl. ❑More Than 3 Fl. Garage Attic Outside Residential Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms Carbon Monox Hood Trash Compact Amt Amps Range(s) Cocktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Warm Draw Incandescent Fluorescent SERVICE Amperage Voltage 1 P 3P #Meters #Disconnect Underground ew ❑Reconnect ❑Overhead ❑Change Visual Re-Inspection Safety Re-Inspection ❑ Re-Inspection Additional Information � 1 Q ` 1 ECEOW E B 14 M VILLAGE OF RYE BROOK BUILDING DEPARTMENT This application is valid for one(1)year from the date received by SWIS.This application Is intended to cover the above listed Itemms to be Inspected,If at arty time or imp•cbw additional items haw been installed,you are authorized to make the inspection and adjust the fee for the additional Items inspected.The applicant declares that there is no open applications a for the above address with ppl any other Inspection company.The applicant owner or authorized agent agrees to all the above terms and conditions as set forth for the application. Inspector Date Finalized Inspector# Company Name Date Signature Address City/State i Zip Code License# Phone# State Wide Inspection Services 1080 Main Street Fishkill, NY 12524 845 202-7224 Phone 914-219-1062 Fax STATE WIDE INSPECTION SERVICES Email: office@swisny.com Website: www.swisny.com Service With Integrity BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: Infinity Solar Systems Waqas Malik& Maria Khan Murphy Panagiotau 70 Rock Ridge Drive 575 Corporate Drive,Suite 2200 Rye Brook, NY 10573 Mahwah, NJ 07430 Located at: 70 Rock Ridge Drive, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP22-029 135.36 19.1 Certificate Number: 2022-0906 Building Permit Number: BP22-016 A visual inspection of the electrical system was conducted at the Residential occupancy described below.The electrical system consisting of electrical devices and wiring is located in/on the premises at: 70 Rock Ridge Drive, Rye Brook, NY 10573 The Photovoltaic System was inspected in accordance with the NYS and NFPA 70-2017 and the detail of the installation, as set forth below,was found to be in compliance on the 1st day of March 2022. Name Quantity Rating Circuit Type PV Modules 32 Micro Inverters 32 Combiner Panel 01 Monitor 01 Fused AC Disconnect 01 Officer: Frank J. Farina This certificate may not be altered in any way and is validated only by the presence of a seal at the location indicated.This certificate is valid for work performed on the date of inspection only. Michael E. Miele, PE Licensed Professional Engineer Licensed In New York, New Jersey, Connecticut& California NOV 15 2023 New York License#079676 New Jersey License#44042 VILLAGE OF RYE BROOK Connecticut License#23158 ` BUILDING DUTARTMEN T California License#31508 �"— November 7, 2023 Village of Rye Brook Building Department The Office of the Building Inspector 938 King Street FILE COPY Rye Brook, NY 10573 Re: POST INSTALLATION LETTER Waqas Malik- 70 Rock Ridge Drive, Rye Brook, NY 10573 Single Family Residence, Solar Panel Loading Certification Village of Rye Brook, County of Westchester,State of New York RE: Permit#BP 22-016 Dear Building Department, I have reviewed the solar energy system installation at 70 Rock Ridge Dr in Rye Brook. The system has been installed in accordance with the manufacturer's installation instructions and the approved construction drawing. I have determined that the installation meets all building code requirements and is certified as for all code and approved plans. I can herby certify that the installation complies with the applicable codes and design loads as referenced on the approved plans. If you have any questions, please feel free to call me at any time. Thanks, in advance. Sincerely Yours t O F NE41 ED Wq fo ,�� r � 0 V\ Michael E. 676 FESSIONP�" 705 Orrs Mills Rd., New Windsor NY 12553 ♦ Phone 845.629.9693 ♦ MieleEngineering@gmail.com Building Permit Check List&Zoning Analysis dress: SBL Zone k�-—l O Use: r 210 Const.Type: r. �y Othe Submittal Date: k L� lZ Z Revisions Submittal Dates: Applicant: y"AL,*- Nature of Work l 3 � fiZo OG-TQ� r4 ZAP eviews:ZBA: J A N - 4 7071 PB. BOT: Other. OK ( ( ) ES:Filing. 7S• �BP: �7S • � C/O: Legalization: ( ) ( P: Dated:s,-� Notarized: ✓SBL: pTruss I.D. Cross Connection: ✓ H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening. ( ) ( ) ENVIRO:Long. Short: Fees: N/A: ( ) ( ) SITE PLAN:Topo: Site Protection: S/W Mgmt.: Tree Plan: Other. ( ) ( ) SURVEY:Dated: Current: Archival: Sealed: Unacceptable: ( ) ( PLANS:Date/Stamped Sealed: `'Copies_2�Electronic ✓ Other. (� ( ) License: V Workers Comp: Liability- i/ Comp.Waiver. Other. ( ) ( ) CODE 753#: Dated: N/A: (Jf ( ) HIGH-VOLTAGE ELECTRICAL:Plans: Permit: N/A: Other. ( ) ( ) LOW-VOLTAGE ELECTRICAL:Plans: Permit: N/A: Other. ( ) ( ) FIRE ALARM/SMOKE DETECTORS:Plans: Permit H.W.I.C.:_Batter)r_Other. ( ) ( ) PLUMBING Plans: Permit: Nat.Gas: LP Gas: N/A/: Other. ( ) ( ) FIRE SUPPRESSION:Plans: Permit: N/A: Other. ( ) ( ) H.V.A.C.: Plans: Permit: N/A Other. ( ) ( ) FUEL TANK:Plans: Permit: Fuel Type: Other. ( ) ( ) 2020 NY State ECCC: N/A: Other. ( ) ( ) Final Survey Final Topo: RA/PE Sign offLetter. As-Built Plans: Other. ( ) ( ) BP DENIAL LETTER: C/O DENIAL LETTER: Other. ( ) ( ) Other. (�ARB in date: 4 s Z Z approval• notes: ( )ZBA mtg.date: approval: notes: ( )PB mtg.date: approval:- notes: REQUIRED EXISTING PROPOSED NOTES D Arc Date: JAN 2 0 2022 Cir FFro=Qe Front: Front: Sim: R0r. Main Cov Accs.Cov F HS : S .HS : Tot,Img F Im : P Height/Stories: notes: BUILDING DEPARTMENT D E C RE �WE D VILLAGE OF RYE BROOK R JAN - 3 2022 938 KING STREET RYE BROOK,NY 10573 (914) 9-0668 BUILDINE OF RYE BROOK G DEPARTMENT ��ww.ry rook.or>: ARCHITECTURAL REVIEW BOARD CHECK LIST FOR APPLICANTS This form must be completed and signed by the applicant of record and a copy shall be submitted to the Building Department prior to attending the ARB meeting. Applicants failing to submit a copy of this check list will be removed from the ARB agenda. Job Address: 7o Rock Ridge Dr Rye Brook, NY 10573 Date of Submission: Parcel ID#: 136.36-1-19.1 Zone: 02 Proposed Improvement(Describe in detail): Rooftop installation of 32 solar panels(13.6 kW) APPLICANT CHECK LIST: MUST BE COMPLETED BY THE APPLICANT The following items must be submitted to the Building Department by the applicant-no exceptions. Property Owner: Waqas Malik 1. ( )Completed Application 2. ( )Two(2)sets of sealed plans. (one full size (maximum Address: 7o Rock Ridge Dr Rye Brook, NY 10573 allowable plan size=36"x 42") and one I 1"x 17") Phone# 609-287-6900 3. ( )Two(2)copies of the property survey. 4. ( )Two(2)copies of the proposed site plan. Applicant appearing before the Board: 5. ( )One electronic/disc copy of the complete Infinity Solar Systems _ application materials. mGb, Lalko= , 6. ( ) Filing Fee. Address:575 Corporate Dr;Ste 2200 Mahwah,NJ 7430 7. ( )Any supporting documentation. Phone# 845-474-oo68 8. ( ) HOA approval letter. (ifapplicable) 9. ( ) Photographs. Architect/Engineer: Mike Miele 10.( ) Samples of finishes/color chart. (a sample board or Phone# 845-534-2628 model may be presented the night of the meeting) By signature below, the owner/applicant acknowledges that he/she has read the complete Building Permit Instructions&Procedures, and that their application is complete in all respects. The Board of Review reserves the right to refuse to hear any application not meeting the requirements contained herein. Sworn to before me this Sworn to before me this day of � �Piyr�N , 2QvZ� day of Z - , 2 Signature of Pro a er Signature of A17Vricant Prin a of Property Owner Print ame of Applicant 1 Notary Public Notary Pu c IL O AGAPOVA ILL GA VA NOTARY BLIC-STATE OF NEW YORK NOTARY PUBLIC-STATE OF NEW YORP No.01 AG6277583 No.01AG6277583 Qualified in New York County Qualified in New York County My Commission Expires 03-1 1-2026 My Commission Expires 03-11-2026 8/12/2021 VILLAGE OF RYE BROOK BUILDING DEPARTMENT 938 KING STREET, RYE BROOK,NY 10573 (T) 939-0668 (F) 939-5801 ARCHITECTURAL REVIEW BOARD Wednesday, January 19, 2022 ANNOUNCEMENT: PER THE GOVERNOR'S EXECUTIVE ORDER THIS MEETING WILL BE HELD VIRTUALLY THROUGH THE ZOOM PLATFORM. THE PUBLIC CAN ACCESS THE MEETING THROUGH THE FOLLOWING LINK: https://us02web.zoom.us/a/81417970741 OR BY OPENING ZOOM AND ENTERING THE MEETING ID: 81417970741 NAME&LOCATION TYPE OF APPLICATION MOTION SECOND APPROVED REJECTED APPL.# 1 Whippoorwill Rd 5 Ft High Black Aluminum Consent 5663 (Davis) Fence w/Arched Gate- Agenda Rear Yard. 19 Talcott Road Add Skylight To Roof Line Consent 5664 (Gamboa) in Conjunction With Agenda Bathroom Renovation 70 Rock Ridge Dr Roof Top Solar Array Consent 5665 (Malik) Agenda (� O 55 South Ridge St Roof Top Solar Array Consent 5666 (Rodriguez) Agenda 51 Hawthorne Ave Add Driveway Consent 5667 (Miller) (Exterior/Interior Agenda Alterations) 23 Berkley Lane 4 Ft High Black Chain Link Consent 5658 (Greenspan) Fence w/Gates. In Rear Agenda 545 Westchester Refurbish Exterior Steps, 5659 Ave(Castiglia) Railing,New Aluminum Awning,&Retaining Wall 12 Birch Lane Revision To Prior Approval 5668 (Shaw) (Outdoor Kitchen) 85 Valley Terrace New Egress Window,and 5669 (Krebs) Window Close Up to Facilitate Basement Renovations ML NM MR SE JM SF AC MI KC Michael E. Miele, PE Licensed Professional Engineer JAN 33 2022 Licensed In New York, New Jersey, Connecticut&California VILLAGE OF RYE BROOK #4404 New York License# BUILDING DEPARTMENT New Jersey License#44042 Connecticut License#23158 California License#31508 December 7, 2021 Village of Rye Brook Building Department The Office of the Building Inspector 938 King Street Rye Brook, NY 10573 Re: Wagas Malik-70 Rock Ridge Drive, Rye Brook, NY 10573 Single Family Residence,Solar Panel Loading Certification Village of Rye Brook, County of Westchester,State of New York Dear Building Department I am the engineer of record for the above referenced project. I have prepared the attached plans dated December 3, 2021 that consists of the installation of(32) LG425QAK-A6 solar panels at the above referenced location. I can herby certify that the existing roof structure combined with the additional weight of the solar panels meets the requirements of The 2020 Residential Code of New York State, Publication Date, November 2019. The design loads were as follows, Roof Design Load: 40psf live load Wind Design Load: 120mph No additional structural members were required. The roof is currently framed with 2x6 true dimensional wood framing @ 16" O.C. The roof structural members are in compliance with ASCE 7-16 for deflection and acceptable bending stress. If you have any questions, please feel free to call me at any time.Thanks in advance. Sincerely Yours, ---_�\ OF NEW 1 P, OF'w- y� Av- DW A'90 09� 5 ED W O * c? A (11 ALU * Z r— m 't 11 J, c� �I F Michael E. Miele, PE _ 0 A"O,-ESSIOV4 ' 079676 V� �O,p�FESSIONa�'� 705 Orrs Mills Rd., New Windsor NY 12553 ♦ Phone/Fax:845.534.2628 ♦ mmielepe@yahoo.com LG N ON'R Prime LG425QAK-A6 425W LG Solar's NeONm R Prime is a powerful solar module that provides premium performance.The NeONO R incorporates a cell structure without electrodes on the front to maximize light utilization and enhance reliability.Providing added value for the customer beyond efficiency,this module features an enhanced warranty,outstanding durability,solid performance in real-world conditions and aesthetic design suitable for roofs 25- C@US YEAR 1"t Features Roof Aesthetics 25-Year Limited Product Warranty LG NeON�R has been designed with aesthetics The NeCiNa R covered by a 25-year limited in mind the lack of any electrodes on the front product warranty.In addition,up to$450 of creates an improved,modern aesthetic labor costs will be covered in the rare case that a module needs to be repaired or replaced. Enhanced Performance Warranty ` More Generation Per Square Meter LG NeON-R has an enhanced performance - A_ The LG NeONO R has been designed to warranty After 25 years,LG NeCiNe R is significantly enhance its output,making it guaranteed at least 92.5%of initial performance efficient even in limited space. When you go solar, ask for the brand you can trust: LG Solar About LG Electronics USA,Inc. Eiecnoh c r-a gwba'Lea de,m electramc oroduct-.r:he clear ere•g,ma- t :`Ir ,c:alx.pl panes ana ene.g;:.craae=.:.e _"-e<om— :,emba�ec o-r ola^e �G rg,:ounce.eoear program,r'9Ei-uopo tad b,_G G U.s..a.:eeoe rer.e :m:e•r :one-;:, m,s= ,1 e :- .., e- -, c a II; eie—c rt:4rct Menccx';e•r tv the market A.& —avanabie m-., ,.rt The Ne7N'mew-Mane)"NeON, WON NeON':,. •, a ala• AIVAR, n',p13 201-nd201E e•h�ch oemo—rate:LG:leade hipandnnovat­,Ln the.ow,ncu:n• _ �;� LG NeON✓r RPrime LG425QAK-A6 General Data Electrical Properties(STC*) Cell Properties(MatenaVType) Monocrystalbne/N-type Model ---- -- —._ ---- -- - --- - - - LG425QAK.A6 Cell Maker - -- - _ _ LG Maximum Power(Pmax) (W] - —---425--- --_-- Cell Configuration 66 Cells(6 x 11) MPP Voltage(Vmpp)- --- IV] - -- - 41?- ---------- Module Dimensions(L x W xH) 91Omm x 1,042mm x 40m.- MPP Current(Impp) —_-- (A] - ---_- lr 31-- -- ---- INeght -- _ 20.5 kg Open Circuit Voltage(Voc,t 5%) --- (v]--- - - 481 - --- - Glass(Material) _ - - _ Temperea Glass with AR Coatlno _ Short Circuit Current(Isc,t 5%) (A) 1084 Backsheet(Color) Black Module Efficiency [%] ---- 21 4 --- Frame(Material) Anodized Aluminium Power Tolerance [%] 0 3 ----" -- Junction Box(Protection Degree) IF 68 with 3 Bypass Diodes 'STC(Standard Test Condition)Irmcluince 1000 Wrm'cell temperature 250C AM 1 5 -- --- - - Measure Tolerance t 3% Cables(Length) 1.250mm x 2EA Connector(Type/Maker) ---- _ MC 4/MC -- - -- --- Operating Conditions Operating Temperature [•C] -40-.85 Certifications and Warranty Maximum System Voltage IV] 1.00G --- - — ----- IECE1215-1/-1-1/2 2016,IEC61730-1/2 201E Maximum Series Fuse Rating [A] 20 -__ - UL 61730-1 2017,UL 61730-2 2017 _ Mechanical Test Load-(Front) [pa/pzf] - - --- 5.400 --- - Certifications ISO 9001.ISO 14001.ISO 50001 --- --- - - ----- ---_ _ Mechanical Test Load"(Rear) IPa/Psf1 4.000 OHSAS 18001 'The operating ambient temperature of these devices me)exceed 40•C a-full load for all wire sue•-if ig Salt Mist Corrosion Test _ _ __ IEC_61701 2012 Seventy 6 determined suitable in the field use application Ammonia Corrosion Test IEC 62716 2013 '•based on IEC 61215Q 2016(Test Load•Design Load x Safety Factor f1 5)) Hail Test 25mm(1")diameter at 23m/s(S 2mph j Module Fire Performance Type 2(UL 61730) Packaging Configuration Fire Rating _ Class C(UL 790.ULC/ORD C 1703 _ Number of Modules per Pallet [EAJ 25 Solar Module Product Warranty 25 year Limited Number of Modules per 40'Container [EA] 60C Solar Modue Output Warranty Unear Warranty Number of Modules per 53'Container [EA] 800 'momved 1 vea,9E SY,from 2-24th year-0 259e/year down S 2 5%fo,25 year-'TSD' Packaging Box Dimensions L x W x H 9n9 ( ) [min] 1.960x 1.120x1,227 Packaging Box Dimensions(L x W x H) [m] - - ----77 2 x 44 1 x 46 1 Temperature Characteristics Packaging Box Gross Weight [kg] 549 NMOT* - ( •C] 44 t 3 Packaging Box Gross Weight [Ib] - - 1,210_--- -- - Pmax I%/•c) -029 _voc ___ (%rc) -024 Dimensions(mm/inch) •NMOT(Nominal Module Operating Temperature)Irradiance 800 W/m Ambient temperature 209C Wind speed 1 in/:Spectrum AM 1 5 WC, 4 C[S e.t Slur Sde Electrical Properties(NMOT) r'6' Model---- - LG425QAK-A6 'Cc2c,394;�a bxnea.-et 4CC Maximum Power(Pmax) IW] ----._- - 322 --- --. MPP Voltage(Vmpp) [V] 39.0 (-1 I-) MPPC.Mit(Impp) [A] _ _ 626 rwnarrofbv: Open Circuit Voltage(Voc) IV] 459 +.e,,1;c•:; - --.--_ - M­q N.w Y> Sham Circuit Current(Isc) [A] ---- - -E 74 IN Curves Mow e0- — taav E t =anl. zorn. 1 Voltage lv1 ® LG Solar B.-seElectronics USA.Inc product AK-AE p Irons are subject to:hange without nonce LG Solar Busoroo Division LG4[SOAK AE pdf 2000 Mhire IL Drive 32122, Lmcomshve IL E0069 LIf2S Good wwwlo-solar coin I e 2C21 LG Elecromcs USA,Inc All nahts reserved o a NZW N a y aWt� z z z w 0 � � Y 2 W V7 U w r W O O .- Omn. Z S I m y z ♦ N N DO1O LL J ` % Qa O� N N W U r Q La I 2 z � ♦ a9: w F- V W Z V V V W z W < _ � W a J Z U U o = Q Q V II^�► ��y 0:W V z z V V 2 Z�Zo m N Ul Z ? o wJWS � w -� o m 3 ° O o 0 p Z Z = �ziW < ° u u �' O O J o'o�o w(n a a Y/ Q Q F J g m W z 0 7 N Zle� <W O r H S __ wo 03 a ui Cl) ^V) W ' ♦� <• '— �, o R a� psi LO o `O J v • cp m o Y o U C M rn uj U - - U U • o O (p Z C) _ Z u1 • 0) CO �3 C ` ZLLJ • i c0 ID • v z CD c o •U a O o - O w- • ■ 0) ` • U O d • T +N+ w N c Z O c U O xsc N 00) N Q t1 ri O a, v� w U n o p M w U M Z LLJ W T C o d ra N • n Z • • QX r� N CL E L) n O CDU N N X X rn LU a) t �� Cm Y m W Z DOuM _ U ` U Z CO F==; i o UN, an d a • a ac C O_� © Y Y C O Q F r j CO N a1 a) m Q) c .� � = V.:� � � m n Em to O I L a :° : - : cc o ` m m C cn cN E O L U y C C O7 N N p Y V `° o m N O C V L O _ o C c c ' cD ar O c O N M N O C • U m o -C c O m 3 ( O . w N " Up' G m a) = ° = U Z p Z U EnLU CD 3 E CT-o N W c: C C N > l D c Z U) Y M C) ! O Q E • CO cC .. . 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Solar Label Value Pack 9OFESStO14P Tne HellennaniiTyton Solar Labe''Value Pack contains an Features and Benefits assortment of the labels required for NEC 2017 code compliance Ali labels are made from LIV stable vinyl and dye-based inks and he most complete collection of required P'v labels in one package protected by a weather-resistant laminate A permanent adhesive saving you time with one-order simplicity adds to their lasting performance This label kit is a convenient, • ALL labels are NEC 20117 compliant,eliminating guesswort and the low-cost solution for helping to ensure your solar installation risk of a tailed inspection due to nonconforming labeling passes Inspection • Lonq•lasting,permanent adhesive ensures high-performance rFurlts on a variety of metals,paints and man-made materials Solar Label Value Pack Part No.. 596-03942 Contents Size: 1' x 6.5' • Qty:6 Size: i' x 6 5 Qty: VIT in• • • • • • . • , , - Size: 1'x 6 S oty: Size: 1 x 5 Qty:2 • NOT DISCONNECTPHOTOVOLTAIC UNDERLOAD SOURCE CIRCUIT Size:4' x 6 • City Size: Qty: SOLAR PV SYSTEM EQUIPPEDSOLAR PV SYSTEM EQUIPPED RAPIDWITH WITH RAPID SHUTDOWN TURN RAPID SHUTDOWN SWITCH TO THE"OFF' , TURN RAPID SHUTDOWN POSITION,TO ASWITCH TO THE , SHUTDOWN CONDUCTORS �_ "OFF"POSITION TO ^"'� OUTSIDE THE ARRAY. SHUT DOWN PV SYSTEM CONDUCTORS WITHIN I AND REDUCE ARRAY REMAIN �— SHOCK HAZARD ENERGIZED IN SUNLIGHT IN THE ARRAY L E_ Size: 1 75" x 5 5' • Qty: Size: 1 75' x 5 5" • Qty: 1 • • • MAIN PHOTOVOLTAIC EQUIPPED RAPID SHUTDOWNDISCONNECT Size: _ _ City: Size: : x Qty:? Size: 1" x.4' Qty:i rel felrfel DCJUNCTIONBOX DC COMBINERBOX Size: '" x 3 75' • City: Size: 1' x 4' • Qty: 1 Size: i' >4' Qty: 1 PHOTOVOLTAIC SYSTEM CAUTION:DO NOT INSTALL kWh METER ADDITIONAL LOADS HellertnannVon Identification Solar Identification Size:2' v 4 125 • City: Sizc Qty: Size: 1 ,4' • Qty ,.A WARNING ELECTRICAL SHOCK HAZARD THIS EQUIPMENT FED BY PV SOURCE CIRCUIT MULTIPLE SOURCES IF A GROUND FAULT IS INDICATED TOTAL RATING OF ALL OVERCURRENT NORMALLY GROUNDED CONDUCTORS DEVICES EXCLUDING MAIN POWER Size. 1 .l' City: ' SUPPLY SHALL NOT EXCEED MAY BE UNGROUNDED AND ENERGIZED AMPACRY OF BUSBAR A CA U T I O N Size:2' x 4 125' • Qty: 1 Size:2' .x 4' • City: INVERTER INPUT CIRCUIT Size: 75' x 4 125" Qty:3 ELECTRICAL SHOCK HAZARD DUAL POWER SUPPLY THE DC CONDUCTORS OF THIS SOURCES:UTILITY GRID PHOTOVOLTAIC SYSTEM ARE UNGROUNDED AND PV SOLAR AND MAY BE ENERGIZED ELECTRIC SYSTEM Size: ,. ' • Qty:_- Size:2` x 4' • Qty: 1 Size:: ? 73 • Qty- A CAUTION WKW_ ARNIN PHOTOVOLTAIC SYSTEM CIRCUIT IS B4CKFED ELECTRICAL SHOCK HAZARD THIS SERVICE METER TERMINALS ON THE LINE AND Size:3?5" x 5" • Qty: 1 IS ALSO SERVED BY A LOAD SIDES MAY BE ENERGIZED PHOTOVOLTAIC SYSTEM IN THE OPEN POSITION ,i�t:•, ' JCIFi Ct1n z Size: • Qty: Size. Qty .. CAUTION: SOLAR CIRCUIT Size: 1 75' x 75" • Qty:2 size Q1y MAX;MUMM VOLTAGE MAX MU CIRCUrTcuRR,N, — CAUTION: SOLAR ELECTRIC MAX RATED OUTPUT CURRENT OF SYSTEM CONNECTED THE CHARGE CONTROLLER (IF NSTALLED) HellermannTyton OF NEI,,y '0' "\-EDWggG 0,9 HellermannTyton North American HellermannTyton Canada C Corporate Headquarters -93;�N Taullne,Rd.P:5cr;45. Au'Wd.��rlar�`.. 4L 4- _n..... xl Cr MdNa.,.ee.W 53224-;5:- nrlune -800 66' 245' tL Phone l414 355.1'30.:800 53- 15:. gar 800 390 3904 rr max ,414�955--341 :80C F4c-955r emal sa es0"e!le n,ar-.,.;. _ Z�S emad CorpOhlamer Ca<_. �O'O 079676 nelierrr.an^too-;:n �. IATF 16949,ISO 9001,and ISO 14001 Certified 90FESSION� Warranty Policy Hene'mann ytor p,Jdum err.+era na7 i0 La f,"'Jm oefeas m ma:er&ano wo.1,man5o,p at the tiny sold bt., wf..ar•ersy ano mat of the se'le'':I.mRed to the,ePlacement of the ptoduC and noll'el:e nJ'the seise,ale DG,,J Cy any olhe,sa':dnty -pressed imp!,.eci. ...,stance'.a'e.':e Y the,elle' I.do'e fcr any iC,.damage.expenses or consequential damage!J'any Lnd a"s."our of the use o' nabLp t_use these prod" .s' ... :hi-Jewand:n^y mar the use•.v.I test them'n aCtua'se and oeterrrxne the,,addplabi le fo,'he,ntenoed use, O He1Iermanr T,,:on Corp:ragJr L IT=D345 37 2015 � l / •r.,rti -�f ion 0 ' r'�I ' Mff /����' •.�"/:;`►tom%/ ' .. s��r t r A if 1! 11,s f�,I i I � r �/ AO 1 + r j + Aq • b ' s f 8y • • pew:: Auk ® , r .•� it 1 M. {I, 1, '+' � ��'�. •`� lk �� a'�`� ,� ��t'; Via►, r ti• t�. fit•, al-�I 'S$ v _`.,�Y �� No Al i - t ci coext s; ; y. 1f�'+ aft, Zn 'R r �• x _� �,. t ..- - .fir•rti. •. ! ?. X- mo Sri {�. it gi:.r S• • JM I I I. - I I I i I � u, i .. C T -t�� ♦�,t - t ui 00 - 00 LU co - - r CN ,t• O t O V ` CD Ir •! 3. 1. ;�f� t 11 �• ;f .� "�'•" oo oO I y'r O i wS ••_ U r- N `' C`7 �a CN r (/�co O o` ► O "��ij�\� 04 c. 1. • 1/21/22,10:03 AM Infinity Solar Systems Mail-Building Permit Application-70 Rock Ridge Drive ,u infi nity Pamela Ziolkowski <Pamela.z@infinitysolarsystems.com> Building Permit Application - 70 Rock Ridge Drive 1 message Laura Petersen <LPetersen@ryebrook.org> Fri Jan 21- 2p22 a" To: "inspections@ infin itysolarsystems.com" <inspections@infinitysolarsystems.com>, MiGh '1 <mikemielepe@gmail.com> i Cc: "wagas.ma1ik87@gmai1.com"<wagas.malik87@gmail.com> JAN 2 5 2Q22 Good morning, VILLAGE OF RYE BROOK BUILDING DEPARTMENT The building permit application has been approved by the Building Inspector. Before I can issue the building permit the following items must be submitted to our office, 1. General contractor's contact name & phone number. 2. Copy of general contractor's valid Westchester County Home Improvement License. 3. General contractor's valid liability insurance (the Village Of Rye Brook must be the certificate holder) 4. General contractor's valid workers compensation on a NY State Board form (C 105-2 or U26.3) 5. Building permit fee $675.00 (due once permit is issued and ready for pick-up) 6.qNOWNINJEENAM Thank you Laura Laura Petersen Office Assistant Village of Rye Brook 938 King Street Rye Brook, New York 10573 Phone(914)939-0668 1 Fax(914)939-5801 1 Ietersen aaryebrook.org https://mail.google.com/mail/u/0/?ik=85a 1 a58bb6&view=pt&search=all&permthid=thread-f%3Al 722574896736911721&simpl=msg-f%3Al 722574896... 1/1 Laura Petersen From: Laura Petersen Sent: Friday,January 21, 2022 9:31 AM To: inspections@infinitysolarsystems.com; Michael Miele Cc: wagas.malik87@gmail.com Subject: Building Permit Application - 70 Rock Ridge Drive Good morning, The building permit application has been approved by the Building Inspector. Before I can issue thebuilding permit the following items must be submitted to our office, V/. General contractor's contact name & phone number. . Copy of general contractor's valid Westchester County Home Improvement License. ✓3. General contractor's valid liability insurance (the Village Of Rye Brook must be the certificate holder) 4. General contractor's valid workers compensation on a NY State Board form (C105-2 or U26.3) 5. Building permit fee $675.00 (due once permit is issued and ready for pick-up) -__r Thank you Laura Laura PetersenSO ) or Office Assistant �j Village of Rye Brook ( �-I n ' n n 938 King Street �Y a 1 Q+O Rye Brook, New York 10573 5 f• ' lNl G(� Phone(914)939-0668 1 Fax(914)939-5801 1 Ipetersenaryebrook.oro 1 I n- G�Q � t 1 D E E JAN 2 5 2022 �- -� InfinityEnerg VIL' OFRYEBROOK BUILDING DEPARTMENT Project Address: 70 Rock Ridge Drive Rye Brook, NY The contractor for this job is Infinity Solar Systems Contact # 845-474-0068 The check for payment is enclosed along with a return envelope for the permit to be mailed to the office. Regards, Pamela Ziolkowski Permit Coordinator 575 Corporate Drive; Suite 2200 1 Mahwah, NJ 07430 1 T: 845.200.3700 1 F: 845.920.8100 www.thenewutility.com Laura Petersen From: Pamela Ziolkowski <Pamela.z@infinitysolarsystems.com> Sent: Wednesday, November 8, 2023 12:41 PM To: Laura Petersen Cc: inspections@infinitysolarsystems.com;wagas.malik87@gmail.com Subject: Re: 70 Rock Ridge Drive - Final Solar Inspection The check will be mailed out today On Wed, Nov 8, 2023 at 11:47 AM Laura Petersen<LPetersen@ryebrook.org>wrote: Good afternoon, / Please advise as soon as possible of the status of the framin✓g letter and the $500.00 Administrative expired permit fee due for 70 Rock Ridge Drive. Once these ite are receivSd we can schedule the final inspection to close out the permit. J Thank you Laura _ Ct C/✓� 'S C) A2 Laura Petersen AJ 42-V D Office Assistant Village of Rye Brook (,,�� 938 King Street �Js 50,-) 'x r� Rye Brook, New York 10573 /y,��� / 'iz� Phone(914)939-0668 1 Ioetersen(a�rvebrook.org � T c� skool-Ao 4e co,?-t� 1 •�Aq y r. A 'PA�J"! A ry�y^('. A A r:` -`11A� �A y ..... K{A �. ns�A tt• ! dgt S....�.._ � �AF' +ti / � , '. 2 __ a1��S __W. �y1/1/1(11 �,--�(�''.toll(//11111 .`t111///1(11�.:. =r� �t;11//11111 .. ..,1i11/111 ..111 111 11111 _ :: �•• �)i� )� _ ii�l/li�.�?x: _.=`h!1�I1/ ,_ y1��J- _ INI�r: -' !I;IIJ,•••� _�!NJIJ tilllll / ' �+ fA N ~O CL { 04 • iceca '.w cn LU •F : � � Q � W o o.Gl U �i . �- 4-w �" O r� Q Q "ow U X z Lo U L iS• Lo dez. 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L afJ� 'I r+ ..WC..W��_ v A��8 DATE(MMIDDIYYYY) CC CERTIFICATE OF LIABILITY INSURANCE 01/21/2022 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(ies)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 CONTACT Sean Greening NAME: SB One Insurance Agency Inc PHONE (973)579-6776 (973)579-0111 A/C No, o Eat): A/C,No): 96 US Highway 206 E-MAI L sgreening@SBOnelnsurance.com ADDRESS: PO Box 4 INSURER(S)AFFORDING COVERAGE NAIL N Augusta NJ 07822 INSURER A: James River Insurance Company 12203 INSURED INSURER 8: Sel Ins CO Of the Southeast 39926 Infinity Solar Systems,LLC DBA Infinity Energy;GARC Construction INSURER C Corp INSURER D 575 Corporate Drive,Ste 2200 INSURER E Mahwah NJ 07430 INSURER F COVERAGES CERTIFICATE NUMBER: 2022-2023 Master#1 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. IN SR TYPE OF INSURANCE /POLICY EFF POLICY INSD WVD POLICY NUMBER MMIDD/VYYY MMIDDIYYYY LIMBS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ®OCCUR PREMISES Ea occurrence $ 50,000 MED EXP(Any one person) $ Excluded 00075197-6 01/01/2022 01/01/2023 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO PoPOLICY2,000,000 JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: Per Project Aggregate $ 5.000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED S2390880 01/01/2022 01/01/2023 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1.000,000 A EXCESS LtAB CLAIMS-MADE 00098464-3 01/01/2022 01/01/2023 AGGREGATE $ 1,000,000 DED I RETENTION$ 0 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-FA EMPLOYEE $ K yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Limit $250,000 Installation Floater B S2390880 01/01/2022 01I01/2023 Deductible $10,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) Certificate Holder is included as an Additional Insured to the above captioned General Liability and Business Auto Policies on a primary and noncontributory basis for work the insured is performing provided a written contract exists requiring such a status.Additional Insured also applies to the above captioned Umbrella Liability Policy.Additional Insured also applies to product completed operations with respect to the above General Liability policy.Per the terms of the policy,coverage for an additional insured is contingent upon an underlying written agreement with the named insured requiring such coverage.Waiver of subrogation applies to the above General Liability,Umbrella Liability,and Business Auto Policies. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Village of Rye Brook ACCORDANCE WITH THE POLICY PROVISIONS. 938 King Street AUTHORIZED REPRESENTATIVE Rye Brook NY 10573 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID:60E94427-2B37-4AA6-8BCD-6E3A5C8El65C -� NEW Workers' CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured 845-200-3700 INFINITY SOLAR SYSTEMS LLC 575 CORPORATE DRIVE;SUITE 2200 MAHWAH.NJ 07430-2330 1c.NYS Unemployment Insurance Employer Registration Number of Insured Work Location of Insured(Only required if coverage is specifically limited to certain locations in New York State, i.e., a Wrap-Up Policy) 1d.Federal Employer Identification Number of Insured or Social Security Number 27-1255670 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier Indemnity Insurance Co.of North America Village of Rye Brook 3b.Policy Number of Entity Listed in Box"1a" 938 King Street C70075817 Rye Brook NY 10573 3c.Policy effective period 10/01/2021 to 10/01/2022 3d.The Proprietor,Partners or Executive Officers are FXI 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"1a"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". The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.) Otherwise,this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent,or until the policy expiration date listed in box"3c",whichever is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder. 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: Lynne Boone n(,�Ap@Mof authorized representative or licensed agent of insurance carrier) 6.1 e. 8/18/2021 Approved by: B48A�721Ei96d8E3 (Signature) (Date) Title: Assistant Program Manager Telephone Number of authorized representative or licensed agent of insurance carrier: 214-721-6248 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 (9-17) www.wcb.ny.gov vm� OOocnoonn z=-c m��- - mpm-�-�T)Omoo OD000z N 1 �7:--0 mm nrZZZ �<CN=D �Dmr- >m-�-n ooze 7- m pZ=mN =OpOm�Omzy �aD=Z OmOcmDD orm l ZZ=r DrnQ T Zm_ mco ��cn DmcnD zmODy Cn -•r,� C"~ rn s, ► Z� loom �oZon�OzzZm 0n�<� p - rn f - ci�cmmm�mOZ ����m 2 �.' _ � z -i =Om -mom=camp �mc�n�� �_ R � �ti� x m T0 znmrpzn Dmrnc -� -T cn=m> co DOO 7mZrn� cn-<zmoom�mCnDrn rnZ�Z -# cnzm 0�O zXm Xy no 0'r rn p -gym _� zi 7 Z �mrn DZ Op Z r � cn Z � � m m= 00o CA)p C O mI71Z N� Dm c r 0 r c!' 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