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BUIL TMENT D E C E I V E
VI E OF RY OOK
938 KING E ET RYE BR ,NY 10573 DEC - l 2022 3D
r VILLAGE OF RYE BROOK
BUILDING DEPARTMENT
FOR OFFICE USE ONLY:Approval Date: DEC z 7 20 ere 'Pt# �� 00/f
Application# acc
Approval Signature: ARCHITECTURAL REVIEW BOARD:
Disapproved: Date: Z z
BOT Approval Date: Case# Chairman:
PB Approval Date: Case# Secretary:
ZBA Approval Date: Case#
Other: // ,1
Application Fee l Permit Fees: c0—`5'
APPLICATION TO INSTALL PHOTOVOLTAIC SOLAR. ARRAY
Application dated:/r-)`7 c'-)-<),- is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Pernit for the
installation of a Photovoltaic Solar Array as per detailed statement described below.
1. Job Address: 25 Windingwood Road North SBL:/c)9t (Y-) Zone:
2 Type,kW&Location of Array,(use additional sheets if necessary): roof mounted, 10.4kW
3.Property Owner: Carmela Fournier Address: 25 Windingwood Road North,Rye Brook NY 10573
Phone#(727) 804-4555 Cell# e-mail sfournier27@gmail.com
4.Applicant: Jason Sampogna Address:327 Captain Lewis Drive Southington, CT 06489
Phone#203-577-7651 Cell# e-mail gina.napomoceno@venturesolar.com
5. Design Engineer: Patrick Bussett Address:327 Captain Lewis Drive Southington, CT 06489
Phone#203-577-7651 Cell# e-mail gina.napomoceno@venturesolar.com
6.Solar Contractor: Venture Solar Address:327 Captain Lewis Drive Southington, CT 06489
Phone#203-577-7651 Cell# e-mail gina.napomoceno@venturesolar.com
7. Occupancy;(1-Fam.,2-Fam.,Commercial.,etc...)Pre-construction:1-Fam Post-construction:1-Fam
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 Framing[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 X Yes ❑ (a separate rooting permit is required to re-roof an existing building)
13. Roofing Material&Number of Layers:
I
8112/2021
14. Will the proposed project disturb 400 sq. ft.or more of land,or create 400 sal. ft.or more of impervious coverage requiring a
Stormwater Management Control Permit as per§217 of Village Code? No: X Yes: ❑ Area:
15, Will the proposed project require a Site Plan Review by the Village Planning Board as per§209 of Village Code?
No: ❑ Yes: ❑ (11%es.applicant must submit a Site Plan Application,&provide detailed dravti ings i
M Will the proposed project require a Tree Removal Permit as per§235 of Village Code?No: ❑ Yes:
(lfycs.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 1:—TIER IL—TIER Ill:_ (il N o. l lome occupation Permit,Application is required)
18, What is the total estimated cost of construction: $43,000.00
(Note:The estimated cost shall include all site improvements,labor,material.scaffolding.fixed equipment.protessional tees,including any material and
labor which may be donated gratis.If the final cost exceeds the estimated cost.an additional fee will he required prior to issuance of the C;O)-
19. Start Date: 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.
STA F NEW YORK,COUNTY OF WESTCHESTER ) as:
1, w m.Q(Z q\).C11�If C ,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,
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 beforethis Sworn to before me this q+1
1 20 day of .20_J
Olin kgd
ry ublic Notary a tic
Signature of Property Owhrf Signa a App t
Q�Cme(a_
\PSO(\ sarm9a1 nq
Print Name of Property Owner Print Name of Applicant
ANTHONY S TERRANERA Elizabeth .Johnson
Notary Public-state of New York
NO. 01TE6324959 - Notary Pubk.Slate of Comeacut
Qualified in Westchester County
My Commission Expires Jun Z 1. 2023 AMy CO111misS1on Expres 07,31=7
8/12/2021