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HomeMy WebLinkAboutBP23-029PERMIT #/U% SECTION TYPE OF WORK JOB LOCATION. EST. COI TCO ISPECTION RECORD DATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING O RGH PLUMBING GAS O SPRINKLER- ELECTRIC LOW -VOLT O ALARM 0 AS BUILT FINAL J 5 (�y 57a-oo�o -Olo9/%ri��ySalai J++� OTHER APP VALS ARB t� alch /S aoa3 BOT PB ZBA OTHER QR CCU.t 1913 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.otg TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE April 29,2024 Gerardo Piaco Eusebio&Libia Declet 493 Ellendale Avenue Rye Brook,New York 10573 Re: 493 Ellendale Avenue, Rye Brook,New York 10573 Parcel ID#: 141.28-1-9 Building Permit#23-029 issued on 3/20/2023 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 `3F r'PA use on For office I BUILDING DERTMENT PERMIT# 3 04 MAR 13 2024 VIL E OF RYE BROOK ISSUED 3--,)0— 3 38 KING STRE YE BROOK,NEw YORK 10573 DATE: 3—/3—a y VILLAGE OF RYE BROOK ��, 9 -06_0-8 FEE: ' PAIDAL 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 tiitiiitititttfiRtRiti Rf;iRtittittttttiitiR Rk kk Ri Rki i;RiiiRiiRtitiiiiiikF 4;ii;irtsif Ri4tii4iittiii RRf itkf ki;;;rtrtit kt tRk ik;krt;t Address: 493 Ellendale Avenue, Rye Brook, NY 10573 Occupancy/Use: R E S Parcel ID#:141.28-1-9 Zone: Owner: Patricia De Clet Address: 493 Ellendale Avenue, Rye Brook, NY 10573 P.E./R.A. or Contractor: Trinity Solar Address: 62 Leone Lane, Chester, NY 10918 %rA& Address: 62 Leone Lane, Chester, NY 10918 Person in responsible charge: Teresa Angelico 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: Trinity Solar - Laura Zakar being duly swom,deposes and says that he/she resides at 62 Leone Lane (Print Name of Applicant) (No and Street) in Chester ,in the County of range in the State of NY ,that (City/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:$ 34,000.00 for the construction or alteration of: Installation of a roof-mounted solar array tied into existing electrical services. 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 duty issued by the Building Inspector ��§250-1fe.A.of the e of theIVeW Village of RyOl�ryok. t99e,� Sworn to before me this Sworn to before me this day 20 day of 12011 e o operty Owner SigiKture of Applicant Patricia De Clet 17 Trinity Solar - Laura Zakar Print Name of Property Owner Print Na a of Applicant Notary Pu is Notary Pt DELORIS GIBES Notary Public-State of New York TERESA ANGELICO NO.01GIO015002 Qualified in Westchester County Notary Public-State of New York My Commission Expires Oct 26, 2027 No.OtAN6430527 Qualified in Orange County My Commission Expres 03114/201� �yE BRC��. • �9�2 BUILDING DEPARTMENT [I BUILDING INSPECTOR 0 1 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 : / z tL 2"'j r" A 11 F. DATE: 7 -Z Z OZJ G / J PERMIT# � .3 0°� / ISSUED: O—ZAECT:! /c//, 29 BLOCK: LOT: LOCATION: �� OCCUPANCY: ❑ Violation Noted THE WORK IS... LJ PASSED ❑ FAILED /REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION LL / ❑ Natural Gas Srn0 ❑ L.P. Gas ❑ FUEL TANK �� ❑ FIRE SPRINKLER (EE ❑ FINAL PLUMBING ❑ CROSS CONNECTION FINAL Er OTHER - �Gt O�` tim 1982 BUILDING DEPARTMENT ❑BUILDING INSPECTOR El"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: 1 `-7 C �J P AJ-0 A V`__ DATE: / - G 3 - Z y L PERMIT# 0 -f ISSUED: L20-Z-SECT: � �U BLOCK: � LOT: LOCATION: �")" , OCCUPANCY: ❑ Violation Noted THE WORK IS... ❑ PASSED FAILED / REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION /1 c ❑ Natural Gas T - S Lam, / . ❑ L.P. Gas 2C ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION 11 ❑ FINAL 1 N1 P 1.) 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V HB � ., .y V z w t '� o • �, M C7 A zCIN C� p 00 t �,� BUIL � a TMENT ((' E �V, F i VI E OF.RY OOK 938 KING EET RYE B NY 10573 JAN 11 2023 (914)9 S 39-5801 r VILLAGE OF RYE BROOK BUILDING DEPARTMENT FOR OFFICE USE ONLY: Approval Date:_ mit# a3-0 `0_ Application# AQ13 MAR 1 7 Approval Signature: - ARCHITECTURAL REVIEW BOARD: Disapproved: - Date: BOT Approval Date: Case# ; Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Case# Other: Application Fee:,J Permit Fees: `.5/o-bur APPLICATION TO INSTALL PHOTOVOLTAIC SOLAR ARRAY Application dated: Jan 10, 2023 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. t. Job Address:493 Ellendale Avenue, Rye Brook, NY 10573 SBL: 141.28-1-9 Zone: F_ 2 Type.kW&Location of Array,(use additional sheets if necessarn): 12.8 kW DC; roof-mounted Modules: 32 HANWHA 400(Q.PEAK DUO BLK ML-G10.a+400) 3.Property Owner: Patricia De Clet Address: q93 Ellendale Avenue, Rye Brook, NY 10573 Phone# (914) 830-1627 Cell# e-mail 4.Applicant: Trinity Solar- Robert Jacoby Address: 62 Leone Ln, Chester, NY 10918 Phone# (845) 572-0060 x1707 Cell# e-mail Robert.Jacoby@trinity-solar.com 5.Design Engineer: Trinity Solar- Ihor Bojcun Address: 2211 Allenwood Road, Wall, NJ 07719 Phone# (732)780-3779 Cell# e-mail ihor.bojcun@trinity-solar.com 6.Solar Contractor:Trinity Solar Address: 62 Leone Ln, Chester, NY 10918 Phone# (845) 572-0060 e-mail operations.upstateny@trinity-solar.com 7.Occupancy;(I-Fam.2-Fam,Commercial.etc )Pre-construction: 1-Fam Res Post-construction: 1-Fam Res 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 ITC];( )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..Bitched 12. Will a New Roof Be Installed: NF❑ Yes ❑ (a separate routing permit is required to re-roof an Q1.1sting hUddiir,) 13. Roofing Material&Number of LayetsAsphalt- 1 Layer I 3/21/19 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: a Yes: ❑ Area: 15. Will the proposed project require a Site Plan Review by the Village Planning Board as per§209 of Village Code? No: a Yes: ❑ (Ifves.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: e Yes: ❑ (Ifves,applicant must submit a Tree Removal Permit Application) 17. Does the proposed project involve a Home-Occupation as per§250-39 of Village Code? No: a Yes: ❑ Indicate:TIER I:—TIER 11:—TIER III:` (if yes,a Home Occupation Permit Application is required) 18. What is the total estimated cost of construction: $34,000.00 (Note:The estimated cost shall include all site improvements,labor,material,scaffolding,fixed equipment,professional fces,including any material and labor which may be donated gratis.Ifthe final cost exceeds the estimated cost,an additional fee will be required prior to issuance of the CIO). 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. STATE OF NEW YOM COUNTY OF WESTCHESTER ) as: r, Trinity Solar - Robert Jacoby ,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, Contractor/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 2 Sworn to before me this day of 120 Z day of .20 Z3 Notary b is 67y Public S to Signatur pplicant Patricia De Clet Trini y Solar _ Robert Jacoby Print Name of Property Owner Print Name ofApplicant Marie Casado Notary Public,State of New York rERESA ANGELICA Reg. No.01 CA6427091 otery Public-State of New York Qualified in Orange County 2 No.01AN&L30527 Commission Expires December 20,2025 Qualified in orange County .ty Commisslon Expires 03114l20-4(t— 3/21/19 fi;fi. C;t.t C;4:00 ; t.C; 40t; tlt+ fi. 4.4;t.wt;4;94aa996t�(11- fi;Catofi 4-; a' P i N N it ^ a ci � t Z .!:I �- � w C Z oAe �- C tvp it N N ►'� 0 Ln Ln Q a Z _g Q_ O rr Ln00 o J ►-, � z a A00 cn uz 0. zow �, Z = >< Olt ►� °° z z - 4o w ' CA w w H o z z `� Qar o O o 8 g � x °; CL y�.4-RvrF Im BUIL �E MENT VIL OF RYE K 938 KN 1 RB1 NY 10573 (914)9 939-5801 or ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY BP#: 3 EP#: Approval Date: Permit Fee: $ Approval Signature: Other: Disapproved: (fees.are non-refundable) Application dated, Dec 19, 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. 1.Address: 493 Ellendale Avenue, Rye Brook, NY 10573 SBL: 141.28-1-9 Zone: 9��F 2,Property Owner: Patricia De Clet Address: 493 Ellendale Avenue, Rye Brook, NY 10573 Phone#: (914) 830-1627 Cell#: email: 3.Master Electrician: William Geiger Address: 62 Leone Ln, Chester, NY 10918 Lic.#: 599 Phone#: (845) 572-0060 Cell#: email: bill.geiger@trinity-solar.com Company Name: Trinity Solar Address: 62 Leone Ln, Chester, NY 10918 4.Proposed Electrical Work/Fixture Count: Installation of a 12.8 kW roof-mounted solar array system tied into existing electrical services. Modules: 12.8 HANWHA 400 (Q.PEAK DUO BLK ML-G10 a+400) STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: Trinity Solar - William Geiger 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/Agent 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 Prev tion&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Swo t fore me this Sworn to efore me this /&`-- day o 20 ?.2-- day of 2Q 3 or e of rty O er tgnature f A plicant Patricia De Clet Trinity Solar- William Geiger Print Name of Pro Print ame of pplicant lic otary I Marie Casado TERESA AN ELICO Notary Public, State of New York Notary Public-State of New Yak Reg. No. 01CA6427091 No.01AN6430527 Qualified in Orange County Qualified in Orange County Commission Expires December 20,2025 My Commission Expires 03114M ge_ STATEWIDE • 0:0 Main Street,Fishkill, NY 12524 1 email. . • • : APPLICATION0. Office Use Elect. Permit# Date Bldg Permit# Utility ID# Final Certificate# City Villag Zip :� r, '�1 Township iy County i•`�, �?� Address Cross Street Section / v Block ! Lot 3FIrN - `� Owner Name/Address(If different than above) ,' ' �' 1 I_. . ; Contact Number Yp" _ y,J t ❑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) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Warm Draw Incandescent Fluorescent SERVICE Amperage Voltage 1 P 3P #Meters #Disconnect ❑Underground ❑New ❑Reconnect ❑Overhead ❑Change ❑Visual Re-Inspection ❑ Safety Re-Inspection ❑ Re-Inspection Additional Information 46 1 pi lfXi577)V 579«Oe-i5 E EME MAR 21 20 VILLAGE OF RYE BROOK BUILDING DEPARTMENT This application is valid for one(1)year from the date received by SMS.This application is intended to cover the above listed items to be inspected,If at any time of Inspection additlnal items have been installed,you am authorized to make the inspection and adjust the fee for the additional Items inspected.The applicant declares that there is no open applications for the above address with 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 -rF `'` w� �;l' 'i.9 (,r s!�_(( Date ,; Signature Address r' - :' City/State + ,'/ � /i ZipC(i�:: ; License# �"�> C' _ ` 4: Phone# DIE �WEE:' State Wide Inspection Services 1080 Main Street Fishkill, NY 12524 4 ®� MAY - 3 2C�23 845 Phone �/ 914-2194-219-1062 Fax STATE WIDE INSPECTION SERVICES VILLAGE OF RYE BROOK Email: office@swisny.com BUILDING DEPARTMENT 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: Trinity Solar Libia Declet&Gerardo Paico Eusebio Bill Geiger 493 Ellendale Avenue 62 Leone Lane Rye Brook, NY 10573 Chester, NY 10918 Located at: 493 Ellendale Avenue, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP 23-069 iai.zs Certificate Number: 2023-3075 Building Permit Number: BP 23-029 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: 493 Ellendale Avenue, 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 May 2023. Name Quantitv Rating Circuit Type PV Modules 32 Inverter 01 Disconnect 01 AC Disconnect 01 Production Meter 01 DC 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. nTr - n I F_ , s c LALjj R ai MAR 2 5 2Q24 i � i Rye Brook Village, NY -= =� March 19, 2024 938 King Street , VILLAGE OF k(E BROOK I Rye Brook, NY 10573 ; BUILDING DEP��R i 1�4FN1 ` Trinity Solar No. 493 Ellendale Avenue 2022-09-759996 Rye Brook, NY 10573 To the Building Official: I hereby certify that I am a Licensed Professional Engineer in the State of New York. The solar photo-voltaic (PV) system installed at the above-referenced location conforms to the manufacturers' requirements/specifications. The PV system complies with all applicable laws, codes and ordinances as specified by all applicable codes, including 2020 Residential Code of New York State and the 2018 IRC, and the provisions of ASCE7-16. Mounting system/PV attachments to roof is the EcoFasten. Regards, Ihor Bojcun, PE Structural Engineer-Trinity Solar 0 NEIV :L'1Cr s 1 ,F NY License No.095675 Trinity Solar 162 Leone Lane I Chester,NY 1(845)572-0060 • , Building Permit Check List&Zoning Analysis ( c q Address Zone: 1�-_1 Use: 2►V Const.Type: y Other. Submittal Date: k 1 2 Revisions Submittalttes: Applicant 064-f N (_. C, Nature of Work. 00R Reviews ZBA: � 3 p$• BOT• Other. NEED OK / Ur— ( ) ( ES:Filing. BP � �J� C/O: Flood Plane: Legalization: ( ) (�P: Dated Notarized SBL: Lrruss 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: 6/ Copies:�Electronic._�Other. ( ) ( License: ✓Workers Comp: Liability:--it-Comp.Waiver. Other. ( ) ( ) CODE 7S3#: Dated: N/A; 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.: Battery:_Other. ( ) ( ) PLUMBING Plans: Pen-nit: 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-off Letter. As-Built Plans: Other. ( ) ( ) BP DENIAL LETTER: C/O DENIAL LETTER: Other. ( ) ( ) Other. (JARB mtg.date: approval:- notes C� ( )ZBA mtg.date: approval• notes: ( )PB mtg.date: approval: notes: APPROVED - REQUIRED EXISTING PROPOSED NO TFS R 17 2023 Ate: Date: s Frontage Frg= Fmnt Main Cov Accs.Cov F S Sd.H/Sb: Tot : Ft.Im Pig: Hcight/Stories notes: BUILD MENT D 0 V l VIL�� E OF RY OOK JAN , ' 20 938 KING .ET RvE BR ,NY 10573 23 (914) 9 9 39-5801 VILLAGE OF RYE BROOK rg BUILDING DEPARTMENT 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. Ellendale Avenue, Rye Brook, Date of Submission: Dec 19, 2022 Parcel ID#:141.28-1-9 Zone: �'F Proposed Improvement(Describe in detail): APPLICANT CHECK LIST: Installation of a roof-mounted solar array M UST BE COMPLETED BY THE APPLICANT The following items must be submitted to the Building system tied into existing electrical services. Department by the applicant-no exceptions. 1. (0)Completed Application 2. (0)Two(2)sets of sealed plans. (otic rule si/e {maxi,mmn Property Owner: Patricia De Clet alloNN able Plan sire 36"x 42• and one I Fx l T") Address: 193 Ellendale Avenue, Rye Brook, NY 3. (0)Two(2)copies of the property survey. 914 81627 4. (0)Two(2)copies of the proposed site plan. Phone# ) 30- 5. (0)One electronic/disc copy of the complete Applicant appearing before the Board: application materials.6. (® Filing Fee. Trinity Solar 7. (®Any supporting documentation. 62 Leone Ln, Chester, NY 10918 8. (®HOA approval letter. (ifapplicable) Address: 9. (0)Photographs. Phone#(845) 572-0060 10.(0) Samples of finishes/color chart. (a sample board or Architect/Engineer: Trinity Solar - Ihor Bojeun model may be presented the night of the meetingd Phone#(732) 780-3779 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. Swo before me this 2q Sworn to before me this day of , 202 Z day of , 20 23 MA Sign re o roperty 104e, Signature o'lar icant Patricia De Clet Trinl - Robert Jacoby t Name of Property Owner Print NaIne of Applicant Marie Casado Nota blic Notary Public, State of New York — - Reg. No.01 CA6427091 Notary P is Qualified in orange County TERESA ANGELICO Commission Expires December 20,2025 Notary Public.State of Now York No.01AN6430627 Qualified in Orange County My Co nmission Expires 0311 2b DR(�v� Village of Rye Brook ML MR y Ag end FB SE Architectural Review Board Meeting AC SF Wednesday,March 15,2023 at 7:30 PM �����►j " �- �. Village Hall,938 Bing Street JM 1. ITEMS: 1.1. ARB23-008(Consent Agenda) Gerardo Paico Eusebio&Libia Declet 493 Ellendale Avenue Rooftop solar array. 1.2. ARB23-015 (Consent Agenda) Blake Silverman&Alexa Silverman 18 Milestone Road Rooftop solar array. 1.3. ARB23-016 (Consent Agenda) Jose Sagastizado&Noemi Sagastizado 28 Division Street Rooftop solar array 1.4. ARB23-017 (Consent Agenda) James Bogucki&Nicole Zillitto 300 South Ridge Street 3'high white vinyl fence and gates. 1.5. ARB23-018 (Consent Agenda) Greenway Close LLC 78 Greenway Close 4'high split rail fence w/black mesh. 1.6. ARB23-019 (Consent Agenda) Daniel Lyons&Michele Lyons 12 Country Ridge Circle 5'high white vinyl picket fence. 1.7. ARB23-020 (Consent Agenda) Scott Levy&Nicole Levy 42 Meadowlark Road 6'high white vinyl privacy fence and 4'high gates. Consent Agenda Approvals: Motion �L Second P/ ( Abstention Aye;L Nay; C3 Adjournment; Notes Page 1 of 3 Architectural Review Board March 15,2023 1.8. ARB23-013 David Richardson&Alexandra de Vaux Richardson 44 Rock Ridge Drive Rear patio,driveway,walkways and fence. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.9. ARB23-021 Win Ridge Realty L.LC (BondVet) 164 South Ridge Street Illuminated sign. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.10. ARB23-022 Jamie Billington&Kara Billington 6 Bonwit Road Front and rear two-story addition,covered front porch,deck and interior alterations. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.11. ARB23-023 Ervin Gomez&Maria Gomez 59 South Ridge Street 2nd story addition over existing two car garage. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes Page 2 of 3 Architectural Review Board March 15,2023 1.12. ARB23-024 Patrick Carroll 8 Oriole Place Rear deck,entry stoop repair,new railings, front door,windows above front door and siding. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes NEXT MEETING: April 19,2023 Page 3 of 3 URnv� Village of Rye Brook ML NIR X Agend FB SE , Architectural Review Board Meeting AC SF Wednesday,February 15,2023 at 7:30 PM JM ,h�� Village Hall,938 Bing Street 1. ITEMS: 1.1. ARB23-007 (Consent Agenda) Joseph Laronga&Susan Eylward 126 North Ridge Street Rooftop solar array. 1.2. ARB23-008 (Consent Agenda) Gerardo Paico Eusebio&Libia Declet 493 Ellendale Avenue Rooftop solar array. Consent Agenda Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.3. ARB23-009 (Amendment to Prior Approval) Mark Posner&Lauren Posner 32 Bonwit Road Changes to house and garage depths,modify a window and door. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.4. ARB23-010 DRJ West LLC 32 Lincoln Avenue Expand existing parking court. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes Page 1 of 2 Architectural Review Board February 15,2023 1.5. ARB23-011 Stuart Gelbard&Adrian Gelbard 51 Winding Wood Road Rear one-story addition and new deck. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.6. ARB23-012 Lal Jhangimal&Prisha Parvani 4 Bobbie Lane 2nd story addition and new front portico. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.7. ARB23-013 David Richardson&Alexandra de Vaux Richardson 44 Rock Ridge Drive Rear patio,driveway,walkways and fence. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.8. ARB23-014(Amendment to Prior Approval) 2 Elm Hill LLC 2 Elm Hill Drive-Lot#3 Exterior staircase to basement with guardrail and handrail;additional windows and doors. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes NEXT MEETING: March 15,2023 Pagc 2 of 2 NY Putnam County Home Improvement Contractor#PC6987 NY Putnam County Electrical License#R23713 NY Westchester County Home Improvement Contractor#WC-27944-H15 s NY Westchester County Electrical License#599 NY Rockland CountyHome Improvement Contractor#H-12313-40 SOLAR NY Rockland County Electrical License#402 NY Orange County Electrical License#198 NY Sullivan County Electrical License#442 NY Greene County Electrical License#502 NY,jurisdictions,license or registration information furnished upon request.For other jurisdictions,please visit: http://www.trinity-solar.com/about-us/locations-and-licenses Village of Rye Brook Building Department 938 King Street Rye Brook, NY 10573 D M T: (914)939-0668 V Jan 10, 2023 FiAN 11 2023 To Whom It May Concern, VILLAGE OF RYE BROOK BUILDING DEPARTMENT On behalf of our customer named below,we wish to submit a Building Permit Application for the installation of a roof-mounted solar array system tied into existing electrical services: Name: Patricia De Clet Address: 193 Ellendale Avenue, Rye Brook, NY 10573 5BL: 141.28-1-9 Please find the attached documents for review: ■ Architectural Review Board Application ■ Building Permit Application ■ Homeowner's Consent Affidavit ■ WC HIC License ■ WC Electrical License ■ Insurances(Disability, Liability, Workers'Compensation) ■ (2)Stamped Plans, Engineer Letter and Spec Sheets ■ (2) Photos of Property and Surrounding Properties ■ (1) Electronic Submission- Flash Drive ■ Application Fee Check-$75.00 Please do not hesitate to contact me with any questions. Thank yoVy Robert Ja Applications Specialist I Trinity Solar—Hudson Valley (845)572-0060 x1707 I Robert.JacobyC@trinity-soiar.com Hudson Valley Office 1-877-SUN-SAVES 62 Leone Lane Ph:845-572-0060 Chester,New York 10918 Fax:845-576-0068 www.trinity-solar.com Laura Petersen From: Robert Jacoby <Robert.Jacoby@trinity-solar.com> Sent: Thursday, January 12, 2023 4:16 PM To: Laura Petersen Subject: Re: Solar Permit Application - Ellendale Avenue, Rye Brook New York Hi Laura, My apologies for the late response. The address should be 493 Ellendale Avenue. If you like I can correct the address on the application and either email it or send it via FedEx. Please let me know how you would like to proceed. Thanks, Robert �����,,►� + Robert Jacoby Application Specialist 11 J11-111y T. (845)572-0060 ext. 1707 Hudson Valley Office:62 Leone Lone,Chester,NY 10918 SOLAR www.Thnity-5olar.com NY,jurisdictions,license or registration information furnished upon request For full license information,please visit:httos�//www trinity-sg,gr gom/lo t r / If you are not the intended recipient of this confidential email,please inform the sender. From: Laura Petersen <LPetersen@ryebrook.org> Sent: Wednesday,January 11, 2023 1:49 PM To: Robert Jacoby<Robert.Jacoby@trinity-solar.com> Subject: Solar Permit Application - Ellendale Avenue, Rye Brook New York Good afternoon, The Building Department has received in the mail a solar application, a check for $75.00 and plans for 193 Ellendale Avenue. Please verify this address as 193 Ellendale Avenue is not a valid address in Rye Brook New York. Thank you Laura Laura Petersen Office Assistant Village of Rye Brook 938 King Street Rye Brook, New York 10573 Phone (914) 939-0668 l petersen(a-)rvebrook org 1 pf L•: A a . z i� 1 r;4/Y�i, -�1 1� i��Odl� Ar1' r. }�,►t r4/1. �1 / F`�/a 1�r +/11,u1f r 1111 tli t4 ��C, 1�.({ i(f(o)> 7 N11j � y�rh>.N�I1 tY,�t vsy.,1H11"+"rti .v�41/.b!ry,; �►11r,� �- ,�,011 i _ '•. . -�_� e 3�Y,,N/r1 zs. cy i, 1NS�:xts{ ( O o a C <(0)1►1 > 4. N p C. O K at. aLi 'O U W ' . = E C a 4. u `: W ca cv O CO C i/ cS 10 yl U w // � O C c, � *"' z � � rn o .� af on JO U J o 0 ZA E O Zch � C Gu cn >- .� z J 0 g w `0 - Y c 04 � Y O �e ap i ►, {..+ mom N > 4 h , O cz <(o)> c�.. : u 0 fj T- J� , co) U y 04 0U ra CL . . -- f(o)►r D '° ---"*i P ATE ACOR" CERTIFICATE OF LIABILITY INSURANCE (MMIDD/YYYY) `i 5/13/2022 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 NAME: Marl(GraSela Arthur J. Gallagher Risk Management Services, Inc. PHONE Fax 4000 Midlantic Drive Suite 200 ac No :856-482-9900 ac No:856 482-1888 Mount Laurel NJ 08054 ADDRESS: Che HiII.BSD.CertM AJG.com NSURER S AFFORDING COVERAGE NAIC S INSURER A:Gotham Insurance Company 25569 INSURED TRINHEA-03 INSURER B:National Union Fire Insurance Company of Pittsburg19445 Trinity Solar Inc.62 Leone Lane INSURERC:Endurance American Specialty Ins Co 41718 Chester NY 10918 INSURER0:Liberty International Underwriters INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER:231041841 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 IL R TYPE OF INSURANCE AUDL POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY GL202100013378 6/1/2021 6/1/2023 EACH OCCURRENCE $2,000,000 CLAIMS-MADE FxI OCCUR DAMA E To RENTED PREMISES Ea occurrence $100,000 MED EXP(Any one person) $5,000 PERSONAL 8 ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY X JPERO- LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER $ e AUTOMOBILE LIABIUTY CA2960145 6/1/2022 6/1/2023 COMBINED SINGLE LIMIT $2,000,000 Ea acolds") X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE S AUTOS ONLY AUTOS ONLY Per accident E $ A UMBRELLA LIAB X OCCUR EX202100001871 6/1/2021 6/1/2023 EACH OCCURRENCE $5,000,000 o X Excess LIAB ELD30006989101 6/1/2022 6/1/2023 CLAIMS-MADE 1000231834-06 6/1/2022 6/1/2023 AGGREGATE $5,000,000 DED RETENTION$ Limn x of S5,000,000 $19,000,000 B WORKERS COMPENSATION WC13588108 6/1/2022 6/1/2023 X I PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTNE ElNIA E.L.EACH ACCIDENT $1,000,000 OFFICER/M EMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 1,000,000 If yes.describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$1,000,000 B Automobile CA2960145 6/1/2022 6/1/2023 All Other Units $250/500 Comp/Collusion Ded. Truck-Tractors and Semi-Trailers $250/500 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101.Additional Remarks Schedule,may be attached if more space is required) Evidence of Insurance CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Village of Rye Brook 938 King St AUTHORIZED REPRESENTATIVE C� 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 NEW KR Workers' CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured Trinity Solar Inc. 631-319-7233 62 Leone Lane Chester,NY 10918 1c.NYS Unemployment Insurance Employer Registration Number of C Insured 49-230977 Work Location of Insured(Only required if coverage is specifically limited to 1d.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-Up Policy) Number 22-3292324 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) National Union Fire Insurance Company Village of Rye Brook 3b. Policy Number of Entity Listed in Box 1 a" 938 King Street Rye Brook,NY 10573 WC 013588108 3c.Policy effective period 6/1/2022 to 6/1/2023 3d.The Proprietor,Partners or Executive Officers are ❑ 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 1 a"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: Michael Price (Print name of authorized representative or licensed agent of insurance carrier) Approved by: A2uZ 6/1/2022 (Signature) (Date) Title: C.E.O.North America Telephone Number of authorized representative or licensed agent of insurance carrier: 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.web.ny.gov