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BUIL TMENT ® �,/ Hr-
VI E OV R' _. OOK
938 KING :v,3r Rvc Big ,NY 10573 APR 2 7 2023
-01
rg VILLAGE OF RYE BROOK
BUILDING DEPARTMENT
FOR OFFICE USE ONLY:
Approval Date: MAY ermit# 3" -73 Application#
Approval Signature: ARCHITECTURAL REVIEW BOARD:
Disapproved: Date: /7
BOT Approval Date: Case# Chairman:
PB Approval Date: Case# Secretary:
ZBA Approval Date: Case# _
Other: --7
Application Fee:' / Permit Fees.
APPLICATION TO INSTALL PHOTOVOLTAIC SOLAR ARRAY
Application dated:7" ��/ is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the
installation of a Photovoltaic Solar Array as per detailed statement described below.
1. Job Address: 309 Betsy Brown Road SgL;�35� 7 Zone:
2 Type,kW&Location of Array,(use additional sheets if necessary): Roof Mounted, 10 kW, front and back roof of home
3.Property Owner: Thomas Bailey Address: 309 Betsy Brown Road, Rye Brook NY 10573
Phone#(845) 270-3439 Cell# e-mail thethomasbailey@gmail.com
4.Applicant: Venture Solar Address:327 Captain Lewis Drive Southington, CT 06489
Phone#203-577-7651 Cell# e-mail 9ina.napomoceno@venturesolar.com
5. Design Engineer: Patrick Bussett Address: 327 Captain Lewis Drive Southington, CT 06489
Phone#860-919-3093 Cell# e-mail patrick.bussett@venturesolar.com
6.Solar Contractor: Venture Solar Address: 327 Captain Lewis Drive Southington, CT 06489
Phone#203-577-7651 Cell# e-mail 9ina.napomoceno@venturesolar.com -�
7. Occupancy;(1-Fam.,2-Fain.,Commercial.,etc...)Pre-construction:1-Fa m Post-construction: 1-Fam
8. If building is located on a comer lot,which street does it front on:
9. NX, State Construction Classification: N.Y. State Use Classification:
10. Construction Type&Location:O Typical Western Lumber Frame;O Timber Frame[TC];()Wood Truss[TT];
O Pre-engineered wood[PW];Located;O 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 V1 Yes ❑ (a separate roofing permit is required to re-roof an existing building)
13. Roofing Material&Number of Layers:
l
8/12/2021
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: V Yes: ❑ Area:
15. Will the proposed project require a Site Plan Review by the Village Planning Board as per§209 of Village Code?
No: ICJ Yes: ❑ (Ifyes,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: V Yes: ❑
(If yes,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: ld Yes: ❑
Indicate:TIER I:—TIER II:—TIER Ill:_ (ifyes.a Home Occupation Permit Application is required)
18. What is the total estimated cost of construction: $56,000
(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 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.
Cpnn�t to Xxl'f?txR��
STATE OF OUNTY OF ) as:
I, ow �0` being duly sworn,deposes and states that he/she is the applicant above named,
(print name of individual signing as the appli t)
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 before me this Sworn to before me this )
day of 20 a 3 day of Xor, 1 209_
otary P N ry P lic
Signature of Property Owner MSuAwKe of Applicant
komq`5 CnInG wolpolrrnocepiO
Print Name of Property Owner Print Name of Applicant
*INotary
Nicole DowDEAN A RADICE SR Pub1N�WtLConrfc6cut
Notary Public E
Connecticut31,My Commission Expires Nov 30, 2027 My Commission F)pac.,
811 212 02 1