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HomeMy WebLinkAboutBP23-209/EST. COST V CO #.c: PERMIT# /'OQ)3- QOL A •/a /9 a3wvmqmQl SECTION < ALOC LOT � TYPE OF WORK S / 00/J Q� JOB LOCATION :� Q I?kly /7 OWNER eSL(S 70/q? 2Z _ 24' %Z CONTRACTOR /�i*fW V�S Qd'� c C ill s> ,-}-��� — Jd gf/, 000 - FEE 4 / � / 4 FEE z �9/y�3�lo-1n�33 7� �d `i 34z:) -P,6 56:7z5 TCO # FEE DATE . INSPECTION RECORD I DATE I NSP FOOTI N G FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING 0 RGH PLUMBING GAS C� SPRINKLER ELECTRIC C!cN u LOW -VOLT 0 ALARM L� AS BUILT 0 --p z.j 5e FINAL T 2oz Tt+yc OTHER APPROVALS ARB II/O✓eAe &� / Qo, BOT PB ZBA OTHER BR, ,y A 19 J �� VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914)939-0668 Christopher J. Bradbury www.ryebrookny.g_ov TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Steven E. Fews David M. Heiser Donald T. Krom,Jr. Salvatore W. Morlino CERTIFICATE OF COMPLIANCE April 10,2025 Jesus Gonzalez&Beatriz Gonzalez 505 Franklin Street Rye Brook,New York 10573 Re: 505 Franklin Street, Rye Brook,New York 10573 Parcel ID#: 135.43-1-43 Building Permit#23-209 issued on 12/19/2023 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 For officeonly: D UI # & (,rJ v j BLD �` - TMENT PERMIT 0,43 VILI E OF RYE OK ISSUED:/,�-i 9-33 FEB 13 2025 ]D �8 KING STRE 1 YF BROOK, YORK 10573 DATE: D -06 Oc FEE: 4 r;) PAID W VILLAGE OF RYE BROOK 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 ssts►stss+rsrs+rr+ss+ssssssssswswsrwr+rtrrtsssrsswsrr+ssr+►+tt++sssrswsrrt+r+tsssss►swsrwssswrs+ssasssrt+rt+ss►tssssssrsswrwr Address: 505 Franklin Street, Rye Brook, NY 10573 Occupancy/Use: single Fam Residential parcel ID#:141 .27-1-46 Zone: Owner: Beatriz Gonzalez Address: 505 Franklin Street, Rye Brook, NY 10573 P.E./R.A. or Contractor: Trinity Solar Address: 62 Leone Lane, Chester, NY 10918 Person in responsible charge: Tara McDevitt Address: 62 Leone Lane, Chester, NY 10918 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 - Tara McDevitt being duly swom,deposes and says that he/she resides at 62 Leone Lane (Print Name of Applicant) (No.and Street) in Chester Orange in the County of g 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:$ 81,000•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 duly issued by the Building Inspector as per§250-10.A. of the Code of the Village of Rye Brook. Sworn to before me this 3 ! Sworn to before me this day of �aTljj , 20 6,-*�--' day of , 20 2—,C� Signature of Koperty Owner 0 Signature of Applicant N w� W O Beatriz Gonzalez oN Trinity Solar - Tara McDevitt Print Name of Property Ow in W Print Name of Applicant o a Z� N Notary Public otary Public TERESA ANGELICO Notary public.State of New York R/12/20'_1 No.01AN643o527 Qualified in orange County eorrxrtission Expires 03/14120 2 �E BRC�k, 1982 BUILDING DEPARTMENT VILDING INSPECTOR SISTANT 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 O.5 r- a 1,21 rJ K I- DATE: 7 - 2- Zoo s- PERMIT# Tel Z 5' Z al ISSUED: I Z��SECT: ) 1 1• 27 BLOCK: , LOT: LOCATION: Qom'N OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... R/ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS f ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER h E BRC��. cu � • �9a2 BUILDING DEPARTMENT ❑BUILDING INSPECTOR ❑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.orl; - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : 0 5 2 A iv k i ==� DATE: Z - Z U 2 j 2-1 PERMIT# \ +; 2 j ISSUED: I 2-'i5—Z-5 SECT: // , Z 7 BLOCK: LOT: '7� LOCATION: 11 / ` T C � r OCCUPANCY: � w ❑ 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 I ❑ Natural Gas -�F C IC ❑ L.P. Gas 1^ / ❑ FUEL TANK ❑ FIRE SPRINKLER F q' (( V - ,fy ��(/✓L C+ �jCQ ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL A i9 f 0 ❑ OTHER N o N _ ILI x •=� (4f) V w x oA ° o ° w.°. oz v w v a v . Qas4c v .004 ,� N w e u o - L; aco O N Q ° w V O r� w A U ''n � U z � v c,, o cJ� F-� © N 't N W rZ 01% , W i b v z cn I a. o p � Ln o . N G� ,150 act o WA � o Ln poi o 4. Q4� °. o '' W � W W •� �a � a.� aa,°' w BUIL TMENT VI f E OF RY OOK � 938 KING EET RYE BR NY 10573 SE� � � 2023 ' (914)9 8 x 39-5801 VILLAGE OF RYE BROOK BUILDING DEPARTMENT FOR OFFICE USE ON LY: NOV 1 6 r) I J Approval Date: ermit# C� J�+� / Application# Approval Signature: ARCHITECTURAL REVIEW BOARD: NIL Disapproved: : Date: BOT Approval Date: Case# : Chairman: PS Approval Date: Case# Secretary, ZBA Approval Date: Case# Other: ' ue Application Fe �PI] Permit Fees: �t APPLICATION TO INSTALL PHOTOVOLTAIC SOLAR ARRAY Application dated: Aug 28, 2023 is hereby made to the Building Inspector orthe Village of Rye Brook,NY,for the issuance of a Permit for the installation of a Photovoltaic Solar Array as)per detailed statement described hetou q�r p L Job Address: 50�5 Ff Ahk!;nSf it �'S-�tla]t N 4105 73 SBL: 1q1 f-f 14 Zone:/C� 2 Type,kW&Location of Array,(uu:additional;hects i(luwes an): 14.175 kW DC; roof-mounted Modules: 35 HANWHA 405(Q.PEAK DUO BLK ML-G10+405) 3.Property Owner:,je4kA5 Clan-00 eZ. 4 7t l- nzCLI Phone# (914) 918-2590 Cell# e-mail 4.Applicant: Trinity Solar-Melvin Banks Address: 62 Leone Ln, Chester, NY 10918 Phone# (845) 572-0060 x1715 Cell# e-mail Applications.LHV@trinity-sol a r com 5.Design Engineer: Trinity Solar- lhor 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;(1-Fain,2-1--arn.Commercial,etc )Pre-construction: Duplex(2 unitslaost-construction: Duplex(2 units, an) 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 IF];( )Roof Framing[RI.( )Floor&Roof Framing[FRI,Other: 11. Number of stories: Roof Style:(hip.shed.mansard.etc.Pitched 12. Will a New Roof Be Installed: NIF❑ Yes ❑ (a separate roofing permit is required it)re-root'an emspng building) 13. Roofing Material&Number of LayersAsphalt- 1 Layer 1 3/21/19 14. Will the proposed project disturb 400 sq.&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: 11 Yes: ❑ Area: 15. Will the proposed project require a Site Plan Review by the Village Planning Board as per§209 of Village Code? No: e Yes: ❑ (If ycs,applicant must submit a Site Plan Application,&provide detailed drawings) 16. Will the proposed project require a Tree Removal Permit as per§235 of Village Code?No: R 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: a Yes: ❑ Indicate:TIER 1: TIER II:TIER III: (if yes,a Home Occupation Permit Application is required) 18. What is the total estimated cost of construction:S 5 7 O o O (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 estimtated cost,an additional fee will be required prior to issuance of the C/O). 19. Start Date: Completion Date: •,►***,r,r,a**f*re*,rf,r****.*.***r*****,t*,t*rt,�,t*f.r,t,t,►+r**,r*.,t***.,r**�*,r,w*.rrw�rw�w***ar,r****+t#********,r*,r,r,r**>F*�r,sr* 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. *rw*«****,rr*r.w**w***,r**�r***r***#**r*r**************��***«***«r*r***.*r�*,r*.��*.***.*+r**�.*****«.***f**,►+r*,e STATE OF NEW YOM COUNTY OF WESTCHESTER ) as: 1, Trinity Solar - Melvin Banks ,being duly swom,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 Sworn to efore me this day of i�yav S T ,2.0 2r day of ,20, ublic ary Public P Signature o operty Owner Signature oPlkpplicant Beatriz Gonzalez Trinity Solar- Melvin Banks Print Name of Property Owner Print Name of Applicant TERESA ANGELICO PEREZ DOUGLAS P Fleury Public•Stab of New vortt NOTARY PUBLIC,STATE OF NEW YORK 2 No.OIANG430527 Registration No.01 PE6445748 Quati4ied M 0wQe minty Qualified in Westchester(;ounly My Gernnission Expires 03114/26 U My Commission Ex irus 0 Oil 4 Luo 3/21/19 . a _ _ f a s a + i V i N of _ I C C a N N N f \ O s W N W. v W = a N F. A w x 0-' , x CA ' w N z B f = W x ar s Lin Z C 00, ` o Q c U N c� r rq CA a A � � o j � z \ � W� C) Z N 00 z , UON r- ° rh ACN W cx Cr � A 00 En Q� h V En W E W z o $ w U ° U U ✓" U v ' V oo � O Z a W C LLB a Ln q a W a, zn a 4-4 m w xC , _ E BUILDING DEPARTMENT D 3D VILLAGE OF RYE BROOK F B - 2 2024 938 KING STREET RYE BROOK,NY 10573 1 (914)939-0668 FAX(914)939-5801 VILLAGE OF RYE BROOK www�Mebrook.org +_ BUILDING DEPARTMENT ELECTRICAL PERNUT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY BP#: � 3 01�� EP '`l Approval Date: ��b\Z Permit Fee: $ Approval Signature: Other: Disapproved: (fees are non-refundable) ************************************************************************************************** Application dated, Aug 09, 2023 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: 505 FRANKLIN ST k'y�,/�,�©�&Y, 10573 SBL: 141.27-1-46 Zone: 2.Property Owner: Beatriz Gonzalez Address: 505 FRANKLIN ST RY cWlft)C�e ' NY, 1051 Phone#: (914) 918-2590 Cell#: (914) 918-2590 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 14.175 kW roof-mounted solar array system tied into existing electrical services. Modules: 35 HANWHA 315 (Q.PEAK DUO BLK-G5 315) STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: Trinity Solar-William Geiger being drily 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 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 afore me this 31SAL day of 2,2 23 day of 202 ep Stgn of Property wner Signature of Applican Beatriz Gonzalez Trinity Solar-William Geiger Print a of Proper Owner Print N of Appli ant ary Publif otary Publ- PEREZDOUGLASP TERESA ANGELICO NOTARY PUBLIC,STATE OF NEW YORK Public-State of New Yak Registration No.OIPE6445748 No.OIAN6430527 Qualified in Westchester t� Qualified in Orange CountY3/2vtMy Commission Expires O LPL [Notary ConvniWon Expires03/1M20J_� STATE WIDE INSPECTION SERVICES, INC., CAD Service With IntegrilY 0•• • • SIVIIS • : APPLICATION tel 845.202.7224 1 fax 914.219.1062 1 SWISNY.coml • Office Use Elect. Permit# P� LJc�1 Date Bldg Permit# XdJ 0� Scl Ft y Plumbing Permit# Final Certificate# City/Village R �POO / Zip • n�7 Building Dept. Ry F �Rc)oK_ County �Swt-�i�s rp Address , Cross Street Section „/ Block 1.7 Lot [1� Owner Name/Address(If different than above) Contact Num 7 Tip/z �'ON7-A A► Z K?10 3 -6 6 33 ❑Basement ❑ 1st FI. ❑2nd FI. ❑3rd Fl. ❑More Than 3 FI. ❑Garage ❑Attic ❑Outside XResidential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C/0 Detector Hood Trash Compact Amt Amps Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer Switch SERVICE Amperage #Panels 1P 3P # Meters # Disconnect ❑Underground ❑ New ❑ Reconnect ❑ Repair ❑Overhead ❑ Upgrade ❑ Disconnect Utility ID# ❑Con Ed ❑ NYSEG ❑Central Hudson ❑ Orange/ Rockland PHOTOVOLTAIC SYSTEM PV Modules Inverters AC Disconnect Junction Box Combiner Box Load Center PV Monitor Energy Storage System DC Disconnect 3"� -Z ❑Legalization ❑ Safety Inspection ❑Consultation 01 ,4 A0F MOv,g A 5U1rrlliC rr,W J y s ySF M 77FD ;tiro If FEB - 2.2024� 77 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 items to be inspected,if at any time of inspection additional items have 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 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. Email Address A f WAPA4•U 57NEN atfxt r -�so/we• CO/A4 Name License# 9 Date Signature p Address ,i.,/!� City/State ,1 `f 72!,e /AV, y Zip Company of ; , I/nl�v�� ,1 /� Phon # �� s � "PO i6 V R DIDState Wide Inspection Services cjk� 2U24 F1080 Main Street MAR ' 6 ishkill, NY 12524 Tb 1 845 202-7224 Phone VILLAGE OF RYE BROOK 914-219-1062 Fax STATE WIDE INSPECTION SERVICES BUILDING DEPARTMENT Email: office(d)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: Trinity Solar Jesus& Beatriz Gonzalez Bill Geiger 505 Franklin Street 62 Leone Lane Rye Brook,NY 10573 Chester,NY 10918 Located at: 505 Franklin Street, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP 24-024 141.27 1 46 Certificate Number: 2024-1157 Building Permit Number: BP 23-209 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: 505 Franklin Street, 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 27' Day of February 2024. Name Quantity Rating Circuit Type PV Modules 35 Inverters 01 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. rTr)- n i L SOLAR NOV 12 2024 Rye Brook Village, NY November 7, 2024 938 King Street VILLAGE OF RYE BROOK Rye Brook, NY 10573 , BUILDING DEPARTMENT Trinity Solar No. 506 Franklin Street 2023-07-904894 Rye Brook,NY 10673 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. Regards, Ayracon Almaraz, PE Structural Engineer-Trinity Solar y Ar � 100315 'r[IfESStO���. NY License No.100315,expiration date:12/31/2026 Trinity Solar 162 Leone Lane I Chester,NY 1(845)572-0060 D [EC IEEE (T�n il D FEB 2 7 2024 SOLAR Rye Brook Village, NY VILLAGE OF RYE BROOK February 21, 2023 938 King Street BUILDING DEPARTMENT Rye Brook, NY 10573 Trinity Solar No. 505 Franklin Street 2023-07-904894 Rye Brook,NY 10573 To the Building Official: The following information constitutes a summary of the relevant design criteria and recommendations for the support of a new photovoltaic [PV]system on the existing roof framing components at the above-referenced location. Criteria is as follows: 1. Existing roof framing: Conventional roof framing at R3 is 2x6 at 16 o.c.;existing rafter span= 12'6'; (horizontal projection) Conventional roof framing at R4 is 2x6 at 16 o.c.;existing rafter span= 12'0"; (horizontal projection) 2. Roof Loading: • 3.Opsf dead load(pounds per square foot-PV panels, mounting rails&hardware) • 5.7psf-existing roof loads(1.7 psf-2x6 framing, 1.5psf roof sheathing,2.5 psf shingles) • Ground Snow Load-30psf-per ASCE Hazard Tool • Wind criteria-Exposure Category B, 116 mph wind 3. Existing roof modification-none required,existing roof framing is acceptable for PV installation. The installation,described above, is in general conformance with the manufacturers'specifications and complies with all applicable laws, codes, and ordinances as specified by applicable codes, including the 2020 Residential Code of New York State. The spacing of the mounting brackets cannot exceed a maximum of 48"o.c. between mounting brackets and will be fastened using 5/16" diameter corrosive-resistant steel lag bolts. In order to evenly distribute the load across the roof rafters, there shall be a minimum of 2 mounting brackets per rafter(4"long lag bolts required)and a minimum 2%"penetration (embedment)of all bracket lag bolts beyond the roofing materials;this is adequate to resist all stated live loads above—including wind shear. Per NDS Section 12.1.4, pilot holes not to exceed one-half the diameter of the shank need to be bored into the primary framing members for the full length of the threaded portion of the screw to avoid splitting of the framing member. Stainless steel lag bolts are required. Regards, Thor Bojcun, PE Structural Engineer-Trinity Solar Y NCH 6 0 r � Ui T/fi5 s z 4eAlev L A 095675 ROFESS IONP�, NY License No.095675 Trinity Solar 62 Leone Lane l Chester,NY 1(845)572-0060 (T_T_�n I L SOLAR Rye Brook Village, NY February 19, 2023 938 King Street Rye Brook, NY 10573 Trinity Solar No. 505 Franklin Street 2023-07-904894 Rye Brook,NY 10573 To the Building Official: The following information constitutes a summary of the relevant design criteria and recommendations for the support of a new photovoltaic [PV]system on the existing roof framing components at the above-referenced location. Criteria is as follows: 1. Existing roof framing: Conventional roof framing at R3 is 2x6 at 16 o.c.; existing rafter span= 12'6"; (horizontal projection) Conventional roof framing at R4 is 2x6 at 16 o.c.; existing rafter span= 12'0"; (horizontal projection) 2. Roof Loading: • 3.Opsf dead load (pounds per square foot-PV panels, mounting rails&hardware) • 5.7psf-existing roof loads(1.7 psf-2x6 framing, 1.5psf roof sheathing, 2.5 psf shingles) • Ground Snow Load-30psf-per ASCE Hazard Tool • Wind criteria-Exposure Category B, 116 mph wind 3. Existing roof modification- none required;existing roof framing is acceptable for PV installation. The installation, described above, is in general conformance with the manufacturers' specifications and complies with all applicable laws, codes, and ordinances as specified by applicable codes, including the 2020 Residential Code of New York State. The spacing of the mounting brackets cannot exceed a maximum of 48"o.c. between mounting brackets and will be fastened using 5/16" diameter corrosive-resistant steel lag bolts. In order to evenly distribute the load across the roof rafters,there shall be a minimum of 2 mounting brackets per rafter(4" long lag bolts required)and a minimum 2%" penetration(embedment)of all bracket lag bolts beyond the roofing materials; this is adequate to resist all stated live loads above—including wind shear. Per NDS Section 12.1.4, pilot holes not to exceed one-half the diameter of the shank need to be bored into the primary framing members for the full length of the threaded portion of the screw to avoid splitting of the framing member. Stainless steel lag bolts are required. Regards, Ihor Bojcun, PE Structural Engineer-Trinity Solar OF N,>:h, HAQ r0 * ? A Z # r, W Z� �• W DD I FEB 21 zQ24 ``�110 095675 VILLAGE OF RYE BROOK R�fiESSIONP� BUILDING DEPARTMENT NY License No.095675 Trinity Solar 162 Leone Lane I Chester,NY 1(845)572-0060 nTr - n I L SOLAR Rye Brook Village, NY August 8, 2023 938 King Street Rye Brook, NY 10573 Trinity Solar No. 505 Franklin Street 2023-07-904894 Rye Brook,NY 10573 To the Building Official: The following information constitutes a summary of the relevant design criteria and recommendations for the support of a new photovoltaic [PV]system on the existing roof framing components at the above-referenced location. Criteria is as follows: 1. Existing roof framing: Conventional roof framing at R3 and R4 is 2x6 at 16 o.c.;existing rafter span= 12'6"; (horizontal projection) 2. Roof Loading: • 3.Opsf dead load(pounds per square foot-PV panels, mounting rails&hardware) • 5.7psf-existing roof loads(1.7 psf-2x6 framing, 1.5psf roof sheathing, 2.5 psf shingles) • Ground Snow Load-30psf-per ASCE Hazard Tool • Wind criteria-Exposure Category B, 116 mph wind 3. Existing roof modification at R4 only-A 2x4"strongback"(L-shaped profile of two 2x4s)to be installed in low height areas to achieve a maximum span of 12' 1". Alternatively, existing roof rafters may be"sistered"with the new 2x6 rafters extending the full length of the existing rafters and terminated before the existing rafter support connection. Non-full-length rafter sisters must"overlap"its accompanied sister a minimum of 24"with nailing from each side in the overlap.Typical sister nailing consists of 1 Od nails top and bottom at 12"o.c. Within overlap, same nailing at 6"o.c. The installation, described above, is in general conformance with the manufacturers'specifications and complies with all applicable laws, codes, and ordinances as specified by applicable codes, including the 2020 Residential Code of New York State. The spacing of the mounting brackets cannot exceed a maximum of 48"o.c. between mounting brackets and will be fastened using 5/16" diameter corrosive-resistant steel lag bolts. In order to evenly distribute the load across the roof rafters, there shall be a minimum of 2 mounting brackets per rafter(4"long lag bolts required)and a minimum 2Yz"penetration (embedment)of all bracket lag bolts beyond the roofing materials,this is adequate to resist all stated live loads above—including wind shear. Per NDS Section 12.1.4, pilot holes not to exceed one-half the diameter of the shank need to be bored into the primary framing members for the full length of the threaded portion of the screw to avoid splitting of the framing member. Stainless steel lag bolts are required. Regards, T ,E MJ 2uG�Nr,I Ihor Bojcun, PE QF Jyf� Structural Engineer-Trinity Solar W UA [C W,4S A,0 �CHAE4 e y O q J e W Z # �-N i �L \�o 095675 2- Z/'L�/ ROFESS010 ' NY License No 095675 Trinity Solar 162 Leone Lane I Chester,NY 1(845)572-0060 � a Building Permit Check List&Zoning Analysis Address: �� J '� C �!� +V SBL: 1 \, Zone: 2 Use: 1 Const.Type: Other. Submittal Date: Revisions Submittal Dates: Applicant: 1 11& 7,_ Nature of Work view C� \ PB BOT: Other. Q Z ( ( ) FEES:Filing. BP: \0 C/O: Flood Plane: Legalization: ( ) ( ) APP: Dated: Notarized: SBL: Truss 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: ( ) ) LANS:Date ed Sealed: Copies: Electronic: Other. (License: Workers Comp: Liability. Comp.Waiver. Other. CODE 753#: Dated: N/A: (� ) HIGH-VOLTAGE ELECTRICAL:Plans: Pemmt N/A Other. ( ) ( ) LOW-VOLTAGE ELECTRICAL:Plans: Permit N/A Other. FIRE ALARM/SMOKE DETECTORS:Plans: Pennit H.W.I.C.:_Battery:_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-off Letter. As-Built Plans: Other. ( ) ( ) BP DENIAL LETTER: C/O DENIAL LETTER. Other. Other. ( �g mtg.date: L. \ rovaL otes• — It ( )ZBA mtg.date: approvaL notes: ( )PB mtg.date: approvaL• notes: REQUIRED EXISTING PROPOSED NOTFS Area: _ Date,(��1 Circle: Frontage Front Front Sides: Rcar. Main Cov Accs.Cov Ft.HS : Sd.H/Sb GFA: Tot.Imp F Im : Parlung HHight/Stories: notes: � • 1 p E jD� BUILDING DEPARTMENT VILLAGE OF RYE BROOK SEP 12 2023 938 KING STREET RYE BROOK,NY 10573 VILLAGE OF RYE BROOK (914)939-0668 FAx(914)939-5801 BUILDING DEPARTMENT wwwamirookina — -- -_- 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:5,05 FRA—N7KLIN ST PORT CHESTEI Date of Submission: Aug 09, 2023 Parcel ID#: / 7�1// � / -`/l y6 Zone: k,)F Proposed Improvement(Describe in detail): APPLICANT CHECK LIST: Installation of a roof-mounted solar array MUST 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. (®Completed Application 2. (®Two(2)sets of sealed plans. (one full size{maximum Property Owner: Beatriz Gonzalez allowable plan size=36"x 42"}and one 11"xl7") Address: 505 FRANKLIN ST PORT CHESTER N 3. ®Two(2)copies of the property survey. 4. ®Two(2)copies of the proposed site plan. Phone#(914) 918-2590 5. ®One electronic/disc copy of the complete Applicant appearing before the Board: 6. (jD application materials. Filing Fee. Trinity Solar 7. ®Any supporting documentation. Address:62 Leone Ln, Chester, NY 10918 8. ® HOA approval letter. (ifapplicable) 9. ®Photographs. Phone#(845) 572-0060 10.® Samples of finishes/color chart. (a sample board or Architect/Engineer: Trinity Solar - Ihor Bojcun model may be presented the night of the meeting) 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. 9 Sworn to before me this Sworn to before me this � day of Aviv S T , 20 3 day of , 2013 Signature of Property Owner Signature of4pplicant Beatriz Gonzalez Trinity Solar- Melvin Banks Print Name of Property Owner Prin�Namc pplicant tirmy Public tary Public PEREZ DOUGLAS P NOTARY PUBLIC,STATE OF NEW YORK TERESA ANGELICO Registration No.O 1 PE6445748 Notary rubbc-State of New YoeK Qualified in Westchester o ty 140.OIANU30527QU~In 0Mn9e COt61tr/19 My Commission Expir C21, 4Q 2 My CmvQuion EVINO03h4*6_1 4_ BRnv� Village of Rye Brook ML MR X Agend FB SE , `�`` Y ti Architectural Review Board Meeting AC SF . Wednesday, October 18,2023 at 7:30 PM JM +;� Village Hall,938 King Street �j 1. ITEMS: 1.1. ARB23-113 (Consent Agenda) Jesus Gonzalez&Beatriz Gonzalez 505 Franklin Street Rooftop solar array. 1.2. ARB23-114 (Consent Agenda) Muharrem Deliallisi&Raimonda Deliallisi 26 Valley Terrace Rooftop solar array. 1.3. ARB23-115 (Consent Agenda) The Concepcion Revocable Family Trust 38 Hawthorne Avenue Black aluminum fence and gate. Consent Agenda Approvals: Motion Y '`— Second Y-n Abstention Aye;_ Nay;_ Adjournment; Notes 1.4. ARB23-116 Michael Holmes&Patricia Holmes 34 Hawthorne Avenue In-ground swimming pool&black aluminum picket fence. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes Page 1 of 3 Architectural Review Board October 18,2023 1.5. ARB23-117 Matthew Gillman&Danielle Gillman 49 Country Ridge Circle Exterior elevation changes,interior renovations and renovate rear patio. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.6. ARB23-118 Amelia Irizarry 6 Lincoln Avenue Remove rear window and door. Install new slider. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.7. ARB23-119 Adolfo Waisburg&Mariela Cohen Sabban 63 Talcott Road Exterior elevation changes and interior renovations. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.8. ARB23-120 Jordan Sedler&Roberta Sedler 10 Elm Hill Drive Relocate side door,new steps and interior kitchen renovation. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes Page 2 of 3 i Architectural Review Board October 18,2023 1.9. ARB23-121 2 Elm Hill LLC 345 Betsy Brown Road Single family dwelling. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.10. ARB23-122 Hidden Falls Homeowners Association Hidden Pond Drive,HOA Common Area Replace tie wall with Redi-Rock wall. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes NEXT MEETING: November 15,2023 Page 3 of 3 { r c _ 9 - a _ _ o OEM x r o b � L cl v , e - OW d J • s N � V1 Y Q CL o � mo • Q Z It a a o w y U) o eD ZE c' Qy x x o N % SIIJ3N38 + S3dnIV33 ; � t T C 01 a y a • m � c � m n � c m � CIS o o c N L m m E c 3 T N .dr c 9 a E N o u IY 4! .d. W V A d K G! y N G OV G c m c o c o ?; L • z V o O i a m q m H O N E o d W ti a W .. Y E i u D V = u a Li 4- ~� O O O s v. $ Ll _- - or _ — Z - Y `J O Q m r i rm. *`• :p fit`` �` _ •,:�.: - z 0 0 _ C]A N O N O O Q L O i y i .1 1 r. z CO � f WIN f: 1 cr w w � r� �.1 a MATERIAL LIST (FOR INTERNAL USE ONLY) JOB NAME: GONZALEZ, BEATRIZ 4 ADDRESS: 505 Franklin Street SOLAR Rye Brook NY 10573 2211 Allenwood Road 877-786-7283 Y Wall,New Jersey 07719 www.Trinity-Solar.com 41.0028985,-73.680684 95.555 ESTIMATED PERSONNEL HOURS 3.98 DAYS 2.99 DAYS 1.99 DAYS • 35 HANWHA 405's(14.175KW) (CREW OF 3) (CREW OF 4) (CREW OF 6) • 2 SEPARATE ARRAYS • 24' PEAK TO GROUND • 31 PORTRAIT&4 LANDSCAPED • 1 INVERTERS INSTALLED OUTSIDE • NO TRENCH ESTIMATED SENT TO JOB USED ❑ HANWHA 405(Q.PEAK DUO BLK ML-G10+405) 35 _ ❑ S440 SE OPTIMIZERS 35 ❑ SE11400H-USOOOBEi4 1 ❑ 60A OUTDOOR FUSED DISCONNECT W/(2)60A FUSES 1 ❑ SOLADECK BOX(ES)&HAYCO CONNECTORS) 2 ❑ PV LEAD WIRE 150' ❑ INSULATED BUG BITES(LINE TAPS) 2 ❑ ECOFASTEN 2012025 CF STD RAIL MLL AL 171.5 21 ❑ ECOFASTEN 2012013 CF RAIL SPLICE 5 ❑ ECOFASTEN 2099017 CF END CLAMP 32MM BLK 36 ❑ ECOFASTEN 2099022 CF MID CLAMP SHORT BLK 52 ❑ ECOFASTEN 4011011 MODULE JUMPER 7 ❑ GROUNDING LUG(NOT PROVIDED BY ECOFASTEN) 2 ❑ ECOFASTEN 2012022 CF UNIV L-FOOT MLL 3 92 ❑ ECOFASTEN 3012020 GF-1 FLASHING GLV BLK 8 x 10 92 ❑ ECOFASTEN 2012019 CF MLPE MOUNT 35 ❑ ECOFASTEN 2012020 CF WIRE MGMT CLIP 35 ❑ ECOFASTEN 2012024 CF END CAP 36 _E cc =£ J i Q N $3z 3 a: rs X w V) N 3 ^ LUm0 Q � w LU ^i w n lD g w wino z g H CC 0 0 a N O V) w N } ° z H Z a z > mzZ ,� z < ui 0 OQ rj w Se ZOo`no Uj zpwz w a00) VYw N oo u H7) O LnLu na o Z0 (D ooCc wCl v w m O < a _ ) . « O � ... m ... ! 2 7 — . - »: , � . . . . � # � ( & � i ` • ƒ k ( Iz )}O _0 � )7| q � ! _ � § () a= ; ! r y - U rt r f - 3' o 8�r - p3 fit _- + O - Sra ! Q opi ya mEll w cL, u` • u u a � + ` wa �3 i E E y u xx Es t o k ! Yi ��3 5 Y 6cai rY O = 3� t� f a d O p 7 A m.f ygu ■ 3 u ■ F I F E - I v _N tq T ■LLI�Va) o Y Y f c E Eo o ca N• W \ ; O T V WV W d ^ 7 6 v O Q Nf Y �r m_ E o sn W V 3 o ms . ccJ aoR - a G P'1 N 0 a CD F � l z i$ 20 oo v 4-0 v Ll� v � co: V1 o-, z I ly y� M w O 3E ; Q NN _ .. _ W V LL z E _ 2 2 Y Z E l/1 v v 5 o If Z o INVERTERS q E O N O L C u�j • p C A � L w c � � V O O 3 q cu N r _ V N O O O w8-' t8 d c W O Q L O O W2 C N N L/) C N 01 E g G O n A V O C O m O u a Q o \ \ \ ' Ocl r 0 I & O ; N w To V) o N� ( m W LCD O Y v C Z a i � o 3 o° d EM W V) .R. 0 Vl Q Vl Ec g a N 2 V) V) 4 C rn q Z a D D i • 0 rn w w • • • • • O. a' d m � V) V) O 0 Z z 10 - W Z N N C 0 5 fS mCD y § Z g O — sy \ Z zCD 0 0 t i e Z O O v+ POWER OPTIMIZER a • E ' $ a. E L � E � o E N E > o d m o a T - r Q a O C L A J i d d r m C d N d O d N 6 L c c L4 E O Y f E LL E LL 5 %o 4+ CL Y O T C Q t T p F p � o &ONLw y W Lr) cp Q u� 1 N m� S 1 L. > 0 o o m Q� V1 a @ a d t E 5 VlLn n d m O t D i Ol O va+ `� O p a N a LL. w $ � -�. �� . . «■�. / ■ : ' ' MOHR ��®| . S � !e| � ■ . k- - . 0 \. . . � 2 )222§§4W7,10 a , 10, /f/§}ff : //{\/§/ � ■ § � - - � | 9 ee . k / � IL ir 2 . I C,L � \ I ■ �' CL | I � NY Putnam County Home Improvement Contractor#PC6987 NY Putnam County Electrical License#R23713 NY Westchester County Home Improvement Contractor#WC-27944-H15 NY Westchester County Electrical License#599 NY Rockland CountyHome Improvement Contractor#H-12313-40 nrilt y 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.Eor other jurisdictions,please visit: http://www.trinity-solar.com/about-us/locations-and-licenses Village of Rye Brook Building Department 938 King Streetf— Rye Brook, NY 10573 D v T: (914)939-0668 Sep 07, 2023 sEP 1 2 2023 10 VILLAGE OF RYE BROOK To Whom It May Concern, 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: Beatriz Gonzalez Address: 505 Franklin St Port Chester NY,10573 SBL: 141.27-1-46 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 you, Melvin Banks Applications Specialist I Trinity Solar—Hudson Valley (845)572-0060 x1715 I Applications.LHV@trinity-solar.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 m NJ,Electrical Contractor business permit number 34E B01547400 NJ,HIC reg.#13VH01244300 (i�S O"LA R For other jurisdictions,please visit:http://www.trinity-solar.com/about-us/locations-and-licenses ID HOMEOWNERS AUTHORIZATION FORM SEP 12 2023 Beatriz Gonzalez VILLAGE OF RYE BROOK (print name) BUILDING DEPARTMENT am the owner of the property located at address: 505 Franklin Street Rye Brook,New York 10573 United States (print address) I hereby authorize Trinity Solar Inc. ("Trinity Solar") and its employees, agents, and subcontractors, including without limitation, Melvin Banks , to act as my Agent for the limited purpose of applying for and obtaining local building and other permits from the Authority Having Jurisdiction as required for the installation of a Photovoltaic System, Battery System, roofing or other Trinity Solar offerings located on my property, applying and obtaining permission and approval for interconnection with the electric utility company, and registration with any state and/or local incentive program(s). This authorization includes the transfer/re-administering, and/or cancellation of any existing permits on file for the purpose of updating/applying with an alternate subcontractor. Without limitation to the generality of the foregoing I specifically authorize Trinity Solar et al.to populate technical details,fill-in,edit,compile,attach drawings, plans, data sheets and other documentation to, date,submit, re-submit, revise, amend and modify application, submission and certification documents("Approvals Paperwork"), including those for which signature pages are included herewith for my signature, in furtherance of the related transaction, and I am providing any signatures to Approvals Paperwork for purposes of the foregoing.Trinity Solar will provide copies of Approvals Paperwork when submitted. My authorizations memorialized herein shall remain in full force and effect until revoked. I acknowledge that these authorizations are not required to proceed with the transaction and are not a condition of the related agreement included herewith but are being given for my own convenience and benefit in order to expedite the approvals processes. Electric Utility Company: ConEdlson Electric Utility Account No.: 55-5604-1081-0007-2 Name on Electric Utility Account: Beatnz Gonzalez Customer Signature Beatnz Gonzalez Print Name July 14,2023 Date Corporate Headquarters 1-877-SUN-SAVES 2211 Allenwood Road Ph: 732-780-3779 Wall, New Jersey 07719 Fax: 732-780-6671 www.trinity-solar.com FOR INFORMATION ABOUT CONTRACTORS AND THE CONTRACTORS' REGISTRATION ACT, CONTACT THE NEW JERSEY DEPARTMENT OF LAW AND PUBLIC SAFETY, DIVISION OF CONSUMERS AFFAIRS AT 1-888-656-6225. ` o)s =t��� ��A:'+� c ,.i� �i' �=s .�ii►ISii y -_:: ,.a��:�ri1�l��i',.%:r ►sr-/hl �P�+r'.r :s �h.�� �, es ;�ti/��'rh�-, rr.- o)> G 0 :a, y LO N L N f v p w 00 cn w� d J O 0 a •' _G O fj O fl M::. •0.4 • / CL Lo ;� a •� Q L i H �ry Lr 4,J ? Q °' c •° ad 't,ection LLJ U LLI <O)> + O O Z J °' n'W yr y h « Q � CN 04 a X �00 Z ( > Q v _ LO .J. J e u O OL d > �t/R w . . . ^ . . _a'-'.:a�t� s=s 7�'77 ern- 7�t""-sue--�7 .:.1 O l . . . . . . ..f'< ,-. ^- <( • s .,����I���h .����'1/���� �.< r:�I��j�/I,��h� a 3 i'j� �� i��'���a r i ,�,r .:YO� +�0�;:•' ,:,t�v�9Y: -:;:",•O :r, y!I:Gvr�`'•': „'jv �'. -;c?S�Ov {Y-' � J AC� DATE(MM/DD/YYYY) `� CERTIFICATE OF LIABILITY INSURANCE 5/24/2023 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: Arthur J. Gallagher Risk Management Services LLC PHONE o Emil:g56 482-9900 FAic,Ne:856 482-1888 4000 Midlantic Drive Suite 200 ADDDRESS: CherryHill.BSD.CertM@AJG.com Mount Laurel NJ 08054 INSURER(S►AFFORDING COVERAGE NAIC0 INSURER A:Gotham Insurance Company 25569 INSURED TRINHEA-03 INSURER B:National Union Fire Insurance Company of Pittsbur 19445 Trinity Solar Inc.62 Leone Lane INSURERC:EnduranceAmerican Specialty Ins Co 41718 Chester. NY 10918 INSURERD:Liberty Insurance Underwriters Inc 19917 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1365370128 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. INSR ADDL SUER -- POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MMIDDMIYY MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY GL202100013378 6/1/2023 6/1/2024 EACH OCCURRENCE $2,000,000 CLAIMS-MADE X OCCUR PREMISES(EaENTED occurrence) $100,000 MED EXP(Any one person) S 5,000 PERSONAL 8 ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER _GENERAL AGGREGATE S 2,000,000_ POLICY X JE� LOC _PRODUCTS-COMP/OP AGG $2,000,000 OTHER S 3 AUTOMOBILE LIABILITY CA 2960145 6/1/2023 611/2024 COMBINED SINGLE LIMIT S 2,000,000 _(Ea accident)__ -- -- X ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS ONLY AUTOS _ _ __- HIRED NON-OWNED PROPERTY DAMAGE S AUTOS ONLY AUTOS ONLY (Per accident) S A UMBRELLA LIAB X OCCUR EX202100001871 6/1/2023 6/1/2024 EACH OCCURRENCE S5,000.000 D X EXCESS uA8 ELD30006989101 6/1/2023 6/1/2024 --- --- - - - - - CLAIMS-MADE 1000231834-06 6/1/2023 6/1/2024 AGGREGATE $5,000,000 DED RETENTIONS Limit x of S5,000,000 S 19,000,000 WORKERS COMPENSATION PER OTH- B WC 13588107 6/1/2023 6/1/2024 X STATUTE — ER AND EMPLOYERS'LIABILITY YIN _— - - --- ANYPROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT S 1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N/A -- -- - — - -- (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 S 1,000.000 B Automobile CA 2960145 6/1/2023 6/1/2024 All Other units $250/500 Comp/Collusion Ded Truck-Tractors and Semi-Trailers $250/500 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The Certificate Holder is named as additional insured with respect to the above General Liability Policy,if required by written contract executed prior to services performed. 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 Rye Brook NY 10573 AUTHORIZED REPRESENTATIVE USA C 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD YORK ' Workers' CERTIFICATE OF STATE Compensation Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE � 1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured Trinity Solar Inc. 631-319-7233 62 Leone Lane 1 c.NYS Unemployment Insurance Employer Registration Number of Chester,NY 10918 Insured 49-230977 Work Location of Insured(Only required if coverage is specifically limited to 1 d.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 3b.Policy Number of Entity Listed in Box"la" Village of Rye Brook WC 013588107 938 King Street 3c.Policy effective period Rye Brook NY 10573 6/1/2023 to 6/1/2024 3d.The Proprietor,Partners or Executive Officers are included.(Only check box if all partners/officers included) ❑ all excluded or certain partnerslofficers 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: �1 /Ou, z 6/1/2023 (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. 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