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BUIL TMENT
VI E OF RI' OOK
938 KING EET Rl'E BR ,NY 10573 APR _ 5 2024
> 9 4 90f ��
° r VILLAGE OF RYE BROOK
BUILDING DEPARTMENT
FOR OFFICE USE ONLY:
Approval Date: A P R 2 2 Application
Approval Signature: _ ARCHITECTURAL REVIEW BOARD:
Disapproved: TV— Date:
BOT Approval Date: Case# Chairman:
PB Approval Date: Case# Secretary
ZBA Approval Date: Case#
Other: 7�
Application Fee Cam` .[]Permit Fees: �3a�
APPLICATION TO INSTALL PHOTOVOLTAIC SOLAR ARRAY
Application dated: 7 J'C�z/ is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance ofa Permit for the
installation of a Photovoltaic Solar Array as per detailed statement described below.
1. Job Address: 4 Westview Ave. Port Chester, NY 10573 SBL,141.35-2-4 Zone:
2 Type,kW&Location of Array,(use additional sheets if necessary): New install of a 13.12kW roof mounted solar array.
(32)410W REC panels w/2 Solaredge inverters. Re roof of 22 Squares; No plywood to be touched
3.Property Owner: Antigona Balidemaj Address: 4 Westview Ave. Port Chester, NY 10573
Phone# Cell#(646) 531-4147 e-mail
4.Applicant: Empire Solar Solutions Address:2-8 Johnes St. Newburgh, NY 12550
Phone# Cell#(845) 219-8031 e-mail Courtney@empiresolarny.com
5. Design Engineer: Michael Miele Address:705 Orrs Mills Rd. New Windsor, NY 12553
Phone# Cell#(845)629-9693 _mail mmielepe@yahoo.com
6.Solar Contractor: Empire Solar Solutions Address:2-8 Johnes St. Newburgh, NY 12550
Phone# Cell# (845)219-8031 e-mail Courtney@empiresolarny.com
7. Occupancy;(1-Fam„2-Fam.,Commercial„etc...)Pre-construction: 1-Family Post-construction: 1-Family
8. If building is located on a corner lot,which street does it front on:N/A
9. N.Y.State Construction Classification: N.Y. State Use Classification:
10. Construction Type&Location:O Typical Western Lumber Frame;()Timber Frame[TC];()Wood Truss[TT];
O Pre-engineered wood[PW];Located;O Floor Framing[F]z�oof Framing[R];O Floor&Roof Framing[FR];Other:v
Roof Mounted Solar Array & Re Roof
IL Number of stories: 1 Roof Style:(hip,shed,mansard,etc...) Hip
12. Will a New Roof Be Installed: No IN Yes ❑ (a separate roofing permit is required to re-roof an existing building)
13. Roofing Material&Number of layers:
l
8/12/202 1
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: 4 Yes: ❑ Area:
15. Will the proposed project require a Site Plan Review by the Village Planning Board as per§209 of Village Code?
No: P Yes: ❑ (If yes,applicant must submit a Site Plan Application,&provide detailed drawings)
16. Will the proposed project require a Tree Removal Permit as per§235 of Village Code?No: e 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: P 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: $17,000 .► -6 t 2, a+ay = N 354 00Q 4&A 1
(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: 2 Weeks after permit is issued Completion Date: 2 Weeks after permit is issued (Same Day)
This application must bear the notarized signature(s)of the legal owner(s)of the subject property, and the
applicant of record in the spaces provided.Any application not properly completed in its entirety and/or not
properly signed shall be deemed null and void and will be returned to the applicant. Please note that application
fees are non-refundable.
STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as:
1 Erin McConnell ,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 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 Zq Sworn to before me this 29
day of . AQCC),�) 20 day of 20 'ZtJ
Notary Public Notary Public
Signature of roperty Owner Signature f A t
Antigona Balidemaj Erin McConnell
Print Name of Property Owner Print Name of Applicant
COURTNEY ELIZABETH ROBERTS COURTNEY ELIZABETH ROBERTS
NOTARY PUBLIC-STATE OF NEW YORK NOTARY PUBLIC-STATE OF NEW YORK
No.01R06439611 2 No.01 R06439611
Qualified in Dutchess County Qualified in Dutchess County
My Commission Expires 08-29-2026 MY Commission Expires 08-29-2026
8/12/2021