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BOT Approval Date: Case# : Chairman• PB Approval Date: Case# : Secreta ZBA Approval Date: Case# Other: Application Permit Fees: "Y d APPLICATION TO INSTALL PHOTOVOLTAIC SOLAR ARRAY Application dated: 3/6/2024 is hereby made to the Building Inspector of the Village of Rye Brook,NY•for the issuance of a Pen-nit for the installation of a Photovoltaic Solar Array as per detailed statement described below. 1. Job Address: 21 Westview Avenue, Rye Brook, NY 10573 SBL: 141.35-2.8 Zone: ��- 2 Type,kW&Location of Array,(use additional sheets if necessary): Installation of a utility approved, grid inter-tie, flush mount, roof mounted,40 Hanwha solar panels, 16.2 KW,"Photo-voltaic electricity generating system. 3.Property Owner: Nancy Webber Address: 21 Westview Avenue, Rye Brook,NY 10573 Phone# 914-646-4784 Cell# 914-646-4784 e-mail Kenawebberl@gmail.com 4.Applicant: Trinity Solar Address: 2180 5th Avenue Unit1, Ronkonkoma,NY 11779 Phone# 631-319-7233 Cell # e-mail Brittany.gaumer@trinity-solar.com 5. Design Engineer: Thor Bojcun Address:2211 Allenwood Rd,Wall, NJ,07719 Phone# 732-780-3779 Cell# e-mail Operations.upstateny@trinity-solar.com 6.Solar Contractor: Brittany Gaumer Address: 2180 5th Avenue Unit 1,Ronkonkoma,NY 11779 Phone# 631-319-7233 Cell# e-mail Brittany.gaumer@trinity-solar.com 7. Occupancy;(I-Fam.,2-Fam.,Commercial-,etc. .)Pre-construction: 2-Fam Post-construction: 2-Fam 8. If building is located on a corner lot,which street does it front on: N/A 9. N.Y.State Construction Classification: Residential N.Y. State Use Classification: Residential 10. Construction Type&Location:()Typical Western Lumber Frame;()Timber Frame[TC];()Wood Truss[TT]; O Pre-engineered wood[PW];Located;O Floor Framing IF];( }Roof Framing[R];O Floor& Roof Framing[FR];Other: Roof Mounted Solar Array System 11. Number of stories: 2 Roof Style:(hip,shed,mansard,etc...> 12. Will a New Roof Be Installed: No 0 Yes ❑ la separate roofing permit is required to re-roof an existing building) 13. Roofing Material&Number of Layers: Pitched Roof-Asphalt 1 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: ❑ Yes: ❑ Area: 15, Will the proposed project require a Site Plan Review by the Village Planning Board as per§209 of Village Code? No: ❑ Yes: ❑ (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: ❑ 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: ❑ Yes: El Indicate:TIER 1:—TIER[L—TIER[I]:_ (if yes,a Home Occupation Permit Application is required) 18. What is the total estimated cost of construction: S��. �]- 1� (Note:The estimated cost shall include all site improvements,labor,material;raftolding,fixed equipment,professional fees,including any material and tabor 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. *,►,�,�xxx�x�*,�*,��:�**�***,��****�**�***�,�**��*�*��****,�xx:xxx*;xxxKxKx;.x�*xx��;xxxx��xx�*xwxxxx*;x;ri,�x�;�*:�*� STATE OF NEW YORK,COUNTY OF WESTCHESTER 1, Brittany Gaumer-Trinity Solar ,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 /5- Sworn to PeAbre me this day of (kftc��, ,20At �Aortnz day of 20 Not& 5ub41c-State of New yarn o.01 ORSD 2 7 706 111._ec,n Westchester county OL My ComM;;cr Expires Dec 10,2025 Notary Public Nota Pub �]� Notarize HereI E_jAb� Sign Here f 1.6�V Z . Signature of P: , toner Signature of App \`ttt111111frr Nancy Webber Brittany Gaumer-Trinity Solar,.\\ Print Name of Property Owner Print Name of Applicant STATE `• i OF NEW YORK 1 NOTARY wre&a�,s„ird,corm / ^ 2 (k%\ 01MA0014357 o S�QN EXPIRsS�\O\ 8/12/2021