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BUILDING DEPARTMENT
VILLAGE OF RYE BROOK R
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938 KING STREET RVF, BROOK, NV 10573
L (� �`G (914)939-0668
JUN 2 0 2024
l VILLAGE OF RYE BROOK
...«««...*«..««.«..««...*«......«.«.....*....«►*«t,*:.«*..►....««.......*«*... BUILDING DEPARTMENT
FOR OFFICE USE ONLY:
— Q
Approval Date: AUG 2 1 # f e� — g Application# o q
Approval Signature:. ARMTECTURAL REVIEW BOARR:
Disapproved:
Date: 2
BOT Approval Date:_ Case# Chairman:
PB Approval Date: Case#_��_ Secretary:
ZBA Approval Date: Case#
1 r
Other:
Application Fee:I$!/'(`U ,' Permit Fe.:
APPLICATION TO INSTALL PHOTOVOLTAIC SOLAR ARRAY
Application dated 6/14124 is hereby made to the Building Inspectorof the Village of RveBrook,NY.for the issnanc c of a Permit forthe
installation of a Photovoltaic Solar Array as per detaited statement described below.
1. Job Address: 10 Red Roof Drive / L/
�_Zolie:� -
2 Type,kW& Location of Array,lose additional sheets ifncce�tan 1: 9.292kw Solar Shingles to be installed on the
South and West facing roof planes. Inverter and AC disconnect to be installed adjacent to existing meter
as per site plan.
3. Property Owner:Jeff Mensch Address' 10 Red Roof Drive, Rye Brook, W 10573
- —
Phone# 917-583-6865 Cell#
e-mail Jeff mensch@yahoo.com
4 Applicant: Sarah Hawkins-Rushing for GAF Ene LLCAddress.5981 Optical Court, San Jose, CA 95138
Phone# 571-409-0287 Cell#
e
5. Design]rngineer:_garun Corp/Yurianto Yuria nto
610-202-45Q6 Address: -imil NYPermits@gaf.com
Phone# Cell# ehrisk ba
GAF Energy e-mail � run-corp,com
6. Solar Contractor:_ gy LLC
Address: I urt San pea u^A g�138
Phone# 571-409-0287 Cell#
— peits�gaf co-� m 7 Occupancy; I 1-I am.2-17mn,C'uazmercL i� .et. ,Pre-construction: e-mail
etiou: 1-Fa
--- Post-construction: 1-Faln
8. If building is located on a corner lot, which street does it front on: NIA
9, N.Y State Construction Classification:
N.Y. State Use Classification:
10. Construction"Type& Location: ()Typical Western Lumber Frame;()Timber Frame[TC],()Wood Truss[TT];
() Pre-engineered wood IPW];Located;()Floor Framing IF];() Roof Framing I RI;()Floor& Roof Framing[FRI,- Other:
------------
i 1. Number of stories:2 Roof Style:011p.slicd,nunixud.cuc...) hip
12. Will a New Roof Be Installed: No ❑ yes Ia scp,iralr tooling hrniril r�rcqund iu rc-rout nn cv.unL huidui�!
13. Roofing Material& Number of Layers: GAF Energy Timberline Solar ES (solar shingle) and Timberline Solar
HDZ asphalt, 1 layer
1
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14. Will the proposed project disturb 400 sq. ft. or more of land,or create 400 sq. fl.or more of impervious coverage requiring a
stormwater Management Control hermit as per§217 of Village Code? No: 0 Yes: ❑ Area:
15, Will the proposed project require a Site Plan Review by the Village Planning Board as per§209 of Village Code?
No: d Yes: ❑ t ll',cs nlsphcant mtisl suhntit a Nite Plan Applicntinn,8 prm idc tleiatictl drrnt most
16, Will the proposed project require a Tree Removal Permit as per§235 of Village Code?No: V Yes: ❑
if�c,agalrlii;i€n ron��t>iihmel❑ IliC l:cn,mal Fcrmit�%pplicau,ari
17. hoes the proposed project involve a Home-Occupation as per §250-38 of Village Code? No: V Yes: ❑
Indicate: TIER 1:__TIER 1l: TIER 11 I: i,l,e, ,l 1nniE:t iccupntion Fcnnit Application is rcquired
18- What is the total estimated cost of construction: $65,000 (which includes re-roof work �( Ov u
iNotc The estimiated cost shall include all site nnprovenients,labor,niaienril,scat Gilding.fixed equipmcnt,prolbssion, es.rnch6ng any m, al and
labor which nm be domaied gratis If the final cost ex+xcds the estimated cost.an additional Ccc u it1 he regvtrcd prior to issuance of the( tab
19. Start Date:TBD Completion Date: TBD
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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 andfor not
properly signed shall be deemed null and void and will be returned to the applicant. Please note that application
fees are non-refundable.
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STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as:
I Sarah Hawkins-Rushing being duly sworn,deposes and states that he/she is the applicant above named,
(print name of indi%ideal iening as the apl,l III:ant)
and further states that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the,
Agent/'Contractor for the legal owner and is duly authorized to make and file this application,
iu,dicalc arcltrtect.cuntracnv.acirt_attotncr cis
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 /y /A Sworn to before me this �{
day of tJ_d/) , .20 0 - day of
,20 Z
<=Notary Public
Notar) l'uh c
5tgnatur C P lityn-ert'k Signature of Applicant
Tct,
Sarah Hawkins-Rushing
PriatNaraeo#Prupr Owner
]jrint Name uCApplicant
SKYLER WAGNER
SAMANTHA JEAN BEYDA StNotary Public
State of Colorado
NOTARY PUBLIC-STATE OF NEW YORK Notary ID tt 20234027959
No.0IBE6441631 My Commission Expires 07-25-2027
Qualified in New York County
My Commission Expires 09-26-2026
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