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BUILDI '� �� MENT ® [E C I M U IE
VILL OF RYE OK
938 KLNG S T RYE-BRO NY 10573 JAN 2 2 2025
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www: eb ov VILLAGE OF RYE BROOK
BUILDING DEPARTMENT
FOR OFFICE USE ONLY: �]
Approval Date: Pe it#: J� / Application#
Approval Signature: ARCHITECTURAL REVIEW BOARD:
Disapproved: : Date:
BOT Approval Date: Case# : Chairman:
PB Approval Date: Case# Secretary:
ZBA Approval Date: Case#
Other:
Application Fee '-5'C1 Permit Fees: ~ < a
APPLICATION TO INSTALL A PERMANENT STANDBY BACKUP GENERATOR
Application dated: n L R) 1'I is hereby made to the Building Inspector of the Village of Rye Brook for the issuance of a Permit to install a
permanent standby backup generator in accordance with§250-4,1,of the Code of the Village of Rye Brook,as per detailed statement described below.
Please note that electrical and plumbing permit applications must be filed separately by those licensed professionals,and that separate permits are required
for the installation of any related fuel tanks.Further note that all applications for commercial use will require a site plan approval from the Village
Planning Board prior to the issuance of any permit.. nn
1. Job Address: 1A (Ae V)tw
2. Parcel ID#: t c�- — Zone:
3. N.Y. State Construction Classification: ft J'iv4 t' N.Y. State Use Classification: /
4. Proposed Generator&Fuel Type(Describe in detail): � 'Q .`u\ Q V 5 y r�`� 11W
5. Property Owner: p � R2�iV�
Address: lk (4e v .W Cy,'
Phone# ' 'b Cell# email: {(hf11U( Q(Ylru�1. tom
Applicant: a
Address: 1k (kf View &A
Phone#%I`q36- Wi, Cell# email: AJ4C,�f Q1 . i oin
Architect or Engineer(if applicable):
Address:
Phone# rots# -/- email:
General Contractor:_�CGZ,Sy-C�/ "-?CD /
Address:
Phone# �40=�p7�� Cell# email:
t
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6- Give exact dimensions from proposed generator to lot lines:
front yard: rear yard: right side yard: I _ left side yard:
7. If building is located on a corner lot,which street does it front on:
8. Will the proposed project disturb 400 sq.ft.or more of land,requiring a Stormwater Management Control Permit from the Village
Engineer as per Chapter 217 of the Code of the Village of Rye Brook? Yes: No: \/_1 _
9. Will the proposed project require a Site Plan Review by the Village Planning Board as per Chapter 209 of the Code of the Village
of Rye Brook? Yes: No:" (provide detailed drawings as per Chaptcr 209)
10. Will the proposed project require a Steep Slopes Permit as per Chapter 213 of the Code of the Village of Rye Brook?
Yes: No: 'Yl (provide a detailed topographical survey)
11. Is the lot or any portion thereof located in a Wetland as per chapter 245 of the Code of the Village of Rye Brook?
Yes: No: 'K1 (provide a detailed survey indicating the Wetland&Buffer Zone)
12. Is the lot or any portion thereof located in a Flood Zone as per the FEMA FIood Insurance Rate Map#36119CO279
dated 9/28I07? Yes: No:
13. Will the proposed project require a Tree Removal Permit as per Chapter 235 of the Code of the Village of Rye Brook?e
Yes: _ No: h (a tree replanting schedule maybe required)
14. Does the proposed project involve a Home-Occupation as per Chapter 250-38 of the Code of the Village of Rye Brook?
Yes;�No: \11 If so,indicate: TIER I: TIER If: TIER III:
15. What is the total estimated cost of construction: S Otcc (The estimated cost shall include all
site improvements,labor,material,scaffolding,fixed equipment,professional fees,and material and labor which may be donated gratis)
16. Estimated date of completion:
STATE OF NEW Y�9RK,COUNTY OF WESTCHESTER ) as:
,h��i�l ►�11 �ECj4� ,being duly sworn,deposes and states that he/she is the applicant above named,
(print name Uindividual signing as the applicant)
and er sates at (s)he is the legal owner of the property to which this application pertains, or that (s)he is the
�(ko 60 at
_for the legal owner and is duly authorized to make and file this application.
(indicatet 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 perforated,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.
Swom to before me this 1 Sworn to before me this
day of De c-�r 7 Lf , 20 day of f ���P , ZQ
Signatdri of P petty Owner Signature of pplicant
Ina A-A4 P4/WC 44a
Print Name jkrop, rty er Print N o f Applicant
o lic �W
of Pub is
This application must be properly completed in its entirety and must in u e the notarized signature(s)of the
legal owner(s) of the subject property,and the applicant of record in the paces provided.Any application not
properly completed in its entirety andfor not properly signed shall be deemed null and void,and will be returned
SALINA FRANCES ROBtR1 %Cpplicant, Please note that application fees are ASAW A9851%OBERTIELLO
Notary Pubric,State of New York 2 Notary Public,State of New York
NO.01RO6433236 NO.01R06433236
Qualified In Westchester County qualified In Westchester County
Commission Expires 05/16/2026 Commission Expires 05/16/2026 611/2024