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BUILD TMENT
V E OF RY OOK JUN - 2 2025
938 KING EET RYE BR ,NY 10573
�' 4 VILLAGE OF RYE BROOK
BUILDING DEPARTMENT
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f OR OFFICE USE ONLY: J�� �j�`�
Approval Date: JUN 2 4 P mi Application# AkIE._J�f �� / �./
Approval Signature: ARCHITECTURAL REVIEW BOARD:
Disapproved: Date:
BOT Approval Date: ase# Chairman:
PI3 Approval Date: Case# Secretary
ZBA Approval Date: Case#
Other:
Application Fee: I60 Permit Fees:
APPLICATION TO INSTALL PHOTOVOLTAIC SOLAR ARRAY
Application dated: is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the
installation of a Photovoltaic Solar Array as per detailed statement described below.
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1. Job Address: ' 7 GrallQ Fd &x k- SBL:��7 i�17�--/'—� Zone:
2 Type,kW&Location of Array,(use additional sheets if necessary): � '� t lnit �f'!�r a Q�'✓�"
l 1.t/7<k-L-J - IC-e-E 01'1�
3.Property Owner:OjeRan IMP K ( E,E rzt Address:
Phone# Cell# 6 v:3 e-mail 0,wt Pi�.D �����•[v>`
4.Applicant: Jc7i:n.
Phone# 17371S�Za67 Cell# LF''<59'V3/`X> e-mail JL>hn,--Z>1n-4eiri yso/arsalw-ti:
5. Design Engineer: Vi VI ce ni�- Puv,�,a on V4 Pi e Z6 Address: �Sd? C/8 rp^>h�- (J✓ _San D,Pi ,C N J.
Phone# Cell# '95-$ - 5/0 S�f Sfl� rip e-mail (344Z e nc4d Solll 'r Qh5�5'►►�+ / .`
6. Solar Contractor: �h PGA) �`% 5ala� S'��c ° __ Address:d0 /tlPiW l7e Y15'�P�6�&I A10P
Phone# / J Cello e-mail JO l n
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7. Occupancy;(1-Farm,2-Fam.,Commercial.,etc...)Pre-construction: / F4 r✓+ Post-construction:
8. If building is located on a comer lot,which street does it front on: AP _
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[PW];Located;()Floor Framing[F];()Roof Framing[R];()Floor&Roof Framing[FRI;Other:
11. Number of stories: Roof Style_(hip,shed,mansard,etc...) S/ D✓
12. Will a New Roof Be Installed: No ❑ Yes Pf(a separate roofing permit is required to re-roof an existing building)
13. Roofmg Material&Number of Layers: le , fa�
1
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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:J0 Yes: ❑ Area:
15. Will the propose project require a Site Plan Review by the Village Planning Board as per§209 of Village Code?
No: ❑ Yes: Of 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) 'f
17. Does the proposed project involve a Home-Occupation as per §250-38 of Village Code? NO/ff Yes: ❑
Indicate:TIER 1: TIER H: TIER III:_ (if yes,a Horne Occupation Permit Application is required)
18, What is the total estimated cost of construction: $ .2 5- 5 5-E'
(Note.The estimated cost shall include all site improvements.labor,material.scaffolding.fixed equipment,professional fees,including any material and
labor which mav_ be donated gratis.If the final cost exceeds the estimated cost.an additional fee will he required prior to issuance of the CIO).
19. Start Date: /�`�S� 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 retumed to the applicant. Please note that application
fees are non-refundable.
STATE OF NEW YOM COUNTY OF WESTCHESTER ) as:
1, 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,
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 X A Sworn to before me this
day of 20 day of >20
f
Notary Public � Notary Pu c
of owner Si atureofApplicant
/ ��•1 '�..J�} 1 a
Amirt(Namc of Property Owner Print Name of Applicant
TIANNA MAJOR GREGORY M.RIVERA
Notary Public-state of w York Notary Public,State of Now York
Qualified in Westchester County
No.Ol RI6441399
My Commission Expires Apr 19,2027 Qualified In Westchester County Cemmission Expires September 26,209
6/1/2024