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BUILDING DEPARTMENT
VILLAGE OF RYE BROOK
938 KING STREET RYE BROOK,NY 10573
(914)939-0668
www.ryebrookny.gov
FOR OFFICE USE ONLY: 9 +�
Approval Date: OZ�
OCT
T 2 3 ' mit# m1)n5 Application #
Approval Signature: ARCHITECTURAL REVIEW BOARD:
Disapproved: Date:
BOT Approval Date: Case# Chairman:
PB Approval Date: Case# Secretary:
ZBA Approval Date: Case#
Other:
111 Application Fee: �� Permit Fees: 2�
APPLICATION TO INSTALL A PERMANENT STANDBY BACKUP GENERATOR
Application dated: 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.
1. Job Address: 011 R,, -e Dcive,, fook Al Y OS 3
2. Parcel ID#: g(7�� — Os - 00 1 " 191200000 Zone: r
3. N.Y. State Construction Classification: N.Y.State Use Classification:
.� �V [4. Proposed Generator&Fuel Type(Describe in detail): 9 I
5. Property Owner: -3�/ 'Yo f M 0,0,n vs
Address: y�- C v Coo Y 0 S` 5
Phone# q I Cell# 913 3as 3 email: %',A'nMag'IV6 .op"
Applicant: I&NM ' kS s.So 2
Address:
Phone# Cell# email:
Architect or Engineer(if applicable):
Address:
Phone# Cell # email:
General Contractor: 1
Address:
Phone# Cell ��— Ljo email:
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6/1/2024
6. Give exact dimensions from proposed generator to lot lines:
front yard: rear yard: right side yard: 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:
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 Chapter 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: (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: (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 Flood Insurance Rate Map#36119CO279
dated 9/28/07? Yes: No: )C
13. Will the proposed project require a Tree Removal Permit as per Chapter 235 of the Code of the Village of Rye Brook?
Yes: No: (a tree replanting schedule may be 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: If so, indicate: TIER 1: TIER 11: TIER Ill:
15. What is the total estimated cost of construction: $ (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 YORK,COUNTY OF WESTCHESTER ) as:
3.5+.,n )'1 0,�h✓S , 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 o=ner of the property to which this application pertains, or that (s)he is the
r\/o. 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 Sworn to before me this CIO
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day of ��ne' , 20 day of �..�C. , 20 o°o N
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e Mohan. D. Buxani
of Property Owner Si of Applicant M a) map j
S vs-;;,. Jt'1A �,I Notary Public, State of New York -Sv)�i M NHS 0n 0 a)
Print Name of Property Owner egistration No. 01 BU6266896 - Z a.
Qualified In New York County Print Name of Applican s - oc c W
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ommission Expires August 06, 2028 y o o
Notary Public CU
Notary Public Z = 'E
Q: E
This application must be properly completed in its entirety and must include the notarized signature(s)of the 0
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.
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6/I/2024