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BUILD TNIENT VI ACE OF RY OOK �1,�] 938 KING EE-r RYE BR ,NY 10573 � ( 1J Lc (914)939-0 6 Q www.ryebroolc.org OCT p 7 2025 FOROFFICE USE ONl.1 : BUIi_D1NGDEPARTME N'l Approval Date: Application# rC �, Approval Signature: ARCHITECTURAL REVIEW BOARD: Disapproved: Date: BOT Approval Date: Case# Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Case# Other: Application Fee: Imod Permit Fees: j Ll jPJ APPLICATION TO INSTALL PHOTOVOLTAIC SOLAR ARRAY Application dated: `J is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of Permit for the installation of a Photovoltaic 5olar Array as per detailed statement described below. 1. Job Address: 13 Highview Ave. Rye Brook, NY 10573 SBL:141 .35-1-14 Zone: +-�` 2 Type,kW&Location of Array,(use additional sheets if necessary,: New install of a 4.35kW roof mounted solar array. 10 Hyundai 435W panels w/ Enphase micro inverters. 3. Property Owner: Alicia LUCero Address: 13 Highview Ave. Rye Brook, NY 10573 Phone# Cell# (914) 565-1750 e-mail 4.Applicant: Empire Solar Solutions, LLC Address:2-8 Johnes St. Newburgh, NY 12550 Phone# Cell#(845) 317-8019 a-mail Courtney@empiresolarny.com 5. Design Engineer: Michael Miele Address:705 Orrs Mills Rd. New Windsor, NY 12553 Phone# Cell#(845) 629-9693 e-mail mmielepe@yahoo.com b.solar contractor: Empire Solar Solutions, LLC Address:2-8 Johnes St. Newburgh, NY 12550 Phone# Cell# (845) 317-8019 e-mail Courtney@empiresolarny.com 7. Occupancy;(I-Fam.,2-Fam.,Commercial.,etc...)Pre-construction:1-Family Post-construction: 1-Family 8. 1fbuilding is located on a corner lot,which street does it front on:N/A 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;O Floor Framing[F];O Roof Framing[R];O Floor&Roof Framing[FR]:Other:7 Roof Mounted Solar Array 11. Number of stories: 1 hoof Style:(hip,shed,mansard,etc...) Hip 12. Will a New Roof Be Installed: No ❑ Yes K (a separate roofing permit is required to re-roof an existing building) 13. Roofing Material&Number of Layers: Shingle:One l s.nzrzozl 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: N Yes: ❑ Area: 15. Will the proposed project require a Site Plan Review by the Village Planning Board as per§209 of Village Code? No: C 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: d Yes: ❑ (If yes,applicant must submit a Tree Removal Permit Application) 17. Does the proposed project involve a dome-Occupation as per§250-38 of Village Code? No: 9 Yes: ❑ Indicate:TIER I:—TIER II:—TIER Ill:_ (iryes,a Home Occupation Permit Application is required) 18. What is the total estimated cost of construction: $23,000 (Note:The estimated cost shall include ail site improvements,labor,material,scaffolding,fixed equipment,professional fees,including any material and labor which may be donated gratis.If the final cost exceeds the estimated cost,an additional fee will be required prior to issuance of the 60) 19. start,Date: 2 Weeks after permit is issued Completion Date: 2 Weeks after permit is issued(Sarre Day) *}t�****�****f*�,��**.*�*�,�*��******�*.**�.**�*��,gut*.**��t�***�*��,��,�***,►*******�**«,�****,�*�*�*�*�****�,�* This application must bear the notarized signature(s)of the legal owner(s) of the subject property, and the applicant of record in the spaces provided.Any application not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. Please note that application fees are non-refundable. STATE OF NEW YORK.COUNTY OF WES I'CHESTER ) as: 1, Shannon Murphy ,being duly sworn,deposes and states that he/she is the applicant above named, i print name of individual signing as the applicant) and further states that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the. Contractor for the legal owner and is duly authorized to make and file this application. (indicateatchitect,contractor,agent,attorney,etc.I That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention& Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to before me this 1$ Sworn to before me this 12 day ofM'Q)'eXnbgX,-207'0 day of 't 1p ,20 � Notary Public Notary Public r� Signature of Property Owner ASIVat.le of Applicant Alicia Lucero Shannon Murphy Print Name of Property Owner Print Name of Applicant C COURTNEY ELIZABETH ROBERTS OURTNEY ELIZA13ETH R013ERTSNOTARY PUBLIC-STATE OF NEW PORK NOTARY PUBLIC-STATE OF NEW YORK Na.01 R084E OF No.01 R064Dutch ss.C Qualified in Dutchess County 611 Qualified in Dutchess County My Commission Expires 08-2'3-2026 My Commission Expires 08-29-2028 8/12/2021 BUIfET PARTMENT VILF RYI�,OOK OCT - 7 2025 938 KINGRYE BROOX,NY 105 3 g 9-0668 VILLAGE OF RYE BROOK rook.orLj, BUILDING DEPARTMENT ARCHITECTURAL REVIEW BOARD CHECK LIST FOR APPLICANTS This form must be completed and signed by the applicant of record and a copy shall be submitted to the Building Department prior to attending the ARB meeting. Applicants failing to submit a copy of this check list will be removed from the ARB agenda. Job Address: 13 Highview Ave. Rye Brook, NY 10573 Date of Submission: Parcel ID 9: 141.35-1-14 Zone: 949-F to t-06 Proposed Improvement(Describe in detail): New install of a 4.35kW roof mounted solar APPLICANT CHECK LIST: array. 10 Hyundai 435W panels wl Enphase MUST BE COMPLETED BY THE APPLICANT The following items must be submitted to the Building Micro inverter's. De Kent by the applicant-no exceptions. Property Owner:Alicia Lucero I. �/ Completed Application 2. Two(2)sets of sealed plans. (one full size Imaximum Address:13 Highview Ave. Rye Brook, NY 10573 allo%%able plan size=36"x 42"I and one I I x 17") Phone#(914) 565-1750 3. Two(2)copies of the property survey. 4. Two(2)copies of the proposed site plan. Applicant appearing before the Board: 5. One electronic/disc copy of the complete Empire Solar Solutions, LLC application materials. 6. 4FiIing Fee. Address:2-8 Johnes St. Newburgh, NY 12550 7. Any supporting documentation. Phone#(845) 317-8019 8. (W4 HOA approval letter. (if applicable) 4. ✓ Photographs. Architect/Engineer: MlChael Miele 10. r„ Samples of finishes/color chart. (a sample board or Phone#(845) 629-9693 model may be presented the night of the meeting) By signature below, the owner/applicant acknowledges that he/she has read the complete Building Permit Instructions& Procedures, and that their application is complete in all respects. The Board of Review reserves the right to refuse to hear any application not meeting the requirements contained herein. S�Nom to belare me this M Skwrn u)before me this 1 g day of ' >e.Q�reM e r , 20_Z5 day of :I IIremb ar , 20_' Signature of Property Owner ignature of Applicant Alicia Lucero Shannon Murphy Print Name of Property Owner Print Name of Applicant Notary Public n,Public COURTNEY ELIZABETH ROBERTS COURTNEY ELIZABETH ROBERTS NOTARY PUBLIC-STATE OF NEW YORK NOTARY PUBLIC-STATE OF NEW YORK No.01 R06439611 No.01 R06439611 Qualified in Dutchess County Qualified in DutChess County 8 12/2021 My Commission Expires 08-29-2026 My Commission Expires 08-29-2026