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VILLAGE OF RYE BROOK
MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR
Jason A. Klein (914) 939-0668 Christopher J. Bradbury
www.ryebrook.org
TRUSTEES BUILDING& FIRE INSPECTOR
Susan R. Epstein Steven E. Fews
Stephanie J. Fischer
David M. Heiser
Salvatore W. Morlino
CERTIFICATE OF COMPLIANCE
February 29,2024
1100 King Associates LLC
4 International Drive
Rye Brook,New York 10573
Re: 1 International Drive, Rye Brook,New York 10573
Parcel ID#: 124.82-1-1
Building Permit#20-004 issued on 1/9/2020
This certifies that the EV chargers installed,and the ADA parking spaces relocated under the above
captioned permit has been satisfactorily completed.
Sincerely,
Steven E. Fews
Building& Fire Inspector
/to
BUILD ENT For offic&onl
`IAPR 21 2020 VIL OF RYE K IT '7ISSUED:9 8 KING STREE YE BROOK, YORK 10573 DATE:
VILLAGE OF RYE BROOK (914)9 939-5801 FEE:
BUILDING DEPARTP>9ENT i
o
APPLICATION FOR CERTIFICATE OF OCCUPANCY,CERTIFICATE OF COMPLIANCE,
AND CERTIFICATION OF FINAL COSTS
TO BE SUBMITTED ONLY UPON COMPLETION OF ALL WORK, AND PRIOR TO THE FINAL INSPECTION
tittittittiititit►ttitttttitiii+Fiittt►titii\4MttiiN►►iiiirtrtirttiitiitrtrtiitiitiiittii#tiitiiitittiiiii4iittttKitiiiittiiiiiiii
Address: no�/1 c>t � �UtoG�14 ,/
Occupancy/Use: Parcel ID#: /a Y't ��L — / Zone: o a_ 1
7 Owner: jt() VII)g A tGLkQS LLO Address: y �48r0aiA11v9 �s(e_l 0--Q
13
P.E./R.A.or Contractor: Address:
Person in responsib}e charge:`"ro—ada Address:
Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issuance of a Certificate of
Occupancy/Certificate of Compliance for the structure/construction/alteration herein mentioned in accordance with law:
STATE O,F,NEW`�Y�CC?�.JNTY OF WESTCHESTER as:
(,P•S• ^1u 1V%� �N tg duly sworn,deposes and says that he/she resides atUPP Klkoa
Pnnt NM*of Applicant) �� (No.an treet)
in 'i�43' i0l in the County of Y amity in the State of-9L.that
(Cityfrown/Vil age)
he/she has supervised t work at the location indicated above,and that the actual total cost ofthe work,including all site improvements,labor,
materials,scaffolding, xed equipment,profess al fees,and including the monetary value of any materials and labor which may have been
donated gratis was:$ /J`.Coo ,
for the construction or alteration of �// (' ► CT�(�P
Deponent further states that he/she has examined the approved plans of the structure/work herein referred to for which a Certificate of
Occupancy/Compliance is sought,and that to the best of his/her knowledge and belief,the structure/work has been erected/completed in
accordance with the approved plans and any amendments thereto except in so far as variations therefore have been legally authorized,and as
erected/completed complies with the laws governing building construction.Deponent further understands that it shall be unlawful for an owner
to use or permit the use of any building or premises or part thereof hereafter created,erected,changed,converted or enlarged,wholly or partly,
in its use or structure until a Certificate ofOccupancy or Certificate ofCoom liiaance shall hay duly issued by the Building Inspector as per
§250-10.A.of the Code of the Villa f Rye Brook. ;+,NYU.110AVA
F'~'K-3y�;iel. Tail� Or'P+
Sworn to before me this �y� r,r P ,^-�; 3
1 E .1 t�I',TFN COL.W i Y Sw to before me this
,10.ZTJOUGM.14
day of 20�Q CCAM.Fyp_. 1 .._dax f 20�
CWS
Signature of Property Owner ignature o App' t
(As• �zt .646 UPS.It~ G<L >
Print N e of Property Owned Print Name of Applicant
Notary Publi Notary Publ c
321:19
�E BRC�v�
o`` tim
• 1982 BUILDING DEPARTMENT
[],BUILDING INSPECTOR
®ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK
❑CODE ENFORCEMENT OFFICER 938 King Street • Rye Brook,NY 10573
(914) 939-0668 FAx (914) 939-5801
www ryebrook.org
- - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - -
ADDRESS : I, S T t 2 Na i,.,r !( c+D_i dQ DATE: !� ' 2- z D Z -I
PERMIT# � O " 00 ISSUED: - °1 Z JSECT: Z �'� Z BLOCK:_LOT: I
LOCATION: L�.S 1 OCCUPANCY:
❑ Violation Noted THE WORK IS... PASSED ❑ FAILED REINSPECTION
❑ SITE INSPECTION REQUIRED
❑ FOOTING
❑ FOOTING DRAINAGE
❑ FOUNDATION
❑ UNDERGROUND PLUMBING NOTES ON INSPECTION:
❑ ROUGH PLUMBING
❑ ROUGH FRAMING
❑ INSULATION
❑ Natural Gas 4 4, 1 I f d (2,) r C k4-
0 L.P. Gas 1,0 � d b/,► �ri�.{-�� VeA
❑ FUEL TANK \
❑ FIRE SPRINKLER �p h
❑ FINAL PLUMBING
❑ GROSS CONNECTION
FINAL U s
❑ OTHER
�yE BRC��,
• 1982 BUILDING DEPARTMENT
❑BBUILDING INSPECTOR
ZASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK
❑CODE ENFORCEMENT OFFICER 938 King Street • Rye Brook,NY 10573
(914) 939-0668 FAx (914) 939-5801
www ryebrook.org
- - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - -
ADDRESS :- 1 iV 1l 2 N�• r i.� 2 'V c DATE: r
PERMIT# 619 Z Q - V U V ISSUED: d SECT: y 6�L BLOCK: LOT:
LOCATION: T /�L� y /' -':i— OCCUPANCY:
❑ Violation Noted THE WORK IS... ❑ PASSED ❑ FAILED /REINSPECTION
El-'SITE INSPECTION REQUIRED
❑ FOOTING
❑ FOOTING DRAINAGE
❑ FOUNDATION
❑ UNDERGROUND PLUMBING NOTES ON INSPECTION:
❑ ROUGH PLUMBING
❑ ROUGH FRAMING
❑ INSULATION /
❑ Natural Gas 'o IZ ZV I, /c'/ -t
❑ L.P. Gas
❑ FUEL TANK
❑ FIRE SPRINKLER 14)'t C-! d 7-�Oc �• U •/�.
❑ FINAL PLUMBING
❑ CROSS CONNECTION
❑ FINAL
❑ OTHER
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D L�C L� V E
BUILDING DEPARTMENT
VILLAGE OF RYE BROOK MAY 2 4 2023
938 KING STREET RYE BROOK,NY 10573
(914)939-0668 VILLAGE OF RYE BROOK
www.lyebrook.org BUILDING DEPARTMENT
ELECTRICAL PERMIT APPLICATION
Westchester County Master Electricians License Required
FOR OFFICE USE ONLY BP#: EP#:
Approval Date: Permit Fee: $
Approval Signature: Other:
Application dated, Z Z is tebmade to the Building Inspector of the Village of Rye Brook NY, for the issuance of
a Permit to install an or remove electrical equipment,wiring, fixtures, or to perform other high or low voltage electrical work as per
the detailed statement described below. By signing this document, the applicant & property owner agree that all electrical work
performed will be in conformance with all applicable Federal, State,County and Local Codes.
1.Address: J /NTF�2,N4�7D�[)-�-t_ �21���� SBL: /Z4, S62 Zone:
2.Property Owner: 1100 /U&�(;_ 4-SSoC.2 -c j Address: l/�S TY�"'� •E 1'-7tJ,(// L w(ICe�7
Phone#:3I q y.3 y —1 3 3 Cell#:
3.Master Electrician/Licensed Installer: T�'l aA/�( S Address: 4f/
Lic.#: Phone#:CJ 7 Cell#: ::�jq-6(dE7— email:
Company Name:/�A �LRDC L 6y&Z i L. Address: 400>
4.Proposed Electrical Work/Fixture Count: /A)5M,U_ VO4IC1�r_A42G—).(9C
5.3'Party Electrical Inspection Agency: !S u,
S EW YORK,COUNTY OF WESTCHESTER ) as:
,being duly swom,deposes and states that he/she is the applicant above named,and does further
t name of individual signing as the applicant)
state that(s)he is the �,g��}-yI [7_g7 , for the legal owner and is duly authorized to make and file this application.
(Master Electrician/Licensed Installer)
The undersigned further states 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 j 1
day of ,20 day of ,20
Signature of Property Owner ignature of Applicant
Print Name of Property Owner nLame f Arzi
_ I L�L
Notary Public Notary Public
SHARI MELILLO
Notary Public,State of New York
No.01ME6160063
Qualified In Westchester County 3/3/2023
Commission Expires January 29,20,_
w
STATEWIDE •
Service Willi litlegrilY
181 Main Street,Fishkill, NY 12524 1 email:office@swisny.com
SWIS
JOB • 845.202.7224914.219.1062 SWISNY.com • •
Office Use Elect.Permit# ) Date,
Bldg Permit# / Utility ID#
-�/
Final Certificate#
City/Village < 2 21L Zip Township County
A ress n Cross t et C�. Section Z Bloch; Z Lot
J '4
r8L,5ne/ dr dill'1�t rlaboveL Con mbe
❑Basement ❑1st FI. /{❑2nd FI. ❑3rd Fl. ❑More Than 3 FI. ❑Garage ❑Attic Outside ❑Residential 01cornmercial
Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms Carbon Monox Hood Trash Compact
Amt Amps
Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Warm Draw
Incandescent Fluorescent
SERVICE
Amperage Voltage 1 P 3P #Meters #Disconnect ❑Underground ❑ New ❑Reconnect
❑Overhead ❑Change
❑Visual Re-Inspection ❑ Safety Re-Inspection ❑ Re-Inspection
Additional Information
D CEC E MC DD
MAY 2 4 2023
VILLAGE OF RYE BROOK
BUILDING DEPARTMENT
This application is valid for one(1)year from the date received by SWIS.This application is intended to cover the above listed items to be inspected,if at any time of inspection additional items have been installed,you are
authorized to make the inspection and adjust the fee for the additional items inspected.The applicant declares that there is no open applications for the above address with any open inspection company.The applicant,owner
or authorized agent agrees to all the above terms and conditions as set forth for the application.
Inspector Date Finalized Inspector#
Co"g Nftt ZI U� Date Z _ Signa re
Acl S city/ 'it Zip C0deC '�C
License# Phone# _ U I
DState Wide Inspection Services
1080 Main Street
AUG - 4 2023 Fishkill, NY 12524
� 845 202-7224 Phone
VILLAGE OF RYE BROOK 914-219-1062 Fax
STATE WIDE INSPECTION SERVICES BUILDING DEPARTMENT Email: office@swisny.com
Website: www.swisny.com
Service With /ntegrlty
BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES
CERTIFIES THAT:
Upon the application of: Upon Premises Owned by:
M4 Electric 1100 King Associates LLC
Thomas Charles 4 International Drive
41 Osborne Hill Road Rye Brook, NY 10573
Sandy Hook,CT 06482
Located at: 1 International Drive, Rye Brook, NY 10573
Section: Block: Lot: Electrical Permit Number: 23-121
124.82 1 1
Certificate Number: 2023-5674 Building Permit Number: 20-004
A visual inspection of the electrical system was conducted at the Commercial occupancy described
below.The electrical system consisting of electrical devices and wiring is located in/on the premises
at: 1 International Drive, Rye Brook, NY 10573
The Exterior was inspected in accordance with the NYS and NFPA 70-2017 and the detail of the
installation,as set forth below,was found to be in compliance on the 4`h day of August 2023.
Name Quantity Rating Circuit Type
EV Charging Station 01
State Wide Inspection Services did not perform a Rough inspection(Rough Performed by WREIS). A
Visual inspection and Final inspection were conducted only.
Officer: Frank J. Farina
This certificate may not be altered in any way and is validated only by the presence of a seal at the location
indicated.This certificate is valid for work performed on the date of inspection only.
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BUILDING DEPARTMENT �CT 2. lul
8 2019
VILLAGE OF RYE BROOK _
938 KING,STREET RYE BROOK,NY 10573 VILLAGE OF RYE BROOK
(914)939-0668 FAX(914)939-5801 BUILDING DEPARTPAENT
�\w\\.rychrook.org
ELECTRICAL PERMIT APPLICATION
Westchester C ty Master Electricians License Required
FOR OFFICE USE ONLY BP EP#: �0-033
Approval Date: DEC 1 1 �,1 Permit Fee: S
Approval Signature: Other:
Disapproved:
(fees are non-refundable)
Application dated, I 00hyis hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of
a Permit to install and/or remove electrical equipment, wiring, fixtures,or to perform other high or low voltage electrical work as per
the detailed statement described below. The applicant & property owner, by signing this document agree that all electrical work
performed will be in
nn conformance with all applicable Federal,State,County and Local Codes�./
I.Address: / �Y��?`f-pp/]�/�{�/� I ' l SBL: �Y. ?ol —Zone:Q
2 PStop�t�j ( �// L Address:
P / -93 q- I Cell #:'1t(-_7 a9 V003 email: 7-r�Ctwly Q 10
3.Master Electrician:TLq C-414 _1y� Address: 44 e% USE 14I (— !!�b _
Lie.#: (;Zq to Phone#:C11 q f9ZS3!lj S Cell#: _54W6 email: �,sL_ 45
Company Name:,44 &Z,02. GpNr' LLB Address: 41 OfBp.Q,A 141 _ ► n6 4AAfA_Y MA4 Cj C&ql
4.Proposed Electrical Work/Fixture Count: /A)57-A4r4_ DeAtc, .6 e f:4_ l✓0A hr - S A4bojn7
x***x��*******���,�****�**,�x*,�*x,��**x,���x,�**;�xx****,�xxxxxxxxxxxxxx,�xxx�x;•,�****,�x;xx,�,�,'<,�xx�xxxxxxxx�xx�;x
STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as:
I-b a 60wuc-37_.being duly sworn.deposes and states that he/she is the applicant above named.and does further
(pim(namr ,i,�ntng as the applicant)
state that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the 40471A'tC4—WL
for the legal owner and is duly authorized to make and file this application.
The undersigned further states 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 Cod fthe Village of Rye Brook and all other applicable laws,ordinances and regulations.
Sworn t bef e me this 4 S lb"
Sworn to before me this
da of 20 /f day of 20Jq
%
i atu f Prroopeerrty Owner (:�;azure of Applicant
Prin Name of Pro pVty Owner I Print Name of Applicant
Notary P blic Notary Public
fiANVIA WKWh
I,#OTAItY P1JBI-10 STATE OF MEIN YG X ALEXANDRA H.FRANK
WESTCNGSTFR COUN!TY Notary Public,State of New York
L.IC.1 116202214 No.01FR6363711
Qualified In Westchester County
COMM. P. �--- -- commission Expires August 28,20�&/19
Westchester Rockland Electrical Inspection Services, Inc. r Phone: 914-347-3595
DO NOT WRITE HERE-FOR OFFICE USE ONLY 43 North Lawn Avenue Fax: 914-347-3596
Elmsford, NY 10523 BUILDING PERMIT NO.
-
TEMP# DATE
CITY OR VILLAGE Z11 CODE TOWNSHIP OUNTY
STREET AND NO.OR ROAD POLE N TB"
/
BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? SECT"M BLOCK LOT
OCCUPANTS NAME BUILDING OCCUPANCY
OWNER'S NAME AND ADDRESS HOME TELEPHONE NUMBER
CURRENT SUPPLIED BY FROM THEIR OFFICE WORK TELEPHONE NUMBER
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETS NO,OF FIXTURES& MOTORS HEATERS OFFICE USE
LOCATION LAMP RECEPTACLES ONLY
SIDEWALL SWITCH INCADE FLUORE NO. H.P.EACH NO, WATTS EACH INSPECTION
OUTSIDE -
r
BASEMENT
1''FL. I r i
Z-FL. `' A C c
GE
REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE:
THIS APPLICATION IS INTENDED TO COVER THE ABOVE LISTED ITEMS TO BE INSPECTED.IF AT ANY TIME OF INSPECTION ADDITIONAL ITEMS HAVE BEEN INSTALLED,YOU ARE
AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE FOR THE ADDITIONAL ITEMS INSPECTED AS PROVIDED BY THE APPLICANT.THE APPLICANT DECLARES THAT THERE IS
NO OPEN APPUCATIONS FOR THE ABOVE WITH ANY OTHER INSPECTION COMPANY.WREIS,INC. IS NOT LISTING,LABELING,UNDERWRITING OR CERTIFYING ANY EQUIPMENT,
MATERIALS OR DEVICES WHICH ARE PERFORMED BY OTHER CERTIFIED TESTING AGENCIES OR INSPECTION COMPANIES.THE APPLICANT,OWNER,OR AUTHORIZED AGENT AGREES TO
ALL THE ABOVE TERMS AND CONDITIONS AS SET FORTH FOR THE APPLICATION.
SIZE OF SERVICE FEEDERS
CHARACTER OF WORK N ❑ ADDMONAL❑ EXPOSED❑ CONCEALED❑ MUST ENTER APPLICANTS
IDENTIFICATION NUMBER
SERVICE ENTERS BUILDING OVERHEAD[' UNDERGROUND❑
AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACE MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
NAME OF COMPANY DATE OF APPLICATION rSIGNATURE OF APPLICANT
7 % - ------ -
STREET ADDRESS TELEPHONE NO.
C o
CRY OR OFFICE nP LICENSE NO.WHEN APPLICABLE
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BUILDING DEPARTMENT� VILLAGE OF RYE BRJ'
�r. OOK ''�:.
PHONE : (914) 939-0668 •PAx: 914 - Z. )w
".( ) 939 5801 www.ryebrook or a !�:
J. NOTICE OF NON-COMPLIANCE / UNSAFE EQUIPMENT
This equipment has been deemed non-code compliant and/or unsafe and shall not be placed back
into service without written authorization from the Office of the Building Inspector.
Unauthorized®rmoval of this tag is a crime punishable by fine, imprisonment or both. '
3 Address: T AT 0 t4 AL_ `
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Notes: —1�' (i, FFFAAA y1i-
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