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HomeMy WebLinkAboutBP20-202PERMIT #tm4:: SECTION TYPE OF WORK JOB LOCATION. CONTR T. COST W O #!� TCO # QC 3: l o boa/ LOT / . 612D FEE DATE INSPECTION RECORD FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING RGH PLUMBING GAS SPRINKLER ELECTRIC Low -VOLT ALARM AS BUILT FINAL Z L ►i.�:iTll1 0 AS-BUILTlFINAL SURVEY ��� REQUIRED PRIOR FINAL INSPECTION -voul /Ve�r4s L p q1 Mae fike P *I J,0p3/�h���p��se �lec,�ric�l Co�sul��lS q _ a$ So,r<P Sok-,d �e�vicPS 7v / vl"ems s12 OTHER APPROVALS ARB BOT PB ZBA OTHER FINISHED BASEMENT NOT APPROVED FOR USE AS A SEPARATE APARTMENT OR DWELLING UNIT THIS BUILDING MUST BE POSTED WITH A PERMANENT CONSTRUCTION TYPE IDENTIFICATION SIGN; V PRIOR TO THE ISSUANCE OF C/O, AS REQUIRED BY NY STATE UAW. VILLAGE OF RYE BROOK WESTCHESTER COUNTY, NEW YORK No: 22-084 Certificate of Occupaucp This is to certify that VOp of, JqUe, d3r00 *VYhaving duly filed an application on oli lit 20 c2 0 requesting a Certificate of Occupancy for the premises known as, ,A3,22ji?e ZAt?ef Rye Brook,NY, located in a PU'J Zoning C' District and shown on the most current Tax Map as Section: Ic2 Block: Lot: 1, 52 and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No.CXU"' , issued 20c-.20, such authority and permission is hereby granted to the property owner to lawfully occupy or use said premises or building or part thereof listed under the following New York State Classifications,Use: Z5 " iam Construction: r- A-, for the following purposes: S) m l&7 Subject to all the privileges, requirements, limitations, and conditions prescribed by law, and subject also to the following: FINISHED BASEMENT NU I APPROVED FOR USE AS A SEPARATE DWELLING UNIT This certificate does not in any way relieve the owners or any person or persons in possession or control of the premises, building,or any part thereof from obtaining such other permits or licenses as may be prescribed by law for the uses or purposes for which the building or premises is designed or intended. Furthermore, it does not relieve such owners or persons from complying with any lawful order issued with the object of maintaining the premises or building in a safe and lawful condition. No changes or rearrangement in the structural parts of the building or in the exit facilities shall be made,and no enlargement, whether by extending on any side or by increasing in height all be made,nor shall the building be moved from one location to another until a permit to accomplish such change has n t ' th gilding Inspector. Building Inspector,Village of Rye Brook: Date: MAY 2 6 2022 �Lryt�oo a�v G. L� L V4��J AV f.[.nnkozwaW VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914)939-0668 Christopher J. Bradbury www.tyebrook.org TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Michael J. Izzo Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE May 26,2022 SC Rye Brook Partners LLC c/o Warjam Group LTD 4 West Red Oak Lane Suite 325 White Plains,New York 10604 Re: 14 Jasmine Lane, Rye Brook,New York 10573 Parcel ID#: 129.25-1-1.58 This document certifies that the work done under Mechanical Permit #21-170 issued on 11/5/2021 for the installation of a new gas Furnace,a new condenser and related ductwork has been satisfactorily completed. Sincerely, Michael J. Izzo Building&Fire Inspector /to t`�' +JI C 4t" aAnh ewaW 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 Michael J. Izzo Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE May 26,2022 SC Rye Brook Partners LLC c/o Warjam Group LTD 4 West Red Oak Lane Suite 325 White Plains,New York 10604 Re: 14 Jasmine Lane, Rye Brook,New York 10573 Parcel ID#: 129.25-1-1.58 Mechanical Permit#20-149 issued on 10/15/2020 for Fire Sprinkler System This certifies that the fire sprinkler system,installed under the above captioned permit,has been satisfactorily completed. Sincerely, Michael J. Izzo Building&Fire Inspector /to D E C E N i= >R,��j> For office use onlv: BUILDIN�-�3EF�►RTMENT PEPmrr# MAY 1 1 2022 VILLAI✓OF RYE BROOK ISSUED: fU 'I_5-12� 9 8 KING STREE1t RYE BROOK,NEW YORK 10573 DATE: VILLAGE OF RYE BROOK (914)93$ ftk_021.ora a)939-5801 FEE: /DPA1D BUILDING DEPARTMENT 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 asgaars►sssrssrrresragpsassarassassasssstsrrsssrssssps►rrptsrutassrssrasrars»ssr►rsgaassaarrrrarrarastsrrs►aassraaa Address: 14 jk�"(fjL L ffi� C4Q , "OL Occupancy/Use: S Parcel ID#: 12- l -25 ( � I S g Zone: P �c7 Owner: SC 0 k- W,VOL PA rt Kk S LL, A _,ss (� �•UN ("TLt �f�{k/h(S P.E./R.A.or Contractor: 'KI�i �fC�ICLOp ((�T Address: thow Person in responsible charge: �IJ I L,I J AN e (&IKIL AddressUa 01Am Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issuance ofa Certificate of Occupancy/Certificate of Compliance for the structure/construction/alteration herein mentioned in accordance with law: STATE OF NEW YOM COUNTY OF WESTCHESTER as: y� �V( I�(,1�rn ►Z I being duly sworn,deposes and says that he/she resides at (Print Name of Applicant) (No.and Street) in ,in the County of t �L L� in the State of GT that (Cityrrown/Village) he/she has supervised the work at the location indicated above,and that the actual total cost of the work,including all site improvements,labor, materials,scaffolding,fixed equipment,professional fees,and including the monetary value of any materials and labor which may have been donated gratis was:S 09 3 a 9�0 - CA) for the construction or alteration of: 5 i r-N k 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 of Occupancy or Certificate of Compliance shall have been duly issued by the Building Inspector as per §250-1 O.A.of the Code of the Village of Rye Brook. Sworn to before me this 'Z�' `t�Z ��Sworn to before me this day of C>Oipt-)p y - , 20� day of 02Avte�_ , 20 . W (-k-A--_ ,-Ij W I.,— Signature of Pro ner Signature of Applicant W I (-L I Af'►'1 KY)C�RA w 6L-L I A W �-- Print Name of Property Owner Prin ame of Applicant 2�A ha, otary Public Notary Public TRISHA MARTINEZ TRISHA MAR INEZ NOTARY PUBLIC-STATE OF NEW YORK NOTARY PUBLIC-STATE OF NEW YORK No.01 MA6331843 No.01 MA6331843 Qualified in Dutchess County Qualified in Dutchess County My Commission Expires 10-19-2023 My Commission Expires 10-19-2023 �yE BRC��. BUILDING DEPARTMENT UILDING 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.aebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS: ' w � �'j 7-- Q�7- DATE: s Z S ZZ PERMIT# LE, C) ` Z']Z ISSUED: t 0 I!/2,oSECT:I Zc( , 7-`7 BLOCK: l LOT: LOCATION: NEW L�G�i-c� �A �--� T` RS OCCUPANCY: Z ❑ VIOLATION NOTED THE WORK IS... ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS a-- Z ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION FINAL OTHER QyE BRcb, �7 O 1982• BUILDING DEPARTMENT ❑BUILDING INSPECTOR Q"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 : \ Gl S G iS1 i G Y L::Cis ' DATE: 1 L4( I )— p PERMIT# 4 ISSUED: CT: BLOCK: LOT: LOCATION: J\ OCCUPANCY: --7 1 ❑ VIOLATION NOTED THE WORK IS... ❑" ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL OTHER 4yE[1RCbl. �� 9�2 BUILDING DEPARTMENT ❑BBUILDING INSPECTOR ,ASSISTANT'' BUILDING INSPECTOR VILLAGE OF RYE BROOK d 4 ❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAX (914) 939-5801 www.ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - -- - - - - - - - - - - - - ADDRESS: 1 y"�" DATE: , `�-z PERMIT* v� ISSUED: \�l$ 1`�ECT:1 q 2� BLOCK: LOT: LOCATION: OCCUPANCY: -l-k(j ❑ VIOLATION NOTED THE WORK IS... ❑' ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING q/INSULATION NATURAL GAS ` ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER QyE BRC��. 1932 BUILDING DEPARTMENT ❑BUILDING INSPECTOR ,`ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK '4r❑CODE ENFORCEMENT OFFICER 938 KING STREET - RYE BROOK,NY 10573 (914) 939-0668 FAX (914) 939-5801 www Uebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS: ' ` , DATE: (f)- 'ZCOZ 1016 PERMIT# ISSUED: SECT: BLOCK: LOT: LOCATION: V ` `�� l OCCUPANCY: L IV ❑ VIOLATION NOTED THE WORK IS... ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ ,UNDERGROUND PLUMBING NOTES ON INSPECTION: p ROUGH PLUMBING [� ROUGH FRAMING ❑ INSULATION NATURAL GAS p L.P. GAS ❑ FUEL TANK p FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL OTHER `` * O * as a! * * O c w * u , �- au * * cu •�•� * u 3 a * * OCIA W pG • v A 3 �- A r�lct M * � •� v � f� Z * ►� `� 04 * Cd * 4-Jcd * }.. Cd * v a O C * :z O D�d U � O O U 4-1 �yE BRC��. '9a2 BUILDING DEPARTMENT ❑BUILDING INSPECTOR SSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK /❑i CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www.Uebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS :— �1�� ,--�'�� DATE: PERMIT# - ISSUED: t r I IliCT: , BLOCK: LOT: LOCATION: O" ` ` ��-�� 1 �' �� OCCUPANCY: �� U ❑ VIOLATION NOTED THE WORK IS... vAcCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER �E BRC�k. BUILDING DEPARTMENT ❑BUILDING INSPECTOR glASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK I❑CODE ENFORCEMENT OFFICER 938 KING STREET - RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www ryebrook.or$ --- - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS: `�1 1 DATE: PERMIT# -C'- ISSUED: l�4 SECT:- t'-z�BLOCK: LOT: LOCATION: 'ZC) - 1-3 5 OCCUPANCY: i ❑ VIOLATION NOTED THE WORK IS... IE ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION / REQUIRED .a'FOOTING C�t�C �CeS� ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING - NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P.GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER QyE BRC�k• O� 2m 1982 BUILDING DEPARTMENT ❑BUILDING INSPECTOR SSISTANT 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 - - - - - - - - - - - - - - - - - - - - S `�v \ �1� DATE: \ -ADDRES PERMIT# - I � -ISSUED: f` L` ECT: �Z BLOCK:_LOT: " 1 LOCATION: 2 U cl OCCUPANCY: I ❑ VIOLATION NOTED THE WORK IS... ❑/ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ` t ❑ NATURAL GAS ISO ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL Ja' OTHER Ie BR 9� .y m� BUILDING DEPARTMENT ❑BUILDING INSPECTOR ` 60mTANT 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 � f��-�1� N`� �`t DATE: PERMIT* t"�"`' `^'� ISSUED: tU ECT: �"'� BLOCK: LOT: LOCATION: `� OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION r REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL OTHER �BR O� Zm 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 : `1 DATE: �VECT.---Iz � , �BLOCK: LOT: PERMIT# � ISSUED: LOCATION: , �, \ OCCUPANCY: Z,• ❑ VIOLATION NOTED THE WORK IS... ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL OTHER QyE BRC��• O� tim '982 BUILDING DEPARTMENT ❑BUUI/ILDING INSPECTOR .,.' SSISTANT 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 `1 `_ 1 N` DATE: "? 1 PERMIT,, ISSUED:% (311 2 SECT.\ �_1 -is BLOCK: LOT: I. I'K LOCATION: OCCUPANCY: Zl V ❑ VIOLATION NOTED THE WORK IS... AC PTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION Q ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL OTHER Q�E BRC��. 1932 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 ' ` _J DATE: !Z PERMIT# v tP ISSUED: i 4( CSACT: BLOCK: / LOT: /� S LOCATION: OCCUPANCY: I-, ❑ VIOLATION NOTED THE WORK IS... ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTIONRE UIRED Q ❑ FOOTING o ti. K �-'�'\:� ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER QyE BRC��. O� 2m 1982 BUILDING DEPARTMENT �rs-s!sl ING INSPECTOR ANT BUILDING INSPECTOR VILLAGE OFRYEBROOK ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : 1 ` J6 NQ DATE: ' 2� PERMIT# C�— �� ISSUED: SECT: BLOCK: LOT ' 1 CS LOCATION: OCCUPANCY: Z ❑ VIOLATION NOTED THE WORK IS... ACCEf TED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ,,,.G--UNDERGROUND PLUMBING (` TOTES ON INSPECTION: ❑ ROUGH PLUMBING r ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER BR 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 : Nl.: C � X l , 1 -2 ��5J DATE• PERMIT# v �v� ISSUED: JECT). BLOCK: ` LOT: LOCATION: , ��- OCCUPANCY: Zk) ❑ VIOLATION NOTED THE WORK IS... ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION /// REQUIRED ❑ FOOTING \ - r FOOTING DRAINAGE FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION {� ❑ NATURAL GAS -6� ❑ FUEL TANK 2- �, � � Jt15 4f f ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER k, oil BUILDING DEPARTMENT ❑BUILDING INSPECTOR la<SSISTANT 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 : 'Sill i N L(:-� C' DATE: ( VIZ rn Z�� � 6-'SECT: BLOCK: LOT: PERMIT# ` �C ISSUED• LOCATION: � � CT�1 OCCUPANCY: 7 y ❑ VIOLATION NOTED THE WORK IS... ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ,[_ FOUNDATION `U S '❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER ol� 19(32 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.or$ - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : \^ �9,56 6� C�+� DATE: PERMIT# 2Q--Z O20 ISSUED: lU� s�--'�CT: 12��BLOCK: LOT: L ' 5�-- LOCATION: l OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED /9,/ OOTING FoOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER fh O �O O\ Q, all n W) co a Q � � z = _ �; Q Z L Y ' p 00 W W ,��o,u V W � Z p V rzl 0 A ON � z QZ o� a w u .a U ` W w as m 4 x N� WFo ti U w o a (A C, � c W z u Q eC c c .. Z ow w W d = MENT BUILD.-G-M , VILL'Adk' RYE'BROOK 9381QNG,S TR E Bi1;ooK,NY 10573 DEC 3 0 2020 (914)939`06 Faf (91h)939-5801 vv�vYv ryebrook.ong ELECTRICAL PERAUT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY BP EP#: C�?/^ 003 Approval Date• J AN ' 4 2021 • Application Fee: $ Approval Signature: Permit Fee:$ 1 Disapproved: Other: (fees are non-refundable) Application dated, e� �( a O is 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 conformance with all applicable Federal,State,County and Local Codes. 1.Address: � <� �/�L SBL:� .�5 -�— I-�� —Zone:2 U D 2.Property Owner: SC Rye Brook Partners, LLC Address: 5 International Drive Suite 114 Rye Brook, NY 10573 Phone#: 914-Q1-1531 Cell#: email: Denis M. Fortino Address: PO Box 713 Rye, New York 10573 3.Master Electrician: Lic.#: E-51 Phone#: 914-760-5226 Cell#: 914-760-5226 email: dfortino@enterpdseelec.com Company Name: Enterprise Electrical Consulting Address: PO Box 713 Rye NY 10573 4.Proposed Electrical Work/Fixture Count: Ltd 2 rw l(- //,::!> STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: Denis M. Fortino being drily sworn,deposes and states that he/she is the applicant above named,and does further (print name of individual sigtiinge 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 Electrical Contractor for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor.agent,attorney,etc.) 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 t }h Sworn to before me this day �— day of 20 Signature of Property Owner $1 2t111 a of ApplieM D nis M. Fortino ��ttttlllltt/1����r�' Prin Name of Ap t ��•�� rG,, Print Name of Property Owner NOT' •.C' q Notary Public o cry Public = Roco�N/F oo sNei•O N�• 17-t7 M'4XP�Y 2o_7 `� Phone: 914-347-3595 Westchester Rockland Electrical Inspection Services, Inc. DO NOT WRITE HERE-FOR OFFICE USE ONLY 43 North Lawn Avenue Fax: 914-347-3596 Elmsford, NY 10523 I;.7 BUILDING PERMIT N0. 1 TEMP# DATE CITY OR VILLAGE /j ZIP CODE TOWNSHIP COUNTY STREET AND NO.OR ROAD J POLE NUMBER / BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? SECTION SL LOT OCCUPANT'S NAME BUILDING OCCUPANCY OWNERS NAME AND ADDRESS HOME TELEPHONE NUMBER t PAS 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 BASEMENT UL 2-FL. 3-FL. REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: V ✓ �-� rs .) 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 APPLICATIONS 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 NEW❑ ADDITIONAL❑ EXPOSED❑ CONCEALED❑ MUST ENTER APPLICANTS IDENTIFICATION NUMBER SERVICE ENTERS BUILDING OVERHEAD L7 UNDERGROUND AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACE MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. NAME OF COMPANY PATE OF APPLICATION SIGMA E O AP T / STREET ADORESB TELEPHONE NO. QR POST OFFICE ZIP CLOD LICENSE NO,WHEN APPLICABLE / WESTCHESTER ROCKLAND WRE 14)ELECTRICAL INSPECTION SERVICES,INC BY THIS CERTIFICATE OF COMPLIANCE THE Westchester Rockland Electrical Inspection Services 43 North Lawn Ave, Elmsford, NY 10523 914-347-3595 (Office) 1 914-347-3596 (Fax) CERTIFIES THAT Upon the application of: Upon premises owned by: Enterprise Electric Inc SC Rye Brook Partners LLC 3881 Danbury Road NY, Brewster 10509 Located at: 14 Jasmine Lane Rye Brook, NY 10573 Certificate Number: 1034368 Section: 129.25 Block: 1 Lot: 1.58 BDC: Permit#: EP:21-003-BP:20-202 A visual inspection of the electrical system at this premise described as a Residential occupancy,wherein the premises electrical system consisting of electrical devices and wiring,described below,located in/on the premises at: 14 Jasmine Lane Rye Brook,NY 10573 Basement 1st Floor 2nd Floor 3rd Floor Garage Attic Outside Other: Inspection was conducted in accordance with the NYS and NFPA 70-2017 International Electrical Code and detail of the installation,as set forth below,was found to be in compliance therewith on 05/09/22 Name Type Quantity Receptacle Convenience ------- 89 Switch Single Pole ------ 61 Fixture-Luminaire Incandescent ------ 23 Fixture-Luminaire Undercabinet ------ 3 Fixture LED ------ 68 Cook Top ------ 1 Dishwasher ------ 1 Exhaust Fan ------ 5 Clothes Dryer ------ 1 Furnace Gas or Oil ------ 2 Electric Room Heaters ------- 1 Dimmers Led ------- 22 Service Disconnect ------- 1 Continued on next page... This Certificate has been approved by Westchester Rockland Electrical Inspection Services. This certificate may not be altered in any way. IL-This certificate is valid for work performed before date of inspection only. WESTCHESTER ROCKLAND ELECTRICAL INSPECTION INEISSERVICES,INC. BY THIS CERTIFICATE OF COMPLIANCE THE Westchester Rockland Electrical Inspection Services 43 North Lawn Ave, Elmsford, NY 10523 914-347-3595 (Office) 1 914-347-3596 (Fax) CERTIFIES THAT Upon the application of: Upon premises owned by: Enterprise Electric Inc SC Rye Brook Partners LLC 3881 Danbury Road NY, Brewster 10509 Located at: 14 Jasmine Lane Rye Brook, NY 10573 Certificate Number: 1034368 Section: 129.25 Block: 1 Lot: 1.58 BDC: Permit#:EP:21-003-BP:20-202 A visual inspection of the electrical system at this premise described as a Residential occupancy,wherein the premises electrical system consisting of electrical devices and wiring,described below,located in/on the premises at: 14 Jasmine Lane Rye Brook,NY 10573 0 Basement 1 st Floor 12 2nd Floor 3rd Floor Garage Attic 0 Outside Other: Inspection was conducted in accordance with the NYS and NFPA 70-2017 International Electrical Code and detail of the installation,as set forth below,was found to be in compliance therewith on 05/09/22 Name Type Quantity Water Heater ------- 1 Cable Homeruns ------- 4 Phone Lines ------- 3 A/C Condenser ------- 2 Sump Pump ------- 1 Panel 225 amps 1 Panel 100 amps 1 Receptacle GFCI ------- 15 Smoke Detector ------- 4 Carbon Monoxide Detector ------- 4 Microwave ------- 1 Refrigerator ------- 2 Disposal ------- 1 Continued on next page... This Certificate has been approved by Westchester Rockland Electrical Inspection Services. This certificate may not be altered in any way. This certificate is valid for work performed before date of inspection only. i WESTCNESTER ROCKLAND ELECTRICAL INSPECTION SERVICES.INC. BY THIS CERTIFICATE OF COMPLIANCE THE Westchester Rockland Electrical Inspection Services 43 North Lawn Ave, Elmsford, NY 10523 914-347-3595 (Office) 1 914-347-3596 (Fax) CERTIFIES THAT Upon the application of: Upon premises owned by: Enterprise Electric Inc SC Rye Brook Partners LLC 3881 Danbury Road NY, Brewster 10509 Located at: 14 Jasmine Lane Rye Brook, NY 10573 Certificate Number: 1034368 Section: 129.25 Block: 1 Lot: 1.58 BDC: Permit#:EP:21-003-BP:20-202 A visual inspection of the electrical system at this premise described as a Residential occupancy,wherein the premises electrical system consisting of electrical devices and wiring,described below,located in/on the premises at: 14 Jasmine Lane Rye Brook,NY 10573 12 Basement 1st Floor 2nd Floor 3rd Floor Garage Attic Outside Other: Inspection was conducted in accordance with the NYS and NFPA 70-2017 International Electrical Code and detail of the installation,as set forth below,was found to be in compliance therewith on 05/09/22 Name Type Quantity This Certificate has been approved by Westchester Rockland Electrical Inspection Services. G ,L�This certificate may not be altered in any way. This certificate is valid for work performed before date of inspection only. g= i i 00 .r N •r, ' N 1! tn W , W Ln r i a n WLn a to M r" w 00 J w W c M y c% : O zLjr)Poo Z w W C `' a o A � fA o t `• s Ono CIN FBI V J MCI �c l t V a pCC N Z � , W �.✓ W as 04CA Cw7 o c O Z d w N < $ i �t v' x Q U z a C L , z w Z 4. < w z l a co �• �I as a a z as w = � a NOV -4 2011 BUIL r `, MENT VIL E bt kYE` 1OK VILLAGE OF RYE BROOK 938 KIN l RY1±B. ,NY 10573 BUILDING DEPARTMENT J*tea or ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required / Q FOR OFFICE USE ONLY BP#: -a oa- EP#: ! l 9 v Approval Date: 5 -2021 Permit Fee: $ C%: / Approval Signature: Other: Disapproved: (fees are non-refundable) Application dated, �7 a�� is 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 conformancewith all applicable Federal,State,County and Local Codes. 1.Address: 14 -TaS`� 11g4 tan.,ip SBL: /;?Q, 25-/,/ 80Zone: � 2.Property Owner: SG lr 4l 6aUk /- 4�f- Address: S /'? a_'A/ ro�'t a /�r, Phone#: 41 q(41 /S 31 Cell#: gI`/Z ltf Sba emaiV�'Chou P WC?rJQyl q�?JYp�C� 3.Master Electrician: �QN {�ZZ�to/L�e,/ Address:: `ro &iieam i C.Q;naclll w AA&x-, I Cell#: 9/�VD 3 Y16G email: 06I"1"' /L ,�2Cs� Company Name: �u> Address: �Y CQi'I�7r�y ht IAWI ? 4.Proposed Electrical Work/Fixture Count: LoW Ub STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: �M S &lfldcO tt being duly swom,deposes and states that he/she is the applicant above named,and does further (print name of individual signing 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 -{�eC' '"'C"N for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent.attorney,etc.) 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 1 ` day of 120 day of A/a/cM)xs ,209 Signature of Property Owner Signature pplicant 1 C'r►,r 5 'T_ Z � Print Name of Property Owner Print Name of Applicant Notary Public Public ALEXANDRA H.MARSHALL Notary Public,State of New York No.01FR6363711 Qualified in Westchester County Commission Expires August 28,20lli 8/12/2021 Phone: 914-347-3595 Westchester Rockland Electrical Inspection Services, Inc. DO NOT WRITE HERE-FOR OFFICE USE ONLY Fax: 914-347-3596 43 North Lawn Avenue Elmsford, NY 10523 ` B 77r- CITYTEMP# ---jDATE OR VILLAGE ZIP CODE TOWNSHIP COUNTY STREET AND OR ROAD POLE NUMBER BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? SECTION BLOCK LOT t, G y OCCUPANT'S NAME r BUILDING OCCUPANCY Cc OWNER'S NAME AND ADDRESS HOME TELEPHONE NUMB 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,R EACH NO. WATTS EACH INSPECTION OUTSIDE BASEMENT 1'FL. 2-FL 3'nFL. VILLA E OF R E BR© K REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: Hein 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 APPLICATIONS 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 NEW ADDITIONAL,-] EXPOSED❑ CONCEALED❑ MUST ENTER APPLICANTS IDENTIFICATION NUMBER SERVICE ENTERS BUILDING OVERHEAD U UNDERGROUND[] AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACE MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. HALE OF CONPANY DATE OF APPLICATION SIGNATURE OF APPLICANT STREET ADDRESS TELEPHONE t` x' l NO. 10 a3 L17-�-, CITY OR POST OFFICE aP LICENSE NO.WHEN APPUC#&J.E i WESTCHESTER ROCKLAND ELECTRICAL INSPECTION iNEIIISERVICES,INC. BY THIS CERTIFICATE OF COMPLIANCE THE Westchester Rockland Electrical Inspection Services 43 North Lawn Ave, Elmsford, NY 10523 914-347-3595 (Office) 1 914-347-3596 (Fax) CERTIFIES THAT Upon the application of: Upon premises owned by: Safe&Sound Home Services Corp SC Rye Brook Partners LLC PO Box 101 NY, Cornwall 12518 Located at: 14 Jasmine Lane Rye Brook, NY 10573 Certificate Number: 1034557 Section: 129.25 Block: 1 Lot: 1.58 BDC: Permit#:EP:21-283-BP:20-202 A visual inspection of the electrical system at this premise described as a Residential occupancy,wherein the premises electrical system consisting of electrical devices and wiring,described below,located in/on the premises at: 14 Jasmine Lane Rye Brook,NY 10573 Basement I5i 1st Floor 2nd Floor 3rd Floor Garage Attic Outside Other: Inspection was conducted in accordance with the NYS and NFPA 70-2017 International Electrical Code and detail of the installation,as set forth below,was found to be in compliance therewith on 05/06/22 Name Type Quantity Smoke Detector/Co2 Combo ------- 4 Smoke Detector ------- 3 Heat Detector ------- 1 This Certificate has been approved by Westchester Rockland Electrical Inspection Services. This certificate may not be altered in any way. � '7 A This certificate is valid for work performed before date of inspection only. C1 O I w " O N � W a ° a `n 00 wa 01, 66 a I > tl) ww 3 a w W C� Cy z Z U Q C C 3 c �, C Z w W � r••r � U Qcc O ONO 0-0 C7 r� Q o d C. � oil o` •• � a. w a 0. ,; oc cc -A , 13RQ ECENE BUILD�T//lG�DR^MENT JUN - 7 2021 VILLAI'OE OF2YE'BROOK I�D� SI�I 938 KING S E`f RYE BR01.K,NY 10573 VILLAGE OF RYE BROOK (914)9s9;0'68 ``(91A 939-5801 BUILDING DEPARTMENT wv�c�v eb ook.org PLUMBING PERMIT APPLICATION n FOR OFFICE USE ONLY BP#: ay J aOa PP# ? Approval Date: J UN 8 2021 Permit Fee: $ Approval Signature: VA Other: Disapproved (fees are non-refundable) Application dated, - 6';1/ is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install and/or remove Plumbing as per detailed statement described below.The applicant&property owner,by signing this document agree that said plumbing workwill be in conformance with all applicable Federal,State,County and Local Codes. 1.Address: I LA3am si Y\C I.UrG II sAlff 1 N t_)y\A*8-4 SBL: �o'� 05- / /•55 Zone: POD 2.Proposed Work:?10MD rA Cam r nCW S 1 VO YY%k d i t\I VM n jCV\fyL 6CaS-AS -ni- 3.Property Owner: Address: Phone#: Q 114-3bI a boo , G� � � �� Cell#: 1� - - 6 email: . bo i oftl 4.Master Plumber q 1 (asl(AlAddress: Lic.#: q K) —Phone#:f9tA - Cell#: n email: �n� W nfk?TC (st du Ovvl` Company Name:�Qb( y 4 UrY�7►\na �' Address:\OIq F-� M E 3 t'N 104 INDICATE FIXTURES&LINES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: Location Water Urinals Drinking Sinks Showers Bath Laundry Domestic Fire Sanitary Natural/ Other* Total Closets Fountains Tubs Tubs Service Service Sewer LP Gas Basement ' 1st Floor , r1 2nd Floor 3`d Floor 41 Floor 5 Floor Exterior 5.* List Other Equipment/Provide Details: (Notarized Signatures Required Next 2 Pages) -1- ��C•pe 3/21/19 STATE OF NEW YORI<,COUNTY OF WESTCBESTER ) as; b ,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 tftat(s)he is the legal owner of the property to which this application pertains,or that(s)he is the CO for the legal owner and is duly authorized to make and file this application. (indicate architect,contmetor,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 -3 t' _ Sworn to before me this 1, day of t4l Q ti 20.2 day of /� ,20 P Signatu f erty Owner Signatur of li&fit n L2'z� I ; Paul ,mot-&Y-a's It Print Name of Property Owner Print Name of Applicant Notary Public A Boyd Notary PubUt Public,Stets of N w York N0.01906166307 QMU4 in Watsheeter County Co=assion Exp}ras May 21,2M 0�3 This application must be properly completed( to its entirety and must include the the legal owner(s)of the subject property, and the applicant of record in the spaces provide([. Applications not properly completed in its entirety and/or not properly signed shall be(teemed null and void and will be returned to the applicant. WENDY J ABBA.GLIATO NOTARY PUBLIC-STATE OF NEW YORK No.01AB6378708 Qualified In Orange County MY Commission Expires 07-30-2022 -2- 321/19 a Lal H v=i 96 N 0 ~ ' ! J g ` in i W �..� 0000 M� 4 ;f 0 *; �S qu C6, co 96 z -, 3 9� =.- !- ! -E 3i = yam C ' r7 A LLI 0*4 ON y 00 f �+ w 'v r7 rn `. Ot -RTO W IL ° FFC/ 9 Ed � Os � d•y 6� E E � .Zr ai V Z W. = 4o as 0 > v i� B D d&AR MENT =2020 I VIL41" E OF RY OK 938 KING ET RYE BR , � ,NY 10573 (914)93g. 68 �9 39-5801 VILLAGE OF RYE 13ROOK �y y -it BUILDING DEPARTMENT APPLICATION TO INSTALL FIRE SUPPRESSION / FIRE SPRINKLER SYSTEM FOR OFFICE USE ONLY: OCT 1 5 2 Approval Date: I #: -doa MP#: / _Application Fee:$ 5 Approval Signature: Permit Nees:$pr^/O-2-62111 Disapproved: - -- Other: Application dated: is hereby made to the Building Inspector ofthe Village of Rye Brook NY liar the issuance ofa Permit to install a hire Suppression System as per detailed statement described below. I. Job Address: I A' Taann',ne_ .awe_ b)! Parcel I.D.: 1 oZCl.�S- - I.SR Y,one: F'UD 2. Proposed System(Describe system in detail including suppression agent): ��j� Q•.x,nkle.r 0.v,-tFem �-hmuatia�e-l- he�d�_._ 3. Number&Types of Fire Sprinkler Leads:F 4. NX State Construction Classification: 5B N.Y.State Use Classification:_P3 5. Cost of Installation:$ A34 S1b (Cost shall include all labor.materials.fixed equipment.professional 1i-es.and materials and labor which may be donated gratis.) G. Property Owner: �21'c__ 'L�roo 1C ps�r 3_hG>-�a. -----_.__Address:gQ Phonc# l 5l E11"1�.�-5�a1� Cell# email: Applicant: �z_� ,rF . atc�+ tier- - - Address: 1 5}fira1 Pu-'K- Puaer M'ac►le��cao,_CT. Phone# Cell#(Ma email: t ►,g mr�clez�mo+� �r e .sum Architect/Engincer: �.�/ . (k„\11\1ar\ E1nG%r�e.0 r-'b Address: 5D9 Mojn 3ttut- %Q1kr_.L� S�oaVor\�-i� ICY oa\aq-tto-+ Phone# (el��Jai- 8aa Cell# email:)F r wcv-., . �Qm General Contractor: � 2Q ����10`]Y1e�- ddress: 3 rY\rr rvr',ei\ D.venuL Pa,.-,%; N� 1d5�cF Phone# - t+bb Cell# email: 12.8.16 This application must be properly completed in its entirety and must include 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 WESTCl1ESTI:R ) as: 214b,%ejds !�[�d�ti ,being duly sworn,deposes and states that he/she is the applicant above named, (prin a rye 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 I• OdAL Girr— RLl,e. _Dn for the legal owner and is duly authorized to snake 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 confortnance 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 belbre the this Sworn to belbre the this Sur, day of , 20 day of_ 1 -- — - , 20 1 Signature of Property Owner Signature ol'Apphca1ntt 2. ..Uo � -V,, C_ — Print Name of Property Owner Print Name ol'Applicant Notary Public Notary Publi M1('14 ' `-L S►1_VA W COMMI JCT.31,2022 J_ 12.8.1 b PO ' � ��� �� � .�• � ago tn tn u v 1+ W u x L � bcv C � 7 �'1 Off ¢ OH CD W O 8IC, H c C x O w oea•- w o C F� A cn ►• ALn w (/�] 00 V w H Ln b Cp G C O f A v w w w co ON ten o w 1.0.00 E V r Z w o � o ` er a v G- � CO W C% cC M E ' j ►�j V �D A E- 0 Id W v H CA E = ram• OZ c. W I* t off " O F W _ p ►� z z A o < O W z pq � a � • o .o _ j j u 4 WE D . BUILD TMENT R [E C IE VIL OF RY ooK NOV -4 2021 938 KING ET RYE BR [ ,NY 10573 4 - ��Y VILLAGE OF RYE BROOK BUILDING DEPARTMENT APPLICATION FOR PERMIT TO INSTALL AND/OR REMOVE HEATING, VENTILATION AND/OR AIR CONDITIONING EQUIPMENT FOR OFFICE IJSE ONLY: PERMIT#: l/ p — � (0q Approval Date: f4 0 y Permit Fee: $ "��� Approval Signature: Other: Disapproved: (fees are non-refundable) REQUIREMENTS FOR RELEASE OF PERMIT&CERTIFICATE OF COMPLIANCE: 1. Properly completed& Signed Application. 2. Site/Staging Plan if Required by the Building Inspector. 3. Copy of Licensed Contractor's Liability Insurance. (Village of Rye Brook must be listed as certificate holder)& Workers Compensation Insurance on a NYS Board form(Form#C 105.2 or Form#U26.3/or NY State Workers Compensation Waiver) 4. Payment of Fees/Unit: RESIDENTIAL= $100.00/unit• COMMERCIAL = $350.00/unit. 5. Inspection by the Building Department for removal and/or installation. (48 hour notice required 6. Electrical work requires a separate Electrical Permit&Electrical Inspection. 7. Plumbing/Gas work requires a separate Plumbing Permit& Plumbing Inspection. Application dated, is hereby made to the Building Inspector of the Village of Rye Brook for a permit for the installation and or removal of the HVAC equipment as listed below.The applicant and property owner,by signing this document agrees that said equipment will be installed and/or removed in conformance with all applicable Local,County,State&Federal laws, codes,rules and regulations. / 1. Address: H A C SBL:AQ 4or:_ 4 0 2. Property Owner: S C Q Vr R r 0 .4 Address: Phone#: Cell#: email: 3. Contractor: T 1 << e 4,J Address: n I&A 3 S °I Id d L w AA 1.2(1 j �1 Phone#: Cell#: email: ✓tt 4. Applicant: k[ti,%e t -o Address: Phone#: a d 3 • S S f' Q 12 3 Cell#: email: 5. Scope of Work:New Installation 01•Replacement( )•Removal( )))•Other( ): 6. List Equipment: �.r✓t a.tc C Q it)e a ?• 7. Location of Equipment: - 8. Method of Installation/Removal(list all equipment needed to perform job): �,I/ d/I &r- mac. Qn4 1,4,1t, e41n 1 8/12/2021 STATE F NEWJORK.COUNTY OF WESTCHESTER ) as: I �.n A",, u ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of Mividual signing as the applicant) and states that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the o J t [ Cj�,jr �_ 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. rah. Sworn to before me this Sworn to before me this i► v 3 day of ,20 day of N D f ,20 a t_1 Signature of Property Owner Signa f Applicant Print Name of Property Owner Name offApplicant 9 TRISHA MARTINEZ Notary Public NOTARY PUBLIC-STATE OF NEW YORK ZNotary Public No.01 MA6331843 Qualified in Dutchess County My Commission Expires 10-19-2023 This application must be properly completed in its entirety and must include 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. 2 8/12/2021 N9MSE Product Specifications HEATING& COOLING PRODUCTS Up to 96% AFUE, Single Stage, PSC Gas Furnace EASIER TO SELL • Up to 961.AFUE in upflow and horizontal positions -- Up to 95%AFUE in downfow positions • Cabinet air leakage less than 2.0%at 1.0 in W.0 and cabinet air leakage less than 1.41. at 0.5 in. W C when tested in accordance with ASHRAE standard 193 • Approved for Twinning applications (0601410 through 1202420) with accessory (order separately) • Approved for Manufactured Housing/Mobile Home applications (0401410 through 1202420) with accessory (order separately) • Low NOx units are designed for California installations and meet 40 ng/J NOx emissions. Can be installed in air quality management districts with a 40 ng/J NOx emissions requirement. TOUGHER • Flame roll-out sensors standard • Adjustable heating blower OFF delay • Factory set blower ON delay • RPJ' primary heat exchanger • Stainless steel secondary heat exchanger Illustratwns and photographs are only representative. • High temperature limit control prevents overheating Some product models may vary. • Direct ignition with Silicon Nitride ignitor • High quality, corrosion-resistant, prepainted steel cabinet WARNING EASIER TO INSTALL AND SERVICE • Direct vent (2--pipe), single-pipe venting or ventilated combustion Failure to follow this warning could result in personal injury, air death,and/or property damage. • 24 VAC humidifier terminal&electronic air cleaner terminal This furnace is not designed for use in recreation vehicles or • 35"(889mm) high.for ease of installation outdoors. This furnace is designed for use in manufactured • Simplified,factory installed internal Condensate drain system (Mobile)homes when an optional Mobile Home accessory kit is • Innovative knobs for easydoor removal and secure installed. Failure to follow this warning could result in personal injury, attachment death,and/or property damage. • Factory shipped for natural gas, with propane gas conversion kits available of s I s t • Four position- upflow/downflow/horizontal (left/right) installation • At least twelve different venting configurations ENERGUIDE • Through the casing flue pipe for counterflow or horizontal applications with accessory (order separately) "••rr'"r'""'°a"r"""I • Concentric vent available THIS MODEL • Self diagnostics with super bright LED L� • Slide out heat exchanger and blower assembly —�—� LIMITED WARRANTY * »•• 82% ITd 97% • 20 heat exchanger limited warranty • 5 year parts limited warranty - With timely registration, an additional 5 year parts limited , CERTIFIED warranty * For residential applications only. See warranty certificate for complete details and restrictions, including warranty coverage for Ua .1 rn•AHRI C "ed TM Mark indxmw it other applications. ��� �a `ate�la de ate,;: go to. ahndveclory erg Efficiency AFUE Cooling Capacity Input CFM range Dimensions H x W x D Shipping Wt. Model Number (MBTUH) Upflow/Hz Downflow Q.5 In.w.c.(125 Pa) Inches(Millimeters) Lbs(Kg) 9 0261408 40,000 96.0% 95.0 40 x 14 /1 x -1/2(889 x 361 x 75 120(54) N9 SE0401410 40.000 96.0% 95.0 625-905 35 x 14 1 x 29-1 2 889 x 361 x ) 123(55) N9 S O40171 40.000 96.0% 95.0% 650-1050 35 x 1 -1 x 29-1/2 889 x 445 x 750) 1 4(61) N9MSE0601410A 60,000 95.5% 95.0% 6 5-1130 35 x 14-3/16 x 29-1/2(889 x 361 x 750) 127(57 N9 SE0601714A 60.000 96.0% 95.0 650-14 0 35 x 1 -1 x -1 x 445 x 144 65 N9 0801716 80.000 96.0 95.0 810 1600 35 x 1 2 x 1/2(889 x 445 x 750) 154(69) N9 802120A 80.000 96.0% 95.0% 1335-1970 35 x 21 x -1 (889 x 533 x 750) 162(73) N9MSE 1002114 100, 000 .0 95.0% 915-1545 35 x 21 x 29-1 889 x 533 x 750 169(76 N9MSE1002120A 100,000 96.0 95.0 134 -2065 3 x 1 x -1 x 3 x 750) 169(76) 9 S 1202420 120.o00 1 96.0% 95. 1320- 10 x 4-1/2 x -1/ (889 x 622 x 7 ) 186(84) N9MSE1402420A 140.000 1 96.0% 94.4% 1 1290-2035 x 24-1 x 29-1/2 889 x 622 x 750) 190(86 G....:fi..A:..ee e.e•.A:e'1 In nAenne..rl,nl nnNe A A^ 4 4 A A^n ^C 4 n 11314 O NXA6 Performance Series HEATING& COOLING PRODUCTS Product Specifications HIGH EFFICIENCY 16 SEER AIR CONDITIONER ENVIRONMENTALLY BALANCED R-410A REFRIGERANT 1112 THRU 5 TONS SPLIT SYSTEM 208 / 230 Volt, 1-phase, 60 Hz ,.. REFRIGERATION CIRCUIT • Scroll compressors on select models • Filter-Drier supplied with every unit for field Installation • Copper tube/aluminum fin coil EASY TO INSTALL AND SERVICE • Easy Access service valves on all models • External high and low refrigerant service ports • Only two screws to access control panel • Factory charged with R-410A refrigerant BUILT TO LAST • Baked-on powder coat finish over galvanized steel • Post-painted (black) coil fins • Coated. weather-resistant cabinet screws • Coated inlet grille with 3/8" (10mm) spacing for extra protection LIMITED WARRANTY* r, Ths vo*,d has been deagned and "'B<*�•d to inset ENERGY STAR artena for en W energr"*Mien • 5 year compressor limited warranty matched wrth appropriate coil oyrVorarts However, pope*ren,gerant dtarge and p W ar eow we orbcal to arhwF axed ceps ty and effogn y. ing"labon of • year parts limited warranty (including compressor and this prodil sOa d foac*M Moe rnanufacteWs rengeran, COII) j r .• powcrwq c rw err 11ory i,may ever to oontrm pope, dwrge and eaflow may redce energy e4haency -With timely registration, an additional 5 year parts limited and shtrten ewipment He warranty (including compressor and coil) * For owner occupied, residential applications only. See CERTIFIEDRio warranty certificate for complete details and U U� US restrictions, including warranty for other applications. LISTED Use of the AHRI Certified TM Mark indcates a ^Nanutacturer g participation in the program.For verb Cdt:on of CeRification for^�'ViC:.at plOduflg. a^tc vaww ahrduectory.org Model Size Nominal Min. Circuit Max. Fuse Operating Dimensions Ship I Operating Number (tons) BTU/hr Ampacity or Breaker height x width x depth in. (mm) Weight lbs.(kg) NXA618GKA 1': 18,000 11 8 20 28-11/16 x 25-3/4 x 25-3/4 154/ 125 (729 x 654 x 654) (70;57) NXA624GKA 2 24,000 17.7 30 28-5/16 x 31-316 x 31-3/16 147/ 183 (719 x 792 x 792) (83/67) NXA630GKA 2':; 30,000 16.8 25 T 32-5/16 x 31-3/16 x 31-3/16 188/ 153 (821 x 792 x 792) (85/69) NXA636GKB 3 36,000 17.5 30 28-5;16 x 35 x 35 204/ 165 (719 x 889 x 889) (93/75) NXA642GKA 31,� 42,000 23.6 40 39-1/8 x 35 x 35 254/213 (994 x 889 x 889) (115/96) NXA648GKA 4 48,000 26.1 40 39-1/8 x 35 x 35 317/264 (994 x 889 x 889) (144/ 120) NXA660GKB 5 60,000 32.4 50 45-11 r16 x 35 x 35 318/280 (1161 x 889 x 889) (144/ 127) Speaficat,ons sugect io change w^thout notice 421 11 6201 05 5/17/19 D [ECEdWE Chester AUG 13 2021 .ID _ o`:corn VILLAGE OF RYE BROOK BUILDING DEPARTMENT George Latimer Count-,,Executive �hcrlita.lmhr,Jli) Cunuui-sinner�d.H'alth August 2, 2021 Russell Palucci, P.E. 140 Princeton Drive Shelton, CT 06484 RE: Log #: 13338-21-DCDA Application for Backflow Prevention Device Kingfield Development 14 Jasmine Lane Rye Brook Dear Mr. Palucci: The plans and specifications for the above project have been reviewed and approved by this office pursuant to the provisions of Chapter 873, Article VII, Section 873.707.1 of the Laws of Westchester and Section 5-1.31, Subpart 5-1, of Part 5 of the New York State Sanitary Code. A Certificate of Approval is attached. Form NYSDOH-1013 is to be utilized as a Request for Completed Works Approval. This form can be downloaded from the following link: https://health.westchestergov.com/images/s!pries/pdfs/crossconnection doh1013.pdf .. NYSDOH- 1013 consists of two parts: (A) the initial test of the device(s) by a certified Backflow prevention device tester, and (B) a certification by a Professional Engineer or Registered Architect, licensed and registered in the State of New York that installation is in accordance with the approved plans. The completed NYSDOH-1013 must be sent to our Department within 45 days of installation of the device(s). This form can be emailed to DOH-BFlow(-westchestergov.com . Respectfully, Delroy Taylor, P. Assistant Commissioner Bureau of Environmental Quality DT/RB:pm cc: Jeff Dubois — SC Rye Brook Partners, LLC Frank McGlynn, Manager— Suez Water Michael Izzo, Bldg. Insp. — Rye Brook ,,/ File ,, y t'a iw-d.'vLt RE SE RE CLE Department of Health 25 DG,ore ,1 'enut Mount Kisco. NY 105 19 T(IIephone: (91 1)SG I-i_"11i F>u: (91 1 i S 13-101)1 NEW YORK STATE DEPARTMENT OF HEALTH CERTIFICATE OF APPROVAL FOR BACKFLOW PREVENTION DEVICES This approval is issued under the provisions of 10 NYCRR, Part 5, Section 5-1.31, and Chapter 873, Article VII, Section 873.707.1 of the Laws of Westchester County. Log No. 13338-21-DCDA Facility: Kingfield Development City, Village, Town: County: 14 Jasmine Lane Rye Brook WESTCHESTER Owner's Mailing Address: Jeff Dubois SC Rye Brook Partners LLC 4 West Red Oak Lane-Suite 325 White Plains, NY 10604 Physical Location of Backflow Prevention Device(s): Dog House Description of Device(s): One 1)—2 inch Wilkins 950XLTDABF DCDA) Water Supplier: Suez Water Name Designated Representative: Frank McGlynn. Mailing Address: Zip: 10801 2525 Palmer Avenue, Suite 3, New Rochelle, NY Conditions of Approval: A. THAT the device(s) shall be installed within 90 days, and that within 45 days of installation the attached New York State Department of Health Form DOH-1013 shall be completed and returned to the water supplier and the Westchester bounty Department of Health. fl TI A .1:r:_J L_� 1 1:�.- J�..:�_ 1_�1__1_�11L� I-. I.rl�... L: D. I /1 cl l:eIIIIICU Uackflow prevention I device tester lest llle above back"Ilow prevellllon device(s) at least yearly and report the results to the water purveyor indicated above. C. THAT any connection made prior to the backflow prevention device(s) shall render this approval void. D. THAT the proposed works be constructed in conformance with plans and specifications approved this day and any amendments thereto. E. THAT certification that installation of device(s) is in accordance with the approved plans, Form NYSDOH-1013, Part B, must be completed by a Professional Engineer or megistered Architect, licensed and registered in the Mate or New York. F. THAT the approved device(s) shall be so set that the test cocks are faced for easy access. G. THAT if facility construction has not commenced within 90 days of the issuance of this Certificate of Approval, then this Certificate shall become null and void unless an extension to the 90 day installation period is secured from the Westchester County Department of Health by the facility owner. Designated Representative ISSUED FOR THE STATE COMMISSIONER OF HEALTH BY: DATE: August 2, 2021 Delroy Taylor, P.E. Assistant Commissioner New vORtt 3TAT6 004MENT OF WALT" Bu�uz7oke t w2Mm l-crmr,, aroeq Report on Test and Maintenance ' erPwa Stave�ti•J-carMc,g i n.s•Law t,to Of Backflow► Prevention Device Please use 9 separate form for each device. For the year zj C. EL Initial Orr. _.-+^�•�O.'K�1^h^-� 1 'O I 0 PwbRs 1Yarr tivooly � SacC- Block U4 { FaciliryName_ ,IxcOavi„a —E :.�catian>F Address 1LA,--67Sitti,tom LCam, �1'�r Tcic f`L� 11jl sr..t CRYDeere Msntffidurer Tyve 0 Ifrtortnafiah Sae Cn inches) Serial Number W Ik,nS my 9f.D XL— C`7�7p C[reetc Vahre No.1 Check Valwe Mo.2 6m--ni et Prpwem Raw Urn Prwun VaMa Test ir ked LeakWarm, ed M Dale Opened poser!gone�_ p �� 5 l�3 3 f PTSISUre amp aanss first chedr waive p i-IJA M D Y OnQitie d Repaired by ellearltais No. Heed 1.1/Ae Lie# �tol Koo, �!14 Dote repaired: F7mm M 0 Y Floated 77 cased%m Opened m w+id b 5 O 3 3 Preemt-dropwnm tir�t ah M 0 Y edt valve_I.5 paid a O m)A V*ft J Aster Number Mtn Rea ft Type or Service:(check one) 9 Dorrteatic 9 Fie 9 Olher Remarks(Dowft dstdendae:bypetm,aumala lido,tpa deyloq ,,nad M behaeen We dawk a erd Print(d entry.mleaft or iradegwale akyaps,etc.) Cerdficarfani This device meets, doss NOT meet,the requirernertta of an a deice at ft time of Mratp r hereby�y Cm 11ons�ohg data to be corner. J11/V-tF\ar I.l.tt c 1 �_- p Pate npaa Carted Teeter Na mown Property owawre oravmew aq-#)ow#ficatian VW trot Mess pvf mot GZA-f - +(''�s�l t Rkel( 2L, S6S d Pnnt"" Tlrye Telephone cardfieation that lnatatMtion Is In a0mordance% t the approved planm fro be eentPMi by the design wbgbvear or aoAtlaot or water taPPear) l baby—My Swt"ft men ie in s«mrdonce with the approved parts; Name Russell Palucci Tme Engineer txt. rv>•t3 DOH Lap# Ucwnw Number 78721-1EPhone(U5)337-6040 m d ;c�S— 1_ -D + f, Y Repraeentlny me 0 ens, U ing, ne Describe n"m walelle6on changes Address 140 PrinCetCn Drive city Shelton she CT zp 06484 SignsWre NamV ewmr elk p arppl/ar mmadlstely if device fame Uip amend,pelt!�aanr�ial fmmadfagly ej in Via Uffira uwm-a 0pt4- �o ta(erari 14 Jasmine Lane Rye Brook NY 2015 IECC Energy Efficiency Certificate Insulation Rating R-Value Above-Grade Wall 19.00 Below-Grade Wall 14.00 Floor 30.00 Ceiling / Roof 38.00 Ductwork (unconditioned spaces): R8 Glass&Door Rating U-Factor 3HGC Window 0.29 0.30 Door 0.30 0.30 CoolingHeating& Heating System: Heil#N9MSE1oo212oA 95.5% Cooling System: Heil 4 Ton#NXa648GKA 16 SEER Water Heater: Model VSCE32 119R 119 Gallon Electric Name: Jobe Leonard Date: 5/12i2022 Comments Envelope Leakage Test Testing Company: Technician: Name: ProChek Name: Frank laconetti Address: 100 Mill Plain Rd Credentials: BPI Danbury, CT 06811 Email: info@prochek.com Phone: 800-338-5050 www.prochek.com Building Information: Customer Information: Project ID: 2989-14 Jasmine Ln Rye Brook NY Name: Address: 14 Jasmine Ln Address: 14 Jasmine Ln Rye Brook, New York 10573 Rye Brook, New York 10573 Geo-Tag Data: Latitude: 41.048862 Longitude: -73.693701 Timestamp: 2022-05-11 08:54:56 Measured Leakage: 2.11 ACH50 Leakage Target: 3.00 ACH50 Compliance with Leakage Target: Pass Test ID: 2989-14 Jasmin Ln Rye Brook NY Purpose of Test: IECC 12/15 Env. Leakage Measured CFM50: 1,249.2 (+/- 2.3%) Effective Leakage Area: 67.8 in Building Volume: 35,600.0 ft3 Enclosure Surface Area: 4,044.0 ft2 Coefficient (C): 96.4 (+/- 15.7%) Exponent (n): 0.655 (+/- 0.044) Correlation Coefficient: 0.99779 Test Standard: ASTM E779 (single mode) Test Mode: Depressurize Test Characteristics: Pre Indoor Temp: 64 °F Post Indoor Temp: 64 °F Pre Outdoor Temp: 61 °F Post Outdoor Temp: 61 °F Altitude: 188.0 ft Time Average Period: 30 seconds Test Date and Time: 2022-05-11 09:00:10 2000 Depressurize — E a 1800 Y 700 v 600 a 500 c -0 400 5 m 300 200 4 5 6 7 8 910 20 30 40 50 60 70 Building Pressure(Pa) Envelope Leakage Test Test Readings: Target (Pa) Bldg_(Pa). Adj Bldg_(Pa). Fan (Pa). Flow (cfm). Config Baseline -0.2 -60.0 -58.3 -57.2 -57.5 1,370.3 Ring A -54.0 -55.9 -54.8 -51.7 1,301.4 Ring A -48.0 -50.7 -49.6 -49.4 1,273.3 Ring A -42.0 -42.8 -41.7 -39.2 1,137.0 Ring A -36.0 -40.3 -39.2 -35.4 1,080.9 Ring A -30.0 -34.0 -32.9 -27.3 953.2 Ring A -24.0 -21.2 -20.1 -127.8 671.0 Ring B -18.0 -18.2 -17.1 -114.4 635.1 Ring B Baseline -2.0 Test Equipment: Flow Device: Model 3 110V Fan Pressure Gauge: DG1000 Serial #: 6006 Calibration Date: 2020-07-01 Deviations from Standard: • The interval between building pressures is greater than 10 Pa. Comments: None Report by TEC Auto Test 1.8.0 (206), © 2021 The Energy Conservatory, Inc. Page 2 of 2 Building Permit Check List&Zoning Analysis Address: l _ AS A I&Z7— SBL Zone:, Use: Z l Const.Type: 3 er. Submittal Date: --p Lz,-7 Revisions Submittal Dates: O ZZ_' Applicant: �1� 1 Nature of Work: r ►J' LPc `--i Reviews:ZBA: 0 C T 1 PB: BOT: Other. OK D ODO ( ( ) FEES:Filing. 7ST BP: -= , i o S, 3 1 2 C/O: ( ) (..YAPP: Dated Notarized:3'SBL: --Truss I.D. --Cross Connection: ✓ H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening. ( ) ( ) ENVIRO:Long. Short: Fees: N/A: ( ) ( ) SITE PLAN:Topo: Site Protection S/W Mgmt.: Tree Plan: Other. ( ) ( ) SURVEY.Dated: Current: Archival• Sealed: Unacceptable: ( ) (%.Y PLANS:Date Stamped Sealed. Copies: -2- Electronic: Other. License: Workers Comp: Liability: �mp.Waiver Other. ( ) ( ) CODE 753#: Dated N/A: (� ( ) HIGH-VOLTAGE ELECTRICAL.Plans: Permit N/A: Other. ( � ( ) LOW-VOLTAGE ELECTRICAL:Plans: Permit: N/A: Other. FIRE ALARM/SMOKE DETECTORS:Plans: Permit: H.W.I.C.:_Battery:_Other. PLUMBING Plans: Permit Nat.Gas: LP Gas: N/A/: Other. (�( ) FIRE SUPPRESSION:Plans: Permit: N/A: Other. (� ( ) H.V.A.C.: Plans: Permit: N/A Other. ( ) ( ) FUEL TANK:Plans: Permit Fuel Type: Other. ( ) ( ) 20I7 NY State ECCC: N/A: Other. Final Survey Final Topo: RA/PE Sign-off Letter. As-Built Plans: Other. ( ) ( ) BP DENIAL LETTER: C/O DENIAL LETTER: Other. ( ) ( ) Other. ( )ARB mtg.date: approval notes: ( )ZBA mtg.date: approval notes: ( )PB mtg.date: approval: notes: p R V F n REQUIRED EXISTING PROPOSED NOTES Date: O C T 1 5 1010 Area: Cir e: Fr n Front Front Sides: Main Cov Accs.Cov FL H Sb: Sd.H Sb: Tor-Imp: EL IMP: Paz ' Hdght/Stories: notes: Residential Building Permit Fee Work Sheet Permit#: Date Issued SBL: Zone: Address: I t'� J k n � Property Owner&Contact Info: Job Description: For all new dwellings and for additions measuring 800 sq. ft. or more made to existing dwellings, the following fee schedule shall apply: (plus any alteration fees) Total Sq. Ft. (excluding basements) x $225.00 x $I 5.00/$I,000.00 Basement Sq. Ft. x $65.00 x $I5.00/$I,000.00 -------------------------------------------------------------------------------------------------------------------- New Construction Sq.Ft. • New Construction Cost • Building Permit Fee Basement (c sq. ft. x $65.00 = $ S l , 7Y0. z$I5.00/$I,000.00= $ 17 1 i # I"Fl. = l sq. ft. x $225.00 =$ x$I5.00/$I,000.00= $ G J Z • �� 2°d Fl. = t G' S sq.ft. x $225.00 =$ 3'7 , 6 ZS, x$I5.00/$1,000.00= $ Attic = _)"0" sq. ft. x $225.00 = $ x$I5.00/$I,000.00= $+ Total Sq.Ft. = 94 SO sq.ft. Total Cost= $ Total B.P.Fee= $ 1 31 1-0J •3 6 °Includes Attached Garage if Applicable. Total Amount Paid = $ Total Amount Due= $ 34 1 D , OCT 1 5 1010 Date: Signed: This form must be properly completed &notarized by the Design Professional of record and the Property Owner. Failure to provide this completed form with your permit application will delay the permitting process. Notice of Utilization of Truss Type, Pre-Engineered Wood, or Timber Frame Construction. Title 19 Part 1264 & 1265 NYCRR To: The Building Inspector of the Village of Rye Brook. From: 13�� ;SN,c�L— �°o�nTS/t.tit � l�N R2L'NI�GC+72�l1L SubjectPropertx: HJ054-rIY1e LOIYe— SBLAA.oZ+J,55 one: RAO Please take notice that the subject; ❑ One or Two Family; ❑ Commercial, YNew Structure ❑ Addition to an Existing Structure ❑ Rehabilitation to an Existing Structure to be constructed or performed at the subject property will utilize; E5 Truss Type Construction(TT) dPre-Engineered Wood Construction(PW) ❑ Timber Construction (TC) in the following location(s); ❑ Floor Framing, including Girders & Beams (F) ❑ Roof Framing(R) [YFloor Framing and Roof Framing (FR) Please note that prior to the issuance of the Certificate of Occupancy,the subject dwelling or building utilizing truss type, pre-engineered wood,or timber construction must be posted with a Truss Identification Sign, installed in conformance with NYCRR§1264 for Commercial Buildings, and NYCRR§iz65 for One&Two Family Dwellings. Date D roressional Z = Date P -rl w r �lag �ao�0 Date Public (7) TRISHA MARTINEZ NOTARY PUBLIC-STATE OF NEW YORK No.01 MA6331843 Qualified in Dutchess County My Commission Expires 10-19-2023 �, CERTIFICATE OF LIABILITY INSURANCE DATE(MM'DD/YYYV, `� oaroe zozo THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S). AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:It the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this 61 certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 'E PRODUCER NAME v � Aon Risk Services Northeast, Inc. PHONE ACT 2a3-7122 Boston MA office AC No Eat): ( No,): (800) 363-0105 53 State Street EMAIL — Suite 2201 ADDRESS: Boston MA 02109 USA INSURER(S)AFFORDING COVERAGE NAIL a INSURED INSURER A: Navigators Insurance Co 42307 SC Rye Brook Partners, LLC INSURERS: Guideone National Insurance Company 14167 230 Park Ave. New York NY 10169 USA INSURER Starr Indemnity & Liability company 38318 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570082993250 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested AM NOR POLICY EXP LTR TYPE OF INSURANCE INS WVD SUORI POLICY NUMBER MM-DOrYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE SS,000,000 CLAIMS-MADE F1 I OCCUR PREMI ES ENTER S1001000 MED EXP(Any one person) EXCl uded PERSONAL&ADV INJURY S5,000.000 GENT AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE s5,000,000 F) POLICY Q PET a LOC PRODUCTS-COMP/OP AGG S 5,000,000 ro OTHER 8 n AUTOMOBILE LIABILITY COMBINED SINGLE LIMB accodlenti ANY AUTO BODILY INJURY(Per person) O Z SCHEDULED OWNED AUTOS IWURY(Per Ilatident) dI AUTOS ONLY HIRED AUTOS NON-OWNED A U ONLY AUTOS ONLYLY PROPERTY DAMAGE Per accident — 61 c 1000579693201 06/3 02011 0112021 EACH OCCURRENCE C) U&BRELLA LIAR OCCUR X EXCESS LIAR CLAIMS-MADE AGGREGATE S5,000.000 DED RETENTION WORKERS COMPENSATION AND PER STATUTE I OTH• EMPLOYERS'LIABILITY YIN ER —ANY PROPRIETOR I PARTNER EXECUTIVE E.L.EACH ACCIDENT OFFICERAry AEMBER EXCLUDED' N t A --_ tMMtdeb in NN) E.L.DISEASE-EA EMPLOYEE If yes oesaNbe under -- DESCRIPTION OF OPERATONS beiuw E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS)LOCATIONS;VEHICLES(ACORD 101.Additional Remarks Schedule.may be attached If more space Is required) rJ �~y CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. village of Rye Brook AUTHORIZED REPRESENTATIVE 938 King Street Rye Brook NY 10573 USA ^N � � c/,I("/ - .Jai _=Be OO 1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016 03) The ACORD name and logo are registered marks of ACORD Certificate of Attestation of Exemption from New York State Workers' Compensation and/or Disability and Paid Family Leave Benefits Insurance Coverage **This form cannot be used to waive the workers'compensation rights or obligations of any party.** The applicant may use this Certificate of Attestation of Exemption ONLY to show a government entity that New York State specific workers'compensation and/or disability and paid family leave benefits insurance is not required. The applicant may NOT use this form to show another business or that business's insurance carrier that such insurance is not required. Please provide this form to the government entity from which you are requesting a permit,license or contract. This Certificate will not be accepted by government officials one year after the date printed on the form. In the Application of Business Alplying For: (Legal Entity Name and Address): Building ermit SC Rye Brook Partner,LLC From:The Village of Rye Brook NY 1100 King St Ste 114 Rye Brook,NY 10573-1057 PHONE:914481-1531 FEIN:XXXXX6509 The location of where work will be performed is 110 King Street,Rye Brook,NY 10573. Estimated dates necessary to complete work associated with the building permit are from March 17,2020 to March 16,2021. The estimated dollar amount of project is over$100,000 Workers'Compensation Exemption Statement: The above named business is certifying that it is NOT REQUIRED TO OBTAIN NEW YORK STATE SPECIFIC WORKERS'COMPENSATION INSURANCE COVERAGE for the following reason: The business is a LLC,LLP,PLLP or a RLLP;OR is a partnership under the laws of New York State and is not a corporation. Other than the partners or members,there are no employees,day labor,leased employees,borrowed employees,part-time employees,unpaid volunteers(including family members)or subcontractors. Partners/Members: Robert Dale Disability and Paid Family Leave Benefits Exemption Statement: The above named business is certifying that it is NOT REQUIRED TO OBTAIN NEW YORK STATE STATUTORY DISABILITY AND PAID FAMILY LEAVE BENEFITS INSURANCE COVERAGE for the following reason: The business MUST be either: 1) owned by one individual; OR 2) is a partnership(including LLC,LLP,PLLP,RLLP,or LP)under the laws of New York State and is not a corporation; OR 3) is a one or two person owned corporation,with those individuals owning all of the stock and holding all offices of the corporation(in a two person owned corporation each individual must be an officer and own at least one share of stock); OR 4) is a business with no NYS location. In addition,the business does not require disability and paid family leave benefits coverage at this time since it has not employed one or more individuals on at least 30 days in any calendar year in New York State. (Independent contractors are not considered to be employees under the Disability and Paid Family Leave Benefits Law.) I,Janice Heusser,am the Office Assistant with the above-named legal entity. I affirm that due to my position with the above-named business I have the knowledge,information and authority to make this Certificate of Attestation of Exemption. I hereby affirm that the statements made herein are true,that I have not made any materially false statements and I make this Certificate of Attestation of Exemption under the penalties of perjury. I further affirm that 1 understand that any false statement,representation or concealment will subject me to felony criminal prosecution,including jail and civil liability in accordance with the Workers'Compensation Law and all other New York State laws. By submitting this Certificate of Attestation of Exemption to the government entity listed above I also hereby affirm that if circumstances change so that workers'compensation insurance and/or disability and paid family leave benefits coverage is required,the above-named legal entity will immediately acquire appropriate New York State specific workers' compensation insurance and/or disability and paid family leave benefits coverage and also immediately furnish proof of that coverage on forms approved by the Chair of the Workers'Compensation Board to the government entity listed above. HERE Signature: Date: '� /-7.ZoLd ExeMF&PAC ,to l�nmber qA ',� ?a ��_ d 20 - 24 Ma 020 ' 1VYS Work n&ll Board CE-200 0112018 '4CC)RV CERTIFICATE OF LIABILITY INSURANCE ��IM ' D4/13C2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the polity, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER CONTACT .AME CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY PHOE HOME OFFICE: P.O. BOX 328 A CNNo Ex::888-333-4949 FAX No):507-446-4664 OWATONNA, MN 55060 E-MAIL CLIENTCONTACTCENTER FEDINS.COM INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 149-868-2 INSURER e:FEDERATED RESERVE INSURANCE COMPANY 16024 MACK FIRE PROTECTION INC INSURER C: 15 INDUSTRIAL PARK PL MIDDLETOWN,CT 06457-1501 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:466 REVISION NUMBER:0 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE DL SUBR POLICY NUMBER POLICY EFF POLICY yEXP YYYI LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 TO RENTE CLAIMS-MADE OCCUR PREMISES Ea occurrence $1DO,DOD MED EXP(Any one person) $10,000 B N N 6042334 05/11/2020 05/11/2021 PERSONAL&ADV INJURY $1,000,000 G N'L AGGR E LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRO- P POLICY ATE ❑LOC PRODUCTS-COMPIOP AGO $2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 Ea accident) X ANY AUTO BODILY INJURY(Per person) OWNED AUTOS ONLY SCHEDULED B AUTOS N N 6042334 05/11/2020 05/11/2021 BODILY INJURY(Per accident) HIRED AUTOS ONLY NON-OWNED PROPERTY DAMAGE AUTOS ONLY r accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $10,000,000 B EXCESS LIAB CLAIMS-MADE N N 6042337 05/11/2020 05/11/2021 AGGREGATE $10,000,000 DED I I RETENTION WORKERS COMPENSATION Y/N OTH- AND EMPLOYERS'LIABILITY X PER STATUTE ER ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $1,000,000 A OFFICERIMEMBER EXCLUDED? ❑NIA N 6042338 05/11/2020 05/11/2021 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below I I E.L DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: KINGSFIELD 1100 KINGS ST RYE BROOK NY CERTIFICATE HOLDER CANCELLATION 149-868-2 4660 VILLAGE OF RYE BROOK NY BUILDING DEPARTMENT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 938 KING ST THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN RYE BROOK, NY 10573-1226 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 4" O 1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD YORK Workers' CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured 860-632-8053 MACK FIRE PROTECTION INC 149-868-2 15 INDUSTRIAL PARK PL 1c. NYS Unemployment Insurance Employer Registration Number of MIDDLETOWN,CT 06457-1501 Insured Work Location of Insured(Only required if coverage is specifically limited to 1d. Federal Employer Identification Number of Insured or Social Security certain locations in New York State.i.e.,a Wrap-Up Policy) Number 04-3814418 2.Name and Address of Entity Requesting Proof of Coverage 3a. Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Federated Mutual Insurance Company Village of Rye Brook NY Building Department #466 938 King St Rye Brook NY 10573-1226 3b. Policy Number of Entity Listed in Box"1 a" 6042338 3c. Policy effective period 05/11/2020 to 05/11/2021 3d.The Proprietor,Partners or Executive Officers are included.(Only check box if all partners/officers included) QX all excluded or certain partners/officers excluded This certifies that the insurance carrier indicated above in box"3" insures the business referenced above in box 1a"for workers' compensation under the New York State Workers'Compensation Law. (To use this form, New York(NY)must be listed under Item,3A on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2". The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.)Otherwise,this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent,or until the policy expiration date listed in box"3c",whichever is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder.Th s certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note: Upon cancellation of the workers'compensation policy indicated on this form, if the business continues to be named on a permit,license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers'Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury, I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Elizabeth Petersen (Print name of authorized representative or licensed agent of insurance carrier) Approved by: Q-r�' 04/13/2020 (Signature) (Date) Title: Authorized Representative Telephone Number of authorized representative or licensed agent of insurance carrier: 888-333-4949 Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insurance brokers are NOT authorized to issue it. C-105.2 (9-17) www.wcb.ny.gov / 7 DATE(MMIDD/VYYV) A6C 2 CERTIFICATE OF LIABILITY INSURANCE 1�21/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME OTT AGENCY PHONE PO Box 659 A/C No Ext (845) 895-8873 A/C No Wallkill, NY 12589 ADDRESSottins200l@yahoo.com INSURER(S) AFFORDING COVERAGE NAIC0 INSURER Main Street America INSURED Total Comfort Inc INSURER B National Grange PO Box 359 INSURER C National Grange 7 Ohara Rd INSURER D National Grange Milton, NY 12547 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS R LT TYPE OF INSURANCE LTR wsD wvo POLICY NUMBER rMM/DO/VYYYI MM DD/YYYV LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1 OOO OOO DAMAGE CLAIMS-MADE � OCCUR PREMISES Ea occurrence $ 500 OOO 1/21/2021 1/21/2022 MEDEXP(Any one person) $ 10,000 A X X MPU7919F PERSONAL BADVINJURY $ 1, 000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 PE LOC PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY DX OTHER $ AUTOMOBILE LIABILITY COMBINED Ea accident $ 1,000 ,000 ANYAUTO 1/21/2021 1/21/2022 BODILY INJURY(Per person) $ OWNED SCHEDULED B1U7 919E B AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPER DAMAGE $ AUTOS ONLY AUTOS ONLY Per accltlent UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 5,000,00O D EXCESS LIAB CW7919F 1/21/2021 1/21/2022 CLAIMS-MADE AGGREGATE S 5,000,000 DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN 1/21/2021 1/21/2022 STATUTE ER ANV PROPRIETOR/PARTNER/EXECUTIVE WCU7919F EL EACH ACCIDENT $ 1000000 C OFFICER/MEMBER EXCLUDED? F7 NIA / / (Mandatory In NH) E L DISEASE-EA EMPLOYEE $ 10 ,573 If yes describe under DESCRIPTION OF OPERATIONS below E L DISEASE POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101 Additional Remarks Schedule may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION VILLAGE OF RYE BROOK SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 938 KING STREET ACCORDANCE WITH THE POLICY PROVISIONS RYE BROOK NY 10573 AUTHORIZED REPR SENTATIV ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD25(2016/03) The ACORD name and logo are registered marks of ACORD PORK Workers' CERTIFICATE OF STATE Compensation Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1a. Legal Name 8 Address of Insured(use street address only) 11b. Business Telephone Number of Insured TOTAL COMFORT INC 203-223-6700 PO BOX 359 7 OHARA RD 1c.NYS Unemployment Insurance Employer Registration Number of MILTON NY 12547 Insured Work Location of Insured(Only required if coverage is specifically limited to 1d. Federal Employer Identification Number of Insured or Social Security certain locations in New York State, i.e., a Wrap-Up Policy) Number 141829022 2.Name and Address of Entity Requesting Proof of Coverage 3a. Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) NATIONAL GRANGE VILLAGE OF RYE BROOK 938 KING ST 3b. Policy Number of Entity Listed in Box"1a" RYE BROOK NY 10573 WCU7919F 3c. Policy effective period 01/21/2021 to 01/21/2022 3d.The Proprietor,Partners or Executive Officers are included.(Only check box if all partners/officers included) X❑ all excluded or certain partners/officers excluded This certifies that the insurance carrier indicated above in box '3" insures the business referenced above in box"la"for workers' compensation under the New York State Workers' Compensation Law. (To use this form, New York(NY)must be listed under Ism 3A on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2" Will the carrier notify the certificate holder within 10 days of a policy being cancelled for non-payment of premium or within 30 days if cancelled for any other reason or if the insured is otherwise eliminated from the coverage indicated on this certificate prior to the end of the policy effective period? ©YES ENO This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect Please Note: Upon cancellation of the workers'compensation policy indicated on this form, if the business continues to be named on a permit, license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers'Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury, I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by' WILLIAM C OTT (Print name of authorized representative or licensed agent of insurance carrier) Approved by (Signature) (Date) Title: PRESIDENT 1/21/2021 Telephone Number of authorized representative or licensed agent of insurance carrier: 845-895-8873 Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insurance brokers are NOT authorized to issue it. C-105.2 (9-15) www wcb.ny.gov RV 3'rAR 11411 Vrr CLRB VA--\ M.CN=10 KE W KIN I V RM NT q14 6.MM(8!7) r9l 3 OCT I Iks 2020 1 4 JA S M I N E tl...A N E U N I T B WATER SUPPLY� }1 #3 � }t � r-�C�� I etsF i STAT11C PSI: 50 PSI VILLAGE 0�_ RYE BRO OK RYE B R O O K y NYI1111 RESD PSI: 40 PS IV UILDI.NG DEPARTM -NT c1QVi: 1Q50 GPNI 0 -------j -M NA ON RMY 2,nWT;T4 CK 120 FROU A WW FLow cwLcn ok JIB V19/20%Iff SO WATUZ CWMI .6 116 1 I PS 114 cpl. 114 0 soa, 112 J3 /to CLUSrER'C'-11!M- NOR LME TIE EDCA=W C-M t CLU51R'%J - M LAIE o 10 FE htW(W' OLC TIC to Iramillmy po I C!USTER 7-7 HMEMOLE LANE V7 CIL51R 2 IMMUCKLE L411 CLUSTER T" 4 PRMROSE'.11NE NFPA-13D GENERAL NOTES WOOC SCREV.-V 0 1 a X 1 1 9 PRIMROSE 1ANE 7 to V tK%XVFV=WW IBM 0, C1 USTFR'11' :SYSTEM -RESIDENTIAL AREAS(WE.SYSTEM,' 14 LL I DESIGN C, a. 27 MX Wc N 8*LICIRDAW VA); IE MNE LRIE C[JJSjER SPRMLER SYSTEM IS A 14YORAWCALI-Y CALCU,ATED MET SYSTEM mm, -is AW LANE I POW.HAS BEEN SIZED USING A I"!HAZARD DENSITY Of.05 CPU OWR MOST FOOOTE 2 SPRINKLERS M PIPE -14�AW Z%j #17 -i0,'ASWN"LME IN A CWAPTWJfT USING FESCIENTIA,SORWLEAt HEADS. - ` .1 18 --I- -. .1�CIPE CLUSTER-%--1' 2 NULE16i�COURI -324 sq P.. . . I N MAXSIUM SPFCMEA HEAD SFAONC I - #13 JI& SYSTEM DESIGN PER tLF.P.A 11*30(200 EDITION) OFFSET HANMM its NUB 02 PIPE MATERIALS nn ALL FIRE AND FITTeiGS ARE ELAZEMASIEr WOOD ISCREW Wa VY='ROW CR OEAM C3. CONTRACT INFORMATION WO=TRUSS 01;taw 17 W43 W. I OF 71'WOW LNMEF THIS COP.JIRACT C%%.SrC. THE FOLLOWG D mscw A MCN A INSTALL A WORKING SPEWKLER SYSTEM PER h.F:.A­:JD 2010 EDTIC!, OFFSErHANGERDETAIL HALF STRAP HANGER DETAIL IT #I -DRAFT STICOMC 901.1 K PqOVXZ EY INE OY11NER IN ACCORDANCE WMI.THE IELC 20M CO-TM N.rS. Mrs. I f4 -ellTHRODUS LESS THAN 59 SOFT Slkl.HE IN CCUPUANCE WTN ThE PEOURENENTS Cr WFFA-1!D 2.6.2 ?L fl, A-BATItHOOM-C ARE N(MCMUS14FLE TEE-RCCI,WTH A 30 IVIN THERMAL BARRIER. tir Oil To&ffr"am tqp -CLOSETS LESS THAN 24 SOYT S-IPiL BE 9,COMPJANCE VArn THE PEWREMENTS OF NFPA-QD 8.6.3. E ---C--O--S-M---ARE.-C-ONSIRuCIEC-Or XCI)COMIAISIRLE 94EET ROCr W-114 A30 Min 114RMAL BARRBARRIER14'FR SMICE NAM;WIRY!RE0 6,Llailcamir VATEF fl! 10 Omcs 70,11'r -EXTERICR MCCN ES SP"KLER PROTECTION r-PROVIDM,0:4 At'-BALCONIES ANG PATIOS OF C%ir—LNG SITE PLAN TIC W=VMEL"24V ROW 13M M MM RW W)M M (V TVM -OWE I r QW-L VXVE UN-Ts IN ACCORDANCE VATH THE IBC 42C05 EDITION.SECTION 903.3.1.2 WNT Iff am SIM W99 Rmr IISYM VALVE XTS. -ATTICS ARE NOT USEC FOR STORAGE ANC W 407 CONTAu,*mY W-,FIRED EOUPMENT A r WWWW114mv- W K-IN PA"i IT W&X 1101a-M-M-66 SUIR51a ADE THU MW P MW Uffff W04 CL 2*1 IV VC141111!WME1.1,*UM 000MC P== NOTES TO THE OWNER PER NFPA 6 P MAINTENANCE j6S*1 THE OWNER SHALL BE RESPONSIBLE FOR THE CONDITION OF A SPRINKLER SYSTEM E) AND SHALL KEEP THE SYSTEM IN NORMAL OPERATING CONDITION BASEtv4.EN 2'2121 IM'OXIDOE'OREM W=OM'IM .3 6.S.2 SPRINKLER SYSTEMS SHALL BE INSPECTED TESTED AND MAINTAINED IN ACCORDANCE 'I -1�t- - SCIM 81171MI wiz.W.010 A tr1twk V"WM WITH NFPA 25.STANDARD FOR THE INSPECTION TESTING AND MAIN'TENANCE OF -jo WATER-BASED FIRE PROTECTION SYSTEMS BASEMENT FLOOR A.6.9 THE RESPONSIBILITY FOR PROPERLY MAINTAINING A SPRINKLER SYSTEM IS THAT OFT­T4E ELEV,=C'Z' OWNER OR MANAGER,WHO SHOULD UNDERSTAND THE SPRINKLER SYSTEM OPERATION. FOR FURTHER INFORMATION SEE NFPA 26.STANDARD FOR THE INSPECTION TESTING AND MAINTENANCE OF WATER-BASED FIRE PROTECTION SYSTEMS 6_67 ADDITIONALLY F 3-7 —c\.r,0 _.�I R& 1:YOU MUST MAINTAIN SUFFICIENT HEA7 THRCUGI IOUT THE PREMISES TO PREVENT THE WET SYSTEM FROM FREEZING SPRINKLER FR S M TEM RISER DE TA IL 2)YOU SHAL,INFORM TENANTS OF PROPER CARE NECESSARY TO MAINTAIN THE SYSTEM, A(TS. 3,1 IF THE CONSTRUCTION OR OCCUPANC-IS ALTERED IN ANY WAY. THE SYSTEM WILL HAVE TO EE UPDATED ACCORDINGLY. OLM SPACES W I`IT FEW57 ! '7 0 4: r P11TEITIM IllY KPA 13,SUMME ofFPWLff- .� 90 it STAIR a fc a E E Wum.amll FR SM"TM M L4. 1-15 1171),NWM anow(ey camr fit: ------ WIT.FMM x0m. 1k F2C0N,`1!RC�i VfkvVrr AND"ki�UNUERG�.�OUITPIPIIZ�' MOMIL SPRMW(Ml 4'S' Is B)OTHM. MACK;IRE PROTECTION'S CONTRACT 3 i zd 2-W T-5-1 UNFINISHED L 7,YK-sw mw%my jAr t.v P;ug�,,a Rwx BEG AS AT 2'FIRE S9RV,CE_WATER!"NEL L rr L MASTER MASTER UNEXCAVATEQ KIT BASEME BATH BEDROOM UTILITY r"M44"URED FOR AF ON, D.O.H.APPROVALRE I RALE,1 BACKFLOW PREVENTION DEVICE. -UNEXC T AVATED U SECOND FLOOR -9 ELEV. C!, !7311 056 2-M WX U-XI.MV-VW&OW t=M ASSE111.1 Writ sr o=n.M'.ous P41 min.A wusk IN-ff WM IMT WEE 1W MOM %Xlr TIBI CIM A NUK 1AELF WCF Ue yXjWS WV_Zrj CMX L ZW CMr M MVR LIVING KITCHEN VA M%V SIMN MU.FROM G*%&•TEM/Mill UME ROOM i. • .6 FIRST FLOOR ------ fELEV. 9-6' C% L P_ j ; FSic RuFm Comm FMNT mw OCtC T 1 5 2020 1 1 T-5 L 9! bDt FINISHED WALK-)N L.. I 1 '_. ; + Lj BASEMENT CL DATE APPR BASEMENT FLOOR BUILDING INSPIJ6�OR, illaaogeof Rye Brooki,NY ELEV. 0*-9 ujvlr om- qF N BAsEmjFA(rFL ooR FIRE PRoTEcTlowr PLAiv. _BUILDING SECTION"A A" i� A V� - SCALE.-114"=IV" SCALE.•I/W"=IV" AI r 1.All pipe locations are to be field measured prior to fabrication Whether or not indicated an the drawings,'be following items are,to be provided, SYMBOL LEGEND SPRINKLER HEAD LEGEND DRAWING TITLE:BASEMENT FLOOR FIRE PROTECTION PLAN JOB INFORMATION cls and head wrench per NFPA 13 SYMBOL DESCRIPTION DESCRIPTION PROJECT,KINGFIELD DEVELOPMENT -Head.Cabinet.spare hen REVISIONS: DATE: and installation by the sprinkler contractor G1 2.All dimensions shown are-end to end -Provisions for flushing connections and draining of all pipe CONTRACT#:13000 ADDRESS:INTERNAT113NAL DRIVE E0ATIT4fElCr,.T0D01Srtj. :RYE BROOK STATE:NY ZIP:10573 3.High temperature heads are to beltrield installed where required. Inspectors test connection shall be pro%Aded to,each systerr 4.All pipes and hangers are to be installed per NFPA 13. Hydraulic idenlificatior.plates NFPA 13 required signsi Eros CCNSTRUCTION:WOOD CLIENT:THE WARJAM GROUD PH13NE:19141761-250 LL. 5.Gridded wet systems shall provide a relief vaive per NFPA 1.3. ......................... LTD. '", l P.'VAT!T4AWVE;RM�1C%. 0 A: PFA311! 20-0) D egnifllf MCI SR{. N 0 Li 6.All new piping is to he hydrostatically tested at not less than 200psl 11 is The building owners responsibility to provide adequate heat fo,all areas-n theL1bPStEIGfI ADDRE59:5 NITERNATIONAL DRIVE-SUITE 114 k for 2 hours,or at 50ps;In excess of the maximum pressure, building protected by a wet type sprinkler system and for all water filled supply pipe valves ntnd- OFM M-SA77C W�w OCCUPANCY:NFPA 13D CITY:RYE BROOK STATE: ZIP:10573 15 INDUSTRIAL PARK PLACE,MIDDLETOWN,CT 06457 when the maximum pressure to be maintained is in excess of 150psi. and system risers to dry type systems. -C-/-C- mursa-mw S-PRREF.1,7hX,.h-5.E.-90%REESM!ftAI43; SYSTEM TYPE:WET P:1360-63Z-8053 F:1360-632-8054 7.A quick opening device is required when dry system volume exceeds Air pressure shall be*maintained on all dry type systems by an approved automatic air -40- F,;­_TVMDVA •I IDATE-O.127,1201? FIRE SPRINKLER CONTRACTOR CONTACT 500 gallons per 13. compressor or plant air system specifically approved for and capable of autornaticaliy P-PERSERY-PA-1 @). I WWW.MACKFIRE.COM IL PORT CHESTER DESIGNER:CHRIE JUDD FHONE:(9612)398-51324 8 NFPA 13D apply as required. mairtaminc the required air pressure. AM-'.'_Fp or,34- on 1 P.,f .....------ IRE MARSHAL E-MAIL:CHRIS@MACKFIRE.COM, L!CENSES: CUI-40291 MA:SC-120494 R11:0 e I AMME tVN5 TAGS YOTA,.Tmis Smcrr .-54 KI N F1 D V RM NT 14 JASMINE LANE UNIT B RYE: BROOKy NYE HYDRAIJI.TC DESIGN CALC AREA d2 rouwn.00R KrT(:1-IEN HYDRAULIC DESIGN CRITERIA Density SpuCinC VARIES WE).DECK,OR K Fccicr 49 )I Allowance- - BLUESTONE PAVER This System.is Designed to Discierge : at c.Rate of GPM per sq it c!Floor Aref;Over a Remcfe A-c of I .-Ei�\ 2 S;rirk!ers when Supp:it!c witir Water I at the Rcle of 26.3 GPM 31 PS,-i ci the IT-06- -K2 V T —2� cam ar r AAW4 III IN P-X1 III OEM 1119 GDffk 020CM 10w--------------- TIE XIEA MCC AUKJ I SFRII ME At,SIOMW HEQ"I 2E WMIR FPE FW F;=#&WM cD TW FDV FFM'PZ ROM ff R90UM M'C RAST^ T W 6L.106 Olt 'A a AVIAV mmw A 'A WX K PF.'919,11240 LTi; ,tY '�"�, 'E2 Zap CM 111WRIN TnDRAULIC DESIGN It A R.J.Rr kMG lyz Sol OF THE BOTTOM 1:�M OF K-Rog 1RIZ CALC AREA P I MASTER yfX...... LIVING7' ,r CHEN -AI 0 (ER) • ;hr Fbt:7$ BATH if caw,mv= <t HYDRAILI!IC DESIGN CRITERIA 11 L V! MASTER .05 Density V: 6 %. j BEDROOM Spacing-VARIES Q31-M,Wit=rem I 9WAM lie K Fv,tor 4.9 I TI\ ".3-5- Hose Allowance A Ui fic 91-1 ;.j ee. ThiE Systern iF Dessioned to Discharge r soa-a Rcte of .05- GPV pe.sq ft SEW FW. U-X --:r-- b,! INSUZ,A TION DF TA A FOR ALL SPRINKLER -.0------- low of Floor Area Over to Remote Are-,of IN OR A DJA CENT TO UNHEA TED SPA CES 2 Sprillriklere wher.Supplied with Wate, M'Vvm,/I oath Rate of 26.3 GPM at 39.6 PSI i C',tte fr-M[W--MODE'I -------- _X 4"11/111//1A 01 All it I isOil X21 jj ------ LALINDIkY A,-s* T IC-. HYDIRLAULIC DESIGN WALK-N T P 4L we T,(!to FLOG;(Q.V me?I S.AIR C--NLC.kRr-A 03 01 P ;CL 21 mww VILW M*Nuak II Soo- II K.00R S :ZEN TAIR Ll I ob.'TYK wAr,.ROW Sitlai(6Y 04M.) 0ARA(W 4-11 2- CRITERIA LA I HALL f(AMFMOD Fay CER&-'a0i LIX IF 4b 1111=111(FlUTFLRS) Q9�0 At 411`1 BAT� -05 1 11ECIRA:M1 qporirjq-VARIES i C, Yk Foster 4.9 T. Bose Allovmnce P4D of Flocr Arec(I c Remcie Area'0't This System:is Desioned to Discho•ge of a Role of .05 GPM per sq 2 Sprinklers*nen Supplied with Water at the Rate of 30.3 GPM a,29..1 PSI 15 FOYER oi the fi-nwz II AS' L 4'.6 902 4 :T =FED* 4b 4 -- - OliI IC I&EQUffELI:NSVATB-THE SELM ► Gllk-w C TW4 Jt1%A fieWL ME UjMli le MUE W X BEDROOM 43 1.RIT 00 Q1 rRaM UP % 2'U F* 705 C IC 0-`--\ M AIR- L DEN X BEDROOM BEDIWOM A2 V 6 1 C Z 17 LI -01I FLOOR 700N, T SC ELEV. !V-6- V'.GARAGE DFf F301 UP. c-LCPEC- 7 CLG. ---------- r IV 00 E8210ED ROM FES W1 THE W2 COLNGS AS 11:10F W Tpuss C 16,0.(. 7 RPI P X41 X.POSS&X-kM FGF WWY A9D T 01 JLAON I j FIRST FLOCIR ........... ELEV. 10;e- GARAGE MIT fW4#f I/lv/;r FIRL fr Unfinished 17W MIE SECUL'FLOOR SPAL Er'LOCATED AT 0-7'EELOM TME CrIM" Basement ALL SIDEVII')F RINK0S ON X Of Nick, —1:0---F Me�hl C- FIRST Fz,ooR FIRE PRO TEC TION PLAN GARAGE SECTION SECOND FLOOR FIRE PRO TEC TION PLA N- SCALE.•11411 IV" N.T.S. SCALE.-I/W".=1*-V" 72*1 to SYMBOL LEGEND SPRINKLER HEAD LEGEND JOB INFORMATION I All pipe locatkm are to be field measured prior to fabrication Whether or not indicated on the drawings,the following items are to be provided, SYMBOL DRAWING TITLE:FIRST SECOND FLOOR FIRE PROTECTION PLAN DESCRIPTION SYMBOL: DES.^RlPnUN PROJECT:KINGFIELD DEVELOPMENT FIE) and installation b�the sprinkler contractor Head Cabinet,spare heads and head wrench per NFPA 1.3 PWAAr,10 RXE.Mr REVISIONS: DATE: ADDRESS,.INTERNATIONAL DRIVE 2.At'dimensions shown are-end to end Provisions for flushing connections and draining of all pipeBEvA:gtlBnOrYOF CONTRACT#.DODO heads are to be field installed where required. • CITY;RYE BROOK STATE:NY ZIP,10573 L6 -Inspector's test connection shall be provided for each sysiem 0 3.High temperature CLIENT:THE WARJAM GROUP PHONE:(9 41761-25013 4.All pipes and hangers are to be Installed per NFPA 13. Hydraulic identification plates&NFPA 13 requires signs '11UPWOOFTOF'O"M I CONSTRUCTION:W130D pasLTD. F I R E P R C3 T E.0 T,I C3 N 0 93 LLL tro--*I Mk 5.Gridded wet systems shall provide a relief valve per NFPA 13. cez I(TUORD)IT .................................. ADDRE55:5 INTERNATIONAL DRIVE-SUITE 1 14 11 6.Al.new piping is to be hydrostatically tested.at not less than 200psi It is the building owners responsibility to provide adequate heat for all areas in the OCCUPANcY:NFPA 13D CITY;RYE BROOK STATE:NY ZIP:10573 for 2 hours o,al 50psi in excess of the maximum pressure, building protected by a wet type sprinkler system.and for all water filled supply pipe,valves -74- COMME IIERATEDWEER 15 INDUSTRIAL PARK PLACE,MIDDEMWN,CT 06457 Pff 105E UP < WNX.11*56,MVEGRE-^h4RA1Q; SYSTEM TYPE:WEr P:B excess of 150psi. and system risers to dry type systems. 60-632-8053 F:8'60-632-8054 when the maximum pressure to be maintained is ir.ex p 7.A quick opening device is required when dry system volume exceeds Air pressure shalt be maintained on all dry type systems by an approved automatic air DATE:03127;2017 FIRE SPRINKLER CONTRACTOR CONTACT it 1`11-51115SArhE 4 t- 1INWINNACKFIRE.COM CL 500 gal*ns per NFPA 13. compressor or plant air system specifically approved for and capable of automatically FORT CHESTER 0 1 NER:CHRIS JUDD PHONE:4660)3 98-5024 I FIR -40291 -MA:SC-120494 RIM-0347 S.NFPA 13D apply as required. maintaining the required air pressure, It f AHI E-MAIL:CHRIE-PMACKFir%E.CCM LICENSES: MF' L.116. WD fOl I FnM4#-)Lll4E0MGTAM TcTjL Irmls'SHEV.—35 TOTAL Ir4is Joe:-54 E MARSHAL FIELDWORK COMPLETED: February 3, 2022 Underground structures, if any exist, are not shown hereon, except as noted. The location of underground improvements or encroachments are FILED MAP REFERENC, not always known and often must be estimated. Subdivision Map of "Kingfield" F.M. No. 29210 if underground improvements, easements, or filed August 30, 2018 encroachments exist and are neither visible during normal field survey operations nor described in Subject Lot. 87 instruments provided to this surveyor, they may Known as 14 Jasmine Lane not be shown on this map and are not certified. Town of Rye Tax ID: Section 129.25 Block 1 Lot 1.58 This property may be affected by instruments which have not been provided to this surveyor. Users of this map should verify title with their 86 attorney or a qualified title examiner. Legend Frome Building Only copies from the original of this survey AC— Air Conditioning Unit marked with the surveyor's embossed seal are ©— Sewer Cleanout genuine, true and correct copies of the surveyor's CRW— Concrete Retaining Wall original work and opinion. A copy of this ® — Curb Stop Water Service N59.04'42" document without a proper application of the ®— Electric Box E 90.17 surveyor's embossed seal should be assumed to 0 — Electric Manhole utility y • — Gas Valve Z y g be an unauthorized copy. Shed Cn - --- Ligh# Pole 0 w � - v • 0 Telecommunication Box 3 ®- Cb Transformer PadUn 0 Cb c�+ Q— Water Valve o o -S�� 00.cov b C v c3 rn Area�4,677 Sq. Ft. r � Frame Building � � I o 4 N � ro D -� `D N MAY To date, no Title Report or Abstract of Title has r c c bD 120 22 been provided. This survey is subject to a 0° V/LLAG � LI of current, up to date Title Report. Ul $(,11��1 RY,E$ �v a 0 NG p�P ROOK MEN Open x. ART Property co0 rner monuments were not P laced as v Porch MINT part of this survey. W Roof . E:::J '03"W Ut►1it 90.25' � R=692.00' This map may not be used in connection with a S58 18 y �- L=9.37' Shed "Survey Affidavit" or similar document, statement or mechanism to obtain title insurance for any Built sveysubsequent or future grantees. Frome - Buildin9'. . . Lane Unauthorized alteration or addition to a survey map bearing a Licensed Land Surveyor's seal is 91 a violation of Section 7sub—divisionUnit 209, 2, of 87 the New York State Education Law. ' Prepared for According to NYSAPLS policy adopted January 23, Sun c.. 1993, the alteration of survey maps by anyone other than the original preparer is misleading, Sft Mft k7 the confusing and not in the general welfare and benefit of the public. Licensed Land Surveyors shall not alter surveymaps, survey plans, or Town of Rye p � yp � survey plats prepared by others. Westchester County, New York 1001 N %9 T E LENGINEERING, SURVEYING �c GRAPHIC SCALE scala � = zo' Date: February s, zo�� LANDSCAPE ARCHfTECTURE, P.C. 0 , 20 40 3 Garre t t Place • Carmel, New York 10512 JEFFRE Y B. D eR OSA, L S Phone (845) 225—9690 • Fax (845) 225—9 717 AS-BUI T New York State License No. 050749 www.fnsite—eng.com DOCUMENT Q 2022 /n si to Engineering, Surveying & Landscape Architecture, P.C. All Rights Reserved, (IN FEET 16227.200 1 inch = 20 ft. Lot Maps/Lot 8 7.d wg