HomeMy WebLinkAboutBP21-114PERMIT # A6 /PI _DATE: l OcD/ IXP:J'S1 O a
SECTION i BLOCK / LOT _ / 9
TYPE OF W0RK._C_'_QQIfZ2_ap&*7te*`/O/A7/'C*4 4e.9 �t6Q
JOB LOCATION y8r k%0C;b(/, 4 VeejLI4Z
OWNER Q/Ii2Pe P?wl�th /7 9/ -�/6
CONTRACTOR
EST. COST i�oo� FEE I7
%oorCO # L 2 IU_7 FEEA jLU::L DA
TCO #
FEE DATE_ �,
INSPECTION RECORD
DATE INSP
FOOTING
FOUNDATION
FRAMING
RGH FRAMING
INSULATION
owmg**L
RGH PLUMBING'
GAS
SPRINKLER ELECTRIC
LOW -VOLT
LOW -VOLT [] ,
ALARM ED
AS BUILT _.
FINAL rL
OTHER APPROVALS
ARB
BOT
PB
ZBA
OTHER
VILLAGE OF RYE BROOK
WESTCHESTER COUNTY, NEW YORK 22-105
Certificate of ®ccupoucp
This is to certify that 110
of. P1' C� 1�I y having duly filed an application on
Y t��
�(Jl 20 2 0( requesting a Certificate of Occupancy for the premises known as,
78 an d In o d Ave h Ue , Rye Brook,NY, located in a�'� Zoning
District and shown on the most current Tax Map as Section: 5. Block: / Lot: `7
and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building
Permit No.a/' / , issued 20_42L, 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: One - /`� Construction:
for the following purposes:
bn-I-t-wonm r&ioyQ hDY7 : 1oe�
Y-P.P I score k24 w i rid o w S
Subject to all the privileges, requirements, limitations, and conditions prescribed by law, and subject also to the
following:
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 shall bp made,nor shall the building be moved from one location
to another until a permit to accomplish such change has been btai fr Inspector.
Building Inspector,Village of Rye Brook: Date: JUL 2 5 2022
R
C ENE ms' For office u onl :
DD BUILDING E AkTMENT PERMIT#
JUL - 1 2022 VILLAGE OF RYE BROOK ISSUED: �5--
938 KING STREET,RYE BROOK,NEw YORK 10573 DATE: '7-/-3 a
VILLAGE OF RYE BROOK (914)939-0668-FAX(914)939-5801 FEE: . //Q-- PAIDR
BUILDING DEPARTMENT Iwww.MbroolLorg
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
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Address: 10 WOODwnd ptyenoe.
Occupancy/Use:j �/41Y Parcel ID#: ,35 .-1 5- 1-1pcl Zone: ka—�
Owner: r?CIYItojV_ F:Vf2"-nGtn Address: -1E) LJGobicAn cj AVeYIUt
P.E./R.A.or Contractor: ' Address:
Person in responsible charge: Address:
Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issuance of Certificate of
Occupancy/Certificate of Compliance for the structure/construction/alteration herein mentioned in accordance with law:
STATE OF NEW YORK,COUNTY OF WESTCHESTER as:
L)011j W-1W Fj9,W-j-nQyl being duly sworn,deposes and says that he/she resides at 1p LNOop�OXriCk AVQViVe.
(Print Name of Applicant) (No.and Street)
in 9V0 RtZL)CjV. in the County of V-P&t-r 4: C-Af:V- in the State of ICJ Y ,that
( ityfrown/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:$ 5 t()nQ
for the construction or alteration of: r NACeiof- kitchen & ha}in 92nova+io,r1 8 mou:) witn�p..:c
Deponent further states that he/she has examined the approved plans of the structure/work herein referred to for which a Certificate of
Occupancy/Compliance is sought,and that to the best of his/her knowledge and belief,the structure/work has been erected/completed in
accordance with the approved plans and any amendments thereto except in so far as variations therefore have been legally authorized,and as
erected/completed complies with the laws governing building construction.Deponent further understands that it shall be unlawful for an owner
to use or permit the use of any building or premises or part thereof hereafter created,erected,changed,converted or enlarged,wholly or partly,
in its use or structure until a Certificate ofOccupancy or Certificate of Compliance shall have been duly issued by the Building Inspector as per
§250-10.A.of the Code of the Village of Rye Brook.
Sworn to before me this 4h Sworn to before me this 4A
day of Pam, , 20 a day of ; 1 , 2041
Sign-dtuELQ01Property Owner Signa Applicant
77�ar-e wk i----x-n ar a n�e� F-r�sz,z.mar�
Print Name of Pr rty Owner Print Name of Iicant
Notarpubf Notary Pu
Lynette B. Coe 3/21/19
Notary Pul)lie. Suite of New York , L)jj(.. t ,t Coe
Notary Puhlir. State of N
No. O:CUG7�b�G9 No. Q:Cf)i,l� eR'York
Qualified ir. V�estcitester Count 98669
Conuuissiun Ex irus Jan. 05, 20:1 �ualif'ic cl ii, bVestc.l. .- ei Count
1' Cuiamis�,un L-%plres Jun. 05, 2OXr
QyE BRC�v�
o`` tim
1982 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 ryebrook.org
- - - - - - - - - - - - - - - - - - - - INSPECT ON REPORT - - - - - - - - - - - - - - - - - - - -
ADDRESS : DATE:
� ` 1 (/ �,j�
PERMIT# ' , 1 ISSUED: ` T: ` BLOCK: ' LOT:Q
LOCATION: \V� V��" " V OCCUPANCY:
❑ 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
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BUILDING DEPARTMENT
VILLAGE OF RYE BU6OK AUG 16 2021
938 KING STREET RYE BRi ,NY 10573
(914)939-0668 FAX(914)93 9-5 801 VILLAGE & R'Yw
www.rvebrQ.ok.org L F,UILDING DEPP,�:i;ylLr:qv'f
ELECTRICAL PERMIT APPLICATION
Westchester County Master Electricians License Required Q
FOR OFFICE USE ONLY BP#: f�1 1 EP#: — 7(� 7
1
Approval Date: AUG 7 2021 Permit Fee: $
Approval Signature: Other:
Disapproved:
(fees are non-refundable)
Application dated, Yleo c:) 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.
I.Address: _T$ W ocA lard A.V P SBL: 1.3,5'1 Zone:Q725-
2.Property Owner: Lj-A0 j ekle •:rtn .n Address: 48 \6 oo6 le-rld A.\,[e
Phone#: Cell#: 71 7- 916 - 416 z email:,4mq S% S t_ t c�_l0 L3d c �m
3.Master Electrician: jGec D Z Fc�_kcc:, Address: 40 1o!wn SA, t`le,w Reach d 1LLt togp l
Lic.#:E42.S Phone#�t4-(c36-f3 �Cell#:9j4 -91)6-431d email:*Ce_ke.4-^4t`k.cGLo�o�JG�ai1,c0p
Company Name: `(" G Cl�c�t��c TryL Address:
4.Proposed Electrical Work/Fixture Count: L Ii cke_h -4 Ge�( n S re-c a ss e A L- 0' off--n-f---—
�3c.i !C-y"ec; uy%t row C.Vea
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STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as:
42)Cio iYc �& L_ D t G7_\« ,being duly swom,deposes and states that he/she is the applicant above named,and does firrther
(print name ofthdividual 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 �lz`�r.te�� Cdsleo.0�Q�(-
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
day of ,20 day of :--A
./ 20 _
Signature of Property Owner Si 61ture of Kpplicant
Print Name of Property Owner t Name EDT Applic t
Notary Public Nosy i� MELILLO
Notary Public, State of New York
No. 01 ME616OC63
O!iali ied in Westchester County
Commission Exnires.lprrn iarP4 pna3
3/21/19
-347-3595
Westchester Rockland Electrical Inspection Services, Inc. j� y Phone: 914
DO N(�T WRITE HERE-FOR OFFICE USE ONLY 43 North Lawn Avenue Fax: 914-347-3596
Elmsford, NY 10523 `�� BUILDING PERMIT NO.
TEMP# DATE ab
CITY OR VILLAGE ZIP CODE TOWNSHIP COUNTY
STREET D NO.OR ROAD POLE NUMBER
1
BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? SECTION BLOCK LOT
OCCUPANT'S NAME BUILDING OCCUPANCY
a.
OWNER'S NAME AND ADDRESS HOME TELEPHONE NUMBER
CURRENT SUPPLIED BY FROM THEIR FFICE 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
1"FL.
FL. AUG 132021 19
3-FL.
ARTM NT
REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE:
C'r. \ �. ,i ��
THIS APPUCATION 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
l08
CHARACTER OF WORK4 NEW❑ ADDITIONAL❑ EXPOSED❑ CONCEALED❑ MUST ENTER APPLICANTS
IDENTIFICATION NUMBER
SERVICE ENTERS BUILDING OVERHEAD L i UNDERGROUND`] LLI
AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACE MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
NAME OF COMPANY DATE OF APPLICATION SIGNATURE OF APPLICANT
STREET ADDRESS TELEPHONE NO.
8C T V
CITY on��POST QFFIC�1 ���C OCODE , LICENSE NO.WHEN APPLICABLE E S
WESTCHESTER
ROCKLANO
ELECTRICAL
INSPECTION
WRE141,,RV,C,,.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:
T&G ELECTRICAL, INC. Danielle Freeman
41 WHITFIELD TERRACE
NY, NEW ROCHELLE 10801
Located at:78 Woodland Ave Rye Brook, NY 10573
Certificate Number: 1030291
Section: 135.75 Block: 1 Lot: 69 BDC: Permit Number: EP:21-199-BP:21-114
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:
78 Woodland Ave Rye Brook,NY 10573
❑Basement 1st Floor 2nd Floor 3rd Floor Garage C1 Attic E?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 08/20/21
Name Type Quantity
Kitchen Reinspection-Kitchen ------- t
Bathroom Reinspection-Bathroom ------- 1
Receptacle;Outdoor GFI ------- 3
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.
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BUILDING RTMENT
=EET
E OF RYE BROOK APR 11 2022
938 RYE BROOK,NY 10573
(914) 939-0668;1 VILLAGE OF RYE BROOK
w\vw.rve brook.orl? BUILDING DEPARTMENT
PLUMBING PERMIT APPLICATION
FOR OFFICE USE ONLY BP#: PP
Approval Date: APR 1 Permit Fee: $ !`T't
Approval Signature: &L Other:
Disapproved:
(fees are non-refundable)
Application dated, is hereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of
a Permit to install an r remove Plumbing as per detailed statement described below.The applicant&property owner,by signing this
document agree that said plumbing work will be in conformance with all applicable Federal,State,County and Local Codes.
1.Address:, to
R LLcapuq b A ve SBL: 135.15—1 -(6 Zone:
2.Proposed Work:LCC-jALIZ)4TIDN-_&F-_PCUM$1AIC-3 FOZ KITCHCAl1 AND 'dpn_
3.Property Owner:DWI �LQ IJ� Address:7$ (.1 W HIV D 1wel f—qe
Phone#: Cell#: email: t/
4.Master Plumber: i QDl-� r�jZF ELQ ___Address: 13 RO& N PL L4 A(tY— NV ugg k
Lic.#: I Phone#:Q W Z1W I Gj[Cn Cell#: email:l'JG PLUM BI AY®off.NE7
Company Name:N 6 pj,LJJyfjll c, Address:('S Q6P2l1U PL ijL/jV&t AJV 1192W—
INDICATE FIXTURES&LINES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE:
Location Water Urinals Drinking Sinks Showcrs Bath Laundry Domestic Fire Sanitary Natural/ Other* Total
Closets I Fountains I Tubs Tubs Service Service Sewer I LP Gas
asement I • —7- T
Ist Floor
2nd Floor
31 Floor
I
4'Floor
5"Floor
Exterior
5.*List Other Equipment/Provide Details:t1jQ4CAJ -31DVE , 01514 5HEP- CC
(Notarized Signatures Required Next 2 Pages)
-t-
8/12/2021
STATE OF NEW/1YORK,COLNTY�OF WISTCHF.STER ) as:
k::MDDt1 (J06;24 I-V ,being duly sworn,deposes and states that he/she is the applicant above named,
(print name of individual signing as the applicant)
acid further states that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the
Pwma/ G �AUTIG
� Ir-7—Q)e-- _for the legal owner and is duly authorized to make and file this application.
(indicate architect,contractor,agent,attorney,etc.)
That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use
conducted at the above captioned property will be in conformance with the details as set forth and contained in this application
and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire
Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations.
Sworn to before me this Sworn to before me this
day of_ (0 ,20 ZO day of 20
Sig of Property wner gignature of Kpplicant
'L1Ct►'t�e111 �rn�,r-� .__ 95������IoCK
Print Name of Property Owner ��60 to 0,%N I Pint Name of Applicant
�OOPv �o1G05�2e�e�Got y�
No No N1e`�cr occ'�'' f�
o ublic a�� a���Gx�`t0� Not ublic
nette B. Coe Q �e",o
Notary Public. State of New York C•0f`s-
No. 0:CO6198669
Qualified in Westchester Countyy,
Commission Expires Jan, 05,2U.d1..
This application must be properly completed in its entirety and must include the notarized signature(s)of
the legal owner(s)ofthe subject property, and the applicant of record in the spaces provided. Applications
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
1
BUILDING DEPARTMENT D C E
� V
VILLAGE OF RYE BROOK APR � 2022 938 Ki,,•c STREET RYE BROOK,NY 10573
(914)939-0668 VILLAGE OF RYE BROOK
www.rvebrogk'or� BUILDING DEPARTMENT
AFFIDAVIT OF COMPLIANCE
VILLAGE CODE §216 • STORM SEWERS AND SANITARY SEWERS
THIS AFFIDAVIT MUST BEAR THE. NOTARIZED SIGNATURE. OF THE LEGAL PROPERTY OWNER AND BE SUBMITTED
ALONG WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION. ANY BUILDING OR PLUMBING PERMIT
APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETURNED TO THE APPLICANT .
STATE OF NEW YORK, COUNTY OF WESI'CHEISI FIZ ) as:
-F��. Carl , residing at, 1,��CX�I j �N\W(l�X'�
(Print nwn4) (Address where tou lire,
bcint, duly sworn, deposes and states that(s)he is the applicant above named, and further states that(s)he is the
legal owner of the property to which this Affidavit of Compliance pertains at;
18 AwdIan ci A\-enVe ,Rye Brook,NY.
Further that all statements contained herein are true,and that to the best of his/her knowledge and belief, that
there are no known illegal cross-connections concerning either the storm sewer or sanitary sewer, and further
that there are no roof drains, sump pumps, or other prohibited stormwater or groundwater connections or sources
of inflow or infiltration of any kind into the sanitary sewer from the subject property in-accordance with all State,
County and Village Codes.
461
--- 1'ropert%
(Print`ome ol'Propcm U%%ner(s))
i
Sworn to before me this
day of 22 , 20 2_�2_
LN,nette B. Coe
Notary PUI)lic• State of New York
('� alifi:clNo .
ii(1`�E(StcLebteJcount -3-
y C,I ;'i.;,:utt ,~:xNires Jail. U5, 2U..oL�
b 8/12/2021
Building Permit Check List&Zoning Analysis
Address:' Z J Vi 4O-t,c.A, .� ,QV J;z_ . SBi- ?s — L — to c1'
Zone 'i2,2-fr Use: I 2 tr-> Const.Type: Other. I-GZ A L t Z A-yI O.j
Submittal Date: t1 L ci l Z Revisions Submittal Dates:
Applicant:
Nature of Work: (1,j T��•o n_ (-t t�7 Fr-� -►- —T3^-T4 —Q N �/ �►�
Reviews ZBA: APR 1 6 2021 PB: BOT: Other.
OK
( ( ) FEES:Filing: �./' BP: t oo. ' C/O: Legalization: 3 So
( ) (�APP: Dated Notarized: SBL: Truss I.D. Cross Connection:
( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening.
( ) ( ) ENVIRO:Long. Shore Fees: N/A:
( ) ( ) SITE PLAN:Topo: Site Protection: S/W Mgmt.: Tree Plan. Other.
( ) ( ) SURVEY:Dated: Current: Archival:- Sealed: Unacceptable:
( ( ) PLANS:Date Stamped Sealed: Copies: Electronic Other.
( ( ) License: Workers Comp: Liability Comp.Waiver. 'w" 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.
(4 ( ) 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.
( ) ( ) 2020 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: APPROVED
REOUIRED EXISTING PROPOSED NOTES
Au Date: APR 2 6 2021
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notes:/D '9 e— rro 17 W 1 n c 'Q�111
Mike Izzo
From: Thomas Freeman <tfreemanS23@yahoo.com>
Sent: Monday, April 26, 2021 8-.S0 AM
To: Mike Izzo
Subject: IMG_1300.jpeg
Danielle Freeman
78 woodland
# —U- — IZO-6--•GOOD t
ENERGY Pf-RFORMANCE RATI 3
ADDITIONAL PERFORMANCE MANCE RATINGS
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Sent from my Whone
1
Laura Petersen
From: Laura Petersen
Sent: Thursday, April 29, 2021 1:41 PM
To: DMF515@ICLOUD.COM
Subject: Building Permit Application - 78 Woodland Avenue - BP-1 form
Attachments: BP -1 Form.pdf
�,,�d shy �r,l� b��.�y � o �C
Good afternoon,
Please see attached BP-1 form. Please complete this form with your notarized signature and return it to the building
department. Our office is open Monday—Friday 8:30am to 4:00pm.
Thank you
Laura Petersen
Office Assistant
Village of Rye Brook
938 King Street
Rye Brook, New York 10573
Phone (914)939-0668 1 Fax (914) 939-5801 1 1Petersen(cDryebrook.ora
1
State Farm Fire and Casualty Company
A Stock Oompany With Home Offices in Bloomington,Illinois
Po Box 88049
Atlanta GA 30356-9901 StateFarm°
AT3 H-28-7242-FOAC F HW DECLARATIONS
FREEMAN, DANIELLE 3201
98 BROOKSIDE PL
NEW ROCHELLE NY 10801-1806
AMOUNT DUE: None
Payment is due by None
Policy Number. 32-CS-0292-8
Policy Period: 12 Months
Effective Dates: OCT 25 2020 to OCT 25 2021
The policy period begins and ends at 12:01 am standard
time at the residence premises.
HOMEOWNERS POLICY Your State Farm Agent
TOM BRODERICK
Location of Residence Premises 211 MAIN ST
78 WOODLAND AVE NEW ROCHELLE NY 10801-5712
RYE BROOK NY 10573-2946
Phone:(914)632-6000
Construction: Frame Roof Material: Composition Shingle
Year Built: 1915 Roof Installation Year: 2018
Automatic Renewal
If the POLICY PERIOD is shown as 12 MONTHS,this policy will be renewed automatically subject to the premiums,rules,
and forms in effect for each succeeding policy period. If this policy is terminated,we will give you and the Mortgagee/Lien-
holder written notice in compliance with the policy provisions or as required by law.
IMPORTANT MESSAGES
Zone:12 Subzone: 09
PREMIUM
Annual Premium $ 1,258.00
Your premium has already been adjusted by the following:
Home/Auto
Total Premium $ 1258.00
Prepared NOV032020 Page 1 of 3
un-
^StateFarm'
NAMED INSURED MORTGAGEE AND ADDITIONAL INTERESTS
FREEMAN, DANIELLE Mortgagee
LOANDEPOT.COM LLC Loan Number:
ISAOA/ATIMA 600202193
PO BOX 7114
TROY MI 48007-7114
Additional Insured
FREEMAN,THOMAS Loan Number:
993 PINEBROOK BLVD N/A
NEW ROCHELLE NY 10804-1809
SECTION I-PROPERTY COVERAGES AND LIMITS
Coverage Limit of Liability
A Dwelling $ 345,000
Other Structures $ 34,500
Building Ordinance/Law 10% $ 34,500
B Personal Property $ 258,750
C Loss of Use $ 103,500
Fungus(including Mold) Limited Coverage $ 20,000
Additional Coverages
Credit Card, Bank Fund Transfer Card,Forgery, and Counterfeit Money $1,000
Debris Removal Additional 5%available/$1,000 tree debris
Fire Department Service Charge $500 per occurrence g
Fuel Oil Release $10,000
Locks and Remote Devices $1,000
Trees,Shrubs,and Landscaping 5%of Coverage A amount/$750 per item
SECTION II-LIABILITY COVERAGES AND LIMITS
Coverage Limit of Liability
L Personal Liability(Each Occurrence) $ 500,000
Damage to the Property of Others $ 1,000
M Medical Payments to Others(Each Person) $ 10,000
INFLATION
Inflation Coverage Index:343.5
DEDUCTIBLES
Section I Deductible Deductible Amount
Hurricane 5% $ 17,250
Other Losses $ 1,000
LOSS SETTLEMENT PROVISIONS
Al Replacement Cost-Similar Construction
B1 Limited Replacement Cost-Coverage B
un�nm
32-CS-D292-8 A StateFarm-
FORMS,OPTIONS,AND ENDORSEMENTS
HW-2132 Homeowners Policy
HO-2304 Amendatory Endorsement
HO-2684 Hurricane Deductible
HO-2687 Work Comp Select Residence Emp
HO-2403 Additional Insured
Option JF Jewelry and Furs$1,500 Each
Article/$2,500 Aggregate
Option ID Increase Dwlg Up to$ 69,000
Option Al Additional Insured
ADDITIONAL MESSAGES
State Fam3®works hard to offer you the best combination of price,service, and protection.The amount you pay for
homeowners insurance is determined by many factors such as the coverages you have,the type of construction,the
likelihood of future claims,and information from consumers reports.
Your premium was influenced by information from consumer reports:
Presence of a finance company installment account that has ever been 60 days or more late;Number of collection agency
filings; Number of accounts ever 30 days or more late;Number of consumer initiated inquiries for credit seeking
purposes in the last 24 months.
Please refer to the enclosed insert for additional details.
Other limits and exclusions may apply-refer to your policy
Your policy consists of these Declarations,the Homeowners Policy shown above,and any other forms and endorsements
that apply,including those shown above as well as those issued subsequent to the issuance of this policy.
This policy is issued bythe State Farm Fire and Casualty Company.
Participating Policy
You are entitled to participate in a distribution of the earnings of the company as determined by our Board of Directors in
accordance with the Company's Articles of Incorporation,as amended.
In Witness Whereof,the State Farm Fire and Casualty Company has caused this policy to be signed by its President and
Secretary at Bloomington, Illinois.
Secretat 4_0_ President
Prepared NOV 03 2020 Page 3 of 3
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Affidavit of Exemption to Show Specific Proof of Workers' Compensation Insurance
Coverage for a 1, 2, 3 or 4 Family, Owner-occupied Residence
"This form cannot be used to waive the workers'compensation rights or obligations of any party.�•
Under penalty of perjury, I certify that I am the owner of the 1, 2, 3 or 4 family, owner-occupied residence
(including condominiums) listed on the building permit that I am applying for, and I am not required to show
specific proof of workers' compensation insurance coverage for such residence because (please check the
appropriate box):
MI am performing all the work for which the building permit was issued.
❑ I am not hiring,paying or compensating in any way,the individual(s)that is(are)performing all the work
for which the building permit was issued or helping me perform such work.
❑ I have a homeowners insurance policy that is currently in effect and covers the property listed on the
attached building permit AND am hiring or paying individuals a total of less than 40 hours per week
(aggregate hours for all paid individuals on the jobsite) for which the building permit was issued.
I also agree to either:
♦ acquire appropriate workers' compensation coverage and provide appropriate proof of that coverage on
forms approved by the Chair of the NYS Workers' Compensation Board to the government entity issuing
the building permit if I need to hire or pay individuals a total of 40 hours or more per week(aggregate hours
for all paid individuals on the jobsite)for work indicated on the building permit,or if appropriate,file a CE-
200 exemption form; OR
♦ have the general contractor, performing the work on the 1, 2, 3 or 4 family, owner-occupied residence
(including condominiums)listed on the building permit that I am applying for,provide appropriate proofof
workers'compensation coverage or proof of exemption from that coverage on forms approved by the Chair
of the NYS Workers' Compensation Board to the government entity issuing the building permit if the
project takes a total of 40 hours or more per week(aggregate hours for all paid individuals on the jobsite)for
work indicated e building permit.
\` S 0- 2.1
(Signature of omeowner) (Date Signed)
MC rl%e ILP Fyak nck n Home Telephone Number -I1-1-Cl I to-L4 l(n Z
(Homeowner's Name Printed)
Sworn to before me this oC h� day of
Property Address that requires the building permit: i _ y,� t
Liz
18 t�00cilCknci AJFnyF � -
C�tunty er or otary Public)
�V Q an c)IL i N`i' (�rJ-1 _ Lynette B.Coe
—r_ Notary Public,State of New York i
No.0 1 C06198869
Qualified in Westchester County
— Commission Expires Jan.OS,20
Once notarized,this BP-1 form serves as an exemption for both workers'compensation and disability benefits insurance coverage.
BP-1 (12/08) NY-WCB
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JUSTICE COURT OF THE TOWN OF RYE
STATE OF NEW YORK: COUNTY OF WESTCHESTER
---------------------------------------------------------------------------X 19
PEOPLE OF THE STATE OF NEW YORK,
-against-
No. E . 1090
DANIELLE FREEMAN
------------------------------------------------------------------------------X
Be it known that 1, STEVEN E. FEWS the complainant herein and duly authorized Code Enforcement Officer of the
Village of Rye Brook, do hereby accuse the defendant(s)named above, residing at 78 WOODLAND AVENUE, who
is the owners of the property at which the following offences were committed, at, 78 WOODLAND AVENUE in the
Village of Rye Brook, State of New York,on the 2 1" day of JANUARY 2021 at or about 11:00AM o'clock.
COUNT ONE: VILLAGE CODE §91-2A BUILDING PERMIT REQUIRED
TO WIT: In that the above-named defendants did allow or cause to allow interior renovation work without permit, said
work is including but not limited to interior kitchen renovations and alterations to the premises. New fixtures and
appliances,counter top ,cabinetry,relocation of a gas stove and piping,and plumbing work.
COUNT TWO: VILLAGE CODE §180-23 PLUMBING PERMIT REQUIRED
TO WIT: In that the above-named defendant in association with interior renovation work has allowed or cause to allow
plumbing work to be done without a plumbing permit. Said plumbing work is including but not limited demo and
installation work on gas piping, rough plumbing supply lines and vent at the premises.
COUNT THREE VILLAGE CODE§113-6. ELECTRICAL PERMIT REQUIRED
TO WIT: In that the above-named defendant has failed to obtain the required electrical permit for interior work
associated with the interior renovations including but not limited to kitchen renovations outlets and fixtures.
COUNT FOUR: VILLAGE CODE §250-10.A CERTIFICATE OF OCCUAPANCY REQUIRED
TO WIT: In that the above-named defendant has failed to obtain a certificate of occupancy or compliance for the
work described in the first three counts of this instrument.
All the above is contrary to the provisions of the statutes in such case made and provided. The above allegations of fact are made
by the complainant herein on direct knowledge(and upon information and belie the source of which being an inspection(s)on,
September 1/21/2021& 1/22,2021 Any false statements made herein are pu 1ble s Class sdemeanor pursuant to
§210.25 of thf NY Penal Law.
Dated Cod rcem nt O
APPEARANCE TICKET
You are hereby directed to appear before the Justice Court of the Town of Rye,350 North Main Street,Port Chester,
New York 10573,(914)-939-3305,at 9:00am on the day of N\ , 20 ,
iin connection with your alleged commission of the above-described offense.
NOTE: UPON FAILURE TO APPEAR A WARRANT MAY BE MEDfM YOUR ARREST
i
Dated Code FnforAR6w6ff icer
i
�tE DR
JUSTICE COURT OF THE TOWN OF RYE
STATE OF NEW YORK: COUNTY OF WESTCHESTER %. 19 1�
--------------------------------------------------------------------------- X
PEOPLE OF THE STATE OF NEW YORK,
-against-
No . E . 1089
DANIELLE FREEMAN
----------------------------------------------------------------------------X
Be it known that 1, STEVEN E. FEWS the complainant herein and duly authorized Code Enforcement Officer of the
Village of Rye Brook, do hereby accuse the defendants)named above, residing at 78 WOODLAND AVENUE.who
is the owners of the property at which the following offences were committed,at, 78 WOODLAND AVENUE in the
Village of Rye Brook, State of New York,on the 2 1" day of JANUARY 2021 at or about 11:00AM o'clock.
COUNT ONE: VILLAGE CODE §91-2A BUILDING PERMIT REQUIRED
TO WIT: In that the above-named defendants did allow or cause to allow exterior work to be performed at the
premises without having first obtained the required permit(s). Said work is including but not limited to renovation of
the front porch/deck with new railings new decking boards, and. new front masonry walkway as depicted in the
attached photos.
COUNT TWO: VILLAGE CODE§113-6 ELECTRICAL PERMIT REQUIRED
TO WIT: In that the above-named defendant in association with the front porch/deck renovations has allowed or cause
to allow new electrical outlets to be installed at the front porch without the required permit.,
COUNT THREE VILLAGE CODE §250-10.A CERTIFICATE OF OCCUAPANCY REQUIRED
TO WIT: In that the above-named defendant has failed to obtain the required certificate of occupancy for the work
described in the first two counts of this instrument.
COUNT FOUR: VILLAGE CODE 250-10.D(2) NULL AND VOID CERTIFICAE OF OCCUAPNCY
TO WIT: In that the above-named defendant has caused the current certificate of occupancy to become null and void
due to the serving of notice of violations on the property in accordance with Village code.
All the above is contrary to the provisions of the statutes in such case made and provided. The above allegations of fact are made
by the complainant herein on direct knowledge(and upon information and belie the source of which being an inspection(s)on,
September I/21/2021& 1/222021 Any false statements made herein are pur !' b ri,lass -Ts meanor pursuant to
§210.2 f the NY Penal La
Dated Coe nforcement ffice
APPEARANCE TICKET
You are hereby directed to appear before the Justice Co rt f the Town of ye,350 North Main Street, Port Chester,
New York 10573, (914)-939-3305,at 9:00am on the _day of ,20�
in connection with your alleged commission of the above-described offense.
NOTE: UPON FAILURE TO APPEAR A WARRANT MAY(S"SSUEMR YOUR ARREST
Dated Code Enf �e �Officer
Qy� ORCuk. CERTIFIED MAIL
BUILDING DEPARTMENT HAND DELIVERED
VILLAGE OF RYE BROOK
t982 ' 938 KING STREET RYE BROOK,NY 10573
(914) 939-0668 FAX (914) 939-5801
NOTICE OF VIOLATION AND ORDER TO REMEDY SAME,
OWNER: l __ y VIOLATION# 2062
_ ;R NOTICE:#
SECTION:
t _-- BLOCK:
LOT: t
j. THE FOLLOWING VIOLATIONS OF THE NEW YORK STATE UNIFORM FIRE PREVENTION AND BUILDING
CODE AND/OR,THE COD.qF THE VILLAGE OF RYE BROOK WERE FOUND TO EXIST AT.....
( % C" !t `r- ,LOCATED IN A ' V Z ZONE,
E IN THE COUNTY OF WESTCHESTER,VILLAGE OF RYE.BROOK,NY ON, - !' 2011 .
CODE SECTION TITLEIDESCRIPTION
--`--------- --- -- - - ---------` (=S)
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NOTES:
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You are hereby directed to contact this department. obtain all necessary permits & commence to correct the above captioned violation(s)
immediately.Violations of the NYSUFP&BC must be remedied by, , 20 <' which is thirty(30)days after the date of this
notice and are returnable at the rate of$1.000.00/day for each day of continued violation. or imprisonment not exceeding one year, or both.
A re-inspection of the premises is required by law to confirm compliance with this notice &all applicable codes.
FAILURE TO CONHOLN- ti['I'll I'lliti %O,rl(:E IS A CRIME, Pt NISIL.,Bl, F'IS�I .jtX1 'I{.t��IE.Ai'OR BOTII.
❑f BUILDING INSPECTOR
❑ ASSISTANT BUILDING INSPECTOR
❑ VILLAGE ENGINEER
E .
§ 250-10 ZONING § 250-12
(4) No residential TCO may be issued by the Building Inspector for any property for
• a time period of more than 30 days. Upon written request, an applicant may
renew a residential TCO for no more than two additional times for a period of 30
days each. Any applicant that applies for a TCO beyond such extended period
must receive such approval from the Village Board of Trustees.
(5) Any fees must be paid in accordance with the License and Fee Schedule on file
in the Village Clerk's office.
C. Nonconforming uses. No nonconforming use shall be maintained, renewed, changed or
extended without a certificate of occupancy having first been issued by the Building
Inspector therefor.
D. Occupancy.
(1) A certificate of occupancy shall be deemed to authorize and is required for both
initial and continued occupancy and use of the building or land to which it
applies and shall continue in effect as long as such building and the use thereof or
of such land is in full fortuity with the provisions of this chapter and any
requirements made pursuant there
(2) On the serving of notice of any violation of any of4aid provisions or
requirements in respect to any building or the use thereof or of land, the
certificate of occupancy for such use shall thereupon become null and void and a
new certificate of occupancy shall be required for any further use of such
building or land.
• E. Fees. Upon written request from the owner, the Building Inspector shall issue a
certificate of occupancy for any building or premises existing at the time of the
enactment of this chapter, certifying, after inspection, conformity with the provisions of
this chapter and by payment to the Village of the requisite fee, as set forth in the
License and Permit Fee Schedule on file in the Village Clerk's office. [Amended 8-23-
2003 by L.L. No. 11-20031
§ 250-11. Pending applications for building permits.
All permits issued prior to the enactment of this chapter for buildings or structures which are
contrary to the provisions of this chapter shall be null and void unless substantial work has
been done toward the completion of said building or structure. If any of the above
requirements shall not have been fulfilled within one year, as stated in Article IV, § 250-
6F(6), or if building operations are discontinued for a period of six months, any other
construction shall be in conformity with the provisions of this chapter.
§ 250-12. Penalties for offenses.
A. Any owner, lessee, tenant, occupant, engineer, architect or builder, or the agent of any
of them, who violates or is accessory to the violation of any provisions of this chapter
or who fails to comply with any of the requirements thereof or who erects, constructs,
alters, enlarges, converts, moves or uses any building or structure, or land in violation
of any detailed statement or plans submitted by him and approved under the provisions
40 250:65 Supp 90,Mar 2019
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1/21/2021 View Larger Photo-Image Mate Online
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Photo March 2017
Photo 1 of 12
Photo for 135.75-1-69 in Village of Rye Brook
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Entry/CC#: RB-000241-21 Date: 01/21/2021 Time: 10:58 Tour: FDesk Officer: 1051 Page: 2
City/State/Zip:RYE BROOK, NY 10573-
Phone Number. . : (914) 305-2961
Sex. . . . . . . . . . . :M Race:
Person Type. . . :CALLER
NARRATIVE
1051:01/21/2021 11:06 - Caller reports there is a party at the listed
location giving him difficulty and requested a unit respond for assistance.
47 dispatched.
1051:01/21/2021 11: 16 - Stop work order issued by the Building Department
inspector; contractor complied.
1050:01/21/2021 11:59 - Upon arrival, I made contact w/ the building
inspector, Steve Fews, who stated he had a verbal dispute w/ a day laborer
at the above listed address. Mr. Fews stated the front porch was done
without a permit and the day laborer would not let him inside the house to
see any other work being done. The laborer refused to give Mr. Fews his
identification and a dispute ensued. Mr. Fews issued a stop work order. I
made contact w/ the day laborer, who verbally identified himself as Julio
Guierre. Mr. Guierre complied and immediately stopped working. Also
on-scene was the homeowner's father, Thomas Freeman. Mr. Freeman was
advised by Mr. Fews and myself that a permit needs to be submitted to the
building department for the front porch work and any future work being
done. The homeowner's boyfriend, who was not identified, appeared on-scene
angry and using profanity towards Mr. Fews. Mr. Fews left the scene. The
boyfriend continued using profanity in regards to Mr. Fews, so I advised
him to leave the scene immediately, which he did. Mr. Freeman stated the
boyfriend lived down the street on Irenhyl Ave for over 30 years and
personally did not like Steve. This report is for documentation purposes
only. Body camera footage was recorded.
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Printed: 01/27/2021 VILLAGE OF RYE BROOK PD Page: 1
At: 15:27:00 938 KING STREET
RYE BROOK, NY 10573-
(914) 937-1020
Entry/CC#: RB-000241-21 Date: 01/21/2021 Time: 10:58 Tour: FDesk Officer: 1051
Call Type. . . . . : ASSIST PARTY Priority. . : 1 How Received: CALL TO PD
Caller. . . . . : FEWS, STEVEN
Bus. Name. . :
Address. . . . : 938 KING STREET
City/St/Zip: RYE BROOK, NY 10573- Call Back # : (914) 906-4114
Location of Assignment: 78 WOODLAND AVENUE, RYE BROOK
Cross Street. . . . . . . . . . :
Business Name. . . . . . . . .
Description. . . . . . . . . . .
Disposition. . . . . . . . . . . : COMPLIED
Post: 47 Dispatched: y Dispatched Date: 01/21/2021 Call Taker: 1051
OFFICERS INVOLVED
Serial #: 1050 Rank:PO Name:MICHAEL DELLA VECCHIA
UNITS INVOLVED
Unit: 47F Officers: (1050)
Disp. Time: 10:57 1 Arv. Time: 10:58 1 Comp Time: 11:35
Rcv'd to Comp: 0:37 : : Disp to Comp: 0:38
ASSOCIATED NUMBERS
PERSONS INVOLVED
Name. . . . . . . . . . :FREEMAN, DANIELLE DOB:05/12/1989
Address. . . . . . . :78 WOODLAND AVENUE
City/State/Zip:RYE BROOK,
Phone Number. . :717-916-4162
Sex. . . . . . . . . . . . Race:
Person Type. . . :NOT INTERVIEWED
Name. . . . . . . . . . :FREEMAN, THOMAS DOB:05/23/1961
Address. . . . . . . : 993 PINEBROOK BLVD
City/State/Zip:NEW ROCHELLE, NY 10804-
Phone Number. . : 914-804-6901
Sex. . . . . . . . . . . :M Race:
Person Type. . . :PERSON INTERVIEWED
Name. . . . . . . . . . :GUIERRE, JULIO DOB: 12/20/1958
Address. . . . . . . : 163 WILLIAM ST
City/State/Zip:PORT CHESTER, NY 10573-
Phone Number. . .
Sex. . . . . . . . . . . . Race:
Person Type. . . :PERSON INTERVIEWED
Name. . . . . . . . . . :FEWS, STEVEN DOB:
Address. . . . . . . : 938 KING STREET
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1/21/2021 Printer Friendly Report-Image Mate Online
Property Description Report For: 78 Woodland Ave,
Municipality of Village of Rye Brook
Cy�sTIE
Status: Active
Roll Section: Taxable
Swis: 554805
Tax Map ID #: 135.75-1-69
_r Property Class: 210 - 1 Family Res
Site: RES 1
• In Ag. District: No
Site Property Class: 210 - 1 Family Res
Zoning Code: R2-F 2FAM
Neighborhood Code: 01001 -
VPC/VRB/PCSD
Total Acreage/Size: 0.12 School District: Port Chester-Rye
Land Assessment: 2020 - $173,000 Total Assessment: 2020 - $424,500
Full Market Value: 2020 - $424,500
Equalization Rate: ---- Property Desc:
Deed Book: 48233 Deed Page: 54
Grid East: 718171 Grid North: 793497
Area
Living Area: 1,216 sq. ft. First Story Area: 634 sq. ft.
Second Story Area: 582 sq. ft. Half Story Area: 0 sq. ft.
Additional Story Area: 0 sq. ft. 3/4 Story Area: 0 sq. ft.
Finished Basement: 0 sq. ft. Number of Stories: 2
Finished Rec Room 0 sq. ft. Finished Area Over 0 sq. ft.
Garage
Structure
Building Style: Colonial Bathrooms (Full - Half): 1 - 0
Bedrooms: 3 Kitchens: 1
Fireplaces: 1 Basement Type: Full
Porch Type: Porch-coverd Porch Area: 270.00
Basement Garage Cap: 0 Attached Garage Cap: 0.00 sq. ft.
Overall Condition: Normal Overall Grade: Average
Year Built: 1915 Eff Year Built: 1978
Owners
Karl C Tsakos
78 Woodland Ave
Rye Brook NY 10573
hftps://townofrye.sdgnys.com/report.aspx?file=PhotoMarch20l 7/T000011/554805135075000106900000000016.jpg&swiscode=554805&printkey=135... 1/2
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Sales
Property Prior Value Arms Addl. Deed Book
Sale Date Price Class Sale Type Owner Usable Length Parcels and Page
8/7/2008 $350,000 210 - 1 Land & Foudy, Yes Yes No 48233/54
Family Building Thomas
Res Barry
4/22/1996 $0 210 - 1 Land & FOUDY, No No No 11407/207
Family Building THOMAS
Res J. &
GRACE
Utilities
Sewer Type: Comm/public Water Supply: Comm/public
Utilities: Gas&elec Heat Type: Hot wtr/stm
Fuel Type: Natural Gas Central Air: No
Improvements
Structure Size Grade Condition Year
Porch-coverd 270.00 sq ft Average Fair 1915
Special Districts for 2020
Description Units Percent Value
CS482-VPC Sewer 0 0% $424,500
SW481-Solid Waste All 0 0% $424,500
Vlgs
Exemptions
Year Description Amount Exempt % Start Yr End Yr V Flag H Code Own %
Taxes
Year Description Amount
2019 County $1,464.89
* Taxes reflect exemptions, but may not include recent changes in
assessment.
https://townofrye.sdgnys.com/report.aspx?file=PhotoMarch20l 7tT000011/554805135075000106900000000016.jpg&swiscode=554805&pdntkey=135... 2/2
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