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HomeMy WebLinkAboutBP21-140PERMIT #9�6al- I YO � DATE: 10 O o7 D(P; SECTION 11), 35 BLOCKK^ � LOT, TYPE OF WORK __Tn7t2r/0/ D400 'C@, 70V JOB LOCATI / " I /Cyc4C22T OWNER Ql.�1 i� OI %•�� SooLLC UPI 396 - CONTRACTOR AQd4.)1ri4j W0101I'L Lc O Lc Q oe/ Zc EST. COST 4 c 6D 000 _ FEE ✓CO # — 1,,Q4 FEE 0�/0-P % DATE TCO # FEE DATE INSPECTION RECORD DATE FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION \ L� PLUMBING RGH PLUMBING GAS 0 SPRINKLER ELECTRIC LOW -VOLT lye ALARM O AS BUILT O FINAL I NSP f �I y)396-9604 0 'a C lec' a941%4jeCl4t4la t � OTHER APPROVALS ARB VILLAGE OF RYE BROOK WESTCHESTER COUNTY, NEW YORK No: 22-124 Certificate of (occupancy This is to certify that of, Byn / V 7 having duly filed an application on 1 ) 20 requesting a Certificate of Occupancy for the premises known as, �/ / Sau fh 0)olGe 3fyeej , Rye Brook,NY, located in a �Zoning District and shown on the most current Tax Map as Section: Iq J. 3 D Block: a Lot: and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No. Q , issued 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: 6US) rIeSSC.0 Construction: for the following purposes: 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 s 11 be made,nor shall the building be moved from one location to another until a permit to accomplish such change hasp o a' om t e ding Inspector. Building Inspector,Village of Rye Brook: Date: SEP 6 2022 D BUILDING DEPARTMENT For office use onl : PERMIT# 1- 2X— 7O APR 1 4 2022 VILLAGE OF RYE BROOK ISSUED: /0=a/ 938 KING STREET,RYE BROOK,NEw YoRK 10573 DATE: —/#— VILLAGE OF RYE BROOK (914)939-0668 FEE: 0 '7/O� PAID$ BUILDING DEPARTMENT I www.ryebrook.org 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 **rtwrtwrwwr*****ww*rtrtrtrrwwrw*****+**w++***rtwrrrwrwwrwr*rwr*w*w**++rtrtrtrtrtrtrt+rtrtrtwrtwwrww***rt*r+w+rtrtrt+*wwwwrrwrrww*++****+**w*++*w* Address: all Occupancy/Use: Parcel ID#: - Zone: CLe Owner: Address: ' P.E./R. or Contrac or, c;' - t�e s: Person in responsible charge: �(/1� l_(F / ZZ���d s: s L Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issuance of a Certificate of Occupancy/Certificate of Compliance for the structure/construction/alteration herein mentioned in accordance with law: STATE OF NEW YORK, COUNTY OF WESTCHESTER as: ►`'ldd e, / being duly sworn,deposes and says that he/she resides at (Print Name of Applicant) �) p (No.and Street) in LJV t'� � 1 ,in the County of ��5y y�l � in the State of f,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:$ On C-2 , for the construction or alteration of: J, /�" / ' I 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§250-10.A.of the Code of the Village of Rye Brook. Sworn to before me this 14 Sworn to before me this day of , 20(�-7/ day of , 20 �Jfi— Sign1re of erty Owner Signature of Applicant Print Name of Property ner/ Print Name of Applicant Notary Publiv/"TLZZ Notary Public STEVEN D. I PUBLIC,STATE OF NEW YOW Registrabon No.4864761 Qualified in Weetchmer Co Commission Expkm June 18 20 �yE BRO cu � 1982 BUILDING DEPARTMENT 1nD UILDING INSPECTOR SSISTANT BUILDING INSPECTOR VILLAGE OFRYEBROOK ODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www ryebrook.org - - - - - - - - - - - -- - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - -- - - - - q'z�� �� '� � ,a- ADDRESS: I 1 DATE: ;� "'--p PERMIT# ' O ISSUED: 'D�2�ECT: `�"I�LOCK:�-- LOT: ,per ! LOCATION: T� �"� �y / C D) �" " VCCUPANCY• ❑ VIOLATION NOTED THE WORK IS... d ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION ! REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION �1 �] NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ Ff*E SPRINKLER ❑ FINAL PLUMBING [].,CROSS CONNECTION FINAL ❑ OTHER �QyE BRC��• O Zm 1982. cu � l7 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 �/ ` ST- DATE: PERMIT#- 1 ` ` ISSUED: I D Z(SECT: BLOCK: LOT: LOCATION: �O l�j��/ N �L \UR N�V OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... �P 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 2 G ❑ FUEL TANK 9 —7 ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ NAL ❑ THER`I �E BRC�k, O�` tim cu � 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 r www.ryebrook.org - - - - - - - - - --- - - - - -�= INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADAESS : l , V� ` Q ' \—Q.L? , DATE:a(�2. -Z I , ��'m -7�7 PERMIT# ISSUED: SECT:--�BLOCK: LOT: LOCATION: OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑" ACCEPTED ❑ REJECTED/REmSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: Z ROUGH PLUMBING f ❑- ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER O 01 rl `o C14 LV oC C 96 � O Lii MOD o M > v Q O� z � O zo a z M .. � � S ommo w as 00 cc 04 1-0 � � V C� W A q L=• U C ?. F60.1 g N z z `" < ^ W /Q�W•• ° i aR ft BUILDING DEPARTMENT JUL 2 8 20211 DD VIL , E OF RYE BROOK 938K1Nq rT IYE B ,NY 10573 VILLAGE OF RYE BROOK (914)9 )939-5801 BUILDING DEPARTMENT .or ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required / FOR OFFICE USE ONLY BP#: ��— O EP#: Q� 1—[ 9� Approval Date: .1(A0 8 2021 Permit Fee: $ 3a-) Approval Signature: Other: Disapproved: (fees are non-refundable) ****************** ***p* ************************************************************************** Application dated, O eD� is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install an or remove electrical equipment,wiring, fixtures,or to perform other high or low voltage electrical work as per the detailed statement described below. 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: 'Z1� S. lK% U� \\ SBL: I l.�1 I t 3 c7 —-�,--3�Zone: �2 I 2.Property Owner: 1 Q-C> I\o!c QL dress: Phone#: Cell#:CW:� 39 tt "1 ill(U email: 3.Master Electric: ►t 1)CLc A 000n W(-j— Address: 3 U n A V-e-C Lic.#:4 1 L Phone#: G11 N qCj 17 1ell#: email: Company Name: E.C. eel LL �, G Address: 4.Proposed Electrical Work/Fixture Count: r tee ak i OfoLAes -!?iaaLKC STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: being duly sworn,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 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 V 20 Signature of Property Owner ignature of Applicant plchcvb Coo+11-Jt' Print Name of Property Owner Name of Applicant L� Notary Public Notary Public SHARI.MEULLO Notary Public,State of New York No. 01 ME6160063 Oualified in Westchester County Commission Exnires Jantta-,Pq pn 3/21/19 Phone: 914-347-3595 Westchester Rockland Electrical Inspection Services, Inc. DO NOT WRITE HERE-FOR OFFICE USE ONLY 43 North Lawn Avenue L Fax: 914-347-3596 Elmsford NY 10523 r� � BUILOINO PERMIT NO. TEMP# DATE _ CITY OR VILLAGE ZIP CODE TOWNSHIP COUNTY STREET AND N0.OR 11 - POLE NUMBER BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATE SECTION,' �-,BLOCK LOT OCCUPANT'S NAME 0 BUILDING OCCUPANCY OWNER'S NAME AND ADDRESS HOME TELEPHONE NUMBER CURRENT SUPPLIED BY FROM THEIR OFFICE WORK TELEPHONE NUMBER LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED NUMBER OF OUTLETS NO.OF FIXTURES& MOTORS HEATERS OFFICE USE LOCATION LAMP RECEPTACLES ONLY SIDEWALL SWITCH INCADE FLUORE N INSPECTION OUTSIDE E al BASEMENT t"FL a� + 2-FL. VI LAGE 3-FL. 121 BULDING DEPARTMENT REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: THIS APPLICATION IS INTENDED TO COVER THE ABOVE LISTED ITEMS TO BE INSPECTED.IF AT ANY TIME OF INSPECTION ADDITIONAL ITEMS HAVE BEEN INSTALLED,YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE FOR THE ADDITIONAL ITEMS INSPECTED AS PROVIDED BY THE APPLICANT.THE APPLICANT DECLARES THAT THERE IS NO OPEN 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 L-; MUST ENTER APPLICANTS IDENTIFICATION NUMBER SERVICE ENTERS BUILDING OVERHEAD❑ UNDERGROUND! AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACE MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. NAME OF COMPANY DATE OF APPLICATION SIGNATURE OF APPLICANT ct x STREET ADDRESS TELEPHONE NO. LICENSE NO.MRIEN APPLICABLE IF WESTCHESTER ROCKLAND ELECTRICAL INSPECTION VNE1%iSFRVICM 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: GEC Electric Inc. Pawling Holdings LLC 33 University Place NY, Portchester 10573 Located at:211 S Ridge St Rye Brook, NY 10573 Certificate Number: 1034069 Section: 141.35 Block:2 Lot:39 BDC: Permit Number: EP:21-190-BP:21-140 A visual inspection of the electrical system at this premise described as a Commercial occupancy,wherein the premises electrical system consisting of electrical devices and wiring,described below,located in/on the premises at: 211 S Ridge St 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 04/11/22 Name Type Quantity Switch Single Pole ------- 46 Receptacle Convenience ------- 35 Receptacle GFCI ------- 12 Fixture-Luminaire Incandescent ------- 112 Exhaust Fan ------- g Microwave ------- 2 Cook Top 1 Exit Lights ------- 4 Emergency Lights ------- 6 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. r a o� ca a Ok 96 v, 3x r mo •' rwl Q V € � m G' 0. I� a w A oo M 0 � wc w Z � � z � Q O oo ,,..1 '~ a a Q 396a y C16 z F C F r, N ZPOO Q Z C G .. a W a A w p �E �MENT BUILale- NOV -$ 2021 VILLAGE OF RYE BROOK 938 KiNd.S tXEET RYE BM 9. ,NY 10573 VILLAGE OF RYE BROOK (914)939-015 %' BUILDING DEPARTMENT www. ytbiook.org ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required `p FOR OFFICE USE ONLY BP#: C;/I— EP Approval Date: NOV — 9 2 21 Permit Fee: $ Approval Signature: Other: Disapproved: (fees are non-refundable) Application dated, U '2/ 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. q 1.Address: SBL: 1 71 i 3 —o�—3 / Zone C/ 2.Property Owner: c ,c Address: Phone#:9/7—39 6—91p lQ6 Cell#: email: ��C 3.Master Electrician: Address: yihone#:ItyCell#:IF/I email: 5UYE j*42ui'(4140, MS-�,o•� Company Name: Address: /0' MQ ow a le^-IDA Qr it AZ-a— n2emlraoil jnc� 4.Proposed Electrical Work/Fixture Count: ********************************************************************************************************* STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: 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 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 ,20 Signature of Property Owner ignature o t y.. C,y 'j- AncL':( ^2 Print Name of Property Owner ame of A an Notary Public Notary B*jgi iOELLLO Notary Public, State of New York No. 01 v1E616!!r'�3 Q-ialified in Westchester County Cornmission Expires January 29.20 L� 8/lv2021 Westchester Rockland Electrical Inspection Services, Inc. Phone: 914-347-3595 DO NOT WRITE HERE-FOR OFFICE USE ONLY 43 North Lawn Avenue lt/ Fax;9.14-347-3596 -i ly BUILDING PERMIT NO. Elmsford, NY 10523 TEMP# DATE -1 L! L CITY OR VILLAGE ZIP CODE- TOWNSHIP COUNTY STREET ANu,,K,6, ROAD So. R y _ - POLE NUMBER BETWEEN WHAT TWO CROSS STREETS IS PREMISEStOCATED7 SECTION BLOCK LOT OCCUPANT'S NAME BUILDIN OCCUPANCY OWNER'S NAME AND ADDRESS fit <.' HOME TELEPHONE NUMBER CURRENT SUPPLIED BY FROM THEIR OFFICE WORK TELEPHONE NUMBER LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED NUMBER OF OUTLETS NO,OF FIXTURES& MOTORS HEATERS OFFICE USE LOCATION LAMP RECEPTACLES ONLY SIDEWALL SWITCH INCADE I FLUORE NO. H.P.EACH NO. WATTS EACH INSPECTION OUTSIDE BASEMENT Q , 1''FL. Nny - Q tf 2-FL. j 3-FL. B ' E REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: THIS APPLICATION IS INTENDED TO COVER THE ABOVE LISTED ITEMS TO BE INSPECTED,IF AT ANY TIME OF INSPECTION ADDITIONAL ITEMS HAVE BEEN INSTALLED,YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE FOR THE ADDITIONAL ITEMS INSPECTED AS PROVIDED BY THE APPLICANT.THE APPLICANT DECLARES THAT THERE IS NO OPEN 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 CONDFTIONS AS SET FORTH FOR THE APPLICATION. SIZE OF SERVICE FEEDERS CHARACTER OF WORK NEW[I ADDITIONAL❑ EXPOSED I] CONCEALED❑ MUST ENTER APPLICANTS IDENTIFICATION NUMBER SERVICE ENTERS BUILDING OVERHEAD❑ UNDERGROUND L 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 x------- ---------- STREET ADDRESS TELE410M N0. Cm OR "� LICENSE NO.WHEN APPUCABLE / ' WESTCHESTER 71 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: Arcuri Alarm Systems Pawling Holdings LLC 1050 Mamaroneck Avenue NY, Mamaroneck 10543 Located at:211 S Ridge St Rye Brook, NY 10573 Certificate Number: 1034027 Section: 141.35 Block:2 Lot: 39 BDC: Permit Number: EP:21-294-BP:21-140 A visual inspection of the electrical system at this premise described as a Commercial occupancy,wherein the premises electrical system consisting of electrical devices and wiring,described below,located in/on the premises at: 211 S Ridge St Rye Brook, NY 10573 Basement E5 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 04/12/22 Name Type Quantity Smoke Detector ------- 44 Heat Detector ------- 1 Pull Stations Fire Alarm ------- 5 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. N aC C,4 M M a = v s y � 3 a. b o • W r W z ON ~ o Q W a `'' pe Q L V g r Gil Www E � zoW � m E a 00cn Ic ~ d a BUIL E v� MENT R VIL E OF RYE OK AUG 12 2021 DD 938 KIN ET RYE B ,NY 10573 (914)9 939-5801 VILLAGE OF RYE BROOK org BUILDING DEPARTMENT PLUMBING PER1M'IT APPLICATION 2 FOR OFFICE USE ONLY BP#: p�I. 7O PP#: �— J Approval Date: Permit Fee: $ A0 Approval Signature: Other: Disapproved: (fees are non-refundable) ************************************************************************************************** Application dated, 08/2/21 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 work will be in conformance with all applicable Federal, State,County and Local Codes. 1.Address: 211 S Ridge St SBL: Zone: C 2.Proposed Work: Relocate plumbing fixtures for bathrooms 3.Property Owner: Address: 2111 S Ridge St / Phone#: Cell #: email: , �/0/1, 4.Master Plumber: Ken McCabe Address: P.O. Box 650 Briarcliff NY 10510 Lic. #: 983 Phone#: Cell#: 914-804-5412 email: Company Name: VFR CONTRACTING Address: P.O. BOX 650 BRIARCLIFF NY 10510 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 i 1 st Floor / 2nd Floor 31 Floor 49, l 4`h Floor 5`h Floor Exterior 5.* List Other Equipment/Provide Details: (Notarized Signatuces Required Next 2 Pages) WIVE -Z- •juraijddu aqj of pauml;)j aq 11!M PUB Pion put,jjnu powoap aq jjvgs pau2is X1.mdoid jou .zo/pu-e Xj3mjua sli ui pajaldwoo Xjndoid jou suoilivilddd •papinoid sands auj ui pioaaz jo jumilddu ;)qj puu `Xiadoid vma qns ogljo (s)jz)unno 10al oqj jo (s)al!njru5is pazpujou aul apnjoui isnw puu Xjanjua sit ui pajajdwoo Xllz)dold aq Isnw uoiluaiiddu sigl CZ=z/Zo 694&3 uolss+.unuoC u0j"W WOO LAURA E SMITH �OISOWiSBM ul PGWIB b Atuno -19 S G Notary Pudic,State of Now YaVc �Wr� k++no'J�else�IseM ul pel}!I 6EL18£9WS LO'°N'�21 Reg.No.Oi SMfi38773A AMeN�°83WS`�pnd NeloN 6ELLMViS I0'°N'Bea Quaidw in westdwter Coup HliWS 3 Vi nyl of n Clelo ►ok hwN 10 eie1S'°1p"d tied°N C��g oy2y�p b Cie o .lg d µ-LmS 3 Y8nV1 jueogddV jo awuX jui.ld laumo Xjaado.ld J0 awsN luiad ageDoIN u;)N ifZ'f\ �A0-1 juuoijddH3o a.lnjeu2!S .lauMO,C 01 o u21S +f , l Z OZ` Bnd 30 Xup 6ZOZ 6ny i 3o Cep puZ sigi ow 31o33q of u.lomS puZ slgj aw a.lojaq o)uaoMS -suoijsln2al puu saoueulp.lo `smsj o1gsoi[dde lagjo 1je pue xooag a/(-d3o 32BI n aqi jo apo:)oqj`apoD 2ulplmg W uo1;uana1d aai,q w103!un ajejs 110A m3K aq;gjIm aouepa000e ut se 11am se`suo«eoyiaads pue sueid panoadde SuiXusdwOooe,Cue ui pue u011e3ildde stgj u►paum1wo pus gj1o3 las se sj!ejap aqi giim aouewao3uoo ui aq Ili,\/Cuadoid pauo«deo anogs aq;m pajonpuoa asn jo `paw.loj.lad jiom,Cue j qj pus 3ailaq pus o9p3lmoul aaq/siq jo 1saq aq1 of ma a.le uia.laq pauisjuoo s;uawnns Ile 1egj (o1a',iau�oue'luaSe`�olae�luoa`loauya�e aleaipw) -uogeoildds sigl alg pue;)1m of pozpogjns,Clnp si pus.launW legal aql ao3 10loealuoD aqj st aq(s)jegl.lo`su►uvod uot;soildde sigl gaigm of X41adoid ag13o.laumo I7a2al oqj st aq(s);sgj saleis.lagl.m3 pus (lueoydde aql se SuiuSis lenpinipu130 aweu wild) `pawsu anoge jueoildde oqj si aqs/aq 1sg3 sajels pus sasodap`uaoms,Clnp Oulaq ` aquD3A u;)N :ss ( 2I31.S3HD1S3M AO A.Ll nOD `MOA Mgtq d0 31VIS BUILDDMENTD CCIEO VE VI E'OOK 938 KING ET NY 10573 AUG 12 2021 (914)9 9-5801 ID VILLAGE OF RYE BROOK BUILDING DEPARTMENT xxxxx�xxxxxxxxxxx��xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx�xxxxxxxxxxxxxxxxxxxx�xxxxxxxxxxxxxxxxxxxxxxx*x AFFIDAVIT OF COMPLIANCE VILLAGE CODE §216 OSTORM 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 WESTCHESTER ) as: 3, "%3 L4V12 , residing at, )i FgK C S (Print name) (Address where you liv being 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; 211 S Ridge St , Rye Brook, NY. (Job Address) 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. (Signature of Pro l sii (Print Name of Property Owner(s)) Sworn to before me this 2nd day of Aug '021 (Notary Public) LAURA E SMITH Notary Public,State of New York Reg,No.01SM6387739 Qualified in Westchester Courtly Commission Expkes 02 25=23 3/21/19 Building Permit Check List&Zoning Analysis Address: Z l S - SBL: Z 3 Zone: G - Use: is Const.Type: ( Other. Submittal Date: Z 1 Revisions Submittal Dates: Applicant: t -Z k Nature of Work: l to t{r-2-( D n— l) F r—l Lf V,A-I—e?r—. vi ws:ZBA:-i I IN PB: BOT: Other. hMp OK ( ( ) FEES:Filing. ZT BP: �2 S�. �� C/O: Legalization: APP: Dated: Notarized -�'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: ( (Jf PLANS:Date/Stamped: Sealed✓ Copies: ZElearonic Other. ( (�License ✓ Workers Comp: ✓ Liability U-- Comp.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. ( ) ( ) 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: REOUIRED EXIMN PROPOSED NOTM APPROVED Ate Qro• .111-Nfl�r� Circle. Fie Front: Front: Ste: RAW Main Cov Acts,Cor. 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THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERISI.AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE NO(DER IMPORTANT If the certlfrcate holder m an ADDITIONAL INSURED tha pohr.Ylies)must have ADDITIONAL INSURED provisions or be andorsed If SUBROGATION IS WAIVED.sub)ect to the terms and condtbons of the policy certain policies may re"ore an andorsament A statement on this ctMMCMs does not confer rights to the carlthcate holder In IIVU of Such ondoraanommal NAB[ lase'••E SaNafve AN NNLIrmuranceAgei;, F -[r Igtar977.11T0 --^ jLtA19Ii-Tt�a `•� Suuth Rr a$I.ef' �'�• LOA a" ADDlttss nalrit:Yal-3v Ayer rr.Utlt t suftIF1st APPOFANG COVEEAM tWta Hw BU.d N*t I-•1 aNaua[R A EvenMon Insurance Company 75378 1NflMED-. __- :r.fu11[IIE IsGM M/Svrancf COntparl/ ta'6t Pa**r9-01oings.LLC 1NsuRFa c 25 Sr,,.r RegerN Skmt 1RFAR -NauIEBB tuElarB E Pon Chester NY ItKT f COVERAGE! CERTIFICATE NUMBER- aJ0r'd1-W1Q2 REMKIN N~111 'MIS K TO CERTIFY T"A-T11E POLIO*% %INS,w-N-E t 1,1tt1IELM HATE SEE-,ISSUED TO THE PSSUAED NAMED ABOVE FOR'-*POLICY PERADD "ODK:ATED NOTWITHSTANDINIU ANY REQURENE NT TERM OR CONDITM CW ANY CONTRACT OR OTHER DOCLAIM WITH RESPECT TO foslcm THE .F R1IFICATE MAY Sk ISSufrU OR MAY pk to l Av. 1..F tNSuRANCF AfF f1RCKn A•TMF POI IrSFS OF Sf,fRl!!♦D MEREM K CUS,If f.T TQ 4.'r4'ERNS LR1:LUSIONS A*��JN.JIrIOWS OE SU(.••oOL1�1Es .Vi'''MOWN MAI-A,•E BEEN REDuC1 D By PAIL _ AWS y 111_ I'm OF Parr FIDE •YYYy fsBaBtYTYY V Lila COINIIRCIAL DEIIERAI MINIM EA.H., •E•. It t t O00 O0r _LAR6 1-11 A X Ww '' f too.000 CEntrataw Lamy I I uEU LaP,Ar.wT remm EXCLUDED A 510000Ded-pat 0" r' WQVfpeco u� 1t n7oz •iJr PERSU%AL%A-.•. 1000000 utNt ACl.rfewn.AA14"" PER LA NE A.ru 00 t"Am S 20 oar)t,-. 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D�PLOIERS LOrfM atAatur♦ YrM tAI I f �Ar1r PVOPwE ••-••awtALWIME pFIGlAfNss1lEAEr:.,aIED' ❑ • A feM EI EA•„+4CGl�' 1 I1 tAFAASI FAFU--: ff f aw.rM,•M zeros• M Vr RIPr�1 OF Jr'ENArM IN6 Miry EL UIWIt atgM r'.ANt f wA DE SC*W YQN or OPtaNTtOht LOCAROM eetdCUB taeBBB n+adara.r Bs.aras tk...r.raw w slrar 1/�...twN....,.a � 1 nn c.Pnalcata Holder s rK*+Osd as an alldAonM msureG wflen nglred manner wane• r.Mnrt a ASneme•+ CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF+ME ABOVE DESCRIBED►OLtCIES BE CANCELLED BEFORE THE EXPIRATION OATS THEREOF NOTICE WILL BE DELIVERED IN V,bge •Rr,.B,00u ACCORDANCE WITH THE POLICY PRONSIONS 938 Kmps Street AUr Hple/ED AF MF7FMtAi1vF Rve Brw• Nv tau+ 1963.2015_ JACORD7CONOMATR31N. AN 091ft r=wv*d. ACORD 25 12016,031 The ACORD name and logo are registered marks of ACORD NYSIF New York State Insurance Fund 199 CHURCH STREET.NEW YORK,N.Y. 10007.1100 nystf.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE O. '— Ail A A A A A A 451481271 LEVITT-FUIRST ASSOCIATES LTD 520 WHITE PLAINS ROAD,2ND FL O TARRYTOWN NY 10591 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER PAWLING HOLDINGS LLC VILLAGE OF RYE BROOK 25 South Regent Street(REAR) 938 KINGS STREET PORT CHESTER NY 10573 RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE G2146 860-8 436679 06/29/2020 TO 06/29/2021 4/13/2 221 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO 2146 860-8, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY,INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WESSITE AT HTTPS:/IWIWW.NYSIF.COM/CERTICERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER THE SOLE PROPRIETOR,PARTNERS AND/OR MEMBERS OF A LIMITED LIABILITY COMPANY THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 947891683 U-26.3