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HomeMy WebLinkAboutBP21-163PERMIT #13`- >/'_/_ eO 3 DATE: 2/$)oc EXP:IF 01 8 �� SECTION..I '9 5' BLOCK f LOT o� TYPE OF WORK OP �I� 7� er�ov%2470"I 10B LOCATION OWN CONTRALTO /EST. COST CO #_� TCO # OTHER APPROVALS ARB BOT PS ZBA OTHER v i sa IF 7S 740 n 3 7- 8a 7y / Qcaeri.� a s7 rpve/ e—I ho Ce.o�ezo loI /51v--C�907 . 2 ii r' FEE 49 `Z ) -I `1 � 09(o FEE ATE l�►o�'r 13� "��=� FEE DATE INSPECTION RECORp I DATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION Z \ PLUMBING Ce RGH PLUMBING GAS NG�Y ^ _ SPRINKLER ELECTRIC LOW -VOLT Q __ ALARM AS BUILT FINAL VILLAGr OF BROOK WESTCHES ` COUNTY, NEW YORK No: 22-076 Certificate of Occupancy This is to certify that JohK) GU�� �r� b a of, Rye BLiDoe o Al y , having duly filed an application on T Y 120 0�0� requesting a Certificate of Occupancy for the premises known as, P/a C(f , Rye Brook,NY, located in a )Q-/5 Zoning District and shown on the most current Tax Map as Section: Block: Lot: C-?> \5 and having fuullly complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No.( C I - / , issued 7 ";;s 20 <;2/, 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: e-3 ore" am// , Construction: for the following purposes: 1 7 C V O Y l� TL!' /�r� s �� I / ��0• r�r�oya-f�or� 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 be made,nor shall the building be moved from one location to another until a permit to accomplish such change has been ob . ed fro Building Inspector. MAY 1 � 1022 Assistant Building Inspector,Village of Rye Brook: Date: E jD D E C E �� For office use only: BUILDING i ARTMENT PERMIT i _l 67,� APR 1 1 2022 VILLAGE OF RYE BROOK ISSUED: - 2) -Z 38 KING STREET,RYE BROOK,NEw YORK 10573 DATE: VILLAGE OF RYE BROOK (914)939-0668 FEE: l oS. PAID BUILDING DEPARTMENT wwlv,ry&1!o1Lorg APPLICATION FOR CERTIFICATE OF OCCUPANCY,CERTIFICATE OF COMPLIANCES AND CERTIFICATION OF FINAL COSTS TO BE SUBMITTED ONLY UPON COMPLETION OF ALL WORK, AND PRIOR TO THE FINAL INSPECTION Address: 0 � v Occupancy/Use: /--/C, Parcel ID#: c�`J /—�� -Zone: Owner: r Owner: -� A\11 W,N Address: ,fie � P.E./R.A.or Contractor: b/eG,WS >gonw..�iH�O 'Address: /6 G(JP�Sf V1F k)AVe w1go A.)y Person in responsible charge: Address: e.- /aS 7`3 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 Y'ORK,COUNTY OF WESTCHESTER as: ( ,C/�A r01 ` j 6 b I !16K being duly sworn,deposes and says that he/she resides at 1 ((,� Iq w (v1 J '5-�Ck e+ Print Name of Applicant) (No.and Street) in ,in the County of t`G?I r L ' e l 4 in the State of c7 ,that (Ci own/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 eqppment,professional fees,and including the monetary value offa any ,materials and labor which may have been donated gratis was:$ Z O () 4 3 '� &ro () = 7, for the construction or alteration of C) ('c` 'r. ke-10.'- .4:5�AA fsqq? 42n0V427�0 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 fiuther 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 tT�ode of the Village of Rye Brook. Sworn to fore me this 41 Swom to before me this day of t.`T ,20� day of ,20aa Si ture of Property Owner i o pplicant Print Name of P ¢e Name of Applicant otary No Notary Public, State of New York P"P.ALMANDER idc. 01l,IiE6160C63 8/12/2021 NW TK)B ,WNEWYOP O+ialified in Westchester County i.D•401AW14646 Commission Exbires January 29,20�1 MY,COMMfON EXMRES 03/01/2025 cu � Q�i� . 'o BUILDING DEPARTMENT UILDING INSPECTOR ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK A]CODE ENFORCEMENT OFFICER 938 KING STREET - RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www.ryebrook.or� - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - -- - - - - - - - - - - ADDRESS: ` � ITE• PERMIT# `' l r`ce � 1 ISSUED: E T: BLOCK: I LOT: LOCATION: �� O�I r�.ea OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... p ACCEPTED ❑ REJECTED/REINSPECTION D SITE ECTION 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 /6 OTHER QyE BR(�v�. O� 2� cu � 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 wwwebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS:— �S���V.YJO17 ��• DATE: G (- Z z PERMIT#- Z t - (C) ISSUED: ( ( SECT: Z�'S� BLOCK: LOT:2--�; LOCATION: �� �L f fl� �L��- � �' D�L �..� - 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 V ❑ FUEL TANK ❑ FIRE SPRINKLER s ❑ FINAL PLUMBING ❑ ROSS CONNECTION FINAL L.L Foel_ -� >(,:LC � ❑ OTHER QyE BRC�uk o`` tim 1982 BUILDING DEPARTMENT ❑BUILDING INSPECTOR ,ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAX (914) 939-5801 www ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - ADDRESS :— � �J�+ DATE: PERMIT# ISSUED: SECT:\--�� �l BLOCK: 1 LOT:' LOCATION: OCCUPANCY: �- - ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/REINSPECTION Gl SITE INSPECTION .%�\�f i� REQUIRED ❑ FOOTING vJt- ❑ FOOTING DRAINAGEV� ❑ 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 DRC�� • �9�2 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 - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - �ADDRESS :- In n kDATE: PERMIT# ISSUED: SECT: BLOCK: LOT: LOCATION: t ���i�, � OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED Cl' REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ XNDERGROUND PLUMBING NOTES ON INSPECTION: ROUGH PLUMBING ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS � C 'tom, _ W� t/L t^l ►-�c5 ❑ L.P.GAS NK: . ❑ FUEL TANK C 0 ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER r•1 0 � O O a LL. l; a ° O Wl w U 6 kn Q = FBI N I oNo � qRr -I OC °..° O wUJ "o oz z O M""' to °` 0 c7 V 0M, •� '" z .� 16 A ~ 00 V z � ►_. � � a U F o 0 o F G J N BUILDING DEPARTMENT ID VILLAGE OF RYE BROOK JUL 16 2021 938 KINcr STREET RYE BROOD,NY 10573 VILLAGE OF RYE BROOK (914)939-0668 FAX(914)939-5801 BUILDING DEPARTMENT v,w.ryebrook.org � ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY RP 4: Approval Date: vO Permit Fee: $ LI0` 0016 Approval Signature: 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 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: n1 3 &x w')�� r a(y 91.1 �c N� . SBL: / �59��—as Zone:,Ie—)S 2.Property Owner: Lj '^5\y^ Address: a 3 Q D kw-.;)o A 4 Phone#: '� 1 L� ,-I-t q 31- 8 a'? A Cell#: �(�')-S5- 36o o email: �bW..,N r,� 3.Master Electrician:AC y tk1 f LPvm-S �, r r Address: 2 L-(DT -/OlvA C Lic.#: I q/ Phone#: /(-/ 6 01, 141 A Cell#: q j y 606 '(1(&email: Company Name: qI {ter f 1 eC-{t j1 C L L C Address:2T LO f Vt[ _ rlr f 1 (r S0 44 4.Proposed Electrical Work/Fixture Count:- �; �( �L A-114 t` J�ftr00 j.,�n a:: oO b'6n *�*****s,►.************:�*s***x***********�*************��***x*�*******as****.:***sa********sir****ss****** STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: being duly sworn,deposes and states that he/she is the applicant above named,and does fitrther (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 fiuther 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 G Sworn to before me this day of ? ,20 1-/ day of ,206Via _ 1 n lure of Property Owner igature f Applicant / Print of Property Owner Name of Applicant LAC Notary Public Moe Notary MULL Notary Public, State of NewYork OuAW inLZ No. 01 ME6160063 cptro"z9T&I -�— Qualified in Westchester County Commission Exnires Janus-29 20 �3 3/21/19 INSPECTIONSTATEWIDE Service With hitegrity ' 1:1 Main Street,Fishkill, NY 12524 1 email:office@swisny.com SWIS JOB APPLICATION845.202.7224914.219.1062 SWISNY.com • • Office Use Elect.Permit# Date Bldg Permit# Utility ID# Final Certificate# City/Village Zip Township County Address Cross Street Section Block Lot Owner Name/Address(If different than above) Contact Number ❑Basement 0 1st A. ❑2nd FI. ❑3rd FI. ❑More Than 3 FI. ❑Garage ❑Attic ❑Outside ❑Residential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms Carbon Monox Hood Trash Compact Amt Amps Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Warm Draw Incandescent Fluorescent SERVICE Amperage Voltage 1P 3P #Meters #Disconnect ❑Underground ❑ New ❑Reconnect ❑Overhead ❑Change ❑Visual Re-Inspection ❑ Safety Re-Inspection ❑ Re-Inspection Additional Information JUL 16 2021 VILLAGE OF RYE BROOK BUILDING DEPARTMENT This application is valid for one(1)year from the date received by SWIS.This application is intended to cover the above listed items to be inspected,if at any time of Inspection additional items have been installed,you are authorized to make the inspection and adjust the fee for the additional items inspected.The applicant declares that there is no open applications for the above address with any other inspection company.The applicant,owner or authorized agent agrees to all the above terms and conditions as set forth for the application. Inspector Date Finalized Inspector# Company Name Date Signature Address City/State Zip Code License# Phone# State Wide Inspection Services CA—C) 1080 Main Street Fishkill, NY 12524 TOVKH5 845 202-7224 Phone 914-219-1062 Fax STATE WIDE INSPECTION SERVICES Email: office@swisny.com Website: www.swisny.com Service With Integrity BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: Mayker Electric, LLC John Winston 27 Lopane Drive 23 Boxwood Place Patterson, NY 12563 Rye Brook, NY 10573 Located at: 23 Boxwood Place, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP: 21-177 129.59 25 Certificate Number: 2021-4309 Building Permit Number: BP:21-63 A visual inspection of the electrical system was conducted at the Residential occupancy described below.The electrical system consisting of electrical devices and wiring is located in/on the premises at: 23 Boxwood Place, Rye Brook, NY 10573 The First Floor Kitchen and Bathroom were inspected in accordance with the NYS and NFPA 70-2017 and the detail of the installation,as set forth below,was found to be in compliance on the 23rd day of November 2021. Name Quantity Rating Circuit Type AFCI Breakers 05 20AMP AFCI Breaker 01 Warm Drawer 01 Hood 01 Gas Stove 01 Microwave 01 Dishwasher 01 Wine Cooler 01 Receptacles 10 LED Recessed Luminaires 11 Light Fixtures 02 Dimmers 03 GFCI 05 Switches 04 � 2 Officer: Frank]. Farina This certificate may not be altered in any way and is validated only by the presence of a seal at the location indicated.This certificate is valid for work performed on the date of inspection only. r C It, N <7 16 ~ 00 Z 02916 b P6� Eno •a — U_ rrhh O V W Z O cz G. 00 on* ad as V c o go !� O a CA d< F r � ►.� � tea- F Q � as O o a. � z �M � g N z Q � < .. a n �I��Ci���i���I������I�1�l�C����ICI��r����1�I�1�����1�1p�►��� BUILDING DEPARTMENT ECENE ID VILLAGE OF RYE BROOK R JUL 2 2 2 221 938 KING STREET RYE BRWK,NY 10573 (914)939-0668 FAX(914)939-5801 VILLAGE OF RYE BROOK w_vvw ryebrook- or, BUILDING DEPARTMENT PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP #: �— S.f7 3 PP#: Approval Date: JUL 2 Z 2021 Permit Fee: S 3co— Approval Signature: 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 or reni6ve 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: SBL: /pZcJ 59��-a5 Zone /5 2.Proposed Work:A64)C�o,,h,, j p Q 2.� 13 rzJt1� LN� 'ns- 3.Property Owner,)AA) W j h S4 tl1 Address:Q3 ,6" W&MJ Phone#: 91 J/— — of 7 Cell#: email: 4.Master Plumber: fi4 Address: ►�� 5 Lic.#:J 3 y Phone#: �- ;2_,-2aCell#: f'7 email: Company Name: /f�-/ .�..^� liz�e Address: /�f� _ �'..-���1_� A-IX /dS-20' 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 1 st Floor 2nd Floor 3 Floor 4 Floor 5 Floor Exterior 5.*List Other Equipment/Provide Details: /1 o wit � S QUAL r (Notarized Signatures Required Next 2 Pages) -l- 3/21/19 IVILLAGEOF C�[ �V BUILDING DEPARTMENT VILLAGE OF RYE BROOK UL 2 2 2021 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 (914)939-5801 RYE BROOKww . ok. NG 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 WESTCHESTER ) as: 3, _�Jhn W ,,�s� , residing at, a3 �)oX c'J 0 oA Q'kau 'Qy d rw ,J'Jq.c"L;--7s i I'rint Wii nr t (Address where you live) 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; a 3 x� � � " �c(_Q. , Rye Brook, NY. (Jot)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. (Sign t re of 1'ropertN,Uwner(s)) (Print Name of Property Owner(s)) kS IV by IVI S is Sworn to before me this day, of 3 , 20 2- ( i Nnlan'I'uhiir i p1 Typed N We5whww Ly -3- 3/21/19 ST F NEW YORK,COUNTY OF WESTCHESTER ) as: being duly sworn,deposes and states that he/she is the applicant above named, (priKt name of indivi 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 6 �(�f � h "\ I -I 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 ,20 day o ,20 0� Sit#ture of Property Owner Signature of Applicant totary ame of Pr Owner of Applicant o lic CLAUDIA UVALDO lic NOTARY PUBLIC,STATE OF NEW YORK A A. EGNO.01UV6107856 NOhfli Pub -State o �w YorR QUALIFIED IN WESTCHESTER COUNTY NO.01RE4960392 COMMISSION EXPIRES APRIL 12,2024 IIfYON/I9d at�� In wostch"tor Cou Of COMMIS n Ezp1►p 12 eal, 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. 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- 3/21/19 Building Permit Check List&Zoning Analysis i Address: 7i_3> �_�O xW o p� SBL. I L -Z Zone:'2 -1 S Use: 2-1 O Const.Type: Other. Submittal Date: 'L Z I Revisions Submittal Dates: Applicant: N Nature of Work: 11. -y—y,Cru -C-)el, �u t� �+-� y- —3&-Ti-- yLil",12,j Reviews:ZBA.J U L 6 2021 PB: BOT: Other. QK ( ( ) FEES:Filing.�S � BP: S 70• / 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. Shore 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 ,--'__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. PLUMBINCx 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: AFPROVLU Arm: REQUIRED EXISTING PROPOSED NOTES Date: JUL - fi 1011 Cir : Fr n : Front: Front: Sides Main Cov Accs.Cov Ft.H Sb: S .HS : Tot.Imp: Ft.Im : Paz ' Hight/Stories: notes: D LANSING J U N 2 9 2021 ACKNO\ FSUILoIN!G PgIr)UCT0, VILLAGE OF RYE BROOK BUILDING DEPARTMENT Customer BILL TO: SHIP TO: LANSING NORWALK CT LANSING 60 DR MAR INNOR ALK L CT PO BOX 6649 UT ER KING JR DR III I II III II NORWALK CT 06854-0000 Phone: 804-266-8893 Fax: 8042616743 Phone: 203-831-0977 Fax: QUOTE NBR CUST NBR CUSTOMER PO DATE CREATEff DATE ORDERED ORI 5071211 1141367 The One 1 6/4 2021 1 Quote Not Ordered ORDERED BY STATUS SHIP VIA I DELIVERY AREA richard None Whse e tvery CLERK JOB NAME COUPON jarn - ose en seta WINSTON LINE# DESCRIPTION QTY UNIT PRICE 10000-1 Slimline DH,Unit Size 71.5 x 40, RO 72 x 40.5 1 $872.70 Unit 1,3:U-Factor=0.30,SHGC=0.51,VT=0.62,HII-M-34-02466- 00001, Size Options=Custom Size,Transactional Order Type=Charge Order,New Construction Unit 2:U-Factor =0.30,SHGC=0.51,VT=0.62,HII-M-34-02466- <e { 00001,Size Options=Custom Size,Transactional Order Type-Charge I u Order,New Construction,Picture Window, Simulated Meeting Rail=No Unit 1,3: Frame Width(Inches)=20,Frame Height(Inches)=40 `20'-" 715"- = Unit 2: Frame Width(Inches)=34,Frame Height(Inches)=40 RO 72' Double Glazed,High SHGc Low-E,Argon Filled _ Base Color=White Unit 1,3: Plain Lock,Label Name=Harvey,Single,Sash Limit Devices =Night Latch Unit 2: Label Name=Harvey,Sash Limit Devices-Night Latch Full Screen,Fiberglass Mesh Integral L Fin,Inside Extension Jamb Receiver Pocket=Yes Overall Frame Width(Inches)=71.5,Overall Frame Height(Inches)=40, Overall Rough Opening Width(Inches)=72,Overall Rough Opening Height(Inches)=40.5 Clear Opening Width= 14.75,Clear Opening Height 15.5625,Clear Opening Square Footage= 1.59 E.Star Zone:North=Yes Room Location: None Assigned Last Update: 6/9/2021 11:58 AM Page 1 Of 2 Printed:6/9, a a Scan with Smartphone to access installation .� instructions in HBP's Document Ccnter i Lisa & John Winston 23 Boxwood_Place Rye rook NY 10573 _from fay€r, hallway, kitchen, laundry and powder-reerx� Remove hardwood floor from living room and dining room. Remove all kitchen appliances, cabinets and laundry equipment. Remove wall between kitchen and dining. Remove existing window, supply and install new window. Supply and install 5 new doors for closets, basement, powder room, laundry. Supply and install new Engenier floor. Patch and paint as needed. Paint kitchen, dining room, living room, foyer, hallway, powder room, laundry. D V//' D JUN 2 5 :2021] DD VILLAGE OF RYE BROOK BUILDING DEPARTMENT i a, .r ;r h ■1 - - .ram, ■1 -- w.� n .%t•s • m i 0 I I V o i e. � � N E x N as W iI cn pw U � N y z 3 a .� W � � o W Lo �..� o (f z O > c �e"'Oil �i X �o ; a. W Z a e o g 3: p c O W O 0 4-4 Lu 1 r d Ir 72 > o v 79 r�i q U =_t :EE = ATE AC CERTIFICATE OF LIABILITY INSURANCE ° 6/17/2021Y 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 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 CONTACTMichelle Randle NAME Asset Security, Inc. pHONE (914)598-3004 Fp/C,No: 19141560-2013 222 Purchase Street # 302 E-MAIL michelle@assetsecurityrm.com ADDRESS. INSURERS AFFORDING COVERAGE NAIL p Rye NY 10580 INSURERA Main StreetAmerica Assurance Co. 29939 INSURED INSURER B.Travelers Property Casualty Company of 25674 JULIO CEREZO INSURER C MY DREAMS HOME IMPROVEMENT INSURER D 680 WESTFIELD AVE INSURER E BRIDGEPORT CT 06606-4004 INSURER F: COVERAGES CERTIFICATE NUMBER:A11 Lines as of 2/24/2021 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. TYPE OF INSURANCE INTfR ADDL SUER POLICY NUMBER MMIDD/YPOLICY EYYYJ (MNUDDfYYYYI LIMITS X COMMERCIAL GENERAL LIABILITY 1,000,000 EACH OCCURRENCE 5 DAMAGE TO RENTED A CLAIMS-M.DE �X GCCUR PREMISES Ea o c",once S 500,000 14PU1995T 2/24/2021 2/24/2022 MED EXP tAny oneperson) S 10,000 PERSONAL 8 ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S 2,000,000 X POLICY JECT PRO- POLICY LOC PRODUCTS-COMP/OP AGG S 2,000,000 OTHER FITRV S 5,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S tEa accident ANYAUTO BODILY INJURY (Per person S ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) S NON-OWNED PROPERTY DAMAGE S HIREDAUTOS AUTOS Per accdent $ UMBRELLA LIAR OCCUR EACH OCCURRENCE S EXCESS LIAR CLAIMS-MADE AGGREGATE S DED I I RETENTION S $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT S 100,000 OFFICER/MEMBER EXCLUDED ❑ N/A B (Mandatory In NH) UBOL53361A 10/18/2020 10/18/2021 E.L.DISEASE-EA EMPLOYEE S 100,000 If yes.descnbe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101.Additional Remarks Schedule,may be attached If more space Is required) Additional Insureds when required by written contract: Village of Rye Brook, 938 King Street, Rye Brook, NY 10573 Re: Winston Residence, Boxwood Place, Rye Brook, NY 10573 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Village of Rye Brook THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 938 King Street ACCORDANCE WITH THE POLICY PROVISIONS. Rye Brook, NY 10573 AUTHORIZED REPRESENTATIVE Paul Randle/MRANUI, w,w; ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD INS025 �­4__ RRK Workers' SOCERTIFICATE OF STATE Compensation Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1a.Legal Naive&Address of Insured(use street address only) 1b.Business Telephone Number of Insured My Dream Home Improvement (646)456-6907 680 WESTFIELD AVE BRIDGEPORT 1c.NYS Unemployment Insurance Employer Registration Number of CT 06606 Insured Work Location of Insured(Only required if coverage is specifically limited to td.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e a Wrap-Up Policy) Number 27-2851704 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Travelers Village of Rye Brook 938 King St 3b.Policy Number of Entity Listed in Box"1 a" Rye Brook 81_53361A NY 10573 3c.Policy effective period in-1R-9mn to 3d.The Proprietor Partners or Executive Officers are included.(Only check box it all partners'officers included) Z 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 "1 a"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. 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: Camilla Macedo de Jesus (Print name of authorized representative or licensed agent of insurance carrier) Approved by: �Sgnowrei (Dmc) Title Producer Telephone Number of authorized representative or licensed agent of insurance carrier. 203 870 9191 Please Note:Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. 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