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Home My WebLink AboutBP21-199PERMIT # � l 99 DATE: 4 C; IXP: R 3 SECTION Ic:;)91 76 BLOCK__ LOT TYPE OF WORK JOB LOCATIO OWNER CONTRACTOR EST. COST ` s vcO #cz TCO # FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING L� RGH PLUMBING GAS 0 SPRINKLER ELECTRIC LOWVOLT ALARM AS BUILT FINAL �1 Or FFF tm FEE DATE INSPECTION RECORD DATE I NSP r�o17v 7leo Q? �90C 05941 OTHER APPROVALS BOT PB ZBA OTHER VILLAGE OF RYE BROOK WESTCHESTE COUNTY, NEW YORK NO: 22-090 \19t12i Certiftrate of Orcupanrp This is to certify that &nr) J*C of, RAC 5VOOP, API y , having duly filed an application on // C/� � �, 20 07 R requesting a Certificate of Occupancy for the premises known as, Cq5(—) 7yee /01) CKe scen-f , Rye Brook,NY, located in a Pup Zoning District and shown on the most current Tax Map as Section: • 7(� Block: Lot: and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No. c;?/-100 , issuedU'.320 ,�/, 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: 9 3/ �hQ" `GZ/�'�/�L/ Construction: -WJ 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 shall be made,nor shall the building be moved from one location to another until a permit to accomplish such change has be o a' om the ding Inspector. ILL. Building Inspector,Village of Rye Brook: Date: JUN 13 M2 DR �' BUILDING DEPARTMENT For office u onl 99 RPERMIT# VILLAO OF RYE K ISSUED: --3-01 MAY 31 2022 938 KING STREET, YE BROOK, YoRK 10573 DATE:,,�-31-,Da (914)9 -0 O ' FEE: N& L/p— PAIDA VILLAGE OF RYE BROOK www. BUILDING DEPARTMENT I - 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 ssssssssssssssrsssasssssssssLssssssss/ss�ssssssssssssssssssssssssssssssssssssssssssssssss►ssssssssssssssssssssssssssssssssssas Address: 2-9-YO ' rye C-/D Occupan y/Use: Parcel ID#: Zone: Pp D Owner: n/'1/ Z S1 t Address: P.E./R.A.or Contractor: Address: � M O�(z L ,i Person in responsible charge: &11, B c Address: 4 t. 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: 11! C <4-e-V being duly swom,deposes and says that he/she resides at 3 { I 7 Curia S C� (Print Name o Applib nti r (No.and Street) in I C I� ,in the County of LiC S�,1 C5-f LY in the State of 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:$ (a f L�, for the construction or alteration of: 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 Sworn to before me this day of f� , 20�� day of , 20 Signature of Property Owner Signature of Applicant Name of Property Own- Print Name of Applicant Notary Public SHARI MELILLO Notary Public Notary Public,State of New York No.OIM E6160063 Qualified In Westchester County Commission Expires January 29.20" • 19a` BUILDING DEPARTMENT ❑BUILDING INSPECTOR ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK /ff` 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 �`�I e�`� PERMIT# A& ` ISSUED: SECT: �` ` •(6 BLOCK:LOT: S� LOCATION: Q 9s--roo OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... EACCEPTED ❑ 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 " ❑ ,ROSS CONNECTION FINAL ❑ OTHER Building Permit Check List&Zoning Analysis Address: Z3'J �C F C��SC SBL• l CO Zone?v Use: Z c p Const Type: Other. Submittal Date: '? Z C Revisions Submittal Dates: Applicant: Sal F l— Nature of Work. I tj Xrzr)0 Reviews:ZB4UG - .2 2071 PB: BOT: Other. OK ( ( ) FEES:Filing BP: /Z 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: ( ) ( ) PLANS:Date Stamped: Sealed Copies: Electronic. Other. ( ) ( .YLicense: -"' Workers Comp: ' Liability: Comp.Waiver. Other. ( ) ( ) CODE 7S3#: 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. O O 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 rntg.date: approval:- notes: ( )PB mtg. date: approval: notes: REOLUED EXISTING PROPOSED NOTES APPRUVLU AUG - 2 1011 At- nate Sitsl� Ersnc 1 $sac Main Cov Accs.Cov Ft H Sd.H/Sb: SEA: Tot.In Ft. Parlttug H�tg /Stories: notes: �r. t lid Cl � w r3. •No Cv o o section y CL i SE O QLU w �'i G V �� y J V L 3 ... � yo r� Y WON m X o wo C 0 z a� a� w v m ¢ L J ti u 'v e O � w p y U CERTIFICATE OF LIABILITY INSURANCE W02;"YY' TN15CENTIHCATE IS ISSUED AS A MATTER OF INFORMATION ONLY ANOCONFFRS NO RIGHTS UPON THE CERTIFICATE HOLDER.THISCERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOTCONSTITUTE A CONTRACT BETWEEN THEtSSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:I(the crtif to holder I sn ADDITIONALINSURED,the poliey(les)mhattwa ADDITIONALINSUREDp--dons-ee Yhdawd.RSUBROGATION IS WAIVED,sut4ectw the terms Intl conditions W the policy.certain policles may require en endorsement.A abNnhent an thb eerUflote does not conlar ri�rh b thehartREotr 1hoMNr in Rea of such endlewwem(sl. PRODUCER CONTACT —_.. STOItER COUCH BRAUNSDORF INSURANCE GRP NAAI CU SERVICE PHONE FAX BOX 888 WC.NO.EM(800)223-5433 Wc.No):(908)5W1274 701 MARTINSVILLE ROAD E-MAIL LIBERTY CORNER, NJ 07938-0888 ADORES& CUSTOMERSERVICEQUTICAFIRST.COM INSURER(S)AFIVRowcmvetAGE wogs INSURED iNwgetA UTICA FIRST INSURANCE COMPANY 15326 BOTEO BROTHERS CONSTRUCTION LLC INSURERS,. 1 TANGO LANE INSURRC CARMEL,NY 10512 INSURBII INSURERS• INSURERS COVERAGES CERTIFICATE NUMBER REVISION NUMBER: THIS IS TOCERTRY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAME ABOVE FOR THE POLICY PERIOD INDICTED.NOTWm15TANpNT'ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TWSCERTIFICATE MAYBE ISSUED OR MAY PERTMH,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,E7C1L510NsAMD CONDITIONS OF SUCH POLICES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.... EXP em TYPE OF INSURANCE ROOM SiW1VBR POUCY OFF POLICYPIUMBEt (MM 00�YT,t,) (��POLICY .. UNITS COMMERCIAIGENERALLIA ILM EA04000URRENCE S 1,000, 000 CLAIMS-MADE OCCUR DAMAGE 1PREMISES IRE ) f 50,OOGi MEDEXP(AnYr—person), f sm X ARTS14642300 07/17=1 0711742M PERsoNALAADVINJUNY S 1,000, taEYI AGGREGATE LIMIT APPLIES PER, GENERAL AGGREGATE 2,000, 00( POLICY F]PROJECT ❑LDc PRODUCTS-COMP/OPAGAG s 2.000.00( OTHER AUTOMOBILELIABILITY COMBINED SINGLE LIMIT f (Ea accident) ANYA�O BODILY INJURY(Perpersw# OWNEDAl11OS Sg1EDLAED ONLY ADIOS BODILY HIREDAUTOS NON-OWNEDONLY AUTOSOWY PROPERTY DAMAGE f f (Perscciderrt) s L1e16RELLhLW OCCUR EACH OCCURRENCE S ELCESSUAB CLAIMS-MADE AGGREGATE f DIED I INIFFEACTRIMS f WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY Si NTE OT1Ep f ANYPROPRIETOR/PARTNER/ Y/N EL EACHACCCDEM f EXECUTIVE OFFICER/MEMBER N/A EXCLUDED?(Mandatwy In NH) EL DISEASE-EA EMPLOYEE If Yet,describe under DESCRIPT ION OF i OPERATIONSbelow E.L.DISEASE-H000Y UMR S [— DESCRIPTION OFOPERATIOPWWCATIONS/VENICIES(ACORD 101,AdditbNl Remarks SehedltlSmry beatbdhetl I—paceit2quhd) ',!Residential Home Repair Construction,Painting,Dry Wag,Carpentry,Flooring,Decks.The certificate holder is listed as an Addit l Insured in accordance with ithe terms,conditions and exclusions of the policy. I -- CERTIFICATE HOLDER - 938 KING STREET EPARTFiENT— DAS�THER oF�,NOTICE WILLBEo ERFED IN POLICIES BE ACCOPCCA1/NCE LED WITHT OgE/�PP1�� RYE BROOK,NY 10573 AUTHORInO REPRESENTATIVE, / ACORO 25(2016/03) 01988-2015 ACORD CORPORATION.All Rights Reserved 31-1769 11-15 The ACORD name and logo arc registered marks of ACORD 7M Workers' Certificate of Attestation of Exemption STATE Compensation from New York State Workers' Compensation and/or Board Disability and Paid Family Leave Benefits Insurance Coverage **This form cannot be used to waive the workers'compensation rights or obligations of any party.** The applicant may use this Certificate of Attestation of Exemption ONLY to show a government entity that New York State specific workers'compensation and/or disability and paid family leave benefits insurance is not required. The applicant may NOT use this form to show another business or that business's insurance carrier that such insurance is not required. Please provide this form to the government entity from which you are requesting a permit,license or contract. This Certificate will not be accepted by government officials one year after the date printed on the form. In the Application of Business Applying For: (Legal Entity Name and Address): Home Improvement Boteo Brothers Construction LLC 1 Tango Ln From:RYE BROOK BUILDING DEPARTMENT Carmel,NY 10512-2242 PHONE:845-902-0594 FEIN:XXXXX3935 Workers'Compensation Exemption Statement.• The above named business is certifying that it is NOT REQUIRED TO OBTAIN NEW YORK STATE SPECIFIC WORKERS'COMPENSATION INSURANCE COVERAGE for the following reason: The business is a LLC,LLP,PLLP or a RLLP;OR is a partnership under the laws of New York State and is not a corporation. Other than the partners or members,there are no employees,day labor,leased employees,borrowed employees,part-time employees,unpaid volunteers(including family members)or subcontractors. Partners/Members: Wilber Y Boteo Rodriguez,Roy D Boteo Rodriguez Disability and Paid Family Leave Benefits Exemption Statement: The above named business is certifying that it is NOT REQUIRED TO OBTAIN NEW YORK STATE STATUTORY DISABILITY AND PAID FAMILY LEAVE BENEFITS INSURANCE COVERAGE for the following reason: The business MUST be either: 1) owned by one individual; OR 2) is a partnership(including LLC,LLP,PLLP,RLLP,or LP)under the laws of New York State and is not a corporation; OR 3) is a one or two person owned corporation,with those individuals owning all of the stock and holding all offices of the corporation(in a two person owned corporation each individual must be an officer and own at least one share of stock); OR 4) is a business with no NYS location. In addition,the business does not require disability and paid family leave benefits coverage at this time since it has not employed one or more individuals on at least 30 days in any calendar year in New York State. (Independent contractors are not considered to be employees under the Disability and Paid Family Leave Benefits Law) I,Wilber Y.Boteo Rodriguez,am the Member with the above-named legal entity. I affirm that due to my position with the above-named business I have the knowledge,information and authority to make this Certificate of Attestation of Exemption. I hereby affirm that the statements made herein are true, that I have not made any materially false statements and I make this Certificate of Attestation of Exemption under the penalties of perjury. 1 further affirm that I understand that any false statement,representation or concealment will subject me to felony criminal prosecution,including jail and civil liability in accordance with the Workers'Compensation Law and all other New York State laws. By submitting this Certificate of Attestation of Exemption to the government entity listed above I also hereby affirm that if circumstances change so that workers'compensation insurance and/or disability and paid family leave benefits coverage is required,the above-named legal entity will immediately acquire appropriate New York State specific workers'compensation insurance and/or disability and paid family leave benefits coverage and also immediately furnish proof of that coverage on forms approved by the Chair of the Workers'Com tion Board to the government entity listed above. HERE Signature: ✓ Date: Exemption Certificat Received 2021-048042 July 29, 2021 NYS Workers'Compensation Board CE-200 01/2018