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HomeMy WebLinkAboutBP21-220PERMIT # TYPE OF JOB LOCI T. COST CO #�4 TCO # FOOTING FOUNDATION FRAMING SIGH FRAMING INSULATION PLUMBING RGH PLUMBING GAS O SPRINKLER ELECTRIC LOW -VOLT ALARM / AS BUILT L.µ- FINAL LOT FEE DATE INSPECTION RECORD DATE INSP 2 ^h a^��oDv �evr4ce lrl�-evio✓ CL�{2rQfions uev 70� 0707 4ifafflME' 177- PD THIS BUILDING MUST BE POSTED WIN A PERMANEM CONSTRUCRON AS-BUILTIFINAL SURVEY TYPE IDENTFCATION SIGN; �- REQUIRED PRIOR TO V FINAL INSPECTION V -e- 2eelVP 530 PRIOR TO THE ISSUANCE OFA C/0. AS REQUIRED BT M STATE LAW. Expired Letter Sent rj oC T0/G/2022 C"� kD�13 22 I�05/�O¢//O ��(rm "i VE 77 - -�lo/FCasle/la ro Cr,Z;� s�/, - cc PPaa-llvy�/�$ae�u��9It�� AIL LOT FEE DATE INSPECTION RECORD DATE INSP 2 ^h a^��oDv �evr4ce lrl�-evio✓ CL�{2rQfions uev 70� 0707 4ifafflME' 177- PD THIS BUILDING MUST BE POSTED WIN A PERMANEM CONSTRUCRON AS-BUILTIFINAL SURVEY TYPE IDENTFCATION SIGN; �- REQUIRED PRIOR TO V FINAL INSPECTION V -e- 2eelVP 530 PRIOR TO THE ISSUANCE OFA C/0. AS REQUIRED BT M STATE LAW. Expired Letter Sent rj oC T0/G/2022 C"� kD�13 22 I�05/�O¢//O ��(rm "i VE 77 - -�lo/FCasle/la ro Cr,Z;� s�/, - cc PPaa-llvy�/�$ae�u��9It�� AIL VILLAGE OF RYE BROOK WESTCHESTEIZ COUNTY, NEW YORK NO: 24-093 (Certificate of ®ccupoucp This is to certify that P ►- SofSoaecaUei— of, VA eC ` (-YJ N having duly filed an application on m /y 3V 20�requesting a Certificate of Occupancy for the premises known as, / Ce// 7 C..,t cue , Rye Brook,NY, located in a R'16 Zoning District and shown on the most current Tax Map as Section: I 5-(0( I Block: ) Lot: 1 and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No. p� c , issued C1 c3� 20 P 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: - Construction: for the following purposes: nenv f:k-00+ '20<41 , ar-KA --ion r 4.6/oe Cc 5 1 nl�erio ,-- 61 I)--e r,-a 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 be made,nor shal a building be moved from one location to another until a permit to accomplish such change has b en obtai fr B i in Inspector. JUL 1 9 2024 Building Inspector, Village of Rye Brook: Date: DR t.y4 W°ya V J V 19 .n t° VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook, N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J.Bradbury www.tyebrookny.gov TRUSTEES BUILDING & FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W.Morlino CERTIFICATE OF COMPLIANCE July 19,2024 Peter Nebauer&Sonja Soper Nebauer 19 Beacon Lane Rye Brook,New York 10573 Re: 19 Beacon Lane, Rve Brook, New York 10573 Parcel ID#: 135.66-1-1 This document certifies that the work done under Mechanical Permit#22-192 issued on 12/22/2022 for the installation of a new gas fired boiler has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to D E C E � V E BUILDr 'RTMENT For office use onl PERMIT# —c�aO VILLE BROOK ISSUED: —c��—01/ MAY 3 0 2024 8 KING STRE K,'NEW YORK 10573 DATE: 5-3066$ FEE: It 3 PAID& VILLAGE OF RYE BROOK wW' -.n ebWQIo .org BUILDING DEPARTMENT > ' APPLICATION FOR CERTIFICATE OF OCCUPANCY, CERTIFICATE OF COMPLIANCE, AND CERTIFICATION OF FINAL COSTS TO BE SUBMITTED ONLY UPON COMPLETION OF ALL WORK, AND PRIOR TO THE FINAL INSPECTION Address: 19 Beacon Ln. Rye Brook, NY Occupancy/Use: / ol---,4 M Parcel ID#: 136- 6 6 Zone: --/O Owner: Peter Nebauer and Sonja Nebauer Address: 19 Beacon Ln P.E./R.A. or Contractor: Felipe Avalos / �t-u Address: Q� wJ')YOAT17-a6Q /j/PWZc.'4elle A)Y Person in responsible charge: /I I Address: /I 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: Peter Nebauer being duly sworn,deposes and says that he/she resides at 19 Beacon Ln (Print Name of Applicant) (No.and Street) in Rye Brook in the County of Westchester in the State of NY ,that (City/Town/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:$ 186, 500 for the construction or alteration of: Remodel &extend existing kitchen, new patio terrace at 2nd floor, remodel existing master bedroom, new master bathroom, new front entry porch, 1st floor patio 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 30 Sworn to before me this 3� day of , 20 day of One, 20.214 _ ignature of Property Owner Signature of App icant ` 1— er Print Name of Property Owner Print Name of App scant Notary Public Notary PutTlc DOMPAGE GAYA VITHANAGE DOMPAGE GAYA VITHANAGE Notary Public-State of New York Notary Public-State of New York NO.01V16424207 NO.OIV16424207 Qualified in Westchester County Qualified in Westchester County My Commission Expires Oct 25, 2025 My Commission Expires Oct 25.2025 QyE BRC��. ` 1982 BUILDING DEPARTMENT A 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 - - - - - - - - - - - - - - - - - - - - el- ADDRESS:— VA - " a l c8 � )'� DATE: PERMIT#�. ISSUED: SECT.��' L BLOCK: LOT: LOCATION: OCCUPANCY: ❑ Violation Noted THE WORK IS... ❑ PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE �-O, , ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas ❑ L.P. Gas ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑- OTHER pppppr �yE BR �. O� Zm BUILDING DEPARTMENT BUILDING INSPECTOR /0 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:_ �<_ �� �„ � DATE: PERMIT# ( � 1� `� ` l ISSUED: SECT: BLOCK: LOT: LOCATION: ,�� ` ` �(�`" -p OCCUPANCY: { V ❑ Violation Noted THE WORK IS... ❑ PASSED 0 FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas 'C c c v�\cam IC !_) Q .1c (Lzu C� ❑ L.P. Gas ❑ FUEL TANK ❑ FIRE SPRINKLER (� ,�� �(\�S� L �'•( ( ,n V I C9 ❑ FINAL PLUMBING ❑ CROSS CONNECTION , n ,, \ 1 J}- FINAL \�Y /1�\��L Ny�{ OC \� `� G\1 ;;oP A ❑ OTHER ' c\J Cam!\F r N \ C r& (Vc Pc:i:� �6 1 (s i'1 V) vc' C30i0- � ( V ar, C 4 CIO \cam► �'�PC� e�( �l 01. V6, r- A, \tip r i. QyE[3RC�k. O�` tim cu � �7 �c BUILDING DEPARTMENT ❑,/BUILDING INSPECTOR E!J 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 : 19 js PG- C O "J �"� DATE:-3- l L - ZOL PERMIT# 9r Z Z Z O ISSUED: ZY- "'SECT:SECT:`3s�C� BLOCK: LOT: LOCATION: ��'� " V OCCUPANCY: ❑ Violation Noted THE WORK IS... ❑ PASSED ❑ FAILED /REINSPECTION -LI'SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas 1 (�► C P S/�J� �'!�t�/l �� (�/� ❑ L.P. Gas ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER BRC�k w � 1932 BUILDING DEPARTMENT ❑BUR DING INSPECTOR VILLAGE OF RYE BROOK ❑VILLAGE ENGIN1MR 938 KING STREET RYE BROOK,NY 10573 ❑ASSISTANT BUILDING INSPECTOR (914) 939-0668 FAx(914) 939-5801 - - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - -- - -- - - - - - - - - ADDRESS: DATE- PER 1 MTf# ISSUED: 1 Z` SECT: BLOCK: LOT: \ II LOCATION: Cl V i ` '� � OCCUPANCY: ❑ VIOLATION NOTED TTi WORK IS... ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION �~ REQUIRED 0 FOOTING ❑ FOOTING DRAINAGE 0 FOUNDATION 0. UNDERGROUND PLUMBING NOTES ON INSPECTION: 0 ROUGH PLUMBING g y�Z ,'O- 6" 11�111? ROUGH FRAMING ' \N �`� �v �<sfD 0 INSULATION ❑ NATURAL GAS ❑ L.P.GAS _ ❑ FUEL TANK 0 FIRE SPRINKLER ❑ FINAL PLUMBING 0 FINAL 0 OTHER �yE BRCv�. 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 : �`��-`-( C 1 DATE: PERMIT# ISSUED: '`� SECT:1 S- LOCK: LOT: LOCATION: LC�� �Ct � DUV �� OCCUPANCY: ' l ❑ VIOLATION NOTED THE WORK IS... ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION \� REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE Cl', FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ROUGH PLUMBING ROUGH FRAMING I ST Tl C)6 C" [� INSULATION NATURAL GAS ❑ L.P. GAS ✓Yn � c1 �4n "\ 1�G� ' \, �l� ' - ❑ FUEL TANK ❑ FIRE SPRINKLER - ❑ FINAL PLUMBING r ❑ CROSS CONNECTION ❑ FINAL z� ���C - �� �1 �� ��� (2? ❑ OTHER 0 N N o w ...� W a N a N 00 75 E-+ in O 0 Wz � c rx oG F00Q L Z o V uz0-4 Z � tr, z N >Im ° V r� < li V z ad z E N � Z z w H o W C a oa z $ w Z 6 U •• 8 $ W .. 0 z o c So 8 cn F 8 I"y u O w zo w �4 � N x y3 16 z A -- z A o w a a R EC ENE BUILDING DEPARTMENT AUG 3 12022 VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK,NY 10573 VILLAGE OF RYE BROOK (914)939-0 6 AX( 14)939-5801 BUILDING DEPARTMENT www:i ook.org ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required 1 FOR OFFICE USE ONLY BP#: c EP#: QQ"d / 0 Approval Date: S E P - 1 20n Permit Fee: $ j3a2�2 Approval Signature: Other: Disapproved: (fees are non-refundable) ******************* * * ************************************************************************** Application dated, 3 2 Z is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install and/or rem ve 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: 16t R ect c-ep r L A tn e— SBL: � I&IV '�" / Zone: 2.Property Owner: M f 4-01 r S N e 10 a u e✓' Address: I q OR 4 C-o" Phone#: Cell#: 90-708- 0?07 email: F--c--k�Ct-laC01201.Co~ l 3.Master Electrician: eq', k C 4 S 4g U Ct.o Address: S8 IS ai&'O-a cep cry Lic.#- 6S?_ Phone#: ?/q—q?O-039LCell#: ?N-00-092- email: F&-41-1 1ciCwt02ctlDaQOt,CO"l Company Name: Ca S 4-e It a rt v e I eC Address: 5_8' ITPO¢tom W ay -�Q'y✓1'f O H_ y /Of l 4.Proposed Electrical Work/Fixture Count: e Ind yQ i-1'e v% o-f 2,4 rx F)o o— Fe owe s' /r-(�t S r eA L90 &'OCCA^ U p 4 vtit t� O�v �.¢a� S'e r v , C� � 2.o e .�r►'rI STATE OF NEWT Y'/ORK,COUNTY OF WESTCHESTER ) as: Fr 4N k CK 144(t%%o being duly sworn,deposes and states that he/she is the applicant above named,and does further (print name of indiv idual signing as the applicant) 6 state that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the G^�✓�1'G 1 a N for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,attorney,etc.) The undersigned further states that all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to before me this Sworn to before me this S3 day of 120 day of 20 Signature of Property Owner Signature of Applicant Fri, 'k CdeS -4 A.? Print Name of Property Owner ( Name of Applica Notary Public Notary P% $l MELILLO Notary Public,State of New York No.O1ME6160063 Qualified In Westchester County 3 Commission Expires January 29,20,2 3/21/19 STATEWIDE • Service Willi Integrity 1:1 Main Street, Fishkill, NY 12524 1 email.office@swisny.com SWIS JOB APPLICATION tel ;. 1 914.219.1062 • • • :�fiice U�I Elect.Permit# ��J � Date Bldg Permit# Utility ID# Final Certificate# City/Village P 1.9 w O Zip Township f y JP (Mark County o ' /W Address I s p G O I G 1 Q Cross Street Section Block Lot Owner Name/Address(if different than above) jr A y1 ��l ^ , u ✓ Contact Number t l — '7 vY_6 7 0-7 ❑Basement 0 1st FI. 0 2nd FI. ❑3rd FI. ❑More Than 3 FI. ❑Garage ❑Attic ❑Outside Q 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 Auerexent SERVICE Amperage Voltage 1 P 3P #Meters #Disconnect ❑Underground ❑New ❑Reconnect / It ❑-Overhead 0 Change ❑Visual Re-Inspection ❑ Safety Re-Inspection ❑ Re-Inspection Additional Information y, .� �� I��V✓ (7''Ci�✓C� It P to 0 v 4 � 1 v C) � J �(u S -fit u Gt va U �� L) J ✓a CQ U L CI VIE AUG 3 1 2022 3D VILLAGE OF RYE BROOK BUILDING DEPARTMENT This application is valid for one(1)year from the date received by SMS.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 Inspections and adjust the fee for the additional items inspected.The applicant declares that there is no open applications for the above address with arty other inspection company.The applcant,owner or authorized agent agrees to all the above terms and conditions as set forth for the application. Inspector Date Finalized Inspector# t _.�-- Company Name .�� ( ,; ; � , ,, , ,y �" �- � Date Signature Address „ City/State Zip Code License# Phone# State Wide Inspection Services 1080 Main Street JAN - 3 2024 i ? Fishkill, NY 12524 ! I 845 202-7224 Phone r1 � VILLAGE OF RYA CROCK � 914-219-1062 Fax W VI STATE WIDE INSPEC71ON SERVICES ! QI,LLAG G DEPARTMENT-1 Email: officeCabswisny.com — - u 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: F Castellano Electric Inc Mr. and Mrs. Nebauer 58 Broadway 19 Beacon Lane Harrison, NY 10528 Rye Brook, NY 10573 Located at: 19 Beacon Lane, Rye Brook, NY 10573 Section: Block: l Lot: Electrical Permit Number: EP22-210 Certificate Number: 2022-5328 Building Permit Number: BP21-220 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: 19 Beacon Lane, Rye Brook, NY 10573 The First and Second Floors 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 15'day of December 2023. Name Quantity Rating Circuit Type Second Floor Master Bedroom Luminaires 06 Pendant Light 01 Receptacles 06 Smoke Detector 01 Visual Inspection Only; Not Tested BY SWIS Switches 05 Master Bathroom Luminaires 04 GFCI Receptacle 01 Switches 03 Wall Heat 01 Fan 01 Name Quantity Rating Circuit Type Bedrooms 1, 2, &3 Smoke Detectors 03 Visual Inspection Only; Not Tested BY SWIS Hall Luminaires 05 C/O Smoke Detector 01 Visual Inspection Only; Not Tested BY SWIS 3-Way Switch 01 First Floor Bedroom 4 Smoke Detector 01 Visual Inspection Only; Not Tested BY SWIS Hall C/O Smoke Detector 01 Visual Inspection Only; Not Tested BY SWIS Kitchen Luminaires 12 GFCI Receptacles 15 Gas Stove 01 Hood 01 Dishwasher 01 Refrigerator 01 Receptacles 04 Switches 12 Pendent Lights 04 Ceiling Lights 01 Pantry Luminaires 02 Receptacles 02 Mechanical Room Luminaires 01 Receptacles 02 C/O Smoke Detectors 01 Visual Inspection Only;Not Tested BY SWIS Switches 02 Sub Panel 01 AFCI Breakers 13 Garage Porcelain Lights 02 Receptacles 01 C/O Smoke Detector 01 Visual Inspection Only; Not Tested BY SWIS Page 2 Name Quantity Rating Circuit Type Switches 02 Exterior GFCI Receptacles 06 Motion Sensor Lights 04 Wall Lights 03 Service 01 200AMP Meter 01 Panel 01 Grounding and bonding of service to current codes. Officer: Frank 1. 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. Page 3 N O� ■ N N N M � y W z F ey, VMI A, � W ti Lti .y H ■ OZ o W o Q a oQ Q • c w O h W Q w x w H o s C e ` z ►'�. W W °° /--� ►7-77� z w 0 A, w z Fitzo Ln ON c�� Z ►.. ,� a w z W . � � M�y■� ^ ~ w w a ■ H h■ ■1 W wk Z z o � n < F � j V Z o W o ■ V Wm W o z z o x or .; Q -1 O U W 0 � p EC EN .y aRnv� BUILDING DEPARTMENT DEC 2 0 2022 DD VIL GE OF RYE BROOK VILLAGE OF RYE BROOK 938 KINt 'ET Rvl: B8 K,NY 10573 BUILDING DEPARTMENT �VtY4V�'Q(J PLUMBING PERMIT APPLICATION �� � VLl FOR OFFICE USE ONLY � x —� 7 c)- PP#:��� Approval Date: /�EC 2 Permit Fee: $ >— !' Approval Signature: Other: Disapproved: (fees are non-refundable) Application dated,f 00_a 4 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: iq SBL: 11315-1 b eo-1 1 ZonvC'/0. 2.Proposed Work: Diet4 3.Property Owner: Nebac*/- Address: i9 8661LOA LNG Phone#: 911 70% -a7o-7 Cell#: email:PAL&A COM 4.Master Plumber: CIIA 16 QX16LO Address:115 WfAll Lic.#: q95 Phone d:: 91y 327 4W7 Cell.-1: email: rl o L .(A# Company Name:W �&-)C.l Pl M� �-Ifta Address: II\DICATE FIXTURES& LINES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: Location Water Urinals Drinking Sinks Sho"ers Bath Laundry Domestic Fire Sanitary Natural, Other* Total Closets Fountains Tubs Tubs Service Service Sewer LP Gas Basement I st Floor end Floor 3'Floor 4`h Floor 5'Floor Exterior 5.* List Other Equipmenv Provide Details: I N SDI (Notarized Signatures Required Next 2 Pages) -1- 8 12_021 STATE OF NEW YORZ COUNTY OF WESTCHESTER ) as. 0Gf112d GrlQ,C.,O .being duly sworn.deposes and states that he/she is the applicant above named, ,•b....g its rh:applicant) rid furthggr states that(s}he is the legal owner of the property to which this application pertains,or that(s)he is the UE C�J Gf P 1 A for the legal owner and is duly authorized to make and file this application. Indicate architect.contractor. ffeer-nt_attorney.cetteeA That all statements contained herein are true to the best of histher knowledge and belicr,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 14th_- _ Sworn to before me thisT�"__ day of December .20 22 - da} of)e ? __ ot We of Property Owner Si?nature of Applicant Peter Nebauer Print Dame of Property Owner PoName,of Applicant Notary Public OQMPAGE GAYA VITHANAGE Notary Public Nctary Public-State of New York NO.01V16424207 Quali++ee in Westchester County TERRI McCANN-GRECO My Corhmission Expires Oct 25, 2025 Notary Public, State of New York No. 01 MC4996965 u lified in Westchester County This application must be properly completed in its entirety and must ;nt it , ��gbq;€ J,oalaytu6( OBF the legal crwnrr('s)of the subject property. and the applicant of record In application not properly completed in its entirety andror not properly signed shall be deemed null and void and\vill be returned to the applicant. S112/.021 BUII.DY 311� rRTMENT VILE OF RYE'�$100K R I DEC 2 0 2022 3D 938 KING*i'r RYE BRpOOk,NY 10573 � 14)�39-Ofiti$:: VILLAGE OF RYE BROOK BUILDING DEPARTMENT tents.rret,:xx';:rtr:ttxao;ttrtiw±et_-a-r��t r.,et,r.rtta.ttt±:n_txf,ntnazxxa±:_r.sm:r rsx t:n;tmx,ttasr,•:-xtta:t+tt,:t�-:t x[:t-.tkt:•,t i:tc,t is AFFIDAVIT OF COMPLIANCE VILLAGE CODE �216• STORM SEWERS AND SANITARY SEWERS TY:Is AFFIDAVIT ?BUST BRAR THE NOTARIZED SSGNATURE OF THE IZ:GAI. PROPXRTY 0%14ER AND BE SUM-11TT£D ALONG WITH ANY SU7 CLDI.NG OP. PLUMBING PERMIT APPLICATION• ANY BUILDING OR PLUMBING PF.RMTT APPLICATIO14 SUM4ITTED WITHOUT THIS CON.2LE'TKD AND NOTARIZED FORM WILL BE RETUP2TED, TO THE APPLICANT . STATE OF NEW YOM COUNTY OF WESTCHESTER ) as: 31, Peter Neb�ug-----__---- residing at, 19 Beacon Ln - :u ------- (A: r. .,wh--tc you h-.vi 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. 19 Beacon Ln _ , Rye Brook, NY. Further that all statements contained herein arc 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 arc no roof drains,sump pumps,or other prohibited stormwater or groundhvatcr 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. x _. ----- Peter Nebauer Sworn to before me this 141h day of December 20 22 — (\u;ar<,Pl:hlit l i i k '10MPAGE GAYA VITHANAGE Notary P;,blic.State of New York 3- NO.O1V16424207 Ouaiif!ed in Westchester County m/-cnmission Expires Oct 25,2025 I 3112/1021 ).�ayors•w, N rl Mr N N N a u a 00 zcc �k bi M G a ON00 Q x 1-4 W Z z V ~ `n '-? 0.cle) en v H . Ozo1-4 O w , �I '� ,� Z fs• z o x W $ a � O W ~' ® c CIIIIN 12 co O w d0 O w l V Zwo o v z uz 0%4 Fp-G 7 W ►-� G1 F-� M a w � � a z cn � O A V a o � �4 CN W O H r H tom~ � � Q � J N ►�- W 0 . oz °� z U N x �' �► . '7 O w � � � z g ►- fx LLB U v W 0 R+ � or cog a a w = � 6 R EC EN BU ILDING DEPARTMENT VILLAGE OF RYE BROOK DEC 21 2022 938 KING STREET RYE BROOK,NY 10573 VILLAGE OF RYE BROOK (914)939-0668 BUILDING DEPARTMENT PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP#: CD//— PP .-approval Date: Permit Fee: $ 3/0'i .approval Signature: 7 Other: Disapproved: lit -4 (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 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: r% SBL: 136 i 66 —J Zone: 2.Proposed Work: 1 L)&/f A J 0 ifAj 5-H PC✓M Mollbl f-04 3.Property Owner: 'PP_kel T_ N P, ,,V. a e, (` Address:TR ��I (�a� `./n %Phone#: k j Ll 4,9 G7 o Cell#: i�d �(j V_ o b l email- a!&L cc rm,j)� NAA► ,_ 4.Master Plumber: J O s&- Cv 6 Z iw Address: 7 f 5. lew— A/ (Nmz_ r-J/OT M j Lic. #: ��{ S Phone#: //'' Cell#:91 y 93���/ email: 76 Se C J�/1",4:: r u-vt% C,7 Company Name:C�Z(�7 I��M� *6� AQVIu 6 L r� Address: `�� S kl� 6AT4'PVdT 14AX O,[ Al� 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 ` 31 Floor I 4'h Floor 5'Floor Exterior 5.*List Other Equipment/Provide Details: (Notarized Signatures Required Next 2 Pages) 8/12/2021 STATE OF NEW YORK_ COUNTY OF WESTCHESTER ) as: P-F?9-K /VETS'+v f/— ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and further states that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the C�� Z4 for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,attomey,etc.) That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to before me this /3 T%-1 Sworn to before me this day of T 20 22 day of P CC F-M&W ,20 2 Z 9�'It Signature of Property Owner Signature of 1} ant SOS c C(�c LL o Print Name of Property Owner Print Name of Applic t Notary Public DOMPAGE GAYA VITHANAGE Notary PubOAGTUS A RODHIGULL Notary NO!OIV16424207 W York NOTARY PUBLIC, STATE OF NEW YORK Qualified in Westchester County Registration No.01 R06323825 My Commission Expires Oct 25. 2025 v� Qualified in Bronx County This application must be properly completed in its entirety and must incliMy 2023 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. 8/12/2021 • BUILDING DEPARTMENT D VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK.NY 10573 DEC 21 2022 (914)939-0668 VILLA EG OF RYE BROOK 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 WESTCHESTER 1 as: 31. l e lc "Uz S__ . residing at. 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; Rve 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. Sworn to before me this '3 day of '- Ec 2-. Ze—f- , 20 22 DOMPAGE GAYA VITHANAGE Notary Public.State of New York NO. O1V16474207 Qualified in Westchester County M•;Commission Expires Oct 25, 2025 , o N N u W h+r � z av]i o0 O cc x+ M Z z A o W 0 o W w 8 z � Z w x W � o w W L r.., w o V oo �..� z a a oz c°� z n z � , z M � W 0 � Ln CN p Z PLO o ~ O z O V � � ~ W U O a a �► � `; x y. w � z , • BUILDING DEPARTMENT ECENE DD VILLAGE OF RYE BROOK R MAR i b 2023 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 VILLAGE OF RYE BROOK BUILDING DEPARTMENT PLUMBINGG PERMIT A�PPLICATION FOR OFFICE USE ONLY BP#: PP#: 3 CIJ Approval Date: MAR I Z,onn Permit Fee: S Approval Signature: Other: Disapproved: _ (fees are non-refundable) Application dated, O is hereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of a Permit to install and/or remove 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:Tq�iRearon L in SBL: / iZ0 Zone:/C p-/C� 2.Proposed Work: j-'0 6 ty 14-ai% t N( s K A umbily(, FcV A Sl�1/K Is I 0'c 3.Property Owner: N �(�Q Address: Phone#: Cell#: 114 709' O:2Q77 email: 0 Zr q M0_ � ,r� 4.Master Plumber: S�SC (.,per U4, ? Address:dal 15- eil (26 • � 7L arvo� NZ /4)f6-� Lic. #: &If Phone#: Cell#: 0/ email: Company Name: Lr"t t0 (wM6/1V6 )b✓P#fT_ 21CAddress: �q S kaL 14 64IZA�/k)T tie IOSG INDICATE FIXTURES & LINES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: Location Water Urinals Drinking Sinks Showers Bath Laundry Domestic Fire Sanitary Natural: Other* Total Closets Fountains Tubs Tubs Service Service Sewer LP Gas Basement 1st Floor 2nd Floor 3rd Floor 4'Floor 5"'Floor Exterior 5.*List Other Equipment/Provide Details: (Notarized Signatures Required Next 2 Pages) -1- 3/3/2023 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: C- E UV ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and further states that(s)he is the Master Plumber for the legal owner and is duly authorized to make and file this application. 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. �n Swom to before me this 5 Sworn to before me thi L day of tAa F C\ ,20_a2�__ day of 20_a-_ IbIJIX Signature of Proppertty er Signatur o pplicant C: LIB Print game of Property Owner Print Name of Applicant 00't� � Notary Public-State of New YJrk No Public N0.01U6443959 ''t, My Qualified ion Expires Nov 14,In Westchester Notary PNo ary Public,State of New York No.01MM60063 Qualifled In Westchester County Commission Expires January 29,202--7 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- 3/3/2023 BUILDING DEPARTMENT D E C E V VILLAGE OF RYE BROOK r�AR 2023 938 KING STREET RYE BROOK,NY 10573 _ (914)939-0668 VILLAGE OF RYE BROOK 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 WESTCHESTER ) as: /l .J, T-e�+--er nt6,w-Lec , residing at, ( Q ze ac Y Ltd 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; P q ?e�:6 n ( n , 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. sJ U ah Sworn to before me this 15 day of��r�►r('fin 20�— MARIA ESTHER LARA Notary Public-State of New York N0.01LA6443959 p" Qualified in Westchester County 1 Gri(k E �ro' My Commission Expires Nov 14, 2026 v� Ill. • W J 0. V � " � G � \ � r� ra j v' c C 03 en ~ $ b u 0«j a. U O � '� C p ro ° � V1 z � 3 � °'•v O . W w z c H - c H w O A Y+q W z H z �- � " � O Fco oo Cn a < O w ° V � Z O a x . H � zvv � c a GN N•y en E 00 Z GMT f-a a w t Q °m Erg (' u O 00 -a s M-i z W W N z n V v a Q S w r.r Q a V z $ 00. vvW C� z � � � •• � sod •° � � w H • �-+ a ! W z A 00 l " as a _ �I a ►°� a a as = t i'lU r D BUILDING 019PARTMENT DEC 2 0 2022 3D VILLI IAGE OF RY1''BROOK 938 KING S`RFE'r RYE BROOK,NY 10573 VILLAGE OF RYE BROOK -0668 i BUILDING DEPARTMENT - W r APPLICATION FOR PERMIT TO INSTALL AND/OR REMOVE HEATING, VENTILATION AND/OR AIR CONDITIONING EQUIPMENT FOR OFFICE USE ONLY: PERMIT#: I`7ld�+_1 9 d— Approval Date: AC 2zAO22 Permit Fee:$ /00 " /`" U Approval Signature: Other: Disapproved: (fees are non-refundable) a***,►**xx, x,�K*;.x*x******a*,xx*a***,t****,t***A*w****,raax,.;.*�**,ra,r,�x***x*x*****a**,r*�*****,t,t*a,�**Yx�xx*xx* REOUIREMENTS FOR RELEASE OF PERMIT&CERTIFICATE OF COMPLIANCE: 1. Properly completed&Signed Application. 2. Site/Staging Plan if Required by the Building Inspector. 3. Copy of Licensed Contractor's Liability Insurance.(Village of Rye Brook must be listed as certificate holder)&Workers Compensation Insurance on a NYS Board form(Form#C105.2 or Form#U26.3/or NY State Workers Compensation Waiver) 4. Payment of Fees/Unit: RESIDENTIAL=$100.00/unit•COMMERCIAL=$350.00/unit. 5. Inspection by the Building Department for removal and/or installation.(48 hour notice required 6. Electrical work requires a separate Electrical Permit& Electrical inspection. 7. Plumbing/Gas work requires a separate Plumbing Permit& Plumbing Inspection. 1:�i:i:*k�;:F A'7k*F;t"r.kic 9:*i;F•Y.;l ktF*;F is k4:;F';tf:i:;@':]Fr.�:9.r.£if'k:F4::c9:::•i:�Ck::i kic;l•k*rtk:tx:k**i::t k 9:;t i:�k::k>.•kki:•Y.•Y.A k*�:i;;c'.c�;�;k'i;A*i;J: Application datedJQk-e' g)c� is hereby made to the Building Inspector of the Village of Rye Brook for a permit for the installation and or removal of the II VAC equipment as listed below.The applicant and property owner,by signing this document agrees that said equipment will be installed and/or removed in conformance with all applicable Local,County,State&Federal laws. codes,rules and /regulations. / / l. Address: J-1at GU c L.CI pn Lf1E SBL: ��j (�'��- Zone: ` c 2. Property Owner: "r N)FILA"a Address: 19 &ugon 4.01416 Phone#: 9 M 709 -07 07 Cell #: email: Rie.6aUF.t S� 1l_Cw1M 3. Contractor: A if- 2_(,Q Sl A Address: II L. S W k) /US'5 Phone#: Cell#: 11y-327_&628 email: ► (b� N4yeCkyG,'F)JvMbl/IG 4. Applicant: 0A n l-E I &f I eC.O Address: ]16 wt4 Sd- t td611 Lt NY" ����S Phone#: C wk iA(06'9)9q Cell#: email:'�A. p (p1v,%6f , LL .cwl 5. Scope of Work:New Installation( )•Replacement( )•Removal( )•Other( ): 01A mykE/'1 CA I � 6. List Equipment: r1ay J eA I b 2_�01 ISO Of114D 466 t,J(Afl 7. Location of Equipment: &S&Y1 dui- 8. Method of Installation/Removal(list all equipment needed to perform job): t 8/12/2021 tl STATE OF TIER'YORK,COUNTY OF WESTCNFSTER ) as: being duly sworn,deposes and states that he/she is the applicant above named, (FQ natrn:of individual signing as th PP ant) and further states that(s)he is the legoal wwner of the property to which this application pertains.or that(s)he is the for the Icgal owner toil is duly authorized to mafc and file this application. (ii:dicatc architect.conuactar.agent.aaumcy- �.) -('hat all statements contained herein arc true to the best of his/her knowledge and belief,anti that any work performed.or use conducted at the above captioned property will be in conformance with die details asset 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 orRve Brook and all other applicable laces,ordinances and regulatMlls. th 14 -y Sworn to before me this Sworn t before ine this Ce day of_ December _•20 22 •of G 24 c Signature of Property Owner iyuture of Applicant Peter Nebauer Print Name of Property ---- P 1*1_.._6 �. roprrty Ow Pnnt aerie of Applicant 1 — - ----.. ---DOMPAGEGAYAVfTHANAGEUL� %<��`--"" Notary Public Notary Public-State of New York NOt�ry Public NO.O1V16424207 Qualified in Westchester county Fol! McCANN GRECO My Commission Expires Oct 25,2025 lic, State of New York 01 MC4996965This application Must be properly completed in its entirety and must include the no111E�(e,9ttatlaster County Expires May 26, 2026 the legal owner(s)of the subject property. and the applicant of record ir, the spaces ided.not properly completed in its entirety and;or not properly signed shall be deemed null and void and will be returned to the applicant. `t/12n_p21 MNavieN NCB-H High-Efficiency Condensing Combination Boiler Engineering Specification 1. General Requirements a. Project scope i. Supply and install 1 (qty) high-efficiency condensing Combination Boiler(s), sealed combustion, modulating, and power vented that use either outside or inside air for combustion. b, Acceptable manufacturers i. The Combination Boiler shall be a Navien NCB-H 240/130 as basis of design with an input rating of 120,000 Btu/hr. and an output of 104,000 Btu/hr. It shall be capable of operating on either natural gas (NG) or propane (LP) with the following performance: Navien Combination Boller Other Specifications Space Heating Ratings Heating Input BTU/H Heating Rating Connection Size Water Model Number Capacity Water AFUE I(%) Water Pressure (Supply,Return) volume Min Max BTU/H BTU/H NCB-190/060H 11,000 60,000 56,000 49,000 95.0 NCB-190/080H 11,000 80,000 74,000 64,000 1 95.0 NCB-240/110H 13,000 11,000 102,000 89,000 1 95.0 12-30psi 1"NPT 1.5gallons NCB-240/130H 13,000 130,000 120,000 104,000 95.0 NCB-250/150H 1 14,000 150,000 138,000 120,000 1 95.0 Navlen Combination Boiler Other Specifications Domestic Hot Water Ratings Heating Input BTU/H Water Minimum Flow Rate 45OF DHW Inlet DHW Outlet Model Number Min Max Pressure Flow Rate (25°C)Temp Rise Connection Size Connection Size NCB-190/060H 10,700 160,000 3.7 GPM(14.0 L/m) NC13-190/080H 10,700 160,000 0.5 GPM(1.9 NCB-240/110H 13,300 199,900 15-150 PSI 3/4"NPT 3/4"NPT L/m) 4.7 GPM(17.8 Um) NCB-240/130H 13,300 199,900 NCB-250/150H 14,000 210,000 1 4.9 GPM(18.5 L.m) 20 Goodyear. Irvine, CA 92618 © 949.420.0420 © 949.420.0430 © Navieninc.com Page 1 of 5 ii. The Combination Boiler shall have a minimum 5.5 to 1 turndown ratio with the full modulation range between the maximum and the minimum output levels. iii. The Combination Boiler shall be capable of operating on natural gas (NG) or propane (LP) gas. The normal operation of the Combination Boiler with natural gas pressure shall be between 3.5 inches of W.C. and 10.5 inches of W.C. The normal operation of the Combination Boiler with propane gas pressure shall be between 8.0 inches of W.C. and 13.5 inches of W.C. c. Installation i. The Combination Boiler shall be installed according to Navien's installation and operation manual. 2. Required Certifications a. The boiler shall be certified and listed by C.S.A. International under the latest edition of the ANSI Z21.13 for the U.S. and CSA 4.9 for Canada. b. The boiler shall bear the ASME "H" stamp for 30 psi maximum working pressure and shall be National Board listed. c. The boiler's AFUE shall be verified by the Hydronics Institute of AHRI and listed in the AHRI Certification Directory. d. The boiler shall be certified for low NOx sub 14 ng/J or 20 PPM at 3% 02 and shall be listed in the South Coast Air Quality Management District directory. e. The boiler controls shall be certified by CSA, UL, or equivalent. f. The boiler shall have CRN registrations g. All electrical components shall be certified by CSA, UL, or equivalent. 3. Product Design a. Enclosure i. The enclosure shall be constructed of cold-rolled carbon steel, primed and painted on both sides. ii. The maximum Combination Boiler dimensions shall be: 17.3 in. (width) x 12.8 in. (depth) x 29.3 in. (height). iii. The maximum Combination Boiler weight shall be 96 Ibs (44 kg). 20 Goodyenr Irvine, CA 92618 © 949.420.0420 0 949,420.0430 © Navieninc.com Page 2 of 5 b. Heat exchanger and combustion components i. The primary and secondary heat exchangers shall be constructed of stainless steel material and engineered to attain the highest level of heat transfer in a compact design. To accomplish this, the heating water shall flow through a series of tubes (secondary heat exchanger) and finned tubes (primary heat exchanger), designed to maximize the heat transfer area. ii. The DHW flat plate heat exchanger installed inside the combination boiler shall be constructed of stainless steel material iii. The heat exchanger shall be able to operate with a 35% mixture of propylene glycol without significant loss of performance. iv. The burner shall be a premix design made with stainless steel and a woven metal fiber covering mesh to provide a wide range of modulating firing rates. The burner and flame observation port shall be provided for visual inspection during boiler operation. The burner flame shall be ignited by direct spark ignition and monitored by the flame sensor. v. The negative pressure regulating gas valve shall use the fan venturi effect to pull the gas through the valve in the correct ratio to inlet air. vi. The boiler shall be equipped with a variable speed blower capable of modulating the boiler firing rate from 100% down to 20% and providing smooth operation throughout the entire operating range. c. Built-in DHW(Domestic Hot Water Module) shall include the following: i. Integrated pump with maximum hot water output 4.9 GPM at 77 deg F delta T ii. Flow adjustment valve iii. Mixing valve iv. 3-way valve with easy access from the front of the unit with motor attached using a clip for tool-less removal v. Stainless steel flat plate heat exchanger d. Venting and combustion air configurations i. The boiler shall be capable of using either outside air (direct vent system) or inside air (non-direct vent system using single pipe) for combustion. Inlet and outlet of the vent system shall be connected to either through- the-roof or sidewall terminations and shall be tested for unbalanced (different pressure zones) locations. ii. Air intake acceptable venting materials include PVC, CPVC, PP, and SS. Total equivalent vent length shall be up to 65 ft. using 2" pipe and up to 150 ft. using 3" pipe. 20 Goodye-+r Irvine, CA 92618 Q 949.420.0420 © 949.420.0430 Q Navieninc.com Page 3 of 5 iii. Exhaust (flue gases) shall be vented using PVC Schedule 40 (solid core), CPVC Schedule 40 or 80 (solid core), SS and approved polypropylene as referenced in the boiler installation manual. Total equivalent vent length shall be up to 65 ft. using 2" pipe and up to 150 ft. using 3" pipe. iv. Common venting flue gases shall use Category IV approved materials. Maximum of eight (8) units including one (1) NCB-H Combination Boiler and seven (7) NPE tankless water heaters can be connected to a common vent with the use of the Common Vent Backflow Damper Collar Kit. e. Electrical i. The main power supply shall be 110-120 VAC, 60 Hz, three phase and shall not exceed 15 Amps. The Combination Boiler shall be supplied with a factory-installed 3-pronged (grounded) plug. ii. The Combination Boiler terminal strip shall be equipped with 120 VAC power for 3 zone pumps, 24 VAC power for 3 zone valves, 3 thermostats, LWCO, Navien SmartZone zone pump controller, universal supply/return temperature sensors, outdoor air temperature sensor, alarm contacts, DHW tank, air handler interrupt, and cascading control for up to 16 Units (1 Combination Boiler and up to 15 NPE tankless water heaters). f. Controls shall be certified and furnished with the following features: i. Backlit Control panel with LCD type display, clear language text, Select Mode buttons and Command Dial to select and view information ii. Operating temperature limit with 194 deg F maximum Combination Boiler water temperature set point iii. High temperature limit control preset at 200 deg F and equipped with manual reset iv. Low water cut off (LWCO) with manual reset v. ASME certified pressure relief valve set to 30 PSIG provided as standard vi. Flue gas, supply and return water temperature sensors vii. Built-in freeze protection viii. Warm Weather Shutdown ix. 4 pump contacts (Combination Boiler, zone1/DHW, zone2 and zone 3/system) x. Fully customizable outdoor temperature reset curve provided along with an outdoor temperature sensor for field installation xi. One (1) Combination Boiler and up to fifteen (15) NPE tankless water heaters system including lead/lag cascading capability and main Combination Boiler rotation functionality 20 Goodyear, Irvine, CA 92618 0 949.420.0420 Q 949.420.0430 © Navieninc.com Page 4 of 5 xii. Alarm contacts indicating manual reset lockouts on flame failure, high temperature limits, high pressure limits, low water cut off limits and air pressure limits xiii. Flame sensor rod xiv. Alarms, errors and operating status xv. Control capability to communicate with Navil-ink to control temperatures remotely, access usage data and receive diagnostic notifications 4. Warranty a. The heat exchanger shall have ten (10) year limited warranty for residential applications. b. All other parts of the boiler shall have five (5) year warranty for residential applications covering defects in materials and workmanship. c. The labor warranty shall be one (1) year. d. The warranty period shall be based on the date of manufacture or the date of installation (whichever period is longer). 5. Manuals a. Complete set of documents including product brochure, installation manual, user manual, wiring diagrams, piping diagrams, controls sequences, engineering specification, submittals and warranties shall be submitted for approval at least seven days before the bid date. 20 Goodyew, Irvine, CA 92618 Q 949.420.0420 Q 949.420.0430 © Navieninc.com Page 5 of 5 • M NavieN The Leader In Condensing Technology NCB-H and NFC-H Series PrimaryManifold Specification Sheet SUPPLY AND RETURN FITTING Navien Combi-Boiler Connection Sizes =— — Description Diameter - s .o°Ob. 0,M 0o. O-V1904MU 00 GasSupplylnlet 3/4" O• MakeFeeder e dWa Inlet 1/2" Z7 T O e •o Y Domestic Cold Water Inlet 3/4" ® i Domestic Hot Water Outlet 3/4" t ` tam Space Heating Return 1" Supply Return Supply Return Space Heating Supply 1" [NCB-H Series] [NFC-H Series] INSTALLATION SAMPLE NCB-H or NFC Series Heating iA servo-ort5rsr r Return Hydronic CIA YL Feed Water Heating r Supply Pump NaviClean Heating I i6 Heating Supply 4W Check- Return � 01 Domestic Cold Water Supply Air Separator with i Expansion Tank Domestic Hot Water Supply Manifold Piping Setup with Accessories •Navlen reserves the night to change spedfloadons at arty time without prior notice Navien,Inc. 20 Goodyear,Irvine,CA 926111 Ph:(949)420-0420 Fax:(949)420-0430 www.Navienlnc.com 4-14aFHM-SS-nn1-1.0 eNavieN The leader in Condensirg Technology NCB-H and NFC-H Series PrimaryManifold Specification Sheet The NCB-H and NFC-H Series Primary Manifold is approved for use with Navien Combi-Boilers ONLY. Compatible with all NCB-H and NFC-H Series boiler models: NCB-190/060H, NCB-190/080H, NCB-240/110H, NCB-240/130H, >u� NCB-250/150H NFC-175H, NFC-200H Compact design that is ideal for hydronic and radiant space heating applications. ,�:�� Package comes pre-assembled in order to reduce labor time and cost for ,� "�► installations while maximizing system efficiency without the need to fabricate a custom manifold. (Part Number:30026576A) The SUPPLY and RETURN connections on the manifold attach directly onto the fittings located at the bottom of the boiler unit. This manifold kit contains the following features: - 1" FNPT dielectric unions for boiler SUPPLY and RETURN. - 1-1/2" sweat connections for heating SUPPLY and RETURN piping. - PRV/Air Vent Adapter. - Adapter from threaded connection to clipped connection. -Set of 1" Isolation Valves with 3/8" drain connections and rubber gaskets. - Male plug when LWCO is not used. - Made of Stainless Steel material. INCLUDED PARTS AND DIMENSIONS _ 12.1 Valve Kit I-NPT Dielectric Union Convection 3/8'Purge Valve - ' Valve Kit �- 3/8'PurgeValve-- cv,p�.-tL'Jh C) —Gasket J Red Sleeves On Handle Blue Sleeves On Handle m ^ M -1'STs 1"sTs-. ^I ®® Dielectric Union-, 11/2'NPT \ '11/21ST Manifold Kit ® (Pipe,Union, - - - -- - - - - - Gasket) 6-_ -Dielectric Union (Aildimensions NCB H,NFC H Series Primary Mangold In inches) (Part Number:30026576A) Check that a pipe,unions,gaskets,and valves are all included in the Manifold kit box and the Valve kit box.After installing the manifold and valve kits,ensure that the fittings,such as the unions and gaskets,are properly sealed with the pipe. 'Navien reserves the right to change specifications of any time without prior notice Navien,Inc 20 Goodyear,Irvine,CA 92618 Ph:(949)420-0420 Fax:(949)420-0430 mm.Navieninc.com 4-NCFH41-SS•001.1.0 0 C] s m :+ r� Y _ w � .. - _ -, a, T3:a W —r 4J �J �S► �1 ve Lij Z cn cl-CO W v co W LL CD LU �r� V Q. V r •� N _ ` {1 V L W v �J LL Lu Q V —• W —� x a Z W � Z CIO W r W W V) ti CO { S Lu O W C) r- 1 �j�� 1 ✓ '^ O �C c✓ i 06 `�7 y J V Mike Izzo From: Mike Izzo Sent: Monday, December 5, 2022 3:30 PM To: Peter Nebauer Cc: Felipe GQ Steven Fews; Tara Orlando; Laura Petersen Subject: RE: 19 Beacon Lane, Question about renovation problems Dear Mr. Nebauer, Thank you for the email. On October 12, 2022, I received an email from you requesting a six (6) month extension to your expired permit #BP21-220, expired 8/24/2022. Upon my reply I informed you that since your permit was issued on 8/24/21, the Building Department had yet to be contacted by your contractor(s) or by anyone else to schedule any inspections of the construction work, and that your plumber had yet to file for his plumbing permit. I have attached a copy of my email of 10/12/22 below for reference. Upon remittance of the $500 Expired Permit Fee on 10/13/22, your permit was duly reinstated with a six (6) month window making the new expiration date 2/24/23. Despite that, the Building Department is still waiting to hear from anyone associated with your job to schedule an inspection for anything, and neither has your plumber filed for a plumbing permit. Given the present situation of your job, the Building Department's options for assisting you are dwindling. Your failure and that on the part of your contractor(s) to proceed as required by code by filing for the required permits and by scheduling construction inspections at the proper intervals is cause for serious concern. And although Village Code allows for up to two six (6) month permit extensions, I have discretion over all such extensions and at this juncture it is unlikely that I would consider granting another permit extension unless your contractors live up to their obligations under the law. Failure to do so and upon expiration of your permit, you and your contractors may be summoned before the Rye Town Court. Unfortunately, I cannot advise you as to how to deal with your contractors. I can only offer that all contractors are licensed by the County of Westchester, and that you are welcome to contact the Westchester County Department of Consumer Protection to file a grievance against your contractor(s) if you wish. Please note that your contractor, AT CONSTRUCTION, 6 Biehn Street-#2, New Rochelle, NY 10801's Westchester Home Improvement License # WC-33430-H2O expired on 11/23/22. Thank you. Michael J. Izzo Building& Fire Inspector Village of Rye Brook, NY (914) 939-0668 Original Message From: Peter Nebauer <pnebauer@gmail.com> Sent: Monday, December 5, 2022 10:19 AM To: Mike Izzo <MIzzo@ryebrook.org> Subject: Question about renovation problems Hi Mike. I'm looking for advice on some problems I'm having with my current renovation. I don't know if this is something you can help me with or possibly point me in the right direction. I recently got a letter from the building department letting me know the current permits on my renovation had expired. I paid $500 to extend them another 6 months. And in that email it also came to my attention that plumbing permits have not been filed yet. I've been doing everything I can to try and get my contractor to finish the work, and at least get inspections completed, but he's always off doing other jobs and only shows up when he feels that he can. (At this point he's showing up maybe 1 day a week at best.) He keeps telling me he's waiting to hear back from the plumbers about permits, but it's been months now. Do you know if there something I can do in my situation? It's causing a lot of stress and financial burden on me and my wife, and I don't see an end to this anytime soon. Original contract timeline was supposed to be around 6 months until completion and it's been over a year now and the project is at a standstill. We just want to find a way to end this as soon as possible, and looking for some guidance if anyone can give some. Thank you, Peter Nebauer Dear Mr. Nebauer, Thank you for the email. In order to consider a permit extension, you must remit the $500 Expired Permit Fee. Once we receive payment your permit will be reinstated for a period of six (6) months. Please note that although this permit is over a year old, we have yet to receive a plumbing permit application. Neither has any trade requested construction inspections for anything. Please consult with your contractors in this regard and note that it is a violation of code to perform plumbing or any other work without the proper permits in place, and a violation to cover up or build over work that requires an inspection by the Building Department. Thank you. Michael J. Izzo Building&Fire Inspector Village of Rye Brook, NY (914) 939-0668 From: Pete N <pnebauer@gmail.com> Sent: Wednesday, October 12, 2022, 1:25 PM To: Mike Izzo <MIzzo@ryebrook.org> Cc: Felipe GC <Felipeavalos 1969@gmail.com> Subject: Building permit extension request I recently received a letter in the mail informing me that our building permit has expired. I would like to request an extension for 6 months. Property address: 19 Beacon Ln Rye Brook NY 10573 2 • My GC, Felipe Avalos will coordinate any paperwork and payment that is required. Felipe can be reached at 914-774-4861 Thank you, Peter Nebauer (Property owner) 3 Mike Izzo From: Mike Izzo Sent: Wednesday, October 12, 2022 2:09 PM To: Pete N Cc: Felipe GC; Steven Fews; Tara Orlando; Laura Petersen Subject: RE: Building permit extension request. BP21-220 Dear Mr. Nebauer, Thank you for the email. In order to consider a permit extension,you must remit the $500 Expired Permit Fee. Once we receive payment your permit will be reinstated for a period of six (6) months. Please note that although this permit is over a year old, we have yet to receive a plumbing permit application. Neither has any trade requested construction inspections for anything. Please consult with your contractors in this regard and note that it is a violation of code to perform plumbing or any other work without the proper permits in place, and a violation to cover up or build over work that requires an inspection by the Building Department. Thank you. AlG 4 a el/(/, �ZZO Building & Fire Inspector Village of Rye Brook, NY (914) 939-0668 From: Pete N <pnebauer@gmail.com> Sent:Wednesday,October 12, 2022 1:25 PM To: Mike Izzo<Mlzzo@ryebrook.org> Cc: Felipe GC<Felipeavalos1969@gmail.com> Subject: Building permit extension request I recently received a letter in the mail informing me that our building permit has expired. I would like to request an extension for 6 months. Property address: 19 Beacon Ln Rye Brook NY 10573 My GC, Felipe Avalos will coordinate any paperwork and payment that is required. Felipe can be reached at 914-774-4861 Thank you, Peter Nebauer (Property owner) 1 [-�yE DR t L,. 404 annivzwaW VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A.Klein (914) 939-0668 Christopher J. Bradbun- www.ryebrook.org TRUSTEES BUILDING & FIRE INSPECTOR Susan R. Epstein Michael J. Izzo Stephanie J. Fischer David M.Heiser Salvatore W. Morlino October 6,2022 Dear Rye Brook Building Permittee, It has come to the attention of the Building Department that your Building Permit has not been closed out in accordance with Village Code and is now expired.All Building Permits have a twelve (12)month lifespan starting from the date of issuance,and the permit expiration date is noted on the front of the permit. Please note that there is a non-waivable Expired Permit Fee of$500.00 now due in connection with your expired permit. Once payment is received,your permit will be reinstated for a period of six(6)months. Please be advised that it is a violation of Village Code to fail to close out a permit,and that a court summons could be issued,and fines may be imposed on the permit holder and/or property owner for failure to apply for and obtain a Certificate of Occupancy(C/O) or Certificate of Compliance (C/C),in accordance with Village Code section 250-10A. Please note that Temporary C/Os&C/Cs are available in accordance with Village Code section 250-10B should you require more time to perform whatever work remains in order to complete your project. Thank you for your attention in this matter,and please feel free to contact this office should you require any further information. Michael J. Izzo Building&Fire Inspector mizzo ,.yebroo�k.or¢ /to cc: Steven E. Fews,Assistant Building Inspector Tara A. Orlando,Planning&Zoning Secretary Laura Petersen,Office Assistant 0 LO O W O a , w � ~ it- CC o �� a ��� 0 :11� . t v Cd v z v r 0 Lr) 0 cd -X cn }� 0 v �n Y c � Z OC •afcW Y 6w 6w i V Q J x J c Y Building Permit Check List&Zoning Analysis • •wCtddress. l � o LAI--VI-1 SBL- � 3.-, Zone -D Use: -2-10 Const.Type: � er. Submittal Date: 51 t:772 ( Revisions Submittal Dates: JZL I 6 Z Applicant: )ty j—_7 ZAo c--: n/ Nature of Work C'o N_.,� OrLVL Paco F �i �j F w F 20,- a-C14 Reviews:ZBA: M A Y 2 7 2021 PB. BOT: Other. OK ( ( ) FEES:Filing. 7 S• ••�z�t BP: 77, 't 40- �C� 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 Pr tection: S/W Mgmt.: Tree Plan: Other. (. VEY:Dated (o Z>� Z �urrent: ✓ Archival_ -Sealed. Unacceptable: ( ) ( �LANS:D_ av Stamped Seale Copies- "L—Electronic Other ( ( ) License. V Workers Comp: VLiabili ✓ Comp.Waiver. Other. CODE 753#: 0 t)oCC J rYD Dated N/A: (•� ( ) HIGH-VOLTAGE ELECTRICAL:Plans: Perot: 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. ^ i (L546,B mtg.date 7-1 approv&- ._ � iLotes: ( )ZBA mtg.date: approval• notes: ( )PB mtg.date: approval: notes: REQUIRED EXISTING PROPOSED NOTES APPROVED t o k Z D S - ok- BMW; —9 Cir 7 ' FropW Fr Front O "3 Z Sides: 1 2s' &W. 3 Main Cov: Z O fg.1Ss' � Ok- Accs.Cov y• o , '7 Z Ckf- Ft.HS : Sd.H/Sb: Tom: (0 2 b Ft 3 P Hcigk/Stories: notes: f 1 -► F.o Z U4 f" C F I Z,.9 10S� o jF_ 7 G 7 ti LREVISSSED JUL - 6 2021 BUILD ^ `ART EWIS / cATION 20.845 M OF RYE B.D; 938 KING STREET RYE BR Oo P1v9 WAY 1 � 2021 l (914)939-0668 Fax(914) e K --- ' k4EN7 Riiittftf#fttf•ft♦tifiti\\flit\t•ttt♦•t\fif#fitlffl\tt\i\\\l♦\\tlitttiitttt►iifitti•#iti/tii itt ARCHITECTURAL REVIEW BOARD CHECK LIST FOR APPLICANTS This form must be completed and signed by the applicant of record and a copy shall be submitted to the Building Department prior to attending the ARB meeting. Applicants failing to submit a copy of this check list will be removed from the ARB agenda. Job Address: 19 beacon lane I Date of Submission: Parcel ID#: l _ \ Zone: R10 Proposed Improvement(Describe in detail): APPLICANT CHECK LIST: Q�"f vv`L v''-Xi3tiliy iCitCii''viii andurc'sanfaSt MUST BE COMPLETED BY THE APPLICANT UtMies. C,Eate ft'Ont porch - The following items must be submitted to the Building RAISE existing roof at master bedroomre Department by the applicant- no exceptions. master bath Create errasse 2nd 1. ( %I Completed Application floor 2. ( y Two(2)sets of sealed plans. (one full size (maximum Property Owner:— Peter NER-AUER allowable plan size=36"x 42"! and one 1 1"xl7") 3. ( \ii)Two(2)copies of the property survey. Address: 19 bear_n lane 4. ( J Two(2)copies of the proposed site plan. Phone# 9147080707 5. ( y One electronic/disc copy of the complete Applicant appearing before the Board: application materials. 6. (V)Filing Fee. •� r.� N 7. ( )Any supporting documentation. Address: 14 Howard Ayi- 'NORWALK-fISAS; 8. ( y HOA approval letter. afapplicable) -- 9. (V)Photographs. Phone# 203 496 4384 10.( )Samples of finishes/color chart.to sample board or model may be presented the night of the meeting/ Architect/Engine-er: Hnvrard RAARE Phone# 2035223559 By signature below, the owner/applicant acknowledges that he/she has read the complete Building Permit Instructions&Procedures,and that their application is complete in all respects. The Board of Review reserves the right to rPfuco to hear any npflitatictn not meotin9 the rvquiromvnts coin tainorl.herein. Swom to before me this Sworn to before me/this day of 3l�lY , 2oz 1 day o �v y , 20_4 Pin47�- alal� cavm Signature of Propaty Owner licant P�( ALAIN CAREN Print.' cfPropertfChsr. Primly ofAppiicant G tiotary Public Ncxa ROSEMARI J MO AVERO ROS RIE J MOGAVERO Notary Public- fate Otary P blic Sta[e of New York ID New or N0. 01M 50234 O.01M05023476 stchester Quali 'ed in Westchester County My Commission Expires ounty My Commission Expires Feb 7, 2022 P es Feb 7 2022 /19 I s VILLAGE OF RYE BROOK BUILDING DEPARTMENT 938 KING STREET, RYE BROOK,NY 10573 (T) 939-0668 (F) 939-5801 ARCHITECTURAL REVIEW BOARD Tuesday, August 17, 2021 NAME& LOCATION TYPE OF APPLICATION MOTION SECOND APPROVED REJECTED I APPL.# 2 Old Orchard Rd Expand Existing Patio Consent 5204 (Zaino/Schinfield) Agenda 44 Country Ridge Dr Amendment to Prior Consent 5205 (Wechsler) Approval, (Outdoor Agenda Kitchen Countertop _ _ Change), 226 S. Ridge St Change Exterior Brick Consent 5236 (Tucci) Facade To Vinyl Siding Agenda 1 Maplewood Lane Replace Existing Wood Consent 5237 (Balanoff) Decking w/Timber-tech Agenda Peakon, Existing Masonry Patio & Wall w/Westchester Blend Pavers 31 Talcott Road New Windows,New Patio Consent 5238 (Frank/Israel) Doors; & Replace Siding Agenda In-Kind 121 Country Ridge New Windows & Doors 5239 Drive (Novick) For Interior/Exterior Changes 2 Old Oak Road New Deck& Patio In Rear 5240 (Wexler) Yard 19 Beacon Lane Re-Appearance Exterior 5241 (Nebauer) Changes. New Front Porch & 2nd Floor Terrace 78 Tamarack Road Legalize Rear Deck 5242 (Zahl) Remodel 52 Valley Terrace Re-Do Driveway, 5243 (Uzzo) Retaining Wall & Walkway ML NM MR SE JM -U/ SF AC ( ' MI- KC / . VILLAGE OF RYE BROOK BUILDING DEPARTMENT 938 KING STREET, RYE BROOK, NY 10573 (T) 939-0668 (F) 939-5801 ARCHITECTURAL REVIEW BOARD Tuesday, August 17, 2021 _ NAME&LOCATION TYPE OF APLLICATION MOTION SECOND APPROVED REJECTED 22 Highview Ave One Story Side Addition 5244 (Saunders/Del- w/Finished Basement Rosario) 90 S. Ridge St(RSP) New Illuminated Sign 5245 Group "Walk In Care Center" 6 Jacqueline Lane New Rear Deck, Patio, 5246 (Gasparino) Windows, Siding & Front Door 108 S. Ridge St New Sign & Awning For 5247 (Win-Ridge) (City M.D.) 9 Charles Lane Legalize 2nd Fl Bedroom, 5248 (Straus) & Install 2 New Casement Egress Windows 2 Jennifer Lane 2nd Floor Addition, New 5245 (Bien LCC) Rear Patio & Renovations 33 Talcott Road Rebuild Rear Deck 5249 (Selzer) I I Whippoorwill Rd 2nd Floor Dormer 5250 (Aspis) Addition 68 Windsor Road Replace Rear Exterior 5251 (Perry) Stairway 134 S. Ridge St(Win New Sign "Buff City 5252 Ridge) Soap" FML NM MR SE JM SF AC MI KC VILLAGE OF RYE BROOK BUILDING DEPARTMENT 938 KING STREET, RYE BROOK, NY 10573 (T) 939-0668 (F) 939-5801 ARCHITECTURAL REVIEW BOARD Wednesday, July 21, 2021 -- - - 3 Edgewood Drive Exterior Projects, Deck 5230 (Feldberg) w/Stairs to Patio, Pergola, Outdoor Kitchen, Pond- less Water Feature 19 Beacon Lane Reconfigure Roof, New * 1 5231 (Nebauer) Front Porch, & 2nd Floor Co l Terrace N U �o�J� ' 4(,1 ?qc� 167 Country Ridge 1 Story Side In-Fill 5232 Drive (Hugon) Addition 11 Berkley Drive Rear 2nd Story Addition, 5233 (Signh/Gawtam) Rear Deck & patio. New Front Portico 19 Birch Lane In-Ground Pool, Turf 5234 (Jaccoma) Patio, Rear Yard Fire Pit 51 Country Ridge Dr Enlarge Existing Deck, 5235 (Wolf) Enlarge Existing Patio, New Front Walk 108 Old Orchard New Front Gable Roof, 5236 Road(Martino) Masonry Steps, Patio, Flagstone Walk& Cupola Over Garage. ML NM MR ✓ SE JM SF AC / MI KC Mike Izzo From: Mike Izzo Sent: Monday, June 14, 2021 9:54 AM To: Pete N Cc: ALAIN CAREN,- Howard Raabe; 'Tara Gerardi'; Laura Petersen Subject: RE: 19 Beacon Lane Dear Mr. Nebauer, Thank you for the email. You don't need another survey, the current one will suffice. Unfortunately to date we have yet to receive an actual original scalable survey of your property. What was provided is a copy of your survey shrunk down and superimposed on the front page of the plans. In order to perform a comprehensive zoning analysis we must have a scalable original survey, a point clarified in my email of 5/27. In addition your permit application remains rife with omissions and in some cases errors on the part of your design team. All of this was related to your professionals and copied to you through email as far back as 5/27 and more recently on 6/1 after reviewing the "corrections" provided by your team. Most notably is the incorrect information regarding impervious coverage on application page (4), and the missing information regarding height setback ratios on page (5). Your architect indicates that the total existing impervious coverage for your property is 880 sq. ft. However on the previous page he indicates that the house alone covers 1,700 sq. ft. as such, the total impervious coverage information provided is also incorrect. The height setback ratio section has no information and was left entirely blank. If your design team doesn't understand the definitions of impervious coverage or height setback ratio as provided in the code book or how to apply such to their zoning calculations then he/she should seek assistance before providing any further information. While we are happy to assist you and your professionals, the Building Department cannot be responsible for completing a permit application especially regarding bulk coverage calculations critical for zoning compliance. All the bulk coverage information must be completed correctly by your design professionals. Please arrange for your professionals to provide an original property survey, and to properly complete the permit application by providing all missing information and corrections to the Building Department for further review. Thank you. Ifflehel( Im Building&Fire Inspector Village of Rye Brook, NY (914) 989-0668 From: Pete N <pnebauer@gmail.com> Sent: Sunday,June 13, 2021 9:05 AM To: Mike Izzo<Mlzzo@ryebrook.org> Subject: Re: 19 Beacon Lane Hi Mike, my name is Pete and I'm the property owner. I've been trying to stay out of the conversation and let the professionals do their job. i I have one question that hopefully you can clarify for me. For the new portico plans,you mentioned we will need to provide an up to date land survey for zoning review. The land survey we provided was completed less than a year ago, in August 2020.That survey includes the set back distance of the house from the road. Will that be sufficient documentation for these permits or is there some other survey we need to provide? I just want to make sure I know exactly what the survey needs to show before I pay a surveyor to come out to the house and do another survey.Sorry if I'm asking a question that was already answered. I've attached a copy of the current property survey for reference. Thanks Pete On Thu, May 27, 2021 at 2:09 PM Mike Izzo<Mlzzo@ryebrook.ore>wrote: Dear Mr. Caren, The Building Department is in receipt of the revised plans and application for the subject property. I have attached a copy of the application hereto for your convenience. Please note that the application is incomplete and in some cases incorrect and unsigned. Please complete the application including all the correct bulk standards and re-submit it for further review. In addition the project calls for a new front portico which requires a zoning setback review. Unfortunately the application materials do not include a current original survey needed for a comprehensive zoning analysis. Please provide a current (within the past 12 months) original property survey for review. Thank you. lfflchell(7, /zzo Building& Fire Inspector Village of Rye Brook, NY (914) 939-0668 2 From: ALAIN CAREN <alain.caren@gmail.com> Sent: Monday, May 17, 2021 12:48 PM To: Mike Izzo<Mlzzo@rvebrook.org> Cc: Howard Raabe <howsthings@gmail.com> Subject: 19 Beacon Lane Good morning, let me follow up on our phone call last week. I am the Designer working with Howard Raabe on the property above. Please find below the plan with the correct stamps for the State of NY; along with the missing page signature regarding page 3,4,5,6 and 7 for the application and the proper related calculations.We updated the general notes on Page 1. Thank you for your collaboration, please let me know if we could take advantage of the upcoming architectural review board, and the modalities for the zoom meeting requirements. I am attaching the pdf file of the corrected plans, and the property pictures on Page 2. 1 will file the corresponding print as soon as you confirm with me the ok with the above. https://1drv.ms/b/s!AgtKAPOfYRunhLxPm9bpUWMz2ga4hQ?e=BSu8k0 Thanks for your help. Alain Caren Designer, Cm 203 496 4384 3 Mike Izzo From: Mike Izzo Sent: Tuesday,June 1, 2021 9:06 AM To: ALAIN CAREN Cc: Howard Raabe; pnebauer@gmail.com;Tara Gerardi; Laura Petersen; Lisa Caren; Ramsay Land Surveying Pc Subject: RE: 19 Beacon Lane Attachments: 19 Beacon Lane Application 5.17.21 ADDED MISSING.pdf Dear Mr. Caren, Please note that the application remains deficient. Please complete ALL pages including the ARB checklist, the height/setback ratio page, and every other application page. Thank you. AG4adcZ IZZO Building& Fire Inspector Village of Rye Brook, NY (914) 939-0668 From:ALAIN CAREN<alain.caren@gmail.com> Sent: Monday, May 31, 20219:10 AM To: Mike Izzo<Mlzzo@ryebrook.org> Cc: Howard Raabe<howsthings@gmail.com>; pnebauer@gmail.com;Tara Gerardi<tgerardi@ryebrook.org>; Laura Petersen<LPetersen@ryebrook.org>; Lisa Caren<lisacaren115@gmail.com>; Ramsay Land Surveying Pc <nvreclandsury@yahoo.com> Subject: Re: 19 Beacon Lane Good morning Mike. Please see the attached updated application and a copy of the plan filed; I will forward the updated survey copy along with the homeowner's signed copy and check for$2,400. Do we need to include the notarized copy, or the original signed copy is sufficient? Please let me know if we will be ok with the above,and should plan accordingly for the June Arb. We will bring the finishes/color chart for the meeting. Thank you Alain Caren besigner, Cm Dvestinyow4mme.nat 203 496 4384 On Thu, May 27, 2021 at 8:09 PM Mike Izzo<Mlzzo@ryebrook.org>wrote: 1 Dear Mr. Caren, The Building Department is in receipt of the revised plans and application for the subject property. I have attached a copy of the application hereto for your convenience. Please note that the application is incomplete and in some cases incorrect and unsigned. Please complete the application including all the correct bulk standards and re-submit it for further review. In addition the project calls for a new front portico which requires a zoning setback review. Unfortunately the application materials do not include a current original survey needed for a comprehensive zoning analysis. Please provide a current (within the past 12 months) original property survey for review. Thank you. lWad(l Ima Building& Fire Inspector Village of Rye Brook, NY (914) 939-0668 From:ALAIN CAREN<alain.caren@gmail.com> Sent: Monday, May 17, 2021 12:48 PM To: Mike Izzo<Mlzzo@ryebrook.org> Cc: Howard Raabe<howsthings@gmail.com> Subject: 19 Beacon Lane Good morning, let me follow up on our phone call last week. I am the Designer working with Howard Raabe on the property above. 2 Please find below the plan with the correct stamps for the State of NY; along with the missing page signature regarding page 3,4,5,E and 7 for the application and the proper related calculations.We updated the general notes on Page 1. Thank you for your collaboration, please let me know if we could take advantage of the upcoming architectural review board, and the modalities for the zoom meeting requirements. I am attaching the pdf file of the corrected plans, and the property pictures on Page 2. 1 will file the corresponding print as soon as you confirm with me the ok with the above. https://1drv.ms/b/s!AgtKApOfYRunhLxpm9bpUWMz2ga4hQ?e=BSu8kO Thanks for your help. Alain Caren Designer, Cm 203 496 4384 3 Laura Petersen From: Laura Petersen Sent: Thursday,August 19, 2021 2:08 PM To: pnebauer@gmail.com Cc: felipeavalos1969@gmail.com Subject: Building Permit Application - 19 Beacon Lane Good afternoon, The building permit application has been approved by the Building Inspector. Before I can issue the building permit the following items must be submitted to our office, Copy of general contractor's valid Westchester County Home Improvement License. 2. General contractor's valid liability insurance (the Village Of Rye Brook must be the certificate holder) 3. General contractor's valid workers compensation on a NY State Board form (C105-2 or U26.3) f ��ri�Y4640rje -7 ;- 4. Building permit fee $2,400.00 (due once permit is issued and ready for pick-up) 5. Contractor must call Dig Safe NY and get a ticket number. 08 aoi-001- 39 s This information can be emailed to me. Thank you and have a good day �� f Laura 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 Ipetersen(Wrvebrook.org 1 ..At.�.+'4'�r'•'•-'t'!tA • 3i•• -/ n:t;A?n.;�� J 1-,�G '/ A.. ,`'A 'j _ .5.5-.: A N3.:v..:...;.. .f� :r ,f•.. '-art .�� �.ii• fi� 1�,._�� t._ :eWtAr�'i:i::•'i_:i:;. J. .i uj<A _s�.� t ' :.,:.+'%•?r,.,. ':O' ,tp'l�t�C�!5{r'y;Y ':O.i ,�, y�T;o- � ;kiL;Yv � � � r .�.�i\tt �. � y�Y�..V\ F +r'Y lip � 1' oc.._. yn ,} l(r<• r�SYy� ,v,:-III.+•��S�At�r}J 0..:""B`��W!ttt{;y{1 OI. 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"�..�� n�.�.£fixtn�""�'+v' , +''•, � �`�'��."rr�l `' ,��,'�'�._°�rr>r, • ,•sfp �< ® DATE(MMIDD/YYYY) ACORO CERTIFICATE OF LIABILITY INSURANCE 1 03/30/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER CONTACT Tom Bruenn _ NAME: M.L.Bruenn Co.,Inc. PHONE (914)632-2222 No): (914)235-6883 240 North Avenue E-MAIL ADDRESS: Com T InsureUsAll.com INSURERS AFFORDING COVERAGE NAIL• New Rochelle NY 10801 INSURER A: UTICA FIRST INSURANCE CO 15326 INSURED INSURER B: _ WILIAN O ARROYO&LUIS ALEJANDRO TORRES PAJUELO INSURERC: DBA AT CONSTRUCTION INSURER ID: 6 BIEHN ST APT 2 INSURER E: NEW ROCHELLE NY 10801 1 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR POLICY NUMBER MM/DD MM/DD LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ❑X REMI OCCUR E TO REN PREMISES Ea occurrence) $ 50,000 MED EXP lAny oneperson) $ 5,000 A ART513750301 12/06/2020 12/06/2021 PERSONAL&ADV INJURY $ 1,000,000 GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JET LOC PRODUCTS-COMP/OP AGG t 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY $ AUTOS ONLY AUTOS (Per accident) HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ s UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I I RETENTIONS $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N/A E.L.EACH ACCIDENT : (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 7- DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CARPENTRY,PAINTING,KITCHEN/BATH,TILE VILLAGE OF RYE BROOK LISTED AS ADDITIONAL INSURED CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN VILLAGE OF RYE BROOK ACCORDANCE WITH THE POLICY PROVISIONS. 938 KING STREET AUTHORIZED REPRESENTATIVE RYE BROOK NY 10573 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD NYSIF New York State Insurance Fund WESTCHESTER ONE,44 SOUTH BROADWAY, 10TH FLOOR,WHITE PLAINS, NY 1 0601-44 1 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ^^^ ^^^ 843271979 GENESIS INSURANCE AGENCY , 171 GRAND ST 4��gj- WHITE PLAINS NY 10601 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER WILIAN 0 ARROYO& VILLAGE OF RYE BROOK LUIS ALEJANDRO TORRES PAJUELO 938 KING STREET 6 BIEHN STREET,APT 2 RYE BROOK NY 10573 NEW ROCHELLE NY 10801 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W2511418-2 795230 04/03/2021 TO 04/03/2022 8/23/2021 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2511418-2, 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, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. 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. THIS POLICY IS CANCELLED EFFECTIVE 09/01/2021. NEW YORK STATE INSURANCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 514657873 U-26.3 ACOR& CERTIFICATE OF LIABILITY INSURANCEDATE(MMIDOfYYYY) a 1 _021 1 10/13/2022 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(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rl hts to the certificate holder In lieu of such endorsements . CONTACT PRODUCER Lockton Companies NAME. 3280 Peachtree Road N-E,Suite#250 PHONE FA No Atlanta GA 30305 E-MAIL (404)460-3600 ADDRESS: INSURERS)AFFORDING COVERAGE NAIL S _ INSURER A:Evanston Insurancem 35378 INSURED Aqueduct Plumbing,Heating&Cooling,LLC INSURER B:Liberty Mutual 1-ire lnsurance Convany 23035 1511838 115 Wall Street INSURER C:The Princeton Excess&Surplus Lines Ins Co 10786 Valhalla NY 10595 INSURER o:LM Insurance Corporation 33600 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 19031663 REVISION NUMBER: XXXXXXX THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE In POLICY NUMBER MM/DD MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY Y N MKLV2PBC001643 8/10/2022 8/10/2023 EACH OCCURRENCE S 1,000,0w DAMAGE TO RENTED CLAIMS-MADE F_x1 OCCUR PREMISES a occurrence) S 100.000 MED EXP(Any one person) s Excluded PERSONAL a ADV INJURY S 1 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2 000 000 POLICY X I JEST 7LOC PRODUCTS-COMP/OP AGO S 2 000 000 OTHER: $ B AUTOMOBILE LIABILITY 2-651-292549-022 COMBINED SINGLE LIMIT Y N AS_ 4/1/2022 4/1/2023 Es a cl ern S 2, 00,000 X ANY AUTO BODILY INJURY(Per person) S XXXXXXX OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE S 1CXy_V'4XX AUTOS ONLY AUTOS ONLY (Per accidentl sXXXXXXX C UMBRELLA LIAB IX I OCCUR Y N 60A3FF0000171-00 8/10/2022 8/10/2023 EACH OCCURRENCE S $5,WO,OW X EXCESS LIAB CLAIMS-MADE AGGREGATE S $5,W000 DED I I RETENTIONS S XXXXXXX WORKERS EMPLOY EMPLOYERS'C OMP ENSATION LIABILITY N WA5-65D-292549-012 4/l/2022 4/l/2023 X STATUTE ERH D AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN❑N N!A E.L.EACH ACCIDENT S 1000 00O OFFICER/MEMBER EXCLUDED9 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE 3 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1 000 000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) Certificate Holder is azt additional insured A ith respect to General Liability.Auto,and Umbrella policies. CERTIFICATE HOLDER CANCELLATION 19031663 Village of Rye Brook SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 938 King St. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Rye Brook NY 10573 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE / ©1988-20, ACORD CORPORATION, All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD E YORK Workers' CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE 4— Board 1a. Legal Name&Address of Insured(use street address only) 1 b Business Telephone Number of Insured Aqueduct Plumbing, Heating & Cooling, LLC 914-666-9199 115 Wall Street Valhalla NY 10595 1c. NYS Unemployment Insurance Employer Registration Number of Insured 5538703 Work Location of Insured (Only required if coverage is specifically limited to lid. Federal Employer Identification Number of Insured or Social Security certain locations in New York State, i.e., a Wrap-Up Policy) Number 88-3136026 2.Name and Address of Entity Requesting Proof of Coverage 3a Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) LM Insurance Corporation Village of Rye Brook 3b, Policy Number of Entity Listed in Box"la" 938 King St Rye Brook NY 10573 WA5-65D-292549-012 3c Policy effective period 9/12/2022 to 4/1/2023 3d,The Proprietor, Partners or Executive Officers are included.(Only check box if all partners/officers included: all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box"la'for workers' compensation under the New York State Workers'Compensation Law. (To use this form, New York(NY) must be listed under 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 ho;der 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. Talor Powers (Pn-'- — -'atrve or licensed agent of insurance carrier) Approved by. 10/7/2022 (Signature) (Gate) Title: Sr. Client Service Coordinator Telephone Number of authorized representative or licensed agent of insurance carrier 470-539-5761 Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insurance brokers are NOT authorized to issue it. C-105.2 (9-17) www wcb.ny gov 7L732373 1 5-292549 ::0S.2 9/22-4/23 Aqueduct t--cing, Neat.ing S con: 17on:::.,� .:3n:5: PM :=7' .age Laura Petersen From: Mike Izzo Sent: Monday, August 23, 2021 8:30 AM To: Tara Gerardi; Laura Petersen Subject: FW: Message from Dig Safely New York, Inc. (DSNY) Michael J. Izzo Building & Fire Inspector Village of Rye Brook, NY (914) 939-0668 -----Original Message----- From: Dig Safely New York Exactix <tickets@exactix.digsafelynewyork.com> Sent: Friday, August 20, 2021 1:35 PM To: Mike Izzo <MIzzo@ryebrook.org> Subject: Message from Dig Safely New York, Inc. (DSNY) ****REGULAR**** DIG REQUEST from DSNY for: VIL RYE BROOK Taken: 08/20/2021 13:33 To: VIL RYE BROOK PRIMARY Transmitted: 08/20/2021 13:35 00003 Ticket: 08201-001-395-00 Type: Regular Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 19 To: Name: BEACON LN Cross: From: To: Name: Offset: ------------------------------------------------------------------------------ Locate: WORKING AT THE FRONT OF THE HOUSE NearSt: MAPLE CT & JENNIFER LN Means of Excavation: HAND TOOLS Blasting: N Site marked with white: N Boring/Directional Drilling: N Within 25ft of Edge of Road: Y Work Type: PORCH INSTALL Estimated Work Complete Date: 08/28/2021 Depth of excavation: 42 INCHES Site dimensions: Length 6 FEET Width 3 FEET Start Date and Time: 08/25/2021 07:00 Must Start By: 09/09/2021 ------------------------------------------------------------------------------ Contact Name: FELIPE ABALOS Company: Addrl: 19 BACON LN Addr2: City: RYE BROOK State: NY Zip: 10573 Phone: 914-774-4861 Fax: i • Email: felipeabalos1969@gmail.com Field Contact: FELIPE ABALOS Alt Phone: 914-774-4861 Working for: CALLER IS PERFORMING THE WORK THEMSELVES ------------------------------------------------------------------------------ Comments: Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: ALTICE USA CONED SUEZ WTR WESTCHESTER VIL RYE BROOK WESTCHESTER CTY SWR 2 v 0 c U) co' C� � < p�ZOv�mr�DmDO�zZ=rv� � � -n ZDmm *t v M;O;u0 ��v OfM*IDmC7mm -` C1'y cfl ommrno O CMKF-vDmm- ;C:F z (gym Z(/)Mwmrvm�m '' q r=.r" v om0�?,c=�Com �r ZMo-<8z4mT � � off' z z �� m r v --i � 7d m-�n �y-IpZ�--O=z<-MODS z �0 rn Do vo nZ�Z zFnr-mo> ZN-D 0 :�.�� C� = W CD 7 ' Co �z �0z >--IXD�ZCz�jN "vim �� o mwor-40;uzomo s �<NpC�Z� - 'rn > � c°o c° ZZ v z�Dp m MN Z m pM � 1 °oomv mz z0-n � � �� = ��0 oDK O-OD � � WW zo FA� o Zr-pmcn Z vC � oamonCCyg nMDZ m � �= na) N< no>M m Oc-Or m oc� ;o Zmz o 226.20 w Zoz• 7'OSp E mv N_ y 3 CA D -� ink Fence •- o �P c �• 3.2' �v0Q �p IA H w n c+ ODFM Wr . 1 0.c Ln < a'C `� o'o v CDM CA 0 IA °•v, S � O, r 3 9 CA)�0 7 p p '� 'Q� W°od q� to ` v% � °a -2. �0+ Bay j M 13o v, O ro r+ o o"z • � OD C/)N = •� m �o' _�o V �.• QO ; X A '"'- r z s N •• -"NO �+t0 10 OD Cc)CD Ian N ,A CD p -�O P s Q Lq In N aoaft N O00 lC} S CD O �0 3�p O Q P Z 0* �1 5 ti � . 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