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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
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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
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AIL
LOT
FEE DATE
INSPECTION RECORD
DATE INSP
2
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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
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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
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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)
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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
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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
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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
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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�
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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
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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
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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
,
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• 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.
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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
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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
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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
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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¢
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cc: Steven E. Fews,Assistant Building Inspector
Tara A. Orlando,Planning&Zoning Secretary
Laura Petersen,Office Assistant
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( ) ( ) 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
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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
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(914)939-0668 Fax(914)
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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
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® 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
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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
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