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HomeMy WebLinkAboutBP21-226PERMIT # o�i�— v1c� ._ pq�;�� IXp��% �.a1 SECTION f 3�• S 7 BLOCK % LpT ''"" �� -�/ , TYPE OF WORK � / i�70� r o!' v�p1�-�iOs%'�'(%I�71�V1�G�c%J� ��• S�/1d/�� JOB LOCATION c� �r7�i � � Q.ne ��l,J,�Fa� /�z�-�r� OWNER !•�� _�. �b �a—OJ % u CONTRACTOR �� ��'IPS p C�%s Cow � iC ,�/� `�D� ri�,,y��"/!�)3�r /53.`� �. COST 3 ©'� �C� /FETE �(p�0�'��b ��� DATE TCO #t FEE INSrECT10N RECORD I DATE i��NS6 FOOTI N G FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING RGH PLUMBING GAS L� SPRINKLER i� ELECTRIC LOW -VOLT O ALARM AS BUILT FINAL �? 2 � - o� -z.r r r�11.IM � �3� '.� �Cft,vti � � 1 ���Z ►.� �.� �, � �y `. ��/' � = '�� �� �� � �► �s III " ��-' � � , � w ' �� � C'u` '' � - 2 OTHEf2 APPROVALS ARB � lt�llS , o, 0a _ BOT PB ZBA OTHER AS-BUILTIFINAL SURVEY REQUIRED PRIOR TO FINAL INSPECTION lv�d /0/3 THIS BUILDING A1US7 BE POSTED WITH A PERMANENT CONSTRUCTION TYPE IDENTIFICATION SIGN; v F PRIORTO THE ISSUANCE OF A C/0, AS REQUIRED BY NY STATE LAW. VILLAGE OF RYE BROOK WESTCHESTER COUNTY, NEW YORK No: 22-172 Certificate of ®ccup ucp This is to certify that �� r1 L L( of, Y ./1' � , 1 V 7 having duly filed an application on 3e �aQ 20��requesting a Certificate of Occupancy for the premises known as, r LJO ni!z , Rye Brook,NY, located in a R-in Zoning District and shown on the most current Tax Map as Section: 135-rD Block: Lot: and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit Noz�)-ateie 4o, issued 20 Q1 , 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: -3 dY�e Construction: for the following purposes: 0C r acAd I-�h(, 10 , y4c i-1 U r no L1)(-io n nfui W) ow-s- KOO s s ne cu via ✓ �a fry 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 hei e!!t building be moved from one location to another until a permit to accomplish such change has b ing spector. jai Building Inspector,Village of Rye Brook: 2' Date: NOV — 7 2022 y BR O�tL�a+Jy LL`w.4+Yo. ��g 1 4& annitwn[f aW VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914)939-0668 Christopher j. Bradbury www.ryebrook.org TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Michael j. Izzo Stephanie J.Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE November 7,2022 Bien LLC 2 Jennifer Lane Rye Brook,New York 10573 Re: 2 Jennifer Lane, Rye Brook,New York 10573 Parcel ID#: 135.57-1-13 Mechanical Permit#22-006 issued on 1/12/2022 for a Wet Fire Suppression Sprinkler System This certifies that the wet fire suppression sprinkler system,installed under the above captioned permit,has been satisfactorily completed. Sincerely, Michael j. Izzo Building&Dire Inspector /to �t 40A annftwmaW VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A.Klein (914) 939-0668 Christopher J. Bradbury www.ryebrook.org TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Michael J. Izzo Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE November 7,2022 Bien LLC 2 Jennifer Lane Rye Brook, New York 10573 Re: 2 Jennifer Lane, Rye Brook, New York 10573 Parcel ID#: 135.57-1-13 This document certifies that the work done under Mechanical Permit#21-203 issued on 12/27/2021 for the installation of a new boiler and hot water heater has been satisfactorily completed. Sincerely, Michael J. Izzo Budding&Fire Inspector /to ��� � �' R'� For office use oJIDnl � V r�- BUILD! TMENT PERMIT# SEP 2 6 2022 VILy� OF RYE 8,460K ISSUED: r �"�3 KING STRE } YE BROOK, W YORK 10573 DATE: 06 FEES '� PAID VILLAGE OF RYE BROOK BUILD! '-PARTPlENT 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 *sssssss**ssss**sssss*s***ss************ss**s*s*s*s*ssss*sssss*sssss*s*ss*****s*ssss****s*********s*s*s*sssss*s*sssss***ss*** Address: Occupancy//Use: 7w#-I ltM Parcel ID#: s��' 13 5. 5 7 B 11c i La.} 13 Zone: /" Owner: /f ki 1-L-� Address: Ae�Uw�j' 0�, L 10 �levt +h- fl� 1�5 P.E./R.A. or Contractor: + SaYvWS 4>v%A%iGtA* Address: W4 Person in responsible charge Ri66 t) Nkv-f�k AddressC6-8[0Z t IE LOV*-66ALec rt{ 115,12 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 NEWYORK, COUNTY OF WESTCHESTER as: being duly swom,deposes and says that he/she resides at L 14he (Print Name of Applicant) Q (No.and Street) in C---,kw 6ou'e- ,in the County of r v-'�.Ssa _ in the State of V1•� ,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:$ 34PG!CW pp for the construction or alteration of: 2 Stv�v�,t �'et� l �•N�ci ��, -F it V\- 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-IO.A.of the Code of the Village of Rye Brook. / X Sworn to before me this d-q +4\ Sworn to before me this day of &44 20 Z 2_ day �r , 2 Nv� Pip t: Signature of '6i iatureofAppliLnt 4 (. Ac ULI121 Print N e of\Propeq Owner Print Name of Applicant r Notary Aublic Notary Public WCY GIOINO Notary Public,State of New York No.01GI6167210 LIM KIM A. S 12 2021 Qualified in Nassau County "3 No. of L Notary Public, State o Now York Commission Expires May 29, 20-C Qualified in Westchester County'1 Commissinn EYnirws Anr_ 9a_ 9n 'D �yE BR(��. O�` tim cu � BUILDING DEPARTMENT BUILDING INSPECTOR ❑ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAX (914) 939-5801 www ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS: —E-b=2t'j :4w L'A'c� DATE: Z PERMIT#��� ` l _Z ISSUED: 2-� AECT:�BLOCK: LOT: LOCATION: '��1 1-�i-``��"'���-� 1 � -�`-�V F� OCCUPANCY: / J ❑ VIOLATION NOTED THE WORK IS... ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION r„ ❑ NATURAL GAS r(� ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING CROSS CONNECTION FINAL OTHER QyE[3R(��• cu � 198,2. BUILDING DEPARTMENT UILDING INSPECTOR ❑ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : 7/ c ) f N l �-(L— Wes-Irz _ DATE: I c Z PERMITO k Z - ZZ ISSUED:)2�SECT: BLOCK: LOT: 13< LOCATION: �l �`-��j �- �� 1 L � L �" OCCUPANCY: �-- ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS �� `�tJQ_�, N-1wcN sri� t/ll rr(-� N 1 ❑ FUEL TANK ❑ FIRE SPRINKLER I (o 03 ❑ FINAL PLUMBING [] ,,CROSS CONNECTION FINAL OTHER t Ar 2Z- L,4GF, oCL BRC�v� Village of Rye Brook Public Works and Engineering Department 938 KING STREET•RYE BROOK,NY 10573 (914)939-0753 Fax(914)939-0242 INSPECTION REPORT Address: /y/ Date: Name: %' � �/� � /y . Location: Permit#: Phone: Email: Work being Inspected: Work Inspected is: ted Rejected Re-Inspection Required Violation Noted Code Section Code Section: Action Taken Code Section: Action Taken 118 Erosion Sediment Pass Fail Violation 210 Storm Water Pass Fail Violation 135 Refuse Pass Fail Violation 215 Street Sidewalk Pass Fail Violation 213 Steep Slopes Pass Fail Violation 235 Trees Pass Fail Violation 216 Illicit Discharge Pass Fail Violation 245 Wetlands Pass Fail Violation Other: Pass Fail Violation Notes: 17 zz Diagram: Signature �� , . QyE 4RC�� 04 1982 BUILDING DEPARTMENT BUILDING INSPECTOR ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 k (914) 939-0668 FAx (914) 939-5801 www ryebrook.org , r , - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS:_ DATE' PERMIT# \� � \ ISSUED. L SECT: � - LOCK: ' LOT: LOCATION: /� C ` OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... '01"ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION �� REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION Pol'UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION Cl NATURAL GAS p L.P. GAS ❑ FUEL TANK :4 ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER QyE BRC�v�, O�` tim BUILDING DEPARTMENT D]PUILDING jASSISTANT 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 : 2�1 �i DATE: PERMIT# ISSUED 'Z SECT: BLOCK: LOT: LOCATION: �U`� f ." \ OCCUPANCY: G Vo :x- ❑ VIOLATION NOTED THE WORK IS... ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION / REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING .❑"`INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER QyE DR(b lam � 0 BUILDING DEPARTMENT ❑B,UILDING INSPECTOR ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK C 938 KING STREET • RYE BROOK,NY 10573 [I CODE ENFORCEMENT OFFICER (914) 939-0668 FAx (914) 939-5801 www ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS: DATE: PERMIT# ISSUED: SECT: BLOCK: LOT: LOCATION: OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION 0 UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑, ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P.GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER �E BRC��. '9a2 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 . 2 DATE:2L 0-lz/ PERMIT# ^ ISSUED: SECT: BLOCK: I LOT: J _ LOCATION: 0 1 OCCUPANCY: ?- ' ❑ VIOLATION NOTED THE WORK IS... d ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION { ❑ NATURAL GAS 1 \ i 1 ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION tt l ❑ FINAL � � ?: - -- ❑ OTHER * O * U � N 'O ri # _ w # 3 Q. # � � t :3 Zvi- a cn Q o O c� a 1D ZwWoQ }' Ilk a.)� a.) (U r d a .� 1� J # U # C 1] y O c P P �yE 4RO 1982 BUILDING DEPARTMENT UILDING INSPECTOR ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS: I r--'\ tr''�c(L � DATE: PERMIT# t'tt?T' — �-� ISSUED: Z ZZ SECT:l BLOCK: LOT: LOCATION: N r(:-�-' ``'i<<-� 1��Fl C� �`'f OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING j ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GASL ❑ L.P.GAS ❑ UEL TANK FIRE SPRINKLER FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER �yE BRC��. l7 c !1 1982 BUILDING DEPARTMENT ❑BUILDING INSPECTOR ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK f❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www ryebrook.org - - - - - - - - - - - - - -- - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS . rA ( ' V "�� ` \ DATE: PERMIT# `A2'" ISSUED: ± SECT: /BLOCK: LOT: LOCATION: N 02— -� �OCCUPANCY: �O ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION c111� f UNDERGROUND PLUMBING l u' NOTES ON INSPECTION: ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS p �� p L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER QyE f3R(�k• • 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 : {V) c �� C\SLATE: O�Z-A �ov l PERMIT# j \� ISSUED: (J {,ECT: LOCK: LOT: LOCATION: OCCUPANCY: ❑ VIOLATION NOTED HE WORK IS... ❑/ ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION -�! �C� REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE 2 FOUNDATION wCJ ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ' ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER QyE BRC�k. BUILDING DEPARTMENT ❑B ILDING INSPECTOR SSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www ryebrook.ors - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : N�� C DATE: PERMIT#6�, 2 '`-' ISSUED: - S SECT: BLOCK: LOT: LOCATION: 1 '--) [� �t..1, r� GV�- OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE (� FOUNDATION o UNDERGROUND PLUMBING NOTES ON INSPECTION: ` ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS �� ❑' L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER �QyE BR(��• O 'k— cu � l7 �c BUILDING DEPARTMENT ❑BUILDING INSPECTOR �J [-ASSISTANT BUILDING INSPECTOR •ILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAX (914) 939-5801 www aebrook.org - - - - - - - - - - - - - - - - -- - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : 1 \ ` �`'� DATE: ' (� PERMIT# 4) --�2 I� � ISSUED: � CT: �LOCK:�LOT: LOCATION: L OCCUPANCY:'''` ❑ VIOLATION NOTED THE WORK IS... EPTED ❑ REJECTED/ REINSPECTION ''❑ SITE INSPECTION / REQUIRED JY FOOTING \ C ` ❑ FOOTING DRAINAGE ❑ FOUNDATION C ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION 1 ❑ FINAL ❑ OTHER C \ 0� is , , N N N O W ` p N N U allo W n ' � x Ln M �" O Z z w z o 00 O 00 �- Z z WE �I W p C w N U►n z • �1 w o V w z a au �a O C7 O v W oc z o z uz CA W� 0.4 V) z n V A %Z V W w v zz W z z eq ►-a � o z F a � CA w z o ' �C Z w c7 � o v� „a W N F g 0'+ z W V o w o a "' � x z w z N w z w a ' .. W o , , p IE C EE WiF 3 0 SEP 2 6 2022 Do NG DEP BUILDIARTMENT VILLAGE OF%yEFfRt,,OK VILLAGE OF RYE BROOK 938KINO,k ETRBNY 10573 BUILDING DEPARTMENT MI ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY BP#: c:DI—Q 3Cp EP#: Approval Date: SEP 2 7 2022 Permit Fee: $ Approval Signature: Other: Application dated, b 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 remove electrical equipment,wiring, fixtures, or to perform other high or low voltage electrical work as per the detailed statement described below. By signing this document, the applicant & property owner agree that all electrical work performed will be in conformance with all applicable Federal,State,County and Local Codes. -� 1.Address: oR t h h t v "ft � SBL: /3�,,6• '�-� 3 Zone:�0 2.Property Owner: 12 v P 0 #''1 � Address: � TC h In ' 'n//t v I.at K I— Phone#: /+Cell#: 7116 `'� 2 Z" d t? 1 email: R tom(-kOt✓'a KO O 3.Master Electrician: q ✓t S 4e L Ca n 0 Address: S ✓o CLdQ W QL y_ /4 W►f o h. Lic.#:� Ph�oone# 7? 7'? 4 `Cell#: � � qqO-4?f email: �tyl kt`QKt6e ►"• so* D'• �� Company Name: s 1el kQ"o G //-e c- Address: S 8 If rO�t u.7 a ✓✓►^f n h ���d 4.Proposed Electrical Work/F' ture Count: W �r C.. r r:r, I c r S w. c.►.r t,'� � l o�ta[o®v� iy►$ ik4fr S'f..-obe �- F low 5.31d Party Electrical Inspection Agency: S '.) ►,.s STATE OF N,EW YORK,COUNTY OF WESTCHESTER ) as: I tt Qn`�"'\+r'6 being duly sworn,deposes and states that he/she is the applicant above named,and does further (print name of individual signing as the applicant) U �r state that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,attorney,etc.) The undersigned further states that all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances,and regulations. Sworn to before me this Sworn to bef re e t i ZC f+\ day of ,20 day of ,201Z Signature of Property Owner Signature of Applicant tq�QiA�41(I'm Print Name of Property Owner Print Na S of Applicant Notary Public Notary Public CHRISTOPHER J.BRAD URY Notary Public,State of New York No.01 BR6159985 Qualified in Westchester County 6/23/2022 Commission Expires January 29,20 STATEWIDE INSPECTION SERVICES, INC. 1:1 Main Street,Fishkill, NY 12524 1 email:office@swisny.com SWIS JOBAPPLICATION tel 845.202.7224914.219.10621 • g.corn Office Use Elect.Permit# Date!, ; Bldg Permit# Utility ID# i Final Certificate# City/Village f Zip Township County ; Address Cross Street Section Block Lot Owner Name/Address(If different than above) Contact Number ❑Basement ❑1st FI. ❑2nd FI. ❑3rd FI. ❑More Than 3 Fl. ❑Garage ❑Attic ❑Outside ❑Residential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms Carbon Monox Hood Trash Compact Amt Amps Li Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Warm Draw Incandescent Fluorescent SERVICE Amperage Voltage 1 P 3P #Meters #Disconnect ❑Underground ❑New ❑Reconnect ❑Overhead ❑Change ❑Visual Re-Inspection ❑ Safety Re-Inspection ❑ Re-Inspection Additional Information ,= � 0 V SEP 2 6 2022 VILLA 7 OF RYE BROOK BUILL_w aCJ [DEPARTMENT This applicat ion is valid for one(1)year from the date received by SWIS.This application is intended to cover the above listed items to be inspected,ff at any time of Inspection additional items have bean installed you we authorized to make the Inspection and adjust the fee for the additional items inspected.The applicant declares that there is no open applications for the above address with arty other Inspection company.The applicant,owner or authorized agent agrees to all the above terms and conditions as set forth for the application. Inspector Date Finalized Inspector# Company Name / Date vet Signature _—-- Address �; r City/State Zip Code V License# Phone# CAC) State Wide Inspection Services 1080 Main Street Fishkill, NY 12524 TO I MUM U& 845 202-7224 Phone 914-219-1062 Fax STATE WIDE INSPECTION SERVICES Email: office@swisny.com Website: www.swisny.com Service With Integrity BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: F Castellano Electric Inc Rich Moring 58 Broadway 2 Jennifer Lane Harrison, NY 10528 Rye Brook, NY 10573 Located at:2 Jennifer Lane, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP 22-234 135.57 13 Certificate Number: 2022-6128 Building Permit Number: BP 21-226 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:2 Jennifer Lane, Rye Brook, NY 10573 The Basement,Second Floor, and Exterior 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 19th day of October 2022. Name Quantity Rating Circuit Tvpe Smoke Detectors 04 C/O Smoke Detectors 02 Sprinkler System w/Bell 01 Horn Strobe w/ Flow Switch 01 Jr f Officer: Frank J. 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. e i [t i i N e� eV of ■ N � � a • Ln Ix O-W CA cl mow/ Ln �Uy o u 4. en ot Z � o z c x o Z rA a y z 00 w io A � N = W � � �0 � 0 Q � > Q V' to zk a � ❑; Q O U c� z z o z W � M � � M o o cN W: R < O U ■ 14 M Q c < W ■ I�■■1 �..1 L a r' U A < n = O W vHi d ►.. W � 77 x < ,� •• 08 a ' i F-� V U Gj •• U e _ ►-� O z < a _ O � w z a 0 Q o ;, ° a pq t = • D BUILDING DEPARTMENT OCT "5 2022 DD VILLAGE OF RYE BROOK VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK,NY 10573 BUILDING DEPARTMENT (914)939-0668 www.Eyebrook.org ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY BP#: — EP#: c�>Q' 33 /''7 Approval Date: OCT — 5 Permit Fee: $ Approval Signature: Other: Application dated, 2�— is hereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of a Permit to install and/or remove electrical equipment,wiring,fixtures,or to perform other high or low voltage electrical work as per the detailed statement described below. By signing this document, the applicant & property owner agree that all electrical work performed will be in conformance with all applicable Federal,State,County and Local Codes. 1.Address: 2— J'< " K 1 PVC., 44pu, e— SBL: t?S-. S 7^ I — 13 Zone: v �/ 2.Property Owner: if %(.G►C( D A&-I " 5 Address: I r h rl 1-Ie f G-Q V% e ./�/t �•�d ok�N,7. Phone#: SSf 6— 3 ZZ "O 17 ) C/e�ll#: St 6"3 ZZ-0177 email:�1nc.44 v-D I` 01"t",� p�'2- h,�Q� C..Ct f f C 114 h 0 Address: IT& cQ P• . fi 3.Master Electrician: �✓�N ✓a7 cZ w o� ✓✓t'S'o Lic.#: _Phone#:f�V—77 7-7 34 q Cell#:�/tt' `/40'618L email: Fyv,✓r i e *110 e— � GY 0 C O Company Name: � CC-S'4 11 Of t�o r�.t C is Address: S L'n✓O Ci of W aY , #W✓✓('f o P,, IU Y• 4.Proposed Electrical Work/Fixture Count: 12. D Cam"�► t' W t e-e— 4o T6 I Y`GN G d GL- -l oh O-C S 1 Sr e- R+tif t Y V KM Q . uOA,rad[e jktrcr .'C-C AL p- c D C of er fT 5.31 Party Electrical Inspection Agency: S. STAT OFF NEW,YaORK,COUNTY OF WESTCHESTER ) as: F-4 0� l 15 tc)(4"w ,being duly swom,deposes and states that he/she is the applicant above named,and does further (print name of individual signing as the applicant) state that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the c`0-1"e- �Oc/ 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 bs this S" ore day of ,20 day of ,20 Z Signature of Property Owner Signature of Applicant �aM A (ft;�e ��4•,o Print Name of Property Owner ame of Applicant Notary Public Notary Public SHARI MEULLO Notary Public,State of New York No.OIME6160063 6/23/2022 Qualified In Westchester County Commission Expires January 29,2oL3 STATEWIDE • 1:1 Main Street,Fishkill, NY 12524 1 emoil:office@swisny.com SWIS JOB APPLICATION84 1 914.219.1062 • • Office USc, Elect.Permit# C� `� �� 7Date/O lv,� Bldg Permit K Utility ID# Final Certificaatee# }✓ ej City/Village �' = Zip Township ,? k County ;- +- ✓ j )rp o Address -+ i) Cross Street i Section Block Lot Owner Name/Address(if different than above) Contact Number r t _ , ? ^, I I % ❑Basement 0 list Fl. E2nd Fl. ❑3rd Fl. ❑More Than 3 Fl. ❑Garage ❑Attic ❑Outside Residential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms Carbon Monox 'Hood Trash Compact �l .1 Amt Amps iJ r 5 � Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Warm Draw tnr2nt3e-RVT Fluorescent SERVICE Amperage Voltage 1 P 3P #Meters #Disconnect ❑underground Q New ❑Reconnect f r l n z Q Overhead IE]Change ❑Visual Re-Inspection ❑ Safety Re-Inspection ❑ Re-Inspection Additional Information D OCT -5 2022 .1D 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 auttariaed to make the inspection and adjust the fee for the additional items Inspected.The applicant declares that there is no open applications for the above address with any other inspection company,The applicant,owner or authorized agent agrees to all the above terns and conditions as set forth for the application. Inspector Date Finalized Inspector# Company Name �" o Date Signature r . Address > City/State Zip Code License# Phone# State Wide Inspection Services CAC) 1080 Main Street � Fishkill, NY 12524 's,�U S 845 202-7224 Phone v 914-219-1062 Fax STATE WIDE INSPECTION SERVICES Email: office(aswisny.com Service With Integrity Website: www.swisny.com BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: F Castellano Electric Inc Bien, LLC 58 Broadway 2 Jennifer Lane Harrison, NY 10528 Rye Brook, NY 10573 Located at: 2 Jennifer Lane, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP 22-237 135.57 � 13 Certificate Number: 2022-6128 Building Permit Number: BP 21-226 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: 2 Jennifer Lane, Rye Brook, NY 10573 The First Floor,Second Floor, Garage, and Exterior 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 11th day of October 2022. Name NameQuanti�RatingCircuit Type Recessed Luminaires 36 110V Surface Mounted Fixtures 24 Receptacles 40 GFCI Receptacles 14 Switches 32 Spotlights 04 HVAC Systems 02 Boiler 01 Smoke Detectors 06 Exhaust Fans 03 Washer 01 Dryer 01 Dishwasher 01 Gas Range 01 Microwave 01 Hood 01 Name Quantity Rating Circuit Type Refrigerator 01 EV Car Charger 01 Service 01 200Amp Meter 01 Panel 01 Grounding and bonding of service to current codes. State Wide Inspection Services did not perform a Rough inspection (Rough Performed by WREIS). A Visual inspection and Final inspection were conducted only. Officer: Frank J. 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 2 fr1 ' in 0 n n N •.• N z �D O� en Owl .' > �- �t c f 00 09 o: 96 a 0-4 O z V w 0 y -7 W) U Q oj tn 0-4 �- .� �e M,•� J M F w U 00 W ,� 2 r. ICI M Q w � < C7 a Q g 3 ao Or o off. Q�I ccl 06 .-A WWI m BUILDING DEPARTMENT F.C IE � V IE VILLAGE OF RYE BROOK DEC 2 2 2021 938 KING STREET RYE BROOK, NY 1057 (914)939-0668 FAX(914) 939-5801 VILLAGE OF RYE BROOK www.ryebrook.org BUILDING DEPARTMENT ELECTRICAL PEMIT APPLICATION Westchester County Maste lectriciins License Required FOR OFFICE USE ONLY BP#: �Ct� EP#: 331 Approval Date: Q1 Permit Fee: $ Approval Signature: Other: Disapproved: (fees are non-refundable) Application dated, /. is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install and/or remove electrical equipment, wiring, fixtures,or to perform other high or low voltage electrical work as per the detailed statement described below. The applicant & property owner, by signing this document agree that all electrical work performed will be in conformance with allapplicable Federal, State,County and Local Codes. 1.Address: e.`nI � t ' - La c, � SBL: / 3��f S 7—�— 3 Zone:)e I(D 2.Property Owner: \"C v q✓,cQ M A r t'�k Address: 2,\ r3-'�'i n .'kje G-4 vl t . �k V,e b�o¢�k ')" Phone#: S-( � -3Z2-0(? 7 Cell#: 9S1 (0732LC)07 email: ���c� a+(Q WloLl 0. "�4b„� u 3.Master Electrician: �Gvl C Oafs 1 �Q ti v P�ddress: n /�,✓', �' N! ff �� db Q 6�W��/ /7R \S O C'I , Lic.#: b Phone#: Cell#: T ��` 8 Z email: I'✓'Q✓1 k(�2 tin o e- 40 C e,-" Company Name: F CG( 4 ( (A'I o •e C— 'I c Address: 8 �o^o Q t�w Q yT�- v✓Joy -y 4.Proposed Electrical Work/Fixture Count: l Z O C o ✓-• 4— n r Q ` �evk�nn� a`�t�o ci o 1` e �tS l� 0L" �Qt/q&— �evk, 0 C a 4-e, O �- ✓ S'trQ� ********************************************************************************************************* STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: being duly sworn,deposes and states that he/she is the applicant above named,and does further (print name of individual signing as the applicant( state that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the CQtk.'t-r 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 bef e me his 22 day of 20 day of 20'2 Signature of Property Owner Signature of Applicant F,11-1 k- Cus -lam/41 v Print Name of Property Owner Print N7zaz: Notary Public Notary&*TOPHER J. R BURY Notary Public,State of New York No.01 BR6159985 Qualified in Westchester County Commission Expires January 29,20 /21/19 Westchester Rockland Electrical Inspection Services, Inc. 1�, Phone: 914-347-3595 `_ DO NOT WRITE HERE-FOR OFFICE USE ONLY 43 North Lawn Avenue �� Fax: 4-347 3596 • Elmsford, NY 10523 ��._� Bl"INIQ MR NO J TEMP n DATE CITY OR VILLAGE j ✓ C ZIP CODE TOWNSHIP v COUNTY STREET AND NO.OR ROAD POLE NUMBER` BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? SECTION BLOCK LOT OCCUPANTS NAME - BUILDING OCCUPANCY ' OWNER'S NAME AND ADDRESS HOME TELEPHONE NUMBER CURRENT SUPPLIED BY FROM THEIR OFFICE WORK TELEPHONE NUMBER- 0 "l�• T ` 1 LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED NUMBER OF OUTLETS NO.OF FIXTURES& MOTORS HEATERS OFFICE USE LOCATION LAMP RECEPTACLES ONLY SIDEWALL SWITCH INCADE FLUORE NO. H.P EACH NO. WATTS EACH INSPECTION OUTSIDE BASEMENT ,s FIL DE 2 2 2021 LJJ 2-FL 3-Fl UILDIN DEPARTMENT REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: V:� � � ✓ c 1, r c. r -N `7J.JS Q THIS APPLICATION IS INTENDED TO COVER THE ABOVE LISTED ITEMS TO BE INSPECTED.IF AT ANY TIME OF INSPECTION ADDITIONAL ITEMS HAVE BEEN INSTALLED,YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE FOR THE ADDITIONAL ITEMS INSPECTED AS PROVIDED BY THE APPLICANT,THE APPLICANT DECLARES THAT THERE IS NO OPEN APPLICATIONS FOR THE ABOVE WITH ANY OTHER INSPECTION COMPANY WREIS,INC. IS NOT LISTING,LABELING,UNDERWRITING OR CERTIFYING ANY EQUIPMENT, MATERIALS OR DEVICES WHICH ARE PERFORMED BY OTHER CERTIFIED TESTING AGENCIES OR INSPECTION COMPANIES.THE APPLICANT.OWNER,OR AUTHORIZED AGENT AGREES TO ALL THE ABOVE TERMS AND CONDITIONS AS SET FORTH FOR THE APPLICATION. SIZE OF SEFMCE FEEDERS �7 li CHARACTER OF WORK NEW❑ ADDITIONAL[] EXPOSED❑. CONCEALED O MUST ENTER APPLICANTS IDENTIFICATION NUMBER SERVICE ENTERS BUILDING OVERHEAD E3 A, UNDERGROUND❑ LIA- I I I L AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACE MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. NAME OF COMPANY / DATE OF APPLICATION SIGNATURE OF APPLICANT X STREET ADDRESS TELEPHONE 0 / .-7 9 C'o CRY OR POST OFFICE ;v f 23P 90M\ LICENSE NO.WHEN APPLICABLE .� . O h N N OG p C11 . of zz96 w 9 H a rA 4 W C > CPS z V c . a e f O z �= o N Q We ow OtA z ►� ^ d' d � w 0044 N � Or F a h C7 � � G7 � C �• N $ oG $ 16 ID 0 < Q�( oq CL ►� OC1 � = v, BUILDING DEPARTMENT D LE C H E VILLAGE OF RYE BROOK DEC 2 2 2021 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 VILLAGE OF RYE BROOK BUILDING DEPARTMENT PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP#: —a��p PP#: Approval Date: Permit Fee: $ Approval Signature: Other: Disapproved: (fees are non-refundable) **************************************** * * *************************************************** Application dated,.(2— 2 -21 is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install and/or remove Plumbing as per detailed statement described below. The applicant&property owner,by signing this document agree that said plumbing work will be in conformance with all applicable Federal,State,County and Local Codes.1.Address: L j e-h 11 t 6e, - .A-w%*- SBL: 13S • S' 7—/—/3 Zone: /Cp —1_0 2.Proposed Work: Ln T 44, /`/&U t 04 AeRfo.z &'I'd f�e, I/ur 71, 3.Property Owner:_ 1 c.hA-2IS 1YIOIZ��I, Address: /�tr GvJ'� �Ge�, �.o� /tryId r -(" Phone#: P1 Cell#: S'/G 3 1- Q/ 7 ]email: x M0 iri Zi c� 4.Master Plumber: ,4-L / 4 414Z) Address: A;-e,, e Z Ave vo�,o ti/y`y Lic.#:qY C) Phone#:9nf-"v6/ ?& Cell#/�¢/y-J06�/1Z3J/ email:/tJ d�4�Vv/°L v/��� • �Q Company Name: A43*W /ar`uir/Flt2rA„d //GWfh 6fiC�o'='o _ Ady— INDICATE FIXTURES&LINES TO BE INSTALLED AS PER'rHE FOLLOWING SCHEDULE/g!:��J42!> 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 Z v 3rd Floor J 4d'Floor 51 Floor Exterior 5.*List Other Equipment/Provide Details: 1F014e..Z (Notarized Signatures Required Next 2 Pages) -1- 8/12/2021 Y STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: "Wba 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 Cfu ��( -", �EA Q T— 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 before me this CAZ4 Sworn t before me this -- day of 20 day of 20 - A4-1� &44—wv Signature of Property Owner Signature o Applicant Ale 4f490IP0V Print Name of Property Owner Print Name of Applicant 4 X 5:�"' 04e"- 6 No liMARUAKE CO.l^ o is Notary Public,State(I �, Ccnmission Expires 1. ; ;? 2' 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. MARGARETV C01'- Notary Public,State ci No.01':Oe34' - Qualitiedin''Jec' n -'•�rCoun Ccnr�fission Expires h;ay 31,20 -2- 8/12/2021 BUILDING DEPARTMENT v VILLAGE OF RYE BROOK DEC 2 2 2021 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 VILLAGE OF RYE BROOK ,•,,,i BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE 4216 • 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: u ' Ao Boy �� I`'►�� 1� ) , residing at, /3 Y GuYsl e<%-& 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; tone, �r 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. Sworn to before me this ��� MARGARETVC'' day of 20 �� Notary Public,State c; No.01�GVo Qualified inlb's�t,I�:.:�,r CCun' Ccnmission Expires t:;:,,y 3t,2' -3- R/12/2021 v W � vi p� t0 a M `7 MT1 a � O z � �, �o = 6Eo ,oc - c g ,o H ao ' " E- ,� �c ' W 060.4 ON � t v p a 7 �J a 1-1a <Ln pp COvo 0 00O E� oo C� ru `~ C7 Z v o w o � � �' a Ln en x . Z a w OctugO rl Lz a � 0 3 N $z � e � � a � W V z � ` " W V V E V d 0 vpi 0-4 Irn z O V g W a N Oy � a'� o w ! :" �� .a Ir oQQ � g R � c � � BUILOR q MENT DD cIVAL REQU�RD ICE. VILOF RY OOK DEC 2 9 2021 ID O-W A EVE CN 938 KINGT RYE BR T ,NY 10573 VILLAGE � OROK BUILDING APPLICATION TO INSTALL FIRE SUPPRESSION / FIRE SPRINKLER SYSTEM FOR OFFICE USE ONLY: JAN - 4 MP#: Approval Date: 20 �� c � - �Q Application Fee:$ Approval Signature: Permit Fees:$ ao _ Disapproved: Other: Application dated: 12 1 271 ZoZ) is hereby made to the Building Inspector of the Village of Rye Brook NY for the issuance of a Permit to install or modify a Fire Suppression/Fire Sprinkler System as per detailed statement described below. 1. Job Address: Lp,NE 2. Parcel I.D.: 46 C�" �S� �Lt�1L— ! -rAY LOT I?j Zone: /0 3. Proposed Work(Describe system in detail including suppression agent): IVErJ uJA!790- �W rl-a SDjej PjK-1,l�i IF 4. Number&Types of Fire Sprinkler Heads: Zy P-FrL-[AWL-15; RFC—'*A� Iss a 5. N.Y State Construction Classificatt n: N.Y.State Use Classification: 6. Estimated Value of Job: $ SCX�O.d o (Value shall include all labor,materials,fixed equipment,professional fees,and materials and labor which may be donated gratis.) 7. Property Owner: &^AR0CT11't' Address: Qi O- J3OY j?Aj 72 1F_�J tiCt't0 Aj Phone# Cell# email: tae4wwfl i-"'O Lt Applicant: L,w GvC t Address: 66 7"uc 5 T. KtO4fa r G^/ti.OLD Cr. o 99 T Phone#k Cell# S45---5-90-9 p7% email: 9m AobgVbT eipz -OP �"S L Architect/Engineer: W t Address: 10 M tt ID t," �. (/a e-%-CW8ri7E Q. Phone#6jl%6—?W-63 7 2 Cell# email: �M t N yV1 IES6/' PC r Cam+ Sprinkler Contractor: W*90 Vtf P1W 940TOOP / Address: 64 j ST: &J7 AOO" er 0"71 Phone# Cell# 8 _90 q07 V email: AFF60"ttlf FW VebTtMcr^tQ !'�44L .Gux1 1 8/12/2021 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. Any application not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. Please note that application fees are non-refundable. STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: ,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 for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,attorney,etc.) That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Swom to before me this Swom to before me this day of ,20 da;2^ 20 Signature of Property Owner --Signature of Applicant Lp Print Name of Property Owner Print Name of Applicant Notary Public Notary Public CHIP KEATING NOTARY PUBLIC-CONNECTICUT MY COMM. EXPIRES 12/31/2026 2 8/12/2021 0 N ;� O C � e ^ oar o 6 y w m ° � a _ ° 6 W OWN x w tn Eno m it fill CPS a W o F-• � � � < � � �' � � G WNow o Zo rco W K Oi Ono04 op OC u e U oo N � fv w_ mt o� 5 !y O u -• .� EE CA p` } •=' � ` rA � � N Ca F, w z C 66 Op € a a �. BUILDING DEPARTMENT R E C E D v E VILLAGE OF RYE BROOK DEC 2 3 2021 938 KING STREET RYE ftom,NY 10573 (914)939-0668 VILLAGE OF RYE BROOK wwwxyebrook.org BUILDING DEPARTMENT APPLICATION FOR PERMIT TO INSTALL AND/OR REMOVE HEATING, VENTILATION AND/OR AIR CONDITIONING EO UIPMENNT FOR OFFICE USE ONLY: PERMIT#: /Ad) -,3)O3 Approval Date: Permit Fee: $ V Approval Signature: Other: Disapproved: t�l (fees are non-refundable) ZPZLEAER;NU�TTCERTJ1FICATE RE UIREMENTS FOR 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. Application dated, /J L44 -)l is hereby made to the Building Inspector of the Village of Rye Brook for a permit for the installation and or removal of the HVAC 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. J �7 ), Q 1. Address: n n.'�e (�A�l r SBL: ,5,,S / " —�3 Zone: " L 2. Property Owner: 1 PN Z �-�. Address:"2Je-,1 h P 2 Phone 3A�^'S 1--?7 Cell#: email: 3. Contractor: ' t "'`e S Address: Phone#: -5 �' ^C7 '7 Cell#: email: 4. Applicant: zk Address: 13 Phone M G�7 _ 022 Cell#: //el—/6�`l�3 email: 10SJ-6 5. Scope of Work:New Installation( •Replace ent( )•Removal( )•Other( ): 6. List Equipment: wf e/W U 1 e e- 4A.0 e•'1 r� 7. Location of Equipment: yacA �I= 8. Method of Installation/Removal(list all equipment needed to perform job): 1 8/12/2021 STA*.?%W YOtt,K,CQU)7 OF WESTCHESTER ) as: ��C �r�ti ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) aner states that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the Al CI- /t7)O 12 16 for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,attorney,etc.) That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code �of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn before me this Sworn to before me this,— day of 20 r9 day, 20_ c / Signature o operty Owner Si ature of Applicant Print N e of Property Owner Prijit Neme of Applicant o P b 'c N Public MARGARETV C01�"^'! Notary Public,Statc cf.. V' Qualified inCcn, This a 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.Any application not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. MMUREMON771 Notary Public,Stats cf Qualified in '? _:r. , Ccnc,ission Expires x si12no21 BRADFoRD WH/TE� W A T E R H E A T E R S rw. Residential Power Vent Gas Water Heater The TTW°°Models Feature: ■ ENERGY STAR®Qualified—Some models meet or exceed requirements for ENERGY STAR1 per the latest ENERGY STARO criteria revision, as well as most utility rebate programs. ■ Bradford White ICON System--Intelligent gas control with spark to pilot ignition system eliminates the constant burning pilot.This results in savings of pilot gas during standby periods (120 VAC). — Enhanced Performance—Proprietary algorithms provide enhanced First Hour Rating and tighter temperature differential. —Advanced Temperature Control System—Microprocessor constantly monitors and controls bumer operation to maintain consistent and accurate water temperature levels. — Intelligent Diagnostics—An exclusive green LED light prompts the installer during start-up and provides ten different diagnostic codes to assist in troubleshooting. — Pilot On Indication—Flashing green LED provides positive indication that pilot is on. �O — Separate Immersed Thermowell--High-strength advanced polymer composite thermowell provides isolation between electric temperature sensor and surrounding water.No need to IL a NIL drain the tank when removing gas valve. ■ Power Vent Water Heater—Designed for installations where atmospheric units cannot be used. Exhaust gases are vented under positive pressure directly out of the building through the roof or the wall. ■ Powerful Blower Motor—Our significantly quiet design has greater resistance to outside winds and the power to vent in many difficult venting situations. —Ten Foot(3 meter) Power Cord—Included(120 VAC). ■ Horizontal and Vertical Venting—PVC, ABS or CPVC(Maximum equivalent vent length on reverse side). ■ Advanced ScreenLok®Technology Flame Arrestor Design—Flame arrestor is designed to prevent ignition of flammable vapor outside of the water heater(excluding RG1 PV55H6N &RG2PV75H6N). ■ Flammable Vapor Sensor—Electronic sensor prevents burner operation if flammable vapors are detected.The sensor will also prevent operation if there is ongoing flammable vapors burning inside the combustion chamber(excluding RG1 PV55H6N &RG2PV75H6N). ■ Maintenance-Free—No regular cleaning of air inlet openings or flame arrestor is required under normal conditions(excluding RG1 PV55H6N & RG2PV75H6N). ' n ■ Sight Window—Offers a view into the combustion chamber to observe the operation of the J l pilot and burner. 00 r ■ Factory-Installed Hydrojer Total Performance System—Sediment reducing device that also increases first hour rating of hot water while minimizing temperature build-up in tank. `...:. %; ■ Vitraglas®Lining—An exclusively engineered enamel formula that provides superior tank „r protection from the highly corrosive effects of hot water.This formula(Vitraglas°) is fused to the steel surface by firing at a temperature of over 1600°F(871°C). ■ Insulation System—Non-CFC foam covers the sides and top of the tank, reducing heat Photo IS of loss.This results in less energy consumption, improved efficiencies, and jacket rigidity. RG2PV50H6N ■ Water Connections-314" (19mm) NPT factory-installed true dielectric fittings extend water heater life and simplify water line connections. FEATURING: ■ 3/4"(19mm)NPT Side Connections-4RG2PV50H6N, RG1 PV55H6N, and RG2PV75H6N only). ICjO� ■ Factory-Installed Heat Traps—Design incorporates a flexible disk that reduces heat loss in System- piping and eliminates the potential for noise generation. 3 tsdli ,j'� ■ Protective Magnesium Rod—(RG1 PV55H6N has 2). lkw�ir ■ T&P Relief Valve—Installed. ■ Thermostatic Mixing Valve(ASSE Approved)—Included (RG1 PV55H6N only). ■ Low Restrictive Brass Drain Valve—Durable tamper proof design. ■ NOx Emissions—Less than 40 ng/J. ® 6 or 10-Year Limited Tank Warranties/6 or f0-Year Limited Warranty on Component Parts. For more information on warranty, please visit www.bradfordwhite.com Pe ® For products installed in USA,Canada,and Puerto Rico.Some states do not allow limitations on warranties.See complete copy of the warranty included with the heater. MANUFACTURED UNDER ONE OR MORE OF THE FOLLOWING U.B.PATENTS:5,682,666;7,634,976;5,660,165;5.954,492;6,056.542;6,935,280;5,372,185;5,485,879;5,574,822:7,971,560;7,992,526;6,684,821;7,334,419; 7,866,168;7,270,087;7,007,748;5,596,952;6,142,216;7,699,026;5,341,770;7,337,517;7,665,211;7,665,210;7,063,132;7,063,133;7,559,293.7,900,589;5,943,984;8,082,888;5,988,117;7,621,238;7,650,859;5,761,379; 7,409,925;5,277,171.8,146,772;7,458,341;2,262,174.OTHER U.S.AND FOREIGN PATENT APPLICATIONS PENDING,CURRENT CANADIAN PATENTS:2,314,945;2,504,824:2,108,186;2,143,031;2,409,271.2,548,958. 2,112,515,2,476,695:2.239,007.2.092,105.2.107,012.Defender Safety System,,ScreenLok',TTW,Vitraglas'and Hydrolet°are registered trademarks of Bradlard White*Corporation. 1�A1-R-f1d1 A Residential Power Vent Gas Water Heater Power Vent Models Meet or exceed ASHRAE 90.1 It(current standard)C.E.C.Listed NATURAL GAS AND LIQUID PROPANE GAS 80%Recovery Efficiency Model Nominal DOE Recovery at Model Nominal DOE Recovery at Gal. 907 Rise' Liter Number Rated First Number Rated First 50'C Rise' Capacity Storage LP Hour Uniform LP LP Capacity Storage LP Hour Uniform LP U.S. Imp. Volume BTU/Hr. BTU/Hr. Rating Energy U.S. Imp. U.S. Imp. Volume kW kW Rating Energy Liters/ Liters/ Gal. Gal. (Gal.) Input Input (Gal.) Factor GPH GPH GPH GPH (Liters) Input Input (Liters) Factor Hour Hour RG1PV40S6N 40 33 38 40,000 38,G00 62 0.61 43 36 41 34 RG1PV4OS6N 151 1 144 11.7 11.1 235 0.61 163 155 RG1PV50S6N 50 42 48 40000 38000 77 0.63 43 36 41 34 RG1PV50S6N 189 182 11.7 11.1 292 0.63 163 155 *RG2PV4OS6N 40 33 38 40,000 38,000 70 0.67 43 36 41 34 *RG2PV4OS6N 151 144 11.7 11.1 265 0.67 163 155 *RG2PV50S6N 50 42 48 40,000 38,000 75 0.70 43 36 41 34 *RG2PV5OS6N 189 182 11.7 11.1 284 0.70 163 155 *RG2PV4OT6N 40 33 38 40,000 40,000 75 0.68 43 36 43 36 *RG2PV4OT6N 151 144 11.7 11.7 284 0.68 163 163 *RG2PV5OT6N 50 42 48 40,000 40,000 71 0.67 43 36 43 36 *RG2PV5OT6N 189 182 11.7 11.7 269 0.67 163 163 *RG2PV5OH6N 48 42 46 65,000 58,000 116 0.68 70 58 62 52 *RG2PV5OH6N 182 174 19.1 17.0 440 0.68 265 235 RG1PV55H6N 55 46 55 78,000 78.000 125 0.68 84 70 84 70 RG1PV55H6N 208 208 22.9 22.9 474 0.68 318 317 RG2PV75H6N 75 62 72 76,000 75,500 121 0.69 82 68 81 67 RG2PV75H6N 284 235 22.3 22.1 459 0.69 310 307 Model A B C D E F G H J K L M R S Approx. Number Floor to Jacket Vent F Ice rto Floor to Floor to Floor to Depth C/L Floor to Floor to Water Spate Gas Shipping Vent Dia. Size TdP Gas Top of Water of Water Space Heating Space Heating Conn. Heating Cann. Weight Conn. Conn, Conn. Heater Conn. Conn. Inlet Outlet NPT Conn.Size Size in. in. in, in. in. in. in, in. in. in. in. in. in. in. lbs. RG1PV40S6N 571/2 20 2or3 40 11112 461/2 49 25157,6 8 N/A N/A 3/4 WA 'h 140 RG1PV50S6N 587/16 22 2or3 405/e 11'12 483/•e 501h 273he 8 N/A N/A 3r4 N/A •h 166 *RG2PV4OS6N 571/2 22 2 or 3 40 Ve 111/2 471he 49 271/s 8 N/A N/A 1/4 WA 1/2 142 *RG2PV50S6N 581h 24 2 or 405h 111/2 483/.6 501/2 287A 8 N/A N/A 3/4 N/A V2 168 *RG2PV4OT6N 674,a 20 2or3 4911/,e 111h 563/4 58 261f,a 8 NIA N/A 1/4 WA 1/2 146 *RG2PV5OT6N 677/e 22 2 or 3 501/16 111/2 571/•6 58 273/,e 8 N/A N/A 3l4 WA 'h 173 *RG2PV5OH6N 661h 22 3 or 4 491/s 111/2 561/4 57114 2615h6 11 133/1 497h 3/4 3/4 1/2 187 RG1PV55H6N 649h6 22 3or4 4715/16 11V2 543/4 56 273h6 71/4 131A 4715/16 3/4 3/4 1/2 219 RG2PV75H6N 691/2 26 3or4 5111he 1315/i6 59111•..6 603/4 3011/,6 11 1 1611/1e 5115116 3/4 3/4 V2 260 Model A 8 C D E F G H J K L AlR S Approx. Number Floor to Jacket Vent Floor to Floor to Floor to Floor to Depth C/L Floor to Floor to Water Space Gas Shipping Vent Dia, Size T&P Gas Top of Water of Water Space Heating Space Healing Conn. Heating Conn. Weight Conn. Conn. Conn. Healer Conn, Conn. Inlet Outlet NPT Conn.Size Size MIT. mmd mme mm. mm. mm. mm. mm. mm. mm. mm. mm. mm. mm. kg. RG1PV40S6N 1461 508 51or76 1016 292 1181 1245 659 203 N/A N/A 19 N/A 13 64 RG1PV50S6N 1494 559 51or76 1032 292 1224 1283 691 203 WA N/A 19 WA 13 75 *RG2PV40S6N 1461 559 51or76 1019 292 1199 1245 689 1 203 1 N/A N/A 19 WA 13 1 64 *RG2PV50S6N 1486 610 1 51or76 1032 292 1244 1 1283 733 203 1 WA WA 19 WA 13L78 *RG2PV4OT6N 1703 508 51or76 1262 292 1441 1473 662 203 WA WA 19 WA 13 *RG2PV5OT6N 1724 559 51or76 1284 292 1462 1473 691 203 N/A WA 19 WA 13RG2PV5OH6N 1689 559 76or102 1267 292 1441 1467 684 279 340 1667 19 19 13RG1PV55H6N 1640 559 76or102 1218 292 1391 1422 691 191 340 1218 19 19 13RG2PV75H6N 1689 660 76or102 1319 354 1516 1543 779 279 424 1319 19 19 13 Propane models feature a Titanium Stainless Steel propane burner. For Propane (LP) models change suffix "N"to "X". For 10 year models, change suffix from "6" f`c to 10" (Not available on RG1 PV55H6N).'Based on manufacturer's rated recovery efficiency. 120 VAC Required for Power Venting / 120 VAC, 601­1z., 3.1 Amperes. Uniform Energy Factor and First Hour Rating is based on the latest AHRI directory listings. . , M B *=ENERGY STAR'Qualified. im H - - RG2PV4OS6N RG1PV50S6N RG2PV5OH6N J R­ RG2PV5OS6N RG2PV4OT6N 2" 3" RG1PV55H6N 3" 4" M RG1PV40S6N RG2PV5OT6N Vent Pipe Vent Pipe RG2PV75H6N Vent Pipe Vent Pipe Max.Equivalent Length t50 ft. t120 ft. Max.Equivalent Length t50 ft. 1180 ft. Min.Equivalent Length 7 ft. 15 ft. Min.Equivalent Length 7 ft. 15 ft. A Number 1 45 ft. 115 ft. Number 1 45 ft. 175 ft. of 2 40 ft. 110 ft. of 2 40 ft. 170 ft. F 90'Elbows 3 35 ft. 105 ft. 90'Elbows 3 35 ft. 165 ft. D&L Subtract 51ft.(1.5m)for each additional 90'elbow t For high altitude installations,consult the installation instructions. S 1 R- . General:Meets NAECA or EPACT Requirements,as applicable.All gas water heaters are certified at 300 PSI T T (2068 kPa)test pressure and 150 PSI(1034 kPa)working pressure.All water connections are 3/4' (19mm)NPT, E K all gas connections are 1/2" (13mm).All models design-certified by CSA International(formerly AGA/CGA),ANSI Z21.10.1 and/or Z21.10.3 and peak performance rated. Dimensions and specifications subject to change without notice in accordance with our policy of continuous product improvement. Suitable for Water(Potable)Heating and Space Heating.Toxic chemicals,such as those used for boiler treatment,shall NEVER be introduced into this system.This unit may NEVER be connected to any existing heating system or component(s)previously used with a non-potable water heating appliance. -BRA DFORD WHITE IS- For field service,contact your professional installer or local Bradford White sales representative. �+ Sales 800-523-2931■Fax 215-641-1612 AM° RICAN BRADFORD iKWITE* Technical Support 800-334-3393■Email techserv@bractfordwhhe.com STRONG- A bie,EPA F.4 Warranty 800-531-2111■Email warranty@bradfordwhite.com Intemational:Telephone 1-215-641-9400■Email intemabonal@bradfordwhite.com/www.bradfordwhde.com Built to be the Best" 1261-B-0418 02018,Bradford White Corporation.All rights reserved. Printed in U.S.A. is Dimensions Ratings & specifications Q Overhead view Navlen Condensing Boiler Space Heating Ratings rs+tm.,N I Model Number' Hang input,BTWH Hang Ca~, Net AHRI Rating,Wnws, AMES, Min Max BTUM BTWH % s 5 NHB-55 8,000 55,000 51,000 44.000 95.0 V A ns..m NHB-80 81000 80.000 74,000 64,000 95.0 NHB-110 10,000 110,000 102,000 89,000 95.0 NHB-150 10,000 150,000 138.000 120,000 g5,p t Ratings are the same for Natural Gas models converted to Propane use. Y Based on U.S.Department of Energy(DOE)test procedures. Front Yew 3 The NET AHRI Water Ratings shown are based on a piping and pickup allowance of 1.15. Consult Navien before selecting a boiler for installations having unusual piping and pickup requirements, such as intermittent system operation,extensive piping systems,etc. SpeCMCations 'tern _ NHB-65 NHB-80 NH8410 NHB-150 i Dimensions 24'(H)x 17e(W)x 12'(D) 24'(H)x 17'(1N)x 13'(D) !� Weight 73 be(33 kg) BO Ibs(36 k9) Installation type Indoor wall-hung Venting type Forced draft direct vent Ignition Electronic Ignition Natural gas supply pressure 3.5'-10.5'WC (from source) ___l Supply Connections Propane gas supply pressure (from source) 8.0'-13.5'WC Natural gas manifold pressure -0.03'WC — -0.08-WC -0.10'WC -0.40'WC Propane gas manifold pressure -0.03'WC -0.07'WC 0.09 WC -0.30'WC Q Gas connection size 3/4'NPT(female) _ 0 p• j Power Main supply 120V AC,80Hz € supply Maximum power d 5 consumption Less than 10A materials Casing Cold rolled carbon steel •tetwssotniirammmi Heat exchangers Primary and secondary heat exchangers:stainless steel .......... --...... C—action She 2'or 3'PVC,CPVC,PP,SS Q Air Intake m z• Exhaust (see Installation manual for more details) ID Exhaust Gas Vent 0 z• 2'or 3'special gas vent type BH(Class III,A/B/C) $Air Vent connection m 3/4• Venting J0 Rubber Grommet oil Intake 2'or 3'PVC,CPVC'FIR SS ®Space Hearing Return 01, 2'or 3'special gas vent type BH(Class III,A/B/C) Q condensate Outlet 01/2' Vent clearances 0'to combustibles a Knock Out tole I'll <' Flame rod,APS, as valve operation detector,Ignition o(a'}Gas connection o ai, Safety devices 9 P 9 peration detector, U Spxe Heating Supply m 1• water temperature high imk switch,exhaust temperature high limit sensor Navien reserves the right to change specifications at any time without prior notice. ® �,\ Please refer to www.Navlaninc.com to verify you have the most current Information. N Input ranges Warranty ...............__......__......_ Model Rage TDR ,ype i • cormneraild NHB-55 8,000-55.000 BTU/H 7:1 - Heat Exchanger 15 year limited warranty 10 year limited warranty NHB-80 8,000-80,000 BTU/H 10:1 NHB-110 10,000-110,000 BTU/H 11.1 Parts 5 Years; 3 years NHB-150 10,000-150.000 BTUM 15:1 Labor 1 year 1 year 'Applies to single family residential locations. For complete details please refer to the full warranty at Navieninc.com. Navien Inc., 20 Goodyear, Irvine, CA 92618 800-519-8794 Navieninc.com dNavieN T H E L E A D E R I N C O N D E N S 1 N 0 T E C H N O L 0 0 Y NHB-BRO02-2108 02021 Navien Inc. ester R 1 AUG 2 5 2022 VCOm VILLAGE OF RYE BROOK BUILDING DEPARTMENT George Latimer County Executive Sherhta Amler,X11) Commissioner of Health August 18, 2022 Steven A. Costa, P.E. Consulting Engineers 756 Palisade Avenue Yonkers, NY 10703 Attn: Steven A. Costa, P.E. RE: Log #: 13684-22-DCV Application for Backflow Prevention Device 2 Jennifer Lane Rye Brook (V) Dear Mr. Costa: The plans and specifications for the above project have been reviewed and approved by this office pursuant to the provisions of Chapter 873, Article VI I, Section 873.707.1 of the Laws of Westchester and Section 5-1.31, Subpart 5-1, of Part 5 of the New York State Sanitary Code. A Certificate of Approval is attached. Form NYSDOH-1013 is to be utilized as a Request for Completed Works Approval. This form can be downloaded from the following link: https:Hhealth.westchestergov.com/images/stories/pdfs/crossconnection doh1013.pdf .. NYSDOH- 1013 consists of two parts: (A) the initial test of the device(s) by a certified backflow prevention device tester, and (B) a certification by a Professional Engineer or Registered Architect, licensed and registered in the State of New York that installation is in accordance with the approved plans. The completed NYSDOH-1013 must be sent to our Department within 45 days of installation of the device(s). This form can be emailed to DOH-BFlow cDwestchestergov.com . Respectfully, Delroy Taylor, P.E. Assistant Commissioner Bureau of Environmental Quality DT:KM cc: Richard Mohring — Robert James Construction Michael Izzo — Building Inspector, Rye Brook (V) Mark Lore—Veolia Water New York File <00) REpUSEkr RECYCLE Department of Health 25 Moore Avenue Mount Kisco,NY 10549 Telephone: (911)813-5000 tax: (91 1)81 3-500:3 NEW YORK STATE DEPARTMENT OF HEALTH CERTIFICATE OF APPROVAL FOR BACKFLOW PREVENTION DEVICES This approval is issued under the provisions of 10 NYCRR, Part 5, Section 5-1.31, and Chapter 873, Article VII, Section 873.707.1 of the Laws of Westchester County. Log No. 13684-22-DCV Facility: 2 Jennifer Lane City, Village, Town: County: -[Rye Brook V WESTCHESTER Owner's Mailing Address: Richard Mohring P.O. Box 134 Glen Head, NY 11545 Physical Location of Backflow Prevention Device(s): Basement Description of Devices : One 1 1"Watts LF007M1QT DCV device for fire service Water Supplier: Veolia Water New York Name Designated Representative: Mark Lore Mailing Address: 2525 Palmer Ave, New Rochelle, 10801 Zip:10801 Conditions of Approval: A. THAT the device(s) shall be installed within 90 days, and that within 45 days of installation the attached New York State Department of Health Form DOH-1013 shall be completed and returned to the water supplier and the Westchester County Department of Health. B. THAT a certified backflow prevention device tester test the above backflow prevention device(s) at least yearly and report the results to the water purveyor indicated above. C. THAT any connection made prior to the backflow prevention device(s) shall render this approval void. D. THAT the proposed works be constructed in conformance with plans and specifications approved this day and any amendments thereto. E. THAT certification that installation of device(s) is in accordance with the approved plans, Form NYSDOH-1013, Part B, must be completed by a Professional Engineer or Registered Architect, licensed and registered in the State of New York. F. THAT the approved device(s) shall be so set that the test cocks are faced for easy access. G. THAT if facility construction has not commenced within 90 days of the issuance of this Certificate of Approval, then this Certificate shall become null and void unless an extension to the 90 day installation period is secured from the Westchester County Department of Health by the facility owner. Designated Representative ISSUED FOR THE STATE COMMISSIONER OF HEALTH BY: 909431 DATE: August 18, 2022 DeIroy Taylor, P.E. Assistant Commissioner Building Envelope and Duct Tightness Report 2018 IECC as amended by the 2020 New York State Supplement,sections 402.4.1.2 and 403.3.4 Address of Test 2 Jennifer Lane, Rye Brook NY 10573 Test Date 9/15/2022 Building Permit#: 21-236 nce Pathway Performance Test Completed by : Christopher Silvia R l� T Rater ID# 4150294 Home Energy Solutions OCT — 6 2022 NATE ID# 187 East Main Street ICC ID# Huntington,NY-11743 VILLAGE OF RYE BROOK BPI# 631-673-0664 BUILDING DEPARTMENT Building Envelope Tightness Volume Calculation : Check if: Floor Area Volume ❑ Conditioned Basement Basement 0 ❑ Conditioned Crawl Space ISt 1078 9702 Sealed Attic 2nd 1154 10386 *The conditioned floor area of dwelling is calculated in 3rd accordance with ANSI Z765,except that conditioned floor Attic 8068 area includes areas where the ceiling height is less than 5 Total Volume 28156 ft' CFM @50 pa 1305 Air changes/hr@50 pa 2.78 Code Compliance: Pass Duct Tightness: Post Construction Test-Total Duct Leakage System-1: Duct Location Floor Area Leakage CFM @ 25pa CFM/100 ftz CFA� Code Compliance: System-2: Duct Location Floor Area Leakage CFM @ 25pa CFM/100 ft 2 CFA� Code Compliance: System-3: Duct Location Floor Area __ - Leakage CFM @ 25pa CFM/100 ftz CFA� Code Compliance: All building envelope tightiness testing has been verified using instruments and procedures specified in ASTM E1827 as required by 2018 IECC as amended by the 2020 New York State Supplement, section 402.4.1.2.The building duct and plenum system has been verified as required by the 2018 IECC �ass amended by 2020 New York State Supplement,Section 4033.4. Signature: ±' -w°'': Date: 9/15/2022 Christopher Silvia,Home Energy Solutions Building Permit Check List&Zoning Analysis Address: 7� fL� L SBL: t ^'S i S 7 Zone l Use: Z Const.Type: Other. Submittal Date: Z-l Revisions Submittal Dates: Z 1 Applicant: 1_1 L 1-7 1-� LL C_ 0 GK-A Nature of Work Zr-'�� ��`(I o►� r i P- -r-,r<U -0 ti__�-_2� vA.T+7 N i 1.9w Reviews:ZBA- J U L 2 0 2021 PB: BOT: Other. OK ( ( ) ES:Filing- BP: 41 1Z SD - ' C/O: Legalization: APP: Dated. +/ Notarized: SBI_ ✓Truss I.D. Cross Connection: ✓ H.O.A.: ( V Scenic Roads:_VSteep Slopes: Wetlands: Storm Water Review: Street Opening. ( ) ( ) ENVIRO:Long. Short: Fees: N/A.- SITE PLAN:Topo: Site Pr tection S/W M� Tree Plan: Other. ( ) ( SURVEY:Dated z Current ✓Archival Sealed: Unacceptable ( ) GLANS:Date Stamped Sealed Copies: Z Electronic ✓ Other. ( ) ( License: ✓ Workers Comp: ✓ I�iabili Comp.Waiver. Other. ( (Jf CODE 753#:f)?a�71—OC�I-40` 00 Dated N/A ( ( ) HIGH-VOLTAGE ELECTRICAL:Plans: Permit: N/A: Other. ( ) ( ) LOW-VOLTAGE ELECTRICAL:Plans: Permit N/A: Other. V( ) 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. G( ) ( ) Other. ARB mtg.date: approval notes: ( )ZBA mtg.date: approvaL• notes: ( )PB mtg.date: approval• notes: REOUIRED EXLSTING PROPOSED NOTES APPROVED Data: A U G 2 5 2021 cirde z s 7.S — F n�taQe: Front: -� - - . � Front: 9 x Si : &ar. 1310 Main Co v Z-2 Acts.Cov 3, Ft.H Sb: Sd H/Sb: Z ,40 QFA.• 2 .0 z to 017, (0 d1- Tot.Imp: Z`f(o Ft.Imp: 'i_571 p i . Z HeiQhteir�/Stories:Aq no _ LtJ�I�+ Residential Building Permit Fee Work Sheet Permit#: Date Issued: SBL: Zone: Address: 2 Frj Property Owner& Contact Info: Job Description: ;%5-b cr? 1)Q-VQ Zf sue— +- F--,�F-0 o ti. A,c> L s7- �i, 5�T17� For all new dwellings and for additions measuring 800 sq. ft. or more made to existing dwellings, the following fee schedule shall apply: (plus any alteration fees) Total Sq. Ft. (excluding basements) x $225.00 x $I 5.00/$1,000.00 Basement Sq. Ft. x $65.00 x $I5.00/$I,000.00 -------------------------------------------------------------------------------------------------------------------- New Construction Sq.Ft. 0 New Construction Cost • Building Permit Fee Basement= sq.ft.x$65.00 =$ x$I5.001$I,000.00= $ Attached Garage= sq. ft.x $225.00= $ x$I5.00/$I,000.00 = $ I"Fl. = 60 sq. ft.x$225.00= $ x$I5.00/$I,000.00= $ 2"d Fl. = l Z 0-7-' sq. ft.x$225.00 = $ x$I5.00/$I,000.00= $ 3`d Fl. = sq. ft.x $225.00= $ x$I5.00/$I,000.00= $ 4,h Fl. = sq. ft.x$225.00= $ x$I5.00/$I,000.00 = $ To"Fi.Ei�l��sq. ft. Total Cost= $ Z� ru Total B.P.Fee= $ C 3� .A'u7 Total Amount Paid = $ Total Amount Due= $ Date: Signed: BUILDING DEPARTMENT CC� LOML VILLAGE OF RYE BROOK a 938 KING STREET RYE BROOK,NY 10573 JUL 1 6 2021 (914)939-0668 UX(914)939-5801 www, ok.or VILLAGE OF RYE BROOK BUILDING DEPARTMENT 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: a L V5t Y`e. Date of Submission: Parcel ID#:135,5 7 - I -' 1 ,3 Zone:�V- -I Proposed Improvement(Describe in detail): APPLICANT CHECK LIST: C3r MAST BE COMPLETED BY THE APPLICANT The following items must be submitted to the Building 2, 1CM �1 . 1 Department by the applicant-no exceptions. I. ( )Completed Application 2. ( )Two(2) sets of sealed plans. (one full size Imaximum Property Owner: 'Bi evx 1_,�, allowable plan si/e=36"x 42") and one I I"xI7") �3� �. N_",p 4 Y. �l 5 3. ( )Two(2)copies of the property survey. Address: 'C"�C 4. ( )Two(2)copies of the proposed site plan. Phone# 51(o — �322- Or 27 5. ( )One electronic/disc copy of the complete Applicant appearing be application materials. fore the Board: 6. ( )Filing Fee. T I a,cv j HOk YLf 1` 7. ( )Any supporting documentation. Address: 8; t C.L., the Cat.(RUC I. ( )HOA approval letter. (ifapplicable) 2 9. ( )Photographs. Phone# 5-16, '3 2-2 77 10.( ) Samples of finishes/color chart. (a sample board or model may be presented the night of the meeting) Architect/Engineer: M t c.k��e l ���at,,,� �(J Phone# 4TI y 6120 V3 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 refuse to hear any application not meeting the requirements contained herein. Sworn to before me this Sworn to before me this '7S✓1. day of 20 Z1 day of 20 Sign r ofPrope Signature of Applicant Print Name o Pr Oxmer Print Name of Applicant Notary tc Notary Public Jacob E AmIr Nobly PWIc.State of New Valk III No.02AM6019480 aualKled In Westchester Cotes, Commission left March 16.20 3/21/19 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 524-7 (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 NY- 33 Talcott Road Rebuild Rear Deck 5249 (Selzer) 11 Whippoorwill Rd 2nd Floor Dormer 5250 (Aspis) Addition 68 Windsor Road Replace Rear Exterior 5251 (Peary) Stairway 134 S. Ridge St(Win New Sign 'Buff City 5252 Ridge) Soap" ML NM MR SE / JM SF AC ✓ MI KC r . �-=�, � ir.� a I � a Z � y IN rVI O I m o m ! � W 12 � o O M/iVl p� o I J o Cc o a �, • s _ � � e V ^ R O W 5 IL N W Mcr, O 9 m cZ w b 43 ' MM0, a W o A d = rN v � !' o Ed ow (f i 2 W �tM w O a c x ' w Q W o V w ►� MIJ VIA 16, ' z ' U Z p _ c w uj Z o W --) oc UJ o z W W 9 — ° m N a m x 2! d O A o � J Eo . ° q d o .. J r &. Ii ,w } %Fr G y t = � 14 .►ol ,{ r t � T !� ¢ 4e00 n5 -101 s J , '+ T All �k , 1 , e . " r i f r 4 l •a V r �a a �• 4 9 p , r M r 1, t� 1 ky � tt h i t -- r CA N k.. n a N o ;�.. ';4'Y. •r w, C� F- co o W l U 0� `O�aCition 1. � 'V`/ i.. m LLJ r J O anW- v O N. Ow Gaw �e i w c �e ap LL X4°, Z A b C f £ a y o P 4 p H N to 3 H a `. • ® DATE(MM/DD/YYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE 12/27/2021 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 endorsement(s). PRODUCER CONTANAME:CT Gary McCarthy GRBM,Inc. (AICC,NN.Extl; (845)878-9293 (AM,No): (845)878-3769 PO Box 231 E-MAIL a rbminc.com ADDRESS: 9 ry@9 INSURE S AFFORDING COVERAGE NAIC# Brewster NY 10509 INSURER A: Houston Specialty Insurance Company 12936 INSURED INSURER B: National Grange Mutual Insurance Company 14788 Branler Ltd DBA Affordable Fire Protection INSURER C: P.O.BOX 315 INSURER D: INSURER E; Cross River NY 10518 INSURERF: 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. 1POL L7R TYPE OF INSURANCE ADDL SUER POLICY NUMBER MMIDD/YYYY MM/IC EFF DDY� LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE �X OCCUR DAMAGE T RENTED PREMISES Ea occurrence $ 50,000 X Contractual Liability MED EXP(Any one person) $ 5,000 A Y Y ESB-HS-GL-0000130-00 05/06/2021 05/06/2022 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY E ECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUT'OMOBILELIABIUTY COMBINED SINGLE LIMIT $ Ea accident 1,000,000 ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED B1 KO050N 04/27/2021 W27/2022 BODILY INJURY(Per accident) $ AUTOS ONLY Ix AUTOS X HIRED NON-OWNED PROPERTYDAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Village of Rye Brook is 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 St. 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 YORK Workers' CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured Branler LTD 845.590.9078 DBA/TA Affordable Fire Protection 1c.NYS Unemployment Insurance Employer Registration Number of PO Box 315 Insured Cross River, NY 10518 Work Location of Insured(Only required if coverage is specifically limited to 1 d.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-Up Policy) Number 26-4695646 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) NorGuard Insurance Company Village of Rye Brook 3b.Policy Number of Entity Listed in Box"l a" 938 King St., BRWC200679 Rye Brook, NY 10573 3c.Policy effective period 04/20/2021 to 04/20/2022 3d.The Proprietor,Partners or Executive Officers are ❑ included.(Only check box if all partners/officers included) Q 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 u1 a"for workers' compensation under the New York State Workers'Compensation Law. (To use this form, New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2". The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate.(These notices may be sent by regular mail.)Otherwise,this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent,or until the policy expiration date listed in box"3c",whichever is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note: Upon cancellation of the workers'compensation policy indicated on this form, if the business continues to be named on a permit,license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers'Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Gary McCarthy (Print name of authorized representative or licensed agent of insurance carrier) Approved by: r' 12/27/2021 (Signature) (Date) Tifle: Licensed Agent Telephone Number of authorized representative or licensed agent of insurance carrier: 845-878-9293 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 10�� 'u:•v �4 J•J. ti e • te r � ��y�r - 1 (.nJrpe Lutlntrr �`..�xn JIi 1 w N r.tr bes(�r(Dual) !ara uah, ��. rtnleer Prot I)�,pa nt of Consumer echo0 Nome Improvement license ROBERT JAMES CONTRACTING CORP. BOX 134 GLEN HEAD,NY-11545 � �.a►id only r. adr ��j this t'cc,it 4. This license is issued in accordance with article XVI of the Westchester Coun(� C unsure=Pratec'r`'t' OS�'tµ presence of the official depanment seal. Proof of citizenship or immigration status Is nu{required is` NOT FOR FEDERAL PURPOSES I o,k C,onsp�P�A of xp�ration =_ License Numberpate WC-33994-H21 0510712023 G o Chester -.---•.--- ,:-�,- � -..- ,-ems . . . . . . . . . �, ,.--s"`a`fi=;'��/{{/I'�� q� Y ?A5 Va►.��;!. .1`� Vti'' V `r»` i .a ` ,.r "'4JSCti —"� ROBEMOH-01 .�"f ORNV CERTIFICATE OF LIABILITY INSURANCE DAMIDONY TE(M 5/26/20212021YY) `VJ 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: ff the certificate holder is an ADDITIONAL INSURED,the pollcy(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 endorsement(s). PRODUCER CONTACT PHONE - - - 100 Stewart Service Agency Inc. No 516 3334611 FAx 100 Stewart Avenue INC.i ( _._.._ ___..__ INc•_N516)997-0816 Hicksville,NY 11801 E-MAIL irlf lihardi.com ADORess: �@ INSURER �IL INSURED �}AFFORDINp INSURER A:Falls Lake Nq#9q i_In q1W� nx _ I - _....._�I��2� INSURER B: Robert James Contracting Corp INBIIRER C:- - 325 Glen Cove Avenue,Unit 1 ENSURER o: Sea Cliff,NY 11579 _---__._-- _INSUR61 L—_--_-----__---_ INSURER F: COVERAGES CERTIFICATE NUMBER: -RIEV11310N 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. ILT R TYPE OF INSURANCE �ADOL'sX1BR POLICY NUMBER POLICY EFF POLICY EXP LIMI'm -- A X COMMERCIAL GENERAL LIABILITY EACFIOCCURRENCE- —{ 1,m0,000 CLAIMS MADE OCCUR CPP 1205929 11/9/2020 11/912021 _E ocar mil— 9Q006 — -- ME.QW cM�a z 5,006 R L NZRDy_g 14RY 11000,000 GEN'L AGGREGATE UMIT APPLIES PER: GE 2,000,000 POLICY jPPT 1-�] LOC PRODUCTS /OPAOG_I}:�--- 2►000r000 01-HER: AUTOMOBILE LIABILITY _ COMBINED SINGLE LIMIT ANY AUTO BODILY INJURY',Par- oh� -;Vy __� _.�___•_._--_ AUTOS ONLY AUTOSED BODILY INJURY Per -- H�RE� VOW PROPERTY DAMAGE ; ..`____._......__.._-.. AUTOS ONLY AUTO ONLY Per accident --— — — UMBRELLA LIAR OCCUR EACH OCCURRE[N( EXCESS LIAR l CLAMAS�MADE r— —---- AGGREGATE _ -_DED RETENTION$ WORKERS COMPENSATION PER 1� AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETORIPARTNER/EXECU I VE WeFICERM NIA ndetoryEBR n E,LDISEASE-EA€t�Pl �A---- H yes,deavibe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS r VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Villa THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Village of Rye Brook ACCORDANCE WITH THE POLICY PROVISIONS. Building Department 938 King Street Rye Brook,NY 10573 AUTHORIZED REPRESENTATIVE ACORD 25(2016103) 01988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD i YORK Workers' CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1 a.Legal Name 8 Address of Insured(use street address only) �1 b. Business Telephone Number of Insured jRobert James Contracting Corp ! 516-351-1535 325 Glen Cove Avenue, Unit 1 1c. NYS Unemployment Insurance Employer Registration Number of i Sea Cliff,NY 11579 i I Insured Work Location of Insured(Only required if coverage is specifically limited to 1d. Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.. a Wrap-Up Policy) Number 27-3939347 2.Name and Address of Entity Requesting Proof of Coverage l 3a. Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Sirius American Insurance Company Village of Rye Brook i Building Department 3b. Policy Number of Entity Listed in Box 1 a" 938 King Street Rye Brook,NY 10573 WC6124100 3c.Policy effective period 11/10/2020 to 11/10/2021 3d.The Proprietor, Partners or Executive Officers are C, included.(Only check box it all partners/officers included) C all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box 'T' insures the business referenced above in box"I a"for workers' compensation under the New York State Workers'Compensation Law. (To use this form, New York(NY)must be listed under(Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box "2". The insurance carrier must notify the above certificate holder and the Workers' Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.) Otherwise, this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent, or until the policy expiration date listed in box"3c", whichever is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note: Upon cancellation of the workers'compensation policy indicated on this form, if the business continues to be named on a permit, license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers' Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury, I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: William Libardi (Print name of authorized representative or licensed agent of insurance carrier) Approved by: 1G(G�,� .�� ^5126121 (Signature) (Date) Title: President Telephone Number of authorized representative or licensed agent of insurance carrier: 516-333-3611 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.web,ny.gov ACORO" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 12/20/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS JPON 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 endorsement(s). PRODUCER CONTACT NAME: Laurie Rubino Hallahan,McGuinness and Lorys,Ltd PHONE (914)9 3 9-813 9 5 (914)939-3104 A!C No): 553 Westchester Avenue AO AILsq laudet@hmlinsurance.com INSURERS)AFFORDING COVERAGE NAIC I Rye Brook NY 10573 INSURERA: Merchants Mutual Insurance Co 23329 INSURED INSURERB: ShefterPointlnsuranceCompany 81434 Albano Plumbing&Heating Inc INSURER C: 132 Archer Avenue INSURER D: INSURER E: Mount Vemon NY 10550 INSURER F: COVERAGES CERTIFICATE NUMBER: new 21-22 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. NOTWITHSTANDINGANY REQUIREMENT,TERM OR CONDITION OFANY CONTRACTOR 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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS MIPOLICY Y X LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMJDDIYYW) (MMIDD/YYW) LIMBS COMMERCIAL GENERAL LIABILITY EACH,=C'_URRENCE ( 1,000,000 _Earn_.-MADE F9 _'_!(F ` ' 300.000 FRE A',L I-'PtN I rrenre $ MED ExP.(Any rce person) $ 15.000 A Y CTR1000612 05/01/2021 05(01/2022 PEPSONALsACvINJUR'r $ 1.000,000 ',EN'L A',-,REaATE LIMIT APPLIES PER =ENEPAL A',".REGATE $ 2,000,000 2.000,000 F'�!LI�=i PRo-JECT L,:-,: F'ROCUCTSCOMF'n'F'A�,�> $ 11 ,THER $ AUTOMOBILE LIABILITY 'M fJEC�-AN1-- LIMIT $ 1,000,000 Ea acoden[ ArJ'i AUTi, BODIL',RJJUPv(Per personi $ A vYNED X SCHEDULED CAP1075678 05/01/2021 05i01/2022 60DILr IrJJUF i iPer accident) $ a.UT05 OW) Al1TOS HIRED NON-OWNED PROPEPTv DAMAGE ) AUTOS ONO AUTOS ONLY Per accident $ UMBRELLA LIAB -„_,_LIP. EACH0,-,:HRPEN'=E •1 3.000.000 A EXCESS LIAB H,:LAJM>MAE,E CUP9151011 05/01/2021 05101/2022 A,_,;RE,-ATE q. 3.000.000 DED I I RETENTION 1 {. WORKERS COMPENSATION F•ER ':,TH. AND EMPLOYERS'LIABILITY STATU Y f N TE ER 100,000 AN,RF•�_�F•F•IETC'F7PAFTtJER1E rEC UTIvE E L EACH ACCIDENT $. A -.FFI--ER'IMEMBEPExCLUDED*> a NIA WCA9102786 05/01/2021 OSr01/2022 (Mandatory in NH) E L Ur_EASE-EA EMFtCn EE $ 100.000 Ir yes,describe under 500.000 DE'=CRIPTIONOF OPERATIONSbe1cw EL DISEASE-FOLK_,LIMIT 1. NYS Disability B D489844 07/01/2016 01,1 999 Continuous Statutory DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101.Additional Remarks Schedule,may be attached if more space Is required) Certificate Holder is listed as additional insured. CERTIFICATE HOLDER CANCELLATION SHOULDANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Village of Rye Brook ACCORDANCE WITH 711E POLICY PROVISIONS. 938 King Street AUTHORIZED REPRESENTATI lE Rye Brook NY 10573 ;V . \— � ._ ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of A::ORD NEW Workers' CERTIFICATE OF �—, STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 18,Legal Name b Address of Insured fuse street address only) 1b.Business Telephone Number of Insured `} i Albano Plumbing&Heating Inc 914-667-0936 132 Archer Avenue lc.NYS Unemployment imirance Employer Registration Numoer of Mount Vernon, NY 10550 insured Work L Xatlon of Insured(only regu►ed d Coverage is SpecMkallyWnlMd to Id.Federal Employer ldentillulion Number of insured or Social Security Colrain locations in New York Stale.La..a Wrap-Up Polic)) Number 133385291 �J 2 Name and Address of Entlry Requesting Proof of Coverage 3a.Name of Insurance Csiftr (Enfiry Being Listed as the Certificate Holder) Merchants Mutual Insurance Co. Village of Rye Brook 3b.Policy Number of Entity Listed in Box-la' 938 King Street WCA9102786 Port Chester, NY 10573 3c.Policy eNoclive penod 5/ _ to 5 1hi /1/70 3d. The Proprietor,Partneni or Executive Officers are Included.IoNy cNau<box II oM partnersralicars includedl all excluded or certain pannersiotficers excluded. This c:nifies that the insurance carrier indicated above in box'3"Insures the business referenced above in bpx'la'for vrorkers' compensation under Me New York State Workers'Compensation Law.(To use this torn,Nerr York(NY)must be listed under 11Em.3A on lho INFORMATION PAGE of the workers'compensation insurance policy)• The insurance Carrier or its licensed agent well sand this Certificate of insurance to the entity listed above as the certificate holder in box'2'. The insurance carrier must notify the above certificate holder and the Workers'Compensation[Ward within 10 days IF a policy is ca lceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy cs eliminate the coverage nfo Certificate. ncap sent sea `IOltre a Cenifcat vaid for one yeaattar thsrm Is approved bythe Insurracecarrier o Its licensed gentoruntihepoky expinition 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 arrend, exlenJ or after the Coverage afforded by the policy listed.nor does it confer any rights or responsibilities beyond those contained in t-W referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance onJy while the underlying policy is in effecl Please Note: Upon cancellation of the workers'compensation policy Incilcated on this foam.If the business continues to be name d on a permit,license or contract Issued by a elxtifieate holder,the business must provide that certificate holder with a new certificate of Wo►kers'Compensation Coverage or other authorized proof that the tuusiness Is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of penury,1 certilfy that I am an authorized ropresentativo or licensed agent of the Insurance carrier references above and that the named Insured has the coverage as depicted on this form. Approved by: Tho as F. Lo s name d ava+Wred rapn utM or 4rrnsW apaM or inw>•tis ur+ier) JApproved by r �'' •1 mn1 Islonarure) (coa) Title. President Tele none Number of authorized representative or licensed agent of insurance carrier: 914-939-8895 Please Note Only Insurance carriers and their licensed agents are authortzed to issue Form C-105.2.Insurance brokers are NOT authorized to Issue R. www wcb n/9rn C-105.2(9-17) Laura Petersen From: Mike Izzo Sent: Monday, August 29, 2022 10:00 AM To: Laura Petersen; Steven Fews;Tara Orlando Subject: FW: Message from UDig NY From: UDig NY Exactix <tickets@exactix.udigny.org> Sent: Monday, August 29, 2022 9:59:46 AM (UTC-05:00) Eastern Time (US & Canada) To: Mike Izzo Subject: Message from UDig NY ****REGULAR**** DIG REQUEST from UDig NY for: VIL RYE BROOK Taken: 08/29/2022 09:58 To: VIL RYE BROOK PRIMARY Transmitted: 08/29/2022 09:59 00001 Ticket: 08292-000-908-00 Type: Regular Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 2 To: Name: JENNIFER LN Cross: From: To: Name: Offset: ------------------------------------------------------------------------------ Locate: BOTH SIDES OF THE ROAD TO THE FRONT OF THE HOUSE NearSt: LEE LN & LEE LN Means of Excavation: BACKHOE Blasting: N Site marked with white: N Boring/Directional Drilling: N Within 25ft of Edge of Road: U Work Type: INSTALL WATER SERVICE Estimated Work Complete Date: 09/01/2022 Depth of excavation: Site dimensions: Start Date and Time: 09/01/2022 07:00 Must Start By: 09/16/2022 ------------------------------------------------------------------------------ Contact Name: KATHERINE CAMARGO Company: SUEZ WATER, WESTCHESTER Addrl: 2525 PALMER AVE Addr2: City: NEW ROCHELLE State: NY Zip: 10801 Phone: 914-637-5302 Fax: Email: katherine.camargo@suez.com Field Contact: JASON FIGUEROA i Alt Phone: 914-632-6900 Email:jason.figueroa@suez-na.com Working for: ------------------------------------------------------------------------------ Comments: WORKING ON BOTH SIDES OF THE STREET. Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: ALTICE USA BELL-VALHALLA/WSCHSTR CONED NYSDOT TFC POKPSE SUEZ WTR WESTCHESTER VIL RYE BROOK WESTCHESTER CTY SWR 2 Laura Petersen From: Dig Safely New York Exactix <tickets@exactix.digsafelynewyork.com> Sent: Friday, August 27, 2021 3:50 PM To: Mike Izzo Subject: Message from Dig Safely New York, Inc. (DSNY) ****REGULAR**** DIG REQUEST from DSNY for: VIL RYE BROOK Taken: 08/27/2021 15:48 To: VIL RYE BROOK PRIMARY Transmitted: 08/27/2021 15:49 00006 Ticket: 08271-001-697-00 Type: Regular Previous Ticket: 05241-002-750-00 ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 2 To: Name: JENNIFER LN Cross: From: To: Name: Offset: ------------------------------------------------------------------------------ Locate: ENTIRE LENGTH OF HOUSE NearSt: LINCOLN AVE Means of Excavation: SMALL EXCAVATOR Blasting: N Site marked with white: Y Boring/Directional Drilling: N Within 25ft of Edge of Road: Y Work Type: HOUSE EXTENSION, NEW WATER & SEWER LINES Estimated Work Complete Date: 09/01/2021 Depth of excavation: 5 FEET Site dimensions: Length 100 FEET Width 25 FEET Start Date and Time: 09/01/2021 07:00 Must Start By: 09/16/2021 ------------------------------------------------------------------------------ Contact Name: RICHARD MOHRING Company: RHINO EXCAVATING Addr1: PO BOX 134 Addr2 City: GLEN State: NY Zip: 11545 Phone: 516-671-0481 Fax: Email: richardmohring@optonline.net Field Contact: RICHARD MOHRING Alt Phone: 516-671-0481 Email: richardmohring@optonline.net Working for: BIENENFELD ------------------------------------------------------------------------------ Comments: Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: ALTICE USA BELL-VALHALLA/ WSCHSTR CONED SUEZ WTR WESTCHESTER VIL RYE BROOK WESTCHESTER CTY SWR 1 Laura Petersen From: Mike Izzo Sent: Wednesday, August 31, 2022 2:31 PM To: Laura Petersen; Steven Fews;Tara Orlando Subject: FW: Message from UDig NY From: UDig NY Exactix <tickets@exactix.udigny.org> Sent: Wednesday, August 31, 2022 2:30:53 PM (UTC-05:00) Eastern Time (US & Canada) To: Mike Izzo Subject: Message from UDig NY ****REGULAR**** DIG REQUEST from UDig NY for: VIL RYE BROOK Taken: 08/31/2022 14:29 To: VIL RYE BROOK PRIMARY Transmitted: 08/31/2022 14:30 00005 Ticket: 08312-001-977-00 Type: Regular Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 2 To: Name: JENNIFER LN Cross: From: To: Name: Offset: ------------------------------------------------------------------------------ Locate: MARK OUT ENTIRE FRONT OF PROPERTY; CURB TO CURB; 20FT BEHIND ALL CURBS NearSt: Means of Excavation: EXCAVATOR, BACKHOE Blasting: N Site marked with white: N Boring/Directional Drilling: N Within 25ft of Edge of Road: Y Work Type: INSTALL WATER SERVICE, REPLACE WATER SERVICE Estimated Work Complete Date: 09/06/2022 Depth of excavation: Site dimensions: Start Date and Time: 09/06/2022 07:00 Must Start By: 09/20/2022 ------------------------------------------------------------------------------ Contact Name: EDWARD PESSOLANO Company: J FLETCHER CREAMER & SON INC Addrl: 101 E BROADWAY Addr2: City: HACKENSACK State: NJ Zip: 07601 Phone: 201-390-3947 Fax: Email: edward.pessolano@jfcson.us i Field Contact: EDWARD PESSOLANO Alt Phone: 201-390-3947 Email: edward.pessolano@jfcson.us Working for: VEOLIA CONTRACTOR ------------------------------------------------------------------------------ Comments: WORKING ON BOTH SIDES OF THE STREET. Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: ALTICE USA BELL-VALHALLA/ WSCHSTR CONED NYSDOT TFC POKPSE SUEZ WTR WESTCHESTER VIL RYE BROOK WESTCHESTER CTY SWR 2 JUN 2 2021 E A VLLAE OF RYE BROOK BIUI DING D ARTMENT N / F TO W N O F R Y E (CRAWFORD PARK)N 85'25'00' E 108 . 77' WSTOKE WALL ALOC :E %0 LOT I w o r 0.36 9 5U J 1 W (0.238 A(�5) — O m R6vtA/k5 O OF PATIO _ Lw 1 STY zI - 112 STORY 1 FRANE I I STY 0 s� RESIDENCE I ONCLSE NO. 2) I 6Na�E U m ui 0� cm. I O 34.0• _ I9.8 o-N. p � Z O 1 A U) O E-0.2' a � c^ O�. S 85'25 '00" W 1 . 68' JENNIFER LANE (50 FT. R. O . W. ) SURVEY OF LOT I *AE SLQ YOVS Ste. S5 TUW&AV ANY CMMranON AFse,Ar+c PREPARED FOR `��• �" r TO nE eear CrHB Oeontww AND°'Q. n!5 SLRWE WAS PWPARM N ACCO�YLT VAIN ne �MeM BIEN LLC SIACrUE LAND ,e W TAMcwr"N >O C� FPAC A4 ADM L Or R new M eTA/e A>feOpATpi Cr or M0ffSSCftAL LAND SLRVErOM NC. 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