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HomeMy WebLinkAboutBP21-287PERMIT# rc.;)/'" c.)P / SECTION 3 J, HL CK� LOT TYPE OF WORK rf�r as /lle Q JOB LOCATION 1 l OWNER CONTRACTOR Q S�S / L( EST. COST DO FEE C.):JrSPb — vCO # FEE4 IIO�'"n 1 DATE 'I a ZCp # FEE DATE ��cpFCTION RECAR� i DATE I NSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION __/ PLUMBING [� RGH PLUMBING GAS SPRINKLER ra ELECTRIC LOW -VOLT i ALARM AS BUILT FINAL V74fo/�? �irolo/k;Q )a fna (yplys4l`/-350) c`�7//Z%fr�/7e37` Jp�9 veoeAa OTHER APPROVALS ARB BOT PB ZBA OTHER VILLAGE OF RYE BROOK WESTCHESTER COUNTY, NEW YORK No: 22-065 Certificate of (9ccup ucp This is to certify that V C Z/m L�rm at--� of, Broo having duly filed an application on 20 -)?o'7 requesting a Certificate of Occupancy for the premises known as, AILQVIlf gC)Od , Rye Brook,NY, located in a )Q— / Zoning District and shown on the most current Tax Map as Section: 5, Block: __L Lot: Ld , and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No. /-,:s 25 7, issued 1115 20 �J, 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: Pie - r a.Kn/ /V Construction: 163 for the following purposes: I r 7 eV l Q Y / / ' s4e/— � hall ho*�)L6o,r� Subject to all the privileges, requirements, limitations, and conditions prescribed by law, and subject also to the following: This certificate does not in any way relieve the owners or any person or persons in possession or control of the premises, building,or any part thereof from obtaining such other permits or licenses as may be prescribed by law for the uses or purposes for which the building or premises is designed or intended. Furthermore, it does not relieve such owners or persons from complying with any lawful order issued with the object of maintaining the premises or building in a safe and lawful condition. No changes or rearrangement in the structural parts of the building or in the exit facilities shall be made,and no enlargement, whether by extending on any side or by increasing in height shall be made nor shall the building be moved from one location to another until a permit to accomplish such change has bee obt 'p om the ' ing Inspector. Building Inspector,Village of Rye Brook: Date: MAY - 9 1022 DE� `" EID ���� For office use onl BUILDIl'�i E 'ARTMENT PERMIT# �11 c,18 f APR 2 5 2022 VILLAGE OF RYE BROOK ISSUED: __57_n_L 938 KING STREET,RYE BROOK,NEW YORK 10573 DATE: — �- VILLAGE OF RYE BROOK (914)939-0668 FEE:&//Q-- PAm.Q BUILDING DEPARTMENT M,rygbeok.org 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 ►sr►►►►►►►/►sr►►srr►►►►■rsr►►•►rs►►►►p►►►►►►r►s►►►►s►►r►►r►►r►pD►rrssr//r►►rs►�►sy►►►►►►►r►►►►►►►■rrr■s►►r►s►srr►►►►►►s►rrs►►srs►• Address: Occupancy/Use: Parcel ID#: 135, 60 Zone: e— 7 Owner: F-I c Address)b 4)y Q P_d e er�"kl lL� /6-r 7_3 P.E./R.A.or Contractor: �ct f�/,L f�e_�t Address: z w c Gres 'wt r C T 6 C`7 Person in responsible charge: � � Address: .f k---e, Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issuance of a Certificate of Occupancy/Certificate of Compliance for the structure/construction/alteration herein mentioned in accordance with law: STATE OF NEW YORK, COUNTY OF WESTCHESTER as: / ,Q Z �C -ih�e.(� being duly sworn,deposes and says that he/she resides at (Print Name of Applicant) � �� l,, (No.and Street) in k y e- f l-do!L in the County of �"�e ��� '`� �`I in the State of / / ,that City/Town/Village) T 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:S for the construction or alteration of: '� o ��,5 ( '� 1 n a✓� Deponent finther 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. Sworn to before me this Sworn to before me this day of , 20a,2_ day of , 20 Si ature of ProperIL94vner Signature of Applicant 1cl Z;Tn/I"QlMO✓) t Name of Property Owner Print Name of Applicant jL Notary Public SHARI MELILLO Notary Public Notary Public, State of New York No. 01 I+.i E6160063 an 2/2021 O!ialified in Westchester County Commission Expires January 29,20 a �E 4RO o`` tim 1982 BUILDING DEPARTMENT BUILDING INSPECTOR ❑ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS:_ LfZ- DATE: S PERMITf22f>Z t -Z�7 ISSUED: I -K SECT: BLOCK: ` LOT: V LOCATION: ►" '^1-�1�-��` l�+i LC. c-t- OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS f ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ ROSS CONNECTION FINAL OTHER �E BRC��• • �9�2 BUILDING DEPARTMENT ❑BUILDING INSPECTOR d ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK Al CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - f ADDRESS : DATE: PERMIT# �(' 2 � ISSUED: SECT: BLOCK: LOT: LOCATION: OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING / ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER QyE BRC�uk • �9�2 BUILDING DEPARTMENT ❑BUILDING INSPECTOR SSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK � [I CODE ENFORCEMENT OFFICER � 938 KING STREET • RYE BROOK NY 10573 (914) 939-0668 FAX (914) 939-5801 www ryebrook.or¢ - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS: Q DATE: O I PERMIT# 1 �� ISSUED: i� SECT: ' BLOCK: LOT: LOCATION: ,w T -� -� � 1 (^.� OCCUPANCY: j ❑ VIOLATION NOTED THE WORK IS... ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: //JROUGH PLUMBING OUGH FRAMING INSULATION ❑ NATURAL GAS ❑ L.P.GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER �E BRC�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 Uebrook.ore - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : I CAJ DATE: I� , Of PERMIT# ' v ISSUED: SECT: BLOCK: LOT: LOCATION: A -� OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION f REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: -El' ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER : 00 N : N N N W C • /�� !A4 _ a a CAD w W 45 Z o 3 ;y W p" `'' W � O 3 ai � � •o R- G% � � O M 5 0000 © n O F. «+ w C W a Ao �/ w E •� rn 3 ° y m = 7 a;�s U .,, b �, as _ O W M :. U .r o '5 a V i 00 Z lam- A w, • E .0 © U w _ \o a W 044% = w � O � .� in ON 00 W _ � //Fyy��� //Fyyil ICI r�l Q �0y � •{�-+�•y�. O., G'1.� i BUILD MENT '�' iL 1 VIL E OF R OOK 938 KING Q ET RYE-B� O,R ,NY 1057 OCT 2 9 2021 VILLAGE OF RYE BROOK BUILDING DEPARTMENT INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: �/ PP NOV 1 1021 �I-d�� / PP Approval Date: Permit#: Application Fee: $ 75_-/'/� Approval Signature: Permit Fees:$ I Disapproved: Other: Application dated: /() A2 9 Az is hereby made to the Building inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the interior alteration of an existing building,or for a change in use,as per detailed statement described below. 1. Job Address: /.2 Rd. SBL: 3%5 t�I—1—/�__ Zone: �r 2. Proposed Improvement.(Describe in detail): a CA -v %ifk —3 NaW jo'.S-t-c ,'., Awl- fin IVe-6.0 in S�L(rk-hvn , /, rv",4 11 . 0ju rock le - &-4k vej /Q A /t,J i07v t.'Vf)c� su {7t rf r' S yn er 5l`on /`.1 IV4- 3. Does the proposed improvement involve a Home-Occupation as per§250-38 of the Code of the Village of Rye Brook? No: Yes: If yes,indicate: TIER 1: TIER H: TIER III: 4. Will the proposed project require the installation of a new,or an extension/modification to an existing automatic fire suppression system(Fire Sprinkler,ANSL System,FM-200 System,Type I Hood,etc...) :No:_K_Yes: (If yes,please submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans) 5. Occupancy;(I fam.,2 fam.,comm.,etc...)Prior to Construction: / 07. After Construction: 6. N.Y State Construction Classification: N.Y. State Use Classification: 7. Property Owner: E r+C 7?---(M M ernq`jam Address: t L &( V/f Phone# 9/4-59a- 77SY Cell# email': p 8, Applicant: M01d Twf'er & fm r, d610?S Address:_ c_-6 PeM�'r'&Ul'( k. iZd Phone# Qrt{ - 9y�{— 35�r Cell# email: 9, Architect: Address: Phone# Cell# email: 10. Engineer: Address: Phone# Cell# email: ., 11. General Contractor:C- i'ornivni a^ ,W la 1(-Xi'l()Address: Qe AA/ oy(- Phone# 1 y — 35D t Cell# email: ol kr hu r I Y1 i [{ 12. Estimated cost of construction $ /9 (NCO rvtat l •COM (NOTE:The estimated cost shall include all labor,material,scaffolding,fixed equipment,professional fees,and material and labor which may be donated gratis.) 13. Job Timetable: Start: Finish: (1) BUILD MENT D rp-- C 17 � Wy C VII. O :I OOK 938 KING ;ET Rlv BR ,NY 10573 O C T 2 9 2021 " VILLAGE OF RYE BROOK BULDING 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 PLUMING PERMIT APPLICATION. ANY BUILDING OR PLUMBING PERMIT APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETURNED TO THE APPLICANT . STATE OF NEW`Y�ORK, COUNTY OF WESTCHESTE/R ) as: r 31 4�r t C- L ;✓vwtp r rn� residing at ! 16l r` �P �C yle 11-4 (Print name) (.Address where you live) being duly sworn, deposes and states that(s)he is the applicant above named, and further states that(s)he is the legal owner of the property to which this Affidavit of Compliance pertains at; b A r J ,Rye Brook,NY. (Job Address) Further that all statements contained herein are true, and that to the best of his/her knowledge and belief, that there are no known illegal cross-connections concerning either the storm sewer or sanitary sewer, and further that there are no roof drains, sump pumps, or other prohibited stormwater or groundwater connections or sources of inflow or infiltration of any kind into the sanitary sewer from the subject property in accordance with all State, County and Village Codes. (Signature of P p r 0%%ner(s)) C Z, -r Print Name of Property Owner(sl) Sworn to before me this t day of � , 20 ry Iti'ot€isti Publicl SHARI 'MELILL0 Notary Public, State of New York No.01 ME6160(}63 Qualified in WestchF,ster County (2) Commission Expires January 29, 202L 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. STAOF NEW YORK,COUNTY OF WESTCHESTER ) as: Z ar n rl?r m cyl_,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. By signing this application, the property owner further declares that he/she has inspected the subject property, and that to the best of his/her knowledge there are no roof drains, sump pumps or other prohibited stormwater or groundwater connections or sources of infiltration into the sanitary sewer system on or from the subject property. Sworn to before me this �—1 Sworn to before me this Dc tb 6 c.tZ day of C- �-25� , 20_a�, day of o� ,20 Signature of Prope wner Signature Jf Applicant i t Name of Property Owner' Print Name of Applicant - K - J � 1r.1 Notary Public Notary Public SHARI MELILLO Notary Public, State of New York No. 01 ViE61 60063 GRACE FAMA NO"Public, State of Newyork 0,ialified in Westchester County No. 4959401 Commission Expires January 29.20t—L Commi l in Westchester County Expires November 27 2Q,.- (4) o� �n 3 N a N N 04 z tn �. N ,a 7 W" ►ter Mcpsg c 96o V 3 x D A rTl U t w Z oC O Q r4 p V y z r a oo z � a V ►z � �" � � � N of � P- z Q c � .. a, w a w d � D EC ENE BUILDING DEPARTMENT VILLAGE OF RYE BROOK DEC - 8 2021 938 KINCr STREJ."f RYE BROOK.NY 10573 (914)939-066 (914)939-5801 VILLAGE OF RYE BROOK wykW; BUILDING DEPARTMENT t�Fit ,ook.or g _ _. _...__._..._ ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY BP#: Q I—D O 7 FP#: / .3 Approval Date: DEC 8 OZ1 Permit Fee: S Approval Signature: Other: Disapproved: (fees are non-refundable) Application dated, 0� is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install an or r move electrical equipment, wiring, fixtures ,or to perform other high or low voltage electrical work as per the detailed statement described below. The applicant & property owner, by signing this document agree that all electrical work performed will be in conformance with all applicable Federal, State,County and Local Codes. 1.Address: SBL: S, S "' 6 0 Zone: _ 2.Property Owner: G 9 Li Address: 16 A re1 le, Ao Phone#: Cell s wy nI S 4 email: 3.Master Electrician: 14 �i Address: 3 j e ,� ,f Cam, Ali Lic.#: %b Q Phone#: $w f' ILl Cell#:Pt%4 4(g0-4AJ�1 email: "ac cam Company Name: &64 &INaL 4 r Address: IV) ToA 31 (VAT 4.Proposed Electrical Work/Fixture Count: STATE O\F'NEW_YAORK,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 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 an)accompanying approved plans and specifications.as well as in accordance with the New York State Uniform Fire Prevention&Building Code.the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to before me this Sworn to before me this day of ,20 day Signature of Property Owner ignature of Applicant Print Name of Property Owner tGN-m of A plican t Notary Public Notary Public SHARI MELILLO Notary Public, State of New York No. 01 1 1:=61 r_,fiCO3 Qualif ed in Westch:ster County Commission Expires January 29.20 Westchester Rockland Electrical Inspection Services, Inc. « Phone: 914-347-3595 DO NOT WRITE HERE-FOR OFFICE USE ONLY 43 North Lawn Avenue �' / Fax: 914-�47-59� • Elmsford, NY 10523 �-� BUILDINq Mrr NO. TEMP# nE Sf' l CITY OR VILLAGE ZIP CODE TOWNS COUNTY I STREET AND NO.OR RO n POLE NUMBER c � BETWEEN WHAT TWO CR EETS IS PREMISES LOCATED? SECTION BLOCK LOT C tV OCCUPANT'S NAME - BUILDING OCCUPANCY OWNER'S NAME AND ADDRESS HOME TELEPHONE NUMBER CURRENT SUPPLIED BY FROM THEIR OFFICE WORK TELEPHONE NUMBER 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 I j I`FL. DEC 2"FL. 3 FL. VILLAGE OF YE BR OK REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: C"a 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 SERVICE FEEDERS CHARACTER OF WORK NEW El ADDITIONAL G EXPOSED f] CONCEALED 0 MUST ENTER APPLICANTS IDENTIFICATION NUMBER SERVICE ENTERS BUILDING OVERHEAD C UNDERGROUND p, AVOID DELAYS BY GIVING FULL AND.ACCURATE INFORMATION.ALL SPACE MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. NAME OF COMPANY DATE OF APPUCATION [SIGNATURE OF APPLICANT STREET ADDRESS_ TELEPHONE NO. CITY OR POST OFFICE \`\ ZIP CODE LICENSE NO.WHEN APPLICABLE IF Ift MIESTCNESTER ROCKLAND ELECTRICAL INSPECTION INE15SERVICES,INC. BY THIS CERTIFICATE OF COMPLIANCE THE Westchester Rockland Electrical Inspection Services 43 North Lawn Ave, Elmsford, NY 10523 914-347-3595 (Office) 1 914-347-3596 (Fax) CERTIFIES THAT Upon the application of: Upon premises owned by: GERARD VERNALI INC. Eric Zimmerman 37 TEMPLE ST NY, HARRISON 10528 Located at: 16 Argyle Rd Rye Brook, NY 10573 Certificate Number: 1034323 Section: 135.51 Block: 1 Lot: 60 BDC: Permit Number:EP:21-319-BP:21-287 A visual inspection of the electrical system at this premise described as a Residential occupancy,wherein the premises electrical system consisting of electrical devices and wiring,described below,located in/on the premises at: 16 Argyle Rd Rye Brook,NY 10573 Basement list Floor 2nd Floor 3rd Floor Garage ❑Attic Outside Other: Inspection was conducted in accordance with the NYS and NFPA 70-2017 International Electrical Code and detail of the installation,as set forth below,was found to be in compliance therewith on 04/25/22 Name Type Quantity Receptacle GFCI ------- 2 Exhaust Fan ------- 1 Fan/Light Combo ------- 1 Fixture-Luminaire Incandescent ------- 5 Switch Single Pole ------- 6 This Certificate has been approved by Westchester Rockland Electrical Inspection Services. IllThis certificate may not be altered in any way. Y" ���L A This certificate is valid for work performed before date of inspection only. I I t t t � o p - M a z tn ° v F c N = w a W O o _ t, �c ON0-4 _; m •: ' ; x _ tn 96 at � O W � /Y► r�i O S [ t' M � 0-4 � a F oo ISO OM� VA w M MCI i u v w Cfl W Z PJ z M � OIN o ce I--, to 00 < o UGv.l U 7 04 zIt V o w 4t 14 92 1-1 > o m �••� F� Z Q u ` ram~ s �i---• ^w O W � m � O � A C7 a4 .a OC1 LL = �n R BUILDING DEPARTMENT NOV 2 4 2021 VILLAGE OF RYE BROOK VILLAGE OF RYE BROOK 938 KING STREET RYE BRooK,NY 10573 , BUILDING DEPARTMENT (914)939-066 A�cT � )939-5801 www.r �ok.or PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP#: ape )'T 7 PP 9 7 DEC - 1 021 �DJ�'��Approval Date: Permit Fee: � Approval Signature: Other: Disapproved: (fees are non-refundable) Application dated, 11//24/21 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: 16 Argyle Road SBL: 5/—/-100 Zone:Xa— Z 2.Proposed Work: Install and or relocate as needed, waste and water lines for three existing full bathrooms. 3.Property Owner: Eric Zimmerman Address: 16 Argyle Road Phone#: Cell #: 914-582-7754 emailezimmerman(UD-eztutorin�service com 4.Master Plumber: Salvatore W Morlino Address: 1 Bonwit Road Rye Brook NY 10573 Lic.#: 725 Phone#: Cell#: 914-260-1592 email: salvatoreserious@gmail.com Company Name. Westchester Plumbing And Heating Address: 1 Bonwit Road Rye Brook NY 10573 INDICATE FIXTURES& LINES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: Location Water Urinals Drinking Sinks Showers Bath Laundry Domestic Fire Sanitary Natural/ Other* Total Closets Fountains Tubs Tubs Service Service Sewer LP Gas Basement 1 1 1 3 1 st Floor end Floor 2 2 1 1 6 3r Floor 4'Floor 51 Floor Exterior 5.* List Other Equipment/Provide Details: Homeowner is remodleing three bathrooms with fixtures in same location, and converting a tub to shower in one location. (Notarized Signatures Required Next 2 Pages) -I- 3/21/19 STer,-'c- OF NEW YORK,COUNTY OF WESTCHESTER ) as: 7i'l,�n1°yt ,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. Sworn to before me this 9 Sworn to before me this tl day of N0'14r��- ,20 day of •41'4V✓ ,20 � Signature of r perty Owner Signature of Applicant Print Name of Property Owner Print Name of Applicant i Notary PublirNotary Public, State of NewYork Notary Public No. 01 IAF61 I,7),r:C53 ,R!\%'ME MORLINO Q iafiiied in Westchester County ;.v PLI"c 6toie of York Commission Expires January 29.20 3 ;•;cN,01M0601IM "ieHd in WeetdMftrGOMIY This application must be properly completed in its entirety and must-includd,*640 i 4t Aks) of the legal owner(s) of the subject property, and the applicant of record in the spaces provided. Applications not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. -2- sn2n021 BUILDING DEPARTMENT D 0 V" LE VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK,NY 10573 NOV 2 4 2021 4 -0 VILLAGE OF RYE BROOK BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE §216 • STORM SEWERS AND SANITARY SEWERS THIS AFFIDAVIT MUST BEAR THE NOTARIZED SIGNATURE OF THE LEGAL PROPERTY OWNER AND BE SUBMITTED ALONG WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION. ANY BUILDING OR PLUMBING PERMIT APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETURNED TO THE APPLICANT . STATE OF NEW YORK, COUNTY OF WESTCHESTER ) as: _ � I 4r f uz, ,/'°1 , residing at, i`w C roc' (� -u (Print name) % (Address here.ou liar) 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; Ik AgA 9d , Rye Brook,NY. (rob nadress) 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. (Signature of Pr fly Owner(s)) C.0 Z �M (Print Name of Property Owner(s)) Sworn to before me this da zJ\J0� f�`��f'l , 20 _ � SHARI MELILLO Notary Public, State of New York No. 01 I;iE616,"C3 _3_ Q'_1ali;ed irI Westchester Couniy Commission Expires January 29.20_a2 8/12/2021 Building Permit Check List&Zoning Analysis Address: b -A t ;t, . SBL: Zone:-1 "j Use: �/'D Const.Type: Other. Submittal Date �4' Z Revisions Submittal Dates: Applicant: 7 1 V--,"`\ Nature of Work: 1J V1,_Z(L U 4 Reviews:ZBA: N 0 V - 1 2 0 21 PB: BOT: Other. bMW OK ( ( ) FEES:Filing. 75,4;> BP: �' �. — C/O: Legalization: ( ) ( yy APP: Dated: `,*' Notarized. ✓ SBL: ./ Truss I.D. Cross Connection: ✓ H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening. ( ) ( ) ENVIRO:Long Shore Fees: N/A: ( ) ( ) SITE PLAN:Topo: Site Protection: S/W Mgmt.: Tree Plan. Other. ( ) ( ) SURVEY:Dated: Current: Archival:- Sealed: Unacceptable ( ) (✓f PLANS:D Stamped Sealed: Copies: Z Electronic. Other. (� ( ) License. t' Workers Comp: we" Liability Comp.Waiver: Other. ( 3 ( ) CODE 7S3#: Dated N/A: (✓) ( ) HIGH-VOLTAGE ELECTRICAL:Plans: Permit: N/A: Other. ( ) ( ) LOW-VOLTAGE ELECTRICAL:Plans: Permit N/A: Other. ( ) ( ) FIRE ALARM/SMOKE DETECTORS:Plans: Permit H.W.I.C.:_Battery:_Other. PLUMBING Plans: Permit Nat.Gas: LP Gas: N/A/: Other. ( ) ( ) FIRE SUPPRESSION:Plans: Permit: N/A: Other. ( ) ( ) H.V.A.C.: Plans: Permit: N/A Other. ( ) ( ) FUEL TANK:Plans: Permit: Fuel Type: Other. O O 2020 NY State ECCC: N/A: Other. ( ) ( ) Final Survey Final Topo: RA/PE Sign-off Letter. As-Built Plans: Other. ( ) ( ) BP DENIAL LETTER: C/O DENIAL LETTER Other. ( ) ( ) Other. ( )ARB mtg.date: approval: notes: ( )ZBA mtg.date approval: notes: ( )PB mtg.date: approval: notes: REOLMED EXISTING PROPOSED NOTES APPROVED A� DADA• NOV - 1 2021 Circle: Fr n e Froru: Front: R Main Cov Accs.0 v Ft.HS : Sd.H/Sb -GEA. Tot.Imp Ft Imp: Hag /stories: notes: Laura Petersen From: Laura Petersen Sent: Thursday, November 4, 2021 11:55 AM To: madhatterbuildingdesign@gmail.com Subject: Building Permit Application - 16 Argyle Road Good morning, The building permit application has been approved by the Building Inspector. Before I can issue the building permit the following items must be submitted to our office, /1. General contractor's valid liability insurance (the Village Of Rye Brook must be the certificate holder) f2. General contractor's valid workers compensation on a NY State Board form W105-2 or U26.3) 3. Building permit fee $180.00 (due once permit is issued and ready for pick-up) This information can be emailed to me. Thank you Laura Laura Petersen Office Assistant Village of Rye Brook 938 King Street Rye Brook, New York 10573 Phone(914)939-0668 1 Fax(914)939-5801 1 li)eterseneryebrook.org 1 • 1 nq� \ � ��~ 11�^�£ty'��� � ssi�l/1/iiif �"���ih/llll/i :•�ii0/11ii��' .•� /�i110i�i 1'��/i/ ^i � ` _ hi111is�h. �i i s=:`;:h► J �:-_�i!.li,�,. _ e Ni �'' � n10 21 �y Ny ys CN •'71 y t3 Ir r d 'V) .� T• ' C L V � :v - t. � ` "A n cu cG cC O CO 88 O Q � . •� i•.I J � = ti�3zfi ` mw co co All C) (tom)) LLI � •� r r 1 Qca LLJ 4-4 ow � a N w O �Ga� •t1e ff O w 00 o :� F, �e aQ : h \ Q N w OZ QU 00 4G \ s«tsDD� y � 4) � •�� � \ R cc ci cz r ae _ Oi? MI =�•� � ON mn+D>' -+.. � -. � t i � � --,ems..i/ 1�s----^-rc iil,lii --c' ;�_•� 1 v s ��,.' 1 - _ a ,_ .y11 1 _ 1 7i�,1'�`I,�q . . � ��� a; n T✓ �� t. A ,3.v\•� •P' '��' 1-1 ` ° - O 3� '� 'T ,£' :r� - � �fi�r�is f�rr�Jr- � if r c,. r r _•:[��.v -��`7 '' 40033180 Madhatter Building&Designs LLC Certificate Of Insurance 11/5/2021 3:03:57 PM A ® 7DATE(MWDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE /5l2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER CONTACT NAME: PHC NNo Ell: 833 2509900 A/C No): E-MAIL BIN Insurance Holdings,LLC ADDRESS: 30 N.LaSalle,25th Floor Chicago,IL 60602 INSURERS AFFORDING COVERAGE NAIC# INSURER A: Evanston Insurance Compariv 35378 INSURED INSURER B: Evanston Insurance Company 35378 Madhatter Building&Designs LLC INSURER C: 28 PEMBERWICK RD,GREENWICH,CT,06831 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MMIDD/YYYY MWDD/YYYY ✓ COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE IV] PREMISESS OCCUR DAMAGE ( RENTED 100,000 Ea occurrence $ MED EXP(Any one person) $5,000 B 3AA515924 10/23/2021 10/23/2022 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 ✓ POLICY PRO LOC PRODUCTS-COMP/OP AGG $2,000,000 JECT OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea $ accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Par accident) E NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident ✓ UMBRELLA LIAB ✓ OCCUR EACH OCCURRENCE $5,000,000 A EXCESS LIAB CLAIMS-MADE MPXS3003475 10/23/2021 10/23/2022 AGGREGATE $ 5,000,000 DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABIUTY YIN STATUTE I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICEWMEMBER EXCLUDED? ❑ N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ DESCRIPTION OF OPERATIONS I LOCATIONS I 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 The Village of Rye Brook THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 938 King Street ACCORDANCE WITH THE POLICY PROVISIONS. Rye Brook,NY 10573 AUTHORIZED REPRESENTATIVE r)40QQ-I)AIA Ar-nDn r1r1D0r1DATIn KI All ZSW Workers' Certificate of Attestation of Exemption A n Compensation from New York State Workers' Compensation and/or Board Disability and Paid Family Leave Benefits Insurance Coverage "This form cannot be used to waive the workers'compensation rights or obligations of any party." The applicant may use this Certificate of Attestation of Exemption ONLY to show a government entity that New York State specific workers'compensation and/or disability and paid family leave benefits insurance is not required. The applicant may NOT use this form to show another business or that business's insurance carrier that such insurance is not required. Please provide this form to the government entity from which you are requesting a permit,license or contract. This Certificate will not be accepted by government officials one year after the date printed on the form. In the Application of Business Applying For: (Legal Entity Name and Address): Building Permit MadHatter Building&Designs LLC From:Village of Rye Brook 28 Pemberwick Rd Greenwich,CT 06831-5042 PHONE:9144844-3501 FEIN:XXXXX5208 The location of where work will be performed is 16 Argyle Road,Rye Brook,NY 10573. Estimated dates necessary to complete work associated with the building permit are from November 5,2021 to January 14,2022. The estimated dollar amount of project is $25,001 -$50,000 Workers'Compensation Exemption Statement: The above named business is certifying that it is NOT REQUIRED TO OBTAIN NEW YORK STATE SPECIFIC WORKERS'COMPENSATION INSURANCE COVERAGE for the following reason: The business is a LLC,LLP,PLLP or a RLLP;OR is a partnership under the laws of New York State and is not a corporation. Other than the partners or members,there are no employees,day labor,leased employees,borrowed employees,part-time employees,unpaid volunteers(including family members)or subcontractors. Partners/Members: Giroloma A Fama Disability and Paid Family Leave Benefits Exemption Statement: The above named business is certifying that it is NOT REQUIRED TO OBTAIN NEW YORK STATE STATUTORY DISABILITY AND PAID FAMILY LEAVE BENEFITS INSURANCE COVERAGE for the following reason: The business MUST be either: 1) owned by one individual; OR 2) is a partnership(including LLC, LLP,PLLP,RLLP,or LP)under the laws of New York State and is not a corporation; OR 3) is a one or two person owned corporation,with those individuals owning all of the stock and holding all offices of the corporation(in a two person owned corporation each individual must be an officer and own at least one share of stock); OR 4) is a business with no NYS location. In addition,the business does not require disability and paid family leave benefits coverage at this time since it has not employed one or more individuals on at least 30 days in any calendar year in New York State. (Independent contractors are not considered to be employees under the Disability and Paid Family Leave Benefits Law.) I,Giroloma A.Fama,am the Member with the above-named legal entity. I affirm that due to my position with the above-named business i have the knowledge,information and authority to make this Certificate of Attestation of Exemption. i hereby affirm that the statements made herein are true,that I have not made any materially false statements and I make this Certificate of Attestation of Exemption under the penalties of perjury. I further affirm that I understand that any false statement,representation or concealment will subject me to felony criminal prosecution,including jail and civil liability in accordance with the Workers'Compensation Law and all other New York State laws. By submitting this Certificate of Attestation of Exemption to the government entity listed above I also hereby affirm that if circumstances change so that workers'compensation insurance and/or disability and paid family leave benefits coverage is required,the above-named legal entity will immediately acquire appropriate New York State specific workers' compensation insurance and/or disability and paid family leave benefits coverage and also immediately furnish proof of that coverage on forms approved by the Chair of the Workers'Compensation Board to the government entity listed above. SIGN I i" / HERE Signature: ( �t� Date: ae- Exemption Certificate Number Received 2021-069728 November 5, 2021 NYS Workers'Compensation Board OCT 2 9 2021 VILLAGE OF RYE BROOK BUILDING C.TMf r C—'n T O IL � n G� l.0 I ..09 -- PERMIT!&������7 SBL# 13S. -5:� I - LFILE COPY DATE APPR NOV BUILDING IN AEC o/Ryo Brook,NY rh 0 D °. II low' i LOCI 2 9 2021 D --____---� VILLAGE OF RYE BROOK 990z BUILDING DEPARTMENJD 11 I I I I I I I tL :Oo J ..Zz:/L zs ME �-- s s i .09