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HomeMy WebLinkAboutBP21-289PERMIT # 4 ��-'��/. DATE: / / � EXP: SECTION 13S, BLOC * LOT ZOO TYPE OF WORK e/301 �7yreJam( Q s Ze JOB LOCATION OWNER 0rn k7 / rnAnTno A�fi'lrl 7�E�� k/I/� /,�iQ W //EST. COST VCO# C DA TCO # __ FEE DATE INSPECTION RECORD DATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING - INSULATION PLUMBING RGH PLUMBING GAS SPRINKLER /t FLECTRIC LOW -VOLT 0 ALARM AS BUILT 0 FINAL � ?C.e,& 4j ) 7�Szl _67q 41 ��� ra`al Varna /I OTHER APPROVALS ARB I3�?T . �•B zB� OTHER VILLAGE OF RYE BROOK WESTCHES'�',� COUNTY, NEW YORK >> NO: 22-066 Certificate of ®ccupaucp 'This is to certify that C.- ZI yY7 M-f r W atO of, Rye BrOOkA / V 7 having duly filed an application on -vY i 20�requesting a Certificate of Occupancy for the premises known as, Aa Argyle RGCO , Rye Brook,NY, located in a R—7 Zoning District and shown on the most current Tax Map as Section: l Block: Lot: LO0 and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No. C.2/'a , issued / 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: /�-3 / Dne- ,6az"/ I Y Construction: 2B for the following purposes: 11e y- ylpY m (Jan1-)aQ e0' P 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 ma 11 the building be moved from one location to another until a permit to accomplish such change has bee ob from the Bui g Inspector. Building Inspector,Village of Rye Brook: Date: MAY - 9 2022 D E ro", B U I L D I I A T M E N T For office use only: VILLAGE OF RYE BROOK PERMIT # _ �/—a8� APR 2 5 2022 938 KING STREET,RYE BROOK,NEw YoRK 10573 DATE: LBUILLAGE OF RYE. BROOK (914)939-0668 FEE: PAID 13 DING DEPARTMENT ww2-rygbr9ok.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 /i/tt►►t►►►tt►►t►►►►►\\\/►\\\■tt\■t\\\t►►►►t►itt►ttl►■ttlt►►t►t►\\\\►ttt\■t/\/tt►►I►►♦tt►►►►\ttt■t•■tttt►►►►t►►ttt1►\►►tt\\t\ Address: /6 621(e Occupancy/Use: Parcel ID#: 13,5 , D / Zone: Owner: /ery�.oLL�',� Address: P.E./R.A. or Contractor: ( �d!7. Address: PG^�erw l Person in responsible charge: l � °� Address: �- 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 rOF NEW YORK,COUNTY OF WESTCHESTER as: �p Q r' C- z-n'��,r^c-being duly swom,deposes and says that he/she resides at `J7 (Print Name of Applicant I �p� (No.and Street) 3 in )Q y C ro a ,in the County of �Q AC-G S�" in the State of ,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:$ 32, 0 o v for the construction or alteration of. -d— t e )I (-6L 3-P,@C-e 117�00% — Deponent further states that he/she has examined the approved plans of the structure/work herein referred to for which a Certificate of Occupancy/Compliance is sought,and that to the best of his/her knowledge and belief,the structure/work has been erected/completed in accordance with the approved plans and any amendments thereto except in so far as variations therefore have been legally authorized,and as erected/completed complies with the laws governing building construction.Deponent further understands that it shall be unlawful for an owner to use or permit the use of any building or premises or part thereof hereafter created,erected,changed,converted or enlarged,wholly or partly,in its use or structure until a Certificate of Occupancy or Certificate of Compliance shall have been duly issued by the Building Inspector as per§250-10.A.of the Code of the Village of Rye Brook. Sworn to before me this Q"� Sworn to before me this day of ,20 a day of , 20 N- 4-1 Si�ature of Prope66.vner Signature of Applicant Name of Property Owner Print Name of Applicant ,\&�' L� . �i— Notary Public Notary Public SHARI MELILLO Notary Public, State of New York 8/12/2021 1110. 0'MiE6160063 Qualified in Westchester County. Commission Expires January 29,24 �E BROv�. SE 1982 BUILDING DEPARTMENT jAssiSTANT UILDING INSPECTOR BUILDING INSPECTOR VILLAGE 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:— G DATE: Z PERMIT# 2 ISSUED: SECT: � BLOCK: LOT: LOCATION: � � S�O�Z_��--'���-' 4 �Z -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 p L.P. GAS �- G ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ ROSS CONNECTION FINAL OTHER t �yE BRCv�, Q) BUILDING DEPARTMENT 1 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 . l 4a DATE: PERMIT#' _ ISSUED: SECT:4� BLOCK: LOT: LOCATION: OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑;q ROUGH PLUMBING ROUGH FRAMING INSULATION `n NATURAL GAS DL 1 — ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER Qy6 DRCw�• O�` tim ���� SCANNED '982 BUILDING DEPARTMENT ❑BUILDING INSPECTOR ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS C, \-CC�-- DATE: PERMIT# \V U �� ISSUED: SECT: BLOCK: LOT: LOCATION: ( z, 2 OCCUPANCY: I ❑ /VIOLATION NOTED THE WORK IS... ❑ ACCEPTED /REJECTED/REINSPECTION ( ❑ SITE INSPECTION /�O REQUIRED ❑ FOOTING S ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION } ❑ NATURAL GAS ❑ L.P. GAS Q f r ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER OC C �C �'l�c cbzJ n CL.Q- i M : N • N N ar 0 ■ � � W � O 00 pp N Ems. •� � �-+ o Ocu U M � • w � � � y bA to CL ^` O . ■ 96 7 o U. a ■ O = � MM p ys > L � c 1 c in qe �+ w FBI C o �cs . L� • ot C p g p O ° o y � .° 'i. ■ -a .Ei C4 W p 0 eu W W 00 z 3 � � 00 .7 9 e 7 w 1 77 "o 25 ,UL, �L -J co � !2c- B V W r A i @ � ob o � o V0-0 W � 0 1Et � Ea cpk4 V oo O � O ICI I--I Q z 6 '� V Oa ■ OEM 00 W W }w c�c u i > o E W @ � !�1 E A z a y ■_ CM E > ° VERO a W @ 8 � q `o ro v BUILD �D s MENT VIL �GE OF RY OOK r 938 KING EFT RvF,R NY 10573 �CT 2 9 2021 (914�939-0 _ VILLAGE (DF RYE BROOK BUILDINI 0FPARTI��ENT _. I INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: Approval Date: NOV - 6 Permit#:6PQ1 d'J Application Fee: $ _ Approval Signature: Permit Fees: $ Disapproved: Other: Application dated: IO OZ q d l is hereby made to the Building inspector of the Village of Rye Brook,NY,for the issuance of Permit for the interior alteration of an a isting wilding,or for a change in use,as per detailed statement described below.1. Job Address: le RCQA SBL:/3J e 5/—/—r- 0 Zone: 2. Proposed Improvement. (Describe in detail): RP i,ns �l� C-ryix'21 e 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 11: TIER Ifl: 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:X Yes: (If yes,please submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans) 5. Occupancy;(1 fam„2 fam.,comm.,etc.,.)Prior to Construction: ) M . After Construction: V-Cc WI G. N.Y State Construction Classification: N.Y.State Use Classification: 7. Property Owner: ErCL Address: 1(o Phone# Cell# C//��58c-,-7?S 7 email: p 8. Applicant: M�(1, Ac ler t� Int'i l'eS Address: Q�►i'J�. C �`>,� 1C, K-CI . Phone# Cl 1 L{ cbW4 - 3 s-b j Cell# email: Metd�l�e r hu ilCV inn) e1Qw 9. Architect: Address: Phone# Cell# email: 10. Engineer: Address: Phone# Cell# email: 11. General Contractor: (rat'RO C 044 W Eiq-W/q Address: 2 @?nq6er-Lok'C-L Rd . Phone# q y - R LI q -;94 Cell# email: 12. Estimated cost of construction $ 30 1 000 (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: (az r4",-14k (1) BUILD NMNT �� `� ILE 11 ti h c V11L OF RY OOK 938 KfNG ET RYE BR NY 10573 OCT 2 9 20s1 d _p VILLAGE OF RYE: BROOK Pl "" DING r3EP.ARTMENT 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 OFNEW YORK, COUNTY OF WESTCHESTER ) as: 1 , residin p _, residing at, J {Q /\ �Je �"'k (Print name) A ress 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; r b /1 LF _ d , 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 Propee y wner(sl) (Print Name of Property Owner(s)) Sworn to before me this D� day of (Notary Public) SHARI MELILLO Notary Public, State of New York No. 01 ME6160063 0,+alified in Westchester County 2 Commission Exnires January 29. 20 { ) 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,�C,OUNTY OF WESTCHESTER ) as: i r01 o V%a 9cX.M& ,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 i r of Uryt Q ;CL M Lt 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 :r-1 Sworn to before me this Qc7o gak— day of � ,20 ^l_\ day of , 20 Signature of Owner Siig+na ofApphcant EL,C- � i✓�'J%k�t/I CC')i ro 10 rVLO,- i-e'Yv'c1— Print Name of Property Owner Print Name -of•Applicant �� . UL tN Notary Public Notary Public SHARI MELILLO Notary Public, State of New York No. ofreste 111AiCE��� Q�lalii�ied in Westchester ster County, Commission Exoires January 29.20� MItCh9 (4) 3/21119 AFFIDAVIT IN SUPPORT OF FEE WAIVER RELATED TO HURRICANE IDA STATE OF COUNTY OF LJ C j /C' 6-/- (insert name), being duly sworn, deposes and says 1. I am the applicant for a Building Permit /Certificate of Occupancy / Demolition Permit Electrical Permit/Plumbing Permit/ Fence & Wall Permit Mechanical Permit/Pod Permit (circle all that apply) 2. I am the legal owner of property located at /� iq!"-` � /� J Rye Brook, New York(insert street address) OR I am the (Architect/Contractor/Engineer/Attorney) (circle one)for the legal owner of property located at l °` - , Rye Brook,New York and I am duly authorized by property owner to make and file the accompanying application. 3. The following is a description of(1)the work to be performed under the permit for which I am applying; and (2)how the work arose as a direct result of Hurricane Ida: r � �t -to Cf a.y 4. The work described herein arose as a direct result of Hurricane Ida and does not include Work which was not caused by Hurricane Ida. Sworn to before me this Day of , 20 a\ %�"-�j aL i Notary Public [,C a �W IE SHARI MELILLO Notary Public, State of New York No. 01 ME6160063 OCT 2 9 2021 QL ia1i`ieci i„Wrstchester County . Commission Expires Jinuary 2.9 20 VILLAGE OF RYE BROOK BUILUNG DEPARTMENT O t N clq oC • W ° o• C9 v M > Q OG 9696 Wcr, M 10 1200 Z _ 000 t W >• r-� °w " 3 r • = y Q Q Q (� co o. w $ ON t W z z �n a v rcn, �% 'tgz w Ole Z w � •• ° w aw, 3 as Q I 0�0 Cam. rZ.i = wii t yt✓ BRC�v� D Bum R MENT VIL E OF RYE OK SEP 2 7 2021 938 KIN ET RYE BR ,NY 10573 (914)9 1 939-5801 VILLAGE OF RYE BROOK n ..org BUILDING DEPARTMENT ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY BP#: F.P#: r^ fl yO Approval Date: I WA - Permit Fee: S)) Approval Signature: SEP 2 B Other: bj01✓'ec�---'r Q Disapproved: (fees are non-refundable) Application dated, /'G)7-o�/ is hereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of a Permit to install and/or remove 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/Coddes. /� 1.Address: Y G ". SBL: /Js.i�I-��1p0 Zone: /C-7 2.Property Owner: Erf-L Zi►,o.r e./K.n Address: y1. Aqy le- Phone#: Cell#: `j/y- S8 2---77Sy email: 3.Master Electrician: 6e'r-" V e rn d i Address: 7 '�u, ,[e- seLre-G,t {_ "rjs o Y) NY lot LB Lic.#: C160 Phone#: q1Y-73r-111j- Cell#: YJY- Y90-'VZo/ email: q✓GrneL*-t/rrnk�ti'te,c4zn If Company Name: Ge ra,uo( VeXyi a 4' Inc. Address: 3? T.GNnelc S He ej � 9A4-r,Jon�A)y /Ofe p 4.Proposed Electrical Work/Fixture Count: L Qro" jew!q dae h o& t- d1AptA?x STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: 6e-Y-"01 Ve-rr?Jl It' 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 l.o►'I- ra cab 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 before me is day of ,20 day o 20 Signature of Property Owner §ignature 6f Applicant X 5!e,,- ,/�i/� Print Name of Property Owner Name of ApplicanlK Notary Public NZifatry Public SHARI MEULLO Notary Public,State of New York No.01 ME6160063 Qualified In Westchester County Commission Exolres J^iuery 29 2C 6/1/1 g Westchester Rockland Electrical Inspection Services, Inc. �� Phone: 914-347-3595 LT y DO NOT WRITE HERE-FOR OFFICE USE ONLY 43 North Lawn Avenue fit✓ Fax: 914-347-3596 Elmsford, NY 10523r� BUILDING PERMIT NO. TEMP H DATE CITY OR VILLAGE ZIP CODE TOWNSHIP COUNTY STREET AND NO.OR ROAD POLE NUMBER BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? SECTION BLOCK LOT 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 I'FL. 2'FL. 3'FL, B OOK REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: """" - ----- dU t' 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 APPUCATIONS 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 Zoo �mP CHARACTER OF WORK NEW❑ ADDITIONAL❑ EXPOSED❑ CONCEALED❑ MUST ENTER APPLICANTS IDENTIFICATION NUMBER SERVICE ENTERS BUILDING OVERHEAD-©. UNDERGROUND EI [ -L I ' AVOID DELAYS BY GIVING FULL AND.ACCURATE INFORMATION.ALL SPACE MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. NAME OF COMPANYSIGNATURE OF APPLICANTt DATE OF APPLICATION !, 71 �/ X STREET ADDRESS TELEPHONE NO. CITY OR POST OFFICE I KWM NO.WHEN APPLICABLE f AFFIDAVIT IN SUPPORT OF FEE WAIVER RELATED TO HURRICANE IDA STATE OF COUNTY OF �, Q'A t� ��j. (insert name), being duly sworn, deposes and says 1. I am the applicant fora Bu' it/Certificate of Occupancy / Demolition Permit ectrical Permit/ mbing Permit/Fence & Wall Permit Mechanical Permit/Pod Permit(circle all that apply) 2. I am the legal owner of property located at Rye Brook, York (insert street address) OR I am the (Archite t/Contra or/Engineer/Attorney) (circle one) for the legal owner of property located at h YP�� p , Rye Brook, New York and I am duly authorized by property owner MQCAW to make and file the accompanying application. 3. The following is a description of(1) the work to be performed under the permit for which I am applying; and (2)how the work arose as a direct result of Hurricane Ida: 4. The work described herein arose as a direct result of Hurricane Ida and does not include Work which was not caused by Hurricane Ida. Sworn to before me this Notary Public SHARI MELILLOL ID ' D Notary Public, State of New York No. 01 ME616-C63 0"alified in'Westchester County SEP 2 7 2021 Commission Exr,ires J-nupry 29 ?0 a� VILLAGE OF RYE BROOK BUILDING DEPARTMENT 17- in WESTCHESTER ROCKLANO ELECTRICAL INSPECTION WREIaSERVICES'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: 1034324 Section: 135.51 Block: 1 Lot:60 BDC: Permit Number: EP:21-240-BP:O 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 12 Basement 1st 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 Switch Single Pole ------- 20 Receptacle Convenience ------- 28 Fixture-Luminaire Incandescent ------- 25 Receptacle GFCI ------- 2 Replace Panel Main 20OAmp 1 Sub Panel 20 Circuit Replace 1 Exhaust Fan ------- 1 Circulator Pump 1/3 HP 4 Electrical Heater Unit 2 Foot 1 Electric Heater Ceiling Unit ------- 1 This Certificate has been approved by Westchester Rockland Electrical Inspection Services. This certificate may not be altered in any way. This certificate is valid for work performed before date of inspection only. • �(1 �!] !�. . ( �( ■ �'( �(,i �T f( ! ! fit, e ■ �a, a �! �(�j ! �( �!,�(, �f P ii O O � 04 M p r Q� O E L�■7 � � N C F`L,., ■ O w '-' '" a ¢ W Q � � � C • �1 a w w - � w j• 3 � � � � � 3s O wtr) u o!v U { w ¢ O cn� w v W r, � 3 0 16 C' w co Ln 16 U m oe = � < QI m 0.4 DD BUILDING DEPARTMENT NOV 2 4 2021 VILLAGE OF RYE BROOK VILLAGE OF RYE BROOK 938 KING S'rttla f RYt-Bw)m NY 10573 BUILDING DEPARTMENT (914)939-0668#Ax(914)939-5801 '- w%%%%.ryebruok.org PLUMBING PERMIT APPLICATION F(111 (►I I I( l l tiF, O`1.1 IS , p��—�J t &Ql-� i)vDEC - 7 Z021 Approval Date: Permit Fee: S Approval Signature: Other: Disapproved: (fees are won-refundable) Application dated, 11//24121 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: /3S.5/—/—/I0 Zone:47 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 eztutoringservice.com 4.Master Plumber: Salvatore W Morlino Address: 1 Bonwit Road Rye Brook NY 10573 Lic.#: 725 Phone#: Cell #: 914-260-1592 email: salvatoresedous@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 Laundn Domestic Fire .anitan Naturali Other' Tot>tl Closets Fountains Tubs I ohs Service Service Sc%%er IT Ga% Basement 1 1 1 3 I st Floor 2nd Floor 2 2 1 1 6 3` Floor 4 Floor 5 Floor Fxterior 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) STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: k—r,`C Z;t„�nloyx ,being duly sworn,deposes and states that he/she is the applicant above named, (print narne 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,attomey,etc.) That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention& Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to before me this 9 Sworn to before me this �i/ day of NJ V�e��eT ,20�� day of �I/U✓ ,20�_ L —K�I— 5:2 Signature of perty Owner Signature of Applicant Z LfL /-� Print Name of Property Owner Print Name of Applicant C2� Notary Publi �. Notary Public �IVotaryf��.;�.�:� , .w Yor i: tO,S'M MORLINO r - r _^ 'y 3 Public,SUP*M NOW York COmriissbncAOu(I5 jai„Jr, : 3 �_� MI01MOe0111M •,".'ed in Weeteho"0'01 This application must he properly completed in its entirety and must incht!ide,*6*xu.rm*M"I4, 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 he deemed null and void and will be returned to the applicant. -z- s1t2 202t BUILDING DEPARTMENT VILLAGE OF RYE BROOK 938 ICING STREET RYE Bttom,NY 10573 NOV 2 4 2021 VA4 Li" VILLAGE OF RYE BROOK BUILDING f?EPARTMENT TM 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 KILL BE RETURNED TO THE APPLICANT. STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: �, �,►' _ :�, uy, � , residing at, Punt n.r, . i i \ I,li. „ r.lirir fur li. i 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; 4 &;IA kC' , 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. t Stenaturr of lh-, r t t',n.:'1,1 11'rinl \.into..I I'i,l�it t tn_it.i Sworn to before me this t, 20 _ t\,qap. I'uhlt t SHARI AELILLO Notary Public. StntE,of^lewYork peat'i�ad in Westch-...ar Cc+tmfv Commission Exnires Janw ry 29 2^ 3 9/12/2021 Building Permit Check List&Zoning Analysis Address: l QO A,RG Y l-P--�17 SBL: Zone _I�-�Use 'lid Const Type Other: Submittal Date: l Z l Revisions Submittal Dates: Applicant: 7, l y'L L t F�v-\4 t—� Nature of Work: ­13 Ate/`- &C>rL- 3 �c - A vi w :ZBA: N O V - 1 2021 PB• BOT• Other. NEED O ( ) ( FEES:Filing._�BP: C/O: Legalization: P ( ) (,4,'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 MgmG: Tree Plan: Other. ( ) ( ) SURVEY:Dated Current Archival: Sealed Unacceptable: PLANS:Date Stamped ✓Sealed Copies: —7--FlectroniC Other. ( ) ( ) License Workers Comp: Liability Comp.Waiver. Other. ( ) ( ) CODE 7S3#: Dated N/A: (� ( ) HIGH-VOLTAGE ELECTRICAL:Plans: Permit: N/A Other. ( ) ( ) LOW-VOLTAGE ELECTRICAL:Plans: Permit: N/A: Other. ( ) ( ) FIRE ALARM/SMOKE DETECTORS:Plans: Pemiir 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. ( ) ( ) 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: REQUIRED EYJSITNG PROPOSED NOTES APPROVED Am Date NOV - g 2021 �irsl� F� Front: Main Cor. Accs.Cov Ft.H/Sb: Sd.H/Sb: a&. Tot.in P *iW. HHdy /Stories ' notes: Vti Lg S� =2,20, o N 1 �9n, • V F?" v, ti , c, t( ( — ` IN *r• a; i wkw r Its I � h. � I art - y, 1 i O • t a- Fr 5 � - l 1 1 ... f a. • i li I F P' i t !MM t - R � �� �, �. y ��/ ��:;. .. /� '". �` . j _ _-_ ;. a ���� !.,l �� � <�'�� _' _ c �. ' 1 �. a �� ,�: �:{ =�` � �- t .��- - `s=��'� x ,� ., .� �� �=' �� � �; _ � . �; � � �'*,..� Y�y ILL I rum Al ~ •r AW F 4 L `S 1 �• .r'y^ • x52S3b 3br1152 • 011vog IOro vs A . n IVVOI d r. .a 6 { ,Af _ f ,P i $ j t O > ti+ G N LL3 O • a :a y p _ (' GO o L on" to > n C *-+ IL � 0 L � ions" .- �„ cA Q co = G O w o q z. .r'. y ❑ o c °C r_ion 4. i J p CO e a �g ` 4=0 Q N Xwz 1 4� _ 00. cc r• !� .r sad R ' � •ca�rr V "O,\ Y cc a► U `� C M .. lbl0>e��r.` . . � ,•.� r--7_�"�1 1�� rC'- -rci�..11j�l 11.,t,� m+r�r_: .� , �� ��- •+'1+1111 i 40033180 Madhatter Building&Designs LLC Certificate Of Insurance 11/5/2021 3:03:57 PM A��® DATE(MM/DD/YYYY) C CERTIFICATE OF LIABILITY INSURANCE 11/5/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER CONTACT NAME: _ __ PHO N E: : 833 2509900 FAX�, EMAIL BIN Insurance Holdings,LLC ADDRESS: 30 N.LaSalle,25th Floor Chicago,IL 60602 INSURERS AFFORDING COVERAGE NAIC A INSURER A: Evanston Insurance Company 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 LTR POLICY NUMBER MM/DD/YYYY) (MM/DDffY-YYI UMFTS ✓ COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE �OCCUR DAMAGE (Ea occurRENTED 100,000 PREMISESS r ence $ 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❑JET PO- LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea 'cent) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE 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'LIABILITY YIN STATUTE I I ER ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ W OFFICEMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 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 rn inast.on1e Amon f nDDnDATInM All ...­, 4 " Workers' Certificate of Attestation of Exemption sT�h Compewtion 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 28 Pemberwick Rd From: Village of Rye Brook 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.) 1,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 HERE Signature: n r��� Date: Exemption Certificate Number Re c ived November Sr 2021 : <' 2021-069728 ' NYS Workers'Compensation Board tiC > - AM bee i 7Z 4 ® oco o 0 1r� o ? a Z �- ZWL co W Z ry 1Y N� mQ u < 3 I (y � mo 0 � ¢ � a .Q �.91lb bZl � n I m m v `m T c 3 m t� - I. I ICP Lo cr- CO 0 C, L LU w��Qo 00 ZuJ L �O J � � CD .9 U L b56 I 2 O N ry fD I I I I E 3 rr a .� a 'a „9l/b bZl � In „8£ o I � o� 4 C 3 l6 J z ow I � I I kD m p c a UJ � I I ml