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HomeMy WebLinkAboutBP22-015PERMITIt —. DATE:-1�E—'�c� IXP: SECTION `- TYPE OF WORK JOB LOCAT� OWNER O CONTRACTOR_ . B�EST VCO # LOT %ice u� /dPs c/vie FEE DATE INSPECTION RECORD DATE INS P FOOTI N G FOUNDATION FRAMING RGH FRAMING �2 INSULATION _.�/ Z �'2 �' PLUMBING [�i Z ZZ 2ad RGH PLUMBING GAS - SPRINKLER ELECTRIC Ulm LOW-VOLT C7 ALARM AS BUILT O FINAL , Fpc)o- a 3®/zo CCCt9nin0 &eC741I C, ��THER APPROVALS ARB BOT PB LBA OTHER - VILLAGE OF RYE BROOK WESTCHESTER COUNTY, NEW YORK No: 23-194 (Certificate of Occupoucp Ehis is to certify that �l_JG T LU�1���/ 1 77jina-ra- &/n k� of, ko Al , having duly filed an application on 40 /2{ 20 requesting a Certificate of Occupancy for the premises known as, atfl /Q/mod Pa ad ,Rye Brook,NY, located in a Zoning District and shown on the most current Tax Map as Section: )CS5. Block: _L Lot: and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No. issued 20 , 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 3_ New York State Classifications,Use: / Construction: -L for the following purposes: 0� 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 b ob om the d g Inspector. DEC 1 1 2013 Building Inspector,Village of Rye Brook: Date: BUILD)EF IRg'MENT For office use onl PERMIT# ol—O) OCT 2 2�22 VILL, OF RYE �#�O,OK ISSUED: 93 KING STREE�,': YE BROOK,l�>' YORK 10573 DATE: VILLAGE OF RYE BROOK (914)9394"4kxj, 0)939-5801 FEE: 0 PAID0 BUILDING DEPARTMENT V*W - tod'k.or APPLICATION FOR CERTIFICATE OF OCCUPANCY / COMPLIANCE AND CERTIFICATION OF COSTS 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 shall have been issued by the Building Inspector. §250-10.A. Code of the Village of Rye Brook ****************************************************************************************** Address: 90 Old Orchard Road Occupancy/Use: Res �,L�ry Parcel ID#: /3 ­3�-T Zone: Owner: Tamara WVnton Address: 90 Old Orchard Road P.E./R.A.or Contractor: Address: Person in responsible charge: Salvatore W Morlino Address: 1 Bonwit Road Rye Brook NY 10573 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 herein mentioned in accordance with law: STATE OF NEW YORK,COUNTY OF WESTCHESTER as: Salvatore W Morlino being duly sworn,deposes and says that he/she resides at 1 Bonwit Road (Print Name of Applicant) (No.and Street) in Rye Brook, NY 10573 ,in the County of Westchester in the State of NY ,that (City/Town/Village) he/she has supervised the work at the location indicated above,and that the actual total cost was: $ $14,000.00 for the construction,alteration or repair of. Bathroom. Deponent further states that he/she has examined the approved plans of the structure 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 has been erected in accordance with the approved plans and any amendments thereto except in so far as variations therefore have been legally authorized,and as erected complies with the laws governing building construction. Sworn to before me this 1 L Sworn to before me this day of 0 GT , 20 '2 2- day of UL / , 20 7 Z Signature of Property Owner Signature of Applicant To/V Print Name of Property Owner Print Name of Applicant or Notary Public ty >� ` � Z� Notary Public r w�' v? •.n. -"�_-•— L, 7r7 17 �yE BRC�j�. cu � • 1982 N5 BUILDING DEPARTMENT rBILDING INSPECTOR ISTANT 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.or - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - -- - - - - - - - - - - - - ADDRESS : -I 0 O i A OrC�,,, R DATE: /Z - a - Z V L.3 PERMIT# '�D? Z 2- O/S ISSUED:A 2S-I SECT: Jj- BLOCK: l LOT: Z LOCATION: SeoG O J A �) d 02 1n a I I 6 'J" , OCCUPANCY: 210 ❑ Violation Noted THE WORK IS... M YASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ^✓� ,� G d-� ❑ Natural Gas ui ❑ L.P. Gas ❑ FUEL TANK ❑ FIRE SPRINKLER FINAL PLUMBING ❑ CROSS CONNECTION ©FINAL ❑ OTHER �E DR(bm.k. a tim 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: l� D`� � ` \/ DATE: v Z� -z PERMITJ;a Z Z -o l ISSUED: SECT: BLOCK: LOT: �J ter. LOCATION: /ill�� �j^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 Ej INSULATION �❑ NATURAL GAS ❑ L.P.GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER f = 9 ■ Ln o O eq o w N ` ■ N cr'v L9) 0 0 . C � r`r` ■ Z o p � `' a a 0.0 w p day �. ►-� N w A ~ LO O s >-� O n tn G CA c en Ln w Q N ao - te, a p, © a _ p 0 V (M■� ��// ��y b N co �o+p y o a ON Cs Uz ,� b � ° rf O w R Q u� 0 (V F+I liar-� �. Lin cm v U a c A. � cn o ° v . 0 ■ N fy b A x U o'ok Ho yE W O V C) O CV7 A z O A ° F ON O ° o � w z x A .. 5 CL z BUILDP_4-&J RA 'MENT VIL E OF R4, OOK JAN 21 2022 938 KING ET RYE BR4 ,PITY 10573 (914)93 ` _ (9 �39-5801 VILLAGE OF RYE BROOK �aL= ',RTA,DJT I INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: � Approval Date: J AN 2 Permit#: / Applica ]tion Fee:$ / 5-- v6b Approval Signature: Permit Fees:$ Z 10 . Disapproved: Other: Application dated: /—cl a c 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 existing building,or for a change in use,as per detailed statement described below. 1. Job Address- 90 Old Orchard Road SBL: 13 t5,3'5-6-) zone: 2. Proposed Improvement.(Describe in detail):Remodel 2nd floor bathroom with 4 fixtures in same location. Double sink,toilet and bathtub. 3. Does the proposed improvement involve a Horne-Occupation as per§250-38 of the Code of the Village of Rye Brook? No: x Yes: If yes,indicate: TIER 1: TIER II: 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...I :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: 1 family After Construction: 1 family 6. N.Y State Construction Classification: RES N.Y. State Use Classification: RES 7. Property Owner: Tamara Wont©n Address: 90 Old Orchard Road Phone#914-305-4854 Cell#914-305-4854 email: tamarawinton@yahoo.com 8. Applicant: Salvatore W Morlino Address: 1 Bonwit Road Rye Brook NY 10573 Phone#914-260-1592 cell#914-260-1592 email: salvatoreserious@gmail.com 9. Architect/Engineer: Address: Phone# Cell# email: 10. General Contractor: Salvatore W Morlino Address: 1 Bonwit Road Rye Brook NY 10573 Phone#914-260-1592 Cell#914-260-1592 email: salvatoreserious@gmail.com 11. Estimated cost of construction $ $14,000.00 (NOTE:The estimated cost shall include all labor,material,scaflirlding,fixed equipment,professional fees,and material and labor which may be donated gratis.) 12. Job Timetable:Start: January 28th 2022 Finish: March 10th 2022 -1- 2l26118 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: Salvatore W Morlina ,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 Contractor 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,stump 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 16 Sworn to before me this 16 day of January , 20 22 day of January , 2022 Signature of Property Owner Signature o Applicant d Tamara W*nton Salvatore W Morlino Print Name of Property Owner Print Name of Applicant - Notary Public i - �yV �xry�r Notary Public .r°.e'�{�, �1;: Ursa �•i,,1,. .,tl��� ��i 3s -2- 2126/18 Q E. 0 LIVE BUILDING DEPARTMENT VILLAGE OF RYE BROOK 'd 2 ZQ2 938 KING STREET RYF,BR©D NY 10573 �--- (914)9;19-0656 VILLAGE OF RYE BROOK �y BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE §216 • STORM SEWERS AND SANITARY SEWERS THIS AFFIDAVIT MUST SEAR 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:: n 41"/ . 1 'li �14t , residing at, �f(/ 0 Z � (�/�C�A, 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; L ,�� ,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 Property Owner(s)) k.L�. 1 (Print Name of Property Owner(s)) Sworn to before me this Z day of Jaen. , 20 :22 ;tc,$ 4 Y 0 2 7� (Notary Public) .yi' FXs, - '.,.4: • a, (2) sn 2/2021 N Ln Ln W a o F' y k N en O ,a low :i. en U LLl O s � U i eno F. W °°�, z' � � O .�.. A z a � o < � w o o � . F�d o w o � aw 0z cr p A Z W Z re" �,,,� N x z I < o z c V A `U' x = W 0O O � C N < z U � o N oz wn x x g $ w z :-• c o O o w z a x Angelo Zaccagnino o.o,Et: ,ti,,,,ss8 yE—v'� FEB 11 2022 Company: BUIL61I fJ DEPARTMENT Zaccagnio Electric VILTE OF RYE BROOK VILLAGE OF RYE BROOK 81 Maple Avenue 938 YING_!4)REET RYE BRQ(QK,W 10573 BUILDING DEPARTMENT Rye,NY 11)580 (914)9 )939-5801 wIL or License No. 755 ECTRICAL PERMIT APPLICATION Expires on:12/31/2022 Peter Elorducci rester County Master Electricians License Required �1,� a�-o FOR OFFICE USE ONLY BP#: - EP#: 3o f EB 1 5 2022 Approval Date: Permit Fee: $ /s Approval Signature: Other: Disapproved: (fees are non-refundable) ******************** *** ************************************************************************* Application dated, his hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install and/or rem a 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: li a1 A`L<:� tfomni SBL: / Z Zone: 2.Property Owner: �!�✓ /v N Address: Phone#: r'h/ G� �5�� Cell#: email: M 3.Master Electrician: w c .3 J Address: �� /► I/�/ Vf"�— Y Lic.#: Phone#:J q-1 a('2 � Cell r9�-�(C�e email 14" Company Name: �G>'L'G /lii.�v ` ��� Address: 4.Proposed Electrical Work/Fixture Count: oil STATF,qF NEW YORK,COUNTY OF WESTCHESTER ) as: LLle r4/ ,being drily sworn,deposes and states that he/she is the applicant above named,and does further _print t me of individual signilig as the applicant) state at(s)he is the legal owner of the property to which this application pertains,or that(s)he is the :Rae CGt 94.',n+J 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&Buil ' Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to eY1 ,2 Sworn o before a is day o day �202 Si of Vert Owner Signature of pplic G�ey� Print Name of Property Owner Print&ame of Applicant STEVEN J. GAGNON Not (iA�:MON NWAWNW E OF NEW YORK NOTARY PUBLIC•ST NEW YORK No. O1 8 No. 610 38 Qualified in ester Count Qualifie Wes ester Count My Commission Expires October 14, 20 My Commission Exp es October 14, 20� 3/21/19 Westchester Rockland Electrical Inspection Services, Inc. ``L r Phone: 914-347-3595 DO NOT WRITE HERE-FOR OFFICE USE ONLY 43 North Lawn Avenue Fax: 914-347-3596 Y797 \ Elmsford, NY 10523BUILDING PERMIT NO. TEMP# D5E r` CITY OR VILLAGE ZIP CODE TOWNSHIP / COUNTY r STREET AND NO.OR ROAD ,,l �) POLE NUMBER kcil BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? /i SECTION BLOCK LOT OCCUPANT'S NAME /G r r &' /6UILDING OCCUPANCY OWNER'S NAME AND ADDRESS/ ' f, �,//rqj HOME TELEPHONE NUMBER 14 If CURRENT SUPPLIED BY FROM THEIR OFFICE WORK TELEPHONE NUMBER LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED NUMBER OF OUTLETS N0.OF FIXTURES& MOTORS HEATERS OFFICE USE LOCATION LAMP RECEPTACLES ONLY SIDEWALL SWITCH INCADE WATTS EACH INSPECTION OUTSIDE I D MU BASEMENT i ni U U- 1'FL. /� 2-FL. VILLAGE OF RYE BRO K BUILDING D_ 3'FL. ,.- REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: 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 ADDITIONAL i 1 EXPOSED❑ CONCEALED❑ MUST ENTER APPLICANTS IDENTIFICATION NUMBER SERVICE ENTERS BUILDING OVERHEAD L! UNDERGROUND❑ AVOID DELAYS BY GIVING FULL AND.ACCURATE INFORMATION.ALL SPACE MUST BE FILLE IN R APP O AY BE RETURNED. NAME OF COMPANY DATE OF APPLICATION IGNATU OF A ANT �vl 14 j ` /i �2 X STREET ADDRESS TELEPHONE NO. G� CITY OR POST OFFICE /r" ZIP CODE LICENSE NO.WHEN APPLICABLE , L WESTCHESTER moll ROCKLAND ELECTRICAL INSPECTION IRE15SERVICES.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: Zaccagnino Electric Robert&Tamara Winton 81 Maple Avenue NY, Rye 10580 Located at:90 Old Orchard Rd Rye Brook, NY 10573 Certificate Number: 1034080 Section: 135.35 Block: 1 Lot:2 BDC: Permit Number: EP:22-030-BP:22-015 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: 90 Old Orchard Rd Rye Brook,NY 10573 Ell 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 04/11/22 Name Type Quantity Exhaust Fan ------- 1 Receptacle GFCI ------- 3 Receptacle GFCI 20 amp 1 Fixture-Wall Sconce(s)Lights Indoor ------- 2 Switch Single Pole ------- 2 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. o o ON C Ln w N N N fA 0 o N aa p i••r F q � a z Q W N �- w a ac x Q M o . : 9 F" O � z _ Z QLn h ■ PLO IT M M ! It It f .-. yypEE W O z a-4 co O A x ►� w �.^ oo �, W �, w? ON V ozwo � z o � � z _ ►-y c! O\ Z a W 04 z z ►-� � z w � � � v F a (, it U 4 W A c ` o z H A z G1 — w v oA .. . w A t ILE BUIL DE JMENT VIL E OF RYE K JAN 2022 938 KIN d ET RYE B ,NY 10573 VILLAGE 01= RYE. BROO (914)9 939-5801 BUILMNG rEPARTMEN PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP#: _ �—0 i's� PP#: Approval Date: J AN 2 4M Permit Fee: $ Approval Signature: Other: Disapproved: (fees are non-refundable) ************************************************************************************************** Application dated, 01//16/22 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. ,Q 1.Address: 90 Old Orchard Road SBL:/35135-/—� Zone: /e—IS 2.Proposed work: Disconnect discard and reinstall sink, toilet, tub, and shower valve in same location. 3.Property Owner: Tamara Winton Address: 90 Old Orchard Road Phone#: Cell#: 914-305-4854 email:rtwinton -optonline.net 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 l st Floor 2nd Floor 1 2 1 4 T,d Floor 4 Floor 5 Floor Exterior 5.* List Other Equipment/Provide Details: Homeowner is remodleing bathroom with fixtures in same location. (Notarized Signatures Required Next 2 Pages) -1- 3/21/l9 STATE OF NEW YOM COUNTY OF WESTCHESTER ) as: Salvatore W Morlino ,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 Contractor 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 16 Sworn to before me this 16 day of January ,20 22 day of January 20 22 S gnature of Property Owner Signature of Applicant Tamara Winton Salvatore W Morlino Print Name of Property Owner Print Name of Applicant Notary Public ,3t s : 22 Notary Public This appiication 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. Application: not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applican. -2- 321/19 V � II-7 BUILD TMENT iD VILE E OF RY OK JAN 21 2022 938 KING iL ET RYE BR NY 10573 --- (914)9 9 39-5801 f VILLP,GE oF RYE BROOK wv1�. t�lJlt.D i;c1 DFPARTME_ JT —4 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: 0 3J, Tamara Wanton , residing at, 90 Old Orchard Road (Print name) (Address%%hcrc you li%c) 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; 90 Old Orchard Road , 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. �ienawrcufl'roperty O�%ner(s)) e Tamara Wgnton 1 Print Name of Propertc O�%ner(s)) Sworn to before me this 16 day of January 2022 (Notan Public -3- 3/21/19 Building Permit Check List&Zoning Analysis Address: �.2 n QX_A-A(21�. —�� SBL: Zone - t __ Use: 7i t o Const.Type Other. Submittal Date: I l 'L 1 (-L Z Revisions Submittal Dates: Applicant: k110—rtp Nature of Work: ��i^�Q �{L- �t� �fl-l-��G3 , a�Fi Reviews ZBA: J A N 2 4 1011 PB• BOT• Other. ( O FEES:Filing. BP: Zt C/O: Legalization: ( ) ( 4,1APP: Dated ✓ Notarized -Truss I.D. Cross Connection: H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening- ) ENVIRO:Long. Short: Fees: N/A: ( ) ( ) SITE PLAN:Topo: Site Protection S/W Mgmt.: Tree Plan: Other: ( ) ( ) SURVEY:Dated Current: Archival:- Sealed Unacceptable: ( ) ( ) PLANS:Date Bumped Sealed Copies: Electronic. 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. ( ) ( ) YIRE 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: Pen-nit: 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 mug.date: approval notes: ( )PB mtg.date: approval: notes: REOUIRED EXISTING PROPOSED NOTES APPROVED Arm,. na,A. J A N 2 4 1011 C:k e: Fin g� Front. Front: Si : 13&ar. Main Cov Accs,Co F S S . Sb: Tot,imp: Ft.Imp: Parking: Height/Stories: notes: % �4g' ? \�'ari�Ci�,L��-.�s ,o-��,,, ..v 4"ylre �1�`A'f� -. •,.,��1^• "'"1�' At•,�� •�`A^r-�. - ,. �ti�tJ il,A,._. \p. ri . i`i��'`� J I� 'rs`� - '�ZI� -� a '��'t.r\�'� i t�'A' 1'�- — I► rtn •• ti�'A,�� �--. , +rh. '�s'Yff: `` ::Pjt,�rtiV�f,��•rt,>n �Bf..-g,�+8titi`�,kf�r�¢sy;. `I�.�:�tf`�tt�.����,f,��.. �4���,�i'rV t ,�. �`�!' {,�,�,�.�1� ��Y �� � l��O� n"F ��r f i �0y =:nth+��i. r' i �?� „ t'�•'��,,lt a y a�R��txl,�s y�tac:.,t�"hyr�y Q :T tN�� au Sys �� y 'd ,�� y .d' r(� r uh� It,� 3��:; .'. /�'� I11+ill G .:tlid{!t 2• c;.111 11t.. '- 'da }}l+llt a 111�11� ysfillil++++{+11t ��_�, / F/ CN We r _... ,C-. C 'O .. }' t '`mkt` •�', W V 0 nz r :?at. i o � L � � I--1 �i• •"'" O W r < W ti od ca W vu Ora � t d w AM-'r}CS x I O W x Q W O W ti o wee Be o w (cii As z MCI cz U i • 00 ,M U �•s(�a�)>� �: � �' � O � In �css)> 1.5 ems.t'•T']I Ss ry. y 4 3', fl}�}II ,. _g i't!}�}I s? tfl�llt p.. ...!}'}Ilt <Qb`> / .,q ~: `4i,+111+Ij1 Ts'g}$g ag���Y Il►1+/+1�1t I1t1110/�+1 i�gpg�NN �I1111/0+,1 -2.w�1't�l!. �1�t11i1/11j1 � It11/`i11t1 " it1 a t x.. ..���A i c,1♦ t'��`o�A yG�PC!'G •� t A. ♦L'�. lt'jta5j^4F� 4i'•���3°�`"''���rY+gt��,,ty qn� ^�� p: +0�,��^ �0♦ ...� - 0 . 1 IWR l.s�i•�y' .\n�vT$/�_. �t F_}jg([� ✓ � r+ a �3��/`,� )4 .:r�1 C.N y .� �� srr� �i.,i y�N'. YT•tt Z_�[�/ Yss% titi�i!raio. z-.r•: 1"arN\,' ��" �_.- <s �hU� •'d&:. ..Oa A1111 coRO® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYY`) 05/18/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON TH CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE FFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUI G INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. H SUBRO 3ATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certifics does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CO A NAME: NORTHEAST AGENCIES,INC. PHONE 833-250-9900 FAX No 820+IBM DR,BUILDING 102 EAEss. ----- PR CHARLOTTE, NC 28262 INSURER(8)AFFORDING COVE GE ___ NAIC 0 INSURER A: LIBERTY MUTUAL INSURAN .E COMPANY 23043 INSURED IN8URER B: ___ SM BUILDERS INC.DBA WESTCHESTER INSURERC: PLUMBING&HEATING INSURERD:_ 1 BONWITRD INSURERE: PORT CHESTER,NY 10573 INSURER F. COVERAGES CERTIFICATE NUMBER: REVISIO 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 DOCUMENI 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 _A5D_1T9WPOLICY EFF POLICY EXP LTR TYPE OF INSURANCE wvnjPOLICY NUMBER MMID MMID /YYYY LIMITS GENERAL LIABILITY EACH OCC41RRENCE E 1,001,000 X COMMERCIAL GENERAL LIABILITY )_0 fICG-E 6 300,000 PREMISES s occurrence E CLAIMS-MADE OCCUR MED EXP one person) E 15,000 A — Y N BKS(22)61273032 05/22/2021 105/22/2022 PERSONAL I&ADV INJURY E 1,000,000 GENERAL 'GGREGATE E 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO $ 2,000,000 X POLICY PR4 r�LOC E AUTOMOBILE LU181LnY COMBINED SINGLE LIMIT Ea acclden ANY AUTO BODILY INJURY(Per person) E ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJ RY(Per accident) S HIRED AUTOS AUTOS NON-OWNED PROPERTY DAMAGE E AUTOS E UMBRELLA LIAR OCCUR -' I EACH OCC RRENCE E EXCESS LIAR CLAIMSAAADE AGGREGA E DED �aETENT10N s WORKERS COMPENSATION S AND EMPLOYERS'LIABILITYY!N Y I WC S AT - OTH- ANY PROPRIETOR/PARTNER/EXECUTIVE _ OFFICER/MEMBER EXCLUDED? NIA E.L.EACH CCIDENT E (Mandatory In NH) ❑ If under E.L.DISE E-EA EMPLOYE E yes,das DESCRIPTIONcdbe OF OPERATIONS below EL.DIS E-POLICY LIMIT !E -J— DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101.Addltlonal Remarks Schedule,H more apace Is required) CERTIFICATE HOLDER LISTED AS AN ADDITIONAL INSURED CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 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 7"ia>�crta, R:cG�ta.Nr7sr' I ACORD 25(2010J05) ©1988-2010 ACORD C PORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NYSIF New York State Insurance Fund WESTCHESTER ONE,44 SOUTH BROADWAY, 10TH FLOOR,WHITE PLAINS,NY 10601-4411 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE a a A A A A A A 133452720 S.M. BUILDERS, INCORPORATED T/A WESTCHESTER PLUMBING&HEATING 7 TOWER HILL DRIVE PORT CHESTER NY 10573 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER S.M. BUILDERS, INCORPORATED T/A VILLAGE OF RYE BROOK WESTCHESTER PLUMBING &HEATING 938 KING STREET 7 TOWER HILL DRIVE RYE BROOK NY 10573 PORT CHESTER NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W1316 251-6 489325 03/02/2021 TO 03/02/2022 5/3/2021 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1316 251-6, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY,INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS:/IWWW.NYSIF.COM/CERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. SALVATORE MORLINO-PRESIDENT S M BUILDERS INC ONE PERSON CORP THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 888652965