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HomeMy WebLinkAboutBP22-071PERMIT #4Qt SECTION .-Z.,] TYPE OF WORK JOB LOCATION _ OWNERA4/7/, CONTRALTO �i DATE: EXPO 77r BLOCK_ LOT l0 3 !Loll Vlz� ga %Q M _ussi JEST. COSTJS� c.�J� � � � " FEvls �' � '7�"� •-/�%� I/CO # FEE&//O" i)6 DATE TCO # FEE DATE INSPECTION RECORD DATE INSP FOOTI N G FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING RGH PLUMBING GAS 0 SPRINKLER ELECTRIC 520 LOW -VOLT CJ rALARM CI AS BUILT FINAL OTHER APPROVALS A IS BOT FIB ZBA I/ y�,,._ 7(o„ o -7� OTHER _ )4veUS�- ns i��9/�/i9Ola /373 VILLAGE OF RYE BROOK WESTCHESTER COUNTY, NEW YORK NO: 23-062 Certif irate of ®rrupaurp This is to certify that 4 /! 110 of, 9L/�c / V� having duly filed an application on Ch .2( 20 J 3 requesting a Certificate of Occupancy for the premises known as, J ��b J&_)o Q� �y/�i'� , Rye Brook,NY, located in a Zoning District and shown on the most current Tax Map as Section: �' Block: Lot: &3 and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No.eo_Q71, issued 20 0��, 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: �/L� / , Construction:, for the following purposes: 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 shalLihe building be moved from one location to another until a permit to accomplish such change has bee to ed t Building Inspector. Acting Building Inspector,Village of Rye Brook: Date: APR 2 5 7071 ��3R� For office use off: D BUILDINd 1 "TMENT PERMIT# -07/ MAR 2 9 2023 0 VILLAGE OF RYE BROOK ISSUED: , 938 KING STREET,RYE BROOK,NEw YORK 10573 DATE:3-3 VILLAGE OF RYE BROOK (914)939-0668 FEE: /$ //Q-- PADR BUILDING DEPARTMENT www,ryebrook.oriz 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 rrrs►►►•►s►►►►►ss►sas►►s►•s►ssss►►►•►►•rr•srr••srr•rs►r►•rrs■•rsr►►►►►►►►►►♦s►►►ss•ss►•srs►s►rss•■ar►rrrrr•►s►rr►•r►►rrs►s►►• Address: ` ') t,I�Wy Of, �_ Occupancy/Use: G4fY Parcel ID#: 63 Zone: /y Owner: fr1 J 1A{yf1 V_ -?�%-, y Address: "2kl✓1 V __ P.E./R.A. or Contractor:�(��/�'( �MJS—(q1jC-7i cx_., Address: Person in responsible charge:U -4a Address: M 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 YOM COUNTY OF WESTCHESTER as: A -1-t- vSSI L►,✓ being duly swom,deposes and says that he/she resides at \l c�LLVJ�� ► x. (Print Name of Applicant) (No.and Street) in 6%6_'3 ak:__ ,in the County of V— -1 C4 tl%K'(Kam_ 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 vV , ju- , for the construction or alteration of: 61<1 lk i- 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 C9 4 Sworn to before me this day of C3.�G� , 20 day of , 20 Signature of Property Owner Signature of Applicant Kt _ VA kh Prr e of Property Owner Print Name of Applicant Notary Public Notary Public SHARI MEULLO Notary Public,State of New York No.OiME6160063 8/12/2021 Qualified In Westchester County Commission Expires January 29,2QLI BRC�v� O Zm w � BUILDING DEPARTMENT "UMDING INSPECTOR VILLAGE OF RYE BROOK ❑ VILLAGE ENGINEER 93 8 KING STREET RYE BROOK,NY 10573 ❑ASSISTANT BUILDING INSPECTOR (914)939-0668 FAx(914)939-5801 - - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT u - - - - - - - - - - - - - - - - - - - - - ADDRESS: , k \/--\ ��� T DATE: PERMIT# ` ISSUED: SECT. \ BLOCK: LET: LOCATION: �.1 JOC OCCUPANCY: y ❑ VIOLATION NOTED THE WORK IS...XACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING 0 FOOTING DRAINAGE ❑ FOUNDATION O UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING 0 INSULATION ❑ NATURAL GAS 0 L.P. GAs ❑ FUEL TANK ❑ FIRE SPRINKLER 0 FINAL PLUMBING ❑ FINAL 0 OTHER �yE BRC��• cu � BUILDING DEPARTMENT BUILDING INSPECTOR ❑ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ( ❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : W _� DATE: `f� PERMIT#:�!Z ISSUED:5; Z ECT: BLOCK: ` LOT: c` T LOCATION: k c7U 1� OCCUPANCY: z ❑ 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 �- ❑ L.P.GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER �yE BRC�uk '9a2 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 :_ �'nbk ' U �V LL. DATE: PERMIT •S �/Zs✓ - - # Co � ISSUED. _SECT: BLOCK: LOT: LOCATION: �n �� OCCUPANCY: 2 " b ❑ VIOLATION NOTED THE WORK IS NCCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: FZ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER ■ O N O W E = CV q w as N N N u In W Pt' Mo.,a N I1 • r = v 5 � o Ocn b1p ' W 1-0. en a O 1�-t � \ C o � w �l Zu 3 a' O Coll O © Q ,� cn u p y i en = p en � � o,z a w l V = 0 W ° `° Q au � y 7 O, : 1(~l N lu 00 U Fr==1 cn W Tn 0 � NOIN = U v y gi rj A _ Q u � oy W C7 O A O C'n a. v, y a'ai o q W W Tool 99 oC ob ■ BUILDING DEPARTMENT EUVED VILLAGE OF RYE BROOK R MAY - 2 2022 938 KING STREET RYE B1tom,NY 10573 (914)939-0668 VILLAGE OF RYE BROOK BUILDING DEPARTMENT www.rvebrook.org INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: MAY +� Approval Date: `� 2 Permit#: / Application Fee:$ 1� Approval Signature: Permit Fees:$ Z-)O—17 U E Disapproved: Other: Application dated: 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: \\ Y-00LILWULD 0 y_>P4 V(_ SBL: l 3S• `" ` b3 Zone: ,- t 0 2. Proposed Improvement. (Describe in detail): 3. Does the proposed improvement involve a Home-Occupation as per§250-38 of the Code of the Village of Rye Brook? No: C Yes: If yes,indicate: TIER I: 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:_/- Yes: (If yes,please submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans) 5. Occupancy;(1 fam.,2 fain.,comm.,etc...)Prior to Construction: After Construction: 6. NX State Construction Classification: N.Y. State Use Classification: 7. Property Owner:A0 0IL t-fV :1 t_x!SJ 4 Address: 1 ` Y-IJ C)L L-VJW0 all\A(— Phone# Cell#_�I 'a(2(o • 7(r email: ANt ,.� rt�l_ (r,W1 8. Applicant: Address: Phone# Cell# email: 9. Architect: 30kt4 FCJy_.IL Address: Phone# Cell# email: 10. Engineer: Address: Phone# Cell# rremail: //��r fl 11. General Contractor: &5ai'C.,d��7✓I � d"re s: ��I-O�L/ CA� �CQ 1V/IQIi Ny 101S3G Phone#_91JV-90&-1373 cater boVP �'4 .ks e%/i1 email: 0(QVe1QSQ7"9n'i1 i C0M 12. Estimated cost of construction $ 4C !`ADO (MOTE: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: �6!2 Finish: (1) 8/12/2021 BUILDING DEPARTMENT R E FF[E VILLAGE OF RYE BROOK MAY - 2 2022 938 KING STREET RYE BROOK,NY 10573 (91.4)939-0668 VILLAGE OF RYE BROOK www.rvebraok.orz 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: 3A01. L 1-A k�-% L CJ'-'.Sg L,L- 0 ,residing at, �� �,I-�dl l_vJUJ0 0 4 --AL 4-n YC- 0&-J0LI. (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; J 0 4-� , 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)) {R O)-BIZ. Nv-< ([' JSS I U,D (Print Name of Property Owner(s)) Sworn to before me this ill day of , 20 (VOL (Notary blic) HOPE B. VESPIA Notary Public, State of New York (2) No. 01 VE5084028 Qualified in Westchester County) Commission Expires August 25,20�a 8/12/2021 This application must be properly completed in its entirety and must include the notarized signature(s) of the legal owner(s) of the subject property, and the applicant of record in the spaces provided. Any application not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. Please note that application fees are non-refundable. STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: Ajj�K A ft1F•1IL *VSS,I-LLD ,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 a?„4>> yLy-"1�j L3 A� for the legal owner and is duly authorized to make and file this application. (indicate arc 'tect,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 egad) Sworn to before me this day of eom ,20_"L day of ,20 Signature of Property Owner Signature of Applicant IkV JC hhkI:A K. fk65►Lwo Print Name of property Owner Print Name of Applicant Notary PublW Notary Public HOPE B. VESPIA Notary Public, State of New York No. 01 VE5084028 Qualified in Westchester County Commission Expires August 25,202V (4) 8/12/2021 i i s 0 00 O O 00 0 oo q w x C4 W e 0. + i zPLIo � W O cz CA rZA MM cle) 28 Ln 0-4 o z w v o U C w z aza W. < s BUIL ,I EPAR MENT R VIL E OF RYE OK AUG 15 2022 938 KIN -ET RYE B ,NY 10573 VILLAGE OF RYE BROOK BUILDING DEPARTMENT .or ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required -E \ C� FOR OFFICE USE ONLY ur —� / EP#: Approval Date: A11G, I Permit Fee: $ Approval Signature: Other: Application dated, is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install and/or remove electrical equipment,wiring,fixtures,or to perform other high or low voltage electrical work as per the detailed statement described below. By signing this document, the applicant & property owner agree that all electrical work performed will be in conformance with all applicable Federal,State,County and Local Codes. /_? L Address: It �n d I tl W °brJ nr' • SBL:�,3S/ 7�1 J/7-1-&J ne: -/0 4 2.Property Owner: , nne M G! 1 ( g UJf t I(1 o Address: It kno(/w 60 d (' r-- gtx rw� Phone#: ft 4 -8 e(-—L l o I Cell#: email: A rn r3 S-0 Qd(• C---n 3.Master Electrician: r%h E Address: 8 Dtoyin•►r;s Lic.#: I3V 9 Phone#: -S -6Sd 5-Cell#:-II('I'�` ] t'IR�'email: C�AYe (v Gl�y U� �+"+•"�- Company Name u c s-, +\l,# r F E J� Address: AVV-� ` 4.Proposed Electrical Work/Fixture Count: N- J �. C rr.ti � � a t, ✓ h ti 7 �'lr� d -�-, t�p n !� �J � •�-� `�.-t �.3"' Party Electrical Inspection Agency: STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: ,being duly swom,deposes and states that he/she is the applicant above named,and does further (print name of individual signing as the applicant) state that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,attorney,etc.) The undersigned further states that all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances,and regulations. Sworn to before me this Sworn to bef this day of ,20 day of ,20 Signature of Property Owner Si ature of App 'cant r t - AyAf ! Print Name of Property Owner Print Name of Applicant Notary Public Notary Public 6/23/2022 STATEWIDE • Service With bitegrity 181 Main Street, Fishkill, NY 12524 1 email:office@swisny.com SWIS JOB APPLICATION845.202.7224914.219.1062 1 SWISNY.com • • Office Use Elect.Permit# Date .�r Bldg Permit# 01 \\ /-� Utility ID# Final Certificate# City/Village 1 r D u ` r Zip + Township County 1, i Address ' n (` Cross Street Section Block Lot Owner Name/Address(if different than above) Contact Number ❑Basement ❑ 1 st H. ❑2nd FI. ❑3rd FI. ❑More Than 3 FI. Q Garage ❑Attic ❑Outside ❑Residential ❑Commercial Receptacles Special Recept GFCI AFC] Switches Dimmers Smoke Alarms Carbon Monox Hood Trash Compact Amt Amps Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Warm Draw Incandescent Fluorescent SERVICE Amperage Voltage 1 P 3P #Meters #Disconnect ❑Underground ❑New ❑Reconnect ❑Overhead ❑Change ❑Visual Re-Inspection ❑ Safety Re-Inspection ❑ Re-Inspection Additional Information RCC� � �ML FUG 15 2022 VILLAGE OF RYE BROOK BUILDING DEPARTMENT This application is valid for one(1)year from the date received by WAS.This application is intended to cover the above listed items to be inspected if at any time of inspection additional items have been in stalled you are authorized to make the inspection and adjust the fee for the additional items inspected.The applicant dedares that there is no open applications for the above address with any other inspection company.The applicant,owner or authorized agent agrees to all the above terms and conditions as set forth for the application. Inspector Date Finalized Inspector# Company Name _ ` ,,� ;` ; Date i t-Z Signature Address City/State Zip Code �t C License# l _ �� Phone# R D IE �Vp E ji State Wide Inspection Services 1080 Main Street NOV 2 2 2022 Fishkill, NY 12524 845 202-7224 Phone VILLAGE OEF� RYE BROOK 914-219-1062 Fax STATE WIDE INSPECTION SERVICES BUILDING DEPARTMENT Email: ofFice0swisny.com Website: www.swisny.com Service With Integrity BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: Hudson River Electric Anne Marie Russillo 8 Downing Court 11 Knollwood Drive Irvington, NY 10533 Rye Brook, NY 10573 Located at: 11 Knollwood Drive, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP22-188 135.44 63 Certificate Number: 2022-5495 Building Permit Number: BP22-071 A visual inspection of the electrical system was conducted at the Residential occupancy described below.The electrical system consisting of electrical devices and wiring is located in/on the premises at: it Knollwood Drive, Rye Brook, NY 10573 The Second Floor Master Bathroom was inspected in accordance with the NYS and NFPA 70-2017 and the detail of the installation, as set forth below,was found to be in compliance on the 16th day of September 2022. Name Quantity Rating Circuit Type Dedicated Circuit 02 GFCI Receptacle 01 Switch w/Timer 01 Exhaust Fan 01 Switch w/Dimmer 02 Recessed Luminaires 03 Vanity Mirror 01 Floor Heater 01 Floor Heat Thermostat 01 f . ID Officer: Frank J. Farina This certificate may not be altered in any way and is validated only by the presence of a seal at the location indicated.This certificate is valid for work performed on the date of inspection only. = i i M C M N N N 0 H vi LnLn w avi `r L ven C CS, � OQ M U E� M W z 4 o � � z � � w w 0-0 � ° $ < z 66 _ I ,A en en oc A - V ,, Mai � ►� � a � � r, d < � V A a W w zz ~ U N O -r, Ln � Q s � 0. zg [O- �' V W Z f3, 60i x I i p' a i� Q W a a 00 '� •• .a O ., L'a a �I a a 4 yE=aRnv� � ID BULL E MENT JUN - 1 2022 VIL E OF RYE OK 938 KIN ET RYE B. ,NY 10573 VILLAGE OF RYE BROOK 8 BUILDING DEPARTMENT org ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY c�' ! EP#: c — Approval Date: JUN ~ 2 Permit Fee: $ Approval Signature: Other: Disapproved: (fees are nun-refundable) Application dated, ( )—/ `Qk�r 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 Codes. ? k__�o 1.Address: I ' �he'lwood �'• SBL: 4 /,�/'_/_ J Zone: 2.Property Owner:/4 H r►E M dk-'i t Kw S P i f l 0 Address: 11 K04 o 11 W a o d Dr-. Phone#: 11 M- R O L - 4 0*4 Cell#: email: A M r 3 8 to 0* C.� 3.Master Electrician: 1: Pt< <"aver) Address: c- G 0"""'^ t C-If- feu; 't �^ Lic.#: 13(9 9 Phone#: q 1 t14 91- L s c r Cell#: 9 �1- I Lf QertYam�ail: C I/A VV'1 W 0 f?f-6n 1i r?r• 'tc'* Company Name;H u d,"- h IZ, F Lt c. Address: EA-pt-A 4.Proposed Electrical)W/ork/Fixture Count: STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: ,being duly sworn,deposes and states that he/she is the applicant above named,and does further (print name of individual signing as the applicant) state that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the 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 me this [���,t, Sworn to b fore me this k to ore day of ,20 _ day of L ,20 Signature of Property Owner a Applicant be S�1L9_ tic` Print NWpe of Propert w er jPame of Applican Not A Notary PU96RI MELILLO Fy PubliC,rtate of New York NO. 01 VE5084028 Notary Public,State of New York N .01ME6160063 Qualified in Westchester CountIn Westchester County Commission Expires August 25,20g Qualifiedo Commission Expires January 29,20&Z 8/12/2021 Westchester Rockland Electrical Inspection Services, Inc. =a1 ' Phone: 914-3'47�95 DCYNOT WRITE HERE-FOR OFFICE USE ONLY P.O. Box 208 t, Fax: 914-3 596 Carmel, NY 10512 1 �" BUILDING TEMP# DATE/ 7/ CITY OR VILLAGE ZIP CODE TOWNSHIP r STREET AND NO.OR ROAD t POLE NUMBER BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? SECTION BLOCK LOT OCCUPANT'S NAME BUILDrCUIPANCY }� t F117.RE- AND ADDRESS l /� HOME TELEPHONE NUMBER IED BY FROM THEIR OFFICE WORK TELEPHONE NUMBER C 7 LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED NUMBER OF OUTLETS NO.OF FIXTURES& MOTORS HEATERS OFFICE USE LOCATION LAMP RECEPTACLES ONLY SIDFWALL SWITCH INCADE FLUOR -.J.LF.. $EACH INSPECTION OUTSIDE BASEMENT ,"FL. tj N - 1 2 22 Y-FL. BUILDI G DEP P.TME REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: p 4- 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 CHARACTER OF WORK NEW❑ ADDITIONAL❑ EXPOSED❑ CONCEALED O MUST ENTER APPLICANTS IDENTIFICATION NUMBER SERVICE ENTERS BUILDING OVERHEAD❑ UNDERGROUND❑ AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACE MUST BE FILLED IN OR APPLI I N MAY BE RETURNED. NAME OF COMPANY I DATE OF APPLICATION SIGNATURE OF APPLICANT STREET ADDRESS � ( TELEPHONE NO. \` // VA` CITY OR POST OFFICE ZIP CODE LICENSE NO.WHEN APPLICABLE ■ N ■, O O N W N \ N ►n a ' ■ N � � � � W a ■n a o t w 1%0 v a x o 60 en rT-4 s �. O �Z oQ A 00 z $ < HCl) ■ 00 a w = h+■1 LTA Op , a C7 A 1-4 � � '—' � x � � � A o . � ,_.., V q a o W • oo Z a Q n zZ ■ A N o � _ 04 O z a U H a N C O H w NC6 U � V � w ■ ILn a a ia x �I � a a � w x � ■ 3 = :2 :2:022 BUILDiEPARTMENT JUN - VILLAGE OF RYE BROOK VILLAGE OF RYE BROOK 938 KING STREET RYE RW ,NY 105 3 BUILDING DEPARTMENT wv' .or PLUMBING PERMIT APPLICATION rr� FOR OFFICE USE ONLY BP#: �d_�� PP#: Approval Date: JUN 2 ZQ Z Permit Fee: $ Approval Signature: Other: Disapproved: (fees are non-refundable) *************** ********************************************************************************** Application dated, &—d D 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: SBL: 14-1-bs Zone:/el/0 2.Proposed Work: 3.Property Owner:4N111 Ahz/ l/U Address: Phone#: "Cell#: y 4'y 6 email: 4.Master Plumber: /'c/2/Y�N� (y�/L/Z�i/�y✓ Address: �5i, 3r64,1, f.("P tlY /060y Lic.#: /56e Ph a#: Cell#: email: Company Name:_ �%�7 e/ Address: i,?jL,¢,�� �i 3Q7/; G(/,D Jl/ INDICATE FIXTURES&LINES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: Location Water Urinals Drinking Sinks Showers Bath Laundry Domestic Fire Sanitary Natural/ Other* Total Closets Fountains Tubs Tubs Service Service Sewer LP Gas Basement 1st Floor 2nd Floor 3r'Floor 4'Floor 5m Floor Exterior 5.*List Other Equipment/Provide Details: (Notarized Signatures Required Next 2 Pages) -1- 8/12i2o21 STATE OF NEW YORK,/C�O�UNTY OF WESTCHESTER ) as: /` ,,r�9 /(�fn C 4/.S;1`/y ,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 oult/C'/1_ 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 bef me this Sworn to before me this day of ,20 a14' day of ,20_2,-2 Signature of Property Owner Sign a of Applicant Print Name of Property Owner Print Name of Applicant o li Notary PublicSHARI MELILLO Notary Public, State of ew York Notary Public,state of New York No. Ol VE5084028 No.OiME6160063 Qualified in Westchester County J Qualified In Westchester county . Commission Expires August 25,20 Commission Expires January 29.20 Z1� This application must be properly completed in its entirety and must include the notarized signature(s) of the legal owner(s)of the subject property, and the applicant of record in the spaces provided.Applications not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. -2- 8/12/2021 BUILDING N&PARTMENT 1 VILLAGE OF RYE oox J U N - 2 2022 �--J 938 KING XT R �R NY 10573 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: H k)k_1C �rV l l�l�D ,residing at, u A:_04;t,1_`.,Jbo'1? ai .*c 4 1rC.. 15kz)lc- (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; 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)) (Print Name of Property Owner(s)) Sworn to before me this day of Z , 20 p� tj (Notary 77fic) HOPE B. VESPIA Notary Public, State of New York No. 01 VE5084028 -3- Qualified in Westchester County, Commission Expires August 25,20 Z 8i12/2021 II Building Permit Check List&Zoning Analysis Address: l tj O L.L_W D SBL I Zone: • I Use: 2 t D Const.Type: Other. i Submittal Date: Revisions Submittal Dates: Applicant: S Nature of Work --L?>A--n4- Reviews:2MA:MAY - 5 2022 PB: BOT: Other. OK ( ( ) FEES:Filing. 7S- BP:A X)'bjtC/O: Flood Plane: Legalization: APP: Dated ✓ Notarized. ✓SBL: —""Truss I.D. Cross Connection H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review Street Opening. ( ) ( ) ENVIRO:Long Short: Fees: N/A: ( ) ( ) SITE PLAN:Topo: Site Protection S/W Mgmt.: Tree Plan: Other. ( ) (XVEY:Dated Current Archival Sealed Unacceptable ( ) ( LANS:Date tamped Sealed '� Copies: 2 Flectronir. Ckher ( (1License Workers Comp: Liability ✓Comp.Waiver Other. ( ) ( ) CODE 753#: 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: I-W.I.C.:_Batter)r_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: APPROVED REQUIRED EXISTING PROPOSED NOTFS Date: MAY - 5 2011 cir FroaW Fs� Si Main Cov Accs.Cov Ft.H/Sb: Sd.H/Sb: _QE6. : Raddw- HH"/Stones: notes: Laura Petersen From: Laura Petersen Sent: Thursday, May 5, 2022 1:23 PM To: AMR38@AOL.COM Subject: Building Permit Application - 11 Knollwood Drive Good afternoon, The building permit application has been approved by the Building Inspector. Before I can issue the building permit the following items must be submitted to our office; y3 7 3 'VA. General contractor's contact name & phone number. Copy of general contractor's valid Westchester County Home Improvement License. ✓3. General contractor's valid liability insurance (the Village Of Rye Brook must be the certificate holder) (A. General contractor's valid workers compensation on a NY State Board form (C105-2 or U26.3) Estimated cost of construction to determine the building permit fee ($15.00 per $1,000.00) (due once permit is issued and ready for pick-up) At-,�)O, 000 n Thank you &3o0--& 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 loetersena-ryebrook.org 1 Laura Petersen From: amr38@aim.com <amr38@aol.com> Sent: Thursday, May 19, 2022 2:23 PM To: Laura Petersen Subject: Building permit application-11 Knollwood Drive Attachments: Losat - COI Village of Rye Brook.pdf Hi Laura- As requested. I'm forwarding the contractor's information. Construction should be about$20,000. Let me know if you need anything else. Thank you, —Anne Marie Russillo Sent from the all new AOL app for iOS begin 7orwarded message: On Wednesday, May 18, 2022, 4:40 PM, Dave Satenstein <davelosat@gmail.com>wrote: That should be everything Sent from my iPhone Dave Satenstein Losat Construction Co., Inc 914.906.4373 i r,. ., iM���d ��t,1►�S t.. yr�ON IL a o > !z O 0 • m C G LIJ" CVCD - Cl L ` •' C Z ' 14 \ CD / �?{` • 6..1 0 Ln Q U@CtlOf} y �., � U O ^,L Ql -may. r �,'-•• � rn .. n, � r, 1J \1 1 C r• - �• C 2 00 y ° ?tu ; L «si)► _/Tlr"fti 1 1� i �n ♦�i�•-2 —^.riok5 , • •O.;: . . . _ . . ^ . . . . . .------------.. r, ;'•' a• l ��S���i►�;, ! •�hy;•t`n F//fi�•� ��� 7ty11��1� RIP �/ c:�� •'• � •• �1�^�I�n ••��'��51�1.1� 0'd 1.. . 'd� �`���' '�.'',\;'���A�1� 0�1' ,'��li ,, ,acoRO® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDfYYYY) 05/18/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT Robert Forbes Robert J.Forbes _ dba Forbes Insurance Agency PHONE I FAX C_Na LA1 __ ___ Arc No): 562 Commerce Street E-MAIL Thornwood,NY 10594 ADDRESS: INSURERS)AFFORDING COVERAGE _ NAIC N INSURERA: Falls Lake National Insurance Company _ 31925M INSURED Losat Construction Co Inc INSURERS: STATE INSURANCE FUND 36188 12 Foley Road Katonah,NY 10536 INSURER c SHELTER POINT LIFE INSURANCE CO A0546 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 IN SR ADDL SUER - - LTR TYPE OF INSURANCE POLICY NUMBER MM/DDYIYYYY MM/DDY/YYYY LIMITS A COMMERCIAL GENERAL LIABILITY `SKP2013602 1 04/16/2022 1 04/16/2023 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE LV I OCCUR RENT 100,000 I PREMISES(Ea occurrence S MED EXP(Any one_person) S 5,000 PERSONAL&ADVINJURY $ 1,000.000 I GEN-L AGGREGATELIMIT APPLIES PER: GENERAL AGGREGATE 5 2,000,000 POLICY F�]JECT n LOC PRODUCTS-COMP/OP AGG S 2,000,000 OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO -(Ea accident) OWNED _SCHEDULED BODILY INJURY(Per person) S_ - - AUTOS ONLY AUTOS BODILY INJURY(Per accident) S HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident) _ $ S UMBRELLA LIAR OCCUR EACH_OCCURRENCE $ EXCESS LIAR -. - - _ _ ,CLAIMS-MADE AGGREGATE DED RETENTION S $ B WORKERS COMPENSATION W14846067 07/11/2021 07/11/2022 PER I TOTH- AND EMPLOYERS'LIABILITY Y/N VSTATUTE R _ ANY PROPRIETOR/PARTNER/EXECUTIVE 1 E L.EACH ACCIDENT_ S 100,000 OFFICERIMEMBER EXCLUDED? El N/A I _ (Mandatory in NH) ! E.L.DISEASE-EA EMPLOYEE S 100,000 If yes,describe under DESCRIPTION OF OPERATIONS bebeloww E.L.DISEASE-POLICY LIMIT $ 500,000 D C Disability D419372 01/01/2022 01/01/2023 Statutory Limits i DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Carpentry-All Locations-Exludes Roofing CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Village of Rye Brook ACCORDANCE WITH THE POLICY PROVISIONS. 938 King Street Rye Brook,NY 10573 AUTHORIZED REPRESENTATIVE \ "� 88-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered\,narks of ACORD NYSIF New York State Insurance Fund PO Box 66699,Albany,NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED) ^A A A A A 133275833 FORBES INSURANCE AGENCY ; 562 COMMERCE ST THORNWOOD NY 10594 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER LOSAT CONSTRUCTION COMPANY INC VILLAGE OF RYE BROOK 12 FOLEY RD 938 KING STREET KATONAH NY 10536 RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W1484 606-7 937723 07/11/2021 TO 07/11/2022 5/18/2022 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1484 606-7, 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://WWW.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. DAVID SATENSTEIN-PRESIDENT OF LOSAT CONSTRUCTION COMPANY INC 1 OF 1 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 SUR NCE FUND T �V DI RECTOR.INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 934610108 U-26.3 RU SILMLMO 5 ' _2 ° � RESIDENCE EXISTING IECE��`EEp I„S �2� D 5ATHROOM WINDOWtlllI MAY - ALTERATIONS VILLAGE OF RYE BROOK BUILDING DEPARTMENT 000 KNOLLWOOD DRIVE RYE BROOK PERMIT# �Pc�•�" G ]� NEWPORK 30 SBIL119 �lei mlwl�� S ,'-Ey - � - 6"� 33X22 VANITY DATE APP E MA-Y - 1021 �y osE� C,Y� Gam eunoincw ECTO aiq.Brook,wv = T— N +i F �7�A't �l—f � 2 2 �� EX16TING WINDOW JOHN POWER 3 1 _ml 1 „ ARCHITECT 2 000 24 VAN WYCK STREET CROTON ON MIDBGN KY.IOStm � I I 914 . 271 . 3221 �oVnyolnpowxer�hneet�em O 3(oX40 - � T P. GL. SHOWER � � 2 4" OOR � m m _ BLDG PERMIT 4/21/22 DESIGN 9 4/8/22 EXISTING 22 DESIGN *1 3/15/12 DOOR DE IGN h IVIIRI EX 3 II/15/21 EXISTING Nona armf DOOR �� BATH PROPOSED ALTERAT D.w rw omr by JJP JJP raw+r 202118 3/4" I'-0" EXISTING WALL NEW WALL EXISTING TO TO REMAIN CONSTRUCTION IBE REMOVED A = 1