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HomeMy WebLinkAboutBP22-109PERMIT/ODATE: 7 as EXP: Q a SECTION . 6,5 BLOCK LOT TYPE OF WORK d_//%_ / La JOB LOCATION / PS��7� 100 OWNE� C �a�'al G���r► �r - � % � e�� CONTRACTOR EST. COST, c�, 3'yCJ FEE^% �CO # - FEE c>36�w PD DATE TCO # FEE DATE INSPECTION RECORD DATE INSP FOOTI N G FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING RGH PLUMBING - GAS Q SPRINKLER / ELECTRIC LOW -VOLT L-] f ALARM Q AS BUILT Q FINAL a/ leanAsselT /,5 P/ OTHER APPROVALS ARB BOT PS ZBA OTHER VILLAG*OF RYE BROOK WESTCHES COU�'TY, NEW YORK No: 23-02J Certificate of Occupaucp This is to certify that R)'C112f-a qkq"&"�Y'U, lf mb�r *7 Ei/zabeJ/7 Pn� of, fJktt V , +'V 7 having duly filed an application on - bvua Y y /Q 20 Q19 requesting a Certificate of Occupancy for the premises known as, J � ^ i'I e R0CA d , Rye Brook, NY, located in a PU D Zoning District and shown on the most current Tax Map as Section: &5 Block: / Lot: 4-00 and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No.A1 19— , 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 New York State Classifications, Use:l�ai--,5 /7,f-rO.,-n , Construction: , for the following purposes: R> �y� / /d/� y Ye e /��/7'I� 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 heights I e made nor s e building be moved from one location to another until a permit to accomplish such change has be obta ied om a Buildin` Inspector. Acting Building Inspector, Village of Rye Brook: Date: f EB ECENE D =iO BUILDING E A iTMENT For office use onI VILLAGE OF RYE BROOK PERMIT# — a9 ISSUED: lv-0 7-a� 38 KING STREET,RYE BROOK,NEW YORK 10573 DATE: J—/0-t13 VILLAGE OF RYE BROOK (914)939-0668 FEE:,— PAIDIR BUILDING DEPARTMENT www,rygbcook,arg 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 Address:,A n"kQ+tWe- Rom -u-Rf oa K VLy 10 s q 3 Occupancy/Use: I F41Y Parcel ID#: 1,) y, Zone: _ Owner: .l A p,' U 1 tek-rOn-o-t'A Address:'( 03'(1.e-40t\je. 96&4 )Q 9rmk< NUJ' l 6S� )3 P.E./R.A. or Contractor: L. r t 0,c�Address: ?� Wive- C dt iy> 1p'ql Person in responsible charge: U Address: 3�0 MS} Shofe Cove C a j 1 05q Application is hereby made and submitted to the BuildinInspector of the Village of Rye Brook for the issuance of a `� Certificate of Occupancy/Certificate of Compliance for the structure/construction/alteration herein mentioned in accordance with law: STATE OF NEW YORK,COUNTY OF WESTCHESTER as: 1 H,?1&M being duly sworn,deposes and says that he/she resides att (Print Name of Applicant (No.and Stree in �,J.e `(oo— ,in the County of � /j}C {� �'P C in the State of ,that I(City own/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:$ , for the construction or alteration of: g eN O�o,--.to n,2 0� "A � 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 V�--) Sworn to before me this day of ?� ,20��� day of , 20 YL u, Signature of Property er Signature of Applicant xc�aA ( 6e ame of Property Owner Print Name of Applicant Notary Public Notary Public SHARI MELILLO Notary Public,State of New York No.01ME616W63 8/12/2021 Qualified In Westchester County commission Expires January 39,20011 �yE Bkaj . 1982 BUILDING DEPARTMENT r DBUILDING 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' ` " \A e ( 4� DATE: PERMIT - ' `V1 Zr � ISSUES. SECT: BLOCK: LOT: LOCATION: 1 � `)�'�v v' 3 � 9 OCCUPANCY: " .'i ❑ VIOLATION NOTED THE WORK IS... ''ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ GROSS CONNECTION FINAL ❑ OTHER Qye 4ROuk 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.or8 - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - -- - ` r , �� S 4--c'(N-Q 1 `� ADDRESS . DATE: �� PERMIT# \ ISSUED: I ` SECT:_ ` BLOCK: + LOT: ' LOCATION: , �1 * --?��� OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION �-`� `� REQIIIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER a a i a i : N M n it wrAcn too rA ON o O � W Q W p wSx o ob s W■ 00001 Q A W 14 y y �- O a 'u 0 MWIM CN a � � � ba y' : �T� MTI x 00 i a w Q U o � oo � v � oOro Uz � ao v) • v ea Q ° t= 00 tu >* � qu Ucl Zo u C7 A z © 1 V' a W d ° q PG b �I ►`� Par. ►V•r O ° m P-0 W W ►'� � vi �' s BUILDING DEPARTMENT VILLAGE OF RYE BROOK RJUN 2 1 2022 938 KING STIIEET RYEBROoK,NY 10573 1 (914)939-0668 VILLAGE OF RYE BROOK wwwxyebrook.orz BUILDNG DEPARTMENT INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: Approval Date: J UN 2 2 a22 Permit#: 6A),' —/o9 Application Fee: $ Approval Signature: Permit Fees:$ Disapproved: Other: ****,tx*wxw,r,rx******\\,t****�*********,�****�************«***********�,r**,t,r*,�***,t***t****,t********,r**,t,t,r**,►•**** 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. f,,� 1. Job Address: .k ar,l� t�oa e Br ac k f11t1 1 1 /&J r& )r�"'' Zone: 2. Pro osed prov ent. ribe in deta) ): U Q. � 'c0/-" 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 I: 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...) :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 fam.,comm.,etc...)Prior to Construction: After Construction: 6. N.Y State Construction Classification: N.Y. State Use Classification: 7. Property Owner:Q'A a Address:].nl l Jg_!M+O rV 2 R G10 A e 9G)n k�13 Phone � � Q�� Cell 0 email:0bdre-e-n6adI a Q0a)k!W'fve-+ 8. Applicant:R1 L ud G-F@e hAfl n Address:i rh j JQ S-r O 1N�L Phone Cell )5;q6- Oaan email:rbQreeYU6fi'gA 4,6o+Atilk 1e' pe_i 9. Architect: 5F-T-(010 M-7,Az 1)0 Address: S rI n TS f-"r 1 9,6 c Phone# ` 4 Q 2zJ O a 8 Cell# 1 Y Qp 7 k'7 2(, email: (�I O c ll/1,�c ✓t. Y►�I 10. Engineer: Address: Phone# Cell email: 11. General Contractor: Address: f Phone# Cell# O email: , ((S tz 12. Estimated cost of construction $ VI) � ,_ C-1-2 e-\, (NOTE:The estimated cost shall include all labor,6kerial,sc"aff'ool 'm , ed equipment,professional fees,and material and labor which may be donated gratis-) 13. Job Timetable:Start: Finish: (t) 8/12/2021 BUILDING DEPARTMENT VILLAGE OF RYE BROOK J U N 2 1 2022 938 KING STREET RYE BRQox,NY 10573 (914)939-0668 i O!= R''E BROOK .r e6 o kur i I_;_r B61DIiNG DEPARTMENT AiFFIDAVIT OF COMPLIANCE VILLAGE CODE §216 • STORM SEWERS AND SANITARY SEWERS THIS AFFIDAVIT MUST BEAR THE NOTARIZED SIGNATURE OF THE LEGAL PROPERTY OWNER AND BE SUB111 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:�, C aT d C, fek , residing at, 4 A nzz R 0 (Print name) (Address where you live) i os 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; I d 1 6S , Rye Brook,NY. (Job A dress) 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. ( ignature of Property Owner(s)) L � (Print Name of Property Owner(s)) Sworn to before me this ) day of 20 _ (Notary Public) SHARI MELILLO Notary Public, State of New York No. 0`_,.IjEC160C63 Qtia[ified in Westchester County (2) Commission Expires Januan,29.20 s/i2r2021 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. ST TE OF NEW YRK,COUNTY OF WESTCHESTER ) as: ! being duly sworn,deposes and states that he/she is the applicant above named, (gnat a of individual signing as the applicant) and further states that (s)he is the legal owner of the property to which this application pertains, or that (s)he is the for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,attorney,etc.) That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable Iaws,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 3\ Sworn to before me this day of �Lv� ,20� day of , 20 signature of Property Owner Signature of Applicant ��. J Gc nine of Property Owner J Print Name of Applicant k-Al-\rdAZD — Notary Public SWARI MELiLLO Notary Public Notary Public,State of New York No.OiME6160063 Qualified In Westchester County Commission Expires January 29,20)/ (4) 3121/19 a N N N 1+1 Lin ►. r W \ ao 00 u *0 v � qC to u 0C 0. lZ MCI :T a Q YL� Cs N et i W ~ CS n O �j ` cq 0 �i z z CA Rr o1-1 �+ w w U leif �+ H oo z as \ a 3 U O w Zo V C w z C� �..., z zCN G� aS w N � w � ait W z u z w ° v: �j — Q M. . a a. w D � rA ! , IGO 1c;(lA4;4;444.49C:41Cl C. 0 t.4.A.4.4.$.C* . fi: 4.426C;Ct4i$6i46t6tooGOa41i 414141 .' yE t3Rn� E� Q V • BUILD`�11� DE��RTMENT VILLA�GGE OF RYE`�4OOK JUL 22 2022 938 KING' ET RY> B[t OK,NY 10573 0668 VILLAGE OF RYE BROOK '- BUILDING DEPARTMENT Xvwb X,ftC&dgk.org ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required ) FOR OFFICE USE ONLY BP EP#: Approval Date: AUG 5 2W Permit Fee: $ Approval Signature: 1 Other: Application dated, 7Z2 2-Z is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install and/or remove electrical equipment, wiring, fixtures, or to perform other high or low voltage electrical work as per the detailed statement described below. By signing this document, the applicant & property owner agree that all electrical work performed will be in conformance with all applicable Federal, State,County and Local Codes.1.Address: ml I�'S�'o� 2CQCt SBL:12LI•(PS — I Zone: (00 2.Property Owner: P—) —1 Address: 11(11 I�S`It LQ. �OAd U(� .� t Ili Phone#: Cell#:C111O1 email:Rg@►rttnbtr9 I@OP}OC1It(�•!\Q� 3.Master Electrician: M(L(>L Fans)n Address: ASS QcMral fl-�t O Slni nq , NY Lic. #: 2171 Phone#:C1M OH I Rkgq Cell #: q 19 490 5S39 email:'l=Qn()1rAQeltetnCQGZ())• (0M Company Name: t-0.nr11 na EEeC' 1 ri C Address: CC OI I it VC OZ I n I(�1G}, NY 10S(62 4.Proposed Electrical Work/Fixturc Count: 1(\$-tOL1I (2) VOLNN T1X-Vf' ,-CM L)a'C•hWn.111MII Z A1=11(hFI VeMtfrS, lMtall 2 LUM(\ 6AMMf r.1,1( IGI I (I)rtt1N ( EC 1 004 4 tm bwhroom,agi all (v�iC 1'ayd aanST p dimmcibu -Am/rirS Iracill (2) txha"+ -fGps , 0)SUii+t'h iQ&. (2) gomla4 f1 mrrS. t1) IC,_ roAfd CADS wl LED dimnbhlQ. AXdVYU, 12)Elm , (2)Lut Q LEDdlm(r1erS , (?)SudlfiCh k'A 5.3`d Party Electrical Inspection Agency: ********************************************************************************************************* �SSTAT/ /—E OFF NEW YORK,COUNTY OF WESTCHESTER ) as: //! " I/I/A,j ,being duly sworn,deposes and states that he/she is the applicant above named,and does furt er (print name of individual signing X the applicant)state that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the 1--le C414 i e' � 1 for the legal owner and is duly authorized to make and file this application. i mdtcatc architec i.conuracior.a;cnt,:un rn; ic.i 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 this day of 120 day off s Signature of Property Owner Signature of Applicant Print Name of Property Owner P M e of Applic Notary Public Notary Pt4ljft MELILLO Notary Public,State of New York No.01ME6160063 Qualified In Westchester County Commission Expires January 29,202Z 6/23/2022 • • STATEWIDE INSPECTION • 1:1 office@swisny.com SWIS JOBAPPLICATION tel845.202.7224 • • 1•21 SWISNY.com I SWISTraining.com Office Use Elect.Permit# Date Bldg Permit x Utility ID# Final Certificate# City/Village �I"a�Q r( Zip I h Township County Address ("�r� Cross Street Secti�n.` l✓ Block i Lot r 0 OO Owner Name/Address(If different than above) R I 1, 0 C1( Contact Number ❑Basement ❑'1 st Fl. ❑y2nd Fl. ❑3rd Fl. ❑More Than 3 Fl. ❑Garage ❑Attic ❑Outside Residential ❑Commercial Receptacles Special Recept GFCI AFCI! ; Switches Dimmers Smoke Alarms Carbon Monox Hood Trash Compact G Amt Amps 2 Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Warm Draw Incandescent Fluorescent SERVICE Amperage Voltage 1 P I 3P #Meters #Disconnect ❑Underground ❑New ❑Reconnect ❑Overhead ❑Change ❑Visual Re-Inspection ❑ Safety Re-Inspection ❑ Re-Inspection Additional Information (�)Od � � hr0 NPvV r�cesS�'d IIoj1 and nPw van) ► �j NfvV fxhobSl -_p� n5 1 n i� r- c � o� i�rt . <'a 2h� POG ( I (Y� NPw ( C- SS�d 1i9 s arm "`n�W t , I AUG - 4 2022 VILLAGE OF RYE BROOK BUILDING DEPARTMENT This application is valid for one(1)year from the date received by 5w15.This application Is intended to cover the above listed items to be inspected,If at airy time of Inspection additional Items haw been Installed,you are authorized to make the inspection and adjust the fee for the additional items inspected.The applicant declares that there is no open applications for the above address with any other inspection company.The applicant,owner or authored agent agrees to all the above terms and conditions as set forth for the application. Inspector Date Finalized Inspector# yl Company Name �- I �; i i , ; Date Signature,.,"/ Address �1 \ i City/State i � )„ Zip Code License# Phone# D IE"C E �V/ 1E-,-' DD State Wide Inspection Services FEB - 1 2023 1080 Main Street Fishkill, NY 12524 VILLAGE OF RYE BROOK 845 202-7224 Phone BUILDING DEPARTMENT 914-219-1062 Fax STATE WIDE INSPECTION SERVICES Email: office@swisny.com Website: www.swisny.com Service With Integrity BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: Fanning Electric Co Inc Richard Greenberg 55 Central Avenue 1 Milestone Road Ossining, NY 10562 Rye Brook, NY 10573 Located at: 1 Milestone Road, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP22-176 124.65 � 60 Certificate Number: 2022-4559 Building Permit Number: BP22-109 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: 1 Milestone Road, Rye Brook, NY 10573 The First Floor Bathroom and Second Floor Bathroom were inspected in accordance with the NYS and NFPA 70-2017 and the detail of the installation, as set forth below,was found to be in compliance on the 1st day of February 2023. Name Quantity Rating Circuit Type AFCI Breakers 03 20AMP Single Pole Switches 08 LED Recessed Luminaires 09 Sconces 04 Bathroom Exhaust Fans 02 GFCI Receptacles 05 Jacuzzi GFCI Block 01 Officer: Frank 1. 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. a f yi y. y 1 'J y a N N N ON ! � w ai CL O N C7 .i n a• �I �, r F r Lt, PO ,, W GO C• y. � xyy O r \ all a a t o ^ y. n 1-�I �-• W OG � t � � A c MW � z z a ►-� r-� � � G a ^ W o X x H �+ E ° z U 0 z , o p a w g LnGq z A z A a CA a -n n ID JUL - 7 2022 BUILDING DEPARTMENT VILLAGE OF RYE BROOK VILLAGE OF RYE BROOK BUILDING DER^RT MENT 938KING STREET RYE BROOK,NY 10573 (914)939-0668 www.Kyebrook.org PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP#: 2 l PP#: Approval Date: J U L 0 8 1022 Permit Fee: $ Approval Signature: Other: Disapproved: (fees are non-refundable) ***************/*�********************************************************************************** Application dated, /'2-0��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 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 Federall,,SSt/ate,/County and Local Codes. 1.Address:1 R n AA il_D :`.c k 1Y i c; ��SBL: I c>7 Zone: ?4b 2.Proposed Work: 3.Property Owner:R;�_ pt`,r�N bf� Address j n, 'S tcryL g�4 R T� 6Lc K jW 1CS Phone Cell#:IfG `�1�- (L L email:('b A f eQ11> {` � Q160 1-aye• IVe`} 4.Master Plumb Address: Lic.#: jj-, 9 Cell#:Y, 7 Y90 3�o S 3 email•Company Name: TT) Address .0,90 < 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 Z f 2nd Floor t r 31 Floor 1 4"Floor 5d'Floor Exterior 5.*List Other EquipmentlProvide Details: kxC'( (Notarized Signatures Required Next 2 Pages) -1- si12r2o21 STATE OF NEW Y RK,yCOUNTY OF WESTCHESTER ) as: K Ia-' ,being duly sworn,deposes and states that he/she is the applicant above named, t name of individual signing as the applicant) Mer states that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the - If//--1 1-Z 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 J10 Sworn to before me this qJ4) day of\yN OJ-0- ,20 day of aJ U f-",( ,20 gnature of Property Owner a of Applicant Pfint Name of Property Owner Print Name of Applicant W01 ' ��D-L �-- AQ�u. 64 Notary Public;!- �; ;' '�) Notary NOTARY PUBUC,STATE OF NEW YOM Registration No.OIAL5002693 Oualified in Putnam County 3 My Commission Expires October 5,2022 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 DEPARTMENT p E CEDNE VILLAGE OF RYE BROOK FEB 2 4 2022 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 VILLAGE OF RYE BROOK www.ry oo_i ore BUILDING DEPARTMENT ****t*ttt**t****ttttt****t***t**ttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttttt 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: '3, ,residing at, t�—rn i l eS♦bYV Cell (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�e.5rtb :ea f 16K T y I 0,!� 1 3 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. 1� P_24� _"k� ( ignature of Property Owne s)) r �'kc�� Lrc� Gi-c" a� (Print Name of Property OwneAs)) Sworn to before me this D_­1 101 ,20_1"'L_ (Notary Public) SHARI MELILLO Notary Public, S'rte of Newyork .3 -3- f'nmmission Emir,,.i?i'1--4?q 20,2-a 9/1212021 ' Building Permit Check List&Zoning Analysis Address: �_ Wll l�rc-��ly� —1 SBL:- G Z4 , 6-c Zor e: c.9 Use: -t Const.Type: Other. Submittal Date 17-k 7 Z Revisions Submittal Dates: Applicant: a 1 3 �G Nature of Work: —��t�1P n�-' �O Fj 9— Reviews:ZBA: J U N 2 2 1012 pg. BOT• Other. OK ( ( ) FEES:Filing: 7 � BP: C/O: Flood Plane: Legalization: ( ) (u-' APP: Dated ✓ Notarized: ✓ SBL: ✓ Truss I.D. Cross Connection: H.O A ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening: ( ) ( ) ENVIRO: Long. Shore Fees: N/A: ( ) ( ) SITE PLAN:Topo: Site Protection: S/W Mgmt.: Tree Plan: Other. ( ) ( ) SURVEY:Dated: Current Archival- Sealed: Unacceptable: ( (.� PLANS:Date tamped: Sealed: Cop Comp Copies- '2— Electronic Other. ( ( ) License: �Workers Comp: t Liability: .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: Pemut H.W.I.C.:_Battery:_Other. (� ( ) PLUMBING Plans: Permit: Nat.Gas: LP Gas: N/A/: Other. ( ) ( ) FIRE SUPPRESSION:Plans: Permit: N/A Other. ( ) ( ) H.V.A.C.: Plans: Permit: N/A Other. ( ) ( ) FUEL TANK:Plans: Permit: Fuel Type: Other: O O 2020 NY State ECCC: N/A Other. ( ) ( ) Final Survey Final Topo: RA/PE Sign-off Letter. As-Built Plans: Other. ( ) ( ) BP DENIAL LETTER: C/O DENIAL LETTER: Other. ( ) ( ) Other. ( )ARB mtg.date: approval- notes: ( )ZBA mtg.date: approval• notes: ( )PB mtg.date: approval;- notes REQUIRED EXISTING PROPOSED NOTES APPRO Date•, . I IN >rq= Front Sides: Rear. Main Cov: Accs,Coa. F HS : S .HS • S,Fa Tom EL Imp: P kind Hight/Stories: notes: Laura Petersen From: Laura Petersen Sent: Thursday,June 23, 2022 10:42 AM To: 'loticontracting@gmail.com' Cc: rbgreenbergl2@optonline.net' Subject: Building Permit Application - 1 Milestone Road Good morning, The building permit application has been approved by the Building Inspector. Before I can issue the building permit the following items must be submitted to our office; . Copy of general contractor's valid Westchester County Home Improvement License. General contractor's valid liability insurance (the Village Of Rye Brook must be the certificate holder) Thank you Laura Laura (Petersen Office Assistant Village of Rye Brook 938 King Street Rye Brook, New York 10573 Phone(914)939-0668 1 Fax(914)939-5801 1 llpetersen(cDryebrook.org 1 �� n►' cYc 1 �11 MIX r�ll��1fli .iili; i«����I�t 1�•.I�'tl +��1����1�� �;1/11,� ,,Ii, 1fL iyl��►'l�,-+:f.:� �I�til�'.i(f:�r I��iFl�lll -.._sL%;i:\,Il�ihll�iafL/�._.L.4iV�'I�,ill% I•_. j(t)►� (ssl► �3�1:�,' 1� ,+h&_..w1��t1?\ti!.1�` ecti_,_..•.11.1 .{'lii C � C � .i •. 4-2 U 4 (a'f�,. � �. '� 7 u � y O G •,�ti�i eAo 43 � 1 E � o -g :r�2•� C, cn Ir amm I J N T 0 ` p., ter".. U-) O ction O 7 Z F— w c`�'i L1 (� •°. . .y. V O 3 co)` ,= L w Q e a _ _ N zz cc co 00 W :: y R may_ qu :7 , fi- . . . . . . . . . . w�--. . . . . ..f .'^^.,^ . . .rry �� . . . . . . . . T. .^^. . . .' .r,.` . .T. .♦J etsi)>� Y `•(S>•)� ,Il ,1�>�'��1h 1�1 1�1-ski'._�fflil�lill�jli,.1:4�...-f fli�1,,11���,,��\;['3_i--�3;)n�l��ll�l�l��t�k[�_•��fi�+��'1,,/,1,,1\'ti.)iE[�.�J,ii'�i jl��ll�l�a:':'. � '•"'�j �I/ ti is •�1//•rf� '�S/ •'. tU� ,' I/IN '��f�►'��� `•��c(�t�\ O►w�li1 /•1�!%. �rr')'ti ` � .to •�,�/�/:/�. a'df�i rN .. ►.1 .ti�j'Lu' �� ,,y��1�{../��(t,�1 Yip • �.. � -��� "�"'�/.1.1'f. �. �� �1 �+FM•"' �O "JN�`."- .. Op :Y O{'.1��1f .0.:, 15 1.\ .O;` ♦/f. ,' ' o •tom„- w .�• %Jl� 4''wi• �` dl1 ..► "�� : �/1 SISM „{d6w . ACORDo CERTIFICATE OF LIABILITY INSURANCE FDATE 6,(�23noz2 312022YY1� 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 NAME: Laura Brady G&N McGovern Insurance Agency,Inc. Co. ; (914)803-1300 (aC,No): 837 Mclean AvenueADDRESS: info'a mcgoverninsurance net INSURER(,)AFFORDING COVERAGE NAIC S Yonkers NY 10704 INSURER A: UTICA FIRST INS CO 15326 INSURED INSURERS: LOTI Contracting LLC INSURER C; 390 W SHORE DR INSURER D: INSURER E: Carmel NY 10512 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE NSD V POLICY NUMBER (MUMD lYYYY) MlOD/YYYY) LAIRS X COMMIERCIAL GENERAL LABILITY EACH OCCURRENCE S 1,000,000 CLAIMS-MADE OCCUR PREMISES(Ea ocamenw) $ 500,000 MED EXP(Any one person) S 5,000 A Y Y ART5111021-04 02/26/2022 02/26/2023 PERSONAL a ADV INJURY $ 1,000,000 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 IOTHER, POLICY ❑JE a LOCPRODUCTS-COMP/OP AGG S 2,000,000 $ AUTOMOBLE LIABILITY (Es accident) S ANY AUTO OWNED SCHEDULED son BODILY INJURY(Per per ) S AUTOS ONLY AUTOS BODILY INJURY(PersccideM S HIRED NON-OWNED AUTOS ONLY AUTOS ONLY (Per axklent) s S UMBRELLA LIAR OCCUR EACH OCCURRENCE t EXCESS LL4BH CLAIMS-MADE AGGREGATE s DED RETENTION s S RKERs;COMPENSATION EMPLOYERS LIABILITY Y/N STATUTE ER PROPR I ETOR/PARTN ER/DCECLMVE FFICEWMEMBER EXCLUDED? ❑ NIA E.L.EACH ACCIDENT S Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S yes.desatbe unnder ESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be atbched if more apace is required) RE:Richard Greenberg, 1 Milestone Rd,Rye Brook, 10573 ADDITIONAL INSUREDS: Village of Rye Brook,938 King St,Rye Brook CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCPJ13ED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Village of Rye Brook ACCORDANCE WITH THE POLICY PROVISIONS. 938 King St AUTHORQID RES@1T—A/TINE Rye Brook NY]0573 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD NYSIF New York State Insurance Fu-t PO Box 66699 Albany NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE a a """""" 935888194 G 8 N MCGOVERN INSURANCE AGENCYINC 0 837 MCLEAN AVE YONKERS NY 10704 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER LOTI CONTRACTING LLC VILLAGE OF RYE BROOK 380 W SHORE DR 938 KING ST CARMEL NY 10512 RYE BROOK NY 1D573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W245624" 108004 10/182021 TO 10/182022 11/18/2021 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO 2456 24", 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,INCLUONG ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR NIEBSITE AT HTTPS:/AVWW.NYSIF.COMPCERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY AFFORDS COVERAGE TO THE SOLE PROPRIETOR.PARTNERS AND/OR MEMBERS OF A LIMITED LIABILITY COMPANY RONAN DOHERTY MEMBER OF LOTI CONTRACTING L LC 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 STAT SU NCE FUND ,v/ DIRECTOR.INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 228953323 U-26.3 as �e r �jGe�i �rti Y �11 � L � \ L (�' k � l To COPY f Cant t � PERMIT# SBL# 6 2 • �S — 4 JUN Nowammommommum 2 1 T — i DATEAPPR D JUN 2 � -��' VILLAGE O�- RYE E BROOK BUll: DEPARTNI✓NT BUILDING INSPE R it 1,106 Q m 6rvolt,IiY n�d / v n � � �v d ,'r z �� �i ,4 � 0 9��- �50�� � ��yj�f�, » �r/� �IDs TO I dc�r Oar, � � 220 41' 1064 352" 79" 2W2742 V1 2- 2W3024 W1242-DW2142- bo N i F3 2U630 6RT 2OCU3096 K618 DISH-IQ6 2SRBWT39 DB15 GC527SS SL N 4 ROLL OUT po coo m0) CAB WITH GLASS DOOR � � N � n 17 A�- Om CT Z A N nO LO M M M [7 D 21324RT WINE.24.STEEL124R my 0 N 4X A X ADIP61-79 N rn 30" co �S�� 3 4 4 ," RICHARD GREENBERG 2 1 MILESTONE RD RYE BROOK NY 10573 zA 1_ SIN � (h oI^N -1 Y/ V r , e z" 702 a�-352 : a 1554"" All dimensions size designations . This is an original design and must Designed:42/2022 given are subject to verification on not be released or copied unless Printed:6/92022 job site and adjustment to fit job � applicable fee has been paid or job conditions. 1_--�y ! order placed. JAI DESIGN 91+231-5889 greenburg richard.kit Architecture Drawing#: 11 No Scale. 220 4" 62 2" 2711 11511-f-384" --115"-,�-301'—f12"�-21" co ti N 2W3024 ]1F1 N 2W274W1542 1542 W12,DW2142-1 Zo — LU 11 MW.HOOD N F:2UB3096R20CU309 `t -o N — KB18 DISH-IQ6 2SRBWT39 DB1 3DB30 SLSB33-R r 30" 30" 184-24" 39" ,, 3b" 33" z 144 92 z" 804" 48" All dimensions size designations This is an original design and must Designed:4/2/2022 given are subject to verification on not be released or copied unless Printed:6/92022 job site and adjustment to fit job '' ' t` a hcable fee has been aid or job 1 j j pPi P conditions. .a order placed. JAI DESIGN 9w271-5889 greenburg richard.kit El 1 Drawing#: 1 No Scale. 864 3it 2111 28 2 11 - 36" ZO N o 2RW3624 N DW2142-R W3042 CO Ir- J ME- ----- REF.MI DW36 d' Ln _ Mir SLSB33-R M65- CIO IU 3 311 16111 _„ 3�" 4 ' 68 6" 1 171fi" All dimensions size designations This is an original design and must Designed:4/2/2022 given are subject to verification on not he released or copied unless Printed:6/9/2022 job site and adjustment to fit job applicable fee has been paid or job conditions. order placed. JAI DESIGN 914-231-5889 greenburg richard.kit El 2 Drawing#: 1 I No Scale. F--1 I B24b-AR . W1NE . 24 . S-,2B24RT i /1 24 " ---7r 23i� 24 /111 6 6 36 36 7211 All dimensions size designations .. , y This is an original design and must Designed:VM022 given are subject to verification on not be released or copied unless Printed:6/9f2022 job site and adjustment to fit job applicable fee has been paid or job conditions. order placed. JAI DESIGN 91+231-5989 greenburg richard.kit El 3 Drawing#: 1 I No Scale.