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HomeMy WebLinkAboutBP22-156PERMIT ## �1 SECTION TYPE OF WORI JOB LOCATION OWNER CONTRACTOR. EST. COST %CO ## TCd #k FEE DATE DATE FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING WOOF RGH PLUMBING GAS SPRINKLER ELECTRIC LOW -VOLT 0 6 ALARM 0 AS BUILT FINAL PII� Ln►1 a79_ 9 V y�3ia-1Do/ 9 Q�-/l9%CL4eplu.M���y / /c 3�6/ OTHER APPROVALS ARB BOT PB ZBA OTHER _ 0 VILLA R BROOD WESTCHEStm COti-N-gv, NEW YORK NO. 23-005 Certificate of Occupaucp This is to certify that 9 1 w Shan das of, having duly filed an application on Q? 20 -0 requesting a Certificate of Occupancy for the premises known as, fflC ouilrark Mood ,Rye Brook,NY, located in a Zoning District and shown on the most current Tax Map as Section: /U?:) ' a 5 Block: I 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 New York State Classifications, Use: 12- 5 ©i,�{�- F tn/1t/ , Construction:, for the following purposes: 4h V-e e— �raorrr�' 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 been obtained from Min nspe or. AN 10 202 3 Acting Building inspector,Village of Rye Brook: Date: EcE�wE D R1 BUILD ENT For office use o 1 PERMIT# DEC 2 2 2022 10 VIL OF RYE OK ISSUED: 8-dllor3a I H KING STRE YE BROOK' YORK 10573 DATE: /a-vlo>- VILLAGE OF RYE BROOK BUILDING DEPARTMENT 0 a FEE: `g a35% PAIDJR 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 ***rrrrrrrrrrrrr***rrr,+/+rrrrrrrr►rrrrrrr***rrrrrrrrrrrrrr*rrrr*rrrrrr*rrrrrrrrrrrrrrrr•rrrrr***********rrrr************srrrr Address: 80Wk 10 Ll lOS 7.3 i Occupancy/Use:6jw,_-fmi1A Parcel ID#:_ , Zone: -�S Owner: H2n �l �� + i AS kC V►GIh Address: 9 I'Y)�adtx.�Iar 1� f y.e Q�0UfC J 100 i P.E./R.A.or Contractor: 1)1e ,-OU S1G. Address: 132- LG(tJ'l1' (e g4 Ave_ WrCbm 36 Person in responsible charge: IMO�'lU 0� Y1CI1 Address: -' VWe'� 1 Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issuance of a Certificate of Occupancy/Certificate of Compliance for the structure/construction/alteration herein mentioned in accordance with law: STATE OF NEW YORK,COUNTY OF WESTCHESTER as: I i W 4k 6l V P411 being duly sworn,deposes and says that he/she resides at 150 m �dOK1�1 V/� (Print Nae of Applicant) (No.and Street) in �zya2 t1- intbeCountyof_ Se4Z 44 intheStateof_bj:�. that (City/Town/Village) he/she has supervised the work at the location indicated above,and that the actual total cost of the work,including all site improvements, labor,materials,scaffolding,fixed equipment,professional fees,and including the monetary value of any materials and labor which may have been donated gratis was:$475,000.00 for the construction or alteration of:3 in 4-e/,'o,- La4-4"0o"1_5 ' 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 lnspector as per§250-10.A.of the Code de of the Village of Rye Brook. rtd Sworn to before me this � Sworn to before me this Al_.� day OfA 20 X1- day f QLr-_ I , 20 Z 1� Si at of Property Owner Signature of Ap cant r S�rd� Print m of Property Owner Print Name o Applicant N Public Notary Pu " '�"�sOJIdX3 UOl1<e1WW0e HERItiAWDO AGUILAR AlunoD Jaalat;rpIseM ui poiplenll Notary Public,State of New York f, MO o e1l01S olAnd AJTION Non West 3 ester S!12:2021 N � Qualified in Westchester County Z3aNVNY3H YWAV"O Commission Expires April 24,2Qz` QyE BR(�� O� 2m �7 1952 BUILDING DEPARTMENT ❑BUILDING INSPECTOR SSISTANT 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 : �e!�Aowo \ )(- DATE: v PERMIT# l' I S ISSUED: CT: ' �1 BOCK: t LOT: LOCATION: OCCUPANCY: I ❑ VIOLATION NOTED THE WORK IS... / ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION I REQUIRED ❑ FOOTING WC` ❑ 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 �yE BRC�vk. � cu � BUILDING DEPARTMENT 4 UILDING INSPECTOR SSISTANT 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:- mea�w h \ �- (AcDATE: PERMIT# 'I I�� ISSUED: 6�� ECT 5 LOCK: LOT: LOCATION: )N � \ b(- 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 .2' INSULATION ❑ NATURAL GAS V ` \n ( ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER QyE BRC�v�. �1' 1982•��O 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 - - - - - - - - - - - - - - - - - - - - 0 1 ADDRESS : ` ``^�W� DATE: �C� PERMIT# L ISSUED Zz SECT: V- I?OCK: LOT: 1 LOCATION: OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS.../XACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑� FOUNDATION 11 UNDERGROUND PLUMBING NOTES ON INSPECTION: J: ROUGH PLUMBING ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER N ■ � NO © w � ■ A © o. ° V� y � o i a 4 (, O co o ,y -d xa a en ■ ■ 1�/i c� hr O o a -p u o 1O Z � 0 i ` O M s � cnb ° H V' © O o r a © QJ CV MM Q ° VJ w � rn rT ► W N go z o ° o a. ■ U 71 r q U W w A O V O O 8 �r =1 w. O ~ 0 d It �' OZ U O [act° ay z A � � q W U 0 vy BUILDING DPI WNT VILLAGE OF RS *OOK AUG 1 1 2022 938 KING STREET RYE BR©U1C,NY 10573 \.v(914)9�,9-0668 VILLAGE OF RYE BROO KEUILDINn DEPARTMENT INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY:Approval Date: Permit 4:IG.� Application Fee:. $ /0r/� Approval Signature: Permit Fees: $ 1 E Z F Disapproved: Other: Application dated: U�r ��t7 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: q YY1 �1�U: 2r1C Rlo. SBL: h�/i d _3-1—/3 Zone: 2. Proposed Improvement.(Describe in detail): nr))SL,pshAT(Ln l°Q t3A� l'SAil1(� A 3. Does the proposed improvement involve a Home-Occupation as per§250-38 of the Code of the Village of Rye Brook? No: .f 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: T--A !,. After Construction: FAM- 6. MY State Construction Classification: V ES N.Y. State Use Classification: Cal_ 7. Property Owner: `]X&>tJ gc_yXID&= Address: 1M Phone# (.nl 1!A) Z-l9- `1l 1 Cell# 9 email: JNsarl%�?T1 8. Applicant:�s� JNE "Ll-g<_.j_I�;Address: 'f_9 MT, aZp&AtX I Phone# (�1 dr) zS-- y� _Cell# email: p {Z1cA�1AStrl'J 9. Architect: ;t:��4,�` -� T ;�Ltr is S2�Tt•Address: 'L t.' 'q Phone#(C�i-r Cell# _11(0) 10. Engineer: Address: Phone# rCell# email: 11. General Contractor: C. Address: )_Q/r_►/1Jo-'7-1-,4IAe,-7a10 Phone# Cell# C.A3 �3& nn,, 12. Estimated cost of construction $ 0)30 1 t (NOTE:The estimated cost shall include all labor,material,scaffolding,fixed equipment,professional fees,and material and labor which may be donated gratis.) 13. Job Timetable: Start: l'o-zaZ Finish: ©C.Tota"g, -Z-0-tZ (I} sn z/2021 D [EC EME BUILDJ,NG DEPARTMENT VILILAGE OF RYE RROOK AUG � 1 0022 938 KING STREET RYE BROox,NY 10573 (914)439-0b68 VILLAGE OF RYE BROOK www.ry ►ro_2k art 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: J P S, 1l , residing at, 9 bA;RAD &&!j P�J �- JL�L 4 (Print sialw) (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; GJ fYAo cxi3, o4L<., an , i3�-�c V_' _ > Rye Brook,NY. (dob 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. (5ignal o Property Owncr(s)) (Print N of Property Owncr(s)) Sworn to before me this to day of ) )— ,20 z) Y (Notary t'ublic) aNAyRA MEAJt1ARDEZ Notary Public State of New York (2) Qualitod in mi Weetchsaler ou ty Commission Expires_! S/12/2021 This form must be properly completed & notarized by the Design Professional of record and the Property Owner. Failure to provide this completed form with your permit application will delay the permitting proces 3,M / (� Notice of Utilization of Truss Type, Pre-Engineered I Vood AUG 11 2022 or Timber Frame Construction. (Title 19 Part 1264& 1265 CXN-AGE OF RYE BROOK U1LDING DEPARTMENT To: The Building Inspector of the Village of Rye Brook.. From: t>,�FNN �EPZ IZ A�Rt�� k1tT�G. C Subject Pro et : �"Y�CXx tp? EG ►Z0 SBL: Zone: Please take notice that the subject;\One or Two Family; u Commercial, ❑ New Structure ❑ Addition to an Existing Structure Rehabilitation to an Existing Structure to be constructed or performed at the subject property will utilize; NIA ❑ Truss Type Construction(TT) to Pre-Engineered Wood Construction(PW) ❑ Timber Construction(TC) in the following location(s); KJA ❑Floor Framing, including Girders&Beams(F) ❑ Roof Framing(R) u Floor Framing and Roof Framing(FR) Please note that prior to the issuance of the Certificate of Occupancy, the subject dwelling or building utilizing truss type, pre-engineered wood, or timber construction must be posted with a Truss Identification Sign, installed in conformance with NYCRR§1264 for Commercial Buildings, and NYCRR§1265 for One& Two Family Dwellings. Swom to beforp me this l014--- Sworn to be ore me this - "I day of 20 da of 5 ,20 2- Z- MAE Sign a of Property Owner Si esign Professional J�S"' �t�C t t:;,1 eA-T R-A Print a of Props er Print Name Design Professional Notary Nblic No Notary O blN DIONfSIO p�AYM NERHANDEZ -Qualified New York Notary PUMIC Stag of Neer Vbrk Westchester County :ualilled In Weetchest+er Co y (3) €]rP, 9/39/26 C,Nmrniaslon Expires- 3 .---- 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: 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 ,tMI�4 cl.36 T. for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,attorney,etc.) That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. By signing this application, the property owner further declares that he/she has inspected the subject property, and that to the best of his/her knowledge there are no roof drains, sump pumps or other prohibited stormwater or groundwater connections or sources of infiltration into the sanitary sewer system on or from the subject property.. Sworn to before me this Sworn to before me this day of U�� ,20 ay day of s�20 Z'Z Signature perty Owner / Q Signature of Applicant Print 1yof Property O Print Name of t Notary Public Notary� ("my"MEIINANDEZ JOHN DIONISIO Notary Public State of New York Notary Public State of New York Qualified in Weetchester o my Qualified - Westchester County CoffaWsslon Expires A3DI48040 € : 9 p /30/26 (4) 8/12/2021 f s: ' N N N W v v = M M 41 r O a n \ et O Q ;F.- CD O0-0 Ln c H a N C1= C d C7� , o 4 u � w � W to H O0 04 z Q > w v 00 en MM d H w A w A zz � � � w d 'x � F 8 ►-� W o w z a. 6n x x � ��� Ili ' Bum E MENT SEP 16 2022 VIL EOFRYE OK VILLAGE 0F ;'4\`YE BROOK 938 KIN ET RYE NY 10573 BUILDINf" 7, ,,�RXTMENT ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY BP#: Q Q)—)'fV_0 EP#: 'DQ)_Q)Q1S_ Approval Date: SEP 2 0 20R Permit Fee: Approval Signature: Other: Application dated, is hereby made to the Iding 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: 9 k4LCAP)OWLAILK RO SBL:I_ag,,?,T-- f — 13 Zone:e-15" 2.Property Owner: J A S o^j R i cknEft- -Address: ? &W d-44000(.4A4C RO, 4 Ye— 190ftIC Aly Phone#: 41y-A?q - q I I/ Cell#: email: 3.Master Electrician: VjfJe_4L.M-r C.C'>#JT4F_ -Address: 41591AJ.ej A1Y_LC_JA1 t Lic.#:6-110 Phone#:qtq_'%,2-( Jo(a Cell#: �aq-ti3ff-i 144. email: U1#,JAtJC00& owsA).0064 Company Name:Xffij40&j eteeTdti -NJc_ Address:Z 1(*,f_C9C ST OSS/AeAj Al fob 4.Proposed Electrical Work/Fixture Count: O'D - 3 54rw sr- L-0,;41<% -1 Jj (ve-cc seer...T LJ.4 L L X..., A' It*'r 14 4 rt .1 e?r4.*,,s 7- �s X r-Z Ae-er S- 5.3"Party Electrical Inspection Agency: STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: N C 4#,.rl Co#j T 0- 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 e_0AJTX#qCT0R— for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor.agc, i no,etc I The undersigned further states that all statements contained herein are true to the best of his/her knowledge and belief,and that any .e ork 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 bqfore me this 31 S day of 20 day —A-Arl-Ot- ,20 ZL;L . Signature of Property Owner azure of Applicant Vj A i c*mor 16)11 e Print Name of Property Owner �nt Nam o icant n n Nam 0 i' Notary Public LISA S Not ry Public t of New York 44850 gistratio 1R16344850 C Qu 09fied in estchester County Expires July ly 1 1.2OW co mi , n Expires July 11.2OW 6/23/2022 C;loz-f INSPECTIONSTATEWIDE 00 Service With hilegrity 21 • . 12524 SWIS JOBAPPLICATIONt. Office Use Elect.Permit# Q��� �� Date Bldg Permit# P a S'/ Scl Ft Temp# �O Utility ID# Final Certificate# City/Village �� 6T Zip O s -7 3 Township County W Q S T Address Cross Street S io g 3 Block ! Lot f - AQIowL f21� 2 1 Owner Name/Address of different than above) J Contact Number saN l� I c HTC2— ❑Basement st Fl. [5j:�Fnd Fl. ❑3rd Fl. ❑More Than 3 Fl. Garage ❑Attic ❑Outside sidential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms Carbon Monox Hood Trash Compact /t Amt Amps Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Warm Draw Incandescent Fluorescent SERVICE Amperage Voltage 1 P 3P #Meters It Disconnect ❑Underground ❑ New ❑Reconnect [E]Overhead 0 Change ❑Visual Re-Inspection ❑ Safety Re-Inspection ❑ Re-Inspection Additional Information e.N O v AT(v nJ or- 6 A'iH H2O 0 04 fF D H r i-i L A _ �j TN C`I A T t`yir� S J A SEP 16 2022 VILLAGE_OE::: 1= "BROOK BUtLt�1N ^E�a,RTMENT _ This application is valid for one(1)year from the date received by SWIS.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.The applicant declares 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# Contractor Date Signature V � =C i ZZ Address vlt LL I City/State OSSi N Zip Code 1 a SG License# C _ ' U ID# Phone# IECE �D V State Wide Inspection Services crk---> 3D 1080 Main Street DEC — 9 2�22 Fishkill, NY 12524 a 845 2 Phone 914-219-119-1062 Fax STATE WIDE INSPECTION SERVICES VILLAGE OF RYE BROOK Email: office@swisny.com BUILDING DEPARTMENT 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: Ancon Electric Inc. Jason Richter 29 Havell Street 9 Meadowlark Road Ossining, NY 10562 Rye Brook, NY 10573 Located at:9 Meadowlark Road, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP22-225 129.83 13 Certificate Number: 2022-5791 Building Permit Number: BP22-156 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:9 Meadowlark Road, Rye Brook, NY 10573 The First Floor and Second Floor Bathrooms,and Bedroom Lights 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 6th day of December 2022. Name Quantity Rating Circuit Type Receptacles 04 GFCI 05 AFCI 03 2 Pole Switches 15 Dimmers 06 LED Recessed Luminaires 31 Bathroom Exhaust Fans 03 Steam Generators 01 7kW :;J ;Ji J�1.r 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. 5 . i s i • o� N � Mr a 14 W v Cn w �. x T-0 �. Oo z � H o. O � w � •--� w 8 � as d $ u� 4 w W � O °° t O W ao z Q Or � a• A O a 7 •- < C r�r > 9 oo A z 0 y M CN a ��, H i O Q Ln � Q zz o a a � z a � N � � �, • PLO w C F A r1 LA) O : Qi (/1 ^ � W 00 z w z oA D rOaR��� SEP 14 2022BUIL0i �E01-1 NT VILGE OF RYE$ROOK VILLAGE OF RYE BROOK 938KIN4t1ETRYEB ' ,NY 10573 BUILDING DEPARTMENT .or PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP#: �d—� p PP#: Approval Date: SEP 1 4 207 Permit Fee: $ Approval Signature: Other: Disapproved: (fees are non-refundable) ************************************************************************************************** Application dated, y- 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 thatsaid plumbing work will be in conformance with all applicable Federal,State,County and Local Codes. I.Address: 7 kb. SBL: /c-)/ 183-/-/-3 Zone: 2.Proposed Work: (3 /U'OV f-T(04 3.Property O�w]ner::/ R/ /-/ %E2 Address: 9 I"o-44 d 4J L✓1?/l, e4. Phone#: of 7 JO' - /Q 7// Cell#: , email: / 4.Master Plumber: G/�f�Zi S ySS��y% Address: `� TO a(;- ey. Lic.#: �413 Phone#: 70(177S/8 3/3 Cell#: ���7 7S��'�'�/� email: Company Name: Cz-/2 P9-/f Address: 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 3''Floor 4's Floor 5'h Floor Exterior 5.*List Other Equipment/Provide Details: (Notarized Signatures Required Next 2 Pages) -1- 8/12/2021 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: 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 PL('/�)-13L A 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 I Sworn to b fore me this day of L,-V- ,20 �-Y day of ,20__21_Z Sign of Property Owner Signature of Applicant Print a of Property Owner Print Name of Applicant EN I TORtr'- Notary Publi « ozYst�of NE �• Public 'Ncu�ry Public mmrtased Exc�'S°`he �°��r CA 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. OMAYRA HERNANDEZ Notary Public State of New York Qualified in Weetchester o nip ComrMssion Expires 1 3Dze -2- g/12no21 BUILDING DEPARTMENT � `� IE VILLAGE OF RYE BROOK 938 KING STREET RYE BR06K,NY 10573 SEP 14 2022 (914)939-0668 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: 3, �/'7�y'J 'I y1 ,residing at, (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; r A24 kyl ©fw , 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. Q__' (Signature of 7ers)) JJ 1 i (Print Name ofllf6perty Owner(s)) Sworn to before me this dayh✓ , 20 2� (Notary Pubhof ONAYRA HERNANDEZ Notary Public State of New York Qualified in Westchester Cho nt_ / _3_ Commission Expires11 8/12/2021 Building Permit Check List&Zoning Analysis Address: 4 IF.Aszl�'W L"S_L r— --Vz-, SBL: t _,7 , ea) — L — l Zone:- - Use: -7-1 Cont.Type: Other. Submittal Date: 7--2- Revisions Submittal Dates: 7iZ Applicant: _ 7,l C,gr�y'rr—C2-- Nature of Work Reviews.•ZBAAUG 7 PB: BOT• Other. M OK FEES:Filing- , � Bp: (, l 2 S( ) g zS�._ � C/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 Shore Fees: N/A- SITE PLAN:Topo: Site Protection: S/W Mgmt.: Tree Plan: Other. ( ) ( ) SURVEY:Dated Current Archival:- Sealed Unacceptable: ( ) ( ) PLANS:Date Stamped Seale Copies Electronic Other. ( ( L ✓icense: 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 H.W.I.C.:_Battery:_Other. (, y ( ) PLUMBING Plans: Permit: Nat. Gas: LP Gas: N/A/: Other. ( ) ( ) FIRE SUPPRESSION:Plans: Permit: N/A: Other. ( ) ( ) I-I.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. ( )AM mtg.date: approval: notes: ( )ZBA mtg.date: approval:- notes: ( )PB mtg. date: approval:- notes: REOURRED EXLSI'RNG PROPOSED NOTFS Arm Circle: Date• AUL 24 2022 Frontage Front: Fron Sides: Main Cov: Accs.Cov: Ft.HS • S .HS • a TotTotImg - F Im : P H_right/StoriElf es: o`- S �J w r., z 3 � o --- ��� V•� • Po 2 �C aL' . O moo• �'C au+ •p v' m N '� p a cis a a w co m y c 1.`otoo C� cl- �, y c `' G� N It 0 ul c� ,Q L U D o z, an } a. LLI a on I^ ~ Z u . a v (A own o O O t j e� a 4w � • p �" Q � Q w .� � C N o Z � 6 > ^ `is A C � ►e «s ea r. y W i � C 3 � a F HANLGRO-01 TJORDAN ACORN CERTIFICATE OF LIABILITY INSURANCE DAT D2^/YY) `-� 8/15/215/2022 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 NAAJACT George Natall Inter-Insurance Agency Service P"cDNNe ;(515)352-7500 FAx Ne; 516 437-0435 380 N Broadway,Suite 400 Jericho,NY 11753 MASSM INSURE 8 AFFORDING COVERAGE NAIC0 INSURER A:EVANSTON INSURANCE CO INSURED INSURER B: Hanley Group Inc INSURERC: 132 Larchmont Ave Suite 12 INSURER0: Larchmont,NY 10538 - INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SU POLICY NUMBER POLICY EFF POLICY OW LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 2,000,000 CLAIMS-MADE OCCUR 8FF6761 =4=222 $JZ4/'on DAMAGE TO RENTED 100,000 MED EXP(Any one rson 5,000 PERSONAL 8 ADV INJURY 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 4,000,000 X POLICY 7 Ppo LOC 4,000 PRODUCTS-COMP/OP AGG 000� OTHER: AUTOMOBILE LIABILITY COMBINED LIMIT ANY AUTO BODILY INJURY Perperson) OWNED SCHEDULED AUTOS ONLY AUUTNOOSyy ED BODILY INJURY PeraccldeM AUTOS ONLY AUTOS ONNLY Perr;.I RTY AMAGE UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS UAW CLAIMS-MADE AGGREGATE DIED I I RETENTION$ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/Nro ANY IM OR EXCLUDED?ECUTIVE N/A E gE E.L.EACH ACCIDENT (Mandatory In NH) It yes,descr be under E.L.DISEASE-EA EMPLOYEE DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMB DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Building Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Village of Rye Brook 938 King Street Rye Brook,NY 10573 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD YORK Workers' CERTIFICATE OF STATE Compensation Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE la.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured Hanley Group Inc 914-372-1098 132 Larchmont Ave.Ste 12 Larchmont,NY 10538-2843 1c.NYS Unemployment Insurance Employer Registration Number of Insured Work Location of Insured(Only required if coverage is specifically limited to 1d. Federal Employer Identification Number of Insured or Social Security certain locations In New York State,i.e.,a Wrap-Up Policy) Number 45-5423163 2.Name and Address of Entity Requesting Proof of Coverage 3a. Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) State Farm Insurance BUILDING DEPARTMENT VILLAGE OF RYE BROOK 938 KING STREET,RYE BROOK,NY 10573 3b. Policy Number of Entity Listed in Box"I a" 92-C3-B770-3 3c.Policy effective period 07/26/2022 to 07/26/2023 3d.The Proprietor,Partners or Executive Officers are included.(Only check box if all partners/officers Included) QX all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"T'insures the business referenced above in box"1 a"for workers' compensation under the New York State Workers'Compensation Law.(To use this form,New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2". The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.)Otherwise,this Certificate is valid for one year after this form is approved by the insurance carrier or Its licensed agent,or until the policy expiration date listed in box"3c",whichever Is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note: Upon cancellation of the workers'compensation policy indicated on this form,if the business continues to be named on a permit,license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers'Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury,1 certify that I am an authorized representative or licensed agent of the Insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by Nicole Pape �/r(print name of authorized representative or licensed agent of insurance carrier)/�Approved by: —JL�L.t 6 L`5 � //7 l—(l2 (Signature) f (Date) Title: Office Representative Telephone Number of authorized representative or licensed agent of insurance carrier. 516-922-1060 Please Note:Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insurance brokers are NOT authorized to issue It. C-105.2(9-17) www.wcb.ny.gov RELOCATE RESISTER. — VERIFY LOCATION IN FIELD REMOVE WALLS J REMOVE DOOR $ TRIM��� 5ASE1-1ENT 5ATH FLAN - DEMOLITION 1 SCALE: 1/2" = 1'-0" REFRAME MEDICINE GAB AS REQUIRED � I REMOVE DOOR 4 TRIM—� i - MALL E3ATH PLAN - DEMOLITION � / SCALE: 1/2" = 1'-0" FRAME NICHE ,l NI J it i REFRAME WALL FOR TANKLE55/ i �A TOILET �A I REMOVE DOOR $ TRIM DEMO BATH INCLUDING FIXTURES b FINISHES. GAP/EXTEND WIRING d PLUMBING AS REQUIRED EXISTING LOW WALL/ FOUNDATION TO REMAIN EXISTING FLOOR REGISTER- HVAG DEMO WALL AS REQUIRED FOR TANKLE55/ BACK OUTLET TOILET DEMO BATH INGLUDIN6 FIXTURES 8 FINISHES. GAP/HXTEND WIRING 8 PLUMBING AS REQUIRED EXISTING WINDOW TO REMAIN.. REMOVE TRIM DEMO BATH INCLUDING FIXTURE5 d FINISHES. GAP/EXTEND WIRING & PLUMBING AS REQUIRED EXI5TIN6 WINDOW TO REMAIN, REMOVE TRIM GENERAL BATHROOM NOTES: EX I. CONSTRUCT BASEMENT WALLS WITH 2X4 P.T. �{�7T 7{�� -- -- -- PLATE $ 2X4 WOOD STUD WALLS. Cl l 1 El\ - 2. INSTALL SOUND ATENUATION INSULATION IN WALLS. INSTALL INSULATION AT EXTERIOR 7-� r—�� 5. INSTALL PANG OR PROPER VENTILATION. RESIDENCE RECESSED (� MED. GAB. 4. VERIFY SIZE OF NICHE AND MEDICINE S, NIG 5, NIG F CABINETS WITH OWNER. _ 5. INSTALL TILES ON SHOWER WALLS FLOOR TO J b GEILIN6. Q6" VANITY, NC, 6. CONTRACTOR TO PROVIDE BLOCKING FOR ALL OWNER ACCESSORIES. 9 MEADOWLARK ROAD I- T. BATHROOM SINK FIXTURES, VANITY, TOILET, �7� U �7 STONE SADDLE ACCESSORIES, TILE, ETC, PROVIDED BY RYE BROOK, IVY OWNER S INSTALLED BY &C. 8. SHOWER ENCLOSURE NIG. %� BATH 9. INSTALL MOLD RE515TANT GYP. BD. ON No. IBSUE/pEECRIPnoN: oars: rI ! TILE FLOOR &. BASE _ EXISTING WINDOW WITH NEW WALL5/CEILIN55. INSTALL CEMENTITIOUS y t � TRIM BACKER BOARDS BEHIND TILES. 1 FOR OLIENT REVIEW 08/08/22 10. INSTALL GEMETITIOUS BACK BOARD AND ry STONE CURB U PROVIDE NEW REGISTER DITRA MAT CRACK RESISTANT MEMBRANE 2 FOR PERMIT 08/10/22 O' LONG MUDROCM !--- -- UNDER FLOOR TILE IN THE HALL AND MASTER BENCH. H0 0K5 PITH t BATH. SHELF ABOVE. i %, _�_ 4' T I,/2• j �.� ! - H T, NIGI � y o � m NICHE INSTALL NEW TOILET IN 1 RAI�I EXISTING LOCATION �\ x ; PROVIDE BLOCKING PROPOSED SHOWER FOR PULL-DOWN� BENCH 3 '� E COPY HANDHELD 5HOWER ON BAR 5ASEMENT E3ATH FLAN a FROFOSED �� SCALE: 1/2" = I'—O" RECESSED FRAME WALL FOR MEP. GAB. TANKLE55 TOILET CARRIER U PROVIDE BLOCKING 5 NIG FOR 5HOWER ROD & STONE T,N TUB FUTURE SHOWER ENC. SADDLE 56" VANITY TANKLE55 TOILET / EXI5TIN6 WINDOW, NEW 10 gAT}{ j INSTALL STONE POOPN 1 +O TILE FLOOR C BASETRIM I i FMB ERR ND I EXIST. LOG. b ry INSTALL TILES ON I I FRAME NICHE WITH TUB WALLS FLOOR STONE JAMB. VERIFY TO GEILIN6 A SIZE WITH OWNER HALL 5ATH FLAN = P OFOSED 5CALE: 1/2" = I'-O" TILE ON 5HONER WALLS FLOOR TO GEILIN6 FRAME NICHE WITH STONE JAMB 42" HIGH LOW WALL WITH STONE GAP >� HANPHE)LP / I ON BAR��� C 5, NIG 15 NIG ',- � ry 60" VANITY, NIG REPLACE 5HOWER PAN T / i�±STONE CURB �.,/ FRAMELESS SHOWER ENC. NIG MASTER T, NIG BATH TANKLE55 TOILET STONE FLOOR 6 BASE ot� FRAME WALL FOR j- e, TANKLE55 TOILET t6, CARRIER ` _ STONE SADDLE NEW DOOR & — TRIM IN EXIST. LOCATION PERMW# DALEApp v - AUG 2 eUN dmI - in HYS GT R, a age of Rye Brook, NY FRAME FOR REGES 5ED MEDICINE CABINET . REVI� VERIFY WITH OWNE ED PLANS AUG 1 9 1022 DATED: EXISTING WINDOW WITH NEW TRIM RD CimwE AUG 11 2022 VILLAGE OF RYE BROOK BUILDING DEPARTMENT ;a 13 '1 ME: O/ PROPOSED PLANS ARCHITECT'S P—ECT NUMBER: ODOG scat[: DATE: SCALE SFN.: DRAWING NUMBER: D-1.0/A-1.0 (5)/ MASTER BATH PLAN - DEMOLITION �/ SCALE: 1/2" = 1'-0" -, MASTER MASTER SAND FLAN - P OFOSED ' 5GALE: I/2" = 1'-0" MWECT: ( DEMO EXISTING POWDER ROOM REFER TO SHEET D-I.O/A-1.0 ( I I n EX I ST I NO 5ASEMENT PLAN I.5GALE: 1/4" = P-O" RICHTER RESIDENCE 9 MEADOWLARK ROAD RYE BROOK, NY W. IBSUE/DESCR—N: M- 1 FOR PERMIT REV/1 08/19/22 wstill, AUG 179 L12022�� ARCNDECTS P ECT NUMBER: amD SCALE: GATE NOAU SEAL - DRAWING NUMBER: I � { �: EX- l .0