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HomeMy WebLinkAboutBP22-187PERMIT #43 SECTION A TYPE OF WORK JOB LOCATI N OWNER CONTRACTOR �ST. COST V CO # TCO d# Z DATE: 10 c D(P: /C A J,43 _ BLOCK / LOT oZ. Ol 4✓Q747b0000? qr? n// U Sri ve FEE DATE INSPECTION REf;,ORD DATE INSP � FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION / PLUMBING as RGH PLUMBING GAS SPRINKLER ELECTRIC - '/ 7� Z LOW -VOLT C� ALARM L� AS BUILT O FINAL 3�/yl 339- 0997 �3~ 030/T �l `STaI /knrb/ j 4 T%ee� 1 1 f%z;03-031/�a/2c%iC� OTHER APPROVALS ARB BOT PB ZBA OTHER VILLAGE) F RYE BROOK WESTCHES' COUNTY, NEW YORK No: 23-101 Certificate of Occupancy This is to certify that rAudireq , of, �(i having duly filed an application on J1 20 requesting a Certificate of Occupancy for the premises known as, Rye Brook,NY, located in a '�5 Zoning District and shown on the most current Tax Map as Section: 7 Block: Lot: and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No.c , issued 20o�, 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: - Q ' la Construction: for the following purposes:.) rq-erJ61' 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. j 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 ' t shal tp'!17 lithe: ed from one location to another until a permit to accomplish such change tain UN 2 1 2023 Building Inspector,Village of Rye Brook: E C E N E BUILDING DEPARTMENT pERMIrT#�j�� VILLAGE OF RYE BROOK ISSUED: JUN 2 2023 9 8 KING STREET,RYE BROOK,NEW YORK 10573 DATE 01�. (914)939-0668 FEE:,& PAID VILLAGE OF RYE BROOK BUILDING DEPARTMENT APPLICATION FOR CERTIFICATE OF OCCUPANCY,CERTIFICATE OF COMPLIANCE, AND CERTIFICATION OF FINAL COSTS Address: /�� ��hG'�1 Occupancy/Use:/2eJ Parcel ID 30, c-- ``Zone: Owner: �, yAddress: �� / U f2 P.E./R.A. or Contractor: Address: C u Person in responsible charge: Address: Application is hereby made and submitted to the Building Inspector of the Vil age 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 NE YORK, COUNTY OF WESTCHESTER as: eing duly sworn,deposes and says that he/she resides at (Print ame of Ap licant) U (No.and Street) in ,in the County of in the State of 'that (City/Town/Village) he/she as 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 equi ment,7p�rofessional fees,and including the monetary value of any materials and labor which may have been donated gratis was:S D for the construction or alteration of: 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 Sworn to before me this day of , 20_4(X :�2 day of , 20 v Signature of Pro rty Owner Signature of Applicant kr1,��f/ Lk4iLc>°��iYlLxc/ Prini,Name of Pro Owner Print Name of Applicant Nc4� kublic Notary Public June Harrison Notay public,State of New York No.02HA4956574 oualified in Westchester County Commission Expires September 25,20 � �yE BRC��. O�` tim cu � • 1982 BUILDING DEPARTMENT ,POCUILDING 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 Uebrook.org - - - - - - - - - - - - - - - - -- - - INSPECTION REPORT - - - - - - -- - - - - - - - - - -- - ADDRESS :— t� "` �� \� V DATE: PERMIT# ISSUED: SECT: � BLOCK: LOT: LOCATION: 'ems OCCUPANCY: - ❑ Violation Noted THE WORK IS... �Y PASSED ❑ FAILED 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 ❑ CROSS CONNECTION FINAL ❑ OTHER s 00 N O w N a a ° y 71 x 00 o � rben T-4 u7 F 0 w y fil ° 00 W I � 40 o. IS V 0 �o wCN�z . a � � o o ed cn F. E A F. w � .�. w A, _ W Vr00 1--1 9. 7 H PG O © O A OM, +� wzro v" coo: Mai w 0-400 E o (� , W Z CVO ►W�+ " rn v a o Ctm : Fyj �r a � bR uFi '� ai c�a 'aS U 5 O .r N Uo W I W © O "` c� Q z o M 2 w W H 0q ' o z C� ° u v �i la O W W ] � � �,� v. W P. 04 W � x � � 9 1 a n BUILDING DEPARTMENT Q �(n �� �'�,'/ 'I VILLA E OF RYE BROOK FSEP 2 9 2022 938 Km ET RYE BROC*,NY 10573 14)939-0668 �. VILLAGE OF R`( TOOK %,.rN ebrouk.or Brsill r-,,! T INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: �'"7' Approval Datc: #: / ` �� Application Fee: $ / Approval Signature: Permit Fees: '3 7 S. Disapproved: Other: Application dated: September 12,2022 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: 13 Magnolia Drive SBL: 130.78-1-2 Zone: `— t S� 2. Proposed Improvement. (Describe in detail): Renovation of existing primary bathroom. 3. Does the proposed improvement involve a Home-Occupation as per§250-38 of the Code of the Village of Rye Brook? No: X 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: X Yes: (If y'ea, please submit a separate Automatic Fire Suppression Svstem Permit application 2 sets of detailed engineered plans) 5. Occupancy;(1 fam.,2 fam.,comm.,etc...)Prior to Construction: 1 Family After Construction: 1 Family 6. N.Y State Construction Classification: 5B N.Y. State Use Classification: 7. Property Owner: William&Audrey Schaenman Address: 13 Magnolia Drive Phone# Cell# 914 450 0390 email: audreyschaen@yahoo.com 8. Applicant: Owner Address: 13 magnolia Drive Phone# Cell# 914 450 0390 email: audreyschaen6yahoo.eom. 9. Architect: Mary Faithorn Scott Address: 33 Fairways Drive, Mt. Kisco, NY 10549 Phone# 914 241 6262 Cell# 914 907 8316 email: mfscottarchOgmail.com 10. Engineer: Address: Phone# Cell# email: 11. General Contractor: Eldan Corp Address: 7 Sleepy Hollow Road, Rye Brook, NY 10573 Phone# 914 939 0997 Cell# 9144509030 email: e1dancm0optimum.net 12. Estimated cost of construction $ 25,000 (No'I 1(: lbe estimated cost shall include all labor.material.scaffolding.9'ixrd equipment,professional tees.and malvrial uid labor which may be donated gratis.) 11 'Job Timetable: Start: 10/1/2022 Finish: 12/1/2022 (I) W1212021 BUILDING DEPARTMENT VILLAGE OF RYE OOK SEP 2 9 2922 938 KING 4REET RYE BiRQ ,NY 10573 (914)939-06 n2b.I-N ebrook.ora 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: 31, Audrey Schaenman , residing at, 13 Magnolia Drive, Rye Brook,NY (Print name) (Address rchere-,nu lice+ 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; 13 Magnolia Drive, Rye Brook, NY , 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. 71 4" �+igniturc of f'rap Occ n• �>. 7 Lh ec C P int Name of P operty(tcc 11,1 Sworn tQ before me this pZ day of .\ , 20 a (Notary 'iblic,) Jutie Harrison Notary Public,State of New Ycr!a No.02HA4956574 Qualified in Nlestchester County Commission Expires September 25,2 (2) 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: Audrey Schaenman ,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 Owner 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. Swom to before me this ! Swom to before me this day o evl , 20c3-�" day of , 20 9 gnature o€Property Signature of Applicant Print Name of P perty Owner Print Name of Applicant Ptary ublic Notary Public Julie Harrison Notary public,State of New York No.02HA4956574 Qualified in Westchester County commission Expires September 25,2Q (4) 8/1 212 0 2 1 M L � C . NN IMP C Ob z v a A OZo aoMz � o � W 00 Ln < R+ a10CIO V A ►-Z a w a > Q V 0-4 • o W �, a z �..� rn W U W 5 r V Gn av Q z i H U v wo o Ln U W o a 0. ( x M z x z 00 0 ,,yE,,a RC�uk BUIL 11L'PAID`MENT FEB 21 2023 ID VIL E OF RYE OK 938 KIN > ET RYE B ,NY 10573 VILLAGE OF RYE BROOK BUILDING DEPARTMENT _ 'o .or ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY BP#: � �! EP#: c;)3--043 Approval Date: 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 an or reTnove 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: 13 M19 G N©Lt i2 SBL: 1310.7 E—1 - Zone:/��� 2.Property Owner:WiLdg !i Audi e€yl �,HAE N H44t4 Address: /_� Mi4tituol trt MR. ����Ny 10573 Phone#:�9ly, q39- 09°l7 Cell#: email: 3.Master Electrician: Address: /40 RUM1;Aj---D 15} W. �i i�c�t NYLQDQ Lic.#: 17o B Phone#: 4 -0110 Cell#:(Rig) 779- 12 8) email: SntFc3 an Company Name: P4 [LiFc-Tr2(r 1 N C_ Address: 4 c7 (Z()T JA N 4.Proposed Electrical Work/Fixture Count: f'(tF-C=I CAA l bil►2i llril e -QUIP610r. ( Rc>0f A 5.31 Party Electrical Inspection Agency: S 11J 15 ********************************************************************************************************* STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: Andrts Goy%i aI CZ ,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 kec�ri c4\ Co4raCIr0r for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,attorney,etc.) The undersigned further states that all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances,and regulations. Sworn to before me this Sworn to before me this o? 15* day of ,20 day of 1:�1-6 ,202 Signature of Property Owner Signa e f Applicant AnprCS GOnza lez. Print Name of Property Owner Print Name of Applicant Notary Public laman NOTARY PUBL C,STATE OF NEW YORI Registration No.01006415940 Qualified in Westchester County Commission Expires 03/29/2011 6/23/2022 STATEWIDE • Service Willi biIi 1:1 Main Street,Fishkill, NY 12524 1 email:office@swisny.com SWIS JOB APPLICATION tel ;. 1 914.219.1062 SWISNY.com • • Office Use Elect.Permit# Date Bldg Permit# Utility ID tf Final Certificate# City/Village K P 81 00 Zip Township County Address /y Cross Street Section Block 1 Lot a . n l bi ✓ Owner Name/Address cif different than above) Contact Number l Q fi � ALl ♦p /_ /,;;;;� � ❑Basement ❑ 1 st Fl. D2'nd 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 Amt Amps - Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Warm Draw lacandeZint Fluorescent SERVICE Amperage Voltage 1 P 3P #Meters #Disconnect ❑Underground ❑New ❑Reconnect ❑Overhead ❑Change ❑Visual Re-Inspection ❑ Safety Re-Inspection ❑ Re-Inspection Additional Information p � JIE FEB 21 2023 VILLAGE "7 RYE BROOK BUILDIW _•IrRARTMENT This application is valid for one(1)year from the date received by SMS.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# Company Name Date Signature Address City/State Zip'Code License# Phone# r��/ State Wide Inspection Services v 1080 Main Street Fishkill, NY 12524 MAY 2 4 2023 845 202-7224 Phone 914-2194-219-1062 Fax STATE WIDE INSPECTION SERVICES Email: otficeCcbswisny.com VILLAGE OF RYE BROOK service With Integrity BUILDINr DEPARTMENT Website: www.swisny.com BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: AG Electric Inc William&Audrey Schaenman Andres Gonzalez 13 Magnolia Drive 40 Rutland Street Rye Brook, NY 10573 Mount Kisco, NY 10549 Located at: 13 Magnolia Drive, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP23-043 130.78 Certificate Number: 2023-3601 Building Permit Number: BP22-187 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: 13 Magnolia Drive, Rye Brook, NY 10573 The Second Floor 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 17T" Day of May 2023. Name Quantity Rating Circuit Type Luminaires 06 Receptacles 02 Switches 05 GFCI 02 Bathroom Exhaust Fan 02 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. � N O O N tLti N \ N w v i' al N O y a it w o p o W v o z o = A W � Z w W H zz 4 x w 4-4 co O 4.4 A `� ✓ `� C �, � x H � " Oa . O w00 ' V 00 fn 5 ►'> a o z � N n N Ci O J ., a Q z $ w w H oo W CZ7 w c Z z can I a w N V N8 ' v O a a W " x M z l N z w � A w z w � �I D CE C E ME BUILDING DEPARTMENT FEB 2 4 2023 VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK,NY 10573 VILLAGE OF RYE BROOK (91 -0668 BUILDING DEPARTMENT w LW_,_A-uok.org PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP#: ��—f(3r PP#: Approval Date: FEB 2 4, 1 Permit Fee: S Approval Signature: Other: Disapproved: (tees are non-refundable) Application dated, c�) 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: .13 m A& ; J l_ t' A p tI t ✓h' SBL: 13O, /dn—1—4 Zone: 2.Proposed Work: R c M 0.) e ''% {=1 o. ot '►1 G� S-��rl G va't bl/t •"✓� „✓ ri 1� __ 1= i k T J A, XAC-r / s e rr, t;'� I o c A-( i o r' 3.Property Owner: � SC o A f M A r/ Address: I S M A G 0 l✓ J I i A 19 1 VL Phone#: 9P7— 9-3 9—&PW Cell#: email: 4.Master Plumber: i R 1 L 13 o y_C tr r Address: `1 3 l,'�t A r, 7 Av_r . zc t_1V, //S e 70 Y Lic.#:_-7 7 3 Phone#: Cell#: t1. 76 c - 31 l 0 email: el? i CIS S"L62 6,47 A iL e't; r,•1 Company Name: f\t L S-r Art P L Cst }kT 6, Address: 1 I -Cm A n-r A Va . V12 o I oY 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 1 st Floor S 2nd Floor 3"Floor 4'Floor 51 Floor Exterior 5.*List Other EquipmenL/Provide Details: (Notarized Signatures Required Next 2 Pages) -1- 8/12/2021 TATE OF�YORK,COUNTY OF WESTCHESTER ) as: ,being duly sworn,deposes and states that he/she is the applicant above named, (print name 6f 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 duty 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 Sworn to before me this da kbruai 2oa�_ day of 20 a3 Oil/ZJ A Signature of P erty�Jwner Signature of plicant Print Name Property Owner Print Name of Appli ant tu pie Hamso Notary Pu>�HARI MELILLO N t ary Tic,State of New Yorko.02HA4956574 Notary Public,State of New York Qualified in Westchester County No.01ME6160063 Commission Expires September 25,20 L5 Qualified In Westchester County, Commission Expires January 29,20 Z This application must be properly completed in its entirety and must include the notarized signaiui'C(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- 8/12i2o21 BUILDING DEPARTMENT R E " IE �" E VILLAGE OF RYE BROOK FEB 2 4 2023 938 KING STRF. :i-RYE BROOK,NY 10573 (914)939-0668 �'�'� VILLAGE OF RYE BROOK %N NN N%.rN ehrook.or= 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: ft*'l3�iNmmo ,residing at, /b M46l1t?Li73 he. "E MCCA lu/ mie) (Addres;whcrc 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-3 YYI S AA21-41 W) E:�IE 612 CCA1— / t/ 49573 ,Rye Brook, NY. (Job Qdl— 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 ($•i!�nauur uir- Sworn to before me this day of Q-h , 203?2 F Jurte Harrison Notary Public,State of New York No.02HA4956574 Qualified in Westchester County Commission Expires September 25,2Q�� -3- 8/12/2021 Building Permit Check List&Zoning Analysis Address: 3 44 t N� SBL: Zone:.2—I.<_ Use: Const.Type: Other. Submittal Date: Z Z Revisions Submittal Dates: Applicant: SC � i t,�4ti Nature of Work ►JT o 1��{ j � ;0 v CZT7 0 Vj Reviews:ZBA PB: BOT: Other. OK ( ( ) FEES:Filing. �Nmotmnizpe:d: 3 C/O: Flood Plane: Legalization: ( ) ( ) APP: Dated , 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. Dated Current Art al Sealed: Unacceptable: ( ) (. PLANS:Date Stamped Sealed Copies ronic Other. ( ) (�License ✓ 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. (� ( ) PLUMBING:Plans: Permit Nan 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 EXLSnNG PROPOSED NOTES A=&- _ Date: - 1011 Ck Front Front: Sid_Q: R.Car. Main Cov Accs.Cov Ft.H/Sb: S .HS : T�Imv: FIL Im : P n • Hight/Stories: notes: M, 1.7 10 qfi, .......... Z:s 04 C) x. LLJ C") C) Z E 0) Cu Cz ILI C) Cu t7, -4--0 Q) LU In Cz Lr) M. o •0 action 0 iC ZD -j C) QI LLJ 0 LLJ LLI W U) i:; CL x C13 CIS ILI T- 4E ILI 0) LO ILI ............ t iN an, 11A 9, APTAXIP Nil, WN.414 TE ACoR" CERTIFICATE OF LIABILITY INSURANCE DA091/28/2022Y) 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 CONTAC Joyce Knizeski Scavone Insurance NAME: y 470 Mamaroneck Avenue PHONN 914-478-2111 aACX No:(914)428 7764 White Plains, NY 10605 E-MAIL ADDRESS: ) y o ce scavoneins.com INSURER 8 AFFORDING COVERAGE NAIL! INSURERA: EVANSTON INSURANCE COMPANY 35378 INSURED EL Dan Corp INSURER B: 7 Sleepy Hollow Road Rye Brook, NY 10573 INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCEOL SU POLICY EFF POLICY EXP LTR guaiffla POLICY NUMBER MMIDDlYYYY) [MIWDO1YYYY1 LIMITS A COMMERCIAL GENERAL LIABILITY Y 3FF8135 10/04/2022 10/04/2023 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE V OCCUR DAMAG O R NTED 100 000 PREMISES Ea occurrence $ MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1,000,000 POLICY E JECT Loc PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY Per accident $ AUTOS ONLY AUTOS t ) HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DIED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE•EA EMPLOYEE S It yee,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached It more space Is required) Village of Rye Brook is included as additional insured under the General Liability Policy for License&Permit Purpose only. Location: 13 Magnolia Drive R ye Brook, NY 10573 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 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD EW Workers' Certificate of Attestation of Exemption STATE Compensation from New York State Workers' Compensation and/or Board Disability and Paid Family Leave Benefits Insurance Coverage **This form cannot be used to waive the workers'compensation rights or obligations of any parot** The applicant may use this Certificate of Attestation of Exemption ONLY to show a government entity that New York State specific workers'compensation and/or disability and paid family leave benefits insurance is not required. The applicant may NOT use this form to show another business or that business's insurance carrier that such insurance is not required. Please provide this form to the government entity from which you are requesting a permit,license or contract. This Certificate will not be accepted by government officials one year after the date printed on the form. In the Application of Business Applying For: (Legal Entity Name and Address): Building Permit Sleep g Of R y Hollow Rd y Corp 7 From:Village e Brook 7 Sleep Rye Brook,NY 10573-1024 PHONE:914-939-0997 FEIN:XXXXX9309 The location of where work will be performed is 13 Magnolia Drive,Rye Brook,NY 10573. Estimated dates necessary to complete work associated with the building permit are ti•om October 1,2022 to March 31,2023. The estimated dollar amount of project is $10,001-$25,000 Workers'Compensation Exemption Statement: The above named business is certifying that it is NOT REQUIRED TO OBTAIN NEW YORK STATE SPECIFIC WORKERS'COMPENSATION INSURANCE COVERAGE for the following reason: The applicant is acting as a general contractor with no employees,day laborers, leased employees,borrowed employees,part-time employees,unpaid volunteers and only has independent contractors that meet the standards of the New York Construction Industry Fair Play Act(Section 861 of the New York State Labor Law). Disability and Paid Family Leave Benefits Exemption Statement: The above named business is certifying that it is NOT REQUIRED TO OBTAIN NEW YORK STATE STATUTORY DISABILITY AND PAID FAMILY LEAVE BENEFITS INSURANCE COVERAGE for the following reason: The business MUST be either: 1) owned by one individual; OR 2) is a partnership(including LLC,LLP,PLLP,RLLP,or LP)under the laws of New York State and is not a corporation; OR 3) is a one or two person owned corporation,with those individuals owning all of the stock and holding all offices of the corporation(in a two person owned corporation each individual must be an officer and own at least one share of stock); OR 4) is a business with no NYS location. In addition,the business does not require disability and paid family leave benefits coverage at this time since it has not employed one or more individuals on at least 30 days in any calendar year in New York State. (Independent contractors are not considered to be employees under the Disability and Paid Family Leave Benefits Law.) I,Amir Leshem,am the President with the above-named legal entity. I affirm that due to my position with the above-named business I have the knowledge,information and authority to make this Certificate of Attestation of Exemption. I hereby affirm that the statements made herein are true,that I have not made any materially false statements and I make this Certificate of Attestation of Exemption under the penalties of perjury. I further affirm that I understand that any false statement,representation or concealment will subject me to felony criminal prosecution,including jail and civil liability in accordance with the Workers'Compensation Law and all other New York State laws. By submitting this Certificate of Attestation of Exemption to the government entity listed above I also hereby affirm that if circumstances change so that workers'compensation insurance and/or disability and paid family leave benefits coverage is required,the above-named legal entity will immediately acquire appropriate New York State specific workers' compensation insurance and/or disability and paid family leave benefits coverage and also immediately furnish proof of that coverage on forms approved by the Chair of the Workers'Compensatio oard to the government entity listed above. SIGN D r nat Sigue: ate: HERE C Exemption Certificate Number Received 2022-066972 September 28, 2022 NYS Workers' Compensation Board CE-200 0 1/201 9 A APPLY 5APeTY FILM y�N TO EXI5TING WINDOW a 01 At PW o �,��: ------------------------- APPLY M SAFETY FILM TO NOTES i� fir'`"`• eX15TING� 36 X 72 1.I,MARY FAIThORN SCOTT.REGISTERED ARCHITECT IN THE STATE OF NEW YORK,CERTIFY THAT THE DE51GN WINDOW TUB PRESENTED IN THESE DRAWINGS 15 IN COMPLIANCE WITH ALL ReQUIREMENT5 OF THE 2020 RESIDENTIAL — CODE OF NY 5TATE. Ln 2.INSTALLATION OF SMOKE DETECTOR5 TO MEET COMPLIANCE WITH R314 IN THE 2020 RESIDENTIAL CODE OF NY5 --- TO BE LOCATED IN51DE ALL SLEEPING ROOM5 AND OUTSIDE ROOMS IN IMMEDIATE VICINrTY OF 5LEEPING ROOMS. EXIT DEVICES MAY BE BATTERY OPERATED IN UND15TURBED AREA5. PAN r TO - - - - 4'-O" I'-1 O' 3.INSTALLATION OF CARBON MONOXIDE DETECTORS TO MEET COMPLIANCE NTH�►9 15 IN THE 2020 FIRE CODE OF NYS EXTERIOR a FILL IN @ REMOVED I i ' WINDOW W/2 X4 5TUD5 WP , TO MATCH ADJACENT, r"� REMOVE ALL FIxrURe5. I �`�_�%� I J FI5eRGLA55 IN5ULATION SHOWER FITTINGS 4 FINISHES I / To PULL DEPTH ------------ t/ 1/2'CEMENT BD PRIMARY BATH I 1l INTERIOR,112"CDX TILE FLOOR , , `� PLYWOOD exremoR, BASE ce55eDTEc w TYVeK i CEDAR 4 MEDICINE Q � rr l� SIDING TO MATCH B C CABINETS l, ORN SC V Remove ------------ WINDOW ------____--I t eX15TING — A WINDOW i l i ---- =_____ 5 FE I 1 1 5LOPeD k SLOPED cc °C �> C IUN�, �� CeIUNG d CEILING Q ----------- ----- --1--- _.�=---- i ' NEW a i 'll L------------ WINDOW GJv o F------------�--�.� P T � PLAT II t / ZD b UU FLAT o 'k-------------- II CEILING b i CeILIN ;� ANDERSeN O CEILING < h+i Remove % . ` , — — D TATE O l�-1 CQ ld LQweR � V11 urS CEILING® iv �— i i li i OPEN PEN 5HELVe9FILE C r'1 5HCLve9 ♦DRAWERS t DOOR `pr BELOW 'lc opy I'-5' 2'-0" PIN s�r PIN O_ZA TH DEMOLITION PLAN 2 BATH ELECTRICAL PLAN BATH CONSTRUCTION PLAN DEMOLITION: ALE: SCALE: 1J2"=I'-a' 3 SCALE: I/2"=1'-0" =s � "\V'i Ifs I I.REMOVE WALL SHOWN DASHED ON PLAN AND CEILINGS IN AREAS INDICATED, ELECTRICAL LEGEND c t !j 97 PROVIDE FOR ALL DEMOLITION.CUTTING, WALL LEGEND P ERIAff"' _ ___--umma PATCHING.AND ALTERATION A5 REQUIRED FOR THE INSTALLATION OF NEW CON5TRUCTION. mow, DUPLEX ncePTACLe(GFI OR WP NvATeRPRoof%A5 NoTeD; ! ! EQUIPMENT AND FINISHES UNDER THE WORK OF THE CONTRACT. REMOVE ALL HEATING AND ® EXISTING WALL TO REMAIN ��� ` GOP j ELECTRICAL ITEMS,AS REQUIRED. I WALL MOUNTED SCONCE,FBO �� '� Q REC1:55ED LED DOWNUGHT,4"(2700K) ���� _ Z SEP 2 9 2022Pi - a o 2.PROTECT THE WORK SCHEDULED TO REMAIN AND.IF DAMAGED,REPAIR TO MATCH EXISTING. EXISTING WALL TO BE REMOVED OL 3 2022 y F..y PROVIDE TEMPORARY 5HORING WHILE STRUCTURAL MEMBeR5 ARE INSTALLED. O++r RECESSED LED DOWNLIGHT,4"WET LOCATION 0����� SAh`ITCH(314 POLE,AS NOTED) 3.REMOVE ALL DEMOLITION DEBRIS.AND ITEMS 5CHEDULED TO Be REMOVED FROM The BUILDING NEW WALL CONSTRUCTION I �-,,_� ,-- R�j 51TE AS SOON AS P0551BLe. Q ReCe55eD EXHAUST FAN-PANA50NIC PV-.vVQ3 OR 4 I = L 80,1 10 OR 150 CFM.51Ze FOR 5PAce-VENT TO EXTERIOR Intenors 2x4 WOOD STUDS @ I C"O.G. �/ L L.r"�. �-;`.. �. ',� ',' x_ o 1/2 GYPSUM BOARD r i .�� _ `_d�-- `7 ,1F[ ,+`- 4.CUTTING AND PATCHING OF WALL.CEILING AND FLOORING SURFACES SHALL Be NEATLY AND °�L�I W CAREFULLY DONE. O ONSTRUCCTIONNCLUDe PATCHING AND SEALING OF ANY POOR CONDITIONS EXISTING PRIOR BUILONG INSP TO , R"amok Vdk&-G'f oa DROPPED CeIUNG: 2X4 Q IV OC WITH 1/2"GYP5UM BD M RECe55eD MEDICINE CABINETS 5CONCE5 ` a' eX151'G `. ADJU5TABLe CAum OPEN WINDOW 5HELVe5 WINDOW 5HELVeS WITH �' / WITH b v 7'VANITY b AWNING SAFETY �, 5APeTY a� cp WINDOW FiLIm POCKET FILM ® ® ANDeR5eN A21 DOORcD Csf TO W.C. DRAWeR,9Li c o c REVISIONS: o c c CABINS DATE: SEPTEMBER 12,2022 FRee 5TANDING TUB M N o 0 o TILE BASE SCALE: 110=V-0" ELEVATION 8 ELEVATION - ELEVATION p ELEVATION 5CALe:1/2"=I'-0" 5CALE: 1/2"=I'-a' 5CALE: I/2"=I'-O" SCALE: 1�2"=I'-0" SMAsr LAN