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Home My WebLink AboutBlum Fire Inspection Application 2020 CL� • v l��o Wyj+ VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook, N.Y. 10573 ADMINISTRATOR Paul S. Rosenberg (914)939-0668 9 Fax(914)939-5801 Christopher J. Bradbury www.ryebrook.org TRUSTEES BUILDING&FIRE Susan R.Epstein INSPECTOR Stephanie J. Fischer Michael J. Izzo David M. Heiser Jason A. Klein December 19, 2019 Via I'Class Mail Blum Center for Health c/o Susan Blum, MD 34 Rye Ridge Plaza Rye Brook,New York 10573 Re: 34 Rye Ridge Plaza, Rye Brook, New York 10573 Dear Susan Blum, MD, It has come to the attention of the Building Department that it has been over three years since the premises located at the above captioned address has undergone and successfully completed a Fire Inspection. Please note that you are required by Rye Brook Village Code §91-4.B,to undergo and successfully complete a Fire Inspection for this location at least every thirty six(36)months. In order to avoid a violation, please complete and submit the attached Fire Inspection/Operating Permit Application form, remit the correct application fee,and schedule your triennial Fire Inspection with the Building Department by no later than,January 19, 2020, which is thirty(30)days after the date of this notice. Please note that the property owner's notarized signature,as well as the business owner's notarized signature must appear on the application form in the appropriate spaces. Upon successful completion of the Fire Inspection,you will be issued a Fire Inspection Certificate valid for three(3)years. Please remember that you must schedule your Fire Inspection every three(3)years by filing a Fire Inspection/ Operating Permit Application, remitting the applicable fee, and scheduling your Fire Inspection with the Building Department at least thirty(30)days prior to the expiration date listed on your Fire Inspection Certificate. Thank you. Michael J. Izzo Building& Fire Inspector mizzo(a-)ryebrook.org cc: Steven E. Fews, Assistant Building& Fire Inspector Alena Hakanjin, Property Manager, Win Ridge Realty LLC /tg F p s O � os ( moo wl wo in 0 in t0 �o 0 y`.ER NOp � r' c`M N �r. � o M x L c4 z U co) o o Y c ® )i CIDZ W W ai o� r. Cdm G .. a C3 u. y aN ^ O cc W 00 J c X M 0� ui x a J e Oi Qji J a� u. - ass $ • m a6 n a¢ @ m m + LL Nd y o�` m N • U r r W0 rs rrrrio rrnorr rrnnn nrorr ❑rrni y 1 VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook, N.Y. 10573 ADMINISTRATOR Paul S. Rosenberg (914)939-0668 • Fax(914)939-5801 Christopher J. Bradbury www ryebrook.org TRUSTEES BUILDING&FIRE Susan R. Epstein INSPECTOR Stephanie J. Fischer Michael J. Izzo David M. Heiser Jason A. Klein December 19, 2019 Via I'Class Certified Mail Blum Center for Health c/o Susan Blum. MD 34 Rye Ridge Plaza Rye Brook.New York 10573 Re: 34 Rye Ridge Plaza. Rye Brook. Neµ York 10573 Dear Susan Blum, MD. It has come to the attention of the Building Department that it has been over three years since the premises located at the above captioned address has undergone and successfully completed a Fire Inspection. Please note that you are required by Rye Brook Village Code§91-4.13,to undergo and successfully complete a Fire Inspection for this location at least every thirty six(36)months. In order to avoid a violation, please complete and submit the attached Fire Inspection/Operating Permit Application form, remit the correct application fee, and schedule your triennial Fire Inspection with the Building Department by no later than,January 19. 2020.which is thim,(30)days after the date of this notice. Please note that the property owner's notarized signature,as well as the business owner's notarized signature must appear on the application form in the appropriate spaces. Upon successful completion of the Fire Inspection,you will be issued a Fire Inspection Certificate valid for three(3)years. Please remember that you must schedule your Fire Inspection every three(3)years by filing a Fire Inspection/ Operating Permit Application,remitting the applicable fee. and scheduling your Fire Inspection with the Building Department at least thirty(30)days prior to the expiration date listed on your Fire Inspection Certificate. Thank you. Michael J. Izzo Building& Fire Inspector mizzo chi ryebrook.org cc: Steven E. Fews, Assistant Building& Fire Inspector Alena Hakanjin. Property Manager. Win Ridge Realty LLC /tg o � m W fJ } W S O I O W 0 1 4a p p of 1, Op O a. co = O 1 tw.z p p O t~ CO g CC ra o o .v >, co 0 Y c ® } m Z W Y U. ' P Q oc ui 00 J G � Y M T D BUILDING DEPARTMENT VILLAGE OF RYE'BROOK F N 2 7 2020 T 938 KING SET RYE BRobK NY 10573 (914)930'=066lro*ag (919)939-5801 VILLAGE OF RYE BROOK BL)ILDING DEPARTMENT FIRE INSPECTION / OPERATING PERMIT APPLICATION FOR OFFICE USE ONLY: / Fee Paid: $ �4Wa Inspection Date&Time: C919 I WZ E FEE SCHEDULE: Re-inspection Date&Time: Triennial&Private School Annual Inspection: =$450.00 Public Assembly Annual Inspection:<100 People=S500.00/>100 People=$750.00 *********************************************************************************************************** pplication,dated:_ I I g I W-0 is her cby made to the Building Inspector of the Village of Rye Brook NY,requesting that a Fire Inspection be conducteh at the building and premises listed below for the purpose of issuing a Permit to Operate the business,private school and/or place ofpublic assembly in conformance with the Code ofthe Village of Rye Brook,the New York State Uniform Fire Prevention &Building Code,Title 19 NYCRR Part 1201,and all other applicable local,County,State&Federal laws,rules&regulations,as per detailed statement described below. -7 (� 1. Address: 3'T 06 P��ntpa"A r,,�1 SBL: 141. � /—)--7 Zone: 1' 2. Business/Occupancy Name: &L r1 � � rlA' NE/9la N NYS/Use Cllass: 3. Property Owner:�/t-W to/I��,& &K i+ (�(.(- Address: P.,,f � n,� Phone# `elf-Mi- `T�.[✓7 Cell# email: 1gwg' r!U@�NfjUlc. CW 5. Business Owner: S U-51 V &Uff) Address: 3+9-yE Q PL#Z-fr Phone# q l'4- b S-a-�Q(e11# T, 00 �,j email J1.()m!' "ft1WRtRf VON•Uff 6. Emergency Contact: At Address: cka-t )94) Te4_1� r��/�rC 7V Phone# /4 -7 00 Cell# / - - 0 email; f 'i r 03 7. Inspection Escort: 1'I Y Title: 06 -a1`6 bIfi-I KToP C o y Phone#: l P S� - '� S OL�ell#:.�D 1'0159 S 7 0 email: h LLW C 4.e It a an'g_r f�✓ COS 8. Provide a brief description outlining the current and/or intended use of the property: 9. List all Hazardous Materials: 10. Occupant Load: Existing: Proposed: Other: 11. Date&Disposition of Previous Fire Inspection: ❑ Pass ❑ Fail 1 3/21/19 This application must include the notarized signature(s) of the legal owner(s) of the above mentioned property, in the space provided below. Any application not bearing the legal property owner's notarized signature(s) shall be deemed null and void, and will be returned to the applicant. STATE OF NEW YORK ) COUNTY OF WESTCHESTER ) as: SJSAP4 &Ur Y 1 ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing applice'ion) and further states that he/she is the legal owner of the property to which this application pertains,or that he/she is the g( 9 A)L-SS OW 11Jilp— ,for the legal owner and is duly authorized to make and file this application. That all (indicate architect,business owner,attorney,agent,etc.) 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 Ll day off/�U V �� , 20 1-0 day of A✓1 VG��l , 20 �fl Notary Public blic Signature of Property Ow iesfflar Si6attie of Applicant /MtJA M1,4 S ivs�r f 1—Gl�N M Q Print Name of Property 0wnart/djW' Print Name of Applicant SLISIE BRUNELLI :mMc.tra>, NOTARY PUBLIC,STATE OF NEW YORK NICOLE KIMBERLY VILLAVICFNCIC- i -" ry Y Registration No.01 BR6146106 Public-State of New No. o i Vl636407a Qualified 1n Westchester County 'ied in Westchester Lc,,,,ty Commission Expires May 1 S,1()27 �Or-.,mission Expires Sep 5, 2021 � 2 3/21/19 SCHEDULE A FLOOR PLAN 49 HADocs\Win Properties,Inc.,\SR55150.131\DFT\100707CSRE.rtf Lease 3 o-' N } N '• N b � � N } p � o �y z R r ° r� s I Tzj n � > - ��—� RYE RIDGE • o 4 R �� SCHEDULE "A" PLAZA BUILDING o E 1 OF 2 .Md XN "" -3r 0 0 in a n 0� SCH%Lf"An 2'OF Z X LY r tX1�9 NbSfl$214 Nv�d 'I l li R :10 30ti=10 ld:)1Q3W rioiinowao JA 8N 8 8 o ys U & x It �� a a" 8_ 9g-F g 8_ Sic a M 9 e, •'8.�� >9 N•w � ,�$'S iY lY� N�m n E'�n Q`8g z° $g8 g� $ D36b �q € #F EEg F 9E¢ ¢ f¢2 3 a ¢n g @a` 5 ¢� s 3cF Su9¢$ °¢cy y ¢ ¢ O h ° 1J " tail I # IP_ a LIIJ IL= Ig II �� II II Jbi ,� J 211, F . l Il a W . mierme xer wr-�as wsnc f W-19 N7sns 214 rro,d s a ^ 3 �O 30I=10 WV lcl3W rou�nalsro� _ Q E -S-2Q S o,cT �$. 6.TtlT i � PaY� CoC Eb «3a r� G4 C b P O c ^ o oC EfA oz 6� boo, c.��8 �oF s'hwfi Z,t��oil•��5:� �� —Yro .? ��'�r� s tp P fiYhb. �'-'`'s5 a3obY5" s 5�.-..��a $6^w oG o� n u8n�'n«uS ao6,5'S��55'�E8��a•��°.�$rO'6�8S�ay$� $ as 8rs3�ao�s`b 3 Ev i t1.Yco. s g o r s 3 c r 6 ,S2_ E b�]cccfi �wa'�v� 55355 fi—ssss 6¢ c lam R Yon gwvH----a SO 4 ma I y p�p } -- x Al} po : .r Z j • 0 IT i as Y •r aF,:.v... . .. aavm�na+�w'7rrr Knns