HomeMy WebLinkAboutBP23-023PER MIT#
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INSPECTION RECORD
I DATE I NSP
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FOUNDATION
FRAMING
RGH FRAMING
INSULATION
PLUMBING
RGH PLUMBING
GAS L�
SPRINKLER
ELECTRIC
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ALARM
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OTHER APPROVALS
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VILLAGE OF RYE BROOK
WESTCHESTER COUNTY, NEW YORK
No: 23-117
Certificate of ®ccupaucp
This is to certify that Li l-'amba"-d/
of, e having duly filed an application on
�JU , ?20 requesting a Certificate of Occupancy for the premises known as,
Rye Brook,NY, located in a 4Q Zoning
District and shown on the most current Tax Map as Section: 135. 4c2Block: Lot:
and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building
Permit No. '3, issued 311 20 c23, 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: /0)9(f" �� Construction: V5
for the following purposes: A)Iwoy- h) -fh roam r[_/ /Q ✓a�V� '
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 Xght shall be made n all the building be moved from one location
to another until a permit to accomplish such change*/been ob ed o the Building Inspector.
JUL 2 5 2023
Building Inspector,Village of Rye Brook: Date:
D �' FMBUILDIN�—k—A-TMENT For office use onl
PERMIT# 073
VILLAGE OF RYE BROOK ISSUED:
JUN - ] 2023 DD 38 KING STREET,RYE BRooK,NEW YoRK 10573 DATE: (o--7—a3
(914)939-0668 FEE:,S//O PA 41r
VILLAGE OF RYE BROOK wwwxyebrook,,org
BUILDING DEPARTMENT
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:
K
Vhttrtrssrttsr►tsrrtstarrrrrr►ruarrrsrrrrarra►►■rsssa►rs►tasarsr►s►s►►s►s►srrssa►t►ss►►s►asaa►raa
O L�qP - ✓� l( �3
Occupancy/Use: /)4;�Al Parcel ID#: 136-
,, -Yc� Zone:
Owner: L I S t 0 r`1lJI' Rd'�t Address: )11 D�
P.E./R.A. or Contractor: L5 o T-Mod j2f]LAA Address:
Person in responsible charge: S _ C�S(� Address:
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
``Y-O-/RK,^,,,COUNTY OF WESTCHESTER as:
SP LO r!t96 being duly sworn,deposes and says that he/she resides at
(Print Name of Applicant) I / (No.an treet)
in I ,in the County of in the State of 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:$ )
for the construction or alteration of ��Ct Z c -"—
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 t Sworn to before me this
day of , 201� day of , 20
Signa f er Signature of Applicant
L
Name of Property rer Print Name of Applicant
Notary Public r Notary Public
CHRI OPHER J.BRADBURY
Notary Public,State of New York
No.01 BR6159985 8/12/2021
Ouslified in Westchester County
Cn--iscinn Exnir,,s January 29,20 ��
DRC�v�'
m
- -a
1982 .-� BUILDING DEPARTMENT
0 BUILDING INSPECTOR VILLAGE OF RYE BROOK
❑ VILLAGE ENGWEER 938 KING STREET RYE BROOK,NY 10573
❑ASSISTANT BUILDING INSPECTOR (914) 939-0668 FAx(914)939-5801
- - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - -- - - - - - --
ADDRESS: \ n ,' DATE: L!72
PERMIT# ISSUED: ` `�$ BLOCK: LOT:
LOCATION: `` �' (� y OCCUPANCY: ? I y
❑ VIOLATION NOTED THE WORK IS... 'ACCEPTED ❑ REJECTED/REINSPECTION
0 SITE INSPECTION REQUIRED
0 FOOTING
0 FOOTING DRAINAGE
❑ FOUNDATION
0 UNDERGROUND PLUMBING NOTES ON INSPECTION:
❑ ROUGH PLUMBING
0 ROUGH FRAMING
❑ INSULATION
❑ NATURAL GAS
❑ L.P. GAS
❑ FUEL TANK
0 FIRE SPRINKLER
0 FINAL PLUMBING
0 FINAL
❑ OTHER
�yE BRC��.
,,,�,��,���Q,��� �9�2 BUILDING DEPARTMENT
ILDING 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.aebrook.org
- - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - -
ADDRESS :- �\ \ DATE:
PERMIT# ISSUED: J SECT: BLOCK: LOT:
LOCATION: ' N`\'�-S �-f� \ �CS Y `F LOCCUPANCY: i
❑ Violation Noted THE WORK IS... l 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
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BUII..D MENT 2
V11, of RY OOK FEB 2 2 2023
938 KING ET RYE RR NY 10573
VILLAGE OF RYE BROOK
BUILDING DEPARTMENT
INTERIOR BUILDING PERMIT APPLICATION
FOR OFFICE USE ONLY:
Approval Date: FEB Z 6 1023 Pe i �pplication Fee: $
Approval Signature: Permit Fees:$ 17
Disapproved: Other:
Application dated: C 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: 1(n VI t IlaCl L�_ KIL SBL:1 � 7 c� `� Zone:
2. Proposed Improvement.(Describe in detail): (2 A," IP {7 L1 bb g-OCIM G0 I ti
v
/f a �
3. Doer
roposed improvement involve a Home-Occupation as per§250-38 of the Code of the Village of Rye Brook?
No: Yes: If yes,indicate: TIER 1: 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:_r4—Yes:
(If yes,please submit a separate Automatic Fire Suppression System Permit application&2 sets of detailedffengineered plans)
5. Occupancy;(I fans.,2 fam.,comm.,etc...)Prior to Construction: After Construction�&Y't t�
6. N.Y State Construction Classification: N.Y.State Use Classification:
7. Property Owner: L 1,5 .L 'L(I(`A=--•—Address:
Phone# `1I411 � " dU+77 Cell# ,64kL, email: 11�5ct_t's IViC sug4 hts),C- -
8. Applicant: L__ Se_ Address:
Phone# '1 - Cell# Ct 1 email: rfs&ol,
9. Architect: Address:
Phone# Cell# email:
10. Engineer: Address:
Phone# Cell# email:
11. General C((o����ntractor: ^l � Address: �_�j�1-7>�uc'�'� Vu eSfG��� a �3
Phone# "1 Iq 1W'QN Cl _Cell# email: na I ceso & ,.a4".—
12. Estimated cost of construction $ 19, `5W
(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: Finish: CL
(l)
811 212 02 1
BUILD MENT
VIL OF RY OOK FEB 2 2 2023
938 KING E'r RYE,BR NY 10573
d �
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 YOM COUNTY OF WESTCHESTER } as:
15c Z_ol residing at, DAe J `
(Print name) (Address4here 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;
Y►��1�'f C� (�I� n -7 3 Rye Brook,NY.
(Job 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.
(Signs f PrffpVjlyOwner(s))
C4
(Print Name of Property Owner(s))
Sworn to before me this
da of �e�C ( �, , 20,1
Ma
(Notary Public)
SHAW MEULLO
Notary Public,State of New York
No,OIME6160063
Qualified In Westchester County (2)
commission Expires January 29,2
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 YOM COUNTY OF WESTCHESTER ) as:
L)SA L,1 (n ice% D J_ ,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
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 61 P Sworn to before me this
day of , 20 day of , 20
ign of er/tyy Ownnerg Signature of Applicant
DT
/ Li
Print Name of Property Owner Print Name of Applicant
1
Aa.l.-
W
Notary Public Notary Public
SHARI MEULLO
Notary Public,State of New York
No.O1ME6160063
Qualified in Westchester County
Commission Expires January 29,20
(4)
8/12/2021
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Angelo 2accagnino BUILDING DEPARTMENTjD
o1 - ,2/11/1966 MAR 16 ZII23
Company: VILLAGE OF RYE BROOK
Zaccagnino Electric )38 KING STREET RYE BROOK,NY 10573 `
81 Maple Avenue VILLAGE OF i` YE BROOK
Rye,NY 1058o (�14) =o6 , BUILDING DEPARTMENT
WWW.j oo[c:or� __....__.
License No. 755 :CTRICAL PERMIT APPLICATION
Expires on:12/31/2023 Peter Borducci !stet County Master Electricians License Required
FOR OFFICE USE ONLY BP#: �`� �
EP#: �
i i t
Approval Date: 113 Permit Fee: S /-640 A�
Approval Signature: Other:
Application dated, 3 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. J)
1.Address: G 1 �— SBL: Zone: � 3
2.Property Owner: l_i SGt r� �� d Address: ">,.q e
Phone#: .7 6 - O$ Cell#: email:
3.Master Electrician: () Lc(�u.tl i A-6 Address:�) /N�p�� (4 �V� � u I�6
Lic.#: 753— Phone .�#: Iq Cell#: email: _� � �t�NT*
Company Name: Zq CGag8('t(p F =r��L rr Address:
4.Proposed Ele ical Work/Fixture Count: C�� ri`n -i O qTn(pG o'l
40
5.31 Party Electrical Inspection Agency:
STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as:
Afim l U 20Leca�yt"� ,being duly swom,deposes and states that he/she is the applicant above named,and does further
(print name of individual signing as the applicant)
state that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the
for the legal owner and is duly authorized to make and file this application. (indicate architect The undersigned further states that all statements contained herein are true to the best of his/her knowledge and belief,and
thac nytwork attorney,etc.)
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.
, ore in
day, Sworn to befo a me this
day L 20_•�_ day ,20
F
Sign re of r P er S A N Sig ature o Ap t
Prin ame�o. Hil Printt A
N e of plic nt
lifted in ter County 07 SIEVE N
tr3 xpires October 14. 20 N nlc
No. 0 0023
Qualified i stchester County
My commissi Expires Octobe 14, 23 022
STATEWIDE •
Service With litjicgri�v
1:1 Main Street, Fishkill, NY 12524 1 email:office@swisny.com
SWIS JOBAPPLICATION tel845.202.72241 fax914.219.1062 I SWISNY.com I SWISTraining.com
Office Use Elect. Permit# Date
Bldg Permit# Utility ID#
Final Certificate#
City/Village Zip 7 -� Township County;f
Address / ' Cross Street Se¢tjpn_� Block; Tot
;
r l
Owner Name/Address(if different than above Contact Number
❑Basement ❑ 1st Fl. ❑2nd Fl. ❑3rd Fl. ❑More Than 3 Fl. ❑Garage ❑Attic ❑Outside Q 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
Incandescent Fluorescent
SERVICE
Amperage Voltage 1 P 3P #Meters #Disconnect ❑Underground ❑New ❑Reconnect
❑Overhead ❑Change
❑Visual Re-Inspection ❑ Safety Re-Inspection ❑ Re-Inspection
Additional Information
p�[ C�ELWE��ID
t
MAR 16 2023
VILLAGE OF RYE BROOK
BUILDING DEPARTMENT I
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 applkaft owner
or audwrized agent agrees to all the above terms and conditions as set forth for the application.
Inspector Date Finalized Inspector#
Company Name - Date, JI 1 Signature
Address City/State Zip�00-1
License# Phone#
a .
State Wide Inspection Services
1080 Main Street
Fishkill, NY 12524
845 202-7224 Phone
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:
Zaccagnino Electric Lisa Lombardi
Angelo P.Zaccagnino 16 Mohegan Lane
81 Maple Avenue Rye Brook, NY 10573
Rye, NY 10580
Located at: 16 Mohegan Lane, Rye Brook, NY 10573
Section: Block: Lot: Electrical Permit Number: EP 23-064
135.42 18
Certificate Number: 2023-2435 Building Permit Number: BP 23-023
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: 16 Mohegan Lane, Rye Brook, NY 10573
The Second Floor 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 26`'day of April 2023.
Name Quantity Rating Circuit Type
GFCI 01
LED Luminaires 01
Switches 03
Fan Light 01
Vanity Lights 02
a�
Officer: Frank]. Farriin�a^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.
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D CC ENE
BUILDING DL RTMENT MAR - 6 2023
3D
VILLAGE OF RYE BROOK
938 KING STREET RYE BR04,NY 10573 TILLAGE OF RYc BROOK
(914)939-0668 BUILDING DEPARTMENT_
wWi&,A,9Ek6ok.org —
PLUMBING PERMIT APPLICATION
FOR OFFICE USE ONLY BP#:���r D�,3 PP#:
Approval Date: MARI Permit Fee: $ �
Ab
Approval Signature: Other:
Disapproved:
(fees are non-refundable)
Application datedM, DA06A is hereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of
a Permit to install a or r&&ve Plumbing as per detailed statement described below.The applicant&property owner,by signing this
document agree that said plum 'ng work will be in onformance with all applicable Federal,State,County and Local Codes.
1.Address: L: �� Zone:
2.Proposed Work: AA
3.Property Owner: Address:
Phone#: - Cell#: email: C
4.Master Plumber: Address:
Lic.#: Ph e#: Cell q y-�p {�yemail:
Company Name: Address:
C
INDICATE FIXTUS&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
2nd Floor
3`d Floor
4"Floor
5`h Floor
Exterior
5.*List Other Equipment/Provide Details:
(Notarized Signatures Required Next 2 Pages)
-I-
3/3/2023
BUILD. MENT
VILLAGE OF RYE OOK MAR - 6 2023 DD
938 KnvG STREET RYE BR NY 10573
i 4 066�jY VILLAGE 01= i�YE BROOK
�8 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 OFNEW Y`OR ��1)K,COUNTY OF WESTCHESTER ) as: /, / /n
( 13�Y ,residing at, /6D OL/'�G6I LNG tJ &Ccv—/f��7
(Print name) (Addres'sLBAcrc you I i e C
being duly sworn, deposes and states that(s)he is the applicant above named,and further states that(s)he is the
legal owner of the property to which this Affidavit of Compliance pertains at;
, Rye Brook,NY.
(Job Address)
Further that all statements contained herein are true,and that to the best of his/her knowledge and belief,that
there are no known illegal cross-connections concerning either the storm sewer or sanitary sewer,and further
that there are no roof drains, sump pumps,or other prohibited stormwater or groundwater connections or sources
of inflow or infiltration of any kind into the sanitary sewer from the subject property in accordance with all State,
County and Village Codes.
(Signature of Proper %Nrl r :))
y�
(Print Name of Property Owner(s))
Sworn to before me this
ky of\--*AC'., iZ\,
'Ae�'_
(Notary PubliC i
SHARI MELILLG
Notary Public,State of New York
No.01ME6160063
Qualified In Westchester County. 3
commission Expires January 29,2���
8/12/2021
STATE OF NEW YOM 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 Master Plumber for the legal owner and is duly authorized to make and file this application.
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 b
day of 20 da r�,(�-� ,20 oZ 3
Si a e o Py erty Owner Sign ture of11plicant
Z' 6A � �
Print N eam of Property Owner Pnnt Name f App cant
No Public Notary Public
SHARI MELILLO SHARI MELILLO
Notary Public,State of New York Notary Public,State of New York
No.01ME6160063 No.OIME6160063
Qualified In Westchester County Quailfied In Westchester County
Commission Explros January 29,20 ] =o!rrrtisalon Expires January 9, 2�7
This application must be proper y completed in its entirety and must include the notarized sign
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-
3/3/2023
r o Building Permit Check List&Zoning AnaLysis
1 1 `p
Address: ►� �-- SBL: -I� LA 2
Zone: Use: ZA Const.Type: Other.
Submittal Date: Z\Z'` 2� Revisions Submittal Dates:
L
Applicant
Nature of Work: \ k C3(-
eview •ZBA: FEB 2 6 2023 PB: BOT• Other:
NEED OK
D cJ�
�( ) ( EES:F' ' BP: '� o�78' C/O: Flood Plane:legalization:
( ) ( ) APP: Dated �LNotarized: SBL: .��Truss I.D. Cross Connernon 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.
( ) ( ) SURVEY:Dated: Current Archival• Sealed: Unacceptable:
( ) ( ) PJ.ANS:Date Stamped Sealed Copies: Electronic: Other.
( ) (v�.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.
(� ( ) 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
Am:
Circle:
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Sides:
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Main Cov
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notes: c-t ,�a.0 \61 A\C4 `,. \C_\Y.
From: Sal Caso rnm
Subject: Certificates of insurance
Date: Feb 21, 2023 at 10:39:30 AM
To: Lisa Perrotta isciuiivid5up► iia(�yahoo.com
Here they are - Sal
Sal Caso
Caso Remodeling, Inc.
mobile 914.760.9089
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CASOREM-01 BPHINITSOVANN .
ACORO CERTIFICATE OF LIABILITY INSURANCE oArc, YY•
1721.'�202 2023
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: 9 the Certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed.
0 SUBROGATION IS WANED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on
this certiicale does not corder rights to the certificate holder in 6eu of such andorsementls►.
CONTACT
PRDDUCrJt RAW
World Insurance Assedabs LLC "n cO1Kt e: (9/A�7a7-11i1 Ac �-
618 Clock Tower Corrtrtons t-KAL
Brewster.NY 10509 ACaree59
Nan 191 ArPORDMO COVt11AGt AIA/C d_
NSURtP A Evanston knsurance Company 3537E
N9untr. N9uRLR a Merchants Mutual Insurance Company 23329
CASO REMODELING.INC M.URtN C
132 HOBART AVENUE NsueeN c
Port Chester,NY 10573
N9uittn t _ ...
NSURtN r
.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 SE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAD CLAIMS
■ t'YR M assunAme POUCT et a POLICY!r/ POLICY eJl� �s
IrOLICY -1S9BI
A X mlretcullanletlAL LlAtalfY 2.000,000
EACH OCCLV#gw-E
{ cLOOM&WAM X cxzurt X 311111111411111111111 6Ai2022 tJ7f2023 TED [ 100,000
trlD EV o.e ! 5,OD0
PessaMAL sADV HAIRY S 2.000,OD0
G&CL ADdlDATE LAIIT AI-FL ItS PEM ,:2HtNA1 AGORE 11T! a 2.000,000
X POLICY X. Luc !:LA#-UPAU: t 2.000,000,
0"It PER PROJECT AGG 5 5.000,000
.__. ___ •-ut.nN _S'#�LtLMI 1.000,000
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CertlBoab h"r Is addWanal Insured on a primary and non-contributory bash with respect to General Liability i
I
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CERTIFICATE HOLGEi
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF NOTICE WILL BE DELIVERED M
Voltage of Rye Brook ACCORDANCE WITH THE POLICY PROVISIONS.
939 King Street
Rya Brook.NY IOS73
AI/TIDe13D IRlR!laTATItY
I
ACORD 25 P@16003) 0 19B6.201S ACORD CORPORATIM AN deft resawd.
The ACORD name and logo are roistered marks of ACORD
NYSIF
NAM YurA llrl.lmu'.-►.tw PO BoK 66699.Albmy,NY'2206
1 nysif-com
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED)
"""" 133909107
CASO REMODELING.INC
132 H06ART AVENUE
PORT CHESTER NY 10573
SCAN TO VALIDATE
AND SUBSCRIBE
POLICYHOLDER CERTII-ICAIE HOLDER
CASO REMODELING.INC V"GE OF RYE BROOK
132 HOBART AVENUE 938 KING ST.
PORT CHESTER NY 10573 RYE BROOK NY 10573
POLICY NUMBER I CERTIFICATE NUMBER POLICY PERIOD DATE
W2455 673-0 198362 08l11;2022 TO 0W 11 t2023 2-2112023
THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE
FUND UNDER POLICY NO 2455673-0, 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 POUCY,INCLUDING ANY NOTIFICATION OF CANCELLATIONS,
OR TO VALIDATE THIS CERTIFICATE.VISIT OUR WESSITE AT HTTPS:IMIWW.NYSIF.COM-CERT!CERTVAL.ASP.THE NEW
YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT Of FAILURE TO GIVE SUCH NOTIFICATIONS.
THIS POLCY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE
INSURED CORPORATION.
PRESIDENT
SAL CASO
CASO REMODELING,INC
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�n'S7CE FUND
,Y r
DIRECTORNSURANCE FUND UNDERWRITING
VALIDATION NUMBER.865540970
U-26.3