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��• �9E32 �' BUILDING DEPARTMENT
�UILDING INSPECTOR
�J ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK
❑CODE ENFORCEMENT OFFICER 938 King Street• Rye Brook,NY 10573
(914) 939-0668 FAx (914) 939-5801
www.ryebrook.org
- - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - -
ADDRESS :- \ DATE:
S
PERMIT# ` {P N \LC ISSUED: \t t�tPtST: BLOCK: -2G LOT
LOCATION: OCCUPANCY'
❑ Violation Noted THE WORK IS... / PASSED ❑ FAILED REINSPECTION
❑ SITE INSPECTION REQUIRED
❑ FOOTING
❑ FOOTING DRAINAGE
❑ FOUNDATION
❑ UNDERGROUND PLUMBING NOTES ON INSPECTION:
❑ ROUGH PLUMBING
❑ ROUGH FRAMING
❑ INSULATION
❑ Natural Gas ` u
❑ L.P. Gas
❑ FUEL TANK
❑ FIRE SPRINKLER
❑ FINAL PLUMBING
❑ OSS CONNECTION
FINAL
❑ OTHER
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• 1932 BUILDING DEPARTMENT
UILDING INSPECTOR
❑ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK
❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573
(914) 939-0668 FAx (914) 939-5801
www ryebrook.org
- - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - -
ADDRESS :— &12 <SA
1 � v r \. 1 DATE:
PERMIT# � ( ISSUED: 40NSE T: 1,41 BLOCK: LOT:
LOCATION: y J ` 1 1� OCCUPANCY:
❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED 124 REJECTED/REINSPECTION
❑ SITE INSPECTION REQUIRED
❑ FOOTING
❑ FOOTING DRAINAGE
❑ FOUNDATION
❑ UNDERGROUND PLUMBING NOTES ON INSPECTION:
❑ ROUGH PLUMBING
❑ ROUGH FRAMING
❑ INSULATION LN
❑ NATURAL GAS 'CV Q� * �►UC N�c c
❑ L.P.GAS �—
❑ FUEL TANK
❑ FIRE SPRINKLER 7 , v�cSZ '" 'v C4 1 C� �.1 Rp
❑ FINAL PLUMBING
❑ CROSS CONNECTION T
❑ FINAL
❑ OTHER ,. �y C`
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D EC IEWE
SEP 3 0 2022
BUILD N� rR� MENT VILLAGE OF RYE BROOK
VI L Fr "�3 ., t OK
BUILDING DEPARTMENT
938 KING ti NY 10573
FIRE INSPECTION / OPERATING PERMIT APPLICATION
FOR OFFICE USE ONLY: n )�,,�� J / �J` r-'
Fee Paid:$ �� 1 L Inspection Date&Time: A��'Ur /�(� � �•� C
FEE SCHEDULE: Re-inspection Date&Time:
Triennial& Private School Annual inspection:=$450.00
Public Assembly Annual Inspection:<100 People=$525.00/>100 People=$775.00
rxxxdxxxxxxarxxxx*x�*xxxxxxx�xxr.-r.xxxx*xx�xxxx*+:x+,xxx,�x:rt**�t*xxx,t*x�xxxx�•+xir.,t,++x*+xn*xxxx*txx*xxx+rxa*ax,�v:
Application,dated:__ _)t_ is hereby made to the Building Inspector of the Village of Rye Brook NY,requesting
that a Fire Inspection be conducted at the building and premises listed below for the purpose of issuing a Permit to Operate the business,
private school and/or place of public assembly in conformance with the Code of the 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.1. Address:_ b2 Suvkl, F 1c P;�Ru 2_T�,�1(p� COy BL: _4 I1 3-IS —�36 Zone:01��
2. Business/Occupancy Name: y S�0mo"c rj�nt i!'' NYS Use Class:
3. Property Owner: OrN ;IM6�c P-LIA-La u =Address: 2_+ J;Y -' - x- PLPr?-A
Phone## dt/,+- -? 1_gayY Cell# email:}nn&A}!AW__3'!ut/!� ��lL��i�'�M
5. Business Owner: 6-1 shmlefs eay k Address: -70( Ktna.`r ti bk , (,)es+ &J&.� P f 161 1
Phone# A Cell#_ N ,1 A- email: ( Lt r �(A)5 Wfsbeue.Id"\
6. Emergency Contact:_Fc 6 z iP_U e r;nt k Address: ?a Ve C'd P+t y6IJ
Phone# Y f Y-7Z6-7/05 Cell# %Y- 5'9q email: 17 21( otO f I'y k CS CVS T'DF e fS LGA)k.!•OM
7. Inspection Escort:411'e'-7 'SC)4x-% Title:
Phone#, 19-11 7 3W9cell#: email:
8. Provide a brief description outli fjng the current and/or intended use of the property:
1Jar,tk;nc, �' t n,r ,,,Cia` S>2/•1�CP.S
9. List all Hazardous Materials: AJO Aje
10. Occupant Load: Existing: Proposed: Other: /
11. Date&Disposition of Previous Fire Inspection: 1"`ti �a 1 Z� I Q Pass ❑ Fail
sr1212021
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 'c, e-retttr-rye +Eats+.
ny.,ttke**tf� f,tx*,rAtintt.,tinr�tt.�•t.�r.t�*�*rt*tc**ww�**�;w+;*u�:,t+rK;r��a*�k*r.:�:+�+is��,rttr,rtt.�:r���:�:+.•r.t.�:r.r.x,r*rtr.*r•*,r��,t,r*x
d:U r.c�•a:�:;c7H r�E7Jt����`l.�%t N l;,
STAGE OF NEi -MM )
COUNTY OF WES&HE5TER ) as:
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being duly sworn,deposes and states that he/she is the applicant above named,
(print name of Individual signing application) I
and further states that he/she is the legal owner of the property to which this application pertains,or that he/she is the
;vfilif� 1,for the legal owner and is duly authorized to make and file this application. That all
(Indicate architect,business owner,attorney,agent,etc.) I
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 this1 ` o�`�/ Sworn to before me this -
day of �� 7�r �l .�G;W ,20 ZZ day of �i�iC,t i I =1� ,20 �-
ILA
"V\
t
of Public Nota tc—`
Si 6 ature of Property natt f Ap)34icant
Print Name of Property Gwmr �7V Print Name of Applicant
KELLY SA*IDLER
Notary Puhl: 1MeW York Conimonwealth of AMEA CAROL SQUADRITO,nNotary Public
la-Notary Seat
NO C1 c n; 2 Befm County
Cvalificd in 1^.�e ;:.h�sr•r Colinty MyCvmmissionExplre$July 8,2025
Commission Expires March 9, 20- ; CommWW Number 1250459
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9;12!2021
r �
Mike Izzo
From: Dillinger IV, Clarence (Rick) <cdillinger@customersbank.com>
Sent: Tuesday, August 23, 2022 2:03 PM
To: Mike Izzo
Cc: Zieverink, Patricia
Subject: RE: Fire Inspection for Customers Bank(102 South Ridge Street)
Thank you very much for the assistance!
Thank you,
Rick Dillinger
Facilities&Security Specialist
CUBI Security Group-PSO,Facilities&Services
701 Reading Ave.
West Reading,Pennsylvania 19611
(Office)610-743-8028
(Cell)484-610-1769
customers
bank
From: Mike Izzo<Mlzzo@ryebrook.org>
Sent:Tuesday,August 23,2022 1:49 PM
To: Dillinger IV, Clarence (Rick) <cdillinger@customersbank.com>
Cc:Zieverink, Patricia <pzieverink@customersbank.com>; Pasquale Colantuono<PColantuono@ryebrook.org>; Steven
Fews<SteveFews@ryebrook.org>; Laura Petersen <LPetersen@ryebrook.org>;Tara Orlando<torlando@ryebrook.org>
Subject: RE: Fire Inspection for Customers Bank(102 South Ridge Street)
PLEASE NOTE:This email is not from a Customers Bank address.
Do not click on suspicious links. Do not give out personal or bank information to unknown senders.
Dear Mr. Dillinger,
Thank you for the email.
Please note that the Building Department is only able to assist you regarding permitting and inspections. We
do not have access to W-9 forms nor any other taxation or accounting information.
As such, your request for a thirty (30) day extension is approved. Please arrange to have your properly
completed and notarized Fire Inspection Application and fee submitted to the Building Department by no
later than Friday, September 30, 2022. Failure to do so will result in a Court Summons.
Please note that I have copied our Treasury Department for further response regarding the W-9 form.
Thank you.
zzo
Building & Fire Inspector
Village of Rye Brook, NY
(914) 939-0668
From: Dillinger IV, Clarence (Rick)<cdillinger@customersbank.com>
Sent:Tuesday, August 23, 2022 1:35 PM
To: Mike Izzo <Mlzzo@ryebrook.org>
Cc: Zieverink, Patricia <pzieverink@customersbank.com>
Subject: Fire Inspection for Customers Bank (102 South Ridge Street)
Good afternoon Michael,
My name is Rick Dillinger and I work in the Facilities and Security department at Customers Bank. I am following up to
my voicemail from last week regarding the application process for the Fire Inspection at our 102 South Ridge St location.
We are currently working on the application but need to request two items from the Village of Rye Brook;
• a W9-Our AP department recently updated their system and not all of our vendors were moved over. I will
need your W9 to re-set you back up in their system. Once you are reactivated, I can have them cut a check for
the application.
• an Extension-Can we please get a 30 day extension on the fire inspection?While we are doing our best to get
the requirements met as quickly as possible, we do not foresee us being able to meet the deadline of August
29tn
Thank you,
Rick Dillinger
Facilities&Security Specialist
CUBI Security Group-PSO,Facilities&Services
701 Reading Ave.
West Reading,Pennsylvania 19611
(office)610-743-8028
(cell)484-610-1769
customers
bank
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VILLAGE OF RYE BROOK
MAYOR 938 King Street,Rye Brook,N.Y. 10573 ADMINISTRATOR
Jason A.Klein (914)939-0668 Christopher J.Bradbun-
www.ryebrook.org
TRUSTEES BUILDING& FIRE INSPECTOR
Susan R. Epstein Michael J. Izzo
Stephanie J. Fischer
David M.Heiser
Salvatore W.Morlino
July 29,2022
Via 1s,Class Certified Mail
Customers Bank
c/o Pati Zieverink
102 South Ridge Street
Rye Brook,New York 10573
Re: 102 South Ridge Street,Rye Brook,New York 10573
Dear Pad Zieverink,
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,
August 29,2022,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@=brook.org
cc: Steven E. Fews,Assistant Building&Fire Inspector
cc:Alena Hakanjin,Property Manager
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VILLAGE OF RYE BROOK
MAYOR 938 King Street, Rye Brook, N.Y. 10573 ADMINISTRATOR
Jason A. Klein (914) 939-0668 Christopher J.Bradbury
www.ryeb rook.o rg
TRUSTEES BUILDING & FIRE INSPECTOR
Susan R.Epstein Michael J. Izzo
Stephanie J. Fischer
David M.Heiser
Salvatore W. Morlino
July 29,2022
Customers Bank
c/o Pati Zieverink
102 South Ridge Street
Rye Brook,New York 10573
Re: 102 South Ridge Street,Rye Brook,New York 10573
Dear Pad Zieverink,
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,
August 29,2022,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.
f"
Michael J. Izzo
Building&Fire Inspector
mizzoQrry�r ebrook.org
cc:Steven E. Fews,Assistant Building&Fire Inspector
cc:Alena Hakanjin,Property Manager
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