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HomeMy WebLinkAboutBP23-078 VILLAGE OF RYE BROOK WESTCHESTI COUNTY, NEW YORK NO. 23-200 Certificate of ®ccupo.urp This is to certify that �U of, CD k having duly filed an application on /2 20 requesting a Certificate of Occupancy for the premises known as, 15 Reck., V, d U ,Rye Brook,NY, located in a I U Zoning District and shown on the most current Tax Map as Section: �• Block: 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: - 3 C1 P " // Construction: , for the following purposes: YP�i�yafior� 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 mad ,nor shall the building be moved from one location to another until a permit to accomplish such change has been o e Om the Building.Inspector. DEC 19 2023 Building Inspector,Village of Rye Brook: Date: D EC EHY i BUILDING DEPARTMENT For office use only: PERMIT# ' 0 V DEC 12 2023 VILLAGE OF RYE BROOK ISSUED:&— �—a 3 938 K KING STRE YE BROOK,NEW YORK 10573 DATE:/,)--/�—c� VILLAGE OF RYA BROOK 9 0 FEE: „�'��� PAID, BUILDING DEPARTf ENT 'o li'or 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 •sss♦sssttsrsttssssu*rrr*r*rrrrrrs*rsrsrrsr*sssrsrsesttsrtt/s�strrss/r 11//srrrr*fss,*rtsatstrr*rrssttttstttsrrttsrs*saassssrrssstst Address: 15 /`U w(,�(� �,�,[7�Y,�Gc. , K &?5;ty Occupancy/Use: / '/�✓t'1 Parcel ID#: / 3 S� 3 5 Zone:k/n Owner: J= fi ud y Address: Axi, djd��y, /11le 9 P.E./R.A. or Contractor: �(a1'I�i2TA,jJG Address: It j r(41/ f, ldh deplain.5 Person in responsible charge: �j y ,Address: III dui% 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/altemtion herein mentioned in accordance with law: STATE OF NEW YORK,COUNTY OF WESTCHESTER as: T, �UYI 5 U I-`eV being duly swom,deposes and says that he/she resides at PJ JOV, �/)J/.ff, (Print Name of Applicant) (No.and Street) in &X 9 ,in the County of W& try in the State of _,that ity/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:$ Q o , 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 �Cr 20 day of 2013 Si a of Property Owner Signature of Applicant 146a, Cudierrez Print Name of Property Owner Print Name of Applicant l Notary Public Notary Publi MAGGIE YANG MAGGIE YANG 8/12 21 Notary Public Notary Public Connecticut Connecticut My Commission Expires Apr 30, 2027 MY Commission Expires Apr 30, 2027 �yE BRC��. O�` tim 0 1982• 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 - - - - - - - - - - - - - - - - - - -- ADDRESS: IC OG`� 1 CLV 3 k_ DATE: 1 Z" PERMIT# W7 23-C) ISSUED: '8 "Z 3 SECT: .S' 5- BLOCK: LOT: 97 LOCATION: k H L L P:,A 4/zotj^"\ • OCCUPANCY:2-% O ❑ 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 11 ❑ Natural Gas F1 ►JCL jd ► F1"ic PLk4 ^ v ❑ L.P.Gas ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION g-'FINAL ❑ OTHER a : s 00 _ r- M �c CD - a M N cV • N o\o 00 Q a.o ■ hM� s w a Q Lr) O x O Cls �) ■ L^ U ay C Y ■ a Z a 0 O W f� 3 rn y „ v ' y v o z C is O (n P: © .� 're- e c) V o Q a s [`� p M Yam" z 0 sd y e ^ [�] \C00 25 Ln Q v � co wr (n m IT r� CO O00 O U z �Ql Qwv} � Vo w � Q ,� . L c o b (� to E 1411 CZ rA U Vy U o m G4 �i Fr O O O v v U ICI W H ZO Z z V Q o V o VgwN v� o •• � Isr (a w � � �y v a �I as a a w � cn : ED BUILDING DEPARTMENT Q E C E N VILLAGE OF RYE BROOK MAY 2 4 2023 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 VILLAGE OF RYE BROOK wwwxyebrook.or>? BUlLb1NG DEPARTMENT INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: Approval Date: J6 2923 �3—© � ' -75fZL Permit#: Application Fee: $ Approval Signature: Permit Fees: $ 3O o [b()C— Disapproved: Other: Application dated: 3 is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the interior alteration J_afi exiisting building,or for as change in use,as per detailed statement described below. 1. Job Address: ! �C �K ;,� 1 `e— SBL: / - one: .F--' 1 C) 2. Proposed Improvement. (Describe in detail): -3 d yakorl / op am G+? �Uc[�h YGl'.11T Leh�l :G r�c�t iUY1 VlGW 012 Lv l' k n 4e Scl�c S7�hJG�[JrG. Ra-kab i l f un ADOA hr-nd n'l 3. Does the proposed improvement involve a Home-Occupation as per§250-38 of the Code of the Village of Rye Brook? No:_V11, 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 existi}g automatic fire suppression system(Fire Sprinkler,ANSL System,FM-200 System,Type I Hood,etc...) :No: V Yes: (If yes,please submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans) 5. Occupancy; (l fam.,2 fam.,comm.,etc...)Prior to Construction: '� C(M After Construction: 6. N.Y State Construction Classification: N.Y. State Use Classification: 7. Property Owner: ,Sxler Address:LS &,k Ridir,, DV, R�� N K AU l Phone# Cell# ql�t-G 1 I- G;'10 email:: LL A 8. Applicant:JI G Gar,7er ,44C, Address: 36 GrzrJ 5T r�5�r lUY �CJS�� Phone# `��Y-.SGS -.2c�.�0 Cell# Cf l y-585- 1"�Q��email: hjCUgr t 14 yi 9. Architect: Address: Phone# Cell# email: 10. Engineer: Address: Phone# Cell# email: 11. General Contractor: CO S, Address: M G Xv Phone# S65 Cell# ?—y-Sl S-O r/Q, emailAwac& Can 12. Estimated cast of construction $ l �".SOd (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: (1) 8/12/2021 BUILDING DEPARTMENT C u V P VILLAGE OF RYE $AOOK FMAYT� 21023 938 KING STREET RYE BROI6x,NY 10573 (914)939-46f$ VILLAGE OF RYTEBROOK On BUILDING DE-PARTMENT wwww,rwwwwwwwwwwwwwwwwwwwwwww,�www*w*ww�r*,rww,t****,�wxww*,rww*wwww*,rwwwwwwwwwww*wwwww**wwwwwwwwwwwwwwwwwwww,r 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: �} ll 3, ason (fey , residing at, l5 /ipc'/[ Riu9, Dyi uc (Print name) (Address where yo 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; l5 1?OG1V z1yi l & /;Qr%l/e , Rye Brook,NY. Cl (Job A 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. (Sign re of Property Owner(s) (Print Name of Property Owner(s)) Sworn to before me this day of 20 A (Notary Pub ' ) MAGGIE YANG Notary Public Connecticut (2) My Commission Expires Apr 30, 2027 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. C.D,nnec•h�- u STATE OF 1 RK,COUNTY OF ER ) as: LTrZe,,+w+i"-I being duly sworn, deposes and states that he/she is the applicant above named, (print name of individual 4ning 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 }6 12(. t�;� -)�l l,� for the legal owner and is duly authorized to make and file this application. (indicate archi&t,con tor,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 ';�q Sworn to before me this 2 q day of , 2013— day of u , 20 Signa a of Property Owner Signature of Applicant �[/ f .Scan l/CY J"I oc (._04afJiryPi rCo"l-G Print Name of Property Owner Print Name of Applicant Notary li Notary Public MAGGIE YANG Notary Public Connecticut MAGGiE YANG My Commission Expires Apr 30, 2027 Notary Pubftc Connecticut +ay CAlttmissien Expires Apr 30, Y0=y (4) s • .--i dd 0 o w • W � � Ln a F c a � wkIt LL. bk lz M en 4 w o $ H10 ' O Lir) O ' 00 oc C o a z ` w w QIt ' z la v 5 } CA A 00 � o V A a H zz w � o e U -- J vk U g . � W w H = Z off a z • V W n V F8 " v W o a � ° Ln zaAzA 1 D,` BUILDING DEPARTMENT VILLAGE OF RYE BROOK SEP - 7 2023 938 KING STREET RYE B4",NY 10573 (9l4)*-0668 VILLAGE OF RYE BROOK WWW.yyCyt,k.org BUILDING DEPARTMENT ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY BP#: 03— 0 / F:l'#: Q3—) LJ Approval Date: SEP 1 2 201 Permit Fee:$ Z�2Z0 Approval Signature: Other: *ssssssssssss***ss*sssssssss*****sss**s*** sss*ss********s**ss*s****s*s*s*sssssss***sssss*s*sss** 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. I.Address:1g_---g o c K- 1Z t r ) SBL: 135:35- I - Lin Zone: Q� 2.Property Owner.ISO VI s t f e N ci —'k u��,II oo— Address: t S :?L-y-1C- 1-k lG--N-( i C"S 4 3 Phone#: Cell#: C email: 2_ ' 3.Master Electrician/Licensed Installer: M u � M�Ca��x.�+ Address: Pj) u g:t Pofir h 9 r N y l 3 ,,' Lic.#:C I1 51 Phone1 , #:q qU 5 S(pL(ACell#: �'1 )� SS`t(,cll email: i'n Fi) L.Xt t �i PG-�y, ,eke G• o•-Y> Company Name:WAt T FI�L� (�L�� t- 4'YLW-k LL Address:P 4c>C 144 -4- Po I-A C"-5 4-,-.,- �s �- tiq I 7 , 4.Proposed Electrical Work/Fixture Count: Bcr I h(-00 en I-e 0(;140,+-1 p,1 -}ri OF C3)nu� It�S �3� -5►�t� l,�s �s� lt�i-��J`txfir�S„ (t) �LYn� C�hct vS3 +n A✓1(I (11 2 o a m a t`f-Lt'L't- 5.3'Party Electrical Inspection Agency: Qt- ,:�:e u t A-C lei.V e c+j c�-) ,S-e,-y 1 c STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: A,� t-,ate 1 0` M A'&i.y being duly swom,deposes and states that he,she is the applicant above named,and does further (print name of indi%idual signing as the appl- t state that(s)he is the M txt�l C I-li ct I'✓1'or the legal owner and is duly authorized to make and file this application. (Masicr Icorician LkvimA Installer) The undersigned further states that all statements contained herein are true to the best of his!hcr 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. Swum to before me this Sworn to before me this 51111- day of ,20 day of se 20 a">ti Signature of Property Owner Signature of Applicant ' Mca'V� --b Print Name of Property Owner Print Name of Applicant / Notary PublicPublic tAURA W B LMONT 313rM3 tkftY PU011c,3t*te of N*W Yb►( NO,018ES1957$3 ektaff"d in Westchestef cffal� Cam ismon Expas October 27,,--!L&q STATEWIDE • Service With Iiiiii 181 Main Street,Fishkill, NY 12524 1 emoil:office@swisny.com SWIS JOB APPLICATION845.202.7224914.219.1062 • • • Office Use Elect.Permit# /���� � /�� Date Bldg Permit# / Utility ID# Final Certificate# City/Village ai -e r,,o k Zip Township County ✓_ /C �� /l S� Address ?UC k- RIl' C, _fr Cross Street Section/3s ? Block �V Lot Owner Name/Address(If different than above) n V r (J� Contact Number 7 ❑Basement ❑ 1st Fl. ❑2nd 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 Incandescent Fluorescent SERVICE Amperage Voltage t P 3P #Meters #Disconnect ❑Underground ❑ New ❑Reconnect ❑Overhead ❑Change ❑Visual Re-Inspection ❑ Safety Re-Inspection ❑ Re-Inspection Additional Information I I SEP - 7 2023 DD VILLAGE_ OF RYE BROOK BUILDING DEPARTMENT 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 appl"rit,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 n City/State Zip Code License# Phone# State Wide Inspection Services C � DEC 1 2 2023 D1080 Main Street I Fishkill, NY 12524 A-- 845 202-7224 Phone VILLAGE OF RYE BROOK 914-219-1062 Fax STATE WIDE INSPECTION SERVICES ,., BUILDING DEPARTMENT Email: officeCa)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: White Electric of New York, LLC Jason Sauer&Mireya Sauer P.O. Box 447 15 Rock Ridge Drive Port Chester, NY 10573 Rye Brook, NY 10573 Located at: 15 Rock Ridge Drive, Rye Brook, NY 10573 section: Block: Lot: Electrical Permit Number: EP 23-194 135.35 1 44 Certificate Number:2023-8864 Building Permit Number: BP 23-078 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: 15 Rock Ridge Drive, Rye Brook, NY 10573 The First 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 81h day of December 2023. Name Quantity Rating Circuit Type Receptacles 03 Switches 03 Light Fixtures 05 Exhaust Fan 01 Circuit 01 20AMP 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 N N r N c " W t a N a 1 a 1~ L O cd C- IT W T 7 N y 44 � • Q 8 Z o � _e Z C W z O r C .41 a x C4 a afr 3 � o 0.4 C. k W 7 N x ce ztn Cn '' O a '~ E■ o R4 en z OC rr�fe CIN �dI / a aCJ ��Q yz >.E5 t", w ti 000CD z w a t el o y ~ n a C7 O z x O a H r ' A � cr, z8 • • �, w �, N c o V w Lr; O z Q a w N V V O a a66 ' Ln t t BUILDING DEPARTMENT VILLAGE OF RYE ftbOK SEP 12 2023 938 KINd k'XEET RYE Bi;qaK,NY 10573 (914)"49=0668 VILLAGE OF RYE BROOK BUILDING DEPARTMENT www. ebtggk.org PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP#: ,Z ' d PP#: C;),3—O 9 7 Approval Date: L Permit Fee: $ Approval Signature: SEP 1 Other: Disapproved: (fees are non-refundable) ************************************************************************************************** Application dated, —/ol-t:�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 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.p 1.Address: Z�C /�GP �/��16' SBL: /t?5., �— T yZone:e—/0 2.Proposed Work: ZTB 3.Property Owner: �Q G/�' Address: Phone#: 7/7—&4/--67/c> Cell#: email: 4.Master Plumber:fC��7c✓�D�O�c�/���/� Address: /c�l� Lic.#:i Z�<Phone#: ?/`r p5.1% _ 1 ?S 5'Cell#:�/% rf Z y,�5`email: � /W/Wv Co. Company Name: /�� / !�'�'1�i _Address: C/ 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 / Yd Floor 41 Floor 51 Floor Exterior 5.*List Other Equipment/Provide Details: (Notarized Signatures Required Next 2 Pages) -I- 3/3/2023 d- STATE OF NEW-'ORK,COUNTY OF CF-STER ) 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 r day of b t'- 120 2 3 day of C �. ,20—di— Siignature of Property Owner Sifnature of Applicant Kk�(0,0' �c U� 6�) Print Name of Property Owner Print Name of Applicant I�uA Notary bhc Notary MAGGIE YANG MAGGIE YANG Notary Public Notary Public Connecticut Connecticut My Comm r fires A r 30 02 This applica ' Edfl� t'e in its entirety and must inclu 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 BUILDING DEPARTMENTRVILLAGE OF RYE BROOK SEP 12 2023 938 KING IT RYE BROO NY 10573 -� VILLAGE OF RYc BROOD BUILDING DEPARTWE-NI T 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, �ke � 5 ,t1le✓ , residing at, 1S rat 01k, PY (P ' 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; 1S 1170C14 ki4l' ,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. l (Signature of Property Owner(s)) (Print Name of Property Owner(s)) Sworn to before me this day of G , 20.g�. (Notary Publi MAGGIE YANG Notary Public _3_ Connecticut My Commission Expires Apr 30, 2027 8/12/2021 Building Pernxit Check List&Zoning Analysis ii Address: l SBL. 1 " Zone: Q. Const.Type: V O Other. Submittal Date: Revisions Submittal Dates: Applicant: Nature of Work Reviews:ZBA: AN 0 1 1023 PB• BOT• Other. NEED Q/K`/ ( ) �t/1 ES:Filing. BP: C/O: Flood Plane Legalization: ( ) ( �P: Dated Notarized SBL Taus 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. ( ) ( ) SURVEY:Dated: Current: Archival:- Sealed: Unacceptable: ( ) ( ) LANS:Date Stamped Sealed Copies: Electronic Other. ( ) ( License:,L Workers Comp: Liability. Comp.Waiver. Other. ( ( ) CODE 7S3#: Dated: N/A: .IIGGH-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: REOUIRED EXISTING PROPOSED NOTES Date: J UN 1 3 Am Sirs] F� F� l3� Main Coo Accs.Cov Ft,H/Sb: Sd.H/Sb: CIFA: HHcjg /Stoles notes: a r u� t M1 3 iJ BATHROOM RENOVATION Delivered to Prepared by Jason Sauer KDC Carpentry LLC iS Rock Ridle Drive 36 Grant Street Rye Brook,NY ioS7 ` PurtChester NIV io _ Proiect Summarv M Down below we have described the work we will be performing at the premises as well as a brief summary of our steps. DESCRIPTIONS Bathroom renovation: cover the areas needed with plastic wrap to prevent dust of flying everywhere in the house. Remove all bathroom features from the current area such as vanity, medicine cabinet, shower door, bathtub and any other small fixtures. Demolish current tiles from the shower wall and floor as well as from the bathroom floor and walls. Demolish all drywall from the walls and ceiling. Remove all debris and take it to dump, clean out the whole project area. Install brand new cement boards inside the shower area. Install brand new tub provided by owner. Install brand new tiles around all the walls of the shower from bottom to top. Install shower door. Install brand new mold-resistant drywall around all the bathroom walls and ceiling. Install brand new baseboards, and crown molding around the walls. Install brand new casing around the window. Install all bathroom fixtures provided by owner such as vanity, medicine cabinet or mirror, toilet, holders ETC. apply joint-tape compound around the whole bathroom walls and ceiling. Prepare, patch and light sand all walls, ceiling and moldings. Apply one coat of Benjamin Moore primer and two coats of top quality finish paint all new walls, ceiling and moldings.Owner provides tiles and bathroom fixtures. ($19,500) Total ($19,500) Tax ($000) Capital improvement Total + Tax (° Let's Work Tooether KD We are ready . get started14R Afft Project Start Date We have an availability to start your project on Monday, July 3rd at 8:30Am if this date/time doesn't work with you, let us know we are flexible! Note This proposal may be withdrawn by us if not accepted within 60 business days. Proposal Timeline 05/15/2023 - 07/15/2023 Terms & Conditions Accepted We propose hereby to furnish The above prices and specifications materials and labor complete in are satisfactory and are hereby accordance with the specifications accepted. You are authorized to do stated above. the work as specified. Z.%r- KDC: Client: «, Klever Gutierrez Jason Sauer F� Y H Oz Ow N m f— �O O } Q L=J a a N W tl Q Q WZ �I L � g� o � � o > m Voo � 0 0 v 0 r O r c6 V • v � O y� • 1 C. V OT V 1 �•J ' tic i.l L CS •..+ L C) „ a Ij N c .•_ N h 7 O C) tr, led \ _: • ���. cCOO Y <o)) E r 0. ,u o _s IL W Z U � W v E Z aF <ors r O O Q Z = y a ci v y X w O f: . 4 y i ce LO All . �? 1 • 1 ,t�.,,-is-�-i};��j�,►��. ••.•L°��111 y �. . � �..'r� It��`� s'`% .11 1, `�'YY 1 60I 411TI 1/111(11 n 'IF, 1/•r•1 1i� ^1■� •• nIA .. �' ,4coRc7 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 05/22,'2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. 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AND ROPRIE ERS'LIRTNEY YIN TORY LIMITS ER ANYCEMMEEBERI EXCLUER/EXECUTIVE EL EACH ACCIDENT 5 Orf ICER/MEMBER EXCLIJDED'r �N I A (Mandatory in NH) I II yes describe undur E L DISEASE-EA EMPLOYEE S . UESCRIPl10N OF OPERATIONS below E L DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101.Additional Remarks Schedule.it more space is required) CARPENTRY/PAINTING/DOOR AND WINDOWS/TILE/MARBLE WORK/CABINETRY'DRYWALL CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE VILLAGE OF RYE BROOK THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 938 KING ST ACCORDANCE WITH THE POLICY PROVISIONS. RYE BROOK,NY 10573 AUTHORIZED REPRESENTATIVE NELLA CARRICO ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. 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