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HomeMy WebLinkAboutBP23-158TCO N FEE DATE eFCTION RECORD DATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING 1-11-io li INSULATION SNewN �. I•t•2`( PLUMBING M 2- RGH PLUMBING .� I • L' Lw GAS El SPRINKLER Jar ELECTRIC ml Low -VOLT E3 ALARM AS BUILT O FINAL OTHER APPROVALS AIRS BOT $O(o PB ZBA OTHER c IDa )3 IQ411frrGw,�/N �Pa3-c�(o5/Cesa�i�i fINBNED BASEMENT NOT gPPR WE0 FOR USE AS A SEPARATE APARTMENT Oq DWELLING UNIT VILLAGE OF RYE BROOK WESTCHESTER COUNTY, NEW YORK No: 24- 1OO Certif irate of ®ccupaucp Ehis is to certify that v 1 n G of, having duly filed an application on 20 requesting a Certificate of Occupancy for the premises known as, QVIY Q , Rye Brook,NY, located in a z-�- F Zoning District and shown on the most current Tax Map as Section: j Block: Q Lot: and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No. , issued 20 �3, 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: 31 -A42D— Amilu Construction: for the following purposes: SI'�er� Subject to all the privileges, requirements, limitations, and conditions prescribed by law, and subject also to the following: FINISHED BASEMENT NOT APPROVED FOR USE AS A SEPARATE APARTMENT OR DWELLING UNIT 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 ex' facilities shall be made,and no enlargement, whether by extending on any side or by increasing in hall be made,n r s 11 the building be moved from one location to another until a permit to accomplish such change h bee d fr th ilding Inspector. Building Inspector,Village of Rye Brook: Date: AUG - 7 2024 I D [E C E ��IF BUILD R ENT For office use only: DD PERMIT# �3--� MAY 2 8 2024 VIL OF RYE OK ISSUED: 938 KING STRE YE BROOK, YORK 10573 DATE: 9 -06 O�c FEE: >g (� PMDAC VILLAGE OF RYE BROOK 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 ►►►rs►ttssttsts►ttttr•***wrt***t**t►sots►ss►►►►►tss►ssss*ss**s***ss**ss*ss*ss*s**tr*ttr*tw*******rw*ww**ws***w**tr**tw****ts Address: 2- O 14'9 k y le W I-n+yP Occupancy/Use: Parcel ID#: ZIA 35-D 1 9 Zone: Owner: jw�yj I"I or<m G Address: ?,O 'bl Vla-i o-yi S-1 P.E./R.A. or Contractor: Address: Person in responsible charge: 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 YORK,COUNTY OF WESTCHESTER as: (JcO-Y7 / _`man 0 being duly swom,deposes and says that he/she resides at 3U < VIP a-�-1 91 (Print Name of Applicant) (No.and Street) in�>[q �roC-K ,in the County of wGs�c�P 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:$ 16 000 for the construction or alteration of: %3c�act�Y►')a�-/ !�a 7itp(/c��i OyJ 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 theCode of the Village of Rye Brook. Sworn to before me this C) V Sworn to before me this day of \­_113, , 2011� day of , 20 ature of Property Owner Signature of Applicant P' t RWe of Property Owner Print Name of Applicant Notary Public SHARI MELILLO Notary Public Notary Public,State of New York No,O1ME6160063 Qualified In Westchester County Commission Expires January 29,20 QyE BRC��• F 0 • �9a2 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 : DATE: PERMIT# J ISSUED: ` SECT: BLOCK: LOT: LOCATION: 4- < `' J 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 ❑ L.P. Gas ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑//CROSS CONNECTION ` FINAL ❑ OTHER �E BR�k, • 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.Uebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS :— `�\ I < (. DATE: PERMIT# ' J�. ISSUED:�I "SECT: � l`1� Jl BLOCK:— LOT: LOCATION: �� C S27 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 ` l 4 E'C I r ❑ L.P. Gas ❑ FUEL TANK • ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION 4 b\ / � ❑ FINAL Y(J \f' ❑ OTHER • �E 4Rc' o`` tim 1932 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 : 2L 1-11 V 1 Y c- A-) /'I yr DATE: PERMIT# l +c ��S(P J 1j - ISSUED: SECT: S 3f BLOCK: LOT: LOCATION: `//-r `4 NLl' OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/ 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 V' r . `� LL i � . 0 s4� Emotions w ° p ww" ' y � � e•I .er wI �1 14 I S VIVA s f r-- a t - M rs, 5 • I�t i t 3 �yE BR( O� y� l7 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 : DATE' c �j PERMIT# ISSUED: ECT: BLOCK: 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 ❑ L.P. Gas ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION f f ( 1 ❑ FINAL ❑ OTHER �E BRC��, BUILDING DEPARTMENT ❑BBUUILDING INSPECTOR 0 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 : Z S N/Gf/y,'r H/ A ✓C- DATE: /' Z O 2- PERMIT# 9 P .2 3 -/Y 3 ISSUED: Z-J SECT: 3S" BLOCK: LOT: / LOCATION: /✓7P 1){ • OCCUPANCY: ❑ Violation Noted THE WORK IS... PASSED ❑ FAILED / REINSPECTION ❑ SITE INSPECTION R141OIL REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING g"ROUGH FRAMING ❑ INSULATION ❑ Natural Gas W 0,e k -L-�,o N e N c) AJ . 1/✓� FE ❑ L.P. Gas f?c V i s e a PIA U J S hoc,// �; Re mo e r✓/3LG S ❑ FUEL TANK ❑ FIRE SPRINKLER Q N New v1//q u � C L"se e'. ❑ FINAL PLUMBING ❑ CROSS CONNECTION ? A LSJ NPR' cl y� SPf'/ hoG� S lY ❑ FINAL /)s'/ [�0 AJ /N �2v1J* /� GH J nW) ❑ OTHER d � N o �./ v - 2 d s/ t�R �1�C'A/� � .S/ a oti e Ku 'j . ( P M S w/ %1 ko N C�)'?)/t/P 64 1JG� ✓Z w 'y 7 �, QyE BR(�k• tD 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 : 2 �� 9 F A Ve- DATE: 1- 2 - Z O2 7 PERMIT# ZE - Z Z ISSUED: 12-/ 2.3 SECT: y� /,3s" BLOCK: Z LOT: /9 LOCATION: S e MG f OCCUPANCY: 2 /0 ❑ Violation Noted THE WORK IS... [" PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: EK ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION / ❑ Natural Gas A 6 0✓� G rOcA�cf nGu A-7 0 v ❑ L.P. Gas �� S ❑ FUEL TANK ❑ FIRE SPRINKLER .5�0 G✓P/" PA - J /AJ S1e'C 1,,,4,1,E Pc ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL OTHER QyE BRC��• • 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.ors - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : 2 S /7/9�N✓I E O Ave— DATE: 12 ` /y - Z yZ .3 PERMIT# T Z 2 7 ISSUED: 1L-/-?0 SECT: 1 y 1 •3.S BLOCK: Z LOT: / LOCATION: ��-SQ,1 P J T ' OCCUPANCY: Z 1 n ❑ Violation Noted THE WORK IS... 0`PASSED ❑ FAILED / REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: B ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas �Lu U U Ja �. v U� C L ❑ FUEL TANK AA MAl4A ocI C�oUc�PvSo-t ❑ FIRE SPRINKLER ! � e �1„�� is CJUN eL c� TD 1 I k VP,� L Iti e /-j ❑ FINAL PLUMBING ❑ CROSS CONNECTION �G SE► F`�i ' ❑ FINAL N �e S A c' -�D e0 o &0 V✓A� ❑ OTHER i lo 0� NG �xPA �v_s�ov rn��s a� bc� ■ O 'z ■ N N N � � O W ■ ■ }� CA 7 4a O ww FI � L a v • U i o a ■ _ N Cl) A 4 ,�, Lam^ w LT. ■ �••, ,z _ V o x A. � A to U +� Q C O "0 3G q O © ■ 00 P-4C co C)* ■ [� SoO �, o G w rr-� ■ ■ Z Pr Q O eas n 'It z U Z °� v 1-0 ■ IRTCIO C)*% Ca PI CA cl �..� Z p p a v V V 00 ew a z b �w U Z x ti vo 0 .1 -. gv � `n U i, a a b v er7 za0 a �'}�� w w z o oFo- v W H W �� h■�q Cn O Z z WE dd v cLai a z W A O - x i 'o a 3 N A w .� o � .a, o a ] 0 A4 Bum MENT - - _--- ---� VIL E OF RY OOK 938 KING ET RYE BR ,NY 10573 -- 4 - LJ L1 JIJN 1 2 1 D VILLAGE~ tJF RYE BROOK INTERIOR BUILDING PERMIT APPLIC A VIM G DEPARTMENT FOR OFFICE USE ONLY:Approval Date: S E 1 2 0 �rm &C)3 J 5YApplication Fee:$ Approval Signature: Permit Fees:$_ Disapproved: Other: Application dated: 49 is hereby made to the' gilding Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the interior alteration of an existi g building,or for a change in use is per detailed statement described below. �� �' 16 V/ � � f J 1. Job Address:�"! ' SBL: � �� ri 1 Zone: 2. Proposed Improvement. Oescribe in detail): (CAJ 3. Does a proposed i wement involve a Home-Occupation as per§250-38 of the Code of the Village of Rye Brook? No: Yes: If yes,indicate: TIER I: TIER 11: 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: Yes: (If yes,please submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans) 5. Occupancy,(I fam.,2 fam.,comm.,etc...)Prior to Construction: 1 FA After Construction: I � 6. N.Y State Construction Classification: < N.Y.State Use tClassification: R 7, Property Owner: Address-2�-(-�f/`yt1�1 Phone# Cell# email: 8. Applicant: Address: J Phone# Cell# email: D 9�lG'L ONE 4 9. Architect: l Address: Y 4 NWT Phone# Cell# - email. 10. Engineer: Address: Phone# Cell# email: Ile I-- 11. General Contractor: - O UI Address: Phone#— Cell# email: 12. Estimated cost of construction $ (NOTE:The estimalcd cost shall include all labor,ma eria,scatfolding,fixed equipment,professional fees,and material and labor which may be donated gratis,) 13. Job Timetable:Start: Finish: (i) 8/12/2t121 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,CO TY WESTCHESTER ) as: �L , being duly sworn, deposes and states that he/she is the applicant above named, (print name of individual tsigning A t pp icant) and further states that 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 ( Sworn to before me this _ day of 2. 1 , 20 day of —1AAr 20 2 3 i ature of Property Owner at re of Applicant) ] ofiAJW 6f Y1 I JL/ ` c Print Name of P rty Owner Print Name o3tApplicant Notary Public Notary b]ic MICHAEL ESQUIVEL Notary Public-State of Ne:11,202]6 No.O1ES6442359 Qualified in Westchester TYLER ANDREW WHrrLEY My Commission Expires Oct Notary Public Connecticut My Commission Expires Feb 28, 2027 (4) S/12/2021 BUILDING DEPARTMENT D (J VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK,NY 10573 JUN 12 2023 (914)939-0668 1 VILLAGE OF RYE BROOK BLJILDfNG 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: ("' A� �/ >residing at, v (Print 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; `j I V , 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. 6t� (2,zZ / ature of Property s)) (Print Name of Property Owner(s)) Sworn to before me this r day of , 20 (Notary Public) LILLIAN SIERRA Notary Public - State of New York NO. 01S16280398 (6) Qualified in westches r My COMMission Expires__ ,r.,. 8/12/2021 LO M� N N \ W � � a a \ N O W � 1Clk � PC u 11 z a v� ON CCN O v a q* ~ g to W , W � � . O 1 o H s p o z � � z A o � � �. � V ° 0 Q a w oo � M N w � O O O Zj +n V z U Z Cl) W Zj G1 M U z Z M 0 Q o W � � � 1~ 00 CN O wA M oZ N x .. a o ' W W HLr) as " zs N g 8 � W w W. o0 U► v`�'i zw W o z o , c/) -� 3 ,� w � U H o �+ , x v w z a Q9. x N z 9 w z 04 A04 w a � z { HI � 09 a z � w 0 � yE RC�v�i i D U V E BUIL E MENT VIL E OF RYE Bk OK DEC 21 2023 938 KIN , ET RYE BROOK,NY 10573 6R VILLAGE OF RYE BROOK Or BUILDING DEPARTMENT ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required / FOR OFFICE USE ONLY BP#: 'Z \ P EP Approval Date: DEC 2 7 Permit Fee: $ Approval Signature: Other: DO NOT START WORK or CONSTR U TIL A PERMIT HAS BEEN ISSUED BY THE BUILDING INSPECTOR. THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12%OF THE TOTAL COST OF CONSTRUCTION WITH A N[Pi MUM FEE OF$750.00 Application dated, /el-a7 33 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. p 1.Address: 2 5- 141 9 A y If w /J'✓( F tr f 912 an 1< SBL: /������—� % Zone:, 2.Property Owner: 2 5 Ih"v w w 4-Vif 1 r1 e, Address: 7_1�_ f X'11t•J �¢✓t Phone#: q/ t{-a6 a-4 46 q Cell#: email: C C rS a n n 1 ®C es a a n/ <o.,�at�i, Ca 3.Master Electrician/Licensed Installer:_1�(� (cs f^_ Address: 1 6 U u t✓na R A Ort's)s Lic.#: o�Phone#: ��tl"o7(�a-996 q Cell#: email: [CeSariHi �><CSaria, c0�r' r{�<„eoni Company Name: CC Sot rl n t (o„�/zcc i�u_ j,,,( Address: 136 U v i vr',r a R o 13 few by 4.Proposed Electrical'Work/Fixture Count: aS-(6W h-/- * (?a6eo-r7e,4 R q 1--6 Q,C c-Ie) 0 OvOlf ft , G-F l . 1 S- ( /�,A t3 5.31 Party Electrical Inspection Agency: STATE OF NEW r YORK,COUNTY OF WESTCHESTER ) as: l/''!_ being duly sworn,deposes and states that he/she is the applicant above named,and does further (print name of individ al si ning as a applicant) state that(s)he is the in CCW( L\CCW%C 4*1for the legal owner and is duly authorized to make and file this application. (Master Electrician/Licensed Installer) 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 Qe C eo4_-_<_'r Sworn to before me this PCC C Cr\\Gt.(— day of a� ,20_23 Jaen M.AfR>--rto day of �t-1 ,20&3 Notary Public,State of New York � � No.0 1 AL6198763 Signature of Property Owner Ouallfied in westchesterCounty SignaUire of A Akan, My Commission Expires 01/05 2o2Y5 Print Name of Property Owner Print Name of Applicant nptlrn l�tC71' Notary Public Notary Publi 10/30/2023 STATE WIDE INSPECTION SERVICES, INC. Service 0"ith Integrity 1 0•0 • • SWIS JOB APPLICATION •. • Office Use Elect. Permit# �� 3� Date Bldg Permit# g i/ — s Scl Ft Plumbing Permit,# 1 Final Certificate# City/Village e (vc)I� Zip Building Dept. County Address f� S h Cross Street Section Block Lot Owner Name/Address(If different than above) , V� Contact Number r L) _ "\ ❑Basement ❑ 1st FI. ❑ 2nd FI. ❑3rd Fl. ❑More Than 3 FI. ❑Garage ❑Attic ❑Outside ❑Residential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C/O Detector Hood Trash Compact Amt Amps Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer Switch SERVICE Amperage #Panels 1P 3P # Meters # Disconnect ❑Underground ❑ New ❑ Reconnect ❑ Repair ❑Overhead ❑ Upgrade ❑ Disconnect Utility ID# ❑Con Ed ❑ NYSEG ❑Central Hudson ❑ Orange/Rockland PHOTOVOLTAIC SYSTEM PV Modules Inverters AC Disconnect )unction Box Combiner Box Load Center PV Monitor Energy Storage System DC Disconnect ❑Legalization jj ❑ Safety Inspection ❑Consultation `l� 5E '1�'v f\ CA t�r�VM DEC 21 2013 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 applicant, owner or authorized agent agrees to all the above terms and conditions as set forth for the application. Email Address r n S L Name n. ��v^ License# 1 6 Date I /��{1,, Signature Address '� �.H �) City/State P !P 'j N t r r Zip Code Company t !-C (, n , t r t , Phone# LI �I` D ECEN State Wide Inspection Services CA]) JUL 2 4 2024 DD1080 Main Street Fishkill, NY 12524 845 202-7224 Phone Swus VILLAGE OF RYE BROOK 914-219-1062 Fax STATE WIDE INSVECTIONSERVICES BUILDING DEPARTMENT Email: office(d)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: Cesarini Contracting, Inc. 25 Highview Avenue Inc. 136 Guinea Road 25 Highview Avenue Brewster, NY 10509 Rye Brook, NY 10573 Located at: 25 Highview Avenue, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP23-265 141.35 19 Certificate Number:2024-1963 Building Permit Number: BP23-158 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: 25 Highview Avenue, Rye Brook, NY 10573 The Basement, First Floor,and Second floor were 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 28`h day of March 2024. Name Quantity Rating Circuit Type Receptacles 13 Recessed Luminaires 18 Switches 08 Bathroom Exhaust Fan 01 Recessed Luminaires 02 Receptacles 02 Electric Water Heater 01 Washer 01 Dryer 01 A Visual Inspection of existing conditions was performed on March 281h, 2024 of the Basement and Conforms to NFPA 70-2017 NEC. No Defects Were Noted. 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 z N \ N W V w a ►.� c z a w to M 0-4o N ° � F cn a •-• a F = OZo wQ � oA A cq ON cn iw w � o F � H O A H x w o a z z x w oo F O A U 0.4 O � Z11 Z o z0�4 ' a �cn , or) 11-11 ►--i W a a ^� ZO 0 ~ w x o U zo o ° Q w It W Z z IDz o v� 3 a w " V 09. '� •• � a w a � o w �I a a w x � BUILDING DEPARTMENT VILLAGE OF RYE BROOK NOV 2 9 2023 938 KING STREET RYE BROOK,NY 10573 VILLAGE OF RYE BROOK (914)939-0668 BU;LD1NG DEPARTMENT % %\\L.rvchrook.org PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP#: a3'1�.J V PP#: 03 Approval Date: Permit Fee: $ Approval Signature: Disapproved: (fees are non-refundable) DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDING INSPECTOR.THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT ISG12%OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00 Application dated, / 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: S (/T / 0, o V/Doc) AV� SBL:��7�i 3�'�� � Zone:6-F 2.Proposed Work: I�U V�'/ h n!, s Ft ��-v :� 3.Property Owner: �5 � k ;1 C)f .,-r Address: Z S S'h t/I LrZ,,i Fly,5— Phone#: f/4-4 DQ 52 0 6 Cell#: email: 4.Master Plumber: �1�5 Ott/J. /t'1C iCOL Address: fa b lJL��,{3 Lic.#: 1644 Phone#: Ql�`jG��g Cell#:y!¢ � /d email: f��C.e;IQ:2 A UL, rdi f Company Name: t9rk r?(7t) /�'C. j,,i�_Address: L© 0 !� r 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 / Ist Floor 1 2nd Floor Yd Floor 4'h Floor 5`h Floor Exterior 5.* List Other Equipment/Provide Details: 'C (Notarized Signatures Required Next 2 Pages) -t- 3/3/2023 STATE OF NEW YORK, OUNTY OF WESTCHESTER ) as: r ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signVog as plicant) 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 Q�A day of 2 ,20 day of kAddv 120 L gnature of Property Owner Si of c Print Name ope ner Print Name of Applicant oIla , AMG11ItEt ESQUIVEL Notary blic Notary Public-State of New York Notary 1C NO,01ES6442359 M.RIVERA Qualified in Westchester County M, Commission Public,State of New York ommsson Expires Oct 11,2026 No.01 Ri6441398 Qua0fied in Westchester County CommMlon Expires September 26,20 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. 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- 10/30/2023 R BUILDIN6VE�� MENT VILJi A,GE OF RYE ROOK 938 KING, X:J___',' ET RYE BROOK,NY 10573 68; .or PLUMBING PERMIT APPLICATION FOR OFFIC SE ONLY BP#: PP#: Approval Date: Permit Fee: S Approval Signature: Disapproved: je are non-refundable) DO NOT START W K or CONSTRUCTION UNTIL A PERMIT HAS BE ISSUED BY THE BUILDING INSPECTOR. THE AbMINISTRATIVE FEE FOR WORK PROGRESSE OR COMPLETED WITHOUT A PERMIT IS 12%OFb4E TOTAL COST OF CONSTRUCTION W H A MINIMUM FEE OF$750.00 Application dated, is hery made to the Building Inspector of Village of Rye Brook NY,for the issuance of a Permit to install and/or remove Plumbing as pe etailed statement described bel .The applicant&property owner,by signing this document agree that said plumbing work will be in nformance with all applic a Federal, State,County and Local Codes. 1.Address: 61fAf o SBL: Zone: 2.Proposed Work: 0 >n G k t 1164 3.Property Owner: ," t-r W&r(0 YJ . dress: 3C> M J' io� � e xe 4 NY Phone#: CI 1¢ y 3 6�/� Cell#:914 4� �s D email: jC MO Z.y f`��Q��iaf �i�• f�/n, 4.Master Plumber: h , Addres . I w 1 Lic. #: D 6 Phone#: t( - 11#: 4 email: Af Company Name: A f-<-Cx i 11rA Address:I INDICATE FIXTURES&L S TO BE INSTALLED AS PERT FOLLOWING SCHEDULE: Location Water Urinals Drinking Si s Showers Bath Laundry Domestic Fi Sanitary Natural/ Other* Total Closets Fountains Tubs Tubs Service Sery a Sewer LP Gas Basement 1 st Floor 2nd Floor 3`d Floor 41 Floor 5`h Floor Exterior 5.* List Other Equipment/Provide Details: AYA (Notarized Signatures Required Next 2 Pages) BUILD NG DEPA MENT D -� ,v VIL E OF RYEOOK 938 Kira ET RYE BROOK,NY 10573 NOV 2 22023 4 -0 �0 VILLAGE OF RYE BROOK BUILDING DEPARTMENT xxxxxxxxxxxxxxxxrxxxxxxxxxxxxrxxxxxx,�xxxxxxxxxxxxx,�x*,�*****xxxxxxxxxxxxrxxxxxxxrxxx*,�xxxxxxxxxxxxxxxrxx 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: fU,)YI C M C lP YIL ,residing at, _: 6 6/14S/Cn� 3 (Print name) (Address where you Be) 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; Z Cl V J Q t/ �� V T" , 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. (S' ure of Propert,, O%kner(s)) )YI C, /f CJre-`Y7 U (Print Name of Propert} Ox�ner(s)) Sworn to before me this day off, 0\/ WV, b ti 2 , 20 3 X-P ( I- - (Kota Pubk' MICH 1 ESQUIVEL FNotary Public-State of New York No.01ES6442359 -3- ed in Westchester County mission Expires Oct 11,2026 8/122021 --------+ .Building Permit``Check List&Zoning Analysis Address:nn Zone: K—�.� Use: 2 Const.Type: n Other. Submittal Date: Revisions Submittal Dates: Applicant f Nature of Work ( 077 Reviews:ZBA: PB• BOT• Other. L�IF�I2 QK �- �J� ( � (1 :Filing _ �P: y C/O: Flood Plane: Legalization: ( ) ( APP: Dated. Notarized. 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. ( ) SURVEY:Dated: Current Archival Sealed: Unacceptable: ( ) ( S:Date Stamped: Sealed: Copies: Electronic: they ( ( 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. (l•Y ( ) 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: REOMED EXISTING PROPOSED NOTES APPROVE,:? Arc 1 4 2 cam: Front: Fronr: 1W Main Q Accs,c F S S S : Tom: Hcj& Storm : notes: S �CYCIIS _ Ar Co k O .C1 cy— R EVI =-------� � P LA S EP 5 2023 DAT Q- ernm elf!-% `BUILDING DEPART NEW YORK ARCHITECT DESIGNERS ADIMINISTRATIVE OFFICE 80 GREENWICH AVE GREENWICH, CT 06830-TEL. : (2030550-3540- FAX: (203)618-0054 ------------------------------------------------------------------------------------------------------------------------ TRANSMITTAL RYE BROOK, NY BUILDING DEPARTMENT PROJECT: 25 HIGH VIEW - UPDATED DRAWINGS - REMOVAL OF PROPOSED WINDOW WELLS SHEET A-001.00 & A-002.00 a September 05 2023 ILE F Daniel F Mayet, RA .r A -- NEW _ United States Liability Insurance Company DlrectBlllPollcy Renewal of Number 1190 Devon Park Drive, Wayne, Pennsylvania 19087 POLICY DECLARATIONS A Member Company of United States Liability Insurance Group No. CP 1798936 NAMED INSURED AND ADDRESS: JUAN CARLOS MORENO 25 HIGHVIEW AVE RYE BROOK, NY 10573 POLICY PERIOD: (MO. DAY YR) From: 10/20/2022 To: 10/20/2023 12:01 A.M.STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE FORM OF BUSINESS: Individual BUSINESS DESCRIPTION: 1 to 4 Family Dwelling IN RETURN FOR THE PAYMENT OF • SUBJECT TO ALL THE TERMS OF POLICY, WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS INDICATED. THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENT. PREMIUM Commercial Liability Coverage Part $587.00 Commercial Property Coverage Part $3,349.00 TOTAL: $3,936.00 Coverage Form(s)and Endorsement(s)made a part of this policy at time of issue See Endorsement EOD (1/95) Agent: SCOTTISH AMERICAN(NY)(4902) Issued: 10/24/2022 10:16 AM 34-07 Steinway St,Suits 201 Long Island City,NY 11101 �;�,Z.IYA.✓)�%Imo""'"Broker: Genesis Insurance 171 Grand Street By Authorized Represe t e White Plains, NY 10601 THESE DECLARATIONS TOGETHER WITH THE COMMON POLICY CONDITIONS,COVERAGE PART DECLARATIONS, UPD(OB-07) COVERAGE PART COVERAGE FORM(S)AND FORMS AND ENDORSEMENTS,IF ANY,ISSUED TO FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED POLICY. EXTENSION OF DECLARATIONS Policy No. CP 1798936 Effective Date 10/20/2022 12:01 AM STANDARD TIME AT YOUR MAILING ADDRESS FORMS AND ENDORSEMENTS The following forms apply to multiple coverage parts Endt# Revised Description of Endorsements CGO104 12/04 New York Changes-Premium Audit CG2173 01/15 Exclusion Of Certified Acts Of Terrorism IL0017 11/98 Common Policy Conditions IL0023 07/02 Nuclear Energy Liability Exclusion Endorsement IL0183 08/08 New York Changes- Fraud IL0268 01/11 New York Changes-Cancellation And Nonrenewal IL0935 07/02 Exclusion Of Certain Computer-Related Losses IL0953 01/15 Exclusion Of Certified Acts Of Terrorism JACKET NY 12/19 Policy Jacket L-61ONY 01/07 Expanded Definition Of Bodily Injury- New York LLQ100 07/06 Amendatory Endorsement LLQ368 08/10 Separation Of Insureds Clarification Endorsement NTE NY 01/15 Notice Of Terrorism Exclusion The following forms apply to the Commercial Liability coverage part Endt# Revised Description of Endorsements CG0001 12/07 Commercial General Liability Coverage Form CGO068 05/09 Recording And Distribution Of Material Or Information In Violation Of Law Exclusion CGO163 07/11 New York Changes- Commercial General Liability Coverage Form CG2107 05/14 Exclusion -Access Or Disclosure Of Confidential Or Personal Information And Data-Related Liability-Limited Bodily Injury Exception Not Included CG2109 06/15 Exclusion -Unmanned Aircraft CG2136 03/05 Exclusion -New Entities CG2144 07/98 Limitation Of Coverage To Designated Premises Or Project CG2147 12/07 Employment-Related Practices Exclusion CG2621 10/91 New York Changes-Transfer Of Duties When A Limit Of Insurance Is Used Up JACKET NY 12/19 Policy Jacket L-697NY 11/07 Absolute Asbestos Exclusion With A Hostile Fire Exception L-698NY 11/07 Absolute Lead Exclusion With A Hostile Fire Exception L-699NY 11/07 Absolute Pollution Exclusion With A Hostile Fire Exception L-70ONY 11/07 Absolute Silica Exclusion With A Hostile Fire Exception L-783 02/14 Amendment Of Liquor Liability Exclusion Notice-Unmanned 05/16 Advisory Notice To Policyholders Aircraft—G L The following forms apply to the Commercial Property coverage part Endt# Revised Description of Endorsements EOD(01/95) All other terms and conditions remain unchanged. Page 1 of 2 EXTENSION OF DECLARATIONS Policy No. CP 1798936 Effective Date 10/20/2022 12:01 AM STANDARD TIME AT YOUR MAILING ADDRESS FORMS AND ENDORSEMENTS CP 112 10/12 Equipment Breakdown Enhancement Endorsement CP 138 NY 02/11 Lead Exclusion CP 141 DEP NY 08/20 Changes-Actual Cash Value and Depreciation Definition CP 142 04/14 Protective Devices Or Services Provisions CP 146 NY 02/09 New York Changes CP 224 02/11 Asbestos Material Exclusion CP 226 02/11 Absolute Pollution Exclusion- Property CP 245 09/15 Earth Movement Exclusion CP0010 06/07 Building And Personal Property Coverage Form CP0030 06/07 Business Income(And Extra Expense) Coverage Form CP0090 07/88 Commercial Property Conditions CP0133 01/11 New York Changes CP0164 03/09 New York Changes- Fungus, Wet Rot And Dry Rot CP0178 08/08 New York- Exclusion Of Loss Due To Virus Or Bacteria CP1030 06/07 Causes Of Loss-Special Form CP1032 08/08 Water Exclusion Endorsement CP1077 12/20 Cyber Incident Exclusion - New York IL0953 01/15 Exclusion Of Certified Acts Of Terrorism JACKET NY 12/19 Policy Jacket Notice-Cyber 12/21 Cyber Incident Exclusion Endorsement-Advisory Notice to Incident Exclusion Policyholders CP NY EOD(01/95) All other terms and conditions remain unchanged. Page 2 of 2 COMMERCIAL PROPERTY COVERAGE PART DECLARATIONS Policy No. CP 1798936 Effective Date: 10/20/2022 12:01 STANDARD TIME DESCRIPTION OF PREMISES Prem Bldg Location, Construction, Occupancy and Other Information Territory Fire Code 1 1 25 Highview Avenue, Rye Brook,NY 10573 009 0197 Description: 1 to 4 Family Dwelling Covered Causes of Loss Special Protection Class 3 Construction Frame Number of Stories 2 Square Footage 1700 Special Deductible: None Special Deductible Type: COVERAGES PROVIDED-INSURANCE AT THE DESCRIBED PREMISES APPLIES ONLY FOR COVERAGES FOR WHICH A LIMIT OF INSURANCE IS SHOWN Limits of Coinsurance % or Prom Bldg Coverage Insurance Deductible Monthly Indemnity + Valuation Premium 1 1 Building $600,000 $1,000 80% ACV $2,658 1 1 Business Income with Extra Expense $100,000 $0 100% $348 1 1 Equipment Breakdown Included $1,000 $343 MINIMUM PREMIUM FOR PROPERTY COVERAGE PART: $593 TOTAL PREMIUM FOR PROPERTY COVERAGE PART: $3,349 MP-minimum premium +Valuation:ACV-Actual Cash Value;RC-Replacement Cost;RC/ACV-Replacement CosVACV Roof FBV-Functional Building Value;AA-Agreed Amount;ALS-Actual Loss Sustained LOSS PAYABLE(S): NONE Coverage Form(s)/Part(s)and Endorsement(s)made a part of this policy at time of issue See Endorsement EOD(01/95 THESE DECLARATIONS ARE PART OF THE POLICY DECLARATIONS CONTAINING THE NAME OF THE INSURED AND THE POLICY PERIOD. Includes copyrighted material of ISO Commercial Risk Services,Inc.,with its permission CIF 150(01I03) Copyright. ISO Commercial Risk Services,Inc., 1983, 1984, 1988 Page 1 Of 1 COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS Policy No. CP 1798936 Effective Date: 10/20/2022 12:01 STANDARD TIME LIMITS OF INSURANCE Each Occurrence Limit $1,000,000 Personal&Advertising Injury Limit(Any One Person/Organization) $1,000,000 Medical Expense(Any One Person) $6,000 Damages To Premises Rented To You (Any One Premises) $100,000 Products/Completed Operations Aggregate Limit Included General Aggregate Limit $2,000,000 LIABILITY DEDUCTIBLE $0 LOCATIONS OF ALL PREMISES YOU OWN,RENT OR OCCUPY Location Address Territory 1 25 Highview Avenue, Rye Brook, NY 10573 009 PREMIUM COMPUTATION Rate Advance Premium oc Classification Code No. Premium Basis Pr/Co All Other Pr/Co All Other 1 Dwellings-two-family 63011 1 Per Dwelling Included 586.712 Included $587 MINIMUM PREMIUM FOR GENERAL LIABILITY COVERAGE PART: $500 TOTAL PREMIUM FOR GENERAL LIABILITY COVERAGE PART: $587 (This Premium may be subject to adjustment.) MP-minimum premium Coverage Form(s)/Part(s)and Endorsement(s)made a part of this policy at time of issue: See Forth EOD (01/95) THESE DECLARATIONS ARE PART OF THE POLICY DECLARATIONS CONTAINING THE NAME OF THE INSURED AND THE POLICY PERIOD. Includes copyrighted material of ISO Commercial Risk Services,Inc.,with its permission. CL150(10103) Copyright,ISO Commercial Risk Services,Inc., 1983, 1984, 1988 Page 1 Of 1 Affidavit of Exemption to Show Specific Proof of Workers' Compensation Insurance Coverage fora 1, 2, 3 or 4 Family, Owner-occupied Residence "This form cannot be used to waive the workers'compensation rights or obligations of any party."* Under penalty of perjury, I certify that I am the owner of the 1,2, 3 or 4 family,owner-occupied residence (including condominiums) listed on the building permit that I am applying for, and I am not required to show specific proof of workers' compensation insurance coverage for such residence because (please check the approoX priate box): I am performing all the work for which the building permit was issued. ❑ I am not hiring,paying or compensating in any way,the individual(s)that is(are)performing all the work for which the building permit was issued or helping me perform such work. ❑ I have a homeowners insurance policy that is currently in effect and covers the property listed on the attached building permit AND am hiring or paying individuals a total of less than 40 hours per week (aggregate hours for all paid individuals on the jobsite) for which the building permit was issued. I also agree to either: ♦ acquire appropriate workers' compensation coverage and provide appropriate proof of that coverage on forms approved by the Chair of the NYS Workers' Compensation Board to the government entity issuing the building permit if I need to hire or pay individuals a total of 40 hours or more per week(aggregate hours for all paid individuals on the jobsite)for work indicated on the building permit,or if appropriate,file a CE- 200 exemption form; OR ♦ have the general contractor,performing the work on the 1, 2, 3 or 4 family, owner-occupied residence (including condominiums)listed on the building permit that I am applying for,provide appropriate proof of workers'compensation coverage or proof of exemption from that coverage on forms approved by the Chair of the NYS Workers' Compensation Board to the government entity issuing the building permit if the project takes a total of 40 hours or more per week(aggregate hours for all paid individuals on the jobsite)for j work in 'cated on the building permit. 0�f 8 Z3 (Signature of Homeowner) (Date Signed) I i1/1 GYIQ Home Telephone Number q 14 48 4 i i O G (Homeowner's Name Printed) Sworn to be ore me this� day of Property Address that requires the building permit: z 202 ql ulgw Ave , ( ownty Clark or Notary rbiie) MICHAEL ESQUIVEL + ' Q Notary Public-State of New York (�J NO.01 ES6442359 Qualified in Westchester Count Once notarized,this BP-1 form serves as an exemption for both workers'compensation and disability benefits insurance coverage. BP-1 (12/08) NY-WCB 11 10 9 1 8 1 7 6 5 4 1 3 1 2 1 i T't H RATIONINTERIOR ALTE � 1 r .:y`r" r�" Hj NEW YORK ARCHITECT DESIGNERS BEDFORD,W10506 25 HIGHVIEW AVE RYE BROOK NY 10573 Greenwich Office,309 Greenwch Av #203 Greenwich,CT 06830 Tel_(203)618-0053-(203)550-3540 Ameocan lnsti[ate ai ANhitecls. Royal lrstnute ai 9rillsh Archgools G DRAWINGS INDEX G A-001.00 SITE PLANS A-002.00 FLOOR PLANS f GENERAL NOTES APPLYING IN PART OR AS A WHOLE DEMOLITION NOTES APPLYING IN PART OR AS A WHOLE SINGLE FAMILY DWELLING GROUP R3 CONSTR. CLASS — TYPE 5 b 1. IT IS THE INTENTION OF THIS CONTRACT TO PERFORM INTERIOR ALTERATION AS PER PLANS 25 highview aVe ry brook, NY IN BASEMENT 1, THIS WORK IS SUBJECT TO THE PROVISIONS OF FOR OCCUPANCY,IN ACCORDANCE WITH THE CONTRACT SPECIFICATIONS,INCLUDING GENERAL,SPECIFIC, F DOCUMENTS AND ALL REQUIREMENTS OF THE LAW. AND SUPPLEMENTAL REQUIREMENTS.ALL WORK FI PROP,ID:141.35-2-19-ZONING DISTRICT R2F SHALL CONFORM TO THE NEW YORK STATE ALTHOUGH ALL NECESSARY WORK MAY NOT BE ITEMIZED IN THE DRAWINGS AND SPECIFICATIONS,THE BUILDING CODE,LATEST EDITION. BUILDING CODE APPLYING TO THIS PROJECT: CONTRACTOR WILL FAMILIARIZE HIMSELF WITH THE 2. ALL ASBESTOS REMOVAL(IF ANY)AND DISPOSAL SHALL BE CONTRA CONTRA CONDITIONS AND INCLUDE ALL WORK PERFORMED PRIOR TO ANY DEMOLITION OR 2020 NYS 2020 RESIDENTIAL BUILDING CODE EXISSPECIFIED OR IMPLIED FOR THE COMPLETE REPAIR CONSTRUCTION WORK AS PER SPECIFIC REQUIREMENTS, AND AMENDMENTS AS SHOWN ON PLANS 3. CONTRACTOR SHALL VISIT THE SITE AND BECOME 2. CONTRACTOR SHALL CHECK AND VERIFY ALL FAMILIAR WITH CONDITIONS PRIOR TO COMMENCING I CONDITIONS AND DIMENSIONS AND REPORT ANY WORK.ALL DIMENSIONS AND CONDITIONS ARE TO DISCREPANCIES TO ARCHITECT PRIOR BE VERIFIED IN FIELD.CONTRACTOR SHALL NOTIFY TO START OF WORK. ARCHITECT OF ANY DISCREPANCIES FROM THE 3. CONTRACTOR SHALL COMPLY WITH ALL REQUIREMENTS CONTRACT DOCUMENTS AND AWAIT INSTRUCTIONS OF THE NEW YORK STATE BUILDING CODE AND ALL FROM THE ARCHITECT. E RULES AND REGULATIONS OF THE COUNTY AND STATE. 4. CONTRACTOR FOR THE DEMOLITION WORK SHALL 5. CONTRACTOR SHALL OBTAIN BUILDING PERMIT,NO COORDINATE HIS WORK WITH ALL OTHER CONTRACTORS, E WORK SHALL PROCEED UNLESS BUILDING PERMIT IS 5. N/A SCOPE OF WORK FOR THIS PROJECT DISPLAYED AT FRONT OF BUT i __. 6. A SEPARATE CONTRACTOR.SHALL OBTAIN A SEPARATE PERMIT FROM THE DEPARTMENT OF HIGHWAYS FOR ALL WORK 6. CONTRACTOR SHALL PROVIDE TEMPORARY SUPPORTS INTERIOR WORK IN BASEMENT AS PER PLANS BEYOND THE BUILDING LINE. FOR EXISTING STRUCTURES AS REQUIRED BY 7. N/A DEMOLITION WORK OR NEW CONSTRUCTION. CONTRACTOR SHALL BE RESPONSIBLE FOR THE HARD�r!rD 8. CONTRACTOR SHALL OBTAIN NEW CERTIFICATE OF STRUCTURAL INTEGRITY OF THE EXISTING BUILDING. IidTERCONNECftD OCCUPANCY.HE SHALL OBTAIN ALL PERMITS AND TEMPORARY BRACINIG SHALL BE SETUP D FINAL APPROVALS OF ALL DEPARTMENTS HAVING r.. gN;CKE[;.;.,TC1pR I JURISDICTION, REQUIII�D N�FtR D BUItDI�IGCODE 9. CONTRACTOR SHALL CARRY WORKMAN'S COMPENSATION pyS INSURANCE AND DISABILITY BENEFITS. 10. CONTRACTOR SHALL PAY FOR ALL PERMITS,LICENSES, INSPECTION FEES AND ALL OTHER CHARGES, 11. WHERE EXISTING WORK IS TO BE CUT AND/OR PROJECT UNDERPINNED,CONTRACTOR SHALL PROVIDE ALL NEEDLING,SHORING,BRACING,WEDGING AND k�!# y�, ��� "� INTERIOR ALTERATION DRY—PACKING AND SHALL BE RESPONSIBLE FOR THE p€CiE,') SE 1 4"`I" 25 HIGHVIEW AVE SAFETY OF THE STRUCTURE DURING THIS OPERATION. 12. THE CONTRACTOR SHALL BE REQUIRED TO PATCH, RYE BROOK NY REPAIR,AND REPLACE ANY AREAS THAT ARE suleowtsN�r;e,Jillag f e9rodyNY ALTERED OR DAMAGED DURING PROCESS OF ALTERATION. O 13. THE CONTRACTOR IS CAUTIONED TO MAKE CONTINUOUS - OWNER C w OBSERVATIONS OF THE EXISTING STRUCTURE DURING REVI c I � THE PERFORMANCE OF HIS WORK.SHOULD HE Q BECOME AWARE OF ANY SITUATIONS THAT REQUIRE PLAN z FURTHER INVESTIGATION OR STUDY,HE SHALL NOTIFY DATE SEP-5 2�23 ARCHITECT IMMEDIATELY. 14. THE STRUCTURAL DESIGN IS BASED UPON EXISTING BUILDING DEPARTMENT DRAWINGS(IF AVAILABLE),FIELD OBSERVATIONS AND/ OR ASSUMPTIONS REGARDING THE EXISTING CONDITIONS AT THE SITE.VARIATIONS BETWEEN THE FIELD CONDITIONS AND THESE DRAWINGS MAY EXIST.WHERE FILE COPY TITLE BLOCK SUCH VARIATIONS ARE ENCOUNTERED THEY SHALL BE BROUGHT TO THE ATTENTION OF ARCHITECT B IMMEDIATELY. B 15. THE CONTRACTOR MUST PROTECT ALL BUILDING AND w STRUCTURAL ELEMENTS INCLUDING ALL CONCRETE OR ~Q MASONRY ELEMENTS AGAINST DAMAGE RESULTING ("SHED BASEMENT NOT o FROM FALLING OBJECTS AND STORAGE OF CONSTRUCTION AIPROVED FOR USE ASA APRIL 25 2023 > MATERIALS AND OTHER HEAVY LOADS DURING ENTIRE SEMRATE APARTMENT OR w COURSE OF DEMOLITION AND CONSTRUCTION. DWELLING UNIT ry I=°a� A-001.00 A, �o�� SHEET 1 OF 2 NEVV 0 A �.. A CHECKED BY: w 11 8 7 6 5 4 3 2 1 ii 11 1 10 1 9 1 8 1 7 1 6 5 4 1 3 1 2 1 1 H H NEW YORK ARCHITECT DESIGNERS BEDFORD,NY 10506 Greenwich Office,309 Greenwich Av #203 Greenwich,CT 06830 Tel(203)151 B-0053-(203)550-3540 .AmDj=Inst tole of AmhitooM Royal Instltote o(13ttlshArenueets G G INSTALL VENT FOR SYSTEM.OPENING TO BE 1 Sq, Inch PER 4000 BTU's I I F BEDROOM 1 F EXITMG LEGEND Sq rt BATHROOM J I BATH m _______DEMO F o i BEDROOM 1 OCCUPANCY s MECHANI�HL II PM404.4.1 AND PM404.5 ROM WA ERe€ O EXISTING PARTITIONS EXISTING AREA:112 S.F. / o /M \ KITCHEN 70 S.F.for 1 PERSON �GI ®NEW PARTITIONS I475gFt AND 50 S.F.FOR ADDITIONAL Ft, { i 0 CL PERSON THEREOF=120S.F. j \ H RAC r� 0 EXISTING C BLOCK WALLS COMPLIES FOR t PERSON SELF CLOSING DOOR 1 `\ � � 10 DRAWING REVISION NUMBER \ /r 2x4 1111 SLID®18' \ D.C.Wjj'GYPSUM BOARD 0 H=8'-0' CL oN BOTH SIDES 1 �*- CLOUD REVISION CL I I 0 LQ — _o— — ,— — 2X5FJ.g16oc. O _oN_ E —_ \ �� A-001 LO�SHEET REVISION# 4-TOSUEFLOOA RECESSED GHT FIXT. \1\ i \`� ®FAN �O PARTMON SCHEDULE _ 2x4 t[)'.O t It' BEDROOM 2 x \\ \ �J / O.C.ROM SIDES eawD LIVING ROOM — 54S Fr \ � r�sq Fr D I \ _ _ s _ / BEDROOM 1 OCCUPANCY D u / r PM404.4.1 AND PM404.5 \ — —- EXISTING AREA:154 S.F. wNc HEICM o BE \k/ 0 UP AND05D S.F.oFOR ADDPERSTOONAL Nm -4 ER THE+B'-e'AND PERSON THEREOF=120S.F. I 6''UNDERPIPES&GIRDERS II COMPLIES FOR 2 PERSONS PROJECT AS-BUILT i i i i ilj I } BASEMENT DN PERMIT `3��� (III INTERIOR ALTERATION BASEMENT FLOOR PLAN ml ___ EXISTING 1 ST FLOOR PLAN PLAN — DATE r, d 2024�— 25HIGHVIEWAVE SCALE:1/4"=1'-O" =—-_—J ( SCALE:1/41'=1'-0" L __—__J — NEW WINDOW WELL 6'GONG. Wa RYE BROOK NY l BLOCK FOUNDATION ON 12"d' - d I CONT,CONIC.FTG.(TYP) „IL.aVt ,"PCT,u,:,'Jil age of Rye Brook,NY C us I DRAIN-1 C _ I OWNER NOT W4,M 3'-a" s' REV Q LAV WC I STA L + P A JUN 2 6 2024 1 sHo �— f ILE COP OATIi III MASO-04T BAN PLIPBW.DIAGRAM NOTES: WASTE LRIEb/60IL STACKS AM D(ISTW-- I STACK YBITMG,FIMURE TRAPS SHALL BE IN Cl �A�°�W��° �`� FLOOR PLANS pIA� � a�<� AS-BUILT g DOCUMENT j B APRIL 25 2023 *,ogNST� A-002-00 ms o P `�-1 b 761 JUNE 26 2024 ISSUE i� SHEET 2 OF 2 A A 1 11 8 7 6 5 4 3 2 1