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HomeMy WebLinkAboutSP23-008PERMIT M'�3-�� DATE 3 SECTION 1441J. Q BLOC it TYPE OF WORK JOB LOCATION CONTRACTOR • k4,. •• DATE FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING RGH PLUMBING GAS SpRINKLER ELECTRIC LOW -VOLT 0 ALARM AS 3UILT 0 FINAL INSP P y) 93 / !03loo �3-03/ zo ell DR . 190 VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury www.ryebrook.org TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE March 19,2024 Win Ridge Realty LLC c/o Alena Hakanjin 24 Rye Ridge Plaza Rye Brook,New York 10573 Re: 104 South Ridge Street, Rye Brook,New York 10573 Parcel ID#: 141.27-1-6 Sign Permit#23-008 issued on 9/26/2023 for a New Tenant Sign This certifies that the new tenant sign,"Mama Mia Dessert Bar",installed under the above captioned permit has been satisfactorily completed. Sincerely, Steven E. Fews Building& Fire Inspector /to BUILDIFlETMENT P°ITTS e onl JAN 4 2024 I VII. A OF RYE* kOOK ! ( ' ISSUED: 908 KI NG STM _ YE BROOK, YORK 10573 DATE: VILLAGE OF RYE BROOK ( �g (9I4 c06 O FEE: k l,2/U- PAID BUILDING DEPARTMENT ! �.w�, a 0 APPLICATION FOR CERTIFICATE OF OCCUPANCY,CERTIFICATE OF COMPLIANCE, AND CERTIFICATION OF FINAL COSTS TO BE SUBMITTED ONLY UPON COMPLETION OF ALL WORK, AND PRIOR TO THE FINAL INSPECTION Address: Occupancy/Use: AMe_rCl'gj Parcel ID#: P0,17 Zone: 7 , �I Owner:JA � eed Address:624 1Li.1 z f,D I( C P/42a, I�rcaal-;��/�-2 3 I (� ��. P.E./R.A.or Contractor: IL�►.l ryiu �► ;C� ,41.)n�Address:l�Q4 (tl l(CfI � {,i�' . 777f, Cat f lu 3 Person in responsible charge: jJAddress: 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: L2ZO-- being duly swom,deposes and says that he/she resides at �TiJ J;I y G in (( `''n Name of A I ant) (No.and Strcet) C—+ L, in the Coun of L()c �7 �r'f ' (City/Town/Village) tY 0 —"' eZ in the State of — that 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 uipment,professional fees,and including the monetary value of any materials and labor which may have been donated gratis was:$ 0 0 C for the construction or alteration of.— �, , ry\ I Q_ 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. Swom to before me this , Sworn to before me this day of Gt�l►'tgt�� , 20 Z3 day of be , 20.h S a of Prope bitmcr j SignaApplicant Lr 1`4 Print Name of PIvoettgC'x� 1 — Print Name o Applicant - t` C e� �L L'CJ Notary No Public i LOIS NNIETO ALENA HAKANJIN NOTARY PUBLIC, STATE OF NEW YORK NOTARY PUBLIC,STATE OF NEW YORK NO, 01 N14899825 SG1220It Registration No.OIHA0013645 QUALIFIED IN WESTCHESTER COUNTY My Expires 911912017 Qualified in Westchester County COMMISSION EXPIRES DECEMBER 3, 2026 MY Commission �yE BRC�v� o`` tim /'• 1982 BUILDING DEPARTMENT ❑BBUILDING INSPECTOR 9"A"SSISTANT 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 : ' CA S Oq l� f. Ap'Q DATE: 2- j e G Uz PERMIT# Sp �3 `C L�ISSUED:q-Z�V- SECT: • Z 7 BLOCK: LOT: LOCATION: 2a7 OCCUPANCY: ❑ Violation Noted THE WORK IS... U/PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION I ❑ Natural Gas ❑ L.P. Gas ❑ FUEL TANK � � � I ❑ FIRE SPRINKLER ❑ 14 FINAL PLUMBING SSFQ -]- ❑ CROSS CONNECTION FINAL OTHER = e w ■ 00 try N y = _ O N PC s 0 \ W N N N CT x 44 �--� " o o u, a, N 4 Q w W 0 ° = aP4 W W a vw 0 Ln v o © 1r = W O T b W ■ en V V v V �d V ■ © O O 7 t o oq ClO C 3 0 1 F� ..�'9 - mv � .� zow1 C� E-' oo v � a n � � o aU � v en = o • frl y w O o04 00 0 N e •_. 14 y � a� ^o U � O �'. °� ^ . 4-4 h�l = Q H ~ G4 U W ] a v v �I vb BUILDING DEPARTMENT IE C r F Y VILLAGE OF RYE BROOK AUG f 5 2023 938 KING SET RYI.BRom,NY 10573 g4; -SOP, VILLAGE OF RYE BR OOK BUILDING DEPARTMENT FOR OFFICE USE ONLY: ,-y� Approval Date: P mit '�_ -CJ`�'P Application# ,3— Approval Signature: ARCHITECTURAL REVIEW BOARD: Disapproved: Date: BOT Approval Date: Case# : Chairman: PB Approval Date: Case# Secretary: IV ZBA Approval Date: Case# Other: _ Application Fee. s' a _ Permit Fees: 4 D 7 SIGN PERMIT APPLICATION Application dated: is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the construction/installation of sign in accordance with Village Code§250-35 as per detailed statement described below. / 1. Address: 10 4 e'AQ� ;2 CIL , �SBL�: Zone: 2. Property Use or Business Name: 3. Proposed Sign(s)(Describe in detail including number of signs,types,sizes,exact location(s),and illumination method(s)if applicable.) (A separate Electrica Permit will be required for any associated electrical work.) : a r 1 Lryv T ^ u ryij e& 6 o r1 g)L, 93.0" 4. Height from grade to highest point of sign: `�, ,to lowest point of sign: �� 1 DD,,L&W� - 1 5. Property Owner: C�1 Address:-,24 c e!"e- P Ict2�-� - I' `i Phone# !f - 1]61 60C'S Cell# email:Q 5. Applicant: �} Address: ',404 Uj kk� &�,Je - loot}Bile stCl( 11 Idis 73 Phone# Cell# email:'S(t� 7. Architect/Engineer: Address: Phone# Cell# +email: yy 8. SignContraacnctor:S?Ca► 1��5149J CA�,,,,� Address: q()4 �na��`�A ,�Ue• �®r+�.�1e:S�,(- k�'1 !Z�7-j Phone# vl 14- 4c3 2 -6-3 46 Cell# email:JUG Ill'.S 16 0 C'iE�S 14 CC rr, A- 8/12/2021 9. Will the proposed sign require a Site Plan Review by the Village Planning Board as per§209 of Village Code? Yes: No: (If yes,you must submit a Site Plan Application,&provide detailed drawings) 10. Does the proposed sign involve a Home-Occupation as per§250-38 of Village Code? Yes: No: If yes,indicate: TIER I:_TIER 11:_TIER III:_ (If yes,a Home Occupation Permit Application is required) 11. If building is located on a corner lot,which street does it front on: 1\1 Iq 12. Property frontage: 13. Property size:Sq.Ft.: Acres: 14. What is the total estimated cost of construction: $ VOD .00R (The estimated cost shall include all site improvements,labor,material,scaffolding,fixed equipment,professional fees,including any material and labor which may be donated gratis.) 15. Estimated date of completion: **************w,c*,t,t********t**««**«,r*,rr..*******•,t,rtt*******,r**,t***w***�***tutrtr*********tert**tr**ir*er*t*,r*f**# This application must include the notarized signature(s) of the legal owner(s) of the subject property, and the applicant of record in the spaces provided. Any application not properly completed in its entirety and/or not properly signed shall be deemed null and void, and will be returned to the applicant. Please note that application fees are non-refundable. STATE OF NEW YOM COUNTY OF WESTCHESTER ) as: J U X Yr ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and finiher StItes that (s)he is the legal owner of the property to which this application pertains, or that (s)he is the L6 n J{`C) 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. ,>��) Sworn to before me this Sworn to before me this /,5 day of /'1�/u V�J 1 , 20 3 day of �/hw1 2Q;R _. Sihm6re of Proptirty Owner AttWT Signa e o licant ACV( E N trill S it 1xr�z�- Print Name of Property Owner MIPJT Print Name of Applicant G L Notary Public Notary Public LOIS NIETO NOTARY PUBLIC, STATE OF NEW YORK THOMAS J CURTIN NO. 01 N14899825 Notary Pu bile,State of New York QUALIFIED IN WESTCHESTER COUNTY Reg. in estc01C ester 97 co COMMISSION EXPIRES DECEMBER 3, 2026 Qualified in Westchester county Commission Expires May 9,2024 -2- 8/12/2021 • s o N w v z a N O a a O v'z-1171 t w O-W c F ►� Q v 9 F d V z A ' Z o Q"r Z u w W O r z Q N w g Q fn 00En W p J N Ln 00 1 W z ►-� Q� c� Trco W W w 0-4 u z v� M c, I--4 oG a V z � 0-4 CN V F d w = �► w ' l ao I "1 M M fz � � Z F w x � z a F" off p g d Lon U ° g w < ' a Ca. z w a' °a � z p U CA w � QI as a � z �n w z a MENT SEP - 1 2023 VIL :. e .ry K 9g8KINNY 10573 VILLAGE OF RYE BROOK BUILDING DEPARTMF-NT �tUO .OIL ELECTRICAL PERMIT APPLICATION Westchester County, a Electricians License Required FOR OFFICE USE ONLY ' .. MGk EP#: _ Approval Date: SEP z 5 20 Permit Fee:$ / Approval Signature: Other: Application dated, 1 e ,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 ague that all electrical work performed willbe in conformance with all applicable Federal,State,County and Local Codes. 1.Address:JM-Sgi i .5�f _SBL: /, 7 Zone: 2.Property Owner. Address: Phone#: jj f -/,d00 6' Cell#: "�- _email: +V►� • 31 f e 3.Master Electticiawticensed lnstaller:—,)C(m Pg ,I& m Address: �f�( PNS pE'Gf Sr &&Chfsk/' � )� Lic.#: 641 Phone#:403 Jy(7, q j Cell#: IIH 7l/0•72 90 p4 a_i S Posrcg el rim ic marl C010 Company Name:-1500sru flecktraj Cm 44 U,LAddress: lay J� 4.Proposed Electrical Work/Fixture Count: Will a 10d 1854ty WW eXk2►ar-5tA,� 5.31d Party Electrical Inspection Agency: +�1+►�+t*sw**w,r r**+�*t*w*:*:,r«�,►,e,rkwwtrww,rww**irk+y►,trw�ts*,et+�,tt*,tr,rtw,t*t►e+t*it+r*,tss,r,t r,rtr***�r***r+es*+►�+ti4i►*rt,►r'ttt�s� Cbl1 2G'7G✓` STATE OF ,�ffi%-V COUNTY OF VffiST6EE&F9R ) as: OS* ,being daly swom,deposes and states that he/she is the applicant above named,and does further (pnut name of individual signing as the applicant) state that(s)he is the c / jc ynse for the legal owner and is duly authorized to make and file this application. (Master Electrician/Licensed lnstnller) Tb.e undersigned fhrther 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 Jr) Sworn to before me this 2q� of 20 2'� day of iqVGyS r ,20 _ 1 � -- iil1r�7->7`" store of P operty Owner i Si of A licant �� Hsu srt ,Jones SPvsrp Ptiat Oev15r �- Print Name of Applicant N lieof � f Notary W .K91Y SAn 01 ER NotEiry P61,lic, �. of New York MARGARET ORSINO in lor County: " ' Notary Public,State of Ccrxrecdcut «`,r-.5',�tlpr: � Commission Expires March 9, 20 My Commission Expires 10-31- 3 STATEWIDE • Service With billegrill 1:1 Main Street,Fishkill, NY 12524 1 email:• • SWIS JOBAPPLICATION tel845.202.72241 fax'914.1119.10621 SWISNY.corn SWISTraining.com Office Use Elect.Permit# —� Dat �A� "F13 1 1 Zoe60 3 O Utility ID# Final Certificate# lJ City/Village p L zip 105 �3 Township County Address l I f Cross Street Section Block Lot Owner Name/Address(if different than ab--ftMA MIA- A_ (IN SNP Oidit Sr Contact Number ❑Basement ❑ 1 st A. ❑2nd FI. ❑3rd FI. ❑More Than 3 Fl. ❑Garage ❑Attic [J Outride ❑Residential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms Carbon Monox Hood Trash Compact Amt Amps Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Warm Draw Incandescent Fluorescent SERVICE Amperage Voltage 1 P 3P #Meters #Disconnect ❑Underground ❑New ❑Reconnect ❑Overhead ❑Change ❑Visual Re-Inspection ❑ Safety Re-Inspection ❑ Re-Inspection Additional Information �Irf QYI� (�S�UII AN OV13►d�P D C CSC OMC ID SEP - 12023 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,d at any time of Inspection additional Mems 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 arty other inspection comparry.The applicant,owner or authorized agent agrees to all the above terms and conditions as set forth for the application. Inspector Date Finalized Inspector# Company Name�390sro '� j h Date 3 4 2 Signature Address City/State ,- Cht i iel LL zip Code ZQS License# alga Phone# q f k x = x ' N N N w M N N �' N � 00 Ti it , a ° cc _ C z �--1 �/ w p` F+�I G1 a - w � ��', w wz x �= W U �'' o ►� Q qj V z s z n � f 00 i- Mz - y u z r , s Ma � 00 a • V Z W a ,� zz o w a ° � a C A o a Q o 00 c ; H CA 0 z � i, i o z W. A A H A a z � CQ P. 1-4 ►z in ;L4 _ D [ECEME I yC BRnvD, BUIL E MENT OCT 2 3 2023 VIL E OF RYE OK 938 KIN 'v f RYE B NY 10573 VILLAGE OF RYE BROOK BUILDING DEPARTMENT .or r ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY Rk"�S �� FP#: Approval Date: ����\ Permit Fee: $ / —V / Approval Signature: Other: Application dated, /a 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. / / 1.Address: 104 SOUTH RIDGE STREET SBL:���i T—�_�; Zonea-V /� 2.Property Owner: Win Ridge Realty LLC Address: 10 Rye Ridge Plaza Ste 200 Rye Brook, NY 10573 Phone#: (914)701-4005 Cell#: email:akakanjin@winddge.com 45-04 162nd Street,Suite 205 3.Master Electrician/Licensed Installer: Joe Y. Lee Address: Flushing N.Y. 11358 Lic.#: E-702 Phone#: (718)888-9177 Cell #: (917)416-3908 email: unitedelectric162@gmail.com company Name: United Electrical Contracting Corte Address: 45-04 162nd Street Ste 205 Flushing NY 11358 4.Proposed Electrical Work/Fixture Count: Connection of a channel letter sign with wordings "Mama Mia Dessert Bar" 5.3rd Party Electrical Inspection Agency: State Wide Inspection Services (SWIS) STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: Joe Y. Lee ,being duly swom,deposes and states that he/she is the applicant above named,and does further (print name of individual signing as the applicant) state that(s)he is the Licensed Master Electrician for 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 fore me this tL%� Sworn to before me this I�_4ti of Ub TV rf 'V 20� day of Oc10 be r 20 2.3 nature of roperty(3GG'ier {tLt:1�1 i Sa cure Applicant Print Nam of roperr(y ner (J�N'(' _j�rint_Name of AaPlicant � No blic Notaryi6lic .NAM HYUNJ %otary Public,Stele of Now Yorr, k No.01 NA613MI ZIuNllled in Ouse m(Aunty �•vmiteinr e,m„oc vnvcmbBr2� �R� 3/3/2023 STATE WIDE INSPECTION SERVICES, INC. 0•• • • SWIS JOB APPLICATION0. SWISTRAINING.CONI Office Use Elect. Permit# L. Date Bldg Permit# 3 — 0 Scl Ft �,-5 OO Plumbing Permit# Final Certificate # rcn City/Village r00 (� Zip O c, 2 Building Dept. �" County i 't t� J til FS C �s r Address 0 utk I Cross Street n�Gn. VC Section Block Lot J 1 Bo fi Owner Name/Address(If different than above) , 1 1 K 1 � L L C Contact Number ❑Basement ❑ 1st Fl. ❑2nd Fl. ❑3rd Fl. ❑More Than 3 A. ❑Garage ❑Attic ❑Outside ❑Residential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C/0 Detector Hood Trash Compact Amt Amps Range(s) Cocktop(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 Junction Box Combiner Box Load Center PV Monitor Energy Storage System DC Disconnect ❑Legalization ❑ Safety Inspection ❑Consultation ECEHIE OCT 2 3 2023 ID 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 anytime 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 -Ai to Name ,To License# L_7U -t Date /p 20 2 j Signature Address l�_ lJ� �U1 nd �YPP ��(�i I� �D` City/State ill Sh ir1 '�, Z. �e // -} 35 Company If T i le L/PCI t i elk l�!rG iif r �, Phone# ' ECIEHWE I 3 � State Wide Inspection Services 1080 Main Street MAR — 5 2024 Fishkill, NY 12524 845 202-7224 Phone VILLAGE OF RYE BROOK 914-219-1062 Fax STATE WIDE INSPECTION SF RVIC IS BUILDING DEPARTMENT Email: office((�swisny.com Website: www.swisny.com Service With Integrity BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: United Electrical Contracting Corp. Win Ridge Realty LLC 45-04 162nd Street, Suite 205 104 South Ridge Street Flushing, NY 11358 Rye Brook, NY 10573 Located at: 104 South Ridge Street, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP23-232 141.27 1 F Certificate Number:2024-1199 Building Permit Number: BP23-008 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: 104 South Ridge Street, Rye Brook, NY 10573 The Exterior 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 29th day of February 2024. Name Quantity Rating Circuit Type Commercial Sign 01 •4. Officer: frank 1. 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. f�'�Buildin Permit Check List & Zonm* Analysis 1 OB & C ONLY v Address: 1Ao S� SBL: Zone: Qlam' Use: Const.Type: Other. Submittal Date: , Revisions Submittal Dates: Applicant V Nature of Work Reviews:ZBA: A U G 2 3 2023 PB• BP: Other: NEED OK (� ( FEES:Filing: P: C/O: Legalization: ( ) ( J,-ATP.: Date Stamped: Li Properly Sign SBL Verifie Cross Connection: F.O.G.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening. ( ) ( ) ENVIRO.:Long Shore Fees: N/A: ( ) ( ) SITE PLAN:Topo: Site Protection: S/W Mgmt.: Tree Plan Other. ( ) ( ) SURVEY:Dated Current Archival Sealed: Unacceptable: Date Stamped --'_Sealed:- Copies: Electronic. Other. ( ( License: Workers Comp: Liability Tmp.Waiver. Other. Code 753#: Dated: N/A: HIGH-VOLTAGE ELECTRICAL:Plans: Permit: N/A: Other. ( ) ( ) LOW-VOLTAGE ELECTRICAL:Plans: Permit N/A: Other. ( ) ( ) FIRE ALARM/SMOKE DETECTORS:Plans: Permit: H.W.I.C.:—Battery:—Other. ( ) ( ) PLUMBING:Plans: Permit Nat.Gas: LP Gas: Grease Trap: 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 Z notes 2 3--/d 7 ( )ZBA mtg.date: approval: notes: ( )PB mtg.date: approval —notes: REOUIRED EXISTING PROPOSED NOTES APPROVED Area: Cir : Vat(): Fron Front — Front FAJU Qpen Hdgk Stories: notes: BUILDING DEPARTMENTR D VILLAGE OF RYE BROOK AUG 15 2023 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 VILLAGE OF RYE BROOK . www."Ibrook.org BUILDING DEPARTMENT ARCHITECTURAL REVIEW BOARD CHECK LIST FOR APPLICANTS This form must be completed and signed by the applicant of record and a copy shall be submitted to the Building Department prior to attending the ARB meeting. Applicants failing to submit a copy of this check list will be removed from the ARB agenda. Job Address: 104 -�eOk tl-d-a[, f-4L Date of Submi sion: Parcel ID#: // /, o) - - ' � Zone: Proposed IImp/ro`vement(Describe in detail): -)54eJ1 L X-�� �,�.�3•�X 7 APPLICANT CHECK LIST: � +1 MUST BE COMPLETED BY THE APPLICANT /�' C�,3cl Ltr s _tYlcirn - m«-- The following items must be submitted to the Building 7 Department by the applicant-no exceptions. G7`S`"r 1. ( (Completed Application Property Owner: n C- 2. ( 4Two(2) sets of sealed plans. (one full size (maximum Address:.,2� �ilc_ eyia e P l o 2z K1�e-6 y-c 3 allowable plan size=36"x 42") and one 11"x 17") Phone# pf I�- p/ - 1�(X�5 3. ( )Two(2)copies of the property survey. 4. ( )Two(2)copies of the proposed site plan. Applicant appearing before the Board: 5. (i)One electronic/disc copy of the complete application materials. _S1 G 4 �S ICa hlJC'_�f�l.`'W�"'�n1G7 6. (�Filing Fee. Address: In 1, die } J,;. P.4(�estce,t-tT3 7. Any supporting documentation. Phone# �'1(�- 3 -11,3C�d 8. ( )HOA approval letter. (ifopplicable) 9. (/Photographs. Architect/Engineer: 10.( )Samples of finishes/color chart. (a sample board or Phone# model may be presented the night of the meeting) By signature below, the owner/applicant acknowledges that he/she has read the complete Building Permit Instructions&Procedures,and that their application is complete in all respects. The Board of Review reserves the right to refuse to hear any application not meeting the requirements contained herein. Sworn to before me this f M 1� Sworn to before me this day of S1 , 20 3 day of ,20 c a 7 kgea of Property AteW Si ture of Ap ' t Print Name of Property Uweer j/,.�.I Print Name o Applicant Notary Public Notary Public THOMAS J CURTIN LOIS NIETO Notary Public,State of New York NOTARY PUBLIC, STATE OF NEW YORK Reg.No.01 CU6341697 No. O 1 N 14899825 Qualified in Westchester County QUALIFIED IN WESTCHESTER COUNTY Commission Expires May 9,2024 COMMISSION EXPIRES DECEMBER 3, 2026 8/12/2021 i BR(�u� Village of Rye Brook Agend L�4.4 `'o'' Architectural Review Board Meeting dJ 4 C�G4Yu J Wednesday,September 20,2023 at 7:30 PM Village Hall,938 King Street 1. ITEMS: 1.1. ARB23-090 (Consent Agenda) Volkert Braren&Maureen Braren 262 North Ridge Street Rooftop solar array. 1.2. ARB23-101 (Consent Agenda) Thomas Mariam&Alyce Mariam 89 Country Ridge Drive 4'high&6'high white vinyl fence. 1.3. ARB23-102(Consent Agenda) Jonathan Starr&Shanen Starr 20 Paddock Road 4'high black aluminum fence and gates. 1.4. ARB23-103 (Consent Agenda) Samuel Marcus&Audrey Marcus 12 Bobbie Lane Rooftop solar array. Consent Agenda Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.5. ARB23-023 (Amendment to Prior Approval) Ervin Gomez&Maria Gomez 59 South Ridge Street Rear 2nd story addition. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes Architectural Review Board September 20,2023 1.6. ARB23-104 Vanderlei Carvalho&Eliane Carvalho 770 King Street Roof over existing terrace. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.7. ARB23-105 Suresh Shanmugam&Anisha Mathur 259 North Ridge Street Enclose existing rear patio w/ steps to grade. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.8. ARB23-106 Lorenzo De Roni&Christine De Roni 16 Jennifer Lane New walkways and retaining walls,install SWM system. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.9. ARB23-107 Win Ridge Realty LLC 104 South Ridge Street New sign. "Mama Mia Dessert Bar" � Approvals: Motion_ \ y Second (), --,<L.—Abstention Aye; Nay;�Z Adjournment; Notes Page 2 of 4 Architectural Review Board September 20,2023 1.10. ARB23-108 Frank Nunziato&Kristina Nunziato 30 Argyle Road 2nd floor addition and interior alterations. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.11. ARB23-109 Washington Park Plaza Associates LLC 243 South Ridge Street New sign. "Wells Fargo" Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.12. ARB23-110 jing Xie&Margaret Chung 141 North Ridge Street Renovate existing deck. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.13. ARB23-111 Sooah Park 47 Bonwit Road New rear patio,retaining wall and fencing. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes Page 3 of 4 • Architectural Review Board September 20,2023 1.14. ARB23-112 Lake Development Co LLC 11 Old Orchard Road Legalize and renovate existing deck. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes NEXT MEETING: October 18, 2023 Page 4 of 4 (MM AcoRV CERTIFICATE OF LIABILITY INSURANCE DA05/31/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: N the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT Stacie Washington NAME: Borrelli Partners Insurance Agency PHONE (914)939-7900 (914)407-5088 287 Bowman Avenue E-MAIL a: swashington@borrellipartners.com ADDRESuite 406 INSURER(S)AFFORDING COVERAGE NAIL e Purchase NY 10577 INSURER A: Travelers Casualty Ins Co of America 19046 INSURED INSURER B: Travelers Indemnity CO 25658 Lanza Corporation D/B/a INSURERC: Phoenix Ins Co 25623 404 Willett Ave INSURER D: INSURER E: Port Chester NY 10573 INSURER F: COVERAGES CERTIFICATE NUMBER: CL235804613 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS LTR TYPE OF INSURANCE INSO POLICY MUMMER MWO MMID LIMITS COMMERCIAL GENERAL LJABILr Y EACH OCCURRENCE = 1,000,000 CLAIMS-MADE ®OCCUR PREMISES(Ea occurrence) $ 300.000 MED EXP(Any one person) s 5'000 A 5805.1175092 06/05/2023 06/05/2024 PERSONAL SADVINJURY S 1,000,000 GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE f 2'D00'000 POLICY®JECT LOC PRODUCTS-COMP/OP AGG S 2,DD0,000 OTHER: S AUTOYOtME LIABILITY COMBINED IN LI I S Ea accident ANY AUTO BODILY INJURY(Per parson) S OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS ONLY I IAUTOS HIRED NON-OWNED PROPER' DAMAGE S AUTOS ONLY AUTOS ONLY Per ecc.enl f UMBRELLALIAM OCCUR EACH OCCURRENCE S 5,000,000 B EXCESSUAa 11 CLAIMS-MADE EX5J175240 06/05/2023 D6/05/2024 AGGREGATE S 5,000,000 DIED I I RETENTION$ $ WORKERS COMPENSATION SPER TATUTE OT AND EMPLOYERS'LIABILITYER C ANY PROPRIETORMARTNEWEXECUTIVE Y❑ NIA UB5J175160 06/05/2023 06/05/2024 EL EACH ACCIDENT s 1,000,000 ER/OFFICMEMBER EXCLUDED? (MenAe"In NH) EL DISEASE-EA EMPLOYEE S 1,000,000 M ym.desorbe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,AdOltlonai Remarks Schedule,may be aaeched M more space Is r Ifed) BLANKET AI-OWNERS,LESSESS OR CONTRACTORS,AI-MANAGERS OR LESSORS OF PREMISES,AI-STATE OR POLITICAL SUBDIVISIONS PERMITS RELATING TO PREMISES,At LESSOR OF LEASED EQUIPMENT,PRIMARY 8 NON-CONTRIBUTORY WORDING,WAIVER OF SUBROGATION-WC POLICY INCLUDES BLANKET WOS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Vidlage of Rye Brook ACCORDANCE WITH THE POLICY PROVISIONS. 938 King Street AUTHORIZED REPRESENTATIVE Rye Brook NY 10573 ©1988-2015 ACORD CORPORATION, All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 2 oRK Workers' CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured Lanza Corporation 914-937-6360 DBA Sign Design and J C Awning 1c.NYS Unemployment Insurance Employer Registration Number of 404 Willett Avenue Insured Port Chester, NY 10573 Work Location of Insured(Only required if coverage is specifically limited to 1d.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-Up Policy) Number 13-3525268 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Phoenix Insurance Company Village of Rye Brook 3b.Policy Number of Entity Listed in Box"l a"938 King Street U65J175160 Rye Brook, NY 10573 3c.Policy effective period 06/05/2023 to 06/05/2024 3d.The Proprietor,Partners or Executive Officers are ® included.(Only check box if all partners/officers included) all excluded or certain partners/officers excluded. This certifies that the insurance career indicated above in box"3"insures the business referenced above in box"1a"for workers' compensation under the New York State Workers'Compensation Law. (To use this form,New York(NY)must be listed under jtQM 3A on the INFORMATION PAGE of the workers'compensation Insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2". Will the carrier notify the certificate holder within 10 days of a policy being cancelled for non-payment of premium or within 30 days if cancelled for any other reason or if the insured is otherwise eliminated from the coverage indicated on this certificate prior to the end of the policy effective period? YES ®NO This certificate is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note: Upon cancellation of the workers'compensation policy indicated on this form,If the business continues to be named on a permit, license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers'Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Joanne SiriCO (Print name of authorized representative or licensed agent of insurance Amer) Approved by: Q!aW4t--& 05/31/2023 (Date) Title: Acct Mgr Telephone Number of authorized representative or licensed agent of insurance carrier: 914-939-7900 Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-105.2.Insurance brokers are NOT authorized to issue it. C-105.2 (9-15) www.wcb.ny.gov