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'9n2 BUILDING DEPARTMENT
❑BBUILDING INSPECTOR
RASSISTANT 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: Lo --37,- DATE: 2 Z O ` Z O L
PERMIT# r a Tti1 s I ir ISSUED: SECT: /yf. 27 BLOCK: LOT:
LOCATION: e -r js?ec 7 J OCCUPANCY:
❑ Violation Noted THE WORK IS... Er PASSED ❑ FAILED REINSPECTION
❑ SITE INSPECTION REQUIRED
❑ FOOTING
❑ FOOTING DRAINAGE
❑ FOUNDATION
❑ UNDERGROUND PLUMBING NOTES ON INSPECTION:
❑ ROUGH PLUMBING
❑ ROUGH FRAMING
❑ INSULATION
❑ Natural Gas F I itc k C ` SJ
❑ L.P. Gas
❑ L L
FUEL TANK C
❑ FIRE SPRINKLER
❑ FINAL PLUMBING
❑ CROSS CONNECTION
❑ FINAL
[OTHER
BUILD ;BROO
TMENT
VILL QQg Initial Inspection Date: ❑ Pass
$1°e V e A/ Fps 938 DING ST EW YORK 10573 �- �� of � Fail
BUILDING&FIRE INSPECTOR (914)9rook.or J Re-Inspection Date: ❑ Pass
mizzo@ryebrook.ore / ❑ Fail
FIRE INSPECTION REPORT, NOTICE OF VIOLATION & ORDER TO REMEDY SAME
Site Address: 1 ( G,e,��` Q S i. Zone:r(_ P SBL: 1�j l. Z '7
Occupancy: ����I�3�_ State Use Classification:
Business Owner: Q,. \2 jo t L Phone: q 1 y - q 3 7- O�'1 c7 u
Building Owner:��� ,,��,��Q Phone:
Emergency Contact: rrm ,4 ,j 7"H A M F/ IL / Phone: 96 — l0 9S- 3'
Building Representative in Attendance:
----------------------------------------------------------------------------7-------------------------------------------------------------------------------------
Take notice that the following violations of the New York State Uniform Fire Prevention&Building Code and/or the Code of the
Village of Rye Brook were found to exist at, ,in the Village of
Rye Brook,NY on, 'I.4.►I�� 20 - q a person or entity served with this Order to Remedy shall
immediately commence to correct all listed violations and shall completely cure each violation described herein by no later than
T-r \-" J -.,o-2-`1 ,which is thirty(30)days after the date of this Order to Remedy.Furthermore,
upon curing any listed violation(s),you shall immediately contact the Building Department during normal business hours to schedule a
re-inspection of the premises to confirm full compliance with all applicable codes,laws,rules®ulations.
BE ADVISED THAT YOUR FAILURE TO CORRECT ALL VIOLATIONS IS A CRIME PUNISHABLE BY FINE,IMPRISONMENT OR BOTH.
------------------------------------------------------------------------------------------------------------------------------------------------------------------
No YES N/A
1.PORTABLE FIRE ExTINGUISHERS (PFE's)
a.906.1. Are PFE's installed throughout the space&on the premises as required by code. a.
b.906.3.1.Is the maximum travel distance to a PFE 75 feet or less. b.
c.906.5.Are PFE's conspicuously located&readily accessible. C.
d.906.6.Are PFE's unobstructed/unobscured from view. d.
e.906.7.Are PFE's properly mounted as per the manufacturers instructions. e.
f.906.9.Are PFE's properly installed:<401bs.max.5'above floor;>40 lbs.max.3.5'above floor. f.
2.FIRE ALARM SYSTEM&SMOKE DETECTORS
a.901.6.1.Is the fire alarm system inspected,tested&maintained in accordance with NFPA 72. a.
b.907.4.2.1.Are manual pull stations located within 5 feet of exits&within 200 feet of each other. b.
c.907.4.2.2.Is the height of the pull station handle located between 42&48 inches above the floor. c.
d.907.3.Is a fire alarm system provided in existing buildings as per section 907.3.1 &907.3.2. d.
3.FIRE SUPPRESSION SPRINKLER SYSTEM&FIRE HYDRANTS
a.901.6.1.Is the sprinkler system inspected,tested&maintained in accordance with NFPA 25-13. a.
b.901.6.1.Are the main valves secured against tampering in the open position. b.
c.901.6.1.Are sufficient clearances maintained from fire sprinkler heads to fixtures or materials. C._ 'Z _
d.901.6.1.Is a supply of six spare heads&a wrench maintained on the premises. d._ _
e.901.6.1.Are sprinkler heads&cover plates unfinished or of factory applied finish only. e.
f.901.6.3.Are records of all system inspections,tests&maintenance reports maintained on the premises. f.
g.913.5.Is the fire pump inspected,tested&maintained in accordance with this section&NFPA 25. g._ _
h.507.5.2.Is the fire hydrant system properly maintained,operational,compatible WNST&tested annually. h.
i.507.5.4.Are fire hydrants&fire protection equipment unobstructed. i.
j.507.5.5.Is a clear space of not less that 3 feet maintained around all hydrants.
k.901.8.Are all fire protection systems in place and maintained untampered. k.
INSPECTOR: DATE: 0 2 3L`t
aew,ea 2/1on2
No YEs N/A
4.STANDPIPE,CABINETS&FIRE DEPARTMENT CONNECTIONS
a.901.6.1.Is the standpipe system inspected,tested&maintained in accordance with NFPA 25-14. a.
b.901.6.1.Has the required flow test been performed within the past 5 years as per NFPA 25-14. b. J _
c.912.2.3 Are standpipe FDC threads compatible with fire department standards. C. A
d.905.7.Are cabinets containing fire fighting equipment unobstructed/unobscured. d.
e.905.7.1.Are cabinets containing fire fighting equipment properly identified&labeled. e. _
f.912.2.1.Are exterior FDC's fully visible&recognizable from the point of fire department access.
g.912.4.Are all FDC's unobstructed and available for immediate access by the fire department. g.
5.EXITS,MEANS OF EGRESS&OCCUPANCY
a. 1031.2.Are exits&exit enclosures continuously maintained free from obstructions or impediments. a.
b. 1031.3.Is the means of egress free from obstructions including accumulated ice&snow. b. _
c. 1031.6.Are exits maintained unobstructed by furnishings,decorations,draperies,mirrors,etc... C. _ V _
d. 1031.7.Are existing emergency escape&rescue openings maintained as per this section. d.
e. 1010.1.Are egress doors provided and maintained as required by this section. e.
f. 1004.9.Are all spaces having an assembly occupancy posted with an approved occupant load sign. f.
g. 1013.1.Are exits marked by a properly located,approved&readily visible exit sign. g.
h. 1013.1.Is the maximum travel distance to any exit sign in an exit access corridor 100 feet or less. h.
i. 1013.4.Are tactile exit signs complying with ICC/ANSI 117.1.provided as required by code. i.
j. 1013.3.Are all exit signs illuminated at all times. j,
k.1008.1.Are the means of egress&exit discharge illuminated at all times the building is occupied. k.
1. 1018.3.Are public aisles in group B&M occupancies maintained at least 36"wide where fixtures
are placed on one side of the aisle&at 44"wide where fixtures are placed on both sides.
m. 1018.3.Are non-public/non-accessible aisles serving less than 50 people maintained at least M. _ Z _
28"wide,or at least 36"wide where serving 50 or more people.
6.COMBUSTIBLE STORAGE&WASTE MATERIALS
a.304.1.Is the building(s)and premises maintained free from accumulated combustible waste material. a.
b.304.1.2.Is property free from weeds,grass,vines or other growth capable of being ignited. b.
c.304.2.Is combustible rubbish stored so as not to create a nuisance or hazard to the public. C.
d.315.3.Are combustible materials properly stored&separated from ignition sources. d.
e.315.3.1.Is storage maintained 24"or more below the ceiling in nonsprinklered buildings, e.
and 18"or more below sprinkler head deflectors in sprinklered buildings.
f.315.3.2.Are exits&exit enclosures maintained free from stored combustible materials. f.
g.315.3.3.Are boiler,mechanical&electrical rooms maintained free from stored combustible material. g.
h.313.1.Is building maintained free from stored fueled equipment.(motorcycles,mopeds,mowers,etc...) h.
7.ELECTRICAL
a.604.1.Is the building free from modified/damaged wiring,devices,appliances,equipment a.
and maintained free from electrical hazards.
b.604.2.Are electrical service equipment areas properly illuminated. b.
c.604.3.Are proper working space clearances provided&maintained for electrical service equipment. c.
d.604.3.Are electrical service equipment working spaces free from any stored materials. d.
e.604.3.1.Are all electrical control panel room doors,panel boards&disconnects properly labeled. e.
f.604.4.Is the building free from unfused multi-plug electrical adapters. f. _ t�
g.604.5.Are electrical extension cords being used in a safe manner as per code. g.
h.604.6.Are all junction,switch&outlet boxes fitted with approved covers or plates. h.
i.604.6.Is the building free from open-wiring spliced electrical connections. i. _ ✓ _
j.604.8.Are electrical motors maintained free from accumulated oil,dirt&debris. i__
k.915.1.Are Carbon Monoxide Detectors installed&maintained as required by this section and by 1103.9. k._
INSPECTOR: DATE: 0 7 y Ly
-2-
Revised 6/11/2020
No YEs N/A
8.ELEVATORS.DUMBWAITERS&ESCALATORS
a.[PM]603.1.Are elevators properly maintained,and is the current certificate of inspection on the premises. a. _ _ _✓
b.606.3.Are approved standardized,pictorial signs posted adjacent to each elevator call station on all b. _ _ v/
floors reading; IN FIRE EMERGENCY,DO NOT USE ELEVATOR.USE EXIT STAIRS
c.606.7.Are keys for elevator car doors&fire department service kept in an approved location. C. _ _ ✓
d.315.3.3.Are elevator machine rooms maintained free from stored combustible material. d.
e.[B]3005.1.Are elevator machine room doors maintained unobstructed at all times. e. _
9.COMMERCIAL KITCHENS
a.906.1. Are portable Class K fire extinguishers installed within 30 feet of cooking equipment. a. _ Vol _
b.904.12.5.Is the fire protection equipment inspected,tested&maintained as per Section 901.6. b. _
c.904.12.5.2.Are automatic fire extinguishing systems serviced at least every 6 months. C. ✓ _
d.904.12.5.3.Are fusible links&automatic sprinkler heads replaced annually. d. _
e.[RBI 122-5.B.Are grease traps provided and installed as required by Village Code. e.
f.[[PC] 1003.10.(RBI 122-6.Are grease traps properly maintained as per State and Village Code. f
g.[RB]122-6.C., 122-9.Are all service,maintenance,&repair records for grease traps and related
plumbing maintained on the premises as required by Village Code. g.
10.HEATING SYSTEMS
a.[PM]603.1.Are all heating appliances properly installed&maintained in a safe working condition. a.
b. [PM]603.2.Are all fuel-burning appliances&equipment connected to an approved chimney or vent. b.
c. [PM]603.3.Are heating appliances maintained with proper clearances from combustible material. C. _ ✓ _
d. [PM]603.4.Are safety controls for fuel-burning equipment maintained in effective operation. d.
e. [PM]603.5.Is the fuel-burning equipment provided with adequate combustion&ventilation air. e.
11.MOTOR FUEL-DISPENSING FACILITIES&REPAIR GARAGES
a.2303.2.Is an approved,labeled&readily accessible emergency disconnect switch provided a.
in an approved location within 100'of,but not less than 20'from fuel dispensers.
b.2304.3.4.Are dispenser operating instructions conspicuously posted on every fuel dispenser. b. _ _ ✓
c.2304.2.4.Are fuel-dispensers unobstructed&in clear view of the attendant at all times. C. _ _ Vol
d.2305.5.Are approved portable fire extinguishers complying with Section 906 with a minimum rating of d.
2-A:20-B:C provided&located not more than 75'from pumps,dispensers&fill-pipe openings.
e.2305.6.Are warning signs provided&posted within sight of each dispenser as per this section. e.
f.2305.7.Are weeds and other combustible materials kept at least 10'from fuel-handling equipment. f.
g.2306.4.Are above-ground tanks provided with vehicle impact protection. g.
h.2306.5.Are above-ground tanks provided with secondary spill containment. h.
12.HAZARDOUS MATERIALS(HAZ-MATS)
a.407.2.Are S.D.S.Sheets for all haz-mats readily available on the premises. a. ✓ _
b.407.3.Are spaces and individual containers containing haz-mats properly labeled&identified. b.
c.5004.2.Are stored haz-mats provided with approved secondary spill containment. C. _ ,L
d.5003.7.1.Are proper NO SMOKING signs provided as per this section. d. ✓
13.MISCELLANEOUS
a.403.1.Is an approved fire safety&evacuation plan prepared&maintained for the building/occupancy. a.
b.405.1.Are emergency evacuation drills conducted at the intervals as specified in Table 405.2. b.
c.405.5.Are records of emergency evacuation drills kept&maintained on the premises. C. _ ✓ _
d.505.1.Are approved address&building numbers properly placed&plainly visible from the street. d. _ �✓
e.506.1.Are approved key boxes(knox boxes)provided,properly located&equipped with the proper keys. e. _ ✓
f.703.1.Is all required fire-resistance rated construction properly maintained as per code. f.
g.703.1.Are openings through fire-resistance rated assemblies properly protected&maintained. g.
h.5303.5.Are compressed gas cylinders&systems secured&safeguarded against damage&access. h.
i.5303.6.1.Are compressed gas cylinder caps or collars in place at all times except when tanks are in use. i.
14.GENERAL HOU A KEEPING
a.Good
b.Fair
c.Inadequate ` _
d.Poor INSPECTOR: DATE: ,l��J
-3-
Revised 9/17/2)
ITEM NUMBER REMARKS
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INSPECTOR: �� ti-+ DATE: J A'`� 30 Z Q 2-1.
-4-
Revised 6/1 112 0 2 0
QyE BRC��.
'9a2 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 :- �i7 , DATE:
PERMIT# t� ISSUED: n�� 'SECT: BLOCK: LO
T:
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
p FINAL
❑ OTHER
�E aRnuk
cu �
BUILDING DEPARTMENT
❑BUILDING INSPECTOR
SSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK
'U LODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573
(914) 939-0668 FAx (914) 939-5801
www.rytbrook.org
- - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - -
ADDRESS: ' • 1 DATE: y
PERMIT# \N<-peck,
ISSUED: SECT: BLOCK: LOT:
LOCATION: �� �� > 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 �� Jvo Y "
❑ NATURAL GAS
❑ L.P. GAS
❑ FUEL TANK
❑ FIRE SPRINKLER
❑ FINAL PLUMBING `
❑ CROSS CONNECTIO \ \ ,Q3
❑ FINAL
�] OTHER
�E Bkj� M«
0 2m
582 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:(AS��
��
PERMIT# �I ISSUED: SECT: BLOCK: LOT:
LOCATION: N \' NC, 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 �� �(1 � (-'e �
❑ FUEL TANK
❑ FIRE SPRINKLER
❑ FINAL PLUMBING �' C Ll( � C' C I ` '^ CV(1j1
❑ CROSS CONNECTION
❑ FINAL
❑ OTHER
r
BUILD TMENT
VILL OF RY QQI{ Initial Inspection Date: ElPass
MICHAEL J.IZZO 938 KING S ,RYE BROO EW YoRK 10573 Fail
BUILDING&FIRE INSPECTOR (914)93 — 6& 39-5801 Re-inspection Date: ❑ Pass
mizzorvebrook.org 1 `DI2
�_ J ❑ Fail
FIRE INSPECTION REPORT, NOTICE OF VIOLATION & ORDER TO REMEDY SAME
Site Address: `�ti �� -'`} Zone: C- , SBL: IA 1 , 2 j -
Occupancy: e - State Use Classification: /�Q- Z
Business Owner: �� NC, n�`�- � t �—`C. Phone: �{��]� y
Building Owner: X, � (,3 1 � 7� �,Pho
Emergency Contact: `-3��' � (O� 1 P (A �� G
Building Representative in Attendance
-------------------------------------------------------------------------------------------------------------------------------------------------------------
Take notice that the following violations of the ew rk State Un orrtn Fire Prevention&Building Code and/or the Code of the Village
of Rye Brook were found to exist at, nq� c- ,in the Village of Rye Brook,NY on,
20 The rsa�n ore tt rved with this Order to Remedy must completely cure each
violation described in this Order to Remedy by��t 1 _L ,which is thirty(30)days after the date of this Order to
Remedy.You are further directed to contact the Building Department during normal business hours to schedule a re-inspection of the
premises to confirm full compliance with all applicable codes,laws,rules®ulations.
BE ADVISED THAT YOUR FAILURE TO CORRECT ALL VIOLATIONS IS A CRIME.PUNISHABLE BY FINE,IMPRISONMENT OR BOTH.
--------------------------------------------------------------------------------------------------------------------------------------------------------------
No YES N/A
1.PORTABLE FIRE EXTINGUISHERS (PFE's)
a.906.1 Are PFE's installed throughout the space&on the premises as required by code. a._
b.906.3.1 Is the maximum travel distance to a PFE 75 feet or less. b._
c.906.5 Are PFE's conspicuously located&readily accessible. C.
d.906.6 Are PFE's unobstructed/unobscured from view. d. `
e.906.7 Are PFE's properly mounted as per the manufacturers instructions. C.
f.906.9 Are PFE's properly installed:<40 lbs.max.5'above floor;>40 lbs.max.3.5' above floor. f_
2.FIRE ALARM SYSTEM&SMOKE DETECTORS
a.901.6.1 Is the fire alarm system inspected,tested&maintained in accordance with NFPA 72. a._
b.907.4.1 Are manual pull stations located within 5 feet of exits&within 200 feet of each other. b._
c.907.4.2 Is the height of the pull station handle located between 42&48 inches above the floor. C.
d.907.3 Is a fire alarm system provided in existing buildings as per section 907.3.1 &907.3.2. d._ ✓ _
3.FIRE SUPPRESSION SPRINKLER SYSTEM&FIRE HYDRANTS
a.901.6.1 Is the sprinkler system inspected,tested&maintained in accordance with NFPA 25-13. a._ _
b.901.6.1 Are the main valves secured against tampering in the open position. b._ _✓
c.901.6.1 Are sufficient clearances maintained from fire sprinkler heads to fixtures or materials. C._ �[ _
d.901.6.1 Is a supply of six spare heads&a wrench maintained on the premises. d._ _✓ _
e.901.6.1 Are sprinkler heads&cover plates unfinished or of factory applied finish only. C.
f.901.6.2 Are records of all system inspections,tests&maintenance reports maintained on the premises. f.
g.913.5 Is the fire pump inspected,tested&maintained in accordance with this section&NFPA 25. g.
h.507.5.2 Is the fire hydrant system properly maintained,operational,compatible w/NST&tested annually. h.
i.507.5.4 Are fire hydrants&fire protection equipment unobstructed. i•
j.507.5.5 Is a clear space of not less that 3 feet maintained around all hydrants. j. _ _✓
k.901.8 Are all fire protection systems in place and maintained untampered. k•
INSPECTOR: DATE:
Revised 10/4117
No YEs N/A
4 STANDPIPE CABINETS&FIRE DEPARTMENT CONNECTIONS
a.901.6.1.Is the standpipe system inspected,tested&maintained in accordance with NFPA 25-14. a. _
b.901.6.1.Has the required flow test been performed within the past 5 years as per NFPA 25-14. b. _ --,Z
c.912.2.3 Are standpipe FDC threads compatible with fire department standards. C. _ __,'Z
d.905.7.Are cabinets containing fire fighting equipment unobstructed/unobscured. d. _
e.905.7.1.Are cabinets containing fire fighting equipment properly identified&labeled. e. _ -6�
f.912.2.1.Are exterior FDC's fully visible&recognizable from the point of fire department access. f.
g.912.4.Are all FDC's unobstructed and available for immediate access by the fire department. g.
5.EXITS,MEANS OF EGRESS&OCCUPANCY
a. 1031.2.Are exits&exit enclosures continuously maintained free from obstructions or impediments. a.
b. 1031.3.Is the means of egress free from obstructions including accumulated ice&snow. b. if—
c. 1031.6. Are exits maintained unobstructed by furnishings,decorations,draperies,minors,etc... C. _
d. 1031.7.Are existing emergency escape&rescue openings maintained as per this section. d. _
e. 1010.1.Are egress doors provided and maintained as required by this section. e. _
f. 1004.3.Are all spaces having an assembly occupancy posted with an approved occupant load sign. f. _ —/
g. 1013.1.Are exits marked by a properly located,approved&readily visible exit sign. g. _ 6�
h. 1013.1.Is the maximum travel distance to any exit sign in an exit access corridor 100 feet or less. h.
i. 1013.4. Are tactile exit signs complying with ICC/ANSI 117.1. provided as required by code. i.
j. 1013.3. Are all exit signs illuminated at all times. j.
k.1008.1.Are the means of egress&exit discharge illuminated at all times the building is occupied. k.
1. 1018.3. Are public aisles in group B&M occupancies maintained at least 36"wide where fixtures 1.
are placed on one side of the aisle&at 44"wide where fixtures are placed on both sides.
m. 1018.3.Are non-public/non-accessible aisles serving less than 50 people maintained at least m. -Y,-
28"wide,or at least 36"wide where serving 50 or more people.
6.COMBUSTIBLE STORAGE&WASTE MATERIALS
a.304.1. Is the building(s)and premises maintained free from accumulated combustible waste material. a. _
b. 304.1.2.Is property free from weeds,grass,vines or other growth capable of being ignited. b. _ 4
c. 304.2.Is combustible rubbish stored so as not to create a nuisance or hazard to the public. C.
d.315.3.Are combustible materials properly stored&separated from ignition sources. d. (X
e. 315.3.1.Is storage maintained 24"or more below the ceiling in nonsprinklered buildings, e. �Lo
and 18"or more below sprinkler head deflectors in sprinklered buildings.
f. 315.2.2.Are exits&exit enclosures maintained free from stored combustible materials. f.
g. 315.2.3.Are boiler,mechanical&electrical rooms maintained free from stored combustible material. g. _
h.313.1.Is building maintained free from stored fueled equipment.(motorcycles,mopeds,mowers,etc...) h.
7.ELECTRICAL
a.604.1.Are emergency&standby power systems properly maintained. _
b. 605.1.Is the building free from modified/damaged wiring,devices,appliances,equipment and
maintained free from electrical hazards.
c.605.2. Are electrical service equipment areas properly illuminated. C.
d.605.3.Are proper working space clearances provided&maintained for electrical service equipment. d.
e.605.3. Are electrical service equipment working spaces free from any stored materials. e. A
f. 605.3.1.Are all electrical control panel room doors,panel boards&disconnects properly labeled. f. _ ✓
g.605.4.Is the building free from unfused multi-plug electrical adapters. 9.
h.605.5.Are electrical extension cords being used in a safe manner as per code. h.
i. 605.6.Are all junction,switch&outlet boxes fitted with approved covers or plates.
j. 605.6.Is the building free from open-wiring spliced electrical connections. j.
k.605.8.Are electrical motors maintained free from accumulated oil,dirt&debris. k.
1. 915.1.Are Carbon Monoxide Detectors installed&maintained as required by this section and by 1103.9. 1.
INSPECTOR: DATE:
eevixa 10/4m
-2-
No YES N/A
8.ELEVATORS.DUMBWAITERS&ESCALATORS
a. [Plot]606.1.Are elevators properly maintained,and is the current certificate of inspection on the premises.a. _
b. 607.3. Are approved standardized,pictorial signs posted adjacent to each elevator call station on all b.
floors reading; IN FIRE EMERGENCY.DO No'r USE ELEVATOR,USE EXIT STAIRS
c. 607.7.Are keys for elevator car doors&fire department service kept in an approved location. C.
d.315.3.3.Are elevator machine rooms maintained free from stored combustible material. d.
e. [B]3005.1.Are elevator machine room doors maintained unobstructed at all times. e.
9.COMMERCIAL KITCHENS
a. 904.12.5.Are portable Class K fire extinguishers within 30 feet of cooking equipment. a.
b. 904.12.6.Is the fire protection equipment inspected,tested&maintained as per Section 901.6. b. _ e
c.904.12.6.2.Are automatic fire extinguishing systems serviced at least every 6 months&after system C.
activation,and is the certificate of inspection forwarded to the code enforcement official.
d.904.12.6.3.Are fusible links&automatic sprinkler heads replaced annually. d� -4
10.HEATING SYSTEMS
a.[Piet]603.1.Are all heating appliances properly installed&maintained in a safe working condition. a.
b.[PM]603.2. Are all fuel-burning appliances&equipment connected to an approved chimney or vent. b.
c. [PM]603.3.Are heating appliances maintained with proper clearances from combustible material. C. _
d. [PM]603.4.Are safety controls for fuel-buming equipment maintained in effective operation. d. _ t✓
e. [PM]603.5. Is the fuel-burning equipment provided with adequate combustion&ventilation air. e. _
11.MOTOR FUEL-DISPENSING FACILITIES&REPAIR GARAGES
a.2303.2. Is an approved, labeled&readily accessible emergency disconnect switch provided a.
in an approved location within 100'of,but not less than 20' from fuel dispensers.
b.2304.3.4.Are dispenser operating instructions conspicuously posted on every fuel dispenser. b. _
c. 2304.2.4.Are fuel-dispensers unobstructed&in clear view of the attendant at all times. C.
d.2305.5.Are approved portable fire extinguishers complying with Section 906 with a minimum rating of d.
2-A:20-B:C provided&located not more than 75' from pumps,dispensers&fill-pipe openings.
e. 2305.6.Are warning signs provided&posted within sight of each dispenser as per this section. e. _ _
f.2305.7.Are combustible materials kept at least 10' from fuel-handling equipment. f.
g.2306.4.Are above-ground tanks provided with vehicle impact protection. g.
h.2306.5.Are above-ground tanks provided with secondary spill containment. h.
12.HAZARDOUS MATERIALS(HAZ-MATS)
e. 407.2.Are M.S.D.S. for all haz-mats readily available on the premises. a. _
d. 407.3.Are spaces and individual containers containing haz-mats properly labeled&identified. b. _ r
e. 5004.2.Are stored haz-mats provided with approved secondary spill containment. C. _ —✓
d. 5003.7.1.Are proper No SMOKING signs provided as per this section. d. _ ✓
13.MISCELLANEOUS
a.403.1. Is an approved fire safety&evacuation plan prepared&maintained for the building/occupancy. a. _
b.405.1.Are emergency evacuation drills conducted at the intervals as specified in Table 405.2. b.
c.405.5. Are records of emergency evacuation drills kept&maintained on the premises. C. _
d. 505.1. Are approved address&building numbers properly placed&plainly visible from the street. d. _ _✓
e. 506.1.Are approved key boxes(knox boxes)provided,properly located&equipped with the proper keys. e. _
f. 703.1.Is all required fire-resistance rated construction properly maintained as per code. f. v
g.703.1.Are openings through fire-resistance rated assemblies properly protected&maintained. g. v
h.5303.5.Are compressed gas cylinders&systems secured&safeguarded against damage&access. h. a/ _
i. 5303.6.1.Are compressed gas cylinder caps or collars in place at all times except when tanks are in use. i.
14.GENERAL HOUSEKEEPING
a.Good
b.Fair
c. Inadequate
d.Poor , C)IL
INSPECTOR: DATE:
Revised 10/4/17
-3-
ITEM NUMBER REMARKS 11 C
_� C � cwE �<.:�� , ; ' !` �� � ' fir► �
J \ `
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i C.stX C \- -� nq Q C
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bn
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—710
Q
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eQ `; 1 (C s :) C kc:-c Ct c< <- --b
INSPECTOR: DATE: 20 �
1
Revised 10/4/17
-4-
Hudson Valley Fire Inc. Hood cleaning
Service History
136 Washington Street Order#259505
Peekskill NY 10566
JOB LOCATION CLIENT
FORTINA RYE RIDGE LLC Pi:(914)273-0900 Same
136 SOUTH RIDGE ST.
RYE BROOK,N.Y. 10573
Service Date: 10/17/2023
CONTACT TECHNICIAN
Johnny Dee (914)273-0900 SC
Christine: (646)423-3820
Luigi 438-6012
restaurant (914)937-0900
johnny dee cell (914)471-0850
Moira (914)510-2032
Samantha(EMAIL HER TO CONFIRM
H/C)
Hood Cleaning
Num: 1
Location:main hood
Length: lift
Last Service: 10/17/2023
I
Service Dates
Description Last Due
Clean 10/17/2023 jJ]
Filters
Qty Size
Fans
Num Belt Size S/N Bar Code Scanned Remarks
Hood Report
I.Check In OK FAIL NA
1. Met with manager C.] ]
2. If NO,had keys or codes
..Condition of ..................... .................................................................................................................
..................................................
3. hood lights OK. .. ❑
........or.k..in....
4 Fans wg
5 Fan condition OK Ll
6. Service area clean
..............
7. Condition of water wash system OK ❑ I
II.Check Out O FAIL NA
1. Roof grease free ......................................... ❑ ❑
_................_......._.......................... .................................................................................... .
1/9
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Hudson Valley Fire Inc. Hood Cleaning'
136 Washington Street Service History
Peekskill NY 10566 Order#259505
JOB LOCATION CLI NT
FORTINA RYE RIDGE LLC Pl:(914)273-0900 Sam
136 SOUTH RIDGE ST.
RYE BROOK,N.Y. 10573
Hood Report
II.Check Out OK FAIL NA
Catch pans emptied
.................................................................................................... ...............:............................................... _
3. Fans working ❑ 1 [j
4. Fans clean ❑ I
5. Hood filter condition OK ❑
6. Ductwork clean............................................................................................................ ..................... ,............,I.... ❑
7. Hoods clean/dried ❑ _I'
.....................................................................................................
:..................
8. Hoods shined ....... ❑ J'
...........
..... i,
9. Grease guard protected during cleaning ❑ LJI
_.......
10. 1.Roof appears to drain properly ❑ n
11. Pilots re-lit ❑ 1_1
12. Service area clean ❑ ];
13. Date cleaned„sticker affixed.................................................................................... ................................. .. ElLEI
14. Floors clean ❑ �I
.. .... .................................................................... ........ ❑ (�15. Back wall clean
..... ................... .......................................................................................................
16. Fire suppression system last service date:
...................................................................................................................................................................... ;
17. Parking area clean ❑ �'
Met with manager
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System inspected and cleaned by:
Crew Leader Service Technicians
X X
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Hudson Valley Fire Inc. Hooq Cleaning
136 Washington Street
Service History
Peekskill NY 10566 Order#259505
I
JOB LOCATION CLIE NT
FORTINA RYE RIDGE LLC Pi:(914)273-0900 Sam
136 SOUTH RIDGE ST.
RYE BROOK,N.Y. 10573
Customer )
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Hudson Valley Fire Inc. Hood Cleaning'
136 Washington Street Service History
Peekskill NY 10566 Order#259505,
I
JOB LOCATION CLIE NT
FORTINA RYE RIDGE LLC Pl:(914)273-0900 Sam
136 SOUTH RIDGE ST.
RYE BROOK,N.Y. 10573
Service Date: 10/17/2023
CONTACT TECHNICIAN
Johnny Dee (914)273-0900 SC
Christine: (646)423-3820
Luigi 438-6012
restaurant (914)937-0900
johnny dee cell (914)471-0850
Moira (914)510-2032
Samantha(EMAIL HER TO CONFIRM
H/C)
Hood Cleaning
Num:2
Location:Charcoal hood
i
Length:4'5"
Last Service: 10/17/2023
Service Dates t
Description Last Due
Clean 10/17/2023 ivl
Filters I
Qty Size !'f
Fans `
Num Belt Size S/N Bar Code Scanned Remarks rf I
Hood Report I
I.Check In OK FAIL N
1. Met with manager 21 El [
................................................................................................................................................................... .........
2. If NO,had keys or codes ❑...................................................................................
3. Condition of hood lights OK ❑ p�
..................................................._.........................................................................................................................I...........
4. Fans working ❑ �'•
_ ............
5 Fan condition OK ❑
__._....... ............. . ...
6.
Service area clean
7. Condition of water wash system OK O21
K OLI NA
II.Check Out
1. Roof grease free ❑ j
_..................................._..................................................................................................................................... f
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Hudson Valley Fire Inc. Hoo Cleaning
Histo
136 Washington Street Servl
Peekskill NY 10566 Orde #25950 'C I
JOB LOCATION CLIENT
FORTINA RYE RIDGE LLC P1: (914)273-0900 Sam
P r
136 SOUTH RIDGE ST. i
RYE BROOK,N.Y. 10573
Hood Report
II.Check Out OK FAIL N
Catch pans emptied r -'
.............. ...... .. ...................................
3. Fans working ❑ .
......................... ............................................................................
4. Fans clean
................ I ❑
L...................................................................
! ........................ .i
6. Ductwork clean
5. Hood ftlter condition..OK.....................................................................................................................:....I............L.... ❑ it ` ?
❑ p a i
7. Hoods clean/dried ❑
.................................................................................................................
8. Hoods shined �_ ❑
.......................................... .............................
,.................. -
9. Grease guard protected during cleaning L—e ❑ 1
a f
10. Roof appears to drain properly..........L....:.............................................................................................................. L�J ❑ I•
...................................................................... . ........................................................ .......
11. Pilots re-lit ❑
...................................................... ................... -
......................................................
12. Service area clean Ll
13. Date leaned sticker affixed ❑ I'I
......... ........................ I
14. Floors clean...............................................r...............................•.................. j..... ❑ I r
................................... .............................
15. Back wall clean
................................................er'vice.�. ............................................................................................................... ❑
16. Fire su ression stem last service date
Q61
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17. Parking area clean ❑ ,
Met with manager c
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Hudson Valley Fire Inc
Hood Cleaning
136 Washington Street Service History,
Peekskill NY 10566 Order#259505
JOB LOCATION CLIENT
FORTINA RYE RIDGE LLC Pi:(914)273-0900 Sam
136 SOUTH RIDGE ST.
RYE BROOK,N.Y. 10573
Customer
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*** End Report: 2**:
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Hudson Valley Fire Inc. Hood Cleaning
136 Washington Street Service History,
Peekskill NY 10566 Order#259505 j
i
JOB LOCATION CLIENT
FORTINA RYE RIDGE LLC PI:(914)273-0900 Same
136 SOUTH RIDGE ST.
RYE BROOK,N.Y. 10573
Service Date: 10/17/2023
CONTACT TECHNICIAN
Johnny Dee (914)273-0900 SC
Christine: (646)423-3820
Luigi 438-6012
restaurant (914)937-0900
johnny dee cell (914)471-0850
Moira (914)510-2032
Samantha(EMAIL HER TO CONFIRM
H/C)
Hood Cleaning
Num:3
Location: BASEMENT HOOD
Last Service: 10/17/2023
Service Dates
Description Last Due
I �
Clean 10/17/2023 JI
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Filters j
QtY Size
Fans
Num Belt Size S/N Bar Code Scanned Remarks I
i
Hood Report
I.Check In OK FAIL NA
1. Met with manager El...... ....... ............. 1-1
2. If N0,haddkeys or codes ❑
3. Condition of hood lights OK Ely
.............
4. Fans working ❑ ;�
{{{
S. Fan condition OK n
6. Service area clean.................................................................................................. ,....... ❑ I
II.Check Out.....................................t ........... OK FAI� i
7. Condition of water wash system OK ❑ .� .
1. Roof grease free ........ L' ❑ I
_.__... ...................................................
.
Catch pans emptied 3'
..................................................................................................................................................................
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son Valle Fire Inc. Hood Cleaning
Hud y
136 Washington Street Service History
Peekskill NY 10566 Order#259505
JOB LOCATION CL.IiiNT
FORTINA RYE RIDGE LLC Pl:(914)273-0900 Same
136 SOUTH RIDGE S-F.
RYE BROOK,N.Y. 10573
Hood Report
II.Check Out OK FAIL NA
3. Fans working ❑
4. Fans clean ❑ )'
5. Hood filter condition OK El !'
............................
6. Ductwork clean L)
7. Hoods clean/dried............................. ._................................................................... _.....,..................._........ ❑
8. Hoods shined.............................................................................. ❑
9 ..........................................................
. Grease guard protected during cleaning . L1 ❑
10. Roof appears to drain properly .......:........................................... ........
................... ❑
11. Pilots re-lit ❑
................................................................................................ ........ . . .. ....
12. Service area clean Elj
................................................. ...... ..... . ....
I
13. Date cleaned sticker affixed �l ❑ ill f
............................................................ ....................................... .............
14. Floors clean El , 1 i
......................................................................................................................
15. Back wall clean _ ❑ _
................................................................................................
16. Fire
Parkin suppression
clean
stem last service date
9 : - ❑
Met with manager
OK FAIL
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System inspected and cleaned by: I
Crew Leader Service Tec7 ician 1
X
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Hudson Valley Fire Inc. Hood Cleaning!
Service History
136 Washington Street Order#259505"
Peekskill NY 10566
JOB LOCATION CLIENT
FORTINA RYE RIDGE LLC Pi: (914)273-0900 Sam
I
136 SOUTH RIDGE ST.
RYE BROOK,N.Y. 10573
Customer
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***End Report: 3***
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1919 9
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DEC - 8 2023
GE OF RYE BROOK
Date WORK ORDER SUMMARY �& DINGDEPARTMENT
To
Fortina Rye Ridge LLC
24A Rye Ridge Plaza
Rye Brook NY 10573
Service Location: Fortina Rye, 136 South Ridge St, Rye Brook NY 10573
Telephone
914-510-2032
Email
lilian@fortinapizza.com
DATE DESCRIPTION OF SERVICE NOTES PAID
1/10/23 Grease Trap Cleaning &Oil Collection Brown Yes
2/14/23 Grease Trap Cleaning &Oil Collection Brown Yes
3/14/23 Grease Trap Cleaning & Oil Collection Brown Yes
4/18/23 Grease Trap Cleaning & Oil Collection Brown Yes
5/16/23 Grease Trap Cleaning &Oil Collection Brown Yes
6/13/23 Grease Trap Cleaning & Oil Collection Brown Yes
7/18/23 Grease Trap Cleaning &Oil Collection Brown Yes
8/15/23 Grease Trap Cleaning &Oil Collection Brown Yes
9/12/23 Grease Trap Cleaning &Oil Collection Brown Yes
10/10/23 Grease Trap Cleaning &Oil Collection Brown Yes
11/14/23 Grease Trap Cleaning &Oil Collection Brown Yes
Thank you for your business!
VELVET ROPE MANAGEMENT LLC
PO BOX 69 �� • `
ARMONK NY 10504
Date WORK ORDER SUMMARY 2023
To
Fortina Rye Ridge LLC
24A Rye Ridge Plaza
Rye Brook NY 10573
Service Location: Fortina Rye, 136 South Ridge St, Rye Brook NY 10573
Telephone
914-510-2032
Email
lilian@fortinapizza.com
DATE DESCRIPTION OF SERVICE NOTES PAID
1/10/23 Grease Trap Cleaning & Oil Collection Brown Yes
2/14/23 Grease Trap Cleaning &Oil Collection Brown Yes
3/14/23 Grease Trap Cleaning &Oil Collection Brown Yes
4/18/23 Grease Trap Cleaning &Oil Collection Brown Yes
5/16/23 Grease Trap Cleaning & Oil Collection Brown Yes
6/13/23 Grease Trap Cleaning &Oil Collection Brown Yes
7/18/23 Grease Trap Cleaning &Oil Collection Brown Yes
8/15/23 Grease Trap Cleaning &Oil Collection Brown Yes
9/12/23 Grease Trap Cleaning &Oil Collection Brown Yes
10/10/23 Grease Trap Cleaning & Oil Collection Brown Yes
11/14/23 Grease Trap Cleaning & Oil Collection Brown Yes
Thank you for your business!
VELVET ROPE MANAGEMENT LLC
PO BOX 69
ARMONK NY 10504
BUILDING.DEPARTMENT
p ECM
VILLAGE OF RYEBROOK DEC - 8 2023 3D
938 KING S�V,,EET RYE BRomK'NY 10573
4 . -0 �$j' VILLAGE OF RYE BROOK
BUILDING' DEPARTMENT
FIRE INSPECTION / OPERATING PERMIT APPLICATION ��
FOR OFFICE USE ONLY: 9-30,4 ""1
Fee Paid: $ -7 Inspection Date& Time: 11-i eS JQ4 Z7Q/I, 30, allay
FEE SCHEDULE: Re-inspection Date& Time:
Triennial & Private School Annual Inspection: =$450.00
Public Assembly Annual Inspection: <100 People= $525.00/>100 People= $775.00
Application,dated: 2 b ,is hereby made to the Building Inspector of the Village of Rye Brook NY,requesting
that a Fire Inspection be conducted at the building and premises listed below for the purpose of issuing a Permit to Operate the business,
private school and/or place of public assembly in conformance with the Code of the Village of Rye Brook,the New York State Uniform
Fire Prevention & Building Code, Title 19 NYCRR Part 1201, and all other applicable local, County, State & Federal laws, rules &
regulations,as per detailed statement described below.
1. Address: 13( , QyM Kid c St. bel ywQ _ SBL: l tI I. 9]t-j-(4 Zone:C-L-2
2. Business/Occupancy Name: Lb hQ NYS Use Class:
3. Property Owner:U)/ )C14& Address: (fie Etd 4c, T La Ad, eH` lc
Phone# �/ mil- 4y(IS Cell# email: Gt'11 Gf Ka(►11( WlniU 6 ./oM
5. Business Owner: at/719 6 , Address:,)y
Phone#�9�5 9, 3 = Cell# email: Qa hn'164yb n'T,2;z�t �orY1
6. Emergency Contact: SQMQ nna k e((S[ Address: It `
Phone# /G/�jj/U a(� Cell# email:
[c[ ��'J{ j✓�j nG�i �Ct LO/Y
7. Inspection Escort: SAa lq a, mP�/S,, Title: P 1 re C-b r 0 ope nt b on_S
Phone#:(q/q)570 D- Cell#: email:,SQ
8. Provide a brief description outlining the current and/or intended use of the property:
&// SerVI('e'9' Ices aw Z
9. List all Hazardous Materials: Al//�
10. Occupant Load: Existing: 131 Proposed: 1,31 Other: _
11. Date& Disposition of Previous Fire Inspection: �C���{� 9,! :2— ❑ Pass ❑ Fail
1
8/12/2021
This application must include the notarized signature(s) of the legal owner(s) of
the above mentioned property, in the space provided below. Any application not
bearing the legal property owner's notarized signature(s) shall be deemed null
and void, and will be returned to the applicant.
STATE OF NEW YORK )
COUNTY OF WESTCHESTER ) as:
a&,"t CCU/ ,being duly sworn, deposes and states that he/she is the applicant above named,
(print name of individual signing apolication)
and further states that he/she is the legal owner of the property to which this application pertains, or that he/she is the
oq&r, i , for the legal owner and is duly authorized to make and file this application. That all
(indicate ar Itect,business owner,attorney,agent,etc.)
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.
r� M
Sworn to before me this
�� Sworn to before me this. 7-
day of D��1 g I'' , 20 Z3 day of yl'� , 20_)
tary Public _ 'Notary Public
7�6� &�Ve
Signature of Property Signatur of Applicant
hmok �A Y—"% D a-hh�
Print Name of Property Owner At&W'r Print Name of Applicant
Lilian Merlo Lilian Merlo
NOTARY PUBLIC,STATE to NEW YORK NOTARY PUBLIC.STATE OF:NEW
KRegistration No OIME6413674 Registration No.01MEQualified in Westchester County Qualified in WestchesteCommission Expires February Ot.2025Commiss on Expires Febru25
2
8/12/2021
8/5/22,12:52 PM Scan_20220805(2).png
BUS _ �MENT AUG - 5 2022 jrD
93KrNc ox
6 NY 10573 VILLAGE OF RYE BROOK
BUILDING DEPARTMENT
FIRE INSPECTION/ OPERATIN G PERMIT APPLICATION .
FOR QFFlCE U5E ON t
aid:$ _ 9"3a4m
Inspection Date&Time: -uulsda Cep4 1
FEE SCHEDULE:
Triennial 8 Private School Annual inspection:=S450.00 Re-inspection Date&Time:
Public Assembly*Annual:: rp#Ay+•Ion:*++r*►rarlt people
..r$i5rra00•+r*00
People=$77 00iMMr�ar�Wt�#:ar�Wairi�Rkar�
Application,dated: e� is hereby made to the Building lnspectorofthe Village of Rye Brook NY in
that a Fire Inspection ba copduoted at the building and premises listed below for the purpose of issuing.a permit to
private school and/or place of public assembly in conformance with the Code of the Village of Rye Brook,the New York State Uniform
Fire Prevention&Building Code,Title 19 NYCRR part 1201 and all other applicable local,County,State&Federal laws,business,&
regulations,as per detailed statement described below.
1. Address:1 ,s• 66 i7 !� a' QQK
149$7 -- SBL:'& .21,-/1D Zone:C�
2• Business/Occupancy Name:_ Qr A
3. Property Owner: NYS Use(lass:__
Phone#�� Cel!# _ —Address: /l 105-T3
email: JU t Om
S. Business Owner:
Phone / /�J'- � -- _Address- � Ny�i5
_Cell# `r__email: .�
6. Emergency Contact l mgd � bill -Address.-___
rya •Corr1
Address: �� ��
Phone# /h - D veil# - — ---
email: OIL?4 �•�DY6nso,-i..
7. Inspection Escort:- tea �1l Title: �lrt�r f ® re j7/Y15 aR Ca?y
Phone# / —
email:sJ tWtha ig hYbu,912•24.con
8. Provide a brief description outlining the current and/or intended use of the property:
s �turar�-
9. List all Hazardous Materials: L4(0-
'3
4�1 ¢11
10. Occupant Load:Existi ng: r
S h
Proposed: _ f1
Othei ,Sam ^ �,
11. Date&Disposition of Previous Fire Inspection:
i ll . ve 1 -r
�f
l y S •e4<�> 9�r
https://mail.google.com/mail/u/0/?tab=rm#inbox/FMfcgzGgPpcnF rkDLjKMCpKppPFZWwJD?projector-1 1/I
8/5/22,12:52 PM Scan_20220805_2(2).png
This application must include the notarized signature(s) of the legal owner(s) of
the above mentioned property, In the space provided below, ;Any application not
bearing the legal property owner's notarized signature(s) shall be deemed null
and void, and will be returned to the applicant.
STATE OF NEW YORK )
COUNTY OF WF/S�TTCHESTER as:
DQfin a L!/Q� _,being duly sworn,deposes and states that he/she is the applicant above named,
(print name of individual eigninq application)
and further states that he/she is the legal owner of the property to which this application pertains,or that he/she is the
jqwt-
for the legal owner and is duly authorized to make and file this application. That all
pndicabg arlItiftect,business owner,attorney,agent,eta)
statements contained herein are true to the best of his/her knowledge and belief,and that any work performed oruse 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 taws,ordinances and regulations.
Sworn to before me this `j+h }�
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-- Sworn to/before me this
day of A U ,20 �.Z r'-1
day of U U15� ,2o22.
Ate.
Notary ub is otary Public
e of Prop ty4� _ Signature F Applicant
Print Name of Property Qwner Print Name of Applicant
Lilian Merlo Lilian Merto
NOTARY PUBLIC,STATE OF NEW YORK NOTARY PUBLIC.STATE OF NEW YORK
Registration No 01ME641 3674 Registration No 01MF6413674
Ouahhed in Wesicheste,County Qualified in Westchester County
Commission Expires Febnidry 01 21125 Commission Expires February 01,2025
2
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VILLAGE OF RYE BROOK
MAYOR 938 King Street,Rye Brook,N.Y. 10573 ADMINISTRATOR
Jason A. Klein (914)939-0668 Christopher J. Bradbury
www.ryebrook.org
TRUSTEES BUILDING&FIRE INSPECTOR
Susan R. Epstein Michael J. Izzo
Stephanie J. Fischer
David M.Heiser
Salvatore W.Morlino
August 1,2022
Via Pt Class Certified Mail
Fortina
C/o Ms.Samantha Melisi
136 South Ridge Street
Rye Brook,New York 10573
Re: 136 South Ridge Street,Rye Brook,New York 10573
Dear Ms. Samantha Melisi,
It has come to the attention of the Building Department that it has been over one year since you applied to renew your
Operating Permit for the subject Place of Public Assembly,and as such your Operating Permit is now expired.Please note
that the Code of the Village of Rye Brook requires that your Place of Public Assembly hold an Operating Permit,and that
such permit be renewed by you annually.Please note that in order to renew your Operating Permit,you are required by Rye
Brook Village Code§91-4.13,to undergo and successfully complete a Fire Inspection for this location at least every twelve (12)
months.
In order to avoid a violation,please complete and submit the attached Fire Inspection/Operating Permit Application form,
remit the correct application fee,and schedule your annual Fire Inspection with the Building Department by no later than,
September 1,2022,which is thirty(30) days after the date of this notice.Please note that the property owners notarized
signature,as well as the business owners notarized signature must appear on the application form in the appropriate spaces.
Upon successful completion of the Fire Inspection,you will be issued a renewed Operating Permit valid for one year.
Please remember that you must renew your Operating Permit every year by filing a Fire Inspection/Operating Permit
Application,remitting the applicable fee,and scheduling your Fire Inspection with the Building Department at least thirty(30)
days prior to the expiration date listed on your Operating Permit.
Thank you.
Michael J. Izzo
Building&Fire Inspector
mizzo .Q&brook.org
cc:Steven E. Fews,Assistant Building&Fire Inspector
cc:Alena Hakanjin,Property Manager
/to
J
Am anni ewacg
VILLAGE OF RYE BROOK
MAYOR 938 King Street,Rye Brook,N.Y. 10573 ADMINISTRATOR
Jason A. Klein (914)939-0668 Christopher J.Bradbury
www.ryeb rook.org
TRUSTEES BUILDING&FIRE INSPECTOR
Susan R.Epstein Michael J. Izzo
Stephanie J.Fischer
David M.Heiser
Salvatore W.Morlino
August 1,2022
Via 1st Class Mail
Fortina
c/o Ms.Samantha Melisi
136 South Ridge Street
Rye Brook,New York 10573
Re: 136 South Ridge Street,Rye Brook,New York 10573
Dear Ms. Samantha Melisi,
It has come to the attention of the Building Department that it has been over one year since you applied to renew your
Operating Permit for the subject Place of Public Assembly,and as such your Operating Permit is now expired.Please note
that the Code of the Village of Rye Brook requires that your Place of Public Assembly hold an Operating Permit,and that
such permit be renewed by you annually.Please note that in order to renew your Operating Permit,you are required by Rye
Brook Village Code§91-4.B,to undergo and successfully complete a Fire Inspection for this location at least every twelve (12)
months.
In order to avoid a violation,please complete and submit the attached Fire Inspection/Operating Permit Application form,
remit the correct application fee,and schedule your annual Fire Inspection with the Building Department by no later than,
September 1,2022,which is thirty(30) days after the date of this notice.Please note that the property owners notarized
signature,as well as the business owners notarized signature must appear on the application form in the appropriate spaces.
Upon successful completion of the Fire Inspection,you will be issued a renewed Operating Permit valid for one year.
Please remember that you must renew your Operating Permit every year by filing a Fire Inspection/Operating Permit
Application,remitting the applicable fee,and scheduling your Fire Inspection with the Building Department at least thirty(30)
days prior to the expiration date listed on your Operating Permit.
Thank you.
Michael J. Izzo
Building&Fire Inspector
mizzo_.ryebr_�ok.org
cc:Steven E. Fews,Assistant Building&Fire Inspector
cc:Alena Hakanjin,Property Manager
/to
r
LOG IN DATE:
BUIL DEPAENT
V 'AGE OF RYEit, COMPLETION DATE:
938 KIN TREET RYE BROOK,NY 10573
8. ASSIGNED TO:
ASSIGNED BY:
COMPLAINT#:
COMPLAINT FORM
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DATE: (L d c� RECEIVED BY:
LOCATION:
PARCEL I.D.#: / Yh >y 7 -- Zone:c/%o USE:
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OWNER: /17 P '
Address& Phone:
SOURCE: Q�D/ /�'�/L Phone/Letter/Other:
Address& Phone:
COMPLAINT: ce 1!S//?5•S iC4-
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POSSIBLE VIOLATION:
INSPECTORS LOG
DATE STATUS IN PE TOR
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