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HomeMy WebLinkAboutFire Inspection Certificate 2024-2027 W � U WcNn W z aw. O H w z w � g O c � H O w zwcw A PQ pq w � pro W � zzoxo � � w Z w � w � WwAwaW, � a a A o � E••r � A Z � � w � z w 14 O w � �•, r� zw � Aw A �" .. LO 00 ;.T4 z w N f'' A W o0 O O F A A A a W � ►.a '-' � x w o w V P, ~" H a. w QyE BR(�k. O� 2� ID ��• �9b2 � BUILDING DEPARTMENT ❑ UILDING INSPECTOR C{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 14 A VII l 4 cm A)c y F DATE: PERMIT# �:3LLO'-'3 f-i r\,O 7-SPec j,1SSUED: SECT: /-2AS-, Wy BLOCK:_LOT: LOCATION: l�U t 1 c� 1 J` OCCUPANCY: ❑ Violation Noted THE WORK IS... [PASSED ❑ FAILED /REINSPECTION Er SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas _e 0 i A e c1 S tvxD ❑ L.P. Gas ¢ , 0, ❑ FUEL TANK ~ ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL OTHER Pe c' QyE DRcbl 1982 t7 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: 12 PERMIT# 1 dZ o, �BSI P G�t J ISSUED: SECT:,BLOCK:LOT: LOCATION: ll i --1: OCCUPANCY: - ❑ Violation Noted THE WORK IS... ❑ PASSED Y/FAILED / REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas �O152 ` <)1 U�/\ I s CL ❑ L.P. Gas ❑ FUEL TANK 1/ ❑ FIRE SPRINKLER V-1 2 s ❑ FINAL PLUMBING n ❑ CROSS CONNECTION S �'��' Apt ' 20, ❑ FINAL 11 - � 2- S MQI�p ❑ OTHER SeC0) r oca irl Ids z - i- sMok� I s ►-�olc;. C.. o, ���, .hn , �,, q Tlka 3locIC a � � � O v0'1 CD D` O O O O O O O O O O O O N M Vl M V1 V1 V1 Vl Vl V1 Vl O1 O\ 00 T O1 O+ M O1 I— l— N N N m Z C> 4� Q ¢ ¢ Q Q Q ¢ Q 0 U p AF A A 0 ¢ A A O A A J cn M m Z J En co cn cn On F' N a" N O p" M �"' N T N a M a. 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O O _ CO L0 d 4) o A id y O C M "az o 7 y > o V e 0C1) v w 'oG 'C > U y _ C Y_ C C C [i ce > > z a z C 7 u O O O O O O M M M MI M M M M M M N N N O O O O O O O O O O O O O O O u O O O O O O Cl O O O O Cl O O S a N N N N N N N N N N N N �V N N N N N O O O �^.. v1 10 Os 00 O� n 00 00 nON�1 M to O oo N 0000 cq CD 7 ^ N - - i N N N r- N N O t- ;S O O �O v1 M M O O 0 0 ^ 0 O a O O O ^ O O O 0 0 0 0 0 0 0 V 0 0 0 m m Z U d eo O m m J E H a E 0 U U m � oNo N M U .Q H 0 0 0 0 0 0 x 0 0 0 m H 0 0 0 0 0 0 'O 0 C. 0 d m o 0 0 C. kn ., 0 0 0 d O o 0 0 F- ca to g 0 0 0 w o 0 0 p o 0 0 H L .Q J uU z 0 c w w z 0 00 R p ►- z z N cn r e� 0 J 'C U o o N 0 o 0 oM LO co � N M U Gl Y 99 C 7 V § o O aG1 O N v�i ` O 0 O O O 4 BUILDi1MENT NOV - 6 2023 VILLAGE OF R OK I 938 KING I, ET RYE BR 1� NY 10573 i VILLAGE OF RYE BROOK -0 �� L BUILDING DEPARTMENT FIRE INSPECTION / OPERATING PERMIT APPLICATION FOR OFFICE USE ONLY: /0' �,4"/1 J/f Fee Paid: $ Inspection Date&Time: es 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: d ,2X c2aV ,is hereby made to the Building Inspector of the Village of Rye Brook NY,requesting that a Fire Inspection be conducted at t e�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. q 1. Address:z � � SBL:�3J i p — �— y Zone: 2. Business/Occupancy Name:1Q Cn lf.. L.0 NYS Use Class: 3. Property Owner: a6 0,Qj 44 egg)]7 f1 Address: Phone#� 7�g—� Cell#qo -� —��/l email: 5. Business Owner: �Q/m,Q_60 Address: Sbegl��,hea Phone# Cell# email: �- 6. Emergency Contact: L1b/)1Q�►t. . ¢ZAddress: 1�dl)1 ? eZLn(_CI Phone# f — S1j'_j©W Cell# email: I Inspection Escort: 4_lX11nn xj Title: PAIDA?,&4_ /XS/A,�dJ_� Phone#: Cell#: email: 8. Provide a brief description outlining the current and/or intended use of the property: T ..GG�Y?�.L�cJ ,ems►. �11� '.T�L�i 12[�x r`►.� ��l 4��- 9. List all Hazardous Materials: 10. Occupant Load: Existing: Proposed: / )—/ Other: &kQ, bU C_" _A fZd 11. Date&Disposition of Previous Fire Inspection: 51'1ass 0 Fail i 8/2/2021 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: �p being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signin(yapplication f and further states that he/she is the legal owner of the property to which this application pertains, or that he/she is the 02 1-1—L' , for the legal owner and is duly authorized to make and file this application. That all (indicate architect,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. Sworn to before me this Sworn to before me this day of , 20 day of 20 Notary Public Notary Public Signature of Property Owner -Signature of Applicant Ll IU44r , G=-hup , 692raf1— Print Name of Property Owner Print Name of Apylicant S : ATTACHED NOTARY DOCUMENT z 8 12 2021 CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE § 8202 0 See Attached Document(Notary to cross out lines 1-6 below) [I See Statement Below(Lines 1-6 to be completed only by document signer[s], not Notary) FAIL-Ah lion .....----------- ................ ............. Signature of Document SIdner No. 1 Signature of Document Signer No. 2(if any) A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California Subscribed and sworn to (or affirmed) before me Countyof on this J5-�dday of 0: Cr - . 20 , by Date Month Year (1) "-xu-)&iFCL- C) (and(2) KAREN MCINNIS Nome(s)of Signer(s) Notary Public-California Contra Costa County T Commission#2419116 proved to me on he basis of satisfactory evidence to �,A. e re m 4t My Comm.Expires Oct I,_2026 be the perso . ho ap e(t= Signature I- - - - --- — Place Notary Seal and/or Stamp Above Signature of Notary Public OPTIONAL Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s)Other Than Named Above: --------------- C2017 National Notary Association i � m � 8 a LL cEn_fi¢ @ e m �+ 16 U ` /Y3l F .0C ? CYy ' w ❑0 00 a J �i c LLnL nnnn n» 71 rrmni � 0 , , )! j ! \/[ k 7■ s » z w ^,\\k E O ] O O {Ik1222/7 CC E ® }ƒocr {] o=n o 00 0 g ] � t .. % a) co { § f y Z {} & 2 { a \ ) D ) (D0 Cr, } @ ] / ) a £ \f!/]§c § ) /\ )}}A? ¥ x a j �<fOu Uc wcoec== ru 2 r @ � / cel > / q � / rCP } /� / } � — a / IZJ — a . g 0254 / } q Ln ) 7 G) L = 7 � � ) _ _ ca CD E ! c © e = \ acts — $ n [ gco - 0 , � _ � 15 m ` = � � ru 2 E § %£ °� / § / 2 Co ° e § G 02� #� — ru \� � \ \ � \ , § {0 — ! t C) a—U) LL ■ ■ ■ w — \ E a _ m o Fa W li C7 0 N.6 d .0 m a) z U 0' m a.to'E c — N — O Z — ca 0 LLJ 0 W � LLJ� O -o - m 0 Z — E _ Z _ c u Z Y Y = J0 n0< = Qo J_ (7) LI) cr J m c:0 > m �- ru L(13 _ ru U ru Y v- to U — o — a a Q� "' cn ru w Q) N � O U)N - Lrl _ � ww � � O =Dla y ` N J l�`4pY yv; (C♦ �4i.V WY 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.00rrQ TRUSTEES BUILDING&FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W. Morlino October 17,2023 Via 11,Class Certified Mail 2 Hawthorne LLC 1855 Danielle Court Walnut Creek,California 94598 Re: 2 Hawthorne Avenue,Rye Brook,New York 10573 Dear 2 Hawthorne LLC, It has come to the attention of the Building Department that it has been over three years since the premises located at the above captioned address has undergone and successfully completed a Fire Inspection.Please note that you are required by Rye Brook Village Code 591-4.B,to undergo and successfully complete a Fire Inspection for this location at least every thirty six (36)months. In order to avoid a violation,please complete and submit the attached Fire Inspection/Operating Permit Application form, remit the correct application fee,and schedule your triennial Fire Inspection with the Building Department by no later than, November 17,2023,which is thirty (30) days after the date of this notice. Please note that the property owner's notarized signature,as well as the business owner's notarized signature must appear on the application form in the appropriate spaces. Upon successful completion of the Fire Inspection,you will be issued a Fire Inspection Certificate valid for three(3)years. Please remember that you must schedule your Fire Inspection every three(3)years by filing a Fire Inspection/ Operating Permit Application,remitting the applicable fee,and scheduling your Fire Inspection with the Building Department at least thirty(30) days prior to the expiration date listed on your Fire Inspection Certificate. Thank you. Steven E. Fews Building&Fire Inspector t v fews ,tyebrook.org cc:Laura Petersen,Office Assistant /to M LO C6 O w O (� I UO Qi _ i 7 C G Nn! 1 41: T r/' 10 �y 1. V 4+ 0 U o 1 � UU v o u 44 U 3 Q a w0 N 00 M f\ Y c CG Z .�aE,w Yp W •Y � P � CG V Q J oG � C Y M O� y l�W�yJJ V i5 MLi . � %:V 7. 19 �-� 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 October 17,2023 Via Pt Class Mail 2 Hawthorne LLC 1855 Danielle Court Walnut Creek,California 94598 Re: 2 Hawthorne Avenue, Rye Brook,New York 10573 Dear 2 Hawthorne LLC, It has come to the attention of the Building Department that it has been over three years since the premises located at the above captioned address has undergone and successfully completed a Fire Inspection. Please note that you are required by Rye Brook Village Code§91-4.B,to undergo and successfully complete a Fire Inspection for this location at least every thirty six (36) months. In order to avoid a violation,please complete and submit the attached Fire Inspection/ Operating Permit Application form, remit the correct application fee,and schedule your triennial Fire Inspection with the Building Department by no later than, November 17,2023,which is thirty(30) days after the date of this notice. Please note that the property owner's notarized signature,as well as the business owner's notarized signature must appear on the application form in the appropriate spaces. Upon successful completion of the Fire Inspection,you will be issued a Fire Inspection Certificate valid for three(3)years. Please remember that you must schedule your Fire Inspection every three (3)years by filing a Fire Inspection/ Operating Permit Application,remitting the applicable fee,and scheduling your Fire Inspection with the Building Department at least thirty(30) days prior to the expiration date listed on your Fire Inspection Certificate. Thank you. Steven E. Fews Building&Fire Inspector stevefews a,ebrook.org cc:Laura Petersen,Office Assistant /to 0 M c0 , O O . a ��o NCr, J�j��J MTV 7 ±1 . 00 C% Ln qt R E -a U U C's U Q a co L Z '^ 00 y3 N ^-� M n Y c ® r � z m -E'w rp W m co V Q J oC J c \ Y M O^