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HomeMy WebLinkAboutBP24-083PERMIT # Q&21_0(Y3 pATE; S/(I gip; S 9 aS SECTION S, S BLO K LOT / TYPE OF WORK Q �0047 o 0�70VQ JOB LOCATI N CZ/C U oQ OWNER Qrle%s 01C)l % O/S �o� .SDI/ �/4%).5-�9 01/O�j CONTRACTOR�C? /I LS P rQ U ,1-aC�/! C — OP I.7 �( C�/%O%/0 C9/y)3d'd EST. COST a)O FEE_ lie, 5' TG �A6 �- � 7(� ✓@0 #.U?' FEE �o1S-PA DATE 3C� TCO # FEE DATE INSPECTION RECORD DATE I NSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION ASS �� 1��D�y/�Q�pML�1� �O�lS UG770� PLUMBING 5 - 21 ' 7,025 cJ RGH PLUMBING `�� 'sG GAS E3 CO 5PRINKLER /1S� ELECTRIC LOW -VOLT CI ALARM C� AS BUILT 13 ZU� ASS �— FINAL OTHER APPROVALS ARB BOT PB ZBA OTHER VILLAGE OF RYE BROOK WESTCHESTER COUNTY, NEW YORK NO: 25-067 Certificate of ®ccupaucp This is to certify that_C-0 1 / Loi's of, having duly filed an application on ACk f r o2 5 20_C&rlequesting a Certificate of Occupancy for the premises known as, '154 /0 /no H R6)0� , Rye Brook,NY, located in a �Z l� Zoning District and shown on the most current Tax Map as Section: J Block: / Lot: 7 , and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No. Q?`�� _6 ,3 issued 20 a , such authority and permission is hereby granted to the property owner to lawfully occupy or use said premises or building or part thereof listed under the following New York State Classifications, Use: Q — / X Construction: for the following purposes: Subject to all the privileges, requirements, limitations, and conditions prescribed by law, and subject also to the following: This certificate does not in any way relieve the owners or any person or persons in possession or control of the premises, building,or any part thereof from obtaining such other permits or licenses as may be prescribed by law for the uses or purposes for which the building or premises is designed or intended. Furthermore, it does not relieve such owners or persons from complying with any lawful order issued with the object of maintaining the premises or building in a safe and lawful condition. No changes or rearrangement in the structural parts of the building or in the exit f 'lities shall be made,and no enlargement, whether by extending on any side or by increasing in height be m nor s all a building be moved from one location to another until a permit to accomplish such change has bee o from the i in r. Building Inspector,Village of Rye Brook: Date: MAY 3 0 2025 p � 'w[ DDBUILD R NT For office use onl OCT 2 5 2024 VIL OF RYE OK ISSUED # —� -,0W3 38 KING STRE YE BROOK,, YoRK 10573 DATE: /0 ay VILLAGE OF RYE BROOK 9 -06 6 FEE sf�a�S— _PAID 4 BUILDING DEPARTMENT r�' ov 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 4rtrti444fttirtrttirtrt'irt##}####}4##44#4####i#4#4#►#►►#►►#nn►►►i#tf►i►ffffitf►fiift4rtirtirtrtirtitttiiirtirt#rt*ttti}#f4##}44#44#i4+####### Address: 51 tot 0 O d 1� L Occupancy/Use: M Parcel ID#: 3si SCE Zone: Owner: Lois 016 tasvuI," Address: s-4 IQ ru goad P.E./R.A.or Contractor: �a„++���1y s Ct�l� (�C j,j4'f Address: 17i 5 M&I, d `ol f`fi yA Person in responsible charge:00", r1y1 C C l O 11 a Address: 16A hu t_ Nil 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: n LID iJ A , a)J S ,'4eing duly sworn,deposes and says that he/she resides at S �f R l C y f+ I Cd ad (I1 n(Name o Applicant) (No.and Street) in (C{�G dk ,in the County of GJ es>Ec h es-re- r ;n the State of y that (Cityrrown/Village) he/she has supervised the work at the location indicated above,and that the actual total cost of the work,including all site improvements, labor,materials,scaffolding,fixed equipment,professional fees,and including the monetary value of any materials and labor which may`t have been donated gratis was:$ - "0 , for the construction or alteration of: Z •,a+lh ry a M C'4. n Ova h&n.1 Deponent further states that he/she has examined the approved plans of the structure/work herein referred to for which a Certificate of Occupancy/Compliance is sought,and that to the best of his/her knowledge and belief,the structure/work has been erected/completed in accordance with the approved plans and any amendments thereto except in so far as variations therefore have been legally authorized,and as erected/completed complies with the laws governing building construction.Deponent further understands that it shall be unlawful for an owner to use or permit the use of any building or premises or part thereof hereafter created,erected,changed,converted or enlarged,wholly or partly,in its use or structure until a Certificate of Occupancy or Certificate of Compliance shall have been duly issued by the Building Inspector as per§250-10.A.of the Code of the Village of Rye Brook. Sworn to before me this Z 5 I r 1 Sworn to before me this day of O C ��Q ( , 201_�_ day of , 20 kwhmh,�_ Signature of Property Owner Signature of Applicant �(� �m n &D ame of Property OwKr Print Name of Applicant Notary Public Notary Public SHARI MELILLO Notary Public,State of New York No.01ME6160063 6/I/2024 Qualified In Westchester County Commission Expires January 29,20_� QyE BR N '9a2 BUILDING DEPARTMENT ❑BYILDING 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 :—9, —I 1 A [,n 4A �rJc QA DATE: ,�J " 1iZ " Z OZS PERMIT# Q>Q ISSUED: •Q'Z V SECT: 3S• V BLOCK:LOT:_12 LOCATION: i` p-t'� 4 H � V L '----A T `-� � OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... G/ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION j� ) ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ IRE SPRINKLER Q' FINAL PLUMBING ❑ CROSS CONNECTION WFINAL 4 2(�^ 1 K-lr �J'J✓4: r � � . ❑ OTHER f� �yE BRC�uk '9a2 BUILDING DEPARTMENT ❑B JILDING INSPECTOR uJ 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 : GI ! A L Co �.&•C� DATE: PERMIT# ISSUED: SECT: � )U BLOCK: LOT: LoCATIONI: 11A ' �J'1 a J�A r k OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING / ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL 2'OTHER �E BR(�jk cu � .��OT 1932 BUILDING DEPARTMENT ❑BUILDING INSPECTOR ° VILLAGE OF RYE BROOK ASSISTANT BUILDING INSPECTOR ❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www.ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - -- - ADDRESS : mac. a IG DATE: PERMIT# 1 C) 8 cI ISSUED: .5- SECT: f 3s •SJ BLOCK: LOT:�Z LOCATION: L n � h 4 ry)n 6� OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ,o ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER a pp ' T N = o (14 O N G: tu cn o Ln N-I Q 1 Q \ A o = Z O c �" E°. W 3 � � a� W © W >., ry 4-4Qr H o w 004 ° o t1 _ Z W onoen 0 Co Lo I!•� W x � ILn tn W Wog ° � .� ►`� W z A to AU N C�4 0 C 00 C o ° Py 11.0 F N z w CO A caq V C U tV ` H V z •D a c.. " a F•-I O M '� W I � � 0 � y W Rt cAi a ono a C7 CN tu \ U I—+ o a A A N 0 ' o v W z $ ao abvw cn lu am y a'a o C7 J2 c b.a A W z d ° � u . .. JJ � O W W � � a � � a BUIL WI DEPAR MENT U L� - I VIL OF RYE&LOOK [APR 2 5 2024 938 KING§Tfli EET RYE BROOK,NY 10573 _ (914)939-0668 I VILLAGE OF RYE BROOK www.rXebrook.org IBUILDING DEPARTMENT INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: n Approval Date: NAY 0 Q 7n Permit# � Application Fee:S /00 F� Approval Signature: Permit Fees:$ 00 _'`7 Disapproved: Other: Application dated: ""LA 2� Is h'crcby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance ofa Permit for the interior alteration of aA existing building,or for a change infuse,as per detailed statement described below. 1. Job Address: � 1 A 1 t~* R©itD' SBL:/,YJ► if—0 7 Zone: 2. Proposed Improvement.(Describe in detail): Jbx-411)YOOMS UPC64flU AQWhA I,A 3. Does the proposed improvement involve a Home-Occupation as per§250-38 of the Code of the Village of Rye Brook? No: Yes: If yes,indicate: TIER 1: TIER II: TIER III: 4. Will the proposed project require the installation of a new,or an extension/modification to an existing automatic fire suppression system(Fire Sprinkler,ANSL System,FM-200 System,Type I Hood,etc...) :No: Yes: (If yes,please submit a separate Automatic Fire Suppression System Permit application& 2 sets of detailed engineered plans) 5. Occupancy;(I fam.,2 fam,comm.,etc...)Prior to Construction: After Construction: 6. N.Y State Construction Classification: N.Y.State Use Classification: —7. Property Owner, dslbl,6 '�I Address: '^57 �dl( at JU Phone# _7 Cell# 9 �� .561 -6 410 email: to asm,, f �h+q tr0 A 8. Applicant: Address: ."14 h V " C a M Phone# Cell# email: 9. Architect: Address: Phone# Cell# email: 10. Engineer: Address: Phone# Cell# email: ,.or 11. General Contractor: rM +5 qemval G ddress: 2� S M iTW P-6 (_p I2 T L A+Ub T M q+IJD Fj NY )05 Phone# Cell# (g141 3 82 —IjG 2 email: AahCs ©L '6'i c*i0110 MC, r©1Y) �12. Estimated cost of construction 14'(3�0-0 A (NOTE:The estimated cost shall include all labor,mat I,scaff h%Cd cgw-pm`cnt,prof'ssionat tees,and material and labor which may be donated gratis.) ` gC 13. Job Timetable:Start: Finish: ban l c Y;of l o (,) CG 14-) ,' 8,Q — ]'2 6/1/2023 Coy'fraigccorz , BUILD � -—_,_ TMLNT ._.._ Q r; VJ r� VILLA E Oi"Ryli�OOK 938 KING STREET RYE BR6k,NY 10573 APR 2 5 2024 (914)939-0668 www.ryebro� Vlt_!_AAGF OF PVc RROOK _NT AFFIDAVIT OF COMPLIANCE VILLAGE CODE §216 • STORM SEWERS AND SANITARY SEWERS THIS AFFIDA`✓IT MUST BEAR THE NOTARIZED SIGNATURE OF THE LEGAL PROPERTY OWNER AND BE SUBMITTED ALONG WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION. ANY BUILDING OR PLUMBING PERMIT APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETURNED TO THE APPLICANT. STATE OF NEW YORK, COUNTY OF WESTCHESTER ) as: I, Lots 6h 1;9 (dS IM,EPA ,residing at, '�__4 TAU C a tl I_f9 ad (Print manic) (Address where you live) being duly sworn,deposes and states that(s)he is the applicant above named, and further states that(s)he is the legal owner of the property to which this Affidavit of Compliance pertains at; 5 t( T a ( C 0 ff Q0 Gtd - , Rye Brook,NY. I(Job Address) Further that all statements contained herein are true, and that to the best of his/her knowledge and belief,that there are no known illegal cross-connections concerning either the storm sewer or sanitary sewer, and further that there are no roof drains, sump pumps, or other prohibited stormwater or groundwater connections or sources of inflow or infiltration of any kind into the sanitary sewer from the subject property in accordance with all State, County and Village Codes. Lfw +11W (St-nature of Property Owner(s)) �D A--n o Ge) I d 5n4 l OA (Print Name ul'Property Owner(s)) Sworn to before me this SHARI MELILLO d Of , 20 `� Nc!ary Public,State of New York No.UME6160063 Cii�i1fied in Westchester Count (Notary Public) Expires January 29,20 (2) 8/12/2021 This application must be properly completed in its entirety and must include the notarized signature(s) of the legal owner(s) of the subject property, and the applicant of record in the spaces provided. Any application not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. Please note that application fees are non-refundable. STATE OF NEW YORK,,CQUNTY�QF WESTCHESTER ) as: � ;� I' , being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and further states that (s)he isAhe-legal owner of the property to which this application pertains, or that (s)he is the for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,attorney,etc.) That all statements contained herein are true to the best of his/her knowledge and belief, and that any work performed, or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications, as well as in accordance with the New York State Uniform Fire Prevention & Building Code, the Code of the'Village of Rye Brook and all other applicable laws, ordinances and regulations. By signing this application, the property owner further declares that he/she has inspected the subject property,and that to the best of his/her knowledge there are no roof drains,sump pumps or other prohibited stormwater or groundwater connections or sources of infiltration into the sanitary sewer system on or from the subject property. s Sworn to before me this Sworn to before me this day of , 20 �� day of 20 CJZ 1 Cit Signature of Property Owner Signature of Applicant or Aft &d WGrh.A t Name of Property Owner Print Name of Applicant ty Public Notary Public SHARI MELILLO Notary Public,State of New York No.01ME6160063 Qualified In Westchester County Commission Expires January 29,20�/_7 (4) 8/12/2021 _ r r 0 M ■ r Ln r ■ O O oo w ■ a a a W , -, � o . � ao ao �. a V H A o x V. .., w v u r w N K V z 3 L. r a. w o O r z U ►-� ■ � ~f , W 0 x r M O � • W ■ z O wLnHN o w •• z O � < r 00 _ It W >l A;Iq ' O W 00 z z Z U z . W V)) 0 1_r M "� _O O • u H a ; o V = A z x a W w __.i W Z CN x H w • M 00 \J W w A w z J w fn . _ ►- 00 V ° o � H W z Q ell ►-a o H a a W H H xcn. = z z4 w O U V U V w w H o � : w KA o x z H w cn , o < BUILDING DEPARTMENT D IE C Lg VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK,NY 10573 AUG 1 9 9'1 (914)939-0668 24 Jy VILLAGE OF RYE BROOK ELECTRICAL PERMIT APPLICATION BUILDING DEPARTMENT Westchester County Master Electricians License Required 70 FOR OFFICE [ISE ON Ll BP#: EP#: Q / —/ Approval Date: Permit Fee: $ /,�5- 6 Approval Signature: Other: ************************************************************************************************** DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDING INSPECTOR THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12% OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00 Application dated,11-8-al 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: 5tj TR1.4Q 7 �.� SBL: 3 l Zone: c)- 2.Property OwnerCN 4Je"s +Lo 15 42otj6#x tT14 Address: SY TA'J-COT RD Phone#: I g(y' 157/-6 L/0() Cell #: email:ic Lh(�wp p�ETN�05,10 3.Master Electrician/LicensedGed Installer: GNrti2lt?5 A4;C Address: 12.S_/?Y2K&*IeW QD IV. Lic.#: 5'0-1 Phone#: Cell #: /tYa�7-75-&3 eQmail.::SuST/2ub'NZG AhX-Corn Company Name:G•G►•b:,1ea cA4 CeNr'*-n*A1rd0P—AAddress: I'Z-T �ttW 24 tU. 4.Proposed Electrical Work/Fixture Count: gt_MUtl-_no-)U GT E�LCQ/&a 40* - 2- 647hr[ArAi S New �Fc_L 5 , tvcw EyhosT�/CIrskrCa-tbo, pewswn4ts "kr� 5.3'Party Electrical Inspection Agency: SW I S STATE OF NEW YORK,COUNTY OF WESTC14ESTER ) as: Gi , ales 6E0Q6e being duly sworn,deposes and states that he/she is the applicant above named,and does further state that(s)he is the for the legal owner and is duly authorized to make and file this application. The undersigned further states that all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances,and regulations. Sworn to before me this Sworn to before me this 12 day of 20 day of 20 Signature of Property Owner Signature of ApjMcanr GNIT 1 t s Ceot&c�, Print Name of Property Owner " "`� "' �° '' `� Tint Name f lic t YESENIA LFPE 1. NM+,r`-Public-State of New Yrrk Notary Public NO.01LE000769 Ot s ,uelifiod in Westchester Courry ary i �d uy :",.: -,ssion ExPirr Mav�r, 2C17 e- 6/1/2024 STATE WIDE INSPECTION SERVICES, INC. Service With Infe-rils 0•0 • • SWIS JOB APPLICATION0. • Office Use Elect. Permit# � �(� Dat Bldg Permit# i J � Sq Ft Plumbing Permit# r Final Certificate# City/Village , - (�,r�i C I Zip Building Dept. ^;JyFId< County Address Cross Street Section Block Lot Owner Name/Address(If different than above) Contact Number ❑Basement ❑1st FI. ❑ 2nd FI. ❑3rd Fl. ❑More Than 3 FI. ❑Garage ❑Attic ❑Outside Residential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C/0 Detector Hood Trash compact Amt Amps Range(s) Cooktop(s) Oven (s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer Switch SERVICE Amperage #Panels 1P 3P # Meters # Disconnect ❑Underground ❑ New ❑ Reconnect ❑ Repair ❑Overhead ❑ Upgrade ❑ Disconnect Utility ID# ❑Con Ed ❑ NYSEG ❑Central Hudson ❑ Orange/Rockland PHOTOVOLTAIC SYSTEM PV Modules Inverters AC Disconnect Junction Box Combiner Box Load Center PV Monitor Energy Storage System DC Disconnect ❑Legalization ❑ Safety Inspection ❑Consultation Kc7VOU4 T r c C � ��'0 ) l f Q'm S Q"O 6,1: ' S �C D � LE���� AUG 19 2024 VILLAGE OF RYE BROOK BUILDING DEPARTMENT I This application is valid for one(1)year from the date received by SWIS.This application is intended to cover the above listed items to be inspected,if at any time of inspection additional items have been Installed,you are authorized to make the inspection and adjust the fee for the additional items inspected.The applicant declares that there is no open applications for the above address with any other inspection company.The applicant, owner or authorized agent agrees to all the above terms and conditions as set forth for the application. Email Address Name License# Date Signature Address „J J) n , City/State Zip Code I Company Phone# State Wide Inspection Services 1080 Main Street Fishkill, NY 12524 DD 84 5 202-7224 Phone MAY - 9 2025 914-219-1062 Fax %TATF WIDE INSPECTION SERVICES Email: office@swisny.com Service With Integrity VILLAGE OF RYE BROOK Website: www.swisny.com BUILDING DEPARTMENT BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: CG Electrical Const Charles& Lois Goldsmith 125 Parkview Road 54 Talcott Road Pound Ridge, NY 10576 Rye Brook, NY 1OS73 Located at: S4 Talcott Road, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP24-170 135.50 1 17 Certificate Number: 2025-0688 Building Permit Number: BP-24-083 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: 54 Talcott Road, Rye Brook, NY 10573 The First Floor Master Bathroom& Hall Bathroom were inspected in accordance with the NYS and NFPA 70-2017 and the detail of the installation, as set forth below,was found to be in compliance on the 31"Day of January 2025. Name Quantitv Rating Circuit Type Master Bathroom GFCI 01 Receptacle 01 Vanity Light 01 Switches 02 Hall Bathroom GFCI 01 Lighted Mirror 01 Exhaust Fan/Light 01 j r. Luminaires 02 Switches 03 Officer: Frank J. Farina This certificate may not be altered in any way and is validated only by the presence of a seal at the location indicated.This certificate is valid for work performed on the date of inspection only. a • a . _ • 00 N G = LA = E■ W oW6 M � a" r- Ln M�1 W o0 a O 0 ~ O Q L� Ln z '✓ •� C" zl p ,� ^ o s 0 O W Ln z H =I w VCN a � � N 0 _ Lnz oo H z o O �, U • O %10 -ry O C7 ,n F, o o , 4 Ln 00 z w z WF-1 M o w V v z V oo0-4 M�y•� —' W � a, cn M� w W Q _ 6-4M Q V F+ i 5 a O w R; rx U : O ° W a o 0 0 � w "D66 z w z a o � Ln w oA 0 � . r p EC EHE BUILDING DEPARTMENT JUN - 6 202� VILI{AO OF RYE ROOK VILLAGE OF RYE BROOK 938 KING r} ET RYE BIPOK,NY 10573 BUILDING DEPARTMENT -0669 Www&ebrook.org PLUMBING PERj�M,IT APPLICATION (� FOR OFFICE USE ONLY BP#: �y�y O �� PP#: / -a? Approval Date: Z. 7- Permit Fee: $ Approval Signature: Disapproved: (fees are non-refundable) ************************************************************************************************** DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BV THE BUILDING INSPECTOR.THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12%OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00 Application dated, JZ4 110 Z is hereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of a Permit to install and/or remove Plumbing as per detailed statement described below.The applicant&property owner,by signing this document agree that said plumbing work will be in conformance with all applicable Federal,�Sta��te,County and Local Codes. 1.Address: �Q l a� 2 p SBL:l,� , (/ 7 Zone:�� 2.Proposed Work: b t)'?17D D/V1 V C1 I 3.Property Owner:`yi 3 If A10 [r0 LO S n+/%// Address: .S �/ %A `- G o i% le-17 Phone#:J�L/'S 94 'O y d O Cell#: email: ©/i_,5"M/7-HS AA to/ Qd 0" 4.Master Plumber: /—'AU-0 C'y"'i /1✓/'I'-1 a Address: ZC/ /���ti�C S /1(/!I 17"ITR2/S6 1- !ma y Lic.#:"5;'5 5 Phone#: Cell#: 917-13 -U7.33 email: 3! �vR IVJo Company Name: L/I ND/14' Address: /O'er Ave INDICATE FIXTURES& LINES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: Location Water Urinals Drinking Sinks Showers Bath Laundry Domestic Fire Sanitary Natural/ Other* Total Closets Fountains Tubs Tubs Service Service Sewer LP Gas Basement I st Floor 7— 2nd Floor 31 Floor 4'Floor 5's Floor Exterior 5.* List Other Equipment/Provide Details: (Notarized Signatures Required Next 2 Pages) -I- 3/3/2023 STATE OF NE�W, YORK,COUNTY OF WESTCHESTER ) as: 1 19 1�/�{I Y 1 (�0-D LOS A�A i being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and further states that(s)he is the Master Plumber for the legal owner and is duly authorized to make and file this application. That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention& Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to before me this I Sworn to before me this day of kAA- ,20 a A day of t.(1'e ,20 LA, S L !I�.c—•Zit-4.4.r�i Signature o roperty Owner Signature of Applicant Print Name of ProperVy Owner Print Name of Applicant Notaq0?Alj3qjbl1c,state of New York Notary Public No.O1ME6160063 SHARI MELILLO Qualified in Westchester County Notary Pubiic,State of New York Commission Expires January 29,20Z No.01ME6160063 Qualified In Westchester Count Cpm is io Expires Janu ry 29,20�� This application must be properly completed in its entirety and must incTIMe t�te notarize signature(s) of the legal owner(s) of the subject property, and the applicant of record in the spaces provided. Applications not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. -2- 10/30/2023 . BUICET MENT D `J L VIL OOK 938 KINGR ,NY10573N - 6 2024 VILLAGE uF ►1YE BROOK i� BUILDING DEPARTMENT xxxx,�,, ;*xxxxxxxxx�x;;;,xxxxxxxxxx,x�, »xx,:x;***********xx,�;:xxxxx�x,xx,xxxxxxKxx*xxxx*�*xxxxx,x,�x,�,�,�x; AFFIDAVIT OF COMPLIANCE VILLAGE CODE §216 • STORM SEWERS AND SANITARY SEWERS THIS AFFIDAVIT MUST BEAR THE NOTARIZED SIGNATURE OF THE LEGAL PROPERTY OWNER AND BE SUBMITTED ALONG WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION. ANY BUILDING OR PLUMBING PERMIT APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETURNED TO THE APPLICANT. STATE OF NEW YORK, COUNTY OF WESTCHESTER ) as: 1, LO lS /(-rin (j0 IdS YU(A , residing at, 57Y f 1 �C 8� �pa (Print name) (Address where you live) being duly sworn, deposes and states that(s)he is the applicant above named, and further states that(s)he is the legal owner of the property to which this Affidavit of Compliance pertains at; .5—y 7-4 Qd , Rye Brook,NY. (Job Address) Further that all statements contained herein are true, and that to the best of his/her knowledge and belief,that there are no known illegal cross-connections concerning either the storm sewer or sanitary sewer, and further that there are no roof drains, sump pumps, or other prohibited stormwater or groundwater connections or sources of inflow or infiltration of any kind into the sanitary sewer from the subject property in accordance with all State, County and Village Codes. (Signature of Property Owner(s)) ` (Print Name of Property Owner(s)) Sworn to before me this day of C\\ , 20 a� (Nolan Public) SHARI MELILLO Notary Public,State of New York No.OIME6160063 Qualified In Westchester County. Commission Expires January 2S 20 -3- 8/12/2021 .Building Permit tCCheck List&Zoning Analysis Address 514 'L T \ ,' 1 SBL• Zone: . Z Use: --2`D Cont.Type Other: Submittal Date: S 24evision Submittal Dates: Applicant: \ Nature of Work �I_r) S Reviews.ZBA: MAY 0 8 2024 PB: BOT: Other. NEED OK P-D � p� ( ) FEES.Filing: _BP. .x.f 1/0: Flood Plane: Legalization. W' ( ) ("P: Dated: Notarized -`_SBL:menus I.D. i Cross Connection: H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening. ( ) ( ) ENVIRO:Long. Short Fees: N/A. �1 ( ) ( ) SITE PLAN:Topo: Site Protection: S/W Mgmt.: Tree Play Other. ( ) ( ) SURVEY:Dated Current: Archival: Sealed: Unacceptable: P4 ( ) ( ) LANS:Date Stamped Sealed Copies: Electronic Other. (License: Workers Comp: Liability Comp.Waiver: Other. ( ) ( ) CODE 753#: Dated: N/A: ( ( ) HIGH-VOLTAGE ELECTRICAL:Plans: Permit" N/A: Other. ( ) ( ) LOW-VOLTAGE ELECTRICAL:Plan: Permit N/A: Other. " FIRE ALARM/SMOKE DETECTORS:Plan: Permit: I-W.I.C.: Battery. )Other. ( ) ( ) PLUMBING:Plan: Permit: Nat.Gas: LP Gas: (�( ) FIRE SUPPRESSION:Plans: Permit: N/A: Other. ( ) ( ) H.V.A.C.: Plan: Permit; N/A: Other. ( ) ( ) FUEL TANK Plan: Permit: Fuel Type: Other. ( ) ( ) 2020 NY State ECCC: N/A: Other. ( ) ( ) Final Survey Final Topo: RA/PE Sign-off Letter As-Built Plan: Other. ( ) ( ) BP DENIAL LETTER: C/O DENIAL LETTER: Other. ( ) ( ) Other. ( )ARB mtg.date: approval:- notes: ( )ZBA mtg.date: approval• notes: ( )PB mtg.date approval:- notes: A DDQny 1= REQUIRED FJQSI'ING PROPOSED NOTES Dom. MAY 0 8 1024 Area: Cirde: Fron�taee: Front: Front: Sides: Rear. Main Cov Accs.Cov. Ft H Sb: Sd.H Sb: GFA: Tot : FL Im Padkng. Height/Stories notes: •Ape tint I w Q ` C) J QiOlt �I= (� Z Wcy- cc 1 r. 0 e =ILUEz ' 4 v� a, CL Q uj a. col m � W = 3t V d W Lu u.i O I�J�I i :3 Q W cn UL Lu 0.0 /\/► S .ar C Q C ram. � �j_ � . W i _ .. p Z 4 . z W F- LC1 i UJ 1 � 0 1 = 3 0! —, hl ELU oa Q ! sw W cn a, V - _ Qj „ zcr uj ImLU - ' g: 2 OL LLJ CL UJ CL E� W z U � NL1.! �' fCO W w � 00,;a W _ `o!U / r� 0 Z 3 q v u, _ U � y0 Cl) f W M ` e in E r.. A W J ro W 06 f c{ W �Ir'W C) - .O o J ....r.........,� >- w 4 � _ 00 �� �ir.nro� III n cif-sf. I)r YOU ARE HEREBY ORDERED AND DIRECTED TO STOP WORK CEASE & RESIST ALL UNLAWFUL. USE OF THIS PROPERTY LOCATED , 4 — . OCATED A7: 'YOU ARE HEREBY ORDERED AND DIRECTED TO STOP WORK AND/OR EASE & DESIST ALL IJNL, AWF JL USE OF THIS PROPERTY LOCATED AT. e ti_ ��. - . i 1 I f A {ti\ -./w A '\ _ ,/Y•'t'�;SgA'''' �_ �, ^•' _ ..A ..A .\- <(o)> '- N +r 0. L1• N �1�• O(C CC di ci CL Lo Al L MGM U V) O ;; p Qt � y Z Q Q �y v, .{>Lu LU 4-4 IZ ca � .fir• � MCI � ¢ `a ; . Gz7 CC U c- Qom• U I;r.-aw(.^%• V ._ .� In T a V + U O r /a __ co o bM `II► ly' 'Ce a� 'II 1 _s'-a tic, ,.:, / a r .ram II►IN,' - 1 f(O • p• /i 11111/ A I/ii// 1/1y11� g #� r111/111j/1 a .1.""1.`S•� %-- a.���i>_•�— ..iidOtSi;..:.4��1t�.:.:i7��::•. _ - - _.-.9'a�:-._ _ .-�e�•_ .CeA. DATE(MM/DD/YYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE 04/25/2024 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: If 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 NAME:_ Dawn M RICClafdl FITZPATRICK INSURANCE CENTER PHONENo,E49 g14-739-6117 FAXUVC, WC.Not: 914-739 1553 54 WELCHER AVENUE E-MAIL dawnr@fttzinsctr.com PEEKSKILL,NY 10566 INSURER 3 AFFORDING COVERAGE NAIC0 INSURERA: ATLANTIC CASUALTY INS CO 42846 INSURED Dannys General Contracting I Inc INSURERB: _ 1 Oakwood Drive Apt 10 INSURERC: Peekskill,NY 10566 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 CONTRACT OR 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. ILTR TYPE OF INSURANCE A L WynSUBRi POLICY NUMBER MUtDO POLICY EFF MPWDID EXP LIMR9 A I COMMERCIAL GENERAL LIABILITY Y L068026996-1 06/18/2023 06/18/2024 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL SADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ OTHER r $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ IF accdent ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED id P BODILY INJURY(Per accent $ AUTOS ONLY AUTOS ) HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE _ ER ANYPROPRI ETOR/PARTN ER/EXECUTIV E OFFICERIMEMBEREXCLUDED? NIA E.L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ N yes,describe under - - DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate holder is listed as Additional Insured. Job Location: Louis Goldsmith 54 Talcott Rd. Rye Brook NY 10573 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN TOWN OF RYE BROOK ACCORDANCE WITH THE POLICY PROVISIONS. 938 KING STREET RYE BROOK, NY 10573 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD NYSIF New York State Insurance Fund PO Box 66699.Albany. NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE 0 Tr A A A A A A 824800617 j•`;�?• '+'�'?r• { FITZPATRICK INSURANCE CENTER t�-y �■, .r. , 54 WELCHER AVE PEEKSKILL NY 10566 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER DANNYS GENERAL CONTRACTING I INC TOWN OF RYE BROOK 22 SMITH RD 938 KING ST CORTLANDT MANOR NY 10567 PORT CHESTER NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W2559 486-2 1 721496 11/17/2023 TO 11/17/2024 4/25/2024 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2559 486-2, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY, INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE.VISIT OUR WEBSITE AT HTTPS://WWW.NYSIF.COM/CERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION PRESIDENT DANILO CRIOLLO SOLE OFFICER/SHAREHOLDER OF DANNYS GENERAL CONTRACTING I INC THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE SUR NCE FUND T4 �/ DIRECTOR.INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 359414313 U-26.3