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HomeMy WebLinkAboutBP24-104PERMIT # 6/,Q4 1a I SECTION 6 TYPE OF WORK �i Z JOB LOCATIS�N �A J, _. DATE: �� t:(P: 5, LOT PMoVP �,l�iSA/2 let e //1 4Ser�ie�� �77�C CONTRACTOR. ''\\ �ST. COST1g 00 0 _ FEE �' V V CO # FEES o1�S pb DATE TCa # FEE DATE FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING RGH PLUMBING GAS Cl SPRINKLER ELECTRIC LOW -VOLT ALARM AS BUILT C� FINAL I DATE I NSP y)1v/9-3530 � i 3� % /a 1j/uM61�y `� �3 EPaLI-C:)%a OTHER APPROVALS OTHER VILLAGE OF RYE BROOK WESTCHESTER COUNTY, NEw YORK No: 25-008 Certffirate of Orrupanrp This is to certify that Jose )pr)zo- "' 96S a Pe Oo� 'Y---o(,� having duly filed an application on QfV/ OV&n&� Q J , 20 024 requesting a Certificate of Occupancy for the premises known as, C , Rye Brook,NY, located in a - 7 Zoning District and shown on the most current Tax Map as Section: ! ,11J Block: Lot: , and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No. - Lo , issued 20 6;?, , such authority and permission is hereby granted to the property owner to lawfully occupy or use sai premises orb 'Iding or part thereof listed under the following New York State Classifications, Use: / /�- / Construction: , for the following purposes: 1 (,4 V/ G)"'o )90'yfmcn � 4�-)- Co tie remo v 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 facilities shall be made,and no enlargement, whether by extending on any side or by increasing in height shall be made,n h�the 'lding be moved from one location to another until a permit to accomplish such change h e ob from t Bpector. Building Inspector,Village of Rye Brook: Date: 010106 t� C v4 vy VILLAGE OF RYE BROOK MAYOR 938 King Street,Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914)939-0668 Christopher J.Bradbury www�ebrookn TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M.Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE January 16,2025 Jose Poza&Rosweny Flores Hidalgo 115 North Ridge Street Rye Brook,New York 10573 Re: 115 North Ridge Street, Rye Brook,New York 10573 Parcel ID#: 135.67-2-1 This document certifies that the work done under Mechanical Permit#24-137 issued on 10/25/2024 for the installation of a heat pump and wall units have been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to D `r Lc� ; ; aR For office use only. BUILD ENT PERMIT#NOV 10 M24 VIL E OK ISSUED:_ 938 KING STRE K, YORK 10573 DATE: //c)0•—QyVILLAGE OF RYE BROOK 6 0 FEE: & QaS-- PAIDBUILDING DEPAR"I-MENTI W .20 V 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 ++►rrtsr►►►rs►►+ttsr►r►s►s►sr,+(s�►s+suss+s►+ss+►s►a►+ars►s►srsrrsQQ►sr+r+r+rsrsstssr►sssssrtr►►ratst►►sssttsra►ssst►ss►rrstrr►r Address: S S� U\ (0v S 3 II__ a Occupancy/Use: 0 otk parlcel ID#: 13S - 2 -1 n ' Zone: - Owner:�(�.�e 0 tit Address: r(3 /V auy P.E./R.A. or Contractor: Address: n 1 Person in responsible charge. C>S.t 90-7" Address:A 3 � 1�► �a„ _ S� I`y C g��y (C 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: 11 )Po -z c, being duly swom,deposes and says that he/she resides at r 3 (V 2 t r! S} (Print Name of Applicant) I (No.and Street) in 'P-y e 13 foy k ,in the County of in the State of Iy ,that I(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 have been donated gratis was:$ 25/d0 0 11 for the construction or alteration of: t o�q 1 t ?C- b"512 ""-+ 0 CO 0 C Re I-V,mac, e x r 34 Il- 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-IO.A.of the Code of the Village of Rye Brook. Sworn to before me this 110 Sworn to before me this day of , 20--2--1 day of , 20 Signature o o li erty Owner Signature of Applicant Prp' t,Namkdf Property Owner Print Print Name of Applicant A�� IAZ Notary u lic _SHARI MELILLO Notary Public Public,State of New York :!c, 01.ME6160063 6/l/2024 .d in Westchester county /� Expires J. .t y 29,207i 1 �yE BRC�k 1987 cu � t7 BUILDING DEPARTMENT [J 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: 115 DATE: I 1 t 16-1, PERMIT# U.`1 ISSUED: SECT: LOCK: LOT: LOCATION: `P t Q �� `� j �� o r� OCCUPANCY: ❑ Violation Noted THE WORK IS...~ 13 PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas �a4_ ❑ L.P. Gas ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION FINAL F ❑ OTHER �E BRC�k, o`` tim ��• �932� BUILDING DEPARTMENT 15,iUILDING 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 - - - - - - - - - - - - - - - - - -- - 5 ADDRESS : 1 ` DATE: 3 1 Qy-L G ' / {t _ PERMIT#� '! 2�� � ISSUED: �f�- 1 SECT: BLOCK: LOT: LOCATION: �� r a�-�' r 4' ` �Y �CJ� OCCUPANCY: ` f a ❑ 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 ��J ( ►fl ,� _c�� - 61�L C-j CJC ❑ L.P. Gas ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING [� ,.."OSS CONNECTION i }Ci. (Y t J1j( ❑::FINAL `�) �],�C� 1 �C7C�C ❑ OTHER '-+ VOL 1RAL-\wjL6Q \ Ucii NsaA � �4 ClQ yy� C���� Ut'�2 YL2 QyE BRC�/f 1982 BUILDING DEPARTMENT ❑BUILDING INSPECTOR ❑ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 King Street • Rye Brook,NY 10573 (914) 939-0668 FAx (914) 939-5801 www ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - 1 1 5 �5b� \ 1�) 5� ,f .i I ?5 ( z L I ADDRESS : DATE: 1�. PERMIT# ISSUED: SECT: BLOCK: LOT: LOCATION: t �Q ! ` OCCUPANCY: G ` ❑ Violation Noted THE WORK IS... d PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: .0 ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION _ ❑ Natural Gas �L— ❑ L.P. Gas ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL /� /''} �( ❑ OTHER \_ `J� gcVA s s _ � N N � � °' • \ W \eq N G. s � cr a w H i cV cn A ym a y M Ln 00 a ° _ � � y9 too, : � 7E00 V U N Z 'o ai � W Iv U W ~ Cs y en 14 cn W , CIA z ��, �WX � w ova 00 cn � v F�1 W w F Z Z ,o g vcn ICI F+ O O F U z A. °C a cn mi py Q W Z z m _ MM� h�l ° U U Lt-) �, ° A pw� Z oC `� ° a ,�, 1 ° .ti c p ECEN BUILDING DEPARTMENT VILLAGE OF RYE BROOK MAY 16 2024 938 KING STREFT RYE BROOK,NY 10573 (914)939_0668 VILLAGE OF RYE BROOK �irvvc. eb,yytook.ur BUILDING DEPARTMENT INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: O toy Approval Date: MAY 20 it#:'_ % Application Fee:$ Approval Signature: Permit Fees:$ Disapproved: Other: Application dated:4/25/2024 is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of Permit for the interior alteration of an existing building,or for a change in use,as per detailed statement described below. 1. Job Address:115 N Ridge St, Rye Brook, NY 10573 SBL: 135.67-2-1 Zone: R-7 2. Proposed Improvement.IDescribe in dewii): Legalize e"basement, Remove existing kitchen`pn basement and attic and `-t n c co�p_ 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 I: TIER IT: 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,I NI-200 System,Type I Ilood.etc...) :No: Yes: (li y cs,please submit a separate Automatic Fire Suppression System Permit application&2.sets ol'detailed engineered plans) 5. Occupancy;(1 fam.,2 fain.,comm.,etc...)Prior to Construction: After Construction: 6. N.Y State Construction Classification: N.Y.State Use Classification: 7. Property Owner:Jose Poza Address: 115 N Ridge St, Rye Brook, NY 10573 Phone#914-619-3530 Cell # email: POZajosel3@gmail.com 8. Applicant:Carlos Sosa Streber Address: 671 Gramatan Ave, Mount Vernon, NY 10553 Phone#914-954-9618 Cell# email: css@crossdesign.com 9. Architect: Address: Phone# Cell # email: 10. Engineer:John Alleyne Address: 158 Drake Ave, Suite#12, New Rochelle, NY 10801 Phone#914-954-9618 Cell# email: Csbecallengineering@gmail.com 11. General Contractor:Vilest- Nam Inc Address: P.O. Box 272 Purdys, NY 10578 ? r?Q F 4 Phone# JM- SZ9— 5,W) Cell# email: kim@west-nam.com 12. Estimated cost of construction $ 25,000.00 (NOTE 'fhc estimated crest shall include all labor,3natvri.d,scaffolding,tuned equipment.professional tees,and material and labor wftich may be delimcd gratis) 13. Job Timetable: Start: Finish: (I) 6/l/2023 r BUILDI TMENTD, VILLAE OF RY BROOK IJUN - 4 2024 938 KING STREET RYE BROOK,NY 10573 t (�4)939-0668 VILLAGE OF RYE BROOK www r ebro�g BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE &216 • STORM SEWERS AND SANITARY SEWERS THIS AFFIDAVIT MUST BEAR THE NOTARIZED SIGNATURE OF THE LEGAL PROPERTY OWNER AND BE SUBMITTED ALONG WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION. ANY BUILDING OR PLUMBING PERMIT APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETURNED TO THE APPLICANT . STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: �b -C ,residing at, (Print name) (Address wh c you Iivc) 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; c� S l /C / l , , Rye Brook,NY. 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. (SignaturccrMrtclhncrl>)I (Print Namc of l)roperly(\vain,,)) Sworn to before me this JOBU M STF OF N ppYARY PUBIJG,STATE OF NEW YORK Registration No.01SU6070919 day of �L� 20 oualified In Westchester County o My Gommisslon Expires March 11,2026 (Notary 1)ub9ic I'1 8/12/2021 L 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,COUNTY OF WESTCHESTER ) as: _Carlos Sosa S_treber _ ,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 legal owner of the property to which this application pertains, or that (s)he is the Agent _ _ T for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,attorney,etc.) That all statements contained herein are true to the best of his/her knowledge and belief, and that any work performed, or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications, as well as in accordance with the New York State Uniform Fire Prevention& Building Code,the Code of the Village of Rye Brook and all other applicable laws, ordinances and regulations. By signing this application,the property owner further declares that he/she has inspected the subject property,and that to the best of his/her knowledge there are no roof drains,sump pumps or other prohibited stormwater or groundwater connections or sources of infiltration into the sanitary sewer system on or from the subject property. Sworn to before me this 21 Sworn to before me this day of I L ,2fl`� day of M ,20 9q 2 SiXPoza of Property Owner Signature o pplieant J Carlo osa Streber Print Name of Property Owner Print Name of A plicant Notary Public Notary Public i WiN80;AZ?AWEt.3 Notary Pu!,)Iic,State of Now York JOHN M SUOZZO No.O1SM3182219 NOTARY PUBLIC,STATE OF NEW YOM Ovalified In t rol'I t Registration No.01 SU6070919 C4M,ITIL"on£xj*os Oualifled In Westchester County My Commission Expires March 11,2026 (4) 8/12/2021 s s s =i �' N C ^ ,,j ■ o � o wwa y x a W a ►—; a � ►n ,Z a 00 � �T- Q� 1 4c N fir. ^ I ch , %D '•�" _ N J LQ _ _ w .. x 00 o @ < a �nl01 �• Q w Ewa _ u; _ w 18 00 r 5 = r', ;;4 Z A. o N W w w N V H8 w z a 2 � �' x • _ Lnz x w z 0 ., 0 = QI ca 0-1 .�1 z w _ E s yE f3RCw BUIL DE ` MENT ti VIL E OF RYE OK 938 KIN , ET RYE B ,NY 10573 OCT 1 1 2024 WW n . ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required / FOR OFFICE USE ONLY EP#: Approval Date: OCT Permit Fee: $ 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, 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: + �S u�N R y— SA Lie `U e ��o✓, N.",. SBL Y3J4—i 6 7 Zone: e_- 7 2.Property Owner:;c7s e� 1`n 7 Address: 3 If atA - v k Phone#: Cell#: U i< — � t1 - 33 3 y email: A vrra E!<c e, c�c•�•.� .e°µt 3.Master Electrician/Licensed Installer: Al Address:A ,(`K Z3 l . /��•1• IV. /os' Lic.#: �J Phone#: Cell#C?<Yl t4 t @ f P S , email: Company Name: Address: 4.Proposed Electrical Work/Fixture Count: 'rr S f t ff 01 C w /0& �f�t�o ��b /�.,�t�1.�i s c o.►e c f e *s art 6 rtse o e '1" /°1 r At(! ✓e,l f ,C...s L f r F�. b,r��i, 7-/4 s ,q 4afr- / ;f rr /cG. fit/.-e A e 4 r. rv,g 5.31 Party Electrical Inspection Agency: Swc err STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: ,9nth ov K R y'rx a being duly swom,deposes and states that he/she is the applicant above named,and does further (print name of individual signing as the applicant) state that(s)he is the for the legal owner and is duly authorized to make and file this application. (Master Electrician/Licensed Installer) The undersigned further states that all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances,and regulations. Sworn t e me this Sworn to before me this A6 day of 20 day of Fr Ar;wJer 20 2-�e Signa f Property Own rgnature of Applicant U�-e— �U Pri t ame of Pro rty O� npr P ' la a of Applicant 74 S Notary u GO Y M. IVERA No' Publk I MELILLO Notary Public,State of New York tary Public,State of New Yo��/2o2a No.01 RI6441398 No.O1M E6160063 Qualified In Westchester County Qualified In Westchester County Commission Expires September 26,201— Commission Expires January 29,20 Zj STATE WIDE INSPECTION SERVICES, INC. 0:0 • • SWIS JOB APPLICATION /02.7224 1 fax 914.219.10621 SWISNY.coml SWISTRAINING.COM Office Use Elect. Permit# — <J y Date ,} \\ Bldg Permit# Scl Ft Plumbing Permit# Final Certificate# City/Village i Zip Building Dept. County Address Cross Street Section Block Lot Owner Name/Address(If different than above) Contact Number ❑Basement ❑1st FI. ❑2nd FI. ❑3rd FI. ❑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 TAT /wi/ Al'w toeX'y I-Pq! /. n/Sctncc>F t 0011t1S r'% h Icrrrc rt kt hci r/ /A OCT 11 202� This application is valid for one(1)year from the date received by SWIS.This application is intended to cover the above listed items to be inspected,if at anytime of inspection additional items have been installed,you are authorized to make the inspection and adjust the fee for the additional items inspected.The applicant declares that there is no open applications for the above address with any other inspection company.The applicant, owner or authorized agent agrees to all the above terms and conditions asset forth for the application. Email Address '' °` ` ` Name License# j y Date Signature Address 7: City/State Zip Code Company „ r Phone # State Wide Inspection Services 1080 Main Street DEC - 3 2024 Fishkill, NY 12524 To U A 845 202-7224 Phone 914-219-1062 Fax STATE WIDE INSPECTION SERVICES Email: office@swisny.com Website: www.swisny.com Service With Integrity BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: Wetlawn, Inc. Rosweny Flores Hidalgo&Jose Poza P. O. Box 732 115 North Ridge Street Armonk, NY 10504 Rye Brook, NY 10573 DO NOT SEND PER ANTHONY RUSSO- Located at: 115 North Ridge Street, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP 24-205 135.67 2 1 Certificate Number: 2024-8411 Building Permit Number: BP 24-104 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: 115 North Ridge Street, Rye Brook, NY 10573 The Basement: Laundry Room was inspected in accordance with the NYS and NFPA 70-2017 and the detail of the installation, as set forth below,was found to be in compliance on the 22"d day of November 2024. Name Quantity Rating Circuit Type Panel 01 100AMP Receptacles 08 Vent Fan Bath 01 Smoke Detectors 05 C/O Smoke Detectors 03 Split HVAC Systems 02 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. _ s s = M N N W - _ °` _ C "o W = a u W M i! ON z 0004 r :i tA W W � u. �■■+ Z a w W enen G iJ = O Z � W ✓� Z � Z x o � Q :� rn .. 010 can = x C w O O "'° U , 00 N N ° v. _ 0 uz z2 x o < Lr F _ Z o � � I , r-+ O w z C o A . p C� L� OMC BUILDING DEPARTMENT SEP - 5 2024 VIU�, E OF RYE BROOK 938 KING, ET RYE BROOK,NY 10573 VILLAGE OF RYE BROOK l!9'=-ow BUILDING DEPARTMENT WWfi Wyebrookny.gov PLUMBING PERMIT /APPLICATION FOR OFFICE USE ONLY BP#: /O I 27 PP#: Approval Date: 1 Z Permit Fee: S Approval Signature: Disapproved: (fees are non-refundable) ************************************************************************************************** DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDING INSPECTOR.THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12%OF TIIE TOTAL COST OF CONSTRUCTION WIT11 A MINIMUM FEE OF$750.00 Application dated, S c is hereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of a Permit to install and/or remove Plumbing as per detailed statement described below.The applicant&property owner,by signing this document agree that said plumbing work will be in conformance with all applicable Federal,State,County and Local Codes. 1.Address: I I S S B°L: 135i i�7 oy Zone: z2 2 2.Proposed Work: 2.Ct1�ior\ . Qsemend 1211xt Sw►�- r SSWey. lavrdNy s\✓ ' 1s"&v uoda� sllariz0&Y u�c�a� key 3.Property Owner:�Z�a -w e n Address: l S N Phone#: (�j _ �, :�S 3 c� Cell#: email: A C 4.Master Plumber: C C_16 �UI A Address: jj(? S ec,r� /F r, L�,/►�5��Cd � \ Lic.#: q A S_ Phone#: fib-2F(1-23 9 Li Cell#: email:TUkCk0V rn)i21t19 I IC 0 Fitt i Company Name: h e S ;nWAddress: Y 0 S e Rr 5 kli- E O-4 6" N 4 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 st Floor 2nd Floor ' 31 Floor � 4'Floor 5's Floor Exterior 5.* List Other Equipment/Provide Details: e Q ec: U9 (1 lsl r 2�` ,r VzAn049 Kr 0' IA Y 4xtsemehk. �„9h laurtk_ ar, ed Signatures Required Next 2 Pages) 6/I/2024 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: ,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 Swom to before me this day of ,20 day of cr ,20 QL SiLtif of Property Owner Signature of Applicant -3 t.�' e Pv -7— G'ara V4-v u I q Print Name of Property Owner Print Name of Applicant Notary IbR GORY M.RIVERA Notary PubligHARI MELILLO me"Public,State of New York Notary Public,State of New York No.01 RI6441398 No.01ME61.60063 Qualified in Westchester County Qualified In Westchester County 7 ompletedExpires September 26,20 Commission Expires January 29,20_ This application must be properly in its entirety and must include the notarized signature(s) of the legal owner(s) of the subject property, and the applicant of record in the spaces provided. Applications not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. -2- 6/I/2024 • p [EC EME BUILDIN660ARTMENT 3D VILLAGE OF RY OOK SEP - 5 2024 938 KING`,bTR`EET RYE BR6,NY 10573 ("4)939-0668` VILLAGE OF RYE BROOK www.ryebrookny.(_yov BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE §216 • STORM SEWERS AND SANITARY SEWERS THIS AFFIDAVIT MUST BEAR THE NOTARIZED SIGNATURE OF THE LEGAL PROPERTY OWNER AND BE SUBMITTED ALONG WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION. ANY BUILDING OR PLUMBING PERMIT APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETURNED TO THE APPLICANT. STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: n I n residing at, (Print namc) (Address%cl rc 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; .y s �u &. S 4- U�-k �r. Yl� /( , Rye Brook,NY. (.lob nddre4s) 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. (Signatur ' mperty 0micr(s)) 0S G (Pant Nano of Property M)"ner(s)) Sworn to before me this day f , 20 _ (Nolan P 1c) GREGORY M.RIVERA Newry Public,State of New York No.01 R16441398 Qualified In Westchester County Commission Expires September 26,204Y 6/1/2024 d N O hd r� m N Ln M N a v Y�I \ N z a �•" Lz. ' ISh i yy 0-0 to ` ve i Lq 91 riri w � F w " '* W Ln � �T ✓ w V w O r:5'o Cc 4° E cc rr ^ V z "� G .C.. O ✓1 CT _ x E = H M oMo W � � a � �� � �e �• � u IS V x � v � .. o 5 i i od _ i EElI c BUILD MENT VIL E OF Ry OOK D E C E � v�%f E 938 KING 'ur RYF,Bit ,NY 10573 1 D OCT 2 4 2024 4 -0 � w Ov VILLAGE OF RYE BROOK BUILDING DEPARTMENT APPLICATION FOR PERMIT TO INSTALL AND/OR REMOVE HEATING, VENTILATION AND/OR AIR CONDITIONING EQUIPMENT FOR OFFICI: USF ONLY: PERMIT#: 9 � .3 L Approval Date: v- 1 Permit Fee: $ Approval Signature: Other: Disapproved: (fees are non-refundable) DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDING INSPECTOR. THE ADMINIS"rRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12% OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00 REQUIREMENTS FOR RELEASE OF PERMIT&CERTIFICATE OF COMPLIANCE: 1. Properly completed& Signed Application. 2. Site/Staging Plan if Required by the Building Inspector. 3. Copy of Licensed Contractor's Liability Insurance. (Village of Rye Brook must be listed as certificate holder)&Workers Compensation Insurance on a NYS Board form(Form#C 105.2 or Form N U26.3/or NY State Workers Compensation Waiver) 4. Payment of Fees/Unit: RESIDENTIAL = $150.00/unit• COMMERCIAL, = $450.00/unit. 5. Complete specifications for each unit being installed. 6. Inspection by the Building Department for removal and/or installation. (48 hour notice required 7. Electrical work requires a separate Electrical Permit&Electrical Inspection. 8. Plumbing/Gas work requires a separate Plumbing Permit&Plumbing Inspection. Application dated. b- is hereby made to the Building Inspector of the Village of Rye Brook for a permit for the installation and or removal of t e HVAC equipment as listed below.The applicant and property owner,by signing this document agrees that said equipment will be installed and/or removed in conformance with all applicable Local,County, State&Federal laws, codes,rules and regulations. 1. Address: J 10f, SBL: �J Jai(O / �d—! Zone:�� 2. Property Owner: O c Address: Phone#: I - _ S 36 Cell#: ���-(�/9-3��d email: �(1►'t^ 3. Contractor: Address: UX Phone#: Cell#: / Iq' �p�� email: ,, %)4e 79�T� 1 C)lv1 4. Scope of Work:New Installation 0•Replacement( )•Removal )•Other( ): 5. 1 r List E uipment: U -vlkrA4s�f? � 6) a-n FSTJ TON) 6. Location of Equi ment: I , v �0 1 U 4 nc)o eA d 7. Method of Installation/Removal(list all equipment needed to perform job): k)dr 00 � t 6/1/2024 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: ,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 Heating,Ventilation and/or Air Conditioning Contractor 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 --k Sworn to before me this day of a ,20�� day of ,20 Zablic operty er 1 e of pplicant I o > k: l Property ame of Applicant Notary Public SHARI MELILLO SHARI MELILLO Notary Public,State of New York Notary Public,State of New York No.01ME6160063 No.01ME6160063 Qualified In Westchester County Qualified In Westchester County Commission Expires January 29,20Z, Comrission Expires January 29,20� This application must be properly completed in its entirety and must include the notarized signature(s) of the legal owner(s) of the subject property. and the applicant of record in the spaces provided. 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. 2 6/1/2024 40 !� f � �K Y O� ,l g y� N7• • d s � .K» Y •.aa�n,w • Y � y 1 t x J Climate 5000 Series Engineering Submittal BOSCH 12K BTU Universal Wall Mounted IDU Sheet Overview and Project Information Project name Location j c 4L w Architect lone n... . Engineer General contractor Reference# 12K Btu Universal Wall Mounted IDU System Data Indoor part number 8733956176 Refrigerant type R410A j r9, DeSigct Electrical Data Fan motor model ZKFP•20-8-6-7 Power supply(V/0/Hz) 208-230/1/60 Fan motor city(ea) 1 Piping I Fan motor input(W) 50 Liquid side(in/mm) 1/4"/06.35 i Fan speed(RPM) 1000/852/778 pf j '¢tt113�7' — 1 Air flow,H/M/L(CFM) 335.29/229.41/176.47 Accessories Approx.Air Throw Range It(m) 4.9(1.5)-31(9.5) BMS-WTI XXC(8733956179) Wired Wall Thermostat Net weight(lb s/kg) 25.57/11.6 BMS k RY XXX j873395 129) 24V Interface Gross weight(Ibs/kg) 30.86/14.0 Standard Parts 8-733-956.822 Remote Control Indoor Unit Dimensions and Connections T— 7 7 i I H I W D Model W(in) D On) H(in) BMS500-AAU012-1AHWXC 33.4 Bosch Thermotechnology Corp. 1 of 1 Londonderry,NH Watertown,MA• Ft.Lauderdale,FL Bosch Thermotechnology Corp.reserves the right to make changes without notice due to continuing engineering and technological advances I BTC 769108353 B 109.2024 Tel: 1.800-283.3787 www.bOSch-homecomfOrt.Us Climate 5000 Series Engineering Submittal ' BOSCH 9K BTU Universal Wall Mounted IDU Sheet Overview and Project Information Project name Location c 4L w Architect Engineer General contractor Reference# • Data Indoor part number 8733956175 Refrigerant type R410A pressure(PSIG) Electrical •, Fan motor model ZKFP 20-8#-6-7 Power supply(V/0/Hz) 208-230/1/60 Fan motor qty(ea) 1 Piping I Fan motor input(W) 50 Liquid side(in/mm) 1/4"/06.35 Fan speed(RPM) 1020/892/828•' '"" "m 0 Air flow,H/M/L(CFM) 335.29/229.41/176.47 Accessories Approx.Air Throw Range ft(m) I 4.9(1.5)-31(9.5) BMS-WT1-XXC(8733956179) Wired Wall Thermostat Net weight(lbs/kg) 25.35/11.5 24V 71' ' Gross weight(lbs/kg) 30.64/13.9 Standard Parts 8-733-956-822 Remote Control DimensionsIndoor Unit ee l •I II hI � I H W D ii Model W(in) D On) H On) -1AHWk Bosch Thermotechnology Corp. 1 of 1 Londonderry,NH Watertown,MA• Ft.Lauderdale,FL Bosch Thermotechnology Corp.reserves the right to make changes without notice due to continuing engineering and technological advances I BTC 769108352 A 106.2023 Tel: 1 866 642 3198 Fax:1 603 965 7581 www.bosch homecomfort.us Climate 5000 Series 36K Btu Multi Zone Max Performance Outdoor Unit - Non Ducted o BOSCH Outdoor Unit Dimensions and Connections _o O H F r E j 0 D C O B I A D B W1 Model W(in) D(in) H(in) WI(in) A(in) 13(in) BMS500-AAM036-1CSXHB 37.5 16.3 52.5 41.1 25.0 15.9 Bosch Thermotechnology Corp. 2 of 2 Londonderry,NH Watertown, MA• Ft. Lauderdale,FL Bosch Thermotechnology Corp.reserves the right to make changes without notice due to continuing engineering and technological advances I BTC 769008135 B 1 11.2020 Tel: 1-866-642-3198 Fax: 1-603-965-7581 www.bosch-thermotechnology.us Climate 5000 Series Engineering 36K BTU Multi Zone Max Performance Submittal I ` BOSCH ' Outdoor Unit - Non Ducted Sheet Overview and Project Information Project Name � Location Architect En` „_ =Ov+ General Contractor ,�....: Intertek - Reference# a, Date 36K Stu Multi Zone Max Performance Outdoor Unit-Non Ducted Indoor model a 8733953094(City 4) Refrigerant precharge(ft/m) 98/30 Indoor model name BMS500-AA0009-IAHWXB(Qty 4) R merge( °, } '" v Outdoor model a 8733953121 Additional charge per It (oz) 0.161 Outdoor model name I BMS500-AAM036-ICSXHB Liquid side(in./mm) 4 x 1/4"/06.35 Performance Data Gas side(in/rum) 3 x 3/8"+ 1 x 1/2" 3 x(D9.52 + 1 x(D12.7 Capacity(Btu/h) 36000 t Input(W) 2667 Max,refrigerant pipe length(ft/m) t 262/80 a4 I ~= Max. length to one IDU (ft/m) 115/35 0 Rated current(A) 11.6 L) Max.height difference between 49/15 EER(Btu/w) 13.5< IDU and ODU(ft/m) SEER(Btu/w) 21.5 Max,height difference between T IDU's(ft/m) 33/10 Capacity(Btu/h) r 36000 System o Input (W) 2777 - ta r` a ro Rated current(A) 12,1 Refrigerant Type R410A COP IW/W) 3.8 Design pressure(PSIG) 550/340 HSPF4 10.5 _Deh 11 umidification (pts hr) _8_A5____ HSPF5 8.5 Fan motorgty(ea) 2Electrical Data a 1 ; Fan motor input I':d) 126.0 Power supply V/0/Hz) 208-230/ 1/60 Fan motor RLA(A) 1,18 Min.Circuit ampacity(A) 35.0 { a Fan motor speed,H/ M/L(RPM) 800/700/600 Max. Fuse (A) 50.0 O Air flow,Max(CFM) 4500 Compressor �. . Noise level,Max (dB(A)) 64.0 Type: Twin-Rotary Net weight(Ibs/kg) 223.8/101.5, Refrigerant oil/oil charge(ml) ESTER OIL VG74/1400 Gross weight(Ibs/kg) 255.1/115.7 Input (W) 30110 _D Minimum a of indoors 2 i o Rated current(RLA/A) 21.00 Maximum#of indoors 4 Operation Cooling(OF/°C) 22-122/ 30-50 F0OO Heating(OF/oC) -22-86/-30-30 m, 1 of 2 Bosch Thermotechnology Corp. Londonderry,NH Watertown,MA• Ft.Lauderdale,FL Bosch Thermotechnology Corp.reserves the right to make changes without notice due to continuing engineering and technological advances I BTC 769008135 B 1 11.2020 Tel: 1-866-642-3198 Fax: 1-603-965-7581 www.bosch-thermotechnology.us JOHNALLEYNE RE BECALL, ENGINEERING SERVICES 158 DRAKE A VENUE-SUITE# 12 NEW ROCHELLE,NY. 10801 Tel. 914-954-9618 Fax:914-459-1187 Steven E. Fews Building Inspector & Fire Inspector Address: 115 N Ridge Rye Brook, NY Applicant:Carlos Sosa Streber, email: css@crossdesign.com Owner:Jose Poza Architect:John Alleyne, email: css@crossdesign.com Date: May 15, 2024 1. No Kitchen. No Kitchen sinks, counter tops, or cabinets. All this must come out. Response: All this was removed 2. No three-fixture bathroom. We will allow only a powder room. Bathroom Sink and toilet. No Shower or Bathtub. Response: Shower was removed 3. Convenience electric outlets and lighting must come out. No outlets on every wall. I circled what must come out. Response: All outlet circled were removed_ 4. No partition wall for an office space, that wall must come out to open up as one big room. Response: This wall was removed. 5. The Egress window in that location is not necessary. The door access is there. Response: All the window maintains the same condition. 6. 1 st floor wall along stairs to 2nd floor must be opened up halfway to add stair railing with spindles Response: This stair was opened. 7. 2nd floor attic level no sink counter tops also. I need the ceiling heights and window egress size for these rooms. Response: The sink countertop was removed, and ceiling high was provided. 8. The plan shows a condenser in the front. Not sure what this is but can't be placed there. Response: The compressor was removed and relocated on rear patio. 9. rear deck to be removed? Is anything replacing it? or just to be grass? Response: Only seed grass with 3'-0"x5'-0" platform. JOHNALLEYNE RE BECALL, ENGINEERING SERVICES 158 DRAKE A VENUE-SUITE#12 NEW ROCHELLE, NY. 10801 Tel. 914-954-9618 Fist- •0/d—dMIIR7 10.He also installed a fence without a permit, needs to file for it. Response: fence file under separate application. 11.Need to know if bedroom egress window meets code at breezeway created bedroom Response: The existing double hung window was replaced with casement egress. 12.Need basement ceiling heights and beam drops on plan. Response: all ceiling high was shown on plan. 13.Must be labeled "Storage Basement" Response: The basement was labeled Storage. Please feel free to contact me if you have any questions or concerns. Sincerely Carlos Sosa Streber. Very Truly Yours. ���� � � . ��\/�� � � �y�x J®- � � � � ^ �� ` \:������� _ . _ \ J p\ \ � a�T�\z \�\\�»-�- 2- �J y/� /\/ � � \���\�/\� .:� \ � _ � � ���{ . § » ° � �\� � � � ��� �� : / \ � . »�«» � .�;< �ƒ ! . �. . , < . . . � . . . � z�_ . : . : ,. �. ,a�� . r . : �2«, � - � - j ,� �, . . (ƒ� �� « � % \ - � � : , ! % . - � ( � » � ��( . , , � � ���j : �\ . § , > ; > _ . � ���} � - i - ' ��\%) ` � ~ � | /^ ' � \ w� \ . _ \ _ \ » � ^ �. �\ . :�� . \ /� � . . k �\< } \ \\ > � .. .. � - :ƒ � ��<� � � ` �\ \, y . . � �: . � c . � � � \� 2 }��. , � :: . > ` �y� � . , . � ! � � . � � . > £ . � � � . .Building Permit Check List&Zonine Analysis Address: 1 t�1 • �h �c Q SBL• Zone:Q Use: Z- Cont.Type: V Other: Submittal Dam 5 Revisions Submittal Dates: Applicant nZ Cx, Nature of Work (_ ' ka�eS * CA- occ R ZBA: P& BOT• Other. NEED OK "50 FEES: /PD w•() S P� ( ( Filing: BP: �S C/O: Flood Plan- Legalization: ( ) (01"APP: Dated otarized:- SBL• —_ Truss LD. Cross Connection: H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening- ) ENVIRO:Long. Short Fees: N/A: ( ) ( ) SITE PLAN:Topo: Site Protection S/W Mgmt.: Tree Plan: Other. ( ) ( ) VEY:Dated Current: Archival• Sealed Unacceptable: (� (V�LANS:Date Stamped Sealed Copies: Electronic Other. License: Workers Comp: Liability Comp.Waiver. Other: ( ) ( ) CODE 753#: Dated N/A: ( ( ) HIGH-VOLTAGE ELECTRICAL:-Plans Permin N/A: Other: LOW-VOLTAGE ELECTRICAL.•Plans: Permit N/A: Other. (� ( ) FIRE ALARM/SMOKE DETECTORS:Plans: Permit H.W.I.C.:_Battery _Other: ( �( ) PLUMBING:Plans: Pemait: Nat.Gas: LP Gas: N/A/: Other. ( ) � ) FIRE SUPPRESSION:Plans: Permit: N/A Other: ( ( ) H.VAC.: Plans: Permit N/A: Other. ( ) ( ) FUEL TANK Plans Permit: Fuel Type: Other. ( ) ( ) 2020 NY State ECCC N/A: Other. ( ) ( ) Final Survey Final Topo: RA/PE Sign-off Letter. As-Built Plans: Other. ( } ( ) BP DENIAL LETTER C/O DENIAL LETIFR. Other. ( ) ( ) Other. ( )ARB m rg.date: approvaL• notes: ( )ZBA mtg.date: approval• notes: ( )PB mrg.dam approvaL• notes: REQUIRED EXL nNG PROPOSED NOTFS APPROVED Arm- 9-ask: ate: FF Frog Front: Sides: Rear. Main Cow. Acm Cow. FL H Sb: Sd.H GFA. Tot. Ft.I o. pmjw. H ' Stories notes: D EcF[ vE =- 5 VILLAGE OF RYE BROOK BUILDING DEPARTMENT West-Nam, Inc. P.O. Box 272 Purdys, New York 10578 Greg Retta 914-539-5208 September 3, 2024 RE: Jose Poza 115 N Ridge Street., Rye Brook, NY 10573 To Whom it May Concern: Please be advised that we will not be contracting with the above for his project. The homeowner Jose Poza has been notified on Friday August 30th that we will no longer be working on his project. Should you have any questions regarding the above please don't hesitate to contact me. Thanks, )00-- Greg Retta VP Laura Petersen From: Steven Fews Sent: Thursday, September 5, 2024 11:28 AM To: Laura Petersen Subject: FW: Cancelation of project 115 N Ridge Street Attachments: Town of Rye Brook -Jose Poza.pdf Expires: Friday,January 3, 2025 12:00 AM Hi Laura, please add this letter to the file. Thank You. Steven E. Fews Building Inspector& Fire Inspector Office (914)939-0668 From: kim@west-nam.com<kim@west-nam.com> Sent:Tuesday,September 3, 2024 7:43 PM To:Steven Fews<sfews@ryebrookny.gov> Cc: 'Maria C. Corrao'<mcorrao@kblaw.com>; 'Christian A.L. Gates' <cgates@kblaw.com>; 'Greg Retta' <gjretta@gmail.com> Subject: Cancelation of project 115 N Ridge Street Hi Steven, please accept the attached letter as notification that West-Nam, Inc. is no longer contracted for the job at Jose Poza 115 N ridge Street Rye Brook, NY 10573. Thanks, Kim West-Nam, Inc. From:Steven Fews<sfews@rvebrooknv.gov> Sent: Friday,August 30, 202411:30 AM To:.kim@west-nam.com Cc: Maria C.Corrao<mcorrao@kblaw.com>; Christian A.L. Gates<cgates@kblaw.com> Subject: RE: Cancelation of project 115 N Good Morning, can you send/attach a short letter on company stationary stating that you are no longer contracting this Job. Include the owner's name and address. Also advised that you have informed the homeowner that he will need to seek a new contractor. Then we will remove your name Thank You. Steven E. Fews Building Inspector& Fire Inspector Office (914)939-0668 i From: kim@west-nam.com<kim@west-nam.com> Sent: Friday,August 30, 2024 11:11 AM To:Steven Fews<sfews@ rye brookny.gov> Subject:Cancelation of project Hi Steve, please let me know what you will need from us to cancel our name on this project. We are informing our insurance company of the cancellation to this project. Thanks, Kim West-Nam, Inc. 2 Affidavit of Exemption to Show Specific Proof of Workers" Compensation Insurance Coverage for a 1, 2, 3 or 4 Family, Owner-occupied Residence "This form cannot he used to waive the workers'compensation rights or obligations of any party.'" Under penalty of perjury, I certify that i am the owner of the 1, '_. 3 or 4 family, owner-occupied residence (including condominiums) listed on the building, permit that I am applying for, and I am not required to rho" specific proof of workers' compensation insurance coverage for such residence because (please check the appropriate box): El I am performing all the work for which the building permit was issued. ❑ I am not hiring,paying or compensating in any way,the individual(s)that is(are)performing all the work for Nk hich the building permit was issued or helping me perform such work. ❑ 1 have a homeowners insurance policy that is currently in effect and covers the property listed on the attached building permit AND am hiring or paying individuals a total of less than 40 hours per week (aggregate hours for all paid individuals on the jobsite) for which the building permit was issued. i also agree to either: ♦ acquire appropriate workers' compensation coverage and provide appropriate proof of that coverage on forms approved by the Chair of the NYS Workers' Compensation Board to the government entity issuing the building permit if 1 need to hire or pay individuals a total of 40 hours or more per week(aggregate hours for all paid individuals on the jobsite)for work indicated on the building permit,or if appropriate. file a C E- 200 exemption form, OR ♦ have the general contractor, performing the work on the 1, 2, 3 or 4 family, owner-occupied residence (including condominiums)listed on the building permit that I am applying for,provide appropriate proof of workers'compensation coverage or proof of exemption from that coverage on forms approved by the Chair of the NYS Workers' Compensation Board to the government entity issuing the building permit if the project takes a total of 40 hours or more per week(aggregate hours for all paid individuals on the jobsite)for work iladicated on the building permit. 3 tore of Homeowner) (Date Signed) C� L. R-) ee, Home Telephone Number (Homeowner's Name Printed) S�w�rn�to h for me this _ day of Property Address that requires the building permit: i� GREGORY K RIVERA r� p v` - Notary Public,State of New Yon 1 No.01 RIW4138a OuapMd in Westchester County -. ComnNssieo Expoft September 26,2� Once notarised,this BP-1 form sers es as an exemption for both porkers'compensation and disabilitN benefits insurance co-,erage. BP-1 (12 08) NY-\k'CB Questions about your Policy? Policy Number: Report a Claim: Lilxrtv Call 1-800-225-8285 H37-221-865516-40 4 5 1-800-2CLAIMS or W%Iutu;a. LibertyMutual.com/Claims $NSURANCE ACTION REQUIRED: PLEASE REVIEW AND KEEP FOR YOUR RECORDS. Policy Declarations Total 12 Month Premium: $2,064.00 LibertyGuarda Deluxe Homeowners Policy Declarations provided and underwritten by Liberty Insurance Corporation (a stock insurance company), Boston, MA. Your discounts and benefits have been applied. Includes local fees and charges where applicable. Insurance Information Named Insured: Jose M Poza Policy Number. H37-221-865516-40 4 5 Rosweny Floreshidalgo Mailing Address: 113 N Ridge St Policy Period: 09/30/2024-09/30/2025 12:01 a.m. Rye Brook NY 10573-2106 standard time at the address of the Named Insured at Insured Location. Insured Location. 115 N Ridge St Declarations Effective:09/30/2024 Port Chester NY 10573-2106 DISCOUNTS AND BENEFITS SECTION Your discounts and benefits have been applied to your total policy premium. Inflation Protection Discount • Recent Home Buyer Discount • New Roof Discount Multi Policy Discount - Auto • Basic Home Safety Coverage Information Standard Policy with HomeProtector Plus "' SECTION I COVERAGES LIMITS PREMIUM A. Dwelling with Expanded Replacement Cost $ 422,600 B. Other Structures on Insured Location $ 42,260 C. Personal Property with Replacement Cost $ 316,950 D. Loss of Use of Insured Location Actual Loss Sustained SECTION II COVERAGES LIMITS PREMIUM E. Personal Liability (each occurrence) $ 300,000 F. Medical Payments to Others (each person) $ 1,000 FMHO 3047 05 16 THIS IS NOT YOUR HOME INSURANCE BILL. YOU WILL BE BILLED SEPARATELY Page 1 of 3 Want to Add a Coverage? Policy Number: Report a Claim: Libc rt)' Call 1-800-225-8285 to talk to H37-221-865516-40 4 5 1-800-2CLAIMS or Mutual. your agent about the availability L ibertyMutual.com/Claims INSURANCE of this coverage and whether it meets your needs. Coverage Information continued POLICY DEDUCTIBLES Losses covered under Section I are subject to a deductible of: $2,500 If losses are a result of Wind they are subject to a deductible of. $2,500 If losses are a result of a Hurricane they are subject to a deductible of 5`%: $21,130 Total Standard Policy with HomeProtector Plus '" $ 2,064 ADDITIONAL COVERAGES DEDUCTIBLE LIMITS PREMIUM Credit Card, Fund Transfer Card, Forgery $ 1 ,000 $ 0 Workers Compensation Coverage INCL Coverage E increased limit INCL Total Additional Coverages S 0 Total 12 Month Policy Premium: $2,064.00 Additional Coverages and Products Available* We've reviewed your policy and have identified additional optional coverages and products that can add valuable protection. Talk to your agent about purchasing the following coverages and products and whether they meet your needs. • Home Computer and Smartphone: If your smartphone or other devices are not insured, repairing or replacing them can be expensive. Did you know you can insure multiple devices for up to $10.000 with a deductible of $50.00? • Identity Fraud Expense: A stolen identity can be scary and expensive. We'll provide counseling, and pay up to $30,000 for expenses such as lost wages and attorney fees incurred to recover your identity. • Water Backup and Sump Pump Overflow: Water damage can ruin your possessions. If your sump pump fails, or you suffer water damage from a sewer or drain backup, we'll pay for covered home and personal property losses. *These optional coverages are subject to policy provisions, limitations, and exclusions. Daily limits or a deductible may apply. For a complete explanation, please consult your agent today. FMHO 3047 05 16 THIS 15 NOT YOUR HOME INSURANCE BILL. YOU WILL BE BILLED SEPARATELY Page 2 of 3 Questions about your Policy? Policy Number: Report a Claim: L>inert-, Call 1-800-225-8285 H37-221-865516-40 4 5 1-800-2CLAIMS or Mutual LibertyMutual.com/Claims INSURANCE Mortgage Information Mortgagee 1 CROSSCOUNTRY MORTGAGE LLC ISAOA LOAN NO 0723894358 PO Box 7729 Springfield, OH 45501 Policy Forms and Endorsements: The following forms and endorsements are applicable to your policy LibertyGuard` Deluxe Homeowner Policy Home Protector Plus (FMHO-2023) (HO 00 03 04 91) Protective Devices (FMHO 4172 1014) Credit Card, Fund Transfer Card, Forgery (HO 04 53 04 91) Amendmt Pol Definitions (FMHO 2934 0720) Special Provisions - New York (FMH06100NY 1117) Workers Compensation Coverage (HO 24 93 05 02) Inflation Protection Endorsement (FMH02835NY 0223) Hurricane Deductible (FMHO 3363 0912) No Covg-Home Daycare Bus (HO 23 43 04 91) NY - Amendatory End (FMHO-2240) Amendatory Seepage End (FMHO-2265) Fuel Storage Exclusion (FMHO 3181 0309) Sexual Molestation Excl (FMHO-949 09/91) Addtl Insured-Res Prem (HO 04 41 04 91) Important Messages Flood Insurance: Your Homeowners policy does not provide coverage for damage caused by flood, even if the flood is caused by a storm surge. Liberty Mutual can help you obtain this coverage through the Federal Emergency Management Agency (FEMA) if your community participates in the National Flood Insurance Program. Please call your representative for more information. Hurricane Deductible: This policy is subject to a hurricane deductible. This deductible is listed with your Standard Policy in the Policy Deductibles section. Please refer to PMKT 999 for further details. Hamid Mirza Damon Hart President Secretary This policy, including endorsements listed above, is countersigned by: flo Parker Koppelman Authorized Representative FMHO 3047 05 16 THIS IS NOT YOUR HOME INSURANCE BILL. YOU WILL BE BILLED SEPARATELY Page 3 of 3 Liberty Mutual. �NEU0AMCE Loss Scenario #1 $5,000 Loss to Dwelling (Coverage A) $1,000 Loss to Detached Garage (Coverage B) $500 Loss to Personal Property (Coverage C) $6,500 Loss Total -$10,000 Deductible $0 Amount we will pay for loss Under this loss scenario, since the $6,500 loss amount is less than the $10,000 Hurricane Deductible amount, we would not pay for any amount of the loss. Loss Scenario #2 $30,000 Loss to Dwelling (Coverage A) $2,000 Loss to Detached Garage (Coverage B) $1,000 Loss to Personal Property (Coverage C) $33,000 Loss Total -$10,000 Deductible $23,000 Amount we will pay for loss Under this loss scenario, since the $33.000 loss amount is greater than the $10,000 Hurricane Deductible amount, we would pay the difference, or $23,000 of the loss. Protecting Your Home From the Hurricane and Windstorm Perils You can take several precautions to help reduce the chance and/or amount of damage by windstorm loss to the interior and exterior of your home and other buildings. Here are just a few items to consider before a hurricane threatens: • In general, four areas of your home should be inspected for weakness - the roof, windows, doors, and garage door(s) • Have composition roof shingles checked and if necessary, reinforce with additional nails or screws to more firmly secure them to the roof sheathing • Install storm shutters over all exposed windows and other glass surfaces • Have a professional reevaluate and strengthen entry and garage doors to withstand hurricane-force winds • Wedge sliding glass doors to prevent their lifting from their tracks • Trim back dead wood from trees • Check for loose rain gutters and down spouts • Secure lawn furniture and other loose material outdoors • Determine where to move your boat in an emergency PMKT 999 09 12 Page 2 of 2 DATE(MM/DD/YYYY) A �-'I CERTIFICATE OF LIABILITY INSURANCE 10/21/2024 TIHIS 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. 1' 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: EICO Commercial Lines Program GEICO Commercial Lines Program PHONE FAX PO Box 6316 A/C,No,Ext: 877 616-2191 A/c No Binghamton NY 13902 E-MAIL ADDRESS: commercialservice@homesite.com INSURERS AFFORDING COVERAGE NAIC# INSURER A: Midvale Indemnity Company 27138 INSURED INSURER B ALPHA OMEGA HVAC MECHANICAL INC 43 Mayfair Way INSURER C White Plains NY 10603 INSURER D: INSURER E INSURER F COVERAGES CERTIFICATE NUMBER:00002272080901 REVISION NUMBER: HIS 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. INSR TYPE OF ADDL SUBR POLICY EFF POLICY EXP LTR INSURANCE INSR WVD POLICY NUMBER MMIDD/YYYY MM/DD/YYYY LIMITS A COMMERCIAL GENERAL LIABILITY P00049697 03/20/2024 03/20/2025 EACH OCCURRENCE $1,000,000 CLAIMS- X DAMAGE TO RENTED MADE OCCUR PREMISES(Ea occurrence) $100.000 MED EXP(Any one person) $5.000 PERSONAL&ADV INJURY $1 000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE 2,000.000 CT X POLICY FI PRO- �OC PRODUCTS-COMP/OP AGG $2.000.000 OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY(Per person) OWNED AUTOS ONLY SCHEDULED AUTOS 30DILY INJURY(Per accident) HIItEDAUTOS NON-OWNED ROPERTY DAMAGE ONLY .AUTOS ONLY Per accident UMBRELLA LIAB UR ACH OCCURRENCE EXCESS LIABHCOLcAc,MS-MADE AGGREGATE DED RETENTION$ ORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECU -TIVE OFFICER/MEMBER EXCLUDED? NIA E.L.EACH ACCIDENT (Mandatory in NH) E L DISEASE-EA If yes,describe under E L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS below L� PROFESSIONAL LIABILITY OCCURRENCE AGGREGATE DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space Is required) He -alm Venting and Air Conditioning Services CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN BUILDING DEPARTMENT VILLAGE OF RYE BROOK ACCORDANCE WITH THE POLICY PROVISIONS. 938 KING STREET AUTHORIZED REPRESENTATIVE RYE BROOK NY 10573 ©1988-2016 ACORD CORPORATION.All rights reserved. ACORD 26(2016/03) The ACORD name and logo are registered marks of ACORD NEW Workers' YORK STATE Compensation CERTIFICATE OF Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1a. Legal Name and address of Insured (use street address only) 1b. Business Telephone Number of Insured ALLAN BROCCOLI (914) 804-4690 43 MAYFAIR WAY WHITE PLAINS NY 10603 1c NYS Unemployment Insurance Employer Registration Number of Insured Work Location of Insured (Only required if coverage is specifically 1d. Federal Employer Identification Number of Insured or limited to certain locations in New York State. i.e. a Wrap-Up Policy) Social Security Number 99-1729031 2. Name and Address of the Entity Requesting Proof of 3a. Name of Insurance Carrier Coverage (Entity Being Listed as the Certificate Holder) Hartford Accident and Indemnity Company Rye Brook Building Department 22357 938 KING ST 3b. Policy Number of Entity Listed in Box 1a": PORT CHESTER NY 10573-1226 76 WEG BF2YVG 3c. Policy effective period: 04/12/2024 to 04/12/2025 3d The Proprietor, Partners or Executive Officers are X] Included. (Only check box if all partners/officers included) all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box "3" insures the business referenced above in box "la" for workers' compensation under the New York State Workers' Compensation Law. (To use this form, New York (NY) must be listed under Item 3A on the INFORMATION PAGE of the workers' compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2". The insurance carrier must notify the above certificate holder and the Workers' Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.) Otherwise, this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent, or until the policy expiration date listed in box "3c", whichever is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Worker's Compensation contract of insurance only while the underlying policy is in effect. Please Note: Upon cancellation of the workers' compensation policy indicated on this form, if the business continues to be named on a permit, license or contract issued by a certificate holder, the business must provide that certificate holder with a new Certificate of Workers' Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers' Compensation Law. Under penalty of perjury, I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Sara Seier (print name of authorized representative or licensed agent of insurance carrier) Approved by: 10/24/2024 (Signature) (Date) Title: Operations Manager Telephone Number of authorized representative or licensed agent of insurance carrier: (866) 467-8730 Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-106.2. Insurance brokers are NOT authorized to issue it. C-106.2 (9-17) Form WC 88 31 21 F Printed in U.S.A. www.wcb.ny.gov Page 1 of 2 r,- 04 O Ea C.J Q � t C4 o M �o 0 T- o O it r _ N N N LL O n n n cO a Jc>>0 LJ Wse r a - (� O Z M > m Q o - b Z _ z Q -ow N V^ ` O W o a_ O m C) A 16O@9 Nw QCO W� 5 W z () o I� � Q T- Q F- t- Z Z W R� V Q 0 e A- _ _ ,!` \-1 L9 �) LO O o � � W z Q J WW `1 � o °� = G� a &D � �&D W Q Q o w 7 I � 41 �1���.,. -- r W F- c� �� 0 o W m � f� "�1 CA� �n Q M@E Q 9 ` l l �' Q � o O O Q O/ (� a ? 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