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Home My WebLink AboutBP24-122PERMIT # Q �cc DAM Q kxp SECTION c� B P,CK Loir TYPE OF WORK r / v/ Q /OD✓LI s7 Ya }OB LOCATION O /I Gv OWNER // , .;). s 03 a9 CONTRACTOF6w eV? !S%S TCO # FEE DATE DATE I NSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION 7 -30 ZDZ`/ AS)QcI PLUMBING 02/00I k 1 1' LO z /� RGH PLUMBING ?` 3O' ZOZ4 AbS eel F�) GAS O SPRINKLER W,( ELECTRIC ICJ S zw% LOW -VOLT CI ALARM LJ AS BUILT CJ FINAL *7C I�P��JSs*C9/y) 906^/9ya� Pl c)'- ©9�j .>� �3 OVER APPROVALS ARB B07 PB `ZBA I OTHER VILLAGE OF RYE BROOK WESTCHESTER COUNTY, NEW YORK NO: 24-154 Certif irate of Occupancy This is to certify that Y000-J-) Par of, Rof 5wkF , having duly filed an application on D!r- ber & 20 requesting a Certificate of Occupancy for the premises known as, 4 7 Eon w INU-n , Rye Brook,NY, located in a i�h Zoning District and shown on the most current Tax Map as Section: lock: Lot: , and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No. — �� , issued � 20-: y 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: R- 3 Construction: , for the following purposes: In y- rlfna► y 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 h ' shall be made,nor shall the building be moved from one location to another until a permit to accomplish such change hWebee- obtnaiorn th uild' Inspector. DEC 1 2 2024 Building Inspector,Village of Rye Brook: Date: BUILDING DEPARTMENT For office use nlv: PERMIT I, VILLAGE OF RYE BROOK ISSUED: —/00_a DEC - 6 2024 938 KING STREET;`,BYE BROOK,`SEW YORK 10573 DATE: FEE: PAID OL n2 I M4 22"1-1101 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 fiiiiftiftitkfffkfik#ftiiittkftiiffiff Ffii#itititiitippfiiif iif i#t#iffkiftittittkkfttiiitii#ifttiiik#kfCf#tiiiiittfitifiiii#iii Address: vJ�'� �-Of� 1� O k ->73 Occupancy/Use: Parcel ID #: �� , y�- — — Zone: /C Owner: �COA Pa�� Address: frvUk t3l koS73 P.E./R.A. or Contractor`=y�?qq ,� �5 �e 2'�\� CAD s 7 S` aa Address: ,�.d -Q Person in responsible charge: CAM Ya� S Address: 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: SMaV C C,,V V, being duly swom,deposes and says that he/she resides at (Print Name of Applicant) (No.and Street) in ,in the County of �S�CQS�2 in the State of that ri�aomi/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:$ \O I for the construction or alteration of:J e-V\k)&e—` O�- MVUCL \06A&—f0?) M 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)*- Sworn to before me this 6 day of ( P �� e �( , 209a day of Q�� b , 20 ZL� Signature rty Signa Ii ant m;a�e olopw,rty Owner Name of Applicant Notary blic SHARI MELILLO Notary Public Notary Public,State of New York SHARI MELILLO No.01ME6160063 Notary Public,State of New York Qualified In Westchester County No.01Mc6160063 Cemmi,�sion Expires J:y)t. y 20.20 Qualified in Westchester County Commission Expires 1-11L I y 29,202— QyE BRC�� O� 2� cu � '9a2 BUILDING DEPARTMENT ❑jBmILDING INSPECTOR YASSISTANT 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 : '-A � L'Q k � � �`( DATE: ` -7 - ? v Z,``1 PERMIT# V Ll , Z,—Z, ISSUED: I�"?`f SECT: B.S. Z BLOCK: LOT: 1 LOCATION: OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING t, ❑ CROSS CONNECTION ' �� L if © FINAL ❑ OTHER �yE BRC�� O�` tim • 1932 BUILDING DEPARTMENT ❑BUILDING INSPECTOR ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : 1 DATE: PERMIT# ISSUED: SECT:8-�- BLOCK: LOT: LOCATION: ��ro (k,�, 4V t o U z'-- 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 fYL, ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER �yE BRC�k• �m 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 - - - - - - - - - - - - - - - - - - - - ADDRESS : Y 2 oAj w ` DATE: PERMIT# JP 2 t I I ?i ISSUED:41 , SECT: 13J9,i' BLOCK: LOT: LOCATION: D'3 r 1 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 ❑ OTHER �yE BRC�k 1932 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.or� - - - - - - - - - - - - - -- - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : `' L U k �� DATE: �= PERMIT# Z �` _ ' ISSUED:- SECT: �'S�L BLOCK: LOT: LOCATION: �A 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 ❑ OTHER a cq N t N w° a ■ cq 94 \ W W _ n Z q P 0 3 ? W W N x AvgLn 14 V^ ✓�j 0, C 0 O O v O ° C*4) 00 '�, O QW ooF .« � z O ©, o4 C co w w W W O V � A Ln ON � � �; w `� M a� w o w W � � � b � a � V ■ V� M � N z C� w c/� �^ o '� D u � � ■ N E-+ O � � x ��00 '� � o � ■ wA °' ; s (� O zCD cn cn O U � �z � U o ?' v 1~ W p H O - z H z O O U O V �o H 0 A z 0 py l > o� � �" A. V1 5 a•— Z op T o = �I a a a w � BUILD \ . MENT VIL 'UF RY OOK 7RF- -0 I.E � 1J 938 KING ET RYE BR ,NY 10573 d � 'G - 1 2024 VILLAGE OF RYE BROOK INTERIOR BUILDING PERMIT APPL1CATH3N 13UILDING DEPARTMENT FOR OFFICE USE ONLY: Approval Date: J UN 1 8 2024 Permit#: Application Fee:$ / Approval Signature: Permit Fees:$ NJ Disapproved: Other: Application dated is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the interior alteration of an existi g building,or for a change in use,asper detailed statement described below.. \ 1. Job Address: _4q C?^!UJ i ! i� SBL: ��i`7 d—�-� Zone: �-/�- 2. Proposed Improvement.(Describe in detail): 0,,frq2oc,1-1 � - /2-em 0I_ Inrl5p 1o2 t/11�1 l l < 1 nS i-�i 1 �t��'►�v i n�i v .�-->�„tJ s ` ✓�lk'T1ilLE-7 3. Does the proposed improvement involve a Home-Occupation as per§250-38 of the Code of the Village of Rye Brook? No:-ZYes: If yes,indicate: TIER I: 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,ANSI,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;(1 fam.,2 fam.,comm.,etc...)Prior to Construction: / .-fi4'1 After Construction: l f.ter 6. N.Y State Construction Classification: N.Y.State Use Classification: 7. Property Owner: �Q�� Address: wv k dY �CY--73 Phone# Cell*9 1-7-2_2S— N32LA 8. Applicant: Address: Phone# Cell# email: 9. Architect: Address: Phone# Cell# email: 10. Engineer: Address: Phone# Cell# email: 11. General Contractor: jlcy� ;��a�p [,Wt L Address: 9.W r r044 Po f-,b 41f U Phone Cell#_ 19 -C(© 14- email: ) L� ��$DCxC Jar t _cot+t1050 12. Estimated cost of construction $ CJ00 10 (NOTE:The estimated cost shall include all labor,material,scaffolding,fixed equipment,professional fees,and material and labor which may be donated gratis.) 13. Job Timetable: Start: Finish: (1) 6/1/2023 BUILDJN I�i� RTMENT VIL .rI E OF RYE'_ ROOK 938 1K1<1vGJT RYE BR66K,NY 10573 fiiQ 4 '7 . l it � 1VU_� AFFIDAVIT OF COMPLIANCE VILLAGE CODE U16 • 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, , residing at, -/k-+ (Print name) (Address where you li e) 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; V'6Q0J, W Ny I Crj , Rye Brook, NY. I 0 (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. (Signi5ereffirOP6 owner(s)) P&(le- (Print Name of Property Owner(s)) Sworn to before me this 5T day of , 2 fl —(. ary 7Fblip) KAT I P. CARPENTIER Not ry i4e,State of dex York g.No.01C'P.5137515 ua;ified in NASSPU County Commission Expires DEC.5.2W_4L� (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 OUNTY OF WESTCHESTER ) as: _ Z1QC>A , _ 1 ,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 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 L141", Sworn to before me this --?AA day o , 24�i__ day of _EUA114_ , 20 12- Signatu p Owner Signat pplic �_�� SIiARI MELI of L C Notary Public,State of New York Q'Itt Name of Property Owner No,01ME6160063 Pr" e of Applicant Qualified In Westchester County Commission Expires January 29,20L Notary Pubhc Notary Public (4) 6/l/2024 r ■ t f N M N � � 0 v ■ � A W r.r V ,� � f LSD., �� t �'' � o vR"i a LSa � w ■ 00 o F-+ ■ V o 00 Ln ° o " W z ' a Q Z x 3G zoo oo z A > O w v �..� 00 (% Z U z � r C z V: M W a M N C O tn 0 w o V C� Al a Q c� °3 '� o � : a g zo f U U a W : w o Z "' W W c7 ■ri O o U O W z C3, 60 z A z a o4 02 0 � �yE. [3 RC) BUILB�I d 1�E RT;MENT E C EW E VILE OF RYE VBOOK 938 KIN ` ET RYE B NY 105 FN 4 2024 nv.gov — VILLAGE l F IRY!F ?PC OK ELECTRICAL PERMIT APPLIC TWKDl1,-'G DEPAf<-1-Vi L'N iT. Westchester County Master Electricians License Required FOR OFFICE USE ONLY BP — c�- EP#: c—�" � '�—� J Approval Date: Permit Fee: $ /C 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$750.00 Application datedZJ,4 Q Z % 20ZI{ is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install and/or remove electrical equipment,wiring, fixtures, or to perform other high or low voltage electrical work as per the detailed statement described below. By signing this document, the applicant & property owner agree that all electrical work performed will be in conformance with all applicable Federal,State,County and Local Codes. 1.Address: 477 %0(VQ6\} �.� �� try V0SXS SBL:/3,5-/71, 3--/`7 Zone:All v- �- 2.Property Owner: 5`Y (A" �D�J Address: 1 �/VI�Jc� N I I 3 Phone#: 2-61 Cell#: S(jV4- email:4-4$O 4)\T jP AV1A&A I. UW 3.Master Electrician/Licensed Installer: Address: 4w.0- a v/ 6751,/)i Lic.#: Q(`7 Phone#: q l y-, S 6 -o oy6ell#: email: 0-4op j a d e c is 2a,&Cm ad.c4 w Company Name: �)Jaaj�d Address: 4.Proposed Electrical Work/Fixture Count: r1h it kl l d, �v/�. ; ,� d irl l ec rp 4c, e% 5.3rd Party Electrical Inspection Agency: �'V Q t z W j d e .7f9 5 Q F c t i-e n STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: Q�P_4-O , 0 i'o ,being duly swom,deposes and states that he/she is the applicant above named,and does further (print a of indrvid al si ning as the applicant) state that(s)he is the Me—no "a for the legal owner and is duly authorized to make and file this application. (haste lectrician�censed 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 to before me this Sworn to before me this day S 20 2-LA day of ,?0n gO ,20� Si of Pr erty Owner Signatur of Appli nt CINo4X/1 Y �� Q►e�o l�oia Names of Prop�L Own Print N e of Applic t EELL 'IDA DA EIRA li St Notary Public-State of New York Zp Zy Notary RubWOE6160063 No.01DA6135830 Notary tc Qualified In Westchester County Qualified in Westchester County Commission Expires January 29,20Z� My Commission Expires 10/24/2025 6/1/2024 STATE WIDE INSPECTION SERVICES, INC.! Service Willi InlegrilY 0•• • • SWIS JOB APPLICATION •2.7224 1 fax 914.219.1062 1 SWISNY.coml SWISTRAINING.COM Office Use Elect. Permit# p l L/ /3 Date / r� " Bldg Permit# Ply—/ Scl Ft Plumbing Permit# Final Certificate# City/Village Zip j;el� Z Building Dept. CountyVe Address Cross Street Section Block Lot Owner Name/Address(If different than above) ri { Contact Number q ' ❑Basement ❑ 1st Fl. ❑2nd Fl. ❑3rd Fl. ❑More Than 3 Fl. ❑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 J 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 ]unction Box Combiner Box Load Center PV Monitor Energy Storage System DC Disconnect ❑Legalization ❑ Safety Inspection ❑Consultation a�? f , R �u-}h��vr'I «�hoveT lvh i l ch � f�Cf'J�/C� ;�►�h� I/d�ni�y ��.1 ofrl� 6<.� r��Cja�e�/� IE C [E �Y IE DD JUN 2 4 2024 VILLAGE OF RYE BROOK BUILDING DEPARTMENT This application is valid for one(1)year from the date received by SWIS.This application is intended to cover the above listed items to be inspected,if at 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 1 .Q ze% r(r'C �/�4 �_ /y/ Name License# QD Date Signature Address ` City/State ^ ) Zip Code Company P22 - / � L L'/'- Phone# �/ -— /- e-� State Wide Inspection Services 6�- � 1080 Main Street i DEC — 5 2�24 0 �- Fishkill, NY 12524 a 845 202-7224 Phone ------� •-----•�-�-•� 914-219-1062 Fax STATE WIDE INSPECTION SERVICES VILLAGE 0IF I�`: :_. 3)Fi00K Email: officeCcbswisny.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: D Tapia Electric, LLC Sooah Park 37 Stone Avenue 47 Bonwit Road Ossining, NY 10562 Rye Brook, NY 10573 Located at: 47 Bonwit Road, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP 24-132 135.42 1 7 Certificate Number: 2024-8599 Building Permit Number: BP-24-122 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: 47 Bonwit Road, Rye Brook, NY 10573 The Second Floor: Bathroom 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 5tn day of December 2024. Name Quantity Rating Circuit Type Receptacles 02 GFCI 01 Luminaires 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. � � N � ►a i W ,.. d' 00 0 v cn a .► v �t N Z 7 w F w a Z a - at CQ ALO Q x Lei W a H a o / A ngo I. 4: UO � r w o o R. z u z �, v � '•�`� z Y V ~ o Z A N Wz W = M 'i w cn a Cn _ zr M� a.0 U a W � F' u `n a a� 8 g W (Aw `�' o Z z � +� - Z Ln o v� V a a (04- x z w z A o � F" A o W A w � + a a � w x � $� IIIi$JIIII � llllll�r �rllfiJifiJlfi�QNIi BR BUIL E MENT vu. E o» OK JU 0 2024 = 938 KIN T`; ,NY 10573 VILLAGE CF .RYL I3ROO'K BUILDING C)EPt`RT!v1E_i�T or PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP#: 'y— �- PP#: ,4— 0 9 ' Approval Date: Permit Fee: $ Approval Signature: Other: Disapproved: (fees are non-refundable) ************************************************************************************************** Application dated, May 30,2024 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 1.Address: 47 Bonwit Road,Rye Brook NY 10573 SBL: ls�T, �s)7 /—_7 Zone: 2.Proposed Work:_ Bathroom Remodel,replacing fixtures. 3.Property Owner: Sooah Park Address: 47 Bonwit Road,Rye Brook,NY 10573 Phone#: Cell#: +1(917)225-0329 email: 47bornvftfgmail.com 4.Master Plumber: Eduardo G.Mendez Address: 25 Hawkes Ave,Ossining NY 10562 Lic.#: 1666 Phone#: Cell#: +1(914)640-0536 email: essentialpiumbing.heating@gmail.com Company Name: Essential Plumbing&Heating Services LLC Address: 25 Hawkes Ave,Ossining NY 10562 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 1st Floor 2nd Floor 1 1 1 31 Floor 41 Floor Y'Floor Exterior 5.* List Other Equipment/Provide Details: Second floor,bathroom remodel replacing fixtures as a toilet bath tub and vanity sink MOST likely is fixtures replacement (Notarized Signatures Required Next 2 Pages) -t- 3/3/2023 STATE OF NEW YOM COUNTY OF WESTCHESTER ) as: Eduardo G.Mendez ,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 Sworn to efore me this o Z day of 120 c o o day o" 20; 7• m f— N ULO / U) in Cl Signature of Property Owner Z C o Signature of pplicant a l Sooah Park o o Eduardo G.Mendez Print Name of Property Owner Z a U Print Name of Appli Notary Public o Public STATE OF NEW YAK COUNTY OF WESTCHEST SWORN BEFORE ME O This application must be properly completed in its entirety and must include the notarized s nat&e(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- 3/3/2023 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: Eduardo G.Mendez ,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 21 S, Sworn to before me this day of Mau 20 2_L4_ day of ,20 Sign of P I,Aperty Owner Signature of Applicant Sooah Park Eduardo G.Mendez Print Name f operty Owner Print Name of Applicant JNo b c Notary Public KATH E P.CARPENTIER Nota, ublic,State of New York Reg.No.01CA6137915 Qualified in NASSAU County Commission Expires DEC.5,20L5 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. 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- 3/32023 BUILDING DEPAR MENT D E �V/ E� VILLAGE OF RYE BOOK �- 938 KING STREET RYE BROOK,NY 10573 I J U N 10 2024 (93,4)9 _ ------- VILLAGE OF RYE BROOK vo 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: Sooah Park ,residing at, 47 Bonwit Road,Rye Brook,NY 10573 (Print name) (.Address x\here ou 1i%e) 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; 47 Bonwit Road,Rye Brook,NY 10573 ,Rye Brook,NY. (R)b:Aua;,> i 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. Q)�- (S w,n t ro rh Owiensj) Sooah Park (Print Name oti Property ONk ner(s) Sworn to before me this 1 5 day of ,207-14 _ HERI P. CARPENTIER Notary b;io,State of New York g.No.01CP6137915 alified in NASSAU County _ Commission Expires DEC.5,20 A� 3 8/12/2021 Budding_P t Check LutLuc&�Zonin�Analyse AddressSBL I IS� . i_� I � Zone i'y V-2- use: t U Conic.Type: �Other. Subrrnttal Daces Z Revucoru Subrruttal I)atn: Applicant: Q r Nauire of Work. \ Rmcws 22 A:SON 1 4 2024 PB BOT: Other. N UD ( ( ) •Filing"^'_ 1HP:�" I /C) Flood Plane: Legah=on: ( ) ( APP: Dated Truss I.D. Cross Conneenon 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. ( ) SURVEY: Dated: Current Archival• Sealed Unaceeptab(c (-J DEWS:Darr Stamped Sealed: Copies: Electronic Other. License Workers Comp: Lability. Comp. Waiver. Other. ( O CODE 753#: Dated N/A: HIGH-VOLTAGE ELECTRICAL Plans: Permit N/A: Other ( ( ) LOW-VOLTAGE ELECTRICAL Plans: Pmmr N/A: Other. FIRE ALARM/SMOKE DG I EM-ORS: Platte: PcnTut H.W.I C.: Battery::) Other: ( ( ) PLUMBING:Plana Permit Nat.Gas: LP Gas: N/A/ Other. ( ( ) FIRE SUPPRESSION:Plans: Permit N/A: Other. ( ( ) FLV.A.C.: Plans: Pemut N/A Other. ( ( ) FUEL TANK;Plans: Pcm= Fucl']'ype: Other. ( ( ) 2020 NY Slue ECCC N/A: Other. ( ( ) Final Survey Final Topo: RA/PE Sign-off L-ettcz As-Built Plans: Other. ( ) BP DaN-IAL II:I`IT: C/O DITIIAL I-E I"I-ER Other. O Other: ( ;ARB mtg.dace approval;- notes: ( )ZBA rnr&dace: approval;- notes: ( )PB mtg.date: approval;- notes: REQUIRED EXISTING PROPO0.SED NO"Il ti Area. F I':ocu Emm- Sees: - Main Cor. Ac u Cov- Ft.H/Sb: - - Sd.H Tct-irrr : ---- i Fes: P HcIght/Stones — notes: f1•f1 K 1111 i !4f ,4(t!)> - ;��-4 /.fir!' '�• .. :i�ltir�- 'jii�ii* = ,ih�ii�-: : 1{i y $ .,�If111;�F a �' 'ill�/1i; v. �:..,, , LO cc CN ,r tt v C 0 C U VCO L Q H Lo •�I Q � O �,•1 ice. V] i.FS�:� z ^ a h f J ;� i section Ai «o», 41 C�1 i�l Q z Q ' LLJLLJ LLJ - z l tiL ^ o z y n yi O � r �a?�In \ LU v O 'C y ^u Q r� o cn � y y v .-•a � �ti j Ilk f Os `M � w� -Al veil, Tal MR. iloy Y) 70ATE(MMIDDM'YY) ACOR" CERTIFICATE OF LIABILITY INSURANCE �i 5/10/2024 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 Nicole Pressler NAME: PF Northeast Brokerage Inc PHONE (845)223 8107 FAX (845)227-8816 A/C No E t: A/C,No 1035 Route 82 E-MAIL n ressler fnortheast.co ADDRESS: p @p m INSURER(S)AFFORDING COVERAGE NAIC# Hopewell Junction NY 12533 INSURER A: Selective Insurance Company of South Carolina 19259 INSURED INSURER B: Merchants Mutual Insurance Company 23329 STEVE DISISTO GENERAL CONTRACTORS INC INSURER C: Utica National Assurance Company 10687 2117 CROMPOND RD INSURER D: Hartford Life Ins.Co. SUITE 25 INSURER E: CORTLANDT MANOR NY 10567 INSURER F: COVERAGES CERTIFICATE NUMBER: CL23102515229 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. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY) (MM/DD LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTEU CLAIMS-MADE �OCCUR PREMISES Ea occurrence $ 500,000 X Contractual Liability MED EXP(Any one person) $ 15,000 A S 2290554 10/09/2023 10/09/2024 PERSONALBADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 JEa LOC PRODUCTS-COMP/OPAGG $ 2,000,000 POLICY IX-1 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED CAP1076829 09/23/2023 09/23/2024 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED H NON-OWNED PROPERTYDAMAGE $ AUTOS ONLY AUTOS ONLY Per accdent X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS-MADE S 2290554 10/09/2023 10/09/2024 AGGREGATE $ 5,000,000 DED I X1 RETENTION$ 10,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN N 500,000 C ANY PROPRIETOR/PARTNER/EXECUTIVE NIA 4595927 11/14/2023 11/14/2024 E.L.EACH ACCIDENT $ OFFICER/MEMBMEMBER EXCLUDED? FYI (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ NYS Disability D LNY630941 03/11/2009 01/01/2025 Per Statute DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Provided it is required by written contract the following would be covered as an additional insured per endorsment CG 7300NY,to the extent provided therein:Village of Rye Brook. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Village of Rye Brook ACCORDANCE WITH THE POLICY PROVISIONS. 938 King Street AUTHORIZED REPRESENTATIVE Rye Brook NY 10573 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD STATE OF NEW YORK WORKERS' COMPENSATION BOARD CERTIFICATE OF NYS WORKERS' COMPENSATION INSURANCE COVERAGE la.Legal Name& Address of Insured(Use street address only) lb.Business Telephone Number of Insured Steve DiSisto General Contractors Inc 914-906-1948 2153 Albany Post Road Montrose NY 10548 lc.NYS Unemployment Insurance Employer Registration Number of Insured Id. Federal Employer Identification Number of Insured Work Location of Insured (Only required if coverage is or Social Security Number specifically limited to certain locations in New York State, i.e., a Wrap-Up Policy) 04-3667969 2.Name and Address of the Entity Requesting Proof of 3a. Name of Insurance Carrier Coverage(Entity Being Listed as the Certificate Holder) Utica National Insurance Company Village of Rye Brook 3b.Policy Number of entity listed in box"la" 938 King Street 4595927 Rye Brook,NY 10573 c. Policy effective period 11/14/2023 to 11/14/2024 3d. The Proprietor,Partners or Executive Officers are ❑ included. (Only check box if all partners/officers included) X all excluded or certainpartners/officers excluded. This certifies that the insurance carrier indicated above in box "T' 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"T'. The Insurance Carrier will also notify the above certificate holder 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. Please Note: Upon the 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: Joseph Pires (Print name of authorized representative or licensed agent of insurance carrier) Approved by: 1 �� 5/10/2024 (Signature) (Date) Title: President Telephone Number of authorized representative or licensed agent of insurance carrier:_845.223.8107 Please Note. Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insurance brokers are NOT authorized to issue it. C-105.2(9-07) www.wcb.state.ny.us