Loading...
HomeMy WebLinkAboutBP24-167PERMif SECTION 13, Si 7, TYPE OF WORK �1—! 10Is LOCATION OWNERW� CONTRACTOR(10,/'�q EST. COST \/CO #.K, TCO # FOOTING FOUNDATION FRAMING RGH FRAMING DAM BLOC LOT, ZD 7r D /�P�OI/C2 o,S �P;re4"IS c� r/�is a,,? CQ1wrion (2/4)7,ao-&39(o FEEZ / , U �% 6 _ FEES c75166 DATE _ FEE DATE INSULATION PLUMBING RGH PLUMBING GAS m SPRINKLER ELECTRIC LOW -VOLT O ALARM O AS QUILT [� FINAL rz - OTHER APPROVALS ARB BOT PB ZBA OTHER VILLAGI+ )DF RYE BROOK WESTCHESTER COUNTY, NEW YORK No: 2 i-U4 1 Certificate of ®ccupaurp This is to certify that /A2// 14ulbet--1 of, having duly filed an application on 1fPhyUQf'a C26. 20c--22,i requesting a Certificate of Occupancy for the premises known as, Alng rly'c-le I Rye Brook, NY, located in a1 Zoning District and shown on the most current Tax Map as Section: / 53 . / Block: C>?, Lot: and having fully complied with the requirementss of the Building Code and the Zoning Ordinance under Building Permit No. , issued CJ( 2024/ , 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: 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 heigig4all be made,,jWr shall the building be moved from one location to another until a permit to accomplish such change ha een bta' a Building Inspector. Building Inspector, Village of Rye Brook: Date: MAR 18 2025 R E C E �7[E R For office use onl DD I BUILD - NT PERMIT# &p 7 FEB 2 0 2025 VIL OF RYE OK ISSUED: 7—,),S--BSI 38 KING STRE YE BROOK,/ YORK 10573 DATE: Q— aO—aS7 VILLAGE OF RYE BROOK 9 -Ob Oc FEE:4,) 7S__ PAIDW BUILDING DEPARTMENT w ov APPLICATION FOR CERTIFICATE OF OCCUPANCY,CERTIFICATE OF COMPLIANCE.) AND CERTIFICATION OF FINAL COSTS TO BE SUBMITTED ONLY UPON COMPLETION OF ALL WORK, AND PRIOR TO THE FINAL INSPECTION fitttiftfi ttttif i#i i4titi fiiifiii4tiftifff#itfifi iifitifif if#i####ii##i#fift#itf##tiiffiif###*##*#**##*#****#######*##**#**## Address: Occupancy/Use: /Lf Parcel ID#: 13 5, 7 S a — (c 7, Zone: Owner: Or- GTjG Address: �/��+/�,ZG��' ,G�olsti�l. P.E./R.A.or Contractor: L PA1 _tieAddress: Person in responsible charge: 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: STAT P OF NEW OR�K,COUNTY OF WESTCHESTER as: being duly swom,deposes and says that he/she resides at (Pr' ame of Applicant) (No.and Street)Z' ,/� in ` _� �/&me_ ,in the County of GCJ f7 ' �� in the State of�that f (CityMwn/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:S fy 00 , for the construction or aheration of: Deponent further states that he/she has examined the approved plans of the structure/work herein referred to for which a Certificate of Occupancy/Compliance is sought,and that to the best of his/her knowledge and belief,the structure/work has been erected/completed in accordance with the approved plans and any amendments thereto except in so far as variations therefore have been legally authorized,and as erected/completed complies with the laws governing building construction.Deponent further understands that it shall be unlawful for an owner to use or permit the use of any building or premises or part thereof hereafter created,erected,changed,converted or enlarged,wholly or partly,in its use or structure until a Certificate of Occupancy or Certificate of Compliance shall have been duly issued by the Building Inspector as per§250-10.A.of the Code of the Village of Rye Brook. Sworn to before me this "q C) Sworn to before me this • day of Ee �&rt- , 20 �� day of ,20 4&-) o'tgw , Signature of roperty Owner Signature of Applicant pl t N ie of P perty Owner Print Name of Applicant Notary Public Notary Public SHARI MEULLO Notary Public,State of New York 6/1/2024 No.01ME6160063 Qualified In Westchester County Commission Expires January 29,0j, _ ( QyE BRC��. • 1932 BUILDING DEPARTMENT ❑BUILDING INSPECTOR 1-1 fl 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.orQ - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : Z A AV..i'_3 � "+Z DATE: -3 - Z 2 - PERMIT# LAC �,�') - 1 �� ISSUED:] Z.S-L'1 SECT: A- 67 X BLOCK:Z LOT: 6 7./ LOCATION: -T^ i`.: OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... 2-'-ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION I ❑ NATURAL GAS s ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION �] ..FINAL npi ❑ OTHER �yE BRC�� O� 2� cu � 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 : S 2 A ! , V Q^-) "" rC (.D DATE: G Z tR— 2U2-7 PERMIT# - 1-1% ! ISSUED: ECT: BLOCK: LOT: / LOCATION: J �`+ —�'t� ��^,__� OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED Ef 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 �E BRC��. cu � 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 : �L/ A V0-j C [ or Lk DATE: � U L PERMIT# w ! I -,/ ISSUED: SECT: BLOCK: 2 LOT: / LOCATION: _+c L"'_ 4 IY6 7-)14 U OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... Cl ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION i ❑ NATURAL GAS ( ❑ L.P. GAS T" ❑ FUEL TANK �- _ U ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER �E f3RC�� .FOOT '9a2 BUILDING DEPARTMENT ❑BUILDING INSPECTOR .ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www.ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - -- - - - - - - - - - - - ADDRESS : S.7 A / 7 V On ) DATE: 1 - 2,5 PERMIT# ? vLA 1 ,-I 3 ISSUED: SECT: /3,Y 7 BLOCK:_ LOT: l LOCATION: � Ir�� �c 6 ) a FCC -1 JV,- �( i j 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 GASf-- ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER e s 1 N v i L Ln W s f V Ln N N � W w O w as ve L - = 94 O. is Sy • L w cn F-4 oy CJ o X v (L4 V to W a -Q v v � w tv0 m n -cs {Ch � © ooQC � g O a g •0 C CA O - h■y uj b Walk ° .� 0 o Ow� cnO - W U q -0 U z 0 N ' o O .n chi V F—� p WICI i M oo .� W W cn 0 -o a 0 - 00 ~ 1 M CM U R' z acn y 6 © ' _ z z ' p4 o ^W hl ai I�-4 ■ ram- O p io- li py p9 � O " a? �o L BUILDING DEPARTMENT [ECIEVIED VILL, E OF RYE"OOK JUL , 7 Z�2 938 KING$r1tEE'r RYE BRlti g ,NY 10573 �` 14 -p6ov VILLAGE OF RYE BROOK BUILDING DEPARTMENT INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: [� �f Approval Date: e i t#: �/ : / —1& + Application Fee:$ -L�12Approval Signature: Permit Fees: $ Cj Disapproved: Other: i��] Application dated:' I 1 is hereby made to the Building Inspectorof the Village of Rye Brook,NY,for the issuance ofa Permit for the interior alterationexisting building,or for a change in use,as per detailed statement described below. 1. Job Address: j�Z DA✓ U n ' +sAITI : /3 5r 7,5 f.)'t07,1 Zone: 2. Pro osed Improvement.(Describe in detail): dy�f � //� i /y�si fit✓'"'/W/1 I / � i✓> I(J f,Cll.�t✓dt �Gto,L i�jt/ p avT v�GS /� S 3. Does the proposed improvement involve a Home-Occupation as per§250-38 of the Code of the Village of Rye Brook? Nix Yes: 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,ANSL System,FM-200 System,Type I Hood,etc...) :No: Yes: (If yes,please submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans) 5. Occupancy;(1 fam.,2 fam.,comm.,etc...)Prior to Construction: G0*0;04T After Construction: 4W.0 G b. N.Y State Construecttioo Classification: / N.Y. State Use Classification: 7. Property Owner:/�/T.�i�7�/`/io • /'�S�*lL Address: Z &4*✓ 41✓✓1-adr Phone# !�y�_7��r 74f ell# email lwwwl Gd4W1& 8. Applicant: Address: Phone# Cell# email: 9. Architect: 1Vd 1✓oe- Address: Phone# Cell# email: 10. Engineer: Address: Phone# Cell# ail:ow 11. General Contractor: /Zd '� A/ddress: D�✓ /�`'� Phone#9/y 76�" u/f ' Cell# �� zI��-le3�/pG email: ' X 12. Estimated cost of construction $_ I�C�� — ywht , (NOTE:The estimated cost shall include all labor,mattfrial,scaffolding,fixed equipment,professional fees,and material and labor which may be donate gratis.) r+ 13. Job Timetable: Start: 5 Finish: `�►'J� � (I) 6n/202a BUILD EVAR MENT JUL 1 7 2024 VIL E OF RY OOK 938 KING ET RYE BR -c,1�1Y 10573 VILLAGE OF RYE BROOK �I4)939-0"1 ) EW LDiNG DEPARTMENT www.ryebrookny.i!ov 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: I, G ,residing at, 57// Print namc) (Address where you lice) being duly sworn, deposes and stapes 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, Rye Brook,NY. (.lob Addre 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. (Signnture of Pro rty Owner(s)) (45r4t Name of Prc criv Owner(s)) �1 Sworn to before me this day of /� , 2 ( Mary Ohre) ,IAYNE IAROSSI Notary Public,State of New Yak No 01IA6122415 Qualified in Westchester County (2) Tetra ExD'e. �C 6/i/2024 This form must be properly completed&notarized by the Design Professional of record and the Property Owner. Failure to provide this completed form with your permit application will delay the permitting process. Notice of Utilization of Truss Type, Pre-Engineered Wood, or Timber Frame Construction. (Title 19 Part 1264& 1265 NYCRR) To:The Building Inspector of the Village Hof Rye Brook. AW Vi From: �'"T/� " Subject Property: 01 _4"-V A0e SBL: Zone: Please take notice that the subject; ❑ One or Two Family; ❑Commercial, ❑ New Structure ❑ Addition to an Existing Structure rehabilitation to an Existing Structure to be constructed or performed at the subject property will utilize; FD ., EME ❑ Truss Type Construction(TT) ❑ Pre-Engineered Wood Construction(PW) JUL 17 2024 ❑ T mb�r Construction(TC) in thev`f/ollowing Ivcation(s); VILLAGE OF RYE BROOK BUILDING DEPARTMENT ❑ Floor Framing, including Girders& Beams(F) ❑ Roof Framing(R) ❑ Floor Framing and Roof Framing(FR) /V/14 Plea a note that prior to the issuance of the Certificate of Occupancy, the subject dwelling or building utilizing truss type, pre-engineered wood, or timber construction must be posted with a Truss Identification Sign, installed in conformance with NYCRR §1264 for Commercial Buildings, and NYCRR§1265 for One&Two Family Dwellings. Sworn to before me this f Sworn to before me this day o 2 day of 20 Signature of Prope Owner Signature of Design Professional L Print Nar f Property..Ow Print Name of Design Professional (�Xotaryoflubfic Notary Public JAYNE IAROSSI Notary Public,State of N"York No.Ol IA6122415 Qualified in Westchester Coin (3) Term ExDirec�r-..',,iary 7 c9�s' 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. �STT4TE OF NEW yOR�COUNT OF WESTCHESTER ) as: fir ,being duly sworn,deposes and states that he/she is the applicant above named, (printname fin idua]sig applicant) and further states the (s)he is the legal owner of the property to which this application pertains, or that (s)he is the _ J _ 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 Sworn to before me this f� day of 201 day of V/e4 20 Signature Property Owner Signature of A 1 is nt Print Name Af roperty Owner Print Name of icant ry Pub c L>1diary Public JAYNE IAROSSI Notary Public,State of New York No.011A6122415 QualMed in Westchester County Term Exrtires cp nary (4) 611/2024 • ���'iil�� �il�'r�il�il�ii�il���'I�il����' �` � ''�'il���il�������il�il��i�I�ii�'����ii�il�ii i �i N i ^N N N a = x c ti ::] � M f U •r, v tc oz v; N o = r R C _ _ W 4i s 46 Ci x V W C ES' o � fws� �J z _ \ t� V I z x J y U CR C w H y s .-r W z 7 x N = C r V W z G z ° ' N Z CA H Z oa W 0. Z w Q . cr w a, �, xcr z 4 Q;I Go c� i m w 4 ' �:� �� �i�a��l��►�+�I��i��ir���+���I�I�I��I�I���+�I�I���I�I��i���I��I�"r = --BR -- BuIL MENT D E C E N C V E OF RYE K 938 KIN ET RYE B ,NY 10573 SEP 10 2024 I VILLAGE OF RYE BROOK ' BUILDING DEPARTMENT ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required ,Q FOR OFFICE USE ONLY BP#: � ( — EP#: 02- --1 `� 4 Approval Date: SEP 1 1 Permit Fee: $ /C-) Approval Signature: Other: DO NOT START WORK or CONSTRUCTION UNTIL A PERMff 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$750.00 Application dated,t�•`ZO.2O'Z is hereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of a Permit to install and/or remove electrical equipment,wiring, fixtures,or to perform other high or low voltage electrical work as per the detailed statement described below. By signing this document, the applicant & property owner agree that all electrical work performed will be in'coponformance with all applicable Federal,State,County and Local Codes. 1.Address:, W vo�'1 GCI II ff2 SBL:�.3J�, 7J c�-�,Z � Zone: 2.Property Owner: ok CG�l 0 CA 6 GLC Address:4f6 r-601 t 1MOC e- r0c• %rA tci Sa'4 µ`j 1 o�5Z$ Phone#:CAI q Cell#:q1 4-J9-, "4'0 6`4" email: 3.Master Electrician/Licensed Installer: vt�CP.u/ 14C aj Address: 1��t�tlr9rw �qhC � 5 Lic.#: �'�- Phone#: Cell#:`�N" 7`->`'��l email:)ors 1 i't. q r9 cs(2o;� Company Name:plk l�t 0LA*i 0 5 e C c -i Address:'a s J11t5vtd S 1 cst�t L (}�✓nn e �,�i,✓t S `! 4.Proposed)Electrical Work/Fixture Count: , t � l9�CAY1 5.3'Party Electrical Inspection Agency: W 1 S ' 1 STATE `OF NEW YORK,COUNTY OF WESTCHESTER ) as: tAA" i Q a eA�T being duly swom,deposes and states that he/she is the applicant above named,and does further (print name of individu lgnin as the apt) state that(s)he is the ✓1C-1) �_&� for the legal owner and is drily 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, a Bode of the Village of Rye Brook and all other applicable laws,ordinances,and regulations. Sworn to ore this I l }^j Swom to before this-/D day of 20 Joseph Cinicolo day of r, 20_ Cr' Notary Public, State of New York Signa of Property Owner Reg. n 01 Westchester C Signature of Applicant Qualified in Westchester County gn PP q'�* vu% LoInmission Expires August 5, 2028 A,idre�- S(r c t ame of pe ROSEMARIE J MOGAVERO Print a of pp li ant e of New York 023476 in Westchester County Notary li Pub ' MY Cc fission Expires Feb 7. 2026 d 6/1/2024 STATE WIDE INSPECTION SERVICES, INC. 0:0 OFFICE(a)SWISNY.CONI swis JOB APPLICATION tel 845.202.7224 1 fax 914.219.1062 1 SWISNYcoml SWISTRAINING.COM Office Use Elect. Permit# L� Date rf.e-) t Bldg Permit# C/ Sq Ft Plumbing Permit# Final Certificate# City/Village G- t Zip Building Dept. County -- Address C I Cross Street Section Block Tot -0�;- P Owner Nam Address(If different than above) Contact Number ❑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 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 LSEP 10 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 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 as set forth for the application. Email Address ✓ ? C� / t. F� /Ei t t t Name ) , License# ii Date Signature �f Address t �L �, �`c 1 ` F `✓, + 4 City/State Zip Code r` ` Company l i `A c ( C Phone# f D C IEN E ID ' State Wide Inspection Services 1080 Main Street JAN 2 1 2025 Fishkill, NY 12524 I845 202-7224 Phone as VILLAGE OF RYE BROOK 914e(1)sw ny. Fax STATE WIDE INSPECTION SERVICES Email: officeCc�swisny.com BUII-DING DEPARTMFNT__, 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: White Plains Electric Harry Hulbert 139 Haviland Lane 52 Avon Circle APT A White Plains, NY 10601 Rye Brook, NY 10573 Located at: 52 Avon Circle APT A, Rye Brook, NY 10573 Section: Block: Trot: Electrical Permit Number: EP24-182 135.75 E 67.1 Certificate Number: 2024-8963 Building Permit Number: 24-167 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: 52 Avon Circle APT A, Rye Brook, NY 10573 The First Floor: 1 Bedroom(s), 1 Bathroom(s), Entire Floor, Kitchen, Livingroom, and Laundry Room were inspected in accordance with the NYS and NFPA 70-2017 and the detail of the installation,as set forth below,was found to be in compliance on the 18`h day of December 2024. Name Quantity Rating Circuit Type Recessed LED light 13 Receptacles 06 GFCI outlets 04 Arc fault circuit 05 Dishwasher 01 Exhaust hood 01 Washer/Dryer Combo 01 Bathroom exhaust fan 01 � Officer: Frank J. Farina This certificate may not be altered in any way and is validated only by the presence of a seal at the location indicated.This certificate is valid for work performed on the date of inspection only. a N N _ ad it fA Rr Z w o rram^^ U YJ , A, W . Mai Z A z F s C cop �. CA W 00 C 00 L z _ , a a J cn p V x a N O F PLO LC oCA ¢¢ .a =1 04 4 =1 w Z can a t� M 6 ¢ yE- aRC���<_> R E C E V E BUILDING DEPARTMENT VIL",,f,E OF RYE BROOK SEP 2 0 2024 938 KINd,�qRfET RYE BI?rQ@K,NY 10573 VILLAGE OF RYE BROOK BUILDING DEPARTMENT PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP#: �_'/ Cf� / PP#: �y'/ / 0 Approval Date: 44_0 1 Permit Fee: $ 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 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 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: q 2 poiq Oo SBL:/,3J, 7,S —c)--/7i / Zone: 2.Proposed W rk: AA 3.Property Owner: Address: fj \ Phone#: JQ Cell#: emai 4.Master Plumber: Address: Lic.#: _Ph e#: 3 Cell#: - email: . G! Company Name: Address: INDICATE LTURES INES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: Location Water Urinals Drinking Sinks Showers Bath Laundry Domestic Fire Sanitary Natural/ Other* Total Closets Fountains Tubs Tubs Service Service Sewer LP Gas Basement I st Floor 2nd Floor 31a Floor 4`s Floor 5'Floor Exterior 5.* List Other Equip nUP ro ide Details: (Not zed Signatures Required NexF*"in -1- 6 4 STATE OF NEVT C,COU TY OF WESTCHESTER ) as: ,being duly sworn,deposes and states that he/she is the applicant above named, (print nan[c of intlividual signing as the applicant) and further states that(s)hc is the Master Plumber for the legal owner and is duly authorized to make and file this application. That all statements contained herein arc 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 m this � = Swo to before m this day of � 20 day of V�-n �� �Wtk Signature o roperty Owner Sig ature of A an Ly �� Q Print Name of Property Owner P ' ame of A licant i RO ota is No[ary P of New York N® LLO U.0 05023 Notary Public,(State of New York QLar: 'ed in estchester ounty No.01ME6160063 My core ;ssio Expires F 7, 2026 Qualified in Westchester County. Commission 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. 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- fnno2a BUILDINCbiPXRTMENT D E C EN E VILLAGE OF RYE'BROOK 938 KING S'i`k'EET RYE BROOK,NY 10573 SEP 2 0 2024 (914)9�9-0668 www.rvelGooknVgov VILLAGE OF RYE BROOK — 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 11 `YORK, COUNTY OF WESTCHESTER ) as: 31, WXW� ti � 5 UL13 -T , residing at, z 14 NVO N Cla,. LS ?-Y£ UV0'1L.jflJ� (Print natm) (.Address where you lire) 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. Z2 , Rye Brook, NY. th A(1 resti) Further that all statements contained herein are true,and that to the bes f 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. vj'�X— (Sienaturc of It ,rerhv OwnerlsIi 0vLs F_¢r (Print Name of Property Chrnei(s)i Sworn to befor me this — day Sri. . 20 iNotary 11uhho ROSEMARIE J MOGAVERO Notary Public-State of New York NO. 01M05023476 Qualified in Westchester County My Commission Expires Feb 7, 2026 6/1/2024 Check List&Zoning Analysis Address A_,,.BujdingPemut �I r. SBA Zones sr. l ConsL Type. Other: Subtmttal Dates ` Re tors. ttal Dat Applicant: 1 T v Nature of Work. R ZBA: PB BOT: Other. �_� (aX ( ktEES:Filing: BP: C/C* Flood Plane: LegaLzanom ( ) (�APP: Dated v-- Noturzed SBL—4,,n'rnm I.D. Cross Connection: I-OA: ( ) ( ) Scenic Roads Steep Slopes: Wetlands: Storm Water Review: Street Opening- Long- Short Fees: N/A: ( ) ( ) SITE PLAN:Top: Site Protection: S/W MgniL: Tree Plan: Other. ( ) ( ) SURVEY: Dated CurrenC Archival: Sealed Unacceptable: ( ( ) PLANS:Due Stamped Sealed Copies: Hectroruc Other. (V w,License Workers Cornp: I.Aabiliry. Ciemr Other. ( ( ) CODE 753#: Dated N/A ( ( ) HIGH-VOLTAGE ELECTRICAL_Plats: Perm u N/A: Other. ( ) ( ) LOW-VOLTAGE ELECTRICAL•Plus: Pemur N/A: Other. FIRE ALARM/SMOKE DG LECTORS Plans: Permit H.W.I.C.:_Bam"T_Other: ( /( ) PLUMBING Plans Permit: Nat.Gat: LP Gas: N/A/: Other. ( ( ) FIRE SUPPRESSION:Plans Pernuc N/A Other. ( ) H.VAC.: Plats: Permar N/A: Other. ( ( ) FUEL TANK:Plans: Pemuc Fud Type: Other. ( ( ) 2020 NY State ECCC: N/A Other. ( ( ) Final Survey Final Topo: RA/PE Sign-off Letter. As-Built Plans: Other. ( ( ) BP DENTIAL LE-171 R: C/O DENIAL Other. ( ( ) Other ( ;ARB mtg.due: approvaL• notes: ( )ZBA mtg.due. approvaL notes: ( )PB mtg.due: approvaL• notes: REQURRED EXIS-LING PROPOBEL) NO_T-S APPROVED Am _ u u � F Fcvric Acm Co Ft.H/Sb: _ G A. Tom: EL ` Hcwht/Stones: notes: I Ows l!ll� I hoZo V. 2 J C C C� F- ww o C r ,� .� oNection Z 6. a_ :. (tom s. w . J O � � x fG, cn ~ � .'.'• C `�t�eaa a `fey :. O z _ M� ! v J eft )► � , '�' �'�"�( Y Y t 2 I 7 7 cocn ��"' �' �,, � — � to �•' '�s' N �. C r y x � DATE(MM/DDlYYYY) ACOROJ CERTIFICATE OF LIABILITY INSURANCE 7/15/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME Courtney Potter McCarthy Insurance iu"c°N o Ell: (914)769-0417 FAX No: 378 Elwood Avenue E-MAIL ADDRESS: courtney@mccarthyinsurance.net Hawthorne, NY 10532 INSURE S AFFORDING COVERAGE NAIL0 INSURERA: Atlantic Casualty INSURED INSURER 8: Carry-On Home Improvements Inc INSURERC: 37 Gibson Avenue INSURERD: White Plains, NY 10607 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 00002044-0 REVISION NUMBER: 6 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. INTSRR TYPE OF INSURANCE INM ADDL SUBR POLICY NUMBER MWDDPOLICY EFF MOMILDI DY YM EXP LIMITS A X COMMERCIAL GENERAL UAIN ITY Y L261006033-2 5/29/2024 5/29/2025 EACH OCCURRENCE $ 1,000,000 CLAIMS MADE DAMAGE TO R Fk OCCUR PREMISES EaENTED occurrence $ 50,000 MED EXP(My one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2.000.000 X JECT Loc PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY❑ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Par accldant $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A -- - (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101.Additional Remarks Schedule,may be attached if more space is required) Certificate Holder is listed as Additional Insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Village of Rye Brook THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 938 King St, ACCORDANCE WITH THE POLICY PROVISIONS. Rye Brook, NY 10573 /yOQR/ �Vpj/q�8, E (CPO) ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Printed by CPO on 07/15/2024 at 03:46PM 17-011k\_ NYSIF New York State Insurance Funr, PO Box 66699,Albany, NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE D�tf k_ . y�, ^^^^^^ 455338871 MCCARTHY INSURANCEi �', 378 ELWOOD AVE i *, HAWTHORNE NY 10532 ❑ �`�L SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER CARRY-ON HOME IMPROVEMENTS INC VILLAGE OF RYE BROOK 37 GIBSON AVE 938 KING ST WHITE PLAINS NY 10607 RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W2350 077-0 967922 12/18/2023 TO 12/18/2024 7115/2124 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2350 077-0, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY, INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS://WWW.NYSIF.COM/CERT/CERTVAL.ASP. THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. PRESIDENT CRISTIAN CARRION CARRY-ON HOME IMPROVEMENTS INC. THE POLICY INCLUDES A WAIVER OF SUBROGATION ENDORSEMENT UNDER WHICH NYSIF AGREES TO WAIVE ITS RIGHT OF SUBROGATION TO BRING AN ACTION AGAINST THE CERTIFICATE HOLDER TO RECOVER AMOUNTS WE PAID IN WORKERS'COMPENSATION AND/OR MEDICAL BENEFITS TO OR ON BEHALF OF AN EMPLOYEE OF OUR INSURED IN THE EVENT THAT, PRIOR TO THE DATE OF THE ACCIDENT. THE CERTIFICATE HOLDER HAS ENTERED INTO A WRITTEN CONTRACT WITH OUR INSURED THAT REQUIRES THAT SUCH RIGHT OF SUBROGATION BE WAIVED. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATESUR NCE FUND �/ DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 396371630 U-26.3