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HomeMy WebLinkAboutBP24-182rERMIT# jL4 DATE: Q1(P: SECTION TYPE OF WORK JOB LOCATION 3 aM OWNER n /ns e�% /cSQ CONTRACTOR rPQMS o e ve EST. COST CEO FEE47�� CCU SCO # — FEE�J�DI� SATE TPA # FEE DATE - INSrECTiON RECORD FOOTING FOUNDATION FRAMING RGH FRAMING DATE INSP lo- t- toZy �ss� I-(//o ePe�zQ Cfn2i`o�1iS�o-10907 INSULATION 0 PLUMBING 3 �ZozS ass RGH PLUMBING ,q sj4 GAS [] SPRINKLER ELECTRIC ` LOW -VOLT 0 f<AIARM 0 3-_ /3- 2ozl' M1ccI a, AS BUILT M FINAL 3 /3.2ot1' ee44 d OTHER APPROVALS OTHER VILLAGE OF RYE BROOK WESTCIIES COUI�I'�Y, NEW PORK 1st .,-,. / ; No : 25-040 Certificate of Occupancy This is to certify that `" hn W/yl y / of, Ra 6, Bffjo k / V ` having duly filed an application on l 1 /(Arc l / 1 _ 20 requesting a Certificate of Occupancy for the premises known as, ,Y J a&�O'X)ry P/O e , Rye Brook, NY, located in a R—h Zoning District and shown on the most current Tax Map as Section: 1,2q5 9 Block: / Lot: and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No. , issued 20g —, 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: 3/011f .1 Construction: for the following purposes: I 1 / T�rI D!' h9 M' QD�7 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 ilities shall be made,and no enlargement, whether by extending on any side or by increasing in h ' hall be nor shall a building be moved from one location to another until a permit to accomplish such change ha e d f the Bu' ng Inspector. MAR 1 1 2025 Building Inspector, Village of Rye Brook: Date: L.1_..L .._/ I V" ' IC� �_ !� ti' ��� , BUILDING DEPARTMENT For office use only: p PERMIT VILLAGE OF RYE BROOK ISSUED: —a LMAR0 2025 L48 KING STREET,RYE BROOK,NEW YORK 10573 DATE: 3/o-,=�� (914)939-0668 FEE: PAID®' VILLAGE OF RYE BROOK www.ryebrooknygov BUILDING DEPARTMENT 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 #####t#######t########k######kt#### a a##t###############t#t####### ##t##k###t##t######ttk#######t#tt#####t##kk######tkk#####tk## Address: ol,W OOQI �Ay. `)r O P�, 1\ Y 10,573 Occupancy/Use: IC;4ry Parcel ID#: ,c3 9, S 9 c> Zone: Owner: ;.�p 4.,�n. 'J \rS i—D Address: n 16m1W ocA � �� \4 Q�J f w N Y I P.E./R.A. or Contractor: �y� O C-0x4-1P Address: go it C j 01a 'AUL ejc CT ow Person in responsible charge: rb %YNO. Address: 194 (ktkn Oi 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��YgqORK, COUNTY OF WESTCHESTER as: K V i V being duly sworn,deposes and says that he/she resides at (Print Name of Applicant) ( \o.and Street) in �-!X-\(A ?3-<T ,in the County of T ol c ^�Q- C� in the State of that (Cif Towni 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:$ 1 5 O U for the construction or alteration of Or-- 0 '^^ 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 Sworn to before me this day of MAIL/ ' , 20 day of \- \aCL\, , 20a:�, /e Sig ure of Property Owner \ -10� (.t��.,S�U•, ', �o,ro( CJ�b tea._ Print Name of Property Owner 7C:Zcant � Notary Public Notary Notary Public,State of New York MIC14AEL KELLMM4 No.O1ME6160063 Notary Public,State of New" Qualified in Westchester County�--7 No.01 KE5036394 ; Commission Expires January 29,20 I Qualified in Westchester County COrninisslon Expires Nov.21L Zd 1 i ,jE BRC�k• F0 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 : �`�•.�.�:1�J��� DATE: PERMIT# i�e��" I --y LI ISSUED: SECT: BLOCK: LOT: t LOCATION: 1 ' ! �') ►�(� ��n �✓W J' `, OCCUPANCY: i ❑ 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 QyE BRcb- O�` 2m F o BUILDING DEPARTMENT ❑BUILDING INSPECTOR Z SSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www.Uebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS :- �� �J-J Y� 1�e1 �� \ L Cn �' DATE: PERMIT# be 20 - 3-L ISSUED: I 1, SECT: ?". BLOCK: LOT: LOCATION: AL �, 1 ),A ? "1 U .� ' OCCUPANCY: -? 1 ❑ 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 BR(�k. uJ � 1982 BUILDING DEPARTMENT ,❑BBUILDING 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 : 2 ---) L�jn'< L? Y ( C.` \ , DATE: i -j L '! _ Z O Z 1 PERMIT# ISSUED: 6 Z/-iySECT: i BLOCK: LOT: LOCATION: ' '� �� >.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 ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER QyE BRC�u�, 1982 BUILDING DEPARTMENT ❑BUILDING INSPECTOR gASSISTANT 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 :- �"7 DATE: PERMIT# &P 2 �'' l J L� ISSUED: -1/- Z ECT: BLOCK: LOT: - LOCATION: OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING Z ROUGH FRAMING ❑ INSULATION 3: 1 ❑ NATURAL GAS �� ❑ L.P. GAS ' ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER �yE BRC�uk • �� tim 1932 BUILDING DEPARTMENT ❑BUILDING INSPECTOR OASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 KING STREET . RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www.ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : 2--.2m Z k `Aym DATE:—'...) PERMIT# 7 2 `/C/ ISSUED: "/9-1'l SECT: BLOCK: LOT:25 LOCATION: /• 45 / 6 4 724 C U U`7 OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED 2 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 /`J S CC, ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER s N N N N Q is. W w ..00 ca '0. ' ° w a v v ur p• - R.� W Ln W aQi c� a. ti v , o V 7 ~ u C OL A O o O 2 O A z z 22 a Lin -21 lo - ICI L J O x N x a air O w �, Hay a5ea V O W L4r." W z n 0 O o w y w° z p Q E f—� � p = WLO ' V Q 11 m Imo+ O A a x � 075PQrn ° C W W rA U z rA a �, vawoc � : z Fz"I �rt a o °' ° " b W a o ' , a r�o � a' v I� rAW Q ceps y e z z U C) o o oo _ W y H �Q V V v z C7 ; A z O °" °• v o 1-4 N Z W od .-- u a _ = A z _ ay A OC) Q V�- 1"/ 1E BUILDS .'�'MENT VIL E OF RY OOK AUG 19 2024 938 KING74'�ET RYE$R ,NY 110573 ' � _-0 VILLAGE OF RYE BROOK W"� e o_l ti ov BUILDING DEPARTMENT INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: Approval Date: AUG 2 1 424 rmit Application Fee:$ Approval Signature: Permit $ Disapproved: Other: l.l. •7- Sot � 3 Application dated: = is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Perm it for the interior alteration of-an existing building,or for a change in use,as per detailedstatement described below. 1. Job Address: SBL: ��/r�9l��� Zone: 2. Proposed Improvement.(Describe in detail): P'am0'1Q, A 'Tl`z- t, 6A rO'D r , MIL Ck-[P, Ao')lpl._ '-N! -b uh 'A (,r a(1T61AA a shvwgc s+&(I iw.(4 4o 4b 3. Does the proposed improvement involve a Home-Occupation as per§250-38 of the Code of the Village of Rye Brook? No: Yes: If yes,indicate: TIER 1: TIER 11: TIER III: 4. Will the proposed project require the installation of a new,or an extension/modification to an existing�utomatie fire suppression system(Fire Sprinkler,ANSL System,FM-200 System,Type I Hood,etc...) :No: Yes: (If yes,please submit a separate Automatic Fire Suppression System Permit application& 2 sets of detailed engineered plans) 5. Occupancy;(I faro.,2 fain.,comm.,etc...)Prior to Construction: After Construction: 6. MY State Construction Classification'.� N.Y.State Use Classification: 4 7. Property Owner: L�0t yy,_ W �%IS Itn Address: 1-3 ZY.W a &-oo F� N Phone# J rr rr Cell# q ILI 255 -3lQUD email: to +may) - C-vm DApplicant: ia,a of VIb5,ice.._ Address: 19 (rt1J �` �Q c i�p o1-y C Phone#_ C� Cell# 203 9g3Q&00 email: 1����nehiC�!�mai -Cy►r 9. Architect: Address: Phone# Cell# email: 10. Engineer: Address: Phone# C 14 email: /� 11. General Contractor: 2s7 Address: ll?c� Lp -S s L1` eA-�A � cl ti✓A�7 e C 42Phone# ,Cell# G 4� , U -d a 7 email: 'KYVtfQa)Lkrk6 a 12. Estimated cost of construction $ QJ 007— V d XA&F<%)14 (NOTE The estimated cost shall include all labor,material,scaffolding,fixed equipment,prolessional fees,and material and labor which may be donated gratis.) 13. Job Timetable:Start: 3/Z3/ZV Finish: V13) ? (I) 6/1/2024 BUILD,)<NG DEPARTMENT D E C E U U E D :! VIL ??,E OF RYE' OOK 938 KING *ET RYE BR6 ,NY 10573 AUG 19 2024 . 4)939-066$� wwwlrVebrooknyizov VILLAGE OF RYE BROOK F_ . 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: p 1 \ I,T _�C) t l WA n ,residing at, a (Print nanic) (Address where you live) being duly sworn, deposes and states that(s)he is the applicant above named,and further states that(s)he is the legal owner of the property to which this Affidavit of Compliance pertains at; w-o o �0. ��� , Rye Brook,NY. (,lob dress) Further that all statements contained herein are true, and that to the best of his/her knowledge and belief,that there are no known illegal cross-connections concerning either the storm sewer or sanitary sewer, and further that there are no roof drains, sump pumps, or other prohibited stormwater or groundwater connections or sources of inflow or infiltration of any kind into the sanitary sewer from the subject property in accordance with all State, County and Village Codes. (Signature i Property Owner(s)) ,� c3k'\n 1,, � (Print Narue of Property Owner(s)) Sworn to before me this 1211- day of hViV3T _ , 20 '�-�` Ad dM!L (Notary Public) MICHAEL KELLMAI# Notary Public,State of NevrYwk N0.01KE5036394 Qualified in Westchester County (2) Commission Expires Nov.28. 1024 6/l/2024 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: -�\., Ds.W,ram\ _` _ ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and further stat that ( )he is the legal owner of the property to which this application pertains, or that (s)he is the _ _ttiYCtc r _ 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 Z Sworn to before m this day of A✓b W7' , 20 2- ! day of , 202i— I ' Si ature of Property Owner Si e of pp n Print Name of Property Owner Print Name of Applicant 1 , Nou itNotary P MICHAEL KEI.LMAN Notary Public. State of New York IRMA QUEZADA No.01 KE50�6394 NOTARY PUBLIC Clualified in Westchester County , STATE OF NEW YORK Commission Expires Nov.28, Z� N0. 01 QU6186064 J� QUALIFIED IN WESTCHESTER COUNTY MY COMMISSION EXPIRES APRII_28,2028 (4) 6/112024 ' t s = s = s = N N t t, W c c cr m a z w 1 a Uj Ln i Ln ,..r 0 n G O N W = eq Ln N V z w kn J ►..r Q _ V :� O oc z o o w o a CN n V: C\ 1 00 M CIA C W u o w V ;� a z w •� � z Z _ U W = W U J O < [l) 16 u w o N A a Z : *I a o U a w d ,:, ■ f t i s t t i _ :I t :' _ � i f f t� ■ f i i i ■ i i ■ t ■ t t' i f ■' i t BUILDING DEPARTMENT VILLAGE OF RYE BROOK SEP - 3 2024 3D 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 VILLAGE OF RYE BROOK www.ryebrookny.gov BUILDING DEPARTMENT ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required C� �Q FOR OFFICE USE ONLY B11#: CQ 7—� U EP#: / — 7U Approval Date:_ Q " a- 2 Permit Fee: $ 6 Approval Signature: r �� Other: DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BV THE BUILDING INSPECTOR. THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12%OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00 Application dated, 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 app icable Federal,State,County and Local Codes. 1.Address: 23 9A 21W 0 l?d0e- SBL: /C 59 -/-a Zone —/S 2.Property Owner:�j94W t%(//f, --Tt Address: Phone#:�T�S „�D U Cell#: email: 3.Master Electrician/Licensed Installer: 41 (ram �1 Address: T_� /_ i✓nI Lic.#:( Phone#: Cell #: �Z � Zemail: Company Name:�14 !Lr-C7&1 C L_(�_L Address: °2 I kr l�n X 4.Proposed Electrical Work/Fixture Count: 22/A f�1,92,6� ,4 02 TJ 5.3,d Party Electrical Inspection Agency: STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: ,being duly sworn,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 to before me this Sworn to efo a me is day of 20 day of Signature of Property Owner ign re of Applicant Print Name of Property Owner rint a of Applicant Notary Public Notary Pu Ic GREGORY M.RNERA 6/l/2024 Notary Public,State of New York No.01R16441398 nNuuned In Westchester County, STATE WIDE INSPECTION SERVICES, INC. Service With Integrity 0•0 • • SWIS JOB APPLICATION0. • Office Use Elect. Permit# i��`/ Date Bldg Permit# 01 11 Sq Ft Plumbing Permit# Final Certificate# City/Village n ( "Cr,,,Street ') Building Dept. County Addres �l Section Block Lot Owner Name/Address(If different than bove) Contact Number ❑Basement ❑ 1st FI. ❑2nd FI. ❑3rd Fl. ❑More Than 3 FI. ❑Garage ❑Attic ❑Outside ❑Residential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C/0 Detector Hood Trash Compact Amt Amps Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer Switch SERVICE Amperage #Panels 1P 3P # Meters # Disconnect ❑Underground ❑ New ❑ Reconnect ❑ Repair ❑Overhead ❑ Upgrade ❑ Disconnect Utility ID# ❑Con Ed ❑ NYSEG ❑Central Hudson ❑ Orange/Rockland PHOTOVOLTAIC SYSTEM PV Modules Inverters AC Disconnect Junction Box Combiner Box Load Center PV Monitor Energy Storage System DC Disconnect ❑Legalization ❑ Safety Inspection ❑Consultation 2 S�r� ► -�c�c�} WIE 2024 r 2 6 lG-J I VILLAGE VE RYE BROOK BUILDIN'— 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 Name License# / Date V ? Signature /I Address / /�✓ City/State /� G11rLcw Zip Code 3 Company Phone# fV,2— _ —517 DwE C Z u E State Wide Inspection Services 080 Main Street FEB 21 2025 JDFishkill, NY 12524 TO�u 845 202-7224 Phone VILLAGE OF RYE BKOOK 914-219-1062 Fax STATE WIDE INSPECTION SERVICES BUILDING DEPARTMENT 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: AJ Electric LLC John & Lisa Winston Jose Agreda 23 Boxwood Place 21 Ridgelane Road Rye Brook, NY 10573 Greenwich,CT 06830 Located at: 23 Boxwood Place, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP 24-178 129.59 1 25 Certificate Number: 2025-1117 Building Permit Number: BP 24-182 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: 23 Boxwood Place, Rye Brook, NY 10573 The Second Floor Master 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 215i Day of February 2025. Name Quantity Rating Circuit Type Switches 02 Luminaires 04 Fan 01 GFCI 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 a ■ Tt O C &r _ N �1 \ c \ M a 4.0 Ci) Ln \ w a a � rjy fn a O � � M N Ln c _ T-4 C O Z Lin O , w AA e V` 6 f lM1 L�J1 z (1; z � q ? 00 oc tn Z w M z Z = r � A z I.- LI) � :44 ►� F CN G, ^ W a w co ^ , F z �" V z o .. V PLO 0 CA o z Ln z z x � e • 1 BUIL E u� MENT SEP 17 2024 DD VIL E OF RYE OK 938 KIN ET RYE B ,NY 10573 VILLAGE OF RYE BROOK BUILDING DEPARTMENT Y.gov PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP#: 'y PP#: 1 Approval Date. SEP 19m2.�,,.nPermit 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 THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00 Application dated, 9-/7-r)y 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: 23 boXv000d ?1occ- (lye. QK-00 "— Zone: 2.Proposed Work: A ij,We — 1 S1,04 Ilt— JI S L 1.ys.1y &_L 3.Property Owner: 0Vtf1 n S+V rl Address: 23 bo7AwpcA 6ce RyQ, �&o*- Y OjI Phone#: Cell#: q ZJ Jr 3(.00 email: b t„W i,-)5fo n 29@ ct m qi cp rn 4.Master Plumber: Address: / All Lic.# Phone#: 1 , - email: Company Name: i I I.-I- �a-i Address a S 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 1 st Floor 2nd Floor 1 3'd Floor 4°i Floor 5'h Floor Exterior 5.* List Other Equipment/Provide Details: (Notarized Signatures Required Next 2 Pages) -1- 6/1/2024 S Tk 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(.@)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 0' Sworn to before me this 4/ day of �scr ,20�'A day of5eAWbex ,209L S' nature of PropertyOwner Signature of Applicant W�nS�y^ Print Name of Property Owner Prin Name of Applicant Notary Public MICHAEI KEILMAN Notary Notary Public, State of NewYoA KAREN M 9Ae of N No.01 KE5036394 Notary NO.Publ -State 0 New York Qualified in Westchester Coun No.O1 eA cheste0 M Qualified in Westchester County Commission Expires Nov.28. 262L My Commission Expires Dec 11,2025 This application must be properly completed in its entirety and must include the notarized signatures)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/l/2024 BUILD MENT3D VIL E OF RY OOK SEP 17 2024 938 KING ET RYE BR ,NY 10573 44-,)..��99-0 VILLAGE OF RYE BROOK wwwa ell'ok ov, BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE§21 fi • 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 OFr NEW YORK,COUNTY OF WESTC14ESTER ) as: A Ay^ , residing at, a3 �5c",»�� 1 \Q� DRY}I� Ny• I Print name) (Address where you live) being duly sworn, deposes and states that(s)he is the applicant above named, and further states that(s)he is the legal owner of the property to which this Affidavit of Compliance pertains at; 1 `du_ ,Rye Brook,NY. (Job Address) Further that all statements contained herein are true, and that to the best of his/her knowledge and belief,that there are no known illegal cross-connections concerning either the storm sewer or sanitary sewer, and further that there are no roof drains, sump pumps, or other prohibited stormwater or groundwater connections or sources of inflow or infiltration of any kind into the sanitary sewer from the subject property in accordance with all State, County and Village Codes. �Q4 /0-,7 �A� (Signature of I' perry Onner(s)) tr.SJh/t —:�' W-.1S�vr, (Print Name of Property Uv\ner(s)) Sworn to before me this VAfA day of , 20 Z Y •'t4"4 E-IGr/— (Notary Public) MICHAEL KELLMAN Notary Public, State of New York No.01KE5036394 Qualified in Westchester County -3- Commission Expires Nov. 28, 2026 6/l/2024 J .Building Permit Check List&Zon Analysis Address: G `moo SBL Zone: c Use: Z- `C Const.Type:_Other. Submittal Date: Z,,\Revisions Submittal Dates: Applicant: 1 1V Nature of Work: ►mil �( \(� ` �1 �� �(� Reviews:ZBA: A U G 2 1 2 024 PR BOT: Other. NEED OK Filing ' BP: C/o Flood Plane: Legalization: ( ) (�APP: Dated: Notarized: SBL: Truss I.D. Cross Connection: H.O.A.: , ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening. ( ) ( ) ENVIRO:Long. Shorn Fees: N/A.- SITE PLAN:Topo: Site Protection: S/W Mgmt.: Tree Plan: Other. ( ) ) SURVEY:Dated: Current: Arcluvah Sealed: Unacceptable: PLANS:Date Stamped Sealed: Copies: Electronic Other. ( ) (> License: Workers Comp: Liability: Comp.Waiver Other. ( ) CODE 753#: Dated: N/A: (� ( ) HIGH-VOLTAGE ELECTRICAL:Plans: Permit: N/A: Other. ( ) ( ) LOW-VOLTAGE ELECTRICAL:Plans: Permit: N/A Other. (� ( ) FIRE ALARM/SMOKE DETECTORS:Plans: Permit: H.W.I.C.:_Battery:_Other. PLUMBING Plans: Permin Nat.Gas: LP Gas: N/A/: Other. ( ) ( ) FIRE SUPPRESSION.Plans: Pen-nit: N/A Other. ( ) ( ) H.V.A.c.: 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 LETTER: Other. ( ) ( ) Other. ( )ARB mtg.date: approval:- notes: ( )ZBA mtg.date: approval• notes: ( )PB mtg.date: approval:- notes: REQUIRED EXISTING PROPOSED NOTM APPROVED Area: Circle: �ak9i Fronta e: Front: Front: Sides: Rear. Main Cov: Accs.Cov: Ft.H Sb: Sd.H Sb: GFA: Tot.imp: FtFt III1D: P� Height/Stories: notes: 1 t 0 f u c C eOrelro 1111WAXIA BRnv� i O� w Rye Brook, NY Q Code Enforcement Department �982 •��O ENFORCEMENTCODE Case number: RB-2024-012 Municipal address: 23 BOXWOOD PL Legal address: Status of inspection: Completed Case description: Doing interior work without a permit Violations DISCOVERY DATE COMPLIANCE DATE REFERENCE DESCRIPTION Before the construction or alteration of any plumbing or drainage 08/12/2024 09/24/2024 system is commenced,the owner or lessee or the agent of either shall obtain a written permit therefor. No electrical work shall be done without a permit.No wiring,devices or equipment for the transmission,distribution or utilization of electric 08/12/2024 09/24/2024 energy for light,power or heat shall be installed within or on any structure,nor shall any alteration or addition be made in any existing wiring,devices or equipment,without first securing a permit therefor No person shall erect,enlarge,improve,remove,relocate,demolish or structurally alter any building,building system,or other structure,or perform nonstructural alterations where permits are required due to the Uniform Fire Prevention and Building Code or as otherwise provided in the Code of the Village of Rye Brook,within the Village of Rye Brook without first obtaining a building permit."Building systems" O8/12/2024 09/24/2024 shall be defined as including,but not limited to,fuel-fired appliances and heating systems,emergency and standby power systems,electrical systems and equipment,plumbing systems and equipment,mechanical refrigeration systems,elevator recall,stationary lead-acid battery systems and commercial kitchen hoods.A building permit will be issued only to the owner(s)of record of the affected real property.The building permit application must be signed by the owner(s)of record. Visits VISIT DATE INSPECTOR VISIT RESULTSITECONDITIONS No person shall erect,enlarge,improve,remove,relocate,demolish or structurally alter any building,building system,or other structure,or perform nonstructural alterations where permits are required due to the Uniform Fire Prevention and Building Code or as otherwise provided in the Code of the Village of Rye Brook,within the Village of Alfredo(Freddy)DiVitto Failed Rye Brook without first obtaining a building permit."Building systems" 08/12/2024,12:11 PM shall be defined as including,but not limited to,fuel-fired appliances +19149390668 Reason for failure:Violations and heatingsystems,emergency and standby y g y y power systems,electrical systems and equipment,plumbing systems and equipment,mechanical refrigeration systems,elevator recall,stationary lead-acid battery systems and commercial kitchen hoods.A building permit will be issued only to the owner(s)of record of the affected real property.The building permit application must be signed by the owner(s)of record. 09/24/2024,4:20 PM Alfredo(Freddy)DiVitto Passed ALL PERMITS FILED.. +19149390668 v A �' +y o o _ Q U' � � w 2 0 v o 0 0 z O i � Ym zo /�. w .� �► .� o w F. sa) 3 � wv�- O U te Q V � ~ a ~f 3 .� Z > V O _ �. cc = w o O cn OZ Ca (D°' Noz o O 0N ^ ~N > _ '2 ( Q w i w cn m m a cn cn i •. 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N II U Z F- =. _-% ri iv > 4 Z Z LLA 0 Q w w W Q lJ +Imz w0Z � ~I N SON Lam0 Of ¢ Cn m OD --------- } cQ Of G Q M O a N W I V w Q Ln N u, O �._._..._..... --- J a UJ oI i Z 0 Z O ' 06 O O Z x \\ i w j I CD w Of p 00 z fd CO (J� = w w W \ Cn Q § N W f� \ w = Q \ Z E W W_ H „9£ ` J (A \\ O w w or _ a Vn T „W£ fA 9 w o oano d3MOHS Ol >1030 3NOlS o �i034 oni HlIM eniag V� 0. cnLu co W02�3 d32�d 2�3MOHS 1NflOW 2�3C1Nfl O O C� �A V H cv H X Q H o .� LL J J Z V1 z CO C7 z Y Ln a � 3 cc v, m z J •:f. M .y�.>I,' 4� w�i / L'r141 ��y.��x��/. — k Ln E rN 16 • 6 / t t Of 0 ell y wcoo Ao = = I ® r' _ Q Y 66 LU � C f v Z7 1 LI t op U r CV V J f I L h d f . � e Y Fr CO0 78/1612024 (MM/DD/YYYY) A ROC" CERTIFICATE OF LIABILITY INSURANCE 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. H 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 NAME: Betanla Almeida Associated Insurance Agency,LLC AA//C NNo Ext: (203)748-9272 (a,No): 203-748-9276 50 Newtown Road,Suite 1 ADDRESS: Betania@AIA-Danbury.com INSURER(S)AFFORDING COVERAGE NAIC Y Danbury CI' 06810 INSURER A: MAIN ST AMER ASSUR CO 29939 INSURED INSURER B: Julio Cerezo INSURER C: 680 WESTFIELD AVE INSURER D: INSURER E: BRIDGEPORT CT 066064004 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MWI)D/YYYY) (MMIDD/YYVY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FRI OCCUR PREMISES(Ea occurrence) $ 500,000 MED EXP(Any one person) $ 10,000 A MPJ9572J 07/27/2024 07/27/2025 PERSONAL&ADV INJURY $ 1,m0,000 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 �OTHER: POLICY ❑jE' ❑LOC PRODUCTS-COMP/OP AGG S 2,000,000 S AUTOMOBILE LIABILITY $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED $ AUTOS ONLY AUTOS ONLY (Per accident) S UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PI,H H- ND EMPLOYERS'LIABILITY y/N STATUTE I I ER ANY PROPRIETOR/PARTNER/EXECUTIVE❑ FFICEWMEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $ Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ f yes,describe under ESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) 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. AUTHORIZED REPRESENTATIVE 938 King Street 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 NE K I Workers' CERTIFICATE OF YO STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1a.Legal Name&Address of Insured(use street address only) tb.Business Telephone Number of Insured 646-456-6907 Julio Cerezo DBA fc.NYS Unemployment Insurance Employer Registration Number of My Dream Home Improvement 680 Westfield Ave Insured Bridgeport,CT 06606 Work Location of Insured(Only required if coverage is specifically limited to Id.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-Up Policy) Number i 4 27-2851704 I 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Travelers 3b.Policy Number of Entity Listed in Box'ta- 9R838015 Village of Rye Brook 3c.Policy effective period 938 King Street 10/18/2023_-- to 10/18/2024 Rye Brook, NY 10573 3d,The Proprietor.Partners or Executive Officers are Cincluded.(onty check boy if all parinemof cars included; i -- -- 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 Workers'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: Ronald Boucher tPlr.rt name of awhorzed representative or lirensed agent of insurance tamer) Approved by: �(J t I C ( e rcw) t)R)1Ri9n24 _ (5rgnaturej (Cate; Title: Owner Telephone Number of authorized representative or licensed agent of insurance carrier: 203-748-9272 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(9-17) vnvw.web.ny q0,1