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HomeMy WebLinkAboutBP24-179PERMIT # SECTION . TYPE OF JOB LOCA OWNER CONTRACTORD114 T. CAST CA #_� TCO # FEE DATE , - IPISrECTION RECORD i DATE INSP FASTING FOUNDATION FRAMING RGH FRAMING Zs� Zc bi/t- SSle INSULATION PLUMBING ? J ?�l dye RGH PLUMBING GAS ED SPRINKLER ELECTRIC �Q LOW-V*LT O ALARM O AS BUILT FINAL W�NOa,.is R('!'�� lr,-2S- 2oay PAsSe� FRAM • 02 p-sse PJ sxowt% e,� w z5 - Z y P 164 (ac237S33- 3©7eoo ion -Ano/ 3 04) 4e n V11,404 Me4 7La 114 Ptf J 45 �P �� aLl00)4e/e� 01ld 61el�33 e(Dlr �P OTHER APPROVALS ARB BOT PB ZBA OTHER VILLAGE OF RYE BROOK WESTCHESTER COUNTY, NEW YORK NO: 25-016 Certifirate of ®rrupoucp This is to certify thatC&C/ Flyij, het of, W k / having duly filed an application on J0fiUaJZY a3 20�45 requesting a Certificate of Occupancy for the premises known as, A0 a kl" 29kl` ,, Rye Brook,NY, located in a /�- Zoning District and shown on the most current Tax Map as Section: • Block: Lot: , and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No 79, issued ?)Ll "7 N 4, 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 7 New York State Classifications, Use: 'c� �" /� Construction: yo , 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 height shall be made,nor shall the building be moved from one location to another until a permit to accomplish such change h en obta' ed fro toe Building inspector. Building Inspector,Village of Rye Brook: Date: aS oa D CC� � OML� -, For office use only: BAN Z 3 ZO25D BUILDING DEPARTMENT � pLRMIT VILLAGE OF RYE BROOK ; ISSUED. _ VILLAGE OF RYE BROOK 938 KING SFREET,RYE BROM-:,NE'A'YORK 10573 i DATE: - 5 i BUILDING DEPARTMENT (9 j 4)939-0668 FF.E: A L/��5� PAID wH'w ryebrookay-gov APPLICATION FOR CERTIFICATE OF OCCUPANCY.CERTIFICATE OF CONIPLiANCE, AND CERTIFICATION OF FINAL COSTS TO BE SUBMITTED ONLY UPON COMPLETION OF ALL WORK, AND PRIOR TO THE FINAL INSPECTION wrrrrrrr...awwrrr►...............rrrrrrgrrrrs•err.rwrrwwrrr►.rrsrrarwrrrrrrrrp•rrrrrrrrrrrrrrrrurwrrwrrrrrrw.rrr.uwrrr• n Address: 1 ( �."r`-! t. • `i r. C r \1 t Occupancy i Use:1� _Pastel ID#: I cl, Zone: -L� Owner: M 1^„ e t A,i Lot , f n C r Address: I( '`^i (c ,\ v �� j t ri -t t' U r , P.E./R.A.or Contractor: ii ij,( {;(. ,, 1 Address: 2 ti'16 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 stricture/constructionialteratiort hereut mentioned in accordance with law: STATE OF NEW YORK,COUNTY OF WESTCHESTER as• n n rti e y t U 1<. being duly sworn.deposes and says that he'shc resides at !'r$6 V,� I(C'Y IPrint Name of Applicaitu iNu.and Street) In (;_'c', m the County of i. ____ in the State of GT ,that rt1ry•'I'oun \'dla�ci 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 l�C't CC , C�- for the construction or alteration of l`t i( i I C r k I t C V)C V, ('VA;'I i C t 41 r ) t C h r i s t I r • 1 Dcpe)ncnt further states that he/she has examined the approved plans of the structure/work herein referred to for which a Ccrificate of Occupancy/Compliance is sought,and that to the best of his/her knowledge and belief,the structtue;work has been erccted/completcd in accordance with the approved plans and any amendments thereto except in so far as variations theretore have been legally authorized,and as erected/completed complies with the laws govemine,building construction.Deponent tirrther tmderstands that it shall be unlawful for an owner to use or permit the use of any building or prerrirses 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-W.A.of the Cod of the Village of Rye Brook. Sworn to before me this 2- i S Sworn to before me this Z"`l day of_. -- 20 2 S day of 20 2S j . ��__ - tur crty Owner ( $i re Of rea711 AJ Print of P ey Owner Print Name of Applicant Notary Public Notary Public JC:1-uA E BALSAM KARINA BRACHLOW NOTARY PUBLIC,STATE OF NEW YORK NOTARY PUE UC., '.iJE OF NEW YORK Registration No,OIBROC119201 Reoistr->:ion NG-lu'i c.r,:9la4963 Qualified in Westchester County Qualified in\i t.stchtstrrr County Commission Expires Dec.29,20 Commist:tun E.:;ces•t.nut,ry,31.2028 QyE BRC�v�, cu � 1982 BUILDING DEPARTMENT ❑BUILDING INSPECTOR 1 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 : O� l_.OV ` �.A— r\..+' I C ► ✓�J DATE: 2 7 — C PERMIT# �PL Y — 1 ISSUED: fi—1 I SECT: BLOCK: LOT: LOCATION: 1 9 P?41 TIvW 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 XJ� V C-T� ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL &L WOT, t._— ❑ OTHER �E BRCv�• BUILDING DEPARTMENT ❑BLHLDING 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 :- `3 0-Ok A J A Z 1 VC DATE: 10- z.5 - Z OL7 PERMIT# Z ISSUED: �-1�- 2;'SECT: /, (o7 BLOCK: LOT: / LOCATION: I`� ,, k ' 4 /'►`+ l 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 CONNECTIONY- ❑ FINAL OTHER 5kL)W tA_ PAJ �E BRC�uk BUILDING DEPARTMENT ❑BBUILDING 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 : 1 O t3 �Oc� �J� �,Q �1C 11�Q DATE: p G r Q PERMIT# 1 1 ��' 7 —i ISSUED: ✓ /g SECT: /1 9 G 7 BLOCK: LOT: LOCATION: t G.l� IVAi 4 L OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... Q ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING [3, INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL te � ❑ OTHER �yE 6Rcb ZFo 1982 BUILDING DEPARTMENT ❑��//BjJILDING 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 : ' lJ C7 ' ��R ��2 ✓L DATE: PERMIT# 2 (-I / c, ISSUED: c� �g 2/SECT: Iz • G/ BLOCK: LOT: 1 LOCATION: ? 9 ^�.�✓l ~ �>n �r1,ao OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED Q ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION2 �t REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ROUGH FRAMING ❑ INSULATION J ❑ NATURAL GASH ❑ L.P. GAS �} ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER QyE BRC�uk,/ !m G '9a2 BUILDING DEPARTMENT ❑BUILDING INSPECTOR QASSISTANT 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 : �_�i DATE: l -�-y ,' f-; i C PERMIT# J 1-1" 13 �I ISSUED: SECT: BLOCK: LOT: LOCATION: �- �' a c', T�" �._7 OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ,0' ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS r ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER 'L �yE BRC��. O�` Zm cu � '9�2 BUILDING DEPARTMENT ❑BUILDING INSPECTOR Q 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.aebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : l Uv/�J =ram �C i CA'r-i C--rZ DATE: PERMIT# _ 3 1 ISSUED: SECT: /2R. ; BLOCK: LOT: LOCATION: 't NL�+ �" � :� 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 ■ ■ s N C w E N eq Or n ■ cr a 00 00 „ „ a za a ,� F ■ r0-10-4 I� CT dd cn W. v v W ■ z V v ; va w L O w � ' YNQ' QJ �, {n F, w SG C O O s 4 -per 14 41 F/�yl hl Q O d -o ti a a" � � w z � � � v ■ M V w G v U ■�••1 �' � M � A C-� � � y o s t�q n cn ,,, op.l, 0 o v Q '� ■ Oo z x a O W Y M o W O 4 M �, F o o z # ■ o O w V z wz � ¢ ° O ■ Z M M W cn � W � �' � N C/y � � 4p '� °°Q U ■ CN 00 w a o of � v ° � V ■ z �C GQ/ U . O w A �� V d V O ■ G� F" O F w O v H r W P.-I 0 Z z �� aYvi 4 ■ O V O O O � w � .� ■ ■ V p o � .. ccn . b BUILD MENT VIL E OF RY OOK AUG - 2 2024 938 KING ET RYE BIR ,NY 10573 4 _0 �j� VILLAGE OF RYE BROOK ov BUILDING DEPARTMENT INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: Approval Date: AUG 2024 U Permit 1: /+)#_ Application Fee:$ Approval Signature: Permit Fees: $ Disapproved: Other: Application dated: is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance ofa Permit for the interior alteration of an existing building,or for a change in use,as per detailed statement described below.1. Job Address: IG B C.OU n trl K*i O� C. �V_4t1✓q SBL:�of /r ki7�� Zone:��+`!5' 2. Proposed Improvement.(Describe in detail):_ i P1 VC if 10V Rt'_VLd VC,--h h V% +© aaAr h Acc2✓+l r^h d V 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 rI: TIER III: 4. Will the proposed project require the installation of a new,or an extension/modification to an existing automatic fire suppression system(Fire Sprinkler,ANSL System,FM-200 System,Type I Hood,etc...) :No: Yes: ' (If yes,please submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans) 5. Occupancy;(I fam.,2 fam.,comm.,etc...)Prior to Construction: I F0,V" After Construction: 1 E6k yn 6. N.Y State Construction Classification: N.Y.State Use Classification: 7. Property Owner: M t Cy��e\ T i S GeV Address: 109 COu eN lry R i o Rd Phone# Cell#911 -31 q -3l 21 email: M r KP, t•-P,Silt r[ rvla+ ok-VN 8. Applicant:A tnd rC l6j V t5 C Vt;q Address: 2 Ss8 VC- ley l2d S u i}e- 2L I C O 5 C0 b C r p 6 YO Phone# 2C3 -53->`-SO7(0 Cell# email: of-C(eodffroS0-,i0 ntkAe_-t 9, Architect: Address: Phone# Cell# email: to. Engineer: WCA lie 6. VkSLh'-Q Address: 219 Uy tt j CA Sy.+e 201 (GS CCbCTOWF7 Phone# 203 -S33,504 Cell# email: CY\yi_\L @dt(lfrUServrG,_:r4Y,Ae�- It. General Contractor: DTF ROSemou'Air L(C Address: 18t Ve11te-1 Rd SU,1C ZOI COS cob (T(}6W) Phone# 2,03 - S33 ' 3U76 Cell# email:ACIP.teCdffrcSCytrtck. tl-Ae � 12. Estimated cost of construction $ 1 Va)OOU-UU (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:_ -a f s Finish: 6rv2a24 D EE-7. s AUG - 2 2024 BUILDING DEPARTMENT VILLAGE OF RYE BROOK VILLAGE OF RYE BROOK BUILDING DEPARTMENT 938 KiNc.STREET RYE BROOK,NY 10573 (914)939-0668 www.rvehrooknuov AFFIDAVIT OF COMPLIANCE VILLAGE CODE §216 • STORM SEWERS AND SANITARY SEWERS THIS AFFIDAVIT MUST BEAR TILE 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 COMPLETYD AND NOTARIZED DORM 'WILL BE RETURNED TO THE APPLICANT_ STATE OF NEW YORK.COUNTY OF WESTCHESTE�R ) as.- 1, , CW14 1 rkA el- .residing at, l— f 'ryep'el0to Let-le_ ��'e 5ra�\,le i Prmi namci 14ddress where wm In,a 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; O �DV V►��� t drl v� ,Rye Brook,NY. 1 i,ah lddressl 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. yV��c�pe I �tsl,�r I I'ur'I 4.n�i. .�f l'.il`c'fl1 1 HI i-i Cfl+11 Sworn to before me this 4a, f -► �fl --- J45HUA E. BALSAM NOTARY PUBLIC,STATE OF NEW YORK Registration No.01 BA4994963 Qualified in Westchester County Commission Expires January,31,2028 (z) n � zoos 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 property completed in its entirety andlor 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 I as n r2 W t Ch.t' being duly sworn,deposes and states thatC he is the applicant above named, 1 print namt of individttal sgntag 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 CG n\Y o+,C 1 C 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 d of ?1 ,20�„� day of Jv I�t 202_ zf�_6_�A , Pro pert otsner S reofAppiicant Pant Narameeo/f Property Owner Print Name of Applicant {J� 7+� 9t tLl4f?Jh 3 Not�blic Notary Public _.T JOSHUA E. BALSAM KARINA BRACHLOW NOTARY PUBLIC STATE OF NEW YORK NOTARY PUBLIC,STATE OF NEW YORK Registration No. 01BA4494963 Registration No.01BROO19201 Qualified in Westchester County Qualified in Westchester County Comrn1 'gin Commission Expires Dec.29,207-1 (4) s fi a =' e = _ � z ■ � G O N N N i Rr c c• =/% _; W N N v p ■ a a z f 00 _ ■ M � .� � T A � z N _ } y G f I J • O �; Z Li. Q, P: it O g f It -- W UJ i! w A — z i J J r-- V � _ oo a O a � � F BUILDING DEPARTMENT - VILLAGE OF RYE BROOK ja L 938 KING STRFFT RYE BROOK,NY 10573 AUG 2 9 2024 (914)939-0668 VILLAGE OF RYE BROOK `\.-Vebt oo k II`,`,t„ BUILDING DEPARTMENT ELECTRICAL PERMIT APPLICATION Westchester Count- Master Electricians License Required Approval Date: 3CA Permit Fee: $ Approval Signature: Application dated,_ is hereby made to the Building Inspector of the Village of Rye Brook NY, for the ' a Permit to install and/or remove electrical equipment, wiring, fixtures, or to erfurm other high or low voltage electrical work a the detailed statement described below. By signing this document, the applicant & roe issuance of performed will be in conformance with all applicable Federal.State,County and Local Codes. s per property rty owner agree that all electrical work 1.Address: u�r .1 0P 2.Property Owner:_ M ;, L SBL: 6 Z9' (07 - Zone: c�r el. .S' G�y .yL F" I d 'hone#: / f `-�L �jdress: g 7y" 3 ?L/ cell#: 3.Master 1lectrician/Licensed Installer: email: Lie.#:17�ZPhone#:Tq5- �� • •� c�Address: �Y9p-c��� - -----Cell #: email: �c"`4 �ur! r o07^7 3 Company Name: ..t F 1 Address: 4.Proposed•Elmricel Work/Fixturc Count: IPA 1 5.3°'Party Electrical Inspection Agency: STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: (print n:uue ufindividual signing a;the applicanb inf'duly swam'deposes and states that hc'she is the applicant above named,and does further state that(s)he is the for the legal owner and is duly authorized to make and file this application. t�Ltslcr Llcctrici:m'Liern.rd Inawllrrl 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 Pre ention&Building Code,the Code of'the Village of'Ryc Brook and all other applicable laws,ordinances,and regulations.Sworn to before me this day of (L D ` ,2p Sworn to betbre me this day ^of A JGv S( 20 a LU C C0 IJ4 ` U,0 O " SigCV f Prop ure oerty Owner � Signature of Applicant Print Name of Prop erh'O wner � 0 3 a �OM rhq Print Name of Applicant w a Z c -5 Notary P tic Z Cy0,12024 STATE WIDE INSPECTION SERVICES, INC.! Service 11"ith Integrity 0:• OFFICEoSWISNY.COM SWIS JOB APPLICATION0. • Office Use Elect. Permit# C`.`_. Q _ Date gas Bldg Permit# *� — f Sq Ft Plumbing Permit# Final Certificate# City/Village C ^G7c7`r� Zip Building Dept. n ^�� County ` `oc— Address l�� ( / e J Cross Street Section Block Lot Owner Name/Address(If different than above) r Contact Number ❑Basement ❑ 1st A. ❑2nd FI. ❑3rd FI. ❑More Than 3 FI. ❑Garage ❑Attic ❑Outside ❑Residential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C/0 Detector Hood Trash Compact 1 Amt Amps 10 Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer Switch 23 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 � I AUG 2 9 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. y^� / Email Address OvJr ��C d r•-� r,. �t� G , iC J., Name ✓� J;cf SpM �e License # I L q aa Date */Zi zy� Signature Address f� Pia S S -t-a City/State I vim+ ), Zip Code O3 7 3 Company C X Phone# l If _ D State Wide Inspection Services ID 1080 Main Street Fishkill, NY 12524 JAN 13 2025 845 202-7224 Phone 914-219-1062 Fax STATE WIDE INSPECTION SERVICES VILLAGE OF RYE BROOK Email: office@swisny.com BUILDING DEPARTMENT 1 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: Power and Energy Corp. Michael &Jaclyn Fisher 114 Pearl Street,Suite 1A 108 Country Ridge Road Port Chester, NY 10573 Rye Brook, NY 10573 Located at: 108 Country Ridge Road, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP24-176 129 67 1 1-9 Certificate Number: 2025-0105 Building Permit Number: BP-24-179 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: 108 Country Ridge Road, Rye Brook, NY 10573 The First Floor Kitchen and Second Floor Master Bathroom were inspected in accordance with the NYS and NFPA 70-2017 and the detail of the installation,as set forth below,was found to be in compliance on the 7th day of January 2025. Name Quantity Rating Circuit Type 2nd Floor Bathroom Switches 04 Luminaires 05 Exhaust Fan 01 Toilet GFCI 01 Dedicated HR Bath GFCI 01 20AMP Name Quantity Rating Circuit Type First Floor Double Oven 01 60AMP Induction Cooktop 01 30AMP Refrigerator 01 20AMP Dishwasher 01 20AMP Garbage Disposal 01 20AMP Hood 01 20AMP Microwave 01 20AMP Wine Refrigerator 01 15AMP Counter Receptacles 02 20AMP Luminaires 10 Receptacles 15 Dimmers 10 Under Cabinet Lighting Sub Panel Basement 01 100AMP 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. Page 2 2 2 M N O a 2 a a, CA M�I f Q G o W Ln 44 00 ul O W � J we A �+ W 2 W ON z E-4 u z 40, r 0.4 • oo .-. Z 00 04 0.4cn W T CA � W -+ z N a ' U cL �$ ix U •i = Ck. ' 0 oA 41 .I 7 . BUIfan MENT SEP - 4 "�.i24 VILOK 938 KIN ,NY 10573 ov PLUMBING PERMIT APPLICATION J FOR OFFICE USE ONLY BP#: PP#: Approval Date: 'I - 6 - 2-0 Z`1 Permit Fee: S Approval Signature: Disapproved: (fees are non-refundable) ************************************************************************************************** DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDING INSPECTOR.THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12%OF 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. l.Address: lot (0(j%,\tf y R I f He D i Iva SBL: It)/i IO'7--1— / Zone: 2.Proposed Work: gea5o d ,ad ,Slop S,o I 3.Property Owner: K�r.hmej `iGhe.v' Address: 10t (UUrAWY 4 F&d C, Ur we Phone#: 5)H - 3 74_.3 7 21 Cell#: email: M,kc . Srntr Q)q ma.\ G rn 4.Master Plumber: F,rc-,n K IMF r\ tt Address: '60 LOA!q H III boys Storwk id c.T 06902 Lic.#: 132. Phone#: )' - 403-3J Z3 Cell#: — email: f rnri eyyt c 7a q mAW,(-0 n-, Company Name: Env,rotnryyy%t 1 PIA ckM Niel Address: LOf\q FW1 Drwc Staw.fc >ci CT 0bCl02 INDICATE FIXTURES&LINES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: Location Water Urinals Drinking Sinks Showers Bath Laundry Domestic Fire Sanitary NaturaU Other* Total Closets Fountains Tubs Tubs Service Service Sewer LP Gas Basement 1 st Floor 2nd Floor 31 Floor 4'h Floor 5°i Floor i Exterior 5.*List Other Equipment/Provide Details: (Notarized Signatures Required Next 2 Pages) -1- 6/1/2024 STATE OF NEW YORK.COUNTY OF WESTCHESTER 1 as: fG�rl K Dc"k-c ,being duly sworn,deposes and states that he/she is the applicant above named, mr-ini name of individual signing w the applicant) and further states that(s)he is the Master Plumber for the legal owner and is duty 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 before me this 23 rd_ day of P�I Lj 20i-Ll_ day of A v!1,3 t 20 2� Signs r of Property Owner Signature of Applicant Print Name of Properttyy Owner Print Name of Applicant ep Votary Public Nota ,Public KARiNA BRACHLOW NOTARY PUBLIC,STATE OF NEW YORK Registration No.01BR0019201 Qualified in Westchester County_ This application must be properly completed in its entirety and must it CQmmi'sstort_ uesD ,120 2, rt the legal owner(s)of the subject property,and the applicant of record In the ;paces provided. Appiwatiuns not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be retumed to the applicant. [ �JOSHUA E BALSAM NIOITAkY PUBLIC,STATE OP NEW YORK Registration No. 01BA4994963Qualified in Westchester County mmission Expires January, 31, 2028 6 1 2024 BUILDING.DEPARTMENT VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK.IVY 10573 SFp - 4 2 (914)939-0668 www,ryebrooknv. ov. srx,c********%***ir***#*%*****3*************is***i**iFw#*%##*k*****#******#*r.***:i'k****4*#*******%**#*:'r'r%'n'✓. AFFIDAVIT OF COMPLIANCE VILLAGE CODE ti216 • STORM SEWERS AND SANITARY SEWERS THIS AFFIDAVIT MUST BEAR THE NOTARIZED SIGNATURE OF THE LEGAL. PROPERTY OWNER AND BE SUBMSITTED ALONG WITH ANY BUILDING OR PLUNGING 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: 3, residing at, 2'461 Tr ee t L o (614W PVC. p 1(--t,k i I'rnu+san!.1 i.\JJrtss u lie rr ruu li�el 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; l L i< Cy4 E nr ti Rye Brook,NY. Further that all statements contained herein are true. and that to the best of his/her knowledge and belief,that there are no known illegal cross-connections concerning either the storm sewer or sanitary sewer,and further that there are no roof drains, sump pumps,or other prohibited stormwater or groundwater connections or sources of inflow or infiltration of any kind into the sanitary sewer from the subject property in accordance with all State, County and Village Codes. 1.'(t a 'Pru nNiirn�li ---- ��Icl,ue � ►' t Prinl Nunn of Prtgwrty"O« ri 1 Sworn to before me this day of .20 ���nan Puhiicl -- -n JOSHIJA E. BALSAM NOTARY PU841C,STATE OF NEW YORK Registration No, 01 BA4994963 Qualified in Westchester County Commission Expires January, 31, 2028 .Building Permit Check List&Zonin Anal sis Address: SBL .6 l Zone: U qkQ Const.Type: lerther; Submittal Date a- .L Revisions Submittal Dates.• Applicant: Nature of Work \ Y \ V Reviews:ZBA: AUG 19 2024 PB: ROT: Other: NEED OK (,) FEES:Filing: Y'� BAN to C/O: Flood Plane: Legalization: ( )/APP: Dated ` Notarized i SBL: Truss I.D. Cross Connection: H O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening: ( ) ( ) ENVIRO:Long Short Fees: N/A.- ( ) ( ) SITE PLAN.Topo: Site Protection: S/W Mgmt.: Tree Plan: Other. ( ) ( ) SURVEY:Dated Current: ArcluvaL• Sealed Unacceptable: ( ) (;PLANS:Date Stamped V Sealed — Copies: - Electrons 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: Permit: Nat.Gas: LP Gas: N/A/: Other. ( ) ( ) FIRE SUPPRESSION:Plans: Permit N/A: Other. (� ( ) I-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 MUMNG PROPOSED NOTES A IMPROVED Area: Date:_A& 1 9 2024 Circle: Fronts e Front: Front: Sides: Rear. Main Cov: Accs.Cov: Ft.H Sb: Sd.H Sb: GFA. Tot : Ft.I Height/Stories^: \ �` notes: !!°.:'?�{y�p:. _""' •!��'�'+9',?�'A !`uVN�\'�';,•r+Q' � f R4. �..�,: a' �� �.y (4S•ry l'll Ali 1ayf1�f>II tPvejF�a ,l'1f�1 fI � F 1 t �o ♦' J. .V 3r �.'_ ._ C T. C .. �., .. ayi m H N CD CN A2CD G \ ,�, cc (" ,tab)►, C� 4.•+ co •~ U :J ate.. fJ� '++�� :y..Y J NorUJ �'3J•. 'F,,,'� ,4•i�� �/ Ira � —J m •_ :t] h �+. J?>: _� _ is n. i a F it a' co C/) L.L N N C Gd eye j.,tY 2j.. Cw ^ _o - ,31 E u J lo� E Hwy. Z � G~i 4 a L C V v t' sal rn u h .. �'"? - - � i� �!'•. '_- .If/ It....s,. .a._g.'�,•, 1,t Vie"..�';?• ���+'^�t�^•z;-•z-�--�-, i 1. .tia,l.I�: _ i,�!/�,," +•, 1 t' ,, J1..,•.., ;t,li, ',t+1t�, Ki>H1J Jl 4'' �.' �'i� FI •f DTFROSE-01 SCHASS ACORO CERTIFICATE OF LIABILITY INSURANCE DATD 4/17/217/2024 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 Susan ChassagnouX Cross Insurance-Westport PHONE,E><t 203 655$974118 FAX One TurkeyHill Road South ( ): ) (A/C,No): Westport,CT 06880 Ao R .susan.chassagnoux@crossagency.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Selective Insurance Company of South Carolina 19259 INSURED INSURER B: DTF Rosemount LLC INSURER C: 288 Valley Road Suite 201 INSURER0: Cos Cob,CT 06807 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTIR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ❑X OCCUR S 2512283 1/15/2024 1/15/2025 DAMAGE TO RISESE,ENTED $ 500,000 MED EXP(Any oneperson) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 X POLICY❑im LOC PRODUCTS-COMP/OPAGG $ 3,000,000 OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT(Ea accident) $ 1,000,000 X ANY AUTO S 2512283 1/15/2024 1/15/2025 BODILY INJURY Per $ AUTOS ONLY AUUTO{S�ULED BODILY INJURY Per accident $ AUTOS ONLY AUTOS ONL� FF%rr PER ,AMAGE $ A X UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE S 2512283 1/15/2024 1/15/2025 AGGREGATE $ 6,000,000 DED I I RETENTION$ A WORKERS COMPENSATION Y X PER OTH- AND EMPLOYERS'LIABILITY 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ C 9097980 1/15/2024 1/15/2025 E.L.EACH ACCIDENT �Aandatory In NHS EXCLUDED? N/A 1,000,000 E.L.DISEASE-EA EMPLOYE $ If yes,descnbe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Village of Rye Brook is shown as an Additional Insured on the General Liability policy as required in the written,signed and executed Agreement/Contract directly with the Named Insured subject to all terms,conditions,and exclusions of the insurance contract in place for the Named 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 g y ACCORDANCE WITH THE POLICY PROVISIONS. 938 King Street Rye Brook,NY 10573 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD PORK Workers' CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1 a.Legal Name 8 Address of Insured(use street address only) 1 b.Business Telephone Number of Insured 203-533-3076 DTF Rosemount LLC 288 Valley Road,Suite 201 1c.NYS Unemployment Insurance Employer Registration Number of Cos Cob,CT 06807 Insured Work Location of Insured(Only required if coverage is specifically limited to 1 d.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-Up Policy) Number 26-4035807 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Selective Insurance Village of Rye Brook 3b.Policy Number of Entity Listed in Box 1 a" 938 King Street Rye Brook,NY 10573 WC9097980 3c.Policy effective period 1/15/2024 to 1/15/2025 3d.The Proprietor,Partners or Executive Officers are included.(Only check box if all partners/officers included) QX 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"1 a"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: Susan Chassagnoux (Print name of authorized representative or licensed agent of insurance carrier) Approved by: �GLd(riL ��!/� 4/17/2024 (Signature) v (Date) Title: Commercial Account Manager Telephone Number of authorized representative or licensed agent of insurance carrier: 203-635-1084 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. 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