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HomeMy WebLinkAboutBP24-201PERMIT A)`q — r)O/i DAB SECTION / 3S, & O LOCK / L07 TYPE OF WORK JOB LOCATION OWNER CONTRACTOR�i EST. COS VC//0 # -46errioe � T /- 00//S u, 50 _ FEE FEE. Z TC• � FEE DATE FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING Gd RGH PLUMBING GAS 0 SPRINKLER 52( ELECTRIC LOW -VOLT Cl ALARM ED AS BUILT El FINAL DATE /o z )t7 - Zy� t02K 1- 13- 2azs -4 to25/ INSP �l 4 L/zf)cm:)/6' %lolol LLC 4e/A (fl%l7�10 &q)&/0-00yy �IN44 Pr j i pay_ ao r'�,�ase��r � �e/>„ces OTHER APPROVALS ARB BOT PS ZBA OTHER VILLAGE OF RYE BROOK WESTCHESTER COUNTY, NEW YORK NO: 25-015 Certificate of Occupou.cp This is to certify that rmaiael Y�Z0 C)ilye SQ� of, ParEvock, , having duly filed an application on 20 (��requesting a Certificate of Occupancy for the premises known as, /`6)6X/ , Rye Brook,NY, located in a 9 / Zoning District and shown on the most current Tax Map as Section: 65.400 Block: / Lot: , and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No.CK 7 issued 20 , 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: Awe- / 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 hall be made,no . all the building be moved from one location to another until a permit to accomplish such change h bee a the ding Ins Building Inspector,Village of Rye Brook: Date: RECENE # BUILD R ENT For office use only: r PERMIT# — Q O/ VIL OF RYE K ISSUED: -a3-ay EDEC8 2024 8 KING STRE YE BROOK, , YORK 10573 DATE: 9 4 O-c FEE: S' 5- PAID VILLAGE OF RYE BROOK 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 ###rt*##k#**ififff###*4i#ifff 4ffif#ii#it*i###ffffff##kifffff##i#f##rtrtk*ffifft##fif*kkki##if#fii#####k**#iif if##fii#fi#rtkf#f#ff Address: `JN WND-Sjk. 12-0,43 Ayl: 4200 NY IoSl3 Occupancy/Use: / �,g 44 Parcel ID#: n -/- y!/p Zone: _ Owner: co iP'E�j ST£�1K�0'J Address: L4 4 W�nl i1S�2 2 p A�J P.E./R.A. or Contractor: '-",R Cej_WC_ Ft e,ST Address: 01_�30 f- AQlS(DJ Ak E Person in responsible charge: t'_'G IT4 CJ t U_rTM Address: I"'! `^ �-O rJ�C� , )Y IDSy3 Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issuance of a Certificate of Occupancy/Certificate of Compliance for the structure/construction/alteration herein mentioned in accordance with law: STATE OF NEW YORK,COUNTY OF WESTCHESTER as: tibeing duly sworn,deposes and says that he/she resides at u y (Pri ame of Applicant) (No.and Street) in s201)SL ,in the County of L&-E8_TCa-�C-e_,T-rZ in the State of _,that (City/Town/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:$ for the construction or alteration ofTHxv�1 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 I � Sworn to before me this d of L , 20 qT day of 520 Signatu f Property Owner Signature of Applicant Print Na of Property Owner Print Name of Applicant Notary G GORY M.RNERA Notary Public Notary Public,State of New York No.01 RI6441398 n/l/2024 Qualirted In Westchester County Commission Expires September 26,2a QyE BR "N w � 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 : U V V "a 1 V DATE: G L J Z PERMIT# Z ISSUED: � $ECT: BLOCK: LOT: `fib LOCATION: S� c : . :� i > Y"l OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... [rACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION f ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION �] FINAL ❑ OTHER QyE BRC�� cu � l7 1982 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.ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : `- `'1 01 U 'A DATE: ./` Z-3 - l 6 e PERMIT# L y - iSl ISSUED: SECT: BLOCK: / LOT: LOCATION: SP a C"i �� OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... D 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 BR(�k• uJ � BUILDING DEPARTMENT ❑BUILDING INSPECTOR E'J 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: H `) r V N '✓t)O�c DATE: PERMIT# lJ\ 2 -1 — 20 1 ISSUED: SECT: BLOCK: LOT:YL LOCATION: --�P c ov i l)J'L OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... El ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION n l J ❑ NATURAL GAS ❑ L.P. GAS l PA�J ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER QyE BRCZj' Fo 193-2. 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.rxebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : 4 Ll y�I 1 J�S ` DATE' PERMIT# bi 7 ���o� ISSUED: 'Z `'SECT: BLOCK: LOT: ' U LOCATION: ti i t { �J�� L OCCUPANCY: f ❑ VIOLATION NOTED THE WORK IS... ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING 0 ROUGH FRAMING E' INSULATION ❑ NATURAL GAS Z! t �- ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER QyE BRQ:� O� Zm r. V' �/�• ' •Fo 982 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 : DATE: 'J Z �/ PERMIT# ISSUED: SECT: BLOCK: LOT: 9/6 LOCATION: 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 ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ¢ ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER : � N eq N N 0.0 v p a a w z cp~a © �a v a 4J Q w per• cn a� ,�q v � 04 M O z x o Ln FFAii../�� \ Q y o ,° o cn F4 W a x � Un � � o � go � vw m _ � '', W N �'' LZ'' � 0 3 v �•p 0. _ Ir t[r�aTI q O m x ~ cti a tC w x a oo z = 0 ( W o F"w D O = Z 0 CZ) wzQ W ~ V] M u o W .. W w Z W �D .. a I� W [� g w (� O x �< 0 1; a H O ^ V N v w �/ x � �� ,ti o z �i z a a y W f� rr Wj� y v a v W ! U = FBI W rC) Ov� jai p w .y L a 7 d cn A a z .a q _ a p BUILD MENT VrL E OF RY OOK 938 Krnc ET RYE BR ,NY 10573 SEP 18 2024 4 -0 �� ov VILLAGE OF RYE BROOK BUILDING DEPARTMENT INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: �h / j� Approval Date:_ SEP l Permit#: r Application Fee:$ l 46 Approval Signature: Permit Fees:$ S7&—b u`e- Disapproved: Other: Application dated: — — 7 is hereby made to the Building Inspector ofthe Village of Rye Brook,NY,for the issuance of Permit for the interior alteration of an existing building,or for a change in use,as per detailed statement described below. ��LL// � 1. Job Address: `TH WI epA D SBL: /3st►eaO-1-116 Zone:1�7 2. Proposed Improvement.(Describe in detail): f u 't Ytc-i S� - 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 I: TIER II: TIER III: 4. Will the proposed project require the installation of a new,or an extension/modification to an ex sting automatic fire suppression system (Fire Sprinkler,ANSL System,FM-200 System,Type t 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: - c"— After Construction: — l 6. N.Y State Construction Classification: N.Y.State Use Classification: 7. Property Owner: I'a?,eC_1 5Trso�� Address:A l 4 1?Q 4� Phone# lq' Cell# 1 -�I • �- email: CDP�-1fSTEP4fA_< (a flyi 41 L 8. Applicant: k% Address: Phone# Cell # email: 9. Architect: Address: Phone# Cell# email: 10. Engineer: Address: Phone# Cell# email: 11. General Contractor: knE 1 %))/ /.M Address: �?, �Q.el� ALA NWQt"' Aft`4f Q1_-- Phone#_9 ItA - (o(c) • 00-4� C.,e" b�1/1 n2- email: 11;C1154-k-ORIQ 12. Estimated cost of construction $ 3 I 2 ,00 1NO CI fhe estimated cost shall include all labor,material,scaffolding,f ixed equipment,professional tees,and material and labor which may be dnnated gratis.) r^ 13. Job Timetable: Start: Finish: n) 6/l/2024 BUILD = MENT M JU VIL E OF RYE° OOK 938 KING ET RYE BR ,NY 10573 If—I 8 2024 d 4 -0 -c ov VILLAGE OF RYE BROOK BUILDING DEPARTMENT AFFIDAVIT OF COIMPLIANCE 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, C � I-rt��c;� ,residing at, u4 v��� 49' �� �i (e. tx��C �lY I3 (Print mince (Address»hcre \uu lip 1 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; ya_c0 1 , Rye Brook,NY. (Joh,Addre.x) 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. (Sign❑ i )J'Propert} Owncr(s)) Curt/e!1 ,S�c2 (Print Nan , 0I Prope Otti'ncrt,li Sworn to before me this r� day of , 20 , GREGORY K RIVERA Net"Public,State of New York No.O1 R16441398 (2) Quallfied In Westchester County mm Q fsslon Expires September 26,201 611/2024 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: _ , being duly sworn, deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and further states that (s)he is the legal owner of the property to which this application pertains, or that (s)he is the for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,attorney,etc.) That all statements contained herein are true to the best of his/her knowledge and belief, and that any work performed, or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications, as well as in accordance with the New York State Uniform Fire Prevention & Building Code, the Code of the Village of Rye Brook and all other applicable laws, ordinances and regulations. By signing this application, the property owner further declares that he/she has inspected the subject property, and that to the best of his/her knowledge there are no roof drains, sump pumps or other prohibited stormwater or groundwater connections or sources of infiltration into the sanitary sewer system on or from the subject property. Sworn to before me this Sworn to before me this d f , , 20 day of , 20 Signat f Property Owner Signature of Applicant , Print NarrvejProperty Owner r Print Name of Applicant Notary Publ Notary Public GREGORY K RNERA Notary Public,Slate of New York No.01 Ri6441398 Qualified In Westchester County Commission Expires September 26,2 (4) 6/I/2024 o ON N � NLn N w aLnw w ad u . z c CA V O V w 0-4 ~ � z aLn v � x j�•j M �L� .-+ u ' r W z O o ~ O Cl)Ate, L y 00 F1 ~ M '+ z •r• ' ■ a/ W � � � � z � � E= � a O 00 i w _ O C7 cn O O o zz v � z Z w) W v W ~ x a O d Z � w H 7-4 .. O at - 6 F z x o H � W x p4 og O 0� U W o F Z CAw V a � O o cr P8 o a z w V z a oA ■ A p„ z w 9 a uwj �I as a a E BUI LDING DEPARTMENT � VILLAGE OF RYE BROOK OCT - 3 2024 3D 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 VILLAGE OF RYE BROOK \vw\N.ryebrookny.2ov BUILDING DEPARTMENT ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ON LY BP#: �"7 — C I EP#: Approval Date: _ A elft111 Permit Fee: $ Approval Signature: Other: DO NOI SI'ARI 'vN ORk or(.:U.NSTRUCTION UNTIL PERMIT HAS BEEN ISS(;ED 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, /0 3 d^7 is hereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of a Permit to install and/or remove electrical equipment,wiring,fixtures, or to perform other high or low voltage electrical work as per the detailed statement described below. By signing this document, the applicant & property owner agree that all electrical work performed will be in conformance with all applicable Federal, State,County and Local Codes. l` 1.Address: ' ���I✓IT lI��1 SBL: l J S 1p b —�—`7 �O Zone: 2.Property Owner: CO T)'b P P cS J d Address: L1�J t0 ,.,a-2( Ad Phone#: - - (o S Cell#: k/ email: Cora y SfZeh e 11,4-�Ja 140Twi 3.Master Electrician/Licensed Installer: J w r1�ylJ Address: rye&oof T�/��yLW Az[GJ'`! Lic.#:_�ZZ Phone#:�y-SL 2 ,Z f�Cell#:y�y- ZZlJemail: L r l e • 0 Company Name: SF-r'y►Cep Address: / !+1 i 4.Proposed Electrical Work/Fixture Count: New (,tJ,r'v1 !3 for 2 ritd Non✓ &V911-7. 5.31'Party Electrical Inspection Agency: *ithhh*hhh*hhhhhh***hhhh*hithhi:hhhhhh hh*lt1kR!!#RRllRRR7tlkRloftIt*hhhhhithhhhithhhh*ithhhh**hh hhh hitRhh hit i:hhh hhhh hr.hi:hh STATE OF NEW YOM 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 1?lectricia❑/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 before a this 3 day of 20 day of O� �J^ 20 _ Signature of Property Owner Signature o p t W 4M a Print Name of Property Owner P ' plicant Notary b f w 44 Notary Public Qualifle n estcgh�ester County Commission Expires January 29,2;z 6/l/2024 STATE WIDE INSPECTION SERVICES, INC. 0•0 • • APPLICATIONSWIS JOB 0. • Office Use Elect. Permit# E1,9,:=) }U / Date Bldg Permit# � _ O/ Scl Ft Plumbing Permit# Final Certificate# City/Village Zip Building Dept. County Address / �f Cross Street Section Block Lot Owner Name/Address(If different than above) Co(it` .e, I r) Contact Number �/ _ 71� 1— ❑Basement ❑1st FI. ❑2nd Fl. ❑3rd FI. ❑More Than 3 FI. ❑Garage ❑Attic ❑Outside ❑Residential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C/0 Detector Hood Trash Compact Amt Amps Range(s) Cocktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer Switch SERVICE Amperage #Panels I 3P s 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 a rK Z-7dd C100 r p 1 DD ! OCT - 3 2024 i VILLAGE OF RYE BROOK i 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. / /!C.LL d �� 4, I �0l'N Name �l�r �l Email Address i G License# Zz Date -03- Z L Signature Address / l/ r y� f City/State /Ilt /U I p Code Company L d (C�1 C ✓/ l /Phone# 7 �� _ (o S— ?77✓ Dv State Wide Inspection Services ID1080 Main Street NOV 12 2024 Fishkill, NY 12524 a 845 202-7224 Phone 914-219-1062 Fax VILLAGE OF RYE BROOK STATE WIDE INSPECTION SERVICES ( Email: office@swisny.com BUILDING D_EPARTR9ENT I 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: Laser Electric Services, LLC Michael Grazio Gustavo Aquino Correy Stephenson 137 Pelham Road 44 Windsor Road New Rochelle, NY 10805 Rye Brook, NY 10573 Located at: 44 Windsor Road, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP24-201 135.60 1 46 Certificate Number: 2024-8014 Building Permit Number: BP24-201 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: 44 Windsor Road, Rye Brook, NY 10573 The Second Floor Bathroom was inspected in accordance with the NYS and NFPA 70-2017 and the detail of the installation, as set forth below, was found to be in compliance on the 11`h Day of November 2024. Name Quantity Rating Circuit Type Bathroom Exhaust Fan 01 Luminaires 01 GFCI 01 L.E.D. Lights 03 Wall Exhaust Fan Timer 01 L.E.D. Dimmers 02 `r 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. 68 00 � Z _ F A a n O 5 PLO `" w � N IQR Lf) hl ✓ � U � x � � � , z a o , �' o `O Z lr) F W F A O W Qlzc w x z F +� � �' '-+ � � ►% ;� WW1 z �n QW R z . F3 = •� � M � T 00 CA oo Z Q o w W 1-4 ►/ " �, C7 a N z 7 z Q x E H z � ` a a 044 to 4 toga a F- BRnv D BUIL � E � MENT Vu. E OF RYE OK OCT ' 2 2024 938 KIN ET RYE B ,NY 10573 I VILLAGE OF RYE BROOK BUILDING DEPARTMENT PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP#: —Q O PP#: —/�� Approval Date: OCT - 3 4 Permit Fee: $ /��D--jDIL 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, I v I 1 1 U is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install and/olk remove Pl mbing 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: LAH VJ t��_ PO AD SBL: 1,3 ,&0—/—7(o Zone: 2.Proposed Work: ZW4�!� %o A,, D o v 3.Property Owner: 00gefii 5k Address: L-414 1jJ1n,►06o0_ iZjoy ✓, Phone#: 9 ILA- 9A9- A(0_311c� Cell#: 0114. Rl S Ado email: 9 � 1S 4.Master Plumber:Al 1 j Ad t.( �a.SJ Address: G` Lic.#: '1 6D Phone#: / y 7jI-/S3 Cell#: iY V'�''! S�17 email: /t'J MW&fAe'Af 6?/ f10/;64111 Company Name:M_&ZU Ak' Giwf; 't- ddress: 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 I st Floor 2nd Floor y 3,d Floor 4"Floor 51 Floor Exterior 5.* List Other Equipment/Provide Details: (Notarized Signatures Required Next 2 Pages) -I- 6/1/2024 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: #71, �,d r! o'D ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of-mdrvi ual signing as the applicant) and further states that(s)he is the Master Plumber for the legal owner and is duly authorized to make and file this application. That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to before me this Sworn to lilefore me this a—,41 day of ,20 crt� day of 20 �.v S' r of Property Owner Signature of Ap licant ice✓ fi' k ee,t 4" , /- arA of Pro erty Owner Print Name of Applicant Not Pul�RLENE E VERNO Notar �byi ublic,state of New York No.01ME6160063 NOTARY PUBLIC-STATE OF NEW YORK Qualified In Westchester County, No.01 VE6352008 Commission Expires January 29,20 Qualified in Westchester County M C missioq Ex Tres 12-19-2024 This application must be properly completed in its entirety and must include re notanzeM signature(s) of the legal owner(s)of the subject property, and the applicant of record in the spaces provided. Applications not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. -2- 6/l/2024 BUILD MENT VIL E OF Ryi'E''J OOK ROCT - 2 2024 DD 938 KING ET RYE BR ,NY 10573 4 -0 `� f VILLAGE OF RYE BROOK W BUILDING DEPARTMENT xxx,,.xxxxx*xxx�xxxxxxx��**x**xxxxxxxxxxxxxxxx**********�xxx�,�*�x�x�xxxxrxxxxxxxxxx,.,xxxxxxxxxxxxxxx,xxx 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: residing at, (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; I ' Y1 L r J , , Rye Brook,NY. blob 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. - &L_/__� (Signature f roperty Owner(s)) C(Dlc-�l S&CPk-L-,-z')f) (Print Name of roperty wner(s)) Sworn to before me this 20 a'-k (Not blic) " SHAftI MELILLO Notary Public,State of New York No.01ME6160063 Qualified in Westchester County,—� Commission Expires January 29,20_ 6/1/2024 Buildin9 Permit Check List&Zoning And is ��S` CEO l - �) . Address: SBL: Zone: Use 40 Const.Type: Other. Submittal Date 7N Revisions Submittal Dates: Applicant: r2 S j�J Nature of Work: Reviews:ZBA:S E P 1 9 2 O 2 4 pB; ROT! Other. NEED bK ( :Filing 9BP- -Ib 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 Shore Fees: N/A; ( ) ( ) SITE PLAN.Topo: Site Protection: S/W Mgmt.: Tree Plan: Other: ( ) ( ) SURVEY:Dated: Current: Archival:- 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: Permit: Nat.Gas: LP Gas: N/A/: Other: ( ) ( ) FIRE SUPPRESSION:Plans: Permit: 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 NOTES Area- APPROVED Circle: Fronta C a Front: Front: Sides: Rear. Main Cov: Accs.Cov FL H Sb: Sd.H Sb: GFa ToL hn : Fc Iu' P� Height/Stories: notes: �5 d'•fi ti 111`...G'� .iS�'�1� i�. ♦ �:ti r_...�_.:! ;,.� �_.�_.. alas) C _ o N !; aco4►� �r��FFPP ,c �• p :.Y L V. a. K ()D LQ t.A e, � U r+. O f•. t. E A O c old r..l V1 O 1.. L Z cor a _O D � U y rwn Z O C Cd LLJ z w •E �==� L'i C� O s w 'T c� O U O a w v h "sr cao» cn .o- LLo .N lie a `S1e ♦., Z C-) ' E w v Y C u = come 4.0 = O co w L 31j1 d t-" I 11� l ;�; I�r Jbl�i.a 1 ACC�KL� CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDDIVYYV) 04/16/24 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 INSURERS). 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. It 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 endorsoment(s). PRODUCER CONTACT NAME WB _ Wm.E. Morrell, Inc. -r WC, N,Ei f, (914)49-0904 FAX No): (914)4 28-8999 - E-MAIL 128 Court St ADDRESS: Info@Dmorrell-insurance.com_ White Plains, NY 10601 INSURER) I AFFORDING COVERAGE NAIca _ INSURER A: UTICA FIRST POURED INSURER B: Timberline First Construction Co. LLC INSURER INSURER D_: 1330 Harrison Ave INSURERE Mamaroneck NY 10543 1 INSURERF: 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. NSR - -_-TYPE OF INSURANCE DDL�9UBR POLICY NUMBER MM DDrYY pY EIfPM X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE f 1,000,000 CLAIMS MADEX__ OCCUR PR MI " f _5_ 000 MED EXP fAm one person) S 5 000 A ART3000564010 10/20/23 10/20/24 PERSONAL aADVINJURY S 1000000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE f 2 000 OOO PRO X POLICY,`)JECT LOC PRODUCTS-COMP/OP AGG S Z OOO OOO OTHER f AUTOMOBILE LIABNJTY OMBINED SINGLE LIMIT S ,OEa awdernL_ �I ANY AUTO BODILY INJURY(Per person) S 1 OWNED SCHEDULED t— AUTOS ONLY AUTOS BODILY Y INJURY(Per awdenn S �HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY f AUTOS ONLY r acadaol f S UMBRELLA LIAR OCCUR EACH OCCURRENCE EXCESS LB � IA CLAIMS-MADE AGGREGATE ----S -— DEL` RETENTION! S WORKERS COMPENSATION TH- AND EMPLOYERS'LIABILITY Y/N STATUTE R ANY PROPRIE TOR/PARTNERIEXECUTIVE ❑ NIA E L EACH ACCIDENT S AA OFFICEREMBER EXCLUDED' (Mandatory In NHI E L DISEASE-EA EMPLOYEE S If es desrnW under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT S I I DESCRIPTION OF OPERATIONS i LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER IS NAMED AS ADD'L INSUREDS IN REGARD TO GENERAL LIABILITY-SUBJECT TO WRITTEN CONTRACT,TERMS,CONDITIONS 8 EXCLUSIONS OF THE ORIGINAL POLICY AT THE TIME OF ISSUANCE BY THE INSURANCE COMPANY. CERTIFICATE HOLDER CANCELLATION Village of Rye Brook SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 938 Kings St THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN Rye Brook NY 10573 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 0'199B-2015 ACOR17 C RPbRpTI N. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD � PORK Workers' CERTIFICATE OF STATE I Compensation �-' Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1a Legal Name 8 Address of Insured(use street address only) 1b Business Telephone Number of Insured Timberline First Construction Company LLC 914-610-0044 1330 Harrison Ave 1c.NYS Unemployment Insurance Employer Registration Number of Insured Mamaroneck, NY 10543 N/A Work Location of Insured(Only required of 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 1330 Harrison Ave, Mamaroneck, NY 10543 72-1601686 2.Name and Address of Entity Requesting Proof of Coverage 3a Narne of Insurance Carrier (Entity Being Listed as the Certificate Holder) Village of Rye Brook NorGUARD Insurance Company 938 KING STREET 3b.Policy Number of Entity Listed in Box"'Ia" Rye Brook, NY 10573 TIWC443254 3c.Policy effective period 10/18/2023 to 10/18/2024 3d The Proprietor.Partners or Executive Officers are included rOnly check box if all partners/officers included) X❑ 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 mall )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 Adam Edelstein (Pant name of authorized representative or licensed agent of insurance tamer) Approved by 04/11/2024 i Date) Title President Telephone Number of authorized representative or licensed agent of insurance carrier 800-673-2465 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) www.wcb.ny.gov