HomeMy WebLinkAboutBP24-207PERMIT #(�}�
SECTION
TYPE OF WORK
JOB LOCH ON
OWNERnf;
T. COST
CO # C
FEE DATE
INSPECTION RECORD
I DATE I NSP
FOOTING
FOUNDATION
FRAMING
RGH FRAMING
INSULATION 2ot Psse //� "7 J/& 7/)V&% /j �'1'Idi/y �Q�� A
PLUMBING
RGH PLUMBING 11 • `I Z O Z'! ASSE
GAS m
SPRINKLER
ELECTRIC
LOW -VOLT C�
ALARM C�
AS BUILT 0
FINAL
-b00%,�-�eccQ
OTHER APPROVALS
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7. 19
VILLAGE OF RYE BROOK
MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR
Jason A. Klein (914) 939-0668 Christopher J.Bradbury
«-ww.ryebrookny.gov
TRUSTEES BUILDING& FIRE INSPECTOR
Susan R. Epstein Steven E. Fews
David M.Heiser
Donald T.Krom,Jr.
Salvatore W.Morlino
CERTIFICATE OF COMPLIANCE
April 15,2025
Samuel Paolini&Bianca Paolini
261 North Ridge Street
Rye Brook,New York 10573
Re: 261 North Ridge Street, Rye Brook,New York 10573
Parcel ID#: 135.35-1-11.2
Building Permit#24-207 issued on 9/30/2024 for a New Stone Veneer& Outdoor Kitchen
This certifies that the new outdoor patio stone veneer and outdoor kitchen,under the above captioned permit
has been satisfactorily completed.
Sincerely,
Steven E. Fews
Building&Fire Inspector
/to
EC E ME BUILD R NIT For office use onl :
PERMIT# ��7
MAR 14 2025 VIL OF RYE ROOK ISSUED:9 - �/
3H KING SIRE YE BROOK,Nfi YORK 10573 DATE:
VILLAGE OF RYE BROOK 9 -0668 FEE: ,� �SC� PAID.
BUILDING DEPARTMENT 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
4444 k#k#4iii#4###k#iii•Rt ik##4##i4tti#kkttRkk#4k4#44#Ri t4t444#44i#i4ti44i4i44ppi4i4t4#ii44444ik##4 k44tiRk#4kR######i kt44##kkii
Address: 2-W n10>'+ q V—i he 0 S 7
Occupancy/Use: //�'44 Parcel ID#: 13,51 Zone:
Owner: &l h (M -f S q ryi PK 0 I 1 n Address: 5�P64, 'V�1-e �
0
P.E./R.A. or Contractor: Address:
Person in responsible charge: Sal m Pu d ( 1 n I Address: Z /Ua 0-t-A iftv(y Prue-� I�Y2 �3Yodl
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 YORKI,pCOUNTY OF WESTCHESTER as:
jl(�it (Gl l�u CC 1 f G b�1 N I being duly swom,deposes and says that he/she resides at Z(� 1 '1 �� y p S ✓t?P —
(Print Name of Applicant) I ,, (No.and Street)
Y'C_.\
in I 4 (6D ,in the County of �; �C�l P S+e Y'- in the State of N y ,that
/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:$ 70 00 b ,
for the construction or alteration of: b q 4f k Y\
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 theCode of the Village of Rye Brook.
Sworn to before me this _\ Sworn to before me this
day of R(-C� , 20 day of 120
St'gnature of Property Owner Signature of Applicant
�19Pool in i
M
of Property Owner Print Name of Applicant
Notary Public SNARI MEULLO Notary Public
Notary Public,State of New York
No.01ME6160M 6/l/2o2a
Qualified in Westchester County
commission Expires lan"'y 29,20��
'yte BR
cb'
cu �
1982 BUILDING DEPARTMENT
❑BADING INSPECTOR
aASSISTANT 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 :- (ev) N'-,�,4 , DATE: _ / Z 0ZS
PERMIT# �� O 3 ISSUED: SECT: BLOCK: LOT: ��z
LOCATION: P(.`Il_ ���`[� OCCUPANCY:
❑ VIOLATION NOTED THE WORK IS... a 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 0.U -
❑ FIRE SPRINKLER
❑ FINAL PLUMBING
❑ CROSS CONNECTION L' /
Q. FINAL V\1 J Z `C GJ c� 0
❑ OTHER f1
�E BRc�k,
O`` tim
cu �
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 :— �j ` N ����-� 1 i DATE:
PERMIT# Z�-- �p`� ISSUED:,, 2 SECT: BLOCK: LOT: / •Z
i
LOCATION: 71�—p r A f1 - s'• 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�j'�.
uJ �
1932 BUILDING DEPARTMENT
❑BUILDING INSPECTOR
ElfASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK
❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573
(914) 939-0668 FAx (914) 939-5801
www.ryebrook.org
- - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - -
ADDRESS : L.. (.0 DATE: - `4" - C (_`(
PERMIT# \ 7 y 1 Cp `� ISSUED: SECT: BLOCK: LOT:
LOCATION: Xr OCCUPANCY:
❑ VIOLATION NOTED THE WORK IS... 0- ACCEPTED ❑ REJECTED/ REINSPECTION
❑ SITE INSPECTION REQUIRED
❑ FOOTING
❑ FOOTING DRAINAGE
❑ FOUNDATION
❑ UNDERGROUND PLUMBING NOTES ON INSPECTION:
,I.] ROUGH PLUMBING
❑ ROUGH FRAMING
❑ INSULATION
❑ NATURAL GAS
❑ L.P. GAS
❑ FUEL TANK
❑ FIRE SPRINKLER
❑ FINAL PLUMBING
❑ CROSS CONNECTION
❑ FINAL
❑ OTHER
II II II II 11 11 11 II 11 II II II 11 II II 11 11 11 II II 11 II I. 11 11 II II 11 11 11 11 II 11 11 11 II 11 II II 11 11 11 II 11 11 II 11 11 11 11 II 11 11 II 11 11 11 11 11 11 11
:; VILLAGE OF RYE BROOK PERMIT#:BP 24-207
II 11
BUILDING DEPARTMENT ISSUED: 9/30/2024
11 11
938 KING STREET, RYE BROOK, NY 10573 EXPIRES: 9/30/2025
II II
(914) 939-0668 www.ryebrookny.govIft
II
II
11 BUILDING PERMIT FOR THE CONSTRUCTION Ift
II 11
Ift;; OUTDOOR PATIO STONE VENEER & OUTDOOR KITCHEN Ift
;;
., AT: 261 NORTH RIDGE STREET Ift
11 11
BUILDING CLASSIFICATION & PARCEL ID#: R-3 / ONE FAMILY RESIDENTIAL 135.35-11.2 Ift
11 11
ift PROPERTY OWNER: SAMUEL PAOLINI & BIANCA PAOLINI (917) 828-3950 Ift
11 II
11 EMERGENCY CONTACT: SAMUEL PAOLINI & BIANCA PAOLINI (917) 828-3950 Ift
11 1f?
>f? VALUATION OF WORK: $20,000.00 FEE PAID: $460.00 Ift
tl Ift
11 CONTRACTOR MUST BE PRESENT ON THE JOBSITE FOR ALL INSPECTIONS !f3
11 11
Ift HOURS OF OPERATION OF CONSTRUCTION EQUIPMENT/VILLAGE CODE§158-4:WEEKDAYS-8:OOAM TO 6:OOPM OR DUSK.,WHICHEVER IS EARLIER; ft
i<°1 SATURDAYS-9:OOAM TO 4:OOPM; - SUNDAYS& HOLIDAYS-No CONSTRt.CTION ACTR'I n-ALLODx"ED Ift
1ft This permit is valid for a period not to exceed twelve(12)months from the date of issuance,and covers only that work listed above. Separate permits are required for lft
any electrical,plumbing,fire suppression,fire/smoke/carbon monoxide detectors/alarms,or any other work not covered under this permit.The approved plans must
ift be kept on the job site&be made available for review by the Building Department upon demand.Any amendments or changes to the approved plans must be It
Ift designed by your architect/engineer and submitted to the Building Department for review and approval prior to performing the work. "
lift A Certificate of Occupancy or Certificate of Compliance is required in order to close out this permit. Ift
11 11
11 11
11 11
/1 4 11
/1 11
11 11
11
Steven E. Fews
Building& Fire Inspector
1 /1
11 .1
THIS PERMIT MUST BE CONSPICUOUSLY POSTED AT THE JOB SITE "
11 11
., 11 11 11 II 11 11 11 11 11 11 N 11 11 11 11 11 11 11 11 11 II II 11 II II II 11 11 11 11 11 11 11 11 11 11 11 11 11 11 .. II 11 11 11 .. 11 II 11 11 11 11 11 11 11 11 11 11 11 11
BUILDING DEPARTMENT I� o �` LE
VILLAGE OF RYE BROOK SEP 2 6 DI
938 KING STREET RYE BROOK,NY 10573
(914)939-0648 VILLAGE OF RYE BROOK
wwwxyebrookny.eov BUILDING DEPARTMENT
ADMINISTRATIVE EXTERIOR BUILDING PERMIT APPLICATION
FOR EXTERIOR WORK WHICH DOES NOT REQUIRE VILLAGE ARCHITECTURAL REVIEW BOARD APPROVAL
FOR OFFICE USE ONLY: A
APPROVAL DATE: SEP 2 Z- IT#��0V-7 APPLICATION FEE::
APPROVAL SIGNATURE: PERMIT FEES: l S�
H.O.A.APPROVAL: DATE:
DISAPPROVED: OTHER:
***********************************************************************************************************
Application dated: g/96/9094 is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the
construction of buildings,structures,additions,alterations or for a change in use,as per detailed statement described below.
1. lob Address: 261 N Ridge St Rye Brook NY 10573
2. Parcel ID#: 135.35-1-11.2 Zone: R-15
3. Proposed Improvement(Describe in detail): Add stone facade to existing patio wall structure,add block to patio wall to house
--apphances,.sun.plumbing andelectrical fromhome a prnyide_waterlpower —
4. Property Owner: Samuel and Rianra Panlini
Address: 261 N Ridge St,Rye Brook,NY 10573
Phone# 917-898-1950 Cell# e-mail Snanl inirha Agmail mm
List All Other Properties Owned in Rye Brook:
Applicant:
Address:
Phone# Cell# e-mail
Architect:
Address:
Phone# Cell# e-mail
Engineer:
Address:
Phone# Cell# e-mail
General Contractor:
Address:
Phone# Cell# e-mail
(1)
6/1/2024
5. Occupancy;(1-Fam.,2-Fam.,Commercial.,etc...)Pre-construction: 1-family Post-construction: 1-family
6. Area of lot: Square feet: 53,332 Acres: 1.22
7. Dimensions from proposed building or structure to lot lines: front yard: rear yard:
right side yard: left side yard: other: -,uq,
8. If building is located on a corner lot,which street does it front on:
9. Area of proposed building in square feet: Basement: 1"fl: 2'fl: 3'fl:
10. Total Square Footage of the proposed new construction: rvta-existing ctnirtura
11. For additions,total square footage added:Basement: IS,fl: 2°d fl: 31 fl:
12. Total Square Footage of the proposed renovation to the existing structure:
13. N.Y.State Construction Classification: N.Y.State Use Classification:
14. Construction Type&Location:O Typical Western Lumber Frame;O Timber Frame[TC];O Wood Truss[TT];
O Pre-engineered wood[PW];Located;O Floor Framing[F];O Roof Framing[R];O Floor&Roof Framing[FR];Other:
_.StoneJacadeNeneer-added to—existing—patio wall ____._ _.. ___—.----_ --
15. Number of stories: Overall Height: Median Height:
16. Basement to be full,or partial: finished or unfinished:
17. What material is the exterior finish: Stone facadetveneer
18. Roof style:peaked,hip,mansard,shed,etc: Roofing material:
19. What system of heating:
20. If private sewage disposal is necessary,approval by the Westchester County Health Department must be submitted with this
application.
21. Will the proposed project require the installation of a new,or an extension/modification to an existing auto tic fire
suppression system?(Fire Sprinkler,ANSL System,FM-200 System,Type I Hood,etc...)Yes: No: V
(if yes,applicant must submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans)
22. Will the proposed project disturb 400 sq.ft.or more of land,or create 400 sq.ft.or more of impervious coverage requiring a
Stormwater Management Control Permit as per§217 of Village Code? Yes: No:�ZArea:
23. Will the proposed project require a Site Plan Review by the Village Planning Board as per§209 of Village Code?
Yes: No: (if yes,applicant must submit a Site Plan Application,&provide detailed drawings)
24. Will the proposed project require a Steep Slopes Permit as per§213 of Village Code Yes: No:
(if yes,you must submit a Site Plan Application,&provide a detailed topographical survey)
25. Is the lot located within 100 ft.of a Wetland as per§245 of Village Code? Yes: V, No:
(if yes,the area of wetland and the wetland buffer zone must be properly depicted on the survey&site plan)
26. Is the lot or any portion thereof located in a Flood Plane as per the FIRM Map dated 9/28/07? Yes:-No:
(if yes,the area and elevations of the flood plane must be properly depicted on the survey&site plan)
27. Will the proposed project require a Tree Removal Permit as per§235 of Village Code?Yes: No:
(if yes,applicant must submit a Tree Removal Permit Application)
28. Does the proposed project involve a Home-Occupation as per§250-38 of Village Code? Yes: No:
Indicate:TIER I: TIER II: TIER III: (if yes,a Home Occupation Permit Application is required)
29. What is the total estimated cost of construction: S.c?t'nnn Note:estimated cost shall include
all site improvements,labor,material,scaffolding,fixed equipment,professional fees, including any material and labor which may be
donated gratis.If the final cost exceeds the estimated cost,an additional fee will be required prior to issuance of the CIO.
30. Estimated date of completion: ►vnyPn,hpr 1 9n9a
(2)
6/1/2024
BUILDING DEPARTMENT IrSEP
CVILLAGE OF RYE BROOK
938 KINGSTREET RYE BROOK,NY 10573 2 6 2024
(914)939-0668
www.rvebrookny.gov VILLAGE OF RYE BROOK
BUILDING DEPARTMENT
*******************************************************************************************************
AFFIDAVIT OF COMPLIANCE
VILLAGE CODE §216 • STORM SEWERS AND SANITARY SEWERS
THIS AFFIDAVIT MUST BEAR THE NOTARIZED SIGNATURE OF THE LEGAL PROPERTY OWNER AND BE SUBMITTED
ALONG WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION. ANY BUILDING OR PLUMBING PERMIT
APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETURNED TO THE APPLICANT .
STATE OF NEW YORK, COUNTY OF WESTCHESTER ) as: `
I, a4 r4L6 l I n 1 , residing at, 2-b i J ) +ti P—Ae J -/ e-e "E
rint name) (Address where yoZ Irve)
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;
210 f N U(-41 r—k ae w-ee_177 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.
(Signature of Property Owner(s))
6114n (A eudllV1 I
(Print Name of Property Owner(s))
Sworn to before me this
da of c , 20 0
(Notary Public)
SHARI MELILLO
Notary Public,State of New York
No.OIME6160063
Qualified in Westchester County 2� (3)
Commission Expires January 29,20
6/1/2024
This application must be properly completed in its entirety by a N.Y. State Registered
Architect or N.Y. State Licensed Professional Engineer & signed by those professionals where
indicated. It must also 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 r-) b Sworn to before me this
day of , 20 day of , 20
Signature of Property Owner Signature of Applicant
5gn1-,q P4011,el
Print Name of Property Owner Print Name of Applicant
I�k' ." &_�L'
Notary Public Notary Public
SHARI MELILLO
Notary Public,State of New York
No.01ME6160063
Qualified in Westchester County
Commission Expires January 29,20 Z1
(4)
6/1/2024
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BUIL NC DE AR MENT
VlZ E OF RYE B` OK F� 2
938 ICrN P T RYE BRC) ,NY 10573
4 �' VILLAGE OF RYE BROOK
W V BUILDING DEPARTMENT
ELECTRICAL PERMIT APPLICATION
Westchester County Master Electricians License Required
FOR OFFICE USE ONLY BP#: c 7 EP#: 04—DOO,
Approval Date: OCT - 3 10 Permit Fee: S
Approval Signature: Other:
DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDING INSPECTOR.
THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12%OF THE
TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00
Application dated, 21 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.
Address: 1 J1/ -t U�e 5r7) SBL: 135--65"',—W? Zone:
2.Property OwnerG�f�Ib'l N r D►aN(f;- t7�L.t Address: 4e�� 11 rA/ IZ 1 d!j F 1
Phone#:gi 7 'M-37 f 0 Cell#: email: /�'
3.Master Electrician/Licensed Installer: AY�W Lk t4ost iD Address: I moke /16NQ
Lic.#: ,5 ��Pho��n"e""#:01 LAN�Q - r_Cell#Vj 9 y Zy`W1 00 email:ll'1,/U, 04t.C�Y�c&a0l•co►'Y�
Company Name:1�Y LXa E kLM L 0 9-lam- 111�,.Address:1(9 MWOL A'l TAUK. Ny I M�m
4.Proposed Electrical Work/Fixture Count: W Y
.k-�ye� C'&'-w! , Co
5.31d Party Electrical Inspection Agency:
STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as:
A►TM o n 3kM ,being duly swom,deposes and states that he/she is the applicant above named,and does further
(print name of in vidual s�i ,g as the a licant
state that(s)he is 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 Sworn to before me this Z�4+ Sworn to before me this 2 1
da of SfO• ef,ae K ,20 2� d y of ,20
tgnature of Property caner Signature of Applicant
172 1 Gt n(A fG D I YI ► ANTt�0 c' 4 81/agrC 0
Print Name of erty Owner FELICITY FULLER Print Na f Applicant
Print
Notary Public-S;eate of New York ��---'----
No.01 FU6425939
Notary Public Qualified in Westchester County Notary Public
y Commission Expires 11/29/2ol�;_ 6/1/2024
STATE WIDE INSPECTION SERVICES, INC.
0•0 • •
SWIS JOB APPLICATION0. SWISTRAINING.CONI
Office Use Elect. Permit# �,J Date
Bldg Permit# �- �y. z)o 7 Sq Ft
Plumbing Permit#
Final Certificate#
City/Village Q � Zip Building Dept. County
Address 2—(0\ �vc\r Cross Street 1 Section 55 Block I Lot 1`
Owner Name/Address(If different than above) �� Contact Number
❑Basement ❑ 1st FI. ❑2nd FI. ❑3rd FI. ❑More Than 3 FI. ❑Garage ❑Attic ❑Outside ❑Residential ❑Commercial
Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C/O Detector Hood Trash Compact
Amt Amps
Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer Switch
SERVICE
Amperage #Panels I 3P # Meters # Disconnect ❑Underground ❑ New ❑ Reconnect ❑ Repair
❑Overhead ❑ Upgrade ❑ Disconnect
Utility ID# ❑Con Ed ❑ NYSEG ❑Central Hudson ❑ Orange/Rockland
PHOTOVOLTAIC SYSTEM
PV Modules Inverters AC Disconnect ]unction Box Combiner Box Load Center PV Monitor Energy Storage System DC Disconnect
❑Legalization ❑ Safety Inspection ❑Consultation
D [E C IE V;E-Dii
�
OCT - 2 2024
VILLAGE OF-RYE BROOK
BUILDING DEPARTMENT i
This application is valid for one(1)year from the date received by SWIS.This application is intended to cover the above listed items to be inspected,if at any time of inspection additional Items have been installed,you are
authorized to make the inspection and adjust the fee for the additional items inspected.The applicant declares that there is no open applications for the above address with any other inspection company.The applicant,
owner or authorized agent agrees to all the above terms and conditions as set forth for the application.
Email Address Y'1 1 ' L 4 u 0 t Corl� Name t1 , `f —X ('
License# ` 15 Date 25 4 Signature f /11
Address ' City/State 1) \ Zip Code ,(D 5�80
Company J Phone# �a� gCal` &'u��
State Wide Inspection Services
DEC 13 2024 1080 Main Street
Fishkill, NY 12524
a - -- , - ----- ----_ I 845 202-7224 Phone
VILL.tivL- OrilYL BROOK 914-219-1062 Fax
STATE WIDE INSPECTIONSERVI"ES BUILDING DEPf\I�Tf�" N7 Email: office(c)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:
Mecca Electric of Rye, Inc. Samuel & Bianca Paolini
Anthony Nostro 261 North Ridge Street
109 Maple Avenue Rye Brook, NY 10573
Rye, NY 10580
Located at: 261 North Ridge Street, Rye Brook, NY 10573
Section: Block: Lot: Electrical Permit Number: EP24-200
135.35 1 11.2
Certificate Number: 2024-8807 Building Permit Number: BP24-207
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: 261 North Ridge Street, Rye Brook, NY 10573
The Exterior Kitchen Area 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 12th day of December
2024.
Name Quantity Rating Circuit Type
Refrigerator 01
Receptacles 03
BBQ Igniter 01
GFCI Breakers 04 20AMP
LED Tape Light 20FT
Switch 01
Officer: Frank 1. 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.
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BUILDING DEPR
A", OCT 2 5 2024 3D ,
VILLAGE OF RYE OK VILLAGE OF RYE BROOK
938 KING ST4-ET RYE B NY 10573 BUILDING DEPARTMENT
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PLUMBING PERMIT APPLICATION //__
FOR OFFICE USE ONLY I, #: _ ��-7 PP#: )z ll/q
Approval Date: \ l Permit Fee. $
Approval Signature: X Disapproved:
(fees are non-refundable)
**+****+**+****+++*++++*++++*++*r*++r*++++*rr**r+++r*+r++++*+*+++*+rrr**rrr*rrr*rrrrrr+rr++rrrrrr+
DO NOT START WORK or CONSTRUCTION 1'N I II.A PERMIT 11AS BEEN ISSIIED BV THE BUILDING
INSPECTOR.THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A
PERMIT IS 12%OF THE TOTAL COST OF CONSTRUCTION NYITH A MINIMUM FEE OF$750.00
Application dated. 10\26 Z 4 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: z- �����.��� SBL: Zone:
2.Proposed Work: c' o t.^ S.J%
3.Property Owner: _)5 1At,.C4 Pilo t,u3 1 Address:
Phone ii: Cell#: email:
4.Master Plumber: Address: Z S �++►�-�- c r�-e�,�s V
Lic.#: AZ3 Phone#: 91 k-*%34-9,p-L Cell#: email: UZ P ,Q.(Q hx-> ,
Company Name: R�-� � � _Address: 7-S Se. Q A.'�JX QA-k�
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 Pubs Service Service Sewer LP Gas
Basement
I st Floor
end Floor j
3`A Floor
4"Floor
St°Floor
Exterior '
5.* List Other Equipment/Provide Details:
(Notarized Signatures Required Next 2 Pages)
c„1/2024
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 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 before me this
day of - 20 _ day of .20
tgnature of Property Owner Signature of Applicant
��faVl lt� Pa a f in►r__-- --
Print Name of Property Owner Print Name of Applicant
l I
Notary Publicjlic,State of New YorkHAR�lI�1ELILLO
UME6160063 Notary Public,State of New York
Westchester County No.01ME6160063
cxnaes January 29.201
Qualified In Westchester County
Commission Expires January 29,20_�
This application must be properly completed in its entirety and must include the notarized signature(s)of
the legal owner(s)of the subject property, and the applicant of record in the spaces provided. Applications
not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be
returned to the applicant.
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BUILDIN EP ARTMENT F
VIL�.A' E OF RYE BROOK ` OCT 2 5 2M
938 KING t i ET RYE BROOR,NY 10573 _
04, 4 9668 VILLAGE OF RYE BROOK
wwwkn ov BUILDING DEPARTMENT
**************************h**k***********h**h*h**,kN****,kA*******************ktk*,k*r*h**Ad***,kit*****#*•k**
AFFIDAVIT OF COMPLIANCE
VILLAGE CODE U16 - STORM SEWERS AND SANITARY SEWERS
THIS AFFIDAVIT MUST BEAR THE NOTARIZED SIGNATURE OF THE LEGAL PROPERTY OWNER AND BE SUBMITTED
ALONG WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION. ANY BUILDING OR PLUMBING PERMIT
APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETURNED TO THE APPLICANT.
STATE OF NEW YO,RRK,COUNTY OF WESTCHESTER ) as:
I,�1 an r irk 0`l n L , residing at. A)o(At 6d Q f Yi`✓io-04-
(Print nano) (Address\\herc)ou lip
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;
2&1 / v(41 i ( ie 5rk-W4— , Rye Brook, NY.
IJoh 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.
(Signature of Property.Okvter(s))
61an ru &101,:,2i
(Print Nume of PropertN Owner(.)) n
Sworn to before me this r �J
d off � 20
(Notan Public)
SHARI MELILLO
NL,tary Public,State of Now York
No,01ME6160063
Q'in ified in Westchester County .3.
COmmis!;on Expires January 29,20'1--1
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�.B\uildin P •t Check List&Zoning Analysis
Address t V SBL•
Zone: 1Z— Use: v Const.Type: Other:
Submittal Date: Z y Revisions Submittal Dates:
4
Applicant
Nature of Work rxAx Q. \ `�(�`QQ�� i`l
Reviews•ZBA: PB: BOT: Other:
NEED OK
( ) ( ) FEES:Filing: tCLN BP: C/O Flood Plane: LegalLti S�b
( ) ( ) Art: Dated Short Notarized: SBL Truss I.D. Cross Connection H•O,A_
( ) ( ) Scenic Roads: Steep
Wetlands: Stoma Water Review: Street Opening:
ENVIRO:Long. —Fees: N/A:
( ) ( ) PLAN:T o Site Protection: gmt•; Other.
°P S/W M Tree Plan:
( ) ( VEY.Dated: Current Archival:- Sealed: Unacceptable:
( ) ( ) PLANS:Date Stamped: Sealed: Copies�.--��--Electronic:
(� ( ) License Workers Comp: Liability: VComp.Waiver. Other.
( ) ( ) CODE 7S3#: Dated: N/A:
0� ( ) HIGH-VOLTAGE ELECTRICAL Plans: Permit N/A: Other
( ) ( ) LOW-VOLTAGE ELECTRICAL Plans: Permit: N/A: Other.
( ) ( ) FIRE ALARM/SMOKE DETECTORS:Plans: Permit I-LW.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 EMMIsiG PROPOSED NOTES
Area:
Circle:
Fronta c
Front r
Front f1 tA• _
Sides:
Rear.
Main Cot.
Accs.Cov:
Ft H Sb:
Sd.H Sb:
GFA:
Tot :
Ft.Im
PP
Height/Stoaes
notes:
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Affidavit of Exemption to Show Specific Proof of Workers' Compensation Insurance
Coverage for a 1, 2, 3 or 4 Family, Owner-occupied Residence
**This form cannot be used to waive the workers'compensation rights or obligations of any party.**
Under penalty of perjury, I certify that I am the owner of the 1, 2, 3 or 4 family, owner-occupied residence
(including condominiums) listed on the building permit that I am applying for, and I am not required to show
specific proof of workers' compensation insurance coverage for such residence because (please check the
appropriate box):
❑ I am performing all the work for which the building permit was issued.
❑ I am not hiring,paying or compensating in any way,the individual(s)that is(are)performing all the work
for which the building permit was issued or helping me perform such work.
❑ I have a homeowners insurance policy that is currently in effect and covers the property listed on the
attached building permit AND am hiring or paying individuals a total of less than 40 hours per week
(aggregate hours for all paid individuals on the jobsite) for which the building permit was issued.
I also agree to either:
♦ acquire appropriate workers' compensation coverage and provide appropriate proof of that coverage on
forms approved by the Chair of the NYS Workers' Compensation Board to the government entity issuing
the building permit if I need to hire or pay individuals a total of 40 hours or more per week(aggregate hours
for all paid individuals on the jobsite)for work indicated on the building permit,or if appropriate,file a CE-
200 exemption form; OR
♦ have the general contractor, performing the work on the 1, 2, 3 or 4 family, owner-occupied residence
(including condominiums)listed on the building permit that I am applying for,provide appropriate proof of
workers' compensation coverage or proof of exemption from that coverage on forms approved by the Chair
of the NYS Workers' Compensation Board to the government entity issuing the building permit if the
project takes a total of 40 hours or more per week(aggregate hours for all paid individuals on the jobsite)for
work indicated on the building permit.
(Signature of Homeowner) (Date Signed)
cc,A (.rl Pa a 1�V1 ; Home Telephone Number
(Homeowner's Name Printed)
go 0-1,0_a
Property Address that requires the building permit: yQ,-(
LO
Notary Public,State of New York
No.OIME6160063
Qualified in Westchester County
Commission Expires January 29,20 li
Once notarized,this BP-1 form serves as an exemption for both workers'compensation and disability benefits insurance coverage.
BP-1 (12/08) NY-WCB