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HomeMy WebLinkAboutBP24-209PERMIT # 4m)& SECTION TYPE OF WORK., JOB LOCATION 'L 19TO COST CO o� TCO # DATE r FEE DATE , I NSP 3�0� 4/-5a3o FOOTING -- FOUNDATION FRAMING a55Elm RGH FRAMING 10-29'2o"t J� 1'� f _ / "s�pr A14'H�) q eQ fig INSULATION � 1 02 'pSec� �` pl /`� 9/ Cvl /� PLUMBING c Z AS RGH PLUMBING Z / GAS � / / \u� \06 l/0No ice SPRINKLER ELECTRIC LOWIIII O r`fALARM C� AS BUILT O FINAL NINE 1239 OTHER APPROVALS ARB __- BOT PB _�- ZBA IOTHER VILLAGE OF RYE BROOK WESTCHESTER COUNTY, NEW YORK NO: 25-010 Certif irate of Orrupaucp This is to certify that C / L �j�/ &/having of, duly filed an application on Lq 20requesting a Certificate of Occupancy for the premises known as, Rye Brook,NY, located in a 9-1e.2 Zoning District and shown on the most current Tax Map as Section: (/ Block: —/—Lot: t11 , and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No.O , issued �� 20, such authority and permission is hereby granted to the property owner to lawfully occupy or use said pre/muses or building or part thereof listed under the following New York State Classifications,Use: "� / / Construction: , for the following purposes: In 7���� � Subject to all the privileges, requirements, limitations, and conditions prescribed by law, and subject also to the following: This certificate does not in any way relieve the owners or any person or persons in possession or control of the premises, building,or any part thereof from obtaining such other permits or licenses as may be prescribed by law for the uses or purposes for which the building or premises is designed or intended. Furthermore, it does not relieve such owners or persons from complying with any lawful order issued with the object of maintaining the premises or building in a safe and lawful condition. No changes or rearrangement in the structural parts of the building or in the exit facilities shall be made, and no enlargement, whether by extending on any side or by increasing in h ' ht shall be made,nor shall the building be moved from one location to another until a permit to accomplish such change s een obtained from the Building Inspector. Building Inspector,Village of Rye Brook: Date: �} BUILD R ENT For office se onl : PERMIT# L? VIL OF RYE OK ISSUED 938 KING STRE YE BROOK, YORK 10573 DATE: i. 939-066 FEE: /_�j/� PAID l k 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 rrr+sr+r►rasrs+++r+srr++sr+tst++++sr+tt+r+r**+****w**rr*wrwr**w***w***wwwr*w**wt**+r*wwwrw**ww****+w***s****rtss*ss*rsrs***ww Address: � M('h e ' Occupancy/Use: — Parcel ID#: Zone: K �a Owner: Address: S P.E./R.A. or Contractor: L P) 2p1r&J t Address: Person in responsible charge: Z-u f Address: Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issuance of a Certificate of Occupancy/Certificate of Compliance for the structure/construction/alteration herein mentioned in accordance with law: STATE OF NEW YORK,COUNTY OF WESTCHESTER as: (11 t LL^a t 1 Z�r o J%r. being duly swom,deposes and says that he/she resides at (Print Name of Applicant) (No.and Street) in R�1 Q r e,,N L ,in the County of W-t;t c " tit I— in the State of IVV ,that (CitV/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:$ 10, o a D for the construction or alteration of: Q' I a t}t u ^ 4 o c.)V>s i'.� (0 CA�If u e,M Deponent further states that he/she has examined the approved plans of the structure/work herein referred to for which a Certificate of Occupancy/Compliance is sought,and that to the best of his/her knowledge and belief,the structure/work has been erected/completed in accordance with the approved plans and any amendments thereto except in so far as variations therefore have been legally authorized,and as erected/completed complies with the laws governing building construction.Deponent further understands that it shall be unlawful for an owner to use or permit the use of any building or premises or part thereof hereafter created,erected,changed,converted or enlarged,wholly or partly,in its use or structure until a Certificate of Occupancy or Certificate of Compliance shall have been duly issued by the Building Inspector as per§250-10.A.of the Code of the Village of Rye Brook. Sworn to before me this q Sworn to before me this day of 20� day of 120 Signature/of Property Owner Signature of Applicant I. lc H 4 G % 1�.0 Print re of Property Owner Print Name of Applicant Notary Pu Notary Public GREGORY M.RNERA Notary Public,State of New York 6/l/2024 No.01 R16441398 Qualified In Westchester County Commission Expires September 26,20 �yE BRC�� cu � '9a2 BUILDING DEPARTMENT ❑BUILDING INSPECTOR 6IASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 KING STREET . RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www.ryebrook.org - - - - - - - - - - - - - -- -- - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : -s l '�O 1 p Sn°�y DATE: 2 0 Z S PERMIT# ) ` Z / 7 V ISSUED: SECT:BLOCK: LOT: &/0 LOCATION: )As e t� 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 1 ❑ NATURAL GAS ❑ L.P. GAS c ❑ FUEL TANK ❑ FIRE SPRINKLER J ❑ FINAL PLUMBING ❑ CROSS CONNECTION [j FINAL ❑ OTHER QyE BRC�k• 0 1932 BUILDING DEPARTMENT ❑BUILDING INSPECTOR J�4SSISTANT 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 t)A p4 `- y /- Gi 'j 1� DATE: �� '� -7 PERMIT# � q ISSUED: SECT:, -' BLOCK: LOT: LOCATION: -7�-> "` p� 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- ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER �yE BRC�k O� Z� cu � 1932 BUILDING DEPARTMENT ❑$UILDING 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 : E _1 -DATE: PERMIT# 2 '1 Z o -1 ISSUED: SECT: � � �V BLOCK: LOT: -} LOCATION: J OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ZI ROUGH FRAMING INSULATION ❑ NATURAL GAS ( j ❑ L.P. GAS ❑ FUEL TANK - t ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER �E 4RC), cu � o 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 : �� M��� J �—l� DATE: -� — Z Je PERMIT# Z ki , 1 ISSUED: SECT; 30 BLOCK: LOT: LOCATION: �L.�� "--p A 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 o ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ��.�c,JQ �.: �' a_Ct (� ( ..✓1` Viti�ZP�� ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER s a 2 a v cy \ C'4 a QN i z o0-4 = w O o U x L p. lu04 V a aCd Ij Ln �-+ � � w r , t © ♦ A/ a a O Q o 0 a © 0 ..� C� © O v O 'O 3q p O z F'� O w W O p •C 7 �Q c O cn W O w � vo _ O Ln 000 [ � a y a � •_ V as O �I Oz A Q � � oU cn = p � z \,Oc WW lu N 1 OC CN �7� a ��+ W o w �, � a ° ✓ -� 0D4.) ° moo _ ICI 643- V � RQ. z �qt ° Aa b (J) 0. L 0 Z z C y@ k _ r.l 0 v 0 O !. O _ �. V h c7 A z O C � BUILD NG DEPARTMENT D VIL E OF R.YE BROOK SAP Z O 2024 938 KING ET RYE BROOK,NY 10573 �,(914)939-0668 VILLAGE OF RYE BROOK ov BUILDING DEPARTMENT INTERIOR BIXDING PERMIT APPLICATION FOR OFFICE USE ONLY: Approval bate: �`� rmit#: X/w, Application Fee:$ t Approval Signature: Permit Fees:$ Disapproved: Other: *****«``******w,►***w**w,rw,r**w********,rtt Application dated: d0-a is hereby made to the Building Inspectorof the Village of Rye Brook,NY,for the issuance of Permit for the interior alteration of an existing boil mg,or for a change in use,as per detailed statement described below. 1. Job Address: J fn cM e 'l c ^ L c, SBL: 1�''• 5'0 - E - 610 Zone: 2. Proposed Improvement.(Describe in detail): Nci A�N) S 1.Q w!t o rx ti a , c (i ,r o Csra d11r�__{ .,I11L A G�rrsn� S�ccE : �t �OA )I. W 1 Sink 0.wl +0. .T. W111 G`S�Ly.� `St�L.Cf 6) �6 9 VLG.^C �}e C.Cc6 CA.0 Sl�a.,y tlf. tide, }ci IN Ce Raox4 I Ac CI-' \OUd V314t`1+� �SAi2 J54<,' -rOS) �j y CVCJLv.�I c� ^+ CNtIQ ^i /�/,x J/ Nz'j CY//t+rM71d'nl p r f' ' 5 / 3. Does the proposed improvement involve a Home-Occupation as per§250-38 of the Code of the Village of Rye Brook? No: •7l Yes: If yes,indicate: TIER 1: TIER II: TIER III: 4. Will the proposed project require the installation of a new,or an extension/modification to an existing automatic fire suppression system(Fire Sprinkler,ANSL System,FM-200 System,Type I Hood,etc...):No:__)C_Yes: (If yes,please submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans) 5. Occupancy;G 2 fam.,comm.,etc...)Prior to Construction: I Vr,yA After Construction: F� 6. NX State Construction Classification: N.Y.State Use Classification: 7. Property Owner: Address: S 1+^01ika g-- i-� Rr Qfaa)1 �\f Phone# 9l4•" 5,rey- SC* tj Cell# q19- Sa'9-V3'(I• email: r4tc►+ eI6,z jr,11�f�0 CYlttt�]1•COm 8. Applicant: Address: Phone# Cell# email: 9. Architect: Address: Phone# Cell# email: 10. Engineer: Address: Phone# Cell# email: pp 11. General Contractor: LLC Address: 15-1 u3 r ti\\&Y­t .Vit,ep. , A.�T�p(hz k Phone# 3 60- S?,( -'C23 6 Cell# J40 - 5_.1 -S-4 m email:. LOS 1 r AW1 LS014 r30&A-XTL.(4r 12, Estimated cost of construction $ 10j C O 0 /p-"is . _0(q (NOTE:The estimated cost shall include all labor,material,scaffolding,fixed equipment,professional fees,and material and labor which may be donated gratis.) p + 13. Job Timetable: Start: [ G ut y -Finish: N (1) 6/1/2024 BUILDING DEPARTMENT VIL ACE OF RYE BROOK 938 IN ET RYE BR06k,NY 10573 (914)"s-066s rN 1N'W okma0v *it:tw**,t,t*air****w,rw*************ir*ir**t,k+*tww,twwww,r*�***t********met+t*ww*wx*etrt�st+rwx*www,�wwwwwwwwww*,tww xw AFFIDAVIT OF COMPLIANCE VILLAGE CODE §2 i 6 • 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, \ 5 0 _J n ,residing at, S 01°kz `f "X (Print name) (Addres, here 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; 5 n��'� `�° A ,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. 7 (Signature of Property Owner(s)) /W/C X 0- / Ef,-,ry L--, (Print Name of Property Owner(s)) Sworn to before me this of �� .20_Q�L (No Public) SHARI MEL ILLO Notary Public,State of New York No.OIME6160063 Qualified In Westchester County (2) Commission Expires January 29,202-7 6/1/2024 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: _M t c u�j 2 '3 r c ,J v- _ ,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 al own r of the ro a 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 day of day of ,20 Signature of Property Owner Signature of Applicant fl71 c fit•ct c 1 _V3� _L7 r- t e of Property Owner Print Name of Applicant Notary Public Notary Public SHARi MEL ILLO Notary Public,State of New York No.01ME6160063 Qualified In Westchester County Commission Expires January 29.20 L 1 (4) b/1/2024 a a. s' N � a x ►^ O � (n pC U �1 cn y 0-0 Ln t - — z N w s < 00 ►--� 1. MLn 00 w Z O x, ►� V z a °° z �' Z z = W F G ~ N g6 x C7 r q O J a Vn : r.. q O F ai Q LLi z w Q C o Q s:• a � a ..5 z a � a si ` BUILDING DEPARTMENT VILLAGE OF RYE BROOK OCT 1 1 2024 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 www.ryebrookny.gov ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required( FOR OFFICE USE ONLY BP#: 7 I EP#: Approval Date: OCT 1 2024 Permit Fee: $ Approval Signature: Other: ****************************** * ********************************************************* DO NOT START WORK or CONSTRUCTION U TIL A PERMIT HAS BEEN ISSUED BY THE BUILDING INSPECTOR. THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12%OF THE q TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00 Application dated, iv 11 i 1''—_'{ is hereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of a Permit to install and/of rerhove 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. 1.Address: t"� 1')t Fit i 'Fw-} l j��_ SBL:��, >�' E �' Zone:_ 2.Property Owner,:�1�C_ fti=J� �J 1�� :�i Address: Phone#: f i i) �;i`j '> ( Cell#: email: 3.Master Electrician/Licensed Installer: Address: 0- -� Lic.#: 1i ..�j Phone#(�i�7��'x -'�;?tlj Cell#: � �{=bj email: '� 4 i_ t;titTfjdof V 1A 0l3 . C;'i I Company Name:`' ,i, :,; �_ !-�T. t _+-�t.t: 4.Proposed Electrical Work/Fixture Count: 5.3`d Party Electrical Inspection Agency: *****,r**+r**,r,r**,t**.***.****,►,►***r*+r*******.+r,r*,r********•*.***,r***,r***,�x,r**«,►***,r,r*w**,e*,�,►***,r,r,►*****,e**,r* STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: � �✓ht.+(f t<•1 hrr_11,w� ,being duly swom,deposes and states that he/she is the applicant above named,and does further (print name of individual signing as the applicang state that(s)he is the VI k Y to o'er) for the legal owner and is duly authorized to make and file this application. (Master Electrician/Licensed Installer) The undersigned further states that all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances,and regulations. Sworn to before me this Sworn to efloye ipe this 1 day of 120 day of ,20 Signature of Property Owner gnature of Applic! Print Name of Property Owner P ' ame o Applicant 47. Notary Public ERA Ne"Public,State of New York 6/l/2024 No.01 RI6441398 Qualified In Westchester County �/ c-1—a CnntamhPr 26.2 STATE WIDE INSPECTION SERVICES, INC. Service With Integrilly 1• 080 Main Street, Fishkill, NY.125241 Email:OFFICE@SWISNY.COM SWIS JOB APPLICATION tel 845.202.7224 1 fax 914.219.1062 1 SWISNY.coml SWISTRAINING.COM Office Use Elect. Permit# Date Bldg Permit# Sq Ft Plumbing Permit# Final Certificate# City/Village Zip Building Wt. County Y-i it Address Cross Street Section Block rt 5 1 Lot J1,11OLl-i Owner Name Address(If different than above) Contact Number ❑Basement [—] 1st Fl. [:]2nd Fl. ❑3rd Fl. ❑More Than 3 Fl. [:]Garage ❑Attic ❑Outside E]Residential [—]commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C/0 Detector Hood Trash Compact Amt Amps Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer Switch SERVICE ❑ ❑Repair 1:1 Overhead —PE❑I Upgrade Reconnect rade 1:1 Disconnect Amperage #Panels 1P 3P A Meters # Disconnect []Underground Utility ID# 0 Con Ed [:] NYSEG ❑central Hudson E] Orange/Rockland PHOTOVOLTAIC SYSTEM PV Modules Inverters AC Disconnect ]unction Box Combiner Box Load Center PV Monitor Energy Storage System DC Disconnect ElLegalization ❑ safety inspection ❑Consultation ,; �\�m�� Cyr.-;`_�x� �2v.��`�n �u� D, OCT 1 1 2024 AIZ Ll 10- VILLA ; B LPIU—'LJ1 This application is valid for one(1)year from the date received by SMS.This application is intended to cover the above,listed items to be inspected,if at any time ofinspectlish 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 of authorized agent agrees to all the above terms and conditions as set forth for the application. Email Address' Name License# Date Signature 14 7717-� Address City State p Code Company Phone# RL Dk State Wide Inspection Services j 1080 Main Street NOV 1 9:20]24 -0Fishkill, NY 12524 845 202-7224 Phone VILLAGE OF RYE BROOK 914-219-1062 Fax LA STATE WIDE INSPECTION SERVICES BUILDING DEPART NIENT Email: office@swisny.com -- "' Website: www.swisny.com Service With Integrity BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: Your Choice Electric LLC Michael Brown 16 Greenhaven Road 5 Mohegan Lane Poughquag, NY 12570 Rye Brook, NY 10573 Located at: 5 Mohegan Lane, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP 24-206 135.50 Certificate Number: 2024-8228 Building Permit Number: BP 24-209 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: 5 Mohegan Lane, Rye Brook, NY 10573 The Basement 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 181h Day of November 2024. Name Quantity Rating Circuit Type GFCI 01 Receptacles 01 Exhaust Fan 01 Dimmers 02 Timers 01 Luminaires 04 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. e Q\ N f+] Ln N N OZ t N N N \ \ W 1 ON C, o� a. H �, W tc m H $ <0-4 O 1.4 w A W z t W $rl ... Linz W w M w z C7 Ln A ►MM� 30 C4 C7 W a z N z� z z W ►� a z w ryl � w z w < .. �- o BUILDING DEPARTMENT VILLAGE OF RYE BROOK OCT 17 2024 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 ,.vww.ryebrookny.gov PLUMBING PERMIT APPLICATION � �/ -/59 Approval Date: Permit Fee: $ Approval Signature: Disapproved: (fees are non-refundable) ************************************************************************************************** Application dated, 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 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: 5 Mohegan Lane SBL: _SQ _Zone: 2.Proposed Work: Rough and finsh plumbing for new shower. Install new toilet sink same location. 3.Property owner: Michael Brown Address: 5 Mohegan Lane Phone 4: Cell 4: 914-589-8517 email: linzerl999@gmail.com 4.Master Plumber: Sal W Morlino Address: 1 Bonwit Road Rye Brook NY 10573 Lic. 4: 725 Phone 4: Cell 4: 914-260-1592 email: salvatoreserious@gmail.com Company Name: Westchester Plumbing And Heating LLgddress: 1 Bonwit Road Rye Brook NY 10573 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 Scnice Ser%ice Sewer LP Gas Basement 1 1 1 3 Ist Floor 2nd Floor 3"Floor 4'Floor 5`s Floor Exterior 5.*List Other Equipment/Provide Details: (Notarized Signatures Required Next 2 Pages) -I- 6/l/2024 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: Sal W Modin0 ,being duly swom,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. Swom to before me this Sworn to before me this day of C`CA-"` 1 20 �\ day of 06 / 20 Signature of Property Owner Signature of Applicant C_ R Sal W Morlino Print Name of Property Owner Print Name of Applicant Notary Public Notary Public SHARI MELILLO 4!4[- =E MORU W Notary public,State of New York : .i Pubk So"of NW YQ* No.01ME6160063 NO.01MOb Ill Qualified in Westchester County "ia!d In W9s1 h—W ^rmmission Expires January 29,20�� Exgire8 AWOL 3, d`�o -2- 6/1/2024 BUILDING DEPARTMENT VILLAGE OF RYE BROOK OCT 17 2024 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 wwwxyebrookny.gov AFFIDAVIT OF COMPLIANCE VILLAGE CODE V 16 - STORM SEWERS AND SANITARY SEWERS STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: 3, Michael Brown ,residing at, 5 Mohegan Lane 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; 5 Mohegan Lane ,Rye Brook,NY. !„i• vdd, 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. IPriut A:any�� Pr„linty O��n�i ,: Sworn to before me this of L' 20 ; (Note , hiblic) SHA'RI MELILLO Notary Public,State of New York No.OIME6160063 Quelifed in Westchester County Commission Expires Jar`uary 29,201 _3_ G/l/2024 Building Permit Check List&Zoning Anal sis Address: � � � L ti 1 SBL• Zon ^k 2 Use �� Const.Type: Other: — Submittal Date: � �-' Revisions Submittal Dates: Applicant: t�� Nature of Wprk: < \•liz �V k be LAw \� Sin \ Reviews:ZBA: 024 P& BOT: Other. NEED OK FEES:Filing: C/a 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. Short 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 Waiver. Other. ( ) J ) 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: 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-Burk Plans: Other. ( ) ( ) BP D241AL 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 VVLD Ana: Date: S 0 2024 Circle: Fronts a Front: Front: Sides: Rear. Main Cov: Accs.Cor Ft.H Sb: Sd.H Sb: GFA: Tot.Imo: Ft.jmL : P� Height/Stories• notes: �- s `Q W e� G � v s \ ........................................................... i ! ., i'r .'l[r ^l5: iJ hf%!�. :�>�'," {,if �1�,.\ �.`• F - W _ T L m N .j ti JIt _ r — f' V/ W Y i r W LLJ «� ^. OEM N — jj' A P X N e O U� 4. a � �(#AIn - ,s 1►y„ /}I ZYffYYYY'/YYrY.;x'f�Yr1CYY Yf[YYYYY YY]`Y1r1....... .. .. .. 'rYYYYY Yv.Y`Y YS'1. w?.;I ..�»/; �i ,,i i/ .. . . ....u :4f��.. a'��10� v�v�►- l ` DATE(MMIDDIYYYY) llk. � n CERTIFICATE OF LIABILITY INSURANCE �� os/ozizoza 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 Sharp Insurance Services Inc CONTACT Moises Rosales NAME. 128 N Main St Port Chester NY 10573 wc.No.Est!:2032479524 (FAX Not:2036638200 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIL 0 INSURER A:SUTTON SPECIALTY INSURANCE COMPANllss4s INSURED LNL Remodeling LLC INSURERS: 253 William Street 2 Rye Brook.NY 10573 INSURERC: INSURER D: 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 ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDD/YYYY MMoD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY r/ EACH OCCURRENCE $1,000,000 ✓ CLAIMS MAUL OCCUR SCB-GL-000049024 03127/2024 03/27/2025 DAMAGE TO RENTED 50,000 PREMISES(Ea occurrence) $ IVIED EXP(Any one person) 55,000 PERSONAL&ADV INJURY $1,000,000 GLN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000,000 ✓ POLICY❑ PRO ❑ 2,000,000 JECT LOC PRODUCTS-COMP/OP AGG $ OTHER $ AUTOMOBILE LIABILITYL-1 Li COMBINED SINGLE LIMIT $ (Ea accident) ANY AU TO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Peracadmnt);$ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE EXCESS LIAR HCLAIMS-MADE AGGREGATE _ $ _ ULU I�LILNTIONS F $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN STATUTE ER ANYPROPRIETOR/PARTNERJEXECUTIVE E.L EACH ACCIDENT $ OFF ICER/MEMBEREXCLUDEDI NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE. $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ r—IF DESCRIPTION OF OPERATIONS r LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) The Commercial General Liability Insurance is endorsed naming"Village of Rye Brook"its officers,partners,shareholders,employees and costumers as additional insureds. Address Job: 5 Mohegan Lane Rye Brook NY 10573 CERTIFICATE HOLDER CANCELLATION Village of Rye Brook SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 938 King Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Rye Brook, NY 10573 ACCORDANCE WITH THE POLICY PROVISIONS AU r HORIZED REPRESENTATIVE Moises Rosales PRODUCER Cc)1988.2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Produced using Forms Ross Web soltwarn.www Forrn%Ross corn '1 Irnprossi—Pubhsl 9 800.208.1911 NYSIF New York State Insurance Fund PO Box 66699,Albany.NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ❑, iW AAAAAA 991563318 SHARP INSURANCE SERVICES.INC 120 N MAIN ST-2ND FL Qr'_7y. PORT CHESTER NY 10573 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER LNL REMODELING LLC VILLAGE OF RYE BROOK 253 WILLIAM ST 938 KING STREET APT 2 RYE BROOK NY 10573 PORT CHESTER NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W2629382-9 1C1701 08,27!2024 TO 08/27/2025 913/2024 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2629 382-9. COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNJER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERA—IONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND. WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY,INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE VISIT OUR WEBSITE AT HTTPS.iiWWW,NYSIF.COM/CERTICERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER THE SOLE PROPRIETOR PARTNERS AND/OR MEMBERS OF A LIMITED LIABILITY COMPANY THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. 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