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Home My WebLink AboutBP24-246PERMITDATE / aS ��/ acP:� SECTION �� c�/%_ LLOCK / LOT TYPE OF WORK _L/Ji'i �� 7E/Q Oils � XJS JOB LOCATI N OWNER 7S C�6O Lot EST. COST ✓CO # ,/TCO # c DATE o/7v I e FEE s S FEE INSP FOOTING - - FOUNDATION FRAMING G D RGH FRAMING I' Z 3- Zo INSULATION I^Z3� C PLUMBING RGH PLUMBING GAS SPRINKLER ELECTRIC LOW -VOLT �z-�-.-� � ALARM AS BUILT *a 3 ar FINAL / OLT755 kU(Ik 1 • 1- 20 • 1- 5 - 20 zS as�e AB r�Py— �o- 000 �SgJA In CP SlIC2S 0)383-5890 OTHER APPROVALS ARB BOT PS ZBA OTHER Po�� OO `7 /rv4� P 0 aa,11v,,`� bra �2cv►Ctnical �2rvlces I — i 8 -z s III, Pay s�e� - pPaS e NI CAS - CC l e �-e✓ 54, 5 /�� oc� vi SNP cv erg l E/Q� c -� 6 Ll a.yp✓/(,,4tvar)( 's t//ateo� Je viC2 � Pas.OylCC 00 �M•l� Igo Z) Ae6() 9;;1111 4c)? VILLAGE of RYE BROOK WESTCHESTER COUNTY, NEW YORK No: 25-107 Certificate of ®ccupaurp This is to certify that A'SP G___6 C of, Rae Bkoo.C,, / V y having duly filed an application on 20 4:;>?5 requesting a Certificate of Occupancy for the premises known as, • , Rye Brook,NY, located in a o�-a Zoning District and shown on the most current Tax Map as Section: cZ 7 Block: Lot: and having fully/complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No.6 ` /T!f, issued 20�V, 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: adsi S (! Construction: for the following purposes: • ) e 0 Gl"Cj r1661 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 ' shall be made,no 'the building be moved from one location to another until a permit to accomplish such change h4 be+o i d fro the ui ing Inspector. Building Inspector, Village of Rye Brook: Date: AUG 19 2025 . 19 VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury www.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 August 19,2025 RSP Group LLC 90 South Ridge Street Rye Brook,New York 10573 Re: 90 South Ridge Street, Rye Brook,New York 10573 Parcel ID#: 141.27-1-9 This document certifies that the work done under Plumbing Permit #25-004 issued on 1/9/2025 the installation of new electric hot water heater has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to BR1 tCC�UJJV . 19 CC��Ca VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury www.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 August 19,2025 RSP Group LLC 90 South Ridge Street Rye Brook,New York 10573 Re: 90 South Ridge Street,Rye Brook,New York 10573 Parcel ID#: 141.27-1-9 This document certifies that the work done under Mechanical Permit #25-002 issued on 1/10/2025 the installation of new branch ductwork,grilles/diffusers,insulation and two exhaust fans have been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to QyE DR 1 LOD . 190 G Ctp y VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury www.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 August 19,2025 RSP Group LLC 90 South Ridge Street Rye Brook,New York 10573 Re: 90 South Ridge Street,Rye Brook,New York 10573 Parcel ID#: 141.27-1-9 Mechanical Permit#25-001 issued on 1/9/2025 for Fire Sprinkler System Modifications This certifies that the fire sprinkler heads,installed under the above captioned permit,have been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to VILLAGE OF RYE BROOK WESTCHESTER COUNTY, NEW YORK NO: 25-025 Eemporarp * Certificate of ®ccupaucp This is to certify that 9SP Ov6u L LC of, k / v having duly filed an application on r-e Y Y CJ CO . 20 requesting a Temporary Certificate of Occupancy for the premises known as, Ob P , Rye Brook, NY, located in a 08-C2 Zoning District and shown on the most current Tax Map as Section: 141 .,:Q:: -7 Block: ' Lot: 9 —, and having fully//complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No.c2`"r , issued 1 20 ca?qsuch 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: J� Construction: for the following purposes: , _ C712 / Y Subject to all the privileges, requirements, limitations, and conditions prescribed by law, and subject also to the following: T 0 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 ' creasing in he sha ll be made, nor shall the building be moved from one location to another until a permit to accomp sh c e h en obtained from the Building Inspector. Building Inspector,Village of Rye Brook: Date: FEB 1 1 2025 DBUILD � R ENT For office use only: / VIL OF RYE OK PERMIT# AUG 1 8 2025 ISsuED: 938 KING STRE YE BRPOKy YORK 10573 DATE: VILLAGE OF RYE BROOK 9 f46 O�c FEE: ' CJ J— PAID E:. 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 *sssssstsssw***sssttswssstww*t*s*ssssstswtw*sssssstss*ssswww****s*ssssss*tts*ts*ws tsssst*tsttstwwstssttsts ss*t****w*asttttstt Address: 90 S. Ridge St., 2nd Floor Occupancy/Use: Parcel ID#:14102700010090000000 Zone: OB-2 Owner: RSP Group LLC Address: PO Box 277, Rye, NY 10580 P.E./R.A. or Contractor: PTSC Northeast Inc. Address:200 Business Park Dr. Ste. 205, Armonk, NY, 10504 Person in responsible charge: Anthony DellaCamera Address:200 Business Park Dr. Ste. 205, Armonk, NY, 10504 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: Anthony DellaCamera being duly sworn,deposes and says that he/she resides at 200 Business Park Dr. Ste. 205 (Print Name of Applicant) (No and Street) in Armonk —,in the County of Westchester in the State of NY that (Cityrrown/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:$ 396,074 for the construction or alteration of: Interior demolition work to combine existing suites at 90 South Ridge St., 2nd Floor 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-I O.A.of the Code of the Village of Rye Brook. ��4 Sworn to before me this 1_7� Sworn to before me this �(� day of —z5 ne , 20 2.cj day of 'fj,( Q_ 20 a- Signatur f Prope O r Signature of Applicant a N 6�;)47 Print Name of Property Owner Print Name of pplicant r NNzjWPublic Notary Mblic CASrYL.SORBARA Notary put State of New York PATRICIA A FEENEY Registration No.01SO6421792 Notary Public, State of New York ,14 Qualified in Westchester County Commission Expires September 7,2025 Registration #01 FE6307615 Qualified In Westchester Count Commission Expires July 7, 2 zJ D [ (Q E� V [E BUILDING D&ARTMENT For office ue onl PERMIT# c�) —off y�o VILLAGE OF RYE BROOK ISSUED: FEB - 6 2025 H KING STREET,�RYE BROOK,NEW YORK 10573 DATE: 014)939-06 FEE: —TJ PAID VILLAGE OF RYE BROOK o ov BUILDING DEPARTMENT �q2 APPLICATION FOR TEMPORARY CERTIFICATE OF OCCUPANCY 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 shall have been issued by the Building Inspector.§250-10.A.code or the village of Rye Brook Address: 90 South Ridge St., 2nd Floor Occupancy/Use: Parcel ID#: 14102700010090000000 Zone: OB-2 Owner: RSP Group LLC Address: PO Box 277, Rye, NY 10580 Contractor: PTSC Northeast Inc. Address:200 Business Park Dr. Ste. 205, Armonk NY 10504 Person in responsible charge: Anthony DellaCamera Address:200 Business Park Dr. Ste. 205, Armonk, NY, 10504 Reason for temporary use: Completion of work in phase B of the approved permit set of drawings Estimated date of completion: 3/7/2025 Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issuance of a Temporary Certificate of Occupancy for the structure herein mentioned in accordance with law: STATE OF NEW YORK, COUNTY OF WESTCHESTER as: Anthony DellaCamera being duly sworn,deposes and says that he/she resides at 200 Business Park Dr. Ste. 205 (Print Name of Applicant) (No.and Street) in Armonk , in the County of Westchester in the State of NY ,that (City/Town/Village) he/she has supervised the work performed to date at the location indicated above, for the construction, alteration or repair of: Interior demolition work to combine existing suites at 90 South Ridge St., 2nd Floor Deponent further states that he/she understands that a Certificate of Occupancy must be applied for and obtained upon completion of the above captioned project in accordance with law, and that a Temporary Certificate of Occupancy shall only be valid for a period not to exceed thirty (30) days. Sworn to before me this (0 Sworn to before me this &`tt' day of r , 20 3� day of 1),rao,(a 20 Signature&Pr er Signature of Applicant Pri ame of vroperty Owner Print Name of A plicant otary Public NVtary Public F,-,TRICiA A FEENEY Notnr Public, State of New York PATRICIA A FEENEY y Notary Public. State of New York Regis,,,,ation #01 FE6307615 Registration #01 FE6307615 Qualified In Westchester County Qualified In %'Jestchester County Commiss_on Expires July 7, 20-2(0 Commission Expires July 7, 20.z� 6/l/2024 �yE BRC��, O�` tim cu � 1982 BUILDING DEPARTMENT ❑/BUILDING INSPECTOR [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 Uebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS :- � DATE: PERMIT# �I . Z �� to ISSUED: SECT: /'�/-• 2 7 BLOCK: LOT: LOCATION: / * �y'JZ. OCCUPANCY: ❑ Violation Noted THE WORK IS... a PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION / II ❑ Natural Gas 04)2 Ic- A,) P ❑ L.P. Gas n ❑ FUEL TANK CIA CA ❑ FIRE SPRINKLER J ❑ FINAL PLUMBING ❑ .CROSS CONNECTION ff'FINAL ❑ OTHER �E BRC�k. cu � 1932 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.ore - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS :- '� DATE: PERMIT# ISSUED: SECT: // Z BLOCK: LOT: LOCATION: pk a) OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... p 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 U_S P L ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER QyE BRC�� 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 : DATE: PERMIT# ISSUED: SECT: BLOCK: LOT: LOCATION: OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER �yE BRCv� cu � 1932 BUILDING DEPARTMENT ❑BUILDING INSPECTOR PASSISTANT 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 : z) �\ j� DATE: PERMIT#Y"1` Z ' OO ISSUED: _`t- Z SECT:- BLOCK: LOT: LOCATION: p PC, -4 J ti- OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑-PACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS 1 ❑ L.P. GAS ❑ FUEL TANK Q FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER �E BRC�vk, cu � '9a2 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 : �7�A �� }j �J�_Q X-, . DATE: PERMIT#t'�4�' -2 S- O y'L ISSUED: '- SECT: BLOCK: LOT: LOCATION: LAP 4 `4t/l �t3J2. 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 n t J V. A ❑ L.P. GAS ❑ FUEL TANK ` J r I- L i--A ❑ FIRE SPRINKLER C' r J ❑ FINAL PLUMBING ❑ CROSS CONNECTION r J S I Q VJ ❑ FINAL ❑ OTHER V\JI We I(ALc• r� I�PPc12 ti QyE BRC�v� 1932 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: PERMIT# ��.5 - D0-1 ISSUED: SECT: BLOCK: LOT: ±/ LOCATION: _u p?P A # rc 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 , t ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER QyE[3RC�jk• .`J�O� 1982 BUILDING DEPARTMENT ❑BUILDING INSPECTOR 2<SSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAX (914) 939-5801 www ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS :- `7 �li T `" DATE: 7 02-S PERMIT# )ap 24- Z Li(.0 ISSUED: SECT: BLOCK: LOT: LOCATION: L A P P eA OCCUPANCY: ❑ _VIOLATION NOTED THE WORK IS... [j ACCEPTED ElREJECTED/ REINSPECTION AT-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 DR j-. 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 : qT-) � { � DATE: ( �J �Z'r PERMIT# Z�I - Z 7-(C, ISSUED: I�'Z r LSECT: • ? BLOCK: / LOT: LOCATION: OCCUPANCY: IL OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... 0 ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING a'.ROUGH FRAMING 9 INSULATION O ❑ NATURAL GAS �� { a C ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION 1N CC9't ❑ FINAL ❑ OTHER QyE BRC�k. 19132 BUILDING DEPARTMENT ❑yBUILDING INSPECTOR yw 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 : -so U L-r el DATE: - v� y PERMIT# ISSUED: SECT:� 2 7 BLOCK: LOT: LOCATION: wU c 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 [I INSULATION ❑ NATURAL GAS U ,n ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION /�- ❑ FINAL ❑ OTHER01 N N N ' � N "' Ln N N o }Yy r'I � • N � M H9 it a '� 1-4 vi O Z a u Cn CA v A S4 O 0 N ��n x O goo - � � A © O o a W v o , PA z � � � � c� � � Q •5 � U U o A © wV � o °' . o c!� 00 U �+ Z w - �J Q � cn � adyovoa ►� a U wca � w � F+ W o CA Q 0f F-i O N M aui w O .q w 1 - C z C7 �.+ w � •" r. G, u v I BUILD MENT VIL OF R OOK OCT 2 8 2024 938 KING ET RYE BR ,NY 10573 Q 4 -0 ov INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: C� Approval Date: V Z 2 1 en Pt -� / Application Fee: Approval Signature: Permit Fees: $9 90 3—DU 4F- Disapprove& Other: Application dated: 10/22/2024 is hereby made to the Building Inspector of the Village of Rye Brook,NY,fur the issuance of Pennit for the interior alteration of an existing building,or for a change in use,as per detailed statement described below. 1. Job Address: 90 South Ridge St., 2nd Floor SBL: 14102700010090000000 Zone: OB-2 2. Proposed Improvement.(Describe in detail): This_pro'ect Consists of interior demolition Work to combine existing suites at 90 South Ride Street, 2nd floor 3. Does the proposed improvement involve a Home-Occupation as per§250-38 of the Code of the Village of Rye Brook? No:_X_ Yes: If yes,indicate: TIER I: TIER 11: TIER III: 4. Will the proposed project require the installation of a new,or an extension/modification to an existing automatic fire suppression system(Fire Sprinkler,ANSL System,FM-200 System,Type I Hood,etc...) :No: Yes: X _ (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: 106 After Construction: 106 6. MY State Construction Classification: TynP I-B N.Y.State Use Classification: BI 0sness 7. Property Owner: RSP Group LLC _Address: PO Box 277, Rye, NY 10580 Phone# Cell# email: 8. Applicant: PTSC Northeast Inc. Address:200 Business Park Dr. Ste. 205, Armonk, NY, 10504 Phone# 914.290.4166 Cell# 310.383.5890 email: zach.sawyer@ptscontracting.eom 9. Architect: Colliers Engineering & Design _Address:35 Pond Park Rd, Bay 16, Hingham, MA 02043 Phone# 781 452-7121 Cell# email:kcholeva@phasezerodesign.eom 10. Engineer: Long Consulting Address:67 Federal Rd. Bldg A, Ste 201, Brookfield, CT 06804 Phone# (203)663-3703 Cell# email: tyler.long@longengineers.com 11. General Contractor: PTSC Northeast Inc. Address: 200 Business Park Dr. Ste. 205, Armonk, NY, 10504 Phone# Cell# 310.383.5890 email: zach.sawver ntscontractina.com 12. Estimated cost of construction $ 396,074 (NOTE:The estimated cost shall include all labor,material,scaffolding,fixed equipment,professional fees,and material and labor which may be donated gratis.) 13. Job Timetable: Start: 12/13/2024 Finish: 02/21/2025 (I) BUIL ENT VIL OOK OCT 2 8 2024 938 KING NY 10573 ov 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. AtbtlrtY 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, Frankion Albanese ,residing at, k-R,i0%'s., h A k Vios3 s • (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; 90 South Ridge St. ,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. { =Ovuner(s}} (Print Name of Property Ov%mer(s)) Sworn to before me this CJ`" day (.@ vW 20 `[ (Notary Puhlic) LZOZ's 3'>0 s4i1dx3 u0issluFw43 AW (2) A�urw�Jals6431soM ul payllenb Zv0C6E93M10'ON xjo,,MaN p 83e75 Ito iUe2oN 6/1/2024 ASS.4ON3M IaO� i J 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,COLNTY OF WESTCHESTER ) as; Zach Sawyer, PTS Contracting ,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 Contractor for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,attorney,etc.) - - That all statem eux are true itie-beg-nfttglh-er�aio—wle&ge an e , an a any woT pe rme 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 ':-1 day of 20 day of ( , 20 J�L Signature of Property Owner igyn of Applicant Print e o roperty Owner Print Name of Applicant Notary Public Notary Public PATRICIA A FEENEY Notary Public, State of New York FtORI WENG0.flFSKY Registration #01FE6307615 tHotary;)ubtic,state of New YorkQualified In Westchester County NO.02WE6393042 Commission Expires July 7, 20"in Westchester County mission Expires Oct 5, 2027 is (4) 6/1/2024 t , ` i •� \ N z • � � ,f, a vs c� � • Z `r' Ln vt 00 i w z z w !n w > Qip) U O O0 Cn J o w a v - V A C: C, a z W c, `-' C V � w v H z : M04 0-4w � �= u x a a z o H z ` 0-4 0 x o � O rp v z z a "..4 < g H s � o z � x •-� .. � a ;�; z w A a oa , v a ` z a fD BUIMENT VI OK DEC 2 3 2024 938 KIN ,NY 10573 ov ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY BP#: BP24-2 EP#: d y— ' o Approval Date: �'� 4 Permit Fee: $ $175.00 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, 12-16-24 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. Q 1.Address: 90 South Ridge Street SBL: I qli c�7-/— / Zone: 2.Property Owner: RSP Group LLC Address: Phone#: 914-906-1100 Cell#: email: 3.Master Electrician/Licensed Installer: Susan K.Walsh Address: 18 Grove Avenue,Branford,CT Lic.#:0191101 Phone#: 203-294-4655 Cell#: 203-996-6942 email: swalsh('Onetwork-install.net Company Name: Network Installation Services,Inc Address: 192 North Plains Industrial Road,Wallingford,CT 06492 4.Proposed Electrical Work/Fixture Count: Network Installation Services will be installing CAT6 plenum low voltage cable for phones and computers.We are working as part of a larger construction project along with PTSC Northeast Inc,BP- 4-246,on the 2nd floor for YNHH OBGYN Renovation P efeet. 5.31 Party Electrical Inspection Agency: Statewide Inspection Services-845-202-7224 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: Susan K.Walsh being duly swom,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 CT Licensed Installer 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 before me this 16th day of ,20 day of December ,20 24 Signature of Property Owner Signature of Applicant Susan K.Walsh,President_ _ Print Name of Property Owner Print a of Ycan Notary Public Q$ INS Nota Public 6/I/2024 Connecticut My Commission Expires Apr 30, 2026 STATE WIDE INSPECTION SERVICES, INC. SWIS JOB APPLICATION Office use Elect.Pem* " y Y C Date- 12-16-24 Bklg Perrlltt s BP 24-246 5kl Ft Plumbw Pt4ind n Rol Cat*wAe+i aty!village Village of Rye Brook zip 10573 Brnkhny Deli. CarnlY 90 South Ridge Street cross street section Bloc. I Ili Owner Name!Address III N"emuNNlat.nr( RSP Group LLC Ctx4act Number 914-906-1100 Basement W N. [3 hxl FI 3rd H. Kxv 111aI1 3 H. Garage ❑Attic Out%kk Residentwl [3Commerc3al Keteptdcies Special Retept GFI_I AFCI Swathes Oirrrras 5n"r Alarms C/O OeWtx Hood Trash Compact Aml Amps Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator I nsfxr rl MII:rIrWaw7 Llxrnnain (rr»tntlN llmnle,ywaLfi SERVICE Amperage "ark-Is IP 3P y Meters + Dts,.rnlect E]Undergraurd ON-w 0 kecofvwd Repak o a t 1pyrade a oiscronrled tKilitY lira Con Ed NYSEG Central[Wson Orange/Rockland PHOTOVOLTAIC SYSTEM VV hhrdlll- Inverters 1 #4DIsaunnectl 1►uxtton fit Il I t1lntllrxv Bnr Load Center I PV MOnitof Energy Storage System DC Dtsco nnect Lvoill:ation ❑ SafetyInW_ncKrn Consultation YNHH OBGYN Suite,2nd floor- Low Voltage Plenum Cable for Phones&Computers DEC 2 3 2024 I»•y�11F.NN»I I`.vAlrl}n.er I;v^er IIrMI Ilr Mir rry r+,.vl IN SM7'.11W aglW M}rrl I,IMr'n•M'I• •purr rM•Y•�.^N,rM Nwn•1.•IR enlw r•:.A Y Mlv 1••rv.•1 Nlq..'a4^•w}I.1»rW NaM low 1.»vr eW�.w1,@I»i-» »nlr»Ur.l 1••n•J•Ilr n.y»^IN n.r»I wlryw Ilr Ir»lu Ilr rN W}rIW M.Y,n Wyrr l..l.Ilr alM1M•rn•V•lar.,rl..,l nr.r.•r r.•'1»YI.n'taN atlrvl•.1••Nr Y»ire r4lrea,vAh.w,y•»Irel»,y.e../}�I'.r,y.rrr.the epp.crM. "wn•■nnlF•1!•rl ny.',rt yT t•,�N!he eiwnrr Iwnn aryl•.»N�I(1111 H fN lutll l•»,Ir yyM ale»�• Emar Address swalsh@network-install.net Name Susan K. Walsh LKe1se IT N/A 12-16-24 Signature Addrl�.s 192 North Plains Industrial Road city/StatWVallingford,CT zip code 06492 (-,—Pdy Network Installation Services, Inc Phone N 203-294-4655 J_I)w Volk ye �� D [E C E ME State Wide Inspection Services CIA 1080 Main Street FEB - 7 2025 Fishkill, NY 12524 a� 845 202-7224 Phone 914-219-1062 Fax STATEWIDE INSPECTIONS E RVICES VILLAGE OF RYE BROOK Email: officeCaOswisnv.com BUILDING DEPARTMENT 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: NetworK Installation Services, Inc RSP Group LLC Susar.Walsh 90 South Ridge Street 192 North Plains Industrial Road Rye Brook, NY 10573 Wallingford,CT 06492 Located at:90 South Ridge Street, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP24-240 141.27 1 9 Certificate Number: 2025-0845 Building Permit Number: BP-24-246 A visual inspection of the electrical system was conducted at the Commercial occupancy described below.The electrical system consisting of electrical devices and wiring is located in/on the premises at:90 South Ridge Street, Rye Brook, NY 10573 The First Floor Examination Rooms and Hallways were inspected in accordance with the NYS and NFPA 70-2017 and the detail of the installation, as set forth below,was found to be in compliance on 7th day of February 2025. Name Quantity Rating Cables for Phones &Computers 46 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. IR to to 444ts tot, 443�4- Cictits i i M _ O ,n � a3 i C�V N N a a W N N y C) rA W �" � � ✓� U H u � w 0 4 W Lin LL.00 p 00 N. z f H H g a Z N Q o CN 00 u Q V Ooo C� ✓ w O O x F. R. O `D O x C7 r r F0 £� M V c .. �. e pw 00 ►--� Z W w V a z v ,� �" ce VCl) a H a zz i� a ••' 0 V H Q o� , ' i i u w OG W OO O FO ►� : Ln O V O W z a � 6 < :L o �I m a � "I w w = _ l��tvi4414twto44 fittt,A;4 4-;4i4rVilt4C 444+44124 tV� yE RRC1�� BUIL MENT VIL E OF RYE OK JAN - 3 2025 938 KIN NY 10573 w o v ELECTRICAL PERMIT APPLICATION Westchester County Master Electr'Mans License Required FOR OFFICE USE ONLY BP#: EP#: Approval Date: \ Permit Fee: $ Approval Signature: Other: ISO 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 R 14 OAL COST OF CONSTRUCTION WIT A MINIMUM F e.r OF a"750.€0 �Application dated, /C-./f_64'2—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. \ 1.Address: � r tsT SBL: f 7J, r)7 -/-"'� Zone: � 2.Property Owner: j�,tf' l e u l+ L,.L 6-6 & N 1 U 5- re s: t>2� c. nn(:yri tl L ISO � �.� o l 4.Proposed Electrical Work/Fixture Count: R r o t S r n c T'e i F PC" C ,r I'hh' 5.3rd Party Electrical Inspection Agency:_ � c ***++*t+,a+.,a*+*►:t�r�r+*+:+****:rt*****�* *+*+*x ++,•++**+r�,�++*+*++,r ++:++++**++ *x,r++*+x**,�s�+tom*+++++++++*�� STATE OF W YORK,COUNTY OF WESTCHESTER ) as: . a ,being drily swom,deposes and states that he/she is the applicant above named,and does further (prinl name of mdi tidual signing as the applicant) state that(s)he is the A&A(h; ,�,�iMCI Ao— for the legal owner and is duly authorized to make and file this application. (Master Electrician t 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. L Sworn to before me this — ncJ Sworn to before me this day of V�.e r ,200�_ �` �� day of 20 Signatuf Owner Joni Lamaj Si re of pplicant Commission#01LA0025681 Print Name of Property Ow,kr Notary Public,State of New York Print Name ofjAplicant My Commission Expires.June 07,2028 Notary 'b' Notary Public W2M STATE WIDE INSPECTION SERVICES, INC. • 0•0 • • swisJOB • • Office Use Elect. Permit# Date Bldg Permit# �� y_ 7(o Scl Ft Plumbing Permit# Final Certificate # City/Village Zip �-7 Building Dept. County �+r�.�.i ��.; Address Cross Street Section Block Lot Owner Name/Address(If different than above) Contact Number q -740 ❑Basement ❑ 1st FI. ❑2nd FI. ❑3rd FI. ❑More Than 3 FI. ❑Garage ❑Attic ❑Outside ,C ❑Residential [:]Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C/0 Detector Hood Trash Compact Amt Amps r '7 Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer Switch SERVICE Amperage #Panels 1P 3P # Meters # Disconnect ❑Underground ❑ New ❑ Reconnect ❑ Repair ❑Overhead ❑ Upgrade ❑ Disconnect Utility ID# ❑Con Ed ❑ NYSEG ❑Central Hudson ❑ Orange/Rockland PHOTOVOLTAIC SYSTEM PV Modules Inverters AC Disconnect )unction Box Combiner Box Load Center PV Monitor Energy Storage System DC Disconnect ❑Legalization ❑ Safety Inspection ❑Consultation cr✓ w. G):� LEI- - 3 202.5 � a E tij D11' � PG PAR --F,M, 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,!fat 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 Name License# Date Signature Address City/State Zip Code Company Phone# ' D E C E ��E State Wide Inspection Services D1080 Main Street FEB — 7 2025 Fishkill, NY 12524 845 202-7224 Phone VILLAGE OF RYE BROOK 914-219-1062 Fax STATE WIDE INSPECTION SERVICES Email: office@swisny.com BUILDING DEPARTMENT --- — - 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: Mars ciectric RSP Group LLC Ti:nothy Mars 90 South Ridge Street 21 Diamond Avenue Rye Brook, NY 10573 B?thel, CT 06801 Located at:90 South Ridge Street, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP 25-013 141.27 1 9 _J Certificate Number: 2025-0503 Building Permit Number: 24-246 A visual inspection of the electrical system was conducted at the Commercial occupancy described below.The electrical system consisting of electrical devices and wiring is located in/on the premises at: 90 South Ridge Street, Rye Brook, NY 10573 The First Floor Patient Exam Rooms,Offices& Break Room were inspected in accordance with the NYS and NFPA 70-2017 and the detail of the installation,as set forth below, was found to be in compliance on the 7th Day of February 2025. Name Quantity Rating Circuit Type General Wiring Devices Receptacles 38 GFCI 09 Quad Receptacles 02 Single Pole Switches 02 Occupancy Sensor Switches 10 Ceiling Mounted Occupancy 05 Lighting Luminaires 38 Emergency Wall Packs 08 Exit Signs 03 Name Quantity Rating Circuit Type HVAC Exhaust Fans 02 120 Volt Fan Powered VA Boxes 03 Appliances Refrigerator 01 Service Work Panels 01 100 Amp Cooper Feeder 100 Feet Special Equipment Call for Aid 01 `Hater Heater 01 208 Volt Pump 01 120 Volt Low Voltage Phone/Data Stubs 14 Card Reader 01 Fire Alarm Strobes 07 Horn/Strobes 13 Visual Inspection Only; Not Tested by SWIS. Smoke Detectors 19 Visual Inspection Only; Not Tested by SWIS. Heat Detector 01 Officer: Frank]. Farina This certificate may not be altered in any way and is validated only by the presence of a seal at the location indicated.This certificate is valid for work performed on the date of inspection only. Page 12 a. ■ s a' ■ s 6 ;. O N N f N N N W � a a ■, N N w v ` s P.0 00 CIA 00 ^ w x a : ►Wry C W u f z Z o > gel Lin N q r OC z Lin r W V O -, a4 •� 00 Cn Z w p O � -' G A V r _ � O ACNor CN V ►- a. •r (1� V LA Ix W w ~ F� cn CA z z a. U 04 v v � V Ug � x Cn v �• O ° Ci i -n z il�il ilk it 1� I I i i r r i #6444*+4tQ tit;4;tt4cc4}c46;4CA- yE f3Rt�v� F C E V E BUIL DEL MENT R DD VIL E OF RYE OK [FEB 12 2025 938 KIN , ET RYE B ,NY 10573 VILLAGE OF RYE BROOK . ov BUILDING DEPARTMENT ELECTRICAL PERMIT APPLICATION Westchester County Mast r Electricians License Required FOR OFFICE USE ONLY BP#: / EP#: l Approval Date: FEB 1 3 26 Permit Fee: P Approval Signature: Other: ******************************************* ****************************************************** DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDING INSPECTOR. THE ADMINISTRAT VE 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, / S S" 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. 1.Address: y� S , ZI t �JL 5�', SBL: Zone: 2.Property Owner:: ,�Qs//� (', u J� L� C Address: Phone#: 9/ / /U — // x) Cell#: email: 3.Master Electrician/Licensed Installer: '& Aw-e— Address: Lic.#:AO I Phone#:aey371664 ?,Y Cell#: _n 5 email: Company Name: k,rs �✓sae I-�C Address: aI �fu A..onC t DG eQj 4.Proposed Electrical Work/Fixture Count: S uoat Yws�l� or s F 3!) 5.31 Party Electrical Inspection Agency: S ********************************************************************************************************* STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: din UAOt being duly swom,deposes and states that he/she is the applicant above named,and does further (print name of individual signing as the a ppplicant) state that(s)he is the p(FAy 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 before me this day of 20 day of t 20 5 Signature of Property Owner Signatur Applicant Print Name of Property Owner nt me of Applican SHAftl M Notary Public Notary Public,St u tc No.O1ME6 Qualified In Westchester County-7 6/1/2024 Commission Expires Jenttary 29.20_ •STATE WIDE INSPECTION SERVICES, INC. •:• SWIS JOB APPLICATION tel 845.202.7224 1 fax 914.219.1062 • Office Use Elect. Permit# `�S �L/ Date Bldg Permit# 7 —�� Sq Ft Plumbing Permit# Final Certificate# City/Village �' ' ' Zip c 7't Building Dept. r 4 County , --tAddress Cross Street Section Block Lot 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/0 Detector Hood Trash Compact Amt Amps Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer Switch SERVICE Amperage #Panels 1P 3P z 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 ! FEB i 2 2025 VILLAGE OF RYE BROOK BUILDING DEPARTMENT This application is valid for one(1)year from the date received by SWIS.This application is intended to cover the above listed items to be inspected,if at any time of inspection additional items have been installed,you are authorized to make the inspection and adjust the fee for the additional items inspected.The applicant declares that there is no open applications for the above address with any other inspection company.The applicant, owner or authorized agent agrees to all the above terms and conditions as set forth for the application. Email Address tf' Name License# 3 Date Signature Address ] r., Av,, City/State Zip Code Company 1 Z�S i i i Phone # [VI EC MWL f DState Wide Inspection Services 1080 Main Street MAR 2 0 2025 Fishkill, NY 12524 845 202-7224 Phone LLAr�GE OF RYE BROOK 914-219-1062 Fax STATE`HIDE INSPECTION SERVICES BUILDING DEPARTMENT Email: ofl•Icelw^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: Mars Electric RSP Group LLC Timothy Mars 90 South Ridge Street 21 Diamond Avenue Rye Brook, NY 10573 Bethel, CT 06801 Located at: 90 South Ridge Street, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP 25-041 141.27 1 9 Certificate Number: 2025-0503 Building Permit Number: 24-246 A visual inspection of the electrical system was conducted at the Commercial occupancy described below.The electrical system consisting of electrical devices and wiring is located in/on the premises at: 90 South Ridge Street, Rye Brook, NY 10573 The First Floor Patient Exam Rooms, Offices& Break Room were inspected in accordance with the NYS and NFPA 70-2017 and the detail of the installation,as set forth below, was found to be in compliance on the 3rd Day of March 2025. Name Quantity Rating Circuit Type Fire Alarm Receptacles 01 GFCI 01 Horn/Strobes 03 Smoke Detectors 03 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. o O N W N Ln C N " W P.( ON H en en n w � W c^ V v u O Z F+� L��l �i z r CPA Z 00 O .zl a a f ih CD w ., w �j , ono U W e wr w � z IC z z W � � ON M ` ap4 � � Z 0-4 W. u � z + z z ' (� W 04 z O N U W A Z a o1-4 Z W c� w a °` x m H Z Z cc F a O U U A � �I � W.. BUILDING DEPARTMENT VILLAGE OF RYE BROOK �AN - 7 ZQZpJ 938 KING STREET RYE BROOic,NY 10573 w�Y.Wftookny.gov PLUMBING ,rP�ERMIT�APPLICATION FOR OFFICE USE ONLY BP#: / / Cp PP#: Approval Date: KVL02'n� Permit Fee: S Approval Signature: Pb /-k /<< Zal (fees are non-refundable) DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDING INSPECTOR.THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12%OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00 Application dated, /— is hereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of a Permit to install and/or remove Plumbing as per detailed statement described below.The applicant&property owner,by signing this document agree that said plumbing work will be in conformance with all applicable Federal,State,County and Local Codes. 1 1.Address. U SBL: - 9�c� Zone: d 2.Proposed Work: i S' c � 3.Property Owner: Address: Phone#9 4-qui- i ii( Z Cell#: email: 4.Master Plumber;,, r rN►r1 RL I h,Q." Address: �- Lic.#: _Phone Aq K- Cell#R 1:1-1[A --r email. CompanyNamerrli AddressCA Lf26Lk--]4_Awi1 ) jI+ 11Y15. �- ( CL10,6. INDICATE FIXTURES&L1NES 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 2nd Floor oor 41 Floor 5'h Floor Exterior o 5.*List Other Equipment/Provide Details: ,c�� i'n ?" C C (Notarized Signatures Required Next 2 Pages) -1- 6/t/2024 STATE /OF NEW YORK,COUNTY OF WESTCHESTER ) as: being duly swom,deposes and states that he/she is the applicant above named. (print Dame of mdtvidtul 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 Prcvcntion&.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 2 U day of J C111 L i C t J .20 day of L if C— ,20<2-V, L Signature of Owner of pp t ft Ai/k Print Name of Property Owner Print Name of Applicant Notatry Public c \t�Ia F t�C A FEENEY NOTARY 110RI-If.STAIEAFy[wYURK N,!;ry Pub;+C State of Ne'.v York Rtystratl(>n No 01OCatll9132 F<eC1Str to #01FEo307a15 (h,WificdIn%IcstchruerCanty. Qua'if:8d !tt `.'jestchesterCounty \tycmm+ssionEvp.nrsSeptembcr'1._02y �+p,'es J 1y 7. 202(0 ,I,, t'.d II,,k rtk r1.1 ill the .III-il o Itrt�pcm .Ind Ihr .Il-lt11,.tol .It roc tt,) !1l lh; �. .. ..,`, - '.._ ' 11 its :11111C1\ .bill t+I 11"I 11!ticd .hall ht t t,1r 11�•tl t++ tftr :11 �11,,tnt :- a i 2024 BUILDING DEPARTMENT JAN - 7 2025 VILLAGE OF RYIF BROOK 938 KING STRF.F I RYE BR(X)K, NY 10573 (914)939-0668 1111111111111f/1f#1f11f#f#Aff#11f1fAf11f1f1f1111iff111/111111ff1f11/11fff/flflfff1111ff11111/ff11f1ffff AFFIDAVIT OF COMPLIANCE VILLAGE CODE$216- STORM SEWERS AND SANITARY SEWERS STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: 3, -- - ---- , j„)c --- ,residing at, 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 f ' , Rye Brook,NY. Further that all statements contained herein are true,and that to the best of his/her knowledge and belief, that there are no known illegal cross-connections concerning either the storm sewer or sanitary sewer, and further that there are no roof drains,sump pumps,or other prohibited stormwater or groundwater connections or sources of inflow or infiltration of any kind into the sanitary sewer from the subject property in accordance with all State, County and Village Codes. Sworn to before me this day of J co lug 20 �J r EENEY =!e of Near York ;1FE6307615 �hesterCounty r . .,u1y 7. 20.)t n 1 Q024 ■ ■ N N C) N N a \ \ w a M a w u ■ � M O � c. a w ON W Q� r- ■ x Oz w a coy A W F-+ 65 c c4 a C� Q or z Lz • ,., O . O oo w O v 7 v ; cn z � r �w < O _ ■ ►� 00 � M C� 96 9 _ ONO h+q F"' a a z a f. - w _ O U N m l `►ri M a4 WGca O f-, F o Q �I��i�1��1�I�1��r�aG��i�i�I�I��'d��+�:�1�:�+��+fi�+�'r�`d��a�l�i��:+ ■ MsC� �Mc� FEB 13 2025 BUILDING DEPARTMENT VILLAGE OF RYE BROOK VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK,NY 10573 BUILDING DEPARTMENT (914)939-0668 ryehrtx,kn\-_o PLUMBING PERMIT APPLICATION t(►R(11 "411C 1 St 0*St.� � (l�— c� Approval Date: F F R 1 3 2U Permit Fee: Approval Signature: Disapproved: (fees are non-refundable) l ltl \M 11 \kl 11t0Hl% "j t 11' lki l I !!' ill 111 hull 111? ll-1 1 1' 1 i It t"i flit t'i Ii iii •t, I\SPE("Rill. lift ♦U\tl\IS l K 1 111 t I t.t 111R 11 OK1. PROt:kt.SSEh OR l'1►�IP11.I E11 1111 IIOI 1 PFI(�117 I--S��12••:11F'IIIF.1uf�1 ( tl`i t)t ( t)\sIRI 1 illl\ NI1'il 1111�1111 1111E 11F 17t(LIN! Application dateZ'13"`._-• 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�Cl� �)CIIC�r-� 1YCc_-4- SBL:4-I •G�J- I-q_ Zon ' Z_ 2.Proposed Work: 1 4 I n L_ lL-5h 0C.1 . YC')L n Yl� l r)c) 3.Property OOwneOwner: Addres, - - - — Phone#q A-qCA--,'- I IocI ) Cell#: email. 4.Master Plumber; jr-nn� I Address: _ Lic.#4�. Phone#r{-I_ email: ][_hnhr4'N-t �m Company Name(_)'_CA_)r r n1(a I Address •I INDICATE FIXTURES& LINES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: Location Water Urinals Drinking Sinks i Showers Bath Laundry Domestic Fire Sanitary Natural/ Other* Total Closets Fountains Tubs Tubs Service Service Sewer LP Gas Basement Is(Floor 2nd Floor 3"Floor 4`s Floor 5"Floor Exterior 5.` List Other FquipmenUProvide Details: (Notarized Signatures Required Next 2 Pages) 1 611/2024 STATEOF NEW YORK,COUNTY OF WESTCHF.STFR being duly sworn,deposes arut t.nes that he she is the applicant above named. (final tiraai:of Wits"swung as tM AW&L al.: and%rdw states that(s)he is the Master Plumber lot the legal owner and is duly author u cd to make and file this application 'i1W all statements contained herein are true to the best of hivTier lim)wleallm and belief,and that any work performed,or Ilse condixted at the abosc captioned property will be in conformance with the detail,a,,et forth and contained in this application and in any accompanying approved plans and specifications,Ax well as in accordance with the New York State Uniform Fire Prevention& Building Codc,the lode of the Village of Rye Brook and all other applicable law s,ordinances and regulations Sworn to Wore me this Sworn to before me this dar of - - .20 1\ day of U�L- —- '20 Stgnatum of Property Owner c of pp i Pnnt Name of Property t)wner Prim Name of Applicant Notan Public --_ , .,,t. u c rfw YORK 5 , L.il+Fej N .'chrster r.-11 v T.,(!,1�!' - >Ir i r r 4 .�tf....Pc•:I.:J:1 7 1'Ai ,i , BUILDING DEPARTMENT JAN - 7 2025 VILLAGY ov Rvir 11sti NNK 938 Kmc;Smt i R%t RR(NIh,`V 10573 (914)939-0"8 ff fffffff ff♦ff flffffflffffff�ff•ff��ffff�f�fff��ff�fff�fffffffffffffffffffflfffl�f�ff�ffffff'�*f��f♦ AFFIDAVIT OF COMPLIANCE VILLAGE CODE 4216•STORM SEWERS AND SANITARY SEWERS STATE OF NEW YORK.COUNTY OF WESTCIIESTER ) as: �. residing at, being dulp s%,orn,deposes and states that (s)hc is the applicant abort a named, and further states that(s)he is the legal owner of the property to which this Affida%it of Compliance pertains at. Rye Brook, NY. Further that all statements contained herein are true,and that to the best of his%her knowledge and belief,that there are no known illegal cross-connections concerning either the storm sewer or sanitary sewer, and further that there are no roof drams, sump pumps, or other prohibited stormwatcr 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. /�k A/17n -- Sworn to before me this !` day of J cuiuL,.7 ,20 Nr:,Vork 7 i i _ 1 O g N O N r ? L � W a U � � � • ° = c ✓� 1-4 Lij ;o s H O v a x O + > =' E- e W Z M mc � ° ° � W �� Z � O � n fay � � '� ° E n,•- CE/� o •' Fil O p Z o; oLn o ' 3 ° Q N d42C � rd W y � °o 4. I■�I % L� � tc p .5 cc ec.00 � CA ce) ON ■ �j r c, K � � O - 4 MTI Cn a C� O N Z 7ot E C a W U � O ,c f cn Z D3 ° .. m V H a z z pig .= � ° �I � O U U � � � � ` a•� a BUILDING DEPARTMENT VILLAGE OF RYE BROOK JAN - 7 2025 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 www,ryebrookny.2ov APPLICATION TO INSTALL FIRE SUPPRESSION / FIRE SPRINKLER SYSTEM FOR OFFICE USE ONLY: a 0�� L4 c0 Q Approval Date: BP#: MPS: _ 'Application Fee: $ � / Approval Signature: Permit Fees: $ Disapproved: Other: I Application dated: is hereby made to the Building Inspector of the Village of Rye Brook NY for the issuance of a Permit to install or modify a Fire Suppression/Fire Sprinkler System as per detailed statement described below. 1. Job Address:—`c) 2. Parcel I.D.: 14 I, 2-:1 - 1 'q , Zone: 018" 3. Proposed Work(Describe system in detail including suppression agent): 4. Number&Types of Fire Sprinkler Heads: 2y Ce� n :Dc� . 5. N.Y State Construction Classification: N.Y. State Use Classification: 6. Estimated Value of Job: $ , t(onn (Value shall include all labor,materials,fixed equipment,professional fees,and materials and labor which may be donated gratis.) 7. Property Owner:gyp C--1 VU J P. ur Address: Phone#qV4 "( ICU- I U-)Cell##`7 email: 8. Architect/Engineer: Address: Phone# Ceell�# email: 9. Sprinkler Contractor: �rQ "1� '�r�u1 rS Address:�L'nl Q�►�5 r"'�{ len /_� Phone# ) ,(j�Cell#��— R_ email: r_ n� J CCM t 0/t/2024 This al)ph(atitw nit►st l,e I.Iuptyly (untpleted III 'Is rntifety and trust nlc.luclf- tllf• 1)t0a11/t ti signature(si of the legal )wnerlsl of the subject propt�rty and the applirarit of t«•r orti lt�,. spaces provider! Any appittation not properly in its entirety andlrtr riot signed shall he deemed mull and void and will be tetutned to the appllt ,Int Please note that applwation fees are non-reftindahli, STATF OF KE%'Y�RfC,COUNTY OF WESTCIILSTFR ) a, - '/!_ ./ .tJG�C� __,being duly sworn,deposes and states that he/she is the applicant above named, (pnnt rtante or tndi%id;ral signing as the appltunt) and further states that (s)hc is the Sprinkler Contractor for the legal owner and is duly authorized to make and file this application. That all statements contained herein arc true to the befit of histher knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details asset 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 h Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to before me this p' Sworn to before me thus Jay of_)c�i� iG t .20 a� day of Sig rue of Proprrf�0%ncr aw — Print Namc of ffopcm 0%ncr Prn'same of Applicant 2 4J.le� G D Xo ary Pubhr N ary Public tJ F c—EN Y Maria E OConnell i. cf N-rr 'r rn NOTARY PUBLIC,STATE OF NEW YORK Registration No.Ol OCfrt091:'_ �,_;_,,•��,�rL� Qualified in WestchesterCounn - s Jt I, ? ^01 My Commission Expires September'I.2028 i x N N ° O � O cd x Ln PLO F Gj W x c W vi W OL M W �,�„� ►..i o a n 0 ar Ln ■ I�J� �i �C G ` p O _ C/� CQ i O M p hey I� CAA a e ,9 O 00 o 0 �° \ b • O � � U � � = y � � v _ u a p w aEG � a °�° Z c x 1-4 z° v ` = cn WZ � UN - c EO of w — 3 cE V � J a a p N c zLo — V O �p i ;j y b z z a/ F cn O N GQ Z z g g � u ✓� U � �u a E H V. w 0.! 0 1- y 0� y L Ey O F- C- u a \ :. • � F � � Z � a �� u Q i CA O z F" W O 0. >" - � ^ o` 16 0' x BUILDING-JI)TPARTMENT VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 1WW W.n,ehrooknv.gov APPLICATION FOR PERMIT TO INSTALL AND/OR REMOVE HEATING, VENTILATION AND/OR AIR CONDITIONING EQUIPMENT FOR OFFICE USE ONLY. P E R M I T#: Alo C) 'L Approval Date: ` Permit Fee: $ Approval Signature: Other: 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 REQUIREMENTS FOR RELEASE OF PERMIT&CERTIFICATE OF COMPLLANCE: 1. Properly completed& Signed Application. 2. Site/Staging Plan if Required by the Building Inspector. 3. Copy of Licensed Contractor's Liability Insurance.(Village of Rye Brook must be listed as certificate holder) &Workers Compensation Insurance on a NYS Board form(Form#Cl 05.2 or Form#U26.3/or NY State Workers Compensation Waiver) 4. Payment of Fees/Unit: RESIDENTIAL=$150.00/unit•COMMERCIAL=$450.00/unit. 5. Complete specifications for each unit being installed. 6. Inspection by the Building Department for removal and/or installation. (48 hour notice required 7. Electrical work requires a separate Electrical Permit& Electrical Inspection. 8. Plumbing/Gas work requires a separate Plumbing Permit& Plumbing Inspection. Application dated, 140 LS is hereby made to the Building inspector of the Village of Rye Brook for a permit for the installation and or removal of the HVAC equipment as listed below.The applicant and property owner,by signing this document agrees that said equipment will be installed and/or removed in conformance with all applicable Local,County,State&Federal laws, codes,rules and regulations. �7 1. Address: �O Sc&A�n at Ine, 5A� /SBL: 7�i d c) Zone: 2. Property Owner: IR5 ftrip LI-C- Address: Phone#: 01 `90(,p - O 0' Cell#: email: 3. Contractor: Address: W OOA" izm< ., Phone#: Cell#: 8bo 30�i-3�(b S email: 4. Scope of Work:New Installation( )•Replacement( )•Removal( )•Other W: 7XAA-erbr a_ tf'0.Atg^ 5. List Equipment: ,yew bDCW t,`A c�L�if.AC� t Gr1 kt4l&4-GAerc , 2 ) Ce, 2q — 2cf 6. Location of Equipment: 4- , `t 0 7. Method of Installation/Removal(list all equipment needed to perform job): LtXc�& 'S C04 V..el AmAS STATE OF NEW YOM COUNTY OF WESTCHESTER ) as: 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 Heating,Ventilation and/or Air Conditioning Contractor 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 )11 h LA U. ..a ,20 day of ` ,20 � Z i Signa operty Owner Signature of Applicant J&a h k,k ��AA hcu 'To'N1 \k�6y G-k-k-A t Name of Property70wnr Print Name of Applicant l Notary Public Ngia EttllliiC Notary p d N.V. No.M42 Ouaft In Westchester�Cou� EReistrat�,on A A FEENEY Commisa�erFr:l-,sFO.2& , State of New York nty #01FE6307615Westres Juely 7�20.2--xp 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. SUBMITTAL 12/23/24 Products: Ceiling Exhaust Fans Manufacturer: Panasonic Project. YNNH Ryebrook OBGYN Suite Rye Brook, NY Plan date: 10/04/24 Contractor: ENCON Engineer: Long Consulting Vendor/Agent: Buckley Associates Submitted by: Joseph Masucci 294 Quarry Road, Milford, CT. 06460 Phone(203) 380-2405 * Fax (203) 380-2151 uantity = 2 a ed: EF-1, 2 Whis FV-0511VK3 perGreerf seCe�c VENTILATION FAN eplaces model -0511 VK2 Specification Submittal Data /Panasonic Ventilation Fan Description Customizable ceiling mount ventilating fan,low sone and rated for continuous operation. FV-0511 VK3 4"or 6"duct NGBS certified.ENERGY STAR®rated and certified by the Home Ventilating Institute(HVI). Evaluated by the Underwriters Laboratories and conforms to both UL and cUL standards. Motor/Blower: •Enclosed brushless ECM smart motor technology rated for continuous operation e •Adjustable ventilation rates at 50-80-110 CFM •Power rating of 120 volts and 60 Hz •UL and cUL listed for tub/shower enclosure when GFCI protected •Motor equipped with thermal cutoff fuse •Removable permanently lubricated plug-in motor Housing: •Environmentally friendly 26 gauge housing using Zinc-Aluminum-Magnesium(ZAM)coating •Built-in damper reduces back draft and helps with blower door testing •Built-in metal flange provides blocking for penetrations through drywall as an Air Barrier,and assists with the decrease in leakage in the Building Envelope during blower door testing } •Suitable for installation in ceilings insulated up to R60 \ •Articulating and expandable installation bracket up to 24" y Grille: •Elegant grille design complements the aesthetics of any room •Attaches directly to housing with torsion springs Performance Curve 6"duct •Includes a motion sensor cap for use as a cover when motion sensor Plug'n Play®module has not been selected ° Warrantl: •ECM Motor:6 Years from original purchase date - •ALL Parts:3 Years from original purchase date °• Architectural Specifications: °„ i - i Customizable ceiling mount ventilation fan,ENERGY STAR@ rated with built-in 110/80/50 4 - CFM speed selector.Fan can be upgraded with multi-speed module FV-VS15VK1 for °m expanded HVI-Certified performance 30-40-50-60-70-80-90-100-110 cfm for continuous t ventilation.Home Ventilating Institute(HVI)Certified at 0.1,0.25,0.375,and 0.5"w.g. 6"Duct as Certified by the Home Ventilating Institute(HV)--ENERGY STAR MOST ° EFFICIENT 2024 C 0.1 w.g.,110/80/50 CFM with<0.3 sone and with energy efficiency no more than 16.7/18.4/14.7 CFM/Watt @ 0.25 w.g., 110/80/50 CFM with no more than 0.3/0.3/0.4 sones and with energy efficiency no more than 9.3/8.8/7.2 CFM/Watt *0.375 w.g.,110/80/50 CFM with energy efficiency no more than 6.6/6.1/5.3 CFM/Watt ° *0.5"w.g., 109/80/50 CFM with energy efficiency no more than 4.8/4.6/4.0 CFM/Watt '° m m • A*"-1CM m w 'm Utilizing 4"Duct with 6"to 4"reducer as Certified by the Home Ventilating Institute(HVI)- ENERGY STAR MOST EFFICIENT 2024 '0,5 ymammb ISp,s°bY"ons,.gm b 010'b0.375- @ 0.1 w.g., 110/80/50 CFM with<0.3 sone and with energy efficiency no more than 11.5/14.2/13.5 CFM/Watt @ 0.25 w.g., 110/80/50 CFM with no more than 0.8/0.7/0.6 sones and with energy Performance Curve 4'duct efficiency no more than 7.3/7.7/7.0 CFM/Watt *0.375 w.g.,110/80/50 CFM with energy efficiency no more than 5.3/5.4/5.0 CFM/Watt °m *0.5"w.g.,104/80/50 CFM with energy efficiency no more than 4.2/4.1/3.8 CFM/Watt The motor shall be enclosed with brushless ECM motor engineered to run continuously. °m - ECM motor speed shall automatically increase when the fan senses static pressure to maintain selected CFM.Power rating shall be 120v/60Hz.Plug'N Play modules provide °m additional features such as Mufti-Speed 30-110 CFM with Time Delay,Condensation Sensor, SmartAction Motion Sensor,Dual Motion Sensor+Condensation Sensor and Wi-Fi Module. Fan shall be RoHS Compliant and UL and cUL listed for tub/shower enclosure when GFCI I. - protected.Also suitable for installation in ceilings insulated up to R60.Fan can be used to comply with NGBS,ASHRAE 62.2,LEED,ENERGY STAR®IAP,EarthCraft,and California °• ! i -m� Title-24. ° I -•"" ECM Motor Technology: ECG When fan senses static pressure, its speed is automatically increased to i ensure that the desired CFM is not compromised, which allows the fan to perform as rated. I I 4,Twy ICFN1 m l Aby 0 X'b 0.315' Wh isperG ree n' Seee�t FV-0511 VK3 VENTILATION FAN Plug 'N PlayTM Modules Plug'N Play"modules provide up to three additional features.Select from Mufti-Speed with Time Delay,Motion Sensor,and Condensation Sensor. FV-VS15VK1:Multi-Speed with Time Delay Allows you to select the proper CFM settings to satisfy ASHRAE 62.2 continuous ventilation requirements. The fan runs continuously at a pre-set lower level(0,30-100 CFM,in 10 CFM increments),then elevates to a maximum level of operation (50-80-110 CFM)when the wall switch is turned on,or when the motion sensor or Condensation Sensor module is activated. - A High/Low delay timer returns the fan to the pre-set CFM level after a period of time set by the user. FV-MSVK1:Motion Sensor Automatically activates when someone enters the room.Once the settings have been applied,the fan bec s truly automatic. This module also activates a 20 minute delay off timer for the fan. FV-CSVK . ondensation Sensor Helps control bath condensation to prevent mold and mildew.Sens hnology detects relative humidity and temperature to anticipate dew point, omatically turning the fan on to control h dity.Built-in Relative Humidity(RH)sensitivity adjustment enables fine tuning for mois nditions and for satisfying Ca en requirements.When the condensation sensor is used in conjunction with mufti-speed fun ' nality,the fan will kic to high speed when the condensation sensor detects moisture in the room.This module also activat 20 minute ay off timer for the fan. FV-CMVK3:Smart Action®M Sensor+Conden ' n Sensor Turns the base fan on or is to higher speed when condensa or motion are detected.Installer/User can choose the desired operation,th s to advanced automation.Only one slot is r ed. WP100PBA:Smart W06 Module �dl;h The Wi-Fi control module connects,monitors and controls through Wi-F the ventilation fan's features �`_ (motion sensor,light,etc.)with the Swidget app. i FAN S er JreerT eee�( Fv-0511VK3 �/ VENTILATION t Duct Diameter bnchesl 6' Static Pressure in inches w.g 0.1 0.25 0.5 1 0.1 0.25 M 0 5 1 0.1 L!:n= 0S 01 0.25 0.5 0.t 025 0.5 01 0.25 M 0 5 1 0.1 0.25 M 05 1 0.1 10.25 0.5 0.1 0.Z 0.5 As Volume ICFMI 110 110 110 109 100 100 100 100 90 90 90 90 80 80 80 80 70 70 70 70 60 60 60 60 50 50 50 50 40 40 40 40 30 30 30 30 No-lsonesl <0.3 0.3 - - <0.3 0.3 - - <03 03 --- --- <0.3 0.3 - -- <0.3 0.3 - .0.3 0.3 <0.3 04 - - <0.3 <0.3 -- <0.3 <0.3 Power Consumptnn lwattsl 6.7 12.1 17.0 23.0 5.5 10.5 15.4 20.5 4.9 9.7 143 19.3 4.4 9.2 13.2 17.6 4.0 8.2 12.2 16-3 3-6 tM. 15.0 3.4 7.0 9.9 13.3 3-0 62 8-7 12-0 2-8 SS 7-9 Ii.l Energy Efficiency lCFMNhttI 16.7 9.3 6.6 l8 t8.5 9.B 6.6 5.0 18.4 9.5 65 4.7 1t1.4 B.B 6.1 4.6 t77 87 5.9 4A 76.8 4.2 td9 7.2 5.3 4.0 13.6 b-b 4.7 3.6 IO.B 5.7 6.0 3.2 Spew(RPMI 595 887 1089 1261 580 892 1097 1260 572 11" 1102 1283 569 908 1109 1261 565 902 1121 1293 570 1293 575 933 1127 1296 563 921 1/26 1291 587 930 112'3 1300 Amps ICurrentl 0.11 0.20 0.27 0.36 0.10 0.18 025 0 n 0.09 O.t 7 0.24 0.71 0 OB 0 16 0 22 0.28 0 OB 0 14 0.20 0.27 0.07 0.13 0.19 OIl 0.07 0 12 0 17 0 22 0 06 0.11 0 15 0 20 0.06 0.10 0 14 0 19 MAC Amps(Cor ml 036 ENERGY STAR Ownt.d Yes Whispet-Green Select(Fan Onlyl- 1 Duct Diameter Imcnesl 4' Static Pressure m inches w.g 0 1 0.25 M 0.5 1 0.1 0.25 M 05 0.1 0.25 0.5 0.: 0.25 0.5 0 t 0.25 0.5 0.1 025 M U.5 U U.25M U.5 U.1 0.25 M 0.5 1 0.1 OS Air volume(CFMI 110 110 110 104 1 100 100 100 100 90 90 90 89 1 90 1 80 80 80 70 1 70 1 70 70 60 1 60 1 60 1 60 50 5U 5C 50 40 40 40 40 30 30 30 30 No-lsones) 4.7 08 --- --- <0.7 0.7 4.3 0.7 -- 1 4.3 1 0.7 --- --- <0.J 0.7 --- --- 4. - -- <0.3 0.6 - ... 4.3 0.6 --- 4.3 0.6 -- --- Power Commptnn lwaRsl 9.7 15.2 21.0 24-7 7.8 13.0 18.0 23.5 6.6 11.6 162 21.0 5.6 10.6 14.7 19.4 5.1 9.3 13.4 17.0 4.4 8-1 11.7 15.5 3.8 7.3 10.4 13.6 3.4 63 9.3 12.0 2.9 5.6 9.4 11.5 Energy Eft-cy ICFMlwattl 11.5 7.3 5.3 4.2 129 7.8 5.6 4.3 13.6 7.7 5.6 4.2 14.2 7.7 56 4.1 t40 76 5.3 4.2 13.8 7.6 52 39 13.5 7.0 5.0 3.8 129 69 4.6 3-6 10s 5.7 3.8 3.0 Speed IRPMI 782 1031 1214 1349 747 1007 1189 1349 714 993 1170 1333 684 985 11" 1340 672 964 114A 1317 6% 956 1148 1324 630 9" 1145 1313 619 938 1142 12" 606 939 1141 1304 Amps ICurreml 0.16 0.26 0.33 0.38 0.14 0.22 0.29 037 0.12 0.20 0.26 0.33 0.10 0.18 0.24 0.31 009 0.16 022 0.27 0.08 0.14 0.19 0.25 0.07 0.13 0.17 0.22 0.66 0.11 0.16 0.20 0.58 0.10 MAX.Amps ICurrerel 0." ENERGY STAR Owbf d Yes Model Qluantflty Comments Project Location: Architect: Engineer: Contractor: Submitted by: Date: For complete Installation Instructions visit na.panasonic.com/us/iaq Panasonic IAQ Division Two Riverfront Plaza Newark.NJ 07102 na-panasonic.com/us/iaq Vla C&us ,� ....�L" Design and specifications subject to change without notice. Plamsmic IAQ24026ST R2 Environmental Control, LLC Corporate Office 4"Heating & AC 1265 Woodend Road Buiiditly LHIC-iency arld 5usicllrijuilliy Stratford, CT 06615 203.375.5228 A Servic7qic Company Per Public Act 91-9S Environmental Control, LLC an HVAC contractor located in Stratford, Connecticut is authorizing our Tom Hlavaty employee to act as our agent of the said company, for the purpose of obtaining an HVAC and/or Plumbing permit in the Town or City of Rye Brook, NY Job Name: YNHH Rye Brook Concierge Address: 90 South Ridge Street Digitally signed by Tom Hlavaty Tom H I avaty DN:NCON Heating&A/CoOU= com, O=ENCON Heating&A/C,OU=Commercial Contract,CN=Tom Hlavaty Date:202 5.01.06 10:19:16-05'00' Signature of Authorized Agent Michael Monahan Manager/Officer License Holder CT License HTG.0386317-S1 CT License PLM.0204624-P1 Building Penniit,Check List & Zonin Anal sis OB & C ONLY Address: :Y 1 �1 C� SBI, Zone �. Use: Coast Type: ,i/ Other: Submittal Date: 0 Z- ions Submittal Dates: Applicant 1 rCat-t L- . Nature of Work- Reviews:ZBA:NOV U 4 2024 PB. Other. _ NEED OK 2 /�9o3—btJ- O O ES:Filing. BP:_ 7 C/O: Legalization: ( ) ( P.: Date Stamped Properly_jgned: SBL Verified: Cross Connection: F.O.G.: ( ) ( ) 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: ( ) (j-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: Grease Trap: 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 Cirde Fro n�ggg: Pate: _ Front: Front: Sides: _ Rear. _ F.A.R.: en Space Height: Stories: no : l �\ ^ CZ 4� . O O O W Q `c' = H- w O Q O O O x O \ m Z. O. 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(<c0)1 L A (Vas C. :uiwygt��ta)�� ° " _ :�• . x m is oj N O � � •p, .v: CU 77 Nco 40 .. ea •�}• u d �; � c�i U �• `sir.:. .:-��1 1�11� t.��.• !�111 �- -C4:�"• "a •. j t 1 Ac" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYVY) 412025 3/7/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). p CONTACT PRODUCER LOckton Companies,LLC NAME: 444 W.47th Street,Suite 900 Kansas City MO 64112-1906 E-MAIL FA/C,No): (816)960-9000 ADDRESS: kcasu@lockton.com INSURERS AFFORDING COVERAGE NAIL 0 INSURER A:XL Insurance Ameri Inc. 24554 INSURED ENVIRONMENTAL CONTROL,LLC INSURER B:Greenwich Insurance Company Compwy 22322 1304803 1265 WOODEND ROAD INSURER C:Allied World National Assurance Company 10690 STRATFORD CT 06615 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 15274014 REVISION NUMBER: XXXXXXX 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICNYYY MM/DD/YYYY LIMITS LTR COMMERCIAL GENERAL LIABILITY s 2,000,000 DAMAGE TO RNTED I; X N N RGD300147505 4/1/2024 4/1/2025 EACH OCCURRENCE CLAIMS-MADE �OCCUR PREMISES EaEoccurrence S 1 OOO OOO MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 4,000,000 POLICY�JET LOC PRODUCTS-COMP/OP AGG $ 4.000.000 OTHER: $ B AUTOMOBILE LIABILITY N N RAD143796405 4/l/2024 4/l/2025 COMBINED(Ea accident)SINGLE LIMIT $ 5,000,000 X ANY AUTO BODILY INJURY(Per person) S ){){OWNED AUTOS ONLY AUTOSULED BODILY INJURY(Per accident) S XXXX� X HIRED NON-OWNED PROPERTY DAMAGE S }�{X AUTOS ONLY AUTOS ONLY Par accident sXXXXXXX C X UMBRELLA LIAB X OCCUR N N 0313-7473 4/1/2024 4/1/2025 EACH OCCURRENCE s 5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE s 5,000,000 DIED I X I RETENTIONS $0 s XXXXXXX A WORKERS COMPENSATION IN X H- AND EMPLOYERS'LIABILITY RWD300147605 4/1/2024 4/l/2025 STATUTE ER A Y/N STOP GAP:ND,OH,WA,WY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) WORKERS COMPENSATION COVERAGE EXTENDS TO NEW YORK STATE CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 15274014 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN VILLAGE OF RYE BROOK ACCORDANCE WITH THE POLICY PROVISIONS. 938 KING STREET AUTHORIZED REPRESENTATIVE RYE BROOK NY 10573 ©1988t 015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD YORK Workers' CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1a.Legal Name&Address of Insured(use street address only) 1b Business Telephone Number of Insured Environmental Control, LLC (203)375-5228 DBA Encon,LLC 1c NYS Unemployment Insurance Employer Registration Number 1265 Woodend Road of Insured 4609688-9 Stratford,CT 06615 ld Federal Employer Identification Number of Insured or Social Work Location of Insured (Only required if coverage is specifically limited Security Number to certain locations in New York State, i.e.,a Wrap-Up Policy) 06-0855856 3a Name of Insurance Carrier 2.Name and Address of Entity Requesting Proof of XL Insurance America, Inc. Coverage(Entity Being Listed as the Certificate Holder) 31b Policy Number of Entity Listed in Box"la" VILLAGE OF RYE BROOK RWD3001476-05 938 KING STREET RYE BROOK, NY 10573 3c Policy effective period 04/01/2024 to 04/01/2025 3d The Proprietor,Partners or Executive Officers are [X] included.(Only check box if all partners/officers included) [ ] 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 1a"for workers' compensation under the New York State Workers'Compensation Law. (To use this form, New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2". The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.) Otherwise,this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent,or until the policy expiration date listed in box "3c",whichever is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers' Compensation contract of insurance only while the underlying policy is in effect. Please Note: Upon cancellation of the workers'compensation policy indicated on this form, if the business continues to be named on a permit, license or contract issued by a certificate holder, the business must provide that certificate holder with a new Certificate of Workers' Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers' Compensation Law. Under penalty of perjury, I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Joseph Tocco (Print of authorized representative or licensed agent of insurance carrier) Approved by: (yr /r`� 03/01/2022 (Signature) (Date) Title: Chief Executive Officer Telephone Number of authorized representative or licensed agent of insurance carrier: 212-915-6815 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 oe ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MM'DDNYVV) 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 UUNIACT NAME: lade Krarnpitz Koverage Insurance Group APHOAX ;C,NO.Ext: (860)633-461 l IF A/C, No): r;57 Enfield Street ADDRESS: jadek(d)koveragegrouP.Com INSURER(S)AFFORDING COVERAGE NAK:# Enfield CT 06082 INSURER A: TRAVELERS IND CO OF CT 25682 INSURED INSURER B: PTSC Northeast Inc. INSURER C: 33 N PLAINS INDUSTRIAL RD,Unit#c INSURER D: INSURER E: WALLINGFORD CT 06492-5841 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FX7 OCCUR PREMISES(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 A DT-120-3Y0026204ND-24 09/16/2024 09/16/2025 PERSONAL 6 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY (Ea accident) $ 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ A AUTOS AUTOS OWNED SCHEDULED BA-3Y000976 09/16/2024 09/16/2025 BODILY INJURY(Per accident) $ ONLY HIRED NON-OWNED $ AUTOS ONLY AUTOS ONLY (Per accident) X UMBRELLA LIAB x OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAR CLAIMS-MADE CUP-3Y015603-24-26 09/16/2024 09/16/2025 AGGREGATE $ 5,000,000 DED RETENTION$ $ ORKERS COMPENSATION ND EMPLOYERS'LIABILITY y/N STATUTE ER %NY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ FFICER/MEMBER EXCLUDED? El N/A Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ f yes,describe under ESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Village of Rye Brook ACCORDANCE WITH THE POLICY PROVISIONS. 938 King Street AUTHORIZED REPRESENTATIVE .MA Rye Brook NY 10573 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD NEW Workers' STATE Compensation CERTIFICATE OF Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE la. Legal Name and address of Insured (use street address only) 1 b. Business Telephone Number of Insured PTSC NORTHEAST INC. (914)497-9180 200 BUSINESS PARK DR STE 205 ARMONK NY 10504-1751 1c. NYS Unemployment Insurance Employer Registration Number of Insured Work Location of Insured (Only required if coverage is specifically 1d. Federal Employer Identification Number of Insured or limited to certain locations in New York State, i.e. a Wrap-Up Policy) Social Security Number 86-2326903 2. Name and Address of the Entity Requesting Proof of 3a. Name of Insurance Carrier Coverage(Entity Being Listed as the Certificate Holder) Sentinel Insurance Company Ltd. Village Of Rye Brook 11000 938 KING ST 3b. Policy Number of Entity Listed in Box 1a": RYE BROOK NY 10573-1226 76 WEG BK4YDB 3c. Policy effective period: 09/22/2024 to 09/22/2025 3d.The Proprietor, Partners or Executive Officers are ❑ Included. (Only 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 mail.) Otherwise, this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent, or until the policy expiration date listed in box"3c",whichever is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Worker's 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: Sara Seier (print name of authorized representative or licensed agent of insurance carrier) Approved by: '5aw, ` "-i4, 10/16/2024 (Signature) (Date) Title: Operations Manager Telephone Number of authorized representative or licensed agent of insurance carrier: (877)287-1312 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) Form WC 88 31 21 F Printed in U.S.A. www.wcb.ny.gov Page 1 of 2 �1JS ACORO CERTIFICATE OF LIABILITY INSURANCE DATE 01/07/2025 07I2025 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 C NTACT Levitt-Fuirst Associates,LTD PHONE FAX 520 White Plains Road A/C,No,Ext:(914)457-4200 A/C,No):(914)457-4200 2nd Floor E-MAIL info@levittfuirst.com Tarrytown,NY 10591 INSURERS AFFORDING COVERAGE NAIC 0 INSURER A:Ohio Securily Insurance Company 24082 INSURED INSURER B:Sutton Specialty Insurance Company 16848 New Era Mechanical Services,Inc. INSURER C:American Fire and Casualty Company 24066 99 Lafayette Avenue INSURER D: White Plains,NY 10603 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 TYPE OF INSURANCE TADDLSUBR WVDPOLICY NUMBER POLICY EFF POLICY EXPLTRMMIDDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE [X]OCCURBKS(25)65576191 3/17/2024 3117/2025 DAMAGE TSESO R(EaENTEDREM occurrence) $ 300,000 MED EXP(Any oneperson) 15,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2,000,000 X POLICY❑ E LOC PRODUCTS 2,000,000JT - OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT.denn $ 1,000,000 ANY AUTO BAS(25)65576191 3/17/2024 3/17/2026 BODILY INJURY Perperson) OWNED SCHEDULED AUTOOS ONLY AUTOS SSWN BODILY INJURY Per accident $ X AUTOS ONLY X AUUTOS ONLY Parr arcidentDAMAGE B UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 X EXCESS LIAB CLAIMS-MADE ISCEX0300001162-00 3/1/2024 3/17/2025 AGGREGATE 5,000,000 DED I I RETENTION$ C WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITYTUTEANY PROPRIETOR/PARTNER/EXECUTIVE Y/N XWA(25)65576191 3/17l2024 3/17/2025 1,000,000 %FFICER/MEMBER EXCLUDED? Y❑ N/A E.L.EACH ACCIDENT (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Village of Rye Brook-is included as Additional Insured for covered operations of the named insured CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Village of Rye Brook THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g y ACCORDANCE WITH THE POLICY PROVISIONS. 938 King Street Rye Brook,NY 10573 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD PORK Workers' CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured New Era Mechanical Services,Inc. 914-461-9994 99 Lafayette Avenue White Plains,NY 10603 1 c.NYS Unemployment Insurance Employer Registration Number of Insured 1d.Federal Employer Identification Number of Insured or Social Security Number Work Location of Insured(Only required if coverage is specifically limited 47-5631199 to certain locations in New York State,i.e.,a Wrap-Up Policy) 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) American Fire and Casualty Company Village of Rye Brook 3b.Policy Number of Entity Listed in Box"1 a" 938 King Street XWA65576191 Rye Brook,NY 10573 3c.Policy effective period 3/17/2024 to 3/17/2025 3d.The Proprietor,Partners or Executive Officers are X included.(Only check box if all partners/officers included) Ej all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"T'insures the business referenced above in box"1a"for workers' compensation under the New York State Workers'Compensation Law. (To use this form,New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2". The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.) Otherwise,this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent,or until the policy expiration date listed in box"3c",whichever is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note: Upon cancellation of the workers'compensation policy indicated on this form,if the business continues to be named on a permit,license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers'Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Joanna Darrigo (Print name of authorized representative or licensed agent of insurance carrier) Approved by: (2&aaiZ4 z2Q� 01/07/2025 (Signature) (Date) Title: Account Executive Telephone Number of authorized representative or licensed agent of insurance carrier: 914-457-4200 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 ACCOR CERTIFICATE OF LIABILITY INSURANCE DATE(MMI/2024 �� 12/16/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Sarah Molnar FAX Ferguson S McGuire, Inc. PHONE (203)269-9565 A/c No: (203)269-9656 6 North Main Street E-MAIL ADDRESS: smolnar@fer songu mc ire.com P.O. BOX 846 INSURERS AFFORDING COVERAGE NAIC 0 Wallingford CT 06492 INSURER A:Hanover 22292 INSURED INSURERB:Mass Bay 22306 Network Installation Service Inc. INSURER C:Citizens Insurance Co. of America 31534 192 North Plains Industrial Rd INSURER D: INSURER E: Wallingford CT 06492 INSURERF: COVERAGES CERTIFICATE NUMBER:CL24_155350 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 SUBR POLICY EFF POLICY EXP rypE OF INSURANCE LTR POLICY NUMBER MMIDD/YYYY) (MMtDDfYYYYI LIMITS X COMMERCIAL GENERAL LIABILITY 1,000,000 EACH OCCURRENCE $ A CLAIMS-MADE ❑X OCCUR DAMAGE TO RENTED 100,000 PREMISES Ea occurrence $ ZHE8582480 17 1/23/2024 1/23/2025 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENIAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 X JECT LO 2,000,000POLICY ❑ PRO � OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident B X ANYAUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED ADE8579688 1/23/2024 1/23/2025 BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIREDAUTOS AUTOS Per accident $ Medical payments S 1,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED I I RETENTION$ UHE8575527 17 1/23/2024 1/23/2025 $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY YIN TAT TE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT S 1,000,000 OFFICER/MEMBER EXCLUDED? N❑NIA C (Mandatory in NH) WBE8965937 1/23/2024 1/23/2025 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Yale New Haven Hospital THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 90 South Ridge Street ACCORDANCE WITH THE POLICY PROVISIONS. Rye Brook, NY 10573 AUTHORIZED REPRESENTATIVE Sarah Molnar/SJM ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) NTEW Workers' CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured (203)294-4655 Network Installation Service Inc 192 North Plains Industrial Rd Wallingford,CT 06492 1 c.NYS Unemployment Insurance Employer Registration Number of Insured Work Location of Insured(Only required if coverage is specifically limited to 1d.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-Up Policy) Number 06-1467262 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Citzens Insurance Co of America Yale New Haven Hospital 90 South Ridge Street 3b.Policy Number of Entity Listed in Box"I a"Rye Brook,NY 10573 WBE 8985937 3c.Policy effective period 1/23/2024 to 1/23/2025 3d.The Proprietor,Partners or Executive Officers are Z included.(Only check box if all partners/officers included) ❑ all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"S'insures the business referenced above in box 1 a"for workers' compensation under the New York State Workers' Compensation Law. (To use this form, New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2". The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.)Otherwise,this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent,or until the policy expiration date listed in box"3c",whichever is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note: Upon cancellation of the workers'compensation policy indicated on this form, if the business continues to be named on a permit, license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers'Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury, I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Sarah Jane Molnar (Print name of authorized representative or licensed agent of insurance carrier) Approved by: 7� &a4. 12/16/2024 gnature) (Date) Title: Licensed Agent Telephone Number of authorized representative or licensed agent of insurance carrier: 203-269-9565 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