HomeMy WebLinkAboutDP25-001 4R
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
Stephanie J. Fischer
David M. Heiser
Salvatore W. Morlino
CERTIFICATE OF COMPLIANCE
January 30,2025
Herman Thomas&Takeya Bobo-Thomas
9 Gardenia Lane
Rye Brook,New York 10573
Re: 9 Gardenia Lane,Rye Brook,New York 10573
Parcel ID#: 129.25-1-1.9
Demolition Permit#25-001 issued on 1/9/2025 to Remove Wall Partition in Garage
This certifies that the wall partition in the garage,demolished under the above captioned permit has been
satisfactorily completed.
Sincerely,
Steven E. Fews
Building&Fire Inspector
/to
v D BUILQBROOK,
ENT For office use oul :
PERMIT# p)S—pp
VIL OK ISSUED:
�A1N - 9 2025 38 KING STRE ,v YoRK 10573 DATE:11 FEE: ,fitj,'SQ— PAIDlXVILLAGE OF RYE BROOKov
BUILDING DEPARTMENT
APPLICATIONT OR 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
Address: I �Cv✓(7 tip �'Z- ?Wcok A f� (0173
Occupancy/'lU�se: �,QrN Parcel ID#: J 4 5 r a� —f—f, 9 Zone: Putt
Owner: 4jwym Address: 6CiPAe'441 C. 10
P.E./R.A. or Contractor: —�— Address:
Person in responsible charge: Address:
Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issuance of a
Certificate of Occupancy/Certificate of Compliance for the structure/construction/alteration herein mentioned in accordance
with law:
STATE OF NEW YORK,COUNTY OF WESTCHESTER as: QCC d I
O being duly swom,deposes and says that he/she resides at ` G tAl 5
(Print Name
of Applicant) (No.and Street)
in� � R-41oOCc ,in the County of Ik,,eSjGCtj41A r in the State of�,that
(City/Town/Village)
he/she has supervised the work at the location indicated above,and that the actual total cost of the work,including all site improvements,
labor,materials,scaffolding,fixed equipment,professional fees,and including the monetary value of any materials and labor which may
have been donated gratis was:$ too
for the construction or alteration of 444 CILLUA c'"V Vcf-- -e—
Deponent further states that he/she has examined the approved plans of the structure/work herein referred to for which a Certificate of
Occupancy/Compliance is sought,and that to the best of his/her knowledge and belief,the structure/work has been erected/completed in
accordance with the approved plans and any amendments thereto except in so far as variations therefore have been legally authorized,and
as erected/completed complies with the laws governing building construction.Deponent further understands that it shall be unlawful for an
owner to use or permit the use of any building or premises or part thereof hereafter created,erected,changed,converted or enlarged,wholly
or partly,in its use or structure until a Certificate of Occupancy or Certificate of Compliance shall have been duly issued by the Building
Inspector as per§250-10.A.of the Code of the Village of Rye Brook.
Sworn to before me this 5 6 Sworn to before me this
day of , 20 day of , 20
Signature of Prope wner Signature of Applicant
9k&n_&W��(t
Print Y,
ame of Property Owner Print Name of Applicant
Notary Notary Public
GREGORY M.RIVERA
NvtM Public,State of New York
No.01 RI6441398
Qualified In Westchester County
Commission Expires September 26,2L
�E 6RCi'
F o
1
982 BUILDING DEPARTMENT
❑BUILDING INSPECTOR
❑ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK
❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573
(914) 939-0668 FAx (914) 939-5801
www.ryebrook.or
- - - - - - - - - - - - - - - - - - - - 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
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BUILDING DEPAR''MENT D E C IE M
VILLAGE OF RY OOK
938 KING�ET RYE BR ,NY 10573 DEC 3 0 2024
�__( 4.Z -0 �
W k , ov I VILLAGE OF RYE BROOK
: BUILDING DEPARTMENT
DEMOLITION PERMIT APPLICATION
FOR OFFICE USE ONLY:
Approval Date: 1► Permit#: f�/�p�sI Application Fee:
Approval Signature: Permit Fees: $ /
Disapproved: Other: C'/p 4
Application dated: is hereby made to the Building Inspector of the Village of Rye Brook,.NY,for the issuance of Permit for the
interior alteration of an existing building,or for a change in use,as per detailed statement described below.
11
1. Job Address: 1 V\' AN SBL: j, as 1—/, 9 Zone: UI--)
2. Proposed Demolition.(Describe in detail): e- t^V-k G4
3. Property Owner: 1 I v Address: q6p g,4 '6( Ch Uo
Phone# j'l7 S'?�(��(�( Cell# email: �'f� Q
Applicant: Address:
Phone# Cell# email:
Architect/Engineer: Address:
Phone# Cell# email:
General Contractor: Address:
Phone# Cell# email:
4. Estimated cost of construction $ 00
(NOTE:The estimated cost shall include all labor.material.scaffolding.fixed equipment.professional fees.and material and labor which may he donated
gratis.)
5. Type of construction:(wood frame,masonry,steel,etc...)
6. Method(s)of Demolition:
7. Number&Location of Fuel Oil Tanks to be Removed: Q
S. Number of Stories: Height to Highest Ridge: To Highest Chimney:
9. Estimated date of completion: i j
i
6/I/2o24
This application must be properly completed in its entirety and must include the notarized
signature(s) of the legal owner(s) of the subject property, and the applicant of record in the
spaces provided. Any application not properly completed in its entirety and/or not properly
signed shall be deemed null and void and will be returned to the applicant.
Please note that application fees are non-refundable.
STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as:
, being duly sworn,deposes and states that he/she is the applicant above named,
(print name of individual signing as the applicant)
and further states that (s)he is the legal owner of the property to which this application pertains, or that (s)he is the
forthe legal owner and is duly authorized to make and file this application.
(indicate architect,contractor,agent,attorney,etc.)
That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use
conducted at the above captioned property will be in conformance with the details as set forth and contained in this application
and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire
Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations.
Sworn to before me this I C) Sworn to before me this
day of ,20-24 day of ,20
Signs Ye of Prop rty O ner Signature of Applicant
VV-ati 114�
Print ame of Property Owner Print Name of Applicant
Notary Pub Notary Public
GREGORY M.RIVERA
Notary Pubtic,State of New York
No,01 RI6MI398
QuallfW in Westchester county
cotntnMIgn Expires September 26,2
6nnoaa
Building Permit Check List&Zoning Anal sis
Address: ( � \ C` `� SBL:
Zone: V Use: 2 k1 Cont.Type: '� Other.
Submittal Date: Z Z Revision Submittal Dates:
Applicant:
Nature of Work: _ Ck V \ 1
Reviews:ZBA: 3 2 PB: BOT: Other.
NEED OK
( ) ( ) FEES:Filing. BP: D C/O: 1 S Flood Plane: Legalization:
( ) ( ) APP: Dated: Notarized: SBL: Truss I.D. Cross Connection: H.O.A.:
( ) ( ) Scenic Roads: Steep Slopes: Wedands: Storm Water Review: Street Opening.
( ) ( ) ENVIRO:Long Short: Fees: N/A:
( ) ( ) SITE PLAN:Topo: Site Protection: S/W Mgmt.: Tree Plan: Other.
( ) ( ) SURVEY:Dated: Current: Archival: Sealed: Unacceptable:
( ) ( ) PLANS:Date Stamped: Sealed Copies: Electronic: Other.
License: Workers Comp: Liability: Comp.Waiver. Other.
( ) ( ) CODE 753#: Dated: N/A:
( ) ( ) HIGH-VOLTAGE ELECTRICAL.Plans: Permit: N/A: Other.
( ) ( ) LOW-VOLTAGE ELECTRICAL:Plan: Permit: N/A: Other.
O O FIRE ALARM/SMOKE DETECTORS:Plans: Permit: H.W.I.C.:_Battery:_Other.
( ) ( ) PLUMBING Plan: Permit: Nat.Gas: LP Gas: N/A/: Other.
( ) ( ) FIRE SUPPRESSION:Plans: Permit: N/A: Other.
( ) ( ) H.V.A.C.: Plans: Permit: N/A Other.
( ) ( ) FUEL TANK:Plans: Permit: Fuel Type: Other.
O O 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:
Circle:
Froptaee:
Front
Front:
Sides:
Rear.
Main Cov:
Accs.Cov:
Ft.H Sb:
Sd.H Sb:
QFA:
Tot.ImR:
Ft.ImR:
ParlunQ
Height/Stories:
notes:
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Farmers Property and Casualty Insurance Company 03/12/2024V
Foremost GrandProtect Homeowners Declarations ST 31
Policy Number: 3951016170 Page 1 of 3
Policy Term: From 05/16/2024 to Renewal Effective Date: 05/16/2024
05/16/2025, 12:01 A.M. Standard Time
at the location of the property Bill To: Mortgagee
insured as stated in the Policy.
Named Insured: First Mortgagee: Loan 0034227579
TAKEYA S BOBO THOMAS STATE OF NEW YORK MORTGAGE AGENCY C
HERMAN P THOMAS /O M&T BANK ISAOA
9 GARDENIA LN PO BOX 5738
PORT CHESTER NY 10573 SPRINGFIELD OH 45501
The residence premises covered by this policy is located at:
9 GARDENIA LN PORT CHESTER NY 10573
Basic Policy Coverages Limits Premiums
Blanket Property Limit: $ 691,200
A- Dwelling
Amount: $ 345,600 Included in Blanket Property Limit $ 948.00
B - Private Structures
Amount: $ 86,400 Included in Blanket Property Limit
C - Personal Property
Amount: $ 259,200 Included in Blanket Property Limit
F - Personal Liability:
Each Occurrence $ 500,000 $ 26.00
G - Medical Payments to Others:
Each Person $ 5,000 $ 9.00
Loss of Use Actual Loss Sustained with Time Limit
Causes of Property Loss
Comprehensive Perils
Building Property Loss Settlement
Coverage A Plus
Personal Property Loss Settlement
Replacement Cost on Contents
Additional Coverages
Ordinance or Law Limit Included in Blanket Property Limit
Personal Injury Coverage
Optional Coverages
Back Up of Sewer, Drain and Sump Pump Coverage $ 20.00
$25,000 Limit, $1,000 Deductible
Current Annual Premium: $ 1,003.00
Deductible(s)
$1000 deductible applies to each loss Other Than Hurricane and any other coverage(s) with distinct
deductibles noted.
$1000 deductible applies to each Hurricane Windstorm Loss except Loss of Use
MPL 1380-000 Printed in U.S.A.0298
Farmers Property and Casualty Insurance Company 03/12/2024V
Foremost Grand Protect Homeowners Declarations ST 31
Policy Number: 3951016170 Page 2 of 3
Policy Term: From 05/16/2024 to Renewal Effective Date: 05/16/2024
05/16/2025, 12:01 A.M. Standard Time
at the location of the property
insured as stated in the policy. Bill To: Mortgagee
Forms and Endorsements: HP1000 0902 HP2300 0205 HP3500 0904 HP4410 0904
HP5100 0105 HP6200 0205 HP7000 0902 HA01 NY 0910 HA05AA 0920 HA06AA 0322
HA30NY 0204 NY114A 0413 HF10NY 1207 HF30NY 0902 HF51 NY 1019
Discounts for the following have been included in the current annual premium:
15% Home Policy Plus, Including
Automobile
*10% Off Premises Theft Exclusion
*10% Superior Home Discount Applies
Rating Information
Territory 56 1 Family Frame Construction
Composition Roof Insured DOB 12/29/1984 Built in 2020
Roof Age 04 Years Co-Insd DOB 08/03/1982 Updated in 2020
Townhouse/Rowhouse 01 Units
A 1% Lead Exposure Exclusion Credit has been applied to your premium.
Farmers Property and Casualty Insurance Company 03/12/2024V
Foremost GrandProtect Homeowners Declarations ST 31
Policy Number: 3951016170 Page 3 of 3
Policy Term: From 05/16/2024 to Renewal Effective Date: 05/16/2024
05/16/2025, 12:01 A.M. Standard Time
at the location of the property
insured as stated in the policy. Bill To: Mortgagee
Messages
Your policy has been renewed. Please read all items shown on this renewal Declarations Page to ensure
that you have your desired protection.
Inflation Protection: Your Blanket Property Limit for Coverages A, B, C, reflects the construction
price index increase of 10.0%.
THE STATE OF NEW YORK REQUIRES THAT WE DISCLOSE THE FOLLOWING INFORMATION ABOUT OUR FEES
IF A PAYMENT IS NOT MADE DUE TO INSUFFICIENT FUNDS FROM YOUR BANK ACCOUNT (NSF FEE) OR IF
YOUR PAYMENT IS LATE (LATE FEE):
UNDER THE CIRCUMSTANCES LISTED BELOW, WE WILL CHARGE YOU FEES ASSOCIATED WITH THE COST OF
PROCESSING CERTAIN POLICY TRANSACTIONS. THESE FEES ARE NOT PREMIUM, BUT ARE REGARDED AS
AN OBLIGATION OF YOURS INCURRED IN CONNECTION WITH THE PAYMENT OF YOUR PREMIUM
THEREFORE, NONPAYMENT OF THESE FEES CAN RESULT IN CANCELLATION OF YOUR POLICY.
FEE CHARGES WILL BE SEPARATELY NOTED ON YOUR INSTALLMENT BILLS.
NSF FEE - IF YOUR REMITTANCE FOR PAYMENT OF YOUR OBLIGATIONS TO US IS DEEMED NSF BY A
BANK, WE WILL CHARGE YOU A $20 NSF FEE.
LATE FEE - IF WE DO NOT RECEIVE YOUR PAYMENT OF A BILL AND A NOTICE OF CANCELLATION FOR
NONPAYMENT IS ISSUED, A $25 CHARGE WILL BE ADDED TO YOUR NEXT BILL.
The cost of any coverage indicated as "Incl" is included in the Basic Policy Coverages premium amount.
Your policy tier level is 15.
This Policy Does Not Provide Coverage for Flood Damage.
Your package policy includes a Single Deductible Loss Clause which protects you from paying more than
one deductible in the event of a covered loss that affects more than one product. Please read the
endorsement carefully for details.
Additional Insured/Mortgagee
First Mortgagee: Loan 0034227579
STATE OF NEW YORK MORTGAGE AGENCY C
/O M&T BANK ISAOA
PO BOX 5738
SPRINGFIELD OH 45501
For claims, see Claim Directory. Your agency is:
SCAVONE INSURANCE AGENCY CENTE
Tel: 914-428-711 1
9CJ-004-1
Affidavit of Exemption to Show Specific Proof of Workers' Compensation Insurance
Coverage for a 1, 2, 3 or 4 Family, Owner-occupied Residence
**Thu form cannot be used to waive the workers'compensation rights or obligations of any party.**
Under penalty of perjury, I certify that I am the owner of the 1, 2, 3 or 4 family, owner-occupied residence
(including condominiums) listed on the building permit that I am applying for, and I am not required to show
specific proof of workers' compensation insurance coverage for such residence because (please check the
appropri ox):
I am performing all the work for which the building permit was issued.
❑ I am not hiring,paying or compensating in any way,the individual(s)that is(are)performing all the work
for which the building permit was issued or helping me perform such work.
❑ I have a homeowners insurance policy that is currently in effect and covers the property listed on the
attached building permit AND am hiring or paying individuals a total of less than 40 hours per week
(aggregate hours for all paid individuals on the jobsite) for which the building permit was issued.
I also agree to either:
♦ acquire appropriate workers' compensation coverage and provide appropriate proof of that coverage on
forms approved by the Chair of the NYS Workers' Compensation Board to the government entity issuing
the building permit if I need to hire or pay individuals a total of 40 hours or more per week(aggregate hours
for all paid individuals on the jobsite)for work indicated on the building permit,or if appropriate, file a CE-
200 exemption form; OR
♦ have the general contractor, performing the work on the 1, 2, 3 or 4 family, owner-occupied residence
(including condominiums)listed on the building permit that I am applying for,provide appropriate proof of
workers' compensation coverage or proof of exemption from that coverage on forms approved by the Chair
of the NYS Workers' Compensation Board to the government entity issuing the building permit if the
project take a total of 40 hours or more per week(aggregate hours for all paid individuals on the jobsite)for
w rk indi ed on the building permit.
(Signature of H7E/
er) ( ate gne )
H;_ i \4s,, C f Home Telephone Number
(Homeowner's Name Printed)
Sworn to before the tbl� l� day of
Property Address that requires the building permit:
ount lerjf or Notary Public)
A
/�� q ( J T7 3 GREGORY M.RIVERA
Notary Public,State of New York
No.01RI6441398
Qualified In Westchester County
Commission Ex epigniber 26 Md,
Once notarized,this BP-1 form serves as an exemption for both workers'compensation and disability benefits insurance coverage.
BP-1 (12/08) NY-WCB