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HomeMy WebLinkAboutBP25-026PERMIIT # SECTION TYPE OF WORI 10B LOCATION CONTRACT T. COST Zo #_�Q TCO # O DATE:Woo c/ a YOB a ccoolv s n e ri v� z oco s -- FEE DATE INSPECTIQN RECORD I DATE INSP FOOTING -- FOUNDATION FRAMING RFRAMING INSULATION PLUMBING � RGH PLUMBINGGAS ED - 2vZ SPRINKLER ELECTRIC LOW -VOLT O , , . 2y ALARM C� AS BUILT CI `' r ZoI. � FINAL hj A M4s74 el� Ige1%7111�001'f�1 �o�_ i ( y9 C14/) 3a�- i 70� os(YJfo bee � 01 1Qy,e2rv/ 7 OTHER APPROVALS ARB BOT Ps ZBA OTHER VILLAGE OF RYE BROOK WESTCHESTER COUNTY, NEW YORK NO: 25-122 Certificate of ®ccupaucp his is to certify thata 4C Of, &C S&06i, /V 7 having duly filed an application on 20 G?5 requesting a Certificate of Occupancy for the premises known as, Rye Brook,NY, located in a ��• Zoning District and shown on the most current Tax Map as Section: . 4a6 Block: __/ Lot: I , and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No. 'C./� , issued 20 4;25, 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: /fC- - Construction: 17 , for the following purposes: `��}� rL/ /� �/� /Q� 0, 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 heihall be made,no Il the building be moved from one location to another until a permit to accomplish such change h Albee obta' d fr m the ilding Inspector. Building Inspector,Village of Rye Brook: Date: SEP 2 2 2025 5ECENE " For office use onl 0BUILDINMENT PERMIT SEP 1 6 2025 VILLAGE OF RYE BOOK ISSUED: - 93 KING STRE l `, YE BROOK, 1W YORK 10573 DATE: — c� VILLAGE OF '.' BROOK ;'4�9 -06 0, FEE: �-75 PAID BUILDING DEPART%LENT w e 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 44*444*4*###ffitfttttiiiii####t##i#ififif*44*i#**i*4#f•■it■ti#iti#44**i4fi*######ttttititi►itiiiiiiitf4tttiiitiiiti*iii####fi Address: llX, O t x��tcy �sa�A.�ye cD7� . �Vy S13 Occupancy/Use: /4 Parcel ID #: /12g. l42(p- /—/f Zone: Owner: % � sL Gn---o-j S;e-CNoS Address: 1 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: nnSTATE OF NEW YORK, COUNTY OF WESTCHESTER as: ^� lam\ �O�t�S being duly sworn,deposes and says that he/she resides at Illy ,N� k-CC, F, !U . (P 'tt Name of Applicant) ',-p (No.and Stree in ,in the County of eSfChe ST( ✓ in the State of ,ry ,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: $ �I�tSC7 for the construction or alteration of:r �D� �� Deponent further states that he/she has examined the approved plans of the structure/work herein referred to for which a Certificate of Occupancy/Compliance is sought,and that to the best of his/her knowledge and belief,the structure/work has been erected/completed in accordance with the approved plans and any amendments thereto except in so far as variations therefore have been legally authorized,and as erected/completed complies with the laws governing building construction.Deponent further understands that it shall be unlawful for an owner to use or permit the use of any building or premises or part thereof hereafter created,erected,changed,converted or enlarged,wholly or partly,in its use or structure until a Certificate of Occupancy or Certificate of Compliance shall have been duly issued by the Building Inspector as per§250-10.A.of the Code of the Village of Rye Brook. Sworn to before me this I < Sworn to before me this 1 S day of 1;1. , r , 20 -aS_ day of Se#' O-vn�tY , 202.S ignatum of Propert Owner Signature of Applicant `_fin t -I0.CbW S Print Name of Pro rty Owner Print Name of Applicant 6?jrd �(4- RL4;�: Notary Public HOSANNA G MARIZ Notary Public NOTARY PUBLIC-STATE OF NEW YORK No.01 MA6435613 Qualified in Bronx County My Commission Expires 06-27-2026 BR(�v� O �m Q 9!" BUILDING DEPARTMENT ❑BUILDINGINS{P1?/;'1'(/R s'sUS 'AN'1•BUILDING 1NS11rC OR VILLAGE OF RYE BROOK pCuur.I?Hloeca.nn.NrOrrlca:.lt 938 King Street . Rye Brook, NY 10573 (914) 939-0668 I"AX (914) 939-5801 mm.ryebrook.org - - - - - INSPECTION n REPORT - - - - - -• - - - - - - - - A m mi;ss : W � 0 W� Iet�+�Q, 0 1 11-(;, 1)n r l:: `7- jq 111?1tm rr# Z` 2" — 0 jt� IS1uvv1:1): 2-1 y-c `vcn.: IZ9. b1- BLOCK: LOCATION: 1•\��(/� .�n'CJ` q-1 �&LL oc(:UI'ANCY: ❑ Violation Noted 7 HP. Wolth Iti... 1* ASSIiD ❑ FAILED / REINShECTION ❑ SITIs ENSPECTION REQUIRED ❑ UoOTING ❑ TOOTING DRAINAGF ❑ FOUNDATION ❑ UNDERGROUND PLUNIUM. NO'1'T.S ON INSPECTION: ❑ Rouc.;l! PLUMBING ❑ ROUGLI I"RAMING ❑ INSULATION O Natural Gas N,,,d � -�J�a,4 �nD� ❑ L R Gas --- ❑ TU r.L TA N h ---[�s�_ _ tea_ 4 Do 0+r ---- Tllu SIbItINKL EM ❑ 1"►NA1. PLUMBING J [I CROSS (.ONNUCTION ---- 1 �� �. "tic __ �� ,ff"HNAI. ❑ (1'1'I1 Ii It _...._.._ ._ _E•!. ._..__.__.._ !'.. QyE BRC�k• BUILDING DEPARTMENT ❑BUILDING INSPEGIOR W SSISTANT IWILDING INSPUCTOR V11.LAGE O1-. RYE BROOK ❑CODE I:NFORCF.MI:NT OFFICER 938 King Street • 11ye Brook, NY 10573 (914)939-0068 FAX (914) 939-5801 www.ry1!_4r k.crrg - - INSPECTION REPORT - - - - - - - - ADDRESS : I t ►..► �tC ,Q, bra-IV? I),\I'I : 111mmrr# W Ogg Issur•.1): Sl:c:r: 12- '. G16 Bl.oc;l.: LOCATION: VA ALL AA-k qJ &i4d 4L !�9 T� ' Oc,vPANCY:._ _---- -. - ❑ Violation Noted 1'ul. WORK IS... PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ 1'00TING ❑ TOOTING DRAINAGE ❑ FoVNDATION ❑ UNDERGHOUND PLUMBING NOTES ON INSPE(.711ON: ❑ RouGil PLUMBING ❑ Rouc ii FRAMING ❑ INSULATION ❑ Natural Gaff LIA4LR Gas to, ❑ FUEL TANK - ❑ DIRE SPRINKLE14Iferl 'INAL PLUMBING ❑ CIMSS CONNI?CTION _---__._._.....__._. _.._.__.--. -___-- ❑ PINAL 0.1'111:It QyE 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.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : I GY 1 P DATE: "I Z Z 0 LS PERMIT# ISSUED: Z'l`1-25' SECT: /17•Ia(D BLOCK: / LOT: LOCATION: '�A As ` L( �G __ 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 FUEL TANK ^ C � �� � `� iuc "' u ✓� � iJ . ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER QyE BRC�k. Zm F, BUILDING DEPARTMENT ❑BUILDING INSPECTOR [JASSISTANT 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 :- , I I 4 �2 ✓ DATE: 7 PERMIT# y j .7 ISSUED: SECT: BLOCK: LOT: LOCATION: '`�1 '.N �, I I a � �_ I 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 ❑ OTHERS. .1 a s a a N N cV w a O N N � _ �`� • .. : y— � Cd O y �� O cn VW O ao o W bA a� ♦ U O j Lr) O L u v w s O (Ti Q O� C o O A Y � -1 ff. - O70 W x 00 o � O ow W xow 00 M o � ry A ^ ooin ,n O C w00 00 A s .Q 1-� 00 0 O WAS - rh z �--I �i F Q O Es•+ � � o C w.b u �t0-4 o oo �� � p4 0 O O (� O 0000 � V © V zoo VrM. CAa, o KU a _ IED BUILpr ...DEPAR MENT D C E� " VIL E OF RY OOK FEB -5 2025 938 KING ET RYE BR ,NY 10573 d-� 4 -0 VILLAGE OF RYE BROOK BUILDING DEPARTMENT INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: Q / Approval Date: FEB 12 2025 Permit#:A61 �(�c�iQ Application Fee:$ - l000ct Approval Signature: ;;�— � t��� Permit Fees: Disapproved: dr Other./ Application dated: 01.28.25 is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance ofa Permit for the interior alteration of an existing building,or for a change in use,as per detailed statement described below. (L-O 5 L Job Address: 116 Country Ridge Drive, Rye Brook,NY 10573 SBL: 129,66-1-11 Zone: Rr1-424 2. Proposed Improvement.(Describe in detail): Renovations to existing primary and hall bathrooms to include demolition of existing fixtures and finishes. Fixtures to be replaced in current locations and new electrical work. 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 II: TIER III: 4. Will the proposed project require the installation of a new,or an extension/modification to an existing automatic fire suppression system(Fire Sprinkler,ANSL System,FM-200 System,Type I Hood,etc,..) ;No: x Yes: (If yes,please submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans) 5. Occupancy;(1 fam.,2 fam.,comm.,etc...)Prior to Construction: 1 family After Construction: 1 family 6. N.Y State Construction Classification: V-B N.Y.State Use Classification: R-2 7. Property Owner: Cindy and Gary Jacobs Address: 116 Country Ridge Drive, Rye Brook,NY 10573 Phone# 914-804-1893 Cell# email: clacobs@ffsupply.com 8. Applicant: Cindy and Gary Jacobs Address: 116 Country Ridge Drive,Rye Brook, NY 10573 Phone# 914-804-1893 Cell# email: ciacobs@ffsupply.com 9. Architect: Arketekeher Architecture DPC Address: 6Americo Circle,Ossining,NY 10562 Phone# 914.762.3936 Cell# 315.794.5870 email: michael@arketekcher.com 10. Engineer: Address: Phone# Cell# email: It. General Contractor: Design Renovation Inc Address: 202 Knollwood Avenue,Mamaroneck,NY 10543 Phone# Cell# 914-381-1704 email: designren.poniros5@gmail.com 12. Estimated cost of construction $ $67.000 (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: March 3, 2025 finish: March 28,2025 (1) 8/1 212 02 1 BUILCET Ek MENT FCMWED VIL RY OOK D 438 KINGE BR ,NY 1057 -0 `� F F B - 5 2025 •r►ok,,sire ., AFFIDAVIT OF COMPLIANCE VILLAGE CODE 4216- STORM SEWERS AND SANITARY SEWERS THIS AFFIDAVIT MUST BEAR THE NOTARIZED SIGNATURE OF THE LEGAL PROPERTY OWNER AND BE SUBMITTED ALONG WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION. ANY BUILDING OR PLUMBING PERMIT APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETURNED TO THE APPLICANT. STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: \ �u �o►Cc�OS. &18esiding at, I IVY Casa L,a�rae .�4 xP_ rzc�c .t:�J I c _r_-,—j3 (Print name) (Ai Iress acre you live) i 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; IlW t)'t- Rye Brook,NY. (lob 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. (Sid ature of Property Owne }) (Prin Name afP, perty OwnerW) Sworn to before me this 3% day of IG►.rtutV(i . 2025 (Notary Public) ROSANNA G MARTE NOTARY PUBLIC-STATE OF NEW YORK No.01 MA6435613 Qualified in Bronx County (2) My Commission Expires 06-27-2026 gn 2/2021 This form must be properly completed &notarized by the Design Professional of record and the Property Owner. Failure to provide this completed form with your permit application will delay the permitting process. Notice of Utilization of Truss Type, Pre-Engineered Wood, or Timber Frame Construction. (Title 19 Part 1264& 1265 NYCRR) To:The Building Inspector of the Village of Rye Brook. From: C _ 91 _ Subject Property: 1I �1 .rc�a� h� ��5 L: Zone: Please take notice that the subject;❑One or Two Family; ❑Commercial, ❑New Structure IE ❑ Addition to an Existing Structure ❑ Rehabilitation to an Existing Structure R 1, FEB 5 2025 to be constructed or performed at the subject property will utilize; L r VILI_AC,c OY RYE PROOK ❑Truss Type Construction(TT) T ❑ Pre-Engineered Wood Construction(PW) �- ❑ Timber Construction(TC) in the following location(s); ❑ Floor Framing, including Girders&Beams(F) ❑ Roof Framing(R) ❑ Floor Framing and Roof Framing(FR) Please note that prior to the issuance of the Certificate of Occupancy, the subject dwelling or building utilizing truss type, pre-engineered wood, or timber construction must be posted with a Truss Identification Sign, installed in conformance with NYCRR§t264 for Commercial Buildings, and NYCRR§1265 for One&Two Family Dwellings. Sworn to before me this Swom to before me this S y of Z yo 20 aL S_ day of Fc ,20LS S nature of Pro rty Owner Si ature of Design Professional '%r\&U '06- 71-,A. Gl Ct�'JS M k+A�'�- -�✓1 V I n-d I?!;'a*ame of Property Own r t Name` , o(f�Deesign rof s "onal Cis.9 %0—W ) l " \ Notary Public Notary Public ROSANNA G MARTE SHARI MELILLO NOTARY PUBLIC-STATE OF NEW YORK Notary Public,State of New York No,01 MA6435613 No.O1ME6160063 Qualified in Bronx County Qualified in Westchester county My Commission Expires 06-27.2026 (3) Commission Expires lamlary 29,2Q 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. TATE OF NEWr YORK,COUNTY OF WESTCHESTER ) as: \ e2v�,t LcX75 ,being duly sworn, deposes and states that he/she is the applicant above named, (print namelofindividual sign ng as the applicant) and further states that (s)he is the legal owner of the property to which this application pertains, or that (s)he is the for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,attorney,etc.) That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. By signing this application,the property owner further declares that he/she has inspected the subject property,and that to the best of his/her knowledge there are no roof drains, sump pumps or other prohibited stormwater or groundwater connections or sources of infiltration into the sanitary sewer system on or from the subject property. Sworn to before me this 31 Sworn to before me this 5 d of ��IQUEktn+l ,20_;k� day ofd�2 `7 , 20 ZS 1 Si ature of Property Ctvner Sign a of A \�L-U d l3(�V1.h ���I�� �l''�V1�tf!-C'i. �'�y� ✓�/y PrintNamccifilroperty Owner I P&' t Name of Applicant Notary Public Notary Public SHARI MEULLO ROSANNA G MARTE Notary Public,State of Now York No.OIME6160063 NOTARY PUBLIC-STATE OF NEW YORK Quallfled In Westchester County--7 No,01 MA6435613 commission Expires JanUary Zg,20t, I Qualified in Bronx County My Commission Expires 06-27-2026 (4) 8/12/2021 a a i r s a Ci G1 a p 00 OC ■ xn Ln N fV ~ 3 = s � wi a H W x e 0.4� a; a W 4 `.% � � � � .� � • rr H a a 1-4 z M, W ~ W rz N s ^/ ✓: 'C _ CA eq Md oc CA OC G, < _ O tN z 3 o z � F+ _ Wz �• FUy+ , j a O ... : w z �. a e�-4 z a w F z LZ r r a BUILDING DEPARTMENT I,� �n VILLAGE OF RYE BROOK D F V Ez 938 KING STREET RYE BROOK,NY 10573 J (914)939-0bC8'' APR - 3 2025 \ \v\\ .rveht(j0kil .gov VILLAGE OF RYE BROOK ELECTRICAL PERMIT APPLICATI NBUILDING DEPARTMENT Westchester County Master Electricians License Required FOR OFFICE USE ONLY BP#: 5 EP#: C:)6—..-O 1 0 Approval Date: APR 0 7 Permit Fee: $ 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, 3"�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. I.Address: (( /VQ- SBL: , to _ l '• Zone: 2.Property Owner: EAM n jLo Address: f Phone#: 8 3Cell#: email: 3.Master Electrician/Licensed Installer: pp�2 Address: S , Lic.#:Phone#: Cell#: (�' 04• 1 g l-email: 1S [- L Company Name: L Address: J� 4.Propos d Electrical Wor ixture Count: V O 5.3rd Party Electrical Inspection Agency: f�4,1 -g STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: 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 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 Swom to efore a this day of 20 day of Signature of Property Owner Signa re o Appli ant ,41ak ao-in Print Name of Property Owner Pri ame of Applicant GREGORY M.RIVERA ziel 0/ Netary Public,State of New York P 0 0,// - &&a Notary Public No.01 R16441398 Nota ub Qualified In Westchester County 6/t/2024 Commission Expires September 26,20 • STATEWIDE INSPECTION Cxk) sel-vief, 47111 SWIS 0:0 • JOBAPPLICATION . Office Use Elect.Permit# ,-5 1 /a Bldg P�rrni f Utility I 1i Final Certificate 11 C II 1 O Zip Township n Y&S Cross Street S Block / I_ot / Owl, d 61 r ff. I Coota i , . 90 - l g 7_2 ❑ sem ❑1 st ❑2nd FI. ❑3 I. ❑More Than 3 FI. ❑Garage ❑Attic ❑Outside ❑Residential ❑Cornmerc:ial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms Carbon Monox Flood Trash Compact Amt Amps Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Warm Draw Incandescent Fluorescent SERVICE Amperage Voltage 1 P 3P #Meters #Disconnect ❑Underground ❑New ❑Reconnect ❑Overhead ❑Change ❑Visual Re-Inspection ❑ Safety Re-Inspection ❑ Re-Inspection Additional Information D EC IEVVE =- 3 VILLAGE OF RYE BROOK BUILDING DEPARTMENT This application is vald 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 it.ois have been Installed.you ad- authorized to make the inspection and adjust the tee for the additional items Inspected.The applicant declares that there is no open applications for lh*above address with any other inspection rompany.The applicant,owner or authorized agent agrees to all the above terms and conditions as set forth for the application. Inspector Date Finalized Inspector it C n, Ar Date Signs r AddErn City l Zip Code O License# Phone It Q l/ 1 T ' State Wide Inspection Services R LE C E ��/j F 1080 Main Street L� L� VV I� Fishkill, NY 12524 845 202-7224 Phone a SEP - 4 2025 DD914-219-1062 Fax STATE WIDE INSPECTION SERVICES Email: officeCc�swisny.com Service With Integrity VILLAGE OF RYE BROOK Website: www.swisny.com BUILDING DEPARTMENT BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: Alan Bonistall Electrical Contr, INC Gary& Cynthia Jacobs Alan Bonistall 116 Country Ridge Drive 53 Purdy Street Rye Brook, NY 10573 Harrison, NY 10528 Located at: 115 Country Ridge Drive, Rye Brooks, NY 10573 Section: Block: Lot: Electrical Permit Number: EP25-090 129.66 1 11 Certificate Number: 2025-5866 Building Permit Number: BP25-026 A visual inspection of the electrical system was conducted at the Residential occupancy described below.The electrical system consisting of electrical devices and wiring is located in/on the premises at: 115 Country Ridge Drive, Rye Brooks, NY 10573 The Basement Bathroom, and First Floor Bathroom 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 29th day of August 2025. Name Quantity Rating Circuit Type Primary Bathroom LED Downlights 10 Sconces 02 Exhaust Fan 01 Single Pole Dimmers 04 3 Way Dimmers 02 GFCI Receptacles 02 TV Receptacle 01 Shower Mirror 01 Toilet GFCI 01 20AMP 120V Steam Unit 01 50AMP Name Quantity Rating Circuit Type Hallway Bathroom LED Downlight 04 Sconces 02 Illuminated Med Cabinets 02 Single Pole Dimmers 03 GFCI Receptacles 02 Phone Jack 01 Shower Mirror Receptacle 01 Toilet GFCI Receptacles 01 20AMP 120V 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. Pagel 2 t i GO L; N -- a Ln O C N0-4 F A CG V x a a W bf tc �y x ° C3 oL. O W _ E it � . �• Z � � W 00 y p W C"' am 1 z R; o p �" 92 A z � ' C, `:'• i--� -. Fes. F+1 W Uw PLO 4... 00 C ! U .. w QI , i • G V1 I E APR - 7 2025 BUILDII��DEAR T\MENT VIL6 E OF RYE$ROOK VILLAGE OF RYE BROOK 938 KING jaEET RYE,BR lax,NY 10573 BUILDING DEPARTMENT Ww1W-TVe O0lzn goy PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP#: Q 5-- V C7(�' PP#: C� Approval Date: APR I 25 Permit Fee: $ Approval Signature: Disapproved: (fees are non-refundable) DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDING INSPECTOR.THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12°/%OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00 Application dated, Y-7-cD,'�_ 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. I.Address: ((o �'O U N i 72�/ �LDC; 17�r1/— SBL: /29.&J. -/- / I Zone: Ile l S 2.Proposed Work: f-LogZ 1',}y s 3.Property Owner:�t�; _�,4 CuRC Address: //(,, PGi] Phone#: Cell#: email: / 4.Master Plumber: OZ�7t i C 9-r-r',L-1=.2 Address: y I) Cgort�ej I,j�lt t Qh CRrjrol� Y I1�52( Lic.#:_Phone#:9/y-_r7/-21.bg Cell#: email:Cro�o Ulu lerrt0 QA (:fOfK Company Name�cne-pj- L1',2r4 ram^ T- Address://�I le7z^,v /).,91- )0 CRi'TG , , /D SZv INDICATE FIXTURES& LINES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: Location Water Urinals Drinking Sinks Showers Bath Laundry Domestic Fire I Sanitary Natural/ Other" Total Closets Fountains Tubs Tubs Service Service I Sewer LP Gas Basement I st Floor 2nd Floor 31 Floor 4"Floor 5"Floor Exterior 5.*List Other Equipment/Provide Details: (Notarized Signatures Required Next 2 Pages) -1- 6/1/2024 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: J?0/SF/2: / 0,eCe° ty k' ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and further states that(s)he is the Master Plumber for the legal owner and is duly authorized to make and file this application. That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to before me this 3 Sworn to before me this v` day of i' ,20 25 day of 20 0� Siinature of PropAvyOwner Signature of Applicant G..z�4 � bS �oaper 1) �' r Print Nam of Property Owner Print N of Applic t Aallotary Public NOTARY PUBLIC-STATE OF NEW YORK otar Public No.01 MA6435613 SHARI L. DUBRAY Qualified in Bronx County Notary Public,State of New York My Commission Expires 06-27-2026 No.01 DU5012Wj This application must be properly completed in its entirety and mgPlftldo Westottt c-pWjF,*ture(s) of Commission Expires Jls_e .I a. the legal owner(s) of the subject property, and the applicant of record in the spaces provided. 0cations not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. -2- 6/l/2024 D BUILD,,IN�GJ. -E-P�R�TMENT VILad'E O.F R4'B4OOK APR - 7 2025 938 KuNG 9MET.RYE BRop-tc,NY 10573 `(91JJ939 0668J�' VILLAGE OF RYE BROOK WWNVryebrookny gov _BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE �216 - STORM SEWERS AND SANITARY SEWERS THIS AFFIDAVIT MUST BEAR THE NOTARIZED SIGNATURE OF THE LEGAL PROPERTY OWNER AND BE SUBMITTED ALONG WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION . ANY BUILDING OR PLUMBING PERMIT APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETURNED TO THE APPLICANT . STATE OF NEW YORK, COUNTY OF WESTCHESTER ) as: 3"4C~Je S ,residing at, //z, eCaWT-i•y REY'z " (Print tt:unc) (Addre;;wluac yuu 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; /a, CJuwr"'�/ �Li��'� /� r✓� , Rye Brook,NY. i7ul?A Itlrcg,) 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. (Signatu of Property Owner(s i U f-\." (k C (PruttNantc(AfPrupcny wnci(;)) Sworn to before me this 3 day of AA. y , 20Z5 &a (Nuuiry FROGANNA NOTARY PUBLIC-STATE OF NEW YORK No.01 MA6435613 Qualified in Bronx County My Commission Expires 06-27-2026 3 6/1/2024 .Building Permit Check List&Zoning Analysis Address: to C,Q to 0 4r N R I.cxdr,, SBI_ /2 9. &6 Zone: Use: L 19 Const.Type: ✓- Other. Submittal Date: 2-' S - 10Z S Revisions Submittal Dates: Applicant: SA C.o 65 l 1 Nature of Work: ?O• er�%o r Re►JOVog,A i n a Of, tFr,,^'VDJvI U.j d �^ ,1 ZA��,rDo+n S . Reviews:ZBA: FEB 1 2 2025 PB: BOT: Other. NEED OK 2 Z to & , FEES:Filing. I QQ Pd BP: Q 80 Ed C/O: Flood Plane: Legalization: ( ) (v�APP: Dated: ✓ Notarized SBL: Truss I.D. Connection:y"H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening: ( ) ( ) ENVIRO:Long. Short: Fees: N/A: ( ) ( ) SITE PLAN:Topo: Site Protection: S/W Mgmt.: Tree Plan: Other. ( ) ( ) SURVEY:Dated Current: Archival• Sealed: Unacceptable: ( ) (�PLANS:Date Stamped Sealed:�Copies:Z Electronic Other. (•� ( ) License: i✓ Workers Comp: Liability:_y 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: V 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 DENLA L LETTER. Other. ( ) ( ) Other. ( )ARB mtg.date: approval: notes: ( )ZBA mtg.date: approval notes: ( )PB mtg. date: approval notes: REQUIRED EXISTING PROPOSED NOTES Area: Circle: Fro=¢e Front: Front: Sides: R APPRMD Main Cov: Accs.Cov: Date: FFR 1 7 Z1175 Ft.H Sb: Sd.H Sb: GFA: ToL in: Ft.imp: Hecht/Stories: notes: �'{ r�'G R¢p4-^� �p3n; - 3 .+�;Y. - .v fit::. � T k a..d ��.E ,7,�,a.•7 "�'% � 1 rt° �nti.�x�"*,j.�1 F�+1 ei :.'�!,r .;. Q i � F.r� � �•>,♦ SsV `�=`�n �p.�. x. t � �1 Sm 96 T O K00 r E e � 0i ttisi►1 i-7 z W r L� Oti£G11J(14�+s1�� t r '1 Li Q �tQfA} E -A r � f J do ui LLJ uj -a = 4, u LX p C to pi U t��an1� r �'$.•,�,is�%iIrrI �l���`�__, a*'x�aij'�P •,���Y1�G t :r�'�� ���'�$����(�� � � �Vi�#�' u 1 �b w ®A�� DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 02/14/2025 �*i­� 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 CONTACT MICHAEL J DONNELLY NAME: Donnelly Insurance Center Agency Inc PHONE Ext: (914)347-6500 A/C.No (914)347-6303 6 North Lawn Ave. E-MAIL INFO@DONNELLYAGENCY.COM ADDRESS: P.O.Box 880 INSURER(S)AFFORDING COVERAGE NAIC# Elmsford NY 10523-0880 INSURERA: SOUTHWEST MARINE&GENERAL INSURANCE 12294 INSURED INSURER B Design Renovation,Inc INSURER C: 202 Knollwood Ave INSURER D: INSURER E Mamaroneck NY 10543 INSURER F COVERAGES CERTIFICATE NUMBER: CL2491735195 REVISION NUMBER: THIS IS TO CERTIFY THATTHE 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 CONTRACTOR 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 ADDLISUHIR POLICY EFF POLICY EXP 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 FX OCCUR PREMISES(Ea occu DAMAGE TO RENTED nte) $ 100,000 MED EXP(Any one person) $ 5.000 A Y GL2024RLH00339 09/15/2024 09/15/2025 PERSONAL&ADV INJURY S 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER. GENERAL AGGREGATE $ 2,000,000 X POLICY JECT PRO LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE S AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LAB OCCUR EACH OCCURRENCE S EXCESS LAB HCLAIMS-MADE AGGREGATE $ DED RETENTION$ S WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION 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) RENOVATIONS/REMODELING CERTIFICATE IS SUBJECT TO TERMS,CONDITIONS AND EXCLUSIONS OF THE ACTUAL POLICY AT THE TIME OF ISSUANCE CERTIFICATE HOLDER NAMED AS ADDITIONAL INSURED AS PER WRITTEN CONTRACT. 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 RYE BROOK NY 10573 `C J ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD i� NYSIF New York State Insurance Fund PO Box 66699,Albany,NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE 0Ilk ^^^^^^ 043633760 DONNELLY INSURANCE CENTER ti AGENCY INC sm PO BOX 880 ELMSFORD NY 10523 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER DESIGN RENOVATION INC VILLAGE OF RYE BROOK 202 KNOLLWOOD AVENUE 938 KING STREET MAMARONECK NY 10543 RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W1248 498-6 732881 02/01/2025 TO 02/09/2026 2/14/2025 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1248 498-6, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW. AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK. TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY, INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS://WWW.NYSIF.COM/CERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. JOHN M PONIROS-PRESIDENT DESIGN RENVATION INC ONE PERSON CORPORATION THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STAT S7NCE FUND V DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 724224670 U-26.3 p�pAy r•1� �� ?�. 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