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HomeMy WebLinkAboutBP25-054PERMIT # SECTION 1 TYPE OF WORK s JOB LOCATION _ nWNFR Q Vi CONTRACTOk/� COST 40 #,�;, TCO # f 2/JO a C WA ac o e/11INNN- 4 J/'// C�'sfi'e FFF FEE DATE INSPECTION RECORD DATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATIONP SING LUM ,�.,(- /�� \ ®•`7����oCcaS/C!�%� �17� RGH PLUMBIN 1 - 20 GAS a SPRINKLER Q.ELECTRIC �' 'A1 Sit w ,S LOW -VOLT O ALARM CJ AS BUILT O FINAL jfto OTHER APPROVALS ARB BOT PB ZBA OTHER VILLAGE OF RYE BROOK WESTCHESTER COUNTY, NEW YORK NO: 25-073 Certif fate of ®ccupancp This is to certify that � F J// / C._ l— of, having duly filed an application on 20 requesting a Certificate of Occupancy for the premises known as, /Cd /PQQc/ , Rye Brook,NY, located in a Zoning District and shown on the most current Tax Map as Section: 5.5 Block: / Lot: , and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No.O issued 20,257'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: &,!2e—,G122-/zy- Construction: , for the following purposes: /� � � !� (�/ JG ya�i��S 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 hei shall e, or hall the bu' ' g be moved from one location to another until a permit to accomplish such change has ee ined fr m e B g Inspector. JUN 1 1 2025 Building Inspector,Village of Rye Brook: Date: E C M V E BUIL9-, Zo ENT For office use only: PERMIT# L1 VILK MAY 15 2025 ISSUED: KING STREYORK 10573 DATE: �--- FEE: PAID VILLAGE OF= RYEBROOKyul- BUILDING DEPARTMENTv 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 wrw*ws*sssssssttswttss+r*ss**ssssssstsrttswtrss+s*+t*r►srssrtrtrtssrsssw+r+++s+**asssstssssstts+rs+sst*sss*tssrtsssrtrwwwswss Address: 5 Lcoff Q Of00 k Occupancy/Use: — "/ arcellD#: Zone: Owner: D A V i h S T 1 c iC Address: 'j 3 TA C(OL (,J �T ��' ,_✓ P.E./R.A. or Contractor: ramu r ,j r;l 0 Address: 1 U I tff 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: (� V j [):j IFT_being duly sworn,deposes and says that he/she resides at (Print Name of Applicant) (No.and Street) in EYE E R k�,k ,in the County of ►N,� ,�,f� in the State of ,that (CnyiTown 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:$ '�-O 000. J 0 for the construction or alteration of: 1' u I O g R CI-)O LP t( c r ) 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 13-r" Sworn to before me this day of A 20 `)' day of , 20 Signature of Property Owtfer Signature of Applicant DAJ=-� S-T�En Print Nape o Property caner Print Name of Applicant YVETTE BAEZ Notary Public Notary Public, State of New York No. OIBA6362930 (qualified in Nassau County Commission Expires August 7, 20pAJ .9 19M- B'IJILDI.N'G 'D-ii,--])'.Al .TME�NT JiRomc 03..11. :4 mv 938RIN4.STRY-F1' - lZ*TC: Ktwou1 ,NY 10573 (9.14 (914) 939-580- -8V IN FWTIONRE'PORT - - - - - - - - - - - - - - - - - -- - A.)xo -us Bj.,OCK.: .AK:.A.114M At.L- LL -i- INA A L 1 OCCUPANCY: 1-1 F'0011N4R 1-1 1.400TING Cl .0.40117, DATIO1N LNOVIRGI-t-OUNI) PLUMOING Na TI-,?,S ON INSVECTION: 11 'ROUG111'34 EI Ro 11 INS W)Wdtl.-14 D[NJ - Fl NATI) A RT, L EI .1-V C,AIS 0 CROSS(-',4.VN-Nl--',CTl0N .Ro'FINA.], 19,, BUILDINGDEPARTMENT D I'll-114,I1ING INSPUCII),tt BlITY.T.)VING INS PEC.-COR VI1_,L.A.G17 01:71 RYE BROOK . .p., 1% NANe, 13,11tooK,NY 10573 (91.4m) 939-1)(ki8 FAX (9.14)939-5801. - - - - -- - -- - - - - - - - - - -- - - - REPO. . T - - - - - - - - - - - - - - - -- -.- - e BLOCK: l Lo-r: &!?J6 J" /304. OCCUPANCY: A 1.9 W I VIOLA No'j'vll� 14.1i"CTIAV 143NS11-FIC-1-to 'N n- SITE INSVECTION It r,etu�V"AcCEPTED F'00TING j."10 LI t-;()0TTNC'-DRAINACU,, 0 FOUNPATYON 1-1 UNDERGROUND PLlrjM.),"F.N(-.. NI 011?,S 4 b N VN S.PFICTIO N. 0 0 Roucm NNAITRAY., S * kA 0 1-4-IM SPRINKIARR ':(NA-11-PLUMBING -:Ro , C N WECTION QyE BRC�v�. O� Zm cu � BUILDING DEPARTMENT ❑BUILDING INSPECTOR 2'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.tyebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : DATE: PERMIT# ISSUED: SECT: BLOCK: LOT: Z46 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 r j ❑ NATURAL GAS Z4 ❑ L.P. GAS ❑ FUEL TANK rP p l �� c� w• �� ❑ FIRE SPRINKLER L,(-k ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER ) LO ►� N w x N ■ � as O W = i H Q � � v °1 -d U ■ a � 'L. � U p p•' : + MM ■ � � w � D� � �' 04 u ~ FBI = os -o v G ..4 .? z a b ■ AJ ` to ,_; B O y p 8 0 Cn pq a O ZLn j o F-�I O 00 ■ M F� O rO O A F sn n v gc 00 104 ■ ^ ILA-' O ON 44 I� 00 GC H V a 5 o-, p t, ,-� (� w V O a0 A [� U 0 sr q Z O OZo V V U z w ioNo en Z A W Od ." ILnq Wow, o � 5 ob U ECEMEB BUIL DEPARTMENT VIL EOFRYEB HR 13 2025 Y Y10573938 KuvG B GRYE BR OOKOF 0 BUILDING DEPARTMENT k ov INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: MAR 2 025 Approval Date: Perm Pd�'a '7 Application Fee:$ Approval Signature: Permit Fees: Disapproved: Other: Application dated: 0 -0-al 5- is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the interior alteration of an existing building,or for a change in use,as per detailed statement described below. / 1. Job Address: o SBL:/�J, ��a�p Zone: 2. Proposed Improvement.(Describe in detail): O N P f ULL BATA REtdoleAr l O d , 0/- E PO W DFfL RaDM [LEI O liAX- o ' , RE PL(A(-E AU Ir-1fFI01L DooQl o„.l M of olr 6s oF o,.�fl a17 Q€. cE f►En �1�uTj 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 I1: TIER III: 4. Will the proposed project require the installation of a new,or an extension/modification to an extsti automatic fire suppression system(Fire Sprinkler,ANSL System,FM-200 System,Type I Hood,etc...) :No: Yes: (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: FRh. After Construction: 6. NX State Construction Classification• N.Y.State Use Classification: 7. Property Owner:_I,)4 V/O( V 4-/:ef2 Address: r 3 I—A t c. o rf rJk r Phone# Cell# 347--q-06—,X99 email 8. Applicant: pA V i b 5 T(E L Address: )"0 IL , Q tk S f I'P't"ax g �y _r�x Phone# Cell# %L/3� 06 " Do q8 email: D<&a, ✓,}/G(�G."tAl 9. Architect: Address: Phone# Cell# email: 10. Engineer: Address: Phone# Cell# email: 11. General Contractor: L VGIRrJO of gf& ( Address: V f 7T! �t, r✓f W (-P(JAA/ C 4A.0 Phone# CellAmi 331-)91S email: Piz,L(f pr.+0.0 L ( t'nA,4 12. Estimated cost of construction $ �b o oo. co (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: ✓' �0" 1 Finish: 5—(Q — JV (I) 6/1/2024 BUILD bk _TMENT VIL 'E OF RP OOK MAR 2 22 225 938 KING ET RYE ,NY 10573 4 VILLAGE OF RYE BROOK W � BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE §216 • STORM SEWERS AND SANITARY SEWERS THIS AFFIDAVIT MUST BEAR THE NOTARIZED SIGNATURE OF THE LEGAL PROPERTY OWNER AND BE SUBMITTED ALONG WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION. ANY BUILDING OR PLUMBING PERMIT APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETURNED TO THE APPLICANT . STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: i, AV 1 O 5 rl r( ,residing at, 5 t �l>�O TT_ (�O (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; AL C- 0 r l � , Rye Brook,NY. (,fob Address) Further that all statements contained herein are true, and that to the best of his/her knowledge and belief,that there are no known illegal cross-connections concerning either the storm sewer or sanitary sewer, and further that there are no roof drains, sump pumps, or other prohibited stormwater or groundwater connections or sources of inflow or infiltration of any kind into the sanitary sewer from the subject property in accordance with all State, County and Village Codes. (Signature of Propert) Owner(s)) I)Avz() f>rs (Print Name of Property Owner(s)) Sworn to before me this- dav of IV) G��Lv , 20 ) ( otan Publifkl MEULLO Notary Public,State of New York No.01ME6160063 Qualifled In Westchester County Commission Expires January 29,202 (2) 6/1/2024 This application must be properly completed in its entirety and must include the notarized signature(s) of the legal owner(s) of the subject property, and the applicant of record in the spaces provided. Any application not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. Please note that application fees are non-refundable. STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: tea✓.1z) ;'T-T'-tT? _ ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as plicant) 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 d -I Sworn to before me this day of laa'c� , 20 day of , 20 Signature of Property Owne Signature of Applicant -0A\Ja9 Print Name of Property OwneCr Print Name of Applicant Noiary Public Notary Public SHAR1 MELILl.O Notary Public,state of New York No.01ME6160063 Qualified in Westchester County Commission Expires lnntlafy 29,202D (4) bn/zaz4 a = s; a C _ = 0 fi a � W ai Lin N N .d ■ s 00 r ►t, OG f 00 OF x L FW�1 a f Ln ar M Qa cJ1 C4 o 7 _ Ln 00 p ® z a f x x •a � W z =� � `" O 00 � t Z z o � � � Z z = O W 1 N M A 0 � d Q = r ° can CA CN 99 w r ► + d x o th x z z a `�I �•W/ O V w N ` i I-r a • i O � 0.� = O Zs i F, V u. O • �, v W z a M z `n A a z w A 0. a � U W hl F1 W ;J., i (n a = f' a. i p IE G(� IMMF BUIL G DEPARTMENT3D VIL E 4RYEOK APR _ 7 2025938 KIN ENY 10573 �M VILLAGE OF RYE BROOK BUILDING DEPARTMENT ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required p� � FOR OFFICE USE ONLY BP#: EP#: C�LI�\ <J / Approval Date: AP ? Permit Fee: $ Approval Signature: I 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, Jy— /'7—,:)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: J0 ,A(.CO`T'T F�.ppU SBL: 3SI 5 ��—�(OZone: Q" 2.Property Owner: OA JIB ErL Address: iAl� Phone#: f/I6 Cell#: email: 9EL 3.Master El ectrician/Licensed Installer: 11 1%(.8 A E-L 7RO`r Address:79 RA4A R &W RO ! —AM C-T Lic.#: 138(a Phone#: Cell#:&/q)$7Q- 91$7 email:A-MELrrCZ141CSoP?'on1uniJ. AJEj Company Name: A 7A EL,CCTA I L Address: 79 8 A.A L &CAE 1 V S-rAM FOW GT Ly.09o-3 4.Proposed Electrical Work/Fixture Count: R&PLAC6 � b&V/C 6_5 t 40 RC6665Lf.0 6-91I LF 5.31 Party Electrical Inspection Agency: �A) i S STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: t"A6 !Q01" being duly sworn,deposes and states that he/she is the applicant above named.and does further (print name of individual signing as the applicanj 1 state that(s)he is the MAS7A& ffLi—rJLIj )A N 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 b fore me this day of ,20 day of ,20 _ Signature of Property Owner Signature of Applic NtcNAcZ TRO? Print Name of Property Owner Pr me of Applicant (\ LL \��) .n p)-� Notary Public N6 W yyftt,State of New York No.01ME6160063 6/112.024 Qualified In VWstchester Coun Commission Expiws Jantlary 29.20 STATE WIDE INSPECTION SERVICES, INC.; Service VVilh Integrity 0•0 • • SWIS JOB APPLICATION0. • Office Use Elect. Permit# L1 Date '47( d) Bldg Permit# Scl Ft Plumbing Permit# Final Certificate# City/Village 8 Zip Building Dept. R County Address D Cross Street vSection Block �v Lot Owner Name/Address(If different than above) ! V( ,t \ SY 64 Contact Number ❑Basement ❑1st FI. [�f2nd FI. ❑3rd FI. ❑More Than 3 Fl. ❑Garage ❑Attic ❑Outside ❑Residential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C/O Detector Hood Trash Compact �C) Amt Amps 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 Junction Box Combiner Box Load Center PV Monitor Energy Storage System DC Disconnect ❑Legalization ❑ Safety Inspection ❑Consultation (�rPAC sl UTi6-7-S w i-7-"dj Ate; �L K toss uG,Iq7s p EL,7 l � ) r APR - 7 2025 ID 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 __ L�CL7�li L L`J ONt_�/1Jt. /�f Name LC44A&L "'SOY License# 13 8t0 Date 'y 7 S Signature -� Address 891AeL -AZ City/State �7A fro,-o ��' Zi e O6 0 Company -7l.A t:L&'�/�l C Phone# 8�_ 7 D State Wide Inspection Services It 'C;ot�" 1080 Main Street FJUN - 4 2025 Fishkill, NY 12524 a T 845 2 Phone VILLAGE OF RYE BROOK 914-219-119-1062 Fax STATE WIDE INSPECTION SERVICES Email: office@swisny.com BUiLD{1G DFFARTMENT 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: ATA Electric, LLC David &Jill Stier 79 Briar Brae Road 53 Talcott Road Stamford,CT 06903 Rye Brook, NY 10573 Located at: 53 Talcott Road, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP25-094 135.58 1 26 Certificate Number: 2025-3209 Building Permit Number: BP25-054 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: 53 Talcott Road, Rye Brook, NY 10573 The First and Second Floor 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 June 2025. Name Quantity Rating Circuit Type Receptacles 20 Switches 31 Recessed Luminaires 40 �Y� `I 1� 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. e x' a ■1 _ r- Lell N _ O O N s 1+� � a ON z v CJ� ■ ■ F�1 �f a� r� � A (3.� .G1G hyl 1-0v ^� L z r—i rMy g c% CU +l1 M h� alp aCO Mz U Z en N V V Fly--•I C7 u a c V Ln `"4 0 5 .. O w c z z2 w 'n V �- 8 i-•' < x V M Z U) q a z q < oA -. w .. QI MI a i m "Ol zA BUILDING DEPARTMENT U VILLM� E OF RYE BROOK APR 9 2025 i 938 KINGINP RYE BROOK,NY 10573 VILLAGE OF RYE BROOK -0668 BUILDING DEPARIVENI www.l,V&brtioknv.gov PLUMBING PERMIT APPLICATION -7 1 FOR OFFICE USE ONLY BP#: PP#: f-)`<- Approval Date: APR 10 2025 Permit Fee: S Approval Signature: Disapproved: (fees are non-refundable) DO NOT START WORK or CONSTRUCTION UNTIL A PERNl1T HAS BEEN ISSUED BY THE BUILDING INSPECTOR THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WIT110UT A PERMIT IS 12%OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF S750.00 Application dated, 7 —% is hereby[Wade 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: 53 -r-AL(.AT T R D. RYE 13 R o e K/ N Y SBL: / - ZoneJC-/'�- 2.Proposed work: 414¢r-A n-n: L l}' ►y- 11-4-) 3.Property Owner: P a V.ZO S TS CR Address: 53 'rO tL C • r T RD, &Y E fT R°`K t ! Phone#: 2 12-$$1-((2.6 Cell#: _email: DS T z Ck - ►J Y C lmi Grt A 1 L--C-0 4.Master Plumber: . Address: /Tr,1 Y�- C 4 d,"i a i - Lic.#: YI G Phone#J/j1 eY /.TS Cell#:`/"Y 2'1'? 1 {7S J email: /•wc . .� Company Name:��/20 S �v n.b,},,, Address: I Y 74�C 51 � �- wj /r, 7 C, INDICATE FIXTURES&LINES TO BE INSTALLED AS PER THE FOLLOWEVG SCHEDULE: Location Water Urinals Drinking Sinks Showers Bath Laundry Domestic Fire Sanitary Natural/ Other's Total Closets Fountains Tubs Tubs Service Service Sewer LP Gas Basement 1 st Floor ! / 2nd Floor (' 3'°Floor 41°Floor 51°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: -P Ay=4 S T'z E4� ,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 01,J Sworn to before me this 9 r day of ,20 day of 20 a G� Signature of Property Owner Signature of Appl' ant tJ Av ZD $-rs.ER, ��4it,t"� )7'9l Print Name of Property Owner Print Name of Applivi tt u- N Public NotarY FMEULLO VVETIE OM Notary Public,State of New York NOTARYFtI0MSTAif0FNEIMV= No.OSME6160063 a�NMOISA636M � � Qualified In Westchester County --7-17 WYCOMMSSON $AUG=Y ommission Expires Jentlaiy 29,20 t This applicatloi. ..�ust be properly comp et«i in its entirety and must include the notarized signature(s) of the legal owner(s) of the subject property, and the applicant of record in the spaces provided. Applications not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. -2- 6/1/2024 BUILDING_DEPARTMENT j L� VILLAGE OF RYE'BROOK 938 KING STREET RYE BR401C,NY 10573 I APR - 9 2025 I ►- -49141 -0668` wwitift okl • ov VILLF�r 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 YOM COUNTY OF WESTCHESTER ) as: D A\/t t> ST-z Er ,residing at, 'S 3 "rh L L O TT K D , (ZX E (30,o •t<<1V Y (Print name) (Address where you live) being duly swom,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; 53 -f Ado 1—r P O A.0 I ,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. A�.,.�.� (Signature of Property Owner(s)) D #"Jx0 Sr.zf� (Print Name of Property Owner(s)) Sworn to before me this day of , 20 ZJ (Nola 11c) �fNMMIENyOpI _ -3- W ODAMdSON ALOW 7 6/1/2024 _ .Building Permit Check List&Zoning Analysis Address: 5 1 C�V�- \4—D SBL: Zone: a— 15 Use: Z Const.Type: V - Other: Submittal Date: 3 V 7. Revisions Submittal Dates: Applicant: �-- Nature of Work Reviews:ZBA: ►SAD 2 6 M- PB: BOT: Other. NEED OK j FEES:Filing.\Q BP: /O: Flood Plane: Legalization: ( ) ('YA P: Dated: v**'Notarized:__ieSBL: Truss I.D. Cross Connection: H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening. ( ) ( ) ENVIRO:Long. Short: Fees: N/A: ( ) ( ) SITE PLAN:Topo: Site Protection: S/W Mgmt.: Tree Plan: Other. ( ) ( ) SURVEY:Dated: Current: Archival• Sealed: Unacceptable: ( ) ( ) PLANS:Date Stamped: Sealed: Copies: Electronic Other. License: Workers Comp: Liability: 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: N/A/: Other. ( ) ( ) FIRE SUPPRESSION:Plans: Permit: N/A: Other. ( ( ) H.V.A.C.: Plans: Permit: N/A Other ( ) ( ) FUEL TANK:Plans: Permit: Fuel Type: Other. ( ) ( ) 2020 NY State ECCC: N/A: Other. ( ) ( ) Final Survey- Final Topo: RA/PE Sign-off Letter. As-Built Plans: Other. ( ) ( ) BP DENIAL LETTER: C/O DENIAL LETTER: Other. ( ) ( ) Other. ( )ARB mtg. date: approval:- notes: ( )ZBA mtg.date: approval:- notes: ( )PB mtg.date: approval: notes: REQUIItED E?QSITNG PROPOSED NOTES ArmAFFKUtr-u pate' ^ MAR 2025 Circle: Fronta¢e: Front: Front: Sides: Rear: Main Cov: Accs.Cov FL H Sb: Sd.H Sb: GFA: Tot : FL IM: Paddng. Height/Stories: notes: F. / co C �� D+ v 1 n ,, v.. r �4$r NPa • .� .: r i tl� .?F v a� �. a ♦♦ I z Ise � •e♦ a vgg �e./e• a ♦.es v •eh � a ,�<tie8)> '� ���{1.3�sv, r�y.3'�lil�l{/a•f ilal►_ems'.. � 11411 1'i {I �a 11�11 ��ult�'e<(�'a 111i. : C Q Q W'94'ner t V a IXd �7 c�i � N rJ / I ♦� ^! C Ay Q "'d iw'�1 060 '1"1 W Iq U .� VWj i Qz N WadF- o o a,ection a F- Z 2 'E LLI F_ a} Q.W W ✓ - L �L. V IIL,q 1 t V O o � 04 � uj CL rX, jell ca i u A � cC „"into N �� ►wt ISHILIAcc Cf) LO ' •' � + 5- �111 a 1/1+ ll�{Olt-, 1{�f{/11! 11{t/f/�11 Il�fff{fy►, lllflf1f�11 0 g !1{ff{yhl, g Idfflfiyl /�i♦Nf hl a ' YA ♦4A t e0 yAry} ♦Y♦ ,nA�Ef� t •♦ i�`. AY .Y, •ee• A Y y♦q�, jt�Ag €y'' / ^ �� ^ ^• i _ 0� t, ! "cSn�IMrft �I ' S' /✓a Y Qv 9p� \ i� CERTIFICATE OF LIABILITY INSURANCE DATE A E(MM/2025 ) 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 CT AJC Insurance Agency PHONE 1850 Silas Deane Hway lE A L° E=i1($60).721_QQ22-__.__ _ _ ___T( Not 860)529-2182 ADDRESS: _ PRODUCER -- -- - Rocky Hill CT 06067 CUSTOMERIO#: INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A:UTICA FIRST INSURANCE COMPANY 5326 LUCIANO PERINOTO PERINOTO HOME IMPROVEMENT LLC INSURERB:HARTFORD UNDERWRITERS INS.CO. 0104 20 MAPLE RIDGE ROAD INSURERC: TRUMBULL CT 06611 IllSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE- FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE WVDPOLICY NUMBER M_OLI C YYYY POLIO LIMIT'S A GENERAL LIABILITY 11/07/2024 11-07-20 EACH OCCURRENCE $ 244- X( COMMERCIAL GENERAL LIABILITY r—x PREMISES(E occcurrence $ __QQQ CLAIMS-MADE OCCUR I !I MED EXP(Any one person) $ 5,000 ART 5046626 06 PERSONAL&AOV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000 000 X POLICY f — PRO- ECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS F BODILY INJURY(Per person) $ SCHEDULED AUTOS BODILY INJURY(Per accident) $ PROPERTY DAMAGE HIRED AUTOS $ (Peracddent) NON-OWNED AUTOS $ $ X UMBRELLA LIAR X OCCUR 5046626 08 EACH OCCURRENCE $ 1 000.000 EXCESS uA8 CLAIMS-MADE �"� ) AGGREGATE $ DEDUCTIBLE - I $ --- RETENTION S $ B WORKERS COMPENSATION 09/30/2024 09/30/2025 WC STATU- OTH- AND EMPLOYERS'LIABILITY � TORY LIMITS R ' ANY PROPRIETOR/PARTNER/EXECUTIVE YIN 6S60UB-4N64529-8-19 1 000000 OFFICER/MEMBER EXCLUDED? � N/A E.L.EACH ACCIDENT� i $ (Mand and yes,describe under atory in I E.L.DISEASE-EA EMPLOYE 0_ $ 1 ,QQ_Q R r r E.L.DISEASE-POLICY LIMIT 1$ 500,000 I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks SChaduls,H more space is required) PAINTING CONTRACTOR CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE Village Of Rye Brook POLICY PROVISIONS. 938 KingStreet AUTHORIZED REPRESENTATIVE Rye Brook NY 10573 Paul Siqueira ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD Clear All NYSIF New York State Insurance Fund PO Box 66699,Albany,NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ^^^^^^ 471282340 PERINOTO HOME IMPROVEMENT LLC (CT LLC) } 22 VITTI ST . NEW CANAAN CT 06840 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER PERINOTO HOME IMPROVEMENT LLC VILLAGE OF RYE BROOK (CT LLC) 938 KING STREET 22 VITTI ST RYE BROOK NY 10573 NEW CANAAN CT 06840 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W2569 700-4 973594 05/13/2024 TO 05/13/2025 1/27/2125 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2569 700-4, 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:NWWW.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 THE SOLE PROPRIETOR, PARTNERS AND/OR MEMBERS OF A LIMITED LIABILITY COMPANY. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STAT SUR NCE FUND 4 DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 25989895 U-26.3