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HomeMy WebLinkAboutBP25-089PERMIT #J6 oc�U /_ DATE: 30Q5� I XP: y 30 SECTION �J�i BLOCK LLOT. TYPE OF WORK �2/f'1D Cj� i /� E' /yg1774 /L/S C'/re44e !� JOB LOCATION to E41 Zo S4Ckes .r ve/7ue OWNER l- 7--AcQ/Son CC9/qy69-30s7 O b TCO # FEE DATE - INSPECTION RECORD I DATE I NSP ri.S�iPcs-,o9e s/,o,?ce fl% � 0/ub 1-4 / �yini sA/, - �Sj/s#•N FOOTING FOUNDATION - FRAMING RGH FRAMING INSULATION 1 Q �/_ �j�l✓ylU144/ �741 PLUMBING J J RGH PLUMBING GAS C7 SPRINKLER ELECTRIC LOW -VOLT C� ALARM AS BUILT O FINAL �. j �P� /33/s�i gel%/ec c OTHER APPROVALS BOT PB ZBA OTH�f2 VILLAGE OF RYE BROOK WESTCHESTER COUNTY, NEW YORK NO: 25-072 Certificate of (9ccupaucp This is to certify that � �,�� Cr� � � �-'�,2 of, RUP, N having duly filed an application on 20 'Z requesting a Certificate of Occupancy for the premises known as, Rye Brook,NY, located in a)Z?F Zoning District and shown on the most current Tax Map as Section: I .g3 Block: / Lot: 53 and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No. ^Lf, issued o 20&�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: M06—Jr AW I Construction: for the following purposes: mo d} ' 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 hej&kt shall be made,nor shall-the ' ' e moved from one location to another until a permit to accomplish such change h be b ' the g Inspector. Building Inspector,Village of Rye Brook: Date: JUN 0 9 2025 DR V� . 19 1'^ tC 4.�jJJ V 4 ji�Vu.r V � O 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 June 9,2025 Shawn Ackerson 564 Westchester Avenue Rye Brook,New York 10573 Re: 564 Westchester Avenue,Rye Brook,New York 10573 Parcel ID#: 135.83-1-53 This document certifies that the work done under Plumbing Permit #25-085 issued on 5/21/2025 for the legalization of a hot water tank has been satisfactorily completed. Sincerely, a4 Steven E. Fews Building&Fire Inspector /to D E C EN E BUILD :BBROOK, ENT For office use onl PERMIT# _0e19 VIL E OK ISSUED:D JUN - 9 2025 938 KING STRE YORK 10573 DATE: O�' FEE: �(`�'j Q= PAID B VILLAGE OF RYE BROOK ov BUILDING DEPARTMENT 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 kftiitif flit#A�itR#fktftfitittitkliittt tiiilti Rii#flit R4i tt k!#tkittfftitiR#i!tltiR#lRtRt#iflt!lRittktttt iftikii lililtiilitil!! Address: S oo 0 S Occupancy /Use: Parcel ID#: Zone: Owner: `��',��..� Address: e P.E./R.A. or Contractor: Address: Person in responsible charge: Address: f, kv 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 a& ��f being duly sworn,deposes and says that he/she resides at S 6!A urA zr ei, k e- (�(I'rin Name of Applicant) (No.and Street) in �l•!Q �(`-0 IKC in the County of �e,�����Q� in the State of that t (CitN/ own/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: $ 000 .00 for the construction or alteration of: 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-IO.A.of the Code of the Village of Rve Brook. Sworn to before me this 12� Sworn to before me this a of i 20�� a of 0(� 20� tilAr iSgna ure ofPropert} Owner of Applicant A Print Name of Property Owner Print Name of ppl scant Notary Public Notary Public MELISSA ISABEL BURSTELL , �- MELISSA ISABEL BURSTELL Notary Public,State of New York Notary Public,State of New York 6/1/2024 No.01 SU6234014 No.01 BU6234014 Qualiffed In Westchester County Qualified in Westchester Countyon Expires March 24,2027 ICoffoilsslon Expires March 24,2027 1 QyE BRCv�. uJ � 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 :- (/'`I A ��k�0 t�l o DATE: (" z J t f J PERMIT# v" - n ISSUED: 'SECT: BLOCK: LOT:_ LOCATION: ��P -��J�' 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 a a 0 LCI o ■ p eq qj v a _ W Q = O H � � s H g 72 C a o vIf - - a Q H - .:� w z `n Z o,x o c o 00 VO i 8 i A C E Z Q O O m0 o PQ 1. V GQ . w�A E 2 ICI W F o z cu W Z pSo° a'dvw CH V Z " 18 - u z V w „ . w �t C7 A Z O C) CA > v _ w � � �� � .. R W A: 09 Y / BUILD PARTMENT D _ VIL 'E OF RYE BOOK 938 KING ET RYE BROOK,NY 10573 APR ' 9 2025 4�99- ' 0668 L_._ W4iXMMDok ov VILLAC INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: Q V9 Approval Date: OLer ;t#;APR 1 6 2025 PP A lication Fee:$ k)0 Approval Signature: _ Permit Fees:$ `4��� Jbo e- SDDisapproved: Other: w _ Application dated: "-� 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:•J d(k W f'Acl ' c Ait SBL: /SSi —/'S3Lone: 2. Proposed Improvement.(Describe in detail): Q—I -_ ��- __ I P--- . - - 3. Does the proposed improvement involve a Home-Occupation as per§250-38 of the Code of the Village of Rye Brook? No: Yes: If yes,indicate: TIER l: TIER U: TIER IIi: 4. Will the proposed project require the installation of a new,or an"tension/modification to an existpig 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: 2 l,'� After Construction: 6. N.Y State Constru tion Classification: N.Y.State Use,C(lktfication: 7. Property Owner f l E k,t Address: ^� U P.11(, -0. Pi= Phone#04_Tk6ct-3 b Ci Cell# email: 8. Applicant: &V't I, Address: Phone# Cell# email: ,,(�,, 9. Architect:�(��A/ Gt. f to S Address: 2iY�-rr! I(N� 1 I r_� oy d (�1 ��3► Phone#TI�,Aki - Cell# email: 10. Engineer: Address: Phone# Cell# email: 11. General Contractor:, ���7 �'�S dd ess: C' Phone# Cell# email: 12. Estimated cost of construction $ Qo 0 _00 (NOTE:The estimated cost shall include all labor material,scatioldmg,fixed equipment,professional fees,and material and labor which may be donated gratis.) d 13. Job Timetable: Start: 1 Finish: O �` (1) 6/1/2024 D BUILDING TIEPAR MENT VIL " o�Rl; ooK APR 0 9 2025 938 KING ET RYE BR ,NY 10573 4 -0 VILLAGE OF RYE BROOK ww ov BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE V16 • 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 . STATEIOF NEW YO K, COUNTY OF WESTCHESTER ) as: If 1 ,residing at, =StL wes�Ap[e�, Ar (Print name) (Address\\here yo i 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; --sk w�CA 4(': me- , 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. mAu (Signature of Property Owner(s)) I (Print Name of Property Ovvner(s)) Sworn to before me this day of n <<( 20,l<11' RANDYLJACKSON NOTARY PUBLIC STATE OF NEW YORK otary PubliC) V WESTCHESTER COUNTY LIC.#01JA6377198 COMM. EXP.09/27/2026 (2) 6/l/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 NFW YORK,COUNTY OF WESTCHESTER ) as: ._ �, __ _ , being duly sworn,deposes and states that he/she is the applicant above named, (print name of individ al signing as the applicant) and further Itateybat (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 Sworn to before me this a of Apt 20 i day f �<' , 202y' all_m' ru� k a ature of PropAcyfp Si ature o App Jr i ant y r . yl Print Name of Pro rty wrier mt Name of Applicant` ary Public �OPLbh�cd RANDY L JACKSON NOTARY PUBLIC STATE OF NEW YORK RANDY L JACKSON WESTCHESTER COUNTY NOTARY PUBLIC STATE OF NEW YORK LIC. #01JA6377198 WESTCHESTER COUNTY COMM. EXP.09/27/2026 LIC•#01JA6377198 COMM. EXP. 09/27/2026 (4) 6/1/2024 try :�•' 1N-3W L'dd _10VI n �i002i8 �� 5zoz z o Nnr _ cG � �-jG c +Ys r t r ling �l SUN p 2 2025 BROOK �'ILLP GEG pEPARTMENT Bv1LO1N ECENE r UN 0 2 2025 i VILLA E OF RYE BROOK �* LDING DEPARTMENT a t M r W N N �n Ln U, w G. (� _ = E. f A CA CA .� en CN F-i Q U N o Q 66 s W �t Go W 3 E-� w � U = MON r- � M z z c.7 A _ u V z w t oc _ Mil CN x a Mai Z �.y W. 00 w ►-� C W < z Ny r 1 ►n O o ,n z w Q z A oA Q W F. QI ca � a z as w z - �BUILENT VILOK MAY 15 2025938 KtN NY 10573 14)�etW6 39-5801 VILLAGE OF RYE BROOK BUILDING DEPARTMENT ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY BP#: Qa EP#: �/ 3 Approval Date: MAY 2 1 5 ,,...>I, •e.,,.�:: �ee: Approval Signature: Permit Fee: Disapproved: Other: (fees are non-refundable) 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 electrical equipment,wiring, fixtures,or to perform other high or low voltage electrical work as per the detailed statement described below. The applicant & property owner, by signing this document agree that all electrical work performed will be in conformance with all applicable Federal, State,County and Local Codes. 1.Address: 564 Westchester Avenue Rye Brook, NY 10573 SBL: 135.83-1-53 Zone: 2.Property Owner: Shawn Ackerson Address: 564 Westchester Avenue Rye Brook, NY 10573 Phone#: 914-469-3057 Cell #: email:_ downriteconstructioninc@gmail.com 3.Master Electrician: Joseph Spirelli Address: 990 East Main Street Shrub Oak NY 105888 Lic. #: 1373 Phone#: 914.455.2158 Cell#: 914.879.7272 email: celia@spirellielectric.com Company Name: Spirelli Electric Inc Address: 990 East Main Street Shrub Oak Ny 10588 4.Proposed Electrical Work/Fixture Count: - File for the removal of electric in an illegal basement. Lbnv STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: being duly sworn,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 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.) 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 441— day of 120 day of—POL / 20 Signature of Property Owner S' tore of Applicant I& V A Print Name of Property Owner PriAt Name of A cant Notary Public Notary Public NICOLE HERNANDEZ NOTARY PUBLIC,STATE Of NEW YORK No.OIHE0001778 Qualified In Westchester County My Commission Expires 212112027 I � Ih STATE WIDE INSPECTION SERVICES INC 0:0 • • SWES JOB APPLICATION0. • Office Use Elect. Permit ++ Bldg Permit # B P Sr)Ft Plumbing Permit # Final Certificate # City/Village Rye Brook Zip 10573 1B,,,ldpg Dept. Village of Rye Brook County Westchester Address 564 Westchester Avenue Cross Street Division Street Section 135.83 Block 1 Lot 53 Owner Name/Address of different than above) Shawn Aekerson Contact Number 914-469-3057 ❑Basement ❑1st Ff. ❑2nd FI. 0 31d Fl. ❑More Titan 3 FI. [:]Garage 0 Attic: ❑Outside ❑✓ Residentiai []Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C 10 Detector Hood Trash Compact Amt Amps Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer Switch SERVICE Amperage #Panels 1 P 4) #Meters # Disconnect ❑Ui icterground ❑ 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 Scope of Work - File for the removal of electric in an illegal basement. NO OTHER WORK PERFORMED - 3D R IE C��V L MAY 15 2025 VILLAGE OF RYE BROOK BUILDING, DEPARTMENT ,ggnication w valid for one i t year from the date received try SWIS This application IS intended to cover the above listed items to be inspected.if at any lime of inspection addnionai items have been installed.you are aulhonted to make the inspection and adjust the fee for the additional items mspecled.The applicant declares that there n no open applications for the above address with any other Inspection company.The applicant.owner its auth ed agent agrees to all the sl.—trrnn and cnndmons f......i„r.i, inplicat on Email Address Celia 9spirellielectric.com Name Joe Spirellf License# 1373 Date 517112025 Signature Address 990 East Main Street City/State Shrub Oak Zip Code 10588 Company Spirel6 Electric Inc Phone # 914-455-2158 RF V L� State Wide Inspection Services 1080 Main Street CA M DDI Fishkill, NY 12524 MAY 3 0 202 8845 202-7224 Phone 914-219-1062 Fax STATE WIDE INSPECTION SERVICES VILLAGE OF RYE BROOK 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: Spirelli Electric, Inc. Shawn Ackerson Patsy F.Spirelli 564 Westchester Avenue 990 East Main Street Rye Brook, NY 10573 Shrub Oak, NY 10588 Located at: 564 Westchester Avenue, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP25-133 135.83 1 53 Certificate Number: 2025-3624 Building Permit Number: 25-089 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: 564 Westchester Avenue, Rye Brook, NY 10573 The Basement was inspected in accordance with the NYS and NFPA 70-2017 and the detail of the installation, as set forth below,was found to be in compliance on the 30`h Day of May 2025. Name Quantity Rating Circuit Type Removal of Convenience Receptacles&Light Fixtures in Basement Only. 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. f y a s, � p O N N W xOC o0 A alo �, 18 a W o cn r � V °O a � MCN w a z we z Z N v • a W o Q :^ N x x x as v oo x V) 7w � � o � o � � 0 7 w V O a aVng, Ln '" w QI as a a � w zd BUIL EPARTMENT ECENE D VIL` ` E OF RYE IROOOK MAY 19 2025 938 KIN , ET RYE En ,NY 10573 VILLAGE OF RYE BROOK _ ov BUILDING DEPARTMENT PLUMBING PERMIT APPLICATION M FOR OFFICE USE ONLY BP#: ' D�J / PP#: Approval Date: MAY 2 1 20 Permit Fee: $ 300 - PIL 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, I • 6-.2p 11 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 plumb)ing work will be in conformance with all applicable Federal, State,County and Local Codes. 1.Address: 6 1� SBL: 135,1 193 S-23 Zone:2= 2.Proposed Work: LL �L r o 3.Property Owner: Address: Q Phone#: Cell#: email: 4.Master Plumber: �-� an\ Q ��2- Address: (3 Q7 Y-,� /^�S fcc� '�� c3 y f0T' Lic.#: AO) Phone#:'1 1� L1,-A0-0A3,8Cell#:9t q C"Q)4-01 (10 em�il: Company Name: Address: D7 I,A 3� k, l`f yl�`Zo� INDICATE FIXTURES& LINES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: Location Water Urinals Drinking Sinks Showers Bath Laundry Domestic Fire Sanitary Natural/ Other* Total Closets Fountains Tubs Tubs Service Service Sewer LP Gas Basement 1st Floor 2nd Floor 31d Floor 4'h Floor 51 Floor Exterior 5.* List Other Equipment/Provide Details: c\ 2 (Notarized skgAtueles Required Next 2 Pages) -1- 6/1/2024 ST}A-TE OF NEUORK,COUNTY OF WESTCHESTER ) as: S✓VC(11U V\ �G�ef-S�"� ,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 Sworn to before me this da of KGLY r, 20 S day of ,20 � ignature of operty weer Signature of Applicant 7operty Owner Print Name of Applicant taryPublic MIRANDA TOMA Notary P bll�c,g�Ee nt New York Notary Public, State of New York No.0-IME6160063 Qualified in Westchester County Qualified In Westchester County Reg. No. 10T06395059 Con Inisslon Expires January 29,20Z-- This application musMe Ipropelillys 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 BUILDINd f XRTMENT p (� VILLAGE OF RY kOOK DD 938 KING$,fi�ET RYE BR 61_k,NY 10573 MAY 19 2025 (A4 -0 wwvr%,' ov VILLAGE OF RYE BROOK 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: 35, S ^ , residing at,Sw Aje (Print name) (Address\01cre v ou 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; yt, , W e r t `,,'AL)L , Rye Brook,NY. I.I ,h:AIIrr„� 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. L '-L (Signature of roperty owner(s)) (Print Name of ro erty Owner(s)) Sworn to before me this da , 20 02� ('N,ota uhli ) MIRANDA TOMA lotar; Public, State of New York 0,zified in Westchester County 3 Reg. No. 10T06395059 z z Immission Expires 6/1/2024 ` , ' .Buildin Permit Check List&Zoningal An s (� V� is Address: � � �� �� SBL• Zone: '1' �-` Use: '2-2-0 Const.Type: Other. Submittal Date 0 Z Revisions Submittal Dates: Applicant l C f-_ `S Nature of Work: Reviews:ZBAAPR �1'1�_PB: BOT: Other. NEED OK ( ( ) FEES:Filing C/O: Flood Plane: Legalization: �7 ( ) (VAPP: Dated: Notarized: SBL: Truss I.D. Cross Connection: H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening.fN/;A.- ENVIRO: Long. Short Fees: ( ) ( ) SITE PLAN:Topo: Site Protection S/W Mgmt.: Tree Plan: Other. ( ) ( ) SURVEY:Dated: Current: ArchivaL Sealed: Unacceptable: ( ) ( ),4q ANS:Date Stamped Sealed Copies Electronic. Other. (`y ( ) 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�yl2(�1WP ( ) ( ) 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 rntg.date: approvaL• notes: REQUIRED EXISTING PROPOSED NOTES APP . OVED Area: Circle: DabA: Fmnta e Front: Front: Sides: Rear. Main Cov Accs.Cov: Ft.H Sb: Sd.H Sb: GFA: Tot.in: Ftt : PP Height/Stories: notes: �E BRC�v� o`` tim 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 :- -1 (c; DATE: PERMIT# PA ISSUED: SECT: BLOCK: LOT: LOCATION: 1,_ r4°,Pia OCCUPANCY: H 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 J '� l U n_, y L/ QyE BR(��• cu � 1982 BUILDING DEPARTMENT ❑RVILDING INSPECTOR QASSISTANT 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 W f- (�I 4 DATE: PERMIT# r� ISSUED: SECT: BLOCK: LOT: LOCATION: OCCUPANCY: f l,6 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 l�U�n ❑ FINAL ) e_��1UV� Con.- ll1 ❑ OTHER 9.7 CA V W LL! W > > OC .. LL. o� W a � LU ww0 �F.�y 3 c W ° Gmw 3 o U F � > � z U' > � _C w Wgozo ao CO p: a H O_ COD w ►-+ �cw � O : a g > r a o c, E"' 26 O w 0 LL CD OZ W ui CO Of Om0Oco CO A. Q co = w F- C7 V W H W i J N =� F W z A �` > � COm ° A n � w z L7 °° ►"'a Z X w W Z z Ix ozam NawLLI N r F-- Q L i w ► ~ a L- Z O a- op > 0 Im coo 103 a Z Q I m Q -._. so to �+ s N is G. N Q 40 i tom)► O >. u •++.fit �_ *am O 'J r. v O O y Z W L a .0-0 Z Z cn U in L o w � : y o Q ° �okection +�.; � ♦ � U (Y v cs. -�- .r ¢> I mom.� �"� 1 .:a r•. Z ��'- u M .41 ui LU owl LO 40 O i to O C ' wILI � L c C V U n NO _r lIn ji�i1'rti t4ac �ii7)1%ii s ' 1 DATE(MM/DD/YYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE kk� 04/07/2025 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 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 HISCOX Inc. NAME: PHONE S Concourse Parkway EA/,No.ExtL_ (�8)202'3007 IX No): Suite 2150 ADDRESS: contact@hiscox.COm Atlanta GA,30328 ___ INSURER(S�AFFORDIIUiCAYERAGE NAIL/ nISl>RER A- Hiscox Insurance Company Inc 10200 INSURED ----�--- INSURER 8: Downrite Construction Inc INSURERC. 564 Westchester Ave - -- -- Port Chester, NY 10573 INSURER0___-_ 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 IN POLICY NUMBER yYY LIMITS X COMMERCIAL GENERAL L.IABLRY EACH OCCURRENCE _ $ 300.000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence, $_100,000 — -- MED EXP(Anyone person) $ 5,000 A Y P103.073.167.2 03/20/2025 03/20/2026 PERSONAL&ADV INJURY $ 300,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMMILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) S HIRED AUTOS NON-OWNED PROPERTY DAMAGE S AUTOS (Per accident) S UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESSLIAB CLAMMS-MADE AGGREGATE S DFD RETENTION$ $ ------ ------ WORKERSCOMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N _ __STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L $ OFFICER/MEMBER EXCLUDED? ❑ N/A •-- ----EACH ACCIDENT- - (Miiindaltory in NH) E.L.DISEASE-EA EMPLOYEE $ II yes,describe under `-- - - DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101.Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION The Village of Ryebrook 938 King St SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Ryebrook,NY 10573 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. NYSIF New York state Insurance Fur PO Box 66699,Albany, NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE Fy, .a n n n n n n 932908272 ti•� DOWNRITE CONSTRUCTION INC '• 1 Y' 564 WESTCHESTER AVE � '}t RYE BROOK NY 10573 i SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER DOWNRITE CONSTRUCTION INC VILLAGE OF RYE BROOK 564 WESTCHESTER AVE 938 KING ST RYE BROOK NY 10573 RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W2608 885-6 284306 03/20/2025 TO 03/20/2026 4/7/2025 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2608 885-6, 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 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 T 1/ DIRECTOR,INSURANCE FUND UNDERWRITING DRnv� LOG IN DATE: BUIL ENT a � ` `J t � K COMPLETION DATE: 938 KIN ` ' ,NY 10573 ASSIGNED TO: ' 19a2 ASSIGNED BY: COMPLAINT#: COMPLAINT FORM DATE: o>d RECEIVED BY: LOCATION: PARCEL I.D.#: � ZoneA- r USE: OWNER: Address& Phone: 6�'y SOURCE: Q,-go/9 yry10 (P:ho3ne/ etter/Other: Address& Phone: COMPLAINT: �as2/✓Ie/��- !Q S / UC��OC�'1.S �o e����gQn�� /' l � f o P' / T , �CD e g i e S S (ky/ CY o /'`, /)(0 60/.-1 c)() Gt)S i 6ecvro c)'lj iS I-)ex4 -lb ,�. �i��i ca/ `ootil POSSIBLE VIOLATION: INSPECTORS LOG DATE STATUS IN ECTOR 1 � 2 t- l o tS S t 1.2 IS I� N o �vSt,.i - 6-6 �- Z%eAGA-- Z-JI-Z0Gs- , P� ,ice .S c }� ti �M or Property Description Report For: 564 Westchester Ave, 6 Municipality of Village of Rye Brook s a y Status: Active Roll Section: Taxable Swis: 554805 Tax Map ID #: 135.83-1-53 Property Class: 230 - 3 Family Res r Site: RES 1 �. In Ag. District: No Site Property Class: 230 - 3 Family Res Zoning Code: R2-F 2FAM Neighborhood Code: 01001 - VPC/VRB/PCSD Total Acreage/Size: 0.15 School District: Port Chester-Rye Land Assessment: 2024 - $191,000 Total Assessment: 2024 - $678,800 Full Market Value: 2024 - $678,800 Equalization Rate: ---- Property Desc: Deed Book: 59115 Deed Page: 3536 Grid East: 717864 Grid North: 792322 Area Living Area: 2,216 sq. ft. First Story Area: 1,316 sq. ft. Second Story Area: 900 sq. ft. Half Story Area: 0 sq. ft. Additional Story Area: 0 sq. ft. 3/4 Story Area: 0 sq. ft. Finished Basement: 0 sq. ft. Number of Stories: 2 Finished Rec Room 0 sq. ft. Finished Area Over 0 sq. ft. Garage Structure Building Style: Old style Bathrooms (Full - Half): 4 - 0 Bedrooms: 6 Kitchens: 3 Fireplaces: 0 Basement Type: Full Porch Type: Porch-up cov Porch Area: 210.00 Basement Garage Cap: 0 Attached Garage Cap: 0.00 sq. ft. Overall Condition: Normal Overall Grade: Average Year Built: 1900 Eff Year Built: 1983 Owners Shawn Ackerson 564 Westchester Ave Rye Brook NY 10573 Sales Property Prior Value Arms Addl. Deed Book Sale Date Price Class Sale Type Owner Usable Length Parcels and Page 4/30/2019 $545,000 230 - 3 Land & Saline, Yes Yes No 59115/3536 Family Building Philip Res 1/19/1999 $0 220 - 2 Land & SALINE, No No No 12246/142 Family Building PHILIP Res 9/12/1998 $120,000 220 - 2 Land A.AVATI Yes No No 7964/572 Family Only Res 9/1/1998 $120,000 220 - 2 Land & Saline, Yes Yes No 12246/142 Family Building Philip Res 5/1/1996 $0 220 - 2 Land & SALINE No No No 11524/217 Family Building PHILIP & Res SADIE Utilities Sewer Type: Comm/public Water Supply: Comm/public Utilities: Gas &elec Heat Type: Hot wtr/stm Fuel Type: Natural Gas Central Air: No Improvements Structure Size Grade Condition Year Porch-up cov 210.00 sq ft Average Normal 1900 Gar-1.0 det 360.00 sq ft Average Normal 1900 Porch-enclsd 32.00 sq ft Average Good 1900 Porch-coverd 120.00 sq ft Average Normal 1900 Patio-concr 0 x 0 Average Normal 1900 Special Districts for 2024 Description Units Percent Value CS481-VRB Sewer 0 0% $678,800 SW481-Solid Waste All 0 0% $678,800 Vlgs Exemptions Year Description Amount Exempt % Start Yr End Yr V Flag H Code Own s -• •-C I i _ . . . 7 • ""' r 4 �v 1' ', a• y NOTICE OF: UNSAFE / UNLAWFUL STRUCTURE NOTICE HEREBY ISSUED&DULY POSTED BY THE BUILDING DEPARTMENT,VILLAGE OF RYE BROOK 938 KING STREET,RYE BROOK,NEW YORK 10573 (914)939-0668 fax(914)939-5801 www.rvebrook.om THIS PREMISES / ByILDING / STR CTURE / EQUIPMENT, LOCATED AT: a -a tn 14 V�cS Cie 5t (�- IS HEREBY DECLARED, UNSAFE / UNLAWFUL / UNFIT FOR HUMAN HABITATION, DATE&TIME ISSUED: �/\ cc I MP ) PERMIT#: �0 i1 e- VIOLATION#: y `^ C //�� 'wC �(-A t t v l OWNER: ACNe��� ✓ � ^ADDRESS&PHONE: NOTES: �� \ �1Q` l� \� 1 e coV C� 1 1 Al \ C ck C C �- S c n I' �- \ BE ADVISED THAT NAUTHORIZED RE VAL OF THIS NOTICE AND/OR NON-COMPLIANCE WITH ANY DIRECTIVE OF THE BUILDING DEPARTMENT AS PERTAINS HERETO IS A CRIME PUNISHABLE BY FINE, IMPRISONMENT,OR BOTH.THERE MAY BE THAT MUST BE PAID IN ASSOCIATION WITH THIS POSTING FOR VIOLATIONS THAT WERE CREATED. A REINSPECTION OF THE PREMISES BY THE BUILDING DEPARTMENT IS REQUIRE RIOR TO RESUMING ANY WORK OR USE. ( )BUILDING INSPECT ( )VILLAGE ENGINEER ( )ASSISTANT BUILDING INSPECTOR r Q w > oz g a cn �ac�o � z� (nmFnw w +1 0 31 Q_'Zo 4 v'aaao oz vo t-=0~Y v X Lr W_Q W Q CC LLJ i N � LU N i ( s c iII 0- c LU Du 4 <� y > LIP ui v CO) � a °- (L< ow Q '- W U zt'iOi--1 z Q =Mw3z 7,; uj 0 Y m � zOQC3 Q(5-{-L)1 I t ECT NS "' w Jed' * S cn v Q w w 0 Q z ry z Ory m LO N a w bi Q z `i z O � r cr � � ww�� LO a w w� oz J O 00 ry = U t— � 0 +� r:�to o � i 1— LJ w o w0cr ma- W� Q O Ln w m -0 m r-) N CC-/J)