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HomeMy WebLinkAboutMP25-097PERMIT */'// Q,5�0 9/ 7 DATE-,,c� y S E�(P• S y SECTION i c� g BLACK LOT TYPE OF WORK 2 c2 %! Qs �.�� ,fie/ r JOB LOCATION �S i Q OWNER o ascA � Arkio Jj {yin ,7A#c?q - 7S3y CONTRACTOR, _woe/e1ji /�'iEC��a�ica / �9/y - 3030 i mww v • Wes! TCO � FEE DATE INS!•ECTION RECORD { DATE 1 NSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING C7 RGH PLUMBING/ GAS SPRINKLER ELECTRIC LEI'- awl LOW -VOLT O ALARM C� AS SU1LT C 3 FINAL ��/ �� /�o�//V 7 T/d'1'IE' MQ/✓1�c��C OTHER APPROVALS ARB BOT PS ZBA OTHER at.l� Cc.�.�. � • l 8- 20 tf P,assc c� � • BR. 190 L VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury www.Uebrookny.gov TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Steven E. Fews David M. Heiser Donald T. Krom,Jr. Salvatore W. Morlino CERTIFICATE OF COMPLIANCE November 19,2025 Jody Rasch&Ann Parkin Living Trust 25 Hillandale Road Rye Brook,New York 10573 Re: 25 Hillandale Road, Rye Brook,New York 10573 Parcel ID#: 135.28-1-32 Mechanical Permit#25-097 issued 6/24/2025 for a New Generator This certifies that the 24kw natural gas fired generator,installed under the above captioned permit has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to Bk 1 9A? BUILDING DEPARTMENT Vl.l>IN(. INSPI:CTl1H 'INI'AN1 BUILDING INa11( rcnc VILLAGE OF RYE BROOK ❑C.ODL I:Nrint(A A11 NA ()l I It j.1t 938 MINI: SHME'r - ItYI: Wtool:, NY 10573 (91.1) 939-0668 FAx (914) 939-5801 - - - - - - - - - - - - - - - - INSPECTION REPORT -- - - -- - - - - - - -- - - - -- - A U D R 1 ,,, : 2..5 ►1`a w1 JA hL•'ItMi'I- 1 `� ,,/ � 2 S ci'� _ IssUhn:�Ly-W tiI=.c r /.3�.2& Bj.ocK•�_LoI• � LOCATION: ._ 11�0,,�, 1� �� � N�7---- OCCUPANCY: ❑ VIOLATION NO•rla► (�� I I I �� �I,1, �! :�ccl:Ii•r1:D ❑ Rctec:TED/ REINSI-Fc•riON 0 SITE' INSPIXTION RelwIR1:D ❑ FooTING 0 FOOTING 1)RAINA(iL ❑ FOUNDA-r1ON ❑ UNDERGROUND PLUMBING 011?ti0N IN.SIIECTiON: ❑ ItOUGH I-'LUM19lNG ❑ ItOUGH FRAMING ❑ INSU1.ATI0N ❑ NATURA L GAS � r 0, k ❑ 1..R GAS ❑ FU1:1. DANK ❑ FIRE SPRINKLER ❑ FINAL PLUM11INl. p C ON LOSS CNrr•TION �NAL OIHEIt �yE BRC�uk 1. 98 BUILDING DEPARTMENT ❑BUILDING INSPECTOR Q ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 King Street . Rye Brook,NY 10573 (914) 939-0668 FAx (914) 939-5801 www ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : DATE: - PERMIT# r 1 Z S 10 Z ISSUED: -2 Y-e'SECT: 13Y BLOCK: LOT: LOCATION: OCCUPANCY: ❑ Violation Noted THE WORK IS... 0 PASSED ❑ FAILED /REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION r J7 Natural Gas ❑ L.P. Gas p ❑ FUEL TANK -�1 C` c� I e ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION �t��p S `'� ❑ FINAL ❑ OTHER * o * u Col. v � � 3 72 is u ~ y* u L1. H O * z r u Q Q Q z xCIS � * o O zen H c i cl Q W rx • v * .� o2S QJ � w w � ►Z-i G7 w A aciM * V ''vz R v ►a W ¢ z ^ A cz w) C,3 o Q) oi * �.. a- * 6 S E a � N N ►y �� � �C a U 00 CA (i7 oG .g v v (rj bA N rn ' Ky 4 z z00 Cl. V I--1 ° 3 . � A h+l O G W Q� o 04 a O V ( � © a A z O V '3 a�ii U s O O ,� .. � � ��r r—�i W UW z ILI '� v a v a H C/] � ✓ M U Q° a c�i a Cr) x z x w � � Va INI* x �OE can 4 " a =Zo -� �, W w c W F z � v m za °aa,.� �+ z � v wvs � a. R� o z W O od .4 '45 N q a z ] 09 'H o4 U w. �I A P-4 .4 a ✓� xv�i a s _ 'I BUILDING DEAR MENT R VILL E OF RYE' QOK U 938 KING S__ V 39 R NY 10573 J U N 12 2025 -- 9 w ' b okn ov VILLAGE OF RYE BROOK BUILDING DEPARTMENT FOR OFFICE USE ONLY: Approval Date3UN 17 it _ ''G� ! / Application# Approval Signature: : ARCHITECTURAL REVIEW BOARD: Disapproved: : Date: BOT Approval Date: Case# : Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Case# Other: Application Fee > Permit Fees:Aft, V.z APPLICATION TO INSTALL A PERMANENT STANDBY BACKUP GENERATOR Application dated: /10—/a Q) is hereby made to the Building Inspector of the Village of Rye Brook for the issuance of Permit to install a permanent standby backup generator in accordance with§250-4.1.of the Code of the Village of Rye Brook,as per detailed statement described below. Please note that electrical and plumbing permit applications must be filed separately by those licensed professionals,and that separate permits are required for the installation of any related fuel tanks. Further note that all applications for commercial use will require a site plan approval from the Village Planning Board prior to the issuance of any permit. I. Job Address: 25 HILLANDALE ROAD RYE BROOK NY 10573 2. Parcel ID#: 135.28-1-32 Zone: R-25 3. N.Y. State Construction Classification: N.Y.State Use Classification: 4. Proposed Generator&Fupl Type(Dcsc in detai _ GFNFRAC Gl lARDIAN SERIES - AIR COOLED GAS ENGINE Lf&6LIZtv'1 bene 5. Property Owner: AN ARKIN LIVING TRUST, JODY RASCH LIVING TRUST Address: 2.5 HII I ANDA1 F ROAD RYE BROOK NY 10573 Phone#914,393,4669 Cell# 914 548 7834 email:JODYRASCH@GMAIL.COM Applicant: NY HOME MAINT , CO INC d/b/a A.BORRELLI MECHANICL Address: 147 WHEELER AVENUE PLEASANTVII I F NY 10570 Phone# 914.495.3030 Cell# email: LTORRES ABORRELL_I.COM Architect or Engineer(if applicable): Address: Phone# Cell# email: General Contractor:V1 0aw fyob1(_'f , WA k� VVdAtttACj Address:14 �n,' W Phone# I 5 Cell# email: LS- YZV115 OYL�Q t 61112024 6. Give exact dimensions from proposed generator to lot lines: t front yard: U (41 rear yard: 3 0 1 right side yard: � left side yard: 6101 7. If building is located on a corner lot,which street does it front on:Hillandale Road 8. Will the proposed project disturb 400 sq.ft.or more of land,requiring a Stormwater Management Control Permit from the Village Engineer as per Chapter 217 of the Code of the Village of Rye Brook? Yes: No: X 9. - Will the proposed project require a Site Plan Review by the Village Planning Board as per Chapter 209 of the Code of the Village of Rye Brook? Yes: No: X (provide detailed drawings as per Chapter 209) 10. Will the proposed project require a Steep Slopes Pennit as per Chapter 213 of the Code of the Village of Rye Brook? Yes: No: X (provide a detailed topographical survey) 11. is the lot or any portion thereof located in a Wetland as per chapter 245 of the Code of the Village of Rye Brook? Yes: No: X (provide a detailed survey indicating the Wetland&Buffer Zone) 12. Is the lot or any portion thereof located in a Flood Zone as per the FEMA Flood Insurance Rate Map#36119CO279 dated 9/28/07? Yes: No: X 13. Will the proposed project require a Tree Removal Permit as per Chapter 235 of the Code of the Village of Rye Brook? Yes:_No: X (a tree replanting schedule may be required) 14. Does the proposed project involve a Home-Occupation as per Chapter 250-38 of the Code of the Village of Rye Brook? Yes: No: X If so,indicate: TIER I: TIER It: TIER III: 15. What is the total estimated cost of construction: S �Sao (The estimated cost shall include all site improvements,labor,material,scaffolding,fixed equipment,professional fees,and material and tabor which may be donated gratis) 16. Estimated date of completion: wwwwwwwwwwwwwwwwwwwew�,r,rw,rw,ewwrwwwwwww�wwwwwwwwwwwwwwwwwwrwxxrwwvewwwwwwwwwwwwwwwww+lwwwwwwwwwww*ww+.x,e�s.�xww STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and further states that (s)he is the legal owner of the property to which this application pertains, or that (s)he is the 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. Sworn to before me this `�111V11 t t t,,/ Sworn to before me this rn day of Ck,QU ,20 P��' ��T 'f day of Juyke 20 ZS ti STATE ` 'P IV OF NEW YORK���N Signature of Property Owrter = j NOTARY PUBLIC I ^y Signatu f Applicant t 0,.ffl a„w rrcartr t NN � Name of Property Ot ry pvbl l 6 Yortc `�i,s��0lV EXP}R����`�\ Print Name of Applicant u tchestar County � Notary Public Catnmisslon Expires Jentlary 28,20 Notary blic 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. b f 2024 �1j N N OL \ \ Ln y � w v z a ►n 7 ry en PLO r1/ Z �Wj z z O /-� •mot z N i I _ (A PLO oc N 7 U cn .. : r" Z W ` cl, r V V s zCh Nul ,� z `' A w ►...� _ W � w r z - � A a = g os w F-� �7 s O Q C) F .r C.i n C BUILJE G 1) MENT � I VII. OF RYE OK MAR 2 8 2025 938 KINT RYF BR) ,NY 10573 __- 4)939-0668 VILLAGE O RYE BROOK ebr ' #in BUILDING DEEARTM' bT , ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required J �j FOR OFFICE USE ONLY - _ 1 / EP th Approval Date: JUL 0 } 25 N 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, 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: 2-5 /5`i���'��1 / "' SBL:I��3��`51 a49 I— ,�� /C-="r- Zone: 2.Property Owner: .T� Address: /� /1 Phone#: 9/�/S'�/B" ��S Cell#: /� email: od a�i rSe4 r moo-' 3.Master Electrician/Licensed Installer: /'�7 c Address: 132 g � Lic.#:/688 Phone#: Cell#: -4/G3:5 email: 60> �/c7ri�/ co," Company Name: ��^c7,/y/i'o �'�c TiiG ii,c Address: I SZ �1 a x �104".1 W-1111/lyre 4.Proposed Electrical Work/Fixture//Count: PLC, c� 5.31 Party Electrical Inspection Agency: 5 �/ 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 for the legal owner and is duly authorized to make and file this application. (Master Electrician/Licensed Installer) The undersigned further states that all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&.Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances,and regulations. Sworn to before me this Sworn to before me#iis d day of 120 day of e. 20 aS a Signature of Property Owner g re f A^ t-- �.� -r �� SQL-�••✓ Print Name of Property Owner P`�j� eAEfkM Applicant 1L..iLL�F3>Z.� Notary Public NWAWPM,iState of New York No.01ME6160063 6/l/2024 Qualified In Westchester County. Cotilmisslon Expires 1anUary 29,20� STATE WIDE INSPECTION SERVICES, INC. 0•0 • • SWIS JOB APPLICATION tel •2.7224 1 fax 914.219.10621 SWISNYcoml SWISTRAINING.COM Office Use Elect, Permit# C Date Bldg Permit# 9 Scl Ft Plumbing Permit# Final Certificate # City/Village Zip Building Dept. �,,; County Address Cross Street Section Block Lot Owner Name/Address(If different than above) Contact Number ❑Basement ❑ 1st FI. ❑2nd FI. ❑3rd A. ❑More Than 3 Fl. ❑Garage ❑Attic ❑Outside ❑Residential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C/0 Detector Hood Trash Compact Amt Amps Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer Switch SERVICE Amperage #Panels 1P 3P # Meters # Disconnect ❑Underground ❑ New ❑ Reconnect ❑ Repair ❑Overhead ❑ Upgrade ❑ Disconnect Utility ID# ❑Con Ed ❑ NYSEG ❑Central Hudson ❑ Orange/ Rockland PHOTOVOLTAIC SYSTEM PV Modules Inverters AC Disconnect ]unction Box Combiner Box Load Center PV Monitor Energy Storage System DC Disconnect ❑Legalization ❑ Safety Inspection ❑Consultation FF F[ MMAR 2 8 2025 VILLAGL i=�:`� F BROOK BUILDIW—, DEFr"r : MENT 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 Name License# Date Signature Address City/State Zip Code Company Phone# DE V E N E State Wide Inspection Services 1080 Main Street AUG 2 9 2025 Fishkill, NY 12524 a ____ 845 202-7224 Phone _ —_ 914-219-1062 Fax O STATE WIDE INSPECTION SERVICES VILLAGE. FRY—E BROOK I Email: office@swisny.com BUILDIN�. ( r-''" MENT 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: Evolution Electric Inc. Jody D Rasch Living Trust Franklin Salazar The Ann Parkin Living Trust 132 Fairfax Avenue 25 Hillandale Road Hawthorne, NY 10532 Rye Brook, NY 10573 Located at: 25 Hillandale Road, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP25-169 135-25 1 32 Certificate Number: 2025-5872 Building Permit Number: MP25-097 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:25 Hillandale Road, Rye Brook, NY 10573 The Basement & Exterior 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 291' Day of August 2025. Name Quantity Rating Circuit Type Generator 01 22kw Automatic Transfer Switch 01 92 Amp jLj7 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. r f a CV N Al O a rl N n1 {aj • 1 \ \ aLn N N a N - w Fa 0-0a � 7 �' F �• s a v�i � �% h v �� ■ s r, N ►7 OD Ln rn O Z w z x o ° A coLn 0-4 cn 4,5 z z a CA • ►►��.. � U z c�A s r w � c� O �, � <,,� E-� � ,Z W � � Z • 00 Z w Cn Ln a z U � a �' t'� U •r w xj U w a � a BUIL ER MENT OF RYE OK RJU 112 2025 938 KIN , ET RYE B ,NY 10573 VILLAGE OF RYE BROOK \ BUILDING DEPARTMENT WWw.t�do Y. oovv PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY _S1r#t- /`�/` ��� �� 9 �7 PP#: cD6 —' Approval Date: Permit Fee: $ 0(o 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, 6—/1—�)J is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install and/or remove Plumbing as per detailed statement described below. The applicant&property owner,by signing this document agree that said plumbing work will be in conformance with all applicable Federal,State,County and Local Codes. 1.Address: 25 HILLANDALE ROAD SBL: 135.28-1-32 Zone: R-25 2.Proposed Work: PIPING FOR GAS STANDBY GENERATOR 3.Property Owner: ANN PARKING LIVING TRUST,JODY RASCH LIVING TRUST Address: 25 HILLANDALE ROAD Phone#: 914.939.4669 Cell#: 914.548.7834 email:JODYDRASCH(a-)_GMAIL.COM 4.Master Plumber: VITO MELE Address: 147 WHEELER AVENUE PLEASANTVILLE NY 10570 Lic. #: 1539 Phone#: 914.495.3030 Cell#: 914.804.8302 email: LTORRES@ABORRELLI.COM Company Name: NY HOME MAINT.,CO.,INC.d/bra A.BORRELLI MECHANICAL Address: 147 WHEELER AVENUE PLEASANTVILLE NY 10570 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 I st Floor 2nd Floor 3`d Floor 4`h Floor 5"Floor Exterior ' o y 5.* List Other Equipment/Provide Details: u �Zl�w l��S '► � � ✓�. (Notarized Signatures Required Next 2 Pages) 1 6/1/2024 STATE OF NE�W,YlORK,COUNTY OF WESTCHESTER ) as: jWXIe (ASpgGe ,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 b Sworn to before me this 941n day of Sc ,20 day of ��(Q 20 _ X Signature of Property Owner SignA6re of Applicant �HMr JKVX /A Print Name of Property Owner �Pi STATE `\'P� print Name of Applicant OF NEW YORK cn � ; t NOTAR i t —_ p N7fiv�,� • - r� � ,WaNfied in Westchester Carly� N Notar}f�ubllc,State of Nuw o 01 TOM 1UUM i�ti Notary PtCic No.01ME61.W)63 Qualified in Westchester county _'�J S/ONP�R��o��\\ Commission Expires}entlary 29.2 / ��//I I i 11100 ' 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. Applications not properly completed in its entirety andior not properly signed shall be deemed null and void and will be returned to the applicant. 6/1/2024 BU11LD,1NG DEPARTMENT R E C E � V E VII,��`G. E OF RYE BROOK JUN 12 2025 938 KING�'*EET RYE BROOK,NY 10573 (914)939 0668 VILLAGE OF RYE BROOK BUILDING DEPARTMENT wrxxxwwxrwwwwwwxxwxwrwrxwxwwwxxxxrrwxxwwwxwxwxrrxwxrwwwrwxxxxxwwwwwrrwwwwwwwwxxrwxwxxwwwwwwwwwwrrrwwrwww 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: 31, ,gAl,1 ! MAKIAI , residing at, 25 HILLANDALE ROAD tPrint name) (Address there you lire) 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; 25 HILLANDALE ROAD ,Rye Brook,NY. (Job Addre��,) 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. ,.� t,Siananue of Property Owner(s)) klAJ (Prim.Name of Property 0%vnerr )) Sworn to before me this d7�f_Z�. k-(, h , 20 0 (Nuiary Public) SHARI MELILLO i4otary Public,state of New York No.01ME616W63 Quailfied in Westchester County�7 Commission Expires lendary 29,20_ _3_ c 1%2o2a Buildin ermit Check List&Zonin Analysis Address: ca � LL2 SBI_ Zone: Use: Cont.Type.'" Other. Submittal Date: Revisions Submittal Dates: Applicant n ;— U Nature of Work: Reviews:ZBA: JUN 1 7 2025 pB: BOT: Other. NEED (V4 (f FEES:Filing. �' BP: C/O: Flood Plane: Legalization: ` ( ) ( ) APP: Dated: Notarized: SBL Truss I.D. Cross Connection: H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening ( ) ( ) ENVIRO:Long. Shore 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. ( ) �) 'PRE ALARM/SMOKE DETECTORS:Plans: Permit: H.W.I.C.:_Battery:_Other. r 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: REQUIRED EXISTING PROPOSED NOTES Area: Circle: Fro�� Front: Front: Sides: Rear. Main Cov: Accs.Cov: Ft.H Sb: Sd.H Sb: GFA: Tot : Fes: P He ovtu notes: 7 � vr• GENERAC 20 2 24 kW GUARDIAN* SERIES _ Residential Standby Generators Air-Cooled Gas Engine Emot- Standby Power Rating , INCLUDES: G007038-1,G007039-1.G007038-3.G007039-3(Aluminum-Bisque)-20 kW 60 Hz • True Power"Electrical Technology G007042-10,G007042-11.G007043-10,G007043-11(Aluminum-Bisque)-22 kW 60 Hz G007209-10,G007210-10(Aluminum-Bisque)-24 kW 60 Hz • Two-line multilingual digital LCD Evolution " controller (English/Spanish/French/Portuguese) • 200 amp service rated transfer switch available Q fay • Electronic governor �. • Standard Wi-Fi� connectivity • System status&maintenance interval LED indicators • Sound attenuated enclosure • Flexible fuel line connector —_ • Natural gas or LP gas operation GENERAC =; • 5 Year limited warranty —— • Listed and labeled for installation as close as 18 in(457 mm)to a structure.' 'Must be located away from doors,windows.and fresh air intakes and in 'roduct shown with optional fascia k accordance with local codes. kit Et4 .or C(&s QviEf-TEST c LISTED Note:CETL or CUL certification only applies to unbundled units and units packaged with limited circuit switches Units packaged with the Smart Switch are ETL or UL .erldied in the USA only FEATURES O INNOVATIVE ENGINE DESIGN &RIGOROUS TESTING are at the heart of Gen- O SOLID-STATE, FREQUENCY COMPENSATED VOLTAGE REGULATION: This erac s success in providing the most reliable generators possible. Generac's G- state-of-the-art power maximizing regulation system is standard on all General mod- Force engine lineup offers added peace of mind and reliability for when its needed els.It provides optimized FAST RESPONSE to changing load conditions and MAXI- the most.The G-Force series engines are purpose built and designed to handle the MUM MOTOR STARTING CAPABILITY by electronically torque-matching the surge rigors of extended run times in high temperatures and extreme operating conditions. loads to the engine.Digital voltage regulation at-1%. O TRUE POWER"ELECTRICAL TECHNOLOGY:Superior harmonics and sine wave O SINGLE SOURCE SERVICE RESPONSE from General s extensive dealer network form produce less than 5%Total Harmonic Distortion for utility quality power.This provides parts and service know-how for the entire unit,from the engine to the smal!- allows confident operation of sensitive electronic equipment and micro-chip based est electronic component. appliances,such as variable speed HVAC systems D TEST CRITERIA: O GENERAC TRANSFER SWITCHES:Long life and reliability are synonymous with PROTOTYPE TESTED NEMA MG1-22 EVALUATION GENERAC POWER SYSTEMS.One reason for this confidence is that the GENERAC SYSTEM TORSIONAL TESTED MOTOR STARTING ABILITY product line is offered with its own transfer systems and controls for total system compatibility. O MOBILE LINK" CONNECTIVITY:FREE with select Guardian Series Home standby generators, Mobile Link Wi-Fi allows users to monitor generator status from any- where in the world using a smartphone,tablet.or PC.Easily access information such as the current operating status and maintenance alerts. Users can connect an account to an authorized service dealer for fast,friendly,and proactive service.With Mobile Link.users are taken care of before the next power outage. -'GENERAC Q Q%PROMISE5- F 0 GENERACM 20/22/24 kW Features and Benefits _ Engine • Generac G-Force design Maximizes engine"breathing"for increased fuel efficiency.Plateau honed cylinder walls and plasma moly rings help the engine run cooler,reducing ail consumption and resulting in longer engine life. • "Spiny-lok"cast iron cylinder walls Rigid construction and added durability provide long engine life. • Electronic ignition/spark advance These features combine to assure smooth.quick starting every time. • Full pressure lubrication system Pressurized lubrication to all vital bearings means better performance,less maintenance,and longer engine ' life.Now featuring up to a 2 year/200 hour oil change interval. • Low oil pressure shutdown system Shutdown protection prevents catastrophic engine damage due to law oil. • High temperature shutdown Prevents damage due to overheating. Generator • Revolving field Allows fora smaller,light weight unit that operates 25%more efficiently than a revolving armature generator. • Skewed stator Produces a smooth output waveform for compatibility with electronic equipment. • Displaced phase excitation Maximizes motor starting capability. • Automatic voltage regulation Regulating output voltage to ±1%prevents damaging voltage spikes. • EPA Certified for non-emergency applications Allows unit to be used for demand response applications(excluding 20 kW units). • UL 2200 listed For your safety. Transfer Switch(if applicable) • Fully automatic Transfers vital electrical loads to the energized source of power. • NEMA 3R Can be installed inside or outside for maximum flexibility. • Integrated load management technology Capability to manage additional loads for efficient power management. • Remote mounting Mounts near an existing distribution panel for simple,low-cost installation. Evolution'" Controls • AUTO/MANUAIJOFF illuminated buttons Selects the operating mode and provides easy.at-a-glance status indication in any condition. • Two-line multilingual LCD Provides homeowners easily visible logs of history,maintenance,and events up to 50 occurrences. • Sealed,raised buttons Smooth,weather-resistant user interface for programming and operations • Utility voltage sensing Constantly monitors utility voltage.setpoints 65%dropout.80%pick-up,of standard voltage. • Generator voltage sensing Constantly monitors generator voltage to verify the cleanest power delivered to the home. • Utility interrupt delay Prevents nuisance start-ups of the engine.adjustable 2-1500 seconds from the factory default setting of 5 seconds by a qualified dealer. • Engine warm-up Verifies engine is ready to assume the load,setpoint approximately 5 seconds • Engine cool-down Allows engine to cool prior to shutdown.setpoint approximately 1 minute. • Programmable exercise Operates engine to prevent oil seal drying and damage between power outages by running the generator for 5 minutes every other week. Also offers a selectable setting for weekly or monthly operation providing flexibility and potentially lower fuel costs to the owner. • Smart battery charger Delivers charge to the battery only when needed at varying rates depending on outdoor air temperature. Compatible with lead acid and AGM-style batteries. • Main line circuit breaker Protects aenerator from overload • Electronic governor Maintains constant 60 Hz frequency. Unit • SAE weather protective enclosure Sound attenuated enclosures ensure quiet operation and protection against mother nature, withstanding winds up to 150 mph(241 km/h).Hinged key locking roof panel for security.Lift-out front for easy access to all routine maintenance items.Electrostatically applied textured epoxy paint for added durability. • Enclosed critical grade muffler Quiet,critical grade muffler is mounted inside the unit to prevent injuries. • Small.compact,attractive Makes for an easy,eye appealing installation,as close as 18 in(457 mm)away from a structure. GENERAC° 20/22/24 kW Features and Benefits Installation System _ • 14 in(35.6 cm)flexible fuel line connector Listed ANSI Z21.75/CSA 6.27 outdoor appliance connector for the required connection to the gas supply piping. • Integral sediment trap Meets IFGC and NFPA 54 installation requirements. Connectivity(Wi-Fi equipped models only) • Ability to view generator status Monitor generator with a smartphone,tablet,or computer at any time via the Mobile Link application for ' complete peace of mind. • Ability to view generator Exercise/Run and Total Hours Review the generator's complete protection profile for exercise hours and total hours. • Ability to view generator maintenance information Provides maintenance information for the specific model generator when scheduled maintenance is due. • Monthly report with previous month's activity Detailed monthly reports provide historical generator information. • Ability to view generator battery information Built in battery diagnostics displaying current state of the battery. • Weather information Provides detailed local ambient weather conditions for generator location. GENERAC' 20/22/24 kW Specifications Generator Model G001038-1 GD07042-10 G007038-3 G007042-11 G007209-10 G007039-1 G007043-10 G007039-3 G007043-11 G007210-10 (20 kW) (22 kW) (20 kW) (22 kW) (24 kW) Rated maximum continuous power capacity(LP) 20.000 Watts' 22.000 Watts' 20,000 Watts' 22,000 Walls' 24,000 Watts' Raled maximum continuous power capacity ING) 18,000 Walls' 19-boo Walls, 18.000 Watts' 19b00 Walls' 21.000 Walls' Rated voltage 240 Rated maximum continuous load current-240 volts(LP/NG) 83 3,'75 0 91 1/81-3 83 3/150 91 1/81 3 100 f 81 b Total Harmonic Distortion Less than 5% Main line circuit breaker 90 amp 100 amp 90 amp 100 amp 100 arnp Phase 1 Number of rotor poles 2 Rated AC frequency 60 Hz Power factor 1 0 Battery requirement(not included) 12 Volts.Group 26R 540 CCA minimum or Group 35AGM 650 CCA minimum Unit weigh)(to/kg) 448'203 466/211 436/198 445,202 455 206 Dimensions(L x W x H)in/cm 48 x 25 x 29/121.9 x 63.5 x 73.7 Sound output in dB(A)at 23 It(7 m)with generator operating at normal load" 61 61 61 67 61 Sound output in dB(A)at 23 4(1 m)with generator in Quiet-Test-low-speed exercise mode" 55 57 55 57 57 Exercise duration 5 min Engine Engme type GENERAC G-Force 1000 Series Number of cylinders 2 Displacement 999 cc Cylinder block Aluminum w/cast iron sleeve Valve arrangement Overhead valve Ignition system Solid-state w/magneto Governor system Electronic. Compression ratio 9.5:1 Starter 12 VDC Oil capacity including fitter Appro)L 1.9 qt/1.8 L Operating rpm 3.600 Fuel consumption Natural gas tl;/h 1/22 Load 204(5.78) 228(6.46) 164(4.64) 203(5.75) 1oad Full Load 301(8.52) 327(9 26) 281(8.13) 306(8.66) Liquid propane 0/hr(gal/hr)[L/hrl 112 Load 87(2.37)[8.991 92(2.53)[9,571 86(2.36)18.951 92(2.53)[9 571 Full Load 130(3.56)113.481 142(3.90)[14.711 136(3.74)[14.151 142(3.90)[14-771 Note Fuel pipe must be sized for full load.Required luel pressure to generator fuel inlet at all load ranges 3 5-/in water column(0-87-1 14 kPa)for NG,10 12 in water column(2 49 2 99 Wa)for LP gas-For BTU cunkra.mulliply IP)/lir x 2500(LP)or 93/hr x 1000 ING) For Megajoule content.multiply rw/hr x 93 15(LP)or m3/hr x 31.26 ING) ControlsTwo line plain text multilingual LCD Simple user interface for ease of operation Mode buttons:AUTO Automatic start on utility failure.Weekly,Bi-weekly,or Monthly selectable exerciser MANUAL Start with starter control.unit stays on.If utility fails,transfer to load takes place OFF Stops unit.Power is removed.Control and charger still operate. Ready to Run,Maintenance messages Standard Engine run hours indication Standard Programmahle start delay botwoen 2 1500 seconds Standard(linopammable by dealer only) Utility Voltage Loss/Return to Utility adjustable(brownout setting) From 140-1 11 V/190-216 V Future Set Capable Exerciser/Exercise Set Error warning Slandarc! Run/AlamVMainlerence logs 50 events each Engine start sequence Cyclic,cranking 16 sec on,7 rest(90 sec maximum duration) Starter lock-out Starter cannot re-engage until 5 sec after engine has stopped. Smart Ballery Charger Slandard Charger FauIpMissing AC warning Standard Low Ballery/Ballery Problem Protection and Battery Condilfon indication Standard Automatic Voltage Regulation with Over and Under Voltage Protection Slandard Under Ovprcurrenl Protection Slandard Safety Fused/Fuse Problem Protection Standard Automatic Low Oil Pressure/High Oil Temperature Shutdown Standard Overcrank/Overspeed(@ 72 Hz)/rpm Sense Loss Shutdown Standard High Engine Ternperalure.Shutdown Standard Internal FaulVlncorrect Wiring protection Standard Common external fault capability Standard Field upgradabie firmware Standard Rating definitions Optional Standby Applicable for supplying backup power for the duration of the utility power outage with correct maintenance performed No overload capability is available for this rating (All ratings in accordance with BS5514.IS03046.UL2200,and DIN6211) Maximum kilovolt amps and current are subject to and limited by such factors as fuel BTU/megajoule content,ambient temperature,altitude.engine power and condition,etc Maximum power decreases Approximately 3 5%for each 1,000 It(304 8 m)above sea level.and also will decrease approximately 1%for each 10'F(6'C)above 60`F If 6'C) "Sound levels are taken from the front of the generator.Sound levels taken from other sides of the generator may be higher depending on installation parameters Rn\ For office use ouly: BUILDI ENT PERMIT# - c17 Ll Ll NOV 1 2 2025 VIL OF RYE OK ISSUED: -�2Lf �j_ , 938 KING STRE YE BROOK, W YORK 10573 DATE: 9 -06 UY' FEE: 5U PAID - -0 fin 0V 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 ............................................................................................................................. Address: 25 HILLANDALE ROAD RYE BROOK NY 10573 Occupancy/Use: RESIDENTIAL Parcel ID#: 135.28-1-32 Zone: R-25 Owner: ANN PARKING LIVING TRUST,JODY RASCH LIVING TRUS Address: 25 HILLANDALE ROAD RYE BROOK NY 10573 P.E./R.A. or Contractor: NY HOM MAINT,C°••INC.dW'"-e°RRELLIMECHANICAL Address: 147 WHEELER AVENUE PLEASANTVILLE NY 10570 Person In responsible charge: VITO MELE Address: 147 WHEELER AVENUE PLEASANTVILLE NY 10570 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: VITO MELE being duly swom,deposes and says that he/she resides at 147 WHEELER AVENUE (Print Name of Applicant) (No.and Street) in PLEASANTVILLE in the County of WESTCHESTER NY in the Stale of that (Cityfrown)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:S 7,500,00 for the construction or alteration of.. STANDBY GAS GENERATOR 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 Rye Brook. Swornto before me this J Sworn to before me this day of NOVEMBER 2025 day NOVEMBER 2025 i Sign{uaie of Property Owner Signature of Applicant 1^ 1 4F VITO MELE erne of Property Owner Print Name of Applicant \ttttllllt/r�r/ ��� ria Public Wre 'ry STATE Wvj OF NEW YORK SHARI MELILLO NOTARY PUBLIC notary Public,State of New York No.01ME6160063 = It�e°An U ty r o e,t OIToao10CM i Qualified in Westchester County 0 /s` ^ ��o��titi\ :ornmission Expires January 29,20 Z'j �i��s'01y EXPiR�Ca GENERAC 20/22/24 kW Switch Options Service Rated Automatic Transfer Switch Features G007039-1,0007039-3(20 kW) • Intelligently manages up to four air conditioner loads with no additional hardware. Mosel G007043-10,G007043-11(22 kW) G007210-10(24 kW) 04 • Up to eight additional large(240 VAC)loads can be managed when used in conjunction No.of poles 2 with Smart Management Modules(SMMs). Currenl ralinn lamps; ?LC • Electrically operated,mechanically-held contacts for fast.clean connections. Voltage rating(VAC) 120/240,10 • Main breakers are rated for 80%continuous load. Utility voltage monitor(fixed)' Pick-up 801A, • 2-pole,250 VAC contactors. -Dropout 65`� • Service equipment rated,dual coil design. Return to Utility' Approx.13 sec 7L or UL lisled Slandard • Rated for both aluminum and copper conductors. Enclosure Mw NEMAML 3R • Main contacts are silver plated or silver alloy to resist welding and sticking. Circuit breaker protected 22 000 • NEMA/UL 3R aluminum outdoor enclosure allows for indoor or outdoor mounting flexibility. Lug range 250 MCM-#6 'Function of Evolution controller Dimensions Exercise can be set to weekly,bi-weekly,or monthly 200 Amps 120/240,1 e Open Transition Service Rated Height Width H1 H2 W1 W2 Depth in 26.8 30.1 10.5 13.5 1 6.9 cm 1 67.95 76.43 26.67 34.18 J I T5 i Wire Ranges Conductor Lug Neutral Lug Ground Lug 250MCM-#6 350MCM-#6 2/0-#14 GENERACe 20/22/24 kW Available Accessories _ Model# Product Descrfptlon G007101-0 Battery Pad Warmer Pad warmer rests under the battery.Recommended for use if temperature regularly falls below 0 'F(-18'C).(Not nec- essary for use with AGM-style batteries). G007102-0 Oil Warmer Oil warmer slips directly over the oil filter.Recommended for use if temperature regularly falls below 0`F(-18"C). G007103-1 Breather Warmer Breather warmer is for use in extreme cold weather applications.For use with Evolution controllers only in climates where heavy icing occurs. r r G005621-0 Auxiliary Transfer Switch The auxiliary transfer switch contact kit allows the transfer switch to lock out a single large electrical load that may not be Contact Kit needed.Not compatible with 50 amp pre-wired switches. G007027-0-Bisque Fascia Base Wrap Kit The fascia base wrap snaps together around the bottom of the new air-cooled generators.This offers a sleek,contoured appearance as well as offering protection from rodents and insects by covering the lifting holes located in the base. G005703-0-Bisque Touch-Up Paint Kit If the generator enclosure is scratched or damaged,it is important to touch up the paint to protect from future corrosion. The touch-up paint kit includes the necessary paint to correctly maintain or touch up a generator enclosure. G006485-0 Scheduled Maintenance Kit Generac's scheduled maintenance kit provides all the items necessary to perform complete routine maintenance on a Generac automatic standby generator(oil not included). G007005-0 Wi-Fi LP Tank Fuel Level The Wi-Fi enabled LP tank fuel level monitor provides constant monitoring of the connected LP fuel tank.Monitoring the Monitor LP tank's fuel level is an important step in verifying the generator is ready to run during an unexpected power failure.Sta- tus alerts are available through a free application to notify users when the LP tank is in need of a refill. G007000-0(50 amp) Smart Management Module Smart Management Modules(SMM)are used to optimize the performance of a standby generator.It manages large elec- G007006-0 trical loads upon startup and sheds them to aid in recovery when overloaded.In many cases.using SMM's can reduce (100 amp) the overall size and cost of the system. G007169-0-413 LTE Mobile Link`'Cellular The Mobile Link family of Cellular Accessories allow users to monitor generator status from anywhere in the world,using G007170-0-Wi-Fi/ Accessories a smart phone,tablet,or PC.Easily access information such as the current operating status and maintenance alerts.Us- Ethernet ers can connect an account with an authorized service dealer for fast.friendly,and proactive service.With Mobile Link, users are taken care of before the next power outage. G007220-0-Bisque Base Plug Kit Base plugs snap into the lifting holes on the base of air-cooled home standby generators.This offers a sleek,contoured appearance,as well as offers protection from rodents and insects by covering the lifting holes located in the base.Kit contains four plugs,sufficient for use on a single air-cooled home standby generator. Dimensions & UPCs Model UPC 1218— M( G007038 696471074185 (25.1 inl toe 0 G007039 696471074192 G007042 696471074208 G007043 696471074215 G007209 696471071511 727211a11 Iza.e mt G007210 696471084801 0 0 648 mm 1232 mm (25.5.1 (48.51q LEFT SIDE VIEW FRONT VIEW Dimensions shown are approximate See installalion manual for exact dimensions DO NOT USE THESE DIMENSIONS FOR INSTALLATION PURPOSES GENERAC Generac Power Systems,Inc. • S45 W29290 HWY.59,Waukesha,WI 53189• generac.com ;�2022 Generac Power Systems,Inc. All rights reserved All specifications are subject to change without notice. Part No.A0000937814 Rev.E 03/15/2022 -: n�'A•,j'. .- ,tAJ, `A .. .�A/, �.Un �s\Ah ,� ti�. .tip .. \i �N o to .� L/��� �,►►►1� �N►►1„ i ��,,.�:\'i��►c►i'.�:�..{ z.��;'ilc►►�►��� y �,t� ;,�►r►►►�,�, a��a- .,,, ►�c�c�i�i_���i, Elt� 'ij►►►►i;!,:�. n;,,rl. .� 1 ��� 7'!'i7t':�►11�. ,�i �st": N/►Is, r s.�•:�i r ��:=.. 1►�Nr�.:�����r'.�_� tz' t�l►r...-,�_`� t l irlt��� /j: _QCN 0. EL 04 CL t.,;. � p vJ l•r Y O u _ i�>• r� 7 L U J o c cn Q r _ V u ti o � �; CL .•.,� z � U C/) `ptiQCil1017 wcj A. y O I— V W Cl CD Z ..<lo)> j- C W W = Z a w ° s' U' r - -• U) r m 0-4 CL �!� it � .0 V � :�-• ,��. ma's � � � Z •rx�� ;,. U N LO N Ch LL �.. .1 O 'A5, • 11`lts)> � .1 flo)s 14t10)►, ,.L*-:y, ►Ily `' s 'l r'I//y 7"'-� �c;J r'►/ly �;r°+ -g• r►•1►•i s AT^ B'j'N a +is r-�* �•yS^!r•-:: ►11,.- ; +flo)>�\ �:.q 4� ,ti�►e►�r 1►�►►►�i��`� y�e i�,e►►�e►11 ��$y 1��►�e►r ry��►ti�y ► ti� ►►�►��y' tr O taw 99 '.X���A'1� t►i � ryA (ii�j +I(i1�� A •• , A A i� •jr I1A�T e \•\ A D D� 0 • O 8i4��{ }, ` .:.� ��� •ft,l�5, ,,: � .-� t�Fw n'r�+�• y A` DATE(MM/ Y) /•1._ CERTIFICATE OF LIABILITY INSURANCE o3/06/2025 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). CUNIAGI PRODUCER NAME: CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY PHONE —— FAX HOME OFFICE: P.O. BOX 328 (A/C,No,Ezt):888-333-4949 (A/C,No):507-446-4664 OWATONNA, MN 55060 E-MAIL ADDRESS:CLIENTCONTACTCENTER@FEDINS.COM INSURERS AFFORDING COVERAGE NAIC U INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED INSURER B: N.Y. HOME MAINT.CO, INC INSURERC: 147 WHEELER AVE PLEASANTVILLE, NY 10570-3011 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:261 REVISION NUMBER:0 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF I POLICY EXP LIMITS LTR INS R WVD MMIDDIYYYY MMIDDIYYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS-MADE FX]OCCUR DAMAGE TO RENTED PREMISES $100 000 (Ea occurrence) MED EXP(Any one person) EXCLUDED A Y N 6037310 12/31/2024 12/31/2025 PERSONAL&ADV INJURY $1 000,000 CENt AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2 000 000 X POLICY �T OTHER: LL����YYYY ❑LOC PRODUCTS&COMPIOP ACC $2,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1 000,000 (Ea accidenQ X ANY AUTO BODILY INJURY(Per Person) A OWNED AUTOS ONLY SAUTEDULED N N 6037310 12/31/2024 12/31/2025 BODILY INJURY(Per Accident) OS HIRED AUTOS ONLY NON-OWNED PROPERTY DAMAGE AUTOS ONLY Per Acciden X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $3,000,000 A EXCESSLIAB CLAIMS-MADE N N 6037312 12/31/2024 12/31/2025 AGGREGATE $3,000,000 DED X t RETENTION$10,000 WORKERS COMPENSATION PER STATUTE OTHER AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNERI EXECUTIVE E.L EACH ACCIDENT OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L DISEASE EA EMPLOYEE It yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached it more space is required) THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN A WRITTEN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY. CERTIFICATE HOLDER CANCELLATION VILLAGE OF RYE BROOK 261 0 938 KING ST SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BUILDING DEPARTMENT BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN RYE BROOK, NY 10573-1226 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE l A FOR 25 HILLANDALE PLUMBING AND GENERATOR PERMIT USE()01 � 15 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD /7--ONON**- NYSIF New York State Insurance Fund PO Box 66699,Albany,NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE 0 � ^^^^^^ 133234047 N.Y. HOME MAINT.CO., INC. '$- 147 WHEELER AVE ❑� PLEASANTVILLE NY 10570 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER N.Y. HOME MAINT. CO., INC. VILLAGE OF RYEBROOK 147 WHEELER AVE BUILDING DEPT. PLEASANTVILLE NY 10570 938 KING STREET RYEBROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE G 1377 900-4 931117 11/01/2024 TO 11/01/2025 6/3/2025 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1377 900-4, 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:/M/WW.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. ALBERT BORRELLI JR 1 OF 1 A. BORRELLI HVAC INC THE POLICY INCLUDES A WAIVER OF SUBROGATION ENDORSEMENT UNDER WHICH NYSIF AGREES TO WAIVE ITS RIGHT OF SUBROGATION TO BRING AN ACTION AGAINST THE CERTIFICATE HOLDER TO RECOVER AMOUNTS WE PAID IN WORKERS'COMPENSATION AND/OR MEDICAL BENEFITS TO OR ON BEHALF OF AN EMPLOYEE OF OUR INSURED IN THE EVENT THAT, PRIOR TO THE DATE OF THE ACCIDENT, THE CERTIFICATE HOLDER HAS ENTERED INTO A WRITTEN CONTRACT WITH OUR INSURED THAT REQUIRES THAT SUCH RIGHT OF SUBROGATION BE WAIVED. 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. rOR 25 HILLANDALE PLUMBING AND GENERATOR PERMIT USE ONLY NEW YORK STAT SUR NCE FUND T 4/ DIRECTORJNSURANCE FUND UNDERWRITING VALIDATION NUMBER:943866890 i a D :�'[E W IE I E JUN 12 2025 VILLAGE OF RYE BROOK BUILDING DEPARTMENT SURVEY OF PROPERTY Ir VILLAGE OF RYE BROOK BflAI& Lff IYa 0 X BLOCK A ON A MAP MM-W AkEM RESUWASM MV OF 9WM A�DGf dTom��FILE COPY II= NO' A� 19 W Na8iltl I'v I .5 C A M, M My skm GARMnO 70** JODY R021 AA0 ANN PAMW ATAMEYSIME 96UUNCE AG= M � _ ,w„ NY Ito1 JOIN J. MULDWN0 La TAPPAN JANVffG ROAD IMYTOWNs N.Y. 10591 (914)000 32