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HomeMy WebLinkAboutBP25-148PMMR #E !I SECTION TYPE OF WORK JOB LOCATION L COST I, O TCO a FEE FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION Co PLUMBING Co RGH PLUMBING GAS C7 SPRINKLER ELECTRIC W-VOLT rT ALARM AS BUILT C7 FINAL pPaS-- ISS�rick ��gox� OTHER APPROVALS ARB BOT PB ZBA OTHER VILLAGE OF RYE BROOK WESTCHESTER COUNTY, NEW YORK No: 25-134 Certificate of Orrupeurp This is to certify that &, . Rea / Y,P of, Pae Akao-k-z having duly filed an application on 20 requesting a Certificate of Occupancy for the premises known as, ;*Ce , Rye Brook,NY, located in a )V- Zoning District and shown on the most current Tax Map as Section: 9. O Block: / Lot: and having fully complied /with the requirements of the Building Code and the Zoning Ordinance under Building Permit No.C945 7 Od & J , issued Q 20 p7.5, such authority and permission is hereby granted to the property owner to lawfully occupy or use aid premises or building or part thereof listed under the following New York State Classifications, Use: �' / Construction: for the following purposes: I Y2 4-et'I6 y 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 fac'Ales shall be made, and no enlargement, whether by extending on any side or by increasing in hei s all be m n r sh I th building be moved from one location to another until a permit to accomplish such change ha een from t e B it nspector. Building Inspector,Village of Rye Brook: Date: OCT 2 1 2025 BUILD (`DEY NT For office use only: G u u i PERMIT# - �O VIL OF RYE OK ISSUED: OCT 16 2025 938 KING STRE YE BROOK, YORK 1OS73 DATE: /Q 9 -0668 FEE: /ter" PAID VILLAGI. ku ov APPLICATION FOR CERTIFICATE OF OCCUPANCY,CERTIFICATE OF COMPLIANCE, AND CERTIFICATION OF FINAL COSTS TO BE SUBMITTED ONLY UPON COMPLETION OOF� ALL WORK, AND PRIOR TO THE FINAL INSPECTION ,, ,p Address: 1 `�11 Occupancy/Use: DTI Parcel ID#: �3 -7[p— L Zone: Owner: Ic:�c s�1c ec. � > Address: 16A atr��n ae �,tvtr , )-` 1() Zvi P.E./R.A. or Contractor: Address: II tt Person in responsible charge: feVnz SL's G 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: ST TE OAF, NEW YORK,COUNTY OF WESTCHESTER as: �, -S C' being duly sworn,deposes and says that he/she resides at 3 y )�fl 4(YI C :�nntNarne of pplicant) r 1 (No.and Street) in 3�� t l 3�k/ ,in the County of l�S� n F�i r in the State of ,that (City/Town/Village) he/she has supervised the work at the location indicated above,and that the actual total cost of the work,including all site improvements, labor,materials,scaffolding,fixed equipment,professional fees,and including the monetary value of any materials and labor which may have been donated gratis was:$ N,Don , 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§250-10.A.of the Code of the Village of Rye Brook. Sworn to before me this Sworn to before me this day of C) 20 day of ,20 C1 Lt e LO k4a Signapre of Property Owner Signature of Applicant RGIC\>rl.e &SC' ri ame of Property Owner Print Name of Applicant Notary Public SHARI MEULLO Notary Public u:tary Public,State of New York No.01ME6160063 6/I/2024 ,;:,alified In Westchester County :-ion Expires January 29,20Z� BRC>uk � � m BUILDING DEPARTMENT ❑BUILDING INSPECTOR VILLAGE OF RYE BROOK 0 VILLAGE ENGINEER 938 KING STREET RYE BROOK,NY 10573 0 ASSISTANT BUILDING INSPECTOR (914) 939-0668 FAx(914) 939-5801 - - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - --- - - - - - - - - -- - - - -- - - ADDRESS: Vl DATE: PERMIT# ? � ISSUED: r \, c SECT: I <�- BLOCK: LOT: LOCATION: `1 N ` ` < < { \r'r t\ OCCUPANCY: 2- ❑ VIOLATION NOTED THE WORK IS... WACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING c - \ ❑ INSULATION � Q ❑ NATURAL GAS �] ry, ❑ L.P.GAS N�) 1 ❑ FUEL TANK V 6 C Q �0� Y�- ❑ FIRE SPRINKLER O FINAL PLUMBING p' FINAL D OTHER S m = T� O C C a O p4 Ra.� O W a r-� } X H S `.1 00 N a 1--I ed cn si s v fi O V x � vv °J o W bo vU u ■ z 8 a V C L a ■ �' o a c/� • 0-4 a'� F� a m W H `O L V L7 U a �Cq y ,end O a N W U Z o v z all bz PIZ oo m E~ U 0. O C0-4 �"I � Q o •• �' v " 0 00 Fo `° a O � gibes .. �'. 021 Or ° 'd 41414 a a 414 a 4 4;4;4;4;a4;4;4;4;9a4;a4;4;4;49 4;9 9 4;.4 4;a a a a a a a a 414N 49-469 BUILD. i .DEPARTMENT VIL LRVE E OOK J� JUN 2025 938 KING RO 4,NY 1057366$. VILLAGE OF RYE BROOK v ov BUILDING DEPARTMENT INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: _ 1� Approval Date: /k� pp Alication Fee:$ je'__ Approval Signature: Permit Fees: Disapproved: _ Other:_ - Application dated: is hereby made to the Building Inspectorof 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: VFW —m-ir- P an L �K,t J S�SBL:V35.% ' -' �� Zone: '�+� 2. Proposed Improvement.(Describe in detail): KgGrter/e. C�Prf �,S'��t1Hri► RS �sr»�(�V—lrserlt- •o���, � 1�. � ���_'�✓1 �Cl��"..v1,� QA►yttt'1r+c !�-t.'r�"'��.. �-'A�t ri��1� � I �ler r�w R1i CfA An�I,^ _Vt�t7Jtc � ��; r � Oy�y L- s Does thp proposed improvement involve a Home-Occupation as per§250-38 of the Code of the Village of Rye Brook? No: V/ Yes: If yes,indicate: TIER I: TIER II: TIER III: FWill the proposed project require the installation of a new,or an extension/modification to an existin automatic fire `` suppression system(Fire Sprinkler,ANSL System,FM-200 System,Type I Hood,etc...) :No: V Yes: (If yes,please submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans) Dccupancy;(I fam.,2 fam.,comm.,etc...)Prior to Construction: 1 C"A*4 After Construction: { N.Y State Construction Classification: `` N.Y.State Use ClaClassification:7. Property Owner: X/*,)Na C.4.;V(! Address: Raw M64%+'X AQ iM &Mv) Oy It94b©l Phone# Cell# %,I 1' ?'41 16 email: Applicant: Hl�oz> Vc'1CJ10 Address: Phone# Cell# °�► Zl 4 2Yr41 email: r► '� Cesvtn 9. Architect: Address: Phone# Cell# email: 10._ Engineer: Address: Ph ne# Cell# email: 11. General Contractor: Address: Phone# Cell# email: 1 timated cost of constructionF$ ��t TE: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: Finish: (1} 6/l/2024 $UILD � J MENT VIL E OFRY ' OOK .SUN 12 2025 938 KnvG ET RYE Bit ,NY 10573 -� ? VILLAGE OF RYE BROOK wwN .901 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, 1cla k fa� to ,residing at, 1 4:lq t NVft&A We, ?nMA r ISY 10by(9 (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; LRye Brook,NY. (Jab 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. vc, — (Signal 'e of ilroperly O vner(s)) 04W�xN 44�, �_�w / (Print Name of Property Owners Sworn to before me this . day of it�P , 20 (Natary P ,i.) GREGORY M.RIVERA - Netmy Public,State of New York (2) No.01RI6441398 Qualified In Westchester County Common Expires September zs,2 4 — 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. STIlkTE OF N %gRK,,COUNTY OF WESTCHESTER ) as: �"la ,being duly swum,deposes and states that he/s a is the applicant above named, (print n 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,attomey,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 day of , 20 day of , 20 E_� SiEp ture of Property Owner Signature of Applicant M�4N . l �1 Print Name of operty Owner A Print Name of Applicant Notary li Notary Public GREGORY M.RIVERA Notary Public,State of New York No.01 R16441398 Qualified In Westchester County Commission Explres Septotnber 26,204 )(4) 6/1/2024 Gs �il N N N a = N O O W 0000CA Z v W t A W V1L--, 2 W C C— 1. rr, u w PLO 0-4 00 r- = Z o , = W W w x o OO " E" eq I Lin Qr o4 a z w cn LnrA 00 - O I'�"1 Cn r. z ►ten a — o - CL u CN ll oo V w H a z _ 0. ccn M "1 M � ! i h� oo i W= W V (+1 J Z U J V :r w z s W V C z a x A � y PLO w a o _ . � o � r BUILDING DEPARTMENT -- VILLAGE OF RYE BROOK L i AUG 11 2025 I 938 KYN ?� ET RYE BIjQ�K,NY 10573 ! { VILLAGE Oiz RYL EROOK ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required � C� FOR OFFICE USE ONLY BP#: o 5-_Iy$ EP#: 1 2 znc5 �5�/' ' Approval Date: AUG 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, `11—c � 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: 11 WA► t M Uv t FI Ol SBL: J -26 1 Zone:,e� 2.Property Owner: r44 sS L l cl . ��, Address: - I Phone#: Cell#: email: SS c . 5M4"Il.cZ e 1 3.Master Electrician/Licensed Installer: JOSGek JajZrNb Address:33 ' AV(, Lic.#: I751 Phone#: Cell#: 914'y03-715'0 email: 0h14k4c.1+/'1e-�( Byn1•:,�'�M Company Name: %M t cs %(_ ��- Address: 4.Proposed Electrical Work/Fixture Count: 6"Al."!) f e• ��-`�� S�1��(ktf , WIZ- +5►^� FikOJIl /AJ►lt 0f 6(A( 5.31 Party Electrical Inspection Agency: ********************************************************************************************************* STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: JOSU\-\ Sd►Q*,'o,)O ,being duly swom,deposes and states that he/she is the applicant above named,and does further (print name o individual signing as the a,Qplic nt) state that(s)he is the l+dt�t3&,r ON M 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 t before me this \ Sworn tokbefore me this d f 20_'�_ day of 20 Si re of Pro erty Owner Si /re f Applicant Zt Name of Prope 0 er Print Name of cant a e o ew or EN 0.01ME6160063 NOTA17 , ATE OF NEW YORK Qualified In Westchester County No. 01 BR6409551 6/l/2024 ;rrtmisslon Expires January 29,20z-:? Qualified in Westchester Coun Commission Expires 09/28/20 STATE WIDE INSPECTION SERVICES, INC. Service With Integrity 0:0 • • SWIS JOB APPLICATION0. • Office Use Elect. Permit# :_�_ Date Bldg Permit#'�p — Sq Ft Plumbing Permit# Final Certificate# City/Village l% Zip ^r Building Dept. County;,lr .-:'• , Address Cross Street Section Block �Lot Owner Name/Address(If different than above) Contact Number ❑Basement ❑ 1st Ff. ❑ 2nd Fl. ❑3rd Fl. ❑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 El 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 C �nan, •r.. f<<ct}...cats , j,,,,;��b�+<� i Nit 1'+��.�- f,r�v��s . Zwti�� r�� �.;r:. . 1 (D EUG 1 2025 VILLAGE OF RYEUROOK 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 01 i lm fckr;C11 r 1, (art Name /OrP44 Fs1fa.,,r; License# / �S Date !{ Signature Address %3 ;.�j s;- y City/State ' a r. y Zip Code Company t���^ ! t C- Phone#.,i •.I - y State Wide Inspection Services CAC) 1080 Main Street Fishkill, NY 12524 845 202-7224 Phone To ( OCT - 2 '"i`r- 914-219-1062 Fax STATE WIDE INSPECTION SERVICES Email: office(a)swisny,com 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: OHM Electric LLC Natasha Realty Corp. Joseph Salerno 11 Whittemore PI, 33 West Stevens Ave. Rye Brook, NY 10573 Hawthorne, NT 10532 Located at: 11 Whittemore PI, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP25-209 135.76 1 18 Certificate Number:2025-6685 Building Permit Number: BP 25-148 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: 11 Whittemore PI, Rye Brook, NY 10573 The First Floor,Second Floor&Third 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 30" Day of September 2025. Name Quantity Rating Circuit Type Receptacles 35 GFCI 04 Switches 20 Luminaries 10 Smoke Detectors 04 C/O Smoke Detectors 04 yZ Officer: Frank J. Farina Jr: 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. 6 !j C 14 N N C � \ \ 00 s' N 00 ap rP u C/) s W � � w00F w � W a tr, r NUO z t = O z � z V0-0 o � _. D ` �--* z C d z z tt F—� W pp Q V 0 IC' -D ad z ° 8g a _ C W W �, o o H z o cn t w U y3 U a a � W � a z a 0 � w � Ef yE BRC�v BUIL E MENT FtOCT 8 2025 Jr VIL E OF RYE OK _ 938 KIN ET RYE B ,NY 10573 VILLAGE OF RYE BROOK e BUILDING DEPARTMENT W V.gov PLUMBING PERMIT APPLICATION Q� FOR OFFICE USE ONL BP#: I PP#: J �y Approval Date: ` Permit Fee: $ Approval Signature: Disapproved: (fees are non-refundable) ************************************************************************************************** DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDING INSPECTOR.THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12%OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00 Application dated, is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install and/or remove Plumbing as per detailed statement described below.The applicant&property owner,by signing this document agree that said plumbing work will be in conformance with all applicable Federal,State,County and Local Codes. I.Address: ,_J� y �NkE' rc r1J L ,Pk• SBL: ) 35'—70 Zone: 2.Proposed Work: ��a o 1 Q \"� 6-Z ,. t n k 3.Property Owner: OSCA Address: 3y Qj+nam Dr Phone#: Cell#: email: 4.Master Plumber: X ft.p.ry Address: VI %rA'5_1A N A\ R4 Nei-'�kOy../s V(; CX041.1 Lic.#:OA6b Phone#:O�kq-4V—'5?k%% Cell#: S email: W '+ SOL of I Company Name: j p 1t JA Address: & (2(0 1/7 a INDICATE FIXTURES&LINES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: Location Water Urinals Drinking Sinks Showers Bath Laundry I Domestic Fire Sanitary Natural/ Other* Total Closets Fountains Tubs Tubs Service Service Sewer LP Gas Basement l st Floor 2nd Floor 31 Floor 4'Floor 5'Floor Exterior 5.* List Other Equipment/Provide Details: (Notarized Signatures Required Next 2 Pages) -1- 6nn024 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: 9G•dll I�C K Csi,r k 1 ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signs g as the e 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 befo a me this Sworn to before me this day of ,20 day of 20 % Sig ature of roperty Ow Signature of pltcant Print a e o r p Owner Print Name of Applicant Ad, Notary JWic 14Frary c 614 GREGORY M.RNERA Ndwy public,State of New York GREGORY M.RNERA No.61R16441398 Netary Public,State of New York Qualified In Westchester County n No.01 R16441388 ��s r g 09 Qualifhd In Westchester County I leafs n mus 6be properly completed in its entire andfi�tratciartl 'aap p p y p entirety 8*ribed 6", ture(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 p ECENE BUILD MENT VIL OF RY OOK OCT - 8 2025 938 KING ET RYE BR ,NY 10573 4 -0 VILLAGE OF RYE BROOK w ov BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE §216 • STORM SEWERS AND SANITARY SEWERS THIS AFFIDAVIT MUST BEAR THE NOTARIZED SIGNATURE OF THE LEGAL PROPERTY OWNER AND BE SUBMITTED ALONG WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION. ANY BUILDING OR PLUMBING PERMIT APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETURNED TO THE APPLICANT . STATE OF NEW YORK, COUNTY OF WESTCHESTER ) as: 3, f111 a v-, L, S 0GQ ,residing at, 3 Q U�I C4 yn bf (Print name) (Address where you lice) 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; ll UJ h 1 40'f i 0cf- , Rye Brook,NY. Oob Addr(2;ti) 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. Sworn to before me this day f , 20 (Notary P lic) GREGORY M.RIVERA NetM Public,State of New York No.01R16441398 Qualified in Westchester Co26 20 commission Expires September 6/1/2024 Laura Petersen From: Steven Fews Sent: Thursday, June 5, 2025 10:11 AM To: Shari Melillo; Alfredo DiVitto Cc: Laura Petersen Subject: RE: 11 Whittemore Place Expires: Friday, October 3, 2025 12:00 AM Good Morning Shari, We will log it in and check it out. Thank You. Steven E. Fews Building Inspector& Fire Inspector Office (914) 939-0668 From: Shari Melillo <SMelillo@ryebrookny.gov> Sent:Thursday,June 5, 2025 10:03 AM To: Steven Fews<sfews@ryebrookny.gov>; Alfredo DiVitto <adivitto@ryebrookny.gov> Subject: 11 Whittemore Place Received two calls this morning from neighbors—11 Whittemore—lots of work going on—received a truck load of sheetrock and construction materials— no permit posted on house Another fine example of neighborly love Sh".MePie& Sez�to the admit i twton ` d&W o f Yaje 53woh i 1 t Building Permit Check List&Zoning Analysis_ Address ` "�� �.�� ���Q SBL: Zone: (L U e: `—L\,Q Const.Type: Other. Submittal Date: � .�2 2� Revisions Submittal Dates: Applicant: 0 Nature of Work ` \ � - ,L k C r u C c�ov(A,ki oc\ Reviews:2BA PB: BOT: Other. NEED OK/ _ ) I FEES:Filing. 00(�o BP: \ C/O: Flood Plane: Legalization: ( ) ( "P: Dated. —Notarized. SBL• Tnus 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. Perm( ) ( ) FIRE SUPPRESSION:Plans: it: N/A: Other. ( ) ( ) H.V.A.C.: Plans: Permit: N/A Other. ( ) ( ) FUEL TANK:Plans: Permit: Fuel Type: Other. O O 2020 NY State ECCC: N/A: Other. ( ) ( ) Final Survey. Final Topo: RA/PE Sign-off Letter. As-Built Plans: Other. ( ) ( ) BP DENIAL LETTER: C/O DENIAL LETTER: Other. ( ) ( ) Other. ( )ARB mtg.date: approval:- notes: ( )ZBA mtg.date: approval• notes: ( )PB mtg. date: approval• notes: REQUIRED EXLSI ING PROPOSED NOTES APPROVED Area: 8 2015 Circle ate: -- FE"ntae Front: Front: Sides: Rear. Main Cor. Accs.Cov: Ft.H Sb: Sd.H Sb: GFA: Tot Imn Ft.imp: Par . Height/Stories: notes: .Itlh11111BI1l1j11111i111t111l1�1tiU4. `�\\'\\ attilNlthglleifjlpittf 1l4flilifUl3Y1. '`v � � �v E!!l1t1!!alfli¢rlllllll¢I Nll1if161t;� .\a�`�1►t\��\; !�INI,I�E tll##1llllliilfil; ulEllllfri� .\ \ P \� V fir- '. • ���� iiGflltltfllQliE111il1ifl!lliltll¢Ii11 _ �`���\��\�a\ ���\,\���bl. ¢ii11111f11EdNtlflU� ! ' \tea\� isi�lUu'plllliTltitl4ff.Htll.... cm I o H a ...�.- .. .. uql.•..,,,4.,1 Y k. a:• ,l4;i::ilElfifilNbl r�/ 3 U o cc e W $ A > ow a " !n `o tj 0 m © C7 00 Q z � 1 a z � � m O W � z _= w W o a o o � o CS, d a a m w O o W Gar Z ct0. 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'wi�:x11;.°{�. ,~i. ~ ,r► ��1� �a k Ir r' Nil L �. 4 1 ' srwn�e _vim - v. ,aafi� s. iw 4� T e �F ..• .n` Asa= .f •.,i:' ;''1 � � - � \• r k f M f.r z or tk Vw y -f iL ,t p /'i- tj- • � r r , •1 � � � � a 'Y I � III � I I t J i GEICO Insurance Agency, LLC Issued by Homesite Insurance Company of New York P.O. Box 5300 Evidence of Insurance For Policy Binghamton, NY 13902-9953 Number 43022743 Tel. (866) 372-8903 Fax (877) 273-2984 This policy covers the listed location(s)from: 12:01 AM June 11, 2025 through Insured Name and Mailing Address: 12:01 AM June 11, 2026 (local time) MIGUEL VALERIO 11 WHITTEMORE PL Send payment to: PORT CHESTER, NY 10573- PO Box 1409 NEWARK, NJ 07101-1409 Insured Location 11 WHITTEMORE PL PORT CHESTER, NY 10573- Residence: Primary home Deductible: $1500 Hurricane Deductible: 5% ($30850.00) Coverage Limit Section I - Property A. Dwelling $617,000 B. Other Structures $61,700 C. Personal Property $308,500 D. Loss of Use $185,100 Section II - Liability E. Personal Liability $300,000 F. Medical Payments to Others $1,000 Total Policy Premium $3301.00 Total Amount Due $2475.72 Total Amount Paid *$825.28 *Please note that installment fees are not included in these totals and vary by payment plan option. Notes: H03— Homeowners HO 04 20 - Specified Additional Amount Insurance for Cov A limit 25% HH D1 06 CW 11 14 Page 1 of 2 The Coverage A Dwelling amount is based on replacement cost as described in the policy. Certain exceptions apply. Please review your policy for further details. All information and representations herein are subject to the policy terms and conditions. Coverage is contingent upon receipt of the initial payment of premium prior to the effective date of the policy. Authorized Representative Date June 24, 2025 This evidence of property insurance is issued as a matter of information only and confers no rights upon the certificate holder. This evidence of property insurance does not amend, extend or alter the coverage afforded by the policy above. HH D1 06 CW 11 14 Page 2 of 2 Affidavit of Exemption to Show Specific Proof of Workers' Compensation Insurance Coverage for a 1, 2, 3 or 4 Family, Owner-occupied Residence **This form cannot be used to waive the workers'eompensadon rights or obligations of any party.** Under penalty of perjury, I certify that I am the owner of the 1, 2, 3 or 4 family, owner-occupied residence (including condominiums) listed on the building permit that I am applying for, and I am not required to show specific proof of workers' compensation insurance coverage for such residence because (please check the appropriate box): ❑ I am performing all the work for which the building permit was issued. ❑ I am not hiring,paying or compensating in any way,the individual(s)that is(are)performing all the work for which the building permit was issued or helping me perform such work. My I have a homeowners insurance policy that is currently in effect and covers the property listed on the attached building permit AND am hiring or paying individuals a total of less than 40 hours per week (aggregate hours for all paid individuals on the jobsite) for which the building permit was issued. I also agree to either: ♦ acquire appropriate workers' compensation coverage and provide appropriate proof of that coverage on forms approved by the Chair of the NYS Workers' Compensation Board to the government entity issuing the building permit if I need to hire or pay individuals a total of 40 hours or more per week(aggregate hours for all paid individuals on the jobsite)for work indicated on the building permit,or if appropriate,file a CE- 200 exemption form; OR ♦ have the general contractor, performing the work on the 1, 2, 3 or 4 family, owner-occupied residence (including condominiums)listed on the building permit that I am applying for,provide appropriate proof of workers'compensation coverage or proof of exemption from that coverage on forms approved by the Chair of the NYS Workers' Compensation Board to the government entity issuing the building permit if the project takes a total of 40 hours or more per week(aggregate hours for all paid individuals on the jobsite)for r2w rk indild o the b ' ding permit. 0�Ila 3o (Signature of Homeowner) (Date igned) Home Telephone Number (Homeowner's Name Printed) Sworn to before ire this day of Property Address that requires the building permit: �o , A►'1 C� ( wnt I k r o ary Public) f� 4�+'� ► ���� 3 GREGORY M.RIVERA Notary Public,State of New York No.01 R16441398 Qualified In Westchester County Once notarized,this BP-1 form serves as an exemption for both workers'compensation and disability benefits insurance coverage. BP-1 (12/08) NY-WCB i i