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HomeMy WebLinkAboutBP25-155PERMIT # ��� J� pgTE; r3- �S ALCTION 3 i 'y p TYPE OF WORK 4e,07�01� /CE'/ l c lva .70 JOB LOCATION AWNER /I%P CONTRACTOR COST awl, ' rge — v 7 ►S crcr: '7 a �14 LOT :J • �% .� /.tea ��s �iy)979�0009 '^� *ILFEE DATE 2ozs- pAsse� SATE INSr FOOTING FOUNDATION FRAMING RGH FRAMING' INSULATION Z /l1J PLUMBING ,L M�3 aSS RGH PLUMBING GAS CO - — SPRINKLER ELECTRIC 1? % swi s LOW40LT ALARM S. AS SUILT FINAL. IM • Z,� 187 sHo�•�e,, P� 7-zB��zr . /v -loll " 6b . i*IAL [. 6 . OTHER APPROVALS ARB BOT P8 ZBA OTHER VILLAGE OF RYE BROOK WESTCHESTER COUNTY, NEW YORK NO: 25-154 Certificate of ®ccupoucp This is to certify that ik l T&u,b Johe=, Taab of, Braj- L I y having duly filed an application on &VAe)r))er p? ,_20 0�5 requesting a Certificate of Occupancy for the premises known as, 12i�e / {� , Rye Brook,NY, located in a �-l Zoning District and shown on the most current Tax Map as Section: I."7 34 Block: Lot: S• � , and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No. " 55 , issued L,--� 20j25, 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: - ne' i/ Construction: , for the following purposes: 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 t 't facilities shall be made, and no enlargement, whether by extending on any side or by increasingIn he�ght shall bemad ,nor shall the building be moved from one location to another until a permit to accomplish such change b e am d fro th 3u' Inspector. Building Inspector,Village of Rye Brook: Date: DEC 15 2025 For oce BUILDING DEPARTMENT PERMIT# use only: 5� VILLAGE OF RYE BROOK ISSUED: NOV 2 5 20 938 KING STREET,RYE BROOK,NEW YORK 10573 DATE: (914)939-0668 FEE: PAID wway.ryebrookny.gov 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 Yii#►Y#YtYkttik#t#i#iii#irtirtiirt#rtrtititiYi##tikititit#i#####4rtirtrtf Yrtrtit iktii ,#,4##rtY#rt trtrti tY#tit YYkii ii ti}#i##rt Address: j� A /V Occupancy/Use: / Parcel ID#:y. �—.!) . �� Zone: / 5 Owner: v Address: P.E./R.A. or Contractor: RS Address: tc� P We Person in responsible cha g Address: 7,F y /Q W 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 YORrK?C y UNTY OF WESTCHESTER as: j� N Nlo 2 )� / -S being duly swom,deposes and says that he/she resides at f L(J T toe- g Y P Y (Print Name of Applicant) (No.and Street) in in the County of C tYV[?G-,1'17� 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,tprofessional fees,and including the monetary value of any materials and labor which may have been donated gratis was:$ / / y(7 c3-2p 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 L-tA Sworn to before me this day of 1� , 207S�- day o , 20 S' n tue of Propqk Owner Signa r t Print Name of Prope Owner P ame of Applicaut nn Notary Public No u is �+ i7�R J. BNADBURY N0ary Public,State of New York GREGORY M.RIVERA No.01 BR6159985 Nay Public,State of New York 6/l/2024 Qualified in Westchester County 2� No.OIR16441398 Commission Expires January 29,20 Qualified In Westchester County Commission Expires September 26,2 yE dRC�,� cu � BUILDING DEPARTMENT ❑B DING 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.ore - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS ji /Wfl� -t�Q 1 Ve. DATE: /6 —Z Z O z. PERMIT# r � _ ISSUED:]_-_2'L1 SECT:_ — y4 BLOCK: LOT:. • LOCATION: V)Aw Al—.44A—!A-¢- A,� C _0"✓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 nCv (A.� . ❑ L.P. Gas ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ GROSS CONNECTION /FINAL ❑ OTHER Qyre-BRCZjk. BUILDING DEPARTMENT LDINGINSPECTOR 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: Z CEO �VCJ •� 'Z�Q\1IQ , DATE: 2 2 Z043r_ PERMIT= w 2S^ ' O _ ISSUED:7!2�Z SECT: _•� BLOCK: ( LOT: '�� LOCATION: VA A 5 .+ �� _ JNp Z,L &4 _ OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... E 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 ❑ EI'RE SPRINKLER FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER QyE DR(��• w � �7 �'• �9aZ �' BUILDING DEPARTMENT ❑BUILDING INSPECTOR R'�SSISTANT 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: O_.___KOD i_ ��_ �Qi DATER- ' 2 C ZS PERMIT# Gt7 ( J_8_ _ _ISSUED:7-L'1�$ECT:_ .AA BLOCK:_LOT:S"It r� ln• 1 ,1 LOCATION: _ Z t �Opz !A Q LL Q(3�oY • OCCUPANCY: ❑ Violation Noted THE WORK IS... P PASSED ❑ FAILED / REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: jk-ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas k1a. LL. ❑ L.P.Gas ►3 A �-�f�J� ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING 1 , ❑ CROSS CONNECTION 4!b-4- El FINAL OTHER nlw� QyE BRnv�. • 1982 BUILDING DEPARTMENT ❑BUILDING INSPECTOR W"ACsSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OPPICER 938 King Street• Rye Brook,NY 10573 (914) 939-0668 FAx (914) 939-5801 www.1Tcbrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - .ADDRESS:— � ,�, ,,V DATE:_ 7- L - Z dZcSr PERMIT'# 2S I _ _IssU1;D: �2_-L,�SEC'I':/_�S• y BLOCK:_LOT: - LOCATION:--- - --- OCCUPANCY: ❑ Violation Noted THE WORK IS... PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: 2�—ROUGII PLUMBING ❑ ROUGH FRAMING ❑ INSULATIO:N ❑ Natural Gas s�•vA,3 v) i Ae ❑ L.P.Gas j/ S u ej L c ❑ FUEL TANK ❑ FIRE SPRINKLER 41, ❑ FINAL PLUMBING ❑ CROSS CONNECTION I 11� � ❑ FINAL ` S�,oc,J Pry PA .� ZMd 4:c4j� OTHER Zkouap, Q : N \ eq [ a O"99 C, O W = rat FF—/I = O ' ./( � Ln oo z v °0c H _ � � � O O W w O0 � o � � a.•.. � , CN M � p �_ C\ F--1 el O O -� cti O s 00 00 ZO © 4-8 � �..i Q1 _ uopa CID 00 n W H oE Q Cl) a o14 � � � o � H : U ' W F' Oo 3 z � Q x � 2 I+I U U U z w a C7 A z W O L7 = BUILDING DEPARTMENT D ECENE 3D VILLAGE OF RYE BROOK JUN 1 8 2025 938 KING STREET RYE BROOK,NY 10573 (914) 0668 VILLAGE OF RYE BROOK wvt ?rti {� yQv BUILDING DEPARTMENT INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: ,,��--^^��nnA /� Approval Date: P mi #: � / ''p.pplication Fee:$^ i,/l..'' 6 Approval Signature: Permit Fees:$ / o 0 —b o e_ Disapproved: Other: Application dated: fY�U 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 bui ing,or for a change in use as per detailed statement described below. 1. Job Address: M kreel^ /e ��ft�k" A/ SBL:/3S1 7�/ �`1 Sr//Zone: 2, -)Proposed Improvement.(Describe in detail): S��w✓� tTA . IfW :Vd ,;e` 8 oQ f uJe +IEr ' y jv yl/ rx/�i7�► ✓ O-V 1 �IDI'L u/�i A/tw/ 1 EhCG449 LvAJ_4im4&wWr 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 I: TIER It: TIER III: 4. Will the proposed project require the installation of a new,or an extension/modification to an existing automatic fire suppression system(Fire Sprinkler,ANSL System,FM-200 System,Type I Hood,etc...) :No: Yes: (If yes,please submit a separate Automatic Fire Suppression System Pe it application&2 sets of detailed engine red plans) 5. Occupancy;(1 fam.,2 fam.,comm.,etc...)Prior to Construction: �NG I-ZY After Construction: 19Ate M 4 6. NX State Construction Classification: N.Y.State Use Clajsssiif_icaf n: )Property Owner: 6 , Q✓ Address: 2 t"�' r AJ Phone# Cell# Ac email: 76A 717 d_ O I T Y yc i — cT 8. Applicant: $5 1 Address: ►C� Phone# / Cell# / - O email: qC a tom i A) 0✓ ✓� 9. Architect: Address: Phone# Cell# email: 10. Engineer: Address: Phone# orn Cell# email: QD1. General Contractor: gw' "Afess: G J Qf� �e1 " �e C r c'r Phone# Cell# fq111 - 0W email: N%� - stimated cost of construction $ 9-/- 75V X TE.The estimated cost shall include all labor, erial,scaffolding,fixed equipment,professional fees,and material and labor which may be donated gratis.) 13. Job Timetable: Start: 7,�Ale_ Finish: (1) 6/l/2024 BUILD MENT R VtL E OF RY OOK J U N 18 2025 938 DING ET RYE BR ,NY 10573 `'( _ 4 -0 VILLAGE OF RYE BROOK w t ON' 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 . New yowk. STATE OF N,EEW YORK,COUNTY OF R ) as: I, `/z w 14 e�i ,residing at, 12 A_j �«�l �r.V L (Print name) (Address wh re 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; t A a tpr%mot , 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. (Signature of Property.Owner(s)) p4nrc 1 (Print Name or Property Owner(s)) Sworn to before me this o 6 day of T..n c 920 5- 1t4W627 (Notary ublic) SUZANA MUAT + Notary PubHe•State of New York No.01M6177520 Quam w In aum m Courtly (2) Conmb*n Fxom it-n2027 61112024 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. NttN Yo dlc STATE OF EW YORK,COUNTY OF ) as: _ E�+^ic/ J ,being duly sworn,deposes and states tha�&he 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. 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 !b Sworn to be re me this day of 14 n C. , 2025 day , 20 � ..�_ --_ AA- Signature of Property Owner idFint Print Name of Property Owner Pr eofApplicant nt !4 !�-�s Notary PAblic Notary_Public SHARI MELILLO Notary Public,state of New York SUZANA MW No.01ME6160063 NftYPubMe•&AMOfMrwYork Qualified In Westchester County ��ti1Or,+•rr"00 Commission Expires January 29.2l L_l w OWA*Mrr Egrw 1"06W (4) 6/1/2024 a4 a ~ N N Ga7 a u ON ,f a w y M k z CA Z O 4,-., 0.4 a f � W -wool r� a - O Ln N t �1 .>a o z 4A64 a W W M 4 O :d 'r' O ( � CL r - w ►-� z r V � A � � a m � as oMc 04 a ,� � r Cl) OJC A Ln d z � A c r a 41 0 O � a A W acc oyc R BUIL1l�E MENT �n VIL1 Ar E OF RYE OK ECEV 938 KINa,�REET RYE BRUO ,NY 10573 JUL 15 2025 (914)939=0668 1 .31 www.ryebrookny.gov VILLAGE OF RYE BROOK ELECTRICAL PERMIT APPLICATION BUILDING DEPARTMENT Westchester County Master Electricians License Required FOR OFFICE USE ONLY BP#: / 5� EP#: C) / gq Approval Date: JUL > > 2025 Permit Fee: $ C, , Approval Signature: _ Other: DO NOT START WORK or CONSTRUCTION NTIL 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,_-,)L_V 15 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. p 1.Address: 1 9- 1 fn ()AD P F JDCk-t V17 SBL: 13 S 5. Zone: 2.Property Owner: f kV i EL A '�-U(> Address: Phone#: Cell#:_q 17 5 89 �R 06 email: 3.Master Electrician/Licensed Installer: 1'(l/. Yk O S c t..V'* Address: Lic.#: q16 Phone#: Cell#1 LfD,-� �j`� $t email: 1QS i LJ l} �—(tCr C�L NIII .Loy Company Name:VA Yl;o S i L✓A t L t ill T Ne Address: "96-C L'H tiQ L'H 5 a21 CfiES72'rt. PYAPS 4.Proposed Electrical Work/Fixture Count: W I cuy c-' A":*T (A I1E2F-j FL-4p ki i No,(; V-; e6-s5 E J=rff 1 y 5 W- 'fL eszSS ev, I-� 4 5 5.31 Party Electrical Inspection Agency: ********************************************************************************************************* �S/TATE OF NEW YYORK,COUNTY OF WESTCHESTER ) as: I.1 P7 lU CD J( (i V T,"being duly swom,deposes and states that he/she is the applicant above named,and does further (print name of individua s ggmnP,as the applic t) _ state that(s)he is the V9S 1C`z y !--c�a fr'-"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 befor me this day of ,20 day of "� ,20 C) Signature of Property Owner Signature of Applicant �(l c S� Print Name of Property Owner P ' Af3 licant Notary Ic cafe o York Notary Public Qua lNoajtry\Da3Wbester county Commission Expires January 29.2;j 6/1/2024 STATE WIDE INSPECTION SERVICES, INC. • • SWIS • : APPLICATION • Elect. Permit # Bldg Permit # (� /S J Sq Ft Plumbing Permit # Final Certificate # C t,y Village 1Z - fi E �� 1 Zip IGS.7-� Bwldrng Dept. County 11,C I(` � Address E 1 `� �c �t1 Cross Street Section V L( Block vV� Lot J c I I 1 Owner Name/Address ju different MWI o Contact Number I rG. C ❑Basement ❑ 1st Fl. ❑ 2nd A. ❑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 Cornpact Amt Amps Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer Switcr• SERVICE Amperage #Panels I 3P # Meters # Disconnect ❑Underground ❑ New ❑ Reconnect ❑ Repair ❑Overhead ❑ Upgrade ❑ Disconnect Utility ID# ❑Con Ed ❑NYSEG ❑Central Hudson ❑Orange/Rockland PHOTOVOLTAIC SYSTEM Pv Modules Inverters AC Disconnect Junction Box Combiner Box Load Center PV Monitor Enemy Storage System DC Disconnect ❑Legalization ❑ Safety Inspectior ❑Consultation Scope of Work Lv AC CI OM[7 JUL 1 5 2025 VILLAGE OF RYE BROOK BUILDING DEPARTMENT this application Is valid for one it)year from the dale received by SWIS This application is intended to cover the above listed items lobe 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,owne, of authorized agent agrees to all the above terms and conditions as set forth for the application Email Address ; L Ctt L N I L: C'C)�+�' Name k� License v 1� Date -f h - Signature Address ' q , a< ; , City/State r- rC' C� T7 r ZIP Code v t 1 1 I L _ b Company t 1� C) c (. A �L t e-r.(C 1lT L / Phone # State Wide Inspection Services D .i 'Al 1080 Main Street C I Fishkill, NY 12524 ID845 202-7224 Phone 55�U TODEC - 4 2025 914-219-1062 Fax STATE WIDE INSPECTION SERVICES Email: office@swisny.com _� I:YE BROOK Website: www.swisny.com Service With Integrity _I_ u L.-PARTMENT BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: Mario Silva Electrical, Inc. Daniel &Julia Taud 121 Grace Church Street 12 Red Roof Drive Port Chester, NY 10573, Rye Brook, NY 10573 Located at: 12 Red Roof Drive, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP25-184 135.43 1 5.11 Certificate Number: 2025-6127 Building Permit Number: BP25-155 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: 12 Red Roof Drive, Rye Brook, NY 10573 The Basement &Second Floor Bathroom were inspected in accordance with the NYS and NFPA 70- 2017 and the detail of the installation,as set forth below,was found to be in compliance on the 24th Day of November 2025. Name Quantity Rating Circuit Type GFCI 02 Receptacles 03 Exhaust Fans 02 Luminaires 17 Switches 03 Dimmers 02 Arc Fault Circuit 01 15 Amp Arc Fault Circuit 02 20 Amp >„ 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. ■ a t r OD N O M ■ ■ .� N \ � W a N N 0�0 I^� Ln y r FBI `may J, kv Q O-W Z u C� v H A owe z O CA x LA Ln FBI C� ~ W z A LL i G1C h�„y O x W so Z x T�' < 00 O U-, N p �o 01.4 V = F o a O x � U z U 7 n Cl% ►--� V-4 Q a w O w CA A cm V CG U -r w ■ o L z 2 g c ►�+ i a U. td f z udi a r t a a a ■ ■ r ■ ■ ■ si a g a r si a ■ : t ■ r t a [ _ %lE- t3 R�1v R BUIL 1�E MENT Vii, E OF RYE OK JUL 18 2025 938 KIN ET RYE B ,NY 10573 =� VILLAGE OF RYE BROOK ov BUILDING DEPARTMENT PLUMBING PERMIT APP CATION FOR OFFICE USE ONLY BP#: PP#: IZ)� l l Approval Date: Permit Fee: $ Z 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, t $— is hereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of a Permit to install and/or remove Plumbing as per detailed statement described below.The applicant&property owner,by signing this document agree that said plumbing work will be in conformance with all applicable Federal,State,County and Local Codes. 1.Address: ✓e. SBL: /—5, I/Zone:,�� 2.Proposed Work: t' 11'1! 12 3.Property Owner. 4N it Address: 1 Rr) ao1 A-,we Rjr Al-d A/ W73_ Phone#: 10 Cell#: 117 SPY r 74 email: � ��� y c•^, 4.Master Plumber: V A 1 O(O Address:,3MALiR#c .DA N'�if•r L,.-S4 7$-SSa _ Lic.#: I4y5 Phone#: 946-41S-a`37 Cell#: email:Q} ry141�JC�a11 Ca►�tbtw�®pot.CorL Company Name:Rjjmwv4_I aag2jQ► ,p2 ft 14 j,ue Address:,3 jH jjk t Am uu w V a&q 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 1 st Floor 2nd Floor 31 Floor 4a'Floor 51 Floor Exterior 5.* List Other Equipment/Provide Details: (Notarized Signatures Required Next 2 Pages) -I- 6/l/2024 or . - Ntw Yii k STATE OF NEW YORK,COUNTY OF WESTRtl5STER ) as: bn t t I 1 aill b ,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. 4h Sworn to before me this lq'r4 Sworn to beforeme this 10 `. day of 20 L r day of 20 oZ S Signature of Property Owner ignature of Applicant �an,'e'( 44 k ZZ Print Name of Property Owner Frint Name of Applicant SUDAA"— ruMo--wM�d l"Yak Notafy Public OmMed M a��o�My t <rir�laNIM0a6pIIM 11 J0+Z021 DELILAH CRUZ Notary Public-State of New York NO.GICR6438058 Qualified In Dutchess County My Commission Expires Aug 8,2026 This application must be properly completed in its entirety and must inclu 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/l/2024 r� BUILD MENT p ECEE DD VIL E OF RYE OOK 938 KINGrET RYE BRO ,NY 10573 JUL 1 8 2025 (914)9 -066'� 'Nw.ry ov VILLAGE OF RYE BROOK BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE x 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. 1/Iw javlr STATE OF NEW YORK,COUNTY OF WE 4� MESTER ) as: 31, �an id /es.t , residing at, 2 R� �►{ ` ` /* (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; R)z 6,-A AF , 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. (Signature of Property Owner(s)) (Print Name of Property Owner(s)) Sworn to before me this V h SUZA ►MW NOW►U MM•WAN of"M Yak day of ,)H I,, , 20 2,S N6.0001"In OAM W In QMM C&j ft ryas�t�aa�on (Notary 6/1/2024 din9 Permit Check List&Zoning Anal sis CC Address: \ SBI,: Zone: —i Use: 1 Cont.Type Other. Submittal Date Revision Submittal Dates: Applicant: Nature of Work ' kt.,� Reviews:ZBA: PB: BOT: Other. NEE OK ( ( ) ES:Filing. BP: 1 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. 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.•Plan: Permit: N/A: Other. ( ) ( ) LOW-VOLTAGE ELECTRICAL:Plan: Permit: N/A: Other. (� ( ) FIRE ALARM/SMOKE DETECTORS:Plan: Permit: H.W.I.C.:_Battery:_Other. (� ( ) PLUMBING Plans: Permit: Nat.Gas: LP Gas: N/A/: Other- FIRE SUPPRESSION:Plan: Permit: N/A: Other. (� ( ) H.V.A.C.: Plan: Permit: N/A: Other. ( ) ( ) FUEL TANK Plan: Permit: Fuel Type: Other. O O 2020 NY State ECCC: N/A: Other. ( ) ( ) Final Survey Final Topo: RA/PE Sign-off Letter. As-Built Plan: 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 V� /� i►R \ Area: \�/p�/ _ - Cirde: Fronts e Front: Front: Sides: Rear. Main Cov: Accs.Cov: Ft.H Sb: Sd.H Sb: GFA: Tot : Ft.Imp: P Height/Stories: notes: • C Q it Ow N O i b toga ^ • i'" J w tion P C� w j 3 •° ° Quo<� f F- * G� IL .;ter d Q v W p i Q ° •' H r� '` •. fin. •� � C �: �', v3 .t. : A i a6ca�) ^* o rn N Gn • c, U � C7 ci a ta :i.•fix ;�y��"7 � - a. ' ' a '� �. �/ `��-✓�`�._'�/� _--' �_\ —�\� - /� - Jam\ — Ac"RO CERTIFICATE OF LIABILITY INSURANCE F DATE(MMIDDIYYYY) `"' 0611 212 02 5 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Nella Carrico NAME: TOP INSURANCE AGENCY, INC PHONE 914-690-1440 FAX 914 890 2875 18 PUTNAM AVE E-MAN�»..---_ - lA14•Net: IL PORT CHESTER,NY 10573 ADDRESS_ topinsny@gmaii.com -- ----------- -- —r - _ INSURE aAFFDRDING COVERAGE ' NAIC# INSURER A: UTICA FIRST INSURANCE CO INSURED ------- ------- ---- - - - LA PASTA PAINTERS LLC INSURE---R B INSURERC- - -- —- - --- ------- _ _--- ---} __ 14 WILLOW ST - INSURER D PORT CHESTER, NY 10573 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 IIISR AWLEXP 8UB i —_ --- ------ ----- LTR TYPE OF INSURANCE POLICY NUMBER POLI DIYYYY MMIDDYYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 100,000 PREMISES(Ea occurrence] S CLAIMS-MADE MED EXP(Any one person) S 5,000 A X ART 30000299620 06/24/2014 06/24/2026 - ----------- i PERSONAL 8 ADV INJURY S 1,000,000 ----------- -- I GENERAL AGGREGATE f 2,000.000 ----... __-------_-—t - N'L AGGREGATE LIMIT APPLIES PER: POLICY PRO, PRODUCTS-COMPIOP AG Sj 2,000,000 --.-_- I fLoc ,s AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT jEs acc dens) ---ANY AUTO Per arson ALL OWNED SCHEDULED BODILY INJURY I _ ( person) $ AUTOS AUTOS BODILY INJURY(Per acadenl) HIRED AUTOS NON-OWNED - AUTOS I f L 8 I 0PER �AMAGE S 5 UMBRELLA LIAR OCCUR EACH OCCURRENCE 1--.1_--- S EXCESS LIAR CLAIMS-MADE - AGGREGATE S DED RETENTIONS r-- ---- WORKERS COMPENSATION S AND EMPLOYERS'LIABILITY WC STATU- OTH- ANVPROPRIETOR/PARTNERIEXECUTIVE YIN I -TORYLIMITS�__-: EIR , OFFICFR/MEMBER EXCLUDED? n NIA E.L.EACH ACCIDENT S (Mandatory In NH) ( --- - ---------- 11 yyes,descnde uOnder PERATIONS below E.L.DISEASE-EA EMPLOYEE $ DESCRIPTION OF --- --- ----- E.L.DISEASE-POLICY LIMIT $ I DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101.Additional Remarks Schedule.d more space is roqurrod PAINTING AND CARPENTRY CERTIFICATE HOLDER CANCELLATION BUILDING DEPARTMENT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN VILLAGE OF RYE BROOK ACCORDANCE WITH THE POLICY PROVISIONS, RYE BROOK,NY 10573 AUTHORIZED REPRESENTATIVE ACORD 25(2010/05) v 1 88-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered mark of ACORD PORK Workers' CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured La Pasta Painters's LLC 914-979-0009 14 Willow Street 1 c.NYS Unemployment Insurance Employer Registration Number of Port Chester, NY 10573 InsuredN/A Work Location of Insured(Only required if coverage is specifically limited to 1 d.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-Up Policy) Number 62-2880978 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) National Liability& Fire Insurance Company VILLAGE OF RYE BROOK 938 KING STREET 3b.Policy Number of Entity Listed in Box"l a" N9WC227212 Rye Brook, NY 10573 3c.Policy effective period 07/20/2024 to 07/20/2025 3d.The Proprietor,Partners or Executive Officers are included.(Only check box if all partners/officers included) x❑ all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box"I a"for workers' compensation under the New York State Workers'Compensation Law. (To use this form, New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2". The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.)Otherwise,this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent,or until the policy expiration date listed in box"3c", whichever is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder.This certificate'does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note: Upon cancellation of the workers' compensation policy indicated on this form, if the business continues to be named on a permit, license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers'Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury, I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Rakesh Gupta (Print name of authorized representative or licensed agent of insurance carrier) n Approved by: _ 1��-� _ _ 06/12/2025 i (Date) Title: Chief Operations Officer Telephone Number of authorized representative or licensed agent of insurance carrier: 844-472-0967 Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insurance brokers are NOT T authorized to issue it. C-105.2 (9-17) www.wcb.ny.gov