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7. 19
VILLAGE OF RYE BROOK
MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR
Jason A.Klein (914) 939-0668 Christopher J.Bradbury
www.i yebrookny.gov
TRUSTEES BUILDING& FIRE INSPECTOR
Susan R. Epstein Steven E. Fews
David M.Heiser
Donald T.Krom,Jr.
Salvatore W.Morlino
CERTIFICATE OF COMPLIANCE
August 29,2025
Daniel Marks&Yael Marks
18 Hillandale Road
Rye Brook,New York 10573
Re: 18 Hillandale Road, Rye Brook,New York 10573
Parcel ID#: 135.28-1-39
Building Permit#25-183 issued on 8/8/2025 to Repair& Replace Existing Drainage Lines
This certifies that the replacement and repair of existing drainage lines,under the above captioned permit has
been satisfactorily completed.
Sincerely,
4
Steven E. Fews
Building&Fire Inspector
/to
Q FE, C E� v F BUIL120
ENT For office use onl : p
DD PERMIT# 0 3
VILK ISSUED: — --�'�
AUG 18 2025 38 KING STREYoRK 10573 DATE:
VILLAGE OF RYE BROOK FEE: PnlnlE�
BUILDING DEPARTMENT_ v
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
iifiiiiiiffiftff1itifitffti#iiitt(tit►\iiifi#iiiiitiii#itktt3iitk#titi###4##it##rt####t##i############iti ti Y##ttttititii#ti#######
Address: 1"�►���� KfJ�
Occupancy/Use: O C - Parcel ID#: i3S.2� - I'3q Zone:
Owner: Address: % �Amcr jr* Q�
P.E./R.A. or Contractor: LlK-K A 0 �Zr�ilu�� Address: 22, N A i 5` . 1�m (orW,Cj MHO
Person in responsible charge: Address:
Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issuance of a
Certificate of Occupancy/Certificate of Compliance for the structure/construction/alteration herein mentioned in accordance
with law:
STATE OF NEW YO�RCK, COUNTY OF WESTCHESTER as:
being duly sworn,deposes and says that he/she resides at
(Print Name of Applicant) `�,, , (No.and Street)
in U ,in the County of �(�1+c�C/Cr in the State of J AY ,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:$ G ,uoo ,
for the construction or alteration of: C)"
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 I's Sworn to before me this
day of 20 cN`_ day of , 20
Signature of Prope'Arl9wrtef Signature of Applicant
;' sd W6-1cs
rm ame of Property Owner Print Name of Applicant
Notary Public SHARI MEULLO Notary Public
Notary Public,state of New York
No.01ME6160063
Qualified in Westchester County b l/'0?4
Commission Expires January 29.202�
I Je DRcb
cu �
1982 BUILDING DEPARTMENT
[BUILDING INSPECTOR
❑ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK
❑CODE ENFORCEMENT OFFICER 938 King Street• Rye Brook,NY 10573
(914) 939-0668 FAx (914) 939-5801
www ryebrook.ors
- - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - -
ADDRESS : ' DATE: �' L
PERMIT#,I?`) " �� '" ` �� ISSUED: SECT: BLOCK: LOT:
LOCATION: ` ` OCCUPANCY:
❑ Violation Noted THE WORK IS... o PASSED ❑ FAILED REINSPECTION
❑ SITE INSPECTION REQUIRED
❑ FOOTING
❑ FOOTING DRAINAGE
❑ FOUNDATION
❑ UNDERGROUND PLUMBING NOTES ON INSPECTION:
❑ ROUGH PLUMBING
❑ ROUGH FRAMING
❑ INSULATION
❑ Natural Gas
❑ L.P. Gas
❑ FUEL TANK
❑ FIRE SPRINKLER
❑ FINAL PLUMBING
❑ CROSS CONNECTION
,FINAL
❑ OTHER
QyE DR��,
04
• 1932 BUILDING DEPARTMENT
.013UILDING INSPECTOR
❑ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK
❑CODE ENFORCEMENT OFFICER 938 King Street • Rye Brook,NY 10573
(914) 939-0668 FAx (914) 939-5801
www.ryebrook.org
- - - - - - - - - - - - - - --- - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - -
1 1\ vlQ DATE:�L� O� I S) e U 2_�
ADDRESS :
1 I
PERMIT# ISSUED: ,SECT: BLOCK: LOT:
LOCATION: ` � ✓ kL OCCUPANCY: `--
❑ Violation Noted THE WORK IS... •[] ' PASSED ❑ FAILED REINSPECTION
❑ SITE INSPECTION REQUIRED
❑ FOOTING r
❑ FOOTING DRAINAGE ,`
❑ FOUNDATION
UNDERGROUND PLUMBING NOTES ON INSPECTION:
❑ ROUGH PLUMBING
❑ ROUGH FRAMING
❑ INSULATION
❑ Natural Gas
❑ L.P.Gas
❑ FUEL TANK
❑ FIRE SPRINKLER
❑ FINAL PLUMBING
❑ CROSS CONNECTION
❑ FINAL
❑ OTHER
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BUInRYE
ENT D F C L
VIOK
938 KINGNY 10573 AUG — 5 2025
v VILLAGE OF RYE BROOK
J9a2 ' l3Uil_i-f\C, nFPARTME7N-I-
ADMINISTRATIVE EXTERIOR BUILDING PERMIT APPLICATION
FOR EXTERIOR WORK WHICH DOES NOT REQUIRE VILLAGE ARCHITECTURAL REVIEW BOARD APPROVAL
FOR OFFICE USE ONLY:
APPROVAL DATE: AUG 13 114P IT#: ��/ ��APFLICATT^1"'"--
"
APPROVAL SIGNATURE: PERMIT FEES: ,d cD3
H.O.A.APPROVAL: DATE:
DISAPPROVED: OTHER:
Application dated: b r�S is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the
construction of buildings,structures,additions,alterations or for a change in use,as per detailed statement described below.
1. Job Address: 1 a AO(40''14 N
2. Parcel ID#: 13 1�.716 —1-39 Zone:
3. Proposed Improvement(Describe in detail): Rf "c cn� if(0'-d- ey-10.n dr wwy 5 Trp[n ():"an
4. Property Owner: -D( "►V �0 I'Idyl yS
Address: k �\ Aic " 4
Phone# 1 14 -114; ''Im Cell# � - 1�� ' � e-mail &(\.(rWV" 'k30� �'►�•twn
List All Other Properties.Owned in Rye Brook:
Applicant: L.1JCIU)j �9(1()UJO
Address:-2 2 V,Nt '54 TIC+ C.axAcv`, CT OGNO
Phone# -I N '3 6q`'2f115 Cell# of y - `I-2�'l� e-mail IcnOCOt�Ittc►�•Ca"*�
Architect:
Address:
Phone# Cell# e-mail
Engineer:
Address:
Phone# Cell# e-mail
General Contractor: l)GMo If
Address: q22 V��'t I � CAnaonI CT dfG�1`'� ,r}
Phone# IN3VA-AK Cell# ����3y�" Z��� e-mail �211uclwot[''q►ut l (VAn
(1)
6nnaz4
5. Occupancy;(1-Fam.,2-Fam.,Commercial.,etc...)Pre-construction: ' u- Post-construction: "^
6. Area of lot: Square feet: q 9, y IN Acres: I U L
7. Dimensions from proposed building or structure to lot lines: front yard: rear yard:
right side yard: left side yard: other: fjf1�
8. If building is located on a corner lot,which street does it front on:
9. Area of proposed building in square feet: Basement: I St fl: 2°d fl: 3`d fl:
10. Total Square Footage of the proposed new construction:
11. For additions,total square footage added:Basement: I"fl: 2°d fl: 31 fl:
12. Total Square Footage of the proposed renovation to the existing structure: 10 A
13. N.Y.State Construction Classification: N.Y. State Use Classification:
14. Construction Type&Location:O Typical Western Lumber Frame;O Timber Frame[TC];O Wood Truss[TT];
O Pre-engineered wood[PW];Located;O Floor Framing[F];O Roof Framing[R];O Floor&Roof Framing[FR];Other:
15. Number of stories: Overall Height: Median Height:
16. Basement to be full,or partial: finished or unfinished:
17. What material is the exterior finish:
18. Roof style: peaked,hip,mansard,shed,etc: Roofing material:
19. What system of heating:
20, If private sewage disposal is necessary,approval by the Westchester County Health Department must be submitted with this
application.
21. 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...)Yes: No:
(if yes,applicant must submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans)
22. Will the proposed project disturb 400 sq.ft.or more of land,or create 400 sq.ft.or more of impervious coverage requiring a.
Stormwater Management Control Permit as per§217 of Village Code? Yes: No: X Area:
23. Will the proposed pryet require a Site Plan Review by the Village Planning Board as per§209 of Village Code?
Yes: No: N (if yes, applicant must submit a Site Plan Application,&provide detailed drawings)
24. Will the proposed project require a Steep Slopes Permit as per§213 of Village Code Yes: No: 7C
(if yes,you must submit a Site Plan Application,&provide a detailed topographical survey)
25. Is the lot located within 100 ft. of a Wetland as per§245 of Village Code? Yes: No: x
(f yes, the area of wetland and the wetland buffer zone must be properly depicted on the survey&site plan)
26. Is the lot or any portion thereof located in a Flood Plane as per the FIRM Map dated 9/28/07? Yes: No:
(if yes, the area and elevations of the flood plane must be properly depicted on the survey&site plan)
27. Will the proposed project require a Tree Removal Permit as per§235 of Village Code?Yes: No:
(if yes,applicant must submit a Tree Removal Permit Application)
28. Does the proposed project involve a Home-Occupation as per§250-38 of Village Code? Yes: No: X
Indicate:TIER I: TIER 11: TIER III: (f yes,a Home Occupation Permit Application is required)
29. What is the total estimated cost of construction: $ R coo Note:estimated cost shall include
all site improvements, labor,material,scaffolding,fixed equipment,professional fees, including any material and labor which may be
donated gratis.If the final cost exceeds the estimated cost,an additional fee will be required prior to issuance of the CIO.
30. Estimated date of completion: Z�
(2)
6/1/2024
BUILDII 16�ti��RTMENT - i
VILL'AgE OF RYE ooK AUG - 5 2025
938 KING S ET RYE BROOK,NY 10573
14� O64)- VILLAGE OF RYE BROOK
wwc�,rye.� 0U `�"0v BUILQ)I�,;G DEPARTMENT
7z7bl- — — -
,AiFFIDAVIT 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, 1�,0 , residing at,
(Print name) (Address where you h%e)
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;
41\�C daQ QJ ?Adk W �US�3 , 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.
I�D
(Signature of Pra er(s))
(Print Name of Property Owner(s))
Sworn to before me this
of '-fit' , 24�
(Notary Public)
SHARI MELlLLO
Notary'Public,State of New York
No.OIM E6160063
Qualified In Westchester County
��
Commission Expires Jandary 29.20_ (3)
6/1/2024
This application must be properly completed in its entirety by a N.Y. State Registered
Architect or N.Y. State Licensed Professional Engineer & signed by those professionals where
indicated. It must also include the notarized signature(s) of the legal owner(s) of the subject.
property, and the applicant of record in the spaces provided. Any application not properly
completed in its entirety and/or not properly signed shall be deemed null and void, and will be
returned to the applicant. Please note that application fees are non-refundable.
STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as.
,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. 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
f
Signature of Property caner Signature of Applicant
Ocoliq�
Print Name of Property Owner Print Name of Applicant
Notary Public Notary Public
SHARI MELILLO
Notary Public,State of New York
No.OIME6160063
Qualified In Westchester County
Commission Expires January 29.20 90
(4)
6r v2024
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ACC)o* CERTIFICATE OF LIABILITY INSURANCE "re mawww—M
03/2512025
THIS CERTIFICATE 18 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(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the
terms and conditions of the policy, certain policies may require an endorsemant. A statement on this certificate does not confer rights to the
cartiflests holder In lieu of such endomement(s).
PRODUCER
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CT AJC Insurance Agency PHONE _ 860 529-2182 Nal��_— 2 -
1850 Silas Deane Hway w_
PRODUCER ---'- --
Rocky Hill CT 06067 cueTsbttRlo� __
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�D NSURERA:UTICA FIRST INSURANCE COMPANY 5328
LUClRNO PERINOTO NsursR a:HARTFORD UNDERWRITERS INS.CO. 104
PERINOTO HOME IMPROVEMENT LLC — -
DiSURER C:
20 MAPLE RIDGE ROAD --------- -
TRUMBULL CT 06B11 rIN_SURERD: _ -
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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 REQUIREMEN7. 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.
TYPE OF INSURANCE POLJCY NU R —U EFF ----- Lam
A OEN»IAL l.IAaILRY 1 11/07/2024 11-07-20 j EACH OCCURRENCE i
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OESCMPTION OF OPERATIONS I LOCATIONS!VV MLES (Attach ACORD SM,Addrdw al Rwari,r schmdvta,It moms apwo in rp o
PAINTING CONTRACTOR
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POUCtEs BE CANCELLED @"ORE THE
EXPIRATION DATE TIEREOF, NOTICE WILL BE DELWERED IN ACCORDANCE wrIN THE
Village Of Rye Brook ►OUCY PROVISIONS.
938 KingStreet
AUTKORtZID REPRESEMTATNE
Rye Brook NY 10573
Paul Siquelre
V 1988-2009 ACORD CORPORATION. All rights reserved.
ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD
Clear NI
17-0-9k-\
NYSIF
New York State Insurance Fund PO Box 66699,Albany.NY 12206
1 nysif.com
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED)
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^^^^A^ 471282340
PERINOTO HOME IMPROVEMENT LLC
(CT LLC)
22 VITTI ST a s
NEW CANAAN CT 06840 SCAN TO VALIDATE
AND SUBSCRIBE
POLICYHOLDER CERTIFICATE HOLDER
PERINOTO HOME IMPROVEMENT LLC VILLAGE OF RYE BROOK
(CT LLC) 938 KING STREET
22 VITTI ST RYE BROOK NY 10573
NEW CANAAN CT 06840
POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE
W2569 700-4 255401 05/13/2025 TO 05/13/2026 6/8/2025
THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE
FUND UNDER POLICY NO. 2569 700-4. COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR
WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL
OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS
OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY
IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY, INCLUDING ANY NOTIFICATION OF CANCELLATIONS,
OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS:I/WWW NYSIF.COM/CERT/CERTVAL.ASP.THE NEW
YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS.
THIS POLICY DOES NOT COVER THE SOLE PROPRIETOR. PARTNERS AND/OR MEMBERS OF A LIMITED LIABILITY COMPANY
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE
COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER
THE COVERAGE AFFORDED BY THE POLICY.
NEW YORK STAT S7NCE FUND
/
DIRECTOR,INSURANCE FUND UNDERWRITING
VALIDATION NUMBER: 740369637
U-2f 3