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HomeMy WebLinkAboutDoc6771 PECEN f�L� BUILDING DEPARTMENT For office use onl `� VILLAGE OF RYE BROOK ISSUED #H -a _ J/ SEP 2 9 2025 38 KING STREET,RYE BROOK,NEW YORK 10573 DATE: - (914)939-0668 FEE: PAID VILLAGE OF RYE BROOK www.ryebrooknv.gov BUILDING DEPARTMENT N OR 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 •tifififffiiitiiiiiiiiiifiiiiiiiiiiififiitiiitiiiititififfitit•iiiftfiifii#iiffiiiffififiii/of/iiiftifitfi/ff/#ff•it/fttii## Address: d''��c•.✓ 1 /V S 3 Occupancy/Use: _ /� Parcel ID#: /3 J-. z7-I- q Zone: g- 15 Owner: Elk4h 4N.1 /��;fd //��� Address: SQ n..r P.E./R.A. or ContractorEc/FC-l2E Address:[,-R��Si Y,F7F 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 YORK, COUNTY OF WESTCHESTER as: Oe— /7� LG— _____being duly swom,deposes and says that he/she resides at 3 ��� Os'c�•o..J ^l (Print Name of Applicant) (No.and Street) in c f'3)-0ulc ,in the County of IAA-- A- in the State of N�,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:S 20v tX0 for the construction or alteration of: rlee r 6".c oF _Z:?s 26 EN CF 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 Cr 1yn Sworn to before me this day of ft nit ✓ , 20 2 j day of , 20 Signatm of Property Owner Signature of Applicant El V 4' /�L L t Name of Property Owner Print Name of Applicant Notary Public SHARI MEULLO Notary Public Notary Public,State of New York No.OIME6160063 Qualified In Westchester County Commission Expires January 29,20 Z� �QyE Mg) O i� W :E Y BUILDING DEPARTMENT ❑It LDING INSPF:CIOR ASSISTANT BUILDING INSPECTOR VILLAGE OP RYE BROOK 0 CODE IiNl-'ORCliMI?N'1'01-'I�ICIiR 938 King Street • Rye Brook, NY 10573 (914) 939-0668 FAx (914) 939-5801 www.y.gkf�(ok.urg - - - - - - INSPECTION REPORT - - - ADDRESS : �) �C _ DATE: �O 1►ERMIT# ' 2S — C)$ I Issul:n: y'LYl2rl�1CAr: / 2'� BLOCK• , l l,crr:-_� LOCATION: S.,A4eA l&-L fu-►a 0Ujl v J � _ OCCUPANCY:___,___. 0 Violation Noted 'Cut: wolm IS... I'AStiIiD ❑ FAILED / REINSPECTION ❑ SITI: INSPEA-1'ION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGI: ❑ FoUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ RoUGN PLUMBING ❑ Rou(m FRAMING 0 INSULATION ❑ Natural Gas T.►,s a v �.,. I O1, ❑ L R Gas ❑ FIRF SPRINKLER ❑ FINAL PLUMBING 0 CROSS CONNECTION )R-1'INAI. A1.A. ❑ �)'1'LII?R O - w � 1 ��OY '9t1? BUILDING DEPARTMENT ❑BUILDING INSPI CfOR ASSISTANT BU11.DING INSPECTOR VILLAGE ON RYE BROOK ❑CInn:IiNrnRCEM1:NT OFFICER 938 King Street • Rye Brook, NY 10573 (914) 939-0668 FAX (914) 939-5801 www.ryel ru k.Urg - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - A 11 m i:.ss ; 1 2--> o l A o(-" DATE: 10 -7- 20 II1:ItwII mP 2S— ),0-7 ISSUI.-Ax _ tiIc1: /35.27ItI.00K:... I Lo•r: f LOCATION: (&N O • 1. 00CUPANCY:,_.__,_._.__._._..___._.. ❑ Violation Noted 1'til WORK IS... tox,-)ASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE. ❑ FOUNDATION ❑ UNDt:RGROUND PLUMBING NOTFSON INSMiC,I'ION: ❑ ROLICII PLUMBING ❑ Rou(m FRAMING ❑ INSULATION ❑ Natural Gas (A C1 loan QQ E o e J,*, I,.P. Gas ❑ FUEL TANK ❑ FIRI'.SPRINKLER ❑ FINAL PLUMBING - - - - ❑ CROSS CONNECTION - �" FINA1. e. . E BRC�h BUILDING DEPARTMENT VILDING INSPECTOR SIS'1'AN•1'BUILDING INWEC-1.011 VILLAGE OF RYI BROOK ❑CODE I:NI+ORc:esn:N r(1r•r•Ic;1:R 938 King;Street • Rye Brook, NY 10573 (914) 939-0668 FAX (914) 939-5801 wwsv.rye hrook.o'rg INSPECTION REPORT - - - - - - - - - - AuuKr:ss : 1 -�) +�(� OcG� DA'1'P.: 1 O -7— ZOLS . PI�ItMrr# —O ISSUI:n: LOCATION: � (� - _._. OCCUPANCY: ❑ Violation Noted I'ul: W(IRK Iti... I'ASSI:D ❑ FAILED REINSPECTION ❑ SITI: INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGI, ❑ FOUNDATION ❑ UNDFRGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGII FRAMING ❑ INSULATION t 1 n ❑ Natural Gas �i� � �.t�t,+,���.� _ d.� �l JG� `yL�4y • ❑ L.R Gas ❑ FUEL TANK ❑ FIRI:SPRINKLIAt — 2"FINAL PLUMBING --- ❑ CROSS CONNL'CTION ❑ FINAL ❑ �)'1'lll�.li �QyE aRn�k. 1982• BUILDING DEPARTMENT ❑BBUILDING INSPECTOR d ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE FmIORCEMENT OFFICER 938 King Street•Rye Brook,NY 10573 (914)939-0668 FAx (914) 939-5801 www r-ebrook.org - - - -- - - -- - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS:- _Q I p rtl c,, � �Oo�.� DATE: PERMIT# Z>P 2 S _ ^ISSUED:, I.ISECT: 155. Z 7 BLOCK:._LOT: T LOCATION: ---1C.1 ,, G/LQ.4k_ OCCUPANCY: ❑ Violation Noted THE WORK IS... 42" PASSED ❑ FAILED /REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGII PLUMBING ❑ ROUGH FRAMING ;ar INSULATION ❑ Natural Gas tiS I J/ o,j ❑ L.P.Gas }� ❑ FUEL TANK --- ---- _- -_ N a V _ J ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION - ❑ FINAL ❑ THER JB Insulation&Drywall LLC I N S U LATI O N 56 Spruce Street,Oakland,NJ 07436 r Te1201.485.8990 Fax 201.485.8989 & O RYWALL Gerard@jB-Insulation.com JB-Insulation.com %"%,w.I B-1 nsulation.com I-JUL 2 1 2025 J VILLAGE OF RYE BROOK JULY 18, 2025 BUILDING DEPARTf-, ENT To: Rye Brook Building Department Re:Thermal Insulation- Insulation Certificate: 13 Old Orchard Road JB Insulation& Drywall LLC supplied and installed the following: Foam Work Area: Exterior Walls R-22 Closed Cell Spray Foam 3"Average Thickness Basement Foundation Walls R-15 Closed Cell Spray Foam 2"Average Thickness Please contact me with any questions at 201-615-2314. Ge.Ycwdi W&W /ecl Gerard Weiser Operations Manager yE DR(�j� 0 �m a � BUILDING DEPARTMENT ❑ISUIl.I)ING 1NNI•Ii(:'.1'OI( Zf'ASSIS'I".0 BUILDING INSPECTOR VILLAGE. OF RYE BROOK ❑COIDE ENPORCEMEWC OkNICER 938 KING STItI3ET• RYI?BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www.ry_e)mik ors - - - - - - - - - - - - - - -- - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS:_ (�- � L O Z,5— ISSUED:-- .----------SECT: LOT:- LOCATION: k I Q� Np (/s ib J OCCUPANCY: ❑ VIOLATION NOTED TH-13 WORK.IS... BACCLP7Y3D ❑ REJECTED/REuNSPECTION ❑ SITE 1NSPI:CTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING (VOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FIZ.AMING ❑ 1NSUL XVION \ ❑ N)v.rURA.I,GAS 1��► �_ �� Q� l��� � �e� ❑ L.P..GA.ti ❑ FURL TANK. ❑ FIRE SPRINKLER AD ❑ FINAL PLUMBING ❑ CROSS CONNECTION -- ❑ FINAL ,� oTIIEIi M•✓A .G BR(�� o 'y m 0Q 1982 BUILDING DEPARTMENT ❑B ILDING 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 uebrooLorg - - - - - - - - - - - - - - - - - -- - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS :_-) 3 �Ld-_ �r��' -C e•oowC� -- DATE: ? - 7 - Z O Z,5- PERMIT# !is- (1 8� ISSUED: SECT: 2-7 BLOCK:_LOT: LOCATION: , ���- � �~ �� 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 e NATURAL GAS j ❑ L.P.GAS IL ❑ FUEL TANK N a ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER �Qy6 BRC�� o 'y Q � /�• �9�2 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.ilebrooLorg - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : OLD ` (M d _ DATE: 7 ' / - Z O Z r PERMIT# SECT:2j� 27 BLOCK:_ LOT: LOCATION: _ _ OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... g 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 v ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER • a a. t a ti a t s � N N N o�G L a aG U W U' c. a Olt W n k Z f3 y p" � W c _ ►d �- O t 5 r—, 19 c �? re� Z o z � ; •--ice. .<� � N ,� � ". A ao o LL w N O R' a _ a4 J am, Ln s GC 00 ►� _ z7 CA .. u M z " w H z � Ca• � � t7� Li 2 � t. t� ,t �E , R[i CC IENE BUILDING P I MENT - 5 2025 VILLAGE OF RYE BROOK 938 KrNG STREET RYE BRooK,NY 10573 VILLAGE OF RYE BROOK (914)9 9 8 BUILDING DEPARTMENT \\%�Wfiftdokny.gQy ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required / FOR OFFICE USE ONLY BP#: EP#: O) — / q? Approval Date: JUN 9 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, 6—S 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 conforman a with all applicable Federal,State,County and Local Codes. 1.Address: 13 � I � c h 14�C SBL: IZ5. a 7 Zone: —� 2.Property Owner:: Q? 41OC17 Address: Phone#: SI& (O S9— -�30(11 Cell#: email: 22 3.Master��Electrician/Licensed Installer: J A I U,,�/ � U Address:2�J A��� S7— Lic.4P4 7 Phone#:_ /,y Cell#:q!'I 6-aZ 99 email: C V4 T�b4RlV e S V—/40/1 C:cfn Company Name:1�L Address: ZCd 3 AAKnleS S j oss'y'f ;r 4.Proposed Electrical Work/Fixture Count: 'F'jtLk�) I � 5.31 Party Electrical Inspection Agency: 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 si II the appl�nt)+ ���A n+ \ state that(s)he is the 1 a< i y IL'['Lfdr 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 regullatiins. Sworn to before me this Sworn to be a me this JvPjel day of 20 d of 20 Signature of Property Owner SiWatVre of App icant d-►a )Ae-� v Print Name of Property Owner Pr t e of A li ant I Notary Public Notar pSdAc of New York No.01ME6160063 6/1/2024 Qualified In Westchester County Commission Expires JanUary 29,20 STATE WIDE INSPECTION SERVICES, INC. Service With litlegrily ••• • • SWIS JOB APPLICATION •2.7224 1 fax 914.219.1062 1 SWISNY.coml SWISTRAINING.COM Office Use Elect. Permit Date / Bldg Permit# Y �� I Scl Ft(Q J Plumbing Permit# Final Certificate# City/Village � (Ocl zip Building Dept. County Address 13 0 I, OieC AQ 1 Cross Street Section Block Lot Owner Name/Address(If different than above) Contact Number ❑Basement E�qst Fl. ❑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 ❑ 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 Energy Storage System DC Disconnect ❑Legalization ❑ Safety Inspection ❑Consultation 1 1-17 JUN - 5 2025 VILLAGE OF RYE BROOK 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 asset forth for the application. Email Address C, VA I D}} ��S �.�C�`- Name Lj lv `1 oC(6, License# 2 7 Date ` ZpLs Signature Address�� A A S City/Stag/ ^C„�;s� Al y Zip Code / S—&Z Compan �A O P L ! Li � Phone# 7� v C _C)Z99 State Wide Inspection Services co" D � E- U V i� 1080 Main Street BFishkill, NY 12524 845 202-7224 Phone SEP 2 3 2025 914-219-1062 Fax STATE WIDE INSPECTION SERVICES Email: office@swisny.com VILLAGE OF RYE BROOK Website: www.swisny.com Service with Integrity BUILDING DEPARTMENT BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: Velardo Electric Inc. Ethan and Haleigh Hoch 203 Barnes Street 13 Old Orchard Road Ossining, NY 10562 Rye Brook, NY 10573 Located at: 13 Old Orchard Road, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP 25-148 135.27 1 q Certificate Number:2025-6343 Building Permit Number: BP 25-081 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: 13 Old Orchard Road, Rye Brook, NY 10573 The First Floor: Dining Room and Kitchen 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 18th day of September 2025. Name Quantity Rating Circuit Type Receptacles 21 Switches 10 Light Fixtures 03 Wall Fixtures 02 LED Luminaires 17 Recessed Lights 02 Range 01 50AMP Hood 01 Sub Zero 01 Refrigerator 01 Bervage Refrigerator 01 Microwave 01 Dishwasher 01 Disposal 01 Name Quantity Rating Circuit Type Sub panel 01 GFCl/AFCI Breakers 06 AFCI Breakers 05 a •if Officer: Frank 1. 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. Page 2 . , a i c 00 N = O N N Ln s t N c ti a 04 cn a -� z v� H A a C v F w _ a . a c H , A = O zJ ' 1.4 � F x LO on ~' ® o can Lin z A G C7 00 A z M x �? > n V ' "' 00 Z � a A q w z W pq pq � r, � a< � o � U H -� a z 8 C4 W z 9 � � w �- a OU D a a (0). A a 0 M a z < � a w „ d c R EC ENE 3D BUILDING DEPARTMENT JUN - 9 2025 VILLAGE OF RYE BROOK 938 K1NArREET RYE BROOK,NY 10573 VILLAGE OF RYE BROOK BUILDING DEPARTMENT PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP#: � PP#: Approval Date: Permit Fee: $ 3 �7_145 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, - - 1�_ 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: 1''3 00� 0'r_h 2 1�ol) SBL: �3�i a 7--�—y Zone:��� 2.Proposed Work: K , ---7' � 1�1,A-OU_d�44 3.Property Owner: 0 C LN Address: 13 [)I d ()��4 c 4 Phone#: Cell#: - email: 4.Master Plumber: VV-X U rr Address: T () U -) m o_'M k i s c J Lic.#: 23 Phone#( - I'A Cell#: !'-r �f - q Q email:Qg }�+i(tuQ PXu L yU j .(_� Company Name: n,��\ R�,4 Address ) Anx a- G yVl yv. KI gC� tiy INDICATE FIXTURES&LINES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: Location Water Urinals Drinking Sinks Showers Bath Laundry Domestic Fire Sanitary atura Other* Total Closets Fountains Tubs Tubs Service Service Sewer as Basement 1st Floor I 2nd Floor 31 Floor 41'Floor 5d'Floor Exterior 5.*List Other Equipment/Provide Details: (Notarized Signatures Required Next 2 Pages) -1- 6/1/2024 FATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: x',/ a r'Ci cr�` � being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and further states that(s)he is the Master Plumber for the legal owner and is duly authorized to make and file this application. That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to before me this Sworn to before me this q day of h ,20 day of 20,( a � Signature of Property Owner enature of Applic t Print Name of Property Owner Print Name of Applicant ofary P b tc Not M,RNERA GR GORY M.RNERA Udag Notary Public,State of New York Notary Public,State of New York No.01 RI6441398 No.01 R16441398 Qualified In Westchester County Qualified In Westchester County Commission Ex Ices September Commission Expires September 26, This application must@ erly 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 and/or not properly signed shall be deemed null and void and will be returned to the applicant. -2- 6/l/2024 BUILDING DEPARTMENT VIL�AGE OF RYE OOK mi , UN - 9 2025 A DD 938 KG T ET RYE BRb; NY 10573 a -0l�� ! 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: 0 u12 �h 1� -Cl.N , residing at, 1 0 I' 0,.(In7V d 2 J (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; 13 Ulf v:1n7. ) Zcad 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. ZZ&& (Signature of Property Owner(s)) C� (Print Name of Property Owner(s)) Sworn to before me this day of , 20 (Notan P ' o GREGORY M.RNERA Netary Public,State of New York No.01 RI6441398 Qualified In Westchester County ' Commission Expires September 26,204 6itno24 A f l Ui N � L r Ln C N W ` N N o- a _ = W O _ a w A z a pC = 041 O M "'� Z � O r z z ram, � aa•o � p = E- Lr _f' z W C E � v r T . � per/ `; < •-+ G E"� o� r .^ �` �' °�' a C = ■ h+■1 _. w C p wk � wE W r ► 1 _� v oc 41 C r r .r ` I + 07 ■ A � 3 p w o F8 = � 'y � �' �� a � M z x w z .. C4 �•� : • 0 72 BUILDI DEPARTMENT D E C E V E VIL AGE OF RYE OOK DD 938 KING OET RYE BROID ,NY 10573 JUL - 9 2025 � .eov VILLAGE OF RYE BROOK BUILDING DEPARTMENT APPLICATION FOR PERMIT TO INSTALL AND/OR REMOVE HEATING, VENTILATION AND/O R A I R CONDITIONING EQUIPMENT FOR OFFICE USE ONLYyy PERMIT#: lh���C)7 Approval Date: JULAV* Permit Fee: $ QQ( — Approval Signature: Other: 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 REQUIREMENTS FOR RELEASE OF PERMIT&CERTIFICATE OF COMPLIANCE: 1. Properly completed&Signed Application. 2. Site/Staging Plan if Required by the Building Inspector. 3. Copy of Licensed Contractor's Liability Insurance. (Village of Rye Brook must be listed as certificate holder) &Workers Compensation Insurance on a NYS Board form(Form#C105.2 or Form#U26.3/or NY State Workers Compensation Waiver) 4. Payment of Fees/Unit: RESIDENTIAL=$200.00/unit • COMMERCIAL= $450.00/unit. 5. Complete specifications for each unit being installed. 6. Inspection by the Building Department for removal and/or installation. (48 hour notice required 7. Electrical work requires a separate Electrical Permit&Electrical Inspection. 8. Plumbing/Gas work requires a separate Plumbing Permit&Plumbing Inspection. Application dated, 7 cS_ is hereby made to the Building Inspector of the Village of Rye Brook for a permit for the installation and or removal of the HVAC equipment as listed below.The applicant and property owner,by signing this document agrees that said equipment will be installed and/or removed in conformance with all applicable Local,County, State&Federal laws, codes,rules and regulations. - I 1. Address: �I �� G.r�_ \ SBL: a 01 rI- Zone: 2. Property Owner7 140c�i 4FI A'c 11 Address: / -3 (--)(d rCC C�-I'c- Phone#: Cell#: email: 3. Contract Address: 4c_� >c,.. .A� A,5, Phone#:(N U�-C-�rf LZ 7 Cell y -51 email_�C_I o('zI 4. Scope of Work:New Installation( )•Replacement( )• Removal( )•Other( ): :�� i'C'- \C C_C_C_� 5. List Equipment: /� A 6. Location of Equipment: N A 7. Method of Installation/Removal(list all equipment needed to perform job): ot t 6/1/2025 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 Heating,Ventilation and/or Air Conditioning Contractor for the legal owner and is duly authorized to make and file this application. That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to before me this Sworn to before me this I day of ,20 day of �� 20 Signature of Property Owner Signature of Applicant :::4, 4 OA Print Name of Property Owner P n e of Applicant Notary Public Notary Public SHARI MEULLO Notary Public,State of New York No.01ME61ON63 Qualified in Westchester County Commission Expires January 29,20?-7 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. 2 6/1/2025 Building Permit Check List&Zoning Analysis Address: 12) 010 C C SBI_ j 0 — Zone: �1'�S U e: Const.Type: Other. Submittal Date: 2S Revisions Submittal Dates: Applicant: VA \ - Nature of Work: �10 c k c- 1 4o t c J__)42_j__j dV0. S Reviews:ZBA: PB: BOT: Other. NEED OK ( r"ES:Filing. \00 C/O: Flood Plane: Legalization: ( ) ( �/ PP: Dated:__jz�—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: ( ) (L,�,4LANS:Date Stamped: Sealed Copies: Electronic Other. License: Workers Comp: Liability Ca�� er, Other. CODE 7S3#: Dated: N/A: HIGH-VOLTAGE ELECTRICAL:Plans: Permit: N/A: Other. LOW-VOLTAGE ELECTRICAL.Plans: Permit: N/A: Other. FIRE ALARM/SMOKE DETECTORS:Plans: Permit: H.W.I.C.:_Battery:_Other. (� ) PLUMBING:Plans: Permit: Nat.Gas: LP Gas: N/A/: Other. ' ( ) � ) FIRE SUPPRESSION:Plans: Permit: N/A: Other. H.V.A.C.: Plans: Permit N/A: Other. ( ) ( ) 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. (k 'ARB mtg.date: Z�k \1, 7_ approval - 16- 'L notes: ( )ZBA mtg. date: approval:- notes: ( )PB mtg.date approval.• notes: APPROVED REQUIRED FJQSTING PROPOSED NOTES Date: APR 2 2 2025 Area: Circle: Frontage Front: Front: Sides: Rear. Main Cor. Accs.Cor. Ft.H Sb: Sd.H Sb: GFA: Tot in: Ft.ImR: Pg&jW. Height/Stories: notes: Residential Building Permit Fee Work Sheet Permit#: Date Issued: SBL: Zone: Address: Property Owner& Contact Info: Job Description: For all new dwellings and for additions measuring 800 sq. ft. or more made to existing dwellings, the following fee schedule shall apply: (plus any alteration fees) Total Sq. Ft. (excluding basements)x $300.00 x $I8.00/$I,000.00 Basement Sq. Ft. x $65.00 x $I8.00/$I,000.00 -------------------------------------------------------------------------------------------------------------------- New Construction Sq.Ft. • New Construction Cost • Building Pemit Fee Basement= sq.ft. x$65.00 = $ x$I8.00/$I,000.00 = $ Attached Garage= sq. ft.x$300.00= $ x$I8.00/$I,000.00 = $ I,Fl. = sq. ft.x $300.00= $ x $I8.00/$I,000.00= $ Z°'Fl. = sq. ft. x $300.00 = $ x $I8.00/$I,000.00 = $ Y Fl. = sq. ft.x$300.00= $ x$I8.00/$I,000.00= $ 4,h Fl. = sq. ft.x$300.00= $ x$I8.00/$I,000.00= $ Tota1Sq,F,r,T. 8 A� + sq. ft. Total Cost= $ Total B.P.Fee= $ • Total Amount Paid = $ Total Amount Due = $ Date: Signed: . BUILDING DEPARTMENT D L v . VILLAGE OF RYE BROOK MAR 31 2025 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 VILLAGE OF RYE BROOK www.rvebruAiiiy.Eov BUILDING DEPARTMENT ARCHITECTURAL REVIEW BOARD CHECK LIST FOR APPLICANTS This form must be completed and signed by the applicant of record and a copy shall be submitted to the Building Department prior to attending the ARB meeting. Applicants failing to submit a copy of this check list will be removed from the ARB agenda. Job Address: 13 Old Orchard Rd Rye Brook 10573 Date of Submi s / Parcel ID#: 135.27-1-4 Zone: R-15 Proposed Improvement(Describe in detaii): 1 st Floor interior renovations and alterations APPLICANT CHECK LIST: New kitchen renovation with exterior window MUST BE COMPLETED BY THE APPLICANT and door alterations at rear side of dwelling. The following items must be submitted to the Building Department by the applicant-no exceptions. Ethan & Halei h Hoch 1. (✓j completed Application Property Owner: 9 2. OTwo(2) sets of sealed plans. (one full size Inhammurn Address: 13 Old Orchard Rd Rye Brook 10573 allowable plan size=36"x 42") and one 11"x1T') Phone# 516-659-2306 3. V/f Two(2)copies of the property survey. 4. 0 Two(2) copies of the proposed site plan. Applicant appearing before the Board: 5. ( One electronic/disc copy of the complete application materials. John Seavelli, PE 6. �-i1inQ Fee. Address: 2875 Route 35 Katonah NY 10536 7. Any supporting documentation. l /� 8. - A approval letter. (if applicable) Phone# 914-487-7580 9. hotographs. p Architect, 10 ngineer: ,John ScaVelll, PE I . Samples of finishes!color chart. (a sample board or Phone# 914-487-7580 model may be presented the night o the meetinv By signature below, the owner/applicant acknowledges that he/she has read the complete Building Permit Instructions& Procedures, and that their application is complete in all respects. The Board of Review reserves the right to refuse to hear any application not meeting the requirements contained herein. Sworn to before me This Sworn to beiore me this day of M1 I 1 , 202 day of CV C , 20 J V Signature of Proper C1N ner y#� tive'of Applicant �4 �I i I � L, 14 �j, lljonn �cavelll, rt Print Name of Property Owner _ Print Namee of Applicant e <zC���i` Notary u c Notary Public GREGORY AL RIVERA III STEPHANIE A SCAVELLI Notary Public,State of New York Notary Public•State of New York No.01R16441398 NO.01S00029215 Qualified in Westchester County Qualified In Westchester County My Commission Expires Sep 26, 2028 Commission Expires September 26,2 6t1t2024 Village of Rye Brook ML MR O� yAgends FB SE Architectural Review Board Meeting AC AD j Wednesday,April 16,2025 at 7:30 PM j Village Hall,938 King Street JM SF 1. ITEMS: 1.1. ARB25-032(Consent Agenda) Thomas Commons&Nicole Pelosi 391 North Ridge Street 4'high black chain link fence and black aluminum gates. 1.2. ARB25-033 (Consent Agenda) Christopher Pascuma&Julie Pascuma 2 Latonia Road 6'high white vinyl fence and gates. 1.3. ARB25-034(Consent Agenda) Min Sik Pang&Gui Suk Pang Yeon 7 Maple Court Legalize patio. 1.4. ARB25-035(Consent Agenda) Christopher Light&Emily Light 7 Bishop Drive South 6'high white vinyl fence and gate. 1.5. ARB25-036 (Consent Agenda) Michael Gorman&Alysse Schumacher 4 Magnolia Drive Rooftop solar array. 1.6. ARB25-019(Consent Agenda) (Amendment to Approved Plans) Michael Fisher&Jaclyn Fisher 108 Country Ridge Drive 4'high white vinyl fence and gates. 1.7. ARB25-014(Consent Agenda) (Amendment to Approved Plans) Joseph Bradford&Amanda Bradford 304 Betsy Brown Road 6'high chocolate woodgrain composite fence. 1.8. ARB25-037 (Consent Agenda) Scott Levy&Nicole Levy 42 Meadowlark Road Re-do and extend existing patio with bluestone. 1.9. ARB25-038(Consent Agenda) Olfer Danilo Mendieta Saraguro 227 Irenhyl Avenue 4'&6'high white vinyl fence. Page 1 of 5 Architectural Review Board April 16,2025 1.10. ARB25-004(Consent Agenda) (Amendment to Approved Plans) Arun Acharya&Bhargavi Panjala 16 Country Ridge Circle Window and door changes,interior alterations. Consent Agenda Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.11. ARB25-039 Michael Weinberg 505 Comly Avenue Enlarge existing deck. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.12. ARB25-040 Marianne Landa Chao 6 BelleFair Road Rear deck. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.13. ARB25-041 Washington Park Plaza Associates LLC 275 South Ridge Street New signs,"Blackstones Steakhouse&Fusion" Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes Page 2 of 5 • Architectural Review Board April 16,2025 1.14. ARB25-042 Ethan Hoch&Haleigh Hoch 13 Old Orchard Road Rear window&door changes and interior alterations.Approvals: Motion�WI Second m 9 Abstention Aye; J Nay; Adjournment; Notes TT 1.15. ARB25-043 Joshua Blackwood&Gretchen Blackwood 6 Dorchester Drive Legalize new wall and extension of existing patio. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.16. ARB25-044 Creighton Cray&Julia Gans 5 Talcott Road Replace rear deck in kind. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.17. ARB25-045 Jamie Billington&Kara Billington 6 Bonwit Road New rear deck and patio. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.18. ARB25-046 Evan Haskell&Sabrina Haskell 22 Red Roof Drive Rear window&door changes and interior alterations. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes Page 3 of 5 Architectural Review Board April 16,2025 1.19. ARB25-047 Daniel Marks&Yael Marks 18 Hillandale Road New deck,renovate existing deck and extend patio. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.20. ARB25-048 Marc Testerman&Kristin Testerman 3 Sunset Road In-ground swimming pool and re-locate existing shed. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.21. ARB25-049 Francisco Lopez Calderon 30 Brook Lane Second floor addition and interior alterations. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.22. ARB25-050 Rohit Sharma&Lovleen Sharma 64 Rock Ridge Drive Second floor addition,new deck and interior alterations. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes Page 4of5 Architectural Review Board April 16,2025 1.23. ARB25-051 Michael Varela&Joan Varela 21 Wilton Road In-ground swimming pool and patio. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.24. ARB25-052 Michael Cohen&Allison Cohen 34 Woodland Drive Change existing vinyl in-ground swimming pool to gunite,add spa and reconfigure patio. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes NEXT MEETING: May 21,2025 Page 5 of 5 RESIREAL DESIGNS Architecture & Engineering Services For Homes Village of Rye Brook Building Dept. y56 MlIg--streer Rye Brook, NY 10573 SUBJECT: i3 Old Orchard Road Rye Brook vY iv 7.— O'v1r'NER AU T i iv^RiZATiOiV to wnorn it may concern, I, -E+La, H, ` , as the owner of 13 Old Orchard Road Rye Brook- NY 10'573, aUtllorize John M. Scavelli, PE of nesneal Designs to sei ve as the agent/applicant in submitting the Architectural Review Board / Building Permit Application to the village or Kye brooK on my oenair. Note: It is the responsibility of the homeowner and/or contractor to schedule all required inspections with the Town, and to complete all related Certificate of Occupancy/Compiiance paperwork to close out the permits. All related fees due to Authorities Having Jurisdiction are the responstoiniy or the nomeowner. Very Respectfully, Owner Signature: Date: �12c s— un oenair or the owner aoove, tnanK you. Sincerely, John M. Scavelli, PE Jrvi--) cngi lee[ii IV,--)ervice5, r- ResReal Designs John@resreal.com www.r esr eaal.corn, State of New York Professional Engineering License #095178 914.487.7580 1 ResReal.com 1 2875 Route 35, Katonah, NY 10536 it-III RESREAL DESIGNS Architecture & Engineering Services For Homes Village of Rye Brook Architectural Review Board Picture Report Property Address 13 Old Orchard Road Rye Brook NY 10563 GIS SITE LOCATION 13 OLD ORCHARD ROAD k � po 4 • . �+ 8 , �' rot FRONT STREET VIEWS 13 OLD ORCHARD ROAD 4 ' 41 i, y. ----1--� ■ " ' os 3 e i A F � 1 r rfYe i r !19, `ry. _ � 4 fly l JIM •l�f, dry a ��� ~�• �. ,.� 77 - _ - f•�i ail �� r HOUSE TO THE LEFT 15 OLD ORCHARD ROAD �T •.�� its_.:_}r + ly, :1 �y�, ' '�h. J •� FYI 'xw+t HOUSE • THE RIGHT 11 OLD ORCHARD RD r,. . `''#1' fit: - "� >jPR+ld►+'� ;�," �• i r 'Iki11�M�•a•'uur.... '"� ?�' a' .l+s•• �r- .41f .bra "� `, � � i �•Fr"'�1sd Tl�q �, •tail ��'i,. r HOUSE ACROSS STREET CROSSWAY • C p mow M' . .sir ,�� _ .. - i�.r• . N •'T�f • Exterior MAI i ME, w ;, 4 d.44 ........... E3 EXISTING REAR ELEVATION I♦n�l\..NxN VI VMI\I I\nx Wl rnll\..a V fl a. uxr lust�\u utu.��u ruNm..r.N m141 Sa+m01 AC8& bUMMMWAMMMW C= ® '' \ ,.]L pV.xIW.4 LVL\I NUIN•_ pp n u.,NNN..I Nml v.\u u nua. u.r lu.uam u�.��.l�nl r 1\n u�w nulx��ava naw un\.ru Lunr\ PROPOSED REAR ELEVATION E4,`SCAM v,.=,.,., EXTERIOR Azek Window/Door Trim and Corner Boards White-Match Existing Home WINDOW Pella 250 Series n r Shoo I:a I Pe tar 250 5r r Pei,250 SeIN•C,••m,nt W.ndow, PELLA, 260 SERIES Vinyl Casement Window A ***** .467 k, it.. 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Laura Petersen From: Ethan Hoch <ethan.hoch@gmail.com> Sent: Thursday, April 24, 2025 2:09 PM To: Anna Keri; Laura Petersen Cc: John Scavelli Subject: RE: Contractor License - Insurance - 13 Old Orchard Rd Confirmed to both. On Apr 24, 2025 at 1:55 PM -0400, Laura Petersen <LPetersen(c)rvebrookny.gov>,wrote: Good afternoon, The application states the estimated cost as $120,000.00 and the contractor as Scott Simonsen from Old World Craftsmen. Please confirm the estimated cost is $127,000.00 and the contractor is Robert Colangelo from Benessere Builders. Thank you Laura Laura(Petersen Office Assistant Village of Rye Brook 938 King Street Rye Brook, NY 10573 (914)939-0668 From:Anna Keri<anna@resreal.com> Sent:Thursday,April 24, 2025 12:48 PM To: Laura Petersen<LPetersen@ryebrookny.gov> Cc: Ethan Hoch<ethan.hoch@gmail.com>;John Scavelli<John@resreal.com> Subject:Contractor License- Insurance- 13 Old Orchard Rd Hi Laura, Please see the attached contractor license and insurance certificates.The owner-Ethan will drop off the check this afternoon or tomorrow. Do you need any hard copies of any items mailed out for the building permit? Thank you, Anna Keri Office:914.487.7580 Email:Anna@ResReaI.com Web:www.ResReal.com Address:2875 Route 35 Katonah NY 10536 <image001.png> From: Laura Petersen<LPetersen@rvebrooknv.gov> Sent:Thursday,April 24, 2025 11:59 AM To:ethan.hoch@gmail.com Cc:John Scavelli<John@resreal.com>; Scott Simonsen<scott@oldworldcraftsmen.com> Subject: 13 Old Orchard Road - Building Permit Application 1 t � •r'' 9't � a. s• ��( : s• A '. s �. `fir- � �'s.-. w ,1 �'�» ,.'-h,��•hl��llra -� ��4/1,� � I,r) ,�,�. _ }` �,I�ili/ 141111ii.. 1 J<(0)).^,^'� �•:.%' 1�li 'S,1 r91c Il�iil�r`g a9c sS 4'T'hl��llj 3r S$ 1• h 'i�Lr_ �y^3tT�1 I...d�+,�b�� 1b 1/1 Ill:i:�oe`�sit}Zt III1 Ir.. I _ al: d pp+ A 04 04 O 000 Ix A ( = -, Is 2ri b ` . _ Ln C. un J U° n . � c� r—' w z �a-ection _ C U Z In o.: p cn i 11(0)It uiy , s ` > cn _l U = PG �G Z� to cnw ire ap ww o z - m m CN '' ns z z t O n (o)>y Utco)� '� a� ► w ti C) \ 4 °fi 1~ rj •�1h5 'r'c�ilN'If +Tgg` 1 ;c ."' maw �ttl `rd 'ins ' v }Ai° �• f li �. #lt � ACo03/20//2025 Y) ® CERTIFICATE OF LIABILITY INSURANCE DATE(M 025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Matthew Pollichino NAME: American Risk Advisors Inc. PHONE Ext: (516)388-5600 FAX No (516)388-5656 510 Broadhollow Road E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Melville NY 11747 INSURER A: Sutton Specialty Insurance Company 16848 INSURED INSURER B Benessere Builders LLC INSURER C: 13 Justine Court INSURER D: INSURER E Briar Cliff Manor NY 10510 INSURER F COVERAGES CERTIFICATE NUMBER: CL24121820646 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 CONTRACTOR 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 POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER I MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ❑X OCCUR DAMAGE TO RENTED 50,000 PREMISES Ea occurrence $ MED EXP(Any one person) $ 10,000 A SC01000000214-00 09/23/2024 09/23/2025 PERSONAL BADVINJURY $ 1.000,000 GEN'LAGGREGATE LIMITAPPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY ❑ PRO- ❑ JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER Employee Benefits $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N PER ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Village of Rye Brook is included as additional insured on a primary and non-contributory basis for ongoing and completed operations including waiver of subrogation when required by written contract. CERTIFICATE HOLDER CANCELLATION 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. 938 King Street AUTHORIZED REPRESENTATIVE Rye Brook, NY 10573 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD NYSIF New York State Insurance Fund PO Box 66699,Albany,NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED) A A A A A A 813014974 PAYCHEX INSURANCE AGENCY INC ATTN P&C DEPARTMENT NMIM. , 225 KENNETH DR STE 100 ROCHESTER NY 14623 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER BENESSERE BUILDERS LLC VILLAGE OF RYE BROOK 13 JUSTINE COURT 938 KING STREET BRIARCLIFF MANOR NY 10510 RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W2518 824-4 838366 07/15/2024 TO 07/15/2025 3/20/2025 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO, 2518 824-4, 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://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 AFFORDS COVERAGE TO THE SOLE PROPRIETOR, PARTNERS AND/OR MEMBERS OF A LIMITED LIABILITY COMPANY. ROBERT COLANGELO OWNER/MEMBER LLC THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STAT SUR NCE FUND T �V DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 290100898 U-26.3 A�Q� DATE(MM/DD/WYY) CERTIFICATE OF LIABILITY INSURANCE 09/12/2024 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). CONIACII PRODUCER NAME: CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY PHONE FAX HOME OFFICE: P.O. BOX 328 (A/C,No,Ext):888-333-4949 IA/c,No):507-446-4664 OWATONNA, MN 55060 E-MAIL ADDRESS:CLIENTCONTACTCENTER FEDINS.COM INSURERS AFFORDING COVERAGE NAIC# INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED INSURER B: DONALD CREADORE AIR CONDITIONING CO INC INSURER C: 177 HARRISON AVE HARRISON, NY 10528-4327 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 74 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 SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD MMIDDIYYYY MM/DD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS-MADE I X OCCUR DAMAGE TO RENTED PREMISES $100,000 `J (Ea occurrence) X BUSINESS OWNER'S LIABILITY MED EXP(Any one person) A N N 9366490 10/15/2024 10/15/2025 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2 000,000 X POLICY r7PRO- ❑ OTHER: LOC PRODUCTS&COMPIOP ACC $2,000,000 ��JJ��" AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per Person) A OWNED AUTOS ONLY SCHEDULED N N 9366491 10/15/2024 10/15/2025 BODILY INJURY(Per Accident) UTOS HIRED AUTOS OWNLY NON-OWNED PROPERTY DAMAGE AUTOS ONLY (Per Accident) X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $1,000,000 A EXCESS LIAB CLAIMS-MADE N N 9366493 10/15/2024 10/15/2025 AGGREGATE $1,000,000 DED I X IRETENTION$10,000 WORKERS COMPENSATION AND EMPLOYERS'LIAB LITY YIN PER STATUTE OTHER ANY PROPRIETOR/PARTNERI EXECUTIVE E.L EACH ACCIDENT OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L DISEASE EA EMPLOYEE If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION VILLAGE OF RYE BROOK 74 0 938 KING ST SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED RYE BROOK, NY 10573-1226 BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE r _ © 1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD NYSIF Neenr York State Insurance Fund PO Box 66699.Albany.NY 12206 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ^^A^^^ 132831826 L F N-4 LEVITY-FUIRST ASSOCIATES LTD520 WHITE PLAINS ROAD.2ND FL : TARRYTOWN NY 10591 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER DONALD CREADORE AIR CONDITIONING VILLAGE OF RYE BROOK CO INC 938 KING STREET 177 HARRISON AVENUE RYE BROOK NY 10573 HARRISON NY 10528 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD �T DATE G 1250 720-8 38620 06/29/2024 TO 06/29/2025 8,16/2024 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSLRANCE FUND UNDER POLICY NO. 1250 720-8, 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 I'VD!CATSD BELOW IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY, INCLUDING ANY NOTIFICATION OF CAN"ELL.ATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HT'FPS:IAVWW.NYSIF.CCMICERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE:FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NDN YORK STATE/fNLSJRR NCE FUND v DIRECT OR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER:949429929 ii oFv