HomeMy WebLinkAboutRB25-0098 Certificate of Occupancy, Certificate of Compliance,
and Certification of Final Costs Application Village of Rye Brook
938 King St Rye Brook, NY 10573
Phone: (914)939-0668 1 www.ryebrook.gov
Building Department
Project Information
Address of Project Parcel ID# Zone Description of Work Performed on Permit
45 Valley Ter 135.59-1-57 kitchen and bathroom
Occupancy/Use (1 Family, 2 Family 3 Family, Commercial?
1 family
Owner Address P.E./R.A.or Contractor Address Person in responsible charge Address
Final Total Cost of Project
28000
Certificate of Occupancy,Certificate of Compliance,and Certification of Final Costs Application,page 1 I 1
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f Interior Building Permit Application
Village of Rye Brook
938 King St Rye Brook, NY 10573
Phone: (914)939-0668 1 www.ryebrook.gov
Building Department
Project Information
SBL Zone Address Line 2
135.59-1-57 45 Valley Ter
Proposed Improvement
Kitchen and bathrooms renovation
Does the proposed project involve a
Home-Occupation as per§250-38 of
Village Code?
❑ Yes 0 No
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 0 No
N.Y. State Construction Classification N.Y. State Use Classification Occupancy Pre-Construction
VB 210 1 fam
Occupancy Post-Construction (1 fam., 2 fam.,comm.,etc...)
same
What is the total estimated cost of construction: (NOTE:The estimated cost shall include all labor, material,
28000 USD scaffolding,fixed equipment, professional fees, and material
and labor which may be donated gratis.)
Interior Building Permit Application,page 1/1
�y BR,nv� VILLAGE OF RYE BROOK
938 King St Rye Brook,NY 10573 �
Q Phone:(914)939-06681 www.ryebrook.gov
■
Building Department
Residential/Interior(Remodel/Renovation) Permit
Permit Set 45 VALLEY TER P#RB25-0098 R#135.59-1-57
PERMIT INFORMATION
Address Permit number Date issued
45 VALLEY TER RB25-0098 11/03/2025
REVIEWED BY
If you have any questions regarding the review of these drawings please contact:
Application in general
Steven Fews
stevefews@ryebrook.org
INSTRUCTION AND ATTENTION
It is the responsibility of the Applicant to print full size the entire approved permit package and provide at the time of inspection.
TABLE OF CONTENTS
Cover page 1
Building Permit 2
Required Inspections 3
Contractor's Workers Compensation Insurance(Showing Rye Brook Cert Holder 4-5
Certificate of Occupancy,Certificate of Compliance,and Certification of Final Costs Application 6
Interior Building Permit Application 7
Building Department.938 King St Rye Brook,NY 10573/Phone:(914)939-0668
�y BRnv� VILLAGE OF RYE BROOK
938 King St Rye Brook,NY 10573
W �
Q Y Phone:(914)939-06681 www.ryebrook.gov
-a0
��• 1 82• i Building Department
INSTRUCTIONS
THE PERMIT HOLDER AND/OR PROPERTY OWNER IS RESPONSIBLE FOR ENSURING THAT ALL REQUIRED/APPLICABLE INSPECTIONS ARE SCHEDULED AND THAT
THE PERMIT IS COMPLETE
o, a
a
REQUIRED INSPECTIONS
Name Description
Final Inspection Completion of all required items under the permit including the site grading and the surveyor's final grading
certificate.
Certificate of Occupancy Completion of ALL Work,All fees Paid and Final Survey in if required)
Rough plumbing Installation of all plumbing including drains,waste,vents and water supply lines.A test for this portion is
required including a 100 psi test on all water supply lines.
Rough Electric Rough Electric
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Electrical Permit Application Village of Rye Brook
938 King St Rye Brook, NY 10573
Phone: (914)939-0668 1 www.ryebrook.gov
Building Department
Project Information
SBL Zone
135.59-1-57
Proposed Electrical Work/Fixture Count 3rd Party Electrical Inspection Agency
3 Recessed Lights, 2-GFI Outlets-3-Switches,1-Mirror Light,
1- Exhaust Fan
Master Electrician/Licensed Installer Information
Name Lic# Address email Phone# Cell# Company Name Company Address
Ralph Diaz 3477643587 3477643587 RRK Electrical Inc
Address of Work?
Homeowner Information
45 Valley Ter
Electrical Permit Application,page 1/1
�y BR(�v� VILLAGE OF RYE BROOK
938 King St Rye Brook,NY 10573 �
W � �
Q Phone:(914)939-0668 1 www.ryebrook.gov I .
Building Department
Electrical/New Fixtures And Wiring(Remodel) Permit
Permit Set 45 VALLEY TER P#RB25-0120 R#135.59-1-57
PERMIT INFORMATION
Address Permit number Date issued
45 VALLEY TER RB25-0120 11/19/2025
REVIEWED BY
If you have any questions regarding the review of these drawings please contact:
Application in general
Steven Fews
stevefews@ryebrook.org
INSTRUCTION AND ATTENTION
It is the responsibility of the Applicant to print full size the entire approved permit package and provide at the time of inspection.
TABLE OF CONTENTS
Cover page 1
Building Permit 2
Required Inspections 3
3rd Party Electrical Inspection Form 4
Application Materials,Property Owner/Homeowner Government ID,and/or Proof of Ownership 5
Electrical License-Photo-Westchester County 6
Electrical Permit Application 7
Building Department.938 King St Rye Brook,NY 10573/Phone:(914)939-0668
4�y BR(�� VILLAGE OF RYE BROOK
938 King St Rye Brook,NY 10573
W �
Q Phone:(914)939-0668 1 www.ryebrook.gov
�O
��• b2• t Building Department
INSTRUCTIONS
THE PERMIT HOLDER AND/OR PROPERTY OWNER IS RESPONSIBLE FOR ENSURING THAT ALL REQUIRED/APPLICABLE INSPECTIONS ARE SCHEDULED AND THAT
THE PERMIT IS COMPLETE
E. - .o
REQUIRED INSPECTIONS
Name Description
Rough Electric Rough Electric
Final Electric Final Electric
BUILDING DEPARTMENT
VILLAGE OF RYE BROOK NOV 12
938 KING STREET RYE BROOK.NY 10573
(914) 9-0668
w%ti%N.ry6 'uukm.wv
ELECTRICAL PERMIT APPLICATION
Westchester County Master Electricians License Required
FOR OFFICE USE ONLY BP#: I I'
Approval Date: Permit Fee: S
Approval Signature: Other: I �`� �J� —' ' — 157
DO NOT START WORK or CONSI'Rt.CTION UNTIL A PERMII 11 \,% HF LN ISSUED Bti THE BUILDING INSPECTOR.
THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR( t t\ll'LF:TED WITHOUT A PERMIT IS 12%OF THE
TOTAL COST OF CONSTRUCTION WITH y MINIMUM FEE OF$750.00
Application dated, It— �Z'2 Y 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.
lb� `
1.Address: �" ` A LL e :'ems SBL: "Lone:
2.Property Owner: Address: g 14 m
Phone#: Cell a: email:
3.Master Electrician/Licensed Installer: l ti A ress: SO 3 r�1,.ls�e 1'
Lic.#: `1 7 P one Cell#: 3 T 7 ?�5 3e ail
Company Name: Y k-61'e rwe. L SW C Address:
4.Proposed Electrical Work/Fixture Count: 2j ' KPauSS LT S
- Sw� 1�ei �. - rnt>rrnr L,g,
5.3rd Party Electrical Inspection Agenc}:
STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as:
Vd I- ' n virk Z. ,being duly sworn,deposes and states that he/she is the applicant above named,and does further
t print name of ntdn tdual st inn the a leant
state that 00he is the // t t CC 14 for the legal o%%ner and is duly authorized to make and file this application.
I Master Electrician I sensed Installen
The undersigned further states that all statements contained herein are true to the best of his/her knowledge and belief,and that am work
performed,or use conducted at the above captioned property till he in conformance with the details as set forth and contained in this
application and in any accompanying approved plans and specifications,as tell as in accordance%%ith the New York State Iiniform Fire
Prevention&Building Code,the Code of the Village of Rye Bnnwk and all other applicable laws.ordinances,and regulations.
Sworn to before me this Sworn to before me this
day,of Q -t.�n ,20 a day of N�! e.1b� 20��
2W -Z-�
S171 a
re of Pr Owner Si nature of Applicant
F I k^W in VN a 1 1� b-14 Z
ame of Property Ow r r Name of Applican
Nohtr ..Public ibllc,State of New York Notary Publ$HARI MEULLO
!v .OIME6160063 iotary Public,State of New YoA/2024
ti.;u to Westchester County No.OIME6160063
Expires January 29,202-1 Qu;:Ufied in Westchester County
•:-Ission Expires January 29,20 Z—1
STATE WIDE INSPECTION SERVICES, INC.'
0•0 • •
SWIS •
Office Use Elect. Permit a Date
Bldg Permit a f✓fCz !Sr— 0 b Sq Ft
Plumbing Permit#
Final Certificate#
City r village t/✓� rop ZIp/V 5772 TB ding Dept. County I �l e S
Address [ j /1 L f p �/ Cross Street J Section Block _ Lot
Owner Name/Address(u different than above) h I/ M V \ Contact Number
[]Basement ❑ I st FL ❑2nd Fl. ❑3rd Fl. ❑More Than 3 Fl. ✓❑Garage ❑Attic ❑Outside Residential ❑Commercial
Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms pDetector Hood Trash Compact
Amt Amps
Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Generator Transfer Switch
SERVICE
Amperage #Panels 1P 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 Energy Storage System DC Disconnect
❑Legalization ❑ Safety Inspection ❑Consultation
?o ' �QCtSS L► 5h� t,
l- � ► rro r �-t �. 4-
This applKatio-s valid for one I i i year from the date received by SWI]i his appiication n intended to toyer the above listed items In be inspected.it at any time of inspecfton additional items have been installed,you en
authorized to make the inspection and adjust the fee for the additional items inspected The applicant derlares that tiw.e n on open applications for the above address with any other inspection company The applicarr
owner w authorized agent agrees to all the above terms and conditions as set forth for tthh—p�pliccation
Email AddressJZ t> I )q Z e'"'�+ Cc)Vie Name 1 �'
License# 1 (p Date 12,2 S' Signature '
Address v b Y City/State V�� -e Y Zip Code AQ s 0 g C7
Company Li I C Q C Phone = 3 - ! tO -J J J
I
Affidavit of Exemption to Show Specific Proof of Workers' Compensation Insurance
Coverage for a 1, 2, 3 or 4 Family, Owner-occupied Residence
"This form cannot be used to waive the workers'compensation rights or obligations of an)-pare."
Under penalty of perjury. I certify that I am the owner of the 1, 2, 3 or 4 family, owner-occupied residence
(including condominiums) listed on the building permit that I am applying for, and I am not required to shoe
specific proof of workers' compensation insurance coverage for such residence because (please check the
appropriate box):
❑ 1 am performing all the work for which the building permit was issued.
❑ I am not hiring,paying or compensating in any okay,the individual(s)that is(are)performing all the work
for which the building permit was issued or helping me perform such work.
i — I have a homeowners insurance policy that is currently in effect and covers the property listed on the
attached building permit AND am hiring or paying individuals a total of less than 40 hours per week
(aggregate hours for all paid individuals on the jobsite) for which the building permit was issued.
I also agree to either: j
♦ acquire appropriate workers' compensation coverage and provide appropriate proof of that coverage on
forms approved by the Chair of the NYS Workers' Compensation Board to the government entity issuing
the building permit if I need to hire or pay individuals a total of40 hours or more per week(aggregate hours
for all paid individuals on the jobsite)for%%ork indicated on the building permit.or if appropriate. file a Cb-
200 exemption form: OR
♦ have the general contractor, performing the work on the 1, 2, 3 or 4 family. owner-occupied residence
(including condominiums)listed on the building permit that I am applying for,provide appropriate proof of
workers' compensation coverage or proof of exemption ['Tom that coverage on forms approved by the Chair
of the NYS Workers' Compensation Board to the government entity issuing the building permit if the
project takes a total of40 hours or more per%eek(aggregate hours for all paid indn iduals on the Jobsite)for
work indicated on the building permit.
(Signature Hom
eowner) (Date Signed) /
k I Ionic Telephone Number v --1 -1-3 3 -q3 Z
(Homeowner's Name ri ed)
iSwern it lefere we this
Property Address that requires the building permit. u �l L
�.L� � O
• (C'ounryZ`Terk—o• Norory
SHARI MELILLO
t votary Public,State of New York
�1C No.OIME6160063
r � 2uaiaied in Westchester County
��b omm1551an Eiplrnc. I,�n!irt� c; 20
Once notarized.this BP-1 form sen es as an exemption for both%orkers'compensation and disahilits benefits insurance co%erage.
BP-I ( 12 OX) NYAVCB