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Home My WebLink AboutMP11-048 DRC� K / G LCV°,�Ji t VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A.Klein (914)939-0668 Christopher J.Bradbury www.iyebrooUy.g_ov TRUSTEES BUILDING & FIRE INSPECTOR Susan R.Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE December 16,2024 Paul Garofalo&Karen Garofalo 3 Beacon Lane Rye Brook,New York 10573 Re: 3 Beacon Lane, Rye Brook,New York 10573 Parcel ID#: 135.58-1-10 This document certifies that the work done under Mechanical Permit#11-048 issued on 11/21/2011 for the installation of a gas fired boiler and water heater has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to �yE BRC�� 1. cu � 19812 BUILDING DEPARTMENT ❑BBILDING 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 - - - - - - - - - - - - - - - - - - - - ADDRESS : -:21�, -C cC a DATE: �( PERMIT# � � ' ISSUED: t('2 1- 1r SECTAQ-4� BLOCK: LOT: LOCATION: "� �� Cp 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 ❑ L.P. GAS Vv , ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER QyE BRC�v� • 1932 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.org - - - - - - - - - - - - - - - - - - — — INSPECTION REPORT — — — — - - - - - - - - - - - - - - - - ADDRESS : 3 DATE: -- PERMIT# l ISSUED: SECT: 135 S BLOCK: LOT: LOCATION: OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... CrACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ' ❑ L.P. GAS (' > Goy NP C'- c ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER 41 ti t`'ccS.fu�,iv BR Qu l�`cuu`ivy 190 VILLAGE OF RYE BROOK MAYOR 938 King Street,Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J.Bradbury www.ryebrook.org TRUSTEES BUILDING & FIRE INSPECTOR Susan R.Epstein Steven E. Fews Stephanie J. Fischer David M.Heiser Salvatore W.Morlino December 3,2024 First Notice Via Mail. Dear Rye Brook Permittee, Mr.&Mrs. Garofalo 3 Beacon Lane. Rye Brook,New York 10573 It has come to the attention of the Building Department that your Mechanical Permit MP 11-048 and Plumbing Permit PP 11- 094 has not been closed out in accordance with Village Code and is now expired.All Permits have a twelve (12)month lifespan starting from the date of issuance,and the permit expiration date is noted on the front of the permit. Please note that we are trying to clean up old files which are open and stagnant.Clearing up the permit will benefit you as the homeowner in two ways. (1)getting the final inspection of the work. (2) for in the future should you sell your home you will not have any open permits in your file.Please contact us so we can schedule a site visit to take care of this matter. Please be advised that it is a violation of Village Code to fail to close out a permit,and that a court summons could be issued. Thank you for your attention in this matter,and please feel free to contact this office should you require any further information. Steven E. Fews Building&Fire Inspector sfews@ryebrookny.gov cc:Alfredo DiVitto,Assistant Building&Fire Inspector Tara A. Orlando,Planning&Zoning Secretary Laura Petersen,Office Assistant _ E E � Oo E � 0000 W U kn OC) 00 x � w A., z �n0 Aq o a Ao E a+ ►--� w � � z � x o a a aa � � � z o � Ah a °� � zpaA W O w E BUILDING DEPARTMENTS`, 1 { F VILLr C OF RYE`RROOK L i f 1 66 938 K>•NG S,, RYE B> o [c,NY 10573 (914)93.9 '90 '(9]?t)939-5801 VILLAGr C Www:�o?Srook.org BUILDING ;� _ :� ''' ��Nl PLUMBING PERMIT APPLICATION *MUST BE FILED B Y A LICENSED MASTER PLUMBER ONLY* Date: !/ 1� 7 �!/ Plumbing Permit#: ^ �. H t'er Fee: .. Approval Signature: (fees are non-refunda leb ) Application is hereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of a Permit to install Plumbing as per detailed statement described below, and in accordance with all applicable Federal, State, County and Local Codes,at the following location: c Address: co Y-,N Cc. L Pn z_ Phone#: ( / 7 , 6 ( :1 - 3 Owner: QP o r rr 10 Address & Phone: Use/Occupancy: iq t;0 S 2. Parcel I.D.#: Zone: LICENSED MASTER PLUMBER'S INFORMATION: / Name(please print): �� A 7T He � (� 0 ` 1ls v Phone#: �/ I L 7 3 1917 Signature: 11�L;ee- Westchester County License#: %0 T Company Name: W v L 1 l� i,�c 6 (N ' + L rc _ +� ' 1 u C Company Address: / 7 A 4 vt e City/Town: t l&a f f • S C State:--f—Zip Code: rU Phone#: 6)l y (' - 0 �- ...................................................................................... FIXTURES&LINES ARE TO BE INSTALLED ACCORDING TO 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 Outside i I i // *Other: To S Y-�_ t C 1 H �.P ,�/ ��S 0 1 CSC"_ ;'2 :.. ,,CJ o� �r,^S �, ; c d C✓f^ -� � !tea�� -- �y TLt �-t-� etailed Description of Appliances etc...: ��o �. `T �" �► �" C e SC-) 04 LC 0 CA, Westchester County Board of Plumbing Examiners Westchester County Clerk's Office Master Piumbing License 2011 Matthew Kolb D.O.B: 11/27/1969 Height:6'00 Weight:170 Hair: Brown Eyes: Blue Company: Kolb Pig and Htg Inc 17 Danner Avenue Harrison,NY 10528 License No. 1099' Expires on:12/31/2011 Mark R.Courtien 11/18/2011 11 : 10 FAX 001/002 STRATI FAIR Qi STEPHEN SULES AGENCY INC* * * TEL: (914) 997-2525 INSUY.NCE Auto-Life-Health-Home and Business °° RARTMALE� AVE.- -]--*AGENT:' 'Stephen Sules FAX: - 5 HARTSDALE, NY 10530 1 *OFFICE Licensed Representative: Cathy Gallagher November 18, 2011 --------------------------FAX$ 914-997-9825---------------------------------- PLEAS DELIVER THE FOLLOWING PAGES TO: NAME: C FIRM: FAX#: OU - THIS I FORMATION WAS SE BY: NAME: ,C FIRM: STATE FARM INS. CO. / STEPHEN SULES AGENCY 10 ' 65A� APPROXIMATE TIME OF TRANSMISSION: THE NUMBER OF PAGES TRANSMITTED (Including this page) IF YOU NOT RECEIVE ALL THE PAGES IN LEGIBLE FORM, PLEASE CALL: AT 914-997-2525 AS SOON AS POSSIBLE. REMARKS: -� C M I L E C 0 V E R S H E E T The information contained in this facsimile is privileged and confidential information intended for the sole use of this addressee. If the reader of this facsimile is not the intended recipient, or the employee or agent responsible for delivering it to the intended recipient, you are hereby notified that any disclosure, dissemination, distribution or copying of the communication or taking any action in reliance on the communication is strictly prohibited. If you have received this facsimile in error, please immediately notify the Stephen Sules Agency at the telephone number listed above, and return the original message to the Stephen Sules Agency at the address listed above. 11/18/2011 11 : 10 FA}( 002/002 CERTIFICATE OF INSURANCE SI M FARM Th C th t ® STATE FARM FIRE AND CASUALTY COMPANY, Bloomington, Illinois ❑ STATE FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois in wi3bedell rig policyholder for the coverages indicated below: 41- of policyholder Matthew Kolb DBA Kolb Plutnbina & Heating Address of policyholder 17 Danner Avenue Harrison, NY 10528 Location of operations Description of operations The p)licies listed below have been issued to the policyholder for the policy periods shown. The insurance described in these policies is subject to all the terms exclusions,and conditions of thosepolicies-The limits of Ilabili shown may have been reduced by any paid claims. POLICY NUMBER TYPE OF INSURANCE POLICY PERIOD LIMITS OF LIABILITY Effective Date Ex (ration Date at beginning of lic riod Comprehensive BODILY INJURY AND 98-1M-J791-7 Business Liability 03/11/11 03/11/12 PROPERTY DAMAGE This insurance includes: [ Products-Completed Operations Contractual Liability ❑ Underground Hazard Coverage Each Occurrence $ 1, 0 0 0, 0 0 0 ❑ Personal Injury ❑Advertising Injury General Aggregate s2, 000, 000 ❑ Explosion Hazard Coverage Products-Completed ❑Collapse Hazard Coverage Operations Aggregate $2, 0 0 0, 0 0 0 ❑General Aggregate Limit applies to each project EXCESS LIABILITY POLICY PERIOD BODILY INJURY AND PROPERTY DAMAGE Effective Date Expiration Date (Combined Single Llmft) ❑ Umbrella Each Occurrence $ ❑ Other Aqqreoate $ Part 1 STATUTORY Part 2 BODILY INJURY Workers'Compensation and Employers Liability Each Accident $ Disease Each Employee $ Disease-Policy,Limit POLICY NUMBER TYPE OF INSURANCE POLICY PERIOD LIMITS OF LIABILITY Effective Date Expiration Date at beginning of policy period) 2 10 0 MM 1MM MM If any of the described policies are canceled before its expiration date, State Farm will try to mail a written notice to the certificate holder 3 0 days before cancellation. If, however, we fail to mail such notice, no obligation or liability will be imposed on State Farm or its agents or representatives. Name and Address of Certificate Holder Village of Rye Brook 938 King St Signatur ofAuthorized Representative Rye Brook, NY 10573 B 2Cl� 558.994 a 2•00 Printed In U.S.A. ata Certificate of Attestation of Exemption From New York State Workers' Compensation and/or Disability Benefits Insurance Coverage "Thu form cannot be used to waive the workers'compensation rights or obligations Of aff}s part}:** The applicant may use this Certificate of Attestation of Exemption ONLY to show a government entity that New York State specific workers' compensation and/or disability benefits insurance is not required. The applicant may NOT use this form to show another business or that business's insurance carrier that such insurance is not requited. Please provide this form to the government entity from which you are requesting a permit,license or contract. This Certificate will not be accepted by government officials one year after the date printed on the form. In the Application of Business Applying For. (Legal Entity Name and Address): Plumbrog Permit KOLB PLUMBING&HEATING,INC From: RYE BROOK,NEW YORK DBA:KOLB PLUMBING&HEATING,INC 17 DANNER AVENUE HARRISON,NV 10528 The location of where work will be performed is PHONE:914-630 4052 FEIN:XXXXX5268 3 BEACON LANE,RYE BROOK,NY 10573. Estimated dates necessary to complete work associated with the building permit are from November 16,2011 to December 16,2011. The estimated dollar amount of project is SO-S1OJM Workers'Compensation Exemption Statement: The above named business is certifying that it is NOT REQUIRED TO OBTAIN NEW YORK STATE SPECIFIC WORKERS'COMPENSATION INSURANCE COVERAGE for the following reason: The business is a one person owned corporation,with that individual owning all of the stock and holding all offices of the corporation. Other than the corporate owner,there are no employees,day labor, leased employees,borrowed employees,part-time employees,other stockholders,unpaid volunteers(including family members)or subcontractors. Disability Benefits Exemption Statement: The above named business is certifying that it is NOT REQUIRED TO OBTAIN NEW YORK STATE STATUTORY DISABILITY BENEFITS INSURANCE COVERAGE for the following reason: The business MUST be either: 1) owned by one individual; OR 2) is a partnership(including LLC,LLP,PLLP,RLLP,or LP)under the laws of New York State and is not a corporation; OR 3) is a one or two person owned corporation,with those individuals owning all of the stock and holding all offices of the corporation(in a two person owned corporation each individual must be an officer and own at least one share of stock); OR 4) is a business with no NYS location. In addition,the business does not require disability benefits coverage at this time since it has not employed one or more individuals on at least 30 days in any calendar year in New York State. (Independent contractors are not considered to be employees under the Disability Benefits Law.) I,MATTHEW P.KOLB,am the President with the above-named legal entity. I affirm that due to my position with the above-framed business I have the knowledge,information and authority to make this Certificate of Attestation of Exemption. I hereby affirm that the statements made herein ape true,that I have not made any materially false statements and I make this Certificate of Attestation of Exemption under the penalties of perjury. I further affirm that I understand that any False statement,representation or concealment will subject me to felony criminal prosecution,including jail and civil liability in accordance with the Workers'Compensation Law and all other New York State laws. By submitting this Certificate of Attestation of Exemption to the government entity listed above I also hereby affirm that if circumstances change so that workers'compensation insurance and/or disability benefits coverage is required,the above-named legal entity will immediately acquire appropriate New York State specific workers'compensation insurance and/or disability benefits coverage and also immediately furnish proof of that coverage on forms approved by the Chair of the Workers'Compensation Board to the government entity listed above. SIGN HERE Signature: /12�1 -� Date: Exemption Certificate Number Received 2011-061315 ! November 16, 2011 3 i NYS Workers' Compensation Board CE-200 12/2008