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Home My WebLink AboutMP13-046 ttQyF„DR . 190 � l`CwuU'JJ V t l7 ��uu v Vy VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury www.ryebrookny.gov TRUSTEES BUILDING&FIRE INSPECTOR Susan R.Epstein Steven E. Fews David M.Heiser Donald T.Krom,Jr. Salvatore W.Morlino CERTIFICATE OF COMPLIANCE April 30,2025 Arthur Cohen&Alice Cohen 3 Paddock Road Rye Brook,New York 10573 Re: 3 Paddock Road, Rye Brook,New York 10573 Parcel ID#: 135.34-1-24 This document certifies that the work done under Mechanical Permit #13-046 issued on 5/1/2013 for the installation of a new air handler has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to Bk o �m BUILDING DEPARTMENT ❑BB LDING 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 : •2, A A O c- �G ,.� DATE: 7 y % G7�XS� PERMIT# 1 '-- C..)y kej ISSUED:.S/-i-7 SECT: 3 BLOCK: LOT: LOCATION: AN� I t-- OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... -Q ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS A\ct ❑ L.P. GAS ❑ FUEL TANK n ❑ FIRE SPRINKLER /h � ,� � �3 SRN, ❑ FINAL PLUMBING ❑ CROSS CONNECTION INAL OTHER ✓v,� /f' d+ o o a� o � fr'1 M r oaC o � b W 00 h+l = W Ma�•l a � o O M o � E a, u � .•• z `Owca � Z O 3 � 42 2 CO i1•l .x O w ['� �o c r o a: ono ,o W 010 Al 00 w w 3 �• W 3 aw „ > c w "C Z ~ G� W Q ❑ z n " U UZ 16 co 00 o 016 16 Q 4 U z w o -c 8 E ob - �. O � U Up •L � o . � � A z LC� oz< -0 > 48 = wo "° a X a) xo > BR v VILL �E Feu BROOK FEB 13 2013 ± BUI NG DEP MENT 01 938 KING T YE K,NY 10573 VILLAGE OF RYE BROOt�91 )939-0668 FA 1 www.ryebrook.ore BUILDING DEPARTMENT APPLICATION FOR PERMIT TO INSTALL AND/OR REMOVE HEATING VENTILATION AND/OR AIR CONDITIONING JE011WMENT Permit#: M 3- Building Inspector: Fee Paid: w Date of Approval: F E B 2013 Parcel ID#: Bldg/Use Class: Res. ( ' Comm. ieicienicicxiccxxncieieicieic4cneieieieee*nFxiecxicicickicieicieieeeieicxFYF�cxFcbiYiet**iek*YFoFFxicxiccicicXicicicxkkkkkkkkK**k 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 Insurance including Liability& Workers Compensation naming the Village of Rye Brook as Certificate Holder. 4. Payment of Fees/Unit: Residential: $75.00;Commercial: $250.00. (fees are non-refundable) 5. Inspection by Building Department for removal and/or installation. (48 hour notice required) 6. Any electrical work requires a separate Electrical Permit and Electrical Inspection. 7. Any gas/plumbing work requires a separate Plumbing Permit and Plumbing Inspection. 4edr*$e$*9e4e'e9r*9e9e4eit*kvk**�r9r9t9e9e*icicdovcY4exicieiezicz�c�c�c�edc*drxieicxxx�c�c9c4c4eitisisiex�c9cdcY9ededeieieisixic�c�cYvc4c4cisisisis�eis Application is hereby made to the Building Inspector of the Village of Rye Brook for the approval of a permit for the installation and or removal of the HVAC equipment as listed below. The applicant, 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. 1. Site Address: 3 PW oC k taaJ 2. Property Owner& Phone: _A r 4- Co�2/J two STr— 3. Applicant: `t.Cc� er�C' V e 13 q U �'i, 6. 51 U• 4. Contractpp name, a ress, contact phone: Gi, e e .,j /Cc. �a J 0 5 �a 5. Scope of Work:New Instal ation ( Replacement( ); Removal ( ); Other( ) 6. Type of Equipment: (r N� �Q� `*- � I� 7. Location of Equipment: T-t' 8. Applicant Signature: too' Date: s l L44tS i AFFIDAVIT IN SUPPORT OF FEE WAIVER RELATED TO 141IRRICANESANDY STATE OF SS.: FEB 13 2013 COUNTY OF Lt ) VILLAGE OF RYE BROOK BUILDING DEPARTMENT (insert name),being duly sworn, deposes and says: 1. I am the applicant fora uildin�P of Occurs /Demolition Permit/Electrical Permit/Plumbing Permit/Fence&Wall Permit] (circle all that apply). I 2. I am the legal owner of property located at 3 O ff" I Rye Brook, New York (insert stmet addirss) OR I am the I [Archite '1 gineer/Attorney] (circle one) for the legal owner of property located at V'V R e Brook, New York (insert strvet address) and I am duly authorized by property owner ' r revs) (insert names) of pVer y onmer(s)),to make and file the accompanying application. ' 3. The following is a description of (1) the work to be performed under the permit for which I am applying;and (2) how the work arose as a direct result of Hurricane Sandy: MA r 4. The work described herein arose as a direct result of Hum Sandy and does not include work which was not caused by Hurricane Sandy. I Sworn to before me this day of ., 20' MItCHELL FMAN Notary Public, t of New York No. 4 91100 Qualified n tchester County 11yot-ary Pub c Term Expires Jan. 21, l�,.*l�• I i Apr 25 13 07: 15a Valley Mechanical 8452678562 p. l VALLEY ► & CONTRACTING INC Fax To: Jennifer From: James Bencivengo Fax: 914-939-5801 Pages: Phone: 845-548-7470 Date: 4/25/2013 Re; CC: ❑Urgent x For Review ❑Please Comment ❑Please Reply ❑Please Recycle Information you requested for Cohen 3 Paddock Rd,Rye Brook Hurricane Sandy Damage Please feel free to contact me if you have any questions James Bencivengo Valley Mechanical&Contracting Inc. 845-353-0972 845-548-7470(cell) 845-267-8562(fax) valleyniechvoc@optonline.net Apr 25 13 07; 15a vazzej Mechanical 8152678562 p. 2 OwA IV III -P 04. CD 4-4 OD 04 Campo Ce Juda ju cj Aw "I W'.1111 111 00 ! 21 ON ^ Apr 25 13 07: 16a Valley Mechanical 8452678562 p. 4 CERTIFICATE OF LIABILITY INSURANCE D/24/V00lY 424/2013 3 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 pollcy(les)must be endorsed. If SUBROGATION 13 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 endomement4a). PRODUCER ICON ACT Add, Antoinette NAME: Milbrandt 6 CO. , Inc. PHONE , (914)738-0100 FAC (914)738-456t1 IAJ 159 Main Street, Suite 2 E-MAIL .aantoinette@milbrandt.coin INSURE 5 AFFORDING COVERAGE NAIC N New Rochelle NY 10801 INSURERA:HarlQ $Ville Woroaster Ina. Co. _6182 INSURED INSURERB:Harle sville Insurance Co. of 10674 Valley Mechanical 6 Contracting, Inc. INSURERC:First Rehabilitation Ins Co 81434 P.O. Box 319 INSURER D: INSURER E: Valley Cottage NY 10989 1 INSURER F: COVERAGES CERTIFICATE NUMBERCL131303522 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IFXP LTR TYPE OF INSURANCE POLICY NUMBER M I Y MW EFFYNYYYI LIMITS GENERAL LIABUTY 1 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABIUTY o RENTEIr- PREMISES Ea occurrencei $ 100,000 A CLAIMS-MADE O OCCUR SPP 98379E /6/2013 /6/2014 MED EXP(Any one person) $ 15,000 X Contractual Liability PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMNUP AGG S 2,000,000 POLICY PRO- LOC $ AUTOMOBILE LABILITY aMBINED SINGLE LIMIT 1 000 000 X ANY AUTO BODILY INJURY(Per person) $ B ALLOSNED SCHEDULED 98380L /6/2013 /6/2014 BODILY INJURY(Per accident) S AUTOS NON-OWNED FROPE DAMAGE S HIRED AUTOS AUTOS S UMBRELLA LIAB OCCUR ! EACH OCCURRENCE S EXCESS LIAB HCLAIMS-MADE AGGREGATE b DED I I RETENTIONS S A WORKERS COMPENSATION YWC STATU- OTH- AND EMPLOYERS'LIABILITY YIN X OPQ ANY,CEROPRIETER EXCLUDED?ECUTIVE a N 1 A E.L.EACH ACCIDENT S 100 000 (Mandatory In NH) 98378E /6/2013 /6/2014 F.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMB S 500,000 C NYS DBL 363319 Continuous-Statutory by Law DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remanhs Schedule,Y more space Is required) Re: Permit The Village of Rye Brook is named as Additional Insured. 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 Rye Brook, NY 10573 AUTHORIZED REPRESENTATIVE John Cofini/ADAl $ `' ''"` ACORD 25(2010105) C 1988-2010 ACORD CORPORATION. All rights reserved. INS025nn+mtilm Tho Annon nomo onel InnA am rnnie►araei-tic of ernRn Apr 25 13 07: 16a Valley Mechanical 8452678562 p. 3 STATE.OF NEW YORK WORKERS'COMP NSATION BOARD CERTIFICATE OF NVS WORKERS' COMPENSATION INSURANCE COVERAGE la.Legal Name&Address of Insured Use street address only) lb.Business Telephone Number of Insured Valley Mechanical&Contracting,Inc. 845-548-7470 PO Box 319 Valley CollxXc,NV 10989 Ic NYS Unemployment Insurance F.mpkiyer Registration Number of Insured Work Location of Insured(Only required if coveraReisspecifically limited to certain locutions in New York State, i.e., a Wrap-Up Id. Federal Employer Identification Number of Insured Policy) or Social Security Number 431975701 2.Name and Address of the Entity Requesting Proof of 3a. Name of Insurance Carrier Coverage(Entity Reing Listed as the Certificate Holder) Harleys,,tlle Worcester Ins.Co Village of Rye Brook 3b.Policy Number of entity listed in box"la" 938 King Street WC 98378E Rye Brook,NY 10573 3c. Policy effective period 1-6-13 l0 1-6-14 3d. The Proprietor,Partners or Executive Officers are included. (Only check box if all partners/officers included) all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"3" insures the business referenced above in box"1 a"for workers' compensation under the New York State Workers'Compensation Law.(To use this form,New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2". The Insurance Carrier will also notify the above certificate holder within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.) Otherwise,this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent,or until the policy expiration date listed in box"30,whichever is earlier. ['lease Note: Upon the cancellation of the workers'compensation policy indicated on this form,if the business continues to he named on a permit. license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers'Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: JOHN J COFINI (Print name of authorized representative or licensed agent of insurance carrier) Approved by: I A- (Signature) (Date) Title: Vice President 4-24-13 Telephone Number of authorized representative or licensed agent of insurance carrier: 914-738-0100 Pleaha Note:Only insursncc carfior&slid thch litrcnsrd ageing aic aulliui il'&J it)ir;r;ue Furut C-105.2.111NnrnneL'In'tlltenl nre NOT aulhui i wd to iaauc it. C-105 2(9-07) www.wab.stttto.ny.us