The URL can be used to link to this page

Home My WebLink AboutMP19-043 �yE BRC�v� c � J l7 Cc��uu u yy /� 19(32•'� 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 ACTING BUILDING&FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W.Morlino CERTIFICATE OF COMPLIANCE March 7,2023 John Salov&Kristina Salov 15 Highview Avenue Rye Brook,New York 10573 Re: 15 Highview Avenue, Rye Brook,New York 10573 Parcel ID#: 141.35-2-11 This document certifies that the work done under Mechanical Permit #19-043 issued on 3/27/2019 for the installation of a new furnace has been satisfactorily completed. Sincerely, Steven E. Fews Acting Building&Fire Inspector /to QyE BRC��. 1982. cu � �c 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.or� - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS . DATE• PERMIT# ISSUED: SECT: 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 ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION Q FINAL ❑ OTHER -;I, ,4`oRCERTIFICATE OF LIABILITY INSURANCE DAT 04/16/ 01'YVV) oansrzola THIS CERTIFICATI .S 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 endorsements . PRODUCER NAANTACT CLIENT O TACT CENTER FEDERATED MUTUAL INSURANCE COMPANY PHONE HOME OFFICE: P.O.BOX 328 A/C No Ext:888-333-4949 FAX No):507-446-4664 OWATONNA, MN 55060 E-MAIL CLIENTCONTACTCENTER rczFEDINS.COM INSURERS)AFFORDING COVERAGE NAIC# INSURER A: FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 330-130-6 INSURER B: WESTMORE FUEL COMPANY INCORPORATED INSURER C: 86 N WATER ST GREENWICH,CT 06830-5886 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:35 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 SUER POLICY NUMBER POLICY EFF POLICY EXP LTR INSR WVO MM/DDIVYYY MM/DDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 D TO RENTED $100,000 C LAIMS•MADE X OCCUR PRAMAGE M S S a occurrence) MED EXP(Any one person) $5,000 A N N 9062815 06/01/2018 06/01/2019 1 PERSONAL a ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRO- X POLICY JECT ❑ LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 a a Id 1 X ANY AUTO BODILY INJURY(Per person) OWNED AUTOS ONLY SCHEDULED A AUTOS N N 9062815 06/01/2018 06/01/2019 BODILY INJURY(Per accident) HIRED AUTOS ONLY NON•O WNED AUTOS ONLY PROPERTY DAMAGE Per a tident X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $7,000,000 A EXCESS LIAR CLAIMS-MADE N N 9062816 06/01/2018 06/01/2019 AGGREGATE $7,000,000 DIED I I RETENTION WORKERS COMPENSATION OTH- AND EMPLOYERS'LIABILITY Y/N X PER STATUTE I ER ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $500,000 A OFFICERIMEMBER EXCLUDED? N/A N 9917566 06/01/2018 06/01/2019 E.L.DISEASE-EA EMPLOYEE (Mandatory In NH) $500,000 11 yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE•POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) CERTIFICATE HOLDER CANCELLATION 330-130-6 35 0 VILLAGE OF RYE BROOK SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 938 KING ST THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN RYE BROOK, NY 10573-1226 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 4", Q 1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD xW Workers' UK CERTIFICATE OF IATE Compensation Board NY WORKER& COMPENSATION INSURANCE COVERAGE 'a.Lepa:N=e&Addres4 r r lrisurerj(use street e.e.`ue Teiephone.Nurnbe.,*f Insured 'AIESTMOREFUELCOMPANY INCORPORATED (203)531-5656 :86 NORTH WATER STREET 1c.NYS Lfnernpioy.menl,Ins-itance Ernploy'er Registration Number ol GREENWICH.CT 06830-5886 .-Nuree. vjorv,L.N.-ation o`•!nsitred!Or.;y coverage i-.z spqcif+caip/limited to 1d. Err-plcyer:d&rhficali(y, lf:rsurea or Social se.-axity !o.A M.,ar;-Up.PrHey) NLJIA:Mr C.6-0739367 2.Name and Address cf Entity Reqoastlng Proot of Coverage 3a.Narnc-of insaance Carver th Federated MLItUcll Insurance Cornpany VILLAGE OF RYE BROOK 35 938 KING ST 3?,Pcl:v.y l-jisinher of rnlity ustrd in Fox"i a, RYE BROOK NY 10573-1226 9917566 3c Po'if;y Ofec6,ee perk-x� 06/01,2018 to 06M1,2019 or Evef;uti,,e.O`rrre:rS t;:ne ine;iAlwl.;only a,.na�tnX i;,13! 311 Nxr;;kwed or certain excivae.,j. This ce fificis that 10he insurariop carrier indicated above in bcx'7.'insures the businps�:iiefereri,-�J above in box`Ia'for-,vorKers' compensation under tha New York-State Workers'Compensation (To use this form,New York(NY)must be listed under ftem.3A on the INFOPMATION PAGE of the workers'compensation insurance policy). The Insurance Cartier or Its lif;snsed agent send this Certificate of Insurancq to the entity Iii-,ted above asthe Certificate holder box'2". 'Mil ttt caqicr notify Vw ce.,fifl.wto holder within 10 days of a policy being cancelled for non-payment of piornium.of Veiil,.in 3L)-Joys if or Kly other:',,Jason or i!th,.!�insur8d is c.eieiv ise efirrilriated frnrn the. i f th , gfs indlt tttyd on this c.,.iillfir.ate prier to Vie erd of the Policy effective peric-d? ZYES 0.140 This certificate is is-Aj,-A as;a matter of information only and confars no rights upon the certificate holder. This,cartificata does not ai-iAno. extend or alter the cc-verage afforded by the po:icy listed.fix does it confer any rights or!esponsiLitilies beyond tliose corilaired in the This certificate may be used as evidence of a contract of insurance only vihill--the Underlying Policy is it)effect. Piear,e Note:Upon camceflation of the workers'rompensation policy indir—ited on this farm,It the business continues to be named on a peirmit,license or contract issued by a certificate holder,the business must provide that certificate holder with a new Cerfifir—ite of Workers'Cnmpensntinn Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation LJ3w. 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 b,.r MELISSA KOPPERLID Approved Cry: wu1j"M,LWAX 04/16/2018 11 nxur�!!1 . . ,;I, Title: Authorized Represpi-ttalive Talep'Doris N'unibcr of authorized representative or licensed agent of insurance c�aniem: (688)333-4949 Please Note:Only ins;urarice crirriers;And their HcAnsed Agents Are Authorized to Issuo Form C-105.2,fnstirarica brok.prs are N.01 authorized to issue it, C-10s.,2 (9-15) b.r,y.g vv