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HomeMy WebLinkAboutBP19-211PERMIT # 4)4 SECTION ��TT TYPE OF WORK JOB LOCATION OWNER CONTRACTORL T- COST #f=L TCO # FEE DATE FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING O RGH PLUMBING GAS C� SPRINKLER ELECTRIC C7 LOW -VOLT O ALARM O AS BUILT O FINAL vD0 ? cp 77,f Ors/ true, Man. ic �-orelI � laved aerore, r / 1ivs�S' OTHER APPROVALS ARB BOT PB ZBA OTHER i AIr wil ;jp GipCwu J jJ w �t BR 7. 190 �•�-a 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 October 16,2025 Cesa=' a Antonelli Irrevocable Income Only Trust Maria Antonelli&Mildred Cerone,Trustees 25 Monroe Place Rye Brook,New York 10573 Re: 25 Monroe Place, Rye Brook,New York 10573 Parcel ID#: 135.84-1-18 Building Permit#19-211 issued on 9/27/2019 for a New Sidewalk&Driveway Apron This certifies that the new sidewalk and driveway apron,installed under the above captioned permit have been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to BR o �m W � t7 BUILDING DEPARTMENT ❑BUILDING INSPECTOR �<tilS TAN'1'BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT Or-PICE.R 938 King Street • Rye Brook, NY 10573 (914) 939-0668 FAX (914) 939-5801 www.r c rook.jw - - - INSPECTION REPORT - - - - - - _ - _ - - - - - ADDRESS : 2.T 1'10/V f20e- PLa.cp— / S- Z0er hliRMl'1'# �' 2 ISSIlEU:9'Z7-I 4 SEC'1 �, BIACK: 1,0CATION: �(jjpJ� _—_-- OCC:UPANCY: ❑ Violation Noted THE WORK IS... 90111,11ASSED ❑ FAILED / REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas 1 ) V.."A to A L ❑ L.P.Gas �,►.� ❑ FUEL TANK - --- ❑ FIRE SPRINKLER ❑ FINAL.PLUMBING ❑ CIMSS CONNECTION - --- 2--fINA1. ❑ OTHER QyE BR(�k, cu � • 1982 BUILDING DEPARTMENT ❑BUILDING INSPECTOR ,P 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.rxebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS• �t) A O y � ( ) ^-- DATE: ? t 1 I L/ PERMIT# �' �/— � ' ` ISSUED: `z� '�SECT: 35 (BLOCK: LOT: 1 \/ LOCATION: �� \. �UU V'Q 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 ❑ FINAL ❑ OTHER 7 Building Permit Check List&Zoning Analysis Address: 2� V�'1 CJ I LO CZ ^?L SBL: — Zone -Z Use: Const.Type: Other. Submittal Date J Revisions Submittal Dates: Applicants A,..)-to►- R LL "TC2-0 -' Nature of Work �13£w v Fiw! p Reviews:ZBA: S E P 2 3 2019 PB: BOT: Other. OK ( ( ) FEES:Filing.��BP:� C/O: Legalizau� ( ) (-KAPP: Dated: ✓ 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: ( ) ( ) PLANS:Date Stamped: Sealed.. Copies: Electronic: Other. ( ) (J�License: -" Workers Comp: -'/ Liability Comp.Waiver. Other. { (Vf CODE 753#: 09 _'2:ZQ - I a 7-n 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 20I7 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. ( )ARB mtg. date: approval;- notes: ( )ZBA mtg. date: approval• notes: ( )PB mtg.date: approval:- notes: REOUIRED EXISTTNG PROPOSED NOTES APPROVED Area: Cirde• Frontage Front: Front: Sides: Rear. Main Cov Accs.Cov: Ft H Sb: Sd.H Sb: GFA: Tot : Ft I : P Height/Stories: notes- x a,4.- ■ "K .h 4� _ Y�„ �,y, - e ... a .. .. �'Al.i✓ .�4-. 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L: J X ~ Q CL 0 =' spa O > cn m W wow cn •- � � •C GCS t�-���0'! ix 40 ..il O b � �--•��v �Mr,. co f N arz- w �. �4�tr I •� �� I Ti -ter .r-a - -s •��--:''i_.ss- a -'-r�- a��^.-r�tr•-... P( �h ' 3 -P 1h s `:Z=,P �h _'' P� PH�h P l�h ,_•,-�( h.g - +.. 1' . y�'' . �(• sl �r1'� 4:�� ta } i.�p .v� ' ��'('fc� "�h ACC> ® DATE(M 5/2019 Y) -��-/R" CERTIFICATE OF LIABILITY INSURANCE 0925/2019 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 Linda Cogan NAME: Cross Insurance-Stamford,Inc. PAHiONN. Ext: (203)321-0001 n/c No): (203)461-8200 30 Buxton Farm Road E-MAIL ADDRESS: Icogan@crossagency.com INSURER(S)AFFORDING COVERAGE NAIC N Stamford CT 06905 INSURERA: Ohio Security Ins CO 24082 INSURED INSURER B: Hartford Casualty Ins CO 29424 Anais Salcedo INSURER C: PO Box 1167 INSURER D: INSURER E: Port Chester NY 10573 INSURER F COVERAGES CERTIFICATE NUMBER: 2019-20 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 MAYBE 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 ADDLISUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE �OCCUR PREMISES Ea occurrence $ 300,000 MED EXP(Any one person) $ 15,000 A BKS55716178 12/01/2018 12/01/2019 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ❑PRO- JECT ❑ LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER. Expense Mod Factor 1 $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED BKS55716178 12/01/2018 12/01/2019 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS IX HIRED �/ NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY /� AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DIED I I RETENTION$ $ WORKERS COMPENSATION SPER OTH- AND EMPLOYERS'LIABILITY T Y/N ATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 B OFFICERIMEMBER EXCLUE N NIA 31 WECAA7SF6 09/27/2019 09/27/2020 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) 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 d1woomw ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD i STATE OF NEW YORK WORKERS' COMPENSATION BOARD CERTIFICATE OF NYS WORKERS' COMPENSATION INSURANCE COVERAGE Ia. Legal Name&Address of insured(Use street address only) lb. Business Telephone Number of Insured 914-804-7539 ANAIS SALCEDO DBA SALCEDO LANDSCAPING lc. NYS Unemployment Insurance Employer 19 SUMMIT AVENUE Registration Number of Insured PORT CHESTER NY 10573 PENDING Work Location of Insured(Only requiredifcoverageis specifically Id. Federal Employer Identification Number of Insured lintited to certain locations in New York State, i.e., a Wrap-Up or Social Security Number Policy) 09-9685179 2. Name and Address of the Entity Requesting Proof of 3a. Name of Insurance Carrier Coverage(Entity Being Listed as the Certificate Holder) The Hartford VILLAGE OF RYE BROOK 3b. Policy Number of entity listed in box"la" 938 KING STREET 31WECAA7SF6 RYE BROOK,NY 10573 3c. Policy effective period 09/27/2019 to 9/27/2020 3d. The Proprietor,Partners or Executive Officers are included. (Only check box if all partners/officers included) X 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 "la" 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 ofpremiums 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 maybe sent by regular mail.) Otherwise,this Certificate is valld 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"3c", whichever is earlier. Please Note: Upon the cancellation of the workers' compensation policy indicated on this form, if the business continues to be 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: Thomas Miller (Print name of authorized representative or licensed agent of insurance carrier) Approved by: Tkomati Mi Uer 09/25/201 q (Signature) (Date) Title: Account Representative Telephone Number of authorized representative or licensed agent of insurance carrier: 203-321-0001 Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insurance brokers are NOT authorized to issue it.