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HomeMy WebLinkAboutMP13-005 t.QyE 4R19 t'l�wujJ.1 V 4' 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 CERTIFICATE OF COMPLIANCE March 8,2024 Roberto Baez 58 Bowman Avenue Rye Brook,New York 10573 Re: 58 Bowman Avenue, Rye Brook, New York 10573 Parcel ID#: 141.28-1-26 This document certifies that the work done under Mechanical Permit #13-005 issued on 1/10/2013 for the installation of two gas fired furnaces have been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to QyE BRC�v�, cu � • 198'2 BUILDING DEPARTMENT V'5 ILDING INSPECTOR ISTANT 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 : �-->D c J Wn AJ A ✓K DATE: 3 - / - Z U Z`/ PERMIT# m Oo� ISSUED: /0-/3 SECT:BLOCK: LOT: Z 1 LOCATION: !"� O /''�Pu� 4 /'1 �T/rG OCCUPANCY: ❑ Violation Noted THE WORK IS... CI PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas T S �f ❑ L.P. Gas ( 1> A ❑ FUEL TANK ❑ FIRE SPRINKLER FINAL PLUMBING CYLOSS CONNECTION INAL BOTHER BRnuk 19012 � BUILDING DEPARTMENT 0 BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑ VILLAGE ENGINEER 938 KING STREET RYE BROOK,NY 10573 ,,.,Id-.ASSISTANT BUILDING INSPECTOR (914) 939-0668 FAX(914) 939-5801 - - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - - ADDRESS: . .i�._ ' .1,}C -x( DATE: mn 2 _cys PERMIT# 1"\ ` J ISSUED: ,u, 3 SECT: I X BLOCK: ' LOT: LOCATION: S L OCCUPANCY: Z ❑ VIOLATION NOTED THE WORK IS... AcCEP I E i ❑ REJECTED/REINSPECTION B3_ SITE INSPECTION REQUIRED 0 FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION mt u ro-Q- 0 UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING 1 �, 0 ROUGH FRAMING \�T]y C-it (0-t 1YG C 0 INSULATION ❑ NATURAL GAS ❑ L.P.GAS j 0 FUEL TANK ❑ FIRE SPRINKLER 0 FINAL PLUMBING ❑ FINAL / C3- OTHER BR(�v� BUILDING DEPARTMENT 0 BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑ VILLAGE ENGINEER 938 KING STREET RYE BROOK,NY 10573 .-@ASSISTANT BUILDING INSPECTOR (914) 939-0668 FAX(914) 939-5801 - - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - - ADDRESS: DATE: - PERMIT# C 1Q— 3 1 SUED: C� SECT: CI 1 -2-� BLOCK: LOT: Z LOCATION: e 6 �_Q(1(1�1� OCCUPANCY: D VIOLATION NOTED THE WORK IS... 0 ACCE.PTED 12K-REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING 0 FOOTING DRAINAGE V-1 0 FOUNDATION D UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING 0 ROUGH FRAMING " 'u S ,(� ❑ INSULATION ❑ NATURAL GAS (y)C, ❑ L.P. GAS ? ❑ FUEL TANK ❑ FIRE SPRINKLER \\ ❑ FINAL PLUMBING �cy c .Q r Oct ❑ FINAL 3�D OTHER BRCuk -1. 982 ,� BUILDING DEPARTMENT 0 BUILDING INSPECTOR VILLAGE OF RYE BROOK 0 VILLAGE ENGINEER 938 KING STREET RYE BROOK,NY 10573 I3ASSISTANT BUILDING INSPECTOR (914) 939-0668 FAX(914) 939-5801 - - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - - ADDRESS: � y DATE: -3� t 3.1 PERMIT# �� 1 ISSUED: t I t ` SECT: BLOCK: I LOT: Z� LOCATION: Ar c— OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... C('LP FF1) ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING 0 FOOTING DRAINAGE 0 FOUNDATION ❑ UNDERGROUND PLUMBING C NOTES ON INSPECTION: ❑ ROUGH PLUMBING 0 ROUGH FRAMING C.O ve f` } X) •-� ` 1� P > `:a t f-.Z , 0 IN§ULATION "ATURAL GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ FINAL ❑ OTHER a ` : a z a a _ L c c ' rwr O C o 4 •v a E c >, 0-0 x F w M" �+ 0; o ; °o R O eV 5 w op x kc-7- pop, ° c 01. ell 11 p 1 Q � � N "d y7 O L. 3 cr co A [Onovb ~ d � c U a o b o00 w �" °ts v v u ;.) = p G •� C .0 cn is N W x = u ~ ( Y d W o L �1 � Ea., o�. O on �, o � Q•I U Uo 'Vcq U [ Qn Z Qo °o G4 a o p U > '> U N p,y � W ICI Q •- p -G C a 72 A d a W A� (J. a I w U 0 U c E c : VILLAGE OF RYE BROOK BUILDING DEPARTMENT 7 L']". 938 KING STREET,RYE$ROOK,NY 10573 (914)939-0668 FAx(914)939-5801 www.ryebrook.ora APPLICATION FOR PERMIT TO INSTALL AND/OR REMOVE HEATING VENTILATION AND/OR AIR CONDITION GLUIMENT Permit#: V ✓ Building Inspector: Fee Paid: Date of Approval: JAN 1 1 7013 Parcel ID#: `�7 j _Z Bldg/Use Class: Res. ( ); Comm. REgUIRElyiENTS FOR RELEASE OF PERMUT&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. • **tk*F9;9:�9r�*kir**iFir**,Ykir�IrY9cy:�9rkktkltiet,k9cFt,rrt�rk**,tirdt,�r,k*�kkdt�ek*drikdkk+tkkint,rkksk*�Ir*kk,k9rir9rlydkk'dkkek� 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: _ 5 9 6A , G-.1-1 ,, 4 -4 e-1 2. Property Owner&Phone: aw AE t 3. Applicant: ,�N II 2 x 4. Contractor name.,address,contact phone. /'� A02 5. Scope of Work: New Installation ; Replacement( ); Removal( ); Other( ) _ 6. Type of Equipment: 7. Location of Equipment: AJ Nam. 8. Applicant Signature- Date: Z 7/3 6.1.12 BUILDING DEPARTMENT U V FE VILLAGE OF RYE BROOK � 938 KING STRKET RYE BROOD,NY 10573 MAR 2 6 2013 (914)939 8 " '939-5801 «N WW. k:or° VILLAGE OF RYE BROOK BUILDING DEPARTMENT ELECTRICAL PERMIT APPLICATION This application must be filed in person at the Building Department by the Licensed Electrician of Record and must be accompanied by the completed Electrical Inspection Agency application form. Office Use Onlv: l Date: I Z Approval Signature: Inspect' n Agency: Electrical Permit#: - >r Fees. `.LJ pai due B Permit#: Application is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit for the installation/removal/repair of Electrical Equipment as per detailed statement described below,and in accordance with the Code of the Village of Rye Brook,NYSUFP&BC,NEC,NFPA and all other applicable State,County and Local Laws. Address: AQ (,cJ M A o-) ye Phone#• �;"X1r— �; , Z Owner: U Address& Phone: /S� �, ��rt.� // Use/Occupancy: Z FA M Parcel I.D.#: Zone: Proposed Electrical Work: 2 SLR LICENSED ELECTRICIAN'S INFORMATION: Name(Please Pr' /ems IP�v Phone# FZ5� ,y e. �� ?r' 2 0�y Signature: d&Z'Cp "'o ----""'�'Westchester County License#: zn' Company Name: N- Al o f F G 2c L Company Address: P' le A lli�' City/Town: y (� State: Zip Code: I P S7 $ Phone Field Contact&Phone: Revised 9/6/11 Westchester Rockland Electrical Inspection Services, Inc. a s Phone: 914-347-3595 DO NOT WRITE HERE—FOR OFFICE USE ONLY Fax: 914-347-3596 43 North Lawn Avenue Elmsford, NY 10523 BUILDING PERMIT NO. TEMP# DATE W S CITY OR VILLAGE- y 6 ZIP CODE TOWNSHIP COU �! STREET AND NO.OR RQ� 0 �G� M A I `S If G POLE NUMBER BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCA'TE'D`? /V SECTION BLOCK LOT OCCUPANT'S NAME BUILDING OCCUPANCY OWNER'S NAME AND ADDRESS ( REQ / �(V NcJ �J l.� w� I/f�C( ,�✓ TELEPHO E4UM CURRENT SUPPLIED BY FROM THEIR OFFICE WORK TELEPHONE NUMBER LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED NUMBER OF OUTLETS NO.OF FIXTURES& MOTORS HEATERS OFFICE USE LOCATION LAMP RECEPTACLES ONLY SIDEWALL SWITCH INCADE FLUORE NO. H.P.EACH NO. WATTS EACH INSPECTION OUTSIDE 1 - BASEMENT I`FL. I 2-FL. 3-FL. VILLAGE O RYE BROOK REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: THIS APPLICATION IS INTENDED TO COVER THE ABOVE LISTED ITEMS TO BE INSPECTED.IF AT ANY TIME OF INSPECTION ADDITIONAL ITEMS HAVE BEEN INSTALLED,YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE FOR THE ADDITIONAL ITEMS INSPECTED AS PROVIDED BY THE APPLICANT.THE APPLICANT DECLARES THAT THERE IS NO OPEN APPLICATIONS FOR THE ABOVE WITH ANY OTHER INSPECTION COMPANY.WREIS, INC.IS NOT LISTING,LABELING,UNDERWRITING OR CERTIFYING ANY EQUIPMENT, MATERIALS OR DEVICES WHICH ARE PERFORMED BY OTHER CERTIFIED TESTING AGENCIES OR INSPECTION COMPANIES.THE APPLICANT,OWNER,OR AUTHORIZED AGENT AGREES TO ALL THE ABOVE TERMS AND CONDITIONS AS SET FORTH FOR THE APPLICATION. SIZE OF SERVICE FEEDERS CHARACTER OF WORK NEW❑ ADDITIONAL❑ EXPOSED❑ CONCEALED❑ MUST ENTER APPLICANTS IDENTIFICATION NUMBER SERVICE ENTERS BUILDING OVERHEAD❑ UNDERGROUND❑ AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACE MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. AME, IF COMP Y _ �j/G DATE OF APPLICATION SIGNAT�OF APPLICCANT LN '��. G ZJ' /j x STREET ADDRESS TELEPHONE NO. 171 CITY OR POST OFF • ZIP QO��-� LICENSE NO.WHEN APPLICABLE f+r1 O 1 M rll o bi 41 M � O ..��- -W._•W r �l, �� 'C.;' � h�'I . ...j`� ,.� '.+�ti�.Z�' •�Y� k� ;Ct �� (r�� F+�1 4 48; All t I• ,'\ ,� /fir p4 o c H o � ao E" � aa ►� O BUILDING DEPARTMENT VILLAVE OF RYE BROOK MR 938 KING STRFr.T RYE BROOK.NY 105 3 1 (914)939-066 R'�Ax 9-i,4)939-5801 `�_ VILLAGE OF RYE SF2pQK www.T_ largo org Bull nlNG DEPARTM ENT PLUMBING PERMIT APPLICATION *MUST BE FILED BYA LICENSED MASTER PLUMBER ONLY* �Date: it Plumbing Permit#. ,J— U3 �3-a.!-\P-ermit#: f4p, )S'WJC Fee: /5V Approval Signature: (fees are non-ref dable) 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: Address: V 60 Lo 10)2� Phone#: Owner: �� ��.P'LkJ Address& Phone: Use/Occupancy: Parcel I.D.#: Zone: LICENSED MASTER PLUMBER'S INFORMATION: Name (please print): RV&r_F� �����i� Phone#: t,� 3 Signature: ' Westchester County License#: Company Name: �SPO p Company Address: City/Town: U �. State: �, Zip Code: J Phone#: ■■aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa■aaaaaaaaaaaaaaaaaaaaaaaaaa�iaaasaaaaaaaaaaaaaaaa■ 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 1st Floor 2nd Floor Outside *Other: DIFS vY4 b FV Z it Ca -� Detailed Description of Appliances etc...: CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 01/04/2013 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 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 NAME:CONTACT LORI MCGEE ALLEN-KEATING CORP PHONE _ FAX No.Exti, Alc No): 845-598-9489 PO BOX 7 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC N PUTNAM VALLEY NY 10579 INSURER A: UTICA FIRST INSURED INSURER B: BEN'S HVAC 222 MORTIMER ST INSURER C: INSURER D: PORT CHESTER NY 10573 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 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 PERTI`.IN, .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 ADDLSUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DDIYYYY GENERAL LIABILITY EACH OCCURRENCE $ 500,000 DAMAGE TO RENTED x COMMERCIAL GENERAL LIABILITY I�r PREMISES Ea occurrence S 50,000 CLAIMS-MADE �OCCUR I JC I MED EXP(Any one person) $ 1,000 A ART1101870 06/06/2012 06/06/2013 PERSONAL&ADV INJURY $ 500,000 GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1 ,000,000 POLICY PRO LOD $ AUTOMOBILE LIABILITY r Mmden IN L I I Ea aBINEDt ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident E UMBRELLA LIAR OCCUR _ EACH OCCURRENCE $ EXCESS UAL" CLAIMS-MADE AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSATION WC STATULIMIT- OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN N/A E.L.EACH ACCIDENT $ OFFICE/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under nr�.QRIPTInN OF OPERATION,-below r r E.L.DISEASE-POLICY LIMIT $ I I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more apace Is required) CERTIFICATE HOLDER IS ALSO ADDITIONAL INSURED CERTIFICATE HOLDER CANCELLATION VILLAGE OF RYE BROOK SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ATTN;BUILDING DEPT ACCORDANCE WITH THE POLICY PROVISIONS. 938 KING ST AUTHORIZED REPRESENTATIVE RYE BROOK NY 10573 LORIMCGEE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Certificate of NYS Workers' Compensation Insurance Coverage Page 1 of 2 STATE OF NEW YORK WORKER'S COMPENSATION BOARD CERTIFICATE OF NYS WORKERS' COMPENSATION INSURANCE COVERAGE Is.Legal Name and address of Insured(Use street address only) lb.Business Telephone Number of Insured BEN'S HVAC 914-310-4728 222 MORTIMER STREET PORT CHESTER,NY 10573-0000 lc.NYS Unemployment Insurance Employer Registration Number of Insured Id.Federal Employer Indentification Number of Insured Work Location of Insured(Only required if coverage is specifically limited or Social Security Number 421748402 to certain location in New York State,i.e.a Wrap-Up Policy) 2.Name and Address of the Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Rochdale Insurance Company VILLAGE OF RYE BROOK ATTN;BUILDING DEPT 3b.Policy Number of entity listed in box"la": 938 KING ST RWC3279213 RYE BROOK,NY 10573 3c.Policy effective period: 11/3/2012 to 11/3/2013 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"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 Certification 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"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: Henry C.Sibley (Print name of authorized representative or licensed agent of insurance carver) Approved By: �� 1/4/2013 (Signature) (Date) Title: Underwriting Manager Telephone Number of authorized representative or licensed agent of insurance carrier:CarrierPhone Please Note:Only insurance carriers and their licensed agents are authorized io issue the C-105.2 form.Insurance brokers are NOT authorized io issue it. C-105.2(9-07) httt)s://ao.amtrustizrout).com/anawc/PolicvNYCertificateOf WcIns.asi)x?IndexId=53682&Ins... 1/4/2013