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HomeMy WebLinkAboutRP21-012PEO AIT # SECTION TYPE OF WORK �< 10B LOCATION i Q 11p1ol1 /6/aa. Sr17uellel� (?/y)30S &vv&s -€oldy GQi����►�)G�3 3- 5649 CONTRACTORV r uc i / v/ vae EST. COST c�� J! FEE ✓CO # C� FEE' DATE TCO # FEE MATE �%4w INSPECTION RECORD I DATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING O RGH PLUMBING GAS SPRINKLER ELECTRIC LOW -VOLT C� ALARM 0 AS BUILT M FINAL Ps zaA OTH OTHER APPROVALS ARB BOT ER VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Paul S.Rosenberg (914) 939-0668 Christopher J. Bradbury avti-%r-.rye broo k.o rg TRUSTEES BUILDING& FIRE Susan R Epstein INSPECTOR Stephanie J. Fischer Michael J. Izzo David M. Heiser Jason A. Klein CERTIFICATE OF COMPLIANCE January 12, 2022 John Schueller&Nikki Schueller 1002 King Street Rye Brook, New York 10573 Re: 1002 King Street, Rye Brook, New York 10573 Parcel ID#: 129.43-1-2 Roof Permit#21-012 issued on 4/6/2021 to Re-Roof Existing Building This certifies that the new roof,installed under the above captioned permit has been satisfactorily completed. Sincerely, Michael J. Izzo Building& Eire Inspector /tg BUILDIN6 DEPARTMENT VILLAGE OF RYE BROOK ISSUED: -4/— JAN - 4 2022 38 KING STREET,RYE BROOK,NEW YORK 10573 DATE: (914)939-0668 FEE: Id 18S-- PAIDJK VILLAGE OF RYE BROOK BUILDING DEPARTMENT APPLICATION FOR CERTIFICATE OF OCCUPANCY, CERTIFICATE OF COMPLIANCE, - AND CERTIFICATION OF FINAL COSTS TO BE SUBMITTED ONLY UPON COMPLETION OF ALL WORK, AND PRIOR TO THE FINAL INSPECTION Address: 1 "12- KIV-1 Pye, &-oo k) N Y 105 73 Occupancy/Use:911"11-6 FA- Parcel ID 7 7- Zone: 0 Owner: �o�n a-kl') � I kl1 SC-h K 1 I V Address: J 0 0 7- 1 n S h-le, - [3 re re k— P.E./R.A. or Contractor: FkoLl Address: lei 1--1Wt"'VAVL' ) RPHI Ptprvthish Person in responsible charge: /0 Address: —105-7 Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issuance of a Certificate of Occupancy/Certificate of Compliance for the structure/construction/alteration herein mentioned in accordance with law: STATE OF NEW YORK,COUNTY OF WESTCHESTER as: )L S&h -being duly sworn,deposes and says that he/she resides at Print Nam f��pjlhcailt) I 17Lb Street in e., 6 vo 0 V- in the County of in the State of NV that ((iIN I I'mN 11/villaye) he/she has supervised the work at the location indicated above,and that the actual total cost of the work,including all site improvements, labor,materials,scaffolding,fixed equipment,professional fees,and including the monetary value of any materials and labor which may have been donated gratis was:S-2-7-1 560 for the construction or alteration of 6 0 Deponent further states that he/she has examined the approved plans of the structure/work herein referred to for which a Certificate of Occupancy/Compliance is sought,and that to the best of his/her knowledge and belief,the structure/work has been erected/completed in accordance with the approved plans and any amendments thereto except in so far as variations therefore have been legally authorized,and as erected/completed complies with the laws governing building construction.Deponent further understands that it shall be unlawful for an owner to use or permit the use of any building or premises or part thereof hereafter created,erected,changed,converted or enlarged,wholly or partly,in its use or structure until a Certificate of Occupancy or Certificate of Compliance shall have been duly issued by the Building Inspector as per§250-1 O.A.of the Code of the Village of Rye Brook. Sworn to b ore me this 3 Sworn to b e ore me this ' j d 20 day of 20 2-2- 0gndiurc of Property Owner Sigfiaturc�'of Applicant -,-) C- l k N I K y- I —C>c cx/ Mint Name of rope , Owner Pri;1 Name of Apphnt 446fairy Publi rotary Public DREW P.ALLXANDER NOTARY PJjBLIC Of NEW YORK DREW P.ALEXALNDER J.D.#OIAL6414646 NOTARY PUBLIC OF NEW YORK My CONMSION EXPIRES 03/01/2025 I.D.#OIAL6414646 My COMMISION EXPIRES 03/01/2025 Fo �9a2 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 : (/ DATE: ����JJ '�- �� �1 � � C1�i �((� PERMIT#K-'t ISSUED: SEC t BLOCK:_I LOT: LOCATION: U ��� \ j 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 py. x1� f _ C .. Jil ri cr r r NW LL, _ gC110fF .a q LL Ui UJ Qj cr- 00 s c4 11 i UP11 f�✓ a 1 AC"R" CERTIFICATE OF LIABILITY INSURANCE GATE(MMIDDIYYYY) 0312212021 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 CEP.TIFICATE 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 Michael J-Donnelly y Donnelly Insurance Center AICONNo Ext: (914)347-6500 FAX C No): (914)347-6303 6 North Lawn Ave. E-MAIL ADDRESS: INFO@DONNELLYAGENCYCOM PO.Box 880 INSURER(S)AFFORDING COVERAGE NAIC N Elmsford NY 10523-0880 INSURER A: Atlantic Casualty Ins.Co. 42846 INSURED INSURERS: Eddy Construction Roofing&Siding, LLC INSURER C: 29 Elmont Avenue#2 INSURER D: INSURER E: Port Chester NY 10573 INSURER F COVERAGES CERTIFICATE NUMBER: CL20102929662 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. ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER M AUULbUHN MIDDYIYYYY MMIDD1YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 50,000 MED EXP(Any one personl $ 10.000 A L068026015-0 10123/2020 10/23/2021 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATELIMITAPPLIES PER. GENERAL AGGREGATE $ 2,000.000 X POLICY PRO 2,000,000 JECTPRO- LOC PRODUCTS-COMPIOPAGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per Dersom $ OWN D SCHEDULED AUTO BODILY INJURY(Per accident $ AUTOS ONLY AUTOS I HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident E UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETORIPARTNERIEXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? NIA E L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes.describe under - DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) REMODELING ROOFING CONTRACTOR CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN BUILDING DEPARTMENT ACCORDANCE WITH THE POLICY PROVISIONS. VILLAGE OF RYE BROOK 938 KING STREET AUTHORIZED REPRESENTATIVE RYE BROOK NY 10573 — \ ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD N `I(SIF New York State insurance Fund WESTCHESTER ONE,44 SOUTH BROADWAY, 10TH FLOOR,WHITE PLAINS,NY 10601-4411 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ova ^A A^A 832395534 +-� ' MICHAEL DONNELLY DBA DONNELLY { p INSURANCE CENTERRy PO BOX 880 ELMSFORD NY 10523 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER EDDY CONSTRUCTION ROOFING 8r BUILDING DEPARTMENT SIDING LLC VILLAGE OF RYE BROOK 29 ELMONT AVE#2 938 KING STREET PORT CHESTER NY 10573 RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W2484122-3 333466 08/28/2020 TO 08/28/2021 3/22/2021 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2484122-3, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY, INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS:IIWWW.NYSIF.COM/CERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER THE SOLE PROPRIETOR, PARTNERS AND/OR MEMBERS OF A LIMITED LIABILITY COMPANY. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 511029480