HomeMy WebLinkAboutBP21-078PERMIT # fJf
SECTION
TYPE OF WORK
JOB LOCATION
OWNER
CONTRACTOR
EST.
✓C0 #
DATE: La )) �,�
BLOCK / LOT_
,O/UC C�rLlt>�'J� A)0'40
i�
7C0 # FEE DATE
INSPECTION RECORD
DATE INSP
FOOTING
FOUNDATION
FRAMING
RGH FRAMING
INSULATION
PLUMBING 71
RGH PLUMBING
GAS 0
SPRINKLER
ELECTRIC
LOW -VOLT
ALARM 0
AS BUILT
FINAL
C
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OTHER APPROVALS
ARB
BOT
PB
ZBA
OTHER
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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 Michael J. Izzo
Stephanie J. Fischer
David M. Heiser
Salvatore W.Morhno
CERTIFICATE OF COMPLIANCE
April 20,2022
Robert Klotz
16 Country Ridge Circle
Rye Brook,New York 10573
Re: 16 Country Ridge Circle, Rye Brook,New York 10573
Parcel ID#: 129.74-1-24
Building Permit#21-078 issued on 4/15/2021 to Replace Eight Windows
This certifies that the eight new windows,installed under the above captioned permit have been satisfactorily
completed.
Sincerely,
i
Michael J. Izzo
Building&Fire Inspector
/to
BUILD R ENT For office use on1 : �-7 p
` PERMIT# o� —0 /p
VIL OF RYE OK ISSUED:
APR ' 7 ZUZZ
38 KING STRE YE BROOK, YoRK 10573 DATE:
VILLAGE OF RYE BROOK > 9 "Q FEE: g //O-- PAID.
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
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Address: CO�AO+-'y ri cy,t '� �.�1� ���Z��I< /�y `7 3
Occupancy/Us1e: tV Parcel ID#: Zone:
Owner: R O k 1 o f Z. Address: �� C J ti n �`/ fl�X��C�C r'c(c
1
P.E./R.A.or Contractor: p U Ln b l t: I; A �I Wu m-& ll mf Address �3� V)t 116-) + c��/`� i�� '1 C y esS 0I6
Person in responsible charge: Pq Address:
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: /
being duly sworn,deposes and says that he/she resides at C,Y'd e,
(Print Name of Applicant) (No.and Street)
in FV t_ y CU a)< ,in the County of l�� ' �' � in the State of 1�,that
(City/Town/Village)
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:$ �_ ,
for the construction or alteration of: '✓"^i_4 u�A) 1)
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§250-10.A.of the Code of the Village of Rye Brook.
Sworn to before me this (:7`.) Sworn tLbTfore me thisday of , ��L��,k , 20' day of ��(r� ,20
� e Lb-L —
Signature of Property 4bwner Sig cure of Applicant
(� L / 1) / r
oe� P"G4I Tltti�'C� �n( ( r
Print Name of Property Owner Print Narhe of Applicant
o Public Public A N N A K I E L B A S A
ANNA KIELBASA ';OTARY PUBLIC-STATE OF NEW YORK
140TARY PUBLIC-STATE OF NEW YORK No.01 K16378519 8/12/2021
No.01 K16378519 Qualified in Putnam County
Qualified in Putnam County ✓1y Commission Expires 07-30-2022
`Ay Commission Expires 07-30-2022
�E BRC��,
4
,,/�' 19t32•'��O
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 ( �•[�- ATE:
PERMIT# ZZ 02 ` ? ISSUED: Z( SECT: v/ BLOCK: LOT:
LOCATION: LA)1 y-oi 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
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^ 100 West 7th Street•Bayonne NJ 07002 QUOTE
Ph: 800.631.3400 • 201.437.4300
Fac 800.758.7528 • 201.437AS33 095029
A www.1den1w1ndow,. m
ID A;C, VVWDOW
Our name eaya it ajjl fO Nis J�DYYt15 on _ Page 1 of 2
Customer Service Hours: Mon - Fri 8:30AM - 4:30PM
DOUBLE R ALL HOME IMPROVEMENT SHIP TO
DOUBLE R ALL HOME IMPROVEMEN
439 WILLETT AVENUE 439 WILLETT AVENUE
PORT CHESTER NY 10573 PORT CHESTER NY 10573
Phone 914_937-4279 FAX 914-937-4172
sl,m Zone Acctu Customer P/O# Est. Ship Date TERMS
4 UB 134672 INVOICE#
KLD65 03/25/2021 NET 30 095029
Line# Ouant. Description Price Total
5 Linen. DH. MAJESTIC
/� 251.7$ 1,258.90
W-35.750 x H-41.500 Finish W�5.750 x H-41.500 Co"H/C6H ✓
Grids: C6H/C6H Ober:]).H Scr. ESM Pka. Foam. Dbl.Low/E rMAXI.Arc. S Ana&H Exp. DS Glass. D Loc
Linen. Reaular Limit Latch. Shd Grv. S Sti Sper
6 Linen. DH. MAJESTIC
234.45 1,406.70
W-34.250 x H-45.500 Finish W-34.250 x H-45.500
Oper:D. H Scr. ESM Pka. Foam. Dbl.Low/E rMAXI.Ara. S Ana & H Exp. DS Glass. D Lock. Linen
Reaular Limit Latch. Shd Grv. S Stl Sper
3 Linen.2-Lites 00. MAJESTIC DSLI
264.04 792.12
W-46.000 x H-34.500 Finish W-46.000 x H-34.500
Oper:00. H Scr. ESM Pka. Foam. Dbl.Low/E rMAXI.Ara. S Ana &H Exp. DS Glass. D Lock. Linen
Reaular Limit Latch. Shd Grv. S Stl Sper
Linen. 2-Lites 00. MAJESTIC DSLI
221.13 221.13
W-34.250 x H-34.250 Finish W-34.250 x H-34.250
0per:00. H Scr. ESM Pka. Foam. Dbl.Low/E rMAXI.Ara.S Ana&H Exp. DS Glass. D Lock, Linen
Reaular Limit Latch.Shd Grv. S Stl Sper
2 Linen,2-Lites 00. MAJESTIC DSLI
221.13 442.26
W-33.500 x H-33.500 Finish W-33.500 x H-33.500
Ooer:00. H Scr. ESM Pka. Foam. Dbl.Low/E rMAX?.Ara. S Ana&H Exp. DS Glass. D Lock. Linen
Reaular Limit Latch.Shd Grv. S Stl Sper
1 Linen.2-Lites 00. MAJESTIC DSLI
310.64 310.64
W-70.500 x H-34.250 Finish W-70.500 x H-34.250
Oner:00. H Scr. ESM Pka. Foam. Dbl.Low/E rMAX1.Ara.S Ana&H Exp. DS Glass. D Lock. Linen
Please Check Revised Delivery Date
Customer Belinda 12/23/20
4 100 West 7th Street•Bayonne NJ 07002 QUOTE
Ph: 800.631.3400 • 201.437A300
Fa=800.75&7528 • 201.437.4833 095029
IDEAL www.ldealwlndow.cm - -
AL WINDOWMaw
Our name Says it Gill faflowus an u Page 2 of 2
Customer Service Hours: Mon - Fri 8:30AM - 4:30PM
DOUBLE R ALL HOME IMPROVEMENT SHIP TO
DOUBLE R ALL HOME IMPROVEMEN
439 WILLETT AVENUE 439 WILLETT AVENUE
PORT CHESTER NY 10573 PORT CHESTER NY 10573
Phone 914-937-4279 FAX 914-937-4172
'�° �O° Customer P/O# Est. Ship Date TERMS
INVOICE#
4 UB 134672 KLD65 03/25/2021 NET 30 095029
Line# Ouant. Deserintion Price Total
Reaular Limit Latch. Shd Grv, S Stl SDcr
Linen , 1-Lite oDer, Csmt Beveled
250.93 250.9
W-22.000 x H-22.250 TTT W-22.000 x H-22.250
Hinae Loc. From Inside : ( R). F Scr. ESM Pka. Foam. Dbl.Low/E rMAXI. Ara. DS Glass
S Stl SDcr
(STK) LINEN BUC 8'-6'8" KO /
✓✓✓ 946.51 946.5'
W-95.500 x H-79.500 TTT W-95.500 x H-79.500
ODer:N, Scr. Low-E,Ara, K.D, -
Elite White-No Kev
SUB TOTAL: 5,629.19
8.3750 %Sales Tax 471.44 #of Items 20 Surcharge 0.00
Deposit 0.00
TOTAL DUE 10 63
Please Check Revised Delivery Date
Belinda 12/23/20
Customer
Building Permit Check List&Zoning Analysis
Address: R`-r ^—24t, s l- •(f//"GIP SBL:
Zone: + - l Use: 7i� Const Type: Other.
Submittal Date: 3 l Z Revisions Submittal Dates:
Applicant: k_ pD�� Z-
Nature of Work: K-t)Q-A-C JZ L AA F N� W+ ti� w 5
Reviews:ZBA: APR - 6 2021 PB: BOT: Other.
hW OK �2-.
( ( ) FEES:Filing. :tag- BP: Z<<{ • ^ -pi —C/O: Legalization:
O (,)/APP: Dated :/ Notarized: _�SBL: ✓ Truss I.D. Cross Connection: H.O.A.:
( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Stone Water Review: Street Opening.
( ) ( ) ENVIRO:Long: Short Fees: N/A:
( ) ( ) SITE PLAN:Topo: Site Protection: S/W Mgrnt.: Tree Plan: Other.
( ) ( ) SURVEY:Dated: Current: Archival: Sealed. Unacceptable:
PLANS:Date Stamped. Seale Copies: Electronic: Other.
( ( ) License: V Workers Comp: V Liability: Comp.Waiver. Other.
( ) ( ) CODE 753#: 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 2020 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: PROVED
REQUI RED EXLSITNG PROPOSED NOTES
Au: Date: APR - 9 2021
Circle:
Fr n e
Front,
Front
Si es:
Main Cov
Accs.Cov
Ft.H Sb:
Sd.H Sb:
.—FA.'
Tot,I :
E IMP:
Parkin¢
Height/Stories:
notes: N£F�j 2L-} U A 1. A L C.F. 7Z2
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A1�R0 CERTIFICATE OF LIABILITY INSURANCE DATEIMMiDD1YVY,
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 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 COUNTA
,NAME Laura RUndinelli
Marenco Insurance Agency Inc PHONE. 914)235-3144 I� No): (914)235-15.1
;ArC,No Ext):
36 Church Street noDREss: Laura(wmarencoinsurance,com
WWJRMM)AFFORDING COVERAGE NAIL a
New Rochelle 1 :U _ INSURER A: UTICA FIRST INS CO 15326
INSURED
INSURER B:
Arc Home Improvements Corp INSURER C
DBA Double R All Home ImprovementsI INSURER 0
439 Willett Ave INSURER E
Port Chester NY 10573 �
MISURER 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 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.
LTR TYPE OF INSURANCE INSD YWD POLICY NUMBER MM/DD/YYYY) MM/OD/YYYY UMITS
x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
CiAIMSMADE OCCUR PREMISES Me ooannaoa 3 50,000
MED EXP(Any one Pam) S 5,000
A Y ART512873700 05 06 2020 05 062021 PERSONA.&ADV INJURY 3 1.000.000
KGEN*L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE 3 2.000,000
OLICY PECOT- LOC PRODUCTS-COMP/OPAGG S 2,000,000THER $
AUTOMOBILE LIABILITY (Ea amdent) $
ANY AUTO
BODILY INJURY(Per Person) 3
OWNED SCHEDULED BODILY INJURY P
AUTOS ONLY AUTOS (Per acatlent) S
HIRED NON-OWNED S
AUTOS ONLY AUTOS ONLY (Par acadan)
s
UMBRELLA LIAR OCCUR EACH OCCURRENCE $
EXCESSLIAB HCLAJMS-MADE AGGREGATE s
DEC) I I RETENTIONS S
WORKERS COMPENSATION
AND EMPLOYERS'LIABILITY Y/N STATUTE 1 1 ER
Y PROPRIE70WPARTNER/EXECUTIVE❑fE.L.EACH ACCIDENT 3
FICER/MEMBEREXCLUDED? N/A
neatory In NH) E.L.DISEASE-EA EMPLOYEE 5
f yes,dewbe under
ESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Ramaraa Schedule,may IN aeached M men epees Is requlnd)
Certificate Holder Also\amed As Additional inured With Respects To General LiahiloN
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 Strcct AUTHORIZED REPRESENTATIVE
R.-,•et A M--
Rye Brook NY 10573
1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
NYSIF
New York State insurance Fund WESTCHESTER ONE, 44 SOUTH BROADWAY, 10TH FLOOR WHITE PLAINS,NY 10601-"11
1 nysif.com
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED)
ftA.
^^ ^^^ 133940830
MARENCO INSURANCE AGENCY INC y36 CHURCH ST
NEW ROCHELLE NY 10801
SCAN TO VALIDATE
AND SUBSCRIBE
POLICYHOLDER CERTIFICATE HOLDER
ARC HOME IMPROVEMENTS CORP VILLAGE OF RYE BROOK
DBA DOUBLE R ALL HOME IMPROVEMENTS 938 KING STREET
439 WILLETT AVE RYE BROOK NY 10573
PORT CHESTER NY 10573
POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE
W2358 628-2 175479 04/16r2020 TO 041l6/2021 1/7/2021
THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE
FUND UNDER POLICY NO. 2358 628-2, 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:/IWWW.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 CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE
INSURED CORPORATION.
PRESIDENT
FRANK J VERRASTRO
TREASURER
RALPH CACCOMO
ARC HOME IMPROVEMENTS CORP
TWO PERSON CORPORATION
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: 720064833
1