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HomeMy WebLinkAboutDP21-002,,//�� PERMIT #�!'�b� �'- D� c� DATE: � �� oZ % ©(P;� � � � SECTION �ti TYPE OF WORK JOB LOCATION OWNER�� CONTRALTO EST. �CO # /, LOT J Q ar �QoG� �o ii�l5 � 3�-C�177 Y / %'. �- b DATE I l ��IC�G�� TCO # FEE DATE INSPECTION RECORD DATE FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING RGH PLUMBING GAS O SPRINKLER ELECTRIC LOW -VOLT 0 AU1RM L-7 AS BUILT FINAL INSP OTHER APPROVALS BOT PB ZBA (OTHER yC 4R .K , . 19 40* anniumaW VILLAGE OF RYE BROOK MAYOR 938 King Street, Rve 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. Morlino CLARIFICATION OF RECORD November 7,2022 Bien LL.0 2 Jennifer Lane Rye Brook,New York 10573 Re: 2 Jennifer Lane, Rye Brook,New York 10573 Parcel ID#: 135.57-1-13 Demolition Permit#21-002 issued on 6/23/2021 for Interior Demolition This certifies that the above captioned permit has been closed out by Building Permit#21-226 issued on 8/27/2021 for a 2sd floor addition,interior renovation,new windows,roof,siding and a new rear patio with Certificate of Occupancy#22-172 issued on 11/7/2022. Sincerely, Michael J. Izzo Building&Fire Inspector /to r, ('a rrII \\I^ For office use only �-� Ll t;� L�, ! ' BUILDIN MENT PERMIT# -00 VILLAGE OF RYE$OOK ISSUED:(q- a3--al EOCT2 2022 j `938 KING STREE4,�,' R, YE BROOK W, YORK 10573 DATE: C ,� � I D-' VILLAGE OF RYE BROOK FEE: PAIn�`, �" BUILDING nc'1DA,PTMFNT 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 ffiiffRiiRii##R#fi###ffiRiiRfiff#ff###R#ikRiifi##ii####i#k###tR###f##fR#kkkfkiRi###ifffff#f###fiRffi#ff##ikRR#R###f##f#fR###f Address: y e ki V1 l fC 12_ L p Y e Occupancy/Use' "3 0r"e-&>-`("-Parcel ID#: '35 s 5�` l 3 'Q 1� Zone: /C JIB Owner: ivs 1 e.UL ZL. 4f- Address: P.E./R.A. or Contractor: ddt'ess:Person in responsible charge: vG � h�l� Address: -) I Re- & cLvL � LwAe ( leg 6o-. Application is hereby made and submitted to the Building nspector 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: Bing duly swom,deposes and says that he/she re ' at I 12?L l^ �h Z-A L`'e (Print Name of A`pp'liic'annt), \ (No.and Street) in �K �-C - ,in the County of �' `') in the State of y� ,that (City/Town/Viliago 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, rofess"onal fees,and including the monetary value of any materials and labor which may have been donated gratis was: S Si for the construction or alteration of 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. Swom to before me this „2 p 0 Sworn to before me this ;14 day of 0 , 20 Z Z day 20'e/y WvL-A' y" Sign�a`ture-of erty, weer Q Si re of Applicant -OI G JG Vj CA Print Name of looperty Owner Orint Name of Applicant \ r No Publi l lM K1p/klotary Public LUCY GIOINO Nwat y Public,Same of NaW lbrlt Notary Public,State of New York No. OILIS144154 11 0,1 No.01GI6167210 Qualified in Westarw9ter County QuailW in Nassau County Commission Expires May 29,20 Commission Expires Apr. 24, 2 �-� 6A.4?fi r„ WIr�V%-�Q. r`''� K`Z` r AA f:nfrpr laUf4rr )`.�)in )►��-rn�~ . \\tvfrlMYfcr(�U9f) F,tR,uut, i*R,+dt G' �` J U,Lp ortrnent of Consumer Protectio0 110"le Improvement 1,icense \ ROBERT JAMES CONTRACTING CORp s" •r BOX 134 �., P� 1 GLEN HEAD,NY-11545 '-F Only a u,d is valid lic rise• This license is issued in accordance with Article X VI of the Westchester County Cottsutnrr Prcxr_tr•,n C` m a cf th 16 ,3 presence of the official department sc-Jl. Proof of citizenship or imtnigration status is not re,qulr<J a� F NOT FOR FEDERAL PURPOSES for r o n s ,o of EXpitatiori License Nurnbct o� pate .' p510712023 WC-33994-H21 ester s"t�.tOwl. ._,,'�'s-'-r-!t~:;;ita1 m,111-•4-N '_;��;I1ljlj�ljlil�.'�.dt`'-� ;^l�j/l1l ll/y8'';� 1 .'v`�/:"t,ll//llr/l�ljliinY�.7i--s-a-*�. EC��., /1,1iy.is-?7 t' ...- `;,Ij.11.�.;r��--.--• ��•'_.r�tr th�Wi�,.. �l�t� -.t,y/am/ , 1 tl t "rlt1, � t -.•per.,,: '(ff =-ltit� y/i�i��Y;e'il���+ - �//w 3= i+is�'I,.:; •♦ Twn �/• ���� //���u u ►� +11�1 -� .•l��/flf, iA ,f,Ay�n},' R:- '. tiflt7Ati r "�J////,,'yrS��''C, �,'r��/,�)\'r �j �"' )/ 1�' „N��J',+,.+1\� Y�,ry pry '•y �� y � :ti�,,1 ;�J r,�� � ':..�/; .IMM '..Q., l/!N.`. �Q FM //O fF O JY���� � ���7� p '•' !1't ;v v( `_ �., ..♦ "rlN +r fr...wi Uv�`ly, f/��X,' !vQ !v�'-. - O V v `�•� �`Lv. 5 346r --� ROBEMOH-01 _BG-R_AHAM ACORO' CERTIFICATE OF LIABILITY INSURANCE DATE(MMI)DNYYY) 5/26/2021 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(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 endorsements. PRODUCER RMACT Libardi Service Agency Inc. PHONE 8 333�13 11 FAXNo):(518 997-0818 100 Stewart Avenue (A/C.No,Ere _51 -�: EDDRE- info@$Ibardi.com Hicksville,NY 11801 ADDRESS:info@$Ibardi.com AFFORDING COVERAGE NAIL III INSURER A:Falls Lake National Insurance Company 31925 INSURED INSURER B: Robert James Contracting Corp INSURER C: 325 Glen Cove Avenue, Unit 1 INSURERD: Sea Cliff,NY 11579 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 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 _..__.. _.._._.ILTR TYPE OF INSURANCEEfLINRI mNLICYEXPMMDD �q iPOIJCYNN/eER _ - -- LIMITS _----- A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X DAMAGE TO RENTED OCCUR CPP 1205929 11/9/2020 11/9/2021 c'REMISULEaQcwrrenccel $ 50,000 --- MED EXP(Mv aria persanl r E 5,000 -- PERSONAL d ADV INJURY 11000,000 GENL AGGREGATE ppLIMMIRIT APPLIES PER: GENERALAGGREGATE s 2,000,000 POLICY❑JECr LOC PRODUCTS-COMPIOPAGG s 2,000,000 OTHER: AUTOMOBILE LIABILITY COMBWED SINGLE LIMrr I $ ANY AUTO OWNED SCHEDULED BODILY INJURY;Per I.erson $ AUTOS ONLY AUTOS i BODILY INJURY IPeraccidenb $ HARED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY [Per accident $ -- I UMBRELLA LIAR OCCUR i EACH OCCURRENCE I EXCESS LIAR CLAIMS-MADE AGGREGATE S. -- - DED RETENTION$ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/p STATUTE ER__�_- ANY ccPROPRIIETgO�RIPARTNER/EXECUTIVE E.L.EACH ACCIDENT (MFendetory In NH) CLUDED? NIA - E.L DISEASE-EA EMPLOYE' $ If yes, each under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT i 111 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if mom space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Village of Rye Brook THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9 Y ACCORDANCE WITH THE POLICY PROVISIONS, Building Department 938 King Street - - Rye Brook,NY 10573 AUTHORIZED REPRESENTATIVE I �J ACORD 25(2016103) 01988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD YORK Workers' CERTIFICATE OF STATE Compensation Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured Robert James Contracting Corp 516-351-1535 325 Glen Cove Avenue, Unit 1 1c. NYS Unemployment Insurance Employer Registration Number of Sea Cliff, NY 11579 Insured Work Location of Insured(Only required if coverage is specifically limited to 1d.Federal Employer Identification Number of Insured or Social Security certain locations in New York State, i.e., a Wrap-Up Policy) Number 27-3939347 2.Name and Address of Entity Requesting Proof of Coverage 3a. Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Sirius American Insurance Company Village of Rye Brook Building Department 3b. Policy Number of Entity Listed in Box"1a" 938 King Street Rye Brook,NY 10573 WC6124100 3c.Policy effective period 11/10/2020 to 11/10/2021 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"I a"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 must notify the above certificate holder and the Workers' Compensation Board 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. This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend. extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note: Upon 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, 1 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: William Libardi (Print name of authorized representative or licensed agent of insurance carrier) Approved by: 5i26/21 _ (Signature) (Date) Title: President Telephone Number of authorized representative or licensed agent of insurance carrier: 516-333-3611 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. C-105.2(9-17) www.wcb.ny.gov Building Permit Check List&Zoning Analysis Address: 7i' J J.r4 V4 L.4� SBL: Zone� • ('J Use Z r Const.Type: Other. Submittal Date: �O Z "L Revisions Submittal Dates: Applicant: t� L—',- L Nature of Work: ►.R-'�JZ-,D�— a pia •o t--Zt"nj Reviews:ZBA: J UN 2 110 pB. BOT Other. OK ( ( ) FEES:Filing. ?7 T BP: �' OD ' ' C/O: Legalization: ( ) (.eAPP: 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. ( ) ( License: ✓ Workers Comp: '� 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. ( ) ( ) 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: REQUIRED EXISTING PROPOSED NOTES J UN 2 11021 Date: Limit Fla Froru: Fmw sido: Rjar. Main Cov Accs Cov Ft H/Sb: Sd.H/SbTot.Imp SOFA: EAciug: HHdAt/Stoles notes: