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HomeMy WebLinkAboutRP21-033OTHER APPROVALS PERMIT # 07�— 03 3 DATE; Ups SECTION + BLOCK 07, TYPE OF WORK e 1C �C,t/�577��i JOB LOCATION OWNER; CONTRACTO EST. 40 is TCO # f idlelC FEE DATE � . INSPECTION RECORD 1 DATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING O RGH PLUMBING GAS 0 SPRINKLER ELECTRIC C7 LOW -VOLT O ALARM 0 AS BUILT C� FINAL f7500(Y/y)9©Co-U74o / ARB BOT . PB ZBA OTHER tL`t�a Jj V VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 .ADMINISTRATOR Paul S. Rosenberg (914) 939-0668 Christopher]. Bradbury www.ryebrook.org TRUSTEES BUILDING & FIRE Susan R. Epstein INSPECTOR Stephanie J. Fischer Michael J. Izzo David M. Heiser Jason A. Klein CERTIFICATE OF COMPLIANCE October 26, 2021 Steven Schoen&Alice Schoen 68 Talcott Road Rye Brook, New York 10573 Re: 68 Talcott Road, Rye Brook,New York 10573 Parcel ID#: 135.50-1-24 Roof Permit#21-033 issued on 7/22/2021 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& Fire Inspector Ag BUILD R ENT For office use only: � PEt2MIT# ,mil-CJ3 V'IL OF RYE K 15sum 7 c 4?CQ! OCT 1 102� ING STREE YF BROOK, YORK 10573 DATE: � Q "c� —,POD l (914)9 939-5801 FEE: f 10 PAM I/ o .or VILLAGE OF RYE BROOK BUIL LIq rl- QEPAR7 ERTIFICATE 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 !i#i###!##t#tlkt#!!i#!t!lktk!#!#kRkk##kitlttktktt#titk4ktt!ltit#iitttltltttitiiiiitiiiltttiikstititsttt4titkks#*stsssststtiks Address: C2 R. i l e-or rd kve- Rcoak . 4.Y Occupancy/Use: Q M CtOS. Parcel ID#: I Sj b ECG 1 Zone: e _ Owner: OlwC cat )L �e ON1L Address: 6? -rgdepTl` rr P.EJR A.or Contractor: _mil��ft-oL sw� Address: //�l/Or'tL/CJ( k . , OAV Pf J�y Person in responsible charge: A lek t^r,wy' b Address: _ � CI c% [�'�, (�fe ao wide , CI 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 --w di�-dc e rd (Print Name of Applicant) rM EE (No.and Street) in Gi ee'lW tf k ,in the County of in the State of 6T- ,that (City4ou7V village) he/she has supervised the work at the location indicated above,and that the actual total cost ofthe 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:$ Ig gc)o / ! (�� j for the construction or alteration of. �E� i gook fj ba L 4'�C�?�I`T /2 �..1�Ockl, �} 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 erectedicompleted 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. nI- /V, 7l- Sworn to before me this V'Li Sworn to before me this cA-) day of C� �be� , 20�I day of d C 11 J eie , 2Qj_ sigmtwc of Property Owner Slgr e o ' nt Print Name o Property Owner Print Name of kart b kc Ge"e C PaWm Notary Pu George C Palmiero No".Pubiic-State Of New York Notary Public-State of New Yolk No.01 PA6089211 No.01 PA6089211 Quah`tied-ir W.a,stch%*CW* Quahfied in W"tches%r CWrAy Cortlrrlissiolt Expires Ntatidt 24,.Zak Commission Expires March 24,209 E BR(�h. �4 ym 1982 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 ryebrooLorg - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - -- - - - - ADDRESS : (0'-6 © V DATE: t �41�-s -1 o PERMIT# �F r ' - ISSUED: SECT: BLOCK: LOT: LOCATION: OCCUPANCY: VIOLATION NOTED THE WORK IS... E 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 "'y s i )) © C o N e" m W CO cv a o O 4 � � L cA Lr C � Q •'r�'. 0 I IL z w a © r a QtQtieciion ar E � ��m ff e- > C O t � LO cc I _ • 1, r � Q r fD U 4� 0 •+ R p, 6 ' DATE IMWDDIYYYY) AC"RV CERTIFICATE OF LIABILITY INSURANCE � a6r2sr2a21 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 914-600-6222 800-860-1151 cDN.' PhilipChriste Philip Christe Insurance a°NN Ex : 914-600-62.22 Fvc NO: 800-860-1151 1 New King Street, #101 ADD ESs: phil@Christeins.com INSURERS AFFORDING COVERAGE NAIC R West Harrison NY 10604 WSURERA: Evanston Insurance Company 35378 INSURED 914-237_0683 914-2370937 INSURER 8: J. Salvatore &Sons, Inc. INSURERC: 1187 Yonkers Avenue INSIIRER0: INSURER E Yonkers NY 10704 INSURERF: 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 TYPE OF INSURANCE ADDL SUB POLICY NUMBER MMM DDY EFF MaoEXP LT LIMITS LTR ✓ COMMERCIALGENERALUABILITY �/ ✓ EACH OCCURRENCE $ 1.00D 000 A CLAIMS-MADE V/1 OCCUR PREMISES Ea ocwtterme $ 100.000 3AA470458 04/20/2021 04/20/2022 MED EXP(Any one person) s 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s2,000,000 POLICY FV]PRO- Q LOC. PRODUCTS-COMPIOPAGG $ 1 000 000 OTHER' $ AUTOMOBILE LIABILITYCOMBINED SINGLE LIMIT $ Ea accident _. ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY{Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLALIAO OCCUR EACH OCCURRENCE $ EXCESS LIARF1 CLAIMS-MADE AGGREGATE $ DIED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANYPROPRIETOPJPARTNERlEXECUTIVE ❑ N f A E.L.EACH ACCIDENT $ OFFICERIMEMBEREXCLUDED7 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ N yes,describe under ❑ESCRIPTION.OF OPERATIONS below E.L.DISEASE,POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES (ACORD 101.Addhional Remarks Schedule,may be attached it more space is requ'red) Certificate holder is included as additional insured per written agreement subject to policy terms and conditions. Certificate holder is included as additional insured per written agreement subject to policy terms and conditions. CERTIFICATE HOLDER CANCELLATION Village of )dye Brook Building Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 938 King 5t. ACCORDANCE WITH THE POLICY PROVISIONS. Rye Brook,NY 10573 AUTHORIZED REPRESENTATIVE OP �j �1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103► The ACORD name and logo are registered marks of ACORD CNEW YORK Workers' CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1 a.Legal Name 8 Address of Insured(use street address only) 1 In.Business Telephone Number of Insured J Salvatore&Sons Inc. 914,237,0683 1187 Yonkers Ave 1 c. NYS Unemployment Insurance Employer Registration Number of Yonkers, NY 10704 Insured Work Location of Insured{Only required if coverage is specifically limited to 1 d.Federal Employer Identification Number of Insured or Social Security certain locations in New York State, i.e„ a Wrap-Up Policy) Number 13-3872277 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Car•ier (Entity Being Listed as the Certificate Holder) New York State Insurance Fund Building Department 3b.Policy Number of Entity Listed in Box"la" Village of Rye Brook 14579296 938 King Street, Rye Brook, NY 10573 3c.Policy effective period 01101/2021 to 01/01/2022 3d.The Proprietor,Partners or Executive Officers are ❑ included.(Only check box itall pannerslotficers included;, x7 all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"T' 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 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, 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: Gary McCarthy (Print name of authorized representative or licensed agent of insurance carrier) Approved by: � 06/24/2021 (Signature) iDate) Title: Licensed Agent Telephone Number of authorized representative or licensed agent of insurance carrier: 845-878-9293 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