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HomeMy WebLinkAboutRP21-0401 /. r ` - • SECTIONBLOC LOT 7 / TYPE • •- - 1/12 Wv5eli4e JOB LOCATIO ,�. OWNER a i •► i r �,�` _.�►i • • - - .r.� s a - a • - 1 _-tea=� ..i . loe'c• �r .� INSPECTION RECORD I DATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING CI RGH PLUMBING GAS C� SPRINKLER ELECTRIC C� LOW -VOLT O ALARM m AS BUILT L3 FINAL OTHER APPROVALS ARB BOT PB ZBA OTHER QyE DR �. E c�4.°jJ�u . 19 L � G 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 September 28,2023 Robert&Tamora Miller III LLC 48 Hawthorne Avenue Rye Brook,New York 10573 Re: 48 Hawthorne Avenue, Rye Brook,New York 10573 Parcel ID#: 135.75-1-74.1 Roof Permit#21-040 issued on 8/13/2021 to Re-Roof Existing Building This certifies that the new roof,installed under the above captioned permit have been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to D E C E � " L' ED � R For office u e only: BUILD ENT PERMIT# -Oqo AUG 11 2023 VIL OF RYE OK ISSUED: — --d� 938 KING STRE YE BROOK, YORK 10573 DATE: —//—3 VILLAGE OF RYE BROOK 9 -0 O�c FEE:y& //0-- PArD)ff- 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 ssrssststssrtswrrrr■rssssswswrst****ra/sswss�rswpwwr*ts*ststsssww,/wsr**rsrtrwrrrrwr*sttssrsrwwwwrsrssss*srttwwrrrssr**tsssrrww Address: Occupanc /U�se:�, / )i¢/"I Parcel ID#: � — — Zone;/C Owner: L�l / `� T�l )'1 1�1� m l L�r' ddress: ) 2° P.E./R.A.or Contractor: /- Address: Z _ / Person in responsible charge: -TOM r�oi S 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 NEWIYORK,COUNTY OF WESTCHESTER as: being duly sworn,deposes and says that he/she resides at (Print Name ol'Applicant) IA r ]_ (No.and Street) in �L y— ,in the County of �Lz- �_ Y`� 1�- '� in the State of 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 impr vements, 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 5 G(� , for the construction or alteration of- " I-C,' f� 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 .4LA— Sworn to before me this day of � 20.Z:S day of , 20 Signature ol'0rovcM d4ner Signature of Applicant V(-'�-)-- Pr' of Pro er Owner Print Name of Applicant Not Pub is PAUL FRANCIS r Notary Public Notary Public, State of New York No. 01 FR5051872 Qualified in Putnam County Commissiun Expires November 13,20 10 BUILDING DEPARTMENT Is BUILDING INSPECTOR ❑ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK I ❑CODE ENFORCEMENT OFFICER 938 King Street. Rye Brook,NY 10573 (914) 939-0668 FAx (914) 939-5801 www.ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - -- - - - - - - - ADDRESS: DATE' PERMIT# `✓ ISSUED: "Si CT: BLOCK: LOT: LOCATION: ��`� OCCUPANCY: (�_ - ❑ Violation Noted THE WORK IS... PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION ` REQUIRED ❑ FOOTING 111 Y 1 ❑ 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 [1-,FINAL ❑ OTHER MILLER AND MILLE R REAL ESTATE ECENE 29 LOCUST AVENUE RYE,NY 10580 (914)939-4136 "AUG 12 2021 ROBERT MILLER VILLAGE OF RYE BROOD( 4)939-4111 PA BUILDING DEPARTMENT ORA MILLER ILL TAMORA BEN PRESTON-FRIDMAN RYAN HORNE ALYCIA FORBES PETER LAURA Ll /i /z01 P Lk c/l oy �a�i S-� cl �� -e �i�� e��.l�S-e� ��_ -�o I Icu��►� . I It( 4-Ki- Uitktv-� NIM J-0 be lf\r[lkd �;I�rt r5 C' � de(U ?1[tld C' w14-yl tvmmav A13ek)- is5 - ; hi�.al Plot ii- V � r 1W f > Z. �. R N o �' -D � W � • ae cv cz O / �)► c w Cl O O Z w CO c �_ction V O o w U 3 J r LL0 0 :� a�Jje 30 » i F- N a to z <c G ' OWN = » N: .. i sf I � (J •en � � N • M Vi .ter'' °�.�'�o'�' '" j►"� �'�' =- ACORO CERTIFICATE OF LIABILITY INSURANCE DATE 08/0303//2021 Y) 021 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 CONTACT Andy Nelson NAME: BNC Insurance Agency AHCNo Ext: (914)937-1230 A/C No): (914)937-1124 90 S Ridge St UL-2 E-MAiL s: anelson@bncagency.com ADDRE INSURER(S)AFFORDING COVERAGE NAIC N Rye Brook NY 10573-2836 INSURER A: Selective Insurance Company of the Southeast 39926 INSURED INSURER B: TWF CONTRACTING INC. INSURER C: 211 CHESTNUT ST INSURER D: INSURER E: PORT CHESTER NY 10573-3122 INSURER F: COVERAGES CERTIFICATE NUMBER: 21-22 GL with auto 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. VTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DDNYYY MM/DDNYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED CLAIMS-MADE �OCCUR PREMISES Ea occurrence $ 500,000 MED EXP(Any one person) $ 15,000 A Y S 2333460 03/19/2021 03/19/2022 PERSONAL&ADV INJURY $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 4,000,000 HPOLICY JEa F1LOC PRODUCTS•COMP/OPAGG $ 4,000,000 OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000.000 Ea accident ANY AUTO BODILY INJURY(Per person) $ SCHEDULED S 2333460 03/19/2021 03/19/2022 BODILY INJURY(Per accident) S AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident IOWNED EPAC $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ElN/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Village of Rye Brook is included as an additional insured when required under written Contract or Agreement. 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 Street AUTHORIZED REPRESENTATIVE Rye Brook NY 10573 5— ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD NYSIF New York State Insurance Fund 199 CHURCH STREET,NEW YORK,N.Y. 10007-1100 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE 0 .0 R� A^^^^A 134157673 LEVITT-FUIRST ASSOCIATES LTD 520 WHITE PLAINS ROAD, 2ND FL a TARRYTOWN NY 10591 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER T W F CONTRACTING INC VILLAGE OF RYE BROOK 211 CHESTNUT STREET 938 KING STREET PORT CHESTER NY 105733122 RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE G1243153-2 745202 06/29/2021 TO 06/29/2022 8/3/2021 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1243153-2, 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. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY,INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS://WWW.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. THOMAS FORBES-PRESIDENT TWF CONTRACTING INC ONE 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: 782862666 U-26.3