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Home My WebLink AboutRP21-023PERMIT #JelpQ\ SECTION TYPE OF WORK _ JOB LOCATION OW N ::�o4J 3 DATE3 Lc;l I Few O%/OGti 't r QP CONTRACTOR___,_., �/ ,/EST. CO I TCO # FEE DATA INSPECTION RECORl2 DATE FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING L7 RGH PLUMBING GAS SPRINKLER ELECTRIC 0 LOW -VOLT 0 ALARM AS BUILT 0 INSP FINAL iy)3a� a y3�/ R APPROVALS �/ ,/EST. CO I TCO # FEE DATA INSPECTION RECORl2 DATE FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING L7 RGH PLUMBING GAS SPRINKLER ELECTRIC 0 LOW -VOLT 0 ALARM AS BUILT 0 INSP FINAL iy)3a� a y3�/ R APPROVALS c4CW+�J v V 4 C� 4014 iZ nnit�a%* 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.Morlino CLARIFICATION OF RECORD June 14,2022 Andrew Calderone&Angela Tolano 105 Brush Hollow Close Rye Brook,New York 10573 Re: 105 Brush Follow Close, Rye Brook,New York 10573 Parcel ID#: 129.84-2-94 Roof Permit#21-023 issued on 6/3/2021 to Re-Roof Existing Building An inspection of the of the above referenced property on June 13,2022,reveals that although Roof Permit #21-023 dated 6/3/2021 was issued, the re-roofing of existing building was never done,and this permit is rendered null and void. Sincerely, Michael J. Izzo Building&Fire Inspector /to RFcF BUILCBR ENT For office use onl VIL K PERMIT JUN 2 4 2021ISSUED: (p—3--3I 8 KING STREE YORK 10573 DATE: VILLAGE OF RYE BROOK (914)9 �939-5801 FEE: .E$ //Q- PAIDit BUILDING DEPARTMENT 0 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 ****s*»*s*ss**ssss»*»s***»****sssssss*ssss***»***»s»s*sss*ss*s*****»*ssss»ss»***»»s»ssssss**s*s»ss*ssss***»*ssss***s****»s»** Address: 105 g,r SL V? )D S q3 Occupancy/Use: 1/WWW Parcel ID#: /c)y.8 -al— y Zone: Au 16 Owner: 4 h 11c� Address: �Sa/✓I e P.E./R.A.or Contractor: Address: Person in responsible charge:,4/ �e(4) _Q/Q/Q/C.Ie Address: >'uS 4 V'10l/ok;C/sOS2 Q,61W� �y /0�73 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 1jYORK,COUNTY OF WESTCHESTER as: (� �'d c e—/ uklzs �- being duly sworn,deposes and says that he/she resides at 105 1�"5 L (Print Name of Applicant) (No.and Street) y� in �J� g-" - ,in the County of �,.t sa-'."W 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 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:$ 3 sd'O 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 §250-1 O.A.of the Code of the Village of Rye Brook. Sworn to before me this Sworn to before me this day of L?�t�� , 201=1�\ day of , 20 ignature of Property Owner Signature of Applicant N �-Jmyr ( ewt P�4qNameof Property Owner Print Name of Applicant Aa'�---V\1'L L— Notary Public Notary Public SHARI MELILLO Notary Public, State of New York No. 01 ME6160063 Ouatified in Westchester County Commission Exo1res.JBflu,'n,pg 20a3 QyE BRC�v�. BUILDING DEPARTMENT ❑BUILDING INSPECTOR pASSISTANT 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.ore - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS :— �-%, D S� V --' CJC" DATE: �O (� L PERMIT# �` j ISSUED: ` SECT: BLOCK: LOT: N vA � C.�b�+` LOCATION: \L` '-" 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 �V� [I NATURAL GAS 0 ❑ L.P.GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION \ ❑ FINAL n Y `Q- y� ❑ OTHER M• . f t Y A 1 'dP Y r OCCIDENTAL FIRE & CASUALTY COMPANY OF NORTH CAROLINA Policy Declarations A Member Of: MINSURANCE GROUP Policy Number: Statement Date: CUSTOMER SERVICE NYP543942300 March 17, 2021 For Policy Service Named Insured: Producer: Call Your Producer: ANDREW CALDERONE EC2051A (914)723-2400 ANGELA TOLANO JOSEPH JOHN SPADAFINO 105 BRUSH HOLLOW CLOSE 64 GARTH ROAD For Claim Service RYE BROOK, NY 10573 SCARSDALE, NY 10583 (914)329-2434 isaadafino@ m allstate.co Call Occidental Claims: (877)842-0227 Additional Insured: Agent of Record: or file a claim online @ None SAGESURE INSURANCE MANAGERS LLC www.IATlnsuranceGroup.com/ PO BOX 12999 claims/report-a-claim-property TALLAHASSEE, FL 32317 For All Other Inquiries: (800)481-0643 Policy Period: Residence Premises: Transaction Type: Endorse March 31, 2021 to March 31, 2022 105 BRUSH HOLLOW CLOSE RYE BROOK, NY 10573 Trans Effective Date: March 31, 2021 12:01am local time at location of the residence premises Trans Amount: $ Your Insurer: OCCIDENTAL FIRE&CASUALTY COMPANY OF NC TOTAL POLICY PREMIUM $680 702 OBERLIN ROAD This is not a bill, you will be invoiced separately if RALEIGH, NC 27605 needed. Policy Coverages and Limits of Liability: Policy Savings: Section I Property Limit The following credits and discounts reduced your total A. Dwelling................................................................ $285,000 policy premium: B. Other Structures................................................... $28,500 C. Personal Property................................................ $171,000 Policy Deductibles: D. Loss of Use.......................................................... $57,000 In case of loss under Policy Coverages, we cover only that part of the loss over the deductible stated. Hurricane Section II Liability Windstorm deductible applies to all Section I coverages E. Personal Liability- Each Occurrence................... $300,000 except for Loss of Use.All Other Perils (including non- F. Medical Payment to Others-Each Person........... $1,000 hurricane windstorm)deductible applies to all Section I coverages. Mandatory Forms and Endorsements: Hurricane(5%of Coverage A)................... $14,250 HO 00 03 10 00-Homeowners 3 Special Form All Other Perils........................................... $1,000 HCO10010 03 10-Amendment of Policy Provision HO 01 31 09 15-Special Provisions-New York HO 04 96 10 00-No Coverage For Home Day Care Business Fees &Taxes: HO 16 10 01 09-Water Exclusion NY Fire Insurance Fee............................... $3 HO 24 93 05 02-Workers'Compensation Endorsement HCO100014 06 15 Page 1 of 2 OCCIDENTAL FIRE & CASUALTY COMPANY OF NORTH CAROLINA Policy Declarations A Member Of: MINSURANCE GROUP Named Insured: Policy Number: Statement Date: ANDREW CALDERONE NYP543942300 March 17,2021 Policy Forms&Endorsements: Limits of Liability($) Increase Total Premium($) HO 04 90 10 00-Personal Property Replacement Cost Loss Settlement Included HCO14171 03 09-Hurricane Windstorm Deductible Cat 1 or Higher-NY Included HO 23 95 05 02-Off Premises Theft Exclusion Included Mortgagees&Other Interests: Mortgagee: LUXURY MORTGAGE CORP ISAOA/ATIMA 4 LANDMARK SQUARE SUITE 300 STAMFORD,CT 06901 LOAN#:2102EM043457 Other Information: Rating Territory:49 Year Built:1979 Protection Class:3 Number of families:1 Construction:Frame Rating tier:0 IN WITNESS WHEREOF, the Company has caused the facsimile signatures of its President and Secretary to be affixed hereto, and has caused this policy to be signed by an authorized representative of the Company. Occidental Fire& Casualty Company of North Carolina tD March 17, 2021 David G. Pirrung Michael Blinson Countersign date President Secretary For information about how the Company compensates insurance producers, agents and brokers, please mail your requests to Occidental Fire&Casualty Company and North Carolina, PO Box 12999,Tallahassee, FL 32317 HCO100014 06 15 Page 2 of 2 OCCIDENTAL FIRE & CASUALTY COMPANY OF NORTH CAROLINA A Member Of: MINSURANCE GROUP March 17, 2021 Policy Number: NYP543942300 LUXURY MORTGAGE CORP ISAOA/ATIMA 4 LANDMARK SQUARE SUITE 300 STAMFORD, CT 06901 To Whom It May Concern, You are receiving this package because you are listed as a mortgagee for the policy below: POLICY NUMBER: NYP543942300 ANDREW CALDERONE ANGELA TOLANO 105 BRUSH HOLLOW CLOSE RYE BROOK, NY 10573 Enclosed you will find the Policy Declarations and related documents for the Homeowners Policy issued by Occidental Fire And Casualty Company of NC. If you have any questions concerning this policy, please contact us at the telephone number displayed on the attached Declarations. We appreciate your attention to this matter. Joseph John Spadafino Affidavit of Exemption to Show Specific Proof of Workers' Compensation Insurance Coverage for a 1, 2, 3 or 4 Family, Owner-occupied Residence **This form cannot be used to waive the workers'compensation rights or obligations of any part},.** Under penalty of perjury, I certify that I am the owner of the 1, 2, 3 or 4 family, owner-occupied residence (including condominiums) listed on the building permit that I am applying for, and I am not required to show specific proof of workers' compensation insurance coverage for such residence because (please check the appropriate box): ❑ I am performing all the work for which the building permit was issued. I am not hiring,paying or compensating in any way,the individual(s)that is(are)performing all the work for which the building permit was issued or helping me perform such work. ❑ I have a homeowners insurance policy that is currently in effect and covers the property listed on the attached building permit AND am hiring or paying individuals a total of less than 40 hours per week (aggregate hours for all paid individuals on the jobsite)for which the building permit was issued. I also agree to either: ♦ acquire appropriate workers' compensation coverage and provide appropriate proof of that coverage on forms approved by the Chair of the NYS Workers' Compensation Board to the government entity issuing the building permit if I need to hire or pay individuals a total of 40 hours or more per week(aggregate hours for all paid individuals on the jobsite)for work indicated on the building permit,or if appropriate,file a CE- 200 exemption form; OR ♦ have the general contractor, performing the work on the 1, 2, 3 or 4 family, owner-occupied residence (including condominiums)listed on the building permit that I am applying for,provide appropriate proof of workers' compensation coverage or proof of exemption from that coverage on forms approved by the Chair of the NYS Workers' Compensation Board to the government entity issuing the building permit if the project takes a total of 40 hours or more per week(aggregate hours for all paid individuals on the jobsite)for work indicated on the building permit. A,0----�—� — 4/)hi, (Signature of Homeowner) Date Signed) AhAlt" C\de1`rQ_ Home Telephone Number g�y - -a4 3 (Homeowner's Name Printed) Sworn to before me this �C ____ day of Property Address that requires the building permit: 5 D raSL Ma" Cask �`, I b r nl� (County Cle l��(L Public) C-N% `� 7 Notary Public,State of Now York No. 01 ME6160063 Oua!ified in Westchester County Commission Exoires J muarl 29 ?^�3 Once notarized,this BP-1 form serves as an exemption for both workers'compensation and disability benefits insurance coverage. BP-1 (12/08) NY-WCB