HomeMy WebLinkAboutRP21-050PERMIT # I" ®, 0
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SECTION . (S
TYPE OF WORK
JOB LOCATION
OWNER / Q/0)
CONTRACTOR%Y=Zt 2
EST. COST %S C;
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TCO #
FOOTING
FOUNDATION
FRAMING
RGH FRAMING
INSULATION
PLUMBING 0
RGH PLUMBING
GAS
SPRINKLER
ELECTRIC 0
Low -VOLT Q
ALARM
AS BUILT 0
FINAL
OTHER APPROVALS
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FEE — 1-
FEESi6p5 J06 DATE 141111I
FEE DATE
INSPECTION RECORD
DATE INSP
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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. Morlino
CERTIFICATE OF COMPLIANCE
April 11,2022
Aidan Walsh&Mary Walsh
17 Longledge Drive
Rye Brook,New York 10573
Re; 17 Longledge Drive, Rye Brook,New York 10573
Parcel ID#: 135.67-1-21
Roof Permit#21-050 issued on 9/16/2021 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
/to
i BUILDING DEPARTMENT For office use ool
PERMIT#
MAR 3 0 2022 VILLAGE OF RYE BROOK ISSUED:
L 1 938 KING STREET,RYE BROOK,NEW YORK 10573 DATE: U--�
VILLAGE OF RYE BROOK (914)9394"8 FEE: vs/ / �,5- PAIDK
BUILDING r) rtARTMENT wwwxyebrookxre
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
Address:17 Longiedge Drive, Rye Brook, NY 10573
Occupancy/Use: 5f H Parcel ID#: 1 3b.b1-1-21 Zone
Owner: Aidan Walsh Address: 17 Longiedge Drive, Rye Brook, NY 10573
P.E./R.A.or Contractor: Home Energy Repair DBA Gunner Address: 194 S Water Street, Greenwich, CT 06830
Person in responsible charge: Andrew Prchal Address: 194 S Water Street, Greenwich, CT 06830
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:
Andrew Prchal being duly sworn,dcposcsandsaysthathc/shc- id;sat194 S Water Street
(Print Name of Applicant) (No.and Street)
in Greenwich ,in the County of Fairfield in the State of CT ,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:S 24,000
for the construction or alteration of: Re-Roof Existing Building
Deponent further states that he/she has examined the approved plans of the structure/work herein referred to for which a Certificate of
Occupancv/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 turther understands that it shall be unlawful for an
nwner to Ilse nr nermit the nsr of anv hnildino nr nremises nr nart therenf hereafter created erected chanverl rnnverted nr enlaroed whnlly
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-IO.A.of the Code of the Village of Rye Brook.
k"L
Sworn to before me this U Sworn to before me this
day of M (-{ ,20 2 Z day of A; �A 20 2'Z_
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Ida V�a S GCA E
e of Property Owner ��!'�`.--- �q�., 7te of Applicant
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O�NEICIT�G��`'�� �,,,oi�/v CT�GJ`'��,
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�yE BRC��.
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 : , N'7 V C 5f - IZ- DATE: 6LZ,.?-
PERMIT#�� - �-� ISSUED:-1 z�SECT:t5S, BLOCK: LOT: 2
LOCATION: �v - �� 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
OF
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George Latimer A f
rS 1M w James Maisano 1
Westchester County Executive •Wm Director,Consumer Protection
.� Department of Consumer Protection
Home Improvement License '
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HOME ENERGY REPAIR LLC
1_AE 6639 E JEAN DRIVE
•__ I t
'- SCOTTSDALE,AZ-85254
7y : This license is issued in accordance with Article XVI of the Westchester County ti
Consumer Protection Code and is valid only upon presence of the official department seal.
,`•�= :I `cam°
License Number °A Date of Expiration
WC-32180-H19 o a 09/13/2021
slchester CON) t
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AC"J?o® CERTIFICATE OF LIABILITY INSURANCE DATE(MNYDDnvrY)
14%.� 1 07/21/2021
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 endorsemen s.
PRODUCER NONE; ETACT idan Gamely
Capital 8t Co Insurance Services PHONE FAx
287 S Robertson Blvd.#207 310 2.2007 MCI; 310 525-5292
Beverly Hills, CA 90211 ADDRE : Eidan@Capcoinsurance.com
License#:6002332 INSURE M)AFFORDING COVERAGE NAcs
_ IN3URERA: AM Specialty Insurance Company
INSURED INSURER S
Home Energy Repair
DBA Gunner Roofing INSURERC:
194 South Water Stree INSURERD:
Greenwich,CT 06830 INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 00000331.19781 REVISION NUMBER: 2
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 CONTRACTOR 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 - --N DL SUER POLICY NUMBER POLICY EFF POLICY E%P �,R
LTRNYY
A X COMMERCIAL GENERAL UAaalTY SIZGLO703A249604 04126=21 04126=22 EACH OCCURRENCE f 1,000,0W
DAMAGE TO RENTED
CLAIMS-MADE I X OCCUR MEMI $ .SO BOO
MED EXP ON eM /nW $ 5,000
PERSONA.&ADV NIJURY f 1,000,000
aENL AGGREGATE LIMIT APPLES PER: GENERA-AGGREGATE $ 2,000,000
X POLICY❑PRO-
CT ElLOC PRODUCTS-COMPlCIP AGG S 1,000,000
s
B AUTOMOBILE LIABILITY CO NXTOGMED-00-CA 05/07/2021 05/07/2022 COMBINarlu_ LELTMR $ 1 000 000
_ aBIN n
ANY AUTO BODILY INJURY OWperson) III
OWNED SCHEDULED BODILY INJURY OW saddert) f
AUTOS ONLY X AUTOS _
HIRED NON-OWNED PROPERTYD/1MAOE f
AUTOS ONLY AUTOS ONLY -.
f
UMBRELLA LIAB OCCUR EACH OCCURRENCE
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DIED I I RETENTION
WoRKEM COMPENSATION PER OTH
AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNERIE7XECUTIVE E.L.EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? ❑ N/A ---___ $ - — —
(Mandatory In NH) E.L.DISEASE-E_A EMPLOYEE_$
It ,describe urxJer
DE RIPTI F PERA 1 w E.L.DISEASE-POLICY LIMIT
DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedote,maybe attached if more space Is required)
Certificate Holder is an Additional Insured on the General Liability policy per the Additional Insured Automatic Status Endorsement.All Certificate Holder privileges apply only if required
by written agreement between the Certificate Holder and the insured,and are subject to the policy terms and conditions.
CERTIFICATE HOLDER CANCELLATION
VILLAGE OF RYE BROOK SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
938 KING STREET ACCORDANCE WITH THE POLICY PROVISIONS.
RYE BROOK,NY 10573
AUTHORIZED REPRESENTATIVE
G b4
®198S-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
Printed by GIA on May 07,2021 at 11:49AM
NYSIF
New York State Insurance Fund WESTCHESTER ONE,44 SOUTH BROADWAY,10TH FLOOR,WHITE PLAINS,NY 10601-4411
1 nysif.com
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
R.. 4*
^^^"^^ 832024199
HOME ENERGY REPAIR LLC D/B/A
GUNNER ROOFING
194 S WATER ST
GREENWICH CT 06830 SCAN TO VALIDATE
AND SUBSCRIBE
POLICYHOLDER CERTIFICATE HOLDER
HOME ENERGY REPAIR LLC D/B/A VILLAGE OF RYE BROOK
GUNNER ROOFING 938 KING STREET
194 S WATER ST RYE BROOK NY 10573
GREENWICH CT 06830
POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE
W2485 011-7 834408 09/12/2021 TO 09/12/2022 9/13/2021
THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE
FUND UNDER POLICY NO. 2485 011-7, 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:/[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 THE SOLE PROPRIETOR,PARTNERS AND/OR MEMBERS OF A LIMITED LIABILITY COMPANY.
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:497710530
U-26.3