Loading...
HomeMy WebLinkAboutDP21-005PERMIT# �I ' DATE: �I EXP: a3 �c- SECTION _43 5 f T v= BLOCK LOT / L TYPE OF WORK Z4 l 4- je 'j&7 w//1 71D li 0(lyi;//1s eol,&eofcoo T OTHER APPROVALS JOB LOCATION / ,�7 Q�)� ARB OWNER r/eeze 97i�koL7 C ® CCO / ��,�! j i'!/! �0 Sys 0/y)�/ %S� %% BOT CONTRACTOR Q `ons%-uG�4a-� E'. C- / /O� &t�e/7o5�ei.n /y)g --43Ps T. COST r�9' FEE Q / l/e ZBA OTHER CO # FEE J fd DATE TCO # FEE DATE INSPECTION RECORD DATE FOOTI N G INSP 19 VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Paul S.Rosenberg (914) 939-0668 Christopher J. 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 February 1,2022 The Estate of Arlene Shirken 10 Carlton Lane Rye Brook, New York 10573 Re: 10 Carlton Lane, Rye Brook, New York 10573 Parcel I D#: 135.42-1-5 Demolition Permit#21-005 issued on 9/23/2021 This certifies that the demolition work performed under the above captioned permit to remove the finished basement has been satisfactorily completed. Sincerely, 0� 7�_- Michael J. Izzo Building&Fire Inspector /tg 1 � C:� bi ,artFvr office use only:BUILDW0.�E TMENT PERMIT# 1v: f A 20 7 VIL �►►tOF RYE 0*90K ISSUED: ' W1 9 8 KING STRE>T3E BROOK,NW YOItIC 10573 DATE: /-a(o-avaa VILLAGE OF RY!:- c-7�r'OK Q. G%' FEE: PAID CI 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 ##i#4####it!!litttiiiliiiti////##ft•tlssitftss•tttf##•ti###4tifssstsfftsstftf/►•f4t##i44iist/sftt►sf#ft4###44i###ttfttsstfti/ Address: 10 C-A&LTvh1 LA N' E f:`A L "F>Qc>C>\S N a573 Occupancy/Use: Y Parcel ID#: /'�J. — /— _Zone: R Owner: fsTAF c -F AKLEnIE 'S14-411ZI'�F Ai Address: 10 CA2LTUN fa4 6 'fsi;c_Dc)K P.E./R.A. or Contractor: ��T Address: I IV\I Person in responsible charge: A 1 S 4 TE NS fE I� 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 NEW YORK,COUNTY OF WESTCHESTER as: Ly, ; Mo;ryC-_Iz q being duly sworn,deposes and says that he/she resides at (Print Name of Applicant) (No.and Street) in—PRIG��'-��K ,in the County of WCS_'VCH in the State of n ,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:$ . Coo for the construction or alteration of: S 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. C� Sworn to before me this Sworn to before me this d day of 20 T� day of ,20� Signature of Property Owner Sipe f Applicant ZC_'c_,T i IFE N rev r- '=� N MSS h1E� t Name of Property thvner ame of Applicant Z Notary Public Notary Public SHARI MELILLO SHAM MELILLO Notary Public, State of New York Notary Public, State of Now York Flo. 01-oiIF6160063 No. (1,stC 6160033 8i12a021 Qualified in Westch ster County Qualified in Westch.=stet County Commission Exr)ires January 29 20� Commission Exoires January 29.20�� �E BR(�v�. o`` tim ' 19.32 BUILDING DEPARTMENT ❑BUILDING INSPECTOR jQ�iMSSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK = LJ CODE ENFORCEMENT OFFICER 938 RING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAX (914) 939-5801 www.ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : �n� c%w DATE: PERMIT# ISSUED: *�l SECT: BLOCK: LOT: LOCATION: O14� �� 5E'.S� �S\ l L`��c kA6A wc-'uPANCY: V ❑ 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 Q FINAL ❑ OTHER Certificate# 238389 Surrogate's Court of the State of New York Westchester County Certificate of Appointment of Executor File#: 2021-372 IT IS HEREBY CERTIFIED that Letters in the estate of the Decedent named below have been granted by this court, as follows: Name of Decedent: Arlene H Shirken Date of Death. December 22, 2020 aka Arlene Shirken Domicile: Rye Brook, New York Fiduciary Appointed: Scott Shirken Mailing Address: 99 Butternut Lane Stamford CT 06903 Type of Letters Issued: LETTERS TESTAMENTARY Letters Issued On: March 3, 2021 Limitations: NONE and such Letters are unrevoked and in full force as of this date. Dated: March 10, 2021 IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of the Westchester County Surrogate's Court at White Plains, New York_ WITNESS, Hon, Brandon R. Sall, Judge of the Westchester County Surrogate's Court. Johanna K. O'Brien, Chief Clerk Westchester County Surrogate's Court This Certificate is Not Valid Without the Raised Seat of the Westchester County Surrogate's Court EQ��� SEP 2 0 2021 VILLAGE OF RYE BROOK BUIL DING_DEPARTMENT ' 9 ��'�n >, A�R1 ��:�A�lfilt _.�rAti i'��A ��j� t,a�tA�rf t� _fi�r,r.� ld�A9,(ft�\" !itb�J}G \- �.%vl�A•,+ �� SIR Etil+t5� � , t 0 ,ko • y 0 4�s ..,,1r •• .E} i. ♦!♦ 3�r�, r, f! t!!}Qif°� 4�:�. ♦• � i1""M!!}�`' •F a � ♦!! 1` ' r} � , „ N,F }II!/!//It} }" is 'i c o u ;,�ccois l; •c u r C7 } y �'?��• u ie Rf N J P. Q4j wU O O N �1PVlYlli lb fC C m ca cc i '4-Fslx` FBI •U y s 1 S AV " fu � s` ` � 4 kor •r� rA '1p�br9ilt� I'. CD y C/7 ilAV .yDs3 ' ! N O CD otieGtiall r? fOi LJ J O zLZ b y� �.• 4 N 2 / R co ©co ! / tw v, N -U(t]!) ,�� .ir. :•/1�11} _.. '3' �!P}Il+lii.s c -rx„11j�111 `s � _ •i-41`11, s�, x �}1;;1,1, a* tJi'}Iri11} .sia.' g. }II,1}..n;s. <t«74))�y � }i►AMA - _111,r/q} "lyl//r/,ri •-,#///r/�1+} r /11l/1/,rl} -,1//#///1�1 .:.' F .. _�yx,��' •�.F4-E. _ a, .� t•I� �"�,, ,� .'0' qr �y tgt 1tiyti� r� UJ�fdr fl Y � •• .f CERTIFICATE OF LIABILITY INSURANCE DA-(MMIDDIYYYY) 09/16/2021 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(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 C NTAC Robert Forbes Robert J. Forbes NAME:_ dba Forbes Insurance Agency PHONE FAX g y 1A1C.No Ertl- _ . : 562 Commerce Street E-01AIL "'� - �C No] - Thornwood, NY 10594 ADDRESS: INSURER _US AFFORDING COVERAGE NAIL a INSURER A: Falls Lake National Insurance Company 31925M nvsuRla LOSat Construction Co Inc 12 Foley Road INsuRER eSTATE INSURANCE FUND 36188 Katonah, NY 10536 INsuRERc. SHELTER POINT LIFE INSURANCE CO A05116 INSURER D: - INSURER E -- 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- IADDL$IJBRR LiR TYPE OF INSURANCE POLICY NUMBER .I M`jyyppryyyy MDpYjyY �� A CONNERCIAL GENERAL LUIBILITY j SKP2013602 �0411612021 U4/1 612 0 22 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE L OCCUR 11kPREMI EIS Ee�pcc�uErrence $ 100,000 - MED EXP(Any one Person) $ 5,000 PERSONAL&ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GEN£RALAGGREGATE S 2,000,000 POLICY E]JECT ❑LOC PRODUCTS-CONPIOPAGG S 2,000,000 OTHER S AUTOMOBILE LIABILITY NEDSI LE LIM ANY AUTO Ea accident S OWNED f BODILY INJURY(Per Parlilln) S SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Peracddent) S AUTOS ONLY AUT03 ONLED NONO DY PROPERTY DAMAG Per acrgent) S UMBRELLA GAB S OCCUR EACH OCCURRENCE S EXCESS LIAR CLAIMSaAADE AGGREGATE S RDED � RETENTION 5 _ S B ANDEMPS YERS' SATION ABJUT W14846067 07/1112021 �107/11/2022 �R AND EMPLOYER$'LIABILITY YIN I T R� I ANY PROPRIETORMARINFRE%ECUTIVE ER EXCLUDED? ❑ N!A E.L.EACH ACCIDENT $ 100,000 (Mandatory In NH) 61 yes describe under E.L.DISEASE-EA EMPLOYEE 5 100,000 DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY UMIT S 500,000 C Disability D419372 01/01/2021 �01/01/2022 Statutory Limits DESCRIPTION OF OPERATIONS f LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if mom space Is required) Carpentry-Al Locations-Exludes Roofing 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. Building Department 938 King Street AUTHORIZED R_EPRESENTA)IVE Rye Brook. NY 10573 r i' 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD NYSIF New York state insurance Fund WESTCHESTER ONE,44 SOUTH BROADWAY, 10TH FLOOR,WHITE PLAINS,NY 10601A411 I nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED) t7. � ""^"^" 133275833 FORBES INSURANCE AGENCY . 562 COMMERCE STr F THORNWOOD NY 10594 Q taj7 _ SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER LOSAT CONSTRUCTION COMPANY INC VILLAGE OF RYE BROOK 12 FOLEY RD KATONAH NY 10536 938 KING STREET RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD W1484 606-7 937723 07/11/2021 TO 07/11/2022 911 PATE ATE 6/2021 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1484 606-7. 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:IIWWW.NYSIF.COMICERT/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. DAVID SATENSTEIN-PRESIDENT OF LOSAT CONSTRUCTION COMPANY INC 1OF1 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 l' DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 934610108 U-26-3