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HomeMy WebLinkAboutRP21-052PERMIT #Ili;6 /7 SECTION TYPE OF WORK JOB LOCATION _ - O S, DATE: /o'� BLOCK LOT T.COST:. • ,�FEEi •# if FEE:. DATETCO FEE- DATE INSPECTION RECORD DATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING O RGH PLUMBING GAS SPRINKLER ELECTRIC 0 -• -�- LOW -VOLT O -- ALARM C� AS BUILT L� FINAL !-cha / Cao317 3093 3 OTHER APPROVALS ARB BOT PS ZBA OTHER 04 v� I'y Lc r 1 1 -2t VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury www.acbrook.org TRUSTEES ACTING BUILDING & FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE January 25,2023 Sean O'Connor&Mary Anderson 5 Lee Lane Rye Brook,New York 10573 Re: 5 Lee Lane,Rye Brook,New York 10573 Parcel ID#: 135.66-1-30 Roof Permit#21-052 issued on 10/4/2021 to Re-Roof Existing Building This certifies that the new roof,installed under the above captioned permit has been satisfactorily completed. Sincerely, Steven E. Fews Acting Building&Fire Inspector /to D IE CIE BUILDING DEPARTMENT For office uAse I : 3D PERMIT# -OT4 JAN 19 2023 VILLAGE OF RYE BROOK ISSUED: - —4 38 KING STREET,RYE BRooK,NEw YORK 10573 DATE: — VILLAGE OF RYE BROOK (914)939-0668 FEE: PAID BUILDING DEPARTMENT wwwxyebroolLorg 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: 5 Lee Lane, Rye Brook, NY 10573 / Occupancy/Use: 2 /5,41y Parcel ID#: /35 i 6� _�— 3 C) Zone: —10 Owner: Sean O'Connor Address: 5 Lee Lane, Rye Brook, NY 10573 P.E./R.A.or Contractor: Home Energy Repair DBA Gunr)ffdress: 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 WESTCUESTER as: Andrew Prchal being duly swom,deposes and says that he/she resides at 194 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:g 10,000 for the construction or alteration of: Roof Replacement 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 Ig 44^ Sworn to before me this day of (AV�VO�( , 20 3 day of ✓l Uri ,20?3— Signature of Property Owner ���� Q E C C q '��,�� Signature of Applicant Se T Li nh o k '�9 �n��r�t� Pr�►,�� Print N e of P erly Owner . O T j ��'' Print N Applicant C� Cq blic ',o BLIG �`V FCTIGv = ;o ,o '� N' C� ' �yE BRC�k. Q��1 T�O� '982 BUILDING DEPARTMENT ❑BUILDING INSPECTOR ` SSISTANT 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 - - - - - - - - - - - - - - - - - - - - INSPECTIONREPORT - - - - - - - - - - - - - - - - - - - ADDRESS:— DATE: CLPERMIT# ISSUED: ( V`4 SECT: BLOCK: LOT: LOCATION: OCCUPANCY• ❑ VIOLATION NOTED THE WORK IS... ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTIONS S(y6C REQUIRED ❑ FOOTING ❑ FOOTING DRAINAG �/T* ❑ 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 �+ O .fie • i. "�G 6+ •�' c i�' �� . .e jh� /�� ", v' �` I George Latitner t. a James Maisano r Westchester County Executive .,�:S;�?�;� �r f 'Wm Director,Consumer Protection - xb. ao2► • ' � Department of Consumer Protection Home Improvement License .�,. HOME ENERGY REPAIR LLC = 11 6639 E JEAN DRIVE 3 -. J � - - SCOTTSDALE,AZ-85254 This license is issued in accordance with Article XVI of the Westchester County w� > department Cottstnnler Protection Code and is valid onlyn presence of the official seal. .� pac.op> 'r . Consm g - o� are v� v _ License Number A Date of Expiration 9x r C 09/13/2023 6 WG32180-HI9 Ck t zcA. hOster Cooc NMI O0c"tur una n usw AcoHo CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD/YYYY) 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 pollcy(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 endorsements. PRODUCER NAM: Elden Gamaiy ACT Capital 8t Co Insurance Services FAX PHONE 287 S Robertson Blvd. #207 310 2.2007 t.C. No: 310 525.5292 Beverly Hills, CA 90211 E Eidan Ca coinsurance.corn License#: 6002332 _INSURER1s1AFFOrtarwcOVEtAOE_ MAICII NVJMA: AW Specialty Insurance Company INSURED NSUIM B Home Energy Repair DBA Gunner Roofing NSUIMC: 194 South Water Stree Sw - COVERAGESMD: Greenwich,CT 06830 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 INOUnANCE ADDL=R� POLICY EFF POLICY LTR POLICY NUMBER LIMITS A X COMM"lli'liculL OMM-4L LWOM SIZGLO703A249604 042WMI 041261= EACH OCCURRENCE $ 1000000 DAMAGE TO RENTED--- - mAus-MADE X OCCUR ISEE$(Ea oocurre- f 50 000 MED EXP Any one person) 5,M PERSONAL III,ADV INJURY $ I.W0,00 GENT AGGREGATE UMIT APPLES PER GENERAL AGGREGATE $ 2,000,000 X POLICY ,I ME COT* 7 LOC PRODUCTS-COMP/OPAGG $ 1,1111INA0 THFR: _ B AUTOMOBILE LIABLITY NXTOGMED-00-CA 05/07/2021 05/07/2022 COMBINED SINGLE t.IMIT S (Fa a"WenU ANY AUTO BODILY INJURY(Per person) _ OWNED SCHEDULED BODILY INJURY(Par acddsnt) $ AUTOS ONLY X AUTOS HIRED NON-OWNED PROPERTY DAMAGE S AUTOS ONLY AUTOS ONLY (Per >j UMBRELLA LAB OCCUR EACH OCCURRENCE III EXCESS LAB CLAIMS-MADE AGGREGATE _ DIED RETENTION WORKERS COMPENSATION I PER AND EMPLOYERS'LABILITY Y NIER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT s OFF ICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE_-EA EMPLOYEE III M ,deavlbe under RIPTI F PE RATIONS below E.L.DISEASE-POLICY LIAR i DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Scheduls,may be afteawd If more space Is requlmd) 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 G IA ©1988-2015 AC RD CORPORATION. All rights reserved. ACORD 25(2016103) 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 �. -'* ^^A A A A 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 9/28/2021 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:/NVWW.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