HomeMy WebLinkAboutRP21-054jr
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INSULATION
PLUMBING
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SPRINKLER
ELECTRIC
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. 19
404 annim"aW
VILLAGE OF RYE BROOK
MAYOR 938 King Street, Rye Brook, N.Y. 10573 ADMINISTRATOR
Jason A. Klein (914)939-0668 Christopher J. Bradbury
w u.ryebrook.org
TRUSTEES BUILDING& FIRE INSPECTOR
Susan R. Epstein Michael J. Izzo
Stephanie J. Fischer
David M. Heiser
Salvatore W. Morlino
CERTIFICATE OF COMPLIANCE
October 19,2022
Anthony Sabia&Amanda Sabia
7 Acker Drive
Rye Brook,New York 10573
Re: 7 Acker Drive, Rye Brook,New York 10573
Parcel ID#: 135.44-1-36
Roof Permit#21-054 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,
Michael J. Izzo
Building&Fire Inspector
/to
D C E O V E BUILDING DEPARTMENT For office use o
PERMIT# � J-
541
VILLAGE OF RYE BROOK ISSUED:
O C T - 6 2022 1 aNG STREET,RYE BROOK,NEW YORK 10573 DATE: )-
(914)939-0668-FAX(914)939-5801 FEE: PAID I3/
VILLAGE OF RYE BROOK www.aebrook.org
BUILDING DEPARTMENT
APPLICATION FOR CERTIFICATE OF OCCUPANCY,CERTIFICATE OF COMPLIANCES
AND CERTIFICATION OF FINAL COSTS
TO BE SUBMITTED ONLY UPON COMPLETION OF ALL WORK, AND PRIOR TO THE FINAL INSPECTION
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Address: 7 Acker Drive, Rye Brook, NY 10573 Occupancy/Use: SFH Parcel ID#: ��3Jr" •`�'�'-� 3(o Zone: �_'^
Owner: Anthony Sabia Address: 7 Acker Drive, Rye Brook, NY 10573
P.E./R.A.or Contractor: Home Energy Repair Ads: 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 YOM COUNTY OF WESTCHESTER as:
Andrew Prchal being duly sworn,deposes and says that he/she resides at 194 S Water Street
(Prim Name of Applicant) (No.and Street)
in Greenwich ,in the County of Fairfield in the State of CT 'that
(Cityfrown/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 16,700
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.
Swom to before me this1 Sworn to before me this
day of Y , 20 day of
Si of Property Owner6E A ��i, Signature ofApplicant
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1982 BUILDING DEPARTMENT
?ASSISTANT
UILDING INSPECTOR
BUILDING INSPECTOR VILLAGE OF RYE BROOK
❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573
(914) 939-0668 FAx (914) 939-5801
www rygbrook.org
- - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - -
ADDRESS : -P2 Qk\-4D DATE: I \ 12 J
PERMIT#(2
ISSUED: kDI`f�2�ECT: IBLOCK:�_LOT:
�Q
LOCATION: '� OCCUPANCY:
❑ VIOLATION NOTED THE WORK IS... ACCEPTED ❑ REJECTED/REINSPLCTION
❑ SITE INSPECTION r 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
A",CROSS CONNECTION
FINAL
❑ OTHER
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�r�P�_ • ��Y•f� i��i'/:•I��'.i
George Latimer S 'r ;Isga Its"
_r Westchester.County Executive I}�5 ' c �.WTIl Diretor,6u mtur Prouetbu
a�►5.' Department of Consumer Protection
Home Improvement License
a .
< HOME ENERGY REPAIR LLC
E 6639 E JEAN DRIVE
SCOTTSDALE,AZ-85254
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�k This license is issued in accordance with Article XVI of the Westchester County -
:: ••�~ Consumer Protection Code and is valid only upon presence of the official departaent seal. {-
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License Number A Date of Expiration
WG32180-H19 0 09/132023 3
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g� �„ys,��v`��� Yv��ys�Y�•��1..,-�l.'.;��y. � ve�. - ����' 'rS,~�!' �<.�"v.,v '„sa'� (` "v
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,acoKr�' CERTIFICATE OF LIABILITY INSURANCE DATEIMWDDNYM
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 al.
PRODUCER CONTACT
NONE_ EldsnGamtrty
Capital &Co Insurance Services PHONE FAX
287 S Robertson Blvd. #207 310 2.2007 ; 310 525.5292
E-MAIL
Beverly Hills,CA 90211 _ADDRESS_ Eidan@Capcoinsurance.com
License M 6002332 _ _ __ INSURER(s)AFFORDING COVERAGE NAIC•
INSURER A: AIX Specialty Insurance Company _
INSURED INSURER B: _$
Home Energy Repair
urance Company,Inc. 12831
DBA Gunner Roofing INSURERC:
194 South Water Stree INSURERD:
Greenwich,CT 06830 INSURERE: _
INSURERF:
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 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.
Lam' TYPE OF INSURANCE ADDLSUBR WvD POLICY NUMBER FOLICYEFF MOLICYEXPillyporrim ---- ------ - L11
A X COAAAAERCIALGENERALLIAELntr SIZGLO703A249604 04/26/2021 D4126/2022 EACH OCCURRENCE $ 1000000
DAM
41 OCCUR AGE TO RENTED S .SO 000
MED EXP one peraonIl 5.00
PERSONAL&ADV INJURY fl 1 000 000
GENL AGGREGATE LIMB APPLES PER GENERAL AGGREGATE S 2,000,000
X PO ❑LICYJECT LOC PRODUCTS-COMP/OPAGG S 1,000,000
$
B AUTOMOBLEUABLf1r NXTOGMED-00-CA 05/07/2021 05/07/2022 COMBINED ccidrSINGLE LIMIT $ ' .00
ANY AUTO BODILY INJURY(PW pown) S
OWNED SCHEDULED BODILY INJURY(PWaodd111t) S
AUTOS ONLY X AUTOS
HIRED NON-OWNED PROPERTY DAAAAf s
AUTOS ONLY AUTOS ONLY -For
$
UMBRELLA LIAR OCCUR EACH OCCURRENCE
EXCESS LIAR HCIAR*PAADE AGGREGATE $
7 ENTION
DED RET $
WORKERS COMPENSATION PER I�
AND EMPLOYERS'LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE Y N E.L.EACH ACCIDENT =
OFF ICER/MEMBER EXCLUDED? N/A
(Mandatory In Nip E.L.DISEASE-EA EMPLOYEE S
II D , u r
PERATI I E.L.DISEASE-POLICY LIMIT
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is requlred)
Cartificate 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 REPRESENTATNE
t�L G IA
9)1588-2015 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 1 0601-441 1
1 nysif.com
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
AAAAAA 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. 2485011-7, 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