Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAboutRP21-061PERMIT #
SECTION
TYPE OF WORI
JOB LOCH ON
OWNER
CONTRACTOR,
E .
0#
TCO #
/ DATE: EXP: / o oilo a 4
BLOCK LOT
/r
INSPECTION RECORD
I DATE INSP
FOOTING
FOUNDATION
FRAMING
RGH FRAMING
INSULATION
PLUMBING []
RGH PLUMBING
GAS [�
SPRINKLER
ELECTRIC CJ
LOW -VOLT F1
ALARM (�
AS BUILT CJ
FINAL
r� �Q�a
74
ofrP rZ1 )3Al 30S3
ZBA
OTHER APPROVALS
ARB
BOT
PB
OTHER
t ry��c. +LU �w„
4014 anniueuaW
VILLAGE OF RYE BROOK
MAYOR 938 King Street, Ave Brook, N.Y. 10573 ADMINISTRATOR
Jason A. Klein (914) 939-0668 Christopher J. Bradbury
www.ryebrookor�
TRUSTEES BUILDING& FIRE INSPECTOR
Susan R. Epstein Michael J. Izzo
Stephanie J. Fischer
David M. Heiser
Salvatore W. Morlino
CERTIFICATE OF COMPLIANCE
April 26,2022
Charles Parker&Dawn Lapiana
94 Grant Street
Rye Brook,New York 10573
Re: 94 Grant Street,Rye Brook,New York 10573
Parcel ID#: 141.43-1-29
Roof Permit#21-061 issued on 10/26/2021 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 E `V� E N E BUILD R ENT For office use onI
PERMIT#
VIL OF,RYE OK ISSUED: /n_9^,
MAR 18 20223D 38 KING STRE YKRoom YoRK 10573 DATE:
VILLAGE OF RYE BROOK FEE: PAID G
BUILDING DEPARTMENT
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
rrrrrwrt►►►■►►►rrrwwwrrr■t►►►►►►r►rrrrwrrw►wrt►■r►r►t►►►♦r►rrrwrrrwwwtrr►►•►r►t►►►tr►►•►►r►rrrrrrrw►wrr►r►►►r►►►►►►►►►►►t►►►►
Address: ? qt
Occupancy/Use:R r*1 JV Parcel lD#: 101 - 14 5-1--2 9 Zone: Rap-
fr-
Owner: 1111 I i )j 1 Address:a",
�►� :�,7(,
l --
P.E./R.A. or Contractor:,--�Ia k'l fl6a( k=c�C);6 Address: ' ALA `c� 1r1,n kr rC'['n m Lj-1
Person in responsible charge: And r ,, Address: .i�~
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:
. 1 Ig Q j ru being duly swom,deposes and says that he/she resides at',
(Print N'ame of Applicant) (No.and Street)
in r'4'r_ \ l ,in the County of in the State of ,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 / 1 15 0
for the construction or alteration of jU C u , r
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 �� Sworn to before me this
day of lv\rrt� ,20ZZ day of , 20
Signature of Pfoperty Owner Signature of Applicant
Print Nam of rop ex Print Name of Applicant
Notary Public Notary Public
CHRISTOPHER J.BRADBURY
Notary Public,State of New York 8/12/2021
No.01 BR6159985
Qualified in Westchester County
Commission Expires January 29,20 23
QyE BRC�v�
o`` tim
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 : ( G 1 l? l .1
1 DATE: tI b L-Z Z
PERMIT# 322 2 JCS ISSUED: o "L ?SECT: BLOCK: I LOT:2T
LOCATION: 1� OCCUPANCY: z�
❑ 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 C C
❑ FUEL TANK
❑ FIRE SPRINKLER
❑ FINAL PLUMBING
❑ ROSS CONNECTION
FINAL
OTHER
e e
a � e
= 0 N °� s
s p � s
r.
N N 47 OC cC as
CIA
W r W)i V o o -o Gzl
W CZ p
f� 11 T yy
s V-4
►�/I r e o -� c ° w e �7
'gunaj
m co
a 0
C� to
o
si � � � r� � �,n OQ M �X C � �s G = ►.�
= O M
a TThh H00 �+ 3 '� a n "c � � � v a.
o° z o va
en Q Q eq
® W Q s
O aCV a1
O VA
^ OC1 Grp I�+' W� v ;,-,-
0 $, o o ®
z < b o Q
O C w
14
gT
� � iBUILDING DEPARTMENT 2 � 2O'1VILLAGE OF RYE BROOK OF RYEZ BROOK
938 KING STREET RYE BRoox,NY 10573 BUILDING DEPARTM"NT
(914)939-0668 FAx(914)939-5801 - -- — - -
www.ryebrook.org.
sssrtssrtssssssartsassrssss**sans*ssssssssssssssrtsssrtrt»»sssrt»artrt»sa»rts*»s»*»»s»»»»s»***aa*****aa»a****a»***asa
FOR OFFICE USE ONLY:
Approval Date:O+T 2 5 2021 I-0 / Application#
Approval Signature: = ARCMTECTURAL REVIE OARD:
Disapproved: Date:
BOT Approval Date: Case Chairman:
PB Approval Date: Case# Secretary:
ZBA Approval Date: Case#
Other: 'L
Application Fee: Permit Fees:
ssssa*ssaasaassassssssssssssrsssssssrtrtsssssrtrtrtrtrtssrtsrtrtrtsrtrtrtrtrtrtrtrtrtrt#*a*ss*****sssrtrtssssrtss*rtss*assssssssssrs
1 ROOF PERMIT APPLICATION
Application dated: is hereby made to the Building Inspector of the Village of Rye Brook,MY,for the issuance of a Permit to
Re-Roof an Existing Building,as per detailed staterrz d�nite���w
1. Job Address: 94 Grant Street, �K ffjj NY 10573 SBL: 141.43-1-29 Zone: ( )_F-7
Property Owner: Michelle Salvatore, Palma Carlucci Trust Address: 94 Grant Street, Port Chester, NY 10573
Phone#:9142168158 Cell#: email: dawn@mpalumbolaw.eom
2. Applicant: Andrew Prchal Address: 194 S Water Street, Greenwich, CT 06830
Phone#: 203 347 3083 cell#: 2033217735 mil: becky@gunnerroofing.com
3. Roofing Contractor: Home Energy Repair DBA Gunner Address: 194 S Water Street, Greenwich, CT 06830
Phone#: 203 347 3083 Cell* 203 321 7735 email: becky@gunnerroofing.com
4. lob Description,list all Methods&Materials: Removal of existing roof. Inspect roof deck to verify that all sheathing
is suitable. Install water and Ice barrier, undellayment, asphalt shingles, and proper ventilation.
5. Estimated Cost of Job:S 11,500 (NOTE. Fhe estimated cost shall include all site
impro4ement�,labor,material,scaffolding,fixed equipment,professional fees,and material and labor which may be donated gratis.)
6. If corner property,indicate street frontage:
7. Construction Type: Roof Replacement NYS Construction Class:
S. Number of stories: 2 Height:
9. Is garage being re-roofed:No:( }+Yes:( )Attached No:O•Yes:( }Number of Cars:
10. Is roof peaked,hip,mansard,flat,etc: Pitched 5/12
11. Estimated date of completion: 11/30/21
-t-
61112=
Please note that this application must include the notarized signature(s) of the
legal owner(s) of the above-mentioned property, in the space provided below.
Any application not bearing the legal property owner's notarized signature(s)
shall be deemed null and void, and will be returned to the applicant.
STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as:
Andrew Prchal ,being duly sworn,deposes and states that he/she is the applicant above named,
(prtint name of individual signing as the applicant)
and further states that (s)he is the legal owner of the property to which this application pertains, or that (s)he is the
Contractor for the legal owner and is duly authorized to make and file this application.
(indicate architect,connector,agent,attorney,etc.)
That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use
conducted at the above captioned property will be in conformance with the details as set forth and contained in this application
and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire
Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations.
�.6N ' S r-
Swom to before me this I Sworn to before me this L-�
day of (5'C , 20_IL day of ()CTD 4 G Q_— ,20 Z`
Signature of Property Owner Signa a of Applicant
Michelle Salvatore Andrew Prchal
Prirb erne of Property er Print Name of Applicant
NdYwy Public Notary Public
,,
,'j,111111IIII,III,r'I
',,11111/1 Opp ry,II
SEC CA B� �IB E C Cq-',•,
%O TA,Q to = �'�' p1 O T
h o - - t o10
?�
� : = n • LIG N�ti:
,b z ,
'••,��'o •,FXP. o •• :4,�,cry o- •.
NNECT IG Ti CUB •'�••
'IIIIIIili11111f►��` 11111/i1111111``'','.
-2-
61112020
AFFIDAVIT IN SUPPORT OF FEE WAIVER RELATED TO HURRICANE IDA
ST TE OF C(hndlt'.CA"l� COUNTY OF eIPI Q.. 1 G
T) r L. (insert name), being duly sworn,deposes and says
1. 1 am the applicant for a 0 wild=Permi /Certificate of Occupancy/Demolition Permit
Electrical Permit/Plumbing Permit/Fence& Wall Permit
Mechanical Permit/Pod Permit(circle all that apply)
2. 1 am the legal owner of property located at
Rye Brook,New York(insert street address)OR I am the
(Architec ,ontracto ngineer/Attorney)(circle one)for the legal owner of property
located at 17� G rA(,JT 5+ff-e+ ,Rye Brook,New York
and I am duly authorized by property owner
to make and file the accompanying application.
3. The following is a description of(1)the work to be performed under the permit for which
I am applying;and(2)how the work arose as a direct result of Hurricane Ida:
Removal of existing roof. Inspect roof deck to verify that all sheathing is suitable.
Install water and Ice barrier, underlayment, asphalt shingles, and proper ventilation.
Roof Damage Caused by Hurricane Ida.
4. The work described herein arose as a direct result of Hurricane Ida and does not include
Work which was not caused by Hurricane Ida.
Sworn to before me this ?-Is r-
D f&13,� 2 ZtI off_
Porr
Notary Pu lic BE C Cq
Y N O Tq ',R`
—•—�`- �� _ ocT � � zoa�
0 �'A�gL IG ,�� , VILLAGE OF RYE BROOK
�,�•Fkp p3�,�•' BUILDING DEPARTMENT
��.L �'��� ..gam T�"��--� n'� �T "�"'•M 'f\�t•�� K��°%�` •-��� F.
`'��)e `/ 3 t_� � ,�1� la.''a' c`����w�� _ •j�d -tj''� t� /(• kS7y 1`4• a7
George lsttoer � Jtes Matsao
WestclestetComety L+ieeutj�e 11.. "i Wm . "abr,Consamer, Proteewn
«. . Department of Consumer Protection
'I Home Improvement License
HOME ENERGY REPAIR LLC =
6639 E JEAN DRIVE
SCOTTSDALE,AZ-85254
I
j 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 department seal. ,Y
License Number A Date of Expiration _
a
•a'°''' WC-32180-H19 0 0 09/13/2023 E
P
('seer Co
��' )�� ;w I,.�i3 � ,'nr��� L s a•P �/.p • ai` ♦` h. _) $�w�:+ 1r yl�
°WEB w,
Llilq H U6A
DATE
ACOR" CERTIFICATE OF LIABILITY INSURANCE 10/21/2021
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 CONTACT. Elden Oamtab
Capital 8 Co Insurance Services PHONE FAX
287 S Robertson Blvd.#207 310 492-2007 1 AIC Not: 310 525-W92
Beverly Hills,CA 90211 ADDRRE : EldanQCepcoinsurence.corn
Ucense#:6002332 INSURE AFFORDING COVERAGE NAIL/
INSURED NsualaR E
Home Energy Repair
DBA Gunner Roofing NW E C:
194 South Water Stree "W �D:
Greenwich,CT 06830 MUMIts: -.
INWRERF:
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 MAYBE 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.
owlTYPEOFINSURANCE POLICY NUMBER POLICY EFF POLICY EXP LMM
A X COWAROAL GENERAL LIABILITY SIZGLO703A249604 W/2612021 04/26/2022 EAcH occuRRENcE $ 1 00 000
CLAIMS-MADE X OCCUR $ 50 000
�j MID EW am pervorri S 5,000
PERSONAL S ADV INJURY S 1,000.00
GE_N'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
X POLICY❑ ❑LOC PRODUCTS-COMP/OP AGG 1,000.00
HER: $
B AUTOMOBILE LIABILITY NXTOGMED-00-CA 05/0712021 05/0712022 COMBINED SINGLE LIMIT s 00
ANY AUTO BODILY INJURY Per person) f
OWNED SCHEDULED BODILY INJURY(Per adCWenQ =
AUTOS ONLY X AUTOS
HIRED NON-OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY - f-
UMBRELLA I M OCCUR EACH OCCURRENCE $
EXCESS LIAR CLNMS4AADE AGGREGATE
WORKERS COMPENSATION PER
AND EMPLOYERS'LIABILITY YIN
-
ANY PRDPRIFTOR(PARTNER/EXrCU-nVE EL FJICH ACCIDENT $
OFFICER/MFMBER EXCLUDED? NIA -
(Mandatory In NH) EL DISEASE-EA EMPLOYE $
If yea,deacre nd'OPERATIONS
- - -----
DE IMlb Nu F er PERATI N F-L DISEASE-POLICY LIMIT
DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be atreehad N more epee IS required)
Certificate Holder Is an Additional Insured on the General Liability policy per the Additional Insured Automatic Status Endorsement.All CerthIcate Holder prMleges apply only d required
by written agreement between the Certlticate 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
VIL
VIL KING STREET THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
938 ACCORDANCE WITH THE POLICY PROVISIONS.
RYE BROOK,NY 10573
AUTHORIZED REPRESENTATIVE
GIA
©1988-2015 AC RD 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 06 01-44 1 1
1 nysif.com
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
�.
HOME ENERGY REPAIR LLC D/B/A
GUNNER ROOFING
194 S WATER ST Al.
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://1MWW.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