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HomeMy WebLinkAboutRP21-066PERMIT # "" 069 DATE: %% IXP: �- SECTION op lip BLOCK LOT,_, TYPE OF WORK ISfa JA JOB LOCAT/� ON OWNER ,C Ll CONTRACTOR EST. COST so oz V/cO # G C L�+f TCO # FFF�4s FEE DATE _ _ INSPECTION RECORD FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING O RGH PLUMBING GAS SPRINKLER ELECTRIC LOW -VOLT ALARM AS BUILT FINAL DATE ci 1 rL.� INSP 0 09- ry &&/ OTHER �%PPROVALS ARB _ PB ZBA OTHER . 19 4llfi Qf ni ebOaW VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook, N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury www.!:yebrook.org TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Michael J. Izzo Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE May 11,2022 Luca Lisella&Cristina Savone 109 North Ridge Street Rye Brook,New York 10573 Re: 109 North Ridge Street, Rye Brook,New York 10573 Parcel ID#: 135.67-2-4 Roof Permit#21-066 issued on 11/3/2021 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 DECENED For office use onl : BUILDING:DEPARTMENT PERMIT# APR 2 0 2022 VILLACrE OF RYEIOOK ISSUED:t/-3-�0� I 938 KING STRE60 I2YE BROOK,NEW YORK 10573 DATE: VILLAGE OF RYE BROOK 9 -0648, FEE: lk p PAID. BUILDING DEPARTMENT } °r 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 rrrrrrsrrrtrtrrrrrrrassrrsrrrrrrrrrrsrrrarsrrrrssssrsrrrrrrsrrrssrrsssrsssssstsrtrrrrrrrrrrtrrrrrrrrrrrrrrrrsrrrrssrrrsrarsss Address: /Qf /to r� A.,ke .S)4a e� iV tK /P57 Occupancy/Use: I'Fr.Yn Parcel ID#: /55 4P-7-9- Zone: 9-7 Owner: Lycol bseIla Address: /Oq ftee 4 Al S/ Rvr_!3►ro�k,,U�/OSJ P.E./R.A. or Contractor: Address: Person in responsible charge: Lea U5Z Address: /0Q V, Ajjr,, i k/1/Y 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: L.U[a SGI/01 being duly swom,deposes and says that he/she resides at /Of w yr 4 Qv'a�y� ,S�' (Print Name of Applicant) L (No.and St et) in 9uG Kok ,in the County of wts 6 S�rf-- 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:$ .3o o,0 0 for the construction or alteration of. goo .,A, 41 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-I O.A.of the Code of the Village of Rye Brook. Sworn to before me this 1 Sworn to before me this day of `( � , 2( day of 920 Signature of Property Owner Signature of Applicant Pr' erne of Property Owner Print Name of Applicant Notary Public SHARI MELILLO Notary Public Notary Public, State of New York No. 01%IE6160063 Qualified in Westchester County�l Commission Expires January 29.20^� QyE BRC�v� 1982 BUILDING DEPARTMENT ❑BUILDING INSPECTOR ASSISTANT 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 - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : OCI\ ' v `. DATE: 1\ch(�) PERMIT# ISSUED: LOCK'( , 1 SECT: LOT.! . q $ C LOCATION: V\'� OCCUPANCY: Zk lU ❑ VIOLATION NOTED THE WORK IS... ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION P REQUIRED ❑ FOOTING w ❑ 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 �D O a� C14 OR 96 U y - W i� JR- ` - � ozl cm Q M� O I O eo H cc 2 OW 04 W W C wi 42 [- c- = � co JR A 01*4 °` w w r0.00 W > c cc, OC Cd W o w -oqR u Ccn $� °ao '� C A z a o P: C U a C v a Q a. CA U Ov $ a3 PN QC000-4 O z96 U � �I CIO. W svei �° -o BUILDING DEPARTMENTfit VILLAGE OF RYE BROOK NOV - 2 2021 93 8 KING$TREET RYE BROOK,NY 10573 VILLAGE 0;= R'(E BROOK { 14)939-0668,; BUILIDING lit:PARTMENT k -` ****+**ww**wwwwwwwwwwwwwwwwwww+w++++++++++++*+**+++++++wwww++*+++++++*++++*+***w++++*+**********+*w+++****w FOR OFFICE USE ONLY: 1 Approval Date: NOV — 2 ermit# �CV/�� Application# Approval Signature: nA ARCHITECTURAL REVI BOARD: Disapproved: Date: BOT Approval Date: Case# : Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Case# : Other: Application Fee: ermit Fees: OQ' ROOF PERMIT APPLICATION Application dated://—Q—c_'�I is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit to Rc-Roof an Existing Building,as per detailed statement described below.. 1. Job Address: l a Q l'_Uol'(�' Ihra9 ge! s SBL:135140-ate"# Zone: Property Owner: 6yrn L�sdla Address: S /It L as agave Phone#: Cell#: /�f/ �D'Ir—fVKI email `S a �tbd•C�+�+'� 2. Applicant: Address: Phone#: Cell#: email: 3. Roofing Contractor: Address: Phone#: Cell#: p email: 4. .lob Description,list all Methods&Materials: 's "� f q ro e' F (a/A Fn k4 wta,4v,'-W9-, HDz co o 5. Estimated Cost of Job:$ %©a©-©U (NOTE:The estimated cost shall include all site improvements,labor,material,scaffolding,fixed equipment,professional fees,and material and labor which may be donated gratis.) 6. If comer property,indicate street frontage:. n 4/ A 7. Construction Type: r gt" NYS Construction Class: 8. Number of stories: 4 YX Height: 9. Is garage being re-roofed:Nq�(T-­Yes:( )Attached No:( )•Yes:( )Number of Cars: 10. Is roof peaked,hip,mansard,flat,etc: H&2 4— 11. Estimated date of completion: -1- 8/1212021 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: ,being duly sworn,deposes and states that he/she is the applicant above named, (print 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 for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,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. Sworn to before me this Q Sworn to before me this day of day of , 20 Signature of Property Owner Signature of Applicant Phntnt Name of Property Owner Print Name of Applicant R_ �V� ��-1 L&- Notary Public Notary Public SHARI MELILLO Notary Public, State of New York No. 01 ME6160063 Q,_ialiiied in Westchester County Commission Expires January 29.20 -2- 8112/2021 DECLARATIONS Coverage afforded by this policy is provided by: State Farm Fire and Casualty Company PO BOX 88049 We will provide the insurance described in this policy Atlanta GA 30356-9901 in return for the premium and compliance with all applicable provisions of this policy. A Stock Company with Home Offices in Bloomington, Illinois. 32-CU-G388-9 Policy Number Named Insured and Mailing Address Lisella, Luca & Savone, Cristina 109 N Ridge St Rye Brook, NY 10573-2106 The Policy Period begins and ends at 12:01 a.m. Automatic Renewal - If the Policy Period is shown as Standard Time at the residence premises. 12 months, this policy will be renewed automatically 05/11/2021 Effective Date subject to the premiums, rules and forms in effect each 12 months -Policy Period succeeding policy period. If this policy is terminated, we 05/11/2022 Expiration of Policy Period will give you and the Mortgagee/Lienholder written notice in compliance with the policy provisions or as Limit of Liability -Section 1 required by law. $602,000 Dwelling $451,500 Personal Property (Minimum 75% of Deductibles - Section I 1/2% $3,010 Dwelling) ALL LOSSES In case of loss under this policy, the Limit of Liability -Section 2 deductible will be applied per occurrence and will be deducted from the amount of the loss. $300,000 Personal Liability Earthquake: $5,000 Medical Payments to Others ° Hurricane 5/° $30,100 Policy Type Homeowners Policy Premium $1753 Al - Replacement Cost - Similar Construction Increased Dwelling Up to $120,400 - Option ID Location of Premises 109 N Ridge St Rye Brook, NY 10573-2106 Forms, Options, & Endorsements HW-2132 Homeowners Policy Amendatory Endorsement Hurricane Deductible Mortgagee &Addl. Interests Agent Name &Address Mortgagee Lisa Vitiello WELLS FARGO BANK NA#936 ITS SUCCESSORS Lisa Vitiello Agcy Inc AND/OR ASSIGNS 282 White Plns Rd PO Box 100515 Eastchester, NY 10709-4404 Florence, SC 29502-0515 (914) 337-4810 Loan Number: 0574590089 Prepared: 11-02-2021 Agent's Code:24D6 559-916.5 APPLICANT COPY 1000007 2020 127534 219 04-23-2021 Affidavit of Exemption to Show Specific Proof of Workers' Compensation Insurance Coverage for a 1, 2, 3 or 4 Family, Owner-occupied Residence **This form cannot be used to waive the workers'compensation rights or obligations of any party.** Under penalty of perjury, I certify that I am the owner of the 1, 2, 3 or 4 family, owner-occupied residence (including condominiums) listed on the building permit that I am applying for, and I am not required to show specific proof of workers' compensation insurance coverage for such residence because (please check the appropriate box): ❑ I am performing all the work for which the building permit was issued. ❑ I am not hiring,paying or compensating in any way,the individual(s)that is(are)performing all the work for which the building permit was issued or helping me perform such work. ❑ I have a homeowners insurance policy that is currently in effect and covers the property listed on the attached building permit AND am hiring or paying individuals a total of less than 40 hours per week (aggregate hours for all paid individuals on the jobsite) for which the building permit was issued. I also agree to either: ♦ acquire appropriate workers' compensation coverage and provide appropriate proof of that coverage on forms approved by the Chair of the NYS Workers' Compensation Board to the government entity issuing the building permit if I need to hire or pay individuals a total of 40 hours or more per week(aggregate hours for all paid individuals on the jobsite)for work indicated on the building permit,or if appropriate,file a CE- 200 exemption form; OR ♦ have the general contractor, performing the work on the 1, 2, 3 or 4 family, owner-occupied residence (including condominiums)listed on the building permit that I am applying for,provide appropriate proof of workers'compensation coverage or proof of exemption from that coverage on forms approved by the Chair of the NYS Workers' Compensation Board to the government entity issuing the building permit if the project takes a total of 40 hours or more per week(aggregate hours for all paid individuals on the jobsite)for work indicated on the buil ing permit. `I \\- (Signature/of Homeowner) (Date Signed) Home Telephone Number (Homeowner's Name Printed) Sworn to before me this day of Property Address that requires the building permit: 3 1y y o a Ayo 4 Ate s� AvenrOv� , / - �©C� (County Clerk Q*,N e�ylLi 8b ie�� C lyS Y J Notary Public, State of UNew York No. 0VJiE6160063 Oualiiied in Westchester County Commission Expires January 29.20..e—_'> Once notarized,this BP-1 form serves as an exemption for both workers'compensation and disability benefits insurance coverage. BP-1 (12/08) NY-WCB