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HomeMy WebLinkAboutBP21-310PERMIT # i5f SECTION TYPE OF WORK JOB LOCATION . OWNER >L CONTRALTO �T. COST CO # c t2 y DATE: �/ r�y old EXP:a�- QC P <rcyo --� //'o C'e`Pz0 �aj)&) isro--6907 "Pb DATE ��(j v�Oc FEE DATE INSPECTION RECORD DATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING 0 RGH PLUMBING GAS 0 SPRINKLER ELECTRIC LOW -VOLT O ALARM AS BUILT C� FINAL OTHER APPROVALS ARB BGi rl3 ZBA OTHER c4`4,.°a JJW(Cu YA ,ice I rq ¢(` anfZ1vPll av* VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury www.tyebrook.org 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 Suzanne Goldberg 180Ivy Hill Crescent Rye Brook,New York 10573 Re: 180 Ivy Hill Crescent, Rye Brook,New York 10573 Parcel ID#: 129.76-1-33 Building Permit#21-310 issued on 11/24/2021 to Replace Three Windows This certifies that the three new windows,installed under the above captioned permit have been satisfactorily completed. Sincerely, Michael J. Izzo Building&Fire Inspector /to I EC�IEVE �R� For office use only: - 0 BUILDIN���A�tTMENT pERlv>1.r# APR 11 2022 K VILLAGE OF RYE BROOK ISSUED: VILLAGE OF RYE BROOK 38 KING STREET,RYE BRooK,NEw YORK 10573 DATE: BUILDING DEPARTMENT (914)939-Q668-FAX(914)939-5801 FEE: U P 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 k#f##t/it r�ifftif►►fff/fffgkMt►gktrt•trtkrtkrt##irtrtrtrti#f#R#rt#t####ff#if►ftf►tMif►►►fi►t►fkf►t►tkkrtkrtffkrti#irtrt###ittiiiq►iftq► Address: `s y .�v� RM (�Ce 5 Cs2 0 Occupancy/Use: Parcel ID#: I Q , Ito —/—3 3cc Zone:Aolb Owner: ��1 Z n n s�c Address: ! O 0 -Ely ���1 C r�S u n+' P.E./R.A.or Contractor: rQq/kS Ogle — �WAfdl ess: 60 0 AMN1 01W d ve Rl/4 4e j- -CT Person in responsible charge: �G�I%O C2.re ZO Address: JQMZ 41 ' �(pbO(p 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 Y'O)RK,COUNTY OF WESTCBESTER as: ('jh O�� V 6-b ,h O� being duly swom,deposes and says that he/she resides at `q q wa 1 '(2 (Print Name of Applicant) J (No.and Street) in �) 6.)d C�r✓PO f' ,in the County of C �-, Q �1 in the State of CIN— ,that (City/To Vill ge) he/she has supervised the work at the location indicated above,and that the actual total cost ofthe 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 L.J� donated gratis was:$ �/ , for the construction or alteration of v y t�' 9-t�'c�L' 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 %a\N , 20 DD day of , 20 l Si Property Owner igna t Aivame of Property er Name of Applicant XA'A-X- Notary Public Notary Public SHARI MELILLO SHARI MELILLO Notary Public, State of New York Notary Public, State of New York 3/21/19 hdo. 01.ME6160063 No. 01 ME6160063 Qualified in Westche-ter County Qualified in Westche:'er County Commission Exr)ires January 29.2Pd Commission Expires January 2.9, 20_A=',> QyE BRcb Q�/ •��0 1 19t32 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: I `�� V C-21- C N DATE: z PERMIT#-�ZZ I '-;> ISSUED:I Z SECT:��BLOCK: ' LOT• LOCATION: !� Ili1'1 I/�-�CFL`�' �� �-CV� WIJ� OCCUPANCY: ❑ 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 ❑ ROSS CONNECTION FINAL OTHER _, q III _ 11 ._, - 11 IJ _. ... -_ N Y H N lad ■ H 11 tl w N N _ 11. q 1 Y 11 11 H H H. M III N II a1 a1 11 P:,. II' 111 II 11 11 Y Y. 11 P N p r —� VILLAGE OF RYE BROOK PERMIT#:BP 21-310 BUILDING DEPARTMENT ISSUED: 11/24/2021 938 KING STREET, RYE BROOK, NY 10573 EXPIRES: 11/24/2022 (914) 939-0668 www.aebrook.org BUILDING PERMIT FOR THE CONSTRUCTION 3 REPLACEMENT WINDOWS 0 AT: 180 IVY DILL CRESCENT 0 BUILDING CLASSIFICATION& PARCEL ID#: R-3 / ONE FAMILY RESIDENTIAL/ 129.76-1-33 PROPERTY OWNER: SUZANNE GOLDBERG (917) 748-4880 ffi LICENSED CONTRACTOR: MY DREAMS HOME IMPROVEMENT(646) 456-6907 EMERGENCY CONTACT: JULIO CEREzO(646)456-6907 VALUATION OF WORK: $4,200.00 FEE PAID: $175.00 > HOURS OF OPERATION OF CONSTRUCTION EQUIPMENT/VILLAGE CODE§158-4:WEEKDAYS-8:00AM TO 6:OOPM OR DUSK,WHICHEVER IS EARLIER; SATURDAYS—9:OOAM TO 4:OOPM; - SUNDAYS& HOLIDAYS—No CONSTRUcTIoN Acrn iTY ALLOW1,A) permit is valid for a period not to exceed twelve(12)months from the date of issuance,and covers only that work listed above.Separate permits are required for any electrical,plumbing,fire suppression,fire/smoke/carbon monoxide detectors/alarms,or any other work not covered under this permit.The f approved plans must be kept on the job site& be made available for review by the Building Department upon demand.Any amendments or changes to the lift approved plans must be designed by your architect/engineer and submitted to the Building Department for review and approval prior to performing the work. A Certificate of Occupancy or Certificate of Compliance is required in order to close out this permit. ` /r Oil 98 Steven E. Fews 0 - Assistant Building& Fire Inspector V THIS PERMIT MUST BE CONSPICUOUSLY POSTED AT THE JOB SITE '� w w w ■ w r r r r w ■ _ n Ie a a1 ■ ■ -.. „ „ ,1 BUILDING DEPARTMENT VILLAGE OF RYt, OOK NOV 2 3 2021 938 KING$TREET RYE BROOK,NY 10573 (914)939-0668 VILLAGE OF RYE BROOK �.ryebrook.oru BUILDING DEPARTMENT ADMINISTRATIVE EXTERIOR BUILDING PERMIT APPLICATION FOR EXTERIOR WORK WHICH DOES NOT REQUIRE VILLAGE ARCHITECTURAL REVIEW BOARD APPROVAL FOR OFFICE USE ONLY: APPROVAL.DATE: ,Y�l � � 1 #:/�J�C?� /`%'APPLICATION FEE:,A V �� APPROVAL SIGNATURE: A PERMIT FEES: LSE H.O.A.APPROVAL: ` DATE: DISAPPROVED: OTHER: *********************************************************************************************************** Application dated: //—d3 r c_4/ is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the construction of buildings,structures,additions,alterations or for ay change in use,as per detailed statement described below. 1. JobAddress: �,k o l v v 11.1 �Y 2.scef1� 2. Parcel ID#: /, 7 — f ^ 3- Zone: 3. Propos d Improvement(Describe in detail): t � 1 -4- I-a - 'YN opCA C1r D X h�r) 1 n t +rIL 4. Property Owner: / O( .9 Address: !V vk} e�(�J Phone# Cell# r '! `[c�� c-mail 5UrCtrjnei(�Mryo List All Other Properties Owned in Rye Brook: �J Applicant: � ti Address: O( Phone# Cell#—( e-mail i .c Orn Architect: Address: Phone# Cell# e-mail Engineer: Address: Phone# Cell# fie-mail General Contractor: cto YQZ.Q y A/11 lP 4IVS c Address: rr II II '' `t(� CT } Phone# Cell e-mail r�ghn5 v v�rneiTf c�VMQ (C 111 8/12/2021 5. Occupancy;(1-Fam.,2-Fam.,Commercial.,etc...)Pre-construction: Post-construction: 6. Area of lot: Square feet: Acres: 7. Dimensions from proposed building or structure to lot lines: front yard: rear yard: right side yard: left side yard: other: 8. If building is located on a corner lot,which street does it front on: 9. Area of proposed building in square feet: Basement: 1"fl: 21 fl: 31 fl: 10. Total Square Footage of the proposed new construction: 11. For additions,total square footage added:Basement: F fl: 2'fl: 31 fl: 12. Total Square Footage of the proposed renovation to the existing structure: 13. N.Y. State Construction Classification: N.Y. State Use Classification: 14. Construction Type&Location:O Typical Western Lumber Frame;O Timber Frame[TC];O Wood Truss[TT]; O Pre-engineered wood[PW];Located;O Floor Framing[F];O Roof Framing[R];O Floor&Roof Framing[FR];Other: 15. Number of stories: Overall Height: Median Height: 16. Basement to be full,or partial: finished or unfinished: 17. What material is the exterior finish: 18. Roof style;peaked,hip,mansard,shed,etc: Roofing material: 19. What system of heating: 20. If private sewage disposal is necessary,approval by the Westchester County Health Department must be submitted with this application. 21. Will the proposed project require the installation of a new,or an extension/modification to an existing automatic fire suppression system?(Fire Sprinkler,ANSL System,FM-200 System,Type I Hood,etc...)Yes:_No:_ (f yes,applicant must submit a separate Automatic Fire Suppression System Permit application&1 sets of detailed engineered plans) 22. Will the proposed project disturb 400 sq.ft.or more of land,or create 400 sq,ft.or more of impervious coverage requiring a Stormwater Management Control Permit as per§217 of Village Code? Yes: No:_Area: 23, Will the proposed project require a Site Plan Review by the Village Planning Board as per§209 of Village Code? Yes: No: (if yes,applicant must submit a Site Plan Application,&provide detailed drawings) 24. Will the proposed project require a Steep Slopes Permit as per§213 of Village Code Yes: No: (if yes,you must submit a Site Plan Application, &provide a detailed topographical survey) 25. Is the lot located within 100 ft.of a Wetland as per§245 of Village Code? Yes: No: (if yes,the area of wetland and the wetland buffer zone must be properly depicted on the survey&site plan) 26. Is the lot or any portion thereof located in a Flood Plane as per the FIRM Map dated 9/28/07? Yes: No: (f yes,the area and elevations of the flood plane must be properly depicted on the survey&site plan) 27. WiIl the proposed project require a Tree Removal Permit as per§235 of Village Code?Yes: No: (if yes,applicant must submit a Tree Removal Permit Application) 28. Does the proposed project involve a Home-Occupation as per§250-38 of Village Code? Yes: No: Indicate:TIER I: TIER II: TIER III: (if yes a Home Occupation Permit Application is required) ' f 29. What is the total estimated cost of construction: $ y, Zoo Note:estimated cost shall include all site improvements,labor,material,scaffolding,fixed equipment,professional fees, including any material and labor which may be donated gratis.If the final cost exceeds the estimated cost,an additional fee will be required prior to issuance of the CIO. 30. Estimated date of completion: 1.— (2) 8/12/2021 BUILDING DE ARTMENT U VIL E OF R OK NOV 2 3 2021 938 KING �u T.RYE B1t' NY 10573 (914)9 39-5801 VILLAGE OF RYE BROOK BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE§216 • STORM SEWERS AND SANITARY SEWERS 'PHIS AFFIDAVIT MUST BEAR THE NOTARIZED SIGNATURE OF THE LEGAL. PROPERTY OWNER AND BE SUBMITTED ALONG WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION. ANY BUILDING OR PLUMBING PERMIT APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETURNED TO THE APPLICANT. STATE OF NEW YORK, COUNTY OF WESTCHESTER ) as: residing at, 12C2 IVK / i rot-dC (Print name) (Adclress where you Gve) being duly sworn, deposes and states that (s)he is the applicant above named, and finther states that (s)he is the legal owner of the property to which this Affidavit of Compliance pertains at; � to Ivy * !!r, � 4 , Rye Brook,NY. (Job Address) Further that all statements contained herein are true, and that to the best of his/her knowledge and belief, that there are no known illegal cross-connections concerning either the storm sewer or sanitary sewer, and further that there are no roof drains, sump pumps, or other prohibited stormwater or groundwater connections or sources of inflow or infiltration of any kind into the sanitary sewer from the subject property in accordance with all State, County and Village Codes. ),_gna(ture of Property Owner(s)) ill,7-4 o (Print Name of Property Owner(s)) Sworn to before me this da of J� f , 20 - (Notary Public) SHARI MELILLO Notary Public, State of New York No. 01.mF616 F^63 Q�lal:i'ed in Westchester County (3) Commission Expires January 29.20 A3 3/21/19 This application must be properly completed in its entirety by a N.Y. State Registered Architect or N.Y. State Licensed Professional Engineer & signed by those professionals where indicated. It must also include the notarized signature(s) of the legal owner(s) of the subject property, and the applicant of record in the spaces provided. Any application not properly completed in its entirety and/or not properly signed shall be deemed null and void, and will be returned to the applicant. Please note that application fees are non-refundable. 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. By signing this application, the property owner further declares that he/she has inspected the subject property, and that to the best of his/her knowledge there are no roof drains, sump pumps or other prohibited stormwater or groundwater connections or sources of infiltration into the sanitary sewer system on or from the subject property. 2 Sworn to before me this K/ Sworn to before me this J day of �u ��M � , 2Q _ day of �oyeY,-,b'1` 20 ZI Signa re&Propefty Owner �_i*gnoXppliccant nt Name of Property Ownef Print Name of Applicant Notary Public Notary Public SHARI MELILL O SHARI MELILLO Notary Public, State of New York Notary Public, State of New York No. 01 M .6160063 No. 01%1 6160053 Q,ialiiied in Westchester County Q-_ialii led in Westchester County Commission Expires January 29.20 3 Commission Expires January 29,20 3 (4) 3/21/19 1D L A N S I N G ME59E-7�D NOV 2 4 2021 9uILn `G r ,r�)c ' VILLAGE OF RYE BROOK BUILDING DEPARTMENT Customer Quote Summary BILL TO: SHIP TO: 'I LANSING O BOX 649RWALK CT 60 DR MARTIN LUT ER KING JR DR uI I II III IIII II III IIIII I III III Ba:code NORWALK CT 06854-0000 Phone: 804-266-8893 Fax: 8042616743 Phone: 203-831-0977 Fax. QUOTE NBR CUST NBR CUSTOAEER PO I DATE CREATED DATE ORDERED ORDER TYPE 5152367 1141367 1 The one 1 9/22/2021 9i30'2021 1020:5 Charge ORDERED BY STATUS SHIP VIA DELIVERY AREA Richard Ordered Whse Delivery DARTMOUTH MANUFACTURING CLERK JOB NAME COUPON JAM -Jose Mendicta Susan LINE# DESCRIPTION OTY UNIT PRICE EXTENDED 10000-1 Welded Vinyl RW 2-Lite,Unit Size 58.25 x 62,RO 58.75 x 62.5, 2 S764.27 $1,528.53 EXTENDED LEADTIME Unit 1:U-Factor=0.26,SHGC=0.30,VT=0.54,HII-M47-00925- 00001,Size Options=Custom Size,Transactional Order Type=Charge Order,New Construction.Simulated Meeting Rail=No,Reverse Sash Pattern=NoUnit I Left Glass, I Right Glass:HII-M-47-00925-00001 mm Frame Width(Inches)=58.25,Frame Height(Inches)=62 6 Double Glazed,Double Low-E RS,Argon Filled,DSB Base Color=White,Painted Unit=Yes,Painted Color Style=Standard, I i Painted Exterior Only,Exterior Painted Color=Dark Bronze Program=None,Label Name=Harvey,Double,Pin Exterior Sash=No, ��s- Adjust Sash Lock Height=No RW Flex Half Screen,Wool Pile Adaptor Color=White,Fiberglass Mesh, Screen Shipping Separate Integral L Fin,Inside Extension Jamb Receiver Pocket=Yes Overall Frame Width(Inches)=58.25,Overall Frame Height(Inches)_ 62,Overall Rough Opening Width(Inches)=58.75,Overall Rough Opening Height(Inches)=62.5 Clear Opening Width=23.9375,Clear Opening Height=57.375,Clear Opening Square Footage=9.54 E.StarZone:North=Yes,E.Star Zone:N orth-Central=Yes Room Location: None Assigned Last Update:9/30/2021 10:21 AM Page 1 Of 2 Printed 11/18/2021 10:05 AM 0 0 Scan with Smartphone to access installation a e instructions in HBP•s Document Center i Scanned with CamScanner QUOTE NBR CUST NBR CUSTOMER PO DATE CREATED DATE ORDERED �RDR TYPE 5152367 1141367 The one 9/22/2021 9/30/2021 10:20:55 arge ORDERED BY STATUS SHIP VIA DELIVERY AREA Richard Ordered Whse Delivery DART MOUTH MANUFACTURING CLERK JOB NAME COUPON IAMJose Men Lela Susan LINE# DESCRIPTION OTY UNIT PRICE EXTENDED 11000-1 Welded Vinyl RW 3-Lite,Unit Size 94.25 x 46,RO 94.75 x 46.5, 1 $1,028.81 $1,028.81 EXTENDED LEADTTME Unit I:U-Factor=0.26,SHGC=0.30,VT=0.54,HII-M-47-00910- 00001,Transactional Order Type=Charge Order,New Construction, Simulated Meeting Rail=NoUnit I Left Glass, I Right Glass:HII-MA7- 1 �i 00910-00001 Unit I Center Glass:HII-M-47-00925-00001 e Frame Width(Inches)=94.25,Frame Height(Inches)=46,Sash Split= g Equalite _ J Unit I Left, I Right:Double Glazed,Double Low-E RS,Argon Filled Ao Mrr- Unit I Center:Double Glazed,Double Low-E RS,Argon Filled,DSB Base Color=White,Painted Unit=Yes,Painted Color Style=Standard, Painted Exterior Only,Exterior Painted Color=Dark Bronze Program=None,Label Name=Harvey,Double,Adjust Sash Lock Height=No RW Flex Flanker Screens,Wool Pile Adaptor Color—White,Fiberglass Mesh,Screen Shipping Separate Integral L Fin,Inside Extension Jamb Receiver Pocket=Yes Overall Frame Width(Inches)=94.25,Overall Frame Height(Inches)_ 46,Overall Rough Opening Width(Inches)=94.75,Overall Rough Opening Height(Inches)=46.5 Clear Opening Width=26.375,Clear Opening Height=41.375,Clear Opening Square Footage=7.58 E.Star Zone:North=Yes,E.Star Zone:North-Central=Yes Room Location: None Assigned This quotation is based on our interpretation of the information provided. All quantities,sizes,extensions, SUBTOTAL: S2,557.34 grand totals,and specifications should be verified by the contractor prior to his/her bidding or ordering of materials. The manufacturer is responsible only for the items as quoted above. Any changes or LABOR: S0.00 addendums will be subject to a requote. We propose to supply the materials as described above,subject to terms and conditions. The prices are guaranteed for 30 days from the date of quotation unless otherwise TAX: 5162.39 noted. Delivery charges may apply and are not reflected on this quote.We appreciate the opportunity to quote this job. ORDER TOTAL: $2,719.73 CUSTOMER SIGNATURE DATE Last Update:9/30/2021 10:21 AM Page 2 Of 2 Printed 11/18/2021 10:05 AM C] p Scan with Smartphone to access installation 1, ruc Insttions in HBP's Document Center Scanned with CamScanner c, Building Permit Check List&Zoning Analysis 1 Address: 1 b� �U�� L 5��� SBL: Zone: `` Use: j Const.Type: Other: Submittal Date: Revisi ns Submittal Dates: Applicant: �1e S PP f ^ \ Nature of Work Reviews:ZBA: PB: BOT: Other. NEED OK ( ) (_' FEES:Filing: BP: C/O: Legalization: O (.T APP: Dated Notarized % SBL Truss I.D. Cross Connection: H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening. ( ) ( ) ENVIRO: Long. Short: Fees: N/A: ( ) ( ) SITE PLAN:Topo: Site Protection S/W Mgmt.: Tree Plan Other. ( ) ( ) SURVEY:Dated Current: Archival: Sealed Unacceptable: ( ) ( ) PLANS:Date ed. Sealed Copies: Electronic: Other. ( ) (,.r License: ✓ Workers Comp: Liability Comp.Waiver. Other. ( ) ( ) CODE 753#: Dated N/A: ( ) ( ) HIGH-VOLTAGE ELECTRICAL Plans: Permit N/A: Other. ( ) ( ) LOW-VOLTAGE ELECTRICAL:Plans: Permit N/A: Other. ( ) ( ) FIRE ALARM/SMOKE DETECTORS:Plans: Permit: H.W.I.C.:_Battery:_Other. ( ) ( ) PLUMBING Plans: Permit Nat.Gas: LP Gas: N/A/: Other. ( ) ( ) FIRE SUPPRESSION:Plans: Permit N/A: Other. ( ) ( ) H.V.A.C.: Plans: Permit N/A: Other. ( ) ( ) FUEL TANK:Plans: Permit Fuel Type: Other. O O 2020 NY State ECCC: N/A: Other. ( ) ( ) Final Survey Final Topo: RA/PE Sign-off Letter. As-Built Plans: Other. ( ) ( ) BP DENIAL LETTER: C/O DENIAL LETTER: Other. ( ) ( ) Other. ( )ARB mtg.date: approval• notes: ( )ZBA mtg.date: approval• notes: ( )PB mtg.date: approvaL• notes: REQUIRED EXISTING PROPOSED NOTES Ami. Cir Fr n g� Front: Front Side: R—ear. Main Cov Accs.Cov Ft.HS : S .H Sb: a Tot limp: Ft.IM: Parinn . Height/Stories: notes: 173'/2 Ivy Hill Crescent Rye Brook, NY 10573 914-939-2440 8/27/21 NOV 2 3 2021 0 VILLAGE OF RYE BROOK Suzanne Goldberg BUILDING DEPARTMENT 180 Ivy Hill Crescent Rye Brook, NY 10573 Re: Window Replacements Dear Suzanne, The Architecture and Grounds Committee (A&G) has reviewed your application for the above named work. This project requires a permit from The Village of Rye Brook. You are directed to submit this letter to the Village along with your permit application. Once the permit is obtained, a copy must be provided to A&G for final review and consideration. Work on the project may not begin until you receive written notice of acceptance from A&G. If any changes are made to the original plans submitted to A&G, due to input from the Village or arising during construction, the Committee must be notified in writing. Work cannot proceed until you receive written approval for those changes. Failure to comply with these procedures will result in fines and/or work stoppage. If you have any questions, please contact me at: Property Manager. Bryan Martinez Property Manager rr AMA 4 4t, is4w. E I a I L I I I IIIIIIIililliiiiiiil I X .y4.: A� 1 S `t�•k s r d.7 I[HIM ,z W7 n I i 1 1 i 1 r tt m .. wr -MYAY. xWa. 77 awe - uEa Vol s�wa ww ,1� wrs Now >3 1 3 ACC CERTIFICATE OF LIABILITY INSURANCE FDATE(MMIDDIYYYYI `..� 6/17/2021 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 poliey(ies)must 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 CONTACT Michelle Randle NAME: Asset Security, Inc. pHONE (914)598-3004 n,c No: ce141560-2013 222 Purchase Street # 302 ADDRESS,IMichelle@assetsecurityrm.com INSURERS AFFORDING COVERAGE NAIL N Rye NY 10580 INSURERA:Main StreetAmerica Assurance Co. 29939 INSURED INSURER 8:Travelers Property Casualty Company of 25674 JULIO CEREZO INSURERC: MY DREAMS HOME IMPROVEMENT INSURER D: jC80 WESTFIELD AVE INSURERE: jiRIDGEPORT CT 06606-4004 INSURERE: COVERAGES CERTIFICATE NUMBER:All Lines as of 2/24/2021 REVISION NUMBER: 1 HIS 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 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. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MMIDDNYYY MMIDD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE a OCCUR DA AG RENTED 500,000 PR MISS Ea occurrence $ MPV1995T 2/24/2021 2/24/2022 MED EXP An one erson) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMITAPPLIES PER GENERAL AGGREGATE $ 2,000,000 i POLICY PRO JECT ❑ LOC PRODUCTS-COMP/OPAGG $ 2,000,U00 X OTHER FITRV $ 5,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY (Per person) $ ( ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS Per accident UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ r DED I I RETENTION$ $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY YIN STAT TE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? N I A B (Mandatory in NH) UBBL53361A 10/18/2020 10/16/2021 E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes.descnbe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ 500,000 I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Additional Insureds when required by written contract: Village of Rye Brook, 938 King Street, Rye Brook, NY 10573 `Re: Winston Residence, Boxwood Place, Rye Brook, NY 10573 I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Village of Rye Brook THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 938 King Street ACCORDANCE WITH THE POLICY PROVISIONS. Rye Brook, NY 10573 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) yo KR Workers' CERTIFICATE OF sTATe Compensation Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured S(j 1 i o CeiCZo D&:Ir 05C0 -- (Dq0+ 1c.NYS Unemployment Insurance Employer Registration Number of Insured a0ocatlon o nsured 4&�% d if coverage rs ficaB limited to 1d.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Map-Up Policy) Number o - ag51 4 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) i 11Ctye- l o� 12k4C SCW �rGtvt� -erS 3b.Policy Number of Entity Listed In Box"1a" X Policy effe 've nod 105'13 i j 2y to o 22- i2� IC 3d.The Proprietor,Partners or Executive Officers are ❑ included.(Only check box if all partnerstofflcers included) all excluded or certain partners/officers excluded. This certifies that the insurance tamer indicated above in box'3"insures the business referenced above in box'I a'for workers' compensation under the New York State Workers'Compensation Law. (To use this form,New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation Insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2". The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate.(These notices may be sent by regular mail.)Otherwise,this Certificate Is valid for one year after this form is approved by the Insurance carrier or its licensed agent,or until the policy expiration date listed In box"3c",whichever Is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend, extend or after the coverage afforded by the policy listed,nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note:Upon cancellation of the workers'compensation policy Indicated on this form,if the business continues to be named on a permit,license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers'Compensation Coverage or other authorized proof that the business Is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the Insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: C,Qf— (Print n;ime of aut ' ed representative or licensed agent of insurance c a�nier) Approved by: / 2— ) 21 gnature) (Date) Title: yJ(\-bt✓ Telephone Number of authorized representative or licensed agent of insurance carrier. Please Note:Only Insurance carriers and their licensed agents are authorized to Issue Form C-106.2.Insurance brokers are NOT authorized to issue It C-105.2(9-17) www.wcb.ny.gov