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HomeMy WebLinkAboutBP21-318PERMIT # A& Ql ' 3 / DATE. EXP: SECTION 9 • 76 BLOCK LOT TYPE OF WORK 40�1el2 G t4� JOB LOCATION �7` e? / /''oe 7,00 OWN CONTR EST. COST %%CO # FOOTI N G FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING I� RGH PLUMBING GAS SPRINKLER ELECTRIC LOW -VOLT 0 ALARM 0 AS BUILT FINAL OffifirM ma FEE DATE INSPECTION RECORD DATE INSP l!P 93 �A 0$4479 10 ;HER APPROVALS ARB BOT PE ZBA 1 44 w LE V v u`L �aE'�'cf•y V 40* tbwdumaW 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 August 10,2022 Mark Kibel&Shari Kibel 248 Tree Top Lane Rye Brook,New York 10573 Re: 248 Tree Top Lane, Rye Brook,New York 10573 Parcel ID#: 129.76-1-73 Building Permit#21-318 issued on 12/3/2021 to Replace Three Windows / Ida Damage This certifies that the three new windows,installed under the above captioned permit has been satisfactorily completed. Sincerely, Michael J. Izzo Building&Fire Inspector /to ^R For office use onl F C ENE E D BUILDINZr. E .TMENT PERMIT# -319 VILLAGE OF RYE R1fdOOK ISSUED: / — 1 E AUG - 3 2022 IC]NG STREET 2vE BROOK,Niw YORK 10573 DATE: - [ 9 -06610' FEE: - D 13 VILLAGE OF RYE BROOK SUILnINIG D17PARTMENT 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: sasssssssrsrsrtttsrsrssssrsrsrssrrrrr]rtsrssswrrswstrtsr►•swswrrrrss►t►rtsrrtsrwtrsssrrsrrrsstrwsrwrrs►ssrwrtrrt►srwrrstr►sttw � L Q n Occupancy/Use: M Parcel iD#: 7 _�— 7 3 Zone: Owner: S�ti �..e/ /t'1�k ,L'%Sc Address: P.E./R.A. or Contractor: /,address: 13 5 W' Person in responsible charge: �4/,ph Address: 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: Sa,-1 & 4,6e/ being duly sworn,deposes and says that he/she resides at T t tIp Print Naeme of Applicant) I 1 (No.and,treet) in �G > 'k ,in the County of in the State of _,that (Cm/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 for the construction or alteration of r ea/cc/cc ! „� v-( eP r•- 0—q / L-4 -� T 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 3 day of ' s+ 20 --Zo day of v , 2Q_ Signat6re of Property Owner Si lure of Applicant C1 Print N e of Property Owner Print ame of Applicant pt, lic LIE D BRANDEIS NotarJfMdc IT13RA#JDEIS Notary Public,State of New York Notary Public,State of NewYork No.01 BR4997M No.01 BR4997675 anNed N westchaft Cowdy Quallfled In Westchester County 8/12/2021 M@' 16$ J �G. Gommisseian Expires June 15,2i 9211 QyE BRC�jk. O� - cu � 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.or$ - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS :_ V DATE. '3 j q /-Z-D-Z-Z_ PERMIT#;.5a 1 �� ISSUED: SECT: `��, LOCK: LOT ia LOCATION: 1t ' `= ► 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 ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING CROSS CONNECTION / ( FINAL ❑ OTHER s OD ° N N W N N i en N N oA = a 4) 00 CL CA 9 jx� IT v� �C �--� 3 -o � o �• qq a, ,� O A ° 00IX co U OLD x �T� A tl W oo U •� o .c o o ,V h•N Urno � °�' '� .°'. `� u i 9z , .Sc v �, Y� Q� � o — OC w Q � y � V MS wo 40. v� ._ 00 U U Z w 0 > E N AG U E" = oac. I z p ° p� v > > W � � � >0. O" R a a a w � � L � 1_1 BUILDING DEPARTMENT �C � �Will E VILLAGE OF RYE BROOK DEC , 1 2021 938 KrNc, STREET RYE BROOK,NY 10573 (914)939-0668 VILLAGE OF RYE BROOK wNvw.n's rook.ors! i BUILDING DEPARTMENT 962. ADMINISTRATIVE EXTERIOR BUILDING PERMIT APPLICATION FOR EXTERIOR WORK WHICH DOI,.S No`r Rt.UUu2E VII.I.AGE ARCHITECTURAL.REVIEW BOARD APPROVAL. FOR OFFICE USE ONLY: p APPROVAL DATE: DEC — 2 6 PERMIT#: J.� �1� 3R APPLICATION FEE: APPROVAL SIGNATURE: PERMIT FEES: H.O.A. APPROVAL: DATE`:,r DISAPPROVED: OTHER. � Q I y —1 C Application dated: rQ1 is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the rnnclrnrtinn nfhniiriinoc ctrnrtllrec Ad(iitinnc gitergtinnq nr fnr;4 P vhsna in rtae ae ner detniie.d state e mnt clrcrrihf-d heinw 1. JobAddress: 2 L- f )re Le-'C e c 2. Parcel ID#: I a 7 r 76 - 7z Zone: u 3. Proposed Improvement(Describe in detail); P 4. Property Owner; S14 !•/+st /-1 o-r/C I ,ye l Address: Phone#_q f 3- . Cell# '�� _ 3 /_ 6 cl�` e-mail e-J, %bo / @ 4 List All Other Properties Owned in Rye Brook: Applicant: Address: r., 1-►1VLG K I.GL rc l;-ll 1A 11 Architect: Address: Phone# Cell# e-mail Engineer: Address: Phu=it cuii 4 c-iusii General Contractor: II ewe Address: 4ye-noe ye-no L4 017,0 A)V Z a5 71-1 Phone# 9/j4- 73 /- '/077 Cell# e-mail cI� 9/12/2021 5. Occupancy;(1-Fam.,2-Fam.,Commercial.,etc...)Pre-construction: Post-construction: U. t1rou Ul lUG Jqu=1GCL: Aufcs. 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 comer lot,which street does it front on: 9. Area of proposed building in square feet: Basement: I'fl: 2'fl: 3d fl: 10. Total Square Footage of the proposed new construction: 11. t'01:addlilullb,LULW�gUarC LUMUgr,aUMU: ndSC1LC11L. L L1: G- 11. 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:()Typical Western Lumber Frame;()Timber Frame [TC];()Wood Truss[TT]; ()Pre--engineered wood[PW];Located;()Floor Framing[F];()Roof Framing[R];()Floor&Roof Framing[FR];Other: 15. Number of stories: Overall Height: Median Heialit: lb. Basement to be full,or partial: finished or unfinished: 17. What material is the exterior fmish: 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 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:_ (if yes,applicant must submit a separate Automatic Fire Suppression System Permit application&2 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? Vn Rln i:f.. li�ur:} ' '••!..'.�.'.:-C.4A Al,. ..., .. . '�'ir . ....... ...... ... 24. Will the proposed project require a Steep Slopes Permit as per§213 of Village Code Yes: No: (tf 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: (f 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 FIood Plane as per the FIRM Map dated 9/28/07? Yes : No: (tfyes, the area and elevations of the flood plane must be properly depicted on the survey&site plan) 27. Will 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) 29. What is the total estimated cost of construction: S 1 J'('/-3. oz) Note:estimated cost shall include all site improvements,labor, material,scaffolding,fired equipment,professional fees,including any material and labor which may be donated gratis the final rnst erreedc the estimated rnst, nn additinnal fee will he required prior to iscnnnre of the 00 30. Estimated date of completion: (2) 811212021 BUILDING DEPARTMENT VILLAGE OF RYE BROOK R DEC _ 1 2021 938 KnvG STREET RYE BROOK,NY 10573 (914)939-0668 VILLAGE OF RYE BROOK wwwxyebrook.org BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE 4216 • STORM SEWERS AND SANITARY SEWERS THIS 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: 3,! SA "z- i h K- l c ( , residing at, '2 L1 J fr-"-kr (Print name) (Address Nvhere you live) being duly sworn,deposes and states that(s)he is the applicant above named, and further states that(s)he is the legal owner of the property to which this Affidavit of Compliance pertains at; ,; L/ y Z - -1 e , 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, f-'niintFr onra "XTillnn�+ +r'nr,r c v....s,.of ...-.. .��w8v �...�..... (tiigna ire of Property ONr ncr{,)I r7' (Print Name of Property Owner(s)) / Sworn to before me this 2C i day of �L�U , 2021 AL SANDRO LUKIC Notary Public-State of New York N0.01LU6311072 Qualified in Westchester County (Notan Public) My Commission Expires Sep 8, my 22 (3) 8/12/2021 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 YO OUNTY OF WESTCBESTER ) as: .r 4l - lt,. c) ,being duly sworn, deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) -! ALUL !.-..."l Uk, +- •"%,,, 4.LLI -1..UA0 ka)A .-. uiLU LUl µlbl j1u74\.+? } ,JjILV LJ I.ILLb 11r�ba1 VY,liVl Vl LIlV iiL viia.L l.j L1J WlllVl! I111J iL�/�,l1LVLLI.1Vil �1vl LtLL11J, Vl LLi0.1 tJfllV 1J Ul%r 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 reguiations. By signing this application, the property owner rurtner aeciares Lila[ ne/sne 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. Sworn to before me this Sworn to before me this #1 day of ,20 day of �` `/. , 20 21 Signature of Property Owner Si attire of Applicant Print Name of Property Owner Print Name of Applicant Notary Public Notary Public SANDRO LUKIC Notary Public-State of New York N0.01LU6311072 Qualified in Westchester County My Commission Expires Sep 8, 2022 (4) 8/12/2021 AFFIDAVIT IN SUPPORT OF FEE WAIVER RELATED TO HURRICANE IDA STATE OF COUNTY OF Z(J�Jt fc�s � (insert name), being duly sworn,deposes and says 1. I am the applicant for a Building Permit/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 .2 Lf S 1r-a4-? L� Rye Brook,New York (insert street address) OR I am the (Architect/Contractor/Engineer/Attorney) (circle one) for the legal owner of property located at A-A /�' , 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: IV I 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 �- + Day of /L'X' 21 SANDRO LUKIC Notary Public-State of New York NO.01LU6311072 Qualified in Westchester County Notary Public My Commission Expires Sep 8, 2022 RIEC Er-WE DEC - 2021 5 VILLAGE OF RYE BROOK BUILDING DEPARTMENT LICENSE NUMBER "THE ORIGINAL'S Westchester WC-8561-H97 p0 U B LE Family Owned And Connecticut 00556256 Operated Since 1960 All Home Improvements EST. 1960 439 Willett Ave. Port Chester,N.Y. 10573 Tel#(914)937-4279 Fax(914)937-4172 http://www.DoubleRwindows.com Shari Kibel November-02-2021 248 Tree top lane. Rye Brook,N.Y. 10573 (917) 734-7868 email mskibel(ayahoo.com Insurance: All work involved within the following proposal is covered by Workmen's compensation,Public Liability,and Completed Operations Insurance. Andersen 400 series gliding windows proposal. II -)uppiy iagor & maienai Tor ine Toiiowing. A- Double'R'to replace the 2 rear windows in the master bed room ,and 1 window in daughter's room with the Andersen 400 series gliding windows. B- The windows are a new construction application with a terratone color on the exterior and a pre finished white wood interior.The windows come with white hardware,full screens, high performance glass, insulation package and all new trim on the interior and all new pvc trim on the exterior that will be painted before installation. C Thcsc w ndovvs- n Andcrscn to-,of thn lin.. D- Total amount of new windows is 3. E- We will cart away all job related debris. F- Permit fees are not included in this price. Terms: Painting,and windows cleaning to be done by others.Hidden rotten wood not included. Standard industry cash term,one half with the order,balance due upon completion. Terms may be modified to meet special conditions. Past due balances are subject to a monthly service charge of 1 1/2%(18%per annum). If the account becomes delinquent,we agree to pay any legal or collection fees expended by Double"R"arising from collection of the account.Permit&Application fees not included. Double"1t"is not responsible for reconnecting existing alarm systems on windows and doors You the owner may cancel this transaction at any time prior to midnight of the third business day. After the date of this transaction,such Cancellation must be made in person,at the offices of community improvements,or in writing postmarked prior to the fourth business day.We accept VISA or Mastercard with a 3%convenience surcharge on total amount being charged. Acceptance: The above prices,specifications and conditions are satisfactory and are accepted. Double"R"is authorized to do the work as specified. Contractor Performance Warranty: Double"R"proposes to furnish and install labor and material in accordance with above specifications in order that the above qualifies for the Manufacturer's Long-Term Warranty. In addition,all labor provided by Double"It"is unconditionally warranted for a period of Two years from the date of installation. Approximate Start Date:6 to 8 WEEKS Approximate Completion Date 2 days: Customer: $9,040.00 (Amount) Date: 0% (Sales Tax) Double"R". Carlo Labianca $9,040.00 (Total Amount) Date: November-02-2021 $4,500.00 (Deposit) $4,540.00 (Balance Due Upon Completion) Return original contract to Double"R", retain a copy for your records. Visit Our Showroom Located At 439 Willett Avenue Port Chester, N.Y. 10573 I Building Permit Check List&Zoning Analysis Address: Z O N a— SBL: 1 2 S , ? - L Z Zone:'L jl Use: Z I Const.Type: Other. Submittal Date: t Z I \I=-k Revisions Submittal Dates: Applicant: Nature of Work Reviews:ZBA: DEC t 2021 PB: BOT: Other. ICED OK (FEES:Filing. Pr' BP: C/O: Legalization: ( ) (-_�APP: Dated: Notarized: ✓ SBL: Muss 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: ( ) ( ) LANS:Date Stamped: Sealed: Copies: Electronic Other. ( ) ( 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. ( ) ( ) 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 APPROVED �.. Date: DEC — 2 1021 Cir Emng Front: _mint s do: R.Mr. Main C�v Accs.Cov Ft.H/Sb: Sd,H/Sb: T Irn : Fc IMR: Hkight/stories: notes: AFFIDAVIT IN SUPPORT OF FEE WAIVER RELATED TO HURRICANE IDA STATE OF /"y COUNTY OF (insert name),being duly sworn, deposes and says 1. I am the applicant for a Building Permit/Certificate of Occupancy/Demolition Permit Electrical Permit/Plumbing Permit/Fence&Wall Permit Mechanical Permit/Pod Permit(circle all that apply) L 2. I am the legal owner of property located at Rye Brook,New York(insert street address) OR I am the (Architect/Contractor/Engineer/Attomey) (circle one)for the legal owner of property located at , 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: 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 3 / 20 Notary Public SHARI MEULLO ►'�, v Notary Public,State of New York No.01ME6160063 Qualified In Westchester County AUG ' 3 2022 Commission Expires January 29,20i3 VILLAGE OF RYE BROOK BUILDING DEPARTMENT 173'/2 Ivy Hill Crescent Rye Brook, NY 10573 914-939-2440 R[SCENE DEC - 1 2021 11/19/2021 VILLAGE OF RYE BROOK BUILDING DEPARTMENT Shari & Mark Kibel _-__- 248 Treetop Lane Rye Brook, NY 10573 Re- Window Replacement Dear Shari & Mark Kibel, This letter serves as confirmation that the Architecture & Grounds (A&G) la0I II111llCC I Id' I CVICVVCU di IU dUUt:: JLCU yuul dpylluduui-i Iu1 a IC auuVU- named work. This approval is valid for six (6) months from today's date. A permit is still needed for this work. If any changes need to be made to the original plans submitted to A&G either before or durinq construction, the Committee must be notified in w ibl Ig dl IU yUUI dF.11.JIlU60UI I I I IU'L uC dl I ICI utCu. VVui K muza JLup di lu cannot proceed until you receive written approval for those changes. You are required to inform the Property Manager when work begins. When the project is complete. the Property Manager must again be notified so that an inspection may take place. Please include a photograph of the work ca ) wCi. Failure to comply with these procedures will result in fines and/or work stoppage. If you have any questions, contact me at- Property Manager. Ashlee Pasquale Interim Property Manager b, M yy i y c 4ILO (n V r G O = 2 .- a 06 • a 0.- w t CL i A pppp- i 4 t 3 L � �i 3 a f l DATE(MM/DD/YYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE �/ 12/1/2021 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 endorsement(s). PRODUCER NAME: Mich Ile Seeley Marenco Insurance Agency Inc. PHONE (A/ IFAX C No Et), (914)235-3144A/C,No): (914)235-1571 IF t LiLi PRimer Avenue Zulre,i i nnnorcc. m7Cit P.iielOim RrBnrnin S71rRnr`P c om INSURER(S)AFFORDING COVERAGE NAIC S New Rochelle NY 10801 INSURER A: UTICA FIRST INS CO 15326 INSURED INSURER B: ARC Home Improvements Corp INSURER C: DBA Double R All Home Improvements INSURER D: 439 Willett Ave INSURER E Port Chester NY 10573 INSURER F rok/mRA_Es CERTW!CATE N IMBER: DF_VIC_IA_N_HUMBER• 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. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 REM CLAIMS-MADE F)7( OCCUR PREMISES(Ea occurrenoe) $ 50,000 MED EXP(Any one person) $ 5,000 i A,. I V , .Tct7Q717.nn �. . . , I. Innnnnt GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY ❑PRO- ❑ JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY Ea accident $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident)is AUTOS ONLY AUTOS HIRED NON-OWNED $ AUTOS ONLY AUTOS ONLY Per accident I I I 1 I I i i I I I C UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER 777R-- AND EMPLOYERS'LIABILITY Y/N STATUTE I JER ANY PROPRIETOR/PARTNER/EXECUTIVE❑ N/A E.L.EACH ACCIDENT $ FFICER/MEMBER EXCLUDED? Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ f yes,describe under ESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ I i I I I I I I DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Addltlonal Remarks Schedule,may be attached If more space is required) Certificate Holder And Shari and Mark Kibel Also Named As Additional Insured With Respects To General Liability. i L CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Village of Rye Brook ACCORDANCE WITH THE POLICY PROVISIONS. 938 King Street AUTHORIZED REPRESENTATIVE Rye Brook NY 10573 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Double R&F Paint Corp. Double R license and insurance Nov 8, 2021 at 11:52:04 AM mskibel@yahoo.com Good afternoon.Sending over the license and insurance certificates. Please find them attached.Thank you! Double R All Home Improvements 439 Willett Avenue Port Chester, NY 10573 914 937-4279 Y S'C ' '� W.,k% CERTIFICATE OF INSURANCE t r` �.T I c�R,P. ,. Board DISABILITY AND PAID FAMILY LEAVE 8 IK)eca tEfio'+wry NY•ROG I RYeM toRl PART 1.To be templiKed by ChvbdQy and P,�d F—ly L—BeAeRta Cr TAM M Ib LegK WF.�AAd%rl%dl.nseo i.x�n-.:.I:•.,,., tr Burw.TetW CERTIFICATE OF WORKERS'COMPENSATION INSURANCE I wLlraR Nrva•FaEh*s urrl.:.,,r.r c......,�.:ArK.�,F.. 914.93742' I ATTN RALPFr CACCCIMO 1 418.1I T AVENUE 0 Q PORI CIESIER.NY•0673 i c aka YN b_V •`pM LMRENI;O NS'URANCE ACENC`�.0 O WaE LaMror d Nw%w%YM'+a+Ir.Iw•ryra aN.+r>n 1..N.er 1339 0830 '_:L:PA AER AVT. a:F1C oar.mrtw.Nw r.+tor.,.+`+.i I1.tYI 133941M30 NEYY RCILHELLE NY•pep• w �2 NaRe ArW AgtoN W E+tEy IyF.Ne.aq PaF1 W Co.NNse ],arise d`IFIra% S..AN")VAa,l1A•c IEIery lMrpllWNMhCrrwaY Nnlla't �Pati AND VI/BSI.M61 I Arbors HOA 173 I:2 k7 HN CMSCWR ARRC•+( m Psry Nu1Ea a I` -10HA %A CLRIE-IGA Tr WxrYR IE'MFMtOVEAENTS CORD ARBOR-1 Rye Book NY 1BS73 DBL13285 )tlA ViXAR.E N HI IKWI AJPNLYaI ML h15 I•J NY M L C rE SI.E%1 JC PdcY eNectw P 439 WILLETT AVE RYE 8W)OK NY 11.573 0701. SORT CHE51CR%Y IM13 J PWvIrPndel lre 1.0-9GVNt4 ®A BaW--V N Ped I—"Yaw Oa1FNA i'OL c:Y k=R CERTIFICI.TE NJMBER POLIO)PERIOD DATE ❑O DA+EAp b—W P•Fr W135e 87A-7 G'JlA OA 16'2C71 10 OL 16`112J I 1 a'IO7' Q G.P-•w+ry swe true'^ant S Po M rMS IS TO CERTIFY THAT THE POLICYHOLDER%ACED ABO.E IS MSURED WTH T.E NEW YORK STATE J%SLXUNI.E ®A MdRN allpbwrl wage tlgeY ado rle NYSf»+ra Pad FaYdylm FLAX) .0"M POLICY NO :WWK-2 CO kWG TIE ENTOF (1BIIGATION I* THIS P(XKYW)kMR FOR BOrr Y�N6F)iy l)aNse�aDrnpoYal arYbRel MORNERS COMPENSATION LMXR THE NEW YORK y1'CMMRS COMPENSATION LAM WI'H RESPEC• TO ALL OPERA'04S h TK STATE C<NEVI YOR% "FP'T AS P4)OrA'FD BELOW A%C 'WIT•f RESPECT'O OPERATwJNs O..1SMF Or %rW•1l TO nr F•(Y.K'..,-0 P:=1 Pf-11—N Y—sT✓r na•t I.•rr`JFiI. WY WMN TO RECENE NOTNICATIONS REGARCWG"M POLICY.PICLUOING ANY NOTWICATIDN OF CAISMLATKM. IAWa P-M.,al P.w"I IaLII M 1�a.YAYa �grraw'I/.e U v k%+eee�—rlhe OR TO YAO q A FE TN CIE. ISA E 1E.1WK.IE V WA W95 A I NM TTVWN Y NY60 CON tE R r CER N A ASP THE NE ll1 W NYS a ari6br Pad F,Yr.t l a aw 11 Mr�f.Ian;arlwFrapa aF dNLrMd. YORK STATE NSURANCE IUND M,s NOT LIABLE IN INE EVENT OF FARURE TO WE SUCH NO T e'ICA TIONB. 'r•I�I•IA:(.Y'L1*b NJ 1:-:E%I,A:Mi JH_,11;.'MIAN1X rRlW SU1I.•1%A RV 1,a f E N L.d.'HL Lr F k L KS La'nL �1,SIP.w1 ltrs'2(I21 TN I/,.Sj ji4e PSLINED CORPORATKOFI e .�....�.........w..a al.... )NLL SKN h• � TRAM J VTRRASrRO ,T kI N— 516-829-8100 N—eC T4 Richard White C rprM10 FR KALI+f CAL t;U W) PPOR LAN' F BOFe9 to a••d SA are tl'etl1M.Ar1P tM bm H r.grtd 4y me wIeull ARC f106E 1104104 WNTS CORP LW—ld hsanarrx AgeIK n1 Rut comer.t^5 cM 6k K COMPLETI TWIP R"NI(JNWtA TIIIIa P 80I a8 sC a 56 s cl—d t,o.,WAK ab s 110T COMPLETE to (, CEA LATE b RAIEO 45 A TaAT TER OF TO CIIOYP"I wNtXXS R5 NO NC 1 FNnMOR FLSIM,TjRAWE DoaKK1Y IPd Pad/ArtWY Lorne BIRIeTh I:Rr E1T.el is m;Wml la%I (.ciK NAIE IIF Ar TIE (2y THE •l31.rxR tlag fERTPICATF tITRS IaUT wLEIIC 1%1FN0 (Ni A.IIR S—I Pu AccePNIKl U—PO 50.S2^_U.B.+prenza).NY-3902 TfE COtERAGF AFZ717DFJ BY TIE POLICY (PARE 2.To be completed by the NYS Worker Compematloe Board lost+e State of New York Workers'Compensation Boa iA[m0•yb HamefAv+mutarledgBN HY�;. a . i . _.il� .. 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