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HomeMy WebLinkAboutRP22-006PERMIT #/QE SECTION TYPE OF WORK JOB LOCATION OWNE& 14Ck CONTRACTOR EST. COST vcO # TCO # oO6 DATE: c) �' Expo I BLOCK LOT a 1 A �et�e1i GS�eeS c?�r.�i c�oa ✓Xr /e T- �udi�i j .S4.ch ,Ae u re 4 '`;- i -o --- . y u�%iv�r� 0 INSPECTION RECORD DATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING 0 RGH PLUMBING GAS SPRINKLER ELECTRIC LOW -VOLT 0 ALARM AS BUILT ED FINAL OTHER APPROVALS ArRE•2 BOT PB OTHER �yE4'y W.j v 1�7. 19 404 (butlCtP1L3[X1# VILLAGE OF RYE BROOK MAYOR 938 King Street, Rve Brook, N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury w,ww..ryebrook.org TRUSTEES BUILDING & FIRE INSPECTOR Susan R. Epstein Michael J. Izzo Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE April 13,2022 Judith L. Sarch 2020 Revocable Trust Judith L. Sarch&Daniel A. Sarch,Trustees 37 Longledge Drive Rye Brook,New York 10573 Re: 37 Longledge Drive, Rye Brook,New York 10573 Parcel ID#: 135.59-1-23 Roof Permit #22-006 issued on 3/7/2022 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 REcE �wE For office u e only: BUILDING DEPARTMENT Pmwu# LIAR 2 8 2022 VILLACCE OF RYE BROOK ISSUED: ` — 938 KING STREET;RYE BROOK,1�1]ER'YORK 10573 DATE: -- VILLAGE OF RYE BROOK (914)939-0668 FEE: ,r95— PAro BUILDING DEPARTMENT «tit:ruti_1Tr� APPLICATION FOR CERTIFICATE OF OCCUPANCY,CERTIFICATE OF COMPLIANCE, AND CERTIFICATION OF FINAL COSTS TO BE SUBMITTRD ONLY UPON CC69%ZTION OF ALL WORK, AND PRIOR TO Tnz BINBL INSPZCTION sruassasssssarassasssssassssssasssssssrossDsrrassasraarrssasassnsssassssas(a�sssssrssssaaaa�saJsassss:raaaaaaaaaaasasrsssessasasa Address: -j7 Loylq je qEC iCl� '�1C� !V q p5�3 Occupancy/Use: I—,Cg Pq Parcel ID#: - e Amok ���► Owner: 4- 1-Pk �T-C Address: ? Lx Aci kdgk 4%" . i'Qt.gmok Aytu73 P.E./R.A.or Contractor: /'(Ark T,I-L)wc+ SO+t, Lhc_Address: A;. kk 9k) eN n I'DODO Person in responsible charge: Q>SWAv\ Su(I WgyA Address: 9)- A). P—+9� C�gers, N J /09 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 11NEW YORK,COUNTY OF WESTCHESTER as: �� b , being duly Swom,deposes and says that he/she resides at le } f� in ,in the County of �A,S in the State of that he/she has s sed the work at the location indicated above,and that the actual total cost of the work,including all site im ements, labor,materials,scaffolding,fixed equipment,professional fees,and including the monetary value of any materials and labor which may have been donated gratis was:.` � for the construction or alteration o 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 structur-e/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 thereofhereafter 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 1 Sworn to before me this day of 20a_ day of ,20 �\I LA Sign of II er Signature ofApplicant -N, � jkc4A 5�,-1 rrbr,Name of Property Owner Pratt Name of Applicant Al-� Notary Public Notary Public SHARI MELILLO Notary Public,State of New York No.01 ME61600,63 Qualified in Westchester County Commission Exaires January 29. �yE 6Raj� .m 1982 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: �- W 1 -4 DATE: PERMIT# � ZZ� Oo ISSUED: SECT: BLOCK: LOT: LOCATION: u��c OCCUPANCY: Zf ❑ VIOLATION NOTED THE WORK IS... �a ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS c Lc-1 ❑ L.P.GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ F NAL PLUMBING ❑ ROSS CONNECTION 4 FINAL / OTHER m = m FI 6 cq N N p4 £w m : N N N r- N W , M Ln v v ,uv, ■ ■ M � CA s2 ■ � ■ k of o r u ■ a W W o � a v h ' x a 148 0 u © �j► `� � � a a A ; •� � o A O �' Qp � ; W H 4 E , x � o W o � w Z I u A u IS o IL 14 `y c, �"� � �' � A � W � � O � a n. �'U W ■ cn Q a � W yA -o n ■ O 0 W enK c u O w o °q �''� rr�h /� Vj a m � cA ■ -00 L -� C C EDT UI MENT V E OF RYE OK MAR - 4 2022 938 KING ET RYE BR NY 10573 �BY VILLAGE OF RYE BROOK BUILDING DEPARTMENT FOR OFFICE USE ONLY: Approval Date: MAR — 7 2022 Application It Approval Signature: ARCHITECTURAL REVIEW BOARD:' Disapproved: : Date: BOT Approval Date: Case# Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Case# Other: Application Fee: Perm it Fees: () L� ll ROOF PERMIT APPLICATION Application dated: i /`off' is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit to Re-Roof an Existing Building,as per detailed statement described below. 1. Job Address; 3 � �� ki , �]OX SBL:/3 J 9'"/ n- zone: pl Property Owner; ✓1 e UC ►�I"1 �I f L Address: 3� �tn lf(T ct,P �,.V I. R 7-P I� ok Phone#: Cell#: 914— S6S— _—) 1 email: „� et Set r��t c1wt 2. Applicant: 0,.A✓r SU Uq I L)CQk RU Gk(4 Address: IV� %L) ( S .)f) Phone#: Cell#: gig— d — email: 6SU r IUa✓1 P +"LeE tZ7U��'C.l. "v�..l 3. Roofing Contractor: Co-ik 1. TL) 2k 4 � Address: 3) /V, lei qK/ CcrMUf3. "10q)() Phone#: 6%- V 7a Cell#: 9N- t{qo- 156S email: Vu-1@_� -tyicek)-o6 (a.-A 4. Job Description, list all Methods&Materials: w1 0 k Q A � d t,.M � 5 ��� a�t� 0' _ f�tr Nf�r 1` .4 G fc_�l�CtV 1 kq[e4 et.-id -'wo lie,,) VC(vex' ^{X+4 clm 's , S. Estimated Cost of Job:$ �. S SZ? (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 corner property,indicate street frontage: 7. Construction Type: NYS Construction Class: 8. Number of stories: Height: 9. Is garage being re-roofed:No:( •Yes: tta hed No:( )fYes: umber of Cars: 10. Is roof P P eaked,hi ,mansard,fiat,etc�Ouy 11. Estimated date of completion: -1- 811212021 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. ***��rxr���xxs�,�K�x,:x���x�..x��*�;:xx*zY��=�xxrx�r*x�xxx{nFrxYxxFxRFx�R�x�x-*�xx�-x,:r.-xxxx�:.xrrxx :;.Yrxxx�..x� STAT ft OF NEW YORK,C(� TY OF WESTCHESTER ) as: _ MA^ S\j, 1`\C4C4n ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of hidividual signing as the applicant) and further states that (s)hg is the legal owner of the property to which this application pertains, or that (s)he is the ct- - �-u C-fD!- 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 Sworn to before me this day of M 04 203�! _ day of .C 4, 0� Si ture orrfPrNope Owner ` Sig a pplicanCi [Name of Property Owner Print Name A Applicant o Public Notary Public SHARI MELILLO Notary Public,State of New York i�O.of fIiE6160r"63 CHRISTOPHER J.BRADBURY 01 jalified in Westche�ter County Notary Public,State of New York commission Expires Janu2ty 29.20� No.01 BR6159985 Qualified in Westchester County Commission Expires January 29,20 23 _Z_ 8/12/2021 ....... ... . . . .. . . . . . . . N —C. z-= Vs�7' v�\V I T�- MM", js 77. 30. .0 C). cr) W. 0 Zx L.I. up- .-LU r7. z a a.0 CN or 2r. *4 g, ATOJ 11 41 114 NOUN —Vq il'. p M ml ACo CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 03/03/2022 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(ies)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 CONTACT NAME: Aaron Epstein Westrock Insurance Agency a/c NE Ex : (845)638-2300 FAX No): (845)638-6222 151 North Main Street E-MAIL Aaron@westrockinsurance.com ADDRENe4thw Floor INSURER(S)AFFORDING COVERAGE NAIC 0 New City NY 10956 INSURER A: Falls Lake National Insurance Company 31925 INSURED INSURER B: Selective Insurance Company of SE 39926 Frank J.Tucek&Son Inc. INSURER C: Century Surety Company 36951 92 North Route 9W INSURER D: INSURER E: Congers NY 10920 INSURER F COVERAGES CERTIFICATE NUMBER: 2021-2022 REVISION NUMBER: 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. INSR TR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY FF POLICY P MM/DD MMIDD/YYY LIMBS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTEIT_CLAIMS-MADE �OCCUR PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 A Y CPP120496912 08/15/2021 08/15/2022 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY ❑PECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED Y S 2260389 11/30/2021 11/30/2022 BODILY INJURY Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ State Surcharge 1 $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000.000 C EXCESS LIAB CLAIMS-MADE Y CCP996503 08/15/2021 08/15/2022 AGGREGATE $ 2,000,000 DED I X1 RETENTION$ 101000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNERIEXECUTIVE E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? N I A (Mandatory In ff yes,describe a under E.L.DISEASE-EA EMPLOYEE $ under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Additional Insured:Village of Rye Brook 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 St. AUTHORIZED REPRESENTATIVE Rye Brook NY 10573 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD • NEW Workers' YORK STATE Compensation CERTIFICATE OF Board NYS WORKERS'COMPENSATION INSURANCE COVERAGE Ia.Legal Name&Address of insured(use street address only) Ib.Business Telephone Number of Insured (845)268-5170 Frank J.Tucek&Son,Inc. 92 N Route 9W lc.NYS Unemployment Insurance Employer Registration Congers,NY 10920-1730 Number of Insured Work Location of Insured(Only required if coverage it specifically I d.Federal Employer Identification Number of Insured or limited to certain locations in New York State, i.e.a Wrap-Up Policy) Social Security Number 133300128 2.Name and Address of Entity Requesting Proof of Coverage(Entity 3a.Name of Insurance Carrier Being Listed as the Certificate Holder) Continental Indemnity Co. Village of Rye Brook 3b.Policy Number of Entity Listed in Box"la" 938 King St. Rye Brook,NY 10573 46-867891-01-09 3c.Policy effective period 04/01/21 to 04/01/22 3d.The Proprietor,Partners or Executive Officers are ® included.(Only check box if all panners/officers included) all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box"1 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 alter 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: Todd Brown (Print name of horized representative or licenced agent of insurance carrier) Approved by: �i-� 03/03/2022 (Signature) (Date) Title: Authorized Representative Telephone Number of authorized representative or licensed agent of insurance carrier: (877)234-4424 Please Note:Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insurance brokers are NOT authorized to issue it. C-105.2(9-17) www.wcb.ny.gov