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HomeMy WebLinkAboutRP22-010PERMIT # �c�c� o�O DATE: � " 10(pl SECTION BLOCK // L01 d % TYPE OF WORK -- T! /' /Ior JOB LOC TION 1 OWNER /7iC> / i'7© � C/ cl YIDMO 33S49 CONTRACTQ i eilnS ✓J Y l'�9�/9-33C3 �C'/O�,C� EST. COST y F EE VCO # FEC�` a�i fir`-' �-i-c � TCO # FEE -- ---r INSPECTION RECORD I DATE I NSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING ED RGH PLUMBING GAS M SPRINKLER ELECTRIC 0 _�` .. FINAL r is AmNow 11 Illinois OTHER APPROVALS +ARS BOT _ PB zBA OTHER �yE BR 4 L 19 40" ClnnivmaW VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury www.1yebrook.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 Daniel Albano&Felicia Albano 57 Tamarack Road Rye Brook,New York 10573 Re: 57 Tamarack Road, Rye Brook,New York 10573 Parcel ID#: 135.60-1-17 Roof Permit#22-010 issued on 4/4/2022 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 F �AV E BUILD ENT For office use only: IDPEitM" # —� Q VIL OF RYE OK ISSUED: —aa AUG - 2 2022 38 KING STRE $ caox YORK 10573 DATE: VILLAGE OF RYE BROOK C?-r FEE: W / s— PAID& 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 Address: p_ Occupancy/Use:lba 't (cs�den� Parcel ID#: I3S-60 I'�1 Zone:_/` — _ Owner��n;�� ��bcthD1 I� fC��ctit� A{,06a o Address: S-1 Iavr.mr-ack_'j, P.E./R.A. or Contractor: % o � e.Ei L0523 i Iv) 211Cppizc ah ev Y Person in responsible charge: 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 NEWYORK,COUNTY OF WESTCHESTER as: �e.1 ,A� �-� 6y o being duly sworn,deposes and says that he/she resides at 5-1 T 01"'('011c (Print Name of Applicant) I (No.and Street) in %AQ 'Ef'0 o k— ,in the County of �e i }'C"_S_6_r in the State of .�)y 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:$ 25+225 1 , for the construction or alteration of: S4- Qagc a_Sa e. 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 2!`0' Sworn to before me this -14 day v,S4- , 20 22 da , 20 22 S gn ure r erty Owner Sig a of A licant ,PFiRt Name of Property Owner Prin a of Applicant 3i6��t aaW Notary Public Notary Public SHARI MELILLO SHARI MELILLO Notary Public,State of New York Notary Public,State of New York No.O1ME6160OP.1 No.01M E6160063 Qualified in Wes;chemQ, . h; Qualified In Westchester County- Commission Expires Janujry;,,Z0 15b Commission Expires January 29,21)._ �yE BRCv� o`` tim 1982 BUILDING DEPARTMENT ❑$UILDING 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:- �� �(-�` o`1 - C+�-� -./ �' �V DATE: PERMIT 0 ISSUED: SECT: `� (,' LOCK: LOT: ' LOCATION: "LS1_ (' �� A OCCUPANCY: l� ❑ VIOLATION NOTED THE WORK IS... ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION a 6 � 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 INAL ❑ OTHER S a � e a y : u = PG rW � U ~ CO � •� � � a ✓ r*1� y W W O \ W It,. —V � W a a o .106 r� en a O r71 Lr) \ O u° W x try a-114 0-4 CA = foe 14 eq w W OQ H O oo � Cj = O Q \ M U Z 4 �rTT�1 � � r � � M � � G� y v �,O � ■ Co a 0 F-r-i W O CN O a o 0 Za "_y �r w c� A U° $ � aQ U d p4 v W O z aQ ' ¢ �° A W Z od . � �I GAR a ►� W � x � � av � BUILaBIRNY NT VI E RAPIR - 12022 938 KING ET 10573 VILLAGE OF RYE BROOK BUILDING DEPARTMENT FOR OFFICE USE ONLY: Approval Date R — 12022 e /`"J��"Q C) Application# Approval Signature: ARCHITECTURAL REVIEW BOARD: Disapproved: Date: - BOT Approval Date: Case# Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Case# : Other: L Application Fee:`JO �A)k Permit Fees: l ^ �i • ROOF PERMIT APPLICATION Application dated: 2 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 Buil ing,as per detailed statement described below. 1. Job Address: 5�)� a ter`-- SBL: 13 5.60 1 i- t 1"I Zone: " Property Owner: >co, 9<T,k�Ge�M�_-L�o Address: 55 Tcc�„�,,,� • Phone#: 141A Cell#: Colt) 3061-35� email: a.ti o'�53��Jv�;,l,carn 2. Applicant: a,am Address: 6-1 Phone#: Cell#: to 10 ZC40 t23,59 email: 3. Rooting Contractor: Address: 2-7 \Ie00e Q,, K.-*2-NMSC� Wy 1d523 Phone#: -3303 Cell : email: } n� p`^ 4. Job Description, list all Methods&Materials: E {U�c==C � g {eP M�'1,a.I,�_ hc5l�f Q A►�L a� e 1 5. Estimate Cost of Job: $ 1<300 (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: W I--h 7. Construction Type: NYS Construction Class: 8. Number of stories: Z Height: 4. Is garage being re-roofed:No:{ )• Yes: (✓jAttached No: (✓j•Yes: ( )Number of Cars: 2 10. Is roof peaked,hip,mansard,Hat,etc:.. A t 11. Estimated date of completion: AAV. S 20 -1- 8/12021 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. S�TE OF NEW „n,W YORK,COUNTY OF WESTCHESTER ) as; . �►oA16 -,being duly sworn,deposes and states that he/she is the applicant above named, (print name of m vidual signing as the applicant) and further states that )he is c legal owner of the property to which this application pertains, or that (s)he is the ;�k 6 c, for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,a ent,attome tc.) That all statements containe 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. 5� Sworn to before me this I Sworn to before me this Vot 20 27i y of 2©Av_�_ 'A, elrty Owner Sii atur o } plicant ` .nee je I A)�4..1Mv -- Print Name of Property Owner Print Name of Applic t v �. Notary Public Notary Public CHRISTOPHER J.BRADBURY Notary Public,State of New York CHRISTOPHER J.BRADBURY Ouaaified in Westchestehests 5 Na 01 BR c Notary Public,State of New York r County No.01BR6159985 Commission Expires January 29,202--1,. Quallfled in Westchester County,� Commission Expires January 29,20 -2- 8J1212021 CL .0 CN C) 0 CD cri co 4) 0 5 Z U 6. 20 8+y Q 'o 4� VIA 0 E c = . 0 u cn UJ :D LO CL z C) LLJ 0 otlectfoll u > < z LL < oG y 0Uj C C) 6. 0 0 0. Q cu of LL LLI U. S a_ CO V i A.tMIm c MI C z LU Li o = -ledaG co > 0 CL x 0 z LLJ 0 0 C 0 P- oo 0 0 z 0) 0 C) 0 W 7, Co n� CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD/YVYY) 03/22/202? 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 I REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. i IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. I 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 NAMFACT Teresa ladarola Edwards and Company PHONE (631 472-8400 FAX A/C No ) A/C,N.: (631)472-8486 140 Greene Avenue E-MAIL tiadarola@edwardsandco.net ADDRESS: INSURERS)AFFORDING COVERAGE NAIL Y Sayville NY 11782 INSURER A: Ategrity Specialty Insurance Cc 16427 INSURED INSURER B: White Plains Roofing&Siding Inc INSURER C: 27 B Nepperhan Ave. INSURER D: INSURER E Elmsford NY 10523 INSURER F COVERAGES CERTIFICATE NUMBER: 21-22 Master-GL 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 I 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/YYYV POLICY EXP LIMITS ) (MM/DD/VVYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000.000 CLAIMS MADE ® OCCUR PREMISES jEa occurrence S 100,000 MED EXP(Any one person) S 10.000 A Y 01-P-GL-P70002424-1 01/01/2021 07/01/2022 PERSONAL&ADV INJURY S 1.000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2.000,000 POLICY ®ECT LOC PRODUCTS-COMP/OPAGG S 2,000,000 OTHER. S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S Ea accident ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE S AUTOS ONLY AUTOS ONLY Per accdent S UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LIAB HCLAIMS-MADE AGGREGATE S DED RETENTION S S WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N STAT LITE TE ER ANY PROPRIETOR/PARTNER/EXECUTIVE El N/A E.L.EACH ACCIDENT S OFF ICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S If yes,desQlbe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) As respects to General Liability if required by written contract the following are included as additional insured per policy form CG2010. Village of Rye Brook I 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. Building Department AUTHORIZED REPRESENTATIVE 938 King Street Rye Brook NY 10573 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) 1 he ACORD name and logo are registered marks of ACORD 3/22/2022 10: 12 : 53 AM PAGE 2/002 Fax Server Workers' YORK 5 A?F ` Compensation CERTIFICATE OF Board NYS WORKERS'COMPENSATION INSURANCE COVERAGE 1 a.Legal Name&Address of Insured(use street address only) l.b.Business Telephone Number of insured i (914)949-3303 White Plains Roofing&Siding,Inc. ic.NYS Unemployment Insurance Fmployer Registration �! 27 Nepperhan Ave#B Number of Insured E Elmsford,NY 10523-2506 Work Location of Insured(Only required if coverage is 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 133462534 ? Name and Address of Entity Requesting Proof of Coverage(Entity 3a.Name of insurance Carrier 1 Being Listed as the Certificate Holder) Continental Indemnity Co. t Village of Rye Brook g y 3b.Policy Number of P,ndty listed in Box"ter" Building Department 938 King St 46 854R79-01-10 Rye Brook,NY 10573 3c.Policy effective period 06 29d21 to 0612W22 3d.The Proprietor,Partners or FAecutive Officers are ..... included(onty check bm if tit pumerNomcers included) -X all excluded or certain partnem/officers excluded. This certifies that the insurance carrier indicated above in boa"3"insures the business referenced above in box "1 a" for workers' compensation under the New York State Workers'Compensation Law. (Tb 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 scud this Certificate of Insurance to the entity listed above as the certificate holder in boa"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.) ()therwise,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 boa"3e".whichever is earner. 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 he 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 Vork 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: `!- r 03J22l2022 (Signature) (Date) Title: Authorized Representative Telephone Number of authorized representative or licensed agent of insurance carrier: _s;M 234.4424_ Please Note:Only insurance carriers and their licensed agents are authorized to fwae Fam C-105.2. Insurance broken: are N 21 authorized to issuc it. C-105.2(9-17) www.wcb.ny.gov