Loading...
HomeMy WebLinkAboutBP22-057PERMIT # eLi�Q o l� CAS 7 DATE: EXP: SECTION BLOCK I LOT TYPE OF WORK 4QC 2/1 �' JOB LOCATI N Q Q OWNER 46�lt e AE e Z ak eieAo 30`/r _ CONTRACTOR r1C. /C Q2 •�S �3o3%9y�'���� EST. COST 1$ i FEE � �CO # FEE O- DATE '7 TCO # FEE DATE FOOTI N G FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING rl RGH PLUMBING GAS SPRINKLER ELECTRIC O LOW -VOLT 0 ALARM ED AS BUILT ' O FINAL VO1v INSPECTION RECORD DATE INSP t� l- 6'L' 2oZ4 max -- 01 HER APPROVALS ARB BOT PB ZBA OTHER QyE DR tt 4°�J�u GG VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury www.gyebrook.org TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE January 16,2024 Thomas Mauriello&Renee Mauriello 15 Talcott Road Rye Brook,New York 10573 Re: 15 Talcott Road, Rye Brook,New York 10573 Parcel ID#: 135.50-1-81 Building Permit#22-057 issued on 4/26/2022 for Replacement Windows This certifies that the ten new windows,installed under the above captioned permit have been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to DR�r-' �- �' �I For office use only: BUILDINEPARTMENT pERMIT# 57 1 Le VILLAGE OF RYE BROOK _ i, NOV �23 1 938 KING STREET,RYE BROOK,NEW YORK 10573 DATED VILU (914)939-0668 FEE: A //Q-- PAID. BUILD ww2,rygbro9k,org 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 ►►►itt►►■■ti►t►itti►►ttttt}►►►►►►►►/►►►ti►i►i►ntttt►t►iit►t►t►i►ii►i►►t►t►►i►►►►t►t►it►►t►/►1►►►►t►►t►►►iiii►itt►iti►ttt►►►►► Address: l U C a 1`u Occupancy_/Use: �'es dP „ +-, �, Parcel ID#:�� 3 3 - t �� Zone: RV a- Owner: V, M�.l d Q C n P 1" le'u Address: t (�/ P.E./R.A.or Contractor: 14: r.e Oe De 'r Address: /-9 0 4&O)( Person in responsible charge: (_� CJ.c P 1 h 0\,J Address: I / < 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:`5 4 v/ c 1 being duly swom,deposes and says that he/she resides at n�( � , (Print Name of Applicant) I (No.and Street) in O,e G'--e ,in the County of r S rC U J�- r in the State of N"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�e�uipment,professional fees,and including the monetary value of any materials and labor which may have been donated gratis was:$ , It , U O 0 for the construction or alteration of (6 W Lj 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 eyM� ,20 a3 day of , 20 i ere of Property Owner Signature of Applicant ��1n ame of Property Owner Print Name of Applicant A�a' �n' Ln—' — Notary Public Notary Public SHARI MELILLO Notary Public,State of New York 8/12/2021 No.01ME6160063 Qualified In Westchester County Commission Expires January 29,20_7 QyE BRC�k, 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 S I G 1 c-o 14 -ilo( DATE: - Z-L l)L`7� PERMIT# Z z -� 2 ISSUED: -ZZ SECT: /36 •R) BLOCK: LOT: LOCATION: V_V R�Ra(J- J� . �1e>� T SOca\j� } 6o?• OCCUPANCY: 2 l� ❑ Violation Noted THE WORK IS... u�y. PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION 1 ❑ Natural Gas \A/ � r,i> +�L 0.U�.c ❑ FUEL TANK` rGOOni1 lc 1 �( �,Q�3 Jfit �GQ 1 ❑ FIRE SPRINKLER Yy 1 N3 c-cz--, w c 0,� out ❑ FINAL PLUMBING ❑ CROSS CONNECTION ��2uy� ' B--FINAL ❑ OTHER ■ i v 72 v � 4-4 u ■ .. Gj v v v U ,M.EMJy Ci, v o q cam+' O i Ln W a H 00 cn a si n� tv _ CD typ M as A/ ,�q ►v. w, �i U � Pa a CID, O o v ~ W 14 a� fin/ Ln Q d a 00 W z a F� FA W a w op OC W ai 0 d'i .rd 1�1 Q L a a i ds 00 eq eq � _ O oo W Q W o v 0 �i ,. p V a R+ 7 W U z .� a o r,/� ■ z o � J a W a x � � � � .�� T a U i � w v 0 z z � � w U i 1 y 4 u 1■■■1 �'' x O � �A z c G a v �v � o � � L w Y W — A a 0 � � �� b BUILD R TMENT D Q VIL �. OF•KY OOK WIED 938 KING E'r RYE BR ` ,NY 10573 APR 18 2022 14)939-066$�c e o VILLAGE OF RYE BROOK 19b2., BUILDING DEPARTMENT ADMINISTRATIVE EXTERIOR BUILDING PERMIT APPLICATION FOR EXTERIOR WORK WIHcH DOES NOT REQUIRE VILLAGE ARCHITECTURAL REVIEW BOARD APPROVAL FOR OFFICE USE ONLY:A. R AR 2 APPROVAL DATE: 5 PERMIT #: ��' � APPLICATION FEE: APPROVAL SIGNATURE: PERMIT FEES: k 7 H.O.A.APPROVAL: / DATE: DISAPPROVED: OTHER: Application dated: O 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 a change in use,as per detailed statement described below. 1. JobAddress: S. - 2. Parcel ID#: . • s-.-O " 1 — ti Zone: 3. Proposed Improvement(Describe in detail)r ��ti VIr�L S� Ze.� � tS-7"� "t G,..tc-y`t�wt �•�/�.�XY'` 4. Property Owner: 0�'r�O'S �Vn f' L U G Address: 1S T'al c_o41 -- Ir�umat.. 0 Phone `C�a`G- O_-=I-Gc� Cell# e-mail List All Other Properties Owned in Rye Brook: Applicant: �� G4`o�� �kdr✓�c S �d erw. .�� Address: L© � � ��I-- �` Lam. ��c1 s�s,ti�oc� �`T G�tp033 Phone# 3p3 �l k'' �S Cetl# e-mail cf m`}'��G O` norW%,�S V rl Architect: Address: Phone# Cell# e-mail Engineer: Address: Phone# Cell# e-mail General Contractor: Address: ��� 1�c.e�S�e la 3c33�'j Phone# �d3lp Cell# e-mail��rw�. �ape rw+ :1-S. o� (1) 8/12/2021 5. Occupancy;(I-Fam.,2-Fam.,Commercial.,etc...)Pre-construction: 1�t�"` t. Post-construction: `' I 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: I"fl: 2"d fl: 3`1 fl: 10. Total Square Footage of the proposed new construction: 11. For additions,total square footage added:Basement: I"fl: 2"d fl: 3'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;()Timber Frame[TC];( )Wood Truss[TT]; ()Pre-engineered wood[PW];Located;O Floor Framing[F];O Roof Framing[R];()Floor&Roof Framing[FR];Other: 15. Number of stories: Overall Heighc 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: X (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:V Area: 23. Will the proposed project require a Site Plan Review by the Village Planning Board as per§209 of Village Code? Yes: No: 'Y (ryes,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 welland 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;y (if yes,the area and elevations of the flood plane Hurst 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: ((fyes,applicant must submit a Free 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 Name Occupation Permit Application is required) L 29. What is the total estimated cost of construction: $ t k , a 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: (2) 8/12/2021 BUILDk k[RTMENT D F. V IE VIL E OF%I'Fo OOK 938 KING ET RYR ,NY 1�0573 APR 18 2022 <L 4 -066$� 4) k. �ir VILLAGE OF RYE BROOK BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE 216 • 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: 31 ` V vwv S V)A of u r` 4_L�o , residing at, i -Vw t e (Print name) (Address where vou lire) 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; S ��l L.o-t1 Q-ek, , Rye Brook, NY. t ob Addressi 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. r,.uc of f'ru�nrq O�ncr(s11 vo�__ ' Gh Sworn to before me this _ f _ - - A,Zl (7 day of -- -) T�Z- k>G Mir''" r►,� 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. *****wwwwwwwwwww,kw,r*+a,rw*,�wrrwww�rw:rxwwwrr*wwW*ww*wwww*wwwwww**ww***w*wwwww**w**,tww*wwwww**w*wwwww*****wwww**w STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: 1'\A i e(-a•<t , 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. Sworn to before me this �/ Sworn to before me this day of v , 20 Z Z day of ,20 Signature of Property Owner Signature of Applicant <, C'Nlc.I t r ' CL utr i Na roperty Owner Print Name of Applicant otary Pu c —2' Notary Public • 7 141 8n 2/2021 22!§ k, ■` S& m, \l . . . s| §| s| ■■ | !� / !} I { , \ 0 0 ; ! ! :\ I x } x a 0 | | - \ ƒ § 2 ( �!k r- � - m | J\ § e a - � ■!! \ } } ff& }f . � . . � � ■/ Q ` ■ ! ! cl - | - � \ f } • | � . ^ ! \ ¥ \ � � ■ : � ;! -ƒ) £ % / f \ �f ■ram , �! !\ | f !!! k ! %- Qa `a Fa Fa Y >gg mill, Z LL U v � ❑ ❑ O O N ~ N N N N LO ❑ ?YO o pia c� co F LL O Z x x x cm Xo g 0 V C y J in �$ E ; � =(J U U yyyg m4s` '" SSSR >s b N a A4 W O 2 2S am o o G O cc e N N N 4 G 41 = W U ¢ o a ❑ o o x x o x g A a w cl ¢ ¢7 Jm v CWj� y2 � 8 Cl) m � E%e vyi UO W w�th a ❑ n n ti w n a UU yy N NNfn� I U �<yy n N N y wg�g� V m 3 W N n n n a e [ N O E .B g ; m m YU m f m m ib fi yg a m z �l e!$$ o— e Olt—If U T �L �z LLS 3 35 � €9A= z z 3 3 b o s d U 0 tc FFF WN _ �> no J o � O no c U U U 4 .. L y g U W GyX�U y N 03 O OC U O n U = G RM pR 3 N N ,fi a 8 _ W - X X 4 d E O Fn w Q s Oa o9 i Is o o F ° w w f UUJ IL W NS U F8$ O Z 3 U O O w N U m mx $ 8 anileluasajdaa saleg uasiapuy 10 iajeep 1noA loeluoo aseeld'uoi;ewlojui aouewlo}jad liun ogioads io j ualauuolw a+ow+o)1 abed-S f[M Et+Ord -Busy of ioa!gns a.o e LIOZ R,rn<,er l•ae We ao s e ea paloalas suogdo pus azis pun!q sauen aoueJwo}iad -Aluo a3ua-1901 10;si uogewioIui s!ql FIFTIFT e/u e/u r/u e/u e/u e/u e/u e/u (101)-1 PaPlMa unl f e/u e/u e/u 1/u e/u e/u e/u e/u Jill)pallddV+oua[a3/'--.14111-11 x . r A f % 2'0> Ql Z1'0 6['0 %'I 9Z'0 TOOOo-S960o-TFN-ONY (sself-ayl-uaawl>4salluf).,lyfllawl R [ ; m Ll 11.0 L['0 %'I 9Z-O E0000-0600'TPN-43NY algeaowatl loualul pallr11u11.(laS).111 PaPN!o P+Je1—IS e/u e/u e/u e/u (101)a111 Paplw llnl E e/u e/u e/u e/u e/u e/u e/u e/u Jill)pagtldV louala3/+a..14f0au!l i 11 1'.1 EL L►'0 9I'0 %'I 92'0 1000D0960o-TI-WONY (step-ay)-uaaxyaq-sallu!)-148IIau!l A ^ — j NINEL► 2'0 a R S1'0 SL'0 %'T 92.0 E00009t60o-TPN-0NV a(ganowatl+oualul pall+lsul+o(la5)-in pap!^to palelnwl5 e/u e/u e/u e/u e/u e/u e/u e/u Jial)aLi PaPin!0 Ilni e/u e/u e/u e/u e/u e/u e/u e/u (3111pallddV+ouau3/as..l4fllau!3 _ E Ell 11 11 K Z'0> BZ FS'0 p'0 91'I IF'0 t000o-S5600 tPN-ONtl (self-ayl-uaaayaq-salluf)..lyfyawl Ell11 11 K Z'O a SZ LYO WO 9L'T TF'0 E00001/WIB-WGNV algenow.V,...lul P+Ilelsul+o JIGS)+pI p+p"o pal 1i 5 e/u e/u e/u e/u e/u e/u e/u e/u 1101).111 P+PM!a Ilnl e/u r/u r/u e/u e/u e/u e/u e/° (1111 p.JJddV 1Ouale3//a..141111-1 �3 .- x f JN 65 1.01 1T E►'0 61.0 59'i -0 TOOOR B560o-IB-N-aNV (self ayl-uaaayaq-saguf)„,1y14w!1 '^ 3 65 L'O> ET WO LI.0 59'1 62'0 F0000-11600-TB-N-... algeaowal+oualu!Pallalsul+o(105)a111 papwa Pale!nw15 e/u e/u e/u r/. e/u Jlal).1!1 PaPlMa Ilnl e/u .1. e/. e/u e/u e/u e/u e/u Jill)pa!lddV lol-3/M.34211au11 65 2'0 a fT fi'0 oct Of'0 100009560PT9-WUNtl Isself-ayl-uaaa4aq-Sall!+11..14211-1i '^ LI Z1'0 ­0 OL'1 OE O FOOOo-Zt60o-TPN-ONY algenowatl+ouawl Pall+lful+o llaSl+1!1 D+P!MO paulnw!5 laleaus�10.t saI1P9/6s-sSejq p9Je".V wwZ-t % I'o> CS ZYO 6["0 FS"[ Li'0 IOOOO ZL[to-[PN-aNtl (101)aPl PaPlMa llni c or Co. 81 WO 6I'0 %'[ 9Z'D IO000b560o-[PN-aW (311)pallddV 10uau3/M..14311au!3 E - 3 wlPfs/ % 2'0> ei Z6'0 6T'0 %'T 92'0 T0000-9560o-IPNaNY Jffele-ayl-uaamlaqulluf).,lyfllauy N o c -I-SOOT % L'0> BT ZVO 6I'0 %'1 9L'0 Z—,—IB-NaNV +jq.....H a.ual.l P+11+1su1+o(laS)aln P.PIA!a PalelnwlS `1 � % Z'O> 61 it OZ'O %'i 9Z'O IDOWLKWIO-N-a NY 1a111+9 oN JN 11 Z'0> IZ 11"O BZ-O WI f2'0 IOOOo-SZSIRIPN'aNV (lal)a4!1 PaP!Ma Ifni )N 11 1"0> It 11.0 B1'0 %'T 11'. 10000E560o-1PN-ONV (311)PayddV 1.11a1>3/M..14311au!l F x JN it 2'0> EZ it BZ"0 %'T 92'0 t0000-ES60D-tPN-a NV (sself-a4l-uaanslaq-sa4uf)..14111auN P JN it Z'0> E2 Lt'D ..0 %'l 92'0 ZOOOO 91600 tPN-ONV +Jgenow.H+oualul Pallelful+o(Iasi a111 Pap!Na PalelnwlS T ]N it Z"0> SZ f5'0 IE'0 %'S 9Z'0 T0000-9060RIB-N-ONY 1a11119 oN ES'0 L►'0 rr, 2E'0 500009T[TPIPN ONV (101)avj PaPlMa l lnl K 20> BZ Is'. 11. 91-1 11'. T0000-BKd M.-ONV (311)Pa11ddY+.uala3/M..14311au!l ES'0 LVO 9L'I TE'0 S000o-%60PSPN-aNY (ssrlf-ayl-uaauslaq-s>!luf)�lylyau!l F K 2'0> 9Z Is'. 11. 91'1 SE'0 ZOOOo-It 1-14-MI algenowatl loualuJ PaOelsul 10(10S)api Pap!M(l palelnwlS K Z'0> IE 09'0 IS'0 9cI TE'0 I0000-1160trTON-ONV sa111+9 oN JN 6S I'D> It WO 61'0 OL'l 01'0 TDOODfi[TO-MN-ONV 1101)a1n PapNla Ifni 6S Z'Oa ►[ E1'o 61'13 S911 620 100DD-TS600-IPN-ONV (313)p+llddY 1o11aPl3/--14311aull 3 61 Z'0> ►[ 110 .1'O s9-I -0 l—I560o-IPN-ONtl (step-ayl-w+ralaq-tall!+')..142113ull E 65 2'0 a ti EVO 61'0 S9.1 6Z'0 Z0000-1,10600-11-N(INY algenowatl+alawl Pallrlsul+.(lay)+1n Papu!o Pa1rinwi5 6S 1'0> SS 6t0 I2'0 S9-t 62'0 10000'►e60P19-N-ONV sa11090N 65 Z'0> LT %'O fZ0 9L't Tuo TOOOPLTTIO-TPN-ONV Jim)w P>P!Ma Ifni JN 65 1.0> fT %'0 92'0 OL'I -0 LOOOo-6►6 l- -ONV Jill)pallddYlou ya au3/M..14fu!1 - 7N 65 Z'0> BI %"0 BZ'0 OCT DE'0 10000-61600-I2-N-aNV (ssrp-ayl-....Wq-salluf)-,lyfllawl II f EA 6S2'0> 91 %"0 or0 OCT OE'0 Z0000-ZO600-TPN-ONV alg +o r-watluatul PaNelsul+o has)al!1 PaPlMa pale!nwl5 \J 6S Z'0> IZ K'0 ZE'0 OL'[ Of'0 t000o-Zt60o-IPNaNY saIIN9 oN .T ue41-al saBu9 Pue 1a11119 oN/in-s5e19 pale—V wwZ'Z g z �' •'• n s c adA1 T1npo+d w •• p m uagwnN A1oAa110 a0A1 sRID 3 $ ei A gonpold PMlWaJ JtldN adAl all!+9 uaslapuV 8"n AnPOId 1lVLS uViS Q S „ `�° awuaPW ADN7N3 A9N3143 3 Home Improvement Agreement: Page 1 Home Depot License#'s - For the most current listing visit www.Homedepot.com/LicenseNumbers Aldervon Brown Salesperson Name Registration #(Req. in CA,CT,ME,MD,MI,NJ,DC) Home Depot U.S.A.,Inc.("Home Depot") or Authorized Service Provider named below will furnish, install and/or service the equipment listed below at the price, terms and conditions as outlined on this form. {1.Seryke Provider Contact,Information The Home Depot The Home Depot Service Provider Contact Name Service Provider Company Name (914) 347-6900 1 Icustomercancellationnor'theast@hom Phone# 99MMwider Email Address Service Provider License#(s) MaurielloI IThomas -� Westchester 1-1Z3BLAZW Customer Last Name Customer First Name Store#/Branch Name Customer Lead/PO# 15 Talcott rd Rye Brook NY 1 110573 Customer Address City State Zip (347) 920-0209 thomas.mauriello@manhattan.edu Home Phone# Work Phone# Cell Phone# Customer Email Address 3.NOTICE OF RIGHT TO CANCEL YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY CONTACTING THE SERVICE PROVIDER OR STORE DIRECTLY; EMAILING SERVICE PROVIDER AT: customercancellationnortheast@homedepot.com OR DELIVERING WRITTEN NOTICE TO HOME DEPOT AT: 6 Skyline Drive 71Hawthorne NY 110532 Address City State Zip BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING, UNLESS THE STATE SUPPLEMENT PROVIDES A DIFFERENT CANCELLATION PERIOD. THE STATE SUPPLEMENT CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN YOUR STATE. YOUR PAYMENT(S) WILL BE RETURNED WITHIN TEN (10) BUSINESS DAYS AFTER HOME DEPOT'S RECEIPT OF YOUR NOTICE. YOU MUST MAKE AVAILABLE FOR PICKUP BY HOME DEPOT OR SERVICE PROVIDER, AT YOUR SERVICE ADDRESS, AND IN SUBSTANTIALLY THE SAME CONDITION AS WHEN DELIVERED, ANY MERCHANDISE OR MATERIALS DELIVERED TO YOU. OR YOU MAY CONTACT HOME DEPOT FOR INSTRUCTIONS REGARDING RETURN SHIPMENT AT HOME DEPOT'S EXPENSE. THE LAW REQUIRES THAT THE HOME DEPOT GIVE YOU A NOTICE EXPLAINING YOUR RIGHT TO CANCEL. PLEASE SIGN BELOW TO ACKNOWLEDGE THAT YOU HAVE BEEN GIVEN ORAL AND WRITTEN NOTICE OF YOUR RIGHT TO CANCEL. Acknowledged by: 03/31/2022 ustomer's Signature Date A6i1 Standard FunnHlAl?IJu1.211i1i1 (7axr-eldDatr Q3/31/?112•� L-d'PON 1-173RI 07W %' 0.1.12 Home Improvement Agreement: Page 2 4.option of Work to be Performed A detailed description of the work to be performed is included in the paragraph entitled Scope of Work,Specification, Customer Summary Sheet, Quote Form, Estimate, Invoice or Measure which is included in this Agreement. 5.Anticipated Delivery Date/Installation Schedule Approximate Start Date: 09/27�2022 Approximate Finish Date: 10/27/2022 All dates are approximate and subject to change based on unforeseen events including inclement weather, permitting delays, and delays in confirming insurance coverage of Your claim for any repair, if applicable. 6. Electronic Records Authorization You are entitled to a paper copy of this Agreement if you choose. If you consent to an e-mailed copy, your consent applies to this Agreement and all subsequent documents and written communications related to this Agreement. By contacting your Service Provider,you may update your email address, withdraw your consent,or obtain a paper copy of the Agreement or related documents at no charge. By providing your consent and verifying your email address above, you confirm that you have access to a computer that can receive and open emails and PDF documents. 7.Contract Price and Payment Schedule Payment of the Contract Price is due upon signing unless a different payment schedule is required by law, specified below or in a payment addendum. Contract Price: $ 111274.31 Includes all applicable taxes. Excludes finance charges.* Sales Tax: $ 10.00 (If applicable, total amount of taxes included in Contract Price) *� Lximum deposit ONLY applicable in ,AID, MA, ME(33%), NJ, if(99%) Deposit% 125.0 1 Deposit Amount $ 2818.58 Remaining Balance $ 18455.73 $.I"imace Charges Any interest payments or other finance charges will be determined by Customer's separate cardholder or loan agreement, to which Home Depot is NOT a party, and will be in addition to Customer's payment under this Agreement. Customer is subject to the terms and conditions of the cardholder or loan agreement, as applicable. No funds should be made payable to Service Provider; however, Service Provider may collect Customer's payments made payable to Home Depot. 9.Acceptance and Authorization By signing below, you authorize Home Depot to: (a) arrange for Service Provider to perform any Services or (b) order and arrange for the delivery of special order merchandise, including special order merchandise that may be custom made, as specified in this Agreement. Do not sign if blank or incomplete. (Service Provider's or permitting information may need to be provided to You later.)By signing,you acknowledge that: (i)You have read,understand, and accept this Agreement in its entirety, including the General Conditions and State Supplement, if any; (ii) You are receiving a complete copy of this Agreement; (iii)all rights and interests under this Agreement are solely vested in the person listed as "Customer"above; and (iv) Electronic signatures will be deemed originals for all purposes. X 03/31/2022 Customer's Signature Date X I/s/The Home Depot 03/31/2022 The Home Depot Digital Signature Date For questions related to your installation, contact Service Provider at (914) For any other concerns, contact The Home Depot at 1-800-466-3337 - 460Stmdud Form H1A(21 Jul.21)(E) C1cneraidUai.' 03/31/2022 L-d/PO4 1-173R1 A7W v 0.1.12 Building Permit Check List&Zoning Analysis Address: t <- SBL: Zone: Use: (o Const.Type: Other. Submittal Date: 11 1 Z Z Revisions Submittal Dates: Applicant: ykj �r y Cl_( F L L�_> Nature of Work: C-AC ✓c�tJ Reviews:ZBA: R 2 5 2022 PB: BOT: Other. OK ( ( ) FEES:Filing* ?5--� BP: { Z 0 - � C/O: Legalization: ( ) C,), APP: Dated: Notarized: ---" SBL: -- Truss I.D. Cross Connection: H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening. ( ) ( ) ENVIRO: Long. Shore Fees: N/A: ( ) ( ) SITE PLAN:Topo: Site Protection: S/W Mgmt.: Tree Plan: Other. ( ) ( ) SURVEY:Dated: Current: Archival• Sealed: Unacceptable: ( ) ( ) PLANS: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. 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: APPROVLUL REQUIRED EXISTING PROPOSED NOTES A P R 2 5 2022 Area: Date: F� JWo: $Cr. Main COo Ads Ft H Sd.H/Sb: T°�: Ft.In HHight/Stories notes: c / /i r ,,,+h21���',��t�IW;^�'. n ��f ,,'� AEI.:>.,� � k i� ..il� �n ;. •.l�n .. .•-..i:r_ H � .,, n j! � "4�': j�rl rrs`':>rD: Q, � } : '�l�.•� t.v•: � ��"�' �� i.Ivy :F p {�,,, S� ,r�� ..• I� j � �`'� ��'' •tiY� 1 �j' Y ♦• ^ �! f.,• ♦P 1' 1f •..fir' !/ A- •• t Y 4 •. y�^'q ' r n,_ •• 'tCn v t'' •• ^ i y A ' t t. 1 l 5 jl�lt'• 11 li : " d �i s. VV 6 \ ( )m)Y C $ `• fir{ C 7 n r /s, O l •�cd+ \? . - ., Ell � /` /lam V QJ \ u CO 00 ;. L M o }� �cctionIj �•-/e. �i a en w oU ate,Lu LLJ l<QiF ,y _ X im roc ,,, 1ch a 'Fz7•� 4 _ QyS'"�� 00 U !;+- ++ , l r. r�,�'4i�, •A 1 �11,qei Kr' ' ,1►�'11;r rtil ,r;r � �,i►+,Ijr � rS/1„I,r r� ;1, . •! �;►,►,(►�+ � � �+0`0,'� Ell, r^.. tr ♦♦ V: n t r n, V n..i apt I� n1 er.,• t 1 D. p4�ya$ '•' �Iv'��tij - - t'y,� .. d �r ,Cjyi �i j?•r t ! v�k.✓- : .,,q(.,sr Nl;'r - -�11M(J/v�t�l' �� � �! w.. �• �F_ _ .q, _ - � a_ / 'i J DATE(MM/DDIYYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE 6"a / 0310112022 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 MARSH USA,INC. NAME: - TWO ALLIANCE CENTER PHIA/C No.III �No: 3560 LENOX ROAD,SUITE 2400 E-MAIL ATLANTA,GA 30326 ADDRESS: INSUREII AFFORDING COVERAGE NAIL 0 CN101642069-HomeD-GAW.22-25 INSURER A: old RepUbliC InSuranoe Co 24147 INSURED INSURER B: NeW Hampshire Ind. 23641 THE HOME DEPOT,INC. HOME DEPOT U.S.A.,INC. INSURER C: ACE ArriericanAnaufance22667 2455 PACES FERRY ROAD INSURER D: BUILDING C20 -- ATLANTA,GA 30339 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: ATL-004348037-16 REVISION NUMBER: 1 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. I NCY EXP TRR TYPE OF INSURANCE ADDL SU POLICY NUMBER MIDDY EFF MM/DD/YYYY uMITS A X COMMERCIAL GENERAL LIABILITY MWZY316648 03/01/2022 03/01/2025 EACH OCCURRENCE CLAIMS-MADE X� : 1,000,000 OCCUR PREMISES Ea occurrence $ 1,000,000 X SIR:$1,000,000 MED EXP(Any one person) $ EXCLUDED PERSONAL 6 ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 X POLICY PO- JET LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: _ A AUTOMOBILE LIABILITY MWTB316649 03/01/2022 03/0112025 MBINED SINGLE LIMIT = Ea accident) 1,000,000 ANY AUTO SELF INSURED AUTO PHY DMG BODILY INJURY(Per Person) III OWNED SCHEDULED BODILY INJURY(Per aoddeM) _ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE _ X1AUTOS ONLY AUTOS ONLY Per accdent $ A UMBRELLA LIAO N OCCUR MWZX316647 03/01/2022 03/01/2025 EACH OCCURRENCE $ 10.000,000 X EXCESS LUB CLAIMS-MADE AGGREGATE $ 10,000,000 DIED 1 1 RETENTION S B WORKERS COMPENSATION WC 065886029(WI) 03101/2022 03/01/2023 X PER TH- AND EMPLOYERS'LIABILITY STATUTE E C ANYPROPRIETOR/PARTNERIEXECUTIVE YIN N/A WLRC68916409(AZ,IL) 03/01/2022 03/01/2023 OFFICER/MEMBEREXCLUDED9 a E.L.EACH ACCIDENT = 5,000,000 (Mandatory In NH) Continued on Additional Page E.L.DISEASE-EA EMPLOYEE S 5,000,000 M yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 5,000.DW DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) VILLAGE OF RYE BROOK IS INCLUDED AS ADDITIONAL INSURED IF REQUIRED BY WRITTEN CONTRACT ON THE ABOVE GENERAL LIABILITY POLICY,BUT ONLY WITH RESPECT TO LIABILITY ARISING OUT OF THE OPERATIONS OF THE NAMED INSURED, CERTIFICATE HOLDER CANCELLATION VILLAGE OF RYE BROOK SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 938 KING STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN RYE BROOK,NY 10573 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD YORK Workers' CERTIFICATE OF STATE Compensation Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured Home Depot USA,Inc. 770-433-8211 2455 Paces Ferry Rd.,C-20 Atlanta,GA 30339 1c.NYS Unemployment Insurance Employer Registration Number of Insured 76011130 Work Location of Insured(Only required if coverage is specifically limited to 1d.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e., a Wrap-Up Policy) Number 58-1853319 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) AIU Insurance Co. 3b.Policy Number of Entity Listed in Box"1 a" Village of Rye Brook WC 065886028 938 King St 3c.Policy effective period Rye Brook,NY 10573 03/01/2022 to 03/01/2023 3d.The Proprietor,Partners or Executive Officers are �✓ included.(Only check box if all partners/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 Carder 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: Michael Price (Print name of authorized representative or licensed agent of insurance carrier) Approved by: r f April 05,2022 (Signature) (Date) C.E.O. North America Title: Telephone Number of authorized representative or licensed agent of insurance carrier: 212-770-7000 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