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Home My WebLink AboutRP22-023PERMIT #A SECTION 13 TYPE OF WORK JOB LOCATION OWNER CONTRACTOR. EST. COST CO # TCO # �? DATE: (0 9 as EXP: FE INSPECTION RECORD I DATE INSP FOOTI N G FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING RGH PLUMBING GAS 0 SPRINKLER ELECTRIC C7 LOW -VOLT C1 ALARM C1 AS BUILT 0 FINAL • F } y OTHER APPROVALS • ti c�C4°'o�v Y VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J.Bradbury www.ryebrookny.gov TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M.Heiser Salvatore W. Morlino CLARIFICATION OF RECORD January 24,2025 Glenda Vito 3 Valley Terrace Rye Brook,New York 10573 Re: 3 Valley Terrace,Rye Brook,New York 10573 Parcel ID#: 135.67-2-39 Roof Permit#22-023 issued on 6/9/2022 to Re-Roof Existing Building An inspection of the of the above referenced property on January 21,2025,reveals that although Roof Permit #22-023 dated 6/9/2022 was issued,the re-roofing was never done,and this permit is rendered null and void. Sincerely, Steven E. Fews Building&Fire Inspector /to �yE BRC�jk. cu � '9a2 BUILDING DEPARTMENT ❑BUILDING INSPECTOR O 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 :- G C t ' DATE: PERMIT# ISSUED: SECT: BLOCK: LOT: LOCATION: C 1 �—P y S P'' OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER — ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER • i �ii�rlr�i�i�iw�l�i{i�l�il�l�r�i�iw�rw�i�i��i�l�rpl�id�r�`I�w' �`ii�rp�ii�iw��l�l�i�i� i i i CV fV 5ga � p N W is C �. ■. N \ R 5 0-M ' �' n 0 �..� M 8 O M R E Z f F P-4 el r C Q to a OD u W ry o- E O �p o O00 �y. � � ' O A CN ON \ ^ O G on"L r 00 G1 O ►� E •.. a CN F np � z O o o oC W 0 z g a C z F U v Q cc !n l w in W � h M A W a Q oG �I as a w cg > w x � i BUILDING DEPARTMENT R [E D VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK,NY 1057 �I►. � _ ._ 3 JUN - 3 2022 (914)939-0668 w,ww.ryebrook.org. VILLAGE OF RYE BROOK BUILDING DEPARTMENT *********************************************************************************************************** FOR OFFICE USE ONLY: 1 Approval Date: 11111 _ G 911�P i 4?Q Application# Approval Signature: ARCHITECTURAL REVIEW BOARD: Disapproved: Date: BOT Approval Date: Case# Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Case# Other: !/ ` Application Fee: / )0UPermit Fees: / \1 ROOF PERMIT APPLICATION Application dated: C�'�' 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: SBL: 13_ ,67--Z—3q Zone:�Z Property Owner: Address: /Q Phone#: Cell#: a 1: _ 2. Applicant:aj0j&)A)j Ptii &IP ( 7rC7 Address: (' 1 Phone#: _ , Cell#: Q LL &�� email 3. Roofing Contractor: Address: Phone#: Cell#: email: 4. Job Description,list all Methods&Materials:�Vat �( d—ti(/ j) aAF PQp jAgr `(/VF, 7 of 5. Estimated Cost of Job: $ (NOTE:The estimated cost shall include all site impro\ements,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: r! - .a(yt 9. Is garage being re-roofed:No:M•Yes:( )Attached No:( )•Yes: ( )Number of Cars: 10. Is roof peaked,hip,mansard,flat,etc: 11. Estimated date of completion: t 8/12/2021 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. STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and further states that (s)he is the legal owner of the property to which this application pertains, or that (s)he is the for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,attorney,etc.) That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to before me this I Sworn to before me this day of ` �!S c , 201c-L day of , 20 Signature ofProperty Owner Signature of Applicant )�. Glea 1� V P i Name of Property Owner j Print Name of Applicant ` Notary Public Notary Public SHARI MELILLO Notary Public,state of New York NO.O1ME6160O63 Qualified In Westchester county, commission Expires January 29.20� -2- 8/12/2021 • 6 packs GAF Royal sovereign 3tab shingles this is for the ridge • 2 boxes of 1- 2 inch collated Roofing nails. • And finally, a 4x6 area will be opened in the back and a % plywood and black paper will be used. 0 "Ilk NATIONAL INSURANCE GROUP M L BRUENN CO. , INC. 240 NORTH AVE . , STE. 200 UTICA NATIONAL INSURANCE OF TEXAS 180 GENESEE STREET NEW ROCHELLE, NY 10801 NEW HARTFORD NY 13413-2299 Producer's Code Y1287 �914)_ 632—_22_22__ NAMED INSURED AND MAILING ADDRESS POLICY NO. 4712483 GLENDA VITO HOMEOWNERS POLICY 3 VALLEY TER ***** RENEWAL CERTIFICATE ***** PORT CHESTER NY 10573 FROM DEC 02, 2021 TO DEC 02, 2022 12:00 Noon 12:01 A.M.SO Time at the Residence Premise The RESIDENCE PREMISES covered by this policy is located at the above address unless otherwise stated. Additional policy provisions are on the reverse side Coverage is provided where a premium or limit of liability is shown for the coverage. COVERAGES SECTION I LIMITS OF LIABILITY A. DWELLING $ 429, 000 B. OTHER STRUCTURES 42, 900 C. PERSONAL PROPERTY 300, 300 D. LOSS OF USE 128, 700 THE DEDUCTIBLE FOR ALL SECTION I PERILS $ 11000 TOTAL ADJUSTED BASE PREMIUM $ 1, 735 . 00 SECTION II E. PERSONAL LIABILITY EACH OCCURRENCE— 500, 000 F. MEDICAL PAYMENTS TO OTHERS EACH PERSON — 1, 000 TOTAL SECTION II PREMIUM $ 37 . 00 ENDORSEMENTS/CREDITS/FEES: SPECIAL FORM HO 00 03 (10/00) INCLUDED jPREMISES ALARM OR FIRE PROTECTION HO 04 16 (10/00) INCLUDED ; SYSTEM (REFER TO DETAIL SECTION) IDENTITY RECOVERY COVERAGE 8—E-3544 (NY) (05/08) INCLUDED OFF PREMISES THEFT EXCLUSION HO 23 95 (05/02) INCLUDED PERSONAL INJURY ENDORSEMENT HO 24 86 (07/11) INCLUDED REFRIGERATED PROPERTY COVERAGE HO 04 98 (10/00) INCLUDED SPECIAL COMPUTER COVERAGE 8—E-1960 (NY) (08/04) INCLUDED WATER BACKUP & SUMP OVERFLOW HO 23 85 (01/09) INCLUDED ! WORKERS COMPENSATION & EMPLOYERS LIAR. HO 24 93 (05/02) INCLUDED END PREMIER EXTENSION PAC 8—E-2252 (NY) (07/12) 40 . 00 PERSONAL PROPERTY REPLACEMENT COST HO 04 90 (10/00) 174 . 00 SPECIFIED ADDL AMT OF INS FOR COVA — HO 04 20 (10/00) 35 . 00 DWELLING AGE OF DWELLING 70 121 . 00 8—E-3650 (03/08) 8—E-3991 (06/19) 8—L-1482 (01/95) 8—L-1700 (02/00) 8—L-937 (04/05) HO 16 10 (01/09) 8—L-1487 (08/08) 8—L-1841 (10/19) HO 04 96 (10/00) 8—L-2003 (01/10) 8—L-2325NY (04/11) SUBTOTAL $ 2, 142 . 00 TOTAL POLICY DISCOUNT $ 69. 00CR TOTAL POLICY PREMIUM $ 2, 073. 00 PREMIUM AMOUNT TO BE REFLECTED ON NEXT BILLING NOTICE UNI—BILL NO. 101009714 )h".' C (� L 1'C�., I C FOR COMPANY USE ONLY: AUTHORIZED REPRESENTATIVE ---_—__ 20730007 EH21191000 AGT 06 313 490415 00 X 111720 --- -- f- -n.M,-�— -- - -- ------ 6TICA NATIONAL INSURANCE GROUP M L BRUENN CO. , INC. V 240 NORTH AVE. , STE. 200 UTICA NATIONAL INSURANCE OF TEXAS 180 GENESEE STREET NEW ROCHELLE, NY 10801 NEW HARTFORD NY 13413-2299 _Producers code Y1287 (914) 6.32-2222 AGT NAMED INSURED AND MAILING ADDRESS I POLICY NO. 4712483 GLENDA VITO HOMEOWNERS POLICY 3 VALLEY TER ***** RENEWAL CERTIFICATE ***** PORT CHESTER NY 10573 FROM DEC 02, 2021 TO DEC 02, 2022 ❑12:00 Noon E 12:01 A.M.Std.Time at the Residence Premise The RESIDENCE PREMISES covered by this policy is located at the above address unless otherwise stated. Additional policy provisions are on the reverse side. Coverage is provided where a premium or limit of liability is shown for the coverage. _ RATING INFORMATION DWELLING IS OF FRAME CONSTRUCTION, TERRITORY IS 49, PROTECTION CODE IS 04, YEAR OF CONSTRUCTION IS 1957, OCCUPIED BY 1 FAMILY A CONSTRUCTION COST INDEX FACTOR OF 1 . 07 HAS BEEN APPLIED TO COVERAGE A. THE DESCRIBED DWELLING IS PRIMARY I MORTGAGEE- SELECT PORTFOLIO SERVICING INC ISAOA PO BOX 7277 SPRINGFIELD OH 45501 LOAN NUMBER: 0013659594 POLICY DISCOUNT DETAIL PROTECTIVE DEVICE: FIRE EXTINGUISHERS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 35 . 00CR DEAD BOLT LOCKS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 34 . 00CR ** TOTAL CREDIT AMOUNT. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 69. 000R TOTAL POLICY DISCOUNT APPLIED TO POLICY. . . . . . . . . . . . . . . . . . . . . . $ 69. 00CR i PREMIUM AMOUNT TO BE REFLECTED ON NEXT BILLING NOTICE UNI-BILL NO. 101009719 IC CONTINUED ON PAGE 2 FOR COMPANY USE ONLY: AUTHORIZED REPRESENTATIVE .___ -- 20730007 EH21191000 AGT 06 313 490415 00 X 111720 ----- - --- - --tea-mac,-x,-.-ems -- ---. -- - - ----- Affidavit of Exemption to Show Specific Proof of Workers' Compensation Insurance Coverage for a 1, 2, 3 or 4 Family, Owner-occupied Residence "*This form cannot be used to waive the workers'compensadon rights or obligations of any party.*" Under penalty of perjury, I certify that I am the owner of the 1, 2, 3 or 4 family, owner-occupied residence (including condominiums) listed on the building permit that I am applying for, and I am not required to show specific proof of workers' compensation insurance coverage for such residence because (please check the appropriate box): I am performing all the work for which the building permit was issued. I am not hiring,paying or compensating in any way,the individual(s)that is(are)performing all the work for which the building permit was issued or helping me perform such work. I have a homeowners insurance policy that is currently in effect and covers the property listed on the /// attached building permit AND am hiring or paying individuals a total of less than 40 hours per week (aggregate hours for all paid individuals on the jobsite) for which the building permit was issued. I also agree to either: ♦ acquire appropriate workers' compensation coverage and provide appropriate proof of that coverage on forms approved by the Chair of the NYS Workers' Compensation Board to the government entity issuing the building permit if I need to hire or pay individuals a total of 40 hours or more per week(aggregate hours for all paid individuals on the jobsite)for work indicated on the building permit,or if appropriate,file a CE- 200 exemption form; OR ♦ have the general contractor, performing the work on the 1, 2, 3 or 4 family, owner-occupied residence (including condominiums)listed on the building permit that I am applying for,provide appropriate proof of workers'compensation coverage or proof of exemption from that coverage on forms approved by the Chair of the NYS Workers' Compensation Board to the government entity issuing the building permit if the project takes a total of 40 hours or more per week(aggregate hours for all paid individuals on the jobsite)for work i icated on the building permit. ignature of Homeowner) (Date Signed) /�i dA Home Telephone Number — D� (Homeowner's Name Printed) Sworn to before me this � day of Property Address that requires the building permit: _� �Oa-� (Cownty Clerk or Notary abllc) J SHARI MELILLO Notary Public,State of New York No.01ME6160063 Qualifie d ed in Westchester County Once notarized,this BP-1 form serves as an exemption for both workers'compensation and disability benefits insurance coverage. BP-1 (12/08) NY-WCB