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HomeMy WebLinkAboutRP22-031hS PERMIT #V. = QQ 3 L DATE: ExP: Q i SECTION o BLOCK LOT TYPE OF WORK ��/ JOB LOCATION OWNER�'P S/YI4 rl/� �- CONTRACTOR �®oo;k5UcA000? Z,,o` G T. COST FEE. "- CO # G e �� FEE �O'"�"1� DATE ve#TCO # FEE DATE INSPECTION RECORD DATE FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING C] RGH PLUMBING GAS F1 SPRINKLER 0 CTRIC ELE LOW -VOLT O - ALARM 0 AS BUILT 0 FINAL I NSP /✓ei4a3�i70 c4�w,y ' 19 ¢0' aftnftwlldSaW VILLAGE OF RYE BROOK MAYOR 938 King Street, Rve Brook, N.Y. 10573 ADMINISTRATOR Jason A. Klein (914)939-0668 ChristopherJ. Bradbury www,ryebrook.org TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Michael J. Izzo Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE August 16,2022 Anne Rossmann 17 fine Ridge Road Rye Brook,New York 10573 Re: 17 Pine Ridge Road, Rye Brook,New York 10573 Parcel ID#: 135.41-1-41 Roof Permit#22-031 issued on 7/21/2022 to Re-Roof Existing Building This certifies that the new roof,installed under the above captioned permit has been satisfactorily completed. Sincerely, � r r �J Steven E. Fews Assistant Building&Fire Inspector /to p IE C IE ME �3 - DD BUILDIN6 E �TMENT For office use onl PERMIT# AUG 10 2022 VILLAGE OF RYE BROOK ISSUED: ' —ol -aa 938 KING STREtT,RYE BROOK,NEw YORK 10573 DATE: VILLAGE OF RYE BROOK (914)939-0668 FEE: 1 PA W BUILDING DEPARTMENT W ,r� b ©okorg 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 trrrrrr►►►►►rrrrrrr►►►►♦r►rrtrr►►►►t►►►►►rrrrttr►t►■rt►trrrrrtrrr►t►■►►rrr►rrrtrr►►'t/►t►►►►rrrrrrtrrt►►►t►►tt►trrtrttrrrr►►tt Address: ell—fl-ic 6�c A � .Pn2 Occupancy/Use: Parcel ID#: J—// /— y f Zone: —/c�- Owner: Address: /���1/`�i bf r /��t• x�,F' j�cv /Vjy P.E./R.A. or Contractor: Address: A/C, ¢�tXjL�, 66�FSy WIC 7— 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 NEW YORK,COUNTY OF WESTCHESTER as: S,�r�4ST/�O/,-S A/ being duly sworn,deposes and says that he/she resides at m/ (Print Name ofApplicant) (No.and Street) in MI LAC-,-tV1 C lY ,in the County of in the State of G 7— ,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 equipmentprofessional fees,and including the monetary value of any materials and labor which may have been donated gratis was:$ 16-GippY7 E) for the construction or alteration of: LOO—EINA, kC/91 A 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 , 20Z2 day o , 20 Q-Z, Z S ature o Property Owner I egistr Wont#01 G06078902 Qualified In AnpP GSS mkn-i Commission Exp resest r C unty Print Name of Property Owne Print ame of Applicant Not CLAUDIA UVALDO Votary Public NOTARY PUBLIC,STATE OF NEW YORK NO.01 UV6107856 8/12/2021 QUALIFIED IN WESTCHESTER COUNTY COMMISSION EXPIRES APRIL 12,2024 �E BR�k• O�` tim 04 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 :_ DATE' PERMIT# - ON ISSUED:D�11'iECT: BLOCK: LOT: LOCATION: V `'� V �� OCCUPANCY: U ❑ 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 IT OTHER ■ = a x `I M w v a N � y x N N N v A a M o ILI o � M r� z � �, i—+ A � o � � •� O w H ~" N © �o to "W 00 v U� w N U 4 M w O ate,►--� U N A en A q �I M t� (> � U z 1-11 00 y ry. a x " v W �[ O �, cn ub CwO L a � W W � V � y o ..� v 1 z 0 v Q U � ° e A W W z Q W f.C �• oU I� O W v H c z U w 4 � p o w o 0 �.�I O O Q � 0 b o � BUILD)FNG DEPARTMENT I Ef-,C E IV, E DD VILLAGE OF RY-90R QOK I J U L 19 2022 938 KING$TREET RYE BROOK,NY 10573 --- _( 14)939-0668 VILLAGE OF RYE BROOK r t*toy.rtir t k: r>7. BUILDING DEPARTMENT FOR OFFICE USE ONLY: 017 Approval Date: JUL O Z022 P t .— Application# Approval Signature: ARCHITECTURAL REVIEW BO ✓ Disapproved: : Date: r BOT Approval Date: se# Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Case# Other: 'I`\ Application Fee U Permit Fees: ROOF PERMIT APPLICATION Application dated: 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. p 1. Job Address: la vine CkA pe �Q(1 yE� llfG�� SBL: .4 1— _1--k Zone: /� v r �s t��� p pp n�' Property Owner: AD DS 1jAA1 P Address: 1i Pi'11,_ �Lc[ LA(I , /�VP I.;f 6JK Phone#: - I-q 3332 Cell#: q4� 6f,S6 1331. email: a ' I 2. Applicant: Address: jqjl' 031 Phone#:_ 3 '1 2.1 }Q Cell#: 20?, 2Z3 21�Q email: 'Aeh05 f kn (lp f G' �t�nt7r�.CC1�1 3. Roofing Contractor: /r�' CC�rJ>'T,e�li�7/�.(L_Address: ID PcP,,4,2T AU K/��E�vr,���H G7' Phone#:_�© _2 Z 3 /Cell#: email:SE44 s /AAl. N f�Tb (J�r E/-�• one 4. Job Description,list all Methods&Materials: N 42 t 11 KrrP aetil Q�V 14)e6 A new .r_;boq 1 1!:b 5. Estimated Cost of Job: S �� , (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: 'A tmk ip q ?f oe lzieAcp 7. Construction Type: NYS Construction Class: 8. Number of stories:_�� Height: 9. Is garage being re-roofed:No:( )•Yes: Attached No:( )•Yes-A Number of Cars: 10. Is roof peaked,hip,mansard,flat,etc: 11. Estimated date of completion: -l- 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�N� EW YORI ,COUNTY OF WESTCHESTER ) as: 7 CCWI ntt n elD ,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 Cnnha" 6 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 regulations. Sworn to before me this hk' Sworn to before e this day of ,20� day f V , 20j2 Signature of weer i e Appltc Rru etl f e bA S I a� r Print Name of Property Owner Prin a of Applicant JIM Public t CLAUDIA UVALDO MIRIAM P GOMEZ NOTARY PUBLIC,STATE OF NEW YORK Notar Public, State of New York NO.01UV6107856TY Registration#01GO6078 02 Q OMMISSION EXPIRES APRIL iO 2024 Qualified In Westche Commission Expires r C unty _2_ 8/12/2021 Win. i " n .-w+, n ��r ^�• +�-- �00 Noy . 0P �0 F ,. .. 0 . 11�1111, g§ (111111i11 iew7HJ/1i1111//1�r ri i l/llll l 111/1/1 11111/11 1 I lill{Ill�h �. •1- 1'7' .�'1 -'� 71�hI Pa.-ai'"3, .11 ) • �,h. 11�1� s __ l( �f(0)► �" ems_ ya.__ 1,.11 4.4 i CL y • N • t O $ > 1.. X /N^ ttit� Lij 1. 6/ V Q CL r..l E 1�1 cn u oy � w y ►� o action <(o) �. all• .� � � j y •� � �� Goo I:�%� ^.. ~ m (, O Z O Z 3 sLT ,.o = w y ui +� O ~ y • •3 c �i N _ � ca 'au N =IL t lu r•. . oc °! u u C..)40 ti C«o)► ►Kt:. 11 11 f.,.•- a ::; 11 1;;y. . . •. 11.j1 ��^1 T�R" fi"':11� a s 11� Ilh`u°�`'T�"�'Ea4',Ij► I/1a `(o Moe, I III v III j111h�'` III III IIII�I lP, 1 1 1 1 1 1 11/11 1�111 11 11 11 11 w 1 1 k.1 1 w A •I �� ••HIV w w '• •• 'y A 1 •� t ^ 1 Sri �' -(( `� AC CM CERTIFICATE OF LIABILITY INSURANCE FD IDDl1^/YY) 711 119/2 B/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 INSUREII AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: M 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 Sharp Insurance Services Inc CONTACT Moises Rosales NAME 128 N Main St PHONE 2032479524 -�-2036638200 Port Chester NY 10573 � __uurdN.e ADDRESS A mrosales@ rpavice.Com ADDR INSURER(S)AFFORDING COVERAGE -_ INSURER A Obsidian Specialty Insurance Lofnpsny Ism insuao 50 Ce1Milruction LLC INSURER e 191 61" Avenue -- OrRaa1lRRAeb CT 011111131 INSURER C INSURER D INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 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 INsp - ADOL SUER POLICY EFF POLICY EX► T TYPE OF INSURANCE INIAPOLICY NUMBER mrr MM LSSma ✓ COMMERCIAL GENERAL LIABILITY I✓ 03/09/2022 03109/2023 EACH OCCURRENCE $1,000,000 ✓ CLAIMS MADE OCCUR DA TO REIk D 1150, A MED EAP lAny"_"am s SA _ _ PE RSC*A&6 ADV PUURY GEML AGGREGATE LIMIT APPLIES PER I GENERAL AGGRI TE f 2rO111110,001111, ✓ POLICY F LOC PRODUCTS-C,OMPrOP AGO 19000a000 OTHER $ AUTOMOG"LIAXLMLiu COMBINED SJWLE LOAT : lEs ) ANY AUTO BODILY IMIURY 0%r PWM) S OWNED SCHEDULED AUTOS ONLY AUTO S BODILY Ei4J1RY(Pr aoelaMlt) f HIRED NON-OWNED AUTOS ONLY AUTOS ONLY = s UMS"LLALIAS OCCUR EACHaaGIls11111INCE i EXCESS LIAs---. � AGGREGATE s i DED RETENTION WORKERS COMPENSATION AND EMPLOYERS'LLASIUTY YIN -- --- ANYPROPRIE T ORrPAR THE RIEXECUTIVE OFFICERrwNEMBEREXCLuDED? NIA'; EL.E �rd EACH ACCIDENT _ $ ( aory In E.L.DISEASE-EA EMPLOYEE f OrU"96 9OP ERATIONSbaoa El DISEASE-POUCYIJMST f LJLJ DeDCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 10+ A(Jdltlonal Remarks sehaduN,may be aNacMd It mcaa apaw Is mgwmd) ddkional Insured:The Certificate Holder Is endorsed as additional Insured CERTIFICATE HOLDER CANCELLATION Village of Rye Brook 938 King Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Rye Brook, NY 10573 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Moises Rosales Producer 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD NYSIF New York State Insurance fUn(I PO Box 66699.Albany. NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE o � a '^^^^A 371954820 SHARP INSURANCE SERVICES INC 128 N MAIN ST a f PORT CHESTER NY 10573 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER E&I CONSTRUCTION LLC VILLAGE OF RYE BROOK 191 HOBART AVE 938 KING STREET GREENWICH CT 06831 RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE X2566 360-0 92911 03/10/2022 TO 03/10/2023 7/18/2022 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO 2566 360-0 COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK. TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY, INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS:I/WWW.NYS IF.C0 MICE RTICERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER THE SOLE PROPRIETOR PARTNERS AND/OR MEMBERS OF A LIMITED LIABILITY COMPANY THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY NEW YORK STAT SUR NCE FUND /U i' �V DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER 866995712