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HomeMy WebLinkAboutDP22-008PERMIT # c"> 00©_ DATE; 9 9 �33 DEP: SECTION lo 7 BLOCK LOT TYPE OF WORK m ash /YI ✓e JOB LOCATION fi/c �2 OWNER e,C04f�e U--_-G2/n P[l 15e 070111f CONTRACTOR T. COST O# TCO # FEE DATE INZW wuT10N RECORD I DATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING El RGH PLUMBING GAS SPRINKLER ELECTRIC 0 LOW -VOLT CD ALARM AS BUILT O FINAL 39- �7(V54 i t1THER APPROVALS .4R6 i30T PB ?BA ETHER 19 Am amrrium aW VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A.Klein (914) 939-0668 Christopher J.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 October 21,2022 Jeffrey Charney&Ilse Chamey 5 Wilton Circle Rye Brook,New York 10573 Re: 5 Wilton Circle,Rye Brook,New York 10573 Parcel ID#: 135.67-1-7 Demolition Permit#22-008 issued on 9/9/2022 to Demolish Carport This certifies that the carport,demolished under the above captioned permit has been satisfactorily completed. Sincerely, Michael J. Izzo Building&Fire Inspector /to IED E C E F " BUILDINGEYAkTMENT For office use onl PERMIT# o �a OCT 4 ZO22 VILLAGE OF RYE BROOK ISSUED: �'-CJ- � 938 KING STREET,RYE BROOK,NEW YORx 10573 DATE: /(l /U" aD VILLAGE OF RYE BROOK (914)939-0668 FEE: /10 PAID BUILDING DEPARTMENT wwW,rXj&0o1Lor2 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 t//►t►\\ttitt/t//ttti►►■•tt4►i//fftitt■tt\tttRttif■itt►►►►►►►/►ttii■i\■ftiR/R►ttRRi►►tti�/►►►►tt►•ttiitttii/►►R►►•t►f►tittt/►► Address: I I ( V/ /6v //�` d S' 3 Occupancy/Use: I—FO./77/� Parcel ID#: 1,36 ,Ca-7— /" —7 Zone: Owner: 1 CA 4'V—n Address: P.E./R.A.or Contractor: Address: 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: p ( �'C C 1�l t being duly sworn,deposes and says that he/she resides at (Print of Applicant (No.and Street) in 7/-�V ,in the County of� ��� �>�� in the State of that (City/Town/Village) he/sh as supervised the work at the location indicated above,and that the actual total cost of the work,including all site im ovements, labor,materials,scaffolding,fixed equipment,professional fees,and including the monetary value of any materials and labor which may have been donated gratis was:$ O 1::) for the construction or alteration of: r e dam— 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 m this Sworn to before me this day of day of , 20 , Lee a, Signature of Property Owner Signature of Applicant Ise.. t me of Property Owner Print Name of Applicant Notary Public Notary Public SHARI MELILLO Notary Public,State of New York No.OIME6160063 8/12/2021 Qualified In Westchester County Commission Expires January 29,20� �yE BRC�� 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 : I L'`2 F--) DATE: 1 C 2-C Z PERMIT# e ISSUED: C ZZSECT: -7 BLOCK' LOT:_l b ' LOCATION: -�. � v n��_ 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 00 0 H T M qVi p� e .n F-i O p Q gi p °w � � � o (�l W ILn CN ° g c'"en cn W W J c.r = O v W a M ry � 4,' •b a,•ti s QCO o � � •� � V? O Woo �, z Q � � ° co � � a c o � y vU CA A C7 C, rn W W ��rs W ar �I V � > � .aBi oaCN Q wA 8 � W a zz � s lxj Wzz ° P3 0 1l) —41 BUILDING DEPARTMENT VILLAGE OF RYE BROOD SEP — 8 2022 938 KING STREET RYE BROO NY 10573 VILLAGE OF RYE BROOK (914)939-064j� BUILDING DEPARTMENT www. ebr 2. DEMOLITION PERMIT APPLICATION FOR OFFICE USE ONLY:Approval Date: S P _ �� Permit#: Application Fee: $ / , —do/� Approval Signature: Permit Fees:$ L 400' r� Disapproved: Other: Application dated:j —isffereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the interior alteration of an us g W buildinlg•,oor for a change in use,as/per _detailed statement described below. 1. Job Address: -5 I 1�r, SBL:/�J,47—/-7 Zone: 2. Proposed Demolition.(Describe in detail): C�1� c �- 3. Property Owner: - 5jj= r 0,C 4 Add ress: w r Phone# `P Ce # 1 email: CAke-ne, rl ®d d 7 Ce Applicant: �� �� Address: Phone# Cell# email: Architect/Engineer: Address: Phone# Cell# email: General Contractor: Address: Phone# Cell# email: 4. Estimated cost of construction $ ,J�� 0 (NOTE:The estimated cost shall include all labor,material,scaffolding,fined equipment,professional fees,and material and labor which may be donated gratis.) 5. Type of construction:(wood frame,masonry,steel,etc...) b. Method(s)of Demolition: - t 6V 7. Number&Location of Fuel Oil Tanks to be Removed: S. Number of Stories: Height to Highest Ridge: To Highest Chimney: 9. Estimated date of completion: l 8/12/2021 This application must be properly completed in its entirety and must 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. 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 Cade of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Swom to before me this Swom to before me this day of w �' r,20 day of , 20 �I Signature of Property Owner Signature of Applicant rin ame of Property Owner Print Name of Applicant Notary Public Notary Public SHARI MELILLO Notary Public,State of New York No.OIME6160063 Qualified in Westchester County ..ommission Expires January 29,20is 2 8/12/2021 IAIG] AIG Private Client Group AIG Property Casualty Company (Name of issuing company) Renewal Effective:1 1/01/2021 New York Homeowners Declarations Page Your Declarations Page shows at a glance the coverage you have and your premium. Your Declarations Page is part of your policy. Please read your policy carefully, including your Declarations Page and any attached Endorsements, for a description of your coverage. Policy Number: Policy Period: 1 1/01/2021 - 1 1/01/2022 PCG 0012430352 At 12:01 A.M.standard time at your mailing address shown below Name of Insured and Mailing Address: Agency Name, Address, Phone # & Code: Jeffrey J Charney Borrelli Partners Insurance Ilse P Charney Agency, LLC 5 Wilton Circle 287 Bowman Ave - Suite 406 Rye Brook, NY 10573 Purchase, NY 10577 (914) 939-7900 - 0105067 YOU WILL BE BILLED SEPARATELY FOR ANY PREMIUM DUE. The kind of losses that are covered and any special limits or deductibles that apply, are explained in detail in your Policy. Summary of Coverage by Location: 5 Wilton Circle, Rye Brook, NY 10573 COVERAGE PAYMENT BASIS COVERAGE LIMIT Dwelling Guaranteed Rebuilding Cost $880,194 Other Permanent Structures Guaranteed Rebuilding Cost $125,742 Contents Replacement Cost $440,097 Additional Living Expense Unlimited Liability $500,000 Medical Payments $10,000 Deductible(s) applied to this location: Standard: $1,000 Location Premium:$2,678.00 Forms and Endorsements Attached for Location: PCHO-DWLL(09/06), PCHO-FRDSG (09/06), PCHO-WC-NY (03/14), PCHO (09/06), PCG-CL NO (06/06) PCHO-FUNGINOT-NY (05/08), PCHO-AENY(09/06), HNOT-NY (01/95), PCHO-DEC-NY (05/13) PCG-OFAC (10/13), PCG-DESNOT-NY (02/21), PCG-CRNOTR-NY 02/09►, 91222 PCG (09/16) PCG-PRIVNOT (08/18), PCG-FEENOTICE (08/18) First Mortgagee Loan #:200086345701 1 Citibank, NA ISAOA c/o Citimortgage Inc PO Box 7706 Springfield,OH,45501,US PCHO-DEC-NY (05/13) IAI AIG Private Client Group AIG Property Casualty Company (Name of issuing company) Homeowners Location Extension Schedule Page Summary of Coverage by Location for Policy: PCG 0012430352 215 Doyle Rd Oakdale CT 06370 COVERAGE COVERAGE LIMIT Liability $500,000.00 Medical Payments $10,000.00 Total Premium: $2,678.00 PCHO-DEC-NY (05/13) AIGAIG Private Client Group AIG Property Casualty Company (Name of issuing company) POLICY NOTICE (SEE YOUR REVISED DECLARATIONS PAGE) Your Declarations Page shows at a glance the coverage you have and your premium. Your Declarations Page is part of your policy. Please read your policy carefully, including your Declarations Page and any attached Endorsements, for a description of your coverage. Policy Number:PCG 0018143438 Policy Period:11/01/2021 - 1 1/01/2022 At 12:01 A.M.standard time at your mailing address shown above. Name of Insured and Mailing Address : Agency Name, Address, Phone # & Code: Jeffrey J Charney Borrelli Partners Insurance Ilse P Charney Agency, LLC 5 Wilton Circle 287 Bowman Ave - Suite 406 Rye Brook, NY 10573 Purchase, NY 10577 (914) 939-7900 0105067 "YOU WILL BE BILLED SEPARATELY FOR ANY PREMIUM DUE." YOUR POLICY HAS BEEN CHANGED Effective Date: 1 1/01/2021 Summary of change: DELETE VEHICLE Change to Annual Premium Revised Annual Premium $1,681.00 Premium charge for endorsement -$103.00 From: 1 1/01/2021 To: 1 1/01/2022 PEL - CHGN (07/01) AIG AIG Private Client Group AIG Property Casualty Company (Name of issuing company) Endorsement Effective:11/01/21 DECLARATIONS PAGE Your Declarations Page shows at a glance the coverage you have and your premium. Your Declarations Page is part of your policy. Please read your policy carefully, including your Declarations Page and any attached Endorsements, for a description of your coverage. Policy Number Policy Period 11/01/2021 - 11/01/2022 PCG 0018143438 At 12:01 A.M.standard time at your mailing address shown below Name of Insured and Mailing Address Agency Name, Address, Phone # & Code Jeffrey J Charney Borrelli Partners Insurance Ilse P Charney Agency, LLC 5 Wilton Circle 287 Bowman Ave - Suite 406 Rye Brook, NY 10573 Purchase, NY 10577 (914) 939-7900 0105067 YOU WILL BE BILLED SEPARATELY FOR ANY PREMIUM DUE. A. PERSONAL EXCESS LIABILITY COVERAGE LIMIT $5,000,000 Excess Uninsured/Underinsured Motorist Limit $1,000,000 B. LIMITED EMPLOYMENT PRACTICES LIABILITY LIMIT Annual Aggregate $ NotApplicable Per Wrongful Employment Act $ Not Applicable Deductible $ NotApplicable Required Underlying Insurance Minimum Required Underlying Limits 1.Personal Liability, Homeowners or Bodily Injury/Property Damage $300,000 each occurrence Comprehensive Personal Liability Combined Single Limit 2 Private Passenger Auto and Licensed Bodily Injury and Property Damage or $250,000 Bodily injury each person Recreational Vehicles $500,000 Bodily injury each accident $ 25,000 Property damage each accident Combined Single Limit: $300,000 each accident Uninsured/Underinsured Motorist Bodily Injury and Property Damage or $250,000 Bodily injury each person Protection $500,000 Bodily injury each accident $ 25,000 Property damage each accident Combined Single Limit: $300,000 each accident PEL-DEC1 (12/05) S AIGAIG Private Client Group AIG Property Casualty Company (Name of issuing company) Endorsement Effective:11/01/21 PERSONAL EXCESS LIABILITY DECLARATIONS PAGE - CONTINUED Policy Number Policy Period 11/01/2021 - 11/01/2022 PCG 0018143438 At 12:01 A.M. standard time at your mailing address shown below Required Underlying Insurance: Continued Minimum Required Underlying Limits 3.Watercraft Less than 26 feet and less than 50 hp Combined Single Limit: $300,000 each occurrence 26 feet or more or more than 50 hp Combined Single Limit: $500,000 each occurrence 4. Unlicensed Recreational Vehicles Bodily Injury and Property Damage or $300,000 each occurrence Combined Single Limit: 5. Employers Liability Combined Single Limit $100,000 each occurrence FORMS AND ENDORSEMENTS: PCG-CL NO (06/06), PEL-OFAC (10/13), PEL (08/01). PEL-AENY (01/09), PEL-DEC1 (12/05), PEL-EPLI (07/01), PEL-SCHED (05/10), PCG-DESNOT-NY (02/21), PCG-PRIVNOT (08/18), 91222 PCG (09/161, PCG-FEENOTICE (08/18), PEL-CHGN (07/01) Total Premium $1,681.00 PEL-DEC1 (12/05) c EA1CG- AIG Private Client Group AIG Property Casualty Company (Name of issuing company) Policy Number:PCG 0018143438 Schedule of Underlying Insurance Homeowners Location Insuring Company 1 215 Doyle Rd AIG - Private Client Group Oakdale, CT 06370 2 5 Wilton Circle AIG - Private Client Group Rye Brook, NY 10573 Private Passenger Auto and Licensed Recreational Vehicles Description Insuring Company 1 2015 NISSAN/DATSUN AIG - Private Client Group NV200 2 2014 NISSAN/DATSUN AIG - Private Client Group FRONTIER SV Unlicensed Recreational Vehicles Description Insuring Company None Yacht and Personal Watercraft Description Insuring Company 1 1990 21 Sylvan Progressive 821 2 1999 20 Monark SS200 Pontoon Boat PEL-SCHED (05/10) 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'eompensadon 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. L.9 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 indicated on the building permit. J � Zo 2-Z (Signature of H eowner) ate Si ed) � Home Telephone Number (Homeowner's Nam Tinted) • Sworn to elore me this _ day of Property Address that requires the building permit: r U� n ( xnty Clerk or Notary Public) o SHARI MEULLO Notary Public,State of New York No.01ME6160063 Qualified In Westchester County Commission Ex Ires January 29 20 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