HomeMy WebLinkAboutRP20-010PERMIT # fir,
SECTION
TYPE OF WORK
JOB LOCATION .
OWNER ) 1
CONTRACTOR_
EST. COST
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TCO #
FOOTING
FOUNDATION
FRAMING
RGH FRAMING
INSULATION
PLUMBING C1
RGH PLUMBING
GAS 0
SPRINKLER
ELECTRIC F1
LOW -VOLT 0
ALARM F1
AS BUILT 0
FINAL
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FEES
FEES �lU"�p� DATE a CX
FEE DATE
INSPECTION RECORD
DATE I NSP
OTHER APPROVALS
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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.or�
TRUSTEES BUILDING&FIRE INSPECTOR
Susan R. Epstein Michael J.Izzo
Stephanie J. Fischer
David M. Heiser
Salvatore W.Morlino
CERTIFICATE OF COMPLIANCE
June 29,2022
Adam Morelli&Alexandra Licurse
19 Ridge Boulevard
Rye Brook,New York 10573
Re: 19 Ridge Boulevard, Rye Brook,New York 10573
Parcel ID#: 135.60-1-20
Roof Permit#20-010 issued on 6/8/2020 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
p E C EN E BUILDING DEPARTMENT For office use oniv:
DD
PERMIT# � ��)�
VILLAGE OF RYE NOOK ISSUED: -
JUN 2 7 2022 38 KING STREET,RYE BROOK,NEW YORK 10573 DATE: &,—A7—,4�0-
(9,1�4)9 -0668 FEE: sd /)O — PAIDk(
VILLAGE OF RYE BROOK N,N ,. id
.a Ic:ar
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
*****»s*sssss*ss»s»*sss*ss*ss»»»***»»»ssssss****»»s*ss*ss*»sass*ss*»ss»ss**s**ss»s»*s***s»*sss***»*s»»s**»*s*ss*s*»»**sss***»
Address:
Occupancy
/Use: -)C,4 M Pia el ID Z /ne::
Owner: ft /l/ /YI'jt7/� G � Address:AA
G [/
P.E./R.A. or Contractor: 1� L� X� Address:
Person in responsible charge: —Address: 1
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:
being duly sworn,deposes and says that he/she resides at lq G6 (�
(Print Name of Applicant)
Ole ^I1•J[ oo k � 1 (No.and Street) /
in ,in the County of W � � �1�S 1�� in the State of 1,�V )( ,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 eqwpment,profe"s�al fees,and including the monetary value of any materials and labor which may
have been donated gratis was:$ `�
for the construction or alteration of: p
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, Sworn to before me this 44-1
day of 0 , 20 Z Z day of u--4— 20 a'
St ature of Property Owner Signature of Applicanj
Print Name of Property Owner Print Name of Applicant
D ... 1 G--- tM
Not Public
JANINE M CARPINELLO JANINE M CARPINELLO
Notary Public,State of New York Notary Public,State of New York
No.01 CA6069735 No.01 CA6059735
Qualified In Westchester County Qualified in Westchester County
Commission Expires June 04,20 - 3 Commission Expires June 04,20
QyE BRC�j�.
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 :— ` � �\ v � J DATE:
PERMIT# ISSUED!. $ECT: c—(ISLOCK: t LOT: ""
LOCATION:
e�- U� �7�J 2 OCCUPANCY: - 2— \Q
❑ 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
C
Proposal
Sergio General Contracting PROPOSAL#68457
DATE:MAY 29,2020
"No job is too small or too big"
22 Norias Rd, Greenwich, CT 06830
Phone 203.532.5264 Cell 914.804.2022
Sergiocontracting@hotmaiI.com
Licensed in NY&CT
To: Adam & Alexandra Morelli
JOB LOCATION: JOB TYPE
19 Ridge Blvd, Rye Brook NY Front house and right side of garage roof replacement
JOB DESCRIPTION
• Remove the singles including the cedar roof
• Install new 5/8 plywood
• Install the water shield paper
• Install synthetic underlayment for roof
• Install new ridge vent
• Remove the existing copper flash around the chimney and install a new one
• Install new Timberline shingles to match the back of the house
• Dumps for debris
• Labor and materials included
TOTAL $7,000.00
Signature:X _ Signature:X
Thank you for your business!
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/le'lli SERGGEN-01
Ak.-- CERTIFICATE OF LIABILITY INSURANCE DA41TE 13/2020 )
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(les)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 endorsenwrtt(s).
PRODUCER --- --- NIACT - -
NAME: _
Joyce Insurance Agency IPHONE
C NMo.E:D (845)942-7200N,L��45)429.1591
2 Joyce Plaza ------
Stony Point.NY 10980 1 ff;service@j0yceins.COm
INSURER(S)AFFORDING COVERAGE NAIL e
INSURER A:Metllfe
INSURED ,INSURER B: _
SERGIO GENERAL CONTRACTING CORP !INSURERC:
22 Nonas Road '4 INSURER D:
Greenwich,CT 06830
INSURER E
INSURERF: -- - -
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POL i.k I .JF 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
DISR --- -- -_-_ ADOL SUER' -- --_ - - POLICY EFF POLICY EXP
LTRTYPE OF INSURANCE -IN POLICY NUMBER TTl IYYiDD/YYYT1 LIMITS
A X cowAmAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
CLAIMS-MADE X OCCUR X i6PO2236OP2020 3/22/2020 3122/2021 .DAMAGE TO RENTED ----- 60.000
PREMISES(Ea RENTED
ncej $ _
MED EXP(Arey we person) {.. - 5,000
_ PERSONAL$ADV INJURY $
GENT AGGREGATE LIMIT APPLIES PER ---i I GENERAL AGGREGATE f 4,000,000
X POLICY jp&Qr LOC i PRODUCTS-COMP�OP AGG S
4,000,000
OTHER_ $
AUTOMOBILE LIABILITY COMBINED LIMIT
(Ea accident) $ANY AUTO __ g ED I BODILY INJURY(Per person f
.AU�OT ppS ONLY AUTO$UL�.E��Dpp BODILY INJURY(Per ecd_� 6_..— —
.AUTOS ONLY A YONLY Q�w ac DAMI�GE $
_ --
----- -------
$
UMBRELLA LIAO OLCIIR
.EACH OCCURRENCE S--
-----__--
EXCESSLIAB `iCIAMISMADE AGGREGATE S _
DED RETENTION$ pER $
WORKERS COMPENSATION AND EMPLOYERS'LIABILITY --
ANY ICPERROaPrREIEMTBOERp)PARTNEE�D'rXECUTIVE MIA
.E L EACH ACCIDENT
�iYrg.RIM N Ml)
N �ult0e I ,E L DISEASE-EA EMPLOYE _- _
_ E L DISEASE
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DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLE$IACORD 101,Adilmoml Remarks Schedule,may be attached If more space is required)
ViNage of Rye Brook named as additional Insured.
TIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Village of Rye Brook THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
0 y ACCORDANCE WITH THE POLICY PROVISIONS.
938 King St
Rye Brook,NY 10573 -- --- --
AUTHORIZED REPRESENTATIVE
ACORD 25(201SM3) ?1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
NYSIF
New vark State 1ns—o— r—d WESTCHESTER ONE,44 SOUTH BROADWAY,LOTH FLOOR,WHITE PLAINS,NY 10601-4411
1 nysif.com
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED)
a
A A A"A A 522454246 ~ '
JOYCE INSURANCE
, d�
2 JOYCE PLAZA � ••-
STONY POINT NY 10980 iy
SCAN TO VALIDATE
AND SUBSCRIBE
POLICYHOLDER CERTIFICATE HOLDER
SERGIO GENERAL CONTRACTING CORP. VILLAGE OF RYE BROOK
22 NORIAS ROAD 938 KING STREET
GREENWICH CT 06830 RYE BROOK NY 10573
POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE
W2275 662-1 156698 04/20/2020 TO 04/20/2021 4/21/2020
THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE
FUND UNDER POLICY NO. 2275 662-1. 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:'IWW V.NYSIF.COM/CERT/CERTVAL.ASP.THE NEW
YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS.
THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE
INSURED CORPORATION.
PRESIDENT
SERGIO ARAUJO
SERGIO GENERAL CONTRACTING CORP.
1 OF 1
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.
BY CAUSING THIS CERTIFICATE TO BE ISSUED TO THE CERTIFICATE HOLDER. THE POLICYHOLDER UNDERTAKES
TO PROVIDE THE CERTIFICATE HOLDER 5 CALENDAR DAYS' NOTICE OF ANY CANCELLATION OF THE POLICY.
NEW YORK STATE INSURANCE FUND
DIRECTOR,INSURANCE FUND UNDERWRITING
VALIDATION NUMBER:25562571
U-26 3