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HomeMy WebLinkAboutRP22-051PERMIT #/` SECTION I TYPE OF WORK JOB LOCATION EST. COST I #�� TCO# DATE: S BLOCK Z L T IF IU O / S761 P1 Lti/ i� <:7eSS /0q .1440 (9);26 7� Y6 09 cues A14 mil' oese�E co — ar ,�/c�cc/ 9z) �73Y )O " FEE FEE //0'7 DATE FEE_______ DATE INSPECTION RECORD DATE I NSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING CI RGH PLUMBING GAS EE3 ••• -•-. - o SPRINKLER -m--- ---- ELECTRIC C� LOW -VOLT O ALARM E� -- ---" AS BUILT E� FINAL OTHER APPROVALS ARB BOT PB ZBA OTHER DR �. Ott V G I � 0 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 Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE May 10,2023 Keith Cheung&Jessica Luk 14 Rock Ridge Drive Rye Brook,New York 10573 Re: 14 Rock Ridge Drive Rye Brook,New York 10573 Parcel ID#: 135.35-1-50 Roof Permit#22-051 issued on 12/1/2022 to Re-Roof Existing Building This certifies that the new roof,installed under the above captioned permit has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to R D ID BUILDING DEPARTMENT For office use onl : L�-112 6 2023 VILLAGE OF RYE BROOK PERMrr# - S� IssuED:/,r-) 938 KING STREET,RYE BROOK,NEW YORK 10573 DATE: -471—,-�/v VILLAGE OF RYE BROOK (914)939-0668 FEE: yj //0-- PAMW BUILDING DEPARTMENT www.ryebrook.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 ............................/....,.p...../...................................................................................... Address: ��/ /�o r /1• �O� •���%V 2 Occupancy/Use , / kwly ^Parcel ID#: Zone: "e/0 Owner:�T� /mot/t�s ca G!�c64 h •► Address: y /�r.6 AweG P.E./R.A.or Contractor: i'd.�,�t ��,, ,({y,fkddress: fiOD XDY Sri'3 t/f O,!'7� Person in responsible charge:��!� �C LtCC/ Address: / t 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: �[ C 6/CC, � being duly swom,deposes and says that he/she resides at ;'f (Print Name of Applicant) (No.and Sttceq in �_Ss;(C ��:��A/•� ,in the County offp/r s �Gij Q.j -le in the State of�_,that 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 equipment,professional fees,and including the monetary value of any materials and labor which may have been donated gratis was:$ for the construction or alteration of/ Deponent frther 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 Villasee of Rve Brook. Sworn to before me this 2 �•- _ Sworn to before me this day of 20 • Z� day of 20Z Si owe of Property Ownw Sipalurc of Applicant — F��i� � _���� �ic i,,� � � Print Name of Property O er Print Nemc of Applicant Notary Public N MAN NOTARY PUBUCA STATE OF NENf YORK L NN RUSSELL 010I6363647 Notary Public•State of New York a, COUNTY NO,01RUS05737S GUAUFIEO IN MMEM ty Qualified In Putnam Coun COMMISSION EXPIRES AUGUST 21,20 ,.J My Commission Expires Mar 25,2026 BRnuk w � � 19132 � BUILDING DEPARTMENT 0 BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑ VILLAGE ENGINEER 938 KING STREET RYE BROOK,NY 10573 0 ASSISTANT BUILDING INSPECTOR (914) 939-0668 FAx(914) 939-5801 - - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - - ADDRESS: <- DATE: 5 ` PERMIT# V` r ISSUED: SECT: ' BLOCK: LOT: .� V LOCATION: r2 OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... i,� ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED 0 FOOTING O FOOTING DRAINAGE 0 FOUNDATION O UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING O ROUGH FRAMING 0 INSULATION ❑ NATURAL GAS ❑ L.P.GAs 0 FUEL TANK 0 FIRE SPRINKLER 0 FINAL PLUMBING 0 FINAL ❑ OTHER f O � ■ O � N �, � 6 _ o v r a ti LA M *-I OLei o H 7 ro 2 V U a H Q Q o a c A u y 00 W v a 0 1� h� � N � $ � a 3 � •a c O ` O O A a -� W ooON W a a, C�o z V en UO W ' z 0 Z & E '- r, N W [W] cn -a A u i a V V O Fii w w .7 A w Q typ 4 a x H W Z1 �J W 0 MW cf z x M o � " o ,� � c 46 V d o Udo ? � � W W. ' r, r, V O o to © © V HBa � y O r, v �I R-i W W ✓ x � � � � b BUILDING DETA tTMENT V E OF RYE OK DEC - 2022 938 KING rtx $R NY 10573 VILLAGE OF RYE BROOK BUILDING DEPARTMENT FOR OFFICE USh Y I Approval Date: P it# —Q / Application# Approval Signature: s ARCHITECTURAL REVIEW Disapproved: : Date: BOT Approval Date: Case# Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Case# Other:Application Fee S',►0,6 Permit Fees: \\ ROOF PERMIT APPLICATION 34 Application dated:/ _4 d_ is hereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of a Permit to Re-Roof an Existing Building,as per detailed statement described below. 1. Job Address: o G , SBL: --sO Zone:�0 Property Owner: Address: V Phone#: Cell 2�'Z- ZZ 4 ail: 2. Applicant: Address: 3 Wi ' Phone#: y/9 z Y-,7—7 3 ell#: / email:� .C?Vr GG!� O�A 4l' 3. Roofing Contractor: _ CL �� ,/��,�yi✓�r, , G, `/d Akddress: (� ,p 3 ,bi�J % k al l Phone#: lfl/ Cell#: email: 4. Job Description,list all Methods/&Materials: CK !J� 5. Estimated Cost of Job:$ 3� (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: 7. Construction Type: NYS Construction Class: 8. Number of stories: /J Height: 9. Is garag re-roofed:No:O•Yes: (/J Attached No:O•Yes: O Number of Cars: 10. Is ro peake p,mansard,flat,etc: /!L' 'C _ 11. Estimated date of completion: 2 -1- V12021 STATE Ol:NEV YORK,COUNTY OF WFSTCIILS'l'T'R ) as: being duly sworn,deposes and states that he/she is the applicant above named, iprtnt name of individual�ignutg as the applic:aml 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,conitactor,agenL aaorney,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 conturtnance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well its in accordance with the New York State Uniform Fire Prevention & Building Code,tine Code of the Village of Rye Brook and ail other applicable laws,ordinances and regulations, Sworn to before me this �� Sworn to before me this .� I ! �� ------- day of7�OSrr/1 ._�.20 zz clay of ._.......... Signature of Property C1nnG Sip naunr ul 11�plieant P ' t Name of Pro Owner Pr it me o7f4p'licant 0 Notary Public CHNON C PACHECO Nolary Public Notary Public—State of New York SHARI MELILLO NO OIPA6165480 Notary Public,State of New York Qualified in Queens Co urtty No.O1ME616006-: My Commission Expires � Qualified InWestchester Cruz This application must be properly- completed in its entirety and must Include t� 11( c rtztet . M f 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. r' 2 aft 12/201 i ^ � $ � ►, 1 r' r GcorKc Latimer e � �5���� James Maisano WcOchester Counh Esecutne NMI I I Director,Consumer Protection Department of Consumer Protection Home Improvement License CASTLE CUSTOM BUILDERS CORP. PO BOX 543 t'! =' MILLWOOD,NY-10514 ..t This license is issued in accordance Hith Article XVI of the Westchester County Consumer Protection Code and is valid only upon' pon presence of the official dcpanment seal. Proof of citizenship or unntigiation status is not ieyuired lot issuance of this license. j NOT FOR I• AA-RAL PURPOSES r;Consulla�A s I ' License Number „� e^ Date of b-Ypiration 0 1 f. e WC-29017-H 16 08/30/2024 m , y F s star CO f == t �/yxZrx J — — — � -_ fit i�� fj•�'�.� .rtl '�INp 1 � 11111, ' q r'j ,� i ice_._.RYI. 11 1-.��'R_..a���. , 'r 111'�1� i s ,11'1./'1''' /1 4t. ���lit^� .l iN 1 ullt��'h) 1• 1• �' 11�u,1t' '4�Rom® CERTIFICATE OF LIABILITY INSURANCE DATE0112IY 22 THIS CERTIFICATE 1S 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 Forbes Agency, Inc. NAME: George Goodman 135 Bedford Road PHONE A&;&_EsU 914-232-7750 ' q� No: 914-232-7226 Katonah, NY 10536 ao ale oodman forbesinsurance.com License#: BR895421 INSURERS AFFORDING COVERAGE NAIC fF INSURED INSURERA: Evanston Insurance Company 537 INSURER B; Castle Custom Builders Corp INSURERC: PO Box 543 Millwood, NY 10546-0543 INSURER DINSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 00002216-851076 REVISION NUMBER: 31 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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, INSR ADDL UBR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP WynD MM N LIMITS A X COMMERCIAL GENERAL UABILITY Y 3FHO794 11/02/2022 11107/2023 EACH OCCURRENCE S 1.000.000 CLAIMS-MADE Fx�OCCUR D EMI Ea D ce $ 100,000 MED EXP(My oneperson) $ 5,000 PERSONAL&ADV INJURY $ 1 000 000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000 000 POLICY a PRO F LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER Deductible-BUPD $ 500 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO Me ccid OWNED SCHEDULED BODILY INJURY(Per person) $ AUTOS ONLY AUTOS 130DILY INJURY(Per accident) $ HIRED NON-OAUTOS N PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY Per a^' ent S UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN TAT E ANY PERIME BERlEXCLUDEDXECUTNE E.L EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? ❑ N/A Ues,(Man desertatory and E.L DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Village of Rye Brook is Additional Insured on a Primary/Non-Contributory basis when required by written contract/permit. Waiver of Subrogation applies to the Additional Insured when required by written contract. CERTIFICATE 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 g y ACCORDANCE WITH THE POLICY PROVISIONS. 938 King Street Rye Brook, NY 10573 AUTHORIZED REPRESENTATIVE GLG ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are reqistered marks of ACORD Printed by GLG on 12/01/2022 at 11:50AM YoRK Workers' CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured Castle Custom Builders Corp 914-924-2738 PO Box 543 1c.NYS Unemployment Insurance Employer Registration Number of Millwood, NY 10546 Insured N/A 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 26-3649315 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Wellfleet New York Insurance Company The Village of Rye Brook 3b.Policy Number of Entity Listed in Box"la' 938 King Street N9WC358208 Rye Brook, NY 10573 3c.Policy effective period 02/02/2022 to 02/02/2023 3d.The Proprietor,Partners or Executive Officers are ❑ included.(Only check box If all partners/officers included) XJ 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"la"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 Carrier 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: Rakesh Gupta (Print name of authorized representative or licensed agent of insurance carrier) Approved by: &,j 10/17/2022 _ 4p (Date) Title: Chief Operations Officer Telephone Number of authorized representative or licensed agent of insurance carrier: 844-472-0967 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