Loading...
HomeMy WebLinkAboutRP22-055PERMIT # SECTION TYPE OF WORK JOB LOCATION OWNE E5T. COST �S/CO # MV DATE: c� c�ai(P• �- 3 > BLOCK LOT_ 01- ' - o is Ui/dim y©� S7' e �i TCO # FEE DATE INSPECTION RECORD I DATE I NSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING 0 RGH PLUMBING GAS 71 SPRINKLER ELECTRIC 0 LOW -VOLT 0 ALARM 0 AS BUILT 0 FINAL �N� 4 l��a 83Y- Y759 e �c/74 / C 10 3-' L 3d83 OTHER APPROVALS ARB BOT PB ZBA I, OTHER t cUC4°�u J�v �' '9U VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury www.Lyebrook.org TRUSTEES ACTING BUILDING&FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W.Morlino CERTIFICATE OF COMPLIANCE February 21,2023 Sanjoy Dey&Sanghita Debmukta 12 Lyon Street Rye Brook,New York 10573 Re: 12 Lyon Street, Rye Brook,New York 10573 Parcel ID#: 141.28-1-2 Roof Permit#22-055 issued on 12/9/2022 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 Acting Building&Fire Inspector /to R[E C E � " For office use only: IDBUILDING DEPARTMENT PERMIT# -{ASS JAN 31 2023 VILLAGE OF RYE BROOK ISSUED: 9 8 KING STREET,RYE BROOK,NEW YORK 10573 DATE: VILLAGE OF RYE BROOK (914)939-0668-FAX(914)939-5801 FEE:,$-//p— PAiDX BUILDING DEPARTMENT www.ryebrook.org APPLICATION FOR CERTIFICATE OF OCCUPANCY, CERTIFICATE OF COMPLIANCE, AND CERTIFICATION OF FINAL COSTS TO BE SUBIQTTZD ONLY UPON CONPLETION OF ALL WORK, AND PRIOR TO THE FINAL INSPECTION ttgH►HgHgttqtqtttttqtttqHtqttttttttgt t gtHtHt q t gttHtgtt gtHi►ttHHtHHHtNtgttttttt►q►►►►tgtq qi►i Address: 12 Lyon Street, Port Chester, NY / Occupancy/Use: c� `/4AV Parcel ID#: y�, �� —�- Zone: kl)-I - c Owner.: Sanjoy Dey Address: 12 Lyon Street, Port Chester, NY P.E./R.A.or Contractor: Home Energy Repair DBA Gunner Address: 194 S Water Street, Greenwich, CT 06830 Person in responsible charge: Andrew Prchal Address: 194 S Water Street, Greenwich, CT 06830 Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issuance of a Certificate of Occupancy/Certificate of Compliance for the structure/construction/alteration herein mentioned in accordance with law: STATE OF NEW YORK,COUNTY OF WESTCBESTER as: Andrew Prchal being duly sworn,deposes and says that he/she resides at 194 S Water Street (Print Name of Applicant) (No.and Street) in Greenwich ,in the County of Fairfield in the State of CT ,that (City/Town/Village) he/she has supervised the work at the location indicated above,and that the actual total cost ofthe work,including all site improvements,labor, materials,scaffolding,fixed equipment,professional fees,and including the monetary value of any materials and labor which may have been donated gratis was:$ 10,000 for the construction or alteration of Roof Replacement Deponent fiuther 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 unlawfW 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-IO.A.ofthe Code ofthe Village of Rye Brook. Sworn to before me this Sworn to before me this day of WLvr , 20 day of V) ,20(2 o Signature ofPhVerty Owner Signature of Applicant n `fie Nroop--euo of Property er ,00 I ',i Print Name of licant `0,� GCA �� '. � .'%V Notary Public ' T ' OVARY Q = _ '� �O o � ,� . , 0 AUB�- G = ,O OBOGrb ; - ,� �Qy_6 DR(�jk• O Zm 193'2 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# ISSUED: SECT: '! LOCK: ! LOT: LOCATION: 5 -Q -1 OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS...,AT 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 ■ In fNV N w � y /� \ y in ' tea to ■ W y �vy b lopp— CIO Q o sa Ni x 00 ►Z x to N ,1 .. o v lb r— It% OCD or 1o � Qo � H . �..{ W 00 41 co O V Q �CIA it o ° ov `° � V z01% p � u O) mQvo °' cn h+i Q Q O N F 191-4 p . w z ° � �� C/) w M O o © v H8WA"".y v. °J � o Docusign Envelope ID:ODA95969.5FBE-40BO-A7D0.8D21417311SC R E IE �V E JD BUILDING DEPARTMENT DEC - 8 2022 VILLAGE OF RYE BROOK VILLAGE OF RYE BROOK 938 KING STREET RYE BRooy,NY 10573 BUILDING DEPARTMENT (914)939-0668 FAX(914)939-5801 www.ryebrook.org. #!#f#REi###f######fi#fff!fill!#i!!!i!i!#f##i!##fi!►!#f!i!!i#!!!!!!#!#!!#!#!!#ttttttitltttttt#ttttttttttttRt FOR OFFICE USE ONLY: Approval Date: DEC — 9 20 Permit# • CJ .J Application# Approval Signature: ARCHITECTURAL REVIEW BOARD: Disapproved: Date: BOT Approval Date: Case# Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Case# Otter.Application Fee:A t06 Permit Fes: 1 S'o • -y-+F- ##!#f######f##!ff##f#fiffififR#ffi###iR##t#R###RR###R###RR#R#R##ti!#R#i######f#######!#!!f!#ff####ilfi#!f!f ` ( ROOF PERMIT APPLICATION Application dated: / ,=-> —d is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuanoe of Permit to Re-Roof an Existing Building,as per detailed statement described below. i. .lob Address: 12 Lyon Street, Rye Brook, NY SBL: 141.28-1-2 zone:kl-)_/C Property Owner: Sanjoy Dey Address: 12 Lyon Street, Port Chester, NY Phone#: 612 839 4759 cell#: email: sanjoydey33@gmail.com t. Applicant: Andrew Prchal Address: 194 S Water Street, Greenwich, CT 06830 Phone#: 203 347 3083 Cell#: 2033217735 email: Becky@gunnerroofing.com 3. Roofing Contractor: Home Energy Repair DBA Gunner Address: 194 S Water Street, Greenwich, CT 06830 Phone#: 203 347 3083 Cell#: 203 321 7735 email: becky@gunnem)ofing.com 4. lob Description,list all Methods&Materials: Removal of existing roof. Inspect roof deck to verify that all sheathing is suitable. Install water and Ice barrier, undedayment, asphalt shingles, and proper ventilation. 5. Estimated Cost of Job:S 10'000 (NOTE:The estimated cost shall include all site improvements,labor,material,scaffolding,fixed equipment,professional foes,and material and labor which may be donated gratis.) 6. If comer property,indicate street frontage: 7. Construction Type: Roof Replacement NYS Construction Class: & Number of stories: Height: 9. Is garage being re-roofed:No:( )•Yes:( )Attached No:( )•Yes:( )Number of Cars: 10. Is roof peaked,hip,mansard,flat,etc: 11. Estimated date of completion: 4- dlt= Docuftn Envebpe ID:ODM5969-5FBE-4080-A70"D214173118C 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 WESTCHFSTER ) as: Andrew Prchal ,being duly sworn,deposes and states that he/she is the applicant above named, (print name ofindivid"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 Contractor 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 7 f-h Sworn to before me this 7 r�� day of OTI L C rvt ntf- , 20 ?_ day of 7 _ Lt e ,20F� �- UucuSagnecl by t Sigiiatum,60rop ty Owner Sig(n�atu Applicant Sanjoy Deyrre-�J �(C-�3` Print Name of Property Owner Print N f Applicant 1.......... �'L�CCGa ��AkL t',:vy Ftaaiiv::ln. ubl' REBECCA BLAKE NOTARY PUBLIC �gECC4 6 STATE OF NEW JERSEY COmrn. �y My Comm. Expires Oct. 27, 2027 Na rjR N . 08UG ✓ERSO 61 M20 i MIS .l _'rilp" ' • ,'� C•O;C:O;O;J;4:0'O'J:CC:.�'C.J'J:J;O;J:4;O;e:p;O:O:O;O:O:O:O;O:O;J;V:O:O:o;J:J'J:V'O:O:O:O;O:O:J:J:J;J:O:J:O;0:0.0;O:O:C:O;O:C;O:J;C:v'J.J.O'O'.O.:'C'O`:O'.C'J:O.O:n.J:J O:C:O:O:0:0;0 � !• e , .✓�fV1 a '�"tr ye o o•rJ./{lW4 e �•, '�'t4a. 0 s . CMi o ection lie _ C . ♦ ' y 1 C CD co Jedad p�� lam. yt LLI LLI CO .52 _ � O r u o e C O o 'C O ;y� J o »- .yy '""+`;(�u`f'p•. 'K`y�s !/�'�a .�.1�ply��' •.1�r����5. ` t!� � !` I a�y, \ l 1,\` ` w Client#:195=21 HOMEEN ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MMODmY") 2/OaPM2 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(ies)must have ADDITIONAL INSURED provisions or be endorsed. H 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER WcT Carmel McCabe USI Insurance Services LLCFAX F,q 855 874.0123 :203 634-SM Me Preston Avenue - usictcorunc Ites@ug l'..t',OID Meriden,CT 06450 855 874-0123 INSURER(8)AFFORDING COVERAGE NAICI s,tsuRER A:Admiral Insunnos Comparry 24856 INSURED INSURER a:Arballa Pro/actlon Insurance Compow 41360 Home Energy Repair LLC 194 South Water Street INSURER C: arty Mutual Insurance Corporation 33600 Greenwich,CST 06830 INSURER 0: -- — 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 CONTRACTOR 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. LTR TAPE OF INSURANCE IanICY MlY1E11 LOM � A X COMMERCIAL LIABILITY 7CAMOZ136011 1&022 04R1 EACHOCCIRREWE $1 OOO CLABMr>B MADE �OCCUR 000, D.. �. $50 000 X 5,000 ded BI,Phy MED EXP(Any one pwannf s5 000 Dom,Per Adl PERSONAL&ADV INJURY $1 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s 000 000 X POLICY JPRO LOC PROOUCTB-COMPIOP AGO $1 000 OTHER: 1 $ g AUTOMOBILE LIABILITY 1020117559 4/21M)" M1R023 COMBI�N eD SINGLE UM" 1 0 000 IX ANY AUTO BODILY INJURY(Ps Perrpn) s OWNED SCHEDULED AUTOS ONLY AUTOS BODILY SLIURY(PWHIRED NON-OWN AUTOS ONLY A ONLY PROPETTTV DAMAGE _ A UMBRELLA LIAR X OCCUR X X CAOMM13601 04MMM 041=21=1 EACH OCCURRENCE $ 000 X EXCESS LIAR CLAIMS-MADEAGGREGATE s Sr000,000 DED_, X RETENTIONS s C WORKERS COMPENSATION X WCS-33S-361O74-019 1/19IZO22O1h912023X P oTM AND EMPLOYERS'LIABILITY •IN A ER ANY PROPRIETORIPARTNERIEXECUTTVEFil EL EACH ACCDENT $ SKWO OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) EL.DISEASE-EA EMPLOYEE$ 5WXO If yes,describe under f a DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $5W DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) Village of Rye Brook is included as an Additional Insured under the General Liability policy when required in a written agreement in accordance with policy terms, conditions, and exclusions regarding services provided by the Named Insured. 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 938 IGng Street ACCORDANCE WITH THE POLICY PROVISIONS. Rye Brook,NY 10573 AUTHORIZED REPRESENTATIVE s>'1M ©199a-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD #S35749643/M35749611 RXTCH NYSIF New York State Insurance Fu^d PO Box 66699,Albany,NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE a a "A"AAA 832024199 HOME ENERGY REPAIR LLC 78 HALLOWEEN BLVD Q STAMFORD CT 06902 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER HOME ENERGY REPAIR LLC VILLAGE OF RYE BROOK 78 HALLOWEEN BLVD 938 KING STREET STAMFORD CT 06902 RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W2485 011-7 596003 09/12/2022 TO 09/12/2023 12/8/2022 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2485011-7, 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://WWW.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 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 SU NCE FUND �r� DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER:932077998 U-26.3