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HomeMy WebLinkAboutRP22-056PERMIT # 0&1 SECTION .2.3 TYPE OF WORK JOB LOCATION _ OWNEFkO/ CO/ CONTRACTOR. DATE: /� / 9l EST. COST �© FEE, V0 # C FEE &" //O - �/ bus PS/fie aoao CSC ww)cof o�Qs ��6PS Cly)yy7- YO 4V HATE TCO # FEE DATE INSPECTION RECORD DATE FOOTI N G FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING C� RGH PLUMBING GAS 0 SPRINKLER ELECTRIC CI LOW -VOLT CI ALARM C7 AS BUILT FINAL I NSP GTHER APPROVALS AREi BOT PB ZBA OTHER 41� yC �.t V . 19 4M Clftnl.1wmLi'W VILLAGE OF RYE BROOK MAYOR 938 Ding 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 December 29,2022 The 2020 Viscome Family Irrevocable Trust Ivan Brightly&Nicole Viscome,Trustees 14 Maple Court Rye Brook,New York 10573 Re: 14 Maple Court, Rye Brook,New York 10573 Parcel ID#: 135.66-1-74 Roof Permit#22-056 issued on 12/19/2022 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 D `V R For office u e only: DD BUILD NT PERMIT#j DEC 19 2022 VIL OF RYE OK IssuEDVA-/9-Q�a 38 KING STRE YE BROOK, YORK 10573 DATE:/ I9-ac'�- VILLAGE OF RYE BROOK 9 -06 O,c FEE: PAroA 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 k##i4#kk##f##if#####+fi#+#+i#####k#f###k#•#44ii4##kii#*#*#*###*##**##*#i#ki#fi#if#ii##i+fk#i#i####kik+ikki###i##ik##ki##if#if Address: //// Occupancy/Use: i'L cm ID#: 3si COIv —�- // / n Zone: Owner: V I S (2m-A )rI)el .b e��Sf- ,,Address:�T �✓(� [ P.E./R.A.or Contractor: ldress: � Person in responsible charge: Address: Application is hereby made and submitted to the Building Inspector of the Village o Rye Brook or a tssuance) 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: )/I/I ow/,(JJ ;i✓ being duly sworn,deposes and says that he/she resides at� {�C(J d- 36rv\v�A (Pr t Name of Applicant) 1 �,p (No.and Street) in ()118 D�t/S ,in the County of �/�/�'��( in the State of ,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 impr vements, 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 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 /3 day of 0 el + °llge ,202y day of e`st.(a¢l , 20A2 Signature of Property wne Signature of Applicant I S��Qon i oM6U) rm e o o e wner Print xa-me-gAgglicant Nota is No Public - PAUL FRANCIS 't �03'£t regruanON Sertdx9 unissnuwo0 Notary Public, State of New York/12/201 AiunoC =ulnd ui psiplpnp No. 01 FR5051872 11 r ZL91505ad l0 '0N Qualit,ed in Put..am "ounty wok N►eN 10 aIp1S `oilgnd /�eloN Commissiur, Expires Novenibsr 13,20� r SION'dad lfldd -- QyE BRC��, i-- '982 BUILDING DEPARTMENT ❑BUILDING INSPECTOR ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK [J CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAX (914) 939-5801 www ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : DATE: C PERMIT# ISSUED: SECT: BLOCK: LOT: LOCATION: 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 `.O N o w ID ev a " v � W a W CZ en v O Z � �a a ° y 4-4 o ,o s Q 3 V a W WA� E„y C _ C w N C QJ QI/ N " O < D. Cr w o � "� 'v � a r-ry LA' J IFFF.��4-i11 C ✓�' V w w t Z pl�. " 6o co ,* 'Ddo O O 1 Uz C4 r r-a Z A w A4 � M oo cn '+ Z ✓u� x O I u m -0 Oj .. a v aI �v ° BUILTMENT o� � oac VI E OF RYE OK R DEC 14 2022 938 KING ET RYE BR NY 10573 -0 ` VILLAGE OF RYE BROOK BUILDING DEPARTMENT FOR OFFICE USE ONLY: ,,rr����// Approval Date: DEC 14 10 Prrmit# �� (?,Z:: Application# Approval Signature: ARCHITECTURAL REVIE OARD: Disapproved: Date: BOT Approval Date: Case# : Chairman: PB Approval Date: Case# _ Secretary: ZBA Approval Date: Case# Other: _ Application FeeA J b Permit Fees: ` Q 3Jr 50- � ROOF PERMIT APPLICATION Application dated: Z is hereby made to the Building Inspector of the Village ofook,NY,for the issuance of a Permit to Re-Roof an Existing Building,as per detailed statement described below. Vfie'eac 1 i J 1. Job Address: (.� SBLU r t�L? one: —l� Property Owner: V St� —� ess: e r Phone#:q j j r — I#: email: 2. Applicant: -11 �L Address:: 2- 11 L cj Cell#: — —t / email: f UJ7� Phone#: J 3. Roofing Contractor: o b Address: 2 Phone#: Cell#: email: 4. ,lob Description,list all Methods&Materials: 5. Estimated Cost of Job: $ r5, !�©® (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.) b. If corner property,indicate,streetnta f ge: / /� e1 7. Construction Type:�7/ ` NYS Construction Cla s: S. Number of stories: Height: Q 9. Is garage being re-roofed:No:{ ) •Yes: Attached No:{ )•Yes:{ )Number of Cars: 10. Is roof peaked,hip,mansard,flat,etc: Ae7 ty 11. Estimated date of completion: 2- Z 0 Z EV1212021 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 YORI OUNTY OF WESTCHESTER ) as: T' C�/na. ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual sibning as the applicant) and furt er states that (s)h 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 Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to before me this / Sworn to before me this /3 day of �,t>e_avw br.� , 20;? day of �lo�' t l , 20 Z?- Signature of Prope y wner Signature of Applicant U 1�eln" /� Pr' ie of Pro er Owner Pri me of Applicant No Publ' tary ublic PAUL FRANCIS r Notary Public, State of New York l T o, 01 FR5051872 j (qualified in Putnam County i Commission Expires Noventbot 13,20 Z� 1 PAUL FRANCIS r Notary Public, State of New York No. 01 Ff:5051072 t Qualified in Putnam County Commissiurt Expires Ncventbor 13,200 8112I2021 v T F O co — a coo r tn Eli tvUJ » i�cs» i.i Z W r cc 01 ��. V ZLLJ = 3 • '� J O .- CL o :t:: Ue ap Cry T U b x w t � o h s1- 1No woo I � Yo IRS z o - •/� L d v G •U � i u U Vl99• 1 : Ar0 = ,., ` ' �0. �d� ,,,toe,, ...,��:�: -,��,,�,�;. - ,�. ,�. • r1 -. ACC 12/13I2022 Y) CERTIFICATE OF LIABILITY INSURANCE DATE(MM/ 022 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. 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). CONTACT Andy Nelson PRODUCER NAME: BNC Insurance Agency AIC' Ext: (914)937-1230 FAX (914)937-1124 AIC,No 90 S Ridge St Ste UL-2 E-MAIL anelson@bncagency.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Rye Brook NY 10573-2836 INSURER A: Selective Insurance Company of the Southeast 39926 INSURED INSURER B: TWF CONTRACTING INC. INSURER c: 211 CHESTNUT ST INSURER D: INSURER E: PORT CHESTER NY 10573-3122 INSURER F COVERAGES CERTIFICATE NUMBER: 22-23 GL master 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. POLICY EFF POLICY EXP TR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDD MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 AM 500,000 CLAIMS-MADE I OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ 15,000 A Y S 2333460 03/19/2022 03/19/2023 PERSONAL s ADV INJURY $ 21000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY ❑PRO- ❑LOC PRODUCTS COMP/OP AGG $ 4,000,000 IECTR OTHER: AUTOMOBILE LIABILITY Ea COMBINED accident) LIMIT $ 1,000,000 BODILY INJURY(Per person) $ X ANY AUTO A OWNED SCHEDULED S 2333460 03/19/2022 03/19/2023 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS PROPERTY DAMAGE HIRED NON-OWNED Per accident) $ AUTOS ONLY AUTOS ONLY EPAC $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ PER OTH- WORKERS COMPENSATION STATUTE ER AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNERIEXECUTIVE ❑ N 1 A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below 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 included as an additional insured when required under written Contract or Agreement. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Village of Rye Brook 938 King Street AUTHORIZED REPRESENTATIVE /p/ Rye Brook NY 10573 /&_.G�•UA_ @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD fi \\ NYSIF New York State Insurance Fund PO Box 66699,Albany,NY 12206 I nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE �. 7.' •M r A A A A A 134157673 'r�� F' LEVITT-FUIRST ASSOCIATES LTD + 520 WHITE PLAINS ROAD, 2ND FL ,t� TARRYTOWN NY 10591 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER T W F CONTRACTING INC VILLAGE OF RYE BROOK 211 CHESTNUT STREET 938 KING STREET PORT CHESTER NY 105733122 RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE G1243153-2 610086 06i29/2022 TO 06/29/2023 12/13/2022 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1243153-2. 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. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY. INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE, VISIT OUR WEBSITE AT HTTPS://WVVW.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. THOMAS FORBES- PRESIDENT TWF CONTRACTING INC ONE PERSON CORPORATION 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. s NEW YORK STATE S7v* NCE FUND 4 DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 882733714