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HomeMy WebLinkAboutBP23-010PERMIT # SECTION _,; TYPE OF WORK JOB LOCATION _ OWNER. 51/e B�EST. % /V%1t I `✓CO # l e TCO # 3- OJ C) DATE: Q ,�,3 �- --� LOT ve I �1 FEE DATE INSPECTION RECORD I DATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING 0 RGH PLUMBING GAS SPRINKLER ELECTRIC LOW -VOLT C� ALARM O AS BUILT L-7 FINAL OTHER APPROVALS ARB zBA OTHER risjec�Aid,�? lVeeole Cfl�o.Ss (o.w?ec�i o� J, r �Qy�,BRA �A t'C 4.�jJJ V . 19 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 February 6,2024 Oswald Nieto&Eileen Nieto 71 Hillcrest Avenue Rye Brook,New York 10573 Re: 71 Hillcrest Avenue, Rye Brook,New York 10573 Parcel ID#: 135.76-1-44 Building Permit#23-010 issued on 2/2/2023 for Replacement Windows This certifies that the six new windows,installed under the above captioned permit have been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to D a � C� r BUILDING DEf'`�' `� ENT office For use only': �-�� O v AR'F�VI DI PERMIT#& —O/O VIL) AGF OF RYE BROOK ISSUED:0—b1-13 JAN 3 0 2024 38 KING STREET,RYE BROOK,NEW YORK 10573 DATE: /--3 p -- ) (914)939-0668 FEE: qV /10-- PAIN) VILLAGE OF RYE BROOK ivwN%.rNehruuk.�)r�� BUILDING_DEPARTME_NT 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 #tirt4#irtrtk rtrtrttyrt#ittii t#i i1##iiitk►i M tyrtrtMy#yt###k#tit#4rtkt#ttt#t#rt44##k##rtttk rtrtyt#yrtttt##yt#ttkttt#t###k###ttkkkt###t#rt4#### Address: 71 Hillcrest Ave Occupancy/Use: Residential Parcel ID#: 135.76-1-44 Zone: Re1� Owner: Eileen Nieto Address: 71 Hillcrest Ave P.E./R.A. or Contractor: Renewal by Andersen Address: 2041 W Main St., Stamford CT 06902 Person in responsible charge: Franklin Barahona Address: 2041 W Main St., Stamford CT 06902 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: Eileen Nieto being duly sworn,deposes and says that he/she resides at 71 Hillcrest Ave i Print Name of Applicant) �No and Street) in RYe Brook ,in the County of Westchester _ in the State of New York that is a,fox,lv v,raset 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:S 13,987 for the construction or alteration of. Installation of( 6 ) Replacement Windows into Exisiting Openings with no Structural Alterations. (914)714-8218 Deponent further states that he/site 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. uu Sworn to before me this ik Swom to before me this 27�l day of OkAv 20 day of � , 20 Signature of Propert% Owner \\\\N'� HYtI ���//, Signamreo t Eileen Nieto Franklin Barahona Prin Z- N0.02ME0006943'•, ame o1; plicant _ QUALIFIED IN ;WESTCHESTER COUNTY: COMM.EXP. Not ry bltc ��J, 05-04-2027 \ Notarc Public '•. PUBL\G.••. Q'�J ,F/otFI tN Ett\\y�� Ntnary Public��New York Reglstrdm No.01R16379354 Qualified In Westchester County Commission Expires:August 13,2025 QyE 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 : 2 Z A ✓E . DATE: Z - 1 " Z O z y PERMIT# -?;:rP Z 3- O J y ISSUED: Z 2—Z3 SECT:/3<, 7(. BLOCK: LOT: LOCATION: S f_ C O F t Oct 2. OCCUPANCY: 6 /0 ❑ Violation Noted THE WORK IS... PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas j n v✓.S /,q ❑ L.P. Gas `j I cx)(? ❑ FUEL TANK -- ❑ FIRE SPRINKLER / ❑ FINAL PLUMBING ❑ CROSS CONNECTION 0' FINAL 'S VA ❑ OTHER O �- C) M N 9 q) a� N • � 1Rvy a � � M 0. b ,185, o p M e� g y .� o " 4-4 o to a o w a °bi v + o o 0 W o H c h+K H W p4 O O O Q Q °0 N " QI cq 0M co �3 a o v w aq W V - a -0 V En M-� A oC c Wz ,a � u : 00 G1 j rT� h-1 �Oyy w CV N la, ° W , hF✓+1 ~ 7' ram- W 4 ' 0 °"' 1 a' : p 4 z (09, V off. o w `" i U A U W 40- U V o � p,� � wV W V © V14 gb cn x C7 A Z O wI ~ 0 > .: �. z W. g F IT, x off ' ° � .. a, '° BUIL 6�r F EPARTMENT CE �G VIL �E OF RYE$LOOK 93s KINGET RYE BRaNY 10573JAN 2 7 2023 -(914)939-0668 w .ryebrook.org VfLLAGE OF RYE BROOK BUILDING DEPARTMENT FOR OFFICE USE ONLY:Approval Date: #4_ �� �I Application# Approval Signature: ARCHITECTURAL REVIEW BOARD: Disapproved: Date: BOT Approval Date: Case# Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Case# Other: Application Fee: Permit Fees: EXTERIOR BUILDING PERMIT APPLICATION Application dated: January 10,2023 is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the construction of buildings,structures,additions,alterations or for a change in use,as per detailed statement described below. 1. JobAddress: 71 (IHillcrest Avenue r` 2. Parcel ID#: -36•-A — 14L-) Zone: 9 0 -F 3. Proposed Improvement(Describe in detail): Installation of(6)Replacement Windows into Existing Openings. NO Structural Alterations, 4. Property Owner: Eileen Nieto Address: 71 Hillcrest Avenue Rye Brook NY 10573 Phone# 914-714-8218 Cell# 914-831-2205 e-mail List All Other Properties Owned in Rye Brook: Applicant: Kat wood Address: 2041 West Main Street, Stamford CT 06902 Phone# 203-406-0545 Cell# 203-482-3181 e-mail Permits@RBAWestchester.com Architect: Address: Phone# Cell# e-mail Engineer: Address: Phone# Cell# e-mail General Contractor: Fairchester Custom Windows dba Renewai by Andersen Westchester Address: 2041 West Main Street Stamford CT 06902 Phone# 203-406-0545 Cell# 203-482-3181 e-mail Permits@RBAWestchester.com (1) 8/12/2021 5: Occupancy;(1-Fam.,2-Fam.,Commercial.,etc...)Pre-construction: I-Faro Post-construction: n/a 6. Area of lot: Square feet: 1456 Acres: 7. Dimensions from proposed building or structure to lot lines: front yard: rear yard: right side yard: left side yard: other: 8. If building is located on a corner lot,which street does it front on: 9. Area of proposed building in square feet: Basement: 1"fl: 2"d fl: Yd fl: 10. Total Square Footage of the proposed new construction: 11. For additions,total square footage added:Basement: 11,fl: 2°d fl: 3rd fl: 12. Total Square Footage of the proposed renovation to the existing structure: n/a 13. N.Y.State Construction Classification: N.Y.State Use Classification: 14. Number of stories: Overall Height: Median Height: 15. Basement to be full,or partial: finished or unfinished: 16. What material is the exterior finish: 17. Roof style;peaked,hip,mansard,shed,etc: Roofing material: 18. What system of heating: 19. If private sewage disposal is necessary,approval by the Westchester County Health Department must be submitted with this application. 20. Will the proposed project require the installation of a new,or an extension/modification to an existing automatic fire suppression system?(Fire Sprinkler,ANSL System,FM-200 System,Type I Hood,etc...) Yes: No: x (fyes,applicant must submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans) 21. Will the proposed project disturb 400 sq.ft.or more of land,or create 400 sq.ft.or more of impervious coverage requiring a Stormwater Management Control Permit as per§217 of Village Code? Yes: No: x Area: 22. Will the proposed project require a Site Plan Review by the Village Planning Board as per§209 of Village Code? Yes: No: x (if yes,applicant must submit a Site Plan Application,&provide detailed drawings) 23. Will the proposed project require a Steep Slopes Permit as per§213 of Village Code Yes: No: x (f yes,you must submit a Site Plan Application,&provide a detailed topographical survey) 24. Is the lot located within 100 ft.of a Wetland as per§245 of Village Code? Yes: No: x (f yes, the area of wetland and the wetland buffer zone must be properly depicted on the survey&site plan) 25. Is the lot or any portion thereof located in a Flood Plane as per the FIRM Map dated 9/28/07? Yes: No: x (if yes, the area and elevations of the flood plane must be properly depicted on the survey&site plan) 26. Will the proposed project require a Tree Removal Permit as per§235 of Village Code? Yes: No: x (f yes,applicant must submit a Tree Removal Permit Application) 27. Does the proposed project involve a Home-Occupation as per§250-38 of Village Code? Yes: No: x Indicate: TIER 1: TIER It: TIER III: (ifyes,a Home Occupation Permit Application is required) 28. List all zoning variances granted or denied for the subject property: 29. What is the total estimated cost of construction: $ 13,987 Note.The estimated cost shall include all site improvements, labor,material,scaffolding,fixed equipment,professional fees,including any material and labor which may be donatedgratis.If the final cost exceeds the estimated cost,an additionalfee will be requiredprior to issuance of the CIO. 30. Estimated date of completion: 3/1/2023 (2) 8/12/2021 BUILD IV L_b MENT D E C IE Q VIL ' 'E OF RED OOK J/�{1 N 2 7 2023 938 KING ET R, $R ,NY 10573 �.( 4 0 VILLAGE OF RYE BROOK ro BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE §216 • STORM SEWERS AND SANITARY SEWERS THIS AFFIDAVIT MUST BEAR THE NOTARIZED SIGNATURE OF THE LEGAL PROPERTY OWNER AND BE SUBMITTED ALONG WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION. ANY BUILDING OR PLUMBING PERMIT APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETURNED TO THE APPLICANT . STATE OF NEW YORK, COUNTY OF WESTCHESTER ) as; -} //�� 3J, 61 L6�1 lJ/�7'D , residing at, 7/ )-ln-L c re f l A)e 9 &,r00i (Print name) (.Address where you live) being duly sworn, deposes and states that(s)he is the applicant above named, and further states that (s)he is the legal owner of the property to which this Affidavit of Compliance pertains at; 7/ llcrn& ,Rye Brook,NY. (Job Address) Further that all statements contained herein are true, and that to the best of his/her knowledge and belief, that there are no known illegal cross-connections concerning either the storm sewer or sanitary sewer, and further that there are no roof drains, sump pumps, or other prohibited stormwater or groundwater connections or sources of inflow or infiltration of any kind into the sanitary sewer from the subject property in accordance with all State, County and Village Codes. r 1 (Signature of Property Owner(s)) (CCCAI tt-TU (Print Name of Property Owner(s)) Sworn to before me this b day of 1111111f , 20 (]Votary Pub4c) (3) 8/12/2021 This application must be properly completed in its entirety by a N.Y. State Registered Architect or N.Y. State Licensed Professional Engineer & signed by those professionals where indicated. It must also 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: k A-i W J o p ,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 J-5—the legal owner of the property to which this application pertains, or that (s)he is the 1' 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. By signing this application, the property owner further declares that he/she has inspected the subject property, and that to the best of his/her knowledge there are no roof drains,sump pumps or other prohibited stormwater or groundwater connections or sources of infiltration into the sanitary sewer system on or from the subject property. Sworn to before me this to Sworn to befor e this day of , 20 day of , 20 I Sign re of Property Ownllr Stgna oftApplicant 16/L675d N16Tv - L-A) orJ Print Name of Property Owner Print Name of Applicant Notary Public No C, (4) 8/t 2/2021 RENEWAL Technical Data byANDERSEN FULL-SERVICE WINDOW&DOOR REPLACEMENT SPECIFICATION AND TECHNICAL MANUAL -- — -vow �r .b T RENEWAL BY ANDERSEN SPECIFICATION &TECHNICAL MANUAL TECHNICAL INFORMATION PERFORMANCE RATINGS AND TEST DATA NFRC Total Unit Performance (continued) Renewal by Andersen' U-Factor Product GlassType - . .. r Without Grilles 0.46 0.44 0.57 0.57 .82 Clear Full Divided Light Grilles 0.46 0.44 0.51 0.51 Low-E4® Without Grilles 0.33 0.30 0.31 0.31 .72 Full Divided Light Grilles 0.34 0.31 0.28 0.28 Without Grilles 0.33 0.30 0.19 0.19 .40 Low-E4®Sun Full Divided Light Grilles 0.35 0.31 0.18 0.17 D•Double-Hung (Full Frame) Low-E41SmartSunTM Without Grilles 0.33 0.29 0.21 0.21 .65 Full Divided Light Grilles 0.34 0.30 0.19 0.19 Low-E4®SmartSun Without Grilles 0.28 0.25 0.20 0.20 .63 with HeatLock® Full Divided Light Grilles 0.28 0.25 0.18 0.18 Enhanced Triple Pane Without Grilles n/a n/a n/a n/a n/a Enhanced Triple pane with Without Grilles n/a n/a n/a n/a n/a SmartSunTM' Clear Without Grilles 0.46 0.44 0.57 0.57 .82 Full Divided Light Grilles 0.46 0.44 0.51 0.51 Without Grilles 0.33 0.30 0.31 0.31 .72 Low-E4® Full Divided Light Grilles 0.35 0.31 0.28 0.28 Without Grilles 0.34 0.30 0.20 0.19 .40 Low-E4®Sun Full Divided Light Grilles 0.35 0.31 0.18 0.18 r• rr (Insert Frame) Low-E4"SmartSunTM Without Grilles 0.33 0.29 0.21 0.21 .65 Full Divided Light Grilles 0.34 0.30 0.19 0.19 Loi SmartSun Without Grilles 0.27 0.25 0.20 0.20 .63 with HeatLock`r Full Divided Light Grilles 0.27 0.25 0.18 0.18 Enhanced Triple Pane Without Grilles n/a n/a n/a n/a n/a Enhanced Triple pane with Without Grilles n/a n/a n/a n/a n/a SmartSunTM' Without Grilles 0.47 0.45 0.59 0.59 .82 Clear Full Divided Light Grilles 0.47 0.45 0.53 0.53 Without Grilles 0.34 0.30 0.31 0.31 .72 Low-E4® Full Divided Light Grilles 0.35 0.32 0.29 0.28 Without Grilles 0.34 0.30 0.20 0.19 .40 Low-E4®Sun Full Divided Light Grilles 0.35 0.32 0.18 0.18 Without Grilles 0.33 0.29 0.21 0.21 .65 Low-E4ID SmartSunTM Full Divided Light Grilles 0.34 0.31 0.19 0.19 Low-E4°SmartSun Without Grilles 0.27 0.25 0.20 0.20 .63 with HeatLock® Full Divided Light Grilles 0.27 0.27 0.18 0.18 Enhanced Triple Pane Without Grilles n/a 0.20 n/a 0.28 .47 Enhanced Triple pane with Without Grilles n/a 0.19 n/a 0.18 .43 SmartSunTM' "Low-E40O SmartSuri'Low-E40,'Low-E4®Sun-and HeatLock@ are Andersen trademarks for-Low-E"glass. 1)U-Factor defines the amount of heat loss through the total unit in BTU/hr/ft2.°F.The lower the value,the less heat is lost through the entire product.Window values represent non-tempered glass.Use of tempered glass can increase U-Factor ratings.See and emenwindows.com/nfrc for specific performance values. 2)Solar Heat Gain Coefficient(SHGC)defines the fraction of solar radiation admitted through the glass both directly transmitted and absorbed and subsequently released inward.The lower the value,the less heat is transmitted through the product. 3)Visible Transmittance(VT)measures how much light comes through a product(glass and frame).The higher the value,from 0 to 1,the more daylight the product lets in over the product's total unit area.Visible Light Transmittance is measured over the 380 to 760 nanometer portion of the solar spectrum. •NFRC ratings are based on modeling by a third-party agency as validated by an independent test lab in compliance with NFRC program and procedural requirements. •This data is accurate as of April 2021.Due to ongoing product changes,updated test results,or new industry standards or requirements,this data may changeover time.Ratings are for sizes specified by NFRC for testing and certification.Ratings may vary depending on use of tempered glass,different grille options,glass with capillary breather tubes for high altitudes.etc."Low-E4m.-Low-E4®SmartSun" and"Low-E4@ Sun" 09-10 COMPANY CONFIDENTIAL- REVISION AA-01 Q Agreement Document and Payment Terms DBA:RENEWAL BY ANDERSEN OF WESTCHESTER AND FAIRFIELD COUNTY Eileen Nieto RENEWAL Legal Name:Fairchester Custom Windows LLC 71 Hillcrest Ave. DER AL CT HIC#.0667292 Rye Brook,NY 10573 brAN SEN 2041 West Main Street I Stamford,CT 06902 Phone:203-406-0545 Fax:203-406-0828 sales@rbawestchester.com Eileen Nieto 12/19/22 BUYER(S)NAME CONTRACT DATE 71 Hillcrest Ave., Rye Brook, NY 10573 BUYER(S)STREET ADDRESS PRIMARY NUMBER SECONDARY NUMBER eduffynieto@gmaii.com PRIMARY EMAIL SECONDARY EMAIL NOTES: Buyer(s)hereby jointly and severally agrees to purchase the products and/or services of Fairchester Custom Windows LLC d/b/a Renewal By Andersen of Westchester and Fairfield County("Contractor"),in accordance with the terms and conditions described in this Agreement Document and Payment Terms, any documents listed in the Table of Contents,and any other document attached to this Agreement Document,the terms of which are all agreed to by the parties and incorporated herein by reference(collectively,this"Agreement"). Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. TOTAL JOB AMOUNT: $13,987 By signing this Agreement,you acknowledge that the Balance Due,and the Amount Financed must be made by personal check,bank check,credit card,or cash. DEPOSIT RECEIVED: $0 BALANCE DUE: $13,987 We schedule installations based on the date of the signed contract and secondarily on the date in which we complete the technical measurements.The installation date that we are providing at AMOUNT FINANCED: $13,987 this time is only an estimate.We will communicate an official date and time at a later date. Rain and extreme weather are the most common causes for delay. METHOD OF PAYMENT: Financing NOTES: Buyer(s)agrees and understands that this Agreement constitutes the entire understandings between the parties and that there are no verbal understandings changing or modifying any of the terms of this Agreement. No alterations to or deviations from this Agreement will be valid without the signed,written consent of both the Buyer(s)and Contractor. Buyer(s)hereby acknowledges that Buyer(s)1)has read this Agreement,understands the terms of this Agreement,and has received a completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date first written above and 2)was orally informed of Buyer's right to cancel this Agreement. NOTICE TO BUYER: Do not sign this contract if blank.You are entitled to a copy of the contract at the time you sign. YOU,THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME NOT LATER THAN MIDNIGHT OF 12/22/2022 OR THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION,WHICHEVER DATE IS LATER. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. SIGNATURE OF SALES PERSON SIGNATURE SIGNATURE Leonard Pesce Eileen Nieto PRINT NAME OF SALES PERSON PRINT NAME PRINT NAME 12/19/22 Page 2 / 12 - F Itemized Order Receipt DBA:RENEWAL BY ANDERSEN OF WESTCHESTER AND FAIRFIELD COUNTY Eileen Niefo Legal Name:Fairchester Custom Windows LLC 71 Hillcrest Ave. RENEWAL CT HIC#.0667292 Rye Brook,NY 10573 byAN D E R S E N 2041 West Main Street i Stamford,CT 06902 Phone:203-406-0545 Fax:203-406-0828 i sales@rbawestchester.com ROOM: SIZE: DETAILS: ow Misc, Misc. Miscellaneous Item, Lead Safe Work Practices 6 0 H to 10 Windows 201 Bed 2 32 W Window, Double-Hung (DG). 1:1, Slope Sill, Insert Frame, 51 H Traditional Checkrail, Exterior White, Interior White, Performance Calculator, PG Rating: 40 1 DP Rating: + 40 / 40, Glass, All Sash: High Performance, No Pattern, Hardware, White, Screen, Fiberglass, Full Screen, Grille Style, No Grille. Misc, Aluminum Casing, Wrap exterior with aluminum coil. 202 Bed 1 32 W Window, Double-Hung (DG), 1:1, Slope Sill, Insert Frame, 51 H Traditional Checkrail, Exterior White, Interior White, Performance Calculator, PG Rating: 40 1 DP Rating: + 40 / 40, Glass, All Sash: High Performance, No Pattern, Hardware, White, Screen, Fiberglass. Full Screen, Grille Style, No Grille. Misc, Aluminum Casing. Wrap exterior with aluminum coil. 203 Bed 1 28 W Window, Double-Hung (DG), 1:1, Slope Sill, Insert Frame, 51 H Traditional Checkrail, Exterior White. Interior White. Performance Calculator, PG Rating: 40 1 DP Rating: + 40 / 40. Glass, All Sash: High Performance, No Pattern, Hardware, White, Screen, Fiberglass, Full Screen, Grille Style, No Grille, Misc, Aluminum Casing, Wrap exterior with aluminum coil. 204 Main 30 W Window, Double-Hung (DG), 1:1. Slope Sill. Insert Frame. 51 H Traditional Checkrail. Exterior White, Interior White, Performance Calculator, PG Rating: 40 1 DP Rating: + 40 / 40, Glass, All Sash: High Performance, No Pattern, Hardware, White. Screen, Fiberglass, Full Screen, Grille Style, No Grille, Misc, Aluminum Casing, Wrap exterior with aluminum coil. 12/19/22 Page 3/ 12 0' Itemized Order Receipt DBA:RENEWAL BY ANDERSEN OF WESTCHESTER AND FAIRFIELD COUNTY Eileen Niefo Legal Name:Fairchester Custom Windows LLC 71 Hillcrest Ave. RENEWAL EWAL CT HIC#.0667292 Rye Brook,NY 10573 E DE R N 2041 West Main Street I Stamford,CT 06902 Phone:203-406-0545 Fax:203-406-0828 1 sales@rbawestchester.com r • • DETAILS: 205 Main 30 W Window, Double-Hung (DG), 1:1, Slope Sill, Insert Frame. 51 H Traditional Checkrail, Exterior White, Interior White, Performance Calculator, PG Rating: 40 1 DP Rating: + 40 / 40, Glass, All Sash: High Performance, No Pattern, Hardware, White. Screen, Fiberglass, Full Screen, Grille Style, No Grille, Misc, Aluminum Casing, Wrap exterior with aluminum coil. 206 Bath 22 W Window, Double-Hung (DG). 1:1, Travel Calculation 34 H Unavailable, Slope Sill, Insert Frame, Traditional Checkrail, Exterior White, Interior White. Performance Calculator, PG Rating: 40 1 DP Rating: + 40 / - 40, Glass, All Sash: High Performance, Obscure, Hardware, White, Screen, Fiberglass, Full Screen, Grille Style, No Grille, Misc, Aluminum Casing, Wrap exterior with aluminum coil. WINDOWS: 6 PATIO DOORS: 0 ENTRY DOORS: 0 SPECIALTY: 0 MISC: 1 TOTAL $13,987 Renewal by Andersen is committed to our customers'safity by complying with the rules and lead-safe work practices specified by the EPA. 12/19/22 Page 4/ 12 J p i 41 I i 'lf f K r \ 1 � e / - low 7"4 ARE 35s�°'..'���...t-%����..tt. �W... 'GJ �'-�'•� irk ��� ��S ��� .. 't.. 30 . '617iG;r7@YdSl�y!'dY ik ,� - -_. �,F'` �'• - ',y 1 . 1 r t j µ x t ' f E ' 1 � .......... .. � � ' � �� �� � �� ��� �� � � _ �� � , , _. �, � � � II , � I . �� � I � Ii �I � �'] 1 Building Permit Check List&Zoning Analysis Address: ( 1 1 � 1 l \ C eS Iwr SBL. `�"7. �� — l `' 1 Zone 1..� —_L6— Use Const.Type: y '_ Other. Submittal Date: Revisions Submittal Dates: Applicant: " \ 0— Nature of Work. 224V kcc_)��A S Reviews:ZBJJFg 0 12023 PB• BOT• Other: NEED OK (✓7 ( FEES:Filing. BP: C/O: Flood Plane: Legalization: ( ) (),,APP: Dated: i-,-- Notarized: ✓ShL: L.- Truss I.D. Cross Connection H O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening: ( ) ( ) ENVIRO: Long. Short: Fees: N/A: ( ) ( ) SITE PLAN:Topo: Site Protection: S/W Mgmt.: Tree Plan: Other. ( ) ( ) SURVEY:Dated: Current: Archival:- Sealed: Unacceptable: ( ) ( ) PLANS:Date Stamped: Sealed Copies: Electronic Other !/ ( ) (k}/License: Workers Comp: 4---Liability: ✓Comp.Waiver. ----Other. ( ) ( ) CODE 753#: Dated: N/A: ( ) ( ) HIGH-VOLTAGE ELECTRICAL:Plans: Permit: N/A Other. ( ) ( ) LOW-VOLTAGE ELECTRICAL:Plans: Permit: N/A Other. ( ) ( ) FIRE ALARM/SMOKE DETECTORS.Plans: Permit: H.W.I.C.:_Battery:_Other. ( ) ( ) PLUMBING Plans: Permit: Nat:.Gas: LP Gas: N/A/: Other. ( ) ( ) FIRE SUPPRESSION:Plans: Permit: N/A: Other. ( ) ( ) H.V.A.C.: Plans: Permit: N/A Other. ( ) ( ) FUEL TANK:Plans: Permit: Fuel Type: Other. ( ) ( ) 2020 NY State ECCC: N/A: Other. ( ) ( ) Final Survey Final Topo: RA/PE Sign-off Letter As-Built Plans: Other. ( ) ( ) BP DENIAL LETTER: C/O DENIAL LETTER: Other. ( ) ( ) Other. ( )ARB mtg.date: approvaL notes: ( )ZBA mtg.date: approval notes: ( )PB mrg.date: approval• notes: APPROVFIJ REQUIRED EXLMNG PROPOSED NOTES Date:LED 0 2 2023 Atx n Sides: R&ar. 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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 Theresa Brandon LJAME: MBI Company Group LLC. PHONE FAX 280 State Street (A/C,No,Ext):(203)288-3401 (A/C,No): North Haven,CT 06473 E-MAIL.DR , theresa.brandon@mbi-ins.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Selective Insurance Company of America 12572 INSURED INSURER B: Fairchester Custom Windows LLC dba:Renewal by Andersen INSURERC: Fairchester 2041 West Main Street INSURER D: Stamford,CT 06902 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 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. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS R N MM DD MMIDDIYYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE F_X]OCCUR X S 2516791 8/12/2022 8/12/2023 PRMrISESAGE TO R(EaENTED occurren $ 500,0 00 MED EXP(Any oneperson) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY JE a LOC PRODUCTS•COMP/OP AGG $ 3,000,000 OTHER: $ A AUTOMOBILE LIABILITY CO 1,11NEDtSINGLE LIMITC. $ 1,000,000 ANY AUTO S 2516791 8/12/2022 8/12/2023 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY X AUTOS BODILY INJURY Per accident $ X HIRED X NON-OWNED PROPERTY AMAGE AUTOS ONLY AUTOS ONLY Per accident $ A X UMBRELLA LAB X OCCUR EACH OCCURRENCE $ 4,000,000 EXCESS LIAB CLAIMS-MADE X S 2516791 8/12/2022 8/12/2023 AGGREGATE $ 4,000,000 DED X RETENTION$ 0 $ A WORKERS COMPE AND EMPLOYERS N SA LIABILITYTIONYIN X PTAT T X JER OTH- ANYPROPRIETOR/PARTNER/EXECUTIVE WC 9099063 8112/2022 8/12/2023 500,000 OFFICER/M EMBER EXCLUDED? ❑ NIA E.L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 500'000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Village of Rye Brook is Additional Insured as required by written contract per the endorsements included with this certificate. 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 ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD YORK workers' CERTIFICATE OF STATE Comp Boardensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1a.Legal Name 8 Address of Insured(use street address only) 1b.Business Telephone Number of Insured Fairchester Custom Windows LLC. 203-406-0545 dba:Renewal by Andersen Fairchester 1c.NYS Unemployment Insurance Employer Registration Number of 2041 West Main Street Stamford,CT 06902 Insured Work Location of Insured(Only required if coverage is specifically limited to 1 d.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-Up Policy) Number 88-2855660 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Selective Insurance Company Village of Rye Brook 3b.Policy Number of Entity Listed in Box"l a" 938 King Street Rye Brook,NY 10573 WC9099063 3c.Policy effective period 08/12/2022 to 08/122023 3d.The Proprietor,Partners or Executive Officers are QX included.(Only check box if all partneWofficers included) ❑ 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"1 a"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: Theresa Brandon (Print name of authorized representative or licensed agent of insurance carrier) Approved a o (Signature) ate) Title: Agent Telephone Number of authorized representative or licensed agent of insurance carrier: 203-288-3401 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