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HomeMy WebLinkAboutBP23-0533 DATE:sin myo FEE DATE PERMIT M&Z SECTION L TYPE OF WORI JOB LOCATION CONTRACTOP EST. COST W ✓Eo 4 Gam. TCO A FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING O RGH PLUMBING GAS SPRINKLER ELECTRIC r7 LOW -VOLT ID ALARM AS BUILT O FINAL i /acen�Pnf E7/70 �oo� 3)ovo0a- 3 18i OTHER APPROVALS ARB BOT P8 ZBA OTHER BRCS GtVCw UJJ� ur c�L° Q Jig+�v W v �C 198 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 27,2024 Kwon Chong&Anne Booth 34 Lincoln Avenue Rye Brook,New York 10573 Re: 34 Lincoln Avenue Rye Brook,New York 10573 Parcel ID#: 135.57-1-9.1 Building Permit#23-053 issued on 5/1/2023 for Replacement Doors This certifies that the three new doors,installed under the above captioned permit have been satisfactorily completed. Sincerely, Steven E. Fews Building& Fire Inspector /to D IE C IE ME i BUILDING DEPARTMENT i „r tII T use oilz:—3 FEB - 6 2024 Pr:Rnu N -o 5'3 VILLAGE OF RYE BROOK Insulin:S/-a3 VILLAGE OF RYE BROOK 938 KING STREET,RYE BR00i:,NEW YORK 10573 Dnrli:o7—lo—a BUILDING DEPARTMENT (914)939-0668 PAID$ www.rvehr•ook.org, APPLICATION FOR CERTIFICATE OF OCCUPANCY, CERTIFICATE OF COMPLIANCE, AND CERTIFICATION OF FINAL COSTS TO BE SUBMITTED ONLY UPON COb1PLETION OF ALL WORK, AND PRIOR TO THE FINAL INSPECTION ..................................................................•.....u................................................... Address: 34 Lincoln Avenue QD 23—D53 Occupancy/Use: Residential Parcel ID#: 135.57-1-9.1 'Lone: R-3 Owner: Anne Booth & Kwon Chong Address: 34 Lincoln Avenue 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: Anne Booth & Kwon Chong being duly sworn,deposes and says that he/she resides at 34 Lincoln Avenue 11'nn1 N;une of Applicant) (No and Strect) in Rye Brook in the County of Westchester in the State of New York ,that (Cnc/lotvni Village) he/she has supervised the work at the location indicated above,and that the actual total cost of the work,including all site iniprovements, 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 44,221 for the construction or alteration of: installation of( 2 ) Replacement Patio Doors & (1 ) Replacement Entry Door into Exisiting Openings with no Structural Alterations. 11 914-497-4267 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 foran owner to use or pennit 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. yy Sworn to befo c me this M Sworn to before me this day of 20 C, day of 20 Zi �6-- -- Signature of Property Otvner Si natur,I 6 t plicant BRIAN MACDONALD Anne Booth & Kwon Chong St tern Conned ,n Franklin Barahona f mt I ne of Properly Owncr My COMMISSION EXPIRES OeL 312026 Print Name of Applicant Notary Public Nolan Public SHARI MELILLO Notary Public,State of New York No.01ME6160063 Qualified In Westchester County commission Expires January 29,2021 3CaO 9 QyE BRnuk o`` tim • 1932 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 Uebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : .3 i .0 /NC O l lJ AV F DATE: 2 - 23 - - U z I PERMIT# �� - 01J3 ISSUED: j-.2, 3 SECT: BLOCK: LOT: LOCATION: F20`j 0 4) ` `yDU S e OCCUPANCY: 21U ❑ Violation Noted THE WORK IS... Ef PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION / 1 ❑ Natural Gas c- coC 2 SLR (� 9 ❑ L.P. Gas r �� ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION FINAL ❑ OTHER s a x x s x LLO O e w 0 � = M N � Q w � ■ LO Ln � CL,� `4 x lo l O U xx�...� Z q o V71LO � h+1 o W w � q 0 o c o cn U [r v a ++ 1-4 73 W o Z z w a' 1 0 � F °0 0 CP A n w Q = I Wr uv 06 A z � z Z Vic% a. O V W 00 z z A wU :: Q .- © U Vr O C z u z O W cry c w M o w Ebv cn 00 � � V u� W _ H x O o wA � tj = z w w O a 2 1 !"� Z Q U z E C P. E:. 1-1 U © V ►-� ° �� a114W W ] ] q,� a BUILD-WARTMENT I IE�V EVIL*kOF RYE SPOOK APR 21 2023 938 KING ETRYE BROOD,NY 10573 4 9,14)939-0668 LAGE OF RYE; BROOK brook 4r LDING DEPARTMENT ADMINISTRATIVE EXTERIOR BUILDING PERMIT APPLICATION FOR EXTERIOR WORK WHICH DOES NOT REQUIRE VILLAGE ARCHITECTURAL REVIEW BOARD APPROVAL FOR OFFICE USE ONLY: APPROVAL DATE: MAT 0 1 MIT# r[J`a�J APPLICATION FEE: APPROVAL SIGNATURE: PERMIT FEES: Y 2�31 _ H.O.A. APPROVAL: DATE: o DISAPPROVED: OTHER: Z3 Application dated: i§hereby ma a to the Building Inspector of 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. 7obAddress: 34 Lincoln Ave, Rye Brook NY 10573 2. Parcel ID#: 135.57-1-9.1 Zone: --� �- 3. Proposed Improvement(Describe in detail): Installation of(9)Replacement Patio Doors and ( 1 ) Replacement Entry Door into Existing Openings No Structural Alterations 4. Property Owner: Anne Booth &Chong Kwon Address: 34 Lincoln Ave, Rye Brook NY 10573 Phone#917-279-8461 Cell#914-497-4267 e-mail KWonsu@gmaii.com List All Other Properties Owned in Rye Brook: x 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: n/a Address: Phone# Cell# e-mail Engineer: n/a Address: Phone# Cell# e-mail General Contractor: FairChester Custom Windows dba Renewal by Andersen 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: 1-Fam Post-construction:1-Fam 6. Area of lot: Square feet: 2820 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: 311 fl: 10. Total Square Footage of the proposed new construction: 11. For additions,total square footage added:Basement: 1'fl: 2nd fl: V fl: 12. Total Square Footage of the proposed renovation to the existing structure: 13. N.Y. State Construction Classification: N.Y. State Use Classification: 14. Construction Type&Location:()Typical Western Lumber Frame;()Timber Frame[TC];()Wood Truss{TT]; ()Pre-engineered wood[PW];Located;{}Floor Framing[F];O Roof Framing[R];O Floor&Roof Framing[FR];Other: n/a 15. Number of stories: 2 Overall Height: Median Height: 16. Basement to be full,or partial: finished or unfinished: 17. What material is the exterior finish: 18. Roof style;peaked,hip,mansard,shed,etc: Roofing material: 19. What system of heating: 20. If private sewage disposal is necessary,approval by the Westchester County Health Department must be submitted with this application. 21. Will the proposed project require the installation of a new,or an extension/modification to an existing automatic fire suppression system?(Fire Sprinkler,ANSI,System,FM-200 System,Type I Hood,etc...)Yes:_No:Q✓ (if yes,applicant must submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans) 22. 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:_Nol__�4rea: 23. Will the proposed ro ect require a Site Plan Review by the Village Planning Board as per§209 of Village Code? Yes: No: (if yes,applicant must submit a Site Plan Application,&provide detailed drawings) 24. Will the proposed project require a Steep Slopes Permit as per§213 of Village Code Yes: No:Q (f yes,you must submit a Site Plan Application,&provide a detailed topographical survey) 25. Is the lot located within 100 ft.of a Wetland as per§245 of Village Code? Yes: No: (f yes, the area of wetland and the wetland buffer zone must be properly depicted on the survey&site plan) 26. Is the lot or any portion thereof located in a Flood Plane as per the FIRM Map dated 9/28/07? Yes: No:0 (if yes,the area and elevations of the flood plane must be properly depicted on the survey&site plan) 27. Will the proposed project require a Tree Removal Permit as per§235 of Village Code?Yes: No:0 (ifyes,applicant must submit a Tree Removal Permit Application) 28. Does the proposed project involve a Home-Occupation as per§250-38 of Village Code? Yes: No:Q Indicate:TIER I: TIER 11: TIER III: (if yes,a Home O-cminn►i)nn Permit d--b--",)n is required) 29. What is the total estimated cost of construction: $ � ote:estimated cost shall include all site improvements, labor,material,scaffolding,fixed equipment,professional fees, incluaong any material and labor which may be donated gratis.If the final cost exceeds the estimated cost,an additional fee will be requiredprior to issuance of the CIO. 30. Estimated date of completion: April 2023 (2) 8/12/2021 BUILDIhI6D MENT VIL'A�7��E OF RY\, OOK 7" 938 KING ��RYE BR ,NY 1057 ; ! 4 ro-o �-�' APB 2 1 2023 .r k to t���fLDIN DEPARTMENT i 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: 31 Anne Boo& � G" kwOn , residing at, 3 Li nco I n ke. 121,'- grc o 3 (Print natue) (Address wherc you live) being duly swom, 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; L► r i co L-tj P*j e 1c-'�l E Q)cL _ 0�J 1 OS--3 , 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. ( 'mature u[ProPettiy l�wtter(sI) d A� (Print Name(if Prope[IV Owticr(s ) Sworn to before me this 3 FRANKLIN E. BA€iAHONA Notary Public, State of Connecticut day of a)Circ—h. , 20 2-3 My Commission Expires Dee 31, 2027 (Notary Publie) (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. *,rwwwwww,twwwwwww*w,r**,�ww**wa*www**ww*w*w,��*w*ww*w**,ra**ww*w**wwwww***wwww*w,t,r*r�,�+twwwwwwwww**w**wwww*w*ww*w STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: k-0 i (,,J co� D ,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 is the legal owner of the property to which this application pertains, or that (s)he is the Co o.) r IZt�!'C_r t7 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 -3 Sworn to before me this Co day of a2c,a r-cA , 20 2 3 day of /91 MCA , 20 D� Signature of Property Owner Signature of Applicant can Cho. &0'e &: � Print Name of Property O ner Print Name of Applicant Notary Pub No �PRA�nn�ectlQV e Llf� E. 8A4iAH4NA Not I p,b lc,Exp�tEe�gC 31,2 t ; . �blic, State of Connecticut P><y Com �ssror' Ex Tres Dec 31,2027 �mrnissi3n P (4) an 2/2021 Fairchester is not using an Engineer / Architect due to installation of replacement windows and doors into EXISTING openings with NO structural alterations . o Chong Kwon & Anne Booth Kwon Chong and Anne Booth Doors 34 Lincoln Ave Brian Greenberg(914i535 9548 Rye Brook . NY 10573 (917)279-8461 rSuite PCS_9 ROOM Misc: Misc, Permit Fees, Quantity 1, Renewal by Andersen will faciliate the application of the building permit to the Town of Rye Brook. Homeowner is responsible for any outstanding permit applications or code violations that may prevent Renewal by Andersen from procuring permit. Renewal by Andersen is not responsible for any historical or architectural review applications and approvals that may be required as pre-requisite for a building permit. n� Misc: Misc, Miscellaneous Job Items. Quantity 1, Details of ProVia door specifications to be provided on supplemental agreement. r 101 Den 71.25 W .s _ Patio Door: Gliding . 200 Series Narroline. 2 Panel, 79.5 H ii Stationary / Active, Exterior White, Interior White Performance Calculator: Performance Data Unavailable Glass: All Sash: Tempered High Perf. Hardware: Albany, Stone , Exterior Keyed Lock, Auxiliary Foot Lock Color MatchedScreen: Gliding , Full ScreenGrille Style: Grilles Between Glass (GBG) Grille Pattern: All Sash: Colonial 4w x 5h Misc: None 102 Den 71.25 W Patio Door: Gliding . 200 Series Narroline, 2 Panel. Active / 79.5 H Stationary, Exterior White, Interior White Performance Calculator: Performance Data Unavailable Glass: All Sash: Tempered High Perf. Hardware: Albany, Stone , Exterior Keyed Lock, Auxiliary Foot Lock Color MatchedScreen: Gliding , Full ScreenGrille Style: Grilles Between Glass (GBG) Grille Pattern: All Sash: Colonial 4w x 5h Misc: None WINDOWS:0 PATIO DOORS:2 ENTRY DOORS:0 SPECIALTY: 0 MISC:2 TOTAL UPDATED: 04/10/23 DocuSign Envelope ID:D7881E36-20D9-484D-BAD9-CICCOA685AE4 RenewalRenewal by Andersen of Westchester 2041 West Main St byAndersen-0 WINDOW REPLACEMENT ❑nAnderKnCompany Stamford CT 06902 SUPPLEMENTAL . . ORDER 3.10.23 2.03.22 Date: Original Contract Date: Anne Booth Original Contract Price: 44221 Name: Additional Cost: 34 Lincoln 9045 Address: Cost Reduction: (negative amount) Current Adjustment: 0 Total Amended Contract Price: 35176 Rye Brook 8844 City: Total Deposits Received: Total Balance Outstanding: 26332 Phone Number: Payment Method: Check Credit Card ❑✓ Finance CLARIFICATION OF CONTRACT © CHANGE OF PAYMENT METHOD MORE WORK LESS WORK ® PRICE ADJUSTMENT SPECIFIC DETAILS & MEASUREMENTS - Change of operation for units 101 & 102. - Unit 101 Stationary/Active (from exterior) - Unit 102 Active/Stationary (from exterior) - Change units 101 & 102 from 400 Series French Sliding Door to Narroline Patio Doors - Remove unit 103 from order DocuSigned by 2B2DEC5731624A4 Company Representativ Owner(Or Representative of Owner) 14 f 41 Z.L 3/16/2023 Date ` Date Agreement Document and Payment Terms DBA:RENEWAL BY ANDERSEN OF WESTCHESTER AND FAIRFIELD COUNTY Kwon Chong&Anne Booth E Legal Name:Fairchester Custom Windows LLC 34 Lincoln Ave RENEWAL NWA E E CT HIC#.0667292,WC-35743-H22,Putnam#51220 Rye Brook,NY 10573 byAN E WA L.wo..00aSEN 2041 West Main Street I Stamford,CT 06902 H:(917)279-8461 Phone:203-406-0545 Fax:203-406-0828 1 sales@rbawestchester.com C:(914)497-4267 Kwon Chong&Anne Booth 02/03/23 BUYER(S)NAME CONTRACT DATE 34 Lincoln Ave, Rye Brook , NY 10573 (917)279-8461 (914)497-4267 BUYER(S)STREET ADDRESS PRIMARY NUMBER SECONDARY NUMBER Kwonsu@gmail.com Abcatering@gmail.com PRIMARY EMAIL SECONDARY EMAIL NOTES: Buyers)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: $44,221 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: $8,844 BALANCE DUE: $35,377 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: $35,377 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: Credit Card 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 02/07/2023 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 Brian Greenberg Kwon Chong Anne Booth PRINT NAME OF SALES PERSON PRINT NAME PRINT NAME 02/03/23 Page 2/ 32 ii��. Itemized Order Receipt y✓ DBA:RENEWAL BY ANDERSEN OF WESTCHESTER AND FAIRFIELD COUNTY Kwon Chong 8 Anne Booth APO` Legal Name:Fairchester Custom Windows LLC 34 Lincoln Ave RENEWAL� CT HIC#.0667292,WC-35743-H22.Putnam#51220 Rye Brook,NY 10573 byANDERSEN 2041 West Main Street I Stamford,CT 06902 H:(917)279-8461 •+.ro.n maawrn Phone:203-406-0545 Fax:203-406-0828 1 sales@rbawestchester.com C:(914)497-0267 ROOM: 0 Misc, Misc, Permit Fees, Town of Rye Brook- Estimated Permit Fees, Renewal by Andersen will faciliate the application of the building permit to the Town of Rye Brook. Homeowner is responsible for any outstanding permit applications or code violations that may prevent Renewal by Andersen from procuring permit. Renewal by Andersen is not responsible for any historical or architectural review applications and approvals that may be required as pre- requisite for a building permit. Misc, Misc, Miscellaneous Job Items, Pro-Via Door, Details of ProVia door specifications to be provided on supplemental agreement. 101 Den 71 1/4 W Patio Door, Gliding, 400 Series Frenchwood, 2 Panel, Active / 79 1/2 H Stationary, Exterior White, Interior Oak, Performance Calculator, Performance Data Unavailable, Glass,All Sash: ` l0\ Tempered High Perf., No Pattern, Hardware, Albany, Stone, l Exterior Keyed Lock, Auxiliary Foot Lock Color Matched, Screen, Gliding, Full Screen, Grille Style, Grilles Between Glass (GBG), Grille Pattern, All Sash: Colonial 3w x 5h, Misc, None 102 Den 71 1/4 W Patio Door, Gliding, 400 Series Frenchwood, 2 Panel, Active / 79 1/2 H Stationary, Exterior White, Interior Oak, Performance Calculator, Performance Data Unavailable, Glass, All Sash: Tempered High Perf., No Pattern, Hardware, Albany, Stone, Exterior Keyed Lock, Auxiliary Foot Lock Color Matched, Screen, Gliding, Full Screen, Grille Style, Grilles Between Glass (GBG), Grille Pattern, All Sash: Colonial 3w x 5h, Misc, None - Page 3/ 32 02/03/23 Itemized Order Receipt MR DBA:RENEWAL BY ANDERSEN OF WESTCHESTER AND FAIRFIELD COUNTY Kwon Chong&Anne Booth Legal Name:Fairchester Custom Windows LLC 34 Lincoln Ave RENEWAL CT HIC#.0667292,WC-35743-H22,Putnam#51220 Rye Brook,NY 10573 by A N D E R S E N 2041 West Main Street 1 Stamford,CT 06902 H:(917)279-8461 Phone:203-406-0545 I Fax:203-406-0828 1 salesOrbawestchester.com C:(914)497-4267 ROOM: SIZE: DETAILS: PRICE: 103 Bathroom 36 W Patio Door, Gliding, 400 Series Frenchwood, 1 Panel, �I 80 H Stationary, Exterior White, Interior White, Performance J Calculator, Performance Data Unavailable, Glass, All Sash: Tempered High Perf., No Pattern, Grille Style, Grilles Between Glass (GBG), Grille Pattern, All Sash: Colonial 3w x 5h, Misc, p None WINDOWS: 0 PATIO DOORS: 3 ENTRY DOORS: 0 SPECIALTY: 0 MISC: 2 TOTAL $44,221 4 Renewal by Andersen is committed to our customers'safery by J' complying u,itb the rules and lead-safe work practices specified by the EPA. 02/03/23 Page 4/ 32 U.S. Canada ENERGY ENERGY Andersen- Andersen NFRC Certified o o u w STAR STAR v 6.0 v 4.1 Product Lira!8 Glass Grille Type Products > Product Type Type Directory Number Z U U m N o o 2 W 3.1 Tempered Glass-wl No Grilles and Grilles Less Than V No Grilles AND-"14)0626-00001 0.29 1.65 0.32 0.56 22 <0.2 NC ur S6nu11/ed Divided Life or IrtsfalkM InhYior Removable AND-"14=26-000(112 029 1.65 0-29 0.49 20 <0.2 NC - moo} Full Divided Lite ANDJi-61.00614-00001 0.30 1.70 0.29 0.49 19 <0.2 NC FineegM"(gMles-betweenthe-glass) ANDJJ-61-00646-00001 02! 1.65 029 0.49 20 <0.2 .: NC - No Grilles ANDN61-"29-00001 0.29 1.65 0.20 0.31 15 <0.2 NC S Simulated Divided Lite or Installed interior Removable ANDN67-00829-00002 0.29 1.65 0.16 0.27 14 <0.2 ': NC -111 - 3 Full Divided Lite AND-N314)063500001 0.31 1.79 0.13 027 11 <0.2 Fine1i91tt^(grilles-1.4 4tie-glass) ANDN61-009474N)001 029 1.65 1 6.19 027 1 14 <0.2 NC - - No Grilles A1404 l4=30-00001 0.23 1,59 021 O.SO 17 <0.2 NC Z1 Simulated Divided Lite or Installed Interior Removable ANDN61-00830-00002 0.28 1.59 0.19 0.44 16 -0.2 NC - o r E Full Divided Lit. ANDN41-00936-00001 0.30 1.70 0.19 0.44 13 <0.2 NC sc - Firelight"(gnllesbetsteen-dte-glass) ANDNL7-00848-00001 0.21 1.59 0.19 0.M 16 <0.2 NC 89 - No Grilles ANDNEI-00627-00001 0.29 1.65 0.54 0.61 34 <0.2 - - M Simulated Divided Lice or Installed Intenor Removable ANDN61-00827-00002 0M 1.. 0.47 0.SM ]0 <0.2 - - - o A '� Full Divided Lite ANDN61-00633-00001 0.31 1.76 OA7 0.54 28 <0.2 - - - - - n Finelight"(grillesbetweart4he-glass) AND-441-0084S)0001 029 1.65 0.47 0.54 30 <0.2 - 1114 No Grilles ANDN61-00957-00001 0.24 1.36 0.32 0.55 28 <0.2 NC Foil Divided Lite ANDN67-00%0-00001 027 1.53 0.28 0.48 22 <0.2 t4C - x Finelight"(gnlles-0etween4heyWss) AND431-00966-00001 0.24 1.36 1 0.28 1 0.48 26 <0.2 NC t s No Grilles ANDN-61-00958-00001 0.24 1.36 0.21 0.49 22 <0.2 NC 3 Y Full Divided Lite AND461-00961 00001 0.27 1.53 0.19 0.43 17 <0.2 NC E x Finelight"(gnlbs4.4--d"tass) ANDNb1-00967-00001 0.24 1.36 0.19 0.43 21 <0.2 NC 200 Series No Grilles ANDN31-00956-001M)1 025 tA2 0.49 0.60 37 <0.2 - Z3 Narroline"Gliding ,,, ` Patio Door 9 i U Full Divided Lite ANDNb1 M59-00001 0.28 1.51 OA3 0.53 29 <0-2 - - 0 s i LA 11 ; Finelight^(grillesbetween-NeyWss) ANDN61-00965-00007 0.25 1 1.42 1 aA3 0.53 33 <0.2 - - - 3.1 Tempered Glass-IN/Grilles 1"or Greater Simulated Divided Lne or Installed Interior Removable AND Nb1-00828-00003 0.29 1.65 0.25 0.42 18 <0.2 NC o Full Divided Lite AN"61-00MG-00001 0.30 1.70 0.25 0.42 17 <0.2 - Fmelight-(grilles-between-the-giass) ANDN-61-M52-00001 0.30 1.70 0.211 0.49 19 <0.2 NC - Simulated Divided Lite or Installed Interior Removable ANDN61 00829-00003 0.29 1.65 0.16 0.24 13 <0.2 NC o Full Divided Lite ANDN614)(3841-00001 0.30 1.70 0.16 0.24 11 <0.2 - Fmelight^l9niks-0etween-theytass) ANDN61-00951-OOW1 0.31 1.76 0.18 0.27 11 <0.2 - - - - Simulated Divided Lite or Installed Interior Removable ANDN61-00830.00003 0.29 1.59 0.17 0.38 14 o Y Full Divided Lite ANDN61-00642-00001 0.29 1.65 8.17 0.38 13 <0.2 NC SC - E '^ Fmehght"(gnllesbetween-Meylass) AND-"I-0854-WM 0.30 1.70 0.19 0.M 13 <0.2 NC SC - - 1. Simulated Divided Lib or Installed Interim Removable AND4461-00827-OOW3 0.29 1.65 0.41 0.47 27 <0.2 - - - - - 0 2 Full Divided Lice ANDN61-00634-00001 0.11 1.76 0.41 0.47 25 <0.2 Zl J 9 u Finelight"(gn6esbetweenJheylass) ANDJN61-MSt-00001 0.31 1.76 0.47 0.54 ZD <0.2 Full Divided Lite ANDN61-N%3-OOMI 0.27 1.53 0.25 0A1 20 <0.2 NC Z1 - o 0 4 Finehght^(grillesbetveen-Me-glass) ANDNb1-00%9-00001 0.26 1.M 0.7D 0.48 23 <0.2 NC - Z7 Finelight"(gMIes4,etween4tte-glass) wa Na We Na Na Ne Nil - - - - - Full Divided Lit. ANDN61-00%4OOM O.Z7 1.53 0.17 0.37 10 <0.2 NC - 0 o C Finelight^(gnffesbetrveenthe-qlass) ANDN61J10970-00001 0.25 1.42 0.12 0.43 19 <0-2 NC Isc Zt - E x '^; Firelight-(gnlbsbetvreen-theglass) Na Na Na Na Na Na Na - - Full Divitled Lite ANDN61-00%2-00001 0.28 1.83 0.38 0.45 27 <0.2 o Firelight -betweenaheylass) ANDN61-00%8-00001 0.26 1.M 0.43 0.53 II <02 - - HE - x x a; Finelight"(grilles-between-Me-glass) This information is for reference only. Performance varies by unit size and options selected. Page32of55 OmaI "� '�°f 15�014aA0,swbje"t°�"9e See page 1 Inr ma-dormaem For specific unit performance information,please contact your dealer or Andersen Sales Representative. N N m W J N � � - C = C N O O o "% a d a 9 E a m m m` v w L m ry > m w r E a v w aEi " ° " a 4 N W N Y N N N O 3 O m O ` a 0 ` a 0 y H Oic ro a w left cEb EtaU C LL uC3 atO o N v=mZ w m `o ° J -O ° E > o m cc co co W O 0N 'O 'c .0 > '0 9 L` N Cc V L J Y Y LL W O c �n x c .co c J m w E x J . V1 C E �_ V m rp u L m >` ' S V C w O E t c W J ^ 0 w a . o w �' o o c 3 s • a a r 3 u NNQ ~ Q m N $ v a $ a �_ $ m G A Q o N Eo a 0 y c `° C w t f �Y v 'c c o o a o N v '^ y 'E t /y • W N �xpp N C '� 1n N C 0- O c a O y EO � � u 0 W c fO — c N li (V J W N m N N � m V C' 1- V S a Q Q Q IL N tt N � N V1 T _ U ir 11 c in O O v ry - o O E N a � � N A T Z O O A q [Fl fL O o O a m - L Z�lE V L T O T J E T C Z ) O ° o NLOLI W LL v w m O i O I q v fi a ry � d z m N O JAFAFA AFAF Order Summary &=RENEWAL BY ANDERSEN OF WESTCHESTER AND Kwon Chong&Anne Booth FAIRRELD COUNTY 34 Lincoln Ave RENEWAL_ Legal Name:Fairchester Custom Windows LLC I License i CT HICB.0667292, Rye Brook,NY 10573 byANDERSEN WC-35743-H22,Putnam 951220 H:(917)279-8461 WIM�94"Ariam 2041 West Main Street I Stamford,CT 06902 C:(914)497-4267 Phone:203-406-0545 1 Fax:203-406-08281 techOrbawestchester.com • • • •• UNIT NOTES Renewal by Andersen will faciliate the application of the building permit to the Town of Rye Brook. Homeowner is Details of ProVia door specifications to be provided on supplemental agreement. i 101 102 02/03/23 Page 5 / 14 x.-s >.�f r „cam, . I �y URA I'l; :.i �� ���� t � �� � .t. ��� �, i I } ,�� z �� s : ti :.��� LAC a"�Y" t a Y. �..,... i __ _ 1 /� _ :.:�st�u-- I I .. - _ .. __ .. 4 T li �� ;� _ � C a i � � �' is 2 — ---- ,s,„,-. •�� _ --� � �, _` . � �' _ ;�i1; :� R +- �.. '' _� f �, 1 Aff � , f #� . �' I ��. �— � 1� � ' nwe - . e n�- -�74W. •. . i i �3 sY' � .sf d j ' 1� 4 4 T�`j`"4k F .` _ �' r}: .Api �.c: 3, � :a.� :,{r :d � ,w.. ., r y't y,d � � r�.. 4 �i .� \ ^ � } K y- d' �{y ,{ �., �� ��= ti� _��_ N �r �.i. l+�Il i„ F�= tip LL _ _ 6+�� ._ .;,. �' - � _�. _. _;. -'' :� t - t S' �: , ' � � �. `r+ w' Y. � � r �. ."; • •� ��. � ` ��� � s � • ` t• ir.. •� .. �• Y ♦� i1►�► ,�. � +� r � 1� i � t _� w s !i It (/I A F - f f :dL- u [ c 1 dm iv, I i r i s 4s wow. e , �r I frGr ,Zen, .�j a,�'a�k�F,,��q}.-T ,AR� � � � ��� Y•�'Q�:{� r , ��,• �,�� '. Fitt errr��1d, IIY rti�• (,,.: ilkt +ail- lily . ,N;•i� r�`.. V` _.♦ f'�,, ,P dry f t'ii�' S� u• 1� r.hl /1� �tl .sir ifr r + . ♦ ti:,`r'"A,',��1���i�.� ';p' ^�- /: ,<(ts» 3a .. .s_.:._. .ram.a.. +�-,... LF. .t..e+ _.... .Y•_...s.z', .._..>uto....rL�l +�__L* .. ��. «o)> K' N 04 •V V ! > N 96 C Y. ZA _ ptjA. to o_ C atection Moemo,.. FQFPIN A I-N co G of ui � ` O CIO �r IW— a, Co R{� �• E E rt Mrs Q = "r i.� rrp�yy w r c v Y UCN r • w N L V J •J V � 1� V J U • � V yr. � `FE, > 3 «a) ,ri*f�•-�1 1 �f'•"',►'1 '• '"+'Y�` �-.�-"'i^. - v `DilQ'X' �_...;. � "r s� d,��h r..,rrr ry „�, v i� ,r`"� r :'��r�9N'�.. (•(, !} l�j�•Irl��' 1{1 ! 1�•,�. j All!! �1�rr/r r r•,. -tilt '� 1 �,. ri ��•�rti i r dot a. �.rh. {� �!t �• ' {�/ ills' 4.•a(,h�' .ff {„ �ii�tir I FAIRCUS-01 TBRAND A�OR� CERTIFICATE OF LIABILITY INSURANCE DATE(M202YYY) 9126/2022 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). PRODUCER CONTACT Theresa Brandon AME: 280 Company Group LLC. A/c No,Ext):(203)288-3401 ac,No): 280 State Street ( North Haven,CT 06473 EooR1E ,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 ADDL SUBR POLICY EFF POLICY EXP T TYPE OF INSURANCE N D WVD POLICY NUMBER DD MMIDD LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE [X]OCCUR X S 2516791 8/12/2022 8/12/2023 DDAAMfAGETISESOERENTEDoccurren $ 500,000 MED EXP(Any onePerson) $ 15,000 PERSONAL&ADV INJURY $ 11000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY�X JE X❑ LOC PRODUCTS-COMP/OP AGG $ 3,000,000 OTHER: $ A AUTOMOBILE LIABILITY COMBINED O aBINEDcl.ntSINGLE LIMIT $ 1,000,000 ANY AUTO S 2516791 8/12/2022 j 8/12/2023 BODILY INJURY Perperson) $ OWNED X SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ �( HIRED X NON-OWNED PROPERTY AMAG E IAUTOS ONLY AUTOS ONLY Per accident $ E 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 I X RETENTION$ 0 $ A WORKERS AND EMPLOYERS'LIABILITYYIN X STAT T X OTH- ANY PROPRIETOR/PARTNER/EXECUTIVE WC 9099063 8/12/2022 8/12/2023 500,000 OFFICER/ME,MBER EXCLUDED? ❑ NIA E.L.EACH ACCIDENT $ (Mandatory m 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 I LOCATIONS I 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 938 King Street ACCORDANCE WITH THE POLICY PROVISIONS. Rye Brook,NY 10573 AUTHORIZED REPRESENTATIVE /- ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NEW YORK Workers' CERTIFICATE OF STATE Compensation Board 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 2041 West Main Street tc.NYS Unemployment Insurance Employer Registration Number of Stamford,CT 06902 Insured Work Location of Insured(Only required if coverage is specifically limited to Id.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 938 King Street 3b.Policy Number of Entity Listed in Box"1 a" Rye Brook,NY 10573 WC9099063 3c.Policy effective period 08/12/2022 to 08/122023 3d.The Proprietor,Partners or Executive Officers are included.(Only check box if all partners/officers 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"ia'for workers' compensation under the New York State Workers'Compensation Law.(To use this form,New York(NY)must be listed under Itern 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 - 0 (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