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HomeMy WebLinkAboutMP23-083 yE 4R(� �1b�4.°la-V G.ui, vu W V r 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 November 28,2023 Enver Balidemaj &Spresa Balidemaj 1 Winding Wood Road Rye Brook,New York 10573 Re: 1 Winding Wood Road, Rye Brook,New York 10573 Parcel ID#: 129.83-1-2 This document certifies that the work done under Mechanical Permit #23-083 issued on 6/1/2023 for the installation of a new hot water heater has been satisfactorily completed. Sincerely, Steven E. Fews Building& Fire Inspector /to �yE BRC�v� F O '• �9�� 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 : , Y ` �` \ / DATE: PERMIT# ISSUED: SECT: BLOCK: LOT: LOCATION: t � \� I( 'A. OCCUPANCY: \� ❑ 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 t, 1 ❑ Natural Gas - ❑ L.P. Gas ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER �E BRC��• BUILDING DEPARTMENT UILDING 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 :- \ .�K1/V DATE: J -7 -75 PERMIT# r ISSUED: "1� `SECT: BLOCK: LOT: LOCATION: � �Q� `V L � OCCUPANCY:. ❑ 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 C } �l 0 \ \U ❑ L.P. Gas y�- ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER QyE BRC�v� o`` tim 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:_ �ju V CC�C DATE: Cl PERMIT# �` `� ISSUED: SECT: BLOCK: LOT: LOCATION: ` y�C� Y i �1+ C '�'� 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 UM "�-• ❑ FINAL PLUMBING ❑ CROSS CONNECTION l ^ 1 ❑ FINAL / 1 ❑ OTHER x m m M e 00 m C M z ! 1 N N W N N CN P4 ZMMMMU m m, ., a G j a In ar U A p w 3, eq s r'r F�j a Ucn00 4.4 aw Q001 Cl) ''14 © 00 to, p 11 as � V Z -� e' t ° . , W Vim} ~ M w w Wo cn -� a a � U 00 A pp Z zzroo o ° Q V z o O V 4 . w > o p. wv ° -t P-4 0.4 a w x � � m - p CECEOE BUILDING DEPAMENT VELLAGE OF RYE kOOK MAY 2 6 2023 938 KING STREET RYE BROOK,NY 1105 (914)r 939-Q l�. VILLAGE OF RYE BROOK BUILDING DEPARTMENT ti��r a. Vcltr ' .or I P ERMIT APPLICATION FOR OFFICE USE ONLY -P-94s— A- C::)-�3'LO 3 Approval Date: Permit Fee: $ Approval Signature: Other: Disapproved: 7 (fees are non-refundable) Application dated, is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install and/or rerdove Plumbing as per detailed statement described below.The applicant&property owner,by signing this document agree that said plumbing work will be in conformance with all applicable Federal,State,County and Local Codes. GL 1.Address: �(.d/'N,L7m—j6—,A)OCR b jC D SBL: 19 • —1 Zone: r) 2.Proposed Work: 6'H19/V 6'e HOE & 4T ee 14T1"Q - 3.Property Owner: �;1�V F—& �► 1��y'-j F}�' Address: f 1J 1 t,)D Y N G 00 0 D I�E) Phone#: Cell#: email: y 4.Master Plumber:_ � if AG G 1 lQ 13 G Address: 13�� K G H kQ 1?E T.> 7-U GKA I40E N 11 107131 Lic.#: �� Phone#: qr✓ 557-�t�af Cell#: �/f�` �7' ` c -1 email: COOLI COMP any Name: CAGG I'fu1^iOlm&f 14eg-rt 0c, Address: 13SSAGe'040i2-e- P4�>TuckA a TJl (0707 INDICATE FIXTURES&LINES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: Location Water Urinals Drinking Sinks Showers Bath Laundry Domestic Fire Sanitary Natural/ Other* Total Closets Fountains Tubs Tubs Service Service Sewer LP Gas Basement 1st Floor 2nd Floor 3'Floor 4'h Floor 51 Floor Exterior 5.* List Other Equipment/Provide Details: (Notarized Signatures Required Next 2 Pages) 2- 3/3/2423 STATE OF NEW YO�RK,COUNTY OF WESTCHESTER ) as: being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual sighting as the applicant) and further states that(s)he is the Master Plumber for the legal owner and is duly authorized to make and file this application. 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 b fore me this day of 2Q day of &" 20 2- Signature of Property Owner Signature of Applicant l rt: CMG Name of Property Owner Print Name of Applicant 46 PAhtELA C:t3Ti70NEL"` e. !iGfQr? Public stoto of Now I'vik t 64 Notary Public �tU t1iCUdtbb•s Nota ublic Qywotsra In vvesicnev *I ZD.Z AHN TED TAESHIK t My ,:.ntn,n1pskort Ex0*G r` ..1 Y Notary Public,State©t New Yolk No.01 AN6286995 oualifted in Westchester Courytf 202b Commission Expires This application must be property completed in its entirety and must include the notarized signature(s) of the legal owner(s) of the subject property, and the applicant of record in the spaces provided. Applications not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. _2_ 3f3/2023 $BILD G D MENT F Fz C [E U Y IE VILL�1'CE OF RYE. OQK gag KING STREET RYE BRU ,NY 10573 MAY 2 6 2023 (9114�_ 9-066$ rrr` [xp � .1 1/I�tf.C: OF MYE BROOK �;i!•G [. _PP,RTMEIgT 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: t C7— , residing at, U rl � ' (Print name) J (�Udress where you li%e) 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; YJ006P O ,Rye Brook,NY. (Jab 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. (Signature of Props rty 0wrter(s)) j C(A/ C; r'¢ {Print Name a1'Property Owner(s)) Sworn to before me this coiRONEO �����A f �r1Ml�•� rk da f , 20 0-uJ it flo stotw C BOO CZCC3616 64' Oa ptwiitea 1n w�elcrteni� t}� l f. iAY 4.o�AhlisNun ExV ,r�+ (Notary LIRC) -3- 8/12/2021 i� CAGGPLU-01 BEGELI A�CORO CERTIFICATE OF LIABILITY INSURANCE DATE 5H11202gYY) 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 Ellen Goldman(egoldman@butwin.com) NAME: Nathan Butwin Company,Inc. PHONE 60 Cutter Mill Rd.Ste.414 (A/C,N ,Ext):(516)466-4200 (,9,No):(516)466-4213 Great Neck,NY 11021 6s:info@butwin.Conl INSU 8 AFFORDING COVERAGE NAIL 0 INSURER A:Utica First Insurance Co. 15326 INSURED INSURER B: Cagg Plumbing&Heating,Inc INSURER C: 133 Sagamore Road INSURERD: Tuckahoe,NY 10707 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. IL R TYP ADDL BUBR POLICY EFF POLICY EXP T E OF INSURANCE POLICY NUMBER LIMITS A X COMMERCIAL GENERAL LIABL TY EACH OCCURRENCE $ _ 1,000,000 DAMAGE TO RENTED ART3000255500 5/30/2022 513W2023 CLAIMS-MADE X OCCUR PREMI $ 509000 MEDEXP one $ 1,000 PERSONAL 3 ADV INJURY 1,000,000 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2r000'000 X POLICY 1 JFR LOC PRODUCTS-COMP/OP AGG III 2'000'000 OTHER: III AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO BODILY INJURY(Per person OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident HIRED NON-OWNED OPERTY AMAGE AUTOS ONLY AUTOS ONLY accident UMBRELLA LIAR OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE DED RETENTION$ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN A LITE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $- OFFICER/MEMBEW EXCLUDED? NIA - -- (Mandatory in NH) E.L.DISEASE-EA EMPLOY If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Toolbox Endorsement Included 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 9 Y ACCORDANCE WITH THE POLICY PROVISIONS. 938 King Street 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 NYSIF New York State Insurance Fund PO Box 66699,Albany, NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE 0 0 ^^^^A^ 300572190 CAGG PLUMBING&HEATING INC. 133 SAGAMORE ROAD TUCKAHOE NY 10707 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER CAGG PLUMBING & HEATING INC. VILLAGE OF RYE BROOK 133 SAGAMORE ROAD 938 KING STREET TUCKAHOE NY 10707 RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W2080 814-3 297086 07/24/2022 TO 07/24/2023 5/10/2023 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2080 814-3, 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:I/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 CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. PRESIDENT GARY CAGGIANO CAGG PLUMBING&HEATING INC 1 OF 1 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. BY CAUSING THIS CERTIFICATE TO BE ISSUED TO THE CERTIFICATE HOLDER, THE POLICYHOLDER UNDERTAKES TO PROVIDE THE CERTIFICATE HOLDER 5 CALENDAR DAYS' NOTICE OF ANY CANCELLATION OF THE POLICY. NEW YORK STAT SUR NCE FUND T4 4/ DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 958555663 U-26.3