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HomeMy WebLinkAboutRP23-027TYPE OF WORK CONTRALTO TCO # rem..DATE FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING 0 RGH PLUMBING GAS SPRINKLER ELECTRIC LOW -VOLT O ALARM AS BUILT 71 FINAL INSPECTION REG43Q DATE INSP V OTHER APPROVALS ARB BOT ZBA OTHER QyE l3R ��/ L� . 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 October 5,2023 Robert Langworth&Francesca Langworth 11 Division Street Rye Brook,New York 10573 Re: 11 Division Street, Rye Brook,New York 10573 Parcel ID#: 141.27-1-16 Roof Permit#23-027 issued on 6/13/2023 to Re-Roof Existing Building This certifies that the new roof,installed under the above captioned permit have been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to D DIE u 11 ' ! R For office us onI BUILDh� E�TMFNT PERMIT# -7 "r. �.�. r JUL 2 4 2023 VILLAGE OF RYE$KOOK ISSUED:Lp/�-a 3 38 KING STREQ�,,! YI BROOK, EW YORK 10573 DATE: —a VILLAGE OF RYE BROOK \ 9 -064 � FEE: f/p— PAiDJ� BUILDING DEPARTMENT w '''��� o kor 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 itststsssrt+ttttsstt+tstrttts+wwrtstttsrstttttttssttrttttsttsrwrttttttsts ssrtttttssssstttttttsstttstsasstssttwtssstsa sttrtst Address: 1 ��`)IC lC�t� S l � (�7� , ��1 �os-73 Occupancy/Use: Parcel ID#I:�/'j/li c�7 —J—1 ( (Zone: Owner: ffa0 PS(C ����(�` , Address: r �l\)1��(�\1J� '6 i' - may lc P.E./R.A. or Contractor: J dress: Person in responsible charge:ftalevcjddress: IL o 31 q(r `fit, U"\y I�; Application is hereby made and submitted to the Iuilding Inspector of the Village of Rye Brook for the issuance oaf 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�)(`fbeing duly swom,deposes and says that he/she resides at I��� (Print Name of Appli t) �� (No and Street) in in the County of LI Mai �kf r in the State of �j ' that '(city/Town,Village) �'T— 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:$ 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 day o \�� , 20 day of , 20 Signature of Property Owner Signature of Applicant FA U e - /- J p P m e of Property Owner V Print Name of Applicant Notary ub is Notary Public SHARI MEULLO Notary Public,State of New York No.0jME6160063 y;t 2!2Q2I Qualified In Westchester County Commission Expires January 29,20 BUILDING DEPARTMENT LDING INSPECTOR L3 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 : " ) 1 C DATE: jol� �1M3 1� rERMIT# l�ISSUED: SECT: � � iLOCK: LOT: LOCATION: V w �--�� OCCUPANCY: ? ❑ Violation Noted THE WORK IS... ' YASSED ❑ FAILED 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 ❑ FINAt-PLUMBING ❑ CROSS CONNECTION jT FINAL ❑ OTHER QyE BRC�� O� y� �7 /'• 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 : '�,/ i \ , f�Cc) DATE: t� PERMIT# ISSUED:I %SECT: BLOCK: LOT: LOCATION: 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 ❑ L.P. Gas ❑ FUEL TANK ❑ FIRE SPRINKLER i k 01 C- Q�, ❑ FINAL PLUMBING ❑ CROSS CONNECTION �� ��4���, FINAL ❑ OTHER a t , o v , = M W an �o �o m o a ' � Fy s � � � a M 0 40 © s Of� O 1� � V y � s {Tl r w p � v ° b L a 00 00 h+1 C + a o co 0 r hry V '� H Z U Z M q q V ° u V ~ `a Y �j �I W V o O a� Zvo 00 1✓ W a O wA � t � . r �j R-` � � d c'•' � oZ `� vW � p OG A Qo o t V. o . Z H O d Zo a o VC W W Q >* . 7° q w z d o � .. � 0 BUILD MENT V1 E of RYE OK JUN 12 2013 938 KING ET RvF,BR NY 10573 A � VILLAGE OF RYE BROOK BUILDING DEPARTMENT FOR OFFICE USE ONLY: Approval Date: 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: ermit Fees: J90—bL)E ROOF PERMIT APPLICATION Application dated: O(P1`Z'20L is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit to Re-Roof an Existing Building,as per detailed statement described below. 1. Job Address: 1 ` �U 1 S Girl i�+ �Z Porno , Nil SBL:;�J�1Y, c)7--Il l�p Zone: Property Owner: C aOfff CaAj ( O[fiq Address: t 4 1JIy �S I o CM �y Phone#: J4 Cell#: email: (c� 2. Applicant: 6-Q rl`1((�',sca ( o 09WOr f-n Address: IN DQ (f) Qj���r �Lj Y Phone#: f j_ - ^] Cell#: email: 3. Roofing Contractor:_ C ' f VL Address: FiNHIIIN Non-1,1M (T Phone#: Cell#: email: 4. Job Description,list all Methods&Materials: Q f eci 5. Estimated Cost of Job:$ "I t WO (NOTE: The estimated cost shall include all site improvements,labor,material,scaffiolding,fixed equipment_professional fees,and material and labor which may be donated gratis.) 6. If corner property,indicate street frontage: 7. Construction Type: NYS Construction Class: r S. Number of stories: Height: 9. Is garage being re-roofed:No:( }•Yes:(X)Attached No: Yes:( )Number of Cars: 10. Is roof peaked,hip,mansard,flat,etc: 11. Estimated date of completion: -t- 8/1212021 Please note that this application must include the notarized signature(s) of the legal owner(s) of the above-mentioned property, in the space provided below. Any application not bearing the legal property owner's notarized signature(s) shall be deemed null and void, and will be returned to the applicant. STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: (+V) ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signin s 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 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 (2 Sworn to before me this Z_ day of JU 20_Za day of 20 Signature of Property Owner 0 Sign re�of App ' nt Ram s(%(L LoPq WN"l Pri Name of perty Owner Vint MA,� 1 1kotaV&1tk Nota MARY KATHERINE RIVERA MARY KATHERINE RIVERA NOTARY PUBLIC- CT 169993 NOTARY PUBLIC- CT 169993 FAIRFIELD COUNTY FAIRFIELD COUNTY MY Commission Expires Sept 30,2025 MY Commission Expires Sept 30,2025 811212021 MAGANA Roofing & Siding, LLC 257 Flax Hill Road, Norwalk, CT 06854 (203) 667-4836 Name �'`� C 11 .a n G, w '( Address (� DO I\jy 1 Phone # Work # ITEMS DESCRIPTION PRICE r x�oSc= � V ar rW-,LL Vt 0 — X1sT1 +t1G ,C'vr s1 i97 ► ►vG. 1�%`�� h')EN� RavF vrv,D �,��m�r�'i PMEry 10 gL s#►Nbis TO ALL F �j�2t"�45. rNSTgt t_ (L►Dbcvc'r'/T Ta m�tlfi -)tV 5t n Nc.y �' iNyT�- GOpR`� FG` H NL T p 'c# 1uC 11. 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C N ate"Cl) ;ico>i o z 0,0 ci y+�'♦ s s pf�.���. 61 C/ y U J d� � S•�,• ;Cis_=3 ;.,•.;f I M�'" L�j.ii' Vic: in��h\ +'f","�3fys �:^" rf 7�'����r' _^, -'',�°��i��j� ;tom � r:�����y f:d� � I�Iljl €j! 4f 1 1f 1� IfJ Q 4:��I�j111j��4` p0 2(ty tt��1 Mpg .y.e. ,I����A' ,A�"'iF�r •��,YS�#Ai�47.: ���•.��,^���,i��� ►t �:.77�^�ic �.Ij1� i 34��A��t� SK.�• j€!>iAifSft i�11�1 �H7^��f�:��3 ��: DATE YYY) (MMIDO/Y ACC)RLi CERTIFICATE OF LIABILITY INSURANCE 5(.M/ oly 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 John M. Glover Agency PHONE Sarah G'idoda FAX Insurance Services c N •203-956-2458 ac No:203-857-7848 P.O. Box 700 ADDRESS: sgjidodaj@jmg.com Norwalk CT 06852 INSURERS AFFORDING COVERAGE NAIC0 INSURERA:Atlantic Casuafty Insurance Co 42846 INSURED MAGAR00-01 INSURERS:Arbella Insurance Group 4'1360 257 FlMagaax a Roofing Siding LLC INSURERC:New York State Ins.Fund 402957 Flax Hill Roadd _ Norwalk CT 06854 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:788789170 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. NSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LTR POLICY NUMBER MM/DD MMIDD LIMITS A X COMMERCIAL GENERAL LIABILITY L311000059-1 7/29/2022 7/29/2023 EACH OCCURRENCE $1,000,000 CLAIMS-MADE �OCCUR DAMA E To RENTED PREMISES Ea occurrence $100.000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2.000,000 X POLICY❑JEC LOC PRODUCTS-COMP/OP AGG $1,000,000 OTHER: $ B AUTOMOBILE LIABILITY Ea accidents INGLE LIMIT $1,000,000 ANY AUTO BODILY INJURY(Per person) $ OWNED X SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ I E UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB Id CLAIMS-MADE AGGREGATE $ DIED RETENTION$ $ C WORKERS COMPENSATION VV2575340-1 7/29/2022 7/29/2023 X PER OTH AND EMPLOYERS'LIABILITY Y/N STATUTE ER NY ONLY ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICE R/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1.000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1.000.000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The certificate holder is included as an additional insured under the General Liability policy on a primary and non-contributory basis if required by written contract executed prior to a loss. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN VILLAGE OF RYE BROOK ACCORDANCE WITH THE POLICY PROVISIONS. BUILDING DEPARTMENT 938 KING STREET AUTHORIZED REPRESENTATIVE RYE BROOK. NY 10573 � ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) 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 �- �.— •� ^^^^A^ 453706395 JOHN T OSTHEIMER AGENCY INC C/O JOHM M GLOVER AGENCY �1c PO BOX 700 NORWALK CT 06852 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER MAGANA ROOFING&SIDING LLC VILLAGE OF RYE BROOK (CT LLC) BUILDING DEPARTMENT 257 FLAX HILL RD 938 KING STREET NORWALK CT 06854 RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W2575 340-1 375755 07/29/2022 TO 07/29/2023 5/30/2023 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2575 340-1, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY,INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS://WWW.NYSIF.COM/CERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER THE SOLE PROPRIETOR, PARTNERS AND/OR MEMBERS OF A LIMITED LIABILITY COMPANY. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. BY CAUSING THIS CERTIFICATE TO BE ISSUED TO THE CERTIFICATE HOLDER, THE POLICYHOLDER UNDERTAKES TO PROVIDE THE CERTIFICATE HOLDER 30 CALENDAR DAYS' NOTICE OF ANY CANCELLATION OF THE POLICY. NEW YORK STAT SUR NCE FUND T �V DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 1017735530 U-26.3