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HomeMy WebLinkAboutBP23-187PERMIT # / C) 3 SECTION 135, 75 _ BLOCK_�.��.� IAT TYPE OF WORK JOB LOC Tq ION OWNER CONTRACTOR T. COST TCO # /C P. /�t FEE%X JmI(2 /`U FEE DATE WE a •' � ' FOOTING FOUNDATION FRAMING — RGH FRAMING INSULATION PLUMBING O RGH PLUMBING GAS O SPRINKLER - Ei_F,CTRIC Cl ;_nw-VOLT 0 A , BUILT 0 4 I iNAL 1 — 2I — ZoLI o &0- 30 700- 06 - an)e4/7 d0/72h011a CIP )ajw/9-190 OTHER APPROVALS ARB B07 P8 ZBA OTHER BR � t4(y j'5 y . 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 21,2024 Donald Amell&Kadyn Amell 235 Irenhyl Avenue Rye Brook,New York 10573 Re: 235 Irenhyl Avenue, Rye Brook,New York 10573 Parcel ID#: 135.75-1-45.1 Building Permit#23-187 issued on 11/13/2023 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 l For office u e oul � ) BUILDING DEPARTNII?NT Pcttatrr4 —/Y7 FEB - 7 M4 I VILLAGE OF Rv-L Biiool: fsulm: - 3- 3 l VILLAGE OF stYc BROOK ( 938 KING STREFT, RYE Bkool.,NEW YORK 10573 D,\re: c-7-a BUILDIi` '. (914)939-0668 Fl:t:: PAID .--.-- tcww.r•vchrontc.ur� APPLICATION FOR CERTIFICATE OT OCCUPANCY, CERTIFICATE OF COMPLIANCE, AND CERTIFICATION OF FINAL COSTS TO BE SUBMITTED ONLY UPON COMPLETION OF ALL WORK, AND PRIOR TO THE FINAL INSPECTION Address: 235 Irenhyl Ave., Port Chester , NY 10573 Occupancy/Use: Residential Parcel IF)at:135.75-1-45.1 — --_-_ ut1e: A0-6- Oyvrier: Katlyn & Donald Amell _ Address: 235 Irenhyl Ave., P.E./R.A. or Contractor: Renewal by Andersen Address: 2041 W Main St., Stamford CT 06902 Pelson 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 i Certificate of Compliance for the structure/construction/alteration herein mentioned in accordance xvith law STATE OF NEW YORK, COUNTY OF WESTCHESTER as: Katlyn & Donald Amell 235 Irenhyl Ave., Port Chester,NY 10573 iluh-swots.deposes and says that hersheresides at t h tceser _--- ,� 1n Rye Brook ,in the Cow*of' Wes in the Slate of York .that he/she has supervised the work at the location indiented above,and that the actual total cost of the work.including all site intprovelitents, labor,materials,scaffolding.fixed equipment.proles sio t-1 1)+r. '.111d including the monetary value of any materials and labor which may have been donated gratis teas ` _ 19.1 p/ilIf For the construction or alteration or: Installation of(6 )Replacement Windows into Exisiting Openings with no Structural Alterations. Deponent further states that he/she has examined the approve.]plans of the structureA:ork herein referred to for which a Certificate of Occupancy Compliance is sought,and that to the best of hisiher knowledge and belief.dte structureiwork has been erected/completed in accordance with the approved plans and any amendments thereto except in so far as variations therefore have been legal(}authorized,and as erected-completed complies,with the laws o-erning building COIIS uctiun.Deponent further understands that it shall be unlawtill foran owner to use or pennit the use orally building nr premises or part thereof hereafter created,erected.changed.converted or enlarged,wholly or partly,in its use or structure-until a cti-titicate of Occupancy or C'er►if icate of Compliance shall have been duly issued by the Building Inspector as per§250-10.A.of the Code of ilic i-illa ce of Ric Brook. Sworn to before(lie this ✓�� _ Sworn to before me this day of �'� � • ?0 za day of tltYc-e kf ,It:.,:w: ,mei tiagnatme nl';\phla�ant Katlyn & Donald Amell Franklin Barahona Print'\ me al ropertc th I r 1 1'nm�::une of Applican! ul.an Puhhc f / Vor.:n I'uNffit John C Ginsey ill Gamsey III NOTARY PUBLIC.STATE OF NEW Y RK STATE OF NEW�lOPot Reglatretieort No.07(31180025T2 No.01GA6002572-- QualiBed in Westchester County, Qualifiedestchester County/' Ccmrrussion Expuss April 7,2Q� p res Aprl17,2 �E BRC��, O�` tim c 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 3S 1- N 1-\v e DATE: PERMIT# � Z3 ' ISSUED: //"/3-23 SECT: 196 .7S BLOCK: LOT: XY, LOCATION: le "P L c c-p nA J U!!Al CO yJ S OCCUPANCY: ❑ Violation Noted THE WORK IS... Er PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas c,C� 11J, O <; ► N ;a 2 y n> , ❑ L.P. Gas ❑ FUEL TANK V 1, ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ C�tOSS CONNECTION INAL ❑ OTHER ;i 00 N N r-I N N 'G a, w N lo ., cr A �a g 3 u" V r o A. C b4 CJ a V ca ✓t M � $ D 'u s Fh II O N Q N Q o z �t W 0 a o H • zx � g a - M N cn IOU s Qy ~ O V O "" z .� 9 cd 00 ` co b N rT rr�r w W a A Azov ° O w v W00 zo Uo V � � tj 08 00 M M W a Gi ►� W W z a v o G -o p., F� V j pQ W A t ', - C MCI o o �V zS 'D. En o 961, 4 Rw-i w C7' A z 0 W � xi a rn N z w W o � " a � A z o �I � a a BUILET MENT D V VILYE 6ROOK 938 KINGBROOK,NY 10573 OCT 3 1 2023 0668 ok.or J VILLAGE OF RYE BROOK BUILDING DEPARTMENT FOR OFFICE USE ONLY: Approval Date:�Qu n� it# ���j/� Application# "' " ' \ Approval Signature: ARCHITECTURAL REV BOARD: Disapproved: : Date: BOT Approval Date: Case# Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Ca e# Q Other: 0 Application Fee b Permit Fees:1&360—job EXTERIOR BUILDING PERMIT APPLICATION Application dated: 10/25/2023 is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of Permit for the construction of buildings,structures,additions,alterations or for a change in use,as per detailed statement described below. 1. JobAddress: 235 Irenhyl Ave.,�x�xJp NY 10573 2. Parcel ID#: 135.75-1-45.1 Zone: 3. Proposed Improvement(Describe in detail): Installation of(6 ) Replacement Windows into Existing Opening. No Structural Alterations 4. Property Owner: Amell , Donald &Katlyn Address: 235 Irenhyl Ave.,,e NY 10573 Phone# (607)760-3072 cell# (607)240-8588 e-mail katlyn,amell@gmail.com List All Other Properties Owned in Rye Brook: Applicant: Franklin Barahona / FairChester Custom Windows, LLC Address: 2041 West Main Street Stamford CT 06902 Phone# 203-406-0545 Cell# 203-249-1986 e-mail Permits i RBAWestchester.com Architect: Address: Phone# Cell # e-mail Engineer: Address: Phone# Cell# e-mail General Contractor: FairChester Custom A,indo� s. LLC Address: 2041 West Main Street Stamford CT 06902 Phone# 203-406-0545 Cell# 203-249-1986 e-mail Pzrntits Fi?RBA 'estchester.eom 111 8/122021 5. Occupancy;(I-Fam.,2-Fam.,Commercial..etc...)Pre-construction: 1 '2 Family Post-construction:same 6. Area of lot: Square feet:50 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: Isr fl: 2nd fl: 3rd fl: 10. Total Square Footage of the proposed new construction: 1 l. For additions,total square footage added:Basement: I s`fl: 2'fl: 3rd 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. Number of stories: Overall Height: Median Height: 15. Basement to be full,or partial: finished or unfinished: 16. What material is the exterior finish: I7. 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 (ifyes,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: S (ifyes,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 (ifyes,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 (ifyes, the area of wetland and the wetland buffer cone must be properly depicted on the survev&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 ('ifyes, the area and elevations oftheJlood 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 (ifyes,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 I[: TIER II[: (ifyes,a Horne 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: $ 19,811 ( permit not included ) Note:The estimated cost shall include all site improvements, labor,material,scaffolding,fired equipment,professional fees, including anv material and labor which may be donated gratis.If the final cost exceeds the estimated cost,em additional fee will be required prior to issuance of the C 0. 30. Estimated date of completion: December 2023 (2) an 2ii2m! p E� 0 ��' BUILD ` MENT VIL OF RY OOK OCT 3 1 2023 938 KING E4 RYE QR Y ,NY 10573 VILLAGE OF RYE BROOK 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 Am®II , Donald & Katlyn residing at, 235 Irenhyl Ave., Port Chester, NY 10573 being duly sworn, deposes and states that (s)he is the applicant above named, atxl l"urther states that(s)he is the legal owner of the property to which this Affidavit of Compliance pertains at; 235 Irenhyl Ave., Port Chester, NY 10573 ,Rye Brook, NY. (Job Ac dt, 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. 15i�n�unrc of PrnF7�rn t r4anerl ilr Amell , Donald & Katlyn Wrint Nome 0(1'ruhcr1� Ownerj,0 Sworn to before me this John C OWwS►IN day O�Tb 20 �3 �+-11 t&GIGAIM7nawkwin 8/12I2021 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: FRANKLIN BARAII0NA , 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 CONTRACTOR 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. Tf Sworn to before me this ag Sworn to before me this .2 day of �C �C.�— , 20 a-3 day of I'°Be 20aJ p dip m�l I;Oex� Signature of Prope y Owner Signatur of plicant Amell , Donald & Katlyn Franklin Barahona Print Name ol'Property O"ner Print Name of Applicant C Notary P hi, Notary P blic John C Gamsey III NOTARY PUBLIC,STATE OF NEW YORK "C Gamsey Ill On No.01 GABOD2572 NOTARY PUBLIC.STATE OF NEW YORK q bon No.01 GAGW2572 CIrrM€ed In 1Mpki»Apr 7.2%t_ p In weatchaster Cou Carrrioion€�pNerr ApAI 7,�j COTOM ,E,pir" April 7. I£l) 8/12/2021 +"_ No Agreement Document and Payment Terms ' - DBA:RENEWAL BY ANDERSEN OF WESTCHESTER AND FAIRFIELD COUNTY Katlyn&Donald Amell Legal Name:Fairchester Custom Windows LLC 235 Irenhyl Ave R E N E WA L CT HIC#.0667292,WC-35743-H22,Putnam 451220 Port Chester,NY 10573 brANDERSEN 2041 West Main Street I Stamford,CT 06902 H:(607)760-3072 Phone:203-406-0545 1 Fax:203-406-0828 sales@rbawestchester.com C:(607)240-8588 Katlyn & Donald Amell 10/22/23 BUYER(S)NAME CONTRACT DATE 235 Irenhyl Ave, Port Chester,NY 10573 (607)760-3072 (607)240-8588 BUYER(S)STREET ADDRESS PRIMARY NUMBER SECONDARY NUMBER katl�n.an-eli@gmaiLcom donald.amell@gmaiLcom 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: $20,381 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: $4,076 BALANCE DUE: $16,305 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: $16,305 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 10/25/2023 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 Richard Creiner Katlyn Amell Donald Amell PRINT NAME OF SALES PERSON PRINT NAME PRINT NAME 10/22/23 Page 2/ 31 Order Summary dba:RENEWAL BY ANDERSEN OF WESTCHESTER AND FAIRFIELD Katlyn&Donald Amell COUNTY 235 Irenhyl Ave RENEWAL Legal Name:Fairchester Custom Windows LLC I License#CT HIC#.0667292, Port Chester,NY 10573 byANDERSEN WC-35743-1-122,Putnam#51220 H:(607)760-3072 ���"�a� 2041 West Main Street I Stamford,CT 06902 C(607)240-8588 Phone:203-406-0545 1 Fax:203-406-0828 1 tech@rbawestchester.com JOB 105 Living 96 53 Window: . Gliding, Triple. 1:2:1, Base Frame. Exterior White, Interior White Performance Calculator: , PG Rating: 30 1 DP Rating: + 30 / - 30 Glass: All Sash: High Performance, No Pattern Hardware: . White Screen: , TruScene. Full Screen Grille Style: . No Grille Misc: . None Construction: Interior Stops Only (1), Remove aluminum window (1), Remove Wood Mullion (1). LSWP per Unit (1) Material: . Alex Plus Painter's Caulking (0.25). White Caulking (1), Fibrex Stop White (9138973) (3). Fiberglass Pipe Insulation (0.5) 102 Dining 311, 61" Window: , Double-Hung (DG), 1:1, Flat Sill, Insert Frame, 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: . None Construction: . Remove aluminum window (1), LSWP per Unit (1) Material: . Alex Plus Painter's Caulking (0.25), White Caulking (1), Fiberglass Pipe Insulation (0.5) 103 Dining 31 " 61 " Window: . Double-Hung (DG), 1:1, Flat Sill, Insert Frame, 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: . None Construction: , Remove aluminum window (1), LSWP per Unit (1) Material: . Alex Plus Painter's Caulking (0.25), White Caulking (1). Fiberglass Pipe Insulation (0.5) 101 Dining 31 " 61 " Window: , Double-Hung (DG), 1:1. Flat Sill. Insert Frame, Traditional Checkrail, Exterior White, Interior White Performance Calculator: . PG Rating: 40 1 DP Rating: + 40/ 40 Glass: . All Sash: High Performance. No Pattern Hardware: . 1 0/25/23 Page 2 / 15 Order Summary dba:RENEWAL BY ANDERSEN OF WESTCHESTER AND FAIRFIELD Katlyn&Donald Amell COUNTY 235 Irenhyl Ave RENEWAL Legal Name:Fairchester Custom Windows LLC I License#CT HICM.0667292, Port Chester,NY 10573 byANDERSEN" WC-35743-H22,Putnam#51220 H:(607)760-3072 2041 West Main Street I Stamford,CT 06902 C:(607)240-8588 Phone:203-406-0545 1 Fax:203-406-0828 1 tech@rbawestchester.com White Screen: . Fiberglass. Full Screen Grille Style: . No Grille Misc: , None Construction: . Remove aluminum window (1), LSWP per Unit (1) Material: . Alex Plus Painter's Caulking (0.25). White Caulking (1), Fiberglass Pipe Insulation (0.5) 104 Living 31 " 61 " Window: . Double-Hung (DG), 1:1. Flat Sill. Insert Frame. 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: . None Construction: , Remove aluminum window (1), LSWP per Unit (1) Material: , Alex Plus Painter's Caulking (0.25). White Caulking (1), Fiberglass Pipe Insulation (0.5) 106 Stairs 31 " 61 " Window: . Double-Hung (DG), 1:1. Flat Sill. Insert Frame, 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: . None Construction: , Remove aluminum window (1). LSWP per Unit (1) Material: , Alex Plus Painter's Caulking (0.25). White Caulking (1), Fiberglass Pipe Insulation (0.5) FEE RYE BROOK 0.. 011 Misc: . Misc, Permit Fees, Town of Rye Brook- Estimated 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. Construction: , None Material: . None PRODUCTS: 7 WINDOWS: 6 PATIO DOORS: 0 ENTRY DOORS: 0 SPECIALTY: 0 MISC: 1 Updated 10125123 LSWP REQUIRED Estimated Duration: 1 days 10/25/23 Page 3 / 15 W _ a o o o o o o 1 O V s e� 2 # �.eeeee eeee = eeeeeeeeee eeee v o 's 6 a +e a yS. SS � € E �� 1� w C 3 g 3 0 3 3 A 3 c 3 3 3 s 3 _ 3 _ 3 _ 3 3 `3 3 _ 3 a 3 3 i 3 3 Y 2 s y9yJ i,t U • E " a �2 111 oil O n eeeeeeeee eeeeeeeeee eeoe e _ � � � z ' a o o m o " o m 0 3 o m O o M1 o o m o M e e e e e e e e e e e e e e e e o 0 0 0 0 0 o o oeoe a eoe = = oe e e ee = = eeee ee oe = a C�Stti e� 5 f c � SSG n � � e � � d � � Q tS m U 9p U Y = G! 9G iJ W Y Y U V ?G Y = Y = Y U m 2 x € s� 3 3 As 3 A 3 0 ig If nil aL�H 11 a $j!l o z e3!Hpq 0 iy 3� Z o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 o C C C C G o G E 6 } Q V ��+1 N R F3 O O O O O o 0 0 0 = o 0 0 0 o O o 0 0 0 O G G C G C O C G o i 3 fffe i Ly •u�iQ p } i �l o �00000000ao o000000000 o000000000 g € i fit ia 3 o4 6z H p @ E q, s a �N 262 3 • O `< "' ` �v _ e m� = gym' _ w y �n" R _c W d 0 3 Z ib w4�i��e4p, SO, i Chi - i U U J A LU WW s Z C � zZ Q . W Q � � V z Z Z Q = Q 11 U w _ �� LU VEWA Order Summary dba:RENEWAL.BY ANDERSEN OF WESTCHESTER AND FAIRFIELD Katlyn&Donald Amell COUNTY 235 Irenhyl Ave R E L Legal Name:Fairchester Custom Windows LLC I License#CT HIC#.0667292, Port Chester,NY 10573 byANDERSEN WC-35743-H22,Putnam#51220 H:(607)760-3072 2041 West Main Street I Stamford,CT 06902 C:(607)240-8588 Phone:203-406-0545 1 Fax:203-406-0828 1 tech®rbawestchester.com •• FLOOR UNIT NOTES 1 0 5 96 x 54 101 F E E Renewal by Andersen will faciliate the 102 application of the building permit to the Town of Rye Brook. Homeowner is 103 106 104 105 JOB PHOTOS 10/26/23 Page 5 / 19 Tax Parcel Maps Address: 235 Irenhyl Ave Print Key: 135.75-1-45.1 SBL: 13507500010450010000 1 � N�UTON AVE r —rviAYTJ�00D lCVF ■ Y ;� - - ----- 1RE.NMAVE 1 - qkaN c/k 1 mixing man 03 I o r T Cie.o Disclaimer: This tax parcel map is provided as a public service to Westchester County residents for general information and planning purposes only,and should not be relied upon as a sole informational source.The County of Westchester hereby disclaims any liability from the use of this GIS mapping system by any person or entity.Tax parcel boundaries represent approximate property line location and should NOT be interpreted as or used in lieu of a survey or property boundary description.Property descriptions must be obtained from surveys or deeds.For more information please contact the assessor's office of the municipality. 4- .•K;� I 1 - sir ''. ' ' �•��� ,��, _ •. __ . r .• 1 ,T � 7 'i 5 rrr. �: .: .. ,. ri :w it ■: aN '� %® Ira Aril �� w "� on a ■■ ■� IN a ire No IN ME owl HIM ■ H IOF � Em m ww ii r ■■ ■m no �w �� 1 ■■ ■� ME all Ill ME 0 ME IMEIN go l' .� I■1 ■ - � N� y s a . .C,' , c 1 Y • I - - T �.. s • 1 - - L r< :ram_-'' ���:{'S{�`fi'l''S--• I a t. r`�� . �, Mr 6 y r�dtV � ytPby Eb;i Qa57 _ I. - yalaca'S)Y .. >, c � C O > G N C) - U h ej N c O 0 y D r cC C U V �.r N O J L U Lj �I •' O W N U chi ►� W o p o0 0 Q�o�ection '�! V � �� G C a� cn o W 5 .. to-O � G o n Qr L J a O e'er C v o `` dwl�e o I N Z X W U N u a � U Y. CS f3 � N F ? O Lill J Z v U-) C? `V V y U rr O! = U N G FAIRCUS-01 TBRAND ACORN CERTIFICATE OF LIABILITY INSURANCE F DATE(MMIDDIYYYY) 912912023 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 NAME: MBI Company Group LLC. PHONE _ .......... 280 State Street (AIC,No,Ext):(203)288-3401 ('n/c,No):(203)281-0414 North Haven,CT 06473 E-MAIL ADDRESS theresa.brandon@mbi-ins.com ..._.__.. _. __ _ ..._.... ......__.. _. ._.__...._ _............... _„ ..,.,...._INSURER)S)AFFORDING COVERAGE,,,,.............. _ _ NAIC.0 INSURER A_Seiective_Insurance Company of America_...._. 12572 INSURED INSURER B __._.._—_... ..__ _...... Fairchester ._. Fairchester Custom Windows LLC dba: Renewal by Andersen INSURER c _.._.._.... __...-_...... _...__. -- 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 NOTVVITHSTAN DING 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 LTIR TYPE OF INSURANCE ADDL SUBRI POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY 1,000,000 CLAIMS-MADE X OCCUR EACH OCCURRENCE S X IS 2516791 8/12/2023 8/12/2024 PRMMGE TO RENTED occurrence) $ 500,000 MED EXP(Any oneperson) $ 15,000 , ' PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 1 3,000,000 PEC ❑ GENERALAGGREGATE $ POLICY X J T X LOC PRODUCTS-COMP/OPAGG $ 3,000'000 OTHER. A AUTOMOBILE LIABILITY 1 COMBINED SINGLE LIMIT $ 1,000,000 ANY AUTO S 2516791 8/12/2023 ! 8/12/2024 BODILY INJURY(Pe(personj__f.._....—_._...............___.._.__.. r .. __. OWNED - _- SCHEDULED I"BODILY'-----�-� AUTOS ONLY .._X.... AUTOS _BODILYINJURY(Peraccident $ .............._.___-___. Eg ..ppyyNEp .- X... AUTODS ONLY X. AUOTOS ONLY PRROPERTY pAMAGE X omp Ded$500 X Collision Ded$500 -- Is A I X UMBRELLA LIAB X OCCUR 4,000,000 EACH OCCURRENCE EXCESS LIAB I CLAIMS MADE X S 2516791 8/12/2023 8/12/2024 41000,000 AGGREGATE__ DED X RETENTION S A WORKERS COMPENSATION X PER X OTH- AND EMPLOYERS'LIABILITY Y/N ..SST _.. F.R _ C 9099063 8/12/2023 8/1212024 _E.L..EACHACCIDENi....__ )S ANY PROPRIETOR/PARTNER/EXECUTIVE r�— 500,000 FFICER/MEMggEREXCLUDED? I_N.l NIA Mandatory In NH) -` _E.L.DISEASE EA EMPLOYEE E 500,000 If yes,describe under - -- - DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 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 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 PORK Workers' CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured Fairchester Custom Windows LLC. 203-406-0545 Renewal by Andersen Fairchester 2041 West Main Street 1c.NYS Unemployment Insurance Employer Registration Number of 204 Stamford,CT 06902 Insured Work Location of Insured(Only required if coverage is specifically limited to 1d.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 1a" 938 King Street Rye Brook,NY 10573 WC9099063 3c.Policy effective period 08/12/2023 to 08/12/2024 3d.The Proprietor,Partners or Executive Officers are QX 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"l 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 by: //� U?�r� 09/29/2023 (Signature) (Date) 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