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HomeMy WebLinkAboutRP23-058PERMIT #/C SECTION TYPE OF WORK JOB LOC ON _ OWNER CONTRACTOR., ,ST. COST s*1 V*400co #� TCO # i 1 / • • �i ♦ • a rcv Irk FEE DATE wSPECTION REC3dRJ2 I DATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING L� RGH PLUMBING GAS 0 SPRINKLER ELECTRIC LOW -VOLT CJ ALARM 0 AS BUILT 0 FINAL OTFi .R APPROVALS ARB BOT P8 ZBA OTHER �yE BR(� . 1913 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 December 11,2023 Douglas Brockman&Jamie Brockman 20 Sleepy Hollow Road Rye Brook,New York 10573 Re: 20 Sleepy Hollow Road, Rye Brook,New York 10573 Parcel ID#: 129.67-1-65 Roof Permit#23-058 issued on 11/21/2023 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 DD BUILD ����T.�MENT For office use only: PERMIT# 3-05e NOV 3 0 2023 VIL OF RYE OK ISSUED:_{/—c�/ VILLAGE OF RYE BROOK 938 KING STRE YE BROOK, Y YORK 10573 DATE: BUILDING DEPARTMENT � 939-06 O, FEE: ,8 //p——PAM AK W.1'y ebrool�:Org APPLICATION FOR CERTIFICATE OF OCCUPANCY9 CERTIFICATE OF COMPLIANCES AND CERTIFICATION OF FINAL COSTS TO BE SUBMITTED ONLY UPON COMPLETION OF ALL WORK, AND PRIOR TO THE FINAL INSPECTION stssarrs+t+++*+++++*+rssssttssrstsrsr+s***s+*+tstsstsrrs*t*+++++*+++**a*ssssssss+srrssssrsrssstsssrsrs♦++rstrssss+*rs*s+*+++* Address: a y S 1 e �''� H e��o�•, Ry Occupancy/Use: QVY t A Parcel ID#: / QL 9/ (0 7 �— iS Zone: X Owner: w ` j IA 'y I e 6 P�v t4 r"q� Address: l Q 0 P.E./R.A. or Contractor: A � Q sy J 7 J "TO-)L Address: U CA V rl/) J L�'I-C I-11 6J V% / Al� Person in responsible charge: V g ti ^�.�1 Address: 2%1 S 1 P P p ) Vo LLB V e4O 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: U l',Li�l lJ 3 U UJI NX) being duly swom,deposes and says that he/she resides at TO J I t c 1 140 U j-, N.4 (Print Name of Applicant) ^ ` J (No-and Street) in �q e 412,0...4 ,in the County of yy�C 1�C^/f_C J/i{ in the State of ,that (City/Town/Village) 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:$ /L, 6 G V , for the construction or alteration of: /L 0 t,F' 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-IO.A.of the Code of the Village of Rye Brook. Sworn to before me this Sworn to before me this day of , 20 day of , 20 Signature of Properly Owner Signature of Applicant QwV M 3 ih A t*)'^ Pr{'\r e of Property Owner Print Name of Applicant fir`--� Notary Public SHARI MELILLO Notary Public Notary Public,State of New York No.01ME6160063 8/1 1202l Qualified in Westchester Coun" Commission Expires January 29,2 QyE BRC�k. cu � 1982 BUILDING DEPARTMENT ❑�BUILDING INSPECTOR D'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 O fc0►, I I oLo DATE: ! ' 2 U L� PERMIT# O 5 ,3 ISSUED: 2 i Z SECT: 2- , 7 BLOCK: LOT: 6-5- 'Rs LOCATION: i\'�A OCCUPANCY: Z ❑ 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 ❑ FINAL PLUMBING ❑ CROSS CONNECTION []� FINAL ❑ OTHER o 00 N � W W a 4-4 W 04 �1 O X E-+ •� R a to u u " O�// w N o 72 H o � a w ° o 00 eon, 1.0 110 s z o w z WzvA °.' Cn W0-4G1 M W c� � o o4 v � z O D A A Ct) v a M� 00 v (�-�/I ,�/ W O V u - C ¢ v w xD ° � " a y UOH ►� Q o v o U � u N z w o IQ z - � BUILDI DEPARTMENT VILLAGE OF RYE BROOK NOV 2 0 2023 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 Nvww.r e ook.4k. y��j� FOR OFFICE USE ONLY: NOV 2 1 2023 Application# Approval Date: Perit# pp Approval Signature: ARCHITECTURAL REVIEW BOARD: Disapproved: : Date: BOT Approval Date: Case# Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Case# Other: /� /\ Application Fee%a/CC, —P-6 Permit Fees:1V�, Q ,6 ROOF PERMIT APPLICATION Application dated: 11-17-2023 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. I. Job Address: 20 Sleepy Hollow Road SBL: 129.67-1-65 Zone: Property Owner: Douglas Brookman Address: 20 Sleepy Hollow Road Phone#: Cell#: 914-433-2549 email: douglas@valuefoodservice.com 2. Applicant: Douglas Brookman Address: 20 Sleepy Hollow Road Phone#: Cell#: 914-433-2549 entail: douglas@valuefoodservice.com 3. Roofing Contractor: A&B Systems Inc. Address: 140 Lauman Lane- Hicksville NY 11801 Phone#: 516-934-0856 Cell#: email: aandbsystemsinc@yahoo.com 4. Job Description,list all Methods&Materials: Remove existing asphalt shingles&replace with new asphalt shingles to match existing style&color per 2020 RCNYS 5. Estimated Cost of Job:$ 10,000 (NOTE:The estimated cost shall include all site improvements,labor,material,scaffolding,fixed equipment,proressional fees,and material and labor which may be donated gratis.) 6. If comer property,indicate street frontage: 7. Construction Type: Wood NYS Construction Class. 5B 8. Number of stories: 2 Height: 20.0' 9. Is garage being re-roofed:No:( )•Yes:(x)Attached No:O•Yes:(x)Number of Cars: 2 10. Is roof peaked,hip,mansard,fiat,etc: Hip&gable 11. Estimated date of completion: 12-8-2023 -I- 10/30/2023 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: Douglas Brookman ,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 Owner 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 1 Sworn to before me this)J day of ,202r2 day of , 20 ;--3 Signature of Property Owner Signature of Applicant Douglas rookman Douglas Brookmap Print Na f Property caner Print Name of App' ant Notait Public Notary Pubfic MICHAEL£$QUIVEL MICHAEL ESQUIVEL Notary Public-State of New York Notary Public-state Of New York NO. 01 ES6442359 NO,OIES6442359 Qualified in Westchester County Qualified in Westchester county My Commission Expires Oct 11, 2026 My Commission Expires Oct 11 2026 10130/2023 ALB SYSTEMS INC. Contract 140 Lauman Lane Date Contract# Hicksville, AT 11801 Phone: (516) 934-0856 11/20/2023 _5777 Fax: (516) 934-0854 Name/Address DOUGLAS BROOKMAN 20 SLEEPY HOLLOW ROAD Rye Brook, NY 10573 Project ROOF REPLACEMENT Description Total We Hereby Propose To Furnish All Labor Necessary To Perform The Following Work At The Below Listed Address: 20 SLEEPY HOLLOW ROAD RYE BROOK,NY 10573 JOB DESCRIPTION: NEW GAF ARCHITECT SHINGLES 10,000.00 BEFORE COMMENCING WORK-WE WILL COVER AND PROTECT AREA RIP DOWN EXISTING ROOF DOWN TO WOOD&CART AWAY REPLACE ANY ROTTED SHEATHING WITH NEW 3/4".4'X 8'PLYWOOD AT A RATE OF$175.00 PER SHEET. ADDITIONAL COST WILL BE ADDED TO INVOICE. INSTALL NEW GAF ARCHITECT HDZ SHINGLES-Roofing Products Timberline®Lifetime Architectural Roofing Shingles-North America's#1 Selling Shingle. Also known as"laminate"shingles, they're made with multiple layers which are fused together,resulting in a rich,multidimensional look. WATER&ICE ON ALL EAVES,PERIMETER,ALONG GUTTERS&UP EAVES - Provides exceptional protection against leaks caused by roof settling and extreme weather. Ideal upgrade at all vulnerable areas including at the eaves in the North. GAF Starter Strip Shingles- Saves time,eliminates waste,and reduces the risk of blow-of..and may even help qualify for upgraded wind warranty coverage." WE WILL SEAL AROUND CHIMNEY AT NO ADDITIONAL COST INSTALL NEW SNOW&COUNTRY Hip&Ridge Cap Shingles-Enhances the beauty and value of your home—while guarding against leaks at the hips and ridges. Install New Roof Vents&Attic Ventilation-Helps remove excess heat and moisture from your attic that can raise your energy bills,cause premature peeling of interior paint and wallpaper,and even affect your health. Total Charges For The Above Work$10,000.00 The Payment Terms Are As Follows: 1/2 Due Upon Contract Signing. $5,000.00 1/3 Due Upon Job Start. $2,500.00 1/3 Due Upon Job Completion. $2,500.00 We Look Forward To Working On This Project With You! Total Page 1 ALB SYSTEMS INC. Contract 140 Lauman Lane Date Contract# Hicksville, NY 11801 Phone: (516) 934-0856 11/20/2023 5777 Fax: (516) 934-0854 Name/Address DOUGLAS BROOKMAN 20 SLEEPY HOLLOW ROAD Rye Brook, NY 10573 Project ROOF REPLACEMENT Description Total Upon Job Completion The Entire Work Area Will Be Thoroughly Cleaned And All Debris Generated Will Be Removed In A Safe And Lawful Manner. Accepted by: Property Owner, Or Duly Authorized Representative, Date: Approved By: Anthony Bouchard, A &B Systems Inc., President, Date: We Look Forward To Working On This Project With You! Total $10,000.00 Page 2 ` se 1U4408rtofo4J Bu ��m aV09NDI1WOtl QA --MM70d /Raia3 to/10Pd,vv; 'vw ry Yq(adNN/ , VIU13+n 1 ! � ! 4 3A79 d3N U T 4J,N0 vAf ssn�osupao ee s�uu wasuoo Ad ; llp[q/3eNo '!V�+4'Ns•r,uK+uarrbeunPJl/9Uf(!( �p .�ap. _-"�a{r�y'�. 0 a�Q�.... 'aBWUI/ (1d �1N4Wquo3 r ON-`q R kv:uqp o Wn''G of o no d 9l soon��u �`Jlt3d lu rt M I a ,rolaiwG4RLFr irg�U6 �P /aee�Y91?@py3 °�,,lwr ecascaiy' eE1r `�^— `� Upe➢/p� •i � L O 4 L C. CV N a� E j � � '✓1 F C �.�r`.�-: 'rid , LQ .I .ruin r' V En f<(0)> v� w Q LLi _E Zr _] — LL] = L �. 0 :I OcnJ U) 3 A-01 CD r _ U p I y V/ 0O \ ' y 4 V 00 E ,n o •,y. �4 � J j C,s ,, v U N N 4 H 0. •. OP ID: TM A�ORD CERTIFICATE OF LIABILITY INSURANCE DATE(M 11/20/20YYY) /2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Ralph Silvers Agency NAME: 315 Walt Whitman Road PHOA/CC,Nt ,-F�631-271-9200 a c.No): Huntington Station,NY 11746 E-MAIL - — — Lon Silvers ADDRESS: PRODUCES as6$Y-1 0lLS�R ro tik -- — — [i3URE1g8)AFFOROIti3 coyEtAgil NAIL A INSURED AVc 9 yst@tns Inc. INSURER A.. Security Ins Co 24082 Lauman Lane Hic INSURERS: National ins.Co. 25498 Hicksville, NY 11801 --- — —_ _ INSURER C:Standard Security Life SM78 INSURER D:Utica National Ins.Co. _ 25976__ 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 SUB POLICY EFF POLICY EXP - LTR TYPE OF INSURANCEINSR WVD POLICY NUMBER MM'DDIYYYV MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1,000,00 A X' COMMERCIAL GENERAL LIABILITY 1BLS(23)64317810 01/19/2023 01/19/2024 PREMISESDANU-GIE To� 3 ocuirrenoe) S 300,000 CLAIMS-MADE FXIOCCUR MED E P(Any arN gtaon) s 15,000 PERSONAL&ADVNAM S 1,000,000 -- ------ GENERAL AGGREGATE $ —2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER:X - - PRODUCTS-COMPAPAGO S 2,000,00 POLICY PRO- LOC S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Era,oddent) $ 100,000 D ANY AUTO IDl1/1UZOx{ 06H� _ - ALLOWNEDAUTOS ODDLY NJJURY(PK -_- BODILY INJURY(PW Wddard) S X SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE S (Pt3tACCIDENT) NON-OWNED AUTOS S S UMBRELLA LIA& X EACH OCCURRENCE S 6,000,00 A X EXCESS LIAR M 1U30(23)64317810 0111ortm 01/18Y202s ------- AGGREGATE t 5,000, DEDUCTIBLE — RETENTION E S WORKERS COMPENSATION X WC STATU- AND EMPLOYERS'LIABILITY 1ToRY LIMA I ER C ANY PROPRIETORtPARTNERIEXECUTIVE Y I N T20221689 01121f2023 011121/2024 E-EApNA�T S 1,000, OFFICER/MEMBER EXCLUDED? N NIA _ (Mandatory In NH) �i E.L.DISEASE-EA�OYE S 1,000,0 If yes,describe under _ DESCRIPTION OF OPERA TIONS below E.1.011SEASE-POLICY LINT I S 1,000,00 B NYS Disability i 16849-000 01/2012023 01/20/2024 I Statute ry DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) The entitles and Individuals listed are hereby collectively named as additonal insured with respects to the foregoing General Liablity,Auto Liability and Wwkers compensation. Douglas Brookman 20 Sleepy Hollow Road Rye Brook,NY 10673 CERTIFICATE HOLDER CANCELLATION RYEBROO 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. Building Department 938 King Street Rye Brook, NY 10573 AUTHORIZED REPRESENTA IVE Lon Silvers — ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD Y RK Workers' CERTIFICATE OF STATE I Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE j Board 1a Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured A&B Systems Inc 516-934-0856 140 Lauman Lane Htcksvllle,NY 11801 1c NYS Unemployment Insurance Employer Registration Number of Insured Work Location of Insured(Only required if coverage is specifically limited to 1 d.Federal Employer identification Number of Insured or Social Security certain locations in New York State,i.e.,a�Nrap-Up Policy) Number 86-1052378 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) National Liability&Fire Ins Co Village of Rye Brook 3b Policy Number of Entity Listed in Box"I a" Building Department T20221689 938 King Street Rye Brook,NY 10573 3c Policy effective period 1/21/23 to 1/21/24 3d.The Proprietor,Partners or Executive Officers are ❑X included.(only check box if all partners/officers included) all excluded or certain partners/officers excluded. This certifies that we insurance carrier indicated above in box"3"insures the business referenced above in box 1 a"for workers' compensation under the New York State Workers'Compensation Law.(To use this form,New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2". The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage Indicated on this Certificate (These notices may be sent by regular mail.)Otherwise.this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent,or until the policy expiration date listed in box"3c",whichever is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend, extend or alter the coverage afforded by the policy listed,nor does it confer any rights or responsibilities beyond those contained in the referenced policy This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect Please Note: Upon cancellation of the workers'compensation policy indicated on this form,if the business continues to be named on a permit,license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers'Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury.I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the Coverage as depicted on this form. Approved by. Ralp Silver Agency (Print name of authorized representative or I�censed agent of insurance camer) Approved by 11/20/23 (Signature) (Date! Title: Representative Telephone Number of authorized representative or licensed agent of insurance carrier: 631-271-9200 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.nygov