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HomeMy WebLinkAboutRP24-012PERMIT # lel SECTION � TYPE OF WORK 10B LOCATION CONTRACTOR EST. COST CO # TCO # O/� DATE; BLOCK LOT o ,lam/ S 7it i� 000 Qe Q 72 ��//ems (9/4v) 6 FEE DATE INSPECTION RECORD I DATE 1 NSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING O RGH PLUMBING GAS C� SPRINKLER ELECTRIC LOW -VOLT O ALARM AS BUILT 0 FINAL t 932 W�/9 OTHER APPROVALS ARB � BOT PB ZBA OTHER DR. p GZu ti 4 (�bf.Vvy 4j+4c W v `C . 193 VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury www.1yebrookny.gov TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE September 23, 2024 Jeanne Keller 15 Parkwood Place Rye Brook,New York 10573 Re: 15 Parkwood Place, Rye Brook,New York 10573 Parcel ID#: 129.67-1-46 Roof Permit#24-012 issued on 4/1/2024 to Re-Roof Existing Building This certifies that the new roof,installed under the above captioned permit has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to BUILD NT For office use only: D LE C IE ME PERMIT# 'q-t��c� VIL OF RYE OK ISSUED: -/-3 y FsEP - 6 2024 938 KING STRE YE BROOK, YoRK 10573 DATE: �- &-a y 9 -0 O�c FEE: � / /Q PAID C` VILLAGE OF RYE BROOK �Jv- 1 l� BUILDING DEPARTMENT- APPLICATI 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 iiki#itittifiiitii##}kttttiiikki}}tiitfikfiiii#iikiiti#itkkiitfii}iitttit##ikkiftttiifitiiiii}}ti}}#}tiitiiitiiittkiktktkkiik Address: 0I c; Lx_ Pye 15 DC4 Occupancy/Use: V_Q 1"' q Parcel ID#: �n C' - L(t%_ Zone: Owner: ;LC L Address: P.E./R.A. or Contractor: D��Ie� T Address: Person in responsible charge: f W1��7 �nN i(Yref Address: 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/Y(O CO-UllUl� F WFSTCHESTER as: being duly sworn deposes and says that he/she resides at q'3� r g Y � P Y (Print Name of Applicant) (No.and Street) in ,?, ,-�--G" f f�� ,in the County of L-W4-�L"4 fU 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:$ f 3y cl CO , for the construction or alteration of: View 2rL �/f?Crc�Ck Lure, ) r' 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 t ode of the Village of Rye Brook. n Sworn to before me this 0 Swom to before me is ! ` day of , 20 a24 day of (�i , 20�4 K / Signldture of Property Owner Signa re of Applicant �.() � �� 7� - Print Name of Property r Print Name of Applicant ME NIA HRABOVSKY NOTARY PUBLIC,STATE OF NEW Nod6lPdVic Registration No. 01 HR6324159 U �c Qualified in Westchester County Commission Expires 05/04/27 8/12/2021 �yE BRC�k cu � 1982 BUILDING DEPARTMENT ❑..,�//BUILDING INSPECTOR 01 SSISTANT 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 : ' fin V. 'tJyZO � �:t .�' DATE: PERMIT# G ? "` -', ISSUED: y-/-Z-5 SECT: BLOCK: LOT: �( LOCATION: 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 ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER _ M y"j Off" Q N a N a a = m ca o H CA P4 a 4-4 0 �--� O _ A v a64 v 0 A o 42 w ai x z 64 ( � L % a O � o � ,o � cn f� 6 -0 a;� O s �.J (174CC `� GJ �j aJ A z tl o �n� s GIN W y fd `0 4.1 O uPLO eq 00 CW C'J Q, aai (� Q C7 v w w d W 0 Q � O rT �! 00 U Z A ain U cn Z bZ08 ,0 -5 V ti .0 Lf3 w o d C7 p c � W c r v �I PLO n - a R ��L'� I1 �� BUILD MENT MAC Z 2fl14 VI E OF RYE OK 938 KING ET RYE BRO NY 10573 VILLAGE OF RYE BROOK_0 BUILDING DEPARTMENT FOR OFFICE USE ONLY- Approval ,Q / Approval Date: P it# / Application# Approval Signature: ARCHITECTURAL REVIEW BOARD: Disapproved: : Date: BOT Approval Date: Case# : Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Case# Other: it Application Fee: Permit Fees:"a C ROOF PERMIT APPLICATION Application dated 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 uilding,as jp�er etailed statement described below. 1. Job Address: l ic- 9 a �L� �� 2_ S`BL: a vl v r Zone: '�5 Property Owner: ��n►Ie ( Address: 1 U✓k�`'�% �] �� Phone#: ("I- IN Jq-C)Q6CI Cell#: email: N f'l 2. Applicant: �� jQ `1 Jf f\ �� Address: ? LtJi f Phone#: ( l'- - _LM -q,')-'l'-/Cell#: 7 email: 3. Roofing Contractor: pA & 91 f, e6 S Address: J �"J 4 A r Phone#: 9/ `f - Cr3 9-4� J Cell#,:: _ email: � 6 L, b2 � /Wq,/. 4. JobDescri tion,list all Methods&Materials: �17i o �LJe is -.S i f'` L-> LqC G A r 5. Estimated Cost of Job: $ 131160 (NOTE:The estimated cost shall include all site improvements,labor,material,scaffolding,fixed equipment,professional fees,and material and labor which may be donated gratis.) b. If corner property,indicate street frontage: 7. Construction Type: NYS Construction Class: 8. Number of stories: Height: 9. Is garage being re-roofed:No:(V�-Yes:( )Attached No:{ )•Yes:( )Number of Cars: 10. Is roof peaked,hip,mansard,flat,etc: (+ilk 11. Estimated date of completion: -1- 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 Og NEW YO UNTY OF WESTCHESTER ) as: - C/,g� ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and further stages that (s)he is the legal owner of the property to which this application pertains, or that (s)he is the C0/1,try*Z>r for the legal owner and is duly authorized to make and file this application. (indicate architec act ,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. r� 9 D Sworn to before me t s cf Sworn to before me this 17 f day of ,2024 day of l f/7 �^ ,20 Sigrlitue of Property Owner Signature of Applicant ��� ��. kc��\-E-;z ���� •-�— ����try Print Name of Property O ner 4Nd ame of Applic Not ublic ublic M��N A HRAsovsKlr INOTARy PUBLIC,STATE of NEWYORK Registration No.01 HR6324159 QU81ifl�d in Westchester County 0rmMission Expires 05J04/27 -2- 1013012023 LICENSE NUMBER "77fE ORIGINAL.. ® Family Owned And Westchester W H23 p O U B LE Connecticut 0668826 8826 Operated Since 1960 All Home Improvements EST. 1960 439 Willett Ave. Port Chester,N.Y. 10573 Tel#(914)937-4279 Fax(914)937-4172 http://www.DoubleRwindows.com Mrs. Keller Mar 22, 2024 15 Parkwood Place Rye Brook, NY 10573 Insurance: All work involved within the following proposal is covered by Workmen's compensation,Public Liability,and Completed Operations Insurance. Roof contract Supply Labor& Material for the following: • Double R to remove the existing roof from the entire house. • Prepare the edge of roof lines with 6 feet of GAF ice/water shield including all valleys. (standard is 3 feet) • Install Rhino pro armor synthetic base sheet on remainder of roof in place of tar paper. • Install all new GAF F- 5 aluminum drip edge around the entire perimeter edge of roof. • Install new GAF Cobra ridge vent if applicable. • Install new GAF Timberline HDZ shingled roofing system in color of your choice. • All roofing will be nailed using 5 to 6 nails per shingle and rated to withstand 130 m.p.h. wind load. • Supply and install new copper flashing on the chimney. • If any additional rotted plywood is found it will be an additional cost. ($130 per sheet) • Supply a container to cart away any job-related debris. Labor and materials $13,960 if Terms: Painting,and windows cleaning to be done by others.Hidden rotten wood not included. Standard industry cash term,one half with the order,balance due upon completion. Terms may be modified to meet special conditions. Past due balances are subject to a monthly service charge of 1 1/2%(18%per annum). If the account becomes delinquent,you agree to pay any legal or collection fees expended by Double"R"arising from collection of the account.Permit&Application fees not included.Due to the fluctuating prices in plywood we reserve the right to adjust price. Double"R"is not responsible for reconnecting existing alarm systems on windows and doors You the owner may cancel this transaction at any time prior to midnight of the third business day. After the date of this transaction,such Cancellation must be made in person,at the offices of community improvements,or in writing postmarked prior to the fourth business day.We accept VISA or Mastercard with a 3%convenience surcharge on total amount being charged.We accept personal or business checks made payable to Double R. Acceptance: The above prices,specifications and conditions are satisfactory and are accepted. Double"R"is authorized to do the work as specified. Contractor Performance Warranty: Double"R"proposes to furnish and install labor and material in accordance with above specifications in order that the above qualifies for the Manufacturer's Long-Term Warranty. In addition,all labor provided by Double"R"is unconditionally wan-anted for a period of Ten years from the date of installation. Approximate Start Date: Approximate Completion Date: Customer: S13,960.00 (Amount) Date: (sales Tax) Double "R": $13,960.00 (Total Amount) Date: $6,980.00 (Deposit) $6,980.00 (Balance Due Upon Completion) Return original contract to Double"R", retain a copy for your records. Visit Our Showroom Located At 439 Willett Avenue Port Chester, N.Y. 10573 T a. a •.y z c Ln al :; NO 0. N •'' p _ O K C14 'I C ► a� W N � O M 7 r.r .. :•rf � p O 0 •.. u G` a L r w w, C� i a co I � o w ,R• •ram W to U U o i G� i•+ J -� w oection Z G 0 E E w G r LU -J J Cl)= 0 0 0 ca OR Q ch Q' w .� o ��/e E V o aQ d > X 4- r JJJ „ o i ¢ A ••T: u L. cM k a� N 6. N N U y U N Ap Y• i y DATE(MMIDD/YYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE 2/20/2024 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 NAME: Belly Reyes The Willett Insurance Agency PHONE 914 481-5599 888 371-9783 g Y A/C.No Ell: A/C,No: 338 Willet Ave ADDRESS: bettyreyes@thewillettinsurance.us INSURER(S)AFFORDING COVERAGE NAIC# Port Chester NY 10573 INSURER A: Westchester Insurance Company INSURED INSURER B USLI Insurance Company Double R PBJ,LLC INSURER C 439 Willett Ave INSURER D: INSURER E: Port Chester, NY 10573-3179 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. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY) (MM/DD/YYYY) LIMITS x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE a OCCUR PREMISES Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 A Y FSF17526960 12/13/2023 12/13/2024 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ❑PRO- JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED $ AUTOS ONLY AUTOS ONLY Per accident x UMBRELLA LIAB MLAIMS-MADE CCUR EACH OCCURRENCE $ 3,000,000 b EXCESS LIAB CUP1572208 03/16/2023 03/16/2024 AGGREGATE $ 3,000,000 DED I I RETENTION$ $ WORKERS COMPENSATION PERAND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE❑ NIA E.L.EACH ACCIDENT $ FFICERIMEMBER EXCLUDED? Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 4es,describe under SCRIPTION 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) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN The Village of Rye Brook ACCORDANCE WITH THE POLICY PROVISIONS. 938 King St AUTHORIZED REPRESENTATIVE 13ef}y R"ej 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 YORWorkers' E Compensation CERTIFICATE OF Bo NYS WORKERS' COMPENSATION INSURANCE COVERAGE ta.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured Double R PBJ,LLC 914 410-7771 439 Willett Ave Port Chester,NY 10573 1c.NYS Unemployment Insurance Employer Registration Number of 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 921106938 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) NYSIF The Village of Rye Brook 938 King St 3b.Policy Number of Entity Listed in Box"l a" Rye Brook.NY 10573 25829110 3c.Policy effective period i 9i9ai9r»,i to R19t9q/9n94 _ 3d.The Proprietor,Partners or Executive Officers are included.(Only check box if all partnerslafficers 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"1a"for workers' compensation under the New York State Workers'Compensation Law.(To use this form,New York(NY)must be listed under ftm 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". Will the carrier notify the certificate holder within 10 days of a policy being cancelled for non-payment of premium or within 30 days if j cancelled for any other reason or if the insured is otherwise eliminated from the coverage indicated on this certificate prior to the end of the policy effective period? ZYES [:]NO 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: Betty Reyes (Print name of authorized representative or licensed agent of insurance tamer) Approved by: (Sigrtatur ) (Date) Title: Insurance Representative Telephone Number of authorized representative or licensed agent of insurance carrier: 914 481-5599 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 (9-15) www.wcb.ny.gov