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HomeMy WebLinkAboutRP24-022PERMIT SECTION J� TYPE OF WORK 4 p JOB LOCATION OUP ,zPrsJj) COST FEE FEE$(ASD—Aob TCO # FEE INSPECTION RECORD DATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION DI.UMBING RGH PLUMBING GAS 0 SPRINKLER ELECTRIC 0 LOW -VOLT Q ALARM O AS BUILT FINAL r� d'I.A�eCY OTHER APPROVALS ARB BOT Pe ZBA OTHER �Qyf`BRC�''tA `•O 4.l�Vi`i1. Y W C G4JUJV V 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 June 11,2024 Bran Fern& Claudia Fern 53 Country Ridge Drive Rye Brook,New York 10573 Re: 53 Country Ridge Drive, Rye Brook,New York 10573 Parcel ID#: 129.59-1-11 Roof Permit#24-022 issued on 5/10/2024 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 D E C E � �/ E I BUILDINd`11�P.FI�RTMENT For office use onl PERMIT VILLAGE OF RYE BROOK ISSUED: — o JUN -6 2024 38 KING STREET,RYE BROOK,N'9w YORK 10573 DATE: !a- _ (914)_939-0668 FEE: W /":7-D—PA►D p1 VILLAGE OF RYE BROOK www,ry0bro0lcny.2ov BUILDING DEPARTMENT 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 tf ttttt tfiititffttitttitf tti ttitttfttitiiti tf tttf q♦tiiiffit Litt ttf qif ititt tut#ttttf itfffffit lilt qtf tf tf tttf ff tf itftif itffR Address: Occupancy/Use: r-C-)I cb✓'h Parcel ID#: Zone: Owner: C I oik 01 A '( 41 a n �'t `�Y-) Address: S-�? Cu l n , iz P.E./R.A. or Contractor: kA- u4, tkt Address: ���%r,Qt;�.�uP ���CC1`s '�j 7 Person in responsible charge: 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 YORK,COUNTY OF WESTCHESTER as: �lA A 1�0 being duly sworn,deposes and says that he/she resides at (Print Name of Applicant) `I - �- (No.and Street) in �m '' 1�rL�� ,in the County of � ! 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:$ , for the construction or alteration of i�)e W (Le-c 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§250-1 O.A.of the Code of the Village of Rye Brook. Sworn to before me this Sworn to before me this day of , 20�!`1 day of , 20 Sigirfiture of Property Owner Signature of Applicant ,t Name of Property Owner Print Name of Applicant gatavyffiJ� blic SHARI MELILLO Notary Public Notary Public,State of New York No.01ME6160063 Qualified In Westchester County Commission Expires January 29,202-7 �yE aRO '9a2 BUILDING DEPARTMENT ❑BALDING 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 : Ou Q DATE: 17 C OZ PERMIT# J�1 O Z Z ISSUED: /D"Z SECT: 12Y,J f BLOCK: LOT: LOCATION: 0.7� OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... 0 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 r ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION FINAL OTHER 1c - N r14 C (V Cm 1 N \ W '9 i N � O c. 6,a s n x a 1dO z A Q1 a y y ai a OL H \ 0i ai O W o A s w o Q o H $ � vp• 2 W 1? -2 H 1 H B ca p Q cL a = Ln C%41 _ co 00 O L � Li 0 v 120 00 y w U s -{ z W O o �+I *04 � c, Q W c� w � ' W �W 0 v� � v � a " z mot' y b Q u A z � O 0 A C4 w zao � V a a� a00cn Oo I d 0 �. w z x a wA v � a. � 2y w 'n w tY, 6H U z of G A. b� q i C4 U v� o td 'so o z z � Q In c7 Q c d G c w w � 9 � vv - � a w � � � _ _ R Bum MENT V E OF Rv_" OK MAY - 8 2024 938 KING STREET RYE BR NY NY 10573 VILLAGE OF RYE BROOK (914)939-0668 BUILDING DEPARTMENT FOR OFFICE. USE ONLY: MAY 10 2024 Approval Date: er i ' u �; 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: 00-P� Permit Fees:4.r�W>W b 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 ruilding,as per detailed statement described below. 1. Job Address: 5� Gf.�b�+✓`1 }� ►rlU�- SBL:/� /i J�9 ` / Zone: ;e_/�i Property Owner: �. d lGl ��ri '` <-✓✓'v Address: � C k kq c£ e 1"I U-c— Phone#: 9 1-�-q`I I-')Cow Cell#: IrT K 3-'-s-S73 I email: dns@ y+1oc f,co", 2. Applicant: Address: S 3 CCxt v,+ -.I dC� rr✓ .- Phone#: 11 -��{ I -?>�o� Cell#: email:-6?U V-KsVG;"AQ+'t Cow.., 3. Roofing Contractor: R ` }}t rt'i e (►yl Ip ras p y►ti(�K t Address: d B✓ J ' 0 1 D Phone ON -376-S�ce-( Cell#:q19 - Zq l la _-email:�o�ow�I+✓Z e.n e T 4. Job Description,list all Methods& Materials: ve Gyl d Lk_ le)G'5-h IqF., ra S/71h I F i I noq j 1 1 G � Li 44f kt er rakd io III vaf l 5 ,ns b c tit, 1 5. Estimated Cost of Job: S > > ! 1 y (No I F: Hie estimated cost shall include all site imprmernuu . .- ,..,ifoldine. IIvell e(Iuipment.professional tees, and material and labor vehich inay be donated gratis.) 6. If corner property,indicate street frontage: 7. Construction Type: NYS Construction Class: S. Number of stories: 7, Height: 9. Is garage being re-roofed:No:O•Yes:(v)"Attached No:( )•Yes:VNumber of Cars: Z 14. Is roof peaked,hip,mansard,flat,etc: o Led 11. Estimated date of completion: �d��/S 4 -�' S 16yf fe- -t- 10(30l2023 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. ST TE OF NEW Y COUNTY OF WESTCHESTER ) as: )6 t,.I l� r r�i - ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and finther sta es 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 irchitcct,eo tor,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 t'_�-7 Sworn to before me this day of ,24 c day of 24 1 ignature of Property bwner Signature of Applicant CXI ckck � Name of Pro Owner Print Name of Applicant Notary Public Notary Public .'AUL F. GENEROSA Notary public, State of Ne ,York f�egisti tion rOtt 1=6315 91 clffafified In Nassau county Commission Expires Nov.24,20 -'- 10/30/2023 A & J Home Improvement Group Date: 4/8/2024 2 Rider Avenue Phone: Yonkers, NY 10710-2730 Cell: (917)941-3008 Tel. (914) 376-5864 Email: claudiafemlCdlgmail_com Cell. (914)424-8616 bcfem0aol.com E-mail:joey1225@optonline_net 'TJ Mrs. Claudia Fern S f'T 53 Country Ridge Dr 10M Rye Brook, NY E WORK QUOTATION Exterior Work: Roof- -remove existing roof shingles -install ice and water shield on first layer of the shingles and all vallc s - install black rolls paper under the shingles - install architectural roof shingles on entire roof - install roof caps on all pcaks Labor: $6,800.00 Material: $7,650.00 Garbage removal: $1,500.00 Total Labor& Material: $15,950.00 Not Included: re lace any rotten wood discovered after roof removal Any extra work$45/hr+material. A & J Home Improvement Group, LLC by: Joe Sipior, Managing Member Page 1 of 2 -^ n St` _ ,tn�r ?y-�n AC. 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IWITI ll/41111. r.. �sF li'11/11}III. .'s.1•.W, 111'}•y 9aa^o'7'7� .P 1�1 f�• J• 1. .; ; s ( i9)D' S1 1 I/11j1� =' fPF''1 1 eee 1 j *d �Pgtpg�t gg 1. � ;i r- !Qr r p?� nit,.; :g ;', , r ,.1 •) 1'1Nt 7t"4�A 4F.1/tt�!♦♦ ti'tH. !!ANC.,,4f eeeee.th�l� , A ""!!i I�O t nF2! !6'TA�BID ;�n llleIY S rt 0 �t'7 !40`� �IAy1h�.+' it o .� tr ! }oli•t t �,'iy ti1. ,�7 " , st:..`'r yr�,y,•,!�11. ytf� iN; r rtC��l}!t'' �'d1S�111'.'i'� rq 0vl rlaj t'f• �e AC"R"® DATE(MM/ Y) CERTIFICATE OF LIABILITY INSURANCE os/o3/20242024 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 Shaindy Brown NAME: JNL Insurance PHONE (gq5)782-3580 FAX (845)783-1713 AIC No Ext: A/C,No): 491 State Rte 208 E-MAIL Shaindy@1nllnsurance.com ADDRESS: Suite 420 INSURER(S)AFFORDING COVERAGE NAIC# Monroe NY 10950 INSURER A: Utica First Insurance Co. 15326 INSURED INSURER B: New South Insurance CO 12130 A&J Home Improvement Group LLC INSURER C: Hartford Property&Casualty 34690 2 Rider Ave INSURER D: Standard Security Life Ins.CO INSURER E Yonkers NY 10710 INSURER F COVERAGES CERTIFICATE NUMBER: CL2441812389 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 AUUL bUtSK POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYV MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ❑x_ OCCUR DAMAGE N SO,000 PREMISES Ea occurrence $ IVIED EXP(Any one person) $ 10,000 A ART3000306180 06/11/2023 06/11/2024 PERSONAL&ADV INJURY $ 1.000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY 7PRO- JECT 7 LOC PRODUCTS-COMP/OPAGG $ 2A00,000 OTHER Employee Benefits $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person) $ 100.000 B OWNED SCHEDULED 2003270750 08/17/2023 08/17/2024 BODILY INJURY(Per accident) s 300,000 AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ 50,000 AUTOS ONLY AUTOS ONLY Per accident RWLAF $ UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER C ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA 16WECAN9JCU 11/28/2023 11/28/2024 EL.EACHACCIDENT $ 100,000 OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ D R06508-000 12/28/2023 12/28/2024 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate holder and Village of Rye Brook 938 King St,Rye Brook,NY 10573 are included as additional insured CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Village of Rye THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Brook ACCORDANCE WITH THE POLICY PROVISIONS. 938 King St Rye Brook, NY AUTHORIZED REPRESENTATIVE 10573 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD STATE OF NEW YORK WORKERS' COMPENSATION BOARD CERTIFICATE OF NYS WORKERS' COMPENSATION INSURANCE COVERAGE Ia.Legal Name&Address of Insured(Use street address only) lb. Business Telephone Number of Insured A&J Home Improvement Group LLC lc.NYS Unemployment insurance Employer 2 Rider Ave Registration Number of Insured Yonkers NY 10710 Work Location of Insured(Only required ifcoverage is specifically Id. Federal Employer Identification Number ofInsured limited to certain locations in New York State, i.e., a Wrap-Up or Social Security Number Policy) 202500858 2.Name and Address of the Entity Requesting Proof of 3a. Name of Insurance Carrier Coverage(Entity Being Listed as the Certificate Holder) Hartford Insurance Group Village of Rye Brook 3b.Policy Number of entity listed in box"la" 938 King St Rye Brook, NY 10573 16WECAN9JCU 3c. Policy effective period 11/28/2023 to 11/28/2024 3d. The Proprietor,Partners or Executive Officers are ❑ 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 "T' 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 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"T'. The Insurance Carrier ivill also notify the above certificate holder within 10 days IFa policy is canceled due to nonpayment ofpremiums 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. Please Note: Upon the 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: Joel Loeb (Print name of authorized representative or licensed agent of insurance carrier) Approved by: 05/03/2024 (Signature) (Date) Title: Insurance Agent Telephone Number of authorized representative or licensed agent of insurance carrier: 845-782-3580 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(9-07) www.wcb.state.ny.us