Loading...
HomeMy WebLinkAboutBP24-152PERMIT SECTION TYPE OF WORK JOB LOCA�TIO%� 3 OWNER 770/1 Sl COSTS vO # TCO # DATE:7v /� ®(P: %L/o/qz)S S e Qeee/! 4u1,e,o�ow s 041( Q ow Qr� q /�C9/#) 93 7-oY 7 9 FEE FEE DATE - JNSPECTION RECORD I DATE I NSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING O RGH PLUMBING GAS 0 SPRINKLER ELECTRIC CJ LOW -VOLT (� ALARM C� AS QUILT - FINAL OTHER APPROVALS ARB BOT PB �ZBA OTHER i VILLAGE OF RYE BROOK MAYOR 938 King Street,Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A.Klein (914)939-0668 Christopher J.Bradbury www.ryebrookny.gov TRUSTEES BUILDING &FIRE INSPECTOR Susan R.Epstein Steven E.Fews David M.Heiser Donald T.Krom,Jr. Salvatore W.Morlino CERTIFICATE OF COMPLIANCE May 14,2025 Benjamin Crasper&Marisa Crasper 3 Meadowlark Road Rye Brook,New York 10573 Re: 3 Meadowlark Road,Rye Brook,New York 10573 Parcel ID#: 129.83-1-10 Building Permit#24-152 issued on 7/10/2024 for Replacement Windows This certifies that the thirteen new windows,installed under the above captioned permit have been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to �U/ � For office use onIN,: BUILDING DEPARTMENT PERMIT# 5 APR 15 2025 VILLAGE OF RYE BROOK ISSUED: '7—/Orc7 938 KING STREET,RYE BROOK,NEW YORK 10573 DATE: -75—a VILLAGE OF'RYE BROOK (914)_93%.0668 FEE: PAID BUILDING DEPARTMENT wiy A'•ryebrookny.Qo-*, 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 YlYi1i11YiiilYlli,YlYiiYlYlYiiYi1Y1111iii/11YiitY1Y1YYYYYY 1iYYYiYYYYYi YYliii1Yi111111Y11iYiY• Address: � t' Occupancy/Use: t Parcel ID#: ?t I t .� I — 1 Zone: Owner: /�,��c1( ije CtGIS �U� Address: 3 /IAG& uc � w - 9uq ) P.E./R.A. or Contractor: ,���l� Address: `{S w ,d c 4-+ AV-_ j:�)j(t (- J*u Person in responsible charge: _��b�.�+' �I��t k.c ,0X>r Address: q3(` U t I I e 4 -" 1✓ - 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: 2 j� being duly swum,deposes and says that he/she resides at (Print Name ofApplicarit) (No.and Street) � r in `ilLc 1 u )L in the County of W-C S �'L, `�S —in the State of ,that (City/Town.'Village) he/site 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:S for the construction or alteration of: A�w 1 •i i. a Deponent further states that he/site 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 ,f �� Sworn to before me this r` day of { , 20 a day of ' 20 Signa we of Property Owner Signature of Applicant %Prin 'ame of Property Ow er Print Name of Applicant �/ ' MELANIA HRABOVSKY U Notary lic / ?NOTARY PUBLIC,STATE OF NEW Y Registration No.01 HR6324159 TPublt` Qualified in Westchester County Commission Expires 05/04/27 �E BRC��, 1982 BUILDING DEPARTMENT ❑BBU''ILDING INSPECTOR O'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 : _) / '/FU ��C21_) � C..h IL DATE: PERMIT# 1>� d� / '�S Z ISSUED: SECT: _ BLOCK:_LOT:w LOCATION: V V I rj 0 L'IS OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... El' 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 ,Q ' FINAL ❑ OTHER I I Ah N hOtAIS �- NAc� a4 s , _ r N • Le) N ocq '" E t v o e e ^ PC a � sa e v W tn � CA ° Q Q a rA~ W 7 y ~ ■ f 0 o Z a� d M , Z $ a O Z W w a o Ln c o mO ~ O gi y 1� W .nl O W N a a+ �` w 44 3U v Cc: 44 40-4 ■""+ W w en C 0 Q v ` m w [ ] _ O W O z '� Z O O aCi Z �--i U Z a oto CZ s rF+�i U i ~ �it W � C) oc: A x E -0 � c 00 Cd r�G � � � � ? i a x Z Z fl `° QO o z j.4 ° vow a - A U d v Vim' o 1--rl W F ZO Z , M 4 U ° S o u 0 Z O aun a c' o z w w ad - 1 M w z oq � o � PO4 ax u -4) - BUInRR ENT VuOx )UL - 8 2024 938 KINGNY 10573 VILLAGE OF RYE BROOK v BUILDING DEPARTMENT ADMINISTRATIVE EXTERIOR BUILDING PERMIT APPLICATION FOR EXTERIOR WORK WHICH DOES NOT REQUIRE VILLAGE ARCHITECTURAL REVIEW BOARD APPROVAL FOR OFFICE USE O O g ; �p ,I ,/'�� ,[� APPROVAL DATE: I #:!� �_ C/6PLICATION FEE �(J��l APPROVAL SIGNATURE: PERMIT FEES: —l".)C1 H.O.A.APPROVAL: DATE: DISAPPROVED: OTHER: Application dated: ���r d / is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the construction of buildings,structures,additions,alterations or for a change in use,as per detailed statement described below. 1. Job Address: MC�J kf l< RUC (z e_ Jr(Z c) 2. Parcel ID#: '�J ` -1 () (, II Zone: S JJ 3. Proposed Improvement(Describe in detail): 5 f 6t L ns I d? f� �c, 1 '- Vl W i v W a✓ °Adt c W�' yar (�"!i d �'i,C Oe4y-uo--� 'a - t,o i 6,A - I /M,04C,-b a f-1 /1A4j+-cam 4. Property Owner: r i So, C CD's I tY It Address:-5 Al ,vt.j q(Ar K t:_C, Phone# 1 L-j - '(;0 I Cell# e-mail List All Other Properties Owned in Rye Brook: Applicant: 01 " �I C fJ ,,J Address: 3 C (-}-1�e I��t`r'i ✓ ' /� c� ( / v �� Phone# Gi - _f / "1 Cell# e-mail !�I lS U J'OLl61 �glnq l Architect: �r1 Address: Phone# Cell# e-mail Engineer: Address: Phone# Cell# e-mail General Contractor: 06 L�}f Address: `l C LJ �' a r�_ L 53 Phone# (� �� / ` Cell# e-mail cn 6/l/2a24 5. Occupancy;(1-Fam.,2-Fam.,Commercial.,etc...)Pre-construction: ffJ?"N I Post-construction: 6. Area of lot: Square feet: g 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 comer lot,which street does it front on: 9. Area of proposed building in square feet: Basement: I"fl: 2n'd fl. 3'd fl: 10. Total Square Footage of the proposed new construction: 11. For additions,total square footage added:Basement: 11,fl: 2"d fl: 3`d 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. Construction Type&Location:O Typical Western Lumber Frame;O Timber Frame[TC];O Wood Truss[TT]; O Pre-engineered wood[PW];Located;O Floor Framing[F];O Roof Framing[R];O Floor&Roof Framing[FR];Other: 15. Number of stories: Overall Height: Median Height: 16. Basement to be full,or partial: finished or unfinished: 17. What material is the exterior finish: 18. Roof style:peaked,hip,mansard,shed,etc: Roofing material: 19. What system of heating: 20. If private sewage disposal is necessary,approval by the Westchester County Health Department must be submitted with this application. 21. Will the proposed project require the installation of a new,or an extension/modification to an existing autom c fire o:suppression system?(Fire Sprinkler,ANSL System,FM-200 System,Type I Hood,etc...)Yes: N (if yes,applicant must submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans) 22, Will the proposed project disturb 400 sq. ft.or more of land,or create 400 sq.ft.or more ofiimpervious verage requiring a Stormwater Management Control Permit as per§217 of Village Code? Yes: No: V Area: 23. Will the proposed project require a Site Plan Review by the Village Planning Board as per§209 of Village Code? Yes: No: (if yes,applicant must submit a Site Plan Application,&provide detailed drawings) 24. Will the proposed project require a Steep Slopes Permit as per§213 of Village Code Yes: No: (if yes,you must submit a Site Plan Application,&provide a detailed topographical survey) 25, Is the lot located within 100 ft.of a Wetland as per§245 of Village Code? Yes: No: (if yes, the area of wetland and the wetland buffer zone must be properly depicted on the survey&site plan) / 26. Is the lot or any portion thereof located in a Flood Plane as per the FIRM Map dated 9/28/07? Yes: No: V/ (if yes, the area and elevations of the flood plane must be properly depicted on the survey&site plan) / 27. Will the proposed project require a Tree Removal Permit as per§235 of Village Code?Yes: No: 1 (if yes,applicant must submit a Tree Removal Permit Application) 28. Does the proposed project involve a Home-Occupation as per§250-38 of Village Code? Yes: No: A.Z Indicate:TIER I: TIER II: TIER III: (if yes,a Home Occupation Permit Application is required) 29. What is the total estimated cost of construction: $ 1 d� Note:estimated cost shall include all site improvements, labor,material,scaffolding,fixed equipment,professional fees, including any material and labor which may be donated gratis.If the final cost exceeds the estimated cost,an additional fee will be required prior to issuance of the CIO. 30. Estimated date of completion: (2) 6/1/2024 -Ir BUILDIBR ENT T!ZIR VIL E OK �}938 KING ETNY 10573 l�(w w, v VILLAGE OF RYE BROOK BUI DING 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: I, J� ek(,''Si,. Cat S ,residing at, � �/t'fextsc)L J Q( < hd(Ak (Print name) I (Address where you live) being duly sworn, deposes and states that(s)he is the applicant above named, and further states that(s)he is the legal owner of the property to which this Affidavit of Compliance pertains at; 11 3 fit'-")a( K 1�6 ,Rye Brook,NY. (Job Address) 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. {Signature of Property Owner(s)) (-L56\ 4.11�y (Print Name of Property Owne (s)) Sworn to before me this 0 MELANIA HRAE30VSKY dayOf I� . 20� +NOTARY PUBLIC,STATE OF NEW YORK Registration No,01 HR6324159 Jb d'4' Qualified in Westchester County Commission Explres 05/04/27 ublic I —.------- ___ (3) 01/2024 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. ***********************************************************************WWWWWWW*WWWWWWWWWW*WWW************* STATE OF NEW YO} COUNTY OF WESTCHESTER ) as: �'z1 (��<, 1 }t 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 o/''h L�_C for the legal owner and is duly authorized to make and file this application. (indicate archite (contractor gent,attorney,etc.) That all statements con coed 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 iA Sworn to before me this Sworn to before me this day of day of ��'�-�� , 2{� Signature of Property Owner Signature of Applicant OcAlitl, Print Name of Property O er Print Name of Applicant No ub is otary ublic mt:LANIA HRABOVSKY NOTARY PUBLIC,STATE OF N1 ,YORK Registration No.01 HR6324159 Qualified in Westchester County COP Misslhn Expires 05/04/27 (4) 6/I/2d24 LICENSE NUMBER 1 "THE ORIGIAIA IDFamily Owned And Westchester WC36200H23 D O���� Connecticut 0668826 Operated Since 1960 14/I Honle h7Z yements —- EST. 1960 *0 439 Willett Ave. Port Chester, N.Y.10573 Tel##(914) 937-4279 Fax(914) 937-4172 http://www.DoubleRwindows.com Marisa Crasper June 28,2024 3 Meadowlark Road Rye Brook itiY 10573 914-450-9802 Insurance: All%wrk unolved within the follocring proposal is covered by Workmen's compensation,Public Liability,and Completed Operations Insurance. Harvey Elite Classic windows contract Labor and material for the following: • Double R to supply and install new Harvey Elite Classic windows. • There are 10 double hung windows and 1 window that is a triple unit mulled with picture window in the center and double hung on sides. The double hung windows have top and bottom operable sashes that tilt in for easy cleaning. • Windows are white interiorlexterior. come with half screens, and made with low E. Argon filled gas for energy efficiency. No grids. Exterior trim to be replaced at time of installation. • Areas of installation are as follows: -Bedroom 1: 2 DH windows $1,358 -Bedroom 2: 2 DH windows $1,358 -Hall Bath: 1 DH window $679 -Master Bath:' -�DH window $679 -Master bedroom: 3 DH window $2,037 -Living Room: DH window $679 -1 picture window center $2,416 • We will cart away any job-related debris. Labor and materials $9,200 -950.00 discount = 8 250 total Term.: Painting,and windows clean ing to be done by others.I Iidden rotten wood not included Standard industry cash term,one half with the order,balance due upon completion Terms may be modif ied to meet special conditions. Past due balances are subject to a monthly service charge of I II2%(18%per annum). If the account becomes delinquent.%Nc agree to pay any legal or collection fees expended by Double-i,"arising from collection of the account Permit&Application fees not included Due to the tluctuaung 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 owier may cancel this transaction at any time prior to imdnight of flu third busutess 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 Ibunh business day.We accept VISA or Mastercard with a 3.5%convenience surcharge on total amount being charged.We accept personal and business checks made payable to Double R. Acceptance: The above prices,specifications and conditions are satislactory and are accepted. Double"R"is authorized to do the work as specified. (_nnirrctor I'crformattce W.irranty: Double-it"proposes to fumish and install labor and material in accordance with above specifications in order that the above qualities for the Manufacturer's Long-Tcrm Warranty In addition,all labor provided by Double"R"is unconditionally warranted for a period of Tevo years from the date of installation Approximate Start Dale: Approximate Completion Date: Customer. S8,250.00 (Amount) Date: % (Sales Tut)0 Double "R": S8,250.00 (Total Aniount) Date: S4,125.00 (Deposit) S4,125.00 (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 L A N S I N G Manufacturing ACKNOWLEDGEMENT BUILDING PRODUCTS www.lansingbp.com Distributor Quote Summary BILL TO: SHIP TO: Lansing Building Products LANSING NORWALK/DOUBLE R BPBJ LANSING NORWALK CT Missing Value 260 DR MARTIN LUTHER KING JR DR RICHMOND,VA 23230-0000 NORWALK,CT 06854-0000 Phone: (804)266-8893 Fax: (804)261 -6743 Phone: (203)831 -0977 Fax: QUOTE NBR CUST NBR CUSTOMER PO CREATED ORDERED JORDERTYPE 5902774 1144009 210880299159 6/28/2024 Quote Only Charge ORDERED BY STATUS SHIP VIA JOB NAME 130B None Whse Delivery MARISSA CRASPER CLERK MESSAGE JAM-Jose Mendieta LINE# DESCRIPTION OTY UNIT PRICE EXTENDED 10000-1 Classic DH,Unit Size 27.75 x 37.5,RO 28 x 38 3 Unit 1:U-Factor=0.25,SHGC=0.47,VT=0.58,HII-M-48-00318- 00001,Size Options=Custom Size,Replacement,Fully Welded i Frame Width(Inches)=27.75,Frame Height(Inches)=37.5 I _ Double Glazed,Double Low-E 180 RS,Argon Filled,DSB,Tempered T ENERGY STAR®Performance Packages=SunGain PLUS(Northern), A Performance Package=SunGain PLUS,Overall DP Rating=DP40 Unit Color=White Program=None,Label Name=Harvey,Lock Option=Single,Lift Rail I T Options=None/Standard,Sash Limit Devices=Night Latch j --- Half Screen,Fiberglass Mesh Ro 7ia• Head Expander,Foam Wrap(Pre-Applied)=No Room Location: BATHS Overall Frame Width(Inches)=27.75,Overall Frame Height(Inches)_ 37.5,Overall Rough Opening Width(Inches)=28,Overall Rough Opening Height(Inches)=38 Clear Opening Width=22.75,Clear Opening Height= 13.625,Clear Opening Square Footage=2.15 E.Star Zone:North=Yes RoughOpening::Head Offset=0.5,RoughOpening::Sill Offset=0.5, RoughOpening::Left Offset=0.5,RoughOpening::Right Offset=0.5, FrameSize::Head Offset=0,FrameSize::Sill Offset=0,FrameSize::Left Offset=0,FrameSize::Right Offset=0 Last Updated:6/28/2024 7:27 PM UTC Page: 1 / 3 Printed:6/28/2024 7:29 PM UTC QUOTE NBR CUST NBR CUSTOMER PO CREATED ORDERED ORDER TYPE 5902774 1144009 210880299159 6/28/2024 1 Quote Only Charge ORDERED BY STATUS SHIP VIA JOB NAME BOB None Whse Delivery MARISSA CRASPER CLERK MESSAGE JAM-Jose Mendieta LINE# DESCRIPTION OTY UNIT PRICE EXTENDED 11000-1 Classic DH,Unit Size 35.75 x 49.5,RO 36 x 50 7 Unit 1:U-Factor=0.25,SHGC=0.48,VT=0.59,HII-M-48-00146- 00001,Size Options=Custom Size,Replacement,Fully Welded Frame Width(Inches)=35.75,Frame Height(Inches)=49.5 Double Glazed,Double Low-E 180 RS,Argon Filled ENERGY STAR®Performance Packages=SunGain PLUS(Northern), N Performance Package=SunGain PLUS,Overall DP Rating=DP40 Unit Color=White Program=None,Label Name=Harvey,Lock Option=Double,Lift Rail Options=None/Standard,Sash Limit Devices=Night Latch Half Screen,Fiberglass Mesh Ro-3r Head Expander,Foam Wrap(Pre-Applied)=No Room Location: BEDROOMS Overall Frame Width(Inches)=35.75,Overall Frame Height(Inches)_ 49.5,Overall Rough Opening Width(Inches)=36,Overall Rough Opening Height(Inches)=50 Clear Opening Width=30.75,Clear Opening Height= 19.625,Clear Opening Square Footage=4.19 E.Star Zone:North=Yes RoughOpening::Head Offset=0.5,RoughOpening::Sill Offset=0.5, RoughOpening::Left Offset=0.5,RoughOpening::Right Offset=0.5, FrameSize::Head Offset=0,FrameSize::Sill Offset=0,FrameSize::Left Offset=0,FrameSize::Right Offset=0 LINE# DESCRIPTION OTY UNIT PRICE EXTENDED 12000-1 Classic DH,Unit Size 29.75 x 49.5,RO 30 x 50 2 Unit 1:U-Factor=0.25,SHGC=0.48,VT=0.59,HII-M-48-00146- 00001,Size Options=Custom Size,Replacement,Fully Welded Frame Width(Inches)=29.75,Frame Height(Inches)=49.5 Double Glazed,Double Low-E 180 RS,Argon Filled ENERGY STAR®Performance Packages=SunGain PLUS(Northern), Performance Package=SunGain PLUS,Overall DP Rating=DP40 &;' Unit Color=White Program=None,Label Name=Harvey,Lock Option=Single,Lift Rail 1 Options=None/Standard,Sash Limit Devices=Night Latch Half Screen,Fiberglass Mesh ao•r3 Head Expander,Foam Wrap(Pre-Applied)=No Room Location: LIVING Overall Frame Width(Inches)=29.75,Overall Frame Height(Inches)_ 49.5,Overall Rough Opening Width(Inches)=30,Overall Rough Opening Height(Inches)=50 Clear Opening Width=24.75,Clear Opening Height= 19.625,Clear Opening Square Footage=3.37 E.Star Zone:North=Yes RoughOpening::Head Offset=0.5,RoughOpening::Sill Offset=0.5, RoughOpening::Left Offset=0.5,RoughOpening::Right Offset=0.5, FrameSize::Head Offset=0,FrameSize::Sill Offset=0,FrameSize::Left Offset=0,FrameSize::Right Offset=0 Last Updated:6/28/2024 7:27 PM UTC Page: 2 / 3 Printed:6/28/2024 7:29 PM UTC QUOTE NBR CUST NBR CUSTOMER PO CREATED ORDERED ORDER TYPE 5902774 1144009 210880299159 6/28/2024 Quote Only Charge ORDERED BY STATUS SHIP VIA JOB NAME BOB None Whse Delivery MARISSA CRASPER CLERK MESSAGE JAM-Jose Mendieta LINE# DESCRIPTION OTY UNIT PRICE EXTENDED 13000-1 Vinyl PW,Unit Size 35.75 x 49.5,RO 36 x 50 I Unit 1:U-Factor=0.23,SHGC=0.51,VT=0.63,HII-M-10-02215- 00001,Size Options=Custom Size,Replacement Frame Width(Inches)=35.75,Frame Height(Inches)=49.5 Double Glazed,Double Low-E 180 RS,Argon Filled ENERGY STAR®Performance Packages=SunGain PLUS(Northern), Performance Package=SunGain PLUS,Overall DP Rating=DP55 &� Unit Color=White Program=None,Label Name=Harvey Head Expander,Foam Wrap(Pre-Applied)=No Overall Frame Width(Inches)=35.75,Overall Frame Height(Inches)= Ro'�. 49.5,Overall Rough Opening Width(Inches)=36,Overall Rough Room Location: LIVING Opening Height(Inches)=50 E.Star Zone:North=Yes RoughOpening::Head Offset=0.5,RoughOpening::Sill Offset=0.59 RoughOpening::Left Offset=0.5,RoughOpening::Right Offset=0.5, FrameSize::Head Offset=0,FrameSize::Sill Offset=0,FrameSize::Left Offset=0,FrameSize::Right Offset=0 "Note: Delivery charges may apply and are not included on this quote. This quotation is based on our interpretation of the information provided. All quantities,sizes,extensions, grand totals,and specifications should be verified by the ordering party prior to bidding or ordering of materials. Harvey Windows and Doors is responsible only for the items as quoted above. Any changes or addendums will be subject to a requote. We propose to supply the materials as described above,subject to terms and conditions. The prices are guaranteed for 30 days from the date of quotation unless otherwise noted. Delivery charges may apply and are not reflected on this quote.We appreciate the opportunity to quote this job. CUSTOMER SIGNATURE DATE Last Updated:6/28/2024 7:27 PM UTC Page: 3 / 3 Printed:6/28/2024 7:29 PM UTC c V` Ll � y C p U O O E C C O ,� a�0 � C � Wi• a W i ev fn m p J = 3so o I r° U m co a o r •v v 3 = 4n z N \ a U - co y t ' T \ C AC7"lllk�R" CERTIFICATE OF LIABILITY INSURANCE DATE(In () YYYV) 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 NAME: Betty Reyes The Willett Insurance Agency PHONE 914 481-5599 FAX 888 371-9783 g Y A/C,No,Ext: A/C,No: 338 Willet Ave MAIL ADDRESS: bettyreyes()Ihewillett111surance.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 10>73-3179 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) (MWDD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ©OCCUR PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 A Y FSF17526960 12/13/2023 12/13/2024 PERSONAL B ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JET 7 LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED $ AUTOS ONLY AUTOS ONLY (Per accident) S x UMBRELLA LIAR OCCUR EACH OCCURRENCE $ 3,000,000 b EXCESS LIAR CLAIMS-MADE CUP1572208 03/16/2023 03/16/2024 AGGREGATE s 3,000,000 DED I I RETENTION$ 5 ORKERS COMPENSATION - ND EMPLOYERS'LIABILITY YIN STATUTE ER %NY PROPRIETOR/PARTNER/EXECUTIVE❑ N/A E.L.EACH ACCIDENT $ FFICER/MEMBER EXCLUDED? Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ f yes,describe under ESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS i LOCATIONS/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 !3e{fy Rryes Rve Brook NY 10573 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Workers'YORK W CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board la.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 1 d.Federal Employer Identification Number of Insured or Social Secunty 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 Carner (Entity Being Listed as the Certificate Holder) NYSIF The Village of Rye Brook 938 King St 31b.Policy Number of Entity Listed in Box"la" Rye Brook,NY 10573 25829110 3c.Policy effective period 19/99/9n24 to 019!9G/2094 3d.The Proprietor,Partners or Executive Officers are included.(only check box if all panners/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"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"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 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: (Signatur ) (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 N_0Z authorized to issue it. C-105.2(9-15) www.wcb.ny.gov