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HomeMy WebLinkAboutRP24-122PERMIT # — o� c�- DATE; /O 9 SECTION 7 S BLOCK / LOT TYPE OF WORK Go _ T q JOB LOCATI N ZI x/O Q.o�) _ OWNER 0a al QZ ;uSie�2 2 iPsJ P yAl7eZ P✓oca 4 e / s�LCPos6/o4778 CONTRACTOR b64 P LL(2 A< O6 7L 71X2-/iJeilllp/ 6/y)937 #c)79 C7T. 0 # 1� FEE DATE �� TCO # FEE DATE INSPECTION RECORD I DATE INSP FOOTING FOUN DATI O N FRAMING RGH FRAMING INSULATION PLUMBING 0 RGH PLUMBING GAS C7 SPRINKLER ELECTRIC LOW -VOLT Cl ALARM C> AS BUILT C� FINAL 12-10 -2ozY Ash OTHER APPROVALS ARB BOT P8 ZBA OTHER �yE DR19 � 3 O GC tip la��� yGG SL G C�GGy�V aJ w G 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.Qov TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE December 18,2024 Karen Martinez as Trustee of The Karen Lee Martinez Revocable Trust 11 Brook Lane Rye Brook,New York 10573 Re: 11 Brook Lane, Rye Brook,New York 10573 Parcel ID#: 135.73-1-8 Roof Permit#24-122 issued on 10/29/2024 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 BUILDING DEPARTMENT PERMI TT#For MI use onh VILLAGE OF RYEwOK ISSUED:10--;�>9—cry DEC — s 2024 938 KING STRE ��21'E BROOK, �Y YORK 10573 DATE: / bl—[,—a5/ 14)9 -0668 FEE: 'T o -- PAiD lid 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 •raas•ata•trrrttrrtssrrrrtt•rstt•rrt•sssatrartstt•str•rrtsrtttttts•srr•ssssrsrsrrsrr►aarasartarstrsstrrartrasaaratrsssssasass Address: >j'0 r< Lea h Occupancy/Use: �CS ; l�,� �� Parcel ID#: > S, Zone: i Owner: Address: i t—.- P.E./R.A. or Contractor: 171< Address: �� `i (`} /C i+ �1�' 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: / being duly sworn,deposes and says that he/she resides at (Print Name of Applicant) rr (No.and Street) in )14-c �}'�D )C in the County of Wes!�`�"Y 1 �-<�.� in the State of that (CityiTow•n 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%%hich ma% have been donated gratis was:S C) for the construction or alteration of: l✓`t' 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 orpart 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. LL �� T Sworn to before me is Sworn to before me this day of /SjOY , 20c� day of %�&z , 20�1- SignaturJbf Property Owner Signanirc of Applicant 1/7 Print Name of Property Own Print Name of Applicant I ^1,ov, MELANIA HRABOVSKY Notary b tc NOTARY PUBLIC,STATE OF NEW YO 4- iIALWWA t Registration No. 01 HR6324159 Qualified in Westchester County Commission Expires 05/04/27 6,1�2024 �E BR(��, O�` tim 1982 BUILDING DEPARTMENT ❑BUILDING INSPECTOR Q 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 : ' 1 L' %"V DATE: i L- -- ` U Z_'0L PERMIT# Z y- 1 Z ISSUED: SECT: / 73 BLOCK:LOT: J 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 S�0 ❑ FUEL TANK } ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER : N � eNi N N C4 •v NN f 00 W ^ p kI as b s O H U a o R a 00 00 � � c1) A 0 � � � � ��., � ►rl a bA V r- ►rS 1 W $ u o \ O G ° °5 .0 �L O © � A Fr� B4 vp. y W 04 CN Av n M zo � O �' a W W O W �O p C7 w �° t E+ o a �� w = W o M W V W wcn °V. � �°° y V r4 Z w o � o E = 1 G1 ! 00 ICI 3 V w z 0 v cn o z U u. 4 o C ,O v p u �, o V � � � x o. tj v av _ E D BUILD MENT E `� E F " V E OF R OK RI OCT 282024 938 KING FT RYE RRO NY 10573 "0 VILLAGE OF RYE BROOK w ov ' BUILDING DEPARTMENT FOR OFFICE USE ONLY: 10 vn\ 2 Approval Date: er it# — 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:' _ Permit ROOF PERMIT APPLICATION Application dated: AD 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. 1. Job Address: 11 g►`ao k Z Qn e, SBL: 135.�3— , -g Zone: - 0 Property Owner: Kul r'P_n l g f i n e Z Address: 13`0 K L o k7 e rr Phone#: f Cell#: 05_ �Q- , email: IK(1 1 q 6SC�gm�,l�� 2. Applicant: (D')L'b 12_ 12 Address: W t eII * AV' J/' - C d*rb Phone#: ��L j 1)-C(�1'2 1 Cell#: email: �lls o 0 MW�1.Go, 3. Roofing Contractor: D d� b l e_ pp h Address: Phone#: y - 3� `�� /� Cell#: email: J, 4. Job Des, iption,list all Methods&Materials: �e w�� =?(I.Sfin4 r b 0 F S�R�P, a k r n� i�f 64 F SC, l a S y4Ae-bC_ c'n"a,(�'l aClc ,(4tV-1-r 5��i� Vr , GAF 14Dz ��,n�i1i✓s. �q 5. Estimated Cost of Job: $ S)0 0 (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.) 6. 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: ( )Attache o: ( )•Yes: ( )Number of Cars: 10. Is roof peaked,hip,mansard,flat,etc: 11. Estimated date of completion: 611 t2024 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. dr&*i:*se�i:ir**:x��:ki:kk:k:k it ic;Y k i- ;*:k9:�k:F:t9:-e:ck:F:'c:kT-ka•:k•kkk*:4*:kk*-k* ;*'.rY*:cxk;l•;Y�:k�•i::Y�:l•kr,-:k;P:Yx�:h:Yi:L-scxxs4 r..l-*x�ic ie:k:Y:k de*lr 9e:k*:F* STATE OF NEW Y R ,COUNTY OF WESTCHESTER ) as: 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 U OT U C- D( for the legal owner and is duly authorized to make and file this application. (indicate architect con ctor gent,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 c�_e Sworn to before me this O1 day of � �,2 , 20_q_ day of (D=ate , 2091 Signa re of Property Owner Signature of Applicant Print Name of Property Owner Print Name of Applicant wj Not ry ublic N to tt 61ic MELANIA HRABOVSKY NOTARY PUBLIC,STATE OF NEW YORK Registration No. O1i-iR6324159 Qualified in Westchester County Commission Expires 05/04/27 -2- 6/112024 LICENSE NUMBER THE ORIGINAL" Westchester WC36200H23 Connecticut 0668826 ROperated Since 1960 D����� ffm Family Owned And S. All Home Improvements _— EST. 1960 439 Willett Ave. Port Chester,N.Y. 10573 Tel#(914)937-4279 Fax(914)937-4172 http://www.Doub)eRwindows.com Karen Martinez Oct 24,2024 11 Brook Lane Rye Brook NY 10573 805-610-1778 karenmz196&*@2rnail.cofn insurance: All work involved within the following proposal is covered by Workmen's compensation.Public Liabilim and Completed Operations Insurance. Roof contract **We are certified GAF installers.Lifetime warranty is included in price.** Supply Labor&Material for the following: C J vd • Remove the existing roof. • Install 6 feet GAF water&ice shield to all roof eaves and centered in valleys. • Install synthetic roof underlayment and secure underlayment to roof deck utilizing 136"cap nails. • Install GAF Weather Ellocker Starter shingles to all roof eaves and rake edges. • Install GAF Timberline HDZ shingles to the roof deck,secured utilizing(6) 1%z"coil roofing nails. • Install GAF Timbertex cap shingles secured to the roof deck utilizing 1 W,coil roofing nails. • Install new copper flashing on the chimney. • Perimeter Edge Flashing:We propose to fabricate and install Aluminum Roof Flashing to rake edges where required,vent pipe flashing, and step flashing as needed. • Double Valley Flashing: For extra protection, we propose to install 36-inch-wide mineral surfaced roll centered in valley. Next install shingles onto adjoining deck at least 12". Opposite side to be cut in straight line forming valley lines. • Cart away all job-related debris. Labor and materials..........$18,900 Dumpster.........$900 Terms: Painting,and windows cleaning to be done by others.I lidden rotten wood not included Standard indusin'cash terns,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 clatree or 1 134e(1 b46 per annum). If the account becomes delinquent you aerce to pay any Ic_aI or collection fees expended by Double"R-ansing 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"It"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 wtilh a 304 convenience surcharge on total amount being charged. Acceptance: The above prices,specifications and conditions are satisfactory and are accepted. Double"R"is autborized to do dic work as specified. Contractor Performan N'armaty: Double"li"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'W'is unconditionally warranted for a period of Ten years from thedate of installation. ApproxinialeStart Dale: .kpproxiniate Completion Date: Customer. �/ 519,J40U.OU (Anwuut) Date: 1 O -Z 8 -2 (Sales Ta-v) Doable "R": �_._� S19,800.00 (Total Amount) Date: 1 I�Q J� � S9,900.00 (Deposit) I ( l S9,900.00 (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 <. 1 `•. f- .:,al . rh' .tom +'� � V C O Q ti` L o � s Q N t o n`, o X NLLJ E R M u�•` 4? � � 'L O 'O s• a. o Q pry O � d1. \ j�l M C O 1 h 41 C p„ 4. w g ° otection co O a_ � W W r o k: W J W f j m ? _ U °o0 in vvo Er h r ", :/: 4•r fy O p rn F- � a°, O Gd eye •� a > - z A A � a w W C 0 N cj N V � C .:a • l ® DATE(MM/DD/(YYY) ACC? o 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: Betty Reyes FAX The Willett Insurance Agency PH ONE 914 481-5599 988 371-9793 g Y A/C No Ext: (AIC,No): 338 Willet Ave ADDRESS: bettyreyes@thewillettinsurance.us INSURER(S)AFFORDING COVERAGE NAIC# Port Chester NY 10573 INSURER A: Westchester Insurance Company INSURED INSURER e: 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/DDNYYY) (MM/DD/YYYY) LIMITS x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE 5c]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 GNENOTHER: 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JE T LOC PRODUCTS-COMP/OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED HKOPLK I Y DAMAUL $ AUTOS ONLY AUTOS ONLY (Per accident) $ x UMBRELLA LIAB x OCCUR EACH OCCURRENCE $ 3,000,000 b EXCESS LIAB CLAIMS-MADE CUP1572208 03/16/2023 03/16/2024 AGGREGATE $ 3,000,000 DED I I RETENTION$ I $ WORKERS COMPENSATION - AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE❑ NIA A E.L.EACH ACCIDENT $ FFICER/MEMBER EXCLUDED? 111:SCRIPTION andatory in NH) E.L.DISEASE-EA EMPLOYEE $ es,describe under 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 13efbi R"e4 Rye Brook NY 10573 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD YORK Workers' CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board la.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured Double R PBJ,LLC 914 410-7771 439 Willett Ave Port Chester,NY 10573 lc.NYS Unemployment Insurance Employer Registration Number of Insured Work Location of Insured(Only required it 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"la" Rye Brook,NY 10573 25829110 3c.Policy effective period i�wv�n�s to m912an1194 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"3"insures the business referenced above in box"I 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". 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 carrier) 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 NOT authorized to issue it. C-105.2 (9-15) www.wcb.ny.gov