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Home My WebLink AboutRB25-0029 � CN O � / N } \ � L \ \ \ j ULMIt • » � 00 (U 0 e2E \ 3 \ / LZ L y 0 f � uE \ w L:E-L e ( ° /® � § w E _ _ 0 X ( \ R u 4-) \ / \ E ) \ t E / w k w 5 a0 w \ ego O Z k : # k / 10) a 2 � Lr) D ° -? \t LLJY oo O04 k w ) 1 z 0 0 § O k § k / Z � � S 0 228E / \ -j � � U CO Ln Eo o k � Q � U m k � ( K %\ w % .\ 7 m � � \ \ ƒ 0 LLJ� � ° = Z U 2 $ � % ` 22 « 2 \ � § � '� \ � § \ u \ \ E = 2 p uj = 2 r LLJ CV)E } U ƒ j U > $ ) \ / \ ( >_ .� e O = 3 § 737 0 % o \ 3 ƒ / § ® / / < � � L / \ \ \ /\ \ 2 / � M -J 0 DLO LL 51J � So 0 G a 0 -Y : (U ru � in � \ 7 � § E < E26' / � m_ 0 a= mm 4 ƒ � / t ƒ ? 2 u \§ § / \ / q 5 5 � « r 2 £ 2 q r 2 q G .2E { 0 / / 7 0 o CL @ � » =5 _ 3 / 3 § a 0 , 01-- ro ® e , V) > E V) k / ƒ® / coco Lu4- E U \ � 02 = 0 Q ~ � 0 = = t a/ < a a } / \ ) Interior Building Permit Application Village of Rye Brook �'79b2 938 King St Rye Brook, NY 10573 Phone: (914)939-0668 1 www.ryebrook.gov Building Department Project Information SBL Zone 24 Red Roof Drive R-15 Proposed Improvement Proposed improvement is replacement of existing stair railing and balusters. Does the proposed project involve a Home-Occupation as per§250-38 of Village Code? ❑ Yes ❑ No Will the proposed project require the installation of a new, or an extension/modification to an existing automatic fire suppression system? (Fire Sprinkler,ANSL System, FM-200 System, Type I Hood,etc...) ❑ Yes ❑ No N.Y.State Construction Classification N.Y. State Use Classification Occupancy Pre-Construction VB 210 1 family Occupancy Post-Construction 0 fam., 2 fam.,comm.,etc...) 1 family What is the total estimated cost of construction: (NOTE: The estimated cost shall include all labor, material, 1000 USD scaffolding,fixed equipment, professional fees, and material and labor which may be donated gratis.) Interior Building Permit Application,page 1/1 �yE 13R— VILLAGE OF RYE BROOK 938 King St Rye Brook,NY 10573 # W � Phone:(914)939-0668 1 www.ryebrook.gov 198 Building Department Residential/Interior(Remodel/Renovation) Permit Permit Set 24 RED ROOF DR P#RB 25-0029 R#135.43-1-5.5 PERMIT INFORMATION Address Permit number Date issued 24 RED ROOF DR RB 25-0029 08/15/2025 REVIEWED BY If you have any questions regarding the review of these drawings please contact: Application in general Steven Fews stevefews@ryebrook.org INSTRUCTION AND ATTENTION It is the responsibility of the Applicant to print full size the entire approved permit package and provide at the time of inspection. TABLE OF CONTENTS Cover page 1 Building Permit 2 Required Inspections 3 General Contractor's Home Improvement License&Insurance 4 Photograph 5 Photograph 6 General Contractor Liability&Workers Compensation Insurance-listing Village of Rye Brook 7-8 Certificate Holder Photograph 9 Interior Building Permit Application 10 Building Department.938 King St Rye Brook,NY 10573/Phone:(914)939-0668 E 13Rnv� VILLAGE OF RYE BROOK 938 King St Rye Brook,NY 10573 W � Phone:(914)939-0668 1 www.ryebrook.gov 1982 Building Department INSTRUCTIONS THE PERMIT HOLDERAND/OR PROPERTY OWNER IS RESPONSIBLE FOR ENSURING THAT ALL REQUIRED/APPLICABLE INSPECTIONSARE SCHEDULED AND THAT THE PERMIT IS COMPLETE 4rmr , REQUIRED INSPECTIONS Name Description Final Inspection Completion of all required items under the permit I y , e e _ I x a M V V � r i1 MIS CL 1�1�1 i 1 1 g 1 1 11 4 • I 1 V C 1t rF Cd C. N •_ �. Py Cs. O N LO C •�a o r r .'by a •. � •1�1 Q � �H;, �,' // i - Ln ', Gt4on ul�= Z Z s �Qj o-LLI } i11 v, � rn .o Lo �g [lGto)► `" 4 V Q•.L .. ... •ram• \ � � fu s _ C40 Y c i, C C•, H Co co • " « w y p cn Vh e^ C .� vti G V U U y 6' 1��4ii11fIV1, ep. `I Yli+lildli r :16-10-44 1 +'<.. a c' o"Iw ri� nIr111� 1 3( k �9/ t 1�NY ' 59 �j! I w�E� yll" -i s Iiir1 � 'fie r 1 1 t Iii11 1:i I� 1 I'll" .• f -7 �1 ^'�! -'4�'1♦ 1 c I< i;. INE"W Workers' CERTIFICATE OF INSURANCE COVERAGE ATE Compensation Board DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW PART 1.To be completed by Disability and Paid Family Leave Benefits Carrier or Licensed Insurance Agent of that Carrier 1 a. Legal Name&Address of Insured(use street address only) 1 b. Business Telephone Number of Insured MJV CONSTRUCTION LLC (914)648-6596 455 TARRYTOWN RD WHITE PLAINS,NY 10607 1 c. Federal Employer Identification Number of Insured or Social Security Work Location of Insured(Only required if coverage is specifically limited to Number certain locations in New York State,i.e.,a Wrap-Up Policy) 862927313 2.Name and Address of Entity Requesting Proof of Coverage 3a. Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) New York State Insurance Fund(NYSIF) VILLAGE OF RYE BROOK 938 KING STREET 3b. Policy Number of Entity Listed in Box"1 a" RYE BROOK,NY 10573 DBL 8051 47-7 3c. Policy effective period 04/06/2025 to 04/06/2026 4. Policy provides the following benefits: ® A.Both disability and paid family leave benefits ❑ B.Disability benefits only ❑ C.Paid family leave benefits only 5. Policy covers: ® A.All of the employer's employees eligible under the NYS Disability and Paid Family Leave Benefits Law ❑ B.Only the following class or classes of employer's employees: 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 NYS Disability and/or Paid Family Leave Benefits insurance �coverage `as described above. Date Signed 7/11/2025 By (Signature of insurance carrier's authorized representative or NYS Licensed Insurance Agent of that insurance carrier) Telephone Number (866)697-4332 Name and Title Kristin Markwica,Head of Disability Insurance Unit IMPORTANT: If Box 4A and 5A are checked, and this form is signed by the insurance carrier's authorized representative or NYS Licensed Insurance Agent of that carrier,this certificate is COMPLETE. Mail it directly to the certificate holder. If Box 4B,4C or 5B is checked,this certificate is NOT COMPLETE for purposes of Section 220, Subd. 8 of the NYS Disability and Paid Family Leave Benefits Law. It must be mailed for completion to the Workers'Compensation Board, DB Plans Acceptance Unit, PO Box 5200, Binghamton, NY 13902-5200 PART 2.To be completed by the NYS Workers'Compensation Board(Only if Box 4C or 513 of Part 1 has been checked) State of New York Workers' Compensation Board According to information maintained by the NYS Workers'Compensation Board, the above-named employer has complied with the NYS Disability and Paid Family Leave Benefits Law with respect to all of his/her employees. Date Signed By (Signature of Authorized NYS Workers'Compensation Board Employee) Telephone Number Name and Title Please Note: Only insurance carriers licensed to write NYS disability and paid family leave benefits insurance policies and NYS licensed insurance agents of those insurance carriers are authorized to issue Form DB-120.1. Insurance brokers are NOT authorized to issue this form. DB-120.1 (10-17) Certificate Number 847051