Some fruit juices and fruits can levitra grapefruit interact with numerous drugs, in many cases causing adverse effects. 1, the effect was first discovered by accident, when a test of drug interactions with alcohol used grapefruit juice to hide the taste of the ethanol. 2, it is still best-studied with grapefruit and grapefruit juice, 1 but similar effects have more recently been levitra grapefruit seen with some (not all) other citrus fruits., one medical review advises patients levitra grapefruit to avoid all citrus juices until further research clarifies the risks. 7, the interacting chemicals are found in many plants, citation needed and so many other foods may be affected; effects have been observed with apple juice, but their clinical significance is not yet known. 8 9 4, normal amounts of food and drink, such as one whole grapefruit or a small glass (200 mL (6.8 US fl oz) of grapefruit juice, can cause drug overdose toxicity. 1, fruit consumed three days before levitra canada the medicine can still have an effect. The relative risks of different types of citrus fruit have not been systematically studied. 1, affected drugs typically have an auxiliary label saying Do not take levitra vs viagra with grapefruit on the container, and the interaction is elaborated on in the package insert. 11, people are also advised to ask their physician or pharmacist about drug interactions. 11, the effects are caused by furanocoumarins (and, to a lesser extent, flavonoids ). These chemicals inhibit key drug metabolizing enzymes, such as cytochrome P450 3A4 (CYP3A4). CYP3A4 is a metabolizing enzyme levitra south africa for almost 50 of drugs, and is found in the liver and small intestinal epithelial cells. 12 As a result, many drugs are affected. Inhibition of enzymes levitra grapefruit can have two different effects, depending on whether the drug is either metabolized levitra canada by the enzyme to an inactive metabolite, or activated by the enzyme to an active metabolite. If the active drug is metabolized by the inhibited enzyme, then the fruit will stop the drug being metabolized, leaving elevated concentrations of the medication in the body, which can cause adverse effects. 11 Conversely, if the medication is a prodrug, it needs to be metabolised to be converted to the active drug. Compromising its metabolism lowers concentrations of the active drug, reducing its therapeutic effect, and risking therapeutic failure. Low drug concentrations can also be caused when the fruit suppresses drug absorption from the intestine. 13 Contents History edit The effect of grapefruit juice with regard to drug absorption was originally discovered in 1989. The first published report on grapefruit drug interactions was in 1991 in the Lancet entitled "Interactions of Citrus levitra south africa Juices with Felodipine and Nifedipine and was the first reported food-drug interaction clinically. However, the effect only became well-publicized after being responsible for a number of bad interactions with medication. Active ingredients edit Citrus fruits may contain a number of polyphenol compounds, 4 15 including the flavonoid naringin and furanocoumarins (such as bergamottin, dihydroxybergamottin, bergapten, and bergaptol ) citation needed. These are natural chemicals. They may be present in all forms of the fruit, including freshly squeezed juice, frozen concentrate, and whole fruit. Citation needed Grapefruit, Seville oranges, 15 bergamot, 16 and possibly other citrus also contain large amounts of naringin. It can take up to 72 hours before the effects of the naringin on the CYP3A4 enzyme are seen. This is problematic as a 4 oz portion of grapefruit contains enough naringin to inhibit the metabolism of substrates levitra grapefruit of CYP3A4. Naringin is a flavonoid which contributes to the bitter flavour of grapefruit. 6 Furanocoumarins seem to have a stronger effect than naringin under some circumstances. 17 15 Mechanism edit Organic compounds that are derivatives of furanocoumarin interfere with liver and intestinal enzyme CYP3A4 and are believed to be primarily responsible for the effects of grapefruit on the enzyme. 18 Cytochrome isoforms affected by grapefruit components also include CYP1A2, CYP2C9, and CYP2D6. 19 Bioactive compounds in grapefruit juice may also interfere with MDR1 (multidrug resistance protein 1) and oatp (organic anion transporting polypeptides either increasing or decreasing the bioavailability of a number of drugs. Drugs that are metabolized by these enzymes may have interactions with citrus chemicals. When drugs are taken orally, they enter the gut lumen to be absorbed in the small intestine and sometimes, in the stomach. In order for drugs to be absorbed, they must pass through the epithelial cells that line the lumen wall before they can enter the hepatic portal circulation to be distributed systemically in blood circulation. Drugs are metabolized by drug-specific metabolizing enzymes in the epithelial cells. Metabolizing enzymes transform these drugs into metabolites.

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Robert Beer, founder of BuiltByBeer, has been building houses for over 25 years.  Robert first started working in construction for his family-founded Birchwood Development company, which had been building homes for over half a century. The company was founded in 1946 and went on to build tens of thousands of homes on Long Island including a 2,200 house community in Jericho.  The company built all different style homes including capes, splits and ranches and built them throughout Long Island.

In 2007, Birchwood was sold to Kimco, a publicly traded company. After fulfilling the requirements of the sale, Robert Beer was able to go off on his own and form BuiltBybeer. Since inception, BuiltBybeer has built dozens of new homes along with a number of commercial renovations.

BuiltByBeer is truly today’s “Master Builder.”  We have been producing the most elegant and well-built residences on Long Island’s East End and Gold Coast. Our professional team is known for working intimately with our clients to provide them with the uniquely conceived and beautifully built home of their dreams.

We have perfected a technique that tastefully merges 19th Century craftsmanship and style with interior living spaces for the 21st Century.  Our design/build model effortlessly integrates process and materials. The client’s time is efficiently spent making real design decisions that will ultimately realize their custom-built dream home.  Our in-house consultants can assist with all the details, such as plumbing fixtures, decorative hardware and lighting. We offer kitchen and bathroom design services and custom cabinet-makers guarantee a perfect finished product. Landscape design and installation are also one of our many specialties.

We strive to maintain an ongoing relationship with our clients extending far beyond the building process. We are steadfast in our commitment to quality and dependable performance.  We provide our customers with straight answers, solid thinking and follow through on ideas.  We dedicate time, talent and financial support to our community.

Whether you are working with your own broker or not, we will be happy to advise you on the merits of your prospective purchase, giving you invaluable insight and an appraisal from a builder’s perspective.

Your new home will be the result of a concentrated effort to create a successful and pleasing design, intensive research into the latest building techniques, the specification of the finest materials to be found, and the meticulous craftsmanship and pride that has always been a benchmark of BuiltByBeer homes. We make this promise with the utmost confidence that your new home will not only meet all of your expectations, but exceed them as well.

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Check out Robert on WPIX 11 News talking about how home owners can save money this winter. Click on “Read More” to watch the video! CLICK HERE FOR VIDEO

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LUXURY Best of 2015 Issue

Check out Robert Beer in the latest issue of LUXURY – Full Story

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BuiltByBeer (formerly known as RB Shore Development) “At my jobs, there’s never a day when something is sitting still,” says owner Robert Beer. His scheduling prowess and long-standing relationships with subcontractors allow him to work quickly—completing homes in less than a year—without sacrificing quality. Beer also builds his homes to Energy Star efficiency specifications. 516-860-6843 […]

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“If you build it, they will come,” said Michael Koblenz, who has been mayor for the last 16 years, recalling his determination to build the park in a community that lacked facilities and a focal point. He sold the former village hall for about $3 million and acquired the land for the same amount. With […]

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Allison Eden Studios highlights one of the BuiltByBeer homes. Link to picture and post

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Check out Robert Beer in the latest issue of Top Long Island Builders TO VIEW IN PDF CLICK – Robert Beer Article TO VIEW ON THE 25A MAGAZINE SITE CLICK – Top Long Island Builders

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Building the new construction home of your dreams!
We are here to help you through the process of building your new home. We can help you starting from the idea phase or jump in at any phase you are up to. Below are some of the major phases of building a new home:

PHASE 1: Selecting a piece of property and engaging an architect.
Selecting the piece of property is an important phase to have an experienced builder involved with. We would be able to walk the property and immediately tell you the type of home, landscaping and other you would be able to build. We would also be able to anticipate any extra costs that you might incur due to the current layout of the property such as the potential need for retaining walls, excessive soil removal or need to bring soil to the property, all of which can cost extra money.
There are a number of great architects so make sure you find someone you feel comfortable with. Make sure you see houses they have designed and speak to home owners they have worked with. We have worked with a number of architects that we can recommend or we can work with any architect you decide to build your dream home.

PHASE 2: Designing your home.
This is another phase that is important to get an experienced builder involved with to make sure you are; 1. designing to stay within your budget, 2. designing to make the home energy efficient and, 3. designing your home to be approved quickly by your village boards. Spending time with a builder during this process will save you a lot of time and money. We have built dozens of homes for others and our own homes on spec so this is a phase we are very familiar with.

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PHASE 3: Pre-Construction
You have designed your home and are now ready to go meet your village to get the necessary permits and approvals to get started! Depending on your location, this process could take as little 2 months or as long as 18+ months. It is important to engage with a builder that has experience with this process to help speed things along. Engaging a builder in the First Phase will speed this up even faster!

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PHASE 4: Site Clearing & Excavation – Approximately 2 weeks
You have all of your permits and approvals and are now ready to start building. The property will most likely have to be fenced in, but this will be determined by the rules of the village you are building in. Once fenced in you will be able to demolish the current house on the property and clear it to prepare for the excavation.
Once the site is cleared, the excavation can now begin. The excavation takes place to create the necessary forms to for the next phase of putting in the foundation and sanitary systems. The excavation is a fairly quick process if done right.

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PHASE 5: Footings & Foundation – Approximately 4-8 weeks
Depending on the region your home is built in, your new home’s foundation consists of a slab, block or poured wall foundation. Long Island homes are typically poured wall foundations. This is when the concrete is poured into foundation form panels. Once the concrete is set, foundation waterproofing is applied, and drain tile piping is installed. Underground plumbing is installed and tied into the sanitary systems. Next your basement slab is poured, and the concrete floors are finished. Foundations can be as deep as you would like.
We have done as much as 20 foot foundations to allow for basketball and other sport courts in the basement. The deeper you go the more expesive it becomes. We can discuss costs and options with you in order to help you make your decision. This is another reason it is important to engage an experienced builder earlier on in the building process.

foundation


PHASE 6: Framing & Exterior – Approximately 6-12 weeks

Framing is the phase where things really start to take shape. Many homeowners think their home is near completion at the end of this stage. Actually, we are still only about one third of the way through the construction process! So while the phases beyond this one may seem much slower in progress, it’s because we are getting into the fine details which may not be apparent but are vital to your finished home.
In the framing phase, the subfloor, walls, and roof structure are built, and your roof is shingled, Exterior trim work is installed. Window and door units are installed, and any backfilling around the foundation is done. This cost and length of time for this phase depends on the size and shape of the home you are building. Designs with a lot of cuts and different shapes will take longer and be costlier. An experienced builder can immediately tell from the design of the home.
Exterior Trim detail work on the exterior of the home and siding detail work will continue longer than this initial phase, but can go on while other phases are taking place.

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PHASE 7: Rough Mechanicals – Approximately 6-10 weeks

“Rough mechanicals” is the term used for the mechanical portions of building including heating, air conditioning, plumbing and electric. This construction phase is a swarm of activity, as plumbing and indoor sewer pipes, your furnace and ducts, and electric wiring, outlets, and switches are installed. This is a very important phase with a number of village inspections along the way to make sure things are being done correctly. The amount of time this takes will also vary greatly based on the size and complexity of the home.

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PHASE 8: Insulation and Drywall – Approximately 4-6 weeks

Once you have passed all of the necessary Rough Mechanical inspections you are ready for this next phase to “close up the walls.” Before closing up the walls, the insulation is installed in the walls for energy efficiency and sound control. Once insulated, the drywall is installed. In this phase, water, gas and electric utilities can also be connected to your home.

PHASE 9: Finishing – Approximately 8-16 weeks
The finishing phase is probably one of the most exciting phases. You’ll see many of the selections you made come to life. This is when kitchen and bath cabinetry, countertops, mirrors, medicine cabinets, interior doors and trim, stair rails, and many other detail features are installed. Kitchen appliances and hard flooring – vinyl, ceramic, and hardwood – are installed, and both the interior and exterior of your home are painted

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PHASE 10: Finish Mechanicals – Approximately 4-8 weeks
“Finish mechanicals” are the visible portions of the rough mechanics. Plumbing hardware, such as faucets, showerheads, commodes, and so on, are installed. Switch plates, plug covers, and light fixtures are put into place, as are your thermostat, outdoor air/heat pump unit, and register and return air covers. Carpeting is installed, and your yard is finish-graded, seeded or sodded.
This is generally an anxious time for many homeowners. Your home construction process is nearing completion and you are awaiting a finish date.

finish mechanicals

PHASE 11: Final Stage – Approximately 1-2 weeks
During this construction phase, finishing touches are added, such as cleaning the windows, floors, baths, kitchen, and so on. Building and Quality Assurance Inspections are scheduled and completed to ensure all of the finishing touches on your new home have been completed according to your custom architectural plan.
At this phase you are now ready to move into your NEW home!

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BUILDER TOOLS
We recognize that building a home is stressful and the longer it takes ends up costing you more money due to the carrying and other costs associated with owning a home you are not living in. We utilize state of the art technology to keep our projects running as efficiently as possible to get you into your new home with out any major delays. We keep all of the phases of the job on a very tight schedule so that we make sure not to lose time outside of weather and other unforeseen and unavoidable delays.
We are in constant contact with you throughout the build and we are available to you 24/7. At the beginning of the job we will go over dates that we need approvals from you on ordering items such as Front Door, Garage Door, Cabinetry and other, in order to avoid delays. We also make sure to upload pictures for you to view in case you can not be on the job site and just make sure to keep the communication going throughout the entire build.
Below is a snapshot of our software that we use to track the schedule, make sure everyone on the job site has the proper/up to date insurance and more. As you can see from the schedule we make sure to plan ahead for inspections, ordering of material to give us plenty of time for items that might take long to get delivered, and a lot more!

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