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HomeMy WebLinkAboutBP20-231PERMIT # V�y���_� DATE: � � �� FJ(R: I l .3 SECTION 3� � 6�0 BLOCK r LOT [ TYPE OF WORK )4FeC t/c o QVeo' Cx).s�� 90B LOCATION OWNERK.n e _ CONTRACTOR EST. vcO #! TCO # FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING 0 RGH PLUMBING GAS L� SPRINKLER ELECTRIC 0 t_O`JV-VOLT C7 /. f ARM Cam' AS gW LT CUB FoiAL icy .tir a eir` hick g/'7)'7 9 59 FEE 3 3 2" FEE4I IO -Pb DATE / if if FEE DATE INSPECTION RECORD 2 i OTHER APPROVALS ARB �� 77J�-1 c�/f v�c�cip eoT PB ZBA OTHER �1S-GUILTIFINAL SURVEY REQUIRED PRIOR TO FINAL INSPECTION eivecj l ►/J/a/ VILLAGE OF RYE BROOK WESTCHESTER COUNTY, NEW YORK FNO: 21-188 Certif t'rate of Orrupaucp This is to certify that of, -Ic �Y[ k , Ai Y , having duly filed an application on IV()Ve ] b er t 20 requesting a Certificate of Occupancy for the premises known as, Rye Brook,NY, located in a Zoning District and shown on the most current Tax Map as Section: 65. Block: _Lot: Le/ , and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building 'WDPermit No. ,-9r 5 � , issued 1 20 oc L1, such authority and permission is hereby granted to the property owner to lawfully occupy or use said premises or building or part thereof listed under the New York State Use Classification of: P,` . { - l� I / ,for the following purposes: r c4eCL Over ex'Ohr70 nab Subject to all the privileges, requirements, limitations and conditions prescribed by law, and subject also to the following: This certificate does not in any way relieve the owners or any person or persons in possession or control of the premises, building,or any part thereof from obtaining such other permits or licenses as may be prescribed by law for the uses or purposes for which the building or premises is designed or intended. Furthermore, it does not relieve such owners or persons from complying with any lawful order issued with the object of maintaining the premises or building in a safe and lawful condition. No changes or rearrangement in the structural parts of the building or in the exit facilities shall be made,and no enlargement, whether by extending on any side or by increasing in height shaji be made,nor shall the building be moved from one location to another until a permit to accomplish such change has beiryob ine a ing Inspector. Neil 18 1011 Building Inspector,Village of Rye Brook: a Date: U v For office use only: BUILMNO-DEP TMENT PERMIT# -a3/ NOV - 1 20" VILLA OF RYE~9000K ISSUED: 938 KING STRELTy,�tYE BRom, w YORK 10573 DATE: VILLAGE OF RYE BROOK (914)_9 -Q666 FEE: g7 I/O— PAID{q BUILDING DEPARTMENT W�4.x a `er - --- 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 »»»w»»wsrstrsarsrsrrsssrtsrt•rt+w++++w+r+t++ssr+rrsrrrrrrrerrrrrrsswrsrwwwrwww»s»»»ws»ws+wt»ttrrwr+sstrrsrrrsssrrrrerrersrrrs Address: 01 1 �e- C.� �(\Do� ►'�`V� � d J 1 Occupancy/Use: f L Parcel ID#: 1 3 S YG — l ` G, � Zone: Owner: 0 ox &c —c,�\\cX Address: 3 � A ct LGnC, P.E./R.A. or Contractor: Lv 4�5 Cc.1Tf`cLcx c(\ Co�Address: { P L S-t. Person in responsible charge: L O a-- Address: S,-"-V 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: G ea-t-K 0k, being duly swom,deposes and says that he/she resides at (Print Name of Applicant) (No.and Street) in R!J-e- Q 0 U k in the County of W ecJ c. \ezt c- in the State of t-A� ,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:$ 1 1 5 C�Ci , for the construction or alteration o£ () e-t✓K, 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 fun ther 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 erilarged,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 S4- Sworn to before me this day of NO , 20 Z1 day of -' 20 Signature of Property owner 2 Signature of Applicant J`la'VJ Print Name of Property owner Print Name of Applicant otary Public Notary Public ALEXANDRA H.MARSHALL Notary Public,State of New York 8/12/2021 No.QiFR6363711 Qualified In Westchester County Commission Expires August 28,20 L/_ 4E BRC��, F o 1982 BUILDING DEPARTMENT BUILDING INSPECTOR ASSISTANT BVILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www.Uebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS:_ DATE` c T- PERMIT# �.' 1IeJ i ISSUED: I SECT: LOT r lV LOCATION: f_ _ ���' . � � �r �'�� �' ' � OCCUPANCY: ❑ VIOLATION NOTED THE WORK �5 ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTINGt j�e'� ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: El ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑' FINAL [] OTHER Qur�� BUILDING DEPARTMENT ❑BUILDING INSPECTOR SSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5501 wrwwr ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - -- - - - - - - ADDRESS :— m DATE: PERMIT# --3-\ ISSUED: t O da:'SECT: BLOCK: LOT: LOCATION: 'C QQL�, OCCUPANCY: Z\ ❑ VIOLATION NOTED THE WORK IS... ACCEPTED © REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING �OUGH FRAMING INSULATION ❑ NATURAL GAS ❑ L.P.GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER E BR[�jk 1982 BUILDING DEPARTMENT BUILDING INSPECTOR SSISTANT 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 : � DATE: PERMIT# S -0 _ � ISSUED: �� �5� BLOCK: LOT: LOCATION: f C OCCUPANCY: `( ❑ VIOLATION NOTED THE WORK ISQ ACCEPTED ❑ REJECTED/ REINSPECTION SITE INSPECTION REQUIRED P400TING 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 ❑ FINAL ® OTHER Building Permit Check List&Zoning Analysis Address: 046,(t�64-- , LNki-Xr SBL: Zone'2Z' 1 Z' Use: J Cont.Type: V Other. Submittal Date: J Revisions Submittal Dates: Applicant F t C_c Nature of Work Reviews:ZBA: P& BOT: Other. OK ( ( ) FEES:Filing 7S- BP: 3 C/o, Legalization: ( ) Q,"APP: Dated Notarized: SBL: ✓Tnm I.D. Cross Connection: `'� H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening. ( ) ( ) ENVIRO: Long. Short: Fees: N/A: ( ) ( ) ITE PLAN:Topo: Site rotection S/W�Igmt.: Tree Plan Other. OSURVEY:Dated: ZO Current Archival: Sealed Unacceptable: PLANS:Date Stamped: ✓ Sealed: Copies:7.Electronic Other. ( { ) License Workers Comp: ility:_✓'�_Comp. Waiver. Other. ( { ) CODE 753#: /I 0_30— 0 Dated //—3--aO N/A: HIGH-VOLTAGE ELECTRICAL.•Plan: Permit: N/A: Other. ( } { } LOW-VOLTAGE ELECTRICAL.•Plans: Permit: N/A: Other. ( } ( ) FIRE ALARM/SMOKE DETECTORS:Plans: Permit: H.W.I.C.:_Battery:—Other. ( ) ( } PLUMBING:Plan: Permit Nat Gas: LP Gas: N/A/: Other. ( ) ( } FIRE SUPPRESSION:Plans: Permir- N/A: Other. ( ) ( ) H.V.A.C.: Plans: Permit N/A: Other: ( ) ( ) FUEL TANK:Plans: Permit: Fuel Type: Other: ( ) ( ) 20I7 NY State ECCC: N/A: Other: Final.Survey Final Topo: RA/PE Sign-off Letter. As-Built Plans: Other. ( ) ( ) BP DENIAL LETTER: C/O DENIAL LETTER Other. { ) ( ) Other. {�' mtg.date: t 2 t 'Z o approval• t,) Z t ? -2 notes: ( )ZBA mtg. date: approval• notes: ( )PB mrg.date: approvaL• notes: REOLMED EXISTING PRIOR N APPROVED G s^ Front: Emw 3 JAW rS yo &W. ',S Main COP. Accs.C F H : Sd,H/Sb Tot,Imp: Z l t Z �. '7r p- () FLIam: '-I J'' 'z-r'•3 P n . HHd&/Stories: notes: ti BUILD .�E�AR�TMENT D ( Q VILE :?T � OOK ',1 k llyt 938 KING FTR}r; R �O �,NY 10573 AUG 2 8 2020 (9I4)9 $ ,.+ .�) 39-5801 w ` �rwo :ofi ViLLAGE OF RYE�� _ t; BROOK BUILDING DEPARTMENT ;-N4 kL ARCHITECTURAL REVIEW BOARD CHECK LIST FOR APPLICANTS This farm mast be completed and signed by the applicant of record and a copy shall be submitted to the Building Department prior to attending the ARB meeting. Applicants failing to submit a copy of this check list will be removed from the ARB agenda. Job Address: 3yno 'rt Date of Submission: Parcel ID#: I-�j, . � -- 1 - C I Zone: APPLICANT CHECK LIST: Proposed Improvement(Describe in detail): MUST B;C COMPLETED BY THE A,PPLTCANT The following items must be submitted to the Building �l b .Department by the applicant-no exceptions. 1. ( )Completed Application rr 2. ( )Two(2) sets of settled plans. (one frill size {tnaxismmn Property Owner: � � � V ercAi eke ullowabie plan size a 36"x 42"f and one I I"xi 7") 3. ( )Two(2)copies of the property survey, Address: �� 4 G►1 h 4. ( )Two(2)copies of the proposed site plan. Phone 4 /91 17 S. ( )One electronic/disc copy of the complete Applicant appearing before the Board: 6. ( )Piling applic F toee. materials. . ahrti �I g,,4-, 7. ( )Any supporting documentation. 33 6a,- �11 ! f A'U7'bnl�f,� 8. ( )HOA approval letter, (ifappiicublc) Address: r � 9. ( )Photographs. Phone# L 7i m- /Or 16.( )Samples of finishes(color chart. (Q sample board oa Arclutect(Bugineer: kn 5e.0,rte rm JAI model may be presented the night of the meeting) Prone#_ R j '7�. S3� By signature below, the owner/applicant acknowledges that he/she has read the complete Building Permit Instructions&Procedures, and that their application is complete in all respects. The Board of Revie reserves the right to refuse to hear any application not meeting the requirements contained herein, Sworn to before rite this b Sworn to befnrre sae this day of IN- day of signature of Propuay 0wncr Aignamrc of Applicant -h� �` S Corr/•� ,�- Frint Neme of Property Owner Print Name of Applicant 'ATU" Notary Public Notary Public SHARI r41ELILLO Notary Public,State of New York IIi 5H No.01VE0t60003 i � Ei-iLLO Ouai"tfied in Westchester County Notary Pubic,State of N$vr York Commission Expires january 29.20 No. 61 MEt716G06a3 Qualified in Wastchester County 3/2U19 no Commission Expires januan, VILLAGE OF RYE BROOK BUILDING DEPARTMENT 938 KING STREET, RYE BROOK, NY 10573 (T) 939-0668 (F) 939-5801 ARCHITECTURAL REVIEW BOARD Wednesday, October 21, 2020 Due to public health and safety concerns from COVID-19, the Architectural Review Board meeting on October 21, 2020 will be closed to members of the public. The public can still watch the live meeting online through Zoom through the app or through the following https://us02web.zoom.uslj/81961552623 If any interested members of the public would like to provide comments during the meeting, comments can be emailed to stevefews@ryebrook.org or called in during the meeting at +1 (929) 205-6099, meeting ID: 819 6155 2623 NAME & LOCATION TYPE OF APPLICATION MOTION SECOND APPROVED REJECTED APPL.# 1 Wyman St North Replace Existing 6' Fence in Consent 5079 (Garcia) Rear Yard (Stockade) Agenda 3 Country Ridge Re- Appearance- For Plans Consent 507 La Close (Porter) Update Agenda 3 Country Ridge September 16th Documents 5071 Circle(Porter) 19 Maywood Ave Legalize Re-Configuration Consent 5080 (Guerrero) of Driveway & Retaining Agenda Wall 2 Country Ridge Window Change to Consent 5081 Drive (Gonzalez) Accommodate Kitchen Agenda Renovation 19 Dorchester Drive 6' High Vinyl Privacy Fence Consent 5082 (Rein) - Rear Yard(Oklahoma Agenda Cedar Grain) 96 Brush Hollow 4' High Post & Rail Fence Consent 5083 Close(Tomback) Agenda 3 Valley Terrace 6' High White Vinyl Fence Consent 5084 (Vito) In Rear Agenda ML NM MR SE JM $F AC MI KC 17 Loch Lane Roof Top Solar Array Consent 5085 (Ashby) Agenda 9 Winthrop Drive Modify Front Walk, & New Consent 5086 (Geller) Landscape Wall Agenda 33 Whittemore Place Legalize Rear Patio Consent 5087 (Tina) Expansion Agenda 5 Red Roof Dr 4' High White Buffalo Style Consent 5088 (Fishbach) Privacy Fence Agenda 5 Little Kings Lane New 48" Rail Fence, Side Consent 5089 (Nathan) Yards Agenda 75 High Point Circle Replace Decking & Railing Consent 5090 (Germaine/Pinals) on Existing Deck Agenda 16 Maywood Ave Replace Rear Yard Wood Consent 5091 (Robles) Fence w/ 6Ft Agenda 45 Mohegan Lane Re- Do Front Steps w/Blue Consent 5092 (Ybarra) Stone Treads, Mosaic Agenda Risers, Walk, & Retaining Wall 3 Mohegan Lane Rear Deck Over Existing 5093 (Gerchick) Patio G A 5 Jean Lane Roof Top Solar Consent 5094 (Scocchera) Array/System Agenda 6 Eagles Bluff(Ham Two Tier Block Wall, New Poss 5095 & Jones) Patio W/ Fire Pit Above Consent New Excavated Basement Agenda Ext, S WM System 18 Rocking Horse Inground Swimming Pool 5096 Trail (Feist) w/Patio, Retaining Walls, Partial Wood Fence, Partial Wrought Iron Guard Rails. Shed 72 Valley Terrace 2nd Story Additions, New 5097 (LLC) Front Portico, New Rear Deck & Alterations ML NM MR SE JM 5F AC �� MI KC 259 N. Ridge St New One Family 5098 (Lazz Development) w/Unfinished Basement, Swimming Pool & Pool Patio 1200 King St (Atria Front Vestibule Expansion, 5099 @Rye Brook) Replace Walkways, Patios, Create A Memory Care Garden, (other interior repo) ML NM MR SE JM SF AC MI KC JOHN G. SCARLATO JR. ARCHITECT 33 Byram Hill Road Armonk, N.Y. 10504 Phone: (914) 273-7350 Fax: (914) 273-9222 JGSCARLATO@GMAIL.CQM 9/30/20 Mike Izzo FREV Building Inspector 0CT - 1 Z020Village of Rye Brook F©938 King Street ���LDING DEPARTMENT Rye Brook,NY 10573 Dear Mike: RE: 3 Mohegan Drive Enclosed is the new updated survey with revised forms and one 24 x 36 and one 11 x 17 copies of the drawing. If you have any questions or need anything else, please give me a call. Thank you for your help. Sincerely, John G. Scarlato Jr. Laura Petersen From: Laura Petersen Sent: Thursday, October 29, 2020 11:31 AM To: KENAMY@OPTONLINE.NET Subject: Building Permit Application - 3 Mohegan Lane The building permit application has been approved by the Building Inspector, before I can issue the building permit the following items must be submitted to our office, 2. General contractor's contact name & phone number. . Copy of general contractor's valid Westchester County Home Improvement License. AGeneral contractor's valid liability insurance (the 'Village Of Rye Brook must be the certificate holder) (lr4. General contractor's valid workers compensation on a NY State Board form (C105-2 or U26.3) ✓�". Contractor must call Dig Safe NY and get a ticket number. t 6. Estimated cost of construction to determine the building permit fee ($15.00 per $1,000.00) (due once permit is issued and ready for pick-up) This information can be emailed to me. ! Thank you and have a great day! Laura Petersen Office Assistant Village of Rye Brook 938 King Street Rye Brook, New York 10573 Phone(914)939-0668 1 Fax (914)939-5801 I Igetersenaryebrook.org 3 C Q IL Q '•V 0 a( e 4 cz s N e > r.. !�. N _� CD rA o u ' • ae U W N 0 _ car (U = o a< u � P" HP r.., o cs it cl. M oLn w . �+� Q Z_ W Z U �sctton }? N. ' U H o (D ae. h— ill v Q c 1 Q Z IL �., d rn C) v 43 .NN O4- ♦, edaO 0-0 is 4 -� a M .. 00 r U U a iqA) CL „M .. .. .. . . . . . .. iics�> sa ,A► .,> A 1 d r Jk r Ih s. s err at.�i. � tr AC�® DATE(MWDWYYYY) l CERTIFICATE OF LIABILITY INSURANCE 03,03,2020 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((es)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 endarsement(s). PRODUCER NAME; Catalina Perdomo Durango Insurance and Financial Servicas Inc ,� No Ext; (203)517-4545 (Ajc,No), (203)487-9626 84 West Ave ADDRESS: catalina{)durangoagency.com apt Al INSURER(S)AFFORDING COVERAGE NAT i Norwalk CT 06854 INSURER A: EVANSTON INSURANCE INSURED INSURER B: THE HARTFORD INSURANCE LUA'S CONTRACTING CORP INSURER C: UNITED STATES LIABILITY INSURANCE 2 SACHEM ST INSURER D: INSURER E: NORWALK CT 06850 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. AUUL LTR TYPE OF INSURANCE INSO WVD POLICY NUMBER (MWDONYYY MWDQIYYYY UIBTS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S I,000,000 CLAIMS-MADE O OCCUR =S"I Es ocamence) S I D0,000 WED EXP(Any one person) $ 5,000 A X 3EY3334 02123/2020 02/2312021 PERSONAL 6 ADV INJuRY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S 2,0w,000 X PCLX;Y ❑ EG'�,r EI LOC PRODUCTS•COMPfOP AGG S 2,000,000 OTHER E AUTOMOBILE LIABILITY Ee 9ccident iINULI=LIMIT— ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED BODILY INJURY(Per&Wdent) S AUTOS ONLY AUTOS HIRED NON-OWNED PRO Ps eoc+dent S AUTOS ONLY AUTOS ONLY S UMBRELLA UAO OCCUR EACH OCCURRENCE S 1,000,000 C x EXCESS UAB �d CLAIMS-WADE XL1595483 04129/2019 04/2912020 AGGREGATE $ 2,000.NO DEL) I I RETENTIONS _ $ ORKERS COMPENSATION ND EMPLOYERS'LIABILITY STATUTE ER Y PROPRIETOR/PARTNERIEXECUTIVE Y!N E.L EACH ACCIDENT S 500,000 B FVCERIMEMSER EXCLUDED? N/A 31 WECEI3326-2 02/23/2020 02/2312021 endatory In NH) FYI E.L.DISEASE-EA EMPLOYEE $ 500,000 yes nb da4Ce under ESCRIPTION OF OPERATIONS below E L.DISEASE•POLICY LIMIT S 500,000 i DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES (ACORD lot,Additional Remarks Schedule,may be attached it more apace is required) Village of Rye Brook 938 King Street,Rye Brook NY 10573 listed as additional insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN VILLAGE OF RYE BROOK ACCORDANCE WITH THE POLICY PROVISIONS. 938 KING STREET AUTHORIZED REPRESENTATIVE RA4ija�GI'i41�w RYE BROOK NY 1057 �c�1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(201M) The ACORD name and logo are registered marks of ACORD wIEw Workers' sORK Compensation CERTIFICATE OF Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE la. Legal Name and address of Insured(use street address only) 1b Business Telephone Number of Insured LUA'S CONTRACTING CORP 914-690-9015 2 SACHEM ST NORWALK CT 06850 1c. NYS Unemployment insurance Employer Registration Number of Insured Work Location of insured (Only required if coverage is specifically limited to certain locations in New York State, i.e. a Wrap-Up Policy) 1 d. Federal Employer Identification Number of Insured or Social Security Number 74-3041486 2. Name and Address of the Entity Requesting Proof of 3a. Name of Insurance Carrier Coverage(Entity Being Listed as the Certificate Holder) Hartford Casualty Insurance Company Village of Rye Brook 29424 938 KING ST 3b, Policy Number of Entity Listed in Box"1 a-. RYE BROOK NY 10573-1226 31 WEC E13326 3c. Policy effective period: 02123/2020 to 02/2312021 3d.The Proprietor, Partners or Executive Officers are Included.(Only check box d 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 "la" 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" The insurance carrier must notify the above certificate holder and the Workers' Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums 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. 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 Worker's 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. Linder 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 Danielle Clausen (print nam/e�of authorized representative or licensed agent of insurance carrier) Approved by: ti9 n�Ak@e( � 0310312020 (Signature) (Date) Title: Operations Manager Telephone Number of authorized representative or licensed agent of insurance carrier (866)467-8730 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 (9-17) Form WC 88 31 21 F Printed in U S.A www.wcb.ny.gov Page 1 of 2 Laura Petersen From: Israel Lua <lua@luascontracting.com> Sent: Tuesday, November 3, 2020 11:48 AM To: Laura Petersen Subject: 3 Mohegan Lane Attachments: Lua's Contracting Documents.pdf; PastedGraphic-2.tiff Hi Laura. Attached are the documents for Lua's Contracting. We are doing the work for Amy Gerchick.The cost of the deck is$17,500. Israel Lua is the Contractor. Call Before You Dig ticket##11030-000-810 Thanks! Claudia 914-708-9065 Israel Lua 914-760-7752 www.luascontracting.com 1 Laura Petersen From: Mike Izzo Sent: Tuesday, November 3, 2020 12:33 PM To: Tara Gerardi; Laura Petersen Subject: FW: Message from Dig Safely New York, Inc. (DSNY) Michael J. Izzo Building& Fire Inspector Village of Rye Brook, NY (914) 939-0668 -----Original Message----- From: Dig Safely New York Exactix<tickets@exactix.digsafelynewyork.com> Sent: Tuesday, November 3, 2020 11:06 AM To: Mike Izzo<Mlzzo@ryebrook.org> Subject: Message from Dig Safely New York, Inc. (DSNY) ****REGULAR**** DIG REQUEST from DSNY for: VIL RYE BROOK Taken: 11/03/2020 11:04 To:VIL RYE BROOK PRIMARY Transmitted: 11/03/2020 11:05 00001 Ticket: 11030-000-810-00 Type: Regular Previous Ticket: ----------------------------------------------------------------------------- State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 3 To: Name: MOHEGAN LN Cross: From: To: Name: Offset: ----------------------------------------------------------------------------- Locate: BACK OF HOUSE NearSt: BONWIT RD Means of Excavation: HAND TOOLS Blasting: N Site marked with white: Y Boring/Directional Drilling: N Within 25ft of Edge of Road: N Work Type: INSTALL DECK Estimated Work Complete Date: 01/06/2021 Depth of excavation: 42 INCHES Site dimensions: Length 12 INCHES Width 12 INCHES Start Date and Time: 11/06/2020 07:00 Must Start By: 11/23/2020 ------------------------------------------------------------------------------ Contact Name: CLAUDIA MACORA Company: LUAS CONTRACTING Addrl: PO BOX 786 Addr2: City: PORT CHESTER State: NY Zip: 10573 Phone: 914-708-9065 Fax: Email: luascontracting930@yahoo.com Field Contact: CLAUDIA MACORA Alt Phone: 914-708-9065 Working for: AMY GERCHICK ------------------------------------------------------------------------------ Comments: Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: ALTICE USA BELL-VALHALLA/WSCHSTR CON-ED SUEZ WTR WESTCHESTER VIL RYE BROOK WESTCHESTER CTY SWR z UNAUTHORIZED ALTERATION TO A MAP BEARING A LICENSED PROFESSIONAL LAND SURVEYOR'S AL IS A VIOLATION OF SECTION 7209, SUBDIVISION 2, OF THE NEW YORK STATE EDUCATION BONWIT RD LAW. THE CERTIFICATION IS NOT AN EXPRESS OR IMPLIED WARRANTY OR GUARANTEE, IT IS PURELY A STATEMENT OF PROFESSIONAL OPINION BASED ON KNOWLEDGE, INFORMATION AND 0 BELIEF, BASED ON EXISTING FIELD EVIDENCE AND DOCUMENTARY EVIDENCE AVAILABLE. 0 CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS. " S PLAN PREPARED PURSUANT TO SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. SUBJECT TO THE FINDINGS OF AN UP TO DATE TITLE SEARCH. UNLESS THE SURVEYOR'S Z SMI m ORIGINAL SIGNATURE AND SEAL APPEARS RAISED ON THIS MAP, IT SHOULD NOT BE CONSIDERED A TRUE AND CORRECT COPY OF THE SURVEYOR'S ORIGINAL WORK AND OPINION. s r N/F BROWN N/F 16 BONWIT LLC POB BEING ALONG THE EASTERLY SIDE CNTRL# v 472830292 CNTRL# 532623700 ; OF MOHEGAN( LN. A DISTANT 67.54' SOUTHERLY FROM A SBL 135.50-1-60 SBL 135.50-1-59 N CURVE END R-30, L=47.12) CONNECTING THE FM 11525 LOT 9B FM 11525 LOT 99 -o EASTERLY SIDE OF MOHEGAN LN. & THE SOUTHERLY v SIDE OF BONWIT RD. ROD: LOCUS MAP _ IRF 0-1' EAST (N.T.s.) c POB N89'50'30"E 0.28� SURVEY NOTES 00 125.31 1. THIS PLAN WAS PREPARED FROM AN ON THE GROUND FIELD SURVEY CONDUCTED BY RLS 0o ON SEPTEMBER 22, 2020 AND ON THE FOLLOWING DATUM— MERIDIAN: FM 11525 HORIZONTAL: ASSUMED L'�'36.58 VERTICAL- ASSUMED ' 2. REFERENCES A_C STREET NAMES, R.O.W. WIDTHS, PROPERTY IDENTIFICATION NUMBERS, OWNER NAMES, EASEMENTS, AND ANY ADDITIONAL INFORMATION SHOWN HEREON ARE REFERENCED FROM 0 THE FOLLOWING MAPS AND DOCUMENTS— m A. LAND CONVEYED TO KENNETH & AMY GERCHICK BY CNTRL# 422910443, FILED IN THE WESTCHESTER CO. CLERKS OFFICE ON SEPTEMBER 10. 2002. D B. MAP 11525 ENTITLED, "SEC. 3, PINE RIDGE", PREPARED BY RUSSELL MUNSON AND Z Z FILED IN THE WESTCHESTER CO. CLERKS OFFICE ON JUNE 26, 1958. -P 00 O 36.36 #3 3. THE SURVEYED PROPERTY IS SUBJECT BUT NOT LIMITED TO THE INFORMATION SHOWN Z J O STONE 0 N/F WEI SZ HEREON. ALL INFORMATION THAT MAY AFFECT THE QUALITY OF TITLE TO BOTH THE 00 �0�� SUBJECT AND ADJOINING PARCELS SHOULD BE VERIFIED BY AND ACCURATE AND CURRENT STORY 4 o CNTRL# 551283340 TITLE REPORT. - - SBL 135.50-1-58 DWELLING •' 4. THE LOCATION OF THE UTILITIES AS SHOWN HEREON HAVE BEEN COMPILED FROM VISIBLE FM 11525 LOT 100 STRUCTURES AND INFORMATION OBTAINED FROM VARIOUS SOURCES. THE ACTUAL LOCA11ON rn OF ALL UTILITIES AND UNDERGROUND STRUCTURES SHALL BE CONSIDERED APPROXIMATE AND SHALL BE VERIFIED BY THE OWNER PRIOR TO ANY CONSTRUCTION. AREA=1 2540.6756±SQ.FT. A(;RES=O.2879f 5. WETLANDS, ENVIRONMENTAL AND/OR HAZARDOUS MATERIALS LOCATION, IF ANY, NOT m M N C�JTRL 422910443 0 27' COVERED UNDER THIS CONTRACT. [OR] WERE LOCATED AS MARKED AT THE TIME OF THE S�'L 135.50-1-61 M� 6. UNAUTHORIZED ALTERATION OR ADDITION TO A SURVEY MAP BEARING A LICENSED LAND �.. 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CONCRETE GA OLD , NY 10 POST ROAD � A.Ito Q�� ��1� GARRISON, NY 10524 914 815 3986 AC AIR CONDITIONER E UNDERGROUND ELECTRIC SC STONE CURB ,o rowanlandsurveying0outlook.com OH W OVERHEAD WIRES SRW STONE RETAINING WALL ��tANOBJ� Drawn By PR Date Job No. (Surveyed By PR $EPTEMBER 28, 2020 020-097 CRW CONCRETE RETAINING WALL Scale Sheet No. 1 20' 1 OF UNAUTHORIZED ALTERATION TO A MAP BEARING A LICENSED PROFESSIONAL LAND SURVEYOR'S BONWIT RD SEAL IS A VIOLATION OF SECTION 7209, SUBDIVISION 2, OF THE NEW YORK STATE EDUCATION LAW. THE CERTIFICATION IS NOT AN EXPRESS OR IMPLIED WARRANTY OR GUARANTEE, IT IS PURELY A STATEMENT OF PROFESSIONAL OPINION BASED ON KNOWLEDGE, INFORMATION AND 0= BELIEF, BASED ON EXISTING FIELD EVIDENCE AND DOCUMENTARY EVIDENCE AVAILABLE. a_ CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS. M Z PLAN PREPARED PURSUANT TO SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. SUBJECT TO THE FINDINGS OF AN UP TO DATE TITLE SEARCH. UNLESS THE SURVEYOR'S m ORIGINAL SIGNATURE AND SEAL APPEARS RAISED ON THIS MAP, IT SHOULD NOT BE CONSIDERED A TRUE AND CORRECT COPY OF THE SURVEYOR'S ORIGINAL WORK AND OPINION. N/F BROWN N/F 16 BONWIT LLC POB BEING ALONG THE EASTERLY SIDE CNTRL# 472830292 CNTRL# 532623700 " } OF MOHEGAN LN. A DISTANT 67.54 SOUTHERLY FROM A SBL 135.50-1-60 SBL 135.50-1-59 N CURVE END (R=30, L=47.12) CONNECTING THE FM 11525 LOT 98 FM 11525 LOT 99 'S EASTERLY SIDE OF MOHEGAN LN. & THE SOUTHERLY = SIDE OF BONWIT RD. ROD: LOCUSIRF 0.1' EAST (N.T.S.) POB N89050'30"E 0.28' SURVEY NOTES o 125.31' 1. THIS PLAN WAS PREPARED FROM AN ON THE GROUND FIELD SURVEY CONDUCTED BY RLS co ON JULY 9, 2021 AND ON THE FOLLOWING DATUM— is °'• MERIDIAN: FM 11525 HORIZONTAL: ASSUMED VERTICAL- ASSUMED 36.58' 2. REFERENCES AC STREET NAMES, R.O.W. WIDTHS, PROPERTY IDENTIFICATION NUMBERS, OWNER NAMES, 512 EASEMENTS, AND ANY ADDITIONAL INFORMATION SHOWN HEREON ARE REFERENCED FROM 0 THE FOLLOWING MAPS AND DOCUMENT'S— = A. LAND CONVEYED TO KENNETH & AMY GERCHICK BY CNTRL#422910443, FILED IN THE m 37 01' WESTCHESTER CO. CLERKS OFFICE ON SEPTEMBER 10. 2002. Z Z B. MAP 11525 ENTITLED, "SEC. 3, PINE RIDGE", PREPARED BY RUSSELL MUNSON AND FILED IN THE WESTCHESTER CO. CLERKS OFFICE ON JUNE 26, 1958. -Po O—� r 3. THE SURVEYED PROPERTY IS SUBJECT BUT NOT LIMITED TO THE INFORMATION SHOWN D O 36.36' ,.—� #3 n O 0 HEREON. ALL INFORMATION THAT MAY AFFECT THE QUALITY OF TITLE TO BOTH THE o I DECK 0 0 0 N/F WEISZ m00 N� __�� ___ v rrt CNTRL# 551283340 SUBJECT AND.ADJOINING PARCELS SHOULD BE VERIFIED BY AND ACCURATE AND CURRENT v yTITLE� -�'� 1 STORY SBL 135.50-1-58 DWELLING 4. THE LOCATION OF THE UTILITIES AS SHOWN HEREON HAVE BEEN COMPILED FROM VISIBLE 37.51' FM 11525 LOT 100 STRUCTURES AND INFORMATION OBTAINED FROM VARIOUS SOURCES. 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