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HomeMy WebLinkAboutBP21-155PERMIT #* )/ - 5: DATE: as a/ E?(P: �Q- SECTION /� f / BLOCK LOT 10 lc TYPE OF WORK I ,� %4C Qj.� i� ' ,� /� JOB LOCATION rolw#07 4 )c/ QIQ4> hr/ve OWNER QN'I� QSzJ✓JJ► go Ilo)S %/�� CONTRACTOR 01Vf; - Iz 1 ssi/l )o po 3)3c 3&54 EST. COST "' 9,03 41o &13 FEE �' Q / V/cO # FEE DATE L-1 i TCO # FEE DATE INgp` N RECORD DATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING CL RGH PLUMBING GAS SPRINKLER ELECTRIC LOW -VOLT ALARM AS BUILT FINAL OTHER APPROVALS I ARE I�-ia / 9 a0�1 BOT ZBA AS-BUILTIFINAL SURVEY REQUIRED PRIOR TO r•tNAL INSPECTION_ e►v�d ll�r��l 1�v4 vuy • 1� VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Paul S. Rosenberg (914) 939-0668 Christopher J. Bradbury- www.ryebrook.org TRUSTEES BUILDING& FIRE Susan R. Epstein INSPECTOR Stephanie j. Fischer Michael J. Izzo David M. Heiser Jason A. Klein CERTIFICATE OF COMPLIANCE November 17,2021 Jason Taxier&Ariella Diamond 41 Country Ridge Drive Rye Brook,New York 10573 Re: 41 Country Ridge Drive, Rye Brook,New York 10573 Parcel ID#: 129.51-1-6 Building Permit#21-155 issued 6/22/2021 for a New Fence This certifies that the new six foot high black chain link fence and the six foot high white PVC fence,installed under the above captioned permit has been satisfactorily completed. Sincerely, Michael j. Izzo Building&Fire Inspector /tg r For office a onl V IE I(� � ��1,�] BUjLD�r,DE R VIENT Pl RwT# `�// VIL ��( I;OF RYE B.R. ,OK ISSUED: c) OCT ' 7 2021 38 KING STR T,RN e, ROOK,,et YORK 10573 DATE:IO�?-� �466 FEE: f PAID VILLAGE OF RYE BROOK BUILDING DEPARTMENT A PLZC•A I 101N F014 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 +++rt**rt+wwwwwwwrtrtw*rt*+rtrtrts**+s*rtrt**+rt*swrtrt«««s+w+++ws+++w*++ss+s+***++++ws+++wwrt*wrtwwrtwrtrt«*«*rt+++*rt+**rt**+**rt«s«*rrt+*****«rt** Address: L4 1 C0*-\-1 'A R t c otc' Dy 1 y'e. Rv a N 1 1051 3 Occupancy/Use: VeS td6-ch&-9 - Parcel lD#: ,Z ,5%- 1—(p Zone: �` S Owner: N fl-1 to+ D lQiman d ti J GSa� 1 f, U e-e Address: 'i1 Cointm 9 t r#L N t Vef P.E./R.A. or Contractor: , t Bol 1 l m O Address: 21- 04ILe, LA-e- Sl� Ck b&902 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: l�rlei d1LVhGh �4�Sa'1 I�Xlgrbeing duly sworn,deposes and saysthat he/she resides at `11 CD�r�rt� Ryj'-�e -DY lV e- (Print Name of Applicant) Mo.and Stfeco in 9, - eyi> 1< in the County of in the State of 141 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:$ 0 34,Li for the construction or alteration of b 1 rA(_r CVI,-Ar+ )\r\�- G^cl I?V G -(�'-Yic c- G-� ` N.�et+- �fJ�lsvt S+Ue. o� -yy,e h OAC' ctn c 1.5,c 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 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§250-1 Q.A.of the Code of the Village of Rye Brook. Sworn to before me this Sworn to before me this day of G &>,zs- , 2(la`_ day of ,20 Signature of Property Owner Signature of Applicant t'l a-vr+C),j rint Name of Property Owner Print Name of Applicant Notary Public SHARI MELILLO Notary Public Notary Public, State of New York No. 01 M E6160063 8/12/2021 Oualified in Westchester County Commission Exnirps Janllptry 29 20 E BRC��. . 1981 BUILDING DEPARTMENT ❑BUILDING INSPECTOR SSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK Z-A❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www ryebrook.or - - - - - - - - -- - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : �. � DATE: PERMIT# 1 '5 ISSUED: SECT: BLOCK: LOT: LOCATION: 4~- 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 j ❑ INSULATION 1 ❑ NATURAL GAS y�V c- I�ycz- �i-1 ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING CROSS CONNECTION FINAL ❑ OTHER 1, i Qye DRcb, w � Fo 19,82 BUILDING DEPARTMENT ❑BUILDING INSPECTOR ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK r EJ CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914)939-0668 FAX (914) 939-5801 www ryebrook.or -- - - - - - - - -- -- -- --- - - INSPECTION REPORT - - - - - - - - - - - - - -- - - - -- ADDRESS :- 5 v- c � DATE: J� jPERMIT# • C 1 l ISSUED: SECT: BLOCK: LOT: LOCATION: 4 bU� OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ACCEPTED 0 REJECTED/ REINSPECTION ❑ SITE INSPECTION � REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING vINSULATION f❑ NATURAL GAS f ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER From: Ariella Diamond ariella.diamond@gmail.00m 6' Subject: Can you print this as well? Date: May 3,2021 at 4:03 PM To: Mark Diamond mark.diamond@sbcglobal.net Thank you! F,a.ct.o­ry Inc-. .--- Fninflyowned and Operated mince 1977 22 Dyke Lane.Stamford C-I'06902 T.(203)324-3654 H.(203)357-I610 K-MiLil Addrtss:inru,'ktener-Faetory.com Wcbsite Address:wwtv.Fence acttsrv.cnm Home Owner. Jason Uxicr Home T, Date: 05.03.2021 Job Address: 41 Country Ridge Dr.Rye Brook.NY 10573 Work'L Email fell T. BiHinE Address: Fox.'1'. ©IN' a We proplrse to tarnish all labor and tnaterial to A.)V nyl Fencing Install 5 sections of 6 f9 high"Illlrsiuns"4'3^07 vinyl.fencing I;solid vrith scalloped ptckel topper I- The color of the vin i€enrine-will be WHITE- The style of the fence topper will be SCALLOPED. The fence panels will be made with 7,'8"x6•v-joUtted ttrngue and gnacowd vcrtirai boards. The topoer will have 1-112"xl-Irk" v mi,cal sp6WJcs,itail5rpcd. These will be a horizontal s6ninum I-beam inside that bottom 1 ail. Theic will be 2 Single ttaaca(4'sand 5'w;dc)installed in the fence line. The gate hinge post will have internal Vx5"aluntimmi I-beam post stiff ner for added strength. All gates will be hang using black stairilm steet hardware. Part and Cap Insunstfon: All posts are 5'x 5"and will have NEW ENOLAND style ca:M. All fiance sections will attacln to the posts taxing a'Mosl;sc and Tenun"systr It (the rails aae inserted into martised holes in the sides ut 1he trusts). Alt posts will be set in ctaterete bases unless otlierwise diiuwd. The fince will be installed by RACKING the panels wlwn adj us6a g fug uneven�t><d.s. 54,4l1►0 H B.)Chadn Urtk lastali 80'of 6'black drain link fence. Set 2-1i2"O-E).ta:rmitlal pofaa and 2"OD.klxe pouts in imams. Install a 1-518"U.D.top tail and bottom coil wilt'-Irutall d WA r"%9 gab La black aiirin link fabric. Cost $7,050.00 Tal(635%) ss04.0 Total S11r45"3 Aorrprrd farm-of pOmralr. Cash. Depusll i 13 of ridrtl Snared F"nrra(dw apaw drliwry and star$) ilautl Parr tdur",un fumpkriant Chrrk,Visa,%1nrrrC"Aimet f{t,ela.]N SUILIX 3I.Fla FN lVa Quotation Is ONLY valid For t4 days. Tt'•AVCnr;n1 alvr ZY w..h e`1 doernt"to intWttw.tatt+d her in h.rd fr•nsx.axntt^ntr.ltu•mils•"Cr•{'t,re�i hr`--,m Fcn v(Parry Wand lh.•c{AilVlrcr erg th[rr are ry,Trayrh>I pgwt,,r Is ur•e'pnwnlMion rn cunncrAian rt+•rc*-bin. Th r aprrrm,nq rJfall n.r7,r r.,xlil inl+ithr G•�m rr,.n1+at by■�aut�r'etd rrprtna nlat�aa:of ran•!{pa+iy and nr+ilhr�Pearly shwll Irnrr i'rc anrhwily 1u aaiw than proinhitwn Cuehmrr con r<:nrl llu..,minut.1111 7?wun ai1',ti a prraUy .�. verbal rwlicr and rulf.nur�up*anfied Mxr a•Tt*ac Fa l.an rnr Ar1`.r'2 bran,any tant'r 1diun:mi w6t el 14•210,cloryr."r real.vrll due h,•.•1 ur cart"and pr-{t{►:iun'Pr 111,—Irrial. Tercr Faak"Mc if N r respanvhk fur dwwl w w annlariud clral.iwl win.iptr,wlr;[r.pniyam�lines,to"cave tayminlh+aT�pi"d and Irn`h r irydf,drite•Kry drxrn,;rc.rig,+r rerlrs:iun of ter ewio-c u,-ih -niehl inlrfcr willr.r hr• dan1WJ by+work, The Time r an c Ii m irW-alU:ion iJnro J bt cmlirrn"l u dh the IdTkc-it the I i{nc ufik Pmfl ,ter:p{.uur n1 pnMvg1l itrplira 11ir'winr ow"wr has tvf.l and aam-1 lu thrla^rxarrrS-livaa"l-Ai J%;IlV11111rr.•n{ Ham{r0warr'%1varare• Frafr Farrar?tor.kuMf rind Slyaatem Qxlr of irrrplar{rr f /� Building Permit Check List&Zoning Astalysis -Address: L tf SBL: t Z�i''• 5 ( � — _ Zone'a- 1 S Use: Z! !Z::, ConsL Type: 2� Other. Submittal Date: _5�L (-Z ( Revisions Submittal Dates: Applicant: � t A—1 a-� / i A x t F- rL— Nat ure of Work: CD -,o `c II L kt. G 11A 4,-j L i+J'r7- `- (9 �" Q `t W 4-t hr, -4-� C_ Gt,•J Ct Reviews:ZBA: MAY 1 0 2071 PB: BOT: Other. { } FEES:Filing ?S -t BP: 13-S7, -- C/O Legalization ( } (✓}�APP: Dated: i Notarized: ✓ SBL: Truss I.D. Cross Connection: H2O.A.: ( } ( } Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening: ( ) ( ) ENVIRO: Long. Short: Fees: N/A.- SITE PLAN:Topo: Site P tection S/W Mgmt.: Tree Plan Other. SURVEY:Dated: �� 3 I7Ak Current: ✓Archival: Sealed:✓ Unacceptable: ( � ( } PLANS:Date Stamped: Sealed: Copies: Electronic: Other. License:�Workers Comp:�Liability ✓ m-p.Waiver. Other: (•�' ( ) CODE 7S3#:._ JO f/—O O r--'!Y:7j6-0 b Dated: ^71=fi1 N/A: ( ) ( ) HIGH-VOLTAGE ELECTRICAL:Plans: Permit; N/A: Other. ( ) ( ) LOW-VOLTAGE ELECTRICAL:Plans: Permit: N/A: Other: ( ) ( ) FIRE ALARM/SMOKE DETECTORS:Plans: Permit KW.I.C.:_Battery:!Other: ( } ( } PLUMBING Plans: Permit: Nat Gas: LP Gas: N/A/: Other. { ) ( } FIRE SUPPRESSION:Plans: Permit N/A: Other: { ) ( } H,V.A.C.: Plans: Permit N/A Other. { ) { } FUEL TANK:Plans: Permit Fuel Type: Other: { ) { } 2020 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. (,ARB mtg. date: s 4 2 approval• notes: { }ZBA mtg.date: approval:- notes: { )PB mtg. date: approval- notes: _ REOUIRED EXLSIING PROPOSED NOTES APF% AV.L—D Am r._._. MAY 9 6 Q21 I� Sides: Btu Main S8s Ft~_HlSb SdL 1:: - -GEA: ate: BUILDING DEPARTMENT D IE C IW IE VIULAGE OF RYE BROOK 938 K[ G STET RYE BROOK, NV 10573 MAY _ 4 2021 (914) 939-0668.FAX�9.14)939-5801 VILLAGE OF RYE BROOK www,ryebrtiolo;ra BUILDING DEPARTMENT ARCHITECTURAL REVIEW BOARD CHECK LIST FOR APPLICANTS This form must 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. .lob Address: +^'4 l QVi(I 1 0e ,4e- Date of Submission: rJ ` oz- Parcel ID#: 0.��` �-V Zone: 9 Proposed Improvement (Describe in detail): APPLICANT CHECK LIST: ���� � a �1L� on �2 ��� �VIiIST BE COMPLETED BY THE APPLICANT The following items must be submitted to the Building (✓ACj SG--�'h SI de. C-:�Vvt-V -�,V\..+ ) J C*f" Department by the applicant-no exceptions. pytp'� Ib ONCAd';c, 1. (/Completed Application 2, Two(2) sets of seated plans. (one full size Imaximum Property Owner: A(161 A O 101 Orl(I E SMOf1T� I ef- allowable plan sue=36"x 42") and one 11"x17") Address: Li I C+,gnP2,l R i d oie, Dt-Ii ve- 3. (--,1 Two(2) copies of the property survey. 4. (Jj Two(2) copies of the proposed site plan. Phone# (o I (p-`l l 7-W 2.5 k 5. One electronic/disc copy of the complete Applicant appearing before the Board: application materials. 6. Filing Fee. 3 M(h Try i I e✓ 7. (,/)Any supporting documentation. COLAISkA Address: t_� �t �� 8. ( Al HOA approval letter. (iI'appllcuhle) 9. ( -� Photographs. Phone#f 1 ( 10.( ,.),Samples of finishes/color chart. (a sample board or Inodel may be presented the night of the meeting) Architect/Engineer: Y1 Phone# 0 4L _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 Review reserves the right to refuse to hear any application not meeting the requirements contained herein. QQ Sworn to before me this 3rtl Sworn to before me this Jl day of 14 a�6 120 2- 1 day of , 20,'?, 6141� Signature of Property owner ature o A can Print Name of Property Owner P ' "ame of Applicant (Xa4ota kp&t� ry Public ry Public EBARALEVY BARBA LBVYC,STATE OF NEW YORtC NOTARY PUBLIC,STATE OF NEW YORKn Na. 01 LE6392102 Re istratipn Nv. 01LE6392102 Westchester CountyQualified in Westchester Coun�y pires May 20. 2023 Commission Expires May (, 1$23 VILLAGE OF RYE BROOK BUILDING DEPARTMENT 938 KING STREET, RYE BROOK,NY 10573 (T) 939-0668 (F) 939-5801 ARCHITECTURAL REVIEW BOARD Wednesday, May 19, 2021 PAGE 2 NAME& LOCATION TYPE OF APPLICATION MOTION SECOND APPROVED REJECTED APPL.# 12 Ridge Blvd Roof Top Solar Array Consent 5193 (Mattinson) Agenda 65 Rock Ridge Dr Re-Do & Expand Front Consent (Ayala) Walk and Landing in Flag Agenda Stone 41 Country Ridge 6Ft Black Chain Link Consent 5195 Dr (Taxier& Fence & 6Ft White PVC Agenda Diamond) Fencing 8 Fairlawn Pkwy Expand Asphalt Driveway Consent 5196 (Levin) Agenda 24 Berkley Dr 6Ft White PVC Fence in Consent 5196 (Gisondi) Rear Agenda 21 Ridge Blvd New Hot Tub on Platform Consent 5197 (Murguia) In Rear Agenda 29 Lincoln Ave New Swim Spa on Consent 5198 (Burathoki) Extended Patio, Relocate Agenda Side Fence 547 Westchester Remove Front Walk, Consent 5199 Ave (Marshall) Expand Driveway &New Agenda Front Landing 59 High Point Circle Replace Existing Deck wl 5200 (Mangino) New Deck 3 High Point Circle Enlarge Existing Rear 5201 (Cao) Deck 12 Birch Lane Amendment to Prior 5202 (Shaw) Approval NAME& LOCATION TYPE OF APPLICATION MOTION SECOND APPROVED REJECTED APPL.# ML NM MR t/' SE / JM SF AC ✓ MI KC i . .-- .,.....:,. � y - _--_•V30D ---.---V3235D 0235Sqk PRIVACY PRIVACY WITH PRIVACY WITH DIAGONAL LATTICE SQUARE LATTICE _ - - T I. Ilalsilil�lA1MLLLlla�r- rr *I .8�CE.��A�C w nmtmmrumtrcrnuq lR I� ilTl � t 4. V32351DS V3 i50 1 - —1l370b ` PRIVACY WITH PRIVACY WITH OLD PRIVACY WITH Y - SMALL DIAGONAL ENGLISH LATTICE STRAIGHT p4 LATTICE �KET TOP IIIIISl111ililllllll!€Illlll 'r'..... "" n r e nee+.o rimnsi ' iannunaruunuun ui i Privacy Panels feature a"V"-Jointed tongue and groove board and come with a wide variety of decorative tops.Privacy fence panels include a metal reinforcement channel in the bottom rail to help create a stronger and longer lasting fence.We 1137.03 —V3706 � - 0707 pride ourselves on offering a Privacy Panel for every taste,They are also offered in PRIVACY WITH PRIVACY WITH PRIVACY WITH color and woodgrain.Lattice comes in color and woodgrain FRAMED STEPPED r SCALLOPED PICKET TOP PICKET TOP 4 PICKET TOP e 1 ,0 .T- 7 i � � r � `5 GRAIN LINK/WELD-WIRE R • "' ''�' �� �: wr'� n�.� •, �,.+�R � Fe� �`� illy -._�'_ ry 4 i!•°' a�'w �. ''� ��r n- �a ,�` _ $ • F l 4 r e t •��� .+' ' � `�. i ICI ' iI 1 ILAACK -46 WWI T' IfI 11 i 1" l FENCE FAC 01RY 5'C IFORD CT06 02 ■ T: 20 24 G 4 a F: 20-3 57-1610 a INFO@PENCE-FACTORY.COM a VGWWYENCE-F!1CTORYCOM .,.: ;��+w r:. -t .�' �.x.ra '�'+Y`E..r'A'ic+6yi'Y'�,�?�l�w�t#1 c�k�'k��l/e Iry,-4s .. • rr4� .F. ',.�. / ^al,'. l v ' ko r O O ` Y� • 4 � a 1 P ' 8 4 ,d CD 9; d e _ Jr St � J�❑ � cli LU on o � r n G + }J L y 4 r ' �t ' - 0 - 0 oLL .. w o ! LL � 4, ti� I �= ' S e: r •] IK� Y J. OD OR Yl 7 r • nv 4 Fy 6 `, .„a '.'` V^k gyav �.' •rain+•� _ FENCFAC-01 ETAVERNA AC©A 0 DATE(MWDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 6/4/2021 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 poiicy(ies)must have ADDITIONAL INSURED provisions or be endorsed. 11 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). o"TACT Eileen Taverna PRODUCER 'NA Tooher Ferraris Insurance Group PHONE FAX 43 Danbury Road (arc,No,Exi):(203)665-6624 (, ,No,(203)665-6674 2nd Floor I a M RIL ,etaverna@toofer.com Wilton,C7 06897 INSURERS AFFORDING COVERAGE NAIC t _ INSURER A;COntinental Western 10804 INSURED INSURER B:Acadia Insurance CO. 31326 Fence Factory Inc INSURER C:Hartford Underwriters Ins.Co. 30104 22 Dyke Lane Stamford,CT 06902 INSURER O: ENSURER E 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, INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MPOLICY EYF POUCY FxP LIMITS INS[) wvD A X COMMERCIAL GENERAL LIABILITY FA HOCCURRENCE $ 1,000,000 CLAIMS-MADE C OCCUR CPA022$009 10/6/2020 10JB/2021 GE TO RENTED $ 300,000 X EBL ME EXP(Any one ereon S 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENLAGGREGATE LIMIT APPLIES PER; GENERAL AGGREGATE S 2,000,006' POLICY 1:1 'PeET F1 LOC PRODUCTS-COMPIOP AGG $ 2,000,000 OTHER: E BL $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 X ANY AUTO CAA0228010 IW2020 1OMM21 BODILY INJURY Per person) S OWNED SCHEDULED BODILY INJURY Per accxleM $ AIU�r�0p5 ONLY AUppT�NO-0-05WNEp AUTOS ONLY AM ONLY Pe�aeEeRide^['SAGE $ B X UMBRELLA UAB A X OCCUR EACH OCCURRENCE 8 2,000,000 EXCESS LIAR I ICLAIMS-MADE CUA0228012 10/6J2020 1118/2021 AGGREGATE S 2,000,000 DIED I X I RETENTION$ 0 $ C WORKERS COMPENSATION X PERTUTE OT}M AND EMPLOYERS'LIABILITY 31WECAClJLH 10/642020 1OVB,/2021 500 ANY PROPRIETORIPARTNEWEXECUTIVE ,000 OFF ICERIMEMBER EXCLUDED? NIA E.L.EACH ACCIDENT ntldescr n fund) EL.DIS_EASE-EA EMPLOYEE S 500,000 M yes.describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,AddRionv Remerke Schedule,mry be elterhod If more> a Is re9ulnW) with respects to permit CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Village of Rye Brook THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 938 King Street Rye Brook,NY 10573 AUTHORIZED REPRESENTATIVE ACORD 25(2016103) Cc]1988-2015 ACORD CORPORATION. All rights reserved, The ACORD name and logo are registered marks of ACORD iYORK workers' CERTIFICATE OF STATE Compensation Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured 203-324-3654 Fence Factory,Inc. 1e.NYS Unemployment Insurance Employer Registration Number of 22 Dyke Lane insured Stamford,CT 06902 Work Location of Insured(Only required if coverage is specifically limited to Id,Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Map-Up Policy) Number 06-1184,7$ 2.Name and Address of Entity Requesting Proof of Coverage 3a,Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Hartford Underwriter Insurance Co. 3b.Policy Number of Entity Listed in Box"1 a" Village of Rye Brook 31 WEC ACIJLH 938 King Street Rye Brook,NY 10573 3c.Policy effective period 1016120 to 10/6/21. 3d.The Proprietor,Partners or Executive Officers are ❑ Included.(Only check box If all partnerstoRcers Included) all excluded or certain partnersiofficers excluded. This certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box'la"forworkers' 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? [NYES ❑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: Eric P. Ferraris (Print name of authorized representative or licensed agent of Insurance carrier) Approved by: 6/4i21 (Signature) (Date) Title: Agent Telephone Number of authorized representative or licensed agent of insurance carrier: 203-665-6615 Please Note: Only insurance carriers and their licensed agents are authorized to issue Form CA05.2.Insurance brokers are NOT authorized to issue it. C-105.2 (9-15) www.wcb.ny.gov Laura Petersen From: Mike Izzo Sent: Thursday,July 1, 2021 1:59 PM To: Tara Gerardi; Laura Petersen Subject: FW: Message from Dig Safely New York, Inc. (DSNY) -----Original Message----- From: Dig Safely New York Exactix <tickets@exactix.digsafelynewyork.com> Sent: Thursday, July 1, 2021 1:21 PM To: Mike Izzo <MIzzo@ryebrook.org> Subject: Message from Dig Safely New York, Inc. (DSNY) ****REGULAR**** DIG REQUEST from DSNY for: VIL RYE BROOK Taken: 07/01/2021 13:10 To: VIL RYE BROOK PRIMARY Transmitted: 07/01/2021 13:20 00004 Ticket: 07011-001-476-00 Type: Regular Previous Ticket: ------------------------------------------------------------------------------ State- NY County: WESTCHESTER Place: RYE BROOK Addr: From: 41 To: Name: COUNTRY RIDGE DR Cross: From: To: Name: Offset: - ----------------------------------------------------------------------------- Locate: BACK OF THE HOUSE & THE SIDE NearSt: FAIRLAWN PKWY Means of Excavation: SHOVEL Blasting: N Site marked with white: N Boring/Directional Drilling: N Within 25ft of Edge of Road: N Work Type: FENCE INSTALL Estimated Work Complete Date: 07/14/2021 Depth of excavation: Site dimensions: Start Date and Time: 07/12/2021 07:00 Must Start By: 07/26/2021 ------------------------------------------------------------------------------ Contact Name: ARRIELLA DIAMOND Company: Addrl: 41 COUNTRY RIDGE DR Addr2: City: RYE BROOK State: NY Zip: 14763 Phone: 646-417-4251 Fax: Email: arriella.diamond@gmail.com Field Contact: ARRIELLA DLAMOND Alt Phone: 646-417-4251 i Working for: WORK TO BE PERFORMED BY: CONTRACTOR ------------------------------------------------------------------------------ Comments: CALLER ADVISED TO HAVE CONTRACTOR CALL DIG SAFELY NEW YORK Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: CON-ED SUEZ WTR WESTCHESTER VIL RYE BROOK WESTCHESTER CTY SWR 2 O ' oz z OZ N �l Of N u'Qr �j �- X LU 17 Win° U.C) Lo CD gJ � J lug >ED � A I i ap "b" 0-1 O r � J ��v b Q' �O �d\ P Y �d \ � w O� Oae„ Oda pa Owa CEO W W zC6 oe W °moos aC4v p;e ti �z� vow V W w z z W O W Q � p W r•, 0.'i � O w � \ y y O V N� y w O v1 a �. y A a U a A�� � W Q V� � ww y3 �� �a FQ W'"O �" O a°vo n y� 4t z [�Ems, '►+ i C� o•., zii U N e o c 3 w a o `� CQ U "4 �O �N '� N �"� �1� �� � Va �+�C a A � 'ti p\ Q N q aka ya F �� aWy 0 tw. 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