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HomeMy WebLinkAboutBP21-160PERMIT # 0'. DATE: EXF c SECTION Iasi Sa BLOCK _ LOT. TYPE OF WORK JOB LOCATION CONTRALTO INSPECTION RECORD DATE FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING CO RGH PLUMBING GAS SPRINKLER ELECTRIC LOW -VOLT a ALARM AS BUILT FINAL FEE, INSP N .. di 17, �� OTHER APPROVALS 607 Pt3 ZBA OTHER UILTIFtNAL SURVEY REQUIRED PRIOR TO FINAL INSPECTION ecelVe 9 14a �yE DR Ytu o� 19 VILLAGE OF RYE BROOK MAYOR 938 King Street,Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914)939-0668 Christopher J.Bradbury www.tyebrookny.gov TRUSTEES BUILDING&FIRE INSPECTOR Susan R.Epstein Steven E. Fews Stephanie J. Fischer David M.Heiser Salvatore W.Morlino CERTIFICATE OF COMPLIANCE November 22,2024 Stephen Sibley&Megan Sibley 66 Tamarack Road Rye Brook,New York 10573 Re: 66 Tamarack Road,Rye Brook,New York 10573 Parcel ID#: 135.52-3-1 Building Permit#21-160 issued on 7/21/2021 for a New Fence This certifies that the new privacy fence,installed under the above captioned permit has been satisfactorily completed. Sincerely, Steven E.Fews Building&Fire Inspector /to D For office use onl BUILDING DEPARTMENT PERMIT# 3JUL 2 9 2024 VILLAGE OF RYE BROOK ISSUED: 1938 KING STREET,RYE BROOK,NEW YORK 10573 DATE: -7 a9-ay VILLAGE OF RYE BROOK (914)939-0668 FEE: # PAID J9 BUILDING DEPARTMENT wwwxyebrookny.2ov 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 Address: Occupancy/Use: //--4 A/ Parcel ID #: ��J, Jac)- — 3— Zone: Owner: S efl aa(Inn ��4m Address: 4Ald C* P.E./R.A. or Contractor: Ck;-LkL C(L, �c4 c d r� `�QO 6 1KS0,7 gVe � e. Address: i � n ^ It Person in responsible charge:�SC'L U� 1D 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: h�lpsd (t,r�, )'-\R tr being duly sworn,deposes and says that he/she resides at Loli G�m O„/tl c,LL (Print Name of Applicant (No.and Street) in�e b-00 11 in the County of V.���rC fry�J yy in the State of Y`y ,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:$ a 5 for the construction or alteration of \y(kt.A4ll� N r 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§250-10.A.of the Code of the Village of Rye Brook. Sworn to before me this Sworn to before me this day of - , 20 Q--\ day of , 20 Signature of 0-4r4 Owner Signature of Applicant �'_ct Cl JAAt \i Print Name of rP operty Owner k Print Name of Applicant Public Notary Public SHARI MELILLO Notary Public,State of New York. No.01ME6160063 Qualified In Westchester County- 7 7 Commission Expires January 29,20_ QyE BRC�v,,s uJ � �7 rc /�• 1982� BUILDING DEPARTMENT ❑BA' LDING INSPECTOR ❑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 : (a � DATE: `( PERMIT# -b Z - ISSUED: SECT: BLOCK: LOT: 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 ❑ FUEL TANK ❑ FIRE SPRINKLER ^! „�, ❑ FINAL PLUMBING ❑ CROSS CONNECTION 0 FINAL ❑ OTHER Building Permit Check List&Zoning Analysis Address: —TZr, SBL: 13S,-S2-3 Zone:. 1-'2 Use: Z l Const.Type: _3� Other. Submittal Date: Z ( Revisions Submittal Dates: Applicant: s C_FLY Nature of Work �1 b•� �2 v is c 7 ,� cp� Reviews:ZBA: PB: BOT: Other. hTLJ2� OK ( ( ) FEES.Filing. 7s' �� BP: L 0-0� ' C/O: Legalization: ( ) (.Y APP: Dated Notarized. SBL Thus I.D. Cross Connection: H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening: ( ) ( ) ENVIRO:Long. Shore Fees: N/A: ( ) ( ) SITE PLAN:Topo: S' Protection: S/W Mgmt.: Tree Plan: Other. ( ) ( SURVEY:Dated: �/ a ( Current: Archival: ✓ Sealed: Unacceptable: ( ) ( ) PLANS:D Stamped: Sealed. Copies: Electronic Other. (� ( ) License -7 Work s omp. CyG _i'1C/c — mp.Waiver Other CODE 753#: 7 I % 1S Dated: -7 L N/A: ( ) ( ) HIGH-VOLTAGE ELECTRICAL-Plans: 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: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. GARB mtg.date: SPq ls approvah S 15 1"21 notes: ( )ZBA mtg.date: approval:- notes: ( )PB mtg.date: approval notes: REQUIRED EXISTING PROPOSED NOTES AMRO M Area: _ MAY 2 6 7071 code: Fro tags Front Front: Sides: R&ar. Main coy Accs,cv F S Sd.H/Sb a& Tom: Et In. : P Hight/Stories: notes: BUILDING-D�ARTMENT R �� VILLA'�E OF RY ORIOOK DD 938 KING Sii EET RYE BR01'6k,NY 10573 APR 0 6 2021 (914)93 9 39-5801 VILLAGE OF RYE BROOK ° 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. Job Address: � TAOA tkC lC 1110/V0 r Date of Submission: L4 �Z4 Parcel ID#: "3 -1 Zone: ' Proposed Improvement(Describe in detail): APPLICANT CHECK LIST: Q MUST BE COMPLETED BY THE APPLICANT Ns�Atk '11D QV- 7 y C The following items must be submitted to the Building 1 ICiL1/�L� d i.0 k---'` PE (0CA Department by the applicant-no exceptions. IN DV TI �+ S oU S t rjEs n;- 1. ( ,,)Completed Application 2. ( jJwo(2)sets of sealed plans. (one full size{maximum Property Owner: S1-k'OHr-tj �I glk4 allowable plan size=36 x 42-1 and one I 1 x17 ) Address: V 1YWA&V-4_ �440 3. ( .-Two(2)copies of the property survey. 4. ( 4Two(2)copies of the proposed site plan. Phone# 41 't��' 16 5. ( ,),One electronic/disc copy of the complete Applicant appearing before the Board: application materials. 6. ( 'Filing Fee. SnzP�l�l SI�I�L� nq -- 7. (,�Any supporting documentation. Address: (,� TY�MA-Qhe+e_ y 8. ( ) HOA approval letter. (ifapplicable) 9. Photographs. Phone# q.l q-:�i31- TlbI5 10.( ) Samples of finishes/color chart. (a sample board or Architect/Engineer: U►SA &1 t�CV�^ model may be presented the night of the meetingd Phone# �i �� �L�• � 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. Sworn to before me this Sworn to before me this -� day of PaPCA , 20 7( day of �I t"t , 2021 Signature of-Property Owner Signature of NWicant SI-wgez 5P44W Print Name of Property Owner Print Name of Applicant 0�z 't, I Notary Public Notary Pu is "ANDPO LUKIC 'ANDPO LUKIC Notary Put!i. -Stagy of New York Notary Put Stag of New York NO.u1LU6311072 NO. v1LU6311072 Qual fled it "' ._che ter County Quai fled it I —che ter County My Commis xpi, ,Sep 8, 2022 My Commi: xpi- ,Sep 8, 2022 3/21/19 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 Due to public health and safety concerns from COVID-19, the Architectural Review Board meeting on May 19, 2021 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 hftps://us02web.zoom.us/i/89843106184 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: 898 4310 6184 NAME& LOCATION TYPE OF APPLICATION MOTION SECOND APPROVED REJECTED APPL.# 66 Tamarack Rd New 6ft White PVC Picket Consent 5185 (Sibley) Fencing Side Yards Agenda Lk 78 Woodland Ave Legalize Replacement of Consent 5186 (Freeman) Wood Deck Railing & Agenda Boards w/Trex, &New Paver Walkway. 112 Country Ridge New Rear Patio w/Fire Pit Consent 5187 Dr(Sandarciero) & Sitting Wall Agenda 14 Berkley Drive Replace & Enlarge Terrace Consent 5188 (Nachman) Patio, Add Built In BBQ Agenda 6 Birch Lane New 4Ft High Black Consent 5189 (Gitkind) Aluminum Fence In Rear Agenda Yard 49 Rock Ridge Dr. New Rear Patio On Grade Consent 5190 (Firestone) (Blue Stone) Agenda 105 N. Ridge St New 4Ft High black Chain Consent 5191 (Sepkowski) Link Fence & 4Ft High Agenda Black Aluminum Fence. 34 Garibaldi Place 6Ft High White PVC Fence Consent 5192 (Crute) Side Yards Agenda ML NM MR SE ✓ JM f SF AC ,/ MI KC 4/5/2021 IMG 5457.PNG 8:411 D AA vrayfajr.com APR 0 6 202i • VILLAGE_ OF RYE BROOK wayfa i r Q BUILDING DEPARTMENT • ® C'� � momw 4 ft. H x 7 ft. W Traditional Classic Fence Panel WomBom Traditional Fence *****15 $91.92 S}30.04 29 Off Free Shipping Get it by Thu.Apr 8 X t Save on Everything • ig Homo .nt �Oj Weather Resist < U m https://mail.google.com/mail/u/0/?tab=rm&ogbl#inbox/FMfcgxwLtQMfngRrFLXSVpvpHfzHSnNx?compose=new&projector=l&messagePartld=0.3 1 r 1 4/5/2021 IMG 5456.PNG M 8:404 .91 LTE S R V AA fi wayfair.com x APR 0 6 201 VILLAGE_ OF RYE BROOK BUILDING DEPARTMENT •wayfair w_ _. .p 6 ft. Hx6 ft. W Belfast Vinyl Fence Panel Sixth Avenue Building Products $132.99 S+*ii99 7%Off Free Shipping > Add to Cart UV Resistant -40 Weather Resist https://mail.google.com/mail/u/0/?tab=rm&ogbl#inbox/FMfcgxwLtQMfngRrFLXSVpvpHfzHSnNx?compose=new&projector=1&message Pardd=0.1 1/1 et. r '.S � a� �•G . L.'.i+. - ,N:.!'` - -tom- .�K • 1 `. �-1�•.- "�!"b� - I/T ✓/r I li�Jti J • �f t • �Ids �4 1 }�,1 s�, �} �,- F -';ir I i i I 1 � t � ,� F ! �, 4 }._ 'F �, r.}.j � t � r_�� �_t i•.�jYc�y 'f?� ��` ����'t y�/.t.� _:� —T^ �` •11�'#n� / / _ r4 y.. �, _�yr, �Na l� ....�111777P�ti �.� C ;±4 F � � � — �� '�-� - e _ �. �` w � •• m � ,: 1�1 � J - _ r i �. ,�; � �° �' �_ - - _ ._ ,\ - ! A AAWL f 3a j..ic Y_ Toy 77 r ♦`rt1 . p`i 'dif`t''r: - 6 t P•F 41t f ^�ij-V� 1�1� ix`` 4 ' b'i-�ul >t' 2�,e. �- •' �x i�� sr. 3 4 �'lYf.�f�/t �• dl�� oeo, 4T: �"�x'� _ _} jFi 2x� I> f a +sv� � ��••4p�'F�.Yk S'!IT��r� '�'2•'�.� _ J = _- Lf � •.apt i� t�}1� .� �l 1 p IJ SIXI), SO, Ac imam t 1y- , 1 r - - - ems. .�`.Kry_;. ✓ :_ �- —._....._ - -_. -. �__ - ���_ Laura Petersen From: Laura Petersen Sent: Thursday, May 27, 2021 8:59 AM To: sbsibs@yahoo.com Subject: Building Permit Application - Fence - 66 Tamarack Road Good morning, 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, General contractor's contact name & phone number. Copy of general contractor's valid Westchester County Home Improvement License. . General contractor's valid liability insurance (the Village Of Rye Brook must be the certificate holder) �4. General contractor's valid workers compensation on a NY State Board form (C105-2 or U26.3) 5. Building permit fee $100.00 (due once permit is issued and ready for pick-up) 6. Contractor must call Dig Safe NY and get a ticket number. This information can be emailed to me. Thank you 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 1 laetersen&ryebrook.ora 1 •rb��"26yr{5 � ra�(e ;- ^�� "x'�KY., A, ,r,�"`;r f�{} A !�N„�''�"��ir w:. ��+r` �, r �-- \� e� '�l\�" '� �t41* �1?: ti\ v ��^K:�: �a,•••� � '�o`�'`: , �1<n'F 4,��0••�. x�c' :3' O� 0 '���.�+`.+�y�tiYf6jil o '����friN'�'l,�'t��Yq�h �.. ''(,�yN�i�};'y}.,.. '� �FF`�ti,�}'t,'e y � r•ti��E ` :11� �kFn. ;;. �`�"�"" � �' ,v ��r� �(,i�s r .�ii}:t. �t�l��1 i�r "���S�t S� i r, �r j�„�•i�S.i;{ � 'lklEK��.�ti�'�n� O ':jR ��.� a O YF.``� .. '��• •11 `F7 r°/�l�j� y °1�/�1°�T 14sw��' `(fl/.l./° 112�!� Lt.' /i..• • t u. h' v � �� I+IilOdl�_,����� 101111► �� �f���'i-�///1 �� � � ` IA+ _� 1, r;l•/c .•. ,► t 'z ,,��.. � �_ ,_,, �7llii� ;.N�11 s7•: 3..:i-.11 11 �'-�€ � ...�_.11 �-. �11 hr 1 r ��� � ,,sJ CN CN CA go as O (p H r At LL Z T- O A W W } C i LLI W LL > WD 5 < Zr oi► 0 U Z = y °0 jm�A 0 ED 'z 0' O V tL t O W �O o :� H w�� aQ F-_• y y „ o 9z cc == � CD CN 460 oj � r11111 i - >>=rj+ 1+ 11 c a_i. •-•S:.r 1 1,. 111 j1�1::: 4 111/,j111. 11111'/l+ll 111/,1+11 �1111/,/1111 iti � /1/. +111+ � +111+ +1/1+ +111+ +t•�1+1 SN(+ A��® DATE(MM/DDIYYYY) C" CERTIFICATE OF LIABILITY INSURANCE 06/01/2021 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 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 CONTACT Michael Donnelly NAME: Donnelly Insurance Center ,CON No Ext: (914)347-6500 aC No): (914)347-6303 6 North Lawn Ave. EMAIL Info@donnellyagency.com ADDRESS: P.O.BOX 880 INSURER(S)AFFORDING COVERAGE NAIC 1f Elmsford NY 10523-0880 INSURER A: RUTGERS CASUALTY INSURANCE CO 41378 INSURED INSURER B: The AZteca Fence Inc. INSURER C: 4 Robinson Ave,FI.1 INSURER D: INSURER E: Bedford Hills NY 10507 INSURERF: COVERAGES CERTIFICATE NUMBER: CL2131830186 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 INSURANCEADDLISUBRI POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE Fx_]OCCUR PREMISES Ea occurrence $ 100'000 MED EXP(Any one person) $ 5,000 A Y SKP 1000565 12 07/26/2020 07126/2021 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JET LOC PRODUCTS-COMP/OP AGG $ 2.000,000 OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ElE.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION 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) FENCE ERECTION CONTRACTOR NO ROOF REPAIRS NO ROOF REPLACEMENT CERTIFICATE IS SUBJECT TO TERMS,CONDITIONS AND EXCLUSIONS OF THE ACTUAL POLICY AT THE TIME OF ISSUANCE.CERTIFICATE HOLDER IS/ARE ADDITIONAL INSURED WITH RESPECT TO WORK PERFORMED BY NAMED INSURED AS REQUIRED BY WRITTEN CONTRACT. 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 BUILDING DEPT ACCORDANCE WITH THE POLICY PROVISIONS. 938 KING ST AUTHORIZED REPRESENTATIVE RYE BROOK NY 10573 � ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD f \\ NYSIF New York State Insurance Fund WESTCHESTER ONE,44 SOUTH BROADWAY, LOTH FLOOR,WHITE PLAINS,NY 10601-4411 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ^A A^^^ 264642807 MICHAEL DONNELLY DBA DONNELLY INSURANCE CENTER PO BOX 880 ELMSFORD NY 10523 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER THE AZTECA FENCE INC VILLAGE OF RYE BROOK 4 ROBINSON AVENUE BUILDING DEPARTMENT FLOOR 1 938 KING STREET BEDFORD HILLS NY 10507 RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W2076160-7 1 586092 05/28/2021 TO 05/28/2022 6/l/2021 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2076160-7, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY,INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS://WWW.NYSIF.COM/CERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. ROSALINO D GAYOSSO-PRESIDENT OF THE AZTECA FENCE INC 1 OF 1 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUND DI RECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER:929226028 U-26.3 r Laura Petersen From: Mike Izzo Sent: Friday, July 9, 2021 7:47 AM To: Tara Gerardi; Laura Petersen Subject: Fwd: Message from Dig Safely New York, Inc. (DSNY) Sent from my iPhone Begin forwarded message: From: Dig Safely New York Exactix<tickets@exactix.digsafelynewyork.com> Date:July 9, 2021 at 7:03:16 AM EDT To: Mike Izzo <Mlzzo@ryebrook.org> Subject: Message from Dig Safely New York, Inc. (DSNY) Reply-To: Dig Safely New York Exactix<tickets@exactix.digsafelynewyork.com> ****LATE**** DIG REQUEST from DSNY for: VIL RYE BROOK Taken: 07/09/2021 07:01 To:VIL RYE BROOK PRIMARY Transmitted: 07/09/2021 07:01 00002 Ticket: 07061-002-120-01 Type: Late Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 66 To: Name: TAMARACK RD Cross: From: To: Name: Offset: ------------------------------------------------------------------------------ Locate: BACKYARD PROPERTY LINE TO PROPERTY LINE NearSt: RIDGE BLVD Means of Excavation: HAND TOOLS, DIGGER BAR Blasting: N Site marked with white: N Boring/Directional Drilling: N Within 25ft of Edge of Road: N Work Type: INSTALL FENCE Estimated Work Complete Date: 07/09/2021 Depth of excavation: 36 INCHES Site dimensions: Length 8 INCHES Width 8 INCHES Start Date and Time: 07/09/2021 07:00 Must Start By: 07/23/2021 ------------------------------------------------------------------------------ Contact Name: ROSALINO GAYSSO Company: THE AZTECA FENCE, THE ACTECA FENCE Addr1: 4 ROBINSON AVE Addr2: City: BEDFORD State: NY Zip: 10507 Phone: 914-943-9437 Fax: Email: aztecafence69@gmail.com Field Contact: ROSALINO GAYSSO 1 • Alt Phone: 914-943-9437 Working for: STEVE SIBLY ------------------------------------------------------------------------------ Comments: Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: CON-ED SUEZ WTR WESTCHESTER VIL RYE BROOK WESTCHESTER CTY SWR z Laura Petersen From: Mike Izzo Sent: Tuesday,July 6, 2021 4:19 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, July 6, 2021 2:34 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: 07/06/2021 14:32 To: VIL RYE BROOK PRIMARY Transmitted: 07/06/2021 14:33 00003 Ticket: 07061-002-120-00 Type: Regular Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 66 To: Name: TAMARACK RD Cross: From: To: Name Offset: ------------------------------------------------------------------------------ Locate: BACK YARD PROPERTY LINE TO PROPERTY LINE NearSt: RIDGE BLVD Means of Excavation: HAND TOOLS, DIGGER BAR Blasting: N Site marked with white: N Boring/Directional Drilling: N Within 25ft of Edge of Road: N Work Type: INSTALL FENCE Estimated Work Complete Date: 07/09/2021 Depth of excavation: 36 INCHES Site dimensions: Length 8 INCHES Width 8 INCHES Start Date and Time: 07/09/2021 07:00 Must Start By: 07/23/2021 ------------------------------------------------------------------------------ Contact Name: ROSALINO GAYSSO Company: THE AZTECA FENCE, THE ACTECA FENCE Addrl: 4 ROBINSON AVE Addr2: City: BEDFORD State: NY Zip: 10507 1 Phone: 914-943-9437 Fax: Email: aztecafence69@gmail.com Field Contact: ROSALINO GAYSSO Alt Phone: 914-943-9437 Working for: STEVE SIBLY ------------------------------------------------------------------------------ Comments: Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: CONED SUEZ WTR WESTCHESTER VIL RYE BROOK WESTCHESTER CTY SWR 2 Tt1LENo. 03/- WZ- /30e3 ------------- rh�P s ARISTOTLE BOURNAZOS, P.C. 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