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HomeMy WebLinkAboutBP21-190PERMIT I SECTION TYPE OF JOB LOCH / 90 RST. COST - FEE A CO# FEEIID� L� DATE (Olt I TCO # FEE DATE INSPECTION RECORD DATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING RGH PLUMBING GAS Q _ SPRINKLER ELECTRIC 0 LOW -VOLT 0 ALARM � ` AS BUILT FINAL /o S qo 14 ScD, a'D o� 9a 9a �q/j/)359- 799/ OTHER APPROVALS BOT PB ZBA OTHER Zad rJo4;�n �A�IaL� a fdA. �eLvvA.14 �l-(r zo?r -BUILTIFINAL SURVEY REQUIRED PRIOR TO FINAL INSPECTION I-4-Zy 04� CD- � �.xP•zed La41.,, I- �'1- Z`I �yE BR A to`Iy UJJJ VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook, N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury www.!3:ebrookny.gov TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE June 11,2024 James Seguljic&Wendie Seguljic 17 Eagles Bluff Rye Brook,New York 10573 Re: 17 Eagles Bluff, Rye Brook,New York 10573 Parcel ID#: 135.27-1-44 Building Permit#21-190 issued on 7/28/2021 for a New Fence This certifies that the new four foot high open picket aluminum rear yard fence,installed under the above captioned permit has been satisfactorily completed. Sincerely, Steven E. Fews Building& Fire Inspector /to For office use only: MAY 17 2024 BUILDING DEPARTMENT PERMIT# � VILLAGE OF RYE BROOK ISSUED: 7-,Q8-a21 VILLAGE OF RYE BROOK 938 KING STREET,RYE BROOK,NEW YORK 10573 DATE: :5 / 7- BUILDING DEPARTMENT (914)939-0668 FEE: 7/0 t L'l www.ryebrook.orQ 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 #iftii4ittiff♦#t####i######R[tiff#t###t#####iiiffiff f###### ti#if#if##tt#f##i##tffiifif##i##ttitJf►fififf Jt###tififfifi#i#### "V Address: Occupancy/Use: Parcel ID#: Zone: Owner: 7 a h le2-> Wevaz Address: 1 J Ccc k e S Q> P.E./R.A. or Contractor: i C0 • ip Address: Person in responsible charge: R�'(S�Ll4 C�cy a!t `'A 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: i �Q•vY\c' se'., being duly sworn,deposes and says that he/she resides at (Print N( e of Ap lic , 1 (No. nd Street) � 1�f 0 in in the County of W in the State of _IN�,that (City[rown/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:$ � E3 V 0 for the construction or alteration of: <\n l)� b G �✓� i �w1 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 l D Sworn to before me this I� day of M� , 20 day of , 202,1 Signature of Pro rty Owner Signature of X41icant 0�_' p I-- _ J G,+wJ -ja V)n VS SQ rint N e of Property Owner (rint Na a of Applicant tary Public Notary Public Lindsay Rand Mcguckin Lindsay Rand Mcguckin Notary Public-Connecticut Notary Public-Connecticut _I My Commission Expires My Commission Expires June 30,2024 June 30,2024 �yE BRC��. t7 T 1932 BUILDING DEPARTMENT ❑BUILDING INSPECTOR J21ASSISTANT 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.or - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : / / c A 6, /Cs T�L u 4 DATE: �- b - C UZ J PERMIT# -t:R 2 1- ( )U ISSUED: o"2/SECT:�Jr,z -7 BLOCK: / LOT: J�� LOCATION: 1 l 4- ,Q , d 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 S ���� 4;,J ❑ L.P. GAS ❑ FUEL TANK 62 ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION �] FINAL r Q OTHER t PJ C.e. �yE BR(� VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A.Klein (914) 939-0668 Christopher J. Bradbury www.ryebrook.org TRUSTEES BUILDING & FIRE INSPECTOR Susan R.Epstein Steven E. Fews Stephanie J. Fischer David M.Heiser Salvatore W.Morlino April 15,2024 2od&Final Notice Via Mail/ Hand Delivered Dear Rye Brook Building Permittee, Mr.&Mrs.Seguljic 17 Eagles Bluff Rye Brook,New York 10573 It has come to the attention of the Building Department that your Building Permit has not been closed out in accordance with Village Code and is now expired.All Building Permits have a twelve(12) month lifespan starting from the date of issuance, and the permit expiration date is noted on the front of the permit. Please note that there is a non-waivable Expired Permit Fee of$500.00 now due in connection with your expired permit.Once payment is received,your permit will be reinstated for a period of six(6) months. Please be advised that it is a violation of Village Code to fail to close out a permit,and that a court summons could be issued, and fines may be imposed on the permit holder and/or property owner for failure to apply for and obtain a Certificate of Occupancy(C/O)or Certificate of Compliance(C/C),in accordance with Village Code section 250-10A. Please note that Temporary C/Os&C/Cs are available in accordance with Village Code section 250-10B should you require more time to perform whatever work remains in order to complete your project. Thank you for your attention in this matter,and please feel free to contact this office should you require any further information. Steven E.Fews Building&Fire Inspector stevefews .1yebrook.org cc:Alfredo DiVitto,Assistant Building&Fire Inspector Tara A. Orlando,Planning&Zoning Secretary Laura Petersen,Office Assistant /to Y � x IN Y • � a= °$ � 8 m � 'L `c4 • N LL� y Q H LL m Q C � O�1fQ m rn La cc 0 i ❑cc rroorr rrnnn ncorr orrni 2 { D K $ o \\( \ \k % 2 - O E q� ❑ ❑ \\� \\§ a!,=aee; G e {D }\//) $ 0 £!2 \± u=c El El Cl � { } ° ! $ 2 + _ - ID : » �{ m 0 q }7 E;\ff5w ƒ . }s \77kk\{®2a =u = !!e CO CC {/ \f�77;;;2® d x a a °<)0000 wenogc= / _ CO co ® Ln CD_ \ & a __ ± \ \ _ co% � q \ —aa . % { m 6 wco \\ j\ . } � \ \ -0 Cl � ! � Z\ ] £ , , — G a c g7 \ a , ® = ƒ \ c § P ,2 C/) 0 � � ; 2 ± / E ( \\ 2 / - a@ u o e 2 + 7 \ q \ \ k) eeee o Q , _ \ I j . m E £a8 § 9 \ � \ — ® E / ± U) _ _ \ r 2 ■ ■ ■ $ co _ w o a o U a Cc) LTaz)a a to N OZ m W m � WO m W Q } m W W E WOO o Z Z co Y Y � W Z o O M O > J U-) ru a > m W 1:0 a) } c:o W' c:o a) m IL W ? m U � � ru -D • !A ru a V) ru � N U Q) o WO) Ir O Ln N w+ C O �a C DR . 193 yle V4 V VY VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J.Bradbury www.ryebrook.org TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W. Morlino January 19,2024 Dear Rye Brook Building Permittee, It has come to the attention of the Building Department that your Building Permit has not been closed out in accordance with Village Code and is now expired.All Building Permits have a twelve (12) month lifespan starting from the date of issuance, and the permit expiration date is noted on the front of the permit. Please note that there is a non-waivable Expired Permit Fee of$500.00 now due in connection with your expired permit. Once payment is received,your permit will be reinstated for a period of six(6) months. Please be advised that it is a violation of Village Code to fail to close out a permit,and that a court summons could be issued, and fines may be imposed on the permit holder and/or property owner for failure to apply for and obtain a Certificate of Occupancy (C/O) or Certificate of Compliance (C/C),in accordance with Village Code section 250-10A. Please note that Temporary C/Os& C/Cs are available in accordance with Village Code section 250-10B should you require more time to perform whatever work remains in order to complete your project. Thank you for your attention in this matter,and please feel free to contact this office should you require any further information. /�g Steven E. Fews Building&Fire Inspector stevefews @ryebrook.org cc:Alfredo DiVitto,Assistant Building&Fire Inspector Tara A. Orlando,Planning&Zoning Secretary Laura Petersen,Office Assistant /to ^ Building Permit Check List&Zoning Analysis . Address: 17 T�`►li CAS �I L j FC-- SBL- 3 L . Zo�- I S Use: Const.Type: Other. Submittal Date: 2 Revisions Submittal Dates: Applicant: �l Nature of Work. -Q`� H-&<4-1 a N (GAF- ,al-kjLA-n �•F�C Reviews:zBAJ UN 2 1 2021 pB• BOT• Other. hMER OK ( ( ) FEES:Filing. ✓ BP: t op, _� C/O: Legalization: ( ) (-"P: Dated Notarized •"SBL cuss 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 Protection: S/W Mgmt.: Tree Plan: Other. ( ) KSURVEY:Dated: Current Archival: Sealed: Unacceptable: ( ) (, PLANS:Date Xwnped. Sealed Copies: -2- Electronic. ✓ Other. ( ( ) License Workers Comp:�Liability V Comp.Waiver. Other. (, ( ) CODE 753#. 0 l� 9/-e�I- 05 7 Dated: -7-0`3-W 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. ( mtg.date: 'I -L Z approval• '-1 2 2 notes: ( )ZBA mtg.date: approval: notes ( )PB mtg.date: approval• notes: REQUIRED EXISTING PROPOSED NOTES APPROVED Ate: date• JUL 2 2 021 Code. Front Front Sides: Rear. Main Cor. Accs.Cow. Ft HS : S .HS : a Tot-!=: ELiw: Height/Stories: notes: BUILDING DEPARTMENT D C IE F V F KING OF RYE BROOK [_!N g 2021 938 KG STREET RYE BRgov,NY 10 (914)939=914 939-5801 VILLAGE OF RYE BROOK r 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: 2+Eon 1 / 6LH Date of Submission: Parcel ID#: I.�t_J ��� `7`-f Zone:-5 Proposed Improvement(Describe in detail): APPLICANT CHECK LIST: MUST BE COMPLETED BY THE APPLICANT n C'e I u n The following items must be submitted to the Building ?� rj UM I rl Vry1 Department by the applicant-no exceptions. 1. (V�Completed Application ��u/n(2)Se*C Af cP�1�nl�nc Property Owner: Address: I 3. (✓)Two(2)copies of the property survey. Phone# — 5. )One electronic/disc copy of the complete Applicant appearing before the Board: application materials. 6. ( Filing Fee. 7. ( )Any supporting documentation. 8. ( HOA approval letter. (ifapplicable) Address: 9. ( Photographs. Phone# 10.( )Samples of finishes/color chart. (a sample board or Architect/Engineer: model may be presented the night of the meeting) Phone# 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 , 2002 day of , 20 i� Si lure of UOwnerein Signature of Applicant , Print Name of Property Owner U k UPrint Name of Applicant �Public �y Pubk State of New York Notary Public No.02HA4956574 Qud led In Wetter County CM ntb"E)Oms September 25,2,oq ��� 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, July 21, 2021 NAME&LOCATION TYPE OF APPLICATION MOTION SECOND APPROVED REJECTED APPL.# 1 Lincoln Ave(Parr) Replace Wood Retaining Consent 5209 Wall, w/Masonry Liberty Agenda Stone, & Walkway 15 High Point Circle Re-Do Existing Deck in Consent (Hashimoto) Trex, Railing& Stairs. Agenda Paver Patio on Grade 8 Fairlawn Pkwy Roof Top Solar Array Consent (Levin) Agenda 17 Eagles Bluff 4' High Open Picket Fence (Seguljic) Rear Yard 3 M 4 Belle-Fair Road 6'0" Fence In Rear Yard Consent 5 222 (Kitchin) Agenda 20 Pine Ridge Road New Fence Consent 5223 (Bassuk) Agenda 39 Mohegan Lane Replacement of Bluestone Consent 5224 (Sheinheit) Walks In Kind Agenda 7 Ridge Blvd Amendment To Prior 5225 (Holleran) Approval -omit window 16 Maywood Ave Rear Yard Deck 5226 (Robles) Expansion 17 Jeniffer Lane Above Ground Swimming 5227 (Dutra) Pool, Retaining Wall, Fence & Re-grade Yard 43 High point Circle Removed Old Existing 5228 (Goldman) Deck, To Build New Deck 8 Heirloom Lane New Rear Deck 5229 (Goldman) ML / NM MR v SE L/ JM / SF AC V✓ MI KC VILLAGE OF RYE BROOK BUILDING DEPARTMENT 938 KING STREET, RYE BROOK, NY 10573 (T) 939-0668 (F) 939-5801 ARCHITECTURAL REVIEW BOARD Wednesday, July 21, 2021 3 Edgewood Drive Exterior Projects, Deck 5230 (Feldberg) w/Stairs to Patio, Pergola, Outdoor Kitchen, Pond- less Water Feature 19 Beacon Lane Reconfigure Roof, New 5231 (Nebauer) Front Porch, & 2nd Floor Terrace 167 Country Ridge 1 Story Side In-Fill 5232 Drive(Hugon) Addition 11 Berkley Drive Rear 2nd Story Addition, 5233 (Signh/Gawtam) Rear Deck&patio. New Front Portico 19 Birch Lane In-Ground Pool, Turf 5234 (Jaccoma) Patio, Rear Yard Fire Pit 51 Country Ridge Dr Enlarge Existing Deck, 5235 (Wolf) Enlarge Existing Patio, New Front Walk 108 Old Orchard New Front Gable Roof, 5236 Road(Martino) Masonry Steps, Patio, Flagstone Walk& Cupola Over Garage. ML NM MR SE JM SF AC MI '�W t•'� S. �� '4 c 4 � 1:.�, . i`y�'�,D\ ��yr ,,1f'f' rk � ,I`� ,. t f ry�`„eirR^:.r-ins^�T.�,�•�a�. _ .. .. - NEU - :�r{lftft`.fL 1 V r � St Ali i kt �� - �vj 4 � I ( ::jam •. ,} �. I �} 'r, y ? , io 49 WJ ,•r, 1�, `y ., �ek.�,,�jty ti1� '� ,. '�. ri� ., .'��)i kl'"'FFF `� . I� ,�! - t t;. I f !• \ _ i . A t �,. y�\r. 1.�/l� 'E Ii'\ 1'�'�� ` I 1.\$..�,I•r - ��`I ,a /. f. •/ _ � i y i Y� t,T' a .� t�1ti�:^�D n, �`��."�� 1y��,i'� r '� `� .�..� ;y rrti`b '$�k"c�;"s,.• - �..w~'' '"'„�ffl{.a `'^a...--a•`arl,,�ti�- — - .���.-_-� .. _-_ - -aC-,t. sue... �,� ?r• "'�'.l.r_Y `/s, j{ �n tf •'� �...'... l l j' '� \ a , rl 7 i Yr� •'w v,\IM • lr zi 41 r C � .. •♦: �"�.' .� 'ram• }�:J.•R , DL^/�� sv� 4A � -y.. rf..,F � `� •y •���,`��'• • �4••.�^ t'� "�! i `tip�.. I - '- _•. j�\ , •_. � �� l ,/a':�y «gilt ,. � T � Lam• , .. ;•� r ` �( v � •q .�/';� ... ( ti r y, t4e, ti •ft t 'tip t ,•, ! _ ��'}:. ',r v �:' �.. L/ 1 � �y ,fir$! a � � �•, 1 Ar st •'�`�,» tom � '. . ..: �'. �`. ,r�fii>4'1 -'—� - ; � �'�� V l . It IK Zq- I• y fir,� ,n,,•, - y-• c.�.. �.,l�E r .. a►•1t � r a4 i�� "tij, ► " !.. -aw . r � C si.. • - �. f. As, .::�•. emu. . � r .•,..•�T r A Y : 14 a- S, ' t SPECRAILFENCES WITHOUT BOUNDARIES Distinctive Ele g • 1 B Desz n S I - Bennington A S4 - aybrook A This fence is designed to blend into the natural cadence This classic design with smooth rail top reflects of virtually any landscape. Embracing a traditional the mood of a late spring evening. fence style, it comes with an accent of spear points across the top. S2 - Berkshire A 5 - Ne Like the Bennington, the Berkshire recreates Inspired by the life of the ocean, this scallop design elegant tradition but comes with staggered spear with traditional spear points is a statement of grace. point picket tops. S3 - Essex A S6 - Citadel With its classic smooth rail top and traditional The Citadel's crown design with traditional spear spear points below, the Essex is designed to points suggests the power of authority with a subtle meet the most demanding aesthetic needs. ease. t ! < < aL I t,Moi i I r 4 A Indicates available also in our patented ALUMINATE`screwless design in all grades. The New Standard of Quality . . . That Makes An Impression " A] Imagine the elegance ' of a beautiful maintenance free fence to enhance your f - S property. SPECRAIL manufactures a comprehensive line of standard fences, r gates, arbors and handrail. We also g = r - offer custom fabrication upon request. P q We will modify any of our standard • . � �Fr;, ,.r.�� styles to accommodate the needs of I your design. Specrail's new patented screwless technology — ALUMINATE° . M is available in most popular styles and all grades. A premium ornamental fence system with an attractive screwless panel design. _ S-3 3 Laura Petersen From: Laura Petersen Sent: Friday,July 23, 2021 1:32 PM To: services@mikefence.com Subject: Building Permit Application - 17 Eagles Bluff Good afternoon, 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. ✓3. 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 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 Igetersen(Wryebrook.org 1 1�i7-- w , .rs.yfy Y.. "-��,.•. 4h �J... v x �,a'6yya,'r.,r, ,!py h p. ; Y __ R 1. . ��tT"'M'- �C'•y' •..Y •.•Sx: h�F a st�/T A f;,•Y. ,,,..�tir'a <� •w rti�jti'k'�s£ rY1�t,' i' 4r'4 trir"Cti, w b:»� t do, e♦ �! E, so♦ C.av .♦♦. r s= eo 'm y �,.., Sr ,Ibe ig ik // 11/ � 111 ♦ ' 3 � + �I►Ifll �' 14e/►11 vi. 1 , 'lls � ; 11 ►Y- � ��: ilel/, �,f� ?i.til�elfifi = :'�I /ffJ $ '`v'• • �-.� ,� •.cat,: y CAI 0 _ N I e �L > 4-1 N -v 0 CD co C) Fes.•,- .,.w:l� � � j.� f. `�.�'. .. P"' �I .^I W p U ee W r LU .• �f. . Q z c� b0 L1. UJ Ito CAI <(0)) f i•I V/ Z g W � L• W G Oi �(A)� UJLL o Y O y oG �Ga eye o . x O $r y • <( D>, V hey y ya(♦or)>� ' C � ,U U = O N d rn p Ch +' C7 r . 'ti„,•1 I G� � C _ . d a 1 Ih r I� f411 , All 1♦� ��A + � s��y» ♦ �, i :�►1 tn94'»t '' A A , A 1 A r Y" x �•�dnvi v4�•`�V,.'iLy. `N Ov�?lfl � 0 ''K , ik o® CERTIFICATE OF LIABILITY INSURANCE DATE / Y) o7/26/zs/20212oz1 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 Melissa Crosson NAME: C.Quick Insurance Agency PHONE (845)497-1119 7010 FAX (845 533-1179 A/C No Ext: AIC,No: ) 13 W.Main Street ADORIess: McIC@cquickinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# Washingtonville NY 10992 INSURERA: Utica First ins 15326 INSURED INSURER B: NGM Insurance Company 14788 Mike Fence Carp INSURER C: Hartford Fire Insurance Company 19682 PO Box 391 INSURER D: ShelterPoint Life Ins Co INSURER E: New Rochelle NY 10805 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2151303878 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 ADDLISUBRI POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD MM/DD LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR PREMISES Ea occurrence $ 50,000 MED EXP(Any one person) $ 5,000 A Y ART511477303 05/11/2021 05/11/2022 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X E]PRO- POLICY ECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 300.000 Ea accident ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED B1Z4851B 05/16/2021 05/16/2022 BODILY INJURY(Per accident) $ AUTOS ONLY I AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PERTUTE E 0TH- AND EMPLOYERS'LIABILITY Y/N STAR C ANY PROPRIETOR/PARTNER/EXECUTIVE F N/A 16WECAD2LZG 04/23/2021 04/23/2022 E.L.EACH ACCIDENT $ 100,000 OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 Disability D D463691 04/23/2021 04/23/2022 NYS Statutory Benefits DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Village of Rye Brook is listed as additional insured as per the above General Liabilty Policy.Work to be performed for Wendie Seguljic,17 Eagles Bluff,Rye Brook NY 10573 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 )) /��� �,� Rye Brook NY 10573 G/" {-��/ L ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD NEW Workers' S ATE Compensation CERTIFICATE OF Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1 a. Legal Name and address of Insured(use street address only) 1 b. Business Telephone Number of Insured MIKE FENCE CORP 914-636-6031 217 WOODLAND AVE 1 c. NYS Unemployment Insurance Employer NEW ROCHELLE, NY 10805 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 06-1723579 2. Name and Address of the Entity Requesting Proof of 3a. Name of Insurance Carrier Coverage(Entity Being Listed as the Certificate Holder) Hartford Fire Insurance Company Village of Rye Brook 19682 938 KING ST 3b. Policy Number of Entity Listed in Box"1a": RYE BROOK NY 10573-1226 16 WEC AD2LZG 3c. Policy effective period: 04/23/2021 to 04/23/2022 3d.The Proprietor, Partners or Executive Officers are ® Included. (Only check box if 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 "1a" 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. 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: Danielle Clausen (print name of authorized representative or licensed agent of insurance carrier) Approved by: 7 >v►ur L�fr_ t`��+�.�,du 07/26/2021 (Signature) (Date) Title: Operations Manager Telephone Number of authorized representative or licensed agent of insurance carrier: 845-497-1119 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: services@mikefence.com Sent: Thursday,July 29, 2021 11:42 AM To: Laura Petersen;Wendie Seguljic Subject: Re: Building Permit for 17 Eagles Bluff Dig Safe Ticket#:07291-001257 Thank you Laura for all your help in this regard. Best, Reyna Mike Fence Corp P.O. Box 391 New Rochelle, NY 10802 Tel: (914) 636-8031 Fax: (914) 636-8031 Check out Mike's Fence Co on Google! https://g_page/mikefencecoM?gm On 07/28/2021 11:50 AM Laura Petersen<lpetersen@ryebrook.org>wrote: Good morning, The building permit " TO" High Open Picket Aluminum Fence in Rear Yard" is ready for pick up. The permit fee is $100.00 (checks made payable to the Village of Rye Brook). Our office is open Monday— Friday 8:30am to 4:00pm. Please provide the DIG number prior to picking up the permit. Thank you Laura Laura(Petersen i Laura Petersen From: Mike Izzo Sent: Saturday, July 31, 2021 5:37 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 29, 2021 at 11:40:43 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> ****REGULAR**** DIG REQUEST from DSNY for: VIL RYE BROOK Taken: 07/29/2021 11:39 To: VIL RYE BROOK PRIMARY Transmitted: 07/29/2021 11:40 00005 Ticket: 07291-001-257-00 Type: Regular Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 17 To: Name: EAGLES BLF Cross: From: To: Name: Offset: ------------------------------------------------------------------------------ Locate: MARKED IN BRIGHT ORANGE RED FLAGS, WORKING IN REAR OF PROPERTY NearSt: MEADOWLARK RD & DEAD END Means of Excavation: HAND DIGGER 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: 08/07/2021 Depth of excavation: 2 FEET Site dimensions: Start Date and Time: 08/03/2021 09:00 Must Start By: 08/17/2021 ------------------------------------------------------------------------------ Contact Name: RENA CHAVARRIA Company: MIKE FENCE CORP Addr1: PO BOX 391 Addr2: City: NEW ROCHELLE State: NY Zip: 10802 Phone: 914-636-8031 Fax: Email: services@mikefence.com Field Contact: RENA CHAVARRIA 1 Alt Phone: 914-636-8031 Email: services@mikefence.com Working for: WENDY SEGULIJIC ------------------------------------------------------------------------------ Comments: 142 SQ FT IN TOTAL FOR FENCE : Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: ALTICE USA CON-ED SUEZ WTR WESTCHESTER VIL RYE BROOK WESTCHESTER CTY SWR 2 'Ag-n I *,,M;"qff-�$.<---tkv�-XW.dNq: Ili 2;20N,- 6:;.g-,)! 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