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Home My WebLink AboutBP21-230PERMIT #/mil SECTION TYPE OF WORK JOB LOCATION . CONTRACTOR EST. COST�� ' VCO# >, DATE' 3 i a ExpoSim BLOCK LOT 7e/Aa ez A l 93 -c 5�19 [2rd i� 'ivi'Cc�s :�q (s03)571%`i FEE_, / = t�r�sPD TCO # INSPECTION RECORD DATE FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING C� RGH PLUMBING GAS SPRINKLER ELECTRIC LOW -VOLT ALARM AS BUILT ER FINAL INSP OTHER APPROVALS BOT PB ZBA OTHER AS-BUILT/FINAL SURVEY REQUIRED PRIOR TO FINAL INSPECTION [tom a Am aAniuvwaW 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 K Epstein Michael J. Izzo Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE July 11,2022 Michael Parr&Kathleen Parr 1 Lincoln Avenue Rye Brook,New York 10573 Re: 1 Lincoln Avenue, Rye Brook,New York 10573 Parcel ID#: 135.74-1-7 Building Permit#21-230 issued on 8/31/2021 to Replace Retaining Wall& New Walk This certifies that the new masonry retaining wall and new walkway,installed under the above captioned permit has been satisfactorily completed. Sincerely, Steven E. Fews Assistant Building&Fire Inspector /to R�� `� `� � R For office u e onl DBUILD MENT PERMIT# J U N 2 3 2022 DVIL OF RYE$ OK ISSUED: --31—a 38 KING STRE YE BROOK. YORK 10573 DATE: --) as VILLAGE 0-Fi BROOK )9 .Ob O-c FEE: A //0, PAID BUILDING DEPARTMENT 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 iRil MtMiMt►iiittitii►Rttitifiitfil ittt4Rtitit44ittit►iiiiliittt4ilR4R4tit Mittitiif tiifftiifti44ititiiiMtititiiif titlitl44ttti Address: 1 Lincoln Avenue Occupancy/Use: / "M Parcel ID#: 135.74-1-7 Zone: R-10 Owner: Michael Parr Address: 1 Lincoln Avenue P.E./R.A. or Contractor: Address:M ame" o&d 6r°PnW/CA CT Ob83C> Person in responsible charge: Michael Parr Address: 1 Lincoln Avenue 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: Michael Parr being duly sworn,deposes and says that he/she resides at 1 Lincoln Avenue (Print Name of Applicant) (No.and Street) in Rye Brook ,in the County of Westchester in the State of NY ,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:$ 15 000.00 for the construction or alteration of: Retaining wail and walkway 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 Swornto before me this day of 6 , 2 0_2' day of 2 0Z2 Signature of roperty Owner Signa a of Apph ant ytt Ge t °�ka2 � �T` � "�?t - Print Name of Property Owner Print Name Applicant --7 �%Ald_Q - Notary Public Notary Public R Pub><e,�e MY ,wry.01LA 4 FLY. y u2I G,dW ptp.piLg6009242 �o ( 42 duaft it IMastchester Cquty q �' n 1 Cow �� C.tx�r -Tk f! F.kia w Feb.2120� Cnmmfss!;n EOM Pob.T�,a.�� QyE aRO BUILDING DEPARTMENT ❑BUILDING 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 Eyebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - y� ADDRESS :_ �✓ 1 , �U DATE: -3 0�y PERMIT# ' y ISSUED: iECT:'S- ! BLOCK: ! L T: LOCATION: VCCUPANCY• ❑ VIOLATION NOTED THE WORK IS... d ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION ( REQUIRED ❑ FOOTING F.. ❑ 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 Mike Izzo From: Mike Izzo Sent: Thursday, May 12, 2022 1:57 PM To: Michael Parr Cc: Steven Fews; Tara Orlando; Laura Petersen Subject: RE: 1 Lincoln Ave, Permit BP 21-230 Dear Mr. Parr Along with the C/O Application & fee you must submit a new as-built property survey. Once we receive and review those items we can schedule the final inspection to close the permit. Thank you. lffl��ad v, Izzo Building & Fire Inspector Village of Rye Brook, NY (914) 939-0668 From: Michael Parr<michael.r.parr@outlook.com> Sent: Wednesday, May 11, 2022 5:19 PM To: Mike Izzo <Mlzzo@ryebrook.org> Subject: 1 Lincoln Ave, Permit BP 21-230 Hello Mr. Izzo, The back yard work is finally done. Besides the cost certification what else do I need to do to close this permit? Thanks, Michael Parr i Building Permit Check List&Zoning Analysis i' Address: t L I►-.+ C•oe,ti 6V v = SBL• 3-� • —' Zone 4> Use: 21 Const.Type: Other. Submittal Date: 2(0 LZ Revisions Submittal Dates: Applicant: Nature of Work: W(AL "S q N 4� QUw LA)A�--Fr.�l�V Reviews:ZBA:J U N - 1 2021 PB: BOT: Other. QK ( ( ) ES:Filing:�� BP: ��A • � C/O: Legalization: ( ) ( P: Dated: ✓ 1�omrized: SBL: Truss I.D. Cross Connection: ✓ I H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening. ( ) ( ) ENVIRO: Long Shore Fees: N/A: ( ) (X SITE PLAN:Topo: Site Protection: S/W Mgmt.: Tree Plan: Other. ( ) (4SURVEY:Dated Current: Archival- Sealed Unacceptable: ( ) ( ) PLANS:]z1*W70r ed: Sealed Copies: Electronic Other. License: kers Comp: Liability Comp.Waiver. Other. CODE 753#: Off 30) --Da ins 93-DO Dated— --3 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. O O 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. (7 mtg.date: (o l b Z 1 approval- notes: ' ( )ZBA mtg.date: approval- notes: ( )PB mtg.date: approval: notes: REQUIRED EXISTING PROPOSED NOTES APPROVED A tok �� Z - �4 JUL 2 2 2021 Circle: FFn g� Front Front- Si c: Main Cov z D 1 6 S Accs.Cov. Ft.H S : Sd.H/Sb Tot, 0 P Hcwk/Stories: notes: FRD JE C IENE BUILP.P�j j �,gTMENT DD VIL,��E OF`]k OK MAY 2 6 2021 938 KING S� ET] BR ,b NY 10573 (914)93 - 9 V`39-5801 VILLAGE OF RYE BROOK aok' ` BUILDING DEPARTMENT ARCHITECTURAL REVIEW BOARD CHECK LIST FOR APLI.CANTS 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 theARB agenda. Job Address: 1 Lincoln Ave. Phone#718.852.6290 Parcel ID#:135.74-1-7 Zone:R-10 Date of Submission: Proposed Improvement(Describe in detail): Remove Railroad tie wall and replace using APPLICANT CHECK LIST: The following items must be submitted to the Building Liberty stone and install paved walkway. Department with the application-no exceptions. 1. (X)Completed Application 2. (X)Three(3)sets of sealed plans. (one Ul size(maximum Property Owner: Michael Parr allowable plan size=36"x 42")and two I I"xl7") Address: 1 Lincoln Ave. 3. (X)Three(3)copies of the property survey. 4. (X)Three(3)copies of the proposed site-plan. Phone#914.939.0549 5. ( One electronic/disc copy ofthe complete Applicant appearing before the Board: application materials,. . ; Michael Parr 6. ( )Filing Fee. 7. ( )Any supporting documentation. Address: 1 Lincoln Ave. 8. ( )HOA approval letter.(rfapplicable) 9. ( )Photographs.. Phone#914.939.0549 10.( )Samples of finishes/color chart. (a sample board or ArchitectlEngineer. Todd Johnson model may be presented the night of the meeting) 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 J �L-- day of , 20 2 1 day of , 20 �\ Signature of Property Owner Signature of Applicant. Michael Parr Michael Pa vi;111 11 Print Name of Property Owner Print Name of Applicant Notary Public Notary Public AthadC 1.1= "gottlY. ILAy�ptant �AN.Y Qlf 242 _� (omft N�achtNaRFWes hesler.23, L7� 1r. 12/8/2016 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 5 219 (Hashimoto) Trex, Railing& Stairs. Agenda Paver Patio on Grade 8 Fairlawn Pkwy Roof Top Solar Array Consent 0 (Levin) Agenda 17 Eagles Bluff 4' High Open Picket Fence 5221 (Seguljic) Rear Yard 4 Belle-Fair Road 6'0" Fence In Rear Yard Consent f,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 SE JM �r SF AC oT MI KC �- — 1 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 M I KC - - VILLAGE OF RYE BROOK BUILDING DEPARTMENT 938 KING STREET, RYE BROOK,NY 10573 (T) 939-0668 (F) 939-5801 ARCHITECTURAL REVIEW BOARD ` Wednesday, June 16, 2021 C Due to public health and safety concerns from COVID-19, the Architectural Review Board meeting on June 16, 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 https://us02web.zoom.us/*/8541117"03 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: 8541117 4403 NAME& LOCATION TYPE OF APPLICATION MOTION SECOND APPROVED REJECTED APPL.# 78 Woodland Ave - Replacement of Railing 5186 (Freeman) and Decking on Front Porch 5 Charles Lane Re-Do Existing Front Consent 5208 (Gasparini) Walkway In Blue Stone Agenda 1 Lincoln Ave(Parr) Replace Wood Retaining Consent 5209 Wall, w/Masonry Liberty Agenda O Stone, & Walkway 4 Candy Lane Replace Decking & Consent 5210 (Dluzhevskiy) Railing On Existing Deck Agenda (PVC Paramount Sandstone) 2 Charles Lane New 6' High Rear Yard Consent 5211 (Kaplan) Fence Agenda 16 Legendary Circle New Deck, New Patio, 5213 (Abramsohn) Retaining Wall, Expand Driveway & Landscaping 18 Rocking Horse Amendment To Prior Consent 5214 Trail (Feist) Approval Fence Change to Agenda Vinyl & Steps 23 Hawthorne Ave Outdoor Fire Place & 5215 (Quinson) Chimney ML NM MR SE JM SF AC MI KC 39 Country Ridge Amendment To Prior 5216 Drive(Austrian) Approval(Pool House Wrap Bottom In Stone Veneer) 65 rock ridge Drive Relocate Patio Door,New 5217 (Ayala) Windows,To Facilitate Inteiror Alterations 13 Knollwood Road Rear 1 Story Addition, 5218 (Luceno) Rear Deck, & Masonry Patio ML NM MR SE JM SF AC MI KC Laura Petersen From: Laura Petersen Sent: Friday,July 23, 2021 2:45 PM To: 'michael.r.parr@outlook.com' Subject: Building Permit Application - 1 Lincoln Avenue Good afternoon, The building permit application has been approved by the Building Inspector. Before I can issue the building uilding permit the following items must be submitted to our office, V/ 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 $140.00 (due once permit is issued and ready for pick-up) f6. 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 IaetersenOryebrook.org 1 V, c a� NF " o u > V5co o o a w o ocr • o ��» � a1 I•r (A � o U c� W r c A w CO M �CD v J W ~ U a n y 0 40 LUJw>- 3 y w ✓ p C� co 0 .5 C� G� X o z u o o <co» 1. a i wis U �Y El s f�\ �. D ---I*i DA ACOR1Y CERTIFICATE OF LIABILITY INSURANCE TE(MMA)D/YYYY) 08/09/2021 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. It 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 endorsements. PRODUCER CONTACT Phil vanegas NAM JOHN M BROWN INSURANCE AGEN PHONE 773-8t19.5980 FAx r 73-657 2010 21750 Hardy Oak Blvd Ste 104 R Phawfarrnerbrown corn MSUR S AFFORDe/0 COVERAGE NA1C a Sari Antonio Tx 782,18 413J6 INSURER A AIX Specialty Insurance Campany INSURED INSURERS J&M Gardening Services LLC INSURER C 158 Byram Rd INSURER D: INSURER E Gfeenwich i VA83i7 INSURER IF COVERAGES CERTIFICATE NUMBER: REVISM 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. INS Trill OF INSURANCE POLICY NUMBER MMIO—YY "DD7YYYY I.IYrT3 x COWIRCIAL GENERAL LLARL Y EACH OCCURRENCE S 1,000.000 CLAMS•MApE a 11109%,15— OCCUR S 50.000 MEOEXP are 5.000 A SIZGLO73OA 46863 03/04/2021 03N4/2022 pERSONALaADVINAMY S 1.000.000 GEV_AGGREGATE LIMIT APPLES PER. GENERALAGGREGATE S I,Ow•000 POL ILA F-1 7 C ❑LOC PRODUCTS•COEpIOP AGO S 1,000,000 OTHER f AUTOMMILE UAMLIT Y = ANY AUTO BODLY IINAJRY(Par paraoiy f OWNED AUTOS ONLY SCHEDULED ODDLY 94AJRY(Par accident) S ON-0WNE HIRED ND AUTOS ONLY AUTOS ONLY S f UMBRDAAUAB OCCUR EACH OCCURRENCE 5 ESCM LIAR CLAIMS-MADE AGGREGATE S Of RETENTIONS f WORKERS COMPOSA11a1 AND EMPLOY�B'LWLITY r/N ANVPROPRIETO"AftT "xECUENE OFFICER,%*11IIIIIIIEREXCLUDED? D M r A E L EACH ACCIDENT(1111a S 'es xsuiha Widet a �Y In1,e E L DISEASE-EA EMPLOYEE S ' c 5:.G aTION Op OPERAT1pN3 babes E L DISEASE•POLICY LMMT f DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD ter.ArailMlal Miaarka Schedule,may be attached N more apace is r;;;td) This policy covers the following operations.Lanchcaping.Masonry.Painting(intenor&extefior)Clear"(outside but laing)and Fencing CERTIFICATE HOLDER CANCELLATION 'v i,iace of Rye SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 938 K rg Strrrt ACCORDANCE WITH THE POLICY PROVISIONS. Rye BrOOK NY 10573 AUTHORIZED REPRESENTATIVE ^ r-J 1J 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD YN'W Workers' Certificate of Attestation of Exemption STATE Compensation from New York State Workers' Compensation and/or Board Disability and Paid Family Leave Benefits Insurance Coverage **This form cannot be used to waive the workers'compensation rights or obligations of any party.** The applicant may use this Certificate of Attestation of Exemption ONLY to show a government entity that New York State specific workers'compensation and/or disability and paid family leave benefits insurance is not required. The applicant may NOT use this form to show another business or that business's insurance carrier that such insurance is not required. Please provide this form to the government entity from which you are requesting a permit,license or contract. This Certificate will not be accepted by government officials one year after the date printed on the form. In the Application of Business Applying For: (Legal Entity Name and Address): Home Improvement J&M Gardening Services,L.L.C. From:Village of Rye Brook 938 King Street 158 Byram Rd Unit B Greenwich,CT 06830-5938 PHONE:203-550-5749 FEIN:XXXXX5864 Workers'Compensation Exemption Statement: The above named business is certifying that it is NOT REQUIRED TO OBTAIN NEW YORK STATE SPECIFIC WORKERS'COMPENSATION INSURANCE COVERAGE for the following reason: The business is a LLC, LLP,PLLP or a RLLP;OR is a partnership under the laws of New York State and is not a corporation. Other than the partners or members,there are no employees,day labor, leased employees,borrowed employees,part-time employees,unpaid volunteers(including family members)or subcontractors. Partners/Members: Diego Ospina Disability and Paid Family Leave Benefits Exemption Statement: The above named business is certifying that it is NOT REQUIRED TO OBTAIN NEW YORK STATE STATUTORY DISABILITY AND PAID FAMILY LEAVE BENEFITS INSURANCE COVERAGE for the following reason: The business MUST be either: 1) owned by one individual; OR 2) is a partnership(including LLC,LLP,PLLP,RLLP,or LP)under the laws of New York State and is not a corporation; OR 3) is a one or two person owned corporation,with those individuals owning all of the stock and holding all offices of the corporation(in a two person owned corporation each individual must be an officer and own at least one share of stock); OR 4) is a business with no NYS location. In addition,the business does not require disability and paid family leave benefits coverage at this time since it has not employed one or more individuals on at least 30 days in any calendar year in New York State. (Independent contractors are not considered to be employees under the Disability and Paid Family Leave Benefits Law.) I,Diego Ospina,am the Member with the above-named legal entity. I affirm that due to my position with the above-named business I have the knowledge,information and authority to make this Certificate of Attestation of Exemption. I hereby affirm that the statements made herein are true,that I have not made any materially false statements and I make this Certificate of Attestation of Exemption under the penalties of perjury. I further affirm that I understand that any false statement,representation or concealment will subject me to felony criminal prosecution,including jail and civil liability in accordance with the Workers'Compensation Law and all other New York State laws. By submitting this Certificate of Attestation of Exemption to the government entity listed above I also hereby affirm that if circumstances change so that workers'compensation insurance and/or disability and paid family leave benefits coverage is required,the above-named legal entity will immediately acquire appropriate New York State specific workers' compensation insurance and/or disability and paid family leave benefits coverage and also immediately furnish proof of that coverage on forms approved by the Chair of the Workers'Compensation Board to the government entity listed above. SIGN Signature: - �Yl U�� Date: CS 3 012 0 Z HERE �i¢✓v '�� u Exemption Certificate Number Received 2021-054931 August 30, 2021 ' NYS Workers'Compensation Board Laura Petersen From: Michael Parr <michael.r.parr@outlook.com> Sent: Monday, August 30, 2021 9:41 AM To: Laura Petersen Subject: Building Permit Application - 1 Lincoln Ave. Attachments: JMGardeningCertificateOflnsurance.pdf; JMGardeningWestchesterLicense jpg; JMGardeningWorkersCompensation.jpg Good morning Ms. Petersen, Attached please find the insurance certificates requested. Dig Safe New York ticket #08301-000-583 My Contractor name and phone number: Diego Ospina AM Gardening Services LLC (203)550-5749 Please let me know when I can pay the $140 fee and pick up the permit. Thanks, Michael Parr i Laura Petersen From: Dig Safely New York Exactix <tickets@exactix.digsafelynewyork.com> Sent: Monday, August 30, 2021 9:27 AM To: Mike Izzo Subject: Message from Dig Safely New York, Inc. (DSNY) ****REGULAR**** DIG REQUEST from DSNY for: VIL RYE BROOK Taken: 08/30/2021 09:26 To: VIL RYE BROOK PRIMARY Transmitted: 08/30/2021 09:27 00001 Ticket: 08301-000-583-00 Type: Regular Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 1 To: Name: LINCOLN AVE Cross: From: To: Name: Offset: ------------------------------------------------------------------------------ Locate: ENTIRE PROPERTY NearSt: WESTCHESTER AVE Means of Excavation: SHOVEL Blasting: N Site marked with white: N Boring/Directional Drilling: N Within 25ft of Edge of Road: Y Work Type: INSTALL SPRINKLER SYSTEM, INSTALL DRAIN TILE, TREE PLANTING Estimated Work Complete Date: 09/23/2021 Depth of excavation: 2 FEET Site dimensions: Start Date and Time: 09/02/2021 07:00 Must Start By: 09/17/2021 ------------------------------------------------------------------------------ Contact Name: MICHAEL PARR Company: Addrl: 1 LINCOLN AVE Addr2: City: RYE BROOK State: NY Zip: 10573 Phone: 914-939-0549 Fax: Email: michael.r.parr@outlook.com Field Contact: MICHAEL PARR Alt Phone: 914-939-0549 Working for: WORK TO BE PERFORMED BY: HIRING CONTRACTOR ------------------------------------------------------------------------------ Comments: CALLER ADVISED TO HAVE CONTRACTOR CALL DIG SAFELY NEW YORK Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: ALTICE USA AT&T BELL-VALHALLA / WSCHSTR CONED FIRSTLIGHT FIBER LEVEL 3 COMMUN 1 MCI NYSDOT TFC POKPSE SUEZ WTR WESTCHESTER VIL RYE BROOK WESTCHESTER CTY SWR ZAYO z LINCOLN AVENUE _ 77.06 Fr REV1 ' /� `c.�Q f NEW ,j PL A JUN - 3 2021 �� ' PAVER 1 DATER: ��'`� 196Ls:WAY y j �c' EXISTING _' 1 BUILDING DEPARTMENT DRIVEWAY EXISTING 882 s.f. FENCE AND GATE j Village of Rye Brook A.rchitectur I Review Board l Approval Date: EXISTING FENCE ] Chairman: AND GATE EXISTING ANDGARAGE ' 00, f... Q 2,058 s.. 1 EXISTING "II /• /' —o� ,VINYL FENCE EXISTING / EXISTING /. GATE STONES -•�� ` 1 240 sBf EXISTING J EXISTING I PAVERS PATIO 440 s.f. 335 S.F. I j EXISTING p1 / p MACADAM II / 1,320 s.f. __ ALL WOOD RETAINING 1 B WALL,REPLACE WITH I /•/ p A LIBERTYSTONE"MIRASTONE 6 IN." j / D i�—EXISTING COLOR:DESERT b � - I CONCRETE / A ''` REMOVED) I % 35 s.f. j $ EXISTING VINYL FENCE EXISTING VINYL FENCE 4j A4? �-_ / 59.48FT --------------- _�__�------- ------ --- --a---- KEY PROPOSED GARDEN ARBORVITAE S PLANTS 1 IN.=20.FT SCALE AT T-0"O.C. 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I I z z I I I I I I I I LL LU I I I I ! ! i l •. r o wo � z MIRASTONE THE INSTALLATION ADVANTAGE > > > Enginetred for strength... designed for beauty Designed for Beauty Installation Advantage Ideal for everything from Mira.Stone"combines durability, residential landscaping to Flexibility and ease of installation for large commercial projects, gravity and geosynthetic reinforced , MiraStone"offers the perfect walls.Each light weight unit has a large combination of strength and hollow core,Securelub connection, f I aesthetic beauty.Unit shape and tapered sides.The gravel and size are balanced to provide intcrloA provides high shear r - a natural profile. For value, resistance and excellent beauty,durability and case of connection strength to ..1;W construction,your best choice geosyntIlLfics. ,. ►�: "=: '.;1 is MiraStonc'. AP tv If ��, `ice' � ��- • -` .' _ — rI t*' 21 r i OFFSET DIMENSIONS ARE NOT TO BE USED FOR CONSTRUCTION. --`' SUBJECT TO EASEMENTS AND RESTRICTIONS OF RECORD. NORTH COVERAGE CALC'S: `. E N E DD DWELLING— 21058 S.F. DRIVEWAY— 882 S.F. PATIOS/WALKS— 2,801 S.F. Em� 26 2021 TOTAL— 5,741 S.F. LOT AREA— 17,672 S.F. L I N CO L N VILLAGE F RYE BROOK BLD'G COVERAGE— 11.65% TOTAL LOT COVERAGE— 32.49% BUILDING DEPARTMENT AVENUE P.O.B. BLOCK CURB N. 9'-35 —50" W. 7 . p BLOCK CURB (TYP.) Z �[` r n CONCRETE 00 a v U j (TYP.) BAY GATE (TYP.) N .. (—�1✓ COV. TIE WALL V PLAT. 3.4' S. `O ^� GATE 1 STORY GARAGE 1 I 1.5 STORY m 1 FRAME _ VC0 DWELLING L`//♦ �F1 ;VINYL FENCE 9.8, -1.0 S. (� Y` PAVERS (TYP.) 1 18 A` cry STONE PATIO J� P ^� FILED MAP LOT # (TYP.) TIE WALL O MACADAM TIE WALL 2 8 S IN (TYP.) a 1/L FCE S. D^ CONS, SEC.-135.74 �O` O119 BLK.-1 Cn LOT-7 o (TAX MAP) I i_p S. 09'-35'-50" E. 159.48' J VINYL FENCE , �!CA- FENCE 6.1' E. SURVEY OF PROPERTY #1 LINCOLN AVENUE LOT 7 , BLOCK 1 , SECTION 135 . 74 RYE BROOK , WESTCHESTER CO . , NY Certified to:Michael R.Parr and Kathleen E.Parr. SCALE: 1"=30' DATE: J U NE 14, 2018 STEPHEN F. HOPPE, L.S. LICENSED PROFESSIONAL LAND. SURVEYOR 111 ROUTE 303 '. Map Reference:Being known as Lot No. 119 on a map entitled: TAPPAN, EW ORK 10983 "Map No.2 of Rye Hills,Town of Rye,Westchester County, N LI . 0 0539. N.Y."filed in the Westchester County Clerk's Office on June 13, 1950 as Map No.7093. L.S. SHEET NO. — 1 OF 1 DRAWN BY— JMC I REVISED: FILE N07 4389-17 OFFSET DIMENSIONS ARE NOT TO BE USED FOR CONSTRUCTION. SUBJECT TO EASEMENTS AND RESTRICTIONS OF RECORD. NORTy COVERAGE CALC'S: DWELLING— 2,058 S.F. DRIVEWAY— 882 S.F. PATIOS/WALKS— 21860 S.F. TOTAL— 5,800 S.F. LOT AREA— 17,672 S.F. LINCOLN BLD'G COVERAGE— 11 .65% TOTAL LOT COVERAGE— 32.82% AVENUE P.0. B. - BLOCK CURB N. 9°-35 —SO" W. 7 � � BOCK CURB (TYP.) Z N � � r � CONCRETE4 � (44; � o � (TYP.) GATE p � j BAY I Q � (TYP.) N 9.7' � COCOV. TIE WALL J PLAT. 3 4' S ol GarE 1 STORY � 1 .5 STORY !T' ^� GARAGE � FRAME oo CO DWELLING ol L #1 VINYL FENCE 1.0 S. PAVERS CO (TYP.) 1 1$ STONE PATIO Dh VI L FENCE ^(40 FILED MAP LOT # (TYP.) TIE WALL hO MACgpAM TIE ALL CALL 2.8' S. VINYL /L FENCE 1.0' S. �KEYSTONE SEC.-135.74 WALL BLK.-1 0 cp (TYP.) LOT-7 (TAX MAP) i O i_L=0 —5 0" E. 159.48 —• _. J -- -----•---� VINYL FENCE N 2 3 2022 C/L FENCE 6.1' E. VILLAGE OF RYE BROOK BUILDING DFPARTMENT SURVEY OF PROPERTY # 1 LINCOLN AVENUE LOT 7 , BLOCK 1 , SECTION 135 . 74 RYE BROOK , WESTCHESTER CO . , NY Certified to: Michael R. Parr and Kathleen E. Pan-. SCALE: 1 "=30' DATE: JUNE 2, 2022 AS-BUILTSTEPHEN F. HOPPE , L.S. DOQUMENT LICENSED PROFESSIONAL LAND SURVEYOR 111 ROUTE 303 Map Reference: Being known as Lot No. 119 on a map entitled: TAPPAN, EW ORK 10983 Map No. 2 of Rye Hills,Town of Rye, Westchester County, N � Y 0539 N.Y." filed in the Westchester County Clerk's Office on June 13, 1950 as Map No. 7093. L.S. SHEET N0. - 1 OF 1 DRAWN BY- JMC REVISED: [moo FILE NC.- 4389-17