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HomeMy WebLinkAboutBP22-010PERMIT # A/ot� ' ` DATE: 4 i iz) c IXP: �1 SECTION y/ o4?' r`60 ` BLOCK l % LOT TYPE OF WORK JOB LOCATI%N OWNE //f/ �10/ bo V'iS a &4 Ili 1 7) CONTRALTO EST. COST %/Co # 1 TCO # -� FEE FEE-r DATE�� FEE DATE._____... --- INSPECTION RECORD I DATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING C� RGH PLUMBING GAS SPRINKLER ELECTRIC 0 LOW -VOLT O ALARM ,3 Z AS BUILT FINAL OTHER APPROVALS ARB 7 4:: ! c3c BOT PB ZBA OTHER � AS-BUILT/FINAL SURVEY ( REQfUIRED PRIOR TO FINAL INSPECTION ww 40th anvil ejo VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury www.tyebrook.org TRUSTEES BUILDING & FIRE INSPECTOR Susan R. Epstein Michael J. Izzo Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE April 20,2022 Christopher Davis&Lauren Davis 1 Whippoorwill Road Rye Brook,New York 10573 Re: 1 Whippoorwill Road,Rye Brook,New York 10573 Parcel ID#: 129.60-1-13 Building Permit#22-010 issued on 1/21/2022 For a New Fence This certifies that the 5 foot high black aluminum fence,installed under the above captioned permit has been satisfactorily completed. Sincerely, Michael J. Izzo Building&Fire Inspector /to D 2�C /]2 For office use only: `/ C�J. BUILDI T M E N T PERMIT# O DVIL OF RYE �60K ISSUED: � 41—aa 8 KING STRE �YE BROOKS` rW YORK 10573 DATE: MAR 2 8 2 222 �4 9 '06 6'I FEE: .$ /1 O— PAtD,6L VILLAGE OF RYE BROOK BUILDING r)FP`.PTMENT 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: W 1^� o,rw;11 ko4l I {lye, '�t/ook- , NY 10 573 Occupancy/Use: Parcel ID#: l 2q. 6 0 - 1 -13 Zone: K-15 Owner: ,1wr;( Davis Address: 1Wln:(poNw;11 RJ., kfe k, NY 10573 P.E./R.A. or Contractor: (lonq �—t.t1# toMpaAN to1(. Address: 144 R&,W4Ic Q., Wkil, P1,%:"S, NY 10167 Person in responsible charge: C-olon;o�' Address: -1411 Harfs)ALc It;. I WA-k ph -t, N1 10607 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: 0\r;S -O viv i S being duly sworn,deposes and says that he/she resides at I W�:Q�o/�^11 Rd• (Print Name of Applicant) (No.and Street) in Ry 4t Z tt Do 1- ,in the County of W l I (,�.c I w in the State of�,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:S I 0 H 0. 0 0 1 for the construction or alteration of: 5- Fief t Z l k 610•t k q l �,:nvr. Ft Alc wild. 0�C. 5-Fno k w i il C a rt'Li gaVe t iA yi,� 6>4v&j 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 b Sworn to before me this day of day of , 20 Signature of operty ner Signature of Applicant Print Name of Property Owner ` Print Name of Applicant J Notary blic SHARI MELILLO Notary Public Notary Public, State of New York No. 01 VIE03160063 Qualified in Westchester County Commission Expires January 29.20� 4ye O4` Zm cu � '9a2 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.ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - -- - - - - - ADDRESS :— ( u'� I DATE: h ?' PERMIT## 1372 Z o ISSUED: ' Z ZZSECT: /Z( • BLOCK: l LOT: / LOCATION: I r( 046 �F OCCUPANCY: �r ❑ 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 l ❑ FINAL PLUMBING ❑ CROSS CONNECTION FINAL ❑ OTHER �' ■ ■ 0 N �V O O O w N N N W 5A v O O u v W ova o 1� rMi b� it o. v O +� ' N ' � v N f14 v 0 z Z w 66 o h+y pLn -JON F- 1 h Z - `� a a `n a u O J-i � ddiii �"✓ U � orb F � � °'�N� eQcCO a = W A d` ` A&;I, zo 8 V z A oov vU O W Q, Uo z v o I� ok cq z d. ICI *k W a as v a z S E � � c 00 h-H W W 4 � � ` o u a cti W O U w Ica 'a pC, H W z O Cc }— Z 1� O Q W o © 2 I� W s � � Ha.� .a z H°~ 8 ,0 .5 UJ co t w4-4 © � ' a � o ti m � �■ a� p W W � a a BUI TMENT c� ��, _ 1 rVIL 4 OF R ROOK 938 KIN EET RYE B ,NY 10573 D�� Z 2021 >] 14 9 e'IG .or« VILLAGE OF RYE BROOK BUILDING D'=PA,rRTMENT FOR OFFICE USE ONLY: 1 Approval Date: Permit# ® Application Approval Signature: ARCHITECTURAL REVIEW BOARD: J AN 1 9 2022 Disapproved: Date: � BOT Approval Date: Case# Chairman: �(Y� PB Approval Date: Case# _ Secretary: ZBA Approval Date: Case# Other: Application Fee:&7`� Y41 Permit Fees: FENCE 1 WALL / GATE PERMIT APPLICATION Application dated: 17,116111 is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the installation,construction,repair or replacement of a Fence,Wall or Gate,in accordance with Section 250-6 B.(1)(g),of the Code of the Village of Rye Brook,as per detailed statement described below. Swimming pool fences must conform to the State Code. 1. Job Address: I W 1^' oa f t,,+0 1 R;. 1 Rye �rpskl NY 10 5 7 3 2. Occupancy/Use: R E S S.B.L.#: I Z 4 . 6 0 — I 13 Zone: IS 3. Proposed Fence/Wall/Gate(describe in detail): fA II 5-kct h; In 61sk c vf%o-AWM tP_Afe W;�J% vA 5—Ft w,'Jt urtL4 JA FC t n 4-t 4. Property Owner: (_k r i S 1Det vi S Address: 1 Wi%;Pfv@fwA1 Rote' R a Gesolc IVI 1D5773 Phone# 111- 2SO- l 14 9 Cell# 11?• 230- 114 email: C.1+riS havi$ mAJ- c o.•+ Applicant: In/►S DA V i S Address: 1 RvJ, Rye 13r•ok , WY 10573 - Phone# 1141 Cel]# 117- 250— 11gq email: f,�r;i)AyisC�c�r`^A:1 . cep+ Architect/Engineer: 01o111 Fentt (OMP001 1 n(. Address: '144 "kr 41C Rb. WIN. 't Iw'A NY 10607 Phone# '114- Wl- 3442 Cell# 114 - 4V7 '5447- email: (olonyFef%(t eAMAI. 00- Contractor:_ St<n-e AS A r l)%-EC j EA j-'^k/ 401 6-f 1f Address&Phone: Ai Ar�l+���� !E^� ^�� b•yC 5. If building is located on a corner lot,which street does it front on: A 104 6. What is the estimated cost of construction �1 1 i O 4 D (NOTE:The estimated cost shall include all site improvements,labor,material,scaffolding,fixed equipment,professional fees,and material and labor which may be donated gratis.) 7. Estimated date of completion: Z I Z 1 i 8/12/2021 Please note that this application must include the notarized signature(s) of the legal owner(s) of the above-mentioned property, in the space provided below. Any application not bearing the legal property owner's notarized signature(s) shall be deemed null and void, and will be returned to the applicant. STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: _ C.1^r j ti p ri v i 5 , being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and further states that (s)he is the legal owner of the property to which this application pertains, or that (s)he is the for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,attorney,etc.) That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to before me this ZO }l" Sworn to before me this day of J Z t e My Z_ , 20 21 day of Die t'c+be.- , 20 21 14 1 Zq Signature roperty ner Signs Applicant Cif) D11V Ji Gkr.-t D"I'5 Print Name of Pro a er-- Print Name of Applicant -"Notary Public otary �c DREW P.ADDER DREW P.ALEXANDER NOTARY PUBLIC OF NEW PORK NOTARY PUBLIC OF NEW YORK LD.#01AL64f4646 LD.iY01AL6i 4646 MY COMMISION ISiON EXPIRES 03/01IM5 EXPIRES 03/01r1025 MY COMM 2 8/1212021 / Building Permit Check List&Zoning Analysis `Address: L � � �2t/�l t'�' _Tz_,> SBL: Zone:'=1 s Use: 2 Const.Type Other: Submittal Date: t-L-1 -LO(Ir Revisions Submittal Dates: Applicant: I S Nature of Work: S D t t Reviews.ZBA: DEC 2 2 2021 PB• BOT• Other. ( ( ) FEES:Filing. 7S-�_BP: t�l �"� C/O: Legalization: ( ) (�APP: Dated: ✓ Notarized SBL Truss I.D. Cross Connection: H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening: ( ) ( ) ENVIRO: Long Shore Fees: N/A: ( ) ( ) ITE PLAN:Topo: Sit Protection S/W Mgrt.: Tree Plan Other. ( ) ( SURVEY:Dated 1 Zy Current: Archival: Sealed Unacceptable: ( ) ( ) PLANS:D Stamped: Seale Copies: Electronic. Other. ( ) (t�Idcense: Workers Comp: Liability: Comp.Waiver. Other. ((, CODE 753#: Yol —000-- 440 9— O CD Dated. —Q&-; - 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. (4� ( ) Final Survey: Final Topo: RA/PE Sign-off Letter. As-Built Plans: Other. ( ) ( ) BP DENIAL LETTER: C/O DENIAL LETTER: Other. ( ) ( ) Other. ti (Jf' RB mtg.date 1 l cl Z Z approval. \ notes: ( )ZBA mtg.date: approval:- notes: ( )PB mtg.date: approval: notes: REQUIRED EXISTING PROPOSED NOTES AVVRUVED J A N 2 0 1011 Cir e: Fin .g� F mt. Front sue: 13Mr. Main Cov Accs.Cov Ft.H Sb: S .HS • S& Tot,!mg: Et Im : P H6&/Stories: notes: BUILDIRTMENT Dy E VIL1r.� E OF RYi.,�OOK 938 KING S ET RYE BR,60K,NY 10573 DEC 2 0 2021 4 9 9-0 � VILLAGE OF RYE BROOK t BUILDING DFP/'.R T MENT 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: I Wh:pPoerti Fu t Rye &°ek, NY 10573 Date of Submission: Parcel I D#: 129 . 6 0- 1 ' 13 Zone: K- 15 1-L Zo 7-1 Proposed Improvement(Describe in detail): IfIS}A11 5-4o+ APPLICANT CHECK LIST: MUST BE COMPLETED BY THE APPLICANT wi4 one. S-Not writ ortL4 1 ,1e , iA l I,t- The following items must be submitted to the Building Department by the applicant- no exceptions. 1. (1/)Completed Application (sec E-&W A) Property Owner: Ckri'S l7uYiS 2. (✓S Two(2) sets of sealed plans. (one full size {maximum Address: l Wk ioleorw:l( Q kit SoW�t NY 10573 allowable plan size=36"x 42"} and one 11"x1T') Phone# 11- 2 5� - I I'{q 3. (✓�Two(2)copies of the property survey.--%(Ste&1643 8) 4. Two(2)copies of the proposed site plan-o(gee Eak:Lr;t C Applicant appearing before the Board: 5. One electronic/disc copy of the complete C !�s Da v►s application materials. p � 6. ( Filing Fee. F,h bi} D) Address: 1 U Bookt NY IP573 7. (✓S Any supportingdocumentation. Phone# 1 ` ZSD - II y� 8. ( ) HOA approval letter. (ifapplicable) 9. (,1 Photographs. Arch itect/Engineer: Co 10AI Ftnte to mpslt y /A t. 10.(,4Samples of finishes/color chart. (a sample board or Phone# j I y - `i q 7- 3 9 4 2. 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 f�2 a Sworn,to before me this u µ da fDe ittr,6e,r , 20 Z I of Dectf%6a/ , 20 2-I Signa re Prop Owner St n of Applicant DAV45 Ch��5 okV4 S Print Name of P perty Owner Print Name of Applicant Notary Public otary Public DW P.ALEUNDER I13tEW P.ALEXANDER NOTARY PUBLIC OF NEW YORK NOTARY PUBLiCOF NEW YORK LD.#01AL6414646 1.D.#OIAL6414646 MY COMMISION EXPIRES 03/012025 MY COWSION EXPIRES 03/012025 an 22021 VILLAGE OF RYE BROOK BUILDING DEPARTMENT 938 KING STREET, RYE BROOK,NY 10573 (T) 939-0668 (F)939-5801 ARCHITECTURAL REVIEW BOARD Wednesday, January 19, 2022 ANNOUNCEMENT: PER THE GOVERNOR'S EXECUTIVE ORDER THIS MEETING WILL BE HELD VIRTUALLY THROUGH THE ZOOM PLATFORM. THE PUBLIC CAN ACCESS THE MEETING THROUGH THE FOLLOWING LINK: https://us02web.zoom.us/m/81417970741 OR BY OPENING ZOOM AND ENTERING THE MEETING ID: 81417970741 NAME & LOCATION TYPE OF APPLICATION MOTION SECOND APPROVED REJECTED APPL.# 1 Whippoorwill Rd 5 Ft High Black Aluminum Consent �� 5663 (Davis) Fence w/Arched Gate - Agenda 3 0 Rear Yard. ��JJ 19 Talcott Road Add Skylight To Roof Line Consent 5664 (Gamboa) in Conjunction With Agenda Bathroom Renovation 70 Rock Ridge Dr Roof Top Solar Array Consent 5665 (Malik) Agenda 55 South Ridge St Roof Top Solar Array Consent 5666 (Rodriguez) Agenda 51 Hawthorne Ave Add Driveway Consent 5667 (Miller) (Exterior/Interior Agenda Alterations) 23 Berkley Lane 4 Ft High Black Chain Link Consent 5658 (Greenspan) Fence w/Gates. In Rear Agenda 545 Westchester Refurbish Exterior Steps, 5659 Ave (Castiglia) Railing,New Aluminum Awning, & Retaining Wall 12 Birch Lane Revision To Prior Approval 5668 (Shaw) (Outdoor Kitchen) 85 Valley Terrace New Egress Window, and 5669 (Krebs) Window Close Up-to Facilitate Basement Renovations ML NM MR SE JM SF AC MI KC r r,� t A�v two M. O ffta)• yr �r• Y ■�`4 dot 19 19 cn tit moo" 19 • ' _ _ 6414 M P• •• _ = = r• Eno C cl) i� COLOFEN-02 LCA_N ACORO CERTIFICATE OF LIABILITY INSURANCE °A TE`514/2021 12021 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: it the certificate holder Is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. H 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 endorsame s PRODUCER CONTACT World Insurance Associates,LLC PHONE FAx 3 Starr Ridge Rd (kC,No,Ent):(54�27l�151 Wc,Ne): Ste 100 ibukSs; Brewster,NY 10509 _ /aSIRtEIt(/1 AFFORDING COVEM imp INSURER A;S•NCWB InSUfaM*CO Of s0111I1 C"1111l1111 1n55 / /(SURER s Colony Fence Company Inc. INSURERC: _ 7"West Hartsdale Rd INSURERD: White Plains,NY 10607 — *— INSURER 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. ILTR lSR TYPE Of INSURANCE ADOL SUBR POLICY NUMBER POLICY EPP POLICY EXP ammoNw LAM A X COMMERCIAL GENERAL LIABILITY -EACH OCCURRENCE $ 2,000= CLAIMS-MADE _X OCCUR s 244090M 2/1/2021 2/1/2022 IS TO RENTED 600,000 (SET Roowrtstldsl $ HIED EXP IAAY err pwson� _ -- 10,000 — __PERSONAL a ADV INJURY 2,000.000 O�FNL AGGREGATE LRIMpB, ENEWIL PER. O AGGREGATE s_ 4r000,000 POLICY X JpECT LOC PRODUCTS-COMPIOP AGG _: 4,000,000 OTHER A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1r�,000 Me evAdenU_ S_ X ANY AUTO S 2"0908-00 2/1/2021 2/1/2022 BODILY INJURYIPN soon OWNED SCHEDULED AUTOS ONLY AUUoTTNOppSyyIEp BODILY INJURY rsodds AUTOS ONLY AU70S ONLY _ X UM/RELLAUAS X OCCUR _€ACHOCC_U_RRENCE __}_ 2,000,000 EXCESS UA/ CLAIMS-MADE S 2"0908-00 2/1�2021 2/1/2022 AGGREGATE 2,000,000 DED X RETENTION$ 10,000 AND KERSEMPLOYERS COMPENSATION AND EMPLOYERS'LUIBILITY YIN STATUTE ER - - ANY PROPRIETgOER PARTNERJEXECUTIVE R[aFnditory In NHR EXCLUDED? NIA -U.EACH ACCIDENT } Irye� d'scnt»unaa� E L.DISEASE•EA EMPLOYEE S DESCRIPTION OF OPERATIONS brow E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS r LOCATIONS I VEHICLES (ACORD 101 Additional RernMa SeMtluN,m.y be NacMd If more space is required) (Certificate Holder Is Additional Insured with respects to dl neral Liability as required by written contract subject to the terms and conditions of the policy. CERTIFICATE HOLDER CANCELLATION i SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Village of Rye Brook THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 938 Kings Street ACCORDANCE WITH THE POLICY PROVISIONS. Rye Brook,NY 10573 AUTHORIZED REPRESENTATIVE ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 5/4/2021 Certificate of NYS Workers'Compensation Insurance Coverage CERTIFICATE OF NEW Workers' NYS WORKERS'COMPENSATION INSURANCE COVERAGE PORK STATE Compensation - Board Insured Detail In.Legal Name and address of Insured(Use street address only) lb.Business Telephone Number of Insured Colony Fence Company Inc 945-279-5151 744 Hartsdale Road White Plains,NY 10607 Ic.NYS Unemployment Insurance Employer Registration Number of Insured id.Federal Employer Identification Number of Insured or Social Security Number Work Location of Insured(Only required ifcocerage is specifically limited to 454912167 certain location in New York State,i.e.a Wrap-Cp Policy) 2.Name and Address of the Entity Requesting Proof of Coverage 3s.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) AmTrust Insurance Company Village of Rye Brook 938 King Street Rye Brook 3b.Polley Number of entity listed in box"la": Rye N-Y 105-3 KWC 1246469 3c.Policy effective period: 4-12021 to4t1/2022 3d.The Proprietor,Partners or Executive Officers are: included(Only check box if all partners officers tnc:uded) all excluded or certain partners/oflicers excluded This certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box"la" for workers'compensation under the New fork State Workers'Compensation Law.(To use this form,New York(\`N�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"1". The insurance carrier must nodfy the above certificate holder and the Workers'Compensadon 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 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: Henry C.Sibley (Print name of authorized representative or licensed agent of msunme canim) Approved Bv. 5/4R021 (Signature) (Date) Title: Undem iting Manager Telephone Number of autborized representative or licensed&Rent of inseraaee carrier:CarrierPhone Please Note:Onlr insurance carriers and their dcensed agents air arrhartttd as lxae the C-/05.2 forms.insurance brokers arr,V0T aufhori.ed to i ere it https:/lwc.amtrtstgroup camIANAWC/PoltcyNYCert!fioateOfWcins.aspx?Indexld=338982&Instanceld=la76422b-4ald-4158.8al3-d605c8e9eec4 1/2 Laura Petersen From: Dig Safely New York Exactix <tickets@exactix.digsafelynewyork.com> Sent: Monday,January 24, 2022 10:21 AM To: Mike Izzo Subject: Message from Dig Safely New York, Inc. (DSNY) ****REGULAR**** DIG REQUEST from DSNY for: VIL RYE BROOK Taken: 01/24/2022 10:19 To: VIL RYE BROOK PRIMARY Transmitted: 01/24/2022 10:20 00003 Ticket: 01242-000-408-00 Type: Regular Previous Ticket: 01242-000-374-01 ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 1 To: Name: WHIPPOORWILL RD Cross: From: To: Name: Offset: ------------------------------------------------------------------------------ Locate: ENTIRE BACK YARD - FROM RIGHT BACK CORNER OF HOUSE TO PROP LINE TO ENTIRE BACK LINE OF PROP TO THE LEFT SIDE OF PROP TO THE LEFT BACK CORNER OF HOUSE, INCLUDING GATED AREA NearSt: COUNTRY RIDGE DR & FAIRLAWN PKWY Means of Excavation: HAND TOOLS 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: 01/31/2022 Depth of excavation: 2 FEET Site dimensions: Length 239 FEET Width 8 INCHES Start Date and Time: 01/28/2022 09:00 Must Start By: 02/11/2022 ------------------------------------------------------------------------------ Contact Name: RUBEN COLONIA Company: COLONY FENCE CO Addrl: 744 HARTSDALE RD Addr2: City: WHITE PLAINS State: NY Zip: 10607 Phone: 914-497-3442 Fax: Email: colonyfence@gmail.com Field Contact: RUBEN COLONIA Alt Phone: 914-497-3442 Email: colonyfence@gmail.com Working for: CHRIS DAVIS ------------------------------------------------------------------------------ Comments: Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: ALTICE USA CONED SUEZ WTR WESTCHESTER VIL RYE BROOK 1 .410!S- i �+ rn Oy E •t N y Z aKlwz:g � .P A N Y FILE COPY 'qt p +$ t3 W dauoie+mA 13 S 46'34'30' W 100.00' ~ {� uACAO- 11 AS-BUILTIFINAL SURVEY . A w REQUIRED PRIOR TO FINAL INSPM.. TION Z w ' N rn tJl �� p 00 O iISL oo Costars[ or+e srr - O PAMO rRAUE t Q O nw O � 0 TWO STORY 0 FRAME 4 Ct o ra.t + g PERMIT# e 1 SBL# 12� ,b — I 3 x DATE APIb0O D AN 2 0 2022 r 1 N 46'34'30' E 100 ege]MR116 BroOk,NY P a". WHIPPOORWILL t2OAD Zlez LlI � 3I IECE-�U� 43 o $ Village of Rye Brook a�� `� z � I Architectura vi w — --R y ( DEC 2 0 2021 $ Tv- x,i; Approval Date: "�� ra Chairman: r VILLAGE OF RYE BROOK BUILDINr rlrn^!?TME�1T _- b �� � •t Land Siu�sra}�ing P.C. 77. N MWO b o080r&J v Wild ih0^}.ftd==ShDdwF 1e$0 64 Virginia Avenix V P O Ibr 1De Naw YG*Sb to AMai&f 0f l:wod Slcvayorc '�Ferry NY 10522 6 liahnh B Be4a1.I«S Ncrr Yafc State 1�onuo Namber t►51)b6G (914)629-7758 SW-M0,16) 'Mommqartw--ic+ws4-a�tt's'it a $vex cs ZZ50I AN A=3 644 v AD—s v—ljo-qm. Y olws*oA—N ov toj or c� 21=AV V MIUA 69 Q-U.waPQwS—w3lum.om mlb=°Pt —m°P— 3 a •'J pUUZ IFUM "m,Pavv gl u go!an ao fonaw aw pu d—°lw lM ICP—M W MI.b �[IT1faAms Uo r ._fNiDAi8'vci-iCl Jhiallna— o o �Joo�1e 3MJ -10 �ISVIIIA dd a 1Z0Z 0 Z 330 W $ 4 zQ wa a A-11 o � < o o 4� 2R 8z �.- J1 �� E��o op yap a � clvo�1 -1-llm�JooddlHM oue + 4 .00•001 3 .oc.tie-9e N + .00'SL t � Y h Off : a + J ' er aw o s� U- u l'ON p oc 3Yt U. OA a A2101s OML oli 0 r o 3S 3m OArd O f,� 3 ILs 3No 3t3u�Iroo o o ' 0 0 00 my�_ Ln (1l W $ x S7 c� cti rwl Z O M'Ov�rIY fl 5 ' Geov in mu wil ,00'OOI M to vc.91r S 8 { fl Gev�w.+n®uro+l � K� 0 Y y� y 4 O u � oz zo v, O p 3 x s ''9Sj pp((yeFf agg3�ra j 9 2 o T � � g �o 0 3= 0 �� RUBEN F. COLONIA baw U C COLONY FENCE COMPANY INC. • 744 Hartsdale Road,White Plains, NY 10607 COLONY Phone: (914)497-3442 FENCE Fax: (914)468-1229 it email: colonyfence@gmail.com DATE 2 b i 2 I - --- ----- �_ INV.# _ We propose to furnish and to install on your property a custom fence in accordance with sketch and quantities listed below. NAME ADDRESS }j Wt,� Noonrl�ritl �� 1 CITY `Zy 2 f,i as k STATE Alf HOME PHONE ZIP BUSICELLPHONE G1-�- 2S0 (t4C\ EMAIL CL1 6S6 v; WI\A QUANTITY SKETCH J t - - bl 5-t• 1i Posts to be embedded in concrete at least _feet deep. _ Take down and cart away old fence is included. DIRECTIONS: You,the buyer,may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction. See the attached notice of cancellation form for an explanation of this right. I All quotations subject to conditions beyond our control.Customer is responsible to establish property lines.This quotation does not include cost of drilling in underlying rock or ou dafions,or clearing trees,brush or other obstructions from working area.This contract embodies the entire understanding between the pa ies,a d there are no verbal agreements or representations in connection herewith. jSUBTOTAL i q 040.� COLONY FENCE COMP NY TAX BY: TOTAL PURCHASER _ ;,,- 50%DOWN PAYMENT *Sign to accept quote 50%BALANCE TERMS: Balance is due upon completion of job-.after customer's inspection and approval. V N ate+ N C Y C 4J u LL- O. O Y N L Q 9 3 v. :s C C. i L v. u v. r cu Q � Y71 f..._ O U _ 41 u a E _ cCL v L- o d° C L c ` 0 o a O > 3 O Y n O u G N CO i u u a _3 p ao in d * -C ca _ O u U •lui a ti CG Of Y k" a) Q co Y u - C +T+ j u k Ln LLn Cc: � v a c v C x x w Y V o Y E o ci a L 3 o v$ Y v a Q v 00 -- N ,✓ C hC0 `C L `O a LL L Ln v C L C y H N O - .0 y CO d Y i O. O r0 ro 'N = �_ a a_ Q LL v�i � a O o - wl W 'o 'o a U Z w w .0y ti Ucs W L L m Q 2 v n U L V = - HhI 00 u u ` � m 00 Ln Lfl 1 � L 1 Cv Y u U 0 a C N.J CN Ln o 0 N .v I1,�Sr CN W w 4M%*%j)t3 CL 77 R _ a M � _ N O z ry ll� N ,, 4 CV < � o 0 t 0 e 00 (L N 43°25'30" W 150,00' ; �4 a 1,9'N > 11,011W I TA X LQ T STONE WALL �--I cis n. U U) HEDGE 4� Q Q �ONLINL U_ IRREG LINE OF METAL FENCE TAX LOT � 5 FEET HIGH 0 L 2 J X; LiRAMP 5,0'N N� i%' O � 0 i 0.2' '� U Q "0 I O W O Uj R.R TIE U)Uj /' ... O _z w = Ld Q Q 3 'ts wO ( ° ww � ,, w� m a Z w I„ p to D w LL_ ! T M c1d N C_�_ co E '� TAX LOT I _ O i �' / `0 M ��- .�3 ,j ;�J' Lj STEPS �O % O V) � 0 N 3 STEPS ,�� w 0 (n Q O � WALK L1.- �"' � 0 �v,1 U O L_ U p Z r/. �� 0 0 3 Q O _� + U Q U /; � i, 0 .�•r LEGENDS: C�-� %='' Z z C.L.F. CHAIN LINK FENCE -� i '- 0 ' \ ! MACADAM DRIVEWAY _ - n BLDG. BUILDING _ t i Qua _ n c� �, �- i ! � O.H.W ''O O cci GV GAS VALVE �AX LOT j 0 %i� 0 ?-' 2 0.4'N NORTH 3 �'� v v DI DRAINAGE INLET ( IRREG LINE OF 0 o Z ° METAL FENCE o C ° o r W.I.F. WROUGHT IRON FENCE �J 5 FEET HIGH 0 0 C � ~ N/F NOW OR FORMERLY STEPPING STONES v� .,D 404 � O.H.W. OVER HEAD WIRES HEDGE �'�r--1rr'-ter^�'--ter-1�'v--err-1,'-�r'�'- ��'Y�('�� ' Y '` 'v��� '•r '�'�' '1 '`� FENCE AS BUILT SURVEY OF 8.8;W TAX LOT 13 IN BLOCK 1 SECTION 129.60 DO NOT SCALE 7,4 S S 43°25'30" E �AX T 1 s�s�s ' U �Lo 15 0,0 0 AS SHOWN IN THE OFFICIAL TAX MAPS OF L_ 12 -1 VILLAGE OF RYE BROOK LOCATED AT . „ BELOW SURFACE ENCROACHMENTS ARE NOT SHOWN.THE EXISTENCE OF RIGHT OF WAYS Certifications indicated are limited only to the person for whom this survey SCALE. 1 =20 VILLAGE OF RYE BROOK AND/OR EASEMENTS OF RECORD,IF ANY,NOT SHOWN HEREON,ARE NOT CERTIFIED. was prepared and on his or her behalf to the title company,governmental Measurement in U.S.Standard. TO" OF RYE p pg A TITLE REPORT OF THE SUBJECT PROPERTY WAS NOT PROVIDED,A DEED OF THE SUBJECT agency and lending institution for the title number listed hereon. The I WESTCHESTER COUNTY STATE OF NEW PORK. PROPERTY WAS PROVIDED. certifications are not transferable. DATE:MARCH 09,2022.(NEW FENCE ADDED). ADDRESS: 1 WHIPPOORWILL ROAD-RYE BROOK,N.Y. UNAUTHORIZED ALTERATION OR ADDITIONS TO A SURVEY MAP BEARING A LICENSED LAND SURVEYORS SEAL IS VIOLATION OF 7209,SUB-DIVISION 2,OF NEW YORK STATE EDUCATION NOT FOR TITLE TRANSFER. JOB NUMBER LAW.COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYORS INKED SEAL OR EMBOSSED SEAL NOT BE CONSIDERED TO BE A WCRO12709-2 TRUE AND VALID COPY. COPYRIGHT C 2022 SUMMIT LAND SURVEYING P.C.