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BP22-030
PERMIT # U,, SECTION TYPE OF WORI JOB LOCATION `- OWNER ! a CONTRACTOR. EST. V eo #f DATE. 44 3boita aP: 3h o a 5 5fao BLOCK / LOT <- W ar 7 2i 11 �G'trk5ia/ INSPECTION RECORD D TE � SP FOOTING 0L-3� FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING Fl RGH PLUMBING GAS C1 SPRINKLER ELECTRIC O LOW -VOLT ALARM AS BUILT FINAL 7C inJr �rp�Da� y ,P-�r4cYirl� %n Pej�l S/o/ 91 - c RAPPROVALS t OTHER � Z7saac 6o4 zaIez C9 j y)8oz/-/a/ ) DATE 64 AS-l3UILTIFINAL SURVEY RI=CI ARED PRIOR TO I : %L INSPECTION c�� vPd A t c�c,9�•�:e W ct� 19 A" anniuvwaW VILLAGE OF RYE BROOK MAYOR 938 King Street, Rve Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury www.gyebrook.org TRUSTEES BUILDING & FIRE INSPECTOR Susan R. Epstein Michael J. Izzo Stephanie J. Fischer David M. Heiser Salvatore W.Morlino CERTIFICATE OF COMPLIANCE October 5,2022 Joshua Kirsch& Kristen Kirsch 2 Lee Lane Rye Brook,New York 10573 Re: 2 Lee Lane,Rye Brook,New York 10573 Parcel ID#: 135.58-1-22 Building Permit#22-030 issued on 3/10/2022 for New Retaining Wall& Fence This certifies that the new rear retaining wall,new side fence and re-grading in a steep slope,installed under the above captioned permit has been satisfactorily completed. Sincerely, Michael J. Izzo Building&Fire Inspector /to u U N 3 0 2022 J For office us•onl VILLAGE 01- RYE BROOK BUILDING UEPART�IE�T PERMITtf VILLAGE of RYE BROOK DING DEPARTMENT ISSI ED: BUILDING 939 KING STRmr,Rv!BRtx)K,Nt%% VORa 1057-1 DATE: (914)9 2414" FEE: —PLOW ww-A,n4groolLure APPLICATION FOR CERTIFICATE OF OCCUPANCY,CERTIFICATE OF COMPLIANCE, AND CERTIFICATION OF FINAL COSTS TO BE SUBMITTED ONLY UPON COMPLETION OF ALL WORM AND PRIOR TO THE FINAL INSPECTION ............................................................................................................................. Address: v2 Lie �'^e t�y— Occupancy,'Use:` ��II _Parcel ID p: S�'t—ZZ- Zone: Q 'Co Owner. �GKVC �ace Address: �� 4e 10(-� W te5� P.E.?R.A.orContractor or- ILe45 (—t'4jn* t/4%nk4*jAddress: ((ek S tk9c ReS'}' A Dqe;$�pba.r�'V�t Person in responsible charge: I I ______ . _ 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 r'Certificate of Compliance for the structurvconstructionr"a Iteration herein mentioned in accordance with law: STATE OF NEW YORK.COUNTY OF WESTCHES?ER as: ��V� �� being duly swam.deposes and sacs slut ha�she n'aides at � �� �� Pun 1—w or Apphaar', No.art%u"n in 2`t Q'tXy. _ .in the County of L'j PS lc r in the State of that Wily town vkuagc) Inc sine has 1�uperviwd the work at the location indicated above,and that the actual total rust of the wort,including all site imptuvements, labor,materials,waffulding,fixed equipment,professional fees,and including the monetary taluc of•any matenals and labor which nay, have been donated gratis was:b f CC)O nut the cvr�uuctivar or altcratiun of. �e'�'4�t r`q t.✓�,\I a�ro� �•a�rct� Deponent further states that he-she has examined the approved plans of the sttuchue work herein referted to for which a Certificate of Occupancy,,Compliance is sought.and that to tine heat of hiuher knowledge and belief,the oructute,'w-ork has been Lfccted contpktcd in accordance with the approved plans and any antesulnteats therelu except in su Lis a,c anatiuns therefore lute been legally authorized and aserected-completed cumplies with the laws go,�cr ning building coeestruction.Dcponeut further unde-tstands that it shall be unlawful for an owner to use us permit the use of any building or premises or part theteuf hereafter created.etected.changed,concerted or enlarged,wholly or partly.in its use ur structure until a CLitificatc of OLi up wy or Certificate of Compliance shall hay a been duly issued by the Building Imgseclur as per a250-10.A.of the Codc of the Village of Rye Brunk Swum to before me this nn^^ Sworn to before me this day of 20 e4.L day of .20 \Ian', or Pr.pnty Uasa slpmre A Appra:anr ry 3 k.rl Property Uw,tei� Ih uu Nurru..r:lppin ara \mu.P.M' VWrn Purdl, SHARI MELILLO Notary Public,State of New York No.OIME6160063 Qualifled In Westchester County . Commission Expires January 29,20c �yE BR(�k. 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 : �/ "� "` DATE: 2 Z PERMIT# Z - D 3 -,Q ISSUED: SECT: BLOCK: LOT: LOCATION: OCCUPANCY: --Z f ❑ VIOLATION NOTED THE WORK IS... ACCEPTED ❑ REJECTED/REINSPECTION ❑ ITE INSPECTION REQumED 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 ❑ FINAL ❑ OTHER �E BRC�v�. l 1982 BUILDING DEPARTMENT �'9UILDING 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 :- �i ��-- DATE: PERMIT# %l �'Z ISSUED: SECT: BLOCK: LOT: LOCATION: �� \/�" (N�1 L-{� OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTIONZ�d REQUIRED FOOTING FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS - � )l l ❑ L.P. GAS ❑ FUEL TANK t, ✓- ❑ FIRE SPRINKLER Y" ❑ FINAL PLUMBING i ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER G> ' N o r, v si 2 v A t. w to W O c"e R. 6r O ■ Ns ® Lnen OH ern ONCD ok 10, W un cq �I P4 W w0 20 ao � W � z Cl) aG `� A AUK � U � ' -y 04 O = A r h � I�I N r• { 'r 0 :- Q N o Q „ U 11 e-a O 0 0 \ CIS ar. , cts CIA d C y o � G/1 rh� c A W U �'' 4 Uoa ' ICI F z A v 1-4 coop © o ° � � N d ( V V U Z a. pp Fes! a ^ � WZ z W W 0 >4 4 -r � : 0 Z4 p4 y o r BUILDING DEPARTMENT 3 2021 VILLAGE OF RYE BROOK 938 KING Sl-RF:ET RYE BROOK,NY 10573 VILLAGE OF RYE BROOK (914)939-0668 FAx(914)939-5801 BUILDING DEPARTMENT N�N%.rveb rook.o rr! ************rt**rt*rtrtrtrtrtrt*#rtrt*rtrtrtrtrt##rt*####rt##*#####rt#######*#*****#********************#**#**#****###*+##**# UOR(Ai l+ F E e 2 3 202 1 Approval DAIL' 1� flit �lr�� +�o30 Application# 15�1,1 18 Approval Signal re: � ARCHITECTURA1L REVIEW BOARD:1 Disappro%ed: Date: FEB '6 2022 BOT Approval Date: Case# Chairman: PB Approval Date: Case# Secretary: ! • AC ZBA Approval Date: Case# {ram Other: Application Fee: Permit Fees: 7 FENCE / WALL / GATE PERMIT APPLICATION Application dated:_ at��-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: 2 Lee Lane 2. Occupancy/Use: Residential S.B.L.#: 135.58-1-22 Zone: R-10 3. Proposed Fence/Wall/Gate(describe in detail): New vinyl fence on sides of house with new retaining wall at rear 4. Property Owner: Josh Kirsch Address: 2 Lee Lane Phone# 914-722-2631 Cell# email: kkid312@aol.com Applicant: Address: Phone# Cell# email: Architect/Engineer: Rob Dallesandro Address: 419 South Lexington Ave White Plains NY 10606 Lam' 917-923-2057 rdallesandro@gmail.com Phone# //'' Cell# email: @g �`' Contractor-, 1�,iL'Q Q/1d �4tS0/!�1 W/i00/Ct, D� /Clsl7o✓JZ4re0 Address&Phon /3i4r~e%S0.17 4w^&e X*W ¢�/e /Vy t0S01 '�l3�� 5. If building is located on a corner lot,which street does it front on: Lee Lane l o 6. What is the estimated cost of construction $25,000 (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: August 2021 9919 3(21119 AN /OS5 > 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: Josh Kirsch ,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 accorfipattying 8roved plank and specifications,as well as in accordance with theNew York State Uniform Fire Prevention &Building Cody,the M6 of the4V111age of Rye Brook and all other applicable laws,ordinances and regulations. a Swom to before,me this Sworn to before me this day of ��` , 20 Z( day of 120 ,fiKature of Property Owner Signature of Applicant e of perry Owner Print Name of Applicant Notary Public Notary Public BLORINA GASHI NOTARY PMUC,STATE OF NEW PORK N0.01GA6405087 COMMISSION QUALIFIED IN MARL H 024 2 3121119 RETAINING WALL EASEMENT THIS AGREEMENT, made this day of ikceY-.6,,- 3oLj- , 20 Z1, between, on the one hand, Craig J. Bergman and Samantha Morgan Bergman, owners and residents of a parcel of real property located at 11 Jennifer Lane, Rye Brook, NY 10573 (hereinafter, the "Grantors"), and, on the other hand, Josh Kirsch, owner and resident of a parcel of real property located at 2 Lee Lane, Rye Brook, NY 10573 (hereinafter, the "Grantee"). WITNESSETH: The Grantors hereby grant and convey unto Grantee a temporary easement over, under and through the following described real estate, during a period not to exceed 8 months, for the purpose of constructing, using, replacing and maintaining a retaining wall and safety railing located solely on Grantee's property, and conducting certain appurtenant work within the easement area, as described on Exhibit A hereto annexed and by this reference made a part hereof. THIS EASEMENT is executed and delivered and said easement is granted upon the following conditions to wit: 1. Grantee's access to the easement area shall be had only on at least one (1) day prior written notice to Grantors. 2. Grantee shall exercise reasonable care and diligence to minimize disturbance of and damages to the easement area and any other portion of the property of Grantors that is traversed to access the easement area. Should there be any such disturbance or damage, Grantee, its agents and employees, assigns and successors shall, as soon as practicable after construction of the retaining wall, restore all property of the Grantors to a neat and presentable condition, including the repair of Grantors' fence, if any, and replacement of any plantings or features that were damaged or disturbed, all at Grantee's cost and expense. 3. Grantee shall require its agents, employees, successors and assigns to take all safety measures necessary to protect Grantors and their property at all times during their access to the easement area, and over Grantors' property, and shall indemnify and hold harmless Grantors, and their invitees, successors and assigns from all charges, claims, causes of action, damages, expenses and liabilities, including attorneys' fees, sustained or incurred for any reason arising out of or relating to any act or omission of Grantee and its agents and employees, assigns and successors during their access to Grantee's property. 3. The rights granted herein shall not be construed to interfere with or restrict the Grantors, or their heirs, executors, administrators, successors and assigns from the use of the premises with respect to the construction and maintenance of property improvements along and over the easement area. Grantors agree that they shall not take any action to undermine or otherwise disturb Grantee's retaining wall. This easement shall be filed of record with the Building Department, in the Village of Rye Brook, New York, and shall be deemed to expire on the date which shall be 8 months after the date hereof. •} 1 l '�Z11 ins WAR--------------- Il Ail LL u I 9. . Y 1 r f r w . r � F CL cr u} Qj Qj j { Ln RECEIVED FEB 11 2022 VILLAGE CLERK'S OFFICE February 10, 2022 Approved RESOLUTION APPROVING A SITE PLAN AND STEEP SLOPES PERMIT APPLICATION FOR PROPERTY LOCATED AT 2 LEE LANE VILLAGE OF RYE BROOK PLANNING BOARD WHEREAS, Rob Dallesandro, RA, on behalf of the property owners,Joshua Kirsch & Kristen Kirsch (the "Applicants"), submitted an application for approval of a Site Plan and Steep Slopes Permit for the replacement of a deteriorating retaining wall with a new, reinforced retaining wall and the installation of a new fence on the property located at 2 Lee Lane, in the R10 Zoning District, Section 135.58, Blockl, Lot 22 as shown on the Town of Rye Tax Assessor's Map (the "Property"); and WHEREAS, the Planning Board is the Approval Authority for the Site Plan application pursuant to Section 209-1.A(2)(a), Section 209-1.B(5)(a)[3]; and WHEREAS, the Planning Board is the Approval Authority for the Steep Slopes Permit application pursuant to Chapter 213 of the Village Code; and WHEREAS, the Planning Board reviewed the following plans and application materials: 1. Short Environmental Assessment Form and EAF Mapper Summary Report dated 12/16/21; 2. Application for Site Plan Approval; 3. Site Plan Submittal Review Checklist; 4. Building Permit Check List & Zoning Analysis; 5. Exterior Building Permit Application; 6. Steep Slope Work Permit Application; 7. A topographic survey prepared by Richard A. Spinelli, Licensed Land Surveyor, dated 8/23/21; 8. The following plans generally entitled, "2 Lee Lane" prepared by RPD Architecture & Design: a. Sheet A100, "New Retaining Wall Plan, Elevations and Details," last revised 1/25/22 b. Sheet A101, "Site Details and Notes," last revised 12/8/21; and WHEREAS, the Proposed Action is a Type II Action pursuant to 6 NYCRR 617.5(c)(12) of the New York State Environmental Quality Review Act (SEQRA) requiring no further environmental review; and WHEREAS, a duly advertised public hearing was opened by the Planning Board on February 10, 2022, at which time all those wishing to be heard on the Application were given such opportunity, and the public hearing was closed on February 10, 2022; and WHEREAS, due to public health and safety concerns related to the current COVID- 19 pandemic, the February 10, 2022 meeting of the Planning Board at which this application was heard,was duly noticed and held via videoconference in accordance with Chapter 1 of the Laws of 2022 amending Sections 1 and 2 of Part E of Chapter 417 of the Laws of 2021, the which suspend the "in-person" requirements of the NYS Open Meetings Law and provide alternative means by which to conduct public meetings and hearings; and WHEREAS, the Planning Board considered the Steep Slopes Work Permit standards set forth at Village Code § 213-6 concerning the disturbance of steep slopes on the Property which will involve the disturbance of 665 square feet of existing very steep slopes (25%-35%) on the Property; and WHEREAS, the Planning Board has considered the site plan review standards set forth in Chapter 209 of the Village Code; and WHEREAS, the Planning Board, Village Planning Consultant and Village staff have reviewed all application materials, including public comments; and WHEREAS, the Planning Board is fully familiar with the application and the property. NOW THEREFORE BE, IT RESOLVED, that for the reasons stated herein, the Village of Rye Brook Planning Board hereby approves the Site Plan and Steep Slopes Work Permit for the replacement of a deteriorating retaining wall with a new, reinforced retaining wall and the installation of a new fence on the Property, subject to the following conditions: 1. The Planning Board hereby waives the requirement that the Applicant submit a Construction Management Plan pursuant to Village Code § 209-2.B. 2. All grading and filling shall comply with the requirements of Chapter 213 of the Village Code. BE IT FURTHER RESOLVED, that no permits shall be issued until the Applicant has paid to the Village all applicable fees and professional review fees incurred in connection with review of this Application. RECEIVED J A N 14 2022 January 13, 2022 APPROVED 6-0 VILLAGE CLERK'S OFFICE RESOLUTION SETTING A PUBLIC HEARING REGARDING SITE PLAN AND STEEP SLOPES PERMIT APPROVALS FOR 2 LEE LANE VILLAGE OF RYE BROOK PLANNING BOARD WHEREAS, Rob Dallesandro, RA, on behalf of the property owners, Joshua Kirsch & Kristen Kirsch, has submitted Applications for approval of a Site Plan and Steep Slopes Permit for the replacement of a deteriorating retaining wall with a new, reinforced retaining wall and the installation of a new fence on the property located at 2 Lee Land, SBL 135.58-1-22 on the Town of Rye Tax Map, in an R-10 Zoning District; and NOW, THEREFORE, BE IT RESOLVED, the Planning Board of the Village of Rye Brook will hold a public hearing on February 10, 2022 at 7:30 p.m. in Village Hall, 938 King Street, Rye Brook, New York or in a virtual format as may be determined depending on public health concerns to consider the above-referenced application; and BE IT FURTHER RESOLVED, that the Applicant is hereby directed to comply with Section 250-40 of the Village Code regarding notification of the public hearing. On motion by Mr. Morlino, seconded Mr. Gottlieb, Mr. Nowak, Superintendent of Public Works, called the roll: MR. GOTTLIEB Voting YES MR. GRZAN Voting YES MR. MORLINO Voting YES MRS. SCHOEN Voting YES MR. TARTAGLIA Voting YES CHAIRMAN GOODMAN Voting YES On motion by Mr. Morlino, seconded by Mr.Tartaglia,Mr. Michal Nowak, Superintendent of Public Works/Village Engineer, called the roll: MR. GOTTLIEB Voting Aye MR. GRZAN Voting Aye MR. MENDELSOHN Voting Aye MR. MORLINO Voting Aye MS. SCHOEN Voting Aye MR. TARTAGLIA Voting Aye CHAIRMAN GOODMAN Voting Aye BUIL MENT E C E� O v L' VIL E OF RY OOK OCT - 2021 938 KING ET RYE BROOD,NY 10573 -0668 VILLAGE OF RYE BROOK aokerg BUILDING DEPARTMENT Foy OFFrcF I IsF orvl-Y: ��lO�aOa a BOT Approval Date: PB Approval Date: BOT Disapproval Date: PB Disapproval Date: Attach Resolution Hereto: BOT[ ] PB ZBA[ ] Chairman: 9, &_Ood/X20./2 SITE PLAN FEE: .3a5.oa DATE PAID: 10 t I a02 ENVIRONMENTAL FEE: 01 50 0 DATE PAID: 16_ / r,Zb-R,4 OTHER: APPLICATION FOR SITE PLAN APPROVAL Submission of this application does not assure placement on any Planning Board Agenda. The Applicant will be notified of such placement. This application references but is not limited to the following sections of the Code of the Village ofRye Brook;§250 ZONING,§209 SITE PLAN REVIEW,§235 TREES,§107 DEMOLITION OF BUILDINGS,§224 SWIMMING POOLS,§121 EXCAVATION&TOPSOIL REMOVAL,§118 EROSION&SEDIMENT CONTROL,§213 STEEP SLOPES PROTECTION,§219 SUBDMSION OF LAND, §250-40 NOTIFICATION REQUIREMENTS. Applicants and their Design Professionals are strongly advised to review the above u I d code sections online at.www.ryebrook.org prior to completing and/or submitting this application. APPLICATION FEE SCHEDULE: Residential Dwellings- $325.00,plus$200.00 per additional dwelling unit. Non-Residential Buildings- S475.00,plus $30.00 per parking space. Planned Unit Development-$600.00,per acre PUD Amendment- $300.00 Site Plan Amendment- $575.00 Wetlands&Watercourse- $1,150.00,permit$250.00 Consultant Review(Escrow)Fee: Minimum fee$250.00-maximum fee$2,500.00 to be determined by the Village Engineer. Application fees are non-refundable. The applicant's Escrow Account inust have a positive balance at all times prior to may Consultant.Attorney, or Village review. Escrow Fees and Site Plan Fees nnrst be paid on separate checks made payable to the Village ofP " 2 Lee Lane 135.58-1-22 R-10 1. Site Address: Parcel Zone: 2. Property Owner: Josh Kirsch Address: 2 Lee Lane E-Mail: kkid3l2@aol.com Tel.#: 914-722-2631 Other: 3. Applicant: Same Address: E-Mail: Tel.#: Other: 4. Design Professional: Rob Dallesandro Address: 419 South Lexington Ave , White Plains E_Mail. rdallesandro@gmail.com Tel.#: 917-923-2057 Other: 5. Designate to whom correspondence is to be sent: Rob Dallesandro-Architect Note:If applicant is a"Contract Vendee".please attach a copy of the contract summary with financial and confidential terms deleted. 1 8/12/2021 6. Street which property abuts: Jennifer 7. Does property connect directly into State or County highway? (x)NO ( )YES: 8. Is site within 500 feet of Village Boundary?(X)NO O YES If yes note all bordering municipalities: 9. Total area of site: 11162 SF Area of site activity: 1000 SF 10. Site coverage: %; Building coverage: 1515 SF °„ 11. Existing building size: 1515 SF New/additional building size: 0 SF 12. Existing parking spaces: N/A New parking spaces: 13. Nature of proposed activity: New Retaining Wall 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. ********ic is is icxx xir:k is ie is icxir it is is is is**ie is iczxt*F*ir is*ic is*ie it is is*F is is it ix it iie is is is iicxis ie is is ix it ixic i 'c ie ie*ic it ie xe is is irx it it it is*iic se is is is is xiex icx icxx STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: ' k fr 3cl_ ,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 3 7 Sworn to before me this day of �2(nbG�' , 20 Z( day of 120 o Notary Public ature of PropertyOwner Signature of Applicant � JL Print Name of Property Owner Print Name of Applicant BLORINA GASHI NOTARY PUBLIC,STATE OF NEW YORK NO.OIGA6405087 QUALIFIED IN BRONX COUNTY COIvU&SSION EXPIRES MARCH 2,2024 2 8/12/2021 V1Q, OF RYE"ROOK 938 King S, t,Rye Brook,N.Y. 10573 9 9-07�3 SITE PLAN SUBMITTAL REVIEW CHECKLIST This form shall serve as a checklist for site plan submittal and review by the Village of Rye Brook. The use of this plan review checklist by the applicant is to ensure compliance with the technical provisions of§209 of the Code of the Village of Rye Brook entitled, Site Plan Review, pertaining to preliminary and final plan preparation. The Village Code is available on the Village Website at: www.ryebrook.org_ Prior to the appearance before ANY meeting or hearing of the Planning Board,the applicant must comply with all Notification Requirements of Code Section 250-40. SITE PLAN SUBMITTAL SHALL INCLUDE: 1. APPLICATIONS. Completed and signed including correspondences. 2. CHECKLIST. Completed and signed. 3. PLANS. Signed, Sealed & Dated. Four paper (4) copies and one (1) electronic version. One (1) record set with original signatures, dates and seals shall be provided and submitted with two (2) copies that clearly indicate the signatures,dates,and seals shown on the record set. 4. FEES: All application fees and Environmental fee. A separate check for filing fee and Environmental fee. 5. Environmental Assessment Form. Form available on the NYS DEC website and mapper. 6. Electronic Copy. Complete copy of all plans and shall be submitted electronically at time of submission. 7. Notarized Affidavit of Sign Posting& Mail Notification. I, (Applicant's signature)have read the Notification Requirements of e Sec dtion 250-40 and will provide notification as required. IDENTIFICATION OF APPLICANT(S): Identification of Applicant: Owner Applicant: Josh Kirsch Address: 2 Lee Lane Tel.#: 914-722-2631 Fax: E-Mail: kkid312@aol.com Project Name: Retaining Wall Project Address: 2 Lee Lane Current Property Owncr: Same Address: Tel.#: Fax: E-Mail: IDENTIFICATION OF PROPERTY: Identifying Title: Single Family Home Tax Designation: Section: 135.58 Block: 1 Lot: 22 Zoning District: R-10 Street which property abuts: Jennifer Plan Submission Date: 9-25-21 Site Plan Checklist Page 1 of 7 8/12/2021 Project Address Y N NA PLAN REQUIREMENTS 000 4 copies of plans prepared and signed by a registered Land Surveyor,Engineer or Architect. • O O One(1)electronic copy of all submitted plans and surveys. 0 O O Topographic Survey stamped by New York State Land Surveyor with license number and seal. 0 O O Topographic survey scale of one(1)inch per twenty(20)feet or larger. ® O O Section, block and lot numbers of the property taken from the latest tax records along with a copy of the most recent property card on file with the Town of Rye Tax Assessor's office. O O A Name of the proposed subdivision plan. (1) O O Name and address of the owner of record. C• O O Name and address of the applicant. O O • Deed reference(s). • O O Names, addresses and signature of every Engineer, Architect, Land Surveyor or Soil Scientist whose professional seal appears on any site plan submitted to the Board. • O O North arrow and scale. 00 0 Location map at the minimum scale of 1"equals 1,000 feet. • O O Area of all lots,in square feet. • O O Engineering notes on plans as stated in application packages. O O • Copies of all existing and proposed deed restrictions or covenants applying to the property, including, but not limited to, covenants and agreements restricting the use and establishing future ownership and maintenance responsibilities for all private roads,recreation,and open space areas. 000 Any prior land use approvals with respect to the subject property. 000 Date the plans were fast drafted. Any revision(s)made to any of the sheets fast submitted are to be so noted in the revision block. The revision block is to be placed on the originals of the revised sheets. Additional paper copies are to be made& submitted for the Planning Board&Building Dept.to replace those sheets previously submitted. 000 Other existing site improvements,including,but not limited to,fences,landscape or retaining walls,landscaping & screening. O O Location of all buildings and structures on the premises and approximate location of all neighboring buildings or structures within 100 feet of the lot line. (4) 00 Fees paid to The Village of Rye Brook Building Department. (9 O O Any revisions to plans shall be identified with a revision cloud and numbered revision triangle Y 1_v NA ABUTTING PROPERTYINFORMATION O O • The names and addresses of all abutting property owners within 250 ft as indicated in the Municipal records. O O 40 Zoning and use of abutting properties noted on plans. O O Q Shape,size,height and location of existing buildings and driveways within one hundred(100)feet of the site. O O • Location and description of existing easements within one hundred(100)feet of the site. O O • Location of existing private or public trails within one hundred(100)feet of the site. O O Location of existing roads,scenic roads and/or driveways within two hundred(200)feet of the site. O O Location of proposed parkland.If none state nearest recreation facility O O • Location of existing septic system leach fields within two hundred(200)feet of the site. O O $ Locations,dimensions,grades and flow direction of existing sewers,culverts,waterlines as well as other underground utilities within and adjacent to the property. Site Plan Checklist Page 2 of 7 8/12/2021 Project Address 000 The location of all existing watercourses,intermittent streams,wetland areas and springs,consistent with the definitions set forth in Chapter 245,Wetlands and Watercourses,of the Code of the Village of Rye Brook. Y N NA PROPOSED SITE PLAN INFORMATION O O Sufficient, acceptable information to readily determine the location,bearing, and length of every street line, lot line, and property boundary line. 000 Location of all building setback lines. * O O Topographic data at a minimum contour interval of 2'-0"increments,showing existing and proposed contours on the property and extending a minimum of 25 feet into all adjacent properties. O O 0 The location and characteristics of the different areas of vegetation,including the identification of all individual trees 12 or more inches in diameter at breast height("DBH"),protected trees of any size,as well as stands of trees and wooded areas, within areas of proposed disturbance,consistent with the provisions of Chapter 235, Trees, of the Code of the Village of Rye Brook. 000 Location and proposed development of all buffer areas,including existing vegetative cover. O O OF Location and description of any zoning district and municipal boundaries including a zoning compliance chart for the existing and proposed lots. W O O Shape,size,height and location of all existing and proposed buildings. 00 A Location and description of any existing and proposed easements. t O O Location and dimensions of all existing and proposed streets,driveways,sidewalks,parking spaces,bicycle parking, loading areas and other facilities associated with the proposed use. 00 • Identification of the location and amount of building area proposed for retail sales or similar commercial activity. O O ♦ Location of existing and proposed utilities(water,sewer,gas,electrical,telephone,oil tank etc.). O O 0 Design and location of all existing and proposed wells,septic tanks and leach field systems,or methods of waste water disposal. O O 4% Location,type and size of all existing and proposed landscaping and screening including fences and walls. O O I Location,size and proposed screening of outdoor storage areas,if any. • O O Location, design and construction material of all existing or proposed site improvements, including drains, culverts, retaining walls,landscape walls and fences. O 0 • Exterior lighting plan and proposed signs to be located on site,including sign orientation,size,height,and elevation view. O O • Storm drainage plan and plans for snow removal and storage. O O • Pedestrian and automobile circulation plan. O O 6 Construction drawings for pavements,walks,steps,curbing,drainage&other structures associated with the proposed use. O O • Erosion and sedimentation control plan,including installation details of proposed control measures,directive construction notations and a schedule for the installation and maintenance of proposed control measure. O O • Description of measures planned to assure proper erosion and sedimentation control in accordance with the requirements of Chapter 118 entitled"Erosion and Sediment Control,"of the Code of the Village of Rye Brook. O O • Drawing and computation for storm water detention design for a 25-year storm in accordance with the Westchester County Best Management Practices O O it Rock outcroppings and areas of steep slope consistent with the definitions set forth in Chapter 213,Steep Slope Protection, of the Code of the Village of Rye Brook. O O A Location of any common lands and/or public lands. O O 1 Phasing or an estimated project construction schedule. O O • Supporting documents,including deeds,maintenance,condominium agreements,etc. Site Plan Checklist Page 3 of 7 8/12/2021 Project Address 000 Location of proposed construction or area of disturbance and its relationship to any property line, easement, building, structure, road, wall, fence, sewage disposal system, well, wetland feature or tree exceeding six inches in diameter measured at a height of four feet from the ground 000 Estimate of earthwork showing the quantity of any material to be imported to and/or removed from the site including a chart with the number/species and size of any trees to be removed. 000 Location and size of areas of soils by soil types in the area of proposed disturbance and to a distance of 100 feet surrounding the area of disturbance. 000 Cross sections of steep slope areas. 000 Retaining walls or like constructions,with details of construction. 000 Approximate boundaries of any areas subject to flooding or stormwater overflows,including areas of special flood hazard and coastal high-hazard areas, consistent with the definitions set forth in Chapter 130, Flood Damage Prevention, of the Code of the Village of Rye Brook.Approximate Wetlands and wetland buffer boundaries shall be clearly delineated. O O • Location of fire and other emergency zones,including the location of fire hydrants. O O • Studies to include,but not necessarily limited to: environmental impact analysis,wildlife,traffic,stormwater management,recreation,public service,fiscal impact,visual impact and historic significance documentation,or a written request to waive the submission requirements for these studies. O 00 Amount of any bonds required. O O • Amount of excavated material to be removed from site,if any. Y N NA OTHER(as applicable) O 00 Record of application for and approval status of all necessary permits from state and county officials and local utility companies. O O • Identification of any federal,state or county permits required for the projecfs execution,including project referrals, if any,&environmental review procedures mandated by Article 8,Environmental Quality Review,of the Environmental Conservation Law(SEQRA). O O r Any other information felt necessary by the Planning Board to allow the Board to proceed with consideration&to make an informed decision. DEVELOPMENT REVIEW CHECKLIST WESTCHESTER COUNTYPL4NNING BOARD Notice to ApplicantsMevelopers: At some point during the development review process your project may be referred to the Westchester County Planning Board for review and comment in accordance with state and county laws that require local planning boards, zoning boards of appeals and governing bodies to refer certain development applications to the County Planning Board. Referral to the County Planning Board may not occur until your project has progressed well along through the design process. Since the Planning Board's comments may impact project design,this checklist is provided to encourage early consideration of these areas of concern by applicants to avoid project changes later. For information on the County Planning Board review process and to access an electronic copy of this checklist, go online to www.westchestergov.com/planningrefenals or contact Lukas Herbert at lah5@westchestergov.com. I.COUNTY PLANNING BOARD POLICIES: Written policies underlie all recommendations of the County Planning Board. Westchester 2025-Context for County and Municipal Planning and Policies to Guide County Planning,adopted by the County Planning Board on 5/6/08,amended 115110,can be found at ww.westchestergov.com/2025. ❑Westchester 2025:Policies should be reviewed to determine how they relate to the development proposal. IL EWPACTS TO COUNTY FACILITIES AND SERVICES: The County Planning Board coordinates the review of development projects with Westchester County departments to identify and address potential impacts on County services and infrastructure.In some situations,permits and approvals may be required that could change project design. Site Plan Checklist Page 4 of 7 8/12/2021 Project Address ❑ Map of County Facilities: Review the State& County Roads and Parks map (which also includes county channel lines)to identify proximity to County facilities at: www.westchestergov.com/planningdocs/pdf naps/countystateroadsparks.pdL Other useful map links for information about environmental features, septic/sewer map, county sewer districts map, etc can be found at: www.westchestergov.com/maps ❑ COUNTY ROAD: Applications for development on sites that abut a County road must be submitted for review by the County Department of Public Works. Information and forms can be found at: www.westchestergov.com/dpw/bldgpenn.htm.Former County Roads do not need review by the Department of Public Works,but will still likely trigger a review by the County Planning Board. ❑ COUNTY CHANNEL LINES: Applications for development on sites within 100 feet of a designated County Channel Line require a stream control permit from the County Department of Public Works. Information and forms can be found at: www.westchestergov.com/dpw/bldgperm.htm ❑ COUNTY PARK: New construction& land alteration projects adjacent to County parks are expected to address screening& buffer of new uses from the park, as appropriate. Stormwater should not drain from a developed site onto a County park without acceptable quantity and quality controls.County parks are designated as Critical Environmental Areas. ❑ SEWAGE TREATMENT AT COUNTY TREATMENT PLANT: Local municipalities are required to reduce and eliminate inflow and infiltration(I&I)into the sanitary sewage systems tributary to County treatment plants.New development will be expected to reduce I&I in relation to generation of new flow at a ratio of three to one. This requirement must be discussed with local officials. ❑BEE-LINE BUS SERVICE: Bee-Line bus stops serving a development site should be identified on plans or noted if located off-site. If a bus stop is located along the site's frontage, the applicant should contact the County Department of Transportation to discuss impacts and the need for improvements. Safe and separate pedestrian access should be provided to link a bus stop and sidewalk with building entrances. Information on County bus service and design guidelines can be found at: westchestergov.com/transportation/itnagesBus%20Service%2OGuidel hies.pdf ❑FAIR AND AFFORDABLE HOUSING: Many municipalities require inclusion of fair & affordable units in new developments. Financial assistance to achieve fair & affordable housing development is available through Westchester County & other sources. Applications that include new residential units to be affirmatively marketed & sold or rented subject to fair& affordable housing provisions should be tied to Westchester County guidelines on affordability including income guidelines of eligible households that can be found at: http://homes.westchestergov.com/. If County funding is sought to develop fair & affordable housing,the County Board of Legislators must be included as an involved agency under SEQR ❑RECYCLING: New buildings must contain a designated area of sufficient size for separation and storage of recyclables and trash. Building expansions should also include sufficient space for separation and storage of recyclables.For more information about County recycling requirements go to: www.westchestergov.com/environment—recycling.htm ❑STORM SEWER SYSTEM: Any connections to a County storm sewer line will require a permit from the Department of Public Works in accordance with the County Illicit Discharge Detection and Elimination (IDDE) law. Information& forms can be found at:www.westchestergov.com/dpwibldgpenn.htm Non-stormwater discharges to the County storm sewer system are prohibited. III.DEVELOPMENT STANDARDS The County Planning Board's land use policies focus attention on several aspects of development that may have intermunicipal and quality of life impacts.The list below includes areas most frequently commented on by the County Planning Board. ❑WATER: All development plans should include sufficient provisions for stormwater management, water quality measures and mitigation of flooding. ❑Plans should identify the major drainage basin or watershed the site is located in (Croton River, Upper Hudson River, Lower Hudson,Upper Long Island Sound,Bronx River and Lower Long Island Sound). An interactive map with watershed boundaries can be found at www.westchestergov.com/planning/maps&lists/drainbasinsI IxI7.html ❑Watershed plans have been developed for several of the County's watersheds - the Croton, Indian Brook-Croton Gorge, Bronx River & Long Island Sound watersheds - that include specific recommendations that apply to development projects. See recommendations in watershed plans at:planning.westchestergov.com/index.php?option=com_content&task=view&id= 1231& Itemid=2204 Site Plan Checklist Page 5 of 7 8/12/2021 Project Address ❑Development that involves filling, creation of impervious surfaces or buildings and substantive loss of natural vegetation in a floodplain or flood prone area should be avoided. ❑Above ground,vegetated retention/detention basins or devices are preferred because they perform better, are easier to inspect and maintain and provide additional environmental benefits over subsurface structural devices. Any such treatments should not be constructed within wetlands or buffer areas around wetlands. El The development should treat and retain as much stormwater on-site as possible,particularly when the site is located in a drainage basin with known flooding problems. A Construction Stormwater Toolbox with tools and sources of technical information related to the construction activities and stormwater management best practices is available from the New York State Department of Environmental Conservation at:www.dec.ny.gov/chemical/8694.html ❑New development should include protection of aquatic resources. For more information about protection of aquatic resourc-es & buffer areas,go to:planning.westchestergov.com/index.php?option=com_content&task=view&id=1491&Itemid=2458 ❑Impervious cover should be minimized. Permeable paving surfaces should be used where feasible. Vegetative rain gardens should be used,particularly in areas of overland or channelized stormwater flow,to improve stormwater quality and reduce runoff volume. For more information,go to: www.westchestergov.com/stormwater ❑Buildings along coastlines and low lying area should consider the impacts of sea level rise. Specific consideration is required of potential impacts to surface and subsurface drinking water supplies. ❑ SITE LAYOUT.Aesthetic design,building orientation and community character should be considered in the site layout and building appearance. ❑In most locations,buildings should face the street and have pedestrian access from the street. ❑Commercial buildings should be located near the front street line with the majority of parking located in the rear of the building. Even gas stations and convenience stores should be upfront in a landscaped setting with parking,pumps and canopy toward the rear. ❑Buildings should be of pedestrian-scale when seen from the sidewalk. ❑Building facades should contribute to and enhance the character of the community. El Driveway and pathway connections should be provided to adjacent sites when possible and crosseasements provided. ❑ STREETS.Street design should reduce unwarranted paving and promote connectivity. ❑New streets should connect with adjacent streets wherever feasible to prevent the proliferation of dead-end streets and promote neighborhood integration. ❑Connections could be vehicular or pedestrian/bicycle only,where appropriate. ❑Street widths should be minimized for streets with low traffic volume to reduce speeds and impervious surfaces.Lane widths of 12 feet are only appropriate for major roadways. El Driveway widths should be no more than 9 feet to reduce impervious surfaces. El Permeable paving surfaces should be used where feasible. ❑ GREEN TECHNOLOGY.New development should include as many green building elements as possible,such as:renewable building materials,energy efficient heating/cooling systems and fixtures,water saving devices,green roofs and permeable paving surfaces.Information can be obtained from the U.S.Green Building Council at: www.usgbc.org. ❑ LANDSCAPING AND LIGHTING.The site improvements should enhance community character. Site Plan Checklist Page 6 of 7 8/12/2021 Project Address ❑ Landscaping should consist of native plant species appropriate for the location.Invasive plant species should be prohibited. Invasive plant information available at:www.westchestergov.com/planning/environmental/Reports/InvasivePlantsBroch08.pdf ❑ Pollutant tolerant plantings should effectively shield parking,loading areas and refuse collection sites. ❑ Site lighting should be provided at the lowest safe levels and lowest heights,avoiding all spillage off site. ❑ PEDESTRIANS.Safe,convenient and ADA accessible pedestrian access is provided. ❑ A sidewalk should be provided along the site frontage along each street. ❑ Direct pedestrian connections should be made from the front of the building to the sidewalk.Pedestrian crossings of drive-ways& parking lots should be minimized or avoided If they must be provided,painted crosswalks should be provided through parking lots. ❑ ADA accessibility must be provided. ❑ BICYCLISTS.Provisions for bicyclists should be incorporated into project design. ❑ Bicycle parking should be provided in commercial and residential developments.Guidelines can be found at: www.apbp.org/resource/resmgr/publications/bicycle_park ing_guidelines.pdf ❑ If near a trailway or bicycle route,extra consideration should be given to bicycle accessibility such as bale lanes on internal roadways,bicycle parking and other amenities. ❑ Drive-thru lanes at uses such as banks and fast-food restaurants should also be accessible for bicycles. Waiver: Upon finding by the Building Inspector, Village Engineer, Planning Board or Board of Trustees that, due to the particular character or limited nature of development or change in use or to special conditions peculiar to a site,the submission of a final site plan,or certain portions of information normally required as part of the site development plan, is inappropriate or unnecessary or that strict compliance with said submission requirements will cause extraordinary and unnecessary hardship, such official or Board may waive such submission requirements wherever, in the opinion of such official or Board, such waiver will be consistent with the goal of promoting the public health, safety and general welfare of the community.The findings for granting such waiver shall become a part of the public record. Any waiver request must be made in writing,and include sufficient detailed information for the appropriate authority to make an informed decision. Design Professional's Certification of Completion of Checklist I have fully reviewed the Village of Rye Brook's requirements and certify this application to be a complete submission. I understand that an incomplete plat or incomplete checklist shall be deemed an incomplete submission and shall be returned to the applicant upon determination of such by the appropriate authority. Name(Print) � roo e3 V QP�I OA(�Fshc`�� Signature d Date l l 3,Tq O3pp4O,hr Pro al Seal Site Plan Checklist Page 7 of 7 8/12/2021 p ECENE Short Environmental Assessment Form DEC 16 2021 Part I -Project Information VILLAGE OF RYE BROOK Instructions for Completing BUILDING DEPARTMENT Part I—Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1.You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1—Project and Sponsor Information Name of Action or Project: New Retaining wall and fence Project Location(describe, and attach a location map): 2 Lee Lane - Rue Brook NY Brief Description of Proposed Action: Replace deteriorating retaining wall with new reinforced concrete retaining wall. Replace existing chainlink fence with new decorative Vinyl Fence. Name of Applicant or Sponsor: Telephone: 917-923-2057 Rob Dallesandro -Architect E-Mail: rdallesandro@gmail.com Address: 419 South Lexington Ave City/PO: State: Zip Code: White Plains NY 10606 1. Does the proposed action only involve the legislative adoption of a plan, local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other government Agency? NO YES If Yes,list agency(s)name and permit or approval: Architectural Review Board, Building Permit- Village of Rye Brook ❑ 3. a.Total acreage of the site of the proposed action? 256 acres b.Total acreage to be physically disturbed? acres c.Total acreage(project site and any contiguous properties)owned .02 or controlled by the applicant or project sponsor? 0.0 acres 4. Check all land uses that occur on,are adjoining[and]or near the proposed action. ❑Urban ❑Rural(non-agriculture) ❑Industrial ❑Commercial C$Residential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland 1'roc 1 of—, 5. Is the proposed action, NO YES N/A a. A permitted use under the zoning regulations? ❑ Fx-1 ❑ b. Consistent with the adopted comprehensive plan? ❑ ❑ NO YES 6. Is the proposed action consistent with the predominant character of the existing built or natural landscape? ❑ ❑X 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: 0 ❑ NO YES 8. a. Will the proposed action result in a substantial increase in traffic above present levels? b. Are public transportation service[(]s[)]available at or near the site of the proposed action? X❑0 ❑❑ c. Are any pedestrian accommodations or bicycle routes available on or near the site of the proposed action? ❑ 9. Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: FIR] ❑ 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: 11. Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: 12. a. Does the proiect site contain,or is it substantially contiguous to,a building,archeological site,or district NO YES that[a structure that] is listed on[either]the National Register of Historic Places or the State Register of Historic Places or that has been determined bathe Commissioner of the NYS Office of Parks,Recreation and Q ❑ Historic Preservation to be eligible for listing on the State Register of Historic Places? b. Is the [proposed action]project site,or any portion of it, located in or adjacent to an area designated as ❑ [archaeologically]sensitive[area] for archaeological sites on the NY State Historic Preservation Office(SHPO) archaeological site inventory? 13. A. Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? ❑ ❑ b. Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? ® ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: Page 2 of 3 14. Identify the typical habitat types that occur on,or are likely to be found on the project site.Check all that apply: ❑Shoreline ❑Forest ❑Agricultural/grass lands ❑Early mid-successional ❑Wetland []Urban UdSuburban 15. Does the site of the proposed action contain any species of animal,or associated habitats,listed by the State or NO YES Federal government as threatened or endangered? 0 ❑ 16. Is the project site located in the IOOyear flood plan? NO YES E ❑ 17. Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, ❑X ❑ a. Will storm water discharges flow to adjacent properties? ® ❑ b. Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? ® ❑ If Yes,briefly describe: 18. Does the proposed action include construction or other activities that would result in the impoundment of water NO YES or other liquids(e.g.,retention pond,waste lagoon,dam)? If Yes,explain the purpose and size of the impoundment: 19. Has the site of the proposed action or an adjoining property been the location of an active or closed solid waste NO YES management facility? If Yes,describe: 0 ❑ 20. Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: X❑ ❑ 1 IAFFIRMI CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MV KNOWLEDGE Applicants or name: Rob Dallesandro Date: 11-29-21 Signature: Title: v Page 3 of 3 EAF Mapper Summary Report Thursday, December 16, 2021 8:39 AM Disclaimer: The EAF Mapper is a screening tool intended to assist project sponsors and reviewing agencies in preparing an environmental assessment form(EAF).Not all questions asked in the EAF are 135.58-1-4 135.58-1-5 answered by the EAF Mapper.Additional information on any EAF 135.57 1 15 135.58-1 2 �I 135.58-1-3 question can be obtained by consulting the EAF workbooks. Although the EAF Mapper provides the most up-to-date digital data available to DEC,you may also need to contact local or other data sources in order to obtain data not provided by the Mapper.Digital data is not a ,ten n,far Lill substitute for agency determinations. r r.1 n tr e-I — — •135.58-1-2, n n _ E5�. 135.5 8-1-21 135.57-1-16 135.58-1-1 f1 2 ` Temnw, ,Rod»ster __-- --------- 135.66-1-1 C ' ( dI)I�tlo ` Albary ` 135.66 1-2 3 i 35.66-1-2 2 FOMrou !� 8 obtan 135.66-1-32 r Ctevtlana arpvldMee ------ -. ! — -L -------. 135.66-1-21 I!.(ew York 135.66-1-31 .05.66-1-24 ,gttsbtegh Crdi Philadelphia ,amun.USGS ta�.MCREMErITP 11R::an Esn Japan 117 Es.n Jh lta iHonj nrid',UK 11!MEhIT�I�kCan Esn Japan IAETI Esn Chula Moi l Kongi. Esn k�qc ►=�Spp�I,i�iiiaw;I CC itiOpaiSt :fca0co''hfAbLItol S!lserComn1ILV y siaitOpautre4_11apcontnb%31RiAlVJVeGIS11s?rCom III tuiib, Part 1 /Question 7 [Critical Environmental No Area] Part 1 /Question 12a [National or State No Register of Historic Places or State Eligible Sites] Part 1 /Question 12b [Archeological Sites] No Part 1 /Question 13a [Wetlands or Other No Regulated Waterbodies] Part 1 /Question 15 [Threatened or No Endangered Animal] Part 1 /Question 16 [100 Year Flood Plain] No Part 1 /Question 20 [Remediation Site] No Short Environmental Assessment Form - EAF Mapper Summary Report 11/28/21,10:59 AM Environmental Resource Mapper •• • LF VER41 I i I V •• • • Environmental Resource Mapper Base Map Topographical _ Using this map Search Tools + Layers and Legend Other Wetland Layers Reference Layers Tell Me More--- Need A Permit? Need a Permit? _ Disclaimer:These maps are for informational purposes only.The Environmental Resources ® „..,..,n Ln. Mapper does not show all natural resources R in which are regulated by NYS DEC,and for which permits from NYS DEC are required.For example, Regulated Tidal Wetlands,and Wild,Scenic,and Recreational Rivers"are currently not included on the maps. at=r Wetlands Permit Required for any physical disturbance,within the boundary or within the 100 foot adjacent area,of a state protected freshwater wetland.Note:Freshwater wetlands within the Adirondack Park are not `x included on these maps;contact the Adirondack Park ency_for permit information. h Contacts 0 150 300 Mtps:/lgisservices-dec.ny.gov/gisternV 1/1 11/28/21,10:58 AM Environmental Resource Mapper YORK STATE DEPARTMENT OF `•NMENTAL CONSERVATIOK Environmental Resource Mapper Base Map:iTo�raphical v using this map Search o Tools Bn Cc rkPV Z Layers and LegendFbdge Other Wetland Layers F�ztc. N Part, EhrchIn �.� • ► Q� Car/E � Reference Layers Rea Root❑r Tell Me More... �A01 = x A Need A Permit? • ° �n T�gd z SV� _ Elm FYp Pack A Need a Permit? crawb"I park Disclaimer:These maps are for informational Fan Rya w; purposes only.The Environmental Resources Mapper does not show all natural resources which are regulated by NYS DEC,and for which L c permits from NYS DEC are required.For example, / V jp Regulated Tidal Wetlands,and Wild,Scenic,and lyr, Recreational Rivers,are currently not included \ F nr3 n yv�ood Ave on the maps. t fid Ire nhy Ave 4 '.e'.lands Permit Required for .usi wesrc star- any physical disturbance,within the boundary or o e '2X" within the 100 foot adjacent area,of a state ti 4 b� protected freshwater wetland.Note:Freshwater ` �.+ c wetlands within the Adirondack Park are not a'Rd \moo Rye BrOOk included on these maps;contact the Adirondack Park lAgency_for permit information. 0 0.1 0.2mi Contacts https://gisseNices.dec.ny gov/gis/erm/ 1/1 ENGINEERING & --- . RKS DEPART C E O VED VIL RCE OF RYE BROOK 938 KING REET RYE BROOK,NY 10573 FL EP 3 0 2021 f 07 VILLAGE OF RYE BROOK BUILDING DEPARTMENT STEEP SLOPE WORK PERMIT APPLICATION FOR OFFICE USE ONLY: PERMIT#: Approval Authority: Permit Fee: $ :25C Pd Planning Board Approval Date: c�211nla'0'2a _ Superintendent of Public Works Approval Date: Disapproved Date: ********x*x�****x�*x*xxx*xxx***xxxxxx*xx�xxxxx*xxx*xx�****�xxx*xxxxxxxxxxxx*xxx�xxxxxxxx*x�xxxxxxxxxxxxxxxx REQUIREMENT SUBMITTALS: 1. Properly completed& signed application. 2. Steep Slope Work Permit fee $250.00 Application dated, 9-25-21 is hereby made for a Steep Slope Work Permit_ 1. Address: 2 Lee Lane SBL: 135.58-1-22 Zone: R-10 2. Property Owner: Josh Kirsch Address: 2Lee Lane Phone#: 914-722-2631 Cell#: email: kkid3l2@aol.com 3. Applicant: Same Address: Phone#: Cell#: email: 4. Contractor: Address: Phone#: Cell#: email: 5. Full Description of Proposed Work: New Retaining wall at rear of property to replace existing deteriorated retaining wall 6. Steep Slope Disturbance: Isolated Steep Slopes under 400 Square Feet: 665 Square Feet Disturbed (a)MODERATELY STEEP SLOPE A slope equal to or greater than 15%but less than 25%: % Square Feet Disturbed (b)VERY STEEP SLOPE A slope equal to or greater than 25%but less than 35%: 33 % 665 Square Feet Disturbed (c)EXTREMELY STEEP SLOPE A slope equal to or greater than 35%: % Square Feet Disturbed 7. Conditions for permit: Deteriorated retaining wall to be replaced IF PERMIT IS GRANTED,I AGREE TO COMPLY WITII ALL RULES AND REGULATIONS SET FORTH BY THE FEDERAL, STATE,COUNTY,LOCAL LAws,SPECIAL ORDINANCES,GENERAL ORDINANCES. Signature of Property Owner 8/12/2021 p EC ENE FEB -3 2022 Josh and Kristen Kirsch 2 Lee Lane VILLAGE OF RYE BROOK BUILDING DEPARTMENT Rye Brook, NY 10573 Rye Brook Building Department 938 King Street Rye Brook, NY 10573 February 3`d, 2022 To whom it may concern: In accordance with the Village Code, we have completed the following information for the Planning Board Public Hearing on February 10'', 2022, in reference to the application for 2 Lee Lane, Rye Brook, NY. On January 31", 2022, a mail notification was sent through first class mail to all abutters within 250 feet of 2 Lee Lane, Rye Brook, NY. A copy of this notification has been submitted to the Building Department. On February 1", 2022, a sign was posted in front of the property at 2 Lee Lane, Rye Brook, NY, and can be seen from both Lee Lane and Jennifer Lane. Sincerely Kristen Kirsch 2 Lee Lane Rye Brook, NY 10573 SHAM MELILLO Notary Public, State of New York No. 01!MCF)160063 Oualified in VJestch?ster County Commission Expires Januarv(�29,�2(0 c- _Sim � ANN- 0 57 Ae 4RI' J •!S v }.y.j �'^�'. -1� ..; !f.�y f•�vy 1 1 I I I I 1 1 i 1 1 e M✓'��y. I 1 1 1 t ✓+��� fi—'v3 ��.�, ���c rt � 1 � � � I 11 I I 1 I I � I <T 1 1 • � '�k +r �� ♦ >, - � Frio .�„i�;� � E �.. J��` ��•�r ',�fi �. �T!. �,1 f y , 1�.'1 y ,,� �. `,:4 0.-. 05 ♦` I '.,� �t"ts ��� J���P 4�',� •t� yt.../ • + �A''h YZ �I I I `` Mond 0 M C n' Q Q W Y — fJi OO S Q m M >; F— li W S � cm comc L ,m Q lii � W 00 co W ui T W W i Eby; `L . " �p 250 foot Abutters List Report �I Rye Town, NY January 29,2022 yfSTEA a!may Subject Property: Parcel Number: 135.58-1-22 Mailing Address: Joshua Kirsch Kristen M. Kirsch CAMA Number: 135.58-1-22 Property Address: 2 Lee Ln 2 Lee Ln, Abutters: Parcel Number: 135.57-1-14 Mailing Address: John Berardi Diana Berardi CAMA Number: 135.57-1-14 Property Address: 4 Jennifer Ln 4 Jennifer Ln, Parcel Number: 135.57-1-15 Mailing Address: Anthony J. Lanzetta Angela D. Lanzetta CAMA Number: 135.57-1-15 Property Address: 6 Jennifer Ln 6 Jennifer Ln, Parcel Number: 135.57-1-16 Mailing Address: Stephen D. Weimar Christine Minahan- CAMA Number: 135.57-1-16 Weimar Property Address: 3 Jennifer Ln 3 Jennifer Ln, Parcel Number: 135.58-1-1 Mailing Address: Hamilton Bullard Whitney Bullard CAMA Number: 135.58-1-1 Property Address: 1 Lee Ln 1 Lee Ln, Parcel Number: 135.58-1-2 Mailing Address: David J. Civetta Michelle D. Civetta CAMA Number: 135.58-1-2 Property Address: 8 Jennifer Ln 8 Jennifer Ln, Parcel Number: 135.58-1-20 Mailing Address: George R. Ehrmann Angelika Ehrmann CAMA Number: 135.58-1-20 Property Address: 13 Jennifer Ln 13 Jennifer Ln, Parcel Number: 135.58-1-21 Mailing Address: Craig J. Bergman Samantha Bergman CAMA Number: 135.58-1-21 Property Address: 11 Jennifer Ln 11 Jennifer Ln, Parcel Number: 135.58-1-23 Mailing Address: Town of Rye CAMA Number: 135.58-1-23 Property Address: 122 N Ridge St 222 Grace Church St, Parcel Number: 135.58-1-3 Mailing Address: Brian Greaige CAMA Number: 135.58-1-3 Property Address: 10 Jennifer Ln 10 Jennifer Ln, Parcel Number: 135.58-1-4 Mailing Address: Robert Antony CAMA Number: 135.58-1-4 Property Address: 12 Jennifer Ln 12 Jennifer Ln, �. .., Ii www.cai-tech.com Data shown on this report is provided for planning and informational purposes only.The municipality and CAI Technologies 1/29/2022 are not responsible for any use for other purposes or misuse or misrepresentation of this report. Page 1 of 3 Abutters List Report- Rye Town, NY 250 foot Abutters List Report r�5 >1 Rye Town, NY ss January 29,2022 FF44 sT IEIt Parcel Number: 135.58-1-5 Mailing Address: Michael Savino Elizabeth Savino CAMA Number: 135.58-1-5 Property Address: 14 Jennifer Ln 14 Jennifer Ln, Parcel Number: 135.65-1-42 Mailing Address: Mario De Lio Anna De Lio CAMA Number: 135.65-1-42 Property Address: 31 Lincoln Ave 31 Lincoln Ave, Parcel Number: 135.65-1-43 Mailing Address: Mario De Lio Anna De Lio CAMA Number: 135.65-1-43 Property Address: 31 Lincoln Ave 31 Lincoln Ave, Parcel Number: 135.65-1-44 Mailing Address: Rabi Burathoki Babita Burathoki CAMA Number: 135.65-1-44 Property Address: 29 Lincoln Ave 29 Lincoln Ave, Parcel Number: 135.66-1-10 Mailing Address: John Habib Farideh Habib CAMA Number: 135.66-1-10 Property Address: 4 Terrace Ct 4 Terrace Ct, Parcel Number: 135.66-1-11 Mailing Address: John Habib Farideh Habib CAMA Number: 135.66-1-11 Property Address: 4 Terrace Ct 4 Terrace Ct, Parcel Number: 135.66-1-12 Mailing Address: Anthony Schorr Irene S. Miller CAMA Number: 135.66-1-12 Property Address: 6 Terrace Ct 6 Terrace Ct, Parcel Number: 135.66-1-19 Mailing Address: Kulwant Sethi Irrevocable Trust Manjeet S. CAMA Number: 135.66-1-19 Sethi Property Address: 7 Terrace Ct 7 Terrace Ct, Parcel Number: 135.66-1-20 Mailing Address: William Piciulli CAMA Number: 135.66-1-20 Property Address: 5 Terrace Ct 5 Terrace Ct, Parcel Number: 135.66-1-21 Mailing Address: Christopher Ware Anita Ware CAMA Number: 135.66-1-21 Property Address: 3 Terrace Ct 3 Terrace Ct, Parcel Number: 135.66-1-22 Mailing Address: Christopher Ware Anita Ware CAMA Number: 135.66-1-22 Property Address: 3 Terrace Ct 3 Terrace Ct, Parcel Number: 135.66-1-23 Mailing Address: Tania Vernon CAMA Number: 135.66-1-23 Property Address: 4 Lee Ln 40 Avon Cir Unit D, www.cai-tech.com Data shown on this report is provided for planning and informational purposes only.The municipality and CAI Technologies 1/29/2022 are not responsible for any use for other purposes or misuse or misrepresentation of this report. Page 2 of 3 Abutters List Report- Rye Town, NY of"r� 250 foot Abutters List Report Rye Town, NY >e Y January 29,2022 f°yfsrea �'� Parcel Number: 135.66-1-24 Mailing Address: Tania Vernon CAMA Number: 135.66-1-24 Property Address: 4 Lee Ln 40 Avon Cir Unit D, Parcel Number: 135.66-1-25 Mailing Address: Kathleen Riley CAMA Number: 135.66-1-25 Property Address: 6 Lee Ln 6 Lee Ln, Parcel Number: 135.66-1-26 Mailing Address: David O'Brien CAMA Number: 135.66-1-26 Property Address: 8 Lee Ln 8 Lee Ln, Parcel Number: 135.66-1-27 Mailing Address: Timothy N. Purk Betsy K. Purk CAMA Number: 135.66-1-27 Property Address: 10 Lee Ln 10 Lee Ln, Parcel Number: 135.66-1-28 Mailing Address: Gillian M. Tracy CAMA Number: 135.66-1-28 Property Address: 9 Lee Ln 9 Lee Ln, Parcel Number: 135.66-1-29 Mailing Address: Michael Zelvin Maritza Zelvin CAMA Number: 135.66-1-29 Property Address: 7 Lee Ln 7 Lee Ln, Parcel Number: 135.66-1-30 Mailing Address: Sean P. O'Connor Mary T. Anderson CAMA Number: 135.66-1-30 Property Address: 5 Lee Ln 5 Lee Ln, Parcel Number: 135.66-1-31 Mailing Address: Christopher Dutra Lisa Dutra CAMA Number: 135.66-1-31 Property Address: 3 Lee Ln 3 Lee Ln, Parcel Number: 135.66-1-32 Mailing Address: Christopher Dutra Lisa Dutra CAMA Number: 135.66-1-32 Property Address: 3 Lee Ln 3 Lee Ln, www.cai-tech.com Data shown on this report is provided for planning and informational purposes only.The municipality and CAI Technologies 1/29/2022 are not responsible for any use for other purposes or misuse or misrepresentation of this report. Page 3 of 3 Abutters List Report- Rye Town, NY O_ N L c O VJ L c O C C C O O C O C c J J C J c > > J > J c > J U L U U L J L J U U U Q Q L Q L J L L= U U c cu J J cu (� c J J J cu (0 —j cu OU OU c J U c J c 0 O O L cu O C L O O a) L L a) C a) O O O C L L a) L c a) a) c a) a) c > 0 > 0 a) (7 ` L c a) a) a) a) a) a) a) a) 7 a) a) a) a) a) a) a) J J a) J a) a) Q Q +- J c a) 0 F— F— J F— J M m N J o c p c p N t F— O (o (o M co M M w w m v v v (o I- co m � N co M y v N U uo N N () Q L a) C 3 O m L Q L C 3 O L cz E cu c _ _ C cz c Q) U E ca �_ �_ a) > �c Z CZ _ m L .0 O O > 'p C L J = a) () c cu cu cu (A c a) p cu cu = m a) _ _ a) a) s N c Q a) cu M Q o � p � � cu a) � m � � � � � Q cu F- •N T i 0) C cu cu !" .— E (> 0) L 'L 'L c c C N L -0 �'i w O c a) N N c c cu C > cB cu cu c4 c c CB cu t a) U Q J J Q Q U Q > LL LL Q Q W Co U m O LL r cu U L cu c O cu N L Cu Cu E E C U cu cu E T L E LO C L 0 0 - E .-. " U m L O O — 0 a) E (B >+ c .c Y >. c 3 O J L 0) L L L L >_ .O W 'p L O O '> > O c 0 O O d 0 0 E U cu a� o a� a) o c F- m L N a) � m L o c� 6 c c >, L) Z > > anQQm000 � � c a) � LcLU mUN � Qcu � c > � a O O O o 0 o c o m = = aoi c 0 m a) an d a) > > L o E C L C N to to (n ca — C C c t 3 .O O L L N c Q (a m p C c4 c c "C L L L L M M a) — a3 O O O O CU � U U CB O a) 2 cu cu E O OQQO� UUUUUC) C) UU = —) -3 —) YY � 2 � 2i � ofCnlnF— F— F— F— 1/31/2022 Dear Neighbors, We are writing to inform you that we are currently seeking a steep slope permit as part of a retaining wall project on our property at 2 Lee Lane (corner of Jennifer Lane and Lee Lane). We will be replacing the current dilapidated wall with a stronger and safer wall in the rear of our property. As part of the process, we are required to inform you of this project and the fact that there will be a public hearing on this application on February 10th, 2022 at 7:30 PM at Rye Brook Village Hall (938 King Street). Additional information is available at the Rye Brook Building Department. Sincerely, Josh & Kristen Kirsch 2 Lee Lane, Rye Brook, NY 10573 C( Mp AREA 92 099AC e �)55 Y y N� 6 - 8 8 . 3 2 13 5 UNI 1 ANl4iER UNE • q a 20 1s 3. �I A 1B ill 1 21 - - .. _. 10 a 22 42 32 __--- - 9 �... I • ..� , 21 - � s - .3 31 24 •� 3. E. 30 O20S 25 _ 44 20 � L $v S 26 ! I r;.>'m-f• `�\\ is ts • u \ ,.. — 4 .E r. Is \�/may .3 �r-r' 21 2 .e 1 r • ` .n 83 y 8 °- °�5'4 W - - - Cu E+ 54 8 5 554805 - 548 - i_1 554805 1 55M05 554805 554805 Crawford Rd 554 56480 105 peer Run - 554805 554805 554M _. ---- 554805 —- i $4 54805�� 564805 60�54809 i 5548M 5480 _ 564805 � 5480 P�8 �� _ 554805 1 5 554805 �4805 ,. 80 8 �� 55480§ 564806 05 554805 554 5 554805 11 54805P54800 L 1804 5546 5 � U _ 5460 55411 554805 55480 a 80 55480 5480 554805� 5480 5480i _ 55480 805 ' '--� m 554 55480 554805 Bell P 1 _ 4 _ cs 554805 554805 554805 805 \ ° �48p5 554805 5548054806 554805 � S4805�5460 05 - 1 — 554805 1__— r 554805 5548W 554805 . 554805 555805 . 554805 554805 554805 554805554805 554805 11 -� 554806 r / 4;\ %4805� 55480y Ydes, 555 Theodore Fremd Ave.,Suite C-301 Rye,NY 10580 &Hanover T:914.967.6540 www.hardestyhanover.com MEMORANDUM D [E C E � v FEB - 4 2022 To: Robert I. Goodman, Chairman, and the Planning Board of the Village of Rye Brook VILLAGE OF RYE BROOK BUILDING DEPARTMENT Date: February 4, 2022 Subject: Kirsch Residence—2 Lee Lane—Application for Approval of a Site Plan and Steep Slopes Permit As requested, we have reviewed applications, correspondence and plans submitted by Rob Dallesandro, RA, on behalf of the property owners, Joshua Kirsch & Kristen Kirsch,for approval of a Site Plan and Steep Slopes Permit for the replacement of a deteriorating retaining wall with a new, reinforced retaining wall and the installation of a new fence on the property located at 2 Lee Land, SBL 135.58-1-22 on the Town of Rye Tax Map, in an R-10 Zoning District. Review We have reviewed application materials and plans that include the following items: 1. Short Environmental Assessment Form and EAF Mapper Summary Report dated 12/16/21; 2. Application for Site Plan Approval; 3. Site Plan Submittal Review Checklist; 4. Building Permit Check List &Zoning Analysis; 5. Exterior Building Permit Application; 6. Steep Slope Work Permit Application; 7. A topographic survey prepared by Richard A. Spinelli, Licensed Land Surveyor, dated 8/23/21; 8. The following plans generally entitled, "2 Lee Lane" prepared by RPD Architecture & Design: a. Sheet Al00, "New Retaining Wall Plan, Elevations and Details," last revised 1/25/22 b. Sheet A101, "Site Details and Notes," last revised 12/8/21. Please note that our review is limited to planning and environmental issues. We offer the following comments regarding the application: 1. SEQRA. The Proposed Action is a Type II action with regard to SEQR because it involves the construction of minor accessory/appurtenant residential structures. OP Hardesty im &Hanover engineering that moves you 2. Steep Slopes Permit. The construction of the replacement retaining wall requires 665 square feet of disturbance to the existing very (25%-35%) steep slopes on the property. Approval of a steep slopes work permit will require compliance of all grading and filling with the requirements of Chapter 213 of the Village Code. All of our previous comments have been addressed. We look forward to discussion with the Board. Sarah L. Brown, AICP Principal Planner cc: Honorable Mayor and the Village Board of Trustees Christopher Bradbury, Village Administrator Michal Nowak, Superintendent of Public Works/Village Engineer Drew Victoria Gamils, Esq., Village Attorney Rob Dallesandro, RA, for the Applicant Hardesty 555 Theodore Fremd Ave.,Suite C-301 Rye,NY 10580 &Hanover T:914.967.6540 www.hardestyhanover.com MEMORANDUM D [E C [E P V IE To: Robert I. Goodman, Chairman, and the JAN - 7 2022 Planning Board of the Village of Rye Brook VILLAGE OF RYE BROOK Date: January 7, 2022 BUILDING DEPARTMENT Subject: Kirsch Residence—2 Lee Lane —Application for Approval of a Site Plan and Steep Slopes Permit As requested, we have reviewed applications, correspondence and plans submitted by Rob Dallesandro, RA, on behalf of the property owners, Joshua Kirsch & Kristen Kirsch,for approval of a Site Plan and Steep Slopes Permit for the replacement of a deteriorating retaining wall with a new, reinforced retaining wall and the installation of a new fence on the property located at 2 Lee Land, SBL 135.58-1-22 on the Town of Rye Tax Map, in an R-10 Zoning District. Review We have reviewed application materials and plans that include the following items: 1. Short Environmental Assessment Form and EAF Mapper Summary Report dated 12/16/21; 2. Application for Site Plan Approval; 3. Site Plan Submittal Review Checklist; 4. Building Permit Check List &Zoning Analysis; 5. Exterior Building Permit Application; 6. Steep Slope Work Permit Application; 7. A topographic survey prepared by Richard A. Spinelli, Licensed Land Surveyor, dated 8/23/21; 8. The following plans generally entitled, "2 Lee Lane" prepared by RPD Architecture & Design, last revised 12/8/21: a. Sheet Al00, "New Retaining Wall Plan, Elevations and Details," b. Sheet Al01, "Site Details and Notes." Please note that our review is limited to planning and environmental issues. We offer the following comments regarding the application: 1. SEQRA. The Proposed Action is a Type II action with regard to SEQR because it involves the construction of minor accessory/appurtenant residential structures. 9ardesty &Hanover engineering that moves you 2. Steep Slopes Permit. The construction of the replacement retaining wall requires 665 square feet of disturbance to the existing very (25%-35%) steep slopes on the property. Approval of a steep slopes work permit will require compliance of all grading and filling with the requirements of Chapter 213 of the Village Code. 3. Landscaping. The plan should be revised to note that the areas of regrading around the retaining wall will be restored and seeded with grass. 4. Easement. An easement from the adjoining property to the north is required for the installation of the retaining wall. The Applicant has noted that an easement agreement letter will be submitted when it is available. We look forward to discussion with the Board. Sarah L. Brown, AICP Senior Planner cc: Honorable Mayor and the Village Board of Trustees Christopher Bradbury, Village Administrator Michal Nowak, Superintendent of Public Works/Village Engineer Drew Victoria Gamils, Esq., Village Attorney Rob Dallesandro, RA, for the Applicant Building Permit Check List&Zoning Analysis Address: Z__ L Fri L r->F SBL: l S' i l — Z Z Zone: — 1,0 Use: Z O Const.Type Other. Submittal Date: Z-.1 Z t Revisions Submittal Dates: 5 3 Z\ , z3O Z-z I r to 1 ti 2 Applicant: J::]C�c ,S GA-� Nature of Work: �PFD_i �1 L�A't r't ry,� ln,0 L Reviews zBA: JUL - 1 2021 PB: BOT: Other. OK ( ( ) FEES:Filing•.�7 BP: 3 72�^ � c/O: Legalization: APP: Date& --' 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: Sim Protection S/W grnL: Tree Plan: Other. ( ( SURVEY:Date& Z� Current: LArchival• Sealed.-7— eale& Unacceptable: PLANS:Date Stamped. --"Sealed: -" Copies:Z Electronic Other. (� erase: ✓ Workers Comp: ✓Liabili �Comp.Waiver. Other. (• ( ODE 753#: 0,z �s� —C:)00—.F9 9—00 Datech 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: Permir- Fuel Type: Other. O O 2020 NY State ECCC: N/A Other. (..Y ( ) Final Survey: Final Topo: RA/PE Sign-off Letter As-Built Plans: Other. ��. C/O DENIAL LETTER: Other. ( ) ( ) Other. ( mtg.date Z 2 approval 6 V— otes: ro ( PB mtg.date: approval otes:If4m'L/.',0, - --- REQUIRED EXISTING PROPOSED NOTFS LU ck& Front; F= Main Cow. Accs,Cov F S : S1 H/Sb jE&- Tot.!W: Et.Imp hviixw Hight/Stories notes: z i Z-A T 1 2 tAll W PC+'J/_3 C141S Z — E S - IO BUILDING DEPARTMENT IEC EHWIE R JUN 2 3 2021 u VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK,NY 10573 VILLAGE OF RYE BROOK (914)939-0668 FAX(914)939-5801 BUILDING DEPARTMENT NN N%.r�ebrook.or( ARCHITECTURAL Ri 1.1EW BOARD CHECK LIST r-jR AN- ICANTS 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 Lee Lane Date of Submission: /p D a I Parcel ID#: 135.58-1-22 Zone: R-10 Proposed Improvement(Describe in detail): APPLICANT CHECK LIST: NIl'ST BE COIIPLETEI) Bl' THE ,AI PLIC'.AN"I New Fence and Retaining wall The following items must be submitted to the Building Department by the applicant-no exceptions. 1. (x)Completed Application Josh Kirsch 2. (x)Two(2)sets of sealed plans. (one till size I maximum Property Owner: alhm able plan w¢-36 x 42 ; and one 1 I x17 Address: 2 Lee Lane 3. (x)Two(2)copies of the property survey. 4. ( )Two(2)copies of the proposed site plan. Phone# 914-722-2631 5. (x)One electronic/disc copy of the complete Applicant appearing before the Board: application materials. 6. (x)Filing Fee. Josh Kirsch 7. ( )Any supporting documentation. 2 Lee Lane 8. ( )HOA approval letter.(rfapplicable) Address: 9. ( x)Photographs. Phone# 10.( )Samples of finishes/color chart.(a sample board or Architect/Engineer: Rob Dallesandro model may be presented the night of the meeting/ Phone# 917-923-2057 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 betore me this Swom to before me this day of 20 2( day of , 20_ t lure of Pr6perty Owner Sipature of Applicant am of Owner Print Name of Applicant Z4 otary Publi Notary Public in BLORINA GASHI NOTARY PUBLIC,STATE OF NEW YORK NO.01GA6405087 QUALIFIED IN BRONX COUNTY 3,12 1 n 9 COMMISSION EXPIRES MARCH 2,2024 FENCE/WALL/GATE PERMIT APPLICATION & INSTRUCTIONS BUILDING DEPARTMENT VILLAGE OF RYE BROOK,NY PHONE(914)939-0668 FAx(914)939-5801 \k w".ry ebrook.ora All applicants seeking a fence,wall or gate permit must first obtain approval from the Village Architectural Review Board. Some applications may be subject to Site Plan Approval from the Village Planning Board as per§209 of Village Code.A representative of the applicant must be present at the ARB meeting which is held on the third Wednesday of every month,7:30 p.m.at Village Hall in the main meeting room.Virtual meetings may be held from time to time and information regarding such will be provided to all applicants as needed.Applications must be submitted to the Building Department by no later than the 1 It Wednesday of the month in order to be eligible for that month's agenda.Please note that the agendas are limited to ten(10) applications per month. Once your application receives ARB approval, the plans must then be reviewed by the Building Inspector for compliance with all applicable state and local building codes and for issuance of the permit. DO NOT START CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDING INSPECTOR APPLICANT'S INITIAL SUBMISSION TO THE BUILDING DEPARTMENT MUST INCLUDE: 1. A properly completed application with notarized signatures where indicated. 2. Application filing fee: Residential=$76.00/ Commercial=$250.00 (Application fees are non-refundable) 3. A completed&signed Application Check List 4. A current,accurate property survey. 5. Two(2)sets of adimensioned site plan based on the survey,wme Il,ll size ,maximum nxl 1.depicting the proposed fence/wall/gate(s)indicating the proposed heights, locations and their proposed setbacks to the adjacent property lines. 6. Color photos or brochures of the proposed fence/wall/gate(s). 7. An electronic copy(disc,thumb drive,etc...)of all materials submitted. FOLLOWING APPROVAL BY THE ARB,THE APPLICANT MUST SUBMIT THE FOLLOWING 1. Full payment of the Permit Fee which is based on the cost of construction at the following rates; Residential: $15.00/$1,000.00 of Construction Cost with a minimum fee of$100.00. Commercial: $26.00/$1,000.00 of Construction Cost with a minimum fee of$275.00. 2. One full size and one scaled I I"x 17"set of sealed construction plans if applicable. 3. Your contractor's valid Westchester County Home Improvement License. 4. Your contractor's valid proof of liability insurance. (Village of Rye Brook must be listed as certificate holder on the insurance form) 5. Your contractor's valid proof of workers compensation insurance. (Form#C 105.2 or Form#U26.3/or NY State Workers Compensation Waiver) 6. The Dig Safe N.Y.Dig Number.(1)1 A 1.s 11) PRIOR TO SCHEDULING THE FINAL INSPECTION THE APPLICANT MUST SUBMIT; 1. The application&fee for the Certificate of Compliance. (fees are based on the final cost of construction) 2. A final survey of the property. N O T E: The finished or good side of your fence must face your neighbor's property.All fence/wall/gate permits must be closed out with a Certificate of Compliance issued by the Building Inspector. Keep this instruction sheet throughout the project for reference. 8/18/20 VILLAGE OF RYE BROOK BUILDING DEPARTMENT 938 KING STREET, RYE BROOK,NY 10573 (T) 939-0668 (F) 939-5801 ARCHITECTURAL REVIEW BOARD Wednesday, February 16, 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:/IusO2web.zoom.us/"/81417970741 OR BY OPENING ZOOM AND ENTERING THE MEETING ID: 81417970741 NAME& LOCATION TYPE OF APPLICATION MOTION SECOND APPROVED REJECTED APPL.# 15B Rye Ridge New Fabric Awning Sign 5674 Plaza(Win Ridge) "Prosper 1.V." 6 Whippoorwill 1&1/2 Story Addition, 5675 Road (Adelson) New Wood Deck& Flag Stone Patio 9 Country Ridge Dr New Rear Deck, Siding, 5676 (Martino) Windows, Roofing & Interior Alterations 5 Boxwood Place Replace Rear Deck And 5677 (Biderman) Patio Area With New Deck 2 Lee Lane (Kirsch) New Rear Retaining Wall, 5678 New Side Fencing and m�— Property Re-grading 980 Anderson Hill New Front Entry Gate 5679 Road (Blind Brook Club Inc) 47 Hawthorne Ave New 1 Family Dwelling 5673 (Miller) ML ✓ NM MR SE JM SF AC MI KC b, �o� .._.. �. ROB DALLESANDRO R.A. .. INS, NY 10606 71, raleesandro@amail.com Dim ARCHITECTURE rf3 �DESIGN10-14-21 1 VILL Rye Brook Building Dept AGE ROOK 938 King St — ART-MENT Rye Brook NY 10573 Attn: Mr. Mike Izzo RE: 2 Lee Lane Map Number: 135.58-1-22 Dear Mr. Izzo: Enclosed are revised drawings per your comments:. 1. Fence in Front Yard setbacks has been lowered to 4'-0" as requested. Please feel free to contact me with any additional questions or to discuss these items further if required. Regards, Rob Dallesandro, R.A. Cc: i r -u.svro.=.ysen��+r.._.�,.....>xw�r� i.;�3N�W �tTSfi,+yiLiaT�a'� hik a ROB DALLESANDRO R.A. Dimrdallesandro@gmail.com ARCHITECTURE 8. DESIGN RIECIE C11-29-21 DEC - 3 20213D Rye Brook Building Dept 938 King St VILLAGE OF RYE BROOK Rye Brook NY 10573 BUILDING DEPARTMENT Attn: Mr. Michal Nowak RE: 2 Lee Lane Map Number: 135.58-1-22 Dear Mr. Nowak: Enclosed are revised drawings per your comments:. 1 . Construction staging and soil and erosion control notes and details have been added. 2. No Trees will be disturbed during construction. A Google earth view of the property shows there are no trees near the retaining wall. 3. A retaining wall elevation has been added showing the top and bottom wall elevations. 4. Additional fence dimensions from the property line have been added. 5. There is no new landscaping proposed. 6. Contours have been further defined around the wall. 7. Short EAF with mapper has been included. 8. An easement letter is being drafted and signed between the Homeowners. It will be submitted as soon as its available. Please feel free to contact me with any additional questions or to discuss these items further if required. Regards, 4l - Rob Dallesandro, R.A. Cc Tara Gerardi From: Tara Gerardi Sent: Thursday, December 9, 2021 8:28 AM To: rdallesandro@gmail.com Cc: kkid312@aol.com Subject: 2 Lee Lane Good morning Mr. Dallesandro, After a review of the revised plans submitted on December 3rd by Michal Nowak,a few items must be submitted. 1. The revised plans submitted do not have a revision date on them. Please submit 4 sets of plans,with revision date, original, signed and sealed. 2. The cover letter indicates the short EAF with mapper was included. This was not included. Please submit the short EAF with mapper. 3. A revised electronic submission was not included. Please submit a revised electronic submission including the revised plans with the revision date. Please feel free to contact me if you have any questions. Thank you, Tara Tara A. Gerardi Secretary - Planning Board, Zoning Board of.Appeals & .Architectural Review Board Village of Rye Brook 938 acing Street Rye Brook, New York 10573 Office (914) 939-0668 i Michal Nowak From: Michal Nowak Sent: Thursday, October 28, 2021 12:50 PM To: kkid312@aol.com; rdallesandro@gmail.com Cc: Tara Gerardi Subject: 2 Lee Lane Review Comments Mr. Dallesandro, The Public works and Engineering Dept have reviewed plans to construct a new retaining wall at 2 Lee Lane.This application needs approval through the Planning Board for Steep Slopes Work permitting. Prior to being scheduled for a planning board meeting the following comments need to be addressed: 1. A Plan labeled "Site Plan" needs to be submitted with the following information: a. Construction staging b. Soil Sediment and Erosion Control c. Tree Protection d. Show existing trees that may be impacted by work. e. Provide Top of wall and bottom of wall spot elevations along wall. f. Show exact location of proposed Fence g. Provide landscaping plan h. Better define grading and provide contours 2. Provide a letter from adjacent neighbor allowing "Construction Easement"to home owner/contractor.Village will not approve a project that needs access through someone else's property without consent from them. 3. Provide Short Environmental Assessment Form complete with Mapper. 4. Familiarize yourselves with Code Section 250-40 for Notifications 5. Once the above items are submitted and reviewed,the application may be scheduled for an Agenda Any questions please feel free to call me Atkf d 1..Nosuak Superintendent of Public Works And Engineering ISA Arborist Village of Rye Brook 938 King Street Rye Brook,NY 10573 P: 914-939-0753 x 2965 F: 914-939-5801 Mike Izzo From: Michal Nowak Sent: Thursday, August 26, 2021 2:39 PM To: Mike Izzo; kkid312@aol.com Subject: RE: 2 Lee Lane - Retaining Wall A site Plan review will be required for the steep slope and regrading of the property Please see attached application for such https://ryebrook.org/documents/site-plan-application/ Atk"J.Nowak Superintendent of Public Works And Engineering ISA Arborist Village of Rye Brook 938 King Street Rye Brook,NY 10573 P: 914-939-0753 x 2965 F:914-939-5801 W*N&-9fie meat of tlU6 vim" From: Mike Izzo<Mlzzo@ryebrook.org> Sent:Thursday,August 26, 2021 2:30 PM To: kkid312@aol.com Cc: Michal Nowak<MNowak@ryebrook.org> Subject: RE: 2 Lee Lane- Retaining Wall Dear Mr. Kirsch, Thank you for the survey. It's difficult to say since there's no proposed wall shown on the survey, but it appears that the installation of a retaining wall and re-grading of the property at the rear elevation will require site plan review by the Planning Board as well as approval from the ARB. I have forwarded this email to the Planning Board Liaison, Mike Nowak for review and further comment. Thank you. 1411c�ae167, /zzo Building & Fire Inspector Village of Rye Brook, NY (914) 939-0668 From: kkid312@aol.com <kkid3126@aol.com> Sent:Thursday,August 26, 20212:13 PM To: Mike Izzo<Mlzzo@ryebrook.org> Subject: 2 Lee Lane- Retaining Wall 1 • Mike, Good afternoon! I hope you've been well. Since we last spoke about the proposed retaining wall project at my home (2 Lee Lane), I got a survey with topographic map of the rear completed on our property. I have attached the new survey in this email. Is this all the information you needed to determine if we can proceed to the ARB? Please let me know if this will suffice or if there is something else that you still need. Thanks and I look forward to hearing back from you. Enjoy the rest of your day. Josh Kirsch z Laura Petersen From: Laura Petersen Sent: Thursday, February 24, 2022 8:54 AM To: Josh Kirsch Subject: Building Permit Application - 2 Lee Lane 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, V 1. General contractor's contact name & phone number. �A. 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) }� Building permit fee $375.00 (due once permit is issued and ready for pick-up) 6. Contractor must call Dig Safe NY and get a ticket number. 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 Ipetersenarvebrook.org 1 Laura Petersen From: kkid312@aol.com Sent: Wednesday, March 2, 2022 2:35 PM To: Laura Petersen Subject: Fwd: Information Needed - 2 Lee Lane Attachments: Village of Rye Brook- Liability 21-22.pdf,Village of Rye Brook -Workers Comp. 21-22.pdf,Westchester License 2021-23.pdf Laura, Attached is the information for the company installing the fencing on my property. Please let me know if they have included everything. The company responsible for doing the retaining wall (Liberty Mason) said they would reach out to you to provide information soon. Thanks! Josh ----Original Message----- From: Isaac Gonzalez <isaacfenceand masonry @live.com> To: kkid312@aol.com <kkid312@aol.com> Sent: Wed, Mar 2, 2022 12:55 pm Subject: Re: Information Needed -2 Lee Lane Good afternoon, I'm sending over the information requested. Please let me know if we are missing anything Dig Safe NY Ticket#02252-000-399 Contractor: Isaac Gonzalez Cel: 914-804-1211 Thanks, Isaac From: kkid312@aol.com <kkid312@aol.com> Sent:Thursday, February 24, 2022 11:29 AM To: Isaacfenceandmasonry@Iive.com <Isaacfenceandmasonry@live.com> Subject: Information Needed -2 Lee Lane Isaac, I am excited to work with you on this project. Below is the information I need for the Village of Rye Brook. Let me know if you have any questions. Thanks! V . General contractor's contact name & phone number. 2. Copy of general contractor's valid Westchester County Home Improvement License. /s 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) Z. Contractor must call Dig Safe NY and get a ticket number. Josh Kirsch i ACO O® CERTIFICATE OF LIABILITY INSURANCE DAMffi°""°°"""' 03MZ12022 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(iies)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 endorsemmL A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER CONTACT NAME: Hiscox Inc PHONE (888)202-3007 I FAX A,No 5 Concourse Parkway EA-MAIL Suite 2159 COn1aCtQhISCOx-Com — Atlanta GA,30328 INSUR S AFFORDING COVERAGE NAIC s INSURER A_ Hiscox Insurance Company Inc 10200 INSURED LIBERTY MASON WORK INSURER B: 312 N 7TH AVE INSURER C: -- MOUNT VERNON,NY 105W INSURER D: INSURER E- INSURER F: COVERAGES CERTIFICATE NUMBER. REVISION NUMBER: THIS 1S 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. R TYPE OF INSURANCE ADDLSUBR LT POLICY EFF POLICY EXP POLICY NUMBER LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLAIMS-MADE a OCCUR DAMAGETORENTM PREMISES oewrrence $ 100,DW MED ExP(ta one ) $5,000 A N UDC-4784504-CGL 21 03/28f2021 03l28/2022 PERSONAL 8 ADV INJURY S 1.000.000 GENL AGGREGATE LIMIT APPLIES PER- GENERAL AGGREGATE S 2,W0000 X POLICY❑JECTPRO- LOC -PRODUCTS-COMPiOPAGG $ 2,000,000 OTHER: S AUTOMOBILELIABILITY COMBINED SINGLE LIMIT $ cdden ANY AUTO BODILY INJURY(Per peraw) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Par acadent) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOSONLY $ S UMBRELLA LIABHCLAIMS-MADE OCCUR EACH OCCURRENCE S EJCCESSLaB AGGREGATE $ DIED RETENTIONS $ WORKEiRSCOMPE/t4ATION 611TERTUTF OTH- AND EMPLOYERS LIABILITY Y I N A ER ANYPROPRIETOR/PARTNER/EXECLMVE EL EACH ACCIDENT S OFFICER/MEMBERD(CLUDED? NIA (Mandatory is NH} It M describe under E L DISEASE-EA EMPLOY $ DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS!LOCATIONS!VMHCL:S.(ACORD 101,Addltlonal Remarks Schedule,maybe attachedif more space is required). Job location:2 Lee Lane,Rye Brook,NY CERTIFICATE HOLDER CANCELLATION Buildup Department Village of Rye Brook 938 King Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Rye Brook NY 10573 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITFf THEP6LICYPROVISMINS. AUTHORED REPRES84TATNE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 26(M'W103} The ACORD name and tc go are registered marks of ACORD NEW 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 parry.** 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): Building Permit ADEILDO DOS REIS From:Village of Rye Brook DBA:LIBERTY MASON WORK 17 W Lincoln Ave Mount Vernon,NY 10550-1125 The location of where work will be performed is PHONE:914-299-9819 FEIN:XXXXX2895 2 Lee Lane,Rye Brook,NY 10573. Estimated dates necessary to complete work associated with the building permit are from March 4,2022 to March 18.2022. The estimated dollar amount of project is $10,001 -$25,000 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 owned by one individual and is not a corporation. Other than the owner,there are no employees,day labor, leased employees,borrowed employees,part-time employees,unpaid volunteers(including family members)or subcontractors. Disabilitv and Paid Family Leave Benefits Exemption Statement: The applicant is NOT applying for a disability and paid family leave benefits exemption and will show a separate certificate of NYS statutory disability and paid family leave benefits insurance coverage. I,ADEILDO DOS REIS,am the Sole Proprietor 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. I SIGN HERE Signature: Date: � 4 /��a� Exemption Certificate ber Received 2022-012571 March 4, 2022 NYS Workers' Compensation Board CE-2W 0l/201a t � C dk ldp F CL N r C V J (QO),fr _ •O O J OTtaai)fa� LLJ LLJ LU CO LU (inns p i _ c '�" LLJ ' JI 4• Q. Q w >> la , 7 a J U Z Leda _ .. LLJ U) pco _ 1. ®rb •+ •ww + 'Y].'XYXVV SYYXXYYYIYXYti, �i>--Y1c ti1[Y,f ��i.iFf 4i�i'• ��llwta� �40 ..�i. ;r(rw��1, i+u 'i!(w��� �• n7w\n' � .I `J 3 c Y ,4Cvxv' CERTIFICATE OF LIABILITY INSURANCE DATL(MN'OD,YYYY) __ o�iaziz�z2 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 INSURERIS), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(les) must have ADOITIONAL INSURED provislons or be endorsed, If SUBROGATION IS WAIVED, subject to the terms and eondlttons of the policy, csrtaln policies may require an endorsement- A statement on this certificate does not confer rights to the certlficate holder in lieu of such endorsements. PROOLCER CONTAC- SUGAR ALMANZAR NAME: StafeFdrw E[7GARALMANZAR vkave ;s1a)356-8112 FAx - ;c1413 $9716 INC.N 'r:o.Ex, - 477 CENTRAL AVE E-VAILADDRI E UGAR t3ENTEDGAR.COM ADDRE SS: ` " -- — — - IFaIIR P r AFFORDING l:y Company _ NA1G P _1 WHITE PLAINS NY 1 Q6Cfi LvsukER A: S'a!u FBRr1 Ere arc CasLal:y Carlpany 75143 INSURED LSSURER W: _ _ ❑� _ _ _ _ ISAAC FENCE AND MASONRY COPP INSURER C. _ _ _Q 13' EMERSON AVE rlsuRER D. 0 I.-NSURER SURER E NEW ROCHELLE NY 10801 F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: TH S IS TO CERTIFY THAI THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLkCY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERN OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHaCH THIS C=RTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CON0,TIONS OF SUCH POLICIES,LIMITS SHOWN MAY I4AVE BEEN REDUCED BY PA;D CLAIMS. INSR� AODl1SU0R•— ! pOLICr SFF j POLICr t7tP L7R TYPE OF INSURANCE POLICY NUMBER LIMITS jX GOMMEACIALGENERAILWILR'! I EACH OCCURRENCE 3 2000000 �41� CONTRAC70RS - CLANS-MAZE X OCCUR I �P�M SLAtE R��rern 300000 (Ca accu raruJ i ARTISAN&SERVICE I ME['EXP imy aM oeaenl S 5000 A Y I Ige-CX-0553-7 C1i24t20221 01124/23 P*NscNAL&ADYWJRv S 2000000 GENL AGGREGATE LIMIT APPLAPPLIES PER C>ENbK4LA GMGATZ _ i 4000000 POLICY-JECT 17 LOC PRODUCTS-CO)VMPAOG S 4000000 OTTER S AUTOMOBILE LLAaILMY v 319-1495-F35-52 OW0512021 0610512022_{[iMaacdeCy51NGLE`JI.!1- s AN"Al. BODILY INJURY IPor pwso i _ 1000.000 A X DV.'NED Y 'SCI LD'U.ED BODILYINJ4RY(Pers S 1,000.000 AUTOS JvL _AUTOS ncife y I.RE: AO`.-C'AhED PROPERrrDAMAGE- i 1,000,000 ALT6S ALTOS�,-V tPE�acsidnitj- I i UMBRELLA LIAR 0CCU9 EACH O=URKENCE S EXCESS L1AB CLAN&MADE AC1,CiREOAIE 'i C6D RFrj;NTK)AS i WORXERS S COMPENSATION PERTATLTfi AND EMPLOYERS LLABILITY - — — ANY PRnPR FTr..R.rHR-'iER^EX2CUTVE Yin I !L.EACH A.CCIDEN- S OFFr¢FFLVEMBFR EXr.LLIED' ;NIA (Mwwatory In VH) V.L DISEASE-EA EMPLOYE S WI dese")e.J1.1v RIP.ION!o•OPT-HA W)Ns bNow E L.EII%FA`i -KA rY'1,Yr t S I _ _ I OESCRIP-IOR OF OPERATIONS;LOCATIONS,VEHICLES IACORD 191,Add Zonal Remnr"Scheeu C.may be adached Ir more space Is mqulred', Addidanal InsU,ud as a Ce'LI11:ale HU.du• CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. V Ilagu o'Ryu Br-ut AUTOO ED RLPRES tT as I(Il,y s, Rye 3mck NY 1•757.3 " W 1988-2D15 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD NYSIF New York State Insurance Fund PO Box 66699,Albany,NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ^^A^^^ 204618267 ISAAC FENCE AND MASONRY CORPORATION 131 EMERSON AVE NEW ROCHELLE NY 10801 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER ISAAC FENCE AND MASONRY CORPORATION VILLAGE OF RYE BROOKE 131 EMERSON AVE 938 KING ST. NEW ROCHELLE NY 10801 RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W 1458 251-4 500893 06/21/2021 TO 06/21/2022 2/25/2022 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1458 251-4, 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. 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. THE POLICY INCLUDES A WAIVER OF SUBROGATION ENDORSEMENT UNDER WHICH NYSIF AGREES TO WAIVE ITS RIGHT OF SUBROGATION TO BRING AN ACTION AGAINST THE CERTIFICATE HOLDER TO RECOVER AMOUNTS WE PAID IN WORKERS'COMPENSATION AND/OR MEDICAL BENEFITS TO OR ON BEHALF OF AN EMPLOYEE OF OUR INSURED IN THE EVENT THAT, PRIOR TO THE DATE OF THE ACCIDENT, THE CERTIFICATE HOLDER HAS ENTERED INTO A WRITTEN CONTRACT WITH OUR INSURED THAT REQUIRES THAT SUCH RIGHT OF SUBROGATION BE WAIVED. 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 STAT SU NCE FUND T �V DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 689539372 U-26.3 Laura Petersen From: Dig Safely New York Exactix <tickets@exactix.digsafelynewyork.com> Sent: Friday, February 25, 2022 12:36 PM To: Mike Izzo Subject: Message from Dig Safely New York, Inc. (DSNY) ****REGULAR**** DIG REQUEST from DSNY for: VIL RYE BROOK Taken: 02/25/2022 12:25 To: VIL RYE BROOK PRIMARY Transmitted: 02/25/2022 12:36 00002 Ticket: 02252-000-399-00 Type: Regular Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 2 To: Name: LEE LN Cross: From: To: Name Offset: ------------------------------------------------------------------------------ Locate: LEFT SIDE OF PROPERTY WHEN FACING THE FRONT OF THE PROPERTY FROM THE ROAD AND RIGHT SIDE NearSt: JENNIFER LN & TERRACE CT Means of Excavation: HAND TOOLS Blasting: N Site marked with white: N Boring/Directional Drilling: N Within 25ft of Edge of Road: Y Work Type: FENCE INSTALL Estimated Work Complete Date: 03/13/2022 Depth of excavation: 30 INCHES Site dimensions: Length 12 INCHES Width 12 INCHES Start Date and Time: 03/11/2022 07:00 Must Start By: 03/25/2022 ------------------------------------------------------------------------------ Contact Name: GLORIA GONZALEZ Company: ISAAC FENCE & MASONRY Addrl: 131 EMERSON AVE Addr2: City: NEW ROCHELLE State: NY Zip: 10801 Phone: 914-636-1404 Fax: Email: isaacfenceandmasonry@live.com Field Contact- ISAIAS GONZALEZ Alt Phone: 914-804-1211 Email: isaacenceandmasonry@live.com Working for: JOSH KIRSCH ------------------------------------------------------------------------------ Comments: FENCE INTALLATION - APPROX. 200 LFT Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: ALTICE USA CONED i C) >C 0 0-(D c 3:: LL. 0 600000 L (D m CIO-vczz-L9 s -VIO I Q) (D 0 < U) N --ANN- I rN c X C) cm 4-j CN 0 c4r) CN r"I CN Q) v-4 z 0 T-4 00 CN + Lr) Ln Q) Ln T--4 Ln 31 --k iz 0 Lr)+ 06 :3< Q) c DO i 0 0 c 0 CTS co 00 D Lu 0 C: z 6 u p 0 Ln+ VIP6 cj) 0 rr7 C3 Q (D C 0 10\ -J -0, 0 z >. o C: 0 C) Ln to + Lr) (D ON > 4,U) 10- c + W5 Q) > c LO a V-4 f4D L.N"S' - w (n = U li U) 0 ( af o Z �AD c \N 0 0 ej ydsd V) go-zz (11 MO. + qlD o� V5 Ft Ln Lr) W �' KA NP 0 .1e) ci LL- � ,mot ` \ oo� � Go J p p► � 0 49 CLI \o�` 0 �d klo Ld O 0O 0 :E >: 0 (D LO 0 -C 6-C,4 C: 0 LL V) .0 m U)00 0 CY) 00 00 J 0 (IN V) 00 c; 4-' 0 c6 PILO PI 0 < .0 1 Ln 0 LL > 00 0 0 c 00 Z A�- L) C (1) U) C: CY) 0 C: > 0 '+.- Z -0 0 0 coo-ogot < z LO C: elf 4 C3 C' 9 aw" 0 CL NO c Ld _0 0 Q) 3 cg� oge 0 -00 c c Qom' N -55: a It —J N LLJ mp _0 0 0 C -D C3 _C 0 > -�j f) -4-J 3NVI L 0 0 0 83JIN E V 0 7T) LLJ L-C) C) 0 C: c :3 > CY) :D 0-0 LLJ C: (0 => Z Z LU LLI ADDTIONA '1CT. & SDECIFICAIIONS: ;eGr PLAN 1FN 28 2022 ru work 6 res %�wqB QATE_ g P N,d c [ t b P -,I r u d t'f h' k F k -p "I"',w k [4 e iNOtl NT All work m�.t co n(em to L'e N Page of Rya Boo*Bu-dry Deport rent Subcort octc s. 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