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HomeMy WebLinkAboutBP22-078PERMIT # SECTION TYPE OF WORK JOB LOCATION OWNER 4: CONTRACTOR. EST. COST v/CO #-(2,( TCO # FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING 0 RGH PLUMBING GAS SPRINKLER ELECTRIC 0 LOW -VOLT F1 ALARM AS BUILT FINAL DID -0%Y /7So� FEE. _ FEE PA IXP; LOT �57 FEE DATE INSPECTION RECORD DATE INSP in,60l yo/ / on 8)9�3-1j733 2�ro,7 - �Sc1�c2C Eirnza/PZ/y) .��JOL �I aG�3 OTH OTHER APPROVALS BOT ' PB ZBA ER IDS-BUILTIFINAL SURVEY `REQUIRED PRIOR TO FINAL INSPECTION �yE V ja4C,th,�� O`C , 19 VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury www.ryebrook.org TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE June 20,2023 Joseph Johnson&Bree Johnson 40 Hillandale Road Rye Brook,New York 10573 Re: 40 Hillandale Road, Rye Brook,New York 10573 Parcel ID#: 130.77-1-5 Building Permit#22-078 issued on 5/25/2022 for a New Fence This certifies that the new five foot high white pvc privacy fence,in rear yard,installed under the above captioned permit has been satisfactorily completed. Sincerely, Steven E. Fews Building& Fire Inspector /to 66"a For office u e onl DDBUILDMENT PERMIT# -07O NOV 6 ZO22 VIL OF RYE UlkOOK ISSUED: J=mil S 938 KING STRE YE BROOK,*W YORK 10573 DATE: VILLAGE OF RYE BROOK ] 9 -0 FEE:,V f Ir) PAI11M BUILDING DEPARTMENT r APPLICATION FOR CERTIFICATE OF OCCUPANCY,CERTIFICATE OF COMPLIANCE, AND CERTIFICATION OF FINAL COSTS TO BE SUBMITTED ONLY UPON COMPLETION OF ALL WORK, AND PRIOR TO THE FINAL INSPECTION sssssssssssssssrssssssss•ssssrsssssssssssssssssssasssssssssssrrssssssssssssssssss■sssssassssss►psasssssssssssssssssssssssssr Address: 1+0 H a-kd Ol-t e Kim d I�.V It I l - LM 1 OS-73:1 Occupancy/Use: SI de ftCC�� Parcel ID#: /30,, 77 l Zone: Owner: Y t'a �•�b S P TI h ,l(> S�rot Address: i I rms-d(,LL 1,��d. P.E./R.A.or Contractor: 'Q -Address: Me rScj,, Person in responsible charge: IcSa-t as e Z Address: SC>w�s�_ Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issuance of a Certificate of Occupancy/Certificate of Compliance for the structure/construction/alteration herein mentioned in accordance with law: STATE OF NEW YORK,COUNTY OF WESTCHESTER as: 1'Q C J�K nsc)Yl being duly swom,deposes and says that he/she resides at 40 H l it OL Y\d 0-le WA. (Print Name of Applicant) (No.and Street) in V_�J PyC,p ,in the County of �'Q S�C _Q S CX in the State of ,that (CityiTown/Village) he/she has supervised the work at the location indicated above,and that the actual total cost of the work,including all site improvements, labor,materials,scaffolding,fixed equipment,professional fees,and including the monetary value of any materials and labor which may have been donated gratis was:$ Ir j cj n p for the construction or alteration of. Ix Q I e Deponent further states that he/she has examined the approved plans of the structure/work herein referred to for which a Certificate of Occupancy/Compliance is sought,and that to the best of his/her knowledge and belief,the structure/work has been erected/completed in accordance with the approved plans and any amendments thereto except in so far as variations therefore have been legally authorized,and as erected/completed complies with the laws governing building construction.Deponent further understands that it shall be unlawful for an owner to use or permit the use of any building or premises or part thereof hereafter created,erected,changed,converted or enlarged,wholly or partly,in its use or structure until a Certificate of Occupancy or Certificate of Compliance shall have been duly issued by the Building Inspector as per§250-10.A.of the Code of the Village of Rye Brook. Sworn to before me this t 10� Sworn to before me this ry y day of V-C4-1 20 t;t day of (W V_r- t t(1 , 20 a'a A 0 dJ.7) A 0 d�]n A_� Signature o Prope wner ignattrre of App tc t 1�)rrP 3-o nce �RVee TAkft_sc: y� Print Name Property Owner Print Name of pplicant Notary Public Notary Public LISA F.GRECO LISA F. GRECO NOTARY PUBLIC STATE OF NEW YORK NOTARY PUBLIC STATE OF NEW YORK 8 I,2021 WESTCHESTER COUNTY WESTCHESTER COUNTY LIC.#01GR6089461 LIC.#01GR6089461 COMM.EXP.03/24/2023 COMM. EXP.03/24/2023 �E BR(��• cu � • 1982 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 :— ` I Ci( 1 \"ATE: �� I PERMIT# J 0 ` ISSUED: �1 SECT:_ BLOCK: LOT: LOCATION: `�"' Cam" �' OCCUPANCY: ❑ Violation Noted THE WORK IS... PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION % REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas ❑ L.P. Gas ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION FINAL ❑ OTHER �E BR(��. Zm 1932• 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 - - - - - - - - - - - - - - - - - - - - INSPECTIO REPORT - - - - - - - - - - - - - - - -- -- - ADDRESS : v ` DATE: G� KJ PERMIT# ISSUED: SECT: I � LOCK:�LOT: LOCATION: 1 1-� � W I` t �� � ` � C�ANCY: L Io ❑ Violation Noted THE WORK IS... ❑ PASSED W//"FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas L1� �' lr ��1 C Ub�JP j Jc+ ❑ L.P. Gas S ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION,- < j FINAL �� V J ❑ OTHER ��- QyE BRC�k, cu � • 1982 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 - - -r-- - - - - - - - - - - - -- - - � 1\ c, ADDRESS : DATE: PERMIT# ISSUED: SECT: BLOCK: LOT: LOCATION: �A—j'-'3 A—qu-\ (0— OCCUPANCY: ❑ Violation Noted THE WORK IS... ❑ PASSED FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ( �p X3VD, Lv 6-'- ❑ Natural Gas ❑ L.P. Gas ❑ FUEL TANK �C ❑ FIRE SPRINKLER ❑ INAL PLUMBING ROSS CONNECTION FINAL ❑ OTHER �E BRO BUILDING DEPARTMENT VILDING INSPECTOR SISTANT 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: ^� GATE' jj ,. PERMIT# � J v ` ISSUED: ECT: BLOCK: / LOT: LOCATION: 0 �' 'may_ -Q.GCUPANCY• 66 VIOLATION NOTED THE WORK IS... ❑ ACCEPTED REJECTED/REINSPECTION SITE INSPECTION -14I' j( , REQUIRED / LJ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION � Z 1 ❑ NATURAL GAS ,va ❑ L.P. GAS �- ❑ FUEL TANK ❑ FIRE SPRINKLER `�- ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER 5 � c-J� u �� N M Q O O C b - 1 N N py 61 rn N N (N �• w MI Ld) y y 0v Ln VJ cn l� w 4.4 p OLr) H \ M o o y S CD3 ° "aauo W a s y 'bCD s a o W as enC� It �A w © M � a ° v eta O x 0 10:) a z O OI u UZb a � c cla oaer N Q a M y W Q QPQ U 0 � A � � p \ OC a� � � � ya. o O z w o wA " �, O zz -I zwo a a �tt A O U G bC��R 3 Q Z ✓ f� d O w O v , O cnQL) 0-4 p U O HST° 4 �j ;, A H J Q z W) A w maz W p W a a � � s BUILDR+1G !,.'2�TMENTDtP VIL 0 RROOK 7 938 Kiev Q ET RYE R ,NY 10573 Z��z -3j 14 9! r VILLAGE OF RYE BUILDfiJG DEPARTMENT ###*#** FOR OFFICE USE ONLY: Approval Date: MAY z 5 202 r t# e�v+—0 1 Application# Approval Signature: ARCHITECTURAL REVIEW BOARD: ` 1 Disapproved: Date: BOT Approval Date: Case# Chairman: /off PB Approval Date: Case# Secretary ZBA Approval Date: Case# Other: Application Fee: 7fzL2aPerinit Fees: FENCE / WALL / GATE PERMIT APPLICATION Application dated: is hereby made to the Building inspector of the Village of Rye Brook,NY,for the issuance of Permit for the installation,construction,repair or replacement of a Fence,Wall or Crate,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: Y\ -2. Occupancy/Use: " �. S.B.L.#: 1-50. 77+ )—\5 Zone: `t 5 3. Proposedd Fence/Wall/Gate(describe in ,d/etail): (` 4. Property Owner: 'C Address: aul� \\�,C��de Phone# \%% o � Cell# email:\,p` -C e.q To�p O, w •('zVe1 Applicant:, G��C�� ©YcLa tSO.t�.c �yt� Ulu�� A]ts�nY`15 lzrc Address:.`:!Z�\ - Phone#S\y b"lo kLk!(y Cell# C{\y C \\ email: \SCkcic S ,o.h�'rr1Q�t�z�1z1k VC. Architect/Engineer: mom Address: Phone# Cell# email: Contractor: Address&Phone: \01(n1 5. If building is located on a corner lot,which street does it front on: 6. What is the estimated cost of construction A\1 1`54 • G d (NOTE:The estimated cost shall include all site improvements,labor,material,scaffolding,fixed equipment,professional fees,and material and labor which may be donated gratis.) 7. Estimated date of completion: I 811212021 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. kid•****�**�**�******kk* �k*** **** •.**** �k9:k9:ki:!:*-kk*•k4:i:*k:Fi*iY********k****�•�:***l**i:*******•t***£* S E OF COLTNTY OF ) as: -r 0�'- ►'? ,being duly sworn,deposes and states that he/she is the applicant above named, tprint 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 1� Sworn to before me this day ofQ� ` , 20 py day of 20� Sign tare _ caner t lure of Applicant Print of pro rty Owner Print Name of Applica Notary blic Notary pub c LAURA MOREA Notary Public Connecticut SALLY 1.ROgCRTS My Commission Expires Sep 30, 2026 Notary Public State of New Yr,4 No.()l t0617 Qualffi ed i 172E torn n Westchester Cote r., mission Expires 07/30/2C3 12_� 802021 FENCE Licensed & Insured MASONARY • Aluminum • Stone Walls • PVC fenceo • Stucco • Wood ' masonrY • Pavers • Chain Link • Patios • Railing CORD • Walkways • Pool Enclosures • Flagstone 131 Emerson Ave. Cell: 914-804-121 1 • Deer Fence New Rochelle, NY 10801 Tel: 914-636-1404 • Belgium Blocks • Drainage • Dry Wall Name: Bree Johnson Date: 03/08/22 Address 40 Hiilandale Rd Rye Brook, NY 10573 Email: bree.graber@gmail.com Phone: 908-963-4733 Invoice Number: DESCRIPTION Proposal Installation of approx. 378 LFT of 5 FT high white PVC privacy fence Installation includes (1) 6 FT opening double gate and (1) 42" opening single gate Gates will be self closing and latching Fence was installed with 5x5 posts and New England post caps Heavy duty posts will be used for gate installation Installation of approx. 21 LFT of 4 FT high diagonal lattice sections to enclose pool equipment Installation includes (1) 36" opening single gate All posts will be set in concrete footing Price includes removing old fence and cart away MATERIALS AND LABOR: $17,1S0.00 This is a proposal on the goods named. subject to the conditions noted above. Sub-Total: (Descrice any conditions pertaining to these prices and any additional terms of the agreement.) Sales Tax: Customer Signuture: TOTAL: Salesperson Signuture: Building Permit Check List&Zoning Analysis E Address: O SBL• 1 3 0, -T Zone:1 2- 'Z S� Us '( 0 Const.Type: Other. Submittal Date: 12-1 Z Z Revisions Submittal Dates: Applicant O N Vj Nature of Work: Ty' W l--l4 44 LAJ 4_(T �V c-- -i>a-l V 4,G y C km Reviews:ZBA: PB: BOT: Other. OK ( ( ) FEES:Filing: S�• A�BP: ��• `�C/O: Flood Plane:�Legalization: ( ) (_�/APP: Dated ✓ Notarized: SBL• ✓ Truss I.D. Cross Connection: H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening. ( ) ( ) ENVIRO:Long. Short Fees: N/A.- SITE PLAN:Topo: Site Protection S/W Mgmt.: Tree Plan: Other. ( ) (•�SURVEY:Dated: Current Archival: Sealed: Unacceptable: ( ) (•� PLANS:Date Stamped Seale Copies: 2 Electronic: ✓ Other. ( ) ( License. ✓ Workers Comp: Liability: '/ Comp.Waiver. Other. ( (�' CODE 753# _ �da-'Or`� g'y�/-CEO Dated '"-., S—c� N/A: ( ) ( ) HIGH-VOLTAGE ELECTRICAL.Plans: Permit N/A Other. ( ) ( ) LOW-VOLTAGE ELECTRICAL:Plans: Permit N/A Other. ( ) ( ) FIRE ALARM/SMOKE DETECTORS:Plans: Permit H.W.I.C.:_Battery:_Other. ( ) ( ) PLUMBING Plans: Permit Nat. Gas: LP Gas: N/A/: Other. ( ) ( ) FIRE SUPPRESSION:Plans: Permit N/A: Other. ( ) ( ) H.V.A.C.: Plans: Permit N/A: Other. ( ) ( ) FUEL TANK:Plans: Permit Fuel Type: Other. ( ) ( ) 2020 NY State ECCC: N/A: Other. Final Survey. Final Topo: RA/PE Sign-off Letter. As-Built Plans: Other. ( ) ( ) BP DENIAL LETTER: C/O DENIAL LETTER: Other. G( ) ( ) Other. ARB mtg.date: S ZZ, approval:- J Z Z notes: ( )ZBA mtg.date: approval• notes: ( )PB mtg.date: approval: notes: REQUIRED EXISTING PROPOSED NOTES APPROVED Arm Date: MAY 7 5 7n�� Circle: Fr n : Front: Front Sides: 1� Main Cor. Accs.Cow F S S .HS • GFA: Tot, Ft.Imb Parlun� Height/Stories: notes: • D � BUILDING.DEPARTMENT CENE VILLAGE OF RYE.j3ROOK APR 2 7 2022 ID 938 KING STREET RYE BROOK',NN 10573 (914)939-0668 VILLAGE OF RYE BROOK www-r4rook.4r2 BUILDING DEPARTMENT ARCHITECTURAL REVIEW BOARD CHECK LIST FOR APPLICANTS This form must be completed and signed by the applicant of record and a copy shall be submitted to the Building Department prior to attending the ARB meeting. Applicants failing to submit a copy of this check list will be removed from the ARB agenda. Job Address:4Q31 y�at`� 1�1& Date of Submission-4 si Parcel ID#: La-) 77—I S Zone: P"o�� kP I Proposed Improvement(Describe in detail): sr h`Ck Wh`t e- APPLICANT CHECK LIST: MUST BE COMPLETED BY THE APPLICANT Pv P<�J cic� l;Cnc C)LI AtfOry t-� The following items must be submitted to the Building (/� SXs Art (iV\� !UG �h� a►�.t pat{c Departrpent by the applicant-no exceptions. Property Owner: 1. ( ,,(Completed Application Pro p y ��� SG�Y�SC�Y 2. ( )Two(2)sets of sealed plans. (one toll size (maximum Address: �(� ��� h G� Qa �W�� Y� allowable plan size=36"x 42"1 and one 11"x17") Phone# L\Nl-� 3. ( ef"Two (2)copies of the property survey. 4. ( )Two (2) copies of the proposed site plan. Applicant appearing before the Board: 5. ( J�(Ine electronic/disc copy of the complete a plication materials. 6. ( /rFlling Fee. Address: 7• ( )Any supporting documentation. Phone#(MA`EGA \LA kp%QA 8. ( OA approval letter. (ifapplicable) 9. (photographs. Architect/Engineer: 10.( ) Samples of finishes/color chart. (a sample board or Phone# model may be presented the night of the meeting,) By signature below, the owner/applicant acknowledges that he/she has read the complete Building Permit Instructions& Procedures,and that their application is complete in all respects. The Board of Review reserves the right to refuse to hear any application not meeting the requirements contained herein. Sworn to before me this Q Sworn to b ' re me this 1,-;?4- e- day of 1 , 20 day of , 20 ova Signauu Sign lure of Applicant of Pro caner t � d- so. icxz Print mc of P erty Owncr Print Name of Applica t otary ublic r,j�iotary u I _ SALLY J.ROBERTS LAURA MOREA tF� Notary Public,State of New York Notary public No'OJR06171726 Connecticut Qumissi mission Expires Westchester07/30/20.23- 'ommission Expires Sep 30, 2026 Corn '+'" 8/12/2021 VILLAGE OF RYE BROOK BUILDING DEPARTMENT Page 1 938 KING STREET, RYE BROOK,NY 10573 (T) 939-0668 (F) 939-5801 ARCHITECTURAL REVIEW BOARD Wednesday, May 18, 2022 ANNOUNCEMENT: PER THE GOVERNOR'S EXECUTIVE ORDER THIS MEETING WILL BE HELD VIRTUALLY THROUGH THE ZOOM PLATFORM. THE PUBLIC CAN ACCESS THE MEETING THROUGH THE FOLLOWING LINK: https://us02web.zoom.us/m/81417970741 OR BY OPENING ZOOM AND ENTERING THE MEETING ID: 81417970741 NAME&LOCATION TYPE OF APPLICATION MOTION SECOND APPROVED REJECTED APPL.# 75 Woodland Ave Roof Top Solar Array Consent 5694 (Mutino) 17 Talcott Road Replace Original Consent 5695 (Bennet) Decking/Railing On Agenda Existing Deck W/Trex Brownstone 257 Betsy Brown Roof Top Solar Array Consent 5696 Road(Mauriello) System Agenda 40 Hillandale Rd New 5Ft High White Consent 5697 (Johnson) PVC Privacy Fence Agenda 20 Magnolia Drive Roof Top Solar Array Consent ` 5697 (Lubin) System Agenda 108 Old Orchard New Fencing Rear Yard Consent 5698 Road(Koslow) Agenda 11 Candy Lane 6'Privacy Fence Rear and Consent (Gordon) Partial @ Side Yard Agenda 165 Betsy Brown Install New Stone Veneer Consent 5699 Road Over Existing Stucco Agenda Finish(Front 44 Lawridge Drive Re Appearance -Partial 5686 (Bauer) Second Story Addition, Interior&Exterior Renonovations ML NM MR ✓ SE JM i/ SF AC // MI KC �.'4r ,��\ y A�h • ��h Y. .� `:tY �cil y.' � '/���1@iJ1( oil a kk �. $:ter ..a 1• s J ti a-.�Rti Av mi Vlff*••} •d - i — e l.. i E k i 1 � { r E I Il r .'t�A ryrj4•,rR AtA� r A tt n15AJfT•.� �q(tiA --• �° , o ., ,a`�; +���;ti 0 c•'J.<dOSwC-, 0 0. s Q � 0�• t ,y tt .O •fit F. 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"t'; O♦♦� '(I A�...�tg:� �♦ �({. A "r.rr a tY , r{ �t� • �'tf 1 ^ 1 til °' �1s,�y� �. 1 !t ^ .,nl`�t {f},�;h`I+P4 A � ZA ,, \•.tfjikV it's' i Nt V Y fV Fs sc• A�6 tl?M+V�1iSSty -417 ttj,,riS'V �1 yr l �vtf! .V, ��'sy� '•..V'xK's..%- .. w'4ry". \" yy.d�i :..• .. �. s 1iy. _ • '� �``d�3 v�Yy�✓` ACO o a3r 1 Q CERTIFICATE OF LIABILITY INSURANCE DA> elO nr2022o2z 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 policy(ies) must Have ADDITIONAL INSURED provislons or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate aces not confer rights to the certificate holder In lieu of such endorsemen s . CONTACT PRODUCER NAME. EDGAR ALMANZAR StateForm EDGAR ALMANZAR �HaNE (914)358-9712 i FAX 914AW9716 tA'G-Nn �1�' I&C Nol: 477 CENTRAL AVE EA ss: EDGARAAGENTEDGAR.COM W5UREAlELAFFORDINO COVERAGE _ - _ NAIC 5_ WHITE PLAINS NY 106DG INSURER A State Farm Fire and Casualty Company 25143 INSURED INSURER a: ISAAC FENCE AND MASONRY CORP INSURER_C: O 131 EMERSON AVE a5URER 0:__ INSVRFR E NEV'r'ROCHELLE NY 10801 IIN5VRER F oF COVERAGES CERTIFICATE NUMBER: REVISION NUMBER. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVL 11EEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION Or 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 ALI THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. --— St1t►R --- -- r`FOLK"EFF POLICY EXP. LTAR TYPE OF INSURANCE POUCY NUMBER M AYYYY M uWTa T x COMMERCIAL GENERAL UABR.f1Y EACH OCCLRREINCE t 2000000 l —� aAIM — cuntsAlA JE X OCCUR Pq ►,,st,IE -rM s 300000 ARTISAN 8 SERVICE Mk0 E_XP(Ary orN v~j s 5000 A CONTRACTORS Y I 98-CX-CS93-7 0112412022 O l 24123 PERSONAL a ACV wA1RY s 20ODDOO DEN•.AGGREGATE LIN NT APPUES PER. GENERAL AGGREGATE S 40ODM ! (� 1i......_.-.--ACT - - PCXICY L—J PRO-- I_ LOC f PRODUCTS•CONP�U�AUG S 4 000000 W HER 5 AUTOMOBLELIAMILITY v 319-1495-FO5-52 0610512021 W05r2022 ,q s_- ANY A'J'U 1 I BOOILV-.NUUNY IVar rArun) s A X 01vNEO SC.IEwtsO I 2OOILY NJUNY;PR(INK s Amolo00 ALTOSCNLY AUTOS t 1`12ku NON-CIANED PHOPEHTYDMUGC L 1,0w,000 AUTOS ONLY .� AUTOS ONLY UMBRELLA LIAR OCCUR EACH OCCURRENCE f _ EXCE33 L" CLNMSAAADE AGGREGATE S DCD RMNTIDN S WORKERS COMPENSATION I TAT T R AND EMPLOYERS LIADWTY Y 1 N I AN"PROPNIE:T OWPAR I NLR.'L XCI J'IYC E L.EACH ACCR1E Y i iCPEICE WMEUJBEN Er<r1uDEG� NIA ,Mandelory IM NMI E L DiSEA$WLEAf-MPLOYEE S d es.Cew be ut101M 01 f rCRIPI ION OF OI+E IL4TIOhS GeErw E L rNSFA$f•PQLIGY LMMIT S l DESCRIPTICK OF OPERATIONS I LOCH noNs/VEHICLES IACORO 101,Add-taml Remerwe SN»dWc m y he uteched it men&Pace le nQVIndI The certiriCate holder Is listed as additional insured 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, Village of Rye Broot. AUTHDRILED RE SENTATIVE _ 938 King S, i Rye Brcok NY 10573 Q 1988-2015 ACORD CORPORATION. All rights reserved. eglstered ACORD 25(2016103) The ACORD name and logo ar marks of ACORD j ,3C!+35 132Ea9 13 G4-22.2C23 NYSIF New York State Insurance Fund PO Box 66699.Albany,NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE a. 'a ^^^^^^ 204618267 ISAAC FENCE AND MASONRY CORPORATION 131 EMERSON AVE O � 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:/NVWW.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 SUR NCE FUND T �V DI RECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER:689539372 U-26.3 Laura Petersen From: Mike Izzo Sent: Wednesday, May 25, 2022 12:43 PM To: Laura Petersen; Steven Fews;Tara Orlando Subject: FW: Message from UDig NY From: UDig NY Exactix <tickets@exactix.udigny.org> Sent: Wednesday, May 25, 2022 12:42:48 PM (UTC-05:00) Eastern Time (US & Canada) To: Mike Izzo Subject: Message from UDig NY ****REGULAR**** DIG REQUEST from UDig NY for: VIL RYE BROOK Taken: 05/25/2022 12:37 To: VIL RYE BROOK PRIMARY Transmitted: 05/25/2022 12:42 00005 Ticket: 05252-001-844-00 Type: Regular Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 40 To: Name: HILLANDALE RD Cross: From: To: Name: Offset: ------------------------------------------------------------------------------ Locate: LEFT CORNER OF PROPERTY AND RIGHT SIDE TOWARS THE BACK NearSt: KING ST & RT 120A Means of Excavation: HAND TOOLS Blasting: N Site marked with white: N Boring/Directional Drilling: N Within 25ft of Edge of Road: N Work Type: INSTALL FENCE Estimated Work Complete Date: 05/31/2022 Depth of excavation: 2 FEET Site dimensions: Length 1 FEET Width 1 FEET Start Date and Time: 05/31/2022 07:00 Must Start By: 06/14/2022 ------------------------------------------------------------------------------ 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: isaacfenceandmasonry@live.com Working for: BREE JOHNSON i ` ------------------------------------------------------------------------------ Comments: WE ARE INSTALLING A FENCE AROUND THE PROPERTY Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: ALTICE USA CONED SUEZ WTR WESTCHESTER TEN GAS-HDS VLY VIL RYE BROOK WESTCHESTER CTY SWR 2 APR 2022 •o.n-,r x cfcw llhtn��v+Toy�Ofi"+n• i�+IQt A ,. ` --"a.__ � .� ': z•=LLAGE OF YE BROOK wwoF�oc�Rnr SITUATED AT ' WLD WG ARTMENT ViLA.WCFRVECf1D0K-A%ST0*S'EPOMA—f N 'Am SELfov Vic?J I^$KOCP. 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