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HomeMy WebLinkAboutBP22-114PERMIT # c;d— OLDATE: 0 EXP: SECTION BLOCK LOT TYPE OF WORK ge Yjee9QL,0,0.�j //74i� JOB LOCATION OWNER_. /cjQ CON EST. wd/cO A TCO # FEE DATE INSPECTION RECORD I DATE INSP F0071NG FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING 0 RGH PLUMBING GAS SPRINKLER ELECTRIC 77 LOW -VOLT C) ALARM AS BUILT FINAL `l \Arl OTHER APPROVALS • i•B1f4L'fIFINALSDRVEY REQUIRED PRIOR TO FINAL INSPECTION VILLAGE OF RYE BROOK WESTCHESTVR COUNTY, NEW YORK NO: 23-193 (fertif irate of Orrupaucp This is to certify that �lF / / (.-� Q- /v-- ate- of, I r , having duly filed an application on �V5 V � ��' / 4 20 �.J requesting a Certificate of Occupancy for the premises known as, Rye Brook,NY,located in a P0 Q Zoning District and shown on the most current Tax Map as Section: `. Block: Lot: , and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No. 22"// �C, issued L'3o 20�, such authority and permission is hereby granted to the property owner to lawfully occupy or use said premises or building or part thereof listed under the following New York State Classifications,Use: - - �// Construction: for the following purposes: U S 1 Subject to all the privileges, requirements, limitations, and conditions prescribed by law, and subject also to the following: This certificate does not in any way relieve the owners or any person or persons in possession or control of the premises, building,or any part thereof from obtaining such other permits or licenses as may be prescribed by law for the uses or purposes for which the building or premises is designed or intended. Furthermore, it does not relieve such owners or persons from complying with any lawful order issued with the object of maintaining the premises or building in a safe and lawful condition. No changes or rearrangement in the structural parts of the building or in the exit facilities shall be made,and no enlargement, whether by extending on any side or by increasing in height shall be ,,nor shall the building be moved from one location to another until a permit to accomplish such change has been d fr the Building Inspector. O E C 0 4 2023 Building Inspector,Village of Rye Brook: Date: BUILD MENT L.J �v N For office use nl I PERMIT# NOV 1 7 2023 VIL OF RYE OK ISSUED: — I ONG STRE YE BROOK, YORK 10573 DATE: VILLAGE OF RYE BROOK 9 -0 O�c FEE: ,�t PAm�ilC BUILDING DEPARTMENT APPLICATION FOR CERTIFICATE OF OCCUPANCY,CERTIFICATE OF COMPLIANCE, AND CERTIFICATION OF FINAL COSTS TO BE SUBMITTED ONLY UPON COMPLETION OF ALL WORK, AND PRIOR TO THE FINAL INSPECTION A N++++♦++++itgitigit ttq/iii •kti MiVi+Y!l itrrllt+Vi!#+NgrTr+rrgir�it+it+**tl rrir rttrr+r++r Address: AYS 72 OccupanZifk- se: / Parcel #: a 9. 3—� Zone: 10aA Owner: /"' Address: P.E./R.A.or Contractor: i (t.Address: Person in responsible charge: Address: Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issuance of a Certificate of Occupancy/Certificate of Compliance for the structure/construction/alteration herein mentioned in accordance with law: S ATE OF �W YORK,COUNTY OF WESTCHESTER as: / IE being duly sworn,deposes and say that he/she resides at in��(I erne of p scant) (No.and Peet) in the County of in the State of that rty/rown/Village) he/she has supervised the work at the location indicated above,and that the actual total cost of the work,including all site improvements, labor,materials,scaffolding,fixed equipment,professional fees,and including the monetary value of any materials and labor which may have been donated gratis was:$_ UO for the construction or alteration of: 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 17I-- Sworn to before me this day N ��- ,20 Z3 day of ,20 - '_41 i I- h4u i ature of P perty Ow Signature of Applicant / Print a of p wn Print Name of Applicant Notary Public Notary Public CARLA A MURRELL NOTARY PUBLIC-STATE OF NEW YORK 81 12 2021 No.01 MUS315908 Qualified in Westchester County My Commission Expires 12-01-2026 �yE BRC�k, O� 2m 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 :� Z 4 V�Z P/yU/\ A) DATE: �Z- - 4 L O Z3 2 16 PERMIT# �l Z Z ! ISSUED: U-Z•2.SECT: Z. BLOCK:LOT: _ LOCATION: qt ?A1 10 F-XPA mS/O J OCCUPANCY: 2 10 ❑ 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 R'FINAL ❑ OTHER , a eq N ,0 � s CV \ W v v N � � v 1-4 Ga L GT] v v s 93" CL CL v w W W O � .�� wQ t \ N LL ' U 4 a 00 0 r a a+ O W C A o o ° to A 00 z �' .� ci M ; 0- W Ln 0d wp � o O U G va Con O o . T-4 cc 00 GN ON ^^ . cyv zzb o u 00 .7 p 4Q y�g v v U � o }.,� W � W z o o ° � � zU .� Zan M V z aCA a ° CIA z • `� V IL � cn °C � � � vb BUILDING DEPARTMENT VILLAGE OF RYE BROOK V [E C IE (j�/J E 938 KING STREET RYE BROOD,NY 10573 u vu (914)939-0668 JUN 2 0 2022 ` v.r�,ebrook.org VILLAGE OF RYE BROOK ADMINISTRATIVE EXTERIOR BUILDING PERMIT BUILDIN it ION G DEPARTMENT FOR EXTERIOR WORK WHICH DOES NOT REQUIRE VILLAGE ARCHITECTURAL REVIEW BOARD APPROVAL FOR OFFICE USE ONLY: APPROVAL DATE: JUN 2 3 2022 ERMIT#: APPLICATION FEE: APPROVAL SIGNATURE: V1 Y PERMIT FEES: H.O.A. APPROVAL: DATE. DISAPPROVED: OTHER: Application dated: (AWis hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the construction of buildings,structures,additions,alterations or for a change in use,as per detailed statement described below. 1. JobAddress: L CG 2. Parcel ID#: , Zone: Tb D 3. Proposed Improvement(Describe in detail): Q ( 'e--I'I (0/&_C-if-AL! L�/^!J ��� Zak_k"— Of CO- dti V it t V71 / - PV, d 17 b f v z 4. Property Owner: 'o— Cc / Address: P� Phone# z 2,0 3 S� Cell# e-mail List All Other Properties Owned in Rye Brook: n 0A41 C7' Applicant: Address: Phone# Cell# e-mail Architect: /7&One- -- Address: Phone# Cell# e-mail Engineer: f a r1 t� Address: Phone# Cell# e-mail General Contractor: 4 d OC, Address: Phone# Cell# e-mail (t) 8/12/2021 ' 5. Occupancy;(1-Fam.,2-Fam.,Commercial.,etc...)Pre-construction: cr/ ost-construction: /6/ 6. Area of lot: Square feet: Acres: 7. Dimensions from proposed building or structure to lot lines: front yard: rear yard: right side yard: left side yard: other: 8. If building is located on a corner lot,which street does it front on: 9. Area of proposed building in square feet: Basement: 1 I fl: 2nd fl; 31d fl: 10. Total Square Footage of the proposed new construction: 11. For additions,total square footage added: Basement: I"fl: 2nd fl: 3'a fl: 12. Total Square Footage of the proposed renovation to the existing structure:_/ el onZ 13. N.Y. State Construction Classification: N.Y.State Use Classification: 14. Construction Type&Location:O Typical Western Lumber Frame;O Timber Frame[TC];O Wood Truss[TT]; O Pre-engineered wood[PW];Located;O Floor Framing[F];O Roof Framing[R];O Floor&Roof Framing[FR];Other: 15. Number of stories: Overall Height: Median Height: 16. Basement to be full,or partial: finished or unfinished: 17. What material is the exterior finish: 06 t4 J 18. Roof style;peaked,hip,mansard,shed,Itc: Roofing material: 19. What system of heating: 20. If private sewage disposal is necessary,approval by the Westchester County Health Department must be submitted with this application. 21. Will the proposed project require the installation of a new,or an extension/modification to an existing automatic fire suppression system?(Fire Sprinkler,ANSL System,FM-200 System,Type I Hood,etc...)Yes:_No:_ (if yes,applicant must submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans) 22. Will the proposed project disturb 400 sq.ft.or more of land,or create 400 sq.ft.or more ofripervious coverage requiring a Stormwater Management Control Permit as per§217 of Village Code? Yes:_No: ✓Area: 23. Will the proposed projec require a Site Plan Review by the Village Planning Board as per§209 of Village Code? Yes: No: V (if yes, applicant must submit a Site Plan Application, &provide detailed drawings) 24. Will the proposed project require a Steep Slopes Permit as per§213 of Village Code Yes: No: (f yes,you must submit a Site Plan Application, &provide a detailed topographical survey) 25. Is the lot located within 100 ft.of a Wetland as per§245 of Village Code? Yes: No: ✓ (if yes, the area of wetland and the wetland buffer zone must be properly depicted on the survey&site plan) 26. Is the lot or any portion thereof located in a Flood Plane as per the FIRM Map dated 9/28/07? Yes: No: li (if yes,the area and elevations of the flood plane must be properly depicted on the survey&site plan) _ 27. Will the proposed project require a Tree Removal Permit as per§235 of Village Code?Yes: No: t/ (if yes,applicant must submit a Tree Removal Permit Application) 28. Does the proposed project involve a Home-Occupation as per§250-38 of Village Code? Yes: No: Indicate:TIER I: TIER II: TIER III: (if yes,a Home Occupation Permit Application is required) 29. What is the total estimated cost of construction: $ L A d 6-0. " Note:estimated cost shall include all site improvements,labor,material,scaffolding,feed equipment,professional fees,including any material and labor which may be donated gratis.If the final cost exceeds the estimated/cost,an additional fee will be required prior to issuance of the CIO. 30. Estimated date of completion: V& r d o (2) 8/12/2021 BUILDING DuA►RTMENT " VILLAGE OF RYE-BROOK EUN 2 0 2022] 938 KING$ ET RV BR ,NY 10573 VILLAGE OF RYE BROOK vVS BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE &216 • STORM SEWERS AND SANITARY SEWERS THIS AFFIDAVIT MUST BEAR THE NOTARIZED SIGNATURE OF THE LEGAL PROPERTY OWNER AND BE SUBMITTED ALONG WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION. ANY BUILDING OR PLUMBING PERMIT APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETURNED TO THE APPLICANT STATE OF NEW YORK, COUNTY OF WESTCHESTER ) as: , J� f, ! f A- cd-I& .1i P^, e. ,residing at,<: '-� �J Pry ,L AU! it (Print name) (Address wtfere you live) being duly sworn, deposes and states that(s)he is the applicant above named, and further states that(s)he is the legal owner of the property to which this Affidavit of Compliance pertains at; J f r-yY e , Rye Brook,NY. (Job Address) Further that all statements contained herein are true, and that to the best of his/her knowledge and belief,that there are no known illegal cross-connections concerning either the storm sewer or sanitary sewer, and further that there are no roof drains, sump pumps, or other prohibited stormwater or groundwater connections or sources of inflow or infiltration of any kind into the sanitary sewer from the subject property in accordance with all State, County and Village Codes. (Signature of Properly Owner(s)) iJ i- (Print Name of Property Owner(s)) Sworn to fore me this Q r2 da of 20 , \ J (Notary Public) SHARI MELILLO Notary Public,State of New York No.01ME6160063 Qualified In Westchester County (3) Commission Expires January 29,20LD 8/12/2021 This application must be properly completed in its entirety by a N.Y. State Registered Architect or N.Y. State Licensed Professional Engineer & signed by those professionals where indicated. It must also include the notarized signature(s) of the legal owner(s) of the subject property, and the applicant of record in the spaces provided. Any application not properly completed in its entirety and/or not properly signed shall be deemed null and void, and will be returned to the applicant. Please note that application fees are non-refundable. STA E OF NE YO K,COUNTY OF WESTCHESTER ) as: / ,being duly sworn,deposes and states that he/she is the applicant above named, Tint name of iniEvidual 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. By signing this application, the property owner further declares that he/she has inspected the subject property, and that to the best of his/her knowledge there are no roof drains,sump pumps or other prohibited stormwater or groundwater connections or sources of infiltration into the sanitary sewer system on or from the subject property. Sworn to before me this o Sworn to before me this (ay of - 1,L ,20_4� day of ,20 a `• ignature of Property OW6& Signature of Applicant xf— Print Name of Property O er Print Name of Applicant Notary Public Notary Public SHARI MELILLO Notary Public,State of New York No.OIME6160063 Qualified In Westchester County Commission Expires January 29,2;2. (4) 8/12/2021 RICHAU MUSTACATO GRIPPI � ASSOCIATES 350 Theodore Fremd Avenue • Rye,New York 10580 • Tel 914-698,5589 Frnc 914,698-5933 July 11, 2023 Mr. Steve Fews D Building Inspector i Village Of Rye Brook, N.Y JUL 1 1 2023 Re: Balcony Post Replacement VILLAGE OF RYE BROOK For Lisa Mary Calabria BUILDING DEPARTMENT 29 Bayberry Lane — -- Section 129.84; Block 2; Lot 18 Please be advised that I have made a site observation at the above referenced property and do certify that the 4 x 4 pressure treated posts, although non structural; have been done in compliance with the applicable 2020 Residential Code Of New York State and further feel there are no structural concerns with the work that was done. Sincerely, ftED gRcy ��j O�Et1CK,c i), 1 N 0 O Frederick F. Grippi, AIA for R.M.G. Associates Mike Izzo From: Mike Izzo Sent: Monday, September 19, 2022 1:50 PM To: Lisa Bhalla Cc: Tara Orlando; Steven Fews; Laura Petersen Subject: RE: 29 Bayberry Ln Rye Brook Dear Ms. Calabria, Thank you for the email. The shed and sliding door steps can be added to the permit. Once the project is completed,please provide an as-built property survey, a completed C/O Application, and the $110 C/O fee to our office for processing. Thank you. Michael J. Izzo Building&Fire Inspector Village of Rye Brook, NY (914)939-0668 —Original Message From: Lisa Bhalla <dropsof upiter8@optonline.net> Sent: Friday, September 16, 2022 8:36 AM To: Mike Izzo <MIzzo@ryebrook.org> Subject: 29 Bayberry Ln Rye Brook Good morning Mr. Izzo, I obtained a permit to put pavers in my backyard on my property in The Arbors. I've completed the project except for the steps which were not in the original plan because we weren't sure what we were going to do. I have placed pavers for steps but have not cemented them in place. The HOA has approved the steps and asked me to check with you to see if I need a permit for the steps. I am enclosing pictures of the completed work. Thank you so much! Sincerely, Lisa Calabria 1 Laura Petersen From: Steven Fews Sent: Friday, August 11, 2023 3:31 PM To: Lisa Bhalla Cc: Laura Petersen Subject: RE: 29 Bayberry Arbors Attachments: Surveyor List.pdf Expires: Saturday, December 9, 2023 12:00 AM Good afternoon. Please be advised that your 6 month extension was granted. Your new expiration date is 12/30/23. Please arrange for all work to be complete and survey to be in so we can schedule your final inspection asap. Attached is an archival list of survey companies and P. E. /Professional Engineer's who in many case can also do land surveys. We are not recommending, but you can use the attached for reference. Thank You. Steven E. Fews Building Inspector & Fire Inspector Office (914) 939-0668 -----Original Message----- From: Lisa Bhalla <dropsofjupiter8@optonline.net> Sent: Wednesday, July 5, 2023 4:54 PM To: Steven Fews <Steve Fews@ryebrook.org> Subject: Re: 29 Bayberry Arbors Ok Steven. Thank you. Just anxious to complete the process. Lisa > On Jul 5, 2023, at 4:43 PM, Steven Fews <Steve Few s@ryebrook.org> wrote: > Good Day, > let me advise you after I receive his letter. > Thank You. > Steven E. Fews > Building Inspector & Fire Inspector > Office (914) 939-0668 > -----Original Message----- > From: Lisa Bhalla <drop sofj upiter8@optonline.net> > Sent: Wednesday, July 5, 2023 10:13 AM i > To: Steven Fews <SteveFews@ryebrook.org> > Subject: 29 Bayberry Arbors > Dear Steven, > Thank you so much for your excellent recommendation for architects. Fred Grippi came out and is sending you a letter in reference to the posts in my backyard. I believe the next step is obtaining a surveyor to finalize the process. Since you were so helpful in securing an architect can you provide me some names of surveyors you have worked with in the past? I would be most grateful! > Thank you! > Sincerely, > Lisa Calabria 2 Building Permit Check List&Zoning Analysis Address: ' SBL: Zone: Use 21 Const.Type: Other. Submittal Date: Revisions Submittal Dates: Applicant: /i p1r,�4�.��I A, Nature of Work � ��,N� P�.CI � Reviews:ZBA: .111 N 2 32022 PB: BOT: Othw. hTIP Q ( ( ) FEES:Filing. - BP: L °o- _ C/O: Flood Plane: Legalization: ( ) (J/Scen Dated: Notarized SBL runs I.D. Cross Connection: H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Stone 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: ( ) ( ) LANS:Date Stamped Sealed Copies:�Electronic Other: (b1f (License: Workers Comp: Liability.. ✓ Comp.Waiver.—V—Other. (� ( ) CODE 753A Dated: N/A: ( ) ( ) HIGH-VOLTAGE ELECTRICAL:Plans: Permit N/A Other. ( ) ( ) LOW-VOLTAGE ELECTRICAL:Plans: Permit N/A Other. ( ) ( ) FIRE ALARM/SMOKE DETECTORS:Plans: Permit H W.I.C.:_Battery _Other. ( ) ( ) PLUMBING Plans: Permit: Nat.Gas: LP Gas: N/A/: Other. ( ) ( ) FIRE SUPPRESSION:Plans: Permit N/A: Other. ( ) ( ) H.V.A.C.: Plans: Permit: N/A Other. ( ) ( ) FUEL TANK:Plans: Permit: Fuel Type: Other. ( ) ( ) 2020 NY State ECCC: N/A Other. Final Survey Final Topo: RA/PE Sign-off Letter. As-Built Plans: Other. ( ) ( ) BP DENIAL LETTER C/O DENIAL LETTER: Other. ( ) ( ) Other. ( )ARB mtg.date: approval• notes: ( )ZBA mtg.date: approval• notes: ( )PB mtg. date: approval• notes: REOL ED EXISITNG PROPOSED NOTE,4 APPROVED circle: FwnWc: 1� From: sue: 1� Main Cor. Accs,Cor.. Ft.HS : S . S • a&. Tom: F Im : P rinno Hag */Stories: notes: 173'/z Ivy Hill Crescent Rye Brook, NY 10573 914-939-2440 June 13, 2022 Lisa Calabria 29 Bayberry Lane Rye Brook, NY 10573 Re: Deck Replacement with Grey Patio Pavers Dear Lisa Calabria, The Architecture and Grounds Committee (A&G) has reviewed your application for the above named work. This project requires a permit from The Village of Rye Brook. You are directed to submit this letter to the Village along with your permit application. Once the permit is obtained, a copy must be provided to A&G for final review and consideration. Work on the project may not begin until you receive written notice of acceptance from A&G. If any changes are made to the original plans submitted to A&G, due to input from the Village or arising during construction, the Committee must be notified in writing. Work cannot proceed until you receive written approval for those changes. Failure to comply with these procedures will result in fines and/or work stoppage. If you have any questions, please contact me at: Property Manager. Ashlee Pasquale Property Manager Laura Petersen From: Laura Petersen Sent: Tuesday,June 28, 2022 4:07 PM To: Lisa Bhalla Subject: BP-1 form for the Building Permit Application - 29 Bayberry Lane Attachments: BP -1 Form.pdf Good afternoon, Per our phone conversation this afternoon, please return the attached BP-1 form to the Building Department at your earliest convenience. A copy of your homeowners insurance declaration page is also required for the issuance of your permit. Our office is open Monday— Friday 8:30am to 4:00pm. Please let me know if you have any questions. 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 laetersen Wryebrook.org 1 Policy Change ,W, Declarations TRAVELERS J HOMEOWNERS POLICY Named Insured Your Agency's Name and Address LISA M CALABRIA DECESARE AGENCY INC 29 BAYBERRY IN 914 MCLEAN AVE RYE BROOK NY 10573-1520 YONKERS, NY 10704 Your Policy Number: 610301918 636 1 For Policy Service Call: (914) 237-2700 Your Account Number: 610301918 For Claim Service Call: 1-800-CLAIM33 Policy Period Location of Residence Premises FROM: 09-15-21 To: 09-15-22 12:01 A.M. 29 BAYBERRY LN STANDARD TIME AT THE RESIDENCE PREMISES RYE BROOK NY 10573-1520 Change Effective Date: 06/12/22 No Change in Premium Reason for Change: Added Endorsement HO-310 Section I-Property Coverages Limits of Premium Liability A - DWELLING $ 50,000 INCL C - PERSONAL PROPERTY 75,000 $ 307.00 D - LOSS OF USE 37,500 INCL Section II-Liability Coverages E - PERSONAL LIABILITY (BODILY INJURY AND $ 500,000 $ 55.00 PROPERTY DAMAGE) EACH OCCURRENCE F - MEDICAL PAYMENTS TO OTHERS- 5,000 INCL EACH PERSON Policy Forms and Endorsements HA-6 (12-86) Homeowners 6 Condominium Unit Owners Form HA-300 NY (05-15) Special Provisions - New York HA-390 NY (12-02) Workers Compensation and Employers Liability HA-406 NY (07-18) Special Condominium (and Cooperative) Form Provisions 56494 NY (07-18) Contents Replacement/Repair Cost $ 119.00 Coverage HA-187 (12-86) Theft Coverage Away From Insured Location HA-32 (12-86) Condominium Unit-Owners or Cooperative Apartment Share-Owners Building Coverage Non Specified Perils 56432 (12-08) Loss Assessment Coverage Section $ 18.00 I 6 II Non-Specified Perils Continued on next page Insured Copy Page 1 of 3 PL-8852 1.97 577/ONN408 DEC#: 4 000712/00246 F3115AH8 0248 05112/22 Policy Forms and Endorsements (continued) HA-208B (05-15) Water Back Up and Sump Discharge or $15,000 $ 110.00 Overflow HO-829 (05-15) Limited Fungi, Other Microbes $ 20,000 INCL or Rot Remediation - New York HO-310 (06-06) Additional Interests INCL THE ARBORS 173 1/2 IVY HILL CRESCENT RYE BROOK NY, 10573 INTEREST: ADDITIONAL INTEREST Total Premium $ 609.00 Your Premium Reflects the Following Credits or State Surcharges Security Credit -24.00 Loss Free Credit -107.00 Policy Deductible: $ 1000.00 All perils insured against In case of loss under section I, only that part of the loss over the stated deductible is covered. First Mortgagee CENTRAL LOAN ADMINISTRATION AN D REPORTING ISAOA/ATIMA PO BOX 202028 FLORENCE SC 29502 LOAN NUMBER: 4788230185 Your Insurer: The Travelers Home and Marine Insurance Company One of The Travelers Property Casualty Companies One Tower Square, Hartford, CT 06183 For Your Information For information about how Travelers compensates independent agents and brokers, please visit www.Travelers.com or call our toll free telephone number 1-866-904-8348. You may also request a written copy from Marketing at One Tower Square, 2GSA, Hartford, Connecticut 06183. Continued on next page Page 2 of 3 PL•86521-97 577i0NN408 DECP 4 Policy Change AM Declarations TRAVELERS J HOMEOWNERS POLICY Named Insured: LISA M CALABRIA Policy Number: 610301918 636 1 Policy Period: 09-15-21 To: 09-15-22 Effective Date: 06-12-22 For Your Information(continued) It is important that the information we used to rate your policy is correct. It is your responsibility to make sure that the information on these Declarations is accurate and complete, including checking that you are receiving all the discounts for which you are eligible. To see a full list of discounts offered, including discounts for having multiple policies with us, protecting your home with safety devices and being claim free, go to www.travelers.com/discounts. Once at the website, type in your policy number 6103019186361 and product code HP1 to view the discounts available. If any of the information on the Declarations has changed, appears incorrect, or is missing, please advise your Travelers agent or representative immediately. Your Travelers agent or representative is also available to review the information on the Declarations with you. Rating Information Only Dwelling Occupied By CONDOMINIUM Territory 00247 Construction FRAME Protection Class 4 Year Built 0000 Not More Than 200 Feet from Hydrant, 1 Miles from Fire Dept. Upon request, we will furnish you, or your representative, with a written estimate of damages to real property, specifying all deductions, provided such estimate has been prepared by us or has been prepared on our behalf for our own purposes. This estimate will be provided within thirty days after your request or its preparation, whichever is later. Thank you for insuring with Travelers. We appreciate your business. If you have any questions about your insurance, please contact your agent or representative. These declarations with policy provisions HA-6 (12-86) and any attached endorsements form your Homeowners Insurance Policy. Please keep them with your policy for future reference. Insured Copy Page 3 of 3 PL•8652 1-97 57710NN408 DECO: 4 000713100246 F31ISMS 0248 05/12/22 affidavit of Exemption to Show Specific Proof of Workers' Compensation Insurance Coverage for a 1, 2, 3 or 4 Family, Owner-occupied Residence "This form control be used to waive the workers'compensation rights or obligations of any party. Under penalty of perjury, I certify that I am the owner of the 1, 2, 3 or 4 family, owner-occupied residence (including condominiums) listed on the building permit that I am applying for, and I am not required to show specific proof of workers' compensation insurance coverage for such residence because (please check the appropriate box): l dia I am performing all the work for which the building permit was issued. lYJ I am not hiring,paying or compensating in any way,the individual(s)that is(are)performing all the work for which the building permit was issued or helping me perform such work. Lld I have a homeowners insurance policy that is currently in effect and covers the property listed on the attached building permit AND am hiring or paying individuals a total of less than 40 hours per week (aggregate hours for all paid individuals on the jobsite) for which the building permit was issued. I also agree to either: ♦ acquire appropriate workers' compensation coverage and provide appropriate proof of that coverage on forms approved by the Chair of the NYS Workers' Compensation Board to the government entity issuing the building permit if I need to hire or pay individuals a total of 40 hours or more per week(aggregate hours for all paid individuals on the jobsite)for work indicated on the building permit,or if appropriate,file a CE- 200 exemption form; OR ♦ have the general contractor, performing the work on the 1, 2, 3 or 4 family, owner-occupied residence (including condominiums)listed on the building permit that I am applying for,provide appropriate proof of workers'compensation coverage or proof of exemption from that coverage on forms approved by the Chair of the NYS Workers' Compensation Board to the government entity issuing the building permit if the p o.e akes a total of 40 hours or more per week(aggregate hours for all paid individuals on the jobsite)for ork,'n icated on th ilding permit. (Si tor�eof omeowner) (Date Signed) / �J r a <f, �� ��� Home Telephone Number (Homeowner's Nade Printed) (Sworn to befiore me this _1 Q day of Property Address that requires the building permit: M a U as (County Clerk or Notar►• Puhlicl SHARI MELILLO Notary Public,State of New York No.OIME6160063 9(2 Qualified In Westchester County — -- --- Commission Expires January 29,20.2—S Once notarized.this BP-1 form series as an exemption for both Horkers'compensation and disability benefits insurance coverage. BP-1 (12/08) NY-WCB Laura Petersen From: Mike Izzo Sent: Thursday,June 30, 2022 10:50 AM To: Laura Petersen; Steven Fews;Tara Orlando Subject: FW: Message from UDig NY From: UDig NY Exactix <tickets@exactix.udigny.org> Sent: Thursday, June 30, 2022 10.50:02 AM (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: 06/30/2022 10:48 To: VIL RYE BROOK PRIMARY Transmitted: 06/30/2022 10:50 00002 Ticket: 06302-000-818-00 Type: Regular Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 29 To: Name: BAYBERRY LN Cross: From: To: Name: Offset: ------------------------------------------------------------------------------ Locate: WORKING AT THE BACK YARD NearSt: ARBOR DR Means of Excavation: HAND TOOLS Blasting: N Site marked with white: Y Boring/Directional Drilling: N Within 25ft of Edge of Road: N Work Type: PAVER INSTALL Estimated Work Complete Date: 07/10/2022 Depth of excavation: 6 INCHES Site dimensions: Length 12 FEET Width 9 FEET Start Date and Time: 07/08/2022 07:00 Must Start By: 07/22/2022 ------------------------------------------------------------------------------ Contact Name: LISA CALABRIA Company: Addr1: 29 BAYBERRY LN Addr2 City: RYE BROOK State: NY Zip: 10573 Phone: 914-419-7035 Fax: Email: dropso�upiter8@optonline.net Field Contact: LISA CALABRIA Alt Phone: 914-419-7035 i • Working for: CALLER IS PERFORMING THE WORK THEMSELVES ------------------------------------------------------------------------------ Comments: Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: ALTICE USA BELL-VALHALLA/ WSCHSTR CONED SUEZ WTR WESTCHESTER TEN GAS-HDS VLY VIL RYE BROOK WESTCHESTER CTY SWR 2 J } i� p EC ENE JUN 2 0 2022 VILLAGE OF RYE BROOK BUILDING DEPARTMENT DRIVE 02�8 �1.2! d0 �0t�1�1A ),RBpR ALL zzoz o r�r�' S *6. 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