Loading...
HomeMy WebLinkAboutBP22-200PERMIT # SECTION TYPE OF WO JOB LOCATIC OWNER/ CONTRACTO . /EST Y COST CO #, a �j®# I o C) — �e FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING M RGH PLUMBING GAS 0 SPRINKLER ELECTRIC C7 ;OW -VOLT O ALARM 0 AS BUILT FINAL DATE I xP: I BLOCK / o !� Ve/a Ip FFFvg FEE DATE INSPECTION RECORD DATE INSP n Klar larcl OTHER APPROVALS AS-SUILTIFINAL SURVEY REQUIRED PRIOR TO I FINAL INSPECTION DR 4' . 19 � O VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914)939-0668 Christopher J. Bradbury www.aebrook.org TRUSTEES ACTING BUILDING& FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M.Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE March 1,2023 Marc Abramson&Erika Abramson 47 Hillandale Road Rye Brook,New York 10573 Re: 47 Hillandale Road,Rye Brook,New York 10573 Parcel ID#: 129.84-1-21 Building Permit#22-200 issued on 10/21/2022 For a New Fence This certifies that the new six foot high white vinyl rear yard fence,installed under the above captioned permit has been satisfactorily completed. Sincerely, Steven E. Fews Acting Building&Fire Inspector /to RLE C E N V 'E R� For office use onI DD BUILDINd kTMENT PERMIT#, JAN 2 4 2023 VILLAGE OF RYE BROOK ISSUED:ZQ— — 938 KING STREXT,RYE BROOK,.NEW YORK 10573 DATE: — — VILLAGE OF RYE BROOK (914)939-0668 FEE: — PAM29 BUILDING DEPARTMENT www,ryjbrgokerg 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 prr►r►►►►►►►►►►►wwwwww�w,wwwwrwwwww rwwr►wp•rrrr►►q►►►►►►►►►►►►►►w►wwwwww wwwwrrrrpwrwrrww rrw►►►►►►►►►►►►www►ww►►wwwww►www►w■ Address: 7 1 1 f 4 `""p— kooA Occupancy/Use: r-91,Y Parcel ID#: 1 a 9 • g V — ' — Q I ff Zone: s Owner: mq'C. +' E fr C-g. ()b rb( ` M ZOn Address: ` 7 14 t[lCnkQ. Roo d P.E./R.A.or Contractor: Address: �V`1`S St rg-FOU(,� <1 aov3c Person in responsible charge: Address: i 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 ' ` 1 CWC A b�r�5o n being duly sworn,deposes and says that he/she resides at 7 r ►`''q r1�'Q, i2 pot d (Fria`erne of Applicant) (No.and Street) in1(�,/ &Ook in the County of UO.SAS69kr- in the State of ,that (City/Town/Village) he/she has supervised the work at the location indicated above,and that the actual total cost of the work,including all site improvements, labor,materials,scaffolding,fixed equZi ment,professional fees,and including the monetary value of any materials and labor which may have been donated gratis was:$ Q 000 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 Z -(1- Sworn to before me this day of 3CI 4"r,r�- , 20 2- day of , 20 Signature of Property Owner Signature of Applicant Mot' .G DIANNE ROJAS �✓`/rq,�,��h Notary Public-State of New York Print Name of Property Owner No.Ot R06127547 Print Name of Applicant Qualified in Westchester County l Ca My Commission Expires May 23,2025 . t,. � Notary Public Notary Public 8/12/2021 �yE BRO o`` tim 1932 BUILDING DEPARTMENT XILDING 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 : 1�1 1 V DATE: I�20 PERMIT# ��- ISSUED:,6�2('-L�ECT:' 6; "�( `BLOCK: LOT:Z k LOCATION: tV S \� OCCUPANCY: -Q ❑ VIOLATION NOTED HE WORK IS... ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ C SS CONNECTION INAL OTHER _ N N N `" s ■ N N N o cn : W M la, = W O : Q, �rA-, �./ 00 ; Nto O a $ i O h+� fn W w o °c v ° 1P-4 %�Q 0 8 0 \ W OD 0 lu 1+1 Q -v �'� moo" Q h M N ti z .y �••� W wo3 W W z O .� OO 0 Z;� o ° W e 1-2. E I C> V u 0-4 M H O O d U N �" z w z a, W w z M W oQ° u A a s N w > Q 0 Wy OI O o �q N �T� ■ G� 1II.1 oGl W W Z E 0 ,5 LSO 0 \ h+l �] M op b ■ t o 14 a H o ° � � v � S pc v z 8 o b 5� w Q � � Cd aao� z $ o �iwcl Z W W 1-1 O 0 >' ° 5cl '' o W W � u a u: �-' E D BUILDING DEPARTMENT E C E N VILLAGE OF RYE BROOK AUG 1 0 2022 938 KING SWMT RYE BW)OK,NY 10573 (914)'39_4►6$ VILLAGE OF RYE BROOK v+ yw.rl�,^ rg BUILDING DEPARTMENT FOR OFFICE USE ONLY: Approval Date: $E P 2 2 If Permit ��� Application# —7-54 Approval Signature: ARCHITECTURAL REVIEW BOARD: Disapproved: : Date: Z BOT Approval Date: Case# Chairman: PB Approval Date: Case# Secretary: i ZBA Approval Date: Case# Other: Application Fee Permit Fees- FENCE / WALL / GATE PERMIT APPLICATION Application dated:9—/0 —� 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: a 7 ��l�A► 4OQ Q p 2. Occupancy/Use: /�RL'�'J S.B.L.#: 7 r O —�� � Zone: 3. Proposed Fence/Wall/Gate(describe in detail): 4. Property Owner: Ma ye- ArprtY*"04 Address: �q 7 hie��+lS!/9�G RP/ 4G B"Uuf /V+y /or Phone 41 7 41� 6 Cell# email: Applicant: Address: e u S S+. Ciee,l1y,ch Cf- F-?0 Phone# Cell# ,903 `25 3 - ) 7 17 email: dbJe f gWe�n( m�C {�7r''1 Architect/Engineer: Address: Phone# Cell# email: Contractor: F ve AD y'y� Address&Phone: •_ `� , eW/S �.S 2e7 C/Pe--7WIA, CT O& 3Q 5. If building is located on a comer lot,which street does it front on: /C 7/7 6. What is the estimated cost of construction f Q S Gb C) (NOTE:The estimated cost shall include all site impmoveme ts,labor,material,scaffolding,Rated equipment,professional fees,and material and labor which may be donated gratis.) / 7. Estimated date of completion: *//5 / �Z- S $112/2©21 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. S TE OF NEMYOM COUNTY OF WESTCHESTER ) as: 1' l�(NYIQ ,being duly sworn,deposes and states that he/she is the applicant above named, (punt name of individual signing as the applicant) and er s #es tha (s)he is the legal owner of the property to which this application pertains, or that (s)hc is the TQ atfGt G (c 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. Swom to before me this S f' Swom to before me this day of ,20 Z Z day of , 20 Signature of Property Owner Signature of Applicant tqrC, A 0­4 05-1sp t ame of erty Owner Print Name of Applicant o Pub Notary Public ANTHONY S TERRANERA Notary Public-State of New York NO,olTE6324959 Qualified in Westchester County My Commission Expires Jun 21. 2023 2 8/12/2021 Building Permit Check List&Zoning Analysis Address: �1_ LL A,1--�>Al�F _=�� SBL: Zone:��Z� Us Const.Type: Other. Submittal Date: `J 10 12 Z Revisions Submittal Dates: Applicant: '4-l S O v Nature of Work. C- rt''�x L(, W l X y l— C-r- )�A S'� Reviews:ZBA: A U G 1 7 2022 PB: BOT: Other. hMER OK ( ( ) FEES-Filing- BP: y ' C/O: Flood Plane: Legalization: ( ) (%.Y APP: Dated- otarized: SBL: ✓Truss I.D. Cross Connection: 7 H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening- ( ) ( ) ENVIRO: Long. Short Fees: N/A: ( ) ( ) SITE PLAN:Topo: Site P otection S/W Mgmt.: Tree Plan: Other. ( ) (� SURVEY:Dated: (D 12.E I 2 Current: ✓ Archival: Sealed:T Unacceptable: ( ) ( ) LANS:Date�Stamped: Seale Copies: Electronic: Other. ( (, ' erase ✓ Workers Comp: Liability �mp.Waiver. Other. ( ) ( ) 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: Z l Z Z approval• 'L notes: ( )ZBA mtg.date: approval• notes: ( )PB mtg.date: approval• notes: APPReVED REQUIRED EXISTING PROPOSED NOTES S E P 2 2 2011 �: Date: Cirde: Fr n e Front_' Front: Sides: Rgr. Main Cov Accs.Cov Ft.H Sb: S .H Sb: G.GFA: Trot,ling: Ft.Im : Height/Stories: notes: BUILDING DEPARTMENT R [E C IE � �/ E VILLAGE OF RYE BROOK 938 KING STREET RYE BROoK,NY 10573 AUG I 0 2022 1�=g . VILLAGE OF RYE BROOK 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 his check list will be removed from the ARB agenda. Job Address: `�' 7 hl, I�.,�dct le IQ Date of Submission: Parcel ID#: Zone: Proposed Improvement(Describe in detail): R�a cd fell C e APPLICANT CHECK LIST: MUST BE COMPLETED BY THE APPLICANT The following items must be submitted to the Building ^^^^ nn Department by the applicant- no exceptions. Property Owner:Mar(l 1. ( Completed Application 2. ( )Two(2) sets of sealed plans. (one full size(maximum Address:4�7 Rle. grwo/" �Ir tosZ3 allowable plan size=36"x 42"; and one I Fx IT') 3. Two (2) copies of the property survey. Phone# 7 66q 7�l 66 4. ( )Two (2) copies of the proposed site plan. Applicant appearing before the Board: 5. One electronic/disc copy of the complete 9ht�vt�y tqye4, application materials. 6. ( Filing Fee. Address:5r L,e ,-E Sy, +w%��i G7 7. ( ) Any supporting documentation. Phone# ZOj 2 3'3 121,2 8. ( ) HOA approval letter. (if applicable) 9. ) Photographs. Architect/Engineer: 10.( ) Samples of finishes/color chart. (a sample board or model may be presented the night of the meeting) Phone# By signature below, the owner/applicant acknowledges that he/she has read the complete Building Permit Instructions& Procedures, and that their application is complete in all respects. The Board of Review reserves the right to refuse to hear any application not meeting the requirements contained herein. Sworn to before me this -/ f-A Sworn to before me this day of y . 20 2 Z- day of , 20 Signature of Property O fwner Signature o Applicant U- l u~L int lame of Pro Print Name of Applicant Notary Nblic Notary Public EANTHONYSTERRANERA c-State of New York 01TE6374959 Westchester County n Expires Jun 21, 2023 8/12/2021 DR(�v� Village of Rye Brook Agcnd Architectural Review Board Meeting Wednesday,September 21,2022 at 7:30 PM Village Hall,938 Sing Street / J 1. ITEMS: 1.1. #5741 (Consent Agenda) Re-Appearance Marilyn Ullman&Lena Vladsky 51 Greenway Lane&52 Greenway Lane New Arbors standard design fencing. 1.2. #5753 (Consent Agenda) Srikanth Ambati&Pranitha Mantrala 7 Talcott Road Rooftop solar array. 1.3. #5754(Consent Agenda) Marc Abramson&Erika Abramson 47 Hillandale Road 6'-0"high white vinyl fence in rear yard. 1.4. #5755 (Consent Agenda) Matthew Byrnes&Helene Byrnes 7 Deer Run New windows to facilitate interior bathroom renovation. 1.5. #5756 (Consent Agenda) Philippe Ledesma&Tonella Ledesma 7 Bell Place 6'-0"high white vinyl privacy fence along rear yard. 1.6. #5757 (Consent Agenda) Benjamin Tapper&Erica Tapper 4 Deer Run Rooftop solar array. 1.7. #5767 (Consent Agenda) Pawling Holdings LLC 261 North Ridge Street New stone and clapboard siding. 1.8. #5768 (Consent Agenda) Ann Parkin&Jody Rasch 25 Hillandale Road Rooftop solar array. Page 1 of 4 1.9. #5769 (Consent Agenda) Michael Rosenfeld&Afton Rosenfeld 56 Lincoln Avenue 4'-0"high aluminum fence along bridge. 1.10. #5771 (Consent Agenda) Blake Silverman&Alexa Silverman 18 Milestone Road 4'-0"high fence in rear yard along BelleFair Boulevard and 4'-0"high fence in side yards. Consent Agenda Approvals: Motion -N(- Second J Abstention Aye; _ Nay; Q Adjournment; Notes 1.11. #5758 Blake Jacoby&Paula Jacoby 16 Elm Hill Drive Rear deck and hot tub. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.12. #5759 Michael Seidenfeld&Daniella Schneider 5 Jacqueline Lane Rear patio&retaining wall. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.13. #5760 Daniel Debari&Catherine Debari 11 Elm Hill Drive One-story addition. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes Page 2 of 4 �.� �;� �. �' � ��' � i t, a rn i - t' --- � {4. � " '�.� �1. � �' ., �� • '`'. 1 s � � �� �_ � "�-� �, . 4 N O 1 � U -� O Y �� V C) Page 1 of 1 i ///E:/Single%20Gate%20.jpg 8/10/2022 'S _. .., i. 1 � �_M � " ; �: - ;s �.: ti� � Laura Petersen From: Laura Petersen Sent: Thursday, October 20, 2022 10:30 AM To: MAA@SPEAKEASY.N ET Cc: buetidevelopment@mac.com Subject: Fence Permit Application -47 Hillandale Road Good morning, The Building Department has received the ticket number from UDig NY. Before I can issue the fence 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. Y3. General contractor's valid liability insurance (the Village Of Rye Brook must be the certificate holder) V4 General contractor's valid workers compensation on a NY State Board form (C105-2 or U26.3) 5. Building permit fee $375.00 (due once permit is issued and ready for pick-up) Thank you Laura Laura Petersen Office Assistant Village of Rye Brook 938 King Street Rye Brook, New York 10573 Phone(914)939-0668 1 Ipetersen(Wrvebrook.org 1 Laura Petersen From: Laura Petersen Sent: Friday, September 23, 2022 4:01 PM To: MAA@SPEAKEASY.NET Subject: Fence Permit Application -47 Hillandale Road Good afternoon, The fence permit application has been approved by the Building Inspector. Before I can issue the fence permit the following items must be submitted to our office; 1. General contractor's contact name & phone number. 2. Copy of general contractor's valid Westchester County Home Improvement License. 3. General contractor's valid liability insurance (the Village Of Rye Brook must be the certificate holder) 4. General contractor's valid workers compensation on a NY State Board form (C105-2 or U26.3) Building permit fee $375.00 (due once permit is issued and ready for pick-up) 6. Contractor must call UDig NY and get a ticket number. Thank you Laura Laura Tetersen Office Assistant Village of Rye Brook 938 King Street Rye Brook, New York 10573 Phone(914)939-0668 1 IaetersenDrvebrook.org 1 4t '•`F Y ,', ,: < ,yfJ • ♦• • .1 A y�r sf /M+� �l' '�' ' !'•v `�'Y .:i. v IIN + y"11�'' j:� S'•N"'�i O rtln`'�, a O 11/ f �r ♦♦ $ r . rs, �. �z. ;• ' �, ���.�,'--.flll/llljl' .111111111 rr�� � 1111111 � 111111 �IA /11/ vt? yA (0)> •:11.as�E : ill1 •'es1x� -'s5•�Illlr{ _a` �l /illllrr �v�.9..• � - 11 rF:'E *`:.111�111 IdS 0. 4 • f ,y N• h o rv+ 111\\ j• �� �/�c. w a+ (,� C) cz N WS� A. N (LO T ) \ co In wd x N • L O � .r.�ryy., �, �.Y t1♦)�.\ •� � ram+ �h •t � /I� a. L) O h (/ All co 00 ui U J > p 44 LLJ LLI � � w � ►. -.. .,�•.. 1\ � V .may O ?• Lo V cz co AV = a „ i7 C 'L7 11u1�€p-`ti�i 11j,111•?r'�"'3' �.IOff# q_f;.e'sa-�c�-a�.-ai, 1j tl'`:4 `F�fµ_.1. .;.:�' ,� •�.::. .;As a / c�^. 111//1/11 1 -- 1�11/�j/11 $ `_. _ Illl�tlll'.t5 .,,.111�{II �,03 :.111�11,` '"k�'�;•/ 1 r : ';'<(d))�� E v .;, , ♦• . 1 4li� �' 1 �'i•111: i�k11 I//j{j1 111)(111 ►11111 1111/11 1 �♦ ..} •. ��>• d111t g �i �I/I/j114 9qg \ RtF ^ r �♦ ^ L 1} ♦♦ .ylt �'A`t �F t ♦�• }i�i�wGf('. \ 0 � vKJimK a b�;l(ONOW �' � •`. .� \_—��, .. k'h� ..�� -- �� �.w�•L�f;�.•'•is �.�, . ,4 CERTIFICATE OF LIABILITY INSURANCE 7EOIMM/Do/YYYY) /19I2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Karen Sobel,CPCU,J.D. NAME: AssuredPartners Northeast,LLC. PHONE (203)989 4723 FAX (203)989-4723 A/C No Ext: A/C No Darton&Company E-MAIL karen.sobel@assuredpartners.com ADDRESS: 728 Post Road East INSURER(S)AFFORDING COVERAGE NAIC# Westport CT 06880 INSORERA: Mesa Underwriters Specialty Insurance Co. INSURED INSURER B Bueti Development Corp. INSURER C: 55 Lewis Street,Suite 7 INSURER D: INSURER E Greenwich CT 06830 INSURER F COVERAGES CERTIFICATE NUMBER: CL2291597160 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AUUIL bUtIlK POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DDIYYYY MWDD LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 'AMAUE ToCLAIMS-MADE FX OCCUR PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 A MP0006001042644 12/23/2021 12/23/2022 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ❑PRO- ❑ JECT LOC PRODUCTS-COMP/OPAGG g 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ElOFFICER/MEMBER EXCLUDED? NIA E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Evidence of coverage for permit to be pulled for 47 Hillanciale Rd,Rye Brook,NY 10573 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Village of Rye Brook ACCORDANCE WITH THE POLICY PROVISIONS. 938 King Street AUTHORIZED REPRESENTATIVE Rye Brook NY 10573 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ZYSTOATEW Workers' Certificate of Attestation of Exemption Compensation from New York State Workers' Compensation and/or Board Disability and Paid Family Leave Benefits Insurance Coverage "This form cannot be used to waive the workers'compensation rights or obligations of any party.** The applicant may use this Certificate of Attestation of Exemption ONLY to show a government entity that New York State specific workers'compensation and/or disability and paid family leave benefits insurance is not required. The applicant may NOT use this form to show another business or that business's insurance carrier that such insurance is not required. Please provide this form to the government entity from which you are requesting a permit,license or contract. This Certificate will not be accepted by government officials one year after the date printed on the form. In the Application of Business Applying For: (Legal Entity Name and Address): Building Permit Bneti Development Corp. 55 Lewis St From:Village of Rye Brook 938 King Street Rye Brook NY 10573 Greenwich,Cr 06830-5528 PHONE:203-253-1717 FEIN:XXXXX2193 The location of where work will be performed is 47 Hillandale Road,Rye Brook,NY 10573. Estimated dates necessary to complete work associated with the building permit are from November 1,2022 to January 1,2023. 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 a one person owned corporation,with that individual owning all of the stock and holding all offices of the corporation. Other than the corporate owner,there are no employees,day labor,leased employees,borrowed cmployees,part-time employees,other stockholders,unpaid volunteers(including family members)or subcontractors. Disability and Paid Family Leave Benefits Exemption Statement: The above named business is certifying that it is NOT REQUIRED TO OBTAIN NEW YORK STATE STATUTORY DISABILITY AND PAID FAMILY LEAVE BENEFITS INSURANCE COVERAGE for the following reason: The business MUST be either: 1) owned by one individual; OR 2) is a partnership(including LLC,LLP,PLLP,RLLP,or LP)under the laws of New York State and is not a corporation; OR 3) is a one or two person owned corporation,with those individuals owning all of the stock and holding all offices of the corporation(in a two person owned corporation each individual must be an officer and own at least one share of stock); OR 4) is a business with no NYS location. In addition,the business does not require disability and paid family leave benefits coverage at this time since it has not employed one or more individuals on at least 30 days in any calendar year in New York State. (Independent contractors are not considered to be employees under the Disability and Paid Family Leave Benefits Law.) I,Anthony N.Bueti,am the President with the above-named legal entity. I affirm that due to my position with the above-named business I have the knowledge,information and authority to make this Certificate of Attestation of Exemption. I hereby affirm that the statements made herein are true,that I have not made any materially false statements and I make this Certificate of Attestation of Exemption under the penalties of perjury. I further affirm that I understand that any false statement,representation or concealment will subject me to felony criminal prosecution,including jail and civil liability in accordance with the Workers'Compensation Law and all other New York State laws. By submitting this Certificate of Attestation of Exemption to the government entity listed above I also hereby affirm that if circumstances change so that workers'compensation insurance and/or disability and paid family leave benefits coverage is required,the above-named legal entity will immediately acquire appropriate New York State specific workers' compensation insurance and/or disability and paid family leave benefits coverage and also immediately furnish proof of that coverage on forms approved by the Chair of the Workers'Compensation Board to the government entity listed above. SIGN HERE Signature: _ Date: Exemption Certificate Num Receive 2022-071112 October 18, 2022 NYS Workers'Compensation Board CE-200 01/2018 Laura Petersen From: Mike Izzo Sent: Thursday, October 13, 2022 12:18 PM To: Laura Petersen; Steven Fews;Tara Orlando Subject: FW: Message from UDig NY From: UDig NY Exactix <tickets@exactix.udigny.org> Sent: Thursday, October 13, 2022 12:17:29 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: 10/13/2022 12:16 To: VIL RYE BROOK PRIMARY Transmitted: 10/13/2022 12:17 00002 Ticket: 10132-001-205-00 Type: Regular Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 47 To: Name: HILLANDALE RD Cross: From: To: Name: Offset: ------------------------------------------------------------------------------ Locate: STARTING AT THE HOUSE, LOCATE BOTH SIDES AND THE REAR OF THE PROP NearSt: KING ST Means of Excavation: POST HOLE DIGGER, AUGER Blasting: N Site marked with white: N Boring/Directional Drilling: N Within 25ft of Edge of Road: N Work Type: FENCE INSTALL Estimated Work Complete Date: 11/30/2022 Depth of excavation: 2 FEET Site dimensions: Length 300 FEET Width 10 INCHES Start Date and Time: 10/27/2022 07:00 Must Start By: 11/10/2022 ------------------------------------------------------------------------------ Contact Name: ANTHONY BUETI Company: BUETI DEVLEOPMENT Addr1: 55 LEWIS ST Addr2: City: GREENICH State: CT Zip: 06830 Phone: 203-253-1717 Fax: Email: buetidevelopment@mac.com Field Contact: ANTHONY GELETTI Alt Phone: 203-253-1717 Email: buetidevelopment@mac.com 1 • Working for: H/O ABRAHMSON ------------------------------------------------------------------------------ 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 Oz 0 LU cc1l'v p W� o 1p } F `ER` Q ��W Y u � ���r ni Z` Q 2• i F i•�a .o o�a c a �. E;'$ g G �y °c ��a -� c .. � y �"i�.�' '� LD LLJ ao ...�3`hz ateLU <gg Prop O$ I �7 p m W0 s m m >'"'Z Q o a Cat M O ©�4 e e r' � ' r (ii = ZQ(� �c.ekn .. W � 8ti L Y K 8 < 042.49'00'C ZLLI ?- Q o Q) stq 8 A a Q- ! N O� h� � t C �� �r-.-� �' � ►Y • ����.��. oi5ti of aPo�oR a J6'972 `^ F ��O r ...o-xmc+amymi� 2 ` `";. `zts t� m ti�5 i='. &B .mac r {Y �, 4✓ ONG It In rl o° ° o c�' a "y O o a o Zon o Cq o� o o� vzt o W E� � [•.� W O w u o won ICon rzt CS O y y • tea; to °'ti Q•o o� e o �a ° o En Z o ° � � � •� ti � W 3 '�' � o '� � m � � � � � .� '° � � F.+ � �' � ° '� � � � � .�>, � v � � '� � o� o � o � � ter' � , � o � F, O o �, 'N •N •� •� o o° U V h "Ci 5 ti IZO 4Ui ° ti a" 0. �CrC a�W 0 4:t4 •• N Q M �r ti ryJ, 00 V 0 z D a a �� N C° W Od o eat } d- I o a Lu en LL z o (D L7 zoo E-1 Q W z a 2 M W ' Q Uti2� V � I V p k Q) a Q) ^ 4 Q) k O C u tea) U x er Wig.. U � U Q) i5_- � Z 00" E Picket Fen Xe _x x o o5 42 49 x_---x--x-- C) U 4 U <° "---- Picket Fence _ _----*-- - w `L o o S ' A o - ---- aouaj app o� Q)! o � a� 'A apn�lookS n o CL m o _ 2 o m z I �;� Q) ^ a _ H x Q) N C)O M M U^ U M C p O m Q) U ^ O (p Q O 2 i o p Q) O U� N U N Q U o amp O) Q) U U U C U w U Ccvcv U o 3 o Q a II a) o a) 10.57' o c c a U� a�i c o o C U� 1 N o = a a Q, �$ Q. u_ Q) � ova w-0 O t o n a c� Mai .c xU h � p O Ln U m 2 ~ O o _ Q) ' a� w a) CL a) LO C Q o N a�i N O Q r) °� U Lo L �, O� va O 6- X N N r / o� L2 O a N 3 12 LU w x "a,nl �,SL'001 U O •S �- �S4 � Q t z r ^` O x a q-inj doaQ Ln j C 1 z x u C p _2 - a Q Jn N U � _ Q) q J auo � � C o o _-¢S.._.._ O -- - --- O N 0 o Q)m _ o w anua 4lpudsb Ln I\ ul c 6 q-inj dorq 0 qrn a ll-is N N Q Q) w,�� U 'pn _ ° Z NVx U p s CV N C N ti O U �j Z) +° • aoua� apa�Ioo�S f l aoua� x x x x aoua� apa�oo�S 96'99z M ,00 ,9F oG` N i. ul x u cV U Q) � U NV Q)C O U LT H LL y Q) �L y LL N L Q) Lo i +�- LL -3C C)^y l� 3 o Q) .� o M U o z° aouaplsa U o._., C a U,51 vM h