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HomeMy WebLinkAboutSP22-006W) Expo PERMIT # � t 09C0 DATE:. 7L `�a SECTION /7 �� ;> 7 BLOCK L07 TYPE OF WORK �('G� JOB LOCATION I 1-i` I 1, - - �_._ ., / n _/mil-/. CONTRACTOR CV 1 G 2.0E. ) q� T. COST �! CO # c TCO # FEE DATE INSPECTION REC�D DATE FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING ED RGH PLUMBING GAS m SPRINKLER _/ ELECTRIC �J LOW -VOLT C] ALARM 0 AS BUILT O FINAL INSP cf� oJ- 005 OTHER APPROVALS �0 C ARB id BOT PB IzeA tt OTHER toE. moo Jj V L��v t uV Vv� 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 September 22,2023 Win Ridge Realty LLC c/o Alena Hakanjin 24 Rye Ridge Plaza Rye Brook,New York 10573 Re: 116 South Ridge Street, Rye Brook,New York 10573 Parcel ID#: 141.27-1-6 Sign Permit#22-006 issued on 7/27/2022 for New Sign &New Awning This certifies that the new sign and awning;Chop't,installed under the above captioned permit has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to ri D EC Eff For office use only: BUILDING DEPARTMENT PERMIT FAUG15 2023 VILLAGE OF RYE BROOK ISSUED: —a,:). 938 KING STREET,RYE BROOK,NEW YORK 10573 DATE: JR VILLAGE OF RYE BROOK (914)939-0668 FEE: -.'6/p-_ PAMJW BUILDING DEPARTMENT www,ryebrook.org APPLICATION FOR CERTIFICATE OF OCCUPANCY,CERTIFICATE OF COMPLIANCES AND CERTIFICATION OF FINAL COSTS TO BE SUBMITTED ONLY UPON COMPLETION OF ALL WORK, AND PRIOR TO THE FINAL INSPECTION titittit+tittiittttitt►►ctft►tt►►tttttttitttiff■t►tft►ft►ttttttiitiift►tffftff■fffttt►tttt►tttttttitittiitit►ti►ttititttt♦►f►t► Address: 1 Rwr Occupancy/,,Use: (�}m m e y-Z,,l,,aQ" Parcel ID#: /7 f. o� 7�J 4� `IC- Zone: C1 1n Owner: WTN r`�C1RV ,I c Address: I" R�c'* V1 rf?& P.E./R.A. or Contractor: 516,nl L,f—S jL-rl ��� ��v�Address:q64 Ll- 1 1 jeA A-Uen. ft�2� C�neSkc��',TIOS-73 Person in responsible charge:S1U�� �IC�N-�� SAddress: �IO� �►7rl+,�f�f�,/e . Y � af�C��/� j 0�5�3 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 NE�W,p,YORK,COUNTY OF WESTCHESTER as: � �- JI�*� L I aA being duly swom,deposes and says that he/she resides at I t* 1j'%) (Print Name of Applicant) (No.and Street) in a cliewi`1 L ,in the County of 1 Jli������ in the State of- that (Cityfrown/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:$ 00010 0 , 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-I O.A.of the Code of the Village of Rye Brook. Sworn to before me this Sworn to,before me this �J day of v�I , 20 Z 3 day of , 20� S e of Prop4ty Owner ?4;ojr- Signature o p craft t I Print Name o Property.GlUA%r Print a of Applicant All Notary blic No Public LOTS NIETO THgMAS J CURTIN NOTARY PUBLIC, STATE OF NE Notary Public,State of New York 1(II,Y(�I�K Reg.No.o1CU6341697 NO. OI N14899825 Qualified in Westchester County QUALIFIED IN WESTCHESTER COUNTY Commission Expires May 9,2024 COMMISSION EXPIRES DECEMBER 3, 2026 �E BRC�� cu � '9b2 BUILDING DEPARTMENT ILDING 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 - - - - - - - - - - - - - - - - - - - - W,0 ADDRESS : `' `, DATE: ` 4�2 PERMIT# `� ISSUED: SECT: �`� BLOCK: LOT: LOCATION: 1�"' "�� � 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 �O'FINAL �' �J OTHER : a Q N O 9; gg o� H cn v ~ . '8 O r [z] o e-� .. o w e cl a O W o p 1.0 .W p Cn ry Ad � � CI v a ^ • o z � Ip � as A �-+ w a . O00 z Q~ 2 O ' (j 0-4 a V W n W p a z o I ' >n o a u N z m d a� z w A z c wa10 � � c° © � � V ~ t O t , P 1 cn U.- L" O II-y_I z P� � o O F_I �O'! © © C CR U �, 0 L'i a'"i ,o G O CL A p ,g V � rl4e� �71NM�ll1�la�7�.������P�� P�� P� i�VI i���� '{•I711 V V���W��:1 �A�7�A�W��� BUILDING DEPARTMENT E C V/ j VILLAGE OF RYE BROOK # D31 938 KING STREET RYE Mom,NY 10573 JUN 2 1 2022 (914)939-0668 www,atbrouk erg VILLAGE Or RYE BROOK EUILDiNG DEPARTMENT FOR OFFICE USE ONLY: JUL 2 6 1012 -Oc& Application# Approval Date: ermit pp Approval Signature: ARCHITECTURAL REVIEW BOARD: Disapproved: Date: -714VIZZ BOT Approval Date: Case# : Chairman: PB Approval Date: Case# : Secretary: ZBA Approval Date: Case# Other: Application Fe —AbPermit Fees: SIGN PERMIT APPLICATION Application dated: l v is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the construction/installation of a sign in accordance with Village Code§250-35 as per detailed statement described below. /? Q 1. Address:-d ly 3, �1f1 /'. �r SBL: /W,oZ 7• / '�,G Zone:(2/—/ 2. Property Use or Business Name:cf ncrr 3. Proposed Sign(s)(Describe in detail including number of signs,types,sizes,exact location(s),and illumination method(s)if applicable.) to separate EleLcctrical Permit will be required f/o�any associated electrical work.) : / rzd- c ✓� r t a S' —3 w,� � 4. Height from grade to highest point of sign: � r to lowest °mt of sign: ff- 5. Property Owner W l In 12td W a, Peal � �T Address: t e' IQ - t" Phone# i'J ' 1)y -,7`61.E-5 Cell# email: (ri�1 ' ti ,1 6. Applicant: Phone# l A4 Cell# email:!S�a.zQ I S ( i 'W r" 7. Architect/Engineer: Address: Phone# Cell# email: I 8. Sign Contractor(:_�ya /" h Address: I/04 Phone _Cell# email: c�A) C u -t- 8/12/2021 9. Will the proposed s'gn require a Site Plan Review by the Village Planning Board as per§209 of Village Code? Yes: No: (If yes,you must submit a Site Plan Application,&provide detailed drawings) 10. Does the proposed sign involve a Home-Occupation as per§250-38 of Village Code? Yes: No: /If yes,indicate: TIER I:_TIER II:—TIER III: (If yes,a Home Occupation Permit Application is required) 11. If building is located on a corner lot,which street does it front on: 12. Property frontage: �I 13. Property size:Sq.Ft.: Acres: 14. What is the total estimated cost of construction: $ (The estimated cost shall include all site improvements,labor,material,scaffolding,fixed equipment,professional fees,including any material and labor which may be donated gratis.) 15. Estimated date of completion: This application must 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. STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: r f05 f4 k Z-an Zc— ,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 t, 4— for the legal owner and is duly authorized to make and file this application. (indicate architect,con,tractor,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 i .L Sworn to before me this day of � �I , 20 day of LZ , 20C e of Prop 9wner T Signature licant 66C IN&LCS14 C Jh ZZZ-0 Print Name of Property Owner A&/J Print Name ol Applicant PAU'W&_ Q�� A Notary Public Notary Public LOIS NIETO NOTARY P B 10,� �2 NEW YORK SUSIE BRUNELLI QUALIFIED IN WESTCHESTER COUNTY COMMISSION EXPIRES DECEMBER 3,202¢L NOTARY PUBLIC,STATE OF NEW YORK Registration No. 01 BR6146106 Qualified in WESTCHESTER COUNTY County -2_ "nmmission Expires MAY 15, 2026 8/12/2021 i i N N N N Ln 006 s W oo V) x v 00 E N J H z f c x O zLO o N x A Z O U p a N " y R� f�A V x Ln cn N 00 o ` Gq C7 lLn Z00 u co z co rr L Z C)ts 4 W Mcl� �0 U ZO w c7 H z h C7 Q z � W a V 00 ,� � � V Z W A F � w � = • � CIO a O w W c Z zF a o. rA z OZ w C a d ° < 4� z � w = � 4 144444t a s o a = 4f��� � e ¢s 4 a s : . s a � ' J U L 11 2023 DD BUIL Ey MENT VIL E OF RYE OK VILLAGE OF RYE BROOK 938 KIN ET RYE B ,NY 10573 BUILDING DEPARTMENT w or ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY � EP#: C;)S—15C- PP Ul. Approval Date: � 1 Permit Fee: $ / �� ��� Approval Signature: Other: Application dated, May 17, 2023 is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install and/or remove electrical equipment, wiring, fixtures, or to perform other high or low voltage electrical work as per the detailed statement described below. By signing this document, the applicant & property owner agree that all electrical work performed will be in conformance with all applicable Federal. State,County and Local Codes. 1.Address: 116 South Ridge Street- Rye Ridge Shopping Center SBL: 141.27-1-6 Zone: 2.Property Owner: Win Ridge Realty LLC Address: 116 South Ridge Street Phone#: 914-701-4005 Cell#: email: 3.Master Electrician/Licensed Installer: Frank J. Turano Address: 3150 East Tremont Avenue Lic.#: 1292 Phone#: 718-931-0011 Cell #:914-420-8989 emailfjturano@iconicelectric.com Company Name: Iconic Electric Corporation Address: 3150 East Tremont Avenue, Bronx, NY 10461 4.Proposed Electrical Work/Fixture Count: Install new 20-ampere, 120-volt circuit for a new store front sign on the front of the building. Circuit to be left in a box with a toggle switch or the sign company to ma e e Ina connec Ion. 5.31 Party Electrical Inspection Agency: SWIS, 1080 Main Street, Fishkill, NY 12524 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: Frank J. Turano ,being duly swom,deposes and states that he/she is the applicant above named,and does further (print name of individual siening as the applicant) state that(s)he is the Vaster Electrician for the legal owner and is duly authorized to make and file this application. (Master Electrician/Licensed Installer) The undersigned further states 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 Sworn to before me this 10+K day of 20 day of o 1 20 Z�5 /ti/tciv..t7' Signature of Property Owner Signature of A licant Frank J Turano Print Name of Property Owner Print ame of Applicant Notary Public NOi- NOTARY Pl1BLJC,STATE OF NEW YORK Registration No.01 PA8385816 Qualified in Bronx County CW,piesbn Eupkes iw%wy 14.20 3!3!'_(i23 STATEWIDE • Service With bilegril-I 1:1 Main Street,Fishkill, NY 12524 1 emoil:office@swisny.com SWIS JOB APPLICATION tel 845.202.7224 1 fax 914.219.1062 • SWISTraining.corn Office Use Elect.Permit# r Date Bldg Permit# Utility ID# Final Certificate# City/Village � �� Zip 1 ,J� 3 Township ` �, C2 i,�,i` County , Address /n 1�tl )� Cross Street SedionV Block vot Owner Name/Address(if different than above) Contact Number ❑Basement ®1 st Fl. ❑2nd Fl. ❑3rd Fl. ❑More Than 3 Fl. ❑Garage ❑Attic ❑Outside ❑Residential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms Carbon Monox Hood Trash Compact Amt Amps Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Warm Draw Incandescent Fluorescent SERVICE Amperage Voltage 1 P 3P It Meters #Disconnect ❑Underground ❑New ❑Reconnect ❑Overhead ❑Change ❑Visual Re-Inspection ❑ Safety Re-Inspection ❑ Re-Inspection Additional Information 20 1ZOv �c u:� -��� �.e,,, ,z �..� S� -ram 1CAN"%-e C; rC_tA ;'1 ',ti c JUL 1 1 2023 ID VILLAGE OF RYE BROOK BUILDING DEPARTMENT This application is valid for one(1)year from the date received by SWIS.This application is intended to cover the above listed items to be inspected,t at any time of inspection additional items have been installed,you are authorized to make the inspection and adjust the fee for the additional items inspected.The applicant declares that there is no open applications for the above address with any other Inspection company.The applicant,owner or authorized agent agrees to all the above terms and conditions as set forth for the application. Inspector Date Finalized Inspector# ` Company Name Date "1 } ; Signature �^ Address ^� r J r 1 City/State (—i Zip Code / License# �. 'I Phone# State Wide Inspection Services 1080 Main Street Fishkill, NY 12524 'JUL 3 1 202 J �--� 845 202-7224 Phone X0 IV 0 S 1 914-219-1062 Fax STATE WIDE INSPECTION SERVICES VILLAGE OF RYE BROOK Email: office@swisny.com BUILDING DEPARTMENT Website: www.swisny.com Service With Integrity BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: Iconic Electric Corporation Win Ridge Realty LLC Frank J Turano 116 South Ridge Street 3150 East Tremont Avenue Rye Brook, NY 10573 Bronx, NY 10461 Located at: 116 South Ridge Street, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP 23-152 141.27 1 6 Certificate Number: 2023-5589 Building Permit Number: SP 22-006 A visual inspection of the electrical system was conducted at the Commercial occupancy described below.The electrical system consisting of electrical devices and wiring is located in/on the premises at: 116 South Ridge Street, Rye Brook, NY 10573 The Exterior was inspected in accordance with the NYS and NFPA 70-2017 and the detail of the installation,as set forth below,was found to be in compliance on the 21st day of July 2023. Name Quantity Rating Circuit Type Store Front Sign 01 20AMP 120V 7127-1 Officer: Frank J. Farina This certificate may not be altered in any way and is validated only by the presence of a seal at the location indicated.This certificate is valid for work performed on the date of inspection only. Building Permit Check List&Zoning Analysis :Address: l �o ��D� �� SBL• l ` •Z� — l " Zone: C k Use: Const.Type:, Other. Submittal Date: Revisions Submittal Dates: Applicant: Lj t N _7,���'E_ Nature of Work l.._s 141- -� Z view •ZBA: J UN 2 8 1011 PB• BOT• Other. ( ( ) g -3 C/o,Fn A Flood Plane: Legalization: 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: ( ) (JJ PLANS:Date Stamped Sealed ✓ Copies: -2- Electronic. ✓ Other. ( ) (Jf License Workers Comp: ✓ Liability: �mp.Waiver. r.Othe ( ) ( ) CODE 753#: Dated: N/A: (� ( ) HIGH-VOLTAGE ELECTRICAL:Plans: Permit: N/A: Other. ( ) ( ) LOW-VOLTAGE ELECTRICALPlans: Permit N/A Other- FIRE ALARM/SMOKE DETECTORS:Plans: Permit: H.W.I.C.:_Battery:_Other. ( ) ( ) PLUMBING:Plans: Permit Nat. Gas: LP Gas: N/A/: Other. ( ) ( ) FIRE SUPPRESSION:Plans: Permit: N/A Other. ( ) ( ) H.V.A.C.: Plans: Permit: N/A Other. ( ) ( ) FUEL TANK Plans: Permit: Fuel Type: Other. O O 2020 NY State ECCC: N/A: Other. ( ) ( ) Final Survey Final Topo: RA/PE Sign-off Letter. As-Built Plans: Other. ( ) ( ) BP DENIAL LETTER: C/O DENIAL LETTER: Other. ( ) ( ) Other. (4ARB mtg.date: 2-0 1-approval notes: ( )ZBA mtg. date: approval• notes: ( )PB mtg.date: approval• notes: REOLMED EXISTING PROP APPROV Am , JUL 2 �022 Cir Fm= Front: Front: Sides: lW Main Cor. Accs.cov: F S S .HS • S,Fa Tot, Ian : F I : Par ' HHd ht/Stories: notes: BUILDING DEPARTMENT VILLAGE OF RYE BROOK UN 2 1 20 ` 938 KING STREET RYE BROOK,NY 10573 ' (914)939-0668 VILLAGE OF RYE BROOK www.rvebrook.ors! R(jil n,F nn.RTNI=NT 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:�/& S L. [,1�a& 91 - Date S bmission: Parcel ID#:/�/,pt'� �/ �j Zone:C � of Proposed Improvement(Describe in detail): APPLICANT CHECK LIST: MUST BE COMPLETED BY THE APPLICANT The following items must be submitted to the Building 14'' ` Department by the applicant-no exceptions. 1. D'` Completed Application Property Owner: f 1 u 2. KTwo(2)sets of sealed plans. (one full size (maximum Address*4 K 1 r"r t`� allowable plan size=36"x 42") and one I VxIT') 1 D Z3 3. Two(2)copies of the property survey. Phone# l3t� _— 4. Two(2)copies of the proposed site plan. Applicant appearing before the Board: 5. ( One electronic/disc copy of the complete application materials. Kati cSrC�N ---�L� L,) iIUG-7 6. Filing Fee. Address:i 64 j,J, ,.Le t411,0673 7. ( )Any supporting documentation. Phone# - 3 2 - 8. ( )HOA approval letter. (fapplicable) 9. ( j 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. l r'- Swom to before me this f Z Sworn to before me this / day of 20 2 Z day of t- ,20 02 1� Signature of Propeox, Signa&I-) t // � �� s K( IZ1.��1�1 S l��-�7 Z-a, Print Name of Property()aaEr �� Print Name of Applicant Notary NotarLM N I ETO SUSIE BRUNELLI NOTARY PUBLIC, STATE OF NEW YORK NOTARY PUBLIC,STATE OF NEW YORK NO.01 N M99825 Registration No.01BR6146106 QUALIFIED IN WESTCHESTER COUNTY Qualified in WESTCHESTER COUNTY County COMMISSION EXPIRES DECEMBER 3,2021 Commission Expires MAY 15, 2026 1 8n2/2021 ' VILLAGE OF RYE BROOK BUILDING DEPARTMENT 938 KING STREET, RYE BROOK,NY 10573 (T) 939-0668 (F) 939-5801 ARCHITECTURAL REVIEW BOARD Wednesday, July 20, 2022 NAME&LOCATION TYPE OF APPLICATION MOTION SECOND APPROVED REJECTED APPL.# 7 Talcott Rd Roof Top Solar Array Consent 57254 (Ambati) System Agenda 18 Belle Fair Rd 4' High White Vinyl Consent 5726 (Desai) Privacy Fence - Rear Agenda 412 N. Ridge Street Roof Top Solar Array Consent 5 72 7 (Yu) System Agenda 65 Winding Wood New 6' High Fence In Consent 5728 Rd(Rubin) Rear, 4'High Side Front Agenda 66 Valley Terrace Roof Top Solar Array Consent 5729 (Friedlander) System Agenda 283 Neuton Ave Roof Top Solar Array Consent 5730 System Agenda 30 Argyle Road 2 Story Addition, & 1 5731 (Nunziato) Story Addition 14 Elm Hill Drive Re-Do Rear Patio, Add 5732 (Levinson) Fire Pit& Outdoor Kitchen 217 S. Ridge Street New Business Signs 5733 (Riemer Insurance group) 37 Winding Wood New Rear Wood Deck & 5734 Road(Chi) Masonry Patio 116 S. Ridge Street New Sign& Store Awning 5735 (Win Ridge) For"Chopt" "lam �\ 27 Lawridge Drive Resurface Pool Patio and \ 5736 (Goldstein) Add Spa to Pool ML NM MR ,/ SE JM f SF AC / MI KC VILLAGE OF RYE BROOK BUILDING DEPARTMENT 938 KING STREET, RYE BROOK,NY 10573 (T) 939-0668 (F) 939-5801 ARCHITECTURAL REVIEW BOARD PAGE 2 July 20, 2022 NAME&LOCATION TYPE OF APPLICATION MOTION SECOND APPROVED REJECTED AP_PL#_ 6 Edgewood Drive 2nd Story Side Addition 5737 (Shalem) 32 Country Ridge Amendment to Prior 5738 Dr. (Hochfelder) Approval 6 Eagles Bluff Basement Addition 5739 (Bruantuch) w/Patio Above & Mesa Block Wall ML NM MR SE JM SF AC MI KC ®ICORO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDlYVVV) 06/20/2022 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 Stacie Washington NAME: Borrelli Partners Insurance Agency PHONE (914)939-7900 FAx (914)407-5088 AIC No Est: AIC,No): 287 Bowman Avenue E-MAIL swashington@borrellipartners com ADDRESS: Suite 406 INSURER(S)AFFORDING COVERAGE NAIC 0 Purchase NY 10577 INSURERA: Travelers Casualty Ins Cc ofAmerica 19046 INSURED INSURER B: Travelers Indemnity Cc 25658 Lanza Corporation INSURER c: Phoenix Ins Cc 25623 dba Sign Design&J C Awning INSURER D: 404 Willett Ave INSURER E: Port Chester NY 10573 INSURER F COVERAGES CERTIFICATE NUMBER: CL2252603715 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 CONTRACTOR 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 INSRR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1.000,000 CLAIMS-MADE FX OCCUR PREMISES ClEa occurrence $ 300,000 MED EXP(Any one person) $ 5,000 A 6805J175092 06/05/2022 06/05/2023 PERSONAL&ADV INJURY $ 1,000,000 MGEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY El JECTPRO_ LOC CPRODUCTS-COMP/OPAGG $ 2,000,000 OTHER S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident S UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 B X EXCESS LIAB CLAIMS-MADE EX5J175240 06/05/2022 06/05/2023 AGGREGATE S 5,000,000 DED I X RETENTION$ 10,000 $ WORKERS COMPENSATION YIN PER OTH- AND EMPLOYERS'LIABILITY STATUTE X ER 500,000 C ANY EMBER/PARTNER/EXECUTIVE N/A UB5J175160 06/05/2022 06/05/2023 E.L EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E L DISEASE-EA EMPLOYEE S 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) BLANKET Al-OWNERS,LESSESS OR CONTRACTORS,AI-MANAGERS OR LESSORS OF PREMISES,AI-STATE OR POLITICAL SUBDIVISIONS PERMITS RELATING TO PREMISES,Al LESSOR OF LEASED EQUIPMENT,PRIMARY&NON-CONTRIBUTORY WORDING,WAIVER OF SUBROGATION-WC POLICY INCLUDES BLANKET WOS 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 NEW Workers' YORK STATE Compensation CERTIFICATE OF Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1a. Legal Name&Address of Insured(use street address only) 1b Business Telephone Number of Insured Lanza Corporation 914-937-6360 DBA Sign Design and J C Awning 1c NYS Unemployment Insurance Employer Registration Number of 404 Willett Avenue Insured Port Chester, NY 10573 Work Location of Insured(Only required if coverage is specifically limited to 1d.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e, a Wrap-Up Policy) Number 13-3525268 2 Name and Address of Entity Requesting Proof of Coverage 3a. Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Phoenix Ins Co Village of Rye Brook 3b Policy Number of Entity Listed in Box"la" 938 King Street LlB5J175160 Rye Brook, NY 10573 3c Policy effective period 06/05/2022 to 06/05/2023 3d, The Proprietor,Partners or Executive Officers are ® included (Only check box if all partners/officers included) all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"3" insures the business referenced above in box"1a"for workers' compensation under the New York State Workers'Compensation Law. (To use this form, New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2" Will the carrier notify the certificate holder within 10 days of a policy being cancelled for non-payment of premium or within 30 days if cancelled for any other reason or if the insured is otherwise eliminated from the coverage indicated on this certificate prior to the end of the policy effective period? YES ®NO This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note: Upon cancellation of the workers'compensation policy indicated on this form,if the business continues to be named on a permit, license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers'Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury, I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Stacie shington 4La ' ameof authorized representative or li ense 2gent of insurance carrier) Approved b (Date) Title r lam/ Telephone Number of authorized representative or licensed agent of insurance carrier 914-939-7900 Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. 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