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HomeMy WebLinkAboutSP22-007PERMIT ik�� DATEFxP: SECTION f , BLOCK LOT 40 TYPE OF WORK IV S .01/4 JOB LOCATI N 0,41A / OWNERAA/ €� Ci� .LLC `7Ol' y00 CONTRALTO J / :B �C%eI — Slid p EST. COST FEE V//CO #0, C p FEE % DATE TCO #i FEE DATE �t�SPECTION RECORD l DATE I NSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING {� RGH PLUMBING GAS 0 SPRINKLER ELECTRIC LQ1•V-VOLT O Ai.ARM CI L. e e7 "6/ (9iy)937- & 3 6 0 � lt;lop 3 - / UL,4 Cp ,l is /�c�►-i e C'a��° OTHER APPROVALS ARB f tL!9L/�T,� /, c)o BOT PB ZBA OTHER QyE DR �. O , t9 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 5,2023 Win Ridge Realty LLC c/o Alena Hakanjin 24 Rye Ridge Plaza Rye Brook,New York 10573 Re: 102 South Ridge Street, Rye Brook,New York 10573 Parcel ID#: 141.27-1-6 Sign Permit#22-007 issued on 8/25/2022 for New Tenant Sign&Awning This certifies that the new tenant sign and awning;Customers Bank,installed under the above captioned permit has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to DD '� For office use Only: BUILDIN DEPARTMENT PERMIT# o� -Lap7 JAN 2 5 2023 VILLAGE OF RYE BROOK ISSUED: -c =c�a- 938 KING STREET,RYE BROOK,NEw YORK 10573 DATE: VILLAGE OF RYE BROOK (914)939-0668 FEE: -I Zo/p-- PAMJ& BUILDING DEPARTMENT www.ryebrook,ori! 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 s»ara►►aria+a++►•ra saaas►+■a►►rtut••rssr+•a+s•a+ptrs••rr tt t+•r eft tttttt rtt■•attest••tttttsrrttstttprts+rsrrs►►s►►►atttttt• Address: D 8 k i l�'r n Occupancy/_ DUse:' Parcel ID#: 141 2 2 -/-C� Zone: Owner: U l 6 d a L �J L Address: ,74 L" Qe P.E./R.A.or Contractor:. i6 uno ''w'&U -Address:4{ 4 b, *�1 ��►e. p r� �a�eir N�k7�73 Person in responsible charge:JOC?e. Address:4t4 "i IIA 1r=C I�q la57;� 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 ox p k -2-4 _ being duly swom,deposes and says that he/she resides at�w al,/ICA A-U-L (Print Name of Applicant) (No.and Street) in Pot'+ LihP,6A-< ' ,in the County of �� �j-�,��1� _� in the State of that (Cityrrown/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:$ o , 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. Iof,,the Code of the Village of Rye Brook. Sworn to before me this �"tt Sworn to before me this day of ,20-2L day of ,20- a. gnature Cwaer Signatur f licant C>'&v t0r-�(:t Print Name of Property Gv was Print Name of A licant Notary Public Notky Public Kai i.Y G,1roof ER Notary p,., C LOIS NIETO w. n' �- lew York NOTARY PUBLIC, STATE OF NEW YORK ed in V , ; ;.�Fs. r` NO. 01N14899825 �ommissign Expires ki�ti�1i �, 2��(D QUALIFIED IN WESTCHESTER COUNTY COMMISSION EXPIRES DECEMBER 3, 2026 QyE BR��, O� Zm uJ � 9°2 BUILDING DEPARTMENa1T 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 t _)-sl: V` - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : � n DATE: PERMIT# ^�Is UED: SECT: B7oCK: LOT: LOCATION: l 5(32�CCUPANCY: ❑ VIOLATION NOTED THE 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 ROSS CONNECTION FINAL ❑ OTHER z _ N : \ \ w Ln N N y ! x 00CA a C VJ +4 �w C2 W ^ W �' v ,� •�o `� A W c ww 9 A y72 0 ' O $ 0 O � o o ' t+ I V y � M w 0 � � � • � W � o �` � [r V v � N U I� H p0 a c.7 "n w o ,�, 4 1 1 V i °O _ v I U U ec! =G a Ncc o cq � Z � v v ca ►. \ w H U Owl maw v Hj O z a o p o w O '°' U I N O Fyl t� A z a D a. cn > 2 -0 x1 a O E y 5 0 '�I GA �l W ✓ x � � b Cl r BLTILDffiG DEPARTMENT VILAOZdE OF RYE BROOK R J U L 14 2022 938 KING T RYE BROOK,NY 10573 14)U970668 VILLAGE OF RYE BROOK y Jr BUILDING DEPARTMENT FOR OFFICE USE ONLY: ,11 Approval Date:- AUG Z 2 Permit c��t��//�� 7 Application# � r Approval Signature: : ARCHITECTURAL REVIEW BOARD: Disapproved: Date: .. BOT Approval Date: Case# : Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Case# — Other: Application Fee• - bPermit Fees: 1/ SIGN PERMIT APPLICATION Application dated: j 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: I SBL:1A11 A 7- '4 Zone:e-/-/ 2. Property Use or Business Name: VS 3. Proposed Sign(s)(Describe in detail including number of signs,types,sizes,exact location(s),and illumination method(s)if applicable.) {A separate Electrical Permit will be required for any associated qlectnical work.) : N 4. Height from grade to highest point of sign: ei 3'� rram�,to lowest point of sign: Q � %lJo� 5. Property Orw�nerf: b)I n 6 A,9" All �1.C'. Addre :, �' � f d • Phone# Cell# email: 16p,Cfyn 6. Applicant:SLq ►"),e- �[1_ j,l i Address: t) I G. rf 1�7.3 Phone# d-9 7-�-3 rib Cell# email: 5ge- tJ q61 A O SL44 c6fYl- 7. Architect/Engineer: Address: Phone# Cell# email: 8. Sign Contractor- �-� Address:4,bA tA It,/G Phone# - '� ' Cell# email:s ,�(�_►l� Sl glnces,�t�•c1y Yl A- 8/12/2021 ` 9. Will the proposed sign 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 1:—TIER II: TIER III:_ (If yes,a Home Occupation Permit Application is required) 11. If building is located on a comer lot,which street does it front on: 12. Property frontage: 13. Property size:Sq.Ft.: Acres: 14. What is the total estimated cost of construction: $ �.066,t7 Q (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: �*,r*,rrr**��,�+�,r+r�r�**,r,r*rr********,r,e,r*******�*w*.*****wr.ww********,a*****w**«**#***,r******ww************«,r*r►wr►« 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: -�h I[ur1 7L1 _ ,being duly sworn,deposes and states that he/she is the applicant above named, (print of indindual 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 115 Sworn to before me this — tI = day of , 20 day of�� , 20,,� e of Prop a.= Signa of App an r DAVO 50clv6w zn� Print Name of Property'T;PJ Print Name of Applicant . a.�, /A.a o �_ V"_4 No Public No blic LOIS NIETO LOIS NIETO NOTARY PUBLIC, STATE OF NEW YORK (VOTARY PUBLIC, STATE OF NEW YORK 9825 QUALIFIED IN NWESTCHESTER COUNTY 99825 NO. ESTC EST COMMISSION EXPIRES DECEMBER 3, 2026 QUALIFIED IN WESTCHESTER COUNTY COMMISSION EXPIRES DECEMBER 3, 2026 -2- 8/12/2021 0 N W c M \ M `n Vi a r� Z vi 4. r, Wg n Qq n W Ft _ v W 00 C. W ti wVs ►'fir M w � V � � s d r `- Z o O w Z O N 000 Ln j 8 o w H cswllf ! O wAW00 c� W wo � � o C� v� �+ Ln0-4 w F a W F- Mai �i Z ii1 Z U U U < O h V` V � O zFO � w w a l V HCA . 17 V z W a x3 zz °+ � � y, � � 0 W � O 0 o�G 1 ►�r~r W N F za E N ■ "' W V *k o C o < Ln �I W � a z c w z � •' � r e � r [n�E RC��k BUILDING DEPARTMENT VILLAGE OF RYE BROOK R I MAY - 2 2023 938 KING STREET RYE BROOK,NY 10573 VILLAGE OF RYE BROOK (914)939-0668 BUILDING DEPARTMENT www.Eyebrook.org ELECTRICAL PERMIT APPLICATION Westchester County Master Master Electricians License Required FOR OFFICE USE ONLY BP-411- /" —U� EP#: r Y� Approval Date: MAY Permit Fee: $ Approval Signature: Other: Application dated, Z 7 Z'? is hereby made to Building Inspector of the Village of Rye Brook NY,for the issuance of a Permit to install an or rem ve 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: )02 S y, ,'Kit'�a&e- SBL: �'7I� 0t1�7 // �-� Zone: 2.Property Owner: Lt /2 s -r.�P�� Address: ��e Q! 4 e c_ P),A Ze Phone#: y" ylr7 =� ?,'1 Cell#: email: W 3.Master Electrician/Licensed Installer: ".j e : Address: 11 C%tn S R,-1 D c',Vx trues t Lic.#: Phone#: 203- �7Z 7.�0Wejl#: email: (" h C,G 0 )I �t 4-le .fcl �l Company Name: ;C, r1e c . ci_ C y_r,->. Address: Y-7 rvdk 4.Proposed Electrical Work/Fixture Count: Qt ': r C 5.31 Party Electrical Inspection Agency: STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: ,being duly swom,deposes and states that he/she is the applicant above named,and does further (print name of individual signing as the applicant) state that(s)he is the for the legal owner and is duly authorized to make and file this application. (Master Electrician/Licensed Installer) The undersigned Rather 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 Tdaof ,20__.� day of ,20 &gnatfire of Pro erty Owmw. T Signature of Applicant C)A�VI0 �L.�SA —� � P ' t N of Prd erty Tame of Applicant . V N6taiV Public Notary PAiir,0 M.RNERA K.FLI Y SA"'DLER Notary Public, c, •i,_ o* New York Nalwy Public,State of Now York No. C1 S,`.- .; '. No.MR1644098 Cualified in ` esichest�-r CiOVr+y QudWIn Westchester County , Commission Expires March 9, 20 Commission Expires September 26,2a3/2023 STATEWIDE INSPECTION SERVICES, INC. Service With billegrity lil Main Street,Fishkill, NY 12524 1 email:• • SWIS JOBAPPLICATION tel 845.202.7224 1 fax 914.219.10621 SWISNY.com I SWISTrilininq,com Office Use Elect. Permit# 0� Date 3 B��iq-PeraurcaF— /J / aj � Utility ID# S �> � Final Certificate# City/Village Zip Township County Address Cross Street Section Block Lot Owner Name/Address of different than above) Contact Number TrD ❑Basement ❑ 1st FI. ❑2nd FI. ❑3rd FI. ❑More Than 3 FI. ❑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 #Meters #Disconnect ❑Underground ❑ New ❑Reconnect ❑Overhead ❑Change ❑Visual Re-Inspection ❑ Safety Re-Inspection ❑ Re-Inspection Additional Information D ID MAY - 2 2023 VILLAGE OF RYE BROOK BUILDING DEPARTMENT This application is valid for one(1)year from the date received by WAS.This application is intended to cover the above listed items to be inspected,if 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 Signature Address fro City/State Zip Code 05 License# �� Phone# p EC IENIF State Wide Inspection Services MAY 12 2023 1080 Main Street Fishkill, NY 12524 a VILLAGE OF RYE BROOK 845 202-7224 Phone BUILDING DEPARTMENT 914-219-1062 Fax STATE WIDE INSPECTION SERVICES Email: office@swisny.com 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: Lelia Electric Corp Win Ridge Realty Richard Zweig 102 South Ridge Street 47 Greenway Lane Rye Brook, NY 10573 Rye Brook, NY 10573 Located at: 102 South Ridge Street, Rye Ridge, NY 10573 Section: Block: Lot: Electrical Permit Number: EP 23-106 iai.z7 Certificate Number: 2023-3474 Sign Permit Number:SP 22-007 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: 102 South Ridge Street, Rye Ridge, 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 121h Day of May 2023. Name Quantity Rating Circuit Type Exterior Sign 01 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%vork performed on the date of inspection only. Building Permit Check List & Zoning Analysis OB & C ONLY Address: O Z 5 h r, C; SBL Z? — Zone: G 1 —7 —Use: Const.Type: 1 Other. Submittal Date: '7 1 14 Z Z Revisions Submittal Dates: Applicant: W l N.) Nature of Work F t,—) C l G k W ti't tt G � Si r2S 3�•-�� � � Reviews:zBA:J U L 1 9 2022 pB: BP: Other. _ OK ( ( ) FEES:Filing. "� BP: C/O: Legalization: ( ) (—)/APP.: Date Stamped:_L,/Properly Signed SBL Verified: ✓ Cross Connection:_ F.O.G.: ( ) ( ) 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: Sealed.• Copies: Electronic: Other. ( ) W License: Workers Comp: ✓ Liability �mp.Waiver. Other. ( ) ( ) Code 753#: 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: Grease Trap: 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. ( )ARB mtg.date: 16 1 t't 1-L'Z approvaL• notes: ( )ZBA mtg.date: approval• notes: ( )PB mtg.date: approvaL• _notes: REQUIRED EXISTING PROPOSED NOTES AUG 2 2 2022 Am; pate: QWV Fm" — Frq= Front: sdcv Ear. F.A.R.: Qpen Space: ht: Stories: notes: BUILDING DEPARTMENT VILLAGE OF RYE BROOK R JUL 14 2022 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 VILLAGE OF RYE BROOK wWw. - ok.or 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: A),)A),) S Ilmnl da e— S f Date of Submission: Parcel ID#: ZoneO—/—/o Proposed Improvement(Describe in detail): �• �i APPLICANT CHECK LIST: n /� MUST BE COMPLETED BY THE APPLICANT ( .off � Lo,•CUe1bNY rS L .� cJ1 � 'D —r—y The following items must be submitted to the Building ,t SC"rbr,�ki. f�YeX GlUS�►��- �n tr�q id[ x��a ��ivy Department by the applicant-no exceptions. p )1 J Paul 1. ompleted Application PropertyOwner:ld n�i � 2. 9�wo(2)sets of sealed plans. (one full size(maximum Address: e' m& allowable plan size=36"x 42")and one 11"x l7") [o 3. ( )Two(2)copies of the property survey. Phone# 4. wo(2)copies of the proposed site plan. Applicant appearing before the Board: 5. (>�)One electronic/disc copy of the complete C; f 4 4 -� PLOD I application materials. �..Z�--- 6Z7 7 6. V-)-Filing Fee. Address:464 Lj r+. I 1AS73 7. ( )Any supporting documentation. Phone# "7 / 3' jp� 8. ( )HOA approval letter. (if applicable) qi I 9. (photographs. Architect/Engineer: 10.(`4,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 e this Sworn to be me this day of , 20 day of _1 L41 , 20 a� SiVaUA of Pro - lure of Ap i t �yn ryaUS t �n Print Name of Property Aww Arwr Print Name of Xpplicant 4� Notary Public Notary Public LOIS NIETO LOlS NIETO NOTARY PUBLIC, STATE OF NEW YORK NOTARY PUBLIC, STATE OF NEW YORK NO. OIN14899825 NO. 01N14899825 QUALIFIED N WESTCHESTER Co QUALIFIED IN WESTCHESTER COUNTY COMM SSIONIEXP EXPIRES DECEMBE( ,°° 026 COMMISSION EXPIRES DECEMBER 3, 2026 • VILLAGE OF RYE BROOK BUILDING DEPARTMENT 938 KING STREET, RYE BROOK,NY 10573 (T) 939-0668 (F) 939-5801 ARCHITECTURAL REVIEW BOARD IN PERSON MEETING AUGUST 17, 2022 @ 7:30PM NAME&LOCATION TYPE OF APPLICATION MOTION SECOND APPROVE RD EJECTED APPL.# 4 Birch Lane Roof Top Solar Array Consent 5740 (Hartman) System Agenda 52 Greenway Lane New Panel(s)of Arbors Consent 5741 (Vladsky) Standard Design Fencing Agenda 9 Phyliss Place Replace Old 6ft High Consent 5742 Stockade Fence with New Agenda Stockade Fence 4 Loch Lane Replace Sliding Door& Consent 5743 (O'Neill) Windows on House. Widen Agenda One Window 15 Paddock Rd Seasonal Above Ground Consent 5744 (Santorelli) 15' Round Swimming Pool Agenda 18 Hillandale Road Amendment to Prior 5745 (Marks) Approval (Pool Barriers) Fence Changes I Castle view Ct 1 Story 2 Car Detached 5746 Garage 14 Whippoorwill Rd In-Ground Swimming Pool 5747 (Martel)CS w/Coping & 4' 0" high Fence Barrier 13 Old Orchard Rd One Story Rear Addition 5748 1 Dorchester Drive 1st Story & 2nd Story 5749 (Duir) Additions, New Windows & Rear Patio 102 S. Ridge Street New Sign and Awning ^� 5748 "Customer's Bank" 124 Country Ridge Legalize New Outdoor 5750 Drive(Brookman) Kitchen & Patio ML V/NM / MR SE / JM 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 IN PERSON MEETING AUGUST 17, 2022 @ 7:30PM - -- PAGE TWO (02) 18 Lincoln Ave New Detached Barn 5750 (Magar) Style Utility Building 18 Lincoln Ave New Solar Array on 5751 Road(Magar) Detached Utility Building. 11 Loch Lane Enclose 2nd Fl Front Porch 5752 (Karasik) � I ML NM MR SE JM SF AC MI KC AC Ro® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDNYYY) 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 3EPRESENTATIVE 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 NAME CONTACT Stacie Washington Borrelli Partners Insurance Agency PHONE (914)939-7900 FAX (914)407-5088 A/C No Ext: A/C No). 287 Bowman Avenue &MAIL s: swashinglon@borrellipartners corn ADDRE Suite 406 INSURER(S)AFFORDING COVERAGE NAIC a Purchase NY 10577 INSURER A: Travelers Casualty Ins Co of America 19046 INSURED INSURER B: Travelers Indemnity CO 25658 Lanza Corporation INSURER C: Phoenix Ins Co 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 MAYBE 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 AIJUL bUtJH POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSO WVD POLICY NUMBER MM/DD/YYYY MMIDD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR PREMISES Ea occurrence $ 300,000 MED EXP(Any one person) $ 5,000 A 6805J175092 06/05/2022 06/05/2023 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 X POLICY ❑JEo- ❑ LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) S HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 5,000,000 B IEXCESSLIAe CLAIMS-MADE EX5J175240 06/05/2022 06/05/2023 AGGREGATE $ 5,000,000 DED I X RETENTION S 10,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE X ER C ANY PROPRIETOR/PARTNER/EXECUTIVED a NIA UB5J175160 06/05/2022 O6/05/2023 E.L EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDE (Mandatory in NH)If yes,describe under E L DISEASE-EA EMPLOYEE $ 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/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 YoeK Workers' CERTIFICATE OF STATE Compe Boardnsation NYS WORKERS' COMPENSATION INSURANCE COVERAGE la.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(Onlyrequired ifcoverage 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"I a" 938 King Street UB5J175160 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"I a"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 / to nt name of authorized represen the or li ense gent of insurance carrier) Approved b : � � � I 06/20/2022 i (Date) Title. CL anager 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. Insurance brokers are N_T authorized to issue it. C-105.2 (9-15) vrww wcb ny gov �1 Un N ,a.4 o0 � � Cl- CU :3 a a j to < Eli� P1 1 n n rD ' Co z (ID (� Sc -0 LL Ln,...,., wo . rD Lo 0 LOCI 0 � p tow rD o�3 o ❑J rDLn r-i in �" Z n fD rD \ Q �� +• rD��-+ X (D ft 3 � = m <' a C _. U3 a� ,G (D ,+ r° .O D � � Ln o ^ m�O O ? �. c o� Ln — -n � w -I M -% m a c c .. t r+ O 01 0 O1 Q1 W _ "Tl X3 ; .. ... 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