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HomeMy WebLinkAboutBP19-162Lan vas . COST i� Rear yard, 416 ) Thl7x JA L I DAzf lrm�oe 7r�Z lo4-:>1 Z DATE FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING Cl RGH PLUMBING GAS SPRINKLER ELECTRIC Cl INSP LOW-VULT CI ALARMa 11 AS BUILT �_ ZOLf rle� FINAL j O FRB THER APPROVALS mu Ia 7 al 0 lq� BOT OTHER tL � ►S-�U1LTIANAL SURVEY REQUIRED PRIOR TO FINAL INSPECTION QyE DR . 19 l 4(Vuy, 4 JaGC'V4�V -( VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury www.ryebrookny.gov TRUSTEES BUILDING&FIRE INSPECTOR Susan R. Epstein Steven E. Fews David M. Heiser Donald T. Krom,Jr. Salvatore W. Morlino CERTIFICATE OF COMPLIANCE December 2,2025 Evan Kanarek&Morgan Shapiro 21 Elm Hill Drive Rye Brook,New York 10573 Re: 21 Elm Hill Drive, Rye Brook,New York 10573 Parcel ID#: 135.50-1-42 Building Permit#19-162 issued on 8/8/2019 for a New Fence This certifies that the four foot high black aluminum fence,installed under the above captioned permit,has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to BUILD R NT For office use on PERMIT# bC� VIL OF RYEdOK ISSUED: 938 KING STRE VE BROOK,N YORK 10573 DATE: -I S/ -0668 FEE: PAID APPLICATION . ov 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 1 #1####`###############t###### Address: E-lI M. I � ► U ` J Occupancy/Use: Or tt Parcel ID#: `/,7 Zone: Owner: ►v re Address: 21 EIM lfi I( Vn ve- r��23���'ry bs' P.E./R.A.or Contractor: ( G2 `- C( rAdaress: Person in responsible charge: V Cc- 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: STATE OF NEW YORK,COUNTY OF WESTCHESTER as: being duly sworn,deposes and says that he/she resides at (Print Name of Applicant) l (No.and Street) in \/'x l\ESL G=�, L 0- ;in the County of C,0� -"� in the State of %—.f::�Mat ( ty/Town/vill e) I 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:$ 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 k Sworn to before me this day of 20- day of ,20 Signature of Property Owner Signature of Applicant t�Va-4\ L6L(,kC4.,C4(_ Pr'n ame of Property Owner Print Name of Applicant otary PubXcV Notary Public GREGORY M.RIVERA Nc{ary Public,State of New York 6/l/2024 No.01 RI6441398 Qualified In Westchester County Commission Expires September 26,2 E 6kC�,� cv � t7 BUILDING DEPARTMENT ❑BUILDING INSPECTOR �SSISTANT 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:2I E_L M I-f/L L "DO I t/E DATE: ' Z Z cka PERMIT#_ R 'q_'__1_. D Z ISSUED: 'v $ECT: jv�•.� BLOCK: LOT: r 2- LOCATION: V �_ • _ OCCUPANCY: ❑ 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 IA/Q&tc Coen Q. ❑ L.P. GAS ❑ FUEL TANK ` I ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION �INAL ❑ OTHER �yE BR(��. • �9r�2 BUILDING DEPARTMENT ❑BUILDING INSPECTOR Q 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.orS - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : 21 G Z DATE: PERMIT# 8P /9 / Z ISSUED: SECT: /SJI Z/ BLOCK: LOT: LOCATION: 7' ''- C/ OCCUPANCY: ❑ Violation Noted THE WORK IS... ❑ PASSED ❑ FAILED REINSPECTION ,-EY SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas / ❑ L.P. Gas ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER 4%i k 1 • AV Ir .i. �� •.. ti ,.. V•i.? �Tr11M� .� - �. .. ram.•- . �"-i• �1T, ^ . •.` .ti e• �:.' •f ._,.R••.�;.�...���..w \ .•�' '. Alfredo DiVitto From: Alfredo DiVitto Sent: Thursday, April 11, 2024 12:58 PM To: 'evan.kanarek@gmail.com' Cc: infor@kingfenceny.com' Subject: EXPIRED FENCE PERMIT BP 19-162 Attachments: 21 ELM HILL DRIVE PERMIT.0001.pdf; 21 ELM HILL DRIVE EXPIRED PERMIT LETTER0001.pdf, CO-CC-Application-8.2021.pdf Good morning, It has come to the attention of the Building Department that your building permits(see attached) have not been closed out in accordance with Village Code and are now expired.All Building Permits have a twelve (12) month lifespan starting from the date of issuance, and the permit expiration date is noted on the front of the permit. Please note that there is a non-waivable Expired Permit Fee of$500.00(for each permit) now due in connection with your expired permits. Once payment is received,your permits will be reinstated for a period of six(6) months. Please be advised that it is a violation of Village Code to fail to close out a permit,and that a court summons could be issued,and fines may be imposed on the permit holder and/or property owner for failure to apply for and obtain a Certificate of Occupancy(C/O)or Certificate of Compliance (C/C), in accordance with Village Code section 250-10A. Please note that Temporary C/O&C/C are available in accordance with Village Code section 250-10B should you require more time to perform whatever work remains to complete your project. The following items are required for submittal prior to the final inspections: 1. C/O application for each permit(see attached) 2. C/O fee for each permit(the fee depends on the final cost of the job) 3. Original signed and sealed final as built survey Thank you for your attention in this matter, and please feel free to contact this office should you require any further information. Thank you, Alfredo (Freddy) DiVitto Assistant Building Inspector Village of Rye Brook 938 King St. Rye Brook,N.Y. 10573 Office:914-939-0668 i J A O C i�`4�1i J�Y GG 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 March 28,2024 15C Notice Via Mail and Hand Delivered Dear Rye Brook Building Permittee, Mr.Kanarek 21 Elm Hill Drive Rye Brook,New York 10573 It has come to the attention of the Building Department that your Building Permit has not been closed out in accordance with Village Code and is now expired.All Building Permits have a twelve (12)month lifespan starting from the date of issuance, and the permit expiration date is noted on the front of the permit. Please note that there is a non-waivable Expired Permit Fee of$500.00 now due in connection with your expired permit.Once payment is received,your permit will be reinstated for a period of six(6)months. Please be advised that it is a violation of Village Code to fail to close out a permit,and that a court summons could be issued, and fines may be imposed on the permit holder and/or property owner for failure to apply for and obtain a Certificate of Occupancy(C/O) or Certificate of Compliance(C/C),in accordance with Village Code section 250-10A. Please note that Temporary C/Os&C/Cs are available in accordance with Village Code section 250-10B should you require more time to perform whatever work remains in order to complete your project. Thank you for your attention in this matter,and please feel free to contact this office should you require any further information. Steven E.Fews Building&Fire Inspector stevefews(@gyebrook.org cc:Alfredo DiVitto,Assistant Building&Fire Inspector Tara A. Orlando,Planning&Zoning Secretary Laura Petersen,Office Assistant /to Building Permit Check List&Zoning Analysis -Address: Z �-�"� �-�-t L� �b rL. SBL: lSO - 1 y Zon - Use: Z 1 a Const.Type: Other. Submittal Date: CD Z 07 Revisions Submittal Dates: Applicant: A- -F--�-C ` Nature of Work: l L L- � 1 1�' j 4 H t 1 A C Pl- 14C.1 1 N 0 ';i; J C R— t ki j7Srv41�- yAti-_C:z.-, Reviews:ZBA: JUN l 8 2019 PB: BOT: Other. OK ( ( ) FEES:Filing: 7S•�a BP: C/O: Legalization: ( ) ( ) APP: Dated: Notarized: SBL Truss I.D. Cross Connection: H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening. ( ) ( ) ENVIRO: Long. ShorC Fees: N/A: ( ) ( ) SITE PLAN:Topo: ite P otection: S/W M� Tree Plan: Other. ( ) (• SURVEY:Dated Current ✓Archival Sealed ✓ Unacceptable ( ( ) PLANS:Date tamped Seale Copies: Electronic: Other. _l License: Workers Co Comp.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: 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 20I7 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. mtg.date: '7 t Z approval•-1 notes: ( )ZBA mtg.date: approval• notes: ( )PB mtg.date: approval• notes: REQUIRED EXISTING PROPOSED NOTES APPROVED Area: .1111 7 n Circle - A I/ Frontaee: Front: Front: Sides: Rear. Main Cov Accs.Cov: Ft.H Sb: Sd.H Sb: GFA: Tot.Imp: Et I : P Height/Stories: notes: BUILDIIV fi'&XRTMErT VILLAGE OF R1' IIIROOK JUN - 7 2019 938 KIN(; STREET RYE 131166., NV 10573 (914)93g` X 9 39-5801 VILLAGE OF RYE BROOK w BUILDING DEPARTN9ENT L 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:Z1 E1w"1fi(I Dri Ire )t 6r'X-1�1"Y its 3 Date of Submission: CD -71 I Parcel ID#: 13 S,SO —.l- `l 2 Zone: CL l 2 Pxoposed Improvement(Describe in detail): APPLICANT CHECK LIST: ke-t �r MUST BE COMPLETED BY THE APPLICANT VV {� I`� a ��`' The following items must be submitted to the Building .fe"-Ce Lj/ �,�91� (.f k y f���(��,�ti r�� Department by the applicant-no exceptions. 1. ( Completed Application ?. ( )Two(2)sets of sealed plans. (one full size(maximum Property Owner: Eyr,^- Kav\arek el allowable plan size=36"x 42")and one 11"xl7") Address:21 Oh I' h 011ve- �j�CK �t s7� 3. (J)Two(2)copies of the property survey. 4. ( yTwo(2)copies of the proposed site plan. Phone# S� - �j s-y7�S 5. (,/)One electronic/disc copy of the complete Applicant appearing before the Board: Application materials. 6. ( Filing Fee. 64r\ `<kqk re K 7. ( )Any supporting documentation. D Address: 8. (�HOA approval letter. (ifapplicable) (Z� /��. Ifi f l ri v� 12e �OCNy I a S 7 9 Photographs. Phone# ��t;',�,f���{�]�� 10.( )Samples of finishes/color chart. (a sample board or Architect/Engineer: 1� `/;•\j RA-,C e 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. tt Sworn to before me this k Sworn to before me this day of �.� , 20 1"1 day of 20 Signature of PropertyOwner (C Signature of Applicant i &-L yya, `-'l ` Print Name of Property Owner Print Name of Applicant = F. 31L'� Notary Public Notary Public THOMAS E HUGHES NOTARY PUBLIC STATE OF NEW YORK QUALIFIED IN NEW YORK COUNTY LIC. #0 1 HU6352344 COMM. EXP, December 27,2020 3/2 P 19 r , FENCE / TE PERMIT APPLIC N & UCTIONS B ING DEP ENT VILL U E K,NY PHovE(914 914)939-5801 c.or All applicants seeking a fence,wall or gate permit must first obtain approval from the Village Architectural Review Board. Some applications may be subject to Site Plan Approval from the Village Planning Board as per§209 of Village Code.A representative of the applicant must be present at the ARB meeting which is held on the third Wednesday of every month,7:30 p.m.at Village Hall in the main meeting room.Applications must be submitted to the Building Department by no later than the 1'Wednesday of the month in order to be eligible for that month's agenda. Please note that the agendas are limited to ten(10)applications per month.Once your application receives ARB approval,the plans must then be reviewed by the Building Inspector for compliance with all applicable state and local building codes and for issuance of the permit. DO NOT START CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDING INSPECTOR APPLICANT'S INITIAL SUBMISSION TO THE BUILDING DEPARTMENT MUST INCLUDE: I. A properly completed application with notarized signatures where indicated. 2. Application filing fee: Residential=$75.00/ Commercial=$250.00 (Application fees are non-refundable) 3. Completed& Signed Application Check List 4. A current,accurate property survey. 5. Two(2)sets of dimensioned plans,(one full size I maximum allowable plan size=36"x 42"}and one I 1"x 17"').depicting the location of all existing and proposed buildings and/or addition,alteration,repair,including proposed elevations&floor plans and all existing and proposed property setbacks.Plans must be signed&sealed by a NY State Registered Architect or NY State Licensed Professional Engineer. 6. Color photos or brochures of proposed improvement. 7. An electronic copy(disc)of all materials submitted. FOLLOWING APPROVAL BY THE ARB,THE APPLICANT MUST SUBMIT THE FOLLOWING 1. Full payment of the Permit Fee: Residential: $15.00/$1,000.00 of Construction Cost with a minimum fee of$100.00. Commercial: $22.00/$1,000.00 of Construction Cost with a minimum fee of$260.00. 2. One full size and one scaled 1 1"x 17"set of sealed construction plans. 3. Your contractor's valid Westchester County Home Improvement License. 4. Your contractor's valid proof of liability insurance. (Village of Rye Brook must be listed as certificate holder on the insurance form) 5. Your contractors valid proof of workers compensation insurance. (Form#C 105.2 or Form#U26.3/or NY State Workers Compensation Waiver) 6. The"Call Before You Dig"(code 53)Number. (DIAL 81 1) PRIOR TO SCHEDULING THE FINAL INSPECTION THE APPLICANT MUST SUBMIT: 1. The application& fee for the Certificate of Occupancy/Compliance. (fees are based on the final cost of construction) 2. A final survey of the property. NOTE: The finished or good side of your fence must face your neighbor's property. All permits must be closed out with a Certificate of Occupancy or Certificate of Compliance issued by the Building Inspector. Keep this instruction sheet throughout the project for reference. 3/21/19 VILLAGE OF RYE BROOK BUILDING DEPARTMENT 938 KING STREET, RYE BROOK,NY 10573 (T) 939-0668 (F) 939-5801 ARCHITECTURAL REVIEW BOARD Wednesday, July 17, 2019 NAME&LOCATION TYPE OF APPLICATION MOTION SECOND APPROVED REJECTED APPL.# 55 Winding Wood 4ft Black Chain Link Fence For Full 4800 Road(Dehardt) @ Rear Yard&4ft Review. Aluminum Picket @ Side Yards 14 Sunset Road 6ft Vinyl Privacy Fence Consent 4801 (Riley) w/Lattice Top 484 N. Ridge St Above Ground Swimming Consent 4802 (Sarrizan) Pool Agenda 159 N. Ridge St Roof Top Solar Array Consent 4803 (Beltas) Agenda 17 Knollwood Drive Amendment To Approved Consort 4804 (Bucci) Application/Siding Change Agenda 21 Elm Hill Dr 4ft Black Aluminum Fence Consent 4805 (Kanarek) In Rear Yard Agenda 4 Oriole Place Change Rear Window To Consent \ 4806 (Esterow) Patio. (Interior Alterations) Agenda 173 Country Ridge Demo Existing House and 4753 Dr(NDRB Construct New One family, Development) New Swimming Pool 260 Linclon Ave Replace Existing Wood Rail 4807 (C.P.W.) W/ Steel Pipe Rail 23 Elm Hilll Drive Amendment To Approved 4808 (Erb) Application 5 Heritage Ct Replace & Build New Deck 4809 (Bhagavan) (Extended) ML NM MR SE JM SF AC MI JB Check List For Release of Building Permits Address: cq'FJ fn JJJ 1 Do*v� Owner/Applicant: )t��van Phone#'s: ��'Gj Dates Attempted To Contact Owner/ Applicant: 7AVIq Comments: exm I hOry?eDvl(r,rVVIq ' Comments: �� n Comments: NEED: (Building Permit Fee $ 5 'e.0 ( ) Fire Sprinkler Plans (2) ( ) Fire Sprinkler Application ( ) Fire Sprinkler Permit Fee ( ) Estimated Cost $ ( ) SWO Fee $ ( ) Legalization Fee $ ( ) Other Liz Caruso From: Liz Caruso Sent: Monday, July 22, 2019 11:43 AM To: 'evan.kanarek@gmail.com' Subject: Fence Permit Application for 21 Elm Hill Drive Good Morning, The fence permit application for 21 Elm Hill Drive has been approved by the Building Inspector. Before we can issue the permit,the following items must be submitted to our office: 1. General contractor's contact name & phone number 2. General contractor's valid Westchester County Home Improvement license 3. General contractor's valid liability insurance (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) 5. Contractor must call Dig Safe NY to get a 10 digit ticket number 6. Building permit fee of$105(due at the time of permit pickup) Thank you. Liz CARUSO OFFICE ASSISTANT BUILDING DEPARTMENT VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK, NEW YORK 10573 OFFICE (914) 939-0668 FAX (914) 939-5801 i .j; C o � � L cm ,r 4+. G r 4 � J a L MW � T w = LL t: Oi to r � a - ; 0 + V O z t13 Y 3 c •� �• fi ao O •1 ,• N r - s � ACORO® CERTIFICATE OF LIABILITY INSURANCE FDATE(MMIDD/YYYY) 7/22/19 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). CONTACT PRODUCER NN2237 NAME:- Frank Cipriani FERENCE-GRAY INS BROKERAGE LLC PHdNE FAX (A/C,N9._E ); IAlC NoP 19 MILL ST E-MAIL ADDRESS: PORT CHESTER,NY 10573-3326 INSURERS AFFORDING COVERAGE NAIC N INSURER A: Erie Insurance Company 26263 INSURED INSURER B: Erie Insurance Property&CasualtyCompany 26830 CIPS Fence Co.,Inc. INSURERC: Erie Insurance Exchange 26271 48 G King Fence Co. INSURER D: Erie Insurance Company of New York 16233 Grassy Sprain Road Yonkers,NY 10710 INSURERE: Flagship City Insurance Company 35585 INSURER F COVERAGES CERTIFICATE NUMBER: N/A REVISION NUMBER:N/A 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. - -- LI --- - INSR POCY EFF POLICY EXP LTR I TYPE OF INSURANCE INSD I WVD POLICY NUMBER MNUDDM/VY MMfDD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1 000 000 CLAIMS-MADE �l OCCUR PREMISES Ee occurrence S 1,000,000 MED EXP(Any one person) $ 5,000 A Q47 6950084 11/19/18 11/19/19 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑PRO- JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY =M9nqrff1TZTE LIMIT_LEa accident) _ $ ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED BODILY INJURY AUTOS ONLY AUTOS (Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTO ONLY AUTOS ONLY Per acGdan!) $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ _ DIED I I RETENTIONS $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT E OFFICER/MEMBER EXCLUDED? N I A If (Mandatory In E.L.DISEASE-FA EMPLOYE S yes,describe under und DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT E DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached It more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Village of Rye Brook THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 938 King Street ACCORDANCE WITH THE POLICY PROVISIONS. Rye Brook,NY 10573 AUTHORIZED REPS�RE'SENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ACORDs provided by Forms Boss.www.FormsBoss.com. (c) Impressive Publishing 800-208-1977 CERTIFICATE OF NEW Workers' NYS WORKERS'COMPENSATION INSURANCE COVERAGE STATE Compensation Board la.Legal Name and address of Insured(Use street address only) lb.Business Telephone Number of Insured Abel HR II,Inc.L/C/F Cips Fence Co,Inc. 860-609-0400 2 Corporate Drive Cranbury,NJ 08512 Ic.NYS Unemployment Insurance Employer DBA: King Fence Registration Number of Insured ld.Federal Employer Identification Number of Insured or Social Security Number 134049813 Work Location of Insured(Only required if coverage is specifically limited to certain location in New York State, i.e. a Wrap-Up Policy) 2.Name and Address of the Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) AmTrust Insurance Company of Kansas,Inc. Village of Rye Brook 938 King Street 3b.Poliev Number of entity listed in box"la": Rye Brook,NY 10573 KWCH62691 3c. Policy effective period: 3/1/2019 to 3/l/2020 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"la" 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". The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail)Otherwise,this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent,or until the policy expiration date listed in box"30,whichever is earlier. 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: Henry C.Sibley (Print name of authorized representative or licensed agent of insurance carrier) Approved By: 7/25/2019 (Signature) (Date) Title: Underwriting Manager Telephone Number of authorized representative or licensed agent of insurance carrier:CarrierPhone Please Note:Onlyinsurance carriers and their licensed agents are authorized to issue the C 105.2 form.Insurance brokers are NOT authorized to issue it. Liz Caruso From: Tara Gerardi Sent: Thursday, August 08, 2019 11:18 AM To: Liz Caruso Subject: FW: Message from Dig Safely New York, Inc. (DSNY) Tara A. Gerardi Secretary—Planning Board, Zoning Board of Appeals & Architectural Review Board Village of Rye Brook 938 King Street Rye Brook, New York 10573 Office (914) 939-0668 Fax (914) 939-5801 -----Original Message----- From: Mike Izzo Sent: Thursday, August 08, 2019 10:46 AM To: Tara Gerardi <tgerardi@ryebrook.org> Subject: FW: Message from Dig Safely New York, Inc. (DSNY) From: sadasupport@ufpo.org Sent: Thursday, August 8, 2019 10:46:09 AM (UTC-05:00) Eastern Time (US & Canada) To: Mike Izzo Subject: Message from Dig Safely New York, Inc. (DSNY) ****REGULAR**** DIG REQUEST from DSNY for: VIL RYE BROOK Taken: 08/08/2019 10:40 To: VIL RYE BROOK PRIMARY Transmitted: 08/08/2019 10:45 00001 Ticket: 08089-211-027-00 Type: Regular Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK /V Addr: From: 21 To: Name: ELM HILL DR Cross: From: To: Name: Offset: ------------------------------------------------------------------------------ Locate: LOCATE THE BACK OF THE HOUSE NearSt: NO CROSS STREETS GIVEN Means of Excavation: POST HOLE DIGGER Blasting: N 1 Site marked with white: N Boring/Directional Drilling: N Within 25ft of Edge of Road: N Work Type: INSTALLING CHAIN LINK FENCE Duration: 2 DAYS Depth of excavation: 2 FEET Site dimensions: Start Date and Time: 08/21/2019 09:30 Must Start By: 09/05/2019 ------------------------------------------------------------------------------ Contact Name: NACY CIPRIANI Company: CIPS FENCE CO INC DBA KING FENCE Addr1: 48 GRASSY SPRAIN RD Addr2: City: YONKERS State: NY Zip: 10710 Phone: 914-337-8700 Fax: Email: MATTHEW.WARNE3@GMAIL.COM Field Contact: FRANK CIPRIANI Email: INFOR@KINGFENCENY.COM Cell Phone: 914-337-8700 Working for: KATNAREK-HOMEOWNER ------------------------------------------------------------------------------ Comments: 110 LINEAR FT : Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: ALTICE USA CON-ED SUEZ WTR WESTCHESTER VIL RYE BROOK WESTCHESTER COUNTY/SEW z ;,r..:.s UX 1NS JUN - 7 2019 VILLAGE OF RYE BROOK BUILDING DEPARTMENT rc—ff �:) \ e � - Oz ouu o 0 `� �� n � 0 Lo 00 0o-0 o� of tom_ (DLLJ .. .. 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