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HomeMy WebLinkAboutSP23-001PERMIT # v SECTION _,! so TYPE OF WORI JOB LOCATION OWNER CONTRACTOR_ EST. CO, ✓CO # TCO # FEE DATE INSPECTION RECORD I DATE I NSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING CI — RGH PLUMBING GAS 0 SPRINKLER ELECTRIC LOW -VOLT ALARM AS BUILT 0 y� 70L AbJc� FINAL OTHER APPROVALS BOT PS ZBA OTHER DRS (C l v4 wvy . 19 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 Stephanie J. Fischer David M.Heiser Salvatore W.Morlino CERTIFICATE OF COMPLIANCE March 7,2025 Win Ridge Realty LLC c/o Alena Hakanjin 24 Rye Ridge Plaza Rye Brook,New York 10573 Re: 164 South Ridge Street, Rye Brook,New York 10573 Parcel ID#: 141.35-2-36 Sign Permit#23-001 issued on 3/31/2023 for New Illuminated Sign This certifies that the new channel letter illuminated sign;"Bond Vet",installed under the above captioned permit has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to QECIEU V E D ,,1,�13('�C,ll�- For office use only: FEB 2 7 2025 BUILD lYllEP' TMENT PERMIT OCR VILLAGE OF RYE BR60K ISSUED: 3--3 i—C)2, VILLAGE OF RYE BROOK �38 KING STREET,'RYE BROOK„NAV YORK 10573 DATE: �)— 4-7 z�iS BUILDING DEPARTMENT--- ._ \(-914)939-0668;CG' T FEE: A,SO-- PAID W 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 ##/##<ssa###isss•si/isaiiltla#ii###aia•/ta♦/##liaiii/tar#♦a!/aiaas#ilia♦s!•s/#/iias/t#//i/iaaitsl ii4la#ibis!#••/#!!�#i•#►##i Address: 1164 S Rldge Street,Rye Brook,NY Occupancy/Use. B°ndvet Parcel ID#: ,y�� 3 — ��— �� Zone: Owner: , 1 Address: " � ,�� P—tv ZAIA P.E./R.A. or Contractor: Address: c Person in responsible charge: Kevin Persaud Address: 111 IN 79th St,NY,NY,10011 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 ' U YORK,CONTY OF WESTCHESTER as: F'f'✓1l�` > being duly swom,deposes and says that he/she resides at 164 S Ridge Street (Print Name of Applicant) (No and Street) in Rye Brook in the County of Westchester in the State of NY that (CityrFown/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:S S1200 for the construction or alteration of: New Channel Letter Illuminated Sign;"Bond Vet" 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. Swom to before me this 7 Swom to before me this Feb 4 day of ! , 20 day of 13th 20 25 Ski y ,re of Pr rty1Aww+F,rr*GJ/,,jam 1 Signature of Applicant �1/j'�V,G e"�i'��' �1 St, 1 Kevin Perseud Pri t le of Pro �i:y�lp Print Name of Applicant c 1 Nota Notary Public ALENANAKANJIN, ; NOTARY PUBLIC,STATE OF NEW YORK Registration No.01MA0013645 _1 Qualified in Westchester County My Commission Expires 911912027 �E BRC�k, 1932 BUILDING DEPARTMENT VBILDING INSPECTOR ISTANT 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 : ' �]u '� y DATE: / Vy PERMIT#,5l 2 n 7 ( ISSUED:3 31 SECT: BLOCK: 7 LOT:5�> LOCATION: OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... 0' ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS 7 G ti V I ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER ■ qu ol ti o z I o O v� n a O cu W 4.4 ao a t u o r4."T �z co eq 04Q �/ oo �cn ar CIN �-+ oc w p k 71 oa A zZ C Cl Q oZ. Q-+ cu ;j O z U w z 2 ,> H cn OR �f Ra a W � 2vCi wb a _ BUILDING DEPARTMENT © `' VILLAGE OF RYE BROOK L FEB 2 7 2023 DID 938 KING 9drREET RYE BROOK,NY 10573 (914)939-0668 ' VILLAGE OF RYE BROOK wwvV.tA6r9o'knr2 BUILDING DEPARTMENT FOR OFFICE USE ONLY: 20 3 �^ y� ��7�.� Approval Date: e t f#S �op� Application# A/�- -o y / Approval Signature: ARCHITECTURAL REVIEW BOARD: Disapproved: Date: BOT Approval Date: Case# Chairm PB Approval Date: Case# Secretary: ZBA Approval Date: Case# Other: / Application Fee C Permit Fees: SIGN PERMIT APPLICATION Application dated: 02/23/2023 is hereby made to the Building Inspectorof 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.. 1 �> 1. Address: 164 S RIDGE STREET,RYE BROOK,NY SBL:,�-7/e 3 zone:CI 2. Property Use or Business Name: BOND VET 3. Proposed Sign(s)(Describe in detail including number of signs,types,sizes,exact location(s),and illumination method(s)il'applicable.) {A separate Electrical Permit will be required for any associated electrical work.) Install(1)Channel Letter illuminated H 14.375"x W 249.5" 4. Height from grade to highest point of sign: I 1`-20.375" to lowest point of sign: I F-6" 5. Property Owner: wnv RIDGE REALTY,LLC/Alena Hakanjin Address: 24 Rye Ride Plaza Rye Brook,NY 10573 Phone# 914-7014005 Cell# N/A email: ahakaniin(awinridge.com 6. Applicant: CAD Signs-Brandon Hernandez Address: 169 Lodi St.Hackensack,NJ 07601 Phone# 201-267-0457 Cell# N/A email: permitstArACADsigns.net 7. Architect/Engineer: Murdoch Engineering Address: 2399 NJ-34 Suite A-2,Manasquan,NJ 08736 Phone# 973-570-8215 Cell# N/A email: proiectsAmurdochenginecring,com 8. Sign Contractor: CAD Signs-Brandon Hernandez Address: 169 Lodi St.Hackensack.NJ 07601 Phone# 201-267-0457 Cell# N/A email: permitsoaCADsigns.net 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: 01'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:— (Ifyes,a home Occupation Permit Application is required) IL If building is located on a corner lot,which street does it front on: 12. Property frontage: Zx , 4.� 13. Property size:Sq.Ft.: Acres: 14. What is the total estimated cost of construction: $ �l too (The estimated cost slraII include all site improvements,labor,material,scaflblding,fixed equipment,pro tessiona]tees,including any materiat 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. STA OF NEW YORK,COUNTY OF WESTCHESTER ) as: AhIb ��P4 being duly sworn, deposes and states that he/she is the applicant above named, (prinf 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 f I�l'i?-PCTb P— 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 L 3 Sworn to before me this X� day of ftKOkM ,20 2-3 day of ~� , 20 2— i re of P perty('1VMr N Signature of. ID ANG EN&Lys t+ � eela r) � Print Name of Property Owner -r Print Nate of Applicant Not blic N t Public Sure o° MA :ARY ' KMMUN MYMISMt3�tRU SNMOEitZ1A1 I6JEBR4S3E Y -2- 8/12/2021 n N � W a \ H � 61 W i A � xx ON OZo 0Ln o � o � < a W w u w w � QI .7 Ln W ,z x v i, a Q o W 1.4 .. CD 0 r' ►� z z V G o8 a o J 1.4 C w d " z z � z w q w w �o W � 00 W o A rn V w w a A ; 3 a = Z z w O U H8 �. ° 5 W W W a a Bum EPARTMENT VM E OF RYE)ROOK OCT 18 2023 01 938 KIN , ET RYE BROOK,NY 10573 k VILLAGE OF RYE BROOK #.or BUILD_IN_G DEPARTMENT ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required �] FOR OFFICE USE ONLY 3 EP Approval Date: CT g 2023 Permit Fee: $ (�—/96 Approval Signature: Other: Application dated, 9/11/2023 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: 164 SOUTH RIDGE ST-RYE RIDGE SHOPPING CENTER SOUTH SBL: /'ql,3S- —.3 to Zonet � 2.Property Owner: WIN RIDGE REALTY LLC Address: Phone#: 914-7014005 Cell#: email: 3.Master Electrician/Licensed Installer: KEVIN KROGER Address. 701 FAIR ST.,CARMEL,NY 10512 Lic.#: 250 Phone#: 845-490-9140 Cell#: email: KKROGER@KROGERELECTRIC.COM Company Name: KROGER ELECTRIC CO INC Address: 4.Proposed Electrical Work/Fixture Count: NEW CHANNEL LETTER ILLUMINATED SIGN;"BONDVET" 5.3'd Party Electrical Inspection Agency: SWIS STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: ,being duly sworn,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 E.Iectrician/I.iccn%M 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 fo this U day of ,20 day of Signature of Property Owner ig ature of App ant Print Name of Property Owner IP ame of Applicant Notary Public No 7dNk1lc,State of New York No.01ME6160063 Qualified In Westchester County q13/2023 Commission Expires January 29,2 STATE WIDE INSPECTION SERVICES, INC. 0•0 • • APPLICATIONSWIS JOB 0. • Office Use Elect. Permit# Date Bldg Permit# '�P �3BOO Scl Ft Plumbing Permit# Final Certificate# City/Village 4?— aAO V_ Zip 'r1J 7 Building Dept. Count��VJ44—. Address . / 1 CL. Cross�Street Section Block v� TLot- Owner Name/Address(If different than above) Q\ C Z:i Contact Number $y,-�"- AIR O _'�114 O ❑Basement ❑ 1st Fl. ❑2nd Fl. ❑3rd Fl. ❑More Than 3 Fl. ❑Garage ❑Attic ❑Outside ❑Residential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C/O Detector Hood Trash Compact Amt Amps Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer Switch SERVICE Amperage xPanels 1P 3P # Meters # Disconnect ❑Underground ❑ New ❑ Reconnect ❑ Repair ❑Overhead ❑ Upgrade ❑ Disconnect Utility ID# ❑Con Ed ❑ NYSEG ❑Central Hudson ❑ Orange/Rockland PHOTOVOLTAIC SYSTEM PV Modules Inverters AC Disconnect Junction Box Combiner Box Load Center PV Monitor Energy Storage System DC Disconnect ❑Legalization ❑ Safety Inspection ❑Consultation ID OCT 18 2023 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,if at anytime 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. Email Address R r —� EI�Qt`�1C.,�0� Name � License# Date �Q a3 Signature Address 701 City/Stat< ,r,,k Zip Code t CS-1OZ Company ,C « C� T� _� Phone# 'qz) I DDState Wide Inspection Services 1080 Main Street AUG - 7 2024 Fishkill, NY 12524 845 202-7224 Phone VILLAGE OF RYE BROOK 914-219-1062 Fax STATE WIDE INSPECTION SERVICES BUILDING DEPARTMENT _ 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: Kroger Electric Co Inc Win Ridge Realty LLC 701 Fair Street 164 South Ridge Street Carmel, NY 10512 Rye Brook, NY 10573 Located at: 164 South Ridge Street, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP 23-227 141.35 2 36 Certificate Number: 2024-1071 Building Permit Number: SP 23-001 A visual inspection of the electrical system was conducted at the Residential occupancy described below.The electrical system consisting of electrical devices and wiring is located in/on the premises at: 164 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 5th day of August 2024. Name Quantity Rating Circuit Type Exterior LED Sign 01 Service Switch 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 work performed on the date of inspection only. A Building Permit Check List & Zoning Analysis OB & C ONLY r- Address: (0� n6 SBL: 1 �� �- y Zone: - Us • Const.Type:'� Other. Submittal Date: Z 2 Revisions Submittal D : Applicant: v `- a tes Nature of Work. N'�� rG 1�1C'<,w�/�y ��`�' L\kuC-n k C-1C,\-Q 3 / Reviews:ZBA: Z BP: Other. NEED OK ; ( ) ( ;/TES:Filing.-BP:0,z); 7S'2)0�5 C/O: Legalization: ( ) (.4--APP.: Date Stamped: --�_ 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 i Unacceptable: ( ) ( ),PLANS:Date SC ed. Sealed: Copies:Electronic: ,/Other. ( ) (-)""License: --Workers Comp: �L bility Comp.Waiver. Other. ( ) ( ) Code 753#: Dated: N/A: (� ( ) HIGH-VOLTAGE ELECTRICAL:Plans: Permit: N/A: Other. ( ) ( ) LOW-VOLTAGE ELECTRICAL:Plans: Permit: N/A: Other. O O 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. (ORB mtg.date: 3 \ approval:- Z- a 3 notes: ( )ZBA mtg.date: approval: notes: ( )PB mtg.date: approval:- -notes: Qn REQUIRED EXISTING PROPOSED NOTES 1'If{R�ED Area ©ate: 3 207, Cir e: Fron�e _ FFr nt: Front: Sides: R—ear. F.A.R.: Qgen Space Hgight- Stories: notes: J0. BUILDING f5kkRTMENT VILLAGE OF RYE BROOK FEB 2 7 2023 938 KING STREET RYE BROOK,NY 10573 (91<4)9 9-06b8 VILLAGE OF RYE BR60K BUILDING DEPARTMENT ,A 0o1. r _.. c 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: 1644�S RIDGE STREET,RYE BROOK,NY Date of Submission: / Parcel ID#: � �r' r—c�-3 tG Zone(�j— Proposed Improvement(Describe in detail): Install(1)Channel letter illuminated H 14.375"x W 249.5" APPLICANT CHECK LIST: MUST BE COMPLETED BY THE APPLICANT The following items must be submitted to the Building Department by the applicant-no exceptions. Property Owner: WIN RIDGE REALTY,LLC/Alena Hakanjin 1. (v ompleted Application 2. ( Two(2)sets of sealed plans. (one full size (maximum Address: 24 Rye Ridge Plaza Rye Brook,NY 10573 allowable plan size=36"x 42")and one 11"x17") Phone# 914-701-4005 3. (,/�j7 wo(2)copies of the property survey. 4. ( Two(2)copies of the proposed site plan. Applicant appearing before the Board: 5. (XOne electronic/disc copy of the complete. application materials. CAD Signs -Brandon Hernandez 6. ( (ling Fee. Address: 169 Lodi St. Hackensack,NJ 07601 7. ( Any supporting documentation. 8. ( )HOA approval letter. (if applicable) Phone# 201-267-0457 9. (/S 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 me this y 3 Sworn to before me this eh day of f'C$A 320 day of 22^NP, 20 Z� Signa A�ofPmpertt0m" A&WT Signature of Applicant Print Name of Properly 1rt1"j Prin Na of Applica ,,,,, c tc Nota Pu is L PiVic l RM M�1W L C �` NOT PUBLIC OF NEW JERSEY C a, i i _,. ;, - -Z lY COMMISSION x Sol 16843 [((DhW COMMISS EXPIRES 11/13/2024 8/12/2021 URnv� Village of Rye Brook ML MR Aand FB SE Architectural Review Board Meeting AC SF 1 tn+V • � Wednesday,March 15,2023 at 7:30 PM Village Hall,938 Sing Street JN1 1. ITEMS: 1.1. ARB23-008 (Consent Agenda) Gerardo Paico Eusebio&Libia Declet 493 Ellendale Avenue Rooftop solar array. 1.2. ARB23-015 (Consent Agenda) Blake Silverman&Alexa Silverman 18 Milestone Road Rooftop solar array. 1.3. ARB23-016 (Consent Agenda) Jose Sagastizado&Noemi Sagastizado 28 Division Street Rooftop solar array 1.4. ARB23-017 (Consent Agenda) James Bogucki&Nicole Zillitto 300 South Ridge Street 3'high white vinyl fence and gates. 1.5. ARB23-018 (Consent Agenda) Greenway Close LLC 78 Greenway Close 4'high split rail fence w/black mesh. 1.6. ARB23-019 (Consent Agenda) Daniel Lyons&Michele Lyons 12 Country Ridge Circle 5'high white vinyl picket fence. 1.7. ARB23-020 (Consent Agenda) Scott Levy&Nicole Levy 42 Meadowlark Road 6'high white vinyl privacy fence and 4'high gates. Consent Agenda Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes Page 1 of 3 Architectural Review Board March 15,2023 1.8. ARB23-013 David Richardson&Alexandra de Vaux Richardson 44 Rock Ridge Drive Rear patio,driveway,walkways and fence. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.9. ARB23-021 Win Ridge Realty LLC (BondVet) 164 South Ridge Street Illuminated sign. n 17 Approvals: Motion Second ;n r \dL' Abstention Aye;_1A - Nay; y Adjournment; Notes 1.10. ARB23-022 Jamie Billington&Kara Billington 6 Bonwit Road Front and rear two-story addition,covered front porch,deck and interior alterations. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.11. ARB23-023 Ervin Gomez&Maria Gomez 59 South Ridge Street 2nd story addition over existing two car garage. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes Page 2 of 3 Architectural Review Board March 15,2023 1.12. ARB23-024 Patrick Carroll 8 Oriole Place Rear deck,entry stoop repair,new railings,front door,windows above front door and siding. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes NEXT MEETING: April 19,2023 Page 3 of 3 Policy Number: Date Entered: 2/23/2023 ACORN® DATE(MMIDOMlYY) . L� CERTIFICATE OF LIABILITY INSURANCE DATE I 023 ONY 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 Farm Family - 5 Walter Foran NAME: Suite 2010 PHONE (732)907-0174 ac No: - E-MAIL contact@ever reene artners.com Flemington, NJ 08822 ADDRESS: g P INSURER(S)AFFORDING COVERAGE NAIC p INSURERA:United Farm Family Insurance Co. 29963 INSURED Signs CAD COLA dba CAD Signs INSURER B:Farm Family Casualty Insurance 13803 INSURER C: 169 Lodi St INSURERD: Hackensack, NJ 07601 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LIMITS TR POLICY NUMBER M DDNYYY M/DD A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS-MADE ®OCCUR 2901X6162 10/24/2022 0/24/2023 DAMAGE TO RENTED 100 OOO PREMISES Ea occurrence $ MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRO ❑ LOC PRODUCTS $2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1 000 000 Ea accident $ ANY AUTO 2901C3301 10/24/2022 0/24/2023 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY nSl AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Pefaccident 2 $ A UMBRELLA LIAB OCCUR EACH OCCURRENCE $5,000,000 EXCESS LIAB �9 CLAIMS-MADE 2901E2418 10/24/2022 0/24/2023 AGGREGATE $5,000,000 DED 1xi RETENTION$10,000 $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER A ANY OFFICER/MEMBER/EXCLUDED?ECUTNE � N/A 2902W6718 10/24/2022 0/24/2023 E.L.EACH ACCIDENT $1,000,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 It yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Disability 2901X6162 10/24/2022 0/24/2023 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Addtdonal Remarks Schedule,may be attached it more space Is required) CERTIFICATE HOLDER CANCELLATION Village of Rye Brook 938 King Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Rye Brook,NY 10573 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Compensation;41NEW Workers' Policy Number:2902W6718 TE CERTIFICATE OF Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured Signs CAD Corp dba CAD Signs 201-267-0457 1c.NYS Unemployment Insurance Employer Registration Number of 196 Lodi St Insured Hackensack, NJ 07601 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 27-0186720 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) FARM FAMILY CASUALTY INSURANCE Village of Rye Brook 938 King Street 3b.Policy Number of Entity Listed in Box"la" Rye Brook, NY 10573 2902W6718 3c.Policy effective period 10/24/2022 to 10/24/2023 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". 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"3c",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. Farm Family - 5 Walter Foran Approved by: Michael Ilg (Print name of authorized representative or licensed agent of insurance carrier) Ilg Approved by: X 2/24/2023 (Signature) (Date) Title: CAPTIVE AGENT FOR FARM FAMILY Telephone Number of authorized representative or licensed agent of insurance carrier: 908-751-5922 Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insurance brokers are NOT authorized to issue it. C-105.2 (9-17) www.wcb.ny.gov 0 CA v > m 0 M z > lb m 0 X rws ro X l< m -Al C CAD 0 0 "Mft--4. z < co < Cr 'TI ,.G) ZM M co 0 0 m rr M C=D z 0 QQ (D U) r+ MOON (D (D r-+ %.o olu (D co OT 0 0 < z m 0 0-1 cm m 0 0 10 O c� l< OD 7 O 77 0 W C/ m o ro s ro (D _. aN U) (D 0 (D O XroCT ,. 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