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HomeMy WebLinkAboutBP23-051PERMIT #ojl SECTION TYPE OF WORK,,,r 10B LOCATION _ OWNER A0.4; . CONTRACTOR TvI . COST 3 ._. DATE: 'q c3 �(P' BLOC Q ` / �-=)97& 9511 TCO # FEE DATE DATE FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING RGH PLUMBING GAS 0 SPRINKLER ELECTRIC 0 LOW -VOLT m ALARM m AS BUILT u FINAL INSP O TIiER APPROVALS U BOT PS ZBA OTHER AS-BUILTIFWAL Sl1RVEY REQUIRED PRIOR TO FINAL INSPECTION �vA t 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.ryebrook.org TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE July 18,2023 Scott Stern&Bonnie Stern 79 Greenway Close Rye Brook,New York 10573 Re: 79 Greenway Close, Rye Brook,New York 10573 Parcel ID#: 129.84-2-68 Building Permit#23-051 issued on 4/28/2023 for a New Fence This certifies that the new three foot high split rail fence and gate,installed under the above captioned permit has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to p ID BUILDW6 ilRTMENT For office us nl JUN - 8 2023 VILLAGE OF RYE BROOK PERMIT# 3- ISSUED: 938 KING STREET,RYE BROOK,NEw YORK 10573 DATE: VILLAGE OF RYE BROOK (914)939-0668 FEE: PA11% BUILDING DEPARTMENT Iwww,rYgbrook.ers? 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 ►iti►t\►flit►Ii►►►t►/fliti►►►►►►tt►f►If►►►i►►•tittl►t►il►►t►►►►t•ti►►►■i►♦►►►fff►t►►f►►f•fluff►f\itftfiii►iiiiiiiiiii►i►ii►►i Address: V r6eqjw 610 Occupancy/Use: Parcel lD#: �� /� O L�— �' C�� Zone: u1� Owner:��7� S � Address: -7 f CLoSe— P.E./R.A. or Contractor: Address: Person in responsible charge: MltAad 1,✓,4&e4 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 Y RK,COUNTY OF WESTCHESTER as: /, �C�� being duly sworn,deposes and says that he/she resides at � e/�Oy-wy e;6.< , (Print Name of plicant) '_`I/ (No.and Streit) V in ,in the County of V :!-�2 Szr,-r- in the State of / ,that (City/fown/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:$ 3 s , 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 Swom to before me this day of �L�-� ,20 day of , 20 r Si ature o Owner Signature of Applicant 5«1-7--5y'e-tl-1 Name of Property Owner Print Name of Applicant Notary Fdblic Notary Public SHARI MEULLO Notary Public,State of New York sii 2i202 1 No.OIME6160063 Qualified In Westchester County Commission Expires January 29,2t� �E BRC�k. w � • 1982 BUILDING DEPARTMENT )XUILDING 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.orl; - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - = - - - - - - - - - - - - ADDRESS: GA C DATE: PERMIT# � � ISSUED:""t -,�� ECT: '�� ` BLPA�,K: ^z- LOT: 71 LOCATION: OCCUPANCY: ❑ Violation Noted THE WORK IS....4ePASSED ❑ 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 ❑ MOSS CONNECTION ,'FINAL ❑ OTHER a � w � e O N CD w ■ ■ N N p3 'O ■ M N W r ■ N o° o.CL e oo0-4 0 w ; s V GO d pp C9 l ` a _ ° Q 7 p cn W V J f 1 h+H C -S 4 C � �./ `o uo s 0 z co N oo a/ z A O W o o © O \ W ^ a Z W z v 0-4 x � w - � W 00 F-4 C/3 ' (To U) .d rCYA � � � � � C .: cn u a, w v M p � ,woo � � Z Cd � � v � O W � w z ° ° a � � „ va O U O O H o .o a� .0 ,.., zova, U O U z w � x ° a Jw av� av ° I..� GG G1 zW W � o : � a tl A w z a o9 o .M � idz_ .. J A. w w ¢ui .v au a BUILDING DEPARTMENT 0 VILLAGE OF RYE BROOK APR - 5 2023 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 VILLAGE OF RYE BROOK Hivtiv.i vebr oul;.ttrg BUILDING DEPARTMENT FOR OFFICE USE ONLY: Approval Date: APR ermit Application#Iy f&q � Approval Signature: ARCHITECTURAL REVIEW BOARD: Disapproved: Date: BOT Approval Date: Case# ; Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Case# Other: /� \ Application Fee: )0b Permit Fees: FENCE / WALL / GATE PERMIT APPLICATION Application dated: 7/3 f Z3 is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the installation,construction,repair or replacement of a Fence,Wall or Gate,in accordance with Section 250-6 B.(1)(g),of the Code of the Village of Rye Brook,as per detailed statement described below. Swimming pool fencess must conform to the State Code. I. Job Address: ! �"� 51✓ / _U� K IJ 73 2. Occupancy/Use: / �!� S.B.L.#: — Zone: loalb 3. Propo/sed Fence/Wall/Gate(describe in detail): .� ff r� (e -4N, C e— w 1`+h /Y+w t�h�` c,✓a r K t� y� " Br�wt�'rK 3�kK �/� 4. Property Owner: � -} [7�� vv , fat Lf D 1 Address: try 5 L ��ti� Phone# /9( 3S /o 7 u Cell# 7/y '41 a 9- •7& email: J� r ej, 5137 e- „V,•i. GD✓�'t Applicant: ` c/ Address::2 a 6A A y LU[�?� yG fJ/1EsU ,� �! le- 7 S Phone# ql7 2-35—le,ZU Cell# fly "16,z '/76 email: �ft°�7J. N37 f- j w Architect/Engineer: Address: Phone# //__ Cell# emai`l:` �J Contractor /►V �4 4 �/t� •��/C t!'`7�1 /2 (+pV / f�q�S Address&Phone: 1Q1,S1///PL/ /`,�1✓� /(,/EGA rC J`!C114P A)7 9Z7— da 7— 1 S� 5. If building is located on a corner lot,which doe front on: 6. What is the estimated cost of construction '35 (NOTE:The estimated cost shall include all site improvements,labor,material,scaffolding,fixed equipment,professional fees,and material and labor which may be donated gratis.) 7. Estimated date of completion: t 811 212 02 1 Please note that this application must include the notarized signature(s) of the legal owner(s) of the above-mentioned property, in the space provided below. Any application not bearing the legal property owner's notarized signature(s) shall be deemed null and void, and will be returned to the applicant. STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: ,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 for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,attorney,etc.) That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Swom to before me this 2 Sworn to before me this day of , 203 day of , 20 Si ature of erty Owner Signature of Applicant .S Cv 7l-- S �� P ' ame of Property Owner Print Name of Applicant — X�� �., V/\1 -i Lkt, Notary Public Notary Public SHARI MEULLO Notary Public,State of New York No.01ME6160063 Qualified in Westchester County Commisslon Expires January 29.20 2 2 8/1212021 Building Permit Check List&Zoning Analysis -7(] �`q e � \c-� - SBL: \'� Address: -1 ��n u Zone: r? Use: Cont.Type: Other. Submittal Date: () -2�ievision Submittal Dates: Applicant: Nature of Work Reviews:ZBA PB• BOT: Other. NEED �� FEES:Filing. BP: �� `' C/O: Flood Plane: Legalization: ( ) (�_APP: Dated �/- otarized: / 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 M Tree Plan: Other. ( ) (),"SURVEY:Dated: 1 23 Current:=vaL• Sealed Unacceptable: ( ) (�I PLANS:Date tamped Sealed:�_Copies:�—Electronic: Other. License: Workers Comp: Liability: ✓ Comp.Waiver. Other. (l ( CODE 753#:_ c1�53 -©O 3 -Cb�I-C XD Dated N/A ( ) ( ) HIGH-VOLTAGE ELECTRICAL:Plans: Permit: N/A Other. ( ) ( ) LOW-VOLTAGE ELECTRICAL:Plan: Permit: N/A: Other. ( ) ( ) FIRE ALARM/SMOKE DETECTORS:Plans: Permit H W.I.C.:_Battery:_Other. ( ) ( ) PLUMBING:Plan: 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:Plan: Permit: Fuel Type: Other: O O 2020 NY State ECCC: N/A: Other. Final Survey Final Topo: RA/PE Sign-off Letter. As-Built Plan: Other: ( ) ( ) BP DENIAL LETTER: C/O DENIAL LETTER: Other: ( ) ( ) Other. (i�ARB mtg.date: t -0-\OU approval • ores: - ( )ZBA mtg.date: approval• notes: ( )PB mtg.date: approvaL• notes: REQUIRED EX1Si'ING PROPOSED NOTES APPROVED Arm CirVale: Fror►t: Front Sides: Main Cov: Accs.Cov Ft.H/Sb: H S S Tot : HHlcj& Stories• notes: DD BUILDING DEPARTMENT VILL` WE OF RYE BROOK APR - 5 2023 938 KING S�>I2EET RYE BROOK,NY 10573 (914)9 9-0668�J` VILLAGE OF RYE BROOK Itiw��.ry rook.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 cto submit a copy of this check list will be removed from the ARB agenda. Job Address: 7 rcew w 4 y olds e— Date of SLu/bmission: Parcel ID#:l80i ej--af &S> Zone: / U, ) 7 o�3 Proposed Improvement(Describe in detail): APPLICANT CHECK LIST: MUST BE COMPLETED BY THE APPLICANT 5r r fri rn 4"t tr� The following items must be submitted to the Building iyq -te- 9X" a 3fK ycq r-;N-) Department by the applicant-no exceptions. Property Owner: �e S f�f ,J 1. (a<Completed Application 2. ( )Two(2)sets of sealed plans. (one tun size {maximum Address: IT &ee,-may G/O S allowable plan size=36"x 42";and one 1 I"x 17") 23S —/0 7 O 3. ( Two(2)copies of the property survey. Phone# 9/'7 4. (/ Two(2)copies of the proposed site plan. Applicant appearing before the Board: 5. (%jOne electronic/disc copy of the complete application materials. 6. (Filing Fee. Address: //v S-e-- 7. ( )Any supporting documentation. Phone# �j' /4 2-3 / / 7 v U 8. (BOA approval letter. (if applicable) 9. (-TPhotographs. Architect/Engineer: 10.( ) Samples of finishes/color chart. (a sample board or model may be presented the night o(dre 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 Sworn to before me this day of ,20 day of , 20___ tgnaturc operty Owner Signature of Applicant S, C P t Name of Property Owner Print Name of Applicant Notary Public SHARI MEULLO Notary Public Notary Public,State of New York No.01ME6160063 Qualified In Westchester County 1 Commission Expires January 29.20Z xn 2i2021 F APR - 5 2023 VILLAGE OF RYE BROOK BUILDING DEPARTMENT The Arbors Homeowners' Association 173 '/z Ivy Hill Crescent In Rye Brook, NY 10573 March 301h 2023 Scott and Bonnie Stern 79 Greenway Close Rye Brook, NY 10573 Re: Fence Installation Dear Scott and Bonnie, The Architecture and Grounds Committee (A&G) has reviewed your application for the above-named work. This project requires a permit from The Village of Rye Brook. You are approved to get a permit from the Village of Rye Brook. You are directed to submit this letter to the Village along with your permit application. Once the permit is obtained, a copy must be provided to A&G. Work on the project may not begin until you receive written notice of receipt of your permit from A&G. If any changes are made to the original plans submitted to A&G, due to input from the Village or arising during construction, the Committee must be notified in writing. Work cannot proceed until you receive written approval for those changes. Failure to comply with these procedures will result in fines and/or work stoppage. If you have any questions, please contact me at: Property Manager. Sincerely, Nicholas Salzarulo Property Manager Village of Rye Brook ML V, MR Agenda J cw `V Architectural Review Board Meeting FB SE to, Ile `' ' g AC ✓ SF .LJ G C�L�..w 4Jy (tl', Wednesday,April 19,2023 at 7:30 PM M / Village Hall,938 King Street J 190 1. ITEMS: 1.1. ARB23-025 (Consent Agenda) James Luciano&Helen Luciano 14 Lyon Street Rooftop solar array. 1.2. ARB23-026(Consent Agenda) Karina Yapur 30 Tamarack Road Rooftop solar array. 1.3. ARB23-027 (Consent Agenda) Han-Hsuan Liu&Haoyun Feng 27 Mohegan Lane Rooftop solar array. 1.4. ARB23-028(Consent Agenda) Victor Patemo&Annemarie Paterno 15 Old Orchard Road Replace front walk,entry steps,driveway retaining wall and re-pave driveway. 1.5. ARB23-029 (Consent Agenda) Christopher Davis&Lauren Davis 1 Whippoorwill Road Replace front walk, front steps,re-do concrete patio with pavers and install gas firepit. 1.6. ARB23-030 (Consent Agenda) Jonathan Fog&Alison Fog 1 Country Ridge Circle 6'&4'high white vinyl fence and gates. 1.7. ARB23-031 (Consent Agenda) Cape Eland LLC 12 Rock Ridge Drive 4'high welded wire fence and gates. 1.8. ARB23-032(Consent Agenda) Scott Stern&Bonnie Stern 79 Greenway Close 3'high split rail fence and gate. 1.9. ARB23-033 (Consent Agenda) Fabricio Denadae&Luciana Chieus do Amaral 110 Brush Hollow Close Replace decking on existing rear deck. Architectural Review Board April 19,2023 Consent Agenda Approvals: Motion C(� Second C'Y\ Abstention Aye;_ Nay; Adjournment; Notes 1.10. ARB23-034(Amendment to Prior Approval) Matan Dvir&Ilana Dvir 1 Dorchester Drive Dormer modifications. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.11. ARB23-035 Eric Goldstein&Rebecca Meban 5 Berkley Drive Rear covered porch,stone walkway and drainage. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.12. ARB23-036 Scott Hirsch&Christine Staeger-Hirsch 1 Beacon Lane Remove rear door,install window.Remove side bay window,install sliding doors. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.13. ARB23-037 (Amendment to Prior Approval) Win Ridge Realty LLC 166 South Ridge Street New store front"Amazing Lash Studio" Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes NEXT MEETING: May 17,2023 OWN 40. .. 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I�,+�5ih4'►A , �I�l�tht� �/t)1 i�t' A ® DATE(MM/ Y CERTIFICATE OF LIABILITY INSURANCE o2/2a/2023zo23 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 Cole Lahey NAME: PF Northeast Brokerage Inc PH cONNo A/ E (845)223-8107 FAX EXt: ,No (845)227-8816 ac 1035 Route 82 E-MAIL clahey@pfnortheast.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Hopewell Junction NY 12533 INSURER A: Selective Insurance Company of South Carolina 19259 INSURED INSURER B: Preferred Professional Insurance Company 36234 Globe Fence&Railings Inc INSURER c: Shelter Point Life Ins.Company Globe Commercial Fence Inc INSURER D: 121 Surrey Drive INSURER E: New Rochelle NY 10804 INSURER F: COVERAGES CERTIFICATE NUMBER: CL229614119 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 AIJULISUBIR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDD MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FX OCCUR PREMISES Ea occurrence $ 500,000 X Contractual Liability 15,000 MED EXP(Any one person) $ A S2376529 09/16/2022 09/16/2023 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE S 3,000,000 POLICY II PRO- ❑ 3,000,000 JECT LOC PRODUCTS-COMP/OP AGG 5 OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000,000 Ea accident IX ANY AUTO BODILY INJURY(Per person) $ AOWNED SCHEDULED S2376529 09/16/2022 09/16/2023 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED IX NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ X UMBRELLA LAB I- OCCUR EACH OCCURRENCE $ 7,000,000 A EXCESS LAB CLAIMS-MADE S2376529 09/16/2022 09/16/2023 AGGREGATE $ 7,000,000 DIED D RETENTION$ 10,000 $ WORKERS COMPENSATION X STATUTE OT ERH AND EMPLOYERS'LIABILITY B ANY PROPRIETOR/PARTNER/EXECUTIVE Y❑ NIA ON13164-01 09/16/2022 09/16/2023 E.L.EACHACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ NYS Statutory Disability C DBL431716 01/01/2022 12/31/2023 NYS Statutory Limits Included DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) RE:79 Greenway Close,Rye Brook,NY 10573. Provided it is required by written contract,the following are named as additional insured as respects general liability with regard to work being performed by the insured under form CG730ONY 0119,to the extent provided therein:Village of Rye Brook. 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 CO(C- Fj "�j `/ ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD STATE OF NEW YORK WORKERS' COMPENSATION BOARD CERTIFICATE OF NYS WORKERS' COMPENSATION INSURANCE COVERAGE la.Legal Name&Address of Insured(Use street address only) lb.Business Telephone Number of Insured (914)576-7100 Globe Fence&Railings Inc. 121 Surrey Drive lc.NYS Unemployment Insurance Employer New Rochelle, NY 10804 Registration Number of Insured Work Location of Insured (Only required if coverage is ld.Federal Employer Identification Number of Insured specifically limited to certain locations in New York State, i.e., a or Social Security Number Wrap-Up Policy) 050573348 2.Name and Address of the Entity Requesting Proof of 3a. Natnc of Insurance Carrier Coverage(Entity Being Listed as the Certificate Holder) Preferred Professional Insurance Company Village of Rye Brook 3b.Policy Number of entity listed in box"la" 938 King Street ON13164-01 Rye Brook, NY 10573 3c. Policy effective period 9/16/22 to 9/16/23 3d. The Proprietor,Partners or Executive Officers are included. (Only check box if all partners/officers included) X all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box "Y' 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"T'. The Insurance Carrier will also noth,the above certificate holder within 10 days IFa 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. Please Note: Upon the 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 1 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: Joseph W.Pires (Print name ofauthorized representative or licensed agent of insurance carrier) Approved by: / *444 2/24/2023 (Signature) (Date) Title: President—PF Northeast Brokerage Inc. Telephone Number of authorized representative or licensed agent of insurance carrier: (845)223-8107 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(9-07) www.wcb.state.ny.us Laura Petersen From: UDig NY Exactix <tickets@exactix.udigny.org> Sent: Tuesday,April 2S, 2023 4:32 PM To: Steven Fews Subject: Message from UDig NY ****REGULAR**** DIG REQUEST from UDig NY for: VIL RYE BROOK Taken: 04/25/2023 16:32 To: VIL RYE BROOK PRIMARY Transmitted: 04/25/2023 16:32 00001 Ticket: 04253-003-004-00 Type: Regular Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 79 To: Name: GREENWAY CLOS Cross: From: To: Name: Offset: ------------------------------------------------------------------------------ Locate: LAST HSE ON THE RIGHT, AREA WITH MARKED OUT W/STRING LINE AND PINS (PINK OR GREEN) IN THE GROUND , SIDE AND REAR YD OF HSE, AS FACING FRT OF HSE FROM STR LEFT SIDE NearSt: GREENWAY LN & BRUSH HOLLOW LN Means of Excavation: POST HOLE DIGGER AND A PRY BAR Blasting: N Site marked with white: N Boring/Directional Drilling: N Within 25ft of Edge of Road: N Work Type: INSTALL WOODEN POST AND RAIL FENCE Estimated Work Complete Date: 05/05/2023 Depth of excavation: 2.6 FEET Site dimensions: Length 70 FEET Width 50 FEET Start Date and Time: 05/02/2023 08:00 Must Start By: 05/16/2023 ------------------------------------------------------------------------------ Contact Name: MICHAEL WALTER Company: GLOBE FENCE & RAILINGS Addr1: 121 SURREY DR Addr2: City: NEW ROCHELLE State: NY Zip: 10804 Phone: 914-576-7100 Fax: Email: globefence@gmail.com Field Contact: MICHAEL WALTER Alt Phone: 914-576-7100 Email: globefence@gmail.com Working for: PRIVATE HOMEOWNER ------------------------------------------------------------------------------ Comments: Lookup Type: ADDRESS ------------------------------------------------------------------------------ Members: ALTICE USA BELL-VALHALLA/ WSCHSTR CON-ED SUEZ WTR WESTCHESTER 1 �`a��1 BLOCK 1 Io D 5 1O A+EDJ� LOT 1 GRAPHIC SCALR (In Feet) S32'00'00'W 55' ) Inch - 10' ft (� TRlI tTIL 0, BLOCK 2 L LOT 1 Q LOT 68co LOT Qe 6 H B� (FM)) 0 ' PAVED fE71L4 FILE CUP . aL •r + LOT 69 LOT 80 (FM) V A/C 1 1/2 STORY CHIMNEY FRAME OV 31M `I (VAIN SEWN:) Cp. Iwte, y`, vii)ago of Rye 1 n w pitur�l Revi ' ' � o 1.= co 0 1 pprovall� ttpN°?. -- )F4-01 N Chairman: l l SCi ;n CAI m ' m-n `M vZADE M D ;0r- / ON �s9• r c LOT 1 �0%0� `+4 < r y� O m PEAMI # '0 5.30' [APR - 5 2023 ssl# a DAT P APR 2 4 jt23 ILLAGE OF RYE BROOK OREENWAY CLOSE BUILDING DEPARTMENT BUILDING SPECTOR,Village of Rye Brook,NY AvaWAM AOM BEING IN THE VILLAGE OF RYE BROOK, TOWN OF RYE,COUNTY OF WESTCHESTER AND STATE OF NEW 5134 SO FT OR YORK. KNOWN AND DESIGNATED AS LOT NO. 79 ON A CERTAIN MAP ENTITLED, 'AMENDED SLJBDV190N 0.118 ACRES OF BERCO RYE TOM CO., SITUATED IN THE TOWN OF RYE, WESTCHESTER COUNTY,N.Y.'.FILED IN THE WESTCHESTER COUNTY CLERKS OMCE. DIVISION OF LAND RECORDS,ON NOVEMBER 23, 1977 AS MAP NO. 19322.WHICH MAP WAS REPLACED AND AMENDED BY FILED MAP NO. 28740 SLWMY OF PROPERTY XNM A& EW SLOW IS �I' TAX MAP LOT$8.BLOCK 2,SECTION 12984 BONNIE STERN AND SCOTT STERN STREET No 79 CREENWAY CLOSE RECORD AND RETURN TITLE AGENCY, INC. (RR-W-46995-22) VILLAGE OF RYE BROOK, TOWN OF RYE, COUNTY OLD REPUBLIC TITLE INSURANCE COMPANY OF WESTCHESTEFI, STATE OF NEW PORK RUSSELL FAYER, ESO ern F• DRAMm BY: 0 BY. M23n 7 R 1'.10' A.S N.M. NY23-M 8 1 OF 1 AV?IM%6XIWAM MAPPMKa 3 LAYOUT 1.UNAUTHORIZED ALTERATION OR ApDI110N TO A SURVEY MAP BEARING A LICENSED LAND SURVEYOR'S SEAL IS A VIOLATION OF THE NEW YORK LAW. ONLY SURVEY MAPS MATH THE SURVEYOR'S EMBOSSED SEAL ARE A MOFIEEIOIAL OU11MY AND MAPPBID pLQUP GENUINE TRUE AND CORRECT COPIES OF THE SURVEYOR'S ORIGINAL WORK AND OPINION. CERTIFICATE OF AUTHORIZAT10N:24GA28278000 2. CERTIFXATKINS INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY 15 230 BROAD STREET, 2L TEL 973-255-5020 PREPARED AND ON THEIR BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING BLOOMFIELD.NA 07003 FAX! 973-258-2550 INSTITUTION LISTED HEREON.AND TO THE ASSIGNEES OF THE LENDING INSTITUTIONS. CERTIFICATIONS ARE I M NOT TRANSFERABLE TO THE ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS. NARINDRA 0. MOMAN PLS N.Y. LIC NO OSl100 3. THIS SURVEY HAS BEEN PREPARED FOR THE PURPOSE OF CONVEYANCE OF TITLE ONLY AND IS SUBJECT RAYMOND P. FELDMAII, P1.5 N.Y UC NO. 050701 TO ANY EASEMENTS,GRANTS,RESTRICTIONS.RIGHT-OF-WAYS AND CONDITIONS OF RECORD AND SUCH P.A. UC. NO. 052337E STATE OF FACTS WHICH AN ACCURATE AND CURRENT ABSTRACT OF TITLE MIGHT DISCLOSE. MICHAEL H SAPERSTEIN,P.L.S. N.J.UC.NO 037806 ♦ AS PER CONTRACTUAL AGREEMENT CORNER MARKERS HAVE NOT BEEN SET. 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