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HomeMy WebLinkAboutBP23-068PERMIT #4jL SECTION TYPE OF WORK JOB LOCA N _ OWNER CONTRACTOR re I o TCO # 3- 06 DATE:mmmml� � ,76o BLOCK LOT FEE / Mttfw 2 FEE DATE INSPECTION RECORD DATE I NSP el -AAR (%uJ it door i Qo!j lie ���► e—dol�l�l�a/ C9/y) 70� 7557 7557 FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING 0 RGH PLUMBING GAS SPRINKLER-,oa3 —//V& Ol/�tc1(c'A'j`•�'/%Q ELECTRIC - - lwoodk LOW-VOLT O ALARM O AS BUILT FINALn A �WAL SURVEY REQUIRED PRIOR TO FINAL INSPECTION ✓e 9 !o y VILLAGE OF RYE BROOK WESTCHESTER COUNTY, NEW YORK No: 24-115 Cratftcate of ®ccupaucp This is to certify that /yo-as 36 Qnw/ of, P8y06) /�� V 7 , having duly filed an application on ffo V� lJi'/� { 20�requesting a Certificate of Occupancy for the premises known as, //0 � � ) / �//dG(� ( /��� , Rye Brook,NY,located in a-P I Zoning Qq I District and shown on the most current Tax Map as Section: Block: / Lot: and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No -� , issued fM 20�, such authority and permission is hereby granted to the property owner to lawfully occupy or use said premises or building or part thereof listed under the following New York State Classifications,Use: - la."w/.k/ Construction: r for the following purposes: *bU I IC.I' to GV U/ S �1� �U h 0l a l G 61- l lh YQ y" d -�hp_ WO //7 kl-)YJ-7'- Subject to all the privileges, requirements, limitations, and conditions prescribed by law, and subject also to the following: This certificate does not in any way relieve the owners or any person or persons in possession or control of the premises, building,or any part thereof from obtaining such other permits or licenses as may be prescribed by law for the uses or purposes for which the building or premises is designed or intended. Furthermore, it does not relieve such owners or persons from complying with any lawful order issued with the object of maintaining the premises or building in a safe and lawful condition. No changes or rearrangement in the structural parts of the building or in the exit facilities shall be made,and no enlargement, whether by extending on any side or by increasing in height shall be made,no 1 the building be moved from one location to another until a permit to accomplish such change has r7T�r ilding Inspector. SEP 1 7 2024 Building Inspector, Village of Rye Brook: Date: D �l I� For office use only: BUILDw6'-DEPARTMENT PERMIT# j r NOV ' YO23 ! VILLAGE OF RYE BROOK ISSUED: !938 KING STREETj'RYE BROOK,NEW YORK 10573 DAZE: /—a3 VILLAGE OF RYE BROOK (0-49 -06 0- FEE: q //p— PAID$ BUILDING DEPARTMENT wwi� E20k.0r,Ly 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 kilo►i►iiiliiti►#iti#iiiii#Iitittfiititiitifitit►lifitil►it►ifittliiiittlLitt►f►lif►l►tiittl3►iiit#k#ki►►#iiiti►kiitif►tk►►lki Address: 1 l b 1r l l S h {-{p I t J (2( OS o f �l� e �j roc)k- DS 73 Occupancy/Use: Parcel ID#: �(P —/—/ 0 Zone: u Owner: "FQ r i c t c) --b rla Cue- Address: t I D LZf u4i t4b1 I t)Q) eI c &bdk 6i o�,�d P.E./R.A. orContractor�.1'��/4 �lr<o%a�L/1/iv�yEjro4 Address: /33 5 P��p y Person in responsible charge: �4e Address: (�/e�J Wypc,��d��x�, A)V //SS/7 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: 4 I _FAD Y'tCi D �>e n ada e. being duly sworn,deposes and says that he/she resides at 1 ( D �rLts 1 jAbj)DUB e I!w (Print Name of Applicant) / (No.and Street) in e `B r ao k in the County of JILleS-�6 7Pr in the State ofK,that (City/Town/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:5 for the construction or alteration of. 0(7 Q .D 0 toA 'Rc 1�Jct 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. / worn to before me this Sworn to before me this o ')o , 20c� o 0v Sign e o opetty Owner tore of ppltcant o� t\a a -- Cl b �11C� Pri Name of Property O er ame of Applicant c Notary Public SHARI MELILLO N6taryPL8HARI MELILLO Notary Public,State of New York Notary Public,State of New York No.OIME6160063 No.O1ME616OO63 Qualified In Westchester County-) Qualified In Westchester County Commission Expires January 29,20L, commission Expires January 29,202q �yE l3RC�,�, o`` tim cu � • 1982 BUILDING DEPARTMENT �BUILDING INSPECTOR 'I]ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 King Street• Rye Brook, NY 10573 (914) 939-0668 FAx (914) 939-5801 www.ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - -- - - - - - =- - - ADDRESS : \ `'` �� 1� ` \ f- C �`-� DATE: 'V I b 2 1 PERMIT# "/ / ISSUED:SECT: t�C ISLOCK: LOT: J LOCATION: { - C. }� W� S O CUPANCY: ❑ Violation Noted THE WORK IS... J - PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas ❑ L.P. Gas ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION FINAL ❑ OTHER a' s. a 00 N pl = N w a : cV M � � • H w -Co. � 1-4 s_ �T , (IJ nS C• y hr"l m o d O a � � � -ECA 0 W LO on04 to u tzrf L H OV C F frl W oo v " a ° yYF�j� CD pz V a 0-1C 444 � 4 hey P"I p V Z '1 a w x a WLn Ln odLo O n Z �« a [� yg *" z o a o V o V PLO Ln 00 ld oo r z y ` �481 � o 'Tom+# � �.• Z O O " "o IS Q a ICI � � y, � g C R. � v 4^, � fwFi�Jl v W Z0. d u a Z W 0 W W ] .A U BUIL A�RTMENT -- - II-11- t�7 VI JET E OF RYE BROOK : U V 938 KING RYE BROOK,NY 10573668 MAY - 3 2023 o r VILLA,,-- _ ""'ROOK FOR OFFICE USE ONLY: bo Approval Date: MAY q m2�&k .&OQ,3 Application# RB 2 -0 Approval Signature: ARCHITECTURAL REVIEW BOARD: Disapproved: Date: BOT Approval Date: Ca # Chairman: PB Approval Date: Case# Secretary ZBA Approval Date: Case# : ; Other: Application Fee: ' Permit Fees:4AX) — u EXTERIOR BUILDING PERMIT APPLICATION Application dated: .3 is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the construction of buildings,structures,additions,alterations or for a change in use,as per detailed statement described below. 1. JobAddress: 11 D r©cLi h Hai lxj G'1D5� , Pye 1j3rQ Ol,' ! 6S73 2. Parcel ID#: q — _ sD Zone: 3. Proposeq I provement(Descnb n detail): r qar S f e S 46 ,�Z C Wes- �4 . CS A- e - '_vS + 4. Property Owner: I G c) -e n o d e Address: P S ix-se D 10�Tf Phone# _f 6,' gb/- Z6�9_5 Cell# Q/L/- 7Z87 s'G 7 e-mail Sac Z AQ bb Ca+Y1 List All Other Properties Owned in Rye Brook: Applicant: `__Q6 rl C(b e_Address: t GU L1&se i2 e t OS73 Phone# Il _ 2b - � �Cell# �y-7�g��5 e-mailS @1 4a bb 16.Cbtn Architect: 'C' aae a ' a ++ Address: (_ 3 C.,Ienwp6d Phone# 2� Cell# q 1[�- 7��-75 a io.? e-mail 6! f Qh Engineer: Address: Phone# Cell# p e-mail General Contractor: r t 0 l t Lb Ue Tnc. Address: � 1 f S '-f Phone# _S(L.- SbL 2 625 Cell# - 109-7 SS 7 C1 90d Ut conq (1} 8/12/2021 5. Occupancy;(1-Fam.,2-Fam.,Commercial.,etc...)Pre-construction:_ ithB1 Post-construction: 6. Area of lot: Square feet: -Z Acres: 7. Dimensions from proposed building or structure to lot lines: front yard: rear yard: N d` right side yard: left side yard: other: 8. If building is located on a corner lot,which street does it front on: 9. Area of proposed building in square feet: Basement: I"fl: 2nd fl: 3rd fl: 10. Total Square Footage of the proposed new construction: 11. For additions,total square footage added: Basement: I"fl: 2nd fl: 31 fl: 12. Total Square Footage of the proposed renovation to the existing structure: 13. N.Y.State Construction Classification: N.Y. State Use Classification: 14. Number of stories: Overall Height: Z Z' Median Height: 15. Basement to be full,or partial: , finished or unfinished: 16. What material is the exterior finish: O'� -r). Vv- 17. Roof style;peaked,hip,mansard,shed,etc: Roofing material: .v.- 18. What system of heating: 19. If private sewage disposal is necessary,approval by the Westchester County Health Department must be submitted with this application. 20, Will the proposed project require the installation of a new,or an extension/modification to an existing automatic fire suppression system?(Fire Sprinkler,ANSL System,FM-200 System,Type I Hood,etc...) Yes: No: I _ (if yes,applicant must submit a separate Automatic Fire Suppression System Permit application&2sets of detailed engineered plans) 21. Will the proposed project disturb 400 sq.ft.or more of land,or create 400 sq.ft. or more of impervious coverage requiring a Stormwater Management Control Permit as per§217 of Village Code? Yes: No: -4,_Area: 22. Will the proposed project require a Site Plan Review by the Village Planning Board as per§209 of Village Code? Yes:T No: (if yes,applicant must submit a Site Plan Application, &provide detailed drawings) 23. Will the proposed project require a Steep Slopes Permit as per§213 of Village Code Yes: No: (if yes,you must submit a Site Plan Application, &provide a detailed topographical survey) 24. Is the lot located within 100 ft. of a Wetland as per§245 of Village Code? Yes: No: (if yes,the area of wetland and the wetland buffer zone must be properly depicted on the survey&site plan) 25. Is the lot or any portion thereof located in a Flood Plane as per the FIRM Map dated 9/28/07? Yes : No: (if yes, the area and elevations of the flood plane must be properly depicted on the survey&site plan) 26. Will the proposed project require a Tree Removal Permit as per§235 of Village Code? Yes: No:---A.— (ifyes,applicant must submit a Tree Removal Permit Application) 27. Does the proposed project involve a Home-Occupation as per§250-38 of Village Code? Yes:___O_No: Indicate: TIER I: TIER IT: TIER III: (if yes,a Home Occupation Permit Application is required) 28. List all zoning variances granted or denied for the subject property: 29. What is the total estimated cost of construction: $ C) 0 Note:The estimated cost shall include all site improvements, labor,material,scaffolding,fired equipment,professional fees, including any material and labor which may be donated gratis.If'the final cast exceeds the a timaied cost,an additional fee will be required prior to issuance of the C/O. 30. Estimated date of completion: (2) 8/12/2021 BUILD . y TMENT V11. �f E OF RYEoox MAY _ 2023 938 KING ET RYE BRO ,NY 10573 ` •. 4 -066$ VILLAGE OF RYE BROOK d: L BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE §216 - STORM SEWERS AND SANITARY SEWERS THIS AFFIDAVIT MUST BEAR THE NOTARIZED SIGNATURE OF THE LEGAL PROPERTY OWNER AND BE SUBMITTED ALONG WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION. ANY BUILDING OR PLUMBING PERMIT APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETURNED TO THE APPLICANT . STATE OF NEW YORK, COUNTY OF WESTCHESTER ) as: ,1, Vab r i e Z d 't>en rA a e— , residing at, EL rLxI H 011 t)u3 C I DSc R-V e Brcac- (Print tiamc) (Address where you live) being duly sworn, deposes and states that(s)he is the applicant above named, and further states that(s)he is the legal owner of the property to which this Affidavit of Compliance pertains at; I U '1�r u SI H O I I b o e b i �y e "6r 6 0� , Rye Brook,NY. (Job Address) Further that all statements contained herein are true,and that to the best of his/her knowledge and belief, that there are no known illegal cross-connections concerning either the storm sewer or sanitary sewer, and fiuther that there are no roof drains, sump pumps, or other prohibited stormwater or groundwater connections or sources of inflow or infiltration of any kind into the sanitary sewer from the subject property in accordance with all State, County and Village Codes. (Signatu1 crt� (?w ner(s)) ` ArcCtb leoAaf_ (Print Name ul'Property Owner(s)) Sworn to before me this 21 day of "1 20 7%5 (Notary Puhiicl M 1t! � ubl 1,,Stela o!r4dw Y6(* No. 4847019 1J flueflNed In Nassau County Commission Expires March 30,20 -"— (fi) a1l2no2t This application must be properly completed in its entirety by a N.Y. State Registered Architect or N.Y. State Licensed Professional Engineer & signed by those professionals where indicated. It must also 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: y c&r i C i o �n D-ACle_ ,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. By signing this application, the property owner further declares that he/she has inspected the subject property, and that to the best of his/her knowledge there are no roof drains, sump pumps or other prohibited stormwater or groundwater connections or sources of infiltration into the sanitary sewer system on or from the subject property. Sworn to before me this Z Sworn to before me this !✓ ay of , 20 ay of y V l , 20 3' J Sig re o P perry Owner Lure jifXpplicant 1bLr(C(0 'baiadae- Print Name of Property Owner Print Name of Applican i Notary Public tary Pub rc Gary Emanuel Notary Public,State al New York Gary Emanuel NO. 484?019 Notary Public, State of New york Qualified in Nassau County No. 4847019 Commission Expires Mdreti 3U 1U Qualified in Nassau Counly CrImmission Expires Mtirch 3o,ZU !f (8) 8/1 212 02 1 �C Q` N \ \ N W 00 ` h L z W �c' r � a O A W Ln .:. • w � � h z � � � J aA x 'n'n Ono z a u • O Z o �" � � V N � " �_ W W ,, � Z ►� z v p N w $ � cn Ln n � � = owz w � w o Q H ° z C Z Z a z rrW �- ' a V 00 • F� Ce) 2 z w o x - � z Z w a U ad W 110 O z z p o cn G'A O w z a � " x C C7 r A O 0 a �y z dl as a a z as w = ��� _aR�'u� D CC E 0�� BUILDING DEPARTMENT VILLAGE OF RYE BROOK JUL 2 6 2023 938 KING STREET RYE B ,NY 10573 VILLAGE OF RYE BROOK 0�4)939-06 BUILDING DEPARTMENT or ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY BP#: O(�� EP#: Approval Date: 2 Z Permit Fee: $ Approval Signature: Other: Application dated, �-2(,-2 3 is hereby made to e B ding Inspector of the Village of Rye Brook NY,for the issuance of a Permit to install and/or remove electrical equipment,wiring, ixtures,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: II c-� Oc1,5Uc SBL: Z q -7 6 - I - I`U Zone: �u 2.Property Owner: G c d Q�oc Ja e- Address: 11 o 3 r,,,1 Hy0ow arm k Iy o i 73 Phone#: ( l, - xb l- Z (,�j Cell#: r l q-7d g -7 S S 7 email: �IeS �d �-�,�.c; 3.Master Electrician/Licensed Installer: �e•� �-o\\` ,, (ten 1 rt(�c TI V Address: ((J 3 Ills Lic.#:Zc);3 Phone#: S l - 7-7 nl C Cell 4. email: r- Company Name: �� ( ���.fS (,as Address: �j�"3 t,,�,�..�►\,u��v;., 'Q,- ��.:k vv �+� 4.Proposed Electrical Work/Fixture Count: j.r -Zo P�zt C \Jw\t 5.31 Party Electrical Inspection Agency: , STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: V c I 1 c \ 6-'t!k✓ ,being duly swom,deposes and states that he/she is the applicant above named,and does further (print name of individual signing the applicant) state that(s)he is the /�(a�w L (c�j-ttc•q^ for the legal owner and is duly authorized to make and file this application. (Master Electrician/Licensed Installer) The undersigned further states that all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances,and regulations. Sworn to before me this Sworn to be 9r me this o` day of ,20 day of ,20 3 Signature of Property Owner Signature of Applicant C Q Print Name of Property Owner t ame of Applic Notary Public Notary Public SHARI MEULLO Notary Public,State of New York NO.01ME6160063 Qualified In Westchester Cgunty 3/3/2023 Commission Expires January 29.20 2 7 STATEWIDE INSPECTION SERVICES, INC. Service Willi liticgri�v 1'1 • • SWIS JOB APPLICATION tel845.202.7224 fax 914.219.1062 SWISNY.com I SWISTraining.com Office Use Elect.Permit# Date Bldg Permit#, r, \\ � � Utility ID# Final Certificate# City/Village t Zip Township County, 1 Address Cross Street Section Block —7 Lot Owner Name/Address(If different than above) \\ Contact Number ❑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 J 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 p EC IEFYIEDqL JUL 2 6JUL 2 6 2� 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 any time of inspection additional items haw been kwtaNd,• 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 applkaK owner or authorized agent agrees to all the above terms and conditions as set forth for the application. Inspector Date Finalized Inspector# Company Name .'.t w� t i Date 7 L > Signature ~ Address ( City/State Zip Code License# Phone# R �� !t-'� ULE --a� State Wide Inspection Services 1080 Main Street FEB — 1 20241 Ej Fishkill, NY 12524 1 845 202-7224 Phone VILLAGE OF RYE BROOK 914-219-1062 Fax STATE WIDE INSPECTION SERVH ES BUILDING DEFARTr0P-- fT Email: office@swisny.com —j 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: Woodhollow Contracting Corp Fabricio Denadae& Luciana Chieus Do Amaral Nicholas Gasparo 110 Brush Hollow Close 103 School Street Rye Brook, NY 10573 Lindenhurst, NY 11757 Located at: 110 Brush Hollow Close, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP 23-166 129.76 1 150 Certificate Number: 2024-0648 Building Permit Number: BP 23-068 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: 110 Brush Hollow Close, Rye Brook, NY 10573 The Exterior Kitchen 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 31st day of January 2024. Name Quantity Rating Circuit Type GFCI Receptacles 03 20 AMP Officer: Frank]. 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. Ar .. , Building Permit�Ch`eck List&Zoning Anal}�isis 1 Address: ` �y `-A k `u\'dw of ,. 1���- - 1- `7 � Zone:' tJ 11 Use: �2� Const.Type: _V—y Other. Submittal Date: cJl3 2D�7 Revisions Submittal Dates: Applicant: �� Ck Nature of Work. 1�1 \ < � S 1 1 A(�_ S �Coa A o ec, -) ,Pr Reviews:ZBA PB: BOT: Other. NEED OKK (� ( ES:Filing. ° BP:,4j60'bVZC/O: Flood Plane: Legalization: ( ) ( 4,' PP: Dated: Notarized SBL: Tniss I.D. Cross Connection: H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening. ( ) ( ) ENVIRO: Long. Short: Fees: N/A: ( ) ( ) SITE PLAN:Topo: Site Protection: S/W Mgmt.: Tree Plan: Other. ( ) ( ) SURVEY:Dated Current Archival' Sealed Unacceptable: ( ) ( 'j'PLANS:Date Stamped ✓ Sealed' Copies Electronic. 'Other. (o}� (_' ease: Workers Commte� Liabili �� Waiver. Other. CO ­'Workers( DE 753#,, 06-31-3---ao/ `� M Dated3%'___)a N/A: HIGH-VOLTAGE ELECTRICAL:Plans: Permit: N/A Other. O O LOW-VOLTAGE ELECTRICAL:Plans: Permit N/A: Other. ( ) ( ) FIRE ALARM/SMOKE DETECTORS:Plans: Pen-nit: H.W.I.C.:_Battery:_Other. ( ) ( ) PLUMBING Plans: Permit: Nat Gas: LP Gas: N/A/: Other. ( ) ( ) FIRE SUPPRESSION:Plans: Permit: N/A: Other. ( ) ( ) H.V.A.C.: Plans: Permit: N/A Other. ( ) ( ) FUEL TANK:Plans: Permit Fuel Type: Other. O O 2020 NY State ECCC: N/A: Other. (� ( ) Final Survey. Final Topo: RA/PE Sign-off Letter. As-Built Plans: Other. ( ) ( ) BP DENIAL LETTER: C/O DENIAL LETTER: Other. Other. I I dp C z2'1 (N mtg.date 1_1 approval notes: _v ( )ZBA mtg.date: approval' notes: ( )PB mtg.date: approval: notes: REOMED EXISTING PROPOSED NOTES APPROVEU MAY 2 5 2023 Fir riw cF--ro__n--t,,: D�D�kB� 6�• M_aiin rC A Ft.H -GEA- -y�I= Ft,imp HHciWx toaes notes: BUILDING DEPARTMENT 4 VILL` E OF RYE BROOK RMAY — 3 2023 -DD 938 KING ET RYE BROOK,NY 10573 a 4 9 9-0 $ VILLAGE OF RYE BROOK 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: I I U Zrusk N bl IocJ C'I bse Date of Sub issi°�' Parcel ID#: j Z q . (�_�- Zone: ?U b q TS I Z3 Proposed Improvement(Describe in detail):. "R e c�k rd I — (.;i-je S S 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: —fctbrl ei D '!)enodac 1. (Y) Completed Application j 2. (,,A Two(2) sets of sealed plans. (one full size {maximum Address: 1 I D "6rush 14p t/OGc) allowable plan size=36"x 42"} and one 11"x17") 3. ()Q Two(2) copies of the property survey. Phone# q j y - -7 D 7 - 7 S S-j 4. (X)Two(2)copies of the proposed site plan. Applicant appearing before the Board: 5. (X)One electronic/disc copy of the complete Ct bY► !'l D application materials. 6. (y) Filing Fee. Address: ( ID Z rQS b 0 C OS e_ 7. ( )Any supporting documentation. 8. ( ) HOA approval letter. (if applicable) Phone# 70 B-`7 S S'7 9. Photographs. Architect/Engineer: q �n 1 o ePtr I n 10.�<) Samples of finishes/color chart. (a sample board or model may be presented the night of the meeting) Phone# SS I — — 143 © Z 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 worn to before me this of Vvi , 20 , 20_� Signat f Prope Owner Signa a of Applicant -rabri ci D 'benodoe_ `tea brrciU Defiadat Print Name of Property Owner Print Name of Applicant Notary Public l Notary b Notary Public,State of New York ry Emanuel No. 4847019 iII Notary Public,State of Now York Oualified in Nassau county No. 4847019 Ouall ied in Nassau county 7,,' Commission Expires March 3U,iU_ Commission Expires March 30,20a 8/12/2021 FMAY F, �v- 8 2023 The Arbors Homeowners' Association 0 VILLAGE OF RYE BROOK 173 '/2 Ivy Hill Crescent BUILDING DEPARTMENT Rye Brook, NY 10573 May 8, 2023 Fabricio Denadae 110 Brush Hollow Close Rye Brook, NY 10573 Re: New Barbecue "Kitchen" on Deck. Dear Fabricio, 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 Ro �c�►Eov 15 MAY - 8 2023 VILLAGE OF RYE BROOK The Arbors Homeowners' Association BUILDING DEPARTMENT 173 %2 Ivy Hill Crescent qt�i Rye Brook, NY 10573 May 8, 2023 Fabricio Denadae Luciana Amaral 110 Brush Hollow Close Rye Brook, NY 10573 Re: New Rear Yard Steps With Hand Rails Dear Fabricio, This approval adds Code required steps to the prior approval letter for the rear steps dated 4/28/23. 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 Laura Petersen To: manager@arbors-ryebrook.com Cc: Steven Fews Subject: HOA Letter for 110 Brush Hollow Close Good morning, The Building Department has received the exterior building permit application for 110 Brush Hollow Close. The proposed work is for new rear yard steps and new BBQ island on deck. The property owner is in receipt of the approved permit for "Replace Decking on Existing Rear Deck". Please send as soon as possible a revised letter approving the work for "New Rear Yard Steps and New BBQ Island on Deck". Thank you Laura Laura Petersen Office Assistant Village of Rye Brook 938 King Street Rye Brook, New York 10573 Phone(914)939-0668 1 Iaetersen(Qrvebrook.org 1 The Arbors Homeowners' Association 173 1/2 Ivy Hill Crescent Rye Brook, NY 10573 II MAY - 3 2023 VILLAGE OF RYE BROOK April 28, 2023 BUILDING DEPARTMENT Fabricio Denadae Luciana Amaral 110 Brush Hollow Crescent Rye Brook, NY 10573 Re: New Rear Yard Steps #e(4) &Q_7 /,Q,-,QI o4 �CJC Dear Fabricio, 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 �— The Arbors Homeowners' Association 173 1/2 Ivy Hill Crescent Rye Brook, NY 10573 ID ' MAY 1 8 2023 VILLAGE OF RYE BROOK April 28t' ,2023 BUILDING DEPARTMENT Fabricio Denadae Luciana Amaral 110 Brush hollow Crescent Rye Brook, NY 10573 Re: Installation of Stepping Stones Dear Fabricio and Lucina, This letter serves as confirmation that the Architecture & Grounds (A&G) Committee has reviewed and accepted your application for the above-named work. This approval is valid for six (6) months from today's date. The stepping stones must be installed 24" on center. If any changes need to be made to the original plans submitted to A&G either before or during construction, the Committee must be notified in writing and your application must be amended. Work must stop and cannot proceed until you receive written approval for those changes. You are required to inform the Property Manager when work begins. When the project is complete, the Property Manager must again be notified so that an inspection may take place. Please include a photograph of the work as well. Please make sure that the shed replacement is to the same as the shed is currently. Failure to comply with these procedures will result in fines and/or work stoppage. If you have any questions, contact me at manager@arbors-ryebrook.com. Sincerely, Nicholas Salzarulo Property Manager Laura Petersen From: Fabricio L Denadae <denadae.iolp@gmail.com> Sent: Thursday, May 4, 2023 1:03 PM To: Steven Fews Cc: Laura Petersen Subject: 110 Brush hollow close ( Deck approval . BBQ island and rear side step) La u ra, it was nice speaking with you today and I want to thank you. Nick, I spoke with Laura this morning, she will be adding the BBQ island application together with the rear step application which both applications were submitted yesterday, waitting for the village board meeting approval on the 17th. Laura requested an approval application letter from the HOA for the BBQ island in order to proceed for the permit. Please let me know when we can expect the approval letter from the HOA. As per Laura this morning the BBQ island is a separate permit and I can proceed with the deck project as I already have approved plans and permit. She will be sending you confirmation over the email so I can proceed with the deck and wait for the rear step and BBQ island to be approved by the village. Let me know if you have any questions or need anything else from me. Best Regards. Fabrico. 110 Brush hollow close. NOTICE OF CONFIDENTIALITY The information contained in this transmission is confidential and may be privileged and/or contain confidential information that is legally protected by state and federal law.This information is intended only for the use of the individual or organization to whom it is addressed. If it is not meant for you please notify the sender immediately by telephone so arrangements may be made to return the documents or destroy them. Use, disclosure, distribution or copying of documents transmitted to you in error is strictly prohibited. WARNING: Computer viruses can be transmitted via email. The recipient should check this email and any attachments for the presence of viruses. The company accepts no liability for any damage caused by any virus transmitted by this email. Please do not print this e-mail unless you really need to.Thank you. President Sales/Design Department. HTTPS://ITALIAPOOLPATIO.COM/ INSTAGRAM: https://instagram.com/italiaoutdoorlivingroup/ C / � 0: (516) 801-2695 OkZa26 A C: (914) 708-7557 qW_' ��s 410A /6/7/ A);arc ck ck— 1 G� hQ - GIQS � I � ti ., �ti x d-•tpk, 5/2/23,'1:05 PM IMG_2551.jpeg i a r �,�-" a ��,� �� r� •j c_ ti h a ita'.1W Yt t httnc-//mail nnnnla rnm/mail/ii/O/#caarrh/arhnrc+cirtw+ctan/Kthxl rrrllR.It.Ir.7nicirtnriwRnhNOiwnr.rn?nrniartnr=1 1/1 The Arbors Homeowners' Association 173 % Ivy Hill Crescent Rye Brook, NY 10573 i -41p �� � D�IE ]D Jun 29, 2023 JUN 2 9 2023 Fabricio Denadae Luciana Amaral VILLAGE OF RYE BROOK 110 Brush Hollow Crescent BUILDING DEPARTMENT Rye Brook, NY 10573 Re:Addition of Refrigerator to Barbecue Set Up Dear Fabricio, The Architecture and Grounds Committee(A&G) has reviewed your resubmitted application and the alteration of original plans for your barbecue kitchen that were approved. You will be responsible for providing a lock on the refrigerator for safety purposes. Kindly sign below agreeing to this condition prior to giving this letter to The Village of Rye Brook. Failure to do so will negate this approval. 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 '9kL_ a icio Denadae I agree to the above-mentioned Lock on Refrigerator The Arbors Homeowners' Association 173 '/2 Ivy Hill Crescent Rye Brook, NY 10573 DIECE WE Jun 29, 2023 R JUN 2 9 2023 Fabricio Denadae VILLAGE OF RYE BROOK Luciana Amaral BUILDING DEPARTMENT 110 Brush Hollow Crescent �— --- ---- -- -- Rye Brook, NY 10573 Re: Stepping Stones Dear Fabricio, The Architecture and Grounds Committee(A&G) has reviewed your resubmitted application and the alteration of original plans for your stepping stones that were approved. You will be responsible for landscaping maintenance at these stepping stones which includes grass cutting, weeding and any necessary work so the area is neat and orderly. It is our understanding that as condition of Village approval you must add dense year-round shrubbery around the small retaining walls which will act as a barrier around the wall for safety and erosion purposes. This is a condition of approval. Kindly sign below agreeing to this condition prior to giving this letter to The Village of Rye Brook. Failure to do so will negate this approval. 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 )o� F ricic Denadae I agree to the above-mentioned landscaping conditions of approval The Arbors Homeowners' Association 173 '/2 Ivy Hill Crescent Rye Brook. NY 10573 JUN 2 9 2023 DI Jun 29, 2023 VILLAGE OF RYE BROOK Fabricio Denadae BUILDING DEPARTMENT Luciana Amaral 110 Brush Hollow Crescent Rye Brook, NY 10573 Re: New Rear Yard Steps Dear Fabricio, The Architecture and Grounds Committee(A&G)has reviewed your resubmitted application and the relocation and alteration of original plans for your rear stairs that were approved. You will be responsible for landscaping maintenance at these steps which includes grass cutting, weeding and any necessary work so the area is neat and orderly. This is a condition of approval. Kindly sign below agreeing to this condition prior to giving this letter to The Village of Rye Brook. Failure to do so will negate this approval. 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 � I L F ricio Denadae I agree to the above-mentioned landscaping conditions of approval �yE BR(�v� Village of Rye Brook NIL MR \ Aggend FB SE `D „��J Architectural Review Board Meeting AC SF . c,..� ILI t Wednesday,May 17,2023 at 7:30 PM Village Hall,938 King Street L JM 1. ITEMS: 1.1. ARB23-025 (Consent Agenda) James Luciano&Helen Luciano 14 Lyon Street Rooftop solar array. 1.2. ARB23-038 (Consent Agenda) Sanjoy Dey&Sanghita Debmukta 12 Lyon Street Rooftop solar array. 1.3. ARB23-039 (Consent Agenda) Thomas Bailey III&Sarah Bailey 309 Betsy Brown Road Rooftop solar array. 1.4. ARB23-040 (Consent Agenda) (Amendment to Prior Approval) Joshua Adelson&Lindsay Adelson 6 Whippoorwill Road Change previously approved deck material color. Consent Agenda Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.5. ARB23-041 Brian Cohen&Dayna Cohen 3 Hills Point Lane Expand pool patio,replace terrace stone floor and replace terrace railing. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes Page 1 of 4 Architectural Review Board May 17,2023 1.6. ARB23-042 John Schueller&Nikki Schueller 1002 King Street Enclose side entry porch to create mudroom with storage area below. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.7. ARB23-043 Mark Kamsik&Danielle Perlman 11 Loch Lane Driveway parking court extension,deck extension,install hot tub and fencing. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.8. ARB23-044 Joshua Rosen&Alison Rosen 6 Fairlawn Parkway New two-story single-family dwelling with finished basement. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.9. ARB23-045 Yuval Meron&Jana Meron 46 Winding Wood Road New deck,new patio,new window and doors in sunroom and interior alterations. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes Page 2 of 4 Architectural Review Board May 17,2023 1.10. ARB23-046 Michael Segal&Debra Segal 996 King Street New deck,pergola and gazebo. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.11. ARB23-047 Michele Wertheimer Fredman 11 Eagles Bluff New front entry and portico. Approvals: Motion Second Abstention Ave; Nay; Adjournment; Notes 1.12. ARB23-048 Salman Nir Messafi&Stephanie Messafi 26 Latonia Road Replace and expand existing patio. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.13. ARB23-049 Fabricio Denadae&Luciana Chieus do Amaral 110 Brush Hollow Close New steps with handrail and new outdoor kitchen. Approvals: Motion ` Second J -D"-1 Abstention Aye; ` Nay;_� Adjournment; Notes 1,� � Page 3 of 4 Architectural Review Board May 17,2023 1.14. ARB23-050 Steven Berger&Debra Berger 3 Castle View Court Replace deck. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.15. ARB23-051 Junyi Me&Yanjun Zhu 46 Bonwit Road Replace deck. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes NEXT MEETING: June 21,2023 Page 4 of 4 5/1123, 10:31 AM IMG_2690.jpeg Existing wood step Proposed new step. Proposed new step. .1 Site map plans. 110 Brush Hollow close. •••• • •• Scale:3/32"= 1 ft R V v Project: Owner: Replace Exiting wood ITC1 LIC1 \ OUTDOOR LIVING GROUP Fabricio Reside MAY - 3 202� step using the same wood material. VILLAGE OF RYE BROOK BUILDING nFPARTMENT https://mail.google.com/mail/u/0/#search/steps/KtbxLxGcDBJtJCZgjsjdpdwRghNQlwgcCg?projector-1 1 r 1 ;I K NU 1 7CH/NSON rn if 1 111 R/VER j vyl kill NZ ilk Pg 't i \ =9 47 lop Q V*p Xk 41 Alf IL A FINAL SUBDIIASION PLAT OELB LO�NLLLAN WEIN TEN THE ARBORS / �a.+�a,��ar / A•f• r' _�/ y. •* L>wjf'. A -.r1oF r- .. .. �ia1�+. :.FA"�• �vr .Yj:.•.. h+RN .:ti`�` �- ��. -.t` �"' y,,ttvr � 'V'Q ti415M1,rt N t � �1.I tlr '.) ^ '.S•�frr + .�.ti� r '! 144tYtfrrlr C •L•'•.�i .. -�,, f' o'• \ V .f -%�ti,,,, l -. 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' 3jR����'�c ��4.C�i.`�� •r`�'�'f'�'sr .� ���•' ��.:a. �\ ITALOUT-02 LAPJA1 ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) lkle � 3/31/2023 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 CAONTACT LPL Risk Mgt.Ltd PHONE FAX 148-2 Remington Blvd. (AIC,No,E:t): (631)676-7020 (A/C,No):(631)676-7030 Ronkonkoma,NY 11779 AD E-MAILDR .info@lplrisk.com INSURERS AFFORDING COVERAGE NAIC It INSURER A:Western World Insurance Co INSURED INSURERS:Merchants Mutual Ins. Company 23329 Italia Outdoor Living Group Inc INSURER C:National Liability& Fire Ins 133 Glenwood Road INSURER D. Glenwood Landing, NY 11547 INSURER E 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 NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLAIMS-MADE �X OCCUR NPP8801180 3/1112023 3111/2024 DAMAGE PREMISES TO ( RENTEDE. $ 100,000 MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 PRO- 2,000,000 X POLICY JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 300 000 ANY AUTO CAP1078955 5/7/2022 5/7/2023 BODILY INJURY Perperson) S OWNED Ix SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident S XAUTOS ONLY AUUTOS ONELDY perOaccltlentDAMAGE $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE DED I RETENTION$ $ C WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY T R ANY PROPRIETOR/PARTNER/EXECUTIVE Y V9WC400956 3118/2023 3/18/2024 E.L.EACH ACCIDENT S 1,000'000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 1,000,000 If yes.describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) As pertains to the insureds operations. 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 9 Y ACCORDANCE WITH THE POLICY PROVISIONS. 938 Kings Street Rye Brook,NY 10573 - AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) @ 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ,ct K Workers' CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE i=, Board 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured 914-708-7557 Italia Outdoor Living Group Inc 133 Glenwood Rd 1 c.NYS Unemployment Insurance Employer Registration Number of Glenwood Landing,NY 11547 Insured 1d. Federal Employer Identification Number of Insured or Social Security Work Location of Insured(Only required if coverage is specifically limited to certain locations in New York State,i.e.,a Wrap-Up Policy) Number 83-3470604 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) National Liability&Fire Insurance Co Village of Rye Brook 3b.Policy Number of Entity Listed in Box 1a" 938 kings street V9WC400956 Rye Brook,NY 10573 3c. Policy effective period 03/18/2023 to 03/18/2024 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 1 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". 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. Approved by: Anthony Pomilla (Print name of authorized representative or licensed agent of insurance carrier) t Approved by: _ 7,0YY'- 3/31/2023 I (Signature) (Date) Title: President Telephone Number of authorized representative or licensed agent of insurance carrier: 631-676-7020 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 Laura Petersen From: UDig NY Exactix <tickets@exactix.udigny.org> Sent: Wednesday, May 31, 2023 11:40 AM To: Steven Fews Subject: Message from UDig NY ****REGULAR**** DIG REQUEST from UDig NY for: VIL RYE BROOK Taken: 05/31/2023 11:39 To: VIL RYE BROOK PRIMARY Transmitted: 05/31/2023 11:39 00002 Ticket: 05313-001-597-00 Type: Regular Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 110 To: Name: BRUSH HOLLOW LN Cross: From: To: Name: Offset: ------------------------------------------------------------------------------ Locate: FRONT AND RIGHT SIDE OF PROPERTY NearSt: ARBOR DR Means of Excavation: EXCAVATOR Blasting: N Site marked with white: N Boring/Directional Drilling: N Within 25ft of Edge of Road: N Work Type: STEPS INSTALL Estimated Work Complete Date: 06/19/2023 Depth of excavation: Site dimensions: Start Date and Time: 06/05/2023 08:00 Must Start By: 06/20/2023 ------------------------------------------------------------------------------ Contact Name: AUGUSTA CARVALHO Company: ITALIA OUTDOOR LIVING GROUP Addrl: 133 GLENWOOD Addr2: City: GLENWOOD LANDING State: NY Zip: 11543 Phone: 516-801-2695 Fax: Email: office@italiapoolpatio.com Field Contact: FABRICIO DENADAE Alt Phone: 914-708-7557 Working for: FABRICIO DENADAE ------------------------------------------------------------------------------ Comments: Lookup Type: ADDRESS ------------------------------------------------------------------------------ Members: ALTICE USA BELL-VALHALLA / WSCHSTR CONED SUEZ WTR WESTCHESTER TEN GAS-HDS VLY VIL RYE BROOK WESTCHESTER CTY SWR z A� 0 �v a z a z rn m rn aq=q �a z A 0 rn z oft rn m Z w r W �4 D ,-� m w n z * r 00 o M D O w0Z w0� � O ZO 00 O X z G) r� C Z -C z G7 "' G) O v C �o 0 z rn rn 0 z rn s � X 01 IAL r� ^ d J � o D ml 03 w C � = O m D � o Z .. rn O m to r 0 O m n Or Z D m L� Ffu f, A r -7j Ch r- w Z t4l �`rnwn> Ul � S r > 00 o M m w0z o w > 0 0 Z 0 00 0 X zx P-4 < z -< z G) Lrl G) 0 o M 0 Lr) n m 0 0 z mv i �r- M 0 Z rm m 0 m 0 0 m Or- vo c 0V)m rn � 0 z m p � v rn n O z D (f) m N OTES: 1. UNAUTHORIZED ALTERATION OR ADDITION TO A SURVEY MAP BEARING A LICENSED LAND SURVEYOR SEAL IS A VIOLATION OF SECTION 7209 SUB-DIVISION 2, OF THE NEW YORK STATE EDUCATION LAW. 2. GUARANTEES OR CERTIFICATION INDICATED HEREON SHALL RUN ONLY TO THE PERSON OR PERSONS FOR WHOM THE SURVEY IS PREPARED AND CERTIFIED TO AND ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS. 3. ONLY COPIES FROM THE ORIGINAL OF THIS SURVEY MARKED WITH AN ORIGINAL OF THE LAND SURVEYOR'S INK SEAL SHALL BE CONSIDERED TO BE VALID TRUE COPIES. 4. NO GUARANTEE IS IMPLIED BY THIS MAP AS TO THE EXISTENCE OR NONEXISTENCE OF ANY EASEMENTS OF RECORD THAT WOULD AFFECT SUBJECT PROPERTY, UNLESS SURVEYOR HAS BEEN FURNISHED WITH SUCH INFORMATION. 5. SURVEYED ONLY FOR THE PERSONS WHOM IT WAS PREPARED FOR AND IT IS FOR BUILDINGS DEPARTMENT USE ONLY. 6. THIS MAP WAS MADE AT A SCALE OF 1"=16' WHEN ORIGINALLY DRAWN. 7. SURVEYED AS IN POSSESSION. NOTE: NO LEGAL DESCRIPTION PROVIDED TO SURVEYOR. THIS IS NOT A TITLE SURVEY. DIMENSIONS PROVIDED BY PROPERTY OWNER. BRUSH HOLLOW CLOSE 9...0 1 » 17 3 w ASPHALT PARKING O 9.099 15I � 3 w o 0 w STONES m z 5.6 u VAULT 18 1 1 STY. Q cn o FRAME 3 6.J No. 109 w C:? 2 STO RY ir) 2.1 No. 1 1 o I FRAME d o � ,� 2 STORY � Z J FRAME ap d 3 o DWELLING w 0 cn U V) .6-, L0 Q C Z U o w c Q Z z YARD w o w = Ln _ of V) ui o m h WOOD 18.1 PATIO ~ STORAGE h 11.4 9 7 ROOM -v: w a, 10.9 16 lei w d WOOD DECK o cn 3 CL v w � N BBQ � ui p TIMBER RETAINING WALL o YARD o TIMBER RETAINING WALL -' YARD 32' 0" -- HEAVY TREES AND BUSHESD [ECIEWIE NOTE: AS-BUILT SEP - 6 20?4 SURVEY SHOWING LOCATIONS ONLY OF:_ DOCUMENT RAIL ROAD TIES STEPS TIMBER RETAINING WALL VILLAGE OF RYE BROOK STEPPING STONES BUILDING DEPARTMENT CERTIFIED TO: DATE SURVEYED: AUGUST 8, 2024 BUILDINGS DEPARTMENT ----- VILLAGE OF RYE BROOK QF NE ANASTASIA I. PARSATOON 5�A1. P4 0 LAND SURVEYING, P.C. `/) 0 1300 JERICHO TPKE., STE. 207 �� NEW HYDE PARK, NY 11040 OFFICE (917) 859-4645 _ EMAIL: PLAKERAM®AOL.COM VILLAGE OF RYE BROOK 0,5108$ TOWN F R ��G SECTION:129.76 T 0 0 YE /,.l S K: 1 COUNTY OF WESTCHESTER -=ND BLOC ANASTASIA i—�`A1�SATOON LOT: 150 STATE OF NEW YORK NEW YORK LICENSE 051088