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HomeMy WebLinkAboutBP23-113PERMIT # AA)3" 13 DATE: 0� t, m c.)�7' SECTION /D9, 68 BLOCK LOT TYPE OF WORK / &j/7 Iv Adeco Q " 10B LOCAT ON / 4e �/ V OWNE 2 Q ✓//Ylc2 � IYIQ Q /� CONTRACTO �S - _ - �Ce *l // I L/ EST, COSTS �O/ �C� FEE. v/cO # Gn Le- FEE `II /Qb TCO # FEE DATE FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING 13 RGH PLUMBING GAS O SPRINKLER ELECTRIC C� LOW -VOLT C� T FINAL DATE I NSP a� C845)30# APPROVALS zBA OTHFR -+sul INAL SURVEY �E IREA PRIOR TO FINAL INSPECTION =�I �yE DR . 19 t VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury www.aebrook.org TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE August 29,2023 Alexander Sherman&Samantha Sherman 26 Lawridge Drive Rye Brook,New York 10573 Re: 26 Lawridge Drive, Rye Brook,New York 10573 Parcel ID#: 129.68-1-5 Building Permit#23-113 issued on 7/25/2023 for a New Fence and Gates This certifies that the new four foot high white vinyl fence and gates,installed under the above captioned permit have been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to Y �� `3R -. For office use onl D �� BUILDING DE �iTMENT PERMITD VILLAGE OF RYE BROOK ISSUED: AUG 14 2023 98 KING STREET,RYE BROOK,NEW YORK 10573 DATE: (914)939-0668 FEE: :4V//O-- PAID)W VILLAGE OF RYE BROOK www^ebrook.org BUILDING DEPARTMENT 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 Address: t l� � CAl. i 0 s- 3 Occupancy/Use: I�M Parcel ID#: / ` f &g —/— !�- Zone: /S Owner: R 0--a)Q- 41A P, + 6I"24048,er EhQ�r&le&J Address: 2(9 fL " ,X f- P.E./R.A. or Contractor: 1-1 ; !gch Fend %ASt a I Address: *7{l7 Zo,1.e 50 142Iley 6646,-4pA)Y Person in responsible charge: `J (Q C e- H i (S '�—h Address: /1 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: / eL e V1(AAr f f VxMQ,✓ being duly sworn,deposes and says that he/she resides at (Print Name of Applicant) (No.and_9treet) in P-Uy R,/bQ I L in the County of b Ls 4 UQ,,,u-r in the State of ,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:$ l 5w > for the construction or alteration of- Q 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. II Sworn to before me this Sworn to before me this /6- 20 2' da of / t S , 20 Signature of Property Owner Siglnature of Applicant 17��Q�NeT.S'�rri,Gr� tilt ra�ld�r �hs>�rnaYJ Print Name of Property Owner Print Name of Applicant Notary P lic Robert Ne e o{New Y0� Notary Pu!ic No 1)CI gta Robert Newman taN Nob01NE506 Go nw Notary Public, State of New Y�II2/2021 Qua��r1ed�� B No. 01 NE5046573 Qualified In Brgnxoun '(ecmT...m�Y^.IfE$ ........Z. ..1..7 QyE BRC��. Ic • 1982 BUILDING DEPARTMENT UILDING 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.Uebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS: � DATE' r �PERMIT# ISSUED: SECT: �L�.7 ol K: LOT+5 LOCATION: -T ���! ` VCCUPANCY: z'� ❑ Violation Noted THE WORK IS...THE WORK ASSEDD D FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas �>b ❑ L.P.Gas ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION FINAL OTHER s p z L to cn 1%0 1"■1 (�� N t� N a c -� I"� ■ V O � p � � � � � � � �.: 3 o C v �' • �J � �' tt � 3 u v a � A • cn �- LO CD �1 o o ^C w L ooco to Z ° o d 'o m 00 �r�/ C) b a�i aai V - O Q U Z _ WLon ® M M W ti) cq � b y ' 00 if �I OO ° vV Imo+ � v w W W vi a ^ N fn W z Z •C aka p V v O �+ n u W o as ,� H a .N � � W w w a � y � � v � W - U o ? �o a �I > Z I"I L�, f�C O �"I w O v \ U 4 a a Q O O C.7 U U � eti �s wZoz IV w : Q � LL x � � BUILD RTMENT Q' E C E N ;k- VILLAGE OF R ROOK JUN 16 2023 938 KING STREET RYE BROO ,NY 10573 (914 39-066g! VILLAGE OF RYE BROOK N%'�ti�v. t�t)a9 �0r T I BUILDING DEPARTMENT FOR OFFICE USE ONLY: Approval Date: _ JUL 2023 ermit# P '/ Application # A0 Approval Signature: ARCHITECTURAL REVIEW BOARD' _ Disapproved: Date: BOT Approval Date: Case# Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Case# Other: Application Fee: Permit Fees: / Q�—�U� FENCE / WALL / GATE PERMIT APPLICATION Application dated; is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the installation,constrdction,repair or replacement of a Fence,Wall or Gate,in accordance with Section 250-6 B.(1)(g),of the Code of the V illage of Rye Brook,as per detailed statement described below. Swimming pool fences must conform to the State Code. 1. Job Address: �(G G. itjl'i�,gG zrr t! ' f,Iae� V 2. Occupancy/Use: Q eCi Ae i1i A S.B.L.#: Z (02- I-' Zone: 3. Proposed Fence/Wall/Gate(describe in detail): ( )e. U 1 l 1 ItOQU, G -A'r oD w -�,Y,Ce R s S' 4. Property Owner: SQ 011gA 14Q f 14e-X 4Pr _S PI.'rymolJ Address: 6 rt 14 I o r 7 Phone# qi-,- Q-6,Zq Cell# - 9- Z email: Q?Cf kt1M00 f Cetj ApplicantI e.�tC,l1 �1a(YYt�t� Address: D V' Q Phone# Cell# / �L email: C24 f AeyY� 10_ q&flip,C L( Architect/Engineer: Address: Phone# Cell# email: Contractor: '' ''J ll AG�..�/ Address&Phone: GC a/� 0 A) /0 /Y 9 / 04 5. If building is located on a corner lot,which street does it front on: ')r tcWA -hA V-0- 6. What is the estimated cost of construction (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: 1 sit/202s 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: Aizxa.gc v,r �Kavymek) , 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. Sworn to before me this Sworn to before me this day of ✓ 20 day o , 20_ Signature of Property Owne Signature n m ure of Applicant ot Name of Property Owner Print Name of Applicant Notaroublic Notary Pu is 8n public,st e 01 NewY`.tC 411`,5E NGeo vi yc� NotaN t '��/.g 75' 6573 count/ e�Nee PS 3� �n b\\G, a �e .Xo ow oC\CL - exP�re' f� 2 6/1/2023 . ` Buildin Permit Check List&Zoningnal A sis Address: SBL Zone: Use: 'ZLD Const.Type: V Other. Submittal Date: 62� Revisions Submittal Dates: Applicant: s` �- Nature of Work S l C-A I tN ASZ Reviews:ZBA: J U N 2 1 2023 PB. BOT: Other: NEED OK (,) (FEES:Filing. kAc BP:W J 0 L_D LC/O: Flood Plane: Legalization: ( ) ( ) APP: Dated: Notarized: SBL: Truss I.D. Cross Connection: H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening. ( ) ( ) ENVIRO:Long. Short: Fees: N/A: ( ) ( ) SITE PLAN:Topo: Site Protection: S/W Mgmt.: Tree Plan: Other. ( ) ( ) SURVEY.Dated: Current:. Archival Sealed Unacceptable: ( ) ( ) PLANS:Date tamped: Seale Copies: Electronic: Other. (, �,��' erase: Workers Comp: Liability: Comp.Waiver. Other. 7 ( ( CODE 753#: )2=-:o,/3 -- '968— bo Dated: ( ) ( ) HIGH-VOLTAGE ELECTRICAL:Plans: Permit: N/A: Other. ( ) ( ) LOW-VOLTAGE ELECTRICAL:Plans: Permit: N/A: Other. ( ) ( ) FIRE ALARM/SMOKE DETECTORS:Plans: Permit: H.W.I.C.:_Battery._Other. ( ) ( ) PLUMBING Plans: Permit: Nat.Gas: LP Gas: N/A/: Other. ( ) ( ) FIRE SUPPRESSION:Plans: Permit: N/A: Other: ( ) ( ) H.V.A.C.: Plans: Permit: N/A Other. ( ) ( ) FUEL TANK:Plans: Permit: Fuel Type: Other. O O 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. (�j'ARB mtg.date: —1 WA753, —approval:- notes: ( )ZBA mtg.date: approval notes: ( )PB mtg. date: approval• notes: APPROVED REQUIRED EXLSITNG PROPOSED NO J U L 2 4 2 02 3 AuxSte• Circle: Fr n : Front: Front: Ste: Rsar. Main Cov Accs.Cov Ft.H Sb: S .HS : a Tot,imp: EL IMP: PP Hight/Stories: notes: Residential Building Permit Fee Work Sheet Permit#: Date Issued: SBL: Zone: Address: Property Owner&Contact Info: Job Description: For all new dwellings and for additions measuring 800 sq. ft. or more made to existing dwellings, the following fee schedule shall apply: (plus any alteration fees) Total Sq. Ft. (excluding basements)x $300.00 x $I8.00/$I,000.00 Basement Sq. Ft. x $65.00 x $I8.00/$I,000.00 -------------------------------------------------------------------------------------------------------------------- New Construction Sq.Ft. • New Construction Cost • Building Permit Fee Basement= sq. ft.x$65.00 = $ x$I8.00/$I,000.00= $ Attached Garage= sq. ft.x $300.00= $ x$18.00/$1,000.00 = $ I,Fl. = sq. ft.x$300.00= $ x S18.00/$I,000.00 = $ 2"1 Fl. = sq. ft.x$300.00 = $ x $18.00/SI,000.00 = $ Y Fl. = sq. ft.x $300.00 = $ x$I8.00/$I,000.00 = $ 411 Fl. = sq. ft.x $300.00= $ x$I8.00/$I,000.00= $ Total Sq.,.Ft. _ sq. ft. Total Cost= $ Total B.P.Fee= $ Total Amount Paid= $ Total Amount Due= $ Date: Signed: BUILD G DEPARTMENT VILnDECENE OF RY OOK 938 KING;;EET RYE BR ,NY 105( 14)939-066#��-;' JUN 16 2023 ww'H.rvebrook.i� VILLAGE OF RYE BROOK 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: V�42i Date of Sub ission: Parcel ID#: Z.9. 'b' Zone: Proposed Improvement(Describe in detail): 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: 1. 4�o mpleted Application 2. wo(2)sets of sealed plans. (one full size{maximum Address: A 1A, %d4.bo MrLkti. , allowable plan size=36"x 42"}and one 11"xl7") Phone# R/"7—Qq-6:g2q 3. Two(2)copies of the property survey. 4. Two(2)copies of the proposed site plan. Applicant appearing before the Board: 5. One electronic/disc copy of the complete y (�� application materials. 6. Filing Fee. Address: c 7. Any supporting documentation. 8. ( ) HOA approval letter. (if applicable) Phone# — 9. . Photographs. Arch itect/Engineer: 10.�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 71 L Sworn to before me this / da of �<1�+^ , 20 y� T�'fAJ ;r day r7P�/.�O— , 20 �3 f,lam y Signature of Property Owner • '�: �?/r. <�Cl 1"� Signature of-Applicant `` Ablic"AA.'er h`�''�► � ` '�'�.r ^�,,�"��°�fQ `�:',, �IzXc✓ld e Sh 7 Print Name of Property Owner "��;�•., �/>, S:� �/�! `�:,/,� Print Name of Applicant NotarjrPublic •'�;,- Notary Public Robert Newman Notary Public, State of New Yu k No, 01 NE5046573 Qualified in/Bronx County i12i2021••» Term expires �/) //��� Home t(h ps://activeyards.comn. ,SSh p-(Ilps://activeyards.com/shop/.,,Chestnut Scallop With its signature New England style, the Chestnut Scallop by CHESTNUT ActiveYards features thin, square pickets — making it the t accent to your garden bed or walkway. 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About Us(https://activeyards.com/about-usn • Matching walk and drive gates `F4x8 Chestnut r 4 � 5'* > COLOR oA-{r T T9; COST $$$ r SOLARGUARD yes 111 STAYSQUARE yes STAYSTRAIGHT yes GLIDELOCK no r> Hirsch Fence Install & Design 747 Route 9W_ Valley Cottage, NY 10989 _lNamr Frr.•.•cr fir":r+l�irss , a CuA1:rnC k(�;I'•mr Vh—N, 9mn.No (ue6 mr'r.1 myl Addy.¢. Nra'rat C roc5 S!•T'rl F�F1,1:T1NS�EC O\INFCTFtdA It�N rc�•+�.'r:�rrc_ -1 •io'nr�.vnrT to nbt.'nn prrmlt nalA lalrnn pra ngannal pc uN0 ,r •. ,.,, :+n r• .,.��r rr„��1.y,ro u�•.tnr.r J r •'1 I,nht:un �nnnd APPROXIMAIL LAYOUT '1 5eledlon ` rr ILI IP.TTArr.CONTAiNFn I4'P'4 PrnM4AL1•AFrRi7Fl•Mtr nA',TF•'dlf, iFl WA,,'F y'll ; F•./L Fu'+F WLI PT A[V.ATED rtASrD ONA(.TIIAI WKF FnnTAGE 111FO A,',LT F[.UIIrIUN TF'•V•.A•.�','.•,;Tr'..': AMITI;NAL COS 7 OPi iONS TAKE �kwAN CLD I ENIE /11,11f•,T c:c- c 1 f IL s 1 S-C;---�- S%,_ES'FX FNALAj.!OjNTU:E ❑ Stock Product Customer assumes all responsibilities as it relates to all adddional labor and material costs as n relates Special Order Product to the fence benq installed on a neighbors property. IJ' Desion Approved Customer 6 ENC INSTALLATION RELATED TO GRADE:PLEASE INITIAL ON hI �-j�/r ,rct e, (,/^I�( J�II ) P,-11:-TOT-111 FZ;UC/ANG FLOW S-E➢PE:)?,STA;UTICN FENCE TO BE LEVU W 11 MG,,aT GFI� SU Gh iLY U w'IEVEN GRADE YNTN iENCL �.re s.Cw w,ta¢r[+:I a veoT c.e• ICUSTOI[ER TO f U.IN WS FOLLONING FLO'N Of GRCU1.7 ¢TIK ��x cara•c uncl oAef�`•Zl FUKEHILL EE lN,EVFI.AT TCP r['•:.t% To Are r+u.ov� Product j, r r _ �/, Product Product Style: Height: Style: Height: Style: Height: Footage. If Gates: Footage: If Gates: Footage: If Gates: Post Cap. 'A/• ';�.(�Cclor.ii -11i Post Cap: Color: Post Cap: Color: ?a..Type: Post Cap: Rail Type: Post Cap: Rail Type Post Cap: Picket Type: S `, Picket Type: S Picket Type: S ��y� [1R�1 �• Village o RdaBrook n Architectural Review Board Meeting c, U,%j �L,`t` Wednesday,July 19,2023 at 7:30 PM Village Hall,938 Bing Street 1. ITEMS: 1.1. ARB23-064(Consent Agenda) DRJ West LLC 32 Lincoln Avenue 4'high white vinyl fence with driveway gate. 1.2. ARB23-065 (Consent Agenda) Brian Zelesky&Alexandra Zelesky 26 Hawthorne Avenue 4'high PVC picket fence,4'high black chain link fence,4'high white PVC driveway gate and C high black chain link fence. 1.3. ARB23-066(Consent Agenda) Alexander Sherman&Samantha Sherman 26 Lawridge Drive 4'high white vinyl fence and gates. 1.4. ARB23-067 (Consent Agenda) Richard Billig&Kathleen Billig 16 Red Roof Drive Replace walkway and front steps. 1.5. ARB23-068 (Consent Agenda) Sherree Amar 45 Lincoln Avenue Rooftop solar array. 1.6. ARB23-069 (Consent Agenda) Sujan Vasavada&Sujasha Vasavada 2 Heritage Court Rooftop solar array. 1.7. ARB23-070 (Consent Agenda) Michael Rackenberg&Stefanie Rackenberg 144 Country Ridge Drive Rear patio. 1.8. ARB23-071 (Consent Agenda) Karen Kuznetzow 267 North Ridge Street 6'stockade fence,post and rail fence along retaining wall and gate. Architectural Review Board July 19,2023 1.9. ARB23-072(Consent Agenda) Eric Gioseffi&Jacqueline Gioseffi 30 Lawridge Drive 4'-1/2"high black aluminum fence and gates. 1.10. ARB23-073 (Consent Agenda) Thais Cunha&Marcela Melgarejo 17 Lincoln Avenue Replace patio and walkway. Consent Agenda Approvals: Motion � Second�`��Abstention Aye, y� Na Adjournment; Notes 1.11. ARB23-074 Jose Sagastizado&Noemi Sagastizado 28 Division Street Rear deck. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.12. ARB23-075 Sheryl Brauman 12 Magnolia Drive Rear deck. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.13. ARB23-076 Joshua Kirsch&Kristen Kirsch 2 Lee Lane One-car attached garage and driveway parking court. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes Page 2 of 4 Architectural Review Board July 19,2023 1.14. ARB23-077 Win Ridge Realty LLC 13 Rye Ridge Plaza New awning. "Stretch Lab" Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.15. ARB23-078 Win Ridge Realty LLC 112 South Ridge Street New facade sign and awning. "DIG." Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.16. ARB23-079 (Amendment to Prior Approval) 760-800 Owner LLC 760 Westchester Avenue Change from Betafence Guardian Dutyguard fence to black chain link with privacy green hedge inserts. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.17. ARB23-080 Jacob Gebrael&Marleine Ishak 1 Hunter Drive In-ground swimming pool. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes Page 3 of 4 Architectural Review Board July 19,2023 1.18. ARB23-081 Gregory Varone 47 Hawthorne Avenue New single-family dwelling with attached garage,in-ground swimming pool,spa,cabana, deck,patio and fencing. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.19. ARB23-082 Richard Gasparino&Bridget Gasparino 6 Jacqueline Lane Legalize 12x24 storage shed. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.20. ARB23-083 Srivatsan Raghavan&Janani Ranganathan 436 North Ridge Street Window and door changes. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.21. ARB23-084 Christopher Baildon&Tamzin Manning 72 Valley Terrace Legalize 10x23 rear paver patio. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes NEXT MEETING: August 16, 2023 Yagc 4 of 4 AA .fa K- ,..n. .. �, ";,, '•'i TeIR 1l, /�r i '[lrF ��/" i li. 5� i; N j) ,tiaili q• rh'�l�/�,� + •>' - i r,,'y�l,r�ftO)► .»-._, .`ii_. t_ - ''')''-'--- r� r� _ai. rl U ff- 'co = _ IL — v A _ C) section LLj LLJ M1 w LIJ :r U J o l to co I J y ^_•e�r iTJ� vi• ?;�_ 1 _ ?•--, 1, ••4` ••;_; ���,�, ".{" ,._1l ,� c a -•i ;� ,l���jri•� ��(as)>, •� �rih'� '��''' �N►.�,�1 �� �Nis��'.,� ''' �liit�►� '''�.s' `ltN.�h�"���:�� � ��+'� �Nlir-.. A��9 DATE(MMIDDNYYY) C CERTIFICATE OF LIABILITY INSURANCE 06/15i2023 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 NAME CourtneyPotter : McCarthy Insurance PHONE 914 769-0417 FAX N 378 Elwood Avenue AIL ADDRESS: courtney@mccarthyinsurance.net Hawthorne, NY 10532 INSURER(S)AFFORDING COVERAGE NAIC0 INSURER A: Preferred Mutual INSURED INSURER B: Hirsch Fence Install 8r Design LLC I,SUPERc: _ 747 Rt 9w Cottage#4 INSURER0: Valley Cottage, NY 10989 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 00002210-543862 REVISION NUMBER: 2 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 LTIR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFFMWDDfyyyyl MO DD/YP UNITS A X COMMERCIAL GENERAL LIABILITY Y BOP0100721375 11/12/2022 11/12/2023 EACH OCCURRENCE 'sDA 1 OOO OOO CLAIMS-MADE [A]OCCUR PRMAGE TO RENTED S SO OOO MED_E7 P(Any one ) $ __5,000 PERSONAL d ADV INJURY $ 1,000,060 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 POLICY F PE LOC PRODUCTS-COMPfOP AGG S 2 000 000 OTHER S AUTOMOBILE LUIBILITY COMB'NED SINGLE LIA11T S cudenl ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE S AUTOS ONLY AUTOS ONLY P acc nt S UMBRELLA LIAB _ OCCUR EACH OCCURRENCE S EXCESS LAB CLAIMS-MADE AGGREGATE S DED RETENTION S S WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY AT UTE YIN SI ES ANY PROPRIETORPARTNER'EXECUTIVE E.L.EACH ACCIDENT S OFFICER MEMBER EXCLUDED? NIA '(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S If yes.describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S �7 , DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101.Additional Remarks Schedule,may be attached if more space is required) Address 26 Lawridge Dr., Rye Brook,NY 10573 Certificate holder listed as Additional Insured CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Village of Rye Brook THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 938 King Street ACCORDANCE WITH THE POLICY PROVISIONS. Rye Brook NY10573 AUTHOR1ZEp REPRESEELS&iWF�—- -- _ CPO ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Printed by CPO on 06/15/2023 at 09:53AM NEW rt YM Workers' Certificate of Attestation of Exemption STATE Compensation from New York State Workers' Compensation and/or Board Disability and Paid Family Leave Benefits Insurance Coverage **This form cannot be used to waive the workers'compensation rights or obligations of any party.** The applicant may use this Certificate of Attestation of Exemption ONLY to show a government entity that New York State specific workers'compensation and/or disability and paid family leave benefits insurance is not required. The applicant may NOT use this form to show another business or that business's insurance carrier that such insurance is not required. Please provide this form to the government entity from which you are requesting a permit,license or contract. This Certificate will not be accepted by government officials one year after the date printed on the form. In the Application of Business Applying For: (Legal Entity Name and Address): Building Permit Hirsch Fence Install&Design LLC 747 Route 9w'p 4 From:Village of Rye Brook Valley Cottage.NY 1 0 999-2 452 PHONE:945-304-8622 FEIN:XX.VX.XO091 The location of where work will be performed is 26 Lawridge Dr.,Rye Brook,NY 10573. Estimated dates necessary to complete work associated with the building permit are from June 15,2023 to Au¢ust 15,2023. The estimated dollar amount of project is SO-S10,000 Workers'Compensation Exemption Statement: The above named business is certifying that it is NOT REQUIRED TO OBTAIN NEW YORK STATE SPECIFIC WORKERS'COMPENSATION INSURANCE COVERAGE for the following reason: The business is a LLC,LLP,PLLP or a RLLP;OR is a partnership under the laws of New York State and is not a corporation. Other than the partners or members,there are no employees,day labor, leased employees,borrowed employees,pan-time employees,unpaid volunteers(including family members)or subcontractors. Partners/Members: Bruce Hirsch Disability and Paid Family Leave Benefits Exemption Statement: The above named business is certifying that it is NOT REQUIRED TO OBTAIN NEW YORK STATE STATUTORY DISABILITY AND PAID FAMILY LEAVE BENEFITS INSURANCE COVERAGE for the following reason: The business MUST be either: l) owned by one individual; OR 2) is a partnership(including LLC,LLP,PLLP,RLLP,or LP)under the laws of New York State and is not a corporation; OR 3) is a one or two person owned corporation,with those individuals owning all of the stock and holding all offices of the corporation(in a two person owned corporation each individual must be an officer and own at least one share of stock); OR 4) is a business with no NYS location. In addition,the business does not require disability and paid family leave benefits coverage at this time since it has not employed one or more individuals on at least 30 days in any calendar year in New York State. (Independent contractors are not considered to be employees under the Disability and Paid Family Leave Benefits Law.) I.Bruce Hirsch,am the Member with the above-named legal entity. I affirm that due to my position with the above-named business I have the knowledge,information and authority to make this Certificate of Attestation of Exemption. 1 hereby affirm that the statements made herein are true,that I have not made any materially false statements and 1 make this Certificate of Attestation of Exemption under the penalties of perjury I further affirm that I understand that any false statement,representation or concealment will subject me to felony criminal prosecution.including jail and civil liability in accordance with the Workers'Compensation Law and all other New York State laws. By submitting this Certificate of Attestation of Exemption to the government entity listed above I also hereby affirm that if circumstances change so that workers'compensation insurance and/or disability and paid family leave benefits coverage is required,the above-named legal entity will immediately acquire appropriate New York State specific workers' compensation insurance and/or disability and paid family leave benefits coverage and also immediately furnish proof of that coverage on forms approved by the Chair of the Workers'Compensation B d to the government entity listed above. SIGN Signature: Date: HERE Exemption Certificate Number Received 2023-043976 June 15, 2023 NYS Workers'Compensation Board CE-200 01 2018 Laura Petersen From: UDig NY Exactix <tickets@exactix.udigny.org> Sent: Friday,July 21, 2023 10:54 AM To: Steven Fews Subject: Message from UDig NY ****REGULAR**** DIG REQUEST from UDig NY for: VIL RYE BROOK Taken: 07/21/2023 10:53 To: VIL RYE BROOK PRIMARY Transmitted: 07/21/2023 10:54 00001 Ticket: 07213-000-802-00 Type: Regular Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 26 To: Name: LAWRIDGE DR Cross: From: To: Name: Offset: ------------------------------------------------------------------------------ Locate: FRONT AND BOTH SIDES OF THE HOUSE AT THE BACK CORNER OF THE HOUSE. NearSt: Means of Excavation: POST HOLE DIGGER Blasting: N Site marked with white: N Boring/Directional Drilling: N Within 25ft of Edge of Road: N Work Type: FENCE INSTALL Estimated Work Complete Date: 08/09/2023 Depth of excavation: 2 FEET Site dimensions: Width 10 INCHES Start Date and Time: 07/27/2023 09:00 Must Start By: 08/10/2023 ------------------------------------------------------------------------------ Contact Name: BRUCE HIRSCH Company: HIRSCH FENCE INSTALL AND DESIGN Addr1: 747 RT 9W Addr2 City: VALLEY COTTAGE State: NY Zip: 10989 Phone: 845-304-8622 Fax: Email: bruce@hirschfence.com Field Contact: BRUCE HIRSCH Alt Phone: 845-304-8622 Email: bruce@hirschfence.com Working for: H/O ------------------------------------------------------------------------------ Comments: Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: ALTICE USA CONED SUEZ WTR WESTCHESTER VIL RYE BROOK WESTCHESTER CTY SWR i Sao — ti Village of Rye Btook O,Q Architectur 1 R ew goatd Approval Date' Chairman: ED(F6o•e0 d A9p9 SURVEY OF PROPERTY SITUATE IN THE VILLAGE of RYE BROOK TOWN of RYE FILE 0 4 j WESTCHESTER COUNTY NEW YORK yA6'�9� '� ��' ,•� Yo�� SCALE:1'=25' PROPERTY MARKERS SET:JULY 21,2010 + %00A. MAPCOMPLETED FEBRUARY B.2011 �/i }/ \ �\ ?J�t CO.• SURVEY PREPARED:MAY 1B.2011 'Co • THE PREMISES SNOM NEREON BEING A PORTION OF LOT 51N y BLOCI(IC AS SHOWN A CERTAIN MAP ENTITLED SUBDIVISION MAP SECT I N SELLS OURT EENC.0 COUNTRY UNT R RIDGE ES ATES'. �•fa'd' \ \, '�' PROFESSIONAL LAND SURVEYORS GATED OCTOBER 2L•IN,, + / 4,LOT O FINAL REVISION GATE MARCH 19,1965.FILED IN THE rt\ PORTION LOTS \ \.. ��*y o^ WESTCHESTER COLINTY CLERICS OFFICE DIVISION OF LAND RECORDSONAPR1128.1RSL-FILED MAP-11—SAID PREMISES DESCRIBED IN DEED RECORDED UNDER CONTROL / \ OD0 ODD 1 IIUMSER L02pp T, / M 9 PREMISES ARE DESIGNATED ON THE TAX MAPS FOR THE ai \ \y •/ 6 TOWN W RYE I VILLAGE OF RYE BROOK MAP 129.068 •BLOCK 1 ' LOT 5 PROPERTY AREA:33,825 Sq Ft./0.7765 Acre \ \� • SURVEY IS SbSUECT TO ANY STATE OF FACTS WHICH AN UP.7`0-0ATE TITLE EXAMINATION MAY DISCLOSE. 0 THE DIMENSIONS SHOWN HEREON,FROM THE STRUCTURES TO THE PROPERTY LINE ARE FOR A SPECIFIC PURPOSE ONLY.THEY \ \ ARE NOT INTENDED TO BE USED FOR THE ERECTION OF FENCES.STRUCTURES OR MY OTHER IMPROVEMENT • ENCROACHMENTS BELOW GRADE ANDIDR SUBSURFACE FEATURES. IF ANY,NOT LOCATED OR SHOWN HEREON OF SECTION A7209.LICENSED LAND SURVEYORS OF THE SEAL IS A VIOLATION N tY p OF SECTION 120B.SUBDIVISION 2.OF THE NEW YORK STATE �1• EDUCATION UWS. �` ID LIT SRYS I / Z�10 •ONLY COPIES FROM THE ORIGINAL OF THIS SURVEY MARRED 4 \ 4 p WITH AN ORIGINAL OF THE LAND SURVEYORS SEAL SMALL p i BE CONSIDERED TO BE TRUE VALID COPIES. THE SURVEYSHOWNHEREON WAS PREPARED FROMAN o J, p .R•R•L r - TWO STORYPPAME l ••Nm-.. o` �° TN SAID SURVEY WAS PERFORMED IN AD SURWY CONO�TED ON CC DATE ORDANCE ANCEE WITAND Z ,LOT V s�. \ ORI v(IAI DWfLUNG . ! 0 THE EXISTING'CODE OF PRACrICEFORLANDSURVEYS' ` LOT P PR TE AOOODBONYTHEEAND EWYOv STAB ASSOCIATIONOF PREPARED FOR: \ 30.3' °" D IA— z 2 J U N 16 2023 L�LAGE OF %K\ Sot w"0"L �' s:ao` 'sue. �, , gl DING DIE TMcNT C '��, an ur eyors P.C. F. ��V- SB q / @ 21 C4rt WBca Spne,B Ptans 8.542E-5" L�•k 4 `// ,Vj\/R MBMpw NY 10541 FBx 845-621-0013 PERN1fiT# i L DA o L. JUL ,3B_ � ER J.LINK BV SP �Of Rye Book,NY �ey srn EucEvsEc