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HomeMy WebLinkAboutBP23-178PERMIT k / `�' DATE:) a3 SECTION %Tf BLOCK L T Q ,, I l' / TYPE OF WORK Qom/ / f // ,V e�//aP� JOB LOCATI N /� U OWNER �� �-- CONTRACTOR Q/ S cY/ C-�in 00/ O EST. COST A - FEE o%U �- ✓CO FEE' P� DATE TCO k FEE DATE FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING RGH PLUMBING GAS SPRINKLER ELECTRIC LOW -VOLT O ALARM AS BUILT FINAL DATE .3- 6- 202•.1 INSP OTHER APPR//O__V LS ARB t�i� 7�1 �/ BOT P8 ZBA OTHER QyE DRn'�. >�' 19t1 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 March 11,2024 Amelia Irizarry 6 Lincoln Avenue Rye Brook,New York 10573 Re: 6 Lincoln Avenue, Rye Brook,New York 10573 Parcel ID#: 135.73-1-29 Building Permit#23-178 issued on 10/23/2023 for a New Sliding Door This certifies that the removal of a rear window&door and the installation of a new sliding door,under the above captioned pernut has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to p BUILDING DEPARTMENT For office use nl �: VILLAGE OF RYE$ROOK PERMIT# 3— 7D8 ISSUED: - 3 a MAR -6 2024 0 938 KING STREET,RYE BROOK,NEW YORK 10573 DATE: 3-6 aly VILLAGE OF RYE BROOK (914)9 9-0668 FEE: 4 /)n— PAID BUILDING DEPARTMENT wvtw,rkrook.ora 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 •sersassrsrsssssassarararassrssssssaaaaaraasssrsesrsssasaraarssssassssssasaasasapsssassssasarassrrssaaa•sasassssresssasseas• Address: Occupancy/Us®: /r7 Parcel ID Zone. �e_lQ Owner: J Z'G*/' Address: /� P.E./R.A. or Contractor: , D /%1 / Address:a3 N Person in responsible charge: Address: Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issuance of a Certificate of Occupancy/Certificate of Compliance for the structure/construction/alteration herein mentioned in accordance with law: STATE OF NEW YORK, COUNTY OF WESTCHESTER as: r being duly swom,deposes and says that he/she resides at � (Print Name of Applicant) (No.and Street) in AOL K ,in the County of llt/ in the State of y,that (Cithfl'oun/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: $ for the nstruction or alteration of: / / /Wil__ ��or 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 Sworn to before me this day of p�,�-(�� , 20 all day of , 20 Signature of Pro pe er Signature of Applicant e of Froporty Owner Print Name of Applicant Notary ublic SHARI MELILLO Notary Public Notary Public,State of New York No.01ME6160063 Qualified in Westchester County Commission Expires January 29,20,L i �E BRC�uk. W BUILDING DEPARTMENT ❑BUILDING 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.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - -- - - - - - - - - - - - - ADDRESS: I V COL'J DATE: 3 V z yZ y PERMIT# ISSUED: ,-�- �-Z� SECT: •7-� BLOCK:LOT: Z LOCATION: c L' OCCUPANCY: ❑ Violation Noted THE WORK IS... PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas L c-4�-C S L I ❑ L.P. Gas ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION 'FINAL ❑ OTHER s a O 1 N a W - Sri c CUI y 10 O / Lj \ Rai O w u �-i N 0 x o o 3 0 in n. CA CA 0 x o 5 � 00v � � p2 G a �; © � z N �, bco _ M�1 LL I v � P� C ' W Z azow � 0 V o , O Os 1-4 O a z x z Wz � � z M M+■1 00 �j q � c, � q7 � � " ANo °°• N M OC M W P4 V v f,� a. �, 3 ° 1 cn h�l G1 V cn Q r�r� g -k °' � p o W z W O rs? Q o ° x _ co v `� v U � H � V oo � �b � � �Wj w O .0 v v v 6 IMCA z Z - � ti N U z Oil O W W � avP4 � u C a BUIL 11 R TMENT 1E CWIE VIL E f OK 938 KING 'l:Rut BR NY 10573 OCT — 5 2023 of VILLAGE OF RYE BROOK BUILDING DEPARTMENT FOR OFFICE USE ONLY: J Approval Date: OCI J 9 rmit# 3-/ Application# P/� Approval Signature: ARCHITECTURAL REVIEW BOARD: Disapproved: : Date: Q BOT Approval Date: Case# Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Case# Other: Application Fee:W W-#4b Permit Fees: /Cx)—bt'&- EXTERIOR BUILDING 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 construction of buil ' gs,dructures,additions,alterations or for a change in use,as per detailed statement described below. 1. JobAddress: /17 /� At> XILIle- /z 2. Parcel ID#: i Zone: 3. Proposed Improvement(Describe in detail)): / / ✓.' Cie 4. Property Owner: Address: Phone# Cell# e-mail List All Other Properties Owned in Rye Brook: ea. Applicant: f Address: Phone# Cell# lY r /L e-mail Q1__;Y01�'r��ircr 7 Architect: Address: Phone# Cell# e-mail Engineer: Address: Phone# Cell# e-mail General Contractor: i Address: Phone# Ce 1# e-mail , �jQA7(� (1) & 2o23 5. Occupancy;(1-Fam.,2-Fam.,Commercial.,etc...)Pre-construction: Post-construction: 6�All 6. Area of lot: Square feet: /4jia//Z Acres: . 7. Dimensions from proposed building or structure to lot lines: front yard: rear yard: right side yard: left side yard: other: 8. If building is located on a comer lot,which street does it front on: 9. Area of proposed building in square feet: Basement: 1 I fl: 2°d fl: 31 fl: 10. Total Square Footage of the proposed new construction: 11. For additions,total square footage added:Basement: I'fl: tad 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: Median Height: 15. Basement to be full,or partial: finished or unfinished: 16. What material is the exterior finish: 17. Roof style;peaked,hip,mansard,shed,etc: Roofing material:. 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 e suppression system?(Fire Sprinkler,ANSL System,FM-200 System,Type I Hood,etc...) Yes: No: (if yes,applicant must submit a separate Automatic Fire Suppression System Permit application&2 sets 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 im ous coverage requirimtg a Stormwater Management Control Permit as per§217 of Village Code? Yes: No; Area: 22. Will the proposed projec3trfquire a Site Plan Review by the Village Planning Board as per§209 of Village Code? Yes: No: i (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: (rf 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: (fyes,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: (►f 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: (if yes,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: No: Indicate: TIER I: TER II: TIER IH: (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: S Note:The estimated cost shall include all site improvements,labor,material,scaffolding,fixed equipment,professional fees,including any material and labor which may be donated gratis.If the final cost exceeds the estimated cost,an additional fee will be required prior to issuance of the C/O. 30. Estimated date of completion: (2) &1=2a 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. ST A OF T W YORI COUNTY OF WESTCHESTER ) as: Z=,= being duly sworn,deposes and states that he/she is the applicant above named, dmint name of individual signing as the licant) 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 Sworn to before me this day of ,20 day of , 20 S' a of Prop er Signature of Applicant Fi�nt Name of Property Owner Print Name of Applicant Notar-Y-715u6lic Notary Public SHARI MELILLO Notary Public,State of New York No.01ME6160063 Qualified In Westchester County~} Commission Expires January 29,20 G_D fig) 8/12/2021 -----+ .Building Permit Check List&Zoning Analysis Address: L SBL: j6 . — l Zone: { V IUse Cont.Type: Other. Submittal Date: 1 Revisions Submittal Dates: Applicant `r Nature of Work 4& V` Reviews:ZBA: LO�1A PB: BOT: Other. NEED OK ( ( ) FEES:Filing: lX : X�00'(��� C/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. Shorn Fees: N/A: ( ) ( ) SITE PLAN:Topo: Site Protection S/W Mgmt: Tree Plan Other. ( ) ( ) SURVEY:Dated: Current Archival Sealed Unacceptable: ( ) ( ) PLANS:Dat tamped Sealed; Copies: , Electronic Other. ( ) License Workers Comp: ,/ Liability: ,0, Comp.Waiver. Other. ( ) ( ) CODE 753#: Dated: N/A: ( ) ( ) HUGH-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. ( ) ( ) 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. (•�ARB mtg.date: UD approval notes: ( )ZBA mtg.date: approval- notes: ( )PB mtg.date: approval- notes: REQUIRED EXISTING PROPOSED NOTES APPROVED Arm- Ci : Date' Oba C7 a Fromm — FS� F� Bf�= Main Cov Accs,Cov Ft H Sd.H/Sb: : a-imp: l'a�ulg: HHzi /Stori notes: 1 - BUILDING DEPARTMENT VILLAGE OF RYE BROOK R OCT - 5 2023 DD 938 KING STREET RYE BROOK,NY 10573 dI4� 9fi 48= 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: 1�� Z!&L_elk Date of Submission: Parcel H)#:4:i, ��3��v?q zone �� 7� Proposed Improvement(Describe in detail): / APPLICANT CHECK LIST: r / MUST BE COMPLETED BY THE APPLICANT �i j-y S r /�U �'• The following items must be submitted to the Building ���,� Department by the applicant-no exceptions. 1. (LIKoompleted Application Property Owner: 2. ( )Two(2) sets of sealed plans. (one full size(maximum Address: allowable plan size=36"x 42")and one 11'xlT 3. ( )Two(2)copies of the property survey. Phone# �/y —` �� 4. ( )Two(2)copies of the proposed site plan. Applicant appearing before the Board: 5. (L�6ne electronic/disc copy of the complete a lication materials. 6. ilmg Fee. Address: ;� �ir�Cc���'! 404 3. ( I,Y by supporting documentation. 8. ( )HOA approval letter. (if applicable) Phone# 9. (t*fh-otographs. Architect/Engineer: 10.( )Samples of finishes/color chart. (a sample board or Phone# model may be presented the night of the meeting) 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 C) �� ,20 day of ,20 S store of Property 011, Signature of Applicant Pli6vame of Property Owner Print Name of Applicant Notary Public Notary Public SHARI MELILLO Notary Public,State of New York No.OIME6160063 Qualified In Westchester County Commission Expires January 29,20�-1 8/12/2021 3R�v� Village of Rye Brook ML MR JIX %41 Agend FB SE Architectural Review Board Meeting AC SF cc'�•-��� �,� Wednesday, October 18,2023 at 7:30 PM Village Hall, 938 King Street JN1 1. ITEMS: 1.1. ARB23-113 (Consent Agenda) Jesus Gonzalez&Beatriz Gonzalez 505 Franklin Street Rooftop solar array. 1.2. ARB23-114(Consent Agenda) Muharrem Deliallisi&Raimonda Deliallisi 26 Valley Terrace Rooftop solar array. 1.3. ARB23-115 (Consent Agenda) The Concepcion Revocable Family Trust 38 Hawthorne Avenue Black aluminum fence and gate. Consent Agenda Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.4. ARB23-116 Michael Holmes&Patricia Holmes 34 Hawthorne Avenue In-ground swimming pool&black aluminum picket fence. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes Page 1 of 3 Architectural Review Board October 18,2023 1.5. ARB23-117 Matthew Gillman&Danielle Gillman 49 Country Ridge Circle Exterior elevation changes,interior renovations and renovate rear patio. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.6. ARB23-118 Amelia Irizarry 6 Lincoln Avenue Remove rear window and door.Install new slider. Approvals: Motion �C- Second Abstention Aye; Nay; `/ Adjournment; Notes 1.7. ARB23-119 Adolfo Waisburg&Mariela Cohen Sabban 63 Talcott Road Exterior elevation changes and interior renovations. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.8. ARB23-120 Jordan Sedler&Roberta Sedler 10 Elm Hill Drive Relocate side door,new steps and interior kitchen renovation. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes Page 2 of 3 • , Architectural Review Board October 18,2023 1.9. ARB23-121 2 Elm Hill LLC 345 Betsy Brown Road Single family dwelling. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.10. ARB23-122 Hidden Falls Homeowners Association Hidden Pond Drive,HOA Common Area Replace tie wall with Redi-Rock wall. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes NEXT MEETING: November 15, 2023 Page 3 of 3 Laura Petersen From: Laura Petersen Sent: Friday, October 20, 2023 3:08 PM To: Amelia I Cc: franks.home@gmail.com Subject: Building Permit - 6 Lincoln Avenue Good afternoon, At your earliest convenience, please send the following updated items for the sliding door permit at 6 Lincoln Avenue; ✓1• General contractor's valid liability insurance (the Village Of Rye Brook must be the Acertificate holder) General contractor's valid workers compensation on a NY State Board form (C105-2 or U26.3) Thank you Laura Laura(Petersen Office Assistant Village of Rye Brook 938 King Street Rye Brook, New York 10573 Phone(914)939-0668 1 Igetersen(&!yebrook.or4 1 1 Z. . - N 0 ;; N 0 a a > o 0. N C ` to d 1 i in w ,: •� Q o V s ch Zctlorl .01 O = J • O z F- O h o G u u V a v O } 3 y Z o o a 4-4 cn a s o 6 Y r- W �.., ._ U. 8 We ♦+ co W o Z m F- 8Q LL / t s S a 3 cz o G TT� It ` E ° 05 O 7 I •• U.S .S ' o ♦M1 ® DATE(MMIDDIYYYY) ACO AC� CERTIFICATE OF LIABILITY INSURANCE 10/23/2023 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 CONTACT NAME: JEFFREY D. KAVOVIT INS AGENCY INC. PHONENo_ .845-562-0701 FARM FAMILY CASUALTY INSURANCE CO. E-MAIL ADDRESS: 81 A WEST MAIN ST INSURER 3 AFFORDING COVERAGE NAIL• WALDEN,NY 12586 INSURERA:FARM FAMILY CASUALTY INS.CO. 13803 INSURED INsuRERB:UNITED FARM FAMILY INS.CO. 29963 FRANKS CONTRACTING CORP INSURER C: 361 N BROADWAY INSURER D: TARRYTOW N, NY 10591 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 ADD SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY) (MMIDD1YYM LIMITS A X COMMERCIAL GENERAL LIABILITY X 3101 X9740 05/01/23 05/01/24 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR PREMISES Ea TO Eoccumence S 100 000 X SELECT BUS PACKAGE MEDEXP(Any one pemon) $ 5,000 PERSONAL 6 ADV INJURY $ 1,000,000 N'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S 2,000,000 POLICY ❑PRI PECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER $ B AUTOMOBILE LIABILITY 3101 C4695 05/01/23 05/01/24 COMBINED SINGLE LIMIT = 1,000,000 Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED X SCHEDULED P BODILY INJURY(Per accident)AUTOS ONLY AUTOS ) S Ix HIRED X NON-OWNED PROPERTY DAMAGE j AUTOS ONLY AUTOS ONLY Per axldent S A X UMBRELLA LIAB OCCUR 3101E3189 05/01/23 05/01/24 EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DIED RETENTION$ 10,000 $ WORKERS COMPENSATION I STATUTE OR AND EMPLOYERS'LIASILMY Y/N ANY PROPRIETORIPARTNER/EXECUTIVE E.L EACH ACCIDENT II OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes descnbe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT II DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is mqulred) VILLAGE OF RYE BROOK IS ADDITIONALLY 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, NY 10573 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD NYSIF New York State Insurance Fund PO Box 66699,Albany,NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED) 0 � ^^^^^A 823931705 LOVELL SAFETY MGMT CO., LLC 110 WILLIAM STREET 12TH FLR NEW YORK NY 10038 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER FRANKS CONTRACTING CORP VILLAGE OF RYE BROOK 361 NO. BROADWAY 938 KING STREET SLEEPY HOLLOW NY 10591 RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE Z2442 768-4 863127 04/01/2023 TO 04/01/2024 10/23/2023 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2442 768-4, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY,INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS://WWW.NYSIF.COM/CERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. OWNER JOSEPH PACI ONE OF ONE OFFICER FRANK'S CONTRACTING CORP THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUND �/4 4 DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 773502557 U-26.3 Pella'- 150 Series Sliding Patio Doors Size Tables - New Construction Frame with 1" Glazing Blinds-Between-the-Glass Sidelites&Venting Units (748) (894) (1 505; it Rt01 (735) (887) (1492) (1797) Opening 2'5 7116" 2'11�'ie" 4'11 1, 5'11 1a' Frame 28 34 ;,:: 58 y.' 70314" to 1 )oZo 0) vN ti� l� East Region Only 5.0 6-8-rO s o s-6 xc Sidelites&Venting Units (757) (910) (1524) (1829) (745) (897) (1511) (1816) Opening 2'5 15f*" 2'11 13i,e" 5'0" 6 9' Frame 296t6" 35''3iw" 591 71 o _ h 6 a-c o 6-a-o ar- - o c-a 6-a_,:o West Region Only Village of Rye Brook PERMIT/ �—� Architectura Review Board Approval Date:_ d SBLI� /, Chairman:_ DATE APP V _ CT 1 BUILDING INSPE TOR,Village of Rye Brook,NY Not to scale. (1)'X'indicates venting or sliding panel and'O'indicates fixed panel as viewed from the exterior. Doors shown as XO are also available as OX. All doors and sidelights are glazed with tempered glass. Pella 2023 Architectural Design Manual I Division 08-Openings I Windows and Doors I www.Pella.com V-SPD-9 Pella 150 Series Sliding Patio Doors Special Sizes and Dimensions •• MINIMUM MINIMUM 46-1/2"W x 70-1/2"H 11-1/2"W x 11-1/2"H (1 181 x 1 791) (292 x 292) East East and West High Performance Standard Performance MAXIMUM MAXIMUM MAXIMUM 94-3/4"W x 82"H 95-1/2"W x 95-1/2"H 95-1/2"W x 17-1/2"H (2 407 x 2 083) (2 426 x 2 426) (2 426 x 445) General Notes: General Notes: • To convert areas to square meters(m2),multiply square feet by 0.0929. • Minimum 1.1 ft2 actual glass size. • Maximum width to height ratio on sidelights:1:8 • If glass width to height ratio is>5 to 1,the glass must be tempered. • Maximum width to height ratio on transoms:8:1 • High Performance door is available up to 95-1/2 W"x 82"H(East Region Only). �- i .�- ?:: .,. , :; ,� ���' � '} � .t::� a ._ -...� L; n. 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