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HomeMy WebLinkAboutBP23-182PERMIT # SECTION TYPE OF WORK JOB LOCATInN CON EST. V/CO # N;rCO ; 318Q HATE: / 7 /4 o Se EC,C 3 a v �S oD/� 2 s: le) ,. / _ INSPECTION RECORD IDATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING L RGH PLUUHAlq GAS SP KLER • •LT jlaF�k J / /o 'Q%f7on 91 93Y=Q<NO �C - 0�2 ot)e d/Y&/y)760- F077 L OTHER APPROVALS ARB BOT PB zBa OTHER �.B�itCTIFINAL SlJRVEY REQ491RED PRIOR TO FINAL INSPECTION VILLAGE OF RYE BROOK WESTCHESTER COUNTY, NEW YORK NO: 25-005 Certif irate of (Occupaucp This is to certify that 0z&r' llpmeozvners of, Poe 8�L)Lk / V Y having duly filed an application on UO,r(4 10 20 _requesting a Certificate of Occupancy for the premises known as, 7 2 l , Rye Brook,NY, located in a PUS Zoning District and shown on the most current Tax Map as Section: 9. 76 Block: f Lot: , and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No.�� _/ >e , issued l l 20 , such authority and permission is hereby granted to the property owner to lawfully occupy or use said premises o building or part thereof listed under the following New York State Classifications, Use: lri — Construction: for the following purposes: 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 hei shall be made,nor shall uilding be moved from one location to another until a permit to accomplish such change has ee ob from B ing Inspector. Building Inspector,Village of Rye Brook: Date: l la oa5 D IE C IE ME DE }� For office use onl Q BUILDI �, � T gENT PERMIT# �/v JAN 10 2025B VIL � OF RYE 0OK ISSUED: _43 38 KING STRE YE BROOK, W YORK 10573 DATE: VILLAGE OF RYE BROOK \ 9 -0 c�j FEE: & 42'SO PAID BUILDING DEPARTMENT (�yrAkA Caw 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 ##########►►►#►►####►►i lilt##########t####ti#■/##i### ■#######►itt►#i►##►#t►►►t►#►t►i►i►it##►#►##ii►#►#t►►########►►►►►►###### Address: �V Hal Get Occupancy/Us Parcel ID#: a 9 ?(a — Zone: /� Owner: r, f Address: 045 P.E./R.A. or Contractor: Vt [ Address: � ff 6. �. Person in responsible charge: ( -2GI U Address: 6 Application is hereby made and submitted to the Building Inspector of the Village o Rye Brook for the issuance of a Certificate of Occupancy/Certificate of Compliance for the structure/construction/alteration herein mentioned in accordance with law: STVZ NE ORK,COUNTY OF WESTCHESTER as: being duly sworn,deposes and says hat he/she resides at ` lhl�<1L f (P i t NXj f Appli I, (No.and Street) in a )� ,in the County of I►l' in the State of that (City/T wn/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 uipment, rofessional fees,and including the monetary value of any materials and labor which may have been donated gratis was:S , for the construction or alteration of: Deponent further states that he/she has examined the approved plans of the structure/work herein referred to for which a Certificate of Occupancy/Compliance is sought,and that to the best of his/her knowledge and belief,the structure/work has been erected/completed in accordance with the approved plans and any amendments thereto except in so far as variations therefore have been legally authorized,and as erected/completed complies with the laws governing building construction.Deponent further understands that it shall be unlawful for an owner to use or permit the use of any building or premises or part thereof hereafter created,erected,changed,converted or enlarged,wholly or partly,in its use or structure until a Certificate of Occupancy or Certificate of Compliance shall have been duly issued by the Building Inspector as per§250-10.A.of the Code of the Village of Rye Brook. II Sworn to before me this 01� Sworn to before me this Y� day of N Val , 20 a day k G�/`��/ , 20� �'q� ae-7�� il ignature of Property Owner Signature o A Leant Print Na f Property ter ,,, Print Na of Applic Notary ublic LAURA J DELUCA IIRA DELU.^,R Notary Public-State of New York Notary Public-State of New York NO. 01DGaocg ;;, NO. 0 1 DE4998586 LMCouiifi 3d In Westchester Countv Qualified In Westchester Coun My Comm, Expires June Y29, My Comm. Expires June 29, �E BRC��, Zm cu � 1932 BUILDING DEPARTMENT r©'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 :— , 7 s L -f-Y DATE: 3/ PERMIT# 132 ' ISSUED: SECT: BLOCK: LOT: LOCATION: U t '' �--� -- y`-� `�' OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/ 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 Q' FINAL ❑ OTHER VILLAGE OF RYE BROOK WESTCHESTER COUNTY, NEW YORK No: 24-079 Tempororp Certificate of Occupaucp This is to certify that(?! b rs P6rneowmrd Of, having duly filed an application on Ju'r?(5 20 C�)qrequesting a Temporary Certificate of Occupancy for the premises known as, / /�I , Rye Brook, NY, located in a Zoning District and shown on the most current Tax Map as Section:/ `7. Cy Block: Lot: , and having full�y complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No. 0ul /- ,:;) , issued ///tp 20 2 �, 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 J following New York State Classifications, Use: 3 b/ CkatoConstruction: , Lf for the following purposes: O ub/ ►o U.S-� tidtk-, vfQ!QC(fMe n J" Subject to all the privileges, requirements, limitations, and conditions prescribed by law, and subject also to the following: _ T us S onJWL4I a � 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, nor shall the building be moved from one location to another until a permit to accomplish such change has been obtained from the Building Inspector. Assistant Building Inspector,Village of Rye Brook:Vc_. .., ��� Date: JON 1 8 2024 For officeA�anllBUILDING -ARTMENTPERMITbT VIL 4 OF RYEI I"OK ISSUED: 938 KING STRE�t YE BROOK,`NEW YORK 10573 DATE: --1%4)939-0668 FEE: "� { PAID �.ry ookU.gov ?90 APPLICATION FOR TEMPORARY CERTIFICATE OF OCCUPANCY 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 /shall have been issued by the Building Inspector.§250--11o.A.Code of the village of Rye Brook Address: F 3 ` 2 I U, C Ks �� � �1 ��� 15 Occupane /Use: Parcel I 4: Zone: Owner: �S Kw,( 0(, Address: Contractor: t r, J 4 14 o QtN_A0_,N U 1 N C.Address: 11 ST_a2_AAA)04D L V. Person in responsible charge: S c249JJt-DAddress: Uk- AS Reason for temporary use: �(VeH Estimated date of completion: Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issuance of a Temporary Certificate of Occupancy for the structure herein mentioned in accordance with law: STATE OF NEW YORK, COUNTY OF WESTCHESTER as: cc7K/ozA)ww0 t'110'J-9� 012e,l_ V being duly sworn,deposes and says that he/she resides at 1 r qt Name ot'Applicant) (No.and Street) in Q.M_Ati► in the County o in the State of , that (City/Town/Village) he/she has supervised the work performed to date at the location indicated above, for the construction, alteration o repair of: cr •I r 1 Of qjLk, Deponent further states that he/she understands that a Certificate of Occupancy must be applied for and obtained upon completion of the above captioned project in accordance with law, and that a Temporary Certificate of Occupancy shall only be valid for a period not to exceed thirty(30)days. Sworn to before me this_ q m— Sworn to before me this /U day tf 20,."4 day of 2Q; Sign e obwperty Owner Signature o pplicant Prim Na ciCPrd2crty t)wncr Print Name of Applicant of Public o Public si�OkN SPINA LAURA J DELUCA Notary Public-State of New York Notary Public-State of New York No.01SP4912189 NO.01 DE4998586 qualified in Westchester County Qualified In Westchester County My Commission Esp ices Nov.30,2025 My Comm. Expires June 29, -2 0--;L 6/lr02a QAE BRC�� 1932 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 : DATE: PERMIT# ISSUED: SECT: . 74' BLOCK: ! LOT: LOCATION: OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/ 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 �E BRC�� • �9a2 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 :— /r \ ' ` 4" LATE• 1 PERMIT# ISSUED L SECT:� � BLOCK: LOT: LOCATION: ��)Ppc �clL OCCUPANCY: ZJC-) ❑ Violation Noted THE WORK IS... (J PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION �Y / REQUIRED 3 FOOTING • C)\5 �� (-01 ❑ 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 N N w v un .. 1-4 0-4 1--=I � u O *Spy �+ 1 , O V P 4 ago o " 'Ln 0 G O 414 o -e o 'J C;N cn CIA p W o Q z H oO � i � U uz ao a PLO ,CV) a V � � a14 81fo H PLO 0 W w ? � E ' W O x p � q0 n ►- rx 0 O 0 C7 a H Zlull U hz ;To O C P v s Q i"'i F-r V W H p p3 z c r d w LLwz M c7 A z O Cy' ` a " ° LU � u ° E ' Q as a a � 1 BUILDING .DEPARTMENT VILLAGE OI+RYE BROOK 938 KING STREET Rn BROOK,NY 110573 (914)939-0668 SEP 5 2C�23 1 www,ryebrook.ore i ####iiii#i�*ww+M##riw+trrYtMr*ww+tt##tttttttrrrtrtai R+i rPttt*+t!#rrir+++t#t+rtt tt�?lal�+hkit*+'!'I+F+Ft7+►•#*t#>w M+Yr�tr _ •. ' M ONA"CT 0 2023 l I r. Approval Date: Approval Signature: _____ ARCHITECTURAL BEVIEW BOARD: 4k) Disapproved- Date: BUT Approval Date: Case# Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Case# Other: ' ?: Application Feet{- � Pb Permit Fees' r*******+*.r»«•:s••fttrrwwwtw*rwrrwwrtsrwarw*sss*#ww###rawwwwwr�rrwtrrwrtt+arwtr*rt•ww#trtwttswswwwrrtttwrw EXTERIOR BUILDING PERMIT APPLICATION 9�/�d 3 t . Application dared: is hereby made to the Building inspector of the Village of Rye Brook,NY,for the issuance of a Permit far the ; construction of buildings,structures,additions,alterations or for a change in use,as per detailed statement described d�escribeed below. 1. JobAddress: i?_'Z7- ��[� a t_C. (`'G F') ��- t{• j ©f 7 Z. ParcelID#: Zone: 3. Proposed Improvement(Describe in detail): vt a. Property Owner: A%-&�Wam MCA CA I Pic Address: 1 c.f �j �L_- NV q, r'Q 9 Phone# 2-4 Cell# e-mail Lit III Other Properties Owned in Rye Brook. t A M Apphcant: ---- - _..- -- Addms: Phone# Cell# ____e-mail Architect: Ads' - Phone# _ Cell# email .. . : Rolle# Cell# e-mail 1 Cenral Contracwr: - ::e Q .. Adriim: J Phone# 21/ Z- 7le 9- 96-75 Cell# 9/y- 760-- 90_7 7 e-mail 6J12023 =9 5. Occupancy;(1-Fam,,2-Fam.,Commercial.,etc...)Pre-construction: - Post-construction: 6. Area of lot: Square feet: N/A-- Acres: 7. Dimensions from proposed building or structure to lot lines: front yard: 1Y rear yard: right side yard: left side yard: other: 8. If building is located on a corner lot,which street does it front on: ri Z/:f- 9. Area of proposed building in square feet: Basement: 11 fl: 21 fl: 31 fl: 10. Total Square Footage of the proposed new construction: %1A 0 11. For additions,total square footage added:Basement: (�� 1"fl: �� 2nd fl: 3nd fl: 12. Total Square Footage of the proposed renov tion to the existing structure: R eLA Cl 4& 6'9 1 tr 1�� +�Et k' 13. N.Y.State Construction Classification: M 4- N.Y.State Use Classification: 14. Number of stories: Overall Height: Median Height: 15. Basement to be full,or partial: /J finished or unfinished: �,, 16. What material is the exterior finish: �.�)( :�A ri�"j 0 -1^I `o- few 1 L- 17. Roof style;peaked,hip,mansard,shed,etc: )J Roofing material: 18. What system of heating: 141 — 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,ANSI,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'mVe,vvious coverage requiring a Stormwater Management Control Permit as per§217 of Village Code? Yes: No Area: 22. Will the proposed pr e t require a Site Plan Review by the Village Planning Board as per§209 of Village Code? Yes: 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: (i(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-y___ Indicate: TIER I: TIER II: TIER III: (if yes,a Home Occupation Permit Application is required) 28. List all zoning variances granted or denied for the subject property: tTJ 29. What is the total estimated cost of construction: $ 1 —n. 720 —79 Note:The estimated cost shall include all site improvements,labor,material,scaffolding, d equipment,professional fees,including any material and labor which may be donated gratis.If the f nal cost exceeds the estimated cost,an additional fee will be requiredp(rrior to issuance of the CIO. completion: Qi�-2 30. Estimated date of co "� � F AdA-T&D (�y �, c�=,tit 611/2023 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: D—n L—' ��} ,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 at (s} e is the legal owner of the property to which this application pertains, or that (s)he is the ho s rYt 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�ources of infiltration into the sanitary sewer system on or from the subject property. Sworn to before me this Sworn to before me this 1 day of UQ � , 20 day of , 20 v Signature of Property Owner Signature of Applicant Print Name of Property Owner Print Name of Applicant I (Ku' Public Notary Pub LAURA J DELUCA Notary Public-State of New York LAURA J DELUCA NO. 01 DE4998586 Notary Public-State of New York Qualified in Westchester C�ou��n�ty/ NO. pl DE4998586 My Comm. Expires June 29, �Jln Qualified in Westchester County My Comm. Expires June 29, RP (8) 8/1212021 Buildine Permit Check List & Zoning Analysis OB & C ONLY Address: ' v q k SBL: Zone: Use: c- Const.Type: Other. Submittal Date: 10(2-Jlevisions Submittal Dates: Applicant " Nature of Work \--x �S l 0 L 04,J3 e ckc U-) —)o, C� Reviews:ZBA• ` �� Other. _ ( �V-tES:Filing. BP C/O: Legalization: P.: Date Stamped: Properly Signed ✓SBL Verified+ Cross Connection: F.O.G.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening- ) ENVIRO.:Long Shore Fees: N/A: ( ( ) SITE PLAN:Topo: Site Protection: S/W Mgmt.: Tree Plan Other. ) SURVEY:Dated Current: Archival: Sealed Unacceptable: ( ) ( ) LANS:Date tamped Sealed Copies: Electronic: Other. ( ' (vr License Workers Comp: Liability Tmp.Waiver. Other. (j�KCo&753#: f/c73 3—OCQ -- 3'3 j—0Q Dated I/-3-- 4 3 N/A: (�( ) 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: Grease Trap: Other. ( ) ( ) FIRE SUPPRESSION:Plans: Permit: N/A: Other. ( ) ( ) H.V.A.C.: Plans: Permit: N/A: Other. ( ) ( ) FUEL TANK: Plans: Permit: FUEL TYPE: Other. O O 2020 NY State ECCC: N/A: Other. (�( ) Final Survey Final Topo: RA/PE Sign-off Letter. As-Built Plans: Other. ( ) ( ) BP DENIAL LETTER: C/O DENIAL LETTER: Other. _ ( ) ( ) Other. ( )ARB mtg.date: approval: notes: ( )ZBA mtg.date: approval: notes: ( )PB mtg. date: approval;- _notes: REQUIRED EXISTING PROPOSED NOTES Dater AmL Circle: Fri _ Erg E� 13s�C FAIL: Qpm Spaces Stories: notes: V e Q c a a,3 t; :mow %Yrn 9 Lill, AL � i s a �4 q i i WWWMWMWAWAOI s s •µ . 11111� A .. \`1,WA1r- {�i�,t` a w�o�a r rva, �� x � - •, };qys g �.wvgw� i � I t , a � 0/6 AM ¢. g me IL wo Ma MIM �t f x � s '.'y ._.. ,r a 7 u ' L ` i i a y , to r . 4. 7717 ' x , NEW fir {j�tl[pYi•'�ja(i {'; ��� t P A. F A I k v f J•i `' t F } Y (• - «L S � ty + i A • a. _ f �. � t «.�..+�'�"��«.mow•: � a r, w P w r�-►."� tom; Laura Petersen From: Laura Petersen Sent: Friday, November 3, 2023 8:53 AM To: manager@arbors-ryebrook.com Subject: 173 1/2 Ivy Hill Crescent - Permit for New Deck Good morning, The building permit application has been approved by the Building Inspector. Before I can issue the building permit the following items must be submitted to our office, �Z1.. General contractor's contact name & phone number. 2. General contractor's valid liability insurance (the Village Of Rye Brook must be the certificate holder) General contractor's valid workers compensation on a NY State Board form (C105-2 or U26.3) 4. Building permit fee $3,250.00 (due once permit is issued and ready for pick-up) 5. Contractor must call UDig NY and get a ticket number. Thank you Laura Laura Petersen Office Assistant Village of Rye Brook 938 King Street Rye Brook, New York 10573 Phone(914)939-0668 1 Igetersen cDryebrook.org 1 George O'Reilly From: tickets@UDigNY.org Sent: Friday, November 3, 2023 11:56 AM To: George O'Reilly Subject: UDig NY Confirmation of Ticket 11033-000-839 GEORGE OREILLY, This is a followup to your recent location request at 173 1/2 IVY HILL CRIES with a work type of INSTALL DECK, INSTALL FOOTERS. You have been assigned an Excavator ID of 51504. You can use 51504 as a shortcut to identify yourself the next time you call in. Please download this Location Request Confirmation Packet to view the summary of what we've done so far,and what should happen next: 11033-000-839 If needed,you can also download the packet by pasting this URL into your web browser: https:Hexactix.UDigNY.org/api/Reports/Export/TicketConfirmation/UDIGNY/6b8df8l0-7a61-11ee-94b5-aa2Obf627012 You should receive another follow up email on or before 2023-11-17 which will summarize the actions taken by the affected member utilities. Visit My.UDiRNY.ora for more information. 1 A ��>` �k�-�`• ilk ^. 7 -_ � ~ A A` A �- v �� ♦ e ♦ v �k �♦� v Syr s s d � � x `� i'.. c t 'si°�ts°i''_ -''r►a oe`� ' i° '�e�1�e``r`: �c s� i Z 44. ion IN at I Coo - _. _. ,a _� --!".•-.. � ,�li...r .: _ .-. � }}�' �,, �:• i • ,� S i ` :`� ,A /,S per,.. O. r K , i r 46 IS a > : />: � {.';}4'Fal+t.-r.5'a` �a ..L! ! \!4 / ;�'�44$��;�4 rA�`N����-``l°e�P°�✓'� Aiig �9°oa�� • L:�•� i� �a�i °ito� •����#��� •��c` r�get. t�, - c ���fk`t�' �� a. p���Ltta 0 .�•' r .'�'- ' '"�•�Gyv��� ��Ejy�!'��L�, .w��yyi° t rkt?',�w tfu�d � � �5�t�`Fh;�/�Foy ACORLY CERTIFICATE OF LIABILITY INSURANCE DATE(NM/DDIYYYY) J11/03/2023 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 914-600-6222 800-860-1151 NCONTAC AME. TPhilip Christe Philip Christe Insurance PHONE 914600-6222 FAX N,:800-860-1151 1575 Cattlemen Rd. WREss: hil chhsteins.com INSURERS AFFORDING COVERAGE NAIL 0 Sarasota FL 34232_ INBURERA: Evanston Insurance Company INSURED 914-769-9575 INSURERS:Continental Indemnity Insurance G. O'Reilly Contracting, Inc. INSURERC: 17 St. Charles St. INSURERD: Thornwood, NY 10594 INSURERE: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE I POLICY NUMBER MMIDO MN1 UCY F)(P LIMIT ✓ COMMERCIAL GENERAL LIABILITY ✓ ✓ EACH OCCURRENCE $ 1 OOO OOO A CLAIMS-MADE a OCCUR PREMISES Ea occurrence $2 000 000 3AA654464 03/22/2023 03/22/2024 MED EXP(Any one person) $5 000 PERSONAL&ADV INJURY $ 1 000 OOO GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE s2,000,000 ✓ POLICY❑PRO- JECT LOC PRODUCTS-COMP/OP AGG $2 000 000 OTHER, $ AUTOMOBILE LIABILITY COMBINED N L T $ ANY AUTO IE,accident OWNED BODILY INJURY(Per person) $ SCHEDULED BODILY INJURY(Per accident) $ AUTOS ON LY AU7 HIRED NED AUTOS ONLY AUTOS AUTOS ONLYLY PROPERTYCIm GE Per accident $ UNBRELLA LIAR OCCUR EXCESS LIAB CLAIMS-MADE EACH OCCURRENCE $ DED RETENTION$ AGGREGATE $ WORKERS COMPENSATION $ AND EMPLOYERS'LUU31LnY Y/N 0574672 10/01/2023 10/01/2024 ✓I PER STATUTE ER OFFICEYPR IMEMBR/PARTNDED? CUTIVE E.L EACH ACCIDENT $ 1 000000 B (Mandatory In Y❑ N/A (Mandatory In NH) If yes,describe under E.L.DISEASE-EA EMPLOYEE $ 1 000 000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1 000 000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached If moro apace Is required) Certificate holder is included as additional insured per written agreement subject to policy terms and conditions. CERTIFICATE HOLDER CANCELLATION Village o Rye Brook 938 King Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Rye Brook, NY 10573 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 914-939-0068 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE?� �B ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <11TE Workers' ATE j Compensation CERTIFICATE OF Board NYS WORKERS'COMPENSATION INSURANCE COVERAGE I a.Legal Name&Address of 111Snred i use street address only) I b.Business Telephone Number of Insured G.O'Reilly Contracting, Inc. (914)769-9575 dba G.O'Reilly Contracting, Inc 17 Saint Charles St Ic.NYS Unemployment Insurance Employer Registration Thornwood,NY 10594-I064 Number of Insured Work L(Wation of Insured(Only reyain'd i/coverage is spec{/ically Id.Federal Employer Identification Number of insured or limited to certain locations illNeu'}'urn,SIUIe.i.e.o 1Vrap-1/1)/'oli(_v) Social Security Number 134003098 2.Name and Address of Entity Requesting Proof of Coverage(Entity 3a.Name of insurance Carrier Being Listed as the Certificate Holder) Continental Indemnity Co. Village of Rye Brox)k 3h.Policy Number of Entity Listed in Box 938 King St Rye Brook,NY 10573 46-574672-01-06 Attn:Project Manager 3c.Policy effective period 10/02/23 to 10/02/24 3d.The Proprietor,Partners or Executive Officers arc II1CIuded.(onl) •heck hoax it all parlivmAtI icers iikluck•dI V all excluded or certain partners/ofl icers excluded. This certifies that the insurance carrier indicated above in box"3" insures the business referenced above in box"I a"for workers' compensation under the New York State Workers'Compensation Law. (To use this form,New York(NY)must he 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 an(I 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 90,whichever is earlier. This certificate is issued as it matter of information only and confers no rights upon the certificate holder. This certificate(toes 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(if 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: Todd Brown___ (Print name of• lorized representative or licenced agent of insurance carrier) Approved by: 11/03/2023 (Signature) (Date) Title: Authorized Representative Telephone Number of authorized representative or licensed agent of insurance carrier: (877)234-4424 Please Note:Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insurance brokers arc P(M authorized to issue it. C-105.2(9-17) www.wcb.ny.gov Laura Petersen From: UDig NY Exactix <tickets@exactix.udigny.org> Sent: Friday, November 3, 2023 11:56 AM To: Steven Fews Subject: Message from UDig NY ****REGULAR**** DIG REQUEST from UDig NY for: VIL RYE BROOK Taken: 11/03/2023 11:55 To: VIL RYE BROOK PRIMARY Transmitted: 11/03/2023 11:55 00003 Ticket: 11033-000-839-00 Type: Regular Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 173 To: Name: 1/2 IVY HILL CRES Cross: From: To: Name: Offset: ------------------------------------------------------------------------------ Locate: ARBORS HOA, 173 1/2 IS THE CLUB HOUSE FOR THE SUBDIVISION, LOCATE NORTH AND WEST SIDE OF STRUCTURE NearSt: IVY HILL LN & ARBOR DR 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: INSTALL DECK, INSTALL FOOTERS Estimated Work Complete Date: 12/04/2023 Depth of excavation: 42 INCHES Site dimensions: Width 12 INCHES Start Date and Time: 11/17/2023 07:00 Must Start By: 12/04/2023 ------------------------------------------------------------------------------ Contact Name: GEORGE OREILLY Company: OREILLY CONTRACTING Addrl: 17 ST CHARLES ST Addr2: City: THORNWOOD State: NY Zip: 10594 Phone: 914-769-9575 Fax: Email: goreilly@oreillycontracting.com Field Contact: GEORGE OREILLY Alt Phone: 914-760-9077 Email: goreilly@oreillycontracting.com Working for: FIRST SERVICE RESIDENTIAL ------------------------------------------------------------------------------ Comments: 15 SONITUBES Lookup Type: MANUAL ------------------------------------------------------------------------------ Members: ALTICE USA BELL-VALHALLA / WSCHSTR CONED SUEZ WTR WESTCHESTER i N N !•- vWi� OS�O-S l 9(Sb8) bZ60 L yI2jOJ. 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