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HomeMy WebLinkAboutBP23-192SECTION TYPE OF JOB LOC —B—( 6c'� EST. TCOA fEE DATE TION RECORD DATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING cl RGH PLUMBING GAS C3 SPRINKLER ELECTRIC 0 LOW -VOLT E ALARM LOW-VOLT �O AS BUILT INAL ER APPROVALS ER Q AL SURVEY -;.ED PRIOR TO INSPECTION BR(�v� t VC�j J�V 198 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.ryebrook.orr TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE April 10,2024 Or Barak& Meredith Barak 10 Mohegan Lane Rye Brook,New York 10573 Re: 10 Mohegan Lane, Rye Brook,New York 10573 Parcel ID#: 135.42-1-15 Building Permit#23-192 issued on 11/21/2023 for a New Fence This certifies that the new black aluminum fence,gates and welded wire fence,installed under the above captioned permit has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to For office use n\\l BUILD ENT ` t� PERMIT# d 3—� 9d- �� VIL OFk3�E: K ISSUED: cc MAR 2 7 2024 38 KING STRE K, YORK 10573 DATE: 3.-8l 7-3 q FEE: A I/O— PAIDJW VILLAGE OF RYE BROOK BUILDING ^FFAPTM^FNT 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 ssssssssss*sss*s*s*ssss►*ssssssr*ssssssssssss*sssssssssssss*ss***sssssss*s*ssssssssssssss*sss*sss:*sssss*ss*sss*ssss*ssssssss Address: 10 Mohegan Lane,Rye Brook,NY 10573 Occupancy/Use: single Family Home Parcel ID#: 135.42-1-15 Zone: R-12 Owner: Meredith and Or Barak Address: 10 Mohegan Lane,Rye Brook,NY 10573 P.E./R.A. or Contractor: Address: Person in responsible charge: Hirsch Fence Install and Design LLO Address: 747 Route 9w,Valley Cottage,NY 10989 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: Meredith Barak being duly swom,deposes and says that he/she resides at 10 Mohegan Lane (Print Name of Applicant) (No.and Street) in Rye Brook ,in the County of Westchester in the State of NY ,that (Cityrrown/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:$ 6.000 for the construction or alteration of: Replace existing chain link fence including gate with new aluminum fence including gate at the rear of the home.Replace existing chain link fence wrm new a ummum Tence on ngnt siae or home.Add new aluminum tence including gate on left side or the home. Add welded wire fence along back and side of property. 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 2-1 Sworn to before me this day of Vl-\CL<—c� , 20 24 day of ,20 24 zwjwA� �! �/lA� S' ature of Property caner Signature of Applicant Meredith Barak Meredith Barak t Name of Property Owner Print Name of Applicant. \t-N LB,, Public SHARI MELILLO Notary Public Notary Public,state of New York No.01ME6160063 Qualified in Westchester county„--1 8/12/2021 Commission Expires January 29,201,'_ 1 'ie 6RCi' 1982 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.ors - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS :- 1 0 Wl('1 C, DATE: 9 Z O 2- PERMIT# -r)'L ISSUED: l' Z SECT: -5�f tl 44,BLOCK: �� LOT: LOCATION: 1`U G./�_ G-1�. OCCUPANCY: ❑ Violation Noted THE WORK IS... 2 PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION r ) ❑ Natural Gas l U�1�� c' w f-.ru "' ❑ L.P. Gas ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION FINAL 13-'OTHER P -IL-t. e N w � O a � u v o a a+ W V as arn Gq ` O W Der cn a yr Q Hz a '� ° 4a0 r o W ao x b4 N Q g u u cn�t1 0 _ a a Q W cl) Q H M GL« ° .� ° Le) o W 8 c � k v Q 00 s W 00 o o z v r� Wa z o x ii O U O a �•+ _ W v CC) 0; 3 u W° ';.' 00 41- aw o IV—t A H Ao pb wd FBI G1 F+ 1 M GQ M [W . o u N Q e C� Q z � W H - 00 a cn W W W H °" v 3 © a ° cn ce © b H U © C4 zZ d � o rJ z 0 a O D e z ' N U �/4 �j } 1rrs-ll1 Q MTI cn [-a 0 z Z VF- U I.T. O = aaQv ` o z O a � P a � o ; LLW � W W , 07� .� �r� _ 'AQ O A W z x ° � ° � ■ 0 Z '' a' W W A 1� A N. u. u7 AOr. u O .0 � > 'd '� a _ Q �I CA '� ►•a W '� x � � � -a s = _ BUILD RTMENT D IF U EN E VIL + OF R ROOK 938 KIINO! EET RYE B ,NY 10573 OCT 2 6 2023 14 39-� r VILLAGE OF RYE BROOK BUILDING DEPARTMENT FOR OFFICE USE ON LN : Approval Date: NOV 1 6 Permit# Application# /� � � Approval Signature: ARCHITECTURAL REVIEW BOARD: Disapproved: : Date: BOT Approval Date: Case# Chairman: PB Approval Date: Case# _V Secreta ZBA Approval Date: Case# Other: ? Application Feed GO Permit Fees: s /. FENCE / WALL / GATE PERMIT APPLICATION Application dated: 10/26/23 is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the installation,construction,repair or replacement of a Fence,Wall or Gate,in accordance with Section 250-6 B.(t)(g),of the Code of the Village of Rye Brook,as per detailed statement described below. Swimming pool fences must conform to the State Code. I. .lob Address: 10 Mohegan Lane,Rye Brook,NY 10573 2. Occupancy/Use: Single famiryhome S.B.L.#: /3J5i 'L/�� -/—� Zone: R-12 3. Proposed Fence/Wall/Gate(describe in detail): Replace existing chain link fence including gate with new aluminum fence including gate at the rear of the home.Replace existing chain link fence with new aluminum fence on right side of home Add new aluminum fence including gate on left side of the home Add welded wire fence along back and side of Property. 81 G t k q I N rh i A u M . 4. Property Owner: Meredith and Or Barak Address: 10 Mohegan Lane,Rye Brook,NY 10573 Phone# 703 965 8477(Meredith) Cell# 415 786 4968(Or) email: meredith.r.barak@gmaii.com ob.orbarak@gmaitcom Applicant: Or Barak Address: 10 Mohegan Lane,Rye Brook,NY 10573 Phone# 415 786 4968 Cell# 415 786 4968 email: ob.orbarak@gmaii.com Architect/Engineer: Hirsch Fence Install and Design Address: 747 Route 9W,Valley Cottage,NY 10989 Phone# 8453048622 Cell# 8453048622 email: bruce@hirschfence.com Contractor: Hirsch Fence Install and Design LLC Address&Phone: 747 Route9W,Valley Cottage,NY 10989 8453048622 5. If building is located on a corner lot,which street does it front on: N/A 6. What is the estimated cost of construction $6,000 (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: Two weeks 1 6/112023 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: Or Barak ,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 Hirsch Fence Install and Design LLC 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 26 Sworn to before me this 26 day of October . 20 23 day of October 20 23 Nv\,Q�j V I/ Signature of Property Owner Signature of Applicant Meredith Barak {3r Barak t Name of Property Owner Print Name of Applicant Notary Public Notary Public SHARI MELILLO Notary Public,State of New York No.O1ME6160063 Qualified in Westchester County commission Expires January 29.20Zq 2 61112023 ' I�j�Buil ndiin,,g'Permit Check List & Zoning Analysis Address: 1 lJ l V ICJ a r, ux SBL: Zone: iL Use: -?-I Const.Type: J Q Other. Submittal Date: D ' Revisions Submittal Dates: Applicant r Nature of Work: (2),o/zn e4 CV n � o 1 l n tc Reviews:ZBA: -2- '�2B: BP: Other. _ NEED OK -M ( ) (VES:Filing. P: O� C/O: Legalization: ( ) ( ) APP.: Date Stamped Properly Signed: SBL Verified: Cross Connection: F.O.G.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Stone 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 Stamped: Sealed: Copies: Electronic: Other: ( ) ( � License: Workers Comp: Liability Comp.Waiver. Other. ( Code753#: ZIo1O.3 -CX3 3Y J-O(7 Dated 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. ( RB mtg. date: I If /�3 approval: < < S notes: /0, ( )ZBA mtg. date: approval• notes: ( )PB mtg. date: approval: _notes: REQUIRED EXISTING PROPOSED NOTES Cir Fromm _ E= Front: sido: RAW F.A.R.: Qpen SFace: Stories: notes CQ - \ \ C BUILDIN13pIRTMENT v i VILL' OF RYIOOK OCT 2 6 2023 938 KING�4ET RYE BR60�4,NY 10573 4 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: 10 Mohegan Lane,Rye Brook,NY 10573 Date of Submission: Parcel ID#: 135.42-1-15 Zone: R-12 10/26/23 Proposed Improvement(Describe in detail): APPLICANT CHECK LIST: garlara arictingrhain linkfance inclurlinnT,gata with naw ahiminnm far in�udinn MUST BE COMPLETED BY THE APPLICANT gate at the rear of the home.Replace existing chain link fence with new aluminum fence on right side of home.Add new aluminum fence including gate on left side of The following items must be submitted to the Building the home.Add welded wire fenceaong back and side of props Department by the applicant- no exceptions. Property Owner: or and Meredith Barak 1. (x)Completed Application 2. (N/A)Two(2)sets of sealed plans. (one full size {maximum Address: 10 Mohegan Lane,Rye Brook,NY 10573 allowable plan size=36"x 42") and one I I"x 17") 3. (x)Two(2)copies of the property survey. Phone# Meredith Barak:703 965 8477,or Barak:415 786 4968 4. (x)Two(2)copies of the proposed site plan. Applicant appearing before the Board: 5. (x)One electronic/disc copy of the complete Or Barak application materials. 6. (x) Filing Fee. Address: 10 Mohegan Lane,Rye Brook,NY 10573 7. (N/A)Any supporting documentation. Phone# 415 786 4968 8• W/A) HOA approval letter. (if applicable) 9. (x) Photographs. ArchitecuEngineer: Hirsch Fence Install and Design LLC 10.(x) Samples of finishes/color chart. (a sample board or Phone# e45-304-8622 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 26 Sworn to before me this 26 day of October , 20 23 day of October , 20 23 qy\91� 7,4� Signature of Property Owner Signature of Applicant Meredith Barak V`� V Or Barak Print Name of Property Owner Print Name of Applicant 2�� J�bi. Notary Public Notary Public SHARI MELILLO Notary Public,State of New York No.01ME6160063 Qualified In Westchester County Commission Expires January 29,2Q1 8/t 2/2021 [3R �• Village of Rye Brook ML MR Ag enda FB SE Architectural Review Board Meeting AC SF W Wednesday,November 15,2023 at 7:30 PM Q Village Hall,938 King Street JM >J 1. ITEMS: 1.1. ARB23-113 (Consent Agenda) Jesus Gonzalez&Beatriz Gonzalez 505 Franklin Street Rooftop solar array. 1.2. ARB23-123 (Consent Agenda) William Fasohno&Patricia Fasolino 252 Irenhyl Avenue Rooftop solar array. 1.3. ARB23-124(Consent Agenda) Ajai Venkatapur&Truti Patil 5 Heritage Court Rooftop solar array. 1.4. ARB23-125 (Consent Agenda) Or Barak&Meredith Barak 10 Mohegan Lane Black aluminum fence,gates and welded wire fence. 1.5. ARB23-126 (Consent Agenda) Alessio Colacino&Kelly Colacino 37 Tamarack Road Rooftop solar array. 1.6. ARB23-23-059 (Consent Agenda) (Amendment to Prior Approval) Srivatsan Raghavan&Janani Ranganathan 436 North Ridge Street 4'high black aluminum fence. Consent Agenda Approvals: Motion_ Second JM Abstention Aye; ! Nay; Adjournment; Notes Page 1of3 Architectural Review Board November 15,2023 1.7. ARB23-127 Anthony Paniccia 496 West William Street Reconstruct fire damaged two-family dwelling. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.8. ARB23-128 (Amendment to Prior Approval) Steven Santiago&Amy Swift 3 Woodland Drive Rear one story addition. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.9. ARB23-129 Win Ridge Realty LLC 112 South Ridge Street New non-illuminated letter signage. "DIG. Seasonal Comfort Food" Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.10. ARB23-130 Pawling Holdings LLC 261 North Ridge Street Attached two car garage and rear trellis. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes Page 2 of 3 Architectural Review Board November 15,2023 1.11. ARB23-131 (Amendment to Prior Approval) 2 Elm Hill LLC 4 Elm Hill Drive Window,door and color changes. Front porch and deck extension. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes NEXT MEETING: December 20,2023 Page 3 of 3 • 1. ,��:. 441, i. ,, •r 6 0010 Wild ZVI w # 4IX r ello v_ i ' ilk ems . I _r � • ti New aluminum fence side of home (above), New welded wire side of property (below) - f NEW- MMA ,r {p y i 4 rt•�y��"fi.�`rp�.f 7« S ~`ti' jf� .,_. t v bbii"' � � 1 ^ems .k v,- ray s1 'f !t f �11`�_�j y�j...ai'. C Y }�Y•A J } l t ,y}fir � • �. '! .. r ��� - fit. �'`�� ��• y. Hirsch Fence Install & Design 747 Route 9W Valley Cottage, NY 10989 Oak P--/ 2 / Cuskil Lew Noma,rk*Name 1 n, Serrlos Address cft sly. rA o-3 CuatanaF`a Daytme Phone No Cusloawr'9 Evw*q Phone No. Cutlaraefs E-natl Address Nsareat Cron SUsel PERM ITANSPEC NINFORMA N Parma npuvee7 Y.. E3NO I Ieowner to obtain perm na pr (seaaraon lRrw rsortss oWy ofpenri Debra anstalaaon) to obtrin M Selection $ /^1-,a APPROXIMATE LAYOUT c r EWE FOOTAGE CONTAINED IN THIS PROPOSAL n APPROXIMATE weo on FIELD u®m FINAL PR" YMLL RE ADJUSTED SMED ON ACTUAL FENCE FOOTAGE USED AS aET FOURTH IN TERM Ah0 CONOrT MS..) ADDAMITI TW PC QTl OPTIONS COLUMN TO THE SELECTON TAKE DOVVN AM KAM $ A"AY OLD FENCE PERYT COST $ r i SUB TOTAL $ SALES TAX $ FINAL AMOUNT DUE (Call in w par cones( $ Stock Product Customer assumes all esponsibinres as it rotates to an additional labor and matanal costs as R relates Ll Special Order Product tD the fence bete instaiped on a nNphbors Property. r'1 - ,(k 1 CewpAQprovsd Customer ENCE NSTALLATION RELATED TO WIDE:PLEASE INITIAL ONE JxJsa*Nc To THEM *UUNEVIE-M OW r3T2WPfW0 aauuADMFBn:EToNLEVEL rmHGNnTGRnvL =M)E THFENCEare..oe'a"C o(CtiA10Y6l TOFLL eI OAPe) FOLLO�ANGFLOtlY Of�ROU1lJWFENCE VALL BE U�(VEN AT TOP aLLlfio w LAM11 aqe UNKS .CJRIpp 1p fti Y eases Product OL,-AlfO& Product('�Uv �J Product Style: �ip1�1 Height 5ty�� Style: L Height: Style. Height: Footage: It Gates: Footage: r' II Gates J Footage. It Gates: Post Cap: Color: Post Cap: Color Post Cap Color Rail Type: Post Cap Rail Type: Post Cap: Rail Type Post Cap: Picket Type: i <-- Picket Type: $ '� Picket Typt; $ J'' C _ L Cl L C 6 iL f y Q LLJ y ' section CD w W C7 E j G9 v' C FQ- Q X �► s V : ? ��► V i U � } 3 y� oJG� �``m ....E N, y e cv Cs. z J o ��e as E w -i IL aI = Q nn L_ lr mr y t i L Vitas)►,` � I _ - -emu'. �' :.4'ia-. y► .. ��y ♦ f ', '', �,, it'a -- ,alas)► ,4coRa CERTIFICATE OF LIABILITY INSURANCE DATE MM/DD/YYYY, 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. —Courtney Potter McCarthy Insurance PHONE 7 FAX IA�No Eau: (916) 69-0417 - ter- - 378 Elwood Avenue E-MAIL Hawthorne, NY 10532 ADDRESS courtney@mccarthyinsurance.net INSURER(SJ AFFORDING COVERAGE NAIC e INSURER A: Preferred Mutual INSURED INSURER B: Hirsch Fence Install & Design LLC INSURER C: 747 Rt 9w Cottage #4 INSURERD: Valley Cottage, NY 10989 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 00002210-577230 REVISION NUMBER: 6 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. Nfit TYPE OF INSURANCE ADDL aUBR POLICY EFF POLICY EXP JJIL POLICY NUMBER LOM A X COMMERCIAL GENERAL UABNLITY Y BOP0100721375 11/12/2022 11/12/2023 EACH OCCURRENCE f 1,000,000 CLAIMS-MADE X OCCUR PREMAMAG ISEO 1NTED f -SO OOO MED EXP(_Any one person) f SL000 PERSONAL&ADV INJURY f 1,000,000 GENL AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE f 2,000,000 POLICY PRO- n LOC PRODUCTS-COMP/OP AGG f 2 OOO 000 OTHER � �f AUTOMOBILE LIABILITY COMBINED SINGLE LIMITkml f ANY AUTO BODILY INJURY(Per person) f OWNED SCHEDULED BODILY INJURY(Per accident) f AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE s AUTOS ONLY AUTOS ONLY f UIMIIRELLA LIAR _OCCUR EACH OCCURRENCE f EXCESS UAB CLAIIMS.MADE AGGREGATE f DIED RETENTION 6f WORKERS COMPENSATION PERTU OTH- ANDEMPLOYERS'LIABILITY YIN ANY PROPRIETOR PARTNER/EXECUTIVE EL_EACH ACCIDENT f OFFICERIMEMSER EXCLUDED? ❑ N/A ( wxWory in NH) EL_DISEASE-EA EMPLOYEE f n yyeesS describe under - DESCRIPTION OF OPERATIONS below E.L DISE/LSE-POLICY U T f ' DESCRIPTION OF OPERATIONS LOCATIONS VEHICLES :AC OR 101 Additional Remarks Schedule,may be attached I more space is required) Address : 10 Mohegan Ln., 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 _ AU TMORIZ�E 4' +--► 1- CPO ®1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Printed by CPO on 10/23/2023 at 11.00AM NEW owe 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'conrpensation rights or obligations of any part)L** 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 Hirse6 Fence Install&Design LLC 747 Route 9w N 4 From: Village of Rye Brook Valley Conage,Nl"109119-2452 PHONE:845-304-8622 FEIN:XXXXX0091 The location of where work will be Performed is 10 Mohegan Ln,Rye Brook,NY 10573. Estimated dates necessary to complete work associated with the building permit are from October 23,2023 to October 22,2024. The estimated dollar amount of project is Sul-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,part-time employees,unpaid volunteers(including family members)or subcontractors. Partners/Members: Bruce Hirsch Disabilith and Paid Famih Leave Benefits ExemDtion 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: 1) 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.) 1,Bruce Hirsch,am the Member with the above-named legal entity. 1 affirm that due to my position with the above-named business 1 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 I 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 1 also hereby affirm that if circumstances change so that workers'compensation insurance and/or disability and paid family leave benefits coverage is required.the a ve-named legal entity will immediately acquire appropriate New York State specific workers' compensation insurance and/or disabili and family leave benefits coverage and also immediately furnish proof of that coverage on forms approved by the Chair of the Workers'Compen ion d to the government entity listed above. HIERE Signature: Date: i M n.,,,K .< r X X '- Received . Exemption Certificate \um er .w Y,��Yx,S �;;� * n" 2023-075829 K: :}: � r�' X^fixKk x'X '�_. �` October 23, 2023 " eNYS Workers' Compensation Board CE-200 01/2019 Laura Petersen From: UDig NY Exactix <tickets@exactix.udigny.org> Sent: Monday, November 20, 2023 2:08 PM To: Steven Fews Subject: Message from UDig NY ****REGULAR**** DIG REQUEST from UDig NY for: VIL RYE BROOK Taken: 11/20/2023 14:08 To: VIL RYE BROOK PRIMARY Transmitted: 11/20/2023 14:08 00005 Ticket: 11203-001-387-00 Type: Regular Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 10 To: Name: MOHEGAN LN Cross: From: To: Name: Offset: ------------------------------------------------------------------------------ Locate: LEFT SIDE OF PROPERTY AS FACING, STARTING FROM FRONT CORNER OF HOUSE TO THE REAR OF THE PROPERTY NearSt: BONWIT RD 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: 12/05/2023 Depth of excavation: 24 INCHES Site dimensions: Length 10 INCHES Width 10 INCHES Start Date and Time: 11/27/2023 07:00 Must Start By: 12/11/2023 ------------------------------------------------------------------------------ Contact Name: BRUCE HIRSCH Company: HIRSCH FENCE INSTALL & 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: HOMEOWNER ------------------------------------------------------------------------------ Comments: WILL BE MARKED IN WHITE Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: ALTICE USA CONED i SUEZ WTR WESTCHESTER VIL RYE BROOK WESTCHESTER CTY SWR z 10 0 20 40 - FOR TITLE PURPOSES ONLY A.L SURVEYED FOR RANDIE PATERNO ORIGINAL SCALE: 1" = 20' AND ONLY FOR THE PERSONS FOR WHOM IT WAS PREPARED.IT IS NOT VAUD FOR ANY OTHER PURPOSES OR FOR ANYONE ELSE DIE CS" V '�- MAP OF PROPERTY SITUATED AT I� VILLAGE OF RYE BROOK—WESTCHESTER COUNTY,N.Y. TOWN OF RYE ICT 2 6 2023 TAX SECTION:135.42 TAX BLOCK:1 TAX LOT:15 VI LA E OF RYE BROOK B IL ING DEPARTMENT ;r FILE MAP FILE MAP FILE 'LlO, I 4.LOT NO.70 LOT No.71 131 a(/I[ N OG 15'00A E YARD 106.00' CURB w^D cURB CURB I.O� C.LF OX NORM WOOD CURB ON WL5T A L0 EAST - C.LF CHAIN LINK FENCE r1 `Q 0.4'EAST YARD cum C.LF 0.55OUM I BRICK PAVERS 1.4'5OUTH YARD i n� INGROUND POOL U I Y WOOD CURB FILE MAP m I LOT No.74 HDT J � TUB N` I u r 1 STOOP BRK:K WALL In P ANTER 24.9' 50.91 T? WOOD DEC FILE MAP LOT No.75 S 0.7 K—YARD 3 GLF) 0 5PUT LEVEL STONE AND FRAME o.7' xsouM 0 = DWDIJNG No. 10 O .0 FILE MAP LOT No.73 37Z 19S Ne ROOF PORCH W a STONE WALL =Q GARAGE .7 co 23.E YARD Village f iye ook CU Architectu al qfvi . Board L� °.4'SouM ' ApprOvai Date m � YARD �oa�. 0 Chair 0h. O G m � I 78.25' _ PERMIT= Elm S 06'15'00a w 106.00' SBL# c� — —//fit ^/Z 1 V 20LV � ASPHALT STREET CURB DAT A v`-- TIFINAL SURVEY Vl/ _ M IRED PRIOR TO LANE BUILDI 5� ,�~� FINAL INSPECTION FILED MAP 'MAP OF SECTION No.3,PINE RIDGE' KNOWN AS LOT No. 7 FILED JUNE 26th, 1958 AS MAP No. 11525 NOTES: DATE DESCRIPTION 1.GUARANTEES OR CERTIFICATIONS INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY,GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON,AND TO THE MAY 11 th,2023 TITLE SURVEY ASSIGNEES OF THE LENDING INSTITUTION.GUARANTEES OR CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUASEOUENT OWNERS. 2 PROPERTY CORNER MONUMENTS WERE NOT PLACED AS PART OF THIS SURVEY. 3.UNAUIHORZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION UW. 4.ONLY COPIES FROM THE OMNAL OF THIS SURVEY MARKED WITH AN ORIGINAL OF THE LAND SURVEYOR'S INKED SEAL OR p,ND SUR HIS EMBOSSED SEAL SHALL BE CONSIDERED TO BE VALID TRUE COPIES. 5.EASEMENTS OF RECORD ARE ONLY GUARANTEED IF AN ABSTRACT OF TITLE IS FURNISHED TO THE SURVEYOR. _�rp LALSA LAND SURVEYING PLLC Q i GUARANTEED T0: � 3 1. MEREDITH BARAK AND OR BARAK ADRIAN S. LALSA 2.BANK OF AMERICA. NA ISAOA/ATIMA NEW YORK LICENSE No. 050936 * F O 3.CATIC TIRE INSURANCE COMPANY 172-24 93rd AVENUE G 1 3 JAMAICA, N.Y. 11433 TELEPHONE (917)882-7394 LF �C c"p FAX (718)206-2814 9,Jj N0.050 O TITLE No. EMAIL GOPAULLALSAUGMAILCOM (q 23 .•,... .r,..xy ..w•..-,..-.r.x.,..,..,,R; >,;m+t� ems'^' =n'.v'a._7^t'!""7i�'"'�i.^�� _ I '1�``ii.at s.� 4:,"`'�. I ...,, ,!;Y��.,. «.u• M< .<. •c r. r.. ..._._........... ............ �un��i aL:ii�•�`�Y.��c.'�.'ieY.wmw�'�- ..r..�i'"•".'s+,(:i'0•r-:i�...udr�"a: "..7L,..�-1'. �� .J'� �sl'l�t.�' '.fit` '�.' "'�'•"a. a ��r7�*?^•irr r,`^"r .yu.::'�:ict:.•X�:.`l.s'�++"3;:.�"�'.r.y....::: �rY..z,",�>�..i:......_._ t 0 20 4.0 - I=OR MUNICIPAL ►='URPOSES ONLY A.L. i 10 R ' I SURVEYED FOR N/IEf;EDIT(-1 BARAK �,,,'•�:.. „ AND ONLY FOR THE PERSONS FOR WHOM IT WAS PREPARED. IT IS NOT VALID ORIGINAL SCALE: 1 = 2 0 FOR ANY OTHER PURPOSES OR FOR ANYONE ELSE } • •''�S:N['dMlii��:::):::x):CiJ:E:%w=�sAL�a)L:1::x:::.+::a:<i).WNi)))XLCi:.WJnS11.1:i6x1J1•sMl:u::al:)se.<oaao:w�:+ts:...::::1:a::::x::i.a:a:s•S:is�1'::JO:.:�:a�i:u.•..:a:.:::a::iite>J:t.fox.:J%s:xY.YJY:J:iHK4iH:,%iSKM1.:.��:0�01�<:t:Nt:,)xif:w]:'ve:YlJ:a.�7 z �rsu•::;::su:.:xra✓i::e:s:esae�axaa:�s�Je:e:ax;:t<�,u:s:t:::.ss::+a)xuawe:wsi:.ssac:::c:c>sw:::saec:c:e:::::uw)sw::oaw:ue:)z;.:<:e:.:e::e:+)::ucx<ae::wnexxa::xu:atc:etmw::ws I.t I 135.42-1-15-RYE-ADRIAN.DWG MAP OF PROPIEPTY SITUATED AT i. VILLAGE OF RYE BROOK-WES T C11-(ESTER COUNTY, N.Y. I r TOWN CI: RYE TAX' SECTION: 35.`I2 TAN BLOCK 1 TAX LOT: 15 t FILE MAP ' FILE MAP LOT No.70 i. r LOT No.71 �(( <. N YARD <.� CURB y v�.J a.6 m`c::'fit.. i[ i.0'WEST C.L.F f CURB 'HOOD CURB ONFL�•dL- WOOD CURB 0.3'WEST � 0.4'NORTH ucutrantmuaar:�is::�t^1.a„.:_ ......»•. ti�....<"'"'<"'rf"-.x....�..��sxr:u�^.mr �e�[autui�rcn�tuti) ro..r�...J�1:A.. ,....sa..� i — C.L.F CHAIN LINK FENCE I1 WIRE MESH FENCE 0.4'CAST YARD f FLAGSTONE RIBBON ' WIRE F-E. _ � x 2.5'FAST C.L.P < CURB € w l v v v v v v I.4'SOU ff1 Ie; 1.4 NORTII v 03 50UTIl � 2f`' BRICK PAVERS � xi YARD < - j i I" o x I -- � I Q < WIRE f L. } I.I'NOKFH < x w INGROUND POOL z u- u° FILE MAP or_ w )�- x WOOD C < Y CURB LOT No.74 HOT z TUB x:-' - W I PVC MESH FENCE s n n n n n n z. U U BRICK WALL mr) sTooP f; I PLANTER " 24.9' -� 50.9' k I x POOL � WOOD DECK I z EQUIPMENT co cy Lu FILE MAP ` _ H.V.A.0_ LOT No.75 0. . UNIT —� o.I x 10.T I—o FENCE Y C.L.f- YARDLd 0.9'50UTI1 L y SPLIT LEVEL STONE AND'FRAME �—H.V.A.0 X o _ DWELLING N 10 UNIT o. FILE MAPCD ' N `JJ qLOT No.73 ,,; }.; p ! UNIT � r ri°y,�syLsce.a► a it 37.8' 193 �:! w IRON FENCE J ' - ROOF PORCH !i«t, WIP.E rC. GATE L< C� 1.4'NOP,TN STONE WALL ! u 23.0 i YARD CURB m OA'SOUTH zD W Ln YARD cLi r - a YARD t_ij t j eo i- a_ i c U> 1` y A -BUILT k, DOCUMENT <z' a, 7h • <•�k:! �::«xY.'c1t'fCnVibY+::bYk"�; LLTxil0.` �`.:.'S'!�:::?Y.:)Yf,Lt'JY:::L':.:.1')`.J>`�41t]'�tL'.:£'�:YXG2",A�'2S�L`.3G:2'.3:t:J?M�.•.l!Y..'.:�.Y`.'.X«i::n:Ylwt.21:Y:2'1�i:.�.^.':T.:?:'.'.�. :':;^.):`'.4t:CZx.:v:!:.L':. .s r.�a.a.rw.�ararwa.►�w..-..�..... �t '3� R '—•-1 � s 0 ! y 01 t{.c,y,'�, 7 541 i ASPHALT STREET CURB AS hqT T -T CURB t �� f - 3 2024 L MAPR )�>.C;AN tt b v tI �t VILLAGE OF RYE BROOK FILED MAP WILDING D E PARTM' "MAP OF SECTION No.3,PINE RIDGE" KNOWN AS LOT No. FILED JUNE 26th, 1958 LOT AREA = 13250.00 SCE. FT. AS MAP No. 11525 1 .aa,<a.MMM.:..%a....1aww%<KSMux M..)3F?a:41.N..A)aNwiwa."M 1».iMOM1CNftlMWiiiGMNKMMIWa»na>.......:...<Mi00<a0i0MW6<xiYKM1R :»aw.:nza,wu<.x<::waaaxeea»•waana:»:waa:»»»)e»x<.erwweax:.<:waa:ls+»::w:xev:•»:+saw:uu:se:axrnwwx<a-s.oeK::<mmar.:e:o.sam:a:atxuxuaaa::.,ax:.<:.a�.a.uansu.:wt„e<x»>::t:we::::xruxwu<:t)fucuesi:::::a.t:c::::::t::>:::::>r.:::axi>:>:wawnunm»>a<erxow<rau»ca:«<at»ane<x<ew<awe.ewra«a.wwwwwa<�..��.. DATE DESCRIPTION NOTES: .m.. wu osxK f� NOTES: 1. GUARANTEES OR CERTIFICATIONS IND ICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM 'THE SURVEY IS PREPARED L;l AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION Lls-rED HEREON, AND TO THE MARCH 24th,2024 MUNICIPAL SURVEY ASSIGNEES OF THE LENDING INSTITUTION. GUARANTEES OR CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS +OR SUBSEQUENT OWNERS. r 2. PROPERTY CORNER MONUMENTS WERE NOT PLACED AS PART OF THIS SURVEY. I ��PND Stjg �? 3. UNAUTHORIZED ALTERATION OR ADDITION To THIS SURVEY IS A VIOLATION OF SECTION 7-09 OF THE NEW Yom< STATE ! EDUCATION LAW. j ���'`5' 4. ONLY COPIES FROM THE ORIGINAL OF THIS SURVEY MARKED WITH AN ORIGINAL OF THE LAND SURVEYOR S INKED SEAL OR 'HIS EMBOSSED SEAL SHALL BE CONSIDERED TO BE VALID TRUE COPIES. �.' 5. EASEMENTS OF RECORD ARE ONLY GUARANTEED IF AN ABSTRACT OF TITLE IS FURNISHED TO THE SURVEYOR. »r_-rwsmerr..a:mom«<rr.::x«:a^r.»�sac•»fnane:•)x�»:x:x:eo»wr.::mx:r,)w.:�•m»m::.... .. .. xvuxerxmrx:x:rorrs:xttx�n:ao:a:c:r::cea�:asoc��xa:rn7:zv::::ist.:yr.<:r.):a.:txeser.:t•.-t<ex:)r_aa::er.:sxzrr..•t:cnmasn:ssmr.:mvas<w:mtar.::�m�aeo:�.. �— LALSA LAND .�FJRV��I ! PLLB ]GUARANTEED TO: ADRIAN S. LALSA � � , �- �-3- - ARAK AND OR BARAK _ � � � 1. MEREDITH B NEW YORK LICENSE No. 050936 4 �i 2. CITY OF RYE DEPARTMENT OF BUILDINGS 172-24- 93rd AVENUE �,p� /V� ���0 �� JAMAICA, N.Y. 11433 �j� '05Q 0 TELEPHONE (917)882-7394- 4F TH S� FAX (718)206-2814. E TITLE= No. EMAIL GOPAULLAI SAOGMAIL.COM ©ALL RIG ERVED 2024