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BP24-075
PERMIT #N� �/'� 7.-�.�� DATE; S a �`/ EtP: S/a/aS SECTION .3�8L0 K LOT TYPE OF WORK P Ql/ZP JOB LOCATION /bQ bf OWN ER/-?/C QP/` 7/042/n/V//Rng2� ia�Pin/ CONTRACTOR § EST. COST '&'/Q> Oil FEE' V//CO # 9LA - U / "] FEE I t DATE LP TCO # FEE DATE INSPECTION RECORD DATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING ED RGH PLUMBING GAS E3 SPRINKLER ELECTRIC O LOW -VOLT O ALARM O AS BUILT O FINAL 3r.—It. tte GSA �9/vWD9-a86& OTHER APPROVALS AR8 QC:IQ BOT PB ZBA OTHER VILLAGE OF RYE BROOK WESTCHEStAR COUNTY, NN.W YORK Certificate of ®ccupaucp his is to certify thatrnJmix/�� 00041h-e Lh/CP19/ni Of, having duly filed an application on /` 20 requesting a Certificate of Occupancy for the premises known as, f Pa(Y610Ck j!10(_r ,Rye Brook,NY, located in a R-15 Zoning District and shown on the most current Tax Map as Section: ' 5.O(D Block: I Lot: 4/L2 and having foully complied with the requirements ss7of the Building Code and the Zoning Ordinance under Building Permit No.o� , issued .5 oC 20 c2 , such authority and permission is hereby granted to the property owner to lawfully occupy or use said premises or building or part thereof listed under the following New York State Classifications,Use: Lo ne' / Construction: for the following purposes: Li // z ear 6lecL 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 h ' lit shall be made,nor hall the building be moved from one location to another until a permit to accomplish such change h s be nob a om uilding Inspector. Building Inspector, Village of Rye Brook: Date: JUN 1 3 2024 t-+ i-rrvvi D �`l n E ��& For office use only: E C Ev BUILDkFdH. "1i 'MENT L. ,. PERMIT# � _Q 7 _ � VIL>k� OF RYE tOK ISSUED: —Q—aq JUN - 7 2024 KING STRE YE BROOK,, W YORK 10573 DATE: —� 9 _06 U FEE: r so PAID WIT VILLAGE OF RYE BROOK w BUILDING DEPARTMENT APPLICATION FOR CERTIFICATE OF OCCUPANCY, CERTIFICATE OF COMPLIANCE, AND CERTIFICATION OF FINAL COSTS TO BE SUBMITTED ONLY UPON COMPLETION OF ALL WORK, AND PRIOR TO THE FINAL INSPECTION rssss+sr++s*++**tttrtttrtsrtt++++*t*rttrstsrrrs+r+++***ttsrrrsrsrs+srrrsrs++r*+s*+ssr*++s******+rttttstsrrrtrrssssssssrsrsss* Address: 10 Paddock Road, Rye Brook, NY 10573 Occupancy/Use: Residential Parcel ID#: 135.26-1-42 Zone: R-15 Owner: Michael Chiappini Address: 10 Paddock Road, Rye Brook, NY 10573 P.E./R.A. or Contractor: Frank Marsella, AIA Address: 178 E. Boston Post Road, Mamaroneck NY, 10543 Person in responsible charge: Michael Chiappini Address: 10 Paddock Road, Rye Brook, NY 10573 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: Frank Marsella, AIA being duly sworn,deposes and says that he/she resides at 6 Burton Road (Print Name of Applicant) (No.and Street) in Larchmont in the County of Westchester in the State of NY ,that Witylfown/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 construction or alteration of. Legalization of rear deck 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-IO.A.of the Cqd of the Village of Rye Brook. Sworn to before me this Sworn to b?tore,me this day of ,202- diAt� , 202�I "of Si ature of Applicant i Frank Marsella, AIA Pr' t erofPrope O r Print Nip nt Notary Public SHANTELL S SMALL Public Si,AN Notary Public. State of New York Notary Public. State of LLSYoAc No. 01SM6249686 g/12/2021 j2�� No.Public. State of 6 Qualif!ed in Nassau inf Qualified in Nassa my Commission Expires Commission Expires QyE DRC�- • F o 1982- BUILDING DEPARTMENT VI' ILDING INSPECTOR SISTANT 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 : ' �_ ) Q,: DATE: PERMIT# 4 Z '1 0 7 S ISSUED: SECT: /�iZ BLOCK: LOT: LOCATION: C-' ,, OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... [I 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 c. ❑ FINAL PLUMBING ❑ CROSS CONNECTION FINAL L L G�(J Z �C 1. C" C Q• �- ❑ OTHER i�eC� /jr L(�^ O� •' i / C �E BRC�� cu � .��OT 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 : J C DATE: -5 G / - 1 uz PERMIT# 1.a ?y -0 2S ISSUED: SECT: j •1 BLOCK: LOT: LOCATION: 1' Pca"% ` : C OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED EJECTED/ 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 ()lJ (� 3 CA cG ti ❑ OTHER � � C �` � � A �L Pe s rec �� � a ■ ■ . : N N \ c w� ■ \ toLin 0 ■ a W ` U �I s ow m N o CAa O a LO C = i rl °—i o .1 v u a N - 0 v o o � © W C% O r' N o A r W C., z `n Q. a a. � a'J � co O = H w U Q � ov � �° � Ui _ 0-4 z prg 04 00 o dal V W a d ' O .s C1 a a U C p ZO a OA �t w Id 0 w Ry F © V W"0 H O �1 „_, W z p� p z � � � x Q N � en av, a0-4 a � ° i a a �ry s BUIL �AE MENT VIL E OEOOK D938 KING ETR ,NY 10573FEB 29 2024 , ID - VILLAGE OF RYE BROOK BUILDING DEPARTNIML FOR OFFICE USE ONLY: Approval Date: APR 2 3 24 Per Q)q o / S ; Application # A9&,-' J6,9 V NJI Approval Signature: ARCHITECTURAL REVIEW BOARD: Disapproved: Date: &h BOT Approval Date: Case# : Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Case# Other: - Ic Application Fee: W— L Permit Fees: EXTERIOR BUILMING PERMIT APPLICATION Application dated: L/ is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the construction of buildings,structures,additions,alterations or for a change in use.as per detailed statement described below. 1. JobAddress: 10 Paddock Road 2. ParcelID#: 135.26-1-42 zone: R-15 3. Proposed Improvement(Describe in detail): Legalization of rear deck. 4. Property Owner: Michael Chiappini Address: 10 Paddock Road, Rye Brook, NY 10573 Phone# 914-937-2062 Cell# 914-309-2866 e-mail actc3738@gmail.com List All Other Properties Owned in Rye Brook: Applicant: Frank Marsella, AIA Address: 178 E. Boston Post Road, Mamaroneck NY, 10543 Phone# 914-630-0800 Cell# e-mail frank@marsella-architects.com Architect: Frank Marsella, AIA for Marsella Architects PC Address: 178 E. Boston Post Road, Mamaroneck NY, 10543 Phone# 914-630-0800 Cell# e-mail frank@marsella-architects.com Engineer: Address: Phone# Cell# e-mail General Contractor: Tom DiNota for DiNota Contracting Inc. Address: 125 Gertrude Ave, Mamaroneck, NY 10543 Phone# 914-755-7291 Cell# e-mail dinotacontractinginc@msn.com (1) 6/1/2023 5. Occupancy;(1-Fam.,2-Fam.,Commercial.,etc...)Pre-construction: 1-Fam. Post-construction: 1-Fam 6. Area of lot: Square feet: 15,062.3 SF Acres: 0.35 ACRES 7. Dimensions from proposed building or structure to lot lines: front yard: 38.92'to exist house rear yard: 65.51'+/- right side yard: 55.02'+1- left side yard: 24.67'+/- 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: NIA I I fl: NIA 2nd fl: NIA 3rd fl: NIA 10. Total Square Footage of the proposed new construction: 228 S.F.of existing deck to be legalized 11. For additions,total square footage added:Basement: NIA 1"fl: NIA 2nd fl: NIA 3,d fl: NIA 12. Total Square Footage of the proposed renovation to the existing structure: NIA 13. N.Y.State Construction Classification: Type V-B N.Y.State Use Classification: R-3 14. Number of stories: NIA Overall Height: NIA Median Height: NIA 15. Basement to be full,or partial: NIA finished or unfinished: NIA 16. What material is the exterior finish: Existing Wood Siding 17. Roof style;peaked,hip,mansard,shed,etc: NIA Roofing material: NIA 18. What system of heating: NIA 19. If private sewage disposal is necessary,approval by the Westchester County Health Department must be submitted with this application. NIA 20. Will the proposed project require the installation of a new,or an extension/modification to an existing automatic fire suppression system?(Fire Sprinkler,ANSL System,FM-200 System,Type I Hood,etc...) Yes: No: (if yes,applicant must submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineeredplans) 21. Will the proposed project disturb 400 sq.ft.or more of land,or create 400 sq.ft,or more of impe ious coverage requiring a Stormwater Management Control Permit as per§217 of Village Code? Yes: No: V Area: 22. Will the proposed pro' 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:V (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: V (if yes, the area and elevations of the flood plane must be properly depicted on the survey&site plan) 26. Will the proposed project require a Tree Removal Permit as per§235 of Village Code? Yes: No: V (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: V Indicate: TIER I: TIER I1: TIER III: (f yes,a Nome Occupation Permit Application is required) 28. List all zoning variances granted or denied for the subject property: NIA 29. What is the total estimated cost of construction: $ 12,000 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 requiredprior to issuance of the CIO. 30. Estimated date of completion: Completed (2) 611/2023 BUILDING DEPARTMENT VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 RESIDENTIAL LOT AREA COVERAGE Address: 10 Padlock Road Section: 135.26 Block: 1 Lot: 42 PERMITTED COVERAGE RATIOS IN RESIDENTIAL DISTRICTS (Local Law 3-88) YOUR ZONE AREA IN MAIN ACCESS. DECK ZONE DISTRICT SQ. FEET BLDG. BLDG. MAX. CHECK MAX. R-35 35,000 14% 4% 5% R-25 25,000 14% 3.5% 4% R-20 20,000 14%© 3.5% 4% R-15 15,000 16% 3.5%© 4% R-15A 15,000 12% 3.5% 4% R-12 12,500 17% 4% 4% R-10 10,000 20% 4.5% 3.5% R-7 7,500 23% 4.5% 3.5% R-5 5,000 30% 5% 3.5% R-217 5,000 30% 5% 3.5% Existing: Proposed: 1. AREA OF LOT 15,062.3 Sq. Ft. 15,062.3 Sq. Ft. 2. AREA OF HOUSE a. Coverage of Main Building (Including Attached Garage or Accessory Building) +� 1,581.1 Sq. Ft. +1-1,581-1 Sq. Ft. b. Area of 15t Floor Divided By Area of Lot x 100 10.5 % 10.6 3. AREA OF ACCESSORY BUILDING (Includes Detached Garages,Tool Shed, Playhouses) +/-120.0 Sq. Ft. +1-120.0 Sq. Ft. a. Coverage of Accessory Building Area of Accessory Building Divided By Area of Lot x 100 0.80 % 0.80 % 4. AREA OF DECK 303.92 Sq. Ft, 303.92 Sq. Ft. a. Coverage of Deck Area of Deck Divided By Area of Lot x 100 2.02 % 2.02 %u I attest to the best of my knowledge and belief, the above information is correct. jchh�itect's Sl,gnature (3) 8/12/2021 BUILDING DEPARTMENT VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK,NY 10573 (914) 939-0668 IMPERVIOUS COVERAGE RATIOS RESIDENTIAL DISTRICTS Address: 10 Paddock Road Seetion: 135.26 Block: 1 Lot: 42 Zone: R-15 IMPERVIOUS SURFACES (Definition): All buildings, as defined herein, and all areas on the ground or elevated above the ground which are comprised of materials through which water cannot readily flow, including, but not limited to asphalt, concrete, masonry, wood, gravel and clay, and which consist of elements including, but not limited to, court yards, sports courts, swimming pools, patios, sidewalks, ramps,terraces and driveways. TOTAL MAXIMUM PERMITTED MAX. PERMITTED COVERAGE Zoning IMPERVIOUS LOT AREA BY IMPERVIOUS SURFACES District COVERAGE IN FRONT (sq.ft.) For Base Lot For Lot Area YARD(%) Area(sq.ft.)* Over Base R-35 15 Lot Area % R-25 20 0 to 4,000 0 55 R-20 30 4,001 to 6,000 2,200 35 6,001 to 12,000 2,900 27 R-15 35 12,001 to 16,000 4,520 26 R-15A 35 16,001 to 20,000 5,560 25 R-12 40 20,001 to 30,000 6,560 24 30,001 to 40,000 8,960 23 R-10 45 40,001 & larger 11,260 22 R-7 40 R-5 30 *"Base Lot Area"is the minimum end of the lot size R2-F 30 range in the"Lot Area"column Area of lot: 15,062.3 sq.ft. Existing Allowed Proposed Total impervious coverage = 3,091.97 S .ft. 5,315.94 sq. ft. 3,091.97 Sq.ft. Front impervious coverage = 17.6 % 35 % 17.6 % I atte the best of my kn ledge and belief,the above information is correct. Arc ect,s Signature' (4) 8/12/2021 BUILDING DEPARTMENT `TILLAGE OF RYE BROOK 938 KING STREET RYE BROOD,NY 10573 (914)939-0668 BULK REGULATIONS IN RESIDENTIAL DISTRICTS AddreSS: 10 Paddock Road Section- 135.26 Block: 1 Lot: 42 MAXIMUM GROSS FLOOR AREA USE FORMULA: Maximum Gross Floor Area = 4,000 + [(Lot Area —21,780) x 0.11478421 ]: a. Allowed = 3,228.9 Sq. Feet b. Existing = N/A Sq. Feet c. Proposed = NO CHANGE Sq. Feet HEIGHT/SETBACK RATIOS FOR RESIDENTIAL DISTRICTS DEFINITION: A standard designed to regulate the height of a building in relation to the average grade of the corresponding portion of the lot line from which it is set back. The ratio modifies the maximum permitted Height of Building by forming an inclined plane beginning at the average grade along the portion of the lot line from which the setback is measured and rising toward the building at the specified ratio above which no part of any building, other than minor architectural features such as chimneys, skylights and dormer windows not covering more than 10%of the entire roof area, shall be permitted to extend. Height and Setback shall be calculated using the formula; Height I Setback=X, where X is the required side or front yard ratio for the zoning district in which a property is located as specified in Article VIII of Chapter 250. A complete elevation view for the proposed improvement must be included on the drawings. FILL IN YOUR RATIOS: ZONE E US77NO PROPOSED REQUIRED FRONT: FRONT: FRONT: .44 I -3s SIDE: SIDE: SIDE: 1.20 FRONT: FRONT: FRONT: .48 AL25 SIDE: SIDE: SIDE: 1.30 FRONT: FRONT: FRONT: .60 IF20 SIDE: SIDE: SIDE: 1.60 FRONT: FRONT: FRONT: .60 R is SIDE: N/A SIDE: N/A SIDE: 1.60 FRONT: FRONT: FRONT: .80 ,ff INA SIDE: SIDE: SIDE: 2.40 FRONT: FRONT: FRONT: .69 R f2 SIDE: SIDE: SIDE: 1.60 FRONT: FRONT: FRONT: .80 R-f0 SIDE: SIDE: SIDE: 2.40 FRONT: FRONT: FRONT: .96 R-1 SIDE: SIDE: SIDE: 3.00 FRONT: FRONT: FRONT: 1.20 Iles SIDE: SIDE: SIDE: 4.00 FRONT: FRONT: FRONT: 1.20 -2F SIDE: SIDE: SIDE: 4.00 to the best my knowledge and belief, the above information is correct. A itect's S ature (5) 8/12/2021 Existing 1family home with 3 bedrooms ILLUSTRATION OF HEIGHT / SETBACK RATIO Setback Line for I Maximum Height I REAR I I Minimum I I Setback Line J I m ` ` C T y J J C < w 1✓ u� G _O kil I iot N r E rn JG POTENTIAL = _ E I? I BUILDING "0 o ' I 1 ENVELOPE < ¢ < rn ' � I FRONT Area in whkh Average Grada Is Measured STREET Average Grade Along Property Line at Property Line ELEVATION PLAN Table R301.2.0) 2020 IRC CLIMATIC & GEOGRAPHIC DESIGN CRITERIA FOR RESIDENTIAL DISTRICTS IN RYE BROOK GROUND- WIND SPEED TOPOGRAPHIC SPECIAL WIND- SEISMIC DESIGN SNOW LOAD (mph) WIND EFFECTS WHO BOURNE CATAGURY WEATHERING REGION DEBRISZONE 20 psf 115/120 ND ND NO D SEVERE FROST LINE TERMITE WINTER DESIGN ICE BARRIER FLOOD AIR FREEZING MEAN ANNUAL DEPTH PROTECTION TEMP. UNDERLAYMENT HAZARDS INDEX TEMP. REQUIRED REQUIRED 42" YES 15 YES FIRM MAP IDDD 52.2 36I19CO779f 9/2B/D7 (5a) 8/12/2021 BUILD - MENT IE C E � v E VIL E OF R OOK 938 KING ET RYE Bit ,NY 10573 FEB 2 9 2024 -0 -� VILLAGE OF RYE BROOK BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE &216 • STORM SEWERS AND SANITARY SEWERS 'PHIS AFFIDAVIT MUST BEAR THE NOTARIZED SIGNATURE OF THE LEGAL PROPERTY OWNER AND BE SUBMITTED ALONG WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION. ANY BUILDING OR PLUMBING PERMIT APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETURNED TO THE APPLICANT . STATE OF NEW YORK. COUNTY OF WESTCHESTER ) as: 3!, Michael Chiappini , residing at, 10 Paddock Road, Rye Brook, NY 10573 (Print name) (Address where you live) being duly sworn,deposes and states that(s)he is the applicant above named, and further states that(s)he is the legal owner of the property to which this Affidavit of Compliance pertains at; 10 Paddock Road , Rye Brook,NY. (Job Address) Further that all statements contained herein are true,and that to the best of his/her knowledge and belief, that there are no known illegal cross-connections concerning either the storm sewer or sanitary sewer,and further that there are no roof drains, sump pumps, or other prohibited stormwater or groundwater connections or sources of inflow or infiltration of any kind into the sanitary sewer from the subject property in accordance with all State, County and Village Codes. (Signature of Prope wner(s)) Michael Chiappini (Print Name of Property Owner(s)) tore to 6 l icl SHANTELL S SMALLS Notary Public, State of New York No. ()1SM6249686 Qualified in Nassau C un ,,, (6) Conirnission Expires 1 8112r2a21 This form must be properly completed ¬arized by the Design Professional of record and the Property Owner. Failure to provide this completed R permit application will delay the permitting proces d * ** ** ********* ** ************ FEB 29 2024 3 Notice of Utilization of Truss Type, Pre-Engineered oh( LAGE OF RYE BROOK or Timber Frame Construction. (Title 19 Part 1264& 1265 N ILDING DEPARTMENT To: The Building Inspector of the Village of Rye Brook. From: Frank Marsella, AIA Subject Property: 10 Paddock Roa/d SBL: 135.26-1-42 j�„y�: R-15 Please take notice that the subject;Vone or Two Family; ❑ Commercial, ❑New Structure ❑ Addition to an Existing Structure ❑ Rehabilitation to an Existing Structure to be constructed or performed at the subject property will utilize; ❑ Truss Type Construction (TT) ❑ Pre-Engineered Wood Construction(PW) ❑ Timber Construction(TC) in the following location(s); ❑ Floor Framing, including Girders& Beams(F) o Roof Framing(R) ❑ Floor Framing and Roof Framing(FR) Please note that prior to the issuance of the Certificate of Occupancy, the subject dwelling or building utilizing truss type, pre-engineered wood, or timber construction must be posted with a Truss Identification Sign, installed in conformance with NYCRR§1264 for Commercial Buildings, and NYCRR§1:265 for One&Two Family Dwellings. i ov�' Sworn to before me this Sworn to b re me this day of ,20 ,20 Si6iatdre of Property wner Si gh+ature of Design Professional Michael Chiappini Fr k Ma ella AIA Print N e erfoperty Owne Print741��off D n Pressix r No Pubh Not Pub 'c V____1 SHANTELL S SMALLS Notary Public. State of New York No. 01 SM6249686 SHANTELL S SMALLS Oualified in Nassa u t Notary Public State of New York Commission Expires 7 (7) No. 01S�16249686 Qualified in rD ssa C un Commission Expires 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: Frank Marsella, AIA , 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 Architect 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 D_ day of , 20 2_0 day of , 20 Signature of Property Owner Sign ure of Applicant Mich pi Frank Marsella, AIA Pi Name of Prope caner Print Na App ant r L N tary Public No u SHANTELL S SMALLS Notary Public. State of New York No. 01 SM16249686 Qualified in Nassau.County Commission Expires l I ( t7��_ i SHANTELL S SMALLS Notary Public. State of New York No. 01 SM16249686 Qualified in NassauQipun Commission Expires T (8) 8/12/2021 BUILD Ne, &i'ARTMENT V (�VILE E OF RY OOKv ►'—�938 KING ET RYE BRt,NY 10573 4 I'll��.b ! !CE 3 0 2024 �1 .�� VILLAGE OF RYE BROOK BUILDING DEPARTMENT FOR OFFICE USE ONLY: [� Approval Date: JUN 3 Perm' # ��� 7 J��� Application# Approval Signature: ARCHITECTURAL REVIEW BOARD: Disapproved: : Date: BOT Approval Date: Case# Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Case# Other: Amendment Fee: Permit Fee: APPLICATION TO AMEND APPROVED PLANS Application dated: 5-3P-c)y is hereby made to the Building Inspector of the Village of Rye Brook,NY,to amend the approved plans associated with an existing open permit,and/or from any prior approvals granted by the approval authority as per detailed statement described below. I. Job Address: 10 Paddock Road Existing Permit#: PP-24-075 2. Parcel ID#: 135.26-1-42 Zone: R-15 Original Approval Date: 05/02/24 3. Proposed Amendment(Describe in detail): Move (3) sono-tube footings to rear edge of deck, including to move (3) 6x6 posts and dropped header 4. Property Owner: Micheal Chiappini Address: 10 Paddock Road, Rye Brook , NY 10573 Phone# Cell# 914-309-2866 e-mail actc3738@gmail.com Applicant: Micheal Chiappini Address: same as above Phone# Cell# e-mail Architect/Engineer: Frank Marsella, AIA for Marsella Architects, P.C. Address: 178 E. Boston Post Road Phone# 914-630-0800 Cell# 914-318-0976 e-mail frank(dmarsella-architects.com 5. Occupancy;(I-Fam.,2-Fam.,Comm.,etc...)Prior to construction: 1 family After construction: 1 family 6. Will the proposed amendment require the installation of a new,or an extension/modification to an existing automatic fire suppression system?(Fire Sprinkler,ANSL System,FM-200 System,Type I Hood,etc...)Yes: No: *V(if yes,you must submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans) 7. Will the proposed amendment disturb 400 sq.ft.or more of land,or create 400 sq.ft.or more of impervious coverage requiring a Storm water Management Control Permit as per§217 of Village Code?Yes:_No: VArea: 4.276 sq.ft. I sn 2r202t 8. Will the proposed amendment require a Site Plan Review by the Village Planning Board as per§209 of Village Code? Yes: No: (if yes,you must submit a Site Plan Application,&provide detailed drawings) 9. Will the proposed amendment 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) 10. Is the lot located within 100 ft of a Wetland as per§245 of Village Code? Yes: No: V(if yes,the area of wetland and the wetland buffer zone must be properly depicted on the survey& site plan) 11. Is the lot or any portion thereof located in a Flood Plane as per the FIRM Map dated 9/28/07? Yes: No: (if yes,the area and elevations of the flood plane must be properly depicted on the survey&site plan) 12. Will the proposed amendment require a Tree Removal Permit as per§235 of Village Code?Yes: No: V (if yes,you must submit a Tree Removal Permit Application) 13. Does the proposed amendment involve a Home-Occupation as per§250-38 of Village Code? Yes: No: %00Tfyes,indicate: TIER 1: TIER II: TIER III: (if yes,a Home Occupation Permit Application is required) 14. Will the proposed amendment result in additional square footage to the building or subject structure, and if so, provide such additional footage here. "A (Please submit additional Bulk Regulation Application Pages for review) 15. What is the total added cost of the work associated with the amendment: $ 0. (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.) 16. N.Y. State Construction Classification: S e N.Y. State Use Classification: X-3 17. Estimated date of completion: within 3-4 days after amendment approval. 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: Micheal Chiappini , being duly swom,deposes and states thage 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 applicant and owner 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 (7 1 s l Signature of Property Owner Signature of Applicant Micheal Chiappini Micheal Chiappini 7ri le of Property Owner Pri a of Applicant Notary Public Notary Public SHAM MELILLO Notary Public,State of New York No.01ME6160063 Qualifled In Westchester County Commission Expires January 29,2 8/12/2021 w.. t f: Y L, x "44 n .Building Permit Check List&Zoninz Anal is Address. 1 a 1' G SBL• `rz Zone - 1� Use: Coast Type Other: Submittal Date Revisions Submittal Dates: Applicant: \a t G Nf Nature of Work Reviews:ZBA: MAR 0 6 2074 PB: BOT: Other. NEED OK �� (a/ ("FEES:Filing:��BP: 2� /O: Flood Plane Legalization: ( ) ( VAPP: Dated: /Notarized. -- SBL: -" Truss I.D. Cross Connection: H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening. ( ) ( ) ENVIRO:Long Short Fees: N/A.- SITE PLAN:Topo: Site Protection: S/W Mgmt.: Tree Plan: Other: SURVEY.Dated Current: Archival:- Sealed Unacceptable: ( ) ( Date Stamped: Sealed Copies: Electronic Other.�fl.,ANS: cense: Workers COMP*..—Liability Comp.Waiver Other: (� CODE 753#: Q'SC) — Ma—c.->/o 3—©C7 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: 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. ( ) ^ ( ) 20 NY State ECCC: N/A: Other. Final Survey: D1�- Final Topo: RA/PE Sign-off Letter. As-Built Plans: Other. ( ) ( ) BP DENIAL LETTER: C/O DENIAL LETTER: Other. ( y) T(T) Other. ( 7�� mtg.date: 17- 11 approval• 4 -17-L K notes: ( )ZBA mtg.date: approval• notes: ( )PB mtg.date: approvaL notes: REOLMED EXISTING PROPOSED NOTES APPROVED Area \L a ►JC Circle: -is Date: oil Front: — y� (� \ N m' Front Sides: Rear. U (7 S N L Main Cov: � Uk— Accs.Cov Ft.H Sb: Sd.H Sb: 9 A: Tot.Imp: 15, 'S O YL Ft.imp: pgd�w. Height/Stories notes: \ V t Existing lfamily home with 3 bedrooms ro • BUILDIN , DEPARTMENT D LE V� IE ME VILLA4 OF RYt*OOK FEB 2 9 2024 938 KING ET RYE BR� ,NY 10573 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 Paddock Road Date of Submission: Parcel ID#: 135.26-1-42 Zone: R-15 Proposed Improvement(Describe in detail): Legalization of rear deck. APPLICANT CHECK LIST: MUST BE COMPLETED BY THE APPLICANT The following items must be submitted to the Building Department by the applicant-no exceptions. Property Owner: Michael Chiappini 1. (: Completed Application 2. (v)Two (2)sets of sealed plans. (one full size(maximum Address: 10 Paddock Road allowable plan size=36"x 42") and one 11"x 17") Phone# 914-309-2866 3. (✓S Two(2)copies of the property survey. 4. (v/ Two(2)copies of the proposed site plan. Applicant appearing before the Board: 5. One electronic/disc copy of the complete Frank Marsella, AIA for Marsella Architects PC application materials. 6. Filing Fee. Address: 178 E. Boston Post Road 7. ( )Any supporting documentation. Phone# 914-630-0800 8. ( ) HOA approval letter. (ifapplicable) 9. (v)Photographs. Arch itect/Engineer: Frank Marsella, AIA 10.( ) Samples of finishes/color chart. (a sample board or Phone# 914-630-0800 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 an lication not meeting the requirements contained herein. Sworn to re me this Sworn to b fore me this day of 20 !i yI +i. nature , 20 ignature of PropertyOwner 40 cant ae 'appini Frank Marsella, AI Print rty O ner Pri e o icant r Notary Pblic otary Pubh SHANTELL S SMALLS III SHANTELL S SMALLS Notary Public. State of New York Notary Public. State of New York No. 01 SN16249686 No. 01 SM6249686 Qualified in Nas Qualified in Nassa C u t Commission Expires 1 L commission Expires i 8/12/2021 Village of Rye Brook ML MR 0� yAgend FB SE Architectural Review Board Meeting AC AD W Wednesday,April 17,2024 at 7:30 PM JM SF Village Hall,938 King Street 1. ITEMS: 1.1. ARB24-028 (Consent Agenda) Daniel Albano&Felicia Albano 57 Tamarack Road Rooftop solar array. 1.2. ARB24-029 (Consent Agenda) Danielle Freeman 78 Woodland Avenue 6'high wood fence. 1.3. ARB24-030 (Consent Agenda) Alex Szigety&Kaylin Searles 2 Jennifer Lane 5'high welded wire fence and 4'high white vinyl fence and gates. 1.4. ARB24-031 (Consent Agenda) Grant Kurti&Antigona Balidemaj 4 Westview Avenue Rooftop solar array. 1.5. ARB24-032 (Consent Agenda) Robert Weisz 22 Elm Hill Drive Replace patio,repair front stairs and foundation. 1.6. ARB24-033 (Consent Agenda) Paul Tyler&Linda Tyler 16 BelleFair Boulevard Install egress window,legalize finished basement. Consent Agenda Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes Page 1 of 4 Architectural Review Board April 17,2024 1.7. ARB24-020 556 Westchester Ave LLC c/o Anthony Guastella 556 Westchester Avenue New rear windows. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.8. ARB24-034 Michael Chiappini&Joanne Chiappini 10 Paddock Road Legalize rear deck. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.9. ARB24-035 Cerebral Palsy of Westchester 260 Lincoln Avenue Exterior handicap ramp. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.10. ARB24-036 Win Ridge Realty LLC 120 South Ridge Street New awning and illuminated sign. "SBG Home&Design" Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes Page 2 of 4 • Architectural Review Board April 17,2024 1.11. ARB24-037 (Amendment to Prior Approval) Peter Glantz&Lynn Glantz 3 Old Orchard Road Keep railroad tie wall as sitting wall. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.12. ARB24-038 713 Westchester Ave LLC c/o Avinash Khatri 713 Westchester Avenue Convert garage to living space and interior renovation. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.13. ARB24-039 Cameron Sager&Jessica Sager 41 Winding Wood Road 2nd story addition over garage,enclose porch and new front entry. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.14. ARB24-040 Jamie Billington&Kara Billington 6 Bonwit Road 2nd story addition,one story rear addition,new deck,portico,siding and windows. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes Page 3 of 4 Architectural Review Board April 17,2024 1.15. ARB24-041 Shubin Ma&Wen He 10 Boxwood Place New deck. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.16. ARB24-042 Dziugas Reneckis&Cristina Pires 9 Maple Court New deck. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes NEXT MEETING: May 15, 2024 Page 4 of 4 MIA 10 Paddock Road, Rye Brook: Site & Neighboring Photographs February 28, 2024 Location: 10 Paddock Road— Front View r_ { J -Y Location: 10 Paddock Road—Left-Side View •K 1' 178 EAST BOSTON POST ROAD,MAMARONECK NY 10543 TEL 914-630-0800 MARSELLA-ARCHITECTS.COM MIA 10 Paddock Road, Rye Brook: Site & Neighboring Photographs February 28, 2024 Location: 10 Paddock Road—Rear View i - Location: 10 Paddock Road—Right-Side View w.- _+a 178 EAST BOSTON POST ROAD,MAMARONECK NY 10443 TEL gi4-630-0800 MARSELLA-ARCHITECTS.COM PaddockMIA \I \Itsl.11-l.� ,\i�( 1111.1�( 'I',, 10 • • Rye Brook: Photographs February 28, 2024 Location: Right Neighbor(12 Paddock Rd.) a � 00 Location: Left Neighbor(8 Paddock Rd.) i 5 �' � .. �f �� �i"r"�'9► � � �: is +u, F MIA �L�ittiri i.� \itci�rrtx"rs 10 Paddock Road, Rye Brook: Site & Neighboring Photographs February 28, 2024 Location: Across the Street Neighbor(7 Paddock Rd.) �• 1' E --�-.cam; l.� � /j, `�Y,r t*�` _} t - y. a 178 EAST BOSTON POST ROAD,MAMARONECK NY 10543 TEL%4-63o-o800 MARSELLA-ARCHITECTS.COM — •4 r H i-- r t 'd T r .r F �!r►� � fir- t Continuation AAW Declarations TRAVELERS .J Travelers Personal Insurance Company One Tower Square, Hartford, Connecticut 06183 (A Stock Insurance Company) HIGH VALUE HOMEOWNERS POLICY Named Insured Your Agency's Name and Address MICHAEL & JOANNE CHIAPPINI HUGUENOT NATIONAL INC 10 PADDOCK RD 2 MADISON AVE STE 211 RYE BROOK NY 10573-1119 LARCHMONT, NY 10538 Your Policy Number: 985570296 633 1 For Policy Service Call: (914) 834-6060 Your Account Number: 985570296 For Claim Service Call: 1-800-CLAIM33 Policy Period Location of Residence Premises FROM: 10-05-23 To: 10-05-24 12:01 A.M. 10 PADDOCK RD STANDARD TIME AT THE RESIDENCE PREMISES RYE BROOK NY 10573-1119 Section I - Property Coverages Limits of Premium Liability A - DWELLING $ 803,000 $ 2,562.00 B - OTHER STRUCTURES 80,300 INCL C - PERSONAL PROPERTY 562,100 INCL D - LOSS OF USE 240,900 INCL Section II - Liability Coverages E - PERSONAL LIABILITY (BODILY INJURY AND $ 500,000 $ 55.00 PROPERTY DAMAGE) EACH OCCURRENCE F - MEDICAL PAYMENTS TO OTHERS- 5,000 INCL EACH PERSON Coverages E and F Extended to Include: 34 VALLEY DRIVE WESTERLY RI 02891 Policy Forms and Endorsements HV 00 03 (10-98) High Value Homeowners Policy HA-390 NY (12-02) Workers Compensation and Employers Liability HV 01 31 (05-15) Special Provisions - New York HA-61-B (06-95) Valuable Items Plus (Coverage G) 160.00 Jewelry $11,000 HV 04 20 (12-99) Specified Additional Amount of Insurance $ 30.00 for Coverage A - Dwelling Total Premium $ 2,807.00 Your Premium Reflects the Following Credits or State Surcharges Security Credit -623.00 Loss Free Credit -294.00 Continued on next page Insured Copy Page 1 of 3 PL-8651 1-97 577/0CFH80 DECO 17 003224/00368 F3115AH5 0567 08/16/23 Policy Deductible: $ 1000.00 All perils insured against In case of loss under section I, only that part of the loss over the stated deductible is covered. Your Insurer: TRAVCO Insurance Company One of The Travelers Property Casualty Companies One Tower Square, Hartford, CT 06183 For Your Information For information about how Travelers compensates independent agents and brokers, please visit www.Travelers.com or call our toll free telephone number 1-866-904-8348. You may also request a written copy from Marketing at One Tower Square, 2GSA, Hartford, Connecticut 06183. You may be eligible for a policy in a newer product from one of our other Travelers companies. The way we determine the price for a policy is done differently for the newer product. For example, we may use new criteria, such as the building characteristics of your home, or we may use the existing criteria in a different manner. A new product policy might cost you less or more than what you now pay. It may also have different features than your current policy. You may continue with your current policy, or you may request a policy in the new program. We also offer many other ways to save on your premium. Travelers is here to help - so contact your agent or Travelers representative to discuss whether a different Travelers Homeowners insurance policy is right for you. We have increased the coverage limit on your home by 9.1% to reflect the estimated cost to rebuild your home. This increase is based on information we received from CoreLogic, an independent firm specializing in construction costs. Each home is unique and you know your home best. Your coverage amount may need to be adjusted, higher or lower, based on your home' s specific construction details, updates or upgrades. If you disagree with your coverage limit, please contact your Travelers representative or agent who can work with you to help you decide the appropriate amount of insurance for your home and process any necessary adjustments. It is important that the information we used to rate your policy is correct. It is your responsibility to make sure that the information on these Declarations is accurate and complete, including checking that you are receiving all the discounts for which you are eligible. To see a full list of discounts offered, including discounts for having multiple policies with us, protecting your home with safety devices and being claim free, go to www.travelers.com/discounts. Once at the website, type in your policy number 9855702966331 and product code HL1 to view the discounts available. If any of the information on the Declarations has changed, appears incorrect, or is missing, please advise your Travelers agent or representative immediately. Your Travelers agent or representative is also available to review the information on the Declarations with you. Continued on next page Page 2 of 3 PL-8651 1-97 577/OCFH80 DEC# 17 Continuation Declarations TRAVELERS J HIGH VALUE HOMEOWNERS POLICY Named Insured: MICHAEL & JOANNE CHIAPPINI Policy Number: 985570296 633 1 Policy Period: 10-05-23 To: 10-05-24 Effective Date: 10-05-23 For Your Information (continued) IMPORTANT FLOOD INSURANCE NOTICE Your homeowners or dwelling policy does NOT provide coverage for loss caused by flood or mudslide, which is defined, in part by the National Flood Insurance Program as: A general and temporary condition of partial or complete inundation of normally dry land areas from overflow of inland or tidal waters or from the unusual and rapid accumulation or runoff of surface waters from any source. If you are required by your mortgage lender to have flood insurance on your property, or if you feel that your property is susceptible to flood damage, insurance covering damage from flood is available on most buildings and contents in participating communities through the National Flood Insurance Program. Information about flood insurance and whether your community participates in the program can be obtained from your insurance company, from your insurance agent/broker, or directly from the National Flood Insurance Program by calling 1-800-638-6620 or via their website at http://www.floodsmart.gov. Rating Information Only Dwelling Occupied By 1 FAMILY Territory 00049 Construction FRAME Protection Class 4 Year Built 1969 Rate Tier SPREF Not More Than 500 Feet from Hydrant, 1 Miles from Fire Dept. Upon request, we will furnish you, or your representative, with a written estimate of damages to real property, specifying all deductions, provided such estimate has been prepared by us or has been prepared on our behalf for our own purposes. This estimate will be provided within thirty days after your request or its preparation, whichever is later. Please be advised that effective March 1, 2013 the New York State Insurance Department's name was changed to the New York State Department of Financial Services. Important Notice: A Loss free credit is applicable to all Homeowner policies if the account has been loss free for three or more years. This credit is applicable for both new and renewal business. The credit is applied at the new business or renewal date and is only removed at the next applicable policy renewal after a qualifying applicable loss. The credit is applied at the time of the fourth policy renewal. This is not a bill. You will be billed separately for this transaction. Thank you for insuring with Travelers. We appreciate your business. If you have any questions about your insurance, please contact your agent or representative. These declarations with policy provisions HV 00 03 (10-98) and any attached endorsements form your Homeowners Insurance Policy. Please keep them with your policy for future reference. Insured Copy Page 3 of 3 PL-8651 1-97 577/OCFH80 DEC# 17 003225/00368 F3115AH5 0567 08/16/23 Affidavit of Exemption to Show Specific Proof of Workers' Compensation Insurance Coverage for a 1, 2, 3 or 4 Family, Owner-occupied Residence "This form cannot be used to waive the workers'compensation rights or obligations of any party." Under penalty of perjury, I certify that I am the owner of the 1, 2, 3 or 4 family, owner-occupied residence (including condominiums) listed on the building permit that I am applying for, and I am not required to show specific proof of workers' compensation insurance coverage for such residence because (please check the appropriate box): ❑ I am performing all the work for which the building permit was issued. ❑ I am not hiring,paying or compensating in any way,the individual(s)that is(are)performing all the work for which the building permit was issued or helping me perform such work. I have a homeowners insurance policy that is currently in effect and covers the property listed on the attached building permit AND am hiring or paying individuals a total of less than 40 hours per week (aggregate hours for all paid individuals on the jobsite) for which the building permit was issued. I also agree to either: ♦ acquire appropriate workers' compensation coverage and provide appropriate proof of that coverage on forms approved by the Chair of the NYS Workers' Compensation Board to the government entity issuing the building permit if I need to hire or pay individuals a total of 40 hours or more per week(aggregate hours for all paid individuals on the jobsite)for work indicated on the building permit,or if appropriate,file a CE- 200 exemption form; OR ♦ have the general contractor, performing the work on the 1, 2, 3 or 4 family, owner-occupied residence (including condominiums)listed on the building permit that I am applying for,provide appropriate proof of workers'compensation coverage or proof of exemption from that coverage on forms approved by the Chair of the NYS Workers' Compensation Board to the government entity issuing the building permit if the project takes a total of 40 hours or more per week(aggregate hours for all paid individuals on the jobsite)for wor indic d on the uilding permit. (Signature of Homeowner) (Date Signed) /11 cke) 01,11 dl-lfi Home Telephone Number 9i1-1-3cl9-112F(1116 (Homeowner's Name Printed) • SW204' rn to before me th � day of Property Address that requires the building permit: to Pa,v 6(og j2omak . 7Couffty Gler r Xotary Public) MICHAEL ESQUIVEL Notary Public-State of New York NO,OfES6442359 Qualified In Westchester County Once notarized,this BP-1 form serves as an exemption for both workers'compensation and disability benefits insurance coverage. BP-1 (12/08) NY-WCB Laura Petersen From: UDig NY Exactix <tickets@exactix.udigny.org> Sent: Thursday, May 2, 2024 3:07 PM To: Steven Fews Subject: Message from UDig NY ****REGULAR**** DIG REQUEST from UDig NY for: VIL RYE BROOK Taken: 05/02/2024 15:06 To: VIL RYE BROOK PRIMARY Transmitted: 05/02/2024 15:06 00014 Ticket: 05024-002-263-00 Type: Regular Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 10 To: Name: PADDOCK RD Cross: From: To: Name: Offset: ------------------------------------------------------------------------------ Locate: BACK YARD NearSt: CROSSWAY & WINDINGWOOD RD S 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: SONET TUBE INSTALL Estimated Work Complete Date: 05/17/2024 Depth of excavation: 48 INCHES Site dimensions: Length 1 FEET Width 1 FEET Start Date and Time: 05/07/2024 07:00 Must Start By: 05/21/2024 ------------------------------------------------------------------------------ Contact Name: MICHAEL CHIAPPINI Company: Addrl: 10 PADDOCK RD Addr2: City: RYE BROOK State: NY Zip: 10573 Phone: 914-309-2866 Fax: Email: actc3738@gmail.com Field Contact: MICHAEL CHIAPPINI Alt Phone: 914-309-2866 Working for: CALLER IS PERFORMING THE WORK THEMSELVES ------------------------------------------------------------------------------ Comments: Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: ALTICE USA CONED SUEZ WTR WESTCHESTER VIL RYE BROOK WESTCHESTER CTY SWR i 'SIM,yli I 1111111 ~01 t tA "IL 4041 A cr Ski jr vQ 'I a iVUlp A 0 16 sA C CA ct s I Vj p jj S 1 0, S Ti-it- Nl!k.*4g o NAYO%n cot" —06vik-f 7t, Al know W&Ulm- r tp LIX 4j I i , q zoo 44 FEB 29 202 0 VILLAGE OF RYE BROOK fQ! BUILDING DEPARTMENT Art ***4 J ?K f.*, Survey of plot situate in the Town of Rye, Village RONALD PERSAUD of Rye Brook, County of Westchester and State of LAND SURVEYING, P.C. New York, known and designated as Lot No. 5 in 15 south Tenth Ave Block G on a certain map entitled, "Map of Section MOUNT VERNON, N.Y. 10550 "A" Rye Acres, the Proerty of Rye Acres Company, Tele (914),�23-5808 situated in the Town ofp Rye, Village of Rye Brook, Ema:;f,,a��er@gmail.com �� Westchester County, N.Y. dated May 2, 1949 and �✓���' P�� �'F;� �o �y �1:� filed in the Office of the County Clerk of Westchester �, o`er County, Division of Land Records on October 13, 1949 � r ,tl,.� o � as Map No. 6921. � r� Also know as 10 Paddock Road, Rye Brook, N.Y. 1Blk.1 Tax Lot 42 : 15,051.E sq ft. 0.345 Acre ° , �2 � F 1 s Asa oar ��ole A M"A 5,)� Tax Lot 18 Lot 4 Tax Lot 40 APR 3 2,R.6...AGE OF Ri y..... BUILDING D� .gym..+:.rv.n-•rro-+u-ra•.n ..�w+., n.+.,-�.. .......r.�• ,•s••r..+.�nsT+. .,::�.vn�:v.-a..rnv�: DV LT.J. �If_ RONALD PERSAUD N.Y.S`--lLIC. No. 051087 Tax Lot 16 Lot 6 Tax Lot 42. Rim245.68 (50' Wide R.O.W.) ROAD G) PADDOCK Macadam Roadway All Elevations referenced to the North American Vertical Datum of 1988. .245.50 Denotes Elevation value in feet. Unauthorized alteration or addition to this survey map is a violation of Section 7209 Subsection 2, of the New York State Education Law. No guarantee is implied by this map as to the existence or non—existence of any easements of record that would affect subject property, unless surveyor has been furnished a complete copy of the title report. Dimensions shown from structures to property lines are not intended to be used for construction of fences, structures or other improvements. "Surveyed AS In Possession Surveyed: March 16, 2024 SCALE ; 1 " � 16' Map Drafted: March 25, 2024 INDEX: COO-3 1 2 c0 Do ID_ c� o o D c s o s D o 0 D D Z C c D ;a O ,D .O-� C Q 7 p S m C o = no (D `° = 9: 0 o to COD, r.- ? .-+- CT C m fD CD m O ?m m - 0 n -0 < y n 3 C) m O rt S : t- ao a3 0 o c �o Z CD 7 3 3 m c 0 o m n m d to 7 ID T m o n 3 0 0= O m 0 7 7 n O S m c m y m CD -0 0 .I o rn p o m n rt rt 3 Z N t=n 0- A p l•: T? to rn-. o o N o o -35 0 7 r+ -0 rt d O Q O m 3 =� 3 0 (o' 0 70 0' o �_ o' "� 3 (D n rt 7 S 0 n 0 O m 0 .Cp... o O m j up-i 7 h m o = 7 Q- O m `•G to - y l< ? 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