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HomeMy WebLinkAboutBP24-157PERMIT # /"� y ' /S 7 DATE1. 7 > 9 Q)LI / 9 SECTION a 9 ;� B)) LOCK LOT 30 TYPE OF WORK / k)j7/ P //! Cl/ r /I P �QkS JOB LOCATION O '1& r Z/ V2 OWNER OlWt9 a CONTRACTOhx 3 AQ// 4 �T. v/ CO # FEE D- ,� DATE L/ TCO # FEE DATE INSPECTION RECOF3)Z DATE FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING L7 RGH PLUMBING GAS SPRINKLER ELECTRIC C� LOW -VOLT O ALARM AS BUILT FINAL INSP imm OTHER APPROVALS BOT PB ZBA OTHER 5-BUILTIFINAL SURVEY REQUIRED PRIOR TO FINAL INSPECTION c . 19 VILLAGE OF RYE BROOK MAYOR 938 King Street,Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A.Klein (914)939-0668 Christopher J.Bradbury www.ryebrookny.gov TRUSTEES BUILDING & FIRE INSPECTOR Susan R.Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W.Morlino CERTIFICATE OF COMPLIANCE October 3,2024 Norman Wang&Esther Wang 180 Country Ridge Drive Rye Brook,New York 10573 Re: 180 Country Ridge Drive, Rye Brook,New York 10573 Parcel ID#: 129.82-1-30 Building Permit#24-157 issued on 7/19/2024 for a New Fence This certifies that the new six foot high white vinyl fence and gates,installed under the above captioned permit have been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to D [ECIENIE For office use onl 3D BUILDING DEPARTMENT PERMIT# — s 7 VILLAGE OF RYE BROOK ISSUED:_rf-i9-ay SEP 13 2024 938 KING STREET,RYE BROOK,NEW YORK 10573 DATE: q—/3— z)y (914)939-0668 FEE: 4 / 50 PAID M VILLAGE OF RYE BROOK www.ryebrookny.i!oy 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 **+************s+s***sss»»»*»»»»»ssssssss***ssss*ssssssssss****************»*»+»s*sss**ss**s»s*****+**+*****+*s+*ss*ssssasss* Address: l$ d CoKrOyt, P-A2 De- Occupancy/Use: SF Zvi Parcel ID#: 1-3c) "Zone: le-1 J Owner: Nor W a Address: 180 Co .Aty R otX D,- P.E./R.A. or Contractor: CQ Address: Person in responsible charge: 3 riAce )K,V-SCE Address: Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issuance of a Certificate of Occupancy/Certificate of Compliance for the structure/construction/alteration herein mentioned in accordance with law: STATE OF NEW YORK, COUNTY OF WESTCHESTER as: NO#' 11A✓t being duly swom,deposes and says that he/she resides at tv C.a� 641S W r (Print Name ofApplic ) (No.and Street) in F-yt lbZ9oy in the County of in the State of0,that (Cityrfown/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:$ (7 1 50 J 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 orpart 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 Coded of the Village of Rye Brook. Sworn to before me this Se f"� Sworn to before me this day of I� , 20 day of , 20 Sigtj,4Wof Property Owner Signature of Applicant � n i me of Property Owner Print Name of Applicant Notary Public Notary Public SHARI MELILLO Notary Public,State of New York No.OIME6160063 Qualified In Westchester County Commission Expires January 29,20 QyE BR(��• '9a2 BUILDING DEPARTMENT AS VILDING 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 : / V COS P 1 e 1 ✓42, DATE: PERMIT# L. -1 - , 5 7 ISSUED: 7-1 -2-�SECT: 12 7. LOCK: / LOT: - LOCATION: RP G--, _mac.-A 16.2 c OCCUPANCY: ❑ VIOLATION NOTED V THE WORK IS... EY ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS N Wu v Il^- ❑ L.P. GAS P ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION FINAL Q" OTHER x x a s � _ ca v N C� � o- n vi a, W ©CA H va r � N a 0 ,z c � Q U , O O A M � �i En }H G y a o .� s W2 ai o v cov •- W �• z c 3V " N � aU �T Aoc- 110, m � - h'�"1 O w U w U_ O \ .aa (Zw W U Zb a o Cnj : a M W W cn o b v QN0 o - � x oO = 11 GAT ol� x o ° zz -0 v 0 U oo Ei H z zp g a c� z y x - 22 Zaa � Q V U z � o � - N 7; J = � 00 A W z � � O � � •p ate" o _ o D = Paz =_ a G4 W W =1 P W W xU) -0 O = _ _ a a 4;Q 49.0 Q 4&9 9 4;4;46 46 46 46 4 a 414;4;4 Q Q a Q 9 4;a Q a 4 4 a 4 a.0 a 4;Q a 41 a BUILD RTMENT _Q � C E, l V/ VIL + OF R ROOK 938 KIN EET RYE B ,NY 10573 JUL - 2 2Q24 J] 14 39- -1 • °V 9 VILLAGE OF RYE BROOK BUILDING DEPARTMENT FOR OFFICE USE ONLY: Approval Date: P r Application# A,�..834"Q7� Approval Signature: ARCHITECTURAL REVIEW BOARD• Disapproved: ; Date: BOT Approval Date: Case# Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Case# Other: Application Fee: Permit Fees: FENCE / WALL / GATE PERMIT APPLICATION Application dated: !A\,, Z zzz y 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.(1)(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. 1. Job Address: V8(3 C-�-'^'ti`ti+ (R� S)f 2. Occupancy/Use: ?-e5, ,.A4n&,� S.B.L.#: 9C) --1-30 Zone: — JT 3. Proposed Fence/Wall/Gate(describe in detail): 6 4�1 v,nyk why n� ZkVbrXx bac� yc�r-r f ,AA'N 2 s�ngl� �aheS 4. Property Owner: Address: 13b Phone# Cell# 4 i'�-Z.53-5'031, email: n ar ma^ wc,,,,, C1Z�v p c,t Applicant;_ pQf C= tea Address: ',10 Cc� Q,�1 Apr Phone-# 5t-s 753-52 t. Cell# Sl3_z53-5-�` email: I Sl° Architect/Engineer: c vice gi � Address: P-oK Co opt Phone# Cell# 9r3- ��S-3�f' email: br� (Z h i(5fhCcnW-_ ^'t Contractor: 2�fLkCo- 4ltrSLh Address&Phone: S+-, r s a190 .4t 5. If building is located on a corner lot,which street does it front on: ICI 6. What is the estimated cost of construction 'A � ,S OO (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: t 6/1/2624 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: ►)arMIAA _,� F_5V 4V' Wa,Xf ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the plicant) and further states that (s)he is the legal owner of the property to which this application pertains, or that (s)he is the o w n e - 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 -1%A Sworn to before me this (A�y day of Z , 20 Z`( day of S ature of Property Owner SignAde of Applican PrlA Name of Property Own Print Name of Applicant ( LAII 214171A tc o ary Pu 4taryry u AMY MOSCATI Notary Public-State of New York AMY MOSCATI No 01M06236%4 Notary Public-State of New York Qualified in W iwcfeyy No.DIM06236564 My Commission moires _ 7 Qualified in Westchester Courity My Commission E*res 5 2 61112024 i .Bsuldin Perrruc_Ch ck Lisc& Zorun�A.nalysu Address: ,�� a � SBL• �� \. 4 0"� . � 1��J Zone Use `� c Type: 2 Other &A.utral Due Revu^ions Submittal [)arm- Applicant: \ ^ p Nature of Work: �� UL7\ 0 T 1 \`� ` 1 r �,qC,_ R L � `� R 23A. P&_ ^ _BO T: Other. Z�QK / S���J-e. ( FEES Ri g P. ` C/O Flood Plane Legalustion: ( ) (,.KAPP: Dated:_�Notuvcd .Fr$r____,,'nm I.D. Cross Connection:% H O.A.: ( ) ( ) Scottie Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening: ( ) ( ) ENVIRO: Long Short Fees: N/A: ( ) ( ) SITE PLAN:Topo: Site Protection S/W Mgrru.: Tree Plan: Other. ( ! ( SURVEY: Dated Cuff cnc ArchivaL• Sealed Unacceptable ( ( ) PLANS:Dace Stamped Sealed Copies: Ejectronic Other: (A/ ( ) Liceme Workers Comp: IAabdiry Comp. Waiver. Other. (� ( ) CODE 753#: Dated N/A ( ( ) FUGH-VOLTAGE ELECTRICAL-Plans: Pemur N/A: Other. ( ) ( ) LOW-VOLTAGE ELECTRICAL•Plans: Pcm r N/A: Other. ( ) ( ) FIRE ALARM/SMOKE DETECTORS Plans: Pemnt FLW.I.C.: Battery: Other ns: _Othe ( ) ( ) PLUMBING:Pla Permit Nat.Gas: I-P Gas: N/A/_ Other. ( ( ) FIRE SUPPRESSION:Plans. Permit N/A Other. ( ) ( ) FLV.A.C.: Plans: Permit N/A Other. ( ( ) FUEL TANK Plans: Peru= fuel Type. Other. ( ( ) 2020 NY State ECCC N/A: Other- Final Survey Final Topo: RA/PE Sign-off Letter. As-Built Plans: Other. r( ) BP DEI�,IAL LbTI1=R C/O DENIAL LI IIUR Other. fin' (VARB mtg.due 2 approvaL• 7- 17 mil'/ notes: ( )ZBA rug.dace- approvaL• notes: ( )PB mtg.date approvaL• notes: REOUIRED EXLSnNG PROPOSED No"Il ti APPROVED C,rc1G Frorica�� —aTr3. Main AScr — Ft H/Sb: Sd H/Sb: 9ti Ft Ins PP Hqght/Stones notes: BUIgD1 MENT D �v VIDDLOK 938 KING ,NY 10573 JUL - 2 2024v 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: IF() C-onp:L,^1 r,>r Date of Submission: Parcel ID#: /� p 91 O c�'- /'30 Zone: Proposed Improvement(Describe in detail): h;rulA \eke h owl uo a C` wk�k y:ny I k�tcrt APPLICANT CHECK LIST: MUST BE COMPLETED BY THE APPLICANT �raw�-� b��raYd ant CS-A- The following items must be submitted to the Building _� Department by the applicant-no exceptions. Property Owner: o f � E a 1. (J Completed Application N W h 2. (�/�Two(2) sets of sealed plans. (one full size {maximum Address: �$0 t v un tm/ R�d� �r allowable plan size=36"x 42") and one 11"x 17") 3. Two(2) copies of the property survey. Phone# S 13-Z S 3 -J;03 L 4. ( Two(2)copies of the proposed site plan. Applicant appearing before the Board: 5. Q)One electronic/disc copy of the complete ESQ application materials. 6. (v)Filing Fee. Address: i' o � ,� � 7. ( )Any supporting documentation. 8. ( )HOA approval letter. (if applicable) Phone# S k o- 121- I`i S 9. (.J)Photographs. Architect/Engineer: B ri, Cq_ E-1kyT-61 10.( ) Samples of finishes/color chart. (a sample board or Phone# ?3LIS'30 9 - KL2_2 model may be presented the night o/'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 ,j CA[y Sworn to before me this )y day of Z , 20 2q day of 2 , 20_Zj_ Signature of Property Owner Sign rjYof Applicant Utz Wc.✓1 /Vot✓�2arc win Pri Name of Property Owner Print Name of Applicant otary Pu u I MY MOSCATI AMY MOSCATI Notary Public-State of New York Notary Public-State of New York No.01M06236564 No.01 MO6236564 Qualified in Wtestohest Qualified in westchest r ry My Commission Expires 5 3 My Commission Expires 2 6/l/2024 �yE pR k• Village of Rye Brook ML MR O� ZAgenda FB SE Architectural Review Board Meeting AC AD W Wednesday,July 17,2024 at 7:30 PM J JM SF Village Hall,938 King Street 1. ITEMS: 1.1. ARB24-063 (Consent Agenda) (Amendment to Approved Plans) Eric Steinert&Caryn Steinert 24 Meadowlark Road Install two skylights on rear deck roof. 1.2. ARB24-069 (Consent Agenda) Eric Steinert&Caryn Steinert 24 Meadowlark Road 6'high white PVC fence and gate. 1.3. ARB24-084 (Consent Agenda) Jeffrey Mensch&Hannah Mensch 10 Red Roof Drive Rooftop solar array. 1.4. ARB24-085 (Consent Agenda) Craig Bergman&Samantha Bergman 11 Jennifer Lane 6'high white vinyl rear yard fence. 1.5. ARB24-086 (Consent Agenda) Norman Wang&Esther Wang 180 Country Ridge Drive 6'high white vinyl rear yard fence&gates. Consent Agenda Approvals: Motion Second X " Abstention Aye; S Nay; a. Adjournment; Notes ` Page 1 of 4 Architectural Review Board July 17,2024 1.6. ARB24-020 556 Westchester Ave LLC c/o Anthony Guastella 556 Westchester Avenue New rear windows. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.7. ARB24-078 G&G Homebuilders Corp 18 Rock Ridge Drive Second story addition,deck and fence. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.8. ARB24-083 Robert ONeill&Melissa ONeill 4 Loch Lane Garage door overhang. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.9. ARB24-087 Win Ridge Realty LLC 19A Rye Ridge Plaza New awning, "Mendel Optical Insight" Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes Page 2of4 Architectural Review Board July 17,2024 1.10. ARB24-088 Paul Cuzzupoli&Pamela Lustig 7 Lincoln Avenue Two-tier retaining wall and drainage. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.11. ARB24-081 (Re-Appearance) Kenneth Gerchick&Amy Bernstein Gerchick 3 Mohegan Lane Second floor dormer addition. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.12. ARB24-089 Emily Groglio Irrevocable Trust,Shari Melillo,Trustee 5 Paddock Road Enlarge rear deck. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.13. ARB24-090 Christine Sciandra 47 Roanoke Avenue Window and door changes,rear paver patio,relocate mechanical equipment. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes Page 3 of 4 Architectural Review Board July 17,2024 1.14. ARB24-091 Francesca Italiano 31 Arrowwood Circle Extend existing deck. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.15. ARB24-092 Michael Oles&Kathleen Oles 33 Arrowwood Circle Extend existing deck. Approvals: Modon Second Abstention Aye; Nay; Adjournment; Notes NEXT MEETING: August 21,2024 Page 4 of 4 1 � t # `ra r �k• `� ate,, r .4 t y, Ike a Y ly. 7/2/24,8:47 AM image0.jpeg Hirsch Fence Install & Design 747 Route 9W Valley Cottage, NY 10989 Cuelatw's Lxsf Nwwb rest Nems SWOM Address city Stete by GUstonlere Ceyww rime No Cuslomm'S["Jeep Phone No, Customers E mtll Address Nearest Cross Su"i PERMITINSPECTiON INFORMATI N !S ❑NO eowner to Dbtaln permit , rslallat on pro Bss ona ;suWr Pn*&Z—e%Rees upy d pars,*Lvelm Insulator) to Cbtain rmR APPROXIMATE LAYOUT Se ecuon 1ENCE FOOTAGE CONTAINED IN TNI3 PROPCSAL ISAPPRCXJy E B CD C>N FIELD ME_S A .-f WN-5 FINAL PR'ce VALL BEADIUSTED BASEDONACTUAL FENCE FOOTAGE USED AS SET FCURTH iN TERMS A D:S-,DMONS.� ADDITIONAL COST OPTIONS AOD'TE eR)CES:N MS COLUMN TO THE SELECT.ON TAKE DOKN AND HAUL $ A"AY OLD FENCE PERMIT COST $ t SL570'A_ $ T SAES 7A 3 FINALAIAOUNT DUE (Do In B[A=danfaa �—aouaaary - LJ Stock Product Custortrr assumes all(esponslDlllUes of it relates to all adtlRbnal IaDor and malenal costs na R reWns Special Order Product to the fence be►q inslalled on a neighbors props �t rtY. Dasgn Approved Customer ---— !Ts/h/;L ENC P NSTALLAT,ON RELATED T GRADE:PLEASE INITIAL ONE !� �[AyTNO TO TIE EYC r�DFO Ll..F:OW S1,P E7 M,STAyLAf ON FENCE TO BE LEVEL WTI*NGNFST GRADE SUGhTLY UNEVEN GRADE NTN FENCE eRV LOAe swty ren[/pANNor+ti� (CJSTOIAMR TO FILL IN OAPG) FOLLOW FLOW Of GRO'JNO rWIAY1�O reUGwaAApt AAo rwrti FENCF N/LL BE Mr,/EN AT TOP fitKea egtAtsla wdMEMaWaVwte 4 rLRelsAmiti Mah Produd o 5 Product Product Style: Height style: Height: Style: Height: Footage: If Gates: Footage If Gates: Footage: If Gates Post Cap: Color: /! Post Cap: Color. Post Cap: Color Rail Type: Post Cep: Rail Type. Post Cap: Rail Type Post Cap, Picket Type: i Picket Type: g Picket Type: $ i https://mail.google.com/mail/u/0/#inbox/FMfcgzQVxRHMPPkWjVdfVVjggbJLjdFTh?projector=I&messagePartld=0.1 1/1 L/l E•O=PllJeda6ess9i.ug =joaoefad�gijpf-lrq66fAAIpnfM�ddWHHxA?jZ6o;wd/xoqul#/o/n/flew/woo•alboo6•llew//:sftq it ..'R�,w 11111,1. 1,1{••t 1',1�'.1)�� �1}� ., , Nt_ .�I/! � ; 211�. u,f 1 ;, ',li_ f�rr ,r�1�o,1 >i� � ,,�1 ay�'-1:JSe.1.1- riJ Yf31ft:�l�ati�1_.�. J....lt'k,"M�li Yi fa_ s i::.l 11 ,.. �a %''_.�.�'yi-".f�...Lttri.r -1-1 wti(0)►� iV I <css)� p rCj •u V N 7. -� •V 0 Go L) Gr a o Q 3 G fftss►, L H � N � C O J U �. '.. aj v)pf y g , lT 17 C.0 '} a s cn o u y p4 ? w �` a �i("w I C ? cc `o�ection Z o tQ LLI 7 _ fir. 1` of 0-1 cn OLIJ wLL Ci wi• -r C/) V C i C ... .._ �"1 .. �• ri- 0 c Zi Go y' t) i.. o Y (1 1 W L It �►J ?`;:�,1/11i1. }1^ 11 j�,i',�+�'�•` y� � a ofs .. ri/ry�Ii�11 `�� '�3'ff1�'�11(�1i1' � � �I�c�.J� �Vi�►�`ti1 1�1/'• lj.�tt �Iy � `�,,:.�.q�< ^Ally 6adf•La6ewi VYV L4:9'4Z/Z/L A��a DATE(MMIDDIYYYY) C" CERTIFICATE OF LIABILITY INSURANCE 712/2024 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 PH ONE (814)769-0417 IA/CFAX No: 378 Elwood Avenue E-MAIL ADDRESS: courtn@ mccarth insurance.n@t Hawthorne, NY 10532 INSURE S AFFORDING COVERAGE NAIC0 INSURERA: Preferred Mutual Insurance Company 15024 INSURED INSURER B: Hirsch Fence Install & Design LLC INSURERC: 747 Rt 9w Cottage#4 INSURERD: Valley Cottage, NY 10989 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 00002210-0 REVISION NUMBER: 10 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. TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY LTIN" /YYYY MM/DD/VYYY LIMITS LTR A X COMMERCIAL GENERAL LIABILITY Y N BOP0100721375 11/12/2023 11/12/2024 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTEY__ CLAIMS-MADE a OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑JECOT- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE s AUTOS ONLY AUTOS ONLY Per accident S UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSATIONPER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Address : -11 Country Ridge Dr., Rye Brook, New York 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 AUTHO D NT/\381E_ (CPO) ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Printed by CPO on 07/02/2024 at 09:54AM YM WOW Certificate of Attestation of Exemption �� fuUmli from New York State Workers'Compensation and/or Disability and Paid Family Leave Benefits Insurance Coverage **This form cannot be used to waive the workers'compensation rights or obligations of any part ** The applicant may use this Certificate of Attestation of Exemption ONLY to show a government entity that New York State specific workers'compensation and/or disability and paid family leave benefits insurance is not required. The applicant may NOT use this form to show another business or that business's insurance carrier that such insurance is not required. Please provide this form to the government entity from which you are requesting a permit,license or contract. This Certificate will not be accepted by government officials one year after the date printed on the form. In the Application of Business Applying For: (Legal Entity Name and Address): Building Permit Hirsch Fence Install&Design LLC 747 Rev 9w 0 4 From:Village of Rye Brook valley Cottage,NY 10"9-2452 PHONE:915-304-9622 FEIN:%XXXX0091 The location of where work will be performed is 100 Country Ridge Dr,Rye Brook,NY 10573. Estimated dates necessary to complete work associated with the building permit are from July 2,2024 to July 1,2025. The estimated dollar amount of project is SO-S10,000 Workers'Compensation Exemption Statement: The above named business is certifying that it is NOT REQUIRED TO OBTAIN NEW YORK STATE SPECIFIC WORKERS'COMPENSATION INSURANCE COVERAGE for the following reason: The business is a LLC,LLP,PLLP or a RLLP;OR is a partnership under the laws of New York State and is not a corporation. Other than the partners or members,there are no employees,day labor, leased employees,borrowed employees,part-time employees,unpaid volunteers(including family members)or subcontractors. Partners/Members: Bruce Hirsch Disability and Paid Family Leave Benefits Exemption Statement: The above named business is certifying that it is NOT REQUIRED TO OBTAIN NEW YORK STATE STATUTORY DISABILITY AND PAID FAMILY LEAVE BENEFITS INSURANCE COVERAGE for the following reason: The business MUST be either: 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-mined legal entity. 1 affirm that due to my position with the above-named business I have the knowledge,information and authority to make this Certificate of Attestation of Exemption. 1 hereby affirm that the statements made herein are true,that I have not made any materially false statements and I make this Certificate of Attestation of Exemption under the penalties of perjury. 1 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 above-named legal entity will immediately acquire appropriate New York State specific workers' compensation insurance and/or disability aid family leave benefits coverage and also immediately furnish proof of that overage on rms approved by the Chair of the Workers'Compensati to the government entity listed above. SIGN Signature: Date: HERE 11 Exemption Certificate Number 1 VReceived 2024-051572 July 2, 2024 NYS Workers'Compensation Board CE-200 01120 19 Laura Petersen From: UDig NY Exactix <tickets@exactix.udigny.org> Sent: Monday, July 22, 2024 11:45 AM To: Steven Fews Subject: Message from UDig NY ****REGULAR**** DIG REQUEST from UDig NY for: VIL RYE BROOK Taken: 07/22/2024 11:44 To: VIL RYE BROOK PRIMARY Transmitted: 07/22/2024 11:44 00073 Ticket: 07224-001-249-00 Type: Regular Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 180 To: Name: COUNTRY RIDGE DR Cross: From: To: Name: Offset: ------------------------------------------------------------------------------ Locate: WORKING IN THE BACK OF THE PROPERTY AND BOTH THE LEFT AND RIGHT SIDES NearSt: COUNTRY RIDGE CIR Means of Excavation: POST HOLE DIGGER Blasting: N Site marked with white: N Boring/Directional Drilling: N Within 25ft of Edge of Road: N Work Type: FENCE INSTALL Estimated Work Complete Date: 08/02/2024 Depth of excavation: 24 INCHES Site dimensions: Length 235 FEET Start Date and Time: 07/26/2024 07:00 Must Start By: 08/09/2024 ------------------------------------------------------------------------------ Contact Name: BRUCE HIRSCH Company: HIRSCH FENCE INSTALL & DESIGN Addrl: 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: CUSTOMER ------------------------------------------------------------------------------ Comments: Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: ALTICE USA CONED SUEZ WTR WESTCHESTER TEN GAS-HDS VLY VIL RYE BROOK WESTCHESTER CTY SWR 1 SYMBOL LEGEND I l I J L THE BEARING SHOWN HEREON ARE v r�- BASE ON FILEMAP NO. 12383 0 MONUMENT FND —— WRE FENCE 0 I.P./I.B.MD ®GAS METER • I.P./I.R.SET ®WATER METER 00 SPOT ELEVATIONS DG GAS VALVE J U L - 2 ZQ2�i 10, UIMITY POLE p0 WATER VALVE >— GUY MR' lij TEST HOLE . 4 U71UTY POLE WIGHT ly TREE SIGN►POE ®SHRUB SIGN ROlAgp VILLAGE OF RYE BROOK• ANT Al WE FLAG 0 FIRE MANHOLE BUILDING DEPARTMEN I' 0 yµ�E O.C.DEPRESSED LURE •A_ly�T FE.FENCE 1VIRY RIDGE ESTATE S /[If 'B'-INLET MAS.MASONRY YARD INLET PLAT.PLATFORM FAE LOT 3 YARD INLET WW.WINDOW WELL TAX LOT 27 A/C UNIT B/W BAY MNOOW TLI ELECTRIC METER C/E CELLAR ENTRANCE PVC -� PVC FENCE(PYC) O/H OVERHANG _ FEN STOCKADE FENCE(STK) R/O ROOF OVER N80W20'20"E 81.52' PIPE 12.E —M— CHAIN LINK FENCE(CUT)CANT.CANTILEVER FND PVC FEN. ®CROSS CUT G.O.L GENERALLY ON LINE STAKE O/L ON LINE PIPE R.O W.RIGHT OF WAY FINAL ff QUIRlED PRIOR TC�/INAL INSPECTtOF� V FM LOT eT FM for 46 �O TAX LOT 29 TAX LOT so A W O 3�2' PVC FEN �" CONC.RET.WALL PVC Z 1610, T !� , FEN o ,e*p --- '►,�00 \ \ W� 121.. m; 21.9' FM LOT 40 F •�O DDEC,, 32.1 FND FAX LOT 31 W . \ / STK / 22 V / 2 STORY FRAME BU80 ILDING rvp g 22.0' b Z / SLAT ; A; / � 22.B �� Village of ye Brook MAS WALK PLAT Architectural evieJKV) a/ h / ' Approval Date: / Chairman: 3� - V \ O w / w q O R = 190.00' R = 2350.00' L = 52.48 L = 66.34' W IL CONC.CURB ~` i COUNTRY RIDGE DRIVE q (50' WIDE) C p VAPHIC SCALE 0 0 20 GUARANTEED TO: LOT AREA THOROUGHBRED TITLE SERVICES, LLC ❑ RADIAN TITLE INSURANCE INC. 15,07J.53 5 IN FEET NORMAN WANG AND ESTHER WANG 1 inch = 20 ft. 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