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HomeMy WebLinkAboutBP24-223PERMIT # A4c� o� 3 DATE: /c`c a a F(P: /c? SEC Tl ON TYPE OF WORK JOB LOCATION OWNERS//P2/J CONTRACTOR rS ST. COST Y `O # aA wiv4PrA LOT �.Ci, eh/�✓e TCO # FEE DATE DATE FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING O RGH PLUMBING GAS O SPRINKLER •IVA�►'ra�1 INSP ck A%l►iil A/rl /1 P e i (! es 'a qS(C;o/) &00p 5333 , ? SBA OTHER AS-BU T/FINAL Sl1RVEY UIRED PRIOR TO FINAL INSPECTION ice/v/.0 14 �y DR G O'C' o JJ J ,n t J Jo4C'Vy..V 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 December 18,2024 Brian Downey-Zayas&Eileen McDonald 97 Country Ridge Drive Rye Brook,New York 10573 Re: 97 Country Ridge Drive,Rye Brook,New York 10573 Parcel ID#: 129.67-1-10 Building Permit#24-223 issued on 10/22/2024 for a New Fence & Gates This certifies that the new four foot high black chain link fence and four foot high black aluminum fence and gates,installed under the above captioned permit have been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to N N O O _ 1 up v m = W v �1 'mil � ■ 0-4 CA cq 00 w � x O _ v fTl a z pIT, W 'I"; a ■ A� w v oo z A o?j `o A H a vz Q c v PLOO w � z ` 7 w F--r oo W a a as � � A W z w a 0. � vaoG ` 2 Od v U p N -0 °' ° a o - U a/ z W w v o � ° ■ O x� ° � 1 y W ■ z �" w-1 Fi � z H � O � z oa, b o a at a.� ,-, u _ bf oz ` �I—" l va O pt� o gL nQd 114 z W z 0 Cu � Q Qo% `L $UILDI,NG DEPARTMENT D [E C E N E �DD VIL ' OF BROOK 938 KEN EET Rl'E BROOK,NY 10573 SEP Q 2024 9,t4) 939-0668` " eUrookV. ©v VILLAGE OF RYE BROOK BUILDING DEPARTMENT FOR OFFICE USE ONLY: - OCT 1 7 202 f Approval Date: P mit# � � ,Application# A-jZj_3 4_—I 1 Approval Signature: e � : ARCHITECTURAL REVIEW BOARD: Disapproved: Date: /P//C,k! BOT Approval Date: Case# Chairman: PS Approval Date: Case# Secretary: AA ZBA Approval Date; Case# Other:Application Fee: 'Ynnb Permit Fees:J���1�'4e_ FENCE / WALL / GATE PERMIT APPLICATION Application dated: is hereby made to the Building Inspector ofthe Village of Rve 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 Rve Brook,as per detailed statement described below. Swimming pool fences must conform to the State Code. I. Job Address: 2. Occupancy/Use: S.B.L.#: Zc /Q , &7—/— U Zone: 3. Proposed Fence/Wall/Gate(delscribe in detail): �L L 1 1 �� l �� „ 4 -F+ gl,m,r��lm�t' jV0 o N+eS bn fra.j I facind S Tq�LIgjh ); —OA 4. Property Owner: a ! 0' v-24 Address: Ude Dr, Phone# 2 r ^ 6 r Cell# 2-W-600- S?D email: �jd2G}�C[_S o tYIttnal •C UM -_ Applicant: Rriari WheY-2 ci vaS - Address:q 7 Cod in� V� 1 d Q p �r Phone# 600- S 33 Cell# email; I Architect/Engineer:r Address: Phone#R`�S '- 3 0r{- &2_Cell# email: Contractor: RruceS Address&Phone: 5. If building is located on a corner lot,which street does it front on: 6. What is the estimated cost of construction / 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: 6il/2424 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: , being duly sworn,deposes and states that he/she is the applicant above named, (print name or 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 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 , Sworn to before me this, day of , 20 day of 20 S gnature of Property caner Signature of pplicart SHARI MELILLO r 1 0 M_LP ( y d S Notary Public,State of New York ra yd)P Y�uS Name of Property Owner T No.01ME6160063 Print Name of Applicant Qualified in Westchester ,county 1�3 29 Commission Expires January 290� Notary Public Notary Public 6M2024 i For office use only: BUILD DEF ENT PERMIT DECf ' VIL OF RYE [OK ISSUED: /p 4 E _ 5 2�� 38 KING STRE YE BROOKS '�ffi YORK 10573 DATE: VILLAGE 0C nY� BROOK 9 -06 O FEE: „eF� S �,_ PAID IN BUILDING DEPARTMENT ov APPLICATION FOR CERTIFICATE OF OCCUPANCY9 CERTIFICATE OF COMPLIANCES AND CERTIFICATION OF FINAL COSTS TO BE SUBMITTED ONLY UPON COMPLETION OF ALL WORK, AND PRIOR TO THE FINAL INSPECTION tss**ss********s*t*w*st*s*sssst*sstts:sssttsssstsssssssssttrts++**++++s*++********sss+sw**twsswwstwwsttssrs+tt*ssss+tststsst+ Address:7(o Q n f r i R i d d Q Occupancy/Use: Parcel ID#: a9 , (p — — O Zone: Owner: A r i On i)�,/h l yG Address: Couhta kJap Dr, P.E./R.A. or Contractor: Wl'r A F e n(e Address: Person in responsible charge: U vir e I r c 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 O�F1 NEW YORK,COUNTY OF WESTCHESTER as: wI 'Jrl 0 A I.l 0�/V h?X�y 4( being duly sworn,deposes and says that he/she resides at 37 (-o�n f r y I U d( A/, (Print Name ofApplicant) `,�' I (No.and Street) .in Ye T D Q k ,in the County of V V egf G r1 PS iP r in the State of��,that City/Town/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:S 7 5 dU J` I L for the construction or alteration of If , 117 b Oq C k A Q I h 1 h (� fence A n p / b l a e PC/" Rlh4 ►vl1 n (Avn -enCe an) Deponent further states that he/she has examined the approved plans of the structure/work herein referred to for which a Certificate of Occupancy/Compliance is sought,and that to the best of his/her knowledge and belief,the structure/work has been erected/completed in accordance with the approved plans and any amendments thereto except in so far as variations therefore have been legally authorized,and as erected/completed complies with the laws governing building construction.Deponent further understands that it shall be unlawful for an owner to use or permit the use of any building or premises or part thereof hereafter created,erected,changed,converted or enlarged,wholly or partly,in its use or structure until a Certificate of Occupancy or Certificate of Compliance shall have been duly issued by the Building Inspector as per§250-10.A.of the Code of the Village of Rye Brook. Sworn to before me this � Sworn to before me this day of �l�cP� , 2Q'' day of , 20 Signature of Prop6vw6er Signature of Applicant grt'Gh DC d i ame of Property Owner Print Name of Applicant WoTgy Public Notary Public SHARI MELILLO Notary Public,State of New York 6/l/2o2a No.01ME6160063 Qualified in Westchester County Commission Expires JOIL^y 29,20al �E BRCov.. F0 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 : rSA Nj DATE: Z PERMIT# XAN d ISSUED: SECT: BLOCK: LOT: LOCATION: 24 L A. r-, l OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ti ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER ' CjIBWildin Permit Check List&ZoningAnalysis Address: Zone: �'1 Usffe 1 Cont.Type Other. Submittal Date: l Z` Revision Submittal Dates: Applicant k-� =_LCZ Q Nature of Work: '} l L, i ex t d" \ &Q-S F Reviews:ZBA: C T P BOT• Other. ( ( FEES:Filing: J� C/O: Flood Plane: Legalization: ( ) ( �/APP: Dated: Notarized: l 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 Mgnpt.: Tree Plan: Other. ( ) ( ,)/SURVEY:Dated: %�),Lam. Current Soed: Unacceptable: ( ) ) LAMS:Date ped: Sealed: Copies: _Electronic Other. (� ( erase: ,/ Workers Comp: Liability: ✓ Comp.Waiver. Other: ( ( CODE 753#: Dated: N/A: ( ) ( ) HIGH-VOLTAGE ELECTRICAL:Plan: permit: N/A: Other: ( ) ( ) LOW-VOLTAGE ELECTRICAL:Plan: Permit: N/A Other. ( ) ( ) FIRE ALARM/SMOKE DETECTORS:Plan: Permit H W.I.C.:_Battery _Other ( ) ( ) PLUMBING:Plans: Permit Nat.Gas: LP Gas: N/A/: Other. ( ) ( ) FIRE SUPPRESSION:Plan: Permit: N/A Other: ( ) ( ) H.V.A.C.: Plans: Permit: N/A: Other. ( ) ( ) FUEL TANK:Plan: Permit Fuel Type: Other; ( ) ( ) 2020 NY State ECCG 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: mtg.date: t0 approval• 1 O'1 b-Lc 24 notes: ` ( )ZBA mtg.date: approval notes: ( )PB mtg.date: approval notes: REQUIRED EXISTING PROPOSED NOTES A'ex Date: OCT 1 7 2024 Circle: Fro�ta¢e: Front: Front: Sides: Rear. Main Cov: Accs.Cov Ft.H Sb: Sd.H Sb: GFA: Tot : Ft.I PP Height/Stories: notes: p [EC IENIE BUILDING.DEPARTNIENT VILLAGE OF R''E.BR.00K SEP 10 2024 938 KING STREET RvE BROO[c,NY 10-73 �(914)939 0668-' VILLAGE OF RYE BROOK wwwa-vebro4k ti 0N, 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: C��f1 n�� If D(` Date of Submission: Parcel ID#: /c�q/l0-7-/-/0 Zone: -/ 0 64 Proposed Imprrovement(Describe in detail): Tniif411 fenC12 in 60 cbar d Froy) APPLICANT CHECK LIST: , I,, Mussr BE CONIPLETED BY THE APPLICANT Q l►^ ;n U " bZl l y,lU 4fif On The following items must be submitted to the Building e-a r h Si m le ferlc,n a tt Ch a I h l� �{ Department by the applicant- no exceptions. Property Owner: 1. ( Completed Application p y 1Cleen M� ona� abil Br�u�,��nPyZdyaS n 2. ( ) Two (2) sets of sealed plans. (one full sire ,n,axirnum Address: 17 Cou►l r Y Rid Q t' Dr. alloN%able plan size=36"x 42") and one I I"x17") Phone# 2 o I - 6 oa - s 3 33 3• (-j')Two (2) copies of the property survey. 4. (kJ Two (2) copies of the proposed site plan. Applicant appearing before the Board: 5. (?j One electronic/disc copy of the complete application inaterials. �rIGn -7now 4hey-7— a� 6. (� Filing Fee. Address: / i 7. (�Any supporting documentation. 8. ) HOA approval letter. (r applicable) Phone#2-01 U - 5 3 9. (�)Photographs. Architect/Engineer: R ru ce I 10.( ) Samples of finishes/color chart. (a sample board or �� _ O ! model maY he presented the night of the meeting) Phone# b 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 l(, k S% orn to before me this dayof pfPv]ber 20 _ day of her . 202 L Signature of Property Owner Signature of Applicant �r�a►� � ol�� vl y-Zr�yas gran owhRY-7qya_� i Name of Property Owner T' SHARI MELILLO Print Name of Applicant Notary Public,State ate o. New York ��' "&6' s No.01ME6160063 Notary Public Qualified in Westchester County Notary Public Commission Expires January 29,20 6/l/2024 FENCE / ALL / TE PERMIT APPLIC N & IT- 9fRUCTIONS B ING Du-PARTMENT VILL OO)F RS'E BROK,NY , 1.1)939-066 w .�ehCjqk�y.gov All applicants seeking a fence,wall or gate permit must first obtain approval from the Village Architectural Review Board. Some applications may be subject to Site Plan Approval from the Village Planning Board as per §209 of Village Code. A representative of the applicant must be present at the ARB meeting which is held on the third Wednesday of every month,7:30 p.m.at Village Hall in the main meeting room.Virtual meetings may be held from time to time and information regarding such will be provided to all applicants as needed.Applications must be submitted to the Building Department by no later than the 1 14 Wednesday of the month in order to be eligible for that month's agenda. Please note that the agendas are limited to ten(10) applications per month. Once your application receives ARB approval, the plans must then be reviewed by the Building Inspector for compliance with all applicable state and local building codes and for issuance of the permit. DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDING INSPECTOR.THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLIAT11 WITHOUT A 13ERMIT IS 12%OF THE TOTAL COST OF CONSTRUCTION WITH A MININI Nl EEE OF$750.00 APPLICANT'S INITIAL SUBMISSION TO THE BUILDING DEPARTMENT MUST INCLUDE: 1. A properly completed application with notarized signatures where indicated. 2. Application filing fee: Residential=$100.00/ Commercial=$300.00 (Application fees are non-refundable) 3. A completed& signed Application Check List 4. A current,accurate property survey. 5. Two(2)sets of a dimensioned site plan based on the survey,(one full size{maximum allowable plan size=36"x 42")and one 11"x 17"),depicting the proposed fence/wall/gate(s)indicating the proposed heights,locations and their proposed setbacks to the adjacent property lines. 6. Color photos or brochures of the proposed fence/walUgate(s). 7. An electronic copy(disc,thumb drive,etc...)of all materials submitted. FOLLOWING APPROVAL BY THE ARB,THE APPLICANT MUST SUBMIT THE FOLLOWING 1. Full payment of the Permit Fee which is based on the cost of construction at the following rates; Residential: $18.00/$1,000.00 of Construction Cost with a minimum fee of$150.00. Commercial: $25.00/$1,000.00 of Construction Cost with a minimum fee of$275.00. 2. One full size and one scaled I I"x 17"set of sealed construction plans if applicable. 3. Your contractor's valid Westchester County Home Improvement License. 4. Your contractor's valid proof of liability insurance. (Village of Rye Brook must be listed as certificate holder on the insurance form) 5. Your contractor's valid proof of workers compensation insurance. (Form#C 105.2 or Form#U26.3/or NY State Workers Compensation Waiver) 6. The Dig Safe N.Y. Dig Number. (DIAL 811) PRIOR TO SCHEDULING THE FINAL INSPECTION THE APPLICANT MUST SUBMIT; I. The application&fee for the Certificate of Compliance. (fees are based on the final cost of construction) 2. A final survey of the property. NOTE: The finished or good side of your fence must face your neighbor's property. All fence/wall/gate permits must be closed out with a Certificate of Compliance issued by the Building Inspector. Keep this instruction sheet throughout the project for reference. 6/1/2024 BR �• Village of Rye Brook ML MR O� yAgenda FB SE Architectural Review Board Meeting AC AD �j Wednesday,October 16,2024 at 7:30 PM Village Hall,938 King Street JM SF 1. ITEMS: 1.1. ARB24-114(Consent Agenda) Daniel O'Keeffe&Denise O'Keeffe 19 Wilton Road Rooftop solar array. 1.2. ARB24-115 (Consent Agenda) Brian Downey-Zayas&Eileen McDonald 97 Country Ridge Drive 4'high black chain link fence and 4'black aluminum fence&gates. 1.3. ARB24-116 (Consent Agenda) Kaloyan Lazarov&Masako Okudaira 215 Betsy Brown Road Rooftop solar array. 1.4. ARB24-117 (Consent Agenda) Christopher Baildon&Tamzin Manning 72 Valley Terrace 6'high white vinyl fence and gate,4'high black chain link fence. 1.5. ARB24-118 (Consent Agenda) Sharon Kane 1 Edgewood Drive 4'high black chain link fence and 4'black aluminum fence&gates. 1.6. ARB24-119 (Consent Agenda) Edwin Gonzalez-Roncancio&Stacy Gonzalez 9 Charles Lane 6'high white vinyl fence and gates. 1.7. ARB24-120(Consent Agenda) Joseph Feisel&Liana Diamond 9 Boxwood Place Rooftop solar array. 1.8. ARB24-121 (Consent Agenda) Robert Promisel&Susan Promisel 10 Meadowlark Road Rooftop solar array. Pagel of 3 Architectural Review Board October 16,2024 Consent Agenda Approvals: Motion�C� Second Abstention Aye; _ Nay; Adjournment; Notes 1.9. ARB24-122 Megan Tyre 1 Berkley Lane Rear one story addition&rear deck on piers. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.10. ARB24-123 Michael Fisher&Jaclyn Fisher 108 Country Ridge Drive Window and Door changes. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.11. ARB24-124 Renato Ochoa&Cynthia Ochoa 8 Maple Court Legalize replacement of existing patio and walkways with pavers,new shed on concrete pad. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes Page 2 of 3 NF Architectural Review Board October 16,2024 1.12. ARB24-125 Howard Miller&Melissa Miller 4 Rock Ridge Drive Enclose part of front porch,widen driveway and new retaining wall. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.13. ARB24-126 Scott Schwartz&Stacy Schwartz 35 Meadowlark Road Second story addition,one story garage addition,new front porch,and new rear deck. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.14. ARB24-127 Matthew Wiener&Erica Wiener 18 Boxwood Place Enlarge deck,new pergola,built in BBQ,window and door changes. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes NEXT MEETING: November 20,2024 Page 3 of 3 • i� ■ ■ :n. f:7fs-n ■■■!!'ill■I���►�ii■■1�■i�■■■■■ iN ■■■r■■■■■■■■■■■■■■■■■ r �.5 p h � , s -f t r 4� i x f Ac, s •. 9 'f ` ''Tl Z'.;Lk:s>y'�r{1,J +. i• ya L •i VAO ��z ) ¢•,r ! e 5 , t°c►z, (ta+!, 6 * �,,, Ly ,�iyv ,A �� • % .. ; ' + '�. ••t RS�• d��2y.�1`�� 11 i ►►W1.i_W dj1'^ r .�a f,,l •• '�. r ► AS ` Vo it � ���,`� �x �• � �;e 31 - ',�;t. .�5.� .� r s �''� ti q'�� r 't a rC•` t rR,r�. 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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(iss)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 a. PRODUCER CONTACT NAME: Courtney Potter McCarthy Insurance PHONE 914 769-0417 FAX 378 Elwood Avenue A DDREES . courtne mccarth insurance.net Hawthorne, NY 10532 INSURERS AFFORDING COVERAGE NAIL N INSURERPreferred Muhml Insurance INSURED INSURER B: Hirsch Fence Install &Design LLC INSURER C: _ 747 Rt 9w Cottage#4 INSURER D Valley Cottage, NY 10989 INSURER E. INSURER F: COVERAGES CERTIFICATE NUMBER: 00002210-0 REVISION NUMBER: 14 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. eLTIR liR TYPE OF INSURAIK:! ADDI SUBIR am POLICY NUMBER POLICY EFF POLICY EXP(I (111111IM01YYYY1 La11T6 A X COMMERCIAL GENERAL UAIIMM Y N SOP0100721375 11/12/2023 11/12/2024 EACH OCCURRENCE f 1,000,000 CLAIMS-MADE 7V7 OCCUR f MED EXP&V am f 10 000 PERSONAL A ADV INJURY f 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE f 2,000,000 POLICY El� LOC PRODUCTS-COMPIOP AGG f 2,000,000 OTHER f AUTOMOBILE LIABRJTY COMBINED SINGLE LIMIT f acr'sdeml ANY AUTO BODILY INJURY(Perpmw) f i OWNED SCHEDULED BODILY INJURY(Pr scddwd) f AUTOS ONLY AUTOS . HIRED NON-OWNED PROPERTY DAMAGE f AUTOS ONLY AUTOS ONLY s UMBRELLA LIAB OCCUR „ EACH OCCURRENCE f EXCESS LIAR CLAIMS-MADE AGGREGATE f OED f WORKERS COMPENBATI10M R OTH- AND EMPLOYERS'LIABILITY Y 1 ER ANY PROPRIETORIPARTNERIEXECUTIVE ( I E.L.EACH ACCIDENT f OFFICER/MEMBER EXCLUDED? u NIA: (Msndsbry in NH) E.L.DISEASE-EA EMPLOYE f tt ---_ yea descr he under DESCRIPTION OF OPERATIONS Ixtow E.L.DISEASE-POLICY UMR f DESCRIPTION OF OPERATIONS I LOCATIONS;VEHICLES (ACORD 101,Additional Remark.Schsdute.may ca attached if more spats s required) Address :97 Country Ridge Dr., 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 CPO 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Printed by CPO on 08/26/2024 at 11:04AM CNEw Workers' Certificate of Attestation of Exemption CComensation 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'compensation rights or obligations of any party.** 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 Route 91V#4 From:Village of Rye Brook Valle%Cottage,NV 10999-2452 PHONE:945-304-9622 FEIN:XXXXX0091 The location of where work will be Dert6mied is 97 Country Ridge Dr,Rye Brook,NY 10573. Estimated dates necessary to complete work associated with the building permit are from August 26,2024 to August 24,2025. ,the estimated dollar amount of project is 50-510,000 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.) I,Bruce Hirsch,am the Member with the above-named legal entity. I 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. I 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 Exernption 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 above-named legal entity will immediately acquire appropriate New York State specific workers' compensation insurance and/or disabili d paid family leave benefits coverage and also immediately furnish proof of that coy rage on forms approved by the Chair of the Workers'Cum do card to the government entity listed above. SIGN I Signature: Date: HERE �11 f Exemption Certificate Number Received 2024-065619 August 26, 2024 NYS Workers' Compensation Board CE-200 01 2018 Laura Petersen From: UDig NY Exactix <tickets@exactix.udigny.org> Sent: Friday, October 18, 2024 2:48 PM To: Steven Fews Subject: Message from UDig NY ****REGULAR**** DIG REQUEST from UDig NY for: VIL RYE BROOK Taken: 10/18/2024 14:47 To: VIL RYE BROOK PRIMARY Transmitted: 10/18/2024 14:47 00002 Ticket: 10184-001-435-00 Type: Regular Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 97 To: Name: COUNTRY RIDGE DR Cross: From: To: Name: Offset: ------------------------------------------------------------------------------ Locate: CHECK OFF BOTH CORNERS TO BACKYARD NearSt: DORCHESTER DR Means of Excavation: POST HOLE DIGGER Blasting: N Site marked with white: N Boring/Directional Drilling: N Within 25ft of Edge of Road: N Work Type: FENCE INSTALL Estimated Work Complete Date: 10/28/2024 Depth of excavation: 24 INCHES Site dimensions Start Date and Time: 10/23/2024 07:00 Must Start By: 11/06/2024 ------------------------------------------------------------------------------ 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: H/O ------------------------------------------------------------------------------ Comments: Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: CONED SUEZ WTR WESTCHESTER VIL RYE BROOK WESTCHESTER CTY SWR i 10 0 20 40 - FOR TITLE PURPOSES ONLY A.L. SURVEYED FOR RANDIE PATERNO,PC. ORIGINAL SCALE: 1' = 20 AND ONLY FOR THE PERSONS FOR WHOM IT WAS PREPARED.IT IS NOT VALID FOR ANY OTHER PURPOSES OR FOR ANYONE ELSE 129.67-1-10-RYE-ADRIAN.DWG MAP OF PROPERTY SITUATED AT FILED MAP VILLAGE OF RYE BROOK-WESTCHESTER COUNTY,N.Y. 'AMP OF FLORAL GARDENS' XS TOWN OF RYE KNOWN AS LOT No. 9 AND PART OF LOT No. 8 TAX SECTION:129.67 TAX BLOCK:1 TAX LOT:10 FILED MARCH 19th, 1956 AS MAP No. 10430 C.LF LAN NOW OR FORMERLY OF PANINGO LAND COMPANY,INC. C.LF 8.1,NORTH �69'NOKM CHAIN LINN FENCEx —x —x x —x —z x —x x —x —x z'00' W S 48'18'00" W 104.11' 8.90' 0.91t Village of Rye Brook MAREFE Architectural ev' w Board 9'x EA9T Approval Date: I= Chairman: `n w ` SA 11`ti\ I YARD 3 ♦/ _ - - _ 0 I � FLED LOT � I FILED LOT D^' P,O W.B No.9 V WIRE FE. -n m 1 0.91i EA5T I IRON RAIL N 0 W H.VAC. F�p 1LOT z!6J UNIT O D C r•. s.a FILED LOT OPEN PORCH r- P07 N0.9 PVC O 15.9' ±ON ONE 1 21.4• - I 21.0 �rnT OVERHANG CA YARD I CONCRETE YARD N r SPILT LEVEL BRICK AND FRAME 3 -i Z C_ LJ.) AT GRADE GARAGE y O DWELLING No.97 s.9 5.q O z--I O 3 to g ROOF ABOVE O'f 1 LO _ N ASPHALT - p 6.0 d. FPAY - STOOP Z ovfKhw y � z1s FLAGSTONE Wq� PERMIT k �{SBL# DATE A Y P.O.B Brock. NY LU N 49'04'00" E 113.00' ASPHALT STREET LURE COUNTRY RIDGE DRIVE 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 1 ft,2024 TITLE SURVEY ASSIGNEES OF THE LENDING INSTITUTION.GUARANTEES OR CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTTTILTIO115 OR SUBSEQUENT OWNERS. N0 Su� 2.PROPERTY CORNER MONUMENTS WERE NOT PLACED AS PART OF THIS SURVEY. 1' EDUCOAUTHO IZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE V L ✓�� ATIO 4.ONLY COPIES FROM THE ORIGINAL OF THIS SURVEY MARKED WITH AN ORIGINAL OF THE LAND SURVEYORS 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. GUARANTEED TO: LALSA LAND SURVEYING PLLC =� ADRIAN S. LALSA {( CL� 1. EILEEN McDONALD AND BRIAN DOWNEY-ZAYAS NEW YORK LICENSE No. 050936 / 2. CMBANK, N.A., ISAOA/ATIMA 172-24 gird AVENUE y �/ 3 3. CATIC TITLE INSURANCE COMPANY 9nI =4t/ JAMAICA, N.Y. 11433 L A. 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