HomeMy WebLinkAboutBP19-154PERMIT
SECTION
TYPE OF WORK
JOB LOCATION
CONTRALTO
T. COST
Cco #�l
TCO � FEE DATE
a
FOOTING
FOUNDATION
FRAMING
RGH FRAMING
I NSULATION
aLUMBING C�
RGH PLUMBING
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SPRINKLER
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LOW -VOLT O
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VILLAGE OF RYE BROOD
MAYOR 938 King Street, Rye Brook, N.Y. 10573 ADMINISTRATOR
Jason A. Klein (914) 939-0668 Christopher J. Bradbury
www.ryebrook.org
TRUSTEES BUILDING& FIRE INSPECTOR
Susan R. Epstein Michael J. Izzo
Stephanie J. Fischer
David M. Heiser
Salvatore W.Morlino
CERTIFICATE OF COMPLIANCE
August 10,2022
Timothy Dehardt&Jennifer Dehardt
55 Winding Wood Road
Rye Brook,New York 10573
Re: 55 Winding Wood Road, Rye Brook,New York 10573
Parcel ID#: 135.33-1-27
Building Permit#19-154 issued on 7/23/2019 For a New Fence
This certifies that the new four foot high black chain Link fence in rear yard and new four foot high black
aluminum picket fence in side yard,installed under the above captioned permit has been satisfactorily
completed.
Sincerely,
Michael J. Izzo
Building&Fire Inspector
/to
LE C lE �t\ �7[ For office use onl
v BUILDING DEPARTMENT PERIw.I,#
VILLAGE OF RYE BROOK ISSUED:
IN 2 5 2019 ING STREET,RYE BROOK,NEw YORK 10573 DATE:
(914)939=&6
914)939-5801 FEE: PAID 00
VILLAGE OF RYE BROOK .or
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
sssrstssrsasasssasssaatsasssssas«atessssrssststarassrsprssaasrrssssetsssasstatststststtssssts««srarsrsserserr«ssr«ssasssst«
Address: W b 00� Pd
Occupancy/Use.:}�"2S►cW Parr'c�el_ #: 1 -26, n3- I - a?,-) Zone:l
Owner: t Vy�D I�t,�1 V VI l T f D��C�1(�V Address: S� V'�11L d Gt �� � t 6�
P.E./R.A.or Contractor: R���ahle� Q,�1(JQ ttiAddress: �a cp H(I �l�l V'P.I
Person in responsible charge: Address: l
Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issuance ofa Certificate of
Occupancy/Certificate of Compliance for the structure/construction/alteration herein mentioned in accordance with law:
STATE OF W YOR�K�COUNTY OF WESTCHESTER as:Q ��/1I UCl IW VJy9ein tduly sworn deposes and says that he/she resides at SS wul w twd
P d
in K( mt Name of plicant) (No.and Str �I
am(Q 1 ,in the County ofS�c�l `^ in the State of f 1 ,that
(Citvrrown/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,p��roofessional fees,and including the monetary value of any materials and labor which may have been V
donated gratis was:S I Q b 0, 0
for the construction or alteration of Q_ l ') ak-61 souk. u
oAd
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 ofOccupancy 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. 1
Sworn to before me this `2� Sworn to before me this 4�
of , 20 day of , 20 �Gk
i re of Property Owner ture of Applicant p
Print Na of Property Owner Print Nam of Applicant
Notary Public Noudy Public
CHRISTINE M.DIAZ CHRISTINE M.DIAZ 3^1 i
Notary Public,State of New York Notary Public,State of New York
No.01 D16130378 No.01 D16130378
Qualified in Westchester Court Qualified in Westchester County.,
Commission Expires July 18,20 Commission Expires July 18,20 --%
QyE BRcb,
O�` tim
cu �
1982 BUILDING DEPARTMENT
❑BUILDING INSPECTOR
❑ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK
❑CODE ENFORCEMENT OFFICER 938 KING STREET . RYE BROOK,NY 10573
(914) 939-0668 FAx (914) 939-5801
www ryebrook.org
- - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - -
ADDRESS : r �10 �� t `' '_ DATE:
PERMIT# C IS UE�T�L'�V\SECT: BLOCK: LOT:
RAI
LOCATION: �1 OCCUPANCY: G,
❑ VIOLATION NOTED THE WORK IS... le ACCEPTED ❑ REJECTED/REINSPECTION
❑ SITE INSPECTION k,,S I M REQUIRED
❑ FOOTING `
❑ FOOTING DRAINAGE
❑ FOUNDATION
❑ UNDERGROUND PLUMBING NOTES ON INSPECTION:
❑ ROUGH PLUMBING
❑ ROUGH FRAMING
❑ INSULATION
❑ NATURAL GAS
❑ L.P. GAS
❑ FUEL TANK
❑ FIRE SPRINKLER
❑ FINAL PLUMBING
❑ CROSS CONNECTION
-FINAL
❑ OTHER
Building Permit Check List&Zoning Analysis
Address: ��5� �� ►.� < o 0-2-- SBL:
Zone - - I ��Use: Const.Type: Other.
Submittal Date: Revisions Submittal Dates:
Applicant: ��—
Nature of Work: L4 L40'` _13 L�t-• tom.)C F I N
L( `� (,l-L- l Ch7 i C Fes. c►- S cb FL AXZ>
Reviews:ZBA: J U N 1 9 1019 PB: BOT: Other.
OK
( ( ) FEES:Filing•. 79
✓ BP: C/O: Legalization:
( ) (_�'APP: Dated ot✓ Narized: SBL: ✓l tuss I.D. Cross Connection: H.O.A.:
( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening.
( ) ( ) ENVIRO:Long. Shore Fees: N/A.-
SITE PLAN:Topo: Site Protection S/W Mgmt.: Tree Plan: Other.
( ) ( ) SURVEY:Dated Current: Archival;- Sealed: Unacceptable:
( ) ( ) PLANS:Date Stamped Sealed Copies: Electronic: Other.
License: Workers orrip: Liability: Comp.Waiver. Other:
(� (�CODE 753#: J a— 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.
O O 20I7 NY State ECCC: N/A: Other.
(•� ( ) Final Survey Final Topo: RA/PE Sign-off Letter. As-Built Plans: Other.
( ) ( ) BP DENIAL LETTER: C/O DENIAL LETTER: Other:
( ) ( ) Other.
GARB mtg.date: ` approval <I notes:
( )ZBA mtg.date: approval;- notes:
( )PB mtg.date: approval:- notes: APPRUVLU
REQUIRED EXISTING PROPOSED NOTES J U L 1 9 1019
Area: Dam: --
Circle:
Fron�ta¢�
Front
Front:
Sides:
Rear.
Main Cov
Accs.Cov
Ft H Sb:
Sd.H Sb:
GFA:
Tot :
FG ImD:
Parkin .
Height/Stories:
notes:
BUILDING DEPARTMENT D IE C IE 0��/
VILLAGE OF RYE BROOK v
938 KING STREET RYE BROOK,NY 10573 JUN 12 2019
(914)939-0668 FAx(914)939-5801
www.1-Yerook.org 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: 55 W WIA4 W Do Date of Submission:
Parcel ID#: Zone: _
Proposed Improvement(Describe in detail): APPLICANT CHECK LIST:
MUST BE COMPLETED BY THE APPLICANT
1. The following items must be submitted to the Building
lt1 rear oT /o ro OQI q V'kA 910-CL Department by the applicant-no exceptions.
�tAMin�w� Qn sic s �� �; 1. (y�ompletedApplication
2. ( )Two(2)sets of sealed plans. lone Cull size :maximum
Property Owner: I yM £'Tenn s�er hard-I allo\%ablc plan sizc 36"x 42 and one I I"x 17")
Address: Prwk- 3. (✓TTwo(2)copies of the property survey.
4. ( )Two(2)copies of the proposed site plan.
Phone# g-)3) 7as-91 So 5. (v}One electronic/disc copy of the complete
Applicant appearing before the Board: application materials.
6. (k,,�'1`iling Fee.
�ost�lti Cm-entnza vz, 7. (v jAny supporting documentation.
Address: 9)-(o LAmon- NY lo!M 8. ( )HOA approval letter.(fapplicable)
9. (v f Photographs.
Phone#010-P1100'-7b 10.(✓f Samples of finishes/color chart. (a sample board or
model may be presented the night of the meeting)
Architect/Engineer:
Phone#
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. �J
Sworn to before me this aoVr\ Sworn to before me this
davof C>, , 20 day of , 20LL
ure ro Owner tur f Applicant
Print Name of Property Owner Print Name Jf Applicant
otary Public Notary Public
CHRISTI .DIAZ ANNA MURTAGH
Notary Public,State of New York Notary Public.state of New York
No.01 D161 30378 N0, 01MU5058044
Ouardled in Westchester County[ Qualified In Westchester County
Commission Expires July 18,20 My CQmmisslon Expires Apr 1, 2022 3/21/19
VILLAGE OF RYE BROOK
BUILDING DEPARTMENT
938 KING STREET, RYE BROOK,NY 10573
(T) 939-0668 (F)939-5801
ARCHITECTURAL REVIEW BOARD
Wednesday, July 17, 2019
NAME&LOCATION TYPE OF APPLICATION MOTION SECOND APPROVED REJECTED APPLX
55 Winding Wood 4ft Black Chain Link Fence For Full 4800
Road(Dehardt) @ Rear Yard&4ft Review. O
Aluminum Picket @ Sided \
Yards `•l
14 Sunset Road 6ft Vinyl Privacy Fence Consent 4801
(Riley) w/Lattice Top
484 N. Ridge St Above Ground Swimming Consent 4802
(Sarrizan) Pool Agenda
159 N. Ridge St Roof Top Solar Array Consent 4803
(Beltas) Agenda
17 Knollwood Drive Amendment To Approved Consnet 4804
(Bucci) Application/ Siding Change Agenda
21 Elm Hill Dr 4ft Black Aluminum Fence Consent 4805
(Kanarek) In Rear Yard Agenda
4 Oriole Place Change Rear Window To Consent 4806
(Esterow) Patio. (Interior Alterations) Agenda
173 CountryRide Demo Existing House and
g g 4753
Dr(NDRB Construct New One family,
Development) New Swimming Pool
260 Linclon Ave Replace Existing Wood Rail 4807
(C.P.W.) W/ Steel Pipe Rail
23 Elm Hilll Drive Amendment To Approved 4808
(Erb) Application
5 Heritage Ct Replace &Build New Deck 4809
(Bhagavan) (Extended)
ML NM
MR SE
JM SF v
AC MI
JB v
f
I
Black Coated
,� ��� �^1•fit
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Ai �iuli � � . I Ililillllll�l 11������11 IIIhI��'''�,
.� �.������,�,►,,11 IIII►IIIIIII II i�
/ BlackPowder Coated
rchmont, New York 10538 (914) 713 -7799- Office
eI ble.fence@aol.com www.myreliablefenceguy.com
Westchester County Home Improvement License#WC-27514-1115
May 3, 2019
To Whom It May Concern
This letter is to confirm that Reliable Fence Company has a valid Home
Improvement License in the county of Westchester, NY. The license
number is WC-27514. Reliable Fence Company is simply waiting for the
hard copy of the new license which expires in March of 2021.
If you need further confirmation you can contact Wanda at the
Department of Consumer'Affairs in the County of Westchester and she
will confirm the license is current and valid. The number to that office is
(914) 995-3290. When calling please refer to the date 04/23/2019 for
easier lookup by the Department of Consumer Affairs.
Thank You,
C, �,Q�
9
Joseph E. Carpan ano
Owner Reliable Fence Company
5/17/2019 Find a Licensed,Contractor
Westchester George Latimer Custom Search
Izl `
I
govCOM Westchester County Executive
(: S)11MEl=c: NF i-AV-1S TRADES ID THEFT F I:\J.4l�l�<;1'_ fit ;
Find a Licensed Contractor
Review the search results below for a contractor.You may search again or make another selection by returning to Seal(-,
Search found 1 records
Company Name License
Contractor Name Expiration Date Phone
Trade Name
RELIABLE FENCE COMPANY 3/12/2021 914-712-7799
CARPANZANO JOSEPH E.
https://consumer.westchestergov.com/trades/choosing-a-contractor/find-a-licensed-contractor 1/2
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L --- CERTIFICATE OF LIABILITY INSURANCE 5/17%019
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(les) must be endorsed- If SUBROGATION IS WANED,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 endomement(s).
PRODUCER NCONjACi
AME:
AI.PIAR & PAPA INSURANCE PHONE FAX 11) 811-10119 e Ne:(914)834-0360
20 N Avenue ADDRIESS:aal iar@verizon.net
Larchmont, NY 10538
INSURER(S) AFFOR0IN0 COVERAGE NAIC1
INSURERA:Utica First Insurance Company
INSURED Joe Carpanzano INSURER B
DBA Reliable Fence Company INSURER C
926 Harmon Drive INSURER D:
Larchmont, NY 10538 INSURERS:
INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
A oL SueR L R TYPE OF INSURANCE LI Y E OLICY EXP
INSD vivo POLICY NUMBER MMIDD7WYY MM/DDNyYY LIMITS
COMMERCIAL GENERAL GkRIL[TY
EACH OCCURRENCE $ 1,000,000
CLAMSMADE ®OCCUR PREMISES Ee occurrence S 50 000 1
ART 50 600 65 03 10/07/2018 10/07/2019 MED EXP(Any one Person) $ 5 OO 0
A x PERSONAL BADVINJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: TE GENERAL AGGREGA S 2,OOO,000
POLICY JE L_ LOC
PRODUCTS-COMPlOP AGG 5 2,OOO,OOO
OTHER:
E
AUTOMOBILE LIABILITY M N D I E LIMIT ALPTAR[PAPA ZRSURAp=
Ea acc dent $
ANYAUTO BODILY INJURY(Per person) S
ALL OWNED SCHEDULED
AUTOS AUTOS BODILY INJURY(Per accident) b
HIRED AUTOS AUTOS NON-OWNED S
AUTOS Per accident
S
— —-UMBRELLA LIAB - OCCUR EACH OCCURRENCE $
EXCESS LIAR CLAIM AGGREGATE IS
DED I I RETENTIONS I $
WORKERS COMPENSATION _
AND EMPLOYERS'LIABILITY YIN STATUTE ER
ANY PROPRIETORlP0.RTNERIEXECUTIVE
OFFICER/MEIJ.eER EXrLLGED7 NIA E.L.EACH ACCIDENT
(Manaarory If EL DISEASE-EA EMPLOYE S
yes,describe under
DESCRIPTION OF OPERATIONS be EL DISEASE-POLICY LIMIT 1$
DESCRIPTION OF OPERATIONS LOCATIONS VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
Additional Insured: Village of Rye Brook and Tim & Jennifer Dehardt
Job location: 55 Winding Wood Road, Rye Brook, NY 10573
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 I
938 King Street WITH TH THE POLICY PROVISIONS.
Rye Brook, NY 10573 AUTHORIZEDLRE� ESENTATIVIE
t .
i
01988-2014 ACORD CORPORATION. All rights reserved.
ACORD25(2014101) The ACORD name and logo are registered marks of ACORD
ORL7� DATE(MM/ODIYYW)
AC
CERTIFICATE OF LIABILITY INSURANCE 12/2/2019
THIS CERTIFICATE IS ISSUED AS A MATTER OF MIFORUATION 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(les)must be endorsed. If SUBROGATION IS WAIVED,subject to
the temis 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).
CONTACT
PRODUCER NAME
;`y?�TAA_ 6 PAPA INSURANCE PHONE (914)834-1011 No (914)834-0360
INC
20 N Avenue A E-MAILSS:aal iar@verizon.net
Larchmont, NY 10538 aalaaRR) AFFORDING COVOUM NMCs
INSURER A:Utica First Insurance Company
INSURED Joe Carpanzano INSURER B'
DBA Reliable Fence Company INSURER C
926 Harmon Drive INSURER D -
Larchmont, NY 10538 I INSURER E:
INSURER F.
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO All. THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR TYPE OF INSURANCE INSO VIVO POLICY NUMBER ~0 1 (MMIDD/YYYYj I LIMITS
C0MWRCIAL GENERAL LIANUT/ EACH OCCURRENCE s 1,000,000
I CLAIMS-MADE Fi�OCCUR I .PRAMSEsT( om,. s 50,000
ART 5060065 04 110/07/2019 L0/0-r/202D MEDEJCP(Myonepersan) s 5,000
A x PERSONAL a AOV INJURY S 1,000,000
- Q!<AQCREGATE LIMIT APPLIES PER I GENERAL AGGREGATE s 2,000,000�
POLICY JEC- �� LOC PRODUCTS•COMP/OP AGG s 2,00O,000
S
OTHER
AtJTOMCe1LE LIABILrIY CAYABMe INED LIMIT $
srddOM
ANYAUTO BODILY INJURY(Per person) s
ALL OWNCD f—i SCHEDULED I BODILY INJURY(Per accdon:)! S
AUTOS A,,rrOS -
�R -ERTY D
NON-OWNED Par sock S
HIRED AUTOS H AUTOS
UMBRELLA LIAB OCCUR EACH OCCURRENCE s
—7 EXCESS LIAR CLAIMS-MADE AGGREGATE s
OED F RETENTION s s
(WORKERS COMPENSATION STATUTE ER
AND EMPLOYERS'LIABILITY YIN
AW PROPRIETO"AWNEIVEXEcunvE E.L.EACH ACCIDENT s
OFFIMP/AENBER EXrUJ0ED? ❑M!A
(Mhands"ry NH) E.L.DISEASE-EA EMPLO s
N yyees descbe under
DESCRIPT)ON OF OPERATIONS below EL DISEASE-POLICY LIMIT s
I
I �
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Adddbnal Remaks Schedule,may be WsrAed M mae space is rpured)
jAdaitional Insured: V' Asrs
I
CERTIFICATE HOLDER CANCELLATION
I
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
e of a Brook THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Village Rye ACCORDANCE WITH THE POLICY PROVISIONS.
938 King Street
Rye Brook, NY 10573 AUTHOR17F.D ENTATIW
61988-20 C RD CORPORATION. All rights reserved.
ACORD25(2014l01) The ACORD name and logo are registered marks of ACORD
New York State Insurance Fund
Workers'Compensation&Disability Benefits Specialists Since 1914
WESTCHESTER ONE,44 SOUTH BROADWAY,10TH FLOOR,WHITE PLAINS,NY 10601-"11
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
o
A A A A A A 472020834 %1w
ALPIAR&PAPA
20 NORTH AVENUE
PO BOX 927
LARCHMONT NY 10538 SCAN TO VALIDATE
AND SUBSCRIBE
POLICYHOLDER CERTIFICATE HOLDER
JOSEPH EDWARD CARPANZANO D/B/A VILLAGE OF RYE BROOK
RELIABLE FENCE COMPANY 938 KING STREET
926 HARMON DRIVE(LOWER LEVEL) RYE BROOK NY 10573
LARCHMONT NY 10538
POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE
W2414 470-1 955530 04/13/2019 TO 04/13/2020 5/17/2019
THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE
FUND UNDER POLICY NO. 2414 470-1, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR
WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL
OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS
OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY.
IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY,INCLUDING ANY NOTIFICATION OF CANCELLATIONS,
OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS://WWW.NYSIF.COWCERT/CERTVAL.ASP.THE NEW
YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS.
THIS POLICY DOES NOT COVER THE SOLE PROPRIETOR,PARTNERS AND/OR MEMBERS OF A LIMITED LIABILITY COMPANY.
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE
COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER
THE COVERAGE AFFORDED BY THE POLICY.
NEW YORK STATE INSURANCE FUND
DIRECTOR,INSURANCE FUND UNDERWRITING
VALIDATION NUMBER:981084216
U-26.3
IRTH One Call Page I of l
Ticket: 07249-174-032-00 Type: Insuf Notice Previous Ticket:
--------------------------------------------- --------------------------------
State: NY County: WESTCHESTER Place: RYE BROOK /V
Addr: From: 55 To: Name: WINDINGWOOD RD N
Cross: From: To: Name:
Offset:
--------------------------------------------- --------------------------------
Locate: ENTIRE BACK YARD
NearSt: LATONIA RD
Means of Excavation: HAND TOOLS Blasting: N
Site marked with white: Y
Boring/Directional Drilling: N
Within 25ft of Edge of Road: N
Work Type: INSTALLING NEW FENCE
Duration:
Depth of excavation: 1 FEET
Site dimensions: Length 6 INCHES Width 6 INCHES
Start Date and Time: 07/25/2019 07:00
Must Start By: 08/08/2019
------------------------------------------------------------------------------
Contact Name: JOSEPH CARPANZANO
Company: RELIABLE FENCE COMPANY
Addrl: 926 HARMON DR Addr2:
City: LARCHMONT State: NY Zip: 10538
Phone: 914-713-7799 Fax:
Email: RELIABLE.FENCE@AOL.COM
Field Contact: JOSEPH
Cell Phone: 914-260-7698
Working for: JENNIFER DEHARDT
------------------------------------------------------------------------------
Comments: CALLER IS REQUESTING ALL UTILITIES PLEASE RE-MARK (CALLER TICKET)
05229-078-023
Lookup Type: MANUAL
------------------------------------------------------------------------------
Members:
CONSOLIDATED EDISON COMPANY OF NY 718-472-2304
SUEZ WATER WESTCHESTER 800-262-8600
VILLAGE OF RYE BROOK 914-939-0753
WESTCHESTER COUNTY 914-613-5419
Service Area Service Area Contact Day Phone Emergency Alt Phone Utility Type Response
Code Name Phone
55
UNMARKED,
MARKING
AND DIG
DELAY
REQUESTED.
LOCATE
TECHNICIAN
HAS OR IS
ATTEMPTING
ELECTRIC, TO CONTACT
CONSOLIDATED PROTEK THE
EDISON DISPATCH (718)472-2304 GAS,GAS EXCAVATOR.
CON-ED COMPANY OF TRANSMISSION EXCAVATION
NY SITE REMAINS
UNMARKED
OR
INCOMPLETE.
A NEW
DEADLINE
FOR
MARKING IS
TO BE OR HAS
BEEN
SCHEDULED.
10 CLEAR,NO
FACILITIES
SUEZ WTR USIC WITHIN 15 FT
WESTCHESTER SUEZ WATER VOICE (800)262-8600 WATER OF THE
WESTCHESTER CALLS EXCAVATOR
DEFINED
WORK AREA
htt„•//;rth cI;¢gafelvnewvork.com//IRTHOneCall/Centers/PrinterFriendlyConfirmation.aspx 7/25/2019
IRTH One Call Page 2 of 2
STORM SEWER,
VIL RYE VILLAGE OF MICHAL CULVERTS,
BROOK RYE BROOK NOWAK (914)939-0753 (914)490-1628 SANITARY
SEWER
10 CLEAR,NO
FACILITIES
WESTCHESTER WESTCHESTER MARIAN SANITARY WITHIN 15 FT
COUNTY/ COUNTY POMPA (914)813-5419 SEWER, OF THE
SEWER WATER EXCAVATOR
DEFINED
WORK AREA
http://irth.digsafelynewyork.com//IRTHOneCall/Centers/PrinterFriendlyConfirmation.aspx 7/25/2019
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BRICK PATIO c BUILDING INSPE ,Vii!ege of Rye Brook,NY
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VILLAGE OF RYE BROOK
L- 6. 11/ BUILDING DEPARTMENT
R-100 oo �
Village of I je Brook ^
Architectur e
Approval Date: N
Chairman: D ROAD NORTH — 1 /� 'CI M 1 tj Ll`J
JOH1V J MULDOON
SURVEY OF PROPERTY 18 77GHE ROAD
SHENOROCK N.Y., 10587
PREPAID FOR (914) 494-2872
TIM DEHARDT
PROPERTY BDNG
LOT 29
ON A61P EN117LED
mAP OF SEC710N V RYE ACRES ! O N v ,
SITUATE AT Al Ci /
TO WY OF RYE
WESTCHESTER COUNTY, NEW YORK CO