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HomeMy WebLinkAboutBP25-028r�M1T � ��� O SECTION �Co � d7 TYPE OF WORK � / 1�a LOCATION r%'�is � EST. COSnT ��'y � 5 C� r �CO � l _[_'. L� LOT_ ���....... i� 0���2�'J�'� e_ CG�a� � y� Sao- 9�95 s �'9.-� 1..L C-,c�'�uc� S�j%"s�� �a'�}s�3o `f- �Co� �. TCO � FEE DATE • � •�r DATE FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUM�i1NG RGH PLUM8ING GAS SPRINKLER ELECTRIC O LOW -VOLT ALARM AS WILT FINAL INSP OTHER APPROVALS ARB BOT PB ZBA jOTHER AS-BUILT/FINAL SURVEY REQUIRED PRIOR TO FINAL INSPECTION DR, 4' 19 u t�4.oJ 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 David M. Heiser Donald T.Krom,Jr. Salvatore W.Morlino CERTIFICATE OF COMPLIANCE December 15,2025 Pak Yun Chan&Jaclyn Chan 745 King Street Rye Brook,New York 10573 Re: 745 King Street, Rye Brook,New York 10573 Parcel ID#: 136.29-1-16 Building Permit#25-028 issued on 2/24/2025 for a New Fence This certifies that the four foot high split rail fence,installed under the above captioned permit,has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to BUILQBROOK� NT For office use only: c, PERMIT# a VILK ISSUED: - 938 KING STREYoRK 10573 DATE:DEC 0 3 2025 FEE: PAID mV 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 +++►►*rtss*ss►sr+►+►s*►•►*+s+►***+*r►+*►srss►***r++*rs►*tsrsr►r►r►►tssws*rp+►s_+t+****a►s►r►�►r►►t►serrw*wr+ww*trssas►s►►sss+s►s Address: I LA< 1j N "lt z OCAL- N 1g (nS13 Occupancy/Use: Parcel ID#: 13 b. ? AP Zone: R—f5 Owner: Q pN\L %�kAIJ G11.R4 Address: TAS \14 G -T• ,` �r p P.E./R.A. or Contractor: 1 t �N L t Address: '1y1 6M 1�wu V r'v'o Person in responsible charge: Address: 10r1�� 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 NE`. YOR`K, COUNTY OF WESTCHESTER as: lw4-�N 14 f f\\ N being duly swom,deposes and says that he/she resides at )At \V ft S' (Print Name Applicant) (No.and Street) in �►i V NO\(, ,in the County of w--S-FAG3t'C1A%-kd intheStateof that % (Cityrrown/Village) he/she has supervised the work at the location indicated above,and that the actual total cost of the work,including all site improvements, labor,materials,scaffolding,fixed equipment,professional fees,and including the monetary value of any materials and labor which may have been donated gratis was:S hw , 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 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 20 �(`1 day of , 20 tl o_ ��TT Signature of Property Owner Signature of Applicant Prin ame of Property Owner Print Name of Applicant Notary Puri Notary Public GREGORY M.RNERA No"Public,State of New York 6/l i2024 No.01 R16441398 Qualified In Westchester County Commission Expires September 26,20 � 6 Bk. ° zc� 198? BUILDING DEPARTMENT ❑B1 A)ING lNhPl l:')'t)lt ,(w1\/tiSISTANT KVIL•DING INSPECTOR VILLAGE OF RYL•' BROOK ❑COIM hNPORCPAIENT OI07CP,It 938 ICING STREXT • Rl•E BROOK, NY 10573 (91 if) 939-06M I-A a (914) 939-5801 wwwryebruu .or --- - - - - - - - - - - -- - - - -- - - INSPECTION REPORT - - -- -- - - -- - - - - - - - - - - lj d`�/tf'`•�j ..... _ nATL: Z0? I)L'RM,r;: -JO /3G•2L BLOcK: / LOT: _ S� LOCATION: OC(:UPANCY: ❑ VIOLATION NO'riu) 'i'llf. WORK IS... f�CClil''L'L'D ❑ RL—C.TCD/ RG1NtiPlC'f10N ❑ SITE INSP1:('ION REQUIREM ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMIIING N(YI FS ON INSPF.(--ION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION � ❑ NATURA1.6AS ys k\j -- , SPL/ T �G ❑ L.i>. Gnu N ❑ FUl-A- ANK ❑ FIRE-SPRINKLE it ❑ I-INAL PLUMItING ❑ (..ROSS CONNIi -VION AA 1 i NA L /�1 L� lv Lc- G ,y pC� D • rc C 72 CA N W ow A W v 41 •v v ° 10 C H F.I.. W L u © Cn — M ao o :00 y �(3/a r,,a.� J u tl ❑ A. 1+1 Oj 1 z id id b ° ~ N z W u ° � -A '— ., \ w 0. o w v w C U 00 G rYl o M U W a w � G1 � � � � .�►. W �WY., � � � ,0 �Q � N s I� z w00 ° v c� 00 z r.. a� w Ji td `.. > t uo CA ^� F. 2 � �7 �k:, W � z 7O It 0 = J '� Q O U Og an. a U V z u� wz z W W 0 >4, .4 ° ►' w--� Vy k. u J � a9 w z o � (3Z �_ a, W W A � cwa �' v ' Q � LL �I a W W `J = n -o G BUILDING DEPARTMENT D [E C O W E VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK,NY 10573 JAN - 8 2025 (914)939-066$ wwwxyebrookuy.a_ov VILLAGE OF RYE BROOK BUILDING DEPARTMENT FOR OFFICE USE ONLY: �a�� ' �C'� Approval DateFBB 19 2025 Per it# Application# � Approval Signature: ARCHITECTURAL REVIEW BOARD: Disapproved: : Date: BOT Approval Date: Case# Chairman: PB Approval Date: Case# Secre ZBA Approval Date: Case# Other: Application Fee: E� Permit Fees: ' FENCE / WALL / GATE PERMIT APPLICATION Application dated: /—9—1�1.5' 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: t t3 i, t / p z 2. Occupancy/Use: / I'-19,eI4 S.B.L.#: /._�(�� ,4 Zone: — I S 3. Proposed Fence/Wall/Gate(describe in detail): 4. Property Owner: Address: yS '�L.I is 1 Phone# �`�b `A-"- "'M Cell# email: D R\Qi a ALVLAA E G;r&t�1L Applicant: Address: Phone# Cell# email: Architect/Engineer: Address: Phone# Cell# email: Contractor. I`I U Address&Phone: M Z U-18 Qyp P '1 Uci"1`1h6 4�'f 10�� t45- Soi-%v'x-;- 5. If building is located on a corner lot,which street does it front on: 6. What is the estimated cost of construction -t ki,j (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 6/112024 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. SITE NEYO CQUNTY OF WESTCHESTER ) as: R� Tw� - \.\ �,fy , 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 forthe 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 S Sworn to before me this day of , 20 a�j day of , 20 Signatu e of Property Owner Signature of Applicant �K�__�",V\r� U�41 e of Property Owner Print Name of Applicant Notary Public Notary Public SHARI MELILLO Notary Public,state of New York No.01MIE6160063 Qualified in Westchester county Cc- ,jmlzs!on Expires J • _ „29,20_ 2 611/2024 Building Permit Check List&Zoning Analysis Address: —7 L 5 I or, S SBL Zone: A- 15 Use: 2 lo Const.Type: Other. Submittal Date Revisions Submittal Dates: Applicant: C VvQ Nature of Work 1 FC'r1C 2C.( Reviews:ZBA: PB: BOT: Other. NEED OK (�} FEES:Filing. BP: C/O: Flood Plane: Legalization: ( ) (�APP: 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 Mgmn: Tree Plan: Other. ( ) ( ) SURVEY:Dated Current: Archival• Sealed: Unacceptable: ( ) (,-PLANS:Date Stamped. Sealed Copies: Electronic: Other. ( ) License: Workers Comp: Liability Comp.Waiver. Other. ( ( ) CODE 7S3#: 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: Nan Gas: LP Gas: N/A/: Other. ( ) ( ) FIRE SUPPRESSION:Plans: Permit: N/A: Other. ( ) ( ) H.V.A.C.: Plans: Pen-nit: N/A: Other. ( ) ( ) FUEL TANK:Plans: Permit: Fuel Type: Other. ( ) ( ) 2020 NY State ECCC: N/A: Other. ( ( ) Final Survey: Final Topo: RA/PE Sign-off Letter. As-Built Plans: Other. ( ) ( ) BP DENIAL LETTER: C/O DENIAL LETTER: Other. ( ) ( ) Other. GARB mtg.date: 'L _ approval• 2 - I q - ZS notes: ; )-0()`1 ( )ZBA mtg.date: approval:- notes: ( )PB mtg.date: approval: notes: REQUIRED EXISTING PROPOSED NOTES 1 9 20 Area: Date: fE8 Cirde. Frorr�tata¢e: Front: Front: Sides: Rear. Main Cov: Accs.Cov- Ft.H Sb: Sd.H Sb: GFA: Ton 1W. Ft.Im : Pa&jW. Hdght/Stories: notes: BUILDING DEPARTMENT,/ L) E C Fc� � v VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK,NY 10573 JAN — 8 2025 3 (914)939-0668 VILLAGE OF RYE BROOK www.ryebrooknN.p,ov 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: lk 'S kLr 0 L I . Date of Submission: Parcel ID#: ;jl (a.0'al Va-t l„ Zone:4— Proposed Improvement(Describe in detail): APPLICANT CHECK LIST: `Z MUST BE COMPLETED BY THE APPLICANT Rr iS `L VJ'1 ( [OAS p� The following items must be submitted to the Building Department by the applicant- no exceptions. Property Owner: f4 1. (--,,completed Application 2. ( )Two(2)sets of sealed plans. (one full size {maximum Address: allowable plan size=36"x 42") and one I I"x1T') (= 3. ( Two(2)copies of the property survey. Phone# ( ��_ v�� - ���� 4. (,,-)'Two(2) copies of the proposed site plan. Applicant appearing before the Board: 5. (,-)'One electronic/disc copy of the complete v�N A application materials. \ 6. (, 'Filing Fee. Address: 1�15 ��t N S� 7. ( )Any supporting documentation. 8. ( ) HOA approval letter. (ifapplicable) Phone# �'� - ��- r��o1 9. (Photographs. Arch itect/Engineer: 10.( ) Samples of finishes/color chart. (a sample board or Phone# OWN 0 K-1L fC0'r\ model may be presented the night of the meeting) By signature below, the owner/applicant acknowledges that he/she has read the complete Building Permit Instructions& Procedures, and that their application is complete in all respects. The Board of Review reserves the right to refuse to hear any application not meeting the requirements contained herein. Sworn to before me this ` Sworn to before me this day of , 20 ell day of , 20 Signature Property Owner Signature of Applicant Name of Property Owner Print Name of Applicant �3�VA Notary Public . .i wiELILLO Notary Public r�oiary P:iblic,state of New York N ,.011,IE6160063 qt, ;iih:.a in Westchester county in Expires Rv «'y 6/1/2024 bR(�vk Village of Rye Brook ML MR t/ ,X Agenda FB SE J <<t„� �' Architectural Review Board Meeting AC AD Wednesday, February 19,2025 at 7:30 PM Village Hall,938 King Street JM SF v+J 1. ITEMS: 1.1. ARB25-005 (Consent Agenda) Pak Yun Chan&Jaclyn Chan 745 King Street 4'high split rail fence. 1.2. ARB25-006 (Consent Agenda) Maxwell Buckley&Whitney Buckley 31 Boxwood Place 6'high white vinyl fence and gates. 1.3. ARB25-007 (Consent Agenda) Purvang Desai&Mehernaz Desai 4 Red Roof Drive Rooftop solar array. Consent Agenda Approvals: Motion Second / 1? Abstention Aye; 1 Nav; Adjournment; Notes 1.4. ARB25-008 Donald Amell&Kadyn Amell 235 Irenhyl Avenue New front entry. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.5. ARB25-009 Bradley Scharf&June Scharf 8 Magnolia Drive New rear deck. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes Page 1 of 3 Architectural Review Board February 19,2025 1.6. ARB25-010 Maxwell Buckley&Whitney Buckley 31 Boxwood Place New front portico,new deck,new windows and interior alterations. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.7. ARB25-011 Thomas Potter&Ellen Potter 16 Beechwood Boulevard Window change and add skylight. Approvals: Motion Second Abstention Ave; Nay; Adjournment; Notes 1.8. ARB25-012(Amendment to Approved Plans) Matthew Wiener&Erica Wiener 18 Boxwood Place Eliminate pergola,add roof over deck,eliminate section of deck,enlarge outdoor kitchen and change railing to cable railing. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.9. ARB25-013 (Amendment to Approved Plans) Michael Frenklakh&Amy Frenklakh 177 Betsy Brown Road Remove stone veneer and change siding material. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes Page 2of3 Architectural Review Board February 19,2025 1.10. ARB25-014 Joseph Bradford&Amanda Bradford 304 Betsy Brown Road In-ground swimming pool,patio,retaining wall and fence. Approvals: Motion Second Abstention Aye; Nay; Adjournment, Notes 1.11. ARB24-133 (Re-Appearance from 11/20/2024) Pak Yun Chan&Jaclyn Chan 745 King Street Roof over existing patio. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes NEXT MEETING: March 2025 Page 3 of 3 ...ram—mjL +rw - Adam -err �•�^a.'�^'• ... tt�''ai�G�:T�4 +-- 30 �lF� ��" ��,' 'oaf ::.sy ..-"+3. � i�'T a�-_^w.'4�•.�W MM �R .eat `�� ,� �" � �N,v, „�.. .,,y err � ,a„�^•'"-i'_'.a'.J, • I •r .,,* Y3�e�.`. l�r- „��, .�h, ,�' ;: # mow. '�#•'� � �ro 4 __-^ .ems�M�_ �S":^ a.�, — •o- r+ � yv r i ar Hirsch Fence Install & Design 747 Route 9W Valle Cottage, NY 10989 (letnme.l LI M Nor..fond Nlnle AfVM!near.:. r ^ t GN S as Zip QMtOrrrar's DNhne Phone IAi CUSIOmeI's Corning Ptluno IJo. ...... cr'a t Inah Address Neerew Cross Street PERMITANSPECTION INFORMATION Per its Yes ❑No omeowner to obtain permit Instal4tt on prctossronal / lmta9alion Professlmal,egUints Copy or permit beforo Instalaton) to obtain n_rmil Selection $ L/ s J APPROXIMATE LAYOUT i/ F:1JCE fOOTAOE CONTAINED UI THIS PROPOSAL IS AP?ROXIMATZ CASED ON FIELD MEASUREMENTS PIKALPWISE VULL CE AOJUSTEO 9ASED ON ACTUAL FENCE FOOTAGE USED.AS SLT FOURTH IN TERMS Ar.D CONOITIONS. ADDITIONAL COST OPTIONS A O Tt1E PRICES:N THIS COLUMN TO THE SELECTION TAKE DCY.N AND HAUL $ AWAY OLD FENCE PERMIT COST $ ------------- SUB TOTAL $ ------------- , SALES TAX $ FINAL AMOUNT DUE IAe ti nc n cor>traa $ all Stock Product ❑ Special Order Product Customer assumes ap re'o Ne tences as ee g p y;ey cn �ors pr en a inasftreL-ates g property.Cesign Approved Custarer_______ff,///(�+//l/ G► rJlj/ % EN INSTALLATION RELATED TO GRADE:PLEASE INITIAL ONE "'EASING to TM[Er[ FOLLG..VIO FLL.y t T aWITIIIyOVVNMENVGfNI(MVW ,NENCeITO 9D LCV VOOAF fOCUSTOMPA TaLNjA TN rEN �raV 410R rM{Ir�(lyR aMnt N7 -iFDJN FiLMaY WnOMOkM�OLNIO��K FEWI,NU L IIL If._1 F.N AT 01 MWIhYfLM10.OM.InOAR RMCI fiiWlOYfN TOgI a W/A Pfodud r` Product Product V1— Style: Hefghl Style: Height: Style Height Footage: It Gates:/ Footage: If Gates: Footage: If Gates: Post Cap: Color: Post Cap: Color: Post Cap: cow: RsW Type: Post Cap. Rag Type Post Cap. Rall Type: Post Cap: Pldcet Type: $ S Plckot Type S r .• .,_f 1 �':' ;•�i '�rY' ill� �' +�tli�i' �� '1. ri��+i�!i .. i,�., iSirr (D a GO1 CY) ^ ._ co Sr :J rn0) _ a ^. (n o y C J W W in V/ o C J rr i ,✓� �V �; ,!(agar)>, ce 4d4i °y Ca�'aY►: r t N L � f r '��, `i._tU!:!:S.v:lwLa:fXXx-�`�?�Y� �n- •;:}a:K]....i}."(+L'n''S.��:`•�y�t�e+t�:wy�t�(XYXYXXY,XIC3SXX5SX "= ' air, r���i, , -• ,, ,� •, ,:: ( °a.=�� �� � '�.<�.�,.' rr t' h. r, 1�),��Ir:. -tl /��. �1+/��lyi rt y a•{`S1l {+�1��.a� � .+ii(�yl �' _ ,+n.�emu• .•�:'�. • .; v` ;:,. ,.,D,. �x � ,. . •... 2119/2024 AcoR CERTIFICATE OF LIABILITY INSURANCE DATE" 1IDD/Y 2/19 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 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 PHONENo, (G14)76Ii 0417 is.No): 378 Elwood Avenue ADDRLE . courtne mccarth Insurance.net Hawthorne, NY 10532 INSURER 8 AFFORDING COVERAGE NAIC r -----_ _- — INSURER A• Preferred Mutual Insurance Company 1,924 INSURED INSURER 8 Hirsch Fence Install & Design LLC INSURERC: 747 Rt 9w Cottage#4 INSURER 0: Valley Cottage, NY 10989 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 00002210-0 REVISION NUMBER: 16 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 ADDLISLTR TYPE OF INSURANCE U9 — - POLICY NUMBER POLICY EFF POUCY EXP --- -LIMITS A X COMMERCIAL GENERAL LIABILITY Y N BOP0100721375 11112/2024 11I1212025 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE L^ OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY[jECT 7 LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY E MBIISINGLE LIMIT $ accidw ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR I CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER AND EMPLOYERS'LIABIUTY Y/N TAT TE R ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? El N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ H yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached M more specs Is mqulrsd) Address: 745 King St. 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 AUTI{O. �D�$ � A TOLE- G CPO ©1988-2016 ACORD CORPORATION. All rights reserved. 'W Workers' Certificate of Attestation of Exemption STATE Compensation from New York State Workers' Compensation and/or Board Disability and Paid Family Leave Benefits Insurance Coverage **This form cannot be used to waive the workers'compensation rights or obligations of any partjt** 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 forth 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 From:Village of Rye Brook 747 Route 9W#4 Valley Cottage,NY 10989-2452 PHONE:845-304-8622 FEIN:XXXXX0091 The location of where work will be performed is 745 King St,Rye Brook,NY 10573. Estimated dates necessary to complete work associated with the building permit are from December 19,2024 to December 18.2025. The estimated dollar amount of project is $0-$10,000 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 Exemption under the penalties of perjury. I further affirm that I understand that any false statement,representation or concealment will subject me to felony criminal prosecution,including jail and civil liability in accordance with the Workers'Compensation Law and all other New York State laws. By submitting this Certificate of Attestation of Exemption to the government entity listed above I 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-name gal entity will immediately acquire appropriate New York State specific workers' compensation insurance and/or disability WV p fam' leave benefits coverage and also immediately furnish proof of that coverage on forms approved by the Chair of the Workers'Compens the government entity listed above. SIGN Signature: Date: L" ✓ HERE 1 <(7& Exemption Certificate Number Received 2024-093230 December 19, 2024 NYS Workers' Compensation Board CE-200 01/2018 Laura Petersen From: UDig NY Exactix <tickets@exactix.udigny.org> Sent: Tuesday, February 25, 2025 10:27 AM To: Steven Fews Subject: Message from UDig NY ****REGULAR**** DIG REQUEST from UDig NY for: VIL RYE BROOK Taken: 02/25/2025 10:26 To: VIL RYE BROOK PRIMARY Transmitted: 02/25/2025 10:26 00003 Ticket: 02255-000-465-00 Type Regular Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 745 To: Name: KING ST Cross: From: To: Name: Offset: ------------------------------------------------------------------------------ Locate: WORKING AT THE BACK YARD NearSt: COMLY AVE 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: 03/07/2025 Depth of excavation: 24 INCHES Site dimensions: Length 200 FEET Width 8 INCHES Start Date and Time: 02/28/2025 07:00 Must Start By: 03/14/2025 ------------------------------------------------------------------------------ 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: HOMEOWNER ------------------------------------------------------------------------------ Comments: WILL BE MARKED Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: ALTICE USA BELL-VALHALLA /WSCHSTR CON-ED MCI SUEZ WTR WESTCHESTER VIL PORT CHESTER 1 PERMIT# ��`� SBL# / , ')�9-/,-/ JAN - 8 2025 DATE P VEU VILLAGE OF RYE BROOK --" . SUIL-DING--DEPARTMENT BUILDING N o. � � • COMLY AVENUE Nl8'43'OO�E i 198.72' .- N76'43' '00E g -,_ . p S � O A rN M yg = b • �`� � �8 N n IAwD N/►11WN1 iM►'v' xr We'45'00-Ea a-� S76'45'00-W ar wq T. �v'etst q V f Village of Rye Brook i n Architectural Review Board Approval'D-1*: Chairman. - ,ov.20 MAP OF PROPERTY Wru4M A TOWN OF R YE WESrCHESTER COUNTY, NEW YORK. C£RTMO TO. CONSlANGE* PIINACEK, PCS PAK N GNAN P.O. 80X 53 sr, NY 117a0 �ACL YN CN rr631 ev-1111 CAUP£R N N Y Ur— NO. 50163 F�EL17 r N I DAIF r/Zy/71 qWft SURVEY IO R TO REf. NO. 14-26M nrLF NO. 7 c z A► - INSPECTION a. TAX MAP OES167VA770N SEC77ON 1.16.029 BLOCK 01 LOTS 15 dr 16.1 JOB NUMBER: R024518-TL16 Possession NOT indicated L�6�Np i" CATCH BASIN ❑ DRAIN INLET C_Q )UTILITY POLE I G N POST 'S-YO HYDRANT WV N WATER VALVE cv GAS VALVE LIGHT POLE -4 TRAFFIC POLE OTELE. MANHOLE ELECTRIC BOX S� SEWER MANHOLE WATER MANHOLE QE ELECTRIC MANHOLE DRAIN MANHOLE MANHOLE I P. Co CONSULTING ENGINEER * LAND SURVEYORS 90 NORTH CENTRAL AVE., HARTSDALE, NEW YORK, 10530 (914) 422-0070 FAX 422-3009 MW This is to certify that this map and the survey on which it is based were made in accordance with the "Minimum Standard" Detail Requirements for New York State Association of Land Surveyors. This Survey is a representation of the property as surveyed on January 2, 2025, the date that the field work was performed. Subsequent revision dates do not constitute an updated survey. Eliot Senor, L.S. New York State Lic. No. 049822 Copies of the survey map not bearing the land surveyor's original blue signature and P FD embossed seal shall not be considered to be a true and valid copy. Copyright Gabriel 2.11S, E. Senor, P.C., 2025. ALL RIGHTS RESERVED. ).9'E A Title report lists easements and restrictions if the report was not provided these SET easements and or restrictions may not be shown . A copy of the title report was not provided. A copy of the deed was provided. Survey may be subject to easements not shown. i:i Wit, "�y �;`_.u�•__.:.,...a�.�R_�..,,:.:-..�..-o:.,.��.i.---.vo•..E•,.� DEC 03 2025 K• + U+z..'ve...! IL I'd i -fit .- ti . � I .ice V 1 y• R Surface elevations and underground appurtenances, if any, whether or not shown are not guaranteed. Fences or possession lines generally do not follow a straight line. The survey shows straight lines between located points. Any dimensions shown are to the surveyed point only. Labeled dimensions cannot be used for any other point along the line. Unauthorized alteration or additions to the survey map is a violation of Section 7209 sub -section 2 of the New York State Education Law NOT FOR TITLE TRANSFER SURVEY OF LOT No. 16.1 AS SHOWN ON THE SUBDIVISION MAP AT COMPLY AVENUE IN THE VILLAGES OF RYE BROOK AND PORTCHESTER LOCATED IN THE VILLAGE OF RYEBROOK WESTCHESTER COUNTY, NEW YORK. FILE COPY SCALE: 1" = 20' DATE: JANUARY 13, 2025 UPDATE: SEPTEMBER 30, 2025 AS= UILT DOCUMEN' Said "Map" is filed in the Westchester County Clerk's office, Division of Land Records, on October 9, 1991 as R.O. Map number 24518. P:\DWG Drawings\RO#\RO24518.dwg, 10/1/2025 5:18:52 PM