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HomeMy WebLinkAboutBP25-225FA mommommi i ul i' : '' I.I • `A10 TCO #� FEE DATE DATE FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING O RGH PLUMBING GAS a SPRINKLER ELECTRIC 0 LOW -VOLT [] ALARM O AS BUILT FINAL v336,679 / :9l11LTEFIi�L SURVEY ;EQUIRED PRIOR TO FINAL INSPECTION �RQ.CP�v,PG�, � )6)� 1 a •. APPROVALS ZBA OTHER DR 1 tlL(y Lfj C G V �. 190 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 October 29,2025 Prakash Krishnan&Raji Krishnan 29 Meadowlark Road Rye Brook,New York 10573 Re: 29 Meadowlark Road, Rye Brook,New York 10573 Parcel ID#: 135.28-1-4 Building Permit#25-225 issued on 10/21/2025 to Legalize Fence This certifies that the six foot high driftwood vinyl fence,installed under the above captioned permit has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to BUILDING DEPARTMENT PERMIT# 5 D VILLAGE OF RYE BROOK ISSUED:/ - OCT 2 12025 2 i 8 KING STREET,RYE BROOK,NEW YORK 10573 DATE: Jg2• -IQ15 (914)939-0668 FEE: PAID VILLAGE OF RYE BROOK vtiwii,ryehrouknl. Yu� ERTIFICATE OF OCCUPANCY, CERTIFICATE OF COMPLIANCE, AND CERTIFICATION OF FINAL COSTS Address: CLIE F D _3 Occupancy/Use: -' Parcel ID#: — Zone: Owner: �V__ -tie!!�Sd Q 514 M d,t j Address: P.E./R.A. or Contractor: 7V—CAOI 17--: Z P-t-lO�jC� Address: Person in responsible charge: 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: ) �, r"�KU SA N A 1,�being duly sworn,deposes and says that he/she resides at q e o,&U,% 1 !i A:mic ul :Ahp11­1111 (No.and Strccu in in the County of��L 1�1P��`� in the State of- that 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: , j 7 C 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-IO.A.of the Code of the Village of Rye Brook. Sworn to before me this Sworn to before me this q w day of , 20_2 � day of 20 �Si ,at erty Owner S ature of Applicant fr) U Ar-11x 1\ r7�7 T) L 7 19- rint Name of Property bwner Print Name of Applicant otary Public CI.AU)DIA ZAMORA Notary Public NOTARY NISUC,STATE OF NEW YORK ReELtestloe Ne.SIZAti37tlip Qr�M b Pad tarty 6/l/202-4 Cemftlm E*m ronmwy So 2� BRC�� o �m 1982 BUILDING DEPARTMENT BUILDING INSPECTOR ice❑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.or - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - -- AQ) h� ADDRESS : ~ J Ca/ DATE: 1�/ PERMIT# a►�- ISSUED: 42'kSECT: r�BLOCK: LOT: 1 LOCATION: { �C¢- (�`Eti OCCUPANCY: C, t ❑ VIOLATION NOTED THE WORK IS... ,❑ ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION //G 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 N ►n N o � cq N O � 44 0-0 p a o w ti °O V o x =� enLn z U Ln � O a O C o O 8 .7 ' C 00 Ven 1-11 z O � fo� >0 o 9 AW x fit LLn O ,o, Z o ao, 'o Sao z A H A " b ° � � a O Q z uz � � aw V � a, P..( w � � v z = (� A � j--� Lo OW E w a A y, � o v : Z ^ ICI O OC N •� d W N o x wA � � w � ? a � w O O O Z WO u a3 x a A O zoaativ4. WO O k. w O � U I.-z 1-0A �, w �, z � z F" �� � � Q u O ■ NO QI O .j R W I+I a N a -wz a °' 95 z_ ] , .� ch -ell w > x9 �.Mubol : a BUILDING DEPARTMENT VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 www.n-ebrookny.!,,oA Approval Date: SEP 2 2 2025 Alermit # 5 Application# ovV Approval Signature: ARCHITECTURAL REVIEW BOARD: : Date: BOT Approval Date: Case# Chairman: PB Approval Date: Case# Secre ZBA Approval Date: Case# Other: //��� Application Fee: 0o Permit Fees: *********************************************************************************************************** FENCE / WALL / GATE PERMIT APPLICATION Application dated: 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: J6S7 7-3 2. Occupancy/Use: B.L.#: tA4 — Zone: 3. Proposed Fence/Wall/Gate(describe in detail): col f I �f . �,t �r � arn�cI Y©n��'y777- a r �xb r rJ�!+lac .2 to�T �T 4. Property Owner: Address: �T Pr i�� \ kW k Phone# Cell# Gq(-) ` mail: a <j P, lt)M,co! Applicant: 14 Isc 12 v1--t1,1 Address: 6f �P� L• Co kA Phone# Cell# email: Architect/Engineer: Address: Phone# Cell# email: Contractor: GveeAT �( t Address&Phone: 5. If building is located on a corner lot,which stree does it front on: D I!e 6. What is the estimated cost of construction (NOTE:The estimated cost shall include all site impr ement4,-tatfor,materia,scaffolding,fixed equipment,professional fees,and material and labor which may be donated gratis.) 7. Estimated date of completion: t 6/1/2024 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 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 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 5 , Sworn to before me this 1 5 1*4n day of ✓5 S d- , 20 -2-5 day of �/s v S f , 20 Z S Si ature of roperty O ner ignature of Applicant s1��IEU6P lac>r3 i u - Print Name of Property Owner r Print Name of Applicant f__ ,�_, :7r= otary Public Notary Public CLAUDIA ZAMORA NOTARY PUBLIC.STATE OF NEW YORK Re0istmtion No.OIZA6370M QrAMW io plan Coro' Contnis w EXPLM Fobmuy 96 v?W 6/1/2024 Tara Orlando From: Tara Orlando Sent: Wednesday,September 24,2025 11:12 AM To: Eddie Zamora Subject: Fence Permit Application-29 Meadowlark Road Follow Up Flag: Follow up Flag Status: Flagged Good morning, The fence permit application has been approved by the Building Inspector.Before we can issue the building permit,the following items must be submitted to our office: VCopy of general contractor's valid Westchester County Home Improvement License. 2/General contractor's valid liability insurance (the Village Of Rye Brook must be the certificate holder) 3. General contractor's valid workers compensation on a NY State Board form(C105-2 or U26.3) (the Village Of Rye Brook must be the certificate holder) 4. Ticket number from U-Dig(free service that marks the underground utilities call 811) 5. Building permit fee$342.00(due once permit is issued and ready for pick-up) 6. Legalization fee$750.00 (due once permit is issued and ready for pick-up) Tara A Orlando Secretary - Planning Board Zoning Board of.Appeals and .Architectural Review Board 1Vidage of Rye Brook Building Department 938 Xing Street Rye Brook, New York 1o573 Office (914)939-0668 Village of Rye Brook Building Department Hours Monday-Friday 8:30am-4:00pm *Closed for lunch,between 1:00pm-2:00pm 1 Building Permit Check List&Zoning Analysis Address: -C1 Dw') t Q I t ",_ tIL: Zone: Use: ` Const.Type: Y Other. Submittal Date: —� �—�Revisions Submittal Dates: Applicant: 'r •, t ,., 1 Nature of Work �.2 lV ` N � 1 ao6- n Reviews:ZBA: SEP 10 202 _5 ,PTB: BOT: Other. NEE OK � ( (t�FEES:Filing: \.� �P: C/O: Flood Plane: Legalization ,6 ( ) ( �APP: Dated Notarized: SBL: Truss 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 Comp: Liability Comp.Waiver. Other. ( ) ( ) CODE 753#: 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. ( 1 � ) '�020 NY State EC(--': N/A: Other. ✓, f inal Survey:_ _r-inal Topo: RA/PE Sign-off Letter. As-Built Plans: Other. ( ) � ) BP DENIAL LETTER: C/O DENIAL LETTER Other. ( ) ( ) Other. ( RB mtg.date approval • /7-�y notes: Aa5-' //— ( )ZBA mtg.date: approval notes: ( )PB mtg.date: approval:- notes: REQUIRED EXISTING PROPOSED NOTES APPROVED Area: SEP 222025 Circle Date: Frontaee: Front Front Sides: Rear. Main Cov: Accs.Cov: Ft.H Sb: Sd.H Sb: a&. Tot.Imp: Ft.Imp: Paddw. Height/Stories: notes n�� _ BUILDING DEPARTMENT D IE P r VILLAGE OF RYE BROOK � 938 KING STREET RYE BROOK,NY 10573 ! AUG 2 7 2025 (914)939-0668 www,nvbrookiry.gov VILLAGE OE RYE BROOK BUILDING i;EP, 2T"tENT -I **s**********************s*************�***�**«****ss********#**s****s*s****** �srss�rssss:ess*s�ss.►, ARCHrrECTURAL REVIEW BOARD CHECK LIST FOR APPLICANTS 1 his form must be completed and signed by ti ie applicant of record and a copy shall be submitted to the Building Department prior to attending the ARB meeting. Applicants failing to s:,ubrnit a copy of this clhprl- girt will he removed from the ARB agenda. Job Address: Zp�-q d4i L a21L Z fl Date of Submission: NJ 1 Parcel ID#: 0Yo I: Proposed Improvement(Describe in detail): ce APPLICANT CHECK LIST: 'Flo- The following items must be submitted to the Building Departm Completed Application t by the applicant-no exceptions. Property Owner: Y ►g IGta�s-4 �.�2 i.St I 1. (2. ( )Two(2) sets of sealed plans. Address: • �2—�) Phone# t`` 3 ijc'v 1�3 j 3. (LXy'o(2)copies of the property survey. 4. ( o(2) copies of the proposed site plan. Applicant appearing before the Board: 5. ( )On'F electronic/disc copy of the complete plication materials. 6. ( - Filing Fee. Address: 7. ( ) Any supporting documentation. 8. ( ) 16A approval letter. (ifapplicable) Phone# 9. ( otographs. Architect/Engineer: 10.( rSamples of finishes/color chart. (a sample board or Phone# 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 1 5 Sworn to before me this I s �•' da `i v S , 20 Z S day of i?�IV S t , 20 �-5 rz'P1-<'A9H nature Property Owner Sig li nt U ��� rvA�/ � I " Print Name of Property Owner Print Name of Applicant Notary Public 7Notary Public NO AW NnACANlV0RK 6/1,2024 FENCE /WALL/ GATE PERMIT APPLICATION & INSTRUCTIONS BUILDING DEPARTMENT VILLAGE OF RYE BROOK,NY (914)939-0668 www.ryebrookm.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 ofthe applicant must be present at the ARB meeting which is held on the third Wednesday ofevery 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 11 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 5-1 ARI N1 ORKor CONSTRUCTION UNTIL ;X PERMIT HAS BEEN ISSUED tal 141F BUILDJy(I INSPECTOR. THE. ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COt�9PLE:TED WITHOUT A FIL1011_? 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= Sl 00.J0/ Commercial=$300.00 (Application fees are non-refundable) 3. A completed&signed Application Check List 4. A current,accurate property survey. 5. Two(2)setsofadimensionedsiteplan based on the survey,(One fullsiz: , iin ;iil; .: ii,nl�:r;-ir 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 ofthe proposed fence/wall/gate(s).Photographs showing front&side views ofthe existing property as well as photographs of properties on either sides and across the street. 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: / .000. of Construction Cost with a minimum fee of Commercial: :6.00/$1,000.00 of Construction Cost with a minimum fee of 2. One full size and one scaled 11"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; The application& fee for the Certificate of Compliance. (fees are based on the final cost of construction) 2. A final survey of the property. 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 X J . . ends FB SE cc� ��`"' y Architectural Review Board Meeting AC AD ��.. `v� � Wednesday, September 17,2025 at 7:30 PM OU Village Hall,938 King Street JM SF 1. ITEMS: 1.1. ARB25-108 (Consent Agenda) (Amendment to Approved Plans) Adam Polay&Bari Polay 31 Mohegan Lane Change to rear stairs. 1.2. ARB25-109 (Consent Agenda) Dziugas Reneckis&Cristina Pires 9 Maple Court 3'&4'high split rail fence. 1.3. ARB25-110(Consent Agenda) Ajai Bhagavan Venkatapur&Trud Yeshwanth Patil 5 Heritage Court 3 1/2'high split rail fence. 1.4. ARB25-111 (Consent Agenda) Bhargavi Panjala&Arun Acharya 16 Country Ridge Circle Legalize 6'high white pvc fence and gates. 1.5. ARB25-112(Consent Agenda) Liam McNeill&Sarah McNeill 46 Roanoke Avenue 6'high wood fence. 1.6. ARB25-113 (Consent Agenda) Prakash Krishnan&Raji Krishnan 29 Meadowlark Road Legalize 6'high driftwood vinyl fence. 1.7. ARB25-114(Consent Agenda) Suchit Kaul&Vaishali Bansilal 28 Legendary Circle Rooftop solar array. 1.8. ARB25-115 (Consent Agenda) Vipul Nayi&Fany Nayi 50 Valley Terrace 6'high gray pvc fence. 1.9. ARB25-116(Consent Agenda) Alex Patchen&Alexandra Patchen 11 Fellowship Lane Rooftop solar array. Page 1 of 3 • Architectural Review Board September 17,2025 Consent Agenda Approvals: Motion S 1 _ Second Abstention Aye;_ Nay; Adjournment; Notes 1.10. ARB25-117 Tian Tan&Yiyang Liu 2 James Way Legalize existing walkway replacement with brick. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.11. ARB25-118 Jillian Hochfelder 32 Country Ridge Drive Construct a two-story rear addition,one-story rear addition,interior alterations and renovations. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.12. ARB25-119 8 Elm Hill Drive LLC 8 Ehn Hill Drive Addition&alterations. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.13. ARB25-120 Doral Greens Homeowners Association Doral Greens Drive New halo lit monument entrance sign. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes Page 2of3 • Architectural Review Board September 17,2025 1.14. ARB25-121 Pak Yuri Chan&Jaclyn Chan 745 King Street Rear pergola,new roof and siding. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.15. ARB25-122 Craig Jacobs&Kate Bartow 22 Reunion Road Add stairs to existing deck. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.16. ARB25-123 Mark Diamond&Lois Diamond 11 Longledge Drive Replace existing decking and railings. Approvals: Motion Second Abstention Aye; Nay; Adjournment; Notes 1.17. ARB25-124 Andrew Wels&Lauren Weis 4 Hills Point Lane Replace existing decking and railings. 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"/;..: �.�.`:� �/��+'� � �' my` � t\'sa.F7��._ �4�q} mow. w t IS^ y Yd/► \ z ill •s� y •va SEW �. •- ��I •• k �` --rr4 � ��: it b;��`�'10. ` `. �{.',�r. 1�.•I -,'W .�� {-+F' �. .,� Y! �+•fir.' .�` � t ''.�! Ali -�+ •:. K'kt � ),.�h,°�tl :J _ ', - t �A max. •l Cyj�¢ r r h •� �� II s �"'�Sk:�"' :' '�'` ' � �.±�� 1. wit"-• �. of �. 7 u t(�s)► i I Lq O '�' � i �• � In J+«, a u A I CDgji O v Qy .� f E c LLJ 3r V CDEn O V Lti7 J w z 0 o ` one o �oect� V Z In 0 p O O v E H v 1 J a Yam,, 8Q ��' r• ,t cc f y w l W u *z i �i C U •a = --. qu : ( IAU 00 e v ° u U t—•. 1 7rtii , Cso , =t5� fisT+i — 1V` of / � P' �:i,►!,� ���j�{N4' 'L 4 � �1'!Ih ���141�14.A I `mow.__ • �s...+i1.. _ ATE A� CERTIFICATE OF LIABILITY INSURANCE D/09120IDDYYYY) 10/09l2025 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 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 Chris Butz Ivanta a FA- PHONE E t: 914-244-0500 M FAIc Ne: 9 E- AIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC It INSURER A: United States Liability Insurance Compas INSURED INSURER B Eddie Zamora dba Green Nature Landscape&Design INSURERC: PO BOX 506 INSURER D: Mount Kisco, NY 10549 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. NSR ADDLSUBR TYPE OF INSURANCE POLICY NUMBER MMIDDYIY LTR YYY MWDDIYYYY ' LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 GL 3003911 B 12/08/2024 12/08=25 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $100,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $5,000 A PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIM IT APPLIES PER: PRODUCTS-COMPIOP AGG $1,000,000 POLICY FI PRO- JECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident S ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS _ AUTOS Per accident $ UMBRELLA LIAB OCCUR _EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE $ E. RETENTIONS $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN IORY_11M! ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/ME M BER EXCLUDED? � N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION Village of Rye Brook SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Building Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 938 King Street ACCORDANCE WITH THE POLICY PROVISIONS. Rye Brook,NY 10573 AUTHORIZED REPRESENTATIVE A C �� 0 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD New Workers' YRK STATE Compensation CERTIFICATE OF Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1a. Legal Name and address of Insured (use street address only) 1b. Business Telephone Number of Insured EDDIE ZAMORA 28 RIDGE WAY (914)659-0055 PURDYS NY 10578-1404 1c. NYS Unemployment Insurance Employer Registration Number of Insured Work Location of Insured (Only required if coverage is specifically 1d. Federal Employer Identification Number of Insured or limited to certain locations in New York State, i.e. a Wrap-Up Policy) Social Security Number 09-7784937 2. Name and Address of the Entity Requesting Proof of 3a Name of Insurance Carrier Coverage (Entity Being Listed as the Certificate Holder) Property and Casualty Insurance Company of Village of Rye Brooke Hartford 938 KING ST 34690 RYE BROOK NY 10573-1226 3b. Policy Number of Entity Listed in Box 1a": 16 WEC BW0P3H 3c. Policy effective period: 09/17/2025 to 09/17/2026 3d.The Proprietor, Partners or Executive Officers are Included. (Only check box if all partners/officers included) x all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box 'T' insures the business referenced above in box "la" for workers' compensation under the New York State Workers' Compensation Law. (To use this form, New York (NY) must be listed under Item 3A on the INFORMATION PAGE of the workers' compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box "2". The insurance carrier must notify the above certificate holder and the Workers' Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.) Otherwise, this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent, or until the policy expiration date listed in box "3c", whichever is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Worker's Compensation contract of insurance only while the underlying policy is in effect. Please Note: Upon cancellation of the workers' compensation policy indicated on this form, if the business continues to be named on a permit, license or contract issued by a certificate holder, the business must provide that certificate holder with a new Certificate of Workers' Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers' Compensation Law. Under penalty of perjury, I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Sara Seier (print name of authorized representative or licensed agent of insurance carrier) 5a4 5'C1VC Approved by: 10/15/2025 (Signature) (Date) Title: Operations Manager Telephone Number of authorized representative or licensed agent of insurance carrier: (866)467-8730 C-105.2 (9-17) Form WC 88 31 21 F Printed in U.S.A. www.wcb.ny.gov Page 1 of 2 V Edge of Asphalt con 410 9 CA 6 e... > r N In M ,ri. ?..,,:+ p n •� ya *p - �,.� ten► � s'. u•• rj•.A{ AD vMEADOWLARK RO z Edge of Asphalt AsphoU Curb caS O rn i p Q a �o `°'" til :b, o :b'a;', o �a Avob a o a 0 ►r p �• � %o' �. n p � co' � � � ��e y Q c`'o �. p � � p � �• � �" � � � � � � � .�' cp A , O • � � 3� � p' pip � y c� � O� Vj �^. � c`►o �D h Oy y °'� � a� �b�• � � A•a53 b �- ��A s off• �o �cz Oct � �� ° o ° o EL t�i � v J � �„ ti cep c�0 ��,1 �• � Q , h � ii� � � � �„ � � w,. O t2•• ern0 �°', h yy `Nj �' �' `�� A a cop °�•�ZZ 1-4 7'C' N �'. �• A fi �• s p Q FL. :3 ff Only copies from the original of this survey marked with an original of the Land Surveyors embossed seal or red colored seal shall be considered to be true, valid copies. Said certifications shall run only to the person for whom this survey is prepared and on his/her behalf to the title company, governmental agency and lending institutions listed hereon. Certifications are not transferable to additional institutions or subsequent owners. Unauthorized alteration or addition to a survey map bearing a licensed Land Surveyors seal is a violation of Section 7209, Subdivision 2 of the HOLE New York State Education Law. Possession only where indicated. Adjacent property lines and easements not surveyed or certified. Access to adjacent rights of way, easements and public or private lands not guaranteed or certified Underground utilities shown hereon are approximate and should be verified before excavating Additional underground utilities are not shown or certified. Encroachments and structures below grade, if any, not shown or certified. Subject to covenants, easements, restrictions, conditions and agreements of record. Elevations shown hereon generally in accordance with North American 'ore Vertical Datum 88. Premises hereon being Lot 24 in BlockA as shown on a certain reap entitled "Subdivision Map, Section No.3, Meadowlark"" Said map filed in the Westchester County Clerk's Office, Division of Land Records April 27, 1960 as map number 12390. Surveyed in accordance with Deed Control Number 470460220. Premises shown hereon designated on the Village of Rye Brook Tax Maps as: Section 135.28, Block 1, Lot 4. Properly Address. 29 Meadowlark Road Rye Brook, NY10573 THIS MAP IS FOR B UILDING DEPARTMENT PURPOSES ONLY. MAP IS NOT TO BE USED FOR TITLE TRANSFER PURPOSES. MAP MAYNOT BE CERTIFIED TO TITLE COMPANIES AND/OR BANKS. AS BUILT SURVEY PREPARED FOR PRAKASH KMSHN. AS -Sulu 7 AND °Or' e- RA U KRISHNA.N 1N3Wf1�C? SITUATE IN THE VILLAGE OF RYE BROOK TOWN OF RYE WESTCHESTER COUNTY, NEW YORK SCALE: I" =15' GRAPHIC SCALE 15 0 7.5 15 30 60 ( IN FEET ) 1 inch = 15 ft. Surveyed. • May 27, 2014 Map Prepared. May 29, 2014 Map Revised: September 27, 2018 to show pool as built Map Revised: February 12, 2019 to show update Map Revised: October 17, 2025 By: j• New York State Licensed Land Surveyor No.050604