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HomeMy WebLinkAboutRB25-0061 �O 0 O � v 04 O 4-J N v v c a00 N -0 cz LL Y .y E Q� W ^, i C Q) a a 'O 7 M N N E m W L L m a c Cl 3 d Y w tea; tea, Ui OX L Ln > a > W � W o u } N > v jE a a>i CoN 2 m o. 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State Construction Classification N.Y. State Use Classification Occupancy Pre-Construction R-15 VB R-3 Occupancy Post-Construction Proposed Improvement Area of lot Pergola over existing raised patio Lot Square Feet 15000.0 sq.ft. Acres Dimensions from proposed building or structure to lot lines Is building located on corner lot? ❑ YES 0 NO Front Yard Rear Yard Right Side Yard Left Side Yard Other Area of Total Square Footage of the For additions, Total Square Footage of the proposed proposed new construction: total square proposed renovation to the building in footage added existing structure: square feet(0 if (0 if N/A) N/A) 0.0 Basement 0.0 Basement sq.ft. sq.ft. 0.0 1st Floor 0.0 1st Floor sq.ft. sq.ft. 00 2nd Floor 0.0 . 2nd Floor q sq.ft. 0.0 3rd Floor 0.0 3rd Floor sq.ft. sq.ft. Construction Type Located Number of stories Overall Height Median Height Basement Basement ❑ Full ❑ Partial 0 N/A ❑ Finished ❑ Unfinished 0 N/A What material is the exterior finish? Roof style Roofing material What system of heating Exterior Building Permit Application,page 2/3 Will the proposed project require the installation of a new, or an extension/modification to an existing automatic fire suppression system? (Fire Sprinkler, ANSL System, FM-200 System, Type I Hood, etc...) ❑ Yes 0 No Will the proposed project disturb 400 sq.ft. or more of land, or create 400 sq. ft. or more of impervious coverage requiring a Stormwater Management Control Permit as per§217 of Village Code? Yes 0 No Will the proposed project require a Site Plan Review by the Village Planning Board as per§209 of Village Code? Yes W No Will the proposed project require a Steep Slopes Permit as per§213 of Village Code? ❑ Yes 0 No Is the lot located within 100 ft. of a Wetland as per§245 of Village Code? ❑ Yes 0 No Is the lot or any portion thereof located in a Flood Plane as per the FIRM Map dated 9/28/07? ❑ Yes 0 No . Will the proposed project require a Tree Removal Permit as per§235 of Village Code? ❑ Yes 0 No Does the proposed project involve a Home-Occupation as per§250-38 of Village Code? Yes 0 No What is the total estimated cost of construction: Note: estimated cost shall include all site improvements, labor, 57110 USD material, scaffolding,fixed equipment, professional fees, including any material and labor which may be donated gratis. If the final cost exceeds the estimated cost, an additional fee will be required prior to issuance of the C/O. Estimated date of completion 01/31/2026 Exterior Building Permit Application,page 3/3 �y BRnvt VILLAGE OF RYE BROOK � 938 King St Rye Brook,NY 10573 W Q Phone:(914)939-0668 1 www.ryebrook.gov ��• a2•'t Building Department Residential/Exterior(Remodel/Renovation) Permit Permit Set 6 EAGLES BLF P#RB25-0061 R#135.27-1-51 PERMIT INFORMATION Address Permit number Date issued 6 EAGLES BLF RB25-0061 12/03/2025 REVIEWED BY If you have any questions regarding the review of these drawings please contact: Application in general Steven Fews stevefews@ryebrook.org INSTRUCTION AND ATTENTION It is the responsibility of the Applicant to print full size the entire approved permit package and provide at the time of inspection. TABLE OF CONTENTS Cover page 1 Building Permit 2 Required Inspections 3 Contractor's Liability Insurance 4 Architectural drawing 5-8 Site plan 9 Architectural drawing 10-13 Contractor's Workers Compensation Insurance(Showing Rye Brook Cert Holder 14-15 Contractor's Liability Insurance 16 Application Materials 17 Building Inspector Stamped&Signed Set of Plans 18-21 Westchester Home Improvement License 22 Application Materials 23 Application Materials 24 Survey(Required Recent Survey) 25 Photograph 26-29 Exterior Building Permit Application 30-32 Building Department.938 King St Rye Brook,NY 10573/Phone:(914)939-0668 �y BR(�� VILLAGE OF RYE BROOK 938 King St Rye Brook,NY 10573 W � Q Phone:(914)939-0668 1 www.ryebrook.gov �O ��• 02• i Building Department INSTRUCTIONS THE PERMIT HOLDER AND/OR PROPERTY OWNER IS RESPONSIBLE FOR ENSURING THAT ALL REQUIRED/APPLICABLE INSPECTIONS ARE SCHEDULED AND THAT THE PERMIT IS COMPLETE REQUIRED INSPECTIONS Name Description Final Inspection Completion of all required items under the permit including the site grading and the surveyor's final grading certificate. Certificate of Occupancy Completion of ALL Work,All fees Paid and Final Survey in if required) BUILDING DEPARTMENT VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 RESIDENTIAL LOT AREA COVERAGE Address: 6 Eagles Bluff Section: 135.27-1-51 Block: 51 Lot: R-15 PERMITTED COVERAGE RATIOS IN RESIDENTIAL DISTRICTS (Local Law 3-88) YOUR ZONE AREA IN MAIN ACCESS. DECK ZONE DISTRICT SQ. FEET BLDG. BLDG. MAX. CHECK MAX. R-35 35,000 14% 4% 5% R-25 25,000 14% 3.5% 4% R-20 20,000 14% 3.5% 4% X R-15 15,000 16% 3.5% 4% R-15A 15,000 12% 3.5% 4% R-12 12,500 17% 4% 4% R-10 10,000 20% 4.5% 3.5% R-7 7,500 23% 4.5% 3.5% R-5 5,000 30% 5% 3.5% R-21F 5,000 30% 5% 3.5% Existing: Proposed: 1. AREA OF LOT 15,000 Sq. Ft. 15,000 Sq. Ft. 2. AREA OF HOUSE a. Coverage of Main Building (Including Attached Garage or Accessory Building) 2,340 Sq. Ft. 2,340 Sq. Ft. b. Area of 1s'Floor Divided By Area of Lot x 100 15.6 % 15.6 3. AREA OF ACCESSORY BUILDING (Includes Detached Garages,Tool Shed, Playhouses) NA Sq. Ft. NA Sq. Ft. a. Coverage of Accessory Building Area of Accessory Building Divided By Area of Lot x 100 NA % NA % 4.AREA OF DECK NA Sq. Ft. NA Sq. Ft. a. Coverage of Deck Area of Deck Divided By Area of Lot x 100 NA % NA % I attest to the best of y knowledge and belief,the above information is correct. .09.2025 Arc ct's S ature (3) 8/12/2021 BUILDING DEPARTMENT VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK,NY 10573 (914) 939-0668 IMPERVIOUS COVERAGE RATIOS RESIDENTIAL DISTRICTS Address: 6 Eagles Bluff Section:135.27-1-51 Block: 1 Lot: 51 Zone: R-15 IMPERVIOUS SURFACES (Definition): All buildings, as defined herein, and all areas on the ground or elevated above the ground which are comprised of materials through which water cannot readily flow, including, but not limited to asphalt, concrete, masonry, wood, gravel and clay, and which consist of elements including, but not limited to, court yards,sports courts, swimming pools,patios, sidewalks,ramps,terraces and driveways. TOTAL MAXIMUM PERMITTED MAX. PERMITTED COVERAGE Zoning IMPERVIOUS LOT AREA BY IMPERVIOUS SURFACES District COVERAGE IN FRONT (sq.ft.) For Base Lot For Lot Area YARD(%) Area(sq.ft.)* Over Base R-35 15 Lot Area % R-25 20 0 to 4,000 0 55 R-20 30 4,001 to 6,000 2,200 35 6,001 to 12,000 2,900 27 R-15 35 12,001 to 16,000 4,520 26 R-15A 35 16,001 to 20,000 5,560 25 R-12 40 20,001 to 30,000 6,560 24 30,001 to 40,000 8,960 23 R-10 45 40,001 &larger 11,260 22 R-7 40 R-5 30 *"Base Lot Area"is the minimum end of the lot size R2-F 30 range in the"Lot Area"column Area of lot: 15,000 sq.ft. Existing Allowed Proposed Total impervious coverage = 3,900 S .ft. 3,900 S . ft. 3,900 S .ft. Front impervious coverage = 6 % 6 % 6 % I attest to the best of knowledge and belief,the above information is correct. 10.09.2025 Arch' is Signature (4) 8/12/2021 `O o g]"rw N c>, ow a N Q L � 7 L co v > cu �••� u c v 'po L > v L v ° c i71 aa v LL p W c �� GC aai a 3 F • N ` LpLwm Dknao wX o W N > M CO > OW U 'p L N Z " Wt-- s Y 7 0 H CN ~ N 4 O 3 °1vo Z m W> IT 3 oC N O m so � v �l WZ o � a o L o0 Y Y `w' �a o Y S 8 L Q C L —j � i Mr-I N j mQ 0 E o ai c ,o +. c m 0 O 0V) g ,>-, ? V-o U c-I Z } O Qwco } UQ aQ E ° L 0 %0 N c � Z CL_ a Y4apic�cvC a Ln .. v m N O N C L m Z p W WZM ��/ o m O Ow 3 ^ LL X v �CO ,.0 0 Lu ao v o v (D >, '� o W > CO Ln o w v E OMO� t , CL w, Z nI L L W pl LL a 'o QC CL p i z x �° w o ' Z m � W U > � _ > m u? O U Q p CC 0 ,� a� y v on v N " W }N c0 c v� �c C� J w c N a>. a� CL CL_ E Q � E � O� N u Z IS,Z u u�i y m Q LIj - U OA 2 N N = = v j s V W M a tO C c-i ,v H Q w 'n o v •— Ln NO IH a N Q 00 Q� J ri (V o o L CN E0 'Ma � m L $� v a, y V cy q W o a 0 M> 7 w V u -0 E , C p � O C EwY 29 :2 _ E tu co ~ W W d W O E Q Q ' a y v O• a+ CL� p L ro n vl Z u a Q) >d �r W Q Q c ~ :E y ai v Q a a = H a, Electrical Permit Application Village of Rye Brook 938 King St Rye Brook, NY 10573 Phone: (914)939-0668 1 www.ryebrook.gov Building Department Project Information SBL Zone 135.27-1-51 Proposed Electrical Work/Fixture Count 3rd Party Electrical Inspection Agency Our proposed fixture count: Heaters (3) Fans (2) Recessed SWIS lights (4)Wall Sconces (2) Outdoor Outlet(1) Master Electrician/Licensed Installer Information Name Lic # Address email Phone# Cell# Angelo Zaccagnino 755 81 Maple Ave, Rye Office@Zaccagnino.net 914-921-3244 Company Name Company Address Zaccagnino Electric Address of Work? Homeowner Information 6 Eagles Bluff, Rye Brook NY 10573 Electrical Permit Application,page 1/1 BRnvt� VILLAGE OF RYE BROOK ■ ■ W JE 938 King St Rye Brook,NY 10573 Q Phone:(914)939-06681 www.ryebrGok.gov �O Q /� 19p2 i Building Department Electrical/New Fixtures And Wiring(New) Permit Permit Set 6 EAGLES BLF P#RB25-0103 R#135.27-1-51 PERMIT INFORMATION Address Permit number Date issued 6 EAGLES BLF RB25-0103 12/03/2025 REVIEWED BY If you have any questions regarding the review of these drawings please contact: Application in general Steven Fews stevefews@ryebrook.org INSTRUCTION AND ATTENTION It is the responsibility of the Applicant to print full size the entire approved permit package and provide at the time of inspection. TABLE OF CONTENTS Cover page 1 Building Permit 2 Required Inspections 3 Electrical License-Photo-Westchester County 4 3rd Party Electrical Inspection Form 5 Electrical Permit Application 6 Building Department.938 King St Rye Brook,NY 10573/Phone:(914)939-0668 �yC BR(�v� VILLAGE OF RYE BROOK O� 7' 938 King St Rye Brook,NY 10573 W � Q Phone:(914)939-0668 1 www.ryebrook.gov �O 1982 i Building Department INSTRUCTIONS THE PERMIT HOLDER AND/OR PROPERTY OWNER IS RESPONSIBLE FOR ENSURING THAT ALL REQUI RED/APPLICABLE INSPECTIONS ARE SCHEDULED AND THAT THE PERMIT IS COMPLETE REQUIRED INSPECTIONS Name Description Final Inspection Completion of all required items under the permit including the site grading and the surveyor's final grading certificate. Certificate of Occupancy Completion of ALL Work,All fees Paid and Final Survey in if required) STATE WIDE INSPECTION SERVICES, INC. 0•0 • • SWIS . : APPLICATION tel 845.202.7224 1 fax 914.219.1062 1 SWISNYcoml SWISTRAINING.COM Office Use Elect. Permit# Date 10/29/25 Bldg Permit# RB-25-0061 Sq Ft Plumbing Permit# Final Certificate# City/Village Rye Brook Zip 10573 Building Dept. Rye Brook County Westchester Address 6 Eagles Bluff Cross street Section 135.27 Block 1 Lot 51 Owner Name/Address(If different than above) David Brauntuch Contact Number ❑Basement ❑1st A. ❑2nd FI. ❑3rd FI. ❑More Than 3 FI. ❑Garage ❑Attic ❑Outside ❑✓ Residential [:]Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C/0 Detector Hood Trash Compact Amt Amps Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer Switch SERVICE Amperage #Panels IP I 3P #Meters # Disconnect ❑Underground ❑ New ❑ Reconnect ❑Repair ❑Overhead ❑ Upgrade ❑ Disconnect Utility ID# ❑Con Ed ❑NYSEG ❑Central Hudson ❑Orange/Rockland PHOTOVOLTAIC SYSTEM PV Modules Inverters AC Disconnect Junction Box Combiner Box Load Center PV Monitor Energy Storage System DC Disconnect ❑Legalization ❑ Safety Inspection ❑Consultation Scope of Work Wiring for outlets, lights, heaters, for backyard pergola project This application is valid for one(1)year from the date received by SWIS.This application is intended to cover the above listed items to be inspected,if at any time of inspection additional items have been installed,you are authorized to make the inspection and adjust the fee for the additional items inspected.The applicant declares that there is no open applications for the above address with any other inspection company.The applicant,owner or authorized agent agrees to all the above terms and conditions as set forth for the application. Email Address Office@Zaccagnino.net Name Angelo Zaccagnino License# 755 Date 10/29/25 Signature Address 81 Maple Ave City/State Rye NY Zip&de 10580 Company Zaccagnino Electric I Phone# 914-921-3244 DoomW ON la; ID.E27SED"2527-097-9F92-71_'I• �- •9 NNst.•A A. sl�s.y,.F Lark IF w sock '9' .s snow, Svwys.14rch ♦2OU $PINELLI — 4•w•rw,. Nr 1 w'YI•r.to—".p.S..tb.... e. _ m., JIM�•1-rnI ".w ar•w".nn 7.eo2e pleadMi.ww16✓wy.pcon Tom of w tlK Vtl•G. C wl'.Dunk SURVEYING FTIfIM Ao low...Map. u l W. , b�`t» a�••"�•• a ren M_ .,Ii.wMn,so tau N U.7'Stl'JB W 100.00' t• Is p g O O 1 g la--— � f I ! I • 15.3' PROPOSED PERGOLA OVER I b EXISTING RAISED PATIO i* • I I I 1 2 1/2 llay I • rr.e.•.ssM I •-•-•� AC- I N• s I I lay I s n N N N O N Yr f S U 'SB'Stl' L 100.00' EAGLES BLUFF fyn.r•1 npt.Y iSswtlu,e shu..w M V G19•Y - D { wy rwe. uvutw. .n.o, .ntr.rtor .. to I*" on,old..c 4 y �l —_ dl.s "cwl.to.s Cft4 WQ.w. grc—s wuntramirs.ow -v—,rx t.on " rwt.wMp or lu(.tb. w RWhord J TOWNIFIRL L.S. NIS I k 50975 a.stwp..tsitws .rpt.A Pr to ce..u•,•w.st •I . I. sW t. trr r.tlpvlN.uty nr tnr rawtru tsr -A.y O•ws•I M Wltwr•n. W.n•vv uu t.s -Ur.ylnOrTiM Otldtlen■ to o< o!sratwn■ o' this *A-" tt. ss— OFth. strut . t.s. po' 4 o MoMt�on of ,srl wr 7M9 of th. Is f S �,�F Nf� "Poir4 /r.ptsr.s,'w ka"r by tw•r.wtrsrt.s- .t Eeucollon Lo. r ti coin..p.n•. ��� Notts 1 THIS PLAT WAS PREPARED WTHOUT 2. THIS PI AT IS RASH) ON A CURRFNT BFNFFII O1 A 11Tt.N REPORT AND FIELD SURVEY AND RESEARCII THFREFORF DOES NOT NECESSARILY PLRFORMLD ON OR PRIOR TO TNF 4 INDICATE ALL ENCUMBRANCES UPON LIAR SHOWN ON PLAI AND IS BASED f *975 a" ML PROPERTY. AND THIS IS SURAC' ON MONUMENTS AND FVIDFNCF FOUND TO ALL RESERVATIONS. RESTRICTIONS. IN P4E FIELD AND MAY NOT CONFORM LAND EASFMFNTS AND A(MIMFNTS OF TO DEEDS, D[SCRWTIONS OR PLATS RECORD TO THE FXTENT THAT TVWY OF RECORD LAWFULLY AMPLY TO THE PROPERTY 3. PROPERTY LORNER MONUMENTS WERE NOT SET DURING TNIS SINEWY Do iSign Envelope ID'.E276ED44-26274F97-9F92-23C0190129AC 650 Halstead Avenue Survey of Lot 11 n Block 'B' as shorn Surveyed,Morch 4,2022 SPINELLI Monaroneck NY 10543 on•Subdivision Hop,Section No.2, w.r»r (914) 381-23yj Meade—t—W in the Village of Rye Brook Map Drarn March 7,2022 rer.SpineluSurveying.con Torn of Rye,Westchester County,NY. Updated De—ber 14,2023 SURVEYING SCALE 1'-20' 'NEAOOWLARK' Filed June IL 1958 as Map No.11511. Q � Meodoriark Sectlon I R.O. 10613 N u s H c N 03'58'38" W 100.00' '4 3 N e � o 0 0 • Ian o I •- f 1 8 Lot 11 S 15000.0 Sq.Feet rc ° • o I � � • Flagetane Roof�l'er Flog.Path Patti Patio 1 a N 1ss is • i 2 1/2 story • Frame D-11Mq �'•-•I/ AC Na B 2.0' a s 24.8' Roof Over Porch 15.4' Conc. at W 3 N N N N O 10 D 10 V) Z R S 03'58'38" E 100.00, Asphalt Cur^ EAGLES BLUFF General Notes -Elvvatk s shorn in NAVD1988 --- -Doly vlsdNe utilities shorn C" 4 -Contractor Is to visit site and verify )♦ all existing conditions Oncludlog undergrountl utilities, pipes,etc) Richard J, i. L.S. NY$ LIc. 50975 -Verification and field narking of location of existing utlUtles is required prior to ct—encnent of rock and Is the responsYlAlty of the contractor -Any tlnnage of disturbance to existing utilities -UnauthorlZed additions to or alterations of this durng the ducat. of the to is to be plan Is o violation of Section 7209 of the N.Y.S. �pF NE w repaired"eplaced 'in kind' by the contractor at Educotion Low. P� yQ his own expense �l vo J.SP, Q NOTES: 1. THIS PLAT WAS PREPARED WITHOUT 2. THIS PLAT IS BASED ON A CURRENT BENEFIT OF A TITLE REPORT AND FIELD SURVEY AND RESEARCH THEREFORE DOES NOT NECESSARILY PERFORMED ON OR PRIOR TO THE INDICATE ALL ENCUMBRANCES UPON DATE SHOWN ON PLAT AND IS BASED 975 O THE PROPERTY, AND THIS IS SUBJECT ON MONUMENTS AND EVIDENCE FOUND `�` B TO ALL RESERVATIONS, RESTRICTIONS, IN THE FIELD AND MAY NOT CONFORM LAND EASEMENTS AND AGREEMENTS OF TO DEEDS, DESCRIPTIONS OR PLATS RECORD TO THE EXTENT THAT THEY OF RECORD. LAWFULLY APPLY TO THE PROPERTY. 3. 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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(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER cgtrCT Ada Ramos Phoenix Insurance Group,Inc. ac°,NN,Ext: 908 879-3574 j i�,Ne: 205 Main Street Chester,NJ 07930 Miss:aramolillfthAns.not INSURERS)AFFORDING COVERAGE NAIL i INSURER A:Selective Insurance Company of America 12572 INSURED INSURERS: Deck Remodelers.com LLC INSURERC: 2 Wilson Dr INSURERD: Sparta,NJ 07871 _- - 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. INSR TYPE OF INSURANCEADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMBS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1,000,000 CLAIMS MADE OCCUR S 2222060 8/10/2025 8/10/2028 DAMAGE I. TO RENTED 500,000 MED EXP oneperson) 15,000 PERSONAL S ADV INJURY 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 3,000,000 POLICY ipr LOC PRODUCTS-COMP/OP AGG 3,000,000 OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,0001--- X ANY AUTO S 2222060 8/10/2025 8/10/2026 BODILY INJURY Perperson) OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident AUTOS ONLY AUTOS ONLYY ;t�08E AMAGE A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE E _ 2'000'000 EXCESS LIAR CLAIMS-MADE S 2222060 8/10/2025 8/10/2028 AGGREGATE $ 2,000,000 DIED .RETENTIONS WORKERS COMPENSATION PER OR- AND EMPLOYERS'LIABILITY Y I N ANY PROPREIIETOEERIPARTNER/EXECUTIVE E.L.EACH ACCIDENT OFandatoryinNHjCLUDED? a NIA l� E.L.DISEASE-EA EMPLOYEE If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMB DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101.Additional Remarks Schedule,may be attached if more space is required) 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 9 y ACCORDANCE WITH THE POLICY PROVISIONS. 938 King St Rye Brook,NY 10573 AUTHORIZED REPRESENTATIVE i ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD vYORK workers' CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1 a.Legal Name&Address of Insured(use street address only) 1 b. Business Telephone Number of Insured Deck Remodelers.Com LLC (973)729-2125 2 Wilson Drive Sparta, NJ 07871 1c. NYS Unemployment Insurance Employer Registration Number of Insured Work Location of Insured(Only required if coverage is specifically limited to 1 d. Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i e. a Wrap-Up Policy) Number 27-0778710 2. Name and Address of Entity Requesting Proof of Coverage 3a. Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Insurance Company of the West 3b. Policy Number of Entity Listed in Box"l a" Village of Rye Brook 938 King St WNJ 5063768 03 Rye Brook, NY 10573 3c.Policy effective period 01/01/2025 to 01/01/2026 3d,The Proprietor, Partners or Executive Officers are © included.(Only check box f all partnersiofficers included) ❑ all excluded or certain partners/offlcers excluded. This certifies that the insurance carrier indicated above in box"3" 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 Workers'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 Gregory Yost (Print name of authorized representative or licensed agent of insurance carrier) Approved by: qwww 2"t 10/10/2025 (Signature) (Date) Title: Head of Operations New Jersey Region Telephone Number of authorized representative or licensed agent of insurance carrier:973-227-0025 Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insurance brokers are NOT authorized to issue it. C-105.2 (9-17) www.wcb.ny.gov W31 F3117 Tara Orlando From: UDig NY Exactix <tickets@exactix udigny.org> Sent: Wednesday,December 3,2025 7:57 AINI To: Steven Fews Subject: :Message from UDig NY ****REGULAR**** DIG REQUEST from UDig NY for.VIL RYE BROOK Taken: 12/03/2025 07:57 To:VIL RYE BROOK PRIMARY Transmitted: 12/03/2025 07:57 00002 Ticket: 12035-000-159-00 Type:Regular Previous Ticket: ----------------------------------------------------------------- State:NY County:WESTCHESTER Place:PORT CHESTER Addr. From:6 To: Name: EAGLES BLF Cross:From: To: Name: Offset: Locate:REAR OF PROPERTY NearSt.MEADOWLARK RD Means of Excavation: HAND TOOLS Blasting:N Site marked with white: N Boring/Directional Drilling: N Within 25ft of Edge of Road:N Work Type:PERGOLA Estimated Work Complete Date: 12/17/2025 Depth of excavation:4 FEET Site dimensions: Length 18 FEET Width 20 FEET Start Date and Time: 12/17/2025 08:00 Must Start By:01/02/2026 Contact Name:DEE MATHEIX'S Company:DECK REMODELERS,SPARTA Addrl:2 WI SON DRIVE Addr2:STET City:SPARTA State:NJ 'Lip:07871 Phone:973-729-2125 Fax: Email: coordinator.production@deckremodelers.com Field Contact: DEE MATHEWS Alt Phone:862-293-0020 Email:coordinator.production@deckremo Working for.DAVID BRAUNTUCH Comments:Lookup Type:PARCEL ------------------------------------------------------------------------- Members:ALTICE USA CON-ED SUEZ WTR WESTCHESTER TEN GAS-HDS VLY VIL RYE BROOK WESTCHESTER CTY SWR 1