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F- (L%j J Ujj O a Ln .o m c aCdc�2� LLI } + Q C W Q Q Q Z m ~ 'a u N E a Q a a = vai v ° Fence/Wall/Gate 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 Occupancy/Use: SBL: Zone: One Family Proposed Fence/Wall/Gate: If building is located on a corner lot,which street does it front Split Rail Fence with Wire Mess at the back of the property,as on? in photo Heritage CT What is the estimated cost of construction? (NOTE: The estimated cost of construction shall include all site $2500 improvements, labor, material, scaffolding,fixed equipment, professional fees, and material and labor which may be donated gratis.) Estimate date of completion 09/30/2025 FencelwalUGate Permit Application,page 1/1 O4�y [lPR VILLAGE OF RYE BROOK ■ . 938 King St Rye Brook,NY 10573AE W Q Phone:(914)939-06681 www.ryebrGok.gov Building Department Residential/(Fence/Wall/Gate) Permit Permit Set 5 HERITAGE CT P#RB 25-0057 R#124.65-1-19 PERMIT INFORMATION Address Permit number Date issued 5 HERITAGE CT RB 25-0057 12/01/2025 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 Building Inspector Stamped&Signed Set of Plans 4 Application Materials 5 Application Materials 6 Application Materials 7 Application Materials 8 Westchester Home Improvement License 9 Contractor's Liability Insurance,Contractor's Workers Compensation Insurance(Showing Rye Brook 10-13 Cert Holder Application Materials 14 Photograph 15 Application Materials 16 Fence/Wall/Gate Permit Application 17 Building Department.938 King St Rye Brook,NY 10573/Phone:(914)939-0668 BR�� VILLAGE OF RYE BROOK 938 King St Rye Brook,NY 10573 W � Q Phone:(914)939-0668 1 www.ryebrook.gov �• b2 •`� Building Department INSTRUCTIONS THE PERM IT HOLDER AND/OR PROPERTY OWNER IS RESPONSIBLE FOR ENSURING THAT ALL REQU IRED/APPLICABLE INSPECTIONS ARE SCHEDULED AND THAT THE PERMIT IS COMPLETE E FL 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) Aamrowner'r Assousr on.Inc. s=+- Box:d o/Duscfors :4 Bt Ui Fw Bfrd.R r r Braok.:Y S 10i' BetleFair ARB 24 Bellefair Blvd Rye Brook, New York 10573 Ajai Venkatapur 5 Heritage Court Rye Brook, New York 10573 Re: Split Rail Fence Installation Dear Mr. Venkatapur, We write in response to your request to the ARB for approval to install a split rail fence at the rear of your property located at 5 Heritage Court, Rye Brook, New York. We are pleased to inform you that, based on the details of your application, your request has been approved. The split rail fence must be installed at least two feet from any property line. Once the work is complete, please contact our FirstService representative, Rafael Reyes, so that a final inspection may take place. Please be advised that our approval will be expressly conditioned upon your continued compliance with Schedule D of the Declaration. Accordingly, if the aforementioned fails at any time to comply with the Regulations, the ARB reserves the right to direct modification or the removal of the improvements at your sole expense to ensure compliance. Please note that approvals are valid for one year as of the date of this letter. As a reminder, certain alterations will require the approval from the Village of Rye Brook. Sincerely, BetleFair ARB x�,�� �, \ �1��A ��. � t /' . �`�� '�+4� 54���1°%�`� I t h `` r ��, +� �t •r ai<1 µ, 1�r ..._M+� ` � .it„i�!}� ��•_.,�I7•'1�j.,�r. v�'{`i.��`:.�,"�h :�-�, `$mod �1 ^'1•1 t ¢ ,. > �:_•- If-1. ✓ ""1 �p ✓� JF � .�. I. `,,�f"�+,\.:l L .•i�,�A�•�'���� f .fit\ s I �!h� C`4 1/\. i�� ��4 t Sal� Y`' '^ � ��'{ � A�" .� ,X"" �����..�� '� \ Y /�• V ^ 1/ �f. lY..� ACT, ,.P.''p•� L g rr � 1�..�}. "-4`�� L �(� t i•1. TT! fi ✓' �sc, � ✓Y' � 1.;''. 't' r .�'- i`�„ e r ; fi r"'- t�!4lff� ' ,Yr ��' 1 -:�_ :, 7�•". s'` df S„1/ •� •.. 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E l r��Zz A 0 J cp 04 Lu 00 cj C) C� .4L 1 �;; C2 gction > z 0 c4) LLJ —3 0 W < L) U UJ LLJ Ln q) LL 0 LL. 0 LLI LLJ F 0 00 z L W E dj 0 V1. 'j co CR3 cV 04 ej 0 'pk :3 'u 0 460 0 CA cn lb of, w-, W17 411M, Ml #02 aim' '`': VWW Aco® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 11121/2025 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 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: _ Arthur J.Gallagher Risk Management Services, LLC PHONE 518-793-3131 Fax 33 Park St#2 IaC,Nor. PO Box 4630 ADDRIESS: Glens Falls NY 12801 INSURERS AFFORDING COVERAGE NAILS License#:OD69293 INSURER A:Selective Insurance Company of SE 39926 INSURED MIKEFEN-01 INSURER B:Property and Casualty Ins Co of Hartford 34690 Mike Fence Corp. PO Box 391 INSURER C:ShelterPOint Life Insurance Com an 81434 New Rochelle NY 10801 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1318141882 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. I TYPE OF INSURANCE ADDVSUBR POLICY EFF POLICY EXP LTR LIMITS LTR POLICY NUMBER MMlDD MMIDD A X COMM ERCIAL GENERAL LIABILITY S 2636741 2/1/2025 2/1/2026 EACH OCCURRENCE $1,000,000 DAMAGE TO D CLAIMS-MADE X� OCCUR PREMISES EaENT occu ence $500,000 MED EXP(Any one person) $15,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 POLICY PRO ❑ JECT LOC PRODUCTS-COMP/OP AGG $3,000,000 X OTHER $ A AUTOMOBILE LIABILITY S 2636741 2/1/2025 2/1/2026 COMBINED SINGLE LIMIT $500,000 Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED X SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ X HIRED X NON-OWNED PROPERTYDAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ �. UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION 01WECAD2LZG 4/23/2025 4/23/2026 X STATUTE OERTH AND EMPLOYERS'LIABILITY Y I N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $100,000 OFFICERIMEMBEREXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $100,000 If es,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 C DBL-D463691 11112025 1/1/2026 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) Certificate Holder is an Additional Insured as respects to the general liability policy,pursuant to and subject to the policy's terms,definitions,conditions and exclusions. Ajai Venkatapur 5 Heritage Court Rye Brook,NY 10573 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Village of Rye Brook 938 King Street Rye Brook NY 10573 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD PORK Workers' CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured Mike Fence Corp. 914-636.8031 PO Box 391 New Rochelle, NY 10801 1 c.NYS Unemployment Insurance Employer Registration Number of Insured Work Location of Insured(Only required if coverage is specifically limited to 1d.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-Up Policy) Number 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Property and Casualty Ins Co of Hartford Village of Rye Brook 938 King Street 3b.Policy Number of Entity Listed in Box"l a" Rye Brook, NY 10573 01WECAD2LZG 3c.Policy effective period 04/23/2025 to 04/23/2026 3d.The Proprietor,Partners or Executive Officers are ❑ included.(Only check box if all partners/officers included) ❑ all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box"1 a"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: Arthur J.Gallagher Risk Management Services,LLC (Print name of authorized representative or licensed agent of insurance carrier) Approved by: Gino Bonacci 11/21/2025 (Signature) (Date) National Client Service Leader,Personal Lines Title: Telephone Number of authorized representative or licensed agent of insurance carrier: 518-793-3131 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 UN"3mUM:AUnylwwn5(ppjUf N >ZSLL-6i94116) 99wK0j;qmN aawl1 awl WA+aN S"17aWB'M*g#II L0901.l.V sumId 1»I�+tl I i S Dal Jo Y -ON atP�1 Z y * a""bofl f.020.PAWUM wnmplw_�q-w a 3pm J d SU I/�nJn S PUln 11 wwn S an&p.g q a grgft no(UM mo p■dmu qM a4 44M a�qgJ O y y i H ?j s w ad De 4j OW 4 Z myr , Oip r' y 3 IS 80r 3HJ A0 o � IdIN 391 - ';�MSNV OIA Addy A( AS F ' LAJ oh 5 O t.., — - 7 O^' Ln Q inn 10 t0 / �J, S A x ,C to W • kVM3ae YVVQV IdYI rc $ v M ..vows. 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