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HomeMy WebLinkAboutDP25-004PERMR # /.J SECTION TYPE OF WORK 10B LOCATION OWNS CONTRACTOR EST. COST TCO � FEE DATE , FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING 0 RGH PLUMB VNG GAS r SPRINKLER ELECTRIC Low -VOLT ALARM AS BUILT FINAL L DATE INSP yc�7 C1 OTHER APPROVALS rirvA! �N�rtL t gun 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 January 20,2026 Greg Mann&Lauren Mann 57 Country Ridge Drive Rye Brook,New York 10573 Re: 57 Country Ridge Drive,Rye Brook,New York 10573 Parcel ID#: 129.59-1-9 Demolition Permit#25-004 issued on 3/7/2025 to Demolish In-Ground Swimming Pool&Patio This certifies that the in-ground swimming pool and patio,demolished under the above captioned permit has been satisfactorily completed. Sincerely, *;- 4 Steven E. Fews Building&Fire Inspector /to BUILDr- E MENT For office use only: PERMIT#�_CXC,14 IL ROOK ISSUED:938 KING STRE ,NF}�'YORK10573 DA�TF: 1 ZDEC 0 y 2Q�� ]� 8 FELL j •�)��PAm w4,ryebrookny.20V 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 ++++s+s+ss***�***ssssssss+*ss++*+ssss+ss+s++++++++*+s++*s+s*++*ss++***s+*+*+s++*sssss+sssss+**•+*.*++s+*s**+*+++ss+ss++ssssss Address: S? 60vti,dvq QY1� 1`�k �Y , 100 - Occupancy/Use: Parcel ID#: 0Q S-w —000sq o4 --001-000 Oo Zone: 9l�—_ Owner: L,(►yAA amn Address: 6-? Low►M I ^[�T,/�0�7,P.E.lR.A. or Contractor:�(�fe�1 S}+a( Q�/V� gpYK,�YIt' Address: 7 �gdbh , Sy 0�r c r J I Person in responsible charge:Agw qV A01a PC6 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: o �� 4illq U M Arl h being duly swom,deposes and says that he/she resides at C— VA Name of Vr i V cant) �/ (No and Street � in o ,in the County of 1 CA 51 1 y in the State of f_,that City/Town/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 a uipment,professional fees,and including the monetary value of any materials and labor which may have been donated gratis was:$ for the construction or alteration of: otmw OJAk W f OO 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 structureiwork 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 3 Sworn to before me this /3 day of , 20� day of Q , 20 Signature of Property Owner S nature of Applicant LavYi� I�IA�►n 40ln0�td MCAnA Print Name of Property Owner Print Name of Applivant Nota Pub is t ary T PHEN B. MANN ` — ROSELYNNE D MIZNER 14OWY Public,State of New York Notary Public-State of New Yolk rIO.30-���7)I s� 6/1/202-i No.0IM15003432 Qualified in New York County Qualified in Nassau County My Commission Expires 03/07/2027 Cbmmiuim Expires April 30,20 JG.s— yE �k�� O 2m Q � O` ❑BUILDING INSPECTOR BUILDING DEPARTMENT ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 KING STREET . RYE BitooK, NY 10573 (914) 939-0668 FAx (914) 939-5801 www-rj: b_roo_ k.or� - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : DATE:_ �G_J � ZOZ J/ ---� V -�- PERMIT# V! 2S �- QQ y ISSUED: -7-2r ' -- - SEc 7 �1..5 9 BLocK:_�LOT: LOCATION: OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ACCEPTED ❑ REIE(:TED/ REINSPECTION ❑ SITE INSPECTION ❑ FOOTING REQUIRED ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION \ ❑ NATURAL GAS L. ❑ L.P.GAS _ E� ❑ FUEL TANK / ❑ FIRE SPRINKLER , ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ,0-OTHER Z�o, rG• (�O E akn�k. O Q � O BUILDING DEPARTMENT ❑BUILDING,INSPECTOR dO0B ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOD ❑CODE ENFORCEMENT OFFICER 938 DING STREET • RYE BROOK, NY 10573 (914) 939-0668 FAx (914) 939-5801 ���lww ryebroc►k.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - _ _ ADDRESS : s-�Cdti--- _� l PERMIT# W 1 S- o 3`p -� ---- - ___ ISSUL'D: _ SECT: BLOCK:BLOCK: � LOT: LOCATION: 4� OCCUPANCY: ❑ VIOLATION NOTIi ) 'FHE WORK IS... ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION ❑ FOOTING REQUIRED ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ I-P. GAS _ i ❑ FUEL TANK u-C ❑ FIRE SPRINKLER Z FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER y- a �tf �' —•yt.. AW :tom AW lr - .�� i\L aim at 1 yf(:�.' '!��,• \ 14 ', • �E aRnuk BUILDING DEPARTMENT ❑B ILDING INSPECTOR ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAX (914) 939-5801 www ryebrook.org - - - - - -- - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS: c ` . _ L(v__ �I �_M�-� _DATE' 4 Z(a _OZ.I ---- PERMIT# ISSUED: SECT: BLOCK: LOT: LOCATION: OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ,ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION 41,7f ILO REQUIRED ❑ FOOTING / ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION f /� ❑ NATURAL GAS �- ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER C� e L L 1 „v [IFINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL O THERE •, ��*K.,' �Yw+. ..:ter 4 � ..� .1, 'r f 1._ :�'• }: \ _ � - � MM r--tit .._. � _ _ - ..•"„f ram• Iv •_A� 'C � ^� r a N• Pry �,;,�,•, _ � �r'ay�`R �. ....- r � y•, ,, � • '� � 'tip 1.'�` •. - •-. t. \ .'✓ ♦.ate �, .�, '.T.. •� :;,. c'fY►yti,. f �! � I 'y i� �•It. 1. {� .:� �. `.. •`� , '` -. ter � ..�� '�"; - M�"' """"''!�++.•i_ u 14 10 IV AA - - - -41# , ; �/!'•r _ _ •;rod *' ♦ .may ..] .>>�V.. 7 ♦ �v'ti�y, � � , r�t.•'0 a ti• � � x J �.!. tic ^�..:.+ 1 � ♦ i �yE BRC)o 1932 BUILDING DEPARTMENT ❑$UILDING INSPECTOR ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www.ryebrook.org - - - - - - - - - - - -- - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : Lc��U r�1�� vt 1� i c�crc_. ►-�� dti DATE: PERMIT# Z' S - C),nV ISSUED: -Z SECT: . :� BLOCK: LOT: LOCATION: ,`_ \ r, G OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... [r ,ACCEPTED ❑ REJECTED/ REINSPECTION Ja` SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS - ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL OTHER i = y i a 0 W 0 od v � i Q ca o W = un � � a 10 m -o 'two o w W a � � y x > 0. CPA 't u ° cn 41 �''� + ICI ✓ W '�j z d Q W'zp o o v •6 _ 00 W i Q bD � v z + ac, : cy w ay+ Cc U � c'a-d � �" U qq > Q C� F p a4O 'a � � Z W E+ z E @ Io aILM V U zC, C7 A O am v o � LuZ W Ei OC J � Q V ZLU Y _ .. ►� C.^ e4v a BUILD DEPARTMENT VIL E OF RY OOK FEB 2 0 2025 938 KING ET RYE BR NY 10573 `'.'Ai, 0 VILLAGE OF RYE BROOK `,�, -% ov BUILDING DEPARTMENT DEMOLITION PERMIT APPLICATION FOR OFFICE USE ONLY:. b�C)6--00 / Approval Date: MAR 2 er ' 6: Application Fee:$,r/ lJ/0 Approval Signature: Permit Fees:$ / Sl1 - Disapproved: Other: _ Application dated: is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the interior alteration of an existing building,or for a change in use,as per detailed statement described below. 1. Job Address: �` C-004AY R(W Pff VC /0�? BL: hl, 'r" Zone: 2. Proposed Demolition.(Describe in detail): R6AIVkAL, QE I Al—C-10 Poet' + t Ot%/-P P-1►1 (>b'(S Av o—E s- C\ 3. Property Owner: �r[�✓/�GNl /V // pp Address: 7 G?U�ITRY RIQb� �R�✓C lRyr B"K/ Phone#. (��_� _ �02) Cell# r6('7�f'9di7 email: L r''KS LJM1�-'4. CAU Applicant:' /REEA(9%e, WV6,q(460 lq JJ M Afl Address: ? Phone# 51�v 866 i Cell# 5APCOL�66( email: &Vj6/yf j1A 196-& 1 Architect/Engineer: Address: Phone# Cell# email: General Contractor:&RC moL W M r dress: ? FATS R s Ya 1 `y I r? 1 Phone#�(6 " OL 96 Cell#51 'r{a L"19 66 ( email:RoNMfYNN /I 04R 4. Estimated cost of construction $1P � (NOTE:The estimated cost shall include all labor,material,scatl'olding,tined equipment,professional fees,and material and labor which may be donated gratis.) 5. Type of construction:(wood frame,masonry,steel,etc...) GdNGRT� 6. Method(s)of Demolition: C X CA SAT(CrLl 7. Number&Location of Fuel Oil Tanks to be Removed: IJyIv 8. Number of Stories: Height to Highest Ridge: To Highest Chimney: 9. Estimated date of completion: t 6/1/2424 This application must be properly completed in its entirety and must include the notarized signature(s) of the legal owner(s) of the subject property, and the applicant of record in the spaces provided. Any application not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. Please note that application fees are non-refundable. STAT�OFNEW YOR���TY OF WESTCHESTER ) as: N ,being duly sworn,deposes and states that he/ is the applicant above named, (print name of individual signing as the applicant) and further states that (s)he is the legal owner of the property to which this application pertains, or that (s)he is the evid&� d,4¢� for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,attorney,etc.) That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to before me this /© Sworn to before me this ! day of6'l3/Q✓ , 20 day of E$l4 , 20 Signature of Property Owner Silriature o Applicant i_frk/�Cb/ MAW AvAAP IM-041AF3;- Print Name of Property Owner Ppnt„jd f p �A1P1V&r otaryPublic N Publ' Li'l tLi's 15. &iA1NN Notary Public, State of New York r,iLN B. Ibi.�,QI No.30-4757153 Public, State of New �'Qrk Qllilifi�d to NasSan County No.304757153 Commission Expires Apri130,20 Qualified in Nassau County. 1,Gsion Expires April30,20 2 6tno2a N N I 00 W a U ti v cn Ln Ln 43 00 ON F ' L w "a Z = p � � ozMCwIt z z z i� 1� Lin P. K' U 7 V Q Y a w •-' •H- W , O Ili �. z 2x VU p W z o 6 + Le) c� a) 1 z A w = � . BUIL �y�~B v� MENT R IE C E V �� OF RYE OK VIL I � E 938 Krry ] DD l RYE BIAS ,NY 10573 � MAR - 5 2025 2_� VILLAGE OF RYE BROOK n BUILDING DEPARTMENT ELECTRICAL PERMIT APPLICATIO Westchester County Master Electricians License Required FOR OFFICE USE ONL1 _MWOOL `-^` / EP 4: � MAR Approval Date: Permit Fee: $ Approval Signature: Other: DO NO I STAR'I'WORK or CONSTRUCT ION UNTIL A 14 li"�i 1 i i 1 S BEEN ISti14FD BY THE BUILDING INSPECTOR. THE ADMINISTRATIVE FEE FOR WORK PROGRESSI-)OR COMPLETED WITHOUT A PERMIT IS 12%OF THE TOTAL COST OF CONSTHUCT'ION WITH A MINIMUM.FEE OF S750.00 Application dated,f/el%.t`202 S is hereby trade to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install and/or remove electrical equipment, wiring, fixtures,or to perform other high or low voltage electrical work as per the detailed statement described below. By signing this document, the applicant & property owner agree that all electrical work performed will be in conformance with all applicable Federal,State,County and Local Codes. 1.Address: 5 7 C 0 ✓r k!2i P-i d 5 e l t ✓ SBL: /of/i 5 —/—9 Zone: 2.Property Owner:_ 6i✓e5 A elAddress: /'fS A'By✓L Phone#: S16 y-S7 8-118 it;o email: lem4 &9(9 !?mAi/. C a M 3.Master Electrician/Licensed Installer: S t NM o n1 L y c A-S Address: /a 441 J FL C u,2 T i►,+rzarvr Svc Lie.#: 199 Phone#: t� 26 6 O0 S7 Cell#: G/ SSZ �8(iFZ email: -r1n+a rt L-CG J e 1i2 C Wtc - y Company Name: L✓c_,-�S Ee.Ec—T(tt C Address: /O Kull Cc C0-/Z7_ _ 1KA11'r,1o/y6cK 4.Proposed Electrical Work/Fixture Count: Re k-�'G ✓e A f— 4-1( 2.N Cy 0 L y w 6r PC)L✓L-2 To (Poo t, � Gt✓ (t'MEN 5.Yd Party Electrical Inspection Agency: ✓j I s ee*ie is�r ir:k ie Y knF it ar it*ie it it ir:F Fxie ie:F:F 4e ie icxix irxic is is�c it ie is ix xic is is ir:e ie ix it ie:c is is it is ix ix is ie is it ie ie is is ie ie*ix is F it ie ie is ix is is ie iex isx*ix is�c is it is ix is is icxic ix is is is is is it S7 A E OF NEW YORK,COUNTY OF WES'TCHESTER ) as: .being duly swom,deposes and states that he/she is the applicant above named,and does further (print name of individual signing as the applicant) state that(s)he is the for the legal owner and is duly authorized to make and file this application. (Master Electrician'Licensed Installer) The undersigned further states 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 Sworn to before mq this day of .20 day of 6 (-Clr, ,20_a Signature of Property Owner Siia- fA;pl t �` I V Print Name of Property Owner sAdRi MJ4Wpof Applicant Notary PA st ypgt'(� N - "r. Notary Public Qualifled 4�"-wWW - ou►+ty Commission Expires January 29,20.L / 6/1/2024 STATE WIDE INSPECTION SERVICES, INC. %,-040 Service With InregritY 080 . • swis JOB APPLICATION0. • Office Use Elect. Permit # Z'r-1 � 0& y Date Bld9'Flel 1 t go /�O�`� l/LJ Cf Sci Ft Plumbing Permit u Final Certificate x City/Village 12 �j iZ C)U ✓— Zip /0 S7 3 TBuilding Dept. oCyC 9Q L747 K County kVf f c HeJ%fiZ Address S7 (O u N 1 TZ-1 P f DG—t ��v Cross Street Section Block Lot Owner Name} ress;if aif i-reni than �RE(� /1/I/1 V/✓ Contact Number--r/ ❑Basement ❑Ist Fl. ❑2nd Fl. ❑3rd FL ❑More Than 3 FL ❑Garage ❑Attic Q•Outsrde 0451dentral ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmei s Smoke Alarms C/O Detector Hood Trash Compact Amt Amps Range(s) Cocktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer Snatch SERVICE Amperage #Panels IP I 3P I Meters a 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 1 F /Vi v ✓ ff c L 1,✓t R 1 IV vT .f(, L, /W G Pc)G-, !=2 %o 1>06 c"OIJ IP/Vl k—N T R[�GcL�OMC� MAR -5 2015 VILLAGE OF RYE BROOK BUILDING DEPARTMENT his applica!ion is valid for one I year from the date received by SVAS.ibis application h intended to cover the above listed items to be inspected,if at any time of inspection additional items have been mstalkd,you are authorized to make the inspection and adjust the fee for the additional items Inspected the applicant dectares"there is no open applications for the above address with any other inspecton company.the applicant,owner or authorized agent agrees to all the above terms andconditions as set forth for the application. Email Address S l tryt0 n I U S Name //j'!p H G(i License # q- 3 Date Signature Address 10 jo(hs1It l ( O✓ (Z ; City/State,y yMAQC),vC[J-r Aj y Zip Code 3 Company LV CrA j il�llk 1 17-k L Phone a 266 60Y DState Wide Inspection Services 1080 Main Street MAR 2 0 2025 Fishkill, NY 12524 To�U A l—_ 845 202-7224 Phone VILLAGE OF RYE BROOK 914-219-1062 Fax STATE WIDE INSPECTION SERVICES BUII._DING DEPARTMENT Email: office swisny.com Website: www.swisny.com Service With Integrity BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: Lucas Electric Company Greg Mann & Lauren Mann Simon Lucas 57 Country Ridge Drive 10 Kassel Court Rye Brook, NY 10573 Mamaroneck, NY 10543 Located at: 57 Country Ridge Drive, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP25-064 129.59 1 9 Certificate Number: 2025-1577 Building Permit Number: DP25-004 A visual inspection of the electrical system was conducted at the Residential occupancy described below.The electrical system consisting of electrical devices and wiring is located in/on the premises at: 57 Country Ridge Drive, Rye Brook, NY 10573 The Exterior was inspected in accordance with the NYS and NFPA 70-2017 and the detail of the installation,as set forth below,was found to be in compliance on the 18th day of March 2025. Name Quantity Rating Circuit Type *All Pool equipment and associated wiring has been removed,terminated and disconnected. Officer: Frank J. Farina This certificate may not be altered in any way and is validated only by the presence of a seal at the location indicated.This certificate is valid for work performed on the date of inspection only. , a =' C N N W � M C a o T_ > CL CA CLW 0-4 W [.y Wr� let ►� a0 �"� - rz _ e �1 4i � � � Mom) �i � � �W ►' � W j _ ►r ON _ 00 O Au 7 ON (A > A v � a� � z z � 0-4 _ w CN4 o z2 O U OCLO z V N J aG 8 ►�+° mi A H a o , �I as a a A w x � Im BUILDING DEPARTMENTVILLAGE OF RYE BROOK 938 KING STREET RYE BROOK,NY 10573(914)939-0668 w v�w.ryebrookny.gov PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY .up-l#r PP#: CD6 J 0 Approval Date: 3\ Permit Fee: $ 22aZA� Approval Signature: Disapproved: (fees are non-refundable) DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDING INSPECTOR.THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12%OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00 Application dated, 3-//—� is hereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of a Permit to install and/or remove Plumbing as per detailed statement described below.The applicant&property owner,by signing this document agree that said plumbing work will be in conformance with all applicable Federal,State,County and Local Codes. �� �U�r�Ry - /�!✓f RYF�s7 `I 59- / q I.Address: i D SBL: 1 !_ Zone: 2.Proposed Work: 3.Property Owner: VAC-Al � Address: �7 �o�ivTi� �D6 F l= e0173 Phone#:5 (?�9�9pv� Cell#: y(D I-�g�_ O Z� email: L Of 4.Master Plumber: A p���- Address: d Lic.#: 1 I Phone#:�]_ O Cell#: C - <yD email: Company Name: �,�- Q( V,,,�/j�� Address: 6- b INDICATE FIXTURES& LINES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: Location Water Urinals Drinking Sinks Showers Bath Laundry Domestic Fire Sanitary Natural/ Other* Total Closets Fountains Tubs Tubs Service Service Sewer LP Gas Basement 1 st Floor 2nd Floor 31 Floor 41 Floor 5'h Floor Exterior 5.* List Other Equipment/Provide Details: C &o;:� l (Notarized Signatures Required Next 2 Pages) -1- 6/1/2024 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 Master Plumber for the legal owner and is duly authorized to make and file this application. 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 /11�1 Sworn to before me this ID day of 20 M day of � \ U ,20 ^1&_ Signature of Property Owner Si ature of A t cant ttf vkek 4*2w (�AQ\):91 Print Name of Property Owner Print Name of Applicant otary Vublic Notary PublicSHARI MEULLO Notary Public,State of New York No.01ME6160063 dU&Ilfisd In Westchester County tOMMIeil0n Expires January 29,20. 7 This application must be properly completed in its entirety and must include the notarized signature(s) of the legal owner(s)of the subject property, and the applicant of record in the spaces provided. Applications not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. STEPHEN B. MANN Notary Public, State of New York No. 30-4757153 fi,,d in Nassau Cotinty -2- 6/l/2024 BUILDING DEPARTMENT D E C IE V VILLAGE OF RYE BROOK MAR 1 1 2025 938 KING STREET RYE BROOK,NY 10573 (914) 39-0668 VILLAGE OF RYE BROOK ww� _91 ov BUILDING DEPART^✓i=N7 AFFIDAVIT OF COMPLIANCE VILLAGE CODE §216 - STORM SEWERS AND SANITARY SEWERS THIS AFFIDAVIT MUST BEAR THE NOTARIZED SIGNATURE OF THE LEGAL PROPERTY OWNER AND BE SUBMITTED ALONG WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION. ANY BUILDING OR PLUMBING PERMIT APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETURNED TO THE APPLICANT. STATE OF NEW YORK, COUNTY OF WESTCHESTER ) as: 31, LcAiai, MIJAil , residing at, S7 tovnnhf, Ate &Ayt IQy( 0IV.0 VY (Print name) (Address where yo ive) being duly sworn, deposes and states that(s)he is the applicant above named, and further states that(s)he is the legal owner of the property to which this Affidavit of Compliance pertains at; 97 CoUKy hlP[T(% D4J , Rye Brook,NY. (Job Address) Further that all statements contained herein are true, and that to the best of his/her knowledge and belief, that there are no known illegal cross-connections concerning either the storm sewer or sanitary sewer, and further that there are no roof drains, sump pumps, or other prohibited stormwater or groundwater connections or sources of inflow or infiltration of any kind into the sanitary sewer from the subject property in accordance with all State, County and Village Codes. (Signature of Property Owner(s)) L_kyRE�/ (Print Name of Property Owner(s)) Sworn to before me this day of �� (/ , 20 y� (Notary Publ ) STEPHEN B. MANN Notary Public, State of New York- No.304757153 Qualified in Nassau County Commission Expires Agri' 6/1/2024 June 24, 2025 D DD Steven E. Fews Building & Fire Inspector JUL - 7 2025 Village of Rye Brook 938 King Street VILLAGE OF RYE BROOK Rye Brook, NY 10573 BUILDING DEPARTMENT Alfredo DiVitto Assistant Building & Fire Inspector Village of Rye Brook 938 King Street Rye Brook, NY 10573 Re: Pool Fill for 57 Country Ridge Drive, Rye Brook, NY 10573 Dear Mr. Fews: We are the owners of the above property. Per the applicable permits, fill from the quarry operated by Thalle Industries, 50 Warehouse Ln S Elmsford, NY 10523, was used to close up and fill in the pool area at the property on or about June 24, 2025. We affirm that, to the best of our knowledge,the fill used to close the pool was not contaminated. Greg Mann Sworn to before me this 24th of Ju e, . 25 YNTROA R.BM Notary Public,State of New YA No.016Z6122395 Nalified in New York CouMY Commission fxiwes 02=2029 Lauren Mann Sworn to before me this 2-4th day of June, 2025 d(v�. �17 SHAWN R FOX Notary public.Stab of New York No.02FO6116924 Qualified in King County lay Commission Expires 0i=12029 Green Star Development Corp. Hon Mann Home building and remodeling 7 Eaton Road Li"m ned and In!:urvd Syo% et. NY11791 N-s!;!;:Su County LIC: H(344767( 000 (516) 902.8661 Suffolk County LIC: 50810-H ronmann11580gmail.com June 25,2025 R[EcE �w [ JUL - 7 2025 Steven E. Few s Building& Fire Inspector VILLAGE OF RYE BROOK Village of Rye Brook BUILDING DEPARTMENT 938 King Street Rye Brook,NY 10573 Alfredo DiVitto Assistant Building&Fire Inspector Village of Rye Brook 938 King Street Rye Brook,NY 10573 Re: Pool Fill for 57 Country Ridge Drive, Rye Brook,NY 10573 Dear Mr. Fews: I am the President of Green Star Development Corp., the general contractor for the demolition of the pool at the above-mentioned premises. Per the applicable permits, fill from the quarry operated by Thalle Industries, 50 Warehouse Ln S Elmsford,NY 10523,was used to close up and fill in the pool area on or about June 24,2025. I affirm that,to the best of my knowledge, the fill used to close the pool was not contaminated. Ron Mann STBPHEN B. MANN Swpm to before me this Notary Public, State of New York ay of une. 2025 No.30-4757153 Qualified in Nassau County Commission Expires April30.20 Elmsford Ticket No.: 2296289 Warehouse Lane Elmsford, NY 10523 Date: 6/25/2025 Time: 1:50:46PM Pounds Tons Metric Location: Elmsford Gross 0 0.00 0.00 Customer: 2978- ROMAN CONSTRUCTION NY INC. Tare 0 0.00 0.00 Order : 497-2025-PRICING-497-2025-PRICING Net 0 0.00 0.00 Cust Job: P.O. : Price 0.00 0.00 Product: FILL- Fill 7.50 Ton Freight 0.00 0.00 Carrier: - Tax WEST 0.00 0.00 Vehicle: - Total: 0.00 Today: 7.50 Loads: 1 RYE BROOK Ticketed By: ANGEL DIAZ Recieved by: Elmsford Ticket No.: Warehouse Lane 2296289 Elmsford, NY 10523 Date: 6/25/2025 Time: 1:50:46PM Pounds Tons Metric Location: Elmsford Gross 0 0.00 0.00 Customer: 2978- ROMAN CONSTRUCTION NY INC. Tare 0 0.00 0.00 Order: 497-2025-PRICING-497-2025-PRICING Net 0 0.00 0.00 Cust Job: P.O. : Price 0.00 0.00 Product: FILL- Fill 7.50 Ton Freight 0.00 0.00 Carrier: - Tax WEST 0.00 0.00 Vehicle: - Total: 0.00 Today: 7.50 Loads: 1 RYE BROOK Ticketed By: ANGEL DIAZ Recieved by: IF 'rElmsford Ticket No.: 2296289 Warehouse Lane IMI Elmsford, NY 10523 Date: 6/25/2025 Time: 1:50:46PM Pounds Tons Metric Location : Elmsford Gross 0 0.00 0.00 Customer: 2978- ROMAN CONSTRUCTION NY INC. Tare 0 0.00 0.00 Order : 497-2025-PRICING -497-2025-PRICING Net 0 0.00 0.00 Cust Job: P.O. . Price 0.00 0.00 Product: FILL- Fill 7.50 Ton Freight 0.00 0.00 Carrier: - Tax WEST 0.00 0.00 Vehicle : - Total: 0.00 D [� [E � V F5, Today: 7.50 Loads: 1 RYE BROOK JUL - 7 2025 DD Ticketed B : ANGEL DIAZ r Iecieved b : Y VILLAGE OF RYE' BROOK y BUILDING DEPAR T MFENT Elmsford Ticket No.: Warehouse Lane 2296304 Elmsford, NY 10523 Date: 6/25/2025 Time: 2:58:24PM Pounds Tons Metric Location: Elmsford Gross 0 0.00 0.00 Customer: 2978- ROMAN CONSTRUCTION NY INC. Tare 0 0.00 0.00 Order : 497-2025-PRICING-497-2025-PRICING Net 0 0.00 0.00 Cust Job: P.O. : Price 0.00 0.00 Product: FILL- Fill 7.50 Ton Freight 0.00 0.00 Carrier: - Tax WEST 0.00 0.00 Vehicle: - Total: 0.00 Today: 15.00 Loads: 2 RYE BROOK Ticketed By: ANGEL DIAZ Recieved by: Elmsford Ticket No.: 2296304 Warehouse Lane Elmsford, NY 10523 Date: 6/25/2025 Time: 2:58:24PM Pounds Tons Metric Location : Elmsford Gross 0 0.00 0.00 Customer : 2978- ROMAN CONSTRUCTION NY INC. Tare 0 0.00 0.00 Order : 497-2025-PRICING-497-2025-PRICING Net 0 0.00 0.00 Cust Job: P.O. : Price 0.00 0.00 Product: FILL- Fill 7.50 Ton Freight 0.00 0.00 Carrier: - Tax WEST 0.00 0.00 Vehicle: - Total: 0.00 Today: 15.00 Loads: 2 RYE BROOK Ticketed By: ANGEL DIAZ Recieved by: Elmsford Ticket No.: 2296304 Warehouse Lane Elmsford, NY 10523 Date: 6/25/2025 Time: 2:58:24PM Pounds Tons Metric Location : Elmsford Gross 0 0.00 0.00 Customer: 2978- ROMAN CONSTRUCTION NY INC. Tare 0 0.00 0.00 Order : 497-2025-PRICING -497-2025-PRICING Net 0 0.00 0.00 Cust Job.- P.O. : Price 0.00 0.00 Product : FILL- Fill 7.50 Ton Freight 0.00 0.00 Carrier: -Vehicle : - D Tax WEST 0.00 0.00 Total: 0.00 Today: 15.00 Loads: 2 RYE BROOK JUL - 7 2025 VILLAGE OF RYE BROOK Ticketed By: ANGEL DIAZ BUILDING DEPARTMENT y: Elmsford Ticket No.: 2296358 Warehouse Lane Elmsford, NY 10523 Date: 6/26/2025 Time: 9:15:55AM Pounds Tons Metric Location: Elmsford Gross 0 0.00 0.00 Customer: 2978- ROMAN CONSTRUCTION NY INC. Tare 0 0.00 0.00 Order: 497-2025-PRICING-497-2025-PRICING Net 0 0.00 0.00 Cust Job: P.O. : Price 0.00 0.00 Product: FILL- Fill 7.50 Ton Freight 0.00 0.00 Carrier : - Tax WEST 0.00 0.00 Vehicle: - Total: 0.00 Today: 22.50 Loads: 3 RYE BROOK Ticketed By: ANGEL DIAZ Recieved by: ;IF Elmsford Warehouse Lane Ticket No.: 2296358 ;; Elmsford, NY 10523 Date: 6/26/2025 Time: 9:15:55AM Pounds Tons Metric Location: Elmsford Gross 0 0.00 0.00 Customer: 2978-ROMAN CONSTRUCTION NY INC. Tare 0 0.00 0.00 Order: 497-2025-PRICING-497-2025-PRICING Net 0 0.00 0.00 Cust Job: P.O. : Price 0.00 0.00 Product: FILL- Fill 7.50 Ton Freight 0.00 0.00 Carrier: - Tax WEST 0.00 0.00 Vehicle: - Total: 0.00 Today: 22.50 Loads: 3 RYE BROOK Ticketed By: ANGEL DIAZ Recieved by: F '" Elmsford Ticket No.: 2296358 Warehouse Lane Elmsford, NY 10523 Date: 6/26/2025 Time: 9:15:55AM Pounds Tons Metric Location : Elmsford Gross 0 0.00 0.00 Customer : 2978 - ROMAN CONSTRUCTION NY INC. Tare 0 0.00 0.00 Order : 497-2025-PRICING -497-2025-PRICING Net 0 0.00 0.00 Cust Job: P.O. : Price 0.00 0.00 Product: FILL- Fill 7.50 Ton Freight 0.00 0.00 Carrier: - Tax WEST 0.00 0.00 Vehicle : - �� � �� �-� D Total: 0.00 Today: 22.50 Loads: 3 RYE BROOK JUL - 7 2025 Ticketed y By: ANGEL DIAZ VILLAGE OF RYE BROOKR4cieved b : BUILDING DEPARTMENT Elmsford Ticket No.: 229637H Warehouse Lane Elmsford, NY 10523 Date: 6/26/2025 Time: 10:43:38AM Pounds Tons Metric Location: Elmsford Gross 0 0.00 0.00 Customer: 2978- ROMAN CONSTRUCTION NY INC. Tare 0 0.00 0.00 Order. 497-2025-PRICING-497-2025-PRICING Net 0 0.00 0.00 Cust Job: P.O. : Price 0.00 0.00 Product: FILL- Fill 7.50 Ton Freight 0.00 0.00 Carrier: - Tax WEST 0.00 0.00 Vehicle: - Total: 0.00 Today: 30.00 Loads: 4 RYE BROOK NY Ticketed By: ANGEL DIAZ Recieved by: Elmsford Warehouse Lane Ticket No.: 2296378 Elmsford, NY 10523 Date: 6/26/2025 Time: 10:43:38AM Pounds Tons Metric Location : Elmsford Gross 0 0.00 0.00 Customer : 2978- ROMAN CONSTRUCTION NY INC. Tare 0 0.00 0.00 Order: 497-2025-PRICING-497-2025-PRICING Net 0 0.00 0.00 Cust Job: P.O. : Price 0.00 0.00 Product: FILL- Fill 7.50 Ton Freight 0.00 0.00 Carrier: - Tax WEST 0.00 0.00 Vehicle: - Total: 0.00 Today: 30.00 Loads: 4 RYE BROOK NY Ticketed By: ANGEL DIAZ Recieved by: Elmsford Ticket No.: 229637H Warehouse Lane Elmsford, NY 10523 Date: 6/26/2025 Time: 10:43:38AM Pounds Tons Metric Location : Elmsford Gross 0 0.00 0.00 Customer : 2978- ROMAN CONSTRUCTION NY INC. Tare 0 0.00 0.00 Order : 497-2025-PRICING -497-2025-PRICING Net 0 0.00 0.00 Cust Job: P.O. : Price 0.00 0.00 Product: FILL- Fill 7.50 Ton Freight 0.00 0.00 Carrier : - Tax WEST 0.00 0.00 Vehicle : - (�� Total: 0.00 Today: 30.00 Loads: 4 RYE BROOK NY JUL - 7 2��5 VILLAGE OF RYE BROOK Ticketed By: ANGEL DIAZ BUILDING DEPARTMENT ecieved by: Elmsford Ticket No.: 2296406 Warehouse Lane Elmsford, NY 10523 Date: 6/26/2025 Time: 12:14:19PM Pounds Tons Metric Location: Elmsford Gross 0 0.00 0.00 Customer : 2978- ROMAN CONSTRUCTION NY INC. Tare 0 0.00 0.00 Order: 497-2025-PRICING-497-2025-PRICING Net 0 0.00 0.00 Cust Job: P.O. : Price 0.00 0.00 Product : SELECTFILL-Select Fill 7.50 Ton Freight 0.00 0.00 Carrier: - Tax WEST 0.00 0.00 Vehicle: - Total: 0.00 Today: 40.20 Loads: 5 RYE BROOK NY Ticketed By: ANGEL DIAZ Recieved by: Elmsford Ticket No.: 22964�6 Warehouse Lane Elmsford, NY 10523 Date: 6/26/2025 Time: 12:14:19PM Pounds Tons Metric Location: Elmsford Gross 0 0.00 0.00 Customer : 2978- ROMAN CONSTRUCTION NY INC. Tare 0 0.00 0.00 Order : 497-2025-PRICING-497-2025-PRICING Net 0 0.00 0.00 Cust Job: P.O. : Price 0.00 0.00 Product: SELECTFILL-Select Fill 7.50 Ton Freight 0.00 0.00 Carrier: - Tax WEST 0.00 0.00 Vehicle: - Total: 0.00 Today: 40.20 Loads: 5 RYE BROOK NY Ticketed By: ANGEL DIAZ Recieved by: Elmsford Ticket No.: 22964�6 Warehouse Lane Elmsford, NY 10523 Date: 6/26/2025 Time: 12:14:19PM Pounds Tons Metric Location : Elmsford Gross 0 0.00 0.00 Customer: 2978- ROMAN CONSTRUCTION NY INC. Tare 0 0.00 0.00 Order: 497-2025-PRICING -497-2025-PRICING Net 0 0.00 0.00 Cust Job: P.O. : Price 0.00 0.00 Product: SELECTFILL- Select Fill 7.50 Ton Freight 0.00 0.00 Carrier: - Tax WEST 0.00 0.00 Vehicle : - RF- cE �w� Total: 0.00 Today: 40.20 Loads: 5 RYE BROOK NY 3 JUL - 7 2025 Ticketed By: ANGEL DIAZ VILLAGE OF RYE BROOK R cieved by: BUILDING DEPARTMENT REC IEWE MAR - 6 2025 JID VILLAGE OF RYE BROOK BUILDING DEPARTMENT Green Star Development Corp. Ron Mann Home building and remodeling 7 Eaton Road Licensed and Intuwd Syosset.NY11791 Nassau County LIC: H0447670000 (516)902 8661 Suffolk County LIC: 50810-H ronmann115SQgmail.com I March 3, 2025 FILE C Village of Rye Brook, NY Building Dept. Proposal for the removal of backyard pool: This proposal seeks approval from the Village of Rye Brook, Building Dept. for the removal of the backyard pool located at 57 Country Ridge Dr. The pool is currently in disrepair, no longer operational, poses potential safety risks, and is an ongoing maintenance burden. Cracked or damaged concrete around the pool create tripping hazards. The debris will be carted away by truck and the excavation will be filled in with clean fill (certificate to follow). Pool area will be seeded and hayed over clean topsoil. A final survey will be submitted upon completion. Regards, Ron Mann .Building Permit Check List&Zoning Analysis Address: 15D Cd)1 SBL: Zone: Use: Ql0 Cont. ype Other. Submittal Date: Revision Submittal Dates: Applicant o ` " \\ Nature of Work I n �;W k 1 00 1 Reviews:ZBA: a BOT: Other. �NEE D�OK t� 1 � l") ( FEES:Filing: \ BP: ` C/O: Flood Plane: Legalization: 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: (� Licene: Workers Comp: Liability Comp.Waiver Other ( �E 753#: Dated N/A GH-VOLTAGE ELECTRICAL:Plans: Permit N/A Ocher. ( ) ( ) LOW-VOLTAGE ELECTRICAL:Plan: Permit: N/A: Other. ( ) ( ) FIRE ALARM/SMOKE DETECTORS:Plan: Permit: H.W.I.C.:_Battery:_Other: (� ( ) PLUMBING:Plan: Permit: Nat.Gas: LP Gas: N/A/: Other. ( ) ( ) FIRE SUPPRESSION:Plan: Permit N/A: Other. ( ) ( ) H.V.A.C.: Plan: Permit: N/A: Other. ( ) ( ) FUEL TANK:Plan: Permit: Fuel Type: Other. (� 2020 NY State ECCC: N/A: Other. ( ( ) Final Survey Final Topo: RA/PE Sign-off Letter. As-Built Plan: Other. ( ) ( ) BP DENIAL LETTER: C/O DENIAL LETTER: Other. ( ) ( ) Other. ( )ARB rntg. date: approval: notes: ( )ZBA mtg.date: approval: notes: ( )PB mtg.date: approval• notes: REQUIRED EXISTING PROPOSED NOTES Area: Circle Fie: Front: Front: Sides: Rear. Main Cov. Accs.Cov: Ft.H Sb: Sd.H Sb: GFA: Tot. mU: Ft.I : P Height/Stories: notes: N� ���L �� 1 C`t� C \ rl SA� IVAIcACC` 0-PI � < Cnn �-1 4 �_f R V • h w_ t• �)v_�3'l:',��«,'+«/ � sY\Ill lfl�� , •# _� 11� � I«�`I - .. %/ c ti y co N Ix rA CN 4u o)s LU o � o o � Q�otiection ,� +: ..•) ,� O > W I- U) a o y _ <(ss)s ss 4�-1 Q s s� � � ui W j� 6 ¢ �+ �\ oj00 ' M 0 .:i ►. h o� a� v U �\ Vrn i fi(.c.)1r 3 Fes- (1t Ac--o CERTIFICATE OF LIABILITY INSURANCE DATE 1/15/DDII'4 11/15/2024 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 State Farm Insurance NAME:cy I.IZ R PHONE----- -. - FAX _ .._,..._�.._ 75 Lake Rd (A/c.No,�,m:_�_- 3 7� U00, A/c Ne: E-MAIL 5 267 2930 _- Congers. NY 10920 AD�REss:Lq&ebbiemcguinness.com INSURERS!AFFORDINf3 COVERAGE CW4C INsu!! A:State Farm Mutual Automobile Insurance C posunD Green Star Development Corp INSURES: 7 Eaton Rd INSURERC: Syosset, NY 11791 INSURER D: 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 ILTR TYPE OF INSURANCE POLICY NUMBER MMIDD YYYY MWDDY YYi UNITS A OENf=RALllAsllirY Y 98 J3 9316 6 09105/2024 09/0512025 EACH OCCURRENCE i 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES tEa occurend = - - CLAIMS-MADE U OCCUR MED EXP(Arty one person) S 5,000 PERSONAL i ADV INJURY tt GENERAL AGGREGATE i 2.000,000 GEWL AGGREGATE LIMIT APPLES PER PRODUCTS-COMP/OP AGG S 2.000,000 X POLICY LOC III AUTOMOEILE W11IRM Me socidefY S ANY AUTO BODILY INJURY(Per person) _ DULED AUTO$OWNED BOSS BODILY INJURY(Per soadem s PROPERTY HIRED AUTOS NON-OWNED Per i UMBRELLA LIASHCLAIIMS-MADE OCCUR EACH OCCURRENCE f EXCM L M AGGREGATE i DF D RETENTION S i WORKERS COMPENSATION TU- JOTH- AND EMPLOYERS'LJABIUTY IT LIMITS ER ANY PROPRIETIN OR/PARTNER/EXECUTIVE Ta MIA A E.L.EACH ACCIDENT III1 OFFICEIMEMBER EXCI.UDFD7 IMandatory In NH) E L DISEASE-EA EMPLOYEE S It yet deu.nbe under 7)F-1r.PIPTi0N OF OPFRATION'�bet E.L.DISEASE-POLICY LIMIT ti IF DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,d more space it.required) Home Improvement Contractor/Frafning/Dormers/Rooting/Siding/Kitchen/Bath/Basement 8 Masonary Sub-Contracting CERTIFICATE HOLDER CANCELLATION Village of Rye Brook SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 938 King Street ACCORDANCE WITH THE POLICY PROVISIONS. Rye Brook, NY 10573 AUTHORIZFJJ"REPR ATAIE l I ( ®1988- 10 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are regist fed m rks of ACORD 1001486 132849 7 03-01-2012 17__9k111\_ NYSIF New York State Insurance Fund PO Box 66699,Albany.. NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED) Mit w h�j��M -d 77 .n n AAnn 113336150GREEN STAR DEVELOPMENT CORP •, 7 EATON ROAD SYOSSET NY 11791 i SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER GREEN STAR DEVELOPMENT CORP VILLAGE OF RYE BROOK 7 EATON ROAD 938 KING STREET SYOSSET NY 11791 RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE H2248 619-5 368848 12/07/2024 TO 12/07/2025 11/13/2024 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2248 619-5, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK. EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY, INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS:/NVWW.NYSIF.COM/CERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. RONALD MANN-PRES OF GREEN STAR DEVELOPMENT CORP-A ONE-PERSON CORP. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY NEW YORK STATE SUR NCE FUND T �V DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 219580373 U-26.3 Laura Petersen From: UDig NY Exactix <tickets@exactix.udigny.org> Sent: Wednesday, March 12, 2025 3:51 PM To: Steven Fews Subject: Message from UDig NY ****REGULAR**** DIG REQUEST from UDig NY for: VIL RYE BROOK Taken: 03/12/2025 15:50 To: VIL RYE BROOK PRIMARY Transmitted: 03/12/2025 15:50 00002 Ticket: 03125-001-820-00 Type: Regular Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 57 To: Name: COUNTRY RIDGE DR Cross: From: To: Name: Offset: ------------------------------------------------------------------------------ Locate: BACKYARD, EXISTING POOL NearSt: FAIRLAWN PKWY Means of Excavation: EXCAVATOR, BOBCAT / SKID STEER Blasting: N Site marked with white: N Boring/Directional Drilling: N Within 25ft of Edge of Road: N Work Type: SWIMMING POOL REMOVAL Estimated Work Complete Date: 04/02/2025 Depth of excavation: 7 FEET Site dimensions: Length 40 FEET Width 20 FEET Start Date and Time: 03/19/2025 07:00 Must Start By: 04/02/2025 ------------------------------------------------------------------------------ Contact Name: RONALD MANN Company: GREEN STAR DEVELOPMENT Addrl: 7 EATON RD Addr2: City: SYOSSET State: NY Zip: 11791 Phone: 516-902-8661 Fax: Email: ronmannll58@gmail.com Field Contact: RONALD MANN Alt Phone: 516-902-8661 Working for: STEPHEN AND GREG MANN ------------------------------------------------------------------------------ Comments: Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: CONED SUEZ WTR WESTCHESTER VIL RYE BROOK WESTCHESTER CTY SWR 1 Laura Petersen From: UDig NY Exactix <tickets@exactix.0 dig ny.org> Sent: Wednesday, March 12, 2025 2:31 PM To: Steven Fews Subject: Message from UDig NY ****REGULAR**** DIG REQUEST from UDig NY for: VIL RYE BROOK Taken: 03/12/2025 14:30 To: VIL RYE BROOK PRIMARY Transmitted: 03/12/2025 14:30 00001 Ticket: 03125-001-618-00 Type: Regular Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 57 To: Name: COUNTRY RIDGE DR Cross: From: To: Name Offset: ------------------------------------------------------------------------------ Locate: BACK YARD, EXISTING POOL NearSt: FAIRLAWN PKWY Means of Excavation: BACKHOE, EXCAVATOR Blasting: N Site marked with white: N Boring/Directional Drilling: N Within 25ft of Edge of Road: N Work Type: SWIMMING POOL REMOVAL Estimated Work Complete Date: 04/02/2025 Depth of excavation: 7 FEET Site dimensions: Length 40 FEET Width 20 FEET Start Date and Time: 03/19/2025 07:00 Must Start By: 04/02/2025 ------------------------------------------------------------------------------ Contact Name: STEPHEN MANN Company: Addrl: 57 COUNTRY RIDGE DRIVE Addr2: City: RYE BROOK State: NY Zip: 10573 Phone: 917-689-4093 Fax: Email: stevebm22@gmail.com Field Contact: STEPHEN MANN Alt Phone: 917-689-4093 Working for: CALLER IS PERFORMING THE WORK THEMSELVES ------------------------------------------------------------------------------ Comments: Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: CONED SUEZ WTR WESTCHESTER = VIL RYE BROOK WESTCHESTER CTY SWR 1 BEARINGS SHOWN HEREON ARE BASED ON FILE MAP NO. 11394 EC 9 2 ?5 SYMBOL LEGEND MONUMENT FND 0 MANHOLE 0 TEST HIM 0 I.P./LB.FTD 'A'-RIFT ©TREE IY./I.B.SET 'B'-HALT a SHRUB ram'SPOT ELEVATIONS M YARD INLET • BOLLARD rO, UTILITY POLL 0 YARD INLET .WETLAND FLAG GUY MARE m ELECTRC METER CANT.CANTILEVER UTILITY POLE W/UQ4T M GAS METER FE.FENCE LIGHT POLE W RATER METER MAS.MASgAY T SON A GAS VALVE PLAT PLATFORM --� PVC FENCE(RC)CK WATER VALVE W.W.LWW�W++ELL STOADE FENCE(ST( B/W BA"WINDOW —A— CHAIN UNI FENCE(CLF)0/N OVERHANG C/E CELLAR ENTRANCE —— "RE FENCE R/O POW OVER FIRE HYDRANT D.C.DEPRESSED CURB Z A/C UNIT BLIND BROOK CLUB- LAND OF PONINGO LAND COMPANY TAX LOT I 14Y KrwAW L1Mt FEN X R "tas " N47.31'00"E-- 11 .0 --- eTK m --- FEN FEN 145 }4e' CO M M h � h MASS Q FM LOT 3 F�1 F s TAX LDT 9 } 1 A, c 1 I P/0 PY LOT 2 1 � (Y I TAX LOT B FE+I rA a PA\ERs ,4 FEN Iii teJ' I fEN 24S' I _—3r] d l9 YT. 1 pry Q I `Ws a4' aae' e•sTOMADE PM!AT I Z m 2 STORY TAX LOT 10 q FRAME eueDR+O Fa 057 Y 30.0' 31.4' PK h 7 1 / „x 15.7, rv�l I j I. M+A-R 0M l 1 QE P♦ N \� roa.91' `IEN bRY R = 4,450.00' i JA1� S46.34'30"A' A PHA r A—T°"° 25.00 COUNTRY RIDGE DRIVE (50' WIDE) GUARANTEED TO: GRAPHIC SCALE LOT AREA TITLE NO.: TST53712 THOROUGHBRED TITLE SERVICES,LLC 30 D 1s 3D 15,799,18 S.F. RADIAN TITLE INSURANCE INC. 0.43 AC. U.S.BANK NATIONAL ASSOCIATION GREG MANN AND LAUREN MANN COLEMAN&SEIFE OW ( IN FEET ) 1 inch = 30 !t + +t 19 2025 UPDATED SURVEY MM ITS REV DATE DESCRIPTION orC PR PERRY CHK OF SCALICE �y` RIDGE D 105 R�E BROOK t� Y NEW YORK 10573 hP )VEAL,ro_c� LOT 3 & PART OF LOT 2, BLOCK A * `r Land s u ry e i SUBDIVISION MAP OF Y n g COUNTRY RIDGE ESTATES o mjslandsurvey.com P;631-957-2400 SECTION NO. 5 i- �� 1 South Bay Avenue, Islip, NY 11751 FILE DATE: 03/07/1958 MAP NO. 11394 T 05073b SITUATE FC�A ND SJP DR.:MC CREW.:FM SCALE: 1' - 30' TAX MAP NO. VILLAGE OF RYE BROOK, TOWN OF RYE DATE SURVEYED:10/16/2024 JOB ND.W24-5771 129.59-1-9 WESTCHESTER COUNTY, NEW YORK Ih� �'�+�m ra,x,a rr,s,r vw�.Iq m.bl M Pmm a'�•'w"or M�w,•�i�wn a•�i�o>,ocn,W�s�,ma�'�"�YRaF BGAK38 9IOWN HEREON.WE BASED ON ME u.P NO 113w-/ SYMBOL LEGEND r E. SIG. lC JS+AK4/.t,-•'I,MY / �•��' I s 1 Irw J"JUM.tIM]ttw' :h Mt[a'Y4K tl;y v.r,�FP�'• •�1 FEB 2 0 VILLAGE OF R", :ROOK BUILDING DER "MENT R11.tD BROOK rLLN UbD OF POVYNYC•O LAND COMP44-I rAX SW I far w N47'31'00"E— rEw 1N f.5 � � o � N AT ` FAf LOT 3 ro.c �I rax core S. ,�<,;,,. �� �•, - t W' � Ip �• •LVr 1 ` � �W nr 7 11my TAX LOT IO ' mu ""� v' o wy r ar Wr 'VC N 4' cq Q� I „y Itii _- 1� 1 I A 1 I N1 1 �$�• hC rwtor 'O1x R 4.450.00' +t S46'34'30"W w 25.00' COUNTRY RIDGE DRIVE (50' WIDE) GRAPHIC SCALE w a GUARANTEED TO: of 'R n n BR NO. T TNOROUCNBRED E SERVICES _:C _ . RADIAN TITLE INSURANCE INC. O < V.S BANK NA71ONAL ASSOCIAnON ( IN FEET j DREG MANN AND LAUREN WARN 1 Inch a 30 fl COLEMAN*SEIFE SCALICE SURVEY OF PROPERTY 5) COUNTRY RIDGE DRIVE RYE BROOK _ NEW YORK 1OP3 LOT 3 & PART OF LOT 2, BLOCK A r 4land J U rve n SUBf MS" YAP OF Y g COUNTRY RIDGE ESTATES mjslandsurvey.com P:631-957-2400 SECTION NO. 5 i FILE DATE- 03/07/1958 MAP NO. 1139E ! / 1 South Bay Avenue, Isl,p, NY 11751 SITUATE OR MC CREW':FM SCALE = 30' iA VILLAGE OF RYE BROOK, TOWN OF Rl' % MAP DATE SURVEYED:I-/16/2024 JOB No.W2A-5771 12a 59 NC� WESTCHESTER COUNTY, NEW PORK