HomeMy WebLinkAboutBP20-005 R 4+44�'
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VILLAGE OF RYE BROOK
MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR
Jason A. Klein (914) 939-0668 Christopher J.Bradbury
www.ryebrook.org
TRUSTEES BUILDING& FIRE INSPECTOR.
Susan R Epstein Michael J. Izzo
Stephanie J.Fischer
David M. Heiser
Salvatore W. Morlino
CERTIFICATE OF COMPLIANCE
December 14,2022
Laudc Haber&Nicole Alessandri-Haber
15 Bonwit Road
Rye Brook,New York 10573
Re: 15 Bonwit Road, Rye Brook,New York 10573
Parcel ID#: 135.42-1-37
Building Permit#20-005 issued on 1/9/2020 for a Window Replacement
This certifies that the new window,installed under the above captioned permit has been satisfactorily
completed.
Sincerely,
Michael J. Izzo
Building&Fire Inspector
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( BUILDIN6 EI'A"� TMENT For office use onl
RpE #
�+ VILLAGE OF RYE BROOK ISSUED:
9 -
OCT � 2 2022 9 8 KING STREET,RYE BROOK,NE w YORK 10573 DATE: /O— - �5
(914)939-0668 FEE: �t PAm 0
VILLAGE OF RYE BROOK H'wR,rr'#brrook,org
I BUILDING DEPARTMENT
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
ass*asras*sssrtrrrsrtssr►rssrsrraaaaasssasaatsass*tasaasrasata*t*rstssrrrssrsrrrrsrsssrsasrar*rrssassssssssssssssassasrssress
Address: ( S I1)A, w i T fZO q b _ /t i iF BIZ vyK A'y l e s-23
Occupancy/Use: ,0',-4,44 Parcel ID Zone:
Owner: 1_4Lf Rt c tj.45Cn, Address: Ai7w571
P.E./R.A. or Contractor:' ty44 ii U)"b da J,1 ,C, Address: 1 15 2g,iL y AIL f T-►ZS%
Person in responsible charge:K ,)r yc Address:
Application is hereby made and submitted to the duilding 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:
"(ApR j (, IAA43,�� being duly swom,deposes and says that he/she resides at
(Print Name of Applicant) (No.and Street)
in 1L7 C�- 13 Pao c--, ,in the County of W es'�Cµ t Tiff - in the State of �Vz 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 equipment,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 IN i yv �1 C'W qjcf
Deponent further states that he/she has examined the approved plans of the structure/work herein referred to for which a Certificate of
Occupancy/Compliance is sought,and that to the best of his/her knowledge and belief,the structure/work has been erected/completed in
accordance with the approved plans and any amendments thereto except in so far as variations therefore have been legally authorized,and
as erected/completed complies with the laws governing building construction.Deponent further understands that it shall be unlawful for an
owner to use or permit the use of any building or premises or part thereof hereafter created,erected,changed,converted or enlarged,wholly
or partly,in its use or structure until a Certificate of Occupancy or Certificate of Compliance shall have been duly issued by the Building
Inspector as per§250-10.A.of the Code of the Village of Rye Brook.
Sworn to before me this a Sworn to before me this
day of �i�r , 2 day of , 20
Signature
of Property Owner Signature of Applicant
lame of Property Owner Print Name of Applicant
. 1
Notary Public SHARI MEULLO Notary Public
Notary Public,State of New York
No.01ME6160063
Qualified In Westchester County
Commission Expires January 29,20L2
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BUILDING DEPARTMENT
❑BUILDING 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:—
15 DATE:
1- 2� (� / 2
PERMIT# `� C� ISSUED� Zf� SECT: ` L_BLOCK: LOT: ✓
e tC�r� 1 ec �r �>>�_ . !\
CZ�r
LOCATION: �`4'Ji� OCCUPANCY:
❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/REINSPECTION
❑ 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
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ANNOUNCEMENT
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April 2, 2019
Changes to Energy Star Northern Zone Compliant Glass Packs On
WW 4000 Series Windows
_ Climate Zones &4��
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t`> Northern ZonAny
Northern Zone-Altemati%Path =0.28 >=0.32 s
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Northern —0.29 >=0.37
North Central =0.30 >=0.42
South Central North-Central <=0.30� <=0.40
_.� _�saume`" South-Central <=0.30 <-
-0.25
° Southern <=0.40 <=0.25
Due to NFRC testing protocol changes, the glass pack/option combinations required to meet Energy Star
Northern Zone thermal performance requirements are changing on the WW 4000 Series windows effective
6/3/19.The current SolarZone ThermD+ iE-Liner will no longer meet the requirements and two new
alternatives will be offered in its place:
1. Enhanced Cavity Foam frame option (qualifies via the Standard Path)
2. New SolarZone ThermD S3 and SolarZone Plus S3 glass packs (qualifies via the Alternative Path)
Performance and details of each option are explained below in more detail.
Enhanced Cavity Foam Frame Option
The first option to achieve Northern Zone Energy Star performance requirements is to pair standard SolarZone
ThermD or SolarZone Plus with the Enhanced Cavity Foam frame option. When selecting this option, Neopor°
foam is inserted into dry cavities of the frame to improve both the in-home sales presentation and thermal
performance, achieving qualifying performance via the Standard Path.
NE
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Frame head and jamb Frame sill
SolarZone ThermD w/Enhanced Cavity Foam Thermal Performance Data
Climate Zones �U-Factor SHGC
3001 DH-ESNZ Data WITH Enhanc d avi+ Option
_ Northern Zone0.27 Any
y Foam Frame O i n Northern Zone-AltematNe Path =0.28 >=0.32
— - =0.29 >=0.37
MODEL OPTIONS Required Glass Pack Grid U-Factor =0;30 1 >=0.42
Standard/Com Reinf. SolarZone ThermD Grid 0.27 0 27 North-Central <=0.3G <=0 40
STOption SolarZone Plus Elite Grid 0,27 South-Central�=�040�<=00�.25
.25
0.19 Southem
The Enhanced Cavity Foam frame option will meet the performance requirement solely by the U-Factor
threshold of 0.27, qualifying the relevant models via the Standard Path.
NEW SolarZone ThermD S3 and SolarZone Plus S3 Glass Packs
The S3 glass pack combines both U-Factor and Solar Heat Gain Coefficient (SHGC) performance data to achieve
Energy Star Northern Zone compliance as prescribed by the Alternative Path method. All Standard and
Alternative Path methods achieve equivalent overall thermal performance as established by Energy Star.
The S3 glass pack changes the location of the glass surface with the low-e coating. In the conventional
SolarZone glass pack, the low-e is on surface 2 (from outside). In the S3 glass pack, the low-e is on surface 3
(from outside). See chart below for a comparison.
Outside Inside
Surface 1 Surface 2 Spacer Surface 3 Surface 4 Gas
SolarZone ThermD Clear Low-E SS Il11WILept Clear Clear Argon
SolarZone Plus Clear Low-E Super Spacer Clear Clear Argon
SolarZone ThermD S3 Clear sic ur ,,intercept Low-E Clear Argon
SolarZone Plus S3 Clear Clear Super Spacer Low-E Clear Argon
This change increases the SHGC of the window and provides for qualification via the Alternative Path as shown
in the chart below.
SolarZone ThermD S3 Glass Package Thermal Performance Data
Climate Zones U-Factor SHGC
Northern Zone —0.2-7
3041 DH-ESNZ Data [.Northern Zone-Alternatiee Path =0.28 I >=0.32
=0 29 >=0.37
MODE�Co
S Required Glass Pack Grid U-Factor SHGC =0.30 >=0.42
Standard einf. SolarZone ThermD 53 Grid 0.28 0.33 North-Central <=0.30 <=o a0
ST Option SolarZone Plus 53 Grid 0.28 0 33 South-Central <_0.30 <=0.25
Southern .<=0.40 <=0.25
The higher SHGC rating of 0.33 coupled with a U-Value of a 0.28 in a model 3001 produces an Energy Star
qualified product for the Northern Zone. The S3 glass packs provide excellent insulation from the cold and
allows the sun's heat to flow into and warm northern homes during colder months. A higher SHGC promotes
greater comfort and lowers heating bills during the late fall and winter months. This gain in energy efficiency
during colder months fully offsets the marginal energy consumed to cool northern homes during warmer
months. All four pairings to achieve Northern Zone compliance are equivalent from an energy efficiency
standpoint.
MEETS STRINGENT ENEftY STAR' REQUIREMENTS! —`
OF , r
WINDOW WOR-LD" .
4000 Series Double- Hung and Sliding
Replacement Windows
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4000 SERJES WINDOWS
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Featuring a beautifully refined silhouette and advanced energy-saving technology, our
4000 Series delivers exceptional style, strength, energy efficiency and value — everything
today's homeowners are looking for in a quality replacement window, and more.
y� This next-generation 4000 Series is precision-engineered to meet or exceed stringent ENERGY STAR"
requirements, providing triple-pane energy-saving performance in a dual-pane unit.The dual-pane,
double-strength insulated glass, thermally optimized frame and sash and non-conductive composite
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reinforcements are just part of the advanced energy engineering that puts 4000 Series Windows in a
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Windows your home will have a fresh, energy-efficient, low-maintenance solution backed by a
Both sashes of Window World
Double-Hung Windows tilt in lifetime limited warranty.'
for easier,safer cleaning from
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Foam-Enhanced Insulated Frame Option. Additional Frame Options.
Increase the insulating performance and the For enhanced appearance and ease of installation,
/ structural integrity of your 4000 Series Windows with two additional frame options also are available.
our foam-enhanced insulation option.The rigid foam
_ r. is precisely contoured to match specific chambers
in the window frame for optimal energy savings. .�
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Available in double-hung and sliding windows, �the ultra-efficient rigid foam is channeled into select components of the head,jamb and sill.This pia �
1-3/8" Nail Fin Set Back 1-3/8" Nail Fin Set Back
innovative insulation incorporates high-purity graphite granules into the expanded with J-channel adaptor
polystyrene(EPS)raw material, resulting in a gray-colored, carbonized foam that
reflects radiant heat.
The foam-enhanced frame further fortifies the window structure and creates a superior
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WINL)ow ACCENTS
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Interior Woodgrains and Exterior Colors. Exterior Palette Interior Palette
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Desert Sand English Forest Dark Oak Foxwood Cherry
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Interior Grids. ISO
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Looking for a touch of elegance that won't obstruct
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1-800 NEXT WINDOW 11-800-639-8946 www.WindowWorld.com EM MadeinUSA
02019 Window World,Inc.Specifications subject to change without notice.tlnsulated glass(IG)units that require capillary tubes may experience some argon gas depletion.`See printed warranty for complete
details.For a copy of the written product warranty,please write to:AMI Window Warranty Department,3773 State Road,Cuyahoga Falls,OH 44223.ENERGY STAR name and symbol are registered U.S.marks and
are owned by the U.S.government. AM-WO-003 01/19 75M/S1
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Maximize Your Energy Savings with a Triple-Pane Glass Option.
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ultra-efficient energy-saving shield.This thermally optimized glass system provides a ,
more balanced,comfortable indoor climate,while also reducing outside noise. TP
Energy Efficiency Is Rooted in the Design. I
Argon is an insulating gas between the glass panes that acts as a
thermal barrier on energy loss,counteracting heat and cold conduction.
Argon gas also helps block noise infiltration for a quieter indoor climate.
Low-E Glass insulating technology features a virtually clear, metallic
coating that acts as a thermal mirror to help keep warm air in during
the winter and solar heat out during the summer. Low-E also filters out
damaging UV rays that can cause furnishings and carpet to fade.
SolarZone ThermD Intercept Stainless Steel Spacer features a '
unique, one-piece U-shaped design that stabilizes the panes of glass
and creates a powerful thermal barrier.Stainless steel is impervious to
gas transmission and withstands the effects of temperature changes, i
thus increasing gas retention and alleviating stress on the sealant bond r1
to help prevent seal failure. I
I
Advanced Triple-Pane Thermal Protection.
Comparing one glass system to the next can help you determine the best glass for
your home and climate challenges. In the table below, U-Factor represents the rate
of heat flow through the window product-the lower the U-Factor,the less energy
is needed to heat a home.The SHGC(Solar Heat Gain Coefficient)represents
the solar heat penetrating through the window-the lower the number,the more
you'll conserve on air-conditioning use.Window World 4000 Series Windows with
SolarZone ThermD TG2 glass technology are 52%more energy-efficient than clear j
double-pane glass windows.
Thermal Performance Comparison' Glass Package Terminology
Clear: .,nit.
Composite Reinforcement SolarZone ThermD TG2: q rle-pane
U-Factor SHGC Low-E glass and I
. ; _
Clear Glass° 0.46 0.59 , ind Intercept
SolarZone ThermD TG2 0.22 0.26 SolarZone ThermD Elite TG2 Triple-pane
SolarZone ThermD Elite TG2 0.22 0.19 unit with one surface of Low-E SHGC I
glass,one surface of Low E glass.argon I
5 whole window values,single-strength glass, gas and Intercept Stainless Steel Spacer.
e Whole vnndow values.double-strength glass, ���I�
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Best-in-Class Performance Features:
• Reinforced narrow silhouette frame and sash profiles make a statement of
style with their low-profile design.The result is a beautiful and expanded glass
area. Under the surface, internal chambers increase structural integrity, rigidity,
and energy efficiency.
• Composite meeting-rail reinforcement allows for secure mounting of
hardware;the non-conductive material helps reduce the transfer of energy.'
• End-of-throw cam shift locking delivers increased strength and protection to I
the recessed lock. It also includes an"unlocked"indicator.
• The smooth and uniform true sloped sill quickly directs water runoff without the
use of weep holes, keeping the exterior of the window clean and attractive.2
• Our telescoping sill dam delivers a triple payoff: protection from air and water
infiltration, increased structural stability, and enhanced beauty.
• When extreme wind and weather hit,our proprietary sill interlock stands strong.
Traditional sloped sill designs can allow the sash to bow during powerful winds,
but with our interlocking sash-to-sill technology,the sash is channeled firmly into
the window frame for a unified wall of strength.
• Our innovative screen bulb seal creates a snug fit that eliminates light and insect
penetration between the screen and frame. It also aids in easy screen installation
and removal.3
Additional Sliding Window Features:
• Sashes glide horizontally for easy opening and closing. _
• Both sashes lift out for convenient cleaning. R
• Nylon-encased dual brass roller system for smooth gliding performance. I
Insulated Glass Packages to Meet Your Needs.
s
Maximize your energy savings by choosing a high-performance SolarZone
insulated glass' package to meet your specific climate challenges.The lower
the U-Factor,the less energy you'll need to heat your home.The lower the Solar
Heat Gain Coefficient(SHGC),the more you'll conserve on air-conditioning.
I
Comparison'Thermal Performance
Clear. e-paned clear glass unit.
SolarZone:Double-paned unit with one
;ass,argon gas and metal
Double-Hung Sliding of
U-Factor SHGC U-Factor SHGC Solarzone iE:rouble-paned unit with one
:.Clear Glass 0.46 0.59 0.45 0.59 -E glass,argon gas and metalspacer,along with insulation-
* me.
SolarZone 0.29 0.30 0.28 0.30
SolarZone Plus:C:,ouble-paned unit with
SolarZone iE 0.28 0.30 0.28 0.30 i glass,argon gas and
SolarZone Plus 0.28 0.30 0.27 0,30 SolarZone Elite:Double-paned unit with
SolarZone Elite 0.28 0.21 0.28 0.21 ',LOW-E SHGC glass,argon ga I
v Intercept spacer.
SolarZone Plus Elite 0.27 0.21 0.26 0.21 SolarZone Plus Elite:'ouble-paned una
SolarZone ThermD 0.28 0.30 0.27 0.30 ;HGC glass.argc
SolarZone ThermD iE 0.27 0.30 0.27 0.30 SolarZone ThermD: ,,ble-paned unit I
,)lass,argon gas
SolarZone ThermD Elite 0.27 0.21 0.27 0.21 �:pt spacer.
4 Whole window values are based on double-strength glass,starldand 4000 Senes offering with SolarZone ThermD iE:Double-paned unit
composite reinforcements.ST and HP performance values am also available. with one pant of Low-E glass.argon gas
and stainless steel Intercept spacer.along r
_. trame.
Air/Water/Structural Results SolarZone ThermD Elite: able-paned
ur�;:.r. :;HGC glass.
Air Water Structural argon gas and stainless steel Intercept
spacer. 1 Double-hung base model will automatically be converted to ST(steel reinforcement)for all
efnl psf units ordered in excess of 48'wide or 84'high.
Window World 4000 Base 04 5.25 DP40 2 For larger size windows or to meet specific DP/PG ratings,optional weeps/performance
package must be ordered.
Window World 4000 ST .08 7.5 DP50 3 Available only with the full screen option
Performance requirements meet or exceed Art.Water and Structural Loads as determined through ASTM
(Aniencen Sooety for Testing and Materials)test methods.
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VILLAGE OF RYE BROOK
MAYOR 938 King Street, Rve Brook, N.Y. 10573 ADMINISTRATOR
Jason A. Klein (914) 939-0668 Christopher J.Bradbury
xs%«v.ryebrook.org
TRUSTEES BUILDING&FIRE INSPECTOR
Susan R. Epstein Michael J. Izzo
Stephanie J. Fischer
David M. Heiser
Salvatore W.Morlino
October 6,2022
Dear Rye Brook Building Permittee,
It has come to the attention of the Building Department that your Building Permit has not been closed out in
accordance with Village Code and is now expired.All Building Permits have a twelve (12)month lifespan
starting from the date of issuance,and the permit expiration date is noted on the front of the permit.
Please note that there is a non-waivable Expired Permit Fee of$500.00 now due in connection with your
expired permit. Once payment is received,your permit will be reinstated for a period of six(6)months.
Please be advised that it is a violation of Village Code to fail to close out a permit,and that a court summons
could be issued,and fines may be imposed on the permit holder and/or property owner for failure to apply
for and obtain a Certificate of Occupancy(C/O) or Certificate of Compliance(C/C),in accordance with
Village Code section 250-10A.
Please note that Temporary C/Os&C/Cs are available in accordance with Village Code section 250-10B
should you require more time to perform whatever work remains in order to complete your project.
Thank you for your attention in this matter,and please feel free to contact this office should you require any
further information.
0��-
Michael J.Izzo
Building&Fire Inspector
mizzo_.rnb�g
/to
cc: Steven E.Fews,Assistant Building Inspector
Tara A. Orlando,Planning&Zoning Secretary
Laura Petersen,Office Assistant
Mike Izzo
From: Mike Izzo
Sent: Wednesday, October 12, 2022 1:06 PM
To: Lauric Haber
Cc: Steven Fews;Tara Orlando; Laura Petersen
Subject: FW: Expired permit? BP20-005 issued 1.9.2020
Attachments: Color0336.pdf, Color5486.pdf; CO - CC Application 8.2021.pdf
Dear Mr. Haber,
Whatever your arrangement may have been with your contractor, under the law the property owner is
ultimately responsible for whatever takes place on their property. That's why the Building Department only
issues building permits to the property owner and why your contact information appears on the permit;you
are the permit holder.
Village Code contains regulations by which building permit holders must abide. That's why we include all the
pertinent information on the filing instructions attached to the permit applications and printed on the permit
itself.
My previous email provided the codified path to close the permit. Please proceed to close out your expired
permit as required by code.
Thank you.
All Lhd(/, �ZZO
Building& Fire Inspector
Village of Rye Brook, NY
(914) 939-0668
From: Lauric Haber<lauric.haber@gmail.com>
Sent: Wednesday, October 12, 2022 9:59 AM
To: Mike Izzo<Mlzzo@ryebrook.org>
Subject: Re: Expired permit? BP20-005 issued 1.9.2020
Hello,
Isn't the contractor supposed to close this after the work is done?They are the ones who filed for the permit. All the
contact informations on the permit are for the contractor.
I never received a prior notice to close this...
I'm very frustrated because it was a very small job to replace the garage window, and you are charging me $500 for an
expired fee?????
Lauric Haber
Sent from my iPhone
On Oct 12, 2022, at 9:37 AM, Mike Izzo<Mlzzo@ryebrook.org>wrote:
1
Dear Mr. Haber,
Thank you for the email.
Your replacement window permit is expired with no C/O in violation of Village Code.
On January 9, 2020,you were issued a permit, #BP20-005, for replacement windows, that
permit expired on January 9, 2021. A copy of the permit is attached hereto for your
convenience.Village Code requires that all Building Permits be closed out with a Certificate of
Occupancy or Certificate of Compliance (C/O) as is stated on the face of the permit and on the
application filing instruction pages. Furthermore, all Building Permits have only a one-year
lifespan, which is also noted on the face of the permit and on the filing instructions sheets. A
copy of the filing instructions sheets is also attached hereto for your convenience. Portions of
those instructions are also printed on the back of your double-sided Building Permit.
To close the permit,you must remit the$500 Expired Permit Fee, apply for a C/O—C/C and
remit the appropriate C/O Fee which is based on the final cost of the job, and call the Building
Department to schedule the final inspection. The application for C/O—C/C was also included
in your permit application package, but I have attached a copy hereto for your convenience.
To avoid a violation,please close out your expired permit as required by code.
Thank you.
lWael(7, /zzo
Building& Fire Inspector
Village of Rye Brook, NY
(914) 939-0668
From: Lauric Haber<lauric.haber@amail.com>
Sent:Tuesday,October 11,2022 7:35 PM
To: Mike Izzo<Mlzzo@ryebrook.ors>
Subject: Expired permit?
Hello,
See attached. I received this mail today,and I have no idea what this is.
Can you tell me what permit you are referring to?
Lauric Haber
2
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MAYOR gn Rya%pre,Rrr IMoak.N.Y- W73 ADMINISTRATOR
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AC R" CERTIFICATE OF LIABILITY INSURANCE DATE(MNUDDIYYYY)
12/26/2019
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 NAME. Edward C Dunbar
The Dunbar Insurance Agency PHONE aq: (518)393-1104 FAX No):
PO Box 4451 -ADDRESS, thedunbarinsurance@gmail.com
INSURERS AFFORDING COVERAGE NAIC#
Schenectady NY 12304 INSURER A: ADMIRAL INS CO 24856
INSURED INSURER B:
Southern NY Windows Inc dba Window World of the Hudson Val INSURERC:
1315 Route 9 INSURER D: _
Suite 201 INSURER E:
Wap finger Falls 12590 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 TERh1S.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE ��SU POLICY NUMBER MM pCpnEYYY POLICY EXP LIMITS
LTRINSD
X COMMERCIAL GENERAL UABLITY EACH OCCURRENCE $ 1,000,000
� R NTED
CLAIMS-MADE �` OCCUR PREM.SES Ea occurrence $ 300,00
MED EXP Any one person) $ 5,000
A CA0000340339-01 04/01/2019 04/01/2020 PERSONAL BADVINJURY S 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 1,000,000
X POLICY❑�O LOC PRODUCTS-COMP/OPAGG S 2,000,000
i
OTHER:
AUTOMOBILE LIABILITY (Ea accident)
SINGLE LIMB S -ANY AUTO BODILY INJURY(Per person) S
OWNED SCHEDULED BODILY INJURY(Per accident) $
AUTOS ONLY AUTOS PROPERTY DAMAGE
HIRED NON-OWNED $
AUTOS ONLY AUTOS ONLY rn accident
$
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAR CLAIMS-MADE AGGREGATE $
DED RETENTIONS $
P O -
WORKERS COMPENSATION 5TAT
AND EMPLOYERS'LIABILITY Y I N
ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $
OFFICERrMEMBFR EXCLUDED? N I A
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S
If yyeLIMIT"s,descnbe .nder E.L.DISEASE-POLICY L $
DESCR'PTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required)
I
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 AUTHORIZED REPRESENTATIVE y
938 KING STREET
RYE BROOK NY 10573
1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
NYSIF
New York state Insurance Fund 1 WATERVLIET AVENUE ALBANY,NEW YORK 12206-1649
1 nysif.com
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
TV
L
^^^^^^ 832514390 f.
SOUTHERN NY WINDOWS INC DBA
WINDOW WORLD OF THE HUDSON VALLEY
1315 ROUTE 9 STE 201
WAPPINGERS FALLS NY 12590 SCAN TO VALIDATE
AND SUBSCRIBE
POLICYHOLDER CERTIFICATE HOLDER
SOUTHERN NY WINDOWS INC DBA VILLAGE OF RYE BROOK
WINDOW WORLD OF THE HUDSON VALLEY 938 KING STREET
1315 ROUTE 9 STE 201 RYE BROOK NY 10573
WAPPINGERS FALLS NY 12590
POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE
A2469 633-8 681374 04/02/2019 TO 04/02/2020 1/2/2020
THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE
FUND UNDER POLICY NO. 2469 633-8, 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://WWW.NYSIF.COM/CERT/CERTVAL.ASP.THE NEW
YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS.
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 INSURANCE FUND
DIRECTOR,INSURANCE FUND UNDERWRITING
VALIDATION NUMBER: 37464543
U-26.3