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Home My WebLink AboutBP16-0303 yR�� k& PERMIT # BP ) & `63O DATE: � 1 to EXP: SECTION L4 I • o�2'T BLOCK LOT % TYPE OF WORK JOB LOCATION OWNER IV)1 CONTRACTOR_., EST. COST CO #�L TCO # FOOTI N G FOUNDATION FRAMING RGH FRAMINg INSULATION PLUMBING bh RGH PLUMBING GAS SPRINKLER ELECTRIC 0 LOW -VOLT 0 ALARM AS BUILT E3 FINAL YDurr? V.- FEE DATE INSP RECORD DATE INSP 1-I� 1 Lo- O ice' )6u c sal� e-/ ' ►d C ! //L &Lot"" Open Permit Letter Sent 4/10/2017 Expired Letter Sent Qpril QyE QR „i 190 VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J.Bradbury www.ryebrookny.gov TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CLARIFICATION OF RECORD December 9,2024 Win Ridge Realty LLC c/o Alena Hakanjin 24 Rye Ridge Plaza Rye Brook,New York 10573 Re: 14 Rye Ridge Plaza,Suite 222, Rye Brook,New York 10573 Parcel ID#: 141.27-1-7 Building Permit#16-030 issued on 3/3/2016 for New Executive Bathroom Suite 222 An inspection of the of the above referenced property on March 15,2024,reveals that although Building Permit#16-030 dated 3/3/2016 was issued, the new executive bathroom was never done, and this permit is rendered null and void. Sincerely, Steven E. Fews Building&Fire Inspector /to �QyE 6Rq:� O Zm t7 ' c >> �O 198,2 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 : , 1 I Q � �!t DATE: PERMIT# ISSUED: SECT: BLOCK: LOT: LOCATION: OCCUPANCY' ❑ Violation Noted THE WORK IS... [� PASSED ❑ FAILED 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 �E BRC�uk • �9a2 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 : DATE: �l PERMIT# `/ y ISSUED: SECT: BLOCK: LOT: LOCATION: OCCUPANCY: ��Pr' Violation Noted THE WORK IS... ❑ PASSED p FAILED REINSPECTION �y SITE INSPECTION / REQUIRED FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas ' �t �('e- ❑ L.P. Gas ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ? \cvC ❑ CROSS CONNECTION ` WC l �/� ❑ FINAL S ! N�\ \() Q ' .�(r Q (J P 2 ❑ OTHER VG, �� } cv 4 o QA 1 ct,\ ) fie_ L O ym w � BR �7 BUILDING DEPARTMENT ❑BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑ VILLAGE ENGINEER 938 KING STREET RYE BROOK,NY 10573 0 ASSISTANT BUILDING INSPECTOR (914) 939-0668 FAx(914) 939-5801 - - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - - ADDRESS: 1 `1�� . l �' DATE: Z`� PEIWT# I(0 ' d?� ISSUED: 3 b SECT: ` 2-7 BLOCK: LOT: LOCATION: � J Z't�g- p4�-N r 0 - OCCUPANCY: - VIOLATION NOTED THE WORK IS... ElAC(`I'PTrD REJECTED/REINSPECTION SITE INSPECTION REQUIRED FOOTING ❑ FOOTING DRAINAGE 0 FOUNDATION 0 UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING 0 ROUGH FLAMING 0 INSULATION ❑ NATURAL GAS ❑ L.P.GAS ❑ FUEL TANK 0 FIRE SPRINKLER O FINAL PLUMBING /� R-I �- ❑ FINAL D OTHER N 1p' C iC S - �L L� x a z _ = w M �� owlzjj - > yvy C a SSy5 a ¢¢ 5 � w N Fr = Onolox cq Of!O% oc _ W � MEMO ��.LL� /z �c LU 04441 v� °' 00 cr � K s _ _ pa t% .• Z W v: Q 0C9 0 _ isCL��t4t:t=. c c tt_c t tit 44 4=4 4;tttf t 4 t V. ,t t.Vt:CVt:� � � BUILDII�6 DEPA T RTMEN V14AC OF RYE BROOK 938 KING,s �,EETRYE B K,NY 105 {AR � 4 2016 (914)9 � A �q #�939-5801 AGE O� RYE BROOK W*, VILLAGE w�uuvl c�,ok'org PLUMBING PERMIT APPLICATI BUILDING DEPARTMENT Westchester County Masten Plumbers License Required FOR OFFICE USE ONLY BP#: J (_0 J V`� PP#: I � G �Z MAR 1 6 Approval Date: Application Fee: $ j Approval Signature: Permit Fee: $ l Disapproved: Other: (fees are non-refundable) Application dated, 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. 1.Address:Al 12YF r/`bi mll/ r/6n ALf/Zi9 SBL: 1y1 r)_7 1 7 Zone: 2.Property Owner: ��/v ��iV�� Address: Phone#: / Cell#: email: 3.Master Plumber: �cy�f Address: Lic.#:�L Phone#- �r� T�j/S Cell#: S//-)-email: iWJ 7�.2 Company Name: �l Address: 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 3` Floor ` Floor 5 Floor Exterior 4.* List Other Equipment/Provide Details: 1/5/16 1. " r o CA La�7 �• W x G. y p N v +J ur)Ali 3 6ci _ v 1 ✓ 1° > a I� s V w � v V /C > ++ FN �•i+ � o = ro a o0017 O W cc — > p tE W Q z a cy < `° `° gay QHis VL � � � � • � � � � 7 O 00 Cc /� 0 : r'l ;^ o -�� O II,IN �" z r�� fUa. rpm.. E w _ _ _ Q � I•iM o„ p I oo woo ,ter (•.� '„ �.. E L s ULL � a WCA F. y = "A . U C v $ o Q oq }i < 3 U x g • Ez LLJI..i�� O Q Z a bH °mac > >. y E a z W a0 cc c w Q I m a .•a W � cz. _ � � � t ' : '� s a f � s f �e� fa s s : � �_ �_ : _ , = s s s a t �ts s EEs s : Qs : fe s • l D BUILDING RTMENT �C� EQ\l[E VILL OiF-RY ROOK �I 938 KING STrt T RYE B ¢x,NY 10573 KV _ 2016 (914)939-0' ' 939-5801 VILLAGE OF RYE BROOK wwwr ok.org BUILDING DEPARTMENT ...............................................................■.............................■ FOR OFFICE USE ONLY: N Approval Date: MAR — 2 2016 BP#: �� PP# I _ Filing Fee: Approval Signature: Permit Fee: Disapproval Date: Disapproval Signature: Other: APPLICATION TO INSTALL FIRE SUPPRESSION /FIRE SPRINKLER SYSTEM Application dated: is hereby made to the Building Inspector of the Village of Rye Brook NY for the issuance of a Permit to install a Fire Suppression System as per detailed statement described below. 1. Job Address: 1 A67 �IH r �d��{ �Z �'arcel I.D. 1't11'Z� " 7 Zone: <✓� — 2. Proposed Syste (Describe system in detail including suppression agent): 5 Pfwu� . ahL 0J 3. Number&Types of Fire Sprinkler Heads: 4c— Z6.1) S9 ti-)X_ 4. N.Y State Construction Classification: N.Y.State Use Classification: 5. Cost of Installation: S Q_5 i . 06 (Cost shall include all labor,materials,fixed equipment,professional fees,and materials and labor which may be donated gratis.) 6. Property Owner: WIN Rl b6-6 IQjAt]& LL C Address:21l Pl PZ,42a i Phone# 914� - 701-�0(7� Cell# (14�- -173- 733 3 email: 1��""W1 Applicant: t° Address: k3S rRdt4W4 I At 4✓E �/jo11',17We0 b f N�� /D S—I Phone# /�tS-323'-s-7,43 Cell# �Il�' �G9-3(� email:/111CKe,.1megecgoe 6A A114Fe,G;e, Q 4ol to Design Engineer: 6d51,11 43-50CIAreS1, 2eWIlee16 Z LLP COM Address: 23,5 IWM4Ko vecl: Atl.E Wgde P 'l,.5 , /0(005- j L / Phone# 1 - /2S'-129I / —Cell C11q "3>'b"`1gL1 7- email:emai �Cy�/� Dy3ingA ,�CC{5_CoM Installer: 4LL 5A FE ` !roE V el n I!Le4 3` 5 ,\eM5 c/ Address: �3s F4AA1L1,14 4✓� c�/�oP17a00 y �/`� a5-91 Phone# &�k-,32.- s12 3 Cell# f l Y-yt/ "3& r email:Q bwe,n 5(A'B 1/5Au r wd"e4l oA Ca M 12116115 . r 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. SKATE OF NEW Y RK COUNTY OF WESTCHESTER ) as: (y-0rlek'D /ll e 6—pego,c ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and further states that (s)he is the legal owner of the property to which this application pertains, or that (s)he is the C04 Ti?ACTo 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, system installed 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 applicable sections of the N.F.P.A., the N.E.C. and with the Code of the Village of Rye Brook,as well as all other applicable Federal,State or County laws,ordinances and regulations. Sworn to before me this Sworn to before me this day of 17 , 201�, day , 201 S::�� r_A*_W Signatur Pro Si a r�of Appl� ant J. 1e'1414 i * Print Name of Property 9wnm M44 451e4. Print Name of Applicant Notary ubti MY A B. GLUCK Notary ubti MYRA B. GLUCK Notary^ul !!r,, State of Newyork Notary Public, State of New York ? o. 01GL654677LI No. 01GL6646770 Qualifieu in Bronv''nunnty Commission Expires April 30,2018 Qualified in Bronx 30 Commission Expires Aprilril 30,2018 12/18/15 Laura Petersen From: Alena Hakanjin <ahakanjin@winridge.com> Sent: Wednesday, November 8, 2023 5:27 PM 3�/ ✓� To: Laura Petersen Cc: Steven Fews;Alena Hakanjin Subject: RE: 14 Rye Ridge Plaza SQ / Hi Laura, Hope you're well. Sorry for delay...I tried to find what I could on this one. Its so old! I remember being told that BD would need a letter stating that no work was conducted for BP16-030 in order to close it out. I do recall Mickey coming out for final inspection of below. I recall him writing up stuff for this vacant room which to my knowledge was never occupied. It is very small —almost like a storage space. Win considered building an executive bathroom in there at one point which is when they filed permit application (BP-16-030). It just never came to fruition. I remember our Accounting Department submitted a check or check(s) for any expired permit fees we accumulated in fall/winter 2018. 1 found an email that I sent to all the maintenance guys in December 2018 letting them know that I believe all deficiencies were rectified, but, to confirm for me ( attached the inspection reports). This included BP16-030. I couldn't find their written response, but, they may have confirmed verbally?! I honestly can't remember 100% at this time how it ended, but, I didn't find correspondence on matter or any letters received since then. We can set up a time when Steve is free to go in that room. Thanks, alena Alena Hakanjin Property Manager WIN RIDGE REALTY, LLC 24 Rye Ridge Plaza Rye Brook, NY 10573 Tele: 914.701.4005 Fax: 914.701.4009 E-mail: ahakanjin@winridge.com For information about Rye Ridge Shopping Center visit our website: www.ryeridgeshoppingcenter.com From: Laura Petersen <LPetersen@ryebrook.org> Sent:Tuesday, November 7, 2023 11:32 AM To:Alena Hakanjin<ahakanjin@winridge.com> Cc:Steven Fews<SteveFews@ryebrook.org> Subject: 14 Rye Ridge Plaza [EXTERNAL] Good morning Alena, i At your earliest convenience, can you please advise as to what ever happened with the attached building permit from 2016. I have also attached an inspection report from 2018. Thank you Laura Laura(Petersen Office Assistant Village of Rye Brook 938 King Street Rye Brook, New York 10573 Phone(914)939-0668 1 petersen c(D.rvebrook.org 2 WIN RIDGE REALTY, L.L.C. 24 Rye Ridge Plaza,Rye Brook,NY 10573 Tel(914)701-4005 Fax(914)701-4009 SEP 10 2018 Friday, August 31, 2018 VIA REGULAR MAIL VIA EMAIL: mizzo@ryebrook.org, sfews@ryebrook.org, tgerardi@ryebrook.org Mr. Michael Izzo, Building & Fire Inspector Village of Rye Brook 938 King Street Rye Brook, NY 10573 Re: BP#16-039 Dear Mr. Izzo, This letter is to inform you that no work was conducted with regards to BP#16-030. If necessary, can you please schedule the Final Inspection. Thank you for your patience in this matter. It is much appreciated. Best Regards, �6f Alena Hakanjin Property Manager �G• � i VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook, N.Y. 10573 ADMINISTRATOR Paul S. Rosenberg (914)939-0668 Fax(914) 939-5801 Christopher J. Bradbury www.rvebrook.orn TRUSTEES BUILDING&FIRE Susan R.Epstein INSPECTOR David M. Heiser Michael J. Izzo Jason A.Klein Jeffrey B. Rednick April 10,2018 Via 1"Class Certified Mail Win Ridge Realty LLC Peter Stahl 10 Rye Ridge Plaza Rye Brook,New York 10573 Re: 14 Rye Ridge Plaza, Rye Brook. New York 10573 Parcel ID#: 141.27-1-7 Building Permit#16-030 Issued: 3/3/2016—Original Expiration Date: 9/3/2017 Extension granted to Date: 3/3/2018 Dear Property Owner, It has come to the attention of the Building Department that your Building Permit listed above has not been closed out in accordance with Village Code. and has been expired since 3/3/2018. Please note that there is a non-waivable expired permit fee of$500.00 now due in connection with your expired permit. 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 250-1 OB 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. Michael J. Izzo Building& Fire Inspector mizzona ryebrook.org /tg cc: Steven E. Fews. Assistant Building Inspector CC 4�uJ�V G Gtt VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook, N.Y. 10573 ADMINISTRATOR Paul S. Rosenberg (914)939-0668 Fax(914) 939-5801 Christopher J. Bradbury www.ryebrook.org TRUSTEES BUILDING&FIRE Susan R. Epstein INSPECTOR David M. Heiser Michael J. Izzo Jason A. Klein Jeffrey B. Rednick April 10, 2017 Via I"Class Mail Win Ridge Realty LLC Joseph Lentim 24 Rye Ridge Plaza Rye Brook.Nev, York 10573 Re: 14 Rye Ridge Plaza Suite 222. Rye Brook, New York 10573 Notice of$500.00 Fee for Expired Permits Open Building Permit#16-030 Issued: 3/3/2016- Expiration Date: 9/3/2017 Dear Property Owner, Please allow this letter to serve as a reminder that your open permit(s) noted above, as is the case with all Building Permits issued by the Building Department must be closed out with a Certificate of Occupancy or Certificate of Compliance in accordance with §250-IO.A. of the Code of the Village of Rye Brook. Building Permits have a life of eighteen (18) months and the expiration date is noted on the front of the permit. Please be advised that should you fail to properly close out your permit(s) in accordance with the law, effective November 1, 2009 the Village will be imposing a $500.00 Administrative Fee in connection with all open expired Building Permits issued after January 1. 2003. Please note that this Administrative Fee applies to each individual permit and must be remitted in addition to any other required fees associated with closing the permit(s).as well as any court imposed fines should a summons(es)be issued. Thank you for your attention in this matter, and please feel free to contact this office should you require any further information. Michael J. Izzo Building& Fire Inspector mizzo@rvebrook.org /tg cc: Steven E. Fews. Assistant Building Inspector 1 2 F � N N 9 :o �e0OCl0❑a wo 01 :v zh2G E924 1000 OE4T 5'[OZ co ui i w ED 0 > C3 C:3 J CU Z r3 ..... C3 c, a -0w te cu .a ....... 1:3 (U m Q) V) cu 0 co LM -j co Mike Izzo From: Joseph Lentini <jlentini@winridge.com> Sent: Thursday, August 03, 2017 3:38 PM To: Mike Izzo Cc: Peter Stahl;Tara Gerardi Subject: RE: BP 16-030 Executive Shower Will do. Thank you very much. From: Mike Izzo [mailto:Mlzzo@rvebrook.org] Sent:Thursday,August 03, 2017 3:34 PM To:Joseph Lentini<jlentini@winridge.com> Cc: Peter Stahl <pstahl@winprop.com>;Tara Gerardi <tgerardi@ryebrook.org> Subject: RE: BP 16-030 Executive Shower Joe, Your request for a six (6) month extension to Win's open permit#BP 16-030 has been approved. Please note the new expiration date is 3/3/18. Please arrange for all work to be completed and inspected, and for all paperwork&fees to be remitted to the Village such to facilitate the issuance of the Certificate of Occupancy on or before that date. Thank you. lfli and(l Izzo Building & Fire Inspector Village of Rye Brook, NY Phone—(914) 939-0668 Fax—(914) 939-5801 mizzo@ryebrook.org From: Joseph Lentini [mailto:jlentini(awinridge.com] Sent: Thursday, August 03, 2017 3:32 PM To: Mike Izzo Cc: Peter Stahl Subject: BP 16-030 Executive Shower Michael— Hope all is well. Listen the attached permit is about to expire on 9/3/17. 1 would like to request a 6 mos extension to complete this work. I asked Tara if there was any paperwork associated with such a request and she instructed me to simply send you an email with the request. This would be greatly appreciated as we haven't even began to conduct any work on this project yet. Please let me know if this extension is ok? Thank you. Joseph C. Lentini 1 Property Manager WIN RIDGE REALTY,LLC 24 Rye Ridge Plaza I Rye Brook,NY 10573 Office: (914)70140051 Fax: (914)701-4009 1 Cell: (646)773-7333 jlentinina.,winrid eg com 2 Building Permit Check List & Zoning Analysis Address:4 l�- �.1 —�� l Q'Z/4- SBL: Zone:G k Use: 3 Const.Type: =i Other: Submittal Date: 7 1 12 I (— Revisions Submittal Dates: Applicant: 1.t9 v-' _7U%,L> �R_ Nature of Work: Ly1 1 u 1` Z Z Reviews: ZBA: FEB 2 3 2016 PB: BP: Other: NEE OK /,� d ( ) FEES: Filing: l 7S-p aBP: t C/O: Legalization: ( ) ( ,�'APP.: Date Stamped: ✓ Properly Signed: ✓ SBL Verified: H.O.A.Approval: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening: ( ) ( ) ENVIRO.: Long: Short: Fees: N/A: ( ) ( ) SITE PLAN: Topo: Site Protection: S/W Mgmt.: Tree Plan: Other: O O SURVEY: Dated: Current: Archival: Sealed: Unacceptable: ( ) (�PLANS: Date Stamped: Sealed: Copies: 3 Incomplete: N/A: Other: ( (�j License: Workers Comp: "-.-I'Liability: c-- Comp.Waiver: Other: ( ) ( ) CODE 753#: Dated: N/A: HIGH-VOLTAGE ELECTRICAL: Plans: Permit: N/A: Other: ( ) ( ) LOW-VOLTAGE ELECTRICAL: Plans: Permit: N/A: Other: (� ( ) FIRE ALARM/SMOKE DETECTORS: Plans: Permit: N/A: Other: PLUMBING: Plans: Permit: Nat. Gas: LP Gas: N/A/: Other: (� FIRE SUPPRESSION: Plans: L/Pern it: N/A: Other: ( ) ( ) H.V.A.C.: Plans: Permit: N/A: Other: ( ) ( ) FUEL TANK: Plans: Permit: Fuel Type: Other: ( ) ( ) 2010 NY State ECCC: N/A: Other: ( ) ( ) Final Survey: Final Topo: RAPE Sign-off Letter: As-Built Plans: Other: ( ) ( ) BP DENIAL LETTER: C/O DENIAL LETTER: Other: ( ) ( ) Other: ( )ARB mtg. date: approval: notes: ( )ZBA mtg. date: approval: notes: ( )PB mtg.date: approval: notes: REOUMED EXISTING PROPOSED NOTES APPft0VFQb16 Area: SAT . Circle: Frontage: Front: Front: Sides: Rear: Main Cov: Accs.Cov: Ft.WSb: Sd.H/Sb: GFA: Tot.Imn: Ft.Imu: Parking: Height/Stories: notes: Check List For Release of Building Permits Address: 2AIC I 0( 6) C P/0 Owner/Applicant: ��j V�, Phone#'s: () 1 — Dates Attempted To Contact Owner/ Applicant: 41 Jr" Comments: Comments: Comments: Comments: Comments: NEED: (4uilding Permit Fee ( ) UFPO # ( ) WC Home Improvement License (,4�pbility ( orkers Comp. / Comp Waiver ( General Contractor's Contact Information (` stimated Cost ( ) SWO Fee ( ) Legalization Fee ( ) Other Tara O 'k CERTIFICATE OF LIABILITY INSURANCE DATE „ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO MGM UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERIS),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IAAPORTANT: If tM eertllkate Doldar Is an ADDITIONAL INSURED,the poHcypes)mUst be aa�/oi M SUBROGATION IS WAWED.subject to the tMM and eondidme of the potley,esttain po0t ias may mgWre an endom ment.A statement on this cartlrkate does not confer rights to the cettlAeate holder In Neu of such srtdorsernent(s). PRODUCER —-- — Quinton Insurance Protection Team VAX --- 2700 Elmwood Ave Suite B � (�388•�0 LAx.slot (585)3WO531 Rochester,NY 14618 tNiUROlttt111MO1ttftNO_CGII®tAOE sacs Phone ...(55 38&9530 Fax i585 36841531 tNstrReR A: �� INSURED --— ---- IMMEft AA Jedson CompanyLLC EtN 45-5081569 B- We klauratlea CO. . F1W RahablbNoit LNa Mw Co J 3 Ryerklge Plus Suite 149 - — - - Rpbro*NY IOS?3 (914)384-8401 F --- MIaI1R®1 F I COVERAGE8 CERTIFICATE NUMBER: RkVIS10N NUMBER: THt18 IS TO CERTFY THAT THE POLICE S OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIRDMKI.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VVITH RESPECT TO WH I CH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERI S. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY WIVE MEN REDUCED BY PAID CI.II U. TY/!pf N1atIRANfM ��+wyp, POLICY rAlaleE(S UM" Gwaft unapt EACH OauRRtal _ 1000 Wo.OD !® COM1AERCIAL GENERAL IJAMLITY f 17T�Doe 500,000.00 A ❑ C Cct CLAML4 MADE ® D R MPt16222G h111110 r f ON 10,000.00 C_ I 04/18R01$ 04l1tI1Z018 PERaONAL a AOV eaAIRY s 1,000 000.00 — --- GENERAL AGGREGATE s zwo.ow 00 GENL AGGREGATE LIMIT APPLIES PEt- PRODUCTS-COMPlDP ADO s 2,000,000.00 POLICY ® LOC = AUTOMOSHLE LIABILITY SMKiLE LIM CANY AUTO • ALL OWNED SCHEDULED eooILYatI1RYlPartlweel� f C AUTOS ❑ AUTOS BODILY MAW lPa1 aexeMetl t J MRED AUTM ❑ MON-O ED171 AUTOS 1 _ f ""MULL"t'A' oar aRCHOCCURRENCE s EACft UABI CLANSMADE AGGREGATE s YrGRIfEItaGOMPEI"noN YYC13TAT11 AND U04AYM r LIABILITY Y/Nfj ARTNERIEXECUTrVE O=FFIC6taY�IBFR eCKCLU MIA ELL EACH ACCIDENT i deaoie under E.L. DL DISEASE-tTADIPLOYE $ UEJ LION OF OPERATIONS below EL DISEASE-PILY umrr s C NY State Disability D430714 1112 M14 110/2015 Statutory co"nW Ot<lCRIPTION OF OPERATIONS 1 LOCATIOti3/V LEs IAeaotl ACORD tot,Addlfbnal Rameft aoh/dula N more• is Vftpe of Ryebrook,938 King Strad,RyebmoK NY 10573 Is named as Additional Insured with respects ��ects to the General lJabiHty coverBpe l CERTIFICATE HOLDER - --- CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED SE°ORE VNtapa of RyeBrook THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED at 08 KIng Shed ACCORDANCE WITH THE POLICY PROVISIONS. Rye Brook NY 10573 AUTHORIZED REPREBENTATM - O bile-2010 ACORD CORPORATION. AN Aphis reserved ACORD 25(20"415)QF The ACORD Rarrte and bp M roodeered merits of ACORD New Yurk State Insurance Fund WarAm'roapru.uWolf A Dbubr lty Remefla Specialists Simee 1914 1a6 CORPORATt. PARKt Rivr*iufrr mo,mnix PLAINS NFW YMK 108W-38t4 rhaw ,314I M-4111 CERTIFICATE OF WORKERS'COMPENSATION INSURANCE A A A A 455091500 AA JCDSON COMPANY LLC 3 RYE RIDGr PLAZA SMITE 149 RYE BROOK NY 10573 POLICYHOLDLR CERTIFICATE HOLDER AA JEDSON COMPANY LI C VILLAGE Of RYC BROOK 3 RYE RIDGE PLAZA Hat!KINC STREET SUITE 140 RYE BROOK NY 10573 RYE BROOK NY 10573 POLICY NUMW.rt CERTIFICATE NUMBER PEMOD COVERED BY n IIS CERTIFICATE DATE V4204 603-1 884MI 0417,412015 TO 04124120lG 80=2015 1HI5 IS 70 CERTIFY THAT THE POLICYHOLDER NAMEO ABOVE Ig INSURED WIN ItIL NEW YORK STATE INSURANCE FUND UNDER POLICY NO 2204 503-1 UNTIL 041241201G, COVERING Tlir ENTIRE OBLIGATION OF THUS POLICYHOLDt'R FOR WORKERS' COMPENSATION UNDER rHE NEW YOWL WORKERS COml"SATION LAW VKTH RESPECT TO Ali OPERATIONS IN THE STATE Of NEW YORK, EXCEPT AS INOICATI D BELOW, AND WITH RESPECT TOOPCRATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NLW YOHK STATE' rMPLOYLLS ONLY IF SAID MLICY IS CANCELLED OR CHANGLD F f($UR'IO 04t2w201G IN SUCHI MANNER As TO AFFECT THIS CERTIFICATr 10 DAYS WRITTEN NOTICC Or SUCH CANCA:UATION WILL ar QVLN TO THE CrRnncATI; HOLDER ABOVE NOTICE BY REGULAR MAIL SO ADDRrSSLD SHALL BE SUFFICIENT COMPLIANCE V44THI TbRS PROVWON Tw ww YOftK STATE wWRANCT'FUND DOES NOT ASSUME ANY LIAOILITY IN THE EVENT Of FAILURL TO CIVE SUCH NOTtCL THIS NOLICY DOES NOT COVCR THE SOLE PROPRIETOR PARTNERS AND)OR 061EIw4wRr Or A LIMITED LM(UL1TY COMPANY THIS CERTIFICATE IS ISSULD AS A MATTER OF INFORMATION ONLY AND CONfCRS NO RIGHTS NOR INSURANCE COVLI4AGE UPON TIIE CCRTA'ICATE HOLDER THM CLFTru lCAfE DOES NOT AMEND EXTrND OR ALTER THE COVERAGE AFFORDED BY THE POLICY NEW YORK STATE INSURANCE FUNS All DIRLCTOR,INSURANCE FUND UNDERWRITING ML oerbficato can be valwIsled on ourweb silo at htlpr:l/www ny,.W oomfcertkertval asp or by raging(ON)871.6790