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HomeMy WebLinkAboutRP22-011PERMIT #� ' DATE: as SECTION 7 BLOCK �^ TYPE OF WORK en4002 /�� JOB LOCATION OWNER /7 % E'. a _ CONTRACTU R Qj; IJ/ e /'/ C0 i'0 C, !. !q 41 7/a 3 LOT_ CD Cie �S ���/ 70J �C X , p li vieo/ Cao3�9 y3 -5�0(0 EST. COST�W�. %i �7 FEE�(O V%CO # `� FEES DATE TCO # FEE DATE INSPECTION RECORD DATE INSP FOOTING -- FOUNDATION FRAMING ----- PGH FRAMING - INSULATION -- --- PLUMBING RGH PLUMBING -- GAS ` SPRINKLER ELECTRIC - LOW -VOLT ALARM AS BUILT C7 I= wi FINAL OTHER APPROVALS ARIA BOT P8 ZBA OTHE4 — 4R t Who o`v 19 L VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J.Bradbury www.tyebrook.org TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W.Morlino CERTIFICATE OF COMPLIANCE January 30,2024 Win Ridge Realty LLC c/o Alena Hakanjin 24 Rye Ridge Plaza Rye Brook,New York 10573 Re: 126-140 South Ridge Street, Rye Brook,New York 10573 Parcel ID#: 141.27-1-6 Roof Permit#22-011 issued on 4/7/2022 to Re-Roof Portion of Existing Building This certifies that the new roof,installed under the above captioned permit has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to ® L� V BUILD :BROOK,F!YoRK NT For office use onl PERMIT V E K ISSUED: — —a JAN 1 2 2024 S KING STRE Y 10573 DATE: /a - FEE: 2I O- PAID VILLAGE OF RYE BROOK BUILDING DPPARTMENT 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 I+�www++wl***+ss+s(s^srtwww***ww***tt+***+t*+*w+***+*+*++*ww*+ww+***+www+ww*+*+*+* Address: ( �- ����V l f' 1 t C 9 e fit e t- Occupancy/Use: Parcel ID#: /-w", Zone: c� Owner:Vj"d 911oK Q ��y , t'-�C- Address: �-� i�`olge Z nn M 1`yc 0tr,0 l� ll; .I •T P.E./R.A.or Contractor: 01 tug er t CO�tt(a G}t+IclC Address: Ba Ca kr fi G�Chr�iry�CT. D61Sjt7 Person in responsible charge: 6 of k%, (}���J u 2 tf�l Address: A 7 f-r— C°Nr f G lee-w%c4 ,(T M9k 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: nn 0 Sri h 0��u 1 e r I being duly swom,deposes and says that he/she resides at � 17 (4 e C°"d (Print Name of Applicant) (No.and Street) T- in G r eeo w t C I ,in the County of + e in the State of ,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:$ �/ b, (6�, 3y for the construction or alteration of: N e-\O✓ p00 OF 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 -S RA Sworn to before me thiis/ 311LA day of cJANV40EY 20 2"1 day of 3 I , 20 / I wyt I OL Iw v t of Pro rty 0.,AVWr Signature of Applicant UNY C l�1(7LlSlf �rA(�—►✓t J ti r I Print a f Property Print am Applic No Public Notary Public ALENA HAKANJIN NOTARY PUBLIC,STATE OF NEW YORK ALENA HAKANJIN Registration No.O1 HAO013645 NARY PUBM,STATE OF NEW YORK /2021 Qualified in Westchester County Registration No.OIHAOO13645 My Commission Expires 911912027 Qualified in Westchester County My Commission Expires 911912027 QyE[iRC��. t7 �O ��• �9t32 `� BUILDING DEPARTMENT ❑BUILDING INSPECTOR 2'XSSISTANT 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 : Z �e - C'1 �-1 l C�� ST DATE: 1- ZS - Z01 PERMIT# 1` / Z 0 1 1 ISSUED:—Y- 7- ZZSECT: /y/• 2 7 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 - S�, 1 v ❑ L.P. Gas - ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER x a ■ w rl M 0 gv rl N N v 'b7D a 0 N O fss y '0 u q CA h� O b ii. a t04 a �.y O O fi v a to � j H a� W n \ Ln pdHaao P4 Qo O L �;, 7 o to A O ° � � ° W ° ECC V M■-r C!� 1 w er o 0-0 W-4 Z a A C7 cl, O W FBI �/ N_ w jo g O a o00 cy A a w z zz � � � x p Ln 0 004 0y o H Q FO O 0o0 3ga C!} W z O IL,o ff a �.oAu R., 14 a h+y � o j Vr C7 A z O a m j..r 4j � w a •x �, f o4 c �'{ 9Q a a W �1- x -10, p EC EdWE BUILDING DEPARTMENT VILLAGE OF RYE BROOK MAR 1 2022 ID 939 KING STREET RYE BROOK,NY 10573 VILLAGE OF RYE BROOK (914)939-0668 BUILDING DEPARTMENT Wwwj�e,b ohorg. FOR OFFICE USE ONLY: / / Approval Date: R 202 a it ti odc / Application# Approval Signature: ARCHITECTURAL REVIEW BOARD: Disapproved: : Date: BOT Approval Date: Case# : Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Case# Other: Application Fee: 6;ql Permit Fees; ROOF PERMIT APPLICATION Application dated: ZZ is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit to Re-Roof an Existing Building,as per detailed statement described below. / 1. Job Address: t Zlo-I,- �V4 V-P TXV S�'(:r�',[^ SBL: I I• �' Cf� Zone:�p Property Owner: W� Ra)bL KLXTYi WC Address:2 9JG MT, Phone#: Cell#: email: 2. Applicant: AMR—T_�N weam za Address: &)-E , bReENOY L O Phone#: Celli#:�yZ+(����` u�1�U email: �' �ZV <QW—S 3. Roofing Contractor: 1i f �lrSe Address: >(j U�QT► -I�'v� 1 Phone#: Cell#: �3� ` ' � email:ij1R>Z1`I @"LMR 0F_r?1V 1 LL'ylrf 4. Job Description, list all Methods&Materials: L o O g 0 ✓I C w ri t e S f m i� f,4 ( ( f o r c - V06c) ft-c[C f4e '(u�ed /'Libber Self GAe '/L'f_, vq"broto E'_ 5. Estimated Cost of Job:S -Z610 l ` 2 • S!-- (NOTE:The estimated cost shall include all site improvements,labor,material,scaffolding,fixed equipment,professional fees,and material and labor which may be donated gratis.) 6. If corner property,indicate street frontage: 7. Construction Type: NYS Construction Class: 8. Number of stories: Height: 9. Is garage being re-roofed:No: ( )•Yes:( )Attached No:O•Yes: ( )Number of Cars: 10. Is roof peaked,hip,mansard,flat,etc: 11. Estimated date of completion: 4- 8112021 Please note that this application must include the notarized signature(s) of the legal owner(s) of the above-mentioned property, in the space provided below. Any application not bearing the legal property owner's notarized signature(s) shall be deemed null and void, and will be returned to the applicant. STATE OF NEW YORK,COUNTY OF WESTC14ESTER ) as: being duly sworn,deposes and states that he/she is the applicant above named, Tint name of individual signing as the applicant) and further states that )he is the 1 al owner of the property to which this application pertains, or that (s)he is the b-'!�M C ftzf M_ for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,auorne ,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 of �` , 20 tj, day,of 20 Zz &pafure of operty Owner 4 _ WVJ 1 %6e 40Y, v—C Signature of Applicant NW co&LI34 �1y�mr, Print Name of Property er �t Name of Applicant N&4 Public Notary Public KFLL't Notary PUDI.C, Nlew York No. 01" SHARI MELILLO 01lalified in V!.= .,cn«;: r Cci or+y _ Notary Public,State of New York Commission Expires Malct) �, _a No. Ot,Mi 616OC63 Q-_iaTfled in lNestchester County Commission Expires January 29,20 3 -2- 8I1212021 �n� tu v t in� MAR 23 2022 'Fitsestone Firestone Building Products TECHNICAL INFORMATION SHE BUILDING OF RYE BROOK FufforceTM EPDM Item Description Item Number .060"x 9'10.5"x 100' W561_6101 OFF (1.5mmx3mx30.5m) ' Weight: 0.47 Ib/ft2 (2.29 kg/mZ) Product Information Description: Firestone FuIlForce EPDM membrane with Secure Bond' Technology is the next generation of self-adhered roof system application.Secure Bond Adhesive is factory applied which ensures uniform adhesion across the entire membrane,creating a powerful bond with the substrate. This advanced technology not only improves installation speed over traditional fully adhered applications, but also widens the installation window with the ability to be installed down to 20 °F (-7 °C). With no VOCs emitted during field membrane application, FuIlForce EPDM with Secure Bond Technology is a reliable solution for all your fully adhered roofing needs. Method of Application: Approved substrates must be clean, dry and free of foreign material such as grease and any debris which could inhibit adhesion. This may require cleaning with a broom or blower. An acceptable Firestone Primer is required for seaming, detailing, sealant work and vertical flashings, but no bonding adhesives are required for field membrane attachment. 1. Prepare substrate and secure insulation per current Firestone technical specifications. 2. Install FuIlForce EPDM membrane only when membrane, substrate and ambient temperatures exceed 20 °F (-7 °C) and rising. Do not install FuIlForce EPDM membrane below this minimum temperature. 3. Unroll and position the membrane over the substrate to achieve the desired alignment and seam overlaps. Allow the membrane to relax a minimum of 30 minutes before final positioning and adhering. 4. Position adjoining sheets in shingle fashion or so that seams run parallel to the flow of water. and that all side and end laps provide a minimum 3" (76.2 mm) overlap. 5. Apply an acceptable Firestone Primer (QuickPrime TM Plus, QuickPrime Plus LVOC, Single-Ply QuickPrime Primer or Single-Ply LVOC Primer) to all EPDM lap surface areas to receive FuIlForce EPDM. 6. All membrane and flashing splices require the application of seam edge treatment using FuIlForce Sealant. 7. An acceptable Firestone Primer(as noted above) is required for vertical surfaces. 8. Refer to the FuIlForce EPDM Application Guide and associated Technical Information Sheets for additional installation information. Storage: • Warehouse membrane in a clean dry location. • FuIlForce EPDM membrane stored on jobsite must be kept dry. • FuIlForce EPDM membrane must be a minimum of 20 °F (-7 °C) prior to installation. • Store away from sources of punctures and physical damage. • Make certain the structural decking will support the loads incurred by material when stored on rooftop. The deck load limitations should be specified by the project designer. • Store away from ignition sources. Shelf Life: 18 Months when stored between 60 °F (16 °C)and 80 °F (27 'C)out of direct sunlight. Firestone Building Products I Sales:(800)428-4442 1 Technical(800)428-4511 1 www.firestonebpco.com 3102/2020 TIS 119 Page 1 of 3 TlrestOtlle Firestone Building Products TECHNICAL INFORMATION SHEET FufforceTM EPDM Precautions: Take care when moving, transporting and handling to avoid sources of punctures and physical damage. Removal of the polymeric release liner from the adhesive backing may create a static electric charge; care should be used when removing and handling the release liner. Refer to Safety Data Sheets (SDS) for additional safety information. LEED® Information: SsIF�Fo Post-Consumer Recycled Content: 0% FM QP Post Industrial Recycled Content: 3-5% CU$ Manufacturing Location: Tuscumbia, AL 1t NOTE: LEEDO is a registered trademark of the U.S.Green Building Council. APPROVED ' Acceptable Substrates Substrate Primer Acceptable Application Special Application Considerations I NOTE Req d Temperatures ISO 95+T11 GL/ No 20- 120°F(-7—49°C) ISOGARDTm GL ISOGARD HD No 20- 120°F -7—49°C Broom only, do not roll in place with weighted roller RESISTA/ No 20-120 °F(-7—49°C) Broom only, do not roll in place with weighted roller ISOGARD CG Must be clean,dry and properly cured prior to Structural Concrete No 20- 120°F(-7—49°C) application Use on clean,dry and properly cured cellular Lightweight Concrete No 20- 120°F(-7—49°C) lightweight concrete only, not acceptable with lightweight aggregate concrete DensDeck®` No 20- 120°F(-7—49°C) DensDeck Prime No 20- 120 °F(-7—49°C) Securock®•• No 20- 120°F(-7—49°C) No 20-120°F(-7 49°C) Check local code for acceptance of direct — Plywood application OSB Board No 20- 120°F(-7—49°C) Check local code for acceptance of direct application CMU/Masonry No 20-120°F(-7—49°C) Must be clean&dry prior to application. Apply an acceptable Firestone primer to Vertical Substrates Yes 20- 120 °F (-7—49 °C) vertical substrates. i DensDeck is a trademark of the G-P Gypsum Corporation "Securock is a registered trademark of the USG Corporation 7Nominal Test Method Units Performance Min. Typical Values -- --- --- Clear ckness ASTM E 408-71 in mm N/A _ 0.007 (0.178 I Weiaht --- Ib/ft2 k /m2 --- 0.040 (0.002�_ Firestone Building Products I Sales:(800)4284442 1 Technical(800)428-4511 1 www.firestonebpco.com 3/0212020 TIS 119 Page 2 of 3 'Firestone Firestone Building Products TECHNICAL INFORMATION SHEET FullForceTM EPDM • • • - .. Foperty ASTM Standard Performance 7mm) Typ.Values -60 mil Thickness, minimum, Sheet-overall D 412 60 mil-0.050" 0.059(1.499) Tensile Strength,min. D 412(Die C) 1305 psi(9.0 MPa) 1450(10.0) Dynamic Puncture Resistance D 5635/D 5635M 5 J min @ 73.4 t 4° Flow slop pass Static Puncture Resistance D 5602/D 5602M 44.1 Ibf(20 kg) pass Elongation, Ultimate, min. D 412(Die C) 300% 475 D 412, 10% 2.0 Tensile set, max. Method A(Die C) Tear Resistance, min. D 624(Die C) 150 Ibf/in(26.27 kN/m) 195(34.1) Brittleness point,max. D 2137 49°F(45°C) Ozone resistance, no cracks D 1149 pass pass Heat Aging: D 573 1205(8.3) 1490 (10.3) Tensile Strength, min. D 412(Die C) 200% 320 Elongation, ultimate,min. D 412 125 Ibffin(21.9 kN/m) 179(31.3) Tear resistance, min. D 624 t1.0% -0.3 Linear dimensional change, max. D 1204 Water absorption, max., mass D 471 +8%, -2% +1.5 Factory Seam Strength,min. D 816 50 Ibf/in(8.8 kN/m)or Sheet Failure Method B(modified) Sheet Failure Weather Resistance: G 151 /D 518 Visual inspection G 151 /D 518 No cracks or crazing Pass PRFSE, min. G 155/D 412 30 53 200 255 Elongation, ultimate, min (Die C) Air Permeance(Material) E2178' <0.004(0.02) pass 1. ;The ASTM 2178 values listed above are for the air permeance of the RubberGard EPDM Membrane component only. 2. When system design includes an air barrier, please consult your Firestone Technical Services Advisor for additional roof system securement enhancements. 3. Consult the Designer/Architect,Code Agency or Authority having Jurisdiction(AHJ)for requirements regarding the selection and use of ar appropriate air barrier material,and its installation into the building envelope. Please contact Firestone Technical Services at 1-800-428-4511 for further information. This sheet is meant to highlight Firestone products and specifications and is subject to change without notice. Firestone takes responsibility for furnishing quality materials which meet published Firestone product specifications or other technical documents, subject to normal roof manufacturing tolerances Neither Firestone nor its representatives practice architecture.Firestone offers no opinion on and expressly disclaims any responsibility for the soundness of any structure.Firestone accepts no liability for structural failure or resultant damages. Consult a competent structural engineer prior to installation if the structural soundness or structural ability to property support a planned installation is in question. No Firestone representative is authorized to vary this disclaimer. Firestone Building Products I Sales:(800)428-4442 1 Technical(800)428.4511 1 www.firestonebpco.com 3/0212020 TIS 119 Page 3 of 3 AFIrestone Firestone Building Products TECHNICAL INFORMATION SHEET FullForceT"' Sealant Item Description Item Number 10.3 oz (0.31 L) Cartridge W563587001 (30 Cartridges per Cardboard Carton) _4q t 28.2 cz (0.83 L) Cartridge W56358282F (12 Cartridges per Cardboard Carton) Product • • Description: Firestone FullForce Sealant is a low volatile organic compound (LVOC)sealant designed to be used with Firestone Primers for seam and flashing edge treatment on Firestone FullForce EPDM roofing systems as indicated by current specifications and details. Method of Application: 1. Surfaces to receive FullForce Sealant shall be clean, dry, and free from loose or foreign materials, oil, and grease. 2. Apply FullForce Sealant by the end of each working day. 3. Prior to application of FullForce Sealant, clean and prime the seam edge a minimum of 1" (25.4 mm)on each side of the step-off with an acceptable Firestone primer (QuickPrime TM Plus, QuickPrime Plus LVOC, Single-Ply QuickPrime Primer or Single-Ply LVOC Primer) and allow to flash off according to the primer specification. If the seam edge has been contaminated, clean the edge with Firestone Splice Wash before applying primer. 4. FullForce Sealant has a working time of approximately 35 minutes. 5. Cut the plastic nozzle applicator tip to create an opening of approximately 1/4" (6.35 mm) diameter at the dispensing end for sealant application. 6. Using the nozzle applicator, apply a continuous bead of FullForce Sealant approximately %" x 1/0 (9.53 mm x 6.35 mm), centered over all seam and flashing edges on Firestone FullForce EPDM roofing systems. Be sure to keep FullForce Sealant nozzle tip centered over the lap step-off. Refer to current Firestone seam details for additional information. 7. FullForce Sealant does not require troweling. 8. Do not disturb freshly applied FullForce Sealant. Protect FullForce sealant from foot traffic, equipment carts, hoses, cables, etc., during cure time, which is typically 24 hours after application. Storage: • Store in original unopened containers at temperatures between 60 °F and 80 °F (15.6 °C and 26.7 °C). • When exposed to lower temperatures, restore to room temperature prior to use. • For optimum results, rotate stock to ensure stored material has not exceeded the shelf life. Shelf Life: • Shelf life of one (1)year can be expected when stored in original, sealed containers at temperatures between 60 °F and 80 °F (15.6 °C and 26.7 °C). • Shelf life will be shortened if exposed to elevated temperatures (temperatures 80 °F, 26.7 °C and above). Firestone Building Products I Sales: (800)428-4442 1 Technical(800)428-4511 1 www.firestonebpco.com 08/12/2020 TIS#1323 Page 1 of 2 Aprestone Firestone Building Products TECHNICAL INFORMATION SHEET FullForceTM Sealant Coverage Rate: • 10.3 oz (0.31 L) Cartridge: 20' to 22' (6.1 m to 6.7 m)of "x Y4" (9.53 mm x 6.35 mm) continuous bead. 28.2 oz(0.83 L)Cartridge: 55 to 60' (16.8 m to 18.3 m)of%"x'/"(9.53 mm x 6.35 mm)continuous bead. Clean-Up: Recommended cleaner is isopropyl alcohol followed by soap and water. Precautions: Review Safety Data Sheet (SDS) prior to use. Flammable. Keep away from fire and open flame during storage and use. Do not smoke during use. • Use only in well ventilated areas. Do not contaminate with foreign materials. LEED® Information: Post-Consumer Recycled Content: 0% Post Industrial Recycled Content: 0% Manufacturing Location: Spring Lake, MI 'NOTE:LEED is a registered trademark of the U.S. Green Building Council. TypicalProperties Property Typical Performance Base STPE j Color Black Solvents None Solids by Volume z 97% Viscosity 20 RPM: 68,500-77,700 cPs Specified Gravity 1.43±0.03 Weight 11.92±0.25 lb/gal. (1.43±0.03 kg/L) Pot Life Approximately 35 minutes V.O.C. Content 21 g/L Please contact Firestone Technical Services Department at 1-800-428-4511 for further information. This sheet is meant to highlight Firestone products and specifications and is subject to change v�ilhouf notice. Firestone takes responsibility for furnishing quality materials which meet published Firestone product specifications or other technical documents. subject to normal roof manufacturing tolerances. Neither Firestone nor its representatives practice architecture.Firestone offers no opinion on and expressly disclaims any responsibility for the soundness of any structure.Firestone accepts no liability for structural failure or resultant damages.Consult a competent structural engineer prior to installation if the structural soundness or structural ability to property support a planned installation is in question.No Firestone representative is authorized to vary this disclaimer. Firestone Building Products I Sales: (800)428-4442 1 Technical(800)428.4511 1 www.firestonebpco.com 08/12/2020 TIS#1323 Page 2 of 2 Technical Information Sheet Firestone ISO 95+ GL Insulation Board 1. Description Firestone ISO 95+ GL consists of a closed-cell Polyisocya n u rate foam core larninated on both sides to a glass reinforced mat facer.The foam technology does not contribute to the depletion of the earth's ozone layer (zero ODP) and uses a HCFC Free blowing agent. The ISO 95+ GL insulation board is suitable for adhered, ballasted and mechanically attached single-ply roofing systems. It provides outstanding thermal resistance, dimensional stability and compressive strength. 2. Preparation Before insulation is placed on the roof deck, the surface must be clean, dry, free of debris, water, ice or snow, and suitably prepared by removing all defects that might affect the quality of the application. 3. Application ISO 95+ GL Insulation boards must be installed by using fasteners and plates, hot bitumen or Firestone approved insulation adhesives. Insulation shall be neatly fitted to all roof perimeters, penetrations and abutments. No more insulation shall be installed than can be covered with membrane and completed before the end of each day's work or before the onset of inclement weather. The ISO 95+ GL board is suitable for adhered, ballasted and mechanically attached single-ply roofing systems. Mechanically Attached System Fasten the insulation boards with a minimum of 5 approved fasteners and plates per 1.22 x 2.25 m board. Additional fasteners may be required in areas of high wind loads or around the perimeter of the roof. Please refer to local wind uplift requirements and/or contact the Firestone Technical Department. Ballasted System For ballasted roof systems,the top layer of Firestone insulation may be loose laid or adhered. If mechanical attachment is specified, contact Firestone Technical Department. Fully Adhered System Number of fasteners per board needs to be determined based on a wind uplift calculation in accordance with local building codes and taking into account the following minimum requirements: ■ Thicknesses less than 38.1 mm: minimum 16 fasteners per 1.22 m x 2.25 m board ■ Thicknesses less than 50.8 mm: minimum 12 fasteners per 1.22 m x 2.25 m board ■ Thicknesses less than 101.4 mm: minimum 8 fasteners per 1.22 m x 2.25 m board 4. Characteristics Physical ASTM test Typical Value EN test Typical Value ■ Density D-1622 32 kg/m3 823 32 kg/m3 ■ Compressive strength D-1621 > 138 kPa 826 > 138 kPa ■ Dimensional stability D-2126 <2% t Water absorption C-209 <1%(by volume) 12087 <3%(by volume) ■ Service temperature -73°C to 121*C Technical ■ Compatible with ballasted,fully adhered and mechanically attached single-ply systems. ■ Available in flat boards of 1.22 m x 2.25 m(4'x 7'4.5")and in thicknesses ranging from 25.4 mm to 101.6 mm(1"to 4"). ■ Coated and perforated glass fleece facer of approx. 150 g/m2. ■ EPDM and TPO Roofing Systems installed over Firestone ISO 95+GL obtain BROOF(tl)fire rating. a Technical Information Sheet Thermal resistance Thickness R-Value [mm) [inches] [m2• KAM 25,4 1,00 1,11 31,7 1,25 1,35 38,1 1,50 1,58 445 1,75 1,82 50,8 2,00 2,05 58,4 2,30 2,26 53,5 2,50 2,44 71,1 2,80 2,71 76,2 3,00 2,89 82,6 3,25 3,02 88,9 3,50 3,24 95,3 3,75 3,45 101,6 4,00 3,68 5. Packaging / Storage / Shelf Life Packaging: Bundles. Tuff-wrap packaging provides a durable protective covering to the top and four sides of the bundle, as well as a portion of the bottom board. Storage: Cool and dry. Store material in unopened packaging in a dry area away from sources of physical damage or chemical contamination. Shelf life: Unlimited. 6. Precautions Combustible. firestone ISO 95+ GI is a non-structural, non-load-bearina material. Therefore, keep insulation dry at all times. Bundles need to be elevated above the water line to prevent moisture infiltration from the bottom side. Do not install over wet, damp or uneven substrates. The finished roof assembly should be protected from excessive roof traffic with proper walkway materials. nAir lFirestone TECHNICAL INFORMATION SHEET BUILDING PRODUCTS ISO 95+TM GL Insulation Item Description Flat and Tapered Polyiso Boards Cellulosic Glass Reinforced Facer Flat Boards: 4' x 4' (1.22 m x 1.22 m) 4' x8' (1.22mx2.44m) K Tapered Boards: 4' x 4 (1.22 m x 1.22 m) Slope range: 1/16" per foot(.5%)to '/z" per foot(4%) Thickness range: 0.5" (12.7 mm) to 4.5" (114.3 mm) Meets or exceeds erformance re uirements of ASTM C 1289,Type 11,Class 1 Foam Core Product Information Description: Firestone ISO 95+ GL flat and tapered roof insulation consists of a closed-cell polyiso foam core laminated to a black glass reinforced mat facer on both major surfaces. Flat and tapered ISO 95+ GL insulation provides outstanding thermal performance on commercial roofing applications, while providing positive rooftop drainage to help eliminate ponding water when tapered ISO 95+ GL insulation is used. All Firestone polyisocyanurate insulations use EPA accepted blowing agents. Firestone ISO 95+ GL incorporates a HCFC- free blowing agent that does not contribute to the depletion of the ozone layer(ODP-free). Method of Application: 1. Insulation shall be neatly fitted to all roof penetrations, projections and nailers. 2. No more insulation shall be installed than can be covered with membrane and completed before the end of each day's work or before the onset of inclement weather. 3. Firestone ISO 95+ GL board may be installed using: Firestone fasteners and plates NOTE: For ballasted systems,the top layer of Firestone insulation may not be mechanically attached. • Hot asphalt(requires a cover board) • Firestone approved insulation adhesives • I.S.O. Twin PackT"" • I.S.O. Stick"" • I.S.O. SprayTm R • I.S.O. FIXTm 11 Acceptable Immediate Substrates: • 3,000 psi Structural concrete (must be clean, dry, and properly cured) • Steel deck (min 22 ga) • Plywood and OSB (min '/2') • Lightweight concrete • Gypsum deck (min 2") NOTE: Please consult the Design Guides and QuickSpecs online at www.firestonebpco.com to review specific information regarding the assembly. Storage: • Keep insulation dry at all times • Elevate insulation above the deck or ground • Cover insulation with waterproof tarps Firestone Building Products I Sales:(800)428.4442 1 Technical(800)428-4511 1 www.firestonebpco.com TIS#901 10/05/2017 Page 1 of 3 Aprestone TECHNICAL INFORMATION SHEET BUILDING PRODUCTS ISO 95+TM GL Insulation Precautions: • Polyiso foam will burn if exposed to a flame of sufficient heat and intensity. Keep away from heat, sparks, and open flames. • Protect against dust that may be generated during installation. • Refer to Safety Data Sheet(SDS)for additional information. • Take care when transporting and handling Firestone insulation to avoid physical damage. Specification Compliance: PssrF,Fo FM Pi��� � ASTM C1289, Type 11, Class 1 U ualit��l�u l: UL Classified—UL1256 APPROVED �- US FM Class 1 Approved Manufactured in an ISO 9001 Registered Facility MIAMI DADE COUNTY CCMC 13274-L CAN/ULC-S704,Type 1, Class 3 LEED® Information: See Recycled Content in table below. Bristol, Ct Manufacturing Locations: Florence, KY Corsicana, TX De Forest, WI Salt Lake City, UT Youngwood, PA Jacksonville, FL NOTE: Miami Dade Classified polyiso is only produced in the Jacksonville, FL and Youngwood, PA facilities. Typical Properties (Meets ASTM C 8' Property ASTM Test Method Firestone Typical Performance Grade 2: 20 psi (138 kPa) Compressive Strength: D1621 Grade 3: 25 psi (172 kPa) Density: D1622 2 pcf(32°kg/m3) Dimensional Stability: D2126 <2/o Moisture Vapor Transmission: E96 <1 perm (<57.5 ng/(Pa•s•m2)) Water Absorption: C209 <1% by volume Service Temperature: -- -100 to 250 °F (-73 to 121 °C) F Index 50 Flame Spread: E84 1 Smoke Development: E84 Index 160- 180 *25 psi(172 kPa)available upon request. Firestone Building Products I sales:(800)428-4442 1 Technical(800)428-4511 1 www.firestonebpco.com TIS#901 10/05/2017 Page 2 of 3 'Firestone TECHNICAL INFORMATION SHEET BUILDING PRODUCTS ISO 95+TM GL Insulation Product • • Thickness• (R-Value) Max Flute S an Approx. Recycled Content inches mm '" inches mm Post Consumer Post Industrial Total 670 15% ° 0.5 12.70 2.9 1.50 38.10 52% ° 1.0 25.40 5.7 2.62 66.67 37% 15% 52/o 15% ° 1.1 27.94 6.3 2.62 66.67 36% 49% 1.2 30.48 6.8 2.62 66.67 34% 15% o 1.3 33.02 7.4 3.67 93.34 32% 15% 45 0 1.4 35.56 8.0 3.67 93.34 30% 15% 4 % 0 0 15% 44% 1.5 38.10 8.6 4.37 111.12 29% 0 1.6 40.64 9.1 4.37 111.12 27% 15% 42/o 1.7 43.18 9.7 4.37 111.12 26% 15% 41% 1.75 44.45 10.0 4.37 111.12 26% 15% 41% 1.8 45.72 10.3 4.37 111.12 25% 15% 40% ° 1.9 48.26 10.8 4.37 111.12 24% 15%15% 39% 2.0 50.80 11.4 4.37 111.12 24% 15% ° 2.1 53.34 12.0 4.37 111.12 22% 37/o 36 15% ° 00 2.2 55.88 12.6 4.37 111.12 21% 2.25 57.15 12.9 4.37 111.12 21% 15% 36/o 3 15% ° 2.3 58.42 13.2 4.37 111.12 21% 2.4 60.96 13.8 4.37 111.12 20% 15% 35% 2.5 63.50 14.4 4.37 111.12 20% 15% 35% 2.6 66.04 15.0 4.37 111.12 19% 15% 34% 15% 2.7 68.58 15.6 4.37 111.12 18% 33° % 2.75 69.85 15.9 4.37 111.12 18% 15% 33 2.8 71.12 16.2 4.37 111.12 18% 15% 33% 2.9 73.66 16.8 4.37 111.12 17% 15% 32% 15% ° 3.0 76.20 17.4 4.37 111.12 17% 31 3.1 78.74 18.0 4.37 111.12 16% 15% ° 3.2 81.28 18.6 4.37 111.12 16% 15% 3100 3.25 82.55 18.9 4.37 111.12 16% 15% 31/o 15% ° 3.3 83.82 19.2 4.37 111.12 16% 30% 3.4 86.36 19.9 4.37 111.12 15% 15% 15% ° 3.5 88.90 20.5 4.37 111.12 14% 29% 3.6 91.44 21.1 4.37 111.12 14% 15% 29/o ° 3.7 93.98 21.7 4.37 111.12 15% 14% 2900 3.75 95.25 22.0 4.37 111.12 14% 15% 29/o 3.8 96.52 22.3 4.37 111.12 14% 15% 29% 3.9 99.06 23.0 4.37 111.12 14% 15% 29% 15/o ° 4.0 101.60 23.6 4.50 114.30 14% 15% 28% 4.1 104.14 24.2 4.50 114.30 13% ° 4.2 1 1.6.58 24.9 4.50 114.30 13% 15% 28/o 15% ° 4.25 107.95 25.2 4.50 114.30 13% 15% 28% 4.3 109.22 25.5 4.50 114.30 13% 0 28% 4.4 111.76 26.1 4.50 114.30 13% 15/o 28 0 15% ° 4.5 114.3 26.8 4.50 114.30 13% 'Other thicknesses available upon request. "R-values provide a 15-year time-weighted average in accordance with CAN/ULC-S770. Please contact Quality Building Services Technical Department at 1-800-428-4511 for further information. This sheet is meant to highlight Firestone products and specifications and is subject to change without notice.Firestone takes responsibility for furnishing quality matehals which meet published Firestone product specifications or other technical documents, subject to normal roof manufacturing tolerances. Neither Firestone nor its representatives practice architecture.Firestone offers no opinion on and expressly disclaims any responsibility for the soundness of any structure.Firestone accepts no liability for structural failure or resultant damages. Consult a competent structural engineer prior to installation if the structural soundness or structural ability to property support a planned installation is in question. No Firestone representative is authorized to vary this disclaimer. _ Firestone Building Products I Sales:(800)4284"2 1 Technical(800)428.4511 1 www.firestonebpco.com TIS#901 10/0512017 Page 3 of 3 Olivieri Contracting, Inc. ROOFING SPECIALIST Proposal 7 bote court Greenwich, CT 06830 (203) 531-1340 (914)422-0527 PROPOSAL SUBMITTED TO PHONE DATE Win Ridge Realty,LLC 11/13/22 STREET JOB NAME 24 Rye Ridge Plaza S.C.Bldg 2-Includes roofs from Cerbones to Rye Ridge Deli CITY,STATE AND ZIP CODE JOB LOCATION Rye Brook,NY 10573 ARCHITECT DATE OF PLANS 14,266 square feet of roof JOB PHONE e hereby propose to urnish rnwena s Wan, necessary for the completion—of Remove existing lavers of rooting material All debris will be hauled aww All metal decking will be inspected for rot/if needed S12 per square foot 5.2 inch isco guard insulation will be installed to the entire roof deck surface 3 inch plates and screws will be used as fasteners Firestone Full Force EPDM .060 thick fire rated rubber self adhesive membrane will be installed as the new rooting system Seams will be primed then a 3 inch seam tape will be installed under seams Rubber will be extended up parapet walls with water cut off applied behind rubber Termination bar will be installed along walls AP sealant will be applied along tops of termination bars Fabricate and install new copper pitch pockets for threw roof penetrations Portable sealer will be applied inside pitch pockets Install new hurricane drains with caste 5 inch alasta lorm flashing tape%ill be used for details Full force lap sealant will be applied along all seams Permit will be provided for job ros ,--e UAtl" I (✓ C�J�t JZ: 1 Workmanship is guaranteed by OLIVIERI CONTRACTING INC. for a 10 year period upon completion of all ..ark Ind final payment ofjob Firestone Certified Installer License#0040007916 WE PROPOSE hereby to furnish material and labor-complete in accordance with above specifications,for the sum of: Payment to be made as follows dollars(S 256.169.34 I/3 to start 1/3 halfway and balance upon completion of job All material is guaranteed to be as specified.All work to be completed in a sub- stantial workmanlike manner according to specifications submitted. per standard Authorized practices.Any alteration or deviation from above specifications involving extra Signature costs will be executed only upon written orders,and will become an extra charge 8 over and above the estimate All agreements contingent upon strikes.accidents or delays beyond our control.Owner to carry fire,tornado and other necessary in- Note This proposal may be surance Our workers are fully covered by Workmen's Compensation Insurance. withdrawn by us if not accepted within 30 days ACCEPTANCE OF PROPOSAL The above Prices,specifications and condi- tions are satisfactory and are hereby accepted. You are authorized to do the work as specified.Payment will be made as outline above. Signature ri>av,rN Dale Of Acceptance ✓' ZZ� `V Signature M •l � 1 r Z ..t .a n // (( Building Permit Check List&Zoning Analysis Address: I?- & ��T 3 S� • SBL: 11 27 Zone: C.k -T- Use: 1 AAA Const.Type: Other. Submittal Date: I `Z-Z Revisions Submittal Dates: Applicant: LM 1 IN ­107 Nature of Work: —1 2Z -LZA�� �1 O R--T'?1_3►� �F ��i�4 1►-�G ��,1� -�2-�i��ll l Reviews:ZBA:MA R 1 4 2022 pB: BOT: Other. 1�1 OK ( ( ) FEES:Filing: ZS, BP: Co r `+O - C/O: Legalization: ( ) ( /APP: 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. ( ) (v�License: Workers Comp: ✓ Liability: 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: H.W.I.C.:_Battery._Other. ( ) ( ) PLUMBING:Plans: Permit: Nat.Gas: LP Gas: N/A/: Other. ( ) ( ) FIRE SUPPRESSION:Plans: Permit: N/A: Other. ( ) ( ) H.V.A.C.: Plans: Permit: N/A Other. ( ) ( ) FUEL TANK:Plans: Permit: Fuel Type: Other. ( ) ( ) 2020 NY State ECCC: N/A: Other. ( ) ( ) Final Survey Final Topo: RA/PE 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: REQUIRED EXISTING PROPOSED NOTES APPROVED Circle: Fie Front. Froru: Sides: l3� Main Cov. Accs.Cov Ft.HS : S . Sb: Tom: E IMP: Paz ' Hdght/Stories: /U no a-- A 4L L_ i ti�T `f 4 G a p —t L,dTtZ F T E� ,o 2E 2 ACORO' CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDlYYYY) 05/26/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED.the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Stacey y Johnson Acrisure, LLC d/b/a: Atlantic Agency (A/�tio _ (s31►zaaa�sa FAX 1469 Deer Park Avenue E-MAIL Steoe J atlantioa eno oom ADDRESS: Y 9 Y• NORTH BABYLON, NY 11703 INSURERS AFFORDING COVERAGE NAIC a INSURERA: Atlantic Casualty Ins Co 42846 INSURED INSURER B OLIVIERI CONTRACTING INC INSURERC: 7 BOTE COURT INSURER D GREENWICH, CT 06830 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 00034389-1198985 REVISION NUMBER: 86 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MM/DDPOLICY/YYYY M EFF O/DD LICY EXP LTR LIMITS A X COMMERCULL GENERAL LIABILITY L068026911-0 0512312021 05/2312022 EACH OCCURRENCE $ 1,000,000 NTED CLAIMS-MADE �OCCUR PREMISDAMAGE ESERE occurrence) $ 100,000 MED EXP(Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2 00O 000 POLICY JET LOC PRODUCTS-COMP/OP AGG S 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ a ac dent ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LAB Ld CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUE I ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) Remodeling/Roofing/Sheet Metal Work-The Certificate of Insurance is issued subject to all policy terms, conditions, limitations,exclusions and language of the policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN RYE Brook Building Dept. ACCORDANCE WITH THE POLICY PROVISIONS. 938 King Street RYE BROOK, NY 10573 AUTHORIZED REPRESEfqATIVE ez-­ (SAJ) ©1988-701T ACORD CORPORATION. All rights reserved. ACORD 26(2016/03) The ACORD name and logo are registered marks of ACORD Printed by SAJ on May 26,2021 at 09:25AM NYSIF New York State Insurance Fund PO Box 66699,Albany. NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED) Tr .0 ^A^A^^ 061505514 + OLIVIERI CONTRACTING INC (A CT CORP) t �' 7 BOTE CT GREENWICH CT 06830 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER OLIVIERI CONTRACTING INC RYE BROOK BUIDLING DEPT (A CT CORP) 938 KING ST 7 BOTE CT RYE BROOK NY 10573 GREENWICH CT 06830 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W2059 276-2 550179 01/12/2022 TO 01/12/2023 3/11/2022 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2059 276-2. 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 POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. MARTIN OLIVIERI OLIVIERI CONTRACTING INC 1 OF 1 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: 412781591 U-26.3