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HomeMy WebLinkAboutBP22-0630ERMIT # iOQ`; -�� `3 DATE: 5 / �a E)(P: / 19ECTION 3 '/ r. BLOCK LOT TYPE OF WORK JOB LOCATIONS O - OWNER U�! /e �i/1 L�/1 :Zhu_l �_ 5V __ 3d9 CONTRACTOR Lt61? All O e $- �0/10�Q6IQoco(�ly)937- a79 T. COS +g I% 4/ Y© ' EE W 70 # �� FEE DATE a TCO # FEE_ DATE INSPECTION RECORD I NSP DATE FOOTI N G FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING ED RGH PLUMBING GAS SPRINKLER ELECTRIC LOW -VOLT ALARM AS BUILT 0 FINAL UTHER APPROVALS I ARB BOT I OTHER t LV�iadr ,�V tt 19 404 an ilovo o V VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A.Klein (914)939-0668 Christopher J.Bradbury www.iyebrook.org TRUSTEES BUILDING& FIRE INSPECTOR Susan R Epstein Michael J. Izzo Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE August 30, 2022 Junyi Xie&Yanjun Zhu 46 Bonwit Road Rye Brook,New York 10573 Re: 46 Bonwit Road, Rye Brook,New York 10573 Parcel ID#: 135.41-1-46 Building Permit#22-063 issued on 5/17/2022 for New Replacement Windows This certifies that the fourteen new windows,installed under the above captioned permit have been satisfactorily completed. Sincerely, Michael J. Izzo Building&Fire Inspector /to DECE �WED R For office use only: BUILD ENT PERMIT# P 3, -G�� AUG 2 4 2022 VIL OF RYE OK ISSUED: —/ - O.�a 9 8 KING STRE YE BROOKi YoRK 10573 DATE- VILLAGE OF RYE BROOK 9 �0 p'� FEE: PAID 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 iitittttti//i#iitk}ik#}ttit}tii}#}#}iRtiktiit#}}#tittitiitk}ttk#}##t}kki}}i}}}#i}t##iiiiiiiiiiiiiiiiti}iititik#k}tktttttiitiiik Address: Occupancy/Use: Parcel ID#: Zone: Owner: T'Y)y xis Anndddress: 1l� art br_ p y /v 7" P.E./R.A.or Contractor: Person in responsible charge: Address: Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issuance of a Certificate of Occupancy/Certificate of Compliance for the structure/construction/alteration herein mentioned in accordance with law: STATE OF NEW YORK,COUNTY OF WESTCHESTER as: I nY x/C being duly sworn,deposes and says that he/she resides at (Print Name of Applicant) (No.and Street) in 1 y e e('3 j n ,in the County of l�',S.j l-Urt�' in the State of NY ,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:S I), 0 for the construction or alteration of: rPf:A-t(;(_�n i` w►/t���S 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 Sworn to before me this L ` day of / ,20 2 Z day of `� ,20 2 2 Signa a of Pro erty Owner Signature of plic/ant Print zme oi' ropery Owner Prini Name of Applicant JL4,� G4�.IC�(/sCS� y Public ry Public / ANNA KIELBASA ANNA ICELBASA Notary Public- State of New York Notary Public. State of New York 8/12/2021 Reg.No.01KI6378519 Reg.No,01K16378519 Qualified In Putnam County Qualified in Putnam County My Commlailon Explras July 30,2026 My COmmICSlon Expires July 30,2026 QyE BRC��. cu � 1982 BUILDING DEPARTMENT ❑BUILDING INSPECTOR WASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK / [I CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS: q DATE: PERMIT# �j oc:�� ISSUED: SECT: BLOCK: LOT: r n "' � t� LOCATION: (� \\��x,�� �'�Vv� `"'"`�`'� OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS.,.-�OrACCEPTED ❑ 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 s - ° tnrA y vi aR, w O La w as A 0 0 N � 9 a Q A d` A O Q 3 b V U 17 ° s I� � W ►.� �,, W O W O � � � � .� CP) a:J o W eh m 4 v .. 0 Nz o y V O q O !� U° zQ � t V., HQy rut c , > o 00 14 1.+.1 ON ri U r7 y 1C F� W a d d uy Oci � \� p � © u� � u� � a V Q � E 4 -0 � Uz o ° W z a c� z o �, Vr Z aC CW7 H 0 � .4 - �I m a a" w x � - BUILD TMENT D E C E I W E Viz of RY OOK A MAY - 6 2022 938 KING ET RYE BR ,NY 10573 14)939-06cc VILLAGE OF RYE BROOK BUILDING DEPARTMENT ADMINISTRATIVE EXTERIOR BUILDING PERMIT APPLICATION FOR EXTERIOR WORK WHICH DOES NOT REQUIRE VILLAGE ARCHITECTURAL REVIEW BOARD APPROVAL FOR OFFICE USE ONLY: /� /�,� �y APPROVAL DATE: - PERMIT#'. / �-o&3 APPLICATION FEE:J- 5- Pb APPROVAL SIGNATURE: PERMIT FEES: H.O.A. APPROVAL: DATE: DISAPPROVED: OTHER: Application dated: J ~S- -�;% is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit dur tlic construction of buildings, /structures,additions,alterations or for a chaannge�in use,as per detailed statement described below. 1. JobAddress: 7�� S o p I„J i f rq�U'�_ (�Y� r K /�,f 1 /U J /`�Q3 2. Parcel ID#: f 35,- 4//' �� 7 to Zone: F_)C_;L 3. Proposed Improvement(Describe in detail): (Ace- PX ISfinG W4hWS L/V i�f-� 44urvev P f;+-(_-' 4. Property Owner: 7 n y 1, ! _ l n n Address: B0 n Wt 1 (D�-q4� - � IJ�✓1U�C r 6S Phone# I C1 ' ��_ 5�O!'Cell# e-mail )( j UI(1 J frX\1 .CD/L) List All Other Properties Owned in Rye Brook: Applicant: // ti V I X/j le— Address: �b Qunt,Ni� hoc Ky� ���)� /U ( 6507 Phone# C7 1 q 31I O C1 }Cell# l e-mail Architect: oULAP(�' e�1 � � 1`+Y-?i-e_ Address: 3(7 / tar' Phone#—((1 if - f 3 Cell# e-mail . ((i✓? GTJ( / v�� Engineer: �G M Address: Phone# Cell# e-mail General Contractor: Ail I- o/-Wq'E'- Ia f?1 Address: � W 1 L la'C 4 CAVXL- -.- M1 f U.-�n f.7 Phone# 1`� " q �I r I Cell# e-mail C j2(A i A-1 U) "VA J I' GU�, s/tsnozl 5. Occupancy;(1-Fam.,2-Fam.,Commercial.,etc...)Pre-construction: Post-construction: 6. Area of lot: Square feet: Acres: 7. Dimensions from proposed building or structure to lot lines: front yard: rear yard: right side yard: left side yard: other: 8. If building is located on a comer lot,which street does it front on: 9. Area of proposed building in square feet: Basement: 11,fl: 2r1d fl: 3rd fl: 10. Total Square Footage of the proposed new construction: 11. For additions,total square footage added:Basement: I'fl: 2nd fl: 3rd fl: 12. Total Square Footage of the proposed renovation to the existing structure: 13. N.Y.State Construction Classification: N.Y.State Use Classification: 14. Construction Type&Location:O Typical Western Lumber Frame;O Timber Frame[TC];()Wood Truss[TT]; ()Pre-engineered wood[PW];Located;O Floor Framing[F];O Roof Framing[R];O Floor&Roof Framing[FR];Other: 15. Number of stories: Overall Height: Median Height: 16, Basement to be full,or partial: finished or unfinished: 17. What material is the exterior finish: 18. Roof style;peaked,hip,mansard,shed,etc: Roofing material: 19. What system of heating: 20. If private sewage disposal is necessary,approval by the Westchester County Health Department must be submitted with this application. 21. Will the proposed project require the installation of a new,or an extension/modification to an exiZt ;-gineered atic fire suppression system?(Fire Sprinkler,ANSL System,FM-200 System,Type I Hood,etc...)Yes: (if yes,applicant must submit a separate Automatic Fire Suppression System Permit application&2 sets of plans) 22. Will the proposed project disturb 400 sq. ft.or more of land,or create 400 sq.ft�f impervious coverage requiring a Stormwater Management Control Permit as per§217 of Village Code? Yes: No: Area: 23. Will the proposed of t require a Site Plan Review by the Village Planning Board as per§209 of Village Code? Yes: No: (if yes,applicant must submit a Site Plan Application.&provide detailed dr 'ngs) 24. Will the proposed project require a Steep Slopes Permit as per§213 of Village Code Yes: No: (i(yes,you must submit a Site Plan Application,&provide a detailed topographical survey) 25. Is the lot located within 100 ft.of a Wetland as per§245 of Village Code? Yes: No: (if yes,the area of wetland and the wetland buffer zone must be properly depicted on the sury &s'a plan) 26. Is the lot or any portion thereof located in a Flood Plane as per the FIRM Map dated 9/28/07? Yes: (\No: R (if yes,the area and elevations of the flood plane must he properly depicted on the survey&site plan) �� 27. Will the proposed project require a Tree Removal Permit as per§235 of Village Code?Yes: ' (if yes,applicant must submit a Tree Removal Permit Application) �_�� 28. Does the proposed project involve a Home-Occupation as per§250-38 of Village Code? Yes: No: Indicate:TIER[: TIER If: TIER III: (Iifye/s,Ia'Hrome Occupation Permit Application iSw d) 29. What is the total estimated cost of construction: $ { + ,q`"f p . U 0 Note:estimated cost shall include all site improvements,labor,material,scaffolding,fixed equipment,professional fees,including any material and labor which may be donated gratis.If the final cost exceeds the estimated cost,an additional fee will be required prior to issuance of the C/O. 30. Estimated date of completion: (2) 8/12/2021 DMCERvi E BUIL;49iiVtkNMP ENT VILOOK MAY r 6 2022 938 KING ,NY 10573 VILLAGE OF RYE BROOK BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE §216 - STORM SEWERS AND SANITARY SEWERS THIS AFFIDAVIT MUST BEAR THE NOTARIZED SIGNATURE OF THE LEGAL PROPERTY OWNER AND BE SUBMITTED ALONG WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION. ANY BUILDING OR PLUMBING PERMIT APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETURNED TO THE APPLICANT . STATE OF NEW YORK, COUNTY OF WESTCHESTER ) as: 3, nvJ X;C , residing at, `I ff0cvd IQ6a,9 &e Jyl 1,6-3 (Print name) (Address where you live) being duly sworn,deposes and states that(s)he is the applicant above named, and further states that(s)he is the legal owner of the property to which this Affidavit of Compliance pertains at; &n w1=!- �oa._ e e Aitss)< Al,l I a, ? ? , Rye Brook,NY. (Job Address) Further that all statements contained herein are true, and that to the best of his/her knowledge and belief, that there are no known illegal cross-connections concerning either the storm sewer or sanitary sewer, and further that there are no roof drains, sump pumps, or other prohibited stormwater or groundwater connections or sources of inflow or infiltration of any kind into the sanitary sewer from the subject property in accordance with all State, County and Village Codes. IVY ;7� (Signature of Pr6perty Owner(s)) (Print Name of Properly Owner(s)) Sworn to before me this 'Jy� day of__ , 20 r4LA—tr: (Na Public) ANNA KIELBASA NOTARY PUBLIC-STATE OF NEW YORK No.01 X16376519 Qualified in Putnam County (3) My Commission Expires 07-30-2022 8/12/2021 This application must be properly completed in its entirety by a N.Y. State Registered Architect or N.Y. State Licensed Professional Engineer & signed by those professionals where indicated. It must also 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. STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: _7�r"yA f )(r Qr ,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 a�fz) for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,attorney,etc.) That all statements contained herein are true to the best of his/her knowledge and belief, and that any work performed, or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. By signing this application, the property owner further declares that he/she has inspected the subject property, and that to the best of his/her knowledge there are no roof drains, sump pumps or other prohibited stormwater or groundwater connections or sources of infiltration into the sanitary sewer system on or from the subject property. Sworn to before me this �� Sworn to before me this 5_+� day of /° t' � , 20��` day of 20 Signature of Property Owner Signature of Applicant Print Name of Property Owner Print Name of Applicant fry PUb12G XOtary Public A.IVNA KIELBASA ANNA KIELBASA 'C"iAR`r PUBLIC-STATE OF NEW YORK NOTARY PUBLX-STATE OF NEW YORK No 01 K16378519 No.01 KI6378519 Ouali#ied m Pulrram County Qualified in Putnam County Ay Cocnn-issoor+Expires 07-30-2022 my Cornmission Expires 07-30-2022 (4) 8/12/2021 LICENSE NUMBER "THE OR/G/NAL" O Westchester WC-8561-H97 pOUBLE Family Owned And Connecticut 00556256 Operated Since 1960 All Home lmpiovements -- EST. 1960 439 Willett Ave. Port Chester,N.Y.10573 Tel#(914)937-4279 Fax(914)937-4172 http://www.DoubleRwindows.com Mr. & Mrs. Junyi Xie May-04-2022 46 Bonwit road. Rye Brook,N.Y. 10573 (919)357-5309 email xiejunyi@gmail.com Insurance: All work involved within the following proposal is covered by Workmen's compensation,Public Liability,and Completed Operations Insurance. Harvey Elite Replacement Windows Contract Supply Labor& Material for the following A- Double W to replace the existing vinyl windows with the new Harvey Elite replacement type windows. B- The windows are all white heavy duty vinyl construction with fully welded frames and sashes,all windows come with the high performance double pane insulated energy star glass.The windows will come with colonial grills between the glass for the top/bottom sashes in a 6/6 pattern.The windows come with half screen,easy tilt,safety vent latches for children.The 2 bath windows will come with safety tempered glass and frosted for the bottom half. C- All windows will be sealed and insulated at time of installation. D- The total amount of windows are 14double hung with 6/6 grills and 1 picture window no grills. 1 large slider no grills. E- We will cart away all job related debris. F- A permit is required by the village of Rye Brook,we will apply but the fee of the permit is not included in this price. L- I Terms: Painting,and windows cleaning to be done by others.Hidden rotten wood not included. Standard industry cash term,one half with the order,balance due upon completion. Terms may be modified to meet special conditions. Past due balances are subject to a monthly service charge of 1 1/2%(18%per annum). If the account becomes delinquent,we agree to pay any legal or collection fees expended by Double"R"arising from collection of the account.Permit&Application fees not included. Double"It"is not responsible for reconnecting existing alarm systems on windows and doors. You the owner may cancel this transaction at any time prior to midnight of the third business day. After the date of this transaction,such Cancellation must be made in person,at the offices of community improvements,or in writing postmarked prior to the fourth business day.We accept VISA or Mastercard with a 3%convenience surcharge on total amount being charged. Acceptance: The above prices,specifications and conditions are satisfactory and are accepted. Double"R"is authorized to do the work as specified. Contractor Performance Warranty: Double"R"proposes to furnish and install labor and material in accordance with above specifications in order that the above qualifies for the Manufacturer's Long-Tern[Warranty. In addition,all labor provided by Double"R"is unconditionally warranted for a period of Ten years from the date of installation. Approximate Start Date:6 to 8 weeks or summer of 2022 Approximate Completion Date:2-1/2 days Customer: $11,440.00 (Amount) Date: 0% (Sales Tax) Double "R": Carlo Labianca $11,440.00 (Total Amount) Date: May-04-2022 $5,000.00 (Deposit) $6,440.00 (Balance Due Upon Completion) Return original contract to Double"R",retain a copy for your records. Visit Our Showroom Located At 439 Willett Avenue Port Chester, N.Y. 10573 Harvev ELITE Series Windows Durability • Never need painting • Operate as smoothly as the day they were installed • Tilt in for easy cleaning Performance • Harvey ELITE Series glass package exceeds ENERGY STAR requirements • Low air infiltration rates maximize comfort and energy savings p . • Harvey is one of few manufacturers that designs their own windows i • Continuous testing in their own ASI-certified lab allows Harvey to monitor and maintain quality } Security& Convenience • Limit latches allow for ventilation while keeping the window secure • Heavy duty hardware lasts a lifetime • Locking screens stay put;won't fall out in inclement weather ta Quality • Harvey vinyl extrusions are engineered for lifetime durability • Extrusions are multi-chambered and insulated with EPS foam technology __j-J- to ensure outstanding structural and thermal performance • Harvey stands by its product with an industry-leading warranty that backs your windows 0 Craftsmanship • Sleek window designs maximize glass area and flow of natural light Attractive. low profile hardware is available in several colors • Harvey's true white vinyl extrusion does not have the'bluish"tint that other extrusions can have • Three standard vinyl colors available plus 28 additional color options to match your home • h = � Peak Performance Replacement windows are a considerable investment In the energy efficiercy and comfort of your home.Therefore, it only makes sense to install windows that wall provide consistent performance from year to year.Harvey ELITE Series windows are made to exceec ENERGY STAR revements with a U-Factor of 0.18 or better and are built to last. The Panes:Triple glaz ng offers the maximum efficiency available, as additenal air pockets have better insulatng properties and create a better sound bamer. The Gas:Krypton provides the ultimate insulator for tnermal performance, It is a .16 6 I.colorless,odorless,inert gas that 9 5.55' augments our 3x glazrg system. 25 _ HARM ENERGY 4.a' STAR GIAZING The Glass: Three surfaces of Low-E .27 3.7 coatng enhance thermal performance by leveraging the angle of the sun's rays to 2.08 retain heat it tho winter months and prevent heat gain in summer. 10% -` TMOMONAL&Ncl.r �r�!• -+�` The Spacers: Our warm ecge PANE DH WNDO: L.A.- tv glazing system ublaes two spacers 1.0•• 1 which,when heated and fused to the PI-VAL M glass,creates a durable seal. i I Increase Comfort and Save Money i Air infiltration is an important, yet widely overlooked, component of overall energy efficiency. Simply put, it's how much air seeps into a home through a closed window. The lower the number the better, because rate of air exchange in a room i has a big impact on energy use and comfort(draftiness)• AIR INFILTRATION=CUBIC FOOT PER MINUTE SERIES11 E 0.10 ctm "A Harvey's quality materials, advanced window des,gn with integrated weatherseals, 'I► and the special care Harvey takes during the manufacturing process, all come ;� tcgether to yield resilient long lasting performance that pays cff year after year. Building Permit Check List&Zoning Analysis Address:7� SBL: Zonet � Use: _ Const.Type: Other: Submittal Date: Z Z.- Revisions Submittal Dates: Applicant: Nature of Work: ::29 ?C A,C F-LAA�Py— W I rr�o w Reviews:ZBA: MAY - g 1011 pB: BOT• Other. OK ( ( ) FEES:Filing. ����BP: Z C/O: Flood Plane: galization ( ) (•,Y APP: Dated , Notarized ✓SBL ✓Truss I.D. Cross Connect-ion: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Stone Water Review: Street Opening: ( ) ( ) ENVIRO: Long Short 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. ( ) ( License: ✓ Workers Comp: ✓ Liability Tmp.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: ED REQUIRED EXISTING PROPOSED NO TF_S AtjtjKUVM MAY — 9 1011 � naw Circle: F � Front: Front Sides: Main Co Accs.Cov Ft.HS : Sd.H/Sb CT& Tom: P Hight/Stories: notes: ol oil Rol 14 C) WCD ti G _ C wj ° action 's: LLJ = J = j G= vLLJ " \ J � U - 'y � J'fG C'�� Sz ONOWLij . C X m y � z 4.0 aft„ L F Av C� v ` 1.IIi A R I CT) v y I 0) 3 � a ��® DATE(MM/DD/YYYY) A C CERTIFICATE OF LIABILITY INSURANCE 05/05/2022 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 Gerard Seward NAME: Borrelli Partners Insurance Agency PNHON o E:t (914)939-7900 ac No (914)407-5088 287 Bowman Avenue E-MAIL ADDRESS: Suite 406 INSURER(S)AFFORDING COVERAGE NAIC If Purchase NY 10577 INSURER A: Evanston Insurance Company 35378 INSURED INSURER B ARC Home Improvements Corp. INSURER C: 439 Willett AVe INSURER D: INSURER E Port Chester NY 10573 INSURER F: COVERAGES CERTIFICATE NUMBER: 22-23 MSTR REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAM RENTED 100,000 CLAIMS-MADE X OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ 5,000 A 3AA550197 04/01/2022 04/01/2023 PERSONAL&ADV INJURY $ 1,000,000 MGEN'LAGGREGATE LIMITAPPLIES PER. GENERAL AGGREGATE $ 2,000,000 POLICY PEA LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER. $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident 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 accidenr UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 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) Included as Additional Insured is: Junyi Xie 46 Bonwit Road Rye Brook,NY 10573 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Village of Rye Brook ACCORDANCE WITH THE POLICY PROVISIONS. 938 King Street AUTHORIZED REPRESENTATIVE 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 PO Box 66699,Albany,NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ^^^^^^ 133940830 MARENCO INSURANCE AGENCY INC � 2525 PALMER AVE SUITE 1 O NEW ROCHELLE NY 10801 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER ARC HOME IMPROVEMENTS CORP VILLAGE OF RYE BROOK DBA DOUBLE R ALL HOME IMPROVEMENTS 938 KING STREET 439 WILLETT AVE RYE BROOK NY 10573 PORT CHESTER NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W2358 628-2 876874 04/16/2022 TO 04/16/2023 5/5/2022 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2358 628-2, 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. PRESIDENT FRANK J VERRASTRO TREASURER RALPH CACCOMO ARC HOME IMPROVEMENTS CORP TWO PERSON CORPORATION 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 STAT SUR NCE FUND ��Y DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 864645330 U-26.3