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HomeMy WebLinkAboutMP22-098 ¢0A Qnn.+[umay* VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury www.tycbrook.org TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Michael J. Izzo Stephanie). Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE August 16,2022 CLPB LLC 217 South Ridge Street Rye Brook,New York 10573 Re: 217 South Ridge Street, Rye Brook,New York 10573 Parcel ID#: 141.35-2-40 This document certifies that the work done under Mechanical Permit #22-098 issued on 6/17/2022 for the installation of a new condenser has been satisfactorily completed. Sincerely, Steven E. Fews Assistant Building&Fire Inspector /to �E BRC�v�, w � 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 V DATE: Z� 0-?-U C PERMIT# (w- VR ISSUED:v', SECT: 1 ( ��LOCK: 2 LOT: \ y LOCATION: 1��-� �- � OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS..%ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION ' REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION FINAL ❑ OTHER s 017, f G N o a v s y �p � v v � ■ ■ F-) I.�W � iO-I VJ � ■ ayd v O Ld a v O `— to cA � q 3 o ti � o � �Q Q ■ o ■ � �-I � O C s 49 � O G H enz Q z � ° � a Z O N C O ■ r"'1 ( h� C?0 V J U o lip, O . 8 v �O u ■ W w v 00d ! �m ' V) GIN r , a OC to U cn W A z A ai ° 4 0 H z U U U w -8 � w N O o 0en I�1 4-64144QQ44194;4;4;94;4;4&9 4;4 4 40 4 Q 4;4;44414414;4;416444 D EC ENE BUILD MENT JUN 16 2022 VIL E OF RY OOK 938 KING ET RYE BR ,NY 10573 VILLAGE OF RYE BROOK 4 -0 -� BUILDING DEPARTMENT APPLICATION FOR PERMIT TO INSTALL AND/OR REMOVE HEATING, VENTILATION AND/OR AIR CONDITIONING EQUIPMENT FOR OFFICE USE ONLY: PERMIT#: "PC:,;0-0 9 Approval Date: JUN Permit Fee:$ r Approval Signature: Other: Disapproved: (fees are non-refundable) REQUIREMENTS FOR RELEASE OF PERMIT&CERTIFICATE OF COMPLIANCE: I. Properly completed&Signed Application. 2. Site/Staging Plan if Required by the Building Inspector. 3. Copy of Licensed Contractor's Liability Insurance. lVillage of R e Brook must be listed as Certificate holder)&Workers Compensation Insurance on a NYS Board form (hone#C 105.2 or Forni#U26.3/or NY State Workers Compensation Waiver) 4. Payment ofFees/Unit: RESIDENTIAL =$100.00/unit - COMMERCIAL =$350.00/unit. 5. Inspection by the Building Department for removal and/or installation. (48 hour notice required) 6. Electrical work requires a separate Electrical Permit&Electrical Inspection. 7. Plumbing/Gas work requires a separate Plumbing Permit&Plumbing Inspection. Application dated, 06/14/2022 is hereby made to the Building Inspector of the Village of Rye Brook for a permit for the installation and or removal of the HVAC equipment as listed below.The applicant and property owner,by signing this document agrees that said equipment will be installed and/or removed in conformance with all applicable Local,County,State&Federal laws, codes,rules and regulations. 1. Address: 217 South Ridge Street, Rye Brook, NY 10573 SBL: /""//-35-; - Zone: 2. Property owner: CLPB, LLC. c/o Stephen Riemer Address: PO Box 250, Hallandale, FL 33008-0250 Phone#: 954-235-5760 cell#: 305-733-5210 email: sriemer@demerinsurance.com 3. Contractor: Donald Creadore Air Conditioning Co, Inc. Address: 177 Harrison Avenue, Harrison, NY 10528 Phone#: 914-835-0747 Cell#: email Il r-e_&,r o t-e 4. Applicants c e--t-L L,- Lo Address: /7 4Ac r r 4n'47 Phone A d) 83S-U W-Cell#: emaile t-C-4-s',,C_ /V— �r 5. Scope of Work:New Installation-Replacement( )•Removal( )•Other( 6. List Equipment: Carrier 24ABB348AO05 3 phase condenser Carrier CNPVP4821ALA indoor evaporator coil 7. Location of EquipmenlI(4) F t :��A- `e-c,� 5�,OC ,^e_ 0.5 y�owsl O S !•e `� t_8. Method of Installation/Removal(list all equipment needed to perform job): + 'y r 1_1 1 r leL 1 8/12/2021 T TE OF N W YORK,COUNTY OF WESTCHESTER ) as: { crp Me,A-v•t e- ,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, at(s)he is the Contractor for the legal owner and is duly authorized to in i e is 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 8c Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to before me this 14th Sworn to before me this day of i U ne ,2022 day of .T✓>n v ,20AF Z n— ature of Property Owner Signature pplicant Stephen L. Riem e, lE'�L C 1-'6-"L r,� Prin f r perty OM Print Name of Applicant Notary Public tNEZ Notaryhb&r MARVIN PILSON � y r Notary public•State of Florida Notary Public, State of New York Commission M HH 68250 No.01 P16289689 oF+, My Comm.Expires Jan 19.2025 Ouaiified in Westchester CountilL Bonded through National Notary Assn. Commission Expires Oct. 28, 20 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. 2 8/12/2021 n n N : � h N N Ln .7 CL : in a y rTl \ \ ON F+1 t� n � a � r ►., it H = 0+ f w W cl a� y a f ¢ F O N F A _ 0 O � in L M00 � � U 1-400 W Ln W N u A H �0 V � z o 5 } (� a U x .. ug a w R� a o o u; 0 3 d Ln Hg Q N A w z w x py ° a • z w W o r QI as a a z � w y � E C FE, V DD BUILy E �M N VIL ,E OF RYE kOOK JUL ' 8 2Q22 938 KINd ET RYE B NY 10573 L ( - / VILLAGE OF RYE BROOK .org BUILDING DEPARTMENT ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY �091' EP#: Qr-/,3& Approval Date: JUL O Permit Fee: S / 50 —/ b Approval Signature: Other: Disapproved: (fees are non-refundable) Application dated, is hereby made to the Building Inspector of the Village of Rye Brook NN'Y,for the issuance of a Permit to install and/or remove electrical equipment,wiring,fixtures,or to perform other high or low voltage electrical work as per the detailed statement described below. The applicant & property owner, by signing this document agree that all electrical work performed will be in conformance'with all applicable Federal,State,County and Local Codes. I.Address:j2,I q � QtA )° �sd- K alt,1P 9606� N I ID6n_� SBL: 14`1 .35--a- - 4 zone: 2.Property Owner:C 1 P6 r ULC C/p S. (2 i emt0 r Address: 100, (?�oX oW Ha l landoL FL 3 3o08 Phone#: 164- 235- 15r)(o0 Cell#: :306- 7'5_3 - Fja o email:,sh'e. 11+t'r r1EfT1 in ai-atia, c'3.Master Electrician:�CL ��t1+1° [Ln«Ci Address: 41 Ntah r�e c S}. P4 -Cca171 l Lic.#: aS8 Phone#:e{I�1 �,(olr]- a8o/�+ Cell#/1 q I�- �j Fj�- y�� email: 10t 4 @ C+V I C,� gpt"p/1(t(lti°, r lC+ Company Name: it W�.'1y(C0.j ( Ali• l p.;kX Address: t-}( 1�'tQ h S} 10'590 4.Proposed Electrical Work/Fixture Count: STA .QF NEW YORK,COUNTY OF WESTCHESTER ) as: / ,being duly swum,deposes and states that he/she is the applicant above named,and does further (print name of individual signing as the applicant) ''�� �,__yy,am�tV 1__ state that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the 4Ae for the legal owner and is duly authorized to make and file this application. (indicate architect.contractor.agent.anorncy,etc.) The undersigned further states that all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Cod f the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn t2_bxXa a me this Sworn to tiefore me this E y k day of 20 1204Z t rg e of roperty 9wriern ature of Applic n n Prin a roperty r Print Name of Applicant lEf1N Nouffy Pu lrc _ _ _ _—_ b9LIC-STATE OF NEW YORK �:aY.•Rm �a o�•... MARIA ROSA MARTINEZ No. Ol MC6127132 o ¢�,: Notary Public•State of Florida A, Commission a HH 68250 Qualified In Westchester County ?c� My Comm.Expires Jan 19,2025 My Commission Expires May 23,2d� Boded through National Notary Assn. 8112R021 • STATEWIDE INSPECTION Service With Integrity 1:1 Main Street,Fishkill, NY 12524 1 email:office@swisny.com SWIS JOBAPPLICATION tel845.202.7224 • • 1•21 SWISNY.com I SWISTraining.com Office Use Elect. Permit# Date 11J CD Bldg Permit# � ` 0 ^ � Utility ID# Final Certificate# 7 � City/Village � Zip Township County T Address i Cross Street S� o `, Block Lot r) 1 7 Owner Name/Address(if different than above) / L P l n3 Contact Number ❑Basement ❑1st Fl. ❑2nd Fl. ❑t� !Z ,ret3rd Fl. :]More Than 3 FL ❑Garage ❑Attic �abutside ❑Residential ommercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms Carbon Monox Hood Trash Compact Amt Amps Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Warm Draw Incandescent Fluorescent SERVICE Amperage Voltage 1 P 3P #Meters #Disconnect ❑Underground ❑New ❑Reconnect ❑Overhead ❑Change ❑Visual Re-Inspection ❑ Safety Re-Inspection ❑ Re-Inspection Additional Information 1 0- U W 1 12- (2 c l L -82022 LLU - i VILLAGE OF RYE BROOK BUILDING DEPARTMENT , This application is valid for one(t)year from the date received by SWIS.This application is intended to cover the above listed items to be inspected,if at any time of inspection additional items have been installed you are authorized to make the inspection and adjust the fee for the additional items inspected.The applicant declares that there is no open applications for the above address with any other inspection company.The applicant owner or authorized agent agrees to all the above terms and conditions as set forth for the application. Inspector Date Finalized Inspector# Company Name f;" Date Signature Address City/State Zip Code License# Phone# State Wide Inspection Services jk�> 1080 Main Street Fishkill, NY 12524 TO a 845 202-7224 Phone 914-219-1062 Fax STATE WIDE INSPECTION SERVICES Email: office@swisny.com Service With Integrity Website: www.swisny.com BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: B&T Electrical Construction Co INC CLPB LLC Robert Tenefrancia 217 South Ridge Street 41 High Street Rye Brook, NY 10573 Rye, NY. 10580 Located at: 217 South Ridge Street, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP22-136 141.35 48 Certificate Number: 2022-4034 Building Permit Number: MP22-098 A visual inspection of the electrical system was conducted at the Commercial occupancy described below.The electrical system consisting of electrical devices and wiring is located in/on the premises at: 217 South Ridge Street, Rye Brook, NY 10573 The Exterior was inspected in accordance with the NYS and NFPA 70-2017 and the detail of the installation, as set forth below,was found to be in compliance on the 21st day of July 2022. Name Quantity Rating Circuit Type HVAC System 01 GFCI WP Receptacle 01 Officer: Frank J. Farina This certificate may not be altered in any way and is validated only by the presence of a seal at the location indicated.This certificate is valid for work performed on the date of inspection only. I 1 B B Comfort'-m 13 Air Conditioner ------- Puron@ Refrigerant ia1 -1/2 to 5 Nominal Tons turn to the experts Data INDUSTRY LEADING FEATURES / BENEFITS Efficiency • 13 SEER/up to I I EER (based on tested combinations) �"" •. • Microtube Technology- refrigeration system • Indoor air quality accessories available II Sound I Sound level as low as 71 dBA Comfort �� �; • System supports Edge® Thermidistat- or standard thermostat controls Reliability • Non-ozone depleting Puron®refrigerant • Scroll compressor • Internal pressure relief valve Comfort • Internal thermal overload 60 cc Filter drier J Pdron. S E R I E • Balanced refrigeration system for maximum reliability Durability Carrier's Air Conditioners with PuronO refrigerant provide a WeatherArmor- protection package: collection of features unmatched by any other family of • Solid,durable sheet metal construction equipment. The 24ABB has been designed utilizing Carrier's non-ozone depleting Puron refrigerant. • Dense wire coil guard • Baked-on,complete outer coverage, powder paint NOTE: Ratings contained in this document are subject to Applications change at any time. Always refer to the AHRI directory (www.ahridirectory.org) for the most up-to-date ratings • Long-line - up to 250 feet(76.20 m) total equivalent information. length, up to 200 feet (60.96 m) condenser above evaporator,or up to 80 ft. (24.38 m)evaporator above condenser(See Longline Guide for more information.) • Low ambient (down to -20°F/-28.9°C)) with accessory kit MODEL NUMBER NOMENCLATURE . 1 2 3 4 5 6 7 8 9 10 11 12 13 N N A A A/N N N N A/N A/N A/N N N 2 4 A B B 3 3 6 A 0 N 3 0 Product Product Major Cooling Design Series Family Tier Series SEER Capacity Grille Variations Variation Region Voltage Series 3=208/230-1 1.000 Btuh 5=208/230-3 0— 24=AC A=RES AC B=Comfort B=Puron 3=13 SEER (nominal) A=Dense Grille N=North 6=460/3 Original 1 =575/3 Series ' Nron _ c U(,) L us Use of the AHRI Certified TM Mark indicates a manufacturer's participation in the program For verification , of certification for individual products,go to www.ahridirectory.org. 9001 ww.ahridirectory.org. OMl-SAI Global STANDARD FEATURES Feature 18 24 30 36 42 48 60 Puron Refrigerant X X X X X X X SEER 13 13 13 13 13 13 13 Scroll Compressor X X X X X X X Field Installed Filter Drier X X X X X X X Front Seating Service Valves X X X X X X X Internal Pressure Relief Valve X X X X X X X Internal Thermal Overload X X X X X X X Long Line capability X X X X X X X Low Ambient capability with Kit X X X X X X X Dense Grille X X X X X X X X=Standard 2 • REFRIGERANT PIPING LENGTH LIMITATIONS Liquid Line Sizing and Maximum Total Equivalent Lengthst for Cooling Only Systems with Puron®Refrigerant: The maximum allowable length of a residential split system depends on the liquid line diameter and vertical separation between indoor and outdoor units. See Table below for liquid line sizing and maximum lengths: Maximum Total Equivalent Length Outdoor Unit BELOW Indoor Unit Liquid AC with Puron Refrigerant Liquid Line Line Maximum Total Equivalent Lengtht: Outdoor unit BELOW Indoor Size Connection Diem. Vertical Separation ft(m) W/TXV 0-5 6-10 11-20 21-30 31-40 41-50 51-60 61-70 71-80 0-1.5) (1.8-3.0) (3.4-8.1) (6.4-9.1) (9.4-12.2) (125-15.2) 155-18.3) (18.6-21.3) 21.6-24.4) 1/4 150 150 125 100 100 75 -- -- -- 18 3/8 5/16 250* 250* 250* 250* 250* 250* 250* 225* 150 3/8 250* 250* 250* 250* 250* 250* 250* 250* 250* 1/4 75 75 75 50 50 -- -- -- -- 24 3/8 5/16 250* 250* 250* 250* 250* 225* 175 125 100 3/8 250* 250* 250* 250* 250* 250* 1 250* 250* 250* 1/4 30 -- -- -- -- -- 30 3/8 5/16 175 225* 200 175 125 100 75 -- -- 3/8 250* 250* 250* 250* 250* 250* 250* 250* 250* 36 3/8 5/16 175 150 150 100 100 100 75 -- -- 3//8 250* 250* 250* 250* 250* 250* 250* 250* 250* 42 3/8 5/16 125 100 100 75 75 50 -- -- -- 3/8 250* 250* 250* 250* 250* 250* 250* 250* 150 48 3/8 3/8 250* 250* 250* 250* 250* 250* 230 160 -- 3/8 3/8 250* 250* 250* 225* 990 150 110 -- -- * Maximum actual length not to exceed 200 ft(61 m) t Total equivalent length accounts for losses due to elbows or fitting.See the Long Line Guideline for details. -- =outside acceptable range Maximum Total Equivalent Length Outdoor Unit ABOVE Indoor Unit Liquid AC with Puron Refrigerant Size Liquid Line Line Maximum Total Equivalent Separation Lengtht: Oft(m) unit ABOVE Indoor Connection Diem. Vertical W/TXV 25 26-50 51-75 76-100 101-125 128-150 151-175 176-200 (7.6) (7.9-15.2) (155-22.9 (23.2- (30.8-38.1 (38.4-45. 46.0-53.3 (53.6-61.0) 1/4 175 250* 250* 250* 250* 250* 250* 250* 18 318 5/16 250* 250* 250* 250* 250* 250* 250* 250* 3/8 250* 250* 250* 250* 250* 250* 250* 250* 1/4 100 125 175 200 225* 250* 250* 250* 24 3/8 5/16 250* 250* 250* 250* 250* 250* 250* 250* 3/8 250* 250* 250* 250* 250* 250* 250* 250* 1/4 30 -- -- -- -- -_ 30 3/8 5/16 250* 250* 250* 250* 250* 250* 250* 250* 3/8 250* 250* 250* 250* 250* 250* 250* 250* 36 3/8 5/16 225* 250* 250* 250* 250* 250* 250* 250* 3/8 250* 250* 250* 250* 250* 250* 250* 250* 42 3/8 5/16 175 200 250* 250* 250* 250* 250* 250* 318 250* 250* 250* 250* 250* 250* 250* 250* 48 3/8 3/8 250* 250* 250* 250* 250* 250* 250* 250* 60 3/8 3/8 250* 250* 250* 1 250* 250* 250* 250* 250* *Maximum actual length not to exceed 200111(61 m) t Total equivalent length accounts for losses due to elbows or flitting.See the Long Line Guideline for details. -- =outside acceptable range 4 PHYSICAL DATA - UNIT SIM SERIES 18-34 24-35 30-33 30-51 36-35 36-51, 42-30, 48-38 -51' 80-34 60-52, 61,11 60,60 61,11 62,12 can*-Too Scroll REFRIGERANT Purons(R-410A) Control TXV(Puronm Hard Shutoff) Charge lb(kg) 3.15 3.15 4.62 4.10 5.42 5.34 5.84 7.37 7.00 8.80 8.00 (1.4) (1.43) (2.10) (1.9) (2.46) (2.4) (2.65) (3.34) (3.2) (4.0) (3.6) COND FAN Propeller Type,Direct Drive Air Discharge Vertical Air Oty(CFM) 1792 2218 2163 2218 3167 2954 3167 3365 3365 3365 3365 Motor HP 1/12 1110 1/10 1/10 1/5 1/4 1/5 1/4 1/4 1/4 1/4 Motor RPM 1100 1100 1100 1100 1100 1100 1100 1100 1100 800 1100 COND COIL Face Area(Sq ft) 8.40 8.40 11.49 9.80 12.93 13.13 17.25 19.40 19.40 12.93 15.09 Fins per In. 20 25 25 25 25 25 25 25 25 20 20 Rows 1 1 1 1 1 1 1 1 1 2 2 Circuits 3 3 3 3 5 3 4 5 5 5 6 VALVE CONNECT.On.ID) Vapor 3/4 3/4 314 3/4 7/8 7/8 7/8 7/8 7/8 7/8 7/8 Liquid 3/8 3/8 3/8 3/8 3/8 3/8 3/8 3/8 3/8 3/8 3/8 REFRIGERANT TUBES*On.OD) Rated Vapor* 3/4 7/8 Max Liquid Linef 3/8 *Units are rated with 25 ft(7.6 m)of lineset length. See Vapor Line Sizing and Cooling Capacity Loss table when using other sizes and lengths of lineset. Note: See unit Installation Instruction for proper installation. f See Liquid Line Sizing For Cooling Only Systems with Puron Refrigerant tables. OUTDOOR UNIT CONNECTED TO A FACTORY APPROVED INDOOR UNIT Check piston size shipped with indoor unit to see if it matches required indoor piston size. If it does not match, replace indoor piston with correct piston size in table below: OUTDOOR UNIT SIZE-SERIES FAN COIL PISTON SIZE BY OUTDOOR MODEL 18-34 FB4CNF* 49 24-35 FB4CNF* 55 30-33 FB4CNF* 61 30-51 FB4CNF* 59 36-35 FB4CNF* - 36-51,61,11 FB4CNF* 67 42-30,50,60 FB4CNF* 73 48-36 FB4CNF* 78 48-51,61,11 FB4CNF* 76 * Ratings contained in this document are subject to change at any time.Always refer to the AHRI directory(www.ahridirectory.org)for the most up-to-date ratings information. NOTE: Pistons shipped with outdoor units are only qualified and approved with the above listed fan coils. The piston included with the FFMANP*and FPMAN* fan coils are unique to those products and CANNOT be replaced with the piston shipped with outdoor unit. Refer to the AHRI directory (www.ahridirectory.org)to check if your combination can use a piston or requires an accessory TXV. I Z d Z V V/ ) N �1 W 0 ��+ a - a o ooso a� �3 °0Yo m � �Oa UO Flo w � t oom w E m W � I I O I I I I I i I I L) i �o I o I 6L }ol O I N a I D IIoM a}ajouoo o M rOZrL 1.69 N O o N 100*00 O > � c Z c W o to R ,9 N � N i = v Ile O` m O pp •7 O O _ 3t CT) C }ol 8L }ol v J W bL }ol LL To D v 0 3 aS m Cl- 00 o 00 i - cV E o O (D C) � Z > o O of -•- Z D w O D > O D o D � � � c ua r00*00l `o o i 9L }ol au!l 6uolb IIoM a}aaouo� 20 I 3 -OU L68 S a'- Do I a vo I v I A� DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE Ci3/10/2022 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 endorsements . PRODUCER CONTACT NAME: CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 328 A CNNo Ext:888-333-4949 FAX No:507-446-4664 OWATONNA, MN 55060 ADDRESS:CLIENTCONTACTCENTER FEDINS.COM INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 382-455-4 INSURER B: DONALD CREADORE AIR CONDITIONING CO INC INSURER C: 177 HARRISON AVE HARRISON, NY 10528-4327 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:74 REVISION NUMBER:0 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 DL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD MM/DD/YYYY MM/DD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS-MADE OCCUR DAMAGE TO RENTED $100,000 PREMISES Ea occurrence X BUSINESS OWNER'S LIABILITY MED EXP(Any one person) A N N 9366490 10/15/2021 10/15/2022 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X ❑PRO- POLICY ❑LOC PRODUCTS-COMPIOP AGG $2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 Ea acciden X ANY AUTO BODILY INJURY(Per person) A OWNED AUTOS ONLY SCHEDULED AUTOS N N 9366491 10/15/2021 10/15/2022 BODILY INJURY(Per accident) NON-OWNED HIRED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per acciden X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $1,000,000 A EXCESS LIAB CLAIMS-MADE N N 9366493 10/15/2021 10/15/2022 AGGREGATE $1,000,000 DED I X I RETENTION$10,000 WORKERS COMPENSATION PER STATUTE OTH- AND EMPLOYERS'LIABILITY Y/N ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION 382-455-4 74 0 VILLAGE OF RYE BROOK SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 938 KING ST THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN RYE BROOK, NY 10573-1226 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 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 '`A A A A A 132831826 ; LEVITY-FUIRST ASSOCIATES LTD 41 520 WHITE PLAINS ROAD, 2ND FL � r,�L TARRYTOWN NY 10591 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER DONALD CREADORE AIR CONDITIONING VILLAGE OF RYE BROOK CO INC 938 KING STREET 177 HARRISON AVENUE RYE BROOK NY 10573 HARRISON NY 10528 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE G1250 720-8 548870 06/29/2021 TO 06/29/2022 6/14/2022 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1250 720-8, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY, INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS://WWW.NYSIF.COM/CERT/CERTVAL.ASP. THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STAY S7NCE FUND V DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 90733450 NYSIF New York State Insurance Fund PO Box 66699,Albany, NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED) l 0 ^^^^^ 132831826 . LEVITT-FUIRST ASSOCIATES LTD 520 WHITE PLAINS ROAD, 2ND FL TARRYTOWN NY 10591 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER DONALD CREADORE AIR CONDITIONING VILLAGE OF RYE BROOK CO INC 938 KING STREET 177 HARRISON AVENUE RYE BROOK NY 10573 HARRISON NY 10528 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE G1250 720-8 8521 06/29/2022 TO 06/29/2023 6/14/2022 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1250 720-8, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY, INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS://WWW.NYSIF.COM/CERT/CERTVAL.ASP. THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE SINCE FUND V DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 206435750