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HomeMy WebLinkAboutRP23-006PERMIT # �` � DATE: a /S a3 �P� . /5 �/ SECTION TYPE OF WORK JOB LOCATION c OWNER. CONTRACTOF EST. COST �CO #n (,, TCO # a AA eZoo/k,3 7a3 0 �is)(U c how o — a �i �So �e (9/ 41/) 93 9 ? 7/ 0 FEE DATE INSPECTION RECORv DATE FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING 0 RGH PLUMBING GAS SPRINKLER 13 ELECTRIC LOW -VOLT O ALARM AS BUILT FINAL INSP OTHER APPROVALS ARB BOT PB ZBA OTHER woft VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury www.ryebrook.org TRUSTEES ACTING BUILDING& FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE March 30,2023 William Wolff&Katie Wolff 2 Pine Ridge Road Rye Brook,New York 10573 Re: 2 Pine Ridge Road,Rye Brook,New York 10573 Parcel ID#: 135.41-1-17 Roof Permit#23-006 issued on 2/15/2023 to Re-Roof Existing Building This certifies that the new roof,installed under the above captioned permit has been satisfactorily completed. Sincerely, Steven E. Fews Acting Building&Fire Inspector /to D nr utlitt•U�'rntl�: MAR - 9 2023 BUILDING DEPARTMENT PERMIT p 006b VILLAGE OF RYE BROOK issiji:fr:tz)-1 S-a3 VILLAGE Of RYr BROOK 938K1Nf.STRFtT.RYERR(X)K,*,4FWVORK10573 DATr-:_,3-9—a3 BUILDING DEPARTMENT (914)9394*01 FEE:,* ~� %%%%%.rjebrook.urL APPLICATION FOR CERTIFICATE OF OCCUPANCY,CERTIFICATE OF COMPLIANCE, AND CERTIFICATION OF FINAL COSTS TO PE SUBMITTED ONLY "PON COMPLETION OF ALL WORK, AND PRIOP TO THE FINAL INSPECTION ................................................... ....................... •......1...........f.f Address: ..D a� *Ry Occupancy i Use: < P t Jn#: /3S. Y/ —�— 7 ne.. —�Owner: 1 �_ vv�l•1 T` Address: S � _=.P.E./R.A.or Contracto 1 1f A CCIIS �tGrl Address: t vbokPersoninresponsiblecharge: _______— Application is hereby made and submitted to the Building Inspector of the Village ook for the issuance of a Certificate of Occupancy/Certificate of Co pliance for the strut'tune/construction/ah ned in accordance with law: STATE OF NEW YORK,COUNTY OF WESTCHESTER as: �( being duly sworn,deposes and says that he/she resides at in r ��- ---•in the County of `PS�C��S 'i� in the State or t4 that ho'she has sttpervised the work at the location indicated above,and that the acual total cast of the Work,including all site improvements. labor,matenals,scaffolding,fixed equipment,professional fees,and including the monetary value of any materials and labor which may hav'c been donated gratis was:S_ 5�-5-,--Qo ___— for the construction or alteration of: I��t de �, �10►1 Ste_, -15+C. e4C I Of �S�' �k oe[) �►` u�_ ` .• .4, B)r\xyY S +0 -- Deponent further states that hoshe has examined the approved plans of the structurelwork herein referred to for w hich a Certificate of Occupancy i Compliance is sought,and that to the best of his/her knowledge and belief,the structurrs'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 authonzed,and as erectedicompleted complies with the laws governing building construction.Deponent fnrtber understands dot it shall be Unlawful for 3n owner to use or permit the use of any building or premises or part thereof hereafter created,erected,chanfxd,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 Butl&ng Inspector as per§250-W.A.of the Code of the Village of Rye Brook. Scum to before me this_ 2 Swom before me this day o 20 sitwraue or PmP'vt►l)wne tii •e f. ry�lteapt -- -- Gl - VVd Prot Nemc of Prwwy Owns Ph"Name of Apphaot rotary Pubtk Nany h — GREGORY At.RNERA GREGORY M.RIVERA Notary Public,State of New York NWWry Public,State of New York No.Ot R16441398 No.01 RI64d 1398 Qu In Westchest er County Qualified i Westchester Comrrtlss4on tdort Expires September 26,20 tY —` uaenestcester Coun Commission Expires September 26,20 �yE BR(�k• cu � '9a2 BUILDING DEPARTMENT BUILDING INSPECTOR ❑ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAX (914) 939-5801 www ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - -1- - - - - - - - " ADDRESS : DATE' PERMIT# ISSUED: JECT. BLOCK: LOT: , 2� LOCATION: `'� ('� �'-''a OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... QV ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION f REQUIRED ❑ FOOTING w���W(yt ❑ 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 _ 7 N N 8 ' Q N eq 4d con w cV N Ur O Cl) OPSU x a h� V) O. v frl CA � � � `� O y IITII ■ ' ,�',� �� �Z � :� � � u � W � (•LLB © Q 6.0 Q O u v w � a p �O O � 0 •O 00 Ln 0 h vZ re) w ,� � 0 z .-. O © V cm a A O pa '$ v aOU : y � Ln W, ` ° H O V O O Ey g FBI ►� C7 A z = N A � H a �I � '(-� � W ►y xudi � � � b : BUILDING DEPARTMENT 21ECEMED VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK,NY 10573 F E B - 8 2023 (914)939-0668 \�wwxyebrook.or:,. VILLAGE OF RYE BROOK BUILDIt,4G (DEPARTMENT FOR OFFICE USE ONLY: Approval Date: P nri Application# Approval Signature: : ARCHITECTURAL REVIEW BOARD: Disapproved: y Date: BOT Approval Date: Case# : Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Case# Other: Application Fee: Permit Fees:Yd/t — 60 ROOF PERMIT APPLICATION Application dated: �������3 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 Buflding,as per detailed statement described below. 1. Job Address: r a SBL: /,5 ,11I--1-1'7 Zones �Z�:, ,—/ Property Owner: O Address: Q �l h P_ Z ry&z_Rd � _ w((- Phone#: (}5 -jrQj r7 a Cell#: email: 2. Applicant: Mona Address: Phone#: 04— L 31"77 10 Cell#: email A ei:')k a(m401, C001 3. Roofmg Contractor: MCQkAe lZ A CcnSivvCtWtn Address: 'j�PQ�n l.n , 01-1. aK. (_ 3 Phone#: 'I N - 13l-D 1 Cell#: email: 1c— C 4C) CU� 4. Job Description,list all Methods&Materials: h0 ks e_ ro&F Qa'1i 5. Estimated Cost of Job:$ (NOTE:The estimated cost shall include all site improvements,labor,material,sc�g,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: O Attached No:O•Yes:(vj'N umber of Cars: 1 10. Is roof peaked,hip,mansard,flat,etc: 1�' CA,14 a 11. Estimated date of completion: 3 4 O a3 -i- 8/1212021 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. ►►�rra►rrr►ur►►•rr►r►►►►r•►r►►►►r♦:••rrrar•r•►r►••►►►►•►•r♦•►rrrr•rrr►•rr••►rr►r►►rse►rsrr►+►rrarrrr►rrrr 5 TI:01 NEW YORK,COUNTY OF W STCHESTI R ) as Mar to..SMIrv-- ,being duly sworn,deposes and states that helshe is the applicant above named. Spngt name of individual upnng as the appiitmat) and 151 her states that (%)he is the legal owner of the property to which this application perlains, or that (s)hc is the (►151 ly—r r-kQC for tic legal owner and is duly authorized to make and file this application. I i ndcate arctutcay.sv�ntlatMtr,aXral dfotuey,ac 1 That all statements contained herein are true to the hest of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will Ix in conformance with the details m 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(:niform Fire Prevention&Building Code,the Code of the Village of Rye Drook and all uthcr applicable laws,ordinances and regulations. Sworn to foie me this_ _ Sworn to before me this day ,20 dly fif br� 20 n Sipaatute of Property Owner pig.n.Mit.arcof Appt,cant —t-* 0 - — -- —Naf Rol. 50-1 rl-k- — P-ini Name of Property Owner Print Name of Applicant Nora. Public ryotary l!tihhc GREGORY K RNERA Nelary Public,State of New Yorti GREGORY M.RIVERA No-01 R1644139B Notary Public,State of New York Oualifwd In Y/estchesterCounty No,DiRI6441398 Cormmkdon Expires September 26,20_ Qualified In Westchester County Comn-dssion Expires September 26,20l� 9112'2G2i ® 5 BBB LICENSE NUMBERS PAGE 1 OF 4 WESTCHESTER: WC-15450-H04 YONKERS: 4017 CONNECTICUT: 578736 PUTNAM: PC-2892-A NEW YORK CrrY: 1230531 I > 4C> B L E A CONSTRIJLC ON CORP. (914)939-7710 F":(914)9393991 9 Jean Lane•Rye Brook,NY 10573 NAME: KATIE WOLFF ADDRESS: 2 PINE RIDGE ROAD CITY: _RYE BROOK STATE/ZIP:_NY 10573 DATE:_FEBRUARY 1,2023_ JOBSCOPE: RIGHT SIDE OF ROOF ONLY INSURANCE: All work involved within the following proposal is covered by Worker's Compensation and Public Liability. All STRIPPING: Yes_X_Remove existing roof down to sheathing,remove existing plywood and install new %2"CDX plywood and underlayment._ROOF RUNNER PLYWOOD: CDX,Exterior grade for right side roof only_X_Yes SIZE'/:" All plywood is installed with 1/8" space for contraction and expansion PERIMETER EDGE FLASHING: Drip edge provides efficient water shedding at the perimeter edges and protects the underlying wood from rotting. Fabricate and install Aluminum Roof Flashing to all rake edges where required. Color: WHITE STARTER AND HIP & RIDGE SHINGLES: YES Customer Initials Date PAGE 2 OF 4 t M' 711 FREEZE BACK FLASHING: A common roof leak problem in this geographic area is freezing ice in the gutters and along the eave edge. Under certain conditions the ice may expand up and under the roof shingles where it may melt when exposed to attic warmth resulting in leaks. For double protection along the eave edge it is recommended to install 6' Freeze Back Flashing; which is designed to stop any expanding ice under the roof shingles from penetrating the roof deck and flap fascia. YES PICTURES ARE FOR INFORMATION PURPOSES ONLY. WE WILL MATCH EXISTING SHINGLE AS CLOSELY AS POSSIBLE. THERE WILL BE A COLOR DIFFERENCE FROM THE OLD SHINGLES TO THE NEW ONES. "ALL PLANS AND PERMITS TO BE OBTAINED BY HOMEOWNER" IF DOUBLE R OBTAINS THE PERMIT THERE IS A$75.00 PER HOUR FEE PLUS THE COST OF THE PERMITS. NOT RESPONSIBLE FOR CRACKING SHEETROCK OR POPPING NAILS ON VAULTED OR CATHEDRAL CEILINGS DOUBLE "R" TO CART AWAY ALL JOB-RELATED DEBRIS. All hidden rotted wood will be priced accordingly. Please note: When a dumpster is removed there may be some wood and a small amount of debris remaining. Please use caution in this area. When changing light fixtures,the new fixtures must be on site for the crew to replace while the work is on- going. If fixtures are installed after the job is completed there will be additional charges incurred. Double"R"A Construction Corp shall guarantee workmanship to be free of defects for the natural life of the products installed by our certified installers and will furnish all necessary materials, labor and equipment. During installation,HOMEOWNER should take necessary precautions as required to protect items stored on walls and/or shelves. Double"R" shall not be responsible for any damaged items that were not protected during installation. Double"R"shall take all necessary precautions to protect the property of our customers, although, some damage may occur. A job sign will be placed on property near road at start of job and shall remain on property for two(2)weeks upon completion of job. Customer Initials Date PAGE 3 OF 4 To accomplish our goals,Double"R",uses photographs of homes and aspects of homes in many types of media (newspapers,radio,television and the internet)and uses photos in our own publications. It is the right of the individual whether or not to consent to the use of his/her photograph for the above publicity purposes. By signing a contract with Double"R",you will hereby authorize us to use any photographs taken of your home before, during or after the project for marketing purposes. Written documentation of disapproval is required by Double"R"if you wish to exercise your right not to allow us to use such materials. 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 Double "R"9 Jean Lane, Rye Brook,NY, or in writing,postmarked prior to the fourth(4)business day. If you cancel this agreement at any time subsequent to midnight of the third business day after the date of the contract and prior to the start of the work,you agree to pay us the difference of the cost of material and labor and the amount of the total sale (our lost profit). We reserve the right to cancel this contract at anytime within fifteen(15) days of this contract. If we cancel,you will be promptly notified in writing by an authorized officer of Double"R"A Construction Corp. If we cancel,we will promptly return any down payment(s)you have made. You agree to pay cash according to the terms show below, or, if your credit is approved, to sign a note provided by us for payment of the amount due. You also agree to sign a completion certificate upon completion of work. If you fail to pay according to the below terms and have not signed our note,the entire unpaid amount becomes immediately due and you must pay a collection cost equal to our actual costs of collection, up to 15%of the total amount you owe,plus attorney's fees and court costs. Material overages are not subject to reimbursements. The installation will begin on or about and will substantially be completed . It is understood by you that the following contingencies could materially change the estimate completion date stated above: customer's inability to obtain or qualify for financing, inclement weather, strikes or other labor disruptions; non-availability of materials; acts of God; or any other. Due to rapidly escalating prices and extreme volatility in the pricing of petroleum based construction products, the price set forth in this proposal/contract applies only to orders that are ordered and paid for within 10 days of the date of this proposal/contract. All other orders shall be subject to change based upon changes in the price material charged to Double "R". The buyer and the seller understand that with reference to the aforementioned completion date,time is not of the essence. CONTRACTOR PERFORMANCE WARRANTY: Double"R' proposes to furnish and install labor and material. All work will continue on job without stopping until completion barring any circumstances beyond contractor's control. Customer Initials Date ° PAGE 4 OF 4 Any changes to the job after signing of the contract are subject to an additional cost, and shall be handled in writing on a change order. ACCEPTANCE: The below prices, specifications and conditions are satisfactory and are accepted. You are authorized to do the work as specified. Payment will be made as follows: 5,595.00 ROOF TOTAL: $ SALES TAX: $ PERMIT FEES (IF APPLICABLE): $ TOTAL SALES: $ PAID WITH ORDER $ Cash Check# BALANCE DUE: $ Terms: Cash to be paid as follows $ (2"d deposit of 1/3rd is due) Half completion Financing balance $ (3,d deposit of 1/3rd is due) Day of completion CUSTOMER SIGNATURE: DATE: DOUBLE "y A CONSTRUCTION AUTHORIZED SIGNATURE -. ,A n`' �� �► ,w° i AI s A -.. �wr r; n w w _ w Y. x' � �� '' '' 0�i•,� r ,,1�1��11,,.�+ ��,Il+�i/l�� � 1�� ,,,+aI�t;n � ��t�"�i M � 1+' ,� ���' _ {� ,� .��'.V�/d_= `' ,,Y=Y.t 1 1 .� a V+�Y�• . . V411d-� -e . 111• Ir ���hi,� 1/'0 ,,�-.y���:�'l��ik�ll, �(o»;, ` O (o)► ? n N ( .. 93. CN , 4 •� v M L• c, ul bq U J ° s 4� ���. 0 •ter o � - ,' ism' J VLn LLi e j •• L O H LP) = c C Y«o» ` , U J W ° •° a ction «as» rA /�I (n N Z Y 1�J C� (�� �c�� o 'er• LU LU +/ �`'�• � � �" � � � � N � ��e a� Vie �� r, O u : LO s rw3„L �• �� u 'UG t�•x� Y �v .a y p { u y u �� .� ---s..•�'•!1'�+11V= E�; t �l�I 1111+�?z .`}; /1 fl+/1 �k� _. 1!1 41!'.a __ d, 111 Illl�:i�� 11/1 11'1 y ��111► 11= ��'. , ...,,E������•���_" 1� 1 1 1 4`���Rf •11 A � 1 �A�y 1�1♦+t� �� `Z♦1 '"+A`4* ♦♦ A -��♦ i9f/� fF. •i R r .• r� A V 1 V V V �► s'} h V V. Aco CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD YYVY) ��- 02/02/2023 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 NAME: George DDuramanit Dur-America Brokerage Inc PHOAIC.NENo,Extio (212)302-2672 FAX N,: 718 956-9731 214 W 39th Street, Suite 207 AIL ADOResS: certificates@duramerica.com New York, NY 10018 INSURERS AFFORDING COVERAGE NAIC# INSURER A: ATLANTIC CASUALTY INSURANCE CO 42846 INSURED fISURER B Double R A Construction Corp INSURERC: 9 Jean Lane INSURER0: Rye Brook, NY 10573 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 00003019-1992780 REVISION NUMBER: 166 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. INSRR PO TYPE OF INSURANCE i N DL SUER POLICY NUMBER MM DDY EFF fMM/D1D Y EXP LIMITS A X COMMERCIAL GENERAL LIABILITY , Y L302001498-0 10/15/2022 10/1512023 EACH OCCURRENCE $ 1,000,000_ RENTED CLAIMS-MADE IXII OCCUR PREM SES E.occurrence) $ 100,000 MED EXP(Any one person) S rJ 00O _ PERSONAL a ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY E] PRO- LOC PRODUCTS-COMP/OP AGG $ 11000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE _ EXCESS IJAB CLAIMS-MADE AGGREGATE S DED I I RETENTIONS $ WORKERS COMPENSATION I PTAT TE ER AND EMPLOYERS'LIABILITY Y''—/'N'1 ANY PROPRIETOR/PARTNER/EXECUTNE L J N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below IE.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Village of Rye Brook is included as additional insured CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Village of Rye Brook THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 938 King Street Rye Brook, NY 10573 AUTHORIZE REPRESENTATIVE t-_� C G ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are reti.tered marks of ACORD Printed by C_G on 02/02/2023 at 03 42PM NYSIF New York State Insurance Fund PO Box 66699,Albany,NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED) 0 O "^^^^A 061605879 f DURAMERICA BROKERAGE INC } 214 W 39TH ST STE 207 fMPt NEW YORK NY 10018 r SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER DOUBLE RA CONSTRUCTION CORP VILLAGE OF RYE BROOK 9 JEAN LANE BUILDING DEPARTMENT RYE BROOK NY 10573 938 KING STREET RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W2336 816-0 972357 06/13/2022 TO 06/13/2023 2/2/2023 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2336 816-0, 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 ANTHONY SOTIRE VICE PRESIDENT MARIA SOTIRE DOUBLE RA CONSTRUCTION CORP 2OF2 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 T �V DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 773230516 U-26.3