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HomeMy WebLinkAboutRP23-010PERMIT # / 07 3 U/ UDATE: 7 c 3 O(P: 3/7)c / SECTION f BLOCK RIOT c� TYPE OF WORK JOB LOCATION _ OWNER,01L4 CONTRACTORZ EST. COST ✓CO #� TCO # FOOTI N G FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING O RGH PLUMBING GAS C� SPRINKLER ELECTRIC LOW —VOLT CJ ALARM CI AS BUILT O FINAL //PS FEE5 // U FEE DATE INSPECTION RECORD DATE I NSP i)a6y-5077 c - eolf�SO4oC5/1)939-3508 3 OTHER APPROVALS ARB BOT PS ZBA OTHER L c4G4•o�i 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.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 May 9,2023 Blake Silverman&Alexa Silverman 18 Milestone Road Rye Brook,New York 10573 Re: 18 Milestone Road, Rye Brook,New York 10573 Parcel ID#: 124.65-1-72 Roof Permit#23-010 issued on 3/7/2023 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 F " BUILDING ' ATMENT For office use onI PERMIT# a31-010 E D VIL � OF RYE BROOK ISSUED: - —33 MAR 23 2023 Yon KING STRE YE BROOK,1NEW YORK 10573 DATE: VILLAGE OF RYE BROOK 9 -O ,, FEE: //0— PAIDf 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 strsssssrr►•rrrsrsrrrrsttsrr►rsrssrsrarssststtssssstrarrsssssr.rsssr•sssses•sssss•ssssss►ssrsstssssessssterttrtsrsssssrsrrsss Address: 18 Milestone Road, Rye Brook, NY 10573 � Occupancy/Use: ReSldential Parcel ID#: Zone: L/ib Owner: Blake Silverman A4dress: 18 Milestone Road, Rye Brook, NY 10573 P.E./R.A.or Contractor: trQ�j-o fi nil mC in Address: _66 IV(fw York AIlenttC' Wig m lv /ff Person in responsible charge: I [ i d 40 Address: 1( / 1K P Application is hereby made and submitted to the Building hnspector 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: Blake Silverman being duly sworn,deposes and says that he/she resides at 18 Milestone Road Rye Brook NY 10573 (Print' icant) (No.and Street) in Rye Brook ,in the County of Westchester 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:Syr/ , for the construction or alteration of: re — rbd 5�4I q 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 afore me this Sworn to before me this day of Al rc 11 ,20__�3 day of ,20 )V /_ Signature of Property Owner Signature of Applicant b 4 4 IL't Name of Property Owner Print Name of Applicant o ary Public Notary Public SHARI MEULLO Notary Public,State of New York No.01ME6160063 Qualified In Westchester County ommisslon Expires January 29,201-l' �yE BR(�k• Q�i� ��O•c 1982 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 - - - - - - - - - - - - - , - - - - - -� a oaf ADDRESS : DATE: -72 PERMIT# ISSUED: SECT: (. LOCK: / LOT: i 6. LOCATION: �" OCCUPANCY: 2f ❑ Violation Noted THE WORK IS... ASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION /' REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas ❑ L.P. Gas ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING CROSS CONNECTION FINAL ❑ OTHER s : a+ N 1l"1 N Opf,' 'b h N \ w v 44 u W U tl, cu Ou a z � a .r 14 W W W 3 a. a rs. otn � g � en w N r en 1-4 0-1 Qj A4 la. co WW w° W oo O O � � P4 z Uzi M Q M vW W W 6 W ",�' o wo A M Imo `'` 0 z � 0 moo � � V . 0 in ON N a3 can w v 0 W " `" H W o .org 9 v z F O b4 (� u, a o is 9 v u w ° -v v ` v r , l� O "� -v , ~ z 00 z x W. d y ° b O (� v 'U v BUILDING DE MENT V E OF RY \ OK MAR - 3 2023 938 DING ET RYE BR NY 10573 VILLAGE OF RYE BROOD -Q BUILDING DEPARTMENT FOR OFFICE USE ONLY: Approval Date: MAR 4 m* a,3-- J0 : 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. Permit Fees:- obVe . ROOF PERMIT APPLICATION Application dated: 2/21/23 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: 18 Milestone Road, Rye Brook, NY 10573 SBL: /a)Y, 105 7� one:AU6 Property Owner: Blake Silverman Address: 18 Milestone Road, Rye Brook, NY 10573 Phone#: Cell#: (201) 264-5077 email: 2. Applicant: Fredi Soto Address: 150 New York Ave, Westbury, NY 11590 Phone#: Cell#: 516-939-3508 email: 3. Roo#'mg contractor: Fredi Soto Address: 150 New York Ave. Westbury, NY 11590 Phone#: Cell#: 516-939-3508 email: 4. Job Description,list all Methods&Materials: Remove existing shingles, cedar and underlayment. Install drip edge, ice and water 6ft from gutter edge,tar paper, shingles, ridge vent and ridge caps 5. Estimated Cost of Job:$ 1 Q (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: Re-Roofing NYS Construction Class: 8. Number of stories: 2 Height: 9. Is garage being re-roofed:No:( )•Yes:( )Attached No:( )•Yes:( )Number of Cars: 10. Is roof peaked,hip,mansard,flat,etc: 11. Estimated date of completion: 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 WESTCHESTER ) as: Blake Silverman ,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 owner 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. Sworn to before me this Sworn to before me this day of / l°'rC 1 ,20 OL day of , 20 ignature of Property Owner Signature of Applicant int Name of Property Owner Print Name of Applicant Notary Public Notary Public SHAM MEULLO Notary Public,State of New York No.01ME6160063 Qualified in Westchester Coun ^ornmissfon Expires January 29, 2ty 81120021 Aaaraworr'r.lrrattbon.(x. 'lid F RECENE BsuO e/Drrrctarr �. 11 BID,F.w Bh&R-Rr .k,ACY.I"" MAR - 3 2023 March 1, 2023 VILLAGE OF RYE BROOK BUILDING DEPARTMENT BelleFair ARB 24 Bellefair Blvd Rye Brook, New York 10573 Blake Silverman 18 Milestone Road Rye Brook, New York 10573 Re: Replacement of Roof Et Installation of Solar Panels Dear Blake, We write in response to your request to the ARB for approval of the replacement of the roof and installation of solar panels on your residence situated at 18 Milestone Road, Rye Brook, New York. We are pleased to inform you that based on the details of your application, your application has been approved. Once this installation is complete contact our FirstService representatives, Rafael Reyes or Michael Napolitano so that a final inspection may take place. Please be advised that our approval will be expressly conditioned upon your continued compliance with Schedule D of the Declaration. Accordingly, if the aforementioned fails at any time to comply with the Regulations, the ARB reserves the right to direct modification or the removal of the improvements at your sole expense to ensure compliance. Please note that approvals are valid for one year as of the date of this letter. As a reminder, certain alterations will require the approval of the Village of Rye Brook's Building Inspector or Engineer. You shall be responsible for obtaining all required approvals and permits. The Village of Rye Brook will consider applications after BelleFair ARB approval is given. The Village of Rye Brook approval does not preclude the need for ARB approval, nor does ARB approval relieve you from any responsibility of obtaining Village of Rye Brook approval. If you have any questions, please do not hesitate to contact us. Very truly yours, The BelleFair Architectural Review Board ANERICAN BREAM Roof Estimate ROME IMPROVEMENT INC 150 New York Avenue • Westbury, NY 11590 Cell: (516) 939-3508 • Office: (516) 280-7902 • Fax: (516) 280-7903 Customer: SunRun Date: 2/15/23 Installation for: Estimate number: 022315 Blake Silverman Quote/Bid Request: 212R-018SILV 18 Milestone Road, Rye Brook, NY 10573 blake.a.silverman@gmail.com, (201)264-5077 Description of work: Roof Installation (Whole House) Remove existing 1 layers of shingles & underlayment from roof of house. We will replace 2 pieces of 5/8 plywood free of charge if needed for rotted wood. If additional 5/8 plywood is needed, it will be $110 per 48 piece of plywood. Cut space for ventilation and install a ridge vent on top of house. Install White Drip Edge edges of house. Install Ice &Water Barrier on edges of house. Install Synthetic Tar Paper on upper sections of roof. Install Starter Shingle on all edges of house. Install GAF Timberline HDZ Architectural Shingles Color: Hickory. Install GAF TimberTex Ridge Caps Color: Hickory. Install Chimney Flashing on house. Remove all debri and material from job site. $14,800, (22sgs, 1 layer rip) (plus permit fee) If house needs plywood it will be an additional$6,600 No Gutters or Downspouts Licensed and Insured Nassau Lic.#H3309810000•Long Beach LJC.#14114•Suffolk Lic.#48043-H•NYC LJC.#1412523•Westchester Lic.#WC-26665-H14 D E C IE M E MIGHTY rNFRIENGINEEPING CO. APR 17 2023 VILLAGE OF RYE BROOK April 12,2023 BUILDING DEPARTMENT RE: CERTIFICATION LETTER Project Address: SILVERMAN RESIDENCE 18 MILESTONE RD RYE BROOK,NY, 10573 Design Criteria: -Applicable Codes=2020 NYSRC,2018 IEBC/IBC,2018 IRC,ASCE 7-16 and 2018 NDS -Risk Category=II -Wind Speed=116 mph,Exposure Category B,Partially/Fully Enclosed Method -Ground Snow Load=30 psf -ROOF AR-01:2 x 10 @ 24"OC,Roof DL=8 psf,Roof LUSL=23 psf(Non-PV),Roof LUSL=16.2 psf(PV) To Whom It May Concern, A structural evaluation of loading was conducted for the above address based on the design criteria listed above. Existing roof structural framing has been reviewed to be adequate to resist the additional loading due to installation of PV Solar System on the roof.The structural review applies to the sections of roof that is directly supporting the solar PV system. Based on this evaluation,I certify that the alteration to the existing structure by installation of the PV system meets the prescriptive compliance requirements of the applicable existing building and/or new building provisions adopted/referenced above. Additionally,the PV module assembly including attachment hardware has been reviewed to be in accordance with the manufacturer's specifications and to meet and/or exceed the requirements set forth by the referenced codes. Sincerely, Pt� NE„ o Digitally signed by Humphrey K - Kariuki r Date:2023.04.12 10:12:13-04'00' Mighty Engineering Co 1 1708 Rorborough Rd Charlotte,NC 2S211 1 (930)689.9776 1 info@ mightyengineeringco.corn pg t of 4 MIGHTY ENGINEERING CO. RESULTS SUMMARY oPrvErioEKfEc.• - . SILVERMAN RESIDENCE,18 MILESTONE RD,RYE BROOK,NY, 10573 MOUNTING PLANE STRUCTURAL EVALUATION PI MOUNTING PLANE RO(dFeg.)CH RESULT GOVERNING ANALYSIS ROOF AR-01 28' MEMBER ANALYSIS Limits of Scope of Work and Liability: The existing structure has been reviewed based on the assumption that it has been onginolly designed and constructed per appropriate codes. T.he structural ono vs`s of the subiect property is based on the provided site survey data. The calculations produced for this structure's assessment ore only for the roof framing supporting the proposed PV installation referenced in the stamped planset and were mode according to generally recognised.tructurol andlvsis standords and procedure:.All PV.modules.racking and attachment components shall be designed and installed per manufacturer`s approved auidelines and specifications. These Plans are not stamped for water leakage or existing damage to the structural component that was not accessed during the site sun.ey.Prwr to commencement ai work, the PVsystem installer should verify that the existing roof and connections are in suitable condition and inspect framing noted on the certification letter and inform the Engineer of Record of any discrepancies prier to installation. The installer should also check for onv damages such as water damage, cracked f romina. etc. and inform the Engineer of Record of existing deficiencies which are unknown andlor were not observable during the time of survey and have not been included in this scope of work. Any change in the scope of the work shall ,at be accepted unless such chanae,addition,or deletion is approved in advance and in wrrtrfg by the Engineer of Record. Mighty Engineering Co 1 1708 Roxborough Rd Charlotte,NC 2S211 1 (930)689.9776 1 info@rnightyengineeringco.corn pg 2 of 4 MIGHTY LOAD CALCULATION rNFRIENG11NEEPlING CO. ROOF AR-01 SILVERMAN RESIDENCE,18 MILESTONE RD,RYE BROOK,NY,10573 PV SYSTEM DEAD LOAD(PV-DL) PV Module Weight = 2.50 psf Hardware Assembly Weight = 0.50 psf Total PV System Dead Load PV-DL= 3.00 psf ROOF DEAD LOAD(R-DL) Existing Roofing Material Weight Composite Shingle Roof 1 Layer(s) = 2.50 psf Underlayment Weight = 0.50 psf Plywood/OSB Sheathing Weight = 1.50 psf Framing Weight 2 x 10 @ 24 in.O.C. = 1.93 psf No Vaulted Ceiling = 0.00 psf Miscellaneous I = 1.50 psf Total Roof Dead Load R-DL= 7.90 psf REDUCED ROOF LIVE LOAD(Lr) Roof Live Load L,,= 20.00 psf Member Tributary Area A, <200 ftZ ROOF AR-01 Pitch 28°or 7/12 Tributary Area Reduction Factor R1= 1.00 Roof Slope Reduction Factor R2= 0.88 __�]Reduced Roof Live Load,Lr=L.(Rl)(RZ) L,= 17.50 psf SNOW LOAD Ground Snow Load pg= 30.00 psf Effective Roof Slope 28° Snow Importance Factor Is= 1.00 Snow Exposure Factor Ce= 1.00 Snow Thermal Factor C,= 1.10 Minimum Flat Roof Snow Load pf_,,,;,,= 20.00 psf Flat Roof Snow Load pf= 23.30 psf SLOPED ROOF SNOW LOAD ON ROOF(Non-Slippery Surfaces) Roof Slope Factor Cs-roof= 1.00 Sloped Roof Snow Load on Roof py,�f= 23.10 psf SLOPED ROOF SNOW LOAD ON PV PANEL(Unobstructed Slippery Surfaces) Roof Slope Factor C,_ = 0.70 Sloped Roof Snow Load on PV Panel PS-Py= 16.20 psf Mighty Engineering Co 1 1708 Roxborough Rd Charlotte,NC 2S21 t 1 (930)689.9776 1 info@niightyengineeringco.com pe 3 of 4 n�MIGHTY WIND UPLIFT CALCULATION ENGINEERING CO. ROOF AR-01 SILVERMAN RESIDENCE,18 MILESTONE RD,RYE BROOK,NY,10573 SITE INFORMATION Ultimate Wind Speed(mph)= 116.00 mph Roof Pitch(deg.)= 28° Risk Category= II Roof Type= Gable Exposure Category= B Kd= 0.85 Mean Roof Height= 23.00 ft K,c= 1 Solar Array Dead Load= 3.00 psf K,=1 0.65 DESIGN CALCULATIONS Wind Velocity Press.(qh)=0.00256*Kz*K,,-Kd*Ke*V = 19.01 psf a(ft)= 4.50 Array Edge Factor(yE)= 1.50 Solar Array Pressure Eq.Factor(ya)= 0.60 Hardware Type: RL UNIVERSAL Allowable Load= 655.00 Ibs SPF,2.5"lag embedment Max.X-Spacing(Zone 1-2r) 6.00 ft Effective Wind Area Max.Y-Spacing(Zone 1-2r) 3.41 ft 20.46 ft2 Max.X-Spacing(Zone 2n&3r) 6.00 ft Effective Wind Area Max.Y-Spacing(Zone 2n&3r) 3.41 ft 20.46 ftz Max.X-Spacing(Zone 3e) 6.00 ft Effective Wind Area Max.Y-Spacing(Zone 3e) 3.41 ft 20.46 ft' ROOF ZONE GC - UPLIFT UPLIFT PRESSURE PULLOUT FORCE 1-2r -1.49 -13.70 psf 280.30 Ibs 2n&3r -1.76 -16.49 psf 337.43 Ibs 3e -2.18 -20.78 psf 425.24 Ibs NOTE. •Wind calculation is based on ASCE 7-16,29.4-C&C,LC N7:0.6D+0.6W is used. Mighty Engineering Co 1 1708 Rotborough Rd Charlotte,NC 2S211 1 (940)689.9776 1 info@rnightyengmeeringco.com pg 4 of 4 COMPANY PROJECT WoodWorksMIGHTY ENGINEERING CO. BLAKE SILVERMAN STRUCTURAL ENGINEERS ROOF AR-01 .11FMR RFMRWnr,nOF1,L\ Apr. 12, 2023 09:13 Design Check Calculation Sheet WoodWorks Sizer 2019(Update 4) Loads: Load Type Distribution Pat- Location [ft] Magnitude Unit tern Start End Start End snow Snow Full Area Yes 23.10 (24.0") psf R-DL Dead Full Area No 7.90 (24.0") psf PV-DL Dead Full Area No 3.00 (24.0") psf Self-weight Dead Full UDL I No 1 1 3.3 1plf Maximum Reactions (lbs) and Bearing Lengths (in) 19.254' 0' 2' 16.564' Unfactored: Dead 267 213 Snow 434 354 Factored: Total 701 568 Bearing: Length 5.50 5.50 Min req'd 0.60** 0.53 **Minimum bea in len t$hovernedl by the required width of the supporting member. ROOF AR-01 Lumber-soft, D.Fir-L, No.2, 2x10 (1-1/2"x9-1/4") Supports:All-Timber-soft Beam, D.Fir-L No.2 Roof joist spaced at 24.0"c/c;Total length: 19.69'; Clear span(horz): 1.75', 14.313';Volume = 1.9 cu.ft.; Slope: 28.0 deg Lateral support:top=continuous, bottom = at supports; Repetitive factor: applied where permitted (refer to online help); This section PASSES the design code check. Analysis vs. Allowable Stress and Deflection using NDS 2018 : Criterion Analysis Value Design Value Unit Analysis/Design Shear fv = 47 Fv' = 207 psi fv/Fv' = 0.23 Bending(+) fb = 1081 Fb' = 1309 psi fb/Fb' = 0.83 Bending(-) fb = 84 Fb' = 524 psi fb/Fb' = 0.16 Deflection: Interior Live 0.37 = L/534 0.82 = L/240 in 0.45 Total 0.70 = L/281 1.10 = L/180 in 0.64 Cantil. Live -0.16 = L/170 0.23 = L/120 in 0.70 Total -0.30 = L/90 0.30 = L/90 in 0.99 WoodWorks® Sizer SOFTWARE FOR WOOD DESIGN ROOF AR-01 WoodWorks®Sizer 2019 (Update 4) Page 2 Design Notes: 1.Analysis and design are in accordance with the ICC International Building Code(IBC 2018)and the National Design Specification (NDS 2018), using Allowable Stress Design (ASD). Design values are from the NDS Supplement. 2. Please verify that the default deflection limits are appropriate for your application. 3. Continuous or Cantilevered Beams: NDS Clause 4.2.5.5 requires that normal grading provisions be extended to the middle 2/3 of 2 span beams and to the full length of cantilevers and other spans. 4. Sawn lumber bending members shall be laterally supported according to the provisions of NDS Clause 4.4.1. 5. SLOPED BEAMS: level bearing is required for all sloped beams. Updated Engineer Letter for 18 Milestone Rd if you have any questions please reach out to me my number is 385-352-6895 or my email is Joe.Guadagno@sunrun .com RIE C [E-WE 3D APR 17 2023 VILLAGE OF RYE BROOK BUILDING DEPARTMENT 1 f �. �- t41��1iP.,,• 0` r��sir• � �• ...r. '.�. � �-. - 3 1 o c 4 CJ G c tz CD v > o N i � r C> L d U o -o i V t / O Zui CK w �j t Iwo to QQ 4.1 ¢, W W N due ap 0 .« ) r, y G� Q v o E r••► Q LLJ Q • tA N 40 o N r TZ 1 a+ k7 cV cv e. co OLDcn Y n *" G C I N. rx i a ,11/1 " 're?; r_P 11�1 [5-3; 1j,111" 11�11�`I� 1 0 1 - f 1/11 i 3 1111/1 N♦ � e 1 /11\ NI��i�ft11 /ib �i� �jO?y ��� �. rp •• i�`1�f.1'��' •• �1"tf� r�� VI.• ���/�w�i� •• 1•i. ylU�,r�ky:._ �..�'� p�>)il ^ dl � `+'•�'e �� ''t '4,fi,rx�l ULN 0 2n���.1 r1��� �`r5�a5� O ��A��yr;�O1t4L, �"'� °' r�'�. tl� ''kt'��7 � {i$�{SI' �fq, .. y;. 11 s., . �::M+� �tl��y,,:•_ •��` . ACC) CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 2/22/2023 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 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: COMMUNITY BROKERAGE OF LI,INC. PHONN 516-565-1600 FAX 82 NORTH FRANKLIN ST. EMAIL ac No): 516-565-1691 HEMPSTEAD,NY 11550 ADDRESS: INSURERS AFFORDING COVERAGE NAIC M INSURER A:ATEGRITY SPECIALTY INS CO INSURED INSURER B: AMERICAN DREAM HOME IMPROVEMENT INC INSURERC: 150 NEW YORK AVE - Westbury, NY 11590 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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', TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR POLICY NUMBER MM/DD MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 ✓ COMMERCIAL GENERAL LIABILITY AGFMOIPREMISES( a occurrence) $ 50000 A CLAIMS-MADE Z OCCUR Y 01-P-GL-P70002269-2 5/12/22 05/12/23 MED EXP(Any one person) $ 5000 PERSONAL&ADV INJURY $ 1000000 GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2000000 ✓ POLICY 7 PRO- LOC S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident)_ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED 1 1 RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N 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/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) ALL OPERATIONS,ALL LOCATIONS SUBJECT TO POLICY TERMS, CONDITIONS, EXCLUSIONS AND DEDUCTIBLES. CERTIFICATE HOLDER IS LISTED AS ADDITIONAL INSURED AS REQUIRED BY WRITTEN CONTRACT. CERTIFICATE HOLDER CANCELLATION VILLAGE OF RYE BROOK SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 938 KING STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN RYE BROOK NY 10573 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIV ✓� ©198 -2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) 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 o ^^^^^^ 271263059 44,40 COMMUNITY BROKERAGE INC 82 N FRANKLIN ST HEMPSTEAD NY 11550 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER AMERICAN DREAM HOME IMPROVEMENT INC VILLAGE OF RYE BROOK 150 NEW YORK AVE 938 KING STREET WESTBURY NY 11590 RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE H2O87 930-0 815607 11/18/2022 TO 11/18/2023 2/22/2023 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2087 930-0, 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 FREDI 0 SOTO ESTRADA PRESIDENT AMERICAN DREAM HOME IMPROVEMENT INC A ONE-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 SU NCE FUND T �V DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER. 1050273551 U-26.3