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HomeMy WebLinkAboutRP23-054PERMIT #4, SECTION 1 TYPE OF WO JOB LOCATIC CONTRALTO 0 COST * # s c TCO # 3 BLOC / 4e Q� J�P//SPi7 4 �iS 4e. cl�61i� / A0,90 zl)9$7 041/o9 or,(o oe z Cc03(� 7- �83� FEE DATE , INSPECTION RECOF3Q I DATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING O RGH PLUMBING GAS 0 SPRINKLER ELECTRIC 0 LOW -VOLT O 4LARM O AS BUILT 0 e 4 FINAL OTHEf2 APPROVALS ARB BOT ZBA dye DRn� 4 J,IVC'V41y 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.ryebrookny.gov TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE August 14, 2024 Peter Jensen&Doris Perez-Santiago 25 Pine Ridge Road Rye Brook,New York 10573 Re: 25 Pine Ridge Road, Rye Brook,New York 10573 Parcel ID#: 135.34-1-65 Roof Permit#23-054 issued on 11/7/2023 to Re-Roof Existing Building& Replace Skylights This certifies that the new roof and skylights,installed under the above captioned permit have been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to REcE�YE BUILDING DEPARTMENT For office se only: PERMIT# VILLAGE OF RYE BROOK ISSUED: K- - 3 AUG 12 2024 38 KING STREET,RYE BROOK,NEW YORK 10573 DATE: (914)939-0668 FEE: PAID VILLAGE OF RYE BROOK www,ryebrookny.pov 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 Address: Occupancy/Use: �' Parcel ID#: (, 13�. �— Zone: Owner:'�� ,,, \NEcD Address: 2—,. P.E./R.A. or Contractor: ? ���, t jrl, Address: 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 Y`ORK, COUNTY OF WESTCHESTER as: being duly sworn,deposes and says that he/she resides at (Print Name of Applicant) vA (No.and Areet) in �p -y-j!ou ,in the County of 1� �` �y�\� in the State of that '- (Citylrown/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:$ SS for the construction or alteration of: Deponent further states that he/she has examined the approved plans of the structure/work herein referred to for which a Certificate of Occupancy/Compliance is sought,and that to the best of his/her knowledge and belief,the structure/work has been erected/completed in accordance with the approved plans and any amendments thereto except in so far as variations therefore have been legally authorized,and as erected/completed complies with the laws governing building construction.Deponent further understands that it shall be unlawful for an owner to use or permit the use of any building or premises or part thereof hereafter created,erected,changed,converted or enlarged,wholly or partly,in its use or structure until a Certificate of Occupancy or Certificate of Compliance shall have been duly issued by the Building Inspector as per§250-10.A.of the Code of the Village of Rye Brook. Sworn to before me this ` Sworn to before me this day of �I� , 20 day of , 20 RR Signature of Property Owner Signature of Applicant nt Name of Property Own c Print Name of Applicant �\ �G otary Public Notary Public SHARI MELILLO Notary Public,State of New Yor:; No.01ME6160063 - Qualified In Westchester County Commission Expires January 29,20�� �E BRC�v� o`` tim 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 - - - - - - - - - - - - - - - - - - - - ADDRESS : 2 u at.-;Z"' DATE: 4 ` ' Z PERMIT# 1\ T Z + QS N ISSUED: //-7- SECT: XI.Q Y BLOCK: / LOT: _ LOCATION: OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... [I- ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION J ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION FINAL El OTHER li oo� S iLn ■ N N pG 0.0 a, x Ln a w W et i—r o b y ' W 64 H o ll�tllttl c'� M � � ° u •� '� � � �r p a W Q W `— ,_..� O M W C .� o 0 H oz v c � � � �] V 14 LO �zNV. U " ram Mug � j u a a, oo o�' ,� O w P4 as h x >, cn _ Q cWj, z ►-a O W O A E . b a z b , o � W Ln - -01 H 0 W w © O cu BUILDING DEPARTMENT R VILLAGE OF RYE BROOK OCT 217 2023 938 KING STREET RYE Batx)K,NY 10573 (914)I -Q668 VILLAGE OF RYE BROOK w��rv- a Qk.or BUILDING DEPARTMENT FOR OFFICE USE ONLY: Approval Date- cr it � 1 Application# Approval Signature: ! ARCHITECTURAL EW BOARD: Disapproved: Date: BOT Approval Date. Case# Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Case# Other: �, 1 Application Feel Permit Fees: 4 ,31 7- 1w6� ROOF PERMIT APPLICATION Application d -7ated:. " r ty is hereby made to the tivaciing Inspector of the Village of Ryc brook.N Y,for the issuance of a Yenntt to Re-Roof an Existim Building,as per detailed statement described below. 1. Job Address: 25 PINE RIDGE RD RYE BROOK NY SBL: /35i-37— Zone: R 15- Property Owner: PETER JENSEN Address: gr Phone#: 914-989-0409 Cell#: email: 'Pe, K 1 'r C�-cioL .oM 2. Applicant: Magana Roofing & Siding LLCM Address: 257 Flax Hill Road Norwalk CT 06854 Phone#: Cell#: 203-667-48m email: eelmagana0 ahoo com 3. Rooting Contractor:Magana Roofing &Siding LLC Address: 257 Flax Hill Road Norwalk CT 06854 Phone#: Cell#: 203-667-4836 email: eelmagana(d)yahoo.com 4. Job Description, list all Methods&Materials: Stripping off entire roof, Inatalling new ice/water shield synthetic a er GAF Architectural Shin ples.Auminum Dr42Edfle Hips Conner Flashing around all chimneys replacing any rotten wood S. Estimated Cost of Job: $ /7 SS�� (NOTE:The estimated cost shall include all sis. improvements,labor,material,scaffoldine.fixed equipment,professional fees,and material and labor which may be donated gratis.) b. If corner property,indicate street frontage: 7. Construction Type: Frame NYS Construction Class: S. Number of stories: 1_zj Height: 9. is garage being re-roofed: No:( )•Yes:( )Attached No: N/Yes:( )Number of Cars: 10. is roof peaked,hip,mansard,flat,etc: HIP 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. ++N,k,Y++sY,4,Filr.kwFwww-Fwirwww-Ywwi.+-++w,t 4,F iir it tk-0r#eww wwir t+k#w k,kie}t iF Je it F^+twd+,F+w++ww+++++++,4++++,F,A-++,Et+++rYi Yi,F,41F 14#ttk heir STATE OF NEW YORK, COUNTY OF WESTCIIESTER ) as: Edgar Lopez , 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 Magana Roofing & Siding LLC _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 ana regulations. Sworn to before me this Sworn to before me this 26th ZX day of 20 day of Octob 2023 Signature of Property Owner Sig/atureApplicant �,rc C'• Nn�t� Edgar LopezContractorr Print Name of Property Owner Print Name of Applicant Notary Public 0m t "r" Notary Public Q54 D GREGORY M.RIVERA MARY KATHERINE RIVERA NO"Public,State of New York NOTARY PUBLIC- CT 169993 No.OIR16441398 FAIRFIELD COUNTY Qualified In Westchester County ,) My Commission Expires Sept 30,2025 Commission Expires September 26,20Qt MAGANA Roofing & Siding, LLC 257 Flax Hill Road, Norwalk, CT 06854 (203) 667-4836 Name Peter Jensen October 24, 2023 Address 25 Pine Ride Road, Rye Brook, NY Phone # 914-989-0409 work ITEMS DESCRIPTION PRICE Stripping existing layer of roof on entire house. S13.3-00.00 Installing new ice and water shield. Installing synthetic paper on entire roof. Installing GAF architectural shingles on entire roof. Installing new aluminum drip edge around entire roof. Installing new Hips on entire house. Replacing any rotten wood. Installing new copper flashing around all chimneys Installing new 6 inch white K Style Aluminum gutters. $4,500.00 Installing white aluminum 3x4 leaders on entire house. Replace old plywood with half inch CDX new plywood on main house only. $2,800.00 Replace two skylights by the garage. $1,250.00 GAF shingles have a 30 year warranty by manufacturer . 10 year warranty on workmanship All garbage will be carted away. 50% Down at contract signing SUBTOTAL TAX TOTAL $22,050.00 Unit Skylights \ �t Deck-Mounted VS 4 I,. VS Manual "Fresh Air" rc a Insect screen and operating hook included with VS skylight. Operated by ZCT 300 control rod or crank handle ZZZ 201, sold separately. 2Cf d VS Roof Pitch 140"850 it ✓. 3:12-13212 A, Add a 425 Solar-Powered $ Pre-Installed Shade -'.�'s� `•� Control all shades with one remote - $150 using the new VELUX Touch a See page 6 for more information Room-Darkening,Double-Pleated Code:CS-Solar y .' Id ;"I#' iyB;i�ili� ■ ,,Y; ,, - u 00 01 44 45 46 k' White Beige Grey Grey Dark _ Melange Sand 4 �' t _ Light-Filtering,Single-Pleated Code:FS-Solar �A r 00 01 34 35 36 1 White Classic Natural Dark Jeans •.� Sand Grey Blue Order code example 2 4 business days Up to 13 business days � Code+Color=CS00 ,for delivery ,for delivery :r All base models are available to have pre-installed shades,however,some optional skylight models may not be available.VELUX Customer Service will confirm availability.Manual Shades not available for VS model. 14 For questions,please call 1-800-888-3589 �'" Standard Sizes C01 C04 C06 C08 M02 M04 M06 M08 S01 S06 (W-in.xH-in.) 0 0 E E ❑ 0 = [�] ❑ ❑ Outside Frame 211hx 21'hx 21'hx 21'hx 30yisx 30V6x 30'/i6x 30Ii6x 44Xx 44Kx 27% 38% 46'/ 54'%6 30% 38% 46 V4 541`'i6 27% 46'1a � Rough Opening 21 x 21 x 21 x 21 x 30!,is x 30'bs x 30'/6 x 30�1e x 44'/x 44'/x 2639 3736 45 X 54 X6 30 37% 45 3/ 54'hs 26'h 45 X Base Model c01 C04 C06 C08 M02 M04 M06 M08 Sol S06 Laminated LowE3 Glass Code 20041 Delivery S $588 $635 $673 $705 $664 $696 $749 $828 $752 $943 • Optional Models'Add price to base model;any size.Applies to standard sizes only. Impact Glass Copper Cladding Snowload Glass Stain Grade Wood Interior +$120 vcsonly +$230 VSE only excluding M02 +$185 +$60 VSS only Code 2006 1 Delivery N Code 2014 1 Delivery D Code 2010 1 Delivery A Code 0004 1 Delivery D Add a pre-installed solar shade to any VS model for$425 and GO homeowners are eligible for a 30% Federal Solar Tax Credit on product and installation.2 SOLAR Add a pre-installed solar shade Receive VELUX App Control system, Harness the power of the sun and 12, I Gateway+App.Control your VELUX control the amount of daylight shades anytime,anywhere with your entering through the skylight. smartphone or smart home device. Flashing Adhesive underlayment included.VELUX flashing required for the No Leak Warranty. Col C04 C06 C08 M02' M04 M06 M08 Sol S06 Step Asphalt Shingles/Wood Shake/Slate $112 $141 $122 $134 1/2 in.max thickness Code EDL I Delivery S Copper Step Asphalt Shingles/Wood Shakes/Slate $237 $299 $2 58 $284 1/2 in.max thickness Code EDL COPPER I Delivery D High Profile Tile-over V4 in.thickness $220 $233 $233 $277 Code EDW I Delivery S Metal Roof Code EDM I Delivery S $359 $398 $385 $408 Biepack' Counter Flashing for Deck-Mounted $233 $233 $266 $282 Code ECB I Delivery S 'Lead time/size availability may vary from base model.2Visit veluxusa.com/go-solar.'Adhesive underlayment not included. «r� Order Code Example vs + cos + 2004 + cs00 �•�-�jg product size code shade N>ti 1 •'�:s 4 veluxusa.com % ay'r �g� r; •.'ii 1.91M �.,yyyi4.t4 Yl 4.,AL. - .:\ I ."•1{•,�•v,•r�Y'f{f" .�i. s' x•`.+,r., .er :9i sr;�.••�" vl3i....t r�YY t•diiy' •�iQ�i 2wi��•il .•�A it —WO �£fi.. .fy.'if�yr - j- •.,ds;t1_<P M t ; j1*1Qi Ftii`tff�41t7 s#zFF t ff0 - < �ar i+ii`i t '',•.. �a cil►fit#fftll'{ 6 ,ItfflfltjY ; '�f�{�,s�tyl+ff/t�i. > yt+=•.""�tldtb{b11113.?'fw.\tl+yd{ftt1.0 .e :.111.{•141fh?;:v:.:�.7 -s ,{,ill:?`.- ri�at E.tt�blf118a (�.•fj'1�i < ° zt 1 c(aYsD o .V '^ m•l "�J. cu _ > N v,: x i :_ Ar ! siy , In r � cc �a > %WVP— p Q a0 o ' �Leot►7?` ction OR U o Q `8� a a� Co)<aa 1T , X Q3n O T O )���� � I V O 0 LaJL. � •�` � � � �4�CA7).D�t ci Lo p z . w a rzcd ca LO ca 00 ai o N : •ti,,i C%4'�'^":_ `fir'•`1 ID N U •' V � \..a�.a�.�".►�fL,�a .��M1f►s. Fr.yIF'.'. .=. .►fF�F1a�•,a ea-�::"�#4+I1�.s,_ ,_a•'�`1.tt1y�►tt r.. a !►f{•FtQ'- -�f►f�F►t <`� ��.'. ti ° ,\-'a..wc ia fs sfR:r,p.•.s..•.-"!i,cPd�bf6bftf�i Emig sv/t `��3+��4ifatyd�d;:b1 f la'l".i=i r�. svAr a'f'c..t-rE..�.'�y"lt'►!b�-fbT�tb-f-►!li.�a 7��'a'..€-�€.vi�►3£`����+1'L.f.!,�d066db t1i9n r i• •�a`4'r+s�o.�.4Pi1,w�i,zYa Ja o.d.-dt.f1s.th4 tt t' `•l•j.ti'L y�ec=.`:3t�_r:a�wR.ati�..f_.-�?iy'tr.:re.j i>9tl?/t if•hf;'t��lh.:!'._.r$nxa€',i .Aw3�sti-�•.•>ruf�pf•,Yjf�,vv�,,�F.,'f:'1♦�+h�6�51 < .. w��• �,.�+. �b ,•,. y .Vjs T,t ti,,• .J i\�- '.." y ° aai3 °�J 'J •.+�..!.�tRN, 3' { •., d tic ti•, -� " x eYr, =�������`vat'-.'�.���a�,;`-•r'���. .°' i ��.#`� �'\`�<J�����,��'�._., �.� ACORO'_ CERTIFICATE OF LIABILITY INSURANCE FDATE(MMIDD/YYYY) 10 26'2023 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 JMG Insurance Corp PHONE FAX P.O. Box 700 WC,No.Exilk 203-838-5554 IAIC.No):203-857-7848 Norwalk CT 06852 E-MAIL ADDRESS: _ INSURERS AFFORDING COVERAGE NAIL# INSURER A:Atlantic Casualty Insurance Co 42846 INSURED MAGAROO-01 INSURER B:Arbella Insurance Group 41360 Magana Roofing Siding LLC 257 Flax Hill Road INSURERC:AmGUARD Insurance Company 42390 257 Flax — Norwalk CT 06854 INSURERD: INSURER E INSURER F COVERAGES CERTIFICATE NUMBER:234149502 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. POLICY EFF POLICY EXP L S TYPE OF INSURANCE ADDL-SU ---- POLICY NUMBER MMIDDNYYY) (MMIDDfYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY L311000059-2 7/29/2023 I 7/29/2024 EACH OCCURRENCE $1,000,000 CLAIMS-MADE u OCCUR HENTED PREMISES Ea occurrence S 100,000 MED EXP(Any one person) $5.000 PERSONAL&ADV INJURY 1$1.000,000 GEN-L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY PRO- `-- JECT LOC PRODUCTS-COMP/OPAGG $1,000,000 OTHER. � ---- ----- ----— 3 AUTOMOBILE LIABILITY 1020109661 7/22/2023 7/22/2024 COMaBIn'SINGLE LIMIT $1,000,000 ANY AUTO BODILY INJURY(Per person) i OWNED X SCHEDULED AUTOS ONLY _AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS ONLY X NON-OWNED PROPERTY DAMAGE $ Per accident) i $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LL48 CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ C WORKERS COMPENSATION R2WC485223 7/29/2023 7/29/2024 X AND EMPLOYERS'LIABILITY y/N STATUTE ER NY ONLY ANYPROPRIETORIPARTNER/EXECUTNE E.L.EACH ACCIDENT $1,000,OOO OFFICER MEMBER EXCLUDED? NIA (Mandatory in NH) E If yes,describe under L.DISEASE-EA EMPLOYEE $1,000,000 DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $1,000,000 f DESCRIPTION OF OPERATIONS I LOCATIONS,VEHICLES (ACCORD 101.Additional Remarks Schedule,may be attached If more space Is required) The certificate holder is included as an additional insured under the General Liability policy on a primary and non-contributory basis if required by written contract executed prior to a loss. 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. BUILDING DEPARTMENT 938 KING STREET AUTHORIZED REPRESENTATIVE RYE BROOK, NY 10573 1988-2015 ACORD CORPORATION. All rights reserved. NYSIF New York State Insurance Fund PO Box 66699,Albany, NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED) ^^^^^^ 453706395a� JOHN T OSTHEIMER AGENCY INC C/O JOHM M GLOVER AGENCY •, i PO BOX 700 NORWALK CT 06852 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER MAGANA ROOFING & SIDING LLC VILLAGE OF RYE BROOK (CT LLC) BUILDING DEPARTMENT 257 FLAX HILL RD 938 KING STREET NORWALK CT 06854 RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W2575 340-1 593191 07/29/2023 TO 07/29/2024 10/26/2023 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2575 340-1, 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 THE SOLE PROPRIETOR, PARTNERS AND/OR MEMBERS OF A LIMITED LIABILITY COMPANY 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. BY CAUSING THIS CERTIFICATE TO BE ISSUED TO THE CERTIFICATE HOLDER, THE POLICYHOLDER UNDERTAKES TO PROVIDE THE CERTIFICATE HOLDER 30 CALENDAR DAYS' NOTICE OF ANY CANCELLATION OF THE POLICY. NEW YORK STATE SUR NCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING