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HomeMy WebLinkAboutBP24-132PERMIT # /' L/ 3 C DATE: a Q 74 Y ®(R SECTION Z-q)l 3 y 1, BLOCK 1 LOT TYPE OF WORK s,, JOBLOCATION cp 4rI k �Opol42 OWNER /7 1p� PLC /y ,57660:— CONTRACTORA 3tea VO S('4,0%.elci ' T70/11e_` EST. COST \,/Co #..0 TCO # FEE DATE ►�'�� �H 1L1�`li�3K�J �' �� DATE FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING RGH PLUMBING GAS 0 SPRINKLER ELECTRIC C� LOW -VOLT CI ALARM I NSP AS BUILT C� FINAL � Z� ZOZ ,<►C�- - - oV�P/00/7A s►C --Ha pel era vo C/y)3&=)- 9o4/G OTHER APPROVALS r i ' BR �l��w UJVV.Vi 190 Cj�vl'Vuy VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury ww-,v.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 28,2024 Vangar LLC 46 Roanoke Avenue Rye Brook,New York 10573 Re: 46 Roanoke Avenue, Rye Brook,New York 10573 Parcel ID#: 141.35-1-46 Building Permit#24-132 issued on 6/27/2024 for Replacement Windows This certifies that the twenty one new windows,installed under the above captioned permit have been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to BUILDING, For office u e onl ARTMENT PERMIT# P VIL OF RYE BROOK... AUG 2 1 i"1.�,''�x ISSUED: 938 KING STRE YE BROOK,NEW YORK 10573 DATE: (9 9 -0668 FEE; 5Q PAID,W www rooks ov 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: kffitfiitiftift4fiiiititi#i#t##,/i##littittlti#t##�i�tltiifittt►ttfttl►►tf►tit►4ff#t►lift►►t►tfti4►f►f►tff►4#4f4iffifttfifffttf yK-11Qp� vv ��e, PyTLr 13rwC,A)!/jj577-3 Occupancy/Use:Qytt fmm Parcel ID#: N/.35' -416 Zone: Owner: ( _ nay y�p ,,,�Addr,�ss: Ski 0 :7 3 P.E./R.A. or Contractor: SCo„ror►� /�oy►tQ +"Address:lks-0/ Qd/� /��o !J`'� Person in responsible charge:Z . ✓,/r,� Address:SO Mc!jyyxe 14ve-4 f 04Sr-ia A)y/os66 Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issuance of a Certificate of Occupancy/Certificate of Compliance for the structure/construction/alteration herein mentioned in accordance with law: STATE OF NEW YORK,COUNTY OF WESTCHESTER as: JJ Q CQ r•, 4 ggsn,.QI V )v,O being duly sworn,deposes and says that he/she resides at (Print'Name of Appl t) / ] (No.and Street) in Pov-F cj,"e' W ,in the County of !�v-c.S�e�..Q.S�-P-]r- in the State of /U Y ,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:$ , for the construction or alteration of: /0 -030 �/ w 1►�txyS . 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 Q 2 Sworn to before me this day of , 20 day of , 20 Signatur P erty O er Signature of Applicant �e-"V' Print Nam o6 f PropertyQVher _ Print Name of Applicant 9V�J/ W'e"" otary P 17 Notary Public GREGORY K RIVERA Notary Public,State of New York 6 1;<0=1 No.01 RI6441398 Ouailfled In Westchester County Cotrm*ston Expires September 26,ZQ2 �yE BRC�v� 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 : cxc ►v 0 DATE: / PERMIT# +" Z 1- ISSUED: 'Z7'7-7SECT: BLOCK: LOT: LOCATION: 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 U"J`_. ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION Q FINAL 0 OTHER _ N N w v en N O w � \ W a 0-4 C� ,4 ai41 d , Z o U M o ,� vru fW wo H o - a � o u4-4 � W � Z o A �,,, . v = O ,Cc) 3 V w w OL4 a u 1-4 � wICI cn G. �T MM W W n, i a. cc"" -" V ,, cc � c00 � � � H � u cc c o � u v w - bv A Q 0 $ 114 'v O - = ZO z z v V w O � 8 U C7 A z O py, 4 o _ A O W w v _ BUILDING DEPARTMENT VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK,NY 10573 JUN 2 1 2024 (914)939-0668 www.ryebrookay.Qov VILLAGE OF RYE BROOK BUILDING DEPARTMENT FOR OFFICE USE ONLY: ` Approval Date: 7�'er ,3 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: EXTERIOR BUILDING PERMIT APPLICATION Application dated: 6/21/2024 is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the construction of buildings,structures,additions,alterations or for a change in use,as per detailed statement described below. 1. JobAddress: 46 Roanoke Ave, Rye Brook, NY 10573 2. ParcelID#: 1,1/, 35-- /— L 6 Zone: �a F 3. Proposed Improvement(Describe in detail): Replace all existing windows on main level for new windows of the same size. 4. Property Owner: VanQaC LLC Address: 26 College Ave. Port Chester, NY 10573 Phone# Cell#914-565-4493 -e-mail gtsanquino@gmail.eom List All Other Properties Owned in Rye Brook: Applicant: Gard Sanauino Address: 26 College Ave, Port Chester, NY 10573 Phone# Cell# 914-565-4493 _e-mail gtsanguino(@amaii.com Architect: Address: Phone# Cell# e-mail Engineer: Sirus Miandoabi - Integral Engineering Serviggg PLLC Address: 27 Main St. Dobbs Ferry, NY 10522 Phone# Cell# 914-774-0343 e-mailsirus0ntegra1engrg.com General Contractor: Bravo Landsca it g & Home Improvement Inc Address.-.1 68 OldRgad. Hapeyvell Junction. NY 12533 Phone# Cell# 914-382-9 46 e-mail bravohomeimprovement@gmail.eom (1) 6/1/2024 5. Occupancy;(1-Fam.,2-Fam.,Commercial.,etc...)Pre-construction: 1-PAM Post-construction: I-FaM 6. Area of lot: Square feet: 7500 Acres: .16 7. Dimensions from proposed building or structure to lot lines: front yard: rear yard: right side yard: left side yard: other: 8. If building is located on a comer lot,which street does it front on: 9. Area of proposed building in square feet: Basement: I"fl: 2°d fl: 3'd fl: 10. Total Square Footage of the proposed new construction: 11. For additions,total square footage added: Basement: 1"fl: 2"d fl: 3'd fl: 12. Total Square Footage of the proposed renovation to the existing structure: 13. N.Y.State Construction Classification: N.Y.State Use Classification: 14. Construction Type&Location:O Typical Western Lumber Frame;O Timber Frame[TC];O Wood Truss[TT]; O Pre-engineered wood[PW];Located;O Floor Framing[F];O Roof Framing[R];O Floor&Roof Framing[FR];Other: 15. Number of stories: Overall Height: Median Height: I& Basement to be full,or partial: Full finished or unfinished: Unfinished 17. What material is the exterior finish: 18, Roof style:peaked,hip,mansard,shed,etc: Roofing material: 19. What system of heating: 20. If private sewage disposal is necessary,approval by the Westchester County Health Department must be submitted with this application. 21. Will the proposed project require the installation of a new,or an extension/modification to an existing automatic fire suppression system?(Fire Sprinkler,ANSL System,FM-200 System,Type I Hood,etc...)Yes: No:_ (if yes,applicant must submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans) 22. Will the proposed project disturb 400 sq.ft.or more of land,or create 400 sq.ft.or more of impervious coverage requiring a Stormwater Management Control Permit as per§217 of Village Code? Yes:—No:—Area: 23. Will the proposed project require a Site Plan Review by the Village Planning Board as per§209 of Village Code? Yes: No: (rf yes,applicant must submit a Site Plan Application.&provide detailed drawings) 24. Will the proposed project require a Steep Slopes Permit as per§213 of Village Code Yes: No: (l(yes,you must submit a Site Plan Application,&provide a detailed topographical survey) 25, Is the lot located within 100 ft.of a Wetland as per§245 of Village Code? Yes: No: (if yes,the area of wetland and the wetland buffer zone must be properly depicted on the survey&site plan) 26. Is the lot or any portion thereof located in a Flood Plane as per the FIRM Map dated 9/28/07? Yes: No: (rf yes,the area and elevations of the flood plane must be properly depicted on the survey&site plan) 27. Will the proposed project require a Tree Removal Permit as per§235 of Village Code?Yes: No: (if yes,applicant must submit a Tree Removal Permit Application) 28. Does the proposed project involve a Home-Occupation as per§250-38 of Village Code? Yes: No: Indicate:TIER I: TIER II: TIER III: (ifyes,a Home Occupation Permit Application is required) 29. What is the total estimated cost of construction: $ 10,000 Note:estimated cost shall include all site improvements,labor,material,scaffolding,fixed equipment,professional fees,including any material and labor which may be donated gratis.If the final cost exceeds the estimated cost,an additional fee will be required prior to issuance of the CIO. 30. Estimated date of completion: July 30, 2024 �T (2) 6/1/2024 BUILDING DEPARTMENT D I E �V LE VILLAGE OF RYE BROOK J U N 2 1 2024 938 KING STREET RyE BROOK,NY 10573 (914)439-ObbB VILLAGE OF RYE BROOK ww I rook.or BUILDING DEPARTMENT _- AFFIDAVIT OF COMPLIANCE VILLAGE CODE §216 - STORM SEWERS AND SANITARY SEWERS THIS AFFIDAVIT MUST BEAR THE NOTARIZED SIGNATURE. OF THE LEGAL PROPERTY OWNER AND BE SUBMITTED ALONG WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION. ANY BUILDING OR PLUMBING PERMIT APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETURNED TO THE APPLICANT. STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: 1, Gary Sanguino ,residing at, 26 College Ave, Port Chester, NY 10573 (Print name) (Address where you lip ci being duly sworn, deposes and states that(s)he is the applicant above named,and further states that(s)he is the legal owner of the property to which this Affidavit of Compliance pertains at; 46 Roanoke Ave ,Rye Brook, NY. (Job Address) Further that all statements contained herein are true,and that to the best of his/her knowledge and belief, that there are no known illegal cross-connections concerning either the storm sewer or sanitary sewer, and further that there are no roof drains,sump pumps,or other prohibited stormwater or groundwater connections or sources of inflow or infiltration of any kind into the sanitary sewer from the subject property in accordance with all State, County and Village Codes. (Signatureof'Pro lu ner(v Gary Sanguino (Print Name of Property Owncr(s)) Sworn to before me this }Yl day of 20'2 (Notat ,Pu. •) MICHAEL ESQUIVEL Notary Public-State of New York (3) NO.OlES6442359 Quatified in'Westchester County µy Commission Expires Oct 11, 2026 6/l/2024 This application must be properly completed in its entirety by a N.Y. State Registered Architect or N.Y. State Licensed Professional Engineer& signed by those professionals where indicated. It must also include the notarized signature(s) of the legal owner(s) of the subject property, and the applicant of record in the spaces provided. Any application not properly completed in its entirety and/or not properly signed shall be deemed null and void, and will be returned to the applicant. Please note that application fees are non-refundable. *****,��,.w*�►*�*******...*..*�#*****�*.�*,.**,.«*,�***,�*******«t�#..«**.#.�.*,�**.,►***.*«.**�..**.*,.**,.***.*..**mow* STAYP OF YORK,COUNTY OF WESTCHESTER ) as: L �G ajaa ,being duly sworn,deposes and states that he/she is the applicant above named, (print name 6f individual Vgning 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 for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,attorney,etc.) That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed, or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. By signing this application, the property owner further declares that he/she has inspected the subject property,and that to the best of his/her knowledge there are no roof drains,sump pumps or other prohibited stormwater or groundwater connections or sources of infiltration into the sanitary sewer system on or from the subject property. Sworn to before me this -�h_ Swom to before emme this a2 0`h day of c 201, day of 20 ignature erty 0,Aner Si true ooppfi4t Gary Sanguino Gary San uino :PrintName ofP rty Owner Print Name of pi cant Note blic / Notary lic MICHAEL ESQUIVEL Notary Public-State of New York NO.01ES6442359 MICHAEL ESQUIVEL Qualified in Westchester County FN.tary Public-State of New York My Commission Expires oct 11, 2026 No.OlES6442359 alified in Westchester County ommission Expires Oct 11,2026 (4) 6/I/2024 To:Steven Fews<SteveFews@ryebrook.org> Subject:46 Roanoke Hi, Mr Fews I talked to you this morning about some window replacements at the 46 Roanoke location. This is what we have on the premises now and I did some drawings specifying most of the details to help us understand the replacements. Let me know at your convenience if this will work for us to move forward with the renovation. We are not altering any of the existing framing of the windows as was mentioned at the beginning of the permit application, however,we are replacing all the windows in the property for newer insulated windows. I'll send you a link of the windows that we will use is an Andersen model#DH3040 200 SERIES. If any concerns please don't hesitate to let me know. I leave you my cell phone number 9144941728. Thank you L'i v�. . . ... (Dk� a � _ Maw�+!Y Laura Petersen From: Steven Fews Sent: Tuesday,June 25, 2024 4:31 PM To: Alfredo DiVitto Cc: Laura Petersen Subject: FW:46 Roanoke Attachments: Replacement windows specs .pdf Expires: Wednesday, October 23, 2024 12:00 AM Freddy, can you go by tomorrow and see if they started any window replacements? Thank You. Steven E. Fews Building Inspector& Fire Inspector Office (914) 939-0668 From: ivan avila <ivan2028@live.com> Sent: Friday,June 21, 2024 4:02 PM To: Laura Petersen <LPetersen@ryebrook.org>; Steven Fews<SteveFews@ryebrook.org> Cc:Alfredo DiVitto<adivitto@ryebrook.org>;Tara Orlando<torlando@ryebrook.org> Subject: Re:46 Roanoke Hi Laura, I hope this email finds you well. Based on what we talked about today, I'll attach the specifications that I obtained from the manufacturer.Also, in the window's elevation plan you can find more information supplied by the architect. Thank you Ivan A Get Outlook for iOS From: ivan avila<ivan2028@live.com> Sent: Friday, May 31, 2024 12:04:16 PM To: Laura Petersen<LPetersen@ryebrook.or >; Steven Fews<Steve Fews @ryebrook.org> Cc:Alfredo DiVitto<adivitto@ryebrook.org>;Tara Orlando<torlando@ryebrook.org> Subject: Re:46 Roanoke Received,thank you. Get Outlook for iOS From: Laura Petersen<LPetersen@rvebrook.org> Sent:Thursday, May 30, 2024 12:44:58 PM To:Steven Fews<SteveFews@ryebrook.org>; ivan avila <ivan2028@live.com> Cc:Alfredo DiVitto<adivitto@rvebrook.org>;Tara Orlando<torlando@ryebrook.org> Subject: RE:46 Roanoke 1 Good afternoon, Please see attached application. Laura Petersen Office Assistant Village of Rye Brook 938 King Street Rye Brook, New York 10573 Phone(914)939-0668 1 Ipetersen(a)ryebrook.org From: Steven Fews<SteveFews@ryebrook.org> Sent:Thursday, May 30, 2024 12:00 PM To: ivan avila <ivan2028@Iive.com> Cc: Alfredo DiVitto <adivitto@ryebrook.org>; Laura Petersen <I-Petersen@rye brook.org>; Tara Orlando <torlando@ryebrook.org> Subject: RE: 46 Roanoke Hi. The windows need to be filed for. Have the owner file an Administrative permit for the windows before any of that work is done. I am sure that he does not want to get another Stop Work order fine. From: ivan avila <ivan2028@live.com> Sent:Thursday, May 30, 2024 9:59 AM To: Steven Fews<SteveFews@ryebrook.org> Subject: Re: 46 Roanoke Definitely Adding some blocks to the bottom will have a better support to the existing one. After properly supporting will go ahead and add the three windows Get Outlook for iOS From:Steven Fews<SteveFews@ rye brook.org> Sent:Thursday, May 30, 2024 8:54:28 AM To: ivan avila <ivan2028@live.com> Subject: RE: 46 Roanoke So, you are adding some framing blocking to the bottom behind the existing sheathing to better support the new windows, then adding the three new windows in the same location? Thank You. Steven E. Fews Building Inspector& Fire Inspector Office (914) 939-0668 From: ivan avila <ivan2028@live.com> Sent: Wednesday, May 29, 2024 8:07 PM 2 A erican catsman m.0��= WINDOWS & DOORS American Craftsman®Product Performance Sound Transmission Ratings Sound Outdoor/Indoor American Craftsman® American Craftsman IG Glass Type Transmission Transmission Product Series Product Type Class(STC) Class(OITC) 70 SERIES SS 27 23 DS 28 22 Casement Window 3/4" 3mm/4mm 33 26 Laminated 35 30 DS-DS/060/DS SS 27 23 70 Series Replacement DS 28 22 & Awning Window 3/4" 3mm/4mm 33 26 New Construction Casement Laminated DS-DS/060/DS 35 30 SS - - Picture&Specialty DS 27 23 Window 3/4" 3mm/4mm 31 26 Laminated 34 29 DS-DS/060/DS SS - - Single-Hung&Gliding DS 27 _ 23 70 Series Single-Hung Windows 3/4" 3mm/4mm 31 26 Laminated 34 29 DS-DS/060/DS SS 27 22 DS 27 22 70 Series Double-Hung Double-Hung Window 3/4" 3mm/4mm 30 26 Laminated 33 28 DS/060/DS-DS SS 27 22 DS 27 22 Double-Hung Window 3/4" 3mm/4mm 30 26 Laminated 33 28 70 Series Pro Replacement DS/060/DS-DS Double-Hung SS 27 22 DS 27 _ 22 Gliding Window 3/4" 3mm/4mm 30 26 Laminated 33 28 DS-DS/060/DS SS - - 70 Series Gliding Patio Door Gliding Patio Door 3/4" DS 27 22 Laminated 33 28 DS-DS/060/DS 50 SERIES sS 28 - Single-Hung&Gliding DS 30 - 50 Series Single-Hung Windows 5/8" 3mm/4mm 32 26 Laminated 34 29 DS-SS/060/SS Data is current as of October 2018 and is subject to change. 1 of 2 Due to ongoing product changes,updated test results or new industry standards or requirements,this data may change over time. All rican Craftsman WINDOWS & DOORS American Craftsman®Product Performance Sound Transmission Ratings American Craftsman® American Craftsman Sound Outdoor/Indoor Product Series Product Type IG Glass Type Transmission Transmission Class(STC) Class (OITC) SS 28 50 Series Replacement Single-Hung&Gliding DS 30 - Single-Hung Windows 5/8" 3mm/4mm 32 26 Laminated 34 29 DS-S S/060/S S SS 27 - 50 Series Replacement DS 28 - Double-Hung Double-Hung Window 5/8" 3mm/4mm 32 26 Laminated 34 29 DS-SS/060/SS SS - - 50 Series Gliding Patio Door Gliding Patio Door 3/4" DS 29 1 24 Laminated 32 28 DS-DS/060/DS KEY SS = Single Strength DS= Double Strength "Sound Transmission Class(STC)"and'Ouldoor/lndoor Transmission Class(OITC)"ratings are for individual units based on independent tests and represent entire unit. This data is accurate as of October 2018. Due to ongoing product changes,updated test results or new industry standards or requirements,this data may change over time. American Craftsman reserves the right to change specifications,product details and other information at any time without prior notification. ®2018,Py Gem.All rights reserved. 2of2 � o I"�fi8 z m j g Y o a m o U Q E wj Tl r � � Y d; 3 � O O C 3111 g Meal. £ 4 4 1 z_ 1141 T f AP 1 r 1 lcr N •ram`= co Oj t` LL G uj w R J cc Z -� 446 At 4 ui r .. .1 ;< 6 x = Q W `c Ix mma L L L F ^s i • :� !' m t C*I)o 2. N� L �. M• J r �s DATE(MMIDD/YYYY) ACORN$ CERTIFICATE OF LIABILITY INSURANCE F04:1512024 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 NAM GONTT EAC Heydi Ortega Lazaro FITZPATRICK INSURANCF CFNTER PHONE 9147396117 FAX 9147391553 INC.No,Ext) [A/C, No). E-MAIL dl 54 WFI CHFR AVFNUF ADURLSs )1e Y @fllllnSClf COIII PFFKSKIIL NY 105bb INSURER(S)AFFORDING COVERAGE NAICa INSURER A MAIN STREET AMERICA ASSURANCE CO 1.993l1 INSURED BRAVO LANDSCAPING&HOME IMPROVEMENT INC INSURER B 168 Old Sylvan Lake Rd INSURER C Hopewell Junction.NY 12533 INSURER D INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERIP Y THA' IHE P01K.IFS OI INSURANCE I ISTf D BELO'.b HAVE 131 I N ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY RLOUIRLMENT TERM ON t:ONDIIIUN Of ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE AFfORULD 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 ADD=SUER POLICY EFF - POLICY EXP IN SR TYPE OF INSURANCE POLICY NUMBER MMI Y LIMITS A COMMERCIAL GENERAL LIABILITY Y MPJ251BU 02119/2024 02/1912025 EACH OCCURRENCE S 1,000.000 DAMAGE PREMISESD(Ea occun�nceJ S RENTED 500.000 MED EXP(Any one person) $ 10.000 PERSONAL d ADV INJURY 5 1,000,000 GFNE RAL AGGHE GATT $ 2,000 000 PRODUCTS COMPIOPAGG $ 2,000.006 S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S Ea accaent) ANY AUII BODILY INJURY wer person) 5 OWNED SCHEDULED BODILY INJURY(Per acaoenif 5 A'JT OS UNLY AUTOS -,IRFD NON-OWNED PROPERTY DAMAGE S AUf OS ONLY AUTOS ONLY (Per acaoent) } 5 UMBRELLA LIAB ,,t EACH OCCURRENCE S EXCESS LIAB t:1 AlV S-MAI II AGGHT GAII ,(!II NINON: WORKERS COMPENSATION T PER OTH- ANDEMPLOYERS'LIABILITY STATUTE ER YIN ANYPROPRIE I OWPAP I NEW[At(.0 IIVE ' EL EACH ACCIDENT S Ul­rICEwMEMBERE XCLUDED� NIA (Mandatory in NN) E L DISEASE-EA EMPLOYEE S If yes deYl N und. ;7f 3L;R 0 IO +I TUN UI o -�IPF HATIONb Lv!Ivv E L DISEASE-POLICY LIMIT 5 DESCRIPTION OF OPERATIONS L OCATIONS VEHICLES IACORD 101 Additional Remarks Scheduie may be attached if more space Is requuedl I Isl the certificate holder as additional In SUred Job location 46 Roanoke Ave.Rye Brook NY 10513 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE VILLAGI. OF RYf BROOK IHL EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN 983 KING STRFFT ACCORDANCE WITH THE POLICY PROVISIONS. RYE BROOK NY 10573 AUTHORIZED REPRESENTATIVE i,_ ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD NYSIF PO Box 66699,Albany,NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE off. ,o 464905373 FITZPATRICK INSURANCE CENTER M' 54 WELCHER AVE �� Y PEEKSKILL NY 10566 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER BRAVO LANDSCAPING &HOME VILLAGE OF RYE BROOK IMPROVEMENT INC 983 KING STREET 168 OLD SYLVAN LAKE RD RYE BROOK NY 10573 HOPEWELL JUNCTION NY 12533 POLICY NUMBER CERTIFICATE NUMBLR POLICY PERIOD DATE A2582 715-5 686372 12!22/2023 TO 12/22/2024 4/15/2024 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO 2582 715-5, 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 NFW YORK 10 THE POLICYHOLDER'S REGULAR NFW 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:/fWWW.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 MANUEL R BRAVO SOLE OWNER/OFFICER OF BRAVO LANDSCAPING&HOME IMPROVEMENT INC THIS CERTIFICATE IS ISSUED AS A MATTER 01 IN[ORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THECOVERAGE AFFORDED BY THE POLICY NEW YORK STATE SUR NCE FUND /vY � DIRECTOR.INSURANCE FUND UNDERWRITING VALIDATION NUMBER 645965424 U-26 3