Loading...
HomeMy WebLinkAboutBP24-163PERMIT # /V/ SECTION 1 i TYPE OF WORK JOB LOCATION OWNER CONTRACTOR, EST. COST �t " JCs# CG TCO # 3 DATE; BLOCK LOT S 2 aoemP,�2"), ioolowS o� P ii ve 194e3�)%Z)39- 3s 70 i:?qoo sO e1 '7 ode ;1? o/ - FFF FEE A L2L2=Q DATE FEE DATE - INSPECTION RECORD DATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING O RGH PLUMBING GAS 0 SPRINKLER ELECTRIC 0 LOW -VOLT O ALARM C� AS BUILT C] FINAL 7/- 4/5 74 OTHER APPROVALS ARB CBOT PB ZBA OTHER DRC� S' O` b0 t t4C4.taJJ w rV CCU La. JJJ �W 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 David M. Heiser Donald T. Krom,Jr. Salvatore W. Morlino CERTIFICATE OF COMPLIANCE June 3, 2025 Himi Kittner 9 Longledge Drive Rye Brook,New York 10573 Re: 9 Longledge Drive, Rye Brook,New York 10573 Parcel ID#: 135.67-1-26 Building Permit#24-163 issued on 7/23/2024 for Replacement Windows This certifies that the three new windows,installed under the above captioned permit have been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to DV R For office use onl : BUILD . ENT PERMIT# —/CO 3 MAY 2 7 2025D VIL OF RYE OK ISSUED: -a3-ay 38 KING STRE YE BROOK, YORK 10573 DATE: VILLAGE OF RYE BROOK 9 -06 OY FEE:�9 �/��Q —PAID X_ BUILDING DEPARTMENT w l 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 sssss*s***q+++s+*+*srs++sw**s*+*++***ss*++***+*+w*w*wsw**w++swwwswwwwssassss*ssssssssssssssssss+ssss*ssssss*+ss+s*ws+*ss*sss* Address: l ki �) CAe— Occupancy/Use: / i� Parcel ID#: 13S, �0^7 — --c) Zone: 1� Owner: 14 1 w1 t 1 -V-T v1 VZ I- Address: -evl C C 1 J P.E./R.A.or Contractor: (Twt ,, �I I�TAddress: Person in responsible charge:A-2 412 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 YORK,COUNTY OF WESTCHESTER as: 91M 1 1(1-�m being duly swom,deposes and says that he/she resides at (Print Name of Applicant) r I ( and eet) in ���`�U `�- ,in the County of W S'���5�� in the State of that (Cityrrown/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: W )'6 o � S 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 12 Sworn to before me this day of , 2 day of ,20 S a re of Property Owner Signature of Applicant , rr� e� jme of Property Owner Print Name of Applicant ��_0� J� Notary Public Notary Public SHARI MEULLO Notary Public,State of New York No.O1ME6160063 6/l/202a Qualifled In Westchester County Commission Expires January 29,202�1 �yE BRC��, cu � _:iV 1932 BUILDING DEPARTMENT ❑�BILDING INSPECTOR pd'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 : , L.� ' 'Y!)e I DATE: S L PERMIT# Q q- I 03 ISSUED:7 Z Z SECT: /:� ' (oZBLOCK: 1 LOT: Z �a LOCATION: V V 1'j A,) OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL }] OTHER � \ e = M = o -V—�II N u� v a 44 x a 4-4 F' _ CA K a vr ` 4-4 14 O 3 u a W t O Q ❑ `n u u ''' ►. q a CNx^Frl zW w w O \yo Cq N H z � y Z� n � '^ U a .. In. ►� o o (h W z V N A a � � v cn ` Q O Uz � vao p = O � w � mems ° ay V � w w ;+ o "q oa Q u to ao ° a u V en aM rn `J M W v O H �D A. � v�� � u' a FF+��IICN z N O a WA 2 E v E-I a z Z � v X ,� � � O = V r� w � � c b0 W 0-0 C +r o vo, a I+� � C v �4 4-4E ' O w0 O u ar u U : 7 (7 M N Uz cic w .� y � : W C7 A Z O w I > o O G1 Z w V od .� a :, Q - s BUILDING DEPARTMENT VILLAGE OF RYE BROOK JUL 2 2 2024 938 KING STREET RYE BROOK,NY 10573 ° VILLAGE Of= R'1'L BROOK (914)939-0668 FAX(914)939-5801 i Bull.- ING EpARTMENT www.Ey2blrook.org ADMINISTRATIVE EXTERIOR BUILDING PERMIT APPLICATION FOR EXTERIOR WORK WHICH DOES NOT REQUIRE VILLAGE ARCHITECTURAL REVIEW BOARD APPROVAL FOR OFFICE USE ONLY: `� o rr�� /�APPROVAL DATE: �"`� "�� MT#: &;)— —/613APPLICATIO/N FEE:Id A L APPROVAL SIGNATURE: PERMIT FEES: H.O.A.APPROVAL: DATE:DISAPPROVED: OTHER: c_ L� I - u T 6 Application dated: 7/16/2024 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:9 Longledge Drive 2. parcel ID#: 135.67-1-26 Zone: 3. Proposed Improvement(Describe in detail): one (1) casement window and two (2) picture transom windows removal/replacement in kind no structrual changes. 4. Property Owner: Himi Kittner Address: 9 Longledge Drive Phone# Cell#732-239-3570 c-mail hkittner@yahoo.com List All Other Properties Owned in Rye Brook: Applicant: Peter Klatt, FranZOSO Remodeling Corp. Address: 33 Croton Point Avenue Croton on Hudson NY 10520 phone#914-271-4572 Cell# e-mail sales@franzoso.com Architect: n/a Address: Phone# Cell# e-mail Engineer: n/a Address: Phone# Cell# e-mail General contractor: Franzoso Remodeling Corp. Address: 33 Croton Point Avenue Croton on Hudson NY 10520 Phone#914-271-4572 Cell# e-mail sales@franzoso.com (l) 3/21/19 5. Occupancy;(1-Fam.,2-Fam.,Commercial.,etc...)Pre-construction:1-Fa m Post-construction: 1- Fam 6. Area of lot: Square feet: Acres: 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: 1a1 fl: 2"fl: 3`d fl: 10. Total Square Footage of the proposed new construction: 11. For additions,total square footage added:Basement: I"fl: 2"d fl: 3"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:()Typical Western Lumber Frame;()Timber Frame[TC];()Wood Truss[TT]; ()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: 16. Basement to be full,or partial: finished or 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:V_ ('dyes,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 Storrnwater Management Control Permit as per§217 of Village Code? Yes:_No:V_Area: 23. Will the proposed project require a Site Plan Review by the Village Planning Board as per§209 of Village Code? Yes: No:_I\/_ (ifyes,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: ('dyes,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 9128107? Yes: No: (if 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: (f 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: ('dyes,a Home Occupation Permit Application is required) 29. What is the total estimated cost of construction: S 7,635.00 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:October 2024 (2) 3121l19 2 BUILDING DEPARTMENT JUL 2 2 209-41 l VILLAGE OF RYE BROOK 938 DING STREET RYE BROOK,NY 10573 VIL LAGS OF RYE BROOK (914)939-0668 FAx(914)939-5801 BUILDING DEPARTMENT ww .w. aok.orl! 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 YORY, COUNTY OF WESTCHESTER ) as: 31, Himi Kittner , residing at, 9 Longledge Dr Rye Brook, NY 10573 (Print name) (Address where you live) 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; 9 Longledge Drive , 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. K , V4V"z-- (Signature of Property Owner(s)) Himi Kittner (Print Name of Property Owner(s)) Sworn to before me this day of U i , 20 �I (Notary PLNIC) Michael Bablt Natary Public,State 0 New York No.01 BA63311 a2 (3) Qualified in Westchester County Commission Expires September 28, 2027 3/21/19 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. STATE OF NEW YORK, COUNTY OF WESTCHESTER ) as: Peter Klatt , 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 contractor 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 � '� Sworn to before me this day of U[VII , 20�q day of 20 Signattre of Property Owner Signature of Applicant Himi Kittner Peter Klatt Print Name of Property Owner Print Name of Applicant �aL _ , 'CGc/'r 6(J17t Notary Public Notary Public N WV Public,Stet@ o of NI w Wit No.01 BA6331102 Michael Babit puaned In Westchester CoAY Notary PubbeI State of New Bork commission Expires September 28,2027 No.01 BA6331102 QuaMed in Westchester County Commission Expires September 28,2027 (4) 3/21/19 Work Scope JOB: PRJ #58936:Kittner, Himi: Window(s) &Transom(s) Replacement ADDRESS: 9 Longledge Drive, Rye Brook, NY 10573 CONTACT: Mr. Himi Kittner, 9 Longledge Drive, Rye Brook, NY 10573 USA PHONE#'S: (732)239-3570 WINDOW REPLACEMENTS: • Insert Replacement: • Remove existing molding and sashes leaving existing window frame. • Inspect, remove and replace any rotten wood where necessary(Owner to be advised prior). • Supply and install the following windows. • Window Manufacturer: ANDERSEN . Window Series: 400 Series • TWO (2) Picture Transoms. • ONE (1) Casement. • Shim to align, fasten and insulate with low impact spray foam to fill any air cavities around perimeter of window openings. • Caulk and seal interior side of stop molding using a 3-point caulking system with high grade interior latex. • Install new Prime painted pine stop molding or re-use existing if possible. • Spray Foam Insulate &Seal around perimeter using slow expanding polyurethane foam to ensure an airtight seal. • Caulk exterior with Solar Seal 900 premium grade weather resistant sealer. • Frames and glass of windows to be cleaned by installer. • OTHERS responsible for finish paint work. {if applicable) • Proper disposal of debris; complete site restoration. Printed 06/05/2024 Franzoso Contracting, Inc. 33 Croton Point Ave Croton On Hudson, NY 10520 Phone: (914) 271-4572 FRANZOSO Fax: (914) 271-8644 www.franzoso.com rlk il-AMA Q r CASEMENT & AWNING WINDOWS FEATURES - FRAME .WX ' 10 A seamless one-piece,rigid vinyl 400 Series casement and awning allowing these units to achieve higher frame cover is secured to the exterior windows ore available with Slormwotchm performance ratings.Performance Grade of the frame to protect the wood tQ Protection.For more details,visit (PG)ratings are more comprehensive frame from moisture and maintain andersenwindows.com/coastal. than Design Pressure(DP)ratings for an attractive appearance while measuring product performance. minimizing maintenance. Performance Grade(PG)Upgrades Visit ondersenwindows.com for 0 The seamless rigid vinyl cover Performance upgrades are available up-to-date performance information extends 1 s/a'(35)around the perimeter for select sizes of standard,non-impact of individual products.Contact your of the unit,creating a flange to help casement and awning windows, Andersen supplier for availability. seal the unit to the structure. 0 Wood frame members are treated EXTERIOR & INTERIOR OPTIONS with o water-repellent preservative for HARDWARE long-losting protection and performance. EXTERIOR COLORS INTERIOR OPTIONS 0 Interior stops are unfinished pine. Smooth Control Hardware System Low-maintenance prefinished white, �, The smooth control dark bronze and block"interiors are 'i hardware system also available. employs a worm gear drive for easy White Canvas Sandtone Terrotone Pine White SASH — operation.Units 0 Rigid vinyl encases the entire with a wash mode sash—a vinyl weld protects each sash have hinges that corner for superior weathertightness. move the sash away MEN E E It maintains an attractive appearance from the frame to Dark Forest Block Dork Block" and minimizes maintenance. provide easier gloss and Green Bronze" cleaning.CXW15,CXVV155,CXW16 0 Wood core members provide and CXW25 sizes not available with HARDWARE OPTIONS Sold Separately excellent structural stability and wash mode.Hardware option and energy efficiency. finish must be specified.Operator Vinyl closed-cell foam weatherstrip handle and cover sold separately. is factory installed on the perimeter of the sash. Single-Actuation Casement Lock GLASS CONTEMPORARY FOLDING TRADITIONAL FOLDING ©In addition to stainless steel glass Block I Bright Bross I Gold Dust Antique Bross I Block I Bright Brass spacers,black or white glass spacers Oil Rubbed Bronze I Satin Nickel Distressed Bronze I Distressed Nickel are now available to allow the spacer Stone I White Gold Dust I Oil Rubbed Bronze to blend in with the unit color. Satin Nickel I Stone I White O A glazing bead and silicone provide On casement windows,a single- Folding handles ovoid interference with window treatments. superior weathertightness and durability. actuation lock easily releases oil 0 High-Performance options include: locking points on the casement sash • Low-E4`glass while the reach-out action eliminates • Low-E4 HeotLockm gloss binding when closing.The lock handle • Low-E4 SmortSun"glass is offered in finishes that coordinate • Low-E4 SmortSun HeatLock glass with your specified hardware option. -- • Low-E4 Sun glass Awning Sash Locks CLASSIC SERIES" ESTATE' Tempered and other glass options Stone I White Antique Brass I Bright Brass ore available.Contact your Andersen 1 Brushed Chrome I Distressed Bronze supplier. Bold name denotes finish shown. Distressed Nickel I Oil Rubbed Bronze A removable translucent film helps Polished Chrome I Satin Nickel shield the gloss from damage during 1 HARDWARE FINISHES delivery and construction,and simplifies �P _ finishing of the job site. Awning sash locks provide on added Patterned Glass measure of security and weathertightness. Patterned glass options are available. Hardware style and finish options are Antique Black Bright Brushed Distressed Distressed See page 12 for more details. compatible with Andersen'casement Bross Brass Chrome Bronze Nickel windows to ensure consistency in appearance when used in window combination designs. `Visit ondersenwindows.com/warrontyfordetails. Gold Dust Oil Rubbed Polished Satin Stone White **Products with dark bronze and block interiors have matching exteriors. Bronze Chrome Nickel Dimensions in parentheses are in millimeters. Naturally occurring variations in grain,color and texture of wood make each window Printing limitations prevent exact replication of colors and finishes. one of o kind.All wood interiors ore unfinished unless o finish is specified. See your Andersen supplier for actual color and finish samples. Distressed bronze and oil rubbed bronze are'living'finishes that will change with time and use. 20 Z � W 0 0 t M N � 3 0 c W a m 03 E O mLL a Z ° Z o m •` U CL Q 3 X c wo ? a � � m U) LU o � w c C� E 3 N o 'p c a� c •— 3 m L a� U O m fd d O N Q Q w U LU m 00 C U) Z o c W H ' U cn p x p J a) c d •V � d � 'L O M a L C M N E N O w In Z (n M - Q y x X U) = d U w Z (J N w � } i 0 0 Q in o U' Z .c aLL w � _ Z d Q N w E O U) a O = •m +�+ L) i N O co fl 2 I O CY M w rn LO 00 U) I � w F- f Q p , O H O Z R LL i 0 N O NN R O Z w i ii C7 < ) O 0 ' Cl saw c ; Q — �— O i Q ° k \ 2a � \ i / \ 2 n Ef @k c 04 Cc \ & m 13- ■ \ = c \ IL - E � § 2 � 0f LU LU W \ $ 2 $ w $ E o _ � 0 2 \ $ / ^ § k 7 \ \ x LL o © \k $ U � / k x 2L \ LE £ � � ' � z . LLc ® w N 0 / \ � � 2 ~ ° � \ 0 d k In c K - (n i � ± k � E co wf d � � � / ) CO d � � m 4 M � (D 'T 4 2 $ I c a) _ /\ / / \\ og = | 2 � m \ &g G I e ; q 'IT= o � r ° w y � c yk u ( co \ k \ f ; m § ( E / 04 = e , owl vF / § 22 ' ° v � maz cr c : o ■ m § } & k \ � � , \ .1 / AU) E (D \ / Cl) q = � @ % � 3 / � a CDƒ o .a o E \ I / . mm $ 2 § Iƒ . E ƒ . � m � _ ee � § ¥ a R / o e n . m . k LL N r - 2 » ' O — b LO y . 0 om o | z _ o 02 X . \ w � * 7k i . � 7c z ; » gym z . a d3 = m CD ± . N _ U) u , El \ fJ m o a Ufa 2 E a- 2 Ems \ 00C-4 e . q 01n o . n �- � -- - . -------- - U') - - o � ---- -- o � / ƒ ; \ L ; \ 2 § 7 ; C ; D . k D . k W.W ,y IT ♦ram .'3 V1 .y�A �� y cl > G P. N w ' E O LO O V^ 49 N w. y w z do <o)s" , I i•r Z Q Z o t�teC f 1 +� .1 W U) X w Z W i ' w9 LL O CC c0 ♦=� api a"i `� V V �= 1 H w . y )> 3 4 a ( Vol _� 11 as \�3 '�1 1 � ai "11 ►1�� i l`�I) Iti �o=s_ 111�1 1 ��-t3• _ / ��yt. �_ ..r 1 i_. .- �"' 11 ' '►�ildi�' � �'ll•�0.4, �. 1�1►•�1�•q� - - 1���i7 i �1)d1y� � '►� � `��\. h�Ma Es ^ ACORO� DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 07/10/2024 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 Certificate Team NAME ROBERT T.KIRKWOOD,INC NCO No Ext: (914)769-9070 C. No): (914)769-4706 91 Washington Avenue E-MAIL s: certificates@kirkwoodinsurance com INSURER(S)AFFORDING COVERAGE NAIC M Pleasantville NY 10570 INSURERA: Selective Way Insurance Company 26301 INSURED INSURER B: Merchants Mutual 23329 Franzoso Remodeling Corp.,DBA.Franzoso Contracting INSURER c: Selective Insurance Company of America 12572 33 Croton Point Ave INSURER D INSURER E Croton On Hudson NY 10520 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 POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE � Ea OCCUR PREMISES occurrence $ 500,000 MED EXP(Any one person) $ 15,000 A S2332054 04/01/2024 04/01/2025 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER I GENERAL AGGREGATE $ 2,000,000 X PRO-J PRO LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED S2332054 04/01/2024 04/01/2025 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 B EXCESS LIAB CLAIMS-MADE CUP0000898 04/01/2024 04/01/2025 AGGREGATE $ 4,000,000 DED I X RETENTION $ 10,000 $ WORKERS COMPENSATION X ER STATUTE EORH AND EMPLOYERS'LIABILITY YIN 1,000,000 C ANY PROPRIETOR/PARTNER/EXECUTIVE N NIA WC9082556 04/01/2024 04/01/2025 E L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED. (Mandatory In NH) E L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Village of Rye Brook is an additional insured under general liability per attached endorsements as respects work performed by the insured. 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. 938 King Street AUTHORIZED REPRESENTATIVE Rye Brook NY 10573 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD PORK Workers' CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1 a. Legal Name&Address of Insured(use street address only) 1 b. Business Telephone Number of Insured (914)271-4572 Franzoso Contracting, Inc. 33 Croton Point Ave. 1 c. NYS Unemployment Insurance Employer Registration Number of Croton On Hudson NY 10520 Insured Work Location of Insured(Only required if coverage is specifically limited to certain locations in New York State,i.e., a Wrap-Up Policy) 1 d.Federal Employer Identification Numberof Insured orSocial Security Number 471320112 2.Name and Address of Entity Requesting Proof of Coverage 3a. Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Selective Insurance Company of America Village of Rye Brook 3b. Policy Number of Entity Listed in Box"la" 938 King Street WC9082556 Rye Brook, NY 10573 3c. Policy effective period 04/01/2024 to 04/01/2025 3d.The Proprietor,Partners or Executive Officers are ® included.(Only check box if all partners/officers included) ❑ all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box"la"for wo rkers' compensation underthe New York State Workers'Compensation Law. (To use this form,New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers' compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box "2". The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate.(These notices may be sent by regular mail.) Otherwise,this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent, or until the po licy expiration date listed in box"3c", whichever is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder.Thiscertificate does not amend, extend or alter the coverage afforded by the policy listed,nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note: Upon cancellation of the workers'compensation policy indicated on this form,if the business continues to be named on a permit,license or contract issued by a certificate holder, the business must provide that certificate holder with a new Certificate of Workers' Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers' Compensation Law. Under penalty of perjury, I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Robert Kirkwood (Print name of authorized representative or licensed agent of insurance carrier) Approved by: Am, 7/10/2024 (Signature) (Date) Title: Principal Telephone Number of authorized representative or licensed agent of insurance carrier: 914-769-9070 Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insurance brokers are NOT authorized to issue it. C-105.2 (9-17) www.wcb.ny.gov