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HomeMy WebLinkAboutRP24-089PERMIT # r7ay ®cr� �9 SECTION / JJ * TYPE OF WORK iC,— 106 LvIa ION l v I. OWNERCC��/Use,04e Q O 14 /C/ //Q/IOC/Jop7 770—�7s8 CONTRACTUk if �(� Q� �U d4I s i /L/C C'd�4e// �$yS) a/9 803/ EST. COST ``O FEE VCO #_ G G -kjp�_ FEES /%5'� A DATE q I 4 TCO # FEE DATE - INSPECTION RECORJZ I DATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING CD RGH PLUMBING GAS CJ SPRINKLER ELECTRIC C7 LOW -VOLT C� ALARM d AS BUILT C7 FINAL 1� 13- ZOzy I AsSe OTHER APPROVALS ARB BOT PS ZBA OTHJ=R ((�yE DR C.G tIt, •4c,�,W y �O`C VILLAGE OF RYE BROOK MAYOR 938 King Street,Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A.Klein (914)939-0668 Christopher J.Bradbury www.ryebrookny.gov TRUSTEES BUILDING & FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M.Heiser Salvatore W.Morlino CERTIFICATE OF COMPLIANCE September 16,2024 Giuseppe Castellano&Alicia Castellano 8 Hunter Drive Rye Brook,New York 10573 Re: 8 Hunter Drive, Rye Brook,New York 10573 Parcel ID#: 135.42-1-30 Roof Permit #24-089 issued on 7/29/2024 to Re-Roof Existing Building This certifies that the new roof,installed under the above captioned permit has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to D BUILD - R ENT For office use onl : Q 3D PERMIT# c� �0y SEP 1 1 2024 VIL OF Rom' OK ISSUED: 938KINGSTRE YE,I3IUKt YORK 10573 DATE: VILLAGE OF RYE BROOK FEE:.$' PAlDJ1E BUILDING DEPARTMENT 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: 8 Hunter Dr. Rye Brook, NY 10573 Occupancy/Use: Single Family Residence Parcel ID#: 1 35.42-1-30 Zone: Owner: Giuseppe Castellano Address: 8 Hunter Dr. Rye Brook, NY 10573 P.E./R.A.or contractor: Empire Solar Solutions Address: 2-8 Johnes St. Newburgh, NY 12550 Person in responsible charge: Patrick Canty Address: 2-8 Johnes St. Newburgh, NY 12550 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: Patrick Canty being duly swom,deposes and says that he/she resides at 2-8 Johnes St. (Print Name of Applicant) (No.and Street) in Newburgh ,in the County of Ora nge _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:$ 18,000 for the construction or alteration of: Re Roof(Permit#RP 24-089) 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 j$U-�e W► (,V , 20 2-� day of S er 4C M I f/" ,20 4ytl� P� Signature of Property Owner Signature of Applicant Giuseppe Castellano Patrick Canty Print Name of Property Owner Print Name of Applicant Notary Public C O U R T N E Y E L I Z A B E T H ROBERTS Notary Public NOTARY PUBLIC-STATE OF NEW YORK No.01 R06439611 Qualified in Dutchess County 6-112024 My Commission Expires 08-29-2026 �yE BRC�� O� Zm cu � ,9a2 BUILDING DEPARTMENT ❑BUILDING INSPECTOR QASSISTANT 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 : Ve. DATE: ? 2 04cl PERMIT# ` �.r 0 1 ISSUED: T 2 7 SECT: /TyLBLOCK: �' LOT: 30 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 ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION {] FINAL OTHER � N C O N d -° ❑�❑ ' t` 00 ►-� c v c W oA ' J C V'^! 00 F" a y 5 ko a o ■ 6 O 7 q!tLr) H 4 U +•+ � cc a W � � p F oo �u � •G 00 p U7 y y o ' II��11 Gill sYW o p W �p �V ~O y�jd a � �' M � oo F• .� � p H a : ° � � wE © (� 7 o „ o v 00 0 U z N w [� o p ^ w Lin IRT W OW cnto tru- o . ' � _ CR a00 - M �`� v F c°n O a. v� vv3oG p4 W u p CY a z c v a p � U � 70 , ; O Q + ° F ° _ AG W yR �1 U U Q IY o o V W O z o 2 O y v C w A z OZ w i o �yW W � 0 � .� •� � y. 1 = W A W o - •• a Q+ w W � W) �I a a w x � � _ a a BUII, MENT JUL VI E OF RYE OK 2 5 202 938 KING .ET RYE BR0O' NY 10573 VILLAGE OF RYE BROOK _0 1 BUILDING DEPARTMENT ov FOR OFFICE ti'�F (l\I N'.�\ Approval Date: 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: AA Permit Fees: ROOF PERMIT APPLICATION Application dated: `J��� 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: 8 Hunter Dr. Rye Brook, NY 10573 SBL: 135.42-1-30 Zone: Property owner: Giuseppe Castellano Address: 8 Hunter Dr. Rye Brook, NY 10573 Phone#: Cell#: (917) 770-6458 email: peppecastellano@gmaiLcom 2. Applicant: Empire Solar Solutions Address: 2-8 Johnes St. Newburgh, NY 12550 Phone#: Cell#: (845) 219-8031 email:Courtney@empiresolarny.com 3, Roofing Contractor: Empire Solar Solutions Address: 2-8 Johnes St. Newburgh, NY 12550 Phone#: Cell#: (845) 219-8031 email: Courtney@empiresolarny.com 4. Job Description,list all Methods&Materials: Re roof of 23 squares. No plywood to be touched. See specs attached. 5. Estimated Cost of Job:$ 18,000 (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: NIA 7. Construction Type: Roof NYS Construction Class: S. 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: Rip 11. Estimated date of completion: 1 Week after permit is issued -t- 6/112024 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: Erin McConnell , being duty sworn,deposes and states that he/she is the applicant above named, (print name or 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. Sworn to before me this ♦r 5 Swom to before me this 15 day of N day of 6 20 2L! ZVZ1_ 6in of Prop46blk Signat4e of cant Giuseppe Castellano Erin McConnell Print Nam of Property Owner Print Name of Applicant Notary Public r Notary Pu lic COURTNEY ELIZABETH ROBERTS COURTNEY ELIZABETH ROBERTS NOTARY PUBLIC-STATE OF NEW YORK NOTARY PUBLIC-STATE OF NEW YORK No.01 R06439611 No.01 R06439611 Qualified in Dutchess County Qualified in Dutchess County My Commission Expires 08-29-2026 My Commission Expires 08-29-2026 6/1/2024 EMPIRESOLARR D JUL 2 5 2024 2-8 Johnes Street Newburgh,NY 12550 VILLAGE OF RYE BROOK OFFICE: (845) 561-3403 , BUILDING DEPARTMENT FAX: (845) 245-6584 July 18,2024 Customer:Giuseppe Castellano Address:8 Hunter Dr. Scope of Work: i Remove 1 layer of comp shingles v Felt asphalt underlay 6 ft.of Ice&Water Shield on the eves bringing the ice and water 4 to 5 ft.(depending on section)past the warm wall. r 3 ft.of Ice&Water Shield on the Rakes&Valleys. %Synthetic Paper for remainder going beyond the code for Ice&Water. i Drip Edge to both Eves&Rakes. v Step Flashing where required. I row of starter shingles(GAF HD Timberline) Should you require further information,please feel free to contact me directly. Courtney Roberts Operations Specialist Empire Solar Solutions (845)219-8031 Courtney@empiresolarny.com STORMGUARD Film-Surfaced Leak Barrier PIrinium Protection For Asphalt Shingle A nd Metal RoofingSysteins 4e4o Protect Your Home 0 *hd--Dnven From W�l Rain And Damagi*ng Ice Dams tVith A eak Bam r StormGuar& Film-Surfaeec Leak Barrier Will Help: Help Protect Your Home! •Prevent leaks at the most vulnerable areas of • The Codes Are Clear...Protection your asphalt shingle or metal roofing system against ice dams is required by most build- (at the eaves and rakes,in valleys,around ing codes•at eaves wherever the January chimneys and skylights,etc.)caused by average temperature is 25T(-4°C)or wind-driven rain,ice dams,and roof settling. lower or where there is a possibility of •Reduce the risk of costly repairs due to wall ice forming in the eaves—i.e., the area or ceiling staining from leaks labeled "North" (shown on back).'Also, in some jurisdictions, full-deck coverage •Prevent leaks due to water backing up in of leak barrier is required." your gutters • But Be Prepared... Ice dams can StormGuard®Film-Surfaced Leak Barrier is a still occur in areas where the average key part of the GAF Lifetime Roofing System temperature is above 25T(-4•C). and has even earned the prestigious Good • Also Remember... In Southern Housekeeping Seal(applicable in U.S.only; climates,a leak barrier helps provide see reverse). protection against wind-driven rain. • •w^^��. •Check local building codes for requirements in your area •GOOD- HOUSEKEEPING t Source:International Building Code(IBC)and gatcom International Residential Code(IRC). Lis . ► i Film-Surfaced Leak Barrier Premium Pmtechon For Asphalt Shingle And Metal Roofing Systems GAF StormGuard® Film-Surfaced Leak Barrier Homeowner's Best Choice MEETS or EXCEEDS the following requirements •Protects...Provides excellent protection against leaks caused of ASTM 01970 by wind-driven rain,ice dams,and roof settling. • Property Method Requirement Great Look...Fiberglass reinforcement helps resist wrinkling and buckling for a more uniform look. Thickness(mils) D5147 Min.40 • Code Compliance...In areas where building codes require a Tensile strength MD(lbf/in) D2523 Min.25 leak barrier'or jurisdictions where full-deck coverage of leak barrier Tensile strength CMD(lbf/in) D2523 Min.25 is required. sir.---i::r_-� •Peace Of Mind...Eligible for Lifetime ltd. Elongation at break, warrantywhen used on Lifetime Shin le roofs', mod1�ied bitumen D2523 Min. 10 g Portion—MD and CMD(%) up to a 25-year Ltd.warranty when used on non-LifetimeShingle roofs',and up to a 10-year Ltd.warranW Adhesion to plywood at 75°F(24°C) D903 Min.12 when used with other approved non-asphaltic roof coverings.' (Ibf/ft-width Adhesion to plywood at 40°F(4°C) D%3 Professional's Best Choice (Ibf/ft-widthT Min.2 •Dependable...Self-seals around nails or metal roofing fasteners Thermal stability(min) D 1204 Max.3 to help avoid leaks. Low temperature flexibility p1970 Pass • Enhanced Walkability...Tough,durable film surface avoids 20°F('2�°C) tearing and helps provide excellent traction for installers-especially Tear resistance MD(Ibf) D4073 Min.20 in full-deck applications. Tear resistance CMD(Ibf) D4073 Min.20 • Versatile...High-temperature compound is perfect for use under asphalt shingle and most metal roofing systems.' Moisture vapor permeance F.96 A Max 0.1 (U.S.Perms) •Easy to Install...Split-back release film peels off in layers for (U.S.Perms) around nail E%D19 A Pass fast installation. Waterproof integrity after ffntheWorth,- ', '• ;-i,.,.., �� „�+�► low temperature flexibility I.)19711 Pass most DuIWMp q' - aoda` � Waterproof integrity of the rise of leeR p g t1 U 1970 Pass barrier at North-. , lap seam the eaves. ]` Applicable Standards Product Specifications (Nominal) See GAF Shingle&Accessory Ltd.Warranoor complete coverage and restrictions.The word "Lifetime"refers to the length of coverage provided by the GAF Shingle&Accessory Ltd.Warranty •Meets or exceeds the perfor- For use with asphalt shingles and most and means as long as the original individual owner(s)of a single-family detached residence(or the mane criteria of ASTM D1970 metal roofing systems' second owner(s)in certain circumstances]owns the property where the shingles and accessories are .Miami-Dade County Product Gross roll coverage:2 squares(200 fcs installed.For ownersistructures not meeting the above criteria,Lifetime coverage is not applicable. Control Approved 118.58 sq.mJ) Lifetime Ltd.Warranty on accessories requires the use of at least three qualifying GAF accessories pp Roll Width.......36 in.(0.914 in) the use of Lifetime Shingles. •State of Florida Approved 2 Roll Length....66.7 ft.(20.33 m) See StormGuarr/•Film-SuAaced Leak BarnerLtd.Warranryfor Non-Asphalh'c Roofing Systems for •U[.Classified(See marketing High-Temp Ravi Z50°F 1 complete coverage and restrictions. on product packaging) gh P Rating. ( 21.1°C}' •1CC-ES Evaluation Report U'Exposure:Up to 90 days,if necessary The high-temperature compound is suitable for most metal roofing system roofing systems, For use P Shelf Life:Best if used within 1 year from under copper and zinc or for information on other approved non-asphaltic roofing systems.contact (ESR-1322) date of manufacture Y GAF Technical Services at 1-80(FROOF-011. n Y Your Just Coverage O C)n Your Shingles! Get Automatic _ See 34FshirgqleBAccessory UWnw Prowdi n t - �. . word dWagifeand tim'refers to The _ _ ,% � word Lifelime'referstotne length of coverage provided by On Your Entire GAF Z _. the Gulf Shmp/e&Accessory - - * lid.Wananryand means as ' long as the original individual Roofing System! l detached dreadence[family GOOD second doresidence fortis HOUSEKEEPING; When you install GAF > _ secumstanesl w certain pry f _ dreumstancesl owns the Lifetime Shingle anc a11east property where the shinClesand q � accessories are installed.For The G.AFLifetinu RoS6NgSyrtem 3 ual' GAF accessories, L owners/structures not meeting A_,m,v,,,,eCpmsn �G..d you'll automatically 9•f: ; t' the above criteria,Lifetime 11.-ehepiag Seal•.�O.Aiaimeaw Aw •�'' coverage'a not applicable. Goadmas, ep'ngrrandr MAiwd •A Lifetime Ltd.warranty on r shingles i wevinedd warranty on µe0�as rw µisna.,(RI- accessories$ EE accessories requires the use roGoodNowetweprng.Mag— and all qualifying GAP oceessoriesl � Ft I_' of at least three qualirymp /orirr m•rwarer rotavro•poluy. •Non-prorated coverage for the first E r, GAF accessories and the use Appti a64 is US.awh.l of Lifetime Shingles. loyears• LimmE Coill ATTIC ROOF DECK LEAK STARTER JiRlp KtDGE i,.,, Z if coy c h. • SHINGLES VENTILATION PROTECTION BARRIER SHINGLES SHINGLES ,:+�`z' ,.. 2B -Cr1fi I • .r • • • • • Timberline HD° High Performance Peace of Mind Shingles Provide Designed with Advanced Protection"' Lifetime ltd. transferable warranty with Shingle Technology,which reduces the Smart Choice®Protection (non-prorated These Unique Benefits: use of natural resources while providing material and installation labor coverage) Great Value excellent protection for your home for the first ten years' Architecturally stylish but (visit gaf.com/APS/to learn more) Perfect Finishing Touch practically priced Stays in Place For the best look, use Timbertex® Dimensional look Dura Grip"Adhesive seals each Premium Ridge Cap Shingles or Features GAF proprietary shingle tightly and reduces the risk of Ridglass®Premium Ridge Cap Shingles" color blends and enhanced shingle blow-off. Shingles warranted shadow effect for a genuine to withstand winds up to 130 mph wood-shake look (209 km/h)' Highest Roofing StainGuard® Protection Fire Rating Helps ensure the beauty of your roof UL Class A, Listed to ANSI/UL 790 against unsightly blue-green algae' rThis wind speed coverage requires special installation;see GAF Shingle&Accessory Ltd.Warranty for details, 'Stain Guard°Protection applies only to shingles with Stain Guard•-labeled packaging.See GAF Shingle&Accessory Ud.Warranty for complete coverage and restrictions, 'See GAF Shingle&Accessory Ltd.Warranty for complete coverage and restrictions.The word'Lifetime'refers to the length of coverage provided by the GAF Shingle&Accessory lld.Warranty and means as long as the original individual owners)of a single-family detached residence lot the second owners)in certain circumstances]owns the property where the shingles are installed.For owners/structures not meeting the above criteria, Lifetime coverage is not applicable. 'These products are not available in all areas.See www.gaf.com/ridgecapavailability for details. • trt i • , • • 111Pewter Gray I 1 1Shakewood Sunset Brick Weathered Wood X Ifl / �r I Mission Brown S s ,'r« I OysterI I Slate Applicable Standards •Texas Department of Insurance listed • Exposure: 5 5/8" (143 mm) & ftt0006 • CSA Al23.52 • Bundles/Square: 3 • ENERGY STAR"'Certified(White Only) • Pieces/Square:64 • UL Listed to ANSI/UL 790 Class A (U.S.Only) • StainGuard"I Protection:Yes" •Miami-Dade County Product Control • Rated b the CRRC roved y • Hip/Ridge:Timbertex®;Sea l-A-Ridge®; approved • Can be used to comply with Title 24 n Ridge;Ridglass® •State of Florida approved cool roof requirements • Starter: Pro-Start"'&WeatherBlocker" • UL 997 modified to 110 mph •Meets the cool roof requirements of ���_ •Classified by UL in accordance the Los Angeles Green Building Code Instal' with ICC-ES AC438 (Birchwood,Copper Canyon,Golden Detailed installation instructions •Meets ASTM D7158,Class H Amber,and White Only) are provided on the inside of each •Meets ASTM D3161,Class F Pr Odud/S tem Spec if iCS3 bundle wrapper of Timberline HD"' •Meets ASTM D3018,Type 1 •Meets ASTM D3462' • Fiberglass Asphalt Construction Shingles. Installation instructions may also be obtained at gaf.com. • ICC-ES Evaluation Reports • Dimensions(approx.): 13 1/4" x 39 3/8" ESR-1475 and ESR-3267 (337 x 1,000 mm) 'Periodically tested by independent and internal labs to ensure compliance with ASTM D3462 at time of manufacture. 'Refers to shingles sold in Canada only. 'Refer to complete published installation instructions. 'SteinGuard°Protection applies only to shingles with Sal nGuard•-labeled packaging.See GAF Shingle 8 Accessory Lid.Warranty for complete coverage and restrictions. Note:It is difficult to reproduce the color clarity and actual color blends of these products.Before selecting your color,please ask to see several full-size shingles ©2017 GAF 12/17 4875 i 10r 1 1 is ?. � i h ,'. ! •6{ , � k• �� // -,A .�: AIM.. ® ° ;�s �•� ,�. �..—may"�- • . - Ilk C r AW Jw Rom..r,a.i' - •� .-X � � ; � ,�.�, - 1 1 1 x atx , VWII f b�l F TT AM� t — 19 `3 Giuseppe Castellano Residence 8 Hunter Dr. Rye Brook, NY 10573 f;• 0. •'a�1s Y f/"mm, 1*J �f` �7! $ Y � .1 Y'Ar` d � �..t +�5 ��if�CC��� .r 1,r� i� � •�+ .^cl'��tl` ,�nL �i,. ' r� � t,• � "L i�SAt, r � y-V 4 l�_a ," 'S <»t•._,1 F• o-.�„ex j�. x �' -t'..,.�A z �- A 1„ Mc �, ,ti1/,►�'*'. F' r+ !.9 '+ + 9 ..'i 41 ✓; vl,G..;,,... East View of House s• { ' Al ;�' !. s.•;k,�i ;v,V fir. 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'•1 a a ca CV cuLU a CO to 40 �•+L _ ^ ;Pm 0 un LLI w • a ttr 'Oection C' b cu y oti� C F L G •� �� O o • Y C of rodic is xo �• or, 4 s 7 'j tAO�.. lrl - (�� :� ' .C/;1�i O. O 4 //'�.' C 4 t: .': J O:O:O CO.O'O:C l.O,O'a'�iO aG♦4O0)0� ) /�+,A' "" ('� +_•�/ �, '. �.� rJri rn �+ �� ! �"�A%y�l� \fir✓�tl�f l�..1'�\:L;. '1�J�J�J i�n;��.V' YV/J�d'+•����� '•Y��Jr^/1y(A ����� 1/��•4.'1 J..."'l )�j. /� �(�:.. `,>� F ��'�"�� 1 t ?....,�41 !��f'1 ..w`11 Y��1 .1�/♦ ♦ T/ 1'' hr�� �1�A�f�� � '�.."^. DATE(MM/DDrYYYYI • ACORi CERTIFICATE OF LIABILITY INSURANCE 111`* i 08/23/2023 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(ios)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 Joseph LaVeCChla NAME Fields Group Insurance Services LLC PHONE (646)979-9010 FAX (646)979-9011 INC.No Eat AIC No: 110 East 42nd Street E MAIL jrou lavecc:hia fields ins com ADDRESS: g p 161h Floor INSURER(S)AFFORDING COVERAGE NAIC a New York NY 10017 INSURER A: Southwest Marine and General Insurance Company INSURED INSURER B: New York State InsuranrR Fund Empire Solar Solutions LLC INSURER C: 2-8 Johnes St INSURER D: INSURER E Newburgh NY 12550 INSURER F: COVERAGES CERTIFICATE NUMBER: CL231502338 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 Nff DDL 5U8R POLICY E F POLICY EXP LTR TYPE OF INSURANCE INSIDWVDPOUCY NUMBER MM/DDIYYYV MM/DD/VYYV LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1.000,000 CLAIMS-MADE �vCCUR PREMISES Ea occurrence S 100,000 MED EXP(Any one person) S 5.000 B I Y GL202300013231 08/26/2023 08/26/2024 PERSONAL BADVINJURY S 1,000.000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S 2.000.000 POLICY ®PRO. 2.000.000 JECT LOC PRODUCTS-COMP/OP AGG $ OTHER S AUTOMOBILE UABIUTY COMBINED SINGLE LIMIT $ Ea a.nt ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per acatlentl S HIRED NON-OWNED PROPERTY DAMAGE S AUTOS ONLY N AUTOS ONLY Per acatl n S UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LIAB HCLAIMS-MADE AGGREGATE S DED I I RETENTION$ S WORKERS COMPENSATION PER OTH- AND EMPLOYERS'UABIUTY Y/N STATUTE ER A ANV PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA Z 2603 447-0 04101/2024 04/01/2025 1.000.000 OFFICER/MEMBER EXCLUDED E L EACH ACCIDENT S (Mandatory In NH) E L DISEASE-EA EMPLOYEE S 1.000.000 If yes describe under 1.000.000 DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be at chard H more space is required) Village of Rye Brook is listed as an additional insured per written contract subject to the terms and limits of the policies listed CERTIFICATE HOLDER CANCELLATION SHOULDANY 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 St AUTHORIZED REPRESENTATIVE Rye Brook NY 1057� �i �rp t �rl�rr(�llrl ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD N Y S I F PO Box 66699,Albany,NY 12206 New York State Insurance Fund I nysif.eom CERTIFICATE OF WORKERS' COMPENSATION INSURANCE A^^A A A 474896823 LOVELL SAFETY MGMT CO.,LLC , 22 CORTLANDT STREET 33RD FLR NEW YORK NY 10007 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER EMPIRE SOLAR SOLUTIONS LLC VILLAGE OF RYE BROOK 2-8 JOHNES STREET 938 KING ST. NEWBURGH NY 12550 RYE BROOK NY 10573 POLICY NUMBER I CERTIFICATE NUMBER POLICY PERIOD DATE Z 2603 447-0 256204 04/01/2024 TO 04/01/2025 04/01/2024 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO 2603 447-0, 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 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. THE POLICY INCLUDES A WAIVER OF SUBROGATION ENDORSEMENT UNDER WHICH NYSIF AGREES TO WAIVE ITS RIGHT OF SUBROGATION TO BRING AN ACTION AGAINST THE CERTIFICATE HOLDER TO RECOVER AMOUNTS WE PAID IN WORKERS'COMPENSATION AND/OR MEDICAL BENEFITS TO OR ON BEHALF OF AN EMPLOYEE OF OUR INSURED IN THE EVENT THAT, PRIOR TO THE DATE OF THE ACCIDENT, THE CERTIFICATE HOLDER HAS ENTERED INTO A WRITTEN CONTRACT WITH OUR INSURED THAT REQUIRES THAT SUCH RIGHT OF SUBROGATION BE WAIVED 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 STATE INSURANCE FUND DIRECTOR,I(CE FUND UNDERWRITING VALIDATION NUMBER. 355858327 mir00 00 00"""711111 Form WC-CFRT-NOPRINT Ve—t 10829201v)IM'P.1 -260344701 11-263 210 (000000000001260"772110001 0000260)44701(•uX 1635e 22Xcn1-NoP-CEaT-I j01-00001)