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RP19-038
e0\10 r OTHER APPROVALS PERMIT CTI EXP7 .• I d2��►7 , • i ari a.i BOT TYPEOFWORK:r�:1y ' arr.::�r.',.PB c203 360-371 vA T. COST CO #Ja TCO # DATE INSPECTION RECORD DATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING _ RGH PLUMBING GAS O _ SPRINKLER ELECTRIC LOW -VOLT 0 ALARM O AS BUILT O FINAL .�-. ' /�' ZOL'I FU CISCY-d QyE DR t4�a y.ly n Y. Gt V C. Vy� VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J.Bradbury www.ryebrook.org TRUSTEES BUILDING & FIRE INSPECTOR Susan R.Epstein Steven E. Fews Stephanie J. Fischer David M.Heiser Salvatore W.Morlino CERTIFICATE OF COMPLIANCE May 15,2024 James Paxton&Kathleen Paxton 13 Hidden Pond Drive Rye Brook,New York 10573 Re: 13 Hidden Pond Drive,Rye Brook,New York 10573 Parcel ID#: 135.67-1-34 Roof Permit#19-038 issued on 11/5/2019 to Re-Roof Existing Building This certifies that the new roof,installed under the above captioned permit has been satisfactorily completed. Sincerely, 12a; Steven E. Fews Building&Fire Inspector /to BUILD R ENT For office use onl . SC PERMIT# —0� ? D VIL OF RYE OK ISSUED: jj— — Mpy 2024 938 NG STRE YE BROOK, YORK 10573 DATE: _/o-a y BR0pK 9 -06 Oc FEE: �' //O PAID)W V„�GEG DEPPR.�MENT w�vv B TION 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 fiik4itt##f#k#iiII#iiii###i#tf PopJD Address: 6 !71D ErJ -64 , 4 L Occupancy/Use: Parcel ID#: Z 35, & 7 Zone: D Owner: -,-JI-)fl L To IJ Address: P.E./R.A.or Contractor: ct a PV Address: 2 W i h a ►ti CJ S 041C QV 0 k Person in responsible charge: '4ll ,-?So Address: // l 1 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 �OFFNNEW YORK,COUNTY OF WESTCHESTER as: _being duly sworn,deposes and says that he/she resides at Gl�P"l /o"-)d 1�)r/Ve (P 'nt Name o pplicant) / / A-- -- (No.and Street) in /�(�� �O UIL in the County of l�tJQS�z h PS 7`L� in the State of ,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 equipm,Ce�nt.arofessional fees,and including the monetary value of any materials and labor which may have been donated gratis was:$�/ : ©Q for the construction or alteration of NEk)�C Q Deponent further states that he/she has examined the approved plans of the structure/work herein referred to for which a Certificate of Occupancy/Compliance is sought,and that to the best of his/her knowledge and belief,the structure/work has been erected/completed in accordance with the approved plans and any amendments thereto except in so far as variations therefore have been legally authorized,and as erected/completed complies with the laws governing building construction.Deponent further understands that it shall be unlawful for an owner to use or permit the use of any building or premises or part thereof hereafter created,erected,changed,converted or enlarged,wholly or partly,in its use or structure until a Certificate of Occupancy or Certificate of Compliance shall have been duly issued by the Building Inspector as per§250-10.A.of the Code of the Village of Rye Brook. Sworn to before me this /,?-wl Sworn to before me this / day of /yyX , 20 day ofyc'lr"' A 20Q? ^ / S Xture of Property Owner Si ature of Applicant l91 F S Cg'�a � � t�✓ Print Name of Property Owner Print Name of Applicant 45 C- Notary Public Notary Publi GLADYS TOUTAC NMary Public State of New York S,1 o,1 No.OIT06152M Commission Expires Sept.25,2 �E BRC�� • 1982 BUILDING DEPARTMENT ❑BUILDING INSPECTOR w(SSISTANT 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: I.3 14) C ';-�z I ✓�c DATE: J- .Z O.2 PERMIT# 1 \ 1 1 `),3 10) ISSUED: L /-s -/iSECT: /1,5• 67 BLOCK: LOT: 3/ LOCATION: 4 \ '00 � OCCUPANCY: ❑ Violation Noted THE WORK IS... PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION n t1 (1 f / ❑ Natural Gas - 1` J 4 O } �r S t i ,�r� �V %1-1 ❑ L.P. Gas ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION @/'FINAL [OTHER R o� , P : A CONTRACTING UNLIMITED INC. 172 Highland St. License# WC-18758-H07 Port Chester NY 10573 Phone: (914) 882-8299 Email : Pa.Contracting(d,)hotmail.com Fax : (914) 939-8917 CUSTOMER 0119 Name : Jim Paxton Date 10/29//2019 Address : 13 Hidden Pond Dr Builden departamento order No. 30.177 City : Rye Brook State : NY Zip 10573 Job name Roof replase Phone: 914 565 9217 Email : Ikkjm1(a�gmail.com T Description Total 1 Scope of Work: Roof remove and install new roof. 2 Labor: Remove all existing layers all over the entire house. 3 At the time we inspect the wood, any rottem or damaged wood will be replaced at 855.00 a sheet(first 3 are free). 4 All garbage will be collecteed in a dumpster provided by us. 5 We install 3'ice&watershield membrane along the bottom of the roof atop the gutterline and including all the details. 6 We install titanium roofing paper over the rest of the entire roof. 7 We install 5 1/2"aluminum drip edge all around the edges of the roof. 8 Atop the aluminum drip edge we install 6"asphalt shingle starters. 9 We install GAF Timberline architectual shingles all over the entire roof. 10 On all the existing pipes we install new aluminum flashing. 11 On all the angles on the roof we install Timbertex asphalt hips. 12 Atop the peak of the roof we install ridge vent with asphalt hips. 13 14 15 16 17 18 19 20 21 This job has 10 years warranty for labor and 30 years for material $11.800.00 22 23 24 PA Contracting is fully Licensed and Insured 25 Note:This will remain the same if everything goes as planned. 26 If something appears damaged we will have to make some arrangements with the customer consent. Acceptance of Proposal - The above prices, specifications and Subtotal 1$11.800.00 conditions are satisfactory and are hereby accepted. You are Tax. 8.375% authorized to do the work as specified. Payment will be made Total as outlined above. Note: If any job that is not specified in the contract there will be an extra charge. Signature Date of Acceptance: Signature Alfredo DiVitto From: Alfredo DiVitto Sent: Tuesday, May 7, 2024 8:33 AM To: James Paxton Subject: RE: Roof permit for 13 hidden pond drive Good morning Mr. Paxton, This is to follow up regarding the expired roof permit last we spoke you had contacted the contractor back in the beginning of April please advise on the progress we will need to get this permit closed out. Also how did you make out regarding the deck in the rear yard, I am notifying the property management regarding the look of the deck not being safe. We will need the engineer to look at it A.S.A.P. Any question feel free to call the Building Department. Thank you, Alfredo (Freddy) DiVitto Assistant Building Inspector Village of Rye Brook 938 King St. Rye Brook,N.Y. 10573 Office: 914-939-0668 -----Original Message----- From: Alfredo DiVitto Sent: Wednesday, April 17, 2024 6:43 PM To: James Paxton <jkkjml@gmail.com> Subject: RE: Roof permit for 13 hidden pond drive Thank you for keeping us in the loop. Thank you, Alfredo (Freddy) DiVitto Assistant Building Inspector Village of Rye Brook 938 King St. Rye Brook,N.Y. 10573 Office: 914-939-0668 -----Original Message----- From:James Paxton<jkkjml@gmail.com> Sent: Wednesday, April 17, 2024 9:55 AM To: Alfredo DiVitto<adivitto@ryebrook.org> Subject: Roof permit for 13 hidden pond drive I just spoke with Alfonso Paltin from PA contracting. He will be back in the office on Monday 4/22. He asked that I call him on Monday with the permit information. Based on our conversation I expect them to handle closing the contract. I will update you on Monday after I speak with Alfonso. If this does not resolve the matter then I will close the contact. 1 Z pedi Aw woaj juaS uo;xed wir sjueyl i� Q 193 VILLAGE OF RYE BROOK MAYOR 938 King Street,Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury www.ryebrook.org TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M.Heiser Salvatore W. Morlino March 28,2024 Pt Notice Via Mail and Hand Delivered Dear Rye Brook Building Permittee, Mr.&Mrs.Paxton 13 Hidden Pond Drive Rye Brook,New York 10573 It has come to the attention of the Building Department that your Building Permit has not been closed out in accordance with Village Code and is now expired.All Building Permits have a twelve(12)month lifespan starting from the date of issuance, and the permit expiration date is noted on the front of the permit. Please note that there is a non-waivable Expired Permit Fee of$500.00 now due in connection with your expired permit.Once payment is received,your permit will be reinstated for a period of six(6) months. Please be advised that it is a violation of Village Code to fail to close out a permit,and that a court summons could be issued, and fines may be imposed on the permit holder and/or property owner for failure to apply for and obtain a Certificate of Occupancy (C/O) or Certificate of Compliance(C/C),in accordance with Village Code section 250-10A. Please note that Temporary C/Os&C/Cs are available in accordance with Village Code section 250-10B should you require more time to perform whatever work remains in order to complete your project. Thank you for your attention in this matter,and please feel free to contact this office should you require any further information. Steven E.Fews Building&Fire Inspector stevefewsQW&brook.org cc:Alfredo DiVitto,Assistant Building&Fire Inspector Tara A.Orlando,Planning&Zoning Secretary Laura Petersen,Office Assistant /to Alfredo DiVitto From: James Paxton <jkkjml@gmail.com> Sent: Thursday, March 28, 2024 11:42 AM To: Alfredo DiVitto Subject: Re: Expired Roof Permit I just spoke with P.A Contracting and they will take care of this matter. I forwarded a copy of the roofing permit(RP 19- 038)to them. Jim Paxton Sent from my iPad On Mar 28, 2024,at 9:36 AM,Alfredo DiVitto<adivitto@ryebrook.org>wrote: Good Morning Mr. Paxton Mr. Paxton going through our records we came across and expired roof permit for your residents 13 Hidden Pond Drive (see attached). Our village code requires that all permits need to be closed and C.O. issued please see attached letter. We can schedule a final inspection once all fees are paid $500.00 for expired permit and $110.00 for C.O.fee .Any questions you can call the building department between 8:30 A.M. and 4:00 P.M. Thank you, Alfredo (Freddy) DiVitto Assistant Building Inspector Village of Rye Brook 938 King St. Rye Brook,N.Y. 10573 Office: 914-939-0668 <13 Hidden Pond Drive permit0001.pdf> <13 Hidden Pond expired Ietter0001.pdf> <CO-CC-Application-8.2021.pdf> 1 Alfredo DiVitto From: Alfredo DiVitto Sent: Thursday, March 28, 2024 9:37 AM To: jkkjml@gmail.com Cc: Laura Petersen;Tara Orlando Subject: Expired Roof Permit Attachments: 13 Hidden Pond Drive permit0001.pdf, 13 Hidden Pond expired Ietter0001.pdf; CO-CC- Application-8.2021.pdf Good Morning Mr. Paxton Mr. Paxton going through our records we came across and expired roof permit for your residents 13 Hidden Pond Drive (see attached). Our village code requires that all permits need to be closed and C.O. issued please see attached letter. We can schedule a final inspection once all fees are paid $500.00 for expired permit and $110.00 for C.O.fee .Any questions you can call the building department between 8:30 A.M.and 4:00 P.M. Thank you, Alfredo (Freddy) DiVitto Assistant Building Inspector Village of Rye Brook 938 King St. Rye Brook,N.Y. 10573 Office:914-939-0668 1 Building Permit Check List&Zoning Analysis Address: ar I vz SBL: `36, 6-1 — ` ' -1i Zone: y�) Use: 2 k Const.Type: Other. Submittal Date: Re=ubtal Dates: Applicant:Nature of Work: Reviews:ZBA: PB: BOT: Other. NEED OK (� ( ) FEES:Filing. BP: �77�-! ' C/O: Legalization: APP: Dated: Notarized SBL:=Truss I.D. Cross Connection: H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening. ( ) ( ) ENVIRO:Long. Short: Fees: N/A: ( ) ( ) SITE PLAN:Topo: Site Protection S/W Mgmt.: Tree Plan: Other. ( ) ( ) SURVEY:Dated: Current: Archival• Sealed Unacceptable: ( ) ( ) PLANS:Date Stamped Sealed Copies: Electronic: Other. ( ) ( ) License: Workers Comp: Liability Comp.Waiver. Other. ( ) ( ) CODE 753#: Dated N/A: () ( ) HIGH-VOLTAGE ELECTRICAL:Plans: Permit: N/A: Other. ( ) ( ) LOW-VOLTAGE ELECTRICAL:Plans: Permit: N/A: Other. ( ) ( ) FIRE ALARM/SMOKE DETECTORS:Plans: Permit H.W.I.C.:_Battery:_Other. ( ) ( ) PLUMBING:Plans: Permit: Nat. Gas: LP Gas: N/A/: Other. ( ) ( ) FIRE SUPPRESSION:Plans: Permit: N/A: Other. ( ) ( ) H.V.A.C.: Plans: Permit N/A: Other. ( ) ( ) FUEL TANK:Plans: Permit: Fuel Type: Other. O O 20I7 NY State ECCC: N/A Other. ( ) ( ) Final Survey Final Topo: RA/PE Sign-off Letter. As-Built Plans: Other. ( ) ( ) BP DENIAL LETTER: C/O DENIAL LETTER: Other. ( ) ( ) Other. ( )ARB mug.date: approval: notes: ( )ZBA mtg.date: approval:- notes: ( )PB mtg.date: approval notes: REQUIRED EXISTING PROPOSED NOTM APPROVF,o, Area Circle: Date: Fronta¢e Front: Front: Sides: Rear. Main Cov Accs.Cor Ft.H Sb: Sd.H Sb: GFA: Tat.i : Ft Imy: ParlunQ Height/Stories: notes: 7-1 tip � �..`��� �'�I/li'�,'.� � �� 1�,�►�►��'1 � � �..{IIiIOP+—��° �� ,p/i►IIi',. �_ la� 11►/i/i1i11 1+►IilOi'+ 14/i10i►+. ., . ... l `` L cC N •!:ti!' C) Al 6 W , yr O � +.+ «�>y)► Poo a� c� W � ♦.+ EE._,. °d � �~ � ((� ° LU uj EnLU U _ 0 O U 3 F04— �. > r� r a. .: i•� �y CA Ln cn co x wL V z C •% ���� , 74 ym a. {► ► d `'1► ►1 ;y??t.a +_a /`fa is d 1 1 3 •a=�J,. 1 ►1..• d 1j 11 �;_ f 1 S(0)►�; ,�1�/►� _= 1�►1�1►�� '+�{►►1�1►►�� _ ..;��►►1�/►1�1 +�11�11� +�►111►,�- �'��',►//1►►��x 11/ �111� /1/� �1/1 111/ ��111 /11MR /r _,v,�,.. ,N "�v„� p, <�v j�'y �' �` "'ice"` "`�'w• `'Asti n ,aco CERTIFICATE OF LIABILITY INSURANCE F DATE(MMIDD VYYY) 10/30/2019 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. It SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME; KIERAN F MURPHY Albert Palencia Agency, Inc. PHO FAX No. . (914)698-1373 (AtCC�o):(914)698.0125 PO Box 26 ADDRESS; kieran@palanciainsurance.co_m _ Mamaroneck, NY 10543 INSURERS AFFORDING COVERAGE NAIL# _ INSURERA: Evanston Ins CO 35378 INSURED INSURER 6: PA CONTRACTING UNLIMITED INC INSURERC: 172 HIGHLAND STREET INSURERD: PORTCHESTER, NY 10573 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 00003863-0 REVISION NUMBER: 26 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. INTR TYPE OF INSURANCE I=JIM& POLICY NUMBER MMIDDY EFF POLICY EXP R LIMIT'S A X COMMERCIAL GENERAL LIABILITY 3EV0371 04/11/2019 04/11/2020 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTE CLAIMS4MDE Ik OCCUR PREMISES Ea occu D $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY jE O- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILnY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per ecddent $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIM -MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE I ER ANY PROPRIFTOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) 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 RYE BROOK, NY 10573 AUTHORIZED REPRESENTATIVE Q �! KFM 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Printed by KFM on October 30,2019 at 12:59PM NYSIF New York State Insurance Fund WESTCHESTER ONE,44 SOUTH BROADWAY,10TH FLOOR,WHITE PLAINS,NY 10601-4411 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE [oil ,.TV ^^^^^^ 208514787 ALBERT PALANCIA AGENCY INC , 116 MAMARONECK AVE �• PO BOX 26 ❑�+n�L MAMARONECK NY 10543 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER PA CONTRACTING UNLIMITED INC VILLAGE OF RYE BROOK 172 HIGHLAND STREET 938 KING STREET PORTCHESTER NY 10573 RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W2441663-8 440513 12/27/2018 TO 12/27/2019 10/30/2019 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2441 663-8, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY, INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS://WWW.NYSIF.COM/CERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION, PRESIDENT ALFONSO PATIN PA CONTRACTING UNLIMITED INC ONE PERSON CORPORATION THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUND DIRECTOR.]NSURANCE FUND UNDERWRITING VALIDATION NUMBER: 1027811328 U-26.3