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HomeMy WebLinkAboutRP24-123PERMIT # of SECTION 35 TYPE OF WORK JOB LOCH ION // X?0C, OWNER Q/ &Qal gs CONTRACTOR 2(/7 e� E T. COST of TCO # DATE: / L/ Exp: 'ICI z4 a/1a(//1 � � `Cz�i�en oni S/6G � FEES 7 )n 7 lim INSPECTION RECOF3p I DATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING RGH PLUMBING GAS SPRINKLER ELECTRIC 0 LOW -VOLT C� ALARM O AS BUILT C FINAL a0.3� 3Sg-55s� OTHER APPROVALS ARB BOT P8 ZBA OTHER �QyE BRn w "y '3 19 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.g_ov TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W. Morhno CERTIFICATE OF COMPLIANCE November 22,2024 Mark Konigsbach& Carmen Konigsbach 11 Rock Ridge Drive Rye Brook, New York 10573 Re: 11 Rock Ridge Drive,Rye Brook,New York 10573 Parcel ID#: 135.35-1-45 Roof Permit#24-123 issued on 11/4/2024 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 (� For oMce use onlc: BUILDING DEP_4RT-NIE-NT pExNm FNOV - VILLAGE OF RYE BROOK ISSUED:14 2024 938 Kr G STREET,RYE BROOK,NEw YORK 10573 DATE: /I (914)939-0668 FEE: 1 _S AID VILI -'` ' ' ��wH.r�e1Dr00k.01'2 F' 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: 11 Rock Ridge Dr Rye Brook NY 10573 Occupancy/Use: Parcel ID#: Zone: R-10 Owner: Mark& Carmen Konigsbach Address: 11 Rock Ridge Dr Rye Brook NY 10573 P.E.,R.A. or Contractor: Gunner LLC Address: 194 S Water St Greenwich CT 06830 Person in responsible charge: Andrew Prchal Address: 194 S Water St Greenwich CT 06830 Application is hereby trade 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/consuuction/alteration herein mentioned in accordance with law: STATE OF NEW YORK.COUNTY OF WESTCHESTER as: Andrew Prchal being duly swom.deposes and says that he/she resides at 11 Rock Ridge Dr (Print Name of Applicant) (No.and Street) in Rye Brook in the County of Westchester in the State of NY that (City'rown/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:S 17,116.48 forthe construction oralterationof: Roof Replacement ASphalt Roof Deponent finther states that he/she has examined the approved plahis of die struct rowork herein referred to for which a Certificate of Occupancy i Compliance is sought,and that to the best of his/her kno-, ledge and belief.the structure/work has been erected/conhpleted 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 slhall 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 ` 3+h Sworn to before me this 1 ,5141 day f N(j UJA t&( 20 c)L( day of 20� S attire of Property Owner Signature of Applicant Carmen Koni sbach %""""""'rrF 9 ,•� Y Andrew Prchal Print Name of Property Own .�''JP,N___- 'q/y��, Print Name of Applicant , J` o�j -z OT %� lie A�) N i blue O, _ I ,gyp AUBL\G ^, C1. EXF �4rrr,ttrtttt�►` �yE BRC��. O� Zm 1982 BUILDING DEPARTMENT ❑BXILDING 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 : 1 ` [ O L�4 1 Q 1 ✓o DATE: PERMIT#A\ t '1 Z ISSUED: SECT: BLOCK: LOT: LOCATION: O'D `t OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... Q ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS �a ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑, CROSS CONNECTION [� FINAL ❑ OTHER �Zo04 , 4,y y 4 Cn w � N = o. ° a = W Q v .� v 04 qq M �+ v) ow ` Ln aj o W ao � a g . Lgi Fes+( 1--� p'� !`� C � �i �•, U + �I �A o rxi m� A G1 Cn aI au p a C � �1 w U v o Gap Lin Lin "' O � M �t z W z (� C7 Q V a C4 0 U x W W =0 9101 04 � • 4 U fit cr$� c- oo o � w � E� tj 1-4 V zo ~ U Q U o cs. - • Gi, p4 E-i w O s .s w W W OOP' = - BUILDING DEPARTMENT D E C E i1 V E VILLAOE OF RYE BROOK 938 G S.- ET RYE BROOK,NY 10573 NOV — 1 2024 44)9 .9-0668 �4r\tic. `ok. r*. VILLAGE OF RYE BROOK BUILDING DEPARTMENT FOR OFFICE USE orv11: 3 Approval Date 24L e it ��- Application# Approvat 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. t»*»t*t«**ttttt**ststtttt**ts****stst*sstsstssssstts*st**sttt**�«***»««**«»*«****t**tt*stt**st*st»tttst««« ROOF PERMIT APPLICATION Application dated: 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. rob Address: 11 Rock Ridge Dr Rye Brook NY 10573 SBL: 135.35-1-45 Zone: R-10 Prop Owner: Mark& Carmen Konigsbach Address: 11 Rock Ridge Dr Rye Brook NY 10573 Phone#: (914) 260-4571 Cell#: email: carmenkonigsbach@gmaii.com 2. Applicant: Andrew Prchal Address: 194 S Water St Greenwich CT 06830 Phone C 203 388 5555 Cell#: email: kauanny.zanetti@gunnerroofing.com 3. Roofing Contractor: Gunner LLC Address: 194 S Water St Greenwich CT 06830 Phone#: 203 388 5555 Cell C email: kauanny.zanetti@gunnerroofing.com 4. Job Description,list all Methods&Materials: Remove&replace existing roof. Inspect roof deck to verify that all all sheathing is suitable. Install seam tape per CT Code. Install water and los barrier,underlayment,asphalt shingles,and oroper ventilation. Install new white aluminum 6° K-Style Gutters using hidden fasteners elbows and downspouts. 5. Estimated Cost of rob: $ 17,116.48 (NO,rE.The estimated cost,I)all 111L I L1dC all site improvements.labor. material.scati6iding.li,:, I uipntent.professional fees,and material and labor which ma} be donated gratis.) b. If corner property,indicate street frontage: interior property 7. Construction Type: Roof Replacement& Gutters NYS Construction Class: 8. Number of stories: 1 stories Height: 9. Is garage being re-roofed: No:( )•Yes:(Attached No: ( )•Yes:,Number of Cars: 10. Is roof peaked,hip,mansard,flat,etc: Pitched 11. Estimated date of completion: Nov/Dec -I- 10130 M3 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. M**#*R#######RMR##R#F RRRkR RRRR*kRMF RRkFRFF#F**#RRRR#RRRFMR#RRRRRR####FFR#RRRRRR#R#MMR#RR#Rk*k*kk**kkkkk*** STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: Andrew Prchal ,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. Sworn to before me this 1 Sworn to before me this 31 day of e 20 QIA day of ©� ,20.21 h�'�----- gnature of Property Owne Signature of Applicant Carmen Konigsbach Andrew Prchal t Name of Prope Owner Print Name of Applicant ! I V Aotary Pu is c ry Public J ' �.' p�Af� a�'� _ , �P. -,tip CD 0 ,O • 'r m; = .,off UB1. 10 ,p o' ` lb 011 -2- 10/30/2023 Docusign Envelope ID:7C734564 66B6-484 V V�K Ni L k,E uuuNNER NY LLC/GUNNER LLC National Headquarters: 78 Halloween Boulevard, Stamford, Connecticut 06902 Phone: 866-262-6005 License No.: CT-0653672 NY- WC32180H19 Yonkers,NY License No.- 7592 Rockland County,NY License No. 20118 NJ HIC- 13VH10245900 RI HIC-GC-44886 Gunner NY LLC Federal EIN No. 92-3168370. RRP License- R-1-18342-21-00015 www.gunnerroofing.com PROPOSAL/ CONTRACT This construction agreement(the"Agreement")is made and entered into this zam d8y of October,2024 by and between(a)if the Project is located in New York, Gunner NY LLC, (b) if the Project is located in New Jersey, Gunner NJ LLC, and(c) if the Project is located in Connecticut,Gunner LLC(hereinafter referred to as"Gunner Roofing" or"Contractor")and Mark Konigsbach(hereinafter the"Owner" or "Customer") whose address is 11 Rock Ridge Drive Rye Brook,NY 10573 (the "Project"). Contractor and Owner hereby agree as follows: Contract Documents:The contract documents consist of this Agreement,and any exhibits attached hereto,Terms and Conditions,Notice of Cancellation, Statutory Warnings, and limited workmanship warranty (if any) and all modifications and change orders issued after execution of the Agreement(the"Contract Documents").Owner represents that it has read,reviewed,analyzed and become familiar with all of the Contract Documents and the identified and included costs in the Contract Price(as defined below),subject to any manifest errors, inconsistencies,omissions,or discrepancies.These contract documents represent the entire agreement of both parties and supersede any prior oral or written agreement. Scone of Work:The scope of work is contained and limited to the work contained on Exhibit"A"—Scope of Work.The scope of work does not include any engineering or design professional work,which engineering or design professional work shall be engaged and/or paid for separately by the Owner. All work shall be performed by Contractor in a workmanlike manner and shall meet or exceed all state and local building codes. Contractor shall obtain all permits necessary for the work to be completed.Contractor shall remove all construction debris and leave the project in a broom clean condition. Contract Price:The labor and materials required for this job will be furnished by Gunner Roofing or its subcontractors,including necessary equipment,and the services performed for a total of$17,116.48(the"Contract Price"). Owner shall pay Contractor the Contract Price in accordance with Exhibit"B"-Schedule of Progress Payments.Each progress payment of the Contract Price shall be paid by Owner to Contractor within seven(7)days of receipt of Contractor's invoice. If Owner disputes any portion of an invoice for the Contract Price,then (a)Contractor shall be entitled to stop work on the Project without penalty or liability until payment in full is received or such dispute is settled to the mutual satisfaction of the parties and(b)Owner shall pay the undisputed portion of any such invoice, such payment to be made without prejudice to Owner's position. If Owner cancels this Agreement other than pursuant to a Notice of Cancellation validly and timely delivered within three(3)business days after the date hereof,then Owner shall pay Contractor each of the following: (a)an amount equal to twenty percent(20%)of the Contract Price(including any Change Orders thereto)plus the full amount of any Permit Costs;and (b)for any special orders or non-returnable materials(including,without limitation,synthetics,cedar,slate,metal roofing,custom-colored items,windows,etc.),an amount equal to the cost thereof plus twenty percent(20%). In the event of cancellation by Owner,Owner shall have the option to either surrender any materials to Gunner Roofing or to take delivery thereof. (In Rockland County,New York: any deposit charged hereunder shall be the lesser of$1,000.00 or 15%of the Contract Price.Upon satisfactory payment being made for any portion of the work performed,the contractor shall,prior to any further payment being made,furnish to the person contracting for the work a full and unconditional release from any claim of a mechanic's lien by the contractor or by a person entitled to enforce a mechanic's lien for that portion of the work for which payment has been made.) Estimated Date of Commencement/Comvtetion:The estimated start date of the Work is November,712024 and the estimated completion date is November 1412024,these dates are subject to change due to delays caused by weather,shortage of materials or labor,Acts of God, riots,revolutions,strikes,pandemics,medical emergencies that have resulted in a local,state,or federal state of emergency,COVID-19 or viruses/illnesses requiring quarantine, or other causes or factors beyond Gunner Roofing's reasonable control.Time is not of the essence for all purposes of this Agreement unless expressly provided to the contrary. Unless otherwise specified,there is no specific completion date for Contractor's work.Contractor shall use good faith,diligent efforts to complete all work in a reasonable amount of time. If Owner fails to timely pay the deposit due hereunder,then the foregoing estimated start date and completion date for the Work may be delayed until such time as such deposit is paid to Contractor and taking into account Contractor's schedule for other projects and work. Chance Orders: All changes to the plans, specifications or selection of finished materials which may be requested in writing by Owner("Change Orders"), shall be submitted to Contractor using Exhibit "C" — Change Order and are subject to Contractor's approval.A Change Order is any change in work from the original,permit set,plans and specifications.Each Change Order shall only be incorporated into the Agreement if signed by both Owner and Contractor prior to the commencement of any work covered by said Change Order.In the absence of an express lump sum agreement with respect to any Change Order,any work covered by such Change Order shall be billed to the Owner at the direct cost to the Contractor plus twenty percent(20%). Additional time needed to complete change orders shall increase the time needed for Project completion. Docusign Envelope ID:7C734564-66BB-484F-ACDO-AE3C638E44CE I HAVE READ AND UNDERSTAND THIS CONTRACT, THE TERMS AND CONDITIONS, AND ALL APPLICABLE CONTRACT DOCUMENTS AND AGREE TO BE BOUND BY THEIR TERMS. ACCEPTANCE OF CONTRACT: The above prices, specifications and conditions are satisfactory and are As Applicable:Gunner 11-VtCunner NJ LLC/Gunner LLC hereby accepted. Contractor is authorized to do the work as specified. By signing below, Customer acknowledges that Customer is the owner(or authorized Authorized Signature: DD5g12FA.455.. agent of the owner)of the property where the work is to be performed. Contractor will provide Customer with a copy of this Contract after it is signed by both parties. By. Signed by: Its: Ct � 1✓IJ'I�IG�I/al� 10/28/2024 Customer Signature: 2EA14CQ167RI465_ Date: 10/28/2024 Date: CONSUMER'S RIGHT TO CANCELLATION.CUSTOMER MAY CANCEL THIS CONTRACT WITHOUT ANY PENALTY OR FURTHER OBLIGATION WITHIN THREE(3)DAYS FROM THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Docusign Envelope ID:7C734564-66BB-484F-ACDO-AE3C638E44CE EXHIBIT A—SCOPE OF WORK DESCRIPTION OF THE WORK TO BE PERFORMED: ROOFING ASPHALT—See photo below, area highlighted is NOT being replaced • Tear off existing shingles (2 asphalt layers) • Inspect plywood and replace damaged plywood as needed (3 sheets included, additional sheets $110 per sheet) • Install Standard Aluminum Drip Edge F5: White • Install GAF Weather Watch Ice and Water Shield -6' along eaves, T along valleys, and T along rake edges. • Install GAF Synthetic Tiger Paw Underlayment • Install underlayment using galvanized T50 Staples • Install GAF Weather Blocker Starter Strip Shingle • Install GAF Architectural Timberline HDZ Asphalt Shingle -Slate • Install Shingles using Galvanized Roofing Coil Nails- 1 1/4" • Install GAF Cobra Snow Country Advanced Ridge Vent • Install GAF Timbertex Hip& Ridge Shingles- Slate • Install Copper Chimney Flashing and Solder all joints L4T Initial • Install Aluminum Pipe Flashing Combo 1%4" �� • Valleys will be woven using shingles if applicable • Use Elastomeric/Caulk (Clear)where applicable • Use Dynamoic Caulk (Limestone) where applicable • Gunner will provide job related materials • Gunner will provide dumpster to clean site and remove job related debris • Magnetic sweep property for nails • Crews will always maintain safety requirement during the construction process • Provide GAF Golden Pledge Warranty(50 Years on materials and 25 years on labor) upon completion and final payment • Gunner will ull permit for owner(and subsequently close)and save receipt for reimbursement from customer(if needed) K-STYLE GUTTERS-ALUMINUM • Remove existing gutters and discard • Install 6" K-style Gutters using quick screw hidden fasteners -White • Install new elbows and downspouts using pipe cleats and zip screws - 3x4 downspouts White • Downspouts will be connected to existing french drains if applicable using pvc adapter • All end cap terminations will be caulked and crimped • Gunner will provide job related materials • Gutter over right front window—Gunner will remove the 1 downspout that is currently there and add a small downspout connecting this gutter to the main run that is over the front door and will re-pitch main run to the left to utilize 1 downspout. (See image below for reference) • Material: .032 Aluminum (Heavy Guage) Initial Initial • Install Gutter Guards: Yes o STYLE: Leaf Blaster Pro—Stainless steel micro-mesh 30-mesh downspout11 Rock Ridge r Add -rtwo I ll� Docusign Envelope ID:7C734564-66BB-484F-ACDO-AE3C638E44CE EXHIBIT B—SCHEDULE OF PROGRESS PAYMENTS Payment shall be made to (a) if the Project is located in New York, Gunner NY LLC, (b) if the Project is located in New Jersey, Gunner NJ LLC, and (c) if the Project is located in Connecticut, Gunner LLC. Checks are to be mailed to 78 Halloween Boulevard, Stamford, Connecticut 06902. Work or Services Performed and Materials Amount Due: $17,116.48 to be Supplied: 10% Deposit $1,711.65 Initial 60% On Start $10,269.88 Initial 30% On Completion $5,134.95 Customer agrees to pay $20 fee for any bounced check for any reason, including Not Sufficient Funds. 1 ►+�N��AIR M�'111� sti'�r a11�Vryb ►' AI I� �� �:� ;:._. !!:' :+tf._ •t:t,'�} ��_' ti�l ..\��t� fM 11 _��tir ! a ? � 7 1 �• . George Latimer ter Jame%Mahanu L% N'evtche�ter('ountt Fvccutite Director.(nnwmrr Protection ;t�e'�►� Department of Consumer r to m �. Depa er Protection Home Improvement License GUNNER LLC c" 194 SOUTH WATER STREET r 0k, GREENWICH CT-06830 Ct� � kThis license is issued in accordance tt ith Article XVI of the Westchester County Consumer Protection Code and is valid onl)upon :; presence of the official department seal.Proof of citizenship or immigration status is not required for issuance of this license. ` = NOT FOR FLDERAL PURPOSES 44 a `ot Const,,,7 �! Q '� -' License Number �F Date of Expiration WC 35879 H22 0 ; $ 11/012024 'ao►.� gy esterCo� r �.�o►�� , .eY.+----r 1,, ,1, 9tj;:" 1 Y ''`s' �- 1 -`—'pF. _t„ lKl• -'SF3. :�c--'�f5: Tz,^�` ,� L '^jx h Y SXY - �f1•t�b +� �lt! �;�: liil% ►i'�t�.}�rr! �lry•W� Witi� rtt!111) a1 t ;:. :i'�s1 aN t;:,�q tJl Y+t,}r��� r n tl _�.,y��_ 1• v� 11171.111E .�.�.S�odl�l•111• xa��Vr '�'%F / Client#: 1952221 HOMEEN DATE(MWDD/VYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE 10/30/2024 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Jennie Foster USI Insurance Services LLC a 2,14E g 5874-0123 FAX A/C No E,r,: A/C No):203 63"701 530 Preston Avenue E-MAIL ADDRESS: usictcertificates@usi.com Meriden. CT 06450 INSURER(S)AFFORDING COVERAGE NAIC x 855 874-0123 Admiral Insurance Company 24856 INSURER A: Pa Y INSURED INSURERB:Liberty Mutual Insurance Company 23043 Gunner LLC Selective Insurance Company 194 S Water St INSURER C: P8 Y of America 12572 Greenwich. CT 06830 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE 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 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 ADDL UB POLICY EFF POLK:Y EXP LTR TYPE OF INSURANCE I R WV POLICY NUMBER MM/DD/YY MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CAOOOO4513602 1/2024 M1/202 EACH OCCURRENCE $1 000000 CLAMS-MADE EY OCCUR PREMISES a Deco rence $60 000 MED EXP(Anyone Person) $5 000 PERSONAL&ADV INJURY $1 000 000 GEN'L AGGREGATE UMITAPPUES PER: GENERAL AGGREGATE $2,000,000 POLICY F7X JECT LOC PRODUCTS-COMP/OP AGG $1 OOO OOO OTHER: $ C AUTOMOBILE LIABILITY S2579842 9/27/2024 M7/2025 COMBINED SINGLE LIMIT Eaaccvlern 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY Per accident $ F UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DELI I RETENTION$ $ B WORKERS COMPENSATION WC533S381014053 1/19/2024'01/19/202 XPER oTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECLMVE Y/N E.L.EACH ACCIDENT $1 OOO 000 OFFICERIMEMBEREXCLUDED? � N/A (Mandatory in NH) E.L DISEASE-EA EMPLOYEE $1 000 000 If yes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY UMIT $1 000 000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Village of Rye Brook is Included as an Additional Insured under the General Liability policy,for ongoing and completed operations, when required in a written agreement In accordance with policy terms,conditions,and exclusions regarding services provided by the Named Insured. CERTIFICATE HOLDER CANCELLATION Village of Rye Brook SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 938 King Street ACCORDANCE WITH THE POLICY PROVISIONS. Rye Brook,NY 10573 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S43188187/M42873328 SZBZP NYSIF New York State Insurance Fund PO Box 66699,Albany,NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE 0 � A A A A A A 832024199 GUNNER LLC 194 S WATER ST GREENWICH,CT 06830 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER GUNNER LLC VILLAGE OF RYE BROOK 194 S WATER ST 938 KING STREET GREENWICH, CT 06830 RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W2485 011-7 336017 09/12/2024 TO 09/12/2025 10/30/2024 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2485011-7, 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.COWCERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER THE SOLE PROPRIETOR, PARTNERS AND/OR MEMBERS OF A LIMITED LIABILITY COMPANY. 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 STAT SU NCE FUND T �V DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 898437915 U-26.3