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HomeMy WebLinkAboutBP24-242PERMIT # of -C r�_ DATE: // / J� �.�„ F�(P: / SECTIONS �o'Z BLOCK LO / TYPE OF WORK 2 OiC Q /Ylel J / / b Lc)S 105 L(CATJON OWNER 0, 6sWe/I �U�PS /act% O ZQ /y)Lv/C% 3530 CONTRACTOR u1e/ O/Y12 eti1 e 6rUU LLC —�c�/r /70ilTQ9UeC�v/off 97 y-soon ST. COST S- FEE v/lco # rC LP,942,r FEEA LJSO�L� DATE / S TCO # FEE DATE DATE FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING C> RGH PLUMBING GAS 0 SPRINKLER ELECTRIC 0 LOW -VOLT O ALARM O AS BUILT O FINAL INSP OTHER APPROVALS ARB BOT P$ ZBA OTHER QyE QR 4 J�VC'V�W V 190 VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury %vwwjyebrookny.gov TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE January 16,2025 Jose Poza&Rosweny Flores Hidalgo 115 North Ridge Street Rye Brook,New York 10573 Re: 115 North Ridge Street, Rye Brook,New York 10573 Parcel ID#: 135.67-2-1 Building Permit#24-242 issued on 11/15/2024 for Replacement Windows This certifies that the nine new windows,installed under the above captioned permit have been satisfactorily completed. Sincerely, Steven E. Fews Building& Fire Inspector /to REcE�wE BR� TFor office use onlPERMIT# of —CycNNOV 2 U 2024 VILL OF RYE OK ISSUED: S— �� 38 KING STRE YE BROOI{� YORK 10573 DATE: //—,40-,e' VILLAGE OF RYE BROOK 9 -06 O FEE: SCO— PAIDW BUILDING DEPARTMENT w 0V 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:T N f�l A -�- Occupancy/Use: C4, Parcel ID#: j 3 S — 2 - Zone: Y(-? V Owner: 7O S-e _ ��, Address: 11 I P.E./R.A.or Contractor: Address: l Person in responsible charge: 50s�' Co r' Address: II�� �j��6 S .� Ke /Gd 1C r 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: ms-_ fo Z S being duly sworn,deposes and says that he/she resides at /l 3 A/ Cd c, _ S 4- (Print Name of Applicant) (No.fidd Street) in ja y.' 13 f G G k ,in the County of (�/ �. A .L ter- in the State of ,that City own/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 ( �t{L(S , for the construction or alteration of 9 /C P p IS C P �c�,.i'.�- w �o[._LS 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. Swots to before me this CO d Sworn to before me this day of JO j.,- 20 9 day of ,20 Signat#tr Property Owner Signature of Applicant Cy t- O Pr ame o Property Owner Print Name of Applicant Notary Public SHARI MELILLO Notary Public .Notary Public,State of New York No.01ME6160063 Qu "i'ied In Westchester County 6/U2o24 �-.rr: .r.nn Explres J, it y 29,20 Z QyE BR��. l7 -c x1. '932. BUILDING DEPARTMENT ❑BUILDING INSPECTOR ❑ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 King Street • Rye Brook,NY 10573 (914) 939-0668 FAx (914) 939-5801 www.Uebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS :- 5 004 P t Y I G 66 t ,�l DATE: �y� -Zv ZVt 1 ) � � � jz PERMIT# 7/ / ISSUED: SECT: BLOCK: LOT: LOCATION: t�4/ (4 W n - OCCUPANCY: _7 r ❑ Violation Noted THE WORK ISASSED ❑ FAILED /REINSPECTION ❑ SITE INSPECTION """ ���/ REQUIRED ❑ FOOTING r ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION n ❑ Natural Gas �3 �/1//tJ�O r�S •� ��62 . ❑ L.P.Gas `` ( ❑ FUEL TANK y 0 Jc. o� , �(/ oa f- ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION 110 -•FINAL ❑ OTHER N ►n N y N c c - � N Npy7' y w _ iLn a O z tn a (n w en Lei w - O Ln CA Z CN 4-4 o O Q A '*Z � � � 10,00 � ..w yv z a <� r, z w � � O W00 w oo H o o Z O N Y 00 CN z H G1 Wcn v w a © Z v Gib 64- a� u V z o � v x _ z 0 v W F O z d w O Z o z � 0 ►.r + Cl)064 (7 u v q a .. A W z W ate' p. ►MM7 ^p,!� ram,, Q ►� E m y❑ ^�4 ' BUILDING WkARTMENT �[NOV ' � �� i VILLAGE OF RYl' $ROOK 938 KIN-(:S'fREET RYE BROOI:,NY 10573 ! (914)939-4668=;i t VILLAGE OF RYE BROOK I -31!II. F� ,.tr- DEPARWENT �ttyrl.'.►-�'ehhonl.nr�,��ti• _ ._.-..�. .�.. ADMINISTRATIVE EXTERIOR BUILDING PERMIT APPLICATION FOR EXTERIOR WORK'"'IIICI-I DOES NOT REQUIRE.Vli.i,ma.— AR('IIITTC iyRA1 RFvIFw Boxim APPROVAL FOR OFFICE USE ON sLY. APPROVAL DATE: \� ER 7 ' APPLICATION FEE: 4/00 --Pb APPROVAL SIGNATURE: PERMIT FEES: -*I=) H.O.A.APPROVAL: DATE: DISAPPROVED: OTHER: ******rt******t*s***/rt*rt•*s***[f***+**rt*rt********a*x*rt*s*+*rt+rw*rt********s**rt******sart***artr*xsr*****+****r****+ Application dated: f i/ � ! is hereby trade 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. Job Address: 115 N Ridge St Port Chester.NY 10573 2. Parcel ID#: 135,67-2-1 _ Zone: 3. Proposed Improvement(Describe in detail): Remove and replace 9 windows with 27 a-value replacements. an windnw- meet egress where raga fired_No structural changeS 4. Property Owner: Address: 115 N Ridge St Port Chester NY 10573 Phone# (914)619-3530 Cell# e-mail pozaiose 13flgmall.com List All Other Properties Owned in Rye Brook: Applicant: Robert Montague Power Home Remodeling) Address: 60 Commerce Drive Trumbull CT 06611 Phone# 610-874-5000 ext.6662 Cell# e-mail ctinstalls@powerhrg.com Architect: Address: Phone# Cell# e-mail Engineer: Address: Phone# Cell# e-mail General Contractor: Power Home Remodeling Address: 60 Commerce Drive.Trumbull CT 06611 Phone# 610-874-5000 ext.6662 Cell# e-mail ctinstalls owerhr .cam (I) 6/1/2024 5. Occupancy;(1-Fam.,2-Fam.,Commercial.,etc...)Pre-construction: 1-fam 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 corner lot,which street does it front on: 9. Area of proposed building in square feet: Basement: I"fl: 2nd fl: 31d fl: 10. Total Square Footage of the proposed new construction: 11, For additions,total square footage added:Basement: 1"fl: 2"d fl: 3'tl: 12. Total Square Footage of the proposed renovation to the existing structure: 13. N.Y.State Construction Classification: VB N.Y.State Use Classification: R3 14. Construction Type&Location:()Typical Western Lumber Frame;()Timber Frame[TC];()Wood Truss[TT]; ()Pre-engineered wood[PW];Located;()Floor Framing[F];()Roof Framing[R];()Floor&Roof Framing[FRI;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: X (if ices,applicant must submit a separate Automatic Fire Suppression,System Permit application&2.sets of detailed engineered plats) 22. Will the proposed project disturb 400 sq.ft.or more of land,or create 400 sq.ft.or more of impervious coverage requiring a Stormwater Management Control Permit as per§217 of Village Code? Yes: No:-X--Area: 23. Will the proposed project require a Site Plan Review by the Village Planning Board as per§209 of Village Code? Yes: No: X (if yes,applicant must submit a Site Plan Application,&-provide detailed drax•ings) 24. Will the proposed project require a Steep Slopes Permit as per§213 of Village Code Yes: No:x f f yes,you must submit a,Site Plan Application,&provide a detailed topographical suve)) 25, Is the lot located within 100 ft.of a Wetland as per§245 of Village Code? Yes: No: X ('fives,the area of m-etland and the wetland bujfer zone must be properly depicted on the survq,&sire plan) 26. Is the lot or any portion thereof located in a Flood Plane as per the FIRM Map dated 9/28I07? Yes:-No: x (!fees,the area and elevations of the flood plane mast be properly depicted on the suer iT&site plan) 27. Will the proposed project require a Tree Removal Permit as per§235 of Village Code?Yes: No: X (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: X Indicate:TIER 1: TIER II: TIER III: (ifyes,a}fame Occupation Permit Application is required) 29. What is the total estimated cost of construction: $ 15,445 Note:estimated cost shall include all site improvements,labor,material,scaffolding,fired equipment•pt ofessional fees,including an),maletial 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 C I0. 30. Estimated date of completion: N/A (2) 6nr2024 DC 1�Cl``r�' 1 BuiLD/'INN DEPARTMENT R - VILtYAc OF RYE BROOK NOV ZOZ 938 KING S 'tza i,-r RYE BRooK,NY 10573 VI L (__)F RYA fV0C) C (914)939-0668,,i ' r r•. _rA,R 1 fliEiJ T w n��a vehrooiSnov _ -- wxxxxxxwx xwxxwxxxxxxxxxxxxwxxxxwwxwwxwwxxxwxx xxxxxxxxxwwwwwwwxwwwwwwwwwwwwwwwwxwxxwxxxxxxxwwxwwww,rwxa�w AFFIDAVIT OF COMPLIANCE VILLAGE CODE §216 • STORM SEWERS AND SANITARY SEWERS THIS AFFIDAVIT MUST BEAR THE NOTARIZED SIGNATURE OF THE LEGAL PROPERTY OWNER AND BE SUBMITTED ALONG WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION. ANY BUILDING OR PLUMBING PERMIT APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETURNED TO THE APPLICANT . STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: I, Poza.Jose ,residing at, 115 N Ridge St Port Chester NY,105„73®, tIldnt name) tad." 'xu 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; 11 s N R daP St Pnrt rhA-MPr NY 10i7:% , Rye Brook,NY. 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. 4 1Sigxlalure of Piolvrry Oxvner(s)) Jose Pon {.'r1311 Nauttc 01 [At'ncr(s)t Sworn to before me this 12th DOUGLAS PERRY JR. ember 20 24 NOTARY PUBLIC MY COMMISSION EXPIRES MARCH 31,2027 I`I 6l1 J2024 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. xxxxxxxx*xx*xxix**xxx#xxxxxxxxxixxxxxxxxxw*w**xx**xxf*x*xxxxxw ww*rtw wW wwwww*wwwww*w***wwwwwwwwwwwwxwww wwwww STATE OF NEW YORK,COUNTY OF WESTC'HESTER ) as; 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 for the legal owner and is duly authorized to snake 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 12th Sworn to before me this 12th day of November 2() 24 clay o q er 20 24 Signature of Property Owner Sigriatu fApplic it Jose Poza Roberl Montague Print Nante of Property Owner Print Name of Applicant l 1 N , Publi 4OTARU DO . LIGL RRY JR.NOTARY PUBLIC MY CO27 MY COMMISSION EXPIRES MARCH 31,2027 (4) 611/2024 National Headquarters Jose Poza and Rosweny Flores 2501 Seaport Drive,Chester,PA 19013 37-88917 888-736-6335 toll-free October 07, 2024 i WWW.POWERHRG.COM 1440776-DCA - CUSTOM REMODELING AND IMPROVEMENT AGREEMENT wc-25267-H12 Buyer(s)'Information and Description of the Property: Project Number: 37-88917 October 07,2024 Jose Poza (914)512-6968(Rosweny's Cell) Date of Agreement Rosweny Flores (914)619.3530(Jose's Cell) pozajosel3@gmaii.com 115 N Ridge St E-Mail Address 1 Port Chester,NY, 10573 roswenyflores@hotmail.com County:Westchester E-Mail Address 2 Township: Buyer(s) listed above hereby jointly and severally agrees to purchase the goods and/or services of Power Home Remodeling Group and its vendors("Contractor") in accordance with the prices and terms described in this 6 page document and the Product Specifications, which are incorporated as part of the Agreement(collectively, this"Agreement"). This Agreement represents a cash sale of goods and services. Buyer(s) agrees to pay the cost of the goods and services purchased as described herein, regardless of timing or approval of any financing Buyer(s) may seek for their purchase. Purchase Price: $15,271.03 Pre Installation Inspection Dates: Down Payment: $0.00 Thu 10/10 between 1:30p and 2:30p Balance Due on $15,271.03 Estimated Project Start: 2 to 4 weeks Substantial Completion: Estimated Project Completion: 1 to 2 days Method of Payment: Other Buyer(s)acknowledge that a definite start and completion dates are NOT of the essence. Delays beyon Any payment(s)made from a bank account will be processed through Contractor's control not included in calculating time frames. See Delay/Unknown Conditions. an Automated Clearing House(ACH)as an electronic funds transfer. Buyer(s) hereby acknowledges receipt of a copy of the pamphlet, "The Lead-Safe Certified Guide to Renovate Right", informing Buyer(s) of the potential risk of lead hazard exposure from renovation activity to be performed in or at Buyer(s)' Property, at the ad ess written above. Buyer(s) received this pamphlet on the date of this Agreement, before commencement of work. Buyer(s)' Initials. This Agreement constitutes the entire agreement and understanding between the parties, and this Agreement replaces any and all prior negotiations, representations, or agreements, either written or oral. No amendment, modification or waiver of this Agreement shall be valid or effective unless in writing and signed by both parties. Buyer(s) hereby acknowledges that Buyer(s) 1) has read the entire Agreement and has received a completed, signed, and dated copy of this Agreement, including the two accompanying Notice of Cancellation forms, on the date first written above, 2) was orally informed of his/her right to cancel this transaction, 3) has received a copy of New York's Consumer Bill of Rights on Contracting for Home Improvement, and 4) has received a Certificate of Workers' Compensation Insurance before work has begun on the Property. Buyer(s) also agrees and understands that if Buyer(s)finances the work with a third-party, the terms of that financing will be contained on separate documents, including any finance charge. Future promotions not applicable. I have read and received each page of this 6 page agreement. Power ome Remodeling Group Buyer(s) Buyer(s) /10/07/24 /10/07/24 e w, /10/07/24 Sig ature of Remodeling Consultant Signature Signature John Abadir Jose Poza Rosweny Flores YOU, THE BUYER(S), MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. October 07, 2024 18:55 IIII I Page 1 of 6 II IIIIIIIIIIIIIII IIIIIIIIIIIIIII I I IIIIIIIIIII National Headquarters Jose Poza and Rosweny Flores 2501 Seaport Drive,Chester, PA 19013 37-88917 888-736-6335 toll-free October 07, 2024 40, WWW.POWERHRG.COM 1440776-DCA -- PRODUCT SPECIFICATIONS WC-25267-H12 Buyer(s)'Information and Description of the Property: Project Number: 37-88917 October 07,2024 Jose Poza Date of Agreement (914)512-6956(Rosweny's Cell) Rosweny Flores (914)619-3530(Jose's Cell) pozajose13@gmail.com 115 N Ridge St E-Mail Address 1 Port Chester,NY, 10573 roswenyflores@hotmail.com County:Westchester E-Mail Address 2 Township: Buyer(s) listed above hereby jointly and severally agrees to purchase the goods and/or services listed on the accompanying specification sheets, in accordance with the prices and terms described in the Custom Remodeling and Improvement and the Product Specifications (collectively, this"Agreement"). Pre Installation Inspection Date: Your pre installation inspection is tentatively scheduled for Thu 10/10 between 1:30p and 2:30p. Windows- Power Symphony Inclusions: Includes welded corners, steel reinforced meeting rails, nighttime safety locks on double hung windows only, foam enhanced frames, Heatshield, Zen Glass, Leak Guard Technology, Lift Assist, Exterior custom capping, installation, clean up and haul away of all job related debris. It is agreed and understood by and between the parties that the Product Specifications, along with the Custom Remodeling and Improvement Agreement, constitutes the entire understanding between the parties, and replace any and all prior negotiations, representations, or agreements, either written or oral. The Product Specifications may not be changed, modified, or varied in any way unless such changes are in writing and signed by both Buyer(s)and Contractor. Buyer(s) hereby acknowledge that Buyer(s) has read the Product Specifications. I have read and received each page of this 3 page agreement. Power Home Remodeling Group Buyer(s) Buyer(s) - X/,_ l /10/07/24 /10/07/24 l J /10/07/24 Sig' a ure of Remodeling Consultant Signature Signature John Abadir Jose Poza Rosweny Flores YOU,THE BUYER(S), MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. October 07, 2024 18:55 IIIIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIII IIIIIIIIIIIII National Headquarters Jose Poza and Rosweny Flores 2501 Seaport Drive,Chester, PA 19013 37-88917 888-736-6335 toll-free October 07, 2024 WWW.POWERHRG.COM 1440776-DCA -- Project Specifications Wc-25267-H12 Windows: 3 seasons room 1 20.0"x45.0" WINDOWS: Model Power Symphony Style Double Hung Type None Config Manual Lock #R OPTIONS: Color White/White l Removal Aluminum/Vinyl I Opening Control Device Manual I Glass Strength Non-Tempered I Hardware Finish Color Match Interior I Grid Pattern None/Glass Options Low-E 1 Screen Type Half I Additional Details None Windows: 3 seasons room 1 60.5"x45.0" WINDOWS: Model Power Symphony Style Slider Type 2-Lite Config Manual Lock OPTIONS: Color White/White I Removal Aluminum/Vinyl I Glass Strength Double Tempered/Hardware Finish Color Match Interior I Grid Pattern None/Glass Options Low-E I Additional Details None Windows: 3 seasons room 1 61.0"x45.0" WINDOWS: Model Power Symphony Style Slider Type 2-Lite Config Manual Lock OPTIONS: Color White/White/Removal Aluminum/Vinyl/Glass Strength Double Tempered/Hardware Finish Color Match Interior I Grid Pattern None/Glass Options Low-E I Additional Details None ! i Windows: 3 seasons room 1 67.0"x43.75" WINDOWS: Model Power Symphony Style Slider Type 2-Lite Config Manual Lock OPTIONS: Color White/White/Removal Aluminum/Vinyl/Glass Strength Double Tempered I Hardware Finish Color Match Interior I Grid Pattern None/Glass Options Low-E I Additional Details None r c Windows: 3 seasons room 1 91.0"x43.75" WINDOWS: Model Power Symphony Style Slider Type 3-Lite Config Manual Lock OPTIONS: Color White/White I Removal Aluminum/Vinyl/Glass Strength Double Tempered/Hardware Finish Color Match Interior I Grid Pattern None/Glass Options Low-E/Split 1/3-1/3-1/3/Additional Details None Windows: 3 seasons room 1 94.25"x43.75" WINDOWS: Model Power Symphony Style Slider Type 3-Lite Config Manual Lock OPTIONS: Color White/White/Removal Aluminum/Vinyl/Glass Strength Double Tempered/Hardware Finish Color Match Interior l Grid Pattern None 1 Glass Options Low-E I Split 1/3-1/3-1/3 I Additional r Details None October 07, 2024 18:55 IIIIIIIIIIIIIII I IIIIII IIIII IIIII I IIIIIIIIIIIII I III National Headquarters Jose Poza and Rosweny Flores 2501 Seaport Drive,Chester, PA 19013 37-88917 888-736-6335 toll-free October 07, 2024 • WWW.POWERHRG.COM 1440776-DCA • - Project Specifications WC-25267-H12 Windows: Daycare room 1 35.0"x48.5" WINDOWS: Model Power Symphony Style Double Hung Type None Config Manual Lock a OPTIONS: Color White/White/Removal Aluminum/Vinyl/Opening Control Device Manual/Glass Strength Non-Tempered I Hardware Finish Color Match Interior I Grid Pattern None I Glass Options Low-E I Screen Type Half/Additional Details Special Options(ie. Full Screen,Obscure Glass,etc)Different Color Capping No l Trim Options Yes New Inside Casing No I New Outside Brickmold No I New Sill Pine/New Stool No I New Apron No I Frame Options Yes Frame In for Vent or A/C unit No l Build Up No I Build Down No I Pack-In No I Buck Frame/Stops/Casing No I Remove and Reinstall No Windows: Daycare room 1 35.0"x48.5" WINDOWS: Model Power Symphony Style Double Hung Type None Config Manual Lock OPTIONS: Color White/White/Removal Aluminum/Vinyl/Opening Control Device Manual I Glass Strength Non-Tempered/Hardware Finish Color Match Interior I Grid Pattern None I Glass Options Low-E I Screen Type Half/Additional Details Special Options(ie. Full Screen,Obscure Glass,etc) Different Color Capping No I Trim Options Yes New Inside Casing No l New Outside Brickmold No I New Sill Pine l New Stool No I New Apron No I Frame Options Yes Frame In for Vent or A/C unit No l Build Up No I Build Down No l Pack-In No I Buck Frame/Stops/Casing No I Remove and Reinstall No Windows: Office 1 24.0"x36.5 WINDOWS: Model Power Symphony Style Double Hung Type None Config Manual Lock OPTIONS: Color White/White I Removal Aluminum/Vinyl I Opening Control Device Manual I Glass Strength Non-Tempered I Hardware Finish Color Match Interior I Grid Pattern None I Glass Options Low-E I Screen Type Half I Additional Details Special Options(ie. Full Screen,Obscure Glass,etc) Different Color Capping No I Trim Options Yes New Inside Casing No I New Outside Brickmold No I New Sill Pine I New Stool No 1 New Apron No I Frame Options Yes Frame In for Vent or A/C unit No I Build Up No I Build Down No I Pack-In No I Buck Frame/Stops/Casing No I Remove and Reinstall No «-=•- a„ October 07, 2024 18:55 IIIIIIIIIII IIIIIIIIIIIIIII IIIIIIIIIIII IIIIIIIIII � v y\ r _/4; I' +e .tiA •Ylb ."N ♦A ^� °..� A y \ ".�.'�y'11�5� 'y��9 .ttA +• w�. �� 7 filualst IIIyi�t4y�� MIR 97'� `4�1i'�i4} ♦it '�aq�p ��yr} �r«�OA)f•-./ -. �1�.111ZS't � nr 1{;f+iil�t'N" '3,.`g y 4; '�... i�1i�t�. .! i y ... v� sa r � O • � 7 v m aan.)r LLI y S• ' U U LO .r v � • 1 C .4-W y �a<O) ui co > V U 0 section rn 4- LLJ :? rzto L) g w« Lli LLJ o c, a(o)f J Q c 1 5� oa atwfs)r tiff 1 :•. wLli a° � ✓�. a�.+.i o s N p 4ila d Q LO Ej r� S o LU O p s�• C- d _ F eu M•' rJ . ca ca LO ! I ♦ �„�, y. xs r, +� ►�- /i h:., y i t ti to sn ye'r". �y .t4F'a'84 y�iy 's� rim i^T" s atw i�A; t Si yitlyy 4A L 4 A { Act CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDMfYY) 3/21/2024 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 Lacher&Associates Insurance Agency PHONE FAX Lacher Insurance Group • 215-723-4378 A/c No:215-723-5757 632 East Broad Street ADDRE : certificate lacherinsurance.com Souderton PA 18964 INSURERS AFFORDING COVERAGE NAIC a INSURER A:Harleysville Insurance Co of New York 10674 INSURED POWERCL-01 INSURER B: Markel American Ins CO 28932 Power Home Remodeling Group, LLC 2501 Seaport Drive,4th Floor INSURER C:Arch Insurance Company 11150 Chester PA 19013 INSURER D:Arch Indemnity Insurance Company 30830 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1912351029 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 ADDL SUBR POLICY EFF POLICY EXP T POLICYNUMBER MM/DD MM LIMITS C X COMMERCIAL GENERAL LIABILITY 11GPP1081300 l/l/2024 1/1/2025 EACH OCCURRENCE $2,000,000 CLAIMS-MADE X DAMAGE TO RENTED OCCUR PREMISES E urr n $2,000,000 MED EXP(Any oneperson) $10,000 PERSONAL&ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 POLICY[flJE0 LOC PRODUCTS-COMP/OP AGG $4,000,000 OTHER: Policy Gen Aggregate $10,000,000 C AUTOMOBILE LIABILITY 11 CAB 1081300 1/1/2024 1/1/2025 COE.MBINED SINGLE LIMIT $2,000,000 C X ANY AUTO 11CA61081400 MA ONLY 1/1/2024 1I1/2025 BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS ONLY AUTOS ( ) HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per id nt A X UMBRELLA LIAB X OCCUR CRA0000027 1/1/2024 l/l/2025 EACH OCCURRENCE $3.000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $9,000,000 DED I X I RETENTION$ GLBProducls Aggregate $3,000,000 C WORKERS COMPENSATION 11WC11081300 FLONLY 1/1/2024 1/1/2025 X IST PERATUTE I I ERH D AND EMPLOYERS'LIABILITY YIN 14WC11081400 1/1/2024 1/1/2025 ANYPROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? r 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 LIMIT $1,000,000 B EXCESS LIABILITY MKLM7EUE101220 4/1/2024 1/l/2025 EACH OCCURRENCE 5,000,000 AGGREGATE 5,000,000 Excess of 3,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/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 St Rye Brook NY 10573 AUTHORIZED REPRESENTATIVE USA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD • YORK Workers' CERTIFICATE OF Board STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured Power Home Remodeling Group LLC 610-874-5000 2501 Seaport Drive,4th Floor Chester,PA 19013 1c.NYS Unemployment Insurance Employer Registration Number of Insured Work Location of Insured(Only required if coverage is specifically limited to 1 d.Federal Employer Identification Number of Insured or Social Securit certain locations in New York State,i.e.,a Wrap-Up Policy) Y Number 23-3030708 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Arch Indemnity Insurance Company Village of Rye Brook 938 King St 3b.Policy Number of Entity Listed in Box"1a" Rye Brook,NY 10573 14WC11081400 3c. Policy effective period 1/1/2024 to 1/1/2025 3d.The Proprietor,Partners or Executive Officers are ❑ included.(Only check box if all partners/officers included) X 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 1 a"for workers' compensation under the 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 policy 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.This certificate 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: Chad Lacher (Print name of authorized representativeor licensed agent of insurance carrier) Approved by: C+ t�e 12/26l2023 (Signature) (Date) Title: Partner Telephone Number of authorized representative or licensed agent of insurance carrier: 215-723-4378 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