Loading...
HomeMy WebLinkAboutRP25-012PERMIT # a �Ple DATE; mrn. P e4o SECTION _135� li BLOCK LOT 5/ /(y TYPE OF WORK — o 4=X/S7`7/? JOB LOCATION /. C/? OWNER Q/ V/ o i G? V) CONTRACTOR Ci4A �J!/e Sa�Q��SO�u7�70//S L EST. V/CO # TCO # FEE DATE FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING ED RGH PLUMBING GAS Cl SPRINKLER ELECTRIC LOW -VOLT C7 ALARM C� AS BUILT FINAL 2t-?-zo2S Fb 4sig 42 4T (v—emo)O3/ �z77 ffCk C0,745r C5��7317- 8UI9 OTHER APPROVALS AR8 BOT PB ZBA OTHER `�yE aR O` 4�11 VJVJ`) Y c ttc v �Wv 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 March 12,2025 Howard Lavitt&Jodi Lavitt 1 Birch Lane Rye Brook,New York 10573 Re: 1 Birch Lane, Rye Brook,New York 10573 Parcel ID#: 135.42-1-5.18 Roof Permit#25-012 issued on 2/11/2025 to Re-Roof Existing Building This certifies that the new roof,installed under the above captioned permit has been satisfactorily completed. Sincerely, /2a; Steven E. Fews Building&Fire Inspector /to For office u e only: DBUILD ENT PERMIT FEB 2 5 202519 VIL OF RYE OK ISSUED: 938 KING STRE YE BROOK, YoRK 10573 DATE: c3 — VILLAGE OF RYE BROOK 9 �-06 OY FEE: — PAIDX BUILDING DEPARTMENT 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 ►►t*rt■r•t►wt►ww►rtrtrtrrtrrtrt**r+*+*t+►***tw+tt►t►w+rtwtt►rrrrrrwrwrr►wwwrr►►rt►tt+trrrrrwrr*r►t■rrrr►►►►rtrrrrrrrr+rtri►►►r►►►rrt Address: 1 Birch Ln. Rye Brook, NY 10573 Occupancy/Use: single Family Residence Parcel ID#: 135.42-1-5.18 Zone: / Owner: Howard Lavin Address: 1 Birch Ln. Rye Brook, NY 10573 P.E./R.A.or contractor: Empire Solar Solutions, LLC 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 Orange 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:$ 19,000 for the construction or alteration of. Re ROOF 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 20 Sworn to before me this day of `�.lp`Up C , 20�`� day of `'ebic 20_Z5 A;7 A C;'_� Sienat of Property-Olver Signature of Applicant Howard Lavin Patrick Canty Print Name of Property Owner Print Name of Applicant Notary Public Notary Public COURTNEY ELIZABETH ROBERTS COURTNEY ELIZABETH ROBERTS ( l 2024 NOTARY PUBLIC-STATE OF NEW YORK NOTARY PUBLIC-STATE OF NEW YORK No.01 R0643961 1 No.01 R0643961 1 Qualified in Dutchess County Qualified in Dutchess County My Commission Expires 08-29-2026 My Commission Expires 08-29-2026 QyE BRCuk 1982 BUILDING DEPARTMENT ❑I BUILDING INSPECTOR 94SSISTANT 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 - - - - - - - - - - - - - - - - - - - - a ADDRESS :- ; V 1 fC C-'`' DATE: .:S 7` PERMIT# \\` Z I L ISSUED: SECT: S - &BLOCK: LOT: S •/o LOCATION: �� � 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 i ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION FINAL ❑ OTHER ff `'0 w ►n N � N W .-�-� E a cn Z w ° v O Ln 1� a O '� u 75 C LT. _ SJ °V O �f Ln f--I v w =o a p FeivaU Ica 0 i C ° w N � � Fo0e °L a O09 p encq ono O w H uo •`" 4 Cn w "o 00 �+ � a rrWl 00 cn z CIS x 41 o � v) y ,.c S _ S BUILDIN(s DEPARTMENT D 3D VI E OF RYE BR�OK FEB - 5 2025 938 KING ET RYE BRooK,NY 10573 VILLAGE OF RYE BROOK _0 --a ov BUILDING DEPARTMENT FOR OFFICE USE ONL1 r 5 2025 Approval Date: f Ei Pe tt 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: Permit Fees: 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-Rooran Existing Building,as per detailed statement described below. 1. Job Address: 1 Birch Ln. Rye Brook, NY 10573 SBL: 135.42-1-5.18' Zone: Property Owner: Howard Lavitt Address: 1 Birch Ln. Rye Brook, NY 10573 Phone#: Cell#: (917) 846-2021 email: howard@lavitt.com 2. Applicant: Empire Solar Solutions, LLC Address: 2-8 Johnes St. Newburgh, NY 12550 Phone#: Cell#: (845) 317-8019 email:Courtney@empiresolamy.com 3. Roofing Contractor: Empire Solar Solutions, LLC Address: 2-8 Johnes St. Newburgh, NY 12550 Phone#: Cell#: (845)317-8019 email: Courtney@empiresolarny.com 4. Job Description,list all Methods&Materials: Discovered on Site-Re roof of 38 squares.No plywood to be touched.See specs attached. 5. Estimated Cost of Job:$ 19,000 (NOTE:The estimated cost shall include all site improvements,labor,material,scaffolding,fixed equipment,professional tees,and material and labor which may he donated gratis.) 6. If comer property,indicate street frontage: NIA 7. Construction Type: Hoof NYS Construction Class: 8. Number of stories: 2 Height: 9. is garage being re-roofed:No©-Yes:( )Attached No:( )•Yes( )Number of Cars: 14. Is roof peaked,hip,mansard,flat,etc: Hip 11. Estimated date of completion:Immediately after permit is issued -1- 61112024 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 Patrick Canty ,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 21? Sworn to before me this 01 day of , 20 Z day of�776-n cN3.Vr N , 20 Z Sig re of Propenrowner Signature of Applicant Howard Lavitt Patrick Canty Print Name of Property Owner Print Name of Applicant Notary Pu is Notary Public COURTNEY ELIZABETH ROBERTS COURTNEY ELIZABETH ROBERTS NOTARY PUBLIC-STATE OF NEW YORK NOTARY PUBLIC-STATE OF NEW YORK No.01 R0643961 1 No.01 R06439611 Qualified in Dutchess County Qualified in Dutchess County My Commission Expires 08-29-2026 My Commission Expires 08.29-2026 -2- 6/1/2024 EMPIRESOLAR 2-8 Johnes Street Newburgh,NY 12550 OFFICE: (845) 561-3403 FAX: (845) 245-6584 Customer: Howard Lavitt Address: 1 Birch Ln. Rye Brook,NY 10573 Scope of Work Remove 1 layer of comp shingles :Install felt asphalt underlay :Install 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. Install 3 ft.of Ice&Water Shield on the Rakes&Valleys. Install Synthetic Roofing Underlayment for Remainder of the Roof Install Drip Edge Along Eaves and Rakes :Install Step Flashing Where Required y Install 1 Row of Starter Shingles(GAF HD Timberline) We certify the roof will be installed per the 2020 RCNY R905.1.1 Code and by the Manufactures instructions and Chapter 10 of the 2020 RCNYS tot Timberline HDINEHD,,,, ""_•. •�ti y., �• •.` LIFETIME HIGH DEFINITION SHINGLES ' o Shingle 1 a .. .. Made to protect your ��+`<v' d?? , `� 4�#'+ , Y �j•, ,,,1 t home. Your story. And �ti��l'+ St�..l = �r.�Vl� '�� r✓a•t!tyrbl,Fy i + i those of over 50 million of our fellow Americans. r? "•1 �;��r ,�, *K+ ••Y�'SSR`-- 'Si�31-'�{� /t1 •����(�f�ii.'`'„ '� ti , I iS'r i��s���..N��{{••ww''r '��- �,T•�a,}fy�y+;�.k"`tY"'1�,✓;1'?.•r�fi�{r,i't�;'.!�'`..:`'f+i���i r�t��f t�,/i�'�i��'���•1Y'ye;'; � YY.`�T``%•':1.'�q`.1�7�.•�rJ,`'4�,.",�r♦ri"r'�:r'pf{• •~ >16 W- 4 tMRX ? ri S� i` �r,'��t'%.�1 t fir- �' ;• .Yp� 797 �j�• 7 • 6 ��•/1� c _r - , • � ;„l �?A„�,�,d,,...', � 4T`•� %�y 'r` F: r1E.e '. I"q' rr' '�k,'�•! v ,fit }�{I4�E, fwb; • ?'.� ,. r r r t ` .� ` . ' / . S,, y��r.�'�. :��•fyy\ y,'�i,771�:��L:,lfFe'�•. , ; .. . lYy(•' ..r1 `, ,'•r I.• }'�i��� � r,`t`'a'},'Y.Va ilr�k ��'';{'4?GGilr� +�,;•�;f� j'i - r 6.- - � � r {r�l,{��tfI;y��,� � I a`t+� 1 l, .�L.At`�,: •^�,r��l:y� ''.?r y I` •°� � L*y�!j`�,�„� , `�,' �r ���;?I��i'l,'.��� ��.��•� j!r'.1�%j'1Y�'�•��i1`ltif�'•A�,.' t .�! ,, .l ' .. VV 1� • J�'• : v r yr M1fy ���T't';S�'7 �, :} �'E4.kr.t�r'ti�t\ 'y. �•, � ., ,+1 5�Fi r��F. -� �r i \f ,�'s��t7�� �'������R. � �l ��yt�lir;t��l J's it 1 _ t •,� , r� ,I� '`r • I���� �r�� t, � ��{• 2•-�f���T"� '�tw �.,�h' '�� � -:r �. .< • c,�YFri• lr •; ', , , g/`rt�yl{y � r•7���'ay �,�j• i•Y +}• o It t J �+� ' . y'� ry�P.:aJ ift �•'� iyJ�`.�! F; Ir ' ' �� I •' • � , �� n'�' �f r 21' , •f t x�jay • • • • • • Patriot I 1 a h Pewter Gray 1 Ill Shakewood Gt Sunset Brick Hunter Green Weathered Wood 111 I I I1 111 I I 1 .I 1 IIIMission Brown 1 1Williamsburg Applicable Standards •Texas Department of Insurance listed • Exposure:5 5/8" (143 mm) & fttacols •CSA A123.52 • Bundles/Square: 3 • ENERGY STAR"I Certified(White Only) • Pieces/Square: 64 • UL Listed to ANSI/UL 790 Class A (U.S.Only) • StainGuards Protection:Yes° •Miami-Dade County Product Control • Rated by the CRRC • Hip/Ridge:Timbertex®;Seal-A-Ridge®; approved • Can be used to comply with Title 24 P 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 Installation with [CC-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 R_ fa J7 J�/Ud/C s tern SpeC�T 1' 3 bundle wrapper of Timberline HD`1 •Meets ASTM D3018,Type 1 r Shingles. Installation instructions may •Meets ASTM D3462' • Fiberglass Asphalt Construction • ICC-ES Evaluation Reports • Dimensions(approx.): 13 1/4"x 39 3/8" also be obtained at gaf.com. 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. 'Refersto shingles sold in Canada only. 'Refer to complete published installation instructions. 'Stai nGuard•Protection applies only to shingles with StainGuaro•-labeled packaging.See GAF Shingle 8 Accessory Ltd.Warrantyfor complete coverage and restrictions. Note:11 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#875 41 Learn SMRMGUARD �'' Film-Surfaced Leak ' i For i i And Metal Roojing Ye4o Protect Your Holne F T om / Rain And 1?amaging Dams With A Leak Bamer StormGuard® Film-Surface( 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, •Prevent leaks due to water backing up in in some jurisdictions,full-deck coverage 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 Systerr temperature is above 25T(-4'Q. 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. e •Check local building codes for requirements in your area. � •Ci00D• HOUSEKEEPINf3 *Source:International Building Code(IBC)and �e *'" gaf tom International Residential Code(IRC). L � ■ 11 Film-Surfaced Leak Barrier Premium Protection 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) 1)25 23 Min.25 leak barrier'or jurisdictions where full-deck coverage of leak barrier Tensile strength CMD(Ibf/in) D2523 Min.25 is required. •Peace Of Mind... Eligible for Lifetime Itd r j ;; Elon ation at break, warranty when used on Lifetime Shingle roofs' 'JM-jjj� portion a MD and CMD(%)bitumen l)Z523 Min. 10 up to a 25-year ltd.warranty when used on non-LifetimeShingle roofs',and up to a 10-year ltd.warranty' Adhesion to plywood at 75°F(24°C) D903 Min.12 when used with other approved non-asphaltic roof coverings.' (Ibf/ft-widthT Adhesion to plywood at 40°F(4°C) D903 Min.2 Professional's Best Choice (Ibf/ft-widthy •Dependable...Self-seals around nails or metal roofing fasteners Thermal stability(mm) D 12W Max.3 to help avoid leaks. Low temperature flexibility D1970 Pass • Enhanced Walkability...Tough,durable film surface avoids -20-F(-29°C) tearing and helps provide excellent traction for installers—especially Tear resistance MD(Ibf) D4073 Min.20 in full-deck applications. Tear resistance CMD(lbf) 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%AD1970 Pass fast installation. Waterproof integrity after tin the Worth: t;. " (' low temperature flexibility D1970 Pass m g most building use it d i Waterproof integrity of barrier at norm',:; , lap seam D1970 Pass the eaves. F Applicable Standards Product Specifications (Nominal) 'See GAFShingle 8 Accessory Ltd.Warranty for complete coverage and restrictions.The word "Lifetime"refers to the length of coverage provided by the GAF Shingle 6 Accessoty 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 w Miami-Dade County Product Gross roll coverage:2 squares(200 fe installed.For owners/structures not meeting the above criteria,Lifetime coverage is not applicable. Control Approved 118.58 sq.ml) Lifetime Ltd.Warranty on accessories requires the use of at least three qualifying GAF accessories pP Roll Width.......36 in.(0.914 m) and the use of Lifetime Shingles. •State of Florida Approved 2 Roll Length....66.7 fc(20.33 m) See StonnGuards Film-Surfaced Leak Barrier Ltd.Warranty for Non-Asphaltic Roofing Systems for •lit,Classified(See marketing complete coverage and restrictions, on product packaging) High-Temp Rating:250°F(121.1°Cy •ICC-ES Evaluation Report UV Exposure:Up to 90 days,if necessary The r copper and compound is suitable for most metal rooting system applications.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,cxltxt (F,SR-1322) date of manufacture y GAF Technical Services at 1-800-ROOF-011. Mare ritan Just Coverage On Your Shingles! J Get Automatic ""° 'SeeGAFShinClellAccessory Lifetime Protection Q t` coverage fretomplete ctions coverage and restrictions The .� word'Liletime'rehrs to the length of coverage provided by On Your Entire GAF �-- - the GAF Sh/rrple6Accessoy ' Ltd.Wana$, and means as Roofing System! 'r "• - '` long as the original individual owner(s)of a single-family GOOD' �. detached residence[or the HOUSEKEEPING When you install any GAF secandowner(s)incertain circumstanceslownsthe Lifetime Shingle and at least property where the shingles and g •y accessories ar mtalled.For The GAF'r.i/eriw Rwisg Syum 3 qualifying GAF accessories, ��_ { owners/structures not meeting has ea,.eede ,rsrigrors G.od you'lautornatical the above criteria.Lifetime Ho harpi.g Seal,shed mean roar lIy get. - r ;`-�}„. coverage is not applicable. CoodHorssEerpr.gsr.&AArhi.d •A Lifetime ltd.warrantyon our shingles Lifetime Itd.warranty on they d.�,,.this system.rR%r Y 1 '�. ..y - 7• accessories requires the use to CoodHmwdr ■M a and all quolifying GAF occessoriesl� y r of at least three qualifying Jorrsm.,mar�nmraro�ho- •Non-prorated coverage for the first • - _� ofALffel me Shingles sories d the use Apylirabrr i.tCS.a.ry.l 10 years' Q LIFETIME COBRA ATTIC ROOF DECK LEAK STARTER STRIP RIDGE CAP '' rA.e ... � 2C1'GAF Ir,I`•t10, ��SUI 116 SHINGLES VENTILATION PROTECTION BARRIER .SHINGLES SHINGLES r101�''1 .n""-'k'i _qaf.Coln 294191-0311 Wr.aw••w r.-m.rrr' M�A�iSt '��M4• A A A t =s N ;. a C N COas p LtO / .. LO p «r N N C N R i o cUi LU O 1, y E a r �O 00 ee 7 D = v O .. .- O ca to � � o T LU �• VJ O Z N E ¢ N CO -� O O w w - N U. e as N Z ° cYri F- i 4 OZ X w w °oco tto i J 3 4 off � U 'L7 �• � ♦�J N � C V .� = M� 1 a o co di Vl IM'. l�l►�►�, - #7iTf '.'►►;,11�L}£x . .°.'_l ,►1�11, i .'. ..:=tFj;,11�11,':, ,=s;t ,►►�►► ::=a ,..=:�,r•�►�„�:. ;;a" .an,i,►y�N�: 11 A N t A i► 3 � P EMPISOL-01 CD ACORO CERTIFICATE OF LIABILITY INSURANCE DATDIYI'YY) s/26/2zsizoza 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 pc icy(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). NTACT Kevin Kelley PRODUCER CO Levitt-Fuirst Associates,LTD PHONE FAX 520 White Plains Road A/C.No,Ext:(914)457-4230 Alc,No:(914)457-4230 2nd Floor E-MAIL ,kkelley@levittfuirst.com Tarrytown.NY 10591 INSURER(S)AFFORDING COVERAGE NAIC M INSURER A:Southwest Marine&General Insurance Company 12294 INSURED INSURER B: Empire Solar Solutions LLC INSURERC: 2-8 Johnes St INSURERD: Newburgh,NY 12550 INSURER E INSURER F: COVERAGE CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLTR MMIDDNYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR GL202400013231 8/26/2024 8/2612025 DAMAGE TO RSr RE =SIE,ENTED $ 100,000 MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE 2,000,000 POLICY❑X PECT F I LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER. AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident HIRED NON- yyNED PROPERTY AMAGE AUTOS ONLY AUTO ONLY Per accident S UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below I I E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Village of Rye Brook is included as Additional Insured for covered operations of the named insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Village of Rye Brook THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g y ACCORDANCE WITH THE POLICY PROVISIONS. 938 King St Rye Brook,NY 10573 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NY S I F PO Box 66699,Albany,NY 12206 New York State Insurance Fur-f nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE A A A A A 474896823 Q ❑� 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 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 SURANCE FUND UNDERWRITING VALIDATION NUMBER: 355858327 im ��000 0010i12 0•�7N���I�IIIIIIII Form WC-CERT-NOPRINT Version 3(08/29/2019)]PVC Policy-260344701 l-26. 210 [00000000000126049777][0001-0000260344701(#*Z](16358-22)[Cert_NoPCERT_1)[01-00001]