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Home My WebLink AboutRP25-018P€RMIT # �o - � � Q.,� DATE: 7 ) S- ®(p: SECTION IQ 41, 3 BLOCK LOT 3" TYPE OF WORK Ae o ai Y/S 70 r7 cf L'[/ /.7' JOB LOCATION c 7 ` / O OWNER _cs ! / 4, zq/,oioC i ,P CONTRACT O i_ Oi»e l0 eln2 f 1LC EST. COST O ©- FEE V CO C FEE 4z54b DATE a , TCO # FEE DATE INSPECTION RECORD DATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING RGH PLUMBING GAS 0 SPRINKLER ELECTRIC LOW -VOLT C] ALARM CI AS BUILT CI FINAL OTHER APPROVALS ARB BOT P8 ZBA OTHER BR � p Uz c VILLAGE OF RYE BROOK MAYOR 938 King Street,Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914)939-0668 Christopher J.Bradbury www.ryebrookny.gov TRUSTEES BUILDING & FIRE INSPECTOR Susan R. Epstein Steven E. Fews David M.Heiser Donald T.Krom,Jr. Salvatore W. Morlino CERTIFICATE OF COMPLIANCE April 30,2025 Kenneth Schiffer&Marcia Schiffer 27 High Point Circle Rye Brook,New York 10573 Re: 27 High Point Circle,Rye Brook,New York 10573 Parcel ID#: 124.73-1-33 Roof Permit#25-018 issued on 4/7/2025 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 n L V E (��/]�� For office use onl u v �l BUILDI�O� MENT PERMIT# /e VILLAt*OF RYE 4400K ISSUED: 'y 7-3 u APR 14 2025 �38 ICING STRE941M BROOK,**YORK 10573 DATE: _ v i ( 14�.9 FEE:�'�a� —PAID 13 VILLAGE_OF RYE BROOK I w� I e 1 ov BU'I nl`.r F)FPM?7!FNT 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 ttttittttitt�ty/ttittii//itti►ititttitiittttttttttttttttittitttittt►tititttttitttttkttittittttttttttttititttttttttkttttittttkttkt Address: / 6 Occupancy/Use: Pamel FD Li, 73 — /—3 3 Zone: Pu� Owner: Q I'l ) l Address: ,-'�/ /J"im P.E./R.A. or Contracto : rim Address: GZLaue Person in responsible c ge: Address: CP Ue. Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issuan f a Certificate of Occupancy/Certificate of Compliance for the structure/construction/alteration herein mentioned in acc ance with law: STATE OF NEW YORK, COUNTY OF WESTCHESTER as:M UU A k N 1 FFE Q being duly sworn,deposes and says that he/she resides at l ]Y H 16 K PD 11 y t Ok RV E B QOO K (Print Name of Applicant) (No.and Street) /O.5-h in RYE F31Z0CV__ in the County of �\ �� 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 equipment,professional fees,and including the monetary value of any materials and labor which may have been donated gratis was:$ O for the construction or alteration of: �P l c� 200 v 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 ST Sworn to before me this S� day of Fig rZL , 20 25— day of MO Wk , 20 94 f C,, L �. sil Signature of Owner Signa of Applicant M pz�q )- - k k 4�' mpkCif) /' Print Name of Property Owner Print Name Applicant M'yOrw MEETA KUMAR ��Not blic Notary Public-State of New York�y lacSIO York NO.OIKU6422235of Ne Qualified in Westchester CountyNotary P3607 My Commission Expires Sep 20, 20256/l/2024 Countys�ct 18,2025QualifiesMY Con nO 3I a0 a 5 �E BRCS-, lm 1982 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.ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - --- - - - - ADDRESS : ) / k ti (--5�-k V,7 , �-) � DATE: 7 - 2 / - Z 0LS PERMIT# 2 S - G I ISSUED: SECT:Io1 • 7 BLOCK:_LOT: 2-3 LOCATION: OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS - �I ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER i� N °° � ■ Cv � s fil a vi Cl) w A a u o ca O v s fy cl) w Z sa NA �W CO) bt 1.6 CU wH - L7 C O 8 0 M. ^Qi. �4 �' �T•� w v ti � z � � � b � � W � '� VJ w LwL w A O �U v 0 .�. O a O Z w w y v tv t _ �✓ � r T'� i cn Ada ° o �= O = uIs W00 wA � � v � a az zN Z H9 � g a ►� V d U o a w u � � x u U z ate ° z H w o � �� .4 N A w z � � � � •� •� o � a 6 BUT LDT1�G 010'ARTMENT VILL 1 E OF RYg OOK APR - 2 2Q25 938 KING h!V ET RYE BR kj NY 10573 IM VILLAGE OF RYE BROOK wvl iov BUILDING DEPARTMENT #t*######t*##*t#t##*t#tt###ttt#t#**#ttttt#####t#####t##t#tt##tt#t#########tttttt##t**ttt#*####*#**##*###### FOR OFFICE USE ONLY: A /1 � Approval Date: APR 204 r it# �v 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:41 0?Pb Permit Fees: ROOF PERMIT APPLICATION Application dated: ��e1 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 slat t described bel vrr 1. Job Address: V !"� SBL: � 3 '1— 3 Zone:Pu6 Property Owner: �L Phone#: �v 7� —� W�i_Cell M email: 12. Applicant: Address: Phone#: Cell#: email: 3. Roofing Contractor. To/'Address Ca-LAW- Phone M. 0 4 Cell#: ail: 4. J b De cription,list all Methods aterials: �5 / 5. Estimated Cost of Job:$ 50) (NOTE:The estimated cost shall include all site improvements,labor,material,scaffolding,fixed equipment,professional fees,and material and labor which may be donated gratis.) b. If corner property,indicate street frontage: 7. Construction Type: 0 1 og NYS Construction Class: 8. Number of stories: Height:_2& 4. Is garage being re-roofed:No:0•Yes:( )Attached No: )•Yes:(Number of Cats: 10. Is roof peaked,hip,mansard,flat,etc: Q 11. Estimated date of completion: v� 4- Please note that this application must include the notarized signature(s) of the legal owner(s) of the above-mentioned property, in the space provided below. Any application not bearing the legal property owner's notarized signature(s) shall be deemed null and void, and will be returned to the applicant. STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: (Print�b i s� t � `'being duly sworn,deposes and states that he/she is the applicant above named, fining 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 ►'ln —e cri,✓✓ ___ _______ for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor.agent,ammey,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 pplicable laws,ordinances and regulations. S � otherworn to before me this 9 I Sworn to before me this. day of , 20_Ly day of niyziot _ - , 20_!27!;_7 Signaturi of Property Owner Sign tore of Applicant l Print Name of Property Owner Print Name of Applicant Nat NotaIFPyW— ip YE liSUNG aA Ne N York STEVE JISUNG PARK 5TE State A116 � Notary Public-State of New York F h°t{{y�N4`1�W4Stche50�t`8n�15 Qualified in Westchester Ma�,p, d tin n Expires My Commission Expires Oct 1$. 2025 _ _ M�Com"�ieato -2- Quinde Home Improvements General Contractors Roofing • Siding • Windows and Doors • Aluminum& Copper Products • Quality&Satisfaction 25 Central Ave Portchester,NY 10573 Is our Number One Goal 914 565 4350 Date: 02/25/2025 Work Phone: Name: Kenneth Marcia Schifter Residence Phone: 8' Address: 27 High Point 9/y—�a City: RyeBrook State: NY Zip: 10573 I/We,the owners of the premises described below,hereinafter referred to as"Purchaser"offer to contract with McLeod Bros.,Inc.hereinafter referred to as"Contractor",to furnish,deliver,and arrange for installation of all materials as called for in this contract to the property located at: Same as above (Street) (City) (State) (Zip) Description of work to be done: 1. Remove old asphalt shingle roof from house. 2.Inspect fascia board for rotten and/or damaged wood. Replace at$10.00/ft. 3.Inspect wood deck, if wood have to be replace, we will replace it at$110 per sheet. 4.Install aluminum flashing ODE behind gutters. 5. Install a Leak barrier to vulnerable areas. Such as eaves, chimney, skylights, valleys, vent pipes, ect. Weather Watch or eyual.Install 6ft from bottom, go up 6ft. 6.Install GAF roof deck protector, Deck Armor. 7.Install aluminum drip edge to all roof edges. Unstall GAF pro starter. _Unstall GAF Timberline HD Lifetime shingles color Weatheredwood. 10. Install 6 nails per full shingle. I I.Install Cobra ridge vent. 12. Install GAF Timber Tex hip caps. 13.Clean and cart all related debris . _ 14. Receive a five year labor warranty from Quinde Home Improvement. 15. Receive a manufactured siding warranty, after completion of job. 16.Install new copper flashing to chimney. 17.Receive a GAF Lifetime shingles warranty(50 years). Total: $22,500.00 The Total price for all Labor $22,500.00 Down Payment t Balanca-�ue(upon completion) Submitted by Signed A� /) a In the event this offer is not accepted by Contractor,any payment made hereunder shall be refunded to the Purchaser(s)and this proposal shall be null and void and of no erect. CONTRACTOR is not responsible for existing structural defects,dry rot,animal and/or pest infestation and/or infiltration,preparation,moving and reinstalling of electrical boxes and meters,water boxes and meters,power lines,plumbing and telephone lines or any existing code violations.No repairing,plastering,carpentry,electrical,plumbing,painting or decorating is included unless specifically charged for and specified in writing herem. PURCHASER agrees to pay to the Contractor the reasonable costs of enforcement of collection,and/or if in the event it is necessary for the Contractor to retain an attomcy and/or to institute legal proceedings.Purchaser agrees to pay reasonable attorney's fees and costs incurred,whether or not court proceedings arc instituted,in addition to other sums. INSTALLATION:It is understood that Contractor may not install said materials but that by Purchasers signature Purchaser authorizes Contractor to arrange for the performance ft the installation by a oualified installer.Purchaser also authorizes Contractor(I)to issue an installation work order with the specifications shown herein and(2)to pay the installer upon your execution of completion certificate establishing that the installation has been satisfactorily completed.Purchaser agrees to pay to Contractor the amount specified here-in,which will cover the prices of said materials and the installation charge. ANY surplus material remaining after completion of this job shall remain the property of Contractor,and Contractor shall have the right to remove it from the premises within a reasonable period of time after completion.No credit is due Purchaser on excess materials. PURCHASER assumes responsibility for removal of all breakable items from walls and shelves inside the home during the installation. THERE shal 1 be no liability for delays in,or failure to complete delivery or installation of all or any of the herein mentioned merchandise,if due to any cause beyond Contractor's control,including but not limited to fire,strikes,acts of God,war,governmental regulations,labor or material shortages. ENTIRE AGREEMENT:Purchaser acknowledges that this contract and the agreement for credit,if any,contains the entire agreement between Purchaser and Contractor. Purchaser affirms that the Contractor has made no promises regarding the goods and services described in this contract other than the promises contained in this contract.No mod- ification of this contract will be effective unless it is in writing and signed by both parties.Purchaser affirms that this contract is completed in full without blank spaces. LAW: This contract will be governed by the law of the State of New York. CONTINUED EFFECTIVENESS:Should any clause,sentence or part of this contract be declared to be illegal,determined invalid by a court or against public policy,it shall not effect the enforceability of the other parts or portion(s)of this Agreement,nor shall it deprive Contractor recovery for any materials installed or labor performed. INSURANCE:The Contractor represents that it carries Worker's Comrrensation and Public Liabilitv Insurance. ADDITIONAL TERMS AND CONDITIONS CONTRACTOR shall not be responsible for conditions beyond its control,including condensation resulting from pre-existing conditions. PURCHASER authorizes Contractor to bring such equipment and machinery necessary to perform the work and Purchaser agrees to obtain,if necessary,permission for Contractor to enter adjoining properties in order to enable Contractor to do the work.. CONTRACTOR is not responsible for any damages to bushes,shrubs,or lawn while it is working at the job unless due to its negligence. CONTRACTOR is not responsible for bearing walls when applying any covering to the walls such as sheetrock,tile,paneling,exterior siding etc. CONTRACTOR is not responsible for pre-existing violations of building,electric,plumbing,or other governmental codes,in the building.Corrections of violations are exclud- ed from this Agreement and shall be the responsibility of Purchaser unless specifically provided for in the contract.Purchaser represents and warrants that there:are no existing violations of any building codes,ordinances or statutes pertaining to the premises,knowing that Contractor has not made an official search thereof and understands Contractor will rely on such representation and warranty.Purchaser agrees to refrain from any work,act or omission on Purchasers part which will or may constitute such violation. WOOD:is one of nature's valuable gifts and Contractor shall not be responsible for varied and different grams,designs,characteristics,color tones and patterns. WHERE concrete or cement is required at any place on the job.Contractor agrees to perform said work in accordance with accepted standards of the building trades and Contractor shall not be responsible for settlement or cracks which may occur later. CONTRACTOR shall be responsible only for the installation of plumbing fixtures,piping and fittings if set forth in this contract.Contractor shall not be responsible for any blockage,change of pressure or any condition or damage which may result to any of the pipes or drains,or their functions in the building or to any damage which may be caused to any of the property except for damages caused by Contractors negligence. If Contractor installs,replaces,or relocates existing leaders to the building,its obligation shall be confined only to the replacement,relocation or removal of the leader for the distance from the gutter to the ground level and no responsibility shall be imposed on it in connection with the drainage to the street,sewer,or to dry wells or to any other method of drainage. IN THE EVENT the Purchaser elects to cancel this contract in accordance with the Notice of Cancellation,or at anytime thereafter prior to the commencement of any work or prevents and/or delays the work being provided by Contractor,Purchaser shall be liable to Contractor for any and all out of pocket costs incurred by Contractor including,fees paid for the issuance of permits,and the cost of any materials to be furnished and installed by Contractor which have been custom ordered and not subject to return. THE Purchasers)hereby indemnifies and holds harmless the Contractor,its officers.laborers,etc.,from any and all claims as to the identification,detection,abatement. encapsulation,or removal of asbestos,lead based products or similar hazardous substances as that term is defined by applicable State and Federal law inside or outside of the structure being improved. CONTRACTOR shall not be liable for any damages to the premises or to any articles of furniture,furnishings or other property unless caused by the negligence of Contractors --`;-• :;.rfi'q v v1�� srdrortr � Lam., ('v h ' �. o f /^��"� F+o1 rr Z *k to �J n cn `'•' ✓^a 11J r O Y,, L o section / tw)� d ice+ ? y o i� VY, O Q W n o p tp) tit ..- / W o : 4 G y . _. i.t 0 'y C. c t4Cital1}7►�i 0 N Lo i y M ( (/ f ti >i ACO DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 03/25/2025 '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). CONTACT PRODUCER Sharp Insurance Services Inc NAME: Moises Rosales 120 N Main St, 2nd Floor PHONE 2032479524 (FAX No 2036638200 Port Chester NY 10673 E-MADDRESS, mrosales@sharpsvcs.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Obsidian Specialty Insurance Company INSURED QUINDE HOME IMPROVEMENT LLC INSURER B: 26 CENTRAL AVE 1 L INSURER C: PORT CHESTER NY 10673 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 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, ILTR NSR OLICY EXP TYPE OF INSURANCE ADDL wvnSUBR POLICY NUMBER MM DD/YYYY POLICY EFF PM DDNYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENT D ✓ CLAIMS-MADE OCCUR PREMISES Ea occurrence $50,000 A SCB-GL-000055124 06/16/2024 06/16/2026 MED EXP(Any one person) $ 5,000 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $2,000,000 ✓ POLICY❑ JE� ❑ LOC PRODUCTS-COMP/OPAGG $ 1,000,000 OTHER $ AUTOMOBILE LIABILITY 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 accident $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ E1EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? F__] N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ I Obi DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Additional Insured:The Certificate Holder is included as additional insured. CERTIFICATE HOLDER CANCELLATION Village of Rye Brook 938 King St SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Rye Brook, NY 10673 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Moises Rosales Producer ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 26(2016/03) The ACORD name and logo are registered marks of ACORD NYSIF New York State Insurance Fund PO Box 66699,Albany, NY 12206 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE q A A A A A A 843303199 SHARP INSURANCE SERVICES, INC 120 N. MAIN ST-2ND FL PORT CHESTER NY 10573 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER QUINDE HOME IMPROVEMENT LLC VILLAGE OF RYE BROOK 25 CENTRAL AVENUE 938 KING ST PORT CHESTER NY 10573 RYE BROOK NY 10573 ii POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W2361675-8 245255 05/15/2024 TO 05/15/2025 3/25/2025 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2361675-8, 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 THE SOLE PROPRIETOR, PARTNERS AND/OR MEMBERS OF A LIMITED LIABILITY COMPANY. 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 4 4/ DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 949569263 U-26.3