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HomeMy WebLinkAboutRP25-034PERMIT # AIOD s G�, DATE: s CO & EXPI SECTION Z. _ BLOCK LOT c TYPE OF WORK / 3 f'7ci A71,1 JOB LOCATION G�J Pc� i�/ve, OWNER �/ Q6o.G -s 0pr� o( CONTRACTOR E?IZ_LlC �� `S� Ta CO # TCn # FEE DATE DATE FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING 0 RGH PLUMBING GAS o SPRINKLER ELECTRIC 0 Lew-V*LT O ALARM C7 AS BUILT O FINAL 1 NSP gay- qzly9 oSr�-fa�c� C9/y) Y%3-13y/ OTHER APPROVALS OTHER DR '1 . 19 t 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 July 17,2025 Steven Koch&Elizabeth Koch 19 Longledge Drive Rye Brook,New York 10573 Re: 19 Longledge Drive, Rye Brook,New York 10573 Parcel ID#: 135.67-1-20 Roof Permit#25-034 issued 6/6/2025 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 D E C E � " For office use only: BUILDING DEPARTMENT � PERMIT# wz 5 3V JUL O 2025 VILLAGE OF RYE BROOK ISSUED: (�-�L� 38 KING STREET,RYE BROOK,NEW YORK 10573 DATE: VILLAGE OF RYE BROOK (914)939-0668 FEE: PAID BUILDING DEPARTMENT www.ryebrook.orQ 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 ssasassssatsssssssssaassasssgtsssas■ssssssars ►ssssessssssssssssssassssastesssssssssssssststsssssssssasassstsststsssssaastss Address: letLc"&LtpG£ 1Lat%JE R`SE QRooic N t IOS13 Occupancy/Use: Parcel ID #: j!s5,Lo7- 1-r Zone: Owner: lE-sY koc.r+ Address: 19 LaNat_E&oc p2 (z,YE 1�Acorc n1`! t0613 P.E./R.A.or Contractor: F"-j tc y I Wctt t S--S 1,4 c- Address: 9 2- N. R-, 9 vA Co Nc eas N*44 1001 OL 0 Person in responsible charge: MhAc Cg<,jm lNlo Address: 9z- N. Rz 10 Co'uGFRS N( % as 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: MAR'- Cost CAPMt o being duly sworn,deposes and says that he/she resides at 19 LDNOL,CA O C t�Awf I& (Print Name of Applicant) (No.and Street) in QY c QRo o t c ,in the County of W rS r cttF s r CZ in the State of N that (CigYTown/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 3,0500.pe for the construction or alteration of: krpwm•NG Pmpter(,z Stkidcra RooF sYs-cm p G4.)71.c2 Ailb L-fftE(L S`(ST4M 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 $'° Swom to before me this day of 20 �S day of 1� 20 Signature of Property Owner Signatu of Applicant ,75Y 1`oco h AQc Co (mOr i0 Print Name of Property Owner Print Name of Applicant Notary Public r— Notary Public MICHAEL S SCHNEIDER MICHAEL S SCHNEIDER Notary Public-State of New York Notary Public-State of New York i 2,202' NO.01SC6434593 N0.01SC6434593 Qualified in Rockland County Qualified in Rockland County My Commission Expires Jun 6, 2026 My Commission Expires Jun 6, 2026 l 0� BUILDING DEPARTMENT ❑BUILDING INSPI(cTOR P<MSISTANI'1tcrll...ulx(#INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OUNCER 938 KING STIMET •Ik.YE BROOK,NY 10573 (91.4) 939-0008 FAx (914)939-5801 www r—ymb k.or - - - - - - -- - - - - - - - - - - - - INSPECTIONREPORT - - - - - - -- -- - - - _ _ _ - - - - - - ADDRESS L!__1�0 I✓� DATE:--2--./S-- Z'O 2-S PERMIT# C Z C'-Q 3 y -4- JSSUED:6L SECT: ?�'/ v v � ��1L- 67 13LOCK:_/ _LO'I':- LOCATION: _ _ 2400 __ OCCUPANC Y: ❑ VIOLATION NOTED 11-1.11 WORK IS... �Accin.'TED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINA.(iN ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROIIGII FRAMING ❑ -INSULATION Ili '►/� n ❑ NAT Fi W LUR.A.I,GAS Av OD {� ❑ L.1� GA.s - ---- �l _ ❑ FUEL TANK - O � - ❑ FIRE SPRINKI.EIt ❑ FINAI,PI,UM1tING ❑ CROSS CONNE(;'1'ION AS FINAL Off OTHEIt e d7 s = x a a s m y a s N N w 1 cn x -0 a�r ►.-� � W v CA CA aj © r u 010 z 'n �+ M o a o 'o o V a O W U Z -u v O Z V w z Z �' z w i -S T v ON re) 31 a 00 W J x u x V o zz r R C W � o O w °� U � � U W I o r C7 F W W 0 > .- -r� ° rC C1+ Z p� Ln H W. dqq " u A � z 0 �G ° v.. ° W W � 0. a BUILDING DEPARTMENT JUN - 2 2025 VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK,NY 10573 VILLAGE OF RYE BROOK (914)939-0668:- BUILDING DEPARTMENT www.ryebrook.org. FOR OFFICE USE ONLY: Approval Date: JUH Q m # J Application# Approval Signature: 3' { ARCHITECTURAL REVIEW BOARD: Disapproved: : Date: BOT Approval Date: Case 1 Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Case# Other: F. Application Fee: 106 Permit Fees: /,� ROOF PERMIT APPLICATION Application dated: (Y 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 Build' g,as per detailed statement described below. 1. Job Address: 1 q Lom&L EtOr E L gwy. R`(a fP�Ok Nv SBL: /,35 r 47 —,--)0 Zone:/C-/0 Property Owner: MS VOC" Address: 1*1 Lotaat.EAO£ La. Rfs ", 01 10513 Phone#: 914 1 411 44H'1 Cell#: email: V. 1<oc4.c.9rna*A.COM 2. Applicant: M nRc COS 1 Mn- 0 Address: 9'l 14• (4 Q 1n1 C0000as N i 1 O't J.0 Phone#: %H S Q619 S 1-1 O Cell#: 914 t4 03 1341 email: SALE S &,i UCC 1_-co 3. Roofing Contractor: Fp^r4v J t ocew " So.4 S 1'4 C_ Address: 'I a N• R 7 °l W CoNG en 5 N Y 10 9 aO Phone#: %'t S Qr- i S 17 O Cell#: email: S1%1S-S M Tuc-SIC,conk 4. Job Description,list all Methods&Materials: RIP*RSputtg 0SPtt1,V' St~,ry0k'E Row SyS-ter►r itw%L S�1� RGLOSt weer - Fiars",wr,S Nevi CopP6rt crrkmr4 S11tN6 tJW Gv7,TVrtS t t ihtil c-a AS PWL —1' m S10'NE4 GoN-Mr(r 5. Estimated Cost of Job:S 30SO O.'° (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.) 6. If comer property,indicate street frontage: 7. Construction Type: NYS Construction Class: 8. Number of stories: Height: 9. Is garage being re-roofed:No:( }•Yes:W Attached No:( )•Yes:O4 Number of Cars: (0 10. Is roof peaked,hip,mansard,flat,etc: ftSPltncur SW Nowt: HIP ROOF 11. Estimated date of completion: Sprat 3O ao 15 I i -1- 6/1/2023 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: MAac Cm4ffi rA o , being duly swom,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 COIF R+4Ctaa / Pr&EN'r' for the legal owner and is duly authorized to make and file this application. (indicate architec contractor,age. ttorney,etc.) That all statements c-o-REM—ed7eirein 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 Sworn to before me this La 4 ti day of ni/1 01 , 2d_�� day of 20_al' 'l k k / Signature of Property Owner Signa re of Applicant ti,Sy I<oc%4 . HAnc COSIMPrNo Print Name of Property Owner Print Name of Applicant N iz ;;� tc otary Public MICHAEL S SCHNEIDER MICHAEL S SCHNEIDER Notary Public-State of New York Notary Public-State of New York NO.OISC6434593 NO.OISC6434593 Qualified In Rockland County QualMed in Rockland County Im y Commission Expires Jun 6,2026 My Commission Expires Jun 6, 2026 -2- 6/1/2023 FRANK J. TUCEK & SONS, INC. Since 1914 ROOFING SIDING REPAIRS RESIDENTIAL COMMERCIAL Main Office and Warehouse: 92 North Route 9W Congers, New York 10920 Fax#(845)268-0593 Rockland/Orange Westchester Connecticut Bergen (845)268-5170 (914)997-8180 (203)622-8280 (201)307-9272 Contractor License No.'s Rockland: H-02737 Westchester:WC-2248-1-189 Yonkers:532 Connecticut:00541051 Contract May 20,2025 A. Frank J. Tucek&Son, Inc. (hereinafter,the Contractor) proposes to furnish to Ms. Be" Koch of 19 Longledge Drive Rye Brook NY 10573, (914-844-4449) (hereinafter,the Customer) materials and or services as described in Job Specifications,at the premises owned by the Customer and located at Same FOR THE PRICE AND CONDITIONS HEREAFTER EXPRESSED. B. The Customer agrees to pay the Contractor in consideration of the foregoing the Total Roof Price of$30,500.00 plus any additional wood if/as needed and Building Permit Fee of$558.00 C. The Contractor employs skilled workmen fully covered by Workman's Compensation Insurance. The Customer's satisfaction with our workmanship is our goal and our best advertisement. D. The Contractor agrees to perform the described services in a workmanlike manner according to standards of the craft.All material furnished by the Contractor carry such warranties as are provided by their respective manufacturers.THE CONTRACTOR MAKES NO FURTHER WARRANTIES RESPECTING SAID MATERIAL INCLUDING IMPLIED WARRANTIES OF MERCHANTABILITY,FITNESS FOR A PARTICULAR PURPOSE OR WARRANTIES WHETHER EXPRESSED OR IMPLIED BY LAW except those pertaining to workmanship as expressly stated herein. E. ' F. In the event that the Contractor is performing work on a limited part of the structure,the Contractor assumes no responsibility for damages caused by defects in areas of the structure where no work was performed,regardless of proximity. G. The Contractor assumes no liability for changes in material specifications occasioned by the manufacturers thereof,but will endeavor to perform with materials specified so long as their availability continues. 1 H. The Customer understands that roofing,siding, gutters, and related installation services involves manual hammering which sets up inherent and unavoidable vibrations in the structure serviced. In these cases,interior wall board and ceiling nails may be caused to pop or work loose. In the event that work is performed over "cathedral" ceilings this condition is more likely to occur than not. Similarly,objects placed upon interior walls may fall or otherwise be damaged.This condition is beyond the Contractor's control and assumes no liability for any consequential damages caused thereby. I. Shingle removal will cause dust and small particles of debris to enter the area immediately below the roof deck. It is the Customer's responsibility to protect items stored in attic space. J. The Contractor shall not be responsible for puncturing any conduits,freon lines,electrical lines,plumbing pipes,or the like that have been improperly installed within nailing proximity of the roof deck.According to building codes,and work standards;these lines should not be installed unshielded in areas where they could possibly be punctured,therefore we assume no responsibility for damage caused by fasteners puncturing these lines. K. Any changes from the above specification involving extra costs will be executed only upon written authorization by the Customer and will be at the latter's additional expense. L. All work is contingent upon the absence of strikes,accidents,inclement weather or delays beyond the Contractor's control,including but not limited to the foregoing illustrative examples.Scheduled commencement dates are approximate. M. Any controversy or claim arising out of or relating to this contract or breach thereof shall be settled by arbitration in accordance with the rules of the American Arbitration Association and judgment upon the award rendered by the arbitrator may be entered in any court having jurisdiction thereof. N. This contract expresses the entire understanding of the parties and,when accepted by the Customer,shall be deemed the entire contract. No other terms,provisions,conditions, specifications,or representations are intended to bind the parties hereto unless reduced to writing and respectively signed by them or their authorized representatives.The Customer represents that he/she has read this proposal and by affixing his/her signature below accepts it as agreeable.This instrument shall be construed in accordance with the laws of the States of New York,New Jersey,or Connecticut;wherever the work is performed. O. If the payment schedule contained in the contract provides for a down payment, such down payment shall not exceed$1,000.00 or 15% of the contract price,excluding finance charges, whichever is the lesser. P. The Customer may cancel the contract until midnight of the third business day after the day on which the owner has signed an agreement or offer to purchase relating to such contract. If owner would like to waive this clause in order to start work immediately,please initial in the following space. Q. Approximate date of work to start is the week of C�S P 2025,weather permitting. Customer understands that these dates are approximate and may deviate due to weather conditions. 2 Job description and Specifications: Rip &Replace Existing Asphalt Shingle Roof System-Reuse Skylights - Reuse Wall Flashings-New Copper Chimney Flashing-New Gutters &Leaders 1. Contractor to set up all safety equipment needed to perform work. All work is to be performed in accordance with the requirements of the Occupational Safety &Health Administration (OSHA). 2. Contractor to carefully cut out, remove and discard the necessary existing clapboard siding from chimney chase walls to allow access to the existing chimney flashing. 3. Contractor to remove the chimney flashing, (2) vent pipe flashings, (3) Broan vents, heating cables and discard. 4. Contractor to remove (1) layer of existing shingles down to the wood deck and discard. 5. Contractor to carefully loosen the gutter system. If customer wishes to replace the gutters and leaders we will remove and discard instead of loosen. 6. Contractor to inspect the wood sheathing. We have included (3) sheets of 1/2" CDX in the proposal price. If any additional sheets of decking are needed there will be an additional cost of$100.00 per sheet of 1/2" CDX above contract price or $120.00 per sheet of 3/4' CDX or$11.00 per foot for T&G. 7. Contractor to cut back decking on both sides of main upper (2) main ridge beams by 1 &5/8" in preparation of new ridge vent installation. 8. Contractor to inspect the rakes and replace any damaged/rotted wood with new primed WHITE at an additional cost of$8.00 per foot installed or primed fascia board wrapped in new WHITE aluminum cladding at an additional cost of$12.00 per foot. We have included 8' of 1" x 6" primed WHITE fascia in the proposal price. 9. Contractor to install new GAF Ice &Water Shield at newly exposed eaves,folding down onto fascia 3" and extending up slope of roof 69". Install over top edge of fascia, a 3" X 3" WHITE aluminum right angle flashing. 10. Contractor to resecure the existing gutters and leaders unless we are replacing the gutters and leaders. 3 11. Contractor to install at all abutting walls, a 3' width of new GAF Ice &Water Shield membrane extending up abutting walls by min of 9". 12. Contractor to install at all valleys, a 6' width of new GAF Ice &Water Shield membrane extending up each side of the transition by appx 36". 13. Contractor to install new GAF Ice &Water Shield perimeter of all roof penetrations. (Chimney, Broan Vents,Vent Pipes &Skylights) 14. Contractor to use GAF DECK ARMOUR synthetic breathable underlayment to the remainder of wood deck, secure with 5/16" staples. 15. Contractor to install new GAF PRO START shingles at all eave and rake areas. 16. Contractor to install new closed face WHITE aluminum drip edge to all rake edges. Secure with roof nails of sufficient length. 17. Contractor to install new open face WHITE aluminum drip edge to all eaves where no gutters exist. Secure with roof nails of sufficient length. 18. Contractor to replace (2) existing vent pipe flashing with (2) new 3" OATEY aluminum vent pipe flashings, complete with neoprene gaskets. Exposed nails in flange and gasket to be sealed with a Black GEOCEL caulk. 19. Contractor to install new GAF HDZ asphalt lifetime architectural style shingles, complete withatchipg color TIMBERTEX Hip & Ridge cap. Color to be &"-j 20. Contractor to install GAF SNOW COLTNTRY ridge vent to (2) prepared ridges secured with provided 3" ring shank nails. 21. New shingles to be installed with(6) galvanized 1.25" collated roof nails per shingle to penetrate roof deck. 22. Contractor to fabricate and install (1) new 16-oz. bright finish copper chimney flashing,complete with base and counter flashing. Corners of base flashings are to be soldered for watertight integrity. 23. Contractor to install new primed WHITE 1"x 6" lumber and newly fabricated WHITE aluminum drip cap where clapboard siding was 4 cut out previously at chimney chase. Contractor to secure new 1" x 6" with 2.5" deck screws and aluminum drip cap with 1.5" roof nails. 24. Contractor to seal existing step flashings using KARNAK flashing grade roof cement. 25. Contractor to install new 6" WHITE seamless "K" style aluminum gutters secured with hidden hangars and screws of sufficient length. 26. Contractor to install new 3" x 4" WHITE aluminum corrugated leaders secured with WHITE aluminum zip screws. 27. All underground drain adapters are included in the proposal pricing. 28. Contractor to be responsible for the removal of all job-related debris from jobsite. Our proposal includes all dumping fees for the removal of said debris. (Contractor does not utilize commercial containers for the disposal of debris. We will remove debris with our small dump trucks and/or trailers.) Provide GAF Silver Pledge "lifetime" limited warranty,which provides non-prorated coverage for the first 50 years for labor &materials, for all installation costs,including tear-offs,for any defects that arise out of manufacturer's product. This roofing system is backed up by the Good Housekeeping seal of protection, and is transferable to a new homeowner. GAF Inc. is to provide a full-service warranty for workmanship on new installations for a period of 10 years, from date of completion. This warranty is limited to problems arising out of improper workmanship during original installation. Contractor shall be notified in the event of any new work that may disturb roofing work area or this warranty may be void. Total Labor &Materials: $30,500.00 + Additional wood replacement if needed + Building Permit Fee 5 Deposit Required at Contract Signui At Job Start Payment: $14,750.00 Due upon Completion of Work: $14,750.00 + Any additional billable items (wood) & (permit) Frank J.Tucek&Sons,Inc. ACCEPTED BY: :12 SL Contractor - Date Customer - Date Sincerely, Marc Cosimano Tucek&Sons Inc 914-403-1341 Marc.Cosimano20l8@gmail.com 6 New York State Department of Taxation and Finance ���� �� New York State and Local Sales and Use Tax Certificate of Capital Improvement (2112) er this certificate is completed and signed by both the customer and the contractor ,performing the capital improvement, oust be kept by the contractor. gad this form completely before making any entries. is certificate may not be used to purchase building materials exempt from tax. tme of customer(print or type) nf� Name of contractor(prntortype) MS `�V s`C K OCH Frank J_Tucek&Son, Inc. dress(number and street) t� Address(number and street) I —ONGuEI1G£ 1�2NE 92 North RL 9W ty State ZIP code city State ZIP code N`i 1 OS-13 Congers NY 10920 ties tax Certlficafe of Authority number(if any) Sales tax Certificate of Authority number(if any) 13-3300128 be completed by the customer scribe capital improvement to be performed: 4.0 NT(zr'(t,1 b 2. —,-"b (Zc P- + 2 c P C, S ri r ry CA-C R o aF s�1 s Enn ri••rth G y t l- `�S*-t s..L S`f.5 inn AS pee -nd-t S i 6v'i s-'o, oject name KouA -eet address(where the work is to be performed) city State ZIP code :ame as above) �riify that: am the(mark one) 0 owner ❑ tenant of the real property Identified on this form;and , he work described above will result in a capital improvement to the real property within the guidelines of this farm;and his contract(mark one) ❑ includes ❑x does not include the sale of any tangible personal property that•,when installed,does n of lecome a permanent part of the real property(for example, a free-standing microwave or washing machine). iderstand that will be responsible for any sales tax,interest,and penalty due on the contractor's total charge for tangible personal property and for ibor if it is determined that this work does not qualify as a capital improvement and will be required to pay the contractor the appropriate sales tax on tangible personal property(and any associated services) •ansferred to me pursuant to this contract when the property installed by the contractor does not become a permanent part of the sal property;and will be subject to civil or criminal penalties(or both)under the Tax Law if I issue a false or fraudulent certificate. natu stomgr True sate ` Owner Q ZSs 2�ZS be completed by the contractor e contractor,certify that I have entered into a contract to perform the work described by the customer named above,and that I -apt this form in good faith.(A copy of the written contract,if airy, is attached)1 understand that my failure to collect tax as a result of ;pting an improperly completed certificate will make me personally liable for the tax otherwise due, plus penalties and interest tature of contradgrdr officer Title T President OSLZO 25 Whis certificate is not valid unless all entries are completed. JOB OVERVIEW If you are like most of our customers, this is probably your first experience with a roofing project. The following overview details what to expect during the roofing project, and the responsibilities of the customer to prevent any misunderstandings after the project begins. Please bring to our attention any special circumstances prior to job start. Noise, etc. Tearing-off an existing roof and installing a new roof is a noisy job. You will hear banging, hammering, compressors, etc. throughout the entire process. Trees, Bushes, Flowers & Shrubbery: If there are any low hanging branches over your driveway or roof that may cause damage to your new roof, some trimming may be necessary. Our crews will cut back only those branches which may damage the new roof and/or limit their ability to do a professional installation job. If you have any bushes, flowers or shrubbery around your building which will need to be protected, please let us know. Some small "unmovable" flowers/plants near the base of the house may get damaged unavoidably due to falling roof debris. If you have smaller "movable" flower pots on decks or walkways, please move them away from the construction area until such time that they are no longer in harm's way. We can work together to take the proper precautions to help protect these landscape items. Light Fixtures, Pictures, Mirrors, Plates, Collectibles, Fans, etc. Due to the inherent vibrations in the house that occur when installing a new roof, these items can fall if they are not firmly attached to the ceilings or walls. Also, breakable items that are on shelves, tables,etc. should be placed on the floor. We ask that you take the necessary precautions and check your personal belongings to make sure they are secure. Access We will be staging our material and trucks/trailers in such a way to minimize any inconvenience during the roofing project. Please keep in mind that everything we use needs to be as close to the building that we are working on to allow us to complete the roofing project in a timely and efficient manner. Please, ensure that all loose animals are properly secured so that our workers, and your animals, do not get hurt. Satellite Dishes Any satellite dishes that are mounted directly through the roof will need to be moved to allow us to properly install your new roof. We will attempt to reinstall these items as best as possible in the same location, but cannot guarantee restoration of the satellite signal. You may need to contact your satellite company to reset the signal to your dish. 12-8 z5 Customer's Signature Da e 'x::Y.}�vti � ': �:V.hti+�:' ;i, i:\Vi� .a• '",N•'�`�fr,-;.,p�y+.::....,... :.`;F„�%.j,`.'.:,}' 1 tiY "'k.': �;: 'j;. t �'_ :y)'f',h susp/�,3� :IO'r ayQ, �r' O P � • '.O p1�,}1f .O ,� ��s::rit,y}r.w• s�tr 1�� f .� t� m ,.. s I (tit'.x5'Y('sy,d �t+`4}��yust,'4 '(vl .q l;}fiaukY'"AIJ 1:.:.� �>; f '�4`,,. � . �E2�.111'i:•y1111111111r s z�``��=a.-y111/111113r.r``�•�—�—�—��d'- 11111/11111, s sl£�� pfi_r�111/111�r s�12sA'1 i:.r�11{Ii/l�r 'i�%�.��€es �j1111/11111r:'ie� E 11111111',_ ��,. ♦ I 0 <O)1) O a`, > o » U 4. wMa : ° o tjs /�, . �y�.1.• i .� �// � b•1 .rye/._ / v---. A r O z U W • .H N «'°" ♦ i �� � r..l O w o o ,o � Q�a,ection � � r f 4 a-. � <(o)j`� a L1J ai f3 W O� 4'o 0 Z N U w •y [s I cz w 0 s x c0 id N 00 3 M. N a J cn � N •/. .1 - 1 1 1 1 1 1 1 - 1 - .a - 1 1 1 1 1 � - •1• .1�1 -�11 I I:a:=.<; �+�I 1 11•.� 111//11 ¢ y 11/1111 _ 11/111/1 t 11111 t T I s i11//1111 .�J' 1{1111{I 1 1{11 N11 cif .♦��♦ z ♦ ♦ ♦ 9 ♦♦ 1 1/1 �p •• •r A r.y ;1 r d► . f !i►CtrF ♦�1♦ ,� ♦N �� nsl�f ♦;�♦ �}� n z s/i+�nl Si � i 1+t# { ^� � • Ysj r 4 t", .. sI3 VAS,. Wv11+ ,. �vh\ V V V v uy� Ybj�• v i\G} •'NV., r� ••v4 ,V., ... � ..� �... ..w l' :'r •�\ +M' r .�..'S V +x"�`•." rt�a� ?r w "xtiSk: •w.'.r: Kc� »l�'. -::. , s'}3`. A� 05/22/2025 CERTIFICATE OF LIABILITY INSURANCE GATE Y) 22/2025 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). PRODUCER CONTACT Aaron Epstein NAME: Westrock Insurance Agency PHA/ONE Eat: (845)638-2300 n/c No): (845)638-6222 151 N Main StE-MAIL Aaron@westrockinsurance.com ADDRESS: Suite 405 INSURER(S)AFFORDING COVERAGE NAIC!< New City NY 10956 INSURER A: Falls Lake National Insurance Company 31925 INSURED INSURER B: Selective Insurance Company of SE 39926 Frank J.Tucek&Son Inc. INSURER C: Century Surety Company 36951 92 North Route 9W INSURER D: INSURER E: Congers NY 10920 INSURER F: COVERAGES CERTIFICATE NUMBER: 2024-2025 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 AUUL bUtSK POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1.000,000 CLAIMS-MADE Fx_]OCCUR PREMISES Ea occurrence $ 100,000 X Blanket-AI-PNC-WOS MED EXP(Any one person) $ 5,000 A X CG2033;CG2001;CG2404;CG2012 Y CPP120496915 08/15/2024 08/15/2025 PERSONAL&ADV INJURY $ 1,000,000 MGEN LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY 0 jE' LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED Y S 2260389 11/30/2024 11/30/2025 BODILY INJURY(Per accident) f AUTOS ONLY AUTOS X HIRED Mx NON-OWNED PROPERTY DAMAGE _ AUTOS ONLY AUTOS ONLY Per accident X Comp Coll Uninsured Motorist $ 1,000,000 X UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 2,000,000 C EXCEssuAB CLAIMS-MADE Y CCP1171353 08/15/2024 08/15/2025 AGGREGATE $ 2,000.000 DED I X RETENTION$ 10,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE I ER ANY PROPRIETOR/PARTNERIEXECUTIVE ❑ NIA E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ N yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101.Additional Remarks Schedule,may be attached If more space is required) Additional Insured:Village of Rye Brook CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Village of Rye Brook ACCORDANCE WITH THE POLICY PROVISIONS. 938 King Street AUTHORIZED REPRESENTATIVE Rye Brook NY 10513 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD NEw Workers' PORKATE Compensation CERTIFICATE OF ST Board NYS WORKERS'COMPENSATION INSURANCE COVERAGE I a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured (845)268-5170 Frank J.Tucek&Son,Inc. 92 N Roue 9W lc.NYS Unemployment Insurance Employer Registration Number of Insured Congers,NY 10920-1730 Work Location of Insured(Only required if coverage is specifically 1 d.Federal Employer Identification Number of Insured or limited to certain locations in New York State, i.e.a Wrap-Up Policy) Social Security Number 133300128 2.Name and Address of Entity Requesting Proof of Coverage(Entity 3a.Name of Insurance Carrier Being Listed as the Certificate Holder) Continental Indemnity Co. Village of Rye Brook 3b.Policy Number of Entity Listed in Box"la" 938 King Street 46-867891-01-13 Rye Brook,NY 10513 3c.Policy effective period 04/01/25 to 04/01/26 3d.The Proprietor,Partners or Executive Officers are ® included.(Only check box ifall pannerstofficers included) all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"T'insures the business referenced above in box"la"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"T'. 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 tights 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: Todd Brown (Print name of thorized representative or licenced agent of insurance carrier) 05/20/2025 Approved by: �i-� (Signature) (Date) Title: Authorized Representative Telephone Number of authorized representative or licensed agent of insurance carrier: (877)234-4424 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