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HomeMy WebLinkAboutBP25-126PERMIT # SECTION ,77 TYPE OF WORK 10B LOCATION CONTRALTO TCO � FEE DATE �6 DATE: �0 5 �� OR _._ BLOC LO1.r / DATE INSP FOOTING FOUNDATION FRAMING cv/y1)Vj /3 3 8 OTHER APPROVALS ARB BOT P8 ZBA OTHER RGH FRAMING INSULATION I' G S�`alb Vltr��OIV11 jaw PLUMBING 0 O' O"0l'OZ 1 RGAS 6jtqa GH PLUMBING �' rV US eroL4 SPRINKLER � /O' o- / ELECTRIC �.��/cz Low -VOLT ALARM LYJ S AS BUILT C7 FINAL Pr:z) 2c, jq /c�o�X Cor�l,u�r ir��an S ra (AP0 ::i -�e /,si 9,;; C�_ cc Lie VILLAGE OF RYE BROOK WESTCHESTER COUNTY, NEW YORK NO: 25-139 (Certificate of ®ccup ucp This is to certify that /l QQ 6'k? of, sp-0(0 y , having duly filed an application on OC�Q r S, 20 a5 requesting a Certificate of Occupancy for the premises known as, � � / O`/ Vl , Rye Brook,NY, located in a UB / Zoning District and shown on the most current Tax Map as Section: 4- •?/ Block: J Lot: and having fully complied/with the requirements of the Building Code and the Zoning Ordinance under Building Permit No.�5 i��(�, issued Cy 5 20 a5, such authority and permission is hereby granted to the property owner to lawfully occupy or use said premises or building or part thereof listed under the following New York State Classifications, Use: &Slnonr y �,r� — Construction: (� for the following purposes: )'7 d Subject to all the privileges, requirements, limitations, and conditions prescribed by law, and subject also to the following: This certificate does not in any way relieve the owners or any person or persons in possession or control of the premises, building,or any part thereof from obtaining such other permits or licenses as may be prescribed by law for the uses or purposes for which the building or premises is designed or intended. Furthermore, it does not relieve such owners or persons from complying with any lawful order issued with the object of maintaining the premises or building in a safe and lawful condition. No changes or rearrangement in the structural parts of the building or in exit facilities shall be made, and no enlargement, whether by extending on any side or by increasing in tAig4t sh ade,n r shall the building be moved from one location to another until a permit to accomplish such change Xas be obtain fro he ing Inspector. Building Inspector,Village of Rve Brook: Date: NOV 0 3 2025 yE DR . 19 L� VILLAGE OF RYE BROOK MAYOR 938 King Street,Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A.Klein (914)939-0668 Christopher J.Bradbury www.ryebrook.org TRUSTEES BUILDING & FIRE INSPECTOR Susan R.Epstein Steven E. Fews David M.Heiser Donald T.Krom,Jr. Salvatore W. Morlino CERTIFICATE OF COMPLIANCE November 3,2025 1100 King Associates LLC 4 International Drive Suite 300 Rye Brook,New York 10573 Re: 6 International Drive,Rye Brook,New York 10573 Parcel ID#: 124.81-1-1 This document certifies that the work done under Mechanical Permit#25-116 issued on 7/29/2025 for the modifications to the existing HVAC system has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to BRA 4 t Gti VJJ v Gl, H4 VyJ� VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury www.ryebrookny.g_ov TRUSTEES BUILDING & FIRE INSPECTOR Susan R. Epstein Steven E. Fews David M. Heiser Donald T.Krom,Jr. Salvatore W. Morlino CERTIFICATE OF COMPLIANCE November 3,2025 1100 King Associates LLC 4 International Drive Suite 300 Rye Brook,New York 10573 Re: 6 International Drive, Rye Brook,New York 10573 Parcel ID#: 124.81-1-1 Mechanical Permit#25-120 issued on 8/4/2025 for Fire Sprinkler System Modifications This certifies that the fire sprinkler heads,installed under the above captioned permit,have been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to �" For office use onl . D BUILDIEATMENT PERMIT# — a VIL%""'�� YE OF RYE U*,OOK ISSUED: — OCT 2 8 2025 38 KING STRE BROOK, Ww YORK 10573 DATE:9 -06 O� FEE: PAIDVILLAGE OF RYE BROOK ov BUILDIt�jc� nFPARTMEN 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 ►i!#►i#►###!4#krtrtrtk#iiit#►iki`t!►i#4#►#�4t#44kk#iiiti►itiiitii#►ii4##4####rt#4iiiiit►t#kti►it#iii#444k444rt#i4#4trt►►i#ttiti!### Address: QOccupancy/Use: ' - Parcel ID#: 2 Zone: 1 Owner: G Address: P.E./R.A. or ContraciorX Address: Person in responsible charge: Address: 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: LL l Il�lbeing duly swom,deposes and says that he/she resides at (PrintNade otAApp_liccaW) (No.and Street) in 1'S/(�l - in the County of_ �C 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:$ gco O� for the construction or alteration of: y2� 17 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-IO.A.of the C de of the Village of Rye Brook. Sworn to before me t is Sworn to or me this 1 day of , 20 )' day of 120 ;;z Signature of Property Owner natu a pplicant W.S. KeILAAW T-OLS Pr4F cc-sMf- Print Name of Property Owner Print Name of Applicant Notary Public - fiANY� Notary Public NOTARY PUBLIC STATE OF NEW YORK WESTCHESTER COUNTY 6 1 2024 LIC. 0 14 COMM.EXP. QyE,DRC�� w � Ix • 1982 BUILDING DEPARTMENT ❑B DING 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 : �� `.+ }c�U q, l_'�✓ i 1�� DATE:_1%O PERMIT# \ Al.�� (��o_ _ ISSUED:&J'Lr SECT: •� BLOCK: LOT: I LOCATION: y C �/p� t� U 5 J. OCCUPANCY: 0011 ❑ Violation Noted THE WORK IS... 0 PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas /' 0.' �'N5 lee G /J•J p L.P. Gas 51PA �• ❑ FUEL TANK w b OO . � ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ OSS CONNECTION 04OOO" FINAL Ss ❑ OTHER E DRcb, cu � • 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 :_ . _ _ _� V'e ------ DATE: 30" ZOZr PERMIT# tti 26- I ISSUED: SECT: I L y p I BLOCK: I LOT: / LOCATION: 0?y T IOdt� U S.:r_- OCCUPANCY: ❑ Violation Noted THE WORK IS... PASSED ❑ FAILED / REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION VAC n N� Spa ❑ Natural Gas �/ • ❑ L.P. Gas �� ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING / Q_ �n • ❑ CROSS CONNECTION - n-j /� !QO� to 1Y FINAL OTHER QyE DR(8 • 1982 BUILDING DEPARTMENT ❑Z.DING INSPECTOR ^� TANT 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 : .Ty .�gt• v� �e ��, DATE: 07042r PERMIT# 1 _L _"_� 7C_ __ ISSUED: SECT: Z I BLOCK:LOT: _ LOCATION: �� I" IO(I'L �U •� • OCCUPANCY: ❑ Violation Noted THE WORK IS... PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas ❑ L.P. Gas S ❑ FUEL TANK v c>-, FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER i oor �!b � M � •� Q SZ • n 1. co OOL 031 ..,.fir • ' • r� 150 100 • --50 250ION -� U AM VWA TER 300 PSI V Qy� BPI O � Village of Rye Brook Building Department-Inspections 938 King St Rye Brook,NY 10573 1 Phone:(914)939-0668 1 Fax:(914)939-5801 1982 FINAL INSPECTION Permit number: RB 25-0027 Permit type: Plumbing— Remodel—New Fixtures and Lines Municipal address: 1100 KING ST Legal address: Status of inspection: Completed Issue date: 08/05/2025 Deficiencies No deficiencies or remarks noted. Visits VISIT DATE •• VISIT RESULT SITE CONDITIONS Alfredo(Freddy)DiVitto 10/30/2025,2:23 PM Alfredo Passed FINAL INSPECTION Parties NAMEANDCOMPANY CONTACTROLES Tanyia Summa 6 International Drive,Rye Brook Property owner 12100 King Associates LLC +19149341338 Chris Cannizzo 523 Commerce Street,Hawthorne Applicant,Plumber Licensed Professional Grotto Plumbing Inc. +19144766659 B P, O 2� Village of Rye Brook �I Building Department-Inspections 938 King St Rye Brook,NY 10573 1 Phone:(914)939-0668 1 Fax:(914)939-5801 99b2 ROUGH PLUMBING Permit number: RB 25-0027 Permit type: Plumbing— Remodel— New Fixtures and Lines Municipal address: 1100 KING ST Legal address: Status of inspection: Completed Issue date: 08/05/2025 Deficiencies No deficiencies or remarks noted. Visits VISIT DATE INSPECTOR VISIT RESULT SITE CONDITIONS 08/11/2025,2:23 PM Alfredo(Freddy)DiVitto Passed ROUGH PLUMBING +19149390668 Parties NAME AND COMPANY • ROLES Tanyia Summa 6 International Drive,Rye Brook Property owner 12100 King Associates LLC +19149341338 Chris Cannizzo 523 Commerce Street,Hawthorne Applicant,Plumber Licensed Professional Grotto Plumbing Inc. +19144766659 QyE BRC��, w � �r BUILDING DEPARTMENT ❑B DINGINSPECTOR 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 - - - - - - - - - - - - - - - - - - - - _ - Q ADDRESS : �- -�y CA v C�,J� / A 1 I�Q1__ DATE: !— Aa Z PERMIT# _t_Z J I I_1p ISSUED: SECT: L4 BLOCK: I LOT: LOCATION: _ 2 _N_ Vc7Q� Z OCCUPANCY: ❑ Violation Noted THE WORK IS... {PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas ❑ L.P. Gas L ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL 1011"O'I'HF.R /�.� A •�� C Maw O Zm w � �c �O BUILDING DEPARTMENT ❑BUILDING INSPECTOR J;;ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 Kilig Street • Rye Brook, NY 10573 (914) 939-0668 FAx (914) 939-5801 www.ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : ,J _ - I V 2 O 2f �`1�A.J� �� �(✓'e - - DATE: / Q PERMIT#�. �_' t L� _ ISSUED:,__ __ _ _SECT': IZ4.8 ( BLOCK:_ LOT: LOCATION: ,.1 __ P)oo-t— lk_g= -, _ OCCUPANCY: ❑ Violation Noted THE WORK IS... PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas p u ' ❑ L.P. Gas ❑ FUEL TANK FIRE SPRINKLER y y T Q,a4 ❑ FINAL PLUMBING `_/ ❑ CROSS CONNECTION �d •LI C C`� ❑ FINAL ❑ OTHER AOL� Aw e Nee PLC y fN r" 4t� QyE BRC�� w � 198'2 BUILDING DEPARTMENT ❑BUILDING INSPECTOR E 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.ore - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - ADDRESS : • ' l ` - Lutf,.����ava..Q �j/� DATE: -1 PERMIT# V1_Z,5-' 2�0 ISSUED:___ SECT: �27•� r BLOCK: / LOT: / LOCATION: O�(�•+ u02 _U'c6►Z__ OCCUPANCY: 1-017 ❑ Violation Noted THE WORK IS... J? PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION n 11 ❑ Natural Gas ❑ L.P. Gas ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL .0—OTHER LI 0 m()l11)'iJWm07SS0w[) El 'winwrld ivmltl. ❑ C7�1 no MMVIAM El 5 a-I o NO!)PURP-Im 0 ,)Mwv-d.4 a-Moll rj 9NIMNIVIij WOLLMSM No N'ttj,()N 519YRIVNI(I"Mizootl ❑ Qaxlnaag MOLIDIMUNI MOULDRdSMIZU GaIlVa --'%, I"(M H-11j, PION 110118101A D 1100�— flu, wou'vao'l aj.v(l - - - - - - - - - ----- - -- - - - -taocuaj[ - - - - - - - - - - - -- -- - - - - - TORS-6C6(M)X-VA W-)K)0-6V6 W16) CLOT AW-T)OAP111 8C6 AGO, ❑3100HR aAH AO 99VIIIA INam"da(j E RRC��� O� 2m 1989 BUILDING DEPARTMENT' 0AWSTAM UU M)IN«INSPECTOR VILLAGE OF RYE BROOK p CODU JIJWORCIJMJ(M,0BPI1;ItIt 938 Killg SlrLN--t*Rye Brook,NY 10573 (914)939-0(►6R F�M(914)939-5801 www_gmkrook.o ru _ - - - - - - - INSPECTION REPORT - - - -- - ---- - - - - - - - - - - AmrmEss: =N p-fir , v0.X '-O e ;Ve. DATE:_ ZO?r PERMIT#_�Q ZS-��? _IssU131):,}?-tiS-Z f � � /Z y. o°/ BLOc.R•�_LOT: LOCATION: G, N _ -- OCCUI.ANCY ❑ Violation Noted THE WORK IS... (] .MASSED t{Y FAILED /REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE O FoUrn).n rum ❑ UNDURGROW41)PLUMBING NOTRS ON INSPECTION: ❑ ROUGH PI,11MIJIN(. ❑ ROUGH FRAMING ❑ INSULATION ❑ I.P.Gms I ❑ FIRE tiP1tINTT.1tlt. �— ❑ PiNA.I,PLUMBING ❑ CROSS CONNECTION ----T �_ 0 FINA.I, p (.)TiIER 198-7 BUILDING DEPARTMENT 0 PlyXIDING INSI-Itc-roat VrA4..%jf;9'AWr RMjj)jNgj IN8PEGfOR Vll,LA.GJF, ou RYE BROOK 0 COOK EN)FORCEWNT 011FICIM 938 King Slj*tvt-Ryc Brook,NY 1.0573 (914)939-0668 FAx(914)939-580:1 www.x,y!pl-)xo-P-L-= - - -- - - ---- - - - - ----- - - INSPECt'.10N REP0'RT - -- - - - - - - -- - - - ai 4r-r#,3 A -...7✓r-� Ae., DATE:—8 - a PERMIT# BLOCK:--1 LOT' __L Loc,&rioN. v, OCCUPANCY: 0 Violation NoW 'rHE WORK IS... PASSED 0 FAILED RE-INSPECTION 0 SITE INSPECTION REQUIRED 11 Foo-rrm; 0 FOOTING DRAINAc.E 11 Foumm-noN 0 UNDURGROTTNIP Plr.UMJJj.N(j 'N(-Y]rJ'.S ON INSPECTION: 0 ROUGH J."LITHIIING )2rltOU`GH FRAMING 11 INSULATION 0 Nidund c-orils d /00 0 L.P.Gas 11 UUELTANK 0 FIRE sPRxNw. jjKx 0 FmAj,PLumj;j[N(., 0 CROSS CONNECTION ❑ FINA1, OTHER S ►qeq N w Lin • ►fir N o y : 7•4 _ Q �q o W u [- : / LnCU ICI I.i Q ^ ',' •+ 01.1 r , y o - V Q W ' cn 1 v V G 0. y °° `'T c O N O i M c~n © a �{ 00 14 p a s Q . ...� +a � V W QO ^ �-1 `n W Q A Q o Y o U CN ID o A00 V o � � � W N o _ CN ci a 0 v as lu © z V H ° p L �-+ H 44 o O E- z 'OD. 0! a. v �« W O Uq ate . y q v Mai zWz H 0 z W 3 z U w 08 o _ C7 A z O aw, v' av o MCI Z 0-4 o U al z S. BUILD MENT VIL E OF R, OOK ! MAY 2 0 2025 938 KING ET RYE.BR. ,NY 10573 4 -q VILLAGE OF RYE BROOK w ov BUILDING DEPARTMENT INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: UN S l#:���/ ` Application Fee:$ Approval Date: 4 Approval Signature: Permit Fees:$ ZU, ��� Disapproved: Other: Application dated: o , is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Pen-nit for the interior alteration of an existing building,or for a change in use,as per detailed statement described below. 1. Job Address: SBL: 42 +f• � " Zone: _ 2. Proposed Improvement. Describe in detail): C 4vs zvro\g- sb�3 C __q__ =)n d /�J:- ()0 Cc 3. Does the used improvement involve a Home-Occupation as per§250-38 of the Code of the Village of Rye Brook? No: Yes: If yes,indicate: TIER I: TIER II: TIER III: 4. Will the proposed project require the installation of a new,or an extension/modification to an existing automatic suppression system(Fire Sprinkler,ANSL System,FM-200 System,Type I Hood,etc...) :No: Yes: (If yes,please submit a separate Automatic Fire Suppression ZSstern Permit application&2 sets of detailed engineered plans) 5. Occupancy;(l fam.,2 fam.,comm.,etc...)Prior to Constructionft4y fit' After Construction: 6. N.Y State Construction Classification: N.Y.State Use Classification: j 7. Property Owner: //0 14Qdress:42L,"I"Ma 1 .U.C� �1� Phone#k43Y"133� a`s Cell# R/4-l - ((O03 email:? SC2e IYY]Q rjA;T 4 .COW 8. Applicant: t `� Q Address: Phone# Cell# email: 9. Architect: Address: Phone# Cell# email: 10. Engineer: Address: Phone# Cell# email: 11. General Contractor: Address: Phone# Cell# email: 12. Estimated cost of construction $ f�00, y0o O (NOTE:The estimated cost shall include all labor,material,scaffolding,fixed equipment,professional fees,and material and labor which may be donated gratis.) 13, Job Timetable: Start: Finish: (l) 6/1/2024 BUILD R MENT D ��7 �J L`� VIL E OF RY\� OOK MAY 2 0 2025 938 KING d ET RYE BR ,NY 10573 4 -0 VILLAGE OF RYt BROOK w ov BUILD NG, nFrPARTMENT 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 OFF NEW YORK, COUNTY 9F WESTCHESTER ) as: I, .414444�AWh� �AtiS�'�'sidi�ng at, Jai R*+M1rrh..bq�4 &PA� (Print nanrel (Address where you life) 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; e- /'&S? , Rye Brook,NY. (Job Add 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 `Tillage Codes. (Signature of Property Owncr(s)) Ex�o K_ti!!� S ItiES. LAC (Print Name of Props OwnCr(s)) Sworn to before me this /C? day of . 20 TVyY4A f,OTARY PLSUC STATE OF NEU"1 YGny, I #L, fCHEGTr_R l:00l Ty 11 (Kota ublic) L C? Ek_P... _. (2) 6/1/2024 r This application must be properly completed in its entirety and must 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. STATE JU NEW YOR OU OF WESM F�ER ) as: �l1•S•_ 1 �. to ring duly sworn, deposes and states that he/she is the applicant above named, (print name of individual sig ng 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 —A6T u _ _ 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. 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 Sworn to before me this day of , 20-' day of , 20'Z 2MW AVC� L� � azure of Prop y Owner ignalure o ant . Cw-% A*Nk K gla. Print Name of Property Owner Lot) M9 We— Print Name of Applicant T � Jal� Notary Poblic Notary Pub1 TANYVI$tMAA i hOTARy plj%le STATE Or-1 V'1 YCt1K I Vr-",TCHEGTEH CO>rl,�TY LIC.# d3U 0221 (4) 6/1/2024 _ ` 000 ` ~ N N W Ee s A N N N W o 0 u W = F. vi w O A W GG L p w "C7 Z. 0 x Q z z m F - ` O v r _ E, OcPLO 74 U � M � M W U — 6iLT]E C j s r 00 • Z ( (, z °: x ? uZ can � I; z z w w �; W CN 0-4 °° CN V w = O z od V O W z a � ►z w ° z a o CA M. A a z Q R. 0 BR BUIL EL MENT VIL E OF RYE OK JUL1 1 2025 938 KIN > ET RYE B ,NY 10573 �_� VILLAGE OF RYE BROOK v BUILDING DEPARTMENT ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY BP#: EP#: ��— / o� Approval Date: JUL 17 Z Permit Fee: $ IQS- Approval Signature: Other: ************************************* * *** ***************************************************** DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDING INSPECTOR. THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12%OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00 Application dated, 7/11/25 is hereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of a Permit to install and/or remove electrical equipment,wiring, fixtures,or to perform other high or low voltage electrical work as per the detailed statement described below. By signing this document, the applicant & property owner agree that all electrical work performed will be in conformance with all applicable Federal,State,County and Local Codes. 1.Address: 6 International Drive -Kingsbrook Office Park SBL: 124.81-1-1 Zone: 2.Property Owner: 1100 King Associates LLC Address: 1100 King Street Phone#: 914-934-1338 Cell#: email: 3.Master Electrician/Licensed Installer: James New Address: 1 Zeiss Drive-Thornwood,NY Lic.#: 275 Phone#: 914-428-1010 Cell#: 914-447-5021 email: inew(c�healy-electric.com Company Name: Healy Electric Contracting Address: 1 Zeiss Drive-Thornwood,NY 4.Proposed Electrical Work/Fixture Count: Interior Tenant Fit-Out; 2nd Floor, "USI". Electrical and Fire Alarm Wiring to include: (100) LED fixtures, (8) exit sigs, (29) occupancy sensor, (38)duplex receptacle, (4)GFCI, (1) flo r outlet, (5)VAV,(1)water heater, (1)heat pump, (1) exhaust fan, (1) 60A 120/208V circuit breaker panel, (41) smoke detector, (8) above ceiling smoke detector, (1) door control relay, (6)horn/strobe, (6) strobe, (1)booster 5.31 Party Electrical Inspection Agency: 115A)l S STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: .2A*1 f S ,being duly swom,deposes and states that he/she is the applicant above named,and does further (print name of individual signing as the applicant) state that(s)he is theM c jj d" 0.1 A for the legal owner and is duly authorized to make and file this application. (Master Electrician/Licensed Installer) The undersigned further states 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 .•��PM F0/q Sworn t o e me this day of ,20 STATE 41 ' day of 20 z OF NEW YORK'% Signature of Property Owner f o 'NOTAR_y p�B�I�'; N re of Applicant t. Qualified in ? a l Westchester county; a Print Name of Property Owner J,�,01 FO629518 t°'•��` FXPIRESN��.�`',.. P of p n utNotary Public 6/1/2024 STATE WIDE INSPECTION SERVICES, INC." Service Wilh Integrity ••• • • SWIS JOB APPLICATION •2.7224 1 fax 914.219.1062 1 SWISNYcoml SWISTRAINING.COM Office Use Elect, Permit# l� — �. Date Bldg Permit# Awl-) S Sq Ft Plumbing Permit# Final Certificate# City/Village Zip Building Dept. / �e� County Address Cross Street Section Block Lot Owner Name/Address(If different than above) Contact Number /V- y41-7_ S Z ❑Basement ❑ 1st FI. [02nd FI. ❑3rd FI. ❑More Than 3 FI. ❑Garage ❑Attic ❑Outside ❑Residential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C/0 Detector Hood Trash Compact Amt Amps Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer switch // D SERVICE Amperage #Panels 1P 3P # Meters # Disconnect ❑Underground ❑ New ❑ Reconnect ❑Repair ❑Overhead ❑ Upgrade ❑ Disconnect Utility ID# [gCon Ed ❑ NYSEG ❑Central Hudson ❑ Orange/Rockland PHOTOVOLTAIC SYSTEM PV Modules Inverters AC Disconnect Junction Box Combiner Box Load Center PV Monitor Energy Storage System DC Disconnect ❑Legalization ❑ Safety Inspection ❑Consultation A C T e✓4 /1 t Vv d�✓ � G i` J U L 11 2025 VILLAGE OF RYE BROOK BUILDING DEPARTMENT This application is valid for one(t)year from the date received by SWIS.This application is Intended to cover the above listed items to be inspected,if at any time of Inspection additional items have been installed,you are authorized to make the inspection and adjust the fee for the additional items inspected.The applicant declares that there is no open applications for the above address with any other Inspection company.The applicant, owner or authorized agent agrees to all the above terms and conditions as set forth for the application. Email Address 3fl)eLA/00 _ c a t Namejyf License# J Date 7, 1/2J— Signature .� Address `7�/SS UiC 7 L o"N w C 6e City/State / Zlp Code 9 J I Company Q ECGc C �tf�z ,�' 1,r4r Phone State Wide Inspection Services D n 1080 Main Street v Fishkill, NY 12524 ,"7 U S ID 845 202-7224 Phone OCT 2 4 2025 914-219-1062 Fax STATE WIDE INSPECTION SERVICES Email: off ice(&swisny.com Service With Integrity VILLAGE OF RYE oRCOK Website: www.swisny.com BUILDING DEPARTMENT BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: Healy Electric Contracting Inc Name 1 Zeiss Drive 6 International Drive Thornwood, NY 10594 Rye Brook, NY 10573 Located at: 6 International Drive, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP25-182 124.81 1 1 Certificate Number: 2025-6139 Building Permit Number: BP25-126 A visual inspection of the electrical system was conducted at the Residential occupancy described below.The electrical system consisting of electrical devices and wiring is located in/on the premises at: 6 International Drive, Rye Brook, NY 10573 The Second Floor Conference Rooms, Cubicles, Break Rooms,and Electrical Room were inspected in accordance with the NYS and NFPA 70-2017 and the detail of the installation, as set forth below, was found to be in compliance on the 17th day of October 2025. Name Quantity Rating Circuit Type Luminaires 60 Exit Lights 08 Occupancy Sensors 15 Duplex Receptacles 38 GFCI 04 Floor Receptacles 02 Circuits 15 20 Amp Electric Water Heater 01 Heat Pump 03 Name Quantity Rating Circuit Type Exhaust Fan 01 Smoke Detectors 41 Visual Inspection Only; Not Tested by SWIS. Horn/Strobe 06 Strobe 06 Officer: Frank J. Farina This certificate may not be altered in any way and is validated only by the presence of a seal at the location indicated.This certificate is valid for work performed on the date of inspection only. Page 2 M � 00 .--i N N W N N a W F ► v. a w ol 0 to il a l Gr: oG ►"`i _ Gi x W " z p O > N ^ U W 0-444 44 � z cc u zx � � � MCI M � ~ J W I F,• 00 99 W v? as z z a Z .�.., w Ln o ZU D z z Ra S � I BUILDING DEPARTMENT JUG 15 2025 VILLAGE OF RYE BROOK 938 KIN-G STREET RN'E BROOK. NY 10573 VILLAGE OF RYE BROOK (914) 939-0668 FAx(914)939-5801 BUILDING DEPARTMENT uw��.rvebruulc.ur�� —__ _ . ELECTRICAL PERMIT APPLICATION «'estchester Count. Master \Electricians License Required l 1� Approval gate: JUL 1 7 2025 Permit Fee: S Approval Signature: Other: Disapproved: (fees are non-refundable) *#�It�k�k�k##�k�k�k+k�k#fit Y��K7ft,K A��R�K�k�K Application dated, /' 3� is hereby made to the Building Inspector of the Village of Rye Brook NY. for the issuance of a Permit to install and or remove electrical equipment, xkiring. fixtures ,or to perform other high or low voltage electrical work as per the detailed statement described belcm. The applicant & property rntiner, by signing this document agree that all electrical work performed,will be in conformance with all applicable Federal. State.County and Local Codes. p 1.Address:( 0 1 al4tcnal st, 2" "'"' SBL: ! a�� a —� / Zone:66-� 2.Property Ovvner: lOO�/.�l�i/`T-SSQG1 q-/e-S Address: Phone;-: 9/4g3 )-j 3,5.a Cell : email: 3.Master Electrician: Address: Lic.=: Phonew: VA-1 ` bn Cell email: '�1 ^ '_ �/� Company Name: f ddress: 1Lt(I j�'bCN 17`�� -I 4.Proposed Electrical Work Fixture Count: STATE OF NE« Y'ORK. COUNTY OF�a/�1 V�C ) as: e c �<� � JLM( -1 1 ',A- being duly sv.-orn.deposes and states that he:sire is the applicant above named.and does further sprint name ofindk iduat signing as the applicant) CA 1 state that(s)he is the legal owner of the propen} to which this application pertains,or that(s)he is the l .l�`�1 ( for the legal owner and is duly authorized to maize and file this application. (indicate architcc%contractor,agent,attorncn•.etc t The undersigned further states 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 properi%will be in conformance with the details as set forth and contained in this application and in any accornpanying approved plans and specifications,as well as in accordance with the New fork State Uniform Fire Prevention&Building Code.the Code of the Village of Rye Brook and all other applicable laws.ordinances and regulations. Steorn to before me this Sworn to efore me this day of 20 day of . 20 Signature of Pro erty Otyner ti'_ ire of. li t p A 1 Up �VMMd� Print Namc of Property Owner i Nan of A 'cant Notary Public [Registration IMBERLY J ,6fJi►irblic PUBLIC,STATE OF NEW YORK No.01JA6324279 alified in Bronx Countyission Expires July 11,2027 STATE WIDE INSPECTION SERVICES, INC. Service With Integrity ••0 • • SWIS • B APPLICATION tel 845.202.7224 1 fax 914.219.1062 1 SWISNYcoml SWISTRAINING.COM Office Use Elect. Permit# ' Date Bldg Permit# !� � —/ Scl Ft Plumbing Permit# Final Certificate# City/Village `�1 DA,� Zip Building Dept. County Address e ^ ��, Cross Street Section Block Lot Owner Name/Address(If different than above) Contact Number ❑Basement ❑ 1st FI. ❑ 2nd FI. ❑3rd FI. ❑More Than 3 FI. ❑Garage ❑Attic ❑Outside ❑Residential [—]Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C/0 Detector Hood Trash Compact Amt Amps Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer Switch SERVICE Amperage #Panels 1P 3P # Meters # Disconnect ❑Underground ❑ New ❑ Reconnect ❑ Repair ❑Overhead ❑ Upgrade ❑ Disconnect Utility ID# ❑Con Ed ❑ NYSEG ❑Central Hudson ❑ Orange/Rockland PHOTOVOLTAIC SYSTEM PV Modules Inverters AC Disconnect Junction Box Combiner Box Load Center PV Monitor Energy Storage System DC Disconnect ❑Legalization ❑ Safety Inspection Consultation ID r I Jf UL 15 2025 VILLAGE OF RYE BROOK I BUILDING DEPARTMENT i This application is valid for one(1)year from the date received by SWIS.This application is Intended to cover the above listed items to be inspected,if at any time of inspection additional items have been installed,you are authorized to make the inspection and adjust the fee for the additional items inspected.The applicant declares that there is no open applications for the above address with any other inspection company.The applicant, owner or authorized agent agrees to all the above terms and conditions as set forth for the application. Email Address j CAM A �� 4 t I�(Y'r Name M,n p License# Date Signature Address Q rr) W<< t P`A C' , v F City/State V Zip Code r , �` I7 !�' Company {or l f11\'\�f^' l 1 ��<� L Phone# ! t•' - b 1 State Wide Inspection Services '�% 1080 Main Street L�V v Fishkill, NY 12524 845 202-7224 Phone OCT 2 7 2025 0 914-219-1062 Fax STATE WIDE INSPECTION SERVICES Email: office@swisny.com VILLAGE OF RYE BROOK Website: www.swisny.com Service With Integrity BUILDING DEPARTMENT BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTI FI ES THAT: Upon the application of: Upon Premises Owned by: Telworx Communications 1100 King Associates LLC Kimberly Jackson 6 International Drive 800 Westchester Avenue N-347 Rye Brook, NY 10573 Rye Brook, NY 10573 Located at: 6 International Drive, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP25-183 124.81 1 1 j Certificate Number: 2025-7454 Building Permit Number: BP25-126 A visual inspection of the electrical system was conducted at the Commercial occupancy described below.The electrical system consisting of electrical devices and wiring is located in/on the premises at:6 International Drive, Rye Brook, NY 10573 The Second Floor: Offices and Cubicles were inspected in accordance with the NYS and NFPA 70-2017 and the detail of the installation, as set forth below, was found to be in compliance on the 241h day of October 2025. Name Quantity Rating Circuit Type Voice/Data Cables 111 Y Officer: Frank J. Farina This certificate may not be altered in any way and is validated only by the presence of a seal at the location indicated.This certificate is valid for work performed on the date of inspection only. s s w c N o• a '� a N N M i E PIE MOD dd p b u W w W _ t 10, `^ ry 4 �4/ _� � ^ O I♦•a� � `� O �: Cad - v o .S Q� T a'd : 0o0 w v C i - a T� w 0 ~ ? 7 C '5 v. d - Q f " _ � ^ w � � orw .. Wr ' � C � � ►� v� �• ,n w � ,9 p � � Z en CA cz w Q _ F O N CQ Z z a o y 10.V ll O Ur = 5 N pC O F p W W z w 28 F- N z � cn 0 Ca G a A a w a x „ .5 GT BUILDING DEPARTMENT D �� � O�n VILL'AC*E OF RYE BROOK V E D 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 Fug 8 2025 ",imryebrookny.gov VILLAGE OF RYE BROOK BUILDING DEPARTMENT APPLICATION FOR PERMIT TO INSTALL AND/OR EMOVE HEATING, VENTILATION AND/OR AIR CONDITIONING EQUIPMENT FOR OFFICE USE ONLY: PERMIT #: Approval Date: Hil 2 1 2025 Permit Fee: $ Zr Approval Signature: XA_& � Other: Disapproved: (fees are non-refundable) ,t,t,re,r,r,r,r******rw•,t,r t♦****wtr,t,t,t,t,r**,►*•****,t,t•*+t**tt*,r,r,rw*,r,r,r,►**,t,r**,r,r,r,r,e,r,r,r,►,trrs,r*,r*****to*tr,r,r,r,r,r*,r,r,rrrt*w,r,r DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDING INSPECTOR.THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12% OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00 REQUIREMENTS FOR RELEASE OF PERMIT&CERTIFICATE OF COMPLIANCE: 1. Properly completed& Signed Application. 2. Site/Staging Plan if Required by the Building Inspector. 3. Copy of Licensed Contractor's Liability Insurance. (Village of Rye Brook must be listed as certificate holder) & Workers Compensation Insurance on a NYS Board form(Form#C105.2 or Form#U26.3/or NY State Workers Compensation Waiver) 4. Payment of Fees/Unit: RESIDENTIAL= $200.00/unit • COMMERCIAL= $450.00/unit. 5. Complete specifications for each unit being installed. 6. Inspection by the Building Department for removal and/or installation. (48 hour notice required 7. Electrical work requires a separate Electrical Permit&Electrical Inspection. 8. Plumbing/Gas work requires a separate Plumbing Permit& Plumbing Inspection. Application dated, 11j 1'L—is hereby made to the Building Inspector of the Village of Rye Brook for a permit for the installation and or removal of the HVAC equipment as listed below.The applicant and property owner,by signing this document agrees that said equipment will be installed and/or removed in conformance with all applicable Local,County, State&Federal laws, codes,rules and regulations. 1. Address: 6 tc.(adrig&% VC;Vt. SBL: IVA 11— 1.1 Zone: 2. Property Owner: Address: Phone#: Lawk Cell#: email: 3. Contractor:SSW —� w� Address: tb sox MA NN0114 Phone#: Cell#: (765)6161•5%03 email: Amm AVs%0 4. Scope of Work:New Installation •Replacement( )•Removal( )•Other( ): J w `to 5. List Equipment: M& wccy. A.tSpG:ifflA tJ*1 9? U-tl6 �UtAiJop% o4 4SW LI) A%,w %joA (Uutm QuW . INS&%\ &A tl`tuj, d++t3<<.�ek �L•t e�� 1�, SOrGCt• v� N.W d►i-�vsuS. 6. Location of Equipment: 014 VAppr %JWs 7. Method of Installation/Removal(list all equipment needed to perform job): S,,k ;" -to %� �* V 1 Q• y oM w�tin umsk-Qik 04. Awt bkad COd„ JsR. is a(s au u Fr t 6/1/2025 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: -16st4,An y0oasoce __,being duly sworn,deposes and slates that he/she is the applicant above named, (print name If individual signing as the applicant) and further states that(s)he is the Heating, Ventilation and/or Air Conditioning Contractor for the legal owner and is duly authorized to make and file this application. 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 efore me this Sworn to before me this `1 day of .20 2- day of__SJ iY ,20-L 5 Ur. 'Signatur-i'trProperty Owner Si ti lure of Applicant �", ,,4-6c,6 rini Name of Prope Owner Print Na f pelican Notary Public Not Stl�r i � P N E R TANYIA SUMMA ��`\�'�� .TA q y NOTARY PUBLIC STATE OF NEW YORK 'NO.O1 CU6367294';?� WESTCHESTER COUNTY U t QUALIFIED IN :O MOLOM14 — :DUTCHESS COUNTY: GI COMM. EXP. COW. �'•, t 1-t3-2025 PUBt��. yp�`•�� This application must be properly completed in its entirely and trust ui till Hzed 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. b a 2 6/l/M �1 W 3 O N O tt fN 00 OG v 19 r CL �^ PL I� P y 40cr Fil � 9 cn M ir.1� �^ py T O ✓. y61 O ~/00 ' l%' O ►--1 �r r ► v� " w IR 00 0-0 U Z B ry x C 7 0 c, C o z W E-- 2 z 8 /W Z , a F O .�, V r U fs; Z F o Z .11 cn H '$ p � F $ � a k V Q 0 A 0 CQ . � Lio w z A Q � t; 4 4:t;4:4: J- t;t;�6 fr4Wt:4iV441Vit: • n - D �J V BUILD NG DEPAR ENT VIL E OF RY F,• OOK J U L 2 5 2025 938 MING 4 ET 0 RYE BR ,NY 10573 4 06�$j'� VILLAGE OF RYE BROOK ov BUILDING DEPARTMENT APPLICATION TO INSTALL FIRE SUPPRESSION /FIRE SPRINKLER SYSTEM FOR OFFICE USE ONLY: \� Q Approval Date: 8' 2C 13P": �25-126 MP#: Application Fee:$ CD1-0— -6 Approval Signature: \ Permit Fees:$ Disapproved: Other: Application dated: 07/21/2025 is hereby made to the Building Inspector of the Village of Rye Brook NY for the issuance of a Permit to install or modify a Fire Suppression/Fire Sprinkler System as per detailed statement described below. 1. Job Address: 1100 King Street (6 International Drive) Rye Brook, NY 2nd Floor 2. Parcell.D.. 124.81-1-1 Zone: 3. Proposed Work(Describe system in detail including suppression agent): Relocation of sprinkler heads to existing Wet System 4. Number&Types of Fire Sprinkler Heads: 91 Concealed Heads 5. N.Y State Construction Classification: Business Group N.Y.State Use Classification: 6. Estimated Value of Job:$ 27,800.00 (Value shall include all labor.materials.fixed equipment.professional fees.and materials and labor which may be donated gratis.) 7. Property Owner: 1100 King Associates, LLC Address: Phone# 914-934-1338 Cell# email: 8. Architect/Engineer: Russell Palucci Address: Phone# Cell# email: rpalucci308@gmail.com 9. Sprinkler Contractor: Michael Uszakiewicz Address: 117 Great Hill Road, Naugatuck CT 06770 Phone#475-269-3473 Cell# 860-933-0465 email: me@blaekwatersevicesgroup.com i 6/1/2024 This application must be properly completed in its entirety and must 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. CT tAcYu 4AVI=N SITE 11„ F C UNTY OF S3)JR ) as: (print name of individual signing as the applicant) being duly sworn,deposes and states that he/she is the applicant above named, and further states that (s)he is the Sprinkler Contractor for the legal owner and is duly authorized to make and file this application. 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 beforevne this Sworn to b me this �,�5T- day of {%, 20 day of re ,20 Signature of Property Owner Si ah ppticanr .S Print Name of property Owner IPr nt Name o pplicvi Notary Pabfic No P (Cu ENOTARY Deb Dibner C STATE Oaf NEW YORK �ESTER COUNTY — Notary Public,State of Connecticut 01 14 My Commission Expires 04/3N2029 2 nv I;2024 Contractor's Material and B LACKWAT=2 Test Certificate for Fire Sprinkler SERVICES GROUP LLC FIRE PROTECTION Systems 117 Great Hill Road Naugatuck, CT 06770 This form is to be completed and given to the AHJ,during the final sprinkler inspection. The Forward Test of the Backflow and the Acceptance Testing of the Sprinkler System(See p.2 of this form&the attached memo),will also be performed during the finalsprinkler inspection. Project Name USI Date 9/16/25 Project Address 6 INTERNATIONAL DRIVE RYE BROOK,NY City mnWAeMd r ` State W �J zip al (v AHJ , Installation conforms to accepted plans X Yes ❑ No PLANS Equipment used is approved? X Yes ❑ No If no,explain deviations Has person in charge of fire equipment been instructed as to location of control valves and care and maintenance of this new equipment? X Yes ❑ No If no,explain INSTRUCTIONS Have copies of the following been left on the premises? 1. Record Drawings&System Components Instructions X Yes ❑ No 2. Care& Maintenance Instructions X Yes ❑ No 3. NFPA 25 N/A ❑ Yes ❑ No Maximum time to operate Alarm device Through test connection ALARM VALVE Type Make Model Minutes Seconds or TENANT WORK FLOW ONLY! INDICATOR N/A Year of Orifice Temp. Make Model Manf. Size Quantity rating Victaulic V5606 2025 .5" 91 155 SPRINKLERS Dry valve QOD Make Model Serial# Make Model Serial# DRY PIPE Time to trip Time water Alarm OPERATING through test Water Air Trip point reached test operated TEST connection a bpressure pressure Air pressure outlet bpro erl Seconds psi psi psi Seconds Yes No Without QOD N/A With QOD a Measured from time inspector's test connection is opened b NFPA 13 only requires the 60 second limitation in specific sections Page 1 of 2 Operation Pneumatic Electric Hydraulic Does valve operate from the manual trip,remote,or both stations Yes No Is there an accessible facility in each circuit for testing Yes No DELUGE If no,explain PREACTION Make Model VALVES Detection media Piping Does each circuit operate Does each circuit Maximum time to supervised supervised supervision loss alarm operate valve operate release N/A I release Yes No Yes No Yes No Yes No Seconds All piping hydrostatically tested at 200 psi for 2 hrs If no,state reason Dry pipe pneumatically tested,per NFPA 13 Yes X No Equipment operates properly X Yes No Do you certify as the sprinkler contractor that additives and corrosive chemicals,sodium silicate or derivatives of sodium silicate,brine,or other corrosive chemicals were not used for testing systems or TESTS stopping leaks XYes No Drain Reading of gauge located near water Residual pressure with valve in test test I Supply test connection: N/A psi N/A connection open wide: N/A psi Underground mains and lead-in connections to system risers Other,explain:Tenant work flushed before connection made to sprinkler piping: only! Verified by copy of the Contractor's Material and Test Certificate for Underground Piping Yes No Flushed by installer of underground sprinkler piping Yes No BLANK TESTING Number used: Locations: N/A Number removed: GASKETS N/A CUTOUTS All cutout discs have been removed from all sprinkler piping X Yes No If no,explain: ISCS Welding piping Yes X No If yes: Do you certify as the sprinkler contractor that welding procedures comply with the requirements of at least AWS 132.1? X Yes ❑ No WELDING Do you certify that the welding was performed by welders qualified in compliance with the requirements of at least AWS 132.1? XYes ❑No Do you certify that the welding was carried out in compliance with a documented quality control procedure to ensure that all discs are retrieved, that openings in piping are smooth,that slag and other welding residue are removed,and that the internal diameters of piping are notpenetrated? X Yes ❑No FORWARD TEST Backflow device forward tested at a minimum of the highest Test readings: OF BACKFLOW challenge system demand plus inside hose stream allowance(if (see attached memo) applicable) Yes No psi_N/A gpm N/A HYDRAULIC Placed on system riser(s) Yes X No If no,explain: TENANT WORK ONLY DATA NAMEPLATE REMARKS Date left in service with all control valves open:9/16/25 Name of sprinkler contractor:Blackwater Services Group LLC. Contractor's address: 117 Great Hill Road SIGNATURES City:Naugatuck State: CT Zip:06770 Tests witnessed b Property owner/Agent: I Title: Date: S rinkle contra o : M.Uszakiewicz JR. Title:Owner Date: AHJ Title: 4Ab - Lh G Date:hb-•�o- L SYSTEM RECORD OF COMPLETION Ye�rLe9e Here Form Completion Date:09/18/2025 Supplemental Pages Attached: 1. PROPERTY INFORMATION Name of property:USI Insurance Address:6 International Dr.2nd FI.Rye Brook,NY 10573 Description of property:Commercial Name of property representative: Address: Phone: Fax: E-mail: 2. INSTALLATION,SERVICE,TESTING,AND MONITORING INFORMATION Installation contractor:Healy Electrical Contracting Corp Address:1 Zeiss Dr.Thornwood NY 10594 Phone:914-428-1010 Fax: E-mail: Service organization:Open Systems Metro Address:258 Route 117 By-Pass rd,Bedford Hills NY 10507 Phone:914-241-0057 Fax:914-241-0058 E-mail:service@osmetro.com Testing organization: Address: Phone: Fax: E-mail: Effective date for test and inspection contract: Monitoring organization: Address: Phone: Fax: E-mail: Account number: Phone line 1: Phone line 2: Means of transmission: Entity to which alarms are retransmitted: Phone: 3. DOCUMENTATION On-site location of the required record documents and site-specific software: 4. DESCRIPTION OF SYSTEM OR SERVICE This is a: ❑New system OModification to existing system Permit number: NFPA 72 edition: 4.1 Control Unit Manufacturer:Edwards Model number: EST-3 4.2 Software and Firmware Firmware revision number: 4.3 Alarm Verification This system does not incorporate alarm verification. Number of devices subject to alarm verification: Alarm verification set for seconds NFPA 72(p.1 of 3) ®2018 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution.No other reproduction or transmission in any form permitted without written permission of NFPA.For inquiries or to report unauthorized NF1W use,contact licensing@nfpa.org. SYSTEM RECORD OF COMPLETION (continued) 5. SYSTEM POWER 5.1 Control Unit 5.1.1 Primary Power Input voltage of control panel: Control panel amps: Overcurrent protection: Type: Amps: Branch circuit disconnecting means location: Number: 5.1.2 Secondary Power Type of secondary power: Location,if remote from the plant: Calculated capacity of secondary power to drive the system: In standby mode(hours): In alarm mode(minutes): 5.2 Control Unit m This system does not have power extender panels ®Power extender panels are listed on supplementary sheet A 6. CIRCUITS AND PATHWAYS Dual Media Separate Survivability Pathway Type Pathway Pathway Class Level Signaling Line Device Power Initiating Device Notification Appliance Other(specify): 7. REMOTE ANNUNCIATORS Type Location 8. INITIATING DEVICES Addressable or Alarm or Sensing Type Quantity Conventional Supervisory Technology Manual Pull Stations Smoke Detectors 49 Addressable Alarm Optical Duct Smoke Detectors Heat Detectors 1 Addressable Alarm Fixed Temp Gas Detectors Carbon Monoxide Detectors Waterflow Switches Tamper Switches NFPA 72(p.2 of 3) ©2018 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution.No other reproduction or transmission In any form permitted without written permission of NFPA.For inquiries or to report unauthorized NFFW use,contact IicensingQnfpa.org. SYSTEM RECORD OF COMPLETION (continued) 9. NOTIFICATION APPLIANCES Type Quantity Description Audible Visual 6 Strobe Combination Audible and Visual 6 Horn/Strobe 10. SYSTEM CONTROL FUNCTIONS Type Quantity Hold-Open Door Releasing Devices HVAC Shutdown Fire/Smoke Dampers Door Unlocking Elevator Recall Elevator Shunt Trip 11. INTERCONNECTED SYSTEMS ❑ This system does not have interconnected systems. ❑ Interconnected systems are listed on supplementary sheet 12. CERTIFICATION AND APPROVALS 12.1 System Installation Contractor This system as specified herein has been installed according to all NFPA standards cited herein. Signed: Printed naive: Date: Organization: Title: Phone: 12.2 System Operational Test This system as specified herein has tested according to all NFPA standards cited herein. Signed: Charlie Carpenter Printed name: Charlie Carpenter Date: 09/18/2025 Organization:Open Systems Metro Title: Fire Alarm Tech Phone: 914-467-0676 12.3 Acceptance Test Date and time of acceptance test: Installing contractor representative: Testing contractor representative: Property representative: AHJ representative: NFPA 72(p.3 of 3) ®2018 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution.No other reproduction or transmission in any form permitted without written permission of NFPA.For Inquiries or to report unauthorized NFFW use,contact IicensingQnfpa.org. CAW INC. PROJECT: USI - 6 International TESTING&BALANCING DATE: 10/8/2025 (914)762-9600 PO#: 25-243 Tech Dave R DESIGN ROOM UNIT/VAV NO. SIZE (in.) CFM FINAL CFM VAV-1 8 725 710 1 8 175 171 2 8 175 171 3 8 150 147 4 6 75 73 5 8 150 147 98% VAV-2 10 1200 1210 1 8 200 200 2 8 200 200 3 8 200 200 4 8 200 200 5 8 200 200 6 8 200 200 100% VAV-3 10 1200 1104 1 8 200 184 2 8 200 184 3 8 200 184 4 8 200 184 5 8 200 184 6 8 200 184 92% VAV-4 8 600 630 1 8 150 157 2 8 150 157 3 8 150 157 4 8 150 157 105% VAV-5 10 1200 1290 1 8 200 214 2 8 200 214 3 8 200 214 4 8 200 214 5 8 200 214 6 8 200 214 107% CAW INC. PROJECT: USI - 6 International TESTING&BALANCING DATE: 10/8/2025 (914)762-96W PO#: 25-243 Tech Dave R DESIGN ROOM UNIT/VAV NO. SIZE (in.) CFM FINAL CFM VAV-6 8 800 840 1 8 125 131 2 8 125 131 3 8 125 131 4 8 125 131 5 8 125 131 6 8 175 179 105% WSHP-1 1400 1340 1 10 300 288 2 10 300 288 3 10 400 384 4 10 400 384 96% WSH P-2 400 400 1 12 400 400 100% WSHP-3 1400 1328 1 10 350 332 2 10 350 332 3 10 350 332 4 10 350 332 95% WSHP-4 600 680 1 10 300 340 2 10 300 340 113% WSHP-5 1500 1620 1 10 300 324 2 10 300 324 3 10 300 324 4 10 300 324 5 10 300 324 108% CAW INC. PROJECT: USI - 6 International TESTING&BALANCING DATE: 10/8/2025 (914) 762-96M PO#: 25-243 Tech Dave R DESIGN ROOM UNIT/VAV NO. SIZE (in.) CFM FINAL CFM WSHP-6 1200 1220 1 10 300 305 2 10 300 305 3 10 300 305 4 10 300 305 102% WSHP-7 600 558 1 10 300 279 2 10 300 279 93 Morning Warm-Up Perimeter Diffusers 1 6 75 75 2 6 75 75 3 6 75 75 4 6 75 75 5 6 75 75 6 6 75 75 7 6 75 75 8 6 75 75 9 6 75 69 10 6 75 65* 11 6 75 65* 12 6 75 65* 13 6 75 60* 14 6 75 60* 15 6 75 60* 16 6 75 60* 17 6 75 55* 18 6 75 60* 19 6 75 57* 20 6 75 59* 21 6 75 1 50* 22 6 75 152* *All dampers are wide open EF-1 300 250** **Unable to get tight hood reading with all IT equipment in the space ET�) E cM v � x v <co N I�I � �N a cOin I !; N N Op �O m � � C O BLAC:KWA17=q SERVICES GROUP LLC FIRE PROTECTION R IECEHWE J U L 2 5 2025 -D July 23, 2025 VILLAGE OF RYE BROOK -BUILDING DEPART_ MENT Building Department Village of RyeBrook 938 King Street Rye Brook. NY 10573 914-939-0668 RE: PERMIT FOR INSTALLATION OF FIRE SUPPRESSION SYSTEM Dear Laura, As per our conversation, please find the enclosed application, as well as the check, for 6 International Drive. Please call of email me with questions or hopefully, just a confirmation of receipt and letting me know everything is all set to move forward with application. Thanks 11 again, Deb Nbl ier Blackwater Services Group cell# 203-996-5670 email: debd@blackwaterservicesgroup.com 117 Great Hill Rd, Naugatuck, CT 06770 •04Women-Owned T B�uiildin Permit Check List&Zonis nal A s`* s Address: •! ,V `�C SBL• Zone: Use Const.Type: Other. Submittal Date Revisions Submittal Dates: ' Applicant: tt 1 1 ) � c_t �' S� C Nature of Work �\ : u � 1 - S 0 00 �'-- Reviews:ZBA: 10 P BOT: Other. NEED OK ) Qbl 00 FEES:Filing. C/O: Flood Plane: Legalization: ( ) (TAPP: Dated: Notarized: ' SBL: Truss I.D. Cross Connection: H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening- ) ENVIRO:Long. Shore Fees: N/A.- SITE PLAN:Topo: Site Protection S/W Mgmt.: Tree Plan: Other. ( ) ( ) SURVEY:Dated: Current: Archival- Sealed: Unacceptable: ( ) ,( PLANS:Date Stamped: ✓ Sealed: 'Copies: ✓ Electronic Other. License: Workers Comp: Liability. Comp.Waiver: Other. �( ) ) CODE 753#: Dated: N/A: ) HIGH-VOLTAGE ELECTRICAL:Plans: Permit N/A: Other. ( ) LOW-VOLTAGE ELECTRICAL:Plans: Perot: N/A: Other- FIRE ALARM/SMO�j DETECTORS:Plans: Permit: H.W.I.C.:_Battery._Other. ( ) PLUMBING:Plans: ✓ Permit: Nat. Gas: LP Gas: N/A/: Other. ( ) FIRE SUPPRESSION•Plans:�G N/A: Other. ( ) H.V.A.C.: Plans: ✓ Permit: N/A Other. ( ) ( ) FUEL TANK:Plans: Permit: Fuel Type: Other. O O 2020 NY State ECCC: N/A: Other. ( ) ( ) Final Survey Final Topo: RA/PE Sign-off Letter. As-Built Plans: Other. ( ) ( ) BP DENIAL LETTER: C/O DENIAL LETTER Other. ( ) ( ) Other. ( )ARB mtg.date: approval- notes: ( )ZBA mtg. date: approval notes: ( )PB mtg.date: approval notes: REQUIRED EXISTING PROPOSED NOT'F_4 APPROVED Area. ps._. JUN A Circle: Fronta e Front: Front: Sides: Rear. Main Cov: Accs.Cov: Ft.H Sb: Sd.H Sb: GFA: Tot : Ft.imp: Parkin . Height/Stories: notes: C T O ■ � Q 74' ri` N� � 0 0 co O L c C: c C v f6 � N a LL vo- ^ � ° 0 w r) CL o- a � Q) - �1 N n L E m W f- c °1 v y a W `n 3 U. X cu o 0 o LL; LJJ a v co v ° y a Q v v Q) H L11 u _ y Z LLI Q) Ln W H :Eo ry N F- 3 3 v o O Z w I 3 Z N J Q o y c Q Y Y O 4J C') � w O 0 o f 0 00 j U) Y o a� o ac o U Q L • O L Ln O W 'p > E .- ZW J o Q0 � co 0 3 oL -0 Ln c Q L Q c } o Q c° ° o m c a 3 YN n, Nco Q 0 O (n I :F- 0 D u o cf) >Qpw00 D y0 a U s E °(z o 10 c o �5 E fl o m O N o uj CO co (� a c-I "p CK Z LLI v c �c W Z M N Q W : N a 3 M U > OLi 1 ao U o -0 v > LL 00 a� c I ti o - v E v w Ocy) cy, a) I o a o C) x ro v Q1 O I� Q o 0 o C) v Q v L c c% N w y E E on E J v 4J N Q, f— f— m J N c s m 0 \ n .� O cn / W N J Lb N L Z C LL O CL @ 7 Q/ Ln 0- u v v on (� Z `� ' d L c a s v } 3 o y O O c0 a o v, U O a Z v v 3 m O O IT O L cM QJ = ULU._ N wNx s .� (V a CN Q '> Ln � ULn C ° c o o o . y o 'o o -a m u a c v, a � o � v a� y r + O O CL W o o n a'> -o@ `° v m -0 _ V o � � � y b > v v N J N O Q c co cc W W W p a a y o p G H U H p p E ° u N � a1 .V Q) w p Q Q `_ � y� �9d1"� a Q a a ivy v � ° Plumbing Permit Application Village of Rye Brook 938 King St Rye Brook, NY 10573 Phone: (914)939-0668 1 www.ryebrook.gov Building Department Project Information SBL_ Zone: 124.81-1-1 Proposed Work: Plumbing for New Pantry Indicate Fixtures&Lines to be installed as per the following schedule: 1st 2nd 3rd 4tj�t Other§{Wipment/Provide Details: FIXTURES Basement Floor Floor Floor RPtoFlo PF1613)W1A6 Pantry iSiink ProFlo PFXC4012 Kitchen 'c Water Heater Water Closets Urinals Drinking Fountains Sinks 1 Showers Bath Tubs Laundry Tubs Domestic Service Fire Service Sanitary Sewer Natural/LP Gas Other* 1 TOTAL 2 Plumbing Permit Application,page 1/1 �y anv� VILLAGE OF RYE BROOK 938 King St Rye Brook,NY 10573 W � Phone:(914)939-0668 1 www.ryebrook.gov . 19 t�O Building Department INSTRUCTIONS THE PERMIT HOLDER AND/OR PROPERTY OWNER IS RESPONSIBLE FOR ENSURING THAT ALL REQUIRED/APPLICABLE INSPECTIONS ARE SCHEDULED AND THAT THE PERMIT IS COMPLETE %L-r , REQUIRED INSPECTIONS Name Description Rough plumbing Installation of all plumbing including drains,waste,vents and water supply lines.A test for this portion is required including a 100 psi test on all water supply lines. Rough Electric Rough Electric Final Electric Final Electric Final Inspection Completion of all required items under the permit including the site grading and the surveyor's final grading certificate. ��E 13R(1vk VILLAGE OF RYE BROOK 938 King St Rye Brook,NY 10573 , Q Phone:(914)939-0668 1 www.ryebrook.gov jc 19b2 ' Building Department Plumbing/New Fixtures And Lines(Remodel) Permit Permit Set 1100 KING ST P#RB 25-0027 R#124.81-1-1 PERMIT INFORMATION Address Permit number Date issued 1100 KING ST RB 25-0027 08/05/2025 REVIEWED BY If you have any questions regarding the review of these drawings please contact: Application in general Alfredo(Freddy)DiVitto adivitto@ryebrook.org INSTRUCTION AND ATTENTION It is the responsibility of the Applicant to print full size the entire approved permit package and provide at the time of inspection. TABLE OF CONTENTS Cover page 1 Building Permit 2 Required Inspections 3 Application Materials 4-11 Plumbing Permit Application 12 Building Department.938 King St Rye Brook,NY 10573/Phone:(914)939-0668 CONSULTING C + F ENGINEERING, PC 420 NORTH BROADWAY.WHITE PLAINS. NY 10603 Shop Drawing No. 1 SHOP DRAWING REVIEW NO EXCEPTION TAKEN ❑ Date: 07-16-25 REJECTED/RE-SUBMIT ❑ EXAMINED ❑ Reviewed By: A.P. APPROVED AS NOTED ❑ REVISE AND RESUBMIT SUBMIT SPECIFIED ITEM ❑ Project Name: USI RESUBMIT FOR RECORD ❑ CHECKING IS ONLY FOR GENERAL CONFORMANCE Project/Location: Rye Brook,NY WITH THE DESIGN CONCEPT OF THE PROJECT AND GENERAL COMPLIANCE WITH THE INFORMATION GIVEN IN THE CONTRACT DOCUMENTS. ANY ACTION CF Project No.: 25024 SHOWN IS SUBJECT TO REQUIREMENTS OF THE PLANS AND SPECIFICATIONS. CONTRACTOR IS RESPONSIBLE FOR DIMENSIONS WHICH SHALL BE CONFORMED AND Discipline: Plumbing CORRELATED AT THE JOB SITE, FABRICATION PRO- CESSES AND TECHNIQUES OF CONSTRUCTION CO- ORDINATION OF HIS WORK WITH THAT OF ALL OTHER Shop Drawing Description: TRADES AND THE SATISFACTORY PERFORMANCE OF Plumbing Submittals I IIS WORK. C&F CONSULTING ENGINEERING, P.C. DATE 07-16-25 BY: A.Pellegrino CF Comments: 1. Submittal does not include the expansion tank,solenoid shut-off valve, leak detection and thermostatic mixing valve. Revise submittal to reflect this information. 2. Installations shall be in accordance with all local AHJ requirements, 2020 New York State Building Code& 2020 New York State Plumbing Code, and manufacturer's requirements. 3. Final approval of plumbing fixtures by architect of record. 4. Flow rates of all fixtures shall be in accordance with Table 604.3 & 604.4 of the 2020 New York State Plumbing Code. 5. Water heater to be installed as per manufacturer's requirements. Coordinate electrical requirements with the electrical contractor. Installations shall be in accordance with all local AHJ requirements, 2020 New York State Building Code & 2020 New York State Plumbing Code, and manufacturer's requirements. 6. Final approval of plumbing fixtures by architect of record. 7. Flow rates of all fixtures shall be in accordance with Table 604.3 & 604.4 of the 2020 New York State Plumbing Code. C&F CONSULTING ENGINEERING, PC 420 NORTH BROADWAY,WHITE PLAINS, NY 10603 TEL: (914)683.7355 FAx: (914) 6837344 8. Water heater to be installed as per manufacturer's requirements. Coordinate electrical requirements with the electrical contractor. 9. Water heater shall be set for 140°F to avoid growth of Legionella. Thermostatic mixing valve to be set to 120°F. M < DA SUBMISSION # PROJECT USI Insurace REVISION# NAME # TYPE: plumbing ADDRESS #6lntemational Dr Review is for compliance with design intent and information given in contract documents.Contractor is responsible for all corrections indicated hereon and for dimensions, quantities, fabrication and construction techniques and coordination with other contractors and subcontractors.Action does not authorize changes to contract requirements,unless stated in separate letter or change order. FURNISH AS SUBMITTED CHECKED BY: FURNISH AS CORRECTED-NOTE MARKINGS Lisa Bauerle FURNISH AS CORRECTED. REVISE + RESUBMIT FOR FILE COPY REVISE + RESUBMIT REJECTED DATE: AS PER ENGINEER 7-17-25 REVIEWED ADDITIONAL NOTES: Sink and faucet are approved. Please revise and resubmit per Engineer's direction. 208 HARBOR DRIVE, SUITE 208, STAMFORD, CT 06902 1 (T) 203.487.3400 C&F CONSULTING ENGINEERING, PC 420 NORTH BROADWAY, WHITE PLAINS, NY 10603 TEL: (914) 683.7355 FAx: (914) 6837344 Specifications • I II Plomosa SeriesOFL103 Stainless Steel Sink Product Features 18 gauge stainless steel Undermount Sink clips included Overall size:23-3/8"x 17-3/4" Bowl size:21-7/16"x 15-13/16" / Bowl depth:6" Drain diameter:3-1/2" E\ Under spray coating and pads for sound deadening and insulation Model Numbers PFUG301A6 23-3/8"x 17-3/4" 18GA 6"1B SS SINK PFUG301A6BULK 23-3/8"x 17-3/4"18GA 6"1B SS Sink-100 pack ADA Installation PFUC301A6 a;wq E c i �• r cwa", � a.o ray io a�s.a wa OWN 1. '--------- " i ---- 23-38"594.4 mm ---' - -"- 21-7/16"(544mm) r m..n« rw..a n"a I E 7 v "All measurements are nominal.Please verify before actual installation. Warranty and Codes This PROFLO stainless steel sink carries a limited lifetime warranty.In an effort to continually improve our products,we will make design changes from time to time.We reserve the right to ship newly designed product to fill any order unless it is agreed to in writing to do otherwise. r c These products meet or exceed ASME/ANSI All 2.19.3m. c , 02024 Ferguson Enterprises,LLC 0324 6324783 FERGUSON.COM/PROFLO Specifications PFXC4012 OIFL 0 0 Loftus Single Handle Pull Down Kitchen Faucet Product Features Ceramic cartridge Metal lever handle 1 or 3 hole installation Optional deck plate included Max.flow rate:1.75 gpm(6.6 Umin)at 60 psi NSF-61 compliant ADA compliant 1 t Optional Accessories/Available Parts PFXC4012CP Chrome PFXC4012CP PFXC4012ZBN PVD Brushed nickel PFXC4012MB Matte black Product Specifications 4,P ,1 ) 1249m41) Min:112nlr(4? n) 3 Y, a, amm To w rolmml mm I i 45 i 2 Tns 1 „4• I ,mm) N E :Fey — I en7-2/NB-28-- 0 0 II ti "All measurements are nominal.Please verify before actual installation. Warranty and Codes This product comes complete with installation, operating, care and maintenance instructions. This PROFLO faucet carries a limited lifetime warranty when installed in residential applications. �� The warranty is five years in commercial applications. Compliant with lead content requirements of California AB 1953 and Vermont S.152. 02021 Ferguson Enterprises,u.0 06/21 PROFMCOM 03 hitCommercial Electric ® Water Heaters DURA-POWERTM Designed for use as a recovery heater having its own storage tank.Available in upright standard models(DEN)and lowboy models(DEL). 2 smw, GLASSLINED TANK CSA CERTIFIED AND ASME RATED • Thirteen sizes;6 thru 119 gallon T&P RELIEF VALVE capacity.Tank interior is coated with SIMPLIFIED CIRCUITRY, COLOR glass specially designed by A.0.Smith CODED FOR EASE OF SERVICE for water heater use. ANODE ROD FOR MAXIMUM ELEMENTS CORROSION PROTECTION • Zinc plated copper sheaths for longer CABINET HAS BONDERIZED life.Medium watt density means lower UNDERCOAT WITH BAKED surface temperature to minimize scale ENAMEL FINISH build-up and more surface to heat water.Element sizes from 1.5 to 6.1 KW. TOP INLET AND OUTLET OPENINGS Maximum input KW(see chart). DRAIN VALVE STANDARD VOLTAGES (EXCLUDES DEL 6-20) • 120,277 single phase and 208,240 UL APPROVED FIELD CONVERSION and 480V unbalanced three-phase PROGRAM delta;easily converted to single-phase at COMPLIANCE terminal block with limited exceptions. Single element heaters,single-phase Meets the standby loss Requirements only. of the U.S.Department of Energy and TERMINAL BLOCK current edition of ASHRAEJIES 90.1 • Factory-installed.lust bring the service LIMITED WARRANTY OUTLINE to heater and connect to block.Terminal If the tank should leak any time during DEN-40 block not supplied on 120V&277 volt the first three years,under the terms of models,(No junction box on DEL6-20) the warranty,A,0,Smith will furnish a DEL-30 CONTROLS replacement heater;installation,labor, handling and local delivery extra.THIS • Temperature control(adjustable OUTLINE IS NOTAWARRANTY.For ` c&us through a range of 110°to 170°F on complete information consult the written single element and 120°to 181°F on warranty or A.0.Smith Water Products dual element)and manual reset high Company. , temperature cutoff per element ®September 2022 A.0.Smith Corporation.All rights reserved. Vane;ni a www.hotwatercom 1800-527-1953 Toll-Free USA I A.0.Smith Corporation I S00 Tennessee Walt:Parkway I Ashland City,TN 37015 AOSCF15400 04 Commercial Electric Sm 'hth ® Water Heaters DES ANODE OUTLET INLET OUTLET INLET OUTLET INLET 3W(FEMALE) O 3/4-(FEMALE) 3/,,'(FEMALE) 0 L{'(FEMALE) 314(FEMALE) 3!a'(FEMALE) NPT D NPT NPT D NPT NPT(D NPT f'D' V4-NPT RELIEF VALVE JUNCTION 21/Z' JUNCTION- OPENING BOX (63.5 mm; wX 21(2' JUNCTION TOPVIEW 21/2' 70P VIEW TOP VIEW (63.5mm) TOP VIE Sox DEN.&120 (,3 "' OFI.JOI40/50 DEN 30-52 DFL 610/1 f l20 ALTERNATE OUTLET B A - 314-(FEMALE)NP7 OUTLET VC 17EIIILEI NPT 3M'NPT 3�4'NPT RELIEF VALVE RrI IEF VnLVC 3/4'NPI • OPENING OPENING RFI I OPENING DRAIN OPENING. VALVE C n R C F1 III[CAL CONNEC7Wry 3314'(55.25 mm) DRAIN BRAIN • VALVE O vA.v O IN_ET FRONT MEW IuvruLe) DEN W120 FRONT VIEW IRON API; M VI EW DEL 3a4a50 rIEN �s7 DEL a11a15rJo -(NO SIDE OUTLET AVAILABLE FOR DEL$MODELS) ROUGH-IN DIMENSIONS No.of Nominal Rated A B C D Shipping Weight Models UEF Elements Capacity Storage Volume Inches mm Inches mm Inches mm Inches mm lbs. Kg. DEL-6 %/A 1 6 6 15-112 394 14-1/4 362 11 279 N/A N/A 35 15.9 DEL-10 N/A 1 10 10 18-1/4 464 18 457 12-1/2 318 NIA N/A 54 24.5 DEL-15 N/A 1 15 15 26 660 18 457 20-1/2 521 N/A NIA 58 26.3 DEL-20 N/A 1 20 19 22-1/4 565 21-3/4 552 15-3/8 391 N/A N/A 73 33.1 DEL-30 0.92 2 36 33 32 813 24 610 1 24 610 8 203 118 1 53.5 DEL-40** 0.92 2 38 35 32 813 23 584 24 610 8 203 118 1 53.5 DEL-50 0.92 2 51 48 36 914 26-1/2 673 25 635 8 203 172 78 NN2 0.92 2 40 37 49-3/4 1264 20-1/2 521 53-1/4 1353 8 203 118 53.5 0.92 2 50 46 59 1499 20-112 521 51-1/4 1302 8 203 125 56.7 0.92 2 55 55 56-1/2 1435 24 610 48-1/2 1232 8 203 145 65.8 N/A 2 66 60 60-3/4 1543 21-3/4 552 N/A N/A 8 203 176 79.8 N/A 2 80 76 59-3/8 1508 24 610 N/A N/A 8 203 211 95.7 N/A 2 120 108 62-7/16 1586 29-3/8 746 NIA NIA 8 203 326 147.9 U.S Gallons/HR and Litres/HR at Temperature Rise Indicated Element 1n LIt F° 36 F° 40 F° 54 F° 60 F° 72 F° 80 F° 90 F° 100 F° 108 F° 120 F° 126 F° Wattaye p (Upper/Lower) KW C. 20 C` 22.2 C" 30 C" 33.3 C" 40 C" 44.4 C' 50 C" 55.5 C" 60 C" 66.6 C" 70 C" 6100/6100" 12.2 GPH 138 124 92 82 69 62 55 49 46 41 39 LPH 522 469 348 310 261 235 208 184 174 153 146 'No side outlet available on DEL-6 Model "Blanket model Note:All 66,80.120 models can only be ordered 277V,240V,or 480V Page]of 4 AOSCE15400 05 t At t h Commercial Electric ®o S Water Heaters ELEMENT AVAILABILITY CHART (LIGHT-DUTY COMMERCIAL ELECTRIC) Models&Elements Voltage Wiring kW Input Available 120V 1.5 2 2.5 3 208V 1.1i 2 2.5 3 Single-Element Models 240V 1.S 2 2.5 3 Singl 277V 1.5 2 2.5 3 480V 2 2.5 3 120V 1.5 2 2.5 3 10-Gallon through 208V 1 5 2 2.5 3 35 4 4.5 5 5.5 6 20-Gallon Models 240V 1.5 2 2.5 3 3.5 4 4.5 5 5.5 6 Single-Element 277V - 1.5 2 2.5 3 4 4.5 5 6 480V 2 2.5 3 4 4.5 5 5.5 6 6 gallon model not available above 3kW 6/10/15/20 gallon models all A6 circuit(2 wire)only Model Element Wattage 120V 208V 240V 277V 480V DEL•30 Min Watts N/A 4500 4500 4500 4500 Max Watts N/A 6000(*) 6000(*) 6000 6000 DEL-40 Min Watts N/A 4500 4500 4500 4500 Max Watts N/A 6000(*) 6000(') 6000 6000 Min Watts N/A 4000 4000 4000 4000 DEL-50 Max Watts N/A 6000(') 6000(`) 6000 6000 DEN-30 Min Watts N/A 4500 4500 4500 4500 Max Watts NIA 6000(') 6000(*) 6000 6000 DEN-40 Min Watts 3000(') 1 3000 1 3000 3000 3000 Max Watts 3000(') 6000(*) 1 6000(') 6000 6000 DEN-52 Min Watts 2500 2500 2500 2500 2500 Max Watts 3000(*) 6000(*) 6000(') 6000 6000 Additional limitations apply to 120V,208V,and 240V-Simultaneous Operation are not available(')for these voltages. 3 phase only on 240 6000 watt for simultaneous operation Page 3 of 4 AOSCE15400 06 ot h Commercial Electric smi Water Heaters RECOVERY CAPACITIES Element Input U.S.Gal Ions/Hr and Litres/Hr at Temperature Rise Indicated n Wattage p(Upped F° 36 1 40 1 54 60 72 80 90 100 1 108 120 126 Lower) kW C' 20 22.2 1 30 33.3 40 44.4 50 55.5 60 66.6 70 Non-Simulataneous Operation 11500 15 GPH 17 15 11 10 8 8 7 6 6 5 5 LPH 64 58 43 38 32 29 26 23 21 19 18 12000 2 GPH 23 20 15 14 11 10 9 8 8 7 6 LPH 85 71 57 51 43 38 34 31 28 26 24 /2500 2.5 GPH 28 25 19 17 14 13 11 10 9 8 8 LPH 1 107 96 1 71 64 53 48 43 38 36 32 30 3000/3000 3 GPH 34 30 23 20 17 15 14 12 11 10 10 LPH 128 115 85 77 64 58 51 46 43 38 37 4000/4000 4 GPH 45 41 30 27 23 20 18 16 15 14 13 LPH 170 153 114 102 85 77 68 61 57 51 49 4500/4500 4.5 GPH 51 46 34 30 25 23 20 18 17 15 14 LPH 192 173 128 115 96 86 77 69 64 58 55 5000/5000 5 GPH 56 51 38 34 28 25 23 20 19 17 16 LPH 213 192 142 128 107 96 85 77 71 64 61 6000/6000 6 GPH 68 61 45 41 34 30 27 24 23 20 19 LPH 256 230 170 153 128 115 102 92 85 77 73 Simulataneous Operation 3000/3000 6 GPH 68 61 45 41 34 30 27 24 23 20 19 LPH 256 230 170 153 128 115 102 92 85 77 73 4000/4000 GPH 90 81 60 54 45 41 36 32 30 27 26 LPH 341 307 227 205 170 153 136 123 114 102 97 4500/4500 g GPH 101 91 68 61 51 46 41 36 34 30 29 LPH 384 345 256 230 192 173 153 1 138 128 115 110 5000/5000 10 GPH 113 101 75 68 56 51 45 41 38 34 32 LPH 426 384 284 256 213 192 170 153 142 128 122 6000/6000 12 GPH 135 122 90 81 68 61 54 49 45 41 39 LPH 511 460 341 307 256 230 205 184 170 153 146 Recovery capacities at 100'F rise equal:for non-simultaneous element operation=4.1 gal.x kW of one element;for simultaneous element operation=4.1 gal,x 2/3 kW of both elements. For other rises multiply element kW as previously explained by 410 and divide by temperature rise.Full load current for single phase=total watts/voltage. SPECIFICATION The water heaters(s)shall be Dura-Power" Model(s)No. as manufactured by A.0.Smith or an approved equal.Heater(s)shall be rated at kW, volts, -phase,60 cycle AC,and listed by Underwriters'Laboratories.Models shall meet the standby loss requirements of the U.S.Department of energy and current edition of ASHRAE/IES 90.1.Tank(s)shall be gallon capacity.Heater(s)shall have 150 psi working pressure and be equipped with extruded high density anode rod.All internal surfaces of the heater(s)exposed to water shall be glasslined with an alkaline borosilicate composition that has been fused-to-steel by firing at a temperature range of 1400°F to 1600°F.Electric heating elements shall be medium watt density with zinc plated copper sheath.Each element shall be controlled by an individually mounted thermostat and high temperature cutoff switch.The outer jacket shall be of backed enamel finish and shall enclose the tank with foam insulation.Electrical junction box with heavy duty terminal block shall be provided(except on 120V&277V(no junction box on DEL-6 thru 20)).The drain valve shall be located in the front for ease of servicing.Heater tank shall have a three year limited warranty as outlined in the written warranty.Fully illustrated instruction manual to be included, for technical inlorination,call 800-527-1953.A-O.Smith Corporation reservesthe right to make product changes or improvements vvithout prior notice. ®September 2022 A.0.Smith Corporation.All rights reserved. Page 4 of 4 www.hotwater.com 1 800-527-1953 Toll-Free USA I A.0.Smith Corporation 1 500 Tennessee waltz Parkway I Ashland City,TN 37015 AOSCE15400 Client#: 1362961 TELWOCOM ACORD.,, CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 7/02/2025 THUS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT-NAME:- ONTACT Donna Volz US[Insurance Services LLC NAME:PHONE 908-732-5554 FAX 7 A/C No Ext: A/C No: 32-349-0186 1433 Hooper Avenue E-MAIL donna.volz@usi.com Suite 110 INSURERS AFFORDING COVERAGE NAIC# Toms River, NJ 08753 INSURER A:Travelers Indemnity Company of RI A18674 INSURED INSURER B:Charter Oak Fire Insurance Company 25615 Telworx Communications LLC INSURER C:New Jersey Manufacturers Insurance Co. 12122 800 Westchester Avenue Rye Brook, NY 10573 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILITRR TYPE OF INSURANCE i R UBR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY ZPP16P8146024 4/01/2025 04/01/2026 EACH OCCURRENCE $1 OOO 000 AMACLAIMS-MADE u OCCUR PREM SESE T RENTED $1 OOO 000 MED EXP(Any oneperson) $10 000 PERSONAL&ADV INJURY $1 00O 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s2,000,000 PR POLICY I X I JECOT U LOC PRODUCTS-COMP/OP AGG s2,000,000 OTHER: $ C AUTOMOBILE LIABILITY 1107694622 9/08/2024 09/08/2025 COMBINED,accident,SINGLE LIMIT S1,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY E AUTOS ONLY $ A X UMBRELLA LIAB X OCCUR EX1 Y81520524 4/01/2025 04/01/2026 EACH OCCURRENCE $5 000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED I X RETENTION$10,000 $ B WORKERS COMPENSATION UB2Y4260742415G 9/09/2024 09/09/2025 X PER OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YY E.L.EACH ACCIDENT $1 00O 000 OFFICER/MEMBER EXCLUDED? Y N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1 000 000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached it more space is required) **Workers Comp Information** Proprietors/Partners/Executive Officers/Members Excluded: Michael Franklin, Ot Michael Franklin, Ot CERTIFICATE HOLDER CANCELLATION Village of Rye Brook SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE g y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 938 King Street ACCORDANCE WITH THE POLICY PROVISIONS. Rye Brook, NY 10573 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S49952964/M48736921 DFAZP 'W Workers' CERTIFICATE OF STATE ! Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured 914 761-7600 Telworx Communications LLC 800 Westchester Avenue 1 c.NYS Unemployment Insurance Employer Registration Number of Rye Brook,NY 10573 Insured Work Location of Insured(Only required if coverage is specifically limited to 1 d.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-Up Policy) Number 26-1768133 2.Name and Address of Entity Requesting Proof of Coverage 3a. Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) The Charter Oak Fire Insurance Company Village of Rye Brook 3b. Policy Number of Entity Listed in Box 1a" 938 King Street Rye Brook,NY 10573 UB2Y4260742415G 3c.Policy effective period 9/9/24 to 9/9/25 3d.The Proprietor,Partners or Executive Officers are ❑X included.(Only check box if all partners/officers included) ❑ 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: Donna Volz (Print name of authorized representative or licensed agent of insurance carrier) Approved by: �o-nna, r of 3/20/25 (Signature) (Date) Title: Commercial Line Manager Telephone Number of authorized representative or licensed agent of insurance carrier: 732-908-5554 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 BLACSER-03 JGRABOWSKI ACORO CERTIFICATE OF LIABILITY INSURANCE DATD/YYYY) 7121 21/2/2025 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 N NTACT World Insurance Associates,LLC PHONE FAX 2725 Whitney Ave ac,No,Ext:(203)281-1123 (a/c,No): Hamden,CT 06518 EA -MIL INSURERS AFFORDING COVERAGE NAIC# INSURERA:Arch Property Casualty Insurance Company 10946 INSURED INSURER 8:Arch Indemnity Insurance Company 30830 Blackwater Services Group LLC INSURER C:Arch Insurance Company 11150 117 Great Hill Rd INSURER D:W.R.Berkley Corporation Naugatuck,CT 06770 INSURER E:Berkley Assurance Company 39462 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. INSR TYPE OF INSURANCE ADDL SUBR INSDPOLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE a OCCUR 11 PKG1999201 1/29/2025 1129/2026 DAMAGE TO RSESEaENTEDPRFM $ 300,000 X No XCU Exclusions MED EXP(Any oneperson) $ 10,000 PERSONAL&ADV INJURY 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY a JEC� LOC PRODUCTS-COMP/OP AGG $ 4,000,000 OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 X ANY AUTO 11 PKG1999201 1/29/2025 1/29/2026 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ X HIRED X NON-AWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 EXCESS UAB CLAIMS-MADE llUFP1999200 1/29/2025 1/29/2026 AGGREGATE $ 10,000,000 DED I X I RETENTION$ 10,000 $ C WORKERS COMPENSATION X I STATUTE I ER PER OTH- AND EMPLOYERS'LIABILITY Y/N 11 WC11999201 1/29/2025 1/29/2026 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,descr be under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ D Equipment Floater CIM5584533-11 1/29/2025 1/29/2026 Stored Materials 500,000 E Prof Poll Liability PCAB-5026322-0125 1/29/2025 1/29/2026 Aggregate 2,000,000 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 Village of Rye Brook THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9 Y ACCORDANCE WITH THE POLICY PROVISIONS. 938 King Street 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 Workers' YORK CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured Blackwater Services Group,LLC 475-269-3473 117 Great Hill Road Naugatuck,CT 06770 1 c.NYS Unemployment Insurance Employer Registration Number of Insured Work Location of Insured(Only required if coverage is specifically limited to 1d.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-Up Policy) Number 84-3744552 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Arch Insurance Village of Rye Brook 3b.Policy Number of Entity Listed in Box"1 a" 938 King Street 11 WC11999201 Rye Brook,NY 10573 3c.Policy effective period 01/29/2025 to 01/29/2026 3d.The Proprietor,Partners or Executive Officers are �X included.(Only check box if all partnerstoffiicers included) all excluded or certain partnerstofficers 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: Jillian Grabowski (Print name of authorized representative or licensed agent of insurance carrier) Approved by: �B� 07/21/2025 (Sig ture) (Date) Title: Account Executive Telephone Number of authorized representative or licensed agent of insurance carrier: 203-281-1123 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 CARE&WA-01 MGIORDANO '4cofzn CERTIFICATE OF LIABILITY INSURANCE DATE /YYYY) 4l2/20/2025 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 Michelle Giordano NAME Assured Partners New England,Inc. PHHC No,Ext: 860 426-6163 aC,No: 860 426-6163 100 Beard Saw Mill Road Shelton,CT 06484 E-MA'L .Michelle.Giordano@AssuredPartners.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Selective Insurance Company of NY 13730 INSURED INSURER B:MS Transverse Specialty Insurance Company 41807 Carey&Walsh,Inc. INSURER C:AmTrust Insurance Company 15954 P.O.Box 2529 INSURER D:Hartford Life&Accident Ins.Co. 70815 Briarcliff Manor,NY 10510-1511 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. INSR TYPE OF INSURANCE ADDL SUBR I= Vivo POLICY NUMBER POLICY EFF POLICY EXP i LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE a OCCUR X X IS 2509239 9/1/2024 9/1/2025 DAMAGE TO RSE E.ENTED $ 500,000 MED EXP(Any oneperson) $ 15,000 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY PRO- LOC PRODUCTS-COMP/OP AGG $ 4,000,000 OTHER: A AUTOMOBILE LIABILITY ' COMBINED SINGLE LIMIT $ 1,000,000 ccident)X ANY AUTO X X S 2509239 9/1/2024 9/1/2025 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS ent BODILY INJURY Per accid $ HIRED NRN-2WNEp PROPERTY AMAGE AUTOS ONLY AUTOS ONLY Per accident B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE X X TSCEEX000344-00 9/1/2024 9/1/2025 AGGREGATE $ 5,000,000 DIED RETENTION$ C WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITYSTATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE YF�] NIA X 'OWC1011944 4/1/2025 4/1/2026 E.L.EACH ACCIDENT 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT D NY Disability LNY612715 4/1/2025 3/31/2026 Statutory DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule.may be attached if more space is required) Coverage: Pollution Liability Insured: Berkley Insurance Company(NAIC 32603) Policy#FEI-ECC-27778-04 Effective Date:9/1/2024 Expiration Date:9/1/2025 Liability Limit per Occurrence$1,000,000 Aggregate$2,000,000 SEE ATTACHED ACORD 101 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 938 King Street ACCORDANCE WITH THE POLICY PROVISIONS. 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 PORK Workers' CERTIFICATE OF TATE Compensation Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1a.Legal Name&Address of Insured(use street address only) 1b. Business Telephone Number of Insured Carey&Walsh, Inc. (914)762-9600 P.O.Box 2529 1c. NYS Unemployment Insurance Employer Registration Number of Insured 529 N. State Road Briarcliff Manor, NY 10510-1511 1d. Federal Employer Identification Number of Insured or Social Security Work Location of Insured(Only required if coverage is specifically limited to Number certain locations in New York State,i.e., a Wrap-Up Policy) 13-2591740 2.Name and Address of Entity Requesting Proof of 3a. Name of Insurance Carrier Coverage(Entity Being Listed as the Certificate Holder) mTrust Insurance Company Village of Rye Brook 3b. Policy Number of Entity Listed in Box"I a" 938 King Street OWC1011944 Rye Brook,NY 10573 3c. Policy effective period /1/2025 to 4/1/2026 3d. The Proprietor,Partners or Executive Officers are ®included.(Only check box if all partners/officers included) El 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"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"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: Michelle Giordano (Print name of authorized representative or licensed agent of insurance carrier) Approved by: 04/02/2025 (Signature) (Date) Title: Account Executive Telephone Number of authorized representative or licensed agent of insurance carrier: 860-426-6163 _ Page 1 of 2 A�® CERTIFICATE OF LIABILITY INSURANCE DATE,M0/2024 12/30/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT WTW Certificate Center NAME: Willis Torero Watson Northeast, Inc. -- c/o 26 Century Blvd PHONE 1-877-945-7378 F� No: 1-888-467-2378 P.O. Box 305191 ADDRIESS: certificates8wtwco.com Nashville, TN 372305191 USA INSURERS AFFORDING COVERAGE NAIC# INSURERA: Endurance Assurance Corporation 11551 INSURED INSURERB: Sompo America Insurance Company 11126 DRA Advisors LLC 575 5TH Ave FL 38 INSURERC: ACE Property & Casualty Insurance Company 20699 New York, NY 10017 INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER:W37170591 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 UBR POLICY NUMBER POUCY EFF POLICYMM/Df EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 DAMAGE CLAIMS-MADE X OCCUR PREMISES Ea occurrence $ 2,000,000 A TRIA Included MED EXP(Any one person) $ Excluded Y Y GGR10010452208 12/31/2024 12/31/2025 PERSONAL BADVINJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 X POLICY❑JECT LOC PRODUCTS-COMP/OP AGG $ 4,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident x ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED Y Y GAR30030321702 12/31/2024 12/31/2025 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident C UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 X EXCESS LIAB CLAIMS-MADE XEU G72556288 003 12/31/2024 12/31/2025 AGGREGATE $ 10,000,000 r DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE I I ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ i DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Named Insured includes: 1100 King Associates LLC, Location Address: 1100 King Street 1-6 International Drive, Rye Brook, NY, 10573. Certificate Bolder is included as Additional Insured in accordance with the policy provisions of the General Liability and Automobile Liability policies. A Waiver of Subrogation is granted in favor of Certificate Holder in accordance with the policy provisions of the CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Village of Rye Brook 938 King Street 4L Rye Brook, NY 10573 4 ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD sR m: 27009628 i— 11 3757262 NYSIF New York State Insurance Func: PO Box 66699,Albany,NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE 0 ^^^A^^ 133983707 THE FLANDERS GROUP ' 300 LINDEN OAKS Y SUITE 210-1ST FLOOR ROCHESTER NY 14625 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER COMFORT MAINTENANCE CORP VILLAGE OF RYE BROOK 1100 KING STREET 938 KING STREET RYE BROOK NY 10573 RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE Z1048 013-5 495350 01/01/2025 TO 01/01/2026 6/5/2025 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1048 013-5, 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. 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 SUR NCE FUND T DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER:286024627 U-26.3 W r� o m 'd o V v Ii O J Q �C Z z (n wO o1aW LLI _86 = Wa z w W ❑ F- U U) U _ ¢ N } a 4� N > I.i.. CD W � h O w, O W rn w a Q h0 CO N Q w I �• a o al Q U z >° w Z > o a) z ci i yr. o o `8 Ri �- O O 0 o o d w O D Jiw 0 civ�c~i w o �G 0O U z z z g�z F , W ¢ 52C0M m L- ❑ gv', Li- ' � / N -�i -Ji N(gN C N t y a\ LL ` z H (D ell a D U) c� ;W U) OLd U Z :. �. 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