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HomeMy WebLinkAboutRB25-0081PERMIT# PARCEL ID: TYPE OF WORK: �� Vy DATE• �O EXP• r y lil I I "vri Cu u n r1 CONTRACTOR: 1 EST. COST: $ FEE: S r �+' _ PAID FEES ,� 7 AID DATE:_' TCO#: FEE:S ❑ MAY PAID FOOTING FOUNDATION FRAMING ROUGH FRAMING INSULATION PLUMBING ROUGH PLUMBING GAS SPRINKLER ELECTRIC LOW VOLTAGE ALARM AS BUILT FINAL ■ n C [•7�1� I - Z"3 - Zo ?.to INSPECTION PERMIT u: 3(o?42 [3 P, 2 VILLAGE OF RYE BROOK Building Department- Inspections p 938 King St Rye Brook,NY 10573 1 Phone:(914)939-0668 1 Fax:(914)939-5801 1982 CERTIFICATE OF OCCUPANCY Occupancy granted date: 01/27/2026 Permit Number: RB25-0081,Issued on 10/24/2025 Visit result: Granted and fully completed Date of inspection: 01/27/2026 Parcel number: 135.26-1-45 Municipal Address: 18 PADDOCK RD Legal Description: 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 the exit facilities shall be made,and no enlargement,whether by extending on any side or by increasing in height shall be made, nor shall the building be moved from one location to another until a permit to accomplish such change has been obtained from the Building Inspector. Additional Occupancy permit description: ALL WORK COMPLETED OK TO ISSUE CERTIFICATE. Outstanding matters: • Melissa Wynn 18 Paddock Rd,Rye Brook +1(914)584-0065 melissadianewynn@gmail.com Inspected : Alfredo(Freddy) DiVitto Building Inspector,Village of Rye Brook +19149390668 — BUILDING DEPARTMENT For office use only: PERMIT# VILLAGE OF RYE BROOK ISSUED: 938 KING STREET,RYE BROOK,NEw YORK 10573 DATE: JAN 16 2026 `J (914)939-0668 FEE: PAID 12/ www.ryebrookny.i!ov VILLA&- 1 BUILDi- 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 ++sssssrssss+r+s+sss+,,s sJJss+++s++++++s+ssssrssss*►►►s►■►s*►*s*►►*►►*►s►ss►*►+ss*s*s**s*►sssss►r+s+++ss►ss*►►ss►*►*►►►s►sss►►►►s Address: 8 V roGlc R� n Occupancy/Use: Parcel ID#: �3J�.Z6- ��S Zone: K-Is­ Owner: 046L I60- L✓y kA'j Address: P.E./R.A.or Contractor: Address: W73 1✓wICL�o,.n Q rr Le Person in responsible charge: Address: ,36 "4�.„1 t C40!"g &—na►wtu, C-r-022z 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: S�/� A��� Lt� being duly swom,deposes and says that he/she resides at 36 SA wN,►G( LA,,p (Print Name of Applicant) (No.and Street) in in the County of4 in the State of CT ,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:$ 8�p 100. 00 for the construction or alteration of: K Deponent further states that he/she has examined the approved plans of the structure/work herein referred to for which a Certificate of Occupancy/Compliance is sought,and that to the best of his/her knowledge and belief,the structure/work has been erected/completed in accordance with the approved plans and any amendments thereto except in so far as variations therefore have been legally authorized,and as erected/completed complies with the laws governing building construction.Deponent further understands that it shall be unlawful for an owner to use or permit the use of any building or premises or part thereof hereafter created,erected,changed,converted or enlarged,wholly or partly,in its use or structure until a Certificate of Occupancy or Certificate of Compliance shall have been duly issued by the Building Inspector as per§250-10.A.of the Code of the Village of Rye Brook. Sworn to before me this Sworn to before me this ' b day of 3 ei -'ra,� , 20 '� � day of ~ , 20,�_ Sidnature of Owner ��atu,4e'bf*rplicant D U2 4M n ame of Property Owner/ jPtNLa1eofApplicant,' ti Not' Public NotaryI MELILLO SHARI MELILLO NOTARY PUBLIC,STATE OF NEW YORK NOTARY PUBLIC,STATE OF NEW YORK NO.0IME6160063 6;;;202 NO.OIME6160063 QUALIFIED IN WESTCHESTER COUNTY QUALIFIED IN WESTCHESTER COU 144MISSION D0'IRES JANUARY 29,20.-, rZMMISS&I EXPIRES JANUARY 29,20 � �yE BRCv� Zm c 1982 BUILDING DEPARTMENT rBILDINGINSPECTOR ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK [1 CODE ENFORCEMENT OFFICER 938 King Street • Rye Brook, NY 10573 (914) 939-0668 FAx (914) 939-5801 www.ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : 18 PC_j joc- L _ a' L' __ DATE: 1- Z 7 - ZbL4 PERMIT# �Zr� ISSUED: SECT: BLOCK: LOT: LOCATION: (� OCCUPANCY: ❑ Violation Noted THE WORK IS... V PASSED ❑ FAILED / REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION D❑ Natural Gas 1 6(4�,�1� ❑ L.P. Gas 6 e ❑ FUEL TANK ❑ FIRE SPRINKLER . FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER QyE DR(�� t7 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 : 1 a To j A04G � _ ea c-j DATE: 1-2 7- Z bZ to PERMIT# R� a s ��O C9 I ISSUED: 2 y.2f`SECT: A5 .ZJp BLOCK: ` LOT: LOCATION: 1 OCCUPANCY: ❑ Violation Noted THE WORK IS... L7 PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION - 0 Natural Gas v �No icy , p L.P. Gas ❑ FUEL TANK ❑ FIRE SPRINKLER AU, M/Q2L Co.-, P a E ❑ FINAL PLUMBING I ❑ CROSS CONNECTION l s j w.te ,FINAL ❑ OTHER w J �� Village of Rye Brook Building Department-Inspections 938 King St Rye Brook,NY 10573 1 Phone:(914)939-0668 Fax:(914)939-5801 19a2 ' PLUMBING FINAL Permit number: RB25-0081 Permit type: Residential — Remodel/Renovation— Interior Municipal address: 18 PADDOCK RD Legal address: Status of inspection: Completed Issue date: 10/24/2025 Deficiencies No deficiencies or remarks noted. Visits VISIT DATE •• VISIT RESULT SITE CONDITIONS 01/27/2026,2:33 PM7— Alfredo(Freddy)Divitto Passed +19149390668 Parties NAMEANDCOMPANY CONTACTROLES 473 West William St.,Port Chester Joseph Aurelio +1 9145578063 Applicant,General contractor Melissa Wynn 18 Paddock Rd,Rye Brook Homeowner/Property Owner,Property owner +1(914)584-0065 William Melikian 53 Cherry Lane,Stormville Plumber Licensed Professional Melikian Plumbing and Heating Inc. +1 914 760 3542 Angelo Zaccagnino 81 Maple Ave,Rye Electrical contractor Zaccagnino Electric +19149213244 Village of Rye Brook Building Department-Inspections 938 King St Rye Brook,NY 10573 1 Phone:(914)939-0668 1 Fax:(914)939-5801 ROUGH PLUMBING Permit number: RB25-0081 Permit type: Residential — Remodel/Renovation— Interior Municipal address: 18 PADDOCK RD Legal address: Status of inspection: Completed Issue date: 10/24/2025 Deficiencies No deficiencies or remarks noted. Visits VISIT DATE INSPECTOR VISIT RESULT SITE CONDITIONS 01/27/2026,2:32 PM Alfredo(Freddy)DiVitto Passed +19149390668 Parties NAMEANDCOMPANY CONTACTROLES Joseph Amelio 473 West William St.,Port Chester p +1 9145578063 Applicant,General contractor Melissa W nn 18 Paddock Rd,Rye Brook y +1(914)584-0065 Homeowner/Property Owner,Property owner William Melikian 53 Cherry Lane,Stormville Plumber Licensed Professional Melikian Plumbing and Heating Inc. +1 914 760 3542 Angelo Zaccagnino 81 Maple Ave,Rye Electrical contractor Zaccagnino Electric +19149213244 Q�E BR(�v'�. 0 Village of Rye Brook Building Department-Inspections 938 King St Rye Brook,NY 10573 Phone:(914)939-0668 1 Fax:(914)939-5801 Permit number: RB25-0081 Permit type: Residential—Remodel/Renovation—Interior Municipal address: 18 PADDOCK RD Legal address: Status of inspection: Completed Issue date: 10/24/2025 Deficiencies No deficiencies or remarks noted. Visits INSPECTOR VISIT RESULT SITE CONDITIONS 11/07/2025,2:00 PM Alfredo(Freddy)DiVitto Passed +19149390668 11/07/2025,3:52 PM Alfredo(Freddy)DiVitto Passed FRAMING OF NEW BEAM AND SMALL WALL IN KITCHEN +19149390668 Parties NAME AND COMPANY CONTACT 473 West William St.,Port Chester Joseph Aurelio +19145578063 Applicant,General contractor Melissa Wynn 18 Paddock Rd,Rye Brook Homeowner/Property Owner,Property owner +1(914)584-0065 William Melikian 53 Cherry Lane,Stormville Plumber Licensed Professional Melikian Plumbing and Heating Inc. +1 914 760 3542 Angelo Zaccagnino 81 Maple Ave,Rye Zaccagnino Electric +19149213244 Electrical contractor BR(�v'�. 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 Permit number: RB25-0081 Permit type: Residential—Remodel/Renovation—Interior Municipal address: 18 PADDOCK RD Legal address: Status of inspection: Completed Issue date: 10/24/2025 Deficiencies No deficiencies or remarks noted. Visits VISIT DATE • CONDITIONS Alfredo(Freddy)DiVitto 11/07/2025,2:00 PM +19149390668 Passed Parties NAMEANDCOMPANY CONTACTROLES Joseph Amelio 473 West William St.,Port Chester Applicant,General contractor +19145578063 18 Paddock Rd,Rye Brook Melissa Wynn +1(914)584-0065 Homeowner/Property Owner,Property owner William Melikian 53 Cherry Lane,Stormville Plumber Licensed Professional Melikian Plumbing and Heating Inc. +1 914 760 3542 Angelo Zaccagnino 81 Maple Ave,Rye Zaccagnino Electric +19149213244 Electrical contractor c O r4` N a O p N o � � o ❑ �' N o L E o c p a am Qa E W ° c M d m a 3 O H p > p > O X O p •— W y � -p � N " a -co Y Z m0 W (D LZ L v -0 0 W F- 3 Y � pY 0 O � 'inam ~ Z 3 p c 3 _ Y N EO � Q O L O a,-, a Z /'1�/ 2 ,-I w Q Ln a c O u o0 W Y Y �+ N •U O Ln W W a oY 0 •c O v O z Q i rl 2 C 0 O W .p .D > 3 Z 't M a Wm 0 0 00 -0 0- COm 0 p � p c pa W i T� m O U Q o J N m m p E V C_ M� O >• to m � O ° cN a� a� � � $ au `c° -° 0 co O m Z tA O m o Q a Y W — uj U OD� N C � Z � `�' � �c o w � � � ti N w NQOO �J c d � Y o ai Ti W C Mn o LL t/� cn a - „ v v LLJ Z i 4. O W H z u p Y .Mp N 00 V > o E a)v Ln W 0 Mo U 0 LL OO e� •� M � = N m W N O w p E W O� Ln O _ C Y e-I F- 0. p Zi Y x m w Q4-j 2 OD O M 2 Q U < o Opp aci J U > C C rl W 0 0 E to E m Z :a m O 3 L = *a- o v t \ CL UQ 'ln'1 � ' Z >y _ uE p Lm++ nto O a Ln N 3 0Q W > > a C� �p s >>O U E > vOi toO n v E .� Q N C v m -cE C p 3 m w. O E pnd > Q � J a LM N J r j CN nj 00.,—f �LJ m ? o v 2 'c a M E cn W ooaa � � N� L.L V O E oo � = E a NSW YOB � '� M, 7 .0 � a, > c N J to n LA a clf d CDw LLI W W O Oo � N � o V F- c � p .Y . p a Q a a 0 a -c (v L 0 u u v a c v L ii 0 to c v LL in 3 v Ld c v v V) N f Interior Building 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 Address Line 2 135.26-1-45 R-15 18 Paddock Rd Proposed Improvement Replace existing kitchen cabinets, add new header for ceiling Does the proposed project involve a Home-Occupation as per§250-38 of Village Code? ❑ Yes 0 No Will the proposed project require the installation of a new, or an extension/modification to an existing automatic fire suppression system? (Fire Sprinkler, ANSL System, FM-200 System,Type I Hood, etc...) ❑ Yes 0 No N.Y. State Construction Classification N.Y. State Use Classification Occupancy Pre-Construction VB R-3 1 fam Occupancy Post-Construction (1 fam., 2 fam.,comm.,etc...) What is the total estimated cost of construction: (NOTE: The estimated cost shall include all labor, material, 85000 USD scaffolding,fixed equipment, professional fees,and material and labor which may be donated gratis.) Interior Building Permit Application,page 1/1 f Electrical 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 135.26-1-45 R-15 Proposed Electrical Work/Fixture Count 3rd Party Electrical Inspection Agency Wiring for kitchen renovation SWIS Master Electrician/Licensed Installer Information Name Lic# Address email Phone# Cell# Angelo Zaccagnino 755 81 Maple Ave, Rye NY 10580 Office@Zaccagnino.net 914 921 3244 Company Name Company Address Zaccagnino Electric Address of Work? Homeowner Information 18 Paddock Rd, Rye Brook NY 10573 Electrical Permit Application,page 1 I 1 STATE WIDE INSPECTION SERVICES, INC. 0•• • • SWIS JOB APPLICATION tel • 0. • Office Use Elect. Permit# Date 10/14/25 Bldg Permit# Sq Ft Plumbing Permit# Final Certificate# City/Village Rye Brook Zip 10573 Building Dept. Rye Brook County Westchester Address 18 Paddock Rd Cross Street Section 135.26 Block 1 Lot 45 Owner Name/Address(If different than above) Melissa Wynn Contact Number ❑Basement ❑1st Fl. ❑ 2nd Fl. ❑3rd Fl. ❑More Than 3 Fl. ❑Garage ❑Attic ❑Outside ❑✓ Residential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C/O 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 Scope of Work Wiring for kitchen renovation 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 Office@Zaccagnino.net Name Angelo Zaccagnino License# 755 Date 10/14/25 Signature Address 81 Maple Ave City/State Rye NY Zip de 10580 Company Zaccagnino Electric I Phone# 914-921-3244 Dr���, 1DD State Wide Inspection Services 1E`�i 1 E �I `� 1080 Main Street Fishkill, NY 12524 �� JAl� 2 0 1026 845 202-7224 Phone 914-219-1062 Fax STATEWIDE INSPECTION SERVICES Email: office(a)swisny.com VILLAGE OF RYE BROOK Website: www.swisny.com Service With Integrity B 1 Dlrq(= r)FPART�A-1F!\!T BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: Zaccagnino Electric Melissa & Howie Wynn 81 Maple Avenue 18 Paddock Road Rye, NY 10580 Rye Brook, NY 10573 Located at: 18 Paddock Road, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: 135.26 1 45 Certificate Number: 2025-7819 Building Permit Number: RB25-0081 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: 18 Paddock Road, Rye Brook, NY 10573 The First Floor Kitchen, Dining Area and Garage 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 8" day of January 2026. Name Quantity Rating Circuit Type LED Lights 13 4" Refrigerator AFCl/GFCI 01 20AMP Disposal AFCl/GFCI 01 20AMP Microwave AFCl/GFCI 01 20AMP Gas Oven 01 Hood Vent 01 Switches 05 Kitchen Counter AFCl/GFCI 03 GFCI 01 Dimmers 02 600WATT 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. 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: 135.26-1-45 R-15 Proposed Work: Renovation of kitchen Indicate Fixtures&Lines to be installed as per the following schedule: 1st 2nd 3rd "t OthergtWipment/Provide Details: FIXTURES Basement Floor Floor Floor RIB nllatiorF15MtchenEsinpkriodishwasher, waterline for fridge Water Closets Urinals Drinking Fountains Sinks 1 Showers Bath Tubs Laundry Tubs Domestic Service Fire Service Sanitary Sewer Natural/LP 1 Gas Other* 2 TOTAL 4 Plumbing Permit Application,page 1/1 BPR VILLAGE OF RYE BROOK 938 King St Rye Brook,NY 10573 a W � .� Phone:(914)939-0668 1 www.ryebrook.gov �O 0 /� 19p2 i Building Department Residential/Interior(Remodel/Renovation) Permit Permit Set 18 PADDOCK RD P#RB25-0081 R#135.26-1-45 PERMIT INFORMATION Address Permit number Date issued 18 PADDOCK RD RB25-0081 10/24/2025 REVIEWED BY If you have any questions regarding the review of these drawings please contact: Application in general Steven Fews stevefews@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 2-3 Required Inspections 4 Building Inspector Stamped&Signed Set of Plans 5-9 3rd Party Electrical Inspection Form 10 Electrical License-Photo-Westchester County 11 General Contractor's Home Improvement License-Westchester 12 3rd Party Electrical Inspection Form 13 Electrical Permit Application 14 Interior Building Permit Application 15 Plumbing Permit Application 16 Building Department.938 King St Rye Brook,NY 10573/Phone:(914)939-0668 I31tnv� VILLAGE OF RYE BROOK 938 King St Rye Brook,NY 10573 W Q O� Phone:(914)939-0668 1 www.ryebrook.gov -a �• 82•`t Building Department INSTRUCTIONS THE PERMIT HOLDER AND/OR PROPERTY OWNER IS RESPONSI BLE FOR ENSURING THAT ALL REQUI RED/APPLICABLE INSPECTIONS ARE SCHEDULED AND THAT THE PERMIT IS COMPLETE ❑� REQUIRED INSPECTIONS Name Description Rough Electric Rough Electric 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. Framing Construction of all structural framing and stairs.(Rough Plumbing and Heating passed and doors,windows& roofing installed.)Engineered drawings must be provided for roof trusses. Insulation Installation of the insulating material and vapour barrier.Blown-in insulation can be installed after the ceiling drywall is applied and confirmed at the Occupancy inspection. 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Y ._ F O co i h •� � 5�<as)s p I R co ' 40 .t 5 0 � v z to I•��:r, `,, r .14 v co >tlasl►� L W a N = N e d v, u LA40 y CL �Cta)► .�(i)f�,t �f+i_ ,(T"_✓is+ Oft 1 c• q:!a,'L+b� �^ ,vyr �A •• , IAh'�: /� r'S� A ♦• .• *IAji.? ���Y. �`� A ,. ♦♦ r,` A y, ,: U� ar. f;,Jy'u•R✓ A. p �j � r .� y ',�, �'\ '•' V'"` �ti'x1I7�S�a � a �•+��,'�'� $�`�!/1�Y`'�� .:G. 5Ay<f+�" k4:. � '•,,�����rC, � �'�+�3•i '� a AMELENT-01 CRODRIGUES ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 9/2/2025 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 N24VCT Carol Mueller Acrisure Insurance Partners Services of NY,LLC PHONE, NN.Ext):(914)908-4612 jAX No: 90 S.Ridge Street Rye Brook,NY 10573 CMMueller@acrisure.com INSURERS AFFORDING COVERAGE NAIL 0 INSURER A:Merchants Mutual Insurance Company 23329 INSURED INSURER B: Amelio Enterprises, Ltd INSURER C: 473 West William Street INSURERD: Port Chester,NY 10573 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. INSIR AML TYPE OF INSURANCE ADDL SUER WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILnY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE I�OCCUR BOP9095693 6/17/2025 6/17/2026 DAMAGE TO RENTED REMISES(Ea occurrence) MED EXP(Any one on 15,000 PERSONAL&ADV INJURY 11000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2,000,000 X POLICY LI JECOT- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER. A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 n _ ANY AUTO CAP8647543 6/28/2025 W2812026 BODILY INJURY Per arson OWNED SCHEDULED AUTOS ONLY X AUTOS BODILY INJURY Per accident X AUTOS ONLY X AUTO ONLY jte08EIs t AMAGE A X UMBRELLA LWB X OCCUR EAACH OCCURRENCE $ 4,000,000 EXCESS LIAB CLAIMS-MADE CUP9137681 6/17/2025 6/17/2026 AGGREGATE $ DIED X RETENTIONS 10,000 4,000,000 WORKERS COMPENSATION STE ATUTET EOT RH AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE 77 E.L.EACH ACCIDENT W.FICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) ,EVIDENCE OF INSURANCE. 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 ACCORDANCE WITH THE POLICY PROVISIONS. 938 KING STREET RYE BROOK,NY 10573 AUTHORIZED REPRESENTATIVE r ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 17-01 rok& NYSIF New York State Insurance Fund PO Box 66699,Albany,NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE An A A A A 133891281 ACRISURE INSURANCE PARTNERS , SERVICES OF NY LLC f� Jd •_ 90 S RIDGE ST UL-2 RYE BROOK NY 10573 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER AMELIO ENTERPRISES LTD VILLAGE OF RYE BROOK T/A ENCORE DEVELOPMENT 938 KING STREET 473 WEST WILLIAM STREET RYE BROOK NY 10573 PORT CHESTER NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W2462 583-2 291708 03/21/2025 TO 03/21/2026 9/2/2025 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2462 583-2, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK. TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY,INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS://WWW.NYSIF.COM/CERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION, PRESIDENT JOSEPH AMELIO AMELIO ENTERPRISES LTD ONE PERSON CORPORATION 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 �V DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 796681447 U-26.3