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HomeMy WebLinkAboutRB25-0069 NCN C O Y j O v +, Er � 0 •� l"'I CC9 C C m - cov� v ii > � L Ln E o c �f 1 O ` W c-i a a- v N L m0E m W � O 11 c W O x z � > a > w W ++ N ° o a U p m > n v CIO3 v v Z 0 bOAO O OLu u = vr `" <° pp w E- E Y o O CV o 0 = N o � y Y a } \ � ~ Z 3' ,3Q r-I c o Z °o o O ao ° o 0 QC Y ac,p �. 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The existing basement is unfinished. We will complete the finished basement. 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 (if yes, applicant must submit a separate Automatic Fire an extension/modification to an existing automatic fire Suppression System Permit application & 2 sets of detailed suppression system? (Fire Sprinkler, ANSL System, FM-200 engineered plans) System, Type I Hood, etc...) © Yes ❑ No N.Y. State Construction Classification rR State Use Classification Occupancy Pre-Construction VB 1 family house Occupancy Post-Construction 0 fam., 2 fam., comm., etc...) 1 family house What is the total estimated cost of construction: (NOTE: The estimated cost shall include all labor, material, 180000 USD scaffolding,fixed equipment, professional fees, and material and labor which may be donated gratis.) Interior Building Permit Application,page 1/1 BPR VILLAGE OF RYE BROOK P 938 King St Rye Brook,NY 10573kv � Phone:(914)939-0668 1 www.ryebrook.gov a2• Building Department Residential/Interior(Remodel/Renovation) Permit Permit Set 19 CAROL CT P#RB25-0069 R#129.35-1-14.19 PERMIT INFORMATION Address Permit number Date issued 19 CAROL CT RB25-0069 11/10/2025 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 Required Inspections 3 Interior Building Permit Application 4 Building Department.938 King St Rye Brook,NY 10573/Phone:(914)939-0668 BRnuk VILLAGE OF RYE BROOK 938 King St Rye Brook NY 10573 W Q Phone:(914)939-0668 1 www.ryebrook.gov �O ��• b2• i Building Department INSTRUCTIONS THE PERMIT HOLDER AND/OR PROPERTY OWNER IS RESPONSIBLE FOR ENSURI NG THAT ALL REQU[RED/APPLICABLE INSPECTIONS ARE SCHEDULED AND THAT THE PERMIT IS COMPLETE REQUIRED INSPECTIONS Name Description Final Inspection Completion of all required items under the permit including the site grading and the surveyor's final grading certificate. Certificate of Occupancy Completion of ALL Work,All fees Paid and Final Survey in if required) 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. Fire Stopping Installation of a continuous air barrier.There are several options for providing an effective Air Barrier. Confirmation may require an inspection during several inspection stages. c O _ �N `o Y � w 00 0 0 i T v Er a cu� r-I c C c E y v - w L cu o c rl� a ^VJ m E I..L W � � c m cu += a 3 a w m 4i " X >o a 'oui L y .0 c V � m > L Q� O w U ( Y Z W L �c C O w � 3 HZ 3vm `o 3 c 3 N �a � } Q 7 y orb O .� d 00 0 L rl J Na �0o Y oL> c Q o c' O w .o 0 3 Z Q � o uo E a� 5m O Ln 3 � s c a LU Q a � o � O � � 5 � � oQ � Tm} p o C--C UZ c - 'm -,oQ J >Y La- FL 3 LLI O Z) QW 00 � O OUZ E = .oW, = < aC O ° p E a cno v pU uw „ m cv WIC` o 0c, �co ZD 3 y $ Oam v Y IT X O w 0 m u o -M v >, w ao mQ� '-,, o w E ` O � o� o � a . z L O o w � a w I Q U Z � w V Q E O mo� E c LNLJ Q = � E � o J (!) F m-J i 1 c0 � t'a z CL i Z CCLL () u w (n G > 2 j u0=0 � J L (D J Q O 4f G1 — N Oa 0 2 Ewa w } a` CA 3 o - .E Ln w WZw da EQ E � N Q M ° QQF- N0 ao °' n U wQ = V QjX � .a) (D U I ON N Q Q 00 j F- Q w N o c > « c 1 a-1 Qcr- .� > C I �. c O N ri nj o 0 o .� L 0E °c '� � v 4-j c0 a v V $ oo.� r c T a� `-° E Wo o a LA > z wE ° f0 V c0 w 2 m a I > E c � N O 00 G c\1 W J W O O} :t a w N Q n a l CL U F, o p W Q 0= 0= Z 0 = a u o r Q a a 0 v 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 129.35-1-14.19 Proposed Electrical Work/Fixture Count 3rd Party Electrical Inspection Agency 37 RECESS-30 OUTLETS-15 SWITCHES-2 SMOKE SWIS DETECTORS-1 EXHAUST FAN -6 GFI OUTLETS Master Electrician/Licensed Installer Information Name Lic# Address email Phone# Cell# Company Name RAFAEL GUEDES 1902 18 DANIELS PLACE 9147745166 Company Address Address of Work? Homeowner Information 19 CAROL CT Electrical Permit Application,page 1/1 y BR VILLAGE OF RYE BROOK 938 King St Rye Brook,NY 10573 �► W Phone:(914)939-06681 www.ryebrook-gov r /� 19f12 i Building Department Electrical/New Fixtures And Wiring(New)Permit Permit Set 19 CAROL CT P#RB25-0126 R#129.35-1-14.19 PERMIT INFORMATION Address Permit number Date issued 19 CAROL CT RB25-0126 11/18/2025 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 Required Inspections 3 Application Materials,Property Owner/Homeowner Government ID,and/or Proof of Ownership 4 3rd Party Electrical Inspection Form 5 Electrical License-Photo-Westchester County 6 Electrical Permit Application 7 Building Department.938 King St Rye Brook,NY 10573/Phone:(914)939-0668 �y (3PR VILLAGE OF RYE BROOK 938 King St Rye Brook,NY 10573 W Q Y Phone:(914)939-0668 1 www.ryebrook.gov O 1902 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 RE .a r. o _. REQUIRED INSPECTIONS Name Description 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. BUILDING DEPARTMENT VILLAGE OF RYE BROOK 938 KI\G STREET Rl'E BROOK.NY 10573 (914)939-0668 \\\\%\.rvchr, ,k i i�ov ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY [if,#: �g 45-CO1s��T1 El'#: -----____-- -- Approval Date: Permit Fee: S 'z 00 • D(-� Approval Signature: Other: DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSL.ED BY THE BUILDING INSPECTOR. THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12%OF THE TOTAL COST OF CONSTRI (TION WITH A MINIMUM FEE OF S750.00 Application dated, 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 inn�conformance with all applicable Federal,State.County and Local Codes. 1.Address: I i la zoo C4 SBL: Zone: 2.Property Owner: 1Z�a� G J q�'�'�� Address: sftyl(/ Phone#: Cell#: II I ) , 2 p ( email: ,n 3.Master Electrician'Licensed Installer: PFE 1. JF --}=�JJ // Address:•• rr � - t hW Lic.#: I�Phone#: Cell #: l�Iy)T I-so {O email: `�N Company Name: I L coo Address: A I I lyl -N 4.Proposed Electri al Work/Fixture Count: CAL K- y v� V Y sw�fih ► n .cam - 0AU - Swkt &6AJTM - WT Q)Vi� _ S.3'4 P rt Electrical Inspection Agency: t*•t**,t**,t,ta**,ttttw�r****,t*t*,r*,trr*,tt►,t*t***,t,r*r�*r,►***4*t*r,t*,t,►rrt,t****r,►**trt*,t**w**,►w,r,tw,t**r*tr**,t**pert STATE OF NEW YORK.COUNTY OF WESTCHESTER ) as: .being duly swom.deposes and states that he/she is the applicant above named.and does further (print name of indn idual signing as the applicant i state that(s)he is the for the legal owner and is duly authorized to make and file this application. ivtaster 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 anv work performed.or use conducted at the above captioned property will he 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 la%%s.ordinances.and regulations. Sworntobeoremethis Sworn to before me t is d 0 .20 Z day of t't�'� �- 'Q Si re of Pr m Owner gnature of Applicant WtgP"ub e of Pir Owner KERRI PEEKE a vs ,91 Notary Public.State of ConneOCuI c, lic t�'My Commission Expires W130 2030 No ate in Westchester County .oii nission Expires January 29,2 4 STATE WIDE INSPECTION SERVICES, INC. (A-) 080 OFFICEPSWISNY.Cop swis JOB APPLICATION tel 845.202.7224 1 fax 914.219.1062 1 SWISNYcoml SWISTRAINING.COM Office Use Elect. Permit # Date I /� Bldg Permit v �5— �C Sq Ft v Plumbing Permit# Final Certificate# n Clty Vlilage L�0 Zip 05� Building Dept. c County19 1 Address Cross Street Section Block Lot r�* Owner Name/Address i u d,+e-e-(^a 3r;wi . {fir - Contact Number Basement ❑1st FI. ❑2nd Fl. ❑3rd FI 1❑More Than 3 FI. 1:1 Garage ❑Attic NOutside IRI sidential ❑Commercial Receptacles Special Recept GFCI AFC? Switches Dimmers Smoke Alarms C/0 Detector Hood Trash Compact Amt Amps Range(s) Cooktop(s) Oven(s) DIShr:asherS Refrigerator Disposal Microwave Luminaires Generator Transfer Swdcr 5�— SERVICE Amperage #Panels ip 3P r Meters = Disconnect ❑Underground ❑New ❑ Reconnect ❑Repair ❑Overhead ❑Upgrade ❑ Disconnect Utility IDr ❑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 41i-� Ich6 This application is valid for one(1)year hom the date received by SWIS.This application is intended to cover the above lured items to be inspected,if at any time of inspection additional items have been installed.you are authorized to make the inspectton and adjust the fee for the addttionai items inspected The applicant declares that there is no open applications for Me above address with any other;nspectron company.The applicant. owner pr authorzed agent agrees to all the atwse te—and(ond,tion,as set forth for the appli atlon Email Address �� — Y Name License r Date 11 Signature 7 Address lYz�AYIJ City/State �,r4� k7 �� Zip Code Company t/ Phone+M 1.0 c Lry N c o N oY +,CN Z o Q E a 4-J V) (fl ' v 11 -• j -0 ciS E o 00 c nL CL v r^'W W L m ti N p, <9 N li v a 3 3 a w LL X ~ N o a v o ui Cl CL H Z O W u ^ v t C W � W_ F— s Y 7 O (N 3 O � 0Y to NO H Z I 3: a) 0 �+ o0 QZ L rU LI U S a d W W w E ]EY a o 8 " - 25 m N 0 +oc` aZ CO 00) 0 3 a L 0a � "0 5 >. � 8Qc +0 `o_ m � p - a Y LAJ — W c� D Z v► vO n > OWao U Qa Emo Y �o Z Q p c o a E a mNo � a. 0 o za W U m WPM 4-J o O o o O � 3 .0`. a�i $ OL o v W M (n d i y o Q O Q vLLJ } 0 0 0 aci Z H `� JW } ~ -p ',l6 a U > Z � LL > _ > " W .1 r; (n � Q N �' O ate. La 0) v v to � aW � W } cV) -Nd c O. O YW aCL a, } o , � M Q M = OZ : Y NO o.0 �°' 3m' a, ^ ON N a W w o, O H Q w v) a, > s Q L.L LL c-I C I C Q 20 m 2c � 2vv .� gOQ-0 W v o o w > > V 0M0 � � � ogo _ v NEwyo� o � a > E .8 S N L , c N W J W O r '(CLLI -LA a a, aci LAJ co p U H O o E u 'u; u � � C ._ -0 a Yd �r LLI Q Q ~ a Q a x a V) F- 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: 129.35-1-14.19 Proposed Work: Rough install bathroom, bar sink, and sewer ejector Indicate Fixtures&Lines to be installed as per the following schedule: 1st 2nd 3rd 4tj�t OthergfWipment/Provide Details: FIXTURES Basement Floor Floor Floor Floor Floor Exterior Water 1 Closets Urinals Drinking Fountains Sinks 2 Showers 1 Bath Tubs Laundry Tubs Domestic Service Fire Service Sanitary Sewer Natural/LP Gas Other* 1 TOTAL 5 Plumbing Permit Application,page 1/1 �y BIR VILLAGE OF RYE BROOK 04 y 938 King St Rye Brook,NY 10573 � W � Q Phone:(914)939-06681 www.ryebrook.gov ��. 1 82 . Building Department Plumbing/New Fixtures And Lines(New) Permit Permit Set 19 CAROL CT P#RB25-0139 R#129.35-1-14.19 PERMIT INFORMATION Address Permit number Date issued 19 CAROL CT RB25-0139 11/26/2025 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 Required Inspections 3 Plumbing License-Photo-Westchester County 4 Plumbing Permit Application 5 Building Department.938 King St Rye Brook,NY 10573/Phone:(914)939-0668 �yC BR— VILLAGE OF RYE BROOK 938 King St Rye Brook,NY 10573 W Q Y Phone:(914)939-0668 1 www.ryebrook.gov 1982 ' Building Department INSTRUCTIONS THE PERMIT HOLDER AND/OR PROPERTY OWNER IS RESPONSI BLE FOR ENSURING THAT ALL REQUIRED/APPLICABLE INSPECTIONS ARE SCHEDULED AND THAT THE PERMIT IS COMPLETE r � r REQUIRED INSPECTIONS Name Description Final Inspection Completion of all required items under the permit including the site grading and the surveyor's final grading certificate. Certificate of Occupancy Completion of ALL Work,All fees Paid and Final Survey in if required) r[PSCONSTRUCTION ExistingEgress — Existing Condition condition and access to the egress located at 19 Carol • Road, Rye Brook, NY 10573. Date: 1 1 Outside:1. Pictures from Ill Morgan Street unit 619 Stamf 1. • • CT 06905 .r v c ',.M1'Fi � ��R .. � �➢a �! '_... 0e'. x"xr, tif:, react r • V[9S CONSTRUCTION ' � -fly` i•j 111 Morgan Street unit 619 Stamford CT 1.•1 • •(c • • • y C C! _ o p •� O Cfl N a _N CJ 1 00 C) Oil � •7 n Ri R � i u 0) C. Cep d cj- 'Clon ?oil c ; LLJ FL oOno U J 73 Y U 1. 04 i cs c Ci N gocn y C �1 J y 1' i ^ ..w^ p' �^ �r - .rat A _ .....;� A� .. �i���y .. I�(I���ti ry,. '�(ibb(�'� 1�` U 'J�(•��I is y��1• �� !a wit. iy���,\, j�, 31�. tiYQi�"� �$^p Ott' �'� ^ � \Y��TdI � it qY'�,�i ^ �.c.��✓' � w t��V�-}3 t�j�Vi�,.j' tl.•;]FVaP¢' v V v V � -' DATE . CERTIFICATE OF LIABILITY INSURANCE DIYYYY) ,(MM/D MMfD0t09/2o25 -- — — � — 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 Mary F.Williams NAME: _ Mary Williams Insurance Agency XCI%�L (914)935-3383 F No• (914)93r`3317 125 N.Main St.Suite 501 E-hUUL frankievaiams.insliMmail.com Port Chester,NY 10573 INSURERS)AFFORDING COVERAGE NAIL e Phone (914)935-3383 Fax (914)935.3317 INSURERA__Acceptance Indemnity Insurance Co. - INSURED INSURER B: L9 Construction,LLC INSURER C: 111 Morgan Street Unit 619 INSURER D: INSURER E: — Stamford CT 06905- 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 HERON IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS. ILNTR TYPE OF INSURANCE ADD UINSR p POLICY NUMBER MW Dr EFF POLICY EXP LIMITS e COMMERC4LL GENERAL LLAwLITY EACH OCCURRENCE $ 1 000,000.00 DAMAGE TO RENTED 1��,� ❑ CLAIMS-MADE © OCCUR PREM ES oxurrence $ _ ED EXP one person) s 5,000.00 A ❑ Y BND0011987 01 12/21/2024 12/21/2025 PERSONAL a ADV INJURY s 1,000,000.00 GEITL AGGREGATE UMITAPPLIESPER: GENERAL AGGREGATE s 2,000,000.00 ❑ POLJCY ❑ JECT ❑ LOC PRODUCTS-COMPIOP AGO S 2,000,000.00 ❑ OTHER _ $ AUTOMOBILE LIABILITY EaM i_ U tNGLE LIMIT S ❑ ANY AUTO BODILY_INJURY(Per person) S ❑ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accidaM) $ ❑ HIRED ❑ NON-OWNED i AUTOS ONLY AUTOS ONLY - ❑ $ ❑ UMBRELLA LIAR ❑OCCUR EACH OCCURRENCE i ❑ EXCESS LIAB ❑CLAMS-MADE AGGREGATE S ❑ DED- RETENTIONS 0111- $ WORKERS COMPENSATION PETATUTER ER AND EMPLOYERS'UAINUTY Y/N ANY PROPRIETOR/PARTNER/EXECURV11—I E.L EACH ACCIDENT 5 OFFICER/MEMBEREXCLUDED? U NIA (Mandatory in NH) IE.L.DISEASE-EA EMPLOYE S M yes,describe under E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS below _ I I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Village of rye Brook is included as additional insured as respects to General Liability subject to Policy Terms and Conditions I 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, new York 10573 TH D F)EPRESENTATIVE 98 - 15 ACOR CORPORATION. All tights reserved. ACORD 25(2016/03)QF T ACORD name and logo are registered marks of ACORD N YS I F New York State Insurance Funu PO Box 66699,Albany,NY 12206 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE 0 n AA AAA 921111898 � MARY F WILLIAMS INS AGENCY 219 WESTCHESTER AVE 4TH FL Qi if" .0 PORT CHESTER NY 10573 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER L9 CONSTRUCTION LLC VILLAGE OF RYE BROOK 111 MORGAN STREET UNIT 619 938 KING STREET STAMFORD CT 06905 RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W2617 603-2 948276 06/26/2025 TO 06/26/2026 10/9/2025 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2617 603-2. 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:I/WWW.NYSIF.COM/CERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER THE SOLE PROPRIETOR,PARTNERS AND/OR MEMBERS OF A LIMITED LIABILITY COMPANY. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. 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