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HomeMy WebLinkAboutMP16-066 �yE 4R b 4J V J� CCU.L� 7. 190 VILLAGE OF RYE BROOK MAYOR 938 King Street,Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914)939-0668 Christopher J.Bradbury www.ryebrookny.gov TRUSTEES BUILDING & FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE August 26,2024 Irwin Simkin,Leomi Simkin&Eric Simkin 93 Brush Hollow Close Rye Brook,New York 10573 Re: 93 Brush Hollow Close,Rye Brook,New York 10573 Parcel ID#: 129.84-2-82 This document certifies that the work done under Mechanical Permit #16-066 issued on 6/2/2016 for the installation of a new oil fired boiler has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to �yE BRcb, • 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 :- J J VI > I J ` 1L i1 c- W DATE: f PERMIT# 'M \ 0(4 (o ISSUED:�-2 I L SECT: 1 BLOCK: LOT: Z LOCATION: 1�P(�-/� c W OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑�ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION FINAL ❑ OTHER t N ` N : H 96 � N � N ' cc '' O = I M r.1 �lf w _ OEM 03 O � co U c p, . t s Jor c W Z < 16 •• C v rA W w aZ Q I 00 0, s QQ p E C IEME Bl111,13ING DE' PARTNIENT DD' VILLAGE OF RVE 0ROOK , r.•3 — S 2"JI6 938 KING STREE•r Rti"F dKVUK, NY 10573 VILLAGE OF RYE BROOK (914) 939-0068 x (9 4)939-5801 BUILDING DEPARTMENT ww t>- tbOkaoib ELECTRICAL PERMIT APPLICATION This application must be filed in person at the Building Department by the Licensed Electrician of Record and must be accompanied by the completed Electrical Inspection Agency application form. Office Use Only: SEP 1 2 2016 Date: Approval Signature: Inspection Agency: Electrical Permit#: � Fees:�`�� paid (, ) due( ) Building Permit M fffifflf♦fff if ffff♦♦♦♦ffff ff ffff♦ff fff#f#fflfffiflff#fflfffff fff♦fffffff►f•♦lffffiflff►►►f ff ffff♦♦►♦♦ffff if tiff#f fff fff#fff►♦#ffff•##ffff• Application is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit for the installation/removal/repair of Electrical Equipment as per detailed statement described below, and in accordance with the Code of the Village of Rye Brook, NYSUFP&BC, NEC, NFPA and all other applicable State, County and Local Laws. Address: (A ( �h nllnw L Phone#: Flu- SZ-� Owner: 1P y-k C Address& Phone: ougL Use/Occupancy: U1 A A rlgzt-�-cx- Parcel I.D.#: Z, Zone: Proposed Electrical Work: LICENSED ELEC R[CL\N':S lNFY1RM:\"fIUN: Name(Please Pr ) Phone Signature: - - Westchester County License#: "j - -- - -- - ----- —-— Cumpan I a -- Company Address: �\ � �, icl 1. - —- ------------ ----- ------ Y "+�'► —i __City-'town: State: _ —Zip Code: AAS'? Phone#: - Field Contact& Phone: ----- - - ..................................................................................�.......I. �7i.,.'Ya.-__q:,�-.: K-•.E.Liu.--i��:._siS:..�-.-:"J•-. __.�_.r+iaf:- �,-.�.:.s--y ..w�. � .-tee.�..._"t-'.�"3f..e,.'SSr rf. ' �� < 1 � Westchdster Rockland Electrical Inspection Services, Inc. Pho b: d-'4 -"'95 DO NOT WRITE HERE—FOR OFFICE USE ONLY 43 North Lawn Avenue Fax: 914-347-3596 Elmsford, NY 10523 BUILDING PERMIT NO. TEMP H DATE ' `" G = --41 r? tj,-,q� CITY OR VILLAGE ZIP CODE TOWNSHIP COUNTY STREET AND NO.OR ROAD POLE NUMBER BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? SECTION BLOCK LOT OCCUPANT'S NAME BUILDING OCCUPANCY OWNER'S NAME AND ADDRESS HOME TELEPHONE NUMBER CURRENT SUPPLIED BY FROM THEIR OFFICE WORK TELEPHONE NUMBER LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED NUMBER OF OUTLETS NO.OF FIXTURES 8 MOTORS HEATERS OFFICE USE LOCATION LAMP RECEPTACLES ONLY SIDEWALL SWITCH INCADE F B ATTS EACH INSPECTION OUTSIDE BASEMENT 4OFRYE 1�'FL. 2-FL. LLAROOK 3'FL. REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: 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 AS PROVIDED BY THE APPLICANT.THE APPLICANT DECLARES THAT THERE IS NO OPEN APPLICATIONS FOR THE ABOVE WITH ANY OTHER INSPECTION COMPANY.WREIS,INC.IS NOT LISTING,LABELING.UNDERWRITING OR CERTIFYING ANY EQUIPMENT, MATERIALS OR DEVICES WHICH ARE PERFORMED BY OTHER CERTIFIED TESTING AGENCIES OR INSPECTION COMPANIES.THE APPLICANT,OWNER,OR AUTHORIZED AGENT AGREES TO ALL THE ABOVE TERMS AND CONDITIONS AS SET FORTH FOR THE APPLICATION. SIZE OF SERVICE FEEDERS CHARACTER OF WORK NEW❑ ADDITIONAL O EXPOSED❑ CONCEALED❑ MUST ENTER APPLICANTS IDENTIFICATION NUMBER SERVICE ENTERS BUILDING OVERHEAD❑ UNDERGROUND❑ AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACE MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. NAME OF COMPANY DATE OF APPLICATION SIGNATURE OF APPLICANT - i - STREET ADDRESS TELEPHONE NO. v4,,--- , , :,. , 2/-3Z`1y ,lid GCCli �� of CITY OR POST OFFICE -. ZIP CODE LICENSE NO.WHEN APPLICABLE �r i r WESTCHESTER ROCK LAND WElb ELECTRICAL INSPECTION - SERVICES,INC. BY THIS CERTIFICATE OF COMPLIANCE THE Westchester Rockland Electrical Inspection Services 43 North Lawn Ave, Elmsford, NY 10523 914-347-3595 (Office) 1 914-347-3596 (Fax) CERTIFIES THAT Upon the application of: Upon premises owned by: Zaccagnino Electric Irwin & Leomi Simkin 81 Maple Avenue Rye NY 10580 Located at: 93 Brush Hollow Close, Rye Brook, NY 10573 Certificate Number: 410018 Section: 129.84 Block: 2 Lot: 82 BDC: Permit Number: EP:15-089 BP:O A visual inspection of the electrical system at this premise described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: 93 Brush Hollow Close, Rye Brook, NY 10573 ❑Basement ❑1st Floor 02nd Floor 03rd Floor ❑Garage ❑Attic QX Outside Inspection was conducted in accordance with the NYS and NFPA 70-08 and detail of the installation, as set forth below, was found to be in compliance therewith on 1/3/2017 Name Quantity Rating Circuit Type Boiler 1 This Certificate has been approved by Westchester Rockland Electrical Inspection Services. This certificate may not be altered in any way. This certificate is valid for work performed before date of inspection only. i .y cLaina y vt Mai s 9= Water with Tankless Heater Chimney Vent f R MBH: 115-295 t Avg.Efficiency:85% SERIES-OILhL GOLD BOILER ® ap HIGH EFFICIENCY s 0 EASY TO INSTALL AND SERVICE OO MADE WITH WEIL-MCLAIN QUALITY r APPLICATIONS INCLUDE: ; Residential Light Commercial Multiple Boilers Indirect-fired Water Heating Radiant Heating ...And Much More MMMMI WEILAILAIN l°�lli pkta4 MADE IN THE �r DOE Ratings ((� i-B=R Chimney Size Model" I I-B=R I %DOE DOE Heating Neti-B-R-1 Tankless I Draft loss Rectangular I Round I Height Approx No1ec Burner Seasonal Capacity Water Rating Heater Through (in.) (n.) (ft) Shipping •' Add llfapadu,gedboaer(WTC>a31rayhWi(3esonly), Cap.(GPH) Efficiency (MBHwater) (MBH) Intermittent Boller(in.w/c) Might(Lbs) Add'X for boiler ority(WfGO-3 through Wr( -9). IT) (AFUE) (2)(3) (3)(5) or-Ming(6) (7) (1)No.2tuelal LbrmeniNStaMard specification fS75-56 Heatngvalueof aT-140,000 BTU/Gat GO-3' 0.95 1 85.3 115 1 100 1 3.25 1 .020 8-�- x8 T6 1 15 1 540 <--(2)Based on starpiard test procodures prescribed by the United States P-WTGO-3L 0.95 84.5 114 99 3.00 .020 8x8 6 15 595 O IYGc.art"'e"tae"ey,u eusmnemda)°"dt31/2%arzanao.gr tl2fC WTGO 4' 1.20 85.0 145 126 3.75 O10 8x8 6 15 645 (3>MBHrefersto thousands ofBTUperfruc (4)I-B`R gross output WTGO-5' 1 1.45 1 85.0 1 175 1 152 4.00 1 .015 1 8 x 8 7 15 760 (5)Net I-B-R ratings are based on net Installed radiation adequate for WTGO 6' 1.75 85.0 212 184 4.25 .015 8 x 8 7 15 860 the requirements of the building,Including a p ping and pickup allowance of 1.15-sufficient for normal conditions.Provide WTGO-7- 2.00 1 85.0 1 242 1 210 5.50 1 .015 1 8 x 8 8 15 1 930 additional allowance only for unusual piping and pickup loads. (6)Tankloss heater rating is In gallons of water per minute,heated from WTGO 8 2.30 - 266" 1 231 5.75 1 .025 1 8 x 12 1 8 1 20 1 1030 40eF to 140OF with 200OF boiler water temperature-tested in accordance with I•W-H Testing and Rating Standard for Indirect WTGO-9 2.55 - 295" 1 257 1 6.00 1 .030 1 8 x 12 1 8 1 20 1 1135 Tankless Water Heaters Test with Boilers. (7)Listed draft losses are for standard burnor settings. Dimensions SuppN'C(in I Rettarl I Dimensions(in) I TarddessHeater I Tapping I size I control I Model I p_M—�A WGO ) M) I B I L I Mxnber I Wet&Outlet(NPT)(m) TaT Control(NPT)(at) Loma' (in) �r WTGO-3 11/4icirmtataeary) 1 1/2 1 1/2 13 1/2 16 7/g Wi 14 1/2 3/q `!i 62 1 V2 Alternate return-A'units only WTGO-3L 111 p-ator E3 V2 Pressure/temperature gauge /4 flange) 1 1/2 1 1/2 101/2 13 3/q WT-14 1/2 3/4 WT(30-4 11/40aaai-Amon)1 1 1/2 1 1 1/2 1 13 5/g 1 16 7/g I wT-14 1 1/2 3/q Drain valve W1`130-5 11/2k5rrrV3VI1aTW)1 1 1/2 1 1 1/2 1 167/81 20 1 wT-14 1/2 3/4 L 3/4 High limit/circulator control WTGO 6 11/2 d cwtafla ge) 1 1/2 1 1/2 20 231/8 WT 14 1/2 3/4 N 1/2 Piping to expansion tank or automatic air vent R1 3/4 Relief valve wTGO-7 not applicable_1 1112 1 11/2 1 231/g 261/4 VJT-20 1/ 3/4 WTGO-8 1 not applicable 1 1/2 1 1/2 261/41 29 3/g 1 WT-20 112 3/a WTGO 9 not applicable 1 1/2 1 1/2 29 3/a 321/2 Wi-20 1/2 3/4 Crate Dimensions: Height-39" Width-23" Length('WTGO-3,-4)-27"/('WTGO-5,-6)-33" 20Y,' 14'approa. 7'A't 51,c _21N 7;5 23e' IN d-- supa'r(c) _ N Supply T diameter (C) 6'!( �—For 7' -- Q Y ° L vent pipe x\ ° Rt E3 ° 1 bur pia. _ 35V burner .B t%- , Q opening 29o/�r;Return i 15y� Return --fi 62 v. 14Ve a _J._._._ 7 Y1s }— —� —H 2'h6 --2'/ts 1 yA H ,1. P.VVTGO Front Side A-VVTGO Front Back Intermediate Standard and Optional Equipment Standard Equipment: Optional Equipment: Limited Lifetime Warranty on Bailer Sections Circulator(Taco 007)-Supplied with High-Efficiency Flame-Retention Oil Burner Factory Tested "Packaged"Units Only (Beckett AFG,Carlin EZ or Riello).Specify Facto ry-Assembi ed Cast Iron Sections with Comb.Temp.Controls,LWCO&Circulator Relay 2-Stage Fuel Unit(optional)if Required. the Following Parts Installed.(not assembled (all P-units/A-units ordered with W-M 5&10 Year Homeowner Protection Plan on 7-,8-and 9-section blocks.) tankless heater) W-M Indirect-Fired Water Heaters Tankless Heater(P-units)or Tankless Electrical Junction Box with Wiring Harnesses Opening Cover Plate(A-units) Junction Box Cover Plate with Service Switch Insulated Steel Jacket Two Vent Pipe Brackets Aluminized Steel Flue Collector Hood Pressure/Temperature Gauge with Flue Cap on Top Outlet 30 PSI ASME Relief VaNe(baler sections tested 4 Swing-Away Burner Mounting Door for 50 PSI working pressure) Refractory Blanket and Target Wall in Drain Valve Combustion Area Balanced Draft Damper [§WEIL-WAIN In the interest of continual improvements in prod and performance,Weil-McLain reserves the right to change specifications without notice. C-751(1009) r u p k 616 d «8601Szz548 zapueudaj wil LGTI 90i0-9L02 AC" ® DATE(MM/DDIYVVY) V CERTIFICATE OF LIABILITY INSURANCE F4/26/2016 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 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 Stephanie Payne Brown & Brown of New York Inc. dba Spain Agency PHCNNo.Ext) (845)628-4500 AX No:(845)628-1804 JAI625 Route 6 E-MAIL ADDRESS:sp P a e@s sinins.com INSURERS AFFORDING COVERAGE NAIC N Mahopac NY 10541 INSURERAAmrica Fire and Casualty Co. 24066 INSURED INSURERB:Ohio Casualty Insurance CO 24074 Thuesen Mechanical Corp. INSURERC12ochdale Insurance Company 12491 345 Lexington Ave. INSURERD: INSURER E: _ Mt. Kisco NY 10549 INSURERF: COVERAGES CERTIFICATE NUMBER:15-16 Master w/16-17 WC 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 I ADDLSUTYPE OF INSURANCE B POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD MMIDDIYYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 ID A CLAIMS-MADE ❑X OCCUR PREMISES(EAENTEoccu occurrence) $ 300,000 X Contractual Liab X BKA55558075 7/31/2015 7/31/2016 MED EXP(Anyone person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 POLICY 1 - PRO - POLICY FI LOC PRODUCTS-COMP/OP AGG S 2,000,000 OTHER: Empl Bane Liab-Each Claim $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 A X ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED AUTOS AUTOS BAA55558075 7/31/2015 7/31/2016 BODILY INJURY(Per accident) S NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per acddenl $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 B EXCESS LIAR CLAIMS-MADE AGGREGATE $ 4,000,000 DED I X F RETENTION$ 10,000 US055558075 7/31/2015 7/31/2016 $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY OFFICER/MEIMBER EXCLUDED?ETOR/pARTNERIEXECUTIVEFN N/A E.L.EACH ACCIDENT $ 1,000,000 C (Mandatory in NH) RWC3412505 5/1/2016 5/1/2017 E.L.DISEASE-EA EMPLOYE E _ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate holder is named as Additional Insured as their interests may appear subject to policy terms and conditions. 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 10580 AUTHORIZED REPRESENTATIVE Michael Spain/SP1 ��- ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INSO?5roman1 Certificate of NYS Workers' Compensation Insurance Coverage Page 50 of 125 STATE OF NEW YORK WORKER'S COMPENSATION BOARD CERTIFICATE OF NYS WORKERS' COMPENSATION INSURANCE COVERAGE Ia.Legal Name and address of Insured(Use street address only) Ib.Business Telephone Number of Insured Thuesen Mechanical Corp&Thuesen Management Corp 914-241-7499 345 Lexington Ave Mt Kisco,NY 10549 lc.NYS Unemployment Insurance Employer Registration Number of Insured Id.Federal Employer lndentification Number of Insured or Social Security Number Work Location of Insured(Only required ijcoverage is specifically limited �1405021 to certain location in New York State,i.e.a Wrap-Up Policy) 2.Name and Address of the Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Rochdale Insurance Company Village of Rye Brook 938 King Street 3b.Policy Number of entity listed in box"la": Rye Brook,NY 10580 RWC3412505 3c.Policy effective period: 5/1/2016 to 5/1/2017 3d.The Proprietor,Partners or Executive Officers are: 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"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 Certification of Insurance to the entity listed above as the certificate holder in box"T'. The Insurance Carrier will also notify the above certificate holder 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. Please Note:Upon the 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: Henry C.Sibley (Print name of authorized representative or licensed agent of insurance carrier) ��_ Approved By: r �� 4/28/2016 (Signature) (Date) Title: Underwriting Manager Telephone Number of authorized representative or licensed agent of insurance carrier:CarrierPhone Please Nate:Only insurance carriers and their licensed agents are authorized to issue the C-105.2 form.Insurance brokers are NOTauthorized m isme it. C-105.2(9-07) mhtml:file://C:\Users\Thuesen Maln\Downloads\Thuesen- C105.2 Renewal Certs.mht 4/28/2016