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HomeMy WebLinkAboutMP12-046 �yE DR 4 i�i.wY, 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 CLARIFICATION OF RECORD September 16,2024 Anthony Artabane&Cheryl Artabane 4 Little Kings Lane Rye Brook,New York 10573 Re: 4 Little Kings Lane,Rye Brook,New York 10573 Parcel ID#: 130.77-1-16.5 Mechanical Permit#12-046 issued on 6/18/2012 to Install Gas Furnace & Condensing Unit This certifies that the above captioned permit has been closed out by Mechanical Permit#24-111 issued on 8/21/2024 to install two new furnaces,two new condensers and coil with Certificate of Compliance issued on 9/16/2024. Sincerely, 0"— 4 Steven E. Fews Building&Fire Inspector /to �E BRC�uk o`` tim 19b2 BUILDING DEPARTMENT ❑BBUILDING INSPECTOR JQ 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 : L J DATE: PERMIT# r ISSUED: SECT: /30. 77 BLOCK: LOT: LOCATION: 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 P ❑ CROSS CONNECTION FINAL OTHER d+ N � 'UO .D p QI ` o zu r- � O Y w fn Lin Q) � V 03 p,� L.3 M � � b g -E d' = W O O w OQ > � � A Op LL U E..� � o8 � 5 °gelL a- cc a Cd kn CZ O w � a Q en a Z a+ Z u Z 4t U Z G: 50 E g 0 a CA — x oo E00 0 0 '0. � u° c •� oa � - � x W 44 cz I� C7 Z ;04 � Z � � W A � Q .-- �° b e .. a Q aw, z a rA � � CL x �Ijo04 of = 0 ^ C'n E VILL F YE BROOK D BUI NG DEPARTMENT 938 KING FL T YE 1l�ROOK,NY 10573 JUN 18 2012 (914)939-0668 F -5801 www. ebrook or �� VILLAGE OF RYE BROOK APPLICATION FOR PERMIT TO INSTALL AND/ EPARTMENT HEATING, VENTILATION AND/OR AIR CONDITIONING EQUIPMENT Permit#: Building Inspector: Fee Paid: 7�- I-A _ Date of Approval: f `' Parcel ID#: �, 71- Bldg/Use Class: Res. ( ; Comm. ( ); 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 Insurance including Liability&Workers Compensation naming the Village of Rye Brook as Certificate Holder. 4. Payment of Fees/Unit: Residential: $75.00;Commercial: $250.00. (fees are non-refundable) 5. Inspection by Building Department for removal and/or installation. (48 hour notice required) 6. Any electrical work requires a separate Electrical Permit and Electrical Inspection. 7. Any gas/plumbing work requires a separate Plumbing Permit and Plumbing Inspection. Application is hereby made to the Building Inspector of the Village of Rye Brook for the approval of a permit for the installation and or removal of the HVAC equipment as listed below. The applicant, 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. Site Address: `41 11/7-2If_ 14,-',V(IJ 2. Property Owner&Phone: H�. -!� "�4?3{�►'�� 3. Applicant: ��f Y1Al P 1 661 /&V 4. Contractor: 7`72�t- 5. Contractor Site Contact: 6. Scope of Work:New Installation( ); Replacemen ' ; Removal Other( ) 7. Type of Equipment: lz,'?CA-f�4 -D 8. Location of Equipment: a", 9. Applicant Signature: I,�✓ Date: 4.9./2 STATE OF CONNECTICUT + DEPARTMENT OF CONSUMER PROTECTION Be it known that i KEVIN MC CORMACK 62XI&MkMR, SHELTM-- C"i464 I ram• �~:-•.•1�y+W,p _s been certified by the Department of Consumer Protection as a , ;,, H��TI�G, PIPING-'& COCA=LING. 11GTED CONTRACTOR our k _;, '-':�`• ;,`4����`�---- ; License 14 i#308094-D1 E ffe c uve: 09/0'-!2011 Expiration: 08/31/2012 _ William M.Rubenstein,Commissioner STATE OF CONNECTICUT + DEPARTMENT OF CONSUINIER•-PROTECTION Be it known that KEVIN P ?vlCCORNLA C-K ea 62 V ISTA-DR- SHELTO-.\', CT-064.824 been certified by the Department of Consumer Protection as a 'I�iITED`.SHEET NIET.A�'GC�NTRACTOR License #- ' :0000444-SM1 Etfec�ve: 09/0. 2011 ' Expiration: 08/31/2012 William M. Rubenstein Commissioner ' W i 1 4p.'M6i��i�� \�J .�0� 4• �� _ �ti�^�V'� 5�,^p,�M•;\,\� .�:�V �� ;\ sa 9,AfyA//'(^� '�'� `i'/p Y••. <t v N m ��`.w"..`, �, r=.�h111/1/► �� --.�jl/lll/lj�: � Ij11/111'� � ►/�111' �v /�/�/r .'. �vl r��r� • r�• v o- <to)> .,:- N111' .:��: N111 =_=:<� `.�•:hull'.=� :,-.- ,i:�'illllii'�-s;:, �,�::,'i1H/�i.,,,� .:��l/jll/l�ih� �� ��11111i�� r � �,•. /';. :.��.: ./ NON �... ,1�/1 cb '11�11'-+••f � •�: CN W Cv •'' .r c3 .r,�. K i � • i1�1 L." U .:r O � • co af(o)i � N ?ram � U • � O � � �•i - � ke n rz- Z CC) y a) U c, r r3 cod► Q- U Q*7. c`'LL h mom: 4-� Q Y Z m b 4i/1edaQ - O ~ Q -d > ', • as C.�.. - 04, wom Of _ ��•: '1/1� =I�Illhl, �-I'1�/' 'dlllh •,,:�► 1 l- 1 ti «O) ��-�"�t'?�`Q *sib w�` i;. t"�^? •°"^�`��y t^ _ •• ' ��. •• - �,.; •�/ �;" �`'��". .vi O •,r�,.s,��,� ��� .,tie.�-;. �:di"- O r=yam--� ')►�`O.'•.:��. -.,��.�. O•:�i -- . Client#:28329 TOTALS ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 1/04/2012 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 pollcy(les)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 Ileu of such endorsement(s). PRODUCER CONTACT Merit Insurance, Inc. PHONE One Enter rise Drive we No. Ex1:203 367.5328 aC No, 2033318608 p E-MAIL Shelton,CT 06484 ADDRESS, 203 367-5328 INSURERS AFFORDING COVERAGE NAIC Y INSURER A:The Travelers INSURED Total Comfort, Inc. INSURERB: 44 Kenosia Avenue INSURER C: Danbury, CT 06810 INSURER 0: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE FOLICIES 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 CF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUB POLICY EFF POLICY FXP LTR TYPE OF INSURANCE R WVD POLICY NUMBER MMIDDlYYYY LM_MtRpjY LIMITS A GENERAL LIABILITY 4TC09785RO54IND1 10/31/2011 10/31/2012 EACH OCCURRENCE $1 000000 X COMMERCIAL GENERAL LIABILITY PREMISES EREoNT el ce 000,000 000 CLAIMS-MADE D OCCLR MED EXP(My one person) $5 000 PERSONAL&ADV INJURY $1 000 000 GENERAL AGGREGATE $2,000 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG $2,000,000 POLICY PRO- LOC _ $ A AUTOMOBILE LIABILITY BA9785R7121N010 10/31/2011 10l31/201 COMBINED SINGLE LIMIT (Ep accident 1,000,000 Ix ANY AUTO BODL INJUR (Perperson) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS Per accident) $ $ A X1 LAB R EXCESS pCC, 4TSMCUP9785RO54TIL 10/31/2011 10/31/201 EACH OCCURRENCE $5 000 000 EXCESS LIAR CLAIAI3-MADE I AGGREGATE $5 000 000 DED RETENTION$ 1 WORKERS EMPLOY RS'LI COMPENSATION 4TCUB224M479All 10/31/2011 10/31l201 X $ A j AND EMPLOYERS'LIABILITY TI N WC STATU- OTH- OFFINY CEWMEMBER EXCLUDED?ECUTr:ED NIA E.L.EACH ACCIDENT $1 00O 000 (Mandatory in nd E.L.DISEASE-EA EMPLOYEE $1 000 000 It yes,desuibe antler L___�_ DESCRIPTION OF OPERATICNS bebw E.L.DISEASE-POLICY LIMIT $1,000 000 i ' I DESCRIPTION OF OPERATIONS i LOCATIOhS r VEHICLES(Attach ACORD 101,Additional Remarks Schedule,II'more space is required) Operations of Insured CERTIFICATE HOLDER CANCELLATION Village of Rye Brook SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 938 King Street Port Chester, NY 10573 AUTHORIZED REPRESENTATIVE r�eoQcJ!/�t ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S116880/M114682 DMM STATE OF NEW YORK WORKERS'CONTENSATION BOARD CERTIFTCATE OF NYS WORKERS'COMPENSATION INSURANCE COVERAGE In.Legal Name&Address of Insured(Use street address only) lb.Business Telephone Numbor of Insured Total OallfCs r, Inc. 203 791-2141 44 Kenosia Avenue 1c.NYS Unemployment Insurance Employer may, CT 06810 RegistraHnn Number of Insured WorkLocatlan ofiusueed(Onlyregrilred if 001'erageisspac07vally Id.Federal Employer Identification Number of Insured limited to certain locations in New Porle State, Le„ a Wrap-Up or Social Security Number Policy) 061-16293O 2.Name and Address of the Entity Requestiaag Proor of 3a. Name of Insurance Carrier Coverage(Cl ntity Being Listed as the Certificate Holder) Village of rye Brook Travelers 31).Policy Number of entity listen In box 1°la" 938 Kim Street Rye Brock, NY 10573 4TCUB224M479All 3e. Policy effective,period 10/31/11 to 10/31/12 3d. The Proprietor,Pnrtners or Executive Officers are FlinelUded, (Only checir box trail poonomfninceratncioaca) [� all excluded or certain parhters/officers excluded. This certifies that tho histuunce carrier indicated above in box "3" Insures the business referenced above in box "la"for workers' compensation under the New York State Workers'Compensntion Law.(To use this forni,New York(NY)must be listed under Item 3A on the MOMMATION PAGE of(lie workers'compensation insurance policy), Tile lnsurnnce.Carrier or its licensed agent will send this Certificate ofInsimance to Oic cudly 11sted above as the ceit flentc holder in box"2", no 1juvr•ance Cariierwill also notify thet abum curl yicare holder ivilhin 10 dayslF a policy is canccled dui to nonpm•uiert of praniiwns•or within JO daytt IF there are reasons other than nonpgfntent of preminors that canceIlha poltcv or elini inate the i)mired from the coverage indicaledon rids Cerilr?cmie. (Tltt sa Notices!tray besarit byregidur+rtail.J Otherwise,this CarNflcate is vnlltl fnruna yern after thtsfurm Is approved by the ln.;uronee carrier or ifs licensed agent,or until thepolley a%pirallon(late listed in box"Je", whichever lv¢artier. Please Note:Upon the canecliation of fire workers'compensation poihq indicated on this form,if the business continues to he named on a permit,license ar coutract issued by a certificate holder,the business must provide(hat certii'icnte holdcr with a new Certificate of Workers' Compensation Coverage or other authorized proof that tile,business is complying witli the inandatoly coverrge requireineuts of the New Yorlt State Workers'Couipeusatinn Law, Under penalty of per}ury,I errdfy that I am an authorizcd represent0ve ov licensed agent of the instir.mea cart•ier referenced above and that the named insured has the coverage its depicted all this form. Approved by: rt P. Cal (Yrinin .e 7p �hvelicersrdegeittoPiusumn�ewniur) Approved by: p� Signnhire) (Dote) Title: Vice President Telephone Plumber of author!/cd representative or licensed agent of instrance cwrier: 203 791-2141 Maim Note: Only Jrrumnce carriers curd their licensed agents are authorizer!to issue Form C-105,2. Insurance brokers are NOT authorized to issue 1t. C-105.2(9-07) www.wcb.statc.oy,us