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HomeMy WebLinkAboutMP10-34 QR C C(C V 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 Stephanie J. Fischer David M. Heiser Salvatore W.Morlino CERTIFICATE OF COMPLIANCE December 19,2023 Patrick Grady&Jennifer Borge 64 Tamarack Road Rye Brook,New York 10573 Re: 64 Tamarack Road, Rye Brook,New York 10573 Parcel ID#: 135.60-1-13 This document certifies that the work done under Mechanical Permit #10-34 issued on 8/11/2010 for the installation of a new furnace has been satisfactorily completed. Sincerely, Steven E.Fews Building&Fire Inspector /to QyE BRC�k ID I 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:- ! /� i1�//� 2 G DATE: /1 -/.S - 1023 PERMIT# N O- Z- ISSUED: II"3- /0 SECT:IJ,5 D BLOCK: / LOT: /-,3 LOCATION: ��J SGG m�/✓ / • OCCUPANCY: Z10 ❑ Miolation Noted THE WORK IS... Er PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION 'g o/ ❑ Natural Gas L 1/�i�f /�{ �o dL ❑ L.P.Gas p ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL PUA G / 0/w / ❑ OTHER 15/ VILLAGE OF RYE BROOK r BUILDING DEPARTMENT AUG 10 2010 938 KING STREET,RYE BROOK,NY 10573 (914)939-0668 FAx(914)939-5801 www:ryebrook.org v APPLICATION TO INSTALL AND/OR REMOVE FUEL BURNER, BOILER OR HOT WATER HEATER Permit#: Building Inspector: Fee Paid: Date of Approval: (fees are non-refundable) REQUIREMENTS FOR RELEASE OF PERMIT&CERTIFICATE OF COMPLIANCE: 1. Properly Completed & Signed Application. 2. Copy of Licensed Contractor's Insurance including Liability & Workers Compensation naming the Village of Rye Brook as Certificate Holder. 3. Fees: $75 per unit. 4. Inspection by Building Department for removal and/or installation. 5. Certificate of Compliance will be provided when all requirements are fulfilled. 6. Any electrical work requires an Electrical Permit and Electrical Inspection. 7. Any gas/plumbing work requires a 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 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. Property Owner's Name: ,41AQV j j,4tLftjC k E�J Phone#:`�0�Y, 2. Job Address: 6�t —TA MA 0 R-C.kr Phone#: 3. Parcel I.D#: Zone: 4. Contractor: OkM-p o ref Phone#: 26 -`l b1 !7V S 5. Contractor Address: (��ro��, �i����E �(' p(o�f(o� Fax: 6. Scope of Work: Install Remove � - Fuel Burner ®!Boiler WWater Heater ❑ 7. Type of Equipment &Fuel: 500m ga tktc 8. Location of Equipment: �M� 61 Signature of Applicant: m Date: Printed Name of Applicant: &JA" OeVA'DDP4 Phone#: a = a a = a _ a x s N Z M o LL4 U a a a N � Q � z � o � z rw O = 3 ¢ wQ w z a Oc) oo pp z w 00 M w � A r.. ww � Qp CA oa°°� BUILDING DEPARTMENT NOV - 3 2010 A/ILLAOE OF RYE BROOD zrF " 938 KING STREET RYE BROOK,NY 10573 914 939-0668 FAx 914 939-5801 www.ryebrook.org PLUMBING PERMIT APPLICATION *MUST BE FILED BY A LICENSED MASTER PLUMBER ONLY*xell Date: h Q Plumbing Permit#: /d 6/ Buz ildiag er it Fee: _ / U Approval Signature: (fees are non-refundable) Application is hereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of a Permit to install Plumbing as per detailed statement described below, and in accordance with all applicable Federal, State, County and Local Codes, at the following location: Address: (� �ff�''� ��� C /� l`� Phone#: Owner: �Qr l (e✓1gr-G0 Address &Phone: Gs Cc'�14/fit Use/Occupancy: t rat'—^ Parcel I.D.#: 13 5 (00--/-)3 /-6F- Zone: LICENSED MASTER PLUMBER'S INFORMATION: / Name (please print `^ — Phone#: Signature: Westchester County License#: 93� Company Name: �'"y'�Ow% � � P. E4 Company Address: �,,S t4, (( Dr'`K City/Town: State: e-`f Zip Code: V&� Phone#: 1�f— 7�a 3 i........................................................■■.............................■. FIXTURES & LINES ARE TO BE INSTALLED ACCORDING TO THE FOLLOWING SCHEDULE: Location Water Urinals Drinking Sinks Showers Bath Laundry Domestic Fie Sanitary Natural/ Other* Total Closets Fountains Tubs Tubs Service Service Sewer LP Gas Basement 1st Floor 2nd Floor Outside *Other: Detailed Description of Appliances etc...: ACC) CERTIFICATE OF LIABILITY INSURANCE DATE/09o2010YY' 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 NAME: Michael J.Murren AA/C. No E:t):203-259-5600 _ _ ..(A//c N0 1:203-259-5655 _ Murren Insurance Agency E-MAIL ADDREss:michaelr�murreninsurance-cam_ 1580 Post Road PRODUCER CUSTOMER ID#: _ Fairfield,CT 06824 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A:The Hartford/VR Hartford Casualty Insurance Co INSURER B: Leonard E.Creadore,Jr. INSURER C 131 Ford St. INSURER D:The Hartford/Pacific Insurance Company,Limited Milford,CT 06460 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. ICY EXP LTR R_ ADDL�TYPE OF INSURANCE INSR rvnUEIR POLICY NUMBER MM/LDDYIYYYY MM%DD//YYYY LIMITS LT A GENERAL LIABILITY 09/08/2010 09/08/2011 EACH OCCURRENCE $ 1,000,000 31 SBMVR7989 x COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) $ CLAIMS-MADE OCCUR l I MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2.000000 X POLICY PE OT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NOWOWNED AUTOS $ $ UMBRELLA LIAR HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE f $ RETENTION S $ WORKERS COMPENSATION 04/06/2010 08/09/2010 x WC STATU- OTH- D AND EMPLOYERS'LIABILITY YIN 31 WECIW0779 T RY LIMIT R ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100.00 OFFICERIMEMBER EXCLUDED? N❑ N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 100,000 If yes,describe under E.L.DISEASE-POLICY LIMIT 1$ 500000 r 1 F DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Installation and service of AC equipment and systems CERTIFICATE HOLDER CANCELLATION Village of Rye Brook SHOULD ANY OF THE ABQVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE Building Department POLICY PROVISIONS, 938 King Street UTHORIZED REP SEN Rye Brook,NY 10573 ©19 -200 A R P RATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACOR