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MP21-048
PERMIT # 1`7t" d/ v DAT SECTION r C; % BLC TYPE OF WORK �iIS7�c/ c JOB LOCATION c Qs7A'Ie V/ OWNER4;Slti%0/0n NaM U K LOT: kiv L. Gas si � uYaLt�f CONTRACTOR OS 7'� �T�O/h P/l QIL&LCIfJOIXY ,Zi C `` EST. COST 3: DOa " FEE 5- VBCO # C�, FEE W JJ0 -,AA DATE FEE DATE INSPECTION RECORD DATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING O RGH PLUMBING /.,.. r GAS SPRINKLER ELECTRIC oolo� J J�— W � LOW -VOLT C� ALARM C� AS BUILT 0 FINAL /Q-Aof )& YJ9)VO79k7eo /04? 6441/01 ��� -ail lqSu1��,6Qn r 19 4t" annuxewc VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury www.tyebrook.org TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Michael J. Izzo Stephanie J. Fischer David M. Heiser Salvatore W.Morlino CERTIFICATE OF COMPLIANCE May 19,2022 Easwaran Nambudiri&Draupathi Nambudiri 9 Castle View Court Rye Brook,New York 10573 Re: 9 Castle View Court, Rye Brook,New York 10573 Parcel ID#: 136.21-1-25 Mechanical Permit#21-048 issued 4/6/2021 for a New Generator This certifies that the 22kw LP gas fired generator,installed under the above captioned permit has been satisfactorily completed. Sincerely, 1 � f 1 Steven E. Fews Assistant Building&Fire Inspector /to DR 406 Gbuuuwmovi* VILLAGE OF RYE BROOK MAYOR 938 King Street,Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914)939-0668 Christopher]. Bradbury vvww.rF eb ro o k.org TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Michael J. Izzo Stephanie J. Fischer David M. Heiser Salvatore W.Morlino CERTIFICATE OF COMPLIANCE May 19,2022 Easwaran Nambudiri&Draupathi Nambudiri 9 Castle View Court Rye Brook,New York 10573 Re: 9 Castle View Court, Rye Brook,New York 10573 Parcel ID#: 136.21-1-25 This document certifies that the work done under Mechanical Permit #21-049 issued on 4/6/2021 for the installation of two above-ground propane tanks have been satisfactorily completed. Sincerely, { Steven E. Fews Assistant Building&Fire Inspector /to BUILDING DEPARTMENT For office use on1 OCT 2 8 2021 VILLAGE OF RYE BROOK PERMIT#/y —D 118 ISSUED: 938 KING STREET,RYE BROOK,NEW YORK 10573 DATEVO-c') -ell VILLAGE OF RYE BROOK (91.4)93.9-0668 FEE:,Z/ // Q — PAID BUILDING DEPARTMEhJ' www,ry ,rook.ory, 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 ttrttttrrttttttttrrrttrtttaarrrtattrrr►•rtattrrttrtrtrrttt•trttttraata►aaraa►rrrtrttttttratrtrat•trttttt►t►rtr►attrarrtrttt• Address: 01 C_A.ST L.L %J\f_ LZ COL" °)LT Occupancy/Use:1�Fi4ry1 Parcel iD#: 13( p, 01 Zone: Owner: C<}-S1n1 4t4." 'tJ An0 6 U D 1Q1 Address: CM7LG L9 t£ e L4 A T P.E./R.A.or Contractor: COST Cl9'WlQ 6�-1-1..- Address: 2.c> $goo K U A L-a FL $4t 41rroe Person in responsible charge: L_L. Ar F%TZ(4W! D Address: Zu IU8114ALe MlM�t'vVd'�o�a Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issu�tice�fa 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: !1 g4 Dblemg duly sworn,deposes and says that he/she resides at � C*ST� V l�� � uu Name of Annlicanu i ho.and Sviceu in IZ`iti ep Lo Oki ,in the County of �,>-tGet �% S_T to in the State of�,that ICaw I own/VIIIaLei 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: for the construction or alteration of: y L 4i�� 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 9 V, Sworn to before me this day of �,20 _ day of , 20 L».,.. Signa6f of Property Own Signature of Applicant / -Sw4k14kI AIA61>3KJD,1� , Adnt Name of Property Owner Print Name of Applicant Notary Public Notary Public SHARI MELILLO Notary Public, State of New York No. 01 ME6160063 0,_lafified in Westchester Count/ /� Commission Expires January 29,2 / QyE BR(��, 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 :- c)2!F A 1 `� "tom"'\ DATE: PERMIT# �` ISSUED: SECT:BLOCK: LOT: LOCATION: L � - ��P`-L� C OCCUPANCY: v ❑ 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 QyE BRC��. cu � 1982 BUILDING DEPARTMENT ❑BUILDING INSPECTOR f®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 : � � �I t�Y\ `� DATE' PERMIT# ` ISSUED:L �SECT: (1��1 BLOCK: I LOT J LOCATION: 0\ OCCUPANCY: ❑ VIOLATION NOTED E 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 `�\ \ (' �s \ ❑ CROSS CONNECTION [3 f FINAL ❑ OTHER Page I • f I 9 Ff _ .:`.,:�' s� \ �`,'"' 'yr - •� !y .. v r�� �}. r `i,�� • � j } f� C a � � � ♦ t •- - •• /. • . • • •• • •• i5/18/2022 Page of •' ` ••D. • • • •• • • •• 5/18/2022 Page 1 of 1 AV .,t .�;: _,.,11�! .i;.•_i Kok ti Z ile:H/C:/Users/lpetersen/AppData/Local/Microsoft/Windows/lNetCache/Content.Outlook/OBUF2MQ V/IM... 5/18/2022 �E BRC�v� '9a2 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 Uebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - ADDRESS :— DATE: PERMIT# \t 1 ISSUED: l SECT: BLOCK: LOT: LOCATION: t� OCCUPANCY: 'r) ❑ VIOLATION NOTED1 THE WORK IS... 6�t ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION t i ! REQUIRED, ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING Cl ROUGH FRAMING ❑ INSULATION ~NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER i, i p F- 0 � ¢ al 16 W � � � c ,. r o; w ° Q �. ■ (!� N L > � � r ry Lt. m w Ilk CL all U ►, O �..� � > 5Or e � � C 0*4 rWi� Z a" O a w pz � a� - ° .c oc a > . - EJ � rr•��. m az a F., dr V C Q z N w 'v a .� F- ` F F Lc -3 E 45 Q I CEI ZI G. R BUIL LNG DEPAR MENT �� VIL 'E OF RYE OOK , MAR 5 2d2Y " 938 KING EET RYE BRA ,NY 10573 VILLAGE OF RYE BROOK (914)9 3' 39-5801 BUILDING DEPARTMENT oY r Application for Permit to Remove, Abandon and/or Install Fuel Storage Tank (*Storage Tanks in excess of 1,100 gallons require registration xe ith the County of Westchester) FOR OFFICE USE ONLY: PERMIT#: /Oc)I—o 4 9 Approval Date: APR Permit Fee: S Approval Signature: � Other: Disapproved: (fees are non-refundable) REQUIREMENTS FOR RELEASE OF PERMIT&CERTIFICATE OF COMPLIANCE: 1.Application Completed by Bonded,Licensed Contractor. 2. Your contractor's valid proof of liability insurance. (Village of Rye Brook must be listed as certificate holder) 3. Your contractor's valid proof of workers compensation insurance. (Form #C 105.2 or Form# U26.3 /or NY State Workers Compensation Waiver) 4. Fee per Tank: Removal,Abandonment, or Installation: S 185.00 per Tank. 5. Dig Safely New York# (dial 81 1): 6. Inspection by Building Department for removal/abandonment and/or installation. 7. Submit all Manifests&Reports(after work has been completed). 8. Certificate of Compliance will be provided when all requirements are fulfilled. Application dated, is hereby made to the Building Inspector of the Village of Rye Brook for a permit to remove,abandon,and/ r install a Fuel Tank as herein described.The applicant and property owner,by signing this document agree that the subject fuel tank(s)will be removed,abandoned and/or installed in conformance with all applicable Village,County, State& Federal laws,codes,rules and regulations. Indicate Permit Tvae: Installation •Removal( ) • Abandonment( )/Above Ground ( )• Buried in Ground ( ) c I. Address: Qk) V�+ SBL: Zone: 2. Property Owner&Address: a �I u_)o n !1 tr, /1 Phone#:q14- U Cell#: email: {,a Q,t 3. Contractor&Address: 1115,rase Go 1 zb Phone#: (Q(Q Cell#: email:�J�°erycD 4. Applicant: _ Phone#: Cell#: email: 5. Indicate Fuel Type: Fuel Oil( )•L.P.Gas( •Gas fine( )•Ot r( ): 6. Number and Capa ity of each Tank: — J L (_J r /p 7. t Location(s)of each Tank: Y l-C- �i' G t 6/l/2020 • � i STATE OF NEW YORE.COUNTY OF\\'ES'rC1iFSTFR A-- JA 9-F}I`J MA t"WIN,'Seting duly s%%orn.deposes and slates that he"she is the applicant above named. (print name of individual signing as the applKann and further states that(s)hc is the legal owner of the property to which this application pertains,or that Whc is the for the legal owner and is duly authorized to make and file this application. (indicate archnccl,contractor,agent.attorne\.etc 1 That all statements contained herein are true to the hest of his'her knowledge and belief,and that any work performed.or use conducted at the above captioned property will be 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 kyith the New York State Uniform fire Prevention& Building Code.the Code of the Village of Rye Brook and all other applicable lau:s,ordinances and regulations. Sworn to befor c this Sworn to beforc me this__ day of yC�2(t � day of 20 Signature of Property Owner Si, c of• icant Print Dame of Property Owner TzintXhme of.applicant Notary Public Notary Public This application must he propwrly completed in its entirety and must include the notarized signature(s)oi'the local ov%ner(s)of the Subject prctpert}. attd the applicant of record in the spaces provided. An\ application not properly completed in its t ntircly ind'or not properly signed ,hall be deemed null and old and ill be rt:turned to the applicant. IiJ -7 9 ¢,3 w THIS IS TO CERTIFY THATI HAVE SURVEYED RICHARD A. SPINELLI ,Lot G os �rhowI7 on �JUfJ dI YIJ/O/7 �o�O of la-eperly 313 HALSTEAD AVENUE be/orryir;9 lV (/l /I4101_1 .�Ya7Ye!!ca/ Lafheran Church, MAMARLDNECK. N. Y. TEL. 38I•2357 y//oge oj� �Qye B/�aa�, �iun o�' /eye, �e�t• G's�, /�y FILED IN THE WESTCHESTER COUNTY CLERK'S OFFICE, DIVISION OF LAND RECORDS (FORMERLY REGISTER'S OFFICE) -r0,0tzS, 1991 AS MAP !v° 245-13 1 HAVE LOCATED ALL EXISTING BUILDINGS AND LINES OF POSSESSION AS SHOWN HEREON. I HEREBY CERTIFY THIS SURVEY TO s i s'`'"' �'`'"''°ua''e! TO WHOM LIABILITY IS LIMITED. C.p'7r"_ GeRP.I 'r r ✓GCEJ=p Qp/Z pNp�R gS31GNS Ja ar crgc. .asarer►v cocs�, SURVEY AND MAP COMPLETED /,/992SCALE ONE INCH TO 30 FEET. GUARANTEED IN ACCORDANCE WITH THE MINIMUM STANDARDS FOR TITLE SURVEYS OF THE NEW YORK STATE LAND TITLE ASSOCIATION NOTE:ALL CERTIFICATIONS MADE HEREON ARE VALID FOR THIS MAP AND „ /"\ COPIES THEREOF ONLY IF SAID MAP OR COPIES©EAR THE IMPRESSED /`�`---(�1�.[r./1 SEAL OF THE SURVEYOR WHOSE SIGNATURE APPEARS HEREON. RICHARO A.SPIN LLI ze tiAC S�1C Vey N Y S LOC.LAND SURVEYOR NO.•YIIAO suCGr.f Ow TO our y.Or.• QF NEw y �Pye .2,dyE Eafo�c3 " tiP��Pp ORf A.Sp, x l��fNs 1. 41) FO LAND yr eoo y,4• - PCArr.L I 0 w e o d 4LL. SDI(LFiLTZOr4l' Pc.v Fo .1 W aet ,f.t1' I F t1.f5 �\ 2- v v y'18 - iJ.zc opy • V n W 57-46 v�6 w o PERMIT# � G u 7- -' 5 2021 Q DATE APPRO x OR VL ag of Rye BrookNY" MAR 2 5 2021 BUILDING INSPE VILLAGE OF RYE BROOK BUILDING DEPARTMENT FIELD BOOK PAGE: d� 01 � N a N _ � a � � U w 00 tr [� tn old ~ pm ON O Z O Qy LZ `-' o O Q 3 ` [•r � � W o � w � O � W 3 z •• Acea CO O F00E"� a W 96 00 ON Lz. Q � F• O �+ Q � L7 V a z = N w 3 e z V w z 16 �. o� w r BUMDPNG DEPARTMENT AUG - 2 2021 VILLAGE OF RYE BROOK 938 KING RYE B ,NY 10573 VILLAGE OF RYE BROOK (914)9 • 939-5801 , BUILDING DEPARTMENT org ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY #' /�-�j°�I—D gg E!'#: Approval Date: AUG - 3 2D21 Permit Fee: S 150 r/"11b Approval Signature: VLk Other: Disapproved: (fees are non-refundable) Application dated, 07—off is herebv 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. The applicant & property owner, by signing this document agree that all electrical work performed will be in conformance with all applicable Federal, State,County and Local Codes. 1.Address: _q Lit tAip SBL: Zone: �S 2.Property Owner: rQ St.tta CG!n' k)Gt yA6t do'e-. Address: C4 S44w- U z ew Cis Phone#:9114.90l -9 30(p Cell#: email: 3.Master Electrician: M 1-LL rk (�p� Address: I n I y1'1 ill S� , y�`et�lVSt-r Lic.#: 1�_Phone#:203 53-L ISS Z. Cell t: 91y-58'(-9QS 5 cmail:AZ;►M Qi ul�c oY�e(Q��r�L • Co,n� CompanyNamc: 11JQ.S0kd F.(0_L4t`rl Address: 101 M:jA b¢. IbtteeL&L&!' -LLk 4.Proposed Electrical Work/Fixture Count: ')-? k- `t (f-)t? e r4`-o %.j t j,4 Q Z00 R,,,t P AT S STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: being duly sworn,deposes and states that he/she is the applicant above named,and does further (taint name of individual signing as the applicant) state that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the for the legal owner and is duly authorized to make and file this application. etc I The undersigned further states that all statements contained herein are true to the best of hi&her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be 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 laws,ordinances and regulations. Sworn to before me this Sworn to before me this A day of 20 day of S� ,20 2)� Signature of Property Owner gignature of Applicant e. L 0 P Print Name of Property Owner t Name of A t Notary Public NotagxARll NIELILLO Notary Public, State of New York No. 01 ME61 GOC63 Qualified in Westchester County Commission Exoires JInuanf 29 2.0 2Z3 3r2l/19 Phone: 914-347-3595 Westchester Rockland Electrical Inspection Services, Inc. DSO NOT WRITE HERE-FOR OFFICE USE ONLY 43 North Lawn Avenue Fax: 914-347-3596 Elmsford, NY 10523 Jb BUILDING PERMIT NO. TEMP# 7DATE ::::] 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& MOTORS HEATERS OFFICE USE LOCATION LAMP RECEPTACLES ONLY SIDEWALL SWITCH INCADE FLUORE NO. H.P.EACH NO. I WATTS EACH INSPECTION OUTSIDE BASEMENT 1'FL. 7-FL. 3-FL. VILL ;GE OF YE BR OK 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 APPUCATIONS 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 t:-1 EXPOSED Cl CONCEALED C 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// I A,G '( ( I,..(. )/C ! ?- I X STREET ADDRESS TELEPHONE NO. CRY OR POST OFFICE _. ZIP CODE LICENSE NO.WHEN APPLICABLE ' WESTCHESTER ROCKLAND WRE 14)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: Weigold Electric Easwaran Nambudiri &Draupat Nambudriri 101 Mill Street CT, Greenwich 06830 Located at:9 Castle View Ct Rye Brook, NY 10573 Certificate Number: 1030113 Section: 136.21 Block: 1 Lot:25 BDC: Permit Number: EP:21-194-BP:MP 21- 048 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: 9 Castle View Ct Rye Brook,NY 10573 Basement 1st Floor 2nd Floor 3rd Floor Garage Attic Outside Other: Inspection was conducted in accordance with the NYS and NFPA 70-2017 International Electrical Code and detail of the installation,as set forth below,was found to be in compliance therewith on 08/11/21 Name Type Quantity Generator Up to 25 KW 22 kw 1 Automatic Transfer Switch ------- 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. a e s a h lot Yt '�k 0. M•iy Z W z °` 4 0 P---4 c .r 0. v t C4n La Q o � c co rT a u U Woc (> � � � z W o �' � cz •a � � � W ,, oc rn 01 Z N O ' o � r� V CG U p -i ■ cQ law. 2 can • �������+�*������i�#�W�W�a Ty 9��s�r�i�T��i��li \iw�������i��i���G�����i�3f yE d RC1Lj r� . D E C EN E BUIL E MENT DID VIL I E OF RYE OK NOV 1 0 2020 938 KING ET RYE B ` ,NY 10573 VILLAGE OF RYE BROOK (914)9 939-5801 BUILDING DEPARTMENT .or PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY I�rP'#: �� C�ry PP# APR - 8 2021 Approval Date: Permit Fee: $ Approval Signature: Other: Disapproved: (fees are non-refundable) Application dated,L C�_O Q)O 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 Plumbing as per detailed statement described below. The applicant& property owner, by signing this document agree that said plumbing work will be in conformance with all applicable Federal, State,County and Local Codes. 1.Address: � l..�i 17 ,V L-C.kUra69t-'�V' ' SBL: ,J�,� - \1— d- Zone: 15- 2.Proposed Work: 'v-L4�yl. Q s �'Q►/�C km L P l ov y�5 by 3.Property Owner: U �_0.1A b,,, ► Address: CgrsTI-C U 1t4/ Phone#: Qt'A- 0-7- i3ob �� `C"ell#: email: 0.-Kb� WM"' 4.Master Plumber: TUW,_A&(L� /I yAo, � Address: �%-�dqlt 1 - �Dv 1 (� Lic. #: 65 Phone#: Cell #: Q email: i 4kQ� oS � 11 u., Company Name: 1�BS�_aklt AXInO-A ,I Address: )o &ba AQII-.6• A V-_ ,,,,, IVy , 101-1-0 INDICATE FIXTURES& LINES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: Location Water Urinals Drinking Sinks Showers Bath Laundry Domestic Fire Sanitary Natural/ Other* Total Closets Fountains Tubs Tubs Service Service Sewer LP Gas Basement Ist Floor 2nd Floor 31 Floor 4`h Floor 5`h Floor Exterior 1 5.* List Other Equipment/Provide Details: `'�&V� QQ�S Q�Q MR L_]wA I \��TES 1 b I)-Q41e Q,�0 (Notarized Signatures Required Next 2 Pages) 3/21/19 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: vt uA6 114 D AA L�XX ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and further states that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the r for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,attorney,etc.) That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be 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 laws,ordinances and regulations. Sworn to before me this___ 11 Sworn to before me this ' F day of N%U tin.-4,� ,20 2-d day of NeJ t^"-0 V ,20 - 'Tignat6re of Property Owner tgnature�of Applicant A S v�A-R.A N__..__'\� li.n,, Print Name of Property Owner Print Nam of App ,...... ", v.' �STATE - G STATE OF NEW YORK G'l /OF NEW YORK` Notary Public %NOTARY PUBLIC 1; N.' Notary Public % o _ -O Putnam County e c Qualified in \; 01 FI6402089 ti O , Putnam County ;� •, ,-;t'. 01FI6402089 -'-his '•. ..•' g` - °'., ��N E),( EX? "11IM111 LWOW This application must be properly corrip"1&8d in its entirety and must include the notarized signature(s)of the legal owner(s)of the subject property, and the applicant of record in the spaces provided. Applications not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. -2- 3rz1/19 BUILP TMENT VIL ]';E OF RYE OK NOV Z 2020 938 KING�ikET RYE BROIDf(, NY 10573 (914)69- 81FAX.(QI4)'939-5801 VILLAGE OF RYE BROOK BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE §216 • STORM SEWERS AND SANITARY SEWERS THIS AFFIDAVIT MUST BEAR THE NOTARIZED SIGNATURE OF THE LEGAL PROPERTY OWNER AND BE SUBMITTED ALONG WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION. ANY BUILDING OR PLUMBING PERMIT APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETURNED TO THE APPLICANT. STATE OF NEW YORJK�,l COUNTY OF WESTCHESTEGR ) as: UQA lif 01 A /V OOA 1 J� t i C'1 , residing at, 1 ��S?lL V I C.W Wr:nl r:,uttrl \ Idre ti 1;hcrc unt li;,) being duly sworn, deposes and states that (s)he is the applicant above named, and further states that(s)he is the legal owner of the property to which this Affidavit of Compliance pertains at; L�, t Q ( t"V CUt�r --- , R e Brook NY. (Joh kAlres,) Further that all statements contained herein are true, and that to the best of his/her knowledge and belied that there are no known illegal cross-connections concerning either the storm sewer or sanitary sewer, and further that there are no roof drains, sump pumps, or other prohibited stormwater or groundwater connections or sources of inflow or infiltration of any kind into the sanitary sewer from the subject property in accordance with all State, County and Village Codes. OPP Pf I t, -_ ---- �ASh)A1RAxi NPrMF3LA ) ) I Print Name of Pmpcny O«ner(,,)1 i� Sworn to before me this day of A)IIU'(/1,_Ivc-✓ 120 r)4, jJZG qq'% .' STATE 3k Ql c ,'OF NEW YORK z_� 'NOTARY PUBLIC N (Noutry Public) Qualified in N Putnam County 01 F 16402089 -3- 3,'21/19 ECENE Nov 2 0 2020 IDraENERAC" BULLAGE OF RYE ILDING D NG DEPARTMEOK NT GUARDIAN° SERIES 14 lk 20/22/24 kW Residential Standby Generators Air-Cooled Gas Engine r , INCLUDES: Standby Power Rating mnr.•, 3,scju) `0 kw GO Hz • True Power" Electrical Technology nn,iium Bisque) 22 kw sG Hz num B,sauc) 24 kw GO Hz • Two-line multilingual digital LCD Evolution" controller (English/Spanish/French/Portuguese) • 200 amp service rated transfer switch available • Electronic governor • Standard Wi-Fis connectivity • System status&maintenance interval LED indicators • Sound attenuated enclosure 0 Flexible fuel line connector • Natural gas or LP gas operation GENERAC' • 5 Year limited warranty • Listed and labeled by the Southwest Research Institute allowing installation as close as 18 in(457 mm)to a structure.' 'Must be located away from doors,windows,and fresh air intakes and in accordance with local codes. https.Ilassets.swri.ofgllibraryIDirectoryOfListedPioducisl �TI� or C .l uS nU' e Constructionlnduslryl973_DoC_204_13204-01-01_Rev9.pdf c 1 I us LISTED �.�[ u^k Note CETL or CUL certification only applies to unbundled units and units ppackaged with limited circuit switches Units packaged with the Smart Switch are ETL or UL certified in the USA only FEATURES O INNOVATIVE ENGINE DESIGN & RIGOROUS TESTING are at the heart of Gen- O SOLID-STATE, FREQUENCY COMPENSATED VOLTAGE REGULATION: This erac's success in providing the most reliable generators possible. Generac's G- state-of-the-art power maximizing regulation system is standard on all Generac mod- Force engine lineup offers added peace of mind and reliability for when it's needed els.It provides optimized FAST RESPONSE to changing load conditions and MAXI- the most.The G-Force series engines are purpose built and designed to handle the MUM MOTOR STARTING CAPABILITY by electronically torque-matching the surge rigors of extended run times in high temperatures and extreme operating conditions. loads to the engine.Digital voltage regulation at±1%. O TRUE POWER'"ELECTRICAL TECHNOLOGY:Superior harmonics and sine wave O SINGLE SOURCE SERVICE RESPONSE from Generac's extensive dealer network form produce less than 5%Total Harmonic Distortion for utility quality power This provides parts and service know-how for the entire unit.from the engine to the small- allows confident operation of sensitive electronic equipment and micro-chip based est electronic component. appliances,such as variable speed HVAC systems O TEST CRITERIA: C) GENERAC TRANSFER SWITCHES:Long life and reliability are synonymous with ✓ PROTOTYPE TESTED NEMA MG1-22 EVALUATION GENERAC POWER SYSTEMS.One reason for this confidence is that the GENERAC ✓ SYSTEM TORSIONAL TESTED MOTOR STARTING ABILITY product line is offered with its own transfer systems and controls for total system compatibility O MOBILE LINK" CONNECTIVITY:FREE with select Guardian Series Home standby PWRVIEW..- TRANSFER SWITCH The Generac PWRview Automatic Transfer generators, Mobile Link Wi-Fi allows users to monitor generator status from any- Switch integrates the PWRview energy monitor to provide real-time energy con- where in the world using a smartphone.tablet,or PC Easily access inlormation such sumption data that can help lower a homes electricity bill Using a convenient as the current operating status and maintenance alerts. Users can connect an mobile app,homeowners can access energy usage and alen information while under account to an authorized service dealer for fast,friendly,and proactive service.With utility power or generator power.The PWRview energy monitor is a simple to use and Mobile Link,users are taken care of before the next power outage. low cost tool which helps save money over the life of the generator.Included with model G007210-0. w GENERAC Q > �� OGENERAC PROMISE `�` kp PWR �! GENERAC' 20/22/24 kW Features and Benefits _ Engine • Generac G-Force design Maximizes engine"breathing"for increased luel efficiency.Plateau honed cylinder walls and plasma moly rings help the engine run cooler,reducing oil consumption and resulting in longer engine life. • "Spiny-lok"cast iron cylinder walls Rigid construction and added durability provide long engine life. • Electronic ignition/spark advance These features combine to assure smooth,quick starting every time. • Full pressure lubrication system Pressurized lubrication to all vital bearings means better performance,less maintenance,and longer engine of life.Now featuring up to a 2 year/200 hour oil change interval. • Low oil pressure shutdown system Shutdown protection prevents catastrophic engine damage due to low oil. • High temperature shutdown Prevents damage due to overheating. Generator • Revolving field Allows for a smaller,light weight unit that operates 25%more efficiently than a revolving armature generator. • Skewed stator Produces a smooth output waveform for compatibility with electronic equipment. • Displaced phase excitation Maximizes motor starting capability. • Automatic voltage regulation Regulating output voltage to _-1%prevents damaging voltage spikes. • UL 2200 listed For your safety Transfer Switch (if applicable) • Fully automatic Transfers vital electrical loads to the energized source of power. • NEMA 313 Can be installed inside or outside for maximum flexibility. • Integrated load management technology Capability to manage additional loads for efficient power management. • Remote mounting Mounts near an existing distribution panel for simple,low-cost installation. PWRview Transfer Switch (if applicable) • PWRview energy monitor Energy usage at-a-glance. • Ability to view real-time energy consumption data Better understand the home's energy profile. • PWRview mobile app Access daily energy intelligence and insights. Evolution" Controls • AUTO/MANUAL/OFF illuminated buttons Selects the operating mode and provides easy,at-a-glance status indication in any condition. • Two-line multilingual LCD Provides homeowners easily visible logs of history,maintenance,and events up to 50 occurrences. • Sealed,raised buttons Smooth,weather-resistant user interface for programming and operations. • Utility voltage sensing Constantly monitors utility voltage.setpoints 65%dropout,80%pick-up,of standard voltage. • Generator voltage sensing Constantly monitors generator voltage to verify the cleanest power delivered to the home. • Utility interrupt delay Prevents nuisance start-ups of the engine,adjustable 2-1500 seconds from the factory default setting of 5 seconds by a qualified dealer. • Engine warm-up Verities engine is ready to assume the load,setpoint approximately 5 seconds. • Engine cool-down Allows engine to cool prior to shutdown,setpoint approximately 1 minute. • Programmable exercise Operates engine to prevent oil seal drying and damage between power outages by running the generator for 5 minutes every other week. Also offers a selectable setting for weekly or monthly operation providing flexibility and potentially lower fuel costs to the owner. • Smart battery charger Delivers charge to the battery only when needed at varying rates depending on outdoor air temperature. Compatible with lead acid and AGM-style batteries. • Main line circuit breaker Protects generator from overload. • Electronic governor Maintains constant 60 Hz frequency. • GENERAC' 20/22/24 kW Features and Benefits 14 Unit _ • SAE weather protective enclosure Sound attenuated enclosures ensure quiet operation and protection against mother nature, withstanding winds up to 150 mph(241 km/h).Hinged key locking roof panel for security.Lift-out front for easy access to all routine maintenance items.Electrostatically applied textured epoxy paint for added durability. • Enclosed critical grade muffler Quiet,critical grade muffler is mounted inside the unit to prevent injuries. • Small.compact,attractive Makes for an easy,eye appealing installation,as close as 18 in(457 mm)away from a structure Installation System • 14 in(35.6 cm)flexible fuel line connector Listed ANSI Z21.75/CSA 6.27 outdoor appliance connector for the required connection to the gas supply piping. • Integral sediment trap Meets IFGC and NFPA 54 installation requirements. Connectivity(Wi-Fi equipped models only) • Ability to view generator status Monitor generator with a smartphone, tablet,or computer at any time via the Mobile Link application for complete peace of mind. • Ability to view generator Exercise/Run and Total Hours Review the generator's complete protection profile for exercise hours and total hours. • Ability to view generator maintenance information Provides maintenance information for the specific model generator when scheduled maintenance is due. • Monthly report with previous month's activity Detailed monthly reports provide historical generator information. • Ability to view generator battery information Built in battery diagnostics displaying current state of the battery. • Weather information Provides detailed local ambient weather conditions for generator location. GENERAC' 20/22/24 kW Specifications Generator Model G007038-1 G007042-2 G007038-3 G007042-3 G007209-0 G007039-1 G007043-2 G007039-3 G007043-3 G007210-0 (20 kW) (22 kW) (20 kW) (22 kW) (24 kW) Rated maximum continuous power capacity(LP) :F .;.rl 20,000 Watts' 22,000 Watts" 20,000 Watts` 22,000 Watts' 24,000 Watts' Rated maximum continuous power capacity 1 18.000 Watts' 19 500 Watts' 18 000 Watts' " Naas' 2'000 Watts' Rated voltage 240 Rated maximum continuous load current-240 volts(LP/NG) 83 3 75 0 91 7/81 3 ':,0 00 87 5 ' Total Harmonic Distortion Less than 5% Main line circuit breaker 90 amp 100 amp 90 amp 100 amp 100 amp Phase 1 Number of rotor poles 2 Rated AC frequency 60 Hz Power factor 1 0 Battery requirement(not included) 12 Volts,Group 26R 540 CCA minimum or Group 35AGM 650 CCA minimum Unit weight tlb kg) 448,203 466/211 436 r 198 445 202 455 206 Dimensions(L x W x H)in/cm 48 x 25 x 29/121.9 x 63.5 x 73.7 Sound output in dB(A)at 231t(7 m)with generator operating at normal load" 67 67 67 Sound output in dB(A)at 23 it(7 m)with generator in Quiet-Test'"low-speed exercise mode" 55 57 55 57 57 Exercise duration 5 min Engine Engine type GENERAC G-Farce 1000 Series Number of cylinders 2 Displacement 999 cc Cylinder block Aluminum w/cast Iron sleeve Valve arrangement Overhead valve Ignition system Solid-slate w/magneto Governor system Electronic Compression ratio 9.5:1 Starter 12 VDC Oil capacity including filter Approx.1.9 qt/1.8 L Operating rpm 3.600 Fuel consumption Natural gas h3/hr(m3/hr) 1/2 Load 204(5.78) 228(6.46) 164(4.64) 203(5.75) Full Load 301(8.52) 327(9,26) 287(8.13) 306(8.66) Liquid propane ft3/hr(gal/hr)[L/hr] 1/2 Load 87(2,37)[8.99) 92(2.53)(9.57] 86(2.36)[8,95] 92(2.53)[9.57] Full Load 130(3.56)[13.481 142(3.90)114.77) 136(3.74)114.15] 142(3.90)[14.77) Note Fuel pipe must be sized for full load.Required fuel pressure to generator fuel mlel at all load ranges-3 5-7 in water column(0.87-1 74 kPa)for NG,10-12 in water column(2 49-2 99 kPa)for LP gas For BTU content multiply ft3/hr x 2500(LP)or 113/hr x 1000(NG) For Megajoule content.multiply ml/hr x 93 15(LP)or m?rhr x 3726(NG) Controls Two-line plain text multilingual LCD Simple user Interface for ease of operation Mode buttons:AUTO Automatic start on utility failure.Weekly,Bi-weekly,or Monthly selectable exerciser. MANUAL Start w,lh starter control,unit slays on If utility fails.transfer to load lakes place OFF Stops unit.Power is removed.Control and charger still operate. Ready to Run/Mainlenance messages Standard Engine run hours indication Standard Programmable start delay between 2-1500 seconds Standard(programmable by dealer only] Utility Voltage Loss/Return to Utility adjustable(brownout setting) From 140-171 V/190-216 V Future Set Capable Exerciser/Exercise Set Error warning Standard RUNAlarnn/Maintenance logs 50 events each Engine start sequence Cyclic cranking 16 sec on 7 rest(90 sec maximum duralion) Starter lock-out Starter cannot re-engage until 5 sec after engine has stopped. Smart Battery Charger Standard Charger Faull/Missing AC warning Standard Low Battery/Battery Problem Protection and Battery Condition indication Standard Automatic Voltage Regulation with Over and Under Voltage Protection Standard Under-FrequencyrOverload/Stepper Overcurreni Protection Standard Safety Fused/Fuse Problem Protection Standard A,rlomalic Low Oil°resswerHtgh Oil Temperature Snuldown Slanuard Overcrank70verspeed(@ 72 Hz)/rpm Sense Loss Shutdown Standard High Engine Temperature Shutdown Standard Internal FaulVlncorrect Wiring protection Standard Common external fault capability Standard Field upgradable firmware Standard "Sound levels are taken from the front of the generator Sound levels taken from other sides of the generator may be higher depending on installation parameters Rating delinitions-Standby.Applicable for supplying emergency power for the duration of the utility power outage.No overload capability is available for this rating.(All ratings in accordance with BS5514.IS03046 and DIN6271) 'Maximum kilovolt amps and current are subject to and limited by such factors as fuel BTU/megajoule content.ambient temperature,altitude.engine power and condition,etc.Maximum power decreases approximately 3 5%for each 1.000It(304.8 m)above sea level:and also will decrease approximately 1%for each 10"F(6`C)above 60`F(16"C). GENERAC 20/22/24 kW Switch Options Service Rated Automatic Transfer Switch Features Model G007039.1,G007039.3(20 kW) • Intelligently manages up to four air conditioner loads with no additional hardware. 0007043-2,G007043.3(22 kW) _ No.of poles 2 • Up to eight additional large(240 VAC)loads can be managed when used in conjunction Current rating(amps) 200 with Smart Management Modules(SMMs). Voltage rating(VAC) 120/240.10 • Electrically operated,mechanically-held contacts for fast.clean connections Utility voltage monitor fixed!' • Rated for all classes of load,100%equipment rated.both inductive and resistive. -Pick-up 60 i -Dropout 65 • 2-pole,250 VAC contactors. Return to Utility Approx.13 sec r • Service equipment rated,dual coil design. Exercises bi-weekly for 5 minutes' Standard • Rated for both aluminum and copper conductors. ETL or UL listed Standard Enclosure type NEi 3R • Main contacts are silver plated or silver alloy to resist welding and sticking. Circuit breaker protected 22.000 • NEMA/UL 311 aluminum outdoor enclosure allows for indoor or outdoor mounting flexibility. Lug range 250 MCM-#6 *Function of Evolution controller Dimensions Exercise can be set to weekly,bi-weekly,or monthly ry y 200 Amps 120/240,1 e Open Transition Service Rated Height Width Depth H1 H2 Wt W2 in 26.8 30.1 10.5 13.5 6,9 cm 67.95 76.43 26.67 34.18 17.5 1 Wire Ranges Conductor Lug Neutral Lug Ground Lug 250 MCM-#6 350 MCM-#6 2/0-#14 DEPTH- N2 PWRview Automatic Transfer Switch Features Model 0007210-0(24 kW) • Integrated PWRview monitor provides real-time energy usage data through PWRview app. No.of poles 4Y " # Current rating(amps) 200 • Intelligently manages up to four air conditioner loads with no additional hardware. Voltage rating(VAC) 12W240,10 • Up to eight additional large(240 VAC)loads can be managed when used in conjunction Utility voltage monitor(fixed)' with Smart Management Modules(SMMs). -Pick-up 80% • Electrically operated,mechanically-held contacts for fast,clean connections. Dropout 65%Return to Utility Approx.13sec. 1111111111 • Rated for all classes of load.100%equipment rated,both inductive and resistive. Exercises to-weekly for 5 minutes' Standard • 2-pole,250 VAC contactors. ETL or UL listed Standard • Service equipment rated.dual coil design Enclosure type NEMA 3R Circuit breaker protected 22,000 • Rated for both aluminum and copper conductors. Lug range 250 MCM-#6 • Main contacts are silver plated or silver alloy to resist welding and sticking *Function of Evolution controller • NEMA 3R aluminum outdoor enclosure allows for indoor or outdoor mounting flexibility. Exercise can be set to weekly,bi-weekly,or monthly • Heavy duty Generac Contactor is an ETL recognized device. -w'- Dimensions ry 200 Amps 120/240,1e Open Transition Service Rated Height Width Hi H2 W1 W2 in 26.8 30.1 10.5 13.5 6.9 cm 67.95 76.43 26.67 34.18 17.5 Wire Ranges prP•" „2 Conductor Lug Neutral Lug I Ground Lug 250 MCM-#6 1 350 MCM-#6 1 2/0-#14 GENERAC 20/22/24 kW Available Accessories 04 _ Model# Product Description G005819-0 26R Wet Cell Battery Every standby generator requires a battery to start the system.Generac offers the recommended 26R wet cell battery for use with all air-cooled standby product(excluding PowerPact®). G007101-0 Battery Pad Warmer Pad warmer rests under the battery.Recommended for use if temperature regularly falls below 0°F(-18°C).(Not nec- essary for use with AGM-style batteries) G007102-0 Oil Warmer Oil warmer slips directly over the oil filter.Recommended for use If temperature regularly falls below 0°F(-18°C). ' G007103-1 Breather Warmer Breather warmer is for use in extreme cold weather applications.For use with Evolution controllers only in climates where heavy icing occurs. G005621-0 Auxiliary Transfer Switch The auxiliary transfer switch contact kit allows the transfer switch to lock out a single large electrical load that may not be Contact Kit needed.Not compatible with 50 amp pre-wired switches. G007027-0-Bisque Fascia Base Wrap Kit The fascia base wrap snaps together around the bottom of the new air-cooled generators.This offers a sleek,contoured (Standard on 22/24 kW) appearance as well as offering protection from rodents and insects by covering the lifting holes located in the base. G005703-0-Bisque Touch-Up Paint Kit If the generator enclosure is scratched or damaged,it is important to touch up the paint to protect from future corrosion. The touch-up paint kit includes the necessary paint to correctly maintain or touch up a generator enclosure. G006485-0 Scheduled Maintenance Kit Generac's scheduled maintenance kit provides all the items necessary to perform complete routine maintenance on a Generac automatic standby generator(oil not included). G007005-0 Wi-Fi LP Tank Fuel Level The Wi-Fi enabled LP tank fuel level monitor provides constant monitoring of the connected LP fuel tank.Monitoring the Monitor LP tanks fuel level is an important step in verifying the generator is ready to run during an unexpected power failure.Sta- tus alerts are available through a free application to notify users when the LP tank is in need of a refill. G007000-0(50 amp) Smart Management Module Smart Management Modules(SMM)are used to optimize the performance of a standby generator.It manages large elec- G007006-0 trical loads upon startup and sheds them to aid in recovery when overloaded.In many cases,using SMM's can reduce (100 amp) the overall size and cost of the system. G007169-0.413 LTE Mobile Link Cellular The Mobile Link family of Cellular Accessories allow users to monitor generator status from anywhere in the world,using G007170-0-Wi-FV Accessories a smart phone,tablet,or PC.Easily access information such as the current operating status and maintenance alerts.Us- Ethernet ers can connect an account with an authorized service dealer for fast,friendly,and proactive service.With Mobile Link, users are taken care of before the next power outage. G007220-0-Bisque Base Plug Kit Base plugs snap into the lifting holes on the base of air-cooled home standby generators.This offers a sleek,contoured appearance,as well as offers protection from rodents and insects by covering the lifting holes located in the base.Kit contains four plugs,sufficient for use on a single air-cooled home standby generator. Dimensions & PCs Model UPC 87 6 mm 1,21e mm I25 I Inl 149.0 in1 G007038-1 696471074185 G007038-3 696471074185 G007039-1 696471074192 G007039-3 696471074192 G007042-2 696471074208 7272mm 1266 nJ G007042-3 696471074208 G007043-2 696471074215 G007043-3 696471074215 0 0 oil G007209-0 696471071511 — G007210-0 696471078220 �'5,n 5 292 mm I I I9861n1 LEFT SIDE VIEW FRONT VIEW Dimensions shown are approximate.See installation manual tot exact dimensions DO NOT USE THESE DIMENSIONS FOR INSTALLATION PURPOSES GENE RAC Generac Power Systems,Inc. • S45 W29290 HWY.59,Waukesha,WI 53189 • generac.com C2020 Generac Power Systems.Inc. All rights reserved All specifications are subject to change without notice. Part No A0000937814 Rev.B 07/30/2020 GENERAC ' Automatic Transfer Switches Service and non-Service rated Automatic Smart Transfer Switches - 100 - 400 Amps, Single Phase c &s LISTED 'CUL only applies to non-service rated switches Description Generac Automatic Transfer Switches are designed for use with single phase generators that utilize an Evolution" or Nexus'" Controller. The 100, 200, and 400 amp open transition switches are available in single phase in both service equipment rated and non-service equipment rated configurations. The 150 and 300 amp open transition switches are only available in a service rated equipment configuration. Standard Features Service rated (RXSW) Generac Automatic Transfer Switches are housed in an aluminum NEMA/UL Type 3R enclosure", with electrostatically applied and baked powder paint. The Heavy Duty Generac Contactor is a UL recognized device, designed for years of service. The controller at the generator handles all the timing, sensing, exercising functions, and transfer commands. All switches are covered by a 5 year limited warranty. Non-service rated (RXSC) switches are housed in a steel enclosure. DPM Technology Through the use of digital power technology (DPM), these switches have the capability to manage up to 4 individual HVAC (24 VAC controlled) loads with no additional hardware. When used in tandem with Smart Management Modules, up to 8 more loads can be managed as well, providing the most installation efficient power management options available GENERAC' GENERAC• 100-400 Amps, Single Phase Automatic Smart Transfer Switches Functions All timing and sensing functions originate in the generator controller Utility voltage drop-out......._ ......_ _ ... ...................................<65% Timer to generator staff........._....... .......... ...... 10 second factory set,adjustable between 2-1500 seconds by a qualified dealer' Engine warm up delay .._. .......5 seconds Standby voltage sensor........_ ......._...........___....__....... _. _ 65%for 5 seconds Utility voltage pickup............__....... .......__ ._.._ ....... >80% Re-transfer time delay ....... ...... _..- _ 15 seconds Engine cool-down timer....... ..... .. .............. ............ ...__..... ._ ......._ _..... ...... ........ ...... .. .........60 seconds Exerciser ........................................................................................................_......... ........ .....................5 or 12 minutes adjustable weekly/Bi-weekly/Monthly.. The transfer switch can be operated manually without power applied 'When used in conjunction with units utilizing Evolution"controls "Adjustable via the controller Specifications Model RXSC10OA3 RXSW100A3 RXSW150A3 RXSC20OA3 RXSW200A3 RXSW300A3 RXSC400A3 RXSW40OA3 Amps 100 100 150 200 200 300 400 400 Voltage 120/240,1e 1201240,to 120/240.1e 120/240.te 120/240,td 120/240,to 120/240,lo 120/240,1e Load Transition Type Open Transition Open Transition Open Transition Open Transition Open Transition Open Transition Open Transition Open Transition (Automatic) Service Rated Service Rated Service Rated Service Rated Service Rated Enclosure Type NEMA/UL 313 NEMA/UL 3R NEMA/UL 311 NEMA/UL 3R NEMA/UL 3R NEMA/UL 3R NEMA/UL 3R NEMA/UL 3R UL Rating UUCUL UL UL UUCUL UL UL UUCUL UL Withstand Rating (Amps) 10,000 10.000 22.000 10.000 22,000 22,000 22.000 22.000 Lug Range 1/0- #14 250 MCM- #6 600 MCM- #4 or 1/0-250 MCM Dimensions w, H2 H, Model RXSC100A3 RXSW100A3 RXSW150A3 RXSC200A3 RXSW200A3 RXSW300A3 RXSC400A3 RXSW400A3 Height a Ht 17.24/437.9 17.24/437.9 26.75/679.4 17.24/437.9 26.75/679.4 42 91/1089 9 31.25/793.8�412.91/1089.91 �! o _ __ _ (in./mm) H2 20/508 20/508 30/762 20/508 30/162 48/1219 2 36,9144 48/1219.2 WI 12.5/317.5 12 5/317 5 10.5/266 7 12.5/317 5 10 5/266 7 16 69/423.9 19 18A87 2 16.69/423.9 Width - (in./mm) — -_ W2 14.6/370.8 14.6/370.8 13.5/342.9 14.6/370.8 13.5/342.9 21.82/554.2 24/609 6 21.82/554.2 Depth(in./mm) 7.09/180.1 7.09/180.1 6.3/160.1 7.09/180.1 6.3/160.1 10 06/255.5 10.06/255.5 10.06/255.5 1@ Hl Weight(lbs./kilos) 2019.07 22.5/10.21 39/17 69 20/9.07 39/1 Z69 140/63.5 133/60.33 140/63.5 ., DEPTH t. yyp I GENERAC" Generac Power Systems,Inc. • S45 W29290 HWY.59, Waukesha,WI 53189 - generac.com C2017 Generac Power Systems,Inc. All rights reserved. All specifications are subject to change without notice Bulletin 10000013459•A 04/24/17 •11/10/2020 Yost&Campbell Proposal �:.. . Yost & Campbell CALL US TODAY ... (800) 640-9678 Your Yost & Campbell Proposalon i FNOV220 VILLAGE OF RYE BROOK Eawaran Nambudiri BUILDING DEPARTMENT Address: 9 Castle View Court Rye Brook, NY 10573 Consultation Code: ENGE5QWQT Phone: (914) 907-9306 Date Presented: Nov 3, 2020 Email: nambudirie@gmail.com Date Accepted: Nov 9, 2020 Presented by: Keith Blades Phone: (914) 459-1825 Email: kblades@yostandcampbell.com About Us At Yost&Campbell Heating, Cooling&Generators we're proud to have been a part of life here in Westchester County for over 75 years. It started back in 1939,when two partners—Leo Yost and Alvin Campbell—began a refrigerator repair business out of Yost's garage. Our business grew from there until it covered all aspects of heating,cooling, plumbing,and indoor air quality,and served homes and businesses throughout Westchester County,The Bronx, Queens, and Rockland. • l HEATING • COOLING • GENERATORS • SINCE 1939 800.640-YOST wwrw.yostwxbcaff4A*ILcorn cc • I t (https://www.youtube.com/watch?v=JaL2cfxGZY8&feature=youtu.be) Today,our business continues adhering to the traditions our founders believed in: providing quality service in a timely fashion without charging our customers an arm and a leg. It's the staples of good business,and it has helped us expand and thrive for over three-quarters of a century.We keep up with the latest developments in the field, and our staff averages 25 years'experience apiece, handling all kinds of household problems. Contact our team today and find out what thousands in the tri-state area already know:Yost&Campbell Heating, Cooling&Generators is the one to count on! https://app.oncallair.com/#/proposal/accepted/249770/724982?showBack=true 1/6 11/10/2020 Yost&Campbell Proposal IEC Factory ACIak . (IM �n + MNti�i a�ira4rM the FINE�� DIAMOND" CONTRACTOR � * j E R5. NYC Master Plumber 1126,Westchester County 654 System Enhancements Notes No notes were entered. https://app.oncallair.com/#/proposal/accepted/249770/724982?showBack=true 2/6 11/10/2020 Yost&Campbell Proposal Includes 4 items J, Category:Generators (Qty: 1) Name: Generac 22 KW LP Generator Number: Category: HVAC Add-Ons (Qty: 1) Name: Gen Pad Number: Customer Reviews Category: Services (Qty: 1) Name: Check Out Our Customer Reviews Number: GENEgALC Ic Category: Services (Qty: 1) Name: Generac Warranty and Terms Number: https://app.oncallair.com/#/proposal/accepted/249770/724982?showBack=true 3/6 11/10/2020 Yost&Campbell Proposal What you'll get 7 items 200 AMP TRANSFER SWITCH INCLUDED 2yr LABOR AND 5YR LIMITED PARTS WARRANTY****CAN BE UPGRADED TO SYR HOME COMFORT CONTRACT-$499.00 SYR LABOR AND PARTS BUMPERTO BUMPER ALL PLUMBING AND ELECTRIC INCLUDED Generator Payment Schedule: 50%Deposit,Balance Due Upon Installation of Equipment Hold$500 to be paid upon final inspection PATCH WORKAND MILLWORK IS NOT INCLUDED The following services are not included: Permits and Filing fees,LP tank and concrete base trenching and landscaping if necessary We will ensure that your home remains clean and everything is replaced properly We Recommend You can add any of the following items that we've carefully selected to complement your proposal: i 1 Home Comfort Club Generator $499.00 or as low as$17.47/month* REMOVE https://app.onGallair.com/#/proposal/accepted/249770/724982?showBack=true 4/6 .11/10/2020 Yost&Campbell Proposal Investment Details Sale Price $14,158.80 REBATE Y&C 81stANNIVERSARY DISCOUNT - $800.00 Recommended Items (1) + $499.00 Total Investment $13,857.80 The Total Investment is the total cost of the goods and services described in this proposal Financing Financing Available $485.03 Qualified Customers Only minimum monthly payment(3.50%) FINANCING OPTION DISCLOSURE Please refer to the Credit Card Agreement about credit costs and terms.This is a deferred interest promotion.This means that if the purchase balance is not paid in full within the special terms promotional period, interest will be charged to the account from the purchase date at the regular APR for purchases.Making regular monthly payments will not pay off the purchase balance within the promotional period Signature https://app.oncallair.com/#/proposal/accepted/249770/724982?showBack=true 5'6 11/10/2020 Yost&Campbell Proposal Terms and Conditions This proposal is for completing the job as described above.We will guarantee the price of material and labor used in determining this quote for a period of 30 days.Additional work, including and additions,changes,or unforeseen problems will be billed at a rate of itemized materials and our labor scale. I n the event a default or breach of this Agreement by the Customer,Yost&Campbell shall be entitled to any and all expenses, including, but not limited to,attorney fees and costs incurred in the instituting or prosecuting any legal action or proceeding related to such default or breach by the Customer. Acceptance of Proposal The above prices, specifications and conditions are satisfactory and are hereby accepted.Y&C is authorized to do the work as specified. Payment will be made as outlined above. Filing fees and permits not included Notice of Cancellation The home owner may cancel this contract until midnight of the third business day after the day in which has signed this agreement. https://app.oncallair.com/#/proposal/accepted/249770/724982?showBack=true 6/6 Mike Izzo From: Mike Izzo Sent: Monday, March 21, 2022 2:18 PM To: Easwaran Nambudiri Cc: Steven Fews; 'Tara Gerardi'; Laura Petersen Subject: RE: 6 month extension for the building permit at 9 Castleview Court Dear Mr. Nambudiri, Thank you for the email. I am pleased to inform you that a six (6) month extension to your open permit #MP21-048 has been approved, and that the new permit expiration date is, October 6, 2022. Please arrange for all work to be completed and successfully inspected, and for all paperwork &fees to be remitted to the Village such to facilitate the issuance of the Certificate of Occupancy/Certificate of Compliance closing out the permit on or before that date. Thank you. /ffk4iae/(7, Izzo Building& Fire Inspector Village of Rye Brook, NY (914) 989-0668 From: Easwaran Nambudiri<rbcheeravally@gmail.com> Sent: Monday, March 21, 2022 2:01 PM To: Mike Izzo<Mlzzo@ryebrook.org> Subject: 6 month extension for the building permit at 9 Castleview Court Sir, We had the permit to install ea GENRAC back up generator which is expiring on the 6th of April, 2022. AS you detailed in the Final inspection report , chains have been added to secure the Propane Tanks together by Suburban Propane Co. The only other adjustment needed was the installation of planters around the generator unit on the eastside. We had to be out of town for several weeks un expectedly, and expect to be back during middle of April. We expect to complete the plant placements by early june . Pictures of both corrective actions will be sent to you as soon the planting is completed. In view of this situation ,Please extend the permit by a period of 6 months from April 6, 2022. 1 Please let me know the review decision. Thank you for your actions, in advance, E.Nambudiri 9 Castleview Court Rye Brook 914907 93o6 2 Building Permit Check List&Zoning Analysis Address: 'ET, CASTt,E� kFz\-J L SBL: 1 Zone:Z-1 -57 Use: 2 k Const.Type: Other: Submittal Date: Il ZO -z, Revisions Submittal Dates: Applicant: 22 1-Lw Z ►'- z O L 43 i S Nature of Work: �t � F_N Reviews:ZBA: NOV 2 4 2020 PB: BOT: Other. OK ( ( ) FEES:Filing: BP: cis •�-L C/O: Legalization: APP: Dated: Notarized. SBL: -,"Truss I.D. Cross Connection: H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening. ( ) ( ) ENVIRO:Long. Shore Fees: N/A: (� ( ) SITE PLAN:Topo: Site Protection S/W Mgmt: Tree Plan: Other. ( ( ) SURVEY:Dated: Current: Archival: Sealed. Unacceptable: ( ) ( ) PLANS:Date Stamped: Sealed Copies: Electronic: Other. ( ) (�License:/Workers Comp: ✓ Liability: Comp.Waiver. Other. ( ) ( ) CODE 7S3#: Dated: N/A: (Jf ( ) HIGH-VOLTAGE ELECTRICAL:Plans: Permit: N/A: Other. O O LOW-VOLTAGE ELECTRICAL:Plans: Permit N/A: Other. ( ) ( ) FIRE ALARM/SMOKE DETECTORS:Plans: Permit H.W.I.C.:_Battery._Other. ( ) (✓Y PLUMBING:Plans: Permit ✓ Nat. Gas: LP Gas: N/A/: Other. ( ) ( ) FIRE SUPPRESSION:Plans: Permit: N/A: Other. ( ( ) H.V.A.C.: Plans: Permit N/A: Other. ( (� FUEL TANK:Plans: Permit Fuel Type: Other. O O 2020 NY State ECCC: N/A: Other. ( ) ( ) Final Survey Final Topo: RA/PE Sign-off Letter. As-Built Plans: Other. ( ) ( ) BP DENIAL LETTER: C/O DENIAL LETTER: Other. ( ) ( ) Other. ( )ARB mtg.date: approval: notes: ( )ZBA mtg.date: approval;- notes: ( )PB mtg.date: approval: notes: REQUIRED EXISTING PROPOSED NOTES APPROVED Awl. „_._: f E B - 3 2021 Cir Fmmg Front Fmnt Main Cov Accs.Cov Ft.H/Sb: Sd.H/Sb SEA: Tot, HHght/Stories notes:d C�2C1.F N �v by a — F T- V zt4 D A i �• '� C 7 Al e y N CN o co s Old g v � v � w aJ Q o�ection w Z Eo a=. �t J # IA LU O :e cZ o rm .b.i E ., kv' � � � L y:��(t�a►J C i R C Ll r` t, Ae" " CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 111%. � 9/11/2020 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 Arthur J. Gallagher Risk Management Services, Inc NAME: SOraya RiveraPHONE —— FAX 250 Park Avenue 3rd Floor LAIC.No.Ext) 212-530 7504 j lac.Not:212-981-3386 _ New York NY 10177 A D" RIE DSS: Sora a Rivera a .com INSURERS AFFORDING COVERAGE I NAIC N INSURER A:Selective Insurance Company of America 1 12572 INSURED YOSTBCA-01 INSURER B: Yost&Campbell, Inc. INSURERC: 20 Brookdale Place Mt. Vernon, NY 10550 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1177726323 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 AD L U R - - - POLICY EFF POLICYEXP LTR TYPE OF INSURANCE POLICY NUMBER MWDD/YYYY MWDDffYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY S2390242 9/15/2020 9/15/2021 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES Ea occurrence) $500,000 _ MED EXP(Any one person) $15,000 PERSONAL&ADV INJURY $1,000.000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE i$2,000,000 POLICY X FE X LOC PRODUCTS-COMP/OP AGG $2,000.000 OTHER --� $ AUTOMOBILE LIABILITY MBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY Per ( Person) $ OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS ONLY AUTOS ( ) HIRED NON-OWNED PROPERTY DAMAGE :$ AUTOS ONLY AUTOS ONLY Per accident �1 $ UMBRELLA LIAB OCCUR EACH OCCURRENCE _ $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER AN YPROPR I E TOR/PARTNER/EXECUTIVE OFFICE RIME MBEREXCLUDED? ❑ NIA E.L EACH ACCIDENT $ (Mandatory In NH) E L DISEASE-EA EMPLOYEE $ If Yes,describe under - DESCRIPTION OF OPERATIONS below L E L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) Village of Rye Brook is included as Additional insured for general liability as per written contract and as per policy terms,conditions and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Village of Rye Brook ACCORDANCE WITH THE POLICY PROVISIONS. 938 King Street Rye Brook NY 10573 AUTHORIZED REPRESENTATIVE USA C.s��--� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD NY S I F 199 CHURCH STREET,NEW YORK,N.Y. 10007-1100 New York State Insurance Fund I nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ""n^^^ 132866714 Q Q YOST&CAMPBELL OF ROCKLAND INC DBA YOST&CAMPBELL INSTALLATIONS r 20 BROOKDALE PL MT VERNON NY 10550 ❑� SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER YOST&CAMPBELL OF ROCKLAND INC VILLAGE OF RYE BROOK 20 BROOKDALE PL 938 KING STREET MT VERNON NY 10550 RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE Z 2261 808-6 823759 04/01/2020 TO 04/01/2021 03/09/2020 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2261 808-6, 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 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 STATE INSURANCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 116146095 IIIIIIIIIIIIIIICn0�010100 iC000�0-7 19 7 161510 11 17 1III III IIIIIII Form WC-CERT-NOPRINT Vemon 3(0829/2019)IWC Policy-22618086J U-26.3 62 (00000000000079765017)[0001-000022618086)[ssZ)[15336-64)(Cert_NoP-CERT_1)[01-000011 ,t�`'}�', „f,+ �^(Jd!► 1 r �sA AQypy',4>• t rr r A -:L< '!) fA .. ,lM�^y//�e'.!A}F°"�'�',���A�/�.a'�. .+�}p� ''t{ -a � 0..' + ~i�Frp7 d11FI1Fm ) vf�l�j� w1., p �111/111 1f/ �f '1. E Il�ill � , : i 11 1 fIig.} . • 111 1 1 1-` 1. r . �111-,'der }j:mvp- $ 111�111� EF�.�,144'�.i.lfl�llllll'�(f .•.`,,. qq V T A:yam. r � � O T,.. =— O =• =f `' tit 03 rA W U .� LUc� o. W co W a 7 rf' a ui w CO i�l�l m W Gp1'�i ell 'r.. •w.•'� �. VJ W CJ III.'.j,'.<l�)I71 �1 '• (f( 5 ti yL. 0 z M i•M1': H 'Ytil ♦ I I, T Fp1�1;1;/11j1` r r Ilf//�lll�l. 111111�' `g taa.. ;Ih. . ..1.1'j1 Jr}-.. . v /Me /1 11 R r � . ' _�a 1 .� 1 � "`r�j NH� .�:1��k'`; 0 �':-.tT�,a7lH v ,,!a' ' o7,Ip�i��aSr'�lx=�` ! O '�4` -�--.`i� � d+ '��_,_„ ',0 ��"`r ,Vr �'�•��'� .,�yi''s AC oG n 2020 CERTIFICATE OF LIABILITY INSURANCE rATE(MM/DDIYYYY) 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 NAME: MARSH USA,INC. - - 445 SOUTH STREET PHONE A Not: MORRISTOWN,NJ 07960-6454 ADDRIESs;__-__ AIM.Momstown.CertRequest@marsh.com Fax:212.948.0979 - -— INSURE S AFFORDING COVERAGE NAIC 0 SP LP CLIE INSURER A:Liberty Mutual Fire Insurance Company 23035 INSURED SUBURBAN PROPANE PARTNERS,L.P. INSURER B:LM Insurance Corporation 33600 240 ROUTE 10 WEST INSURER C:Liberty Insurance Corporation 42404 WHIPPANY,NJ 07981 INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: NYC-009138921-40 REVISION NUMBER: 4 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR POLICY NUMBER MWDDIYYYY MM/DD/YYYY LIMITS X COMM ERCtAL GEN ERAL LIABILITY TB2-631-507975-080 10/01/2020 10/01/2021 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED CLAIMS-MADE M OCCUR PREMISES Ea occurrence $ 250,000 MED EXP(Arty one person) $ 10,000 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER $ AUTOM0131LELIABILITY AS2-631-507975-070 10/01/2020 10/01/2021 COMBINED SINGLE LIMIT $ Ea accident 2,000,000 X ANY AUTO BODILY INJURY(Per person) $ X OWNED LXX SCHEDULED AUTOS ONLY AUTOSBODILY INJURY(Per acc dent) $ XHIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ B WORKERS COMPENSATION WA5-63D-507975-090 (AOS) 10 11 0 1 X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER C ANYPROPRIETOR/PARTNER/EXECUTIVE YIN WA7-63D-507975-100 (MA) 10/01/2020 10I01/2021 1,000,000 B OFFICER/MEMBEREXCLUDED? N NIA E.L.EACH ACCIDENT $ (Mandatory in NH) WC5 631-507975-110 (WI) 10/0112020 10I01/2021 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 It yes.describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) VILLAGE OF RYEBROOK IS SHOWN AS AN ADDITIONAL INSURED SOLELY WITH RESPECT TO GENERAL LIABILITY COVERAGE AS SHOWN HEREIN AND SOLELY IN THE EVENT THIS STATUS IS REQUIRED BY WRITTEN CONTRACT BETWEEN SUBURBAN PROPANE,L.P.OR ITS SUBSIDIARIES OR AFFILIATES AND CERTIFICATE HOLDER. CERTIFICATE HOLDER CANCELLATION VILLAGE OF RYEBROOK SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ATTN:BUILDING DEPARTMENT THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 938 KING STREET ACCORDANCE WITH THE POLICY PROVISIONS. RYEBROOK,NY 10573 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. ManashiMukher)ee jtilc��.not• .�d..t�nandu ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Workers' sORK Compensation CERTIFICATE OF Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured Suburban Propane Partners LP 973-887-0500 240 Route 10 West Whippany NJ 07981 1c.NYS Unemployment Insurance Employer Registration Number of Insured 892-18602 Work Location of Insured(Only required if coverage is specifically limited to 1d.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-Up Policy) Number 22-3410353 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) LM Insurance Corporation Village of Rye Brook 3b.Policy Number of Entity Listed in Box 1a" 938 King Street Rye Brook NY 10583 WA5-63D-507975-090 3c.Policy effective period 101112020 to 10/1/2021 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 Certificate of Insurance to the entity listed above as the certificate holder in box"2". The insurance carrier must notify the above certificate holder and the Workers'Compensation Board 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. This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note: Upon 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: Karyn Lessard insurance carrier) Approved by: - ZJ"` �' `�— 9/28/2020 (Signature) (Date) Title: Client Service Coordinator Telephone Number of authorized representative or licensed agent of insurance carrier: 781-647-8140 Please Note:Only insurance carriers and their licensed agents are authorized to issue Form C-105.2.Insurance brokers are NOT authorized to issue it. C-105.2 (9-17) www.wcb.ny.gov 57802709 1 LM_686 1 10/20-10/21 C105.2 i Linda Bradfiah 1 9/28/2020 9:36:00 AM (CDT) i Page i of 2 THIS IS TO CERTIFY THAT I HAVE SURVEYED RICHARD A. SPINELLI /,Of e as ahozvv7 O/7 �(J[/60�/Y/J/O/J /117O/D of Rroperly 313 HALSTEAD AVENUE he/onyiny Ao Z&AhcraI7 Charch, MAMARONECK. N. Y. � �j ,./ TEL. 361-2357 . FILED IN THE WESTCHESTER COUNTY CLERK'S OFFICE, DIVISION OF LAND RECORDS (FORMERLY REGISTER'S OFFICE) -s;ePfzS, /99/ AS MAP AJ 245/3 I HAVE LOCATED ALL EXISTING BUILDINGS AND LINES OF POSSESSION AS SHOWN HEREON. I HEREBY CERTIFY THIS SURVEY TO ��AtIP/i7N/ n/AMQ o/ei TO WHOM LIABILITY IS LIMITED. JY'D/C,Ac.. ioBSr,QAGT GOGP, SURVEY AND MAP COMPLETED 992SCALE ONE INCH TO ,30 FEET. GUARANTEED IN ACCORDANCE WITH THE MINIMUM STANDARDS FOR TITLE SURVEYS OF THE NEW YORK STATE LAND TITLE ASSOCIATION NOTE:ALL CERTIFICATIONS MADE HEREON ARE VALID FOR THIS MAP AND �� COPIES THEREOF ONLY IF SAID MAP OR COPIES BEAR THE IMPRESSED -' (�R) SEAL OF THE SURVEYOR WHOSE SIGNATURE APPEARS HEREON. L s.,tv6V -T-i JY /�, /99L RICHARD A.SPINELLI N V.S.LIC.LAND SURVEYOR N0.49240 �/ /1 SUCCESSOR TO GUY VROMAN S SAL SPINELLI/9 li /0 ��0 NEW yoR to /PlJC /Pid9C Eafo��3 ' VA.SP/h�1 82' /2 :38 l /• S 9 °. 492AD �� c hSEO lANT SV� w RoO 3.4 P6A,�G �-r✓k- �„ 1% ywoed h ' Pt.o Fe �� W oetK if.s1' a• g9' I e.ty F0 ` �' a�f o r J •' o is 6e� F�o.+�e oo.,fe.nja, ZZ ;� is6V /SLc Ciji��tf7�Tp rL. �,. � p 0 'e`2s 22 88, PERMITt . �/ ���' © CASTLE ✓/EW GoueT' 131-9 ATE APPR V -Tr LU (� IE cIE Z "^- UILDINGINS TO �C IlageofRye REVI JAN 19 20�21 � L, PLAN DATE a rlELD BOOK PAGE