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BP21-225
PERMIT # U1 SECTION TYPE OF WORK JOB LOCATION _ OWNER,44/9 CONTRACTOR EST. COST �` �CO # FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING RGH PLUMBING GAS 0 �/— cQ5 DATE: Cp ca% oZ/ p(p BLOCK / LOT FEE �5 Q `�QLJ�� DA INSPECTION RECORD D TE ,I AS BUILT lug �e�Sky /,^yh4s Sciai'�;�o�9��/i�loa -5y93 . 14c;) N 41 Lq 7/PC4yei e �c l" OTHER APPROVALS ARB ,C}u �Ljs� QcQ BOT PB ZBA OTHER THlS BUILDING MUST BE POSTED MlRH A PERMANENT CONSTRUCTION TYPE IDENTIFICATION SIGN; V FR PRIOR 10 THE ISSUANCE OF A C/09 AS REQUIRED BY NY STATE LAW. VILLAGE OF 1�VE BROOK WESTCHESTPR COUNTY, NEW YORK NO: 22-187 Certificate of Occupaucp This is to certify that Alaq &D12 bG2 /� Aspis, of, )?V e &-00 k, !V Y having duly filed an application on November ) t5 20 requesting a Certificate of Occupancy for the premises known as, I K1 k7 i p Pao rW i 1( PDad , Rye Brook,NY, located in a Zoning District and shown on the most current Tax Map as Section: la`s• &0 Block: / Lot: and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No. C,21"4969,t5 , issued L)7 20 42 f, such authority and permission is hereby granted to the property owner to lawfully occupy or use said premises or building or part thereof listed under the following New York State Classifications, Use: -T�J oy?e" family Construction: for the following purposes: ��`� 11000/ ck)' y M e r�etu h Or h-�5 Subject to all the privileges, requirements, limitations, and conditions prescribed by law, and subject also to the following: This certificate does not in any way relieve the owners or any person or persons in possession or control of the premises, building,or any part thereof from obtaining such other permits or licenses as may be prescribed by law for the uses or purposes for which the building or premises is designed or intended. Furthermore, it does not relieve such owners or persons from complying with any lawful order issued with the object of maintaining the premises or building in a safe and lawful condition. No changes or rearrangement in the structural parts of the buildin or in the exit facilities shall be made,and no enlargement, whether by extending on any side or by increasing in heigh shall made,nor shall the buil2e: be moved from one location to another until a permit to accomplish such change has b b in nsor. oEc - s 2022 Building Inspector,Village of Rye Brook: t CV 4(" anniuvoaW VILLAGE OF RYE BROOD MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J.Bradbury www.iyebrook,org TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Michael). Izzo Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE December 8,2022 Alan Aspis&Barbara Aspis 11 Whippoorwill Road Rye Brook,New York 10573 Re: 11 Whippoorwill Road, Rye Brook,New York 10573 Parcel ID#: 129.60-1-8 This document certifies that the work done under Mechanical Permit#21-180 issued on 11/18/2021 for the installation of a new heat pump and air handler has been satisfactorily completed. Sincerely, Michael J. Izzo Building&Fire Inspector /to D BUILD ENT For office use only: DD PERMIT# — S [NOV 5 2022 VIL OF RYE OK ISSUED: $--r�7 a/ 38 KING STRE YE BROOK, YORK 10573 DATE: VILLAGE OF RYE BROOK 9 -0 FEE: PAIDB BUILDING DEPARTMENT APPLICATION FOR CERTIFICATE OF OCCUPANCY, CERTIFICATE OF COMPLIANCE, AND CERTIFICATION OF FINAL COSTS TO BE SUBMITTED ONLY UPON COMPLETION OF ALL WORK, AND PRIOR TO THE FINAL INSPECTION ws**stsr►►asssss**ss*rsss►s**s►sit►sss►s*srsr**s*s*sssss*srsw*►wsstwsstswtss►sst►►tstsssrsr►s*swss*►twrssss******►ss►rstrw**r Address: /v I onoo W/ wk, JJ Occupancy/Use: 4�yParcel ID#: O Zone: Owner: Q 1 S Address: P.E./R.A. or Contractor: , (WAddress: / Person in responsible charge: Tt Cr,(\1L SCE C,f v- I Y) b Address: LJ G YC kY Qdk L—U Y) C� Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issuance of a Certificate of Occupancy/Certificate of Compliance for the structure/construction/alteration herein mentioned in accordance with law: STATE OF NEW YOM COUNTY OF WESTCHESTER as: V �rGSp l S being duly sworn,deposes and says that he/she resides at (Print Name of Applicatll ) ( o.and Street) in kAe 6 Y dC)< ,in the County of �5�. in the State of. that (CityfFown/Village) he/she has supervised the work at the location indicated above,and that the actual total cost of the work,including all site improvements, labor,materials,scaffolding,fixed equipment,professional fees,and including the monetary value of any materials and labor which may have been donated gratis was:$ I -? 9 JV t 0 for the construction or alteration of: I (7,of O f VYw,--✓ t.W 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-I O.A.of the Code of the Village of Rye Brook. Sworn to before me this Sworn to before me this day of b6v(47 hit', 20 t) day of , 20 Signature of Property Owner Signature of Applicant 'NYbG�k,n,ss Print Name of Property Ow er Print Name of Applicant �1 l UV tary PubLi6 f Notary Public GREGORY M.RIVERA Notary Public,State of New York No.01 RI6441398 Qualified in Westchester cow,ty Cortrmisslon Expires September 25.2 �m 9az 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.or - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS: i 102f W I DATE: PERMIT# `�' ISSUED: k bli CT: I LOT: LOCATION: `' At, )aTmvfi 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 ❑ OSS CONNECTION (FINAL ❑ OTHER QyE BR(�� cu � l7 1982 BUILDING DEPARTMENT ❑BUILDING INSPECTOR J�8SISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK F/❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 ! (914) 939-0668 FAx (914) 939-5801 www ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - -- - - - - - - - ADDRESS � I vv� ' W � , � DATE: PERMIT# � ' �� ISSUED: SECT: BLOCK: LOT: LOCATION: ��� � V'�c�C� C�C� OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... LY ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION t , ` 1 REQUIRED ❑ FOOTING W \� ❑ 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��. O� Zm cu � '9a2 BUILDING DEPARTMENT _❑BUILDING INSPECTOR ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK LJ CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www Uebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS:— l `"� � DATE: PERMIT# 2� ' ISSUED: 1 SECT: BLOCK: LOT: LOCATION: �—!1� {j!�\ OCCUPANCY: Z'0 ❑ VIOLATION NOTED THE WORK IS... �ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: Er ROUGH PLUMBING (24 ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER QyE BR(�k. 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 : �1\ ` DATE• PERMIT# ISSUED: SECT: BLOCK: LOT: LOCATION: ��- \�l `^?�C -\�I� x ' OCCUPANCY: 4 1 ❑ VIOLATION NOTED THE WORK IS... ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION 1 .� 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 �)2 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.aebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS: i,�1 �W� (����� \` ��� J DATE: �, i v ` '. PERMIT# ISSUED:• l SECT: LOCK: LOT: LOCATION: � -.>� �_P i. 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 f'❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER BRC�k. cu � 1982 BUILDING DEPARTMENT ❑BUILDING INSPECTOR ❑ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK f ❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www ryebrook.org - - - - - - -- - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : `� �`-'y1� / VJ 1, DATE: w,�I w� PERMIT# ISSUED: l SECT: BLOCK: LOT: LOCATION: OCCUPANCY: ?f J ❑ VIOLATION NOTED THE WORK IS... El ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ( FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING n �J ❑ ROUGH FRAMING I INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER cn in N N a 04 v � a ai 96 mob O U 000 ' p4 � z � O � z � o � : �► a 1-4 W Z C14 O > c m V Q 9600 i r••� ►3 ' O Q z F d 0. W c QQ sum � $ a, ci 0 U W O 4 ~ z w F z 6 C w C6 w � � p [EC� C�M� yE, (3RCrJ,�' BUILDIII�a00'?" MENT OCT - 6 2021 VIL�GGE OF RYE BROOK 938 KiNd. t' ET RYE B ,NY 10573 VILLAGE OF RYE BROOK BUILDING DEPARTMENT .or ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY BP#: CD/ �o�-� EP#: rp/Q53 Approval Date: OCT — 7 Permit Fee: $ Approval Signature: Other: Disapproved: (fees are non-refundable) Application dated, is hereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of a Permit to install and/or remove electrical equipment,wiring, fixtures,or to perform other high or low voltage electrical work as per the detailed statement described below. 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. Q 1.Address: f l G(//7t,7��R w.� ( SBL: Z`1 ,GD l Zone:/C—lS 2.Property Owner: )q lAy R,ASAddress: Phone#: '-{ w Cell#: email: 3.Master Electrician: `r(4LV"RS 6'_'rZAn.41'3 Address: lIG Con+Vj-,�j Lic.#:)3L4 Co Phone#:&S-62 B-Ct 7p Cell#: 9 1l-�'Go-0919 i, email: _T c- n t 6-U-Al Company Name: N l✓(EG{6Zi Address: 4.Proposed Electrical Work/Fixture Count: 1 /n� Z t�1J41(Z �' `j.,..1-Cl�Q �Z - Cl 1� CS 4(_ t)kj wtlR►.rJ R3 P --Z_L �, N�� Li wi t (r� 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 (print 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. (indicate architect,contractor,agent,attorney,etc.) The undersigned further states 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 Sworn to bef re t e thi day of 120 day of 0 r ,20 Signature of Property Owner Sigafture of A 96hcant Print Name of Property Owner Name of A hicant LJU Notary Public NoiRM&LILLO Notary Public, State of New York No. 01 ME6160063 Cualified in Westchester County Commission Expires January 29 20 8/12/2021 STATEWIDE • CAO Service With hitegrity 0:0 SWIS • : APPLICATION0. Office Use Elect. Permit# Date _ io- S - 2 Bldg Permit# -- Utility ID# Final Certificate# City/Village Zip Township County Address Cross Street Section Block Lot Owner Name/Address(if different than above) Contact Number ❑Basement ❑ 1st A. ❑2nd FI. ❑3rd Fl. ❑More Than 3 FI. ❑Garage ❑Attic ❑Outside ❑Residential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms Carbon Monox Hood Trash Compact Amt Amps f Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Warm Draw Incandescent Fluorescent SERVICE �- Amperage Voltage 1 P 3P #Meters #Disconnect ❑Underground ❑New ❑Reconnect ❑Overhead ❑Change ❑Visual Re-Inspection ❑ Safety Re-Inspection ❑ Re-Inspection Additional Information OCT 6 2021] ID VILLAGE OF RYE BROOK BUILDING DEPARTMENT C 7{� i+ — This application is valid for one(1)year from the date received by SWIS.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.The applicant declares that there is no open applications for the above address with any other inspection company.The applicant,owner or authorized agent agrees to all the above terms and conditions as set forth for the application. Inspector Date Finalized Inspector# Company Name Date Signature Address City/State Zip Code License# Phone# State Wide Inspection Services 1080 Main Street 5_ Fishkill, NY 12524 Va 845 202-7224 Phone aj- 914-219-1062 Fax STATE WIDE INSPECTION SERVICES Email: office@swisny.com Website: www.swisny.com Service With Integrity BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: TJN Electric Inc. Alan& Barbara Aspis Thomas M.Giustino 11 Whipporwill Road 116 Cortland Road Rye Brook, NY 10573 Mahopac, NY 10541 Located at: 11 Whipporwill Road, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP21-253 129.60 Certificate Number: 2021-5796 Building Permit Number: BP21-225 A visual inspection of the electrical system was conducted at the Residential occupancy described below.The electrical system consisting of electrical devices and wiring is located in/on the premises at: 11 Whipporwill Road, Rye Brook, NY 10573 The Second Floor Master Bathroom, Bedroom,and Closet were inspected in accordance with the NYS and NFPA 70-2017 and the detail of the installation,as set forth below,was found to be in compliance on the 29th day of March 2022. Name Quantity Rating Circuit Type Main Breaker Panel 01 200AMP AC Condenser 01 Air Handler 01 Bathroom Exhaust Fan 01 Circuit 01 20AMP New#4 WM Ground Only 01 Receptacles 12 GFCI 01 AFCI 01 15AMP Switches 05 Luminaires 10 2 - Sconces 02 ""�� T � Officer: Frank J. Farina This certificate may not be altered in any way and is validated only by the presence of a seal at the location indicated.This certificate is valid for work performed on the date of inspection only. 1 N N NCM w O N N a 0016 (s. 00 ar O a y 19 W CA O o z m Go F < < �. 30L00 p o w O v W 0 v a W Z o o 4 ups z r~ o 00 00 • M Q a tn w M..1 r2.r N z r% a 0�3 a o N � a O F U a w w o ~ Z oe x U rl w G1 p � z a v, z , < .. a No w 0 a � � yE 13Rc'v� BUIL E MI V E OF RYE YE NOV 12 2021 938 KIN , ET RYE B ,NY 10573 6 VILLAGE OF RYE BROOK ok.or BUILDING DEPARTMENT PLUMBING PERMIT APPLICATION 'f FOR OFFICE USE ONLY BP#: PP#: �f —1 ! 7 Approval Date: A � Permit Fee: S Approval Signature: Other: Disapproved: (fees are non-refundable) Application dated, is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to instal)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`annd Local Codes. 1.Address:I(Ait I P e0twiI.L � D 1 �YE Q�FyOY. SBL: IQ9, 2Q—f— i Zone: 2.Proposed Work: N E U1 P L Otj b I J G FOt- r'I A 3T-4 �A T kl 3.Property Owner: J�A f (S A ti A o s f'I S D Q ',Address: If W 4 E P f O+CW I t_[_ F_ Phone#: Cell#: /A/"7/Q—8S q& email: 4.Master Plumber: MCL&j IIJ Q Q A--H E cU Address: O Rj O 1C I T, b E.D E O F-,D f V 7 10s()6 Lic.#: JS(p; Phone#: q/y �q3 $o 22 Cell#: ,,/q email:Vh IUMLinkA"d k&4irq Company Name: E j'1�11 4 5 f LU rn1)1r G� N D HFA"rlAddre s:_PC, &)� 11 b ZO(C'tuD NY ,L S U 6 COMAk. C Wy+y 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 1 st Floor 2nd Floor ^ I 3'd Floor 1 4th Floor 5t6 Floor Exterior 5.*List Other Equipment/Provide Details: (Notarized Signatures Required Next 2 Pages) 8/12/2021 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: ,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 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 a Sworn to before me this day of Nov 201!)N _ day of 20a\ C,00 sl� --0-11T A I §iknH=of Property Owner gigna o plicant TIXAYAOCAY-�, 1 S ,�t /�J A Q Ac. RO f�int Name of Property Owner JPrint Name of Applicant Notary Publi6HARl MEULLO ic, State of New York Notary Public,State of New York No. 01 ME6160063 No.01 ME6160063 0aalrted in Westchester County Ot.ialified in Westchester Coun Commission Expires January 29,209n Commission Expires January 29.2 This application must be properly completed 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- 8/1=o2l BUILCETRYE;, DE PA NT D IE C `� V� DD 9 8 OK VILBR NY 10573 NOV 12 2021 3 KING , VILLAGE OF RYE BROOK ' BUILDING DEPARTMENT !i 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 D,LONG 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 YORK,COUNTY OF WESTCHESTER ) as: t\^\\ X ;�� (154tt ,residing at, Y1 l ►, 6V 1 �7 (Print name) (A d ess where you IiNe) 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; 1�6-9 ,Rye Brook,NY. (.lob Address) Further that all statements contained herein are true,and that to the best of his/her knowledge and belief,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. AA r�6�a � (S nature of Property Ov.ner(s)) Ck lit / 1� rint Name of Property Owner(s)) Sworn to before me this 12 day of 6 e c� t� , 20 ?�� (Notary Public) SHARI MELILLO Notary Public, State of New York No. 01 ME6160063 0'_!alified in Westchester County _3_ Commission Exoires January 29,20a_;;� 8/12/2021 O O 0 C6 00 y w o _ W y E" 0-4 � � 0 0. a a L a a a N o w cam`, C4 A qv 0 x 4 TI co ;D .." t- b14 s o £ O 00 o U wl ZOO zit U W d A p = e > 40 m �I oo 9 > .y E U a' • M W n.a U Now E' 't v� ✓ OWN d (D " ' �4i t� C u el ug o � oa, � 0. O Q d oQ o � $ S U O U a � > > dl .. Clow n. a D EC EUVE BUILD MENT NOV 17 2021 VILE ; OOK 938 KING >� ,NY 10573 VILLAGE OF RYE BROOK d BUILDING DEPARTMENT APPLICATION FOR PERMIT TO INSTALL AND/OR REMOVE HEATING VENTILATION AND/OR AIR CONDITIONING EQUIPMENT FOR OFFICE USE ONLY: PERMIT#: — / Q Approval Date: N0V 1 2021 Permit Fee: $ Approval Signature: Other: Disapproved: (fees fees are ntea# dable)*********** 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 Liability Insurance. (Village of Rye Brook must be listed as certificate holder)&Workers Compensation Insurance on a NYS Board form(Form#C105.2 or Form#U26.3/or NY State Workers Compensation Waiver) 4. Payment of Fees/Unit: RESIDENTIAL=$100.00/unit • COMMERCIAL=$350.00/unit. 5. Inspection by the Building Department for removal and/or installation. (48 hour notice required) 6. Electrical work requires a separate Electrical Permit&Electrical Inspection. 7. Plumbing/Gas work requires a separate Plumbing Permit&Plumbing Inspection. *f*,rss***,tf*s**,offs**sffffff*ffeef*f*ffssf*fff**fss*s*xfsssf*f*ss*s*s*sir:tsar*:rss*see*****,�***sfsets** Application dated, 11/1/2021 is hereby made to the Building Inspector of the Village of Rye Brook for a permit for the installation and or removal of the HVAC equipment as listed below.The applicant and property owner,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. Address: 11 whippoorwill Road Rye Brook / 1Q Q n SBL: 4p0 —�—d Zone: 2. Property owner: Barbara Aspis Address: 11 whippoorwill Road Rye Brook Phone#: 914-934-2272 Cell#:914-934-2272 email: albara@aol.com 3. contractor: Total Comfort Inc Address: 44 Kenosia Ave Danbury CT 06810 Phone#: 203-791-2141 Cell#: email: total@totalcomfort-ct.com 4. Applicant: Address: _ Phone#: Cell#: email: 5. Scope of Work:New Installation(00•Replacement( )•Removal( )•Other( ):_ 6. List Equipment: 2-ton-Lennox Heat Pump and matching air handler 7. Location of Equipment: see attched site p an 8. Method of Installation/Removal(list all equipment needed to perform job):_- no special equipment needed 1 8/12/2021 Z(print E C(F NEW YO C,COUNTY OF WESTCHESTER ) as: ,being duly sworn,deposes and states that he/she is the applicant above named, name of individual signing a the applicant) andf p ther st tees`t_ha�(S)h f 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. (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 r_�_ Sworn to before m'e^this � day of �110 t_�e►'h 6,20 —_ day of 06y c✓ 20,,-;2- - Si ature of Property Ow r t ture of Applic r" Print Name of Property Owner Pri -4 nt N e of Applicant No tc _ Notary ubJic ALEJANDRO A GARCIA MONTAS l/ Notary Public•State o,New York i1.f'OZ NO.OIGA6383865 N .,.,r PUBLIC Qualified in Bronx County MY COMMISSION EXPIRES APR,30,2022 My Commission Expires Nov 26. 2022 This application must be properly completed 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. Any application 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 8/12/2021 4 \ I \ I \ I \ I I \ \ \ I I \ I I \ \ I I \ I \ I I � I I � I � I i i i h � I \ � I \ I \ Ya� b ` i m I \ §6$$$i n i ASPIS RESIDENCE o 1 1 WHIP P O OR W I L L R O AD RYE BROOK . NEW YORK € n is w ,� TOTAL& COMFORT 44 Kenosia Avenue Danbury, Connecticut 06810 CT LIC.#308094 Phone: (203) 791-2141 Fax: (203) 790-5736 PURCHASE AGREEMENT NAME: Barbara Aspis DATE: October 14, 2021 ADDRESS: 11 Whippoorwill Road PHONE: 914-934-2272 Rye Brook. NY 10573 EMAIL: albara@aol.com Total Comfort, Inc. proposes to install a Ducted Central Warm Air Heating and Air Conditioning System. The following equipment and material to be included: 1—Lennox 2 Ton Heat Pump, Model#ML14XPI-024-230 1—Lennox 2 Ton Air Handler, Model#CBA25UH-024-230 1—Lennox Electric Heater, Model#ECBA25-10CB 1—L15-26-50 Refrigeration Line Set 1—M62S Condensing Unit Mounting Pad 1—Heat Pump Thermostat "Electrical wiring to be done by others "All necessary registers,grilles,ductwork,refrigeration&condensate piping are included with this proposal EXCLUSION:Duct pressure test,if required,is not included with this proposal. WARRANTY: Labor will be guaranteed for one year from date of installation. All equipment parts will be covered under the manufacturer's warranty. The guarantee is void if the system is not maintained, is misused,or is serviced by an unqualified service technician. Routine maintenance is recommended. Proper performance of the heating and air conditioning system assumes that the owner or builder provides R values that meets or surpasses the state building code and that the end user provides appropriate window treatment(curtains,blinds,etc.). EXTENDED WARRANTY:We would like to thank you for choosing Total Comfort, Inc.to bid on this project. We take pride in providing our customers with optimal service and support_ Attached you will find the Lennox Extended Limited Warranty program brochure for selected products,which is offered to Lennox equipment buyers at no additional charge. Upon acceptance of this proposal,please take the time to register your newly installed equipment online within 60 days of installation to qualify for this great plan. Please contact our office to inquire about the equipment model and serial information and with any questions or concerns regarding your new equipment purchase. PAYMENT TERMS:PROGRESS PAYMENT ACCEPTANCE: This order when accepted by the Seller,Total Comfort, Inc.,and the Purchaser constitutes a binding contract covering all agreements expressed or implied. No other agreements,written or implied shall limit or FJS Service Corp.—11 Whippoorwill Rd. Rye Brook, NY—HP/ 11900 STANDARD OF EXCELLENCE Welcome to the Lennox standard of excellence. Merit' Series is the introductory product line that TBACKUP NAL ELECTRIC raises the bar for heatingand cooling equipment. HEAT go an instant boost of hot air foi Don't settle when it comes to the air inside your ,: 1 added comfort when you need it most. home - ask for more. Ask for Merit. COMPACT DESIGN Ask More from Your Air. Fits into tighter spaces so you don't have to worry about costly renovations. FULLY-INSULATED CABINET Reduces sound for quiet operation and helps prevent cabinet sweatinr, LENNOXin hot and humid environments. QUANTUM'MCOIL STURDY STEEL CABINET Made to last,with an attractive, high-quality finish. With years of rigorous testing under the most SLEEVED DISTRIBUTOR TUBES Protects tubes from rubbing and extreme conditions, our Quantum r. Coil-featuring vibrating to help prevent leakage a proprietary aluminum alloy exclusive to Lennox-is designed to weather the harshest elements. ANTIMICROBIAL DRAIN PAN Inhibits mold and mildew growth and is made from a durable composite material that won't corrode or rust, keeping the air inside your home clean. PEACE-OF-MIND PROTECTION WrrrfPROOlx.-r The CBA25UH air handler comes with a 5-year limited warranty on covered components." 'Covered components may be eligible to receive a 10-year limited warranty.Online equipment registration at www.lennoxregistration.com is required within 60 days of installation(except in California and Quebec)or Lennox base warranty will apply.Applies to residential applications only.See actual warranty certificate for details. Note:Due to Lennox ongoing commitment to quality,specifications and ratings are subject to change without notice. CBA25UH-036 Model CBA25UH-018 CBA25UH-024 CBA25UH-030 CBA25UH-042 CBA25UH-048 CBA25UH-060 Dimensions h,, i,xU x 1;-,, 45-'^x 18-%• HxWxD(in,- J5 x.470 x 559 1156 x 470 x 559 559 1397.546x559 1518 LENNL77 :00 • • For a complete list of the registered and common law trademarks owned'Lennox Industries Inc. 18LNX01intertek Enhanced control for greater comfort Lennox Mein Series 14ii, ,.nieowners who want reliable cooling and heating perfr,,,- ,,,r� ar+,-r f,,; . , `)ility and inoney-saving enercf,,r efficiencv. What makes the 14HPX even better is the enhanced humidity control that comes with the optional addition of our exclusive Humiditrol`i"whole-home dehumidification system.* Plus, like every product Lennox manufactures, the 14HPX is designed for exceptional durability inside and out. Ideal comfort year 'round Efficient, economical cooling and heating The 14HPX is an all-in-one -- Direct-DriveFan-Precision-balanced cooling and heating system, direct-drive outdoor fan is designed for quieter operation and longer perfectly suited to warmer i product life. climates. During summer , t Dependable Scroll Compressor- months, it works like an air Ensures reliable and efficient operation. conditioner, extracting heat our home and High-Efficiency Outdoor Coil- from inside Y S Provides exceptional heat transfer and moving it outdoors.When 1� low air resistance for high-efficiency the weather turns cooler,the operation. process is reversed as the � � — PermaGuard'"Cabinet-Heavy-gauge, unit collects heat from the air galvanized steel construction,louver coil guard,baked-on powder finish and outside and transfers it inside. ! durable zinc-coated steel base provide long-lasting protection against rust and corrosion. 10-year limited warranty on all covered components.** ' 14HPX meets or exceeds 14.00 SEER***(Seasonal Energy Efficiency Ratio)and 7.70 HSPF(Heating Seasonal Performance Factor) ,:Must be accompanied by either a variable speed air handler or furnace and the Comfortsense'7000 Series touchscreen thermostat. Online equipment registration at www.lennoxregistration.com is required within 60 days of installation(except in California and Quebec)or Lennox'base warranty will apply.Applies to residential applications only.See actual warranty certificate for details —Actual system efficiency may vary depending on the exact system match.Efficiencies are representative of a single AHRI Most Popular matched combination. Always verify actual system efficiencies through AHRI or by visiting AHRI ratings database at www.ahridirectory.org. Merit` Series 14HPX Specificntions Model 018 024/030 036 042/048 060 Dimensions HxWxD(in) 29.25 x 28 25 x 28.25 37.25 x 28.25 x 28.25 33.25 x 28.25 x 28.25 37.25 x 32.25 x 32.25 143.25 x 3225 x 32.25 HxWxD(mm) 743x718x718 946x718x718 845x718x718 946x819x819 1099x819x819 Note:Due to Lennox'ongoing commitment to quality,all specifications,ratings and dimensions are subject to change without notice. ® Proper sizing and installation e ..�.....' This NAHB Research -,}� equipment is critical to achieve � �I x NAHB Center Green 10 optimal performance.Split c V us �Ers.11. Approved mark is your ® system air conditioners and heat fiR n assurance that a Lennox is proud of Pumps must be matched with appropriate 0 j�j�d j Intertek APPROVED product is eligible for the fact tht these coil components to meet ENERGY STARa �s',w,�,,, 0A®j j�aernMzr�a points toward National criteria.Ask our Lennox Dealer for details, Green Building Certification.Visit products have Y www.GreenApprovedProducts.com earned the Good or visit www.energystar.gov. for more details. Housekeeping Seal. For a complete list of the LENNOX registered and common law trademarks owned by Lennox Industries Inc., Innovation never felt so good." please visit www.lennox.com. www.lennox.com 1-800-9-LENNOX ©2013 Lennox Industries Inc. PC7689911/13 (69W78) LEHNOX RESIDENTIAL COOLING DATA SHEET 2-To JOB NAME: Barbara Aspis DATE 11/1/2021 ADDRESS: 11 whippoorwill Road OUTDOOR TEMP: 90- INDOOR TEMP: 75- TEMP DIFFERENCE: 15- SENSIBLE LOAD CALCULATIONS GLASS SINGLE DOUBLE TRIPLE NO SHADE DESIGN TEMPERATURE DIFFERENCE COMPASS GLASS AREA 10 15 20 25 30 35 GAIN G 10 15 20 25 30 35 10 15 20 25 30 35 BTUH POINT SQ. FEET HEAT TRANSFER MULTIPLIER N 6 25 29 33 37 41 45 20 22 24 26 28 30 15 16 18 19 20 21 132 NE& NW 55 60 65 70 75 80 50 54 56 58 60 37 38 40 41 42 44 E& W 84 80 85 90 95 100 105 70 72 74 76 78 80 55 56 58 59 60 62 6048 SE& SW 70 74 78 82 86 90 60 54 66 68 70 47 49 51 52 53 54 S 1 16 40 44 48 52 56 60 35 37 39 41 43 45 26 27 29 31 32 33 592 GLASS SINGLE DOUBLE TRIPLE INSIDE SHADE DESIGN TEMPERATURE DIFFERENCE COMPASS GLASS AREA 10 15 20 25 30 35 10 15 20 25 30 35 10 15 2D 25 30 35 BTUH POINT SQ. FEET HEAT GAIN HEAT TRANSFER MULTIPLIER N 15 19 23 27 31 35 15 17 19 21 23 25 10 12 14 16 17 19 NE& NW 35 39 43 47 51 55 30 32 34 36 38 40 22 24 26 28 30 31 E&W 50 54 58 62 66 70 45 47 49 51 53 55 35 36 38 40 42 44 SE& SW 40 44 48 52 56 60 35 37 39 41 43 45 29 30 32 34 36 38 S 25 29 33 37 41 45 20 22 24 26 28 30 16 18 20 22 24 26 DESIGN TEMPERATURE DIFFERENCE DOORS SQUARE 10 15 20 25 30 35 BTUH FEET HEAT GAIN HEAT TRANSFER MULTIPLIER SOLID WOOD 6.3 8.6 10.9 13.2 14.4 15.5 SOLID WOOD '• 42 4.2 5.7 7.3 8.8 9.6 10.4 239 METAL URETHANE 2.6 3.5 4.5 5.4 5.9 6.4 METAL URETHANE " 2.2 3.0 3.8 4.6 5.0 5.4 " Weatherstripped or Storm RUNNING FEET _ CEILING HEIGHT X WALLS GROSS WALL = WINDOWS& DOOR AREAS NET WALL AREA SQUARE DESIGN TEMPERATURE DIFFERENCE BTUH FRAME WALL FEET 10 15 20 25 30 35 HEAT GAIN HEAT TRANSFER MULTIPLIER NO INSULATION 3.7 5.0 6.4 7.8 8.5 9.1 R-11, 3" INSULATION 1.2 1.7 2.1 2.6 2.8 3.0 R-13, 3-1/2" INSULATION 908 1.1 1. 1.9 2.3 2.5 2.7 1362 R-13 + 1" POLYSTYRENE 0.8 .1 1.4 1.7 1.8 2.0 R-19 + 1/2" POLYSTYRENE 0.7 1.0 1.3 1.6 1.7 1.8 MASONRY WALL SQUARE DESIGN TEMPERATURE DIFFERENCE BTUH ABOVE GRADE FEET 10 15 20 25 30 35 HEAT GAIN HEAT TRANSFER MULTIPLIER NO INSULATION 3.2 5.8 8.3 10.9 12.2 13.4 R-5, 1" INSULATION 0.9 1.6 2.3 3.1 3.5 3.8 R-11, 3" INSULATION 0.5 0.9 1.3 1.6 1.8 2.0 R-19, 6" INSULATION 0.3 0.5 0.8 1.0 1.2 1.3 SENSIBLE HEAT GAIN SUBTOTAL 8373 Sensible Heat Gain Subtotal from Page 1 8373 DESIGN TEMPERATURE DIFFERENCE CEILING SQUARE FEET 10 15 20 25 30 35 BTUHGHEAT TRANSFER MULTIPLIER HEAT GAIN No Insulation 14.9 17.0 19.2 21.4 22.5 23-6 R-11, 3" Insulation 2.8 3 2 3.7 4.1 4.3 4.5 R-19, 6" Insulation 768 1.8 2.1 2.3 2.6 2.8 2.9 1613 R 30, 10" Insulation 1.1 1.3 1.5 1.6 1.7 1.8 R-38, 12" Insulation 0.9 1.0 1.1 1.3 1.3 1.4 FLOOR OVER SQUARE DESIGN TEMPERATURE DIFFERENCE BTUH UNCONDITIONED SPACE FEET 10 15 20 25 30 35 HEAT GAIN HEAT TRANSFER MULTIPLIER No Insulation 1.9 3.9 58 7.7 8.7 9.6 CARPET FLOOR-NO INSULATION 1.3 2.5 3.8 5.1 5.7 6.3 R-11, 3" INSULATION 0.4 0.8 1.3 1.7 1.9 2.1 R-19, 6" INSULATION 768 0.3 0.5 0.8 1.1 1.2 1.3 384 R-30, 10" INSULATION 1 0.2 0.4 0.6 0.7 0.8 0.9 FLOOR SQ FT. x CEILING HEIGHT = CUBIC FT INFILTRATION/ VENTILATION 0.40 x CUBIC FT - 60 = CFM MECHANICAL VENTILATION CFM = FRESH AIR INTAKE DESIGN TEMPERATURE DIFFERENCE BTUH CFM 10 15 20 25 30 35 HEAT GAIN HEAT TRANSFER MULTIPLIER INFILTRATION 11.0 16.5 22.0 27.0 32.0 38.0 MECHANICAL VENTILATION 11.0 16.5 22.0 27.0 32.0 38.0 INTERNAL HEAT GAIN BTUH HEAT GAIN Number of People x 300 15W Kitchen A Iowance 1,2W SENSIBLE HEAT GAIN SUBTOTAL 13070 DUCT GAIN BTUH HEAT GAIN R-4, 1" Flexible Blanket Insulation: ADD 15% (.15) R-7,2" Flexible Blanket Insulation:ADD 10% (.101 1307 TOTAL SENSIBLE HEAT GAIN 14377 LATENT LOAD CALCULATIONS Conditions Outdoor Wet Bulb Indoor Wet Bulb Grains Wet 80 62.5 50 Medium 75 62.5 35 Medium Dry 70 62.5 20 Dry 65 62.5 0 Based on 75OF Indoor Dry Bulb at 50% RH- LATENT LOAD-INFILTRATION 0.68 x Grains x Infiltration CFM LATENT LOAD-VENTILATION 0.68 x Grains x Ventilation CFM LATENT LOAD-PEOPLE Number of People x 230 TOTAL LATENT HEAT GAIN 4313 TOTAL SENSIBLE AND LATENT HEAT GAIN 18690 NOTE: All Heat Transfer Multipliers from ACCA Manual "J" Sixth Edition and for a medium outdoor daily temperature range. CL-84t-L7 002345 Litho U.S.A. LENMIX RESIDENTIAL HEATING DATA SHEET 2-Ton JOB NAME: Barbara As is DATE ADDRESS: 11 whirmoorw4il OUTDOOR TEMP: y INDOOR TEMP: 70' TEMP. DIFFERENCE: 70' DESIGN TEMPERATURE DIFFERENCE MOVABLE GLASS WINDOWS SQUARE 30 35 40 45 50 55 60 65 70 80 85 90 L HEAT L 95 BTUH FEET HEAT TRANSFER MULTIPLIER LOSS SINGLE GLASS 39 1 45 1 52 158 65 71 78 84 90 97 103 110 116 123 SINGLE GLASS W/STORM 21 1 25 1 28 31 35 38 42 45 49 1 52 1 56 59 163 166 DOUBLE GLASS 1 28 1 32 1 37 41 46 50 55 60 g 1 69 1 73 78 ffi 87 DOUBLE GLASS W/STORM 106 1 16 1 19 1 21 24 27 29 1 32 35 37 40 142 45 148 1 50 1 3922 DESIGN TEMPERATURE DIFFERENCE SLIDING GLASS DOORS SQUARE 30 35 40 45 50 55 60 65 70 75 80 85 90 95 BTUH FEET HEAT LOSS HEAT TRANSFER MULTIPLIER SINGLE GLASS 42 48 55 62 69 76 83 90 97 104 110 117 124 131 SINGLE GLASS W/STORM 22 1 26 29 33 137 1 40 144 48 1 51 1 55 1 59 1 62 1 66 1 70 DOUBLE GLASS 29 1 34 39 43 1 48 1 53 1 58 63 167 1 72 1 77 1 82 1 87 1 91 DESIGN TEMPERATURE DIFFERENCE DOORS SQUARE 30 35 40 45 50 55 60 65 70 75 80 85 90 95 BTUH FEET HEAT LOSS HEAT TRANSFER MULTIPLIER SOLID WOOD 31 36 41 46 51 56 162 1 67 1 72 I T7 1 82 1 87 1 92 1 97 SOLID WOOD" 42 18 21 24 1 27 30 33 36 39 42 45 47 50 53 56 1764 METAL URETHANE 23 27 30 1 34 38 42 45 49 57 60 64 68 72 METAL URETHANE" 13 16 18 20 2 225 27 29 1 31 33 136 38 1 40 42 **Weatherstripped or Storm RUNNING FEET CEILING HEIGHT X WALLS GROSS WALL WINDOWS & DOOR AREAS NET WALL AREA DESIGN TEMPERATURE DIFFERENCE FRAME WALL SQUARE 30 35 40 46 50 55 60 65 70 75 80 85 90 95 BTUH FEET HEAT LOSS HEAT TRANSFER MULTIPLIER NO INSULATION 8 10 11 12 14 1 15 1 17 18 19 1 21 1 22 23 25 26 R-11, 3" INSULATION 2.7 3.1 3.6 4.0 4.5 4.9 5.4 5.8 6.3 6.7r4.8 7.6 8.1 8.5 R-13, 3-1/2" INSULATION 908 2.1 2.4 2.8 3.2 3.5 3.8 4.2 4.6 4-9 5.3 5.9 63 6.64449 R-13 + 1" POLYSTYRENE 1.8 2.1 2.4 2-7 3.0 3.3 3.6 3.9 4.5 5.1 5.4 5.7R-19 + 1/2" POLYSTYRENE 1.6 1.9 2.2 2.5 2.8 30 3.3 3.6 3.8 4.1 4.7 4.9 5.2 DESIGN TEMPERATURE DIFFERENCE MASONRY WALL SQUARE BTUH ABOVE GRADE FEET 30 1 35 1 40 1 45 1 50 155 160 1 67 70 1 75 1 80 1 85 190 1 HEAT LOSS HEAT TRANSFER MULTIPLIER NO INSULATION 16 18 I 21 23 26 28 31 33 36 38 41 44 46 49 R-5, 1" INSULATION 4.3 15.0 15.8 16.5 7.2 7.9 8.6 9.4 110.1 10.8 11.5 12.2 13.0 13.7 R-11, 3" INSULATION 2.3 12.7 13.1 13.5 3.8 4.2 14.6 5.0 15.4 5.8 16.2 6.5 6.9 7-3 R-19, 6" INSULATION 11.4 1-7 11.9 122 2.4 2.6 2-9 3.1 3.4 3.6 3.8 4.1143 4.6 DESIGN TEMPERATURE DIFFERENCE MASONRY WALL SQUARE BTUH BELOW GRADE FEET 30 1 35 1 40 1 45 1 50 1 55 1 60 1 65 1 70 1 75 80 1 85 190 1 95 HEAT LOSS HEAT TRANSFER MULTIPLIER NO INSULATION 4.4 5.1 15.9 16.6 7.3 8.1 8.8 9.6 10.3 11-011.812.513-2 14.0 R-5, 1" INSULATION 2.6 3.0 3.5 3.9 4.3 4.8 5.2 5.7 6.1 6.5 7.0 7.4 7.8 8.3 R-11, 3" INSULATION 1.8 2.1 2.4 2.7 3.0 3.3 3.6 3.9 4.2 14.5 14.8 5.1 15.4 15.7 R-19, 6" INSULATION 1.2 1.4 1.6 1.8 2.0 2.2 2.4 2.6 2.8 3.0 3.2 3A 3.6 E 88 HEAT LOSS SUBTOTAL 10135 Heat Loss Subtotal from Page 1 10135 DESIGN TEMPERATURE DIFFERENCE CEILING SQUARE FEET 30 35 40 45 50 55 60 65 70 75 80 85 90 95 BTUHLHEAT TRANSFER MULTIPLIER HEAT LOSS NO INSULATION 18 21 1 24 127 30 33 36 39 42 1 45 1 48 51 54 1 57 R-11, 3" INSULATION 2.6 3.1 3.5 4.0 4.4 4.8 5.3 5.7 52 6.6 7.0 7.5 7.9 8.4 R-19, 6" INSULATION 768 1.6 1.912.1 12.4 2.6 2.9 3.2 3.4 3.7 4.0 4.2 4.5 4.8 5.0 2842 R-30, 10" INSULATION 1.0 T-2 1.3 1.5 1.6 7.8 2.0 2.1 2.5 12.6 2.8 3.0 3.1 R-38, 12" INSULATION 0.8 0.9 11.0 11.2 1.3 1.4 1.6 1.7 1.8 2.0 12.1 2.2 2.3 2.5 DESIGN TEMPERATURE DIFFERENCE FLOOR OVER AN SQUARE BTUH UNCONDITIONED SPACE FEET 30 35 40 45 150 56 160 1 66 170 175 180 85 90 95 HEAT LOSS HEAT TRANSFER MULTIPLIER NO INSULATION 10 11 13 14 1 16 17 1 19 1 21 1 22 124 1 25 27 28 30 R-11, 3" INSULATION 768 2.4 2.8 3.2 3.6 4.0 4.4 14.8 15.21L5.2 6.0 1 6.4 16.8 17.2 7.6 4301 R-19, 6"INSULATION 1.6 11.8 12.1 12.3 12.6 2.9 13.113.4 3.9 14.2 14.4 14.7 4.9 R-30, 10"INSULATION 11.1 11.3 11.5 11.7 11.8 12.0 12.2 12.4 12.6 12.8 13.0 13.1 13.3 13.5 DESIGN TEMPERATURE DIFFERENCE BASEMENT FLOOR SQUARE 30 35 40 45 50 55 60 65 70 75 80 85 90 95 BTUH FEET HEAT TRANSFER MULTIPLIER HEAT LOSS BASEMENT FLOOR 0.8 1.0 1.1 1.3 1 1.4 11.5 11.7 11.8 12.0 12.1 12.2 12.4 2.5 2.7 DESIGN TEMPERATURE DIFFERENCE CONCRETE SLAB WITHOUT LINEAR BTUH PERIMETER SYSTEM FOOT30 35 40 45 50 56 60 65 70 75 80 ! 95 HEAT LOSS HEAT TRANSFER MULTIPLIER NO EDGE INSULATION 25 29 33 37 41 145 49 53 1 OU 1 61 1 65 69 73 77 1" EDGE INSULATION 13 15 17 19 21 1 23 25 27 Q9A 31 133 35 37 39 2" INSULATION 6.3 17A 18.4 19.4 10.5 11.5 12.6 13.6 14.7 15.8 16.8 17.8 18.9 20.0 CONCRETE SLAB LINEAR DESIGN TEMPERATURE DIFFERENCE BTUH WITH PERIMETER SYSTEM FOOT 30 1 35 140 145 150 155 160 165 1 70 175 1 80 1 85 190 1 95 HEAT LOSS HEAT TRANSFER MULTIPLIER NO EDGE INSULATION 57 67 76 86 195 1105 1114 11241133 1143 1152 162 1 171 181 1" EDGE INSULATION 34 40 46 52 57 1 63 1 69 1 74 80 86 91 97 1 03 109 2" EDGE INSULATION 28 133 137 142 47 1 51 1 56 1 61 65 70 75 1 79 1 84 1 89 An additional infiltration load is calculated only if the home is loosely constructed or when window infiltration is greater than.5 CFM per linear foot of crack. FLOOR SQ FT. x CEILING HEIGHT = CUBIC FT INFILTRATION/ VENTILATION 0.40 x CUBIC FT - 60 = _ CFM MECHANICAL VENTILATION CFM = FRESH AIR INTAKE DESIGN TEMPERATURE DIFFERENCE BTUH CFM 30 35 40 45 150 55 160 165 170 175 180 1 85 1 90 196 HEAT LOSS HEAT TRANSFER MULTIPLIER INFILTRATION 1 45 33 39 44 50 1 55 61 166 1 72 1 77 1 83 1 88 1 94 1 99 1105 3465 MECHANICAL VENTILATION 50 33 39 44 50 1 55 61 166 1 72 1 77 1 83 1 88 1 94 1 99 1105 3850 HEAT LOSS SUBTOTAL 24593 DUCT LOSS BTUH HEAT LOSS R-4, 1" Flexible Blanket Insulation: ADD 15% (.15) R-7, 2" Flexible Blanket Insulation: ADD 10% (.10) 2459 TOTAL HEAT LOSS 27052 NOTE: All Heat Transfer Multipliers from ACCA Manual "J" Sixth Edition. HL-841-0 (14G4A) Litho U.S.A. 1►� Mike Izzo From: Mike Izzo Sent: Tuesday, August 23, 2022 1:56 PM To: albara@aol.com Cc: alan.aspis@cnb.com; Steven Fews;Tara Orlando; Laura Petersen Subject: RE: Permit Extension 11 Whippoorwill Rd. Dear Ms. Aspis, Thank you for the email. I am pleased to inform you that a six (6) month extension to your open permit #BP21-225 has been approved, and that the new permit expiration date is, February 27, 2023. 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. Please note that in accordance with Village Code§250-10.A., it is a violation to use or occupy or to allow the use or occupancy of any building, premises, or part thereof without a Certificate of Occupancy duly issued by the Building Inspector. Thank you. AlWae,1(7 Izz0 Building& Fire Inspector Village of Rye Brook, NY (914) 939-0668 From: albara@aol.com<albara@aol.com> Sent: Monday, August 22, 2022 1:40 PM To: Mike Izzo<Mlzzo@ryebrook.org> Cc:alan.aspis@cnb.com Subject: Permit Extension 11 Whippoorwill Rd. Building Permit#BP 21-225 Expires 8/27/2022 As per instructions from your department, I am writing to let you know that I will need to extend this permit until the end of this year(2022) as the project is not yet completed. I will let you know when everything is done and we can call for an final inspection. Please let me know if there is anything else I need to do.Thank you. Barbara Aspis 914-772-8546 1 Mike Izzo From: Mike Izzo Sent: Tuesday,August 23, 2022 1:56 PM To: albara@aol.com Cc: alan.aspis@cnb.com; Steven Fews;Tara Orlando; Laura Petersen Subject: RE: Permit Extension 11 Whippoorwill Rd. Dear Ms. Aspis, Thank you for the email. I am pleased to inform you that a six (6) month extension to your open permit #BP21-225 has been approved, and that the new permit expiration date is, February 27, 2023. 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. Please note that in accordance with Village Code§250-10.A., it is a violation to use or occupy or to allow the use or occupancy of any building, premises, or part thereof without a Certificate of Occupancy duly issued by the Building Inspector. Thank you. A4011(7, /zzo Building& Fire Inspector Village of Rye Brook, NY (914) 939-0668 From: albara@aol.com <albara@aol.com> Sent: Monday,August 22,2022 1:40 PM To: Mike Izzo<Mlzzo@ryebrook.org> Cc:alan.aspis@cnb.com Subject: Permit Extension 11 Whippoorwill Rd. Building Permit#BP 21-225 Expires 8/27/2022 As per instructions from your department, I am writing to let you know that I will need to extend this permit until the end of this year(2022)as the project is not yet completed. 1 will let you know when everything is done and we can call for an final inspection. Please let me know if there is anything else I need to do.Thank you. Barbara Aspis 914-772-8546 1 Building Permit Check List&Zoning Analysis Address:�� u-l��00 Q—\,J 1 L SBL• — Zone —l 5— Use: 2 i O Cont.Type: r.Othe Submittal Date: 7 l 1 Z ( Revision Submittal Dates: Applicant a I S Nature of Work. A:r_�1�2 0 N Reviews:ZBA: J U L - 7 2021 PB• BOT Other. 1 ( ( ) ES:Filing: BP: �`{��• � C/O: Legalization: ( ) (�P: Dated Notarized: SBL ✓Truss I.D. Cross Connection: H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening. ( ) ( ) ENVIRO: Long. Short: Fees: N/A: ( ) ( )(SITE PLAN:Topo: Site Pr tection: S/W Mgmt.: Tree Plan: Other. ( ) ( SURVEY:Dated Z3 ( Current: Archival: ✓ Sealed: Unacceptable: ( ) (-�'PLANS:Date Stamped Sealed: ✓ Copies:,_?� Electronic ✓ Other- License: _;�Workers Comp: Liability �/ Comp.Waiver. Other. Dated: N/A: (•� ( ) HIGH-VOLTAGE ELECTRICAL:Plan: Permit: N/A Other. ( ) ( ) LOW-VOLTAGE ELECTRICAL:Plan: Permit N/A Other. (� ( ) FIRE ALARM/SMOKE DETECTORS:Plan: Permit H.W:I.C.:_Battery:_Other. PLUMBING:Plan: Permit: Nat.Gas: LP Gas: N/A/: Other. ( ) ( ) FIRE SUPPRESSION:Plan: Permit; N/A: Other. ( ) ( ) H.V.A.C.: Plan: Permit: N/A Other. ( ) ( ) FUEL TANK Plan: Permit: Fuel Type: Other. ( ) ( ) 2020 NY State ECCC: N/A: Other. ( ) ( ) Final Survey Final Topo: RA/PE Sign-off Letter. As-Built Plan: Other. ( ) ( ) BP DENIAL LETTER: C/O DENIAL LETTER: Other. ( ) ( ) Other. GARB mtg.date: `( Z( Z l approval• notes: ( )ZBA mtg.date: approval• notes: ( )PB mtg.date: approval• notes: APPROVLU REQUIRED EXISTING PROPOSED NOTES AUG 1 9 2021 Art 1 _�;_ k— Date: Cir FroaM Front: Front: sue: MMc_ow ,-7 .4 Accs.Cov Ft.H S S .H Sb: r 3 T t.1W IOD(. L40o_!�, — Q F�Im : P HH6 ht/Stories: notes: BUILDING DEPARTMENT R VILLAGE OF RYE.BROOK JUL - 7 2021 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 �(914 939-5801 VILLAGE OF RYE BROOK BUILDING DEPARTMENT ARCHITECTURAL REVIEW BOARD CHECK LIST FOR APPLICANTS This form must be completed and signed by the applicant of record and a copy shall be submitted to the Building Department prior to attending the ARB meeting. Applicants failing to submit a copy of this check list will be removed from the ARB agenda. Job Address: 11 Whippoorwill Rd Date of Submission: Parcel ID#: 129.60-1-8 Zone: R-15 Proposed Improvement(Describe in detail): APPLICANT CHECK LIST: MUST BE COMPLETED BY THE APPLICANT Construct new dormer roof to accommodate new The following items must be submitted to the Building bedroom and bathroom with new walk-in closet. Department by the applicant-no exceptions. Add skylights to existing roof. 1. ()Q Completed Application 2. Two(2)sets of sealed plans. Lone full size{maximum Property Owner: Barbara and Alan Aspis alloy\ahle plan si/e ',6"x 42"} and one I Fx I T') 3. ( Two(2)copies of the property survey. Address: 11 Whippoorwill Rd, Rye Brook, NY 4. Two(2)copies of the proposed site plan. Phone# 914-772-8546 5. (X)One electronic/disc copy of the complete Applicant appearing before the Board: application materials.6. (X) Filing Fee. Evan Sakofskv 7. Any supporting documentation. 8. Address: 11 Berkley Ln, Rye Brook, NY 9. ()KI Photographs. Phone# 516-314-1385 10.()0 Samples of finishes/color chart. (a sample board or Architect/Engineer: Evan Sakofsky Architect model may be presented the night of the meeting) Phone# 516-314-1385 By signature below, the owner/applicant acknowledges that he/she has read the complete Building Permit Instructions&Procedures,and that their application is complete in all respects. The Board of Review reserves the right to refuse to hear any application not meeting the requirements contained herein. Sworn to before me this Z9 t4 Sworn to before me this —Att day of , 20 2( day of � St_ , 20 9—I S_watuVlroperty Owner Signature ofAppll ram' )KS is f�JAO ��c Print Name of Property Owner 1 Print Name of Applicant Pub c Notary Publ SANDRO LUKIC III Notary Public-State of New York N0.01 LU6311072 DIANNE ROJAS Qualified in Westchester County Notary public-State Of Now york My Commission Expires Sep 8,2022 No.01RO61 27547 Quslikd In eater VNestchester County 3/21/19 My Commisalon Expires May 23,my VILLAGE OF RYE BROOK BUILDING DEPARTMENT 938 KING STREET, RYE BROOK,NY 10573 (T) 939-0668 (F) 939-5801 ARCHITECTURAL REVIEW BOARD Tuesday, August 17, 2021 NAME&LOCATION TYPE OF APLLICATION MOTION SECOND APPROVED REJECTED 22 Highview Ave One Story Side Addition 5244 (Saunders/Del- w/Finished Basement Rosario) 90 S. Ridge St(RSP) New Illuminated Sign 5245 Group "Walk In Care Center" 6 Jacqueline Lane New Rear Deck, Patio, 5246 (Gasparino) Windows, Siding & Front Door 108 S. Ridge St New Sign & Awning For 5247 (Win-Ridge) (City M.D.) 9 Charles Lane Legalize 2nd Fl Bedroom, 5248 (Straus) & Install 2 New Casement Egress Windows 2 Jennifer Lane 2nd Floor Addition, New 5245 (Bien LCC) Rear Patio & Renovations 33 Talcott Road Rebuild Rear Deck 5249 (Selzer) 11 Whippoorwill Rd 2nd Floor Dormer 5250 (Aspis) Addition AC 68 Windsor Road Replace Rear Exterior 5251 (Perry) Stairway 134 S. Ridge St(Win New Sign "Buff City 5252 Ridge) Soap" ML NM MR SE JM SF AC ,/ MI KC --- EVAN • :-•• 10573 • 314 1385 EVAN.SAKOFSKY@GMAIL.COM lima Existing Front . Existing Rear Ib Aspis RESIDENCE 11 WHIPPOORWILL ••- ROAD RYE BROOK r < c�r� ��,�P�y�!i•� 9 _ ''i, \ S�lr��5 � ,�� _VW11 � 1 � c 1W VF ;�.�ty�WO f 4 �.y ® ri t;� ti� i� JIJ �w� it y��✓ '�Y`� y q � � •'.• ��} •�'i � 90@fit.' �\�,� � I'�( .r�l` `��rr %�'� t 14 a. GJ +a� f, • r Laura Petersen From: Laura Petersen Sent: Friday, August 20, 2021 11:28 AM To: albara@aol.com Subject: Building Permit Application - 11 Whippoorwill Road Good morning, The building permit application has been approved by the Building Inspector. Before I can issue the building permit the following items must be submitted to our office, 9r� �a-S y93 1. General contractor's contact name & phone number. A--0_171e6C1,Gt1-1-i.70 ,,/2. Copy of general contractor's valid Westchester County Home Improvement License. X3. General contractor's valid liability insurance (the Village Of Rye Brook must be the certificate holder) ® General contractor' valid workers compensation on a NY State Board form (C105-2 or U26.3) Of i93na1 5. Building permit fee $1,470.00 (due once permit is issued and ready for pick-up) .6 This information can be emailed to me. Thank you and have a good day Laura Laura(Petersen Office Assistant Village of Rye Brook 938 King Street Rye Brook, New York 10573 Phone(914)939-0668 1 Fax(914)939-5801 1 Ioetersen(cDrvebrook.oro 1 Laura Petersen From: albara@aol.com Sent: Monday, August 23, 2021 3:37 PM To: Laura Petersen Subject: Aspis Construction Project Attachments: Workers Compensation.heic; General Contractors License.jpg; liability insurance.pdf Attached please find the information you requested regarding the upcoming construction project for: Aspis 11 Whippoorwill Rd. The contractor is: Frank Sciarrino FJS Service Corp. 4 Great Oaks Lane North Salem, NY 10560 914-262-5493 1 hp 0 elm. v r .g !'may �- *• p �etlon 1 El fiEr- 40 t"`„W QO coo rid AE M r 4 106. w �r_* _ J r_ 3. r � .�tis.aatZ";xYZ771Y,�'aiiL�ty�.Yy�YYtrti'rYr►iX�_�Yi1{'� �, r��v�.� +r�e� r 4ti ,.• ,*r•� r� ti Y..N... �„t��,r �rr7'�" : � J L FJSSERV-01 DTRINCERI A�ORD CERTIFICATE OF LIABILITY INSURANCE DATEIM 8/20/20212021 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(les)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 C TACT The Robert C.Man I Agency Inc. PHONE FAX 950 Franklin Ave.SATE 100 R.,Ext:(516)294-1072 AIC,No:(516)294-1764 Garden City,NY 11530 iftss.service contractor3insurance.0 INSURE 8 AFFORDING COVERAGE NAIL 0 INSURER A:UTICA FIRST INSURANCE COMPANY 15326 INSURED INSURER B' FJS SERVICE CORP INSURERC: 4 GREAT OAKS LANE INSURERD: NORTH SALEM,NY 10560 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP Lw1TS A X COMMERCIAL GENERAL LIABILITY 1,000,000 EACH OCCURRENCE CLAIMS-MADE C OCCUR XART509114404 9/2512020 9/26/2021 DA M A G E SrEg NTED 50,000 REMIS MED EXP oneperson) 5,000 PERSONAL 8 ADV INJURY 1,000,000 GEN'L AGGREGATE pECLRIMpIT.APPLIES PER: GENERAL AGGREGATE 2,000,000 X POLICY JT 7 LOC PRODUCTS-COMP/OP AGG S 2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT OEM awkilard) ANY AUTO BODILY INJURY r non OWNED SCHEDULED -- AUTOS ONLY AUTOS BODILY INJURY Per accident AUTOS ONLY AUTOSyy ItS ? M AMAGE UMBRELLA LW OCCUR EACH OCCURRENCE EXCESS LIAR CLAIMS-MADE AGGREGATE DED I RETENTION$ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER(EXECUTIVE OFFICER/MEMBER EXCLUDED? NIA E.L.EACH ACCIDENT (Mandatory In NH) If yes,describe under E.L.DISEASE-EA EMPLOYEE DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMB DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached If more apace Is required) VILLAGE OF RYE BROOK INCLUDED AS ADDITIONAL INSURED CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE VILLAGE OF RYE BROOK THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 938 KING ST RYE BROOK,NY AUTHORIZED REPRESENTATIVE 0/.V ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Workers' Certificate of Attestation of Exemption STATE Compensation from New York State Workers' Compensation and/or Board Disability and Paid Family Leave Benefits Insurance Coverage **TJdds form cannot be used to waive the workers'compensation rights or obligations of any party.** The applicant may use this Certificltte of Attestation of Exemption ONLY to show a government entity that New York State specific workers'compensation and/or disability and paid family leave benefits insurance is not required. The applicant may NOT use this form to show another business or that business's insurance carrier that such insurance is not required Please provide this form to the government entity from which you are requesting a permit,license or contract. This Certificate will not be accepted by government officials one year after the date printed on the form. In the Application of Business Applying For. (Legal Entity Name and Address): Building Permit FJS Service Corp From:Village of Rye Brook NY 4 Great Oaks Ln North Salem,NY 10560-2900 PHONE:914-262-5493 FEIN:X)OM4303 The location of where work will be performed is i I Whipporwill Rd,Rye Brook,NY 10573. Estimated dates necessary to complete work associated with the building permit are from September 30,2021 to December 15,2021. The estimated dollar amount of project is SM,001-$100,000 Workers'Compensation ExegR§2n Statement: The above named business is certifying that it is NOT REQUIRED TO OBTAIN NEW YORK STATE SPECIFIC WORKERS'COMPENSATION INSURANCE COVERAGE for the followin*reason: The business is a one person owned corporation,with that individual owning all of the stock and holding all offices of the corporation. Other than the corporate owner,there are no employees,day labor,leased employees,borrowed employees,part-time employees,other stockholders,unpaid volunteers(including family members)or subcontractors. Disability and Paid Family Leave Benefits Exemption Statement: The applicant is NOT applying for a disability and paid family leave benefits exemption and will show a separate certificate of NY statutory disability and paid family leave benefits insurance coverage. 1,Frank J.Sciarrino,am the President with the above-named legal entity. I affirm that due to my position with the above-named business I have the knowledge,information and authority to make this Certificate of Attestation of Exemption. I hereby affptn that the statements made herein are true,that I have not made any snaterially false statements and I make this Certificate of Attestation of Exemption under the pRlalties of perjury. I further affirm that I understand that any false statement,representation or concealment will subject me to felony criminal prosecution,including jail and pivil liability in accordance wi0i the Workers'Compensation Law and all other New York State laws. By submitting this Certificate of Attestation of Exemption to the government entity listed above 1 also hereby affirm that if circumftnces change so that workers'compensation insurance and/or disability and paid family leave benefits coverage is required,the above-named legal entity will immediately acquire appropriate New York State specific workers' compensation insurance and/or disability and paid family leWe benefits cov"e and also immediately furnish proof of that coverage on forms approved by the Chair of the Workers'Compensati to the government entity listed above. SIGN Signature: ^��. Date: HERE Exemption Certificate Number ; < Received 2021-053303 August 23, 2021 NYS Workers'Compensation Board .. .. .. ... .....�yWAFR.YMyiG. ea,NacaRt.F1Wx.+{/{.. :n nwwQrs�wltlx+:ar:AasF�lY�ti:+6.1/-NY�w'�A�OR CE-200 01/2018 -1 XF i - •=� - _ ---"~� it '�� --�- �---'�-cw dp jG..... :Y•- 7 •.x r:�� :f m - C) I CO V. ® t� gr CO � m � � ^ cc Y < � wo Per- 0 0 63 �.� n n `` a ze ;y- � 1 X O � q�.'• i v O o � �, A i �3 � � §R: ► vt�. ?fir�et®i9 AC"R" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 116. � 10/29/2021 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: Michelle DlLeorlard Arthur J. Gallagher Risk Management Services, Inc. PHONE FAX One Enterprise Drive, Suite 310 N E, •2034476578 A/c No:2039250070 Shelton CT 06484 ADDRESS: Michelle Di Leona rdo@ajg.com INSURERS AFFORDING COVERAGE NAIC$ INSURER A.Selective Insurance Company of America 12572 INSURED TOTACOM-11 INSURER B: Total Comfort, Inc. 44 Kenosia Avenue INSURERC: Danbury, CT 06810 INSURERD: INSURER E: INSURERF: — - -� - - -- �- COVERAGES CERTIFICATE NUMBER:271067777 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR I TYPE OF INSURANCE N DL SU D POLICY NUMBER MOL pY EFF MM/DD EXP LIMITS LTR A X COMMERCIAL GENERAL LIABILITY S 2377527 10/31/2021 10/31/2022 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES Ee occurrence) $500,000 MED EXP(Any one person) $15,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 POLICY—�] PRO- ❑ JEC7 LOC PRODUCTS-COMP/OP AGG $3.000,000 OTHER $ A AUTOMOBILE LIABILITY S 2377527 10/31/2021 10/31/2022 COMBINED SINGLE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED L NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident A UMBRELLALIAB X OCCUR S 2377527 10/31/2021 10/31/2022 EACH OCCURRENCE $5,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y f N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ OFFICE R/MEM BER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Operations of Insured, 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 Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 938 King Street Rye Brook NY 10573 AUTHORIZED REPRESENTATIVE USA / ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD STATE OF NEW YORK WORKERS'COMPENSATION BOARD CERTIFICATE OF NYS WORKERS' COMPENSATION INSURANCE COVERAGE la.Legal Name&Address of Insured(Use street address only) lb.Business Telephone Number of Insured Total Comfort,Inc. 203-791-2141 44 Kenosia Avenue. lc.NYS Unemployment Insurance Employer Danbury,CT 06810 Registration Number of Insured Work Location of Insured (Only required if coverage is specifically limited to certain locations in New York State, i.e., a ld.Federal Employer Identification Number of Insured Wrap-Up Policy) or Social Security Number 061162930 2.Name and Address of the Entity Requesting Proof of 3a. Name of Insurance Carrier Coverage(Entity Being Listed as the Certificate Holder) Hartford Life Insurance Company 3b.Policy Number of entity listed in box 111 a" Village of Rye Brook LNY785823-001 938 King Street Rye Brook,NY 10573 3c. Policy effective period 02/19/2021_to 02/19/2022 3d. The Proprietor,Partners or Executive Officers are included. (Only check box if all partners/officers included) al excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box "Y' 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"T'. The Insurance Carrier will also notify the above certificate holder within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.) Otherwise, this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent, or until the policy expiration date listed in box "3c'; whichever is earlier. Please Note: Upon the cancellation of the workers' compensation policy indicated on this form, if the business continues to be named on a permit,license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers' Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Sean Carroll (Print name of authorized representative or licensed agent of insurance carrier) Approved by: $eau came& 11/11/2021 (Signature) (Date) Title: Area Vice President