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HomeMy WebLinkAboutMP21-199 BR 7• 19 VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Paul S. Rosenberg (914) 939-0668 Christopher J.Bradbury www.ryebrook.org TRUSTEES BUILDING& FIRE Susan R. Epstein INSPECTOR Stephanie J.Fischer Michael J. Izzo David M. Heiser Jason A. Klein CERTIFICATE OF COMPLIANCE January 20, 2022 Andrew Zeitlin&Susan Loeb-Zeidin 201 Country Ridge Drive Rye Brook,New York 10573 Re: 201 Country Ridge Drive,Rye Brook,New York 10573 Parcel ID#: 129.82-1-20 This document certifies that the work done under Mechanical Permit#21-199 issued on 12/21/2021 for the installation of a new gas fired hot water heater has been satisfactorily completed. Sincerely, Michael J. Izzo Building&Fire Inspector /tg �yE BRC��. 04 ti� w � 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.orr - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : c�— l A DATE: PERMIT# 1 �' t ISSUED: ~1 L SECT: BLOCK: LOT: —7 LOCATION: ` { l ` OCCUPANCY: � ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION 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 F• u9 � � � o `� v � � � E.y 3 p� � .� •� a loy y � rA 3-y � Z O M N o � oa � •° G=7 : r-� °p a� w V E. 05 00 W w k- v;� CL co o° V1 x w E3C a - UOS a ff � � �� u � � z a O C/] M a � p .Gn S a a� tiw � mod' � � � Q � ��,, � _ � � '� � V • F MM pC) v �j Qy rj en c C z Uo � � � � x � N O w c o vacqj b � a O Oam' EE >0 C7 w rA BUILDM4 _0 MENT �' VIL !RYEROOK I-� 938 KING k,NY 10573DEC 2 0 2021 VILLAGE OF RYE BROOK BIJlLDING DEPARTMENT APPLICATION FOR PERMIT TO INSTALL AND/OR REMOVE HEATING, VENTILATION AND/OR AIR CONDITIONING EQUIPMENT FOR OFFICE USE ONLY: PERMIT #: ! 9 Approval Date: DEC 2 2021 Permit Fee: $ l 00—}''D Approval Signature: Other: Disapproved: (fees are non-refundable) ***A&*rlr�r***,+r*�*�e**tr*ir*********tr*,t****F*Y*t k tr,rtr,r*F*F**********,r,r**#aF,rk*******,t*ir,r,►**********#*�**,r****** 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#C 105.2 or Form#U26.3/or NY State Workers Compensation Waiver) 4. Payment ofFees/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. Application dated,/J C�o,a/ 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. O 1. Address: t90/ C ltu�. rrC- /*t'�{.� �J/�/v� SBL:,/Q/-8Q-/—e1O Zone: � �s 2. Property Owner: S(l�e Z 7_111t- Address: Phone#: 4/7 - -;?t!3 - ©6 q0 Cell#: email: 1 Contractor: S41, Ald 11"A U Address: 1 1. _i T,/1-�J Phone#: g!ki-,;e 0 -!P9 2 Cell#: email: 4. Applicant: L MaILI,"o - _ Address: / / 'rt�o• lr ,/L� Phone#:—!2 ! ! _4 2_ Cell#; email: 5. Scope of Work:New Installation( )-Replacement(K-Removal( )-Other( ): ` 6. List uipment: ram! A -eT /4-e Phut 5 0 64 tt 0A1 rt QA/(,,I Al t_1 04/4 t- 7. Location of Equipment: 8. Method of Installation/Removal(list all equipment needed to perform job): AW&Z ZI yr_ /i -e.0 1 8/12/2021 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: 4✓ft A o/1.tt t w ,being duly sworn,deposes and states that he/she is the applicant above named, (prfnt 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 CG/11 PAellj l� 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 /y Sworn to before me this / c/ day of —fZ C. ,20_1�:11_ day of 120 2- 1 A0 tgnature of PIWperty Owner Sign re of Applicant at-) Z e , 41 1 n :at Print ame of Property Owner Print Name of Applicant Notary Public a Notary Public No 5'Ify o 4 t1V wut►titc�g►�` 0 AWOL This application must be properly completed in its entirety and ae t tee 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. a 9/1212021 PERFORMANCE PLUS keem ..._ The PERFORMANCE PLUSO atmospheric gas water heaters are engineered for more hot water at a low operating cost Efficiency Longer Life ■.58- .65 UEF ■Premium grade anode rod provides Performance long-lasting tank protection ■FHR: 68-81 gallons High Altitude Compliant ■Recovery p U to 40.4 GPH at a ■All models certified up to 8,500 ft. 90°F rise,depending on model above sea level, some modelscertified up to 10,200 ft.See Diagnostic Valve specifications chart** "I!Self powered diagnostic Plus... gas control valve for improved monitoring ■Easy to light-no matches required and service ■Temperature and pressure relief valve Low Emissions included i Eco-friendly burner, low NOx design ■Low lead compliant •Meets 40 ng/J NOx requirements warranty Self-Cleaning RN 9-Year limited warranty for tank rr and parts, 2-year full in-home labor ■Fights sediment and warranty` mineral build-up 'See written warranty for complete details ■Reduces fuel costs Units meet or exceed ANSI requirements and have 0 been tested according to D.O.E.procedures.Units Maintenance Free meet or exceed the energy efficiency requirements Burner System of NAECA,ASHRAE standard 90,GCC Code and all state energy efficiency performance criteria. ■Exclusive air/fuel shut-off device PERFORMANCE PLUS Maintenance free-no filter to clean Atmospheric Disables the heater in the presence of 40 and 50-Gallon Capacities flammable vapor accumulation Up to 40,000 Btu/h ® LP Com6usUon Shut-otl S"bm Flom.Amstw Pleb L --ij (D � n_- WlMMAn Fiw See specifications chart on back. 12 20 --OPlu.o I HO v­L Pie,__ 41 The new 6e8rm of comfort' PERFORMANCE PLUS" • • • ' a+ Nt,b wdmr Waller 1At4ArtR NlelYr g� On IngA Raw" F1nt Hoer IR InTint GoY41rr1 Conn. Nl.to 84d• Can. 8Hp Brig! Bli Ylr YeM ti TWOL In a.P.IL Re" V6 IriBe[ Ol•nL Carlo. Blar Carts T8P VNrt Bb• BIt u raw i itY1yM• ONtellMle QWo too* 8!•elltr bWh 110'FRIo (Bader* A 8 C 0 E F a N o M TO 50 48 XOW09HE4000 40 40.4 T7 62-3/4 59-1/4 21-12 14 3or4 8 52-12 3/4 166 0.64 To 40 38 XG4(YT09HE4000" 40 40.4 81 63-Yt 60.1/4 19.12 14 3or4 8 53-12 314 135 0.65 S09H Short 40 39 XG40E3800" 38 38.4 953.1/4 50-1/4 21.12 14 3 8 44 3/4 125 0.50 Tall 50 48 RUTME381A 38 38.4 77 82-W4 58.114 21.12 14 3 or 4 8 52-12 3/4 165 0.64 Tall 40 38 XP40T09HE3600" 36 36.4 81 63a/4 80-1/4 %-12 14 30r4 8 53.1/2 3/4 IN 0.85 Short 40 39 XP40S09HEWW" 38 NA 68 53-Y4 50-1/4 21-12 1 /4 1 3 1 8 44 3/4 125 0.58 Uniform Energy Factor and rated gallon capacity based on Department of Energy(DOE)requirements. "Models cer88ed up to 12.500 ft.above sea level. FLUE O ANODE ROD H HOT � � COLA WATER r ' WATER CONNECTION ; CONNECTION r r r F r r 4►IE , 3/4' N.P.T. RELIEF VALVE OPENING C 1/2" G D In keeping with its pWicy of continuous progress and product imlomm"nant f;xwn reserves the right to make changes without notice. Rheem Water Heating • 1115 Northmeadow Parkway,Sulte 100 Roswell,Georgia 30076 • www.rheem.com 12120 FORM NO.THD-P.HE Rw.5 ACC o5,a�2o CERTIFICATE OF LIABILITY INSURANCE DATE118120/Y1 21 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: NORTHEAST AGENCIES,INC. PHONE 833-250-9900 FAX ALC No.Ext) 820+IBM DR,BUILDING 102 E-MAI RLL ESS: CHARLOTTE. NC 28262 INSURER(G)AFFORDING COVERAGE _ NAIC Y INSURER A; LIBERTY MUTUAL INSURANCE COMPANY 23043 INSURED INSURERS: SM BUILDERS INC.DBA WESTCHESTER INSURERC: PLUMBING&HEATING INSURERD: r 1 BONWIT RD INSURERE: -- PORT CHESTER, NY 10573 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. IN A DL U POLICY EFF POLICY EXP t LTR TYPE OF INSURANCE POLICY NUMBER p MMI LIMITS GENERAL LIABILITY EACH OCC RRENCE S 1,000.000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea oixurrence)— S 300,000 CLAIMS-MADE Fx_1 OCCUR MED EXP one parson) $ 15,000 A Y N BKS(22)61273032 06/22/2021 05/2212022 PERSONAL&ADV INJURY $ 1,000,000 GENERAL A GGREGATE $ 2,000,000 GEWL AGGREGATE LIMIT APPLIES PER: PRODUCT -COMPIOP AGG S 2,000,000 X POLICY� PRO- LOC ti AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT a acaden ANY AUTO BODILY INJ JRY(Per persm) $ ALL OWNED SCHEDULED BODILY INJ JRY(Per aoddent) S AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE s AUTOS (Per accident) s UMBRELLA LIAR OCCUR EACH OCCURRENCE EXCESS LIAR CLAIMS-MADE AGGREGATE $ DEO RETENTi0N$ $ WORKERS COMPENSATION WC S ATU- OTH- AND EMPLOYERS'LIABILITY Y I N I ER ANY PROPRIETOR/PARTNERIEXECUTIVE ❑ NIA E.L.EACH CCIDENT $ OFFICFRIMEMBER EXCLUOED7 (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ K yes,describe under DESCRIPTION OF OPERATIONS below E.L.DIS E•POLICY LIMIT S DESCRIPTION OF nPFRATIONS I LOCATfONS I VEHICLE$ (Attach ACORr)101,Additional Remarks Schedule;if more space Is requlnedl CERTIFICATE HOLDER LISTED AS AN 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 938 KING STREET ACCORDANCE WITH THE POLICY PROVISIONS, RYE BROOK,NY 10573 AUTHORIZED REPRESENTATIVE 7 cavuz.a R.tc�dp- ACORD 25(2010105) Q 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NYSIF Now York State Insurance Fund WESTCHESTER ONE,44 SOUTH BROADWAY, 10TH FLOOR,WHITE PLAINS,NY 10601-4411 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE 0 n n n n n n 133452720 S.M.BUILDERS, INCORPORATED T/A WESTCHESTER PLUMBING&HEATING 7 TOWER HILL DRIVE 0� PORT CHESTER NY 10573 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER S.M. BUILDERS, INCORPORATED T/A VILLAGE OF RYE BROOK WESTCHESTER PLUMBING&HEATING 938 KING STREET 7 TOWER HILL DRIVE RYE BROOK NY 10573 PORT CHESTER NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W1316 251-6 489325 03/02/2021 TO 03/02/2022 5/3/2021 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1316 251-6, 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/CERTICERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION, SALVATORE MORLINO-PRESIDENT S M BUILDERS INC ONE PERSON CORP 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: 888652965 U-26.3