HomeMy WebLinkAboutMP22-041 DR
L.�vLi s�
VILLAGE OF RYE BROOD
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
March 30,2022
Giovanni Del Peschio&Delfina Del Peschio
20 Woodland Avenue
Rye Brook,New York 10573
Re: 20 Woodland Avenue, Rye Brook,New York 10573
Parcel ID#. 135.84-1-23
This document certifies that the work done under Mechanical Permit #22-041 issued on 3/25/2022 for the
installation of a new oil fired boiler has been satisfactorily completed.
Sincerely,
�I
Michael J. Izzo
Building&Fire Inspector
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1982 BUILDING DEPARTMENT
UILDING 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.ore
- - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - -
ADDRESS:- �Z � � / I� v�- DATE: - z�
PERMIT# ISSUED:] 7 2 2SECT: BLOCK: t LOT: 2
LOCATION' OCCUPANCY:
❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/REINSPECTION
❑ SITE INSPECTION REQUIRED
❑ FOOTING
❑ FOOTING DRAINAGE
❑ FOUNDATION
❑ UNDERGROUND PLUMBING NOTES ON INSPECTION:
❑ ROUGH PLUMBING
❑ ROUGH FRAMING
❑ INSULATION _
❑ NATURAL GAS /`T -L OVA �= �-�" D t L-
❑ L.P. GAS —jp tom- t N - AS F�-j k
❑ FUEL TANK
❑ FIRE SPRINKLER
❑ FINAL PLUMBING
❑ CROSS CONNECTION
❑ FINAL
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BUILD MENT D
VIL OF RY OOK MAR Z 4 2022
938 KING ET RYE BR ,NY 10573
4 VILLAGE OF RYE BROOK
BUILDING DEPARTMENT
APPLICATION FOR PERMIT TO INSTALL AND/OR REMOVE
HEATING, VENTILATION AND/OR AIR CONDITIONING EQUIPMENT
FOR OFFICE USE ONLY: PERMIT#:
Approval Date: MAR 2 5 Z02Z, Permit Fee: $ l.J�
Approval Signature: Other:
Disapproved:
(fees are non-refundable)
RE UIREMENTS 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 of Fees/Unit: RESIDENTIAL= $I00.00/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, 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. 11 n
1. Address: 4� \l A� sBL: �`��j. — "�3 Zone:
2. Property Owner: 0u""Ni"t Address:2_Q)XX1C(:A\1arAr If�
Phone#:q y - '"I J"t n—l� Cell#: email:Q6 e ApPS_�Ld.A ,Y e
3. Contractor:l S' C��U,p � � ra Address: e C
Phone#: x\ k .92R•?�-ICAO Cell# email:zCr,(,c eta e.�`�urzl v 4A
l
4. Applicant:l tq L V :((D_ ire ,dle,l( G d ess:
Phone#:o1% {00 Cell#: T email'RKr,Pr;,,y��►�S�lhrna- ��fP�.0
5. Scope of Work:New Installation( )•Replacement VK•Removal( )•Other( ): J
6. List Equipment: 1
S
7. Location of Equipment: C N-
8. Method of Installation/Removal(list all equipment needed to perform job):
t
R/12/2021
JATE OF N� �C?OUNTT�YOF ) as:
being duly sworn,deposes and states that he/she is the applicant above named,
(print name of individual signinp
apd furth r states tl at{s)he i Plic legal owner of the property to which this application pertains, or that(s)hc is the
`- -lY ce, for the legal owner and is duly authorized to make and file this application.
(indicate architect,contractor,agent;,attorncy,etc.)
That all statements contained herein are true to the best of his/her knowledge and belief,and that any work perrormcd,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 Statc 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 _
day of [ln O'` ,20 ,r} day of ,20
Si nature of Property Owner Signature of App icant
Print Nam f Property O Print N �e of Applicau
otair� ublic Notary Public
✓�- SEAO•] LYTI_E: �•'' SE�IN LYTLE - -
NOTARYMKIC
MY'r nmissloP Ecp)res Aug,61,2025 NOJ-'QkFUBLIC
W commisaon Spires Aug.
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
M/12/202 I
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There are models
and sizes available for every
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orem informationIII •
EM
System 2000 is an integrated system - •
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300'net stack temperature Up to87.9%efficiency
POWER VENTING Homeowners who
Water content.EK t,2%gal.,EK2.4 gal. Rapid heat up,cool down
plan to save money by converting from Wet base design Minimizes heat losses
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Bioheat compatible Works with renewable fuel standard
find themselves Up against a brick Wall: Jacket/insulation:EK1=901bs.,EK2-110lbs. Minimizes heat losses
the high cost of chimney construction. Buried combustion Quiet operation
But with System 2000's unique combustion 3116•pressure vessel steel throughout 50%thicker than boiler tubes
No chimney ASME code construction and Carefully inspected,pressure tested,
is needed! chamber, combined with a 10 foot long flue Nat'l Board of Pressure Vessels registered and certified
Ground level e leave System 2000 clean,
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stays relatively and relatively cool. So they can be vented Built-In dynamic air elimination Eliminates air from system,no"gurgles"
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needed!An excellent benefit for home- Standard burner and accessories Serviceable with normal stock parts
owners converting from electric heat, Small size Compact and stackable installations
heat pumps or for new home construction, chimney venting Ideal for retrofit installations
Power venting is the safest method of side Power vent chimneyless option available Save thousands on chimney construction
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to chimney construction. EKI FRONTIERSPECIFICATIONS
Oilheat home heating system Domestic
Input Gross output AFUE Hot Water'
.68 GPH 83,000 BTU/HR 87.9% 170 Gal/Hr.
.74 GPH 90,000 BTU/HR 87.7% 180 Gal/Hr.
.85 GPH 104,000 BTU/HR 87.5% 202 Gal/Hr.
1.00 GPH 121,000 BTU/HR 86.2% 228 Gal/Hr.
Domestic hot water rating based on first hour draw with 77°F rise and 40 gallon tank.
Energy Converter Weight 270 lbs.
FRONTIER SPECIFICATIONS
Oilheat home heating system Domestic
Input Gross output AFUE Hot Water'
1.20 GPH 147,000 BTU/HR 87.6% 293 Gal/Hr.
"` 1.40 GPH 175,500 BTU/HR 87.0% 334 Gal/Hr.
1.60 GPH 190,500 BTU/HR 85.5% 368 Gal/Hr.
1.75 GPH 2O6,000 BTU/HR 84.0% 395 Gal/Hr.
'Domestic hot water rating based on first hour draw with 77°F rise and 40 gallon tank.
Energy Converter Weight 350 lbs.
i, "o a o Lifetime limited A
warranty on C Ds S
IJFETIME LIMITED WARRANTY Digital Energy M
Manager and E
,,,-Ri ENERGY ASME pressure
_'TK/NET1C5 vessels LISTED
H
"^ . As an ENERGY STAR"Partner,Energy Kinetics has
determined that model EK7 meets the ENERGY STARS Q S r
guidelines for energy efficiency for oil heat input from 0.68 ti
to 0.85 gph.®The color yellow for heating boilers 'r
is a registered trademark of Energy Kinetics. 1rr
Accepted For Use City of New York ❑
! Department of Buildings MEA 140.03•E web site
ENERGY
Easy service compact oilheat EK1 Frontier,
with 40 gallon low boy tank and stand 51 Molasses Hill Road, Lebanon, New Jersey 08833
T: 800 323 2066 • F: 800 735 2068
visit: www.energykinetics.com
EK1 and EK2 System 2000 Frontier and Stackable Installation Dimensions
EK1:41"
EK1/EK2 Frontier Dim"A" W/O box With box "B" EK2:49" _ EK1:2112"
Installed dimensions with n
a low profile boiler base* Beckett AFG 8 9 1/2 9' _ 24„ — EK2:291
or a standard boiler base.** Carlin EZ-1 9" 9 1/2" 9' 1 1 _"A" —
Shown without the required Riello 40F5 13" N/A 15' „
water storage tank. 9 r 0
At right:Dimensions"A"and"B" _ EK1:41" — - —
depending on different burners. EK2:49" _
EK1:211"
24" - EK2:291"
_'A" . 30 rr
73
Ll
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30"
48"'� ' E 40 gallon
56" Lo Boy
water storage EK1/EK2 Stackable
1 J/ 34" tank installs Installed dimensions
91" 1 Swing down door Expansion beneath with stackable base.
4 tank stackable
1 , boiler.
� 1
Low profile base 9"" �B r+ 291 Stack
able
"** base
1 �17 �__ •• I 1
12"it installed with a low profile
base and a Beckett AFG burner.
� Service clearances:20"from front door
• • • face,0"left side and right side.Clearance
011heat home heatings to combustibles:4"from the rear cover; ,
system Up to Domestic
Input Gross output BTU/hr AFUE Hot Water* 16"above top cover;4"from flue pipe.
.68 GPH 83,000 87.9 i° 169 Gal/Hr. Included(factory piped and assembled): 1
.74 GPH 90,Do0 87.7% 180 Gal/Hr. Boiler base,blocked vent switch,dynamic ------
.85 GPH 104,000 87.5% 202 Gal/Hr.1.00 GPH 121,000 86.2% 228 Gal/Hr. air elimination manifold,ON/OFF switch, I fP•
surge protection and junction box,3/4"drain
'Domestic twl water rating based on first how drew with 77•F rise and ao ga•on tank. valve,plate heat exchanger on hot water
Energy Converter weight 270[bit. ... .
_ models,circulator and door safety switch. _
• • • Draft regulator not required or recommended
due to advanced combustion chamber. J
Oilheat home heating system Up to Domestic ���
Input Gross output BTU/hr AFUE Hot Water* M-1171., _
1.20 GPH 147,000 87.6% 269 Gal/Hr.
1.40 GPH 175,000 87.0% 313 Gal/Hr. Weight 270 Ibs 350 Ibs Resolute°RT
1.60 GPH 190,000 185.5% 336 Gal/Hr. Water Content 21/2 4 No chimney?No power vent?
1.75 GPH 2O6,000 84.0% 360 Gal/Hr. gallons gallons NO PROBLEM!Look at Resolute RT!
'Domestic hot water rating based on first hour draw with 77•F rise and 40 gallon tank. Air Inlet Pipe 2" 3" r
Energy Converter wegt i 350lbs Or scan the code
Boiler Flue Outlet 4" 6" at right to see F ,
• : • the complete r 'r,: } •
Minimum Flexible line of all V +1,
Natural Gas and Propane home heating system 5"Dia. 6"Dia. Energy Kinetics •
Chimney Liner boilers. �l
Input Up to Domestic
BTU/hr Gross output STWhr AFUE Hot Water' Hydronic Supply 1" 1/:
80,000 70,000 88% 149 Gal/Hr. Hydronic Return 1" 1'/4"
10,000 88,000 8 % Gal/Hr. ENERGY
120,000 105,000 877 203% 203 Gal/Hr. Hydronic Circulator Taco 007e Taco 0010 6;i
150,000 129,000 86% 241 Gal/Hr. KINETICS•e'Domestic hot water rating based on first hour draw with 77'F rise and 40 gallon tank. amethaim,bwer sn9$ftmim
Energy Converter weight 270 lbs. EmWKvW=1WwyolprodLxft
Lifetime limited •
• • E¢*eUs"VIM � warranty on the Energy Kinetics/System 2000
• lr y�L�� Digital Energy 51 Molasses Hill Road,Lebanon,NJ D8833
Manager and on
1 (600)323.2066 Fax(800)735.2068
Natural Gas and Propane home heating system the residential
u ETIME LIMITED WARRAY ASME pressure visit www.energykinetics.com
In U to Domestic vessels.See the
p RGY . actual wananr As an ENERGY STAR°Partner,Energy Kinetics
BTURtr Gross output BTU/hr AFUE Hot Water ♦�E K NETICS for details. y has determined that model EK1 meets the
175,000 153,000 87% 278 Gal/Hr,
ENERGY STAR•guidelines for energy efficiency
200,000 172,000 87% 308 Gal/H r. for oil heat input from 0.68 to 0.85 gph.
225,000 192,000 85/° 339 Gal/Hr. ®The color yellow for heating boilers is a
250,000 209,000 84% 365 Gal/Hr. q U registered trademark of Energy Kinetics.
'Domestic hot water rating based on first hour draw with 77*F rise and 40 gallon tank. L � SME ®The color yellow for heating boilers is a
Energy Converter weight 350lbs. - LISTED registered trademark of Energy Kinetics.
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A� CERTIFICATE OF LIABILITY INSURANCE �TEIMMIDD 0151062021
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, slJbject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this
certificate does not confer rl hts to the certificate holder In lieu of such endorsements.
PRODUCER CONTACT
FEDERATED MUTUAL INSURANCE COMPANY NAM : CLIENT ONTACT CENTER
HOME OFFICE:P.O.BOX 328 IA CNNo Ertl:888-333-4949 Fn c me):507-JAS-4664
OWATONNA,MN 55060 nooiiess: IENTCONTACTCENTER FEDINS.COM
INSURERISI AFFORDING COVERAGE HAH:R
INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935
INSURED 330-130-6 INSURER B:
WESTMORE FUEL COMPANY INCORPORATED INSURER C:
86 N WATER ST
GREENWICH,CT 06830-5886 INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:35 REVISION NUMBER:0
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 DL SUBR POUCY NUMBER POLICY EFF POLICY EXP LIMITS
LTR I SR WVD MMI I YYV MMI YY
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S1,000,000
CLAIMS-MADE OX OCCUR DAMAGE To
ERENTED $100,000
MED EXP(Any one person) $5,000
A N N 9062815 06/01/2021 06/01/2022 PERSONAL S ADV INJURY $1,0D0,000
FX 'L AGGR¢T—GATTE LIMIT APPUES PER: GENERAL AGGREGATE $2,000.000
POLICY I�JJECT PRO �LOC PRODUCTS-COMPIOPAGO $2,ODO,000
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000
X ANY AUTO 1
BODILY INJURY leer Person)
A OWNED AUTOS ONLY AUTOSULED N N 9062815 06/01/2021 06/01/2022 BODILY INJURY IPar a.cidimQ
NON-OWNED
AUTOS ONLY PROPERTY DAMAGE
HIRED AUTOS ONLY
P r I
X UMBRELLA LIAB j X OCCUR EACH OCCURRENCE $7,000,000
A iEXCESS LIAB CLAIMs-MADE N N 9D62816 06/01/2021 06/01/2022 AGGREGATE ET,000,000
DED I RETENTION
WORKERS COMPENSATION X PER STATUTE GTM•
AND EMPLOYERS'LIABILITY ER
ANY PROPRIETORIPARTNERIEXECUTIVE E.L EACH ACCIDENT
A OFFICERIMEMBER EXCLUDED' NIA N 9917566 06/01/2021 D6/01/2022
(Mandatory in NH) E.L DISEASE-EA EMPLOYEE $5 0000
II yas,describe under
DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $500 01
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Addibonal Remarks Schedule,may be al adned it more st see is re)Ililed)
CERTIFICATE HOLDER CANCELLATION
330-130-6 35 0
VILLAGE OF RYE BROOK SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
938 KING ST THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
RYE BROOK,NY 10573-1226 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
4�
O 1988.2015 ACORD CORPORATION.All rights reserved.
ACORD 25(2018/03) The ACORD name and logo are registered marks of ACORD
5.. f NEftW{ Workers' CERTIFICATE OF
§yt i Compensation
Boarel NYS WORKERS' COMPENSATION INSURANCE COVERAGE
1a.Legal Name 8 Address of Insured(use street address only) 1 b Business Telephone Number of Insured
WESTMORE FUEL COMPANY INCORPORATED 203-531-5656
86 N WATER ST
GREENWICH.CT 06830-5886 1c.NYS Unemployment Insurance Employer Registration Number of
Insured
Work Location of Insured(Only required it coverage is specifically limited to 1d.Federal Employer Identification Number of Insured or Social Security
certain incations in New York Stata,i.e,a Wrap-Up Policy) Number
06-0739367
2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier
(Entity Being Listed as the Certificate Holder) Federated Mutual Insurance Company Ln
Village Of Rye Brook #35 3b.Policy Number of Entity Listed in Box-1a*
938 King St
Rye Brook,NY 10573-1226 9917566
3c.Policy effective period
06101/2021 to 06i0112022
3d.The Proprietor,Partners or Executive Officers are
included.(Only rbeck bnx it all partnersinttirws incWded)
® 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"1a"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: April Myer
(Pnnt name of authorized cepresenlative or ficerued agent of insurance carrier)
Approved by: 49!L4!-L/
gnature) (Date)
Title: Authorized Representative
Telephone Number of authorized representative or licensed agent of insurance carrier. 888-333-4949
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) wxvv.wcb.ny.gov