HomeMy WebLinkAboutMP22-064 yE DR
Q (�44 wZs
40* anniUewaW
VILLAGE OF RYE BROOK
MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR
Jason A. Klein (914) 939-0668 Christopher J.Bradbury
www.ryebrook.org
TRUSTEES BUILDING & FIRE INSPECTOR
Susan R. Epstein Michael J. Izzo
Stephanie J. Fischer
David M. Heiser
Salvatore W.Morlino
CLARIFICATION OF RECORD
September 21,2022
Vinpin Thomas Kovoor&Merin Thomas Kovoor
32 Valley Terrace
Rye Brook,New York 10573
Re: 32 Valley Terrace, Rye Brook,New York 10573
Parcel ID#: 135.59-1-65
Mechanical Permit#22-064 issued 4/21/2022 to Install New Oil Fired Boiler
An inspection of the of the above referenced property on September 16,2022,reveals that although
Mechanical Permit#22-064 dated 4/21/2022 was issued, the oil fired boiler was never done and this permit
is rendered null and void.
Sincerely,
i
Michael J. Izzo
Building&Fire Inspector
/to
■
V � y ■
a � N
'd r
R «3 0 �
_ a + V1 ■
v _
bo
0 072
O'l __rL4 C)
124
o m 14
O z
00
O r 5► � O� V�jI � z 0 � a V `° v � � `' M..I a
v V
R � � � o
� � w
H � d Ei O � wA � � � � a � ■
Ovi0-4
V w vo be E�
� U
Oooa � � W i o N a v
~ OC w O .v
z O po o v
►� > t w �
a
:
BUILC-:�- 4
P ' MENT
VILRY OOK E C E � V E
938 KINGF BRo; ,NY 10573DD
9-0669aPR 2 Q ?Q22
ra
VILLAGE OF RYE BROOK
APPLICATION FOR PERMIT TO INSTALL AND/ B LARTMENT
HEATING, VENTILATION AND/OR AIR CONDITIONING EQUIPMENT
FOR OFFICE USE ONLY: PERMIT#:
APR 222022 1
Approval Date: Permit Fee: $
Approval Signature: Other:
Disapproved:
(fees are non-refundable)
REQUIREMENTS FOR RELEASE OF PERMIT&CERTIFICATE OF COMPLIANCE:
l. 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=$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, H 15-Z2- 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: 32 V a1le,f 12f`d(t, C�Ur -&:NJ 1Q�73 SBL: zone:
2. Property Owner: ` KOVOOr Address: 32 Vall&.v urnte.
Phone#: 9W-420 -3641 Cell#: 114-4zo-3(00 email: VrPtn.U\100(
3. Contractor: WeAmm(& ,f 1W Co. Address: 86 N Waimac 3t-Gc Ith. CT pwo
Phone#: 4_ -3 Cell#: email: er41 prtreAt Q tnlCS� C9m
4. Applicant: &n��l� -WeA t iw, -TJ Address: & J�J �,�et'St Aretr);&l G~( O68'3,
Phone#: iH793q moo Cell#: email: !Sm�� (orq
5. Scope of Work:New Installation(4-Replacement( - Removal(X-Other( ):
6. List Equipment: T)�J*.M zu)o F.L-1 7-(& Wr bo*Aer 611 C'n� n borm jQQ h-4 tdrAt ! ' ^ toAK.
7. Location of Equipment: Oftme-A
8. Method of Installation/Removal(list all equipment needed to perform job): &J%d& e,Xt5''4% bol6r -fFcw b0.XMP1ft i miakl
moo 'RK-I )0Jr&f`1n "1* 5an,r �afo�iQp
t
X,,12f2021
STATE OF Di 6't COUNTY OF ) as:
I C rn M ,being duly sworn,deposes and states that he/she is the applicant above named,
(print name of indivi ual signing as the applicant)
and further states t(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,c ntractor,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 be ore me this ( � Sworn to before me this
20 f �-- day of �,20 c3-)
Signavhre of Property Owner Signatureldf Applicant
it k . ;n K oyou r k)ep�P4ma e VJ&l
Print a roperty Own Print Nam f A plicant
Notary Publi Notary Public
�EAN LYTLE SEAOV LYTLE
NOTARY p UBZIC NOTARYPUBLI�
My C-0MMI8tinn Exp[res Aug,31,2025 �tp Gorllnlseion Explres Aug,31,2025
This app!lcaticyn must be properly completed in its entirety and must include the notarized signatwe(s) of
the legal owners"of the subject property, and the applicant of record in the space~provided.Any
application not properly completed in its entirety and/or not properly signed shall be deenned null and void
and will be returned to the applicant.
2
8/12/2021
EK11 and EK2 System 2000 Frontier and Stackable Installation Dimensions
- EK1:41" -
EK1/EK2 Frontier Dim"A" W/O box With box "B" EK2:49" _ EK1:21i"
a lowlled p profile bo Iler baseh - 24" - EK2:29}"* Beckett AFG 8 9 1/2 9'
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" 4r,
At right:Dimensions'A"and'B" _ EK1:41" —
11
depending on different burners. EK2:49"
EK1:21 z" -'
24" - EK2:291"
"A" _ 30++
i
i
_ 1_ 73" 1 S—g d—,door
1
1
30"
7 -
48"
40 galion
56"** Lo-Boy
water storage EK1/EK2Stackable
1 r 34" tank installs Installed dimensions
91+, I swing down door E.pars o„ beneath with stackable base.
4 la„k stackable
I I boiler.
I 1
I-ow profile base 9'
1 k� nBf1 — — 294 Stackable
*� base
1 117 L 1 1
2"If 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
Oilheat home heatin s stem to combustibles:4"from the rear cover;
9 Y 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% 169 Gal/Hr. Included (factory piped and assembled):
.74 GPH 90,000 87.7% 180 Gal/Hr. Boiler base,blocked vent switch,dynamic
.85 GPH 104,000 87.5% 202 Gal/Hr. air elimination manifold,ON/OFF Switch,
1.00 GPH 121,000 86.2% 228 Gavlir. surge protection and junction box,3/4"drain
'Domestic hot water rating based on first hour draw with 7rF rise and 40 gallon tank. valve,plate heat exchanger on hot water
Energy Converter weight 270 lbs.
_ models,circulator and door safety switch.
• a 3133MM Draft regulator not required or recommended ;-
Oilheat home heatingsystem Domestic
due to advanced combustion chamber.
Y Up to
Input Gross output BTU/hr AFUE Hot Water',„
1.20 GPH 147. Weight 270 lbs 350 lbs 000 87.6% 269 Gal/Hr. Wei
1.40 GPH 175:000 87.0% 313 Gal/Hr. ReSOIUtd'RT
1.60 GPH 190,000 05.5% 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.I
•Dtxnestic hot water rating based on first hour draw with 7rF rise and 40 gallon tank. Air I n let Pipe 2" 3"
Energy Convener weight 350 lbs. Or scan the code
Boiler Flue Outlet 4" 6" at right to see tiI•W.- ,
•• • the complete,!" }
Minimum Flexible line of all Lail +tic
Natural Gas and Propane home heating system 5"Dia. 6"Dia. Energy Kinetics �-P4
Chimney Liner boilers.
Input Up to Domestic
BTU/hr Gross output BTU/hr AFUE Hot Water' Hydronic Supply 1" 11/4"
80,000 70,000 88% 149 Gal/Hr. Hydronic Return 1" 11/4"
100,000 88,000 88% 177 Gal/Hr.
120,000 105.000 87% 203 Gal/Hr. Hydronic Circulator Taco 007e Taco 0010 ENERGY
150,000 129,000 86% 241 Gal/Hr. 6;;rKINETICS*
'Domestic hot water rating based on first hour draw with 77eF rise and 40 gallon tank. . eenmroatrg.bgger—ngs aom me
Energy Convener weigh 270 lbs.
E-W Kml s tamly otprodcs
>. Lifetime limited •
•• • 6¢ so1.m warranty on the Energy Kinetics/System 2000
+ 0 1 Digital Energy 51 Molasses Hill Road,Lebanon,NJ 08833
Natural Gas and Propane home heating system Manager and on (800)323.2066 Fax(800)735.2068
RANTY the residential
on
ASMEp—ure visit www.energykinetics.com
vessels.See the
Input Up to Domestic ERGy actual warrany As an ENERGY STAR*Partner,Energy Kinetics
B7U/fir Gross output BTU/hr AFUE Hot Water ��EN for derails. has determined that model EK1 meets the
KiNETiCS�
175,000 153,000 87% 278 Gal/Hr. ENERGY STAR°guidelines for energy efficiency
200,000 172,000 87% 308 Gal/Hr. ?s w for oil heat input from 0.68 to 0.85 gph.
225,000 192,000 85% 339 Gal/Hr. ®The color yellow for heating broilers is a
250,000 209,000 84% 365 Gal/Hr. Y. q UO registered trademark of Energy Kinetics.
*Domestic hot water rating based on first hour draw with 77eF rise and 40 gallon tank. SME ®The color yellow for heating boilers is a
Energy Convener weigh)350 lbs. LISTED
registered trademark of Energy Kinetics.
10-20M FEB 2021 N
N Eq
�. N '+s •• ' '� •.• �r c. )•• ' tit ' 1♦ tit
E NMI, ''e:-;`,411�,11{I:•`! s'bs`:'11f+1�111hr, k,sY'illl�l,'111�1.�+' .P -'I�Illl,/llllj av ,Ij/l;�lll'1. 5.91�/�1�Ile LI��11111{I.. '.
ch
? N>
CO
Eca � O co
Oco
1 /
• E c ~•••
u U
0 �
'<[ >j/fib •may W O
\, rn
LLI
ection
w Q U y -0
(ts» > _
• cam, l j w �Ga CWQ
00
o ;
LLI
R") cc
q U
E L v
O
F
aav`yl�_. F°-�N�/ a.�= 1p 4�1{I�1/1'• _ tt1{I�HI il+.•. fit 11 111 Y.{ 7.111�11�:.i= ;�111� Il si.. . . .Rs.:''1{I,111-:+'+= `\
� -gq 1{I/11�j1 1/{I/lll` 11111111 Iljllllll �INNII 1111j11 111/1111 \
•1/1• �A /•/•• ! /•1•( li. il•/ A ( •1/•• A ••�• ,. .4 1�•/ A %
t a&rKl t o x zr 5 &t k'i'e
y ^L •� ,.nI, .... _.,,•„�1. �.. ti.J�� ,��` q ' �. ,:Tirtyb"� �v``.. „`-
A� CERTIFICATE OF LIABILITY INSURANCE DATE
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 HOT 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 teens 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 Ileu of such endorsements.
PRODUCER CONTACT
FEDERATED MUTUAL INSURANCE COMPANY NAMECLIENT CONTACT CENTER
HOME OFFICE:P.O.BOX 328 PHONE
Eat):888-333-4949 FAX No)!507-446-4664
OWATONNA,MN 55060 nooaess:CLIENTCONTACTCENTER FEDINS,COM
INSURER(S)AFFORDING COVERAGE NAIC 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.
ILT TYPE OF INSURANCE DL SUBR POLICY EFF POLICY EXP
LT INS!! WVD POLICY NUMBER MMIDDIYYYY MMIDOIYYYY LIMITS
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S1,000,OOO
CLAIM6.MADE ❑X OCCUR DAMPREMAGE To RENTED 5 E100 QDD
MED EXP[Any one person) $5,000
A N N 9062815 06/01/2021 06/01/2022 PERSONAL&ADV INJURY S1,000,000
OEN'L AOORE(Oq TE LIMIT APPUES PER; GENERAL AGGREGATE $2,000,000
J
�POLICY I I ECTRO- F LOC
u ECT PRODUCTS•COMPIOP AGO $2,000,000
OTHER:
AUTOMOBILE LIABILITY
COMBINEDfC, I SINGLE LIMIT $1,000,000
X ANY AUTO
BODILY INJURY(Per person)
A OWNED AUTOS ONLY &CHEOULFD
AUTos N N 9062815 06/01/2021 06/01/2022 BODILY INJURY(Par attldanU
MIRED AUTOS DNLV NON•OWNED PROPERTY DAMAGE
AUTOS ONLY Per accldenl
X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $7,000,000
A EXCESS LIAB cLAIMs.MADE N N 9062816 06/01/2021 06/01/2022 AGGREGATE $7,000,000
DEO I I RETENTION
WORKERS COMPENSATION X PER STATUTE OTN•
AND EMPLOYERS'LIABILITY ! ER
ANY PROPRIETORIPARTNERIEXECUTIVE E.L EACH ACCIDENT $500,000
A OFFICER/MEMBER EXCWDED7 NIA N 9917566 06/01/2021 06/01/2022
(Mandatory in NH E.L.DISEASE•EA EMPLOYEE $500,000
II yea,describe under
DESCRIPTION OF OPERATIONS below E.L DISEASE•POLICY OMIT $500000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ADDING 1GI.Aadldonll Remaeta Sd dule,may M slowed it more space Is required)
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 10573-1225 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
V 4,
O 1988-2015 ACORD CORPORATION.All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
rufwt 'Workers'
`STATE ;Compensation CERTIFICATE OF
Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE
1a.Legk> Name 8 Address of Insured(use street addiess only) U.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 requ/red it coverage is specifically limited to .Federal Identlflcation Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-Up PoticyJ td Fdl El y
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
Village Of Rye Brook #35 3b.Policy Number of Entity Listed in Box^1 a^
938 King St
Rye Brook,NY 10573-1226 9917566
3c.Policy effective perlod
06/01/2021 to 0&01/2022
3d.The Proprietor,Partners rx Executive Officers are
indUded.(Only cht1f;r box it all partnerSlofMars included)
® all excluded or certain partnerstofficers 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 effec.
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,1 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
(Print name of authanwd representative or licerued agent of Insuiance center)
Approved by: rQyO. 2ff:�+I?2 ctiFlb,
�Slgnature) �7 (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) www.wcb.ny.gov