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HomeMy WebLinkAboutMP22-081 _<cb4.°..L�1 its C 1,�4 War 40' anniam aW VILLAGE OF RYE BROOK MAYOR 938 King Street, Rve 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 J. Izzo Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE July 25,2022 Salvatore Pelliccia 500 West William Street Rye Brook,New York 10573 Re: 500 West William Street, Rye Brook,New York 10573 Parcel ID#: 141.36-3-7 This document certifies that the work done under Mechanical Permit#22-081 issued on 5/20/2022 for the installation of a new oil fired boiler has been satisfactorily completed. Sincerely, r Michael j. Izzo Building&Fire Inspector /to . ��f3RC�k• l7 c BUILDING DEPARTMENT ❑BUILDING INSPECTOR ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK [I CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAX (914) 939-5801 www ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS: ��W \\1� DATE: PERMIT# ` ISSUED:5 WVSECT: BLOCK: LOT: LOCATION: ���� C� V / 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 ❑ CROSS CONNECTION ❑ FINAL OTHER r w - N \ \ a�i O• � � - _ 00 a PG G1. y n x V 0. ►-� W � neT rn a. � 3d .:: B CA e4 o o M � � � � y y o �_ LZI � � ■ .� � M •� C b a '� � � � r W o c40a L 0 O O .0 o r cs .. -. 4 14 Ixxl �1 r� ro- A r7 . C. co �, w � C-+ Wpo Z �, Uzi E © _ 0-4 Fo 0.0 W ►-� o 7 i-o y� O W. W CA p� Ei o V Q Q (pj ■ Z p W o �q ~~ � " U W °' „ ° I G4 ►-a � r.a GW x � � d .r� -� _ _V BUILD 'G I 'MENT D Q v VIL 1GE OF RYE BROOK 938 KING �T ET RYE BRQp ,NY 10573 MAY 2 0 2022 Ili 066�`` 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#: -/,��D—De/ Approval Date: ermit Fee: S /00—A AKA I Approval Signature: 01W�Other: Disapproved: (fees are non-refundable) **t,��,t,r***:�*:t�****t�***,t*****t*****,�*�***�*,►***********�*t,t**********�**:r*,t*#****,t,t**tr******rr,r*,�***:t**� 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 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, c')c'*** 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: EO 5 1W 1S I16M St. SBL: 141 AL-3-7 Zone:JeQ_F 2. Property Owner: SoIwaiorz, ce-Il;r:t Address: 500 W WtJJ1aM 5r, Phone#: 914-934 - 07-70 Cell#: email: 3. Contractor: R Address: $may C gt j„ICh� Cl Phone#:�I�-Q9 3�0Q Cell#: email: .ricl�(�e'�ne�i�u��7 +1LS�r'IOI1i�.Cpf 4. Applicant: yui�-C I!aS ors 'Fad Address: & N watec St. Gfeerhw1&71 GT Dam Phone#.114-QUA' 1�J0 Cell#: email: 5. Scope of Work:New Installation(-�• Replacement(+I•Removal(-I•Other( ): 6. List Equipment: V54 yi 2XQ SKI Y(W E 61kr W (A& btlfnP[ 7. Location of Equipment: 00: &` 8. Method of Installation/Removal(list all equipment needed to perform job): Ml 545hn 2 I_ l 5 1 8/12/2021 (:cnne'J'CCI- Ita:r�l� STAZOF FORK,COUNTY OF ) as: Ib A cl K l e-M Mn ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of indi dual signing as the applicant) and further states at(s)he i�the legal owner of the property to which this application pertains,or that(s)he is the 9 C V.- r(`- for the legal owner and is duly authorized to make and file this application. (indicate architect, 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 before me this �� Sworn to before me this day of L ,20-D-c-A-- day of a2z--�;' Signature of P opeof Owner Signature tot Applicant Print Na e of Property O r Print Name of plicant 1`lotary.Publi Nota Public J LYTLE SEAM LYTLE. . 14'OTARYPL'BLIC 'i 14rDY,iRYPUBLIG` 'My Commission Expires Aug,31,2025 My Commlaslon Expires Aug,M,202F This app'ication 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. a gn 21202 r 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" _ EK1:212" Installed dimensions with a low profile boiler base* Beckett AFG 8" 9 112 9' _ 24" _ EK2:29z or a standard boiler base.** Carlin EZ-1 9" 9 112 9 1 1 _„A" - Shown without the required Riello 40F5 13" N/A 15" water storage tank 9" At right:Dimensions"A"and"B" _ EK1:41" depending on different burners. EK2:49" EK1:212" - -i 24" - EK2:292 i _"A„ - 30" 7 9" _ 73" t A8" 40 gallon 56" * j Lo-Boy water storage EK1/EK2 Stackable r ff 34" tank installs Installed dimensions 91„ I Swing down door E.pznsion beneath with stackable base. 4 lanh stackable 1 1 boiler. Low profile base 9"* ^B» — — 294 Stackable base t 7 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 heating system stem Up to Domestic to combustibles:4"from the rear cover; Input Gross output BTU/hr AFUE Hot Water' 16"above top cover;4"from flue pipe. - ®� z .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 Gal/Hr. surge protection and junction box,3/4"drain ; 'Domestic hot water rating based on first hour draw with 77°F rise and 40 gallon lank. I Energy convener weight 270 lh%. valve,plate heat exchanger on hot water • 95111111 Emma= models,circulator and door safety switch. Draft regulator not required or recommended Oilheat home heating system Up to Domestic due to advanced combustion chamber. Input Gross output BTU/hr AFUE Hot Water* 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 GI H 190,000 135.5% 336 Gal/Hr. 2112 4 No chimney?No power vent? 1.75 GI H 2O6,000 84.0% 360 Gal/Hr. Water Content gallons gallons NO PROBLEM!Look at Resolute RTI 'Domestic hot water rating based on first hour draw with 77oF rise and 40 gallon lank. Air Inlet Pipe 2" 3" r r Energy Comerter wegnt 350 Ibs. Or scan the Code a �� Boiler Flue Outlet 4" 6" at right to see • • the complete ti' } • Minimum Flexible line of all =rr +1, Chimney Liner Natural Gas and Propane home heating system 5"Dia. 6"Dia. Energy Kinetics ❑� ,.,,,, Input Up to Domestic boilers. BTU/hr Gross output BTU/hr AFUE Hot Water' Hydronic Supply 1" 1'/4" 80,000 70,000 88% 149 Gal/Hr. Hydronic Return 1" 1'/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;►KINETICS 'Domestic hot water rating based on first hour draw with 77oF rise and 40 gallon tank. Beier neaerx.bpger savings Aran the Energy Converter weght 270 lbs. E--f-hinny of pw.ts Lifetime limited • ' s¢ep°°"�+�'• ~ warranty on the Energy Kinetics/System 2000• Digital Energy 51 Molasses Hill Road,Lebanon,NJ 08833 Manager and on Natural Gas and Propane home heating system i.1 t. the residential Input 1800)323.2066 Fax(800)735-2068 LIFETIMEUMITEDWARaANTV ASMEpressure visit www.er*rgykinetics.com Up to Domestic vessels.See the As an ENERGY STAR Partner,Energy Kinetics BTU/hr Gross Output BTU/hr AFUE Hot Water �E IN I actual warranty meets ��L. KINEtiC5 y for derails. has determined that model EKt meets the 175,000 153,000 87% 278 Gal/Hr. j "";?n ?�' ENERGY STAR'aguidelines for energy efficiency 200,000 172.000 87% 308 Gal/Hr. ? r a 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% 365Ga1/Hr. •""�•, � AS � registered trademark of Energy Kinetics. 'Domestic hot water rating based on first hour draw with 770F rise and 40 gallon tank. JJ ME ° @The color yellow for heating boilers is a Energy Converter weigh)350Ibs. LisrEo registered trademark of Energy Kinetics. ,e-zosa FEe 2oz, N ...... ------- 'A g W'N -wev, '111IMMIlln"N"wr i?,`Mt qjj . qll I' TigI'll 11 mopS m, ►J. .........."m, JI I........... lAf m 4n ca N 0 N > o a u 00 tv co cu ANN A&I, a ui 4-j cc m U LIJ 0 W 6. M. Lij r 0 CC) C 10 11A 0 1AP I-S �11 f1c I V; LL) A L) M z LIJ LIJ CP NO M, LU Z) C LL Z (D WC, ;Pr iLLJ (D c z 00 0 UJ 0 (N C u u 0 CtM u iIF OD 6. >1 a. t9 .......... IMF" A 11 a • o v lilt, "h A 6 Au CERTIFICATE OF LIABILITY INSURANCE 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. It 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 Ileu of such endorsements. PRODUCER CONTACT FEDERATED MUTUAL INSURANCE COMPANY NAME: CLIENT CONTACT CENTER HOME OFFICE:P.O.BOX 328 N F (A CNo E.1:888-333-4949 n c No):S07-4464664 OWATONNA,MN 55060 ADonless:CLIENTCONTACTCENTER FEDINS.COM INSURER(S)AFFORDING COVERAGE NAIL# INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 330-130-6 INSURER a: 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 POLICY EFF POLICY EXP LTR IN SR WVD POLICY NUMBER MM1oo1YYYYI (MMIDOly-YY-YI LIMITS PC--E---E MMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,OOD,000 ❑X❑OCCUR DAMAGE TO RENTED $100,000 MED EXP(Any om person) $5,000 A N N 9062815 06/01/2021 06/01/2022 PERSONAL ADV INJURY $1,000,000 OEN'L AOGREOATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY PROJECT ❑• LOC PRODUCTS•COMPIOP A00 S2,000,OOO OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIIAIT X ANY AUTO ..el cn $1,000,000 BODILY INJURY(Per person) A OWNED AUTOS ONLY SCHEDULED AUTOS N N 9062815 06/01/2021 DB/01/2022 BODILY INJURY(P.,x Id.np HIRED At1To5 ONLY NON-OWNED AUTOS ONLY PROPERTY DAMAGE Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $T,000,000 A EXCESS LIAR CLAIMS-MADE N N 9062816 06/01/2021 06/01/2022 AGGREGATE $7,000,000 DED RETENTION WORKERS COMPENSATION X PER STATUTE OTH AND EMPLOYERS'LIABILITY ER ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $S0O,000 A OFFICEFUMEMBER EXCLUDED? NIA N 991756E 06/01/2021 06/01/2022 (Mandatory in NH) E.L DISEASE•EA EMPLOYEE $SQO,DOD II yet,de"iee under DESCRIPTION OF OPERATIONS below EL DISEASE•POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Addldon.I Remarta Smedule,MAY be M,M1d It more fps..i 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 10573-1226 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE G G O 1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Nt'OFE:L?F5' CERTIFICATE OF `sTaTtt ;Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE =- Board la.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 ic.NYS Unemployment Insurance Employer Registration Number of Insured Work Location of Insured(Only required d coverage is specifically limited to td.Federal Employer Identification Number of Insured or Social Security certain locations in New Yoi*State,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 Village Of Rye Brook #35 31b.Policy Number of Entity Listed in Box'1a' 938 King St Rye Brook,NY 10573-1226 9917566 3c.Policy effective period 06/01/2021 to 06i01/2022 3d.The Proprietor,Partners ry Executive Officers are InCluded.(Only rhe(A box if all partnerslnfflcers included) ® all excluded or certain partners/officers excluded. This certifies that the Insurance carrier indicated above in box`3"Insures the business referenced above in box"I a"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 after 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 certifleate 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 (Plug nsrro ur authorized repiesemalive of iicerudd agent of insurance caniur) Approved by: Rlpu�///Gc/?iL >I Sgnature) (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